Cancer prevention: from public health interventions to individual tailoring

Lectin-based biosensors as analytical tools for clinical oncology

The review focus on the use of lectin-based biosensors in the oncology field, and ponders the potentialities of using these devices as analytical tools to monitor the levels of cancer glycobiomarkers in biological fluids, helping in the diagnosis, prognosis and treatment assessment. Several examples of lectin-based biosensors directed for cancer biomarkers are described and discussed, and their potential application in the clinic is considered, taking into account their analytical features, advantages and performance in sample analysis. Technical and practical aspects in the construction process, which are specific for lectin biosensors, are debated, as well as the requirements in sample collection and processing, and biosensor validation. Today's challenges for real implementation of these devices in the clinic are presented, along with the future trends in the field.

Using the interactive systems framework to support a quality improvement approach to dissemination of evidence-based strategies to promote early detection of breast cancer: planning a comprehensive dynamic trial

Dissemination efforts must optimize interventions for new settings and populations. As such, dissemination research should incorporate principles of quality improvement. Comprehensive Dynamic Trial (CDT) designs examine how information gained during dissemination may be used to modify interventions and improve performance. Although CDT may offer distinct advantages over static designs, organizing the many necessary roles and activities is a significant challenge. In this article, we discuss use of the Interactive Systems Framework for Dissemination and Implementation to systematically implement a CDT. Specifically, we describe "Bronx ACCESS", a program designed to disseminate evidence-based strategies to promote adherence to mammography guidelines. In Bronx ACCESS, the Intervention Delivery System will elicit information needed to adapt strategies to specific settings and circumstances. The Intervention Synthesis and Translation System will use this information to test changes to strategies through "embedded experiments". The Intervention Support System will build local capacities found to be necessary for intervention institutionalization. Simulation modeling will be used to integrate findings across systems. Results will inform on-going policy debate about interventions needed to promote population-level screening. More generally, this project is intended to advance understanding of research paradigms necessary to study dissemination.

The E2D2 model: a dynamic approach to cancer prevention interventions

The E2D2 model is a systematic, evidence-informed approach to designing comprehensive and strategic interventions focused on cancer prevention, with potential applications to the broader chronic disease community. The model was developed using an omnibus approach to account for multilevel influences and determinants of individual and population health, quality of life, and cancer risk. It is focused on the four pillars of health promotion and intervention practice (evidence, evaluation, development, and delivery) and moves through three fundamental phases: identification of risk factors and sensitizing concepts; mediating mechanisms and modifiable contexts; and program development, delivery, and evaluation. Distinguished from other models in the health promotion field, the E2D2 model is designed to be both sequential and feedback oriented, which allows for the emergence of new evidence, procedural revisions, and knowledge exchange to occur during any of its phases.