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Background: Continuous quality improvement in cancer care relies on the collection of accurate data on the quality of care provided. It is suggested that such an approach should: (i) measure the patient's care experience throughout the cancer trajectory; (ii) use items and response scales that measure concrete and specific aspects of care; (iii) minimise recall bias; (iv) minimise the burden placed on patients for providing data; (v) minimise administrative burden; and (vi) collect actionable data. The System for Patient Assessment of Cancer Experiences (SPACE) was developed to meet these objectives. This study describes the feasibility and acceptability of the SPACE in a sample of oncology outpatients.Methods: The SPACE was examined in four medical oncology centres. Adult patients were approached by a research assistant prior to their scheduled consultation. Consenting participants completed the SPACE on a computer tablet. Items were tailored to the patient's cancer treatment phase.Results: Of the eligible participants, 1143 consented (83%) and 1056 completed the survey (92%). The average time taken to complete the survey was 6 min 28 s. A large proportion of the sample indicated that the survey was acceptable (88-93% across three acceptability items).Conclusion: This study demonstrates that the SPACE can be feasibly administered each time a patient comes to the oncology unit and is acceptable to patients. The SPACE could be used to quantify the care experiences which patients receive during their cancer care. The resulting data could be used to set benchmarks and improve the performance of cancer clinics. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify the most prevalent unmet needs of haematological cancer survivors. Methods: Haematological cancer survivors aged 18-80 years at time of recruitment were selected from four Australian state cancer registries. Survivors completed the Survivor Unmet Needs Survey. The most frequently reported "high/very high" unmet needs items were identiied, as well as characteristics associated with the three most prevalent "high/very high" unmet needs reported by haematological cancer survivors. Results: A total of 715 eligible survivors returned a completed survey. "Dealing with feeling tired" (17%), was the most frequently endorsed "high/very high" unmet need. Seven out of the ten most frequently endorsed unmet needs related to emotional health. Higher levels of psychological distress (e.g., anxiety, depression and stress) and indicators of inancial burden as a result of cancer (e.g., having used up savings and trouble meeting day-to-day expenses due to cancer) were consistently identiied as characteristics associated with the three most prevalent "high/very high" unmet needs. Conclusions: A minority of haematological cancer survivors endorsed a "high/very high" unmet need on individual items. Additional emotional support may be needed by a minority of survivors. Survivors reporting high levels of psychological distress or those who experience increased inancial burden as a result of their cancer diagnosis may be at risk of experiencing the most prevalent "high/very high" unmet needs identiied by this study. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify the most prevalent unmet needs of haematological cancer survivors. Methods: Haematological cancer survivors aged 18–80 years at time of recruitment were selected from four Australian state cancer registries. Survivors completed the Survivor Unmet Needs Survey. The most frequently reported “high/very high” unmet needs items were identified, as well as characteristics associated with the three most prevalent “high/very high” unmet needs reported by haematological cancer survivors. Results: A total of 715 eligible survivors returned a completed survey. “Dealing with feeling tired” (17%), was the most frequently endorsed “high/very high” unmet need. Seven out of the ten most frequently endorsed unmet needs related to emotional health. Higher levels of psychological distress (e.g., anxiety, depression and stress) and indicators of financial burden as a result of cancer (e.g., having used up savings and trouble meeting day-to-day expenses due to cancer) were consistently identified as characteristics associated with the three most prevalent “high/very high” unmet needs. Conclusions: A minority of haematological cancer survivors endorsed a “high/very high” unmet need on individual items. Additional emotional support may be needed by a minority of survivors. Survivors reporting high levels of psychological distress or those who experience increased financial burden as a result of their cancer diagnosis may be at risk of experiencing the most prevalent “high/very high” unmet needs identified by this study. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effectiveness of an ''enhanced'' invitation letter in increasing participation in an Australian cancer registrybased study and assess the representativeness of the study sample. Study Design and Setting: Eight hundred hematological cancer survivors, diagnosed within the last 3 years and aged 18e80 years at recruitment, were selected from one Australian state-based cancer registry. Half were randomly allocated to receive the standard invitation letter (control group). The remaining half received a modified invitation letter, incorporating content and design characteristics recommended to improve written communication (intervention group). Results: Of the 732 eligible survivors, 268 (37%) returned a completed survey. There was no difference in participation between the intervention (n5131, 36%) and control groups (n5137, 38%; P50.53). Participants were representative of the population for characteristics assessed, except for age group at diagnosis. Survivors 50 years or older at diagnosis had higher odds of returning a completed survey, 50e59 (odds ratio [OR]: 2.53; 95% confidence interval [CI]: 1.47, 4.35), 60e69 (OR: 2.69; 95% CI: 1.58e4.58), and 70e80 (OR: 1.90; 95% CI: 1.07e3.35), than survivors aged 15e39 years at diagnosis. Conclusion: An enhanced invitation letter was not effective in increasing participation of hematological cancer survivors in an Australian cancer registry study. The study sample was moderately representative on variables assessed, with age group at diagnosis the only variable associated with participation. Research should evaluate strategies to increase participation in registry studies and focus on tailoring techniques to patient's age. @2013 Elsevier Inc. All rights reserved. [ABSTRACT FROM AUTHOR]

