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Results for “Early-stage acceptance”

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At least 19 recordsLinked to original sources

PubMed2026

Innovation-related perception as a key driver of alternative protein acceptance: evidence from an early-stage model for cultivated meat and algae-/microalgae-based alternative protein products in Italy.

Alternative proteins are increasingly considered part of the transition toward more sustainable food systems, yet their diffusion depends critically on consumer acceptance. This study investigates the early-stage acceptance of two alternative protein categories in Italy-cultivated meat and algae-/microalgae-based alternative protein products. Focusing on the first three phases of acceptance, the analysis examines how innovation-related perception (IRP) shapes consumer perceived value (CPV), consumer perceived risk (CPR), and subsequent affective (AFF), cognitive (COG), and conative (CON) responses. Data were collected through an online survey administered to 238 Italian respondents and analysed using partial least squares structural equation modelling (PLS-SEM). The results show that IRP is the main upstream driver of early-stage acceptance in both product domains: more favourable perceptions strongly increase perceived value and reduce perceived risk. In turn, CPV exerts a much stronger influence than CPR on both affective and cognitive attitudes. A tentative cross-model comparison suggests only a descriptive variation in the final transition toward conative acceptance: affective and cognitive responses were both significant in the two models, with a relatively larger affective coefficient for cultivated meat and more balanced coefficients for algae-/microalgae-based products. Overall, the findings support a process-based interpretation of alternative protein acceptance and highlight the central role of innovation-related perception in shaping early consumer responses. These results provide relevant implications for communication strategies, product positioning, and policy actions aimed at improving the acceptability of alternative proteins in food cultures characterised by strong culinary traditions.

Italy↗

PubMed1992

Reconstruction of the radiated partial mastectomy defect with autogenous tissues.

As conservative surgery and radiation therapy have become accepted treatments for early-stage breast cancer, increasing attention has focused on the cosmetic results of this technique. When partial mastectomy--a term which encompasses a diversity of excisional techniques--is followed by radiation therapy, breast defects characterized by parenchymal loss, nipple-areola complex distortion, and cutaneous abnormalities can occur. From 1981 to 1990, eight patients sought reconstructive correction of a radiated partial mastectomy deformity. Patients were from 42 to 70 years of age (mean 49 years). All had breast cancer, except for one patient with diffuse and chronic breast abscesses. Six patients were reconstructed with latissimus dorsi flaps and two with rectus flaps. No patient underwent reconstruction sooner than 1 year after completion of radiation therapy; for the entire group, a mean of 2.6 years elapsed from completion of radiation therapy to flap reconstruction of the breast. Mammograms were obtained on all the breast cancer patients before and after the myocutaneous flap procedure. Follow-up extended from 1 to 9 years after reconstruction (mean 3.6 years) and included both physical examination and serial mammographic evaluations. Myocutaneous flap reconstruction with either latissimus or rectus flaps achieved an aesthetic improvement of the partial mastectomy deformity in all eight patients. Complications consisted only of seroma formation in two patients following latissimus flap reconstruction. Mammographic evaluation revealed fibrofatty degeneration of the soft tissues of both types of flaps, a change that occurs as early as 6 months after operation and appears as a radiolucent area. The feasibility of mammography as a screening adjunct for recurrent cancer in this group of patients is demonstrated. Advantages of this technique of autogenous tissue reconstruction are improvement of contour deformities associated with conservative surgery and radiation therapy, preservation of normal, sensate breast skin, enhancement of symmetry with the contralateral breast, and avoidance of a prosthesis.

Adult↗

PubMed1995

Treating early-stage breast cancer: hospital characteristics associated with breast-conserving surgery.

Despite growing acceptance of the fact that women with early-stage breast cancer have similar outcomes with lumpectomy plus radiation as with mastectomy, many studies have revealed the uneven adoption of such breast-conserving surgery. Discharge data from the Hospital Cost and Utilization Project, representing multiple payers, locations, and hospital types, demonstrate increasing trends in breast-conserving surgery as a proportion of breast cancer surgeries from 1981 to 1987. Women with axillary node involvement were less likely to have a lumpectomy, even though consensus recommendations do not preclude this form of treatment when local metastases are present. Non-White race, urban hospital location, and hospital teaching were associated with an increased likelihood of having breast-conserving surgery.

Aged↗

PubMed1994

Prostate-specific antigen in screening of prostate cancer.

