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BackgroundDespite the accumulation of research papers on aspirin and cancer, there is doubt as to whether or not aspirin is an acceptable and effective adjunct treatment of cancer. The results of several randomised trials are awaited, and these should give clear evidence on three common cancers: colon, breast and prostate. The biological effects of aspirin appear likely however to be of relevance to cancer generally, and to metastatic spread, rather than just to one or a few cancers, and there is already a lot of evidence, mainly from observational studies, on the association between aspirin and survival in a wide range of cancers.AimsIn order to test the hypothesis that aspirin taking is associated with an increase in the survival of patients with cancer, we conducted a series of systematic literature searches to identify clinical studies of patients with cancer, some of whom took aspirin after having received a diagnosis of cancer.ResultsThree literature searches identified 118 published observational studies in patients with 18 different cancers. Eighty-one studies report on aspirin and cancer mortality and 63 studies report on all-cause mortality. Within a total of about a quarter of a million patients with cancer who reported taking aspirin, representing 20%-25% of the total cohort, we found aspirin to be associated with a reduction of about 20% in cancer deaths (pooled hazard ratio (HR): 0.79; 95% confidence intervals: 0.73, 0.84 in 70 reports and a pooled odds ratio (OR): 0.67; 0.45, 1.00 in 11 reports) with similar reductions in all-cause mortality (HR: 0.80; 0.74, 0.86 in 56 studies and OR: 0.57; 0.36, 0.89 in seven studies). The relative safety of aspirin taking was examined in the studies and the corresponding author of every paper was written to asking for additional information on bleeding. As expected, the frequency of bleeding increased in the patients taking aspirin, but fatal bleeding was rare and no author reported a significant excess in fatal bleeds associated with aspirin. No author mentioned cerebral bleeding in the patients they had followed.ConclusionsThere is a considerable body of evidence suggestive of about a 20% reduction in mortality in patients with cancer who take aspirin, and the benefit appears not to be restricted to one or a few cancers. Aspirin, therefore, appears to deserve serious consideration as an adjuvant treatment of cancer, and patients with cancer, and their carers, have a right to be informed of the available evidence.

Objective – Evidence from systematic reviews a decade ago suggested that face-to-face and online methods to provide information literacy training in universities were equally effective in terms of skills learnt, but there was a lack of robust comparative research. The objectives of this review were (1) to update these findings with the inclusion of more recent primary research; (2) to further enhance the summary of existing evidence by including studies of blended formats (with components of both online and face-to-face teaching) compared to single format education; and (3) to explore student views on the various formats employed. Methods – Authors searched seven databases along with a range of supplementary search methods to identify comparative research studies, dated January 1995 to October 2016, exploring skill outcomes for students enrolled in higher education programs. There were 33 studies included, of which 19 also contained comparative data on student views. Where feasible, meta-analyses were carried out to provide summary estimates of skills development and a thematic analysis was completed to identify student views across the different formats. Results – A large majority of studies (27 of 33; 82%) found no statistically significant difference between formats in skills outcomes for students. Of 13 studies that could be included in a meta-analysis, the standardized mean difference (SMD) between skill test results for face-to-face versus online formats was -0.01 (95% confidence interval -0.28 to 0.26). Of ten studies comparing blended to single delivery format, seven (70%) found no statistically significant difference between formats, and the remaining studies had mixed outcomes. From the limited evidence available across all studies, there is a potential dichotomy between outcomes measured via skill test and assignment (course work) which is worthy of further investigation. The thematic analysis of student views found no preference in relation to format on a range of measures in 14 of 19 studies (74%). The remainder identified that students perceived advantages and disadvantages for each format but had no overall preference. Conclusions – There is compelling evidence that information literacy training is effective and well received across a range of delivery formats. Further research looking at blended versus single format methods, and the time implications for each, as well as comparing assignment to skill test outcomes would be valuable. Future studies should adopt a methodologically robust design (such as the randomized controlled trial) with a large student population and validated outcome measures.

Introduction Diverse communities - people with dementia, intellectual disabilities (ID) and religious beliefs, have lower rates in accessing palliative and hospice care services (Johnson, 2013). Healthcare providers also encounter problems in delivering appropriate services to these communities (Koffman, 2014). Aim To identify the barriers to accessing and delivering hospice care services for diverse communities. Method A rapid review was conducted using a systematic search protocol. The search yielded 95 relevant titles from which 34 were screened for data extraction and 23 met the inclusion criteria. Thematic approach was used for data analysis. Results The overall barriers identified were mainly physical, psycho-social and economic. People with dementia were challenged by the uncertainty of their survival time. Their lack of awareness of service facilities, availability and financial circumstances hindered them accessing hospice care. Difficulties associated with prognostication; communication; inadequate medical interventions; and appropriateness of palliative care intervention were the main barriers for those providing palliative care to this group. For individuals with ID, social, emotional and cognitive issues (patient understanding, capacity to consent etc.) were the main factors affecting palliative care provision. The main barriers for services providers were lack of guidelines and support, access to general healthcare facilities and internal staffing issues. For those with specific religious beliefs, unwillingness to involve outsiders, being well supported by their religious community, distrust of medical establishments and unawareness of the need and availability of services were the main barriers. Lack of diversity among health care staff and resource constraints were barriers to service delivery. Conclusions Addressing specific needs of diverse communities would encourage better utilisation of hospice care.

This review will aim to establish if there is strong evidence to suggest a student preference for delivery format within information literacy teaching. This research supports and builds on research previously undertaken by Cardiff University (Weightman et al., 2017). Weightman et al (2017) addressed the effect of face-to-face or online learning specifically on learning outcomes. This review specifically focuses on the effects of these methods, and blended formats, on student preference. This research informs teaching practice specifically within Cardiff University’s library service but also teaching practice generally. A comprehensive systematic literature search was undertaken in four databases: Library, Information Science and Technology Abstracts (LISTA), British Education Index, ERIC and Scopus. Seven new papers were identified to update the previous discussions on student preference of information literacy teaching format (Weightman et al., 2017). Critical appraisal was undertaken of these newly identified papers. Weightman et al.’s (2017) systematic review suggested that there was no student preference in relation to delivery format. Of the seven new papers identified in this review, two (DaCosta, 2007; Gorman & Staley, 2018) show a slight preference for format; one for online and one for face-to-face although there are limitations to the studies. Of the five remaining studies (Craig & Friehs, 2013; Kelly, 2017; Lag, 2016; Lapidus et al., 2012; Matlin & Lantzy, 2017) all showed a comparable experience between formats, although limitations of these studies are also acknowledged. The update search and appraisal of the literature concurs with previous conclusions (Weightman et al., 2017) that experiences are comparable and student preference is generally neutral in relation to delivery format. Student learning outcomes and student preference are comparable regardless of format (Weightman et al., 2017).

Background Evidence is growing that low-dose aspirin used as an adjuvant treatment of cancer is associated with an increased survival and a reduction in metastatic spread. We therefore extended up to August 2017 an earlier systematic search and meta-analyses of published studies of low-dose aspirin taken by patients with a diagnosis of cancer. Methods Searches were completed in Medline and Embase to August 2017 using a pre-defined search strategy to identify reports of relevant studies. References in all the selected papers were scanned. Two reviewers independently applied pre-determined eligibility criteria and extracted data on cause-specific cancer deaths, overall mortality and the occurrence of metastatic spread. Meta-analyses were then conducted for different cancers and heterogeneity and publication bias assessed. Sensitivity analyses and attempts to reduce heterogeneity were conducted. Results Analyses of 29 studies reported since an earlier review up to April 2015 are presented in this report, and these are then pooled with the 42 studies in our earlier publication. Overall metaanalyses of the 71 studies are presented, based on a total of over 120 thousand patients taking aspirin. Ten of the studies also give evidence on the incidence of metastatic cancer spread. There are now twenty-nine observational studies describing colorectal cancer (CRC) and post-diagnostic aspirin. Pooling the estimates of reduction by aspirin which are reported as hazard ratios (HR), gives an overall HR for aspirin and CRC mortality 0.72(95% CI 0.64-0.80). Fourteen observational studies have reported on aspirin and breast cancer mortality and pooling those that report the association with aspirin as a hazard ratio gives HR 0.69 (0.53-0.90). Sixteen studies report on aspirin and prostate cancer mortality and a pooled estimate yields an HR of 0.87 (95% CI 0.73-1.05). Data from 12 reports relating to other cancers are also listed. Ten studies give evidence of a reduction in metastatic spread; four give a pooled HR 0.31 (95% CI 0.18, 0.54) and five studies which reported odds ratio of metastatic spread give OR 0.79 (0.66 to 0.95). Conclusion Being almost entirely from observational studies, the evidence of benefit from aspirin is limited. There is heterogeneity between studies and the results are subject to important biases, only some of which can be identified. Nevertheless, the evidence would seem to merit wide discussion regarding whether or not it is adequate to justify the recommendation of low-dose therapeutic aspirin, and if it is, for which cancers?

Social networking sites feature significantly in the lives of many young people. Where these young people are bilingual, social networking sites may have an important role to play in terms of minority language use and in shaping perceptions of that language. Through a quantitative and qualitative study, this paper investigates the use of language in social networking sites by young Welsh speakers, focussing particularly on Facebook. Language choice and behaviour, factors influencing that behaviour, and attitudes towards use of the Welsh language in Information Technology are explored. The data suggests that there are a number of different factors at play, and that it is necessary to consider language behaviour in social networking sites in the context of offline language behaviour.

BACKGROUND: Aspirin has been shown to lower the incidence and the mortality of vascular disease and cancer but its wider adoption appears to be seriously impeded by concerns about gastrointestinal (GI) bleeding. Unlike heart attacks, stroke and cancer, GI bleeding is an acute event, usually followed by complete recovery. We propose therefore that a more appropriate evaluation of the risk-benefit balance would be based on fatal adverse events, rather than on the incidence of bleeding. We therefore present a literature search and meta-analysis to ascertain fatal events attributable to low-dose aspirin. METHODS: In a systematic literature review we identified reports of randomised controlled trials of aspirin in which both total GI bleeding events and bleeds that led to death had been reported. Principal investigators of studies in which fatal events had not been adequately described were contacted via email and asked for further details. A meta-analyses was then performed to estimate the risk of fatal gastrointestinal bleeding attributable to low-dose aspirin. RESULTS: Eleven randomised trials were identified in the literature search. In these the relative risk (RR) of 'major' incident GI bleeding in subjects who had been randomised to low-dose aspirin was 1.55 (95% CI 1.33, 1.83), and the risk of a bleed attributable to aspirin being fatal was 0.45 (95% CI 0.25, 0.80). In all the subjects randomised to aspirin, compared with those randomised not to receive aspirin, there was no significant increase in the risk of a fatal bleed (RR 0.77; 95% CI 0.41, 1.43). CONCLUSIONS: The majority of the adverse events caused by aspirin are GI bleeds, and there appears to be no valid evidence that the overall frequency of fatal GI bleeds is increased by aspirin. The substantive risk for prophylactic aspirin is therefore cerebral haemorrhage which can be fatal or severely disabling, with an estimated risk of one death and one disabling stroke for every 1,000 people taking aspirin for ten years. These adverse effects of aspirin should be weighed against the reductions in vascular disease and cancer.

Neither sociolinguists nor the sociology of language have taken seriously the role of language in the labour market. This paper aims to consider the specific nature of the class structure in a peripheral economy in Wales, and the role of language in the creation of class fractions. Drawing upon data from research carried out in Gwynedd at the end of the 1980s, the work focuses on the new middle class which, on account of being both employers of labour whilst at the same time being employees of capital, are in a contradictory class location within the class structure and may be expected to orientate either upwards towards the bourgeoisie or downwards towards the proletariat. The cultural division of labour within the peripheral economy in Wales involves a tendency for the private sector management to be non‐Welsh, being drawn from the English core, whereas the public sector management contains a significant number of Welsh speakers. Employing social relationships as an indicator of class orientati...