title: Patient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort study

authors: Blackmore, Tania Louise

subjects: Science & Technology

abstract: Background and objectives
New Zealand (NZ) has high rates of colorectal cancer (CRC) but low rates of early detection. The majority of CRC is diagnosed through general practice, where lengthy diagnostic intervals are common. We investigated factors contributing to diagnostic delay in a cohort of patients newly diagnosed with CRC.

Methods
Patients were recruited from the Midland region and interviewed about their diagnostic experience using a questionnaire based on a modified Model of Pathways to Treatment framework and SYMPTOM questionnaire. Descriptive statistics were used to describe the population characteristics. Chi-square analysis and logistic regression were used to analyse factors influencing diagnostic intervals.

Results
Data from 176 patients were analysed, of which 65 (36.9%) experienced a general practitioner (GP) diagnostic interval of >120 days and 96 (54.5%) experienced a total diagnostic interval (TDI) > 120 days. Patients reporting rectal bleeding were less likely to experience a long TDI (odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.14–0.78) and appraisal/help-seeking interval (OR, 0.19, 95% CI: 0.06–0.59). Patients <60 were more likely to report a longer appraisal/help-seeking interval (OR, 3.32, 95% CI: 1.17–9.46). Female (OR, 2.19, 95% CI: 1.08–4.44) and Māori patients (OR, 3.18, 95% CI: 1.04–9.78) were more likely to experience a long GP diagnostic interval.

Conclusion
NZ patients with CRC can experience long diagnostic intervals, attributed to patient and health system factors. Young patients, Māori, females, and patients experiencing change of bowel habit may be at particular risk. We need to increase symptom awareness of CRC for patients and GPs. Concentrated efforts are needed to ensure equity for Māori in access to screening, diagnostics, and treatment.

text: Patient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort study Background and objectives
New Zealand (NZ) has high rates of colorectal cancer (CRC) but low rates of early detection. The majority of CRC is diagnosed through general practice, where lengthy diagnostic intervals are common. We investigated factors contributing to diagnostic delay in a cohort of patients newly diagnosed with CRC.

Methods
Patients were recruited from the Midland region and interviewed about their diagnostic experience using a questionnaire based on a modified Model of Pathways to Treatment framework and SYMPTOM questionnaire. Descriptive statistics were used to describe the population characteristics. Chi-square analysis and logistic regression were used to analyse factors influencing diagnostic intervals.

Results
Data from 176 patients were analysed, of which 65 (36.9%) experienced a general practitioner (GP) diagnostic interval of >120 days and 96 (54.5%) experienced a total diagnostic interval (TDI) > 120 days. Patients reporting rectal bleeding were less likely to experience a long TDI (odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.14–0.78) and appraisal/help-seeking interval (OR, 0.19, 95% CI: 0.06–0.59). Patients <60 were more likely to report a longer appraisal/help-seeking interval (OR, 3.32, 95% CI: 1.17–9.46). Female (OR, 2.19, 95% CI: 1.08–4.44) and Māori patients (OR, 3.18, 95% CI: 1.04–9.78) were more likely to experience a long GP diagnostic interval.

Conclusion
NZ patients with CRC can experience long diagnostic intervals, attributed to patient and health system factors. Young patients, Māori, females, and patients experiencing change of bowel habit may be at particular risk. We need to increase symptom awareness of CRC for patients and GPs. Concentrated efforts are needed to ensure equity for Māori in access to screening, diagnostics, and treatment.

year: 2021

title: "Kia Mauri Tau!" Narratives of recovery from disabling mental health problems

authors: Lapsley, Hilary

subjects: Maori

abstract: A bicultural research team at the University of Waikato successfully applied for funding from the Health Research Council to do a qualitative research project in the area of ‘pathways to wellness’. The Mental Health Narratives Project set out to gather forty narratives of mental ill health, recovery and life after recovery by interviewing Maori and non-Maori women and men who once had a disabling mental health problem. We aimed to describe journeys to mental health, identify key themes in accounts of the recovery process and describe the impact of the experience of mental ill health on life after recovery.

text: "Kia Mauri Tau!" Narratives of recovery from disabling mental health problems A bicultural research team at the University of Waikato successfully applied for funding from the Health Research Council to do a qualitative research project in the area of ‘pathways to wellness’. The Mental Health Narratives Project set out to gather forty narratives of mental ill health, recovery and life after recovery by interviewing Maori and non-Maori women and men who once had a disabling mental health problem. We aimed to describe journeys to mental health, identify key themes in accounts of the recovery process and describe the impact of the experience of mental ill health on life after recovery.

