Interventions for raising breast cancer awareness in women

Background: Breast cancer continues to be the most commonly diagnosed cancer in women globally. Early detection, diagnosis and treatment of breast cancer are key to better outcomes. Since many women will discover a breast cancer symptom themselves, it is important that they are breast cancer aware i.e. have the knowledge, skills and confidence to detect breast changes and present promptly to a healthcare professional.Objectives: To assess the effectiveness of interventions for raising breast cancer awareness in women.Search methods: We searched the Cochrane Breast Cancer Group's Specialised Register (searched 25 January 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 12) in the Cochrane Library (searched 27 January 2016), MEDLINE OvidSP (2008 to 27 January 2016), Embase (Embase.com, 2008 to 27 January 2016), the World Health Organization’s International Clinical Trials Registry Platform (ICTRP) search portal and ClinicalTrials.gov (searched 27 Feburary 2016). We also searched the reference lists of identified articles and reviews and the grey literature for conference proceedings and published abstracts. No language restriction was applied.Selection criteriaRandomised controlled trials (RCTs) focusing on interventions for raising women’s breast cancer awareness i.e. knowledge of potential breast cancer symptoms/changes and the confidence to look at and feel their breasts, using any means of delivery, i.e. one-to-one/group/mass media campaign(s).Data collection and analysis: Two authors selected studies, independently extracted data and assessed risk of bias. We reported the odds ratio (OR) and 95% confidence intervals (CIs) for dichotomous outcomes and mean difference (MD) and standard deviation (SD) for continuous outcomes. Since it was not possible to combine data from included studies due to their heterogeneity, we present a narrative synthesis. We assessed the quality of evidence using GRADE methods.Main results: We included two RCTs involving 997 women: one RCT (867 women) randomised women to receive either a written booklet and usual care (intervention group 1), a written booklet and usual care plus a verbal interaction with a radiographer or research psychologist (intervention group 2) or usual care (control group); and the second RCT (130 women) randomised women to either an educational programme (three sessions of 60 to 90 minutes) or no intervention (control group).Knowledge of breast cancer symptoms: In the first study, knowledge of non-lump symptoms increased in intervention group 1 compared to the control group at two years postintervention, but not significantly (OR 1.1, 95% CI 0.7 to 1.6; P = 0.66; 449 women; moderate-quality evidence). Similarly, at two years postintervention, knowledge of symptoms increased in the intervention group 2 compared to the control group but not significantly (OR 1.4, 95% CI 0.9 to 2.1; P = 0.11; 434 women; moderate-quality evidence). In the second study, women’s awareness of breast cancer symptoms had increased one month post intervention in the educational group (MD 3.45, SD 5.11; 65 women; low-quality evidence) compared to the control group (MD −0.68, SD 5.93; 65 women; P < 0.001), where there was a decrease in awareness.Knowledge of age-related risk: In the first study, women’s knowledge of age-related risk of breast cancer increased, but not significantly, in intervention group 1 compared to control at two years postintervention (OR 1.8; 95% CI 0.9 to 3.5; P < 0.08; 447 women; moderate-quality evidence). Women's knowledge of risk increased significantly in intervention group 2 compared to control at two years postintervention (OR 4.8, 95% CI 2.6 to 9.0; P < 0.001; 431 women; moderate-quality evidence). In the second study, women’s perceived susceptibility (how at risk they considered themselves) to breast cancer had increased significantly one month post intervention in the educational group (MD 1.31, SD 3.57; 65 women; low-quality evidence) compared to the control group (MD −0.55, SD 3.31; 65 women; P = 0.005), where a decrease in perceived susceptibility was noted.Frequency of Breast Checking: In the first study, no significant change was noted for intervention group 1 compared to control at two years postintervention (OR 1.1, 95% CI 0.8 to 1.6; P = 0.54; 457 women; moderate-quality evidence). Monthly breast checking increased, but not significantly, in intervention group 2 compared to control at two years postintervention (OR 1.3, 95% CI 0.9 to 1.9; P = 0.14; 445 women; moderate-quality evidence). In the second study, women’s breast cancer preventive behaviours increased significantly one month post intervention in the educational group (MD 1.21, SD 2.54; 65 women; low-quality evidence) compared to the control group (MD 0.15, SD 2.94; 65 women; P < 0.045).Breast Cancer Awareness: Women’s overall breast cancer awareness did not change in intervention group 1 compared to control at two years postintervention (OR 1.8, 95% CI 0.6 to 5.30; P = 0.32; 435 women; moderate-quality evidence) while overall awareness increased in the intervention group 2 compared to control at two years postintervention (OR 8.1, 95% CI 2.7 to 25.0; P < 0.001; 420 women; moderate-quality evidence). In the second study, there was a significant increase in scores on the Health Belief Model (that included the constructs of awareness and perceived susceptibility) at one month postintervention in the educational group (mean 1.21, SD 2.54; 65 women) compared to the control group (mean 0.15, SD 2.94; 65 women; P = 0.045).Neither study reported outcomes relating to motivation to check their breasts, confidence to seek help, time from breast symptom discovery to presentation to a healthcare professional, intentions to seek help, quality of life, adverse effects of the interventions, stages of breast cancer, survival estimates or breast cancer mortality rates.Authors' conclusions: Based on the results of two RCTs, a brief intervention has the potential to increase women’s breast cancer awareness. However, findings of this review should be interpreted with caution, as GRADE assessment identified moderate-quality evidence in only one of the two studies reviewed. In addition, the included trials were heterogeneous in terms of the interventions, population studied and outcomes measured. Therefore, current evidence cannot be generalised to the wider context. Further studies including larger samples, validated outcome measures and longitudinal approaches are warranted

