Publications by authors named "R Andrew Swann"

Unlabelled: Policy Points A redirection of measurement in health care from a narrow focus on diseases and care processes towards assessing whole person health, as perceived by the person themself, may provide a galvanizing view of how health care can best meet the needs of people and help patients feel heard, seen, and understood by their care team. This review identifies key tensions to navigate as well as four overarching categories of whole person health for consideration in developing an instrument optimized for clinical practice. The categories (body and mind, relationships, living environment and finances, and engagement in daily life) include nine constituent domains.

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Background And Aims: Scotland has the highest rate of deaths from chronic liver disease (CLD) in the UK. Socioeconomic and geographic isolation represent significant challenges to delivery of care. The multidisciplinary Scottish Hepatology Access Research Partnership (SHARP) aimed to identify and break down barriers to diagnosing and treating liver disease in Scotland.

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Eco-evolutionary responses to environmentally induced selection fundamentally depend on magnitudes of genetic variation underlying traits that facilitate population persistence. Additive genetic variances and associated heritabilities can vary across environmental conditions, especially for labile phenotypic traits expressed through early life. However, short-term seasonal dynamics of genetic variances are rarely quantified in wild populations, precluding inference on eco-evolutionary outcomes in seasonally dynamic systems.

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Introduction: Use of investigations can help support the diagnostic process of patients with cancer in primary care, but the size of variation between patient group and between practices is unclear.

Methods: We analysed data on 53 252 patients from 1868 general practices included in the National Cancer Diagnosis Audit 2018 using a sequence of logistic regression models to quantify and explain practice-level variation in investigation use, accounting for patient-level case-mix and practice characteristics. Four types of investigations were considered: any investigation, blood tests, imaging and endoscopy.

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Article Synopsis
  • Prostate-Specific Antigen (PSA) testing is utilized in primary care to identify prostate cancer, and this study focuses on how many cases are diagnosed through asymptomatic PSA screenings.
  • An analysis of data from the 2018 English National Cancer Diagnosis Audit revealed that 19% of prostate cancer cases were detected via asymptomatic PSA testing, with a significant portion (52.1%) being patients aged 50-69 years.
  • Factors such as younger age, non-White ethnicity, lower deprivation, and fewer co-morbidities were linked to a higher likelihood of asymptomatic PSA diagnoses, highlighting considerable variability among different GP practices.
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