Analysis of motion during the breast clamping phase of mammography

Objectives: To measure paddle motion during the clamping phase of a breast phantom for a range of machine/paddle combinations. Methods: A deformable breast phantom was used to simulate a female breast. Twelve mammography machines from three manufacturers with twenty two flexible and twenty fixed paddles were evaluated. Vertical motion at the paddle was measured using two calibrated linear potentiometers. For each paddle, the motion in millimeters was recorded every 0.5 seconds for 40 seconds while the phantom was compressed with 80 N. Independent t-tests were used to determine differences in paddle motion between flexible and fixed, small and large, GE Senographe Essential and Hologic Selenia Dimensions paddles. Paddle tilt in the medial-lateral plane for each machine/paddle combination was calculated. Results: All machine/paddle combinations demonstrate highest levels of motion during the first 10s of the clamping phase. Least motion is 0.17±0.05 mm/10s (n=20) and the most is 0.51±0.15 mm/10s (n=80). There is a statistical difference in paddle motion between fixed and flexible (p<0.001), GE Senographe Essential and Hologic Selenia Dimensions paddles (p<0.001). Paddle tilt in the medial-lateral plane is independent of time and varied from 0.04° to 0.69°. Conclusions: All machine/paddle combinations exhibited motion and tilting and the extent varied with machine and paddle sizes and types. Advances in knowledge: This research suggests that image blurring will likely be clinically insignificant 4 seconds or more after the clamping phase commences

Cervical screening uptake, political interest and voter turnout: a population-based survey of women in England.

To examine the relationship between cervical screening uptake and political engagement, and to test whether political engagement and voting behaviour mediate the association between age and cervical screening uptake

The role of learning disability nurses in promoting cervical screening uptake in women with intellectual disabilities: a qualitative study

Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women with intellectual disabilities to access cervical screening in order to examine their role in promoting attendance and elucidate potential barriers and facilitators to uptake. Ten participants recruited from a specialist learning disability service completed a semi-structured interview and data were analysed using experiential thematic analysis. Identified individual barriers included limited health literacy, negative attitudes and beliefs and competing demands; barriers attributed to primary care professionals included time pressures, limited exposure to people with intellectual disabilities and lack of appropriate knowledge, attitudes and skills. Attendance at cervical screening was facilitated by prolonged preparation work undertaken by learning disability nurses, helpful clinical behaviours in the primary care context and effective joint working

Screening for breast cancer : medicalization, visualization and the embodied experience

Women’s perspectives on breast screening (mammography and breast awareness) were explored in interviews with midlife women sampled for diversity of background and health experience. Attending mammography screening was considered a social obligation despite women’s fears and experiences of discomfort. Women gave considerable legitimacy to mammography visualizations of the breast, and the expert interpretation of these. In comparison, women lacked confidence in breast awareness practices, directly comparing their sensory capabilities with those of the mammogram, although mammography screening did not substitute breast awareness in a straightforward way. The authors argue that reliance on visualizing technology may create a fragmented sense of the body, separating the at risk breast from embodied experience

Blurred digital mammography images : an analysis of technical recall and observer detection performance

Background: Blurred images in Full Field Digital Mammography (FFDM) are a problem in the UK Breast Screening Programme. Technical recalls may be due to blurring not being seen on lower resolution monitors used for review. Objectives: This study assesses the visual detection of blurring on a 2.3 megapixel (MP) monitor and a 5 MP report grade monitor and proposes an observer standard for the visual detection of blurring on a 5 MP reporting grade monitor. Method: Twenty-eight observers assessed 120 images for blurring; 20 had no blurring present whilst 100 had blurring imposed through mathematical simulation at 0.2, 0.4, 0.6, 0.8 and 1.0 mm levels of motion. Technical recall rate for both monitors and angular size at each level of motion were calculated. Chi-squared (X2) tests were used to test whether significant differences in blurring detection existed between 2.3 and 5 MP monitors. Results: The technical recall rate for 2.3 and 5 MP monitors are 20.3 % and 9.1% respectively. Angular size for 0.2 to 1 mm motion varied from 55 to 275 arc seconds. The minimum amount of motion for visual detection of blurring in this study is 0.4 mm. For 0.2 mm simulated motion, there was no significant difference X2 (1, N=1095) =1.61, p=0.20) in blurring detection between the 2.3 and 5 MP monitors. Conclusion: According to this study monitors equal or below 2.3 MP are not suitable for technical review of FFDM images for the detection of blur. Advances in knowledge: This research proposes the first observer standard for the visual detection of blurring. Key words: Simulated motion; technical recall; monitor resolution; observer standard; blurring detectio

Women with learning disabilities and access to cervical screening: retrospective cohort study using case control methods

<p>Abstract</p> <p>Background</p> <p>Several studies in the UK have suggested that women with learning disabilities may be less likely to receive cervical screening tests and a previous local study in had found that GPs considered screening unnecessary for women with learning disabilities. This study set out to ascertain whether women with learning disabilities are more likely to be ceased from a cervical screening programme than women without; and to examine the reasons given for ceasing women with learning disabilities. It was carried out in Bury, Heywood-and-Middleton and Rochdale.</p> <p>Methods</p> <p>Carried out using retrospective cohort study methods, women with learning disabilities were identified by Read code; and their cervical screening records were compared with the Call-and-Recall records of women without learning disabilities in order to examine their screening histories. Analysis was carried out using case-control methods – 1:2 (women with learning disabilities: women without learning disabilities), calculating odds ratios.</p> <p>Results</p> <p>267 women's records were compared with the records of 534 women without learning disabilities. Women with learning disabilities had an odds ratio (OR) of 0.48 (Confidence Interval (CI) 0.38 – 0.58; <it>X</it>²: 72.227; p.value <.001) of receiving a cervical screening test; an OR of 2.05 (CI 1.88 – 2.22; <it>X</it>²: 24.236; p.value <.001) of being ceased from screening; and an OR of 0.14 (CI 0.001 – 0.28; <it>X</it>²: 286.341; p.value <0.001 of being a non-responder compared to age and practice-matched women without learning disabilities.</p> <p>Conclusion</p> <p>The reasons given for ceasing and/or not screening suggest that merely being coded as having a learning disability is <b>not </b>the sole reason for these actions. There are training needs among smear takers regarding appropriate reasons not to screen and providing screening for women with learning disabilities.</p

Understandings of cervical screening in sexual minority women: A Q-methodological study

Discursive perspectives argue that cervical screening carries social and moral meaning. Overlooked by research into the health needs of sexual minority women, previous literature that has examined uptake of cervical screening has instead targeted increasing attendance via information and service provision. In order to explore the diversity of meanings that British sexual minority women have about cervical screening, the Q-sorts of 34 sexual minority women were factor analysed by-person and rotated to simple structure using Varimax. The five factors are interpreted and discussed relative to competing discourses on information provision within cervical screening. The five accounts are labelled 'cervical screening is': an essential health check that women have the right to refuse; a woman's health entitlement; a vital test but degrading experience; a sensible thing to do; and an unnecessary imposition for some women. Critical approaches to informed choice are explored with attention to recent developments in cervical cancer prevention. Findings highlighting the need for affirmation of diversity within healthcare are considered in relation to existing criteria for UK national screening programmes