Prostate-specific antigen (PSA) is a well-characterized human prostate-specific glycoprotein. PSA has been shown to be the most effective immunohistologic marker for prostate cancer, as well as the most useful serologic test in staging and monitoring prostate cancer and in early detection of recurrent disease. The greatest clinical value of PSA is an aid for early detection of prostate cancer. Recent studies have indicated that PSA-based screening of the older population for organ-confined early-stage prostate cancer is an acceptable, practical, and reliable modality. The accuracy of PSA screening is within the same range as the mammogram. The cost-effectiveness of PSA is comparable to other cancer screening tests. Although the increase in the patient's survival due to PSA-based detection of early prostate cancer remains to be documented, it is generally agreed that the PSA test along with digital rectal examination (DRE) should be included in the annual physical examination for men 50 years of age or older. High-risk men are urged to commence at age 40. Asymptomatic men who have both a negative DRE and normal PSA blood test need only to continue an annual DRE and PSA check-up. Men who have a negative DRE and elevated PSA, and all those who have a suspicious DRE regardless of PSA results, should undergo further diagnostic workup, such as transrectal ultrasonography with biopsy of visible lesions. The cure rate is high with timely treatment, when prostate cancer is detected while still confined to the prostate.

Cost-Benefit Analysis↗

PubMed1986

Treatment of cutaneous T cell lymphomas with PUVA.

A series of 39 patients with CTCL was treated with PUVA over a period of 5 years, comprising 6 patients in stage IA, 13 in stage IB, 15 in stage IIA and 5 in stage IIB. PUVA treatments were administered four times weekly until clearing; a maintenance therapy employed 2 to 1 exposures per week for 2 months. Complete clinical and histological examinations were taken. We obtained a complete remission in all stage IA patients, and a partial remission in stage IB and IIA patients, who required longer treatment schedules and more frequent maintenance therapy. Stage IIB patients required additional local and/or systemic therapy to achieve a partial remission. Recurrences were observed in 33% stage IA patients, in 84% stage IB patients and in all stage IIA and IIB patients. They responded to new induction phases only in early-stage CTCL. PUVA is well accepted by patients, and compares well with other treatments.

Follow-Up Studies↗

PubMed1992

Invasive cervical cancer complicating intrauterine pregnancy: treatment with radical hysterectomy.

OBJECTIVE: Radical hysterectomy and bilateral pelvic lymph node dissection have become the mainstay of treatment for early-stage cervical cancer because of both a high success rate and acceptable morbidity. However, those cervical lesions that occur concomitant with an intrauterine pregnancy have historically been treated with irradiation. We report the morbidity and results of radical hysterectomy and bilateral pelvic lymph node dissection for the treatment of early-stage cervical cancer complicating intrauterine pregnancy. METHODS: Between 1955-1991, 13 patients were treated with radical hysterectomy and bilateral pelvic lymph node dissection with the fetus in situ, and eight others with cesarean delivery followed by radical hysterectomy and bilateral pelvic lymph node dissection. Charts were reviewed retrospectively. RESULTS: Mean operative time was 281 minutes. The mean blood loss was 777 mL with radical hysterectomy and bilateral pelvic lymph node dissection alone, and 1750 mL with cesarean delivery, radical hysterectomy, and bilateral pelvic lymph node dissection (P less than .01). Intraoperative morbidity included a single accidental cystotomy that was complicated in the postoperative period by a vesicovaginal fistula. Fever was the most common postoperative cause of morbidity (29%), while two patients (10%) had wound seromas and a single patient (5%) each had a pulmonary embolism, cystitis, and transfusion-related hepatitis. No perioperative deaths occurred. After documentation of maturity, seven healthy infants were delivered with no major morbidity. Twenty patients (95%) are alive and free of disease with a mean follow-up of 40 months. CONCLUSION: Radical surgery offers immediate treatment for early-stage cervical cancer during intrauterine pregnancy, with low associated morbidity, acceptable survival, and preservation of ovarian function.

Cesarean Section↗

PubMedDate not supplied

Primary surgical management of cervical cancer.

Early-stage cervical cancer can be readily cured by surgery, with acceptably low morbidity. Successful treatment depends on appropriate surgical training, tight organisation, thorough selection of patients, selection of the right operation and close liaison with the pathologist and radiotherapist.

Female↗

PubMed1990

Neoadjuvant bleomycin, ifosfamide and cisplatin in cervical cancer.

