A prognostic survival model for women diagnosed with invasive breast cancer in Queensland, Australia.

PURPOSE: Prognostic models can help inform patients on the future course of their cancer and assist the decision making of clinicians and patients in respect to management and treatment of the cancer. In contrast to previous studies considering survival following treatment, this study aimed to develop a prognostic model to quantify breast cancer-specific survival at the time of diagnosis. METHODS: A large (n = 3323), population-based prospective cohort of women were diagnosed with invasive breast cancer in Queensland, Australia between 2010 and 2013, and followed up to December 2018. Data were collected through a validated semi-structured telephone interview and a self-administered questionnaire, along with data linkage to the Queensland Cancer Register and additional extraction from medical records. Flexible parametric survival models, with multiple imputation to deal with missing data, were used. RESULTS: Key factors identified as being predictive of poorer survival included more advanced stage at diagnosis, higher tumour grade, "triple negative" breast cancers, and being symptom-detected rather than screen detected. The Harrell's C-statistic for the final predictive model was 0.84 (95% CI 0.82, 0.87), while the area under the ROC curve for 5-year mortality was 0.87. The final model explained about 36% of the variation in survival, with stage at diagnosis alone explaining 26% of the variation. CONCLUSIONS: In addition to confirming the prognostic importance of stage, grade and clinical subtype, these results highlighted the independent survival benefit of breast cancers diagnosed through screening, although lead and length time bias should be considered. Understanding what additional factors contribute to the substantial unexplained variation in survival outcomes remains an important objective

General rules for environmental management to prioritise social ecological systems research based on a value of information approach

This is the final version. Available on open access from Wiley via the DOI in this record1. Globally, billions of dollars are invested each year to help understand the dynamics of social ecological systems (SES) in bettering both social and environmental outcomes. However, there is no scientific consensus on which aspect of an SES is most important and urgent to understand; particularly given the realities of limited time and money. 2. Here we use a simulation‐based “value of information” approach to examine where research will deliver the most important information for environmental management in four SESs representing a range of real‐life environmental issues. 3. We find that neither social nor ecological information is consistently the most important: instead, researchers should focus on understanding the primary effects of their management actions. 4. Thus, when managers are undertaking social actions the highest research priority should be understanding the dynamics of social groups. Alternatively, when manipulating ecological systems it will be most important to quantify ecological population dynamics. 5. Synthesis and applications. Our results provide a standard assessment to determine the uncertain social ecological systems (SES) component with the highest expected impact for management outcomes. First, managers should determine the structure of their SES by identifying social and ecological nodes. Second, managers should identify the qualitative nature of the network, by determining which nodes are linked, but not the strength of those interactions. Finally, managers should identify the actions available to them to intervene in the SES. From these steps, managers will be able to identify the SES components that are closest to the management action(s), and it is these nodes and interactions that should receivepriority research attention to achieve effective environmental decision making.Centre of Excellence for Environmental Decisions, Australian Research Counc

Linear Estimation of Location and Scale Parameters Using Partial Maxima

Consider an i.i.d. sample X^*_1,X^*_2,...,X^*_n from a location-scale family, and assume that the only available observations consist of the partial maxima (or minima)sequence, X^*_{1:1},X^*_{2:2},...,X^*_{n:n}, where X^*_{j:j}=max{X^*_1,...,X^*_j}. This kind of truncation appears in several circumstances, including best performances in athletics events. In the case of partial maxima, the form of the BLUEs (best linear unbiased estimators) is quite similar to the form of the well-known Lloyd's (1952, Least-squares estimation of location and scale parameters using order statistics, Biometrika, vol. 39, pp. 88-95) BLUEs, based on (the sufficient sample of) order statistics, but, in contrast to the classical case, their consistency is no longer obvious. The present paper is mainly concerned with the scale parameter, showing that the variance of the partial maxima BLUE is at most of order O(1/log n), for a wide class of distributions.Comment: This article is devoted to the memory of my six-years-old, little daughter, Dionyssia, who leaved us on August 25, 2010, at Cephalonia isl. (26 pages, to appear in Metrika

Long and short paths in uniform random recursive dags

In a uniform random recursive k-dag, there is a root, 0, and each node in turn, from 1 to n, chooses k uniform random parents from among the nodes of smaller index. If S_n is the shortest path distance from node n to the root, then we determine the constant \sigma such that S_n/log(n) tends to \sigma in probability as n tends to infinity. We also show that max_{1 \le i \le n} S_i/log(n) tends to \sigma in probability.Comment: 16 page

