Cancer Caregivers

2019 ◽  
Keyword(s):  
Life Stage ◽  
Psychosocial Interventions ◽  
New Drugs ◽  
Diagnostic Tools ◽  
Healthcare Team ◽  
Ethical Concerns ◽  
Treatment Type ◽  
Hospital Stays ◽  
Cancer Caregivers ◽  
Ethnic Group Membership

Cancer caregivers are an essential extension of the healthcare team. Rapid advances in cancer care, including new drugs and immunotherapies and more sophisticated diagnostic tools, have improved our ability to extend lives and enhance survival. As patients are living longer and with today’s shorter hospital stays and shift towards increased outpatient care, however, the burden on caregivers and their needs have substantially increased. Cancer Caregivers reveals the depth of complexities of caregiving experiences that the field of Psycho-Oncology has been exploring and the vast expanses we have left to understand. This text describes the characteristics and experiences of cancer caregivers based on their life stage, relationship to the patient, and ethnic group membership, as well as patients’ disease and treatment type. It highlights the significant progress in research focused on the development and dissemination of psychosocial interventions for cancer caregivers, and includes in-depth case studies to illustrate their delivery and application. The text also explores the provision of support to caregivers in the community and the legal and ethical concerns faced by caregivers across the care trajectory. Cancer Caregivers offers both fundamental and practical information and is a resource for all healthcare professionals who work with patients and families facing cancer.

Early palliative care for those who care: A qualitative exploration of cancer caregivers’ information needs during hospital stays

2019 ◽  
Vol 28 (2) ◽  
pp. e12990 ◽  
Author(s):  
Martina Preisler ◽  
Amy Rohrmoser ◽  
Ute Goerling ◽  
Friederike Kendel ◽  
Konrad Bär ◽  
...  
Keyword(s):  
Palliative Care ◽  
Information Needs ◽  
Early Palliative Care ◽  
Hospital Stays ◽  
Cancer Caregivers ◽  
Qualitative Exploration

scholarly journals Circulating Biomarkers of Diabetic Retinopathy: An Overview Based on Physiopathology

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Olga Simó-Servat ◽  
Rafael Simó ◽  
Cristina Hernández
Keyword(s):  
Diabetic Retinopathy ◽  
Therapeutic Strategy ◽  
New Drugs ◽  
Diagnostic Tools ◽  
Diabetic Patients ◽  
Circulating Biomarkers ◽  
Pharmacological Treatments ◽  
Early Stages ◽  
Working Age ◽  
Advanced Stages

Diabetic retinopathy (DR) is the main cause of working-age adult-onset blindness. The currently available treatments for DR are applicable only at advanced stages of the disease and are associated with significant adverse effects. In early stages of DR the only therapeutic strategy that physicians can offer is a tight control of the risk factors for DR. Therefore, new pharmacological treatments for these early stages of the disease are required. In order to develop therapeutic strategies for early stages of DR new diagnostic tools are urgently needed. In this regard, circulating biomarkers could be useful to detect early disease, to identify those diabetic patients most prone to progressive worsening who ought to be followed up more often and who could obtain the most benefit from these therapies, and to monitor the effectiveness of new drugs for DR before more advanced DR stages have been reached. Research of biomarkers for DR has been mainly based on the pathogenic mechanism involved in the development of DR (i.e., AGEs, oxidative stress, endothelial dysfunction, inflammation, and proangiogenic factors). This review focuses on circulating biomarkers at both early and advanced stages that could be relevant for the prediction or detection of DR.

scholarly journals Disparities in ADHD Diagnosis and Treatment by Race/Ethnicity in Youth Receiving Kentucky Medicaid in 2017

2021 ◽  
Vol 31 (1) ◽  
pp. 67-76
Author(s):  
Deborah Winders Davis ◽  
Kahir Jawad ◽  
Yana Feygin ◽  
Liza Creel ◽  
Maiying Kong ◽  
...  
Keyword(s):  
Population Density ◽  
Psychosocial Interventions ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Treatment Modalities ◽  
Adhd Diagnosis ◽  
Stimulant Use ◽  
Treatment Type ◽  
Race Ethnicity ◽  
To Receive

