The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women.

BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain. METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights. RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population). CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.This article is an independent research supported by different funding bodies, beyond the authors’ own employing organisations. MJR was partially funded by a Cancer Research UK Postdoctoral Fellowship (CRUK_A13275). GL is supported by a Postdoctoral Fellowship award by the National Institute for Health Research (NIHR PDF-2011-04-047) to end of 2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. We thank all staff at the National Cancer Registration Service, Public Health England, Eastern Office who helped collect and code data used in this study. We particularly acknowledge the help of Dr Clement H Brown and Dr Brian A Rous who were responsible for staging.This is the final published version. It first appeared at http://www.nature.com/bjc/journal/v112/n1s/full/bjc201551a.html#ack

The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women

This is the final published version. Available from Springer Nature via the DOI in this record.BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain.METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights.RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population).CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.Cancer Research UKCancer Research UKNational Institute for Health Research (NIHR

An inventory of the South african fitness industry

Objective. The aim of this study was to create an inventory of fitness facilities in South Africa, their location, equipment and services offered, and the demographics, education and training of the staff working in these facilities. Design. A total of 750 facilities were identified, and descriptive data were gathered from 442 facilities (59%) with the use of a questionnaire administered telephonically and via the website of the Sports Science Institute of South Africa. Setting. The study was initiated by the Sports Science Institute, and the results were presented at the 4th Annual Discovery Vitality Fitness Convention on 4 May 2006. Results. Results show that the industry comprises mainly independent facilities (68%). All types of facilities were found to be located mostly within urban areas, and reported providing services to just less than 2% of the South African population. Facilities offer a wide range of equipment and services to their members. Of the fitness-related staff at facilities, the majority were reported to be young (18 - 25 years, 55% of male, and 49% of female staff), and in terms of racial proportions most staff were white (males 40% of total staff and females 33% of total staff).Less than a quarter of fitness-related staff hold university qualifications, and just over 80% of instructors hold qualifications aligned with the National Qualifications Framework. The importance of education and training of staff was emphasised by respondents. Conclusions. This report highlights the widespread value of assessing the fitness industry, particularly within the context of the rise of chronic diseases in South Africa and government initiatives to promote healthy lifestyles. South African Journal of Sports Medicine Vol. 18 (3) 2006: pp. 93-10

A novel form of spontaneous tool use displayed by several captive greater vasa parrots (Coracopsis vasa)

Parrots are frequently cited for their sophisticated problem-solving abilities, but cases of habitual tool use among psittacines are scarce. We report the first evidence, to our knowledge, of tool use by greater vasa parrots (Coracopsis vasa). Several members of a captive population spontaneously adopted a novel tool-using technique by using pebbles and date pits either (i) to scrape on the inner surface of seashells, subsequently licking the resulting calcium powder from the tool, or (ii) as a wedge to break off smaller pieces of the shell for ingestion. Tool use occurred most frequently just prior to the breeding season, during which time numerous instances of tool transfer were also documented. These observations provide new insights into the tool-using capabilities of parrots and highlight the greater vasa parrot as a species of interest for studies of physical cognition

Estimating the potential survival gains by eliminating socioeconomic and sex inequalities in stage at diagnosis of melanoma

This is the final published version. Available from Springer Nature via the DOI in this record.BACKGROUND: Although inequalities in cancer survival are thought to reflect inequalities in stage at diagnosis, little evidence exists about the size of potential survival gains from eliminating inequalities in stage at diagnosis.METHODS: We used data on patients diagnosed with malignant melanoma in the East of England (2006-2010) to estimate the number of deaths that could be postponed by completely eliminating socioeconomic and sex differences in stage at diagnosis after fitting a flexible parametric excess mortality model.RESULTS: Stage was a strong predictor of survival. There were pronounced socioeconomic and sex inequalities in the proportion of patients diagnosed at stages III-IV (12 and 8% for least deprived men and women and 25 and 18% for most deprived men and women, respectively). For an annual cohort of 1025 incident cases in the East of England, eliminating sex and deprivation differences in stage at diagnosis would postpone approximately 24 deaths to beyond 5 years from diagnosis. Using appropriate weighting, the equivalent estimate for England would be around 215 deaths, representing 11% of all deaths observed within 5 years from diagnosis in this population.CONCLUSIONS: Reducing socioeconomic and sex inequalities in stage at diagnosis would result in substantial reductions in deaths within 5 years of a melanoma diagnosis.Cancer Research UKCancer Research UKNational Institute for Health Research (NIHR

Ambulatory blood pressure monitoring and morning surge in blood pressure in adult black and white South Africans

