scholarly journals Basic Characteristics, Status, and Challenges of Integrative Oncology in China

2021 ◽  
Vol 20 ◽  
pp. 153473542110635
Author(s):  
Geliang Yang ◽  
Huiqing Zhang ◽  
Yun Xu ◽  
Aiguang Zhao ◽  
Peng Shu ◽  
...  
Keyword(s):  
Public Funding ◽  
Treatment Patterns ◽  
Future Perspectives ◽  
Integrative Oncology ◽  
Academic Hospitals ◽  
Basic Characteristics ◽  
Set Up ◽  
Integrative Therapies ◽  
Professional Guidelines

Integrative oncology has developed for about 20 years in some countries; however, integrative oncology is still a relative new term for most China’s oncologists. Thus, it is essential to summarize the experience and expertise, share details of differing existing models and discuss future perspectives to help define and guide practice in integrative oncology in China. This study presents a summary of the basic characteristics, status, and challenges of integrative oncology in China, and also reports on China’s integrative physicians’ service delivery, clinical practice and research patterns of integrative oncology by an online national survey, including 405 oncologists. It is easy for cancer patients to access to integrative therapies in China. Public funding is sufficient for integrative oncology in China, and services are often provided through general hospitals and academic hospitals. Most (95.3%) of oncologists showed a positive attitude toward the development of integrative oncology. More than half (55.6%) of the oncologists worried about the influence on integrative oncology of COVID-19, especially for routine treatment, follow-up and holding seminars. We found that integrative oncology in China has swiftly developed in recent years. However, we suggest that standard diagnosis and treatment patterns and national professional guidelines should be set up as soon as possible.

scholarly journals 829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Holmes ◽  
U Mirza ◽  
C Manning ◽  
R Cooke ◽  
R Jugdey
Keyword(s):  
Common Theme ◽  
Telephone Triage ◽  
Telephone Consultation ◽  
Face To Face ◽  
Clinician Satisfaction ◽  
Set Up ◽  
Local Protocol ◽  
Telephone Questionnaire

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

scholarly journals Current role of ultrasound in hemodialysis access evaluation

2021 ◽  
pp. 112972982110346
Author(s):  
Meola Mario ◽  
Jose Ibeas ◽  
Jan Malik
Keyword(s):  
Turning Point ◽  
Point Of Care ◽  
Low Cost ◽  
Wireless Systems ◽  
Future Perspectives ◽  
Maturation Period ◽  
Surveillance Programs ◽  
Dialysis Nurses

Physical examination (PE) is considered the backbone before vascular access (VA) placement, during maturation period and for follow-up. However, it may be inadequate in identifying suitable vasculature, mainly in comorbid patients, or in detecting complications. This review highlights the advantages of ultrasound imaging to manage VA before placement, during maturation and follow-up. Furthermore, it analyses the future perspectives in evaluating early and late VA complications thank to the availability of multiparametric platforms, point of care of ultrasound, and portable/wireless systems. Technical improvements and low-cost systems should favor the widespread ultrasound-based VA surveillance programs. This significant turning point needs an adequate training of nephrologists and dialysis nurses and the standardization of exams, parameters, and procedures.

scholarly journals Have Changing Treatment Patterns Affected Outcome for Operable Breast Cancer? Ten-year Follow-up in 1288 Patients, 1965 to 1978

1991 ◽  
Vol 213 (4) ◽  
pp. 297-307 ◽  
Author(s):  
HIRAM S. CODY ◽  
EDWARD H. LAUGHLIN ◽  
CARLOS TRILLO ◽  
JEROME A. URBAN
Keyword(s):  
Breast Cancer ◽  
Treatment Patterns ◽  
Operable Breast Cancer

Real-world evidence of cancer immunotherapy (CIT) combination treatment in first-line (1L) extensive-stage small cell lung cancer (ES-SCLC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8561-8561
Author(s):  
Eric S. Nadler ◽  
Anupama Vasudevan ◽  
Kalatu Davies ◽  
Yunfei Wang ◽  
Ann Johnson ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Real World ◽  
Performance Status ◽  
Descriptive Analysis ◽  
Patient Characteristics ◽  
Treatment Patterns ◽  
Combination Regimen ◽  
Duration Of Treatment ◽  
The Real

