Associations Between Breast Cancer Survivorship and Adverse Mental Health Outcomes: A Systematic Review.

Background: We aimed to systematically review the evidence on adverse mental health outcomes in breast cancer survivors (≥1 year) compared with women with no history of cancer. Methods: Studies were identified by searching MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Social Sciences Citation Index, and through backward citation tracking. Two researchers selected the studies, extracted data, and assessed the risk of bias. Results: Sixty studies were included. Of 38 studies of depression, 33 observed more depression in breast cancer survivors; this was statistically significant in 19 studies overall, including six of seven where depression was ascertained clinically, three of four studies of antidepressants, and 13 of 31 that quantified depressive symptoms. Of 21 studies of anxiety, 17 observed more anxiety in breast cancer survivors, statistically significant in 11 studies overall, including two of four with clinical/prescription-based outcomes, and in eight of 17 of anxiety symptoms. Breast cancer survivors also had statistically significantly increased symptoms/frequency of neurocognitive dysfunction (18 of 24 studies), sexual dysfunctions (5 of 6 studies), sleep disturbance (5 of 5 studies), stress-related disorders/PTSD (2 of 3 studies), suicide (2 of 2 studies), somatisation (2 of 2 studies), and bipolar and obsessive-compulsive disorders (1 of 1 study each). Studies were heterogeneous in terms of participants' characteristics, time since diagnosis, ascertainment of outcomes, and measures reported. Approximately one-half of the studies were at high risk of selection bias and confounding by socio-economic status. Conclusions: There is compelling evidence of an increased risk of anxiety, depression and suicide, and neurocognitive and sexual dysfunctions in breast cancer survivors compared with women with no prior cancer. This information can be used to support evidence-based prevention and management strategies. Further population-based and longitudinal research would help to better characterize these associations

Adverse mental health outcomes in breast cancer survivors compared to women who did not have cancer: systematic review protocol.

BACKGROUND: Recent increasing trends in breast cancer incidence and survival have resulted in unprecedented numbers of cancer survivors in the general population. A cancer diagnosis may have a profound psychological impact, and breast cancer treatments often cause long-term physical sequelae, potentially affecting women's mental health. The aim of this systematic review is to identify and summarise all studies that have compared mental health outcomes in breast cancer survivors, versus women who did not have cancer. METHODS: This study will be a systematic review of the literature. Four databases, including MEDLINE and PsycINFO, will be searched to identify potentially relevant studies. The search expressions will use a Boolean logic, including terms for the target population (women who have had breast cancer), outcomes (psychiatric disorders) and comparators (e.g. risk, hazard). All mental disorders will be eligible, except those with onset normally occurring during childhood or strong genetic basis (e.g. Huntington disease). The eligibility of the studies will be assessed in two phases: (1) considering the information provided in the title and abstract; (2) evaluating the full text. Studies including women diagnosed with breast cancer 1 year or more ago and that provide original data on mental health outcomes will be eligible. Studies in which all women were undergoing surgery, chemotherapy or radiotherapy, or hospitalised or institutionalised, will be excluded, as well as studies that include patients selected on the basis of symptomatology. Two investigators will do the screening of the references and the data extraction independently, with results compared and discrepancies resolved by involving a third investigator when necessary. Study quality and risk of bias will be assessed across six broad domains. Results will be summarised by outcome, and summary measures of frequency and/or association will be computed if possible. DISCUSSION: This review will summarise the evidence on the mental health outcomes of women who have been diagnosed with breast cancer. This information can be used to motivate further research and increase understanding of the most common mental health conditions affecting this growing population of women. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017056946

Bound for the Kingdom: The Land Promise in God's Redemptive Plan

Oren Rhea Martin, Ph.D. The Southern Baptist Theological Seminary, 2013 Chair: Dr. Bruce A. Ware Chapter 1 introduces the thesis, states the purpose, and defines the dissertation's specific goals. Attention is then given to a summary of research before a closing section presents the methodology that is used: a historical-exegetical, epochal, and canonical-eschatological approach to biblical interpretation and theological formulation. Chapter 2 provides the biblical-theological framework from which a theology of land can be canonically understood. More specifically, the framework for understanding the place, or land, of God's people is the kingdom. God's kingdom commences in Eden, and after the fall of mankind into sin God's kingdom will come through his divinely-initiated covenants with his people. In the end, God will once again create a place--a new heaven and a new earth--for his people through the fulfillment of his covenant promises in Christ, who wins the new creation and reigns in his kingdom forever. Working out of this framework, the next two chapters trace the theme of land as it progressively unfolds across the canon. To begin, Chapter 3 connects the promise of land to Abraham to the preceding events in Genesis 1-11. Then, the promise of land within the Abrahamic covenant is evaluated, which is followed by partial fulfillments through Israel's history under leaders such as Joshua, David, and Solomon. However, each stage of fulfillment is not final, for every fulfillment is followed by covenant failure. Instead, each fulfillment and failure anticipates something greater, which the canonical prophets proclaim. What begins in the Old Testament is fulfilled in the New. Chapter 4, then, demonstrates the inaugurated fulfillment of the kingdom with the coming of Christ and his work. That is, the blessings of the land come now to those who are united to Christ by faith and they await their future, final fulfillment in the new creation. Thus, the fulfillment of the land in the New Testament is inaugurated but not yet consummated. Finally, chapter 5 summarizes and concludes the overall argument of this dissertation. The argument is then evaluated in light of the two dominant theological systems today, namely, dispensationalism and covenant theology

