The epidemiology of basal cell carcinoma

Basal cell carcinoma (BCC) is a skin cancer of particular importance to the Australian community. Its rate of occurrence is highest in Queensland, where 1% to 2% of people are newly affected annually. This is an order of magnitude higher than corresponding incidence estimates in European and North American populations. Individuals with a sun-sensitive complexion are particularly susceptible because sun exposure is the single most important causative agent, as shown by the anatomic distribution of BCC which is in general consistent with the levels of sun exposure across body sites. A distinguishing feature of BCC is the occurrence of multiple primary tumours within individuals, synchronously or over time, and their diagnosis and treatment costs contribute substantially to the major public health burden caused by BCC. A primary knowledge gap about BCC pathogenesis however was an understanding of the true frequency of multiple BCC occurrences and their body distribution, and why a proportion of people do develop more than one BCC in their life. This research project sought to address this gap under an overarching research aim to better understand the detailed epidemiology of BCC with the ultimate goal of reducing the burden of this skin cancer through prevention. The particular aim was to document prospectively the rate of BCC occurrence and its associations with constitutional and environmental (solar) factors, all the while paying special attention to persons affected by more than one BCC. The study built on previous findings and recent developments in the field but set out to confirm and extend these and propose more adequate theories about the complex epidemiology of this cancer. Addressing these goals required a new approach to researching basal cell carcinoma, due to the need to account for the phenomenon of multiple incident BCCs per person. This was enabled by a 20 year community-based study of skin cancer in Australians that provided the methodological foundation for this thesis. Study participants were originally randomly selected in 1986 from the electoral register of all adult residents of the subtropical township of Nambour in Queensland, Australia. On various occasions during the study, participants were fully examined by dermatologists who documented cumulative photodamage as well as skin cancers. Participants completed standard questionnaires about skin cancer-related factors, and consented to have any diagnosed skin cancers notified to the investigators by regional pathology laboratories in Queensland. These methods allowed 100% ascertainment of histologically confirmed BCCs in this study population. 1339 participants had complete follow-up to the end of 2007. Statistical analyses in this thesis were carried out using SAS and SUDAAN statistical software packages. Modelling methods, including multivariate logistic regressions, allowed for repeated measures in terms of multiple BCCs per person. This innovative approach gave new findings on two levels, presented in five chapters as scientific papers: 1. Incidence of basal cell carcinoma multiplicity and detailed anatomic distribution: longitudinal study of an Australian population The incidence of people affected multiple times by BCC was 705 per 100,000 person years compared to an incidence rate of people singly affected of 935 per 100,000 person years. Among multiply and singly affected persons alike, site-specific BCC incidence rates were far highest on facial subsites, followed by upper limbs, trunk, and then lower limbs 2. Melanocytic nevi and basal cell carcinoma: is there an association? BCC risk was significantly increased in those with forearm nevi (Odds Ratios (OR) 1.43, 95% Confidence Intervals (CI) 1.09-1.89) compared to people without forearm nevi, especially among those who spent their time mainly outdoors (OR 1.6, 95%CI 1.1-2.3) compared to those who spent their time mainly indoors. Nevi on the back were not associated with BCC. 3. Clinical signs of photodamage are associated with basal cell carcinoma multiplicity and site: a 16-year longitudinal study Over a 16-year follow-up period, 58% of people affected by BCC developed more than one BCC. Among these people 60% developed BCCs across different anatomic sites. Participants with high numbers of solar keratoses, compared to people without solar keratoses, were most likely to experience the highest BCC counts overall (OR 3.3, 95%CI 1.4-13.5). Occurrences of BCC on the trunk (OR 3.3, 95%CI 1.4-7.6) and on the limbs (OR 3.7, 95%CI 2.0-7.0) were strongly associated with high numbers of solar keratoses on these sites. 4. Occurrence and determinants of basal cell carcinoma by histological subtype in an Australian community Among 1202 BCCs, 77% had a single growth pattern and 23% were of mixed histological composition. Among all BCCs the nodular followed by the superficial growth patterns were commonest. Risk of nodular and superficial BCCs on the head was raised if 5 or more solar keratoses were present on the face (OR 1.8, 95%CI 1.2-2.7 and OR 4.5, 95%CI 2.1-9.7 respectively) and similarly on the trunk in the presence of multiple solar keratoses on the trunk (OR 4.2, 95%CI 1.5-11.9 and OR 2.2, 95%CI 1.1-4.4 respectively). 5. Basal cell carcinoma and measures of cumulative sun exposure: an Australian longitudinal community-based study Dermal elastosis was more likely to be seen adjacent to head and neck BCCs than trunk BCCs (p=0.01). Severity of dermal elastosis increased on each site with increasing clinical signs of cutaneous sun damage on that site. BCCs that occurred without perilesional elastosis per se, were always found in an anatomic region with signs of photodamage. This thesis thus has identified the magnitude of the burden of multiple BCCs. It does not support the view that people affected by more than one BCC represent a distinct group of people who are prone to BCCs on certain body sites. The results also demonstrate that BCCs regardless of site, histology or order of occurrence are strongly associated with cumulative sun exposure causing photodamage to the skin, and hence challenge the view that BCCs occurring on body sites with typically low opportunities for sun exposure or of the superficial growth pattern are different in their association with the sun from those on typically sun-exposed sites, or nodular BCCs, respectively. Through dissemination in the scientific and medical literature, and to the community at large, these findings can ultimately assist in the primary and secondary prevention of BCC, perhaps especially in high-risk populations.

