Long term health related quality of life following colorectal cancer surgery: patient reported outcomes in a remote follow-up population

Background: Remote follow-up (RFU) after colorectal cancer (CRC) surgery allows delivery of surveillance tests without the need for regular outpatient clinical appointments. However, little is known about health related quality of life (HRQoL) in RFU patients.Methods: EQ-5D, QLQ-C30 and QLQ-C29 questionnaires were distributed to CRC patients enrolled in a RFU programme. The primary outcome of HRQoL scores was analysed by year of RFU, demographics, operation-type, stoma and adherence to RFU protocols. Results:428 respondents (59.3%), mean age of 71years(SD 10.1) and a median RFU time of 2.6years (IQR: 1.6-4.8 years) were included. 26.6% of patients reported ‘perfect health’. The median EQ-5D index score was 0.785 (IQR: 0.671-1) and QLQ-C30 Global HRQoL score was 75 (IQR: 58.3-83.3). Females had significantly lower EQ-5D median score of 0.767 (IQR: 0.666-0.879, p=0.0088). Lower QLQ-C30 HRQoL scores were seen in stoma patients, median 66.6 (IQR: 58.3-83.3, p=0.0029). Erectile dysfunction (p=0.0006) and poor body image (p=0.001) were also reported more frequently in stoma patients. Patients undergoing right-sided resection reported a lower median EQ-5D score of 0.765 (IQR: 0.666-0.879, p=0.028) and higher pain severity (p=0.0367) compared with left-sided resections. There were 128 (29.4%) patients that breached RFU protocol and were seen in adhoc colorectal clinics. However, there was no statistical difference in HRQoL between patients who adhered to or breached RFU protocols.Conclusions: Overall HRQoL in patients in RFU is good, with no difference in those strictly followed up remotely. However, females, right-sided resections and patients with stomas may require additional clinical reviews.

CAD/CAM in the woven textiles industry

Weaving is one of the oldest crafts known to man. Fragments of woven cloth have been dated to the Neolithic/Eneolothic period [1]. The woven fabric has been regarded as possessing mystical qualities: woven rags are offered as part of the prayers in some Buddhist shrines, form the requisite set of ceremonial accoutrements for many different religions’ prayer settings, and as observed by Kramrisch [1a] “in the Rig Veda and the Upanishads, the universe is envisioned as a fabric woven by the gods. The cosmos, the ordered universe, is one continuous fabric; the uncut fabric is a symbol of totality and integrity” (Kramrisch [1a, pp. 67–68]). Knowledge and mastery of the skill has long been a matter of intellectual pride – as illustrated by the Greek myth of the weaving competition between the goddess Athena and the human Arachnida. Arachnida won the competition but her demonstration of pride in winning was punished by Athena who turned Arachnida into a spider and cursed her to forever spin and weave. To understand and be knowledgeable about woven design is a matter of mastering weaving techniques and mathematics and the competitive environment within which the textiles industry operates requires computer-aided design and manufacture (CAD/CAM) skills to develop new products and new textiles applications