14 However, current practice is not underpinned by robust evidence, and is notoriously variable between hospitals. Patients with prostate cancer are normally followed up in out-patient clinics in hospital for up to 5 years, to monitor and manage the risk of recurrence, and the physical symptoms following treatment. 13 Thus, the assessment and management of the adverse treatment effects, related psychosocial needs (also affecting their partners) and the impact on the management of other comorbid conditions is, for many patients, complex and prolonged. 9 The diagnosis and treatment toxicities also affect the patients' immediate families, 10 particularly through psychological distress related to anxiety, depression 11, 12 and psychosexual problems. 6–8 Psychological distress is also significant, and most prostate cancer survivors require prompt information about treatment outcomes and its impact on daily living. 5 The management of chronic comorbid conditions (eg, cardiovascular disease and cerebrovascular disease, hypertension, diabetes) often further increases the level of need, and about two-thirds of patients with prostate cancer are expected to have at least one major comorbidity. 1, 2 Common physical symptoms are related to sexual function, urinary incontinence, 3 bowel symptoms, 4 hot flushes and the risk of bone fracture. Over the past 20 years, in the UK, incidence rates have doubled, but mortality rates have dropped by a quarter. Prostate cancer is the most common cancer for men in the UK (second worldwide), and many survivors experience long-lasting physical and psychological needs.
TOPCAT MANUAL TRIAL
Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Healthcare service use will be measured over 36 weeks. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. Top Cat® repair parts restore tools to original quality and performance standards, and are available from your distributor.Methods and analysis Prostate cancer survivors diagnosed in the past 9–48 months and currently biochemically stable will be identified from hospital records by their treating clinician. tools comply with OSHA and ANSI standards.Īuthorized Agents Worldwide assure prompt delivery of tools and parts, and provide complete repair services. Designed for user efficiency and safety, all T.C. machinery at our Willoughby, Ohio (a suburb of Cleveland) plant. Top Cat® air tools are American made by skilled machinists using the latest in C.N.C.
TOPCAT MANUAL FULL
From vertical grinders, horizontal grinders, right angle grinders, die grinders, burr grinders, belt sanders, chipping hammers, scaling hammers (scalers), needle scalers, to abrasive cut off machines, and drills - our full product line will have all of the material removal tools you require.Ĭomputer Aided Design and extensive use of finite element analysis enables us to perform stress tests and is instrumental in developing and perfecting the products we sell. Service Company employs modern technology and equipment to produce top quality Top Cat® industrial air tools. Welcome to the Top Cat® Air Tools home on the web.