Background: Kentucky has among the highest rate of attention deficit/hyperactivity disorder (ADHD) and stimulant use in the United States. Little is known about this use by race/ethnicity and geography. This article describes patterns of diagnosis of ADHD and receipt of stimulants and psychosocial interventions for children aged 6-17 years receiving Kentucky Medicaid in 2017 and identifies factors associated with diagnosis and treatment.Methods: Using Medicaid claims, children with and without ADHD (ICD-10 codes F90.0, F90.1, F90.2, F90.8, and F90.9) were compared and predictors of diag­nosis and treatment type were examined. Psychosocial interventions were defined as having at least one relevant CPT code. Chi-squared tests and logistic regression models were used for univariate and multivariable analysis, respectively.Results: The rates of ADHD, stimulant use, and psychosocial interventions in our study population exceeded the national aver­age (14% vs 9%; 75% vs 65.5%; and 51% vs 46.5%, respectively). The distributions varied by sex, race/ethnicity, sex among race/ethnicities, and population density. In general, race/ethnicity predicted ADHD diagnosis, stimulant use, and receipt of psy­chosocial interventions with non-Hispanic White children being more likely to receive diagnosis and medication, but less likely to receive psychosocial therapy than other children. Differences were also shown for rural compared with urban residence, sex, and sex within racial/ethnic groups.Conclusions: Diagnosis and treatment modalities differed for children by race/ ethnicity, population density, and sex. More data are needed to better understand whether differences are due to provider bias, child characteristics, or cultural varia­tions impacting the utilization of different treatment options.Ethn Dis. 2021;31(1):67- 76; doi:10.18865/ed.31.1.67

Therapeutic Strategies in Diseases of the Digestive Tract - 2015 and Beyond Targeted Therapies in Colon Cancer Today and Tomorrow

2016 ◽  
Vol 34 (5) ◽  
pp. 574-579 ◽  
Author(s):  
Michael Pohl ◽  
Wolff Schmiegel
Keyword(s):  
Targeted Therapies ◽  
Immune Checkpoint ◽  
Predictive Biomarkers ◽  
Therapeutic Strategies ◽  
New Drugs ◽  
Diagnostic Tools ◽  
Molecular Heterogeneity ◽  
Cancer Type ◽  
Significant Progress ◽  
Ras Genes

Background: Colorectal cancer (CRC) is the third most common cancer type in Western countries. Significant progress has been made in the last decade in the therapy of metastatic CRC (mCRC) with a median overall survival (OS) of patients exceeding 30 months. The integration of biologic targeted therapies and anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MABs) in the treatment of patients with genomically selected all-RAS wild-type mCRC leads to a significant progress in advanced incurable disease state. After the introduction of the anti-VEGF MAB bevacizumab, the FDA approved with ramucirumab the second antiangiogenic MAB for the mCRC treatment. Further new drugs are on the horizon and new diagnostic tools will be introduced soon. Key Messages: Molecular heterogeneity of mCRC has been recognized as pivotal in the evolution of clonal populations during anti-EGFR therapies. Mutations in RAS genes predict a lack of response to anti-EGFR MABs. Mutations in the mitogen-activated protein kinase-phosphoinositide 3-kinase pathways like BRAF or PIK3CA mutations or HER2/ERBB2 or MET amplifications bypass EGFR signaling and also may confer resistance to anti-EGFR MABs. HER2/ERBB2 amplification is a further driver of resistance to anti-EGFR MABs in mCRC. The phase II study of HER2 Amplification for Colo-Rectal Cancer Enhanced Stratification (HERACLES) discovers that a dual HER2-targeted therapy may be an option for HER2-amplified mCRC. The mismatch repair deficiency predicts responsiveness to an immune checkpoint blockade with the anti-PD-1 immune checkpoint inhibitor pembrolizumab. Conclusions: The understanding of primary (de novo) and secondary (acquired) resistance to anti-EGFR therapies, new targeted therapies, immuno-oncology and about predictive biomarkers in mCRC is guiding the development of rational therapeutic strategies. Combinations of targeted therapies are necessary to effectively treat drug-resistant cancers. Liquid biopsy is an upcoming new tool in the primary diagnosis and follow-up analysis of mutations in circulating tumor DNA.

