Breast cancer worry in higher-risk women offered preventive therapy: a UK multicentre prospective study

PURPOSE: Women's worry about developing breast cancer may influence their decision to use preventive therapy. However, the direction of this relationship has been questioned. We prospectively investigated the relationship between breast cancer worry and uptake of preventive therapy. The socio-demographic and clinical factors associated with high breast cancer worry were also investigated. METHODS: Women at increased risk of developing breast cancer were recruited from clinics across England (n = 408). Participants completed a survey on their breast cancer worry, socio-demographic and clinical factors. Uptake of tamoxifen was recorded at 3 months (n = 258 women, 63.2%). Both primary and sensitivity analyses were conducted using different classifications of low, medium and high worry. RESULTS: 39.5% of respondents reported medium breast cancer worry at baseline and 21.2% reported high worry. Ethnic minority women were more likely to report high worry than white women (OR = 3.02, 95%CI 1.02, 8.91, p = 0.046). Women educated below degree level were more likely to report high worry than those with higher education (OR = 2.29, 95%CI 1.28, 4.09, p = 0.005). No statistically significant association was observed between worry and uptake. In the primary analysis, fewer respondents with medium worry at baseline initiated tamoxifen (low worry = 15.5%, medium = 13.5%, high = 15.7%). In the sensitivity analysis, participants with medium worry reported the highest uptake of tamoxifen (19.7%). CONCLUSIONS: No association was observed between worry and uptake, although the relationship was affected by the categorisation of worry. Standardised reporting of the classification of worry is warranted to allow transparent comparisons across cohorts

Promoting Health and Nutrition Through Sport: Attitudes of the Junior Sporting Community

Introduction: This study aimed to provide information on parents’, children’s and sporting officials’ attitudes to sponsorship arrangements, and their support of potential policy interventions to reorient sponsorship to be more health promoting. Methods: Sports clubs (n=20) known to have food and beverage sponsors in Sydney, Illawarra and Canberra/Queanbeyan were selected. Parents and children at sports clubs were recruited through convenience sampling by approaching those attending the sports club at the time of the survey and those children who had a signed consent form. Sports clubs were visited between May and November 2010. At each club, one sports club official, ten parents of players aged 5 to 14 years, and five children aged 10 to 14 years were surveyed. Results: The majority of sporting officials and parents were supportive of policies to restrict unhealthy food and beverage sponsorship of elite sport and children’s sports clubs. More than two-thirds of all children were able to correctly recall sponsors of their sports club and almost half could correctly name at least one sponsor of their favourite elite sports team. Most children thought that food and beverage companies sponsored sport to help out sports clubs and liked to return the favour to these sponsors by buying their products. Conclusion: Children’s high level of recall of food and beverage sponsors is concerning as this recall is likely to be linked to children’s product preferences and consumption behaviours. Alternative funding mechanisms are required to replace community and elite sport sponsorship from unhealthy food and beverage companies to reduce the promotional effects of this marketing on children’s food choices and eating behaviours

Promoting Health and Nutrition Through Sport: Attitudes of the Junior Sporting Community

Introduction: This study aimed to provide information on parents’, children’s and sporting officials’ attitudes to sponsorship arrangements, and their support of potential policy interventions to reorient sponsorship to be more health promoting. Methods: Sports clubs (n=20) known to have food and beverage sponsors in Sydney, Illawarra and Canberra/Queanbeyan were selected. Parents and children at sports clubs were recruited through convenience sampling by approaching those attending the sports club at the time of the survey and those children who had a signed consent form. Sports clubs were visited between May and November 2010. At each club, one sports club official, ten parents of players aged 5 to 14 years, and five children aged 10 to 14 years were surveyed. Results: The majority of sporting officials and parents were supportive of policies to restrict unhealthy food and beverage sponsorship of elite sport and children’s sports clubs. More than two-thirds of all children were able to correctly recall sponsors of their sports club and almost half could correctly name at least one sponsor of their favourite elite sports team. Most children thought that food and beverage companies sponsored sport to help out sports clubs and liked to return the favour to these sponsors by buying their products. Conclusion: Children’s high level of recall of food and beverage sponsors is concerning as this recall is likely to be linked to children’s product preferences and consumption behaviours. Alternative funding mechanisms are required to replace community and elite sport sponsorship from unhealthy food and beverage companies to reduce the promotional effects of this marketing on children’s food choices and eating behaviours

Building Solutions to Protect Children from Unhealthy Food and Drink Sport Sponsorship.

