The Work-Retirement Environment

For most individuals who have the opportunity, paid work is a defining background to achievement in life. Employment has the potential to satisfy economic necessities, educational achievements, professional development, and social and cultural objectives. In many cases, it also assists individuals to define their identity, grow their self esteem, achieve personal ambitions, explore and develop collegial and professional relationships, grow skills and wisdom, and transmit this to the following generations. For many individuals, this process is not now defined and limited by a mandatory retirement date. Individuals are choosing to extend their engagement in the paid workforce and this has its benefits and challenges. This chapter examines these issues in the background of an increasingly ageing population.

Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations

Purpose The LUX-Lung 3 study investigated the efficacy of chemotherapy compared with afatinib, a selective, orally bioavailable ErbB family blocker that irreversibly blocks signaling from epidermal growth factor receptor (EGFR/ErbB1), human epidermal growth factor receptor 2 (HER2/ErbB2), and ErbB4 and has wide-spectrum preclinical activity against EGFR mutations. A phase II study of afatinib in EGFR mutation-positive lung adenocarcinoma demonstrated high response rates and progression-free survival (PFS). Patients and Methods In this phase III study, eligible patients with stage IIIB/IV lung adenocarcinoma were screened for EGFR mutations. Mutation-positive patients were stratified by mutation type (exon 19 deletion, L858R, or other) and race (Asian or non-Asian) before two-to-one random assignment to 40 mg afatinib per day or up to six cycles of cisplatin plus pemetrexed chemotherapy at standard doses every 21 days. The primary end point was PFS by independent review. Secondary end points included tumor response, overall survival, adverse events, and patient-reported outcomes (PROs). Results A total of 1,269 patients were screened, and 345 were randomly assigned to treatment. Median PFS was 11.1 months for afatinib and 6.9 months for chemotherapy (hazard ratio [HR], 0.58; 95% CI, 0.43 to 0.78; P = .001). Median PFS among those with exon 19 deletions and L858R EGFR mutations (n = 308) was 13.6 months for afatinib and 6.9 months for chemotherapy (HR, 0.47; 95% CI, 0.34 to 0.65; P = .001). The most common treatmentrelated adverse events were diarrhea, rash/acne, and stomatitis for afatinib and nausea, fatigue, and decreased appetite for chemotherapy. PROs favored afatinib, with better control of cough, dyspnea, and pain. Conclusion Afatinib is associated with prolongation of PFS when compared with standard doublet chemotherapy in patients with advanced lung adenocarcinoma and EGFR mutations.

Symptom control and quality of life in lux-lung 3 : a phase III study of afatinib or cisplatin/pemetrexed in patients with advanced lung adenocarcinoma with EGFR mutations

Purpose Patient-reported symptoms and health-related quality of life (QoL) benefits were investigated in a randomized, phase III trial of afatinib or cisplatin/pemetrexed. Patients and Methods Three hundred forty-five patients with advanced epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma were randomly assigned 2:1 to afatinib 40 mg per day or up to six cycles of cisplatin/pemetrexed. Lung cancer symptoms and health-related QoL were assessed every 21 days until progression using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Lung Cancer-13 questionnaires. Analyses of cough, dyspnea, and pain were preplanned, including percentage of patients who improved on therapy, time to deterioration of symptoms, and change in symptoms over time. Results Questionnaire compliance was high. Compared with chemotherapy, afatinib significantly delayed the time to deterioration for cough (hazard ratio [HR], 0.60; 95% CI, 0.41 to 0.87; P = .007) and dyspnea (HR, 0.68; 95% CI, 0.50 to 0.93; P = .015), but not pain (HR, 0.83; 95% CI, 0.62 to 1.10; P = .19). More patients on afatinib (64%) versus chemotherapy (50%) experienced improvements in dyspnea scores (P lt; .010). Differences in mean scores over time significantly favored afatinib over chemotherapy for cough (P lt; .001) and dyspnea (P = .001). Afatinib showed significantly better mean scores over time in global health status/QoL (P = .015) and physical (P = .001), role (P = .004), and cognitive (P lt; .007) functioning compared with chemotherapy. Fatigue and nausea were worse with chemotherapy, whereas diarrhea, dysphagia, and sore mouth were worse with afatinib (all P = .01). Conclusion In patients with lung adenocarcinoma with EGFR mutations, first-line afatinib was associated with better control of cough and dyspnea compared with chemotherapy, although diarrhea, dysphagia, and sore mouth were worse. Global health status/QoL was also improved over time with afatinib compared with chemotherapy.

