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West Yorkshire (west + yorkshire)
Selected AbstractsHelp-seeking behaviour in patients with lymphomaEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2008D.A. HOWELL Reducing cancer mortality is a priority for the UK Government and emphasis has been placed on introducing targets to ensure prompt diagnosis. Help seeking is the first step on the pathway to diagnosis and should occur promptly; however, patients with lymphoma take longer to seek help for symptoms than those with many other cancers. Despite this, the help seeking behaviour of these patients has not been investigated. This qualitative study examined the beliefs and actions about help seeking among 32 patients, aged 65 and over and newly diagnosed with lymphoma in West Yorkshire during 2000. Patients reported an extremely wide range of symptoms which were not always interpreted as serious or potentially caused by cancer. This, in association with a clear lack of knowledge about lymphoma, often led to help seeking being deferred. The range and characteristics of symptoms can largely be explained in terms of variations in the type, site and size of the lymphoma. The UK Government targets focus on the time after help seeking, yet for lymphoma it is also crucial to reduce the time taken to seek help. More education about the potential symptoms of this disease is needed among the general public. [source] Referral pathways and diagnosis: UK government actions fail to recognize complexity of lymphomaEUROPEAN JOURNAL OF CANCER CARE, Issue 6 2007D.A. HOWELL rgn Referral pathways and diagnosis: UK government actions fail to recognise complexity of lymphoma To gain survival advantages potentially associated with prompt diagnosis, the UK government introduced identical waiting-time targets for all cancers, and guidelines to ensure that general practitioners make appropriate hospital referrals. For lymphoma, the evidence guiding these actions is limited. This study examined referral pathways in patients with lymphoma and variations in time to diagnosis by discipline of first referral. A case series study was conducted including all patients aged over 25 years, newly diagnosed with lymphoma in the UK county of West Yorkshire, during 2000. Data were extracted from primary care and hospital records of 189 patients. Referral pathways were described, and the number of days between first referral and diagnosis calculated. A distinct referral pathway did not exist; patients were initially referred to many disciplines. Surgical referrals predominated, and only 12% of patients were sent directly to haematology. Time to diagnosis varied by discipline and was shorter for patients sent to haematology than for most other common disciplines. UK government actions to ensure the prompt diagnosis of patients with lymphoma are not evidence-based. The complexity of the referral pathway in patients with lymphoma, which affects time to diagnosis, has been underestimated. Further government actions should be evidence-based, ensuring prompt diagnosis of lymphoma from whatever discipline patients originate. [source] ,Balance' is in the eye of the beholder: providing information to support informed choices in antenatal screening via Antenatal Screening Web ResourceHEALTH EXPECTATIONS, Issue 4 2007Shenaz Ahmed BSc (Hons) PhD Abstract Objectives, The Antenatal Screening Web Resource (AnSWeR) was designed to support informed prenatal testing choices by providing balanced information about disability, based on the testimonies of disabled people and their families. We were commissioned by the developers to independently evaluate the website. This paper focused on how participants evaluated AnSWeR in terms of providing balanced information. Setting, West Yorkshire. Participants, A total of 69 people were drawn from three groups: health professionals, people with personal experience of tested-for conditions (Down's syndrome, cystic fibrosis and spina bifida) and people representing potential users of the resource. Method, Data were collected via focus groups and electronic questionnaires. Results, Participants believed that information about the experience of living with the tested-for conditions and terminating a pregnancy for the conditions were important to support informed antenatal testing and termination decisions. However, there were differences in opinion about whether the information about the tested-for conditions was balanced or not. Some people felt that the inclusion of photographs of people with the tested-for conditions introduced biases (both positive and negative). Many participants were also of the opinion that AnSWeR presented insufficient information on termination of an affected pregnancy to support informed choice. Conclusion, This study highlighted the difficulty of designing ,balanced' information about tested-for conditions and a lack of methodology for doing so. It is suggested that AnSWeR currently provides a counterbalance to other websites that focus on the medical aspects of disability. Its aim to provide ,balanced' information would be aided by increasing the number and range of case studies available on the website. [source] Using focus groups to seek the views of patients dying from cancer about the care they receiveHEALTH EXPECTATIONS, Issue 3 2000Norma V. Raynes Purpose The prime purpose of the study was to investigate whether focus groups were a practical way of seeking the views of dying people and whether the information collected added to that collected by more established methods. Design A sample frame of Macmillan nurse patients was collated from which three cluster