The impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy on survival in patients with a history of breast cancer – a population-based data linkage study

Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy (BSO) is recommended in BRCA positive women, while in women from the general population, hysterectomy plus BSO may increase the risk of overall mortality. The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population-base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (n=21,067). We fitted flexible parametric breast cancer specific and overall survival models with 95% confidence intervals (also known as Royston-Parmar models) to assess the impact of risk-reducing surgery (removal of uterus, one or both ovaries). We also stratified analyses by age 20-49 and 50-79 years, respectively. Overall, 1,426 women (7%) underwent risk-reducing surgery (13% of premenopausal women and 3% of postmenopausal women). No women who had risk-reducing surgery, compared to 171 who did not have risk-reducing surgery developed a gynaecological cancer. Overall, 3,165 (15%) women died, including 2,195 (10%) from breast cancer. Hysterectomy plus BSO was associated with significantly reduced risk of death overall (adjusted HR = 0.69, 95% CI 0.53-0.89; P =0.005). Risk reduction was greater among premenopausal women, whose risk of death halved (HR, 0.45; 95% CI, 0.25-0.79; P < 0.006). This was largely driven by reduction in breast cancer-specific mortality (HR, 0.43; 95% CI, 0.24-0.79; P < 0.006). This population-based study found that risk-reducing surgery halved the mortality risk for premenopausal breast cancer patients. Replication of our results in independent cohorts, and subsequently randomised trials are needed to confirm these findings.

Indigenous cultural values and journalism in the Asia-Pacific region : a brief history of Māori journalism

A number of scholars in the Asia-Pacific region have in recent years pointed to the importance that cultural values play in influencing journalistic practices. The Asian values debate was followed up with empirical studies showing actual differences in news content when comparing Asian and Western journalism. At the same time, such studies have focused on national cultures only. This paper instead examines the issue against the background of an Indigenous culture in the Asia-Pacific region. It explores the way in which cultural values may have played a role in the journalistic practice of Māori journalists in Aotearoa New Zealand over the past nearly 200 years and finds numerous examples that demonstrate the significance of taking cultural values into account. The paper argues that the role played by cultural values is important to examine further, particularly in relation to journalistic practices amongst sub-national news cultures across the Asia-Pacific region.

Modeling the effectiveness of counterterrorism interventions

After the terrorist attacks in the United States on 11 September 2001, terrorism and counter-terrorism efforts moved to the front of popular consciousness and became the focus of national security for governments worldwide. With this increased attention came an urgent interest in understanding and identifying what works in fighting terrorism (Belasco 2010). For Australia, understanding the relative effectiveness of counter-terrorism efforts in nearby neighbours of Indonesia, Thailand and the Philippines is highly relevant for our country's national security. Indonesia, Thailand and the Philippines are all countries that are important to Australia not just because of geographic proximity, but also because of a history of economic ties and the role these countries play as Australia’s regional partners...

Re-reading the reading lesson : episodes in the history of reading pedagogy

Reading pedagogy is constantly an object of discussion and debate in contemporary policy and practice but is rarely a matter for historical inquiry. This paper reports from a recent study of the history of reading pedagogy in Australia and beyond. It focuses on a recurring figure in the historical record—the ‘reading lesson’. Presented as a distinctive trope, the reading lesson is traced in its regularity in and through the discourse of reading pedagogy, starting in 1930s Australia and moving back into 19th-century Europe, and with specific reference to the UK and the USA. Teaching reading is expressly identified as a moral project—something that, it can be argued, clearly continues into the present.

A history of environmental management in the field in Queensland : episodes of activity

This paper reviews a wide range of literature on environmental management in the field in Queensland, and analyzes this by period and by author. An episodic pattern of activities since European settlement is evident. Periods of exploration (pre-1950) and inventory- compilation (ca. 1950-1970) were followed by two decades of media and non-government organization campaigning (ca. 1970-1990), then an era dominated by government regulatory action (ca. 1990-2010). These eras dominated public perception of what was happening in environmental practice. They were delineated by historic ‘interventions’ (summarily, the end of World War II, the 1971 inflationary crisis, and computerization respectively).

Embedding nature into cities – a case study of economic lessons from Singapore

Built environment design around the world faces a number of 21st Century challenges such as rising urban heat island effect and rising pollution, which are further worsened by consequences of climate change and increasing urban populations. Such challenges have caused cities around the globe to investigate options that can help to significantly reduce the environmental pressures from current and future development, requiring new areas of innovation. One such area is ‘Biophilic Urbanism’, which refers to the use of natural elements as design features in urban centres to assist efforts to address climate change issues in rapidly growing economies. Singapore is an illustration of a thriving economy that exemplifies the value of embedding nature into its built environment. The significance of urban green space has been recognised in Singapore as early as the 1960s when Lee Kuan Yew embarked on the ‘Garden City’ concept. 50 years later, Singapore has achieved its Garden City goal and is now entering a new era of sustainability, to create a ‘City in a Garden’. Although the economics of such efforts is not entirely understood, the city of Singapore has continued to pursue visions of becoming a biophilic city. Indeed, there appears to be important lessons to be learned from a city that has challenged the preconceived notion that protecting vegetation in a city is not economically viable. Hence, this paper will discuss the case study of Singapore to highlight the drivers, along with the economic considerations identified along the way. The conclusions have implications for expanding the notion of biophilic urbanism, particularly in the Australian context by discussing the lessons learned from this city. The research is part of Sustainable Built Environment National Research Centre, and has been developed in collaboration with the Curtin University Sustainability Policy Institute.

