Differential pathologic variables and outcomes across the spectrum of adenocarcinoma of the esophagogastric junction

Background Adenocarcinoma of the esophagogastric junction (AEG) as described by Siewert et al. is classified as one entity in the latest (7th Edition) American Joint Cancer Committee/International Union Against Cancer (AJCC/UICC) manual, compared with the previous mix of esophageal and gastric staging systems. The origin of AEG tumors, esophageal or gastric, and their biology remain controversial, particularly for AEG type II (cardia) tumors. Methods We adapted a large prospective database (n = 520: 180 type I, 182 type II, 158 type III) to compare AEG tumors under the new TNM system Pathological variables associated with prognosis were compared (pT, pN, stage, differentiation, R status, lymphovascular invasion, perineural involvement, number of positive nodes, percent of positive nodes, and tumor length), as well as overall survival. Results Compared with AEG type I tumors, type II and type III tumors had significantly (p\0.05) more advanced pN stages, greater number and percentage of positive nodes, poorer differentiation, more radial margin involvement, and more perineural invasion. In AEG type I, 14/180 patients (8%) had[6 involved nodes (pN3), compared with 16 and 30% of patients classified type II and III, respectively. Median survival was significantly (p = 0.03) improved for type I patients (38 months) compared with those with tumors classified as type II (28 months) and type III (24 months). In multivariate analysis node positivity and pN staging but not AEG site had an impact on survival. Conclusions In this series AEG type I is associated with more favorable pathologic features and improved outcomes compared with AEG type II and III. This may reflect earlier diagnosis, but an alternative possibility, that type I may be a unique paradigm with more favorable biology, requires further study. © Société Internationale de Chirurgie 2010.

Developmental lessons from the Capricornia Arts Mob (CAM)

The Capricornia Arts Mob (CAM) is a collective of Aboriginal and Torres Strait Islander visual artists, sculptors, photographers, carvers and writers based in the Rockhampton region of Central Queensland. This paper explores the early development of CAM, identifies some of the lessons its members have learned about working together, and considers its role as a regional artists’ collective. The authors identify that traditional Indigenous practices, such as yarning and the sharing of food, have helped to facilitate the emergence of CAM as a vibrant, challenging, eclectic artistic family. They recognise the cultural challenges faced by the collective – including finding a culturally appropriate place to meet and work, and the cross-cultural issues that can emerge within Aboriginal and Torres Strait Islander groups. In just 18 months, CAM has held successful exhibitions and developed public artworks. It is a strong part of regional Queensland’s arts scene, which supports emerging artists and provides a space to celebrate and support Indigenous art.

Exenatide extended-release; clinical trials, patient preference, and economic considerations

Type 2 diabetes remains an escalating world-wide problem, despite a range of treatments. The revelation that insulin secretion is under the control of a gut hormone, glucagon-like peptide 1 (GLP-1) led to a new paradigm in the management of type 2 diabetes, medicines that directly stimulate, or that prolong the actions of the endogenous GLP-1, at its receptors. Exenatide is an agonist at the GLP-1 receptors, and was initially developed as a subcutaneous twice daily medication, ExBID. The clinical trials with ExBID established a role for exenatide in the treatment of type 2 diabetes. Subsequently, once weekly exenatide (ExQW) was shown to have advantages over ExBID, and there is now more emphasis on the development of ExQW. ExQW alone reduces glycosylated haemoglobin (HbA1c) and body weight, and is well tolerated. ExQW has been compared to sitagliptin, pioglitazone and metformin, and shown to have a greater ability to reduce HbA1c than these other medicines. The only preparation of insulin, which ExQW has been compared to, is insulin glargine, and the ExQW has some favourable properties in this comparison, notably causing weight loss, compared to the gain with insulin glargine. ExQW has been compared to another GLP-1 receptor agonist, liraglutide, and ExQW is non-inferior to liraglutide in reducing HbA1c. The small amount of evidence available, shows that subjects with type 2 diabetes, prefer ExQW to ExBID, and that adherence was high to these in the clinical trial setting. Healthcare and economic modelling suggests that ExQW will reduce diabetic complications and be cost-effective, compared to other medications, with long term use. Little is known about whether subjects with type 2 diabetes prefer ExQW to other medicines, and whether adherence is good to ExQW in practice, and these important topics require further study.

Distance education and the application of academagogy : a case study

The education sector has dramatically changed in the past half decade. In a time of globalisation of education and tightening budgets, various paradigm shifts and challenges have rapidly changed learning and teaching. These include: meeting student expectation for more engaging, more interactive learning experiences, the increased focus to deliver content online, and the complexities of fast-changing technologies. Rising to these challenges and responding to them is a complex and multi-faceted task. This paper discusses educational theories and issues and explores current educational practices in the context of teaching undergraduate students via distance education in the university context. A case study applies a framework drawn from engineering education using the learner-centric concept of academagogy. Results showed that academagogy actively empowers students to build effective learning, and engages facilitators in meaningful teaching and delivery methods.

