Purpose To provide population norms for the EQ-5D-3L by age and gender based on a representative adult sample in Queensland, Australia; to assess differences in health-related quality of life by ...applying the Australian, UK and USA value sets to these data; and to assess differences in utility scores for key preventive health indicators. Methods A cross-sectional computer-assisted telephone interview survey (March–June 2011) with 5,555 adults. Respondents rated their impairment (none, moderate, severe problems) across five domains (mobility, self-care, usual activities, pain and discomfort, anxiety or depression) using the validated EQ-5D-3L health-related quality of life instrument. Utility score indexes were derived using the Australian, UK and USA value sets. Results Forty per cent of adults reported pain and discomfort while 3 % indicated problems with self-care. Approximately one in six had limitations with mobility, usual activities or anxiety or depression. The three value sets performed similarly in discriminating differences based on most characteristics, and clinically meaningful differences were seen for age, body weight, physical activity and daily smoking. There were no differences in utility scores for gender. Conclusions This is the first study to report general population findings for the Australian EQ-5D-3L value set. Overall, the Australian value set performed comparably with other value sets commonly used in the Australian population; however, differences were observed. Results will enable further refinement to health and economic studies in an Australian-specific context.
Germline mutations in BRCA1/2 predispose individuals to breast cancer (termed germline-mutated BRCA1/2 breast cancer, gBRCA-BC) by impairing homologous recombination (HR) and causing genomic ...instability. HR also repairs DNA lesions caused by platinum agents and PARP inhibitors. Triple-negative breast cancers (TNBCs) harbor subpopulations with BRCA1/2 mutations, hypothesized to be especially platinum-sensitive. Cancers in putative 'BRCAness' subgroups-tumors with BRCA1 methylation; low levels of BRCA1 mRNA (BRCA1 mRNA-low); or mutational signatures for HR deficiency and those with basal phenotypes-may also be sensitive to platinum. We assessed the efficacy of carboplatin and another mechanistically distinct therapy, docetaxel, in a phase 3 trial in subjects with unselected advanced TNBC. A prespecified protocol enabled biomarker-treatment interaction analyses in gBRCA-BC and BRCAness subgroups. The primary endpoint was objective response rate (ORR). In the unselected population (376 subjects; 188 carboplatin, 188 docetaxel), carboplatin was not more active than docetaxel (ORR, 31.4% versus 34.0%, respectively; P = 0.66). In contrast, in subjects with gBRCA-BC, carboplatin had double the ORR of docetaxel (68% versus 33%, respectively; biomarker, treatment interaction P = 0.01). Such benefit was not observed for subjects with BRCA1 methylation, BRCA1 mRNA-low tumors or a high score in a Myriad HRD assay. Significant interaction between treatment and the basal-like subtype was driven by high docetaxel response in the nonbasal subgroup. We conclude that patients with advanced TNBC benefit from characterization of BRCA1/2 mutations, but not BRCA1 methylation or Myriad HRD analyses, to inform choices on platinum-based chemotherapy. Additionally, gene expression analysis of basal-like cancers may also influence treatment selection.
Objectives: To assess the population prevalence of property, income and emotional impacts of the 2010–2011 Queensland floods and cyclones.
Design, setting and participants: Cross‐sectional ...telephone‐based survey using a brief trauma exposure and impact screening instrument, conducted between 11 March and 6 June 2011, of 6104 adults who answered natural disaster and mental health questions.
Main outcome measures: Natural disaster property damage exposure and emotional wellbeing impacts.
Results: Two‐thirds of respondents (62%) reported being affected by the disasters, with property damage exposure ranging from 37.2% (suburb or local area) to 9.2% (own home, with 2.1% living elsewhere at least temporarily). Income was reduced for 17.0% of respondents and 11.7% of income‐producing property owners reported damage to those properties. Trauma impacts ranged from 14.3% of respondents feeling “terrified, helpless or hopeless” to 3.9% thinking they might be “badly injured or die”. Up to 5 months after the disasters, 7.1% of respondents were “still distressed” and 8.6% were “worried about how they would manage”. Adults of working age and residents of regional and remote areas and of socioeconomically disadvantaged areas were disproportionately likely to report exposure to damage and emotional impacts.
Conclusions: Weather‐related disasters exact a large toll on the population through property damage and resultant emotional effects. Vulnerable subpopulations are more severely affected. There is a need for realistic, cost‐effective and rapid‐deployment mass interventions in the event of weather disasters.
The contributors to this special issue consider how urban, rural, local, and global communications, experimental and innovative media used alongside indigenous knowledge and folkloric craft ...practices, respect for the disparity of human identity, heritage, tradition, and culture, and the importance of documenting, preserving, and protecting, and enhancing creativity and cultural diversity is essential for our collective future. They presented their research at the Woxsen and Banaras Hindu Universities’ international conference ‘Cultural Diversity for Sustainable Development in Art and Design’ in June 2023.The context of their work is the sophisticated networks across nations that link product ideation, production, consumption, post-consumption management, and policy in highly complex chains. These chains see wealth move upwards, often at the expense of those lower in the chain, those nearer to the making of the products, arguably those with the greatest creative talent and technical skill. In an inverted triangle of development, the advancement of economies is often at the expense of the sustenance of communities, resources, histories, and individual humans.Radical, and in some cases painful, adjustments to how we live are no longer ‘design decisions’ or ‘sustainable choices’. While we have considered for some time that perhaps we need to slow down, take time to breath, consume less, and cease striving, we have not yet come collectively and universally to understanding that advancement is not always positive. We have not yet concluded that we are operating an obsolete and unsustainable business model, and we have not yet seen holistically that thinking in terms of a smaller Earth is conceivably our only solution.These papers challenge us to think about why humans first created, so that their ‘things’ were not only functional and utilitarian. Communities from distinct geographic regions across the world developed decorative, expressive, ritualised, secular, and sacred objects from early in human development. Individuals sustained themselves, their communities, their beliefs, and their environments by applying their creative imaginations to their tools, coverings, shelters, surroundings, this growing rapidly in sophistication, purpose and embeddedness as human societies and cultures evolved.Our ancestors preserved cultural diversity without even thinking of it, both in their material surroundings and civilisations, but also through storytelling that illuminated their spirit world and imaginations. They gave us the myths and legends, superstitions and belief systems, ideologies and moralities that persist into our folk traditions, societal customs, disparate identities, and artisan-based cultures today. This excellent Special Issue resists a homogenised globalist culture that erases the diversity nourishing vital philosophical, intellectual, instinctual, or imaginary concepts that make up the immaterial and intangible aspects of sustainable development that we so need to protect.
