• Menopause, sexuality and culture: Is there a universal experience?

      Astbury-Ward, Edna; Deeside Community Hospital (Taylor & Francis, 2003-05)
      Menopause is a universal phenomenon, but do all women experience a universal event? The aim of this article is to identify common trends or patterns occurring exclusively within certain different cultures, and whether these have an effect on how menopause is experienced or perceived by those women. This paper will first consider the physiological changes that occur during menopause and will then look at psychosocial influences that may affect women's perception and experience of menopause.
    • Mental Health Decisions; what every officer should consider

      Williams, Barry; Jones, Steven; University of Chester (Police Professional, 2012-05-24)
      It can often appear to Police officers that they are damned if they do make decisions, and damned if they don’t in mental health cases. A culture has evolved that triggers decision apathy and defensive decisions that arguably do not benefit the Police, public, or the mental health arrestee. Decisions of this presenting complexity in whatever profession must be made and firmly rooted within the current evidence base, lawful, and also be reasonable in the given situation. It is therefore not unreasonable to expect officers to explain and account for how and why they acted as they did, and the frameworks (statutes/ codes) which should underpin such practice decisions. It is of paramount importance that Police officers are kept appraised of developments in mental health cases and how this crucially will inform, and sometimes correct custom and practice. This article in three parts aims firstly to refresh officer’s knowledge. Second, inform current practice and address practice from recent cases involving the police and mental health patients. Thirdly, and perhaps the most crucial through case examples offer a decision making framework to support operational staff in the right direction for mental health practice and defend practice challenges that may arise at all levels.
    • Mental practice, motor performance, and the late CNV

      Smith, Dave; Collins, Dave; University College Chester ; University of Edinburgh (North American Society for the Psychology of Sport and Physical Activity, 2004-09)
      The aim of these two studies was to examine the application of Lang’s (1979, 1985) bioinformational theory to the mental practice (MP) of a strength task, the maximal voluntary contraction of the abductor digiti minimi, and the MP of a computerized barrier knockdown task. Study 1 divided 18 males into three groups: a physical practice (PP) group; a stimulus and response proposition mental practice (SRP) group; and a stimulus proposition mental practice (SP) group. Each participant either physically or mentally practiced 40 contractions twice a week for 3 weeks, and electroencephalograms (EEGs) were recorded during testing sessions. All three groups significantly increased abduction strength, but there were no significant between-group differences in the mag-nitude of the improvements. In addition, late contingent negative variation (CNV) waves were apparent prior to both real and imagined movements in all conditions. Study 2 allocated 24 participants to PP, SRP, SP, and control groups. Participants performed 120 imaginary or actual barrier knockdown trials, with EEGs recorded as in Study 1. A Group x Test ANOVA for movement time revealed that the PP and SRP groups improved to a significantly greater degree than the SP and control groups. Also, the late CNV was observed prior to real and imagined movement in the SRP group, but not prior to imagined movement in the SP group. These results support bioinformational theory with respect to cognitively oriented motor tasks, but not strength tasks.
    • Metabolic demands and replenishment of muscle glycogen after a rugby league match simulation protocol.

      Bradley, Warren J.; Hannon, Marcus P.; Benford, Victoria; Morehen, James C.; Twist, Craig; Shepherd, Sam; Cocks, Matthew; Impey, Samuel G.; Cooper, Robert G.; Morton, James P.; et al. (2017-02-22)
      Objectives: The metabolic requirements of a rugby league match simulation protocol and the timing of carbohydrate provision on glycogen re-synthesis in damaged muscle were examined. Design: Fifteen (mean ± SD: age 20.9 ± 2.9 y, body-mass 87.3 ± 14.1 kg, height 177.4 ± 6.0 cm) rugby league (RL) players consumed a 6 g•kg•day-1 CHO diet for 7-days, completed a time to exhaustion test (TTE) and a glycogen depletion protocol on day-3, a RL simulated-match protocol (RLMSP) on day-5 and a TTE on day-7. Players were prescribed an immediate or delayed (2-h-post) re-feed post-simulation. Methods: Muscle biopsies and blood samples were obtained post-depletion, before and after simulated match-play, and 48-h after match-play with PlayerLoad and heart-rate collected throughout the simulation. Data were analysed using effects sizes ± 90% CI and magnitude-based inferences. Results: PlayerLoad (8.0 ± 0.7 AU•min-1) and %HRpeak (83 ± 4.9%) during the simulation were similar to values reported for RL match-play. Muscle glycogen very likely increased from immediately after to 48-h post-simulation (272 ± 97 cf. 416 ± 162 mmol•kg-1d.w.; ES ± 90%CI) after immediate re-feed, but changes were unclear (283 ± 68 cf. 361 ± 144 mmol•kg-1d.w.; ES ± 90%CI) after delayed re-feed. CK almost certainly increased by 77.9 ± 25.4% (0.75 ± 0.19) post-simulation for all players. Conclusions: The RLMSP presents a replication of the internal loads associated with professional RL match-play, although difficulties in replicating the collision reduced the metabolic demands and glycogen utilisation. Further, it is possible to replete muscle glycogen in damaged muscle employing an immediate re-feed strategy.
    • Metabolic demands of elite rugby competition after 36 hours of a high (6 g·kg-1) or low (3 g·kg-1) carbohydrate diet: implications for dietary recommendations.

