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Geelong West, Australia

Shewbridge A.,Guys and St Thomas NHS Foundation Trust | Wiseman T.,Nursing | Richardson A.,University of Southampton
European Journal of Cancer Care | Year: 2012

The purpose of this study was to estimate the number of patients who continue to work when undergoing ambulatory chemotherapy and to identify personal or treatment-related factors that influence this. Patients undergoing final cycles of adjuvant chemotherapy for breast or colorectal cancer or first-line chemotherapy for lymphoma at two cancer treatment centres were approached to take part in a cross sectional survey (n= 55, RR 55%). Sixty-four per cent (n= 35) of respondents were working when cancer was diagnosed. Fifty-four per cent (n= 19) of respondents were working when chemotherapy began but as treatment progressed only 29% (n= 10) continued to work in any capacity. The most important influencing factor when making decisions about work was the need to concentrate on looking after oneself. Overall, respondents found their employers and colleagues supportive but there was some evidence they became less supportive as treatment progressed. While this was a small study it highlights the need for health care professionals to understand patient's needs and wishes in relation to work while undergoing chemotherapy by including this issue as part of routine assessment. Strategies to allow those who wish to continue to work during treatment should be put in place early to support this. © 2011 Blackwell Publishing Ltd. Source

Nelligan M.,Nursing
Nursing Times | Year: 2015

Recent national reports on NHS care failings highlight the need to support, develop and provide evidence of compassion in practice. This article describes a nurse training and leadership programme that teaches nurses to become champions of compassionate care, delivering cultural change across their teams and areas of practice. © 2015 Nursing Times. Source

Chen C.-Y.,National Yang Ming University | Chen C.-Y.,Taipei Veterans General Hospital | Lee W.-J.,Min Sheng General Hospital | Asakawa A.,Kagoshima University | And 6 more authors.
Current Medicinal Chemistry | Year: 2013

To compare endocrine, metabolic, and inflammatory changes induced by gastric bypass (GB) and sleeve gastrectomy (SG) in patients with type 2 diabetes mellitus (T2DM), and to investigate the mechanisms of success after metabolic surgery. Sixteen GB and 16 SG patients were followed up before and at 1 year after surgery. The 75-g oral glucose tolerance test (OGTT) was performed before and after surgery. Glucose homeostasis, serum interleukin-1β, plasma gut hormones and adipokines, and the United Kingdom Prospective Diabetes Study (UKPDS) ten-year cardiovascular risks were evaluated. The diabetes remission rate was significantly higher in GB than SG. Changes in the area under the curve (AUC) for glucose were greater in those with complete and partial remission after GB and remitters after SG than non-remitters after SG, whereas changes in AUC for C-peptide were higher in complete and partial remitters after GB than non-remitters after SG. Insulinogenic index was enhanced and serum interleukin-1β was reduced in complete remitters after GB and remitters after SG. Logistic regression analysis confirmed that insulinogenic index and interleukin-1β, not insulin resistance, were the factors determining the success of diabetes remission after metabolic surgeries. GB and SG significantly reduced the ten-year risk of coronary heart disease and fatal coronary heart disease in T2DM patients after surgery, while GB had the additional benefit of reduced stroke risk. Human diabetes remission after metabolic surgery is through insulin secretion and interleukin-1β dependent mechanisms. GB is superior to SG in cardiocerebral risk reduction in Asian non-morbidly obese, not well-controlled T2DM patients. © 2013 Bentham Science Publishers. Source

Lalloo C.,McMaster University | Stinson J.N.,Nursing | Hochman J.R.,Womens College Hospital | Adachi J.D.,St. Josephs Healthcare | Henry J.L.,McMaster University
Clinical Journal of Pain | Year: 2013

OBJECTIVES: To evaluate usability and pain iconography of the Iconic Pain Assessment Tool Version 2 (IPAT2), a self-report instrument that combines word descriptors and representative images (icons) to assess pain quality, intensity, and location, among adults and adolescents with arthritis. METHODS: Adults with inflammatory arthritis and adolescents with juvenile idiopathic arthritis partook in a single, semistructured, audio-recorded interview to evaluate: (1) the concreteness (object representativeness) and semantic distance (pain representativeness) of the IPAT2 iconography; (2) participants' current pain; and (3) perceptions and likes/dislikes of the IPAT2. Quantitative data were summarized descriptively and a line-by-line coding analysis identified key concepts from interview transcripts. The criterion for icon acceptability was mean and median ratings ≥5.0 for concreteness, semantic distance, and satisfaction for describing arthritis pain. RESULTS: The sample was comprised of 15 adults (87% female, mean 57 y) and 15 adolescents (67% female, mean age 15 y). The IPAT2 was reported to be easy to use and understand, well liked, quick to complete, and perceived as potentially valuable for communicating arthritis pain to health care providers. The median time needed to complete a single pain record, after 5-minute demonstration, was 2.3 minutes and 1.4 minutes for the adults and adolescents, respectively. All pain quality icons met or exceeded the criterion for acceptability. DISCUSSION: All a priori objectives for the IPAT2 were achieved in this sample of rheumatology outpatients. With its unique blend of pain quality descriptors and representative images, the IPAT2 may importantly aid the assessment of pain in adults and adolescents with arthritis. Copyright © 2012 by Lippincott Williams &Wilkins. Source

Alexander R.T.,PIC LD Services | Green F.N.,Nursing | O'Mahony B.,Psychology | Gunaratna I.J.,PIC LD Services | And 2 more authors.
Journal of Intellectual Disability Research | Year: 2010

Aim: To establish any differences between patients with and without a diagnosis of personality disorders, being treated in a secure inpatient service for offenders with intellectual disability (ID) in the UK. Method: A cohort study involving a selected population of people with ID and offending behaviours. Results: The study included a total of 138 patients, treated over a 6 year period - 77 with a dissocial or emotionally unstable personality disorder and 61 without. Women were more likely to be in the personality disorder group. Both groups had high prevalence of abuse with no significant differences. Depressive disorders and substance abuse were more common in the personality disorder group, while epilepsy and autistic spectrum disorders were more common in the non-personality disorder group. Rather than differences, what was more striking was the rate and range of these comorbidities across both groups. Although past histories of violence and institutional aggression were no different, compulsory detention under criminal sections and restriction orders were more common in the personality disorder group. There were no differences in treatment outcomes. Conclusions: Although about half of patients detained in secure units for offenders with ID have a personality disorder, there were more similarities than differences between this group and the rest. While good treatment outcomes supported the case for specialised secure treatment units for people with ID, the case for establishing a more specialised ID-personality disorder unit was less convincing. There is also a need to explore whether there are alternative diagnostic models that can delineate better the group with personality difficulties in this population. © 2010 The Authors. Journal Compilation © 2010 Blackwell Publishing Ltd. Source

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