Using the Patients Concerns Inventory for Distress Screening in Post-treatment Head and Neck Cancer Survivors, Journal of Cranio-Maxillofacial Surgery in press.

Purpose Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. Methods 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. Results The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2–8) vs 2.61, 2 (0–4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. Conclusions Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function

Marking Movements - new drawings by Catherine Flexen and Craig Staff

Keen to support artists working today, the Art Gallery & Museum invited Catherine Flexen and Craig Staff to create work specifically for Gallery 13. This exhibition of new drawing explores the way in which the body is involved as the maker of marks, rather than as the subject of representation. For both artists, the form that their drawings eventually take is a result of a lengthy process of physical activity, although in very contrasting ways. Whereas for Flexen drawing is a response to the physical motion of walking in the Cotswolds, for Staff it is a consideration of the fragility of human concentration and the body's capabilitie