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Goodfellow M, O'Hara J, Kennedy M, Adams J. Novel method to plan and design services. Using software to optimise the head and neck cancer patient's commute to hospital. Br J Oral Maxillofac Surg 2024; 62:150-156. [PMID: 38155067 DOI: 10.1016/j.bjoms.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/11/2023] [Accepted: 10/26/2023] [Indexed: 12/30/2023]
Abstract
Travelling for hospital appointments represents a significant burden to patients. We have developed a computer programme that accurately evaluates patient commutes between their home and treatment hospital in public and private transport. This has been applied to a cohort of Head and Neck Cancer (HNC) patients to plan the locations of satellite hospitals and assess their impact on patients' commutes. Patients diagnosed with HNC were identified from our hospital's database between December 2019 and January 2022. Using Python, commuting distances from patients' postcodes to our tertiary referral hospital were calculated. These commutes incorporated routes along defined roads, traffic data, and were calculated using public and private transport. Patient commutes from their postcodes to four satellite hospitals were also calculated. We identified their closest hospital and compared that journey to the patients' journey to our tertiary centre. We included 709 patients in our analysis. Patients would have a significantly shorter journey distance and time in both public and private transport if satellite hospitals were used for appointments alongside our tertiary centre. Average travel times would reduce by 10 minutes in private and 25 minutes in public transport. Furthermore, 70% of patients required ≥2 forms of public transport to get to our hospital. This would drop to 44.1% of patients if satellite hospitals were included in our service. Our programme would allow the most accessible sites to be identified for establishing outreach clinics at appropriate satellite hospitals, therefore improving patient access to healthcare.
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Affiliation(s)
- Michael Goodfellow
- Department of Otolaryngology, Freeman Hospital, Freeman Rd, High Heaton, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, United Kingdom.
| | - James O'Hara
- Department of Otolaryngology, Freeman Hospital, Freeman Rd, High Heaton, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, United Kingdom
| | - Matthew Kennedy
- Department of Oral & Maxillofacial Surgery, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - James Adams
- Department of Oral & Maxillofacial Surgery, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, United Kingdom
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von Witzleben A, Ellis M, Thomas GJ, Hoffmann TK, Jackson R, Laban S, Ottensmeier CH. Tumor-Infiltrating CD103+ Tissue-Resident Memory T Cells and CD103-CD8+ T Cells in HNSCC Are Linked to Outcome in Primary but not Metastatic Disease. Clin Cancer Res 2024; 30:224-234. [PMID: 37874322 DOI: 10.1158/1078-0432.ccr-23-0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/14/2023] [Accepted: 10/23/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE High numbers of tumor-infiltrating lymphocytes (TIL) are linked to better survival in patients with cancer. Tissue-resident memory T cells (TRM; CD8+CD103+) are recognized as a key player of anticancer immune response. To assess TRM cells in primary, metastatic, and recurrent head and neck squamous cell carcinoma (HNSCC), we developed a tissue microarray (TMA) and used multiplex IHC (MxIHC). EXPERIMENTAL DESIGN Samples from primary tumors of 379 HNSCC cases treated at Southampton Hospitals between 2000 and 2016 were collected and analyzed. Of these, 105 cases had lymph node metastases and 82 recurrences. A TMA was generated with triplicate cores for each sample. MxIHC with a stain-and-strip approach was performed using CD8, CD103, and TIM3. Scanned slides were analyzed (digital image analysis) and quality checked (QC). RESULTS After QC, 194 primary tumors, 76 lymph node metastases, and 65 recurrences were evaluable. Alcohol consumption was statistically significantly correlated with a reduction of TRM cells in primary tumors (nondrinker vs. heavy drinker: P = 0.0036). The known survival benefit of TRM cell infiltration in primary tumors was not found for lymph node metastasis. In recurrences, a high TRM cell number led to a favorable outcome after 12 months. The checkpoint molecule TIM3, was expressed significantly higher on TRM and non-TRM cells in the lymph node compared with primary tumors (P < 0.0001), which was also seen in recurrences (P = 0.0134 and P = 0.0007, respectively). CONCLUSIONS We confirm the prognostic impact of TIL in primary tumors and in recurrences. TRM cell density in lymph node metastases was not linked to outcome. The role of TIM3, as a therapeutic target remains to be defined.
