First marine litter survey on beaches in Solomon Islands and Vanuatu, South Pacific: Using OSPAR protocol to inform the development of national action plans to tackle land-based solid waste pollution.

The increasing abundance of marine litter is impacting the environment, human health and economies in the South Pacific. Small Islands Developing States are particularly affected by marine litter, primarily due to insufficient waste management systems. For the first time, marine litter was quantified and characterised on 13 beaches in Solomon Islands and Vanuatu in the South Pacific region using the OSPAR beach litter monitoring guidelines. A total of 1053 (±1017) and 974 (±745) items of litter per 100 m beach were recorded in Solomon Islands and Vanuatu respectively. Litter composition and distribution show that the majority of the litter comes from local land-based sources and large quantities of fragments and single use plastics were found by cities and river mouths. Actions to reduce single use plastic, improve collection, reuse and recycling, together with outreach campaigns would reduce marine litter significantly in these countries. Furthermore, there is great potential to develop a more circular economy to manage the substantial quantities of recyclable items that were found stranded on the beaches.

Reliably colonising broiler chickens with Campylobacter spp. using a litter-based method.

1. Chicken-associated Campylobacter spp. are the cause of most food poisoning cases in Europe. In order to study the host-pathogen interactions, a reliable and reproducible method of colonising chickens with the bacteria is required. 2. This study aimed to identify a more appropriate and less invasive method of colonisation (cf. gavaging) by seeding bedding material (litter) that commercial chickens are kept on with a mixture of Campylobacter spp., broth and faeces. 3. The first phase of the study tested the longevity of Campylobacter spp. recovery in seeded litter over 24 h: significantly more Campylobacter spp. was recovered at 0 or 3 h post-seeding than at 6 and 24 h post-seeding, indicating that the pathogen can survive to detectable levels for at least 3 h in this environment. 4. In the second phase, three groups of 10 broiler chickens (negative for Campylobacter spp. prior to exposure) were exposed at 21 days of age to one of three different Campylobacter jejuni and C. coli mixes (A, B, C), using the method above. At 28 days of age, birds were euthanised by overdose of barbiturate or cervical dislocation, and livers and caeca removed for Campylobacter spp. assessment. 5. All liver and 28/30 caeca samples tested positive for Campylobacter spp., with mix A and C giving higher counts in the caeca than mix B. The method of euthanasia did not affect Campylobacter spp. counts. 6. In conclusion, a successful method for reliably colonising broiler chickens with Campylobacter spp. has been developed which negates the need for gavaging and is more representative of how contamination occurs in the field.

Patients' experiences of completing treatment for colorectal cancer in a Scottish District General Hospital.

A review of the cancer literature from 1990 to 2003 indicated that some patients with cancer felt abandoned by healthcare professionals upon completion of treatment. With this in mind, a small qualitative study was undertaken to explore the experiences of patients completing treatment for colorectal cancer within a Scottish District General Hospital. A small purposeful sample of eight participants (surgery only n = 4 and surgery with adjuvant chemotherapy n = 4) who had completed treatment were recruited. Semi-structured interviews, in a venue chosen by the participants (home n = 7; hospital n = 1), were tape-recorded and transcribed verbatim. The mean time since completion of treatment was 30 weeks (range 9-95 weeks). Transcripts were read and reread several times to identify categories. By thematic analysis, five categories were identified: physical impact of treatment, completion of treatment, support of family and friends, impact of healthcare professionals and coping mechanisms. Despite the significant physical impact of treatment patients returned to their previous lifestyles and status. Although very optimistic and positive when treatment was completed, participants reflected upon their cancer recurring. Family and friends were the main providers of support during their experiences, and healthcare professionals impacted upon participants both positively and negatively. Overall, the completion of treatment was described as a 'great feeling' and 'relief', with patients reporting that they felt adequately supported by healthcare professionals after completion of treatment.

The experience of dysphagia and its effect on the quality of life of patients with oesophageal cancer.

This qualitative study was designed to explore the experience of dysphagia in oesophageal cancer and how this impacts on quality of life. The aim of the study was to add to the knowledge and comprehension of this poorly understood symptom. Data was collected through in-depth interview and administration of the EORTC QLQ-C30 and EORTC QLQ-OES24 quality of life tools with six people with incurable oesophageal cancer who had dysphagia. The interviews were tape-recorded and then transcribed verbatim for each participant. Through a thematic analysis of the interview data and a descriptive analysis of the questionnaires a detailed description of the experience of dysphagia and its impact on quality of life was obtained. Five basic themes emerged from the participant's accounts and these were recognizing dysphagia, the physical experience, the emotions evoked, the impact on social life and dysphagia and treatment. In conclusion dysphagia is a troublesome symptom which affects all aspects of quality of life.

Attendance at cancer follow-up clinic: does it increase anxiety or provide reassurance for men successfully treated for testicular cancer?