      Bradley, Warren J.; Morehen, James C.; Haigh, Julian; Clarke, Jon; Donovan, Timothy F.; Twist, Craig; Cotton, Caroline; Shepherd, Sam; Cocks, Matthew; Sharma, Asheesh; et al. (Elsevier, 2016-04-22)
      Objectives: Although the physical demands of Rugby League (RL) match-play are well-known, the fuel sources supporting energy-production are poorly understood. We therefore assessed muscle glycogen utilisation and plasma metabolite responses to RL match-play after a relatively high (HCHO) or relatively low CHO (LCHO) diet. Design: Sixteen (mean ± SD age; 18 ± 1 years, body-mass; 88 ± 12 kg, height 180 ± 8 cm) professional players completed a RL match after 36-h consuming a non-isocaloric high carbohydrate (n = 8; 6 g kg day−1) or low carbohydrate (n = 8; 3 g kg day−1) diet. Methods: Muscle biopsies and blood samples were obtained pre- and post-match, alongside external and internal loads quantified using Global Positioning System technology and heart rate, respectively. Data were analysed using effects sizes ±90% CI and magnitude-based inferences. Results: Differences in pre-match muscle glycogen between high and low carbohydrate conditions (449 ± 51 and 444 ± 81 mmol kg−1 d.w.) were unclear. High (243 ± 43 mmol kg−1 d.w.) and low carbohydrate groups (298 ± 130 mmol kg−1 d.w.) were most and very likely reduced post-match, respectively. For both groups, differences in pre-match NEFA and glycerol were unclear, with a most likely increase in NEFA and glycerol post-match. NEFA was likely lower in the high compared with low carbohydrate group post-match (0.95 ± 0.39 mmol l−1 and 1.45 ± 0.51 mmol l−1, respectively), whereas differences between the 2 groups for glycerol were unclear (98.1 ± 33.6 mmol l−1 and 123.1 ± 39.6 mmol l−1) in the high and low carbohydrate groups, respectively. Conclusions: Professional RL players can utilise ∼40% of their muscle glycogen during a competitive match regardless of their carbohydrate consumption in the preceding 36-h.
    • Metacarpophalangeal pattern profile analysis of a sample drawn from a North Wales population

      Lewis, Stephen J.; Chester College of Higher Education (Taylor & Francis, 2001)
      Sexual dimorphism and population differences were investigated using metacarpophalangeal pattern profile (MCPP) analysis. Although it is an anthropmetric technique, MCPP analysis is more frequently used in genetic syndrome analysis and has been under-used in the study of human groups. The present analysis used a series of hand radiographics from Gwynedd, North Wales, to make comparisons, first, between the sexes within the sample and then with previously reported data from Japan. The Welsh sexes showed MCPP analyses that indicated size and shape differences but certain similarities in shape were also evident. Differences with the Japanese data were more marked. MCPP anlysis is a potentially useful anthropmetric technique but requires further statistical development.
    • Metatarsophalangeal joint function during sprinting: A comparison of barefoot and sprint spike shod foot conditions

