Early career patterns, experiences, and influences: reflections from women engineers in senior roles

Early career experiences provide the foundation for career progression and inform career choices and decisions. For women in the engineering profession, positive early career experiences have been linked to persistence and retention within the profession A recent focus on early careers within engineering has provided insight into early career role types and related competencies, competency and capability gaps experienced by novice engineers, and their perceptions of meaningful engineering work. There is opportunity to diversify and contextualise this understanding by exploring early career experiences of women working within the engineering profession, and by considering the influence of gender on early career experiences and decisions. This paper reports on an empirical investigation of the career experiences of 22 women engineers in senior roles within engineering organisations in the Australian context. Phenomenological and temporal analysis of their career reflections provides evidence of three early career patterns of varied sequence and focus. The influences shaping these career paths are described. By making explicit possible, diverse early career paths, determinants and outcomes, this paper aims to continue to bridge the engineering education-practice gap and to contribute to greater equality, diversity, and inclusion within the profession

Adherence to prescribing restrictions for HER2-positive metastatic breast cancer in Australia: A national population-based observational study (2001-2016)

Background: Targeted cancer therapy is often complex, involving multiple agents and chemotherapeutic partners. In Australia, prescribing restrictions are put in place to reflect existing evidence of cost-effectiveness of these medicines. As therapeutic options continue to expand, these restrictions may not be perceived to align with best practice and it is not known if their use in the real-world clinic adheres to these restrictions. We examined the treatment of women receiving trastuzumab for HER2-positive metastatic breast cancer (HER2+MBC) to determine the extent to which treatment adhered to national prescribing restrictions. Patients and methods: Our population-based, retrospective cohort study used dispensing records for every Australian woman initiating publicly-subsidised trastuzumab for HER2+MBC between 2001±2013, followed through 2016. We used group-based trajectory models (GBTMs) to cluster patients, first on their patterns of trastuzumab exposure, and then on their patterns of lapatinib and chemotherapy exposure. We described the characteristics of patients within each cluster, and examined their treatments and combinations of treatments to determine restriction adherence. Results: Of 5,052 patients initiating trastuzumab, 1,795 (36%) received at least one non-adherent HER2-targeted treatment. The most common non-adherent treatments were trastuzumab combinations involving vinorelbine (24% of non-adherent treatments); capecitabine (24%); and anthracyclines (10%). Non-adherent lapatinib use was observed in 4% of patients. GBTM identified three trastuzumab exposure clusters, each containing three further subclusters. The largest proportions of non-adherent treatments were in sub-clusters with longer trastuzumab exposure and more non-taxane chemotherapy. Patients in these sub-clusters were younger than those in sub-clusters with less non-adherent treatment. Conclusions: Our study highlights that, even during the relatively simpler treatment era of our study period, a substantial amount of treatment did not adhere to prescribing restrictions. As more trials are conducted exploring pertuzumab and T-DM1 in combination with different chemotherapies and other HER2-targeted therapies, the regulation and funding of HER2-targeted treatment will become more challenging

Use and outcomes of targeted therapies in early and metastatic HER2-positive breast cancer in Australia: Protocol detailing observations in a whole of population cohort

Background: The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) has changed dramatically with the introduction and widespread use of HER2-targeted therapies. However, there is relatively limited real-world information on patterns of use, effectiveness and safety in whole of population cohorts. The research programme detailed in this protocol will generate evidence on the prescribing patterns, safety monitoring and outcomes of patients with BC treated with HER2- targeted therapies in Australia. Methods/design: Our ongoing research programme will involve a series of retrospective cohort studies that include every patient accessing Commonwealth-funded HER2-targeted therapies for the treatment of early BC and advanced BC in Australia. At the time of writing, our cohorts consist of 11 406 patients with early BC and 5631 with advanced BC who accessed trastuzumab and lapatinib between 2001 and 2014. Pertuzumab and trastuzumab emtansine were publicly funded for metastatic BC in 2015, and future data updates will include patients accessing these medicines. We will use dispensing claims for cancer and other medicines, medical service claims and demographics data for each patient accessing HER2- targeted therapies to undertake this research. Ethics and dissemination: Ethics approval has been granted by the Population Health Service Research Ethics Committee and data access approval has been granted by the Australian Department of Human Services (DHS) External Review Evaluation Committee. Our findings will be reported in peer-reviewed publications, conference presentations and policy forums. By providing detailed information on the use and outcomes associated with HER2-targeted therapies in a national cohort treated in routine clinical care, our research programme will better inform clinicians and patients about the real-world use of these treatments and will assist third-party payers to better understand the use and economic costs of these treatments