Studio teaching in Australian planning curriculum

Planning studio pedagogy has long been a part of planning education and has recently re-emerged as a topic of investigation. Scholarship has: 1) critically examined the fluctuating popularity of studio teaching and the changing role of studio teaching in contemporary planning curricula in the USA and New Zealand; 2) challenged conceptualizations of the traditional studio and considered how emerging strategies for blended and online learning, and ‘real world engagement’ are producing new modes of studio delivery; 3) considered the benefits and outcomes of studio teaching, and; 4) provided recommendations for teaching practice by critically analysing studio experiences in different contexts (Aitken-Rose & Dixon, 2009; Balassiano, 2011; Balassiano & West, 2012; Balsas, 2012; Dandekar, 2009; Heumann & Wetmore, 1984; Higgins, Thomas & Hollander, 2010; Lang, 1983; Long, 2012; Németh & Long, 2012; Winkler, 2013). Twenty-three universities in Australia offer accredited planning degrees, yet data about the use of studio teaching in planning programs are limited. How, when and why are studio pedagogies used? If it is not a part of the curriculum – why?, and has this had any impact on student outcomes? What are the opportunities and limitations of new models of studio teaching for student, academic, professional and institutional outcomes? This paper presents early ideas from a QUT seed grant on the use of studio teaching in Australian planning education to gain a better understanding of the different roles of studio teaching in planning curricula at a National level and opportunities and challenges for this pedagogical mode in the face of dilemmas facing planning education.

Pollen image classification using the classifynder system: Algorithm comparison and a case study on New Zealand honey

We describe an investigation into how Massey University’s Pollen Classifynder can accelerate the understanding of pollen and its role in nature. The Classifynder is an imaging microscopy system that can locate, image and classify slide based pollen samples. Given the laboriousness of purely manual image acquisition and identification it is vital to exploit assistive technologies like the Classifynder to enable acquisition and analysis of pollen samples. It is also vital that we understand the strengths and limitations of automated systems so that they can be used (and improved) to compliment the strengths and weaknesses of human analysts to the greatest extent possible. This article reviews some of our experiences with the Classifynder system and our exploration of alternative classifier models to enhance both accuracy and interpretability. Our experiments in the pollen analysis problem domain have been based on samples from the Australian National University’s pollen reference collection (2,890 grains, 15 species) and images bundled with the Classifynder system (400 grains, 4 species). These samples have been represented using the Classifynder image feature set.We additionally work through a real world case study where we assess the ability of the system to determine the pollen make-up of samples of New Zealand honey. In addition to the Classifynder’s native neural network classifier, we have evaluated linear discriminant, support vector machine, decision tree and random forest classifiers on these data with encouraging results. Our hope is that our findings will help enhance the performance of future releases of the Classifynder and other systems for accelerating the acquisition and analysis of pollen samples.

A comparison of classification algorithms within the Classifynder pollen imaging system

We describe an investigation into how Massey University's Pollen Classifynder can accelerate the understanding of pollen and its role in nature. The Classifynder is an imaging microscopy system that can locate, image and classify slide based pollen samples. Given the laboriousness of purely manual image acquisition and identification it is vital to exploit assistive technologies like the Classifynder to enable acquisition and analysis of pollen samples. It is also vital that we understand the strengths and limitations of automated systems so that they can be used (and improved) to compliment the strengths and weaknesses of human analysts to the greatest extent possible. This article reviews some of our experiences with the Classifynder system and our exploration of alternative classifier models to enhance both accuracy and interpretability. Our experiments in the pollen analysis problem domain have been based on samples from the Australian National University's pollen reference collection (2890 grains, 15 species) and images bundled with the Classifynder system (400 grains, 4 species). These samples have been represented using the Classifynder image feature set. In addition to the Classifynder's native neural network classifier, we have evaluated linear discriminant, support vector machine, decision tree and random forest classifiers on these data with encouraging results. Our hope is that our findings will help enhance the performance of future releases of the Classifynder and other systems for accelerating the acquisition and analysis of pollen samples. © 2013 AIP Publishing LLC.

