The ENHANCES study--Enhancing Head and Neck Cancer patients' Experiences of Survivorship: study protocol for a randomized controlled trial

Background Few cancers pose greater challenges than head and neck (H&N) cancer. Residual effects following treatment include body image changes, pain, fatigue and difficulties with appetite, swallowing and speech. Depression is a common comorbidity. There is limited evidence about ways to assist patients to achieve optimal adjustment after completion of treatment. In this study, we aim to examine the effectiveness and feasibility of a model of survivorship care to improve the quality of life of patients who have completed treatment for H&N cancer. Methods This is a preliminary study in which 120 patients will be recruited. A prospective randomised controlled trial of the H&N Cancer Survivor Self-management Care Plan (HNCP) involving pre- and post-intervention assessments will be used. Consecutive patients who have completed a defined treatment protocol for H&N cancer will be recruited from two large cancer services and randomly allocated to one of three study arms: (1) usual care, (2) information in the form of a written resource or (3) the HNCP delivered by an oncology nurse who has participated in manual-based training and skill development in patient self-management support. The trained nurses will meet patients in a face-to-face interview lasting up to 60 minutes to develop an individualised HNCP, based on principles of chronic disease self-management. Participants will be assessed at baseline, 3 and 6 months. The primary outcome measure is quality of life. The secondary outcome measures include mood, self-efficacy and health-care utilisation. The feasibility of implementing this intervention in routine clinical care will be assessed through semistructured interviews with participating nurses, managers and administrators. Interviews with patients who received the HNCP will explore their perceptions of the HNCP, including factors that assisted them in achieving behavioural change. Discussion In this study, we aim to improve the quality of life of a patient population with unique needs by means of a tailored self-management care plan developed upon completion of treatment. Delivery of the intervention by trained oncology nurses is likely to be acceptable to patients and, if successful, will be a model of care that can be implemented for diverse patient populations.

Relating Across Difference : A Case Study in Transformative Learning

This chapter examines the process of “transformative learning” for the 2008 cohort of the St. Thomas More College–Intercordia Canada (STM/IC) international community service-learning program. My primary data comes from the eight students who were part of that cohort, when I was their program coordinator. That data later became the heart of my Master’s thesis and was approved by the Research Ethics Office of the University of Saskatchewan. In this chapter I focus on three of those eight participants, outlining the critical elements of their experiences that were conducive to their transformative learning. To be sure, my sample size is too small to draw generalizable conclusions, but the quality of information I received from these students and their colleagues, coupled with the follow-up conversations I had with other educators and with the accompanying literature, supports the value of reflecting at length here about these students’ comments. I have chosen to highlight the experiences of these three participants because together they provide a range of experiences that best enables an analysis of the conditions that both did and did not lead to transformative learning. This case study suggests that transformative learning occurs through: the dynamics of vulnerability, a discovery of persisting differences within inter-personal relationships, and an experience of welcome and hospitality in the host environment. In contrast to other studies that focus on the enhanced capacities, skills and subsequent employability of participants through international education, transformative learning for these students required a relinquishing of securities, a disorientation and critical interrogation of the self, and enhanced receptivity to the newly recognized Other. Moreover, consistent with the critical-humanistic educational philosophy shared in different ways by the participants of the STM/IC program, this study suggests that international community service-learning can most responsibly contribute to good global citizenship through the construction of relationships of solidarity across difference.

Generalised cumulative arrays in secret sharing

Cumulative arrays have played an important role in the early development of the secret sharing theory. They have not been subject to extensive study so far, as the secret sharing schemes built on them generally result in much larger sizes of shares, when compared with other conventional approaches. Recent works in threshold cryptography show that cumulative arrays may be the appropriate building blocks in non-homomorphic threshold cryptosystems where the conventional secret sharing methods are generally of no use. In this paper we study several extensions of cumulative arrays and show that some of these extensions significantly improve the performance of conventional cumulative arrays. In particular, we derive bounds on generalised cumulative arrays and show that the constructions based on perfect hash families are asymptotically optimal. We also introduce the concept of ramp perfect hash families as a generalisation of perfect hash families for the study of ramp secret sharing schemes and ramp cumulative arrays.