      Smith, Grace; Lake, Mark; Lees, Adrian; University of Chester ; Liverpool John Moores University ; Liverpool John Moores University (2013-09-13)
      The metatarsophalangeal joint is an important contributor to lower limb energetics during sprint running. This study compared the kinematics, kinetics and energetics of the metatarsophalangeal joint during sprinting barefoot and wearing standardised sprint spikes. The aim of this investigation was to determine whether standard sprinting footwear alters the natural motion and function of the metatatarsophalangeal joint exhibited during barefoot sprint running. Eight trained sprinters performed maximal sprints along a runway, four sprints in each condition. Three dimensional high speed (1000 Hz) kinematic and kinetic data were collected at the 20 m point. Joint angle, angular velocity, moment, power and energy were calculated for the metatarsophalangeal joint. Sprint spikes significantly increase sprinting velocity (0.3 m/s average increase), yet limit the range of motion about the metatarsophalangeal joint (17.9 % average reduction) and reduce peak dorsiflexion velocity (25.5 % average reduction), thus exhibiting a controlling affect over the natural behaviour of the foot. However, sprint spikes improve metatarsophalangeal joint kinetics by significantly increasing the peak metatarsophalangeal joint moment (15 % average increase) and total energy generated during the important push-off phase (0.5 J to 1.4 J). The results demonstrate substantial changes in metatarsophalangeal function and potential improvements in performance-related parameters due to footwear.
    • Methadone‐Assisted Opiate Withdrawal and Subsequent Heroin Abstinence: The Importance of Psychological Preparedness

      Jones, Steven; Jack, Barbara; Kirby, Julie; Wilson, Thomas; Murphy, Philip; University of Chester
      Background and Objectives: Treatment guidelines emphasize patients’ readiness for transitioning from opiate substitution treatment (OST) to opiate withdrawal and abstinence. Psychological preparedness indicators for this transition were examined. Methods: Patients (all male) were recruited from three treatment settings: prison, an inpatient detoxification unit, and an outpatient clinic. Time 1 (T1) was admission to methadone‐assisted withdrawal in all settings. Time 2 (T2) was a 6‐month follow‐up. With n = 24 at T1 for each group (N = 72), a battery of instruments relevant to psychological preparedness was administered. Results: At T1, inpatients had higher self‐efficacy beliefs for successful treatment completion than prison patients. For patients contactable at T2, T1 self‐efficacy positively predicted T2 opiate abstinence. No other variable improved prediction. T1 SOCRATES (Stages of Change Readiness and Treatment Eagerness Scale) ambivalence scores, age, and lifetime heroin use duration predicted maintenance of contact or not with treatment services and contactability by the researcher. Measures of mood did not differ between groups at T1 or predict T2 outcomes. Discussion and Conclusions: Self‐efficacy beliefs are a potentially useful indicator of readiness for transitioning from OST to a medically assisted opiate withdrawal and subsequent abstinence. Ambivalence regarding change, age, and lifetime heroin use duration are potentially useful predictors of patients maintaining contact with services, and of being retained in research. Scientific Significance: These findings advance existing literature and knowledge by highlighting the importance of self‐efficacy in psychological preparedness for opiate abstinence, and the predictive utility to clinicians of this and other variables measurable at admission, in the clinical management of opiate users
    • Methods of measuring proximity in primates - a comparison

      Skyner, Lindsay J.; Smith, Tessa E.; Roberts, Jason A.; University of Chester (Primate Society of Great Britain, 2004-06)
    • MHC-I peptides get out of the groove and enable a novel mechanism of HIV-1 escape

      Pymm, Phillip; Illing, Patricia; Ramarathinam, Sri; O'Connor, Geraldine M.; Hughes, Victoria A.; Hitchen, Corinne; Price, David A.; Ho, Bosco; McVicar, Daniel W.; Brooks, Andrew G.; et al. (Macmillan Publishers, 2017-02-20)
      Major histocompatibility complex class I (MHC-I) molecules play a crucial role in immunity by capturing peptides for presentation to T cells and natural killer (NK) cells. The peptide termini are tethered within the MHC-I antigen-binding groove, but it is unknown whether other presentation modes occur. Here we show that 20% of the HLA-B*57:01 peptide repertoire comprises N-terminally extended sets characterized by a common motif at position 1 (P1) to P2. Structures of HLA-B*57:01 presenting N-terminally extended peptides, including the immunodominant HIV-1 Gag epitope TW10 (TSTLQEQIGW), showed that the N terminus protrudes from the peptide-binding groove. The common escape mutant TSNLQEQIGW bound HLA-B*57:01 canonically, adopting a dramatically different conformation than the TW10 peptide. This affected recognition by killer cell immunoglobulin-like receptor (KIR) 3DL1 expressed on NK cells. We thus define a previously uncharacterized feature of the human leukocyte antigen class I (HLA-I) immunopeptidome that has implications for viral immune escape. We further suggest that recognition of the HLA-B*57:01-TW10 epitope is governed by a 'molecular tension' between the adaptive and innate immune systems.
    • Microclimate & limestone pavement biodiversity: A pilot project to look at the longterm effects of grike orientation on microclimate and biodiversity in North Wales

