Impact of tumour epithelial subtype on circulating microRNAs in breast cancer patients.

While a range of miRNAs have been shown to be dysregulated in the circulation of patients with breast cancer, little is known about the relationship between circulating levels and tumour characteristics. The aim of this study was to analyse alterations in circulating miRNA expression during tumour progression in a murine model of breast cancer, and to detemine the clinical relevance of identified miRNAs at both tissue and circulating level in patient samples. Athymic nude mice received a subcutaneous or mammary fat pad injection of MDA-MB-231 cells. Blood sampling was performed at weeks 1, 3 and 6 following tumour induction, and microRNA extracted. MicroRNA microArray analysis was performed comparing samples harvested at week 1 to those collected at week 6 from the same animals. Significantly altered miRNAs were validated across all murine samples by RQ-PCR (n = 45). Three miRNAs of interest were then quantified in the circulation(n = 166) and tissue (n = 100) of breast cancer patients and healthy control individuals. MicroArray-based analysis of murine blood samples revealed levels of 77 circulating microRNAs to be changed during disease progression, with 44 demonstrating changes >2-fold. Validation across all samples revealed miR-138 to be significantly elevated in the circulation of animals during disease development, with miR-191 and miR-106a levels significantly decreased. Analysis of patient tissue and blood samples revealed miR-138 to be significantly up-regulated in the circulation of patients with breast cancer, with no change observed in the tissue setting. While not significantly changed overall in breast cancer patients compared to controls, circulating miR-106a and miR-191 were significantly decreased in patients with basal breast cancer. In tissue, both miRNAs were significantly elevated in breast cancer compared to normal breast tissue. The data demonstrates an impact of tumour epithelial subtype on circulating levels of miRNAs, and highlights divergent miRNA profiles between tissue and blood samples from breast cancer patients.

A multi-method approach to assessing health information systems end users' training needs.

Many existing training programs for Health Information Systems (HIS) do not adequately satisfy end users' needs nor meet training objectives. This is because they do not envisage the problems that users may encounter when performing specific tasks. Therefore the first priority for the development of an effective training program is to precisely assess the end users' training needs, a process called Training Needs Assessment (TNA). Applying traditional approaches for TNA, such as interviews or surveys alone, however, may be insufficient because they are limited in their capacity to reveal the cognitive processes of end users. Usability testing, with its ability to gather data about human computer interaction, overcomes the deficiencies of these traditional approaches. This paper proposes a multi-method approach, which combines usability testing together with traditional methods, such as interviews or questionnaire surveys to assess HIS end users' training needs. This innovative method is able to precisely reveal the training needs for different levels of HIS users. A case study, which applied this method to assess the training needs for users of a nursing information system demonstrates its feasibility.

Benefits of ICT adoption and use in regional general medical practices: a pilot study.

This paper presents a pilot study of benefits derived from information and communications technology(ICT) adoption and use in medical practices in regional Australia. The study involved 122 regional medical practitioners. The results show that like the more general small business sector, the perception of certain benefits is associated with the size of the practice (in terms of employee levels) and/or the gender of the respondent practitioner. The data also showed that the level of skill of certain software used within the practice was significantly associated with the level of perceived benefit derived from ICT adoption and use.