Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma : clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study

Background The effects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical Surgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confirmed mesothelioma and were deemed fit enough to undergo trimodal therapy were included. In a prerandomisation registration phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. After further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratified by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (five patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in five patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively after receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92-3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21-6·26; p=0·016). Median survival was 14·4 months (5·3-18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no significant differences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients. Funding Cancer Research UK (CRUK/04/003), the June Hancock Mesothelioma Research Fund, and Guy's and St Thomas' NHS Foundation Trust. © 2011 Elsevier Ltd.

Carrot mottle mimic virus (CMoMV): A second umbravirus associated with carrot motley dwarf disease recognised by nucleic acid hybridisation

Carrot mottle umbravirus (CMoV) has always been found co-infecting plants with carrot red leaf luteovirus (CRLV) and in carrot (Daucus carota) these co-infections are associated with carrot motley dwarf disease (CMD). CMD occurs wherever carrots are grown. Hence, CMoV was believed to have a corresponding global distribution. However, little or no hybridisation was detected between cDNA generated from the sequenced Australian isolate of CMoV (CMoV-A) and RNA from the much studied Scottish isolate of CMoV (CMoV-S). A weak hybridisation signal was obtained using cDNA to a conserved part of the RNA-dependent RNA polymerase gene of CMoV-A, but when cDNAs to other parts of the CMoV-A genome were used as probes there was no detectable hybridisation with CMoV-S RNA. This lack of hybridisation suggests that the two virus isolates have relatively divergent genomes and that they should be regarded as distinct virus species. Both viruses are transmitted by Cavariella aegopodii, but only with the help of CRLV, and they yield almost identical double-stranded RNA profiles. For these reasons, we propose that the CMoV isolate from Australia be renamed carrot mottle mimic umbravirus (CMoMV). cDNA to CMoMV RNA hybridised with RNA from an isolate from New Zealand, whereas cDNA to CMoV-S RNA hybridised with RNA from isolates from England and Morocco but not to RNA from the isolate from New Zealand. Although preliminary, these data suggest that CMoV and CMoMV may have different global distributions.

Queensland diabetic foot hospitalisations (2005-10) : in what state is our foot hospital problem?

Background Diabetes foot complications are a leading cause of overall avoidable hospital admissions. Since 2006, the Queensland Diabetes Clinical Network has implemented programs aimed at reducing diabetes-related hospitalisation. The aim of this retrospective observational study was to determine the incidence of diabetes foot-related hospital admissions in Queensland from 2005 to 2010. Methods Data on all primary diabetes foot-related admissions in Queensland from 2005-2010 was obtained using diabetes foot-related ICD-10-AM (hospital discharge) codes. Queensland diabetes foot-related admission incidences were calculated using general population data from the Australian Bureau of Statistics. Furthermore, diabetes foot-related sub-group admissions were analysed. Chi-squared tests were used to assess changes in admissions over time. Results Overall, 24,917 diabetes foot-related admissions occurred, resulting in the use of 260,085 bed days or 1.4% of all available Queensland hospital bed days (18,352,152). The primary reasons for these admissions were foot ulcers (49.8%), cellulitis (20.7%), peripheral vascular disease (17.8%) and osteomyelitis (3.8%). The diabetes foot-related admission incidence among the general population (per 100,000) reduced by 22% (103.0 in 2005, to 80.7 in 2010, p < 0.001); bed days decreased by 18% (1,099 to 904, p < 0.001). Conclusion Diabetes foot complications appear to be the primary reason for 1.4 out of every 100 hospital beds used in Queensland. There has been a significant reduction in the incidence of diabetes foot-related admissions in Queensland between 2005 and 2010. This decrease has coincided with a corresponding decrease in amputations and the implementation of several diabetes foot clinical programs throughout Queensland.

Asking for it? Practices and structures that perpetuate employee silence in pursuing customised work arrangements

A component of broader scholarship addressing the social context in which individuals work, has focused on the role of ‘employee voice’ in determining flexible-work outcomes (Donnelly et al., 2012). Employee voice incorporates a spectrum of practices designed to give employees a say in organisational decisions (Dundon et al., 2004). This paper extends work on voice and workplace flexibility in two ways. First, it focuses not simply on ‘voice’ but on its antithesis, employee silence, which is defined (following Van Dyne et al., 2003) as the intentional withholding of ideas and opinions. We utilise an alternative reading of silence to the majority of literature which interprets it as a product of employee motivation, by focusing on the role of management and by adopting a framework which considers silence as a control dialectic (Donaghey et al., 2011). Second, the study examines silence with respect to preferences for customising the terms/conditions of employment beyond narrowly defined notions of ‘flexible work’ (e.g., reduced hours; home-working). The study utilises 30 telephone interviews with employees who had been previously identified as ‘discontent non-requesters’ (Skinner and Pocock, 2011: 75), that is they had expressed a desire to request flexible working provisions, but had not done so. Interviewees were asked to articulate the reasons for, and consequences of, their silence. The findings reveal nuanced workplace practices and structures that close down possibilities for employee voice and perpetuate silence on matters relating to customising work. They also illustrate a disjuncture between espoused organizational goals and everyday practices and norms encountered in workplaces.

