Evaluation of the current knowledge limitations in breast cancer research: a gap analysis

BACKGROUND A gap analysis was conducted to determine which areas of breast cancer research, if targeted by researchers and funding bodies, could produce the greatest impact on patients. METHODS Fifty-six Breast Cancer Campaign grant holders and prominent UK breast cancer researchers participated in a gap analysis of current breast cancer research. Before, during and following the meeting, groups in seven key research areas participated in cycles of presentation, literature review and discussion. Summary papers were prepared by each group and collated into this position paper highlighting the research gaps, with recommendations for action. RESULTS Gaps were identified in all seven themes. General barriers to progress were lack of financial and practical resources, and poor collaboration between disciplines. Critical gaps in each theme included: (1) genetics (knowledge of genetic changes, their effects and interactions); (2) initiation of breast cancer (how developmental signalling pathways cause ductal elongation and branching at the cellular level and influence stem cell dynamics, and how their disruption initiates tumour formation); (3) progression of breast cancer (deciphering the intracellular and extracellular regulators of early progression, tumour growth, angiogenesis and metastasis); (4) therapies and targets (understanding who develops advanced disease); (5) disease markers (incorporating intelligent trial design into all studies to ensure new treatments are tested in patient groups stratified using biomarkers); (6) prevention (strategies to prevent oestrogen-receptor negative tumours and the long-term effects of chemoprevention for oestrogen-receptor positive tumours); (7) psychosocial aspects of cancer (the use of appropriate psychosocial interventions, and the personal impact of all stages of the disease among patients from a range of ethnic and demographic backgrounds). CONCLUSION Through recommendations to address these gaps with future research, the long-term benefits to patients will include: better estimation of risk in families with breast cancer and strategies to reduce risk; better prediction of drug response and patient prognosis; improved tailoring of treatments to patient subgroups and development of new therapeutic approaches; earlier initiation of treatment; more effective use of resources for screening populations; and an enhanced experience for people with or at risk of breast cancer and their families. The challenge to funding bodies and researchers in all disciplines is to focus on these gaps and to drive advances in knowledge into improvements in patient care

Development of the ‘ACT now & check it out’ intervention to support patient-initiated follow up for Head and Neck cancer patients

Objective: Current Head and Neck cancer (HNC) follow-up models are considered sub-optimal at detecting re currences. We describe the development of a patient-initiated follow up (PIFU) trial intervention support package, to support HNC patients to engage in PIFU self-care behaviors. Methods: An intervention mapping approach, informed by evidence synthesis, theory and stakeholder consul tation, guided intervention development. Data sources included a patient survey (n = 144), patient interviews (n = 30), 7 workshops with patients (n = 25) and caregivers (n = 3) and 5 workshops with health professionals (n = 21). Results: The intervention (‘ACT now & check-it-out’) comprises an education and support session with a health professional and an app and/or a booklet for patients. The main targets for change in patient self-care behaviors

Development of the ‘ACT now & check it out’ intervention to support patient-initiated follow up for Head and Neck cancer patients

Objective: Current Head and Neck cancer (HNC) follow-up models are considered sub-optimal at detecting re currences. We describe the development of a patient-initiated follow up (PIFU) trial intervention support package, to support HNC patients to engage in PIFU self-care behaviors. Methods: An intervention mapping approach, informed by evidence synthesis, theory and stakeholder consul tation, guided intervention development. Data sources included a patient survey (n = 144), patient interviews (n = 30), 7 workshops with patients (n = 25) and caregivers (n = 3) and 5 workshops with health professionals (n = 21). Results: The intervention (‘ACT now & check-it-out’) comprises an education and support session with a health professional and an app and/or a booklet for patients. The main targets for change in patient self-care behaviors

Towards an EU measure of child deprivation

This paper proposes a new measure of child material and social deprivation (MSD) in the European Union (EU) which includes age appropriate child-specific information available from the thematic deprivation modules included in the 2009 and 2014 waves of the “EU Statistics on Income and Living Conditions” (EU‑SILC). It summarises the main results of the in-depth analysis of these two datasets, identifies an optimal set of robust children MSD items and recommends a child‑specific MSD indicator for use by EU countries and the European Commission in their regular social monitoring. In doing this, the paper replicates and expands on the methodological framework outlined in Guio, Gordon and Marlier (2012), particularly by including additional advanced reliability tests

Recognize Tone Languages Using Pitch Information

An innovative method for speech recognition of tone languages is reported. By definition, the tone of a syllable is determined by the pitch contour of the entire syllable. We propose that the pitch information on the main vowel of a syllable is sufficient to determine the tone of that syllable. Therefore, to recognize tone languages, only main vowels are needed to associate with tones. The number of basic phonetic units required to recognize tone languages is greatly reduced. We then report experimental results on Cantonese and Mandarin. In both cases, using the main vowel method, while the number of phonemes and the quantity of training data are substantially reduced, the decoding accuracy is improved over other methods. Possible applications of the new method to other tone languages, including Thai, Vietnamese, Japanese, Swedish, and Norwegian are discussed

Soldiers in psychiatric therapy: the case of Northfield military hospital 1942-1946

This article discusses the psychiatric therapeutics of Northfield military psychiatric hospital and suggests that treatment in Northfield was characterised by ideals of citizenship typical of the period and inextricably linked to the military. The two Northfield experiments, for which Northfield has become famous, glorified the group as a social unit and promoted adaptation to the needs and values of society as the route to mental health. In the context of the Second World War, such adaptation meant accepting the duties of a soldier. In the published writings regarding the first Northfield experiment, the psychiatrist Wilfred Bion emphasised his military role in returning patients to their units, a job which he thought was best conducted by men like himself who had experience of leading men into battle. Writing about the second experiment, Tom Main emphasised the importance of including military staff in every aspect of the hospital life from therapy to administration. Some Northfield psychiatrists were less content with this strongly military approach and this led to the conflict which ended the first experiment and continued to spark disagreements throughout the hospital's existence