Early recognition of ipilimumab-related autoimmune hypophysitis in patients with metastatic melanoma: case studies and recommendations for management

Ipilimumab is a human anti-CTLA-4 monoclonal antibody recently approved for the treatment of advanced melanoma. Stimulation of T-cell activity unmasks antitumor activity, but can cause immune-related adverse events. Autoimmune hypophysitis is of particular importance because its presentation can be subtle but life threatening. We present two cases where early recognition of ipilimumab-related autoimmune hypophysitis led to timely intervention and low subsequent morbidity, without compromise of antitumor effects. We provide recommendations for detection and management of this potentially life-threatening complication of ipilimumab.

Implementation of innovative technologies in small-scale construction firms: five Australian case studies

Purpose - The users of construction technologies such as builders and trades people have been acknowledged as sources of potentially important innovations. These innovations may be in the form of safer, less labour intensive, or cheaper methods and processes. The purpose of this paper is to assess whether the Australian construction industry is providing an environment where user-based innovation is being supported and implemented. Design/methodology/approach - An explorative study was undertaken to provide an insight into actual experiences of the implementation of user-based innovation. The data were collected through faceto- face semi-structured interviews providing case studies on multiple aspects of the implementation of innovative construction technologies. The cases involved a cross section of advances, including product, tool, and system technologies. Findings - The main motivation behind developing the technologies was problem solving. The associated industries of manufacturing and retail, as well as consultants within the construction industry present the greatest barriers to implementation. Originality/value - This research provides a better understanding of the factors that are preventing the successful implementation of user-based innovative construction technologies in small firms.

A multidisciplinary perspective on motor impairment as an early behavioural marker in children with autism spectrum disorder

Objectives: There is no medical test for autism spectrum disorder (ASD), a heterogeneous condition currently defined in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) by dysfunction in social, communication, and behavioural dimensions. There is agreement in the literature that the motor profile of ASD may hold the key to improving clinical and diagnostic definition, with DSM-5 now referring to motor deficits, including “odd gait” (p. 55), as part of the ASD clinical description. This review describes the history of motor impairment in ASD, types of motor problems, and age-related motor findings and highlights evidence gaps and future research. Method: A narrative review is provided of the research literature describing motor impairment in ASD and its ability to differentiate between ASD versus non-ASD cohorts. Results: Findings show differences in motor development in children with ASD from infancy onwards, including difficulties across motor coordination, arm movements, gait, and postural stability. Motor disturbance may appear in young children with ASD prior to social and language difficulties becoming clinically apparent. However, challenges remain in defining and measuring the early motor profile that is specific to ASD. Despite well-established motor impairments in ASD, there is a lack of evidence regarding which motor-based interventions will be effective in this group. Conclusions: Motor impairment holds promise as an early diagnostic sign, a behavioural marker, and a means by which to improve identification and possibly phenotypic delineation in ASD. Further research is required to determine whether motor abnormalities can sensitively differentiate ASD from other developmental conditions and to establish evidenced-based interventions to reduce the associated impairment.

Managing intragroup conflicts in construction project teams : case studies in Sri Lanka

Conflict is intrinsic to individuals, teams and organisations. Due to the unique and complex nature with various parties, conflict is inevitable in most construction projects. According to the general management literature, three distinct types of intragroup conflicts can be identified: task, process and relationship conflicts. However, very little consideration has been given in the literature addressing the three types individually in a construction project team setting. Therefore, this study has explored the existence of types of intragroup conflicts and their management in this context. This research was approached through case studies of six construction projects, which were operating under the traditional procurement method in Sri Lanka. Semi-structured interviews were conducted with three distinct participants from each team. The findings revealed that both process and relationship conflicts offer disruptive effects to construction projects and teams, while task conflicts offer positive effects when they exist at low levels. Based on the most critical sources identified within the cases, suggestions are offered here to construction project team managers on how to manage intergroup conflicts proactively. Since the research is based on six case studies on traditional procurement arrangement in Sri Lanka, further research is required to generalise the findings across different contexts.

E-Commerce, human resource strategies, and competitive advantage: two Australian banking case studies

Service organizations need to consider in depth the human resource management (HRM) strategies that will enable them to achieve sustained competitive advantage in the e-commerce era. This paper analyzes the HRM strategies developed to accommodate the changing customer service practices associated with B2C e-commerce in the retail banking sector. Based on case study data, it describes how two banks in Australia, one large, the other small, have linked their e-commerce strategies with their overall business strategy, and the extent to which their HRM strategies have helped them to utilize their e-commerce capability to achieve sustained competitive advantage.