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Affiliation(s)
- Adrian von Witzleben
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Ulm, Germany
- CRUK and NIHR Experimental Cancer Medicine Center and School of Cancer Sciences, Faculty of Medicine, H, Southampton, United Kingdom
| | - Matthew Ellis
- CRUK and NIHR Experimental Cancer Medicine Center and School of Cancer Sciences, Faculty of Medicine, H, Southampton, United Kingdom
| | - Gareth J Thomas
- CRUK and NIHR Experimental Cancer Medicine Center and School of Cancer Sciences, Faculty of Medicine, H, Southampton, United Kingdom
- Southampton University Hospitals NHS Foundation Trust, Southampton, United Kingdom
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Ulm, Germany
| | - Richard Jackson
- Liverpool Clinical Trials Center, University of Liverpool, Liverpool, United Kingdom
| | - Simon Laban
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Ulm, Germany
| | - Christian H Ottensmeier
- Liverpool Head and Neck Center, Institute of Systems, Molecular and Integrative Biology and Liverpool CRUK and NIHR Experimental Cancer Medicine Center, UK University of Liverpool, Liverpool, United Kingdom
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Higashionna T, Harada K, Maruo A, Niimura T, Tan E, Vu QT, Kawabata T, Ushio S, Hamano H, Kajizono M, Zamami Y, Ishizawa K, Harada K, Hinotsu S, Kano MR, Hagiya H, Koyama T. Trends in Head and Neck Cancer Mortality from 1999 to 2019 in Japan: An Observational Analysis. Cancers (Basel) 2023; 15:3786. [PMID: 37568602 PMCID: PMC10417308 DOI: 10.3390/cancers15153786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 08/13/2023] Open
Abstract
Globally, the numbers of head and neck cancer (HNC) cases and related deaths have recently increased. In Japan, few studies have examined crude or age-adjusted HNC mortality rates. Therefore, this study aimed to determine the trends in crude and age-adjusted mortality rates for HNC per million individuals in Japan from 1999 to 2019. Data on HNC-associated deaths were extracted from the national death certificate database using the International Classification of Diseases, Tenth Revision (n = 156,742). HNC mortality trends were analysed using joinpoint regression models to estimate annual percentage change (APC) and average APC (AAPC). Among men, no significant change was observed in the age-adjusted death rate trend from 1999 to 2014; however, a marked decrease was observed from 2014 to 2019. No changing point was observed in women. Age-adjusted mortality rates continuously decreased over the 21-year period, with an AAPC of -0.7% in men and -0.6% in women. In conclusion, the overall trend in age-adjusted rates of HNC-associated deaths decreased, particularly among men, in the past 5 years. These results will contribute to the formulation of medical policies to develop targeted screening and prevention programmes for HNC in Japan and determine the direction of treatment strategies.
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Affiliation(s)
- Tsukasa Higashionna
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan; (T.H.); (K.H.); (A.M.)
- Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan; (T.K.); (S.U.); (H.H.); (M.K.)
| | - Keisaku Harada
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan; (T.H.); (K.H.); (A.M.)
- Department of Pharmacy, Kitakyushu City Yahata Hospital, Fukuoka 8058534, Japan;
| | - Akinari Maruo
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan; (T.H.); (K.H.); (A.M.)
- Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan; (T.K.); (S.U.); (H.H.); (M.K.)
| | - Takahiro Niimura
- Department of Clinical Pharmacology and Therapeutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708503, Japan; (T.N.); (K.I.)
| | - Elizabeth Tan
- Graduate School, Centro Escolar University Manila, Manila 1008, Philippines;
- Department of Pharmacy, University of San Carlos, Cebu City 6000, Philippines
| | - Quynh Thi Vu
- Faculty of Pharmacy, Haiphong University of Medicine and Pharmacy, Haiphong 04254, Vietnam;
| | - Takayoshi Kawabata
- Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan; (T.K.); (S.U.); (H.H.); (M.K.)
| | - Soichiro Ushio
- Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan; (T.K.); (S.U.); (H.H.); (M.K.)
| | - Hirofumi Hamano
- Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan; (T.K.); (S.U.); (H.H.); (M.K.)
| | - Makoto Kajizono
- Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan; (T.K.); (S.U.); (H.H.); (M.K.)
| | - Yoshito Zamami
- Department of Pharmacy, Kitakyushu City Yahata Hospital, Fukuoka 8058534, Japan;
| | - Keisuke Ishizawa
- Department of Clinical Pharmacology and Therapeutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708503, Japan; (T.N.); (K.I.)
| | - Ko Harada
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY 10029, USA;
| | - Shiro Hinotsu
- Department of Biostatistics and Data Management, Sapporo Medical University, Hokkaido 0608556, Japan;
| | - Mitsunobu R. Kano
- Department of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama 7008530, Japan;
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan;
| | - Toshihiro Koyama
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan; (T.H.); (K.H.); (A.M.)
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Perera I, Amarasinghe H, Jayasinghe RD, Udayamalee I, Jayasuriya N, Warnakulasuriya S, Johnson NW. An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise. Community Dent Oral Epidemiol 2023. [PMID: 37377376 DOI: 10.1111/cdoe.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES Over the past several decades, oral cancer has been the most common malignancy among Sri Lankan males and the top 10 cancer among females, disproportionately affecting low socio-economic groups. Sri Lanka is a lower-middle-income developing country (LMIC), currently striking through an economic crisis, and social and political unrest. Occurring at an accessible body site and predominantly attributed to potentially modifiable health-related behaviours, oral cancer should be preventable and controllable. Unfortunately, broader contextual factors that are socio-cultural, environmental, economic, and political and mediated through social determinants of people's lives consistently hinder progress. Many LMICs with a high burden of oral cancer are now gripped by economic crises, consequent social and political unrest, all compounded by reduced public health investments. The aim of this review is to provide a critical commentary on key aspects of oral cancer epidemiology including inequalities, using Sri Lanka as a case study. METHODS The review synthesizes evidence from multiple data sources, such as published studies, web-based national cancer incidence data, national surveys on smokeless tobacco (ST) and areca nut use, smoking and alcohol consumption, poverty headcount ratios, economic growth, and Gross Domestic Product (GDP) health expenditure. National trends in the oral cancer, ST use, smoking and alcohol consumption in Sri Lanka are identified alongside inequalities. RESULTS Using these evidence sources, we discuss 'where are we now?', together with the availability, accessibility and affordability of oral cancer treatment services, oral cancer prevention and control programmes, tobacco and alcohol control policies, and finally, outline macroeconomic perspectives of Sri Lanka. CONCLUSIONS Finally, we speculate, 'where to next?' Our overarching goal of this review is to initiate a critical discourse on bridging the gaps and crossing the divides to tackle oral cancer inequalities in LMIC such as Sri Lanka.
