Search

Your search keyword '"Lythgoe, J"' showing total 227 results
Start Over Author "Lythgoe, J"
227 results on '"Lythgoe, J"'

1. Experiences of pregnant women recieving acupuncture treatment from Midwives

Author

Lythgoe, J.

Subjects
615.8
Abstract

Acupuncture is potentially an effective treatment for common conditions of pregnancy and labour pain with midwives being well placed to offer it. The aims of this study were to explore the experiences of pregnant women receiving acupuncture treatment from midwives, to provide insight into their perceptions of effect including the influence and value of the midwife on this experience. The lack of qualitative evidence has provided the rationale for this study. Within a phenomenological methodology an 'Interpretative Phenomenological Analysis' (IPA) approach was adopted, with 10 women attending the Salford Midwifery Acupuncture Service (SMAS) being recruited to this study. Data was collected via semi-structured interviews and the IPA analysis identified five main themes; justification of choice, relief & relaxation, trust & understanding, regaining self, discovering and sharing a secret. The women were happy to access acupuncture if recommended by a health professional; they gained pain relief and improved function, with more ability to care for their children and to continue working. They were grateful for the opportunity to access acupuncture, finding it enjoyable and reporting intense emotional and physical sensations. It offered prolonged effect, improving sleep and wellbeing, and it correlated well with purported neurophysiological mechanisms. Responses seemed more intense than in previous reports, possibly due to their pregnant state or heightened affective component. A midwife-acupuncturist was advantageous having knowledge and understanding of pregnancy, with ‘understanding’ being more important than professional background. The women felt optimistic and empowered to make plans for birth and parenthood and were wishing to share their experiences with others. The ‘lay network’ was an important factor within the women’s choice to access acupuncture. These findings indicate acupuncture is an acceptable treatment which can provide relief, improved wellbeing and support normality. Midwives could offer acupuncture as an adjunct to their role to facilitate individualised reflexive practice.

Published
2015

13. Overview of Randomized Trials of Postoperative Adjuvant Radiotherapy in Breast Cancer

Author

Cuzick, J., Stewart, H. J., Peto, R., Baum, M., Fisher, B., Host, H., Lythgoe, J. P., Ribeiro, G., Scheurlen, H., Wallgren, A., Herfarth, Ch., editor, Senn, H. J., editor, Baum, M., editor, Diehl, V., editor, von Essen, C., editor, Grundmann, E., editor, Hitzig, W., editor, Rajewsky, M. F., editor, Scheurlen, Hans, editor, Kay, Richard, editor, and Baum, Michael, editor

Published
1988
Full Text
View/download PDF

22. A report on the health and social care listening event

Author

Williamson, T, Ball, E, Choucri, LP, Collier, E, Devitt, P, Franks, H, Howarth, ML, Lythgoe, J, Mcandrew, S, Roberts, D, Rowswell, K, Seppala, L, Wray, J, and Yates-Bolton, N

Subjects
health_and_wellbeing
Abstract

The purpose of the Listening Event was to enable a wide range of people, including professionals working in statutory, voluntary and other organisations and members of the public, to ‘have a say’ about health and social care and what we as a University can do for and with these partners and the public. We particularly wanted to hear about key concerns of the University such as:\ud • Strengthening community engagement and partnerships\ud • Health and social care training we should be providing, for whom, and how this is delivered\ud • Ideas relating to the University themes including media, use of space and buildings, human rights, social justice and security \ud • Research topics we should be addressing\ud However the main strength of the Listening Event approach is that topics for discussion are mostly led by participants who attend. On this occasion, the\ud discussion topics were very much focused on the concerns of participants and lots of information and ideas were generated. The task now is for the event planning team to review the discussion notes and identify what can be\ud addressed and how, in the short, medium and long term. This planning will be taking place over the Autumn in 2011, and any participants or readers of this report are more than welcome to get in touch to work with us or add their views.\ud The purpose of this report is to record all discussion summaries for sharing amongst participants and others. It is important that participants especially get to read what others had said at the event. The report will lead to changes in University practices such as the content of some of our courses and new business ideas and relationships will also be explored. The event itself provided a useful means of public engagement that others may wish to adopt.