Circles in the surf : Australian masculinity, mortality and grief

This article examines the constructs of masculinity that are predominant in contemporary Australian society and their influence upon men's perception of their health and well-being. It questions the currency of ‘male stoicism’ at a time when changed perceptions of masculinity are emerging. In particular, it considers how these constructs are evidenced in men's embracing of human mortality and their public expressions of grief. The nature of men's health promotion is discussed and a platform for promoting healthy approaches to masculinity, mortality and grief is presented.

Experimental creative practices

From the earliest human creative expressions there has been a relationship between art, technology and science. In Western history this relationship is often seen as drawing from the advances in both art and science that occurred during the Renaissance, and as captured in the polymath figure of da Vinci. The 20th century development of computer technology, and the more recent emergence of creative practice-led research as a recognised methodology, has lead to a renewed appreciation of the relationship between art, science and technology. This chapter focuses on transdisciplinary practices that bring together arts, science and technology in imaginative ways. Showing how such combinations have led to changes in both practice and forms of creative expression for artists and their partners across disciplines. The aim of this chapter is to sketch an outline of the types of transdisiplinary creative research projects that currently signify best practice in the field, which is done in reference to key literature and exemplars drawn from the Australian context.

Supporting cooperative design through "living" artefacts

We present findings from a field trial of CAM (Cooperative Artefact Memory) -- a mobile-tagging based messaging system -- in a design studio environment. CAM allows individuals to collaboratively store relevant information onto their physical design artefacts, such as sketches, collages, story-boards, and physical mock-ups in the form of messages, annotations and external web links. We studied the use of CAM in three student design projects. We observed that CAM facilitated new ways of collaborating in joint design projects. The serendipitous and asynchronous nature of CAM facilitated expressions of design aesthetics, allowed designers to have playful interactions, supported exploration of new design ideas, and supported designers' reflective practices. In general, our results show how CAM transformed mundane design artefacts into "living" artefacts that made the creative and playful side of cooperative design visible.

Production and isolation of ligated metal(IV)-oxo ions by tandem mass spectrometry

High valent metal(IV)-oxo species, \[M(=O)(Melm)(n)(OAc)](+) (M = Mn-Ni, MeIm = 1-methylimidazole, n = 1-2), which are relevant to biology and oxidative catalysis, were produced and isolated in gas-phase reactions of the metal(II) precursor ions \[M(MeIm)(n)(OAc)](+) (M = Mn-Zn, n = 1-3) with ozone. The precursor ions \[M(MeIm)(OAc)](+) and \[M(MeIm)(2)(OAc)](+) were generated via collision-induced dissociation of the corresponding \[M(MeIm)(3)(OAc)](+) ion. The dependence of ozone reactivity on metal and coordination number is discussed. Copyright (C) 2010 John Wiley & Sons, Ltd.