Organic residue analysis of Egyptian votive mummies and their research potential

YesVast numbers of votive mummies were produced in Egypt during the Late Pharaonic, Ptolemaic, and Roman periods. Although millions remain in situ, many were removed and have ultimately entered museum collections around the world. There they have often languished as uncomfortable reminders of antiquarian practices with little information available to enhance their value as artefacts worthy of conservation or display. A multi-disciplinary research project, based at the University of Manchester, is currently redressing these issues. One recent aspect of this work has been the characterization of natural products employed in the mummification of votive bundles. Using gas chromatography–mass spectrometry and the well-established biomarker approach, analysis of 24 samples from 17 mummy bundles has demonstrated the presence of oils/fats, natural waxes, petroleum products, resinous exudates, and essential oils. These results confirm the range of organic materials employed in embalming and augment our understanding of the treatment of votives. In this first systematic initiative of its kind, initial findings point to possible trends in body treatment practices in relation to chronology, geography, and changes in ideology which will be investigated as the study progresses. Detailed knowledge of the substances used on individual bundles has also served to enhance their value as display items and aid in their conservation.RCB is supported by a PhD studentship from the Art and Humanities Research Council (43019R00209). L.M. and S.A.W. are supported by a Leverhulme Trust Research Project Award (RPG-2013-143)

Fighting Fat: How Do Fat Stereotypes Influence Beliefs About Physical Education

Article discussing a study on how fat stereotypes influence beliefs about physical education

Characterising Tidal Features Around Galaxies in Cosmological Simulations

Tidal features provide signatures of recent mergers and offer a unique insight into the assembly history of galaxies. The Vera C. Rubin Observatory's Legacy Survey of Space and Time (LSST) will enable an unprecedentedly large survey of tidal features around millions of galaxies. To decipher the contributions of mergers to galaxy evolution it will be necessary to compare the observed tidal features with theoretical predictions. Therefore, we use cosmological hydrodynamical simulations NewHorizon, EAGLE, IllustrisTNG, and Magneticum to produce LSST-like mock images of $z\sim0$ galaxies ($z\sim0.2$ for NewHorizon) with $M_{\scriptstyle\star,\text{ 30 pkpc}}\geq10^{9.5}$ M$_{\scriptstyle\odot}$. We perform a visual classification to identify tidal features and classify their morphology. We find broadly good agreement between the simulations regarding their overall tidal feature fractions: $f_{\text{NewHorizon}}=0.40\pm0.06$, $f_{\text{EAGLE}}=0.37\pm0.01$, $f_{\text{TNG}}=0.32\pm0.01$ and $f_{\text{Magneticum}}=0.32\pm0.01$, and their specific tidal feature fractions. Furthermore, we find excellent agreement regarding the trends of tidal feature fraction with stellar and halo mass. All simulations agree in predicting that the majority of central galaxies of groups and clusters exhibit at least one tidal feature, while the satellite members rarely show such features. This agreement suggests that gravity is the primary driver of the occurrence of visually-identifiable tidal features in cosmological simulations, rather than subgrid physics or hydrodynamics. All predictions can be verified directly with LSST observations.Comment: 25 pages, 14 figures, accepted in MNRA

Exploring the provision of services to support people with cancer-related pain

Background. Cancer-related pain is the most reported symptom across all cancer types. Its impact on the person experiencing it is significant and reduces their quality of life. Cancer-related pain is complex, to ensure optimal management, it requires specialist support from the multi-disciplinary team. Aim: To map the current provision of these specialist services that focus on the management of cancer-related pain.Method: An online survey was developed by a team of specialists with expertise in cancer-related pain. The survey was circulated via social media platforms for a period of 4 weeks. Results: There were 63 survey responses from across England, with no responses from the other nations of the UK. 54.7% (n=35) services were multi-professional, the remaining services contain either one or two different professionals. 37% (n=23) did not accept referrals for those with late effects cancer pain and 20% (n=13) did not accept referrals for those undergoing palliative treatment. All respondents agreed more education and support is needed regarding cancer-related pain.Conclusion: The results of this survey indicate that the provision of cancer-related pain services across the UK is inconsistent. More work is needed to improve access to these services and healthcare professionals education of cancer-related pain

Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Background Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. Methods Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995-99, 2000-04, and 2005-09), sex, and age at diagnosis (< 1, 1-4, 5-9, and 10-14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Findings We analysed data from 89 828 children from 198 registries in 53 countries. During 1995-99, 5-year agestandardised net survival for all lymphoid leukaemias combined ranged from 10.6% (95% CI 3.1-18.2) in the Chinese registries to 86.8% (81.6-92.0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005-09, when age-standardised survival for lymphoid leukaemias ranged from 52.4% (95% CI 42.8-61.9) in Cali, Colombia, to 91.6% (89.5-93.6) in the German registries, and for AML ranged from 33.3% (18.9-47.7) in Bulgaria to 78.2% (72.0-84.3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000-04 and 2005-09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1-4 and 5-9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. Interpretation Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood survival