Randomized trial of breast self-examination in Shanghai: methodology and preliminary results

BACKGROUND: The efficacy of breast self-examination in helping to reduce mortality from breast cancer has not been rigorously demonstrated. PURPOSE: To assess efficacy, a large, randomized trial was initiated in Shanghai, China. METHODS: From October 1989 to October 1991, 267040 current and retired female employees associated with 520 factories in the Shanghai Textile Industry Bureau were randomly assigned on the basis of factory to either a self-examination instruction group (133375 women) or a control group (133665 women). The women were born within the period from 1925 through 1958. Women in the instruction group were given intensive training in breast self-examination, including the use of silicone breast models and personalized instruction, plus two subsequent reinforcement sessions and multiple reminders to practice the technique. Women in the control group were asked to attend training sessions on the prevention of low back pain. All women have been followed for the development of breast diseases and for death from breast cancer. RESULTS: A high level of participation during the first 4-5 years of the trial was documented among women in the instruction group. Randomly sampled women in this group demonstrated greater proficiency in detecting lumps in breast models than did randomly sampled women in the control group. Approximately equal numbers of breast cancers were detected in the two groups (331 in the instruction group and 322 in the control group) through 1994, which is the last year for which case-finding efforts have been completed. The breast cancers detected in the instruction group were not diagnosed at an appreciably earlier stage or smaller size than those in the control group. More benign breast lesions were detected in the instruction group than in the control group (1457 versus 623, respectively), suggesting a higher index of suspicion for women who received training. Cumulative breast cancer mortality rates through 5 years from entry into the study were nearly equivalent for the two groups. CONCLUSIONS: Breast self-examination has not led to a reduction in mortality from breast cancer in this study cohort in the first several years since the trial began. A shift toward the diagnosis of disease at a less advanced stage in women given instruction has also not been demonstrated. Longer follow-up of participants in this trial is required before final assessment can be made of the efficacy of breast self-examination. IMPLICATIONS: At this time, there is insufficient evidence to recommend for or against the teaching of breast self-examination.     

Modified oil agglomeration process for coal beneficiation. III. Grinding and agglomeration using different szego mill designs

The simultaneous grinding/agglormeration process has been used to beneficiate Minto coal. Experiments with the Szego Mill, a planetary ring-roller mill with grooved rollers, have given good results. Different roller ridge/groove sizes have been tested and favourable oil-coal-water ratios established. Ash removal is closely related to grinding performance. Very short mill residence times, of the order of 10 seconds, are sufficient for microagglomerate formation. Considerable equipment and operating cost savings are possible with the modified process.     

Perceived equity, motivation, and final-offer arbitration in major league baseball.

Final-offer salary arbitration in major league baseball offers a unique institutional arrangement that creates a naturally occurring, non-equivalent-groups, repeated measures research design. The structural arrangements allow for examination of anticipatory expectancy effects and assessment of behavioral responses consistent with equity theory predictions. In addition, equity theory can be tested without the methodological problems inherent in defining the referent other. Performance and mobility were examined for major league baseball position players who won and lost their arbitration hearings. Prearbitration performance significantly predicted arbitration outcome. A significant relationship was noted between losing arbitration and postarbitration performance decline. Losers were significantly more likely to change teams and leave major league baseball. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminating age-associated memory impairment from Alzheimer's disease.

The authors attempt to provide a better understanding of the differences between the normal memory decline characteristic of age-associated memory impairment (AAMI) and the pathological decline typical of mild Alzheimer's disease (AD). Batteries of traditional memory tests and computer-simulated everyday-memory tests discriminated between the 2 groups, which were matched on age, gender, and education, with reasonable degrees of accuracy (87.5% and 88.4%, respectively). False positives were the most frequent classification errors when using either battery. These results indicate that it is possible to use ecologically valid memory assessment paradigms without sacrificing discriminant validity. The clinical significance of discriminating mild AD from AAMI is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowledge, attitude and behavior among patients with Chlamydia. Perspectives for prevention

Patients with chlamydial infections (Ct) attending the outpatient Venereal Disease Clinic of Copenhagen from July 1-November 30 1995 were asked to fill in a questionnaire focusing upon knowledge, attitude and behaviour related to sexually transmitted diseases (STDs) in order to strengthen the future prevention of Ct. The questionnaire was answered by 37 men and 35 women with a median age of 27 and 21 years and a median number of three and two sexual partners within the last six months, respectively. Half of the patients had previously had an STD, and 92% had been tested for HIV, of whom one homosexual man was known HIV-positive. Notification about exposure from a partner was the reason for attending for 24%. All but one were in favour of partner notification, but only 6% wanted provider referral. During last intercourse condoms had neither been used with a steady partner by 75% especially by the young and women, who thought themselves safe, nor with a casual partner by 52% especially among the young and men, mainly because of thoughtlessness or perception of low risk. Before the actual STD diagnosis only 49% were able to name one symptom and 35% one complication related to Ct. A majority (79%) stated, that fear of catching another Ct would lead to better protection, and 70% found that more information would have a preventive effect. Future Ct prevention programs in Denmark should include intensified chlamydial screening and partner notification together with centrally produced mass media information supplemented by individual counselling.     

Clinical evaluation of technetium-99m-L,L-ethylenedicysteine in patients with chronic renal failure

1. Effects of feeding condition from birth were examined on the sensitivity of neuromuscular transmission to d-tubocurarine (dTc) in vitro in male mice of the ddY strain. 2. Mice were trained to climb two separated cylindrical steel-wire tubes for feeding and drinking, respectively, from 16 days of age. Some mice were conventionally fed, from 99 days of age. Nerve-muscle preparations were made from the left phrenic nerve diaphragm muscle (DPH), the sciatic nerve soleus muscle (SOL), and the sciatic nerve extensor digitorum longus muscle (EDL) of 99-day-old and 155-day-old mice. The nerve trunk was electrically activated with trains of four pulses and tetanic pulses. 3. The sensitivity to the effects of dTc decreased in the order EDL, SOL, and DPH. This result held true in all mice tested. 4. This sensitivity was significantly potentiated by the compulsory movement. 5. The supersensitivity remained even when mice were conventionally fed after 99 days of age. 6. The compulsion rendered EDL antifatigable on tetanic stimulation. This property was also retained after a return to conventional feeding. 7. These results suggest that the effects of feeding condition from birth might remain on neuromuscular functions after termination of the conditioning.