Localising national identity : Albany's Anzacs

Local representations of the significance of Albany, Western Australia, in the first world war and of the city's part in the birth of Anzac register substantial points of departure from national histories. While both the Anzac mythos and official renderings of Australia's wars are vigorously contested, Albany's reformulation offers a clear example of the ways in which communities actively inflect national narratives to create expressions of differentiated local identity. This article explores the relationship between the national and the local by focusing on the local narrative of the massing and departure of'The Great Anzac Convoy' in King George Sound in 1914. Particular attention is given to the way Albany has been able to appropriate and localise this event and the origins of Anzac, consequently promoting itself as an important element of the national identity, from which it nevertheless remains distinct. This localisation of an important element of national identity confers cultural standing and a potentially empowered position in relation to this national identity.

Optimising offsets and bandwidths in vehicle traffic networks

Bandwidths and offsets are important components in vehicle traffic control strategies. This article proposes new methods for quantifying and selecting them. Bandwidth is the amount of green time available for vehicles to travel through adjacent intersections without the requirement to stop at the second traffic light. The offset is the difference between the starting-time of ``green'' periods at two adjacent intersections, along a given route. The core ideas in this article were developed during the 2013 Maths and Industry Study Group in Brisbane, Australia. Analytical expressions for computing bandwidth, as a function of offset, are developed. An optimisation model, for selecting offsets across an arterial, is proposed. Arterial roads were focussed upon, as bandwidth and offset have a greater impact on these types of road as opposed to a full traffic network. A generic optimisation-simulation approach is also proposed to refine an initial starting solution, according to a specified metric. A metric that reflects the number of stops, and the distance between stops, is proposed to explicitly reduce the dissatisfaction of road users, and to implicitly reduce fuel consumption and emissions. Conceptually the optimisation-simulation approach is superior as it handles real-life complexities and is a global optimisation approach. The models and equations in this article can be used in road planning and traffic control.

Personal media and wireless cities : towards an urban spatial analysis

For the past decade, at least, varieties of small, hand held networked instruments have appeared on the global scene, selling in record numbers, and being utilized by all manner of persons from the old to the young; children, women, men, the wealthy and the poor and in all countries. Their presences bespeak a radical shift in telecommunications infrastructure and the future of communications. They are particularly visible in urban areas where mobile transmission network infrastructure (3G, 4G, cellular and Wi-Fi) is more established and substantial, options more plentiful, and density of populations more dramatic. These end user products—I phones, cell phones, Blackberries, DSi, DS, IPads, Zooms, and others – of the mobile communications industry are the latest, hottest globalized commodities. At the same time, wirelessness, or the state of being wireless, and therefore capable of taking along one's networks, communicating from unlikely spaces, and navigating with GPS, is a complex social, political and economic communications phenomenon of early 21st century life. This thesis examines the specter of being wireless in cities. It lends the entire idea an experimentally envisioned, historical and planned context wherein personalization of media tools is seen both as a design development of corporate, artistic, and military imagination, as well as a profound social phenomenon enabling new forms of sharing, belonging, and urban community. In doing that it asserts the parameters of a new mobile space which, aside from clear benefits to humankind by way of mobility, has reinscribed numerous categories including gender. Moreover, it posits the recognition of other, more nuanced theoretical spaces for complex readings of gender and gendered use, including some instantiation of the notion of 'network' itself as a cyborgian and gendered social form. Additionally, cities are studied as places where technology is not only quickly popularized, but is connected to larger political interests, such as the reading of data, tracking of information, and the new security culture. In so doing the work has been undertaken as an urban spatial analysis and experimental ethnography, utilizing architectural, feminist, techno-utopian, industrial and theoretical literatures as discursive underpinnings from whence understandings and interpretations of mobile space, the mobile office, networked mobility, and personal media have come, linking the space of cities to specific, pioneering urban public art projects in which voice, texting and MMS have been utilized in expressions of ubiquitous networks and urban history. Through numerous examples of techno art, the thesis discusses the 'wireless city' as an emerging cultural, socially constructed economic and spatial entity, both conceived and formed through historic processes of urbanization.

