Beliefs about weight and breast cancer: An interview study with high risk women following a 12 month weight loss intervention

This is an Version of Record of an article published by BioMed Central in Hereditary Cancer in Clinical Practice on 9 January 2015, available online: http://www.hccpjournal.com/content/13/1/1 This is an Open Access article distributed under the terms of the Creative Commons Attribution License(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Breast cancer is the most common cancer in the UK. Lifestyle factors including excess weight contribute to risk of developing the disease. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change. Overweight/obese premenopausal women (aged 35–45) with a family history of breast cancer (lifetime risk 17–40%) were invited to a semi-structured interview following their participation in a 12 month weight loss intervention aimed at reducing their risk of breast cancer. Interviews were carried out with 9 women who successfully achieved ≥5% weight loss and 11 who were unsuccessful. Data were transcribed verbatim and analysed using thematic analysis. Three themes were developed from the analysis. The first theme how women construct and understand links between weight and breast cancer risk is composed of two subthemes, the construction of weight and breast cancer risk and making sense of weight and breast cancer risk. The second theme - motivation and adherence to weight loss interventions - explains that breast cancer risk can be a motivating factor for adherence to a weight loss intervention. The final theme, acceptance of personal responsibility for health is composed of two subthemes responsibility for one’s own health and responsibility for family health through making sensible lifestyle choices.Beliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer. Our study has highlighted common doubts, anxieties and questions and the importance of providing a credible rationale for weight control and weight loss which addresses individual concerns

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Habitat associations and breeding bird community composition within the city of Bristol, UK.

Results: Three communities were identified: a rural community associated with woodland, managed grassland and inland water; a suburban community associated with buildings and residential gardens; and an intermediate community that shared some of these habitat characteristics. Species richness, but not total bird abundance, was lowest in the suburban community. Conclusion: The diversity of species in urban areas appears to be most dependent upon the availability of patches of natural and semi‐natural habitats. Residential gardens support fewer species, but those species that are present may be found at high densities.Different urban breeding bird communities are associated with different habitat types, but, although community species diversity varies significantly, total bird density does not. Aims: To investigate the association between breeding bird communities and habitats within Bristol, UK and how these communities vary in terms of species diversity and total bird abundance. Methods: Breeding density data for 70 species in the metropolitan area of Bristol, UK were subjected to de‐trended correspondence analysis to identify the number of different communities present and their indicator species. These data were then used to identify patterns of habitat association with each community and differences in species richness and total bird density

Atlas - Channel Catchment Cluster

Westcountry Rivers Trust publication : "The 3Cs (Channel Catchment Cluster) is a project that looks at the river basins that drains into the channel. Capitalizing on common aspects of recent Interreg-funded projects in the Channel area that have focussed on water quality within coastal catchments (from groundwater to the sea) and disregarding political boundaries and focussing on the geography, the 3Cs incorporates all facets of the hydrological cycle within catchment basins. This includes groundwater, rivers, transitional waters & the coastal zone together with aspects of port and estuarine sediment quality. A multi – stakeholder project, our role was to collate, share and disseminate the tools, techniques, data and best practices developed within the Interreg Iva FCE projects in order to improve scientific understanding, monitoring and management of water quality in the region."Channel Catchment Cluster (3C

Habitat associations and breeding bird community composition within the city of Bristol, UK

Capsule: Different urban breeding bird communities are associated with different habitat types, but, although community species diversity varies significantly, total bird density does not. Aims: To investigate the association between breeding bird communities and habitats within Bristol, UK and how these communities vary in terms of species diversity and total bird abundance. Methods: Breeding density data for 70 species in the metropolitan area of Bristol, UK were subjected to de-trended correspondence analysis to identify the number of different communities present and their indicator species. These data were then used to identify patterns of habitat association with each community and differences in species richness and total bird density. Results: Three communities were identified: a rural community associated with woodland, managed grassland and inland water; a suburban community associated with buildings and residential gardens; and an intermediate community that shared some of these habitat characteristics. Species richness, but not total bird abundance, was lowest in the suburban community. Conclusion: The diversity of species in urban areas appears to be most dependent upon the availability of patches of natural and semi-natural habitats. Residential gardens support fewer species, but those species that are present may be found at high densities