1,720,967 research outputs found
The breast cancer book: an essential guide to dealing with diagnosis, treatment and life after breast cancer. 2nd Edition
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A support group for breast cancer patients: development of a cognitive-behavioural approach
No full textCognitive behavioural therapy has been shown to be effective in reducing anxiety and depression in cancer patients when provided within the context of individual sessions. We describe the application of a cognitive behavioural model to a group therapy context. This represents a novel approach to the psychological treatment of cancer patients. Fourteen breast cancer patients attending the Royal Marsden Hospital were included in an assessment of treatment outcome pre-and post-group therapy. Outcome was assessed using the Hospital Anxiety and Depression (HAD) Scale and a study-specific visual analog measure relating to perceived efficacy of the therapeutic techniques. Rationale and organization of group therapy is described along with the preliminary pilot study results.<br/
Helping patients to help themselves after breast cancer treatment
No full textThere is a rise in the number of women living with the long-term consequences of cancer and continuing to suffer unmet need as breast cancer survival improves. This paper includes an introduction to self-management and a discussion of the evidence around the effectiveness of the key intervention types that could help patients to help themselves after treatment. Self-management interventions are particularly beneficial in reducing bother from symptoms, without patients having to take on the additional burden of more unwanted side-effects frequently seen with pharmacological interventions. There is a need to prioritise the funding of these financially viable self-management strategies to ensure equity of access and that these interventions are available for those in need
A feasibility study: a mixed methods exploratory phase II cluster randomised trail to investigate the effectiveness of the 'Macmillan Approach to Weight loss and Eating difficulties'(MAWE)
No full textBackground: this study is part of a programme of work using the MRC complex interventions framework to develop and test a psychosocial intervention for weight and eating related distress in people with cancer cachexia syndrome.Aim: to establish the feasibility of conducting a cluster randomised controlled trial to evaluate the effectiveness of the Macmillan Approach to Weight and Eating (MAWE) by testing i) recruitment and data collection process, ii) the deliverability and acceptability of MAWE, and iii) the efficacy of MAWE.Method: two specialist community palliative care teams in the South of England, 2006/07 were randomised to offer MAWE, or to deliver care as usual. Twenty-five patients supported by MAWE were compared with 25 patient controls. All participants were new referrals and concerned about weight loss or eating problems.Primary outcome measure: VAS scales of weight related distress and eating related distress were completed by patient and carer at two time points. Secondary outcome measures: At the same time points all participants were interviewed and patient participants completed the EORTC-QLQ-C15-PAL.Results: fifteen of the 65 recruited patients dropped out of the study, most because of death or deteriorating condition (n=12). Selecting only patients receiving nurse-led management delayed achievement of the recruitment target. MAWE trained nurses were able to integrate the approach within their everyday practice. But enthusiastic adoption of MAWE led to contamination of the baseline data and difficulty interpreting the measures. Descriptive statistics are consistent with MAWE mitigating weight and eating related distress. Qualitative data indicate that MAWE can help with self-management of weight and eating related problems. MAWE could be refined to address issues relating to co-morbidities.Conclusion: this feasibility study has provided important information that can be used to guide the design and methodology of a full cluster randomised controlled trial
A feasibility study of a Nordic walking intervention for women experiencing aromatase inhibitor associated arthralgia
No full textBackground: Women taking AIs (Aromatase Inhibitors) as treatment for breast cancer commonly experience joint pain and stiffness (aromatase inhibitor associated arthralgia; AIAA) which can lead to early discontinuation of treatment. Exercise is often recommended and there is preliminary evidence it might prove helpful. Nordic Walking is a popular form of exercise in women with breast cancer, and based on a biopsychosocial model, could provide additional benefits over normal walking alone. There is a need to find interventions for this problem; therefore a study was designed to determine the acceptability and safety of a Nordic walking intervention in women with AIAA, and to test the feasibility of a proposed randomised controlled trial in terms of recruitment, methods and measures.Methods: A feasibility study was carried out in a sample of women with AIAA using a randomised control design, with a waiting list control. Forty women were recruited and randomised to either intervention (six weeks of supervised group Nordic walking training followed by six weeks of 4 x 30min/week self managed Nordic walking) or enhanced usual care. Data were collected on feasibility outcomes including recruitment, acceptability (attrition and adherence), safety, and research design issues. Outcome data (pain, depression, quality of life & self-efficacy) were collected at baseline, T1 (following supervised group Nordic walking training) and T2 (following self managed Nordic walking).Findings: The recruitment rate (25%) was comparable to other breast cancer exercise studies, suggesting that there was interest in this type of intervention despite joint pain. Attrition was low (10%) and safety demonstrated. In the intervention group, adherence was high for weekly supervised Nordic walking sessions (>90%) but low for self managed sessions (average of two sessions per week, with most (70%) only managing one), although higher exercise frequencies were attained when all aerobic activity was considered together. Participants in the control group also reported increased physical activity, mainly through normal walking. Most of the outcome measures used appeared suitable for use, demonstrated responsiveness to change and gave support for using a biopsychosocial model of pain. Improvements in pain and other outcomes were demonstrated in both the intervention and control groups, possibly as both increased their physical activity.Conclusions: Our findings indicate that women with AIAA may not adhere to an intensive programme of self-managed NW; however, increasing physical activity is feasible in this population, and may improve symptoms. A future trial should test a physical activity intervention including a supervised component throughout to maximise adherence.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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