Introduction and Aims. Primary health-care services need to maximise prevention activities to improve the health of Aboriginal and Torres Strait Islander people. This study determined Aboriginal and Torres Strait Islander people's risk status and screening history for cardiovascular, diabetes and cancer, and identified opportunities for prevention based on patient's health concerns. Design and Methods. Consenting adult patients attending an Aboriginal Community Controlled Health Service completed interview surveys. Outcome measures were: patient's self-reported rates of smoking, at-risk alcohol consumption, body mass index and screening rates for cholesterol, diabetes, blood pressure, cervical and breast cancer, the proportion of patients with multiple risk factors and health information patients prioritise to receive from their doctor. Results. We surveyed 587 patients giving a consent rate of 77%. Patient's self-reported being at risk due to smoking (51%), harmful alcohol consumption in both short term (10%) and long term (10%), and overweight (28%) and obese (49%) body mass index. The proportion of patients who had not been screened within the recommended guidelines was 27% for cholesterol, 24% for diabetes, 40% for blood pressure, 47% for cervical cancer and 54% for breast cancer. The majority (73%) of patients had multiple risk factors. Patients prioritised receiving health information on diabetes (45%), weight (43%) and heart disease (43%). Discussion and conclusions. Many patients were at high risk, and were concerned about the health risks they experience. Strategies are needed to help clinic staff identify risks, and maximise prevention activities according to best-practice guidelines, particularly to patients who experience multiple risk factors. [Stewart JM, Sanson-Fisher RW, Eades S, Fitzgerald M. The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service. Drug Alcohol Rev 2012;31:617-624] [ABSTRACT FROM AUTHOR]

Background: If public health research does not progress beyond descriptive research to testing the effectiveness of interventions that can provide causal data, its contribution to evidence-based practice will not be realized. This paper examined the number and percentage of public health research publications over three time periods (1987–1988, 1997–1998, 2005–2006) for three preventive health issues: tobacco use, alcohol use, and inadequate physical activity. Methods: A computer-based literature search was conducted, using the Medline and PsycINFO databases. A random sample of 1000 abstracts for each preventive health issue was examined per time period. The abstracts were first categorized as public health or not, and then as data-based or non–data-based public health research. Data-based publications were classified according to research type as measurement-, descriptive/epidemiologic-, or intervention-oriented. Data analysis occurred in 2007. Results: The number of data-based public health research publications examined for each topic ranged between 180 and 346 in 1987–1988, 199 and 322 in 1997–1998, and 302 and 364 in 2005–2006. Despite a significant increase over time in the percentage of intervention publications for tobacco (from 10% in 1987–1988 to 18% in 2005–2006, p=0.008), the majority of publications in all three time periods were descriptive/epidemiologic for all topics (62%–87% in 1987–1988, 64%–85% in 1997–1998, 78%–79% in 2005–2006). There were fewer measurement (3%–7% in 1987–1988, 2%–6% in 1997–1998, 4%–10% in 2005–2006) or intervention publications (9%–31% in 1987–1988, 10%–30% in 1997–1998, 12%–18% in 2005–2006). Conclusions: Descriptive research does not provide optimal evidence for how to reduce preventable illness. Reasons for the lack of measurement and intervention public health research are explored. [Copyright &y& Elsevier]

Presents information on a study which rated the importance of principles and steps to guide clinicians on how to inform patients that they have breast cancer. Methodology; Specific guidelines recommended for telling bad news, as perceived by breast cancer patients, doctors and nurses; Results and discussion.