This cross-sectional descriptive study examined the meaning of the cancer follow-up clinic for men who have been successfully treated for testicular cancer. The sample of 62 men were selected using a nonprobability quota sampling method before attendance at a routine testicular cancer follow-up clinic within the Directorate of Clinical Oncology, Western General Hospitals NHS Trust, Edinburgh, Scotland. Subjects were given four instruments to complete immediately before seeing the doctor in the clinic, and two instruments to complete on day 8 after the clinic appointment. Instruments included the State-Trait Anxiety Inventory (STAI), a demographic questionnaire, and two Likert scales adapted for use in the study: the Common Concerns about Testicular Cancer questionnaire and the Psychological Consequences of Screening questionnaire (PCQ). Results demonstrated that men attending the clinic exhibit low levels of anxiety at the points measured, but gain a great deal of reassurance from the clinic visit. Results also demonstrated the areas of concern about testicular cancer and its management that influence anxiety in the follow-up clinic.

The quality of life of cancer patients participating in phase I clinical trials using SEIQoL-DW.

The nature of phase I clinical trials in cancer patients raises many ethical issues. An area of major importance is the quality of life (QoL) of these patients. However, there is limited information available concerning the impact of phase I clinical trials on the QoL of patients with cancer. The primary aim of this study was to examine the QoL of cancer patients participating in phase I clinical trials. A descriptive triangulation approach was employed. The secondary aim was to determine the acceptability of the Schedule for the Evaluation of Individual Quality of Life - Direct Weighting (SEIQoL-DW) within this group of patients. SEIQoL-DW is a relatively new tool which investigates the areas identified by individual patients as important to their QoL. Cancer patients (n=15) participating in phase I clinical trials were interviewed using the SEIQoL-DW tool. During this interview patients nominated the areas of life important to them and rated their relative weighting and current status. Cues nominated were described and results analysed using non-parametric statistical tests. The results showed that health and family were particularly important to patients in relation to their QoL. The importance of an individualized approach in the measurement of QoL was evident. SEIQoL-DW was found to be acceptable and practical to use in cancer patients participating in phase I clinical trials. Recommendations for practice were drawn and suggestions made for further research.

Women's breast cancer and epidemiology: Scotland and Iceland, contrasts and comparisons.

Epidemiology is a scientific discipline concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability and mortality in populations. This article reviews the literature on women's breast cancer from an epidemiological point of view. Special attention is given to epidemiology and cancer in terms of sources of information, geographical variations, incidence and mortality, risk factors and prevention. Iceland and Scotland were chosen to compare and contrast the epidemiology of breast cancer. These countries were chosen because of the author's general knowledge and acquaintance with both countries and because of her experience in working with breast cancer patients.

Survivorship and the cancer follow-up clinic.

In recent years there has been growing interest in the needs of those individuals who have survived cancer. It is now possible to describe the adjustments that these individuals will make, predict when such difficulties will arise, and identify those most vulnerable to adjustment difficulty. The value of the cancer follow-up clinic has also received scrutiny, drawing on work previously undertaken in the cancer screening clinic setting. Issues discussed in the literature include the purpose of follow-up, the most appropriate health care professional to undertake the follow-up clinic, and the financial cost of cancer follow-up. There exists an opportunity for cancer nurses at present to develop roles in the clinic setting, offering patient-centred and cost-effective alternatives to physician-led follow-up.

Epidemiology of prostate cancer in two European countries: Scotland and Norway.

The incidence of prostate cancer varies enormously throughout the world. Scotland and Norway are two European countries with similar populations, yet the incidence of prostate cancer in Norway is much greater than in Scotland. The aetiology and epidemiology of prostate cancer in both countries is discussed. Reference is made to age, socio-economic status, diet, hormones, genetic factors and vasectomy.

A literature review of adolescence and cancer.

Cancer is a relatively rare phenomenon in adolescents and a traumatic experience which arouses feelings of anger, anxiety, fear and sadness. For the adolescent with cancer, there are missed opportunities, not only in daily life but also through lost social events such as dances or football games with friends. Adolescent cancer patients may understand the implications of the diagnosis of cancer but lack the personal resources or life event experience which could equip them to cope and make sense of the many potential problems which may accompany cancer. This paper reviews and explores the literature associated with the adolescent with cancer.

Metastasis: the deadly part of cancer.

The most malignant characteristic of any cancer cell is the cell's ability to metastasize. The movement of the malignant cell from the primary neoplasm to a distant site, and the cell's subsequent growth there, is the most dangerous characteristic of any tumour cell. Metastatic development occurs via a series of complicated events. This article explores the stepwise process of metastatic spread, known as the 'metastatic cascade', highlights the organs commonly involved in metastatic spread, and debates the seed and soil hypothesis of metastasis. The nurse is introduced to the importance of recent medical research which highlights the genetic links identified in metastatic cell formation. Tumour suppressor genes and oncogenes, which are genes known to induce or promote cancer, and their implications for prognosis, are explained. Finally, the nurse's responsibility in maintaining his/her knowledge and understanding of metastasis in order that he/she may provide appropriate care and support for the patient and family is discussed.