The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women.

BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain. METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights. RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population). CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.This article is an independent research supported by different funding bodies, beyond the authors’ own employing organisations. MJR was partially funded by a Cancer Research UK Postdoctoral Fellowship (CRUK_A13275). GL is supported by a Postdoctoral Fellowship award by the National Institute for Health Research (NIHR PDF-2011-04-047) to end of 2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. We thank all staff at the National Cancer Registration Service, Public Health England, Eastern Office who helped collect and code data used in this study. We particularly acknowledge the help of Dr Clement H Brown and Dr Brian A Rous who were responsible for staging.This is the final published version. It first appeared at http://www.nature.com/bjc/journal/v112/n1s/full/bjc201551a.html#ack

The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women

This is the final published version. Available from Springer Nature via the DOI in this record.BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain.METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights.RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population).CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.Cancer Research UKCancer Research UKNational Institute for Health Research (NIHR

An inventory of the South african fitness industry

Objective. The aim of this study was to create an inventory of fitness facilities in South Africa, their location, equipment and services offered, and the demographics, education and training of the staff working in these facilities. Design. A total of 750 facilities were identified, and descriptive data were gathered from 442 facilities (59%) with the use of a questionnaire administered telephonically and via the website of the Sports Science Institute of South Africa. Setting. The study was initiated by the Sports Science Institute, and the results were presented at the 4th Annual Discovery Vitality Fitness Convention on 4 May 2006. Results. Results show that the industry comprises mainly independent facilities (68%). All types of facilities were found to be located mostly within urban areas, and reported providing services to just less than 2% of the South African population. Facilities offer a wide range of equipment and services to their members. Of the fitness-related staff at facilities, the majority were reported to be young (18 - 25 years, 55% of male, and 49% of female staff), and in terms of racial proportions most staff were white (males 40% of total staff and females 33% of total staff).Less than a quarter of fitness-related staff hold university qualifications, and just over 80% of instructors hold qualifications aligned with the National Qualifications Framework. The importance of education and training of staff was emphasised by respondents. Conclusions. This report highlights the widespread value of assessing the fitness industry, particularly within the context of the rise of chronic diseases in South Africa and government initiatives to promote healthy lifestyles. South African Journal of Sports Medicine Vol. 18 (3) 2006: pp. 93-10

A novel form of spontaneous tool use displayed by several captive greater vasa parrots (Coracopsis vasa)

Parrots are frequently cited for their sophisticated problem-solving abilities, but cases of habitual tool use among psittacines are scarce. We report the first evidence, to our knowledge, of tool use by greater vasa parrots (Coracopsis vasa). Several members of a captive population spontaneously adopted a novel tool-using technique by using pebbles and date pits either (i) to scrape on the inner surface of seashells, subsequently licking the resulting calcium powder from the tool, or (ii) as a wedge to break off smaller pieces of the shell for ingestion. Tool use occurred most frequently just prior to the breeding season, during which time numerous instances of tool transfer were also documented. These observations provide new insights into the tool-using capabilities of parrots and highlight the greater vasa parrot as a species of interest for studies of physical cognition

Estimating the potential survival gains by eliminating socioeconomic and sex inequalities in stage at diagnosis of melanoma

This is the final published version. Available from Springer Nature via the DOI in this record.BACKGROUND: Although inequalities in cancer survival are thought to reflect inequalities in stage at diagnosis, little evidence exists about the size of potential survival gains from eliminating inequalities in stage at diagnosis.METHODS: We used data on patients diagnosed with malignant melanoma in the East of England (2006-2010) to estimate the number of deaths that could be postponed by completely eliminating socioeconomic and sex differences in stage at diagnosis after fitting a flexible parametric excess mortality model.RESULTS: Stage was a strong predictor of survival. There were pronounced socioeconomic and sex inequalities in the proportion of patients diagnosed at stages III-IV (12 and 8% for least deprived men and women and 25 and 18% for most deprived men and women, respectively). For an annual cohort of 1025 incident cases in the East of England, eliminating sex and deprivation differences in stage at diagnosis would postpone approximately 24 deaths to beyond 5 years from diagnosis. Using appropriate weighting, the equivalent estimate for England would be around 215 deaths, representing 11% of all deaths observed within 5 years from diagnosis in this population.CONCLUSIONS: Reducing socioeconomic and sex inequalities in stage at diagnosis would result in substantial reductions in deaths within 5 years of a melanoma diagnosis.Cancer Research UKCancer Research UKNational Institute for Health Research (NIHR