      Burek, Cynthia V.; Legg, Colin; Chester College of Higher Education (Countryside Council for Wales/Cyngor Cefn Gwlad Cymru, 1999-07)
      A long-term project (two years initially) was set up to produce a valuable database of microclimate data across two complete seasonal changes through two winter and summer soltices. The results of the project to date are: grike orientation has the potential to greatly affect the vegetation within the grikes and influence both the timing of its germination, growth and development; the bottom of the grike sufferts less temperatire fluctuation than the surface; there is a significant difference in the solar ration at 57 cm depth between the winter solstice and Mid February 1999; the range of bottom temperatures is significatnly higher in the north-south grikes during the winter months; north-south grikes suffer lower minumum temperatures during the autumn months. Grikes at Y Taranau and Bryn Pydew nature reserve were analysed.
    • Minichromosome maintenance protein in myxofibrosarcoma

      Sington, James D.; Freeman, Alex; Morris, Lesley S.; Vowler, Sarah L.; Arch, Barbara N.; Fisher, Cyril; Coleman, Nicholas; University of Cambridge ; Royal Marsden Hospital (Fisher) (Nature, 2004-02-01)
      Histopathological assessment of myxofibrosarcoma may be difficult, especially on the basis of a small core biopsy, which enables only a crude evaluation of grade and prognosis. Hypothesis - that determination of cell cycle state may assist in the diagnostic assessment of myxofibrosarcoma. 51 cases of high-grade (n=20), intermediate-grade (n=21), and low-grade (n=10) myxofibrosarcomas were studied, as well as nine cases of benign myxoma. Cell cycle state within tumors was determined by immunostaining for the recently described marker minichromosome maintenance protein 2 (MCM2), together with Ki67. Labelling indices for both markers were correlated with tumor grade, mitotic index, and time to first recurrence. The MCM2 labelling indices were significantly higher than the Ki-67 labelling indices. Both indices showed a significant correlation with the mitotic index and both showed significant increases with increasing grade of myxofibrosarcoma. The MCM2 labelling index (but not the Ki67 labelling index) showed a significant inverse exponential correlation with the time to first recurrence. Myxoid and cellular areas showed no difference in the MCM2 and Ki-67 labeling index, suggesting that clinically useful information could be obtained from any component of a myxofibrosarcoma sampled in a needle biopsy and/or cytological specimen. We therefore suggest that assessment of cell cycle state may be a useful diagnostic adjunct in the histopathological assessment of myxofibrosarcoma, by enabling more accurate determination of grade and prediction of outcome.
    • Mircoplate assay for the measurement of hydroxyproline in acid-hydrolyzed tissue samples

      Brown, Sharon J.; Worsfold, Michael; Sharp, Christopher A.; Charles Salt Centre, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust in Oswestry/University College Chester ; Charles Salt Centre, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust in Oswestry ; Charles Salt Centre, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust in Oswestry (Eaton Publishing Company, 2001-01)
    • Misperception: No evidence to dismiss RPE as regulator of moderate-intensity exercise

      Eston, Roger; Coquart, J.; Lamb, Kevin L.; Parfitt, Gaynor; University of South Australia; Universite´ de Rouen; University of Chester (American College of Sports Medicine, 2015-12-01)
      Dear Editor-in-Chief, Shaykevich et al. (7) demonstrate the efficacy of auditory feedback anchored at 75% of age-predicted HRmax to regulate intensity (claimed as ‘‘moderate’’) during several 20-min bouts of cycling. Their technical approach is novel, but 76% HRmax is the upper limit of moderate intensity, so given the large error in age-predicted HRmax, it is unlikely that their exercise bandwidth was ‘‘moderate’’ for all participants. This is not our major concern, but it reveals one among other inaccuracies: the most serious include training, interpretation, and inferences relating to the RPE.
    • Mission impossible? Reflecting upon the relationship between physical education, youth sport and lifelong participation

