Options for early breast cancer follow-up in primary and secondary care : a systematic review

Background Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. Method A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1) Risk of second breast cancer over time - incidence compared to general population. 2) Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3) Level 1–4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011). Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. Results Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. Conclusions Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed

Interoception and Autonomic Correlates during Social Interactions. Implications for Anorexia

The aim of this study is to investigate the bodily-self in Restrictive Anorexia, focusing on two basic aspects related to the bodily self: autonomic strategies in social behavior, in which others’ social desirability features, and social cues (e.g., gaze) are modulated, and interoception (i.e., the sensitivity to stimuli originating inside the body). Furthermore, since previous studies carried out on healthy individuals found that interoception seems to contribute to the autonomic regulation of social behavior, as measured by Respiratory Sinus Arrhythmia (RSA), we aimed to explore this link in anorexia patients, whose ability to perceive their bodily signal seems to be impaired. To this purpose, we compared a group of anorexia patients (ANg; restrictive type) with a group of Healthy Controls (HCg) for RSA responses during both a resting state and a social proxemics task, for their explicit judgments of comfort in social distances during a behavioral proxemics task, and for their Interoceptive Accuracy (IA). The results showed that ANg displayed significantly lower social disposition and a flattened autonomic reactivity during the proxemics task, irrespective of the presence of others’ socially desirable features or social cues. Moreover, unlike HCg, the autonomic arousal of ANg did not guide behavioral judgments of social distances. Finally, IA was strictly related to social disposition in both groups, but with opposite trends in ANg. We conclude that autonomic imbalance and its altered relationship with interoception might have a crucial role in anorexia disturbances

Effect of pH on inhibition of papain by zinc, cadmium and mercuric ions

No Abstract

Environmental Management and Conflict in Southeast Asia – Land Reclamation and its Political Impact

Conduct research on security, strategic and international issues. Provide general and graduate education in strategic studies, international relations, defence management and defence technology. Promote joint and exchange programmes with similar regional and international institutions; organise seminars/conferences on topics salient to the strategic and policy communities of the Asia-Pacific. Constituents of IDSS include the International Centre for Political Violence and Terrorism Research (ICPVTR) and the Asian Programme for Negotiation and Conflict Management (APNCM). Research Through its Working Paper Series, IDSS Commentaries and other publications, the Institute seeks to share its research findings with the strategic studies and defence policy communities. The Institute’s researchers are also encouraged to publish their writings in refereed journals. The focus of research is on issues relating to the security and stability of the Asia-Pacific region and their implications for Singapore and other countries in the region. The Institute has also established the S. Rajaratnam Professorship in Strategic Studies (named after Singapore’s first Foreign Minister), to bring distinguished scholars t

Natural resource management and environmental security in Southeast Asia : a case study of clean water supplies to Singapore

The concept of environmental security in Southeast Asia has assumed greater urgency in recent years. The Southeast Asian environmental crisis has long been a matter of concern at the regional level - long before the onset of economic crisis. Decades of rapid industrialisation and urbanisation without effective environmental management programmes have led to environmental degradation. Most countries have been grappling to clean up their major rivers, despoiled by industries and households using them as wast dumps in the absence of adequate infrastructure to treat wastes and dispose of them. on a bilateral basis, the question of trade or the sharing of resources such as water is potential source of tension between countries such as Malaysia, Singapore, and potentially, Indonesia. Since Singapore buys water from only one Malaysian State it has long been a source of irritation for the Malaysian people and its political leadership. If Southeast Asia is now part of a globalising world, the ownership and management of natural resources remain strictly a national concern. Environmental studies have highlighted however, that with globalization, cities and affluent countries have ecological footprints, which are many times the sizes of the territories that they occupy. The need for trade and for sharing resources among nation-states in the region will grow over time. with diminishing supplies of such resources and contestation over them for even domestic needs, tensions are likely to grow not only within countries but also at the regional level. under the region as a whole adopts and effectively enforces common environmental standards, the problem could emerge as a potential source of conflict. The paper proposes to consider regional efforts which have been made to reach a common understanding about the management of natural resources and the setting of environmental standards. Environmental problems can threaten a nation's security and economy -- not only at national but regional levels as well. This paper intends to issues of clean water supplies

Fifty-year-old jetties in a tropical Marine environment

Proceedings of the International Conference on Concrete for Transportation Infrastructure333-34

Purification of ginger protease using affinity chromatography and chromatofocusing

No Abstract

IT strategy of the Singapore construction sector

10.1061/40513(279)83Proceedings of the 8th International Conference on Computing in Civil and Building Engineering279635-64