The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

On embracing plurality and tolerating ambiguity in the definitions of hypnosis

5 page(s

High hypnotizability : unity and diversity in behviour and experience

24 page(s

Defining and identifying the highly hypnotisable person

31 page(s

Defining hypnosis : process, product, and the value of tolerating ambiguity : commentary : on the centrality of the concept of an altered state to definitions of hypnosis

3 page(s

The Province of “highs”: the high hypnotizable person in the science of hypnosis and in psychological science

The ability to genuinely and completely respond to hypnotic suggestion is the province of high hypnotizable people (“highs”). The abilities and experiences of highs are fascinating and important to hypnosis researchers in particular and to psychological researchers generally. To illustrate, first we discuss the role of highs in the science of hypnosis. We introduce the high hypnotizable people who helped shape theoretical discussions about the nature of hypnosis. Second, we discuss the contributions of highs in psychological science. We focus on the relevance of hypnosis research to general scientific problems in psychology and the use of hypnosis to turn highs temporarily into virtual patients to understand a range of psychological phenomena. Finally, we consider why highs are so helpful in these enterprises. We consider the nature of hypnotic models, the correlates and components of high hypnotizability, and the best ways to tap potential overlaps between hypnotic ability and differences in or predictors of the specific psychological phenomena that highs help us study.16 page(s