BackgroundA change of cervical cancer screening algorithms to an HPV-based screening setting is discussed in many countries, due to higher sensitivity of HPV testing compared to cytology. Reliable triage methods are, however, an essential prerequisite in such a setting to avoid overtreatment and higher screening costs.ResultsIn this study, a series of cervical scrapes collected in PreservCyt liquid-based cytology (LBC) medium from women with cervical cancer (n = 5), cervical intraepithelial neoplasia grade 1–3 (n = 74), and normal cytology (n = 201; further n = 352 collected in SureThin®) were assessed for methylation of the marker regions ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671 using the GynTect assay and compared to cobas® HPV and CINtec Plus® biomarker results. All samples from women with cervical cancer, 61.2% of CIN3, 44.4% of CIN2 and 20.0% of CIN1 cases were scored positive for the GynTect methylation assay. In contrast, all CIN, irrespective of severity grade, and carcinomas were positive by both, CINtec Plus and cobas HPV. The specificity of GynTect for CIN3+ was 94.6% compared to 69.9% for CINtec Plus and 82.6% for cobas HPV (all HPV types) and 90.6% for cobas HPV 16/18. DNA methylation analysis of this methylation marker panel (GynTect assay) in cervical scrapes consistently detects cervical cancer and the majority of CIN3 as well as a subset of CIN1/2 lesions. The detection rate among cytologically normal samples is extraordinarily low (1.5%).ConclusionGynTect shows excellent performance when using cervical scrape material collected in liquid-based cytology media, a prerequisite for employing such a test as a triage in screening programs. Compared to the other test systems used in this work, GynTect showed higher specificity while still detecting all cancer cases.

The fishery for Karluk Lake (Kodiak Island, Alaska) sockeye salmon Oncorhynchus nerka has undergone a period of high production (1920s to mid‐1940s), decline (mid‐1940s to late 1970s), and recovery (late 1970s to present). We evaluated historical spawner–recruit data and recent (1980–1994) limnological data to develop an escapement goal (EG) to provide maximum sustainable yield for sockeye salmon. Ricker analysis of the spawner–recruit data explained only a small proportion of the total variation (r2 = 0.17) in loge recruit/spawner (R/S) and exhibited a significant first‐order autocorrelation (r1 = 0.68; P < 0.0001). Ricker time–polynomial regression exhibited no significant residual autocorrelation, explained 71% of the variation in loge R/S, and indicated that intrinsic productivity (α parameter) has remained fairly constant, whereas system capacity (β parameter) has been temporally unstable. Markov transition probabilities indicated that escapements between 0.8 and 1.0 million fish maximize yield. In comparison, a graphical assessment of actual spawner abundance versus predicted maximum sustained yield indicated a production threshold (about 0.8 million spawners) and revealed a temporal pattern in production related to spawner abundance. These findings suggest a positive‐feedback mechanism related to the size of the escapement, which we hypothesize is primarily due to nutrients from spawner carcasses. Sockeye salmon carcasses produce an estimated 90% of the phosphorus above baseline loading and have accounted for 40% or more of the total phosphorus in Karluk Lake. The historical trend in sedimentary δ15N shows a strong reduction in marine‐derived nutrients since the onset of commercial fishing around 1890, a pattern that roughly corresponds to the decline in sockeye salmon production and system capacity. These findings and other trophic‐level limnological analyses suggest an EG of 0.8–1.0 million fish. Our evaluations also indicated that approximately equal proportions of early‐run (before July 15) and late‐run (after July 15) spawners are needed to optimize sockeye salmon production at Karluk Lake.

Research capacity building in healthcare works to generate and apply new knowledge to improve health outcomes; it creates new career pathways, improves staff satisfaction, retention and organisational performance. While there are examples of investment and research activity in rural Australia, overall, rural research remains under-reported, undervalued and under-represented in the evidence base. This is particularly so in primary care settings. This lack of contextual knowledge generation and translation perpetuates rural–metropolitan health outcome disparities. Through greater attention to and investment in building research capacity and capability in our regional, rural and remote health services, these issues may be partially addressed. It is proposed that it is time for Australia to systematically invest in rurally focussed, sustainable, embedded research capacity building.

Background: The calls for increased numbers of researchers in rural health are growing. To meet this demand, training is needed. If training is to be effective, the value placed on research, the organisational need for research training and key targets for research skill development within a rural health organisation must be understood. Methods: This qualitative study was underpinned by a critical realist perspective that allowed exploration of the organisational, cultural and structural contexts of research training and of the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation's board, executive and facility management (n = 7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n = 11) were held. Data were analysed using NVivo software and thematic analysis. Results: The themes emerging from this study were the fragmentation of research activity, a need for systems that support research and collaboration for expertise. Conclusions: This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.

On December 18, 2002, the Food and Drug Administration (FDA) announced the Consumer Health Information for Better Nutrition Initiative. The initiative's goal is to make available more and better information about conventional foods and dietary supplements to help Americans improve their health and reduce risk of disease by making sound dietary decisions. It included a rating system to assess the "weight of the publicly available evidence." It assigns one of four ranked levels to the claim thus resulting in qualified health claims. Two phases of research were conducted by the International Food Information Council (IFIC) Foundation. Qualitative research to assess consumer understanding, vocabulary, and familiarity with claims helped with the design and orientation of the second quantitative research phase. The quantitative phase employed a Web-based survey. The claim formats included: report card graphic, report card text, embedded claim text, point-counterpoint, structure/function claim, and nutrient content claim. Respondents were asked to rate the product for perceived strength of scientific evidence provided to support the claim, and questions about the product's perceived healthfulness, quality, safety, and purchase intent. Consumers found it difficult to discriminate across four levels and showed inclination to project the scientific validity grade onto other product attributes. Consumers showed preference for simpler messages.