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H Hancock

Publications and source records attributed to H Hancock.

17 recordsLinked to original sources
PubMed2004

Localised extranodal lymphoma of the head and neck: the Sheffield Lymphoma Group experience (1971-2000).

AIMS: Over the 30-year period from 1971-2000, 3750 cases of lymphoma were referred to the Sheffield Lymphoma Group for investigation and treatment. Of these, 580 were extranodal presentations and, of these, 190 (33%) were localised to the head and neck region. The aim of this lymphoma database review was to evaluate the patient characteristics and survival rates for these patients. MATERIALS AND METHODS: The sample included 98 women and 92 men, with a median age at presentation of 65 years. RESULTS: The most common site affected was tonsil (34%), followed by salivary glands (16%). Other common sites were the thyroid, orbit and nasopharynx. The most frequent presenting feature was a swelling or mass, with pain, dysphagia and nasal obstruction also comprising large groups. All cases were non-Hodgkin's lymphoma. Fifty-five cases were histological grade 1; 132 were grade 2. Diffuse large B cell was the most common histological subtype. The overall 5- and 10-year survival rates were 55% (95% CI 47-62) and 44%, (95% CI 36-53), respectively, with a median survival of 92 months (95% CI 56-128). Stage and grade were both found to influence survival. CONCLUSION: This data concords with and extends information available from previous studies. More detail is now required on specific head and neck sites.

Adolescent↗
PubMed2003

Peripheral T cell lymphoma: The Sheffield Lymphoma Group experience (1977-2001).

Peripheral T-cell lymphomas (PTCL) account for approximately 10% of all non-Hodgkin's lymphomas. The aim of this retrospective study was to analyse the presentation, management, outcome and significant prognostic factors in a large series of patients with PTCL. It includes 104 consecutive patients who presented to the Sheffield Lymphoma Group between 1977 and 2001. Clinical parameters were recorded for each subgroup. End points were response to treatment and survival. Survival analysis was used to assess the prognostic value of the variables. PTCL not otherwise specified contributed 52% of cases followed by anaplastic large cell lymphoma with 17% and angiocentric type with 13% of cases. The overall complete remission (CR) of the series was 59%. Stage at diagnosis affected response to treatment with 81% of cases in stage 1 and 2 achieving CR compared to 43% in stages 3 and 4 (p</=0.001). Extranodal presentations also showed a favourable response with 74% obtaining CR compared to 46% of nodal presentations (p<0.01). Median survival of all patients was 87 months with a five-year probability of survival of 52%. Variables found to be related to poor outcome are age >60 years (p<0.05), high grade histology (p<0.001), presence of B symptoms (p<0.005), nodal presentation (p<0.005) and advanced stage at diagnosis (p<0.001). Histological sub-type did not significantly correlate to outcome. In conclusion whilst a number of prognostic indicators can assist in determining the outcome in PTCL, these lymphomas are complex and often follow an unpredictable course. In order to make the best clinical decisions in individual cases, more clinical study is required.

Female↗
PubMed2001

Localised extranodal non-Hodgkin's lymphoma of the gastrointestinal tract: Sheffield Lymphoma Group experience (1989-1998).

Extranodal non-Hodgkin's lymphoma (NHL) of the gastrointestinal tract accounts for about one third of all extranodal NHL. We retrospectively reviewed the clinical and histopathologic records of 71 patients with stage IE and IIE primary gastrointestinal NHL referred to the Sheffield Lymphoma Group (SLG) from 1989 to 1998. Cross-referencing with the Hospital Histopathology Department database revealed that only two-thirds of all cases were seen by the Group. The most common primary site was the stomach (45 patients, 63% of all cases), followed by the small intestine (16, 23%) and large intestine (9, 13%). The median age of patients was 62 years; the majority of patients presented with stage I (61%) and/or grade (65%) NHL. Mucosa-associated lymphoid tissue (MALT) lymphomas were the largest histologic subtype seen (57%), with 87% of these arising from the stomach; next most frequent was the diffuse large B-cell subtype (21% of all cases) most frequently arising from the intestine (60%). For treatment of gastric MALT lymphoma, a combined approach (surgery followed by chemotherapy, antihelicobacter therapy followed by chemotherapy) was favoured (22 cases). Five-year and 10-year overall survivals were 52% and 45% respectively. Knowledge of the Revised European American Lymphoma classification and the Helicobacter pylori/MALT association has influenced treatment approaches over the 10-year study period. For small intestinal lymphoma, surgery (with or without chemotherapy) gave 5- and 10-year survivals of 60%. Overall survival of patients with primary gastrointestinal lymphoma managed by the SLG is similar to that reported from other large series.