Design of a valid simulation for researching physical, physiological and cognitive performance in volunteer firefighters during bushfire deployment.

Every year, Australian firefighters protect our nation from the devastation of bushfire. Understanding the impact of consecutive long shifts in hot, smoky conditions is essential for making decisions during campaign fires. At present, the evidence-base for such decisions is limited to laboratory studies with little relevance to bushfire suppression or field research where the impact of environmental and workload stressors cannot be measured. To counter these limitations, we have developed a three-day simulation that mimics the work and environment of campaign bushfire suppression. Construction of the simulation involved three stages; 1) data collection and analysis; 2) design and development; and 3) trial and refinement. The frequency, intensity, duration and type of physical work performed on the fireground is well documented and a modified applied cognitive task analysis, using experienced firefighters was used as a framework to describe in detail the non-physical aspects of the work. The design and development of the simulation incorporated the physical and non-physical aspects of the work into simulated tasks. Finally, experienced firefighters participated in trials of the simulation and reviewed digital recordings to ensure that the simulation accurately represented campaign bushfire suppression work. The outcome of this project is a valid, realistic, and reliable simulation of the physiological, physical and cognitive aspects of a volunteer firefighter on a three-day bushfire deployment.<br /

Metastatic breast cancer incidence, site and survival in Australia, 2001-2016: A population-based health record linkage study protocol

Introduction: Advances in systemic therapy for early and metastatic breast cancer (BC) over the last two decades have improved patients’ survival, but their impact on metastatic disease outcomes at a population level is not well described. The aim of this study is to investigate changes in the incidence, site and survival of metastatic disease for women with a first diagnosis of BC in 2001– 2002 vs 2006–2007. Methods and analysis: Population-based retrospective cohort study of women with first primary invasive BC registered in the New South Wales (NSW) Cancer Registry in 2001–2002 and 2006–2007. We will use linked records from NSW hospitals, dispensed medicines, outpatient services and death registrations to determine: women’s demographic and tumour characteristics; treatments received; time to first distant metastasis; site of first metastasis and survival. We will use the Kaplan-Meier method to estimate cumulative incidence of distant metastasis, distant recurrence-free interval and postmetastasis survival by extent of disease at initial diagnosis, site of metastasis and treatment-defined tumour receptor type (hormone receptor-positive, human epidermal growth factor receptor-2-positive, triple negative). We will use Cox proportional hazards regression to estimate the relative effects of prognostic factors, and we will compare systemic therapy patterns by area-of- residence and area-level socioeconomic status to examine equity of access to healthcare. Ethics and dissemination: Research ethics committee approval was granted by the Australian Institute of Health and Welfare (#EO2017/2/255), NSW Population and Health Services (#HREC/17/CIPHS/19) and University of Notre Dame Australia (#0 17 144S). We will disseminate research findings to oncology, BC consumer and epidemiology audiences through national and international conference presentations, lay summaries to BC consumer groups and publications in international peer-reviewed oncology and cancer epidemiology journals

Defining Spoken Language Benchmarks and Selecting Measures of Expressive Language Development for Young Children with Autism Spectrum Disorders