      Green, Ken; University of Chester (Taylor & Francis, 2012-05-08)
      It is widely believed that school physical education (PE) is or, at the very least, can (even should) be a crucial vehicle for enhancing young people’s engagement with physically active recreation (typically but not exclusively in the form of sport) in their leisure and, in the longer run, over the life-course. Despite the prevalence of such beliefs there remains a dearth of evidence demonstrating a ‘PE effect’. Indeed, the precise nature of the relationship between PE, youth sport and lifelong participation is seldom explored other than in implicit, often speculative and discursive, ways that simply take-for-granted the positive effects of the former (PE) on the latter (youth and adult participation in sport and physically active recreation). Using largely European studies to frame the issue, this paper reflects upon the supposedly ‘causal’ relationship between PE, youth sport and lifelong participation and, in doing so, highlights the inherent problems associated with attempts to identify, characterise and establish a ‘PE effect’.
    • Mitochondrial ROS regulate oxidative damage and mitophagy but not age-related muscle fiber atrophy

      Nye, Gareth; Sakellariou, Giorgos; Pearson, Timothy; Lightfoot, Adam; Wells, Nicola; Giakoumaki, Ifigeneia; Vasilaki, Aphrodite; Griffiths, Richard; Jackson, Malcolm; McArdle, Anne; et al. (Nature Research, 2016-09-29)
      Age-related loss of skeletal muscle mass and function is a major contributor to morbidity and has a profound effect on the quality of life of older people. The potential role of age-dependent mitochondrial dysfunction and cumulative oxidative stress as the underlying cause of muscle aging remains a controversial topic. Here we show that the pharmacological attenuation of age-related mitochondrial redox changes in muscle with SS31 is associated with some improvements in oxidative damage and mitophagy in muscles of old mice. However, this treatment failed to rescue the age-related muscle fiber atrophy associated with muscle atrophy and weakness. Collectively, these data imply that the muscle mitochondrial redox environment is not a key regulator of muscle fiber atrophy during sarcopenia but may play a key role in the decline of mitochondrial organelle integrity that occurs with muscle aging.
    • A mixed methods study of the early development of childhood overweight and obesity: Understanding the process of infant feeding

      Thurston, Miranda; Perry, Catherine (University of Liverpool (University of Chester)University of Chester, 2013-03)
      Prevalence of overweight and obesity has increased in adult and child populations during the last two to three decades in both developed and developing countries. Childhood obesity is common in the United Kingdom and has become a major public health issue. There is a growing body of evidence to suggest that the development of overweight and obesity in children has its roots in early life, with evidence of increasing weight over time in pre-school children. The study explored the early development of overweight in infants in Halton, an area of Northwest England. It was a mixed methods study comprising a quantitative analysis of routinely collected infant weight data and a longitudinal qualitative study of the process of weaning. Phase one - patterns of weight in Halton infants: The retrospective quantitative study utilised birthweight, and weight and length/height at eight weeks, eight months and 40 months of age from Halton infants born between 1994 and 2006 (16,328 singleton births). Analysis of these data provided further evidence of the early development of overweight, and highlighted patterns of infant overweight at eight months of age not previously reported. Phase two - longitudinal qualitative study of the process of weaning: Given the findings of phase one, factors that may influence early weight gain were considered. Therefore, the second phase focussed upon weaning, which has been little researched in terms of the way in which mothers manage the process. The aim was to explore weaning as a social process, focussing on the experience, knowledge, perceptions and actions of mothers as they weaned, in order to consider whether this could shed light on infant growth and development in general and the early development of overweight in particular. A grounded theory approach was utilised. Twenty one women were recruited and interviewed antenatally and then up to three times after their babies were born. A total of 67 interviews took place. A grounded theory, or ‘plausible account’, of the weaning process was developed. The centrality of the baby, and the way in which mothers talk about following the lead of the baby as they wean was highlighted, along with the ways in which this focus may falter or shift because of the complexity of influences on mothers’ lives. The primacy of embodied knowledge, that is the knowledge that mothers built up through the experience of feeding and weaning their infant, and the significance of being a mother in terms of being an ‘authority’ on feeding and weaning, were evident. In addition, the limitations of providing information, such as the feeding and weaning guidelines, without taking account of the individual mother, infant and their context was indicated. This is how some mistrust of the advice of health professionals, and possibly other ‘health messages’ emerged, as mothers did not see the advice as appropriate to them, their infant, or circumstances. Mothers did recognise babies as ‘bigger’ or ‘smaller’, but through valuing weight and weight gain were particularly aware of having small babies, which may have limited their capacity for recognising the significance of early signs of overweight in their infants. Final conclusions: Using mixed methods in this study allowed a broad picture of patterns of weight and overweight in Halton infants, and what some of the contributory factors to those patterns might be, to emerge, than if a single research method had been used. A number of implications for policy and practice: at an individual level in terms of the way in which women are supported to feed and wean their babies; and at a population level in terms of the monitoring of weight, were identified.
    • MODIS time series contribution for the estimation of nutritional properties of alpine grassland