Low-temperature assembly of ordered carbon nanotip arrays in low-frequency, high-density inductively coupled plasmas

High-density inductively coupled plasma (ICP)-assisted self-assembly of the ordered arrays of various carbon nanostructures (NS) for the electron field emission applications is reported. Carbon-based nano-particles, nanotips, and pyramid-like structures, with the controllable shape, ordering, and areal density are grown under remarkably low process temperatures (260-350 °C) and pressures (below 0.1 Torr), on the same Ni-based catalyst layers, in a DC bias-controlled floating temperature regime. A high degree of positional and directional ordering, elevated sp2 content, and a well-structured graphitic morphology are achieved without the use of pre-patterned or externally heated substrates.

Overview of the ShARe/CLEF eHealth Evaluation Lab 2014

This paper reports on the 2nd ShARe/CLEFeHealth evaluation lab which continues our evaluation resource building activities for the medical domain. In this lab we focus on patients' information needs as opposed to the more common campaign focus of the specialised information needs of physicians and other healthcare workers. The usage scenario of the lab is to ease patients and next-of-kins' ease in understanding eHealth information, in particular clinical reports. The 1st ShARe/CLEFeHealth evaluation lab was held in 2013. This lab consisted of three tasks. Task 1 focused on named entity recognition and normalization of disorders; Task 2 on normalization of acronyms/abbreviations; and Task 3 on information retrieval to address questions patients may have when reading clinical reports. This year's lab introduces a new challenge in Task 1 on visual-interactive search and exploration of eHealth data. Its aim is to help patients (or their next-of-kin) in readability issues related to their hospital discharge documents and related information search on the Internet. Task 2 then continues the information extraction work of the 2013 lab, specifically focusing on disorder attribute identification and normalization from clinical text. Finally, this year's Task 3 further extends the 2013 information retrieval task, by cleaning the 2013 document collection and introducing a new query generation method and multilingual queries. De-identified clinical reports used by the three tasks were from US intensive care and originated from the MIMIC II database. Other text documents for Tasks 1 and 3 were from the Internet and originated from the Khresmoi project. Task 2 annotations originated from the ShARe annotations. For Tasks 1 and 3, new annotations, queries, and relevance assessments were created. 50, 79, and 91 people registered their interest in Tasks 1, 2, and 3, respectively. 24 unique teams participated with 1, 10, and 14 teams in Tasks 1, 2 and 3, respectively. The teams were from Africa, Asia, Canada, Europe, and North America. The Task 1 submission, reviewed by 5 expert peers, related to the task evaluation category of Effective use of interaction and targeted the needs of both expert and novice users. The best system had an Accuracy of 0.868 in Task 2a, an F1-score of 0.576 in Task 2b, and Precision at 10 (P@10) of 0.756 in Task 3. The results demonstrate the substantial community interest and capabilities of these systems in making clinical reports easier to understand for patients. The organisers have made data and tools available for future research and development.

Service quality and performance measurement : evidence from the Indian Water Sector

The conventional measures of benchmarking focus mainly on the water produced or water delivered, and ignore the service quality, and as a result the 'low-cost and low-quality' utilities are rated as efficient units. Benchmarking must credit utilities for improvements in service delivery. This study measures the performance of 20 urban water utilities using data from an Asian Development Bank survey of Indian water utilities in 2005. It applies data envelopment analysis to measure the performance of utilities. The results reveal that incorporation of a quality dimension into the analysis significantly increases the average performance of utilities. The difference between conventional quantity-based measures and quality-adjusted estimates implies that there are significant opportunity costs of maintaining the quality of services in water delivery.

Socio-demographic vulnerability to heatwave impacts in Brisbane, Australia : a time series analysis

Objective: Examining the association between socioeconomic disadvantage and heat-related emergency department (ED) visits during heatwave periods in Brisbane, 2000–2008. Methods: Data from 10 public EDs were analysed using a generalised additive model for disease categories, age groups and gender. Results: Cumulative relative risks (RR) for non-external causes other than cardiovascular and respiratory diseases were 1.11 and 1.05 in most and least disadvantaged areas, respectively. The pattern persisted on lags 0–2. Elevated risks were observed for all age groups above 15 years in all areas. However, with RRs of 1.19–1.28, the 65–74 years age group in more disadvantaged areas stood out, compared with RR=1.08 in less disadvantaged areas. This pattern was observed on lag 0 but did not persist. The RRs for male presentations were 1.10 and 1.04 in most and less disadvantaged areas; for females, RR was 1.04 in less disadvantaged areas. This pattern persisted across lags 0–2. Conclusions: Heat-related ED visits increased during heatwaves. However, due to overlapping confidence intervals, variations across socioeconomic areas should be interpreted cautiously. Implications: ED data may be utilised for monitoring heat-related health impacts, particularly on the first day of heatwaves, to facilitate prompt interventions and targeted resource allocation.