Shared values : diverse perspectives – engaging engineering educators in integrating Indigenous engineering knowledge into current curricula

BACKGROUND Engineering is a problem-based practically oriented discipline, whose practitioners aim to find effective solutions to engineering challenges, technically and economically. Engineering educators operate within a mandate to ensure that graduate engineers understand the practicalities and realities of good engineering practice. While this is a vital goal for the discipline, emerging influences are challenging the focus on ‘hard practicalities’ and requiring recognition of the cultural and social aspects of engineering. Expecting graduate engineers to possess communication skills essential for negotiating satisfactory outcomes in contexts of complex social beliefs about the impact of their work can be an unsettling and challenging prospect for engineering educators. This project identifies and addresses Indigenous engineering practices and principles, and their relevance to future engineering practices. PURPOSE This Office of Learning and Teaching (OLT) project proposes that what is known/discoverable about indigenous engineering knowledge and practices must be integrated into engineering curricula. This is an important aspect of ensuring that engineering as a profession responds competently to increasing demands for socially and environmentally responsible activity across all aspects of engineering activity. DESIGN/METHOD The project addresses i) means for appropriate inclusion of Indigenous students into usual teaching activities ii) assuring engineering educators have access to knowledge of Indigenous practices and skills relevant to particular engineering courses and topics iii) means for preparing all students to negotiate their way through issues of indigenous relationships with the land where engineering projects are planned. The project is undertaking wide-ranging research to collate knowledge about indigenous engineering principles and practices and develop relevant resource materials. RESULTS It is common to hear that such social issues as ‘Indigenous concerns’ are only of concern to environmental engineers. We challenge that perspective, and make the case that Indigenous knowledge is an important issue for all engineering educators in relation to effective integration of indigenous students and preparation of all engineering graduates to engage with indigenous communities. At the time of first contact, a rich and varied, technically literate, Indigenous social framework possessed knowledge of the environment that is not yet fully acknowledged in Australian society. A core outcome of the work will be development of resources relating to Indigenous engineering practices for inclusion in engineering core curricula. CONCLUSIONS A large body of technical knowledge was needed to survive and sustain human society in the complex environment that was Australia before 1788. This project is developing resource materials, and supporting documentation, about that knowledge to enable engineering educators to more easily integrate it into current curricula. The project also aims to demonstrate the importance for graduating engineers to appreciate the existence of diverse perspectives on engineering tasks and learn how to value - and employ - multiple paths to possible solutions.

Uptake of influenza vaccination in pregnancy amongst Australian Aboriginal and Torres Strait Islander women: A mixed-methods pilot study

Background Influenza infection during pregnancy is associated with significant morbidity and mortality. Immunisation against influenza is recommended during pregnancy in several countries but uptake of vaccine is poor. There are limited data on vaccine uptake, and the determinants of vaccination, in Australian Aboriginal and/or Torres Islander women during pregnancy. This study aimed to establish an appropriate methodology and collect pilot data on vaccine uptake and attitudes towards, and perceptions of, maternal influenza vaccination in that population in order to inform the development of larger studies. Methods A mixed-methods study comprised of a cross-sectional survey and yarning circles (focus groups) amongst Aboriginal and Torres Strait Islander women attending two primary health care services. The women were between 28 weeks gestation and less than 16 weeks post-birth. These data were supplemented by data collected in an ongoing national Australian study of maternal influenza vaccination. Aboriginal research officers collected community data and data from the yarning circles which were based on a narrative enquiry framework. Descriptive statistics were used to analyse quantitative data and thematic analyses were applied to qualitative data. Results Quantitative data were available for 53 women and seven of these women participated in the yarning circles. The proportion of women who reported receipt of an influenza vaccine during their pregnancy was 9/53. Less than half of the participants (21/53) reported they had been offered the vaccine in pregnancy. Forty-three percent reported they would get a vaccine if they became pregnant again. Qualitative data suggested perceived benefits to themselves and their infants were important factors in the decision to be vaccinated but there was insufficient information available to women to make that choice. Conclusions The rates of influenza immunisation may continue to remain low for Aboriginal and/or Torres Strait Islander women during pregnancy. Access to services and recommendations by a health care worker may be factors in the lower rates. Our findings support the need for larger studies directed at monitoring and understanding the determinants of maternal influenza vaccine uptake during pregnancy in Australian Aboriginal and Torres Strait Islander women. This research will best be achieved using methods that account for the social and cultural contexts of Aboriginal and Torres Strait Islander communities in Australia.