Adult↗
PubMed2001

Non-Hodgkin's lymphoma presenting with spinal involvement: the Sheffield Lymphoma Group experience (1970-2000).

Spinal non-Hodgkin's lymphoma is rare. We retrospectively reviewed the clinical and histopathologic records of 39 consecutive patients referred to the Sheffield Lymphoma Group from 1970 to 2000 and analysed the prognostic differences between localised (stage IE and IIE) and secondary (stage III and IV) spinal non-Hodgkin's lymphoma (S-NHL) patients. Forty-five percent of all patients were over 60 years old. More patients were male (58%); presented with stage IE and IIE (63%), mostly of intermediate/high grade histology (74%); over a third had symptoms; nearly a third (11 patients) were paraplegic and 14 had sphincter dysfunction at diagnosis. The overall survival of all patients was 39% at 5 years (median 24.7 months), whilst that of localised S-NHL was 51% (median 89.7 months). Univariate analysis showed better survival for patients with good mobility status at presentation (p < 0.0l) and complete response to initial treatment (p < 0.00l). In primary S-NHL, histology (p < 0.05) significantly influenced overall survival. In conclusion, disease is frequently locally advanced at presentation with aggressive histologic grade: thorough staging should always be performed to exclude widespread disease. Good mobility status predicts for good survival outcome. Optimal treatment is still uncertain.

Actuarial Analysis↗
PubMed2001

Prognostic markers in malignant lymphoma: an analysis of 1,198 patients treated at a single centre.

The prognostic significance of 20 putative markers has been assessed in a consecutive series of 1,198 patients with malignant lymphoma seen by the Sheffield Lymphoma Group over three decades. Univariate analysis disclosed that ten factors for both Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) Grade I, and twelve factors for NHL Grade II had prognostic significance. However, multivariate analysis selected only three (age, serum albumin and lymphocyte count) for HD, one (serum albumin) for NHL Grade I and five (age, stage, erythrocyte sedimentation rate, serum albumin and serum lactate dehydrogenase) for NHL Grade II as independent predictors for survival. Risk adjusted prognostic models were derived for Hodgkin's disease and NHL Grade II. For Hodgkin's disease the presence of 3 risk factors predicted for only 35% long-term survival for this group of patients. For NHL Grade II the group with 3-5 risk factors present had a median survival of less than 2 years compared to a 9-year median survival in patients with 1 risk factor present. Whilst these models are being validated on a larger series of patients and will also be tested prospectively, new markers are needed to facilitate decisions on treatment for individual patients.

Adult↗
PubMed2000

They were different and few: an Australian study of midwives' attitudes to research and computerised research findings.

This study sought to determine factors influencing the utilisation of research findings by Australian midwives before and after exposure to an on-line research database within their practice setting. The setting was a large maternity hospital in South Australia and data were collected via pre and post intervention questionnaires. 14 midwives from the Delivery Suite and Birth Centre of this hospital participated in the study. Midwives showed an increased receptivity to the concept of computerised research findings after exposure to the database. They rated research as highly important to providing quality midwifery care and for the midwifery profession, and saw midwives as the key players in maternity care research. These findings are not in keeping with previous research--largely accounted for, we believe, by the particular, and small number of, midwives who volunteered to participate in the study (24% of those invited).

Adult↗
PubMed1998

Localised non-Hodgkin's lymphoma: the Sheffield Lymphoma Group experience (1970-1995).

