Platinum-based chemotherapy in metastatic breast cancer : current status

Cisplatin and carboplatin are active in previously untreated patients with metastatic breast cancer (MBC) with mean response rates (RRs) of 50 and 32%, respectively. In pretreated patients the RR to cisplatin/carboplatin monotherapy declines markedly to <10%. Cisplatin and carboplatin have been combined with many other cytotoxics. In first-line setting high activity has been observed in combination with taxanes or vinorelbine (RRs consistently ∼60%). It appears that these newer combinations are superior to older regimens with etoposide (RRs 30 to 50%) or 5-fluorouracil (RRs 40 to 60%). Cisplatin-/carboplatin-based regimens with infusional 5-FU and epirubicin/paclitaxel/vinorelbine achieve high RRs of around 60 to 80%. However these regimens are difficult to administer in all patients because they require central venous access for continuous 5-FU infusion. In pretreated MBC the combinations of cisplatin-taxane/vinorelbine/gemcitabine or carboplatin-docetaxel/vinorelbine yield RRs of 40 to 50%, which are higher than those achieved with platinum-etoposide/5-FU. In locally advanced disease cisplatin-based regimens achieve very high RRs (>80%). This would suggest that in chemotherapy-naïve patients platinum-based therapy might have an important role to play. Additionally the synergy demonstrated between platinum compounds, taxanes and herceptin, in preclinical and clinical studies is of immense importance and the results of the two ongoing Breast Cancer International Research Group randomized phase III studies are eagerly awaited. These studies may help clarify the role of platinum compounds in the treatment of metastatic and possibly early breast cancer. © 2003 Elsevier Ltd. All rights reserved.

Epidural analgesia is associated with an increased incidence of postoperative complications in patients requiring an abdominal hysterectomy for early stage endometrial cancer

Objective Analgesia and early quality of recovery may be improved by epidural analgesia. We aimed to assess the effect of receiving epidural analgesia on surgical adverse events and quality of life after laparotomy for endometrial cancer. Methods Patients were enrolled in an international, multicentre, prospective randomised trial of outcomes for laparoscopic versus open surgical treatment for the management of apparent stage I endometrial cancer (LACE trial). The current analysis focussed on patients who received an open abdominal hysterectomy via vertical midline incision only (n = 257), examining outcomes in patients who did (n = 108) and did not (n = 149) receive epidural analgesia. Results Baseline characteristics were comparable between patients with or without epidural analgesia. More patients without epidural (34%) ceased opioid analgesia 3–5 days after surgery compared to patients who had an epidural (7%; p < 0.01). Postoperative complications (any grade) occurred in 86% of patients with and in 66% of patients without an epidural (p < 0.01) but there was no difference in serious adverse events (p = 0.19). Epidural analgesia was associated with increased length of stay (up to 48 days compared to up to 34 days in the non-epidural group). There was no difference in postoperative quality of life up to six months after surgery. Conclusions Epidural analgesia was associated with an increase in any, but not serious, postoperative complications and length of stay after abdominal hysterectomy. Randomised controlled trials are needed to examine the effect of epidural analgesia on surgical adverse events, especially as the present data do not support a quality of life benefit with epidural analgesia. Keywords Endometrial cancer; Hysterectomy; Epidural; Adverse events

Retaining the thin blue line : What shapes workers' intentions not to quit the current work environment

Purpose – The purpose of this paper is to investigate the relationship between workplace factors and the intentions of police officers to quit their current department. Design/methodology/approach – Data from a survey of Baltimore officers, designed to examine the relationship between police stress and domestic violence in police families were used. Using multivariate regression analysis, the authors focus on the officers' stated intentions to look for alternative employment, with proxies for social and workplace factors. Findings – Higher levels of cooperation (trust), interactional justice and work-life-balance reduce police officers' intentions to quit. While high levels of physical and psychological strain and trauma are not correlated with intentions to quit. Research limitations/implications – A discernible limitation of this study is the age of the data analyzed and that many changes have occurred in recent times (policing and social). It would be of great interest to repeat this study to gauge the true effect. Practical implications – There are policy implications for retention and recruitment: it may possible to decrease the ethnic and gender gaps, through identifying officers at risk and creating programs to hold existing minorities, recruit more, whilst maintaining a strong, happy and healthy department. Originality/value – This study examines the impact of workplace factors on quitting intention for police officers. It is demonstrated that social capital, fairness and work-life balance are moderators for quitting, adding to the literature on worker retention, as little research has been done using multivariate analysis on quitting intentions.

InterLACE : a new international collaboration for a Life course approach to women's reproductive health and chronic disease events.