samples were randomly selected to participate in focus groups. The focus groups were structured with an experienced facilitator and recorder to answer three key questions. Setting and participants Patients of Macmillan nurses in three NHS Trusts in West Yorkshire who were living at home with incurable cancer. They were aware of their condition and were willing to participate. Main variables studied The three key questions were; what kind of help are you currently receiving? What sort of help do you want? Of the kind of help you are receiving what kind is most important to you? Results 17 patients participated in three focus groups. Participants were generally fairly able and living with spouses or relatives. They were of varying age with different types and duration of cancer. They were receiving a range of health and social services of varying importance to them. More help was particularly wanted with support for daily living, support from specialist cancer nurses, help getting out and with housework. Macmillan nurses and general practice services were highly rated in some but not all three trust areas. Conclusions We propose that focus groups are a practical way of collecting information about dying patients that can complement other sources of information in planning and auditing the provision of care. [source] Osman and police immunity in the English law of tortsLEGAL STUDIES, Issue 3 2000Paula Giliker This article examines and questions the nature of police immunity from claims for negligence in the investigation and suppression of crime, as stated by the House of Lords in Hill v Chief Constable of West Yorkshire. This issue has been discussed before the European Court of Human Rights in Osman v United Kingdom, where the court held that a blanket application of the immunity was contrary to art 6 of the European Convention on Human Rights. This article will argue that this decision does not overturn the basic public policy principles for the immunity stated in Hill and that further examination of this area of law is required. It is submitted that if the law is considered in terms of proximity rather than in terms of public policy immunity, a clearer understanding of the principles underlying this area of law can be reached together with the desirable goal of removing the term ,immunity' from this area of law. [source] Patient priorities of care in rheumatology outpatient clinics: a qualitative studyMUSCULOSKELETAL CARE, Issue 4 2007Vicky Ward PhD Abstract Objective:,To provide more understanding of what rheumatoid arthritis (RA) patients want and need from an outpatient visit. Methods:,25 patients who experienced care in a nurse practitioner clinic (n = 10), junior doctor clinic (n = 9) or consultant clinic (n = 6) in a large teaching hospital in West Yorkshire were interviewed about their perceptions and experiences of care. Interviews were approximately 11/2 hours in duration and were carried out in a neutral environment by a research nurse. Interview data were subjected to atheoretical content analysis, which resulted in the identification of emergent themes. Results:,Five main themes emerged from the analysis of interview data: 1) patients want to be communicated to clearly and effectively and value positive relationships with practitioners. These help to give patients confidence in the care they are receiving; 2) patients want to feel in control of their condition and tend to refuse interventions as a way of gaining control; 3) patients want to be given clear explanations during consultations, and want information in oral and written forms; 4) patients want to be able to access practitioners between scheduled appointments as a way of gaining reassurance; and 5) patients want to feel valued by society through having their difficulties appreciated and understood by others. Conclusion:,This research adds to the body of evidence on what patients want from their rheumatology care, and each theme has clear implications for future practice. Copyright © 2007 John Wiley & Sons, Ltd. [source] The Late-Devensian proglacial Lake Humber: new evidence from littoral deposits at Ferrybridge, Yorkshire, EnglandBOREAS, Issue 2 2008MARK D. BATEMAN Proglacial Lake Humber is of UK national significance in terms of landscape drainage and development of the British Ice Sheet (BIS) during Marine Isotope Stage 2 (MIS 2), yet it is poorly understood in terms of its dynamics and timing. Sands and gravels exposed at Ferrybridge, West Yorkshire, UK, are interpreted as part of the Upper Littoral sands and gravels related to a high-level Lake Humber, which inundated the Humber Basin to ,30 m OD during MIS 2. Excavations exposed well-rounded gravels of local origin extending downslope from the 27.5 m OD contour and interbedded sands and fine gravels, which are interpreted as the coarse littoral deposits and nearshore associated deposits. A sample from the distal sands returned an Optically Stimulated Luminescence age of 16.6±1.2 kyr, providing the first direct age for the high-level lake and for when North Sea Basin ice must have blocked the Humber Gap. An underlying sequence included a diamicton dated to after 23.3 ±1.5 kyr and before 20.5±1.2 kyr, indicating that the Late Devensian ice reached at least 15 km south of the Escrick Moraine prior to the high-level lake. Previous to both the high-level lake and this ice advance, loess found at the two sites investigated indicates a long period of loess deposition earlier in MIS 2. These new data for the history of Lake Humber are discussed in the context of ice-marginal oscillations in both the Vale of York and the North Sea Basin. [source] | ||||||||||