Cognitive Behavioral Therapy for Informal Cancer Caregivers

2019 ◽  
pp. 149-163
Author(s):  
Jamie M. Jacobs ◽  
Lara Traeger ◽  
Emily A. Walsh ◽  
Joseph A. Greer
Keyword(s):  
Quality Of Life ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Outpatient Setting ◽  
Cognitive Behavioral ◽  
Healthcare Team ◽  
Loved One ◽  
Cancer Caregivers ◽  
And Coping

As cancer treatment shifts progressively to the outpatient setting, informal caregivers, including family and friends, play an increasingly central role in ensuring optimal ongoing care of these patients. Cancer caregivers may provide a range of emotional, instrumental, and informational support, including handling complex treatment schedules, managing side effects, juggling household chores and transportation, communicating with the healthcare team and friends and family, and coping with the uncertainty of their loved one’s prognosis. Cancer caregivers may become overwhelmed and burdened by these tasks, receiving minimal support and guidance related to managing distress and maintaining their own quality of life while caring for a loved one. Cognitive behavioral therapy is evidence- and skills-based therapy efficacious for patients with cancer in managing anxiety and depression and improving quality of life. This chapter reviews the application of and evidence for cognitive behavioral therapy for addressing psychosocial distress and burden in informal cancer caregivers.

scholarly journals Electrohysterogram for ANN-Based Prediction of Imminent Labor in Women with Threatened Preterm Labor Undergoing Tocolytic Therapy

Sensors ◽  
2020 ◽  
Vol 20 (9) ◽  
pp. 2681
Author(s):  
J. Mas-Cabo ◽  
G. Prats-Boluda ◽  
J. Garcia-Casado ◽  
J. Alberola-Rubio ◽  
R. Monfort-Ortiz ◽  
...  
Keyword(s):  
Preterm Labor ◽  
Time Horizon ◽  
Prediction Models ◽  
Test Group ◽  
Diagnostic Tools ◽  
Clinical Use ◽  
Hospital Stays ◽  
Threatened Preterm Labor ◽  
Fetal Wellbeing ◽  
Prediction Techniques

Threatened preterm labor (TPL) is the most common cause of hospitalization in the second half of pregnancy and entails high costs for health systems. Currently, no reliable labor proximity prediction techniques are available for clinical use. Regular checks by uterine electrohysterogram (EHG) for predicting preterm labor have been widely studied. The aim of the present study was to assess the feasibility of predicting labor with a 7- and 14-day time horizon in TPL women, who may be under tocolytic treatment, using EHG and/or obstetric data. Based on 140 EHG recordings, artificial neural networks were used to develop prediction models. Non-linear EHG parameters were found to be more reliable than linear for differentiating labor in under and over 7/14 days. Using EHG and obstetric data, the <7- and <14-day labor prediction models achieved an AUC in the test group of 87.1 ± 4.3% and 76.2 ± 5.8%, respectively. These results suggest that EHG can be reliable for predicting imminent labor in TPL women, regardless of the tocolytic therapy stage. This paves the way for the development of diagnostic tools to help obstetricians make better decisions on treatments, hospital stays and admitting TPL women, and can therefore reduce costs and improve maternal and fetal wellbeing.

scholarly journals Present and future management of anti-neutrophil cytoplasmic antibody associated vasculitis: how therapy changed the prognosis

