Search

Responses by 156 Canadian college and university professionals who provide disability-related services to students were used to construct, develop, and validate the Accessibility of Campus Computing for Students With Disabilities Scale (ACCSDS): Service Provider Version. This is a 19-item, self-administered tool that evaluates institutional computing accessibility for students with disabilities from the perspective of disability service providers. The measure contains 4 empirically derived subscales: Access to Adaptive Computers, Infrastructure and Collaboration, Academic Inclusion, and Adaptive Technology Competence. Results indicate that these 4 factors account for 54% of the variability in total scores. The data also show good internal consistency for the subscales and the full scale. Data concerning validity show strong relationships between scores and a key criterion variable. The ACCSDS can be used to evaluate disability service providers' views about an institution's technology accessibility, to provide empirical data to influence information and instructional technology policy, and to pinpoint areas of strength as well as areas needing improvement. (Contains 4 tables.)

It is widely recognized that the review of settlement agreements executed by the formal parties to class action litigation—the representative plaintiff and the defendant—represents the most important and challenging task that judges presiding over such litigation face. In order to facilitate this judicial task the views with respect to proposed class action settlements are sought from those persons who will be bound by such compromises despite having had no involvement in the settlement negotiations and in the conduct of the litigation itself: the class members. If the trial court approves the settlement despite the filing of objections to the settlement (or aspects of the settlement) by one or more of the affected class members, can these dissatisfied class members or objectors seek the intervention of an appellate court? This general question has been considered by American appellate courts on numerous occasions. But in Canada this question has been considered only in Quebec and in a somewhat indirect manner, given that it has been held in that province that settlement approval orders are not appealable regardless of whether the appeal is filed by the representative plaintiff or one of the class members. The aim of this article is to explore the major issues that will need to be grappled with when the intervention of Canadian appellate courts will be sought by dissatisfied class members. This study will be undertaken with respect to British Columbia, which has Canada’s third longest-running class action regime. [ABSTRACT FROM AUTHOR]

Class actions often require judges to address issues and requests that do not arise in traditional litigation. An increasingly important example is the honorarium payment: additional compensation made to the representative plaintiffs of a class action in the event of a successful outcome. The current Ontario class action regime does not expressly authorize honorarium payments despite the higher risks, and monetary and time commitments made by representative plaintiffs. As a result, the author argues that Ontario judges have dealt with these requests for honorarium payments in an inconsistent and overly restrictive manner. This article attempts to explain some of these judicial inconsistencies through conceptual, empirical and comparative lenses. The author first reviews the honoraria jurisprudence and investigates how honorarium payments interact with the interests of the class members and the need for representative plaintiffs to provide adequate representation for the class. The author then decodes cross-jurisdictional data gained through independent research in an attempt to reconcile the number of honorarium payments that are granted, the quantum of the payments, and the judicial reasons for doing so with the relevant jurisprudence. Ultimately, the data reveals that there is far too much discrepancy in the issuance of honorarium payments, resulting in an unsatisfactory class action landscape in Ontario. [ABSTRACT FROM AUTHOR]

The recently introduced class action regime in the Federal Court of Canada which-unlike the class action regimes in Quebec, British Columbia, Manitoba, Saskatchewan, Newfoundland and Labrador and Alberta-authorizes the certification of defendant class actions renders a study of defendant class actions desirable. The aim of this article is to explore the most important issue concerning the operation of defendant class actions, namely, whether any restrictions should be placed upon the ability of members of a defendant class to exclude themselves from the class, that is, to opt out. [ABSTRACT FROM AUTHOR]

Highlights the judicial supervision of individual settlements with class members in Australia, Canada and the U.S. Operation of class action procedure; Protection for the interest of class members; Design and operation of the class action model.