Jane McCredie - Making Girls and Boys : Inside the Science of Sex [Book Review]

Activists, Feminists, queer theorists, and those who live outside traditional gender narratives have long challenged the fixity of the sex and gender binaries. While the dominant Western paradigm posits sex and gender as natural and inherent, queer theory argues that sex and gender are socially constructed. This means that our ideas about sex and gender, and the concepts themselves, are shaped by particular social contexts. Questioning the nature of sex can be puzzling. After all, isn’t sex biology? Binary sex – male and female – was labelled as such by scientists based on existing binary categories and observations of hormones, genes, chromosomes, reproductive organs, genitals and other bodily elements. Binary sex is allocated at birth by genital appearance. Not everyone fits into these categories and this leads queer theorists, and others, to question the categories. Now, “some scientists are also starting to move away from the idea of biology as the fixed basis on which the social artefact of gender is built” (5). Making Girls and Boys: Inside the Science of Sex, by Jane McCredie, examines theories about gender roles and behaviours also considering those who don’t fit the arbitrary sex and gender binaries.

Establishing sustainable and reliable smart grids

This paper addresses challenges part of the shift of paradigm taking place in the way we produce, transmit and use power related to what is known as smart grids. The aim of this paper is to explore present initiatives to establish smart grids as a sustainable and reliable power supply system. We argue that smart grids are not isolated to abstract conceptual models alone. We suggest that establishing sustainable and reliable smart grids depend on series of contributions including modeling and simulation projects, technological infrastructure pilots, systemic methods and training, and not least how these and other elements must interact to add reality to the conceptual models. We present and discuss three initiatives that illuminate smart grids from three very different positions. First, the new power grid simulator project in the electrical engineering PhD program at Queensland University of Technology (QUT). Second, the new smart grids infrastructure pilot run by the Norwegian Centers of Expertise Smart Energy Markets (NCE SMART). And third, the new systemic Master program on next generation energy technology at østfold University College (Hiø). These initiatives represent future threads in a mesh embedding smart grids in models, technology, infrastructure, education, skills and people.

A therapeutic approach to assessing legal capacity in Australia

Australia lacks a satisfactory, national paradigm for assessing legal capacity in the context of testamentary, enduring power of attorney and advance care directive documents. Capacity assessments are currently conducted on an ad hoc basis by legal and/or medical professionals. The reliability of the assessment process is subject to the skill set and mutual understanding of the legal and/or medical professional conducting the assessment. There is a growth in the prevalence of diseases such as dementia. Such diseases impact upon cognition which increasingly necessitates collaboration between the legal and medical professions when assessing the effect of mentally disabling conditions upon legal capacity. Miscommunication and lack of understanding between legal and medical professionals involved could impede the development of a satisfactory paradigm. This article will discuss legal capacity assessment in Australia and how to strengthen the relationship between legal and medical professionals involved in capacity assessments. The development of a national paradigm would promote consistency and transparency of process, helping to improve the professional relationship and maximising the principles of autonomy, participation and dignity.

'I wouldn't say that' : finding a young adult, female voice in a Queensland mining town

This is a practice-led project consisting of a Young Adult novel, Open Cut, and an exegesis, 'I Wouldn't Say That': Finding a Young Adult, Female Voice in a Queensland Mining Town. The thesis investigates the use of first person narration in order to create an immediate engaging, realist Young Adult Fiction. The research design is bound by a feminist interpretative paradigm. The methodology employed is practice-led, auto-ethnography, and participant observation. Particular characteristics of first person narration used in Australian Young Adult Fiction are identified in an analysis of Dust, by Christine Bongers, and Jasper Jones, by Craig Silvey. The exegesis also contains a reflection on the researcher's creative work, and the process used to draft, edit, plot and construct the novel. The research contributes to knowledge in the field of Young Adult Literature because it offers a graphic portrayal of an Australian mining town that has not been heard before.

A systemic view of innovation adoption in the Australian beef industry

Significant investments in developing technological innovations have been made in the Australian beef industry but with low adoption rates. By modelling the key variables and their interactions in the innovation adoption process, this research seeks to demonstrate the complexity and dynamics of the process. This research uses causal loop modelling and develops a holistic model of the current innovation adoption system in the Australian beef industry to show the complexity of dynamic interactions among multiple variables. It is suggested that innovation adoption is such an extremely complex issue, and we need to shift our views on this issue from a paradigm of linear thinking to systems thinking. Innovation adoption is more likely to be enhanced based on a full understanding of the complexity and dynamics of the system as a whole. The paper demonstrates to practitioners and developers of innovation the multiple variables and interactions impacting innovation adoption.

