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1.
D. J. W. Hunter C. M. McKee N. A. Black C. F. B. Sanderson 《Quality of life research》1995,4(4):335-341
Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to the decision to undergo surgery. A cross-sectional population survey using postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing prostatectomy (North West Thames and Oxford regions). The subjects in the first survey were 221 men aged 55 and over with previously reported mild, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy. Main outcome measures were selfreported symptom severity, bothersomeness and general health status (Nottingham Health Profilie, Part 1). The response rate among eligible responders in the population survey was 85.7%. Increasing symptom severity was associated with worsening NHP scores for energy, emotional reactions, sleep and physical mobility (p<0.01). Increasing bother-someness of symptoms was associated with emotional reactions, sleep and pain (p<0.05). Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards emotional reactions, energy and pain. For a given level of symptom severity, the impact of those symptoms on aspects of a man's general health status may be the determinant of seeking and undergoing surgery. Greater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept treatment. 相似文献
2.
Toshiaki Moriki Tamotsu Takahashi Makoto Hiroi Toshiko Yamane Hiroshi Hara 《Pathology international》1996,46(6):417-425
Thirty cases of invasive ductal carcinoma of the breast were classified to histological subtype according to the General Rules for Clinical and Pathological Recording of Breast Cancer of the Japanese Breast Cancer Society and histologically graded using the Nottingham method and the correlation of histology with proliferative activity was investigated using bromodeoxyuridine (BrdU). In addition, the overexpression of p53 protein, c-erbB-2 oncoprotein and estrogen receptor (ER) were immunohistochemically examined in order to discuss the relationship with histological subtype and histological grade. Histological grade correlated positively to the BrdU labeling index (LI) and overexpression of p53. High grade carcinoma demonstrated c-erbB-2 more frequently and exhibited a low incidence of ER. However, no significant relationship was found between BrdU LI, overexpression of p53 and c-erbB-2 and histological subtype. These results suggest that the histological grade does represent the proliferative activity of tumor cells and that adding the histological grade to the pathological diagnosis in invasive ductal breast carcinoma may be useful from the clinicopathological aspect concerning tumor behavior. 相似文献
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4.
P J Tyrer I Lee J G Edwards B Steinberg E J Elliott J H Nightingale 《Journal of affective disorders》1980,2(3):149-156
The outcome of antidepressant drug treatment was measured in 200 patients, 145 seen in psychiatric out-patient clinics and 55 in general practice, after 4 weeks of therapy. The results of the 200 patients taken together suggested that prognosis was largely determined by factors dependent on the natural history of the disorder and that clinical symptoms were unimportant, but when the results for patients in each drug group were analysed separately symptoms were more important than natural history factors. We conclude that clinical symptoms are only important predictors of response to antidepressant drugs when the patients studied are homogeneous with regard to natural history factors, particularly duration of illness. 相似文献
5.
A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively. 相似文献
6.
Background
Emergency departments see uniquely large numbers of patients across all demographic groups who are more likely to smoke and who attend with acute health concerns that can provide an impetus for behaviour change. Despite this potential opportunity, no smoking cessation programme in any UK emergency department yet exists. This study sought to identify perceived barriers and facilitators for emergency department smoking cessation activity, as well as potential modes of intervention, by exploring staff attitudes.Methods
16 members of staff from the Emergency Department, Derby NHS Teaching Hospital were purposively sampled to include a spectrum of clinical and non-clinical roles, grades, and employment duration. Semi-structured interviews were conducted within the department, and thematically analysed with dual-coding for validity under an interpretivist paradigm.Findings
Three themes were identified: roles of emergency departments, effects of smoking, and scope for intervention. Effects were described in individual-health and department-management contexts, with belief that reducing patient smoking would benefit both. Health promotion was seen as theoretically part of, and practically achievable within, the emergency department role. Lack of organisational support was a key barrier. Staff practice included occasional ad-hoc smoking cessation activity, but nothing routine. Those who did not incorporate smoking cessation into their practice felt that lack of training and support, rather than time, stopped them from doing so.Interpretation
Support for emergency department smoking cessation was found in the face of major barriers. Options to address these barriers were suggested, highlighting a willingness to engage. Complex interventions appeared impractical, and no single approach seemed universally applicable to emergency department environments. This study addresses the paucity of evidence around emergency department attitudes towards smoking cessation by providing a unique and in-depth picture of staff in the study department. It also balances clinical and population health viewpoints and has potential to inform promising prevention strategies in the emerging population-focused health-care structures. However, the study might not be generalisable to other emergency departments. Further research exploring patient attitudes would be a valuable next step.Funding
Health Education East Midlands. 相似文献7.
