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.

Knowledge Management Strategies in Technopreneurial Firms

Intellectual capital is increasingly viewed as the single most important asset of organisations. While most large organisations have resources, staff and plans in place to support and develop intellectual capital, many smaller organisations do not. In particular technology-oriented young firms (technopreneurial firms), which play an important role in innovation and commercialisation of new ideas, do not have well developed strategies for managing their intellectual capital. These firms are often founded by engineers, scientists or academics who posses great scientific/technological knowledge, but limited know-how in other aspects of managing a business including knowledge management (KM). Successful managing and integrating their specialised knowledge is of particular importance when it comes to developing a new product or process. This article therefore focuses on developing strategies for knowledge management within technopreneurial organisations as they incorporate technology and strive to build and retain a productive and creative workforce.

Shadow boxing with an imaginary enemy : a response to "Law and Order Blues"

In our rejoinder to Don Weatherburn's paper,"Law and Order Blues", we do not take issue with his advocacy of the need to take crime seriously and to foster a more rational approach to the problems it poses. Where differences do emerge is (1) with his claim that he is willing to do so whilst we (in our different ways) are not; and (2) on the question of what this involves. Of particular concern is the way in which his argument proceeds by a combination of simple misrepresentation of the positions it seeks to disparage, and silence concerning issues of real substance where intellectual debate and exchange would be welcome and useful. Our paper challenges, in turn, the misrepresentation of Indermaur's analysis of trends in violent crime, the misrepresentation of Hogg and Brown's Rethinking Law and Order, the misrepresentation of the findings of some of the research into the effectiveness of punitive policies and the silence on sexual assault in "Law and Order Blues". We suggest that his silence on sexual assault reflects a more widespread unwillingness to acknowledge the methodological problems that arise in the measurement of crime because such problems severely limit the extent to which confident assertions can be made about prevalence and trends.

An examination of the liability of a construction contract certifier who gets it wrong

Construction contracts often provide that decisions under the contract will be made by a certifier. This paper reviews the liability issues when a certifier makes a mistake. We do that in light of recent pronouncements by the High Court of Australia and the New South Wales Court of Appeal on negligence. We look at this question in the context of traditional construction contract arrangements and also consider the implications for Public Private Partnerships and the typical contract arrangements entered into to facilitate these transactions.

Vulnerability held not to be pre-requisite for establishing a duty of care in claims of pure economic Loss

Case note Apache Energy Ltd v Alcoa of Australia Ltd (No 2) [2013] In 2011, headlines were made when Alcoa sued Apache Energy and its partners for $158 million, a loss it claimed was a consequence of Apache Energy failing to adequately inspect and maintain the gas pipelines that supplied the gas used by Alcoa in its business. As the loss was not a consequence of any property damage or injury to Alcoa, the loss is characterised as pure economic loss...

Calligraphy and causation : two obstetric management cases

Child born with gross hydrocephalus - cerebral palsy - questions surrounding obstetrician's notes - ultrasound not ordered - illegible handwriting - importance of legible, accurate and detailed medical records - causation - child born with congenital varicella syndrome (CVS) - chicken pox - forseeability of risk.

Brief guided imagery and body scanning interventions reduce food cravings

Elaborated Intrusion (EI) Theory proposes that cravings occur when involuntary thoughts about food are elaborated; a key part of elaboration is affectively-charged imagery. Craving can be weakened by working memory tasks that block imagery. EI Theory predicts that cravings should also be reduced by preventing involuntary thoughts being elaborated in the first place. Research has found that imagery techniques such as body scanning and guided imagery can reduce the occurrence of food thoughts. This study tested the prediction that these techniques also reduce craving. We asked participants to abstain from food overnight, and then to carry out 10 min of body scanning, guided imagery, or a control mind wandering task. They rated their craving at 10 points during the task on a single item measure, and before and after the task using the Craving Experience Questionnaire. While craving rose during the task for the mind wandering group, neither the guided imagery nor body scanning group showed an increase. These effects were not detected by the CEQ, suggesting that they are only present during the competing task. As they require no devices or materials and are unobtrusive, brief guided imagery strategies might form useful components of weight loss programmes that attempt to address cravings.