Designing Assessment for Quality Learning

- Considers broad-scale assessment approaches and how they impact on educational opportunity and outcomes. - Brings together internationally recognised scholars providing new insights into assessment for learning improvement and accountability. - Presents different theoretical and methodological perspectives influential in the field of assessment, learning and social change. - Contributes to the theorising of assessment in contexts characterised by heightened accountability requirements and constant change. This book brings together internationally recognised scholars with an interest in how to use the power of assessment to improve student learning and to engage with accountability priorities at both national and global levels. It includes distinguished writers who have worked together for some two decades to shift the assessment paradigm from a dominant focus on assessment as measurement towards assessment as central to efforts to improve learning. These writers have worked with the teaching profession and, in so doing, have researched and generated key insights into different ways of understanding assessment and its relationship to learning. The volume contributes to the theorising of assessment in contexts characterised by heightened accountability requirements and constant change. The book’s structure and content reflect already significant and growing international interest in assessment as contextualised practice, as well as theories of learning and teaching that underpin and drive particular assessment approaches. Learning theories and practices, assessment literacies, teachers’ responsibilities in assessment, the role of leadership, and assessment futures are the organisers within the book’s structure and content. The contributors to this book have in common the view that quality assessment, and quality learning and teaching are integrally related. Another shared view is that the alignment of assessment with curriculum, teaching and learning is linchpin to efforts to improve both learning opportunities and outcomes for all. Essentially, the book presents new perspectives on the enabling power of assessment. In so doing, the writers recognise that validity and reliability - the traditional canons of assessment – remain foundational and therefore necessary. However, they are not of themselves sufficient for quality education. The book argues that assessment needs to be radically reconsidered in the context of unprecedented societal change. Increasingly, communities are segregating more by wealth, with clear signs of social, political, economic and environmental instability. These changes raise important issues relating to ethics and equity, taken to be core dimensions in enabling the power of assessment to contribute to quality learning for all. This book offers readers new knowledge about how assessment can be used to re/engage learners across all phases of education.

From “anytime, anywhere” to “here and now”: place and time restrictions in mobile narratives to enhance situated engagement of mobile users

The usage of the mobile Internet has increased tremendously within the last couple of years, and thereby the vision of accessing information anytime, anywhere has become more realistic and a dominant design principle for providing content. However, this study challenges this paradigm of unlimited and unrestricted access, and explores the question whether constraints and restrictions can positively influence the motivation and enticement of mobile users to engage with location-specific content. Restrictions, such as a particular time or location that gives a user access to content, may be used to foster participation and engagement, as well as to support content production and to enhance the user’s experience. In order to explore this, a Mobile Narrative and a Narrative Map have been created. For the former, the access to individual chapters of the story was restricted. Authors can specify constraints, such as a location or time, which need to be met by the reader if they want to read the story. This concept allows creative writers of the story to exploit the fact that the reader’s context is known, by intensifying the user experience and integrating this knowledge into the writing process. The latter, the Narrative Map, provides users with extracts from stories or information snippets about authors at relevant locations. In both concepts, a feedback channel was also integrated, on which location, time, and size constraints were imposed. In a user-centred design process involving authors and potential readers, those concepts have been implemented, followed by an evaluation comprising four user studies. The results show that restrictions and constraints can indeed lead to more enticing and engaging user experiences, and restricted contribution opportunities can lead to a higher motivation to participate as well as to an improved quality of submissions. These findings are relevant for future developments in the area of mobile narratives and creative writing, as well as for common mobile services that aim for enticing user experiences.

The subject and architecture

Invited Presentation on my book Architecture for a Free Subjectivity. In March of 1982, Skyline, the Institute for Architecture and Urban Studies serial, published the landmark interview between Paul Rabinow, an American anthropologist, and Michel Foucault, which would only appear two years later under the title “Space, Knowledge, and Power,” in Rabinow’s edited book The Foucault Reader. Foucault said that in the spatialization of knowledge and power beginning in the 18th century, architecture is not a signifier or metaphor for power, it is rather the “technique for practising social organization.” The role of the IAUS in the architectural dissemination of Foucault’s ideas on the subject and space in the North American academy – such as the concept “heterotopia,” and Foucault’s writing on surveillance and Jeremy Bentham’s Panopticon, subsequently analysed by Georges Teyssot, who was teaching at the Venice School – is well known. Teyssot’s work is part of the historical canalization of Foucauldianism, and French subjectivity more broadly, along its dizzying path, via Italy, to American architecture schools, where it solidified in the 1980s paradigm that would come to be known as American architecture theory. Foucault was already writing on incarceration and prisons, from the 1970s. (In the 1975 lectures he said “architecture was responsible for the invention of madness.”) But this work was not properly incorporated into architectural discussion until the early ’80s. What is not immediately apparent, what this history suggests to me is that subjectivity was not a marginal topic within “theory”, but was perhaps a platform and entry point for architecture theory. One of the ideas that I’m working on is that “theory” can be viewed, historically, as the making of architectural subjectivity, something that can be traced back to the Frankfurt School critique which begins with the modern subject...

