Are there socioeconomic gradients in stage and grade of breast cancer at diagnosis? Cross sectional analysis of UK cancer registry data

Socioeconomic gradients in uptake of breast cancer screening in the United Kingdom should, intuitively, lead to socioeconomic gradients in disease progression at diagnosis. However, studies have found little evidence of such an effect. Although this could be interpreted as evidence that socioeconomic gradients in uptake of screening do not have clinically important consequences, all of the published studies have used data from before (pre-1988) or during the early stages (1988-95) of implementation of the national breast cancer screening programme. We investigated the relation between socioeconomic position and progression of breast cancer at diagnosis by using recent data from the Northern and Yorkshire Cancer Registry and Information Service (NYCRIS), which is estimated to achieve around 93% ascertainment

The excess burden of cancer in men in the UK

In general men are at significantly greater risk than women from nearly all of the common cancers that occur in both sexes (with the exception of breast cancer) (White 2009, Wilkins 2006, DH 2007). This report will consider the current overall burden of cancer among men in the UK, estimated from the latest statistics, and outline the extent of the differences between the sexes. All figures and calculations reported here are based on data extracted from the Cancer Research UK CancerStats web pages extracted in June 2009 (Cancer Research UK, 2009)

A simplified test of universality in Lattice QCD

A simplified test of universality in Lattice QCD is performed by analytically evaluating the continuous Euclidean time limits of various lattice fermion determinants, both with and without a Wilson term to lift the fermion doubling on the Euclidean time axis, and comparing them with each other and with the zeta-regularised fermion determinant in the continuous time--lattice space setting. The determinant relations expected from universality considerations are found to be violated by a certain gauge field-dependent factor, i.e. we uncover a "universality anomaly". The physical significance, or lack thereof, of this factor is a delicate question which remains to be settled.Comment: 6 pages. v2: Revised to include a further result on the zeta-regularised fermion determinant in the continuous time--lattice space setting which impacts on the conclusions; typos corrected; acknowledgement and reference added; to appear in Phys.Rev.Let

Joint disease mapping using six cancers in the Yorkshire region of England

OBJECTIVES: The aims of this study were to model jointly the incidence rates of six smoking related cancers in the Yorkshire region of England, to explore the patterns of spatial correlation amongst them, and to estimate the relative weight of smoking and other shared risk factors for the relevant disease sites, both before and after adjustment for socioeconomic background (SEB). METHODS: Data on the incidence of oesophagus, stomach, pancreas, lung, kidney, and bladder cancers between 1983 and 2003 were extracted from the Northern & Yorkshire Cancer Registry database for the 532 electoral wards in the Yorkshire region. Using postcode of residence, each case was assigned an area-based measure of SEB using the Townsend index. Standardised incidence ratios (SIRs) were calculated for each cancer site and their correlations investigated. The joint analysis of the spatial variation in incidence used a Bayesian shared-component model. Three components were included to represent differences in smoking (for all six sites), bodyweight/obesity (for oesophagus, pancreas and kidney cancers) and diet/alcohol consumption (for oesophagus and stomach cancers). RESULTS: The incidence of cancers of the oesophagus, pancreas, kidney, and bladder was relatively evenly distributed across the region. The incidence of stomach and lung cancers was more clustered around the urban areas in the south of the region, and these two cancers were significantly associated with higher levels of area deprivation. The incidence of lung cancer was most impacted by adjustment for SEB, with the rural/urban split becoming less apparent. The component representing smoking had a larger effect on cancer incidence in the eastern part of the region. The effects of the other two components were small and disappeared after adjustment for SEB. CONCLUSIONS: This study demonstrates the feasibility of joint disease modelling using data from six cancer sites. Incidence estimates are more precise than those obtained without smoothing. This methodology may be an important tool to help authorities evaluate healthcare system performance and the impact of policies

The rich cluster of galaxies ABCG 85. III. Analyzing the ABCG 85/87/89 complex

We present a combined X-ray and optical analysis of the ABCG 85/87/89 complex of clusters of galaxies, based on the ROSAT PSPC image, optical photometric catalogues (Slezak et al. 1998), and an optical redshift catalogue (Durret et al. 1998). From this combined data set, we find striking alignments at all scales at PA$\simeq$160\deg. At small scales, the cD galaxy in ABCG 85 and the brightest galaxies in the cluster are aligned along this PA. At a larger scale, X-ray emission defines a comparable PA south-southeast of ABCG 85 towards ABCG 87, with a patchy X-ray structure very different from the regular shape of the optical galaxy distribution in ABCG 87. The galaxy velocities in the ABCG 87 region show the existence of subgroups, which all have an X-ray counterpart, and seem to be falling onto ABCG 85 along a filament almost perpendicular to the plane of the sky. To the west of ABCG 85, ABCG 89 appears as a significant galaxy density enhancement, but is barely detected at X-ray wavelengths. The galaxy velocities reveal that in fact this is not a cluster but two groups with very different velocities superimposed along the line of sight. These two groups appear to be located in intersecting sheets on opposite sides of a large bubble. These data and their interpretation reinforce the cosmological scenario in which matter, including galaxies, groups and gas, falls onto the cluster along a filament.Comment: accepted for publication in Astronomy & Astrophysic

