Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer : lessons from the experience of a high-volume center

Objective: Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed. Methods: Three time periods were studied, 1990 to 1998 (period 1), 1999 to 2003 (period 2), and 2004 to 2008 (period 3), in which 471, 254, and 342 patients, respectively, with esophageal cancer were treated with curative intent. All data were prospectively recorded, and staging, pathology, treatment, operative, and oncologic outcomes were compared. Results: Five-year disease-specific survival was 28%, 35%, and 44%, and in-hospital postoperative mortality was 6.7%, 4.4%, and 1.7% for periods 1 to 3, respectively (P < .001). Period 3, compared with periods 1 and 2, respectively, was associated with significantly (P < .001) more early tumors (17% vs 4% and 6%), higher nodal yields (median 22 vs 11 and 18), and a higher R0 rate in surgically treated patients (81% vs 73% and 75%). The use of multimodal therapy increased (P < .05) across time periods. By multivariate analysis, age, T stage, N stage, vascular invasion, R status, and time period were significantly (P < .0001) associated with outcome. Conclusions: Improved survival with localized esophageal cancer in the modern era may reflect an increase of early tumors and optimized staging. Important surgical and pathologic standards, including a higher R0 resection rate and nodal yields, and lower postoperative mortality, were also observed. Copyright © 2012 by The American Association for Thoracic Surgery.

Examining workload models in online and blended teaching

Over the past decade, most Australian universities have moved increasingly towards online course delivery for both undergraduate and graduate programs. In almost all cases, elements of online teaching are part of routine teaching loads. Yet detailed and accurate workload data are not readily available. As a result, institutional policies on academic staff workload are often guided more by untested assumptions about reduction of costs per student unit, rather than being evidence-based, with the result that implementation of new technologies for online teaching has resulted in poorly defined workload expectations. While the academics in this study often revealed a limited understanding of their institutional workload formulas, which in Australia are negotiated between management and the national union through their local branches, the costs of various types of teaching delivery have become a critical issue in a time of increasing student numbers, declining funding, pressures to increase quality and introduce minimum standards of teaching and curriculum, and substantial expenditure on technologies to support e-learning. There have been relatively few studies on the costs associated with workload for online teaching, and even fewer on the more ubiquitous ‘blended’, ‘hybrid’ or ‘flexible’ modes, in which face-to-face teaching is supplemented by online resources and activities. With this in mind the research reported here has attempted to answer the following question: What insights currently inform Australian universities about staff workload when teaching online?

Labour attraction and retention in rural and remote Queensland communities

Attracting and retaining a skilled labour force is a critical yet complex issue for rural and remote communities. This article reports the findings of a study investigating the current approaches to attraction and retention in two separate Australian regions. Building on previously developed models, this research analyses the roles employers and wider communities are playing, or potentially could play, in addressing issues that influence labour shortages. The findings of this research highlight the complexities of labour attraction and retention and emphasise the need for communities and businesses to work together to overcome labour shortages in rural and remote locations.

Small RNA viruses of insects : expression in plants and RNA silencing

Interest in insect small RNA viruses (SRVs) has grown slowly but steadily. A number of new viruses have been analyzed at the sequence level, adding to our knowledge of their diversity at the level of both individual virus species and families. In particular, a number of possible new virus families have emerged. This research has largely been driven by interest in their potential for pest control, as well as in their importance as the causal agents of disease in beneficial arthropods. At the same time, research into known viruses has made valuable contributions to our understanding of an emerging new field of central importance to molecular biology-the existence of RNA-based gene silencing, developmental control, and adaptive immune systems in eukaryotes. Subject to RNA-based adaptive immune responses in their hosts, viruses have evolved a variety of genes encoding proteins capable of suppressing the immune response. Such genes were first identified in plant viruses, but the first examples known from animal viruses were identified in insect RNA viruses. This chapter will address the diversity of insect SRVs, and attempts to harness their simplicity in the engineering of transgenic plants expressing viruses for resistance to insect pests. We also describe RNA interference and antiviral pathways identified in plants and animals, how they have led viruses to evolve genes capable of suppressing such adaptive immunity, and the problems presented by these pathways for the strategy of expressing viruses in transgenic plants. Approaches for countering these problems are also discussed. © 2006 Elsevier Inc. All rights reserved.

