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排序方式: 共有402条查询结果,搜索用时 62 毫秒
1.
文章通过对国内"医享网"癌症社区"肺癌圈"中33篇精华帖的叙事分析,探究其中生命故事的主体对自我身份的建构路径及其对生命价值的意义探寻,并尝试性地提出一些反思。研究发现,在自述和他述生命故事中,叙事者在信息寻求过程中改善自我印象,并运用"写作疗法""阅读疗法"和叙事隐喻理解疾病,帮助患者重塑自身角色。通过社群互动,患者形塑了对自身的身份认同,并形成了集体层面的生命价值观。从本研究的结论看,疾病叙事是癌症网络社区患者建构个体身份、形成身份认同的重要途径,叙事或可成为未来增进社会对癌症乃至其他疾病的理解、推进治疗与康复的可行之路。  相似文献   
2.
One of the challenges in the design of confirmatory trials is to deal with uncertainties regarding the optimal target population for a novel drug. Adaptive enrichment designs (AED) which allow for a data-driven selection of one or more prespecified biomarker subpopulations at an interim analysis have been proposed in this setting but practical case studies of AEDs are still relatively rare. We present the design of an AED with a binary endpoint in the highly dynamic setting of cancer immunotherapy. The trial was initiated as a conventional trial in early triple-negative breast cancer but amended to an AED based on emerging data external to the trial suggesting that PD-L1 status could be a predictive biomarker. Operating characteristics are discussed including the concept of a minimal detectable difference, that is, the smallest observed treatment effect that would lead to a statistically significant result in at least one of the target populations at the interim or the final analysis, respectively, in the setting of AED.  相似文献   
3.
In Europe, countries following the traditional Mediterranean Diet (MeDi), particularly Southern European countries, have lower prostate cancer (PCa) incidence and mortality compared to other European regions. In the present study, we investigated the association between the MeDi and the relative risk of PCa and tumor aggressiveness in a Spanish population. Among individual score components, it has been found that subjects with PCa were less likely to consume olive oil as the main culinary fat, vegetables, fruits and fish than those without. However, these differences were not statistically significative. A high intake of fruit, vegetables and cooked tomato sauce Mediterranean style (sofrito) was related to less PCa aggressiveness. Results showed that there are no differences in the score of adherence to the Mediterranean dietary patterns between cases and controls, with mean values of 8.37?±?1.80 and 8.25?±?2.48, respectively. However, MeDi was associated with lower PCa agressiveness according to Gleason score. Hence, relations between Mediterranean dietary patterns and PCa are still inconclusive and merit further investigations. Further large-scale studies are required to clarify the effect of MeDi on prostate health, in order to establish the role of this diet in the prevention of PCa.  相似文献   
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Researchers consider older women in rural Appalachia to have low levels of agency and high levels of fatalism regarding decision making about cancer treatment. Using the life course perspective, we examined older women’s agency with information seeking about gynecological cancer. Semistructured interviews with 20 White women living in central Appalachia revealed four trajectories: Surrendering Control, Accepting Death, Self-Care, and Advocacy, each with its own forms of agency. Some women experienced personal transformation, increased self-efficacy, and a passion for community empowerment. Fatalism was not understood apart from placing trust in medical expertise. We implore researchers to further explore rural expressions of agency.  相似文献   
6.
For high dimensional data, the SigClust is developed for testing the significance of clustering. The cluster index (CI) for SigClust is conducted by the ratio of the within-cluster and total sum of squares. But its empirical size is too conservative to be over controlled. By removing the cumbrous terms in the CI, an improved index (BCI) is proposed in this paper. The coefficient of variation of the BCI can be significantly reduced, implying that the new index BCI is stable. Moreover, the new significance test (NewSig) maintains the size, meanwhile, provides a greater power. Simulation experiments and two real cancer data examples are analysed for illustrating the performance of the new methodology.  相似文献   
7.
Randomised controlled trials are considered the gold standard in trial design. However, phase II oncology trials with a binary outcome are often single-arm. Although a number of reasons exist for choosing a single-arm trial, the primary reason is that single-arm designs require fewer participants than their randomised equivalents. Therefore, the development of novel methodology that makes randomised designs more efficient is of value to the trials community. This article introduces a randomised two-arm binary outcome trial design that includes stochastic curtailment (SC), allowing for the possibility of stopping a trial before the final conclusions are known with certainty. In addition to SC, the proposed design involves the use of a randomised block design, which allows investigators to control the number of interim analyses. This approach is compared with existing designs that also use early stopping, through the use of a loss function comprised of a weighted sum of design characteristics. Comparisons are also made using an example from a real trial. The comparisons show that for many possible loss functions, the proposed design is superior to existing designs. Further, the proposed design may be more practical, by allowing a flexible number of interim analyses. One existing design produces superior design realisations when the anticipated response rate is low. However, when using this design, the probability of rejecting the null hypothesis is sensitive to misspecification of the null response rate. Therefore, when considering randomised designs in phase II, we recommend the proposed approach be preferred over other sequential designs.  相似文献   
8.
Multivariate panel count data often occur when there exist several related recurrent events or response variables defined by occurrences of related events. For univariate panel count data, several nonparametric treatment comparison procedures have been developed. However, it does not seem to exist a nonparametric procedure for multivariate cases. Based on differences between estimated mean functions, this article proposes a class of nonparametric test procedures for multivariate panel count data. The asymptotic distribution of the new test statistics is established and a simulation study is conducted. Moreover, the new procedures are applied to a skin cancer problem that motivated this study.  相似文献   
9.
Joinpoint regression model identifies significant changes in the trends of the incidence, mortality, and survival of a specific disease in a given population. The purpose of the present study is to develop an age-stratified Bayesian joinpoint regression model to describe mortality trend assuming that the observed counts are probabilistically characterized by the Poisson distribution. The proposed model is based on Bayesian model selection criteria with the smallest number of joinpoints that are sufficient to explain the Annual Percentage Change. The prior probability distributions are chosen in such a way that they are automatically derived from the model index contained in the model space. The proposed model and methodology estimates the age-adjusted mortality rates in different epidemiological studies to compare the trends by accounting the confounding effects of age. In developing the subject methods, we use the cancer mortality counts of adult lung and bronchus cancer, and brain and other Central Nervous System cancer patients obtained from the Surveillance Epidemiology and End Results data base of the National Cancer Institute.  相似文献   
10.
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