It is with sorrow that we mark the loss in August 2021 of Editorial Board member, Linda Eaton, following a long-term illness. Linda was the retired John T. and Marjorie McGraw Director of Collections ...at Winterthur Museum, known worldwide for its preeminent collection of American decorative arts, naturalistic garden, and research library for the study of American art and material culture. Her impact and influence were significant, and she was globally recognized as a leader in the field of interdisciplinary textile scholarship. Over more than 30 years at Winterthur, Linda oversaw the acquisition, interpretation, care, and exhibition of the museum’s textile collections, bringing her specialist knowledge of textile conservation as well as expertise in textile history to her work both in the museum and through her inspirational teaching at the University of Delaware.
Crafting the Intimate Body Harper, Catherine
Women (Oxford, England),
07/2022, Volume:
33, Issue:
3
Journal Article
Peer reviewed
The intimate body-essentialized in Judy Chicago's The Dinner Party, complicated in Helen Chadwick's Eat Me-is revisited through discourse on intersex, debate around trans identities and contemporary ...feminisms, via the subversive actions of radical crafting and visual, textual, material and performic queering.
HER2-positive, estrogen receptor-positive breast cancer (HER2+, ER+ BC) is a distinct disease subtype associated with inferior response to chemotherapy plus HER2-targeted therapy compared with HER2+, ...ER-negative BC. Bi-directional crosstalk leads to cooperation of the HER2 and ER pathways that may drive treatment resistance; thus, simultaneous co-targeting may optimize treatment impact and survival outcomes in patients with HER2+, ER+ BC. First-line (1L) treatment for patients with HER2+ metastatic BC (mBC) is pertuzumab, trastuzumab, and taxane chemotherapy. In clinical practice, dual HER2 blockade plus a fixed number of chemotherapy cycles are given as induction therapy to maximize tumor response, with subsequent HER2-targeted maintenance treatment given as a more tolerable regimen for long-term disease control. For patients whose tumors co-express ER, maintenance endocrine therapy (ET) can be added, but uptake varies due to lack of data from randomized clinical trials investigating the superiority of maintenance ET plus dual HER2 blockade versus dual HER2 blockade alone. Giredestrant, a novel oral selective ER antagonist and degrader, shows promising clinical activity and manageable safety across phase I-II trials of patients with ER+, HER2-negative BC, with therapeutic potential in those with HER2 co-expression.
This phase III, randomized, open-label, two-arm study aims to recruit 812 patients with HER2+, ER+ locally advanced (LA)/mBC into the induction phase (fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection PH FDC SC plus a taxane) to enable 730 patients to be randomized 1:1 to the maintenance phase (giredestrant plus PH FDC SC or PH FDC SC plus optional ET), stratified by disease site (visceral versus non-visceral), type of LA/metastatic presentation (de novo versus recurrent), best overall response to induction therapy (partial/complete response versus stable disease), and intent to give ET (yes versus no). The primary endpoint is investigator-assessed progression-free survival. Secondary endpoints include overall survival, objective response rate, clinical benefit rate, duration of response, safety, and patient-reported outcomes.
heredERA BC will address whether giredestrant plus dual HER2 blockade is superior to dual HER2 blockade alone, to inform the use of this combination in clinical practice for maintenance 1L treatment of patients with HER2+, ER+ LA/mBC.
ClinicalTrials.gov, NCT05296798; registered on March 25, 2022. Protocol version 3.0 (November 18, 2022).
F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124 4070, Basel, Switzerland.
Objective: To assess the current frequency of sunburn, a preventable risk factor for skin cancer, among Queensland adults.
Design and setting: Cross‐sectional population‐based surveys of 16 473 ...residents aged ≥ 18 years across Queensland in 2009 and 2010.
Main outcome measures: Proportion of the adult population reporting sunburn (skin reddening lasting 12 hours or more) during the previous weekend, by age, sex and other risk factors.
Results: One in eight men and one in 12 women in Queensland reported being sunburnt on the previous weekend. Age up to 65 years was the strongest predictor of sunburn: eg, people aged 18–24 years were seven times more likely (adjusted odds ratio OR, 7.35; 95% CI, 5.09–10.62) and those aged 35–44 years were five times more likely (adjusted OR, 5.22) to report sunburn compared with those aged ≥ 65 years. Not having a tertiary education and being in the workforce were also significantly associated with sunburn. Those who had undertaken any physical activity the previous week were more likely to be sunburnt than those who were physically inactive. Sunburn was significantly less likely among people who generally took sun‐protective measures in summer. Sunburn was not related to location of residence, socioeconomic disadvantage, skin colour, body weight or current smoking status.
Conclusions: Sunburn remains a public health problem among Queensland residents, especially those under 45 years of age. Sun‐safe habits reduce sunburn risk, but advice must be integrated with health promotion messages regarding physical activity to reduce the skin cancer burden while maintaining active wellbeing.
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