Published
2011

25. Photochemistry of Vision

Author

Abrahamson, E. W., primary, Baumann, Ch., additional, Bridges, C. D. B., additional, Crescitelli, F., additional, Dartnall, H. J. A., additional, Eakin, R. M., additional, Falk, G., additional, Fatt, P., additional, Goldsmith, T. H., additional, Hara, R., additional, Hara, T., additional, Japar, S. M., additional, Liebman, P. A., additional, Lythgoe, J. N., additional, Morton, R. A., additional, Muntz, W. R. A., additional, Rushton, W. A. H., additional, Shaw, T. I., additional, Wiesenfeld, J. R., additional, and Yoshizawa, T., additional

Published
1972
Full Text
View/download PDF

26. SYSTEMIC TREATMENT OF EARLY BREAST-CANCER BY HORMONAL, CYTOTOXIC, OR IMMUNE THERAPY - 133 RANDOMIZED TRIALS INVOLVING 31000 RECURRENCES AND 24000 DEATHS AMONG 75000 WOMEN .2

Author

ABE, O, ABE, R, ASAISHI, K, ENOMOTO, K, HATTORI, T, INO, Y, KIKUCHI, K, KOYAMA, H, SAWA, K, UCHINO, J, YOSHIDA, M, HAYBITTLE, J, VANDEVELDE, T, VERMORKEN, J, HARVEY, V, HOLDAWAY, T, KAY, R, MASON, B, FORBES, J, BASTERT, G, SAUERBREI, W, SCHEURLEN, H, SCHUMACHER, M, FOCAN, C, LOBELLE, J, PEEK, U, OATES, G, POWELL, J, DURAND, M, MAURIAC, L, GELMAN, R, HENDERSON, I, SHAPIRO, C, HANCOCK, A, JACKSON, S, RAGAZ, J, KORZUN, A, WOOD, W, YOSHIMOTO, M, BAUM, M, HOUGHTON, J, HORGAN, K, HUGHES, L, STEWART, H, GORDON, N, DAVIS, H, DELOZIER, T, MACELESECH, J, RAMBERT, P, ANDRYSEK, O, BARKMANOVA, J, OWEN, J, HOWELL, A, RIBEIRO, G, SWINDELL, R, DEOLIVEIRA, C, CARSTENSEN, B, PALSHOF, T, JOHANSEN, H, KORZENIOWSKI, S, SKOLYSZEWSKI, J, ANDERSEN, K, DOMBERNOWSKY, P, MOURIDSEN, H, ROSE, C, CORCORAN, N, TRAMPISCH, H, ABELOFF, M, CARBONE, P, GLICK, J, GRAY, R, TORMEY, D, BUYSE, M, MIGNOLET, F, PARIDAENS, R, VANDRIEL, O, SYLVESTER, R, VANDEVELDE, C, VANDONGEN, J, WELVAART, K, SCANLON, E, SCHURMAN, S, CATALANO, R, CREECH, R, DESCHRYVER, A, MCGREGOR, K, YOSEF, H, MCARDLE, C, SMITH, D, LARA, P, DENT, D, GUDGEON, C, HACKING, A, BOCCARDO, F, IZUO, M, BENTLEY, A, DORAN, Z, FENTIMAN, I, HAYWARD, J, RUBENS, R, KAUFMANN, M, JONAT, W, VONFOURNIER, D, KLEFSTROM, P, CUZICK, J, MARGREITER, R, ASSELAIN, B, POUILLARD, P, BAHI, J, MILLA, A, SANCHIZ, F, CASTIGLIONE, M, CAVALLI, F, COLLINS, J, GELBER, R, GOLDHIRSCH, A, ISLEY, M, LINDTNER, J, PRICE, K, RUDENSTAM, C, SENN, H, BLISS, J, CHILVERS, C, COOMBES, R, MARTY, M, BOROVIK, R, BRUFMAN, G, ROBINSON, E, PANNUTI, F, TAKASHIMA, S, YASUTOMI, T, HOLM, L, SONOO, H, YAMASHITA, J, BONTE, J, BUZDAR, A, SMITH, T, MARTIN, P, ROMAIN, S, AHMANN, D, SCHAID, D, HAKES, T, NORTON, L, WITTES, R, FOROGLOU, P, LISSAIOS, B, BONADONNA, G, DELVECCHIO, M, VALAGUSSA, P, VERONESI, U, DUBOIS, J, HAYAT, H, BIANCO, A, LIPPMAN, M, PIERCE, L, SIMON, R, STEINBERG, S, NOMURA, Y, DELAHUERTA, R, SAINZ, M, BROWN, A, FISHER, B, REDMOND, C, WOLMARK, N, JACKSON, I, PALMER, M, INGLE, J, BENGTSSON, N, LARSSON, L, LYTHGOE, J, KISSIN, M, BLAMEY, R, MITCHELL, A, ROBERTSON, J, FLUCKIGER, H, NAKAMURA, Y, MATHE, G, MISSET, J, DESHPANDE, N, DIMARTINO, L, CLARKE, E, MCLAUGHLIN, J, CLARK, R, LEVINE, M, MORIMOTO, K, GUNDERSEN, S, HAUERJENSEN, M, HOST, H, CROSSLEY, E, DURRANT, K, HARRIS, A, CLARKE, M, COLLINS, R, GODWIN, J, GREAVES, E, HARWOOD, C, MEAD, G, PETO, R, WHEATLEY, K, HILL, C, LACOUR, J, LAPLANCHE, A, LE, M, SARRAZIN, D, SEMIGLAZOV, V, BROCKSCHMIDT, J, COOPER, M, MEAKIN, J, PANZARELLA, T, PRITCHARD, K, TREURNIETDONKER, A, VANPUTTEN, W, EASTON, D, POWLES, T, GAZET, J, DOUGLAS, P, LINDTNER, A, NOTTER, G, BRYANT, A, EWING, G, KRUSHEN, J, NISSENMEYER, R, FORREST, A, MCDONALD, C, MOLLER, T, RYDEN, S, CARSTENSEN, J, HATSCHEK, T, SODERBERG, M, CARPENTER, J, CRAWLEY, J, GREEN, S, OSBORNE, C, RUTQVIST, L, WALLGREN, A, BRENNER, H, HERCBERGS, A, DEBOER, G, PATERSON, A, NAJA, A, REID, M, SPITTLE, M, SENANAYAKE, F, MEIER, P, TENGRUP, I, TENNVALLNITTBY, L, CAFFIER, H, BEZWODA, W, HOLMBERG, L, SEVELDA, P, ZIELINSKY, C, JAKESZ, R, BUCHANAN, R, CROSS, M, DUNN, J, GILLESPIE, KELLY, K, MORRISON, J, LITTON, A, and CHLEBOWSKI, R