In Australia, and indeed across the world, the proportion of children who are overweight or obese is increasing. Almost one-quarter of school-aged children are now overweight or obese. While the causes of obesity are complex and many, children’s exposure to high levels of unhealthy food marketing is one factor that affects the food and drinks that children like, ask for, buy and consume. Extensive research evidence has found that, in general, children are exposed to high levels of food marketing, most of which is for unhealthy or high fat, sugar and/or salt food and drinks. The most commonly advertised foods have been found to be sugar-sweetened breakfast cereals, savoury snacks, fast food restaurants, onfectionery and soft drinks

"Food company sponsors are kind, generous and cool": (Mis)conceptions of junior sports players

<p>Abstract</p> <p>Background</p> <p>Children's exposure to unhealthy food marketing influences their food knowledge, preferences and consumption. Sport sponsorship by food companies is widespread and industry investment in this marketing is increasing. This study aimed to assess children's awareness of sport sponsors and their brand-related attitudes and purchasing intentions in response to this marketing.</p> <p>Methods</p> <p>Sports clubs known to have food sponsors and representing the most popular sports for Australian children across a range of demographic areas were recruited. Interview-based questionnaires were conducted at clubs with children aged 10-14 years (n = 103) to examine their recall of local sports club and elite sport sponsors, and their attitudes towards sponsors and sponsorship activities.</p> <p>Results</p> <p>Most children (68%) could recall sponsors of their sports club, naming a median of two sponsors, including a median of one food company sponsor each. Almost half (47%) of children could recall any sponsors of their favourite elite sporting team. Children aged 10-11 years were more likely than older children to report that they thought about sponsors when buying something to eat or drink (P < 0.01); that they liked to return the favour to sponsors by buying their products (P < 0.01); and that sponsors were 'cool' (P = 0.02). Most children had received a voucher or certificate from a food or beverage company to reward sport performance (86% and 76%, respectively). Around one-third of children reported liking the company more after receiving these rewards.</p> <p>Conclusions</p> <p>Children's high recall of food and beverage company sport sponsors and their positive attitudes towards these sponsors and their promotions is concerning as this is likely to be linked to children's food preferences and consumption. Limiting children's exposure to this marketing is an important initiative to improve children's nutrition.</p

Can voicing conflict within experiential learning groups facilitate connection? : Building and developing effective multi-disciplinary team-working skills

This is an Accepted Manuscript of an article published by Taylor & Francis in Reflective Practice on 24 November 2016, available online at: http://dx.doi.org/10.1080/14623943.2016.1251408. Under embargo. Embargo end date: 24 May 2018.In the UK, Clinical Psychologists (CPs) work in a variety of settings within the National Health Service (NHS), often within Multi-Disciplinary Teams (MDTs). Problem-Based Learning (PBL) within CP training at the University of Hertfordshire (UH) offers unique opportunities to combine scientist-practitioner and reflective-practitioner models to learn about group dynamics from the personal experience of working within an experiential learning group. Further, given Trainees work three days per week on placement within MDTs in the NHS, the learning gained within a ‘safer’ PBL context can be utilised within these clinical settings. For two years, Trainees at UH have to work in small PBL groups with five or six members learning to work together to achieve a goal (four assessed presentations) negotiating their own personal and professional journey, as well as a group journey. Consequently, PBL offers trainees opportunities to learn (1) how individuals work within a group; (2) how personal experiences influence this process; (3) how others influence them and are influenced by them; and (4) how a group of diverse individuals conceptualise, understand and convey case vignettes to an audience. Within these groups, many Trainees learn to speak out, reflect, listen attentively, empathise, validate and accept diverse experiences. Further, when differences dominate they often learn to negotiate these, finding a way to maintain effective team working in order to complete the presentation. Focusing on the conflict that can occur within (any) group, this paper explores themes from the reflective narratives of six trainees: parallels and differences between MDTs and PBL groups, striving for and achieving authenticity; and conflict as a ‘swear’ word. We conclude that exploring the role PBL can play in training individuals to work effectively in teams may be of benefit within the training of other professional groups.Peer reviewedFinal Accepted Versio

Skin conductance responses indicate children are physiologically aroused by their favourite branded food and drink products