UK Skills and Productivity in an International Context

A nation's prosperity depends largely on its ability to raise the level of its productivity. The education level of its workforce, and how effectively the skills are used in the production processes, are considered important factors in this process. In this report we investigate the extent to which skills have contributed to recent productivity performance in the UK. We do this within a cross-country framework, where we compare the UK's productivity trajectories with those of other close competitors. We quantify the role played by different types of certified skills, both academic and vocational, taking account of the influence of other factors, such as capital investment and technological change. Furthermore, we assess the influence of intangible investments, usually excluded from published data and traditional growth studies. We use a wide range of data sources, and employ growth accounting and panel data econometric techniques. The study begins with a comprehensive review of the literature on the role of human capital in productivity and growth, from both a theoretical and empirical point of view (section 1). We then provide a description of aggregate productivity and employment trends in section 2. Section 3 contains detailed results of the growth accounting decomposition and Section 4 summarises the econometric analysis. Sections 5 and 6 outline the key findings and conclusions emerging from this analysis. The main research questions addressed in this report are: • What have been the main sources of growth in the UK and other major economies since the recession? How have these differed relative to the previous periods? • What is the link between skills and productivity/growth? How have skills contributed to growth over recent years? • What is the contribution of different types of skills to growth? Where does the UK fare better and worse compared to international competitors? • What is the role of training and other intangible assets in explaining productivity and growth outcomes? Do they interact differently with different types of skilled workers

Estimation of the Serviceability of Forest Access Roads

The purpose of this study was to ascribe attributes to forest access roads, to allow for estimation of their serviceability on the basis of their current condition. The approach estimates the quantity of timber that may be hauled through without critically damaging the flexible pavements. Seventy-two roads were classified on the basis of their surface conditions, subgrade material, and surface deflection as the strength parameter, for 40 and 60 t Gross Vehicle Weight. Using non-parametric statistical techniques, it was found that the surface quality of pavements was largely dependent on drainage conditions (coefficient of determination r2 = 0.84), and that a strong relationship (r2 = 0.90) also existed between drainage and the number of potholes. Pavements with peat subgrades were found to exhibit significantly higher critical deflections (5.6 mm) than pavements with mineral subgrades (1 mm), coupled with their inherent variability, it is arguable that visual classification may not be suitable for such pavements. On the basis of these results, the serviceability of individual roads, in Equivalent Standard Axle Loads (ESAL) was estimated. Potential pavement damage by a standard 6 axle timber haulage truck, of 40 t Gross Vehicle Weight, with a payload of 27 t, was evaluated to be triple that due to a standard axle (8.16 t). Increasing the payload by about 10%, increased the ESAL required to transport a unit volume of timber, hence potential pavement damage, by 20%. Consequently, a significant reduction in the serviceability of forest access roads may be incurred by small overload margins that are usually ignored

Darned in 2013: inclusion of model organisms and linking with Wikipedia

DARNED (DAtabase of RNA EDiting, available at http://darned.ucc.ie) is a centralized repository of reference genome coordinates corresponding to RNA nucleotides having altered templated identities in the process of RNA editing. The data in DARNED are derived from published datasets of RNA editing events. RNA editing instances have been identified with various methods, such as bioinformatics screenings, deep sequencing and/or biochemical techniques. Here we report our current progress in the development and expansion of the DARNED. In addition to novel database features the DARNED update describes inclusion of Drosophila melanogaster and Mus musculus RNA editing events and the launch of a community-based annotation in the RNA WikiProject

Colloidal, tribological and sensory properties of oral nutritional supplements

This study aims to evaluate the physicochemical and sensory properties of oral nutritional supplements (ONSs). High physical stability was measured in ONSs with mean particle sizes <0.33 !m and viscosity >19.3 mPa·s. ONSs formulated with dairy-soy protein mixtures displayed low friction coefficients, whereas ONSs containing dairy proteins alone had high friction coefficient values in the boundary regime. Sensory analysis revealed low to medium liking across the products and the highest preference was found in samples with the highest perceived 'sweetness', 'vanilla aroma' and 'thickness'. The results will underpin the formulation of novel ONSs with good physical stability and sensory acceptability

A 3D Bioprinter Specifically Designed for the High-Throughput Production of Matrix-Embedded Multicellular Spheroids

Biotechnology; Cell Biology; Biomaterial

Demonstration of an application-aware resilience mechanism for dynamic heterogeneous networks

Business uptake of IP-centric services has been strong and necessitates reliable, highly-available, high-quality Internet access. Real time services such as mission-critical broadcast video, video conferencing and voice over IP (VoIP) have low tolerance for short-term network outages. However, applications like bulk data transfer maybe much more resistant to such events. Many different network resilience mechanisms can be offered to customers by service providers allowing for slower (or faster) recovery of network access. Yet in current networks, offering different resilience mechanisms for different services is complicated, involving multiple interfaces. In this work, we propose that services be offered differentiated resilience levels within a single physical interface. In order to do so, an application aware resilience mechanism is proposed based on using the supplementary IP header type of service (ToS) field to define arbitrary values in addition to the 6-bit differentiated services code points (DSCP). This mechanism allows different levels of resilience to be assigned to applications such as VoIP for emergency and mission critical services