Search results

1 – 10 of 54
Per page
102050
Citations:
Loading...
Access Restricted. View access options
Article
Publication date: 12 March 2018

David W. Borowski, Sarah Cawkwell, Syed M. Amir Zaidi, Matthew Toward, Nicola Maguire, Dharmendra K. Garg and Talvinder S. Gill

The NHS Bowel cancer screening programme (NHSBCSP) aims to reduce colorectal cancer (CRC) cumulative mortality by up to 23 per cent; long-term outcomes at national level are not…

324

Abstract

Purpose

The NHS Bowel cancer screening programme (NHSBCSP) aims to reduce colorectal cancer (CRC) cumulative mortality by up to 23 per cent; long-term outcomes at national level are not yet known. The purpose of this paper is to examine a local population of CRC patients of screening age for their characteristics and long-term survival in relation to their presentation, including through the NHSBCSP.

Design/methodology/approach

Retrospective analysis of a prospectively maintained CRC database for the years 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.

Findings

Of 528 CRC patients diagnosed in the screening age range, 144(27.3 per cent) presented through NHSBCSP, 308(58.3 per cent) electively with symptoms and 76(14.4 per cent) as emergency. NHSBCSP-diagnosed patients were younger (median 66 vs 68 and 69 years, respectively, p=0.001), had more often left-sided cancers (59(41.0 per cent) vs 82(26.6 per cent) and 24(31.6 per cent), respectively, p=0.001), more UICC-stage I (42(29.2 per cent) vs 49(15.9 per cent) and 2(2.6 per cent)), stage III (59(41.0 per cent) vs 106(34.4 per cent) and 20(26.3 per cent)) and less stage IV disease (8(5.6 per cent) vs 61(19.8 per cent) and 34 (44.7 per cent), respectively, p<0.001). Three-year overall survival was best for NHSBCSP and worst for emergency patients (87.5 per cent vs 69.0 per cent and 35.3 per cent, respectively, LogRank p<0.001).

Originality/value

Patients diagnosed within the NHSBCSP have improved outcome compared to both symptomatic elective and emergency presentations. A reduction in overall cumulative mortality in order of 25 per cent may well be achieved, but continuing high levels of emergency presentations and undetected right-sided disease emphasise need for further improvement in public participation in the NHSBCSP and research into more sensitive and acceptable alternative screening methods.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Access Restricted. View access options
Article
Publication date: 12 June 2017

David W. Borowski, Sarah Cawkwell, Syed M. Amir Zaidi, Matthew Toward, Nicola Maguire and Talvinder S. Gill

Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known…

141

Abstract

Purpose

Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. The purpose of this paper is to examine general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients’ overall survival.

Design/methodology/approach

The paper retrospectively analyses a prospectively maintained CRC database for 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.

Findings

Of 1,145 CRC patients, 937 (81.8 per cent) were diagnosed as symptomatic cancers. In total, 210 GPs from 44 practices were stratified according to their CRC caseload over the study period into low volume (LV, 1-4); medium volume (MV, 5-7); and high volume (HV, 8-21 cases). Emergency presentation (LV: 49/287 (17.1 per cent); MV: 75/264 (28.4 per cent); HV: 105/386 (27.2 per cent); p=0.007) and advanced disease at presentation (LV: 84/287 (29.3 per cent); MV: 94/264 (35.6 per cent); HV: 144/386 (37.3 per cent); p=0.034) was more common amongst HV GPs. Three-year mortality risk was significantly higher for HV GPs (MV: (hazard ratio) HR 1.185 (confidence interval=0.897-1.566), p=0.231, and HV: HR 1.366 (CI=1.061-1.759), p=0.016), but adjustment for emergency presentation and advanced disease largely accounted for this difference. There was some evidence that HV GPs used elective cancer pathways less frequently (LV: 166/287 (57.8 per cent); MV: 130/264 (49.2 per cent); HV: 182/386 (47.2 per cent); p=0.007) and more selectively (CRC/referrals: LV: 166/2,743 (6.1 per cent); MV: 130/2,321 (5.6 per cent); HV: 182/2,508 (7.3 per cent); p=0.048).