      Ranghetti, Luigi; Bassano, Bruno; Bogliani, Giuseppe; Polmonari, Alberto; Formigoni, Andrea; Stendardi, Laura; von Hardenberg, Achaz; Consiglio Nazionale delle Ricerche; Università di Pavia; Parco Nazionale Gran Paradiso; Università di Bologna; Università di Firenze; University of Chester (Taylor & Francis, 2017-02-17)
      Despite the Normalised Difference Vegetation Index (NDVI) has been used to make predictions on forage quality, its relationship with bromatological field data has not been widely tested. This relationship was investigated in alpine grasslands of the Gran Paradiso National Park (Italian Alps). Predictive models were built using remotely sensed derived variables (NDVI and phenological information computed from MODIS) in combination with geo-morphometric data as predictors of measured biomass, crude protein, fibre and fibre digestibility, obtained from 142 grass samples collected within 19 experimental plots every two weeks during the whole 2012 growing season. The models were both cross-validated and validated on an independent dataset (112 samples collected during 2013). A good predictability ability was found for the estimation of most of the bromatological measures, with a considerable relative importance of remotely sensed derived predictors; instead, a direct use of NDVI values as a proxy of bromatological variables appeared not to be supported.
    • Modulation of Innate and Adaptive Immune Responses by Arabinoxylans

      Fadel, Abdulmannan; Plunkett, Andrew; Li, Weili; Ashworth, Jason J.; Manchester Metropolitan University; University of Chester; Al-Baha University; Al-Ahliyya Amman University; Universiti Putra Malaysia; Istanbul Universitesi (Wiley, 2017-11-30)
      Humans are exposed to harmful pathogens and a wide range of noxious substances every day.The immune system reacts to, and destroys, these pathogens and harmful substances. The immunesystem is composed of innate and adaptive immunity, which liaise to protect the host and maintainhealth. Foods, especially cereals, have been reported to modulate the immune response.Arabinoxylans are nonstarch polysaccharides that have been shown to possess immune-modulatory activities. This review article discusses the fundamentals of the immune system andprovides an overview of the immunomodulatory potential of arabinoxylans in conjunction withtheir structural characteristics and proposed similarities with lipopolysaccharides
    • Molecular and Cellular Mechanisms of Action of Tumour Suppressor GAS5 LncRNA

      Pickard, Mark R.; Williams, Gwyn T.; Keele University (MDPI, 2015-07-07)
      It is increasingly recognised that lncRNAs play essential regulatory roles in fundamental biological processes and, consequently, that their dysregulation may contribute to major human diseases, including cancer. Better understanding of lncRNA biology may therefore offer new insights into pathogenetic mechanisms and thereby offer novel opportunities for diagnosis and therapy. Of particular interest in this regard is GAS5 lncRNA, which is down-regulated in multiple cancers, with expression levels related to both clinico-pathological characteristics and patient prognosis. Functional studies have further shown that GAS5 lncRNA both inhibits the proliferation and promotes the apoptosis of multiple cell types, and that together these cellular mechanisms of action are likely to form the basis of its tumour suppressor action. At the same time, advances have been made in our understanding of the molecular mechanisms of GAS5 lncRNA action in recent years, including riborepression of certain steroid hormone receptors and sequestration of miR-21, impacting key regulatory pathways of cell survival. Overall this accumulating knowledge has the potential to improve both the diagnosis and treatment of cancer, and ultimately patient outcome.