Curriculum renewal in interprofessional education in health: establishing leadership and capacity

The Curriculum Renewal for Interprofessional Education in Health: ‘Establishing Leadership and Capacity’ (ELC) project builds from a number of Australian and global studies and reports that address a range of critical issues associated with the development of interprofessional education (IPE) and interprofessional practice (IPP) within Australia and globally2.The Curriculum Renewal for Interprofessional Education in Health: ‘Establishing Leadership and Capacity’ (ELC) project builds from a number of Australian and global studies and reports that address a range of critical issues associated with the development of interprofessional education (IPE) and interprofessional practice (IPP) within Australia and globally2

Curriculum renewal for interprofessional education in health

In this preface we comment on four matters that we think bode well for the future of interprofessional education in Australia. First, there is a growing articulation, nationally and globally, as to the importance of interprofessional education and its contribution to the development of interprofessional and collaborative health practices. These practices are increasingly recognised as central to delivering effective, efficient, safe and sustainable health services. Second, there is a rapidly growing interest and institutional engagement with interprofessional education as part of pre-registration health professional education. This has changed substantially in recent years. Whilst beyond the scope of our current studies, the need for similar developments in continuing professional development (CPD) for health professionals was a consistent topic in our stakeholder consultations. Third, we observe what might be termed a threshold effect occurring in the area of interprofessional education. Projects that address matters relating to IPE are now far more numerous, visible and discussed in terms of their aggregate outcomes. The impact of this momentum is visible across the higher education sector. Finally, we believe that effective collaboration is a critical mediating process through which the rich resources of disciplinary knowledge and capability are joined to add value to existing health service provision. We trust the conceptual and practical contributions and resources presented and discussed in this report contribute to these developments

Using a research-informed interprofessional curriculum framework to guide reflection and future planning of interprofessional education in a multi-site context

Abstract Background: Over the past two years health educators in Australia have benefited from funding made available from national organizations such as the Office of Learning and Teaching (OLT) and Health Workforce Australia (HWA). Funded research has been conducted into educational activities across the country that aim to promote integrated and sustainable interprofessional learning. Methods and Findings: A collaboration between multiple stakeholders led to the establishment of a consortium of nine universities and interprofessional organizations. This collaboration resulted in a series of research studies and the development of a conceptual framework to guide the planning and review of interprofessional health curricula. A case study of the development of a suite of health education programs at a regional university in Australia is used to demonstrate how the framework can be used to guide curricular reflection and to plan for the future. Shedding a light on interprofessional health education activities across multiple sites provides a rich picture of current practices and future trends. Commonalities, gaps, and challenges become much more obvious and allow for the development of shared opportunities and solutions. Conclusions: The production of a shared conceptual framework to facilitate interprofessional curriculum development provides valuable strategies for curricular reflection, review, and forward planning

Attributes of effective interprofessional placement facilitation

Background: The quality of facilitation is an important influence on the efficacy of interprofessional education (IPE) delivery. The research objective was to increase understanding of the attributes of effective facilitation of students during external IPE placements in primary care situations. Methods and Findings: A thematic analysis of the experiences of academics, students, and placement-site staff at three placement sites was employed to explore participants’ perceptions of the attributes of effective IPE facilitators. These attributes included experience in an interprofessional context, together with an understanding of the specific clinical and assessment requirements of different disciplines. Facilitators also needed empathy with respect to the requirements of the external IPE placement sites and the ability to liaise between student and site needs. Conclusions: Models of IPE placement facilitation were most effective when, while following general principles, facilitators tailored them specifically for the individual situations of the placement sites and the learning requirements of particular groups of students. The most rewarding IPE learning experiences occurred when IPE facilitators provided sufficient clinical opportunities for students to work collaboratively with individual clients, provided the students perceived that their participation was relevant to their own discipline

Work based assessment of teamwork: an interprofessional approach.

This report Work-based assessment of teamwork: an interprofessional approach describes the Office for Learning and Teaching (OLT) funded project of the same name. It focuses on the rationale for, the development of and the piloting of a tool for observing and giving feedback on an individual student’s behavior in an interprofessional team based activity. The study was conducted during 2012–2014 with a project team initially led by the University of Queensland, and included team members from five Australian universities in three states (University of Queensland, University of Technology Sydney, The University of Sydney, Central Queensland University and Curtin University), as well as from the UK (University of Derby) and Canada (University of British Columbia)