Population screening for colorectal cancer: the implications of an ageing population

Population screening for colorectal cancer (CRC) has recently commenced in the United Kingdom supported by the evidence of a number of randomised trials and pilot studies. Certain factors are known to influence screening cost-effectiveness (e.g. compliance), but it remains unclear whether an ageing population (i.e. demographic change) might also have an effect. The aim of this study was to simulate a population-based screening setting using a Markov model and assess the effect of increasing life expectancy on CRC screening cost-effectiveness. A Markov model was constructed that aimed, using a cohort simulation, to estimate the cost-effectiveness of CRC screening in an England and Wales population for two timescales: 2003 (early cohort) and 2033 (late cohort). Four model outcomes were calculated; screened and non-screened cohorts in 2003 and 2033. The screened cohort of men and women aged 60 years were offered biennial unhydrated faecal occult blood testing until the age of 69 years. Life expectancy was assumed to increase by 2.5 years per decade. There were 407 552 fewer people entering the model in the 2033 model due to a lower birth cohort, and population screening saw 30 345 fewer CRC-related deaths over the 50 years of the model. Screening the 2033 cohort cost £96 million with cost savings of £43 million in terms of detection and treatment and £28 million in palliative care costs. After 30 years of follow-up, the cost per life year saved was £1544. An identical screening programme in an early cohort (2003) saw a cost per life year saved of £1651. Population screening for CRC is costly but enables cost savings in certain areas and a considerable reduction in mortality from CRC. This Markov simulation suggests that the cost-effectiveness of population screening for CRC in the United Kingdom may actually be improved by rising life expectancies

Religions, Poverty Reduction and Global Development Institutions

Religious traditions have always played a central role in supporting those experiencing poverty, through service delivery as well as the provision of spiritual resources that provide mechanisms for resilience at both the individual and community level. However, the fact that religions can be seen to support social structures and practices that contribute towards inequality and conflict, also underscores a role for religious traditions in creating conditions of poverty. While the Western-led modern global development institutions that have emerged since the Second World War have tended to be secular in nature, over the past decade or so there has been an apparent ‘turn to religion’ by these global development institutions, as well as in academic development studies. This reflects the realization that modernization and secularization do not necessarily go together, and that religious values and faith actors are important determinants in the drive to reduce poverty, as well as in structures and practices that underpin it. This paper traces three phases of engagement between religions and global development institutions. In phase one, the ‘pre-secular’ or the ‘integrated phase’ seen during the colonial era, religion and poverty reduction were intimately entwined, with the contemporary global development project being a legacy of this. The second phase is the ‘secular’ or the ‘fragmented’ phase, and relates to the era of the global development industry, which is founded on the normative secularist position that modernization will and indeed should lead to secularization. The third phase is characterized by the ‘turn to religion’ from the early 2000s. Drawing the three phases together and reflecting on the nature of the dynamics within the third phase, the ‘turn to religion’, this paper is underpinned by two main questions. First, what does this mean for the apparent processes of secularization? Is this evidence that they are being reversed and that we are witnessing the emergence of the ‘desecularization of development’ or of a ‘post-secular development praxis’? Second, to what extent are FBOs working in development to be defined as neo-liberalism’s ‘little platoons’—shaped by and instrumentalized to the service of secular neo-liberal social, political and economic systems, or do we need to develop a more sophisticated account that can contribute towards better policy and practice around poverty reduction

Immunological control of Toxoplasma gondii and appropriate vaccine design

Toxoplasma gondii, by all conceivable ecological and epidemiological measurements and analysis, has to be regarded as an extremely successful parasite. It has been found in high incidence in most warm blooded vertebrates and has a generally global distribution. Approximately 30% of the world’s human population is infected, although the prevelance varies markedly from country to countr

High-affinity glucose transport in Aspergillus nidulans is mediated by the products of two related but differentially expressed genes

Independent systems of high and low affinity effect glucose uptake in the filamentous fungus Aspergillus nidulans. Low-affinity uptake is known to be mediated by the product of the mstE gene. In the current work two genes, mstA and mstC, have been identified that encode high-affinity glucose transporter proteins. These proteins' primary structures share over 90% similarity, indicating that the corresponding genes share a common origin. Whilst the function of the paralogous proteins is little changed, they differ notably in their patterns of expression. The mstC gene is expressed during the early phases of germination and is subject to CreA-mediated carbon catabolite repression whereas mstA is expressed as a culture tends toward carbon starvation. In addition, various pieces of genetic evidence strongly support allelism of mstC and the previously described locus sorA. Overall, our data define MstC/SorA as a high-affinity glucose transporter expressed in germinating conidia, and MstA as a high-affinity glucose transporter that operates in vegetative hyphae under conditions of carbon limitation. © 2014 Forment et al