Published
1992

37. The arrangement of collagen fibrils in the iridescent cornea of the scorpion fish, Taurulus (Cottus) bubalis, and the transparency of vertebrate corneal stroma.

Author

Lythgoe, J N

Abstract

The iridescent layer in the corneal stroma of the scorpion fish, Taurulus (Cottus) bubalis (Scorpaeniformes), is composed of alternating thin lamellae of normal stroma containing collagen fibrils and lamellae of an amorphous dense‐staining material. 2. Iridescence is lost after conventional resin embedding procedures, but is retained after embedding in urea‐glutaraldehyde polymer. 3. The retention of iridescence and the absence of gross thickness changes during embedding in urea‐glutaraldehyde polymer are an indication that the fine structure of the cornea is less altered than by conventional resin embedding. 4. It is believed that in life the collagen fibrils in the cornea of the scorpion fish and the cornea of the frog and rabbit are slightly larger and much more closely packed than is revealed by conventional resin‐embedded sections.

Published
1976
Full Text
View/download PDF

38. The visual pigments of rods and cones in the rhesus monkey, Macaca mulatta.

Author

Bowmaker, J K, Dartnall, H J, Lythgoe, J N, and Mollon, J D

Abstract

1. New microspectrophotometric measurements have been made of the photo‐pigments of individual rods and cones from the retina of the rhesus monkey (Macaca mulatta). The measuring beam was passed transversely through isolated outer segments. 2. The transverse absorbance for rods ranged from 0.02 to 0.04 and that for cones from 0.01 to 0.03. 3. The mean absorbance spectrum for rods (n = 25) had a peak of 502 +/‐ 2.7 nm. A digitonin extract from the same group of eyes gave a lambda‐max. of 499 +/‐ 1 nm. 4. Of a sample of 82 cones, 40 were 'red' (P565 nm) and 42 were 'green' (P536 nm). The mean absorbance spectrum for the green cones is very similar to the Dartnall nomogram, but that for the red cones is narrower. 5. No bleachable, blue‐sensitive outer segments were recorded, although structures were found that absorbed at short wave‐lengths and were neither photosensitive nor dichroic. 6. If the long wave‐length and middle wave‐length cone pigments of the rhesus monkey are assumed to be identical to those of man and if additional assumptions are made about the lengths of human outer segments and about prereceptoral absorption, it is possible to derive psychophysical sensitivities that closely resemble the pi5 and pi4 mechanisms of W. S. Stiles.

Published
1978
Full Text
View/download PDF

39. Changes in spectral reflexions from the iridophores of the neon tetra.

Author

Lythgoe, J N and Shand, J

Abstract

1. The iridescent stripe of the freshwater teleost, the neon tetra, changes from green in the daytime to violet‐blue at night. 2. Spectral reflectance measurements were used to follow these colour changes. 3. Light causes a shift in reflectance to longer wavelengths in living fish and in isolated tissue from the lateral stripe. The change is reversed in darkness. 4. The spectral reflectance shifts to longer wavelengths when the fish is disturbed in darkness. No such colour changes were seen in fishes kept alive in 10(‐4) M‐reserpine. 5. Hypotonic Ringer solution causes a reflectance shift to longer wavelengths and hypertonic solution causes a shift to shorter wavelengths. 6. The iridescent reflexions from the lateral stripe which is continued across the iris originate from iridophores in the dermis. These iridophores contain regular stacks of broad, double‐sided hexagonal plates that are about 10 nm thick. Each plate is contained within a pouch in the cytoplasm and is separated from its neighbour by approximately one quarter the wavelength of light. 7. A distinction is drawn between the physiologically active iridophores in the lateral stripe and iris that have broad hexagonal crystal plates which are very thin and the physiologically inactive iridophores that are also found in the iris, but in addition are found on the flanks below the lateral stripe, and on the head. These iridophores contain hexagonal crystals that are usually narrower than the active type, but are about 60‐100 nm thick.

Published
1982
Full Text
View/download PDF

40. Light-induced colour changes by the iridophores of the neon tetra, Paracheirodon Innesi

Author

Clothier, Jennifer and Lythgoe, J. N.

Abstract

The iridophores of the Neon tetra Paracheirodon innesi consist of alternating layers of guanine and cytoplasm. In the dark-adapted state the reflected light from constructive interference is in the ultraviolet or blue. When exposed to light the cytoplasm layers increase in thickness and as a result the reflections shift to longer wavelengths and the iridophores appear green. The iridophores are thought to contain a rhodopsin-like molecule and we suggest that the colour-change mechanism involves the light-induced opening of sodium channels in the plasma membrane, leading osmotically to an increase in thickness of the cytoplasm layers. Experimental support for this suggestion was obtained by the substitution of choline chloride for sodium chloride in the perfusing medium, which can be done without altering the osmotic strength of the perfusing medium. This procedure almost abolished the light response and makes it seem likely that sodium ions are necessary for the light response to take place.