Genome-wide association study of CNVs in 16,000 cases of eight common diseases and 3,000 shared controls

Copy number variants (CNVs) account for a major proportion of human genetic polymorphism and have been predicted to have an important role in genetic susceptibility to common disease. To address this we undertook a large, direct genome-wide study of association between CNVs and eight common human diseases. Using a purpose-designed array we typed 19,000 individuals into distinct copy-number classes at 3,432 polymorphic CNVs, including an estimated 50% of all common CNVs larger than 500 base pairs. We identified several biological artefacts that lead to false-positive associations, including systematic CNV differences between DNAs derived from blood and cell lines. Association testing and follow-up replication analyses confirmed three loci where CNVs were associated with diseaseIRGM for Crohns disease, HLA for Crohns disease, rheumatoid arthritis and type 1 diabetes, and TSPAN8 for type 2 diabetesalthough in each case the locus had previously been identified in single nucleotide polymorphism (SNP)-based studies, reflecting our observation that most common CNVs that are well-typed on our array are well tagged by SNPs and so have been indirectly explored through SNP studies. We conclude that common CNVs that can be typed on existing platforms are unlikely to contribute greatly to the genetic basis of common human diseases. © 2010 Macmillan Publishers Limited. All rights reserved.

Genome-wide association study of ulcerative colitis identifies three new susceptibility loci, including the HNF4A region

Ulcerative colitis is a common form of inflammatory bowel disease with a complex etiology. As part of the Wellcome Trust Case Control Consortium 2, we performed a genome-wide association scan for ulcerative colitis in 2,361 cases and 5,417 controls. Loci showing evidence of association at P 1 × 10 5 were followed up by genotyping in an independent set of 2,321 cases and 4,818 controls. We find genome-wide significant evidence of association at three new loci, each containing at least one biologically relevant candidate gene, on chromosomes 20q13 (HNF4A; P = 3.2 × 10 17), 16q22 (CDH1 and CDH3; P = 2.8 × 10 8) and 7q31 (LAMB1; P = 3.0 × 10 8). Of note, CDH1 has recently been associated with susceptibility to colorectal cancer, an established complication of longstanding ulcerative colitis. The new associations suggest that changes in the integrity of the intestinal epithelial barrier may contribute to the pathogenesis of ulcerative colitis. © 2009 Nature America, Inc. All rights reserved.

Velum

Velum continues material experimentation with edible materials as explored within Formations: New Practices in Australian Architecture 2012. 1 The work employs the central theme of veiling as a ‘second skin’, an intermediary agent simultaneously engaging with Heideggerian themes of ‘nearness and revealing’ (1927, 1954). This second skin creates a liminality distorting everyday objects of popular culture and technological consumption. In doing so, the work puts forth multiple considerations, the figurative play upon consumption itself; the role of the strange and obscure to affect a deepening awareness of our accelerated consumption and experience; and more tangentially, questions surrounding imminent scenarios of hybridity between body and technology. Velum represents a recent focus of the authors’ creative practice, ‘Making Strange’ (Strange Making) published and presented elsewhere. Making Strange explores the sublime process, fundamental to both the final design outcome and the designing experience. The sublime process is seen as a leading, a physiological overpowering of self to a state of intense self-presence, often leading to self-transcendence or state of otherness. As such, the work engages with the body and materials, experimentally and in a trans-disciplinary manner to inform new material practice.

Developing a moderation community of practice

This paper reports on a study to evaluate technology-based processes for assessment moderation. The aim was to evaluate standard features found in an institutional Learning Management System, and their compatibility with the values and practices of a large teaching team. The process used an online discussion board forum for tutors, the paring of more experienced tutors with those new to the process, and further meetings conducted in both face-to-face and web conferencing environments. Online rubrics were used for assessing student work and the provision of feedback. A focus group conducted after marking was concluded and the analysis of the discussion board forum demonstrated a strong community of practice with a shared understanding of assessment requirements.

