Geography, private costs and uptake of screening for abdominal aortic aneurysm in a remote rural area.

Science.gov (United States)

Lindsay, Sandra M; Duncan, John L; Cairns, John; Godden, David J

2006-03-29

The relationship between geographical location, private costs, health provider costs and uptake of health screening is unclear. This paper examines these relationships in a screening programme for abdominal aortic aneurysm in the Highlands and Western Isles of Scotland, a rural and remote area of over 10,000 square miles. Men aged 65-74 (n = 9323) were invited to attend screening at 51 locations in 50 settlements. Effects of geography, deprivation and age on uptake were examined. Among 8,355 attendees, 8,292 completed a questionnaire detailing mode of travel and costs incurred, time travelled, whether accompanied, whether dependants were cared for, and what they would have been doing if not attending screening, thus allowing private costs to be calculated. Health provider (NHS) costs were also determined. Data were analysed by deprivation categories, using the Scottish Indices of Deprivation (2003), and by settlement type ranging from urban to very remote rural. Uptake of screening was high in all settlement types (mean 89.6%, range 87.4-92.6%). Non-attendees were more deprived in terms of income, employment, education and health but there was no significant difference between non-attendees and attendees in terms of geographical access to services. Age was similar in both groups. The highest private costs (median 7.29 pound sterling per man) and NHS screening costs (18.27 pound sterling per man invited) were observed in very remote rural areas. Corresponding values for all subjects were: private cost 4.34 pound sterling and NHS cost 15.72 pound sterling per man invited. Uptake of screening for abdominal aortic aneurysm in is remote and rural setting was high in comparison with previous studies, and this applied across all settlement types. Geographical location did not affect uptake, most likely due to the outreach approach adopted. Private and NHS costs were highest in very remote settings but still compared favourably with other published studies.

Geography, private costs and uptake of screening for abdominal aortic aneurysm in a remote rural area

Directory of Open Access Journals (Sweden)

Cairns John

2006-03-01

Full Text Available Abstract Background The relationship between geographical location, private costs, health provider costs and uptake of health screening is unclear. This paper examines these relationships in a screening programme for abdominal aortic aneurysm in the Highlands and Western Isles of Scotland, a rural and remote area of over 10,000 square miles. Methods Men aged 65–74 (n = 9323 were invited to attend screening at 51 locations in 50 settlements. Effects of geography, deprivation and age on uptake were examined. Among 8,355 attendees, 8,292 completed a questionnaire detailing mode of travel and costs incurred, time travelled, whether accompanied, whether dependants were cared for, and what they would have been doing if not attending screening, thus allowing private costs to be calculated. Health provider (NHS costs were also determined. Data were analysed by deprivation categories, using the Scottish Indices of Deprivation (2003, and by settlement type ranging from urban to very remote rural. Results Uptake of screening was high in all settlement types (mean 89.6%, range 87.4 – 92.6%. Non-attendees were more deprived in terms of income, employment, education and health but there was no significant difference between non-attendees and attendees in terms of geographical access to services. Age was similar in both groups. The highest private costs (median £7.29 per man and NHS screening costs (£18.27 per man invited were observed in very remote rural areas. Corresponding values for all subjects were: private cost £4.34 and NHS cost £15.72 per man invited. Conclusion Uptake of screening for abdominal aortic aneurysm in this remote and rural setting was high in comparison with previous studies, and this applied across all settlement types. Geographical location did not affect uptake, most likely due to the outreach approach adopted. Private and NHS costs were highest in very remote settings but still compared favourably with other published studies.

Prostate screening uptake in Australian BRCA1 and BRCA2 carriers

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McKinley Joanne M

2007-09-01

Full Text Available Abstract Men who carry mutations in BRCA1 or BRCA2 are at increased risk for prostate cancer. However the efficacy of prostate screening in this setting is uncertain and limited data exists on the uptake of prostate screening by mutation carriers. This study prospectively evaluated uptake of prostate cancer screening in a multi-institutional cohort of mutation carriers. Subjects were unaffected male BRCA1 and BRCA2 mutation carriers, aged 40–69 years, enrolled in the Kathleen Cuningham Consortium for Research into Familial Breast Cancer (kConFab and who had completed a mailed, self-report follow-up questionnaire 3 yearly after study entry. Of the 75 male carriers in this study, only 26 (35% had elected to receive their mutation result. Overall, 51 (68% did not recall having received a recommendation to have prostate screening because of their family history, but 41 (55% had undergone a prostate specific antigen (PSA test and 32 (43% a digital rectal examination (DRE in the previous 3 years. Those who were aware of their mutation result were more likely to have received a recommendation for prostate screening (43 vs. 6%, p = 0.0001, and to have had a PSA test (77 vs. 43%, p = 0.005 and a DRE (69 vs. 29%, p = 0.001 in the previous 3 years. The majority of unaffected males enrolled in kConFab with a BRCA1/2 mutation have not sought out their mutation result. However, of those aware of their positive mutation status, most have undergone at least one round of prostate screening in the previous 3 years.

A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach.

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Lake, Amelia J; Browne, Jessica L; Abraham, Charles; Tumino, Dee; Hines, Carolyn; Rees, Gwyneth; Speight, Jane

2018-05-31

Young adults (18-39 years) with type 2 diabetes are at risk of early development and rapid progression of diabetic retinopathy, a leading cause of vision loss and blindness in working-age adults. Retinal screening is key to the early detection of diabetic retinopathy, with risk of vision loss significantly reduced by timely treatment thereafter. Despite this, retinal screening rates are low among this at-risk group. The objective of this study was to develop a theoretically-grounded, evidence-based retinal screening promotion leaflet, tailored to young adults with type 2 diabetes. Utilising the six steps of Intervention Mapping, our multidisciplinary planning team conducted a mixed-methods needs assessment (Step 1); identified modifiable behavioural determinants of screening behaviour and constructed a matrix of change objectives (Step 2); designed, reviewed and debriefed leaflet content with stakeholders (Steps 3 and 4); and developed program implementation and evaluation plans (Steps 5 and 6). Step 1 included in-depth qualitative interviews (N = 10) and an online survey that recruited a nationally-representative sample (N = 227), both informed by literature review. The needs assessment highlighted the crucial roles of knowledge (about diabetic retinopathy and screening), perception of personal risk, awareness of the approval of significant others and engagement with healthcare team, on retinal screening intentions and uptake. In Step 2, we selected five modifiable behavioural determinants to be targeted: knowledge, attitudes, normative beliefs, intention, and behavioural skills. In Steps 3 and 4, the "Who is looking after your eyes?" leaflet was developed, containing persuasive messages targeting each determinant and utilising engaging, cohort-appropriate imagery. In Steps 5 and 6, we planned Statewide implementation and designed a randomised controlled trial to evaluate the leaflet. This research provides an example of a systematic, evidence

A closer look at cervical smear uptake and results pre- and post- introduction of the national screening programme.

LENUS (Irish Health Repository)

Gallagher, F

2012-02-01

Prior to the introduction of a national cervical screening programme, death rates from cervical cancer in the Republic of Ireland were greater than the death rates in all other regions in Britain and Northern Ireland. The following audit compares the impact of the national cervical screening programme, established on 1 September \\'08, on uptake and results per age group screened before and after its implementation. This retrospective audit was carried out in a four-doctor practice with approximately 1554 GMS and 5000 private patients. Data over a ten month period in \\'08\\/\\'09 was collected from the practice record of cervical smears and compared to the same period in \\'07\\/\\'08. A cohort of 534 Irish urban women was included. A total number of 148 women were screened between October 2007 and July 2008 compared with 386 women screened over the same months in 2008\\/2009. Increase in uptake was most marked in the 25-44 years age group, 100 (\\'07-\\'08) vs. 303 (\\'08-\\'09). The majority of results for both time periods were negative (85% 07\\/08, 81% 08\\/09). There was a higher number of HSIL in \\'08-\\'09 (an increase from 1% to 3.37% of the total screened). This audit clearly supports the introduction of the national cervical screening programme showing both an increase in uptake and a increased pick-up of high grade lesions.

Self-perceived Mental Health Status and Uptake of Fecal Occult Blood Test for Colorectal Cancer Screening in Canada: A Cross-Sectional Study

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Celestin Hategekimana

2016-06-01

Full Text Available Background: While colorectal cancer (CRC is one of the most preventable causes of cancer mortality, it is one of the leading causes of cancer death in Canada where CRC screening uptake is suboptimal. Given the increased rate of mortality and morbidity among mental health patients, their condition could be a potential barrier to CRC screening due to greater difficulties in adhering to behaviours related to long-term health goals. Using a population-based study among Canadians, we hypothesize that self-perceived mental health (SPMH status and fecal occult blood test (FOBT uptake for the screening of CRC are associated. Methods: The current study is cross-sectional and utilised data from the Canadian Community Health Survey 2011-2012. Multinomial logistic regression analysis was undertaken to assess whether SPMH is independently associated with FOBT uptake among a representative sample of 11386 respondents aged 50-74 years. Results: Nearly half of the respondents reported having ever had FOBT for CRC screening, including 37.28% who have been screened within two years of the survey and 12.41% who had been screened more than two years preceding the survey. Respondents who reported excellent mental health were more likely to have ever been screened two years or more before the survey (adjusted odds ratio [AOR] = 2.08; 95% CI, 1.00-4.43 and to have been screened in the last two years preceding the survey (AOR = 1.53; 95% CI, 0.86-2.71 than those reported poor mental health status. Conclusion: This study supports the association between SPMH status and FOBT uptake for CRC screening. While the efforts to maximize CRC screening uptake should be deployed to all eligible people, those with poor mental health may need more attention.

Barriers to uptake among high-risk individuals declining participation in lung cancer screening: a mixed methods analysis of the UK Lung Cancer Screening (UKLS) trial.

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Ali, Noor; Lifford, Kate J; Carter, Ben; McRonald, Fiona; Yadegarfar, Ghasem; Baldwin, David R; Weller, David; Hansell, David M; Duffy, Stephen W; Field, John K; Brain, Kate

2015-07-14

The current study aimed to identify the barriers to participation among high-risk individuals in the UK Lung Cancer Screening (UKLS) pilot trial. The UKLS pilot trial is a randomised controlled trial of low-dose CT (LDCT) screening that has recruited high-risk people using a population approach in the Cambridge and Liverpool areas. High-risk individuals aged 50-75 years were invited to participate in UKLS. Individuals were excluded if a LDCT scan was performed within the last year, if they were unable to provide consent, or if LDCT screening was unable to be carried out due to coexisting comorbidities. Statistical associations between individual characteristics and UKLS uptake were examined using multivariable regression modelling. In those who completed a non-participation questionnaire (NPQ), thematic analysis of free-text data was undertaken to identify reasons for not taking part, with subsequent exploratory linkage of key themes to risk factors for non-uptake. Comparative data were available from 4061 high-risk individuals who consented to participate in the trial and 2756 who declined participation. Of those declining participation, 748 (27.1%) completed a NPQ. Factors associated with non-uptake included: female gender (OR=0.64, pemotional barriers. Smokers were more likely to report emotional barriers to participation. A profile of risk factors for non-participation in lung screening has emerged, with underlying reasons largely relating to practical and emotional barriers. Strategies for engaging high-risk, hard-to-reach groups are critical for the equitable uptake of a potential future lung cancer screening programme. The UKLS trial was registered with the International Standard Randomised Controlled Trial Register under the reference 78513845. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Exploring the uptake and framing of research evidence on universal screening for intimate partner violence against women: a knowledge translation case study.

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Wathen, C Nadine; Macgregor, Jennifer Cd; Sibbald, Shannon L; Macmillan, Harriet L

2013-04-12

Significant emphasis is currently placed on the need to enhance health care decision-making with research-derived evidence. While much has been written on specific strategies to enable these "knowledge-to-action" processes, there is less empirical evidence regarding what happens when knowledge translation (KT) processes do not proceed as planned. The present paper provides a KT case study using the area of health care screening for intimate partner violence (IPV). A modified citation analysis method was used, beginning with a comprehensive search (August 2009 to October 2012) to capture scholarly and grey literature, and news reports citing a specific randomized controlled trial published in a major medical journal on the effectiveness of screening women, in health care settings, for exposure to IPV. Results of the searches were extracted, coded and analysed using a multi-step mixed qualitative and quantitative content analysis process. The trial was cited in 147 citations from 112 different sources in journal articles, commentaries, books, and government and news reports. The trial also formed part of the evidence base for several national-level practice guidelines and policy statements. The most common interpretations of the trial were "no benefit of screening", "no harms of screening", or both. Variation existed in how these findings were represented, ranging from summaries of the findings, to privileging one outcome over others, and to critical qualifications, especially with regard to methodological rigour of the trial. Of note, interpretations were not always internally consistent, with the same evidence used in sometimes contradictory ways within the same source. Our findings provide empirical data on the malleability of "evidence" in knowledge translation processes, and its potential for multiple, often unanticipated, uses. They have implications for understanding how research evidence is used and interpreted in policy and practice, particularly in

[Breast cancer screening in Austria: Key figures, age limits, screening intervals and evidence].

Science.gov (United States)

Jeitler, Klaus; Semlitsch, Thomas; Posch, Nicole; Siebenhofer, Andrea; Horvath, Karl

2015-01-01

In January 2014, the first nationwide quality-assured breast cancer screening program addressing women aged ≥ 40 years was introduced in Austria. As part of the process of developing a patient information leaflet, the Evidence Based Medicine (EBM) Review Center of the Medical University of Graz was charged with the task of assessing the potential benefits and harms of breast cancer screening from the available evidence. Based on these results, key figures were derived for mortality, false-positive and false-negative mammography results, and overdiagnosis, considering Austria-specific incidence rates for breast cancer and breast cancer mortality. Furthermore, the current evidence regarding age limits and screening interval, which were the subjects of controversial public discussions, was analyzed. A systematic search for primary and secondary literature was performed and additional evidence was screened, e. g., evaluation reports of European breast cancer screening programs. On the basis of the available evidence and of the Austrian breast cancer mortality and incidence rates, it can be assumed that - depending on the age group - 1 to 4 breast cancer deaths can be avoided per 1,000 women screened in a structured breast cancer screening program, while the overall mortality remains unchanged. On the other hand, 150 to 200 of these 1,000 women will be affected by false-positive results and 1 to 9 women by overdiagnosis due to the structured breast cancer screening. Therefore, the overall benefit-harm balance is uncertain. If women from 40 to 44 or above 70 years of age are considered, who can also participate in the Austrian screening program, even a negative benefit-harm balance seems possible. However, with the implementation of quality standards in breast cancer screening and the dissemination of a patient information leaflet, an improvement in the medical treatment situation, specifically in terms of informed decision-making, can be expected. Copyright © 2015

Lay health educators within primary care practices to improve cancer screening uptake for South Asian patients: challenges in quality improvement

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Lofters AK

2017-03-01

Full Text Available AK Lofters,1–4 M Vahabi,5 V Prakash,6 L Banerjee,7 P Bansal,8 S Goel,7,8 S Dunn1,2,9 1Department of Family and Community Medicine, 2Dalla Lana School of Public Health, University of Toronto, 3Department of Family and Community Medicine, 4Centre for Urban Health Solutions, St Michael’s Hospital, 5Daphne Cockwell School of Nursing, Ryerson University, Toronto, 6Screening Saves Lives Program, Canadian Cancer Society, Mississauga, 7Wise Elephant Family Health Team, Brampton, 8Mississauga Halton Central West Regional Cancer Program, Mississauga, 9Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada Background: Cancer screening uptake is known to be low among South Asian residents of Ontario. The objective of this pilot study was to determine if lay health educators embedded within the practices of primary care providers could improve willingness to screen and cancer screening uptake for South Asian patients taking a quality improvement approach.Materials and methods: Participating physicians selected quality improvement initiatives to use within their offices that they felt could increase willingness to screen and cancer screening uptake. They implemented initiatives, adapting as necessary, for six months.Results: Four primary care physicians participated in the study. All approximated that at least 60% of their patients were of South Asian ethnicity. All physicians chose to work with a preexisting lay health educator program geared toward South Asians. Health ambassadors spoke to patients in the office and telephoned patients. For all physicians, ~60% of South Asian patients who were overdue for cancer screening and who spoke directly to health ambassadors stated they were willing to be screened. One physician was able to track actual screening among contacted patients and found that screening uptake was relatively high: from 29.2% (colorectal cancer to 44.6% (breast cancer of patients came in for screening

Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

International Nuclear Information System (INIS)

Idowu, A.; Olowookere, S. A.; Fagbemi, A.T.; Ogunlaja, O. A.

2016-01-01

Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at P<0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, P= 0.001), respondents who were aware of the disease (100.0%, p=0.001), and those who were aware of cervical cancer screening (88.9%, P=0.001). Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.0-0.28). Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.

Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

Directory of Open Access Journals (Sweden)

Ajibola Idowu

2016-01-01

Full Text Available Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p<0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, p=0.001, respondents who were aware of the disease (100.0%, p=0.001, and those who were aware of cervical cancer screening (88.9%, p=0.001. Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01–0.28. Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.

Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review

Science.gov (United States)

Islam, Rakibul M; Billah, Baki; Hossain, Md Nassif; Oldroyd, John

2017-07-27

Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs. Creative Commons Attribution License

Evidence-based medicine: the value of vision screening.

Science.gov (United States)

Beauchamp, George R; Ellepola, Chalani; Beauchamp, Cynthia L

2010-01-01

To review the literature for evidence-based medicine (EBM), to assess the evidence for effectiveness of vision screening, and to propose moving toward value-based medicine (VBM) as a preferred basis for comparative effectiveness research. Literature based evidence is applied to five core questions concerning vision screening: (1) Is vision valuable (an inherent good)?; (2) Is screening effective (finding amblyopia)?; (3) What are the costs of screening?; (4) Is treatment effective?; and (5) Is amblyopia detection beneficial? Based on EBM literature and clinical experience, the answers to the five questions are: (1) yes; (2) based on literature, not definitively so; (3) relatively inexpensive, although some claim benefits for more expensive options such as mandatory exams; (4) yes, for compliant care, although treatment processes may have negative aspects such as "bullying"; and (5) economic productive values are likely very high, with returns of investment on the order of 10:1, while human value returns need further elucidation. Additional evidence is required to ascertain the degree to which vision screening is effective. The processes of screening are multiple, sequential, and complicated. The disease is complex, and good visual outcomes require compliance. The value of outcomes is appropriately analyzed in clinical, human, and economic terms.

Nutrition screening tools: an analysis of the evidence.

Science.gov (United States)

Skipper, Annalynn; Ferguson, Maree; Thompson, Kyle; Castellanos, Victoria H; Porcari, Judy

2012-05-01

In response to questions about tools for nutrition screening, an evidence analysis project was developed to identify the most valid and reliable nutrition screening tools for use in acute care and hospital-based ambulatory care settings. An oversight group defined nutrition screening and literature search criteria. A trained analyst conducted structured searches of the literature for studies of nutrition screening tools according to predetermined criteria. Eleven nutrition screening tools designed to detect undernutrition in patients in acute care and hospital-based ambulatory care were identified. Trained analysts evaluated articles for quality using criteria specified by the American Dietetic Association's Evidence Analysis Library. Members of the oversight group assigned quality grades to the tools based on the quality of the supporting evidence, including reliability and validity data. One tool, the NRS-2002, received a grade I, and 4 tools-the Simple Two-Part Tool, the Mini-Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Screening Tool (MST), and Malnutrition Universal Screening Tool (MUST)-received a grade II. The MST was the only tool shown to be both valid and reliable for identifying undernutrition in the settings studied. Thus, validated nutrition screening tools that are simple and easy to use are available for application in acute care and hospital-based ambulatory care settings.

A cluster randomized trial of strategies to increase uptake amongst young women invited for their first cervical screen: The STRATEGIC trial.

Science.gov (United States)

Kitchener, H; Gittins, M; Cruickshank, M; Moseley, C; Fletcher, S; Albrow, R; Gray, A; Brabin, L; Torgerson, D; Crosbie, E J; Sargent, A; Roberts, C

2018-06-01

Objectives To measure the feasibility and effectiveness of interventions to increase cervical screening uptake amongst young women. Methods A two-phase cluster randomized trial conducted in general practices in the NHS Cervical Screening Programme. In Phase 1, women in practices randomized to intervention due for their first invitation to cervical screening received a pre-invitation leaflet and, separately, access to online booking. In Phase 2, non-attenders at six months were randomized to one of: vaginal self-sample kits sent unrequested or offered; timed appointments; nurse navigator; or the choice between nurse navigator or self-sample kits. Primary outcome was uplift in intervention vs. control practices, at 3 and 12 months post invitation. Results Phase 1 randomized 20,879 women. Neither pre-invitation leaflet nor online booking increased screening uptake by three months (18.8% pre-invitation leaflet vs. 19.2% control and 17.8% online booking vs. 17.2% control). Uptake was higher amongst human papillomavirus vaccinees at three months (OR 2.07, 95% CI 1.69-2.53, p < 0.001). Phase 2 randomized 10,126 non-attenders, with 32-34 clusters for each intervention and 100 clusters as controls. Sending self-sample kits increased uptake at 12 months (OR 1.51, 95% CI 1.20-1.91, p = 0.001), as did timed appointments (OR 1.41, 95% CI 1.14-1.74, p = 0.001). The offer of a nurse navigator, a self-sample kits on request, and choice between timed appointments and nurse navigator were ineffective. Conclusions Amongst non-attenders, self-sample kits sent and timed appointments achieved an uplift in screening over the short term; longer term impact is less certain. Prior human papillomavirus vaccination was associated with increased screening uptake.

Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers.

Science.gov (United States)

Nazzal, Zaher; Sholi, Hisham; Sholi, Suha; Sholi, Mohammad; Lahaseh, Rawya

2016-01-01

Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other

Genome-wide RNAi screen reveals ALK1 mediates LDL uptake and transcytosis in endothelial cells

Science.gov (United States)

Kraehling, Jan R.; Chidlow, John H.; Rajagopal, Chitra; Sugiyama, Michael G.; Fowler, Joseph W.; Lee, Monica Y.; Zhang, Xinbo; Ramírez, Cristina M.; Park, Eon Joo; Tao, Bo; Chen, Keyang; Kuruvilla, Leena; Larriveé, Bruno; Folta-Stogniew, Ewa; Ola, Roxana; Rotllan, Noemi; Zhou, Wenping; Nagle, Michael W.; Herz, Joachim; Williams, Kevin Jon; Eichmann, Anne; Lee, Warren L.; Fernández-Hernando, Carlos; Sessa, William C.

2016-01-01

In humans and animals lacking functional LDL receptor (LDLR), LDL from plasma still readily traverses the endothelium. To identify the pathways of LDL uptake, a genome-wide RNAi screen was performed in endothelial cells and cross-referenced with GWAS-data sets. Here we show that the activin-like kinase 1 (ALK1) mediates LDL uptake into endothelial cells. ALK1 binds LDL with lower affinity than LDLR and saturates only at hypercholesterolemic concentrations. ALK1 mediates uptake of LDL into endothelial cells via an unusual endocytic pathway that diverts the ligand from lysosomal degradation and promotes LDL transcytosis. The endothelium-specific genetic ablation of Alk1 in Ldlr-KO animals leads to less LDL uptake into the aortic endothelium, showing its physiological role in endothelial lipoprotein metabolism. In summary, identification of pathways mediating LDLR-independent uptake of LDL may provide unique opportunities to block the initiation of LDL accumulation in the vessel wall or augment hepatic LDLR-dependent clearance of LDL. PMID:27869117

A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

OpenAIRE

Lu Mingshan; Moritz Sabina; Lorenzetti Diane; Sykes Lindsay; Straus Sharon; Quan Hude

2012-01-01

Abstract Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing interve...

Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study.

Science.gov (United States)

Nazzal, Zaher; Sholi, Hisham; Sholi, Suha B; Sholi, Mohammad B; Lahaseh, Rawya

2018-02-21

Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. This cross-sectional study included all governmental primary health-care centres in the West Bank. Governorates were grouped into three regions as follows: north West Bank (Nablus, Jenin, Tulkarm, Tubas, Qalqiliya, and Salfit), middle West Bank (Jerusalem, Jericho, and Ramallah), and south West Bank (Hebron, and Bethlehem). The study population included all female health-care workers older than 40 years. Those who performed mammography for a suspected mass or other breast abnormalities were excluded. A self-administered questionnaire was used to collect data on demographic characteristics, knowledge about mammography screening, the extent and regularity of mammography screening, and motivators and barriers influencing their mammography screening uptake. The rate of mammography screening uptake was calculated. χ 2 test and t tests were used to assess screening motivators and barriers. The study was approved by the Institutional Review Board of the An-Najah National University. Participation was voluntary, and written consent was obtained from each participant. 299 female health-care workers completed a self-administered questionnaire. The mean age of the participants was 46 years (SD 4·7). 284 (95%) women had adequate knowledge about breast cancer and mammography screening, and 149 (50%) women reported having had at least one mammogram. 62 (21%) women had had regular scheduled mammograms. The most frequent reported motivators were the perceived benefit that early detection of breast cancer is important for its management (269 [90

Explaining variation in the uptake of HPV vaccination in England

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Whynes David K

2011-03-01

Full Text Available Abstract Background In England, two national programmes of HPV vaccination for girls have been instituted, a routine programme for 12- and 13-year-olds and a catch-up programme for 17- and 18-year-olds. Uptake rates across the country have been far from uniform, and this research sought to identify factors explaining the variation in uptake by locality. Methods An association between uptake, deprivation and ethnic background had been established in pilot research. The present analysis was conducted at an aggregate, Primary Care Trust (PCT, level for the first year of the programmes. Published measures of HPV vaccination uptake, material deprivation, ethnic composition of PCT populations, primary care quality, and uptake of cervical screening and of other childhood immunisations were collated. Strong evidence of collinearity amongst the explanatory variables required a factor analysis to be undertaken. This provided four independent factors, used thereafter in regression models to explain uptake by PCT. Results The factor analysis revealed that ethnic composition was associated with attitudes towards cervical screening and other childhood vaccinations, whilst material deprivation and quality of primary care were orthogonal. Ethnic composition, early childhood vaccination, cervical screening and primary care quality were found to be influential in predicting uptake in both the routine and the catch-up cohorts, although with a lower degree of confidence in the case of the last two independent variables. Lower primary care quality was significant in explaining a greater fall in vaccination uptake between the first two doses in the catch-up cohort. Greater deprivation was a significant explanatory factor for both uptake and the fall in uptake between doses for the catch-up cohort but not for uptake in the routine cohort. Conclusion These results for uptake of the first year of the national programme using aggregate data corroborate findings from

The Lung Screen Uptake Trial (LSUT): protocol for a randomised controlled demonstration lung cancer screening pilot testing a targeted invitation strategy for high risk and 'hard-to-reach' patients.

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Quaife, Samantha L; Ruparel, Mamta; Beeken, Rebecca J; McEwen, Andy; Isitt, John; Nolan, Gary; Sennett, Karen; Baldwin, David R; Duffy, Stephen W; Janes, Samuel M; Wardle, Jane

2016-04-20

Participation in low-dose CT (LDCT) lung cancer screening offered in the trial context has been poor, especially among smokers from socioeconomically deprived backgrounds; a group for whom the risk-benefit ratio is improved due to their high risk of lung cancer. Attracting high risk participants is essential to the success and equity of any future screening programme. This study will investigate whether the observed low and biased uptake of screening can be improved using a targeted invitation strategy. A randomised controlled trial design will be used to test whether targeted invitation materials are effective at improving engagement with an offer of lung cancer screening for high risk candidates. Two thousand patients aged 60-75 and recorded as a smoker within the last five years by their GP, will be identified from primary care records and individually randomised to receive either intervention invitation materials (which take a targeted, stepped and low burden approach to information provision prior to the appointment) or control invitation materials. The primary outcome is uptake of a nurse-led 'lung health check' hospital appointment, during which patients will be offered a spirometry test, an exhaled carbon monoxide (CO) reading, and an LDCT if eligible. Initial data on demographics (i.e. age, sex, ethnicity, deprivation score) and smoking status will be collected in primary care and analysed to explore differences between attenders and non-attenders with respect to invitation group. Those who attend the lung health check will have further data on smoking collected during their appointment (including pack-year history, nicotine dependence and confidence to quit). Secondary outcomes will include willingness to be screened, uptake of LDCT and measures of informed decision-making to ensure the latter is not compromised by either invitation strategy. If effective at improving informed uptake of screening and reducing bias in participation, this invitation

Uptake of Cervical Cancer Screening and Associated Factors among Women in Rural Uganda: A Cross Sectional Study.

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Rawlance Ndejjo

Full Text Available In developing countries, inadequate access to effective screening for cervical cancer often contributes to the high morbidity and mortality caused by the disease. The largest burden of this falls mostly on underserved populations in rural areas, where health care access is characterized by transport challenges, ill equipped health facilities, and lack of information access. This study assessed uptake of cervical cancer screening and associated factors among women in rural Uganda.This descriptive cross sectional study was carried out in Bugiri and Mayuge districts in eastern Uganda and utilised quantitative data collection methods. Data were collected using a semi-structured questionnaire on cervical cancer screening among females aged between 25 and 49 years who had spent six or more months in the area. Data were entered in Epidata 3.02 and analysed in STATA 12.0 statistical software. Univariate, bivariate and multivariate analyses were performed.Of the 900 women, only 43 (4.8% had ever been screened for cervical cancer. Among respondents who were screened, 21 (48.8% did so because they had been requested by a health worker, 17 (39.5% had certain signs and symptoms they associated with cervical cancer while 16 (37.2% did it voluntarily to know their status. Barriers to cervical cancer screening were negative individual perceptions 553 (64.5% and health facility related challenges 142 (16.6%. Other respondents said they were not aware of the screening service 416 (48.5%. The independent predictors of cervical cancer screening were: being recommended by a health worker [AOR = 87.85, p<0.001], knowing where screening services were offered [AOR = 6.24, p = 0.004], and knowing someone who had ever been screened [AOR = 9.48, p = 0.001].The prevalence of cervical cancer screening is very low in rural Uganda. Interventions to increase uptake of cervical cancer screening should be implemented so as to improve access to the service in rural areas.

A community-based trial of educational interventions with fecal immunochemical tests for colorectal cancer screening uptake among blacks in community settings.

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Christy, Shannon M; Davis, Stacy N; Williams, Kimberly R; Zhao, Xiuhua; Govindaraju, Swapomthi K; Quinn, Gwendolyn P; Vadaparampil, Susan T; Lin, Hui-Yi; Sutton, Steven K; Roethzeim, Richard R; Shibata, David; Meade, Cathy D; Gwede, Clement K

2016-11-15

Intervention studies among individuals in diverse community settings are needed to reduce health disparities in colorectal cancer (CRC) screening and mortality rates. The current study compared the efficacy of 2 intervention conditions promoting CRC screening among black individuals. Black individuals ages 50 to 75 years (N = 330) were recruited in community settings in 4 Tampa Bay counties. After obtaining consent and conducting a baseline interview to assess sociodemographic and health-related variables, participants received either a culturally targeted CRC photonovella booklet plus a fecal immunochemical test (FIT) kit or a standard CRC screening brochure plus an FIT kit. The primary outcome was FIT kit screening uptake. FIT screening uptake at 6 months was 86.7% overall (90.3% in the brochure group and 81.9% in the photonovella group). Controlling for baseline between-group differences, there was no influence of intervention on FIT kit uptake (P = .756). Significant predictors of not returning an FIT kit included being unable to work (P = .010), having higher religious belief scores (P = .015), and living farther from the cancer center (P = .015). Providing FIT kits and educational print materials to black individuals in community settings resulted in high rates of CRC screening. The study also identified subgroups of participants who were less likely to return an FIT kit and provides insight for future interventions. Cancer 2016;122:3288-3296. © 2016 American Cancer Society. © 2016 American Cancer Society.

Determinants of Uptake of Cervical Cancer Screening Services at a No-cost Reproductive Health Clinic Managed by Nurse-Midwives.

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Osingada, Charles P; Ninsiima, Gloria; Chalo, Rose N; Muliira, Joshua K; Ngabirano, Tom

2015-01-01

The incidence of cervical cancer (CC) has been rising in sub-Saharan Africa, and health authorities in this region have responded by increasing the availability of cheap or no-cost CC screening services (CCSS), public health education, and others. However, the efforts have not yet resulted into the expected uptake of CCSS. The aim of this study was to examine the determinants of uptake of CCSS at a no-cost reproductive health clinic managed by nurse-midwives. A descriptive design and a structured interview questionnaire were used to collect data from 236 women attending the reproductive health clinic. Logistic regression statistics were used to examine the determinants of uptake of CCSS. The mean age of participants was 28.7 years, and only 29% had received CC screening. The significant determinants of uptake of CCSS were concern about the gender of the healthcare professional (HCP) (odds ratio [OR], 5.03; P = .001), age older than 25 years (OR, 3.09; P = .005), contraceptive use (OR, 0.28; P = .02), encouragement by HCPs (OR, 0.16; P = .00), and perceived quality of CCSS (OR, 0.08; P = .00). Gender of the HCP and encouragement or reminders by the HCP influence uptake of CCSS. Because nurse-midwives have successfully led strategies to promote other integrated reproductive health services, they can also play a key role in enhancing uptake of CCSS in resource-poor settings. Interventions to enhance service quality and deliberate policies requiring HCP to recommend encourage and remind clients may help to enhance uptake of CCSS in resource-poor settings.

Explaining low uptake for Down syndrome screening in the Netherlands : (and predicting utilisation of other programmes)

NARCIS (Netherlands)

Crombag, NMTH

2016-01-01

In the Netherlands, only a quarter of all pregnant women take part in the current Down syndrome screening(DSS) programme. Compared to other Northern European countries, Dutch uptake rates are very low. This thesis concentrates on the test-utilisation of DSS, in particular the factors impeding or

Cancer risk awareness and screening uptake in individuals at higher risk for colon cancer: a cross-sectional study.

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Salimzadeh, Hamideh; Bishehsari, Faraz; Delavari, Alireza; Barzin, Gilda; Amani, Mohammad; Majidi, Azam; Sadjadi, Alireza; Malekzadeh, Reza

2016-12-20

We aimed to measure cancer knowledge and feasibility of a screening colonoscopy among a cohort of individuals at higher risk of colon cancer. This study was conducted as part of an ongoing screening cohort, in which first degree relatives (FDRs) of patients with colon cancer are invited to participate in a free of charge screening colonoscopy. We enrolled 1017 FDRs in the study between 2013 and 2014 measuring their data on demographics, cancer knowledge and colonoscopy uptake. A p value of aware of their increased risk for cancer, near 35.0% had ever heard about colonoscopy with 22% aware of the correct age to start screening. Comparing cancer knowledge of FDRs at high risk versus those at moderate risk, we recorded non-significant differences (p>0.05). Almost two-thirds of FDRs expressed willingness to undergo a colonoscopy and 49.2% completed the procedure, of which 12.8% had advanced neoplasm. Our data indicated that remarkable numbers of FDRs were not still informed of their cancer risk or never received a physician recommendation for screening. The desirable uptake at first invitation, which would be higher over successive invitations, supports the feasibility of a family-based recruitment approach for early screening. This has promising implications to introduce targeted screening colonoscopy into the healthcare system in Iran and other developing nations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The role of learning disability nurses in promoting cervical screening uptake in women with intellectual disabilities: A qualitative study.

Science.gov (United States)

Lloyd, Jennifer L; Coulson, Neil S

2014-06-01

Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women with intellectual disabilities to access cervical screening in order to examine their role in promoting attendance and elucidate potential barriers and facilitators to uptake. Ten participants recruited from a specialist learning disability service completed a semi-structured interview and data were analysed using experiential thematic analysis. Identified individual barriers included limited health literacy, negative attitudes and beliefs and competing demands; barriers attributed to primary care professionals included time pressures, limited exposure to people with intellectual disabilities and lack of appropriate knowledge, attitudes and skills. Attendance at cervical screening was facilitated by prolonged preparation work undertaken by learning disability nurses, helpful clinical behaviours in the primary care context and effective joint working. © The Author(s) 2014.

Hepatic FDG Uptake is not associated with hepatic steatosis but with visceral fat volume in cancer screening

International Nuclear Information System (INIS)

Pak, Kyoung June; Kim, Seong Jang; Kim, In Joo; Kin, Keun Young; Kim, Hee Young; Kim, So Jung

2012-01-01

We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG)uptake of the liver measured by maximum or mean standardized uptake value. We retrospectively analyzed 96 consecutive records of positron emission tomography/computed tomography (PET/CT)performed for cancer screening between May 2011 and December 2011. Subjects were divided into 2 groups according to Hounsfield unit (HU)of the liver comparing with that of the spleen. The control group (20 women, 56 men)demonstrating HU of the liver equal or greater than that of the spleen included 76 patients, while the fatty liver group (2 Women, 18 men)showing HU of the liver less than that of the spleen included 20 patients. We compared FDG uptake of the liver and visceral fat volume between two groups. We evaluated correlation of hepatic FDG uptake measured by maximum or mean standardized uptake value (SUV)with visceral fat volume and attenuation. The fatty liver disease group showed higher aspartate aminotransferase (AST)of (24.42±7.22, p=0.012), alanine aminotransferase (ALT)of (25.16±11.68, p=0.011), body mass index (BMI)of (24.58±3.29, p=0.021), and visceral fat volume (3063.53±1561.42, p=0.011)than the control group. There were no statistically significant differences of mean standardized uptake value of the liver (liver SUV mean )(2.73±0.19, p=0.723), maximum standardized uptake value of the liver (liver SUV max )(3.39±0.53, p=0.8248)and liver SUV mean /spleen SUV mean (1.13±0.10, p=0.081)between the two groups. Strong correlations were shown between liver SUV mean and BMI (r=0.609, p mean and visceral fat volume (r=0.457, p max was also strongly correlated with BMI (r=0.622, p=0.001)and visceral fat volume (r=0.547, p mean )with liver SUV mean (r=0.003, p=0.979)or liver SUV max (r=-0.120, p=0.244). Hepatic FDG uptake quantified as SUV mean of SUV max is not correlated with hepatic steatosis but with visceral fat volume in cancer screening

Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

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Mirembe Florence

2007-06-01

Full Text Available Abstract Background Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. Methods We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers. We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Results Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Conclusion Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas and involve them in the awareness campaign. Cultural and economic

A Comparison of Colorectal Cancer Screening Uptake Among Average-Risk Insured American Indian/Alaska Native and White Women

Science.gov (United States)

Perdue, David G.; Chubak, Jessica; Bogart, Andy; Dillard, Denise A.; Garroutte, Eva Marie; Buchwald, Dedra

2014-01-01

Introduction American Indian and Alaska Native (AI/AN) women have among the lowest rates of colorectal cancer (CRC) screening. Whether screening disparities persist with equal access to health care is unknown. Methods Using administrative data from 1996-2007, we compared CRC screening events for 286 AI/AN and 14,042 White women aged 50 years and older from a health maintenance organization in the Pacific Northwest of the U.S. Results The proportion of AI/AN and White women screened for CRC at age 50 was similar (13.3% vs. 14.0%, p =.74). No differences were seen in the type of screening test. Time elapsed to first screening among AI/AN women who were not screened at age 50 did not differ from White women (hazard ratio 1.0, 95% confidence interval 0.8-1.3). Conclusions Uptake for CRC screening was similar among insured AI/AN and White women, suggesting that when access to care is equal, racial disparities in screening diminish. PMID:23974386

Evaluating the evidence: direct-to-consumer screening tests advertised online.

Science.gov (United States)

Lovett, Kimberly M; Mackey, Timothy K; Liang, Bryan A

2012-09-01

Unsupervised online direct-to-consumer (DTC) access to medical services has rapidly expanded to medical screening tests, which have not been critically evaluated for their evidence basis. The objective of this study is to identify the scope of online-advertised DTC screening tests, outline the evidence for use of available DTC testing and suggest regulatory reform to address the relevant issues. An observational study of website advertisements, testing services and counselling/follow-up services for DTC testing was conducted. Data were collected from websites between 4 April and 1 June 2011. Each website was assessed for tests offered, advertised indications and availability of counselling/follow-up services. Advertised testing indications were compared with US Preventive Services Task Force recommendations and/or specialty guidelines and categorized as Supported, Against, Insufficient Evidence or No Guidance. Of 20 companies identified as offering DTC screening tests, 95% (19/20) do not clearly offer pretest counselling, post-test counselling and/or test follow-up. One hundred and twenty-seven different tests were identified. Only 19/127 (15%) could be Supported for screening in a target group selected for testing; 38/127 (30%) were given recommendations to avoid use in specific target group(s) selected for testing ('Against recommendations'); 29/127 (23%) had Insufficient Evidence of value, and for 64/127 (50%) No Guidance could be given. Only 4/127 (3%) tests were Supported for general screening use. Virtually all identified medical tests advertised and offered DTC are not recommended for use in screening by evidence-based guidelines. Limited oversight may lead to inaccurate self-diagnosis, treatment and wasted health resources.

Hepatic FDG Uptake is not associated with hepatic steatosis but with visceral fat volume in cancer screening

Energy Technology Data Exchange (ETDEWEB)

Pak, Kyoung June; Kim, Seong Jang; Kim, In Joo; Kin, Keun Young; Kim, Hee Young; Kim, So Jung [Pusan National Univ. Hospital, Busan (Korea, Republic of)

2012-09-15

We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG)uptake of the liver measured by maximum or mean standardized uptake value. We retrospectively analyzed 96 consecutive records of positron emission tomography/computed tomography (PET/CT)performed for cancer screening between May 2011 and December 2011. Subjects were divided into 2 groups according to Hounsfield unit (HU)of the liver comparing with that of the spleen. The control group (20 women, 56 men)demonstrating HU of the liver equal or greater than that of the spleen included 76 patients, while the fatty liver group (2 Women, 18 men)showing HU of the liver less than that of the spleen included 20 patients. We compared FDG uptake of the liver and visceral fat volume between two groups. We evaluated correlation of hepatic FDG uptake measured by maximum or mean standardized uptake value (SUV)with visceral fat volume and attenuation. The fatty liver disease group showed higher aspartate aminotransferase (AST)of (24.42{+-}7.22, p=0.012), alanine aminotransferase (ALT)of (25.16{+-}11.68, p=0.011), body mass index (BMI)of (24.58{+-}3.29, p=0.021), and visceral fat volume (3063.53{+-}1561.42, p=0.011)than the control group. There were no statistically significant differences of mean standardized uptake value of the liver (liver SUV{sup mean})(2.73{+-}0.19, p=0.723), maximum standardized uptake value of the liver (liver SUV{sup max})(3.39{+-}0.53, p=0.8248)and liver SUV{sup mean}/spleen SUV{sup mean}(1.13{+-}0.10, p=0.081)between the two groups. Strong correlations were shown between liver SUV{sup mean} and BMI (r=0.609, p<0.001)and between liver SUV{sup mean} and visceral fat volume (r=0.457, p<0.001). Liver SUV{sup max} was also strongly correlated with BMI (r=0.622, p=0.001)and visceral fat volume (r=0.547, p<0.001). There was no significant association of mean attenuation value of the liver (liver HU{sup mean})with liver SUV{sup mean} (r=0.003, p=0.979)or liver SUV{sup max} (r

Uptake of a colorectal cancer screening blood test in people with elevated risk for cancer who cannot or will not complete a faecal occult blood test.

Science.gov (United States)

Symonds, Erin L; Cock, Charles; Meng, Rosie; Cole, Stephen R; Fraser, Robert J L; Young, Graeme P

2017-03-31

Participation rates in colorectal cancer (CRC) screening programmes using faecal occult blood tests (FOBTs) are low. Nonparticipation is commonly attributed to psychosocial factors, but some medical conditions also prevent screening. These barriers might be partially overcome if a blood test for CRC screening was available. This study determined whether people who had always declined screening by FOBT would participate if offered a blood test. An audit of registrants within a personalized CRC screening programme was undertaken to determine the reasons for regular nonparticipation in FOBT. Consistent nonparticipants (n=240) were randomly selected and invited for CRC screening with a blood test. Demographic characteristics and the reasons for prior FOBT nonparticipation were collected by means of a questionnaire. Nonparticipation in the screening programme could be classified as either behavioural (8.6%), with consistent noncompliance, or due to medical contraindications (8.5%), which included chronic rectal bleeding, being deemed unsuitable by a health professional, and needing personal assistance. Blood test uptake was 25%, with participation in the medical contraindications group greater than that in the behavioural group (43 vs. 12%, Pprocrastination and dislike of the test, but these were not associated with blood test uptake (P>0.05). There is a subgroup of the community who have medical reasons for nonparticipation in CRC screening with FOBT but will participate if offered a blood test. The option of a blood test does not, however, improve uptake in those who admit to behavioural reasons for noncompliance with screening.

Thyroid Scan and Uptake

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Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses ...

Changes in geographic variation in the uptake of cervical cancer screening in Taiwan: possible effects of "leadership style factor"?

Science.gov (United States)

Chiou, Shu-Ti; Lu, Tsung-Hsueh

2014-01-01

Wennberg proposed the "practice style factor" to explain the large variations in the use of medical care. As a corollary, we propose the "leadership style factor" of the director of the city/county bureau of public health to explain changes in geographic variation in the uptake of cervical cancer screening. We first calculated the triennial Pap smear rates for women aged 30-69 years from 1997 through 2010 for each city/county in Taiwan and the rate difference and rate ratio between the highest and the lowest city/county to illustrate the geographic variation in the uptake of cervical cancer screening. We then created an expert panel to conduct a hypothesis generation process to examine the possible effects of "leadership style factors" in explaining the changes. The Pap smear rate in Taiwan as a whole was 35% in 1997 and increased to 56% in 2001, and was then stable until 2010 (55%). In 2002, the geographic variation in the Pap smear rate was the smallest, ranging from 49% in Penghu County to 63% in I-lan County, with a rate ratio of 1.28. Unfortunately, the rate ratio increased to 1.49 in 2010, the rate being lowest in Penghu County (42%) and highest in Tainan City (63%). We identified four cities/counties with unique patterns of change in Pap smear rates, which were highly associated with the leadership style of the director of the city/county bureau of public health. Despite the launch of an organized cancer screening program in Taiwan, geographic variation in the uptake of cervical cancer screening still exists and has increased during the past decade. The "leadership style factor" of the director of the city/county bureau of public health might play a plausible role in explaining the pattern of change in geographic variation in the use of cervical cancer screening in Taiwan. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Thyroid Scan and Uptake

Medline Plus

Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) is also known as a thyroid uptake. ...

Increased uptake and improved outcomes of bowel cancer screening with a faecal immunochemical test: results from a pilot study within the national screening programme in England.

Science.gov (United States)

Moss, Sue; Mathews, Christopher; Day, T J; Smith, Steve; Seaman, Helen E; Snowball, Julia; Halloran, Stephen P

2017-09-01

The National Health Service Bowel Cancer Screening Programme (BCSP) in England uses a guaiac-based faecal occult blood test (gFOBt). A quantitative faecal immunochemical test (FIT) for haemoglobin (Hb) has many advantages, including being specific for human blood, detecting Hb at a much lower concentration with a single faecal sample and improved uptake. In 2014, a large comparative pilot study was performed within BCSP to establish the acceptability and diagnostic performance of FIT. Over a 6-month period, 40 930 (1 in 28) subjects were sent a FIT (OC-SENSOR) instead of a gFOBt. A bespoke FIT package was used to mail FIT sampling devices to and from FIT subjects. All participants positive with either gFOBt or FIT (cut-off 20 µg Hb/g faeces) were referred for follow-up. Subgroup analysis included cut-off concentrations, age, sex, screening history and deprivation quintile. While overall uptake increased by over 7 percentage points with FIT (66.4% vs 59.3%, OR 1.35, 95% CI 1.33 to 1.38), uptake by previous non-responders almost doubled (FIT 23.9% vs gFOBt 12.5%, OR 2.20, 95% CI 2.10 to 2.29). The increase in overall uptake was significantly higher in men than women and was observed across all deprivation quintiles. With the conventional 20 µg/g cut-off, FIT positivity was 7.8% and ranged from 5.7% in 59-64-year-old women to 11.1% in 70-75-year-old men. Cancer detection increased twofold and that for advanced adenomas nearly fivefold. Detection rates remained higher with FIT for advanced adenomas, even at 180 µg Hb/g. Markedly improved participation rates were achieved in a mature gFOBt-based national screening programme and disparities between men and women were reduced. High positivity rates, particularly in men and previous non-respondents, challenge the available colonoscopy resource, but improvements in neoplasia detection are still achievable within this limited resource. Published by the BMJ Publishing Group Limited. For permission to use (where not

Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research.

Science.gov (United States)

Young, B; Bedford, L; Kendrick, D; Vedhara, K; Robertson, J F R; das Nair, R

2017-05-09

This review aimed to better understand experiences of being invited to cancer screening and associated decision-making. Qualitative evidence explaining UK cancer screening attendance decisions was systematically identified. Data were extracted and meta-ethnography used to identify shared themes, synthesize findings and generate higher level interpretations. Thirty-four studies met inclusion criteria. They related to uptake of breast, cervical, colorectal, prostate, ovarian and lung cancer screening. Three primary themes emerged from the synthesis. 'Relationships with the health service' shaped decisions, influenced by trust, compliance with power, resistance to control or surveillance and perceived failures to meet cultural, religious and language needs. 'Fear of cancer screening' was both a motivator and barrier in different ways and to varying degrees. Strategies to negotiate moderate fear levels were evident. 'Experiences of risk' included the creation of alternative personal risk discourses and the use of screening as a coping strategy, influenced by disease beliefs and feelings of health and wellness. The findings highlight the importance of the provider-patient relationship in screening uptake and enrich our understanding of how fear and risk are experienced and negotiated. This knowledge can help promote uptake and improve the effectiveness of cancer screening. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The Role of Learning Disability Nurses in Promoting Cervical Screening Uptake in Women with Intellectual Disabilities: A Qualitative Study

Science.gov (United States)

Lloyd, Jennifer L.; Coulson, Neil S.

2014-01-01

Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women…

Examining Student Work for Evidence of Teacher Uptake of Educative Curriculum Materials

Science.gov (United States)

Bismack, Amber Schultz; Arias, Anna Maria; Davis, Elizabeth A.; Palincsar, Annemarie Sullivan

2015-01-01

The purpose of this study was to identify evidence in student work of teachers' uptake of educative features in educative curriculum materials. These are features in curriculum materials designed with the specific intent of supporting teacher learning and enactment. This study was prompted by previous work on educative curriculum materials and the…

Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: three public policy implications.

Science.gov (United States)

Lyimo, Frida S; Beran, Tanya N

2012-01-10

Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Less than one quarter (22.6%) of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03) and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10) were significantly associated with screening uptake. Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of the disease must include specific information on how to prevent it

Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: Three public policy implications

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Lyimo Frida S

2012-01-01

Full Text Available Abstract Background Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. Methods A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Results Less than one quarter (22.6% of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03 and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10 were significantly associated with screening uptake. Conclusions Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of

Global Forum 2015 dialogue on "From evidence to policy - thinking outside the box": perspectives to improve evidence uptake and good practices in the African Region.

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Kirigia, Joses Muthuri; Pannenborg, Charles Ok; Amore, Luis Gabriel Cuervo; Ghannem, Hassen; IJsselmuiden, Carel; Nabyonga-Orem, Juliet

2016-07-18

The Global Forum 2015 panel session dialogue entitled "From evidence to policy - thinking outside the box" was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region. The Global Forum 2015 debate attributed African Region's low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organizations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region. The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening NHRS governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of

Cervical Cancer Screening Service Uptake and Associated Factors among Age Eligible Women in Mekelle Zone, Northern Ethiopia, 2015: A Community Based Study Using Health Belief Model.

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Hinsermu Bayu

Full Text Available Cervical cancer is the third most common cancer among women worldwide, with about 500,000 new patients diagnosed and over 250,000 deaths every year. Cervical cancer screening offers protective benefits and is associated with a reduction in the incidence of invasive cervical cancer and cervical cancer mortality. But there is very low participation rate in screening for cervical cancer among low and middle-income countries.This study aimed to determine cervical cancer screening service uptake and its associated factor among age eligible women in Mekelle zone, northern Ethiopia, 2015.A community based cross-sectional study was conducted in Mekelle zone among age eligible women from February to June 2015. Systematic sampling technique was used to select 1286 women in to the study. A pre-tested structured questionnaire was used to collect relevant data. Data was entered and cleaned using EPINFO and analyzed using SPSS version 20 software package. Bivariate and Multivariate logistic regression was performed to assess association between dependent and independent variables with 95% CI and p-value less than 0.05 was set for association.The study revealed that among 1186 age eligible women, only 235(19.8% have been screened for cervical cancer. Age (AOR = 1.799, 95%CI = 1.182-2.739, history of multiple sexual partners (AOR = 1.635, 95%CI = 1.094-2.443, history of sexually transmitted disease (AOR = 1.635,95%CI = 1.094-2.443, HIV sero status (AOR = 5.614, 95%CI = 2.595-12.144, perceived susceptibility to cervical cancer (AOR = 2.225, 95%CI = 1.308-3.783, perceived barriers to premalignant cervical lesions screening (AOR = 2.256, 95%CI = 1.447-3.517 and knowledge on cervical cancer and screening (AOR = 2.355, 95%CI = 1.155-4.802 were significant predictors of cervical cancer screening service uptake.Magnitude of cervical cancer screening service uptake among age eligible women is still unacceptably low. Age of the women, history of multiple sexual partners

The effect of women's decision-making power on maternal health services uptake: evidence from Pakistan.

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Hou, Xiaohui; Ma, Ning

2013-03-01

A large body of research has explored the links between women's decision making and their uptake of maternal health services, but the evidence so far is inconclusive. This study uses the Pakistan Social and Living Standards Measurement Survey to examine the influence of household decision making on women's uptake of maternal health services. We find that women's decision-making power has a significant positive correlation with maternal health services uptake and that influential males' decision-making power has the opposite effect, after controlling for socio-economic indicators and supply-side conditions. Our findings suggest that empowering women and increasing their ability to make decisions may increase their uptake of maternal health services. They also suggest that policies directed toward improving women's utilization of maternal health services in Pakistan must target men as well as women.

HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data.

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Palmer, T J; McFadden, M; Pollock, K G J; Kavanagh, K; Cuschieri, K; Cruickshank, M; Nicoll, S; Robertson, C

2016-03-01

To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign. A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years. There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95% CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95% CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation. HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.

