This thesis focuses on the modelling and prediction of factors affecting attendance to screening invitations of the NHS Breast Screening Programme. The analysis is based on data collected by the Warwickshire, Solihull and Coventry Breast Screening Unit from 1989 up to 2001 with respect to invitation to screening for the prevention of breast cancer in non-symptomatic women. Using a novel approach to the analysis of the data, from the perspective of the screening episode of each woman, rather than the usual analysis from the perspective of the screening round of the units, a statistical analysis is carried out on the whole registered population for the first time. Amendments to the current formulae for coverage calculations, the introduction of a new parameter (invitation rate) and the proposal for a reduction of the invitation period (period of time between two consecutive invitations) follows from the analysis. A preliminary analysis of predictive methodologies, including traditional statistical methods and artificial intelligent methods, gives the foundation to the formulation of two new algorithms; the first, for the prediction of attendance of women to screening invitations, and the second for the prediction of occurrence of screening variation (change of appointment dates) of women to invitations. Both algorithms are based on neural network generated models able to learn from the previous screening behaviour history of the woman, a technique not previously explored for the prediction of attendance. The accuracy of the new proposed algorithm for the prediction of attendance to invitation is tested on a blind study using data not previously seen by the predictive system, and for which results were unknown at the time when the predictions were made. From the obtained results, it is concluded to recommend the implementation by the NHS Breast Screening Unit of the two algorithms proposed for the prediction of the women’s attendance and screening variation to their invitation for screening. With these predictions, women likely not to attend, or change appointment date, can be identified and appropriately targeted with the aim of increasing their attendance in the short term, and in the long term, reducing breast cancer mortality.

<p>The Application of Magnetic Resonance (MRI) and Computed Tomography Imaging (CT) in the Diagnosis and Management of Maxillofacial Tumours. For decades maxillofacial surgeons over the world have been frustrated by the high and often fatal recurrence of certain advanced jaw tumours. This study conclusively proves that Computed Tomography and especially Magnetic Resonance Imaging significantly decreases recurrence of Odontogenic Keratocyst and Ameloblastoma and allows surgical planning to avoid these recurrences.</p>

Includes bibliographical references (18 leaves). / 2 v. : ill., maps ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the factors that predict attendence to mammography screening by comparing various groups of attenders and non-attenders. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 1999

Thesis (MFamMed)--Stellenbosch University, 2014. / OBJECTIVE: The purpose of the study was to assess the safety, acceptability and feasibility of Visual Inspection with Acetic Acid and Cervicography (VIAC) followed by Cryotherapy or Loop Electrical Excision Procedure (LEEP) at a single visit for prevention of cancer of the cervix in Bulawayo, Zimbabwe. STUDY DESIGN: The study was descriptive using retrospective data extracted from electronic medical records of women attending the VIAC clinic at United Bulawayo Hospital in the period 1st February2010 to 31st December2012.Over 24 months 4641 women visited the clinic and were screened for cervical cancer using VIAC. If positive and eligible, cryotherapy or LEEP was offered immediately. Treated women were followed up at 3months and 1 year. RESULTS: The VIAC test positive rate was 10.8%.Of those eligible,17.0% received immediate cryotherapy, 44.1%received immediate LEEP, 1.9% delayed treatment and 37.0% were referred to a gynaecologist. No major complications were recorded after cryotherapy or LEEP. Among those treated99.5% expressed satisfaction with their experience. Only 3.2% of those treated at the clinic were VIAC positive one year later. The service was shown to be feasible to sustain over time with the necessary consumables. There were no service-related treatment postponements and the clinic staff and facility were able to meet the demand for the service. CONCLUSION: A single visit approach using VIAC, followed by cryotherapy or LEEP proved to be safe, acceptable and feasible in an urban African setting in Bulawayo, Zimbabwe. / AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.