We examined whether there were differences in the circadian variation in blood pressure and the morning surge in blood pressure between black and white Africans. Clinic and ambulatory blood pressure data obtained from the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study was examined (n = 406; 49% black African). Ambulatory blood pressure readings were fitted to a six-parameter double logistic equation to determine the power and rate of the morning surge in blood pressure. Multiple linear regression analysis was used to examine differences in blood pressure between black and white participants. Clinic and ambulatory blood pressure were higher in black participants throughout the day and night. In those taking medications, blood pressure was less well controlled in black subjects. Despite the higher systolic blood pressure, the day-night difference estimated by the logistic function was similar in black and white participants. However, the rate of rise and power in the morning surge in blood pressure was lower in black participants. We conclude that black participants of the SABPA study present with higher blood pressure throughout the day and night but have a lower power of the morning surge in blood pressure due to a slower morning rate of increase. Moreover, they had an increased prevalence of undiagnosed hypertension and, in those taking medication, were less likely to have their blood pressure controlled than their white counterparts

An inventory of the South african fitness industry

Objective. The aim of this study was to create an inventory of fitness facilities in South Africa, their location, equipment and services offered, and the demographics, education and training of the staff working in these facilities. Design. A total of 750 facilities were identified, and descriptive data were gathered from 442 facilities (59%) with the use of a questionnaire administered telephonically and via the website of the Sports Science Institute of South Africa. Setting. The study was initiated by the Sports Science Institute, and the results were presented at the 4th Annual Discovery Vitality Fitness Convention on 4 May 2006. Results. Results show that the industry comprises mainly independent facilities (68%). All types of facilities were found to be located mostly within urban areas, and reported providing services to just less than 2% of the South African population. Facilities offer a wide range of equipment and services to their members. Of the fitness-related staff at facilities, the majority were reported to be young (18 - 25 years, 55% of male, and 49% of female staff), and in terms of racial proportions most staff were white (males 40% of total staff and females 33% of total staff).Less than a quarter of fitness-related staff hold university qualifications, and just over 80% of instructors hold qualifications aligned with the National Qualifications Framework. The importance of education and training of staff was emphasised by respondents. Conclusions. This report highlights the widespread value of assessing the fitness industry, particularly within the context of the rise of chronic diseases in South Africa and government initiatives to promote healthy lifestyles. South African Journal of Sports Medicine Vol. 18 (3) 2006: pp. 93-10

Fragment reattachment, reproductive status, and health indicators of the invasive colonial tunicate Didemnum vexillum with implications for dispersal

This manuscript is not subject to U.S. copyright. The definitive version was published in Biological Invasions 14 (2012): 2133-2140, doi:10.1007/s10530-012-0219-8.The invasive colonial tunicate Didemnum vexillum is now widespread in coastal and offshore waters of New England, USA. D. vexillum can inflict ecological and economic damage through biofouling and habitat modification. Natural and anthropogenic processes that fragment colonies of D. vexillum may be accelerating the spread of this invader. Reattachment success and fragment viability were confirmed in the laboratory after four weeks of suspension in experimental aquaria. The shape of suspended D. vexillum fragments progressed from flattened to globular spheres and then flattened again after reattachment to the substrate. Reproductive activity, confirmed by the presence of eggs and larvae, was observed for fragments suspended up to three weeks suggesting that D. vexillum is capable of reproducing while in a fragmented, suspended state. An index of colony health was used to monitor change in D. vexillum health while in suspension. Overall, colony health declined with time in suspension although colonies that appeared dead (black and gray in overall color) still contained a substantial number of healthy live zooids. These results suggest that activities that cause fragmentation can significantly facilitate the spread of D. vexillum. Coastal managers should consider reducing or eliminating, when practical, activities that return fragmented colonies of D. vexillum to the water. In-water cleaning of biofouling and dredging are likely expediting the spread of this invasive species unless biofouling can be contained and removed from the water.This research was funded by the NOAA Aquatic Invasive Species Program

STANDARDS ASSESSMENT OF BUSINESS USE CASES PROPOSED IN TDX-ASSIST

The Transmission System Operator and Distribution System Operator information exchange has been identified as a key subject to improve the performance of power systems. The standard assessment of the business objects needed to improve this exchange of information is illustrated in the paper. The standard assessment is based on the pertinent business and system Use Cases identified in European project TDX-ASSIST and on EC Core Standards as defined in IEC 63097 Technical Report Smart Grid Roadmap. These standards are considered as standards having an enormous effect on any Smart Grid application and solution. They are seen as a backbone of a future Smart Grid. The used methodology based in three main steps is detailed and some examples of the standard assessment are described.European Union’s Horizon 202