Carrot red leaf and carrot mottle viruses : observations on the composition of the particles in single and mixed infections

Particles of carrot red leaf virus (CRLV; luteovirus group) purified from chervil (Anthriscus cerefolium) contain a single ssRNA species of mol. wt. about 1.8 x 106 and a major protein of mol. wt. about 25000. CRLV acts as a helper for aphid transmission of carrot mottle virus (CMotV; ungrouped) from mixedly infected plants. Virus preparations purified from such plants possess the infectivity of both viruses but contain particles indistinguishable from those of CRLV; some of the particles are therefore thought to consist of CMotV RNA packaged in CRLV coat protein. When RNA from such preparations was electrophoresed in agarose/polyacrylamide gels, CMotV infectivity was associated with an RNA band that migrated ahead of the CRLV RNA band and had an estimated mol. wt. of about 1.5 x 106, similar to that previously found for the infective ssRNA extracted directly from Nicotiana clevelandii leaves infected with CMotV alone. Preparations of dsRNA from CMotV-infected N. clevelandii leaves contained two species: one of mol. wt. about 3.2 x 106, presumably the replicative form of the infective ssRNA, and the other, mol. wt. about 0.9 x 106, of unknown origin and function. The infective agent in buffer extracts of CMotV-infected N. clevelandii was resistant to RNase (although the enzyme acted as a reversible inhibitor of infection at high concentrations) and is therefore not unprotected RNA. It may be protected within the approximately 52 nm enveloped structures previously reported.

An exploratory study of child-feeding practices of Indian mothers with children aged 1-5 years residing in Australia and Mumbai, India

This research has taken the first step to study child-feeding practices of Indian mothers in relation to childhood obesity. It compares feeding practices of Indian mothers with children aged 1-5 years living in Australia and Mumbai. Mothers in the Australian sample were more likely to use 'positive' feeding practices hypothesized to promote healthy growth and weight status. However, mothers in both samples commonly used coercive feeding practices that potentially increase the risk of childhood obesity. These results will inform interventions designed to promote healthy weight status in this cultural group.

Twitter and Sports : Football Fandom in Emerging and Established Markets

Twitter and other social media have become increasingly important tools for maintaining the relationships between fans and their idols across a range of activities, from politics and the arts to celebrity and sports culture. Twitter, Inc. itself has initiated several strategic approaches, especially to entertainment and sporting organisations; late in 2012, for example, a Twitter, Inc. delegation toured Australia in order to develop formal relationships with a number of key sporting bodies covering popular sports such as Australian Rules Football, A-League football (soccer), and V8 touring car racing, as well as to strengthen its connections with key Australian broadcasters and news organisations (Jackson & Christensen, 2012). Similarly, there has been a concerted effort between Twitter Germany and the German Bundesliga clubs and football association to coordinate the presence of German football on Twitter ahead of the 2012–2013 season: the Twitter accounts of almost all first-division teams now bear the official Twitter verification mark, and a system of ‘official’ hashtags for tweeting about individual games (combining the abbreviations of the two teams, e.g. #H96FCB) has also been instituted (Twitter auf Deutsch, 2012).

Provisional matrix deposition in hemostasis and venous insufficiency: Tissue preconditioning for nonhealing venous ulcers

Significance: Chronic wounds represent a major burden on global healthcare systems and reduce the quality of life of those affected. Significant advances have been made in our understanding of the biochemistry of wound healing progression. However, knowledge regarding the specific molecular processes influencing chronic wound formation and persistence remains limited. Recent Advances: Generally, healing of acute wounds begins with hemostasis and the deposition of a plasma-derived provisional matrix into the wound. The deposition of plasma matrix proteins is known to occur around the microvasculature of the lower limb as a result of venous insufficiency. This appears to alter limb cutaneous tissue physiology and consequently drives the tissue into a ‘preconditioned’ state that negatively influences the response to wounding. Critical Issues: Processes, such as oxygen and nutrient suppression, edema, inflammatory cell trapping/extravasation, diffuse inflammation, and tissue necrosis are thought to contribute to the advent of a chronic wound. Healing of the wound then becomes difficult in the context of an internally injured limb. Thus, interventions and therapies for promoting healing of the limb is a growing area of interest. For venous ulcers, treatment using compression bandaging encourages venous return and improves healing processes within the limb, critically however, once treatment concludes ulcers often reoccur. Future Directions: Improved understanding of the composition and role of pericapillary matrix deposits in facilitating internal limb injury and subsequent development of chronic wounds will be critical for informing and enhancing current best practice therapies and preventative action in the wound care field.

Estrogen receptor α antagonists mediate changes in CCL20 and CXCL1 secretions in the murine female reproductive tract

PROBLEM Estradiol regulates chemokine secretion from uterine epithelial cells, but little is known about estradiol regulation in vivo or the role of estrogen receptors (ERs). METHOD CCL20 and CXCL1 present in reproductive washes following treatment with selective estrogen receptor modulators (SERMs) were compared with that during estrous and following estradiol-treated ovariectomized BALB/c mice. Cellular regulation was determined using isolated vaginal and uterine epithelial/stromal cells in vitro. RESULTS Uterine and vaginal chemokine secretion is cyclically regulated with CCL20 at low levels but CXCL1 at high levels during high estradiol, generally mimicking estradiol effect in vivo. ERα but not ERβ regulated CCL20/CXCL1 secretion by uterine epithelial cells in vitro and vaginal CCL20 in vivo. Estradiol/SERMs failed to alter uterine CCL20 secretion in ovariectomized mice. Diminished uterine epithelial ERα staining following ovariectomy corresponded with estradiol unresponsiveness of uterine tissue. CONCLUSION Estrogen receptors α regulates CCL20/CXCL1 secretion in the female reproductive tract, and ERα antagonists directly oppose the regulation by estradiol. Understanding ER-mediated antimicrobial chemokine expression is important to elucidate cyclic susceptibility to sexually transmitted pathogens.