8561 Background: Atezolizumab plus chemotherapy was the first CIT combination regimen approved for 1L treatment of ES-SCLC in 2019. This study investigated patient characteristics and treatment patterns for patients with ES-SCLC receiving this regimen in the real-world community oncology setting. Methods: This was a retrospective study including adult patients diagnosed with ES-SCLC between 01-Oct-2018 (after IMpower 133 publication in NEJM Sep-2018) and 31-Dec-2019, with follow-up through 31-March-2020 using The US Oncology Network electronic health records data. Descriptive analyses of patient characteristics and treatment patterns were conducted, with Kaplan-Meier (K-M) methods used to assess time to treatment discontinuation (TTD) and time to next treatment/death (TTNT). Results: Of the 408 patients included in this study, 267 (71.4%) received atezo+carboplatin+etoposide (Atezo+Chemo), 80 (21.4%) received carboplatin+etoposide (Chemo only) and the rest received other regimens. The Atezo+Chemo patients in the real-world cohort compared with the IMpower 133 trial (n = 201) were older (median age 68 vs. 64 years) and included fewer males (45% vs. 64%), fewer white race (73% vs. 81%), more patients with brain metastases at baseline (23% vs. 9%), and more patients with worse ECOG (2/3) performance-status score (24% vs. 0%). The median follow-up, TTD, and TTNT in months (mo) for the real-world cohort are presented in the table alongside the best comparable measures reported for the trial. Conclusions: Most patients in this real-world ES-SCLC cohort received the Atezo+Chemo regimen in the 1L setting. While the follow-up was much shorter and patients had worse baseline characteristics (age, brain metastases, ECOG) in the real-world setting compared to the IMpower 133 trial, the real-world median TTD in this descriptive analysis was found to be in line with the median duration of treatment in the trial. Further research with longer follow-up comparing the real-world effectiveness of the CIT and chemo regimens is needed.[Table: see text]

scholarly journals Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
David M. Kern ◽  
M. Soledad Cepeda ◽  
Frank Defalco ◽  
Mila Etropolski
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Medication ◽  
The United States ◽  
Treatment Patterns ◽  
First Line ◽  
Inpatient Hospitalization ◽  
Class Level ◽  
Treatment Of Depression ◽  
Antidepressive Treatment

Abstract Background Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. Methods Patients with depression were identified from four large national claims databases during 1/1/2014–1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and 3 years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. Results We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29 to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. Conclusions Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients.

scholarly journals MAGIC electromagnetic follow-up of gravitational wave alerts

2016 ◽  
Vol 12 (S324) ◽  
pp. 287-290
Author(s):  
Barbara De Lotto ◽  
Stefano Ansoldi ◽  
Angelo Antonelli ◽  
Alessio Berti ◽  
Alessandro Carosi ◽  
...  
Keyword(s):  
Black Hole ◽  
Data Analysis ◽  
Gravitational Wave ◽  
Laser Interferometer ◽  
Cherenkov Telescopes ◽  
Direct Observations ◽  
Binary Black Hole ◽  
Set Up

AbstractThe year 2015 witnessed the first direct observations of a transient gravitational-wave (GW) signal from binary black hole mergers by the Advanced Laser Interferometer Gravitational-wave Observatory (aLIGO) Collaboration with the Virgo Collaboration. The MAGIC two 17m diameter Cherenkov telescopes system joined since 2014 the vast collaboration of electromagnetic facilities for follow-up of gravitational wave alerts. During the 2015 LIGO-Virgo science run we set up the procedure for GW alerts follow-up and took data following the last GW alert. MAGIC results on the data analysis and prospects for the forthcoming run are presented.

scholarly journals Proposal for an intelligent digital teacher’s textbook solution adapted to the Bachelor-Master-Doctorate system

