Breast screening attendance of Aboriginal and Torres Strait Islander women in the Northern Territory of Australia

Objective: To compare breast screening attendances of Indigenous and non-Indigenous women. Methods: A total of 4,093 BreastScreen cases were used including 857 self-identified Indigenous women. Chi-squared analysis compared data between Indigenous and non-Indigenous women. Logistic regression was used for groupings based on visits-to-screening frequency. Odds ratios and 95% confidence intervals were calculated for associations with low attendance. Results: Indigenous women were younger and had fewer visits to screening compared with non-Indigenous women. Non-English speaking was mainly associated with fewer visits for Indigenous women only (OR 1.9, 95%CI 1.3-2.9). Living remotely was associated with fewer visits for non-Indigenous women only (OR 1.3, 95%CI 1.1-1.5). Shared predictors were younger age (OR 12.3, 95%CI 8.1-18.8; and OR 11.5, 95%CI 9.6-13.7, respectively) and having no family history of breast cancer (OR 2.1, 95%CI 1.3-3.3; and OR 1.8, 95%CI 1.5-2.1, respectively). Conclusions: Factors associated with fewer visits to screening were similar for both groups of women, except for language which was significant only for Indigenous women, and remoteness which was significant only for non-Indigenous women. Implications for public health: Health communication in Indigenous languages may be key in encouraging participation and retaining Indigenous women in BreastScreen; improving access for remote-living non-Indigenous women should also be addressed

Dissecting Sources of Quantitative Gene Expression Pattern Divergence Between Drosophila Species

The function of a transcriptional circuit is compared in three closely related species of Drosophila. Using quantitative imaging of gene expression, targeted transgenic reporter fly lines, and a computational framework, the sources of their differing expression outputs are identified

A Review of Cardiac Radioablation (CR) for Arrhythmias: Procedures, Technology, and Future Opportunities.

Purpose: Cardiac radioablation (CR), a new treatment for cardiac arrhythmias such as ventricular tachycardia and atrial fibrillation, has had promising clinical outcomes to date. There is consequent desire for rapid clinical adoption. However, CR presents unique challenges to radiation therapy, and it is paramount that clinical adoption be performed safely and effectively. Recent reviews comprehensively detail patient selection, clinical history, treatment outcomes, and treatment toxicities but only briefly mention the technical aspects of CR. To address this knowledge gap, this review collates currently available knowledge regarding CR technology choice and procedural details to help inform and guide clinics considering implementing their own CR program, to aid technique standardization, and to highlight areas that require further development or verification. Methods and materials: Original preclinical and clinical scientific articles that sufficiently detailed CR technical aspects, including pretreatment electrophysiology and imaging, motion analysis and management techniques, treatment planning, and/or treatment delivery, were identified within a comprehensive literature search. Results: Nineteen preclinical and 18 clinical scientific articles sufficiently detailed the technical aspects of CR treatment deliveries on live subjects. The technical aspects of these scientific articles were diverse: Preclinical treatments have been performed with brachytherapy, photons, protons, and carbon ions, and clinical treatments have been performed with photons using conventional, robotic, and magnetic resonance imaging guided systems. Other technical aspects demonstrated similar variability. Conclusions: This review summarizes the technical aspects and procedural details of preclinical and clinical CR treatment deliveries and highlights the complexity and current variability of CR. There is need for standardized procedural reporting to aid multicenter and multiplatform evaluation and potential for significant technological improvements in imaging, planning, delivery, and monitoring to maximize the clinical outcomes for selected patients with arrhythmia

“From the technology came the idea”: safe implementation and operation of a high quality teleradiology model increasing access to timely breast cancer assessment services for women in rural Australia

Abstract: Breast cancer is the most commonly diagnosed cancer in Australian women. Providing timely diagnostic assessment services for screen-detected abnormalities is a core quality indicator of the population-based screening program provided by BreastScreen Australia. However, a shortage of local and locum radiologists with availability and appropriate experience in breast work to attend onsite assessment clinics, limits capacity of services to offer assessment appointments to women in some regional centres. In response to identified need, local service staff developed the remote radiology assessment model for service delivery. This study investigated important factors for establishing the model, the challenges and enablers of successful implementation and operation of the model, and factors important in the provision of a model considered safe and acceptable by service providers. Methods: Semi-structured interviews were conducted with service providers at four assessment services, across three jurisdictions in Australia. Service providers involved in implementation and operation of the model at the service and jurisdictional level were invited to participate. A social constructivist approach informed the analysis. Deductive analysis was initially undertaken, using the interview questions as a classifying framework. Subsequently, inductive thematic analysis was employed by the research team. Together, the coding team aggregated the codes into overarching themes. Results: 55 service providers participated in interviews. Consistently reported enablers for the safe implementation and operation of a remote radiology assessment clinic included: clinical governance support; ability to adapt; strong teamwork, trust and communication; and, adequate technical support and equipment. Challenges mostly related to technology and internet (speed/bandwidth), and maintenance of relationships within the group. Conclusions: Understanding the key factors for supporting innovation, and implementing new and safe models of service delivery that incorporate telemedicine, will become increasingly important as technology evolves and becomes more accessible. It is possible to take proposed telemedicine solutions initiated by frontline workers and operationalise them safely and successfully: (i) through strong collaborative relationships that are inclusive of key experts; (ii) with clear guidance from overarching bodies with some flexibility for adapting to local contexts; (iii) through establishment of robust teamwork, trust and communication; and, (iv) with appropriate equipment and technical support