An online community designed to support future makers in educational reform

Australian education is undergoing national reform at many levels. The school sector, where preservice teachers will be employed, are adjusting to the demands of the National Curriculum and improving teacher quality through the National Professional Standards for Teachers. In addition, the university sector, where pre-service teachers are prepared, is undergoing its own education reform through the introduction of a demand-driven system and ensuring quality for tertiary education interns through the Higher Education Standards Framework. In moving to prepare preservice teachers for the school system; universities are grappling with the double-barreled approach to teacher quality; quality within the university course and quality within the student teachers being prepared. Through a collaborative partnership including university lecturers, Department of Education central administration staff, school principals, school coordinators, practicum supervisors, mentor teachers and pre-service teachers; the stakeholders have formed an online community of learners engaging in reflective practice who are committed to improving teacher quality. This online community not only links the key stakeholders within the project, it facilitates the nexus between theory and practice often missing in our pre-service teacher placements. This paper reports preliminary data about an initiative to ensure final year pre-service teachers are aspiring to meet the graduate professional standards through the use of an innovative online community.

A preliminary investigation into technology and processes facilitating the assurance of learning

This paper reports on the outcomes from a preliminary evaluation of technologies and processes intended to support the Assurance of Learning initiative in the business faculty of an Australian university. The study investigated how existing institutional information systems and operational processes could be used to support direct measures of student learning and the attainment of intended learning goals. The levels at which learning outcomes had been attained were extracted from the University Learning Management System (LMS), based on rubric data for three assessments in two units. Spreadsheets were used to link rubric criteria to the learning goals associated with the assessments as identified in a previous curriculum mapping exercise, and to aggregate the outcomes. Recommendations arising from this preliminary study are made to inform a more comprehensive pilot based on this approach, and manage the quality of student learning experiences in the context of existing processes and reporting structures.

Afatinib versus gefitinib as first-line treatment of patients with EGFR mutation-positive non-small-cell lung cancer (LUX-Lung 7): a phase 2B, open-label, randomised controlled trial

Background The irreversible ErbB family blocker afatinib and the reversible EGFR tyrosine kinase inhibitor gefitinib are approved for first-line treatment of EGFR mutation-positive non-small-cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and gefitinib in this setting. Methods This multicentre, international, open-label, exploratory, randomised controlled phase 2B trial (LUX-Lung 7) was done at 64 centres in 13 countries. Treatment-naive patients with stage IIIB or IV NSCLC and a common EGFR mutation (exon 19 deletion or Leu858Arg) were randomly assigned (1:1) to receive afatinib (40 mg per day) or gefitinib (250 mg per day) until disease progression, or beyond if deemed beneficial by the investigator. Randomisation, stratified by EGFR mutation type and status of brain metastases, was done centrally using a validated number generating system implemented via an interactive voice or web-based response system with a block size of four. Clinicians and patients were not masked to treatment allocation; independent review of tumour response was done in a blinded manner. Coprimary endpoints were progression-free survival by independent central review, time-to-treatment failure, and overall survival. Efficacy analyses were done in the intention-to-treat population and safety analyses were done in patients who received at least one dose of study drug. This ongoing study is registered with ClinicalTrials.gov, number NCT01466660. Findings Between Dec 13, 2011, and Aug 8, 2013, 319 patients were randomly assigned (160 to afatinib and 159 to gefitinib). Median follow-up was 27·3 months (IQR 15·3–33·9). Progression-free survival (median 11·0 months [95% CI 10·6–12·9] with afatinib vs 10·9 months [9·1–11·5] with gefitinib; hazard ratio [HR] 0·73 [95% CI 0·57–0·95], p=0·017) and time-to-treatment failure (median 13·7 months [95% CI 11·9–15·0] with afatinib vs 11·5 months [10·1–13·1] with gefitinib; HR 0·73 [95% CI 0·58–0·92], p=0·0073) were significantly longer with afatinib than with gefitinib. Overall survival data are not mature. The most common treatment-related grade 3 or 4 adverse events were diarrhoea (20 [13%] of 160 patients given afatinib vs two [1%] of 159 given gefitinib) and rash or acne (15 [9%] patients given afatinib vs five [3%] of those given gefitinib) and liver enzyme elevations (no patients given afatinib vs 14 [9%] of those given gefitinib). Serious treatment-related adverse events occurred in 17 (11%) patients in the afatinib group and seven (4%) in the gefitinib group. Ten (6%) patients in each group discontinued treatment due to drug-related adverse events. 15 (9%) fatal adverse events occurred in the afatinib group and ten (6%) in the gefitinib group. All but one of these deaths were considered unrelated to treatment; one patient in the gefitinib group died from drug-related hepatic and renal failure. Interpretation Afatinib significantly improved outcomes in treatment-naive patients with EGFR-mutated NSCLC compared with gefitinib, with a manageable tolerability profile. These data are potentially important for clinical decision making in this patient population.