Colorectal cancer screening knowledge, attitudes and behavioural intention among Indigenous Western Australians

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Christou Aliki

2012-07-01

Full Text Available Abstract Background Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes. Methods Interviewer-administered surveys were carried out with a convenience sample (n = 93 of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening. Results Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p  Conclusions Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening. These findings should guide the development of interventions to encourage screening uptake and reduce bowel cancer related deaths among Indigenous Australians.

A Qualitative Methodological Framework to Assess Uptake of Evidence on Social Determinants of Health in Health Policy

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Fisher, Matthew; Baum, Frances; MacDougall, Colin; Newman, Lareen; McDermott, Dennis

2015-01-01

Despite abundant evidence on social determinants of health (SDH) and health inequities, effective uptake of the evidence in health policies of high-income countries has been limited. Health policies might acknowledge evidence on SDH but still direct most strategies towards biomedical and behavioural interventions. This article reports on a…

Radioiodine uptake measurements in thyroid

International Nuclear Information System (INIS)

Kadireshn, A.; Kapur, S.C.; Samuel, J.R.; Mahajan, M.K.

1988-01-01

Evaluation of thyroid function can be carried out by measuring the uptake of orally administered radioactive iodine. The results of the thyroid uptake measurements for the period 1982-1987 in Christian Medical College, Ludhiana are presented here. About 3000 patients were screened during the analysis period. (author)

Does journal club membership improve research evidence uptake in different allied health disciplines: a pre-post study

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Lizarondo Lucylynn M

2012-10-01

Full Text Available Abstract Background Although allied health is considered to be one 'unit' of healthcare providers, it comprises a range of disciplines which have different training and ways of thinking, and different tasks and methods of patient care. Very few empirical studies on evidence-based practice (EBP have directly compared allied health professionals. The objective of this study was to examine the impact of a structured model of journal club (JC, known as iCAHE (International Centre for Allied Health Evidence JC, on the EBP knowledge, skills and behaviour of the different allied health disciplines. Methods A pilot, pre-post study design using maximum variation sampling was undertaken. Recruitment was conducted in groups and practitioners such as physiotherapists, occupational therapists, speech pathologists, social workers, psychologists, nutritionists/dieticians and podiatrists were invited to participate. All participating groups received the iCAHE JC for six months. Quantitative data using the Adapted Fresno Test (McCluskey & Bishop and Evidence-based Practice Questionnaire (Upton & Upton were collected prior to the implementation of the JC, with follow-up measurements six months later. Mean percentage change and confidence intervals were calculated to compare baseline and post JC scores for all outcome measures. Results The results of this study demonstrate variability in EBP outcomes across disciplines after receiving the iCAHE JC. Only physiotherapists showed statistically significant improvements in all outcomes; speech pathologists and occupational therapists demonstrated a statistically significant increase in knowledge but not for attitude and evidence uptake; social workers and dieticians/nutritionists showed statistically significant positive changes in their knowledge, and evidence uptake but not for attitude. Conclusions There is evidence to suggest that a JC such as the iCAHE model is an effective method for improving the EBP knowledge

Nudging in screening: Literature review and ethical guidance.

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Hofmann, Bjørn; Stanak, Michal

2018-03-27

Nudging is the purposeful alteration of choices presented to people that aims to make them choose in predicted ways. While nudging has been used to assure high uptake and good outcome of screening programs, it has been criticized for being paternalistic, undermining free choice, and shared decision making. Accordingly, the objective of this study is to explore a) nudging strategies identified in screening, b) arguments for and against nudging; and on basis of this, to c) suggest a tentative conclusion on how to handle nudging in screening. Literature searches in Ovid MEDLINE and PsycINFO for combinations of screening and nudging. Screening based on content analysis of titles, abstracts, and articles. 239 references were identified and 109 were included. Several forms of nudging were identified: framed information, default bias, or authority bias. Uptake and public health outcome were the most important goals. Arguments for nudging were bounded rationality, unavoidability, and beneficence, while lack of transparency, crowding out of intrinsic values, and paternalism were arguments against it. The analysis indicates that nudging can be acceptable for screenings with (high quality) evidence for high benefit-harm ratio (beneficence), where nudging does not infringe other ethical principles, such as justice and non-maleficence. In particular, nudging should not only focus on attendance rates, but also on making people "better choosers." Four specific recommendations follow from the review and the analysis: 1) Nudging should be addressed in an explicit and transparent manner. 2) The means of nudging have to be in proportion to the benefit-harm ratio. 3) Disagreement on the evidence for either benefits or harms warrants special care. 4) Assessing and assuring the intended outcome of nudging appears to be crucial, as it can be context dependent. Copyright © 2018 Elsevier B.V. All rights reserved.

A systematic review of randomised controlled trials examining the effectiveness of breast and cervical cancer screening interventions for ethnic minority women.

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Chan, Dorothy N S; So, Winnie K W

2015-10-01

To examine the effect that breast and/or cervical cancer screening programmes for ethnic minority women have on their knowledge of and beliefs about breast or cervical cancer and screening, and on their screening intentions and uptake rates. Recommendations are also made for the format and content of such programmes, based on existing evidence. A comprehensive literature search was carried out both manually and by means of five electronic databases. The findings are summarised and synthesised in narrative fashion. The ten RCTs included here were conducted among ethnic minority women in the United States or Canada, where breast or cervical cancer screening programmes have led to improvements in screening intentions, knowledge of cervical cancer and pap test uptake. The Breast Cancer Screening Belief Scale and self-reporting were the methods commonly used to measure outcomes. The shared characteristics of both countries' programmes were that they were theory- and language-based, the instruction took place in a community setting, the materials were culturally relevant, the content highlighted key messages about breast or cervical cancer and screening measures, and there were multiple intervention strategies. Breast or cervical cancer screening programmes in Western countries have demonstrated improvements in knowledge of the disease, screening intentions and pap test uptake, although evidence on the effectiveness of the interventions has been limited. The common characteristics of programmes are identified, but a comprehensive model is still needed to link these characteristics with other factors and mediators influencing outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Efficacy of interventions to increase the uptake of chlamydia screening in primary care: a systematic review

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Donovan Basil

2011-08-01

Full Text Available Abstract Background As most genital chlamydia infections are asymptomatic, screening is the main way to detect and cases for treatment. We undertook a systematic review of studies assessing the efficacy of interventions for increasing the uptake of chlamydia screening in primary care. Methods We reviewed studies which compared chlamydia screening in the presence and the absence of an intervention. The primary endpoints were screening rate or total tests. Results We identified 16 intervention strategies; 11 were randomised controlled trials and five observational studies, 10 targeted females only, five both males and females, and one males only. Of the 15 interventions among females, six were associated with significant increases in screening rates at the 0.05 level including a multifaceted quality improvement program that involved provision of a urine jar to patients at registration (44% in intervention clinics vs. 16% in the control clinic; linking screening to routine Pap smears (6.9% vs. 4.5%, computer alerts for doctors (12.2% vs. 10.6%; education workshops for clinic staff; internet-based continuing medical education (15.5% vs. 12.4%; and free sexual health consultations (16.8% vs. 13.2%. Of the six interventions targeting males, two found significant increases including the multifaceted quality improvement program in which urine jars were provided to patients at registration (45% vs. 15%; and the offering by doctors of a test to all presenting young male clients, prior to consultation (29 vs. 4%. Conclusions Interventions that promoted the universal offer of a chlamydia test in young people had the greatest impact on increasing screening in primary care.

Cost-effectiveness of computed tomography colonography in colorectal cancer screening: a systematic review.

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Hanly, Paul; Skally, Mairead; Fenlon, Helen; Sharp, Linda

2012-10-01

The European Code Against Cancer recommends individuals aged ≥ 50 should participate in colorectal cancer screening. CT-colonography (CTC) is one of several screening tests available. We systematically reviewed evidence on, and identified key factors influencing, cost-effectiveness of CTC screening. PubMed, Medline, and the Cochrane library were searched for cost-effectiveness or cost-utility analyses of CTC-based screening, published in English, January 1999 to July 2010. Data was abstracted on setting, model type and horizon, screening scenario(s), comparator(s), participants, uptake, CTC performance and cost, effectiveness, ICERs, and whether extra-colonic findings and medical complications were considered. Sixteen studies were identified from the United States (n = 11), Canada (n = 2), and France, Italy, and the United Kingdom (1 each). Markov state-transition (n = 14) or microsimulation (n = 2) models were used. Eleven considered direct medical costs only; five included indirect costs. Fourteen compared CTC with no screening; fourteen compared CTC with colonoscopy-based screening; fewer compared CTC with sigmoidoscopy (8) or fecal tests (4). Outcomes assessed were life-years gained/saved (13), QALYs (2), or both (1). Three considered extra-colonic findings; seven considered complications. CTC appeared cost-effective versus no screening and, in general, flexible sigmoidoscopy and fecal occult blood testing. Results were mixed comparing CTC to colonoscopy. Parameters most influencing cost-effectiveness included: CTC costs, screening uptake, threshold for polyp referral, and extra-colonic findings. Evidence on cost-effectiveness of CTC screening is heterogeneous, due largely to between-study differences in comparators and parameter values. Future studies should: compare CTC with currently favored tests, especially fecal immunochemical tests; consider extra-colonic findings; and conduct comprehensive sensitivity analyses.

Thyroid Scan and Uptake

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Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake ...

18F-FDG uptake in the stomach on screening PET/CT: value for predicting Helicobacter pylori infection and chronic atrophic gastritis

International Nuclear Information System (INIS)

Kobayashi, Shigeki; Ogura, Mayumi; Suzawa, Naohisa; Horiki, Noriyuki; Katsurahara, Masaki; Ogura, Toru; Sakuma, Hajime

2016-01-01

The aim of this study was to determine the value of 18 F-FDG uptake on screening PET/CT images for the prediction of Helicobacter pylori (H. pylori) infection and chronic atrophic gastritis. Among subjects who underwent 18 F-FDG PET/CT for cancer screening from April 2005 to November 2015, PET/CT images were analyzed in 88 subjects who had gastrointestinal fiberscopy within 6 months. The volumes of interest (VOIs) were placed in the fornix, corpus and antrum of the stomach to determine maximal standardized uptake value (SUVmax) and mean SUV (SUVmean). Receiver operating characteristic curve (ROC) analysis was performed to determine the diagnostic performance of SUV indicators in predicting H. pylori infection and chronic atrophic gastritis. SUV indicators of the stomach were significantly higher in subjects with H. pylori infection than those without (from P < 0.001 to P < 0.05). ROC analysis revealed that SUVmean had the highest performance in predicting H. pylori infection (AUC 0.807) and chronic atrophic gastritis (AUC 0.784). SUVmean exhibited the sensitivity of 86.5 % and the specificity of 70.6 % in predicting H. pylori infection, and the sensitivity of 75.0 % and 78.6 % in predicting chronic atrophic gastritis. Assessment of 18 F-FDG uptake in the stomach reflecting active inflammation is useful in predicting patients with H. pylori infection and subsequent chronic atrophic gastritis which is closely associated with the risk of gastric neoplasms

Incidence and characteristics of uterine leiomyomas with FDG uptake

International Nuclear Information System (INIS)

Nishizawa, Sadahiko; Inubushi, Masayuki; Kido, Aki; Miyagawa, Masao; Inoue, Takeshi; Shinohara, Katsura; Kajihara, Makoto

2008-01-01

Uterine leiomyomas sometimes show focal 18 F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) images that may result in a false-positive diagnosis for malignant lesions. This study was conducted to investigate the incidence and characteristics of uterine leiomyomas that showed FDG uptake. We reviewed FDG-PET and pelvic magnetic resonance (MR) images of 477 pre-menopausal (pre-MP, age 42.1±7.3 years) and 880 post-MP (age 59.9±6.8 years) healthy women who underwent these tests as parts of cancer screening. Of 1357, 323 underwent annual cancer screening four times, 97 did three times, 191 did twice, and the rest were screened once. Focal FDG uptake (maximal standardized uptake value >3.0) in the pelvis was localized and characterized on co-registered PET/MR images. Uterine leiomyomas were found in 164 pre-MP and 338 post-MP women. FDG uptake was observed in 18 leiomyomas of 17 of the 164 (10.4%) pre-MP women and in 4 leiomyomas of 4 of the 338 (1.2%) post-MP women. The incidence was significantly higher in pre-MP women than in post-MP women (chi-square, P<0.001). Of the 22, 13 showed signal intensity equal to or higher than that of the myometrium on T2-weighted MR images, which suggested abundant cellularity, whereas the majority of leiomyomas without FDG uptake showed low signal intensity. Of the 13 women, 12 examined more than twice showed substantial changes in the level of FDG uptake in leiomyomas each year with FDG uptake disappearing or newly appearing. These changes were observed frequently in relation with menopause or menstrual phases. Leiomyomas with focal FDG uptake were seen in both pre- and post-MP women with a higher incidence in pre-MP women. Abundant cellularity and hormonal dependency may explain a part of the mechanisms of FDG uptake in leiomyomas. It is important to know that the level of FDG uptake in leiomyomas can change and newly appearing FDG uptake does not necessarily mean malignant transformation. (author)

Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

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Hall, Michael J.; Ruth, Karen; Giri, Veda N.

2011-01-01

Background Screening by fecal occult blood test and lower endoscopy have lowered colorectal cancer (CRC) mortality, but compliance gaps persist. Of concern are possible disparities in uptake of CRC screening between White and African American (AA) men. Our goal was to assess for disparities in uptake of CRC screening among men participating in a high-risk prostate cancer clinic. If present, such disparities could support hypotheses for further research examining racial differences in awareness and patient preferences in undergoing CRC screening. Methods Baseline data on a racially diverse cohort of men age 50–69 at increased risk of prostate cancer collected via the prostate cancer risk assessment program (PRAP) at Fox Chase Cancer Center were analyzed. Predictors of uptake of CRC screening were assessed using multivariable logistic regression. Results Compared to Whites, AA men had statistically significantly lower uptake of fecal occult blood testing (AA 49.0% vs White 60.7%, p=0.035), lower endoscopy (AA 44.1% vs White 58.5%, p=0.011), and any CRC screening (AA 66.2% vs White 76.3%, p=0.053). Predictors of uptake of lower endoscopy among AA men included older age (OR 3.61, 95% CI 1.87–6.97), family history of CRC (OR 3.47, 95% CI 1.30–9.25), and insurance status (OR 1.90, 95% CI 1.04–3.46). Conclusion Despite awareness of cancer risk and motivation to seek prostate cancer screening through a specialized prostate cancer risk assessment program, evidence supporting compliance gaps with CRC screening among men was found. Tailored messages to younger AA men with and without a family history of CRC are needed. PMID:21751189

Screening on urogenital Chlamydia trachomatis

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Busse, Reinhard

2005-12-01

: The main limitation of this report is that we relied only on published results. Most of research has been conducted in countries other than Germany. The fulfilment of the criteria for introduction of screening depends on contextual factors. More data from Germany are needed in order to answer the main questions concerning acceptance, use of selection criteria to identify subgroups and economical aspects of screening for Chlamydia trachomatis in Germany. Conclusions: The criteria for introduction of screening for Chlamydia trachomatis are partially fulfilled. The available evidence indicates that the success of a screening programme for Chlamydia trachomatis will depend on the implementation of strategies for uptake enhancement and probably on the participation of men as well. A pilot project should be conducted in order to assess cost-effectiveness, acceptance and feasibility of different screening strategies in Germany. On the light of the available evidence, the inclusion of screening for Chlamydia trachomatis in the benefit basket without embedding it in a multifaceted programme targeting primary prevention of sexually transmitted diseases and participation in screening cannot be recommende.

Newborn screening for proximal urea cycle disorders: Current evidence supporting recommendations for newborn screening.

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Merritt, J Lawrence; Brody, Linnea L; Pino, Gisele; Rinaldo, Piero

2018-04-20

Current newborn screening (NBS) for urea cycle disorders (UCD) is incomplete as only distal UCDs are included in most NBS programs by measuring elevated amino acid concentrations. NBS for the proximal UCDs involves the detection in NBS spots of low citrulline values, a finding which is often overlooked because it is considered to be inadequate. We retrospectively analyzed NBS blood spots from known UCD patients comparing the utility of the Region 4 Stork (R4S) interpretive tools to conventional cutoff based interpretation. This study shows the utility of R4S tools in detecting all UCDs, and provides evidence to support the nomination to add proximal UCDs to the recommended uniform screening panel. Copyright © 2018 Elsevier Inc. All rights reserved.

UPTAKE AND PERFORMANCE OF CLINICAL BREAST EXAM SCREENING BY TRAINED LAYWOMEN IN MALAWI.

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Gutnik, L; Lee, C; Msosa, V

2017-09-01

Breast cancer awareness and early detection are limited in sub-saharan Africa. Resource limitations make screening mammography or clinical breast examination (CBE) by physicians or nurses impractical in many settings. We aimed to assess feasibility and performance of CBE by laywomen in urban health clinics. Four laywomen were trained to deliver breast cancer educational talks and conduct CBE. Eligible women were 30 years, with no prior breast cancer or breast surgery, and clinic attendance for reasons other than a breast concern. Women with abnormal CBE were referred to a study surgeon. All palpable masses confirmed by surgeon examination were pathologically sampled. Patients with abnormal screening CBE but normal surgeon examination underwent breast ultrasound confirmation. Among 1220 eligible women, 1000 (82%) agreed to CBE. Lack of time (69%) was the commonest reason for refusal. Educational talk attendance was associated with higher CBE participation (83% versus 77%, P¼ 0.012). Among 1000 women screened, 7% had abnormal CBE. Of 45 women with normal CBE randomized to physician examination, 43 had normal examinations and two had axillary lymphadenopathy not detected by CBE. Sixty of 67 women (90%) with abnormal CBE attended the referral visit. Of these, 29 (48%) had concordant abnormal physician examination. Thirty-one women (52%) had discordant normal physician examination, all of whom also had normal breast ultrasounds. Compared with physician examination, sensitivity for CBE by laywomen was 94% (confidence interval (CI, 79%-99%), specificity 58% (CI, 46%-70%), positive predictive value 48% (CI, 35%-62%), and negative predictive value 96% (CI, 85%-100%). Of 13 women who underwent recommended pathologic sampling of a breast lesion, two had cytologic dysplasia and all others benign results. CBE uptake in Lilongwe clinics was high. CBE by laywomen compared favourably with physician examination and followup was good. Our intervention can serve as a model for wider

Screening women at high risk of breast cancer on the basis of evidence

International Nuclear Information System (INIS)

Warren, Ruth

2001-01-01

Geneticists are able to identify the risk of breast cancer. Strategies on offer include prevention, early diagnosis by screening, and prophylactic surgery. This paper analyses the evidence for offering screening. The radiation dose of mammography has been measured, but the risk is not fully known. Mammography screening of women of 40-50 years in the normal population has known effect. Little evidence is available for women under 40 years or for women with genetic susceptibility to breast cancer. Dense parenchymal pattern is associated with high grade cancers, and is both a risk factor and a reason for impaired screening sensitivity. Whether this applies to younger women or women at high risk is speculative. The pathological features of the cancers in gene carriers show differences from those occurring in normal women. This work should be correlated with imaging features. There is no literature to support the use of newer imaging methods in these women. Ultrasound and MRI avoid radiation and may be useful in dense breasts. SestaMIBI and PET scanning are not yet mature enough for screening, and may never have such a role. Any newer modality must be subjected to a formal randomised trial before being offered to screen women at high risk

Impact of non-clinical community-based promotional campaigns on bowel cancer screening engagement: An integrative literature review.

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Martini, Angelita; Morris, Julia N; Preen, David

2016-10-01

This paper reviewed the relationship between non-clinical, client-oriented promotional campaigns to raise bowel cancer awareness and screening engagement. An integrative literature review using predefined search terms was conducted to summarise the accumulated knowledge. Data was analysed by coding and categorising, then synthesized through development of themes. Eighteen of 116 studies met inclusion criteria. Promotional campaigns had varying impact on screening uptake for bowel cancer. Mass media was found to moderately increase screening, predominately amongst "worried well". Small media used in conjunction with other promotional activities, thus its effect on screening behaviours was unclear. One-on-one education was less effective and less feasible than group education in increasing intention to screen. Financial support was ineffective in increasing screening rates when compared to other promotional activities. Screening engagement increased because of special events and celebrity endorsement. Non-clinical promotional campaigns did impact uptake of bowel cancer screening engagement. However, little is evident on the effect of single types of promotion and most research is based on clinician-directed campaigns. Cancer awareness and screening promotions should be implemented at community and clinical level to maximize effectiveness. Such an approach will ensure promotional activities are targeting consumers, thus strengthening screening engagement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cervical screening in HPV-vaccinated populations.

Science.gov (United States)

Canfell, K

2018-06-01

Cervical screening with cytology has been the basis for substantial reductions in cervical cancer incidence and mortality in most high-income countries over the last few decades. More recently, there have been two key, parallel developments which have prompted a major re-consideration of cervical screening. The first is the emergence of evidence on the improved sensitivity of human papillomavirus (HPV) DNA testing compared to cytology, and the second is the large-scale deployment of prophylactic vaccination against HPV. A key challenge to be overcome before HPV screening could be introduced into national cervical screening programs was the specificity of an infection, for detection of precancerous lesions. This has been done in three ways: (1) by considering the appropriate age for starting HPV screening (30 years in unvaccinated populations and 25 years in populations with mature vaccination programs and high vaccine uptake) and the appropriate screening interval; (2) via development of clinical HPV tests, which are (by design) not as sensitive to low viral loads; and (3) by introducing effective triaging for HPV-positive women, which further risk-stratifies women before referral for diagnostic evaluation. This review discusses these major developments and describes how the benefits of HPV screening are being optimized in both unvaccinated and vaccinated populations.

Development and application of a fluorescent glucose uptake assay for the high-throughput screening of non-glycoside SGLT2 inhibitors.

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Wu, Szu-Huei; Yao, Chun-Hsu; Hsieh, Chieh-Jui; Liu, Yu-Wei; Chao, Yu-Sheng; Song, Jen-Shin; Lee, Jinq-Chyi

2015-07-10

Sodium-dependent glucose co-transporter 2 (SGLT2) inhibitors are of current interest as a treatment for type 2 diabetes. Efforts have been made to discover phlorizin-related glycosides with good SGLT2 inhibitory activity. To increase structural diversity and better understand the role of non-glycoside SGLT2 inhibitors on glycemic control, we initiated a research program to identify non-glycoside hits from high-throughput screening. Here, we report the development of a novel, fluorogenic probe-based glucose uptake system based on a Cu(I)-catalyzed [3+2] cycloaddition. The safer processes and cheaper substances made the developed assay our first priority for large-scale primary screening as compared to the well-known [(14)C]-labeled α-methyl-D-glucopyranoside ([(14)C]-AMG) radioactive assay. This effort culminated in the identification of a benzimidazole, non-glycoside SGLT2 hit with an EC50 value of 0.62 μM by high-throughput screening of 41,000 compounds. Copyright © 2015 Elsevier B.V. All rights reserved.

Awareness of breast cancer and barriers to breast screening uptake in Bangladesh: A population based survey.

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Islam, Rakibul M; Bell, Robin J; Billah, Baki; Hossain, Mohammad B; Davis, Susan R

2016-02-01

To investigate the awareness of breast cancer (BCa) and BCa screening amongst women at midlife in Bangladesh. A nationally representative cross-sectional survey of women aged 30-59 years was conducted in 7 districts of the 7 divisions in Bangladesh, using a multistage cluster sampling technique. The factors associated with the awareness of BCa and breast assessment of asymptomatic women were investigated separately, using multivariable logistic regression. Of the 1590 participants, mean age 42.3 (±8.0) years, 81.9% had ever heard of BCa and 64.2% of any methods of BCa screening, respectively. Awareness of BCa was associated with being aged 40-49 years (adjusted OR 2.04, 95% CI 1.46-2.84), aged 49-59 years (1.96, 1.32-2.91), being overweight (1.46, 1.07-2.01) and obesity (1.62, 1.01-2.62), while inversely associated with rural dwelling (0.37, 0.22-0.61), primary education (0.44, 0.27-0.70), having no education (0.23, 0.14-0.36) and parity (0.62, 0.44-0.87). Of the 750 women who were aware of clinical breast examination (CBE) or mammography, reasons provided for not undergoing screening included that they had no symptoms (92%) and that they did not know screening was needed (40%). 8% of women reported CBE. Women with no education were less likely to have undergone CBE (0.38, 0.141.04; p=0.059). Lack of understanding of the assessment of asymptomatic women is the key obstacle to BCa screening uptake in Bangladesh. Health education programs, especially BCa awareness programs, have the potential to increase BCa awareness and down-staging of the disease. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement.

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Lin, Kenneth; Fajardo, Kevin

2008-07-01

Asymptomatic bacteriuria is common, and screening for this condition in pregnant women is a well-established, evidence-based standard of current medical practice. Screening other groups of adults has not been shown to improve outcomes. To review new and substantial evidence on screening for asymptomatic bacteriuria, to support the work of the U.S. Preventive Services Task Force. English-language studies of adults (age >18 years) indexed in PubMed and the Cochrane Library and published from 1 January 2002 through 30 April 2007. For benefits of screening or treatment for screened populations, systematic reviews; meta-analyses; and randomized, controlled trials were included. For harms of screening, systematic reviews; meta-analyses; randomized, controlled trials; cohort studies; case-control studies; and case series of large multisite databases were included. Two reviewers independently reviewed titles, abstracts, and full articles for inclusion. Two reviewers extracted data from studies on benefits of screening and treatment (including decreases in the incidence of adverse maternal and fetal outcomes, symptomatic urinary tract infections, hypertension, and renal function decline). An updated Cochrane systematic review of 14 randomized, controlled trials of treatment supports screening for asymptomatic bacteriuria in pregnant women. A randomized, controlled trial and a prospective cohort study show that screening nonpregnant women with diabetes for asymptomatic bacteriuria is unlikely to produce benefits. No new evidence on screening men for asymptomatic bacteriuria or on harms of screening was found. The focused search strategy may have missed some smaller studies on the benefits and harms of screening for asymptomatic bacteriuria. The available evidence continues to support screening for asymptomatic bacteriuria in pregnant women, but not in other groups of adults.

Incentives in Diabetic Eye Assessment by Screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London.

Science.gov (United States)

Judah, Gaby; Vlaev, Ivo; Gunn, Laura; King, Dominic; King, Derek; Valabhji, Jonathan; Darzi, Ara; Bicknell, Colin

2016-03-18

Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only 81 %, leaving many people at risk of preventable sight loss. This is a three arm randomized controlled trial to investigate the impact of different types of financial incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within the last 24 months. Eligible participants will be randomized to one of three conditions: 1. Control condition (usual invitation letter) 2. Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment) 3. Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000 if they attend their appointment). Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test whether the incentive scheme has a differential impact on patients from different demographic or socio-economic groups, information will be recorded on age, gender, distance from screening center, socio-economic status and length of time since they were last screened. A cost-effectiveness analysis will also be performed. This study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If

Social disparities in access to breast and cervical cancer screening by women living in Spain.

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Ricardo-Rodrigues, I; Jiménez-García, R; Hernández-Barrera, V; Carrasco-Garrido, P; Jiménez-Trujillo, I; López de Andrés, A

2015-07-01

To describe uptake of breast and cervical cancer screening by women living in Spain, analyse the possible associated social and health factors, and compare uptake rates with those obtained in previous surveys. Cross-sectional study using data from the 2011 Spanish national health survey. Uptake of breast cancer screening was analysed by asking women aged 40-69 years whether they had undergone mammography in the previous two years. Uptake of cervical cancer screening was analysed by asking women aged 25-65 years whether they had undergone cervical cytology in the previous three years. Independent variables included sociodemographic characteristics, and variables related to health status and lifestyle. Seventy-two percent of women had undergone mammography in the previous two years. Having private health insurance increased the probability of breast screening uptake four-fold [odds ratio (OR) 3.96, 95% confidence interval (CI) 2.71-5.79], and being an immigrant was a negative predictor for breast screening uptake. Seventy percent of women had undergone cervical cytology in the previous three years. Higher-educated women were more likely to have undergone cervical cancer screening (OR 2.59, 95% CI 1.97-3.40), and obese women and women living in rural areas were less likely to have undergone cervical cancer screening. There have been no relevant improvements in uptake rates of either breast or cervical cancer screening since 2006. Uptake of breast and cervical cancer screening could be improved in Spain, and uptake rates have stagnated over recent years. Social disparities have been detected with regard to access to these screening tests, indicating that it is necessary to continue researching and optimizing prevention programmes in order to improve uptake and reduce these disparities. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

What Prevents Men Aged 40-64 Years from Prostate Cancer Screening in Namibia?

International Nuclear Information System (INIS)

Kangmennaang, J.; Mkandawire, P.; Luginaah, I.

2016-01-01

Although a growing body of evidence demonstrates the public health burden of prostate cancer in SSA, relatively little is known about the underlying factors surrounding the low levels of testing for the disease in the context of this region. Using Namibia Demographic Health Survey dataset (NDHS, 2013), we examined the factors that influence men’s decision to screen for prostate cancer in Namibia. Methods. We use complementary log-log regression models to explore the determinants of screening for prostate cancer. We also corrected for the effect of unobserved heterogeneity that may affect screening behaviours at the cluster level. Results. The results show that health insurance coverage (OR = 2.95, ) is an important predictor of screening for prostate cancer in Namibia. In addition, higher education and discussing reproductive issues with a health worker (OR = 2.02, P = 0.05) were more likely to screening for prostate cancer. Conclusions. A universal health insurance scheme may be necessary to increase uptake of prostate cancer screening. However it needs to be acknowledged that expanded screening can have negative consequences and any allocation of scarce resources towards screening must be guided by evidence obtained from the local context about the costs and benefits of screening.

Uptake of community-based, self-collected HPV testing vs. visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial.

Science.gov (United States)

Moses, Erin; Pedersen, Heather N; Mitchell, Sheona M; Sekikubo, Musa; Mwesigwa, David; Singer, Joel; Biryabarema, Christine; Byamugisha, Josaphat K; Money, Deborah M; Ogilvie, Gina S

2015-10-01

To compare two cervical cancer screening methods: community-based self-collection of high-risk human papillomavirus (HR-HPV) testing and visual inspection with acetic acid (VIA). Pilot randomised controlled trial of 500 women aged 30-65 in the community of Kisenyi, Uganda. Women randomised to self-collection-based HR-HPV testing provided a cervico-vaginal swab for HR-HPV, and results were provided by phone after laboratory testing. Women who tested HPV positive were referred for VIA at the local health unit. Women randomised to VIA underwent screening at the local health unit, where women who tested positive with VIA were provided cryotherapy at time of screening, as per local standard of care. Women were referred for colposcopy when indicated. Outcome measures were uptake of screening, HR-HPV prevalence, VIA result and treatment rates. In the HR-HPV arm, 248 of 250 (p < 0.01) women provided samples, while in the VIA arm, 121 of 250 (48.4%) women attended screening. Among the 73 of 248 HR-HPV-positive women, 45.2% (N = 33) attended VIA screening for follow-up, 21.2% (N = 7) of whom screened positive; five received treatment and two were missing clinical follow-up records. Of the 121 women in the VIA arm who attended screening, 13.2% (N = 16) screened positive; seven received cryotherapy, three refused treatment, five were referred to colposcopy; and one woman had suspected cervical cancer and received treatment after confirmatory testing. This pilot study demonstrated trial feasibility and willingness of the women to participate and be randomised successfully into the two arms. Self-collection-based cervical cancer screening had a higher uptake than VIA. © 2015 John Wiley & Sons Ltd.

Breast cancer screening utilization among women from Muslim majority countries in Ontario, Canada.

Science.gov (United States)

Vahabi, Mandana; Lofters, Aisha; Kim, Eliane; Wong, Josephine Pui-Hing; Ellison, Lisa; Graves, Erin; Glazier, Richard H

2017-12-01

Breast cancer screening disparities continue to prevail with immigrant women being at the forefront of the under screened population. There is a paucity of knowledge about the role of religious affiliation or cultural orientation on immigrant women's cancer screening uptake. This study examined differences in uptake of breast cancer screening among women from Muslim and non- Muslim majority countries in Ontario, Canada. A cohort of 1,851,834 screening-eligible women living in Ontario during April 1, 2013 to March 31, 2015 was created using linked health and social administrative databases. The study found that being born in a Muslim majority country was associated with lower breast cancer screening uptake after adjusting for region of origin, neighbourhood income, and primary care-related factors. However, screening uptake in Muslim majority countries varied by world region with the greatest differences found in Sub-Saharan Africa and South Asia. Screening uptake was lower for women who had no primary care provider, were in a traditional fee-for service model of primary care, had a male physician, had an internationally trained physician, resided in a low income neighbourhood, and entered Canada under the family class of immigration. Religion may play a role in screening uptake, however, the variation in rates by regions of origin, immigration class, and access to primary care providers alludes to confluence of socio-demographic, cultural beliefs and practices, immigration trajectories and system level factors. Facilitating access for immigrant women to regular primary care providers, particularly female providers and enrollment in primary care models could enhance screening uptake. Copyright © 2017 Elsevier Inc. All rights reserved.

Determinants in the uptake of the Human Papillomavirus vaccine: a systematic review based on European studies

Directory of Open Access Journals (Sweden)

Victoria eFernández de Casadevante

2015-06-01

Full Text Available Background Cervical cancer is the fourth most common cancer affecting women worldwide. Since 2006, two Human Papillomavirus vaccines (HPVV have been licensed to protect women against the virus that causes cervical cancer. However, worldwide coverage remains unequal. Studies from the USA found strong evidence for differences in HPVV uptake by ethnicity and healthcare coverage. As the profile of ethnic groups and the healthcare system in the USA differ from countries in Europe where HPVV is free in most of the countries, we conducted a systematic review in order to analyze the determinants of HPVV uptake in Europe.Methods We performed a systematic Pubmed, Scopus and Science Direct search to find articles published from HPVV availability in European countries until April 2014. No age restriction was applied. We included all studies assessing factors associated with HPVV uptake. Uptake refers to either initiation and/or completion of the three dose vaccination program. Results Out of the 23 eligible studies, 14 were retrospective reviews of data, six were cross-sectional surveys and three were prospective cohort studies. Higher HPVV uptake was associated with ethnic majority populations, higher socio-economic status, regular cervical screening participation by the mother and having received previous childhood vaccinations.Conclusions Since the vaccine is offered for free in most of the European countries, the findings suggest that ethno-cultural and educational factors play an important role when it comes to HPVV uptake. Girls who were undervaccinated had also a lower uptake of standard childhood vaccines and mothers who were less likely to attend cervical cancer screening. This may indicate, that only few parents have specific concerns with HPVV, and that preventive health care should seek ways to target these vulnerable groups.

Factors Influencing Colorectal Cancer Screening Participation

Directory of Open Access Journals (Sweden)

Antonio Z. Gimeno García

2012-01-01

Full Text Available Colorectal cancer (CRC is a major health problem worldwide. Although population-based CRC screening is strongly recommended in average-risk population, compliance rates are still far from the desirable rates. High levels of screening uptake are necessary for the success of any screening program. Therefore, the investigation of factors influencing participation is crucial prior to design and launches a population-based organized screening campaign. Several studies have identified screening behaviour factors related to potential participants, providers, or health care system. These influencing factors can also be classified in non-modifiable (i.e., demographic factors, education, health insurance, or income and modifiable factors (i.e., knowledge about CRC and screening, patient and provider attitudes or structural barriers for screening. Modifiable determinants are of great interest as they are plausible targets for interventions. Interventions at different levels (patient, providers or health care system have been tested across the studies with different results. This paper analyzes factors related to CRC screening behaviour and potential interventions designed to improve screening uptake.

Attitude of antenatal patients in Enugu toward HIV screening ...

African Journals Online (AJOL)

The reason for declining HIV Screening was that AIDS has no known cure, followed by fear of positive result. Conclusion: The awareness and attitude of Nigeria pregnant women towards HIV Screening and uptake of the test is good. Educational level has a significant effect on the uptake and perceived benefit of the test.

Translations of Developmental Screening Instruments: An Evidence Map of Available Research.

Science.gov (United States)

El-Behadli, Ana F; Neger, Emily N; Perrin, Ellen C; Sheldrick, R Christopher

2015-01-01

Children whose parents do not speak English experience significant disparities in the identification of developmental delays and disorders; however, little is known about the availability and validity of translations of developmental screeners. The goal was to create a map of the scientific evidence regarding translations of the 9 Academy of Pediatrics-recommended screening instruments into languages other than English. The authors conducted a systematic search of Medline and PsycINFO, references of identified articles, publishers' Web sites, and official manuals. Through evidence mapping, a new methodology supported by AHRQ and the Cochrane Collaboration, the authors documented the extent and distribution of published evidence supporting translations of developmental screeners. Data extraction focused on 3 steps of the translation and validation process: (1) translation methods used, (2) collection of normative data in the target language, and (3) evidence for reliability and validity. The authors identified 63 distinct translations among the 9 screeners, of which 44 had supporting evidence published in peer-reviewed sources. Of the 63 translations, 35 had at least some published evidence regarding translation methods used, 28 involving normative data, and 32 regarding reliability and/or construct validity. One-third of the translations found were of the Denver Developmental Screening Test. Specific methods used varied greatly across screeners, as did the level of detail with which results were reported. Few developmental screeners have been translated into many languages. Evidence map of the authors demonstrates considerable variation in both the amount and the comprehensiveness of information available about translated instruments. Informal guidelines exist for conducting translation of psychometric instruments but not for documentation of this process. The authors propose that uniform guidelines be established for reporting translation research in peer

Cases with focal FDG uptake in the thyroid gland detected by FDG-PET screening

International Nuclear Information System (INIS)

Takeda, Yutaka; Iguchi, Atsuko; Matsuo, Chikashi; Otawa, Kouichi; Nakamura, Mamoru

2007-01-01

We examined fifteen cases with focal fluorodeoxyglucose (FDG) uptake in the thyroid gland detected by FDG-positron emission tomography (PET) screening for cancer. Examination of the thyroid gland was carried out by using computer tomography, ultrasound sonography, laboratory test and fine needle aspiration cytology (FNAC). Surgical operation was performed to the patient who was suspected of having thyroid cancer by FNAC or clinical findings. Thyroid cancer was histologically confirmed in 4 cases. Malignancy was not ruled out by FNAC in one patient. Seven patients were suspected of having benign thyroid tumor (adenoma, adenomatous goiter). Three patients were diagnosed with thyroiditis (Hashimoto thyroiditis, subacute thyroiditis, painless thyroiditis) by laboratory tests. It was not easy to differentiate between cancer and benign diseases only by FDG-PET. However, it was useful to detect thyroid tumor especially if the tumor is hardly palpable. FDG-PET was also valuable as a diagnostic imaging technique to evaluate metastasis and the extent of cancer. (author)

Mortality of non-participants in cervical screening

DEFF Research Database (Denmark)

Dugué, Pierre-Antoine; Lynge, Elsebeth; Rebolj, Matejka

2014-01-01

The selective uptake of screening by healthy participants and its impact on the evaluation of screening effectiveness in non-randomized studies have been discussed, but hardly studied. We quantified excess mortality among cervical screening non-participants compared to participants. Based on Dani...

Evidence-based screening for low bone mineral density in HIV-infected men.

Science.gov (United States)

Albright, Patsi; Du, Ping; Haas, Richard E; Pugh, Linda C

2014-01-01

Low bone mineral density, which leads to osteoporosis and fracture risk, is an emerging clinical problem in HIV-infected patients. Our evidence-based practice project screened a convenience sample of 225 HIV-infected men for low bone mineral density using the Osteoporosis Self-Assessment Tool, and of those men, 173 were also screened by quantitative ultrasound of the calcaneus. One hundred twelve men had low bone mineral density by either or both screening methods. Seventy-one of these 112 men were tested by dual-energy x-ray absorptiometry and 73% had low bone mineral density. The positive protective value of the Osteoporosis Self-Assessment Tool was 73% and for quantitative ultrasound was 88%. These results suggest that routine low bone mineral density screening should be included as standard practice for all HIV-infected patients. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Radioiodine uptake in inactive pulmonary tuberculosis

International Nuclear Information System (INIS)

Bakheet, S.M.; Powe, J.; Al Suhaibani, H.; Hammami, M.M.; Bazarbashi, M.

1999-01-01

Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases. (orig.)

The impact of community health educators on uptake of cervical and breast cancer prevention services in Nigeria.

Science.gov (United States)

Chigbu, Chibuike O; Onyebuchi, Azubuike K; Onyeka, Tonia C; Odugu, Boniface U; Dim, Cyril C

2017-06-01

To determine the impact of trained community health educators on the uptake of cervical and breast cancer screening, and HPV vaccination in rural communities in southeast Nigeria. A prospective population-based intervention study, with a before-and-after design, involved four randomly selected communities in southeast Nigeria from February 2014 to February 2016. Before the intervention, baseline data were collected on the uptake of cervical and breast cancer prevention services. The intervention was house-to-house education on cervical cancer and breast cancer prevention. Postintervention outcome measures included the uptake of cervical and breast cancer screening, and HPV vaccination within 6 months of intervention. In total, 1327 women were enrolled. Before the intervention, 42 (3.2%) women had undergone cervical cancer screening; afterwards, 897 (67.6%) women had received screening (Pbreast examination was performed for 59 (4.4%) women before and 897 (67.6%) after the intervention (Pbreast cancer prevention education was associated with significant increases in the uptake of cervical cancer screening, clinical breast examination, and HPV vaccination. © 2017 International Federation of Gynecology and Obstetrics.

Colorectal cancer screening knowledge, attitudes and behavioural intention among Indigenous Western Australians.

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Christou, Aliki; Thompson, Sandra C

2012-07-18

Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC) screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT) among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes. Interviewer-administered surveys were carried out with a convenience sample (n = 93) of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening. Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p < 0.0001). Nearly two-thirds (63%; 58/92) of respondents reported intending to participate in screening, while a greater proportion (84%; 77/92) said they would participate on a doctor's recommendation. Multivariate analysis with logistic regression demonstrated that independent predictors of screening intention were, greater perceived self-efficacy (OR = 19.8, 95% CI = 5.5-71.8), a history of cancer screening participation (OR = 6.8, 95% CI = 2.0-23.3) and being aged 45 years or more (OR = 4.5, 95% CI = 1.2-16.5). A higher CRC knowledge score (medium vs. low: OR = 9.9, 95% CI = 2.4-41.3; high vs. low: 13.6, 95% CI = 3.4-54.0) and being married or in a de-facto relationship (OR = 6.9, 95% CI = 2.1-22.5) were also identified as predictors of intention to screen with FOBT. Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening. These findings should guide the development of interventions to encourage screening uptake and

Improving access to screening for people with learning disabilities.

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Marriott, Anna; Turner, Sue; Giraud-Saunders, Alison

2014-11-04

People with learning disabilities have poorer health than their non-disabled peers, and are less likely to access screening services than the general population. The National Development Team for Inclusion and the Norah Fry Research Centre developed a toolkit and guidance to improve uptake of five national (English) screening programmes (one of which is delivered through local programmes), based on work to improve access by people with learning disabilities in the south west peninsula of the UK. This article describes the findings in relation to the five English screening programmes and suggests ways to improve uptake of cancer screening by people with learning disabilities.

Optimal screening mammography reading volumes; evidence from real life in the East Midlands region of the NHS Breast Screening Programme

International Nuclear Information System (INIS)

Cornford, E.; Reed, J.; Murphy, A.; Bennett, R.; Evans, A.

2011-01-01

Aim: To assess real-life reader performance as a function of both volume of mammograms read and reading experience in a multicentre cohort. Materials and methods: Thirty-seven film readers from the East Midlands Breast Screening Programme had 3 years of consecutive screen reading results available for comparison. Markers of screening performance as the first film reader [cancer detection rates, small cancer detection rates, recall rates, positive predictive value of recall (PPV), and missed cancers] were compared with both volume of films read and years of film reading experience. For reading volume, readers were categorized according to film reading volume over the 3 year period: <15,000 (i.e., on average less than the recommended 5000/year); 15-<20,000; 20-<25,000; and ≥25,000. For years of experience, readers were categorized into the following groups: <5 years, 5-<10 years, 10-<15 years, and 15-<20 years. Results: There was no evidence to suggest a relationship between years of film reading experience and film-reading performance. For reading volume, there was a significant difference in the distribution of cancer-detection rate between the four groups (p = 0.01); however, there was no difference in small cancer-detection rates, missed cancers or PPV. The median cancer detection rate in the high-volume group (≥25,000 mammograms/3 years) was significantly lower than the other groups combined (6.9 per 1000 women screened versus 7.9 per 1000 women screened). The lowest median recall rate was also in the high-volume group, whilst those readers not meeting the NHSBSP minimum requirement had the highest median recall rate; however, there was borderline evidence to suggest a difference in the distribution of recall rates between the four groups. Conclusion: The data from the East Midlands do not provide any evidence for reducing the threshold volume of 5000 cases /year. However, there appears to be an upper limit above which reader performance deteriorates in

There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

Science.gov (United States)

Green, A; Tait, C; Aboumarzouk, O; Somani, B K; Cohen, N P

2013-05-01

Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom. To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men. Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis. In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment. Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.

Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14-50 years: a systematic review and meta-analysis.

Science.gov (United States)

Odesanmi, Tolulope Y; Wasti, Sharada P; Odesanmi, Omolola S; Adegbola, Omololu; Oguntuase, Olubukola O; Mahmood, Sajid

2013-12-01

Home-based sampling is a strategy to enhance uptake of sexually transmissible infection (STI) screening. This review aimed to compare the screening uptake levels of home-based self-sampling and clinic-based specimen collection for STIs (chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and trichomoniasis) in females aged 14-50 years. Acceptability and effect on specimen quality were determined. Sixteen electronic databases were searched from inception to September 2012. Randomised controlled trials (RCTs) comparing the uptake levels of home-based self-sampling and clinic-based sampling for chlamydia, gonorrhoea and trichomoniasis in females aged 14-50 years were eligible for inclusion. The risk of bias in the trials was assessed. Risk ratios (RRs) for dichotomous outcomes were meta-analysed. Of 3065 papers, six studies with seven RCTs contributed to the final review. Compared with clinic-based methods, home-based screening increased uptake significantly (P=0.001-0.05) in five trials and was substantiated in a meta-analysis (RR: 1.55; 95% confidence interval: 1.30-1.85; P=0.00001) of two trials. In three trials, a significant preference for home-based testing (P=0.001-0.05) was expressed. No significant difference was observed in specimen quality. Sampling was rated as easy by a significantly higher number of women (P=0.01) in the clinic group in one trial. The review provides evidence that home-based testing results in greater uptake of STI screening in females (14-50 years) than clinic-based testing without compromising quality in the developed world. Home collection strategies should be added to clinic-based screening programs to enhance uptake.

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?

Science.gov (United States)

Cannon, Michael J; Griffiths, Paul D; Aston, Van; Rawlinson, William D

2014-09-01

Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries, we analyzed existing evidence of potential benefit that could result from newborn CMV screening. We first estimated the numbers of children with the most important CMV-related disabilities (i.e. hearing loss, cognitive deficit, and vision impairment), including the age at which the disabilities occur. Then, for each of the disabilities, we examined the existing evidence for the effectiveness of various interventions. We concluded that there is good evidence of potential benefit from nonpharmaceutical interventions for children with delayed hearing loss that occurs by 9 months of age. Similarly, we concluded that there is fair evidence of potential benefit from antiviral therapy for children with hearing loss at birth and from nonpharmaceutical interventions for children with delayed hearing loss occurring between 9 and 24 months of age and for children with CMV-related cognitive deficits. We found poor evidence of potential benefit for children with delayed hearing loss occurring after 24 months of age and for children with vision impairment. Overall, we estimated that in the United States, several thousand children with congenital CMV could benefit each year from newborn CMV screening, early detection, and interventions. Copyright © 2014 John Wiley & Sons, Ltd.

Screening for dementia in primary care: a summary of the evidence for the U.S. Preventive Services Task Force.

Science.gov (United States)

Boustani, Malaz; Peterson, Britt; Hanson, Laura; Harris, Russell; Lohr, Kathleen N

2003-06-03

Dementia is a large and growing problem but is often not diagnosed in its earlier stages. Screening and earlier treatment could reduce the burden of suffering of this syndrome. To review the evidence of benefits and harms of screening for and earlier treatment of dementia. MEDLINE, PsycINFO, EMBASE, the Cochrane Library, experts, and bibliographies of reviews. The authors developed eight key questions representing a logical chain between screening and improved health outcomes, along with eligibility criteria for admissible evidence for each question. Admissible evidence was obtained by searching the data sources. Two reviewers abstracted relevant information using standardized abstraction forms and graded article quality according to U.S. Preventive Services Task Force criteria. No randomized, controlled trial of screening for dementia has been completed. Brief screening tools can detect some persons with early dementia (positive predictive value caregiver interventions may delay nursing home placement of patients who have caregivers, the relevance of this finding for persons who do not yet have caregivers is uncertain. Other potential benefits and harms of screening have not been studied. Screening tests can detect undiagnosed dementia. In persons with mild to moderate clinically detected Alzheimer disease, cholinesterase inhibitors are somewhat effective in slowing cognitive decline. The effect of cholinesterase inhibitors or other treatments on persons with dementia detected by screening is uncertain.

Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: A pragmatic cluster randomized controlled trial study protocol

Directory of Open Access Journals (Sweden)

Clouston Kathleen

2012-05-01

Full Text Available Abstract Background Fecal occult blood test screening in Canada is sub-optimal. Family physicians play a central role in screening and are limited by the time constraints of clinical practice. Patients face multiple barriers that further reduce completion rates. Tools that support family physicians in providing their patients with colorectal cancer information and that support uptake may prove useful. The primary objective of the study is to evaluate the efficacy of a patient decision aid (nurse-managed telephone support line and/or colorectal cancer screening website distributed by community-based family physicians, in improving colorectal cancer screening rates. Secondary objectives include evaluation of (disincentives to patient FOBT uptake and internet use among 50 to 74 year old males and females for health-related questions. Challenges faced by family physicians in engaging in collaborative partnerships with primary healthcare researchers will be documented. Methods/design A pragmatic, two-arm, randomized cluster controlled trial conducted in 22 community-based family practice clinics (36 clusters with 76 fee-for-service family physicians in Winnipeg, Manitoba, Canada. Each physician will enroll 30 patients attending their periodic health examination and at average risk for colorectal cancer. All physicians will follow their standard clinical practice for screening. Intervention group physicians will provide a fridge magnet to each patient that contains information facilitating access to the study-specific colorectal cancer screening decision aids (telephone help-line and website. The primary endpoint is patient fecal occult blood test completion rate after four months (intention to treat model. Multi-level analysis will include clinic, physician and patient level variables. Patient Personal Health Identification Numbers will be collected from those providing consent to facilitate analysis of repeat screening behavior. Secondary outcome

Hydrogen uptake by Azolla-Anabaena

International Nuclear Information System (INIS)

Ruschel, A.P.; Freitas, J.R. de; Silva, P.M.

1984-01-01

The hydrogen uptake in the Azolla-Anabaena system is studied. Tritium is used as tracer. Plants are incubated under different atmosphere composition: a) Air + 3 H 2 ; b) Air + CO 2 + 3 H 2 + CO; c) Air + 3 H 2 + CO; d) Air + CO 2 + 3 H 2 + CO to study the pathway of absorbed hydrogen in the Azolla - Anabaena system. Azolla-Anabaena showed greater hydrogen uptake under argonium atmosphere than under air. Carbon monoxide decreased hydrogen uptake. There are evidences of recycling of the hydrogen evolved through notrogenease. (Author) [pt

Retinal screening acceptance, laser treatment uptake and follow-up response in diabetics requiring laser therapy in an urban diabetes care centre

International Nuclear Information System (INIS)

Memon, S.

2015-01-01

To determine the acceptance of retinal screening, Laser uptake and subsequent follow-up in diabetic patients attending the Diabetes Centre of Diabetic Association of Pakistan (DAP), Karachi. Study Design: Observational case series. Place and Duration of Study: Diabetic Centre of Diabetic Association of Pakistan (DAP), Karachi, from January 2011 to December 2012. Methodology: All the diabetic patients were screened for Diabetic Retinopathy (DR) with non-Mydriatic Fundus Camera (NMFC). Patients with DR were examined by the ophthalmologist using fundus lens and slit lamp. DR was graded for severity on the basis of modified Airlie House Classification. Patients with Sight Threatening Diabetic Retinopathy (STDR) were advised Laser treatment. Each patient was followed-up for at least 6 months. The records of patients recommended Laser were retrieved, and called for re-examination. Results: Retinal screening was accepted by all of the 8368 registered diabetics attending DAP Centre. On fundus photography, 21.2% (1777) individuals were found to have DR. Seven hundred and five (39.5%) patients were found to have STDR. Laser was advised to 96.4% (680) of STDR patients; amongst whom 70.5% (480) accepted Laser treatment. Out of 480 patients who had Laser treatment, 21.2% (107) turned out for follow-up after 6 months. Conclusion: Acceptance of retinal screening and Laser application was good; but follow-up was suboptional. (author)

Promoting community practitioners' use of evidence-based approaches to increase breast cancer screening.

Science.gov (United States)

Leeman, Jennifer; Moore, Alexis; Teal, Randall; Barrett, Nadine; Leighton, Ashely; Steckler, Allan

2013-07-01

Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients. © 2013 Wiley Periodicals, Inc.

Patient and primary care provider attitudes and adherence towards lung cancer screening at an academic medical center

Directory of Open Access Journals (Sweden)

Duy K. Duong

2017-06-01

Full Text Available Low dose CT (LDCT for lung cancer screening is an evidence-based, guideline recommended, and Medicare approved test but uptake requires further study. We therefore conducted patient and provider surveys to elucidate factors associated with utilization. Patients referred for LDCT at an academic medical center were questioned about their attitudes, knowledge, and beliefs on lung cancer screening. Adherent patients were defined as those who met screening eligibility criteria and completed a LDCT. Referring primary care providers within this same medical system were surveyed in parallel about their practice patterns, attitudes, knowledge and beliefs about screening. Eighty patients responded (36%, 48 of whom were adherent. Among responders, non-Hispanic patients (p = 0.04 were more adherent. Adherent respondents believed that CT technology is accurate and early detection is useful, and they trusted their providers. A majority of non-adherent patients (79% self-reported an intention to obtain a LDCT in the future. Of 36 of 87 (41% responding providers, only 31% knew the correct lung cancer screening eligibility criteria, which led to a 37% inappropriate referral rate from 2013 to 2015. Yet, 75% had initiated lung cancer screening discussions, 64% thought screening was at least moderately effective, and 82% were interested in learning more of the 33 providers responding to these questions. Overall, patients were motivated and providers engaged to screen for lung cancer by LDCT. Non-adherent patient “procrastinators” were motivated to undergo screening in the future. Additional follow through on non-adherence may enhance screening uptake, and raising awareness for screening eligibility through provider education may reduce inappropriate referrals.

Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

Science.gov (United States)

Choma, Kim; McKeever, Amy E

2015-02-01

The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

Diselenolane-mediated cellular uptake.

Science.gov (United States)

Chuard, Nicolas; Poblador-Bahamonde, Amalia I; Zong, Lili; Bartolami, Eline; Hildebrandt, Jana; Weigand, Wolfgang; Sakai, Naomi; Matile, Stefan

2018-02-21

The emerging power of thiol-mediated uptake with strained disulfides called for a move from sulfur to selenium. We report that according to results with fluorescent model substrates, cellular uptake with 1,2-diselenolanes exceeds uptake with 1,2-dithiolanes and epidithiodiketopiperazines with regard to efficiency as well as intracellular localization. The diselenide analog of lipoic acid performs best. This 1,2-diselenolane delivers fluorophores efficiently to the cytosol of HeLa Kyoto cells, without detectable endosomal capture as with 1,2-dithiolanes or dominant escape into the nucleus as with epidithiodiketopiperazines. Diselenolane-mediated cytosolic delivery is non-toxic (MTT assay), sensitive to temperature but insensitive to inhibitors of endocytosis (chlorpromazine, methyl-β-cyclodextrin, wortmannin, cytochalasin B) and conventional thiol-mediated uptake (Ellman's reagent), and to serum. Selenophilicity, the extreme CSeSeC dihedral angle of 0° and the high but different acidity of primary and secondary selenols might all contribute to uptake. Thiol-exchange affinity chromatography is introduced as operational mimic of thiol-mediated uptake that provides, in combination with rate enhancement of DTT oxidation, direct experimental evidence for existence and nature of the involved selenosulfides.

Text Messaging Interventions on Cancer Screening Rates: A Systematic Review.

Science.gov (United States)

Uy, Catherine; Lopez, Jennifer; Trinh-Shevrin, Chau; Kwon, Simona C; Sherman, Scott E; Liang, Peter S

2017-08-24

Despite high-quality evidence demonstrating that screening reduces mortality from breast, cervical, colorectal, and lung cancers, a substantial portion of the population remains inadequately screened. There is a critical need to identify interventions that increase the uptake and adoption of evidence-based screening guidelines for preventable cancers at the community practice level. Text messaging (short message service, SMS) has been effective in promoting behavioral change in various clinical settings, but the overall impact and reach of text messaging interventions on cancer screening are unknown. The objective of this systematic review was to assess the effect of text messaging interventions on screening for breast, cervical, colorectal, and lung cancers. We searched multiple databases for studies published between the years 2000 and 2017, including PubMed, EMBASE, and the Cochrane Library, to identify controlled trials that measured the effect of text messaging on screening for breast, cervical, colorectal, or lung cancers. Study quality was evaluated using the Cochrane risk of bias tool. Our search yielded 2238 citations, of which 31 underwent full review and 9 met inclusion criteria. Five studies examined screening for breast cancer, one for cervical cancer, and three for colorectal cancer. No studies were found for lung cancer screening. Absolute screening rates for individuals who received text message interventions were 0.6% to 15.0% higher than for controls. Unadjusted relative screening rates for text message recipients were 4% to 63% higher compared with controls. Text messaging interventions appear to moderately increase screening rates for breast and cervical cancer and may have a small effect on colorectal cancer screening. Benefit was observed in various countries, including resource-poor and non-English-speaking populations. Given the paucity of data, additional research is needed to better quantify the effectiveness of this promising intervention

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?†

Science.gov (United States)

Cannon, Michael J.; Griffiths, Paul D.; Aston, Van; Rawlinson, William D.

2015-01-01

SUMMARY Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries, we analyzed existing evidence of potential benefit that could result from newborn CMV screening. We first estimated the numbers of children with the most important CMV-related disabilities (i.e. hearing loss, cognitive deficit, and vision impairment), including the age at which the disabilities occur. Then, for each of the disabilities, we examined the existing evidence for the effectiveness of various interventions. We concluded that there is good evidence of potential benefit from nonpharmaceutical interventions for children with delayed hearing loss that occurs by 9 months of age. Similarly, we concluded that there is fair evidence of potential benefit from antiviral therapy for children with hearing loss at birth and from nonpharmaceutical interventions for children with delayed hearing loss occurring between 9 and 24 months of age and for children with CMV-related cognitive deficits. We found poor evidence of potential benefit for children with delayed hearing loss occurring after 24 months of age and for children with vision impairment. Overall, we estimated that in the United States, several thousand children with congenital CMV could benefit each year from newborn CMV screening, early detection, and interventions. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24760655

Rationale and design of the HOME trial: A pragmatic randomized controlled trial of home-based human papillomavirus (HPV) self-sampling for increasing cervical cancer screening uptake and effectiveness in a U.S. healthcare system.

Science.gov (United States)

Winer, Rachel L; Tiro, Jasmin A; Miglioretti, Diana L; Thayer, Chris; Beatty, Tara; Lin, John; Gao, Hongyuan; Kimbel, Kilian; Buist, Diana S M

2018-01-01

Women who delay or do not attend Papanicolaou (Pap) screening are at increased risk for cervical cancer. Trials in countries with organized screening programs have demonstrated that mailing high-risk (hr) human papillomavirus (HPV) self-sampling kits to under-screened women increases participation, but U.S. data are lacking. HOME is a pragmatic randomized controlled trial set within a U.S. integrated healthcare delivery system to compare two programmatic approaches for increasing cervical cancer screening uptake and effectiveness in under-screened women (≥3.4years since last Pap) aged 30-64years: 1) usual care (annual patient reminders and ad hoc outreach by clinics) and 2) usual care plus mailed hrHPV self-screening kits. Over 2.5years, eligible women were identified through electronic medical record (EMR) data and randomized 1:1 to the intervention or control arm. Women in the intervention arm were mailed kits with pre-paid envelopes to return samples to the central clinical laboratory for hrHPV testing. Results were documented in the EMR to notify women's primary care providers of appropriate follow-up. Primary outcomes are detection and treatment of cervical neoplasia. Secondary outcomes are cervical cancer screening uptake, abnormal screening results, and women's experiences and attitudes towards hrHPV self-sampling and follow-up of hrHPV-positive results (measured through surveys and interviews). The trial was designed to evaluate whether a programmatic strategy incorporating hrHPV self-sampling is effective in promoting adherence to the complete screening process (including follow-up of abnormal screening results and treatment). The objective of this report is to describe the rationale and design of this pragmatic trial. Copyright © 2017 Elsevier Inc. All rights reserved.

Breast Cancer Screening and Social Media: a Content Analysis of Evidence Use and Guideline Opinions on Twitter.

Science.gov (United States)

Nastasi, Anthony; Bryant, Tyler; Canner, Joseph K; Dredze, Mark; Camp, Melissa S; Nagarajan, Neeraja

2018-06-01

There is ongoing debate regarding the best mammography screening practices. Twitter has become a powerful tool for disseminating medical news and fostering healthcare conversations; however, little work has been done examining these conversations in the context of how users are sharing evidence and discussing current guidelines for breast cancer screening. To characterize the Twitter conversation on mammography and assess the quality of evidence used as well as opinions regarding current screening guidelines, individual tweets using mammography-related hashtags were prospectively pulled from Twitter from 5 November 2015 to 11 December 2015. Content analysis was performed on the tweets by abstracting data related to user demographics, content, evidence use, and guideline opinions. Standard descriptive statistics were used to summarize the results. Comparisons were made by demographics, tweet type (testable claim, advice, personal experience, etc.), and user type (non-healthcare, physician, cancer specialist, etc.). The primary outcomes were how users are tweeting about breast cancer screening, the quality of evidence they are using, and their opinions regarding guidelines. The most frequent user type of the 1345 tweets was "non-healthcare" with 323 tweets (32.5%). Physicians had 1.87 times higher odds (95% CI, 0.69-5.07) of providing explicit support with a reference and 11.70 times higher odds (95% CI, 3.41-40.13) of posting a tweet likely to be supported by the scientific community compared to non-healthcare users. Only 2.9% of guideline tweets approved of the guidelines while 14.6% claimed to be confused by them. Non-healthcare users comprise a significant proportion of participants in mammography conversations, with tweets often containing claims that are false, not explicitly backed by scientific evidence, and in favor of alternative "natural" breast cancer prevention and treatment. Furthermore, users appear to have low approval and confusion regarding

Disparities in the use of screening magnetic resonance imaging of the breast in community practice by race, ethnicity, and socioeconomic status.

Science.gov (United States)

Haas, Jennifer S; Hill, Deirdre A; Wellman, Robert D; Hubbard, Rebecca A; Lee, Christoph I; Wernli, Karen J; Stout, Natasha K; Tosteson, Anna N A; Henderson, Louise M; Alford-Teaster, Jennifer A; Onega, Tracy L

2016-02-15

Uptake of breast magnetic resonance imaging (MRI) coupled with breast cancer risk assessment offers the opportunity to tailor the benefits and harms of screening strategies for women with differing cancer risks. Despite the potential benefits, there is also concern for worsening population-based health disparities. Among 316,172 women aged 35 to 69 years from 5 Breast Cancer Surveillance Consortium registries (2007-2012), the authors examined 617,723 negative screening mammograms and 1047 screening MRIs. They examined the relative risks (RRs) of MRI use by women with a college or technical school were 43% more likely and those who had at least a college degree were 132% more likely to receive an MRI compared with those with a high school education or less. Among women with a ≥20% lifetime risk, there was no statistically significant difference noted with regard to the use of screening MRI by race or ethnicity, but high-risk women with a high school education or less were less likely to undergo screening MRI than women who had graduated from college (RR, 0.40; 95% confidence interval, 0.25-0.63). Uptake of screening MRI of the breast into clinical practice has the potential to worsen population-based health disparities. Policies beyond health insurance coverage should ensure that the use of this screening modality reflects evidence-based guidelines. © 2015 American Cancer Society.

Breast cancer screening: evidence for false reassurance?

NARCIS (Netherlands)

R. de Gelder (Rianne); E. As, van (Elisabeth); M.M.A. Tilanus-Linthorst (Madeleine); C.C.M. Bartels (Carina); R. Boer (Rob); G. Draisma (Gerrit); H.J. de Koning (Harry)

2008-01-01

textabstractTumour stage distribution at repeated mammography screening is, unexpectedly, often not more favourable than stage distribution at first screenings. False reassurance, i.e., delayed symptom presentation due to having participated in earlier screening rounds, might be associated with

Socioeconomic position and participation in colorectal cancer screening

DEFF Research Database (Denmark)

Frederiksen, B L; Jørgensen, Torben; Brasso, K

2010-01-01

Colorectal cancer (CRC) screening with faecal occult blood test (FOBT) has the potential to reduce the incidence and mortality of CRC. Screening uptake is known to be inferior in people with low socioeconomic position (SEP) when compared with those with high position; however, the results of most...... information on education, employment, and income to encompass different but related aspects of socioeconomic stratification. Also, the impact of ethnicity and cohabiting status was analysed.......Colorectal cancer (CRC) screening with faecal occult blood test (FOBT) has the potential to reduce the incidence and mortality of CRC. Screening uptake is known to be inferior in people with low socioeconomic position (SEP) when compared with those with high position; however, the results of most...... previous studies have limited value because they are based on recall or area-based measures of socioeconomic position, and might thus be subject to selective participation and misclassification. In this study we investigated differences in CRC screening participation using register-based individual...

Pre-screening Discussions and Prostate-Specific Antigen Testing for Prostate Cancer Screening.

Science.gov (United States)

Li, Jun; Zhao, Guixiang; Hall, Ingrid J

2015-08-01

For many men, the net benefit of prostate cancer screening with prostate-specific antigen (PSA) tests may be small. Many major medical organizations have issued recommendations for prostate cancer screening, stressing the need for shared decision making before ordering a test. The purpose of this study is to better understand associations between discussions about benefits and harms of PSA testing and uptake of the test among men aged ≥40 years. Associations between pre-screening discussions and PSA testing were examined using self-reported data from the 2012 Behavioral Risk Factor Surveillance System. Unadjusted prevalence of PSA testing was estimated and AORs were calculated using logistic regression in 2014. The multivariate analysis showed that men who had ever discussed advantages of PSA testing only or discussed both advantages and disadvantages were more likely, respectively, to report having had a test within the past year than men who had no discussions (ptesting with their healthcare providers were more likely (AOR=2.75, 95% CI=2.00, 3.79) to report getting tested than men who had no discussions. Discussions of the benefits or harms of PSA testing are positively associated with increased uptake of the test. Given the conflicting recommendations for prostate cancer screening and increasing importance of shared decision making, this study points to the need for understanding how pre-screening discussions are being conducted in clinical practice and the role played by patients' values and preferences in decisions about PSA testing. Published by Elsevier Inc.

Mechanisms regulating brain docosahexaenoic acid uptake: what is the recent evidence?

Science.gov (United States)

Chouinard-Watkins, Raphaël; Lacombe, R J Scott; Bazinet, Richard P

2018-03-01

To summarize recent advances pertaining to the mechanisms regulating brain docosahexaenoic acid (DHA) uptake. DHA is an omega-3 polyunsaturated fatty acid highly enriched in neuronal membranes and it is implicated in several important neurological processes. However, DHA synthesis is extremely limited within the brain. There are two main plasma pools that supply the brain with DHA: the nonesterified pool and the lysophosphatidylcholine (lysoPtdCho) pool. Quantitatively, plasma nonesterified-DHA (NE-DHA) is the main contributor to brain DHA. Fatty acid transport protein 1 (FATP1) in addition to fatty acid-binding protein 5 (FABP5) are key players that regulate brain uptake of NE-DHA. However, the plasma half-life of lysoPtdCho-DHA and its brain partition coefficient are higher than those of NE-DHA after intravenous administration. The mechanisms regulating brain DHA uptake are more complicated than once believed, but recent advances provide some clarity notably by suggesting that FATP1 and FABP5 are key contributors to cellular uptake of DHA at the blood-brain barrier. Elucidating how DHA enters the brain is important as we might be able to identify methods to better deliver DHA to the brain as a potential therapeutic.

Reasons for low uptake of referrals to ear and hearing services for children in Malawi.

Directory of Open Access Journals (Sweden)

Tess Bright

Full Text Available Early detection and appropriate intervention for children with hearing impairment is important for maximizing functioning and quality of life. The lack of ear and hearing services in low income countries is a significant challenge, however, evidence suggests that even where such services are available, and children are referred to them, uptake is low. The aim of this study was to assess uptake of and barriers to referrals to ear and hearing services for children in Thyolo District, Malawi.This was a mixed methods study. A survey was conducted with 170 caregivers of children who were referred for ear and hearing services during community-based screening camps to assess whether they had attended their referral and reasons for non-attendance. Semi-structured interviews were conducted with 23 caregivers of children who did not take up their referral to explore in-depth the reasons for non-uptake. In addition, 15 stakeholders were interviewed. Thematic analysis of the interview data was conducted and emerging trends were analysed.Referral uptake was very low with only 5 out of 150 (3% children attending. Seven main interacting themes for non-uptake of referral were identified in the semi-structured interviews: location of the hospital, lack of transport, other indirect costs of seeking care, fear and uncertainty about the referral hospital, procedural problems within the camps, awareness and understanding of hearing loss, and lack of visibility and availability of services.This study has highlighted a range of interacting challenges faced by families in accessing ear and hearing services in this setting. Understanding these context specific barriers to non-uptake of ear and hearing services is important for designing appropriate interventions to increase uptake.

"Pee-in-a-Pot": acceptability and uptake of on-site chlamydia screening in a student population in the Republic of Ireland

LENUS (Irish Health Repository)

Vaughan, Deirdre

2010-11-11

Abstract Background The aim of the study was to explore the acceptability and uptake of on-campus screening using a youth friendly approach in two Third Level higher education institutions (HEIs). This study is part of wider research exploring the optimal setting for chlamydia screening in Ireland. Methods Male and female students were given the opportunity to take a free anonymous test for chlamydia during a one week programme of "pee-in-a-pot" days at two HEI campuses in the West of Ireland. The study was set up after extensive consultation with the two HEIs and advertised on the two campuses using a variety of media in the two weeks preceding the screening days. Screening involved the provision and distribution of testing packs at communal areas and in toilet facilities. In Ireland, chlamydia notifications are highest amongst 20-29 year olds and hence the screening criterion was aimed at 18-29 year olds. Urine samples were tested using a nucleic acid amplification test (NAAT). Following the screening days, qualitative in-depth interviews were conducted with participants about their experiences of the event. Results Out of 1,249 test kits distributed in two HEIs, 592 specimens were collected giving a return rate of 47.5%. Tests excluded (54) were due to labelling errors or ineligibility of participants\\' age. Two thirds of those tested were females and the mean age was 21 years. Overall,3.9% (21\\/538) of participants tested positive, 5% (17\\/336) among females and 2% (4\\/191) among males. Participant interviews identified factors which enhanced student participation such as anonymity, convenience, accessibility of testing, and the informal and non-medical approach to testing. Conclusions Screening for chlamydia using on-campus "pee-in-a-pot" days is an acceptable strategy in this population. This model can detect and treat asymptomatic cases of chlamydia and avoid many of the barriers associated with testing for sexually transmitted infections (STIs) in

A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

Science.gov (United States)

Geddie, Hannah; Dobrow, Mark J; Hoch, Jeffrey S; Rabeneck, Linda

2012-06-01

Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media

Estimation of maximal oxygen uptake without exercise testing in Korean healthy adult workers.

Science.gov (United States)

Jang, Tae-Won; Park, Shin-Goo; Kim, Hyoung-Ryoul; Kim, Jung-Man; Hong, Young-Seoub; Kim, Byoung-Gwon

2012-08-01

Maximal oxygen uptake is generally accepted as the most valid and reliable index of cardiorespiratory fitness and functional aerobic capacity. The exercise test for measuring maximal oxygen uptake is unsuitable for screening tests in public heath examinations, because of the potential risks of exercise exertion and time demands. We designed this study to determine whether work-related physical activity is a potential predictor of maximal oxygen uptake, and to develop a maximal oxygen uptake equation using a non-exercise regression model for the cardiorespiratory fitness test in Korean adult workers. Study subjects were adult workers of small-sized companies in Korea. Subjects with history of disease such as hypertension, diabetes, asthma and angina were excluded. In total, 217 adult subjects (113 men of 21-55 years old and 104 women of 20-64 years old) were included. Self-report questionnaire survey was conducted on study subjects, and maximal oxygen uptake of each subject was measured with the exercise test. The statistical analysis was carried out to develop an equation for estimating maximal oxygen uptake. The predictors for estimating maximal oxygen uptake included age, gender, body mass index, smoking, leisure-time physical activity and the factors representing work-related physical activity. The work-related physical activity was identified to be a predictor of maximal oxygen uptake. Moreover, the equation showed high validity according to the statistical analysis. The equation for estimating maximal oxygen uptake developed in the present study could be used as a screening test for assessing cardiorespiratory fitness in Korean adult workers.

The effects of pH and temperature on phosphate and nitrate uptake ...

African Journals Online (AJOL)

The objective of this study was to ascertain the effects of pH and temperature on nutrient uptake efficiency of 3 wastewater protozoan isolates (Aspidisca (A), Trachelophyllum (B) and Peranema (C)) that have previously been screened for nutrient uptake ability. The study was carried out in shake flask at pH 5, 6, 7, 8 and 9 ...

Fecal occult blood test for colorectal cancer screening: an evidence-based analysis.

Science.gov (United States)

2009-01-01

The colorectal cancer (CRC) screening project was undertaken by the Medical Advisory Secretariat (MAS) in collaboration with the Cancer Care Ontario (CCO).In November 2007, the Ontario Health Technology Advisory Committee (OHTAC) MAS to conduct an evidence-based analysis of the available data with respect to colorectal cancer diagnosis and prevention. The general purpose of the project was to investigate the effectiveness, cost effectiveness, and safety of the various methods and techniques used for colorectal cancer screening in average risk people, 50 years of age and older.The options currently offered for colorectal cancer screening were reviewed and five technologies were selected for review:Computed tomographic (CT) colonographyMagnetic resonance (MR) colonographyWireless capsule endoscopy (PillCam Colon)Fecal occult blood test (FOBT)Flexible sigmoidoscopyIn this review, colonoscopy was considered as the "gold standard" technique by which the effectiveness of all other modalities could be evaluated. An economic analysis was also conducted to determine cost-effectiveness of different screening modalities.Evidence-based analyses have been prepared for each of these technologies, as well as summary document that includes an economic analysis, all of which are presented at the MAS Web site: http://www.health.gov.on.ca/english/providers/program/mas/tech/techmn.html The objective of this evidence review is to examine the effectiveness and cost-effectiveness of fecal occult blood testing (FOBT), including guaiac FOBT (gFOBT) and immunochemical FOBT (iFOBT), for use in colorectal cancer (CRC) screening in asymptomatic, average-risk adults. Specifically: Is the use of gFOBT or iFOBT associated with a reduction in CRC and overall mortality?What are the sensitivity and specificity of gFOBT and iFOBT for the detection of 1) CRC and 2) large polyps (≥ 1 cm)? CRC is the most common cause of non-tobacco related cancer death in Canada. It has been estimated that in 2007, 7

Screening tool for oropharyngeal dysphagia in stroke - Part I: evidence of validity based on the content and response processes.

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Almeida, Tatiana Magalhães de; Cola, Paula Cristina; Pernambuco, Leandro de Araújo; Magalhães, Hipólito Virgílio; Magnoni, Carlos Daniel; Silva, Roberta Gonçalves da

2017-08-17

The aim of the present study was to identify the evidence of validity based on the content and response process of the Rastreamento de Disfagia Orofaríngea no Acidente Vascular Encefálico (RADAVE; "Screening Tool for Oropharyngeal Dysphagia in Stroke"). The criteria used to elaborate the questions were based on a literature review. A group of judges consisting of 19 different health professionals evaluated the relevance and representativeness of the questions, and the results were analyzed using the Content Validity Index. In order to evidence validity based on the response processes, 23 health professionals administered the screening tool and analyzed the questions using a structured scale and cognitive interview. The RADAVE structured to be applied in two stages. The first version consisted of 18 questions in stage I and 11 questions in stage II. Eight questions in stage I and four in stage II did not reach the minimum Content Validity Index, requiring reformulation by the authors. The cognitive interview demonstrated some misconceptions. New adjustments were made and the final version was produced with 12 questions in stage I and six questions in stage II. It was possible to develop a screening tool for dysphagia in stroke with adequate evidence of validity based on content and response processes. Both validity evidences obtained so far allowed to adjust the screening tool in relation to its construct. The next studies will analyze the other evidences of validity and the measures of accuracy.

Perspectives on cervical cancer screening among educated Muslim women in Dubai (the UAE): a qualitative study.

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Khan, Sarah; Woolhead, Gillian

2015-10-24

Cervical cancer (CC) is the seventh leading cause of death among women in the United Arab Emirates (UAE), with most deaths attributed to late detection of this cancer. The UAE lacks a national CC screening programme. Thus, cervical screening is only performed opportunistically during women's visits to health facilities. CC screening rates in the UAE are as low as 16.9 %, and little is known about the perspectives of the nation's educated Muslim women regarding screening. Consequently, the aim of this study is to explore Muslim women's perspectives towards cervical screening in Dubai to promote strategies for increasing its uptake, thereby leading to a decrease in morbidity and mortality associated with CC. Interpretivist and social constructivist epistemological approaches were applied for this qualitative study. Data were obtained through 13 in-depth interviews. Purposive and snowballing methods were used to recruit six South Asian women and seven Emirati women living in Dubai. Thematic content analysis was concurrently applied with comparative analysis to the data. Four themes regarding women's perceptions of CC emerged from the data. First, CC was considered a 'silent disease' that could be detected with early screening. However, it was also associated with extramarital sexual relations, which negatively influenced screening uptake. Second, women's fear, pain and embarrassment, along with cultural influences, deterred them from undergoing screening. Third, a growing mistrust of allopathic medicine and impersonal healthcare promoted a negative view of screening. Last, women became aware of screening mainly when they were pregnant or receiving fertility treatment. The study highlighted a number of important factors relating to cultural, religious and sexual behaviour that shaped educated Muslim women's perspectives on CC screening. Evidently, the current opportunistic approach to screening is flawed. A national awareness programme on CC screening should be

Promoting breast screening in Glasgow.

Science.gov (United States)

Cohen, L; Dobson, H; McGuire, F

2000-03-01

To establish whether there is a role for advertising in the promotion of the Breast Screening Programme and what the role of advertising might be. Four hundred and sixty questionnaires were completed by women attending their breast screening appointment. Quantitative and qualitative data were collected from the static unit at Calder Street and the mobile unit in Govan. The advertising (budget 30,000 Pounds) campaign ran over an eight week period in the Govan, Paisley Road West and Cardonald areas of Glasgow. Media used included press advertising, The Glasgow Underground, adshells, bus advertising (interiors) and poster distribution via local outlets. Forty-two per cent of the sample were aware of the campaign. Ninety-seven per cent liked the campaign images. Eighty eight per cent felt that breast screening should be advertised more. Screening uptake increased in the areas covered by the advertising campaign. Govan -58%-71% and Ibrox (Paisley Road West and Cardonald) -59%-61%. Women were very supportive of the role of advertising for the Breast Screening Programme. In particular they found the campaign images and messages reassuring, supportive and credible. Their views suggest that the role of advertising should be: To raise awareness of the service To make women more conscious of the benefits of screening To change public perceptions of the screening process However, it is recognised that a fully integrated approach is required for the promotion of the service to account for the improvement in uptake, as advertising cannot be expected to work in isolation.

Plant-uptake of uranium: Hydroponic and soil system studies

Science.gov (United States)

Ramaswami, A.; Carr, P.; Burkhardt, M.

2001-01-01

Limited information is available on screening and selection of terrestrial plants for uptake and translocation of uranium from soil. This article evaluates the removal of uranium from water and soil by selected plants, comparing plant performance in hydroponic systems with that in two soil systems (a sandy-loam soil and an organic-rich soil). Plants selected for this study were Sunflower (Helianthus giganteus), Spring Vetch (Vicia sativa), Hairy Vetch (Vicia villosa), Juniper (Juniperus monosperma), Indian Mustard (Brassica juncea), and Bush Bean (Phaseolus nanus). Plant performance was evaluated both in terms of the percent uranium extracted from the three systems, as well as the biological absorption coefficient (BAC) that normalized uranium uptake to plant biomass. Study results indicate that uranium extraction efficiency decreased sharply across hydroponic, sandy and organic soil systems, indicating that soil organic matter sequestered uranium, rendering it largely unavailable for plant uptake. These results indicate that site-specific soils must be used to screen plants for uranium extraction capability; plant behavior in hydroponic systems does not correlate well with that in soil systems. One plant species, Juniper, exhibited consistent uranium extraction efficiencies and BACs in both sandy and organic soils, suggesting unique uranium extraction capabilities.

Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries.

Science.gov (United States)

Ali, Suhailah; Skirton, Heather; Clark, Maria T; Donaldson, Craig

2017-12-01

Population-based screening programs have resulted in minimizing mortality and morbidity from cervical cancer. The aim of this integrative review was to explore the factors influencing access of women from Western Asian and Middle Eastern Arab countries to cervical cancer screening. A systematic search for studies conducted in Arab countries in those regions, and published in English between January 2002 and January 2017, was undertaken. Thirteen papers were selected and subjected to quality appraisal. A three step analysis was used, which involved a summary of the evidence, analysis of both quantitative and qualitative data, and integration of the results in narrative form. Few population-based cervical cancer screening programs had been implemented in the relevant countries, with low knowledge of, and perceptions about, cervical screening among Arab women, the majority of whom are Muslim. Factors affecting the uptake of cervical cancer screening practices were the absence of organized, systematic programs, low screening knowledge among women, healthcare professionals' attitudes toward screening, pain and embarrassment, stigma, and sociocultural beliefs. Policy changes are urgently needed to promote population-based screening programs. Future research should address the promotion of culturally-sensitive strategies to enable better access of Arab Muslim women to cervical cancer screening. © 2017 John Wiley & Sons Australia, Ltd.

Scientific Evidence for Different Options for GDM Screening and Management: Controversies and Review of the Literature

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Claudia Caissutti

2017-01-01

Full Text Available Background. Gestational diabetes (GDM affects up to 7% of pregnant women and is associated with several maternal and perinatal morbidities. International organizations suggest several different recommendations regarding how to screen and to manage GDM. Objective. We aimed to analyze the most important and employed guidelines about screening and management of GDM and we investigated existing related literature. Results. We found several different criteria for screening for GDM, for monitoring GDM, and for starting pharmacological therapy. When using IADPSG criteria, GDM rate increased, perinatal outcomes improved, and screening became cost-effective. Compared to no treatment, treatment of women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria has limited evidence for an effect on adverse pregnancy outcomes.

Using online adverts to increase the uptake of cervical screening amongst "real Eastenders": an opportunistic controlled trial.

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Jones, Ray B; Soler-Lopez, Mar; Zahra, Daniel; Shankleman, Judith; Trenchard-Mabere, Esther

2013-03-26

Cervical screening uptake has increased as a result of occurrences of cervical cancer in TV 'soap operas' and in real life celebrities such as Jade Goody. Media analysis at the time of Jade Goody's death suggested the NHS did not take sufficient advantage of this opportunity to improve cervical screening rates. Google AdWords has been used to recruit and raise awareness of health but we were not aware of its use to supplement media events. This was an opportunistic service evaluation to accompany a cervical cancer storyline in Eastenders (a TV 'soap opera'). We ran an AdWords campaign based on keywords such as 'Eastenders', and 'cervical cancer' in a one mile radius in East London, linked to one webpage giving details of 10 practices and other links on cervical cancer. We recorded costs of adverts and setting up the webpage. We used routine statistics from Tower Hamlets, City and Hackney, and Newham Primary Care Trusts (PCTs) of the number of smears, eligible populations, and coverage by practice by month from September 2010 to January 2012 to compare the ten intervention practices with controls. Eight people per day in the target area viewed the project webpage. The cost of setting up the website and running Google AdWords was £1320 or £1.88 per person viewing the webpage. Unlike Jade Goody's death, there was no major impact from the Eastenders' storyline on Google searches for cervical cancer. There was considerable monthly variation in the number of smear tests in the 3 PCTs. The AdWords campaign may have had some effect on smear rates but this showed, at best, a marginal statistical difference. Assuming a 'real' effect, the intervention may have resulted in 110 'extra' women being screened but there was no change in coverage. Although the Eastenders storyline seemed to have no effect on interest in cervical cancer or screening, the AdWords campaign may have had some effect. Given the small scale exploratory nature of the study this was not statistically

Phosphorus deficiency enhances molybdenum uptake by tomato plants

International Nuclear Information System (INIS)

Heuwinkel, H.; Kirkby, E.A.; Le Bot, J.; Marschner, H.

1992-01-01

Water culture experiments are described which provide conclusive evidence that Mo uptake by tomato plants is markedly enhanced by P deficiency. In a longterm experiment, which ran for 11 days, in marked contrast to the uptake of other nutrients, a three fold higher Mo uptake rate was observed after only four days of withdrawal of P from the nutrient medium. In contrast to the gradual increase in pH of the nutrient medium of the plants supplied with P, the pH in the medium of the -P plants fell. Throughout the growth of these plants net H+ efflux could be accounted for by excess cation over anion uptake, indicating that organic acid extrusion plays no major role in the observed fall in pH. Further evidence that Mo uptake is enhanced in P deficient tomato plants is provided in short-term nutrient solution experiments (1h and 4h) using radioactive molybdenum (99Mo). Compared with P sufficient plants, the uptake rates of 99Mo by P deficient plants were three to five times higher after 1h and nine to twelve times higher after 4h. Resupplying P during the uptake periods to deficient plants reduced the uptake rate of 99Mo to values similar to those of P sufficient plants. It is concluded that the uptake of molybdate occurs via phosphate binding/ transporting sites at the plasma membrane of root cells. Further support for this conclusion comes from exchange experiments with non-labelled molybdenum, which show a much larger amount of 99Mo exchangeable from the roots of P deficient plants

Impact of gender on decisions to participate in faecal immunochemical test-based colorectal cancer screening: a qualitative study.

Science.gov (United States)

Clarke, Nicholas; Gallagher, Pamela; Kearney, Patricia M; McNamara, Deirdre; Sharp, Linda

2016-12-01

Faecal immunochemical tests (FITs) are increasingly being used in population-based colorectal cancer-screening programmes. Uptake of FIT is lower in men than women; however, the reasons for this are not well understood. We aimed to explore gender differences in influences on decisions to participate in FIT screening. This is a qualitative study using in-depth face-to-face interviews of four groups of screening invitees (male and female screening users and male and female screening non-users), purposively sampled from the database of a population-based FIT screening programme. Recruitment continued until saturation was reached. Interviews were audio recorded and transcribed verbatim. Thematic analysis using the framework approach was employed with the theoretical domains framework guiding analysis. Forty-seven screening invitees were interviewed. Six theoretical domains influenced screening uptake: 'environmental context and resources', 'beliefs about capabilities', 'beliefs about consequences', 'emotions', 'social influences' and 'knowledge'. Male non-users were often fatalistic, less knowledgeable and misinformed about cancer and FIT screening compared with other groups. Female non-users expressed negative attitudes, beliefs and emotions towards FIT screening, cancer, social influences and the medical profession and were over-confident about their health. Negative attitudes and emotions to screening dominated non-user decision-making but differed by gender. Opportunities to improve uptake in men and women exist. Greater national discussions on the benefits of FIT screening, and development of screening materials tackling negative attitudes and beliefs while recognising male/female differences, may improve screening uptake. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Uptake of benzyladenine by excised watermelon cotyledons.

Science.gov (United States)

Lampugnani, M G; Fantelli, R; Longo, G P; Longo, C P; Rossi, G

1981-07-01

The uptake of 8-[(14)C]N(6)-benzyladenine (BA) was studied in excised watermelon (Citrullus vulgaris Schrad.) cotyledons 24 hours after the start of imbibition. The passive nature of this uptake is suggested by the following evidence: (a) no sign of saturation on increasing external concentration of BA; (b) no decrease in uptake under conditions that inhibit ATP synthesis; (c) no change in amount of radioactivity absorbed when cotyledons are frozen and thawed before the uptake test. About two-thirds of the radioactivity taken up is released after 12 hours of washing. If the washing is performed at 2 C very little radioactivity is released.There seems to be a correlation between the level of radioactivity (i.e. of BA + derivatives) present in the cotyledons and the magnitude of hormonal responses that are observed four days after uptake. This relationship holds regardless of whether a given level of radioactivity has been reached after a short period of uptake or after a long period of uptake followed by washing.

Xe-133 accumulation in fatty liver: hepatic uptake and washout correlated with pulmonary and mesenteric retention

International Nuclear Information System (INIS)

Samuels, L.D.

1980-01-01

Xe-133 uptake in patients with fatty livers is described and compared with uptake and retention in lungs, blood and mesenteric fat and with normal hepatic uptake. In the absence of obstructive lung disease or excessive obesity, Xe-133 uptake and retention is a valuable means of screening patients for the presence of fatty liver. Although non-specific for the etiology of fatty liver, the test is an effective and non-invasive method of detection which merits further application. (author)

Barriers to Breast and Cervical Cancer Screening in Singapore: a Mixed Methods Analysis.

Science.gov (United States)

Malhotra, Chetna; Bilger, Marcel; Liu, Joy; Finkelstein, Eric

2016-01-01

In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism. By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.

Serologic Screening for Genital Herpes: An Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Science.gov (United States)

Feltner, Cynthia; Grodensky, Catherine; Ebel, Charles; Middleton, Jennifer C; Harris, Russell P; Ashok, Mahima; Jonas, Daniel E

2016-12-20

Genital herpes simplex virus (HSV) infection is a prevalent sexually transmitted infection. Vertical transmission of HSV can lead to fetal morbidity and mortality. To assess the evidence on serologic screening and preventive interventions for genital HSV infection in asymptomatic adults and adolescents to support the US Preventive Services Task Force for an updated recommendation statement. MEDLINE, Cochrane Library, EMBASE, and trial registries through March 31, 2016. Surveillance for new evidence in targeted publications was conducted through October 31, 2016. English-language randomized clinical trials (RCTs) comparing screening with no screening in persons without past or current symptoms of genital herpes; studies evaluating accuracy and harms of serologic screening tests for HSV-2; RCTs assessing preventive interventions in asymptomatic persons seropositive for HSV-2. Dual review of abstracts, full-text articles, and study quality; pooled sensitivities and specificities of screening tests using a hierarchical summary receiver operating characteristic curve analysis when at least 3 similar studies were available. Accuracy of screening tests, benefits of screening, harms of screening, reduction in genital herpes outbreaks. A total of 17 studies (n = 9736 participants; range, 24-3290) in 19 publications were included. No RCTs compared screening with no screening. Most studies of the accuracy of screening tests were from populations with high HSV-2 prevalence (greater than 40% based on Western blot). Pooled estimates of sensitivity and specificity of the most commonly used test at the manufacturer's cutpoint were 99% (95% CI, 97%-100%) and 81% (95% CI, 68%-90%), respectively (10 studies; n = 6537). At higher cutpoints, pooled estimates were 95% (95% CI, 91%-97%) and 89% (95% CI, 82%-93%), respectively (7 studies; n = 5516). Use of this test at the manufacturer's cutpoint in a population of 100 000 with a prevalence of HSV-2 of 16% (the

Determinants of Breast and Cervical Cancer Screening Uptake Among Women in Turkey.

Science.gov (United States)

Sözmen, Kaan; Unal, Belgin; Sakarya, Sibel; Dinc, Gonul; Yardim, Nazan; Keskinkilic, Bekir; Ergör, Gül

2016-09-01

The aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening. © 2016 APJPH.

Colorectal cancer screening

OpenAIRE

Plumb, A. A.; Halligan, S.

2015-01-01

Colorectal cancer is a major public health burden worldwide. There is clear-cut evidence that screening will reduce colorectal cancer mortality and the only contentious issue is which screening tool to use. Most evidence points towards screening with fecal occult blood testing. The immunochemical fecal occult blood tests have a higher sensitivity than the guaiac-based tests. In addition, their automation and haemoglobin quantification allows a threshold for colonoscopy to be selected that can...

Determinants of a GP visit and cervical cancer screening examination in Great Britain.

Directory of Open Access Journals (Sweden)

Alexander Michael Labeit

Full Text Available In the UK, women are requested to attend a cervical cancer test every 3 years as part of the NHS Cervical Screening Programme. This analysis compares the determinants of a cervical cancer screening examination with the determinants of a GP visit in the same year and investigates if cervical cancer screening participation is more likely for women who visit their GP.A recursive probit model was used to analyse the determinants of GP visits and cervical cancer screening examinations. GP visits were considered to be endogenous in the cervical cancer screening examination. The analysed sample consisted of 52,551 observations from 8,386 women of the British Household Panel Survey.The analysis showed that a higher education level and a worsening self-perceived health status increased the probability of a GP visit, whereas smoking decreased the probability of a GP visit. GP visits enhanced the uptake of a cervical cancer screening examination in the same period. The only variables which had the same positive effect on both dependent variables were higher education and living with a partner. The probability of a cervical cancer screening examination increased also with previous cervical cancer screening examinations and being in the recommended age groups. All other variables had different results for the uptake of a GP visit or a cervical cancer screening examination.Most of the determinants of visiting a GP and cervical cancer screening examination differ from each other and a GP visit enhances the uptake of a smear test.

Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

Science.gov (United States)

D'Souza, Gypsyamber; Rajan, Shirani D.; Bhatia, Rohini; Cranston, Ross D.; Plankey, Michael W.; Silvestre, Anthony; Ostrow, David G.; Wiley, Dorothy; Shah, Nisha; Brewer, Noel T.

2013-01-01

Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM). Methods. Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression. Results. A history of anal Pap screening was uncommon among non–HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was “not a big deal” or “not as bad as expected,” and 3% reported that it was “scary.” Declining to have screening was associated with Black race, anxiety about screening, and low interest, but not age or HIV status. Conclusions. This study demonstrated high acceptance of anal Pap screening among both HIV-infected and non–HIV-infected MSM across 4 US sites. PMID:23865658

Seeing the electroporative uptake of cell-membrane impermeable fluorescent molecules and nanoparticles

Science.gov (United States)

Kim, Kisoo; Kim, Jeong Ah; Lee, Soon-Geul; Lee, Won Gu

2012-07-01

This paper presents direct visualization of uptake directionality for cell-membrane impermeant fluorescent molecules and fluorescence-doped nanoparticles at a single-cell level during electroporation. To observe directly the uptake direction, we used microchannel-type electroporation that can generate a relatively symmetric and uniform electric field. For all the image frames during electroporation, fluorescence intensities that occurred at cell membranes in both uptake directions toward the electrodes have been sequentially recorded and quantitatively analyzed pixel by pixel. In our experiments, we found that fluorescent molecules, even not labeled to target biomolecules, had their own uptake direction with different intensities. It is also observed that the uptake intensity toward the cell membrane had a maximal value at a certain electric voltage, not at the highest value of voltages applied. The results also imply that the uptake direction of fluorescence-doped nanoparticles can be determined by a net surface charge of uptake materials and sizes in the electroporative environments. In summary, we performed a quantitative screening and direct visualization of uptake directionality for a set of fluorescent molecules and fluorescence-doped nanoparticles using electric-pulsation. Taking a closer look at the uptake direction of exogenous materials will help researchers to understand an unknown uptake phenomenon in which way foreign materials are inclined to move, and furthermore to design functional nanoparticles for electroporative gene delivery.This paper presents direct visualization of uptake directionality for cell-membrane impermeant fluorescent molecules and fluorescence-doped nanoparticles at a single-cell level during electroporation. To observe directly the uptake direction, we used microchannel-type electroporation that can generate a relatively symmetric and uniform electric field. For all the image frames during electroporation, fluorescence intensities

What implementation interventions increase cancer screening rates? a systematic review

Directory of Open Access Journals (Sweden)

Lent Barbara

2011-09-01

Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic

Preferences for Mental Health Screening Among Pregnant Women: A Cross-Sectional Study.

Science.gov (United States)

Kingston, Dawn E; Biringer, Anne; McDonald, Sheila W; Heaman, Maureen I; Lasiuk, Gerri C; Hegadoren, Kathy M; McDonald, Sarah D; Veldhuyzen van Zanten, Sander; Sword, Wendy; Kingston, Joshua J; Jarema, Karly M; Vermeyden, Lydia; Austin, Marie-Paule

2015-10-01

The process of mental health screening can influence disclosure, uptake of referral, and treatment; however, no studies have explored pregnant women's views of methods of mental health screening. The objectives of this study are to determine pregnant women's comfort and preferences regarding mental health screening. Pregnant women were recruited (May-December 2013) for this cross-sectional descriptive survey from prenatal classes and maternity clinics in Alberta, Canada, if they were aged >16 years and spoke/read English. Descriptive statistics summarized acceptability of screening, and multivariable logistic regression identified factors associated with women's comfort with screening methods. Analysis was conducted in January-December 2014. The participation rate was 92% (N=460/500). Overall, 97.6% of women reported that they were very (74.8%) or somewhat (22.8%) comfortable with mental health screening in pregnancy. Women were most comfortable with completing paper- (>90%) and computer-based (>82%) screening in a clinic or at home, with fewest reporting comfort with telephone-based screening (62%). The majority of women were very/somewhat comfortable with provider-initiated (97.4%) versus self-initiated (68.7%) approaches. Women's ability to be honest with their provider about emotional health was most strongly associated with comfort with each method of screening. The majority of pregnant women viewed prenatal mental health screening favorably and were comfortable with a variety of screening methods. These findings provide evidence of high acceptability of screening--a key criterion for implementation of universal screening--and suggest that providers can select from a variety of screening methods best suited for their clinical setting. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Cervical cancer screening and psychosocial barriers perceived by patients. A systematic review.

Science.gov (United States)

Bukowska-Durawa, Alicja; Luszczynska, Aleksandra

2014-01-01

This study aimed at integrating research discussing the role of perceived psychosocial barriers in cervical cancer screening (CCS) uptake. In particular, we analyzed the evidence for the associations between CCS uptake and perceived psychosocial barriers and frequency of psychosocial barriers identified by women. A systematic search of peer-reviewed papers published until 2011 in 8 databases yielded 48 original studies, analyzing data obtained from 155 954 women. The majority of studies (k = 43) applied correlational design, while 5 had experimental design. Experimental research indicated a positive effect of 75% of psychosocial interventions targeting barriers. The interventions resulted in a significant increase of CCS uptake. Overall 100% of correlational studies indicated that perceiving lower levels of barriers significantly predicted higher CCS uptake. 53 psychosocial barriers were listed in at least 2 original correlational studies: 9.5% of barriers were related to CCS facilities/environment, 67.9% dealt with personal characteristics of the patient, and 22.6% addressed social factors. As many as 35.9% of perceived barriers referred to negative emotions related to CCS examination procedures and collecting CCS results, whereas 25.7% of barriers referred to prior contacts with health professionals. Leaflets or discussion on psychosocial barriers between patients and health professionals involved in CCS might increase CCS uptake and thus reduce cervical cancer mortality rates. Communication skills training for health professionals conducting CCS might focus on the most frequently reported barriers, referring to emotions related to CCS examination and collecting CCS results.

Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence.

Science.gov (United States)

Hope, Kirsty A; Moss, Esther; Redman, Charles W E; Sherman, Susan M

2017-08-01

Cervical cancer is the fourth most common cancer in women worldwide (WHO, 2016). In many developed countries the incidence of cervical cancer has been significantly reduced by the introduction of organised screening programmes however, in the UK, a fall in screening coverage is becoming a cause for concern. Much research attention has been afforded to younger women but age stratified mortality and incidence data suggest that older women's screening attendance is also worthy of study. This paper provides a review of current evidence concerning the psycho-social influences that older women experience when deciding whether to attend cervical screening. Few studies have focussed on older women and there are significant methodological issues with those that have included them in their samples. Findings from these studies indicate several barriers which may deter older women from screening, such as embarrassment and logistical issues. Drivers to screening include reassurance and a sense of obligation. Physical, social and emotional changes that occur as women age may also have an impact on attendance. This review concludes that there is a clear need for better understanding of the perceptions of older women specifically with regard to cervical cancer and screening. Future research should inform the design of targeted interventions and provision of information to enable informed decision-making regarding cervical screening among older women. Copyright © 2017 Elsevier Inc. All rights reserved.

Evidence on Synthesized Two-dimensional Mammography Versus Digital Mammography When Using Tomosynthesis (Three-dimensional Mammography) for Population Breast Cancer Screening.

Science.gov (United States)

Houssami, Nehmat

2017-09-28

One limitation of using digital breast tomosynthesis (3-dimensional [3D] mammography) technology with conventional (2-dimensional [2D]) mammography for breast cancer (BC) screening is the increased radiation dose from dual acquisitions. To resolve this problem, synthesized 2D (s2D) reconstruction images similar to 2D mammography were developed using tomosynthesis acquisitions. The present review summarizes the evidence for s2D versus digital mammography (2D) when using tomosynthesis (3D) for BC screening to address whether using s2D instead of 2D (alongside 3D) will yield similar detection measures. Comparative population screening studies have provided consistent evidence that cancer detection rates do not differ between integrated 2D/3D (range, 5.45-8.5/1000 screens) and s2D/3D (range, 5.03-8.8/1000 screens). Also, although the recall measures were relatively heterogeneous across included studies, little difference was found between the 2 modalities. The mean glandular dose for s2D/3D was 55% to 58% of that for 2D/3D. In the context of BC screening, s2D/3D involves substantially less radiation than 2D/3D and provides similar detection measures. Thus, consideration of transitioning to tomosynthesis screening should aim to use s2D/3D to minimize harm. Copyright © 2017 Elsevier Inc. All rights reserved.

Hg uptake in ureteral obstructions

International Nuclear Information System (INIS)

Desgrez, J.P.; Bourguignon, M.; Raynaud, C.; CEA, 91 - Orsay

1976-01-01

In the presence of a total obstruction the results obtained with the Hg uptake test, as indeed with other functional tests, inform on the value of the kidney function at the time but have no prognostic value where repair possibilities are concerned. Some preliminary results seem to show however that very soon after the obstacle is removed, by the 10th or 15th day perhaps, quantitative functional tests may once more be used to evaluate the functional prognosis. This would mean that by waiting about two weeks after the disappearance of a total obstruction the Hg uptake test may again be used in all confidence. In order to check this deduction, which is based on slender evidence but which nevertheless has important practical implications, the measurement of the Hg uptake rate during the days following removal of the obstacle appears essential. In long-standing partial obstructions the Hg uptake rate gives an accurate assessment of the functional balance and helps considerably in the choice of therapy [fr

Screening for type 2 diabetes: a short report for the National Screening Committee.

Science.gov (United States)

Waugh, N R; Shyangdan, D; Taylor-Phillips, S; Suri, G; Hall, B

2013-08-01

The prevalence of type 2 diabetes mellitus (T2DM) has been increasing, owing to increases in overweight and obesity, decreasing physical activity and the changing demographic structure of the population. People can develop T2DM without symptoms and up to 20% may be undiagnosed. They may have diabetic complications, such as retinopathy, by the time they are diagnosed, or may suffer a heart attack, without warning. Undiagnosed diabetes can be detected by raised blood glucose levels. The aim of this review was to provide an update for the UK National Screening Committee (NSC) on screening for T2DM. As this review was undertaken to update a previous Health Technology Assessment review published in 2007, and a more recent Scottish Public Health Network review, searches for evidence were restricted from 2009 to end of January 2012, with selected later studies added. The databases searched were MEDLINE, EMBASE, MEDLINE-in-Process & Other Non-Indexed Citations, Science Citation Index and Conference Proceedings Citation Index. The case for screening was considered against the criteria used by the NSC to assess proposed population screening programmes. Population screening for T2DM does not meet all of the NSC criteria. Criterion 12, on optimisation of existing management, has not been met. A report by the National Audit Office (NAO) gives details of shortcomings. Criterion 13 requires evidence from high-quality randomised controlled trials that screening is beneficial. This has not been met. The Ely trial of screening showed no benefit. The ADDITION trial was not a trial of screening, but showed no benefit in cardiovascular outcomes from intensive management in people with screen-detected T2DM. Criterion 18 on staffing and facilities does not appear to have been met, according to the NAO report. Criterion 19 requires that all other options, including prevention, should have been considered. A large proportion of cases of T2DM could be prevented if people avoided becoming

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

Directory of Open Access Journals (Sweden)

Alex Ghanouni

2017-04-01

Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

Science.gov (United States)

Ghanouni, Alex; Renzi, Cristina; Waller, Jo

2017-04-18

There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an

Emerging role of HPV self-sampling in cervical cancer screening for hard-to-reach women: Focused literature review.

Science.gov (United States)

Madzima, Tina R; Vahabi, Mandana; Lofters, Aisha

2017-08-01

To provide a focused critical review of the literature on the acceptability, feasibility, and uptake of human papillomavirus (HPV) self-sampling among hard-to-reach women. A focused search to obtain relevant literature published in English between 1997 and 2015 was done using PubMed and EMBASE using search terms including HPV self-test or HPV self-sample or HPV kit in combination with acceptability or feasibility . Only studies that focused on never-screened or underscreened populations were included in this review. Human papillomavirus self-sampling was found to be highly acceptable and feasible among these hard-to-reach women across most studies. Mailing of self-sampling kits has been shown to increase participation among hard-to reach women. Some concerns remain regarding adherence to further follow-up among high-risk women with positive test results for HPV after screening. There is a strong body of evidence to support the usefulness of HPV self-sampling in increasing participation of hard-to-reach women in screening programs (level I evidence). Convenience, privacy, ease of use, and, likely, cost-effectiveness of HPV self-sampling are driving forces in its emerging role in cervical cancer screening among hard-to-reach women. Key barriers to participation could be addressed by overcoming disparities in HPV-related knowledge and perceptions about cervical cancer screening. Copyright© the College of Family Physicians of Canada.

Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

Science.gov (United States)

Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

2017-10-05

To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Completing the cervical screening pathway: Factors that facilitate the increase of self-collection uptake among under-screened and never-screened women, an Australian pilot study.