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Affiliation(s)
- Irosha Perera
- Preventive Oral Health Unit, National Dental Hospital (Teaching), Colombo, Sri Lanka
| | - Hemantha Amarasinghe
- Department of Community Dental Health, Faculty of Dental Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Ruwan D Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Iresha Udayamalee
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Griffith, Queensland, Australia
| | - Nadeena Jayasuriya
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, London and the WHO Collaborating Centre for Oral Cancer, London, UK
| | - Newell W Johnson
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Griffith, Queensland, Australia
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, London and the WHO Collaborating Centre for Oral Cancer, London, UK
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Menger F, Deane J, Patterson JM, Fisher P, O’Hara J, Sharp L. The nature and content of rumination for head and neck cancer survivors. Front Psychol 2022; 13:995187. [DOI: 10.3389/fpsyg.2022.995187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionHead and neck cancer (HNC) diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth (PTG), which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited (11 male, 9 female, age range 46–83). They had a range of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking (e.g., on treatment decisions made) and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears (e.g., concerns about their future) or returned to negative experiences (e.g., distressing exchanges with healthcare professionals or what they perceived as poor care).ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination (commonly focused on ongoing fears or inability to resolve difficult experiences) helps to identify those who may benefit from more directed psychological support.
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Sheldrick H, Houghton L, Fleming C, Crane J. An integrated care systems model approach for speech and language therapy head and neck cancer services in England: service development and re-design in Cheshire and Merseyside. Curr Opin Otolaryngol Head Neck Surg 2022; 30:177-181. [PMID: 35635112 DOI: 10.1097/moo.0000000000000800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The incidence of head and neck cancer (HNC) is increasing globally and changes in treatment mean that patients are living longer with the condition. It is recognised that while there have been improvements at the diagnostic phase of the pathway, follow-up and on-going care can be fragmented and inequitable. Integrated care models (ICMs) are acknowledged as beneficial. The National Health Service in England is moving to a model whereby services are being re-organised to integrated care systems. This paper reviews the literature and discusses potential models of care to enhance speech and language therapy (SLT) provision for patients with HNC in line with the emerging ICS. RECENT FINDINGS The COVID-19 pandemic has provided an opportunity to review service provision and SLT teams quickly adapted to offering remote support. Discussions are currently on-going to explore the potential for patient initiated follow-up via the PETNECK 2 trial and the Buurtzorg 'neighbourhood model' holds promise. SUMMARY ICMs put the patient at the centre of care and have reported benefits for experience of care and clinical outcomes. Navigating organisational structures is complex. The Buurtzorg model provides a practical and theoretical framework to support organisational change.
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Affiliation(s)
| | | | | | - Julie Crane
- Sohool of Health Sciences, University of Liverpool, Liverpool, UK
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Abbatemarco JR, Carlson A, Ontaneda D, McGinley M, Bermel RA, Husak S, Bruckman D, Schold JD, Miller DM. Association of Socioeconomic Disadvantage and Neighborhood Disparities with Clinical Outcomes in Multiple Sclerosis Patients. Mult Scler Relat Disord 2022; 61:103734. [DOI: 10.1016/j.msard.2022.103734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/20/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
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Lau AS, Milinis K, Roode M, Williams SP, Cook C, Walijee H, Zammit M, Siau R, Emerson H, Wright R, Hampton T. The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with symptoms of peritonsillar abscess or cellulitis: A retrospective multicentre study. Clin Otolaryngol 2021; 46:1362-1367. [PMID: 34407287 DOI: 10.1111/coa.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/08/2021] [Accepted: 08/08/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Anecdotal evidence suggests that oropharyngeal squamous cell carcinoma (OPSCC) should be suspected in patients presenting with symptoms of peritonsillar abscess (PTA) or cellulitis (PTC). The aim of this study was to estimate the prevalence of OPSCC in patients presenting with symptoms of PTA/PTC. METHOD, SETTING AND PARTICIPANTS We retrospectively identified all adults with a coded diagnosis of PTA or PTC who presented between 2012 and 2016 inclusive, across six ENT units in Merseyside. Records were compared to that of the centralised regional head and neck cancer database. The clinical records of a subset of patients were reviewed for the purposes of data validation. RESULTS A total of 1975 patients with PTA/PTC were identified. Three patients were subsequently diagnosed with OPSCC. None of the three actually had an objective underlying diagnosis of PTA/PTC on the same side. The prevalence of OPSCC in patients admitted with symptoms of PTA/PTC was 0.15% or approximately 1:650 admissions. The records of 510 patients who presented over a one-year period (2016) were reviewed in even greater detail. There were 298 patients with PTA (59.4%) and 151 with PTC (29.1%) and 61 had an alternative diagnosis (11.9%). High-risk features (age ≥40, tonsillar asymmetry or tonsillar lesion) were present in 106 patients (24%). Urgent follow-up was expedited for 77 patients (73%). CONCLUSION This study estimates the risk of OPSCC in patients with peritonsillar symptoms. The prevalence is low, even in a region with a relatively heavy disease burden. Clinicians should, however, retain a high level of suspicion in patients with persistent symptoms.