Shadow boxing with an imaginary enemy : a response to “law and order blues”

In our rejoinder to Don Weatherburn's paper, “Law and Order Blues”, we do not take issue with his advocacy of the need to take crime seriously and to foster a more rational approach to the problems it poses. Where differences do emerge is (1) with his claim that he is willing to do so whilst we (in our different ways) are not; and (2) on the question of what this involves. Of particular concern is the way in which his argument proceeds by a combination of simple misrepresentation of the positions it seeks to disparage, and silence concerning issues of real substance where intellectual debate and exchange would be welcome and useful. Our paper challenges, in turn, the misrepresentation of Indermaur's analysis of trends in violent crime, the misrepresentation of Hogg and Brown's Rethinking Law and Order, the misrepresentation of the findings of some of the research into the effectiveness of punitive policies and the silence on sexual assault in “Law and Order Blues”. We suggest that his silence on sexual assault reflects a more widespread unwillingness to acknowledge the methodological problems that arise in the measurement of crime because such problems severely limit the extent to which confident assertions can be made about prevalence and trends.

Sustainable retirement village for older people: A case study in Brisbane, Australia

Retirement villages are regarded as a viable accommodation option for the ever increasing ageing population in Australia. This paper aims to identify sustainability features and practices adopted in retirement villages and associated benefits to improve the life quality of older people. A case study of an existing retirement village 10kms from Brisbane CBD was conducted involving a series of interviews with the village managers and residents together with documents relating to the village's operations and activities. The environmentally friendly features that were incorporated into the development mainly include green design for the site and floor plan and waste management in daily operation. More importantly, a variety of facilities are provided to strengthen the social engagement and interactions among the residents. Additionally, different daily services are provided to assist independent living and improve the health conditions of residents. Also, the relatively low vacancy rate in this village indicates that these sustainability features offer good value of money for the residents. The paper provides a first look at sustainable retirement villages in terms of triple bottom line sustainability with emphasis on social aspects, reveals the importance in maintaining an appropriate balance, and provides examples of how this can be achieved in practice.

Developing a framework for subcontractor appraisal using a balanced scorecard

Subcontractors contribute significantly to construction projects and their performance can seriously affect over-all project success. It is crucial, therefore, to appraise the performance of subcontractors to ensure they satisfy the client's expectations and project requirements. To increase the transparency and accuracy of subcontractor appraisal, the baseline and target performance levels should be set at the outset so that the appraisers and those being appraised realize exactly what standards are to be achieved. The balanced scorecard, being a powerful tool for performance appraisal, offers a potentially good approach for modeling the subcontractor appraisal process. In this paper, an approach to developing a balanced scorecard subcontractor appraisal model is proposed and demonstrated through a questionnaire survey administered in Hong Kong and from which the baseline and target performance levels for large-scale skilled subcontractors are identified. A case example is used to illustrate the operation of the model. Finally, a means by which the model may be validated is demonstrated through the use of field experts. The results demonstrate the feasibility of developing a balanced scorecard model that can help improve the transparency of subcontractor appraisal despite the baseline and target performance levels changing according to the project characteristics, subcontractor categories and size.

Critical reflections on the use of participatory methodologies to build evaluation capacities in international development organisations

"In this chapter the authors present a critique of Participatory Evaluation as worked in development projects, in this case, in Nepal. The article works between established claims that Participatory Evaluation builds capacity at programmatic and organisational levels, and the specific experiences of these claims in the authors’ current work. They highlight the need to address key difficulties such as high turn-over of staff and resulting loss of capacity to engage in Participatory Evaluation, and the difficulty of communication between academic as compared with local practical wisdoms. A key issue is the challenge of addressing the inevitable issues of power inequities that such approaches encounter. While Participatory Evaluation has been around for some time, it has only enjoyed more widespread recognition of its value in comparatively recent times, with its uptake in international development environments. To this extent, the practice is still in its early stages of development, and Jo, June and Michael’s work contributes to strengthening and more comprehensively understanding it. With regard to the meta-theme of this publication, this chapter is an example of how context not only influences the methodology to be used and the praxis of how it is to be used, but contributes to early explication of the core nature of an emerging methodology."