Science.gov (United States)

McLachlan, E; Anderson, S; Hawkes, D; Saville, M; Arabena, K

2018-02-01

To examine factors that enhance under-screened and never-screened women's completion of the self-collection alternative pathway of the Renewed National Cervical Screening Program (ncsp) in Victoria, Australia. With the Australian ncsp changing, starting on 1 December 2017, the Medical Services Advisory Committee (msac) recommended implementing human papillomavirus (hpv) testing using a self-collected sample for under-screened and never-screened populations. In response, a multi-agency group implemented an hpv self-collection pilot project to trial self-collection screening pathways for eligible women. Quantitative data were collected on participation rates and compliance rates with follow-up procedures across three primary health care settings. Forty women who self-collected were interviewed in a semi-structured format, and seven agency staff completed in-depth interviews. Qualitative data were used to identify and understand clinical and personal enablers that assisted women to complete self-collection cervical screening pathways successfully. Eighty-five per cent (10 women) of participants who tested positive for hpv successfully received their results and completed follow-up procedures as required. Two remaining participants also received hpv-positive results. However, agencies were unable to engage them in follow-up services and procedures. The overall participation rate in screening (self-collection or Pap test) was 85.7% (84 women), with 79 women self-collecting. Qualitative data indicated that clear explanations on self-collection, development of trusting, empathetic relationships with health professionals, and recognition of participants' past experiences were critical to the successful completion of the self-collection pathway. When asked about possible inhibitors to screening and to following up on results and appointments, women cited poor physical and mental health, as well as financial and other structural barriers. A well-implemented process, led by

Physiological FDG uptake in the ovaries after hysterectomy

International Nuclear Information System (INIS)

Nishizawa, Sadahiko; Inubushi, Masayuki; Ozawa, Fukujiro; Kido, Aki; Okada, Hiroyuki

2007-01-01

It is known that focal 18 F-fluorodeoxyglucose (FDG) uptake is physiologically seen in the ovaries and uterus of premenopausal women in correlation with the menstrual cycle, which may cause false-positive diagnoses on the images of FDG positron emission tomography (PET). The objective of this study was to clarify whether women of reproductive age after hysterectomy whose ovaries were preserved, also showed physiological ovarian FDG uptake. We reviewed 26 women after hysterectomy (age 51.1±5.0 years), who underwent annual cancer screening, including FDG-PET and pelvic magnetic resonance (MR) imaging, three times. Seven women (age 45.9±5.8 years, range 34-52 years) had at least one ovary, showing changes in its appearance including the size and number of follicles on MR images each year, which suggested that the ovary was functioning. Four of the seven women showed focal FDG uptake (standardized uptake value 4.2±1.1) that corresponded to the normal ovaries on five PET examinations. Another group of 19 women (age 53.1±3.1 years, range 47-59 years) who had small ovaries without changes on MR images each year did not show FDG uptake in the ovaries. Physiological FDG uptake observed in the ovaries of women of reproductive age even after hysterectomy is reasonably common. As it is not easy to determine the hormonal cycle in these women, it is essential to correlate focal FDG uptake in the pelvis with anatomical and morphological findings on MR images to avoid false-positive diagnoses. (author)

Correlation of hepatic 18F-fluorodeoxyglucose uptake with fatty liver

International Nuclear Information System (INIS)

An, Young Sil; Yoon, Joon Kee; Hong, Seon Pyo; Joh, Chul Woo; Yoon, Seok Nam

2006-01-01

Liver demonstrates heterogeneous FDG uptake and sometimes it shows abnormally increased uptake even though there is no malignant tissue. However, there was no previous study to correlate these various pattern of hepatic FDG uptake with benign liver disease. Therefore, we evaluated the significance of hepatic FDG uptake associated with various clinical factors including fatty liver, liver function tests and lipid profiles. We reviewed a total of 188 patients (male/female: 120/68, mean age: 50 ± 9) who underwent PET/CT for screening of malignancy. Patients with DM, impaired glucose tolerance, previous severe hepatic disease or long-term medication history were excluded. The FDG uptake in liver was analyzed semi-quantitatively using ROI on transaxial images (segment 8) and we compared mean standardized uptake value (SUV) between fatty liver and non-fatty liver group. We also evaluated the correlation between hepatic FDG uptake and various clinical factors including serum liver function test (ALT, AST), γ -GT, total cholesterol and triglyceride concentration. The effect of alcoholic history and body mass index on hepatic FDG uptake was analyzed within the fatty liver patients. The hepatic FDG uptake of fatty liver group was significantly higher than that of non-fatty liver group. Serum total cholesterol and triglyceride concentration showed significant correlation with hepatic FDG uptake. However, there was no significant correlation between other factors (ALT, AST, and γ -GT) and FDG uptake. Also there was no difference of mean SUV between normal and abnormal groups on the basis of alcoholic history and body mass index within fatty liver patients. Fatty liver and high serum triglyceride concentration were the independent factors affecting hepatic FDG uptake according to multivariate analysis. In conclusion, hepatic FDG uptake was strongly correlated with fatty liver and serum triglyceride concentration

Uptake of uranium from sea water by microalgae

International Nuclear Information System (INIS)

Sakaguchi, Takashi; Horikoshi, Takao; Nakajima, Akira

1978-01-01

The uptake of uranium from aqueous systems especially from sea water by various microalgae was investigated. The freshwater microalgae, Chlorella regularis, Scenedesmus bijuga, Scenedesmus chloreloides, Scenedesmus obliquus, Chlamydomonas angulosa, Chlamydomonas reinhardtii, accumulated relatively large amounts of uranium from the solution containing uranium only. The concentration factors of the above mentioned algae were: Chlorella regularis 3930, Chlamydomonas 2330 - 3400, Scenedesmus 803 - 1920. The uptake of uranium from sea water by Chlorella regularis was inhibited markedly by the co-existence of carbonate ions. Chlorella cells could take up a great quantity of uranium from decarbonated sea water. The uptake of uranium was affected by the pH of sea water, and the amount of uranium absorbed was maximum at pH 5. The experiment was carried out to screen marine microalgae which have the ability to accumulate a large amount of uranium from sea water. The uptake of uranium from sea water by marine microalgae of different species turned out to be in the following decreasing order: Synechococcus > Chlamydomonas >> Chlorella > Dunaliella > Platymonas > Calothrix > Porphyridium. The amount of uranium absorbed differed markedly with different species of marine microalgae. (author)

Does gallium uptake in the pulmonary hila predict involvement by non-Hodgkin's lymphoma?

International Nuclear Information System (INIS)

Champion, P.E.; Groshar, D.; Hooper, H.R.; Palmer, M.; Catz, Z.; Belch, A.; McEwan, A.

1992-01-01

67 Ga imaging of non-Hodgkin's lymphoma is useful for evaluating the presence of viable tumour in a residual mass after treatment. However, we have frequently seen gallium uptake in the pulmonary hila without other evidence of lymphoma. To study the significance of this finding, 79 patients with intermediate grade non-Hodgkin's lymphoma were reviewed. Thirty-seven (47%) had abnormal hilar gallium uptake. Twenty-three of these could be fully evaluated, and only five (22%) had hilar lymphoma. A pattern of bilateral, symmetric hilar uptake was seen in 19 patients, but only one had evidence of lymphoma. In 15 cases, this pattern was seen only on single photon emission computed tomography (SPECT). The aetiology of this uptake remains unknown. It is not treatment related, as 12 patients had hilar gallium uptake prior to chemotherapy. Unless confirmed by other methods, hilar gallium uptake should not be attributed to lymphoma, and should not influence patient management. (Author)

[Can a mobile phone short message increase participation in breast cancer screening programmes?].

Science.gov (United States)

Arcas, M M; Buron, A; Ramis, O; Esturi, M; Hernández, C; Macià, F

2014-01-01

To evaluate the impact of a mobile phone short message on women's uptake in a breast cancer screening programme. A total of 703 women from a Basic Health Area of Barcelona, and with a mobile phone number registered, were invited to participate in a breast cancer screening programme between 25 January 2011 and 22 March 2011. The control group (n=470) followed the usual appointment track, and the intervention group (n=233) received, after the first letter of invitation, a mobile phone short message reminder. The differences between the two groups were analysed, comparing the uptake rates according to age, educational level, and participation in previous round, as well as the number of re-invitation calls to non-attenders according to uptake, age and level of education;and the percentages of exclusions of both groups. The intervention group had a greater uptake than the control group (78.1% vs. 72.3%), with a significant trend observed in the 55-59 years age group (P=.036) and the low secondary educational level (P=.014).The intervention group mean of re-invitation calls of non-attenders lower than the control group (.41 vs. .65, Pcancer screening programme may increase uptake rates and lead to a management improvement. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

START (screening tool to alert doctors to the right treatment)--an evidence-based screening tool to detect prescribing omissions in elderly patients.

LENUS (Irish Health Repository)

Barry, P J

2012-02-03

BACKGROUND: Inappropriate prescribing encompasses acts of commission i.e. giving drugs that are contraindicated or unsuitable, and acts of omission i.e. failure to prescribe drugs when indicated due to ignorance of evidence base or other irrational basis e.g. ageism. There are considerable published data on the prevalence of inappropriate prescribing; however, there are no recent published data on the prevalence of acts of omission. The aim of this study was to calculate the prevalence of acts of prescribing omission in a population of consecutively hospitalised elderly people. METHODS: A screening tool (screening tool to alert doctors to the right treatment acronym, START), devised from evidence-based prescribing indicators and arranged according to physiological systems was prepared and validated for identifying prescribing omissions in older adults. Data on active medical problems and prescribed medicines were collected in 600 consecutive elderly patients admitted from the community with acute illness to a teaching hospital. On identification of an omitted medication, the patient\\'s medical records were studied to look for a valid reason for the prescribing omission. RESULTS: Using the START list, we found one or more prescribing omissions in 57.9% of patients. In order of prevalence, the most common prescribing omissions were: statins in atherosclerotic disease (26%), warfarin in chronic atrial fibrillation (9.5%), anti-platelet therapy in arterial disease (7.3%) and calcium\\/vitamin D supplementation in symptomatic osteoporosis (6%). CONCLUSION: Failure to prescribe appropriate medicines is a highly prevalent problem among older people presenting to hospital with acute illness. A validated screening tool (START) is one method of systematically identifying appropriate omitted medicines in clinical practice.

Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

Science.gov (United States)

Parker, Lisa

2017-07-01

Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

Colonic uptake patterns of F-18-FDG PET in asymptomatic adults: comparison with colonoscopic findings

International Nuclear Information System (INIS)

Pai, Moon Sun; Cho, Yoo Kyung; Jung, Sung Ae; Shim, Ki Nam; Lee, Hong Soo

2005-01-01

Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET. Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate them with colonoscopic findings. We reviewed retrospectively 64 subjects (age: 27-87, M:F=31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake patterns were classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. In 13 patients FDG bowel uptake was interpreted as focal, in 17 patients as segmental and in 34 patients as diffuse uptake. Six adenomas (17.6%, average diameter=5.0 mm) were found in diffuse pattern, 7 adenomas (41.1%, 5.6 mm) in segmental and 4 adenomas and 1 adenocarcinoma (38.5%, 16.4 mm) in focal uptake pattern. In patients with focal uptake, four were non-adenomatous pathologic lesions (30.8%, 2 intestinal tuberculosis, 2 mucosal ulcer). There is no difference of mean SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (Diffuse: 1.7 ± 0.1 vs 1.9 ± 0.5, Segmental: 4.8 ± 3.6 vs 4.2 ± 1.2, Focal: 6.5 ± 4.7 vs 3.5 ± 1.3). Large adenomas (>1 cm) can be detected more in the focal uptake pattern (4 out of 5) rather than in segmental (1 out of 7) or diffuse uptake (none) and had higher SUV (6.3 ± 4.8) than small adenomas (3.5 ± 3.0)(statistically insignificant). Focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may have more chance to be normal

Cervical cancer screening and psychosocial barriers perceived by patients. A systematic review

Science.gov (United States)

Bukowska-Durawa, Alicja

2014-01-01

Aim of the study This study aimed at integrating research discussing the role of perceived psychosocial barriers in cervical cancer screening (CCS) uptake. In particular, we analyzed the evidence for the associations between CCS uptake and perceived psychosocial barriers and frequency of psychosocial barriers identified by women. Material and methods A systematic search of peer-reviewed papers published until 2011 in 8 databases yielded 48 original studies, analyzing data obtained from 155 954 women. The majority of studies (k = 43) applied correlational design, while 5 had experimental design. Results Experimental research indicated a positive effect of 75% of psychosocial interventions targeting barriers. The interventions resulted in a significant increase of CCS uptake. Overall 100% of correlational studies indicated that perceiving lower levels of barriers significantly predicted higher CCS uptake. 53 psychosocial barriers were listed in at least 2 original correlational studies: 9.5% of barriers were related to CCS facilities/environment, 67.9% dealt with personal characteristics of the patient, and 22.6% addressed social factors. As many as 35.9% of perceived barriers referred to negative emotions related to CCS examination procedures and collecting CCS results, whereas 25.7% of barriers referred to prior contacts with health professionals. Conclusions Leaflets or discussion on psychosocial barriers between patients and health professionals involved in CCS might increase CCS uptake and thus reduce cervical cancer mortality rates. Communication skills training for health professionals conducting CCS might focus on the most frequently reported barriers, referring to emotions related to CCS examination and collecting CCS results. PMID:25520573

Uptake of selected organics and metals by terrestrial vegetation and insects at a site in Arizona

International Nuclear Information System (INIS)

Day, C.H.; Ayers, T.A.; Ellingson, S.B.; Braddy, L.

1995-01-01

As part of an investigation at a CERCLA site in Arizona, 27 potential sources of contamination (PSCS) were identified for study. A screening level ecological risk assessment was conducted for each PSC using generic plant uptake factors and conservative exposure parameters. Risk estimates were calculated for the indicator species using the hazard index (HI) approach. Results of the screening level assessment indicated that 4 of the 27 PSCs required further evaluation due to elevated HIs. The contaminants of potential concern (COPCS) are antimony, cadmium, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and total petroleum hydrocarbons (TPH). A field sampling program at the 4 PSCs and a site-specific background location was conduct4ed to collect the food sources for the indicator species. The samples have been analyzed for the COPCs and the results are being used to validate the screening level risk calculations. The site-specific soil-to-plant uptake factors will be compared to generic soil-to-plant uptake factors obtained from the scientific literature, with emphasis placed on studies done in similar arid environments. Contaminant-specific soil-to-insect bioaccumulation factors (BAFs) will be presented and compared to BAFs derived using published bioaccumulation models

Study protocol: Addressing evidence and context to facilitate transfer and uptake of consultation recording use in oncology: A knowledge translation implementation study

Directory of Open Access Journals (Sweden)

Ruether J Dean

2011-03-01

Full Text Available Abstract Background The time period from diagnosis to the end of treatment is challenging for newly diagnosed cancer patients. Patients have a substantial need for information, decision aids, and psychosocial support. Recordings of initial oncology consultations improve information recall, reduce anxiety, enhance patient satisfaction with communication, and increase patients' perceptions that the essential aspects of their disease and treatment have been addressed during the consultation. Despite the research evidence supporting the provision of consultation recordings, uptake of this intervention into oncology practice has been slow. The primary aim of this project is to conduct an implementation study to explicate the contextual factors, including use of evidence, that facilitate and impede the transfer and uptake of consultation-recording use in a sample of patients newly diagnosed with breast or prostate cancer. Methods Sixteen oncologists from cancer centres in three Canadian cities will participate in this three-phase study. The preimplementation phase will be used to identify and address those factors that are fundamental to facilitating the smooth adoption and delivery of the intervention during the implementation phase. During the implementation phase, breast and prostate cancer patients will receive a recording of their initial oncology consultation to take home. Patient interviews will be conducted in the days following the consultation to gather feedback on the benefits of the intervention. Patients will complete the Digital Recording Use Semi-Structured Interview (DRUSSI and be invited to participate in focus groups in which their experiences with the consultation recording will be explored. Oncologists will receive a summary letter detailing the benefits voiced by their patients. The postimplementation phase includes a conceptual framework development meeting and a seven-point dissemination strategy. Discussion Consultation

Digital Screen Time Limits and Young Children's Psychological Well-Being: Evidence From a Population-Based Study.

Science.gov (United States)

Przybylski, Andrew K; Weinstein, Netta

2017-12-13

There is little empirical understanding of how young children's screen engagement links to their well-being. Data from 19,957 telephone interviews with parents of 2- to 5-year-olds assessed their children's digital screen use and psychological well-being in terms of caregiver attachment, resilience, curiosity, and positive affect in the past month. Evidence did not support implementing limits (< 1 or < 2 hr/day) as recommended by the American Academy of Pediatrics, once variability in child ethnicity, age, gender, household income, and caregiver educational attainment were considered. Yet, small parabolic functions linked screen time to attachment and positive affect. Results suggest a critical cost-benefit analysis is needed to determine whether setting firm limits constitutes a judicious use of caregiver and professional resources. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Using the Frailty Assessment for Care Planning Tool (FACT) to screen elderly chronic kidney disease patients for frailty: the nurse experience.

Science.gov (United States)

Moffatt, Heather; Moorhouse, Paige; Mallery, Laurie; Landry, David; Tennankore, Karthik

2018-01-01

Recent evidence supports the prognostic significance of frailty for functional decline and poor health outcomes in patients with chronic kidney disease. Yet, despite the development of clinical tools to screen for frailty, little is known about the experiential impact of screening for frailty in this setting. The Frailty Assessment for Care Planning Tool (FACT) evaluates frailty across 4 domains: mobility, function, social circumstances, and cognition. The purpose of this qualitative study was as follows: 1) explore the nurse experience of screening for frailty using the FACT tool in a specialized outpatient renal clinic; 2) determine how, if at all, provider perceptions of frailty changed after implementation of the frailty screening tool; and 3) determine the perceived factors that influence uptake and administration of the FACT screening tool in a specialized clinical setting. A semi-structured interview of 5 nurses from the Nova Scotia Health Authority, Central Zone Renal Clinic was conducted. A grounded theory approach was used to generate thematic categories and analysis models. Four primary themes emerged in the data analysis: "we were skeptical", "we made it work", "we learned how", and "we understand". As the renal nurses gained a sense of confidence in their ability to implement the FACT tool, initial barriers to implementation were attenuated. Implementation factors - such as realistic goals, clear guidelines, and ongoing training - were important factors for successful uptake of the frailty screening initiative. Nurse participants reported an overall positive experience using the FACT method to screen for frailty and indicated that their understanding of the multiple dimensions and subtleties of "frailty" were enhanced. Future nurse-led FACT screening initiatives should incorporate those factors identified as being integral to program success: realistic goals, clear guidelines, and ongoing training. Adopting the evaluation of frailty as a priority

Strength of recommendations in WHO guidelines using GRADE was associated with uptake in national policy.

Science.gov (United States)

Nasser, Syed Muhammad Umar; Cooke, Graham; Kranzer, Katharina; Norris, Susan L; Olliaro, Piero; Ford, Nathan

2015-06-01

This study assesses the extent to which the strength of a recommendation in a World Health Organization (WHO) guideline affects uptake of the recommendation in national guidelines. The uptake of recommendations included in HIV and TB guidelines issued by WHO from 2009 to 2013 was assessed across guidelines from 20 low- and middle-income countries in Africa and Southeast Asia. Associations between characteristics of recommendations (strength, quality of the evidence, type) and uptake were assessed using logistic regression. Eight WHO guidelines consisting of 109 strong recommendations and 49 conditional recommendations were included, and uptake assessed across 44 national guidelines (1,255 recommendations) from 20 countries. Uptake of WHO recommendations in national guidelines was 82% for strong recommendations and 61% for conditional recommendations. The odds of uptake comparing strong recommendations and conditional recommendations was 1.9 (95% confidence interval: 1.4, 2.7), after adjustment for quality of evidence. Higher levels of evidence quality were associated with greater uptake, independent of recommendation strength. Guideline developers should be confident that conditional recommendations are frequently adopted. The fact that strong recommendations are more frequently adopted than conditional recommendations underscores the importance of ensuring that such recommendations are justified. Copyright © 2015 Elsevier Inc. All rights reserved.

Correlation of hepatic {sup 18}F-fluorodeoxyglucose uptake with fatty liver

Energy Technology Data Exchange (ETDEWEB)

An, Young Sil; Yoon, Joon Kee; Hong, Seon Pyo; Joh, Chul Woo; Yoon, Seok Nam [Ajou University School of Medicine, Suwon (Korea, Republic of)

2006-10-15

Liver demonstrates heterogeneous FDG uptake and sometimes it shows abnormally increased uptake even though there is no malignant tissue. However, there was no previous study to correlate these various pattern of hepatic FDG uptake with benign liver disease. Therefore, we evaluated the significance of hepatic FDG uptake associated with various clinical factors including fatty liver, liver function tests and lipid profiles. We reviewed a total of 188 patients (male/female: 120/68, mean age: 50 {+-} 9) who underwent PET/CT for screening of malignancy. Patients with DM, impaired glucose tolerance, previous severe hepatic disease or long-term medication history were excluded. The FDG uptake in liver was analyzed semi-quantitatively using ROI on transaxial images (segment 8) and we compared mean standardized uptake value (SUV) between fatty liver and non-fatty liver group. We also evaluated the correlation between hepatic FDG uptake and various clinical factors including serum liver function test (ALT, AST), {gamma} -GT, total cholesterol and triglyceride concentration. The effect of alcoholic history and body mass index on hepatic FDG uptake was analyzed within the fatty liver patients. The hepatic FDG uptake of fatty liver group was significantly higher than that of non-fatty liver group. Serum total cholesterol and triglyceride concentration showed significant correlation with hepatic FDG uptake. However, there was no significant correlation between other factors (ALT, AST, and {gamma} -GT) and FDG uptake. Also there was no difference of mean SUV between normal and abnormal groups on the basis of alcoholic history and body mass index within fatty liver patients. Fatty liver and high serum triglyceride concentration were the independent factors affecting hepatic FDG uptake according to multivariate analysis. In conclusion, hepatic FDG uptake was strongly correlated with fatty liver and serum triglyceride concentration.

Screening for Syphilis: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Science.gov (United States)

Cantor, Amy G; Pappas, Miranda; Daeges, Monica; Nelson, Heidi D

2016-06-07

Screening for syphilis infection is currently recommended for high-risk individuals, including those with previous syphilis infection, an infected sexual partner, HIV infection, or more than 4 sex partners in the preceding year. To update a 2004 systematic review of studies of syphilis screening effectiveness, test accuracy, and screening harms in nonpregnant adults and adolescents. Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews through October 2015 and Ovid MEDLINE (January 2004 to October 2015), with updated search through March 2016. English-language trials and observational studies of screening effectiveness, test accuracy, and screening harms in nonpregnant adults and adolescents. One investigator abstracted data, a second checked data for accuracy, and 2 investigators independently assessed study quality using predefined criteria. Transmission of disease, including HIV; complications of syphilis; diagnostic accuracy; and harms of screening. No evidence was identified regarding the effectiveness of screening on clinical outcomes or the effectiveness of risk assessment instruments; the harms of screening; or the effectiveness of screening in average-risk, nonpregnant adolescents or adults or high-risk individuals other than men who have sex with men (MSM) or men who are HIV positive. Four non-US studies indicated higher rates of syphilis detection with screening every 3 months vs 6 or 12 months for early syphilis in HIV-positive men or MSM. For example, there was an increased proportion of asymptomatic, higher-risk MSM in Australia (n = 6789 consultations) receiving a diagnosis of early syphilis when tested every 3 months vs annually (53% vs 16%, P = .001), but no difference among low-risk MSM. Treponemal and nontreponemal tests were accurate in asymptomatic individuals (sensitivity >85%, specificity >91%) in 3 studies but required confirmatory testing. Reverse sequence testing with an initial automated

Prostate-Specific Antigen (PSA)–Based Population Screening for Prostate Cancer: An Evidence-Based Analysis

Science.gov (United States)

Pron, G

2015-01-01

evidence of a PC mortality reduction in the American PLCO trial, which investigated a screening program in a setting where opportunistic screening was already common practice. Given that opportunistic PSA screening practices in Canada are similar, it is unlikely that the introduction of a formal PSA screening program would reduce PC mortality. PMID:26366236

What factors influence uptake of retinal screening among young adults with type 2 diabetes? A qualitative study informed by the theoretical domains framework.

Science.gov (United States)

Lake, Amelia J; Browne, Jessica L; Rees, Gwyneth; Speight, Jane

2017-06-01

Young adults with type 2 diabetes (T2D, 18-39years) face increased risk of vision loss from diabetic retinopathy (DR). Retinal screening is essential to detect DR, yet screening rates for this group are low and little is known about the underlying factors influencing this important behavior. Using the theoretical domains framework (TDF) to guide data collection and analysis, we explored screening barriers and facilitator, contrasting them with a comparator group of older adults with T2D (40+ years). Thirty semi-structured telephone interviews (10 younger, 20 older adults) were conducted. Data were coded into TDF domains with salience identified by "frequency" of reference. Screening facilitators and barriers were systematically compared between groups. Although many screening facilitators and barriers were shared by younger and older adults, additional factors highly relevant to the former included: social comparison with others ('social influences'); concern for the impact on the family unit, unrealistic optimism and perceived invulnerability ('beliefs about consequences'); lack of time and financial resources ('environmental context and resources'), and DR misconceptions ('knowledge'). This study demonstrated that young adult retinal screening behavior was influenced by additional social cognitive factors compared to older adults, providing a first-step evidence base for clinicians and other health professionals, and potential targets for future eye health and retinal screening interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Elevated sacroilac joint uptake ratios in systemic lupus erythematosus

International Nuclear Information System (INIS)

De Smet, A.A.; Mahmood, T.; Robinson, R.G.; Lindsley, H.B.

1984-01-01

Sacroiliac joint radiographs and radionuclide sacroiliac joint uptake ratios were obtained on 14 patients with active systemic lupus erythematosus. Elevated joint ratios were found unilaterally in two patients and bilaterally in seven patients when their lupus was active. In patients whose disease became quiescent, the uptake ratios returned to normal. Two patients had persistently elevated ratios with continued clinical and laboratory evidence of active lupus. Mild sacroiliac joint sclerosis and erosions were detected on pelvic radiographs in these same two patients. Elevated quantitative sacroiliac joint uptake ratios may occur as a manifestation of active systemic lupus erythematosus

Chinese peoples' perceptions of colorectal cancer screening: a New Zealand perspective.

Science.gov (United States)

Bong, Genevieve; McCool, Judith

2011-03-25

A national cancer screening programme requires a level of perceived acceptability of the procedure among the target population groups to be successful (that is, achieve a high uptake rate). In this study we explored Chinese immigrants' attitudes and perceptions towards colorectal cancer screening. A grounded theory methodology was used explore the determinants of colorectal cancer screening. In depth one-on-one interviews were conducted and subsequently analysed to develop an appreciation of the perspectives on colorectal cancer screening among Chinese people living in New Zealand. Findings indicated a high degree of perceived acceptability for the concept of a national colorectal cancer screening programme. Chinese participants valued health care and preventive health measures were highly prioritised. However, colorectal cancer suffered from the 'poor cousin' syndrome whereby other more highly publicised cancers, such breast cancer, or skin cancer, were perceived to be more relevant and serious, thus marginalising the perceived priority of colorectal cancer screening. Overall, participants paid close attention to their bodies' balance and were proactive in seeking medical advice. Patient practitioner interaction was also found to be influential in the patient's decision to seek screening. The results of the study suggest that the introduction of a colorectal cancer screening programme in New Zealand would benefit from close attention to cultural determinants of screening uptake to provide an equitable service and outcome. Chinese patients who are eligible for participating in the colorectal cancer screening would benefit from access to appropriately detailed and culturally relevant information on the risks, benefit and procedures associated with colorectal cancer screening.

Characteristics of first-trimester screening of non-responders in a high-uptake population

DEFF Research Database (Denmark)

Wolf, Hanne Trap; Wulff, Camilla Bernt; Ekelund, Charlotte

2016-01-01

INTRODUCTION: Our aim was to compare demographic, social and reproductive health-related medical factors between women who did and women who did not undergo combined first-trimester screening (cFTS) and to examine their reasons for declining a screening offer, especially whether non-participation......INTRODUCTION: Our aim was to compare demographic, social and reproductive health-related medical factors between women who did and women who did not undergo combined first-trimester screening (cFTS) and to examine their reasons for declining a screening offer, especially whether non...... with the following factors: country of origin other than Denmark (p ... of a conscious choice based on ethical considerations, rather than being the result of a lack of information. However, a low response rate decreases the strength of our conclusions. FUNDING: none. TRIAL REGISTRATION: not relevant....

Radiocolloid Uptake in the Pancreas Islet Cell Tumor: Case Report

Energy Technology Data Exchange (ETDEWEB)

Yang, W. J.; Chung, S. K.; Yeon, S. K.; Shinn, K. S.; Bahk, Y. W. [Catholic University College of Medicine, Seoul (Korea, Republic of)

1994-03-15

Colloid uptake in various hepatic conditions such as focal nodular hyperplasia, regenerating nodular in the cirrhotic liver, hamartoma, hemangioma and rarely hepatoma has been documented. Extrahepatic tumors may show colloid uptake and they include splenic hemangioma, malignant fibrous histiocytoma, breast carcinoma and Kaposi's sarcoma. The mechanism of colloid uptake in those lesions is associated with phagocytic activity in or around the tumors. We report a pancreas islet cell tumor that showed colloid uptake on {sup 99m}Tc-phytate liver scan without histologic evidence of phagocytosis by tumor cells or infiltration of phagocytes in the tumor. Microscopically the tumor was highly vascular and showed diffuse hemorrhage throughout the tumor. We postulated that extravasation of the colloid into the tumor interstitium caused nonspecific colloid uptake in this tumor. It is expected that hemorrhagic tumor may show nonspecific colloid uptake without phagocytosis in or about the lesion.

Radiocolloid Uptake in the Pancreas Islet Cell Tumor: Case Report

International Nuclear Information System (INIS)

Yang, W. J.; Chung, S. K.; Yeon, S. K.; Shinn, K. S.; Bahk, Y. W.

1994-01-01

Colloid uptake in various hepatic conditions such as focal nodular hyperplasia, regenerating nodular in the cirrhotic liver, hamartoma, hemangioma and rarely hepatoma has been documented. Extrahepatic tumors may show colloid uptake and they include splenic hemangioma, malignant fibrous histiocytoma, breast carcinoma and Kaposi's sarcoma. The mechanism of colloid uptake in those lesions is associated with phagocytic activity in or around the tumors. We report a pancreas islet cell tumor that showed colloid uptake on 99m Tc-phytate liver scan without histologic evidence of phagocytosis by tumor cells or infiltration of phagocytes in the tumor. Microscopically the tumor was highly vascular and showed diffuse hemorrhage throughout the tumor. We postulated that extravasation of the colloid into the tumor interstitium caused nonspecific colloid uptake in this tumor. It is expected that hemorrhagic tumor may show nonspecific colloid uptake without phagocytosis in or about the lesion.

A nurse-facilitated depression screening program in an Army primary care clinic: an evidence-based project.

Science.gov (United States)

Yackel, Edward E; McKennan, Madelyn S; Fox-Deise, Adrianna

2010-01-01

Depression, sometimes with suicidal manifestations, is a medical condition commonly seen in primary care clinics. Routine screening for depression and suicidal ideation is recommended of all adult patients in the primary care setting because it offers depressed patients a greater chance of recovery and response to treatment, yet such screening often is overlooked or omitted. The purpose of this study was to develop, to implement, and to test the efficacy of a systematic depression screening process to increase the identification of depression in family members of active duty soldiers older than 18 years at a military family practice clinic located on an Army infantry post in the Pacific. The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to develop a practice guideline incorporating a decision algorithm for nurses to screen for depression. A pilot project to institute this change in practice was conducted, and outcomes were measured. Before implementation, approximately 100 patients were diagnosed with depression in each of the 3 months preceding the practice change. Approximately 130 patients a month were assigned a 311.0 Code 3 months after the practice change, and 140 patients per month received screenings and were assigned the correct International Classification of Diseases, Ninth Revision Code 311.0 at 1 year. The improved screening and coding for depression and suicidality added approximately 3 minutes to the patient screening process. The education of staff in the process of screening for depression and correct coding coupled with monitoring and staff feedback improved compliance with the identification and the documentation of patients with depression. Nurses were more likely than primary care providers to agree strongly that screening for depression enhances quality of care. Data gathered during this project support the integration of military and civilian nurse-facilitated screening for depression in the military primary care

Screening for bioactive metabolites in plant extracts modulating glucose uptake and fat accumulation

DEFF Research Database (Denmark)

El-Houri, Rime Bahij; Kotowska, Dorota Ewa; C. B. Olsen, Louise

2014-01-01

while weekly activating PPARγ without promoting adipocyte differentiation. In addition, these extracts were able to decrease fat accumulation in C. elegans. Methanol extracts of summer savory (Satureja hortensis), common elder, and broccoli (Brassica oleracea) enhanced glucose uptake in myotubes...

Familial Screening for Left-Sided Congenital Heart Disease: What Is the Evidence? What Is the Cost?

Directory of Open Access Journals (Sweden)

Daniel J. Perry

2017-12-01

Full Text Available Since the American Heart Association’s recommendation for familial screening of adults with congenital heart disease for bicuspid aortic valve, similar recommendations for other left-sided heart defects, such as hypoplastic left heart syndrome (HLHS, have been proposed. However, defining at-risk populations for these heart defects based on genetics is less straightforward due to the wide variability of inheritance patterns and non-genetic influences such as environmental and lifestyle factors. We discuss whether there is sufficient evidence to standardize echocardiographic screening for first-degree relatives of children diagnosed with HLHS. Due to variations in the inclusion of cardiac anomalies linked to HLHS and the identification of asymptomatic individuals with cardiac malformations, published studies are open to interpretation. We conclude that familial aggregation of obstructive left-sided congenital heart lesions in families with history of HLHS is not supported and recommend that additional screening should adopt a more conservative definition of what truly constitutes this heart defect. More thorough consideration is needed before embracing familial screening recommendations of families of patients with HLHS, since this could inflict serious costs on healthcare infrastructure and further burden affected families both emotionally and financially.

Brain docosahexaenoic acid uptake and metabolism.

Science.gov (United States)

Lacombe, R J Scott; Chouinard-Watkins, Raphaël; Bazinet, Richard P

2018-02-08

Docosahexaenoic acid (DHA) is the most abundant n-3 polyunsaturated fatty acid in the brain where it serves to regulate several important processes and, in addition, serves as a precursor to bioactive mediators. Given that the capacity of the brain to synthesize DHA locally is appreciably low, the uptake of DHA from circulating lipid pools is essential to maintaining homeostatic levels. Although, several plasma pools have been proposed to supply the brain with DHA, recent evidence suggests non-esterified-DHA and lysophosphatidylcholine-DHA are the primary sources. The uptake of DHA into the brain appears to be regulated by a number of complementary pathways associated with the activation and metabolism of DHA, and may provide mechanisms for enrichment of DHA within the brain. Following entry into the brain, DHA is esterified into and recycled amongst membrane phospholipids contributing the distribution of DHA in brain phospholipids. During neurotransmission and following brain injury, DHA is released from membrane phospholipids and converted to bioactive mediators which regulate signaling pathways important to synaptogenesis, cell survival, and neuroinflammation, and may be relevant to treating neurological diseases. In the present review, we provide a comprehensive overview of brain DHA metabolism, encompassing many of the pathways and key enzymatic regulators governing brain DHA uptake and metabolism. In addition, we focus on the release of non-esterified DHA and subsequent production of bioactive mediators and the evidence of their proposed activity within the brain. We also provide a brief review of the evidence from post-mortem brain analyses investigating DHA levels in the context of neurological disease and mood disorder, highlighting the current disparities within the field. Copyright © 2017. Published by Elsevier Ltd.

What Do Men Want from a Health Screening Mobile App? A Qualitative Study

Science.gov (United States)

2017-01-01

There is a lack of mobile app which aims to improve health screening uptake developed for men. As part of the study to develop an effective mobile app to increase health screening uptake in men, we conducted a needs assessment to find out what do men want from a health screening mobile app. In-depth interviews and focus group discussions were conducted with 31 men from a banking institution in Kuala Lumpur. The participants were purposely sampled according to their job position, age, ethnicity and screening status. The recruitment was stopped once data saturation was achieved. The audio-recorded interviews were transcribed verbatim and analyzed using thematic approach. Three themes emerged from the analysis and they were: content, feature and dissemination. In terms of the content, men wanted the app to provide information regarding health screening and functions that can assess their health; which must be personalized to them and are trustable. The app must have user-friendly features in terms of information delivery, ease of use, attention allocation and social connectivity. For dissemination, men proposed that advertisements, recommendations by health professionals, providing incentive and integrating the app as into existing systems may help to increase the dissemination of the app. This study identified important factors that need to be considered when developing a mobile app to improve health screening uptake. Future studies on mobile app development should elicit users’ preference and need in terms of its content, features and dissemination strategies to improve the acceptability and the chance of successful implementation. PMID:28060953

Screening Children for Family Violence: A Review of the Evidence for the US Preventive Services Task Force

Science.gov (United States)

Nygren, Peggy; Nelson, Heidi D.; Klein, Jonathan

2004-01-01

BACKGROUND We wanted to evaluate the benefits and harms of screening children in primary health care settings for abuse and neglect resulting from family violence by examining the evidence on the performance of screening instruments and the effectiveness of interventions. METHODS We searched for relevant studies in MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Controlled Trials Register, and reference lists. English language abstracts with original data about family violence against children focusing on screening and interventions initiated or based in health care settings were included. We extracted selected information about study design, patient populations and settings, methods of assessment or intervention, and outcome measures, and applied a set of criteria to evaluate study quality. RESULTS All instruments designed to screen for child abuse and neglect were directed to parents, particularly pregnant women. These instruments had fairly high sensitivity but low specificity when administered in high-risk study populations and have not been widely tested in other populations. Randomized controlled trials of frequent nurse home visitation programs beginning during pregnancy that address behavioral and psychological factors indicated improved abuse measures and outcomes. No studies were identified about interventions in older children or harms associated with screening and intervention. CONCLUSIONS No trials of the effectiveness of screening in a health care setting have been published. Clinician referrals to nurse home visitation during pregnancy and in early childhood may reduce abuse in selected populations. There are no studies about harms of screening and interventions. PMID:15083858

The influence of knowledge and perception of the risk of cervical cancer on screening behavior in mainland Chinese women.

Science.gov (United States)

Gu, Can; Chan, Carmen W H; Twinn, Sheila; Choi, Kai Chow

2012-12-01

Theories of health behavior and empirical research highlight the risk perception as a significant factor for people adopting cancer screening. However, screening uptakes and risk perception of cervical cancer in mainland Chinese women remains unknown. This paper adopted the protection motivation theory (PMT) to examine Chinese women's knowledge and perceptions of cervical cancer risk and factors influencing utilization of cervical screening. A self-administered questionnaire was completed by 167 participants in mainland China (79 nonscreened and 88 screened women) in 2007 which consisted of four sections: background information, women's attendance pattern for cervical screening, perceptions related to body health and knowledge about cervical cancer and screening, and PMT measures. All women considered themselves at low risk of cervical cancer. No significant association was observed between previous screening uptake and PMT variables. Using multivariate analysis, having children, a perception that visiting doctors regularly is important to health, average and high levels of knowledge about cervical screening were significantly associated with having been received screening. Chinese women demonstrated an unrealistic optimism about their personal risk of cervical cancer. The findings do not support an association between risk perception and screening uptake. In spite of this, current findings revealed some possible factors influencing women's screening behavior. This study highlights the significance of knowledge and culturally-relevant health behavior and beliefs about cervical screening for Chinese women in determining whether or not they receive screening. The promotion of cervical cancer prevention and early detection should be integrated into public education about women's health. Copyright © 2011 John Wiley & Sons, Ltd.

Changes in spectral signatures of red lettuce regards to Zinc uptake

Science.gov (United States)

Shin, J.; Yu, J.; Koh, S. M.; Park, G.; Kim, S.

2017-12-01

Heavy metal contaminations caused by human activities such as mining and industrial activities caused serious soil contamination. Soil contaminations causes secondary impact on vegetation by uptake processes. Intakes of vegetables harvested from heavy metal contaminated soil may cause serious health problems. It would be very effective if screening tool could be developed before the vegetables are distributed over the market. This study investigated spectral response of red lettuce regards to Zn uptake from the treated soil in a laboratory condition. Zn solutions at different levels of concentration are injected to potted lettuce. The chemical composition and spectral characteristics of the leaves are analyzed every 2 days and the correlation between the Zn concentration and spectral reflectance is investigated. The experiment reveals that Zn uptake of red lettuce is significantly higher for the leaves from treated pot compared to untreated pot showing highly contaminated concentrations beyond the standard Zn concentrations for food. The spectral response regards to Zn is manifested at certain level of concentration threshold. Below the threshold, reflectance at NIR regions increases regards to increase in Zn concentration. On the other hand, above the threshold, IR reflectance decreases and slope of NIR shoulder increases regards to higher Zn concentration. We think this result may contribute for development of screening tools for heavy metal contaminations in vegetables.

Finding Qualitative Research Evidence for Health Technology Assessment.

Science.gov (United States)

DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

2016-08-01

Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. © The Author(s) 2016.

Employee Screening : Theory and Evidence

OpenAIRE

Fali Huang; Peter Cappelli

2007-01-01

Arguably the fundamental problem faced by employers is how to elicit effort from employees. Most models suggest that employers meet this challenge by monitoring employees carefully to prevent shirking. But there is another option that relies on heterogeneity across employees, and that is to screen job candidates to find workers with a stronger work ethic who require less monitoring. This should be especially useful in work systems where monitoring by supervisors is more difficult, such as tea...

Factors affecting gastric uptake in whole body FDG-PET imaging

International Nuclear Information System (INIS)

Tomemori, Takashi; Kitagawa, Mami; Nakahara, Tadaki; Wu, Jin; Nakagawa, Keiichi; Uno, Kimiichi; Abe, Kinji; Tomiyoshi, Katsumi

2001-01-01

Positron emission tomography (PET) using 2-deoxy-2-[ 18 F]-fluoro-D-glucose (FDG) is very useful for the detection and staging of tumors. However, FDG is also accumulated in the normal tissues in various degrees. This physiological FDG uptake is often seen in intestine, making confusion with malignant tumor. The aim of this study was to identify factors influencing physiological FDG uptake in the stomach. A total of 136 people who underwent cancer screening or staging of tumors except for gastric cancer using FDG whole-body PET was examined (mean age: 55.6 yrs). All subjects fasted for at least 4 hours before the PET study and were administrated with FDG intravenously (mean FDG dose: 308.9 MBq). Emission images were acquired on a whole-body PET scanner and images were reconstructed without attenuation correction. The intensity of gastric uptake of FDG whole-body PET image was visually classified into 3 grades; grade 2 = the intensity of gastric uptake more than pulmonary uptake, grade 1 = the intensity of gastric uptake equal to or less than pulmonary uptake, grade 0 = no contrast between gastric uptake and background. Twenty-eight subjects (20.6%) were classified into grade 2, 42 subjects (30.9%) were grade 1 and 66 subjects (48.5%) were grade 0. Subjects' age, fasting time, FDG dose, serum glucose level, free fatty acid level and insulin level were not significantly correlated with the intensity of gastric uptake. But the subjects with higher gastric uptake tended to have anti-Helicobactor pylori (H. pylori) antibodies. The rate of having anti-H.pylori antibodies in the grade 2 group is significantly higher than the grade 1 group (85.7% vs. 72.5%, p<0.05), and that of the grade 1 group is significantly higher than the grade 0 group (72.5% vs. 42.2%, p<0.01). Gastric uptake was observed in about half of subjects. Especially, approximately 20% of all showed high gastric uptake, which was associated with H.pylori infection. Therefore, most of the subjects with high

Factors affecting gastric uptake in whole body FDG-PET imaging

Energy Technology Data Exchange (ETDEWEB)

Tomemori, Takashi; Kitagawa, Mami; Nakahara, Tadaki; Wu, Jin; Nakagawa, Keiichi; Uno, Kimiichi; Abe, Kinji; Tomiyoshi, Katsumi [Nishidai Clinic Diagnostic Imaging Center, Tokyo (Japan)

2001-06-01

Positron emission tomography (PET) using 2-deoxy-2-[{sup 18}F]-fluoro-D-glucose (FDG) is very useful for the detection and staging of tumors. However, FDG is also accumulated in the normal tissues in various degrees. This physiological FDG uptake is often seen in intestine, making confusion with malignant tumor. The aim of this study was to identify factors influencing physiological FDG uptake in the stomach. A total of 136 people who underwent cancer screening or staging of tumors except for gastric cancer using FDG whole-body PET was examined (mean age: 55.6 yrs). All subjects fasted for at least 4 hours before the PET study and were administrated with FDG intravenously (mean FDG dose: 308.9 MBq). Emission images were acquired on a whole-body PET scanner and images were reconstructed without attenuation correction. The intensity of gastric uptake of FDG whole-body PET image was visually classified into 3 grades; grade 2 = the intensity of gastric uptake more than pulmonary uptake, grade 1 = the intensity of gastric uptake equal to or less than pulmonary uptake, grade 0 = no contrast between gastric uptake and background. Twenty-eight subjects (20.6%) were classified into grade 2, 42 subjects (30.9%) were grade 1 and 66 subjects (48.5%) were grade 0. Subjects' age, fasting time, FDG dose, serum glucose level, free fatty acid level and insulin level were not significantly correlated with the intensity of gastric uptake. But the subjects with higher gastric uptake tended to have anti-Helicobactor pylori (H. pylori) antibodies. The rate of having anti-H.pylori antibodies in the grade 2 group is significantly higher than the grade 1 group (85.7% vs. 72.5%, p<0.05), and that of the grade 1 group is significantly higher than the grade 0 group (72.5% vs. 42.2%, p<0.01). Gastric uptake was observed in about half of subjects. Especially, approximately 20% of all showed high gastric uptake, which was associated with H.pylori infection. Therefore, most of the subjects

Selective information seeking: can consumers' avoidance of evidence-based information on colorectal cancer screening be explained by the theory of cognitive dissonance?

Science.gov (United States)

Steckelberg, Anke; Kasper, Jürgen; Mühlhauser, Ingrid

2007-08-27

Evidence-based patient information (EBPI) is a prerequisite for informed decision-making. However, presentation of EBPI may lead to irrational reactions causing avoidance, minimisation and devaluation of the information. To explore whether the theory of cognitive dissonance is applicable to medical decision-making and useful to explain these phenomena. 261 volunteers from Hamburg (157 women), >or=50 years old without diagnosis of colorectal cancer. DESIGN AND VARIABLES: Within an experiment we simulated information seeking on colorectal cancer screening. Consumers' attitudes towards screening were surveyed using a rating scale from -5 (participate in no way) to +5 (participate unconditionally) (independent variable). Using a cover story, participants were asked to sort 5 article headlines according to their reading preferences. The headlines simulated the pro to contra variety of contents to be found in print media about colorectal cancer screening. The dependent variable was the sequence of article headlines. Participants were very much in favour of screening with scores for faecal occult blood test of 4.0 (0.1) and for colonoscopy 3.3 (0.1). According to our hypothesis we found statistically significant positive correlations between the stimuli in favour of screening and attitudes and significant negative correlations between the stimuli against screening and attitudes. The theory of cognitive dissonance is applicable to medical decision-making. It may explain some phenomena of irrational reactions to evidence-based patient information.

Increased FDG uptake in the wall of the right atrium in people who participated in a cancer screening program with whole-body PET

International Nuclear Information System (INIS)

Fujii, Hirofumi; Ide, Michiru; Yasuda, Seiei; Takahashi, Wakoh; Shohtsu, Akira; Kubo, Atsushi

1999-01-01

The purpose of this study was to evaluate the characteristics of patients who showed increased FDG uptake in the wall of the right atrium. We have encountered 10 patients with increased activity in the wall of the right atrium among a total of 2,367 examinees who participated in our cancer screening program with whole-body PET. The mean age of these examinees was 62.9 yr, higher than that of the total population. All suffered from cardiac disorders, especially atrial fibrillation. FDG accumulated almost exclusively in the wall of the right atrium, whereas only slight activity was seen in the wall of the left atrium. Although the average size of the right atria was significantly enlarged, left atria were more severely dilated than right ones. Therefore overload does not seem to account for the FDG accumulation in the wall of the right atrium. In conclusion, the increased activity in the wall of the right atrium was a rare finding that was made in older people who suffered from cardiac disease. Although the mechanism of induction of the high metabolic state of glucose in the wall of the right atrium remains unclear, this unusual activity would be another false positive finding in cancer screening with whole-body FDG PET. (author)

Application of Fragment Ion Information as Further Evidence in Probabilistic Compound Screening Using Bayesian Statistics and Machine Learning

NARCIS (Netherlands)

Woldegebriel, Michael; Zomer, Paul; Mol, Hans G.J.; Vivó-Truyols, Gabriel

2016-01-01

In this work, we introduce an automated, efficient, and elegant model to combine all pieces of evidence (e.g., expected retention times, peak shapes, isotope distributions, fragment-to-parent ratio) obtained from liquid chromatography-tandem mass spectrometry (LC-MS/MS/MS) data for screening

Characteristics of sugar uptake by immature maize embryos

International Nuclear Information System (INIS)

Griffith, S.M.; Jones, R.J.; Brenner, M.L.

1986-01-01

Characteristics of sugar uptake by immature maize embryos were determined in vitro utilizing a 14 C-sugar solution incubation method. Hexose uptake rates were greater than those for sucrose, however, all showed biphasic kinetics. Glucose and fructose saturable components were evidence at <50 mM and sucrose at <5 mM. Chemical inhibitors (CCCP, DNP, NaCN, and PCMBS) and low temperature reduced sugar uptake. Sucrose influx was pH dependent while glucose was not. Embryos maintained a high sucrose to hexose ratio throughout development. At 25 days after pollination sucrose levels exceeded 200 mM while hexose levels remained below 5 mM. Glucose was rapidly converted to sucrose upon transport into the embryo. These circumstantial data indicate that sugar uptake by immature maize embryos is metabolically dependent and carrier mediated. Furthermore, sucrose transport appears to occur against its concentration gradient involving a H+/sucrose cotransport mechanism, while glucose influx is driven by its concentration gradient and subsequent metabolism

Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature

Directory of Open Access Journals (Sweden)

Coretti S

2015-04-01

Full Text Available Silvia Coretti,1 Federica Romano,1 Valentina Orlando,2 Paola Codella,1 Sabrina Prete,1 Eugenio Di Brino,1 Matteo Ruggeri1 1Post-Graduate School of Economics and Management (ALTEMS, Università Cattolica del Sacro Cuore, Rome, Italy; 2Center of Pharmacoeconomics (CIRFF, Department of Pharmacy, Federico II University, Naples, Italy Background: Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO, more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources. Objective: To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C. Methods: A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA agencies. Three reviewers dealt with study selection and data extraction blindly. Results: Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US $4,200 and $50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between $848 and $128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers. Conclusion: Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C. Keywords: hepatitis C, screening

Interventions for acute stroke management in Africa: a systematic review of the evidence

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Leonard Baatiema

2017-10-01

Full Text Available Abstract Background The past decades have witnessed a rapid evolution of research on evidence-based acute stroke care interventions worldwide. Nonetheless, the evidence-to-practice gap in acute stroke care remains variable with slow and inconsistent uptake in low-middle income countries (LMICs. This review aims to identify and compare evidence-based acute stroke management interventions with alternative care on overall patient mortality and morbidity outcomes, functional independence, and length of hospital stay across Africa. Methods This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guideline. An electronic search was conducted in six databases comprising MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL, Web of Science, Academic Search Complete and Cochrane Library for experimental and non-experimental studies. Eligible studies were abstracted into evidence tables and their methodological quality appraised using the Joanna Briggs Institute checklist. Data were analysed and presented narratively with reference to observed differences in patient outcomes, reporting p values and confidence intervals for any possible relationship. Results Initially, 1896 articles were identified and 37 fully screened. Four non-experimental studies (three cohort and one case series studies were included in the final review. One study focused on the clinical efficacy of a stroke unit whilst the remaining three reported on thrombolytic therapy. The results demonstrated a reduction in patient deaths attributed to stroke unit care and thrombolytic therapy. Thrombolytic therapy was also associated with reductions in symptomatic intracerebral haemorrhage (SICH. However, the limited eligible studies and methodological limitations compromised definitive conclusions on the extent of and level of efficacy of evidence-based acute stroke care interventions across Africa

Are Treponema pallidum specific rapid and point-of-care tests for syphilis accurate enough for screening in resource limited settings? Evidence from a meta-analysis.

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Yalda Jafari

Full Text Available Rapid and point-of-care (POC tests for syphilis are an invaluable screening tool, yet inadequate evaluation of their diagnostic accuracy against best reference standards limits their widespread global uptake. To fill this gap, a systematic review and meta-analysis was conducted to evaluate the sensitivity and specificity of rapid and POC tests in blood and serum samples against Treponema pallidum (TP specific reference standards.Five electronic databases (1980-2012 were searched, data was extracted from 33 articles, and Bayesian hierarchical models were fit.In serum samples, against a TP specific reference standard point estimates with 95% credible intervals (CrI for the sensitivities of popular tests were: i Determine, 90.04% (80.45, 95.21, ii SD Bioline, 87.06% (75.67, 94.50, iii VisiTect, 85.13% (72.83, 92.57, and iv Syphicheck, 74.48% (56.85, 88.44, while specificities were: i Syphicheck, 99.14% (96.37, 100, ii Visitect, 96.45% (91.92, 99.29, iii SD Bioline, 95.85% (89.89, 99.53, and iv Determine, 94.15% (89.26, 97.66. In whole blood samples, sensitivities were: i Determine, 86.32% (77.26, 91.70, ii SD Bioline, 84.50% (78.81, 92.61, iii Syphicheck, 74.47% (63.94, 82.13, and iv VisiTect, 74.26% (53.62, 83.68, while specificities were: i Syphicheck, 99.58% (98.91, 99.96, ii VisiTect, 99.43% (98.22, 99.98, iii SD Bioline, 97.95%(92.54, 99.33, and iv Determine, 95.85% (92.42, 97.74.Rapid and POC treponemal tests reported sensitivity and specificity estimates comparable to laboratory-based treponemal tests. In resource limited settings, where access to screening is limited and where risk of patients lost to follow up is high, the introduction of these tests has already been shown to improve access to screening and treatment to prevent stillbirths and neonatal mortality due to congenital syphilis. Based on the evidence, it is concluded that rapid and POC tests are useful in resource limited settings with poor access to laboratories or screening

Fungal inoculation and elevated CO2 mediate growth of Lolium mutiforum and Phytolacca americana, metal uptake, and metal bioavailability in metal-contaminated soil: evidence from DGT measurement.

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Song, Ningning; Wang, Fangli; Zhang, Changbo; Tang, Shirong; Guo, Junkang; Ju, Xuehai; Smith, Donald L

2013-01-01

Fungal inoculation and elevated CO2 may mediate plant growth and uptake of heavy metals, but little evidence from Diffusive Gradients in Thin-films (DGT) measurement has been obtained to characterize the process. Lolium mutiforum and Phytolacca americana were grown at ambient and elevated CO2 on naturally Cd and Pb contaminated soils inoculated with and without Trichoderma asperellum strain C3 or Penicillium chrysogenum strain D4, to investigate plant growth, metal uptake, and metal bioavailability responses. Fungal inoculation increased plant biomass and shoot/root Cd and Pb concentrations. Elevated CO2 significantly increased plants biomass, but decreased Cd and Pb concentrations in shoot/root to various extents, leading to a metal dilution phenomenon. Total Cd and Pb uptake by plants, and DGT-measured Cd and Pb concentrations in rhizosphere soils, were higher in all fungal inoculation and elevated CO2 treatments than control treatments, with the combined treatments having more influence than either treatment alone. Metal dilution phenomenon occurred because the increase in DGT-measured bioavailable metal pools in plant rhizosphere due to elevated CO2 was unable to match the increase in requirement for plant uptake of metals due to plant biomass increase.