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Affiliation(s)
- Andrew S Lau
- Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.,Mersey ENT Research Collaborative, Liverpool, UK
| | - Kristijonas Milinis
- Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.,Mersey ENT Research Collaborative, Liverpool, UK
| | - Mila Roode
- Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.,Mersey ENT Research Collaborative, Liverpool, UK
| | - Stephen P Williams
- Mersey ENT Research Collaborative, Liverpool, UK.,Arrowe Park Hospital, Wirral University Teaching Hospitals NHS Foundation Trust, Wirral, UK
| | - Colette Cook
- Countess of Chester Hospital NHS Foundation Trust, Chester, UK
| | - Hussein Walijee
- Mersey ENT Research Collaborative, Liverpool, UK.,Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK
| | - Matthew Zammit
- Mersey ENT Research Collaborative, Liverpool, UK.,Royal Liverpool Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Richard Siau
- Mersey ENT Research Collaborative, Liverpool, UK.,Royal Liverpool Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Hannah Emerson
- Mersey ENT Research Collaborative, Liverpool, UK.,Warrington Hospital, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
| | - Rosanna Wright
- Mersey ENT Research Collaborative, Liverpool, UK.,Warrington Hospital, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
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Burton S, Puddephatt JA, Baines L, Sheen F, Warren JG, Jones A. Limited Evidence of Associations Between Executive Functioning and Alcohol Involvement In UK Adolescents. Alcohol Alcohol 2021; 56:754-762. [PMID: 33836535 PMCID: PMC8557664 DOI: 10.1093/alcalc/agab020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 11/29/2022] Open
Abstract
Aims Deficits in motor inhibitory control and working memory have been hypothesized to be both a cause and consequence of heavy alcohol use. Adolescence is a critical developmental stage for inhibitory control and working memory, and it is also a stage when individuals are most likely to initiate alcohol use. This study aimed to examine whether inhibitory control and working memory would predict alcohol use and involvement in a group of UK adolescents. Methods We recruited 220 (N = 178, female) adolescents, aged between 16 and 18, from eight higher education settings in the Merseyside region of the UK. Alcohol use was examined using the Timeline Follow-Back and involvement (and related problems) using the Adolescent Alcohol Involvement Scale. A reward-based inhibitory control task (Go/No-Go) was used to examine the inhibition and reward sensitivity, and a self-ordered pointing task was used to measure working memory. Results Multiple regression demonstrated that neither inhibitory control (b = 0.02 (95% confidence interval (CI): −0.21, 0.24)) nor working memory (b = −0.12 (95% CI: −0.30, 0.07)) were significant predictors of alcohol use (units consumed). Inhibitory control (b = 0.61 (95% CI: 0.12, 1.09), specifically, in the no reward condition and school deprivation (b = 0.67 (95% CI: 0.06, 1.28) significantly predicted alcohol-related problems. Conclusions Our findings demonstrated limited evidence that deficits in specific mechanisms of executive functioning (i.e. motor inhibition and working memory) were associated with alcohol-related problems in UK adolescents. This study adds to an increasing body of literature suggesting weak or non-existent links between inhibitory control, working memory and alcohol use.
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Affiliation(s)
- Sam Burton
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Jo-Anne Puddephatt
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Laura Baines
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Florence Sheen
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Jasmine G Warren
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
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Leong CH, Mohd Slim MA, Sabri H, Douglas CM, Montgomery J. Sociodemographics and survival characteristics of 253 human papilloma virus-related oropropharyngeal cancer cases in Glasgow, Scotland - A retrospective analysis. Clin Otolaryngol 2021; 46:854-860. [PMID: 33548091 DOI: 10.1111/coa.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/13/2021] [Accepted: 01/24/2021] [Indexed: 11/30/2022]
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Clarke N, Dunne S, Coffey L, Sharp L, Desmond D, O'Conner J, O'Sullivan E, Timon C, Cullen C, Gallagher P. Health literacy impacts self-management, quality of life and fear of recurrence in head and neck cancer survivors. J Cancer Surviv 2021. [PMID: 33420906 DOI: 10.1007/s11764-020-00978-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/03/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Little is known about whether health literacy is associated with affects certain key outcomes in head and neck cancer (HNC) survivors. We investigated (i) the socio-demographic and clinical profile of health literacy and (ii) associations among between health literacy and self-management behaviours, health-related quality of life (HRQL) and fear of recurrence (FoR) in HNC survivors. METHODS A population-based survey was conducted in Ireland. Health literacy was assessed using a validated single-item question. Socio-demographic, clinical and psychosocial outcome variables (FoR, self-management behaviours, HRQL) were collected. Multivariable linear regression was performed to estimate associations between health literacy and each psychosocial outcome. RESULTS Three hundred ninety-five (50%) individuals responded to the survey. Inadequate health literacy was evident among 47% of the sample. In adjusted models, HNC survivors with inadequate health literacy had significantly lower levels of self-management behaviours in the domains of health-directed behaviour, positive and active engagement in life, self-monitoring and insight, constructive attitudes and approaches and skills and technique acquisition. Inadequate health literacy was independently associated with lower functional well-being and HNC disease-specific HRQL. FoR was also significantly higher among those with inadequate health literacy. CONCLUSIONS HNC survivors with inadequate health literacy have lower levels of self-management behaviours, lower functional HRQL and increased FoR compared to those with adequate health literacy. IMPLICATIONS FOR CANCER SURVIVORS Clinicians, healthcare providers and those developing interventions should consider how inadequate health literacy among HNC survivors might affect post-treatment outcomes when developing services and providing support for this group.
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Ravaghi V, Durkan C, Jones K, Girdler R, Mair-Jenkins J, Davies G, Wilcox D, Dermont M, White S, Dailey Y, Morris AJ. Area-level deprivation and oral cancer in England 2012-2016. Cancer Epidemiol 2020; 69:101840. [PMID: 33126041 DOI: 10.1016/j.canep.2020.101840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND The relationship between deprivation and oral cancer is complex. We examined magnitude and shape of deprivation-related inequalities in oral cancer in England 2012-2016. METHODS Oral cancer was indicated by cancers of the lip and oral cavity (ICD10 C00-C06) and lip, oral cavity and pharynx (C00-C14) and deprivation by the Index of Multiple Deprivation. Deprivation inequality in incidence and mortality rates of oral cancer outcomes was measured using the Relative Index of Inequality (RII). Fractional polynomial regression was used to explore the shape of the relationships between deprivation and oral cancer outcomes. Multivariate regression models were fitted with the appropriate functions to examine the independent effect of deprivation on cancer adjusting for smoking, alcohol and ethnicity. RESULTS Incidence rate ratios (IRRs) and mortality rate ratios (MRRs) were greater for more deprived areas. The RII values indicated significant inequalities for oral cancer outcomes but the magnitude of inequalities were greater for mortality. The relationships between deprivation and oral cancer outcomes were curvilinear. Deprivation, Asian ethnicity and alcohol consumption were associated with higher incidence and mortality rates of oral cancer. CONCLUSION This is the first study, to our knowledge, exploring the shape of socioeconomic inequalities in oral cancer at neighbourhood level. Deprivation-related inequalities were present for all oral cancer outcomes with a steeper rise at the more deprived end of the deprivation spectrum. Deprivation predicted oral cancer even after accounting for other risk factors.
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Midgley A, Levy A, Price R, Cunha F, Rogers S. Should survivors of head and neck cancer be considered a distinct special population within the context of exercise prescription? Br J Oral Maxillofac Surg 2020; 58:738-43. [DOI: 10.1016/j.bjoms.2020.03.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/28/2020] [Indexed: 12/16/2022]
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Rogers S, Staunton A, Girach R, Langton S, Lowe D. Audit of the two-week pathway for patients with suspected cancer of the head and neck and the influence of socioeconomic status. Br J Oral Maxillofac Surg 2019; 57:419-424. [DOI: 10.1016/j.bjoms.2018.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 09/19/2018] [Indexed: 10/26/2022]
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Burges Watson D, Lewis S, Campbell M, Bryant V, Storey S, Deary V. Food play: A novel research methodology for visceral geographers and health researchers. Health Place 2019; 57:139-146. [DOI: 10.1016/j.healthplace.2019.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
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Harding KE, Wardle M, Carruthers R, Robertson N, Zhu F, Kingwell E, Tremlett H. Socioeconomic status and disability progression in multiple sclerosis: A multinational study. Neurology 2019; 92:e1497-e1506. [PMID: 30796140 DOI: 10.1212/wnl.0000000000007190] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/16/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To examine the association between socioeconomic status (SES) and disability outcomes and progression in multiple sclerosis (MS). METHODS Health administrative and MS clinical data were linked for 2 cohorts of patients with MS in British Columbia (Canada) and South East Wales (UK). SES was measured at MS symptom onset (±3 years) based on neighborhood-level average income. The association between SES at MS onset and sustained and confirmed Expanded Disability Status Scale (EDSS) 6.0 and 4.0 and onset of secondary progression of MS (SPMS) were assessed using Cox proportional hazards models. EDSS scores were also examined via linear regression, using generalized estimating equations (GEE) with an exchangeable working correlation. Models were adjusted for onset age, sex, initial disease course, and disease-modifying drug exposure. Random effect models (meta-analysis) were used to combine results from the 2 cohorts. RESULTS A total of 3,113 patients with MS were included (2,069 from Canada; 1,044 from Wales). A higher SES was associated with a lower hazard of reaching EDSS 6.0 (adjusted hazard ratio [aHR] 0.90, 95% confidence interval [CI] 0.89-0.91), EDSS 4.0 (aHR 0.93, 0.88-0.98), and SPMS (aHR 0.94, 0.88-0.99). The direction of findings was similar when all EDSS scores were included (GEE: β = -0.13, -0.18 to -0.08). CONCLUSIONS Lower neighborhood-level SES was associated with a higher risk of disability progression. Reasons for this association are likely to be complex but could include factors amenable to modification, such as lifestyle or comorbidity. Our findings are relevant for planning and development of MS services.
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Affiliation(s)
- Katharine E Harding
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK.
| | - Mark Wardle
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK
| | - Robert Carruthers
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK
| | - Neil Robertson
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK
| | - Feng Zhu
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK
| | - Elaine Kingwell
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK
| | - Helen Tremlett
- From the Faculty of Medicine (Neurology) and Djavad Mowafaghian Centre for Brain Health (K.E.H., R.C., F.Z., E.K., H.T.), University of British Columbia, Vancouver, Canada; Institute of Psychological Medicine and Clinical Neuroscience (K.E.H., N.R.), Cardiff University, University Hospital of Cardiff; and Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology (M.W., N.R.), University Hospital of Wales, Heath Park, Cardiff, UK
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