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BackgroundRoutine measurement of Patient Reported Outcomes (PROs) linked with clinical data across the patient pathway is increasingly important for informing future care planning. The innovative electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system was developed to integrate PROs, collected online at specified post-diagnostic time-points, with clinical and treatment data in cancer registries. ObjectiveThis study tested the technical and clinical feasibility of ePOCS by running the system with a sample of potentially curable breast, colorectal, and prostate cancer patients in their first 15 months post diagnosis. MethodsPatients completed questionnaires comprising multiple Patient Reported Outcome Measures (PROMs) via ePOCS within 6 months (T1), and at 9 (T2) and 15 (T3) months, post diagnosis. Feasibility outcomes included system informatics performance, patient recruitment, retention, representativeness and questionnaire completion (response rate), patient feedback, and administration burden involved in running the system. ResultsePOCS ran efficiently with few technical problems. Patient participation was 55.21% (636/1152) overall, although varied by approach mode, and was considerably higher among patients approached face-to-face (61.4%, 490/798) than by telephone (48.8%, 21/43) or letter (41.0%, 125/305). Older and less affluent patients were less likely to join (both P

To further understand the barriers and facilitators to attending colonoscopy examination following a positive routinely offered stool test result, from the perspective of patients and Specialist Screening Practitioners (SSPs). Qualitative semi-structured interviews were conducted. Participants (N = 32) were patients (n = 20) who, as part of the Bowel Cancer Screening Programme (BCSP) in England, were invited to attend a colonoscopy examination, and SSPs (n = 12), who worked for the BCSP in England. Framework analysis included inductive and deductive coding. Anxiety was as a key barrier cited by patients and SSPs, arising from the moment the patient received the invitation letter. Notably, procedural-related anxieties centred upon the fear of pain and discomfort and test invasiveness. The role of family, friends and the SSP were recognised by patients and SSPs to facilitate participation. Many patients, yet not SSPs, emphasised an obligation to attend all medical test invitations. Practically orientated strategies suggested by patients and SSPs address the patient barriers identified. These include earlier information to patients on the option of sedation for pain relief, earlier notification of potential financial support for patients unable to fund their own travel costs, and fewer uses of the term cancer within written materials. [ABSTRACT FROM AUTHOR]

Background: Family carers of people living with comorbid dementia and cancer (CDC) play a vital supportive role, but this may be particularly burdensome and adversely impact their own health and wellbeing. Objective: To examine the experiences and psychosocial support needs of caregivers of people with CDC. Methods: A flyer advertising the study was distributed to relevant UK voluntary sector organisations and shared across social media. 13 carers of people with CDC were recruited. In-depth semi-structured interviews were conducted and transcripts were analysed using reflexive thematic analysis, underpinned by an inductive phenomenological approach. Results: Complex interactions of dementia and cancer resulted in heightened responsibility for carers, who played a crucial role in recognition/management of symptoms, performing difficult cancer-related care, and treatment decision-making that posed difficult ethical challenges. Care-recipients had reduced insight into their cancer diagnosis and prognosis, so carers often carried the emotional burden alone. Responsibilities faced by carers were compounded by a lack of targeted, accessible information/support for CDC. Carers expressed a desire to talk to and learn from others who understand the unique challenges of navigating cancer-related decision-making, treatment and care for people who are also living with dementia. Conclusions: Cancer alongside dementia presents complex challenges for carers, who desire more cancer-related information and support which is tailored to people living with dementia and their family caregivers. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether modifications made to the current National Health Service (NHS) invitation letter for follow‐up colonoscopy examination affect participant state anxiety and behavioural intentions to attend. Methods: Five hundred and thirty‐eight adults of bowel cancer‐eligible screening age (56–74) were randomized to receive the current NHS invitation letter or the modified version of the letter as a hypothetical scenario. Modifications to the letter included fewer uses of the term cancer and awareness of alternative screening options. The history of the colonoscopy invitation, anticipated state anxiety, behavioural intention to attend the nurse appointment, and colonoscopy concerns upon reading the letter were measured. Results: Behavioural intentions were high in both conditions; however, participants reading the current letter reported significantly higher behavioural intentions compared to the modified letter. There was no main effect of previous invite status or interaction between previous invite status and letter condition on behavioural intentions. However, the effect of the letter on levels of anxiety depended on the participant's invitation history. Those never invited for a colonoscopy were more anxious when reading the modified letter compared to the current letter. Conversely, previous colonoscopy invitees were less anxious following reading the modified letter than those reading the current letter. Those never invited for a colonoscopy were more concerned about embarrassment and test invasiveness. All findings remained the same when controlling for age and education. Conclusion: Modifications to the invitation letter were not beneficial to levels of screening intention or anxiety. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionTo investigate the effect of two brief self-affirmation interventions, immediately prior to reading standard information about bowel cancer screening, on state anxiety, message acceptance and behavioural intention to screen for bowel cancer.242 adults aged 49 were randomised to one of two self-affirmation interventions (health or values) or one of two control conditions, before reading an NHS England bowel cancer screening leaflet. Participant friend and family history of bowel cancer, state anxiety, message acceptance, behavioural intention to screen, trait self-esteem and spontaneous self-affirmation were measured. Data were analysed using between-participants analysis of variance, planned contrasts and moderated regression.No main effects of experimental condition on levels of state anxiety, message acceptance and behavioural intention were found. However, planned contrasts showed participants who self-affirmed about their health or values (conditions-collapsed) were significantly less anxious and reported significantly higher behavioural intentions compared to participants in the controls (conditions-collapsed). Irrespective of condition, higher levels of spontaneous self-affirmation and trait self-esteem were correlated with lower anxiety, higher intentions, and message acceptance.There was some evidence of the effect of health-based self-affirmation on lowering anxiety; however, further research is needed to explore the effectiveness of different self-affirmation interventions in larger samples. [ABSTRACT FROM AUTHOR]

