General health outcome measure

It is to be noted that using screening strategy as reference, all prevention strategies and interventions to modify behaviour and life styles would extend the survival and improve the outcome of the patients. The most general health outcome measure is survival. For breast cancer, 5-year survival or the interval of disease free survival has customarily been used to evaluate the success of the intervention. Most cancers once established are difficult to cure. Even when cure is possible, the costs of treatment may be enormous enough to exceed the individual’s or societies willingness to pay.

Increasing consumerism, strict and willing governance, and patient participation in healthcare decisions occurring in parallel had set the stage for development of patient-based breast cancer related measures. Thus, there is a clear need for expanded research on practice-based outcome intervention measures. For such intervention measures to be clinically relevant and feasible to collect, it is key that the research and clinical communities work together to take an active leadership role in this process.

To set the stage for such activities, the primary prevention measures would consist of interventions directed to employ the findings of determinant analysis in the practical field (Pierce, J. P. , Faerber, S. , Wright, F. , et al. , 2002). Goal and Objective: A possible relationship between diet and risk for primary breast cancer has been the focus of much scientific interest. Results from observational studies suggest that diet may influence prognosis of breast cancer, and its incidence may reduce with diet interventions.

There are several mechanisms by which diet composition might influence incidence and survival after the diagnosis of breast cancer. One possible mechanism is through an effect on reproductive steroid hormones. An important characteristic of normal mammary cell proliferation and differentiation is the responsiveness of these cells to oestrogen. Thus minimizing oestrogen stimulation following the diagnosis of breast cancer is a standard management strategy.

The fact that antioestrogen therapy is now acceptably standard in management of breast cancer can lead to interventions that control fat in the diet and increase fruits and vegetables in the diet that tantamount to reduction of circulating steroids. The purpose of the present project plan is to construct a strategy to implement intervention measures in the population concerned a diet consisting of high-vegetable, high-fiber, and low-fat and evaluate its effects on serum concentration of reproductive steroid hormones in women with proved cases of carcinoma breast in the community during their first year of participation.

The objectives, as a result, are to implement and test the effects of diet modification on breast cancer incidence and survival. Another objective is academic in the sense that it would examine the relationships between changes in the intakes of fibers and fat and changes in serum bioavailable oestradiol and total oestradiol concentration from baseline to 1 year in these participants. Intervention Development: The strategies that can be employed is first to assess the dietary status of the target population by means of a questionnaire.

Many women now are working outside home, and this single factor has contributed to the change in conventional dietary pattern to a high fat one (Day, N. E. , McKeown, N. , Wong, M. Y. , Welch, A. , Bingham, S. A. , 2001). This can be done by an eligibility screening form containing pertinent history of breast cancer in family or relations and other detailed data about the lifestyle and dietary habits. A consent form will be signed of the willing candidates after explaining the goal of the intervention pointing out all the determinants.

Those who are willing would be contacted over telephone or physical face to face meetings, where a survey of the diet will be undertaken (Willett, W. , 2001). Strategy Mix: Strategy 1 : The dietary judgment would decide what modification is to be implemented without affecting the cultural beliefs of the candidates. The intervention would be designed to promote dietary change with the goals of reducing total fat intake and increasing fruit, whole grain, or vegetable intake (Goris, A. H. , Westerterp-Plantenga, M.S. , Westerterp, K. R. , 2000).

The target reduced total fat intake would be 20% of total food energy as fat and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to 6 servings daily. By reducing the total fat to 20% of total energy, the amount of saturated fat also would be reduced to about 7% of energy. This is acceptable since this would not hamper the balance of the nutritional requirements, and at the same time, it would take care of reduction of weight.

Additional research on diet and breast cancer prevention could focus on those women most likely to benefit from a low-fat dietary pattern, such as those with diets habitually high in fat. The potential differential effect of a low-fat dietary pattern should continue to further characterize and encourage the exploration of underlying mechanisms. (Vuckovic, N. , Ritenbaugh, C. , Taren, D. L. , Tobar, M. , 2000).

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