Un système est dit robuste s'il est possible de garantir son bon comportement Le cancer est en passe de devenir la première cause de décès dans le monde avec un nombre de cas de cancer qui a pratiquement doublé sur les trente dernières années. Le diagnostic du cancer est d’autant plus important qu’il est maintenant reconnu que, plus la prise en charge du patient est rapide, plus les traitements thérapeutiques sont efficaces. Ce diagnostic doit être précis, fiable, et établi dans les premiers stades de la maladie afin d’augmenter significativement les chances de succès du/des traitements. Les techniques conventionnelles pour le diagnostic du cancer sont essentiellement basées sur des techniques d’imagerie (radiographies, IRM…) associés à des tests cytologiques et biochimiques. Avec le développement récent des technologies de biologie moléculaire (et notamment en protéomique), de nombreux marqueurs tumoraux ont été identifiés et sont utilisés dans des tests d’immunoassay pour le diagnostic voire pronostic du cancer en oncologie clinique. Cependant, le faible taux de marqueurs tumoraux dans le sérum de patient, ainsi que leur grande diversité, sont un challenge important pour l’établissement d’un diagnostic d’autant plus que les techniques de détection souffrent souvent d’un manque de sensibilité et de sélectivité. De plus, du fait de la diversité et de la variabilité des cancers, aucun marqueur tumoral n’est suffisamment spécifique pour permettre un diagnostic précis. Aussi, afin d’augmenter la fiabilité et la précision du diagnostic, il est nécessaire d’utiliser plusieurs marqueurs tumoraux. Dans ce contexte, grâce à leur capacité d’analyse haut débit en parallèle et le faible volume d’échantillon nécessaire, les technologies de puces à protéines (protein microarray)présentent de nombreux avantages pour l’identification de marqueurs tumoraux associés à la réponse humorale. Comme les marqueurs tumoraux sont souvent présents dans les échantillons en très faible quantité (à l’échelle sub micro-molaire), il y a un besoin urgent de développer des puces à protéines avec une détection ultrasensible de marqueurs tumoraux. La spécificité du diagnostic sera fortement liée au choix des protéines que l’on veut détecter(notées protéines cibles) et par conséquent au choix des protéines sondes que l’on va immobiliser sur le support. Un des paramètres critiques dans le développement de puces à protéines sensibles est la chimie de surface qui détermine le mode d’immobilisation de la protéine sonde sur le support et influence son activité biologique et donc sa capacité à reconnaitre et interagir avec la protéine cible que l’on cherche à détecter. Comme de nombreuses études suggèrent qu’un seul biomarqueur n’est pas suffisamment spécifique et sensible, la recherche d’une combinaison pertinente de biomarqueurs est un axe important pour l’amélioration d’un tel diagnostic. L’objectif de ce travail de thèse est donc le développement d’un outil original basé sur la technologie de puces à protéines fonctionnalisées avec différentes chimies de surface pour la détection sensible et spécifique de biomarqueurs tumoraux afin d’améliorer le diagnostic du cancer. Deux types de puces à protéines seront développés pour des applications différentes. Une première puce, avec comme protéines sondes des anticorps, sera développée pour la détection de biomarqueurs tumoraux impliqués dans le cancer colorectal. Une deuxième puce, où les protéines sondes seront des antigènes, sera étudiée en vue de l’identification de réponses autoimmunes de patientes atteintes d’un cancer du sein. [...] / Protein microarrays are becoming powerful tools to screen and identify tumor markers for cancer diagnosis, because of the multiplex detection and minute volume of sample requirement. Due to the diversity and variation in different cancers, no single tumor marker is sensitive and specific enough to meet strict diagnostic criteria. Therefore, a combination of tumor markers is required to increase sensitivity and to establish distinct patterns to increase specificity. To obtain reliable tests, the development of reproducible surface chemistry and immobilization procedure are crucial steps in the elaboration of efficient protein microarrays. In this thesis, 3D micro-structured glass slides were functionalized with various surface chemistries like silane monolayer (amino, epoxy and carboxy), and polymer layers of Jeff amine, chitosan, carboxymethyl dextran (CMD), maleic anhydride-alt-methyl vinyl ether copolymer (MAMVE) for physical adsorption or covalent binding with proteins. Surface characterizations, such as X-ray photoelectron spectroscopy (XPS) and Attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), confirmed the monolayer/polymer grafting on the glass slides. Colorimetric assay for determining amine density of three aminated surfaces demonstrated that APDMES had more grafting density than Jeffamine and chitosan. Contact angle measurements show that polymer surfaces were more hydrophilic than monolayer surfaces due to the increasing dosages of polar functional groups. Moreover, the parameters such as additives and pH of spotting buffer, probe concentration, blocking procedures etc, were optimized for tumor marker detection. Under the optimized conditions, antibody microarrays were validated with purified tumor antigens. The best analytical performances obtained for each tumor antigen tested were strongly dependent on functionalized surfaces, e.g. MAMVE exhibited best analytical performances for CEA andHsp60 while NHS leads to best results for PDI and CA19-9. Besides, the implemented antibody microarrays were applied to tumor marker detection from colorectal cancer sera. This evaluation shows the interest to combine several tumor markers on the same surface and the combination of tumor markers on their specific surface lead to remarkably increase the positive responses of tested cancer sera (even up to 100 %). A second type of microarrays (tumor-associated antigens - TAA microarrays) was designed to discriminate breast cancer patients from healthy donors through the detection of tumor autoantibodies. This study included a cohort of 29 breast cancer patients’ and 28 healthy donors’ sera. A panel of fiveTAAs (Hsp60, p53, Her2, NY-ESO-1 and Hsp70) immobilized on their respective optimized surface chemistry allowed to specifically detect over 82% of breast cancer patients.