2013 ◽  
pp. 14-25
Author(s):  
Massimo L’Andolina ◽  
Giovanni Forte ◽  
Norma M. Marigliano ◽  
Salvatore Galasso ◽  
Francesca Mazzei ◽  
...  
Keyword(s):  
Immune System ◽  
New Drugs ◽  
Diagnostic Tools ◽  
Second Phase ◽  
Treatment Protocols ◽  
Therapeutic Guidelines ◽  
Chest X Ray ◽  
Diagnostic Approaches ◽  
Therapeutic Protocols

Anti-neutrophil cytoplasmic antibody associated vasculitis is part of a multi-systemic idiopathic, small vessel pouci-immune vasculitis. Given the heterogeneous spectrum of the disease, and the need to update therapeutic protocols, the aim of this review was to evaluate clinical-diagnostic approaches. We examined statistical data available in the literature, in particular the 2010 review of St. Hamour et al. Management of Anca-associated Vasculitis, published in Therapeutics and Clinical Risk Management. Acute immunosuppressive therapy and long-term maintenance, with the use of prednisolone, have significantly changed the prognosis of this disease, particularly compared with the 1970s before the introductions of steroids and cyclophosphamide. New drugs such as rituximab, monoclonal antibodies and other modulating immune system molecules are entering clinical use, and experience will confirm whether or not therapeutic guidelines are appropriate. The current diagnostic tools, ranging from laboratory and autoimmune tests, chest X-ray, broncho-alveolar lavage to capillaroscopy, allow prompt diagnosis and early treatment through a first phase of induction-remission, and a second phase of maintenance. There are, however, recurrent and refractory forms of the disease that require long-term immunosuppression and further research into this is merited. These issues have continued to drive the search for safer and more effective modulation of the immune system using targeted immunotherapy. However, the treatment limitations of incomplete efficacy, infection, and cumulative toxicity persist. Modifications to traditional treatment protocols by the use of azathioprine or methotrexate rather than cyclophosphamide, and the introduction of newer agents, such as rituximab, have meant that outcomes have been maintained while toxicity has been reduced.

scholarly journals Care for the cancer caregiver: A systematic review

2012 ◽  
Vol 11 (3) ◽  
pp. 231-252 ◽  
Author(s):  
Allison J. Applebaum ◽  
William Breitbart
Keyword(s):  
Systematic Review ◽  
Couples Therapy ◽  
Behavioral Therapy ◽  
Supportive Therapy ◽  
Psychosocial Interventions ◽  
Interpersonal Therapy ◽  
Problem Solving Skills ◽  
Final Sample ◽  
Cancer Caregiver ◽  
Cancer Caregivers

AbstractObjective:Informal caregivers (ICs) are relatives, friends, and partners who have a significant relationship with and provide assistance (i.e., physical, emotional) to a patient with a life- threatening, incurable illness. The multidimensional burden that results from providing care to a patient with cancer is well documented, and as a result, a growing number of psychosocial interventions have been developed specifically to address this burden. The purpose of the present study was to characterize the state of the science of psychosocial interventions for informal cancer caregivers.Method:A comprehensive systematic review of interventions for cancer caregivers was conducted via an electronic literature search of publications between 1980 and January 13, 2011. A final sample of 49 interventions was reviewed in detail.Results:The interventions, which varied in terms of modality and patient population, fell into the following eight categories: psychoeducation, problem-solving/skills building interventions, supportive therapy, family/couples therapy, cognitive-behavioral therapy, interpersonal therapy, complementary and alternative medicine interventions, and existential therapy. Benefits and disadvantages of each of the categories are discussed, with special attention given to studies that produced null findings.Significance of results:Beyond specific techniques, structured, goal-oriented, and time-limited interventions that are integrative appear to be the most feasible and offer the greatest benefits for ICs of cancer patients. Future studies are needed to examine the specific benefits and challenges of delivering interventions in alternative modalities (Internet, Skype) so that the needs of a greater number of ICs may be addressed.