Originality/value

Higher GP CRC caseload in primary care may be associated with advanced disease and poorer survival; more work is required to determine the reasons and to develop targeted intervention at local level to improve elective referral rates.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Access Restricted. View access options
Article
Publication date: 27 December 2021

Nigel Rees, Patrick Rees, Lois Hough, Dylan Parry, Nicola White and Brady Bowes

Ambulance services staff worldwide have long been at risk of encountering violence and aggression directed towards them during their work. Verbal forms of violence and aggression…

500

Abstract

Purpose

Ambulance services staff worldwide have long been at risk of encountering violence and aggression directed towards them during their work. Verbal forms of violence and aggression are the most prevalent form, but sometimes incidents involve physical injury, and on rare occasions homicides do occur. Exposure to such violence and aggression can have a lasting negative impact upon ambulance staff and has been associated with increased levels of stress, fear, anxiety, emotional exhaustion, depersonalisation and burnout syndrome. Despite the significance of this issue, little progress has been made to tackle it. The purpose of this paper is to describe this multi-agency approach being taken in Wales (UK) to reduce such harms from violence and aggression directed towards ambulance services staff.

Design/methodology/approach

An interpretative post-positivist narrative methodology and policy analysis approach was followed. Snowball methods of gathering data were used to construct this narrative involving meetings, telephone calls, review of policy documents, legislation and academic literature.

Findings

The authors report how tackling violence and aggression directed towards emergency workers has become a priority within Wales (UK), resulting in policy developments and initiatives from groups such as the UK and Welsh Government, the Welsh Ambulance Services National Health Services (NHS) Trust, Health Boards, the NHS Wales Anti-Violence Collaborative and the Joint Emergency Services Group (JESG) in Wales. This has included changes in legislation such as the Assaults on Emergency Workers (Offences) Act 2018 that came into force on 13th November 2018 and policy changes such as the obligatory responses to violence in health care and the JESG #WithUsNotAgainst Us campaign. Our study however reflects the complexity of this issue and the need for further high-quality research.

Originality/value

The experiences and activities of Wales (UK) reported in this paper adds to the international body of knowledge and literature on violence and aggression directed towards ambulance services staff.

Details

Journal of Aggression, Conflict and Peace Research, vol. 14 no. 2
Type: Research Article
ISSN: 1759-6599

Keywords

Access Restricted. View access options
Book part
Publication date: 27 January 2022

Katie Liston

This chapter examines the (in)visibility and symbolism of women in sports governance on the island of Ireland, taking as its main empirical focus available data on the boards of…

Abstract

This chapter examines the (in)visibility and symbolism of women in sports governance on the island of Ireland, taking as its main empirical focus available data on the boards of government-funded national governing bodies, north and south. The distinctiveness of the Irish case is explained by three factors: the governance minefield, itself a legacy of Irish-British relations and partition in the 1920s, recognisable patterns in gender relations north and south and the functioning of sport as a safe, largely unquestioned and intriguingly vague symbolism for inclusion and peace in Northern Ireland. These conditions have resonance today, not only for women in sport and the approach to quotas, for instance, but that also play out in the delivery of Brexit and the struggles that characterise Irish-British relations more generally. The chapter concludes with a consideration of future challenges and areas for further research.

Details

Gender Equity in UK Sport Leadership and Governance
Type: Book
ISBN: 978-1-80043-207-9

Keywords

Access Restricted. View access options
Article
Publication date: 7 June 2019

Josie Evans, Karen Methven and Nicola Cunningham

As part of a pilot studyassessing the feasibility of record-linking health and social care data, the purpose of this paper is to examine patterns of non-delivery of home care…

52

Abstract

Purpose

As part of a pilot studyassessing the feasibility of record-linking health and social care data, the purpose of this paper is to examine patterns of non-delivery of home care among older clients (>65 years) of a social home care provider in Glasgow, Scotland. The paper also assesses whether non-delivery is associated with subsequent emergency hospital admission.

Design/methodology/approach

After obtaining appropriate permissions, the electronic records of all home care clients were linked to a hospital inpatient database and anonymised. Data on home care plans were collated for 4,815 older non-hospitalised clients, and non-delivered visits were examined. Using case-control methodology, those who had an emergency hospital admission in the next calendar month were identified (n=586), along with age and sex-matched controls, to determine whether non-delivery was a risk factor for hospital admission.

Findings

There were 4,170 instances of “No Access” non-delivery among 1,411 people, and 960 instances of “Service Refusal” non-delivery among 427 people. The median number of undelivered visits was two among the one-third of clients who did not receive all their planned care. There were independent associations between being male and living alone, and non-delivery, while increasing age was associated with a decreased likelihood of non-delivery. Having any undelivered home care was associated with an increased risk of emergency hospital admission, but this could be due to uncontrolled confounding.

Research limitations/implications

This study demonstrates untapped potential for innovative research into the quality of social care and effects on health outcomes.

Originality/value

Non-delivery of planned home care, for whatever reason, is associated with emergency hospital admission; this could be a useful indicator of vulnerable clients needing increased surveillance.