year: 2002

title: Reactions of cyclomanganated compounds

authors: Mace, Wade

abstract: This thesis describes novel reactions of cyclomanganated compounds of the general form shown below. The ligand is bonded by a metal-carbon σ-bond, with X acting as a donor atom to form the chelate ring. The organic ligands were derived from aryl and heteroaryl ketones, chalcones, dienones and azabutadienes. 
A preliminary investigation has previously been undertaken into the reaction of carbon disulfide with some orthomanganated aryl ketones. In the present study these reactions were further investigated, with the isolation of new η2-S, S-dithiocarboxylate complexes, e.g. 46. In other cases the reaction of carbon disulfide with cyclomanganated compounds afforded the novel Mn4 species 50 in low yield. 
The reactions of orthomanganated acetyl-aryl compounds with organic isocyanides (C≡NR) afforded a number of novel compounds. For example η2-(2-acetylphenyl)-tetracarbonylmanganese (79) afforded four different types of products depending on the isocyanide; tert-butyl isocyanide produced 82, ethyl isocyanide produced 95 and 96, and 4-methoxyphenyl isocyanide produced 98 and 99. 
With orthomanganated 2-acetylthiophene, CNBut gave the quinone species 88 and 89,which showed high anti fungal and antitumor activity. 
Cyclomanganated dienones (e.g. 127) were previously known to react with alkynes to give either (η5-pyranyl)Mn(CO)3 (e.g. 130) or (η5-oxocycloheptadienyl)Mn(C0)3 (e.g.129) products. The factors influencing which product is formed were more systematically investigated and a deuterium-labelling experiment was used to probe the1,2-phenyl shift that occurs for the (η5-oxocycloheptadienyl)Mn(C0)3 products . 
A preliminary investigation of the reactions of 4-phenyl-1-(4-tolyl)-l-azabuta-1, 3-diene(TAD) with PhCH2Mn(CO)5 and unsaturated substrates including phenyl acetylene, methyl acrylate, PhNCO, ButNC and carbon disulfide is also described. A number of novel compounds were produced, including 169 from the reaction involving PhNCO. 
In contrast η2-(5-methoxy-2-acetylphenyl)tetracarbonylmanganese with ally1 isothiocyanate gave simply 2-allyl-4-methoxyacetophenone by allylation of the orthomanganated starting compound. Allyl bromide behaved similarly. However, allyl bromide and ethyl bromide when reacted with the cyclomanganated chalcone 54 gave furanone products (e.g. 190 and 191). An oxidative addition and reductive elimination mechanism was proposed to explain this reaction. 
Among others, the crystal structures of 50, 89 and 130 were determined.

text: Reactions of cyclomanganated compounds This thesis describes novel reactions of cyclomanganated compounds of the general form shown below. The ligand is bonded by a metal-carbon σ-bond, with X acting as a donor atom to form the chelate ring. The organic ligands were derived from aryl and heteroaryl ketones, chalcones, dienones and azabutadienes. 
A preliminary investigation has previously been undertaken into the reaction of carbon disulfide with some orthomanganated aryl ketones. In the present study these reactions were further investigated, with the isolation of new η2-S, S-dithiocarboxylate complexes, e.g. 46. In other cases the reaction of carbon disulfide with cyclomanganated compounds afforded the novel Mn4 species 50 in low yield. 
The reactions of orthomanganated acetyl-aryl compounds with organic isocyanides (C≡NR) afforded a number of novel compounds. For example η2-(2-acetylphenyl)-tetracarbonylmanganese (79) afforded four different types of products depending on the isocyanide; tert-butyl isocyanide produced 82, ethyl isocyanide produced 95 and 96, and 4-methoxyphenyl isocyanide produced 98 and 99. 
With orthomanganated 2-acetylthiophene, CNBut gave the quinone species 88 and 89,which showed high anti fungal and antitumor activity. 
Cyclomanganated dienones (e.g. 127) were previously known to react with alkynes to give either (η5-pyranyl)Mn(CO)3 (e.g. 130) or (η5-oxocycloheptadienyl)Mn(C0)3 (e.g.129) products. The factors influencing which product is formed were more systematically investigated and a deuterium-labelling experiment was used to probe the1,2-phenyl shift that occurs for the (η5-oxocycloheptadienyl)Mn(C0)3 products . 
A preliminary investigation of the reactions of 4-phenyl-1-(4-tolyl)-l-azabuta-1, 3-diene(TAD) with PhCH2Mn(CO)5 and unsaturated substrates including phenyl acetylene, methyl acrylate, PhNCO, ButNC and carbon disulfide is also described. A number of novel compounds were produced, including 169 from the reaction involving PhNCO. 
In contrast η2-(5-methoxy-2-acetylphenyl)tetracarbonylmanganese with ally1 isothiocyanate gave simply 2-allyl-4-methoxyacetophenone by allylation of the orthomanganated starting compound. Allyl bromide behaved similarly. However, allyl bromide and ethyl bromide when reacted with the cyclomanganated chalcone 54 gave furanone products (e.g. 190 and 191). An oxidative addition and reductive elimination mechanism was proposed to explain this reaction. 
Among others, the crystal structures of 50, 89 and 130 were determined.

year: 2003