Ambulatory blood pressure monitoring and morning surge in blood pressure in adult black and white South Africans

We examined whether there were differences in the circadian variation in blood pressure and the morning surge in blood pressure between black and white Africans. Clinic and ambulatory blood pressure data obtained from the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study was examined (n = 406; 49% black African). Ambulatory blood pressure readings were fitted to a six-parameter double logistic equation to determine the power and rate of the morning surge in blood pressure. Multiple linear regression analysis was used to examine differences in blood pressure between black and white participants. Clinic and ambulatory blood pressure were higher in black participants throughout the day and night. In those taking medications, blood pressure was less well controlled in black subjects. Despite the higher systolic blood pressure, the day-night difference estimated by the logistic function was similar in black and white participants. However, the rate of rise and power in the morning surge in blood pressure was lower in black participants. We conclude that black participants of the SABPA study present with higher blood pressure throughout the day and night but have a lower power of the morning surge in blood pressure due to a slower morning rate of increase. Moreover, they had an increased prevalence of undiagnosed hypertension and, in those taking medication, were less likely to have their blood pressure controlled than their white counterparts

An inventory of the South african fitness industry

Objective. The aim of this study was to create an inventory of fitness facilities in South Africa, their location, equipment and services offered, and the demographics, education and training of the staff working in these facilities. Design. A total of 750 facilities were identified, and descriptive data were gathered from 442 facilities (59%) with the use of a questionnaire administered telephonically and via the website of the Sports Science Institute of South Africa. Setting. The study was initiated by the Sports Science Institute, and the results were presented at the 4th Annual Discovery Vitality Fitness Convention on 4 May 2006. Results. Results show that the industry comprises mainly independent facilities (68%). All types of facilities were found to be located mostly within urban areas, and reported providing services to just less than 2% of the South African population. Facilities offer a wide range of equipment and services to their members. Of the fitness-related staff at facilities, the majority were reported to be young (18 - 25 years, 55% of male, and 49% of female staff), and in terms of racial proportions most staff were white (males 40% of total staff and females 33% of total staff).Less than a quarter of fitness-related staff hold university qualifications, and just over 80% of instructors hold qualifications aligned with the National Qualifications Framework. The importance of education and training of staff was emphasised by respondents. Conclusions. This report highlights the widespread value of assessing the fitness industry, particularly within the context of the rise of chronic diseases in South Africa and government initiatives to promote healthy lifestyles. South African Journal of Sports Medicine Vol. 18 (3) 2006: pp. 93-10