Bayesian networks in environmental and resource management

This overview article for the special series “Bayesian Networks in Environmental and Resource Management” reviews 7 case study articles with the aim to compare Bayesian network (BN) applications to different environmental and resource management problems from around the world. The article discusses advances in the last decade in the use of BNs as applied to environmental and resource management. We highlight progress in computational methods, best-practices for model design and model communication. We review several research challenges to the use of BNs in environmental and resource management that we think may find a solution in the near future with further research attention.

Stress, lifestyle and quality of life in midlife and older Australian women : results from the stress and the health of women study

Background Chronic psychological stress may pose a serious threat to health, although the mechanisms are not fully understood. This study examines the impact of stress on modifiable lifestyle factors, depressive symptoms, health-related quality of life (HRQOL) and chronic illness in older Australian women. Methods Cross-sectional data were collected from a random sample of 181 older adults aged 60-70 years from rural and urban areas of South-East Queensland, Australia. We used structural equation modelling to examine associations between stress, modifiable lifestyle factors, HRQoL, and chronic illness. Findings Parameter estimates show that older women who reported life stressors where they felt helpless and feared for their life (high magnitude stressors) also reported higher body mass index (p = 0.03) and more chronic illness (p <0.01). In contrast, duration of exposure to life stressors was associated with higher depressive symptom scores (CES-D, p = 0.02) and sleep disturbance scores (p <0.01). Conclusions Our findings support the link between traumatic personal histories (exposure to high magnitude stressors) and unhealthy lifestyle factors. Findings highlight the need for more research on how stress reduction healthy lifestyle and positive coping strategies can be used to reduce the effects of high magnitude stress on health-related quality of life and chronic illness.

Career Development in Childhood and Adolescence

"In the past few years, many career theorists have noted the dearth of literature in the area of career development in childhood and adolescence. A growing need for integrating theory and research on the early stages of vocational development within a systemic, life-span developmental approach has been articulated. This volume, the first book dedicated to career development of children and adolescents, provides a broad and comprehensive overview of the current knowledge about the key career processes that take place in this age group. Each of the eighteen chapters represents an in-depth examination of a specific aspect of career development with a focus on integrating modern career theory and ongoing research and further developing theory-practice connections in understanding child and adolescent career behaviour. Twenty-six authors, leading experts from eight countries, provide a state-of-the-art summary of the current thinking in the field and outline directions for future empirical work and practice."--publisher website

In vivo and in vitro models demonstrate a role for caveolin-1 in the pathogenesis of ischaemic acute renal failure

Caveolae and their proteins, the caveolins, transport macromolecules; compartmentalize signalling molecules; and are involved in various repair processes. There is little information regarding their role in the pathogenesis of significant renal syndromes such as acute renal failure (ARF). In this study, an in vivo rat model of 30 min bilateral renal ischaemia followed by reperfusion times from 4 h to 1 week was used to map the temporal and spatial association between caveolin-1 and tubular epithelial damage (desquamation, apoptosis, necrosis). An in vitro model of ischaemic ARF was also studied, where cultured renal tubular epithelial cells or arterial endothelial cells were subjected to injury initiators modelled on ischaemia-reperfusion (hypoxia, serum deprivation, free radical damage or hypoxia-hyperoxia). Expression of caveolin proteins was investigated using immunohistochemistry, immunoelectron microscopy, and immunoblots of whole cell, membrane or cytosol protein extracts. In vivo, healthy kidney had abundant caveolin-1 in vascular endothelial cells and also some expression in membrane surfaces of distal tubular epithelium. In the kidneys of ARF animals, punctate cytoplasmic localization of caveolin-1 was identified, with high intensity expression in injured proximal tubules that were losing basement membrane adhesion or were apoptotic, 24 h to 4 days after ischaemia-reperfusion. Western immunoblots indicated a marked increase in caveolin-1 expression in the cortex where some proximal tubular injury was located. In vitro, the main treatment-induced change in both cell types was translocation of caveolin-1 from the original plasma membrane site into membrane-associated sites in the cytoplasm. Overall, expression levels did not alter for whole cell extracts and the protein remained membrane-bound, as indicated by cell fractionation analyses. Caveolin-1 was also found to localize intensely within apoptotic cells. The results are indicative of a role for caveolin-1 in ARF-induced renal injury. Whether it functions for cell repair or death remains to be elucidated.