Children’s favourite food and beverage brands use various tactics to foster positive associations and loyalty. This brand-consumer dynamic is frequently influenced by the use of implicit techniques and emotional appeals. Few studies have used physiological methods to examine the connections that brands build with children and the influence this has on their automatic responses. These techniques are potentially less prone to bias than behavioural or cognitive methods. This is the first study to explore the implicit response that children have to images of their favourite food and beverage brands using skin conductance responses as a marker of arousal. Australian children aged 8–11 years (n = 48) were recruited. Images of the participants’ favourite branded food and beverage products, alongside images of the same products unpackaged, their family and friends, and neutral objects were presented in a randomised order with a standard timed interval between images. Children were significantly more aroused by branded images of their favourite food and beverage products than by their unpackaged counterparts (p < 0.042, d = 0.4). The physiological response to the branded products was similar to the response to the children’s family and friends (p = 0.900, d = −0.02). These findings suggest that children may have an implicit connection to their favourite branded products

Use of Buffers in Specific Contexts : Highly Trained Female Athletes, Extreme Environments and Combined Buffering Agents - A Narrative Review

This narrative review evaluated the evidence for buffering agents (sodium bicarbonate, sodium citrate and beta-alanine), with specific consideration of three discrete scenarios: female athletes, extreme environments and combined buffering agents. Studies were screened according to exclusion and inclusion criteria and were analysed on three levels: (1) moderating variables (supplement dose and timing, and exercise test duration and intensity), (2) design factors (e.g., use of crossover or matched group study design, familiarisation trials) and (3) athlete-specific factors (recruitment of highly trained participants, buffering capacity and reported performance improvements). Only 19% of the included studies for the three buffering agents reported a performance benefit, and only 10% recruited highly trained athletes. This low transferability of research findings to athletes’ real-world practices may be due to factors including the small number of sodium citrate studies in females (n = 2), no studies controlling for the menstrual cycle (MC) or menstrual status using methods described in recently established frameworks, and the limited number of beta-alanine studies using performance tests replicating real-world performance efforts (n = 3). We recommend further research into buffering agents in highly trained female athletes that control or account for the MC, studies that replicate the demands of athletes’ heat and altitude camps, and investigations of highly trained athletes’ use of combined buffering agents. In a practical context, we recommend developing evidence-based buffering protocols for individual athletes which feature co-supplementation with other evidence-based products, reduce the likelihood of side-effects, and optimise key moderating factors: supplement dose and timing, and exercise duration and intensity

Drought-Ready Communities: A Guide to Community Drought Preparedness

Table of Contents Introduction to Drought-Ready Communities........................................................ 4 Section 1. Getting Started: Invite the Community to Participate, Commit to the Process...................... 7 1.1 Establish a leadership team that includes individuals with responsibility for monitoring, communication, and implementation .............................................. 7 1.2 Identify stakeholders or groups in the community that may need additional resources to participate in the Drought-Ready Communities process .................... 8 1.3 Include government agencies and regulators ....................................... 9 1.4 Develop a contact list ................................................................ 9 1.5 Gather community perceptions of drought .................................................. 10 Section 2. Information Gathering: Understand Water Sources and Uses, Develop a Drought History . 11 2.1 Identify water sources and uses ....................................................... 11 2.2 Learn how drought has affected the community in the past ........................ 12 2.3 Gather data on water and climate ................................................................. 13 2.4 List factors that affect the severity of drought impacts ..................................... 1

Geographic Coincidence of Increased Malaria Transmission Hazard and Vulnerability Occurring at the Periphery of two Tanzanian Villages.

The goal of malaria elimination necessitates an improved understanding of any fine-scale geographic variations in transmission risk so that complementary vector control tools can be integrated into current vector control programmes as supplementary measures that are spatially targeted to maximize impact upon residual transmission. This study examines the distribution of host-seeking malaria vectors at households within two villages in rural Tanzania. Host-seeking mosquitoes were sampled from 72 randomly selected households in two villages on a monthly basis throughout 2008 using CDC light-traps placed beside occupied nets. Spatial autocorrelation in the dataset was examined using the Moran's I statistic and the location of any clusters was identified using the Getis-Ord Gi* statistic. Statistical associations between the household characteristics and clusters of mosquitoes were assessed using a generalized linear model for each species. For both Anopheles gambiae sensu lato and Anopheles funestus, the density of host-seeking females was spatially autocorrelated, or clustered. For both species, houses with low densities were clustered in the semi-urban village centre while houses with high densities were clustered in the periphery of the villages. Clusters of houses with low or high densities of An. gambiae s.l. were influenced by the number of residents in nearby houses. The occurrence of high-density clusters of An. gambiae s.l. was associated with lower elevations while An. funestus was also associated with higher elevations. Distance from the village centre was also positively correlated with the number of household occupants and having houses constructed with open eaves. The results of the current study highlight that complementary vector control tools could be most effectively targeted to the periphery of villages where the households potentially have a higher hazard (mosquito densities) and vulnerability (open eaves and larger households) to malaria infection