Suchergebnisse

Body Language Getting Off to a Good Start -- Oral Assessment -- At a Job Interview -- On the Telephone Talking to Customers or Clients -- Asking the Boss for Something -- Showing Someone How to do Something -- In a Formal Meeting Chairing a Discussion -- Group In Front of a Group of People -- Media Interviews.

Australia is facing long term workforce shortages coupled with a population increasingly burdened with chronic disease. The National Chronic Disease Strategy recognises the central role general practice has to play in the prevention, detection and management of chronic illness. Implementing the strategy will require considerable change in the way general practice teams work. Organisational development (OD) is used in businesses to improve how individuals and organisations perform in achieving organisational objectives. We assessed how these practices could be used in a general practice setting. ; The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy.

Australia is facing long term workforce shortages coupled with a population increasingly burdened with chronic disease. The National Chronic Disease Strategy recognises the central role general practice has to play in the prevention, detection and management of chronic illness. Implementing the strategy will require considerable change in the way general practice teams work. Organisational development (OD) is used in businesses to improve how individuals and organisations perform in achieving organisational objectives. We assessed how these practices could be used in a general practice setting. ; The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy.

This qualitative research informed the Theory of Planned Behaviour (TPB)-based intervention development. This dataset was generated as part of formative research conducted on patients of chronic respiratory disease (CRD), their caregivers and community members to get a perception of their awareness, practices of health behaviour and their opinions regarding CRD. The study also elicited the socio-cultural barriers and the psycho-social effects due to the disease. The insight into the existing health behaviour and the barriers to appropriate behaviour informed the development of a TPB based health intervention for behaviour change in patients with CRD. ; Focus Group Discussion 1.txt - transcript of focus group discussion (FGD) among females with Chronic respiratory disease (CRD), =50 years of age from a rural village (village 1) Focus Group Discussion 3.txt - transcript of FGD among females with CRD, >=50 years of age from a rural village (village 2) Focus Group Discussion 4.txt - transcript of FGD among males with CRD, =50 years of age from a rural village (village 3) Focus Group Discussion 6.txt - transcript of FGD among males with CRD, =50 years of age from a rural village (village 4) Focus Group Discussion 2.txt - transcript of FGD among females with CRD, <50 years of age from a rural village (village 4) In-depth Interview 1.txt - transcript of in-depth interview with caregiver 1 (male) in village 2 In-depth Interview 2.txt - transcript of in-depth interview with caregiver 2 (male) in village 4 In-depth Interview 3.txt - transcript of in-depth interview with caregiver 3 (male) in village 3 In-depth Interview 4.txt - transcript of in-depth interview with caregiver 4 (female) in village 1 In-depth Interview 5.txt - transcript of in-depth interview with caregiver 5 (female) in village 3 Key Informant Interview_BDO.txt - transcript of key informant interview with block development officer Key Informant Interview_BMO.txt - transcript of key informant interview with block medical officer Key Informant Interview_Head Govt Girls High School.txt - transcript of key informant interview with the head of a girls high school Key Informant Interview_Panchayat Menber.txt - transcript of key informant interview with member of a local government

Funding The National Cancer Diagnosis Audit (NCDA) in Scotland received enabling support from Cancer Research UK and the Scottish Government. Acknowledgements This audit used data provided by patients and collected by NHS as part of their care and support. The authors would like to thank all GPs and health professionals who participated in the NCDA in Scotland, the members of the NCDA Steering Group, as well as contributing staff at Cancer Research UK; Information Services Division (NHS Scotland); Scottish Government; the Royal College of General Practitioners; and Macmillan Cancer Support. National Cancer Diagnosis Audit (2014) Steering Group: Sue Ballard (patient †), Patricia Barnett, David H Brewster, Cathy Burton, Anthony Cunliffe, Jane Fenton-May, Anna Gavin, Sara Hiom (chair), Peter Hutchison, Dyfed Huws, Maggie Kemmner, Rosie Loftus, Georgios Lyratzopoulos, Emma McNair, John Marsh (patient), Jodie Moffat, Sean McPhail, Peter Murchie, Andy Murphy, Sophia Nicola, Imran Rafi, Jem Rashbass, Richard Roope, Greg Rubin, Brian Shand, Ruth Swann, Janet Warlow, David Weller, and Jana Witt. ; Peer reviewed ; Postprint