Child sexual abuse in China : a meta-analysis of 27 studies

Objective: To examine whether Chinese studies of child sexual abuse (CSA) in the general population show lower prevalence rates than other international studies, and whether certain features of these studies may help to account for variation in estimates. Methods: A meta-analysis and meta-regression were conducted on 27 studies found in the English and Chinese language peer reviewed journals that involved general populations of students or residents, estimated CSA prior to age 18, and specified rates for males or females individually. Results: Estimates for Chinese females were lower than the international composites. For total CSA for females, the Chinese pooled estimate was 15.3% (95% CI = 12.6–18.0) based on the meta-analysis of 24 studies, lower than the international estimate (Stoltenborgh, van IJzendoorn, Euser, & Bakermans-Kranenburg, 2011) but not significantly. For contact CSA for females, the pooled estimate was 9.5% (95% CI = 7.5–11.5), based on 16 studies, significantly lower than the international prevalence. For penetrative CSA for females, the pooled estimate was 1% (95% CI = 0.7–1.3), based on 15 studies, significantly lower than the international estimate of 15.1%. Chinese men reported significantly less penetrative CSA but significantly more total CSA than international estimates; while contact CSA reported by Chinese and international males appeared to be roughly equivalent. Chinese CSA prevalence estimates were lower in studies from urban areas and non-mainland areas (Hong Kong and Taiwan), and in surveys with larger and probability samples, multiple sites, face-to-face interview method and when using less widely used instruments. Conclusions: The findings to date justify further research into possible cultural and sociological reasons for lower risk of contact and penetrative sexual abuse of girls and less penetrative abuse of boys in China. Future research should examine sociological explanations, including patterns of supervision, sexual socialization and attitudes related to male sexual prowess. Practice implications: The findings suggest that future general population studies in China should use well validated instruments, avoid face-to-face interview formats and be careful to maintain methodological standards when sampling large populations over multiple sites.

Critical discourse analysis

This chapter outlines the reasons why discourse analysis is an important dimension of critical social work practice. It brings to the forefront the very significant new contributions that sociologists focusing on the politics of recognition and redistribution, such as Nancy Fraser and Axel Honneth, can make in casting a "new politics of critical social work". In making this case, it begins by discussing some key developments in discourse theory and analysis within the social sciences and how they relate to the normative concerns of social work, specifically social justice and its multiple interpretations. Developing an appropriate analytical framework for social work practice can be difficult because there are conflicting and overlapping definitions of discourse formulated from various theoretical and disciplinary standpoints (Fairclough, 1992; Macdonnell, 1991). There are many different accounts of discourse that have developed in the social sciences, which is partly a result of recent interest in discourse theory among a wide range of academic disciplines. Whether language has assumed more of a central focus as a result of increased academic interest, or whether there has been an increase in the social importance of language in the operations of power is open to question...

A novel energy efficient controllable stiffness joint

Achieving energy efficient legged locomotion is an important goal for the future of robot mobility. This paper presents a novel joint for legged locomotion that is energy efficient for two reasons. The first reason is the configuration of the elastic elements and actuator which we show analytically has lower energy losses than the typical arrangement. The second is that the joint stiffness, and hence stance duration, is controllable without requiring any energy from the actuator. Further, the joint stiffness can be changed significantly during the flight phase, from zero to highly rigid. Results obtained from a prototype hopper, demonstrate that the joint allows continuous and peak hopping via torque control. The results also demonstrate that the hopping frequency can be varied between 2.2Hz and 4.6Hz with associated stance duration of between 0.35 and 0.15 seconds.