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Pregnancy is a stage of high vulnerability due to significant physical and psychological changes that occur rapidly. Depression during pregnancy(PMAD) is associated with negative events such as inadequate maternal nutrition, substance use, low birth weight, among others. The objective of this study was to describe the nutritional status (NS) and risk of depression in pregnant women in the city of Cordoba from December 2021 to June 2022. With the approval of the Institutional Ethics Committee for Health-related Research (CIEIS) of the Cordoba University Hospital for Maternity and Neonatal Care, a descriptive cross-sectional study was carried out in a sample of 65 pregnant women over 18 years of age attending public and private healthcare centers in Córdoba. Anthropometric measurements were taken to assess NS according to BMI/gestational age (Calvo et al., 2009), which was categorized into low weight, normal weight, overweight, and obesity. The self-administered questionnaire Edinburgh Postnatal Depression Scale (EPDS) was used to assess the risk of PMAD (with risk ≥13 points). The distribution of NS and PMAD risk was described and a comparison of proportions test was applied to assess possible differences in the occurrence of PMAD risk in each category of NS (significance level=0.05). Stata V17 software was used. The average age was 28 years old (DE 5). 27.7% were underweight, 10.8% overweight, and 1.5% obese. 23.1% of the women (n=15) were at risk of PMAD. 20.5% (n=8) of the women with an NS within the expected range and 22.2% of the women with low weight showed symptoms of PMAD. In women with some degree of excess weight, 37.5% showed risk of PMAD; however, these differences were not statistically significant (p>0.05). These results demonstrate that a significant percentage of women with depression symptoms and an NS outside of the expected range suggest a greater occurrence of PMAD risk in those who are overweightEl embarazo es una etapa de alta vulnerabilidad debido a los importantes cambios físicos y psíquicos que se producen a gran velocidad. La depresión durante el embarazo (DDE) se asocia a eventos negativos como inadecuada nutrición materna, consumo de sustancias, bajo peso al nacer, entre otros. El objetivo de este estudio fue describir el estado nutricional (EN) y el riesgo de depresión en mujeres embarazadas de la ciudad de Córdoba en el periodo diciembre 2021-junio 2022. Con la aprobación del CIEIS del Hospital Universitario de Maternidad y Neonatología, se realizó un estudio descriptivo de corte transversal en una muestra de 65 mujeres gestantes mayores de 18 años asistentes a centros de salud públicos y privados de Córdoba. Se tomaron medidas antropométricas para valorar el EN según IMC/edad gestacional (Calvo y cols, 2009) que fue categorizado en bajo peso, normopeso, sobrepeso y obesidad. Se utilizó el cuestionario autoadministrado "Escala de Depresión Perinatal de Edimburgo" para evaluar el riesgo de DDE (con riesgo≥13 puntos). Se describió la distribución del EN y del riesgo de DDE y se aplicó un test de comparación de proporciones para valorar posibles diferencias en la ocurrencia del riesgo de DDE en cada categoría de EN (nivel de significación=0,05). Se utilizó el software Stata V17. La edad promedio fue 28 años (DE 5). El 27,7% presentó bajo peso, el 10,8% sobrepeso y el 1,5% obesidad. Un 23,1% de las mujeres (n=15) se encontraba en riesgo de DDE. El 20,5% (n=8) de las mujeres con un EN dentro de lo esperado y el 22,2% de las mujeres con bajo peso, presentó síntomas de DDE. En las mujeres con algún grado de exceso de peso la proporción que evidenció riesgo de DDE fue de 37,5%, no obstante, estas diferencias no resultaron estadísticamente significativas (p>0,05). Estos resultados evidencian un porcentaje importante de mujeres con sintomatología depresiva y un EN por fuera de lo esperado y sugieren una mayor ocurrencia de riesgo de DDE en aquellas que presentan sobrepeso.

Fragment reattachment, reproductive status, and health indicators of the invasive colonial tunicate Didemnum vexillum with implications for dispersal

This manuscript is not subject to U.S. copyright. The definitive version was published in Biological Invasions 14 (2012): 2133-2140, doi:10.1007/s10530-012-0219-8.The invasive colonial tunicate Didemnum vexillum is now widespread in coastal and offshore waters of New England, USA. D. vexillum can inflict ecological and economic damage through biofouling and habitat modification. Natural and anthropogenic processes that fragment colonies of D. vexillum may be accelerating the spread of this invader. Reattachment success and fragment viability were confirmed in the laboratory after four weeks of suspension in experimental aquaria. The shape of suspended D. vexillum fragments progressed from flattened to globular spheres and then flattened again after reattachment to the substrate. Reproductive activity, confirmed by the presence of eggs and larvae, was observed for fragments suspended up to three weeks suggesting that D. vexillum is capable of reproducing while in a fragmented, suspended state. An index of colony health was used to monitor change in D. vexillum health while in suspension. Overall, colony health declined with time in suspension although colonies that appeared dead (black and gray in overall color) still contained a substantial number of healthy live zooids. These results suggest that activities that cause fragmentation can significantly facilitate the spread of D. vexillum. Coastal managers should consider reducing or eliminating, when practical, activities that return fragmented colonies of D. vexillum to the water. In-water cleaning of biofouling and dredging are likely expediting the spread of this invasive species unless biofouling can be contained and removed from the water.This research was funded by the NOAA Aquatic Invasive Species Program