Risk of second cancer after lymphohematopoietic neoplasm

People living with lymphohematopoietic neoplasms (LHNs) are known to have increased risks of second cancer; however, the incidence of second cancers after LHNs has not been studied extensively in Australia. The Australian Cancer Database was used to analyze site-specific risk of second primary cancer after LHNs in 127,707 patients diagnosed between 1983 and 2005. Standardized incidence ratios (SIRs) were calculated using population rates. Overall, patients with an LHN had nearly twice the risk of developing a second cancer compared to the Australian population. Among 40,321 patients with non-Hodgkin's lymphoma (NHL), there was over a fourfold significant increase in melanoma, Kaposi sarcoma, cancer of the lip, connective tissue and peripheral nerves, eye, thyroid, Hodgkin's disease (HD) and myeloid leukemia. Among 6,396 patients with HD, there was over a fourfold significant increase in melanoma, Kaposi sarcoma, cancer of the lip, oral cavity and pharynx, female breast, uterine cervix, testis, thyroid, NHL and myeloid leukemia. Among the 33,025 patients with lymphoid and myeloid leukemia, significant excess were seen for cancers of the lip, eye, connective tissue and peripheral nerves, NHL and HD. Among the 13,856 patients with plasma cell tumors, there was over fourfold significant increase for melanoma, cancer of the connective tissue and peripheral nerves and myeloid leukemia. Our findings provide evidence of an increased risk of cancer, particularly ultraviolet radiation- and immunosuppression-related cancers, after an LHN in Australia. Copyright © 2010 UICC.

A Research Framework for Investigating Public Private Partnerships (PPP) in Hong Kong

PPP is a general term covering all contracted relationships between the public and private sectors to produce a public asset or to deliver a public service. Its major advantage lies in utilising resources from the private sector to alleviate some of the financial burdens of the government. The Asian financial turmoil in the late 1990s has imposed enormous pressure on the budget of the Hong Kong Special Administrative Region (HKSAR) Government. With a continuous outcry for better public services due to the rapid development of Hong Kong, alternative financing models need to be sought to ensure sustainability. Hong Kong has the advantage of being the international gateway to Mainland China, and with this benefit has attracted overseas enterprises to base their offices in Hong Kong for the Asian market. Obviously the private sector has much to contribute. The HKSAR Government has realised the benefits of using PPP in Hong Kong as well as the success achieved overseas. But a more thorough research is needed to develop the most suitable practice of PPP in terms of project nature, project complexity, project type and project scale under which PPP is most appropriate for Hong Kong. This paper provides an initial report of a research project being funded by the Research Grants Council (RGC) of the HKSAR. The project aims to evaluate the benefits and risks of PPP adopted in Australia and the United Kingdom, and from these previous experiences to develop a best practice framework for implementing PPP in Hong Kong. It firstly reports on the status of PPP development trend and the hands-on experiences which have been drawn in these countries. Qualitative and quantitative research methods applied in conducting the research are discussed. The likely impacts of the study are highlighted. It is believed that the construction industry and the government would benefit a lot as a result of this study, and further procurement and project financing options would be opened up for delivering better future public service.

Smart Measures for Sustainable Outcomes: Integrated Considerations for Sustainable Refurbishment of Office Buildings

The increasing stock of aging office buildings will see a significant growth in retrofitting projects in Australian capital cities. Stakeholders of refitting works will also need to take on the sustainability challenge and realize tangible outcomes through project delivery. Traditionally, decision making for aged buildings, when facing the alternatives, is typically economically driven and on ad hoc basis. This leads to the tendency to either delay refitting for as long as possible thus causing building conditions to deteriorate, or simply demolish and rebuild with unjust financial burden. The technologies involved are often limited to typical strip-clean and repartition with dry walls and office cubicles. Changing business operational patterns, the efficiency of office space, and the demand on improved workplace environment, will need more innovative and intelligent approaches to refurbishing office buildings. For example, such projects may need to respond to political, social, environmental and financial implications. There is a need for the total consideration of buildings structural assessment, modeling of operating and maintenance costs, new architectural and engineering designs that maximise the utility of the existing structure and resulting productivity improvement, specific construction management procedures including procurement methods, work flow and scheduling and occupational health and safety. Recycling potential and conformance to codes may be other major issues. This paper introduces examples of Australian research projects which provided a more holistic approach to the decision making of refurbishing office space, using appropriate building technologies and products, assessment of residual service life, floor space optimisation and project procurement in order to bring about sustainable outcomes. The paper also discusses a specific case study on critical factors that influence key building components for these projects and issues for integrated decision support when dealing with the refurbishment, and indeed the “re-life”, of office buildings.

Identification of key competences of design-builders in the construction market of the People’s Republic of China (PRC)

Design-builders play a vital role in the success of DB projects. In the construction market of the People’s Republic of China, most of the design-builders, however, lack adequate competences to conduct the DB projects successfully. The objective of this study is, therefore, to identify the key competences that design-builders should possess to not only ensure the success of DB projects but also acquire the competitive advantages in the DB market. Five semi-structured face-to-face interviews and two rounds of Delphi questionnaire survey were conducted to identify the key competences of design-builders. Rankings have been assigned to these key competences on the basis of their relative importance. Six ranked key competences of design-builders have been identified, which are, namely, (1) experience with similar DB projects; (2) capability of corporate management; (3) combination of building techniques and design expertise; (4) financial capability for DB projects; (5) enterprise qualification and scale; and (6) credit records and reputation in the industry. The design-builders can make use of the research findings as guidelines to improve their DB competence. These research findings will also be useful to clients during the selection of design-builders.