Purpose: The aims of this article are twofold: (a) to offer a set of recommended measures that can be used for evaluating the efficacy of interventions that target spoken language acquisition as part of treatment research studies or for use in applied settings and (b) to propose and define a common terminology for describing levels of spoken language ability in the expressive modality and to set benchmarks for determining a child\u27s language level in order to establish a framework for comparing outcomes across intervention studies.Method: The National Institute on Deafness and Other Communication Disorders assembled a group of researchers with interests and experience in the study of language development and disorders in young children with autism spectrum disorders. The group worked for 18 months through a series of conference calls and correspondence, culminating in a meeting held in December 2007 to achieve consensus on these aims.Results: The authors recommend moving away from using the term functional speech, replacing it with a developmental framework. Rather, they recommend multiple sources of information to define language phases, including natural language samples, parent report, and standardized measures. They also provide guidelines and objective criteria for defining children\u27s spoken language expression in three major phases that correspond to developmental levels between 12 and 48 months of age

Defining Spoken Language Benchmarks and Selecting Measures of Expressive Language Development for Young Children With Autism Spectrum Disorders

Purpose The aims of this article are twofold: (a) to offer a set of recommended measures that can be used for evaluating the efficacy of interventions that target spoken language acquisition as part of treatment research studies or for use in applied settings and (b) to propose and define a common terminology for describing levels of spoken language ability in the expressive modality and to set benchmarks for determining a child’s language level in order to establish a framework for comparing outcomes across intervention studies. Method The National Institute on Deafness and Other Communication Disorders assembled a group of researchers with interests and experience in the study of language development and disorders in young children with autism spectrum disorders. The group worked for 18 months through a series of conference calls and correspondence, culminating in a meeting held in December 2007 to achieve consensus on these aims. Results The authors recommend moving away from using the term functional speech, replacing it with a developmental framework. Rather, they recommend multiple sources of information to define language phases, including natural language samples, parent report, and standardized measures. They also provide guidelines and objective criteria for defining children’s spoken language expression in three major phases that correspond to developmental levels between 12 and 48 months of age

Tracing groundwater flow paths in fractured rock using naturally-occurring organic biomarkers

Determining the source of infiltrating surface water into a groundwater system is often difficult, especially when the candidates are chemically similar. Here we explore how organic biomarkers that naturally occur at the surface can be used to establish the source of infiltration. This novel approach to groundwater tracing avoids the need to add chemical tracers to the water system; such tracers are often not fully recoverable and may be damaging to the environment. Different surface environments have specific biomarker signatures, reflecting the flora and fauna in each particular environment. As surface water infiltrates it transports surface organic biomarkers into the groundwater system. Analyses of biomarker signatures from different surface environments can therefore be compared to that of the groundwater under investigation. Here we present the results of a case study using naturally occuring biomarkers to trace the source and infiltration pathways of the groundwater, in combination with compound-specific isotope analysis of d13C. Our study focuses on groundwater sampled from boreholes advanced from within the tunnels in the Grimsel Test Site (GTS), Switzerland. The GTS cuts granitoid host rocks up to 500m below a topographic ridge adjacent to a glacial-fed lake. This is a well-characterised groundwater system in which our method can be validated using previous investigations into the source of the groundwater. Soil, lake and groundwater samples were collected and tested for naturally occuring biomarkers using GC-MS, and for compoundspecific isotopes (d13C) using GC-IRMS. These were then compared to biomarkers found within the groundwater. Seven out of eight samples contained only biomarkers derived from surface soils and had none characteristic of the adjacent lake. This confirms that the fractures are fed from surface water and not from the lake as independently validated by O and H isotope data. Our study shows that naturally occuring biomarkers are useful tools for determining groundwater origins, particularly when used in combination with traditional analytical techniques

Effects of a Brief Early Start Denver Model (ESDM)–Based Parent Intervention on Toddlers at Risk for Autism Spectrum Disorders: A Randomized Controlled Trial

This study was carried out to examine the efficacy of a 12-week, low intensity (one-hour-per-week of therapist contact), parent-delivered intervention for toddlers at risk for autism spectrum disorders (ASD) ages 14–24 months and their families