Published
1987
Full Text
View/download PDF

41. The Structural Basis for Iridescent Colour Changes in Dermal and Corneal Iridophores In Fish

Author

Lythgoe, J. N. and Shand, Julia

Abstract

The reflectance from the iridophores in the skin of the neon tetra Paracheirodon innesi (Myers) and the iridophores in the cornea of the sand goby Pomatoschistus minutus (Pallas) changes in response to light. In both cases the reflectance comes from the constructive interference of alternating plates of material of high and low refractive index. In the neon tetra the high refractive index plates are mainly guanine, and the low refractive index plates are cytoplasm. In the goby cornea the plates are made of intercellular matrix and cytoplasm, but it is not known which has the higher refractive index. In neon tetra dermal iridophores, the response to light is a shift to longer wavelength reflection without an accompanying increase in the amplitude of reflectance. In goby cornea, light can induce an increase in the amplitude of reflectance without a shift in wavelength. It is suggested that the wavelength shift is produced by an inflow of material into the iridophore and that the change in amplitude, without a shift in wavelength, is produced by a transfer of material, such as water, between the high and low refractive index layers of the multilayer stack.

Published
1989
Full Text
View/download PDF

42. Visual pigments and the acquisition of visual information

Author

Lythgoe, J. N. and Partridge, J. C.

Abstract

All the information available to the brain for the interpretation of the visual scene comes from the number of photons absorbed by a very limited number of photoreceptor types which are characterized by their spectral sensitivity. In vertebrates there are considerable differences in the spectral absorption of the rods and cones making up the retinal mosaic of different animals and, in some cases, including fish and primates, there are considerable differences between the cone sets of individuals within a species. Broadly speaking, the spectral sensitivity of the photoreceptors is related to the spectral distribution of the ambient light and this is particularly true of the colour-biased light under water. When an animal migrates from one visual environment to another, its cone complement may change to that suited to the new conditions. However, significant differences between the cone sets of animals living within the same environment and colour vision polymorphism within a species suggest that visual tasks critical to survival or breeding success require particular visual pigment sets. A start has been made in trying to understand what tasks are best served by different pigment sets.