Evidence from population-based studies of women increasingly points to the inter-related nature of reproductive health, lifestyle, and chronic disease risk. This paper describes the recently established International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease. InterLACE aims to advance the evidence base for women's health policy beyond associations from disparate studies by means of systematic and culturally sensitive synthesis of longitudinal data. Currently InterLACE draws on individual level data for reproductive health and chronic disease among 200,000 women from over thirteen studies of women's health in seven countries. The rationale for this multi-study research programme is set out in terms of a life course perspective to reproductive health. The research programme will build a comprehensive picture of reproductive health through life in relation to chronic disease risk. Although combining multiple international studies poses methodological challenges, InterLACE represents an invaluable opportunity to strength evidence to guide the development of timely and tailored preventive health strategies.

Atmospheric particles as a pollutant source in the urban water environment in Sri Lanka – current research trends and future directions

Human and ecosystem health impacts imposed by water pollution are a major problem in the urban areas of Sri Lanka. A primary source of pollutants to urban water sources is atmospheric particles. Hence, it is important to develop a detailed understanding of atmospheric particle characteristics, their sources of origin and the transport pathways. Several research studies have been conducted in Sri Lanka on atmospheric pollution and these studies have tended to differ in their scope, study region and the investigated pollutants. The objectives of this paper are: (1) to report the outcomes of a detailed state-of-art literature review of atmospheric pollution related studies in Sri Lanka to understand the current trends and (2) to discuss the future research activities necessary to generate the important knowledge required for the development of effective strategies to control the adverse impacts of atmospheric pollution on urban waterways.

The valuation of long life mines : current issues and methodologies

The past decade has seen an increasing focus on the mining and extractive industries in Australia. The significant increases in both new mines, commodity prices and employment opportunities has lead to considerable discussion on the value of this industry and the contribution that the industry makes to exports, GDP and the public in general. This debate has resulted in the introduction of the Mineral Resources Rent Tax being introduced in 2012. An issue that follows from the introduction of these taxes is the current exposure of property valuers to mine and extractive industry valuations and the most appropriate method that should be employed for valuing long life mines for rating and taxing purposes, finance and accounting purposes. This paper will provide a detailed review of past and current valuation methods for long life mines and will highlight the current issues and problem facing valuers who are currently working in or intend to carry out valuation work in this industry.

Rapid scanning of spectrograms for efficient identification of bioacoustic events in big data

Acoustic sensing is a promising approach to scaling faunal biodiversity monitoring. Scaling the analysis of audio collected by acoustic sensors is a big data problem. Standard approaches for dealing with big acoustic data include automated recognition and crowd based analysis. Automatic methods are fast at processing but hard to rigorously design, whilst manual methods are accurate but slow at processing. In particular, manual methods of acoustic data analysis are constrained by a 1:1 time relationship between the data and its analysts. This constraint is the inherent need to listen to the audio data. This paper demonstrates how the efficiency of crowd sourced sound analysis can be increased by an order of magnitude through the visual inspection of audio visualized as spectrograms. Experimental data suggests that an analysis speedup of 12× is obtainable for suitable types of acoustic analysis, given that only spectrograms are shown.

An evaluation of different features and learning models for anomalous event detection

The huge amount of CCTV footage available makes it very burdensome to process these videos manually through human operators. This has made automated processing of video footage through computer vision technologies necessary. During the past several years, there has been a large effort to detect abnormal activities through computer vision techniques. Typically, the problem is formulated as a novelty detection task where the system is trained on normal data and is required to detect events which do not fit the learned ‘normal’ model. There is no precise and exact definition for an abnormal activity; it is dependent on the context of the scene. Hence there is a requirement for different feature sets to detect different kinds of abnormal activities. In this work we evaluate the performance of different state of the art features to detect the presence of the abnormal objects in the scene. These include optical flow vectors to detect motion related anomalies, textures of optical flow and image textures to detect the presence of abnormal objects. These extracted features in different combinations are modeled using different state of the art models such as Gaussian mixture model(GMM) and Semi- 2D Hidden Markov model(HMM) to analyse the performances. Further we apply perspective normalization to the extracted features to compensate for perspective distortion due to the distance between the camera and objects of consideration. The proposed approach is evaluated using the publicly available UCSD datasets and we demonstrate improved performance compared to other state of the art methods.

A longitudinal study of the impact of chronic psychological stress on health-related quality of life and clinical biomarkers : protocol for the Australian Healthy Aging of Women Study

BACKGROUND: Despite advancements in our understanding of the importance of stress reduction in achieving good health, we still only have limited insight into the impact of stress on cellular function. Recent studies have suggested that exposure to prolonged psychological stress may alter an individual's physiological responses, and contribute to morbidity and mortality. This paper presents an overview of the study protocol we are using to examine the impact of life stressors on lifestyle factors, health-related quality of life and novel and established biomarkers of stress in midlife and older Australian women.The primary aim of this study is to explore the links between chronic psychological stress on both subjective and objective health markers in midlife and older Australian women. The study examines the extent to which exposure frightening, upsetting or stressful events such as natural disasters, illness or death of a relative, miscarriage and relationship conflict is correlated with a variety of objective and subjective health markers.Methods/design: This study is embedded within the longitudinal Healthy Aging of Women's study which has collected data from midlife and older Australian women at 5 yearly intervals since 2001, and uses the Allostastic model of women's health by Groer and colleagues in 2010. The current study expands the focus of the HOW study and will assess the impact of life stressors on quality of life and clinical biomarkers in midlife and older Australian women to explain the impact of chronic psychological stress in women. DISCUSSION: The proposed study hypothesizes that women are at increased risk of exposure to multiple or repeated stressors, some being unique to women, and the frequency and chronicity of stressors increases women's risk of adverse health outcomes. This study aims to further our understanding of the relationships between stressful life experiences, perceived quality of life, stress biomarkers, chronic illness, and health status in women.