Individual, social and home environment determinants of change in children's television viewing: the Switch-Play intervention

Understanding potential determinants of change in television (TV) viewing among children may enhance the effectiveness of programs targeting this behaviour. This study aimed to investigate the contribution of individual, social and home environment factors among 10-year-old Australian children to change in TV viewing over a 21-month period. A total of 164 children (49% boys) completed a 19-lesson (9-month) intervention program to reduce TV viewing time. Children completed self-administered surveys four times over 21 months (pre- and post-intervention, 6- and 12-month follow-up). Baseline factors associated with change in TV viewing during the intervention and follow-up periods were: ‘asking parents ≥once/week to switch off the TV and play with them’ (21.6 min/day more than those reporting <once/week, p = 0.007); being able to ‘watch just 1 h of TV per day’ (26.1 min/day less than those who could not, p = 0.010); ‘watching TV no matter what was on’ (36.6 min/day more than those who did not, p < 0.001); and ‘continuing to watch TV after their program was over’ (33.0 min/day more than those who did not, p = 0.006). With every unit increase in baseline frequency of TV viewing with family and friends, children spent on average 4.0 min/day more watching TV over the 21-month period (p = 0.047). Baseline number and placement of TVs at home did not predict change in children's TV viewing over the 21 months. Greater understanding of the family dynamics and circumstances, as well as the individual and social determinants of TV viewing, will be required if we are to develop effective strategies for reducing TV viewing in children.

Estimating the effects of energy imbalance on changes in body weight in children

BACKGROUND: Estimating changes in weight from changes in energy balance is important for predicting the effect of obesity prevention interventions. OBJECTIVE: The objective was to develop and validate an equation for predicting the mean weight of a population of children in response to a change in total energy intake (TEI) or total energy expenditure (TEE). DESIGN: In 963 children with a mean (+/-SD) age of 8.1 +/- 2.8 y (range: 4-18 y) and weight of 31.5 +/- 17.6 kg, TEE was measured by using doubly labeled water. Log weight (dependent variable) and log TEE (independent variable) were analyzed in a linear regression model with height, age, and sex as covariates. It was assumed that points of dynamic balance, called "settling points," occur for populations wherein energy is in balance (TEE = TEI), weight is stable (ignoring growth), and energy flux (EnFlux) equals TEE. RESULTS: TEE (or EnFlux) explained 74% of the variance in weight. The unstandardized regression coefficient was 0.45 (95% CI: 0.38, 0.51; R(2) = 0.86) after including covariates. Conversion into proportional changes (time(1) to time(2)) gave the equation (weight(2)/weight(1)) = (EnFlux(2)/EnFlux(1))(0.45). In 3 longitudinal studies (n = 212; mean follow-up of 3.4 y), the equation predicted the mean follow-up measured weight to within 0.5%. CONCLUSIONS: The relation of EnFlux with weight was positive, which implied that a high TEI (rather than low physical activity and low TEE) was the main determinant of high body weight. Two populations of children with a 10% difference in mean EnFlux would have a 4.5% difference in mean weight.

One to one eMarketing strategy alignment: five internet case studies

Despite widespread adoption of new online business models and the rise of online or eMarketing using the Internet (Net) and its current graphical face the World Wide Web (Web), there remains a need for empirical research into specific aspects of eMarketing strategy beyond clickthrough analysis, Web audience analysis and scrutiny of Websites properties to mention the most widely examined elements. This paper discusses Peppers and Rogers (1999) OnetoOne strategy matrix and synthesises their approach with a series of personal interviews with business managers, drawn from a broader empirical study. It does so in an endeavour to improve outcomes from eMarketing strategy and the use of individual Net technologies. The aim is to aid both business practitioner and academician alike in further improving the effectiveness and efficiency gained from using converging technologies in eBusiness.

Aligning system requirements with stakeholder concerns : use of case studies and patterns to capture domain experience

Traditionally system development starts with the specification of system requirements. The focus of such an approach is on the system under construction, which is considered as of primary importance to the development success. The major problem with such an approach, however, is the neglect of concerns held by the various system stakeholders, whose opinions, loyalties and fears may impact considerably the perception and the reception of the implemented system, its functions and its features. Typically, stakeholder concerns are not collected or identified, and are viewed as of little significance in the system development process. In this paper, however, we present the case for recognising the value of stakeholder concerns, and their use in aligning business needs with system requirements. We describe a method of gathering and analysing stakeholder concerns across an application domain, and then packaging the development experience in dealing with these concerns into patterns. Experience patterns can subsequently be used to guide systems analysts in selecting the most appropriate requirements for the target stakeholder community.

Internal representation of movement in children with developmental coordination disorder : a mental rotation task

Recent studies show that children with developmental coordination disorder (DCD) have difficulties in generating an accurate visuospatial representation of an intended action, which are shown by deficits in motor imagery. This study sought to test this hypothesis further using a mental rotation paradigm. It was predicted that children with DCD would not conform to the typical pattern of responding when required to imagine movement of their limbs. Participants included 16 children with DCD and 18 control children; mean age for the DCD group was 10 years 4 months, and for controls 10 years. The task required children to judge the handedness of single-hand images that were presented at angles between 0° and 180° at 45° intervals in either direction. Results were broadly consistent with the hypothesis above. Responses of the control children conformed to the typical pattern of mental rotation: a moderate trade-off between response time and angle of rotation. The response pattern for the DCD group was less typical, with a small trade-off function. Response accuracy did not differ between groups. It was suggested that children with DCD, unlike controls, do not automatically enlist motor imagery when performing mental rotation, but rely on an alternative object-based strategy that preserves speed and accuracy. This occurs because these children manifest a reduced ability to make imagined transformations from an egocentric or first-person perspective.

