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Treweek S.,University of Aberdeen | Dryden R.,Institute for Research and Innovation in Social Services | McCowan C.,University of Glasgow | Harrow A.,University of Dundee | Thompson A.M.,The Surgical Center
European Journal of Cancer | Year: 2015

Aim To describe the proportion of women in Tayside, Scotland diagnosed with early breast cancer who would have been eligible for influential adjuvant breast cancer trials. Methods Phase III trials of adjuvant treatment for breast cancer referenced in five national guidelines were shortlisted by breast cancer specialists to identify the twelve considered most influential. Eligibility criteria were extracted from protocols and applied to a 16-year cohort of women who had received a diagnosis of breast cancer and the proportion meeting trial criteria calculated. The criteria used clinically in Tayside to make decisions about use of the trial treatments were also applied to the cohort. Finally, the proportion of women receiving adjuvant endocrine therapy as part of their care and who would have been eligible for the trial evaluating that therapy was calculated. Results Of the cohort's 4811 women, 3535 (73%) were eligible for at least one trial but eligibility for an individual trial rarely exceeded 45%. There were substantial differences between the proportion of women meeting trial eligibility criteria and the proportion considered clinically eligible for the same treatment. The proportion of women receiving an endocrine therapy as part of their care who would also have been eligible for the trial evaluating that treatment ranged from 17% to 56%. Conclusion Clinical eligibility criteria may be at variance with trial criteria. For adjuvant endocrine therapy, a substantial proportion of women who would have been ineligible for a trial nevertheless received the trial treatment as part of their care. © 2015 Elsevier Ltd. Source

Ballantyne N.,University of Strathclyde | Duncalf Z.,University of Strathclyde | Daly E.,Institute for Research and Innovation in Social Services
Journal of Technology in Human Services | Year: 2010

In the past few years the risks associated with use of the Internet and social networking sites by children and young people have become a recurrent focus of attention for the media, the public, and policymakers. Parents, caregivers, and child care professionals alike are rightly concerned about exposure to pornography, pedophiles, and cyberbullies. At the same time Internet researchers have been steadily collecting evidence about the actual opportunities and risks associated with the young people's use of the Internet. In this article we describe some of the emerging evidence on opportunities and risks for young people and consider the challenges for social welfare professional charged with the role of safeguarding "looked after" children. © Taylor & Francis Group, LLC. Source

Harrow A.,University of Dundee | Dryden R.,Institute for Research and Innovation in Social Services | McCowan C.,University of Glasgow | Radley A.,NHS Tayside | And 3 more authors.
BMJ Open | Year: 2014

Objective: To explore women's experiences of taking adjuvant endocrine therapy as a treatment for breast cancer and how their beliefs about the purpose of the medication, side effects experienced and interactions with health professionals might influence adherence. Design: Qualitative study using semistructured, one-toone interviews. Setting: 2 hospitals from a single health board in Scotland. Participants: 30 women who had been prescribed tamoxifen or aromatase inhibitors (anastrozole or letrozole) and had been taking this medication for 1-5 years. Results: Women clearly wished to take their adjuvant endocrine therapy medication as prescribed, believing that it offered them protection against breast cancer recurrence. However, some women missed tablets and did not recognise that this could reduce the efficacy of the treatment. Women did not perceive that healthcare professionals were routinely or systematically monitoring their adherence. Side effects were common and impacted greatly on the women's quality of life but did not always cause women to stop taking their medication, or to seek advice about reducing the side effects they experienced. Few were offered the opportunity to discuss the impact of side effects or the potential options available. Conclusions: Although most women in this study took adjuvant endocrine therapy as prescribed, many endured a range of side effects, often without seeking help. Advice, support and monitoring for adherence are not routinely offered in conventional follow-up settings. Women deserve more opportunity to discuss the pros, cons and impact of long-term adjuvant endocrine therapy. New service models are needed to support adherence, enhance quality of life and ultimately improve survival. These should ideally be community based, in order to promote self-management in the longer term. Source

Petch A.,Institute for Research and Innovation in Social Services | Lightowler C.,Center for Youth and Criminal Justice | Pattoni L.,Institute for Research and Innovation in Social Services | Watson I.,Institute for Research and Innovation in Social Services
Evidence and Policy | Year: 2014

This paper explores ways in which IRISS (Institute for Research and Innovation in Social Services) promotes the delivery of cost effective social services in Scotland that support the achievement of positive outcomes. The approach to evidence-informed practice is characterised as four pillars of activity. The first focuses on improving awareness and access to evidence. The second refers to strengthening the evidence base and is discussed in the context of work on self-directed support. Improving skills and confidence to use evidence forms the third pillar. The final pillar is embedding evidence in organisations, through coproduction, creating spaces to test and challenge evidence, and through the development of evidence-based products. © Policy Press 2014. Source

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