2021 ◽  
Author(s):  
Ulrich Hermann Semevo Boko ◽  
Bessan Melckior Degboe ◽  
Samuel Ouya ◽  
Gervais Mendy
Keyword(s):  
Real Time ◽  
African Countries ◽  
Digital Textbook ◽  
Quality Of Higher Education ◽  
Teaching Content ◽  
Sub Saharan ◽  
Set Up ◽  
E Mail

This paper proposes an intelligent solution for course monitoring based on the use of a digital textbook coupled with an algorithm for verifying the conformity of the teaching content. The proposed solution allows to follow in real time the evolution of the courses and to alert the pedagogical managers in case of non-compliance with the syllabus. In most sub-Saharan African countries engaged in the Bachelor-Master-Doctorate (BMD) reform, incessant strikes prevent teachers from completing the program. Also, there is no way for the teacher to know whether students have the necessary prerequisites. In addition, constraints related to agendas sometimes prevent the holding of pedagogical animation meetings. To solve these problems, we propose the implementation of an intelligent digital teacher's textbook. The tool helps in the follow-up and the respect of the pedagogical objectives. It implements an algorithm to evaluate in real time the concordance between the courses given and the requirements of the syllabus. An SMS and e-mail alert system has also been set up to inform training actors in case of non-compliance with the syllabus. The proposed solution contributes to the overall improvement of the quality of higher education in Saharan Africa.

scholarly journals Characteristics, Treatment Patterns, Healthcare Resource Use, and Costs among Pediatric Patients Diagnosed with Neurofibromatosis Type 1 and Plexiform Neurofibromas: A Retrospective Database Analysis of a Medicaid Population

2020 ◽  
Author(s):  
Xiaoqin Yang ◽  
Kaushal Desai ◽  
Neha Agrawal ◽  
Kirti Mirchandani ◽  
Sagnik Chatterjee ◽  
...  
Keyword(s):  
Resource Use ◽  
Neurofibromatosis Type 1 ◽  
Pediatric Patients ◽  
Healthcare Resource ◽  
Neurofibromatosis Type ◽  
Treatment Patterns ◽  
Healthcare Resource Use ◽  
The Mean

Abstract Background: Neurofibromatosis type 1 (NF1)-related plexiform neurofibromas (PN) can cause substantial morbidity by disfigurement and compression of vital structures. Real-world data on the burden and cost of disease among pediatric patients with NF1 and PN is limited. The objectives of this study were to describe the characteristics, treatment patterns, healthcare resource use (HCRU), and costs of these patients.Results: A total of 383 patients were included in the retrospective analysis of patients aged ≤18 with at least 1 ICD-10-CM diagnosis code for both NF1 and PN enrolled in the MarketScan® Multistate Medicaid database from October 1, 2014 to December 31, 2017. The mean follow-up was 448 days. The mean age was 11.4 years and 52.0% of patients were male. Most patients were diagnosed by a specialist (63.5%). During the follow-up period, pain medications were used by 58.5% of patients, 25.1% were treated with chemotherapy, 7.1% received surgery for PN, 1.6% received MEK inhibitors, and 0.8% received radiation. Mean per patient per year inpatient, outpatient, emergency room, pharmacy, and other visits were 1.4, 17.3, 1.6, 13.6, and 25.8, respectively. Mean ±SD (median) total per patient per year healthcare costs (2018 USD) were $17,275 ±$61,903 ($2,889), with total medical costs of $14,628 ±$56,203 ($2,334) and pharmacy costs of $2,646 ±$13,303 ($26). Inpatient costs were the largest drivers of medical cost, with a mean per patient per year cost of $6,739.Conclusions: This study showed that many pediatric patients diagnosed with NF1 and PN were treated with supportive care only, highlighting a substantial unmet medical need. This study also highlights the considerable economic burden among patients with NF1 and PN.

DOES MORE SPECIALIST PHARMACIST TIME IN A CLINICAL AREA EQUAL MORE ACTIVITY?

