Second ESMO consensus conference on lung cancer : pathology and molecular biomarkers for non-small-cell lung cancer

To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The Second ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on management of patients with nonsmall- cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, early stage disease, locally advanced disease and advanced (metastatic) disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on recommendations for pathology and molecular biomarkers in relation to the diagnosis of lung cancer, primarily non-small-cell carcinomas.

A review of preschool children's physical activity and sedentary time using objective measures

CONTEXT: Identifying current physical activity levels and sedentary time of preschool children is important for informing government policy and community initiatives. This paper reviewed studies reporting on physical activity and time spent sedentary among preschool-aged children (2-5 years) using objective measures. EVIDENCE ACQUISITION: Databases were searched for studies published up to and including April 2013 that reported on, or enabled the calculation of, the proportion of time preschool children spent sedentary and in light- and moderate to vigorous-intensity physical activity. A total of 40 publications met the inclusion criteria for physical activity and 31 met the inclusion criteria for sedentary time. Objective measures included ActiGraph, Actiwatch, Actical, Actiheart, and RT3 accelerometers, direct observation, and Quantum XL telemetry heart rate monitoring. Data were analyzed in May 2013. EVIDENCE SYNTHESIS: Considerable variation in prevalence estimates existed. The proportion of time children spent sedentary ranged from 34% to 94%. The time spent in light-intensity physical activity and moderate to vigorous-intensity physical activity ranged from 4% to 33% and 2% to 41%, respectively. CONCLUSIONS: The considerable variation of prevalence estimates makes it difficult to determine the "true" prevalence of physical activity and sedentary time in preschool children. Future research should aim to reduce inconsistencies in the employed methodologies to better understand preschoolers' physical activity levels and sedentary behavior.

Is climate change litigation an effective strategy for promoting greater action to address climate change? What other legal mechanisms might be appropriate?

In recent times a widespread consensus on the reality and gravity of anthropogenic climate change has emerged. Perceived inadequacies in the Australian government’s legal and policy responses to climate change issues have resulted in environmental activists increasingly turning to the courts as a strategy to promote greater action to address adverse climate impacts. The efficacy of this strategy for achieving climate goals is limited by the time and expense of litigating, the restrictions inherent in environmental law administrative challenges, and the possibility that judicial decisions may be overruled by the legislature. To date, climate change litigation in Australia has met with varied success, yet its significance extends beyond the court room as an important mechanism for raising public, political and commercial awareness about climate change issues. Ultimately, however, the types of far-reaching changes needed to mitigate and manage adverse climate impacts require strong regulatory backing. The most effective approach to addressing the complex challenges posed by climate change is a coordinated suite of regulatory measures spearheaded by the Federal Government.

Employee perceptions of alcohol and drug policy effectiveness: Policy features, concerns about drug testing, and the key role of preventative measures

As negative employee attitudes towards alcohol and other drug (AOD) policies may have serious consequences for organizations, the present study examined demographic and attitudinal dimensions leading to employees’ perceptions of AOD policy effectiveness. Survey responses were obtained from 147 employees in an Australian agricultural organization. Three dimensions of attitudes towards AOD policies were examined: knowledge of policy features, attitudes towards testing, and preventative measures such as job design and organizational involvement in community health. Demographic differences were identified, with males and blue-collar employees reporting significantly more negative attitudes towards the AOD policy. Attitude dimensions were stronger predictors of perceptions of policy effectiveness than demographics, and the strongest predictor was preventative measures. This suggests that organizations should do more than design adequate and fair AOD policies, and take a more holistic approach to AOD impairment by engaging in workplace design to reduce AOD use and promote a consistent health message to employees and the community.

Regressive measures won’t help youth into work or training

The 2014 federal budget implemented a so-called crackdown on what Minister for Social Services Kevin Andrews calls young people who are content to “sit on the couch at home and pick up a welfare cheque”. The crackdown will change access to income support for people under 30 years of age. From January 1 2015, all young people seeking Newstart Allowance and Youth Allowance for the first time will be required to “demonstrate appropriate job search and participation in employment services support for six months before receiving payments”. Upon qualifying, recipients must then spend 25 hours per week in Work for the Dole in order to receive income support for a six-month period. What happens beyond this six months is unclear. What is clear is that these policy changes, together with the Minister’s accompanying statements, are informed by a deficit view of disadvantaged youth. It is a view that demonstrates how little politicians know or understand about these young peoples’ past circumstances.