Procedural learning in children with developmental coordination disorder

Despite the fact that developmental coordination disorder (DCD) is characterised by a deficit in the ability to learn or automate motor skills, few studies have examined motor learning over repeated trials. In this study we examined procedural learning in a group of 10 children with DCD (aged 8–12 years) and age-matched controls without DCD. The learning task was modelled on that of Nissen and Bullemer [Cognitive Psychology 19 (1987) 1]. Children performed a serial reaction time (SRT) task in which they were required to learn a spatial sequence that repeated itself every 10 trials. Children were not aware of the repetition. Spatial targets were four (horizontal) locations presented on a computer monitor. Children responded using four response keys with the same horizontal mapping as the stimulus. They were tested over five blocks of 100 trials each. The first four blocks presented the same repeating sequence, while the fifth block was randomised. Procedural learning was indexed by the slope of the regression of RT on blocks 1–4. Results showed that most children displayed strong procedural learning of the sequence, despite having no explicit knowledge about it. Overall, there was no group difference in the magnitude of learning over blocks of trials – most children performed within the normal range. Procedural learning for simple sequential movements appears to be intact in children with DCD. This suggests that cortico-striatal circuits that are strongly implicated in the sequencing of simple movements appear to be function normally in DCD.

Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature

Preventing the development of obesity in children is an international health priority. To assess the effectiveness of interventions designed to prevent obesity, promote healthy eating and/or physical activity and/or to reduce sedentary behaviours in 0–5-year-old children, a systematic review of the literature was performed. Literature searches were limited to articles published between January 1995 and June 2006, printed in English and sampling children aged 0–5-years. Searches excluded literature concerned with breastfeeding, eating disorders, and interventions which were school-based or concerned with obesity treatment. Two reviewers independently extracted data and assessed study strengths and weaknesses. Nine included studies were grouped based on the settings in which they were delivered. Most studies involved multi-approach interventions, were conducted in the USA and varied in study designs and quality. All showed some level of effectiveness on at least one obesity-behaviour in young children. These studies support, at a range of levels, the premise that parents are receptive to and capable of some behavioural changes that may promote healthy weight in their young children. The small quantity of research heralds the need, particularly given the potential for early intervention to have long-lasting impacts on individual and population health, to build in a substantial way upon this evidence base.

Interventions for preventing obesity in children (Review)

Background
Obesity prevention is an international public health priority. The prevalence of obesity and overweight is increasing in child populations throughout the world, impacting on short and long-term health. Obesity prevention strategies for children can change behaviour but efficacy in terms of preventing obesity remains poorly understood.

Objectives
To assess the effectiveness of interventions designed to prevent obesity in childhood through diet, physical activity and/or lifestyle and social support.

Search strategy
MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 to February 2005. Non-English language papers were included and experts contacted.

Selection criteria
Randomised controlled trials and controlled clinical trials with minimum duration twelve weeks.

Data collection and analysis
Two reviewers independently extracted data and assessed study quality.

Main results
Twenty-two studies were included; ten long-term (at least 12 months) and twelve short-term (12 weeks to 12 months). Nineteen were school/preschool-based interventions, one was a community-based intervention targeting low-income families, and two were family-based interventions targeting non-obese children of obese or overweight parents.

Six of the ten long-term studies combined dietary education and physical activity interventions; five resulted in no difference in overweight status between groups and one resulted in improvements for girls receiving the intervention, but not boys. Two studies focused on physical activity alone. Of these, a multi-media approach appeared to be effective in preventing obesity. Two studies focused on nutrition education alone, but neither were effective in preventing obesity.

Four of the twelve short-term studies focused on interventions to increase physical activity levels, and two of these studies resulted in minor reductions in overweight status in favour of the intervention. The other eight studies combined advice on diet and physical activity, but none had a significant impact.

The studies were heterogeneous in terms of study design, quality, target population, theoretical underpinning, and outcome measures, making it impossible to combine study findings using statistical methods. There was an absence of cost-effectiveness data.

Authors' conclusions
The majority of studies were short-term. Studies that focused on combining dietary and physical activity approaches did not significantly improve BMI, but some studies that focused on dietary or physical activity approaches showed a small but positive impact on BMI status. Nearly all studies included resulted in some improvement in diet or physical activity. Appropriateness of development, design, duration and intensity of interventions to prevent obesity in childhood needs to be reconsidered alongside comprehensive reporting of the intervention scope and process.

Aboriginal art market : intellectual property case studies

The Indigenous Art Market: Intellectual Property Case Studies project is a national study aiming to gain an overview of how intellectual property issues intersect with the Indiegenous artists and the Indigenous art market in Australia. The initiative comes from the Deakin University Centre for Leisure Research Management with funding from the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS