Search

Introduction\ud The COLO-COHORT study aims to produce a multi-factorial risk prediction model for colorectal neoplasia that will be able to be used to target colonoscopy to those at greatest risk of colorectal neoplasia, ensuring that people are not investigated unnecessarily and maximising the use of limited endoscopy resources. The study will also explore the link between neoplasia and the human gut microbiome. Additionally, the study aims to generate a cohort of colonoscopy patients who are ‘research ready’ through the development of a consent-for-contact platform (C4C), to facilitate a range of CRC prevention studies to be conducted at scale and speed.\ud \ud Methods and Analysis\ud This is a multi-centre observational study involving sites across the UK. Recruitment is over a 6-year period (2019 – 2025). Patients recruited to the study are those attending for colonoscopy. Patients are recruited into two groups, namely; observational Group A (10,000 patients) and C4C Group B (10,000 patients), known as COLO-SPEED (Colorectal Cancer Screening Prevention Endoscopy and Early Diagnosis; https://colospeed.uk).\ud \ud Patients complete a health questionnaire, provide anthropometric measurements and submit biosamples (blood and stool - depending on the part of the study they are recruited into). Patients’ colonoscopy and histology findings are also recorded. Models of factors associated with presence of neoplasia at colonoscopy will be developed using logistic or multinomial regression. For internal validation, model discrimination and calibration will be assessed and bootstrapping and cross-validation approaches used. To enable long-term follow up for outcomes related to CRC and polyps, patients are asked to consent to follow up through data linkage with national databases.\ud \ud Dissemination\ud In keeping with good research practice, following analysis by the study team the study investigators will make the anonymised dataset available to other researchers. The C4C platform will also be accessible to other researchers. The study findings will be submitted for publication in peer reviewed journals and lay summaries will be disseminated to participants and the wider public.

PurposeIn a rapidly changing world organisations are constantly presented with threats and opportunities and the need to be responsive and resilient. This necessitates developing risk and uncertainty management capabilities within organisations. This article aims to consider risk and uncertainty competence, knowledge, skills, attitudes and the behaviours required by contemporary managers to protect their organisations from threat and harm, whilst seizing opportunity and reward.Design/methodology/approachThis article presents answers to three fundamental questions: (1) Do all managers (those not specialising in risk management) need to be competent in risk and uncertainty management? (2) What does risk competence mean? And (3) How can managers develop the capabilities to become risk competent? The content can be used by practicing managers or educators to develop individual and ultimately organisational risk competence.FindingsAll contemporary managers should have some degree of risk competence. Risk competence behavioural indicators and requisite risk knowledge and skills are identified and discussed.Originality/valueThis article provides a contemporary view on risk and uncertainty management competence, drawing on relevant competence frameworks and the existing risk literature.

Little is known about health-related quality of life (HRQOL) following treatment for bladder cancer (BC).To determine this, we undertook a cross-sectional survey covering 10% of the English population.Participants 1-10 yr from diagnosis were identified through national cancer registration data.A postal survey was administered containing generic HRQOL and BC-specific outcome measures. Findings were compared with those of the general population and other pelvic cancer patients.Generic HRQOL was measured using five-level EQ-5D (EQ-5D-5L) and European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ)-C30. BC-specific outcomes were derived from EORTC QLQ-BLM30 and EORTC QLQ-NMIBC24.A total of 1796 surveys were completed (response rate 55%), including 868 (48%) patients with non-muscle-invasive BC, 893 (50%) patients who received radiotherapy or radical cystectomy, and 35 (1.9%) patients for whom treatment was unknown. Most (69%) of the participants reported at least one problem in any EQ-5D dimension. Age/sex-adjusted generic HRQOL outcomes were similar across all stages and treatment groups, whilst problems increased with age (problems in one or more EQ-5D dimensions:65 yr [67% {95% confidence interval or CI: 61-74}] vs 85+ yr [84% {95% CI: 81-89}], p = 0.016) and long-term conditions (no conditions [53% {95% CI: 48-58}] vs more than four conditions [94% {95% CI: 90-97}], p0.001). Sexual problems were reported commonly in men, increasing with younger age and radical treatment. Younger participants (under 65 yr) reported more financial difficulties (mean score 20 [95% CI: 16-25]) than those aged 85+ yr (6.8 [4.5-9.2], p 0.001). HRQOL for BC patients (for comparison, males with problems in one or more EQ-5D dimensions 69% [95% CI: 66-72]) was significantly worse than what has been found after colorectal and prostate cancers and in the general population (51% [95% CI: 48-53], all p 0.05).HRQOL following BC appears to be relatively independent of disease stage, treatment, and multimodal care. Issues are reported with sexual function and financial toxicity. HRQOL after BC is worse than that after other pelvic cancers.Patients living with bladder cancer often have reduced quality of life, which may be worse than that for other common pelvic cancer patients. Age and other illnesses appear to be more important in determining this quality of life than the treatments received. Many men complain of sexual problems. Younger patients have financial worries.