OBJECTIVE: To explore symptom appraisal and help-seeking decisions among patients recently diagnosed with melanomas, and to compare experiences of people with 'thinner' (2 mm) melanomas, as thickness at diagnosis is an important prognostic feature. METHODS: In-depth interviews with patients within 10 weeks of melanoma diagnosis explored the factors impacting on their pathways to diagnosis. Framework analysis, underpinned by the Model of Pathways to Treatment, was used to explore the data with particular focus on patients' beliefs and experiences, disease factors, and healthcare professional (HCP) influences. RESULTS: 63 patients were interviewed (29-93 years, 31 women, 30 thicker melanomas). All described their skin changes using rich lay vocabulary. Many included unassuming features such as 'just a little spot' as well as common features of changes in size, colour and shape. There appeared to be subtly different patterns of symptoms: descriptions of vertical growth, bleeding, oozing and itch were features of thicker melanomas irrespective of pathological type. Appraisal was influenced by explanations such as normal life changes, prior beliefs and whether skin changes matched known melanoma descriptions. Most decisions to seek help were triggered by common factors such as advice from family and friends. 11 patients reported previous reassurance about their skin changes by a HCP, with little guidance on monitoring change or when it would be appropriate to re-consult. CONCLUSIONS: Patients diagnosed with both thinner and thicker melanomas often did not initially recognise or interpret their skin changes as warning signs or prompts to seek timely medical attention. The findings provide guidance for melanoma awareness campaigns on more appropriate images, helpful descriptive language and the need to stress the often apparently innocuous nature of potentially serious skin changes. The importance of appropriate advice, monitoring and safety-netting procedures by HCPs for people presenting with skin changes is also highlighted. ; Thanks to our funding organisation the National Awareness and Early Diagnosis Initiative (NAEDI), and to their funding partners: Cancer Research UK; Department of Health, England; Economic and Social Research Council; Health and Social Care Research and Development Division; Public Health Agency, Northern Ireland, National Institute for Social Care and Health Research, Wales and the Scottish Government. All researchers were independent of the funding body and the study sponsors and funder had no role in study design; data collection, analysis and interpretation of data; in the writing of the report; or decision to submit the article for publication. FW was supported by an NIHR Clinical Lectureship followed by a NIHR Clinician Scientist award at the time of this study. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. ; This is the final published version. It's also available from BMJ Open at http://bmjopen.bmj.com/content/4/7/e005566.abstract.

IntroductionPopulation-based screening has been shown to reduce cancer specific mortality. Within Scotland, three national screening programmes exist: breast, cervical and bowel. Despite being a common and preventable form of cancer, the uptake for bowel cancer screening among women lags behind that for breast and cervical cancer.
Objectives and ApproachSince the benefits of screening accrue with participation, it is important to understand why differences in screening uptake exist. In this study, data on women aged 24-74 in the Greater Glasgow and Clyde Health Board, invited to take part in one or more screening programme during the period 2009-2013, were linked to demographic and medical data. Uptake was determined based on the presence of a screening attendance or result; the impact of age, deprivation and co-morbidity on uptake was determined using logistic regression for each individual programme, and for the cohort of women invited to participate in all three programmes.
ResultsOverall, 430,591 women were invited to take part in one or more screening programme during the study period. The uptake for bowel screening was, at 61.7%, lower than that seen in either the breast (72.6%) or cervical (80.7%) programme. Despite these differences, the same demographic factors were associated with uptake of each individual screening programme: older women and those living in affluent areas were most likely to attend. Medical factors did differentially influence uptake, those with multi-morbid illness being less likely to participate in breast and bowel, but not the cervical programme. For the 68,324 women invited to participate in all programmes, 52.1% took part in all three while 7.2% participated in none.
Conclusion/ImplicationsUptake of bowel screening was confirmed as lower than uptake of other programmes, although all were similarly impacted by demographic, clinical and socioeconomic factors. Individuals were more likely to complete bowel screening if they participate in another programme, suggesting these may serve as a vehicle for improving bowel screening uptake.

Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer. This final Series paper highlights the challenges and opportunities for small island nations, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities to strengthen cancer-related health systems to improve sharing of technical assistance for research, surveillance, workforce, and service development, and to support small island nations with policy changes to reduce the consumption of commodities (eg, tobacco and unhealthy food products) that increase cancer risk.

Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer. This final Series paper highlights the challenges and opportunities for small island nations, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities to strengthen cancer-related health systems to improve sharing of technical assistance for research, surveillance, workforce, and service development, and to support small island nations with policy changes to reduce the consumption of commodities (eg, tobacco and unhealthy food products) that increase cancer risk.

© 2015 Elsevier Ltd. The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise-from epidemiologists, psychologists, policy makers, and cancer specialists-has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care-its continuous, coordinated, and comprehensive care for individuals and families-are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.

The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise-from epidemiologists, psychologists, policy makers, and cancer specialists-has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care-its continuous, coordinated, and comprehensive care for individuals and families-are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.