Pleural mesothelioma usually presents at an advanced, incurable stage. Chemotherapy with platinum–pemetrexed is a standard treatment. We hypothesised that the addition of pembrolizumab to platinum–pemetrexed would improve overall survival in patients with pleural mesothelioma. We did this open-label, international, randomised phase 3 trial at 51 hospitals in Canada, Italy, and France. Eligible participants were aged 18 years or older, with previously untreated advanced pleural mesothelioma, with an Eastern Cooperative Oncology Group performance status score of 0 or 1. Patients were randomly assigned (1:1) to intravenous chemotherapy (cisplatin [75 mg/m2] or carboplatin [area under the concentration-time curve 5–6 mg/mL per min] with pemetrexed 500 mg/m2, every 3 weeks for up to 6 cycles), with or without intravenous pembrolizumab 200 mg every 3 weeks (up to 2 years). The primary endpoint was overall survival in all randomly assigned patients; safety was assessed in all randomly assigned patients who received at least one dose of study therapy. This trial is registered with ClinicalTrials.gov , NCT02784171 , and is closed to accrual. Between Jan 31, 2017, and Sept 4, 2020, 440 patients were enrolled and randomly assigned to chemotherapy alone (n=218) or chemotherapy with pembrolizumab (n=222). 333 (76 %) of patients were male, 347 (79%) were White, and median age was 71 years (IQR 66–75). At final analysis (database lock Dec 15, 2022), with a median follow-up of 16·2 months (IQR 8·3–27·8), overall survival was significantly longer with pembrolizumab (median overall survival 17·3 months [95% CI 14·4–21·3] with pembrolizumab vs 16·1 months [13·1–18·2] with chemotherapy alone, hazard ratio for death 0·79; 95% CI 0·64–0·98, two-sided p=0·0324). 3-year overall survival rate was 25% (95% CI 20–33%) with pembrolizumab and 17% (13–24%) with chemotherapy alone. Adverse events related to study treatment of grade 3 or 4 occurred in 60 (27%) of 222 patients in the pembrolizumab group and 32 (15%) of 211 patients in the chemotherapy alone group. Hospital admissions for serious adverse events related to one or more study drugs were reported in 40 (18%) of 222 patients in the pembrolizumab group and 12 (6%) of 211 patients in the chemotherapy alone group. Grade 5 adverse events related to one or more drugs occurred in two patients on the pembrolizumab group and one patient in the chemotherapy alone group. In patients with advanced pleural mesothelioma, the addition of pembrolizumab to standard platinum–pemetrexed chemotherapy was tolerable and resulted in a significant improvement in overall survival. This regimen is a new treatment option for previously untreated advanced pleural mesothelioma. The Canadian Cancer Society and Merck & Co. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors have activity in mesothelioma. IND.227 was a phase 2 trial (120 patients planned) comparing progression-free survival of standard platinum and pemetrexed (CP) versus CP + pembrolizumab (pembro) versus pembro. Accrual to the pembro arm was discontinued on the basis of interim analysis (IA-16 wk disease control rate). CP + pembro was tolerable, with progression-free survival similar between arms and median survival and overall response rate higher than those of CP alone (19.8 mo [95% confidence interval or CI: 8.4-41.36] versus 8.9 mo [95% CI: 5.3-12.8] and 47% [95% CI: 24%-71%] versus 19% [95% CI: 5%-42%], respectively). The subsequent phase 3 trial has completed accrual; results are expected in 2023., (Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Background: Dacomitinib is an irreversible pan-HER tyrosine-kinase inhibitor with preclinical and clinical evidence of activity in non-small-cell lung cancer. We designed BR.26 to assess whether dacomitinib improved overall survival in heavily pretreated patients with this disease., Methods: In this double-blind, randomised, placebo-controlled, phase 3 trial, we enrolled adults (aged ≥18 years) with advanced or metastatic non-small-cell lung cancer from 75 centres in 12 countries. Eligible patients had received up to three previous lines of chemotherapy and either gefitinib or erlotinib, and had assessable disease (RECIST 1.1) and tumour tissue samples for translational studies. Patients were stratified according to centre, performance status, tobacco use, best response to previous EGFR tyrosine-kinase inhibitor, weight loss within the previous 3 months, and ethnicity, and were then randomly allocated 2:1 to oral dacomitinib 45 mg once-daily or matched placebo centrally via a web-based system. Treatment continued until disease progression or unacceptable toxicity. The primary outcome was overall survival in the intention-to-treat population; secondary outcomes included overall survival in predefined molecular subgroups, progression-free survival, the proportion of patients who achieved an objective response, safety, and quality of life. This study is completed, although follow-up is ongoing for patients on treatment. This study is registered with ClinicalTrials.gov, number NCT01000025., Findings: Between Dec 23, 2009, and June 11, 2013, we randomly assigned 480 patients to dacomitinib and 240 patients to placebo. At the final analysis (January, 2014), median follow-up was 23·4 months (IQR 15·6-29·6) for patients in the dacomitinib group and 24·4 months (11·5-38·9) for those in the placebo group. Dacomitinib did not improve overall survival compared with placebo (median 6·83 months [95% CI 6·08-7·49] for dacomitinib vs 6·31 months [5·32-7·52] for placebo; hazard ratio [HR] 1·00 [95% CI 0·83-1·21]; p=0·506). However, patients in the dacomitinib group had longer progression-free survival than those in the placebo group (median 2·66 months [1·91-3·32] vs 1·38 months [0·99-1·74], respectively; HR 0·66 [95% CI 0·55-0·79]; p<0·0001), and a significantly greater proportion of patients in the dacomitinb group achieved an objective response than in the placebo group (34 [7%] of 480 patients vs three [1%] of 240 patients, respectively; p=0·001). Compared with placebo, the effect of dacomitinib on overall survival seemed similar in patients with EGFR-mutation-positive tumours (HR 0·98, 95% CI 0·67-1·44) and EGFR wild-type tumours (0·93, 0·71-1·21; pinteraction=0·69). However, we noted qualitative differences in the effect of dacomitinib on overall survival for patients with KRAS-mutation-positive tumours (2·10, 1·05-4·22) and patients with KRAS wild-type tumours (0·79, 0·61-1·03; pinteraction=0·08). Compared with placebo, patients allocated dacomitinib had significantly longer time to deterioration of cough (p<0·0001), dyspnoea (p=0·049), and pain (p=0·041). 185 (39%) of 477 patients who received dacomitinib and 86 (36%) of 239 patients who received placebo had serious adverse events. The most common grade 3-4 adverse events were diarrhoea (59 [12%] patients on dacomitinib vs no controls), acneiform rash (48 [10%] vs one [<1%]), oral mucositis (16 [3%] vs none), and fatigue (13 [3%] vs four [2%])., Interpretation: Dacomitinib did not increase overall survival and cannot be recommended for treatment of patients with advanced non-small-cell lung cancer previously treated with chemotherapy and an EGFR tyrosine-kinase inhibitor., Funding: Canadian Cancer Society Research Institute and Pfizer., (Copyright © 2014 Elsevier Ltd. All rights reserved.)