A systematic review of the prevalence, associations and outcomes of dementia in older general hospital inpatients

2010 ◽  
Vol 23 (3) ◽  
pp. 344-355 ◽  
Author(s):  
Naaheed Mukadam ◽  
Elizabeth L. Sampson
Keyword(s):  
Older People ◽  
General Hospital ◽  
English Language ◽  
Functional Decline ◽  
Acute Hospital ◽  
Diagnostic Tools ◽  
Prevalence Estimates ◽  
Hospital Stays ◽  
Medical Wards ◽  
Demographic Features

ABSTRACTBackground: Older people are commonly admitted to the acute hospital and increasing numbers will have dementia. In this study we systematically reviewed the prevalence, associations and outcomes of dementia in older people in the general hospital, to examine the range of diagnostic tools used and highlight gaps in the literature.Methods: We searched the English language literature using Embase, PsychInfo and Medline. Studies were included if they used validated criteria for diagnosing dementia, involved subjects over the age of 55 years and were set in the general hospital.Results: Fourteen papers were identified. Prevalence estimates for dementia in studies with robust methodology were 12.9–63.0%. Less than a third of studies screened for delirium or depression and therefore some subjects may have been misclassified as having dementia. The data were highly heterogeneous and prevalence estimates varied widely, influenced by study setting and demographic features of the cohorts. Patients with dementia in the acute hospital are older, require more hours of nursing care, have longer hospital stays, and are more at risk of delayed discharge and functional decline during admission.Conclusions: When planning liaison services, the setting and demographic features of the population need to be taken into account. Most study cohorts were recruited from medical wards. More work is required on the prevalence of dementia in surgical and other specialties. A wider range of associations (particularly medical and psychiatric comorbidity) and outcomes should be studied so that care can be improved.

scholarly journals Pre-equilibrium competitive library screening for tuning inhibitor association rate and specificity toward serine proteases

2018 ◽  
Vol 475 (7) ◽  
pp. 1335-1352 ◽  
Author(s):  
Itay Cohen ◽  
Si Naftaly ◽  
Efrat Ben-Zeev ◽  
Alexandra Hockla ◽  
Evette S. Radisky ◽  
...  
Keyword(s):  
Serine Proteases ◽  
Proteolytic Enzymes ◽  
Sequence Similarity ◽  
Surface Display ◽  
Amyloid Β ◽  
Yeast Surface Display ◽  
New Drugs ◽  
Diagnostic Tools ◽  
Amyloid Β Protein ◽  
Docking Simulations

High structural and sequence similarity within protein families can pose significant challenges to the development of selective inhibitors, especially toward proteolytic enzymes. Such enzymes usually belong to large families of closely similar proteases and may also hydrolyze, with different rates, protein- or peptide-based inhibitors. To address this challenge, we employed a combinatorial yeast surface display library approach complemented with a novel pre-equilibrium, competitive screening strategy for facile assessment of the effects of multiple mutations on inhibitor association rates and binding specificity. As a proof of principle for this combined approach, we utilized this strategy to alter inhibitor/protease association rates and to tailor the selectivity of the amyloid β-protein precursor Kunitz protease inhibitor domain (APPI) for inhibition of the oncogenic protease mesotrypsin, in the presence of three competing serine proteases, anionic trypsin, cationic trypsin and kallikrein-6. We generated a variant, designated APPIP13W/M17G/I18F/F34V, with up to 30-fold greater specificity relative to the parental APPIM17G/I18F/F34V protein, and 6500- to 230 000-fold improved specificity relative to the wild-type APPI protein in the presence of the other proteases tested. A series of molecular docking simulations suggested a mechanism of interaction that supported the biochemical results. These simulations predicted that the selectivity and specificity are affected by the interaction of the mutated APPI residues with nonconserved enzyme residues located in or near the binding site. Our strategy will facilitate a better understanding of the binding landscape of multispecific proteins and will pave the way for design of new drugs and diagnostic tools targeting proteases and other proteins.

Sign in / Sign up

Export Citation Format

Share Document