Patients with advanced and bulky early-stage cancer of the cervix have an unfavourable prognosis, which may be improved by initial neoadjuvant, cytoreductive chemotherapy. In a phase II study, coordinated at the West Midlands CRC Clinical Trials Unit, Birmingham, using ifosfamide (IFX) in combination with cisplatin and bleomycin (BIP) in advanced and recurrent cervical cancer, we demonstrated a response rate of 69%. This regimen produces rapid responses with acceptable toxicity and has potential for use as neoadjuvant therapy prior to radical radiotherapy in patients presenting with advanced and bulky early-stage disease. In an initial pilot study of this approach, 13 of 19 patients (68%) with primary inoperable disease showed significant tumour regression prior to radical local radiotherapy. Interim analysis of the first 66 patients entered into a randomized study evaluating the value of this approach has shown complete clinical tumour resolution after radical radiotherapy in 24/32 patients (75%) treated with up to three cycles of BIP prior to radiotherapy vs 19/34 patients (56%) treated with radiotherapy alone. There was no evidence that neoadjuvant chemotherapy enhances the acute toxic effects of pelvic radiotherapy. This approach has the potential for improving the outlook in patients with poor-prognosis primary disease.

Adult↗

PubMed1995

A short-term psychoeducational intervention for patients newly diagnosed with cancer.

The psychological and medical problems encountered by cancer patients are numerous and unique. The diagnosis of cancer frequently produces psychological distress. A review of the literature and the authors' clinical and research experience suggest that cancer patients may benefit from a variety of psychological intervention programs. A structured, psychiatric intervention consisting of health education, stress management/behavioral training, coping (including problem-solving techniques), and psychosocial group support offers the greatest potential benefit for patients newly diagnosed or in the early stages of their treatment. Early-stage interventions that encourage active behavioral coping and active cognitive coping rather than avoidance or passive acceptance of the illness can be helpful psychologically. These active behavioral and cognitive coping behaviors, which can be learned, can attenuate the psychological distress caused by stressful illness, decrease the amount of psychosocial adjustment to the illness needed, improve overall quality of life, and may also be associated with longer survival times.

Adaptation, Psychological↗

PubMed1992

Long-term survival and sequelae after surgical management of invasive cervical carcinoma diagnosed at the time of simple hysterectomy.

From 1956 to 1988, 27 women (median age, 60 years) found to have occult invasive carcinoma of the cervix at total hysterectomy underwent radical reoperation consisting of radical parametriectomy, upper vaginectomy, and pelvic lymphadenectomy. Residual disease was present at reexploration in 4 (15%) of the 27 patients: in the pelvic lymph nodes in 2, in the parametrium in 1, and in the vagina and a para-aortic node in 1. All patients were followed a minimum of 18 months; there were no deaths within 3 months of operation. However, 2 (7%) of the 27 patients developed ureterovaginal fistulas. Recurrent disease was observed in 6 (22%) of the patients: 2 had successful salvage procedures, and 4 died of disease, all within 4 years of reoperation. Recurrence correlated with the presence of residual disease at reoperation and with nonsquamous histologic findings. At a median follow-up of 8.4 years, 23 of the 27 patients were alive and disease-free. The 5-year absolute survival estimate (Kaplan-Meier) was 82%. Radical reoperation can be performed safely in selected patients who have early-stage invasive carcinoma of the cervix at the time of total hysterectomy with the expectation of an acceptable rate of long-term disease-free survival.

Adenocarcinoma↗

PubMed1986

An overview of clinical trials with high-dose medroxyprogesterone acetate (HD-MPA) in endocrine-related tumors other than breast cancer.

High-dose medroxyprogesterone acetate (HD-MPA) has been successfully employed in the treatment of hormone-related tumors, especially advanced breast cancer. However, progestins in general and MPA in particular are considered a useful treatment also in other types of tumors such as endometrial, prostatic and renal cancer. Furthermore, MPA has been evaluated in tumors which are not classically considered hormone-related, such as ovarian cancer. Therapy with one of a number of progestational agents has been the conventional approach to the management of endometrial carcinoma not amenable to surgery or radiation therapy. Among the various synthetic progestins, MPA has been the most widely employed both by i.m. and oral routes, according to a variety of doses and schedules. Objective responses have been obtained in a percentage of women varying between 30 and 50% in the different series. While the role of MPA in the palliative treatment of advanced disease is well accepted, opinion is divided on the role of progestins in the adjuvant setting. On the basis of available data, it should be concluded that the usefulness of adjuvant therapy with progestins in high risk, early-stage endometrial cancer has not yet been clearly demonstrated. As far as prostatic cancer is concerned, data coming from comparative trials show that MPA is less effective than diethylstilbestrol (DES), and therefore should not be considered the first choice for previously untreated patients. However, it can achieve responses in patients who no longer respond or who are refractory to DES, and represents the treatment of choice for those patients who, due to their cardiovascular conditions, cannot be given estrogens.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

PubMed1995

Sensory perceptions of women receiving tamoxifen for breast cancer.

