There is a real need for improvements in cancer detection. Significant problems are encountered when utilising the gold standard of excisional biopsy combined with histopathology. This can include missed lesions, perforation and high levels of inter- and intra-observer discrepancies. The clinical requirements for an objective, non-invasive real time probe for accurate and repeatable measurement of tissue pathological state are overwhelming. This study has evaluated the potential for Raman spectroscopy to achieve this goal. The technique measures the molecular specific inelastic scattering of laser light within tissue, thus enabling the analysis of biochemical changes that precede and accompany disease processes. Initial work has been carried out to optimise a commercially available Raman microspectrometer for tissue measurements; to target potential malignancies with a clinical need for diagnostic improvements (oesophagus. colon, breast, andd prostate) and to build and test spectral libraries and prediction algorithms for tissue types and pathologies. This study has followed rigorous sample collection protocols and histopathological analysis using a board of expert pathologists. Only the data from samples with full agreement of a homogeneous pathology have been used to construct a training data set of Raman spectra. Measurements of tissue specimens from the full spectrum of different pathological groups found in each tissue have been made. Diagnostic predictive models have been constructed and optimised using multivariate analysis techniques. They have been tested using cross-validation or leave-one-out and demonstrated high levels of discrimination between pathology groups (greater than 90% sensitivity and specificity for all tissues). However larger sample numbers are required for further evaluation. The discussions outline the likely work required for successful implementation of in vivo Raman detection of early malignancies.

Although much effort has gone into promoting early skin-to-skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding. We describe a 'natural' approach that mimics the situation at vaginal birth by allowing (i) the parents to watch the birth of their child as active participants (ii) slow delivery with physiological autoresuscitation and (iii) the baby to be transferred directly onto the mother's chest for early skin-to-skin. Studies are required into methods of reforming caesarean section, the most common operation worldwide.

Methodological knowledge on surveying young adolescents is scarce and researchers often rely on theories and methodological studies based on adult respondents. However, young adolescents are in the process of developing their cognitive, psychological, emotional and social skills, therefore present a unique set of considerations. Question characteristics including; question type and format, question difficulty, wording, ambiguity, the number of response options, and the inclusion of a neutral mid-point, play a pivotal role in the response quality of young adolescents. Failure to address these factors is likely to encourage young adolescents to use satisficing techniques. In this article, we provide a science based guide for developing surveys for use with adolescents aged 11 to 16 years. The guide considers the characteristics and developmental stages of adolescents as survey responders and incorporates advice on appropriate question characteristics, survey layout and question sequence, approaches to pre-testing surveys and mode of survey administration. The guide provides recommendations for developmentally appropriate survey design to improve response quality in survey research with young adolescents.

As most of the breast concerns raised in this survey could be addressed via education and 87% of girls wanted to know more about breasts, this study demonstrates a need for breast education for school girls, which may reduce the influence of the breast on sport and exercise participation.

Occupational therapists have been concerned with the health-promoting aspects of children's play. The evidence suggests that children's freedom to play away from adult supervision has declined in recent years and that parental perception of risk may be a factor in this. This research used a qualitative approach to explore six parents' views on how their fear of risk might be shaping their children's play. The parents stated that their children were now more likely to take part in activities supervised by adults.The article shows that these findings may be linked to national trends and that occupational therapists should be concerned about the health implications of these changes. It is suggested that further research should take into account other factors that might affect children's play.COTAS offers a complete external assessors package to ensure that vacancies are filled by occupational therapists professionally up to date and competent to meet the demands of the post in order to provide the best possible service to clients.