Orchids : My Intersex Adventure

Orchids: My Intersex Adventure is a multi-award winning autobiographical documentary film. The film follows documentary filmmaker, Phoebe Hart, as she comes clean on her journey of self-discovery to embrace her future and reconcile the past shame and family secrecy surrounding her intersex condition. Despite her mother’s outright refusal to be in the film, Phoebe decides she must push on with her quest to resolve her life story and connect with other intersex people on camera. With the help of her sister Bonnie and support from her partner James, she hits the open road and reflects on her youth. Phoebe’s happy and carefree childhood came to an abrupt end at puberty when she was told she would never menstruate nor have children. But the reasons why were never discussed and the topic was taboo. At the age of 17, Phoebe’s mother felt she was old enough to understand the true nature of her body and the family secret was finally revealed. Phoebe then faced an orchidectomy, invasive surgery to remove her undescended testes, the emotional scars of which are still raw today. Phoebe’s road trip around Australia exposes her to the stories of other intersex people and holds a mirror to her own experience. She learns valuable lessons in resilience and healing but also sees the pervasive impact her condition has on all her relationships. At home, Phoebe and James want to start a family but dealing with infertility and the stress of the adoption process puts pressure on their marriage. Phoebe also starts to understand the difficult decisions her parents faced and is excited but apprehensive when they eventually agree to be interviewed. Will talking openly with her mother give Phoebe the answers she has been looking for? The film was produced and directed by Phoebe Hart and commissioned by the Australian Broadcasting Commission. The film premiered at the Brisbane International Film Festival in 2010 where it was voted the number one film of the festival by audiences. Orchids was broadcast on ABC1 in Australia in 2012, appeared in more than 50 film festivals internationally and has since been broadcast nationally in Switzerland, Sweden, Israel, Spain, France, Russia, Poland, Germany and the USA.

Gender studies : Intersex by Catherine Harper

Intersex is the condition whereby an individual is born with biological features that are simultaneously perceived as male and female. Ranging from the ambiguous genitalia of the true 'hermaphrodite' to the 'mildly or internally intersexed', the condition may be as common as cleft palate. Like cleft palate, it is hidden and surgically altered, but for very different reasons. Intersex draws heavily on the personal testimony of intersexed individuals, their loved ones and medical carers. The impact of early sex-assignment surgery on an individual's later life is examined within the context of ethical and clinical questions. Harper challenges the conventional and radical 'treatment' of intersexuality through non-consensual infant sex-assignment surgery. In doing so, she exposes powerful myths, taboos and constructions of gender - the perfect phallus, a bi-polar model of gender and the infallibility of medical decisions. Handling sensitive material with care, this book deepens our understanding of a condition that has itself only been medically understood in recent years.

Social media, data analytics and videogames development : Halfbrick case study

Social media platforms are of interest to interactive entertainment companies for a number of reasons. They can operate as a platform for deploying games, as a tool for communicating with customers and potential customers, and can provide analytics on how players utilize the; game providing immediate feedback on design decisions and changes. However, as ongoing research with Australian developer Halfbrick, creators of $2 , demonstrates, the use of these platforms is not universally seen as a positive. The incorporation of Big Data into already innovative development practices has the potential to cause tension between designers, whilst the platform also challenges the traditional business model, relying on micro-transactions rather than an up-front payment and a substantial shift in design philosophy to take advantage of the social aspects of platforms such as Facebook.

Innovation & workplace culture in the Australian interactive entertainment industry : the Halfbrick story

A recent success story of the Australian videogames industry is Brisbane based Halfbrick Studios, developer of the hit game for mobile devices, Fruit Ninja. Halfbrick not only survived the global financial crisis and an associated downturn in the Australian industry, but grew strongly, moving rapidly from developing licensed properties for platforms such as Game Boy Advance, Nintendo DS, and Playstation Portable (PSP) to becoming an independent developer and publisher of in-house titles, generating revenue both through App downloads and merchandise sales. Amongst the reasons for Halfbrick’s success is their ability to adaptively transform by addressing different technical platforms, user dynamics, business models and market conditions. Our ongoing case-study research from 2010 into Halfbrick’s innovation processes, culminating with some 10 semi-structured interviews with senior managers and developers, has identified a strong focus on workplace organisational culture, with staff reflecting that the company is a flat, team-based organisation devolving as much control as possible to the development teams directly, and encouraging a work-life balance in which creativity can thrive. The success of this strategy is evidenced through Halfbrick’s low staff turnover; amongst our interviewees most of the developers had been with the company for a number of years, with all speaking positively of the workplace culture and sense of creative autonomy they enjoyed. Interviews with the CEO, Shainiel Deo, and team leaders highlighted the autonomy afforded to each team and the organisation and management of the projects on which they work. Deo and team leaders emphasised the collaboration and communication skills they require in the developers that they employ, and that these characteristics were considered just as significant in hiring decisions as technical skills. Halfbrick’s developers celebrate their workplace culture and insist it has contributed to their capacity for innovation and to their commercial success with titles such as Fruit Ninja. This model of organisational management is reflected in both Stark’s (2009) idea of heterarchy, and Neff’s (2012) concept of venture labour, and provides a different perspective on the industry than the traditional political economy critique of precarious labour exploited by gaming conglomerates. Nevertheless, throughout many of the interviews and in our informal discussions with Halfbrick developers there is also a sense that this rewarding culture is quite tenuous and precarious in the context of a rapidly changing and uncertain global videogames industry. Whether such a workplace culture represents the future of the games industry, or is merely a ‘Prague Spring’ before companies such as Halfbrick are swallowed by traditional players’ remains to be seen. However, as the process of rapid and uncertain transformation plays out across the videogames industry, it is important to pay attention to emerging modes of organisation and workplace culture, even whilst they remain at the margins of the industry. In this paper we investigate Halfbrick’s workplace culture and ask how sustainable is this kind of rewarding and creative workplace?