Objectives. Outdoor workers are at high of developing skin cancer. Primary prevention in this group can potentially reduce the incidence of skin cancer, and also potentiates the spontaneous remission of existing solar keratoses. A randomized controlled trial was conducted to evaluate a solar protection intervention targeting outdoor workers. Methods. Outdoor workers were randomly allocated to an intervention (n=65) or control group (n=77). The intervention group received individual skin screening by a dermatologist and participated in an education session. Pre-and posttest outcome measures included solar protection behavior (assessed using a validated diary), knowledge, and attitudes. Results. There was a significant increase (16%) in the percentage of outdoor workers who were using a high level of solar protection at post-test compared to pretest in the intervention group, but there was no change in the control group. Although both groups improved in their knowledge score, the intervention group showed a significantly greater improvement at posttest. No changes in attitudes were detected. Conclusions. The findings suggest that changes in solar protection are achievable with outdoor workers. [ABSTRACT FROM AUTHOR]

Offers guidelines on breaking bad news to patients. General principles in breaking bad news; Specific steps for breaking the news; Important way to determine the appropriateness of guidelines for conveying bad news.

Outlines steps to encourage physicians to adopt the best practices for conveying bad news to medical patients. Characteristics that increase the likelihood that clinical guidelines are credible and acceptable to clinicians; Most commonly used mechanisms informing providers about guidelines; Importance of providing performance-based feedback to clinicians.

Outlines steps to encourage clinicians to adopt the best practices for communicating bad news to patients. Production of medical practice guidelines; Ways to disseminate the guidelines; Provision of performance-based feedback to clinicians.

Discusses guidelines on how physicians should break bad news to their patients. Perspectives on the types of information that patients desire; Physicians' competence in breaking bad news; General principles for breaking bad news to patients. INSET: Essential steps in breaking bad news to medical patients.

Abstract: Background: To ensure the provision of patient‐centred health care, it is essential that consumers are actively involved in the process of determining and implementing health‐care quality improvements. However, common strategies used to involve consumers in quality improvements, such as consumer membership on committees and collection of patient feedback via surveys, are ineffective and have a number of limitations, including: limited representativeness; tokenism; a lack of reliable and valid patient feedback data; infrequent assessment of patient feedback; delays in acquiring feedback; and how collected feedback is used to drive health‐care improvements. Objectives: We propose a new active model of consumer engagement that aims to overcome these limitations. This model involves the following: (i) the development of a new measure of consumer perceptions; (ii) low cost and frequent electronic data collection of patient views of quality improvements; (iii) efficient feedback to the health‐care decision makers; and (iv) active involvement of consumers that fosters power to influence health system changes. [ABSTRACT FROM AUTHOR]

Abstract: Adolescent smoking prevalence is usually assessed via self-complete questionnaires. However, concern has been expressed about the validity of such self-report. One approach to increase validity involves the threat of biological validation, known as the bogus pipeline method (BPL).This study aimed to assess the effects of BPL, using an expired air carbon monoxide monitor, and of questionnaire anonymity on student smoking self-report data. High school students (n =801) were randomly allocated to one of four conditions: anonymous questionnaire+BPL, named questionnaire+BPL, anonymous questionnaire without BPL and named questionnaire without BPL. Overall, 37% of students agreed that questionnaires were a good way to obtain honest answers. In a logistic regression analysis, students in the BPL condition had significantly higher odds of reporting weekly smoking (OR=1.83 95% CI 1.27–2.65) and monthly smoking (OR=1.66 95% CI 1.21–2.28) but not of lifetime smoking compared with non-BPL students. Students in the named questionnaire condition had a significantly higher odds of reporting lifetime smoking (OR=1.49 95% CI 1.08–2.04) compared with anonymous students. Studies assessing current smoking patterns in adolescents should consider incorporating a BPL method. [Copyright &y& Elsevier]

In order to develop and tailor treatment approaches in drug and alcohol counselling accurately, it is necessary to identify characteristics of the relevant client group. This study describes the demographic and substance use characteristics of 1212 community-based drug and alcohol counselling clients from a regional Area Health Service in NSW, Australia. Findings identify these clients as predominantly young, unmarried, unemployed males with low incomes. Alcohol use is characterized by binge consumption (83%) and alcohol-related problems (94%). A substantial proportion use tobacco (74%), cannabis (61%), opiates (15%) and amphetamines (22%). Of those using illicit drugs other than marijuana, the incidence of sharing syringes (10%) is of concern. These data differ from those reported by both general practice patients in the same geographical area, as a treatment-seeking population in an alternative community-based setting, and a general community sample. It is argued that there is a need for interventions delivered in community-based drug and alcohol settings that are aimed specifically at polydrug use, attempt to minimize drug-related harm and are relevant to those of lower socio-economic status. [ABSTRACT FROM AUTHOR]

