Enhancing decision-making about adjuvant chemotherapy in early breast cancer following EndoPredict testing

Objective Chemotherapy side‐effects can be substantial. There is increasing recognition that some oestrogen receptor positive (ER +ve), human epidermal growth factor receptor 2 negative (HER2 −ve) patients with breast cancer derive no benefit from chemotherapy and experience only iatrogenic harm. Gene expression profiling tests help refine recurrence risk and likely chemotherapy benefit. EndoPredict® is one such test, which classifies risks of distant recurrence as low or high in patients treated with surgery and adjuvant endocrine therapy alone. We compared treatment decisions pre‐test and post‐test results, patients' anxiety, decisional conflict, and oncologists' confidence about the decisions made. Methods Fourteen oncologists in 7 UK hospitals saw 149 pts judged to have equivocal indications for chemotherapy. Provisional treatment decisions were recorded then reconsidered when EPClin results were available. Pre‐test and post‐test results, patients completed State/Trait Anxiety Inventories (STAI), and the decisional conflict scale. Oncologists also recorded basic clinical details, their agreement with, and confidence about treatment decisions. Results Sixty‐seven percent patients initially prescribed endocrine alone with high risk result upgraded to endocrine+chemotherapy (E + C); 83% prescribed E + C and had low risk scores, downgraded to E. None of 46 patients initially favouring E alone, who were low risk, changed decisions. Oncologists' confidence about decisions was significantly increased following the results (P = 0.002). Patients with downgraded treatment decisions had significantly lower anxiety scores (P = 0.045); those upgraded had increased scores (P = 0.001). Overall decisional conflict and uncertainty fell significantly post‐test (P < 0.022). Conclusions EndoPredict scores increased oncologists' and patients' decision‐making confidence, generally improving the matching of risk with therapy decisions

Einfluss der relativen Luftfeuchte und Futtermenge auf die Überlebensrate während des ersten Larvenstadiums der Schwarzen Soldatenfliege (Hermetia illucens)

Im Rahmen dieser Bachelorarbeit wurde in einer schweizweit einzigartigen Versuchsanlage des Forschungsinstitut für biologischen Landbau (FiBL) in Frick ein Versuch aufgestellt, welcher den Einfluss der relativen Luftfeuchte auf die Überlebensrate der Schwarzen Soldatenfliege (Hermetia illucens) während des ersten Larvenstadiums innerhalb von 24h nach dem Schlupf eruiert. Dabei galt primär die Frage, ob die relative Luftfeuchte (rLF) einen Einfluss hat, und wenn ja, wie hoch diese gewählt werden soll. Zusätzlich wurde unter gleichen klimatischen Bedingungen der Einfluss der Futtermenge auf die Überlebensrate, das durchschnittliche Larvengewicht und auf den gesamten Biomassen-Aufbau untersucht. Nebenbei wurde eine Literaturrecherche durchgeführt, um eine Übersicht über die Bedürfnisse der Schwarzen Soldatenfliege (Hermetia illucens) zu schaffen, deren Ansprüche, welche sie an eine Zucht stellt, und den Stand der Forschung inkl. Forschungslücken zu beleuchten.During this Bachelor thesis, an experiment was undertaken in a unique experimental facility: ‘The Research Institute for Organic Agriculture’ (FiBL) in Frick, Switzerland, which focused on the survival rate of the Black Soldier Fly (Hermetia illucens) during the first larval stage within 24 hours of hatching. The primary question was: could the relative humidity have an influence within this time period on the survival rate, and if so, how high the relative humidity must be for successful breeding. In addition, under the same climatic conditions, the influence of the feed quantity on: survival rate; average larval weight and overall biomass formation was investigated. In the meantime, a literature search was conducted to provide an overview of the demands of the Black Soldier Fly (Hermetia illucens), with a particular focus on breed and current research gaps. The conditions of the experiment were already based on the generated findings of the experimental facility

Interorganizational IT governance : an exploratory research

This research project aimed to better understand how IT governance supports organizations in their business exchanges with other organizations. A model for interorganizational IT governance was synthesized based on literature from network governance streams. Through interviews with senior interorganizational IT governance committee members and IT executives, the critical IT governance factors and tactics employed that bring about successful interorganizational relationships were identified. These factors included IT governance structures, process tools and participants when undertaking interorganizational relationships, as well as interorganizational maturity. Identifying these factors allowed for the creation of a strategic model of interorganizational IT governance. Patterns of interorganizational IT governance constructs were analyzed against the success of interorganizational relationships. Emergent interorganizational IT governance construct classes were identified from the gathered data: emergent structure categories included outsourced form, networked form and value-chain form; emergent process focus included inward and outward focuses; emergent participant groups included unilateral, bilateral and committees; and emergent maturity stages included market, network and hierarchy