We report a retrospective study of all patients with localised non-Hodgkin's lymphoma referred to the Sheffield Lymphoma Group (1970-1995). A total of 1,979 patients with non-Hodgkin's lymphoma were seen: 553 (28%) presented with stage I or II disease, 411 (21%) extranodal, 142 (7%) nodal. The commonest extranodal sites were head and neck, gastrointestinal tract, skin and central nervous system, accounting for 87% of patients. Most patients received primary localised radiotherapy. Overall observed survival was 52.5% at 5 years in the extranodal group and 65% in the nodal group. For both groups the 10-year observed survival was 42.5%. An age of 45 years and over was a poor prognostic factor in both groups (p<0.001). Patients with skin and non-Waldeyer's head and neck lymphomas survived best (5-year observed survivals 67 and 70% respectively) and CNS worst (5-year survival 38%). There is no cause for complacency in the management of localised non-Hodgkin's lymphoma, particularly for the less common extranodal sites where multicentre clinical studies are still essential.

Adult↗
PubMed1996

The complexity of pain assessment and management in the first 24 hours after cardiac surgery: implications for nurses. Part I.

Pain has been recognised as a problem within the realms of health care for many years (Szanto & Heaman 1972, Melzack 1973). The management of pain in the immediate postoperative period remains one of the most serious inadequacies of health care today (Royal College of Surgeons 1990). Recent evidence suggests that up to 75% of hospitalised patients fail to receive adequate pain relief (Carr 1990), with postoperative cardiac patients reporting detailed recollections of their pain experiences during their stay in critical care areas (Ferguson 1992). To accountable health care professionals these figures are humiliating and cannot be allowed to continue (Hollinworth 1994). Indeed, the persistance of postoperative pain can seriously compromise the status of postoperative cardiac patients (Wild 1992). An exploration of current practices in pain management for adult individuals following cardiac surgery included a review of the methods of assessment and treatment interventions employed at three English critical care units. With the literature providing substantial evidence of research into post-operative pain management the persistence of postoperative pain was questioned. Inadequacies in nursing knowledge were identified in all areas of postoperative pain management. The persistence of the theory-practice gap was identified as a major factor contributing to the maintenance of current practice. Similarly, the inappropriate use of change strategies, aimed ultimately at enhancing patient care, proved significant. The findings, which show neglect of the nursing responsibility for the provision of research-based, high quality patient care, carry implications for all nurses. Recommendations including the development of new strategies for the inclusion of existing knowledge into practice appear vital, in order that clinical practice, and ultimately patient care, can be enhanced.

Adult↗
PubMed1996

Midwifery--the turning point?

This paper endeavours to respond to suggestions about the 'fate' of midwifery in Australia and to provide stimulus for further discourse and analysis about where and how midwifery is going and growing, now and in the future. The tone is set as one of optimism and self-determination, as midwifery evolves within its history in Australia and finds and affirms, its own way from nursing and medico-obstetrics its own genre with women, and its own unique heritage. It is argued that only with a self-determined commitment to the integrity of midwifery and of women (seeing the two as inseparable if we truly are with women). Will we as midwives be able to transcend notions of dependence, control, submission, and competitiveness among others. The writer has specifically chosen to present this paper without references to make clear the content of the response without the camouflage of other writers. It is hoped this paper may provoke other midwives to examine and debate their perspectives and ideas.

Australia↗
PubMed1992

Midwifery education: whither will we wander?

The results of a study into the nature and conduct of midwifery programs in higher education institutions in Australia indicate diversity and disparity both between and within states. This paper presents data from this study and raises issues that arise from the findings. As midwives strive for professional authority and integrity, midwifery education must be recognised at both national and local levels to promote congruency for registration and practice.

Australia↗
PubMedDate not supplied

Developing the role of the healthcare assistant.

AIM: Two studies are described in this article. The first evaluated the preparedness of healthcare assistants (HCAs) to develop a new role and attend an HCA development programme. The second examined the impact of one NHS trust's HCA development programme on the role of the HCA, on other members of the multidisciplinary team and on patients. METHOD: The research methodology was qualitative and inductive, using a naturalistic approach in both studies, and a 360 degree model of assessment and feedback in study two. For both studies, the data were analysed following the principles of thematic analysis. Findings Eight out of 12 HCAs in study one were prepared to attend the programme and to develop their role. Study two indicated a positive but restricted impact of the HCA development programme on the HCAs' role, that of other healthcare professionals and on patient care. CONCLUSION: The findings have implications for role development in the NHS and for the development of programmes that aim to address these changes. The HCA development programme has been reviewed and extended, and strategies to promote and support role development in the clinical setting have been introduced in the trust where the research was conducted.

Attitude of Health Personnel↗