Objective To compare alcohol-related intervention and general interactional skills performance of medical students from a traditional (Sydney) and a non-traditional (Newcastle) medical school, before and after participation in an alcohol education programme about brief intervention. Design In two controlled trials, students received either a didactic alcohol education programme or didactic input plus skills-based training. Prior to and after training, all students completed videotaped interviews with simulated patients. Setting The Faculties of Medicine at the University of Newcastle and the University of Sydney, Australia. Subjects Fifth-year medical students (n=154). Results Both alcohol-related intervention and general interactional skills scores of the Newcastle students were significantly higher than those of the Sydney students at pre-test but not after training. Although alcohol-related interactional skills scores improved after training at both universities, they did not reach a satisfactory level. The educational approach used had no effect on post-test scores at either university. Conclusions Significant baseline differences in interactional skills scores favouring non-traditional over traditional students were no longer evident after both groups had been involved in an alcohol education programme. Further research is required to develop more effective alcohol intervention training methods. [ABSTRACT FROM AUTHOR]

Background: People with brain cancer and their support persons (SPs) are critical sources of information on the components of care that contribute to psychosocial outcomes. Aims: To determine the proportion of studies that examined (1) at least one of 14 nominated components of psychosocial cancer care and (2) more than one component of care. Methods: Medline, The Cochrane Library, PsycINFO and Embase were electronically searched for publications from January 1999 to December 2019. Publications that met the inclusion criteria were coded according to the number and type of psychosocial care components assessed from 14 listed components, and whether patient and/or SPs' views about care were elicited. Results: Of the 113 included publications, 61 publications included patient-reported data only (54%), 27 included both patient and SP-reported data (24%) and 25 included SP-reported data only (22%). Most assessed a single component of care (77% of patient-reported and 71% of SP-reported). No publications assessed all 14 components. The "Psychosocial" component was the most frequently assessed component of care for patient-reported (n = 80/88, 91%) and SP-reported publications (n = 46/52, 88%). Conclusions: Publications reporting on psychosocial care in brain cancer present a relatively narrow view of patient and support person experiences. The inclusion of both patient and support person perspectives and the assessment of multiple components of care are required in future research to optimize psychosocial outcomes in brain cancer. [ABSTRACT FROM AUTHOR]

Introduction: This review examined the: (1) number of publications exploring psychosocial outcomes of adults with brain cancer and/or support persons between 1999 and 2019 and whether there has been a change in the type of research over time; and (2) proportion of intervention studies meeting Cochrane Effective Practice and Organisation of Care (EPOC) research design criteria. Methods: Embase, The Cochrane Library, Medline and PsycINFO databases were electronically searched January 1999 to December 2019. Articles were examined against inclusion/exclusion criteria and coded into measurement, descriptive or intervention categories. Intervention studies were assessed against the EPOC design criteria. Results: 220 eligible publications were identified. The number of total publications significantly increased by an average of 1 each year (95%CI = 0.7–1.3; p < 0.001). There was no significant change in the proportion of publications by study type across three time periods. Descriptive research represented the majority within each time period. Of the 17 intervention studies, only 7(41%) met EPOC design criteria. Conclusions: Published literature on brain cancer psychosocial outcomes has increased significantly. However, descriptive research dominates research output. To increase high‐level knowledge that can guide psychosocial care of people with brain cancer, there is a need to undertake methodologically rigorous intervention trials. [ABSTRACT FROM AUTHOR]

There is currently uncertainty regarding the relative performance of a retrospective diary (RD) and a quantity–frequency index (QFI) measure of weekly alcohol consumption. While some previous studies have found more consumption reported on an RD than a QFI, others have found the reverse. As yet, however, no study has compared computerized versions of these two measures. This cross-sectional study involved administration of a computerized survey in a community-based drug and alcohol treatment setting. Five hundred and eighty-six clients (420 males) attending counselling for a range of drug- and alcohol-related issues agreed to participate in the study. The major finding was that more alcohol consumption was reported on the RD, than on the QFI. Similarly, the RD detected a greater proportion of both heavy and high-risk drinkers than the QFI. It is argued that the RD may be preferable to the QFI as a measure of weekly alcohol consumption, for use in community-based treatment settings. [ABSTRACT FROM PUBLISHER]

Offers a look at related literature on breaking bad news to medical patients. Sources of materials; Types of citations; Methodological quality of randomized controlled trials.