A History of Popular Indigenous Music

SINCE THE INVENTION OF recording technologies like the phonograph in the late 1800s, Indigenous music has been performed and recorded across Australia for a wide range of audiences. In the early twentieth century, for instance, music was recorded by anthropologists keen to capture the sounds of a culture that was believed to be in rapid decline (Thomas). Individual performers were not considered important in these recordings; their music was produced for scientific posterity rather than popular pleasure. And even though Aboriginal participation in local music festivals, touring vaudeville shows, and community gatherings was well documented throughout the twentieth century, it was not until the 1950s that Indigenous “pop stars” began to sell records for mass consumption(Dunbar-Hall and Gibson). Yet, with the persistence of recording artists like Jimmy Little over the past sixty years, Indigenous musicians have steadily gained prominence in Australia’s mainstream. This has been particularly true of the past twenty years, especially since the Sydney Olympics, where promotional strategies have brought about a new popular pride in musical achievements, based upon a celebrated history of diverse sounds and voices.

Book review "Moving Innovation: A History of Computer Animation by Tom Sito , The MIT Press: Cambridge, MA, 2013"

As a Lecturer of Animation History and 3D Computer Animator, I received a copy of Moving Innovation: A History of Computer Animation by Tom Sito with an element of anticipation in the hope that this text would clarify the complex evolution of Computer Graphics (CG). Tom Sito did not disappoint, as this text weaves together the multiple development streams and convergent technologies and techniques throughout history that would ultimately result in modern CG. Universities now have students who have never known a world without computer animation and many students are younger than the first 3D CG animated feature film, Toy Story (1996); this text is ideal for teaching computer animation history and, as I would argue, it also provides a model for engaging young students in the study of animation history in general. This is because Sito places the development of computer animation within the context of its pre-digital ancestry and throughout the text he continues to link the discussion to the broader history of animation, its pioneers, technologies and techniques...

On the (ir)relevance of rates of return measures of economic performance to small boats

A common measure of the economic performance of different fleet segments in fisheries is the rate of return on capital. However, in the English Channel (UK), observed changes in the fleet structure are at odds with expectations given the observed rates of return on capital. This disjunction between expected and observed behaviour raises the question as to the appropriateness of rate of return on capital as a measure of economic performance for small boats whose main input is often non-wage labour. In this paper, an alternative performance indicator is developed based on returns on owner-operator labour. This indicator appears to be of more relevance to small scale boats than the traditional returns on capital, and a better indicator of the direction of adjustment in the fishery.

History of Work Health and Safety Laws

This definitive guide (formerly the Australian Master OHS & Environment Guide) is a first point of reference for work health and safety best practice and strategy. Written by WHS and legal experts, the guide provides key information on the challenges that professionals and organisations face in relation to WHS. It includes valuable information on legal obligations and risk management, and covers the latest changes brought about by the Work Health and Safety Act.

The driving visual field and a history of motor vehicle collision involvement in older drivers: A population-based examination

Purpose We designed a visual field test focused on the field utilized while driving to examine associations between field impairment and motor vehicle collision involvement in 2,000 drivers ≥70 years old. Methods The "driving visual field test" involved measuring light sensitivity for 20 targets in each eye, extending 15° superiorly, 30° inferiorly, 60° temporally and 30° nasally. The target locations were selected on the basis that they fell within the field region utilized when viewing through the windshield of a vehicle or viewing the dashboard while driving. Monocular fields were combined into a binocular field based on the more sensitive point from each eye. Severe impairment in the overall field or a region was defined as average sensitivity in the lowest quartile of sensitivity. At-fault collision involvement for five years prior to enrollment was obtained from state records. Poisson regression was used to calculate crude and adjusted rate ratios examining the association between field impairment and at-fault collision involvement. Results Drivers with severe binocular field impairment in the overall driving visual field had a 40% increased rate of at-fault collision involvement (RR 1.40, 95%CI 1.07-1.83). Impairment in the lower and left fields was associated with elevated collision rates (RR 1.40 95%CI 1.07-1.82 and RR 1.49, 95%CI 1.15-1.92, respectively), whereas impairment in the upper and right field regions was not. Conclusions Results suggest that older drivers with severe impairment in the lower or left region of the driving visual field are more likely to have a history of at-fault collision involvement.

Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes : Development of a potential measure of diabetic peripheral neuropathy

Purpose To investigate longitudinal changes of subbasal nerve plexus (SNP) morphology and its relationship with conventional measures of neuropathy in individuals with diabetes. Methods A cohort of 147 individuals with type 1 diabetes and 60 age-balanced controls underwent detailed assessment of clinical and metabolic factors, neurologic deficits, quantitative sensory testing, nerve conduction studies and corneal confocal microscopy at baseline and four subsequent annual visits. The SNP parameters included corneal nerve fiber density (CNFD), branch density (CNBD) and fiber length (CNFL) and were quantified using a fully-automated algorithm. Linear mixed models were fitted to examine the changes in corneal nerve parameters over time. Results At baseline, 27% of the participants had mild diabetic neuropathy. All SNP parameters were significantly lower in the neuropathy group compared to controls (P<0.05). Overall, 89% of participants examined at baseline also completed the final visit. There was no clinically significant change to health and metabolic parameters and neuropathy measures from baseline to the final visit. Linear mixed model revealed a significant linear decline of CNFD (annual change rate, -0.9 nerve/mm2, P=0.01) in the neuropathy group compared to controls, which was associated with age (β=-0.06, P=0.04) and duration of diabetes (β=-0.08, P=0.03). In the neuropathy group, absolute changes of CNBD and CNFL showed moderate correlations with peroneal conduction velocity and cold sensation threshold, respectively (rs, 0.38 and 0.40, P<0.05). Conclusion This study demonstrates dynamic small fiber damage at the SNP, thus providing justification for our ongoing efforts to establish corneal nerve morphology as an appropriate adjunct to conventional measures of DPN.