Meta-analyses of Phase 3 randomised controlled trials of third generation aromatase inhibitors versus tamoxifen as first-line endocrine therapy in postmenopausal women with hormone receptor-positive advanced breast cancer

Background Four randomised controlled trials (RCTs) in postmenopausal women with advanced breast cancer (ABC) comparing aromatase inhibitors (AIs) versus the selective estrogen receptor modulator tamoxifen, each individually reported significantly longer progression free survival (PFS) but none showed a significant difference in overall survival (OS). In these trials between 6.8%–55% of tumours were hormone receptor (HR) status unknown or negative. This meta-analysis restricted the comparison to HR-positive (HR+) tumours. MethodsAnonymised individual patient data were obtained from three RCTs, EORTC (exemestane versus tamoxifen), Study 0027 and Study 0030 (both anastrozole versus tamoxifen). For the remaining RCT (Femara Study PO25; letrozole versus tamoxifen), odds ratio (OR) or hazard ratio (HzR), with confidence intervals were obtained from the clinical study report, for patients with HR+ tumours, in addition to published data. In total, data were obtained from 2296 patients; 1560 (68%) had HR+ ABC. FindingsThe OR for clinical benefit rate was 1·56, in favour of AIs (p[less than] 0·001). The duration of clinical benefit was not significantly increased by AIs (hazard ratio [HzR] 0·88; p=0·08). For PFS the HzR (0·82) was in favour of AIs (p=0·007). However, for OS the HzR (1·05) was not significantly different between AIs and tamoxifen (p=0·42).InterpretationAlthough third generation AIs put significantly more patients into ‘clinical benefit’, their tumours were not controlled for significantly longer. Overall, while this resulted in a significantly greater PFS in favour of the AIs, this did not translate into improvement in OS

The European Union, borders and conflict transformation: the case of Cyprus

Much of the existing literature on the European Union (EU), conflict transformation and border dynamics has been premised on the assumption that the nature of the border determines EU intervention and the consequences that flow from this in terms of EU impact. The article aims to transcend this literature through assessing how domestic interpretations influence EU border transformation in conflict situations, taking Cyprus as a case study. Moreover, the objective is to fuse the literature on EU bordering impact and perceptions of the EU’s normative projection in conflict resolution. Pursuing this line of inquiry is an attempt to depart from the notion of borders being constructed solely by unidirectional EU logics of engagement or bordering practices to a conceptualization of the border as co-constituted space, where the interpretations of the EU’s normative projections by conflict parties, and the strategies that they pursue, can determine the relative openness of the EU border

Health-related quality of life from the FALCON phase III randomised trial of fulvestrant 500 mg versus anastrozole for hormone receptor-positive advanced breast cancer

Background The phase III randomised FALCON trial (NCT01602380) demonstrated improved progression-free survival with fulvestrant 500 mg versus anastrozole 1 mg in endocrine therapy-naïve postmenopausal women with hormone receptor-positive (HR+) locally advanced or metastatic breast cancer (LA/MBC). Furthermore, overall health-related quality of life (HRQoL) was maintained and comparable for fulvestrant and anastrozole. Here, we present additional analyses of patient-reported HRQoL outcomes from FALCON. Methods Women with endocrine therapy-naïve HR+ LA/MBC were randomised 1:1 to fulvestrant (days 0, 14, 28, then every 28 d) or anastrozole (daily) until disease progression or discontinuation. HRQoL was assessed by FACT-B questionnaire (TOI and FACT-B total score) at randomisation and every 12 weeks during treatment. HRQoL data post-treatment (with or without progression) were also collected. Results In total, 462 patients were randomised (fulvestrant, n = 230; anastrozole, n = 232). Compliance to FACT-B overall ranged from 60.0 to 97.4%. Mean change from baseline in TOI and FACT-B total score remained broadly stable (approximately ± 3 points to week 132) and was similar between arms during treatment. HRQoL was also maintained in FACT-B subscales. Approximately one-third of patients had improved TOI (≥+6 points) and FACT-B (≥+8 points) total scores from baseline up to week 120 and 132, respectively, of treatment with fulvestrant (ranges 26.4–45.0% and 22.4–35.8%, respectively) and anastrozole (ranges 18.6–32.9%, and 22.7–37.9%, respectively). Conclusions Mean change from baseline in TOI and FACT-B total score was maintained for fulvestrant and anastrozole; similar proportions of patients in both arms had improved TOI and FACT-B total scores

miramap a collective awareness platform to support open policy making and the integration of the citizens perspective in urban planning and governance