Effect of strong acids on red mud structural and fluoride adsorption properties

The removal of fluoride using red mud has been improved by acidifying red mud with hydrochloric, nitric and sulphuric acid. This investigation shows that the removal of fluoride using red mud is significantly improved if red mud is initially acidified. The acidification of red mud causes sodalite and cancrinite phases to dissociate, confirmed by the release of sodium and aluminium into solution as well as the disappearance of sodalite bands and peaks in infrared and X-ray diffraction data. The dissolution of these mineral phases increases the amount of available iron and aluminium oxide/hydroxide sites that are accessible for the adsorption of fluoride. The removal of fluoride is dependent on the charge of iron and aluminium oxide/hydroxides on the surface of red mud. Acidifying red mud with hydrochloric, nitric and sulphuric acid resulted in surface sites of the form ≡ SOH2+ and ≡ SOH. Optimum removal is obtained when the majority of surface sites are in the form ≡ SOH2+ as the substitution of a fluoride ion doesn’t cause a significant increase in pH. This investigation shows the importance of having a low and consistent pH for the removal of fluoride from aqueous solutions using red mud.

Origins of the observed asymmetry in out-of-field dose from a linac fitted with an external micro-MLC

Objective Recently, Taylor et al. reported that use of the BrainLAB m3 microMLC, for stereotactic radiosurgery, results in a decreased out-of-field dose in the direction of leaf-motion compared to the outof- field dose measured in the direction orthogonal to leaf-motion [1]. It was recommended that, where possible, patients should be treated with their superior–inferior axes aligned with the microMLCs leafmotion direction, to minimise out-of-field doses [1]. This study aimed, therefore, to examine the causes of this asymmetry in outof- field dose and, in particular, to establish that a similar recommendation need not be made for radiotherapy treatments delivered by linear accelerators without external micro-collimation systems. Methods Monte Carlo simulations were used to study out-of-field dose from different linear accelerators (the Varian Clinacs 21iX and 600C and the Elekta Precise) with and without internal MLCs and external microMLCs [2]. Results Simulation results for the Varian Clinac 600C linear accelerator with BrainLAB m3 microMLC confirm Taylor et als [1] published experimental data. The out-of-field dose in the leaf motion direction is deposited by lower energy (more obliquely scattered) photons than the out-of-field dose in the orthogonal direction. Linear accelerators without microMLCs produce no asymmetry in out-offield dose. Conclusions The asymmetry in out-of-field dose previously measured by Taylor et al. [1] results from the shielding characteristics of the BrainLAB m3 microMLC device and is not produced by the linear accelerator to which it is attached.

The project approach in early childhood education for sustainability : examplars from Korea and Australia

Sustainability is a global issue that urgently needs addressing, and for which the most serious consequences are for children and future generations. This insightful research text tackles one of the most significant contemporary issues of our times – the nexus between society and environment – and how early childhood education can contribute to sustainable living. By offering international and multidisciplinary research perspectives on Early Childhood Education for Sustainability, each chapter explores and investigates the complex topic of sustainability and its relationship to early childhood education. A particular emphasis that runs through this text is young children as empowered citizens, capable of both contributing to and creating change for sustainability. The chapter authors work from, or are aligned with, a transformative education paradigm that suggests the socio-constructivist frameworks currently underpinning Early Childhood Education require reframing in light of the social transformations necessary to address humanity’s unsustainable, unjust and unhealthy living patterns. This research text is designed to be provocative and challenging; in so doing it seeks to encourage exploration of current understandings about Early Childhood Education for Sustainability, offers new dimensions for more deeply informed practice, and proposes avenues for further research in this field.

Calibration of the biotrainer pro activity monitor in children

The unique physical and movement characteristics of children necessitate the development of accelerometer equations and cut points that are population specific. The purpose of this study is to develop an ecologically valid cut point for the Biotrainer Pro monitor that reflects a threshold for moderate-intensity physical activity in elementary school children. A sample of 30 children (ages 8-12) wore a Biotrainer monitor while completing a series of 7 movement tasks (calibration phase) and while participating in an organized group activity (cross-validation phase). Videotapes from each session were processed using a computerized direct-observation technique to provide a criterion measure of physical activity. Analyses involved the use of mixed-model regression and receiver operator characteristic (ROC) curves. The results indicated that a cut point of 4 counts/min provides the optimal balance between the related needs for sensitivity (accurately detecting activity) and specificity (limiting misclassification of activity as inactivity). Results with the cross-validation data demonstrated that this value yielded the best overall kappa (.58) and a high classification agreement (84%) for activity determination. The specificity of 93% demonstrates that the proposed cut point can accurately detect activity; however, the lower sensitivity value of 61% suggests that some minutes of activity might be incorrectly classified as inactivity. The cut point of 4 counts/min provides an ecologically valid cut point to capture physical activity in children using the Biotrainer Pro activity monitor.