Twitter-archive und die Herausforderungen von "Big Social Data" für die Medien- und Kommunikationswissenschaft

Twitter ist eine besonders nützliche Quelle für Social-Media-Daten: mit dem Twitter-API (dem Application Programming Interface, das einen strukturierten Zugang zu Kommunikationsdaten in standardisierten Formaten bietet) ist es Forschern möglich, mit ein wenig Mühe und ausreichenden technische Ressourcen sehr große Archive öffentlich verbreiteter Tweets zu bestimmten Themen, Interessenbereichen, oder Veranstaltungen aufzubauen. Grundsätzlich liefert das API sehr langen Listen von Hunderten, Tausenden oder Millionen von Tweets und den Metadaten zu diesen Tweets; diese Daten können dann auf verschiedentlichste Weise extrahiert, kombiniert, und visualisiert werden, um die Dynamik der Social-Media-Kommunikation zu verstehen. Diese Forschung ist häufig um althergebrachte Fragestellungen herum aufgebaut, wird aber in der Regel in einem bislang unbekannt großen Maßstab durchgeführt. Die Projekte von Medien- und Kommunikationswissenschaftlern wie Papacharissi und de Fatima Oliveira (2012), Wood und Baughman (2012) oder Lotan et al. (2011) – um nur eine Handvoll der letzten Beispiele zu nennen – sind grundlegend auf Twitterdatensätze aufgebaut, die jetzt routinemäßig Millionen von Tweets und zugehörigen Metadaten umfassen, erfaßt nach einer Vielzahl von Kriterien. Was allen diesen Fällen gemein ist, ist jedoch die Notwendigkeit, neue methodische Wege in der Verarbeitung und Analyse derart großer Datensätze zur medienvermittelten sozialen Interaktion zu gehen.

Characterization of two homologous disulfide bond systems involved in virulence factor Biogenesis in Uropathogenic Escherichia coli CFT073

Disulfide bond (DSB) formation is catalyzed by disulfide bond proteins and is critical for the proper folding and functioning of secreted and membrane-associated bacterial proteins. Uropathogenic Escherichia coli (UPEC) strains possess two paralogous disulfide bond systems: the well-characterized DsbAB system and the recently described DsbLI system. In the DsbAB system, the highly oxidizing DsbA protein introduces disulfide bonds into unfolded polypeptides by donating its redox-active disulfide and is in turn reoxidized by DsbB. DsbA has broad substrate specificity and reacts readily with reduced unfolded proteins entering the periplasm. The DsbLI system also comprises a functional redox pair; however, DsbL catalyzes the specific oxidative folding of the large periplasmic enzyme arylsulfate sulfotransferase (ASST). In this study, we characterized the DsbLI system of the prototypic UPEC strain CFT073 and examined the contributions of the DsbAB and DsbLI systems to the production of functional flagella as well as type 1 and P fimbriae. The DsbLI system was able to catalyze disulfide bond formation in several well-defined DsbA targets when provided in trans on a multicopy plasmid. In a mouse urinary tract infection model, the isogenic dsbAB deletion mutant of CFT073 was severely attenuated, while deletion of dsbLI or assT did not affect colonization.

A novel saliva-based microRNA biomarker panel to detect head and neck cancers

Background MicroRNAs (miRNAs) are known to play an important role in cancer development by post-transcriptionally affecting the expression of critical genes. The aims of this study were two-fold: (i) to develop a robust method to isolate miRNAs from small volumes of saliva and (ii) to develop a panel of saliva-based diagnostic biomarkers for the detection of head and neck squamous cell carcinoma (HNSCC). Methods Five differentially expressed miRNAs were selected from miScript™ miRNA microarray data generated using saliva from five HNSCC patients and five healthy controls. Their differential expression was subsequently confirmed by RT-qPCR using saliva samples from healthy controls (n = 56) and HNSCC patients (n = 56). These samples were divided into two different cohorts, i.e., a first confirmatory cohort (n = 21) and a second independent validation cohort (n = 35), to narrow down the miRNA diagnostic panel to three miRNAs: miR-9, miR-134 and miR-191. This diagnostic panel was independently validated using HNSCC miRNA expression data from The Cancer Genome Atlas (TCGA), encompassing 334 tumours and 39 adjacent normal tissues. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic capacity of the panel. Results On average 60 ng/μL miRNA was isolated from 200 μL of saliva. Overall a good correlation was observed between the microarray data and the RT-qPCR data. We found that miR-9 (P <0.0001), miR-134 (P <0.0001) and miR-191 (P <0.001) were differentially expressed between saliva from HNSCC patients and healthy controls, and that these miRNAs provided a good discriminative capacity with area under the curve (AUC) values of 0.85 (P <0.0001), 0.74 (P < 0.001) and 0.98 (P < 0.0001), respectively. In addition, we found that the salivary miRNA data showed a good correlation with the TCGA miRNA data, thereby providing an independent validation. Conclusions We show that we have developed a reliable method to isolate miRNAs from small volumes of saliva, and that the saliva-derived miRNAs miR-9, miR-134 and miR-191 may serve as novel biomarkers to reliably detect HNSCC. © 2014 International Society for Cellular Oncology.