Quality assurance of assessment and moderation discourses involving sessional staff

Quality assurance is a major agenda in tertiary education. The casualisation of academic work, especially in teaching, is also a quality assurance issue. Casual or sessional staff members teach and assess more than 50% of all university courses in Australia, and yet the research in relation to the role sessional staff play in quality assurance of student assessment outcomes is scarce. Moderation processes are a pivotal part of robust quality assurance measures. Drawing upon previous work surrounding four discourses of moderation, this pilot project reports the results of research into the role and impact of sessional staff in moderation processes at tertiary level. Qualitative data were gathered through focus interviews. Results, in the form of various moderation discourses, indicate that sessional staff impact the formal quality assurance processes in numerous ways.

Can different measures of intelligence be used interchangeably? A comparison of the Wechsler and Stanford-Binet scales

The Wechsler and Stanford Binet scales are among the most commonly used tests of intelligence. In clinical practice, they often seem to be used interchangeably. This paper reports the results of two studies that compared the most recent editions of two Wechsler scales (WPPSI-III and WISC-IV) with the Stanford-Binet Fifth Edition (SB5). The participants in the first study were 36 typically developing 4-year-old children who completed the WPPSI-III and SB5 in counter-balanced order. Although correlations of composite scores ranged from r = .59 to r = .82 and were similar to those reported for earlier versions of the two instruments, more than half the sample had a score discrepancy greater than 10 points across the two instruments. In the second study, the WISC-IV and SB5 were administered to 30 children aged 12-14 years. There was a significant difference between Full Scale IQs on the two measures, with scores being higher on the WISC-IV. Differences between the two verbal scales were also significant and favoured the WISC-IV. There were moderate correlations of Full Scale IQs (r = .58) and Nonverbal IQs (r = .54) but the relationship between the two Verbal scales was not significant. For some children, notable score differences led to different categorisations of their level of intellectual ability The findings suggest that the Wechsler and Stanford Binet scales cannot be presumed to be interchangeable. The discussion focuses on how psychologists might reconcile large differences in test scores and the need for caution when interpreting and comparing test results.

The impact of simulated astigmatism on functional measures of visual performance

Uncorrected refractive error, including astigmatism, is a leading cause of reversible visual impairment. While the ability to perform vision-related daily activities is reduced when people are not optimally corrected, only limited research has investigated the impact of uncorrected astigmatism. Given the capacity to perform vision-related daily activities involves integration of a range of visual and cognitive cues, this research examined the impact of simulated astigmatism on visual tasks that also involved cognitive input. The research also examined whether the higher levels of complexity inherent in Chinese characters makes them more susceptible to the effects of astigmatism. The effects of different powers of astigmatism, as well as astigmatism at different axes were investigated in order to determine the minimum level of astigmatism that resulted in a decrement in visual performance.

An empirical analysis of the factors and measures of Enterprise Architecture Management success

Enterprise Architecture Management (EAM) is discussed in academia and industry as a vehicle to guide IT implementations, alignment, compliance assessment, or technology management. Still, a lack of knowledge prevails about how EAM can be successfully used, and how positive impact can be realized from EAM. To determine these factors, we identify EAM success factors and measures through literature reviews and exploratory interviews and propose a theoretical model that explains key factors and measures of EAM success. We test our model with data collected from a cross-sectional survey of 133 EAM practitioners. The results confirm the existence of an impact of four distinct EAM success factors, ‘EAM product quality’, ‘EAM infrastructure quality’, ‘EAM service delivery quality’, and ‘EAM organizational anchoring’, and two important EAM success measures, ‘intentions to use EAM’ and ‘Organizational and Project Benefits’ in a confirmatory analysis of the model. We found the construct ‘EAM organizational anchoring’ to be a core focal concept that mediated the effect of success factors such as ‘EAM infrastructure quality’ and ‘EAM service quality’ on the success measures. We also found that ‘EAM satisfaction’ was irrelevant to determining or measuring success. We discuss implications for theory and EAM practice.

Managing knowledge to promote sustainability in Australian transport infrastructure projects

To deliver tangible sustainability outcomes, the infrastructure sector of the construction industry needs to build capacities for the creation, application and management of ever increasing knowledge. This paper intends to establish the importance and key issues of promoting sustainability through knowledge management (KM). It presents a new conceptual framework for managing sustainability knowledge to raise the awareness and direct future research in the field of transport infrastructure, one of the fast growing sectors in Australia. A holistic KM approach is adopted in this research to consider the potential to “deliver the right information to the right person at the right time” in the context of sustainable development of infrastructure. A questionnaire survey among practitioners across the nation confirmed the necessity and identified priority issues of managing knowledge for sustainability. During infrastructure development, KM can help build much needed industry consensus, develop capacity, communicate decisions, and promote specific measures for the pursuit of sustainability. Six essential elements of the KM approach and their priority issues informed the establishment of a conceptual KM framework. The transport infrastructure sector has come to realise that development must not come at the expense of environmental and social objectives. In practice however, it is facing extensive challenges to deliver what has been promised in the sustainability agenda. This research demonstrates the importance of managing sustainability knowledge, integration of various stakeholders, facilitation of plans and actions and delivery of tangible benefits in real projects, as a positive step towards meeting these challenges.

