1,721,070 research outputs found
Examining patients' accounts of their pathway to the diagnosis of lung cancer: searching for new approaches to early detection
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A systematic review and thematic synthesis of quality of life in the informal carers of cancer patients with cachexia
No full textBackground: informal carers of cancer patients with cachexia face additional challenges to those encountered by informal carers in general because of the central role food and eating play in everyday life. Patient weight loss and anorexia, core features of cancer cachexia, are frequent causes of distress in caregivers. Identification of quality of life (QOL) issues can inform the development of interventions for both caregivers and patients, and facilitate communication with healthcare professionals (HCPs).Aim: to identify QOL issues that are relevant to carers of cancer patients with cachexia. Design: A systematic review and thematic synthesis of the qualitative literature were conducted. Reporting followed the PRISMA guidelines.Data sources: PubMed, ISI web of knowledge, EMBASE, Medline, CINAHL, PsychINFO, and PsycARTICLES were searched for publications dated from January 1980 to June 2013 using search terms relating to cancer, cachexia, QOL and carers. Papers written in the English language, featuring direct quotes from the carers of adult patients with any cancer diagnosis and cachexia or problems with weight loss or anorexia were included. Results: five themes were extracted from the sixteen identified studies. These highlighted the impact on everyday life, the attempts of some carers to take charge, the need for HCP input, conflict with the patient and negative emotions. Conclusions: the complexity of caring for a cancer patient with cachexia translates into a range of problems and experiences for informal carers. By addressing the impact of caring for a patient with cancer cachexia on carers, both caregiver and patient QOL may improve<br/
Trends in stomach and pancreatic cancer incidence and mortality in England and Wales, 1951-2000
No full textBackground: The aim of this study was to describe period and cohort effects in incidence and mortality of stomach and pancreatic cancer in England and Wales.Methods: National figures for mortality (1951-2000) and incidence (1971-2000) were analysed using log-linear Poisson regression models to obtain relative risks (RR) for period (year of incidence or death) and cohort (year of birth).Results: Stomach cancer shows a pronounced cohort effect in mortality with a decline in RR in men from 2.20 (1876) to 0.47 (1946) and a reduction from 2.79 to 0.41 for women. Mortality to incidence ratios are now less than 0.70. Pancreatic cancer mortality (men) RR rose from 0.91 (1951-1955) to a peak 1.11 (1976-1980) and then declined to 0.90 (1996-2000). Women showed a similar pattern. Cohort RR (men) increased to a peak of 1.14 in 1916 and declined to 1.01 in 1946, and continued to fall; the peak occurred slightly later in women. Mortality to incidence ratios were near 1 in the first 20 years, declining to 0.95 in the last 10 years.Conclusion: Stomach cancer incidence has fallen continuously from 19(th) century birth cohorts onwards. Incidence of pancreatic cancer has fallen in successive birth cohorts after 1920; peak period risk was 1976-1990. Age-standardized mortality and case mortality for pancreatic cancer are declining
Trends in stomach and pancreatic cancer incidence and mortality in England and Wales, 1951-2000: analysis by age, period and cohort
No full textRedesigning the patient journey. What is the feasibility of nurse-led chemotherapy services from a user perspective?
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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
Is late diagnosis of lung cancer inevitable? Interview study of patients’ recollections of symptoms before diagnosis
No full textBackground: A study was undertaken to explore the pathway to diagnosis among a group of patients recently diagnosed with lung cancer. Methods: A directed interview study triangulating patients’ accounts with hospital and GP records was performed with 22 men and women recently diagnosed with lung cancer at two cancer centres in the south and north of England. The main outcome measures were the symptoms leading up to a diagnosis of lung cancer and patient and GP responses before diagnosis. Results: Patients recalled having new symptoms for many months, typically over the year before their diagnosis, irrespective of their disease stage once diagnosed. Chest symptoms (cough, breathing changes, and pain in the chest) were common, as were systemic symptoms (fatigue/lethargy, weight loss and eating changes). Although symptoms were reported as being marked changes in health, these were not in the main (with the exception of haemoptysis) interpreted as serious by patients at the time and not acted on. Once the trigger for action occurred (the event that took patients to their GP or elsewhere in the healthcare system), events were relatively speedy and were faster for patients who presented via their GP than via other routes. Patients’ beliefs about health changes that may indicate lung cancer appeared to have played a part in delay in diagnosis. Conclusion: Further investigation of the factors influencing the timing of diagnosis in lung cancer is warranted since it appears that patients did not readily attend GP surgeries with symptoms. Insight into patients’ perspectives on their experience before diagnosis may help medical carers to recognise patients with lung cancer more easily so that they can refer them for diagnosis and treatment. Encouragement to present early with signs of lung cancer should be considered alongside other efforts to speed up diagnosis and treatment
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