Tamoxifen has been used as adjuvant treatment in advanced and early-stage breast cancer for the past decade. Recently this synthetic antiestrogen drug assumed a new role of chemoprevention for women at risk of developing breast cancer. The commonly occurring side effects associated with tamoxifen administration contribute to the acceptance of this antineoplastic drug for palliation and cure. However, there are no data about the sensory effects of women receiving tamoxifen. The purpose of this study was to elicit subjects' descriptions of sensory experiences while receiving tamoxifen. These descriptions are essential for developing nursing interventions to help patients use self-care behaviors and cope with the side effects of tamoxifen. Sensory data were collected from 20 women who had been receiving tamoxifen for at least 1 month and were not receiving any other chemotherapy. Subjects provided descriptors about all senses. The senses for which subjects most frequently provided descriptors were touch, taste, and sight.

Adaptation, Psychological↗

PubMed1995

Localized prostate cancer treated by external-beam radiotherapy alone: serum prostate-specific antigen--driven outcome analysis.

PURPOSE: To determine the 5-year rate of survival with no evidence of disease (NED) using strict biochemical criteria in men with prostate cancer treated by external-beam radiotherapy alone and to examine possible clinical and treatment factors that predict the likelihood of NED survival. MATERIALS AND METHODS: Five hundred men with clinically localized prostate cancer consecutively treated with external-beam radiotherapy alone with no prior, concomitant, or adjuvant endocrine therapy were identified. All patients had serial serum prostate-specific antigen (PSA) values determined after treatment and 451 patients had pretreatment PSA values determined. The median follow-up duration is 20 months (range, 2 to 72; mean, 36). RESULTS: The 5-year rate of overall survival in this group of patients was 80%. The 5-year rate of survival without clinical evidence of disease (cNED) was 72%. The 5-year rate of survival without evidence of clinical, radiographic, or biochemical relapse (bNED) was 51%. Multivariate analysis demonstrated that a pretreatment serum PSA level < or = 15 ng/mL was the most important predictor of bNED survival (P < .0001). Patients with early-stage (T1, T2a/b) tumors and a pretreatment serum PSA less than 15 ng/mL had a 3-year rate of bNED survival of 86%. The rate of bNED survival for patients with a pretreatment PSA level greater than 15 ng/mL was 38% at 3 years. CONCLUSION: Pretreatment serum PSA level is the most important predictor of treatment outcome in this group of patients treated with definitive radiotherapy alone. External-beam radiation alone can produce acceptable early rates of bNED survival in patients with clinically organ-confined tumors and a pretreatment PSA level < or = 15 ng/mL. To produce acceptable results in those patients with pretreatment PSA levels more than 15 ng/mL, effective adjuvant treatments in addition to aggressive local treatments are necessary.

Aged↗

PubMed1990

Selection of patients with early-stage breast cancer for conservative surgery and radiation.

The great majority of patients with an early-stage breast cancer can be successfully treated with conservative surgery and radiotherapy (CS + RT). Careful clinical, radiologic, and pathologic assessment of the tumor's extent and characteristics is the key to appropriate patient selection. While disagreements remain, some guidelines for who should not be so treated have emerged. Patients with multiple palpable or radiologically detected lesions or widespread microcalcifications of the breast ordinarily should undergo mastectomy. Patients who present with a nipple discharge or subareolar mass are not suitable candidates for CS + RT unless nipple-areolar resection is acceptable to the patient. The role of pathologic margins in treatment selection remains controversial. The authors believe that margins have clinical meaning only when interpreted in relation to the histology of the primary tumor and that "negative" margins are not always needed to achieve a high rate of local tumor control.

Age Factors↗

PubMedDate not supplied

Family physicians' beliefs about screening for colorectal cancer using the stool guaiac slide test.