The Top Scoring Pair (TSP) classifier, based on the notion of relative ranking reversals in the expressions of two marker genes, has been proposed as a simple, accurate, and easily interpretable decision rule for classification and class prediction of gene expression profiles. We introduce the AUC-based TSP classifier, which is based on the Area Under the ROC (Receiver Operating Characteristic) Curve. The AUCTSP classifier works according to the same principle as TSP but differs from the latter in that the probabilities that determine the top scoring pair are computed based on the relative rankings of the two marker genes across all subjects as opposed to for each individual subject. Although the classification is still done on an individual subject basis, the generalization that the AUC-based probabilities provide during training yield an overall better and more stable classifier. Through extensive simulation results and case studies involving classification in ovarian, leukemia, colon, and breast and prostate cancers and diffuse large b-cell lymphoma, we show the superiority of the proposed approach in terms of improving classification accuracy, avoiding overfitting and being less prone to selecting non-informative pivot genes. The proposed AUCTSP is a simple yet reliable and robust rank-based classifier for gene expression classification. While the AUCTSP works by the same principle as TSP, its ability to determine the top scoring gene pair based on the relative rankings of two marker genes across {\em all} subjects as opposed to each individual subject results in significant performance gains in classification accuracy. In addition, the proposed method tends to avoid selection of non-informative (pivot) genes as members of the top-scoring pair.\\ We have also proposed the use of the AUC test statistic in order to reduce the computational cost of the TSP in selecting the most informative pair of genes for diagnosing a specific disease. We have proven the efficacy of our proposed method through case studies in ovarian, colon, leukemia, breast and prostate cancers and diffuse large b-cell lymphoma in selecting informative genes. We have compared the selected pairs, computational cost and running time and classification performance of a subset of differentially expressed genes selected based on the AUC probability with the original TSP in the aforementioned datasets. The reduce sized TSP has proven to dramatically reduce the computational cost and time complexity of selecting the top scoring pair of genes in comparison to the original TSP in all of the case studies without degrading the performance of the classifier. Using the AUC probability, we were able to reduce the computational cost and CPU running time of the TSP by 79\% and 84\% respectively on average in the tested case studies. In addition, the use of the AUC probability prior to applying the TSP tends to avoid the selection of genes that are not expressed (``pivot'' genes) due to the imposed condition. We have demonstrated through LOOCV and 5-fold cross validation that the reduce sized TSP and TSP have shown to perform approximately the same in terms of classification accuracy for smaller threshold values. In conclusion, we suggest the use of the AUC test statistic in reducing the size of the dataset for the extensions of the TSP method, e.g. the k-TSP and TST, in order to make these methods feasible and cost effective.

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2015. / The most common cancer in women worldwide is breast cancer. It is also the leading cancer affecting women in South Africa. When breast cancer is detected early, it improves the outcome of the disease and reduces mortality. The aim of this study was to determine the knowledge, beliefs, attitude and practice of breast self-examination among female university students. The objectives were, to explore the levels of knowledge of female university students on breast cancer and breast self-examination; to ascertain the beliefs of female university students on breast cancer and breast self-examination; to examine the attitudes of female university students toward breast cancer and breast self-examination and to determine if female university students regularly practice breast self-examination. A Mixed method descriptive design was used for this study. The selected site for this study was a higher education institution in the Western Cape. The population included all female university students in the Western Cape. The sample was female university students studying in the selected higher education institution who reside on the institution’s campus. Convenience sampling was used to select the sample. Two methods were used to collect data; these were questionnaires and face-to-face interviews. Questionnaires were analysed by the use of Microsoft Excel and Statistical Package for Social Sciences. Frequency Distribution was used to analyse descriptive statistics. Interviews were transcribed and analysed by using coding and thematic analysis. Participants lacked knowledge on breast cancer risk factors, as majority of them only knew about family history being a risk factor. Majority of the participants had never been educated by their healthcare provider on breast cancer and its screening. Most of the participants had never examined their breast before. Most of the participants who did not examine their breast did not have any knowledge on how to do BSE. Education on breast cancer and cancer as a whole should be initiated in high schools and higher institutions of learning as part of their curriculum. Posters on breast cancer screening and breast self-examination should be put up at public places and campuses. Breast awareness campaigns must be done every month not only in October which is the breast cancer awareness month. Health care professionals should give information on breast cancer to women when they visit the hospital or health centre

Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2018-08-22T13:22:10Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PaulaKielingRies.pdf: 3167125 bytes, checksum: 098524a661311a798864532206adad42 (MD5) / Made available in DSpace on 2018-08-22T13:22:10Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PaulaKielingRies.pdf: 3167125 bytes, checksum: 098524a661311a798864532206adad42 (MD5) Previous issue date: 2017-06-08 / Childhood and adolescent cancer is a group of malignant diseases with a multifactorial origin that, despite the low incidence and despite advances in diagnosis and treatment, remains the second cause of infant mortality in developed countries aged from one to 14 years. Currently, early diagnosis is considered the best policy for improving prognosis and reducing treatment intensity. Knowing the factors related to the late diagnosis allows establishing strategies for early diagnosis of cancer in childhood and adolescence. Few studies related to this topic have been carried out in developing countries. Objectives: Report clinical and epidemiological data on cases of childhood and juvenile cancer, know the factors related to the late diagnosis of pediatric tumors; measure the intervals of the initial clinical presentation at diagnosis and treatment and correlate these intervals with larger clinical outcomes. Methods: A retrospective cohort study in which clinical and epidemiological data were collected from 198 patients aged zero to 18 years old, attended at a referral center in a public hospital in the central region of Rio Grande do Sul from January 2008 to December 2015. Results: Of the 198 patients, 56.1% were male, the age group with the highest frequency of diagnosis was from zero to four years. The most frequent diagnosis was leukemia, followed by lymphoma. Most of them, that is, 94.6% of the patients presented specific symptoms of the neoplasia, and yet 67.2% of the cases of solid tumors presented with locally invasive or metastatic disease. The median time for the diagnosis of 31 days, the delay of the parents was of 12 days and the one of the doctors was of six days. Tumor type was the only factor with relevance that interfered in time for the diagnosis (p <0.01). Event-free survival and overall 5-year survival were 73.6% and 80.9%, respectively. When comparing the survival curves for patients with late and non-late diagnosis, there was no significant difference (log-rank = 0.604). Conclusion: The time for diagnosis of childhood and juvenile neoplasms is among the lowest published. The results may reflect the parents difficulty in recognizing the signs and symptoms of childhood neoplasms, since the parents delay in seeking care is superior to that of the physicians in the oncologist. Corroborating, the great majority of patients have specific symptoms at diagnosis and yet they present with advanced disease, indicating the need for educational campaigns, familiarizing the population with the signs and symptoms of neoplasms. / O câncer infanto-juvenil é um grupo de doenças malignas com origem multifatorial que, apesar da baixa incidência e a despeito dos avanços obtidos no diagnóstico e tratamento, permanece como segunda causa de mortalidade infantil nos países desenvolvidos. Atualmente, considera-se o diagnóstico precoce como a melhor política para a melhora no prognóstico e redução da intensidade do tratamento. Conhecer os fatores relacionados ao diagnóstico tardio permite estabelecer estratégias para diagnóstico precoce do câncer na infância e adolescência. Poucos estudos relacionados a esse tema têm sido realizados em países em desenvolvimento. Objetivos: Relatar dados clínicos e epidemiológicos dos casos de câncer infanto-juvenil, conhecer os fatores relacionados ao diagnóstico tardio dos tumores pediátricos; mensurar os intervalos da apresentação clínica inicial ao diagnóstico e tratamento e correlacionar esses intervalos com desfechos clínicos maiores. Método: Estudo de coorte retrospectivo em que foram avaliados dados clínicos e epidemiológicos de 198 pacientes de zero a 18 anos, atendidos em um centro de referência de um hospital público da região central no Rio Grande do Sul, no período de janeiro de 2008 a dezembro de 2015. Resultados: Dos 198 pacientes, 56,1% pacientes eram do sexo masculino, a faixa etária com maior frequência de diagnóstico foi a de zero a quatro anos. O diagnóstico mais frequente foi o de leucemia, seguido pelo linfoma. A maioria, ou seja, 94,6% dos pacientes apresentaram sintomas específicos da neoplasia e, ainda assim, 67,2% dos casos de tumores sólidos apresentaram-se com doença localmente invasiva ou metastática. A mediana de tempo para o diagnóstico de 31 dias, a demora dos pais foi de 12 dias e a dos médicos foi de seis dias. O tipo de tumor foi o único fator com relevância que interferiu no tempo para o diagnóstico (p< 0,01). A sobrevida livre de eventos e a sobrevida global em cinco anos foram de 73,6% e 80,9%, respectivamente. Ao comparar as curvas de sobrevida dos pacientes com diagnóstico tardio e não tardio, não houve diferença significativa (log- rank = 0,604). Conclusão: O tempo para o diagnóstico das neoplasias infanto-juvenis está entre os menores publicados. Os resultados podem refletir a dificuldade dos pais em reconhecer os sinais e sintomas das neoplasias na infância, tendo em vista que a demora dos pais em procurar atendimento é superior à dos médicos em acionarem o oncologista. Corroborando, a grande maioria dos pacientes tem sintomas específicos ao diagnóstico e, mesmo assim, apresentam-se com doença avançada, indicando a necessidade de campanhas educativas, familiarizando a população quanto aos sinais e sintomas das neoplasias.