From evidence to action: applying gender mainstreaming to pay gaps in the Welsh public sector

Progress on reducing gender disparities remains painfully slow, despite efforts to identify the determinants of gender pay gaps and specify size and shape. Recent studies highlight the need for a more nuanced account of the way that public policy shapes organizational responses and insights into the types of organizational practices that diminish pay disparities. In response, this research reports on an action research intervention in three large Welsh public organizations, subject to a unique statutory equality duty. Data demonstrate how an evidence‐based gender mainstreaming approach facilitated the development of a ‘no blame’ strategy, which legitimized organizational proactivity through collaborative and empowering change management processes. The research contributes to the study of gender pay gaps by demonstrating that gender mainstreaming, with facilitative local conditions and supportive public policy, shapes action on gender segregation, with particular success in women's low‐paid employment. Conclusions highlight theoretical and policy implications arising from the research

Young people's attitudes to religious diversity : quantitative approaches from social psychology and empirical theology

This essay discusses the design of the quantitative component of the ‘Young People’s Attitudes to Religious Diversity’ project, conceived by Professor Robert Jackson within the Warwick Religions and Education Research Unit, and presents some preliminary findings from the data. The quantitative component followed and built on the qualitative component within a mixed method design. The argument is advanced in seven steps: introducing the major sources of theory on which the quantitative approach builds from the psychology of religion and from empirical theology; locating the empirical traditions of research among young people that have shaped the study; clarifying the notions and levels of measurement employed in the study anticipating the potential for various forms of data analysis; discussing some of the established measures incorporated in the survey; defining the ways in which the sample was structured to reflect the four nations of the UK, and London; illustrating the potential within largely descriptive cross-tabulation forms of analysis; and illustrating the potential within more sophisticated multivariate analytic models

Factors predictive of treatment by Australian breast surgeons of invasive female breast cancer by mastectomy rather than breast conserving surgery

Background: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery; and (2) to consider service delivery implications. Materials and Methods: Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Results: Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidencelimits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (≤10) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmedin multiple logistic regression analysis. Conclusions: Results confirmprevious studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman’s choice and access to radiotherapy services.David Roder, Helen Zorbas, James Kollias, Chris Pyke, David Walters, Ian Campbell, Corey Taylor, Fleur Webste

Floral temperature and optimal foraging: is heat a feasible floral reward for pollinators?

As well as nutritional rewards, some plants also reward ectothermic pollinators with warmth. Bumble bees have some control over their temperature, but have been shown to forage at warmer flowers when given a choice, suggesting that there is some advantage to them of foraging at warm flowers (such as reducing the energy required to raise their body to flight temperature before leaving the flower). We describe a model that considers how a heat reward affects the foraging behaviour in a thermogenic central-place forager (such as a bumble bee). We show that although the pollinator should spend a longer time on individual flowers if they are warm, the increase in total visit time is likely to be small. The pollinator's net rate of energy gain will be increased by landing on warmer flowers. Therefore, if a plant provides a heat reward, it could reduce the amount of nectar it produces, whilst still providing its pollinator with the same net rate of gain. We suggest how heat rewards may link with plant life history strategies

Chapter 9 - Buildings

This chapter aims to update the knowledge on the building sector since the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4) from a mitigation perspective. Buildings and activities in buildings are responsible for a significant share of GHG emissions, but they are also the key to mitigation strategies. In 2010, the building sector accounted for approximately 117 Exajoules (EJ) or 32% of global final energy consumption and 19% of energy-related CO2 emissions; and 51% of global electricity consumption. Buildings contribute to a significant amount of F-gas emissions, with large differences in reported figures due to differing accounting conventions, ranging from around an eighth to a third of all such emissions. The chapter argues that beyond a large emission role, mitigation opportunities in this sector are also significant, often very cost-effective, and are in many times associated with significant co-benefits that can exceed the direct benefits by orders of magnitude. The sector has significant mitigation potentials at low or even negative costs. Nevertheless, without strong actions emissions are likely to grow considerably - and they may even double by mid-century - due to several drivers. The chapter points out that certain policies have proven to be very effective and several new ones are emerging. As a result, building energy use trends have been reversed to stagnation or even reduction in some jurisdictions in recent years, despite the increases in affluence and population. The chapter uses a novel conceptual framework, in line with the general analytical framework of the contribution of Working Group III (WGIII) to the IPCC Fifth Assessment Report (AR5), which focuses on identities as an organizing principle