A single institution experience of streptozocin/fluorouracil combination chemotherapy : a case series

Background The combination chemotherapy regimen of streptozocin and 5-fluorouracil (FU/STZ) has been used for the treatment of metastatic neuroendocrine tumours. Aim The aim of this study was to analyse the use of this regimen in a tertiary oncology referral centre over a 10-year period. Method We retrospectively analysed nine cases from February 2000 to May 2010. Patient demographics, chemotherapy schedule, toxicities, progression-free and overall survival were tabulated for each patient. Result The median progression-free survival was 17 months (range 3-48+ months), and overall survival 31 months (range 12-53+ months) with no toxicity related deaths. Conclusion FU/STZ was a well-tolerated regimen that produced significant benefit in the setting of metastatic and progressive disease. Our case series demonstrated comparable progression-free survival and overall survival in relation to randomized controlled studies and previous case series. © Royal Academy of Medicine in Ireland 2011.

Advances in skin cancer early detection and diagnosis

OBJECTIVES: To provide an overview of 1) traditional methods of skin cancer early detection, 2) current technologies for skin cancer detection, and 3) evolving practice models of early detection. DATA SOURCES: Peer-reviewed databased articles and reviews, scholarly texts, and Web-based resources. CONCLUSION: Early detection of skin cancer through established methods or newer technologies is critical for reducing both skin cancer mortality and the overall skin cancer burden. IMPLICATIONS FOR NURSING PRACTICE: A basic knowledge of recommended skin examination guidelines and risk factors for skin cancer, traditional methods to further examine lesions that are suspicious for skin cancer and evolving detection technologies can guide patient education and skin inspection decisions.

Computer-assisted measurements of coronal knee joint laxity in vitro are related to low-stress behavior rather than structural properties of the collateral ligaments

The relationship between coronal knee laxity and the restraining properties of the collateral ligaments remains unknown. This study investigated correlations between the structural properties of the collateral ligaments and stress angles used in computer-assisted total knee arthroplasty (TKA), measured with an optically based navigation system. Ten fresh-frozen cadaveric knees (mean age: 81 ± 11 years) were dissected to leave the menisci, cruciate ligaments, posterior joint capsule and collateral ligaments. The resected femur and tibia were rigidly secured within a test system which permitted kinematic registration of the knee using a commercially available image-free navigation system. Frontal plane knee alignment and varus-valgus stress angles were acquired. The force applied during varus-valgus testing was quantified. Medial and lateral bone-collateral ligament-bone specimens were then prepared, mounted within a uni-axial materials testing machine, and extended to failure. Force and displacement data were used to calculate the principal structural properties of the ligaments. The mean varus laxity was 4 ± 1° and the mean valgus laxity was 4 ± 2°. The corresponding mean manual force applied was 10 ± 3 N and 11 ± 4 N, respectively. While measures of knee laxity were independent of the ultimate tensile strength and stiffness of the collateral ligaments, there was a significant correlation between the force applied during stress testing and the instantaneous stiffness of the medial (r = 0.91, p = 0.001) and lateral (r = 0.68, p = 0.04) collateral ligaments. These findings suggest that clinicians may perceive a rate of change of ligament stiffness as the end-point during assessment of collateral knee laxity.

Neoliberal issues in public education

We finished penning this special issue and sending it to press on martin Luther King Jr. Day. We take pause, honoring Martin Luther King's memory and we are dedicating this project to his profound vision as a public intellectual and world activist for whom two of his breakthrough ideas are particularly relevant to this collection. The guest editors, along with the contributors, are reinforcing his messages for the current and future eras that "leadership is the action of ideas to make change, through the agency of individuals" (p. 74) and that "Injustice anywhere is a threat to justice everywhere" (p. 75) (see Temes 1996).

Modeling users’ web search behavior and their cognitive styles

Previous studies have shown that users’ cognitive styles play an important role during Web searching. However, only limited studies have showed the relationship between cognitive styles and Web search behavior. Most importantly, it is not clear which components of Web search behavior are influenced by cognitive styles. This paper examines the relationships between users’ cognitive styles and their Web searching and develops a model that portrays the relationship. The study uses qualitative and quantitative analyses to inform the study results based on data gathered from 50 participants. A questionnaire was utilised to collect participants’ demographic information, and Riding’s (1991) Cognitive Style Analysis (CSA) test to assess their cognitive styles. Results show that users’ cognitive styles influenced their information searching strategies, query reformulation behaviour, Web navigational styles and information processing approaches. The user model developed in this study depicts the fundamental relationships between users’ Web search behavior and their cognitive styles. Modeling Web search behavior with a greater understanding of user’s cognitive styles can help information science researchers and information systems designers to bridge the semantic gap between the user and the systems. Implications of the research for theory and practice, and future work are discussed.