Background: Adequately preparing patients for medical interventions is an important component of quality healthcare. Nevertheless, few instruments for assessing patients' preparation exist.Objectives: To develop a psychometrically rigorous instrument to assess patients' perceptions of the quality of preparation.Methods: An instrument to measure patients' preparation for medical interventions (MiPrep) was developed and tested with patients undergoing medical imaging, radiotherapy, or surgery. Patients were recruited and asked to complete 2 surveys. Survey A assessed patient and intervention characteristics. Survey B (postintervention) contained MiPrep to assess validity (face, content, and construct) and reliability (internal consistency and test-retest).Results: A total of 869 (85%) patients consented to participate and 551 (63%) returned the postintervention survey. Face and content validity were demonstrated. Exploratory factor analysis identified 2 survey modules: receipt and adequacy of information (2 domains) and overall appraisal of patient-centered care (1 domain). Reliability was evidenced by adequate internal consistency (Cronbach α 0.81-0.89) and item-total correlations higher than 0.20. Nevertheless, individual item test-retest reliability requires further confirmation. The final instrument contained 27 items.Conclusions: The MiPrep instrument has evidence of being a valid and reliable instrument of preparation for medical interventions. Healthcare providers can use the instrument as a quality assurance tool to identify areas for improvement and areas of excellence in patients' preparation. Future studies should verify these findings in other populations and examine the divergent and predictive validity of the instrument. [ABSTRACT FROM AUTHOR]

Objectives: To improve imaging utilisation and reduce the widespread overuse of staging investigations, in the form of computed tomography (CT) and whole‐body bone scans for men with newly diagnosed prostate cancer in the Hunter region of NSW, Australia, by implementation of a multifaceted clinician‐centred behaviour change programme. Patients and Methods: Records of all patients with a new diagnosis of prostate cancer were reviewed prior to the intervention (July 2014 to July 2015), and the results of this audit were presented to participating urologists by a clinical champion. Urologists then underwent focused education based on current guidelines. Patterns of imaging use for staging were then re‐evaluated (November 2015 to July 2016). Patients were stratified into low‐, intermediate‐ and high‐risk groups as described by the D'Amico classification system. Results: A total of 144 patients were retrospectively enrolled into the study cohort. The use of diagnostic imaging for staging purposes significantly decreased in men with low‐ and intermediate‐risk disease post intervention. In low‐risk patients, the use of CT decreased from 43% to 0% (P = 0.01). A total of 21% of patients underwent bone scans in the pre‐intervention group compared with18% in the post‐intervention group (P = 0.84). In intermediate‐risk patients, the use of CT decreased from 89% to 34% (P < 0.001), whilst the use of bone scan decreased from 63% to 37% (P = 0.02). In high‐risk patients, the appropriate use of imaging was maintained, with CT performed in 87% compared with 85% and bone scan in 87% compared with 65% (P = 0.07). Conclusion: Our results show that a focused, clinician‐centred education programme can lead to improved guideline adherence at a regional level. The assessment of trends and application of such a programme at a state‐based or national level could be further assessed in the future with the help of registry data. This will be particularly important in future with the advent of advanced imaging, such as prostate‐specific membrane antigen positron‐emission tomography. [ABSTRACT FROM AUTHOR]

Purpose: There are few recent longitudinal studies investigating the quality of life of colorectal cancer patients in the early years following diagnosis. This study aimed to (i) compare the health status of people with colorectal cancer less than 1 year from diagnosis with health status 1 year later and (ii) determine the characteristics associated with a change in overall health status.Methods: The study was conducted as part of a larger trial. Participants (n = 539) were identified via the Victorian Cancer Registry in Australia, completed a computer-assisted baseline telephone interview (including the EQ-5D-3L) within 6-12 months of diagnosis, and mailed a survey 12 months later.Results: At baseline, the majority of participants (55 %) reported some problems, including difficulties in usual activities (26 %), pain or discomfort (25 %), anxiety or depression (23 %) and mobility issues (15 %). Sixty-nine percent had either an unchanged or increased health utility score from baseline to follow-up. The largest proportion reporting an increase in problems between baseline and follow-up related to pain or discomfort (18 %). While visual analogue scale scores indicated a significantly improved health state over time overall, 32 % reported a decreased health utility score from baseline to follow-up. Those aged over 80 years were more likely to report a decreased health utility score compared to 60-80-year-olds.Conclusions: A sizeable minority of patients experience ongoing problems in their daily lives and should be offered assistance in overcoming disabilities and returning to best possible functioning, particularly older patients who appear to be vulnerable to poor outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To explore outcomes of psychological distress, including anxiety, depression and stress, amongst adult haematological cancer survivors, with a specific focus on potential differences between rural and urban survivors.Methods: One thousand four hundred fourteen urban and rural survivors were recruited from five Australian population-based cancer registries and completed a self-report pen-and-paper survey on their well-being, including the Depression Anxiety and Stress Scale 21-item version.Results: A quarter of survivors were identified as reporting above normal levels of anxiety and depression, respectively, and almost one fifth (17 %) reported above normal levels of stress. There were no statistically significant differences in the percentage of rural and urban survivors reporting above normal levels of anxiety, depression, or stress. Survivors who had experienced financial burden due to their cancer or were of middle age had higher odds of reporting multiple domains of psychological distress, compared to their counterparts.Conclusions: Haematological cancer survivors diagnosed during middle age or who experience increased financial burden as a result of their diagnosis may require additional support and care with regards to psychological distress. [ABSTRACT FROM AUTHOR]