TfR Binding Peptide Screened by Phage Display Technology ...

African Journals Online (AJOL)

Purpose: To screen an hTfR affinity peptide and investigate its activity in vitro. Methods: hTfR ... Keywords: Peptide, hTfR, Transferrin receptor, Phage display technology, Enhanced green ..... mediated uptake of peptides that bind the human.

Can colorectal cancer mass-screening organization be evidence-based? Lessons from failures: The experimental and pilot phases of the Lazio program

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Valle Sabrina

2008-09-01

Full Text Available Abstract Background Screening programmes should be organized to translate theoretical efficacy into effectiveness. An evidence-based organizational model of colorectal cancer screening (CRCS should assure feasibility and high compliance. Methods A multidisciplinary Working Group (WG, reviewed literature and guidelines to define evidence-based recommendations. The WG identified the need for further local studies: physicians' CRCS attitudes, the effect of test type and provider on compliance, and individual reasons for non-compliance. A survey of digestive endoscopy services was conducted. A feasibility study on a target population of 300.000 has begun. Results Based on the results of population trials and on literature review the screening strategy adopted was Faecal Occult Blood Test (FOBT every two years for 50–74 year olds and, for positives, colonoscopy. The immunochemical test was chosen because it has 20% higher compliance than the Guaiac. GPs were chosen as the preferred provider also for higher compliance. Since we observed that distance is the major determinant of non-compliance, we choose GPs because they are the closest providers, both geographically and emotionally, to the public. The feasibility study showed several barriers: GP participation was low, there were administrative problems to involve GPs; opportunistic testing by the GPs; difficulties in access to Gastroenterology centres; difficulties in gathering colonoscopy results; little time given to screening activity by the gastroenterology centre. Conclusion The feasibility study highlighted several limits of the model. Most of the barriers that emerged were consequences of organisational choices not supported by evidence. The principal limit was a lack of accountability by the participating centres.

Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?

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Warren-Gash, Charlotte; Bartley, Angela; Bayly, Jude; Dutey-Magni, Peter; Edwards, Sarah; Madge, Sara; Miller, Charlotte; Nicholas, Rachel; Radhakrishnan, Sheila; Sathia, Leena; Swarbrick, Helen; Blaikie, Dee; Rodger, Alison

2016-01-04

Domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net. A series of observational studies. Three outpatient clinics at the Royal Free London NHS Foundation Trust. 10,158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period. (1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3 years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources. Of the 10,158 patients screened, 57.4% were female with a median age of 30 years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere. Selective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in

Selective information seeking: can consumers' avoidance of evidence-based information on colorectal cancer screening be explained by the theory of cognitive dissonance?

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Mühlhauser, Ingrid

2007-08-01

Full Text Available Background: Evidence-based patient information (EBPI is a prerequisite for informed decision-making. However, presentation of EBPI may lead to irrational reactions causing avoidance, minimisation and devaluation of the information. Objective: To explore whether the theory of cognitive dissonance is applicable to medical decision-making and useful to explain these phenomena. Setting and participants: 261 volunteers from Hamburg (157 women, ≥50 years old without diagnosis of colorectal cancer. Design and variables: Within an experiment we simulated information seeking on colorectal cancer screening. Consumers’ attitudes towards screening were surveyed using a rating scale from -5 (participate in no way to +5 (participate unconditionally (independent variable. Using a cover story, participants were asked to sort 5 article headlines according to their reading preferences. The headlines simulated the pro to contra variety of contents to be found in print media about colorectal cancer screening. The dependent variable was the sequence of article headlines. Results: Participants were very much in favour of screening with scores for faecal occult blood test of 4.0 (0.1 and for colonoscopy 3.3 (0.1. According to our hypothesis we found statistically significant positive correlations between the stimuli in favour of screening and attitudes and significant negative correlations between the stimuli against screening and attitudes. Conclusion: The theory of cognitive dissonance is applicable to medical decision-making. It may explain some phenomena of irrational reactions to evidence-based patient information.

How many "Get Screened" messages does it take? Evidence from colorectal cancer screening promotion in the United States, 2012.

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Cooper, Crystale Purvis; Gelb, Cynthia A; Hawkins, Nikki A

2014-03-01

Colorectal cancer screening has been widely promoted in the United States. We investigated the association between reported exposure to screening information during the past year and screening participation and knowledge. Data from the 2012 HealthStyles Fall survey of U.S. adults were examined using adjusted logistic regression to examine the frequency of exposure to screening information as a predictor of screening participation and knowledge; analyses were limited to participants aged ≥50years with no history of colorectal cancer or polyps (N=1714). Nearly half of the participants (44.9%) reported exposure to colorectal cancer screening information during the previous year. The most common sources of screening information were news reports, advertisements, and health care providers. Screening participation and knowledge consistently increased with the reported frequency of exposure to screening information, and these associations generally persisted when demographic variables were controlled. Compared with unexposed participants, significant gains in screening participation were associated with exposure to screening information 2-3 times (Adj. OR=1.84, p=0.001), 4-9 times (Adj. OR=2.00, p=0.001), and ≥10 times (Adj. OR=3.03, p<0.001) in the adjusted model. Increasing public exposure to screening promotion messages may augment screening participation and knowledge. Published by Elsevier Inc.

A Cost-Utility Analysis of Prostate Cancer Screening in Australia.

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Keller, Andrew; Gericke, Christian; Whitty, Jennifer A; Yaxley, John; Kua, Boon; Coughlin, Geoff; Gianduzzo, Troy

2017-02-01

The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. A decision model that incorporated Markov processes was developed from a health system perspective. The base-case scenario compared a population-based screening programme with current opportunistic screening practices. Costs, utility values, treatment patterns and background mortality rates were derived from Australian data. All costs were adjusted to reflect July 2015 Australian dollars (A$). An alternative scenario compared systematic with opportunistic screening but with optimisation of active surveillance (AS) uptake in both groups. A discount rate of 5 % for costs and benefits was utilised. Univariate and probabilistic sensitivity analyses were performed to assess the effect of variable uncertainty on model outcomes. Our model very closely replicated the number of deaths from both prostate cancer and background mortality in the Göteborg study. The incremental cost per quality-adjusted life-year (QALY) for PSA screening was A$147,528. However, for years of life gained (LYGs), PSA-based screening (A$45,890/LYG) appeared more favourable. Our alternative scenario with optimised AS improved cost utility to A$45,881/QALY, with screening becoming cost effective at a 92 % AS uptake rate. Both modelled scenarios were most sensitive to the utility of patients before and after intervention, and the discount rate used. PSA-based screening is not cost effective compared with Australia's assumed willingness-to-pay threshold of A$50,000/QALY. It appears more cost effective if LYGs are used as the relevant outcome, and is more cost effective than the

[3H]Dopamine uptake by platelet storage granules in schizophrenia

International Nuclear Information System (INIS)

Rabey, J.M.; Graff, E.; Oberman, Z.; Lerner, A.; Sigal, M.

1992-01-01

[ 3 H]Dopamine (DA) uptake by platelet storage granules was determined in 26 schizophrenic male patients, paranoid type (14 acute stage; 12 in remission) and 20 age-matched, normal controls. maximum velocity (Vmax) of DA uptake was significantly higher in acute patients, than patients in remission or controls (p>0.05). The apparent Michaelis constant (kM) of DA uptake in acute patients was also significantly different from chronic patients a substantial diminution of DA uptake, while haloperidol produced a substantial diminution of DA uptake, while haloperidol (10 -4 , 10 -5 M) did not affect the assay. Considering that a DA disequilibrium in schizophrenia may be expressed not only in the brain, but also in the periphery and that an increased amount of DA accumulated in the vesicles, implies that an increased quantity of catecholamine is available for release, our findings suggest additional evidence for the role of DA overactivity in the pathophysiology of this disorder

Is there a strategy I iron uptake mechanism in maize?

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Li, Suzhen; Zhou, Xiaojin; Chen, Jingtang; Chen, Rumei

2018-04-03

Iron is a metal micronutrient that is essential for plant growth and development. Graminaceous and nongraminaceous plants have evolved different mechanisms to mediate Fe uptake. Generally, strategy I is used by nongraminaceous plants like Arabidopsis, while graminaceous plants, such as rice, barley, and maize, are considered to use strategy II Fe uptake. Upon the functional characterization of OsIRT1 and OsIRT2 in rice, it was suggested that rice, as an exceptional graminaceous plant, utilizes both strategy I and strategy II Fe uptake systems. Similarly, ZmIRT1 and ZmZIP3 were identified as functional zinc and iron transporters in the maize genome, along with the determination of several genes encoding Zn and Fe transporters, raising the possibility that strategy I Fe uptake also occurs in maize. This mini-review integrates previous reports and recent evidence to obtain a better understanding of the mechanisms of Fe uptake in maize.

Rates of detection of developmental problems at the 18-month well-baby visit by family physicians' using four evidence-based screening tools compared to usual care: a randomized controlled trial.

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Thomas, R E; Spragins, W; Mazloum, G; Cronkhite, M; Maru, G

2016-05-01

Early and regular developmental screening can improve children's development through early intervention but is insufficiently used. Most developmental problems are readily evident at the 18-month well-baby visit. This trial's purpose is to: (1) compare identification rates of developmental problems by GPs/family physicians using four evidence-based tools with non-evidence based screening, and (2) ascertain whether the four tools can be completed in 10-min pre-visit on a computer. We compared two approaches to early identification via random assignment of 54 families to either: 'usual care' (informal judgment including ad-hoc milestones, n = 25); or (2) 'Evidence-based' care (use of four validated, accurate screening tools, n = 29), including: the Parents' Evaluation of Developmental Status (PEDS), the PEDS-Developmental Milestones (PEDS-DM), the Modified Checklist for Autism in Toddlers (M-CHAT) and PHQ9 (maternal depression). In the 'usual care' group four (16%) and in the evidence-based tools group 18 (62%) were identified as having a possible developmental problem. In the evidence-based tools group three infants were to be recalled at 24 months for language checks (no specialist referrals made). In the 'usual care' group four problems were identified: one child was referred for speech therapy, two to return to check language at 24 months and a mother to discuss depression. All forms were completed on-line within 10 min. Despite higher early detection rates in the evidence-based care group, there were no differences in referral rates between evidence-based and usual-care groups. This suggests that clinicians: (1) override evidence-based screening results with informal judgment; and/or (2) need assistance understanding test results and making referrals. Possible solutions are improve the quality of information obtained from the screening process, improved training of physicians, improved support for individual practices and acceptance by the regional

Uptake and utilization of nutrients by developing kernels of Zea mays L

International Nuclear Information System (INIS)

Lyznik, L.A.

1987-01-01

The mechanisms involved in amino acid and sugar uptake by developing maize kernels were investigated. In the pedicel region of maize kernel, the site of nutrient unloading from phloem terminals, amino acids are accumulated in considerable amounts and undergo significant interconversion. A wide spectrum of enzymatic activities involved in the metabolism of amino acids is observed in these tissues. Subsequently, amino acids are taken up by the endosperm tissue in processes which require energy and the presence of carrier proteins. Conversely, no evidence was found that energy and carriers are involved in sugar uptake. This process of sugar uptake is not inhibited by metabolic inhibitors and shows nonsaturable kinetics, but the uptake is pH-dependent. L-glucose is taken up at a significantly reduced rate in comparison to D-glucose uptake. Based on analysis of radioactivity distribution among sugar fractions after incubations of kernels with radiolabeled D-glucose, it seems that sucrose is not efficiently resynthesized from D-glucose in the endosperm tissue. Thus, the proposed mechanism of sucrose transport involving sucrose hydrolysis in the pedicel region and subsequent resynthesis in endosperm cells may not be the main pathway. The evidence that transfer cells play an active role in D-glucose transport is presented

Breast cancer screening awareness, knowledge, and practice among arab women in the United Arab Emirates: a cross-sectional survey.

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Yusra E Elobaid

Full Text Available BACKGROUND: Breast cancer screening can reduce morbidity and mortality and improve the survival rate for this malignancy. Low participation in screening programs has been attributable to many factors including lack of knowledge. The aim of this study was to assess breast cancer screening knowledge, attitudes and practices among women of screening age (≥40 years old in the city of Al Ain, United Arab Emirates (UAE. METHODS: A cross-sectional survey was conducted in 2013 using the Breast Cancer Awareness Measure (CAM. Four out of twelve cultural and religious community centers in Al Ain city were randomly selected. Two hundred and forty seven women were interviewed. Chi Square test and regression analysis were used to analyze the data. RESULTS: Despite the increase in the uptake of screening modalities in our study group, a lack of knowledge about breast cancer screening is still evident. Almost half (44.8% of women who never had a Clinical Breast Exam (CBE and 44.1% of women who never had a mammography expressed a lack of knowledge about the existence of these screening techniques. Nearly one third of the participants interpreted the presence of a breast lump incorrectly and, moreover, expressed fewer worries about the nature of the lump than would normally be expected. CONCLUSIONS: The National screening program needs to be improved and directed towards more efficient and targeted utilization of resources. Healthcare professionals play a major role in alerting women to the importance of periodic screening.

School scoliosis screening programme-a systematic review.

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Sabirin, J; Bakri, R; Buang, S N; Abdullah, A T; Shapie, A

2010-12-01

A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.

Colonic uptake patterns of F-18-FDG PET in asymptomatic adults: correlation with colonoscopic findings

International Nuclear Information System (INIS)

Pai, M.; Cho, Y.; Shim, K

2004-01-01

Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET. Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate those with colonoscopic findings. We reviewed retrospectively 64 subjects (age: 27-87, M:F = 31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake pattern was classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. In 34 patients FDG bowel uptake was interpreted as diffuse(group I), in 17 patients as segmental(group II) and in 13 patients as focal uptake(group III). Six adenomas(17.6%, average diameter = 5 mm) were found in group I, 7 adenomas (41.1%, 5.57 mm) in group II and 4 adenomas and 1 adenocarcinoma (30.7%, 16.4 mm) in group III. There was no difference in averages of SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (group I: 1.675±1.15 vs 1.94±0.62, group II: 4.78±3.66 vs 4.23±1.13, group III: 6.50±4.68 vs 4.1±1.01). Large adenomas( >1 cm) were detected more frequently in group III (4 out of 5) rather than in group II (1 out of 7) or group I (none) and had higher SUV (6.30±4.84) than small adenomas (3.74±3.23). In group III, 4 patients without adenomas were non-physiologic(30.7%, 2 intestinal tuberculosis, 2 mucosal ulcer). Focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may imply normal or having small adenomas

LOAD-ENHANCED MOVEMENT QUALITY SCREENING AND TACTICAL ATHLETICISM: AN EXTENSION OF EVIDENCE.

Science.gov (United States)

Glass, Stephen M; Schmitz, Randy J; Rhea, Christopher K; Ross, Scott E

2017-06-01

Military organizations use movement quality screening for prediction of injury risk and performance potential. Currently, evidence of an association between movement quality and performance is limited. Recent work has demonstrated that external loading strengthens the relationship between movement screens and performance outcomes. Such loading may therefore steer us toward robust implementations of movement quality screens while maintaining their appeal as cost effective, field-expedient tools. The purpose of the current study was to quantify the effect of external load-bearing on the relationship between clinically rated movement quality and tactical performance outcomes while addressing the noted limitations. Crossover Trial. Fifty young adults (25 male, 25 female, 22.98 ± 3.09 years, 171.95 ± 11.46 cm, 71.77 ± 14.03 kg) completed the Functional Movement Screen™ with (FMS™W) and without (FMS™C) a weight vest in randomized order. Following FMS™ testing, criterion measures of tactical performance were administered, including agility T-Tests, sprints, a 400-meter run, the Mobility for Battle (MOB) course, and a simulated casualty rescue. For each performance outcome, regression models were selected via group lasso with smoothed FMS™ item scores as candidate predictor variables. For all outcomes, proportion of variance accounted for was greater in FMS™W (R 2 = ;0.22 [T-Test], 0.29 [Sprint], 0.17 [400 meter], 0.29 [MOB], and 0.11 [casualty rescue]) than in FMS™C (R 2 = ;0.00 [T-Test], 0.11 [Sprint], 0.00 [400 meter], 0.19 [MOB], and 0.00 [casualty rescue]). From the FMS™W condition, beneficial performance effects (ptactical performance ability. Future designs should seek to identify mechanisms explaining this effect. 3.

International Cancer Screening Network

Science.gov (United States)

The International Cancer Screening Network promotes evidence-based cancer screening implementation and evaluation with cooperation from multilateral organizations around the globe. Learn more about how ICSN aims to reduce the global burden of cancer by supporting research and international collaboration.

Evidence for a plasma-membrane-bound nitrate reductase involved in nitrate uptake of Chlorella sorokiniana

Science.gov (United States)

Tischner, R.; Ward, M. R.; Huffaker, R. C.

1989-01-01

Anti-nitrate-reductase (NR) immunoglobulin-G (IgG) fragments inhibited nitrate uptake into Chlorella cells but had no affect on nitrate uptake. Intact anti-NR serum and preimmune IgG fragments had no affect on nitrate uptake. Membrane-associated NR was detected in plasma-membrane (PM) fractions isolated by aqueous two-phase partitioning. The PM-associated NR was not removed by sonicating PM vesicles in 500 mM NaCl and 1 mM ethylenediaminetetraacetic acid and represented up to 0.8% of the total Chlorella NR activity. The PM NR was solubilized by Triton X-100 and inactivated by Chlorella NR antiserum. Plasma-membrane NR was present in ammonium-grown Chlorella cells that completely lacked soluble NR activity. The subunit sizes of the PM and soluble NRs were 60 and 95 kDa, respectively, as determined by sodium-dodecyl-sulfate electrophoresis and western blotting.

Awareness of cervical cancer and willingness to participate in screening program: Public health policy implications

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Somdatta Patra

2017-01-01

Conclusions: The country's national program advocates for opportunistic and targeted screening of women. An understanding of the factors that influences womens' willingness to participate in screening program is essential for the success of such programs. Hence, this study emphasizes the need for dissemination of knowledge about various aspects of cancer cervix which is critical for uptake of any screening program in a developing country.

Inhibitors of glutamate dehydrogenase block sodium-dependent glutamate uptake in rat brain membranes

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Brendan S Whitelaw

2013-09-01

Full Text Available We recently found evidence for anatomic and physical linkages between the astroglial Na+-dependent glutamate transporters (GLT-1/EAAT2 and GLAST/EAAT1 and mitochondria. In these same studies, we found that the glutamate dehydrogenase (GDH inhibitor, epigallocatechin-monogallate (EGCG, inhibits both glutamate oxidation and Na+-dependent glutamate uptake in astrocytes. In the present study, we extend this finding by exploring the effects of EGCG on Na+-dependent L-[3H]-glutamate (Glu uptake in crude membranes (P2 prepared from rat brain cortex. In this preparation, uptake is almost exclusively mediated by GLT-1. EGCG inhibited L-[3H]-Glu uptake in cortical membranes with an IC50 value of 230 µM. We also studied the effects of two additional inhibitors of GDH, hexachlorophene (HCP and bithionol (BTH. Both of these compounds also caused concentration-dependent inhibition of glutamate uptake in cortical membranes. Pre-incubating with HCP for up to 15 min had no greater effect than that observed with no pre-incubation, showing that the effects occur rapidly. HCP decreased the Vmax for glutamate uptake without changing the Km, consistent with a non-competitive mechanism of action. EGCG, HCP, and BTH also inhibited Na+-dependent transport of D-[3H]-aspartate (Asp, a non-metabolizable substrate, and [3H]-γ-aminobutyric acid (GABA. In contrast to the forebrain, glutamate uptake in crude cerebellar membranes (P2 is likely mediated by GLAST (EAAT1. Therefore, the effects of these compounds were examined in cerebellar membranes. In this region, none of these compounds had any effect on uptake of either L-[3H]-Glu or D-[3H]-Asp, but they all inhibited [3H]-GABA uptake. Together these studies suggest that GDH is preferentially required for glutamate uptake in forebrain as compared to cerebellum, and GDH may be required for GABA uptake as well. They also provide further evidence for a functional linkage between glutamate transport and mitochondria.

Mammography for women in their 40s : to screen or not to screen

International Nuclear Information System (INIS)

Le Heron, J.

1997-01-01

In the United States there is currently a raging controversy as to whether women in their 40s should be screened for breast cancer, with responsible medical bodies each issuing divergent recommendations. With the imminent commencement of the national breast screening programme in New Zealand, it is relevant to briefly review what underlies these differences. The evicence from international studies is that breast cancer deaths on the population of women aged 50 to 69 can be reduced by about 30% by good mammography screening programes. However the evidence in not so unequivocal for the 40 to 49 age group. Breast cancer in younger women tends to be more virulent, growing faster, and killing faster, and detection of cancer in younger breasts is more difficult than in breasts of older women due to the presence of greater amounts of glandular tissue. Where does this leave breast screening in New Zealand? The nationwide breast screening programme will commence with asymmptomatic women aged 50-64 eligible for screening. Extension to women older than 64 will be considered again once the programme is in place and running well. The Ministry of Health has not recommended routine screening for women in their 40s, but will continue to monitor the latest information and if, sufficient new evidence becomes availabe, the screening guidelines will be reassessed. (author)

Using the Frailty Assessment for Care Planning Tool (FACT to screen elderly chronic kidney disease patients for frailty: the nurse experience

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Moffatt H

2018-05-01

Full Text Available Heather Moffatt,1 Paige Moorhouse,1,2 Laurie Mallery,1,2 David Landry,1 Karthik Tennankore2 1Nova Scotia Health Authority, Halifax, NS, Canada; 2Dalhousie University, Halifax, NS, CanadaPurpose: Recent evidence supports the prognostic significance of frailty for functional decline and poor health outcomes in patients with chronic kidney disease. Yet, despite the development of clinical tools to screen for frailty, little is known about the experiential impact of screening for frailty in this setting. The Frailty Assessment for Care Planning Tool (FACT evaluates frailty across 4 domains: mobility, function, social circumstances, and cognition. The purpose of this qualitative study was as follows: 1 explore the nurse experience of screening for frailty using the FACT tool in a specialized outpatient renal clinic; 2 determine how, if at all, provider perceptions of frailty changed after implementation of the frailty screening tool; and 3 determine the perceived factors that influence uptake and administration of the FACT screening tool in a specialized clinical setting.Methods: A semi-structured interview of 5 nurses from the Nova Scotia Health Authority, Central Zone Renal Clinic was conducted. A grounded theory approach was used to generate thematic categories and analysis models.Results: Four primary themes emerged in the data analysis: “we were skeptical”, “we made it work”, “we learned how”, and “we understand”. As the renal nurses gained a sense of confidence in their ability to implement the FACT tool, initial barriers to implementation were attenuated. Implementation factors – such as realistic goals, clear guidelines, and ongoing training – were important factors for successful uptake of the frailty screening initiative.Conclusion: Nurse participants reported an overall positive experience using the FACT method to screen for frailty and indicated that their understanding of the multiple dimensions and subtleties of �

Screening Children for Caries: An Ethical Dilemma in Nigeria.

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Oluwatoyin Folayan, Morenike; Gabriella Haire, Bridget; Adeniyi, Abiola A; Lanre Adeyemo, Wasiu

2018-03-13

Dental caries is the main oral health challenge for children in Nigeria. Concern about its negative impact makes screening for caries in children an attractive public health strategy. The ability to detect the preclinical phase of caries, the availability of screening tools with high accuracy, and the possibility of treatment before onset of clinical symptoms with significant cost and health benefits, makes it appropriate for screening. However in Nigeria, the poor availability of highly specific and sensitive screening tools, poor access to oral health care and concerns with pre-screening consent, raise the question of the appropriateness of conducting screening programmes for children. We argue that a number of structural challenges associated with poor uptake of oral health care services need to be addressed before screening for caries can be considered ethically appropriate. These include facilitating access of children to quality oral health care and a systematic national approach to oral health implementation. Failure to address challenges associated with dental service utilization by children in Nigeria increases the risk of screening programmes promoting inequitable access to oral health care services.

( sup 3 H)Dopamine uptake by platelet storage granules in schizophrenia

Energy Technology Data Exchange (ETDEWEB)

Rabey, J.M.; Graff, E.; Oberman, Z. (Tel-Aviv Sourasky Medical Center (Israel)); Lerner, A.; Sigal, M. (Tel-Aviv Univ. (Israel))

1992-01-01

({sup 3}H)Dopamine (DA) uptake by platelet storage granules was determined in 26 schizophrenic male patients, paranoid type (14 acute stage; 12 in remission) and 20 age-matched, normal controls. maximum velocity (Vmax) of DA uptake was significantly higher in acute patients, than patients in remission or controls (p>0.05). The apparent Michaelis constant (kM) of DA uptake in acute patients was also significantly different from chronic patients a substantial diminution of DA uptake, while haloperidol produced a substantial diminution of DA uptake, while haloperidol (10{sup {minus}4}, 10{sup {minus}5} M) did not affect the assay. Considering that a DA disequilibrium in schizophrenia may be expressed not only in the brain, but also in the periphery and that an increased amount of DA accumulated in the vesicles, implies that an increased quantity of catecholamine is available for release, our findings suggest additional evidence for the role of DA overactivity in the pathophysiology of this disorder.

Integrating cervical cancer screening and preventive treatment with family planning and HIV-related services.

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White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia

2017-07-01

Cervical cancer is a leading cause of mortality in Sub-Saharan Africa-in large part because of inadequate coverage of screening and preventive treatment services. A number of programs have begun integrating cervical cancer prevention services into existing family planning or HIV/AIDS service delivery platforms, to rapidly expand "screen and treat" programs and mitigate cervical cancer burden. Drawing upon a review of literature and our experiences, we consider benefits and challenges associated with such programs in Sub-Saharan Africa. We then outline steps that can optimize uptake and sustainability of integrated sexual and reproductive health services. These include increasing coordination among implementing organizations for efficient use of resources; task shifting for services that can be provided by nonphysicians; mobilizing communities via trusted frontline health workers; strengthening management information systems to allow for monitoring of multiple services; and prioritizing an operational research agenda to provide further evidence on the cost-effectiveness and benefits of integrated service delivery. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy-A Randomized Controlled Trial.

Science.gov (United States)

Mehta, Shivan J; Feingold, Jordyn; Vandertuyn, Matthew; Niewood, Tess; Cox, Catherine; Doubeni, Chyke A; Volpp, Kevin G; Asch, David A

2017-11-01

Behavioral economic approaches could increase uptake for colorectal cancer screening. We performed a randomized controlled trial of 2245 employees to determine whether an email containing a phone number for scheduling (control), an email with the active choice to opt in or opt out (active choice), or the active choice email plus a $100 incentive (financial incentive) increased colonoscopy completion within 3 months. Higher proportions of participants in the financial incentive group underwent screening (3.7%) than in the control (1.6%) or active choice groups (1.5%) (P = .01 and P < .01). We found no difference in uptake of screening between the active choice and control groups (P = .88). The $100 conditional incentive modestly but significantly increased colonoscopy use. ClinicalTrials.gov no: NCT02660671. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends

DEFF Research Database (Denmark)

Jørgensen, Karsten Juhl; Gøtzsche, Peter C

2009-01-01

. DATA SOURCES: PubMed (April 2007), reference lists, and authors. Review methods One author extracted data on incidence of breast cancer (including carcinoma in situ), population size, screening uptake, time periods, and age groups, which were checked independently by the other author. Linear regression......OBJECTIVE: To estimate the extent of overdiagnosis (the detection of cancers that will not cause death or symptoms) in publicly organised screening programmes. DESIGN: Systematic review of published trends in incidence of breast cancer before and after the introduction of mammography screening...... was used to estimate trends in incidence before and after the introduction of screening and in older, previously screened women. Meta-analysis was used to estimate the extent of overdiagnosis. RESULTS: Incidence data covering at least seven years before screening and seven years after screening had been...

Pathophysiology, risk factors, and screening methods for prediabetes in women with polycystic ovary syndrome.

Science.gov (United States)

Gourgari, Evgenia; Spanakis, Elias; Dobs, Adrian Sandra

2016-01-01

Polycystic ovary syndrome (PCOS) is a syndrome associated with insulin resistance (IR), obesity, infertility, and increased cardiometabolic risk. This is a descriptive review of several mechanisms that can explain the IR among women with PCOS, other risk factors for the development of diabetes, and the screening methods used for the detection of glucose intolerance in women with PCOS. Few mechanisms can explain IR in women with PCOS such as obesity, insulin receptor signaling defects, and inhibition of insulin-mediated glucose uptake in adipocytes. Women with PCOS have additional risk factors for the development of glucose intolerance such as family history of diabetes, use of oral contraceptives, anovulation, and age. The Androgen Society in 2007 and the Endocrine Society in 2013 recommended using oral glucose tolerance test as a screening tool for abnormal glucose tolerance in all women with PCOS. The approach to detection of glucose intolerance among women with PCOS varies among health care providers. Large prospective studies are still needed for the development of guidelines with strong evidence. When assessing risk of future diabetes in women with PCOS, it is important to take into account the method used for screening as well as other risk factors that these women might have.

Evidence of arterial wall uptake of fluorodeoxyglucose on imaging can indicate recent or future cardiovascular events in high-risk patients

International Nuclear Information System (INIS)

Paulmier, B.; Khayat, R.; Duet, M.; Pierquet-Ghazzar, N.; Maunoury, C.; Sauvaget, E.; Faraggi, M.; Laissy, J.P.

2007-01-01

With this study, we sought to identify plaque inflammation as assessed by 18 FDG uptake on positron emission tomography (PET)/computed tomography (CT) as an independent cardiovascular risk factor in patients at high risk for cardiovascular events. We compared 31 consecutive cancer patients presenting with visually enhanced 18 FDG uptake in arterial walls on PET/CT (Group 1) to a selection of 34 matched cancer patients not showing arterial uptake (Group 2). All patients were followed for two years before and six months after PET/CT... Cardiovascular events were classified as older (>6 months before PET/CT) or recent ( 18 FDG uptake was computed on non-attenuation corrected data by a AW/L ratio: mean Arterial Wall uptake/Lung uptake in a normal area, and by SUV on corrected data. A calcium score (CS) was also calculated. 18 FDG uptake and CS were higher in Group 1 than Group 2 (both p = 0.02), and older and recent cardiovascular events were significantly more frequent in Group 1 than Group 2 (p = 0.001 and p = 0.03. respectively). Among the following parameters: number of conventional risk factor, calcium score and presence of 18 FDG uptake, only the latter was significantly related to the occurrence of a recent event by multivariate analysis (p = 0.02). Patients with elevated arterial 18 FDG uptake have a high risk of immediate or future cardiovascular events. Arterial 18 FDG uptake is an indicator of evolving atherosclerotic process and can indicate future cardiovascular events. (authors)

Screening for speech and language delay in preschool children: systematic evidence review for the US Preventive Services Task Force.

Science.gov (United States)

Nelson, Heidi D; Nygren, Peggy; Walker, Miranda; Panoscha, Rita

2006-02-01

PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Published in the public domain by the American Academy of Pediatrics. Speech and language development is a useful indicator of a child's overall development and cognitive ability and is related to school success. Identification of children at risk for developmental delay or related problems may lead to intervention services and family assistance at a young age, when the chances for improvement are best. However, optimal methods for screening for speech and language delay have not been identified, and screening is practiced inconsistently in primary care. We sought to evaluate the strengths and limits of evidence about the effectiveness of screening and interventions for speech and language delay in preschool-aged children to determine the balance of benefits and adverse effects of routine screening in primary care for the development of guidelines by the US Preventive Services Task Force. The target population includes all children up to 5 years old without previously known conditions associated with speech and language delay, such as hearing and neurologic impairments. Studies were identified from Medline, PsycINFO, and CINAHL databases (1966 to November 19, 2004), systematic reviews, reference lists, and experts. The evidence review included only English-language, published articles that are available through libraries. Only randomized, controlled trials were considered for examining the effectiveness of interventions. Outcome measures were considered if they were obtained at any time or age after screening and/or intervention as long as the initial assessment occurred while the child was birth order, and family size. The performance characteristics of evaluation techniques that take or =2 screening techniques in 1 population, and comparisons of a single screening technique across different populations are lacking. Fourteen good- and fair-quality randomized, controlled trials of interventions

Knowledge, attitude and practice of cervical cancer screening (pap smear) among female nurses in Nnewi, South Eastern Nigeria.

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Udigwe, G O

2006-06-01

To determine the knowledge and practice of cervical cancer screening among practicing female nurses with a view to sensitizing them as a first step towards increasing screening uptake in the community. A self administered questionnaire survey of all the female nurses working in Nnamdi Azikiwe university Teaching Hospital Nnewi center. 144 out of 166 questionnaires were correctly completed and returned. 122 (87%) were aware of the existence of screening services. Although 9.3% had lost relations to cancer of the cervix, only 5.7% had ever undergone a pap smear. While 52 (37.1%) had no reason for not screening, 21 (15%) were afraid of the possible outcome and 35 (25%) felt they were not likely candidates for cancer of the cervix. knowledge of cervical cancer screening services among female nurses in Nnewi is high while uptake rate is abysmally poor. There is need to further educate the nurses who will play a major role in enlightening the public on the availability and need for cervical screening services.

[CT-Screening for Lung Cancer - what is the Evidence?

Science.gov (United States)

Watermann, Iris; Reck, Martin

2018-04-01

In patients with lung cancer treatment opportunities and prognosis are correlated to the stage of disease with a chance for curative treatment in patients with early stage disease. Therefore, early detection of lung cancer is of paramount importance for improving the prognosis of lung cancer patients.The National Lung Screening Trial (NLST) has already shown that low-dose CT increases the number of identified early stage lung cancer patients and reduces lung cancer related mortality. Critically considered in terms of CT-screening are false-positive results, overdiagnosis and unessential invasive clarification. Preliminary results of relatively small European trials haven´t yet confirmed the results of the NLST-study.Until now Lung Cancer Screening by low dose CT-scan or other methods is neither approved nor available in Germany.To improve the efficacy of CT-Screening and to introduce early detection of lung cancer in standard practice, additional, complementing methods should be further evaluated. One option might be the supplementary analysis of biomarkers in liquid biopsies or exhaled breath condensates. In addition, defining the high-risk population is of great relevance to identify candidates who might benefit of early detection programs. © Georg Thieme Verlag KG Stuttgart · New York.

Value for money from HPV vaccination and cervical screening

DEFF Research Database (Denmark)

Ashton, Toni; Sopina, Elizaveta (Liza)

2012-01-01

Introduction of human papillomavirus (HPV) vaccination programs raises some important questions about the future organization of cervical screening programs. Two studies - from NZ and Canada - have addressed the question of what combination of vaccination and screening strategies might be most cost......-effective in preventing cervical cancer. Both studies indicate that some modifications to existing screening programs may be desirable as immunized females enter these programs. Variables in HPV vaccination that are likely to be particularly important for determining the future cost-effectiveness of cervical screening...... programs include: vaccine uptake rate, compliance with full doses, timely completion of doses, duration of protection, male vaccination and HPV infection rate. If value for money is to be achieved, it is important that the appropriate data are collected so that policy makers can consider the combined...

Approaching the Hard-to-Reach in Organized Colorectal Cancer Screening: an Overview of Individual, Provider and System Level Coping Strategies

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Jason Liwen Huang

2017-06-01

Full Text Available Background: Despite the proven effectiveness of colorectal cancer (CRC screening on reduction of CRC mortality, the uptake of CRC screening remains low. Participation rate is one of determinants for the success of organized population-based screening program. This review aims to identify those who are hard-to-reach, and summarize the strategies to increase their screening rate from individual, provider and system levels. Methods: A systematic search of electronic English databases was conducted on the factors and strategies of uptake in CRC screening for the hard-to-reach population up to May 2017. Discussion: The coverage rate and participation rate are two indexes to identify the hard-to-reach population in organized CRC screening program. However, the homeless, new immigrants, people with severe mental illness, the jail intimates, and people with characteristics including lower education levels and/or low socioeconomic status, living in rural/remote areas, without insurance, and racial minorities are usually recognized as hard-to-reach populations. For them, organized screening programs offer a better coverage, while novel invitation approaches for eligible individuals and multiple strategies from primary care physicians are still needed to enhance screening rates among subjects who are hard-to-reach. Suggestions implied the effectiveness of interventions at the system level, including linkages to general practice; use of decision making tools; enlisting supports from coalition; and the continuum from screening to diagnosis and treatment. Conclusion: Organized CRC screening offers a system access to approach the hard-to-reach populations. To increase their uptake, multiple and novel strategies from individual, provider and system levels should be applied. For policymakers, public healthcare providers and community stakeholders, it is a test to tailor their potential needs and increase their participation rates through continuous efforts to

Screening of sunflower cultivars for metal phytoextraction in a contaminated field prior to mutagenesis.

Science.gov (United States)

Nehnevajova, Erika; Herzig, Rolf; Federer, Guido; Erismann, Karl-Hans; Schwitzguébel, Jean-Paul

2005-01-01

Sunflower can be used for the remediation of metal-contaminated soils. Its high biomass production makes this plant species interestingfor phytoextraction and using sunflower oil for a technical purpose may improve the economic balance of phytoremediation. The aim of the present field study was to screen 15 commercial cultivars of Helianthus annuus L. grown on metal-contaminated soil, to find out the variety with the highest metal extraction, which can be further improved by mutation or in vitro breeding procedures. Two different fertilizers (ammonium sulphate and ammonium nitrate) were also used to enhance the bioavailability of metals in soil Highly significant differences were observed within tested varieties for metal accumulation and extraction efficiency. Furthermore, ammonium nitrate increased cadmium extraction, whereas ammonium sulphate enhanced zinc and lead uptake in most tested cultivars. In this field-based sunflower screening, we found enhanced cumulative Cd, Zn, and Pb extraction efficiency by a factor 4.4 for Salut cultivar. We therefore emphasize that prior to any classical breeding or genetic engineering enhancing metal uptake potential, a careful screening of various genotypes should be done to select the cultivar with the naturally highest metal uptake and to start the genetic improvement with the best available plant material.

Gestational diabetes mellitus screening, management and outcomes in the Cook Islands.

Science.gov (United States)

Aung, Yin Yin May; Sowter, Martin; Kenealy, Timothy; Herman, Josephine; Ekeroma, Alec

2015-04-17

To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose greater than or equal to 7.8 mmol/L) was followed by a 75 g oral glucose tolerance test (gestational diabetes mellitus diagnosed if fasting glucose greater than or equal to 5.2 mmol/L or 2-hour glucose greater than or equal to 8.0 mmol/L; pregnancy impaired glucose tolerance if positive screen and negative diagnostic test). Uptake of the screening programme rose from 49.0% to 99.6% by the end of the study period. 646 women had a glucose challenge; for 186/646 (28.8%) the challenge was positive; 183 had an oral glucose tolerance test; 89/646 (13.8%) had pregnancy impaired glucose tolerance; 94/646 (13.9%) had gestational diabetes mellitus. Median maternal weight gain was 6 kg (gestational diabetes mellitus) and 10 kg (normal glucose tolerance); caesarean section rates were 25% and 11% respectively; baby birthweights were not significantly different. 59 women with gestational diabetes mellitus had a post-natal glucose tolerance test at their 6-week check and 21 (35.6%) had diabetes confirmed. The gestational diabetes mellitus screening programme has a high uptake and current management appears effective in reducing maternal and fetal weight gain. A proposed new screening programme is outlined.

99mTc-HYNIC-TOC increased uptake can mimic malignancy in the pancreas uncinate process at somatostatin receptor SPECT/CT.

Science.gov (United States)

Yamaga, Lilian Yuri Itaya; Neto, Guilherme Campos Carvalho; da Cunha, Marcelo Livorsi; Osawa, Akemi; Oliveira, Julio Cesar Silveira; Fonseca, Ricardo Quartim; Nogueira, Solange Amorim; Wagner, Jairo; Funari, Marcelo Gusmão

2016-03-01

The aim of this study was to assess the occurrence and frequency of increased physiologic uptake of 99mTc-HYNIC-TOC by the uncinate process of the pancreas in SPECT/CT images. Forty-six scans of 41 patients were evaluated retrospectively. The uptake of 99mTc-HYNIC-TOC was considered to be physiologic in patients with normal findings at dedicated abdominal CT or MR and lack of neoplastic lesions in clinical follow-ups. The intensity of uncinate process uptake was compared to the uptake of the normal liver. Focal uptake was attributed to the presence of pancreatic NET in 5 patients. Among the 36 patients without any evidence of malignancy in CT, MR and follow-up, 7 (19.4 %) showed increased uptake in the uncinate process. The intensity of uptake was lesser in 3 (8.3 %), similar in 3 and greater than the normal liver in 1 (2.8 %) case. Increased 99mTc-HYNIC-TOC uptake occurred in 19.4 % of those subjects without any evidence of neuroendocrine tumor in the uncinate process.

Difference in F-18 FDG uptake after esophago gastroduodenoscopy and colonoscopy in healthy sedated subjects

Energy Technology Data Exchange (ETDEWEB)

Oh, Jong Ryool; Chang, Woo Jin; Bae, Seung Il; Song, In Wook; Bong, Jin Gu; Jeong, Hye Yeon; Park, So Young; Bae, Jeong Yup; Yoon, Hyun Dae [Raphael Hospital, Daegu (Korea, Republic of); Seo, Ji Hyoung [Dept. of Nuclear MedicineFatima Hospital, Daegu (Korea, Republic of)

2017-09-15

We aimed to evaluate the difference in fluorodeoxyglucose (FDG) uptake in sedated healthy subjects after they underwent esophagogastroduodenoscopy (EGD) and colonoscopy procedures. The endoscopy group (n = 29) included healthy subjects who underwent screening via F-18 FDG positron emission tomography/computed tomography (PET/CT) after an EGD and/or colonoscopy under sedation on the same day. The control group (n = 35) included healthy subjects who underwent screening via PET/CT only. FDG uptake in the tongue, uvula, epiglottis, vocal cords, esophagus, stomach, duodenum, liver, cecum, colon, anus, and muscle were compared between the two groups. Maximum standardized uptake value (SUVmax) in the tongue, pharynx, larynx, and esophagus did not significantly differ between the endoscopy and control groups. In contrast, mean SUVmax in the whole stomach was 18 % higher in the endoscopy group than in the control group (SUVmax: 2.96 vs. 2.51, P = 0.010). In the lower gastrointestinal track, SUVmax from the cecum to the rectum was not significantly different between the two groups, whereas SUVmax in the anus was 20 % higher in the endoscopy group than in the control group (SUVmax: 4.21 vs. 3.50, P = 0.002). SUVmax in the liver and muscle was not significantly different between the two groups. Mean volume of the stomach and mean cross section of the colon was significantly higher in the endoscopy group than in the control group (stomach: 313.28 cm{sup 3} vs. 209.93 cm{sup 3}, P < 0.001, colon: 8.82 cm{sup 2} vs. 5.98 cm{sup 2}, P = 0.001). EGD and colonoscopy under sedation does not lead to significant differences in SUVmax in most parts of the body. Only gastric FDG uptake in the EGD subjects and anal FDG uptake in the colonoscopy subjects was higher than uptake in those regions in the control subjects.

Evidence-based medical research on diagnostic criteria and screening technique of vascular mild cognitive impairment

Directory of Open Access Journals (Sweden)

Xia-wei LIU

2015-07-01

Full Text Available Background Vascular mild cognitive impairment (VaMCI is the prodromal syndrome of vascular dementia (VaD and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI.  Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level Ⅰ, 5 on Level Ⅱ studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA/American Stroke Association (ASA in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG in 2014. Fifteen literatures (4 on LevelⅠ, 11 on Level Ⅱ described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level Ⅰ, 10 on Level Ⅱ described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN was being good consistency with other neuropsychological

Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

LENUS (Irish Health Repository)

Buckley, B S

2011-12-12

Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.

Small Screen Technology Use among Indigenous Boarding School Adolescents from Remote Regions of Western Australia

Science.gov (United States)

Johnson, Genevieve Marie; Oliver, Rhonda

2014-01-01

The uptake of small screen technology by adolescents is widespread, particularly in industrial nations. Whether the same is true for Australian Aboriginal youth is less clear as there is a dearth of research in this regard. Therefore, in this exploratory study the use of small screen technology by Indigenous students was examined. Twenty-four…

What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers.

Science.gov (United States)

Sicsic, Jonathan; Krucien, Nicolas; Franc, Carine

2016-10-01

General practitioners (GPs) play a key role in the delivery of preventive and screening services for breast, cervical, and colorectal cancers. In practice, GPs' involvement varies considerably across types of cancer and among GPs, raising important questions about the determinants of GPs' implication in screening activities: what is the relative impact of financial and non-financial incentives? Are GPs' preferences for financial and non-financial incentives cancer-specific? Is there preference heterogeneity and how much does it differ according to the screening context? This study investigates the determinants of GPs' involvement in cancer screening activities using the discrete choice experiment (DCE) methodology. A representative sample of 402 GPs' was recruited in France between March and April 2014. Marginal rates of substitution were used to compare GPs' preferences for being involved in screening activities across three types of cancers: breast, cervical, and colorectal. Variability of preferences was investigated using Hierarchical Bayes mixed logit models. The results indicate that GPs are sensitive to both financial and non-financial incentives, such as a compensated training and systematic transmission of information about screened patients, aimed to facilitate communication between doctors and patients. There is also evidence that the level and variability of preferences differ across screening contexts, although the variations are not statistically significant on average. GPs appear to be relatively more sensitive to financial incentives for being involved in colorectal cancer screening, whereas they have higher and more heterogeneous preferences for non-financial incentives in breast and cervical cancers. Our study provides new findings for policymakers interested in prioritizing levers to increase the supply of cancer screening services in general practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Projected national impact of colorectal cancer screening on clinical and economic outcomes and health services demand.

Science.gov (United States)

Ladabaum, Uri; Song, Kenneth

2005-10-01

Colorectal cancer (CRC) screening is effective and cost-effective, but the potential national impact of widespread screening is uncertain. It is controversial whether screening colonoscopy can be offered widely and how emerging tests may impact health services demand. Our aim was to produce integrated, comprehensive estimates of the impact of widespread screening on national clinical and economic outcomes and health services demand. We used a Markov model and census data to estimate the national consequences of screening 75% of the US population with conventional and emerging strategies. Screening decreased CRC incidence by 17%-54% to as few as 66,000 cases per year and CRC mortality by 28%-60% to as few as 23,000 deaths per year. With no screening, total annual national CRC-related expenditures were 8.4 US billion dollars. With screening, expenditures for CRC care decreased by 1.5-4.4 US billion dollars but total expenditures increased to 9.2-15.4 US billion dollars. Screening colonoscopy every 10 years required 8.1 million colonoscopies per year including surveillance, with other strategies requiring 17%-58% as many colonoscopies. With improved screening uptake, total colonoscopy demand increased in general, even assuming substantial use of virtual colonoscopy. Despite savings in CRC care, widespread screening is unlikely to be cost saving and may increase national expenditures by 0.8-2.8 US billion dollars per year with conventional tests. The current national endoscopic capacity, as recently estimated, may be adequate to support widespread use of screening colonoscopy in the steady state. The impact of emerging tests on colonoscopy demand will depend on the extent to which they replace screening colonoscopy or increase screening uptake in the population.

Uptake of /sup 86/Rb/sup +/ into photoautotrophic mesophyll cells of Papaver somniferum

Energy Technology Data Exchange (ETDEWEB)

Kaiser, W.M.; Jeschke, W.D.; Hartung, W.

1982-06-01

Uptake of /sup 86/Rb/sup +/, used as a tracer for potassium, into isolated photoautotrophic mesophyll cells of Papaver somniferum was weakly but consistently stimulated in the light. It showed mono-phasic saturation kinetics with a pH optimum of 7.0, a Vsub(max) of 6.7 ..mu..mol mg/sup -1/ Chl x h/sup -1/ and a Ksub(m) of 2.7 mmol l/sup -1/. Different anions as Cl/sup -/, NO/sub 3//sup -/ and PO/sub 4//sup 3 -/ had no effects on /sup 86/Rb/sup +/ uptake. Sodium ions influenced Rb/sup +/-uptake very weakly, indicating a high K/sup +/ -specificity of the mesophyll cell plasmalemma. Fusicoccin stimulated /sup 86/Rb/sup +/ -uptake strongly whereas abscisic acid inhibited uptake only following preincubation for two hours. Nitrite, CCCP and Dio-9 inhibited /sup 86/Rb/sup +/-uptake which gives evidence that this process is dependent on intact pH-gradients within the cells and on ATP-formation.

Enablers and Barriers to Large-Scale Uptake of Improved Solid Fuel Stoves: A Systematic Review

Science.gov (United States)

Puzzolo, Elisa; Stanistreet, Debbi; Pope, Daniel; Bruce, Nigel G.

2013-01-01

Background: Globally, 2.8 billion people rely on household solid fuels. Reducing the resulting adverse health, environmental, and development consequences will involve transitioning through a mix of clean fuels and improved solid fuel stoves (IS) of demonstrable effectiveness. To date, achieving uptake of IS has presented significant challenges. Objectives: We performed a systematic review of factors that enable or limit large-scale uptake of IS in low- and middle-income countries. Methods: We conducted systematic searches through multidisciplinary databases, specialist websites, and consulting experts. The review drew on qualitative, quantitative, and case studies and used standardized methods for screening, data extraction, critical appraisal, and synthesis. We summarized our findings as “factors” relating to one of seven domains—fuel and technology characteristics; household and setting characteristics; knowledge and perceptions; finance, tax, and subsidy aspects; market development; regulation, legislation, and standards; programmatic and policy mechanisms—and also recorded issues that impacted equity. Results: We identified 31 factors influencing uptake from 57 studies conducted in Asia, Africa, and Latin America. All domains matter. Although factors such as offering technologies that meet household needs and save fuel, user training and support, effective financing, and facilitative government action appear to be critical, none guarantee success: All factors can be influential, depending on context. The nature of available evidence did not permit further prioritization. Conclusions: Achieving adoption and sustained use of IS at a large scale requires that all factors, spanning household/community and program/societal levels, be assessed and supported by policy. We propose a planning tool that would aid this process and suggest further research to incorporate an evaluation of effectiveness. Citation: Rehfuess EA, Puzzolo E, Stanistreet D, Pope D, Bruce

Albumin has no role in the uptake of copper by human fibroblasts

International Nuclear Information System (INIS)

McArdle, H.J.; Guthrie, J.R.; Ackland, M.L.; Danks, D.M.

1987-01-01

The mechanism of copper uptake by cells has been the subject of controversy for some time. This paper examines the possibility of a role for albumin in the uptake of copper by fibroblasts. Although the cells could accumulate copper from a copper-albumin complex, there was no evidence for either copper-albumin or albumin receptors on the cell surface. The possibility of a surface exchange mechanism for copper was examined. While copper uptake showed saturation with increasing concentrations of labelled copper-albumin, adding unlabelled copper to the incubation medium did not inhibit uptake. Adding albumin or histidine to the copper-albumin complex resulted in an inhibition of copper uptake. The results can only be explained by the cell taking up free copper from the incubation medium, with the albumin then releasing its copper to maintain the equilibrium between free and bound metal. Since, in vivo there is essentially no free copper in serum, it is concluded that albumin is most unlikely to play a role in the uptake of copper by fibroblasts

South Asian ethnicity, socioeconomic status, and psychological mediators of faecal occult blood colorectal screening participation: A prospective test of a process model.

Science.gov (United States)

Orbell, Sheina; Szczepura, Ala; Weller, David; Gumber, Anil; Hagger, Martin S

2017-12-01

Although ethnicity and socioeconomic status (SES) correlate with health inequality, efforts to explain variance in health behavior attributable to these factors are limited by difficulties in population sampling. We used ethnicity identification software to test effects of psychological beliefs about screening as mediators of ethnicity and SES on faecal occult blood colorectal screening behavior in a no-cost health care context. Adults aged 50-67 years (N = 1,678), of whom 28% were from minority South Asian religiolinguistic ethnic groups (Hindu-Gujarati/Hindi, Muslim-Urdu and Sikh-Punjabi), participated in a prospective survey study. Subsequent screening participation was determined from medical records. Screening nonparticipation in the most deprived SES quintile was 1.6 times that of the least deprived quintile. Nonparticipation was 1.6 times higher in South Asians compared with non-Asians. A process model in which psychological variables mediated effects of ethnicity and SES on uptake was tested using structural equation modeling. Self-efficacy and perceived psychological costs of screening were, respectively, positive and negative direct predictors of uptake. Paths from Hindu, Muslim, and Sikh ethnicity, and SES on uptake were fully mediated by lower self-efficacy and higher perceived psychological costs. Paths from South Asian ethnicity to participation via self-efficacy and psychological costs were direct, and indirect via SES. SES is implicated, but does not fully account for low colorectal screening uptake among South Asians. Targeting increased self-efficacy and reduced perceived psychological costs may minimize health inequality effects. Future research should test independent effects of SES and ethnicity on lower self-efficacy and higher psychological costs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Selenium Uptake and Volatilization by Marine Algae

Science.gov (United States)

Luxem, Katja E.; Vriens, Bas; Wagner, Bettina; Behra, Renata; Winkel, Lenny H. E.

