A multilevel investigation of inequalities in clinical and psychosocial outcomes for women after breast cancer

Background In Australia, breast cancer is the most common cancer affecting Australian women. Inequalities in clinical and psychosocial outcomes have existed for some time, affecting particularly women from rural areas and from areas of disadvantage. We have a limited understanding of how individual and area-level factors are related to each other, and their associations with survival and other clinical and psychosocial outcomes. Methods/Design This study will examine associations between breast cancer recurrence, survival and psychosocial outcomes (e.g. distress, unmet supportive care needs, quality of life). The study will use an innovative multilevel approach using area-level factors simultaneously with detailed individual-level factors to assess the relative importance of remoteness, socioeconomic and demographic factors, diagnostic and treatment pathways and processes, and supportive care utilization to clinical and psychosocial outcomes. The study will use telephone and self-administered questionnaires to collect individual-level data from approximately 3, 300 women ascertained from the Queensland Cancer Registry diagnosed with invasive breast cancer residing in 478 Statistical Local Areas Queensland in 2011 and 2012. Area-level data will be sourced from the Australian Bureau of Statistics census data. Geo-coding and spatial technology will be used to calculate road travel distances from patients' residence to diagnostic and treatment centres. Data analysis will include a combination of standard empirical procedures and multilevel modelling. Discussion The study will address the critical question of: what are the individual- or area-level factors associated with inequalities in outcomes from breast cancer? The findings will provide health care providers and policy makers with targeted information to improve the management of women with breast cancer, and inform the development of strategies to improve psychosocial care for women with breast cancer.

Differential expression of chemokine and matrix re-modelling genes is associated with contrasting schistosome-induced hepatopathology in murine models

The pathological outcomes of schistosomiasis are largely dependent on the molecular and cellular mechanisms of the host immune response. In this study, we investigated the contribution of variations in host gene expression to the contrasting hepatic pathology observed between two inbred mouse strains following Schistosoma japonicum infection. Whole genome microarray analysis was employed in conjunction with histological and immunohistochemical analysis to define and compare the hepatic gene expression profiles and cellular composition associated with the hepatopathology observed in S. japonicum-infected BALB/c and CBA mice. We show that the transcriptional profiles differ significantly between the two mouse strains with high statistical confidence. We identified specific genes correlating with the more severe pathology associated with CBA mice, as well as genes which may confer the milder degree of pathology associated with BALB/c mice. In BALB/c mice, neutrophil genes exhibited striking increases in expression, which coincided with the significantly greater accumulation of neutrophils at granulomatous regions seen in histological sections of hepatic tissue. In contrast, up-regulated expression of the eosinophil chemokine CCL24 in CBA mice paralleled the cellular influx of eosinophils to the hepatic granulomas. Additionally, there was greater down-regulation of genes involved in metabolic processes in CBA mice, reflecting the more pronounced hepatic damage in these mice. Profibrotic genes showed similar levels of expression in both mouse strains, as did genes associated with Th1 and Th2 responses. However, imbalances in expression of matrix metalloproteinases (e.g. MMP12, MMP13) and tissue inhibitors of metalloproteinases (TIMP1) may contribute to the contrasting pathology observed in the two strains. Overall, these results provide a more complete picture of the molecular and cellular mechanisms which govern the pathological outcome of hepatic schistosomiasis. This improved understanding of the immunopathogenesis in the murine model schistosomiasis provides the basis for a better appreciation of the complexities associated with chronic human schistosomiasis.

Modelling passenger flow at airport terminals : individual agent decision model for stochastic passenger behaviour

Airport system is complex. Passenger dynamics within it appear to be complicate as well. Passenger behaviours outside standard processes are regarded more significant in terms of public hazard and service rate issues. In this paper, we devised an individual agent decision model to simulate stochastic passenger behaviour in airport departure terminal. Bayesian networks are implemented into the decision making model to infer the probabilities that passengers choose to use any in-airport facilities. We aim to understand dynamics of the discretionary activities of passengers.

Numerical modelling of load bearing LSF Walls under fire conditions

Abstract. Fire safety of light gauge cold-formed steel frame (LSF) stud walls is significant in the design of buildings. In this research, finite element thermal models of both the traditional LSF wall panels with cavity insulation and the new LSF composite wall panels were developed to simulate their thermal behaviour under standard and real design fire conditions. Suitable thermal properties were proposed for plasterboards and insulations based on laboratory tests and literature review. The developed models were then validated by comparing their results with available fire test results. This paper presents the details of the developed finite element models of load bearing LSF wall panels and the thermal analysis results. It shows that finite element models can be used to simulate the thermal behaviour of load bearing LSF walls with varying configurations of insulations and plasterboards. Failure times of load bearing LSF walls were also predicted based on the results from finite element thermal analyses.