Details

Quality in Ageing and Older Adults, vol. 20 no. 2
Type: Research Article
ISSN: 1471-7794

Keywords

Access Restricted. View access options
Book part
Publication date: 26 August 2014

Nicola Mirc

The contribution revisits existing research on human impacts on the performance of mergers and acquisitions. Findings are grouped into three categories: individual-…

Abstract

The contribution revisits existing research on human impacts on the performance of mergers and acquisitions. Findings are grouped into three categories: individual-, organizational- and managerial-related factors. Results show that while research seems various and abounding, influential factors are often studied as static setting approached in isolation, without measuring their direct relation to post-acquisition outcomes.

Details

Advances in Mergers and Acquisitions
Type: Book
ISBN: 978-1-78190-836-5

Keywords

Access Restricted. View access options
Book part
Publication date: 27 August 2014

Damian Tago, Henrik Andersson and Nicolas Treich

This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.

Abstract

Purpose

This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.

Design/methodology/approach

This study presents literature reviews for the period 2000–2013 on (i) the health effects of pesticides and on (ii) preference valuation of health risks related to pesticides, as well as a discussion of the role of benefit-cost analysis applied to pesticide regulatory measures.

Findings

This study indicates that the health literature has focused on individuals with direct exposure to pesticides, i.e. farmers, while the literature on preference valuation has focused on those with indirect exposure, i.e. consumers. The discussion highlights the need to clarify the rationale for regulating pesticides, the role of risk perceptions in benefit-cost analysis, and the importance of inter-disciplinary research in this area.

Originality/value

This study relates findings of different disciplines (health, economics, public policy) regarding pesticides, and identifies gaps for future research.

Details

Preference Measurement in Health
Type: Book
ISBN: 978-1-78441-029-2

Keywords

Access Restricted. View access options
Article
Publication date: 8 May 2018

James J. Zhang, Euisoo Kim, Brandon Mastromartino, Tyreal Yizhou Qian and John Nauright

The purpose of this paper is to encourage scholarly inquiries to critically examine broad perspectives of marketing and business operations in the sport industry of growing…

5145

Abstract

Purpose

The purpose of this paper is to encourage scholarly inquiries to critically examine broad perspectives of marketing and business operations in the sport industry of growing economies.

Design/methodology/approach

A comprehensive review of literature was the primary research method to introduce the following critical questions, “what are the major challenges in the sport industry of developing economies in a globalized market environment and what to do?”.

Findings

Seven articles are selected based on their theoretical and practical contributions.

Originality/value

This special issue is committed to trigger more investigations into sport businesses in developing countries and ultimately advancing theories and seeking solutions.

Details

International Journal of Sports Marketing and Sponsorship, vol. 19 no. 2
Type: Research Article
ISSN: 1464-6668

Keywords

Access Restricted. View access options
Book part
Publication date: 25 July 2014

Nicola Carr and Kym Fraser

International figures on university expenditure on the development of next generation learning spaces (NGLS) are not readily available but anecdote suggests that simply…

Abstract

International figures on university expenditure on the development of next generation learning spaces (NGLS) are not readily available but anecdote suggests that simply retrofitting an existing classroom as an NGLS conservatively costs $AUD200,000, while developing new buildings often cost in the region of 100 million dollars and over the last five years, many universities in Australia, Europe and North America have developed new buildings. Despite this considerable investment, it appears that the full potential of these spaces is not being realised.

While researchers argue that a more student centred learning approach to teaching has inspired the design of next generation learning spaces (Tom, Voss, & Scheetz, 2008) and that changed spaces change practice (Joint Information Systems Committee, 2009) when ‘confronted’ with a next generation learning spaces for the first time, anecdotes suggest that many academics resort to teaching as they have always taught and as they were taught. This chapter highlights factors that influence teaching practices, showing that they are to be found in the external, organisational and personal domains.

We argue that in order to fully realise significant improvements in student outcomes through the sector’s investment in next generation learning spaces, universities need to provide holistic and systematic support across three domains – the external, the organisational and the personal domains, by changing policies, systems, procedures and localised practices to better facilitate changes in teaching practices that maximise the potential of next generation learning spaces.

Details

The Future of Learning and Teaching in Next Generation Learning Spaces
Type: Book
ISBN: 978-1-78350-986-7

Keywords

Access Restricted. View access options
Book part
Publication date: 28 November 2024

Olga Suhomlinova and Saoirse Caitlin O'Shea

Abstract

Details

Transgender and Non-binary Prisoners' Experiences in England and Wales
Type: Book
ISBN: 978-1-80071-045-0

1 – 10 of 54
Per page
102050