Y Fong J Evans D Brook J Kenkre P Jarvis K Gower-Thomas 《Annals of the Royal College of Surgeons of England》2015,97(2):137-139
Introduction
The Nottingham Prognostic Index (NPI) is an established prognostication tool in the management of breast cancers (BCs). Latest ten-year survival data have demonstrated an improved outlook for each NPI category and the latest UK five- and ten-year survival from BC has been reported to be 85% and 77%, respectively. We compared survival of each NPI category for BCs diagnosed within the national breast screening service in Wales (Breast Test Wales (BTW)) to the latest data, and reviewed its validity in unselected cases within a screened population.Methods
All women screened between 1998 and 2001 within BTW were included. The NPI score for each cancer was calculated using the size, nodal status, and grade of the primary tumour. Survival data (all-cause) were calculated after ten years of follow-up.Results
In the three-year screening period, 199,082 women were screened. A total of 1,712 cancers were diagnosed, and 1,546 had data available for calculating the NPI. Overall five-year and ten-year survival was 94% and 82%, respectively.Conclusions
Overall five-year and ten-year survival (all-cause) has improved even when compared with UK data for BC-specific survival. We found that the NPI remains valid for BC treatment, and that our data provide a reference for updating the all-cause survival of women diagnosed with BCs within a screened population. 相似文献8.
Relationship between mammaglobin expression and estrogen receptor status in breast tumors 总被引:3,自引:0,他引:3
Guan XF Hamedani MK Adeyinka A Walker C Kemp A Murphy LC Watson PH Leygue E 《Endocrine》2003,21(3):245-250
9.
10.
The aim of the present study was to assess the health related quality of life of adult diabetic patients using the Nottingham Health Profile (NHP) as a measure. A further aim was to describe different Quality of Life (QOL) outcomes in different treatment groups of diabetes. The target population consisted of all registered adult (18 years or older) diabetic patients (n = 2519) in the district of Oulu, a city of 100000 inhabitants in Northern Finland. All these persons were invited to participate in a screening examination for diabetic retinopathy, and the NHP questionnaire was mailed along with this invitation. A total of 1804 patients (72 %) returned the NHP questionnaire when they came to the fundus photography session. The data were analysed by using mean values of NHP dimensions with the 95 % confidence intervals (CI) and the logistic regression analysis to predict the risk (OR) for having at least one health problem in a particular dimension. The results indicated that patients with tablet treatment had significantly lower QOL levels than the ‘general population’ in all NHP dimensions. The diet treatment group patients had lower QOL levels than the ‘general population’ only in the ‘Sleep’ and ‘Social isolation’ dimensions. The diet group had a significantly better QOL level in all six dimensions of QOL of NHP than the tablet treatment or combined treatment (patients treated with tablets and insulin) groups. The tablet treatment and combined treatment groups did not differ significantly in any of the NHP dimensions. The logistic models testing the presence of at least one problem in the NHP dimensions showed that the number of other diseases increased the risk of having QOL problems in all dimensions and duration of the diabetes and the age of the patient had risk increasing effects in four NHP dimensions while the gender had only a small effect on the QOL in diabetic patients. The study shows that the NHP questionnaire as a general measure of the QOL reveals differences in the QOL between the different treatment groups and between diabetic patients and general population. 相似文献