Medicine and Health Sciences Commons^™

The Association Between Hysterectomy And Ovarian Cancer Risk: A Population-Based Record-Linkage Study, Suzanne C. Dixon-Suen, Penelope M. Webb, Louise F. Wilson, Karen Tuesley, Louise M. Stewart, Susan J. Jordan

Health Sciences Papers and Journal Articles

Background: Recent studies have called into question the long-held belief that hysterectomy without oophorectomy protects against ovarian cancer. This population-based longitudinal record-linkage study aimed to explore this relationship, overall and by age at hysterectomy, time period, surgery type, and indication for hysterectomy.

Methods: We followed the female adult Western Australian population (837 942 women) across a 27-year period using linked electoral, hospital, births, deaths, and cancer records. Surgery dates were determined from hospital records, and ovarian cancer diagnoses (n¼1640) were ascertained from cancer registry records.We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the …

Heat Shock Proteins As Modulators And Therapeutic Targets Of Chronic Disease: An Integrated Perspective, Adrienne L. Edkins, John T. Price, A Graham Pockley, Gregory L. Blatch

Health Sciences Papers and Journal Articles

Many heat shock proteins (HSPs) are essential to survival as a consequence of their role as molecular chaperones, and play a critical role in maintaining cellular proteostasis by integrating the fundamental processes of protein folding and degradation. HSPs are arguably among the most prominent classes of proteins that have been broadly linked to many human disorders, with changes in their expression profile and/or intracellular/extracellular location now being described as contributing to the pathogenesis of a number of different diseases. Although the concept was initially controversial, it is now widely accepted that HSPs have additional biological functions over and above their …

The Improving Rural Cancer Outcomes Trial: A Cluster-Randomised Controlled Trial Of A Complex Intervention To Reduce Time To Diagnosis In Rural Cancer Patients In Western Australia, Jon D. Emery, Victoria Gray, Fiona M. Walter, Shelley Cheetham, Emma J. Croager, Terry Slevin, Christobel Saunders, Timothy Threlfall, Kirsten Auret, Anna K. Nowak, Elizabeth Geelhoed, Max Bulsara, C D'Arcy J. Holman

Health Sciences Papers and Journal Articles

Background: Rural Australians have poorer survival for most common cancers, due partially to later diagnosis. Internationally, several initiatives to improve cancer outcomes have focused on earlier presentation to healthcare and timely diagnosis. We aimed to measure the effect of community- based symptom awareness and general practice-based educational interventions on the time to diagnosis in rural patients presenting with breast, prostate, colorectal or lung cancer in Western Australia.

Methods: 2_2 factorial cluster randomised controlled trial. Community Intervention: cancer symptom awareness campaign tailored for rural Australians. GP intervention: resource card with symptom risk assessment charts and local cancer referral pathways implemented through …

Clinical Consultations And Investigations Before And After Discontinuation Of Endocrine Therapy In Women With Primary Breast Cancer, Derrick Lopez, Anna Kemp-Casey, Christobel Saunders, Elizabeth Roughead, Frances Boyle, Max Bulsara, David Preen

Health Sciences Papers and Journal Articles

Objective: Although clinical trials recommend that women with hormone-dependent primary breast cancer remain on endocrine therapy for at least 5 years, up to 60% discontinue treatment early. We determined whether these women had consulted with clinicians or had investigations for cancer recurrence or metastasis around the time they discontinued endocrine therapy, and whether clinical contact continued after discontinuation.

Methods: We performed case-control and cohort studies of women from the 45 and Up Study who were diagnosed with invasive primary breast cancer between January 2003 and December 2008, and who had ≥12 months of anastrozole, exemestane, letrozole or tamoxifen subsequently dispensed. …

How Do Patients With Advanced Cancer Cope With An Uncertain Disease Trajectory? Implications For Grief Counselling, Elizabeth A. Lobb

Health Sciences Papers and Journal Articles

A growing number of cancer patients are living longer with incurable disease. This paper describes strategies that patients use to cope with the uncertain trajectory of their disease. Twenty-seven patients with a prognosis of 12 months were recruited from the oncology and palliative care service at three metropolitan Sydney hospitals. A semi-structured face-to-face interview was conducted, which was audiotaped and transcribed verbatim. The patients coped with the uncertain trajectory of their disease through avoidance, maintaining a normal life, comparing themselves favourably with others in a similar situation and remaining positive. Participants indicated that they did not wish referral for psychological …

The "Specter" Of Cancer: Exploring Secondary Trauma For Health Professionals Providing Cancer Support And Counseling, Lauren Breen, Moira O'Connor, Lauren Y. Hewitt, Elizabeth Lobb

Health Sciences Papers and Journal Articles

Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in “high-death” contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) …

The Role Of Notch Receptors And Ligands In Regulation Of Immune Responses, Gerard F. Hoyne

Health Sciences Papers and Journal Articles

Notch signalling has an important role in the immune system in directing cell fate decisions in a range of diverse cell types. We are beginning to obtain a better understanding of the roles that the different Notch ligands and receptors play in both cellular differentiation of precursor cells and the regulation of immune responses by mature lymphocytes in the periphery. This review will examine the key findings that have emerged in relation to function of Notch in differentiation of T cells, B cells and dendritic cells and how modulation of Notch signalling seems to have potential for therapeutic applications in …