Methodologies for measuring research impact for a new interdisciplinary institute

Interdisciplinary research is often funded by national government initiatives or large corporate sponsorship, and as such, demands periodic reporting on the use of those funds. For reasons of accountability, governance and communication to the tax payer, knowledge of the outcomes of the research need to be measured and understood. The interdisciplinary approach to research raises many challenges for impact reporting. This presentation will consider what are the best practice workflow models and methodologies.Novel methodologies that can be added to the usual metrics of academic publications include analysis of percentage share of total publications in a subject or keyword field, calculating most cited publication in a key phrase category, analysis of who has cited or reviewed the work, and benchmarking of this data against others in that same category. At QUT, interest in how collaborative networking is trending in a research theme has led to the creation of some useful co-authorship graphs that demonstrate the network positions of authors and the strength of their scientific collaborations within a group. The scale of international collaborations is also worth including in the assessment. However, despite all of the tools and techniques available, the most useful way a researcher can help themselves and the process is to set up and maintain their researcher identifier and profile.

Making mangoes move

A landscape of mangoes most likely brings to mind a place in a tropical location. By the end of the nineteenth century that place could have been located on any continent in the world. Mangoes were found in geographic locations; in scientific institutions; as crop plants; and as a backyard trees. Here I trace the movement of mangoes Mangifera indica Linn., focusing on the transnational links formed through colonial botanic gardens in Australia. Botanic gardens were largely understood through their work in establishing economically successful plantation crops, such as sugar and tea. Mangoes were not a success crop of the age of botanic imperialism. Instead, mangoes were simply one species among the millions of plants that botanic gardens moved in addition to these well known commercial crops. Colonial science moved plants for a myriad of other types of reasons, for ornament, for curiosity, for lesser commercial purposes and for pure science. In each site the mango emerged, the discourses and technologies that traveled with it changed according to local needs. Indeed, rather than finding mangoes located in one place, tracing their movement demonstrates that this was an extended landscape connecting these things across time and space...

Experimental study on the fire performance of superior LSF wall systems

Load bearing Light Gauge Steel Frame (LSF) walls are commonly made of conventional lipped channel sections and gypsum plasterboards. Recently, innovative steel sections such as hollow flange channel sections have been proposed as studs in LSF wall frames with a view to improve their fire resistance ratings. A series of full scale fire tests was then undertaken to investigate the fire performance of the new LSF wall systems under standard fire conditions. Test wall frames made of hollow flange section studs were lined with fire resistant gypsum plasterboards on both sides, and were subjected to increasing temperatures as given by the standard fire curve on one side. Both uninsulated and cavity insulated walls were tested with varying load ratios from 0.2 to 0.6. This paper presents the details of this experimental study on the fire performance of LSF walls and the results. Test results showed that the walls made of the new hollow flange channel section studs have a superior fire performance in comparison to that of lipped channel section stud walls. They also showed that the fire performance of cavity insulated walls was inferior to that of uninsulated walls. The reasons for this fire behaviour are described in this paper.

Selling new neighborhoods as good for walking : issues for measuring self-selection

Background: Self-selection-whether individuals inclined to walk more seek to live in walkable environments-must be accounted for when studying built environment influences on walking. The way neighborhoods are marketed to future residents has the potential to sway residential location choice, and may consequently affect measures of self-selection related to location preferences. We assessed how walking opportunities are promoted to potential buyers, by examining walkability attributes in marketing materials for housing developments. Methods: A content analysis of marketing materials for 32 new housing developments in Perth, Australia was undertaken, to assess how walking was promoted in the text and pictures. Housing developments designed to be pedestrian-friendly (LDs) were compared with conventional developments (CDs). Results: Compared with CDs, LD marketing materials had significantly more references to 'public transport,' small home sites,' walkable parks/open space,' ease of cycling,' safe environment,' and 'boardwalks.' Other walkability attributes approached significance. Conclusion: Findings suggest the way neighborhoods are marketed may contribute to self-reported reasons for choosing particular neighborhoods, especially when attributes are not present at the time of purchase. The marketing of housing developments may be an important factor to consider when measuring self-selection, and its influence on the built environment and walking relationship.