31 research outputs found
Type of cancer treatment and cognitive symptoms in working cancer survivors: an 18-month follow-up study
Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands
Hypopharynx cancer has the worst prognosis of all head and neck squamous cell cancers. Since the 1990s, a treatment shift has appeared from a total laryngectomy towards organ preservation therapies. Large randomized trials evaluating treatment strategies for hypopharynx cancer, however, remain scarce, and frequently this malignancy is evaluated together with larynx cancer. Therefore, our aim was to determine trends in incidence, treatment and survival of hypopharynx cancer. We performed a population-based cohort study including all patients diagnosed with T1-T4 hypopharynx cancer between 1991 and 2010 in the Netherlands. Patients were recorded by the national cancer registry database and verified by a national pathology database. 2999 patients were identified. The incidence increased significantly with 4.1% per year until 1997 and decreased non-significantly afterwards. For women, the incidence increased with 1.7% per year during the entire study period. Total laryngectomy as primary treatment significantly decreased, whereas radiotherapy and chemoradiation increased. The 5-year overall survival significantly increased from 28% in 1991-2000 to 34% in 2001-2010. Overall survival for T3 was equal for total laryngectomy and (chemo)radiotherapy, but for T4-patients the survival was significantly better after primary total laryngectomy (+/- adjuvant radiotherapy). This large population-based study demonstrates a shift in treatment preference towards organ preservation therapies. The 5-year overall survival increased significantly in the second decade. The assumed equivalence of organ preservation and laryngectomy may require reconsideration for T4 diseas
Salivary gland pleomorphic adenoma in the Netherlands:A nationwide observational study of primary tumor incidence, malignant transformation, recurrence, and risk factors for recurrence
Social and Economic Challenges of Implementing Sustainable Materials on Buildings in Kuwait
Many factors affect attaining the required credits for LEED materials and Many factors affect attaining the required credits for LEED materials and
resources (MR) section. There are disadvantages in obtaining credits and LEED
certifying an existing building in Kuwait to become a sustainable green building. LEED
is still relatively new in Kuwait and the Gulf region, therefore, when certifying an
existing governmental building, difficultly is faced with obtaining complete building
owners, building upper management and occupant cooperation. This raises challenges
when requiring cooperation from building occupants and cleaning staff for the solid
waste management credits which require dedication to reduce the amount of waste going
to landfills and incinerating facilities. The mindset of the contractor and subcontractor
has to change to gain full understanding and cooperation in the waste management of
construction materials when constructing new buildings and performing facility
alterations on site. The selection of sustainable materials is more challenging as many
materials are not available in Kuwait and the surrounding Gulf countries. Transportation
from aboard should be decreased as much as possible to reduce cost as well as decreasing
negative environmental impacts. Green certified materials are more expensive, therefore
decision maker have to be willing to pay the extra cost.
This paper discusses the challenges faced by KISR team as a consultancy body to
certify an existing building according to LEED rating system from the material and
resources aspect. It discusses the acceptance of the building owners, building upper
management and the building occupants to this change and their understanding and
cooperation. Many materials for MR credits 2 and 3 were found difficult to be obtained in
Kuwait and the surrounding gulf region. Some materials were found to be available in the
resources (MR) section. There are disadvantages in obtaining credits and LEED
certifying an existing building in Kuwait to become a sustainable green building. LEED
is still relatively new in Kuwait and the Gulf region, therefore, when certifying an
existing governmental building, difficultly is faced with obtaining complete building
owners, building upper management and occupant cooperation. This raises challenges
when requiring cooperation from building occupants and cleaning staff for the solid
waste management credits which require dedication to reduce the amount of waste going
to landfills and incinerating facilities. The mindset of the contractor and subcontractor
has to change to gain full understanding and cooperation in the waste management of
construction materials when constructing new buildings and performing facility
alterations on site. The selection of sustainable materials is more challenging as many
materials are not available in Kuwait and the surrounding Gulf countries. Transportation
from aboard should be decreased as much as possible to reduce cost as well as decreasing
negative environmental impacts. Green certified materials are more expensive, therefore
decision maker have to be willing to pay the extra cost.
This paper discusses the challenges faced by KISR team as a consultancy body to
certify an existing building according to LEED rating system from the material and
resources aspect. It discusses the acceptance of the building owners, building upper
management and the building occupants to this change and their understanding and
cooperation. Many materials for MR credits 2 and 3 were found difficult to be obtained in
Kuwait and the surrounding gulf region. Some materials were found to be available in th
Feedback preferences of patients, professionals and health insurers in integrated head and neck cancer care
Risk of breast cancer in women after a salivary gland carcinoma or pleomorphic adenoma in the Netherlands
Salivary and mammary gland tumors show morphological similarities and share various characteristics, including frequent overexpression of hormone receptors and female preponderance. Although this may suggest a common etiology, it remains unclear whether patients with a salivary gland tumor carry an increased risk of breast cancer (BC). Our purpose was to determine the risk of BC in women diagnosed with salivary gland carcinoma (SGC) or pleomorphic adenoma (SGPA). BC incidence (invasive and in situ) was assessed in two nationwide cohorts: one comprising 1567 women diagnosed with SGC and one with 2083 women with SGPA. BC incidence was compared with general population rates using standardized incidence ratio (SIR). BC risk was assessed according to age at SGC/SGPA diagnosis, follow-up time and (for SGC patients) histological subtype. The mean follow-up was 7.0Â years after SGC and 9.9 after SGPA diagnosis. During follow-up, 52 patients with SGC and 74 patients with SGPA developed BC. The median time to BC was
Feedback preferences of patients, professionals and health insurers in integrated head and neck cancer care
Background: Audit and feedback on professional practice and health care outcomes are the most often used interventions to change behaviour of professionals and improve quality of health care. However, limited information is available regarding preferred feedback for patients, professionals and health insurers. Objective: Investigate the (differences in) preferences of receiving feedback between stakeholders, using the Dutch Head and Neck Audit as an example. Methods: A total of 37 patients, medical specialists, allied health professionals and health insurers were interviewed using semi-structured interviews. Questions focussed on: “Why,” “On what aspects” and “How” do you prefer to receive feedback on professional practice and health care outcomes?. Results: All stakeholders mentioned that feedback can improve health care by creating awareness, enabling self-reflection and reflection on peers or colleagues, and by benchmarking to others. Patients prefer feedback on the actual professional practice that matches the health care received, whereas medical specialists and health insurers are interested mainly in health care outcomes. All stakeholders largely prefer a bar graph. Patients prefer a pie chart for patient-reported outcomes and experiences, while Kaplan-Meier survival curves are preferred by medical specialists. Feedback should be simple with firstly an overview, and 1-4 times a year sent by e-mail. Finally, patients and health professionals are cautious with regard to transparency of audit data. Conclusions: This exploratory study shows how feedback preferences differ between stakeholders. Therefore, tailored reports are recommended. Using this information, effects of audit and feedback can be improved by adapting the feedback format and contents to the preferences of stakeholders