1,327 research outputs found
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The Supportive Care Needs of Regional and Remote Cancer Caregivers
Objective: As cancer survival rates continue to increase, so will the demand for care from family and friends, particularly in more isolated settings. This study aims to examine the needs of cancer caregivers in regional and remote Australia. Methods: A total of 239 informal (i.e., non-professional) cancer caregivers (e.g., family/friends) from regional and remote Queensland, Australia, completed the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C). The frequencies of individuals reporting specific needs were calculated. Logistic regression analyses assessed the association between unmet needs and demographic characteristics and cancer type. Results: The most frequently endorsed needs were lodging near hospital (77%), information about the disease (74%), and tests and treatment (74%). The most frequent unmet needs were treatment near home (37%), help with economic burden (32%), and concerns about the person being cared for (32%). Younger and female caregivers were significantly more likely to report unmet needs overall (OR = 2.12; OR = 0.58), and unmet healthcare staff needs (OR = 0.35; OR = 1.99, respectively). Unmet family and social support needs were also significantly more likely among younger caregivers (OR = 0.35). Caregivers of breast cancer patients (OR = 0.43) and older caregivers (OR = 0.53) were significantly less likely to report unmet health and psychology needs. Proportions of participants reporting needs were largely similar across demographic groups and cancer type with some exceptions. Conclusions: Caregiver health, practical issues associated with travel, and emotional strain are all areas where regional and remote caregivers require more support. Caregiversâ age and gender, time since diagnosis and patient cancer type should be considered when determining the most appropriate supportive care
A systematic review of geographical differences in management and outcomes for colorectal cancer in Australia.
BACKGROUND: Australia and New Zealand have the highest incidence of colorectal cancer (CRC) in the world, presenting considerable health, economic, and societal burden. Over a third of the Australian population live in regional areas and research has shown they experience a range of health disadvantages that result in a higher disease burden and lower life expectancy. The extent to which geographical disparities exist in CRC management and outcomes has not been systematically explored. The present review aims to identify the nature of geographical disparities in CRC survival, clinical management, and psychosocial outcomes. METHODS: The review followed PRISMA guidelines and searches were undertaken using seven databases covering articles between 1 January 1990 and 20 April 2016 in an Australian setting. Inclusion criteria stipulated studies had to be peer-reviewed, in English, reporting data from Australia on CRC patients and relevant to one of fourteen questions examining geographical variations in a) survival outcomes, b) patient and cancer characteristics, c) diagnostic and treatment characteristics and d) psychosocial and quality of life outcomes. RESULTS: Thirty-eight quantitative, two qualitative, and three mixed-methods studies met review criteria. Twenty-seven studies were of high quality, sixteen studies were of moderate quality, and no studies were found to be low quality. Individuals with CRC living in regional, rural, and remote areas of Australia showed poorer survival and experienced less optimal clinical management. However, this effect is likely moderated by a range of other factors (e.g., SES, age, gender) and did appear to vary linearly with increasing distance from metropolitan centres. No studies examined differences in use of stoma, or support with stomas, by geographic location. CONCLUSIONS: Overall, despite evidence of disparity in CRC survival and clinical management across geographic locations, the evidence was limited and at times inconsistent. Further, access to treatment and services may not be the main driver of disparities, with individual patient characteristics and type of region also playing an important role. A better understanding of factors driving ongoing and significant geographical disparities in cancer related outcomes is required to inform the development of effective interventions to improve the health and welfare of regional Australians
Geographic disparities in previously diagnosed health conditions in colorectal cancer patients are largely explained by age and area level disadvantage
© 2018 Goodwin, March, Ireland, Crawford-Williams, Ng, Baade, Chambers, Aitken and Dunn. Background: Geographical disparity in colorectal cancer (CRC) survival rates may be partly due to aging populations and disadvantage in more remote locations; factors that also impact the incidence and outcomes of other chronic health conditions. The current study investigates whether geographic disparity exists amongst previously diagnosed health conditions in CRC patients above and beyond age and area-level disadvantage and whether this disparity is linked to geographic disparity in CRC survival. Methods: Data regarding previously diagnosed health conditions were collected via computer-assisted telephone interviews with a cross-sectional sample of n = 1,966 Australian CRC patients between 2003 and 2004. Ten-year survival outcomes were acquired in December 2014 from cancer registry data. Multivariate logistic regressions were applied to test associations between previously diagnosed health conditions and survival rates in rural, regional, and metropolitan areas. Results: Results suggest that only few geographical disparities exist in previously diagnosed health conditions for CRC patients and these were largely explained by socio-economic status and age. Living in an inner regional area was associated with cardio-vascular conditions, one or more respiratory diseases, and multiple respiratory diagnoses. Higher occurrences of these conditions did not explain lower CRC-specific 10 years survival rates in inner regional Australia. Conclusion: It is unlikely that health disparities in terms of previously diagnosed conditions account for poorer CRC survival in regional and remote areas. Interventions to improve the health of regional CRC patients may need to target issues unique to socio-economic disadvantage and older age
Pure-glue hidden valleys through the Higgs portal
We consider the possibility that the Higgs boson can act as a link to a
hidden sector in the context of pure-glue hidden valley models. In these models
the standard model is weakly coupled, through loops of heavy messengers fields,
to a hidden sector whose low energy dynamics is described by a pure-Yang-Mills
theory. Such a hidden sector contains several metastable hidden glueballs. In
this work we shall extend earlier results on hidden valleys to include
couplings of the messengers to the standard model Higgs sector. The effective
interactions at one-loop couple the hidden gluons to the standard model
particles through the Higgs sector. These couplings in turn induce hidden
glueball decays to fermion pairs, or cascade decays with multiple Higgs
emission. The presence of effective operators of different mass dimensions,
often competing with each other, together with a great diversity of states,
leads to a great variability in the lifetimes and decay modes of the hidden
glueballs. We find that most of the operators considered in this paper are not
heavily constrained by precision electroweak physics, therefore leaving plenty
of room in the parameter space to be explored by the future experiments at the
LHC.Comment: 44 pages, 16 figures. Major revision for JHEP, corrected an error in
Eq. 5.1, comments adde
The predictive and prognostic potential of plasma telomerase reverse transcriptase (TERT) RNA in rectal cancer patients
Background: Preoperative chemoradiotherapy (CRT) followed by surgery is the standard care for locally advanced rectal cancer,
but tumour response to CRT and disease outcome are variable. The current study aimed to investigate the effectiveness of plasma
telomerase reverse transcriptase (TERT) levels in predicting tumour response and clinical outcome.
