3,307 research outputs found

    A case study of survival and presentation of gastroesophageal cancer in local neighbourhoods

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    This thesis presents a quantitative case study on incidence, survival and presentation of patients diagnosed with gastroesophageal cancer to evaluate whether where people live affects how they present and survive with a gastroesophageal cancer diagnosis. The focus research evolved from studies on gastroesophageal cancer’s ‘geographic affiliation’ and a desire to review whether patient and population attributes could be harnessed to reveal potential ‘hotspots’ to inform targeted health intervention strategies. As the most crucial stage for intervention was associated with patients detecting symptoms early enough for intervention, the focus of this case study was narrowed to survival and presentation.This research analysed data from 2785 patients who presented to a regional referral specialist cancer treatment centre between the years 2000 and 2013. Cohort analysis revealed common attributes and survival, and data were merged with demographic information in a geographic information system to present findings in mapped format.Descriptive analysis revealed an association between later stage presentation and reduced survival outcome. Emergency presentations tended to have worse outcomes. Survival deteriorated with advancing age. Gastroesophageal cancer diagnoses in the under 54 age group was more common in lower socioeconomic groups and survival outcomes were marginally lower than in those patients from the least deprived areas. Spatial analysis revealed variation in incidence, presentation and survival across the region. Though this case study revealed several new findings on gastroesophageal cancer presentation and survival, there remains no single solution to informing and encouraging earlier diagnosis interventions. Though presenting data at finer scales of resolution is more clinically relevant, it threatens patient confidentiality

    Comparing Wearer DNA Sample Collection Methods for the Recovery of Single Source Profiles

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    Wearer DNA is the deposit of epithelial cells on clothing worn by an individual. Detection of the last individual to handle or wear an item is often an important and desirable determination in forensic science. The most commonly used collection methods for wearer DNA include swabbing and scraping. These often result in mixture profiles. Recently, adhesives have been introduced as a possible reliable method for the collection of biological evidence. The goal of the research was to compare the current collection methods of swabbing and scraping with a gel film called Gel-Pak ‘0’ which shares similar properties with adhesives. Gel-Pak ‘0’ has been previously studied in comparison to other adhesives for the collection of epithelial cells, and was shown to recover the top layer of loose particulate. This particulate had a tendency to be deposited by the individual who last came in contact with an item. Therefore, in comparison to the other two collection methods, Gel-Pak ‘0’ was hypothesized to recover single source profiles on clothing items from the most recent wearer. DNA analysis was performed on samples collected by the three methods from various clothing items including baseball hats, t-shirts, sweatpants, socks, and other items commonly submitted to crime labs for DNA analysis. The habitual wearer and the second/last wearer wore each item for a predetermined amount of time. The results of the research showed that Gel-Pak ‘0’ recovered a similar number of CODIS (local and national) eligible profiles as swabbing. However, coupled with the fact that it is time consuming, costly, and cannot be used on all surfaces, Gel-Pak ‘0’ was determined to not make for an effective collection method of the most recent wearer’s DNA. Therefore, Gel-Pak ‘0’ will not be considered for casework. Although Gel-Pak ‘0’ will not be further used, the results did reveal some trends that may shed light on how DNA analysts may approach wearer DNA cases. Swabbing had a tendency to yield smaller amounts of DNA in comparison to scraping, but obtain DNA from the last wearer of the piece of clothing more effectively than the other two methods. Scraping had a tendency to yield greater quantities of DNA, recovering more DNA from the habitual wearer due to its invasive nature. Revealing individuals who last wore an item can be of great importance in forensic science, and therefore, further research with various adhesives and gel films could be vital for solving forensic investigations

    Healthcare professionals must communicate with patients and relatives. They must enable informed, realistic and appropriate decisions in end-of-life pharmacotherapy

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    Commentary on: Morin L, Wastesson JW, Laroche ML, et al. Howmany older adults receive drugs of questionable clinical benefitnear the end of life? A cohort study. Palliat Med 2019;33:1080–90. doi: 10.1177/0269216319854013

    Long term outcomes in men screened for abdominal aortic aneurysm : prospective cohort study

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    PMID: 22563092 [PubMed - indexed for MEDLINE] PMCID: PMC3344734 Free PMC ArticlePeer reviewedPublisher PD

    Older people’s motivations for participating in community singing in Australia

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    The aim of this project was to investigate the motivations of older people who regularly attend community singing groups in Australia. Four focus group interviews were conducted with 64 participants belonging to three community singing groups. Participants explained their motivation to attend and sing with others in the groups. A total of eight motivating factors were identified via an inductive thematic analysis, including (1) the importance of singing in my life; (2) enormous pleasure of singing with little pressure; (3) challenge and achievement; (4) spiritual and uplifting emotions; (5) strength in overcoming my age, disease and hardship; (6) good leadership; (7) fellowship with others; and (8) purpose and meaning of group singing. The themes were discussed from various perspectives including positive psychology and the PERMA well-being model. The findings suggest that the older participants seem to experience different motivation factors while at different stages of their engagement in the groups
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