Developing a transdisciplinary approach to improve urban traffic congestion based on Product Ecosystem theory

Product Ecosystem theory is an emerging theory that shows that disruptive “game changing” innovation is only possible when the entire ecosystem is considered. When environmental variables change faster than products or services can adapt, disruptive innovation is required to keep pace. This has many parallels with natural ecosystems where species that cannot keep up with changes to the environment will struggle or become extinct. In this case the environment is the city, the environmental pressures are pollution and congestion, the product is the car and the product ecosystem is comprised of roads, bridges, traffic lights, legislation, refuelling facilities etc. Each one of these components is the responsibility of a different organisation and so any change that affects the whole ecosystem requires a transdisciplinary approach. As a simple example, cars that communicate wirelessly with traffic lights are only of value if wireless-enabled traffic lights exist and vice versa. Cars that drive themselves are technically possible but legislation in most places doesn’t allow their use. According to innovation theory, incremental innovation tends to chase ever diminishing returns and becomes increasingly unable to tackle the “big issues.” Eventually “game changing” disruptive innovation comes along and solves the “big issues” and/or provides new opportunities. Seen through this lens, the environmental pressures of urban traffic congestion and pollution are the “big issues.” It can be argued that the design of cars and the other components of the product ecosystem follow an incremental innovation approach. That is why the “big issues” remain unresolved. This paper explores the problems of pollution and congestion in urban environments from a Product Ecosystem perspective. From this a strategy will be proposed for a transdisciplinary approach to develop and implement solutions.

Editorial

Welcome to the third issue of Clothing Cultures. We are honoured to have served as the guest editors for this issue. The authors in this issue explore three intersecting themes in using various methods: identity, cross-cultural encounters and everyday practices related to designing, branding and wearing clothing. These themes are at the core of fashion and dress: as an everyday individual and social project, and as a system in which people and objects (clothing) globally circulate. The performance of identity (Goffman 1979; Butler 1990), social practices and the movement of people and commodities (Appadurai 1986, 1996) create and transfer cultural meanings.

Mind the insolvency gap : lessons to be learned from audit expectations gap theory

There is a general perception that public confidence in the insolvency profession is low as the result of the recent unethical practices of a few high profile liquidators. As a result, the effectiveness of the current regulatory mechanisms has been questioned, leading to a review of the performance of insolvency practitioners and subsequent regulation proposals. The challenge for the insolvency profession is balancing the expectations of the general public whilst ensuring that the obligations and duties imposed upon them are performed to acceptable and realistic standards. It is difficult (if not impossible) for the profession to meet this challenge in the absence of a cohesive framework which identifies those issues that require further regulation as opposed to those that relate to general education on the insolvency process. This paper will examine the audit expectations gap theory in the context of insolvency practitioners and suggests that a model based on this theory provides an effective framework for evaluating the regulation of the insolvency industry.

Making climate change manageable : how accounting constructs new power-knowledge regimes

This paper examines the modern power of accounting to permeate new spheres and create new objects by examining how climate change becomes a new category for accounting’s attention. It outlines the socio-political problem space where accounting and climate change connect by tracing the emergence of the UK’s Climate Change Act (2008) to a specifically modern calculating attitude described here as ‘managing by the numbers’. It suggests the intersection of accounting and climate change was made possible by accounting’s role in tying disciplinary subjectivities and objectivities together whilst operating simultaneously at the level of individuals, organisations and government. Such that when faced with new unknowns we revert to previous ways of managing we have come to know and experienced throughout our formative years in schools, hospitals, firms and government departments. In this way, accounting’s emergence in the domain of managing climate change implies a transformation that cannot be explained merely as a practical response to a global warming problem, but rather as an example of a new power-knowledge regime that makes possible the management and control of a new organisational phenomenon called climate change.