This paper addresses the politics of researching private education with special reference to the Indian context. Due to a recent increase in privatised forms of education globally and recognition of the private sector by governments, international agencies and researchers as a policy and academic interest, this is shifting ground. The evolving nature of the politics of researching the private in the recent past is discussed with reference to research on private school outreach for out-of-school children in India. First the author critically examines the reception of this research when it was conducted in 2000-2003 in relation to the discourse and policy in Indian education at the time. The research is then revisited in the contemporary context in the light of considerable changes in Indian education policy, involving increased public-private partnership. In this new climate private school outreach is reconceptualised -- previously considered an educational anomaly, it now has renewed relevance. Finally, findings from the research are drawn on to shed light on emerging concerns about the Right of Children to Free and Compulsory Education Act's (2009) requirement for private schools to reserve at least 25% of school places for economically disadvantaged children in their neighbourhoods. (Contains 3 tables.)

As many countries experience population aging, patients with cancer are becoming older and have more preexisting comorbidities, which include prevalent, age‐related, chronic conditions such as dementia. People living with dementia (PLWD) are vulnerable to health disparities, and dementia has high potential to complicate and adversely affect care and outcomes across the cancer trajectory. This report offers an overview of dementia and its prevalence among patients with cancer and a summary of the research literature examining cancer care for PLWD. The reviewed research indicates that PLWD are more likely to have cancer diagnosed at an advanced stage, receive no or less extensive cancer treatment, and have poorer survival after a cancer diagnosis. These cancer disparities do not necessarily signify inappropriately later diagnosis or lower treatment of people with dementia as a group, and they are arguably less feasible and appropriate targets for care optimization. The reviewed research indicates that PLWD also have an increased risk of cancer‐related emergency presentations, lower quality processes of cancer‐related decision making, accessibility‐related barriers to cancer investigations and treatment, higher experienced treatment burden and higher caregiver burden for families, and undertreated cancer‐related pain. The authors propose that optimal cancer care for PLWD should focus on proactively minimizing these risk areas and thus must be highly person‐centered, with holistic decision making, individualized reasonable adjustments to practice, and strong inclusion and support of family carers. Comprehensive recommendations are made for clinical practice and future research to help clinicians and providers deliver best and equitable cancer care for PLWD and their families. [ABSTRACT FROM AUTHOR]

This paper contributes to arguments for the potential of Giddens' structuration theory in educational research. It illustrates how "conceptual schemes" from structuration theory were applied to the author's empirical research on a type of alternative educational practice in India, "private school outreach". It shows how Giddens' concepts of "social system", "structure" and "agency" helped to conceptualize private school outreach, and how "constraint" and "ontological security" offered explanations of apparent contradictions in private school outreach practice within the context of the reasons and motivations of actors. It also argues that when schools attempt to do things differently, contradictions may occur because the same "rules and resources" that are drawn on in the production of alternative practice are drawn on in the reproduction of practice. Finally, acknowledging the debates around structuration theory, some of its key criticisms are addressed in relation to the empirical application. (Contains 1 table.)

Drawing upon empirical data from a multiple case study of "private school outreach" initiatives in India, this paper compares linkages with government schools initiated by two of the cases with the intent of rendering them more conducive to the education of children not in school. This inter-school working was rooted in cultures of resource sharing maintained by the two cases of private school outreach which was evident in the relations between their private schools and "outreach programmes." Further, differences in resource sharing cultures had implications for "how" the two cases sought to influence change through their relations with government schools, and "who" they recruited as agents of change. Despite these differences, the managements of both cases found that long-term responsive relationships based on respect were critical to build capacity within the government schools and enable them to become resource centres and loci of change in their own right. (Contains 1 figure and 6 notes.)

Contributes to scholarship of journalism history, social movements, and feminism by analyzing framing techniques found in coverage of the women's movement. Finds widespread delegitimation of feminists, including reporting aspects of the women's appearance, using quotation marks around such words as "liberation," and emphasizing dissension within the movement. Notes that antifeminists were described as well-organized and attractive. (SR)