Published
1989
Full Text
View/download PDF

48. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials

Author

Abe, O., Abe, R., Enomoto, K., Kikuchi, K., Koyama, H., Masuda, H., Nomura, Y., Sakai, K., Sugimachi, K., Tominaga, T., Uchino, J., Yoshida, M., Haybittle, J. L., Davies, C., Harvey, V. J., Holdaway, T. M., Kay, R. G., Mason, B. H., Forbes, J. F., Wilcken, N., Gnant, M., Jakesz, R., Ploner, M., Yosef, H. M. A., Focan, C., Lobelle, J. P., Peek, U., Oates, G. D., Powell, J., Durand, M., Mauriac, L., Di Leo, A., Dolci, S., Piccart, M. J., Masood, M. B., Parker, D., Price, J. J., Hupperets, P. S. G. J., Jackson, S., Ragaz, J., Berry, D., Broadwater, G., Cirrincione, C., Muss, H., Norton, L., Weiss, R. B., Abu-Zahra, H. T., Portnoj, S. M., Baum, M., Cuzick, J., Houghton, J., Riley, D., Mansel, R. E., Gordon, N. H., Davis, H. L., Beatrice, A., Mihura, J., Naja, A., Lehingue, Y., Romestaing, P., Dubois, J. B., Delozier, T., Mace Lesec'h, J., Rambert, P., Petruzelka, L., Pribylova, O., Owen, J. R., Harbeck, N., Jänicke, F., Meisner, C., Meier, P., Howell, A., Ribeiro, G. C., Swindell, R., Burrett, J., Clarke, M., Collins, R., Darby, S., Elphinstone, P., Evans, V., Godwin, J., Gray, R., Harwood, C., Hicks, C., Jackson, D., James, S., Mackinnon, E., Mcgale, P., Mchugh, T., Mead, G., Morris, P., Oulds, J., Peto, R., Taylor, C., Wang, Y., Albano, J., De Oliveira, C. F., Gervásio, H., Gordilho, J., Johansen, H., Mouridsen, H. T., Gelman, R. S., Harris, J. R., Henderson, I. C., Shapiro, C. L., Christiansen, P., Ejlertsen, B., Møller, S., Overgaard, M., Carstensen, B., Palshof, T., Trampisch, H. J., Dalesio, O., De Vries, E. G. E., Rodenhuis, S., Van Tinteren, H., Comis, R. L., Davidson, N. E., Robert, N., Sledge, G., Tormey, D. C., Wood, W., Cameron, D., Chetty, U., Forrest, P., Jack, W., Rossbach, J., Klijn, J. G. M., Treurniet-Donker, A. D., Van Putten, W. L. J., Costa, A., Veronesi, U., Bartelink, H., Duchateau, L., Legrand, C., Sylvester, R., Van Der Hage, J. A., Van De Velde, C. J. H., Cunningham, M. P., Catalano, R., Creech, R. H., Bonneterre, J., Fargeot, P., Fumoleau, P., Kerbrat, P., Namer, M., Jonat, W., Kaufmann, M., Schumacher, M., Von Minckwitz, G., Bastert, G., Rauschecker, H., Sauer, R., Sauerbrei, W., Schauer, A., De Schryver, A., Vakaet, L., Belfiglio, M., Nicolucci, A., Pellegrini, F., Sacco, M., Valentini, M., Mcardle, C. S., Smith, D. C., Galligioni, E., Boccardo, F., Rubagotti, A., Dent, D. M., Gudgeon, C. A., Hacking, A., Erazo, A., Medina, J. Y., Izuo, M., Morishita, Y., Takei, H., Fentiman, I. S., Hayward, J. L., Rubens, R. D., Skilton, D., Scheurlen, H., Von Fournier, D., Dafni, U., Fountzilas, G., Klefstrom, P., Blomqvist, C., Saarto, T., Margreiter, R., Asselain, B., Salmon, R. J., Vilcoq, J. R., Arriagada, R., Hill, C., Laplanche, A., M. G., Lê, Spielmann, M., Bruzzi, P., Montanaro, E., Rosso, R., Sertoli, M. R., Venturini, M., Amadori, D., Benraadt, J., Kooi, M., Van De Velde, A. O., Van