The investigation of design-build variants in the construction market of the People’s Republic of China

Design-Build (DB) system has been widely adopted overseas but it has not received the same popularity yet in the People’s Republic of China. The selection of design-build variant is regarded as one of the critical obstacles to the application of this alternative. This paper investigates categories of design-build variants in the construction market of China. The develop-and-construction, enhanced design-build, traditional-design-build and engineering procurement-construction (EPC) are the four current designbuild variants adopted by clients. Each of them is developed to meet a varying set of circumstances and has its own advantages and disadvantages. The develop-and-construction is mostly used in large, complex projects in housing industry and it will guarantee client’s great control over the project while still leave some design room for the contractor. The traditional-design-build and enhanced-design-build systems are mostly applied in projects that are comparatively simple, small-scale, and the DB contractors will have greater control of the projects. The EPC is the extension of pure design-build method and is widely adopted in the petrochemical, metallurgical and electronic fields because of the high-technique requirements and the necessity for one entity to control the design, construction, procurement and commissioning etc. Four corresponding design-build projects are also presented in this paper in order to better illustrate the operational process and provide the insight for understanding the design-build variants in Mainland China.

Wound healing angiogenesis : the clinical implications of a simple mathematical model

Nonhealing wounds are a major burden for health care systems worldwide. In addition, a patient who suffers from this type of wound usually has a reduced quality of life. While the wound healing process is undoubtedly complex, in this paper we develop a deterministic mathematical model, formulated as a system of partial differential equations, that focusses on an important aspect of successful healing: oxygen supply to the wound bed by a combination of diffusion from the surrounding unwounded tissue and delivery from newly formed blood vessels. While the model equations can be solved numerically, the emphasis here is on the use of asymptotic methods to establish conditions under which new blood vessel growth can be initiated and wound-bed angiogenesis can progress. These conditions are given in terms of key model parameters including the rate of oxygen supply and its rate of consumption in the wound. We use our model to discuss the clinical use of treatments such as hyperbaric oxygen therapy, wound bed debridement, and revascularisation therapy that have the potential to initiate healing in chronic, stalled wounds.

Medical ultrasound imaging

Ultrasound is used extensively in the field of medical imaging. In this paper, the basic principles of ultrasound are explained using ‘everyday’ physics. Topics include the generation of ultrasound, basic interactions with material and the measurement of blood flow using the Doppler effect.

Modified texture menu analysis

Lower energy and protein intakes are well documented in patients on texture modified diets. In acute hospital settings, the provision of appropriate texture modified foods to meet industry standards is essential for patient safety and nutrition outcomes. The texture modified menu at an acute private hospital was evaluated in accordance with their own nutritional standards (NS) and Australian National Standards (Dietitians Association of Australia and Speech Pathology Australia, 2007). The NS documents portion sizes and nutritional requirements for each menu. Texture B and C menus were analysed qualitatively and quantitatively over 9 days of a 6 day cyclic menu for breakfast (n=4), lunch (n=34) and dinner (n=34). Results indicated a lack of portion control, as specified by the NS, across all meals including breakfast (65–140%), soup (55–115%), meat (45–165%), vegetables (55–185%) and desserts (30–300%). Dilution factors and portion sizes influenced the protein and energy availability of Texture B & C menus. While the Texture B menu provided more energy, neither menu met the NS. Limited dessert options on the Texture C menu restricted the ability of this menu to meet protein NS. A lack of portion control and menu items incorrectly modified can compromise protein and energy intakes. Strategies to correct serving sizes and provision of alternate protein sources were recommended. Suggestions included cost-effectively increasing the variety of foods to assist protein and energy intake and the procurement of standardised equipment and visual aids to assist food preparation and presentation in accordance with texture modified guidelines and the NS.

Benign Epilepsy with Centro-temporal Spikes: Spike Triggered fMRI Shows Somato-sensory Cortex Activity

Summary:  Objective: We performed spike triggered functional MRI (fMRI) in a 12 year old girl with Benign Epilepsy with Centro-temporal Spikes (BECTS) and left-sided spikes. Our aim was to demonstrate the cerebral origin of her interictal spikes. Methods: EEG was recorded within the 3 Tesla MRI. Whole brain fMRI images were acquired, beginning 2–3 seconds after spikes. Baseline fMRI images were acquired when there were no spikes for 20 seconds. Image sets were compared with the Student's t-test. Results: Ten spike and 20 baseline brain volumes were analysed. Focal activiation was seen in the inferior left sensorimotor cortex near the face area. The anterior cingulate was more active during baseline than spikes. Conclusions: Left sided epileptiform activity in this patient with BECTS is associated with fMRI activation in the left face region of the somatosensory cortex, which would be consistent with the facial sensorimotor involvement in BECT seizures. The presence of BOLD signal change in other regions raises the possibility that the scalp recorded field of this patient with BECTs may reflect electrical change in more than one brain region.