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Biomedical subjects

J Weeks

Publications and source records attributed to J Weeks.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Stage III and IV ovarian cancer in the South West of England: five-year outcome analysis for cases treated in 1998.

This study evaluates the 5-year outcome data for the management of advanced ovarian cancer in the South West of England. Anonymized data for 361 stage III and IV ovarian cancers registered between January 1, 1998, and December 31, 1998, were obtained from the central gynecological tumor database. The following data were identified: age at diagnosis, FIGO stage, American Society of Anesthesiologists (ASA) grade, tumor differentiation, treating network and surgeon, amount of residual disease after debulking surgery, current life status, and date of death if applicable. Survival analysis was performed using Kaplan-Meier crude survival for univariate analysis, and multivariate analysis was performed by Cox regression. In our data the 5-year survival for patients with stage III was 16% and with stage IV was 10%. Survival analysis demonstrated that patients in whom the disease was debulked to less than 1 cm were more likely to be alive 5 years after diagnosis than those with a 2-cm residuum (P < 0.0001). There was no significant survival difference for those patients operated on by subspecialist surgeons despite these surgeons being twice as likely to achieve optimal debulking. Therefore, there must be other variables influencing survival apart from cytoreductive surgery. While there is near-complete data collection about ovarian cancer surgery, our database on chemotherapy is incomplete. This is clearly crucial for a complete view of cancer care in our region.

Adenocarcinoma↗
PubMedDate not supplied

Hospitals for health.

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History, 20th Century↗
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Utilization, patient satisfaction, and cost implications of acupuncture, massage, and naturopathic medicine offered as covered health benefits: a comparison of two delivery models.

CONTEXT: Increasing numbers of health plans in the United States offer complementary and alternative medicine (CAM) benefits despite limited information. OBJECTIVE: To determine the utilization rates and costs associated with providing CAM services in 2 benefit designs, and to determine the satisfaction of patients in both plans. DESIGN: Two health plans were identified: a traditional indemnity plan offered through a defined preferred provider organization (PPO) of CAM providers and a health maintenance organization (HMO). Costs and utilization rates for CAM services were compared during a 1-year period of coverage beginning November 1, 1996. SETTING AND PARTICIPANTS: 1091 patients in both plans who used CAM services during the month of May 1997 in Washington state. RESULTS: Only 1% of all patients covered for CAM accessed these services during the study period. A significantly higher percentage of patients in the PPO plan (1.2%) used CAM services compared to the HMO plan (0.6%) (P < .001). However, the average total cost of annual CAM services (plan benefit + user contribution) was similar ($347 in the HMO and $376 in the PPO), and the price per member per month was nearly identical ($0.20 in the HMO and $0.19 in the PPO). Most users perceived these services as helpful. CONCLUSIONS: Utilization of CAM services and per member per month costs were lower than expected given the high interest in CAM services reported in consumer surveys. The high level of satisfaction with CAM services and self-reported decrease in the use of pain medications suggests the need for prospective studies examining the effect of CAM treatments.

Acupuncture Therapy↗
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Pioneering change.

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Adult↗
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Inverts, perverts, and Mary-Annes. Male prostitution and the regulation of homosexuality in England in the nineteenth and early twentieth centuries.

The paper examines the relationship between patterns of male prostitution and the changing definitions (and regulation) of homosexual behavior in the late nineteenth and early twentieth centuries. A series of problems is explored. First, an attempt is made to delineate the changing patterns of legal and ideological control in the nineteenth century. This leads to a discussion of the second problem, the ways in which the social and legal context dictated the close relationship between the homosexual subcultures and the cash nexus represented by the prostitution relationship. The third problem concerns the ambivalent nature of the "prostitution," the complex self-concepts that developed, and the factors inhibiting the development of a distinctive subculture of male prostitution. The differences between female and male prostitution are discussed. The paper concludes by underlining the ambivalence of "male prostitution".

England↗