The effect of procurement on competition and flexibility : determining the suitability of public-private partnerships in major infrastructure projects

A procurement decision-making model is developed based on a novel integration of leading-edge microeconomic theory and empirically tested in major road and health projects. The model provides a more reliable approach to identifying projects suited to Public-Private-Partnerships (PPPs) and it is expected that the model will enable government to deliver improved value-for-money from their portfolio of PPP projects.

Finite element analysis of the in-plane shear behaviour of masonry panels confined with reinforced grouted cores

A combined experimental and numerical program was conducted to study the in-plane shear behaviour of hollow concrete masonry panels containing reinforced grout cores. This paper is focused on the numerical program. A two dimensional macromodelling strategy was used to simulate the behaviour of the confined masonry (CM) shear panels. Both the unreinforced masonry and the confining element were modelled using macromasonry properties and the steel reinforcement was modelled as an embedded truss element located within the grout using perfectly bonded constraint. The FE model reproduced key behaviours observed in the experiments, including the shear strength, the deformation and the crack patterns of the unconfined and confined masonry panels. The predictions of the validated model were used to evaluate the existing in-plane shear expressions available in the national masonry standards and research publications.

Aspects of Keno modelling

In two earlier papers, an intricate Jackpot structure and analysis of pseudo-random numbers for Keno in the Australian state of Queensland circa 2000 were described. Aspects of the work were also reported at an international conference . Since that time, many aspects of the game in Australia have changed. The present paper presents more up-to-date details of Keno throughout the states of Queensland, New South Wales and Victoria. A much simpler jackpot structure is now in place and this is described. Two add-ons or side-bets to the game are detailed: the trivial Heads or Tails and the more interesting Keno Bonus, which leads to consideration of the subset sum problem. The most intricate structure is where Heads or Tails and Keno Bonus are combined, and here, the issue of independence arises. Closed expressions for expected return to player (ERTP) are presented in all cases.

The renormalization group and the implicit function theorem for amplitude equations

This article lays down the foundations of the renormalization group (RG) approach for differential equations characterized by multiple scales. The renormalization of constants through an elimination process and the subsequent derivation of the amplitude equation [Chen, Phys. Rev. E 54, 376 (1996)] are given a rigorous but not abstract mathematical form whose justification is based on the implicit function theorem. Developing the theoretical framework that underlies the RG approach leads to a systematization of the renormalization process and to the derivation of explicit closed-form expressions for the amplitude equations that can be carried out with symbolic computation for both linear and nonlinear scalar differential equations and first order systems but independently of their particular forms. Certain nonlinear singular perturbation problems are considered that illustrate the formalism and recover well-known results from the literature as special cases. © 2008 American Institute of Physics.

Swelling induced finite strain flexure in a rectangular block of an isotropic elastic material

The deformation of a rectangular block into an annular wedge is studied with respect to the state of swelling interior to the block. Nonuniform swelling fields are shown to generate these flexure deformations in the absence of resultant forces and bending moments. Analytical expressions for the deformation fields demonstrate these effects for both incompressible and compressible generalizations of conventional hyperelastic materials. Existing results in the absence of a swelling agent are recovered as special cases.

The subset sum problem in Keno modelling

Aspects of Keno modelling throughout the Australian states of Queensland, New South Wales and Victoria are discussed: the trivial Heads or Tails and the more interesting Keno Bonus, which leads to consideration of the subset sum problem. The most intricate structure is where Heads or Tails and Keno Bonus are combined, and here, the issue of independence arises. Closed expressions for expected return to player are presented in each case.

Methods for sociological inquiry on emotion in educational settings

Sociological approaches to inquiry on emotion in educational settings are growing. Despite a long tradition of research and theory in disciplines such as psychology and sociology, the methods and approaches for naturalistic investigation of emotion are in a developmental phase in educational settings. In this article, recent empirical studies on emotion in educational contexts are canvassed. The discussion focuses on the use of multiple methods within research conducted in high school and university classrooms highlighting recent methodological progress. The methods discussed include facial expression analysis, verbal and non-verbal conduct, and self-report methods. Analyses drawn from different studies, informed by perspectives from microsociology, highlight the strengths and limitations of any one method. The power and limitations of multi-method approaches is discussed.