2016 ◽  
Vol 101 (9) ◽  
pp. e2.60-e2
Author(s):  
Rhian Isaac ◽  
Astrid Gerrard ◽  
Kevin Bazaz
Keyword(s):  
Ward Round ◽  
Pharmacy Service ◽  
Medicines Management ◽  
Clinical Area ◽  
Drug Assays ◽  
Set Up ◽  
Time Critical ◽  
Specialist Pharmacist ◽  
Safety Strategy

BackgroundFollowing a medication safety initiative proposed by the PICU Safety Strategy group a pilot was set up to extend the presence of a PICU trained pharmacist in the clinical area.One of the main safety initiatives was to assess whether increased pharmacist exposure decreased drug omission of time critical medicines, which was highlighted from incident reporting patterns on PICU.AimTo assess what impact extending a pharmacist with specific PICU training would have on the medicines management of the PICU patients.MethodThe pilot involved attendance on the afternoon ward round, review of all new admissions and follow up of priority patients as highlighted by the “day” PICU pharmacists. The pilot “late” PICU pharmacist was resident in the hospital, on PICU, for an hour longer than the pharmacy opening hours. A rota ofA basic data collection form was set up on Microsoft Excel. Data collected included start and finish times of the ward round, time leaving PICU, clinical interventions made, queries by staff on PICU and outside of PICU, supplies made, drug omissions prevented, number of times the presence on the unit prevented need to call in the on call pharmacist and interpretation of drug assays reported after pharmacy hours. Follow up of specific medicines management issues highlighted by the “day” pharmacists as requiring action prior to following day pharmacy visit were recorded.ResultsDuring the 74 days data were collected there was 395 drug related queries by PICU staff (252 by nursing staff, 143 by prescribers). The “late” PICU pharmacist was contacted for advice regarding non-PICU patients by the on call or dispensary pharmacist on 7 occasions and 11 times from clinical staff outside of PICU.The “late” pharmacist intervened on 412 prescriptions, some of the interventions arose from the 260 follow up reviews requested by the “day” pharmacists. Of the 236 drug assays reported after pharmacy hours, 126 required intervention by pharmacist.Omission of time critical medicines was prevented on 17 occasions following 79 supplies of non-stock medicines. Calling out the on-call pharmacist was circumvented 11 times.ConclusionThe Safety Strategy teams’ request for increased access to a “late” PICU pharmacist resulted in a number of clinical interventions, appropriate dosing advice on late-in-day reported drugs assays and prevention of delays in medicines, including time critical drugs. Benefits of the specialist pharmacist being on-site to the pharmacy service included less need to access the on call pharmacist for either advice or supplies of medicines. During a pharmacy 7 day working review these data were used to secure the increased clinical pharmacy service to PICU.

Couples Facing the Birth of a Newborn with a Congenital Anomaly: PTSD Symptoms in the First Year

2018 ◽  
Vol 35 (12) ◽  
pp. 1168-1172 ◽  
Author(s):  
Francesca Bevilacqua ◽  
Francesco Morini ◽  
Antonio Zaccara ◽  
Chiara De Marchis ◽  
Annabella Braguglia ◽  
...  
Keyword(s):  
First Year ◽  
Stressful Situation ◽  
Ptsd Symptoms ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Stress Symptoms ◽  
Parental Gender ◽  
Set Up ◽  
The Impact

Objective The objective of this study was to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parental couples of newborn requiring early surgery at 6 and 12 months after birth. Study Design A longitudinal study was set up from January 2014 to June 2015. As a measure of PTSD, we used the Italian version of the Impact of Event Scale—Revised (IES-R). Results Thirty-four couples form the object of the study. At 6 months, half of mothers (52.9%) and fathers (44.1%) reported traumatic stress symptoms above the clinical cutoff. Percentages remained stable at 12 months. When parental gender and length of follow-up were compared with two-factor analysis of variance, none had an impact on IES-R score, nor an interaction between these factors was found. A significant correlation of IES-R total score was present within the couple both at 6 and 12 months (6 months—r: 0.6842, p < 0.0001 and 12 months—r: 0.4045, p = 0.0177). Conclusion Having a child with a repaired malformation represents a complex prolonged stressful situation with persistent burden for both parents who are at high risk of developing PTSD symptoms.

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