Current dementia research in Australia : a report from the Alzheimer's Australia 15th National Conference

The Alzheimer’s Australia 15th National Conference held on 14–17 May 2013 in Hobart (Tasmania, Australia) attracted a wide range of attendees, including people living with dementia, family caregivers, health professionals and researchers. The conference theme, The Tiles of Life Coloring the Future, invoking a vision of a better future for those affected by dementia, had seven subthemes: liberation, rehabilitation, leisure,service, creativity, wellbeing and research.

Report on a workshop to investigate the current status of environmental bio-acoustic monitoring

This workshop was supported by the Australian Centre for Ecological Analysis and Synthesis (ACEAS, http://www.aceas.org.au/), a facility of the Australian Government-funded Terrestrial Ecosystem Research Network (http://www.tern.org.au/), a research infrastructure facility established under the National Collaborative Research Infrastructure Strategy and Education Infrastructure Fund - Super Science Initiative, through the Department of Industry, Innovation, Science, Research and Tertiary Education. Hosted by: Queensland University of Technology, Brisbane, Queensland. (QUT, http://www.qut.edu.au/) Dates: 8-11 May 2012 Report Editors: Prof Stuart Parsons (Uni. Auckland, NZ) and Dr Michael Towsey (QUT). This report is a compilation of notes and discussion summaries contributed by those attending the Workshop. They have been assembled into a logical order by the editors. Another report (with photographs) can be obtained at: http://www.aceas.org.au/index.php?option=com_content&view=article&id=94&Itemid=96

Development of a computer based 1D-2D dynamic flood model. Case study of the Pagsangaan river basin in Leyte, the Philippines

Floods are among the most devastating events that affect primarily tropical, archipelagic countries such as the Philippines. With the current predictions of climate change set to include rising sea levels, intensification of typhoon strength and a general increase in the mean annual precipitation throughout the Philippines, it has become paramount to prepare for the future so that the increased risk of floods on the country does not translate into more economic and human loss. Field work and data gathering was done within the framework of an internship at the former German Technical Cooperation (GTZ) in cooperation with the Local Government Unit of Ormoc City, Leyte, The Philippines, in order to develop a dynamic computer based flood model for the basin of the Pagsangaan River. To this end, different geo-spatial analysis tools such as PCRaster and ArcGIS, hydrological analysis packages and basic engineering techniques were assessed and implemented. The aim was to develop a dynamic flood model and use the development process to determine the required data, availability and impact on the results as case study for flood early warning systems in the Philippines. The hope is that such projects can help to reduce flood risk by including the results of worst case scenario analyses and current climate change predictions into city planning for municipal development, monitoring strategies and early warning systems. The project was developed using a 1D-2D coupled model in SOBEK (Deltares Hydrological modelling software package) and was also used as a case study to analyze and understand the influence of different factors such as land use, schematization, time step size and tidal variation on the flood characteristics. Several sources of relevant satellite data were compared, such as Digital Elevation Models (DEMs) from ASTER and SRTM data, as well as satellite rainfall data from the GIOVANNI server (NASA) and field gauge data. Different methods were used in the attempt to partially calibrate and validate the model to finally simulate and study two Climate Change scenarios based on scenario A1B predictions. It was observed that large areas currently considered not prone to floods will become low flood risk (0.1-1 m water depth). Furthermore, larger sections of the floodplains upstream of the Lilo- an’s Bridge will become moderate flood risk areas (1 - 2 m water depth). The flood hazard maps created for the development of the present project will be presented to the LGU and the model will be used to create a larger set of possible flood prone areas related to rainfall intensity by GTZ’s Local Disaster Risk Management Department and to study possible improvements to the current early warning system and monitoring of the basin section belonging to Ormoc City; recommendations about further enhancement of the geo-hydro-meteorological data to improve the model’s accuracy mainly on areas of interest will also be presented at the LGU.

Honesty about adverse events - more honoured in the breach than in the observance

The medical board of Australia Code of conduct reminds doctors that" "When adverse events occur, you have a responsibility to be open and honest in your communication with your patient, to review what has occurred and to report appropriately." More honoured in the breach rather than the observence may or may not be correct. Faced with the English concerns and the Netherlands research, an evidence based assessment of compliance with the ethical duty to disclose adverse events is warranted.