Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA)

As the mean age of the global population increases, breast cancer in older individuals will be increasingly encountered in clinical practice. Management decisions should not be based on age alone. Establishing recommendations for management of older individuals with breast cancer is challenging because of very limited level 1 evidence in this heterogeneous population. In 2007, the International Society of Geriatric Oncology (SIOG) created a task force to provide evidence-based recommendations for the management of breast cancer in elderly individuals. In 2010, a multidisciplinary SIOG and European Society of Breast Cancer Specialists (EUSOMA) task force gathered to expand and update the 2007 recommendations. The recommendations were expanded to include geriatric assessment, competing causes of mortality, ductal carcinoma in situ, drug safety and compliance, patient preferences, barriers to treatment, and male breast cancer. Recommendations were updated for screening, primary endocrine therapy, surgery, radiotherapy, neoadjuvant and adjuvant systemic therapy, and metastatic breast cancer.

"You can see some eagles. And hear the trumpets": the literary and political hinterland of T.S. Eliot's 'Coriolan'

There has been an increased amount of scholarly interest lately in T.S. Eliot's unfinished sequence, Coriolan (1932)—interest drawn from its Shakespearian allusiveness, and from analysis of this writing's particularly rebarbative, jarring poetic. Although, however, the two parts of the sequence published by Eliot are acknowledged as being his nearest approach to poetic commentary upon contemporary political ideas, little criticism exists establishing the hinterland of the political thought, with which Eliot was most familiar, as editor of the Criterion. Coriolan emerges at a time when the lure of fascism pulled hardest at Eliot's sensibility. This article reviews the full political context provided by Eliot's journal, as well as considering the connections between that political engagement and the readings of Shakespeare he was also promulgating through this forum, in order to provide a more complex sense than hitherto of the diverse pressures underlying the unsettled nature of the existing Coriolan poems.

The meteorology of the Western Indian Ocean, and the influence of the east African highlands

This paper reviews the meteorology of the Western Indian Ocean and uses a state–of–the–art atmospheric general circulation model to investigate the influence of the East African Highlands on the climate of the Indian Ocean and its surrounding regions. The new 44–year re–analysis produced by the European Centre for Medium range Weather Forecasts (ECMWF) has been used to construct a new climatology of the Western Indian Ocean. A brief overview of the seasonal cycle of the Western Indian Ocean is presented which emphasizes the importance of the geography of the Indian Ocean basin for controlling the meteorology of the Western Indian Ocean. The principal modes of inter–annual variability are described, associated with El Niño and the Indian Ocean Dipole or Zonal Mode, and the basic characteristics of the subseasonal weather over the Western Indian Ocean are presented, including new statistics on cyclone tracks derived from the ECMWF re–analyses. Sensitivity experiments, in which the orographic effects of East Africa are removed, have shown that the East African Highlands, although not very high, play a significant role in the climate of Africa, India and Southeast Asia, and in the heat, salinity and momentum forcing of the Western Indian Ocean. The hydrological cycle over Africa is systematically enhanced in all seasons by the presence of the East African Highlands, and during the Asian summer monsoon there is a major redistribution of the rainfall across India and Southeast Asia. The implied impact of the East African Highlands on the ocean is substantial. The East African Highlands systematically freshen the tropical Indian Ocean, and act to focus the monsoon winds along the coast, leading to greater upwelling and cooler sea–surface temperatures.

Water reuse for irrigated agriculture in Jordan: challenges of soil sustainability and the role of management strategies

Reclaimed water provides an important contribution to the water balance in water-scarce Jordan, but the quality of this water presents both benefits and challenges. Careful management of reclaimed water is required to maximize the nutrient benefits while minimizing the salinity risks. This work uses a multi-disciplinary research approach to show that soil response to irrigation with reclaimed water is a function of the management strategies adopted on the farm by the water user. The adoption of management methods to maintain soil productivity can be seen to be a result of farmers’ awareness to potentially plant-toxic ions in the irrigation water (70% of Jordan Valley farmers identified salinization as a hazard from irrigation with reclaimed water). However, the work also suggests that farmers’ management capacity is affected by the institutional management of water. About a third (35%) of farmers in the Jordan Valley claimed that their ability to manage salinization was limited by water shortages. Organizational interviews revealed that institutional awareness of soil management challenges was quite high (34% of interviewees described salinization as a risk from water reuse), but strategies to address this challenge at the institutional level require greater development.

A.P. Watt and the marketing of 'Ian Maclaren'

This article examines the role of the literary agent A.P. Watt in the successful marketing and global dissemination of the work of the popular Scottish writer 'Ian Maclaren' (Rev. John Watson). Based on extensive archival research, it analyses the magazines and periodicals which published his work in Britain and America and demonstrates the continued impact of his writing in the Scottish media in the twentieth century.

D. H. Lawrence and the publication of Look! We Have Come Through!

In 1917 D.H. Lawrence's whole outlook on the social and cultural environment of his country was embodied in his attitude towards the literary marketplace. The suppression of The Rainbow in 1915 and his opposition to the war contributed to his feeling of detachment from what he called ‘the bourgeois world, the world which controls press, publication and all’. Presenting new archival evidence, this article examines the publishing history of the poetry volume Look! We Have Come Through, issued by Chatto & Windus in 1917. Closer examination of the motives of the individual editors involved in the production of the volume reveals why Lawrence was required to make changes to his text but also why the firm were eager to publish a volume that was to have little commercial impact. Issued at a critical moment in Lawrence's relationship with the marketplace, and in the history of literary modernism, the episode shows how, in spite of general hostility to his work, there were forces in the mainstream publishing market that were keen to embrace modern literary forms and take risks with the work of authors whose subject-matter was challenging and potentially dangerous.

Advertising, promotion, and the rise of a national building society movement in interwar Britain

This article examines the role of advertisement and promotion in the successful development of nationwide building societies in interwar Britain and the rapid overall growth of the building society movement. Major building societies are shown to have used extensive advertising to compensate for their initial lack of established national brands, promote home-ownership, and make savers aware of the attractive earnings and high security of building society savings. During a period when most building societies had very limited branch networks, extensive advertising increased the public profile of the major societies and thus assisted their rapid expansion via lower-cost modes such as agency networks.

Processes controlling surface, bottom and lateral melt of Arctic sea ice in a state of the art sea ice model

We present a modelling study of processes controlling the summer melt of the Arctic sea ice cover. We perform a sensitivity study and focus our interest on the thermodynamics at the ice–atmosphere and ice–ocean interfaces. We use the Los Alamos community sea ice model CICE, and additionally implement and test three new parametrization schemes: (i) a prognostic mixed layer; (ii) a three equation boundary condition for the salt and heat flux at the ice–ocean interface; and (iii) a new lateral melt parametrization. Recent additions to the CICE model are also tested, including explicit melt ponds, a form drag parametrization and a halodynamic brine drainage scheme. The various sea ice parametrizations tested in this sensitivity study introduce a wide spread in the simulated sea ice characteristics. For each simulation, the total melt is decomposed into its surface, bottom and lateral melt components to assess the processes driving melt and how this varies regionally and temporally. Because this study quantifies the relative importance of several processes in driving the summer melt of sea ice, this work can serve as a guide for future research priorities.