The stool guaiac slide test (SGST) is a relatively recent innovation in screening for colorectal cancer. The test detects occult blood in the stool that may indicate the presence of cancer. In recent years, the SGST has been widely promoted as a screening test to aid in the detection of colorectal cancer. However, data from public and mass screening programs indicate that many people are unaware of the test and that few have actually taken it. The findings from these studies suggest that many physicians may not be using the test in their medical practices. The literature on diffusion theory suggests that acceptance of an innovation is influenced by the potential adopter's perception of the innovation's relative advantages over those of the ideas it supersedes, its perceived complexity, and its compatibility with the existing values and practices of the receiver. This research examined these factors as they relate to use of the SGST among a sample of 131 family physicians in New York State. Eighty-two percent of these physicians reported that they provide guaiac slides to at least some of their patients to collect stool specimens at home. The test was reportedly more commonly used for older patients than for younger ones. The physicians' beliefs about the relative effectiveness of the test in detecting early-stage colorectal cancer, compared with the effectiveness of alternative screening tests, and their perceptions about patients' willingness and ability to do the test at home were found to be important factors distinguishing between physicians who said they used the test and physicians who did not. The findings from this study suggest that future efforts aimed at promoting the use o1 theSGST among primary care physicians should emphasize the relative merits of the test in comparison with those of alternative screening procedures, especially with regard to its effectiveness in detecting early stage cancers, its simplicity, and its acceptance by patients.

Adult↗

PubMed1992

Is there a role for preference assessments in research on quality of life in oncology?

The development of ways to evaluate interventions that may have an impact on quality of life is a rapidly-developing area of research in clinical oncology, especially within the context of randomized controlled trials. We propose a role for assessments of preferences in such evaluations, including preference studies designed to assess attitudes toward the clinical acceptability of interventions, and preference trials designed to assess choice behaviour in relation to interventions. We suggest that such preference assessments represent a specific case of a more general issue: the need to develop an 'ethics of evidence', that is, standards for the creation, assessment and communication of evidence. We then outline a framework within which an 'ethics of evidence' might be developed, and suggest that the framework also may provide a useful model for the processes involved in the transfer of research results into clinical practice. As an illustration, we consider the problem of decision making in circumstances where the choice of therapy depends primarily on the patient's own preferences, as, for example, in the choice of mastectomy or breast-conserving treatment in early-stage breast cancer. The long-term goal is to develop criteria which might be used to foster shared rational decision making in such circumstances.

Beneficence↗

PubMed1992

Combined treatment with oral etretinate and electron beam therapy in patients with cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome).

BACKGROUND: Total skin irradiation for early-stage mycosis fungoides produces clinical remission in 90% of patients, but the median duration of remission is only 2 to 4 years. Etretinate has proven efficacy in advanced mycosis fungoides. Its potential as adjuvant therapy to radiation could be limited by toxicity from the combination. OBJECTIVE: Our purpose was to determine whether oral etretinate at 1 mg/kg can be combined with 35 Gy of radiation without intensifying or prolonging the radiation reaction and to determine the relapse-free survival rate. METHODS: Twenty-three patients began etretinate on day one of radiation and the dose was reduced for nose bleeds, dry skin, or hyperlipidemia. During the reaction skin toxicity questionnaires were completed weekly. Nine concurrent patients receiving only radiation completed identical forms. RESULTS: Etretinate did not intensify the skin reaction but did prolong it by 2 weeks. At a median follow-up of 2 years the relapse-free survival rate in complete responders was similar to stage-matched concurrent and historic control subjects. CONCLUSIONS: Both radiation and etretinate can be given together with acceptable toxicity and without compromising either therapy.

Administration, Oral↗

PubMed1995

Conservative surgery without radiotherapy in the treatment of patients with early-stage invasive breast cancer. A review.

OBJECTIVE: The authors determined whether some patients with clinical stage I or II invasive breast cancer can be adequately treated by conservative surgery without radiotherapy. SUMMARY BACKGROUND DATA: Currently, there are many patients who are being treated in this manner in both academic and community hospitals. This approach is not as effective as either mastectomy or conservative surgery followed by radiotherapy in preventing local recurrence. However, there may be subsets of patients who might be adequately treated by surgery alone with acceptably low recurrence rates. METHODS: The authors reviewed retrospective studies of conservative surgery alone and of randomized trials comparing the results of treatment with and without postoperative radiotherapy. RESULTS: The local recurrence rate is unacceptably high when random patients are treated with conservative surgery without radiotherapy. More favorable results may be possible when relatively wide excisions are performed on selected postmenopausal patients with small lesions without an extensive intraductal component, lymphatic or blood-vessel invasion, and histologically negative axillary nodes. The role of tamoxifen in reducing the risk of breast recurrence is uncertain. Despite salvage therapy, some individuals may develop disseminated disease as a result of local recurrence. CONCLUSIONS: The authors believe that conducting carefully designed prospective studies of conservative surgery alone is reasonable for patients who are adequately informed of the potential risks of omitting radiation therapy. However, currently, patients should not be treated with conservative surgery alone (without radiotherapy) without such stringent guidelines.

Adult↗