Higher education policy in China 1992-2010 : a genealogical analysis of the enterprise university

In the context of globalisation and the knowledge economy, universities worldwide are undertaking profound restructuring. Following these pressures for reform, the entity of the "enterprise university" has emerged internationally. Characteristics of this new form of educational institution can be summarised as deploying corporate styles of governance and management in order to enhance economic competitiveness and academic prestige. The higher education sector in China is no different, as it has undergone extensive reforms particularly since the "socialist market economy" was introduced in 1992. Hence, this study aims to investigate the emergence of the enterprise university in a Chinese context. The research question is: How have discourses of globalisation manifested and constituted new forms of social and educational governance within China's higher education sector during the period 1992 to 2010? Following this research question, the study uses a genealogical methodology to conduct a critical analysis of reforms in Chinese higher education (1992 -2010). At a national level, China's higher education policy is examined using the analytical framework of governmentality. This discloses the underlying rationalities and technologies of Chinese political authorities as they seek to refashion higher education policy and practice. At a local level, a case study of a particular university in China is conducted in order to facilitate understanding of reform at the national level. The aim is to uncover the kinds of educational subjects and spaces that have been constituted in the university's efforts to reconfigure itself within the context of national higher education reform. The study found that the concept of the enterprise university in China has features shared by the one that has emerged internationally. However, the analysis showed that the emergence of the enterprise university in China has specific social, economic, political, and cultural environments which impact on local educational practices. The study is significant because it is one of the few examples where the framework of governmentality.a research approach or perspective employed largely to examine Western society.is applied in a Chinese context, which is a non-Western and non-liberal democratic site.

Comments on the Australian Accounting Research Foundation's Legislation Policy Discussion Paper NO.4 (A framework for financial reporting by incorporated associations)

The Australian Accounting Research Foundation (AARF) recently issued Legislative Policy Discussion Paper No.4 which proposes a framework for financial reporting by Australian incorporated associations.This paper comments on both the merits and deficiencies of the proposal. In particular it notes that the proposal simply advocates that the application of differential reporting, accounting standards, and the conceptual framework be imposed on incorporated associations by amended statutes. It is noted that in light of long experience in the corporate sector, he espoused benefits of such a move may not eventuate. Further, concern is expressed that the proposal is a blank cheque one because of the inadequacy of existing relevant accounting standards and the proposal to introduce new relevant standards. Another major defect in the proposal is that it emanates from accountants who acknowledge in their conceptual framework, the need for external reports to report on performance through both financial and non-financial reporting methods. Despite that acknowledgment, the standard set of external reports prepared by accountants do not measure performance as defined in their own conceptual framework (SAC 2) and in their auditing pronouncements (AUP 33), and they have restricted their domain to financial reporting (SAC 2). Accordingly the proposal appears to be seriously deficient and it is suggested that it be rejected and a new proposal be prepared by a multi-party group free from vested interests.

Understanding teachers' reporting of child sexual abuse : measurement methods matter

The present study considered factors influencing teachers' reporting of child sexual abuse (CSA). Conducted in three Australian jurisdictions with different reporting laws and policies, the study focused on teachers' actual past and anticipated future reporting of CSA. A sample of 470 teachers within randomly selected rural and urban schools was surveyed, to identify training and experience; knowledge of reporting legislation and policy; attitudes; and reporting practices. Factors influencing actual past reporting and anticipated future reporting were identified using logistic regression modelling. This is the first study to simultaneously examine the effect of important influences in reporting practice using both retrospective and prospective approaches across jurisdictions with different reporting laws. Teachers who have actually reported CSA in the past are more likely have higher levels of policy knowledge, and hold more positive attitudes towards reporting CSA along three specific dimensions: commitment to the reporting role; confidence in the system's effective response to their reporting; and they are more likely to be able to override their concerns about the consequences of their reporting. Teachers indicating intention to report hypothetical scenarios are more likely to hold reasonable grounds for suspecting CSA, to recognise that significant harm has been caused to the child, to know that their school policy requires a report, and to be able to override their concerns about the consequences of their reporting.