Objective The concept of living with and beyond cancer is now emerging in policy and literature. Rather than viewing this notion simply as a linear timeline, developing an agreed understanding of the lived experience of people affected by cancer will aid the development of person‐centred models of care. Methods A systematic review was conducted. The review question was “What does the term ‘living with and beyond cancer’ mean to people affected by cancer?” The protocol for the review was preregistered in the PROSPERO database (PROSPERO CRD42017059860). All included studies were qualitative, so narrative synthesis was used to integrate descriptions and definitions of living with and beyond cancer into an empirically based conceptual framework. Results Out of 2345 papers that were identified and 180 that were reviewed, a total of 73 papers were included. The synthesis yielded three interlinked themes: Adversity (realising cancer), Restoration (readjusting life with cancer), and Compatibility (reconciling cancer), resulting in the ARC framework. Conclusions Three themes describe the experience of living with and beyond cancer: adversity, restoration, and compatibility. The ARC framework provides an empirically informed grounding for future research and practice in supportive cancer care for this population.
Abstract. The task of IMRT planning, particularly in head-and-neck cancer, is a difficult one, often requiring days of work from a trained dosimetrist. One of the main challenges is the prescription of achievable target doses that will be used to optimize a treatment plan. This work explores a data-driven approach in which effort spent on past plans is used to assist in the planning of new patients. Using a database of treated patients, we identify the features of patient geometry that are correlated with received dose and use these to prescribe target dose levels for new patients. We incorporate our approach in a quality-control system, identifying patients with organs that received a dose significantly higher than the one recommended by our method. For all these patients, we have found that a replan using our predicted dose results in noticeable sparing of the organ without compromising dose to other treatment volumes.
The results suggest that individual differences and social and clinical factors impact on disclosure and that medical professionals play an important role in the disclosure process.
Lonchocarpol A, a flavanone, demonstrates in vitro inhibitory activity against methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium. This activity is antagonized by mouse plasma, which may account for its lack of in vivo activity. This compound demonstrates no differentiation with respect to the inhibition of RNA, DNA, cell wall, and protein synthesis.
Background: Ciliated cells in gastrectomies from patients dwelling in the Pacific and Atlantic basins have been reported previously. Aim: To compare all the results in an attempt to explain the findings. Methods: Sections from 3406 gastrectomies were reviewed: 1966 and 1440 from the Atlantic and Pacific basins, respectively. Ciliated cells and intestinal metaplasia (IM) were recorded; IM was classified into focal or extensive IM. The total number of sections/gastrectomy was noted. Results: In the Atlantic basin, 5% of specimens had ciliated metaplasia (CM); it was more frequent in intestinal carcinoma (IC; 9%) than diffuse carcinoma (DC; 3%) or miscellaneous gastric diseases (MGD; 3%). In the Pacific basin, the frequency of specimens with CM was 29%: it was more frequent in IC (43%) than in DC (16%) or MGD (10%). The difference between the frequency of CM in specimens with IC or with DC/MGD in the Atlantic and the Pacific basins was significant (p ( 0.05). The presence of CM was influenced by age and the extent of IM in both basins, but not by sex or the number of sections investigated. Conclusions: CM-apparently an independent microscopic marker-was significantly higher in the Pacific than in the Atlantic basin. Environmental carcinogens involved in the evolution of IM and IC seem to be implicated in gastric ciliogenesis. Carcinogens that differ in nature and/or in strength in both basins might activate the latent natural genes encoding ciliated processes in gastric cells in patients subsequently developing gastric carcinoma, more notably of intestinal type.
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