Background: Emergency department staff play a crucial role in the triage of stroke patients and therefore the capacity to deliver time-dependent treatments such as tissue Plasminogen Activator. This study aimed to identify among emergency physicians, (1) rates of agreement with evidence supporting tissue Plasminogen Activator use in acute stroke care; and (2) individual and hospital factors associated with high agreement with evidence supporting tissue Plasminogen Activator use. Methods: Australian fellows and trainees of the Australasian College for Emergency Medicine were invited to complete an online cross-sectional survey assessing perceptions of tissue Plasminogen Activator use in acute stroke. Demographic and hospital characteristics were also collected. Results: 429 Australasian College for Emergency Medicine members responded (13% response rate). Almost half (47.2%) did not agree with any statements regarding the benefits of tissue Plasminogen Activator use for acute stroke. Perceived routine administration of tissue Plasminogen Activator by the head of respondents'emergency department was significantly associated with high agreement with the evidence supporting tissue Plasminogen Activator use in acute stroke. Conclusions: Agreement with evidence supporting tissue Plasminogen Activator use in acute stroke is not high among responding Australian emergency physicians. In order for tissue Plasminogen Activator treatment to become widely accepted and adopted in emergency settings, beliefs and attitudes towards treatment need to be in accordance with clinical practice guidelines. [ABSTRACT FROM AUTHOR]

Issues addressed: The National Bowel Cancer Screening Program (NBCSP) was introduced in Australia in 2006, offering free immunochemical Faecal Occult Blood Test (FOBT) to persons aged 50, 55 or 65. The study aimed to examine the prevalence of self- reported screening for colorectal cancer (CRC) using the FOBT and factors associated with not having an FOBT. Methods: A cross-sectional study of Australian general practice patients aged 50 and over with no personal history of CRC completed a health risk survey while waiting for scheduled appointments between November 2010 and November 2011. Results: A total of 5671 patients from 12 practices were approached to participate. Of the 4707 eligible patients (adults attending for care who understood English and were capable of providing informed consent), 4062 (86%) consented to participate, with 2269 eligible to complete the FOBT items. Approximately half (52%) of participants reported ever having an FOBT. More than one-third (39.7%) of the sample reported having an FOBT in the prior three years. Those who recalled receiving a mailed kit as part of the NBCSP were five times more likely to report being screened. Those less likely to report screening were aged 50-59 years, were female and had been diagnosed with a form of cancer other than CRC. Conclusions: There is justification for the extension of the NBCSP to ensure a majority of the age-appropriate population is screened for CRC. [ABSTRACT FROM AUTHOR]

Background. Information about the unmet supportive care needs of haematological cancer patients is needed for service planning and to inform clinical practice. This study described the prevalence of, and factors associated with, unmet supportive care needs among haematological cancer patients. Material and methods. A total of 380 adults diagnosed with haematological cancer were recruited from the outpatient department at three comprehensive cancer treatment centres in Australia. Of these, 311 completed a self-report questionnaire. Unmet needs were assessed using the 34-item Supportive Care Needs Survey (SCNS-SF34). The data were examined using descriptive statistics and logistic regression. Results. Overall, 51% (95% CI 45-57%) of participants reported having at least one 'moderate to high' level unmet need, while 25% (95% CI 20-30%) reported 'no need' for help with any items. Unmet needs were most commonly reported in the psychological (35%; 95% CI 30-41%) and physical aspects of daily living (35%; 95% CI 30-41%) domains. The three most frequently endorsed items of 'moderate to high' unmet need were: lack of energy/tiredness (24%; 95% CI 20-30%), not being able to do the things you used to do (21%; 95% CI 17-26%), and uncertainty about the future (21%; 95% CI 16-25%). Patients' sociodemographic characteristics influenced unmet needs more than disease characteristics. Patients who were female, aged less than 55 years or not in the labour force had higher odds of reporting 'moderate to high' level unmet supportive care needs. Conclusion. Unmet supportive care needs are prevalent among haematological cancer patients, particularly in the psychological and physical aspects of daily living domains. These findings provide valuable insight about the range of resources, multidisciplinary linkages and referral pathways needed to address haematological cancer patients' unmet needs. [ABSTRACT FROM AUTHOR]