Coexpression of epidermal growth factor receptor with related factors is associated with a poor prognosis in non-small-cell lung cancer

The epidermal growth factor receptor (EGFR) is commonly expressed in non-small-cell lung cancer (NSCLC) and promotes a host of mechanisms involved in tumorigenesis. However, EGFR expression does not reliably predict prognosis or response to EGFR-targeted therapies. The data from two previous studies of a series of 181 consecutive surgically resected stage I-IIIA NSCLC patients who had survived in excess of 60 days were explored. Of these patients, tissue was available for evaluation of EGFR in 179 patients, carbonic anhydrase (CA) IX in 177 patients and matrix metalloproteinase-9 (MMP-9) in 169 patients. We have previously reported an association between EGFR expression and MMP-9 expression. We have also reported that MMP-9 (P=0.001) and perinuclear (p)CA IX (P=0.03) but not EGFR expression were associated with a poor prognosis. Perinuclear CA IX expression was also associated with EGFR expression (P<0.001). Multivariate analysis demonstrated that coexpression of MMP-9 with EGFR conferred a worse prognosis than the expression of MMP-9 alone (P<0.001) and coexpression of EGFR and pCA IX conferred a worse prognosis than pCA IX alone (P=0.05). A model was then developed where the study population was divided into three groups: group 1 had expression of EGFR without coexpression of MMP-9 or pCA IX (number=21); group 2 had no expression of EGFR (number=75); and group 3 had coexpression of EGFR with pCA IX or MMP-9 or both (number=70). Group 3 had a worse prognosis than either groups 1 or 2 (P=0.0003 and 0.027, respectively) and group 1 had a better prognosis than group 2 (P=0.036). These data identify two cohorts of EGFR-positive patients with diametrically opposite prognoses. The group expressing either EGFR and or both MMP-9 and pCA IX may identify a group of patients with activated EGFR, which is of clinical relevance with the advent of EGFR-targeted therapies. © 2004 Cancer Research UK.

The obesity epidemic : both energy intake and physical activity contribute

Recent data from Australia, the United States and Europe show increased self-reported energy intake associated with obesity, in contrast to earlier suggestions that the obesity epidemic has occurred despite minimal or no increase in per capita energy intake from food. The effect of increased energy intake is compounded by sedentary lifestyles. Both physical activity and nutrition must be addressed to reduce the prevalence of obesity and improve the health of Australians.

Strategies for developing and delivering a parental physical activity intervention : answers to the what and how

Background Parents are at risk for physical inactivity; however, few studies have designed physical activity (PA) interventions specifically applied to individuals with young children. To ensure the effectiveness of interventions, it may be useful to first elicit the needs from the target population and incorporate salient strategies identified to the design and delivery of a resultant intervention. We aimed to explore strategies for what to include in and how to best deliver a program designed to increase parental PA. Methods Twelve parents (6 mothers, 6 fathers) of children younger than 5 years participated in focus group discussions exploring strategies for an intervention program designed to increase parental PA. Results A range of themes such as Focus on the Children and Flexible Life/Family Plans imbedded in strategies such as persuasion and information, problem-solving, skill building, and environmental approaches were identified. In addition, a range of strategies for how to best deliver a parental PA intervention evidenced in emerging themes such as Diverse and Brief and Individualized Approach was discussed. Conclusions Future research should continue to adopt a ground up, community-based approach to the development and implementation of interventions for this at-risk group to ensure sustained involvement in regular PA.

A vibrational spectroscopic study of the phosphate mineral minyulite KAl2(OH,F)(PO4)2⋅4(H2O) and in comparison with wardite

