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Objective: To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision‐making. Patients and Methods: Men aged 50–69 years diagnosed with localised prostate cancer by prostate‐specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external‐beam radiotherapy (EBRT) with concurrent androgen‐deprivation therapy (ADT) and 77 low‐dose‐rate brachytherapy (BT, not a randomised treatment). Patient‐reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results: Treatment‐received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion: Treatment decision‐making for localised prostate cancer can be informed by these 6‐year functional and QoL outcomes. [ABSTRACT FROM AUTHOR]

Background: Students on health and social care degree programmes spend 50% of their time on practice placements. Because of the diversity of settings and the need to evidence their work, it is vital to understand the information and resource needs of placement students. Objectives: The aim of this investigation was to understand the needs of placement students in terms of accessing resources whilst they are in the field in order to inform a guide to meet these needs. Methods: Focus groups were conducted with students on midwifery, social work and post-registration health professions degree programmes on three different sites across the region. Data were analysed using Thematic Content Analysis. Results: Three themes emerged from the data: inequality, user education needs and students’ solutions and strategies. Conclusions: It is essential to speak to placement students in order to understand their needs in terms of accessing and using library resources. The timing and content of information skills training is key to meeting student needs while on placement. [ABSTRACT FROM AUTHOR]

Purpose. To assess the risks and benefits of early urethral catheter removal following laparoscopic radical prostatectomy. Materials and Methods. Between June 2009 and April 2011, 114 patients underwent laparoscopic radical prostatectomy for clinically organconfined prostate cancer. Candidates for early removal of the urethral catheter were selected intraoperatively on the basis of the integrity of the vesicourethral anastamosis and the ease of recatheterisation. In the selected cohort of patients, the urethral catheter was removed at day 2. Recatheterisation rates within this group were recorded and analysed. Results. Of the 114 patients who underwent laparoscopic prostatectomy, 64 (56%) were deemed suitable for removal of catheter on second postoperative day prior to discharge. The first 20 patients selected for early removal of urethral catheter were covered with a suprapubic catheter inserted at the time of surgery. Out of 64 patients deemed suitable for early removal of urethral catheter, 53 (83%) were able to pass urine without complication. 11 patients (17%) developed urinary retention that necessitated recatheterisation. In all cases, reinsertion of catheter was performed easily and successfully without the need for cystoscopic guidance or adjuncts. Conclusions. Removal of the urethral catheter at day 2 following laparoscopic prostatectomy is a safe procedure in carefully selected patients. [ABSTRACT FROM AUTHOR]

In this article the author discusses the incorporation of quality improvement techniques of industry and healthcare. It mentions the Randomized Controlled Trial (RCT) which is being applied for the quality improvement of Mercedes Benz and also being used to deliver better operations, diagnostics, and systems of healthcare. However, RCTs are discovered inappropriate by health service researchers to apply to surgery so quantitative observational methods was developed to recompense the problems.