The determinants of household water consumption: A review and assessment framework for research and practice

Achieving a thorough understanding of the determinants of household water consumption is crucial to support demand management strategies. Yet, existing research on household water consumption determinants is often limited to specific case studies, with findings that are difficult to generalize and not conclusive. Here, we first contribute an updated framework for review, classification, and analysis of the literature on the determinants of household water consumption. Our framework allows trade-off analysis of different criteria that account for the representation of a potential water consumption determinant in the literature, its impact across heterogeneous case studies, and the effort required to collect information on it. We then review a comprehensive set of 48 publications with our proposed framework. The results of our trade-off analysis show that distinct groups of determinants exist, allowing for the formulation of recommendations for practitioners and researchers on which determinants to consider in practice and prioritize in future research

An assessment framework for classifying determinants of household water consumption and their priorities for research and practice

Achieving a thorough understanding of the determinants of household water consumption is crucial to support demand management strategies. Yet, existing research on household water consumption determinants is often limited to specific case studies, with findings that are difficult to generalize and not conclusive. Here, we contribute a framework for review, classification, and analysis of the literature on the determinants of household water consumption. Firstly, we identify a comprehensive set of 48 relevant publications, based on a systematic paper search. The framework firstly classifies household determinants into observable (physically seen/measured aspects of the house), latent (relates to the way occupants think/act/feel) and external (external to house and influence at regional level). Secondly, we undertake a trade-off analysis of different criteria that account for the representation of a potential water consumption determinant in the literature, its impact across heterogeneous case studies, and the effort required to collect information on it. The results of our trade-off analysis show that distinct groups of determinants exist, allowing for the formulation of four recommendation categories. These provide guidance for practitioners on which determinants to consider in practice and for researchers to prioritize in future research (Figure 1).A. Cominola, L. Preiss, M. Thyer, H. R. Maier, P. Prevos, R. Stewart, and A. Castellett

Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program : validation of results in a large multireader, multicase study

OBJECTIVES: Contrast-enhanced spectral mammography (CESM) is a promising problem-solving tool in women referred from a breast cancer screening program. We aimed to study the validity of preliminary results of CESM using a larger panel of radiologists with different levels of CESM experience. METHODS: All women referred from the Dutch breast cancer screening program were eligible for CESM. 199 consecutive cases were viewed by ten radiologists. Four had extensive CESM experience, three had no CESM experience but were experienced breast radiologists, and three were residents. All readers provided a BI-RADS score for the low-energy CESM images first, after which the score could be adjusted when viewing the entire CESM exam. BI-RADS 1-3 were considered benign and BI-RADS 4-5 malignant. With this cutoff, we calculated sensitivity, specificity and area under the ROC curve. RESULTS: CESM increased diagnostic accuracy in all readers. The performance for all readers using CESM was: sensitivity 96.9 % (+3.9 %), specificity 69.7 % (+33.8 %) and area under the ROC curve 0.833 (+0.188). CONCLUSION: CESM is superior to conventional mammography, with excellent problem-solving capabilities in women referred from the breast cancer screening program. Previous results were confirmed even in a larger panel of readers with varying CESM experience. KEY POINTS: • CESM is consistently superior to conventional mammography • CESM increases diagnostic accuracy regardless of a reader's experience • CESM is an excellent problem-solving tool in recalls from screening programs

Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program : validation of results in a large multireader, multicase study

OBJECTIVES: Contrast-enhanced spectral mammography (CESM) is a promising problem-solving tool in women referred from a breast cancer screening program. We aimed to study the validity of preliminary results of CESM using a larger panel of radiologists with different levels of CESM experience. METHODS: All women referred from the Dutch breast cancer screening program were eligible for CESM. 199 consecutive cases were viewed by ten radiologists. Four had extensive CESM experience, three had no CESM experience but were experienced breast radiologists, and three were residents. All readers provided a BI-RADS score for the low-energy CESM images first, after which the score could be adjusted when viewing the entire CESM exam. BI-RADS 1-3 were considered benign and BI-RADS 4-5 malignant. With this cutoff, we calculated sensitivity, specificity and area under the ROC curve. RESULTS: CESM increased diagnostic accuracy in all readers. The performance for all readers using CESM was: sensitivity 96.9 % (+3.9 %), specificity 69.7 % (+33.8 %) and area under the ROC curve 0.833 (+0.188). CONCLUSION: CESM is superior to conventional mammography, with excellent problem-solving capabilities in women referred from the breast cancer screening program. Previous results were confirmed even in a larger panel of readers with varying CESM experience. KEY POINTS: • CESM is consistently superior to conventional mammography • CESM increases diagnostic accuracy regardless of a reader's experience • CESM is an excellent problem-solving tool in recalls from screening programs

Cancer Surveillance in Healthy Carriers of Germline Pathogenic Variants in BRCA1/2: A Review of Secondary Prevention Guidelines

Germline pathogenic alterations in the breast cancer susceptibility genes 1 (BRCA1) and 2 (BRCA2) are the most prevalent causes of hereditary breast and ovarian cancer. The increasing trend in proportion of cancer patients undergoing genetic testing, followed by predictive testing in families of new index patients, results in a significant increase of healthy germline BRCA1/2 mutation carriers who are at increased risk for breast, ovarian, and other BRCA-related cancers. This review aims to give an overview of available screening guidelines for female and male carriers of pathogenic or likely pathogenic germline BRCA1/2 variants per cancer type, incorporating malignancies that are more or less recently well correlated with BRCA1/2. We selected guidelines from national/international organizations and/or professional associations that were published or updated between January 1, 2015, and February 1, 2020. In total, 12 guidelines were included. This review reveals several significant discordances between the different guidelines. Optimal surveillance strategies depend on accurate age-specific cancer risk estimates, which are not reliably available for all BRCA-related cancers. Up-to-date national or international consensus guidelines are of utmost importance to harmonize counseling and proposed surveillance strategies for BRCA1/2 carriers