2015-04-01

Selenium (Se) is an essential trace nutrient for humans. An estimated one half to one billion people worldwide suffer from Se deficiency, which is due to low concentrations and bioavailability of Se in soils where crops are grown. It has been hypothesized that more than half of the atmospheric Se deposition to soils is derived from the marine system, where microorganisms methylate and volatilize Se. Based on model results from the late 1980s, the atmospheric flux of these biogenic volatile Se compounds is around 9 Gt/year, with two thirds coming from the marine biosphere. Algae, fungi, and bacteria are known to methylate Se. Although algal Se uptake, metabolism, and methylation influence the speciation and bioavailability of Se in the oceans, these processes have not been quantified under environmentally relevant conditions and are likely to differ among organisms. Therefore, we are investigating the uptake and methylation of the two main inorganic Se species (selenate and selenite) by three globally relevant microalgae: Phaeocystis globosa, the coccolithophorid Emiliania huxleyi, and the diatom Thalassiosira oceanica. Selenium uptake and methylation were quantified in a batch experiment, where parallel gas-tight microcosms in a climate chamber were coupled to a gas-trapping system. For E. huxleyi, selenite uptake was strongly dependent on aqueous phosphate concentrations, which agrees with prior evidence that selenite uptake by phosphate transporters is a significant Se source for marine algae. Selenate uptake was much lower than selenite uptake. The most important volatile Se compounds produced were dimethyl selenide, dimethyl diselenide, and dimethyl selenyl sulfide. Production rates of volatile Se species were larger with increasing intracellular Se concentration and in the decline phase of the alga. Similar experiments are being carried out with P. globosa and T. oceanica. Our results indicate that marine algae are important for the global cycling of Se

Incidental Focal 18F FDG Uptake in the Prostate: Clinical Significance and Differential Diagnostic Criteria

International Nuclear Information System (INIS)

Cho, Suk Kyong; Choi, Joon Young; Yoo, Jang; Cheon, Miju; Lee, Ji Young; Hyun, Seung Hyup; Lee, Eun Jeong; Lee, Kyung Han; Kim, Byung Tae

2011-01-01

The extent and intensity of 18F FDG uptake in prostate cancer patients are known to be variable, and the clinical significance of focal 18F fluorodeoxyglucose ( 18F FDG) uptake that is incidentally found on positron emission tomography (PET) has not been established. We investigated the clinical significance of incidental focal prostate uptake of 18F FDG on PET/computed tomography (CT) and analyzed differential findings on PET/CT Between malignant and benign uptake. A total of 14,854 whole body 18F FDG PET/CT scans (4,806 that were conducted during cancer screening and 10,048 that were conducted to evaluate suspected of alleged cancer outside of the prostate) were retrospectively reviewed to determine the presence, location, multiplicity reviewed to determine the presence, location, multiplicity and maximum standardized uptake value (SUVmax) of focal prostate uptake and combined calcification. The final diagnosis determined by serum prostate specific antigen (PSA) level and biopsy was compared with PET findings. Incidental focal prostate uptake was observed in 148 of 14,854 scans (1.0%). Sixty seven of these 148 subjects who had diagnostic confirmation were selected for further analysis. Prostate cancer was diagnosed in nine of 67 subjects (13.4%). The remaining 58 subjects had no malignancy in the prostate based on normal serum PSA level (n=53), or elevated serum PSA level with a negative biopsy result (n=5). While 84.6% (11/13) of malignant uptake was peripherally located in the prostate glands, 60.2% (50/83) of benign uptake was centrally located (p 18F FDG uptake un the prostate is not common, the incidence of cancer with focal uptake is not low. Therefore, these findings deserve further evaluation. The location of the focal prostate uptake may help with the selection of high risk prostate cancer patients.

Critical assessment of the test of 131I radioiodine uptake in the thyroid

International Nuclear Information System (INIS)

Nemec, J.; Roehling, S.; Vana, S.; Zamrazil, V.

1979-01-01

The value of radioiodine 131 I uptake by the thyroid gland was studied to differentiate the functional disorders of the thyroid gland by analysing a smaller group of patients using the classical method and the computer method for the evaluation of 2500 determinations. The conclusion may be drawn that the uptake of radioiodine was caused by a disturbance of the thyroid gland function only in a minority of cases whereas in the others it is dependent on the intake of iodine or of goitrogens. It is therefore not suitable as a screening method for the diagnosis of thyroid gland diseases. It is, however, useful for the differentation of various types of hyperthyroidism. (author)

Unmasking the Role of Uptake Transporters for Digoxin Uptake Across the Barriers of the Central Nervous System in Rat

Directory of Open Access Journals (Sweden)

Kunal S Taskar

2017-03-01

Full Text Available The role of uptake transporter (organic anion–transporting polypeptide [Oatp] in the disposition of a P-glycoprotein (P-gp substrate (digoxin at the barriers of central nervous system, namely, the blood-brain barrier (BBB, blood-spinal cord barrier (BSCB, and brain-cerebrospinal fluid barrier (BCSFB, was studied using rat as a preclinical species. In vivo chemical inhibition of P-gp and Oatp was achieved using elacridar and rifampicin, respectively. Our findings show that (1 digoxin had a low brain-to-plasma concentration ratio (B/P (0.07 in rat; (2 in the presence of elacridar, the B/P of digoxin increased by about 12-fold; (3 rifampicin administration alone did not change the digoxin B/P significantly when compared with digoxin B/P alone; (4 rifampicin administration along with elacridar resulted only in 6-fold increase in the B/P of digoxin; (5 similar fold changes and trends were seen with the spinal cord-to-plasma concentration ratio of digoxin, indicating the similarity between BBB and the BSCB; and (6 unlike BBB and BSCB, the presence of rifampicin further increased the cerebrospinal fluid-to-plasma concentration ratio (CSF/P for digoxin, suggesting a differential orientation of the uptake transporters at the BCSFB (CSF to blood compared with the BBB (blood to brain. The observations for digoxin uptake, at least at the BBB and the BSCB, advocate the importance of uptake transporters (Oatps. However, the activity of such uptake transporters became evident only after inhibition of the efflux transporter (P-gp.

Downstream mechanisms of nitric oxide-mediated skeletal muscle glucose uptake during contraction.

Science.gov (United States)

Merry, Troy L; Lynch, Gordon S; McConell, Glenn K

2010-12-01

There is evidence that nitric oxide (NO) is required for the normal increases in skeletal muscle glucose uptake during contraction, but the mechanisms involved have not been elucidated. We examined whether NO regulates glucose uptake during skeletal muscle contractions via cGMP-dependent or cGMP-independent pathways. Isolated extensor digitorum longus (EDL) muscles from mice were stimulated to contract ex vivo, and potential NO signaling pathways were blocked by the addition of inhibitors to the incubation medium. Contraction increased (P contraction by ∼50% (P contraction; however, DTT attenuated (P contraction-stimulated glucose uptake (by 70%). NOS inhibition and antioxidant treatment reduced contraction-stimulated increases in protein S-glutathionylation and tyrosine nitration (P skeletal muscle glucose uptake during ex vivo contractions via a cGMP/PKG-, AMPK-, and p38 MAPK-independent pathway. In addition, it appears that NO and ROS may regulate skeletal muscle glucose uptake during contraction through a similar pathway.

Influence of inhibitors of serotonin uptake on intestinal epithelium and colorectal carcinomas.

OpenAIRE

Tutton, P. J.; Barkla, D. H.

1982-01-01

Previous studies have shown that in certain tissues, including colonic carcinomas, cell proliferation may be promoted by serotonin, and indirect evidence suggests that the effects of this amine on colonic tumours involves a cellular-uptake mechanism. In the present study, two specific inhibitors of serotonin uptake, Citalopram and Fluoxetine, are examined for their effects on cell proliferation and tumour growth. Each of the agents was found to suppress cell division in dimethylhydrazine-indu...

Questioning screening | Kent | Obstetrics and Gynaecology Forum

African Journals Online (AJOL)

This article raises new evidence about screening and argues for the evaluation in all screening on a benefits/harms ratio and then the choice being agreed by the care-giver and patient. As the evidence changes, so do our prejudices come under scrutiny. Are we prepared to objectively review our position in the light of new ...

Thyroid uptake test

International Nuclear Information System (INIS)

Ganatra, R.D.

1992-01-01

The uptake of radioiodine by the thyroid gland is altered by the iodine content of diet or drugs. American diet has a high iodine content because each slice of the white bread contains nearly 150μg of iodine due to the bleaching process employed in the production of the bread. This carrier content of iodine reduces the uptake so much, that the normal American uptakes are usually three to four times lower than the uptakes in the developing countries. The other drawback of the thyroid uptake test is that it is affected by the iodine containing drugs. Anti-diarrhoea medications are quire common in the developing countries and many of them contain iodine moiety. Without a reliable drug history, a low thyroid uptake value may lead to a misleading conclusion

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

Science.gov (United States)

Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (Pintervention addressing CRC screening among Iranian population. Creative Commons Attribution License

Factors affecting the uptake of new medicines in secondary care - a literature review.

Science.gov (United States)

Chauhan, D; Mason, A

2008-08-01

The rate of uptake of new medicines in the UK is slower than in many other OECD countries. The majority of new medicines are introduced initially in secondary care and prescribed by specialists. However, the reasons for relatively low precribing levels are poorly understood. This review explores the determinants of uptake of new medicines in secondary care. Nine electronic databases were searched covering the period 1992-2006. Once the searches had been run, records were downloaded and those which evaluated uptake of new medicines in secondary care were identified. UK studies were of primary interest, although research conducted in other countries was also reviewed if relevant. With the exception of 'think pieces', eligibility was not limited by study design. Studies published in languages other than English were excluded from the review. Determinants of uptake in secondary care were classified using Bonair and Persson's typology for determinants of the diffusion of innovation. Almost 1400 records were screened for eligibility, and 29 studies were included in the review. Prescribing of new medicines in secondary care was found to be subject to a number of interacting influences. The support structures which exist within secondary care facilitate access to other colleagues and shape prescribing practices. Clinical trial investigators and physicians who sit on decision-making bodies such as Drug and Therapeutic Committees (DTCs) appear to have a special influence due to their proximity to their research and understanding of evidence base. Pharmaceutical representatives may also influence prescribing decisions through funding of meetings and academic detailing, but clinicians are wary of potential bias. Little evidence on the influence of patients upon prescribing decisions was identified. The impact of clinical guidelines has been variable. Some guidelines have significantly increased the uptake of new medicines, but others have had little discernible impact despite

Politics and patriarchy: barriers to health screening for socially disadvantaged women.

Science.gov (United States)

Peters, Kathleen

2012-10-01

Health screening and early detection of cancer results in significantly better health outcomes and lower mortality. However barriers to such screening are multiple and complex. This paper specifically addresses barriers to women's health screening for socially disadvantaged women in an economically and service disadvantaged area. In this qualitative study, women's healthcare workers and consumers of women's health screening were interviewed and data related to issues for women who had special needs were analysed. Findings indicate there is a lack of access to appropriate services for socially disadvantaged women which affects their screening uptake rates. This study also highlights the difficulties socially disadvantaged women encountered when they were able to access these services which also influenced their decisions regarding subsequent health screening. Implications for nurses and other healthcare professionals are manifold and include advocating for greater access to services and more sensitive care in the delivery of health screening services for socially disadvantaged women.

18F-FDG uptake in bone metastases

International Nuclear Information System (INIS)

Dineva, S.; Kostadinova, I.; Hadjidekov, V.

2012-01-01

Full text: Introduction: PET-CT is an established technique in staging cancer patients and monitoring the therapeutic response. In the literature it has been pointed out the different uptake in osteosclerotic and osteolytic metastases due to different metabolic activity. Objective: The aim of this study is to share authors initial experience in 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET-CT) evaluation of bone metastases secondary to breast cancer with different morphological appearance and to compare the diagnostic accuracy of CT and PET alone and in combination. Patients and methods: Fifty-nine (59) patients with bone lesions secondary to breast carcinoma are included in the retrospective study. The imaging protocol included a low-dose 16-raw detector CT scan with consequent PET scanning after the administration of 5 MBq/kg 18F-FDG activity. Bone metastases were characterized morphologically as being osteolytic, osteoblastic or mixed and metabolically as active, nonactive. Standard uptake value (SUV) of the most active metastatic lesion in each patient is measured. Results: Most patients had more than one type of bone metastases. 23 patients (38.98%) had osteolytic bone metastases, 32 (54.23%) had mixed, 14 (23.72%) had osteoblastic and 8 (13.55%) patients had metabolically active bone metastases without any morphological evidence. All of the osteolytic and all of the mixed bone lesions were metabolically active (100%). Amongst the osteoblastic bone metastases metabolic activity was seen in 11 (78.57%) patients and the rest 3 (21.42%) of them had only morphological evidence of bone lesions due to good therapeutic response. SUV varies from 3.2 to 18.5 (normal uptake threshold - 2.5). The aggressiveness of bone lesions is related to high metabolic activity and the lack of the latter is usually a sign of good therapeutic response. Metabolic activity without morphological changes is a feature of early bone marrow affection and

Breast screening policy: Are we heading in the right direction?

International Nuclear Information System (INIS)

Evans, A.; Whelehan, P.

2011-01-01

There is a large body of evidence supporting 2-yearly screening of women aged 50-69 years. There is good evidence for a mortality reduction from mammographic screening in women aged 40 to 49 years but a 1-year interval is required. The lack of specificity of screening in young women does remain a problem. There is no evidence to suggest that a single screen between the ages of 47 and 50 years within a programme screening at 3-year intervals will reduce mortality; the trials showing a mortality benefit in women in their 40s included multiple screening episodes and shorter screening intervals. There is no randomized, controlled trial evidence to support screening in women aged above 70 years and screening this age group will cause greater harm than in younger women through higher rates of over-diagnosis and consequent over-treatment. The randomized phase of the screening age extension, which at the moment is planned to last only 6 years, should not be immediately followed by general implementation of the policy. Only if and when additional mortality reductions and an acceptable balance between benefit and harms are shown to be achieved by the extra screens should the 2007 Cancer Reform Strategy policy on age extension be implemented. Resources saved by delaying or abandoning the roll-out of the age extension could potentially be redirected towards reducing the current 3 year screening interval to 2 years in women aged 50-69 years. However, reducing the screening interval to 2 years for women aged 50-69 years would require significantly more screening invitations and resources than the proposed age extension.

Breast screening policy: Are we heading in the right direction?

Energy Technology Data Exchange (ETDEWEB)

Evans, A., E-mail: a.z.evans@dundee.ac.uk [Dundee Cancer Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee (United Kingdom); Whelehan, P. [Dundee Cancer Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee (United Kingdom)

2011-10-15

There is a large body of evidence supporting 2-yearly screening of women aged 50-69 years. There is good evidence for a mortality reduction from mammographic screening in women aged 40 to 49 years but a 1-year interval is required. The lack of specificity of screening in young women does remain a problem. There is no evidence to suggest that a single screen between the ages of 47 and 50 years within a programme screening at 3-year intervals will reduce mortality; the trials showing a mortality benefit in women in their 40s included multiple screening episodes and shorter screening intervals. There is no randomized, controlled trial evidence to support screening in women aged above 70 years and screening this age group will cause greater harm than in younger women through higher rates of over-diagnosis and consequent over-treatment. The randomized phase of the screening age extension, which at the moment is planned to last only 6 years, should not be immediately followed by general implementation of the policy. Only if and when additional mortality reductions and an acceptable balance between benefit and harms are shown to be achieved by the extra screens should the 2007 Cancer Reform Strategy policy on age extension be implemented. Resources saved by delaying or abandoning the roll-out of the age extension could potentially be redirected towards reducing the current 3 year screening interval to 2 years in women aged 50-69 years. However, reducing the screening interval to 2 years for women aged 50-69 years would require significantly more screening invitations and resources than the proposed age extension.

The effectiveness and cost-effectiveness of screening for latent tuberculosis among migrants in the EU/EEA

DEFF Research Database (Denmark)

Greenaway, Christina; Pareek, Manish; Chakra, Claire Nour Abou

2018-01-01

Background: Migrants account for a large and growing proportion of tuberculosis (TB) cases in lowincidence countries in the European Union/European Economic Area (EU/EEA) which are primarily due to reactivation of latent TB infection (LTBI). Addressing LTBI among migrants will be critical to achi...... by the large pool of migrants with LTBI, poorly predictive tests, long treatments and a weak care cascade. Targeted LTBI programmes that ensure high screening uptake and treatment completion will have greatest individual and public health benefit....... to achieve TB elimination. Methods: We conducted a systematic review to determine effectiveness (performance of diagnostic tests, efficacy of treatment, uptake and completion of screening and treatment) and a second systematic review on cost-effectiveness of LTBI screening programmes for migrants living...... eligible for screening completed treatment because of losses along all steps of the LTBI care cascade. Limited economic analyses suggest that the most cost-effective approach may be targeting young migrants from high TB incidence countries. Discussion: The effectiveness of LTBI programmes is limited...

Assessing the efficacy of cancer screening

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Gemma Jacklyn

2017-07-01

Full Text Available Background: Population-based cancer screening has been established for several types of cancer in Australia and internationally. Screening may perform differently in practice from randomised controlled trials, which makes evaluating programs complex. Materials and methods: We discuss how to assess the evidence of benefits and harms of cancer screening, including the main biases that can mislead clinicians and policy makers (such as volunteer, lead-time, length-time and overdiagnosis bias. We also discuss ways in which communication of risks can inform or mislead the community. Results: The evaluation of cancer screening programs should involve balancing the benefits and harms. When considering the overall worth of an intervention and allocation of scarce health resources, decisions should focus on the net benefits and be informed by systematic reviews. Communication of screening outcomes can be misleading. Many messages highlight the benefits while downplaying the harms, and often use relative risks and 5-year survival to persuade people to screen rather than support informed choice. Lessons learned: An evidence based approach is essential when evaluating and communicating the benefits and harms of cancer screening, to minimise misleading biases and the reliance on intuition.

European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination

Directory of Open Access Journals (Sweden)

Lawrence von Karsa

2015-12-01

Full Text Available In a project coordinated by the International Agency for Research on Cancer (IARC 31 experts from 11 European countries and IARC have developed supplements to the current European guidelines for quality assurance in cervical cancer screening. The supplements take into account the potential of primary testing for human papillomavirus (HPV and vaccination against HPV infection to improve cervical cancer prevention and control and will be published by the European Commission in book format. They include 62 recommendations or conclusions for which the strength of the evidence and the respective recommendations is graded. While acknowledging the available evidence for more efficacious screening using HPV primary testing compared to screening based on cytology, the authors and editors of the supplements emphasize that appropriate policy and programme organization remain essential to achieve an acceptable balance between benefit and harm of any screening or vaccination programme. A summary of the supplements and all of the graded recommendations are presented here in journal format to make key aspects of the updated and expanded guidelines known to a wider professional and scientific community. Keywords: Mass screening, Vaccination, Cervical neoplasms, Human papillomavirus, Evidence-based guidelines, Population-based programme

Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

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Katzenellenbogen Judith M

2010-06-01

Full Text Available Abstract Background Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population. This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups. Methods A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions. Results The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the test and comprehensiveness of its contents, cultural perceptions of cancer and prevailing low levels of knowledge and awareness of bowel cancer and the importance of screening. Conclusions Our findings suggest that the population-based approach to implementing bowel cancer screening to the Australian population unintentionally excludes vulnerable minorities, particularly Indigenous and other culturally and linguistically diverse groups. This potentially contributes to exacerbating

Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans

Science.gov (United States)

2014-01-01

Background Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption – the proportion and representativeness of organizations that decided to implement the program. Methods During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having ≥ 150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Results Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14 = 79%) and among organizations that were referred to us by community partners (5/10 = 50%) and lowest among new organizations (6/20 = 30%). Few organizational differences were found between adopters and non-adopters. Conclusions The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings. PMID:24618267

Inferring foliar water uptake using stable isotopes of water.

Science.gov (United States)

Goldsmith, Gregory R; Lehmann, Marco M; Cernusak, Lucas A; Arend, Matthias; Siegwolf, Rolf T W

2017-08-01

A growing number of studies have described the direct absorption of water into leaves, a phenomenon known as foliar water uptake. The resultant increase in the amount of water in the leaf can be important for plant function. Exposing leaves to isotopically enriched or depleted water sources has become a common method for establishing whether or not a plant is capable of carrying out foliar water uptake. However, a careful inspection of our understanding of the fluxes of water isotopes between leaves and the atmosphere under high humidity conditions shows that there can clearly be isotopic exchange between the two pools even in the absence of a change in the mass of water in the leaf. We provide experimental evidence that while leaf water isotope ratios may change following exposure to a fog event using water with a depleted oxygen isotope ratio, leaf mass only changes when leaves are experiencing a water deficit that creates a driving gradient for the uptake of water by the leaf. Studies that rely on stable isotopes of water as a means of studying plant water use, particularly with respect to foliar water uptake, must consider the effects of these isotopic exchange processes.

Evidence-based policymaking: A review

Directory of Open Access Journals (Sweden)

Karen Nortje

2010-05-01

Full Text Available The process of facilitating the uptake of evidence, for example, scientific research findings, into the policymaking process is multifaceted and thus complex. It is therefore important for scientists to understand this process in order to influence it more effectively. Similarly, policymakers need to understand the complexities of the scientific process to improve their interaction with the scientific sphere. This literature review addresses those factors that influence the uptake of scientific evidence into policymaking, the barriers to using science in policymaking, as well as recommendations for improved science–policymaking interaction. A visual diagram of the gears of a car is used to convey the message of the complexities around the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised.

Implementation research evidence uptake and use for policy-making

Directory of Open Access Journals (Sweden)

Panisset Ulysses

2012-07-01

Full Text Available Abstract A major obstacle to the progress of the Millennium Development Goals has been the inability of health systems in many low- and middle-income countries to effectively implement evidence-informed interventions. This article discusses the relationships between implementation research and knowledge translation and identifies the role of implementation research in the design and execution of evidence-informed policy. After a discussion of the benefits and synergies needed to translate implementation research into action, the article discusses how implementation research can be used along the entire continuum of the use of evidence to inform policy. It provides specific examples of the use of implementation research in national level programmes by looking at the scale up of zinc for the treatment of childhood diarrhoea in Bangladesh and the scaling up of malaria treatment in Burkina Faso. A number of tested strategies to support the transfer of implementation research results into policy-making are provided to help meet the standards that are increasingly expected from evidence-informed policy-making practices.

Lectins as endocytic ligands: an assessment of lectin binding and uptake to rabbit conjunctival epithelial cells.

Science.gov (United States)

Qaddoumi, Mohamed; Lee, Vincent H L

2004-07-01

To investigate the binding and uptake pattern of three plant lectins in rabbit conjunctival epithelial cells (RCECs) with respect to their potential for enhancing cellular macromolecular uptake. Three fluorescein-labeled plant lectins (Lycoperison esculentum, TL; Solanum tuberosum, STL; and Ulex europaeus 1, UEA-1) were screened with respect to time-, concentration-, and temperature-dependent binding and uptake. Chitin (30 mg/ml) and L-alpha-fucose (10 mM) were used as inhibitory sugars to correct for nonspecific binding of TL or STL and UEA-1, respectively. Confocal microscopy was used to confirm internalization of STL. The binding and uptake of all three lectins in RCECs was time-dependent (reaching a plateau at 1-2 h period) and saturable at 1-h period. The rank order of affinity constants (km) was STL>TL>UEA-1 with values of 0.39>0.48>4.81 microM, respectively. However, maximal, specific binding/uptake potential was in the order UEA-1>STL>TL with values of 53.7, 52.3, and 15.0 nM/mg of cell protein, respectively. Lectins showed temperature dependence in their uptake, with STL exhibiting the highest endocytic capacity. Internalized STL was visualized by confocal microscopy to be localized to the cell membrane and cytoplasm. Based on favorable binding and uptake characteristics, potato lectin appears to be a useful candidate for further investigation as an ocular drug delivery system.

Following patient pathways to psycho-oncological treatment: Identification of treatment needs by clinical staff and electronic screening.

Science.gov (United States)

Loth, Fanny L; Meraner, Verena; Holzner, Bernhard; Singer, Susanne; Virgolini, Irene; Gamper, Eva M

2018-04-01

In this retrospective investigation of patient pathways to psycho-oncological treatment (POT), we compared the number of POT referrals before and after implementation of electronic screening for POT needs and investigated psychosocial predictors for POT wish at a nuclear medicine department. We extracted medical chart information about number of referrals and extent of follow-up contacts. During standard referral (November 2014 to October 2015), POT needs were identified by clinical staff only. In the screening-assisted referral period (November 2015 to October 2016), identification was supported by electronic screening for POT needs. Psychosocial predictors for POT wish were examined using logistic regression. We analysed data from 487 patients during standard referral (mean age 56.4 years; 60.2% female, 88.7% thyroid carcinoma or neuroendocrine tumours) of which 28 patients (5.7%) were referred for POT. Of 502 patients in the screening-assisted referral period (mean age 57.0 years; 55.8% female, 86.6% thyroid carcinoma or neuroendocrine tumours), 69 (13.7%) were referred for POT. Of these, 36 were identified by psycho-oncological (PO) screening and 33 by clinical staff. After PO-screening implementation, referrals increased by a factor of 2.4. The strongest predictor of POT wish was depressive mood (P patients visited the PO outpatient unit additionally to inpatient PO consultations. Our results provide evidence from a real-life setting that PO screening can foster POT referrals, reduce barriers to express the POT wish, and hence help to meet psychosocial needs of this specific patient group. Differences between patients' needs, wish, and POT uptake should be further investigated. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Plant uptake of dual-labeled organic N biased by inorganic C uptake

DEFF Research Database (Denmark)

Rasmussen, Jim; Sauheitl, Leopold; Eriksen, Jørgen

2010-01-01

glycine or CO2-3 , but found no differences in uptake rates between these C-sources. The uptake of inorganic C to the shoot tissue was higher for maize grown in full light compared to shading, which indicates a passive uptake of inorganic C with water. We conclude that uptake of inorganic C produced...

Screening from the epidemiological point of view

International Nuclear Information System (INIS)

Becker, N.

2002-01-01

The scope of screening is to identify disease in a clinically inapparent stage in order to treat more effectively. However, the required application of a test to large subsets of the population implies risks which cannot be ignored. Thus, the introduction of a test for use in screening without previously established evidence of a benefit which exceeds potential harm by far cannot be justified. With regard to cancer, evidence of effectiveness has been proven for screening on cervical (Papsmear), breast (mammography) and colorectal (faecal occult blood test) cancer. The routine application of a screening procedure which has been proven effective provides the benefit in terms of mortality reduction seen in the trials only if the entire screening chain, from the test over potentially required assessment to treatment, is offered with highest quality and is under permanent quality control. (orig.) [de

A high-content subtractive screen for selecting small molecules affecting internalization of GPCRs

CSIR Research Space (South Africa)

Kwon, Y-J

2012-03-01

Full Text Available was screened against seven agonist-induced GPCR internalization cell models as well as transferrin uptake in human embryonic kidney cells. Molecules acting on a single receptor were identified through excluding pan-specific compounds affecting housekeeping...

Cancer screening guidelines.

Science.gov (United States)

Zoorob, R; Anderson, R; Cefalu, C; Sidani, M

2001-03-15

Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.

RNAi Screen in Drosophila melanogastor Identifies Regulators of Steroidogenesis and Developmental Maturation

DEFF Research Database (Denmark)

Danielsen, Erik Thomas

and duration required for juvenile-adult transition. This PhD project demonstrates the power of Drosophila genetics by taking an in vivo genome-wide RNAi screening approach to uncover genes required for the function of steroid producing tissue and developmental maturation. In total, 1909 genes were found...... to be required for the prothoracic gland function and affected the developmental timing for the juvenile-adult transition. Among the screen hits, we focused on an uncharacterized gene, sit (CG5278), which is highly expressed in the gland and is required for ecdysone production. Sit is a homolog of mammalian very...... flux of cholesterol uptake in the gland cells and affected the endosomal trafficking. Therefore this gene was suggested to be named stuck in traffic (sit). Sit’s role in cholesterol uptake was also supported by the observation that the developmental delayed phenotype from loss of sit expression...

Studies on the T sub 3 suppression test with reference to the thyrodial sup 123 I uptake in Graves' disease; Comparison of 24-hour and 3-hour uptake

Energy Technology Data Exchange (ETDEWEB)

Yamaguchi, Takahiko; Kobayashi, Isao; Yamaguchi, Yoshiyuki; Iwashita, Akira; Inukai, Toshihiko; Ohshima, Kihachi; Shimomura, Yohnosuke; Kobayashi, Setsuo (Gunma Univ., Maebashi (Japan). School of Medicine)

1990-06-01

Eighty-three patients with Graves' disease had been treated with methylmercaptoimidazole (MMI). They were prescribed a maintenance dose of antithyroid drug (MMI, 5 mg/day) at the time of a T{sub 3} suppression test. The 3-hour and 24-hour thyroidal {sup 123}I uptake after T{sub 3} administration (75 {mu}g/day, 2 weeks) were measured (post T{sub 3} uptake). In 38 patients whose post T{sub 3} uptake was below 35% in post T{sub 3} 24-hour uptake, treatment was stopped. The T{sub 3} suppression test was then repeated 1 and 3 months later. During a one-year follow up, 26 remained well, while 12 relapsed within 6 to 12 months. We have observed a good correlation between 3-hour uptake and 24-hour uptake of {sup 123}I after T{sub 3} administration (r=0.847, p<0.001). In 38 patients who showed positive T{sub 3} suppression, most patients with MMI withdrawal produced a marked overshoot of post T{sub 3} 3-hour and 24-hour uptake at one month. Retrospective analysis indicated that there was no significant difference in circulating thyroid hormone levels between remission and relapse groups. The present study provides evidence that 3-hour uptake values are able to be substituted for 24-hour uptake values during a T{sub 3} suppression test. In addition, overshoot of thyroidal uptake after antithyroid drug withdrawal was observed in 3-hour values, similar to 24-hour values. (author).

Moessbauer study of iron uptake in cucumber root

Energy Technology Data Exchange (ETDEWEB)

Kovacs, K.; Kuzmann, E., E-mail: kuzmann@para.chem.elte.hu [Eoetvoes Lorand University, Research Group for Nuclear Methods in Structural Chemistry, Hungarian Academy of Sciences, Department of Nuclear Chemistry (Hungary); Fodor, F. [Eoetvoes Lorand University, Department of Plant Physiology and Molecular Plant Biology (Hungary); Vertes, A. [Eoetvoes Lorand University, Research Group for Nuclear Methods in Structural Chemistry, Hungarian Academy of Sciences, Department of Nuclear Chemistry (Hungary); Kamnev, A. A. [Russian Academy of Sciences, Institute of Biochemistry and Physiology of Plants and Microorganisms (Russian Federation)

2005-09-15

{sup 57}Fe Moessbauer spectroscopy was used to study the uptake and distribution of iron in the root of cucumber plants grown in iron-deficient modified Hoagland nutrient solution and put into iron-containing solution with 10 {mu}M Fe citrate enriched with {sup 57}Fe (90%) only before harvesting. The Moessbauer spectra of the frozen roots exhibited two Fe{sup 3+} components with typical average Moessbauer parameters of {delta} = 0.5 mm s{sup -1}, {Delta} = 0.46 mm s{sup -1} and {delta} = 0.5 mm s{sup -1}, {Delta} = 1.2 mm s{sup -1} at 78 K and the presence of an Fe{sup 2+} doublet, assigned to the ferrous hexaaqua complex. This finding gives a direct evidence for the existence of Fe{sup 2+} ions produced via root-associated reduction according to the mechanism proposed for iron uptake for dicotyledonous plants. Monotonous changes in the relative content of the components were found with the time period of iron supply. The Moessbauer results are interpreted in terms of iron uptake and transport through the cell wall and membranes.

Quantitative understanding of nanoparticle uptake in watermelon plants

Directory of Open Access Journals (Sweden)

Ramesh Raliya

2016-08-01

Full Text Available The use of agrochemical-nutrient fertilizers has come under scrutiny in recent years due to concerns that they damage the ecosystem and endanger public health. Nanotechnology offers many possible interventions to mitigate these risks by use of nanofertilizers, nanopesticides, and nanosensors; and concurrently increases profitability, yields, and sustainability within the agricultural industry. Aerosol based foliar delivery of nanoparticles may help to enhance nanoparticle uptake and reduce environmental impacts of chemical fertilizers conventionally applied through a soil route. The purpose of this work was to study uptake, translocation, and accumulation of various gold nanostructures, 30 to 80 nm, delivered by aerosol application to a watermelon plant. Cellular uptake and accumulation of gold nanoparticles were quantified by Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS. Observations suggested that nanoparticles could be taken up by the plant through direct penetration and transport through the stomatal opening. Observed translocation of nanoparticles from leaf to root shows evidence that nanoparticles travel by the phloem transport mechanism. Accumulation and transport of nanoparticles depend on nanoparticle shape, application method, and nature of plant tissues.

Application of Fragment Ion Information as Further Evidence in Probabilistic Compound Screening Using Bayesian Statistics and Machine Learning: A Leap Toward Automation

NARCIS (Netherlands)

Woldegebriel, M.; Zomer, P.; Mol, H.G.J.; Vivó-Truyols, G.

2016-01-01

In this work, we introduce an automated, efficient, and elegant model to combine all pieces of evidence (e.g., expected retention times, peak shapes, isotope distributions, fragment-to-parent ratio) obtained from liquid chromatography-tandem mass spectrometry (LC-MS/MS/MS) data for screening

The evolving role of new imaging methods in breast screening.

Science.gov (United States)

Houssami, Nehmat; Ciatto, Stefano

2011-09-01

The potential to avert breast cancer deaths through screening means that efforts continue to identify methods which may enhance early detection. While the role of most new imaging technologies remains in adjunct screening or in the work-up of mammography-detected abnormalities, some of the new breast imaging tests (such as MRI) have roles in screening groups of women defined by increased cancer risk. This paper highlights the evidence and the current role of new breast imaging technologies in screening, focusing on those that have broader application in population screening, including digital mammography, breast ultrasound in women with dense breasts, and computer-aided detection. It highlights that evidence on new imaging in screening comes mostly from non-randomised studies that have quantified test detection capability as adjunct to mammography, or have compared measures of screening performance for new technologies with that of conventional mammography. Two RCTs have provided high-quality evidence on the equivalence of digital and conventional mammography and on outcomes of screen-reading complemented by CAD. Many of these imaging technologies enhance cancer detection but also increase recall and false positives in screening. Copyright © 2011 Elsevier Inc. All rights reserved.

Quadrivalent human papillomavirus vaccine uptake in adolescent boys and maternal utilization of preventive care and history of sexually transmitted infections.

Science.gov (United States)

Hechter, Rulin C; Chao, Chun; Sy, Lina S; Ackerson, Bradley K; Slezak, Jeff M; Sidell, Margo A; Jacobsen, Steven J

2013-09-01

We examined whether maternal utilization of preventive care and history of sexually transmitted infections (STIs) predicted quadrivalent human papillomavirus vaccine (HPV4) uptake among adolescent boys 1 year following the recommendation for permissive use of HPV4 for males. We linked maternal information with electronic health records of 254 489 boys aged 9 to 17 years who enrolled in Kaiser Permanente Southern California health plan from October 21, 2009, through December 21, 2010. We used multivariable Poisson regression with robust error variance to examine whether HPV4 initiation was associated with maternal uptake of influenza vaccine, Papanicolaou (Pap) screening, and history of STIs. We identified a modest but statistically significant association between initiation of HPV4 series and maternal receipt of influenza vaccine (rate ratio [RR] = 1.16; 95% confidence interval [CI] = 1.07, 1.26) and Pap screening (RR = 1.13; 95% CI = 1.01, 1.26). Boys whose mothers had a history of genital warts were more likely to initiate HPV4 (RR = 1.47; 95% CI = 0.93, 2.34), although the association did not reach statistical significance (P = .1). Maternal utilization of preventive care and history of genital warts may influence HPV4 uptake among adolescent boys. The important role of maternal health characteristics and health behaviors needs be considered in intervention efforts to increase vaccine uptake among boys.

Richtlijn 'screening en diagnostiek van het mammacarcinoom' (herziening).

NARCIS (Netherlands)

Zonderland, H.M.; Tuut, M.K.; den Heeten, G.J.; Asperen, C.J.; de Bock, G.H.; Rutqers, E.J.; Westenend, P.J.; Smit, G.M.; Benraadt, J.

2008-01-01

Revised practice guideline 'Screening and diagnosis of breast cancer' The evidence-based revision of the practice guideline 'Screening and diagnosis of breast cancer' was necessitated by new insights, for instance on the cost-effectiveness of screening modalities other than mammography. Mammography

Behavior of radionuclides and related elements in plants. Screening and characterization of cesium requirement mutants from mutagenized arabidopsis thaliana

Energy Technology Data Exchange (ETDEWEB)

Yamagami, Mutsumi; Yanai, Masumi; Hisamatsu, Shunichi; Inaba, Jiro [Inst. for Environmental Sciences, Rokkasho, Aomori (Japan)

2002-07-01

We have investigated the effect of climate on the metabolic behavior of various elements in a specific plant. The following items have been examined: the effect of climate conditions including Yamase (prevailing windows from the Pacific Ocean side area of Aomori Prefecture) on the elemental transfer factor of rice, the effect of light conditions on metabolism of elements in a plant, the effect of environmental factors on elemental movements at a cell level, and establishment of a mutant plant strain to obtain elemental requirement. This paper describes the development of a method for screening and characterizing cesium resistance mutants from Arabidopsis thaliana. Arabidopsis is a small herbaceous plant which is used for experimental molecular botany. To isolate mutant in cesium uptake or accumulation, we have devised a screening method using energy-dispersive x-ray microanalysis (EDX) of mutagenized Arabidopsis leaves. The seeds for the selection were M{sub 2} seeds derived from ethyl methane sulfonate (EMS)-treated plants. A double screening method was used to isolate about 50 Cs-resistant mutants. In the first screening experiment, EMS-mutagenized seeds were grown in medium containing 3 mM Cs. The wild type Arabidopsis usually died, but Cs-resistant mutants survived. These were transferred into soil for harvest of first-screening-seeds. In the successive experiment, first-screening-seeds were grown in medium containing 1 mM Cs, and Cs of the leaves was analyzed by EDX. We identified about 50 mutants in Cs uptake or accumulation after screening over 100,000 seedlings. These mutants showed either excessive accumulation of Cs in leaves or an inability to accumulate Cs at a normal concentration. The uptake rates of Cs in those mutants were also examined by using {sup 134}Cs radioactive tracer. (author)

AIDS stigma as an obstacle to uptake of HIV testing: evidence from a Zimbabwean national population-based survey.

Science.gov (United States)

Sambisa, William; Curtis, Sian; Mishra, Vinod

2010-02-01

Using the 2005-2006 Zimbabwe Demographic and Health Survey, we investigated the prevalence of HIV testing uptake within a sample of women (6839) and men (5315), and identified the independent effects of AIDS stigma on testing uptake, with particular emphasis on three pathways to testing: voluntary testing, testing when offered, and testing when required. The prevalence of self-reported HIV testing was higher among women (31%) than men (22%). For women, the main pathway to testing uptake was to accept testing when it is offered (46%), whereas for men it was voluntary testing (53%). In the logistic regression models, we found that social rejection stigma was inversely associated with uptake across all pathways of testing for women, but not men. As regards observed enacted stigma, respondents who both knew someone with HIV and had observed discrimination against someone with HIV were more likely to test for HIV through all pathways, while those who knew someone with HIV but had not observed stigma were more likely to test voluntarily. Individual characteristics important to the adoption of testing included high educational attainment, religion, exposure to mass media, and ever use of condoms; while being never married and self-perceived risk were barriers to testing. Programmatic strategies aimed at increasing HIV testing uptake should consider reducing stigma toward people living with HIV/AIDS and also addressing the role of agency and structure in individual's decision to be tested for HIV.

Community screening for visual impairment in older people.

Science.gov (United States)

Clarke, Emily L; Evans, Jennifer R; Smeeth, Liam

2018-02-20

Visual problems in older people are common and frequently under-reported. The effects of poor vision in older people are wide reaching and include falls, confusion and reduced quality of life. Much of the visual impairment in older ages can be treated (e.g. cataract surgery, correction of refractive error). Vision screening may therefore reduce the number of older people living with sight loss. The objective of this review was to assess the effects on vision of community vision screening of older people for visual impairment. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 10); Ovid MEDLINE; Ovid Embase; the ISRCTN registry; ClinicalTrials.gov and the ICTRP. The date of the search was 23 November 2017. We included randomised controlled trials (RCTs) that compared vision screening alone or as part of a multi-component screening package as compared to no vision screening or standard care, on the vision of people aged 65 years or over in a community setting. We included trials that used self-reported visual problems or visual acuity testing as the screening tool. We used standard methods expected by Cochrane. We graded the certainty of the evidence using GRADE. Visual outcome data were available for 10,608 people in 10 trials. Four trials took place in the UK, two in Australia, two in the United States and two in the Netherlands. Length of follow-up ranged from one to five years. Three of these studies were cluster-randomised trials whereby general practitioners or family physicians were randomly allocated to undertake vision screening or no vision screening. All studies were funded by government agencies. Overall we judged the studies to be at low risk of bias and only downgraded the certainty of the evidence (GRADE) for imprecision.Seven trials compared vision screening as part of a multi-component screening versus no screening. Six of these studies used self

Characterization of iron uptake from hydroxamate siderophores by Chlorella vulgaris

International Nuclear Information System (INIS)

Allnutt, F.C.T.

1985-01-01

Iron uptake by Chlorella vulgaris from ferric-hydroxamate siderophores and the possible production of siderophores by these algae was investigated. No production of siderophores or organic acids was observed. Iron from the two hydroxamate siderophores tested, ferrioximine B (Fe 3+ -DFOB) and ferric-rhodotorulate (Fe 3+ -RA), was taken up at the same rate as iron chelated by citrate or caffeate. Two synthetic chelates, Fe 3+ -EDTA and Fe 3+ -EDDHA, provided iron at a slower rate. Iron uptake was inhibited by 50 μM CCCP or 1 mM vanadate. Cyanide (100 μM KCN) or 25 μM antimycin A failed to demonstrate a link between uptake and respiration. Labeled iron ( 55 Fe) was taken up while labeled ligands ([ 14 C] citrate or RA) were not accumulated. Cation competition from Ni 2+ and Co 2+ observed using Fe 3+ -DFOB and Fe 3+ -RA while iron uptake from Fe 3+ -citrate was stimulated. Iron-stress induced iron uptake from the hydroxamate siderophores. Ferric reduction from the ferric-siderophores was investigated with electron paramagnetic resonance (EPR) and bathophenathroline disulfonate (BPDS). Ferric reduction was induced by iron-stress and inhibited by CCCP. A close correlation between iron uptake and ferric reduction was measured by the EPR method. Ferric reduction measured by the BPDS method was greater than that measure by EPR. BPDS reduction was interpreted to indicate a potential for reduction while EPR measures the physiological rate of reduction. BPDS inhibition of iron uptake and ferricyanide interference with reduction indicate that reduction and uptake occur exposed to the external medium. Presumptive evidence using a binding dose response curve for Fe 3+ -DFOB indicated that a receptor may be involved in this mechanism

Tuberculosis screening in patients with HIV

DEFF Research Database (Denmark)

Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey

2016-01-01

BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...

Review of the evidence on the use of arbitration or consensus within breast screening: A systematic scoping review

International Nuclear Information System (INIS)

Hackney, L.; Szczepura, A.; Moody, L.; Whiteman, B.

2017-01-01

Objectives: A systematic scoping review was undertaken to establish the evidence base on arbitration and consensus in mammography reporting. Database searches were supplemented with hand searching of peer-reviewed journals, citation tracking, key author searching, grey literature and personal contact with experts. A 3-stage process was utilised to screen a large volume of literature (601) against the inclusion and exclusion criteria. 26 papers were retained. Key findings: A lack of guidance and underpinning evidence to inform how best to use arbitration or consensus to resolve discordant reads. In particular, a lack of prospective studies to determine effectiveness in real-life clinical settings. Conclusion: The insufficiency of follow-up or reporting of true interval cancers compromised the ability to conclude the effectiveness of the processes. - Highlights: • Lack of guidance to inform how best to use arbitration or consensus. • Insufficient evidence to assess the effectiveness of one strategy versus the other. • International variance in strategies to resolve discordant cases.

[Weak evidence concerning sedentary lifestyle and its association with cardio-metabolic illness among young people. "Junk food" and late evenings in front of the screen part of a complex connection].

Science.gov (United States)

Fröberg, Andreas; Raustorp, Anders

2015-06-16

During recent decades there has been a rapidly growing interest in youths' sedentary behaviour and its association with cardio-metabolic health. Currently there is little-to-no evidence for a cross-sectional and longitudinal association between volume and pattern (bouts and breaks) of objectively measured sedentary behavior and body weight in youth. Likewise, there is little-to-no evidence for a cross-sectional association between volume and pattern of objectively measured sedentary behavior and other markers for cardio-metabolic risk in youth. However, there is sufficient evidence for a cross-sectional and longitudinal association between screen-time and body weight and blood pressure and blood lipids. Furthermore, there is evidence for a cross-sectional association between youths' screen-time and clustered metabolic risk and insulin resistance. Overall, the level of evidence was low and, therefore, caution is required when interpreting the results.

Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-east Nigeria: a before and after study.

Science.gov (United States)

Mbachu, Chinyere; Dim, Cyril; Ezeoke, Uche

2017-06-09

Effective female education on cervical cancer prevention has been shown to increase awareness and uptake of screening. However, sustaining increase in uptake poses a challenge to control efforts. Peer health education has been used as an effective tool for ensuring sustained behavior change. This study was undertaken to assess the effectiveness of peer health education on perception, willingness to screen and uptake of cervical cancer screening by women. A before and after intervention study was undertaken in 2 urban cities in Enugu state, Nigeria among women of reproductive age attending women's meeting in Anglican churches. Multistage sampling was used to select 300 women. Peer health education was provided once monthly for 3 consecutive sessions over a period of 3 months. Data was collected at baseline and after the intervention using pre-tested questionnaires. Descriptive statistics and tests of significance of observed differences and associations were done at p-value of education, employment status and parity (p education is an effective strategy for increasing women's perception of benefits of early detection of cervical cancer through screening. It is also effective for increasing their practice of screening for cervical cancer.

Industrial screening programs for workers

International Nuclear Information System (INIS)

Lavine, M.P.

1982-01-01

Industrial screening efforts to identify classes of workers who are more susceptible to workplace hazards, by virtue of their fertility, genetic, or lifestyle characteristics, represent a relatively new approach to reducing workplace risks. Screening has already raised some important economic, legal, social, medical, and moral questions. Employers, employees, administrative agencies, and the courts are offering different, often conflicting answers. Ultimately the acceptability of various screening schemes rests upon judgments about how a society justifies the distribution of risk. The questions that industrial screening programs raise are only partially answered by empirical evidence; the rest is a matter of values

Lactose uptake driven by galactose efflux in Streptococcus thermophilus: Evidence for a galactose-lactose antiporter

International Nuclear Information System (INIS)

Hutkins, R.W.; Ponne, C.

1991-01-01

Galactose-nonfermenting (Gal - ) Streptococcus thermophilus TS2 releases galactose into the extracellular medium when grown in medium containing excess lactose. Starved and de-energized Gal - cells, however, could be loaded with galactose to levels approximately equal to the extracellular concentration (0 to 50 mM). When loaded cells were separated from the medium and resuspended in fresh broth containing 5 mM lactose, galactose efflux occurred. De-energized, galactose-loaded cells, resuspended in buffer or medium, accumulated [ 14 C]lactose at a greater rate and to significantly higher intracellular concentrations than unloaded cells. Uptake of lactose by loaded cells was inhibited more than that by unloaded cells in the presence of extracellular galactose, indicating that a galactose gradient was involved in the exchange system. When de-energized, galactose-loaded cells were resuspended in carbohydrate-free medium at pH 6.7, a proton motive force (Δp) of 86 to 90 mV was formed, whereas de-energized, nonloaded cells maintained a Δp of about 56 mV. However, uptake of lactose by loaded cells occurred when the proton motive force was abolished by the addition of an uncoupler or in the presence of a proton-translocating ATPase inhibitor. These results support the hypothesis that galactose efflux in Gal - S. thermophilus is electrogenic and that the exchange reaction (lactose uptake and galactose efflux) probably occurs via an antiporter system

Determination of maximum physiologic thyroid uptake and correlation with 24-hour RAI uptake value

International Nuclear Information System (INIS)

Duldulao, M.; Obaldo, J.

2007-01-01

Full text: In hyperthyroid patients, thyroid uptake values are overestimated, sometimes approaching or exceeding 100%. This is physiologically and mathematically impossible. This study was undertaken to determine the maximum physiologic thyroid uptake value through a proposed simple method using a gamma camera. Methodology: Twenty-two patients (17 females and 5 males), with ages ranging from 19-61 y/o (mean age ± SD; 41 ± 12), with 24-hour uptake value of >50%, clinically hyperthyroid and referred for subsequent radioactive iodine therapy were studied. The computed maximum physiologic thyroid uptake was compared with the 24-hour uptake using the paired Student t-test and evaluated using linear regression analysis. Results: The computed physiologic uptake correlated poorly with the 24-hour uptake value. However, in the male subgroup, there was no statistically significant difference between the two (p=0.77). Linear regression analysis gives the following relationship: physiologic uptake (%) = 77.76 - 0.284 (24-hour RAI uptake value). Conclusion: Provided that proper regions of interest are applied with correct attenuation and background subtraction, determination of physiologic thyroid uptake may be obtained using the proposed method. This simple method may be useful prior to I-131 therapy for hyperthyroidism especially when a single uptake determination is performed. (author)

Provider Perspectives on Promoting Cervical Cancer Screening Among Refugee Women.

Science.gov (United States)

Zhang, Ying; Ornelas, India J; Do, H Hoai; Magarati, Maya; Jackson, J Carey; Taylor, Victoria M

2017-06-01

Many refugees in the United States emigrated from countries where the incidence of cervical cancer is high. Refugee women are unlikely to have been screened for cervical cancer prior to resettlement in the U.S. National organizations recommend cervical cancer screening for refugee women soon after resettlement. We sought to identify health and social service providers' perspectives on promoting cervical cancer screening in order to inform the development of effective programs to increase screening among recently resettled refugees. This study consisted of 21 in-depth key informant interviews with staff from voluntary refugee resettlement agencies, community based organizations, and healthcare clinics serving refugees in King County, Washington. Interview transcripts were analyzed to identify themes. We identified the following themes: (1) refugee women are unfamiliar with preventive care and cancer screening; (2) providers have concerns about the timing of cervical cancer education and screening; (3) linguistic and cultural barriers impact screening uptake; (4) provider factors and clinic systems facilitate promotion of screening; and (5) strategies for educating refugee women about screening. Our findings suggest that refugee women are in need of health education on cervical cancer screening during early resettlement. Frequent messaging about screening could help ensure that women receive screening within the early resettlement period. Health education videos may be effective for providing simple, low literacy messages in women's native languages. Appointments with female clinicians and interpreters, as well as clinic systems that remind clinicians to offer screening at each appointment could increase screening among refugee women.

Pharmacist-led screening in sexually transmitted infections: current perspectives

Directory of Open Access Journals (Sweden)

Wood H

2018-06-01

Full Text Available Helen Wood, Sajni Gudka School of Allied Health, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia Introduction: Sexually transmitted infection (STI screening is a crucial initiative that aims to reduce the increasing global prevalence of many common STIs such as chlamydia, gonorrhea, and herpes simplex virus (HSV. Many STIs are either asymptomatic or show mild symptoms that are often attributed to other infections; hence, screening is the only way to identify – and by extension, treat – them. In this way, the spread of STIs can be reduced, and the health implications of an untreated STI are minimized. Community pharmacies could provide an avenue to convenient, confidential STI screening by using noninvasive or minimally invasive sample collection techniques that are used by the consumer or pharmacist. We identified the most common STIs found globally and investigated the current and potential role of pharmacists in provision of STI screening interventions.Discussion: There is sufficient evidence for pharmacy-based chlamydia screening, with many consumers and pharmacists finding it an acceptable and highly valued service. Some evidence was found for pharmacy-based gonorrhea, hepatitis B virus (HBV, and human immunodeficiency virus (HIV screening. Appropriate sample collection for gonorrhea screening needs to be further examined in a pharmacy setting. HBV screening presented an increased risk of personal injury to pharmacists through the collection of whole blood specimens, which could be reduced through consumer self-sampling. Pharmacist-collected specimens for HIV is less risky as an oral swab can be used, nullifying the risk of transmission; but pre- and post-screen consultations can be time-intensive; hence, pharmacists would require remuneration to provide an ongoing HIV screening service. Not enough evidence was found for syphilis screening through community pharmacies; more studies are

Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria.

Science.gov (United States)

Rukuni, Ruramayi; Knight, Marian; Murphy, Michael F; Roberts, David; Stanworth, Simon J

2015-10-20

Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes. Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness. Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy. Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.

Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics : a qualitative study

NARCIS (Netherlands)

Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

2016-01-01

BACKGROUND: Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is

Zirconium intermetallics and hydrogen uptake during corrosion

International Nuclear Information System (INIS)

Cox, B.