Mammographic densities of Aboriginal and non-Aboriginal women living in Australia's Northern Territory

Objectives: To compare the mammographic densities and other characteristics of Aboriginal and non-Aboriginal women screened in Australia. Methods: Population screening programme data of Aboriginal (n = 857) and non-Aboriginal women (n = 3236) were used. Mann–Whitney U test compared ages at screening and Chi-square tests compared personal and clinical information. Logistic regression analysis was used for density groupings. OR and 95% CI were calculated for multivariate association for density. Results: Mammographic density was lower amongst Aboriginal women (P < 0.001). For non-Aboriginal women, higher density was associated with younger age (OR 2.4, 95% CI 2.1–2.8), recall to assessment (OR 2.2, 95% CI 1.6–3.0), family history of breast cancer (OR 1.4, 95% CI 1.2–1.6), English-speaking background (OR 1.4, 95% CI 1.2–1.6), and residence in remote areas (OR 1.2, 95% CI 1.1–1.4). For Aboriginal women, density was associated with younger age (OR 2.7, 95% CI 2.0–3.5; P < 0.001), and recall to assessment (OR 2.3, 95% CI 1.4–3.9; P < 0.05). Conclusions: Significant differences between Aboriginal and non-Aboriginal women were found. There were more significant associations for dense breasts for non-Aboriginal women than for Aboriginal women

Therapeutic touch for anxiety disorders

Background Anxiety disorders are a common occurrence in today's society. There is interest from the community in the use of complementary therapies for anxiety disorders. This review examined the currently available evidence supporting the use of therapeutic touch in treating anxiety disorders. Objectives To examine the efficacy and adverse effects of therapeutic touch for anxiety disorders. Search strategy We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (search date 13/01/06), the Controlled Trials website and Dissertation Abstracts International. Searches of reference lists of retrieved papers were also carried out and experts in the field were contacted. Selection criteria Inclusion criteria included all published and unpublished randomised and quasi-randomised controlled trials comparing therapeutic touch with sham (mimic) TT, pharmacological therapy, psychological treatment, other treatment or no treatment /waiting list.The participants included adults with an anxiety disorder defined by the Diagnostic and Statistical Manual (DSM-IV),the International Classification of Diseases (ICD-10), validated diagnostic instruments, or other validated clinician or self-report instruments. Data collection and analysis Two review authors independently applied inclusion criteria. Further information was sought from trialists where papers contained insufficant information to make a decision about eligibility. Main results No randomised or quasi-randomised controlled trials of therapeutic touch for anxiety disorders were identified. Authors' conclusions Given the high prevalence of anxiety disorders and the current paucity of evidence on therapeutic touch in this population, there is a need for well conducted randomised controlled trials to examine the effectiveness of therapeutic touch for anxiety disorders

Psychological illness is commonly associated with functional gastrointestinal disorders and is important to consider during patient consultation: a population-based study

BACKGROUND: Some individuals with functional gastrointestinal disorders (FGID) suffer long-lasting symptoms without ever consulting their doctors. Our aim was to study co-morbidity and lifestyle differences among consulters and non-consulters with persistent FGID and controls in a defined adult population. METHODS: A random sample of the general adult Swedish population was obtained by a postal questionnaire. The Abdominal Symptom Questionnaire (ASQ) was used to measure GI symptomatology and grade of GI symptom severity and the Complaint Score Questionnaire (CSQ) was used to measure general symptoms. Subjects were then grouped for study by their symptomatic profiles. Subjects with long-standing FGID (n = 141) and subjects strictly free from gastrointestinal (GI) symptoms (n = 97) were invited to attend their local health centers for further assessment. RESULTS: Subjects with FGID have a higher risk of psychological illness [OR 8.4, CI(95)(4.0–17.5)] than somatic illness [OR 2.8, CI(95)(1.3–5.7)] or ache and fatigue symptoms [OR 4.3, CI(95)(2.1–8.7)]. Subjects with psychological illness have a higher risk of severe GI symptoms than controls; moreover they have a greater chance of being consulters. Patients with FGID have more severe GI symptoms than non-patients. CONCLUSION: There is a strong relation between extra-intestinal, mental and somatic complaints and FGID in both patients and non-patients. Psychological illness increases the chance of concomitantly having more severe GI symptoms, which also enhance consultation behaviour