Culturally Targeted Decision Aid Use in Intention to Complete Colorectal Cancer Screening among African American Women

Title: Culturally Targeted Decision Aid Use in Intention to Complete Colorectal Cancer Screening among African American Women Purpose: African American (AA) women experienced approximately 41% more deaths related to Colorectal Cancer (CRC) than White women in 2016. Provider recommendation has been a positive predictor of screening behavior. Along with provider recommendation, decision aids (DAs) can be useful tools to decrease health disparities and increase screening rates in racial, sex, and gender minorities. The purpose of the project is to determine if the use of DAs along with provider recommendation improve intention to complete CRC screening. Method: 21 AA women ages 45-75 years where recruited from a primary care office and asked to complete a 5 question survey gauging intention to complete CRC screening. They then viewed a culturally targeted DA regarding CRC screening. After viewing the DA, they completed the same 5-question survey regarding intention to complete CRC screening. Results: Twenty-one AA women aged 47-69 years completed the project. A Wilcoxon Signed rank test was conducted to evaluate the changes in intentions following of the culturally targeted DA intervention on AA women’s intention to complete CRC screening. Level of intention to complete screening did not differ significantly from the pre (M rank=8.44) to the post intervention group (M rank=9.50) where the sum of the ranks was 67.50 and 85.50 respectively and z=.666. Conclusion: Though the study did not show statistical significance in intention to complete screening, it did seem to increase knowledge of CRC screening. Addressing social issues and bringing awareness to the AA community about CRC screening is imperative to reduce morbidity and mortality related to CRC. More research is needed on the use of decision aids specifically targeting high-risk populations such as African American women

Study designs for clinical trials applied to personalised medicine: a scoping review

International audienceObjective Personalised medicine (PM) allows treating patients based on their individual demographic, genomic or biological characteristics for tailoring the ‘right treatment for the right person at the right time’. Robust methodology is required for PM clinical trials, to correctly identify groups of participants and treatments. As an initial step for the development of new recommendations on trial designs for PM, we aimed to present an overview of the study designs that have been used in this field. Design Scoping review. Methods We searched (April 2020) PubMed, Embase and the Cochrane Library for all reports in English, French, German, Italian and Spanish, describing study designs for clinical trials applied to PM. Study selection and data extraction were performed in duplicate resolving disagreements by consensus or by involving a third expert reviewer. We extracted information on the characteristics of trial designs and examples of current applications of these approaches. The extracted information was used to generate a new classification of trial designs for PM. Results We identified 21 trial designs, 10 subtypes and 30 variations of trial designs applied to PM, which we classified into four core categories (namely, Master protocol, Randomise-all, Biomarker strategy and Enrichment). We found 131 clinical trials using these designs, of which the great majority were master protocols (86/131, 65.6%). Most of the trials were phase II studies (75/131, 57.2%) in the field of oncology (113/131, 86.3%). We identified 34 main features of trial designs regarding different aspects (eg, framework, control group, randomisation). The four core categories and 34 features were merged into a double-entry table to create a new classification of trial designs for PM. Conclusions A variety of trial designs exists and is applied to PM. A new classification of trial designs is proposed to help readers to navigate the complex field of PM clinical trials

In vivo fate mapping with SCL regulatory elements identifies progenitors for primitive and definitive hematopoiesis in mice.

One of the principal issues facing biomedical research is to elucidate developmental pathways and to establish the fate of stem and progenitor cells in vivo. Hematopoiesis, the process of blood cell formation, provides a powerful experimental system for investigating this process. Here, we employ transcriptional regulatory elements from the stem cell leukemia (SCL) gene to selectively label primitive and definitive hematopoiesis. We report that SCL-labelled cells arising in the mid to late streak embryo give rise to primitive red blood cells but fail to contribute to the vascular system of the developing embryo. Restricting SCL-marking to different stages of foetal development, we identify a second population of multilineage progenitors, proficient in contributing to adult erythroid, myeloid and lymphoid cells. The distinct lineage-restricted potential of SCL-labelled early progenitors demonstrates that primitive erythroid cell fate specification is initiated during mid gastrulation. Our data also suggest that the transition from a hemangioblastic precursors with endothelial and blood forming potential to a committed hematopoietic progenitor must have occurred prior to SCL-marking of definitive multilineage blood precursors