Pancreatic ductal adenocarcinoma (PDAC) has the poorest five-year survival rate of any cancer. Currently, there are no effective diagnostics or chemotherapeutics. Surgical resection is the only curative therapy. However, most patients experience recurrence due largely to challenges in assessing tumor margin status in the operating room. Molecular probes that selectively highlight pancreatic cancer tissue, having the potential to improve PDAC margin assessment intraoperatively, are urgently needed. In this work, a series of red and near-infrared fluorescent probes is reported. Two were found to distribute to normal pancreas following systemic administration. One selectively accumulates in genetically modified mouse models of PDAC, providing cancer-specific fluorescence. In contrast to the small molecule probes reported previously, it possesses inherent affinity for PDAC cells and tissue, and thus does not require conjugation to targeting agents. Moreover, the probe exhibits intracellular accumulation and enables visualization of four levels of structure including the whole organ, tissue, individual cells and subcellular organelles. It can thus promote new strategies for precision image-guided surgery, pancreatic cancer detection, the monitoring of therapeutic outcomes and basic research.

Cancer är ett samlingsnamn för omkring 200 olika sjukdomar och har blivit en vanlig förekommande sjukdom inom vården. Sjukdomen är negativt laddad och förknippas med svår sjukdom, rädsla, oro och död. Cirka 65 000 individer diagnostiserades med cancer i Sverige år 2015. Efter ett cancerbesked kan det uppstå tankar, känslor och frågor som kan resultera i att individer känner övergivenhet och kaos. Syftet med litteraturstudien var att beskriva patienters upplevda behov av stöd efter ett cancerbesked. Data arbetades fram med hjälp av två databaser som täcker ämnena omvårdnad och medicin. Sammanlagt valdes 11 vetenskapliga artiklar ut efter att ha kvalitetsgranskats. Resultatet ledde till att tre teman och två subteman under två tema arbetades fram. Första temat, Patienters upplevda behov av stöd genom information, hade subteman: Information från hälso- och sjukvårdspersonal och Information från internet. Andra temat, Patienters upplevda behov av emotionellt stöd, hade subteman: Emotionellt stöd från hälso- och sjukvårdspersonal och Emotionellt stöd från närstående. Tredje temat belyste patienters upplevda behov av stöd genom stödgrupper. Resultatet visade att patienter upplevde behov av stöd genom information, emotionellt stöd och stöd genom stödgrupper. Utökad kunskap och riktlinjer för hälso- och sjukvårdspersonalen behövs för att kunna uppfylla cancerpatienters behov av stöd. / Cancer is a term for approximately 200 diseases that has become a common disease in healthcare. Cancer is negatively charged and associated with severe disease, fear, worry and death. Approximately 65000 individuals were diagnosed with cancer in Sweden 2015. A cancer diagnosis may lead to thoughts, feelings and questions that can result in desolation and chaos. The purpose of the literature study was to describe individuals’ experienced needs of support after a cancer diagnosis. Data was collected from two databases focusing on nursing and medicine, and resulted in eleven articles after a quality inspection. The result led to three themes and two subthemes under two of the themes. The first theme, patients’ experienced needs of support through information, included subthemes: Information through healthcare professionals and Information through internet. The second theme, Patients’ experienced needs of emotional support, included subthemes: Emotional support from healthcare professionals and Emotional support from relatives and friends. The third theme highlighted patients’ experienced needs of support through support groups. The result showed that patients experienced needs of informational and emotional support as well as support through support groups. Healthcare professionals need increased knowledge and guidelines in order to fulfill cancer patients’ support needs.