Methods: 176 rectal cancer patients were included. Plasma samples were collected at baseline (before CRT\ubcT0), 2 weeks after
CRT was initiated (T1), post-CRT and before surgery (T2), and 4\u20138 months after surgery (T3) time points. Plasma TERT mRNA levels
and total cell-free RNA were determined using real-time PCR.
Results: Plasma levels of TERT were significantly lower at T2 (Po0.0001) in responders than in non-responders. Post-CRT TERT
levels and the differences between pre- and post-CRT TERT levels independently predicted tumour response, and the prediction
model had an area under curve of 0.80 (95% confidence interval (CI) 0.73\u20130.87). Multiple analysis demonstrated that patients with
detectable TERT levels at T2 and T3 time points had a risk of disease progression 2.13 (95% CI 1.10\u20134.11)-fold and 4.55 (95% CI
1.48\u201313.95)-fold higher, respectively, than those with undetectable plasma TERT levels.
Conclusions: Plasma TERT levels are independent markers of tumour response and are prognostic of disease progression in rectal
cancer patients who undergo neoadjuvant therapy
Evidence-Based Assessment of Child Obsessive Compulsive Disorder: Recommendations for Clinical Practice and Treatment Research
Obsessive-compulsive disorder (OCD) presents heterogeneously and can be difficult to assess in youth. This review focuses on research-supported assessment approaches for OCD in childhood. Content areas include pre-visit screening, diagnostic establishment, differential diagnosis, assessment of comorbid psychiatric conditions, tracking symptom severity, determining psychosocial functioning, and evaluating clinical improvement. Throughout this review, similarities and differences between assessment approaches geared towards clinical and research settings are discussed
The Cosmology of Composite Inelastic Dark Matter
Composite dark matter is a natural setting for implementing inelastic dark
matter - the O(100 keV) mass splitting arises from spin-spin interactions of
constituent fermions. In models where the constituents are charged under an
axial U(1) gauge symmetry that also couples to the Standard Model quarks, dark
matter scatters inelastically off Standard Model nuclei and can explain the
DAMA/LIBRA annual modulation signal. This article describes the early Universe
cosmology of a minimal implementation of a composite inelastic dark matter
model where the dark matter is a meson composed of a light and a heavy quark.
The synthesis of the constituent quarks into dark mesons and baryons results in
several qualitatively different configurations of the resulting dark matter
hadrons depending on the relative mass scales in the system.Comment: 31 pages, 4 figures; references added, typos correcte
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Demonstration of the event identification capabilities of the NEXT-White detector
In experiments searching for neutrinoless double-beta decay, the possibility of identifying the two emitted electrons is a powerful tool in rejecting background events and therefore improving the overall sensitivity of the experiment. In this paper we present the first measurement of the efficiency of a cut based on the different event signatures of double and single electron tracks, using the data of the NEXT-White detector, the first detector of the NEXT experiment operating underground. Using a 228Th calibration source to produce signal-like and background-like events with energies near 1.6 MeV, a signal efficiency of 71.6 ± 1.5 stat± 0.3 sys% for a background acceptance of 20.6 ± 0.4 stat± 0.3 sys% is found, in good agreement with Monte Carlo simulations. An extrapolation to the energy region of the neutrinoless double beta decay by means of Monte Carlo simulations is also carried out, and the results obtained show an improvement in background rejection over those obtained at lower energies. [Figure not available: see fulltext.
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Radiogenic backgrounds in the NEXT double beta decay experiment
Natural radioactivity represents one of the main backgrounds in the search for neutrinoless double beta decay. Within the NEXT physics program, the radioactivity- induced backgrounds are measured with the NEXT-White detector. Data from 37.9 days of low-background operations at the Laboratorio SubterrĂĄneo de Canfranc with xenon depleted in 136Xe are analyzed to derive a total background rate of (0.84±0.02) mHz above 1000 keV. The comparison of data samples with and without the use of the radon abatement system demonstrates that the contribution of airborne-Rn is negligible. A radiogenic background model is built upon the extensive radiopurity screening campaign conducted by the NEXT collaboration. A spectral fit to this model yields the specific contributions of 60Co, 40K, 214Bi and 208Tl to the total background rate, as well as their location in the detector volumes. The results are used to evaluate the impact of the radiogenic backgrounds in the double beta decay analyses, after the application of topological cuts that reduce the total rate to (0.25±0.01) mHz. Based on the best-fit background model, the NEXT-White median sensitivity to the two-neutrino double beta decay is found to be 3.5Ï after 1 year of data taking. The background measurement in a QÎČÎȱ100 keV energy window validates the best-fit background model also for the neutrinoless double beta decay search with NEXT-100. Only one event is found, while the model expectation is (0.75±0.12) events. [Figure not available: see fulltext.]
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