1987-04-01

The routes by which hydrogen can enter zirconium alloys containing second phase particles during corrosion are discussed. Both direct diffusion through the bulk of the oxide film, and migration through second phase particles that intersect the surface are considered. An examination of results for hydrogen uptake by zirconium alloys during the early stages of oxidation, when the oxide film is still coherent, suggests that for Zr, Zr-1%Cu and Zr-1%Fe the hydrogen enters by diffusing through the bulk ZrO 2 film, whereas for the Zircaloys the primary migration route may be through the intermetallics. The steps in the latter process are discussed and the evidence available on the properties of the intermetallics collated. A comparison of these data with results for hydrogen uptake by two series of ternary alloys (Zr-1%Nb - 1%X, Zr-1%Cu - 1%X) suggests that high hydrogen uptakes often correlate with intermetallics with high hydrogen solubilities and vice versa. The properties of Zr(Fe/Cr) 2+x intermetallics are examined in an attempt to understand the behaviour of the Zircaloys, and it is concluded that present data establishing composition and unit cell dimensions for such intermetallic particles are not of sufficient accuracy to permit a correlation

Evidence-based investigation of the influence of computer-aided detection of polyps on screening of colon cancer with CT colonography

International Nuclear Information System (INIS)

Yoshida, Hiroyuki

2008-01-01

Computed tomographic colonography (CTC), also known as virtual colonoscopy, is a CT examination of the colon for colorectal neoplasms. Recent large-scale clinical trials have demonstrated that CTC yields sensitivity comparable to optical colonoscopy in the detection of clinically significant polyps in a screening population, making CTC a promising technique for screening of colon cancer. For CTC to be a clinically practical means of screening, it must reliably and consistently detect polyps with high accuracy. However, high-level expertise is required to interpret the resulting CT images to find polyps, resulting in variable diagnostic accuracy among radiologists in the detection of polyps. A key technology to overcome this problem and to bring CTC to prime time for screening of colorectal cancer is computer-aided detection (CAD) of polyps. CAD automatically detects the locations of suspicious polyps in CTC images and presents them to radiologists. CAD has the potential to increase diagnostic performance in the detection of polyps as well as to reduce variability of the diagnostic accuracy among radiologists. This paper presents an evidence-based investigation of the influence of CAD on screening of colon cancer with CTC by describing the benefits of using CAD in the diagnosis of CTC, the fundamental CAD scheme for the detection of polyps in CTC, its detection performance, the effect on the improvement of detection performance, as well as the current and future challenges in CAD. (author)

Intestinal uptake of bone seeking radiotracer: possible mechanisms and review of the literature

Energy Technology Data Exchange (ETDEWEB)

Kim, D. W.; Kim, C. G.; Park, S. A.; Chang, J. A. [WonKwang University Hospital, Iksan (Korea, Republic of)

2007-07-01

This study was undertaken to investigate the frequency of intestinal accumulation of Tc-99m 3, 3-diphosphono-1, 2-propanedicarboxylic acid (DPD) on bone scans, describe the patterns of intestinal Tc-99m DPD uptake and discuss the possible mechanisms of this unusual finding. Three thousand, one hundred and ninety-four consecutive patients have been evaluated for intestinal Tc-99m DPD uptake on bone scans. A whole-body bone scan and various spot views were obtained to evaluate the location and intensity of intestinal uptake. Delayed scan and SPECT study were performed to define characteristics of intestinal uptake in some of patients. Available reports of co-relative radiologic imaging, endoscopic studies and laboratory tests were also reviewed to explain the intestinal uptake. Eighteen (9 female, 9 male) patients out of 3194 with a mean age of 57 years showed intestinal Tc-99m DPD uptake. The locations of intestinal uptake were well dispersed throughout the abdomen. The majority of the cases showed lower intensity than iliac spine (12/18, 67%). Eight patients didn't show significant change of uptake characteristics on the delayed images, while intestinal uptake traveled distally in nine patients. Two cases were revealed uptake of peritoneal carcinomatosis with small amount ascites and three cases were revealed tumoral uptake of intestine. Four patients with gastritis showed similar characteristic of intestinal uptake. Six cases of distally traveled intestinal uptake suggested intraluminal Tc-99m DPD activity such as gastrointestinal bleeding. However, stool occult blood tests were negative in three patients, and there is no clinical evidence of gastrointestinal bleeding in other three patients. Intestinal Tc-99m DPD uptake can be observed in 0.5% of bone scans. The mechanism of intestinal uptake is still unclear in some of the patients. Delayed imaging additional spot views and SPECT studies help in the differentiation of this finding from possible

Application of Fragment Ion Information as Further Evidence in Probabilistic Compound Screening Using Bayesian Statistics and Machine Learning: A Leap Toward Automation.

Science.gov (United States)

Woldegebriel, Michael; Zomer, Paul; Mol, Hans G J; Vivó-Truyols, Gabriel

2016-08-02

In this work, we introduce an automated, efficient, and elegant model to combine all pieces of evidence (e.g., expected retention times, peak shapes, isotope distributions, fragment-to-parent ratio) obtained from liquid chromatography-tandem mass spectrometry (LC-MS/MS/MS) data for screening purposes. Combining all these pieces of evidence requires a careful assessment of the uncertainties in the analytical system as well as all possible outcomes. To-date, the majority of the existing algorithms are highly dependent on user input parameters. Additionally, the screening process is tackled as a deterministic problem. In this work we present a Bayesian framework to deal with the combination of all these pieces of evidence. Contrary to conventional algorithms, the information is treated in a probabilistic way, and a final probability assessment of the presence/absence of a compound feature is computed. Additionally, all the necessary parameters except the chromatographic band broadening for the method are learned from the data in training and learning phase of the algorithm, avoiding the introduction of a large number of user-defined parameters. The proposed method was validated with a large data set and has shown improved sensitivity and specificity in comparison to a threshold-based commercial software package.

Review of the evidence on the use of arbitration or consensus within breast screening: A systematic scoping review.

Science.gov (United States)

Hackney, L; Szczepura, A; Moody, L; Whiteman, B

2017-05-01

A systematic scoping review was undertaken to establish the evidence base on arbitration and consensus in mammography reporting. Database searches were supplemented with hand searching of peer-reviewed journals, citation tracking, key author searching, grey literature and personal contact with experts. A 3-stage process was utilised to screen a large volume of literature (601) against the inclusion and exclusion criteria. 26 papers were retained. A lack of guidance and underpinning evidence to inform how best to use arbitration or consensus to resolve discordant reads. In particular, a lack of prospective studies to determine effectiveness in real-life clinical settings. The insufficiency of follow-up or reporting of true interval cancers compromised the ability to conclude the effectiveness of the processes. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Colorectal cancer screening

OpenAIRE

McLoughlin, Monica Ramona

2008-01-01

Colorectal cancer is a major public health burden and is the most common cause of mortality from cancer in Europe. Over the last two decades robust evidence from randomised clinical trials and case-control series have confirmed that the mortality from colorectal cancer can be reduced by screening. The challenge over the next decade is how to implement this in clinical practice. This is what we set out to answer with this thesis. Not all individuals are equal when it comes to screening and tho...

HIV screening at health facilities and community pharmacies in Kenya : Enhancing test uptake and early diagnosis

NARCIS (Netherlands)

Mugo, P.M.

2017-01-01

Despite a tremendous scale-up of antiretroviral therapy, as many as 54% of HIV-infected persons globally remain undiagnosed hence are not on treatment. This thesis presents findings from a series of studies conducted in Coastal Kenya aiming to enhance HIV test uptake and early diagnosis. We found

Retinopathy of prematurity screening criteria and workload ...

African Journals Online (AJOL)

Larger infants require screening to include a few outliers, but they ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

Linking marine resources to ecotonal shifts of water uptake by terrestrial dune vegetation.

Science.gov (United States)

Greaver, Tara L; Sternberg, Leonel L da S

2006-09-01

As evidence mounts that sea levels are rising, it becomes increasingly important to understand the role of ocean water within terrestrial ecosystem dynamics. Coastal sand dunes are ecosystems that occur on the interface of land and sea. They are classic ecotones characterized by zonal distribution of vegetation in response to strong gradients of environmental factors from the ocean to the inland. Despite the proximity of the dune ecosystem to the ocean, it is generally assumed that all vegetation utilizes only freshwater and that water sources do not change across the ecotone. Evidence of ocean water uptake by vegetation would redefine the traditional interpretation of plant-water relations in the dune ecosystem and offer new ideas for assessing maritime influences on function and spatial distribution of plants across the dune. The purpose of this study was to identify sources of water (ocean, ground, and rain) taken up by vegetation using isotopic analysis of stem water and to evaluate water uptake patterns at the community level based on the distribution and assemblage of species. Three coastal dune systems located in southern Florida, USA, and the Bahamian bank/platform system were investigated. Plant distributions across the dune were zonal for 61-94% of the 18 most abundant species at each site. Species with their highest frequency on the fore dune (nearest the ocean) indicate ocean water uptake as evidenced by delta 18O values of stem water. In contrast, species most frequent in the back dune show no evidence of ocean water uptake. Analysis of species not grouped by frequency, but instead sampled along a transect from the ocean toward the inland, indicates that individuals from the vegetation assemblage closest to the ocean had a mixed water-harvesting strategy characterized by plants that may utilize ocean, ground-, and/or rainwater. In contrast, the inland vegetation relies mostly on rainwater. Our results show evidence supporting ocean water use by dune

A centrally generated primary care physician audit report does not improve colonoscopy uptake after a positive result on a fecal occult blood test in Ontario's ColonCancerCheck program.

Science.gov (United States)

Stock, D; Rabeneck, L; Baxter, N N; Paszat, L F; Sutradhar, R; Yun, L; Tinmouth, J

2017-02-01

Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario's population-wide ColonCancerCheck Program. This prospective cohort study used data sets from Ontario's ColonCancerCheck Program (2008-2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy ( p for linear trend: audit and feedback reports does not improve colonoscopy uptake for screening participants with a positive fobt result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.

Lactate uptake against a concentration gradient

DEFF Research Database (Denmark)

Nordström, Carl-Henrik; Nielsen, Troels Halfeld; Nielsen, Hans Boye

2014-01-01

The recently published article by Jalloh et al (Jalloh I, Helmy A, Shannon RJ, Gallagher CN, Menon D, Carpenter K, Hutchinson P. Lactate uptake by the injured human brain - evidence from an arterio-venous gradient and cerebral microdialysis study. J Neurotrauma. 2013 Aug 22. [Epub ahead of print......]) concludes that lactate may be transported across the blood brain barrier into the brain against a concentration gradient. Unfortunately the authors have misinterpreted the concept of analytical imprecision and their conclusion is based on analytical artifact. As the topic of lactate transport into the brain...

Meta-analysis of screening and case finding tools for depression in cancer: evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group.

Science.gov (United States)

Mitchell, Alex J; Meader, Nick; Davies, Evan; Clover, Kerrie; Carter, Gregory L; Loscalzo, Matthew J; Linden, Wolfgang; Grassi, Luigi; Johansen, Christoffer; Carlson, Linda E; Zabora, James

2012-10-01

To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. We identified 63 studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer settings. We used a standardized rating system. We excluded 11 tools without at least two independent studies, leaving 8 tools for comparison. Across all cancer stages there were 56 diagnostic validity studies (n=10,009). For case-finding, one stem question, two stem questions and the BDI-II all had level 2 evidence (2a, 2b and 2c respectively) and given their better acceptability we gave the stem questions a grade B recommendation. For screening, two stem questions had level 1b evidence (with high acceptability) and the BDI-II had level 2c evidence. For every 100 people screened in advanced cancer, the two questions would accurately detect 18 cases, while missing only 1 and correctly reassure 74 with 7 falsely identified. For every 100 people screened in non-palliative settings the BDI-II would accurately detect 17 cases, missing 2 and correctly re-assure 70, with 11 falsely identified as cases. The main cautions are the reliance on DSM-IV definitions of major depression, the large number of small studies and the paucity of data for many tools in specific settings. Although no single tool could be offered unqualified support, several tools are likely to improve upon unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy. Copyright © 2012 Elsevier B.V. All rights reserved.

Retinopathy of prematurity screening criteria and workload ...

African Journals Online (AJOL)

Larger infants require screening to include a few outliers, but they require ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

Different transport mechanisms for cadmium and mercury in Caco-2 cells: inhibition of Cd uptake by Hg without evidence for reciprocal effects

International Nuclear Information System (INIS)

Aduayom, Ismaeel; Campbell, Peter G.C.; Denizeau, Francine; Jumarie, Catherine

2003-01-01

Cadmium/Hg interactions have been studied in the TC7 clone of the enterocytic-like Caco-2 cells to test the hypothesis that these metals may compete for intestinal transport. Comparison of the kinetic parameter values for 203 Hg(II) and 109 Cd(II) uptake in a serum-free medium revealed that Hg is accumulated much more rapidly and to higher concentrations. The very rapid uptake/binding step and the initial uptake rate of 109 Cd were both significantly inhibited by an excess of unlabeled Cd or Hg (apparent K i for Hg of 9.3 ± 1.2 μM) without reciprocal effects. 109 Cadmium uptake was highly sensitive to temperature and a significant fraction of accumulation (12%) was EDTA extractable. 203 Hg uptake remained insensitive to temperature or the EDTA washing procedure. However, the uptake of both tracers was half-decreased when an excess of the respective unlabeled metal was added in the stop solution, suggesting an exchange mechanism for adsorption. Cell pretreatment with N-ethylmaleimide (NEM) led to a 30% decrease or a 73% increase in the 3-min specific transport of 109 Cd when NEM was still present in or removed from the uptake medium, respectively. NEM had no effect on 203 Hg uptake. Overall our results suggest the involvement of a saturable specific mechanism for Cd, which is highly sensitive to inhibition by Hg and NEM under some conditions, and a nonspecific passive diffusion for Hg. The Hg- or NEM-induced inhibition of Cd uptake likely involves a thiol-mediated reaction, but our results suggest that NEM pretreatment may activate other cellular mechanisms leading to a stimulatory effect

Screening for cerebrovascular disease in microcephalic osteodysplastic primordial dwarfism type II (MOPD II): an evidence-based proposal.

Science.gov (United States)

Perry, Luke D; Robertson, Fergus; Ganesan, Vijeya

2013-04-01

Microcephalic osteodysplastic primordial dwarfism type II (OMIM 210720) is a rare autosomal recessive condition frequently associated with early-onset cerebrovascular disease. Presymptomatic detection and intervention could prevent the adverse consequences associated with this. We reviewed published cases of microcephalic osteodysplastic primordial dwarfism type II to ascertain prevalence and characteristics of cerebrovascular disease and use these data to propose an evidence-based approach to cerebrovascular screening. Of 147 cases identified, 47 had cerebrovascular disease (32%), including occlusive arteriopathy (including moyamoya) and cerebral aneurysmal disease. Occlusive disease occurred in younger individuals, and progression can be both rapid and clinically silent. A reasonable screening approach would be magnetic resonance imaging and angiography of the cervical and intracranial circulation at diagnosis, repeated at yearly intervals until 10 years, and every 2 years thereafter, unless clinical concerns occur earlier. At present it would appear that this needs to be life-long. Families and professionals should be alerted to the potential significance of neurologic symptoms and measures should be taken to maintain good vascular health in affected individuals. Copyright © 2013 Elsevier Inc. All rights reserved.

Determinants of participation in colorectal cancer screening with faecal occult blood testing

DEFF Research Database (Denmark)

von Euler-Chelpin, My; Brasso, Klaus; Lynge, Elsebeth

2009-01-01

BACKGROUND: Colorectal cancer is one of the most common cancers in men and women. Participation rates in faecal occult blood testing (FOBT) screening activities are, however, relatively low. In terms of lowering the colorectal cancer mortality, high participation rates are essential, and therefore......, but determinants varied across countries and test settings. There was no systematic variation in participation across age groups. CONCLUSION: The participation pattern depends in part on local circumstances, which makes it difficult to point to a general strategy for increasing the uptake in FOBT screening...

The next Sub Saharan African epidemic? A case study of the determinants of cervical cancer knowledge and screening in Kenya.

Science.gov (United States)

Kangmennaang, Joseph; Onyango, Elizabeth O; Luginaah, Isaac; Elliott, Susan J

2018-01-01

Early cervical cancer screening has been shown to be beneficial in reducing cervical cancer related deaths. Despite the benefits of early cervical cancer screening, uptake remains limited, with wide disparities in access and uptake in most developing countries. As part of a larger study, this paper uses a socio-ecological framework to explain the determinants of cervical cancer knowledge and screening among women of reproductive age (15-49 years) in Kenya. We conducted a multilevel analysis of cervical cancer knowledge (n = 11,138) and screening (n = 10,333) using the 2014 Kenya Demographic and Health Survey (KDHS). Results show regional disparities in cancer knowledge and the utilization of cervical cancer screening services; regions with high wealth inequality (OR = 0.70, 95% CI [0.56-0.87]) emerged as vulnerable regions where women were less likely to screen for cervical cancer. Gender equity, health insurance coverage and education level significantly predicted cervical cancer screening rates. Results further revealed regional as well as rural-urban wealth inequalities in cervical cancer screening. We argue that given that Kenyan women are highly exposed to human papilloma virus (HPV) due to the legacy of human immunodeficiency virus (HIV) in the country, cervical cancer may be the next epidemic if integrated measures are not adopted to increase cervical cancer knowledge and overcome the barriers to utilizing early screening services. The paper concludes with policy recommendations and directions for future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tamizaje del cáncer colorrectal Screening for colorectal cancer

Directory of Open Access Journals (Sweden)

2002-10-01

Full Text Available This piece summarizes new recommendations from the Preventive Services Task Force of the United States of America concerning screening for colorectal cancer (CRC. These recommendations update and replace ones that were issued in 1996. The Task Force strongly recommends that physicians carry out CRC screening tests for both men and women who are 50 years of age or older. The Task Force found fair or good evidence that: 1 several screening methods are effective in reducing mortality from CRC, 2 the benefits of screening outweigh its risks, although the quality of the tests, the magnitude of the benefits, and the potential harms vary according to the method, and 3 periodic fecal occult blood testing (FOBT reduces mortality from CRC. In addition, there is fair evidence that sigmoidoscopy, either alone or in combination with FOBT, reduces CRC mortality. There is no direct evidence that screening colonoscopy is effective in reducing CRC mortality, nor is it clear if the greater accuracy of colonoscopy in comparison to other tests compensates for its additional complications, inconvenience, and costs. Double-contrast barium enema is less sensitive than colonoscopy, and there is no direct evidence that it is effective in lowering mortality rates. There are insufficient data to determine which screening strategy is best in terms of the balance of benefits, potential harms, and cost-effectiveness. Regardless of the strategy chosen, CRC screening is likely to be cost-effective (less than US$ 30 000 per year of life gained.

Influence of TSH on uptake of [18F]fluorodeoxyglucose in human thyroid cells in vitro

International Nuclear Information System (INIS)

Deichen, J.T.; Schmidt, C.; Prante, O.; Maschauer, S.; Kuwert, T.; Papadopoulos, T.

2004-01-01

Recent clinical evidence suggests that positron emission tomography with fluorine-18 fluorodeoxyglucose (FDG-PET) is more accurate in detecting thyroid carcinomatous tissue at high than at low TSH levels. The aim of this study was to determine the influence of TSH on FDG uptake in human thyroid cells in vitro. Monolayers of human thyroid tissue were cultured after mechanical disintegration and enzymatic digestion of samples from patients undergoing surgery for nodular goitre. The purity of thyroid cell preparations was ascertained by immunohistochemical staining for the epithelial antigen KL-1, and their viability by measuring the synthesis of thyroglobulin in vitro. The cells were incubated with 0.8-1.5 MBq FDG/ml uptake medium for 1 h. FDG uptake in thyroid cells was quantified as percent of whole FDG activity per well (% ID) or as % ID in relation to total protein mass. This experimental protocol was subsequently varied to study the effect of incubation time, glucose dependency and TSH. Furthermore, radio-thin layer chromatography was used to identify intracellular FDG metabolites. FDG accumulated in the thyroid cells linearly with time, doubling roughly every 20 min. Uptake was competitively inhibited by unlabelled glucose and decreased to approximately 70% at 100 mg/dl glucose compared to the value measured in glucose-free medium. FDG was intracellularly trapped as FDG-6 phosphate and FDG-1,6-diphosphate. TSH significantly increased FDG uptake in vitro in a time- and concentration-dependent manner: Cells cultured at a TSH concentration of 50 μU/ ml doubled FDG uptake compared to TSH-free conditions, and uptake after 72 h of TSH pre-incubation was approximately 300% of that without TSH pre-incubation. TSH stimulates FDG uptake by benign thyroid cells in a time- and concentration-dependent manner. This supports the clinical evidence that in well-differentiated thyroid carcinomas, most of which are still TSH-sensitive, FDG-PET is more accurate at high levels of

Screening for colorectal cancer: what fits best?

LENUS (Irish Health Repository)

Lee, Chun Seng

2012-06-01

Colorectal cancer (CRC) screening has been shown to be effective in reducing CRC incidence and mortality. There are currently a number of screening modalities available for implementation into a population-based CRC screening program. Each screening method offers different strengths but also possesses its own limitations as a population-based screening strategy. We review the current evidence base for accepted CRC screening tools and evaluate their merits alongside their challenges in fulfilling their role in the detection of CRC. We also aim to provide an outlook on the demands of a low-risk population-based CRC screening program with a view to providing insight as to which modality would best suit current and future needs.

Breast Cancer Screening (PDQ®)—Patient Version

Science.gov (United States)

Breast cancer screening is performed using mammogram, clinical breast exam (CBE), and MRI (magnetic resonance imaging) tests. Learn about these and other tests that have been studied to detect or screen for breast cancer in this expert-reviewed and evidence-based summary.

Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.

Science.gov (United States)

Onega, Tracy; Haas, Jennifer S; Bitton, Asaf; Brackett, Charles; Weiss, Julie; Goodrich, Martha; Harris, Kimberly; Pyle, Steve; Tosteson, Anna N A

2017-01-01

Breast cancer screening guidelines and metrics are inconsistent with each other and may differ from breast screening practice patterns in primary care. This study measured breast cancer screening practice patterns in relation to common evidence-based guidelines and accountability metrics. Cohort study using primary data collected from a regional breast cancer screening research network between 2011 and 2014. Using information on women aged 30 to 89 years within 21 primary care practices of 2 large integrated health systems in New England, we measured the proportion of women screened overall and by age using 2 screening definition categories: any mammogram and screening mammogram. Of the 81,352 women in our cohort, 54,903 (67.5%) had at least 1 mammogram during the time period, 48,314 (59.4%) had a screening mammogram. Women aged 50 to 69 years were the highest proportion screened (82.4% any mammogram, 75% screening indication); 72.6% of women at age 40 had a screening mammogram with a median of 70% (range = 54.3%-84.8%) among the practices. Of women aged at least 75 years, 63.3% had a screening mammogram, with the median of 63.9% (range = 37.2%-78.3%) among the practices. Of women who had 2 or more mammograms, 79.5% were screened annually. Primary care practice patterns for breast cancer screening are not well aligned with some evidence-based guidelines and accountability metrics. Metrics and incentives should be designed with more uniformity and should also include shared decision making when the evidence does not clearly support one single conclusion.

Thyroid Scan and Uptake

Medline Plus

Full Text Available ... for a thyroid scan is 30 minutes or less. Thyroid Uptake You will be given radioactive iodine (I-123 or I-131) in liquid or capsule form to swallow. The thyroid uptake will begin several hours to 24 hours later. Often, two separate uptake ...

Clinically targeted screening for congenital CMV - potential for integration into the National Hearing Screening Programme.

Science.gov (United States)

Kadambari, S; Luck, S; Davis, A; Williams, Ej; Berrington, J; Griffiths, Pd; Sharland, M

2013-10-01

Screening for a condition should only be undertaken if certain strict criteria are met. Congenital CMV (cCMV) is a leading cause of sensorineuronal hearing loss (SNHL) and meets many of these criteria, but is not currently screened for in the UK. Ganciclovir reduces CMV-induced progressive SNHL if treatment is begun in the first month of life. The Newborn Hearing Screening Programme (NHSP) has been shown to identify SNHL at the earliest possible age. The potential of integrating screening for cCMV into the NHSP is discussed to consolidate the link between screening, early diagnosis and management. The early diagnosis and treatment of cCMV may prevent a small proportion of late SNHL. In the absence of any screening programme, we provide evidence that clinically targeted screening through the NHSP is a potential option in the UK, enhancing the diagnostic pathway and enabling appropriate early treatment to reduce long-term morbidity. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The prion-ZIP connection: From cousins to partners in iron uptake

Science.gov (United States)

Singh, Neena; Asthana, Abhishek; Baksi, Shounak; Desai, Vilok; Haldar, Swati; Hari, Sahi; Tripathi, Ajai K

2015-01-01

ABSTRACT Converging observations from disparate lines of inquiry are beginning to clarify the cause of brain iron dyshomeostasis in sporadic Creutzfeldt-Jakob disease (sCJD), a neurodegenerative condition associated with the conversion of prion protein (PrPC), a plasma membrane glycoprotein, from α-helical to a β-sheet rich PrP-scrapie (PrPSc) isoform. Biochemical evidence indicates that PrPC facilitates cellular iron uptake by functioning as a membrane-bound ferrireductase (FR), an activity necessary for the transport of iron across biological membranes through metal transporters. An entirely different experimental approach reveals an evolutionary link between PrPC and the Zrt, Irt-like protein (ZIP) family, a group of proteins involved in the transport of zinc, iron, and manganese across the plasma membrane. Close physical proximity of PrPC with certain members of the ZIP family on the plasma membrane and increased uptake of extracellular iron by cells that co-express PrPC and ZIP14 suggest that PrPC functions as a FR partner for certain members of this family. The connection between PrPC and ZIP proteins therefore extends beyond common ancestry to that of functional cooperation. Here, we summarize evidence supporting the facilitative role of PrPC in cellular iron uptake, and implications of this activity on iron metabolism in sCJD brains. PMID:26689487

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis.

Science.gov (United States)

Welton, Nicky J; McAleenan, Alexandra; Thom, Howard Hz; Davies, Philippa; Hollingworth, Will; Higgins, Julian Pt; Okoli, George; Sterne, Jonathan Ac; Feder, Gene; Eaton, Diane; Hingorani, Aroon; Fawsitt, Christopher; Lobban, Trudie; Bryden, Peter; Richards, Alison; Sofat, Reecha

2017-05-01

-effective than systematic population screening, as long as the uptake of opportunistic screening observed in randomised controlled trials translates to practice. Modified blood pressure monitors, photoplethysmography or nurse pulse palpation were more likely to be cost-effective than other screening tests. A screening strategy with an initial screening age of 65 years and repeated screens every 5 years until age 80 years was likely to be cost-effective, provided that compliance with treatment does not decline with increasing age. A national screening programme for AF is likely to represent a cost-effective use of resources. Systematic opportunistic screening is more likely to be cost-effective than systematic population screening. Nurse pulse palpation or modified blood pressure monitors would be appropriate screening tests, with confirmation by diagnostic 12-lead electrocardiography interpreted by a trained GP, with referral to a specialist in the case of an unclear diagnosis. Implementation strategies to operationalise uptake of systematic opportunistic screening in primary care should accompany any screening recommendations. Many inputs for the economic model relied on a single trial [the Screening for Atrial Fibrillation in the Elderly (SAFE) study] and DTA results were based on a few studies at high risk of bias/of low applicability. Comparative studies measuring long-term outcomes of screening strategies and DTA studies for new, emerging technologies and to replicate the results for photoplethysmography and GP interpretation of 12-lead electrocardiography in a screening population. This study is registered as PROSPERO CRD42014013739. The National Institute for Health Research Health Technology Assessment programme.

Foliar uptake of cesium from the water column by aquatic macrophytes

Energy Technology Data Exchange (ETDEWEB)

Pinder, J.E. [Savannah River Ecology Laboratory, University of Georgia, Drawer E, Aiken, SC 29801 (United States); Hinton, T.G. [Savannah River Ecology Laboratory, University of Georgia, Drawer E, Aiken, SC 29801 (United States)]. E-mail: thinton@srel.edu; Whicker, F.W. [Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618 (United States)

2006-07-01

The probable occurrence and rate of foliar absorption of stable cesium ({sup 133}Cs) from the water column by aquatic macrophyte species was analyzed following the addition of {sup 133}Cs into a small reservoir near Aiken, South Carolina, USA. An uptake parameter u (10{sup 3} L kg{sup -1} d{sup -1}) and a loss rate parameter k (d{sup -1}) were estimated for each species using time series of {sup 133}Cs concentrations in the water and plant tissues. Foliar uptake, as indicated by rapid increases in plant concentrations following the {sup 133}Cs addition, occurred in two floating-leaf species, Brasenia schreberi and Nymphaea odorata, and two submerged species, Myriophyllum spicatum and Utricularia inflata. These species had values of u {>=} 0.75 x 10{sup 3} L kg{sup -1} d{sup -1}. Less evidence for foliar uptake was observed in three emergent species, including Typha latifolia. Ratios of u to k for B. schreberi, M. spicatum, N. odorata and U. inflata can be used to estimate concentration ratios (CR) at equilibrium, and these estimates were generally within a factor of 2 of the CR for {sup 137}Cs for these species in the same reservoir. This correspondence suggests that foliar uptake of Cs was the principal absorption mechanism for these species. Assessments of: (1) the prevalence of foliar uptake of potassium, rubidium and Cs isotopes by aquatic macrophytes and (2) the possible importance of foliar uptake of Cs in other lentic systems are made from a review of foliar uptake studies and estimation of comparable u and k values from lake studies involving Cs releases.

Screening for colorectal cancer.

Science.gov (United States)

He, Jin; Efron, Jonathan E

2011-01-01

March is national colorectal cancer awareness month. It is estimated that as many as 60% of colorectal cancer deaths could be prevented if all men and women aged 50 years or older were screened routinely. In 2000, Katie Couric's televised colonoscopy led to a 20% increase in screening colonoscopies across America, a stunning rise called the "Katie Couric Effect". This event demonstrated how celebrity endorsement affects health behavior. Currently, discussion is ongoing about the optimal strategy for CRC screening, particularly the costs of screening colonoscopy. The current CRC screening guidelines are summarized in Table 2. Debates over the optimum CRC screening test continue in the face of evidence that 22 million Americans aged 50 to 75 years are not screened for CRC by any modality and 25,000 of those lives may have been saved if they had been screened for CRC. It is clear that improving screening rates and reducing disparities in underscreened communities and population subgroups could further reduce colorectal cancer morbidity and mortality. National Institutes of Health consensus identified the following priority areas to enhance the use and quality of colorectal cancer screening: Eliminate financial barriers to colorectal cancer screening and appropriate follow-up of positive results of colorectal cancer screening. Develop systems to ensure the high quality of colorectal cancer screening programs. Conduct studies to determine the comparative effectiveness of the various colorectal cancer screening methods in usual practice settings. Encouraging population adherence to screening tests and allowing patients to select the tests they prefer may do more good (as long as they choose something) than whatever procedure is chosen by the medical profession as the preferred test.

Understanding Transgender Men's Experiences with and Preferences for Cervical Cancer Screening: A Rapid Assessment Survey.

Science.gov (United States)

Seay, Julia; Ranck, Atticus; Weiss, Roy; Salgado, Christopher; Fein, Lydia; Kobetz, Erin

2017-08-01

Transgender men are less likely than cisgender women to receive cervical cancer screening. The purpose of the current study was to understand experiences with and preferences for cervical cancer screening among transgender men. Ninety-one transgender men ages 21-63 completed the survey. The survey evaluated experiences with and preferences for screening, including opinions regarding human papillomavirus (HPV) self-sampling as a primary cervical cancer screening. Half (50.5%) of participants did not have Pap smear screening within the past 3 years. The majority (57.1%) of participants preferred HPV self-sampling over provider-collected Pap smear screening. Participants who reported discrimination were more likely to prefer HPV self-sampling (odds ratio = 3.29, 95% confidence interval 1.38-7.84, P = 0.007). Primary HPV testing via HPV self-sampling may improve cervical cancer screening uptake among transgender men. Future work should pilot this innovative cervical cancer screening method within this population.

Diffuse and diffuse-plus-focal uptake in the thyroid gland identified by using FDG-PET. Prevalence of thyroid cancer and Hashimoto's thyroiditis

International Nuclear Information System (INIS)

Kurata, Seiji; Ishibashi, Masatoshi; Hiromatsu, Yuji; Kaida, Hayato; Miyake, Ikuyo; Uchida, Masafumi; Hayabuchi, Naofumi

2007-01-01

The objective of this study was to investigate and evaluate the prevalence of incidental thyroid diffuse and diffuse-plus-focal fluorine-18 fluorodeoxyglucose (FDG) uptake in healthy subjects who underwent cancer screening on positron emission tomography (PET) scan, and also to evaluate the prevalence of thyroid cancer and Hashimoto's thyroiditis. We carried out a retrospective review of 1626 subjects who underwent PET scanning at our institution. Diffuse uptake was defined as FDG uptake in the whole thyroid gland, whereas diffuse-plus-focal uptake was defined as a thyroid lesion with both diffuse uptake and focal FDG uptake. The maximum standardized uptake value of the thyroid lesions was recorded and reviewed. In each selected subject with positive thyroid FDG uptake, serum thyroid-stimulating hormone, thyroid hormone, and thyroid antibodies were measured. Fine needle aspiration cytology was performed on patients with a definite nodule using ultrasonography. Twenty-nine subjects (1.78%) were identified as having either diffuse FDG uptake (n=25, 1.53%) or diffuse-plus-focal FDG uptake (n=4, 0.24%). All subjects with diffuse FDG uptake were diagnosed as having Hashimoto's thyroiditis. In 1 of the 25 subjects with diffuse FDG uptake and two of the four with diffuse-plus-focal FDG uptake, histopathologic diagnosis showed papillary thyroid carcinoma associated with Hashimoto's thyroiditis. However, PET scan did not detect papillary carcinoma associated with Hashimoto's thyroiditis in one of the three subjects. Our results suggest that although diffuse FDG uptake usually indicates Hashimoto's thyroiditis, the risk of thyroid cancer must be recognized in both diffuse FDG uptake and diffuse-plus-focal FDG uptake on PET scan. (author)

Pitfalls and Opportunities in Colorectal Cancer Screening

NARCIS (Netherlands)

P.G. van Putten (Paul)

2013-01-01

textabstractColorectal cancer (CRC) is the third most common cancer and the second leading cause of death from cancer in the Western world. Screening has been shown to reduce CRC incidence and mortality. The first evidence that colorectal cancer screening could effectively reduce mortality dates

European position statement on lung cancer screening

DEFF Research Database (Denmark)

Oudkerk, Matthijs; Devaraj, Anand; Vliegenthart, Rozemarijn

2017-01-01

Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified...... specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes...... need to set a timeline for implementing lung cancer screening....

Influence of inhibitors of serotonin uptake on intestinal epithelium and colorectal carcinomas.

Science.gov (United States)

Tutton, P J; Barkla, D H

1982-08-01

Previous studies have shown that in certain tissues, including colonic carcinomas, cell proliferation may be promoted by serotonin, and indirect evidence suggests that the effects of this amine on colonic tumours involves a cellular-uptake mechanism. In the present study, two specific inhibitors of serotonin uptake, Citalopram and Fluoxetine, are examined for their effects on cell proliferation and tumour growth. Each of the agents was found to suppress cell division in dimethylhydrazine-induced colonic tumours in rats, and to retard the growth of 2 out of 3 lines of human colonic tumours propagated as xenografts in immune-deprived mice.

The Impact of a Population-Based Screening Program on Income- and Immigration-Related Disparities in Colorectal Cancer Screening.

Science.gov (United States)

Kiran, Tara; Glazier, Richard H; Moineddin, Rahim; Gu, Sumei; Wilton, Andrew S; Paszat, Lawrence

2017-09-01

Background: A population-based program promoting the Fecal Occult Blood Test (FOBT) for colorectal cancer screening was introduced in 2008 in Ontario, Canada, where opportunistic screening with colonoscopy had been increasing in frequency. We evaluated the impact of the program on income and immigration-related disparities in screening. Methods: We used linked administrative data to calculate colorectal cancer screening rates for eligible Ontarians in each year between 2001/02 ( n = 2,852,619) and 2013/14 ( n = 4,139,304). We quantified disparities using an "inequality ratio" of screening rates in the most disadvantaged group relative to the most advantaged group. We performed segmented logistic regression analyses stratified by screening modality and adjusted for age, sex, rurality, comorbidity, and morbidity. Results: Between 2001/02 and 2013/14, the income and immigration inequality ratios narrowed from 0.74 to 0.80 and 0.55 to 0.69, respectively. Before the screening program, the income inequality ratio was widening by 1% per year (95% CI 1% to 1%); in the year it was introduced, it narrowed by 4% (95% CI 2% to 7%) and in the years following, it remained stable [0% decrease (95% CI 1% decrease to 0% decrease) per year]. Results were similar for immigration-related disparities. After program introduction, disparities in receiving FOBT were narrowing at a faster rate while disparities in receiving colonoscopy were widening at a slower rate. Conclusions: Introduction of a population-based screening program promoting FOBT for colorectal cancer was associated with only modest improvements in immigration and income-related disparities. Impact: Reducing immigration and income-related disparities should be a focus for future research and policy work. Disparities in Ontario seem to be driven by a higher uptake of colonoscopy among more advantaged groups. Cancer Epidemiol Biomarkers Prev; 26(9); 1401-10. ©2017 AACR . ©2017 American Association for Cancer Research.

The Registry of Knowledge Translation Methods and Tools: a resource to support evidence-informed public health.

Science.gov (United States)

Peirson, Leslea; Catallo, Cristina; Chera, Sunita

2013-08-01

This paper examines the development of a globally accessible online Registry of Knowledge Translation Methods and Tools to support evidence-informed public health. A search strategy, screening and data extraction tools, and writing template were developed to find, assess, and summarize relevant methods and tools. An interactive website and searchable database were designed to house the registry. Formative evaluation was undertaken to inform refinements. Over 43,000 citations were screened; almost 700 were full-text reviewed, 140 of which were included. By November 2012, 133 summaries were available. Between January 1 and November 30, 2012 over 32,945 visitors from more than 190 countries accessed the registry. Results from 286 surveys and 19 interviews indicated the registry is valued and useful, but would benefit from a more intuitive indexing system and refinements to the summaries. User stories and promotional activities help expand the reach and uptake of knowledge translation methods and tools in public health contexts. The National Collaborating Centre for Methods and Tools' Registry of Methods and Tools is a unique and practical resource for public health decision makers worldwide.

ACR Appropriateness Criteria® Ovarian Cancer Screening.

Science.gov (United States)

Pandharipande, Pari V; Lowry, Kathryn P; Reinhold, Caroline; Atri, Mostafa; Benson, Carol B; Bhosale, Priyadarshani R; Green, Edward D; Kang, Stella K; Lakhman, Yulia; Maturen, Katherine E; Nicola, Refky; Salazar, Gloria M; Shipp, Thomas D; Simpson, Lynn; Sussman, Betsy L; Uyeda, Jennifer; Wall, Darci J; Whitcomb, Bradford; Zelop, Carolyn M; Glanc, Phyllis

2017-11-01

There has been much interest in the identification of a successful ovarian cancer screening test, in particular, one that can detect ovarian cancer at an early stage and improve survival. We reviewed the currently available data from randomized and observational trials that examine the role of imaging for ovarian cancer screening in average-risk and high-risk women. We found insufficient evidence to recommend ovarian cancer screening, when considering the imaging modality (pelvic ultrasound) and population (average-risk postmenopausal women) for which there is the greatest available published evidence; randomized controlled trials have not demonstrated a mortality benefit in this setting. Screening high-risk women using pelvic ultrasound may be appropriate in some clinical situations; however, related data are limited because large, randomized trials have not been performed in this setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Testicular Cancer Screening (PDQ®)—Health Professional Version

Science.gov (United States)

For testicular cancer, there is no standard or routine screening test. Review the limited evidence on the benefits and harms of screening for testicular cancer using ultrasound, physical examination, and self-examination in this expert-reviewed summary.

Standardized uptake values of fluorine-18 fluorodeoxyglucose: the value of different normalization procedures

International Nuclear Information System (INIS)

Schomburg, A.; Bender, H.; Reichel, C.; Sommer, T.; Ruhlmann, J.; Kozak, B.; Biersack, H.J.

1996-01-01

While the evident advantages of absolute metabolic rate determinations cannot be equalled by static image analysis of fluorine-18 fluorodexyglucose positron emission tomographic (FDG PET) studies, various algorithms for the normalization of static FDG uptake values have been proposed. This study was performed to compare different normalization procedures in terms of dependency on individual patient characteristics. Standardized FDG uptake values (SUVs) were calculated for liver and lung tissue in 126 patients studied with whole-body FDG PET. Uptake values were normalized for total body weight, lean body mass and body surface area. Ranges, means, medians, standard deviations and variation coefficients of these SUV parameters were calculated and their interdependency with total body weight, lean body mass, body surface area, patient height and blood sugar levels was calculated by means of regression analysis. Standardized FDG uptake values normalized for body surface area were clearly superior to SUV parameters normalized for total body weight or lean body mass. Variation and correlation coefficients of body surface area-normalized uptake values were minimal when compared with SUV parameters derived from the other normalization procedures. Normalization for total body weight resulted in uptake values still dependent on body weight and blood sugar levels, while normalization for lean body mass did not eliminate the positive correlation with lean body mass and patient height. It is concluded that normalization of FDG uptake values for body surface area is less dependent on the individual patient characteristics than are FDG uptake values normalized for other parameters, and therefore appears to be preferable for FDG PET studies in oncology. (orig.)

Uptake of nuclides by plants

International Nuclear Information System (INIS)

Greger, Maria

2004-04-01

This review on plant uptake of elements has been prepared to demonstrate how plants take up different elements. The work discusses the nutrient elements, as well as the general uptake and translocation in plants, both via roots and by foliar absorption. Knowledge of the uptake by the various elements within the periodic system is then reviewed. The work also discusses transfer factors (TF) as well as difficulties using TF to understand the uptake by plants. The review also focuses on species differences. Knowledge necessary to understand and calculate plant influence on radionuclide recirculation in the environment is discussed, in which the plant uptake of a specific nuclide and the fate of that nuclide in the plant must be understood. Plants themselves determine the uptake, the soil/sediment determines the availability of the nuclides and the nuclides themselves can interact with each other, which also influences the uptake. Consequently, it is not possible to predict the nuclide uptake in plants by only analysing the nuclide concentration of the soil/substrate

Uptake of nuclides by plants

Energy Technology Data Exchange (ETDEWEB)

Greger, Maria [Stockholm Univ. (Sweden). Dept. of Botany

2004-04-01

This review on plant uptake of elements has been prepared to demonstrate how plants take up different elements. The work discusses the nutrient elements, as well as the general uptake and translocation in plants, both via roots and by foliar absorption. Knowledge of the uptake by the various elements within the periodic system is then reviewed. The work also discusses transfer factors (TF) as well as difficulties using TF to understand the uptake by plants. The review also focuses on species differences. Knowledge necessary to understand and calculate plant influence on radionuclide recirculation in the environment is discussed, in which the plant uptake of a specific nuclide and the fate of that nuclide in the plant must be understood. Plants themselves determine the uptake, the soil/sediment determines the availability of the nuclides and the nuclides themselves can interact with each other, which also influences the uptake. Consequently, it is not possible to predict the nuclide uptake in plants by only analysing the nuclide concentration of the soil/substrate.

Screening for cancer-related distress: Summary of evidence from tools to programmes

DEFF Research Database (Denmark)

Bidstrup, P. E.; Johansen, C.; Mitchell, A. J.

2011-01-01

and critically discuss the findings of randomized trials of the effect of screening and to identify components necessary for future studies of the effectiveness of screening programmes. Methods. A search was made of the Embase/Medline and Web of Knowledge abstract databases from inception to September 2010. Our...

Do negative screening test results cause false reassurance? A systematic review.

Science.gov (United States)

Cooper, Grace C; Harvie, Michelle N; French, David P

2017-11-01

It has been suggested that receiving a negative screening test result may cause false reassurance or have a 'certificate of health effect'. False reassurance in those receiving a negative screening test result may result in them wrongly believing themselves to be at lower risk of the disease, and consequently less likely to engage in health-related behaviours that would lower their risk. The present systematic review aimed to identify the evidence regarding false reassurance effects due to negative screening test results in adults (over 18 years) screened for the presence of a disease or its precursors, where disease or precursors are linked to lifestyle behaviours. MEDLINE and PsycINFO were searched for trials that compared a group who had received negative screening results to an unscreened control group. The following outcomes were considered as markers of false reassurance: perceived risk of disease; anxiety and worry about disease; health-related behaviours or intention to change health-related behaviours (i.e., smoking, diet, physical activity, and alcohol consumption); self-rated health status. Nine unique studies were identified, reporting 55 measures in relation to the outcomes considered. Outcomes were measured at various time points from immediately following screening to up to 11 years after screening. Despite considerable variation in outcome measures used and timing of measurements, effect sizes for comparisons between participants who received negative screening test results and control participants were typically small with few statistically significant differences. There was evidence of high risk of bias, and measures of behaviours employed were often not valid. The limited evidence base provided little evidence of false reassurance following a negative screening test results on any of four outcomes examined. False reassurance should not be considered a significant harm of screening, but further research is warranted. Statement of contribution

Depression Screening and Patient Outcomes in Cancer : A Systematic Review

NARCIS (Netherlands)

Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael E.; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.

2011-01-01

Background: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer

Is the tide turning against breast screening?

DEFF Research Database (Denmark)

Jørgensen, Karsten Juhl

2012-01-01

ABSTRACT: Herein I argue that mammographic screening has not delivered on its fundamental premise: to reduce the incidence of advanced breast cancer. Indeed, achieving this goal is required if screening is to reduce breast cancer mortality or mastectomy use. Rather, screening has caused substantial...... increases in the incidence of in situ and early invasive cancers. Moreover, evidence indicates that these screen-detected cancers are unlikely to be cases that were 'caught early', but instead represent women who would not have been diagnosed in the absence of screening and who, as a result, have received...... harmful, unnecessary treatment. If true, these observations raise the specter that screening creates breast cancer patients and that this practice carries little or no benefit....

Knudsen cell and smog chamber study of the heterogeneous uptake of sulfur dioxide on Chinese mineral dust.

Science.gov (United States)

Zhou, Li; Wang, Weigang; Gai, Yanbo; Ge, Maofa

2014-12-01

The heterogeneous uptake processes of sulfur dioxide on two types of Chinese mineral dust (Inner Mongolia desert dust and Xinjiang sierozem) were investigated using both Knudsen cell and smog chamber system. The temperature dependence of the uptake coefficients was studied over a range from 253 to 313 K using the Knudsen cell reactor, the initial uptake coefficients decreased with the increasing of temperature for these two mineral dust samples, whereas the steady state uptake coefficients of the Xinjiang sierozem increased with the temperature increasing, and these temperature dependence functions were obtained for the first time. In the smog chamber experiments at room temperature, the steady state uptake coefficients of SO2 decreased evidently with the increasing of sulfur dioxide initial concentration from 1.72 × 10¹² to 6.15 × 10¹² mol/cm³. Humid air had effect on the steady state uptake coefficients of SO₂onto Inner Mongolia desert dust. Consequences about the understanding of the uptake processes onto mineral dust samples and the environmental implication were also discussed. Copyright © 2014. Published by Elsevier B.V.

DEVELOPMENT OF A SCREENING APPROACH TO DETECT THYROID DISRUPTING CHEMICALS THAT INHIBIT THE HUMAN SODIUM IODIDE SYMPORTER (NIS)

Data.gov (United States)

U.S. Environmental Protection Agency — Data pertaining to a NIS-expressing cell line, hNIS-HEK293T-EPA, and its screening capabilities for determining inhibitors of NIS-mediated iodide uptake. This...

Assessing the Spread and Uptake of a Framework for Introducing and Evaluating Advanced Practice Nursing Roles.

Science.gov (United States)

Boyko, Jennifer A; Carter, Nancy; Bryant-Lukosius, Denise

2016-08-01

Health system researchers must ensure that the products of their work meet the needs of various stakeholder groups (e.g., patients, practitioners, and policy makers). Evidence-based frameworks can support the uptake and spread of research evidence; however, their existence as knowledge translation tools does not ensure their uptake and it is difficult to ascertain their spread into research, practice, and policy using existing methods. The purpose of this article is to report results of a study on the spread and uptake of an evidence-based framework (i.e., the participatory, evidence-based, patient-focused process for advanced practice nursing [PEPPA] framework) into research, practice, and policies relevant to the introduction and evaluation of advanced practice nursing roles. We also reflect on the utility of using a modified citation methodology to evaluate knowledge translation efforts. We searched four databases for literature published between 2004 and 2014 citing the original paper in which the PEPPA framework was published, and carried out an Internet search for grey literature using keywords. Relevant data were extracted from sources and organized using NVivo software. We analysed results descriptively. Our search yielded 164 unique sources of which 69.5% were from published literature and the majority (83.4%) of these were published in nursing journals. Most frequently (71.5%), the framework was used by researchers and students in research studies. A smaller number of citations (11.3%) reflected use of the PEPPA framework in practice settings with a focus on role development, implementation, evaluation, or a combination of these. This study demonstrates that the PEPPA framework has been used to varying degrees as intended, and provides guidance on how to evaluate the spread and uptake of research outputs (e.g., theoretical frameworks). Further research is needed about ways to determine whether evidence-informed research tools such as frameworks have been

Screening for disability in a community: the 'ten questions' screen for ...

African Journals Online (AJOL)

Background: Although the need for early identification and interventions of disabilities is evident, the current state of routine screening practice in Kenya needs intensive training of screeners before more rigorous techniques are introduced. Objective: To compare the precision and practical utility of the 'ten questions' and ...

Radioiodine treatment of hyperthyroidism in patients with low thyroid iodine uptake

International Nuclear Information System (INIS)

Ruchala, M.; Sowinski, J.; Dolata, M.; Skiba, A.; Gembicki, M.; Junik, R.

2005-01-01

The aim of the study was to analyze the effectiveness of radioactive 131I in hyperthyroid patients with confirmed lowered iodine uptake as compared to patients with an uptake of over 30%. We retrospectively analyzed 53 consecutive patients aged from 29 to 84 (mean age 60 years) suffering from hyperthyroidism caused by Graves disease or toxic nodular goitre. The patients were divided into 2 sub-groups: the 1 st with a maximum iodine uptake of 18.7 ± 3.2% (range, 11 - 23%) - 24 patients; the 2 nd with a maximum iodine uptake of 27.1 ± 2.1% (range, 24 - 30%) - 29 patients. The control group consisted of 50 patients treated with 131I with an iodine uptake of over 30%. Each patient was evaluated before, and 6 months after, treatment for fT3, fT4 and TSH with ECLIA; TRAb with RIA; ultrasound with a 7.5 MHz linear probe. The volume of the thyroid gland was determined using the Gutekunst method. All these factors underwent statistical analysis and were considered along with the results of clinical examinations. Clinical remission of hyperthyroidism was evident in 79.3% of both sub-groups, in total (83.3% and 75.3%, respectively). TSH was normalized in 62.3% of these patients (54.2% and 69.0%, respectively). The mean range of TSH levels increased from 0.081 mU/ml to 4.0 mU/ml after therapy; that is, from 0.087 mU/ml to 4.97 mU/ml in the 1 st sub-group and from 0.076 mU/ml to 3.3 mU/ml in the 2 nd sub-group. The volume of the thyroid gland was uniformly significantly lower, with a mean range of 40.5 ml before treatment and 21.7 ml afterwards.The results seen in both sub-groups were similar; only age and dose of radioiodine were slightly higher in the 1 st , while mean uptake was higher in the 2 nd . By comparison of these results to those of the control patients, we observed that the values of TSH, as well as thyroid volume and evidence of clinical remission, reflected those found in the control group.The mean dose of 131I was lower in the control group, that is 11.3 m

An evidence-based treatment algorithm for colorectal polyp cancers: results from the Scottish Screen-detected Polyp Cancer Study (SSPoCS).

Science.gov (United States)

Richards, C H; Ventham, N T; Mansouri, D; Wilson, M; Ramsay, G; Mackay, C D; Parnaby, C N; Smith, D; On, J; Speake, D; McFarlane, G; Neo, Y N; Aitken, E; Forrest, C; Knight, K; McKay, A; Nair, H; Mulholland, C; Robertson, J H; Carey, F A; Steele, Rjc

2018-02-01

Colorectal polyp cancers present clinicians with a treatment dilemma. Decisions regarding whether to offer segmental resection or endoscopic surveillance are often taken without reference to good quality evidence. The aim of this study was to develop a treatment algorithm for patients with screen-detected polyp cancers. This national cohort study included all patients with a polyp cancer identified through the Scottish Bowel Screening Programme between 2000 and 2012. Multivariate regression analysis was used to assess the impact of clinical, endoscopic and pathological variables on the rate of adverse events (residual tumour in patients undergoing segmental resection or cancer-related death or disease recurrence in any patient). These data were used to develop a clinically relevant treatment algorithm. 485 patients with polyp cancers were included. 186/485 (38%) underwent segmental resection and residual tumour was identified in 41/186 (22%). The only factor associated with an increased risk of residual tumour in the bowel wall was incomplete excision of the original polyp (OR 5.61, p=0.001), while only lymphovascular invasion was associated with an increased risk of lymph node metastases (OR 5.95, p=0.002). When patients undergoing segmental resection or endoscopic surveillance were considered together, the risk of adverse events was significantly higher in patients with incomplete excision (OR 10.23, p<0.001) or lymphovascular invasion (OR 2.65, p=0.023). A policy of surveillance is adequate for the majority of patients with screen-detected colorectal polyp cancers. Consideration of segmental resection should be reserved for those with incomplete excision or evidence of lymphovascular invasion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Uptake of genital mucosal sampling in HVTN 097, a phase 1b HIV vaccine trial in South Africa.

Directory of Open Access Journals (Sweden)

Erica Maxine Lazarus

Full Text Available Because sexual transmission of HIV occurs across mucosal membranes, understanding the immune responses of the genital mucosa to vaccines may contribute knowledge to finding an effective candidate HIV vaccine. We describe the uptake of rectal secretion, cervical secretion and seminal mucosal secretion sampling amongst volunteers in a Phase 1b HIV vaccine trial. Age at screening, gender, study site and the designation of the person conducting the informed consent procedure were collected for volunteers who screened for the HVTN 097 study. A total of 211 volunteers (54% female were screened at three sites in South Africa: Soweto (n = 70, 33%, Cape Town (n = 68, 32% and Klerksdorp (n = 73, 35%. Overall uptake of optional mucosal sampling amongst trial volunteers was 71% (n = 149. Compared to Cape Town, volunteers from Soweto and Klerksdorp were less likely to consent to sampling (Soweto OR 0.08 CI: 0.03-0.25 p<0.001 and Klerksdorp OR 0.13 CI: 0.04-0.41 p = 0.001. In contrast, volunteers over 25 years of age were 2.39 times more likely to consent than younger volunteers (CI: 1.13-5.08, p = 0.02. Further studies are required to better understand the cultural, demographic and sociobehavioral factors which influence willingness to participate in mucosal sampling in HIV prevention studies.ClinicalTrials.gov: NCT02109354.

Newborn screening for X-linked adrenoleukodystrophy: further evidence high throughput screening is feasible.

Science.gov (United States)

Theda, Christiane; Gibbons, Katy; Defor, Todd E; Donohue, Pamela K; Golden, W Christopher; Kline, Antonie D; Gulamali-Majid, Fizza; Panny, Susan R; Hubbard, Walter C; Jones, Richard O; Liu, Anita K; Moser, Ann B; Raymond, Gerald V

2014-01-01

X-linked adrenoleukodystrophy (ALD) is characterized by adrenal insufficiency and neurologic involvement with onset at variable ages. Plasma very long chain fatty acids are elevated in ALD; even in asymptomatic patients. We demonstrated previously that liquid chromatography tandem mass spectrometry measuring C26:0 lysophosphatidylcholine reliably identifies affected males. We prospectively applied this method to 4689 newborn blood spot samples; no false positives were observed. We show that high throughput neonatal screening for ALD is methodologically feasible. Copyright © 2013 Elsevier Inc. All rights reserved.

Use of faecal markers in screening for colorectal neoplasia: a European group on tumor markers position paper.