Background To facilitate translation of evidence into clinical practice, it is critical that clear, specific, and detailed information about interventions is provided in publications to promote replication, appropriate aggregation in meta-analysis, and implementation. This study examined whether twenty elements of interventions deemed essential for such translational application were reported in sufficient detail in smoking cessation trials with pregnant women. Methods Searches of electronic databases using MeSH terms and keywords identified peer-reviewed English language studies published between 2001 and 2012. Eligible studies reported a smoking cessation intervention targeted at pregnant women and met Cochrane's Effective Practice and Organization of Care group study design criteria. Each intervention arm of eligible studies was assessed against the developed twenty criteria. Results Thirty relevant studies reported the findings of 45 intervention arms. The mode of delivery of the intervention was reported in 100% of intervention arms. Other well-reported criteria included reporting of the provider who delivered the intervention (96%), sample characteristics (80%), and the intervention setting (80%). Criteria not reported adequately included care provided to women who relapse (96% not reported), details about training given to providers (77% not reported), and the method of quit advice advised (76% not reported). No studies reported 100% of relevant criteria. Conclusions Current standards of reporting of intervention content and implementation are suboptimal. The use of smoking cessation specific checklists for reporting of trials, standard reporting using behaviour change taxonomies, and the publication of protocols as supplements should be considered as ways of improving the specificity of reporting. [ABSTRACT FROM AUTHOR]

Objective A patient-centred approach to discussing life expectancy with cancer patients is recommended in Western countries. However, this approach to eliciting and meeting patient preferences can be challenging for clinicians. The aims of this study were the following: (i) to examine cancer patients' preferences for life expectancy disclosure; and (ii) to explore agreement between cancer patients' preferences for, and perceived experiences of, life expectancy disclosure. Methods Cancer patients undergoing radiotherapy treatment in metropolitan Australia completed a cross-sectional touchscreen computer survey including optional questions about their life expectancy disclosure preferences and experiences. Results Of the 208 respondents, 178 (86%) indicated that they would prefer their clinician to ask them before discussing life expectancy, and 30 (14%) indicated that they would prefer others (i.e. clinicians, family) to decide whether they were given life expectancy information. Of the 175 respondents who were classified as having a self- determined or other-determined disclosure experience, 105 (60%) reported an experience of life expectancy disclosure that was in accordance with their preferences. Cohen's κ was −0.04 (95% CI, −0.17, 0.08), indicating very poor agreement between patients' preferences for and perceived experiences of life expectancy disclosure ( p = 0.74). Conclusions In light of patient-centred prognosis disclosure guidelines, our findings of a majority preference for, and experience of, a self-determined approach to life expectancy disclosure amongst radiation oncology patients are encouraging. However, poor agreement between preferences and experiences highlights that additional effort from clinicians is required in order to achieve a truly patient-centred approach to life expectancy disclosure. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: There is growing international interest in the use of financial incentives in smoking cessation, yet little research on public opinion of the scheme. This paper reports on the acceptability of incentives for reducing smoking in pregnant women and the perceived size of incentive that would encourage smoking cessation during pregnancy. Methods: A cross-sectional survey was conducted on a convenience sample of 213 women attending the antenatal clinic of a large public hospital in Australia. Participants completed a questionnaire on their views on the use of incentives with responses measured on a 5-point Likert scale. Results: The majority of participants (60%) did not agree that paying pregnant smokers to quit is a good idea. Opinions regarding the likely effectiveness were mixed with 30% of respondents in agreement and 22% undecided. Most (62%) were not willing to pay smokers any amount to quit. Smokers were more likely to have more favorable views about incentives than nonsmokers (p < .0001) and considered payments of between $100 and >$1,000 acceptable as reward for quitting smoking. Conclusions: Acceptability for the use of financial incentives in reducing antenatal smoking is low among pregnant women. Future research should explore views of a wider audience and continue to gather stronger evidence of the efficacy of rewards for reducing smoking in pregnancy. [ABSTRACT FROM AUTHOR]

The aim of this short report was to describe the output and citation rates of public health. Data-based publications and literature reviews from the year 2008, and their 5-year citation rates were extracted from 10 randomly selected public health journals. In total, 86.2% of publications were descriptive/epidemiological studies, 56.8% used cross-sectional (56.8%) designs and 77.8% were classified as research translation stage 2. Reviews and publications describing randomized controlled trials were the most highly cited, but were infrequently published. Strategies to address the discordance between public health research output and research citation may improve the impact of public health research. [ABSTRACT FROM AUTHOR]