Dongen, J. A., Vermorken, J. B., Castiglione, M., Cavalli, F., Coates, A., Collins, J., Forbes, J., Gelber, R. D., Goldhirsch, A., Lindtner, J., Price, K. N., Rudenstam, C. M., Senn, H. J., Bliss, J. M., Chilvers, C. E. D., Coombes, R. C., Hall, E., Marty, M., Borovik, R., Brufman, G., Hayat, H., Robinson, E., Wigler, N., Bonadonna, G., Camerini, T., De Palo, G., Del Vecchio, M., Formelli, F., Valagussa, P., Martoni, A., Pannuti, F., Cocconi, G., Colozza, A., Camisa, R., Aogi, K., Takashima, S., Ikeda, T., Inokuchi, K., Sawa, K., Sonoo, H., Korzeniowski, S., Skolyszewski, J., Ogawa, M., Yamashita, J., Bonte, J., Christiaens, R., Paridaens, R., Van Den Bogaert, W., Martin, P., Geniez, ROMAIN SYLVAIN JEAN, Hakes, T., Hudis, C. A., Wittes, R., Giokas, G., Kondylis, D., Lissaios, B., De La Huerta, R., Sainz, M. G., Altemus, R., Cowan, K., Danforth, D., Lichter, A., Lippman, M., O'Shaughnessy, J., Pierce, L. J., Steinberg, S., Venzon, D., Zujewski, J. A., Paradiso, A., De Lena, M., Schittulli, F., Myles, J. D., Pater, J. L., Pritchard, K. I., Whelan, T., Anderson, S., Bass, G., Brown, A., Bryant, J., Costantino, J., Dignam, J., Fisher, B., Redmond, C., Wieand, S., Wolmark, N., Jackson, I. M., Palmer, M. K., Ingle, J. N., Suman, V. J., Bengtsson, N. O., Jonsson, H., Larsson, L. G., Lythgoe, J. P., Kissin, M., Erikstein, B., Hannisdal, E., Jacobsen, A. B., Varhaug, J. E., Gundersen, S., Hauer-Jensen, M., Høst, H., Nissen-Meyer, R., Blamey, R. W., Mitchell, A. K., Morgan, D. A. L., Robertson, J. F. R., Di Palma, M., Mathé, G., Misset, J. L., Clark, R. M., Levine, M., Morimoto, K., Takatsuka, Y., Crossley, E., Harris, A., Talbot, D., Taylor, M., Di Blasio, B., Ivanov, V., Semiglazov, V., Brockschmidt, J., Cooper, M. R., Ueo, H., Falkson, C. I., A'Hern, R., Ashley, S., Powles, T. J., Smith, I. E., Yarnold, J. R., Gazet, J. C., Corcoran, N., Deshpande, N., Di Martino, L., Douglas, P., Lindtner, A., Notter, G., Bryant, A. J. S., Ewing, G. H., Firth, L. A., Krushen-Kosloski, J. L., Foster, L., George, W. D., Stewart, H. J., Stroner, P., Malmström, P., Möller, T. R., Rydén, S., Tengrup, I., Tennvall-Nittby, L., Carstenssen, J., Dufmats, M., Hatschek, T., Nordenskjöld, B., Söderberg, M., Carpenter, J. T., Albain, K., Crowley, J., Green, S., Martino, S., Osborne, C. K., Ravdin, P. M., Glas, U., Johansson, U., Rutqvist, L. E., Singnomklao, T., Wallgren, A., Maibach, R., Thürlimann, B., Brenner, H., Hercbergs, A., Yoshimoto, M., Deboer, G., Paterson, A. H. G., Meakin, J. W., Panzarella, T., Shan, Y., Shao, Y. F., Wang, X., Zhao, D. B., Chen, Z. M., Pan, H. C., Bahi, J., Reid, M., Spittle, M., Deutsch, G. P., Senanayake, F., Kwong, D. L. W., Bianco, A. R., Carlomagno, C., De Laurentiis, M., De Placido, S., Buzdar, A. U., Smith, T., Bergh, J., Holmberg, L., Liljegren, G., Nilsson, J., Seifert, M., Sevelda, P., Zielinsky, C. C., Buchanan, R. B., Cross, M., Royle, G. T., Dunn, J. A., Hills, R. K., Lee, M., Morrison, J. M., Spooner, D., Litton, A., Chlebowski, R. T., Caffier, H., Clarke, M, Collins, R, Darby, S, Davies, C, Elphinstone, P, Evans, E, Godwin, J, Gray, R, Hicks, C, James, S, MacKinnon, E, McGale, P, McHugh, T, Peto, R, Taylor, C, and Wang, Y

