Purpose A phase III trial (Cancer and Leukemia Group B CALGB-49907) was conducted to test whether older patients with early-stage breast cancer would have equivalent relapse-free and overall survival with capecitabine compared with standard chemotherapy. The quality of life (QoL) substudy tested whether capecitabine treatment would be associated with a better QoL than standard chemotherapy. Patients and Methods QoL was assessed in 350 patients randomly assigned to either standard chemotherapy (cyclophosphamide, methotrexate, and fluorouracil [CMF] or doxorubicin and cyclophosphamide [AC]; n = 182) or capecitabine (n = 168). Patients were interviewed by telephone before treatment (baseline), midtreatment, within 1 month post-treatment, and at 12, 18, and 24 months postbaseline by using questionnaires from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30), a breast systemic adverse effects scale (EORTC BR23), and the Hospital Anxiety and Depression Scale (HADS). Results Compared with patients who were treated with standard chemotherapy, patients who were treated with capecitabine had significantly better QoL, role function, and social function, fewer systemic adverse effects, less psychological distress, and less fatigue during and at the completion of treatment (P ≤ .005). Capecitabine treatment was associated with less nausea, vomiting, and constipation and with better appetite than standard treatment (P ≤ .004), but worse hand-foot syndrome and diarrhea (P < .005). These differences all resolved by 12 months. Conclusion Standard chemotherapy was superior to capecitabine in improving relapse-free and overall survival for older women with early-stage breast cancer. Although capecitabine was associated with better QoL during treatment, QoL was similar for both groups at 1 year. The brief period of poorer QoL with standard treatment is a modest price to pay for a chance at improved survival.
This article critically assesses the compliance model of employment standards enforcement through a study of monetary employment standards violations in Ontario, Canada. The findings suggest that, in contexts where changes to the organisation of work deepen insecurity for employees, models of enforcement that emphasise compliance over deterrence are unlikely to effectively prevent or remedy employment standards violations.
The current results highlight the importance of considering a range of childhood adversities and suggest that public health approaches that aim to decrease the prevalence and severity of child maltreatment have the potential to ameliorate adult multimorbidities. Future research is encouraged to investigate these issues using longitudinal population-level data.
Solicited journal entries are a qualitative research method with a fairly strong tradition in sociological research and particularly in qualitative health research. However, the practices and strengths associated with solicited journal entries have not been explored as frequently or comprehensively as more conventional qualitative research methods, such as interviews. During the COVID-19 pandemic we carried out two online studies employing solicited written journal entries and photos. One study focused on pregnancy and health care experiences during the pandemic and the other on everyday life while working from home due to public health restrictions. Here, we discuss solicited online journal entries as a qualitative method and reflect on the strengths and challenges we encountered, including those related to using the online survey tool LimeSurvey for a qualitative diary-based study. The richness of data and the ability to solicit participants’ contemporaneous reflections over the course of a set length of time, the ability to reach people across time zones and in multiple places, and the ability to adapt prompts in a quickly changing research context are major strengths of online journaling. The level of commitment required by participants, the potential for attrition, the need for literacy and technology access, and the large amount of data from each participant are potential limitations for researchers to consider.
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