The chapter intends to explore an innovative approach for a more inclusive and sustainable urban planning and governance through the use of the ICT matched with a participatory process. It describes the transition process from a pilot project (Crowdmapping Mirafiori Sud/CMMS) headed by the Politecnico di Torino in 2013 in the Mirafiori Sud district of Turin (Italy)—whose aim was to design and test an open-source crowdmapping platform to identify and categorize, aggregating large amounts of user-generated inputs, the nature, the location and the consistency of the obstacles, which prevent vulnerable categories to use the public space in their neighbourhood—to the set up of a proper governing tool (MiraMap) to enhance open policy-making and the integration of the citizens' perspective through their effective engagement. Such platform is expected to have very concrete impacts both in empowering citizens, supporting grassroots processes and practices, sharing knowledge and in allowing policy options and design to become more informed and targeted. The methodology and the technological implementation supporting the creation of the platform have been developed by a multidisciplinary research team (urban planners, architects, sociologists, engineers, computer scientists, legal experts) in consultation with—and with the support of—the local public administration and the community-based organizations

Some Uses and Potentials of Qualitative Methods in Planning

Planners use methods borrowed from many disciplines. These are usually modified and adapted to meet planner's needs to acquire and sift through many diverse information sources helpful in dealing with complex problems. The quantitative methods which planners use are well known, well established in practice, and acknowledged by most as tools of the planners' trade. In contrast to this, most planners also use qualitative methods but these are rarely explicitly acknowledged.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68912/2/10.1177_0739456X8600600110.pd

Transatlantic intelligence and security cooperation

Despite recent advances in transatlantic intelligence and security cooperation, significant problems remain. The bombings in Madrid in March 2004 have demonstrated how terrorists and criminals can continue to exploit the limits of hesitant or partial exchange to dangerous effect. Intelligence and security cooperation remain problematic because of the fundamental tension between an increasingly networked world, which is ideal terrain for the new religious terrorism, and highly compartmentalized national intelligence gathering. If cooperation is to improve, we require a better mutual understanding about the relationship between privacy and security to help us decide what sort of intelligence should be shared. This is a higher priority than building elaborate new structures. While most practical problems of intelligence exchange are ultimately resolvable, the challenge of agreeing what the intelligence means in broad terms is even more problematic. The last section of this article argues that shared NATO intelligence estimates would be difficult to achieve and of doubtful value

Understanding parental stressors: An investigation of British tennis-parents

This article was published in the Journal of Sports Sciences [Routledge (© Taylor & Francis)] and the definitive version is available at: http://dx.doi.org/10.1080/02640410802603871In this study, we examined the stressors experienced by British tennis-parents. The parents (n¼123) completed an extensive survey focused on the internal and external demands that they had encountered through having a child compete in the sport. The survey consisted of open-ended questions related to competition, coaching, organizational, personal, and developmental issues. Inductive and deductive content analysis resulted in the development of seven core themes of tennis-parental stressor: competition, coaches, finance, time, siblings, organization-related, and developmental. Parents experienced a diverse number of competitive stressors indicating the particular difficulties they faced before, during, and after matches involving their child, opponents, other parents, and officials. They also reported a wide range of organizational stressors that paralleled the financial, social, and personal investments that accompanied their support roles. The results of this research reinforce the importance of parents possessing the necessary skills to cope with the psychological, developmental, and logistical demands of competitive tennis. Implications with respect to induction workshops and education for coaches and parents are presented, as well as consideration for governing bodies to enhance their communication channels and logistical support. Future research recommendations are posed to build upon the study of this domain in youth sport

Ownership constraints to brownfield redevelopment

The authors examine the nature and significance of ownership constraints within the urban redevelopment process. They suggest that such constraints derive from the distinctiveness of land as a commodity, the imperfect nature of the land market, the behavioural characteristics of landowners, and the institutional context for land ownership, exchange, and development. From this, they propose a common definition of ownership constraints as a basis for their practical classification. This divides ownership constraints between those that concern deficiencies in, or limitations to, the extent of ownership rights in potential development land and those that relate specifically to the strategies, interests, and actions of those who hold such rights. The various types of ownership constraints that fall under these headings are then explored, with research presented into the extent to which they each disrupted plans to use, market, develop, or purchase eighty large redevelopment sites in four British cities between 1991 and 1995

Change in the political economy of land value capture in England

Variations in the character, performance and impact of policies and practices to capture land value for the community are usually examined by analysing experience in different countries. Such international comparative research is cross-sectional and does not cover the evolving relations between systems of land value capture and the economies, polities and societies within which they are set. This paper examines the relations in England between the extant political economy and supporting ideologies, and the distinctive forms of land value capture that they produced. It traces the shift from a top-down, strategic approach in an era of corporatist government before 1979 to the subsequent extension and consolidation of bottom-up practice set within the context of neo-liberalism. The analysis highlights the evolution of the idea of land value capture and the policies and practices associated with it, especially the contestation that informed such changes