Vibrational spectroscopy enables subtle details of the molecular structure of minyulite KAl2(OH,F)(PO4)2⋅4(H2O). Single crystals of a pure phase from a Brazilian pegmatite were used. Minyulite belongs to the orthorhombic crystal system. This indicates that it has three axes of unequal length, yet all are perpendicular to each other. The infrared and Raman spectroscopy were applied to compare the structure of minyulite with wardite. The reason for the comparison is that both are Al containing phosphate minerals. The Raman spectrum of minyulite shows an intense band at 1012 cm−1 assigned to the ν1PO43- symmetric stretching vibrations. A series of low intensity Raman bands at 1047, 1077, 1091 and 1105 cm−1 are assigned to the ν3PO43- antisymmetric stretching modes. The Raman bands at 1136, 1155, 1176 and 1190 cm−1 are assigned to AlOH deformation modes. The infrared band at 1014 cm−1 is ascribed to the PO43- ν1 symmetric stretching vibrational mode. The infrared bands at 1049, 1071, 1091 and 1123 cm−1 are attributed to the PO43- ν3 antisymmetric stretching vibrations. The infrared bands at 1123, 1146 and 1157 cm−1 are attributed to AlOH deformation modes. Raman bands at 575, 592, 606 and 628 cm−1 are assigned to the ν4 out of plane bending modes of the PO43- unit. In the 2600–3800 cm−1 spectral range, Raman bands for minyulite are found at 3661, 3669 and 3692 cm−1 are assigned to AlOH/AlF stretching vibrations. Broad infrared bands are also found at 2904, 3105, 3307, 3453 and 3523 cm−1. Raman bands at 3225, 3324 cm−1 are assigned to water stretching vibrations. A comparison is made with the vibrational spectra of wardite. Raman spectroscopy complimented with infrared spectroscopy has enabled aspects of the structure of minyulite to be ascertained and compared with that of other phosphate minerals.

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.

Exploring socioecological correlates of active living in retirement village residents

This study explored individual, social, and built environmental attributes in and outside of the retirement village setting and associations with various active living outcomes including objectively measured physical activity, specific walking behaviors, and social participation. Residents in Perth, Australia (N = 323), were surveyed on environmental perceptions of the village and surrounding neighborhood, self-reported physical activity, and demographic characteristics and wore accelerometers. Managers (N = 32) were surveyed on village characteristics, and objective neighborhood measures were generated in a Geographic Information System (GIS). Results indicated that built- and social-environmental attributes within and outside of retirement villages were associated with active living among residents; however, salient attributes varied depending on the specific outcome considered. Findings suggest that locating villages close to destinations is important for walking and that locating them close to previous and familiar neighborhoods is important for social participation. Further understanding and consideration into retirement village designs that promote both walking and social participation are needed.

Pharmacists' understanding of their CPD obligations

The article offers information on the requirement of the continuing professional development (CPD) training and lifelong learning for the legal registration of the Australian practitioners and pharmacists. Topics discussed include reviewing the competitiveness and pharmacy practice benefits, strategic planning for getting the requirement of CPD, and improving and broadening of the knowledge and developing the personal and professional qualities of pharmacists.

Hydroxyl radical formation in the gas phase oxidation of distonic 2-methylphenyl radical cations

The reactions of distonic 4-(N, N, N-trimethylammonium)-2-methylphenyl and 5-(N, N, N-trimethylammonium)-2-methylphenyl radical cations (m/z 149) with O-2 are studied in the gas phase using ion-trap mass spectrometry. Photodissociation (PD) of halogenated precursors gives rise to the target distonic charge-tagged methylphenyl radical whereas collision-induced dissociation (CID) is found to produce unreactive radical ions. The PD generated distonic radicals, however, react rapidly with O-2 to form \[M + O2](center dot+) and \[M + O-2 - OH](center dot+) ions, detected at m/z 181 and m/z 164, respectively. Quantum chemical calculations using G3SX(MP3) and M06-2X theories are deployed to examine key decomposition pathways of the 5-(N, N, N-trimethylammonium)-2-methylphenylperoxyl radical and rationalise the observed product ions. The prevailing product mechanism involves a 1,5- H shift in the peroxyl radical forming a QOOH-type intermediate that subsequently eliminates (OH)-O-center dot to yield charge-tagged 2-quinone methide. Our study suggests that the analogous process should occur for the neutral methylphenyl + O-2 reaction, thus serving as a plausible source of (OH)-O-center dot radicals in combustion environments. Grants: ARC/DP0986738, ARC/DP130100862

Evoking gesture in interactive art

In this paper, we describe an interactive artwork that uses large body gestures as its primary interactive mode. The artist intends the work to provoke active reflection in the audience by way of gesture and content. The technology is not the focus, rather the aim is to provoke memory, to elicit feelings of connective human experiences in a required-to-participate audience. We find the work provokes a diverse and contradictory set of responses. The methods used to understand this include qualitative methods common to evaluating interactive art works, as well as in-depth discussions with the artist herself. This paper is relevant to the Human - Centered Computing track because in all stages of the design of the work - as well as the evaluation - the focus is on the human aspect; the computing is designed to enable all-too-human responses.

Talk2Me : engaging interactive installation environments

In this research I explore what elements there may be in common between tangible interactive-technology works that successfully engage their participants. An exploration of existing methods for obtaining useful evaluations for non-use and ambiguous environments forms a part of the discussion.