Disability, public space performance & spectatorship : Unconscious performers

Why would disabled people want to re-engage, re-enact and re-envisage the everyday encounters in public spaces and places that cast them as ugly, strange, stare-worthy? In Disability, Public Space Performance and Spectatorship: Unconscious Performers, Bree Hadley examines the performance practices of disabled artists in the US, UK, Europe and Australasia who do exactly this. Operating in a live or performance art paradigm, artists like James Cunningham (Australia), Noemi Lakmaier (UK/Austria), Alison Jones (UK), Aaron Williamson (UK), Katherine Araniello (UK), Bill Shannon (US), Back to Back Theatre (Australia), Rita Marcalo (UK), Liz Crow (UK) and Mat Fraser (UK) all use installation and public space performance practices to re-stage their disabled identities in risky, guerilla-style works that remind passersby of their own complicity in the daily social drama of disability. In doing so, they draw spectators' attention to their own role in constructing Western concepts of disability. This book investigates the way each of us can become unconscious performers in a daily social drama that positions disability people as figures of tragedy, stigma or pity, and the aesthetics, politics and ethics of performance practices that intervene very directly in this drama. It constructs a framework for understanding the way spectators are positioned in these practices, and how they contribute to public sphere debates about disability today.

The Use of Ecological Design to Achieve Sustainable Development in Queensland, Australia

This series of technical papers arose out of the action by a private entrepreneur to initiate a process beyond mere regulatory compliance in order to achieve best environmental practice at proposed large new visitor gateways to Australia’s Great Barrier Reef. Because of the complexity of issues involved at such urbanized downstream sites, the range of topics covered is wide – though still only those considered at this juncture to be of management priority. Included on this platform is one introductory paper reviewing the history of environmental management in the field in Queensland, and three papers which seek to appreciate the main techniques by which government contributes to the solutions viz. through the national park, threatened species list, and environmental impact assessment. The history paper was designed to allow the present series to be considered in broad context as well as performance to date. The work emphasizes that much of the fertile land that must be sustained nowadays lies in the province of the private sector, and that the initiative to create any new cost-effective paradigm in ecologically-sustainable practices lies mostly in their hands. In all instances, this strategic approach to large-scale property planning is through ecological design – using field case studies around the immediate biophysical catchment of the development, with attendant focus on the associated legal catchment (the actual development site) and the social catchment (the effective land managers). The first of these has given rise to a document termed a Regional Landscape Strategy, its implementation planned in concert with an Environmental Impact Assessment of the site and with a Strategic Regional Initiative (still being tested in the field) for community engagement. The first document takes into account the aspirations of government as expressed in its broad-scale regional plans.

A Bayesian regression approach to assess uncertainty in pollutant wash-off modelling

Due to knowledge gaps in relation to urban stormwater quality processes, an in-depth understanding of model uncertainty can enhance decision making. Uncertainty in stormwater quality models can originate from a range of sources such as the complexity of urban rainfall-runoff-stormwater pollutant processes and the paucity of observed data. Unfortunately, studies relating to epistemic uncertainty, which arises from the simplification of reality are limited and often deemed mostly unquantifiable. This paper presents a statistical modelling framework for ascertaining epistemic uncertainty associated with pollutant wash-off under a regression modelling paradigm using Ordinary Least Squares Regression (OLSR) and Weighted Least Squares Regression (WLSR) methods with a Bayesian/Gibbs sampling statistical approach. The study results confirmed that WLSR assuming probability distributed data provides more realistic uncertainty estimates of the observed and predicted wash-off values compared to OLSR modelling. It was also noted that the Bayesian/Gibbs sampling approach is superior compared to the most commonly adopted classical statistical and deterministic approaches commonly used in water quality modelling. The study outcomes confirmed that the predication error associated with wash-off replication is relatively higher due to limited data availability. The uncertainty analysis also highlighted the variability of the wash-off modelling coefficient k as a function of complex physical processes, which is primarily influenced by surface characteristics and rainfall intensity.