Bladder cancer (BC) is the 10th most common malignancy worldwide and the patient experience is found to be worse than that for patients diagnosed with other cancer types. We aimed to develop a wellbeing intervention to help improve the bladder cancer patient experience by ameliorating their health-related Quality of Life (HRQoL). We followed the 3 phases of the modified Medical Research Council (MRC) Framework for development of complex interventions. Following a systematic review of the literature on mental, sexual, and physical wellbeing, we conducted discussion groups with patients and healthcare professionals on these 3 themes. A consultation phase was then conducted with all relevant stakeholders to co-design a wellbeing intervention as part of a feasibility study. A pragmatic wellbeing feasibility trial was designed based on the hypothesis that a wellbeing program will increase patient awareness and attendance to services available to them and will better support their needs to improve HRQoL. The primary feasibility endpoints are patient attendance to the services offered and changes in HRQoL. The principle of patient centered care has strengthened the commitment to provide a holistic approach to support BC patients. In this study, we developed a wellbeing intervention in collaboration with patients and healthcare professionals to meet an unmet need in terms of the BC patient experience.

OBJECTIVES: Colorectal cancer (CRC) is a leading cause of cancer death worldwide, although effective uptake of bowel cancer screening is below 60% in England. This trial investigated the influence of volitional and motivational interventions and their combination on increasing guaiac fecal occult blood testing (gFOBT) screening uptake.\ud \ud METHOD: In total, 34,633 participants were recruited (via North-East of England bowel cancer screening hub) into a 2×2 factorial cluster randomized controlled trial. Social norm-based motivational intervention (SNA); Implementation intention-based Volitional Help Sheet (VHS); Combined intervention (SNA+VHS); Treatment as usual control. Screening rate (gFOBT kit return rate within 8 weeks of invitation) was the primary outcome.\ud \ud RESULTS: Screening kits were returned by 60% of participants (N=20,847/34,633). A substantial imbalance was observed in participant characteristics, participants in the combined intervention group were younger and more likely to be first time invitees. Adjusted analyses found insufficient evidence that any of the interventions were different to control (Combined: OR = 1.18, 95% CI 0.97-1.44; SNA alone: OR=0.93; 95% CI: 0.76-1.15; VHS alone OR= 0.88; 95% CI: 0.75-1.03). Subgroup analyses demonstrated a significant beneficial effect of the combined intervention in the youngest age group compared to control (OR = 1.27; 95% CI: 1.05-1.54).\ud \ud CONCLUSIONS: The study did not support any benefit of either VHS or SNA interventions alone on bowel cancer screening uptake. The combined SNA+VHS intervention was significantly different from control only in the youngest age group in adjusted analyses. However, the magnitude of effect in the youngest age group suggests that further testing of VHS plus SNA interventions in carefully targeted populations may be warranted.

Globalization changes the composition of the adult classroom, increasing diversity and bringing new associated teaching and learning problems; problems with group work. Educators may have goals to teach transferable multicultural group working skills yet learners find such work more challenging, showing a propensity to form groups containing students more like themselves i.e. unicultural. Using survey data from MBA students spanning 25 countries, this empirical article documents an investigation into methods and techniques used to create groups for teaching and learning in diverse classrooms and considers the arguments for and against a range of approaches. We conclude the educational goal directing the use of group work, student stage and the need for attaining affective and performance outcomes are important determinants of group allocation methods.

PurposeThe purpose of this paper is to consider how to form and compose work‐groups for teaching and learning in diverse classrooms comprising internationally mobile students.Design/methodology/approachThis study uses survey data from 150 MBA students from 25 countries.FindingsThe way members are allocated to a group impacts on both affective and performance outcomes.Originality/valueFor educators and trainers, these results emphasize the importance of group allocation and composition methods for affective and performance outcomes.

Comparisons between classical and critical geopolitics are made with the suggestion that both versions, although different in most respects, are equally legitimate for study and perhaps may be brought closer together, at least in ways that may complement each other, after inspection of their comparative approaches. The classical version deserves consideration as a contribution to international relations theory and to foreign policy making. The critical approach provides a needed and necessary critique of the classical, exposing its weaknesses and suggesting an emancipatory alternative. Accordingly, the author has selected a variety of associated characteristics that show the primary variations between the classical and the critical, illustrated by appropriate quotations and examples, with again the conclusion that both versions of geopolitics, the classical and the critical, merit credibility, and that a possibility exists where certain connections may be located between the two that could mutually clarif...

In response to the challenges regarding the way organisations think individually and collectively about and act upon risk (risk culture) plus recent calls for new approaches to risk management, we investigate risk specialists' current thinking on risk and risk practice. In particular, we seek to review and develop the concept of risk culture in organisations. Organisational risk culture is conceptualised in terms of collective risk thinking to include risk perception and other cognitive processes and risk behaviour. Having conceptualised risk culture, we investigate its determinants and consequences – contingency theory and the concepts of dysfunctional and congruent risk cultures. Drawing on the literature and an empirical study primarily of risk specialists from 100 companies spread over 40 countries, we explore the relationships between organisational cultural variables and review the measurable components of risk culture.