LENUS (Irish Health Repository)

Duffy, Michael J

2012-02-01

Several randomized controlled trials have shown that population-based screening using faecal occult blood testing (FOBT) can reduce mortality from colorectal neoplasia. Based on this evidence, a number of countries have introduced screening for colorectal cancer (CRC) and high-risk adenoma and many others are considering its introduction. The aim of this article is to critically review the current status of faecal markers as population-based screening tests for these neoplasia. Most of the available faecal tests involve the measurement of either occult blood or a panel of DNA markers. Occult blood may be measured using either the guaiac faecal occult blood test (gFOBT) or a faecal immunochemical test (iFOBT). Although iFOBT may require a greater initial investment, they have several advantages over gFOBT, including greater analytical sensitivity and specificity. Their use results in improved clinical performance and higher uptake rates. Importantly for population screening, some of the iFOBTs can be automated and provide an adjustable cutoff for faecal haemoglobin concentration. However, samples for iFOBT, may be less stable after collection than for gFOBT. For new centres undertaking FOBT for colorectal neoplasia, the European Group on Tumour Markers recommends use of a quantitative iFOBT with an adjustable cutoff point and high throughput analysis. All participants with positive FOBT results should be offered colonoscopy. The panel recommends further research into increasing the stability of iFOBT and the development of improved and affordable DNA and proteomic-based tests, which reduce current false negative rates, simplify sample transport and enable automated analysis.

Systematic screening of imaging biomarkers for the Islets of Langerhans, among clinically available positron emission tomography tracers

International Nuclear Information System (INIS)

Karlsson, Filip; Antonodimitrakis, Pantelis Clewemar; Eriksson, Olof

2015-01-01

Introduction: Functional imaging could be utilized for visualizing pancreatic islets of Langerhans. Therefore, we present a stepwise algorithm for screening of clinically available positron emission tomography (PET) tracers for their use in imaging of the neuroendocrine pancreas in the context of diabetes. Methods: A stepwise procedure was developed for screening potential islet imaging agents. Suitable PET-tracer candidates were identified by their molecular mechanism of targeting. Clinical abdominal examinations were retrospectively analyzed for pancreatic uptake and retention. The target protein localization in the pancreas was assessed in silico by –omics approaches and the in vitro by binding assays to human pancreatic tissue. Results: Six putative candidates were identified and screened by using the stepwise procedure. Among the tested PET tracers, only [ 11 C]5-Hydroxy-tryptophan passed all steps. The remaining identified candidates were falsified as candidates and discarded following in silico and in vitro screening. Conclusions: Of the six clinically available PET tracers identified, [ 11 C]5-HTP was found to be a promising candidate for beta cell imaging, based on intensity of in vivo pancreatic uptake in humans, and islet specificity as assessed on human pancreatic cell preparations. The flow scheme described herein constitutes a methodology for evaluating putative islet imaging biomarkers among clinically available PET tracers

Role of uranium speciation in the uptake and translocation of uranium by plants

Energy Technology Data Exchange (ETDEWEB)

Ebbs, S. D.; Brady, D. J.; Kochian, L. V. [US Plant, Soil, and Nutrition Laboratory, USDA-ARS, Cornell University, Ithaca, NY 14853 (United States)

1998-07-01

Uranium (U) uptake and translocation by plants was characterized using a computer speciation model to develop a nutrient culture system that provided U as a single predominant species in solution. A hydroponic uptake study determined that at pH 5.0, the uranyl (UO2{sup 2+}) cation was more readily taken up and translocated by peas (Pisum sativum) than the hydroxyl and carbonate U complexes present in the solution at pH 6.0 and 8.0, respectively. A subsequent experiment tested the extent to which various monocot and dicot species take up and translocate the uranyl cation. Of the species screened, tepary bean (Phaseolus acutifolius) and red beet (Beta vulgaris) were the species showing the greatest accumulation of U. In addition to providing fundamental information regarding U uptake by plants, the results obtained also have implications for the phytoremediation of U-contaminated soils. The initial characterization of U uptake by peas suggested that in the field, a soil pH of <5.5 would be required in order to provide U in the most plant-available form. A pot study using U-contaminated soil was therefore conducted to assess the extent to which two soil amendments, HEDTA and citric acid, were capable of acidifying the soil, increasing U solubility, and enhancing U uptake by red beet. Of these two amendments, only citric acid proved effective, decreasing the soil pH to 5.0 and increasing U accumulation by a factor of 14. The results of this pot study provide a basis for the development of an effective phytoremediation strategy for U-contaminated soils. (author)

Role of uranium speciation in the uptake and translocation of uranium by plants

International Nuclear Information System (INIS)

Ebbs, S.D.; Brady, D.J.; Kochian, L.V.

1998-01-01

Uranium (U) uptake and translocation by plants was characterized using a computer speciation model to develop a nutrient culture system that provided U as a single predominant species in solution. A hydroponic uptake study determined that at pH 5.0, the uranyl (UO2 2+ ) cation was more readily taken up and translocated by peas (Pisum sativum) than the hydroxyl and carbonate U complexes present in the solution at pH 6.0 and 8.0, respectively. A subsequent experiment tested the extent to which various monocot and dicot species take up and translocate the uranyl cation. Of the species screened, tepary bean (Phaseolus acutifolius) and red beet (Beta vulgaris) were the species showing the greatest accumulation of U. In addition to providing fundamental information regarding U uptake by plants, the results obtained also have implications for the phytoremediation of U-contaminated soils. The initial characterization of U uptake by peas suggested that in the field, a soil pH of <5.5 would be required in order to provide U in the most plant-available form. A pot study using U-contaminated soil was therefore conducted to assess the extent to which two soil amendments, HEDTA and citric acid, were capable of acidifying the soil, increasing U solubility, and enhancing U uptake by red beet. Of these two amendments, only citric acid proved effective, decreasing the soil pH to 5.0 and increasing U accumulation by a factor of 14. The results of this pot study provide a basis for the development of an effective phytoremediation strategy for U-contaminated soils. (author)

Communicating the balance sheet in breast cancer screening.

Science.gov (United States)

Giordano, Livia; Cogo, Carla; Patnick, Julietta; Paci, Eugenio

2012-01-01

Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening. In this paper we review the issues in communication of benefits and harms of medical interventions and discuss these in terms of the principles of the balance sheet proposed in this supplement. The balance sheet can be seen as a tool to convey estimates based on the best available evidence and addressed to a readership wider than just potential screening participants. It reflects a re-assessment of screening efficacy, showing again that screening is effective and brings more benefits than harms. It can be viewed as an opportunity to re-affirm some basic principles of good evidence-based communication. Further research is needed to improve communication strategy, to assess the impact of this communication on women's awareness and to evaluate its utility in the informed decision-making process. The balance sheet could be a starting point for a broader vision of informed decision-making in screening, which should also recognize the role played by 'non-numerical' factors on women's choice of participating in breast cancer screening.

Breast cancer screening-opportunistic use of registry and linked screening data for local evaluation.

Science.gov (United States)

Roder, David; Farshid, Gelareh; Gill, Grantley; Kollias, Jim; Koczwara, Bogda; Karapetis, Chris; Adams, Jacqui; Joshi, Rohit; Keefe, Dorothy; Powell, Kate; Fusco, Kellie; Eckert, Marion; Buckley, Elizabeth; Beckmann, Kerri

2017-06-01

Screening has been found to reduce breast cancer mortality at a population level in Australia, but these studies did not address local settings where numbers of deaths would generally have been too low for evaluation. Clinicians, administrators, and consumer groups are also interested in local service outcomes. We therefore use more common prognostic and treatment measures and survivals to gain evidence of screening effects among patients attending 4 local hospitals for treatment. To compare prognostic, treatment, and survival measures by screening history to determine whether expected screening effects are occurring. Employing routine clinical registry and linked screening data to investigate associations of screening history with these measures, using unadjusted and adjusted analyses. Screened women had a 10-year survival from breast cancer of 92%, compared with 78% for unscreened women; and 79% of screened surgical cases had breast conserving surgery compared with 64% in unscreened women. Unadjusted analyses indicated that recently screened cases had earlier tumor node metastasis stages, smaller diameters, less nodal involvement, better tumor differentiation, more oestrogen and progesterone receptor positive lesions, more hormone therapy, and less chemotherapy. Radiotherapy tended to be more common in screening participants. More frequent use of adjunctive radiotherapy applied when breast conserving surgery was used. Results confirm the screening effects expected from the scientific literature and demonstrate the value of opportunistic use of available registry and linked screening data for indicating to local health administrations, practitioners, and consumers whether local screening services are having the effects expected. © 2016 John Wiley & Sons, Ltd.

Uptake of DNA by cancer cells without a transfection reagent

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Yanping Kong

Full Text Available Abstract Background Cancer cells exhibit elevated levels of glucose uptake and may obtain pre-formed, diet-derived fatty acids from the bloodstream to boost their rapid growth; they may also use nucleic acid from their microenvironment. The study of processing nucleic acid by cancer cells will help improve the understanding of the metabolism of cancer. DNA is commonly packaged into a viral or lipid particle to be transferred into cells; this process is called transfection in laboratory. Cancer cells are known for having gene mutations and the evolving ability of endocytosis. Their uptake of DNAs might be different from normal cells; they may take in DNAs directly from the environment. In this report, we studied the uptake of DNAs in cancer cells without a transfection reagent. Methods A group of DNA fragments were prepared with PCR and labeled with isotope phosphorous-32 to test their uptake by Huh 7 (liver cancer and THLE3 (normal liver cells after incubation overnight by counting radioactivity of the cells’ genomic DNA. Multiple cell lines including breast cancer and lung cancer were tested with the same method. DNA molecules were also labeled with fluorescence to test the location in the cells using a kit of “label it fluorescence in situ hybridization (FISH” from Mirus (USA. Results The data demonstrated that hepatocellular carcinoma cells possess the ability to take in large DNA fragments directly without a transfection reagent whereas normal liver cells cannot. Huh7 and MDA-MB231 cells displayed a significantly higher Rhodamine density in the cytoplasmic phagosomes and this suggests that the mechanism of uptake of large DNA by cancer cells is likely endocytosis. The efficacy of uptake is related to the DNA’s size. Some cell lines of lung cancer and breast cancer also showed similar uptake of DNA. Conclusions In the present study, we have revealed the evidence that some cancer cells, but not nontumorigenic cells, can take DNA

Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation.

Science.gov (United States)

Van Dongen, A J C M; Kremer, J A M; Van Sluisveld, N; Verhaak, C M; Nelen, W L D M

2012-12-01

Is patient screening for emotional risk factors before starting IVF treatment feasible? Introduction of screening for emotional risk factors by a validated instrument (SCREENIVF) in couples treated by IVF or ICSI is feasible, indicated by a moderate to high and stable uptake rate, a high acceptance of the process of SCREENIVF, and a high acceptability of the presented risk profile by the patients. SCREENIVF is a validated screening tool to identify women at risk for emotional maladjustment preceding the start of their IVF/ICSI treatment. This was a prospective cohort study, including data of two cohorts of patients (304 and 342 patients), with a duration of 3 months per cohort. For the first cohort, we sent a process evaluation to 210 patients and it was completed by 91 patients. All 304 patients (male and female) who started IVF/ICSI between 1 December 2009 and 28 February 2010 in our tertiary IVF clinic were eligible. The uptake rate of SCREENIVF was assessed as the response rate to the screening questionnaire. One year later, we re-assessed the uptake rate in 342 new patients to assess the stability of the uptake rate. A non-responder assessment in patients who did not complete SCREENIVF was carried out. Finally, patients' characteristics and their experiences with SCREENIVF as well as their consequent actions were assessed by an additional process evaluation questionnaire sent some months later to 210 patients. The uptake rate of SCREENIVF was 78-80%. One-third of the responders were found to be at risk for emotional maladjustment, which was comparable with previous studies using SCREENIVF. Of 27 non-responders to SCREENIVF, 41% explained non-response by 'no actual need for psychological help' and 19% forgot to complete the screening. The response rate to the process evaluation was 43% (n = 91). Of these, 90% found the screening was useful, and almost all patients were positive about the SCREENIVF questionnaire. Furthermore, 93% recognized themselves in the

Screening for lung cancer: Does MRI have a role?

International Nuclear Information System (INIS)

Biederer, Juergen; Ohno, Yoshiharu; Hatabu, Hiroto; Schiebler, Mark L.; Beek, Edwin J.R. van; Vogel-Claussen, Jens; Kauczor, Hans-Ulrich

2017-01-01

Highlights: • From a technical point of view, the feasibility of using MRI for lung cancer screening is evident. • Experience with the clinical use of lung MRI is growing, standardized protocols are available. • If lung cancer screening becomes effective, there will be an opportunity for MRI as primary screening modality or adjunct to CT. • Validation of better patient outcomes (test effectiveness) for the use of MRI is still missing, therefore. • A simultaneous evaluation of MRI should be embedded into any future prospective lung cancer screening trials. - Abstract: While the inauguration of national low dose computed tomographic (LDCT) lung cancer screening programs has started in the USA, other countries remain undecided, awaiting the results of ongoing trials. The continuous technical development achieved by stronger gradients, parallel imaging and shorter echo time has made lung magnetic resonance imaging (MRI) an interesting alternative to CT. For the detection of solid lesions with lung MRI, experimental and clinical studies have shown a threshold size of 3–4 mm for nodules, with detection rates of 60–90% for lesions of 5–8 mm and close to 100% for lesions of 8 mm or larger. From experimental work, the sensitivity for infiltrative, non-solid lesions would be expected to be similarly high as that for solid lesions, but the published data for the MRI detection of lepidic growth type adenocarcinoma is sparse. Moreover, biological features such as a longer T2 time of lung cancer tissue, tissue compliance and a more rapid uptake of contrast material compared to granulomatous diseases, in principle should allow for the multi-parametric characterization of lung pathology. Experience with the clinical use of lung MRI is growing. There are now standardized protocols which are easy to implement on current scanner hardware configurations. The image quality has become more robust and currently ongoing studies will help to further contribute experience

Screening for lung cancer: Does MRI have a role?

Energy Technology Data Exchange (ETDEWEB)

Biederer, Juergen, E-mail: Juergen.biederer@uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Translational Lung Research Center Heidelberg (TLRC), Member of the German Lung ResearchCenter (DZL), Im Neuenheimer Feld 430, 69120 Heidelberg (Germany); Radiologie Darmstadt, Gross-Gerau County Hospital, 64521 Gross-Gerau (Germany); Ohno, Yoshiharu [Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Advanced Biomedical Imaging Research Centre, Kobe University Graduate School of Medicine, Kobe (Japan); Hatabu, Hiroto [Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (United States); Schiebler, Mark L. [Department of Radiology, UW-Madison School of Medicine and Public Health, Madison, WI (United States); Beek, Edwin J.R. van [Clinical Research Imaging Centre, University of Edinburgh, Scotland (United Kingdom); Vogel-Claussen, Jens [Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Translational Lung Research Center Heidelberg (TLRC), Member of the German Lung ResearchCenter (DZL), Im Neuenheimer Feld 430, 69120 Heidelberg (Germany)

2017-01-15

Highlights: • From a technical point of view, the feasibility of using MRI for lung cancer screening is evident. • Experience with the clinical use of lung MRI is growing, standardized protocols are available. • If lung cancer screening becomes effective, there will be an opportunity for MRI as primary screening modality or adjunct to CT. • Validation of better patient outcomes (test effectiveness) for the use of MRI is still missing, therefore. • A simultaneous evaluation of MRI should be embedded into any future prospective lung cancer screening trials. - Abstract: While the inauguration of national low dose computed tomographic (LDCT) lung cancer screening programs has started in the USA, other countries remain undecided, awaiting the results of ongoing trials. The continuous technical development achieved by stronger gradients, parallel imaging and shorter echo time has made lung magnetic resonance imaging (MRI) an interesting alternative to CT. For the detection of solid lesions with lung MRI, experimental and clinical studies have shown a threshold size of 3–4 mm for nodules, with detection rates of 60–90% for lesions of 5–8 mm and close to 100% for lesions of 8 mm or larger. From experimental work, the sensitivity for infiltrative, non-solid lesions would be expected to be similarly high as that for solid lesions, but the published data for the MRI detection of lepidic growth type adenocarcinoma is sparse. Moreover, biological features such as a longer T2 time of lung cancer tissue, tissue compliance and a more rapid uptake of contrast material compared to granulomatous diseases, in principle should allow for the multi-parametric characterization of lung pathology. Experience with the clinical use of lung MRI is growing. There are now standardized protocols which are easy to implement on current scanner hardware configurations. The image quality has become more robust and currently ongoing studies will help to further contribute experience

Household HIV Testing Uptake among Contacts of TB Patients in South Africa.

Directory of Open Access Journals (Sweden)

Kavindhran Velen

Full Text Available In high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB patients. We evaluated the uptake of HIV counselling and testing (HCT among household contacts of index TB patients and the proportion of newly diagnosed HIV-infected persons linked into care as part of a household TB contact tracing study.We recruited index TB patients at public health clinics in two South African provinces to obtain consent for household contact tracing. During scheduled household visits we offered TB symptom screening to all household members and HCT to individuals ≥14years of age. Factors associated with HCT uptake were investigated using a random effects logistic regression model.Out of 1,887 listed household members ≥14 years old, 984 (52% were available during a household visit and offered HCT of which 108 (11% self-reported being HIV infected and did not undergo HCT. Of the remaining 876, a total of 304 agreed to HCT (35%; 26 (8.6% were newly diagnosed as HIV positive. In multivariable analysis, factors associated with uptake of HCT were prior testing (odds ratio 1.6; 95% confidence interval [CI]: 1.1-2.3 and another member in the household testing (odds ratio 2.4; 95% CI: 1.7-3.4. Within 3 months of testing HIV-positive, 35% reported initiating HIV care.HCT as a component of household TB contact tracing reached individuals without prior HIV testing, however uptake of HIV testing was poor. Strategies to improve HIV testing in household contacts should be evaluated.

Deciding on PSA-screening - Quality of current consumer information on the Internet.

Science.gov (United States)

Korfage, Ida J; van den Bergh, Roderick C N; Essink-Bot, Marie-Louise

2010-11-01

Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a must. We assessed the quality of consumer information available through the Internet per November 2009 and its possible contribution to informed decision-making by potential screenees. Consumer information on PSA-screening was sought through the Internet in November 2009. Materials had to be targeted at potential consumers, offered by not-for-profit organisations, released in 2005 or after, in English or Dutch. Per material 2 of the authors assessed independently from each other whether standardised pre-defined topics were addressed, whether the content was correct and which approach was taken towards the decision-making process about uptake. Twenty-three materials were included, of which 11 were released (shortly) after the results of 2 large randomized-controlled trials (RCTs) that evaluated the effectiveness of screening for prostate cancer had been published in March 2009. That a PSA-test result can be abnormal because of non-cancerous conditions (false positive) and that it may miss prostate cancer (false negative) was not addressed in 2/23 and 8/23 materials, respectively. The risk of overdiagnosis and overtreatment was not mentioned in 6 out of 23. PSA-screening was presented as a usual thing to do in some materials, whereas other materials emphasised the voluntary nature of PSA-screening ('it is your decision'). The content of 19/23 materials was considered sufficiently informative according to the pre-defined criteria, 12/23 materials were considered supportive of informed decision-making by men. Most materials of not-for-profit organizations supplied adequate information about PSA-screening, whilst the degree of persuasion towards uptake reflected variations in opinions on men

Physiological and tumoral uptake of 68Ga-DOTATATE. Standardized uptake values and challenges in interpretation

International Nuclear Information System (INIS)

Kuyumcu, Serkan; Oezkan, Zeynep Goezde; Sanli, Yasemin; Yilmaz, Ebru; Mudun, Ayse; Adalet, Isik; Unal, Seher

2013-01-01

The objective of this study is to determine the range of standardized uptake value (SUV) max of 68Ga-DOTA-tyr3-octreotate (DOTATATE) in normal organs and tumoral lesions and establish uptake unrelated to neuroendocrine tumors (NET). One hundred and twenty patients (57 men, 63 women), who underwent 68 Ga-DOTATATE positron emission tomography (PET)/CT imaging in our institution were analyzed. Patients were indicated for 68 Ga-DOTATATE PET/CT imaging to detect primary tumor or metastasis of suspected or previously known NET, to determine somatostatin receptor (SSTR) positivity and to detect occult source of ectopic Cushing syndrome. Normal range of uptake was calculated for the organs that were proven to have no pathology by either conventional radiological imaging or clinical follow-up, using SUV max as a semiquantitative measure. Uptake and tumor to background (T/B) ratios of tumoral lesions in liver, pancreas, bone, brain and lymph nodes were calculated. Uptakes due to lesions unrelated to NET were also documented. Significant uptake was found in spleen, kidneys, adrenal glands, liver and pituitary gland with mean SUV max of 24.67, 14.30, 13.73, 9.12 and 9.74 respectively. Uptake was measured separately for the pancreatic head and body separately, however, besides a slightly heterogeneous uptake; the difference was not statistically significant. Uptake in the tumoral lesions had high (T/B) ratios with mean SUV max of 28.72, 25.21, 18.28, 34.73 and 12.59 for liver, pancreas, bone, brain and lymph nodes, respectively. Incidental benign tumoral lesions were detected in 3 patients (2.5%) which were meningioma and fibrous dysplasia demonstrating significant and breast fibroadenoma demonstrating mild 68 Ga-DOTATATE uptake. Non-neoplastic processes were detected in 4 patients (14.1%), including postsurgical inflammation, reactive lymph nodes, arthritis and demonstrated faint to mild 68 Ga-DOTATATE uptake, with the exception of significant uptake in accessory spleen. 68 Ga

Use of an evidence-based protocol to screen for sleep-disordered breathing in a heart failure disease management clinic.

Science.gov (United States)

Garner, Shelby L; Traverse, Ramona D

2014-01-01

Undiagnosed and untreated sleep-disordered breathing can lead to negative health outcomes and increased utilization of health resources among patients with heart failure. The purpose of this evidence-based practice project was to implement and evaluate a new multifaceted sleep-disordered breathing screening protocol in a heart failure disease management clinic. The combined use of a symptoms questionnaire, the Epworth sleepiness scale, and overnight pulse oximetry was significantly more effective in identifying patients with a positive diagnosis of sleep-disordered breathing than using the Epworth sleepiness scale alone (P < .05).

Proximal Tubules Have the Capacity to Regulate Uptake of Albumin.

Science.gov (United States)

Wagner, Mark C; Campos-Bilderback, Silvia B; Chowdhury, Mahboob; Flores, Brittany; Lai, Xianyin; Myslinski, Jered; Pandit, Sweekar; Sandoval, Ruben M; Wean, Sarah E; Wei, Yuan; Satlin, Lisa M; Wiggins, Roger C; Witzmann, Frank A; Molitoris, Bruce A

2016-02-01

Evidence from multiple studies supports the concept that both glomerular filtration and proximal tubule (PT) reclamation affect urinary albumin excretion rate. To better understand these roles of glomerular filtration and PT uptake, we investigated these processes in two distinct animal models. In a rat model of acute exogenous albumin overload, we quantified glomerular sieving coefficients (GSC) and PT uptake of Texas Red-labeled rat serum albumin using two-photon intravital microscopy. No change in GSC was observed, but a significant decrease in PT albumin uptake was quantified. In a second model, loss of endogenous albumin was induced in rats by podocyte-specific transgenic expression of diphtheria toxin receptor. In these albumin-deficient rats, exposure to diphtheria toxin induced an increase in albumin GSC and albumin filtration, resulting in increased exposure of the PTs to endogenous albumin. In this case, PT albumin reabsorption was markedly increased. Analysis of known albumin receptors and assessment of cortical protein expression in the albumin overload model, conducted to identify potential proteins and pathways affected by acute protein overload, revealed changes in the expression levels of calreticulin, disabled homolog 2, NRF2, angiopoietin-2, and proteins involved in ATP synthesis. Taken together, these results suggest that a regulated PT cell albumin uptake system can respond rapidly to different physiologic conditions to minimize alterations in serum albumin level. Copyright © 2016 by the American Society of Nephrology.

Pathophysiology, risk factors, and screening methods for prediabetes in women with polycystic ovary syndrome

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Gourgari E

2016-08-01

Full Text Available Evgenia Gourgari,1 Elias Spanakis,2 Adrian Sandra Dobs3 1Division of Pediatric Endocrinology, Georgetown University School of Medicine, Washington, DC, 2Division of Endocrinology, University of Maryland School of Medicine, 3Department of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Polycystic ovary syndrome (PCOS is a syndrome associated with insulin resistance (IR, obesity, infertility, and increased cardiometabolic risk. This is a descriptive review of several mechanisms that can explain the IR among women with PCOS, other risk factors for the development of diabetes, and the screening methods used for the detection of glucose intolerance in women with PCOS. Few mechanisms can explain IR in women with PCOS such as obesity, insulin receptor signaling defects, and inhibition of insulin-mediated glucose uptake in adipocytes. Women with PCOS have additional risk factors for the development of glucose intolerance such as family history of diabetes, use of oral contraceptives, anovulation, and age. The Androgen Society in 2007 and the Endocrine Society in 2013 recommended using oral glucose tolerance test as a screening tool for abnormal glucose tolerance in all women with PCOS. The approach to detection of glucose intolerance among women with PCOS varies among health care providers. Large prospective studies are still needed for the development of guidelines with strong evidence. When assessing risk of future diabetes in women with PCOS, it is important to take into account the method used for screening as well as other risk factors that these women might have. Keywords: IR, OGTT, obesity, hyperandrogenism, anovulation, BMI, insulin resistance, PCOS

Uptake and distribution of cadmium in corn

International Nuclear Information System (INIS)

Peel, J.W.; Vetter, R.J.; Christian, J.E.; Kessler, W.V.; McFee, W.W.

1978-01-01

The uptake and distribution of cadmium in corn (Zea mays) treated at various time intervals after planting and sampled at various times after treatment were measured. Cadmium was found to accumulate in all parts sampled. As shown in field studies, stems and leaves generally concentrated more cadmium than did husks, cobs, kernels, silks, or tassels. Samples of stems and leaves from corn treated 23 days after planting and sampled 5 days later exhibited higher concentrations of cadmium than samples taken 25, 45, 65, or 85 days after treatment. Concentrations generally decreased with time. Greenhouse studies showed that corn exposed to cadmium for the longest period of time accumulated the greatest total cadmium. The highest cadmium concentrations were found in the base or lowest leaves sampled 45 days after planting; this suggests a useful technique for quick screening corn crops for cadmium pollution

European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Quality assurance in pathology in colorectal cancer screening and diagnosis.

Science.gov (United States)

Quirke, P; Risio, M; Lambert, R; von Karsa, L; Vieth, M

2012-09-01

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology in colorectal cancer screening and diagnosis includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease. © Georg Thieme Verlag KG Stuttgart · New York.

Positron imaging feasibility studies: characteristics of [3H]thymidine uptake in rodent and canine neoplasms

International Nuclear Information System (INIS)

Larson, S.M.; Weiden, P.L.; Grunbaum, J.

1981-01-01

Uptake [ 3 H]thymidine was studied in BALB/c mice with EMT-6 sarcoma, in Buffalo rats with Morris 7777 hepatoma, and in nine dogs with spontaneous neoplasms: four lymphomas, two osteosarcomas, two soft-tissue sarcomas, and a thyroid carcinoma. High tumor-to-tissue ratios were observed for all tumor types assayed, and absolute uptakes, when computed as percent dose per gram tumor normalized for body weight, were similar for transplanted and spontaneous tumors. In the rodent tumors, radiothymidine was retained for at least 3 hr in the tumor without appreciable loss. In canine neoplasms, although the highest uptakes were observed in cellular tumors with many mitotic figures, tumor uptake showed significant variability that did not correlate with any obvious histologic change, and thus may reflect true biologic differences in metabolism among tumors at different sites in the same animal. These studies provide additional experimental evidence that the ratios of neoplastic to normal tissue and the kinetics of thymidine uptake by tumors are suitable for positron emission tomography of neoplasms in small and large, animals, including both transplanted and spontaneous tumors

Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda

Directory of Open Access Journals (Sweden)

Orem Juliet

2012-02-01

Full Text Available Abstract Background Use of evidence in health policymaking plays an important role, especially in resource-constrained settings where informed decisions on resource allocation are paramount. Several knowledge translation (KT models have been developed, but few have been applied to health policymaking in low income countries. If KT models are expected to explain evidence uptake and implementation, or lack of it, they must be contextualized and take into account the specificity of low income countries for example, the strong influence of donors. The main objective of this research is to elaborate a Middle Range Theory (MRT of KT in Uganda that can also serve as a reference for other low- and middle income countries. Methods This two-step study employed qualitative approaches to examine the principal barriers and facilitating factors to KT. Step 1 involved a literature review and identification of common themes. The results informed the development of the initial MRT, which details the facilitating factors and barriers to KT at the different stages of research and policy development. In Step 2, these were further refined through key informant interviews with policymakers and researchers in Uganda. Deductive content and thematic analysis was carried out to assess the degree of convergence with the elements of the initial MRT and to identify other emerging issues. Results Review of the literature revealed that the most common emerging facilitating factors could be grouped under institutional strengthening for KT, research characteristics, dissemination, partnerships and political context. The analysis of interviews, however, showed that policymakers and researchers ranked institutional strengthening for KT, research characteristics and partnerships as the most important. New factors emphasized by respondents were the use of mainstreamed structures within MoH to coordinate and disseminate research, the separation of roles between researchers and

Inorganic carbon uptake during photosynthesis. II. Uptake by isolated Asparagus mesophyll cells during isotopic disequilibrium

International Nuclear Information System (INIS)

Espie, G.S.; Owttrim, G.W.; Colman, B.

1986-01-01

The species of inorganic carbon (CO 2 or HCO 3 - ) taken up as a source of substrate for photosynthetic fixation by isolated Asparagus sprengeri mesophyll cells is investigated. Discrimination between CO 2 or HCO 3 - transport, during steady state photosynthesis, is achieved by monitoring the changes (by 14 C fixation) which occur in the specific activity of the intracellular pool of inorganic carbon when the inorganic carbon present in the suspending medium is in a state of isotopic disequilibrium. Quantitative comparisons between theoretical (CO 2 or HCO 3 - transport) and experimental time-courses of 14 C incorporation, over the pH range of 5.2 to 7.5, indicate that the specific activity of extracellular CO 2 , rather than HCO 3 - , is the appropriate predictor of the intracellular specific activity. It is concluded, therefore, that CO 2 is the major source of exogenous inorganic carbon taken up by Asparagus cells. However, at high pH (8.5), a component of net DIC uptake may be attributable to HCO 3 - transport, as the incorporation of 14 C during isotopic disequilibrium exceeds the maximum possible incorporation predicted on the basis of CO 2 uptake alone. The contribution of HCO 3 - to net inorganic carbon uptake (pH 8.5) is variable, ranging from 5 to 16%, but is independent of the extracellular HCO 3 - concentration. The evidence for direct HCO 3 - transport is subject to alternative explanations and must, therefore, be regarded as equivocal. Nonlinear regression analysis of the rate of 14 C incorporation as a function of time indicates the presence of a small extracellular resistance to the diffusion of CO 2 , which is partially alleviated by a high extracellular concentration of HCO 3 -

Colonoscopy uptake for high-risk individuals with a family history of colorectal neoplasia: A multicenter, randomized trial of tailored counseling versus standard information.

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Ingrand, Isabelle; Defossez, Gautier; Richer, Jean-Pierre; Tougeron, David; Palierne, Nicolas; Letard, Jean-Christophe; Beauchant, Michel; Ingrand, Pierre

2016-08-01

Colonoscopic screening is recommended for first-degree relatives of patients diagnosed with colorectal cancer (CRC) or colorectal adenomatous polyps (CAP) before the age of 60 years. This has the potential to reduce CRC-related morbidity and mortality, but uptake is currently inadequate. The aim of the study was to compare the effectiveness of standard information versus a nurse-led tailored intervention designed to promote uptake of colonoscopy screening by siblings of CRC or CAP patients. A randomized controlled trial was conducted. Digestive surgeons and gastroenterologists recruited index patients who developed CRC or CAP before the age of 60 years. All index patients received standard screening information for their siblings, in keeping with current guidelines. Centrally computerized randomization of index patients resulted in allocating all their siblings to the same group, intervention or control. The tailored intervention targeted the index patient first, to help them convey information to their siblings. The nurse then provided the siblings with tailored information based on their answers to a self-questionnaire which explored health behaviors, derived from psychosocial models of prevention. Then the siblings were given a personalized information leaflet to hand to their regular physician. The primary endpoint was the rate of documented colonoscopy performed in siblings within 1 year after diagnosis of the index patient. The intent-to-treat analysis included siblings who refused to participate in the study. Statistical analysis was adjusted for intrafamilial correlation. A total of 304 siblings of 125 index patients were included: 160 in the intervention group and 144 in the control group. The rate of colonoscopy uptake among siblings was 56.3% in the intervention group and 35.4% in the control group (P = 0.0027). The respective rates after exclusion of refusals were 69.2% and 37.0% (P group (1 invasive cancer and 11 advanced adenomas vs 5 advanced

Window screening, ceilings and closed eaves as sustainable ways to control malaria in Dar es Salaam, Tanzania

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Chaki Prosper P

2009-09-01

Full Text Available Abstract Background Malaria transmission in Africa occurs predominantly inside houses where the primary vectors prefer to feed. Human preference and investment in blocking of specific entry points for mosquitoes into houses was evaluated and compared with known entry point preferences of the mosquitoes themselves. Methods Cross-sectional household surveys were conducted in urban Dar es Salaam, Tanzania to estimate usage levels of available options for house proofing against mosquito entry, namely window screens, ceilings and blocking of eaves. These surveys also enabled evaluation of household expenditure on screens and ceilings and the motivation behind their installation. Results Over three quarters (82.8% of the 579 houses surveyed in Dar es Salaam had window screens, while almost half (48.9% had ceilings. Prevention of mosquito entry was cited as a reason for installation of window screens and ceilings by 91.4% (394/431 and 55.7% (127/228 of respondents, respectively, but prevention of malaria was rarely cited (4.3%, 22/508. The median cost of window screens was between US $ 21-30 while that of ceilings was between US $301-400. The market value of insecticide-treated nets, window screening and ceilings currently in use in the city was estimated as 2, 5 and 42 million US$. More than three quarters of the respondents that lacked them said it was too expensive to install ceilings (82.2% or window screens (75.5%. Conclusion High coverage and spending on screens and ceilings implies that these techniques are highly acceptable and excellent uptake can be achieved in urban settings like Dar es Salaam. Effective models for promotion and subsidization should be developed and evaluated, particularly for installation of ceilings that prevent entry via the eaves, which are the most important entry point for mosquitoes that cause malaria, a variety of neglected tropical diseases and the nuisance which motivates uptake.

Attitudes, access and anguish: a qualitative interview study of staff and patients' experiences of diabetic retinopathy screening.

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Hipwell, A E; Sturt, J; Lindenmeyer, A; Stratton, I; Gadsby, R; O'Hare, P; Scanlon, P H

2014-12-15

To examine the experiences of patients, health professionals and screeners; their interactions with and understandings of diabetic retinopathy screening (DRS); and how these influence uptake. Purposive, qualitative design using multiperspectival, semistructured interviews and thematic analysis. Three UK Screening Programme regions with different service-delivery modes, minority ethnic and deprivation levels across rural, urban and inner-city areas, in general practitioner practices and patients' homes. 62 including 38 patients (22 regular-screening attenders, 16 non-regular attenders) and 24 professionals (15 primary care professionals and 9 screeners). Antecedents to attendance included knowledge about diabetic retinopathy and screening; antecedents to non-attendance included psychological, pragmatic and social factors. Confusion between photographs taken at routine eye tests and DRS photographs was identified. The differing regional invitation methods and screening locations were discussed, with convenience and transport safety being over-riding considerations for patients. Some patients mentioned significant pain and visual disturbance from mydriasis drops as a deterrent to attendance. In this, the first study to consider multiperspectival experiential accounts, we identified that proactive coordination of care involving patients, primary care and screening programmes, prior to, during and after screening is required. Multiple factors, prior to, during and after screening, are involved in the attendance and non-attendance for DRS. Further research is needed to establish whether patient self-management educational interventions and the pharmacological reformulation of shorter acting mydriasis drops, may improve uptake of DRS. This might, in turn, reduce preventable vision loss and its associated costs to individuals and their families, and to health and social care providers, reducing current inequalities. Published by the BMJ Publishing Group Limited. For

Noninvasive Screening for Pulmonary Hypertension by Exercise Testing in Congenital Heart Disease.

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Müller, Jan; Heck, Pinar Bambul; Ewert, Peter; Hager, Alfred

2017-05-01

Patients with congenital heart disease and native or palliated conditions are at risk to develop pulmonary hypertension (PH) in later life. Screening for PH is currently performed by regular echocardiographic follow-up, which appears to be difficult in several congenital conditions. This study evaluated the screening for PH in congenital heart disease by cardiopulmonary exercise testing (CPET). We analyzed our database including all patients with congenital heart disease referred for CPET in our institution from June 2001 to September 2013 and identified 683 patients who had an accompanied heart catheterization less than 6 month after CPET. Those 130 patients with proven PH were compared with the other 563 patients with congenital heart disease but without PH. Peak oxygen uptake was the most discriminative variable, showing two thresholds at 16.3 mL/min per kg and 25.2 mL/min per kg. The highest specificity of 95% for PH was found in patients with a peak oxygen uptake of 16.3 mL/min per kg or less and a breathing reserve of 37.4% or less. In patients with a peak oxygen uptake exceeding 16.3 mL/min per kg, there was a high specificity of 86.3% but a low sensitivity of 53.1%. With 25.2 mL/min per kg as the threshold, the sensitivity for PH was only 10.0%. Detection of PH in patients with congenital heart disease by CPET is difficult because of many falsely positive tests. However, a peak oxygen uptake higher than 25.2 mL/min per kg makes the diagnosis of PH unlikely. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A lack of information engagement among colorectal cancer screening non-attenders: cross-sectional survey

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Lindsay C. Kobayashi

2016-07-01

Full Text Available Abstract Background The NHS Cancer Screening Programmes in England now operate a policy of ‘informed choice’ about participation in cancer screening. Engagement with written information about screening is important to facilitate informed choice, although the degree to which the screening-eligible public engages with the available information is unknown. We examined the association between reading of the standard informational booklet (‘Bowel Cancer Screening: The Facts' and participation in the nationally organised NHS Bowel Cancer Screening Programme in England. Methods Face-to-face interviews were conducted with 1307 adults who were age-eligible for nationally organised colorectal cancer (CRC; also called bowel cancer in a population-based survey in England in 2014. Respondents were shown an image of ‘The Facts’ booklet and were asked how much of it they had read when they received their screening invitation (‘none’, ‘a little’, ‘some’, ‘most’, ‘almost all’, or ‘all’. Logistic regression was used to estimate the associations between screening uptake status (‘never’ vs. ‘ever’ and self-reported reading of ‘The Facts’ booklet (dichotomised to ‘none vs. ‘any’, adjusting for age, sex, ethnicity, educational attainment, and occupation-based social grade. Results Overall, 69 % of the sample (908/1307 had participated in CRC screening at least once (‘ever’ screeners. One-fifth of the sample reported that they had read ‘none’ of ‘The Facts’ booklet (22 %; 287/1307, while half reported having read ‘all’ of it (52 %; 680/1307. Reading of the booklet was strongly differential according to screening uptake status: nearly two-thirds of ‘never’ screeners had read none of ‘The Facts’ booklet (63 %; 251/399, compared to less than one in twenty ‘ever’ screeners (4 %; 36/908; adjusted OR = 39.0; 95 % CI: 26.2-58.1 for reading ‘none’ in ‘never’ vs. �

{sup 18}F-FDG uptake at the surgical margin after hepatic resection: Patterns of uptake and differential diagnosis

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Peungjesada, Silanath [University New Mexico, Department of Radiology, Albuquerque, NM (United States); Aloia, Thomas A. [University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Unit 444, Houston, TX (United States); Fox, Patricia [University of Texas MD Anderson Cancer Center, Department of Biostatistics, Unit 1411, Houston, TX (United States); Chasen, Beth [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Unit 1483, Houston, TX (United States); Shin, Sooyoung; Loyer, Evelyne M. [University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Unit 1473, Houston, TX (United States); Baiomy, Ali [Cairo University, National Cancer Center, Cairo (Egypt)

2015-08-15

To evaluate the patterns of {sup 18}F-FDG uptake at the surgical margin after hepatectomy to identify features that may differentiate benign and malignant uptake. Patients who had undergone a PET/CT after hepatectomy were identified. Delay between resection and PET/CT, presence of uptake at the surgical margin, pattern of uptake, and maximal standardized value were recorded. The PET/CT findings were correlated with contrast-enhanced CT or MRI. There were 26 patients with increased 18F-FDG uptake; uptake was diffuse in seven and focal in 19. Diffuse uptake was due to inflammation in all cases. Focal uptake was due to recurrence in 12 and inflammation in seven cases. Defining a focal pattern only as a positive for malignancy yielded 100 % sensitivity, 87 % specificity, 37 % false positive rate. As expected, SUV{sub max} was significantly higher for recurrence than inflammation, but did overlap. Contrast-enhanced CT allowed differentiation between malignant and benign uptake in all cases. F-FDG uptake after hepatectomy does not equate to recurrence and yields a high false positive rate. Diffuse uptake did not require additional evaluation in our sample. Focal uptake, however, may be due to recurrence; differentiating benign and malignant nodular uptake relies on optimal contrast-enhanced CT or MRI. (orig.)

Systematic skin cancer screening in Northern Germany.

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Breitbart, Eckhard W; Waldmann, Annika; Nolte, Sandra; Capellaro, Marcus; Greinert, Ruediger; Volkmer, Beate; Katalinic, Alexander

2012-02-01

The incidence of skin cancer is increasing worldwide. For decades, opportunistic melanoma screening has been carried out to respond to this burden. However, despite potential positive effects such as reduced morbidity and mortality, there is still a lack of evidence for feasibility and effectiveness of organized skin cancer screening. The main aim of the project was to evaluate the feasibility of systematic skin cancer screening. In 2003, the Association of Dermatological Prevention was contracted to implement the population-based SCREEN project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany) in the German state of Schleswig-Holstein. A two-step program addressing malignant melanoma and nonmelanocytic skin cancer was implemented. Citizens (aged ≥ 20 years) with statutory health insurance were eligible for a standardized whole-body examination during the 12-month study period. Cancer registry and mortality data were used to assess first effects. Of 1.88 million eligible citizens, 360,288 participated in SCREEN. The overall population-based participation rate was 19%. A total of 3103 malignant skin tumors were found. On the population level, invasive melanoma incidence increased by 34% during SCREEN. Five years after SCREEN a substantial decrease in melanoma mortality was seen (men: observed 0.79/100,000 and expected 2.00/100,000; women: observed 0.66/100,000 and expected 1.30/100,000). Because of political reasons (resistance as well as lack of support from major German health care stakeholders), it was not possible to conduct a randomized controlled trial. The project showed that large-scale systematic skin cancer screening is feasible and has the potential to reduce skin cancer burden, including mortality. Based on the results of SCREEN, a national statutory skin cancer early detection program was implemented in Germany in 2008. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All

Decreased uptake of cadmium by a resistant strain of Staphylococcus aureus

Energy Technology Data Exchange (ETDEWEB)

Chopra, I

1971-01-01

Penicillinase plasmids, and some related extrachromosomal elements in Staphylococcus aureus, can specify resistance to inorganic ions, including Hg/sup 2 +/ and Cd/sup 2 +/. There is some tentative evidence that resistance to Hg/sup 2 +/ ions is due to the impermeability of the cells to the ions and not to a higher concentration of free -SH groups in resistance to cadmium ions is unknown. Experiments are described which show that there is a markedly decreased rate of uptake of Cd/sup 2 +/ ions by resistant cells when compared with strains that lack the cad-r gene. The uptake of Cd/sup 2 +/ ions has been studied in the cadmium resistant Staphylococcus aureus strain 8325 (..cap alpha...i/sup +/p/sup +/.cad-r.mer-r) and in its cadmium-sensitive derivative, strain 8324(N). Strain 8325(N) was obtained from 8325 (..cap alpha...i/sup +/.cad-r.mer-r) by isolating a variant which had spontaneously lost the ..cap alpha.. penicillinase plasmid specifying resistance to Cd/sup 2 +/ ions. Cadmium uptake was estimated by adding /sup 115m/CdCl/sub 2/ (final concentration: 10/sup -4/M) to exponentially growing cultures of the sensitive and resistant strains and following the uptake of radioactivity.

Effect of health education on the knowledge and attitude to sickle cell disorder and screening practices among school of nursing students in Sokoto, Nigeria.

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Abiola, A O; Ojika, B O; Mannir, B; Abba, S K; Muhammad, M; Ibrahim, M T O; Aschcroft, B N; Akanmu, S S

2013-01-01

Sickle cell disorder is the most important genetic hematological disease that affects people of black African descent. The years of young adulthood present a good opportunity for screening and counseling for this genetic blood disorder. To assess effect of health education and provision of free sickle cell haemoglobin screening on knowledge of sickle cell disorder, attitude towards sickle cell haemoglobin screening, and uptake of sickle cell haemoglobin screening among students of a School of Nursing. Study design was a quasi-experimental noncontrolled study. Self-administered questionnaire was used for pre- and post-intervention data collection. Implemented interventions were seminar on sickle cell disorder combined with free sickle cell haemoglobin screening. The data was analyzed with Epi-info version 3.5.1 statistical software package. Respondents who participated in all the study phases were 104. Mean knowledge score (%) was high (80.9 +/- 22.8%) at baseline and improved significantly to 91.8 +/- 9.4% (p marriage if self and fiancée are carriers of sickle cell haemoglobin. Phenotype of the respondents that volunteered to be screened for sickle cell haemoglobin were: A (70.5%), AC (6.8%) and AS (22.7%). Implemented interventions, seminar on sickle cell disorder combined with free sickle cell haemoglobin screening service yielded significant impact on respondents' knowledge, attitude and uptake of sickle cell haemoglobin screening.

CUP-1 Is a Novel Protein Involved in Dietary Cholesterol Uptake in Caenorhabditis elegans

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Valdes, Victor J.; Athie, Alejandro; Salinas, Laura S.; Navarro, Rosa E.; Vaca, Luis

2012-01-01

Sterols transport and distribution are essential processes in all multicellular organisms. Survival of the nematode Caenorhabditis elegans depends on dietary absorption of sterols present in the environment. However the general mechanisms associated to sterol uptake in nematodes are poorly understood. In the present work we provide evidence showing that a previously uncharacterized transmembrane protein, designated Cholesterol Uptake Protein-1 (CUP-1), is involved in dietary cholesterol uptake in C. elegans. Animals lacking CUP-1 showed hypersensitivity to cholesterol limitation and were unable to uptake cholesterol. A CUP-1-GFP fusion protein colocalized with cholesterol-rich vesicles, endosomes and lysosomes as well as the plasma membrane. Additionally, by FRET imaging, a direct interaction was found between the cholesterol analog DHE and the transmembrane “cholesterol recognition/interaction amino acid consensus” (CRAC) motif present in C. elegans CUP-1. In-silico analysis identified two mammalian homologues of CUP-1. Most interestingly, CRAC motifs are conserved in mammalian CUP-1 homologous. Our results suggest a role of CUP-1 in cholesterol uptake in C. elegans and open up the possibility for the existence of a new class of proteins involved in sterol absorption in mammals. PMID:22479487

Women's attitude towards routine human platelet antigen-screening in pregnancy.

Science.gov (United States)

Winkelhorst, Dian; Loeff, Rosanne M; van den Akker-Van Marle, M Elske; de Haas, Masja; Oepkes, Dick

2017-08-01

Fetal and neonatal alloimmune thrombocytopenia is a potentially life-threatening disease with excellent preventative treatment available for subsequent pregnancies. To prevent index cases, the effectiveness of a population-based screening program has been suggested repeatedly. Therefore, we aimed to evaluate women's attitude towards possible future human platelet antigen-screening in pregnancy. We performed a cross-sectional questionnaire study among healthy pregnant women receiving prenatal care in one of seven participating midwifery practices. Attitude was assessed using a questionnaire based on the validated Multidimensional Measurement of Informed Choice model, containing questions assessing knowledge, attitude and intention to participate. A total of 143 of the 220 women (65%) completed and returned the questionnaire. A positive attitude towards human platelet antigen-screening was expressed by 91% of participants, of which 94% was based on sufficient knowledge. Attitude was more likely to be negatively influenced by the opinion that screening can be frightening. Informed choices were made in 87% and occurred significantly less in women from non-European origin, 89% in European women vs. 60% in non-European women (p = 0.03). Pregnant women in the Netherlands expressed a positive attitude towards human platelet antigen-screening in pregnancy. We therefore expect a high rate of informed uptake when human platelet antigen-screening is implemented. In future counseling on human platelet antigen-screening, ethnicity and possible anxiety associated with a screening test need to be specifically addressed. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Young men's views toward the barriers and facilitators of Internet-based Chlamydia trachomatis screening: qualitative study.

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Lorimer, Karen; McDaid, Lisa

2013-12-03

There is a growing number of Internet-based approaches that offer young people screening for sexually transmitted infections. This paper explores young men's views towards the barriers and facilitators of implementing an Internet-based screening approach. The study sought to consider ways in which the proposed intervention would reach and engage men across ages and socioeconomic backgrounds. This qualitative study included 15 focus groups with 60 heterosexual young men (aged 16-24 years) across central Scotland, drawn across age and socioeconomic backgrounds. Focus groups began by obtaining postcode data to allocate participants to a high/low deprivation category. Focus group discussions involved exploration of men's knowledge of chlamydia, use of technology, and views toward Internet-based screening. Men were shown sample screening invitation letters, test kits, and existing screening websites to facilitate discussions. Transcripts from audio recordings were analyzed with "Framework Analysis". Men's Internet and technology use was heterogeneous in terms of individual practices, with greater use among older men (aged 20-24 years) than teenagers and some deprivation-related differences in use. We detail three themes related to barriers to successful implementation: acceptability, confidentiality and privacy concerns, and language, style, and content. These themes identify ways Internet-based screening approaches may fail to engage some men, such as by raising anxiety and failing to convey confidentiality. Men wanted screening websites to frame screening as a serious issue, rather than using humorous images and text. Participants were encouraged to reach a consensus within their groups on their broad design and style preferences for a screening website; this led to a set of common preferences that they believed were likely to engage men across age and deprivation groups and lead to greater screening uptake. The Internet provides opportunities for re-evaluating how we

Systematic review of the effect of immunization mandates on uptake of routine childhood immunizations.

Science.gov (United States)

Lee, Cecilia; Robinson, Joan L

2016-06-01

The efficacy of immunization mandates for childcare or school entry is a long-standing controversy. The United States (US) adopted school entry immunization mandates in the 1800s, while most countries still do not have mandates. The objective of this systematic review was to analyze the evidence that immunization uptake increases with mandates. A search was conducted for studies that compared immunization uptake in a population prior to and after mandates, or in similar populations with one group having and the other not having mandates. Data were extracted and synthesized qualitatively due to the heterogeneity of study design. Eleven before-and-after studies and ten studies comparing uptake in similar populations with and without mandates were included. Studies were from the US (n = 18), France (n = 1) and Canada (n = 2). Eleven of the 21 studies looked at middle school mandates. All but two studies showed at least a trend towards increased uptake with mandates. Higher uptake was associated with a more long-standing mandate. Immunization mandates have generally led to increased short-term and long-term uptake in the group to whom the mandate applies. Many studies have centered around middle school mandates in the US and there is a paucity of studies of childcare mandates or of studies of mandates in other countries or in settings with relatively high baseline immunization uptake. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Screening for Abdominal Aortic Aneurysm

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... benefits. When there is not enough evidence to judge benefits and harms, the Task Force does not ... nurse practitioners, physician assistants, and nurses. selectively offer Decide whether screening is right for a patient on ...

Let's talk about smear tests: social marketing for the National Cervical Screening Programme.

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Bethune, G R; Lewis, H J

2009-09-01

The overall aim of the work was to increase participation by Māori and Pacific women in the National Cervical Screening Programme (NCSP) in New Zealand using a social marketing informed approach. Key objectives for this target group included: increasing awareness, understanding and discussion of cervical cancer and cervical screening; increasing telephone calls to the NCSP's 0800 number; and increasing uptake of cervical screening. A social marketing intervention with mixed qualitative and quantitative evaluation. Focus groups with priority women and key stakeholder interviews were used to identify a set of key messages from which television, radio and print media advertisements were developed. The advertising campaign was one element of a broader programme of activity, which involved changes to service delivery and improvement to access to services, particularly for the target groups. The campaign was evaluated in three ways: quantitative surveys conducted before, during and after the intervention; monitoring the number of calls to the NCSP's 0800 number; and monitoring NCSP monthly coverage statistics. The social marketing intervention achieved measurable behavioural impacts with its primary target audiences, delivering significant increases in screening uptake by Māori (6.8%) and Pacific women (12.7%) after 12 months. In addition, there was a secondary positive impact on other women (not the immediate target audience) whose rate of update also increased (2.7%). Overall, the intervention helped to reduce inequalities and delivered substantial increases in awareness, understanding and discussion of cervical cancer and cervical screening amongst the target groups. The results demonstrate that social marketing can be effective in targeting marginalized or under-represented groups. The intervention has not only changed the way in which women in New Zealand talk about a previously 'taboo' subject, but it has also provided a platform for significant behaviour change

Diagnostic significance of /sup 99m/tc-marked phosphate uptake in the soft tissues of the breast

Energy Technology Data Exchange (ETDEWEB)

Bostel, F.; Meybier, H.

1981-03-01

A patient with a right-sided carcinoma of the breast had a bone scintigram with sup(99m)Tc-methylendisphosphonate (sup(99m)Tc-MDP), which showed intensive uptake in the abnormal breast; a year after mastectomy, similar high uptake of the drug was found in the remaining breast. The radiological findings indicated a fibrocystic mastopathy without evidence of malignancy in the left breast. A review of the literature suggested that uptake of osteotropic polyphosphate compounds in the breast was of considerable significance, indicating incipient or developing malignancy. A review of our own cases cast considerable doubt on this interpretation. It is probable that MDP uptake in the breast depends in part on the hormonal pattern and may occasionally be observed during oestrogen therapy in the male (e.g. carcinoma of the prostate).