Pheo-type: A diagnostic gene-expression assay for the classification of pheochromocytoma and paraganglioma

Context: Pheochromocytomas and paragangliomas (PPGLs) are heritable neoplasms that can be classified into gene-expression subtypes corresponding to their underlying specific genetic drivers. Objective: This study aimed to develop a diagnostic and research tool (Pheo-type) capable of classifying PPGL tumors into gene-expression subtypes that could be used to guide and interpret genetic testing, determine surveillance programs, and aid in elucidation of PPGL biology. Design: A compendium of published microarray data representing 205 PPGL tumors was used for the selection of subtype-specific genes that were then translated to the Nanostring gene-expression platform. A support vector machine was trained on the microarray dataset and then tested on an independent Nanostring dataset representing 38 familial and sporadic cases of PPGL of known genotype (RET, NF1, TMEM127, MAX, HRAS, VHL, and SDHx). Different classifier models involving between three and six subtypes were compared for their discrimination potential. Results: A gene set of 46 genes and six endogenous controls was selected representing six known PPGL subtypes; RTK1–3 (RET, NF1, TMEM127, and HRAS), MAX-like, VHL, and SDHx. Of 38 test cases, 34 (90%) were correctly predicted to six subtypes based on the known genotype to gene-expression subtype association. Removal of the RTK2 subtype from training, characterized by an admixture of tumor and normal adrenal cortex, improved the classification accuracy (35/38). Consolidation of RTK and pseudohypoxic PPGL subtypes to four- and then three-class architectures improved the classification accuracy for clinical application. Conclusions: The Pheo-type gene-expression assay is a reliable method for predicting PPGL genotype using routine diagnostic tumor samples.

Corporate accountability in relation to human rights: Have RIOs done enough?

This chapter focuses on the development of corporate human rights standards since the United Nations Conference on Environment and Development, better known as the Earth Summit was held in Rio de Janeiro in 1992. One of the important agendas for this Summit was human rights (apart from the climate change issue). This chapter provides a critical evaluation of institutional change in human rights guidelines and associated corporate (non) accountability in relation to human rights in line with the RIO summit. Based on a review of the media reports, archival documents and a case study, we argue that while there are a number of international organisations working towards the creation of corporate accountability in relation to human rights, there is limited real change in corporate action when faced with no government regulation. A radical (reform-based) approach, such as mandatory monitoring (compliance audit) and disclosure requirements is necessary to ensure corporate accountability in relation to human rights.

Learning to write: Analysing writing samples as part of considering how children become writers

This chapter draws on a large data set of children's work samples collected as part of a five-year school reform project in a community of high poverty. One component of the data set from this project is a corpus of more than 2000 writing samples collected from students across eight grade levels (Prep to year 7) annually, across four years of the project (2009-2013). This paper utilises a selection of these texts to consider insights available to teachers and schools through a simple process of collecting and assessing writing samples produced by children over time. The focus is on what samples of writing might enable us to know and understand about learning and teaching this important dimension of literacy in current classrooms.

Asia literate schooling in the Asian century [Book review]

In her introduction to this edited collection, Christine Halse lays out the purpose of the book as being about addressing three questions for education in contemporary times: What does Asia literacy mean?; Why is it important?; and How might or ought schools do Asia literacy? As a literacy educator it was these three questions that led to my interest in first reading and then reviewing the book. On numerous occasions I’ve felt the expectation that an expertise in Asia literacy should be a part of my toolbox. And yet I’ve always considered Asia literacy to be the responsibility of those who profess to know about – or have some expertise in – history, politics, or studies of society. But here was an edited collection with chapters from a variety of scholars who have informed my work over many years, framing schooling as a noun that could be described qualitatively as more or less Asia literate. As such, I took on the challenge to open up to these ideas and to the opportunity to think again about literacy and the use of this term in pairings such as Asia literacy. I had my own question to add to those of the editor. Can, or even should, literacy be used to describe the skills, capacities and understandings required for citizens to “reflect and explore cultural differences in the Asian region” (Asia Literacy Teachers’ Association of Australia, n.d.) in ways that support engagement within and with Asian peoples and their cultures?

The accounting and accountability practices of Fairtrade International (FLO)

This study examines the accounting and accountability practices of Fairtrade International (FLO), one of the largest Fair Trade umbrella organizations. Our aim is to explore whether new forms of accounting and related disclosures emerge in the reporting practices of FLO and how these reflect their self-declared social mission towards the emancipation and sustainability of producers. Using thematic analysis and reflecting on Bourdieu’s theory of symbolic power, we analyse FLO’s reporting practices from 2006 to 2013. Our findings reveal that FLO mobilises the taken-for-granted images and symbols of ’fairness’ in the Fair Trade system by using descriptive statistics of Fair Trade premium distributions and pictures of producers but keeps silent to current concerns surrounding the limitations of Fair Trade. Such findings extend important insights into how new forms of accounting and related disclosure are used to legitimise the practice of Fair Trade.

General Practitioner Antimicrobial Stewardship Programme Study (GAPS): protocol for a cluster randomised controlled trial

Background There is a strong link between antibiotic consumption and the rate of antibiotic resistance. In Australia, the vast majority of antibiotics are prescribed by general practitioners, and the most common indication is for acute respiratory infections. The aim of this study is to assess if implementing a package of integrated, multifaceted interventions reduces antibiotic prescribing for acute respiratory infections in general practice. Methods/design This is a cluster randomised trial comparing two parallel groups of general practitioners in 28 urban general practices in Queensland, Australia: 14 intervention and 14 control practices. The protocol was peer-reviewed by content experts who were nominated by the funding organization. This study evaluates an integrated, multifaceted evidence-based package of interventions implemented over a six month period. The included interventions, which have previously been demonstrated to be effective at reducing antibiotic prescribing for acute respiratory infections, are: delayed prescribing; patient decision aids; communication training; commitment to a practice prescribing policy for antibiotics; patient information leaflet; and near patient testing with C-reactive protein. In addition, two sub-studies are nested in the main study: (1) point prevalence estimation carriage of bacterial upper respiratory pathogens in practice staff and asymptomatic patients; (2) feasibility of direct measures of antibiotic resistance by nose/throat swabbing. The main outcome data are from Australia’s national health insurance scheme, Medicare, which will be accessed after the completion of the intervention phase. They include the number of antibiotic prescriptions and the number of patient visits per general practitioner for periods before and during the intervention. The incidence of antibiotic prescriptions will be modelled using the numbers of patients as the denominator and seasonal and other factors as explanatory variables. Results will compare the change in prescription rates before and during the intervention in the two groups of practices. Semi-structured interviews will be conducted with the general practitioners and practice staff (practice nurse and/or practice manager) from the intervention practices on conclusion of the intervention phase to assess the feasibility and uptake of the interventions. An economic evaluation will be conducted to estimate the costs of implementing the package, and its cost-effectiveness in terms of cost per unit reduction in prescribing. Discussion The results on the effectiveness, cost-effectiveness, acceptability and feasibility of this package of interventions will inform the policy for any national implementation.