Effects of resistance training on measures of muscular strength in people with Parkinson’s disease: A systematic review and meta-analysis

Objective The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson’s disease (PD). Methods Controlled trials with parallel-group-design were identified from computerized literature searching and citation tracking performed until August 2014. Two reviewers independently screened for eligibility and assessed the quality of the studies using the Cochrane risk-of-bias-tool. For each study, mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes based on between-group comparisons using post-intervention data. Subgroup analysis was conducted based on differences in study design. Results Nine studies met the inclusion criteria; all had a moderate to high risk of bias. Pooled data showed that knee extension, knee flexion and leg press strength were significantly greater in PD patients who undertook RT compared to control groups with or without interventions. Subgroups were: RT vs. control-without-intervention, RT vs. control-with-intervention, RT-with-other-form-of-exercise vs. control-without-intervention, RT-with-other-form-of-exercise vs. control-with-intervention. Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention. Compared to treadmill or balance exercise it resulted in greater knee flexion, but not knee extension or leg press strength. RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention. Discussion Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise. However, depending on muscle group and/or training dose, RT may not be superior to other exercise types. Interventions which combine RT with other exercise may be most effective. Findings should be interpreted with caution due to the relatively high risk of bias of most studies.

Test-retest reliability of graph theory measures of structural brain connectivity

The human connectome has recently become a popular research topic in neuroscience, and many new algorithms have been applied to analyze brain networks. In particular, network topology measures from graph theory have been adapted to analyze network efficiency and 'small-world' properties. While there has been a surge in the number of papers examining connectivity through graph theory, questions remain about its test-retest reliability (TRT). In particular, the reproducibility of structural connectivity measures has not been assessed. We examined the TRT of global connectivity measures generated from graph theory analyses of 17 young adults who underwent two high-angular resolution diffusion (HARDI) scans approximately 3 months apart. Of the measures assessed, modularity had the highest TRT, and it was stable across a range of sparsities (a thresholding parameter used to define which network edges are retained). These reliability measures underline the need to develop network descriptors that are robust to acquisition parameters.

Scalar connectivity measures from fast-marching tractography reveal heritability of white matter architecture

Recent advances in diffusion-weighted MRI (DWI) have enabled studies of complex white matter tissue architecture in vivo. To date, the underlying influence of genetic and environmental factors in determining central nervous system connectivity has not been widely studied. In this work, we introduce new scalar connectivity measures based on a computationally-efficient fast-marching algorithm for quantitative tractography. We then calculate connectivity maps for a DTI dataset from 92 healthy adult twins and decompose the genetic and environmental contributions to the variance in these metrics using structural equation models. By combining these techniques, we generate the first maps to directly examine genetic and environmental contributions to brain connectivity in humans. Our approach is capable of extracting statistically significant measures of genetic and environmental contributions to neural connectivity.

How does angular resolution affect diffusion imaging measures?

A key question in diffusion imaging is how many diffusion-weighted images suffice to provide adequate signal-to-noise ratio (SNR) for studies of fiber integrity. Motion, physiological effects, and scan duration all affect the achievable SNR in real brain images, making theoretical studies and simulations only partially useful. We therefore scanned 50 healthy adults with 105-gradient high-angular resolution diffusion imaging (HARDI) at 4T. From gradient image subsets of varying size (6 ≤ N ≤ 94) that optimized a spherical angular distribution energy, we created SNR plots (versus gradient numbers) for seven common diffusion anisotropy indices: fractional and relative anisotropy (FA, RA), mean diffusivity (MD), volume ratio (VR), geodesic anisotropy (GA), its hyperbolic tangent (tGA), and generalized fractional anisotropy (GFA). SNR, defined in a region of interest in the corpus callosum, was near-maximal with 58, 66, and 62 gradients for MD, FA, and RA, respectively, and with about 55 gradients for GA and tGA. For VR and GFA, SNR increased rapidly with more gradients. SNR was optimized when the ratio of diffusion-sensitized to non-sensitized images was 9.13 for GA and tGA, 10.57 for FA, 9.17 for RA, and 26 for MD and VR. In orientation density functions modeling the HARDI signal as a continuous mixture of tensors, the diffusion profile reconstruction accuracy rose rapidly with additional gradients. These plots may help in making trade-off decisions when designing diffusion imaging protocols.