Aims To examine the effectiveness of a brief intervention (BI) and cognitive behaviour therapy (CBT) for alcohol abuse. Design A randomized trial with clients randomized within counsellors. Setting Community-based drug and alcohol counselling in Australia. Participants Of all new clients attending counselling, 869 (82%) completed a computerized assessment at their first consultation. Four hundred and twentyone (48%) were defined as eligible, of whom 295 (70%) consented and were allocated randomly to an intervention. Of these, 133 (45%) were followed-up at 6 months post-test. Interventions BI comprised the elements identified by the acronym FRAMES: feedback, responsibility, advice, menu, empathy, self-efficacy. Face-to-face counselling time was not to exceed 90 minutes. CBT comprised six consecutive weekly sessions: introduction; cravings and urges; managing crises; saying 'no' and solving problems; emergencies and lapses; and maintenance. Total face-toface counselling time was 270 minutes (six 45-minute sessions). Measurements Treatment outcomes are measured in terms of counsellor compliance, client satisfaction, weekly and binge consumption, alcohol-related problems, the AUDIT questionnaire and cost-effectiveness. Findings When analysed on an intention-to-treat basis and for those followedup, treatment outcomes between BI and CBT were not statistically significantly different at pre- or post-test, whether considered as continuous or categorical variables. BI was statistically significantly more cost-effective than CBT and there was no difference between them in clients' reported levels of satisfaction. Conclusion For low-dependence alcohol abuse in community settings, BI may be the treatment of choice. [ABSTRACT FROM AUTHOR]

Aim. It is the purpose of this paper to develop a model which may be used in conjunction with scenario analysis to evaluate strategies which are available to assist the general practitioner (GP) in reducing smoking behaviour among their patients. Design. The scenario analysis uses a four-step procedure which involves identifying opportunities for detection, intervention and efficacy, and assigning probabilities to outcomes to enable a range of prevention strategies to be examined in both isolation and in combination. Setting and participants. This study deals specifically with Australian general practice and the model is derived by using information for a smoker visiting their GP within a 6-month period together with empirical evidence on the rates of detection, intervention and efficacy. Measurements. The outcome measures, which are evaluated in terms of marginal effectiveness, include the number of smoking patients detected, the number of smoking patients offered an intervention, the number of smoker patients who quit as a result of the intervention and the additional years of life saved due to an intervention. Findings. The most significant indicator for reducing smoking rates among patients is improving the efficacy of interventions. The results also suggest that although improvements in the rate of GP detection of patients' smoking status have a potentially greater effect on quit rates than increasing intervention levels, increasing both detection and intervention levels had a greater effect than each strategy alone. Discussion. General practitioners have an important role to play in preventive medicine. The knowledge, skill and attitude of practitioners toward smoking are significant, and they can be the prime motivators in persuading their patients to stop smoking. Detection, intervention and efficacious strategies are all key elements in achieving this result. [ABSTRACT FROM AUTHOR]

Background: To facilitate translation of evidence into clinical practice, it is critical that clear, specific, and detailed information about interventions is provided in publications to promote replication, appropriate aggregation in meta-analysis, and implementation. This study examined whether twenty elements of interventions deemed essential for such translational application were reported in sufficient detail in smoking cessation trials with pregnant women.Methods: Searches of electronic databases using MeSH terms and keywords identified peer-reviewed English language studies published between 2001 and 2012. Eligible studies reported a smoking cessation intervention targeted at pregnant women and met Cochrane's Effective Practice and Organization of Care group study design criteria. Each intervention arm of eligible studies was assessed against the developed twenty criteria.Results: Thirty relevant studies reported the findings of 45 intervention arms. The mode of delivery of the intervention was reported in 100% of intervention arms. Other well-reported criteria included reporting of the provider who delivered the intervention (96%), sample characteristics (80%), and the intervention setting (80%). Criteria not reported adequately included care provided to women who relapse (96% not reported), details about training given to providers (77% not reported), and the method of quit advice advised (76% not reported). No studies reported 100% of relevant criteria.Conclusions: Current standards of reporting of intervention content and implementation are suboptimal. The use of smoking cessation specific checklists for reporting of trials, standard reporting using behaviour change taxonomies, and the publication of protocols as supplements should be considered as ways of improving the specificity of reporting. [ABSTRACT FROM AUTHOR]