A model for quality of life measures in patients with dementia: Lawron's next step

The introduction of drugs that are claimed to improve cognitive function and activities of daily living in patients with Alzheimer's disease raises the question of whether these drugs also influence dementia patients' quality of life (QOL). We describe a hierarchic model of QOL of dementia patients, which can guide the development of measurement instruments. After initially discussing broadly QOL research, we focus on two highly important characteristics of the concept, its broadness and subjectivity, against the background of the relevant literature on QOL in dementia. Dementia-specific dimensions and domains are presented. We identify psychological well-being as the core dimension for QOL of patients with dementia. Copyright © 2004 S. Karger AG, Basel

Geriatrische Assessments und Diagnostik beim älteren Patienten

As is the case with younger patients, the treatment decisions for elderly patients with thoracic tumours are primarily based on the results of the usual routine diagnostics. Standardised assessments of existing comorbidities and geriatric assessments may provide information which are of particular relevance for intensive and/or complex therapy modalities and which may require early corresponding intervention or measures for support

Regional environments and sector developments: the biotech sector in Oxfordshire

This paper explores the interdependence between national policy, the local characteristics of the UK’s biotechnology sectoral system of innovation and the growth of Oxfordshire’s biotech sector. It considers on the one hand the county’s research capacity and on the other its innovation performance. The latter is captured by a series of indicators from a recently completed study of the sector, recording the sector’s evolution both in the number of firms and their employment size, their status (independent, merged/acquired), product group and contribution to local employment and wealth creation. It considers the implications of the relative weaknesses in the system of innovation in this sector which relate to an underperformance of its firms in relation to the strength of the science base

Innovation capacity in the healthcare sector and historical anchors: examples from the UK, Switzerland and the US

Innovation is an integral part of economic development in developed economies. In the post 2008 period, a key policy agenda is that of sustainable development, which calls for innovation in all aspects of value-chains. In this paper, we focus on innovation from the biotech—pharma perspective to see whether or not this will lead to a sustainable future for the regions where there are clusters of firms in this sector. We examine data from a recently completed European Union study of innovation in the Healthcare sector from the UK and Switzerland, countries with an historical base in pharma, to understand how innovation pathways vary at the regional level in the broader life sciences, which incorporate biotech and more. Innovation in the healthcare sector in two regions, Oxfordshire in the UK and Zurich in Switzerland are compared. We contextualize our discussion by drawing on studies that focus on the sector in the US, specifically Boston. The analytical framework comprises three elements: innovation systems and national and regional economic development theories are the first two, followed by approaches which consider organizational or institutional activity. This framework is used to help explain and understand the complexity of how innovation is organized at the sub-national level. The overall context is that it is increasing becoming a condition for government financing of research that it has more immediate application in industry or have the possibility of commercialisation (e.g., translational research)

Policies for new path development: the case of Oxfordshire

This chapter reflects on how evolutionary economic geography (EEG) can be extended to incorporate public policy in its explanations of path development. A weakness of EEG is the poor conceptualisation of the role of the state (central, regional, local) in regional path development. It is therefore argued that a multi-scalar perspective of policy is required and that a large set of policies deserve attention. Oxfordshire in the UK is used to explore the link between public policy and path development

Social support and sense of loneliness in solitary older adults

Older people are vulnerable to loneliness and isolation. Solitary seniors are more likely to suffer the feelings of loneliness with inadequate social networks. Based on a face-to-face questionnaire survey with 151 community-dwelling solitary seniors, the present study examined the associations between social support and the sense of loneliness among solitary older adults in Hong Kong. The results showed that poor mental health status, financial inadequacy and weak social support networks were significantly associated with the sense of loneliness of solitary older adults, with social support being the most prominent risk factor. Frequent contacts with siblings, relatives or friends were found to be important sources of social support to combat loneliness. Policy and service implications are discussed

Staging quality is related to the survival of women with endometrial cancer: a Scottish population based study.Deficient surgical staging and omission of adjuvant radiotherapy is associated with poorer survival of women diagnosed with endometrial cancer in Scotland during 1996 and 1997

The association between treatment variation and survival of women with endometrial cancer was investigated. A retrospective cohort based upon the complete Scottish population registered on in-patient and day-case hospital discharge data (Scottish Morbidity Record-1) and cancer registration (Scottish Morbidity Record-6) coded C54 and C55 in ICD10, between 1st January 1996 to 31st December 1997 were analysed. Seven hundred and three patients who underwent surgical treatment out of 781 patients that were diagnosed with endometrial cancer in Scotland during 1996 and 1997. The overall quality of surgical staging was poor. The quality of staging was related to both the year that the surgeon passed the Member of the Royal College of Obstetricians and Gynaecologists examination and also to ‘specialist’ status but was not related to surgeon caseload. Two clinically important prognostic factors were found to be associated with survival; whether the International Federation of Obstetrics and Gynaecology stage was documented, RHR=2.0 (95% CI=1.3 to 3.1) and also to the use of adjuvant radiotherapy, RHR=2.2 (95% CI=1.5 to 3.5). The associations with survival were strongest in patients with advanced disease, International Federation of Obstetrics and Gynaecology stages 1C through to stage 3. Deficiencies in staging and variations in the use of adjuvant radiotherapy represent a possible source of avoidable mortality in patients with endometrial cancer. Consequently, there should be a greater emphasis on improving the overall quality of surgical staging in endometrial cancer