Subjects
medicine.medical_specialty, Time Factors, medicine.medical_treatment, Breast Neoplasms, Rate ratio, Breast Conservation Treatment, Disease-Free Survival, Breast cancer, Cause of Death, Breast-conserving surgery, Medicine, Humans, Lung cancer, Aged, Probability, Randomized Controlled Trials as Topic, business.industry, Female, Middle Aged, Neoplasm Recurrence, Local, Medicine (all), General Medicine, medicine.disease, Surgery, Radiation therapy, Unilateral Breast Neoplasms, Neoplasm Recurrence, Local, business, Mastectomy
Abstract

Background In early breast cancer, variations in local treatment that substantially affect the risk of locoregional recurrence could also affect long-term breast cancer mortality. To examine this relationship, collaborative meta-analyses were undertaken, based on individual patient data, of the relevant randomised trials that began by 1995. Methods Information was available on 42 000 women in 78 randomised treatment comparisons (radiotherapy vs no radiotherapy, 23 500; more vs less surgery, 9300; more surgery vs radiotherapy, 9300). 24 types of local treatment comparison were identified. To help relate the effect on local (ie, locoregional) recurrence to that on breast cancer mortality, these were grouped according to whether or not the 5-year local recurrence risk exceeded 10% (10%, 25 000 women). Findings About three-quarters of the eventual local recurrence risk occurred during the first 5 years. In the comparisons that involved little (10%) differences, however, 5-year local recurrence risks were 7% active versus 26% control (absolute reduction 19%), and 15-year breast cancer mortality risks were 44·6% versus 49·5% (absolute reduction 5·0%, SE 0·8, 2p These 25 000 women included 7300 with breast-conserving surgery (BCS) in trials of radiotherapy (generally just to the conserved breast), with 5-year local recurrence risks (mainly in the conserved breast, as most had axillary clearance and node-negative disease) 7% versus 26% (reduction 19%), and 15-year breast cancer mortality risks 30·5% versus 35·9% (reduction 5·4%, SE 1·7, 2p=0·0002; overall mortality reduction 5·3%, SE 1·8, 2p=0·005). They also included 8500 with mastectomy, axillary clearance, and node-positive disease in trials of radiotherapy (generally to the chest wall and regional lymph nodes), with similar absolute gains from radiotherapy; 5-year local recurrence risks (mainly at these sites) 6% versus 23% (reduction 17%), and 15-year breast cancer mortality risks 54·7% versus 60·1% (reduction 5·4%, SE 1·3, 2p=0·0002; overall mortality reduction 4·4%, SE 1·2, 2p=0·0009). Radiotherapy produced similar proportional reductions in local recurrence in all women (irrespective of age or tumour characteristics) and in all major trials of radiotherapy versus not (recent or older; with or without systemic therapy), so large absolute reductions in local recurrence were seen only if the control risk was large. To help assess the life-threatening side-effects of radiotherapy, the trials of radiotherapy versus not were combined with those of radiotherapy versus more surgery. There was, at least with some of the older radiotherapy regimens, a significant excess incidence of contralateral breast cancer (rate ratio 1·18, SE 0·06, 2p=0·002) and a significant excess of non-breast-cancer mortality in irradiated women (rate ratio 1·12, SE 0·04, 2p=0·001). Both were slight during the first 5 years, but continued after year 15. The excess mortality was mainly from heart disease (rate ratio 1·27, SE 0·07, 2p=0·0001) and lung cancer (rate ratio 1·78, SE 0·22, 2p=0·0004). Interpretation In these trials, avoidance of a local recurrence in the conserved breast after BCS and avoidance of a local recurrence elsewhere (eg, the chest wall or regional nodes) after mastectomy were of comparable relevance to 15-year breast cancer mortality. Differences in local treatment that substantially affect local recurrence rates would, in the hypothetical absence of any other causes of death, avoid about one breast cancer death over the next 15 years for every four local recurrences avoided, and should reduce 15-year overall mortality.

49. Experiences of pregnant women recieving acupuncture treatment from Midwives

Author

Lythgoe, J

Abstract

Acupuncture is potentially an effective treatment for common conditions of pregnancy and labour pain with midwives being well placed to offer it. The aims of this study were to explore the experiences of pregnant women receiving acupuncture treatment from midwives, to provide insight into their perceptions of effect including the influence and value of the midwife on this experience. The lack of qualitative evidence has provided the rationale for this study. Within a phenomenological methodology an 'Interpretative Phenomenological Analysis' (IPA) approach was adopted, with 10 women attending the Salford Midwifery Acupuncture Service (SMAS) being recruited to this study. Data was collected via semi-structured interviews and the IPA analysis identified five main themes; justification of choice, relief & relaxation, trust & understanding, regaining self, discovering and sharing a secret. The women were happy to access acupuncture if recommended by a health professional; they gained pain relief and improved function, with more ability to care for their children and to continue working. They were grateful for the opportunity to access acupuncture, finding it enjoyable and reporting intense emotional and physical sensations. It offered prolonged effect, improving sleep and wellbeing, and it correlated well with purported neurophysiological mechanisms. Responses seemed more intense than in previous reports, possibly due to their pregnant state or heightened affective component. A midwife-acupuncturist was advantageous having knowledge and understanding of pregnancy, with ‘understanding’ being more important than professional background. The women felt optimistic and empowered to make plans for birth and parenthood and were wishing to share their experiences with others. The ‘lay network’ was an important factor within the women’s choice to access acupuncture. These findings indicate acupuncture is an acceptable treatment which can provide relief, improved wellbeing and support normality. Midwives could offer acupuncture as an adjunct to their role to facilitate individualised reflexive practice.

Catalog

Books, media, physical & digital resources
See catalog results