Integrating the patient (pt) voice with clinician reports to identify cancer-specific subsets of symptomatic adverse events (SymAE).

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 155-155
Author(s):  
Jim Shaw ◽  
Rebecca Speck ◽  
William Lenderking ◽  
Caroleen Quach
Keyword(s):  
Clinical Trial Data ◽  
Long Term Effects ◽  
Qualitative And Quantitative ◽  
Medical Oncologists ◽  
Bowel Movements ◽  
Hand Foot Syndrome ◽  
Cancer Care Continuum ◽  
Pugh Class ◽  
The Common

155 Background: The Pt-Reported Outcomes Version of the Common Terminology Criteria for AE (PRO-CTCAE) was developed for pts to report on the frequency, severity, and interference of SymAE. A study was conducted to identify a hepatocellular carcinoma (HCC)-relevant subset of the PRO-CTCAE's 124 items to enhance evaluation of SymAE in HCC trials and long-term effects in survivorship. Methods: Qualitative and quantitative data were collected from medical oncologists specializing in HCC and pts diagnosed with HCC stratified by Child-Pugh class and treatment. Oncologists were asked about HCC diagnosis, treatment, and SymAE and provided ratings (ranging from 0 = unimportant to 10 = very important) of the following: 1) importance to pts of 34 prevalent SymAE from past HCC trials (all phases); 2) importance to pts of each PRO-CTCAE item; and 3) their own perceived importance of each PRO-CTCAE item with regard to tolerability. Pts were asked about their diagnosis, treatment, and experience of SymAE after which they completed the PRO-CTCAE and were debriefed on the importance of each item. Results: Four medical oncologists from Spain, Taiwan, Korea, and Hong Kong with ≥ 20 years of experience completed interviews. SymAE from prior trials rated highly important to pts (mean rating across oncologists ≥ 7) included hand-foot syndrome, diarrhea, fatigue, decreased appetite, rash, vomiting, and weight loss. PRO-CTCAE items rated highly important to pts included diarrhea, vomiting, shivering or shaking chills, hand-foot syndrome, rash, fatigue, difficulty swallowing, and loss of control of bowel movements. Items rated highly for tolerability included diarrhea, shivering or shaking chills, and hand-foot syndrome. Pt interviews (planned up to 24) are ongoing. Conclusions: Oncologists identified 10 clinically relevant items from sponsor SymAE data and the PRO-CTCAE for use in HCC trials. Findings from pt interviews will compare provider and pt perspectives about SymAE and strengthen the set of selected items. Combining clinician and pt ratings with clinical trial data may be a promising method for identifying cancer-specific PRO-CTCAE item sets for use throughout the cancer care continuum.

scholarly journals Feasibility and Enjoyment of Exercise Video Games in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
Sara Freed ◽  
Briana Sprague ◽  
Lesley Ross
Keyword(s):  
Older Adults ◽  
Video Games ◽  
Game Design ◽  
Long Term Effects ◽  
Short Term ◽  
Qualitative And Quantitative ◽  
Before And After ◽  
Xbox Kinect ◽  
Game Developers

Abstract Interventions using exercise video games, or exergames, have shown short-term cognitive and physical benefits to older adults, though long-term effects are less promising. Enjoyment of exergames may promote exergame use after the intervention period, though little work has examined older adults’ views of exergames before and after gameplay experience. We invited 20 older adults between 65 and 84 years of age (M=73.30, SD=5.95) to play two Xbox Kinect games, Just Dance and Kinect Sports Rivals, for twenty minutes. In our presentation, we will present qualitative and quantitative findings of this pilot study, including findings that older adults reported that they were not likely to play similar exergames in the future and that they did not find the exergames to be more fun compared to other ways of exercising. We will discuss implications for game design and research relevant to game developers, manufacturers, and researchers. Part of a symposium sponsored by Technology and Aging Interest Group.

Post-disaster sheltering process after the 2019 floods, in Golestan province, Iran

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mahsa Shariat Alavi ◽  
Alireza Fallahi ◽  
Zoheir Mottaki ◽  
Fereshteh Aslani
Keyword(s):  
Rural Areas ◽  
Hybrid Approach ◽  
Long Term Effects ◽  
Content Type ◽  
Qualitative And Quantitative ◽  
The Future ◽  
Golestan Province ◽  
Depth Interviews ◽  
Post Disaster

Purpose As a flood-prone region in Iran, Golestan province has encountered various disasters in its history. The last one occurred in March 2019, affected Aq-Qala County and caused irreparable physical, economic, social and environmental problems. The purpose of this study is to investigate the process of providing shelter in emergency, rehabilitation and reconstruction phases after the floods in the villages of Aq-Qala. Design/methodology/approach A research method is a hybrid approach. The collection of data involved a combination of qualitative and quantitative approaches in addition to reviewing the documented texts in resources to collect the required data using observations, field survey activities, questionnaires and in-depth interviews. From April 2019 to December 2019, nine separate visits have occurred to collect the needed information. Findings This paper shows dissatisfaction with providing shelter and attempts to identify the factors which caused the challenges. The findings revealed issues such as hygienic problems in collective camps, lack of thermal resistance in temporary accommodations and rising material prices. These findings lead to a contributive list of suggestions avoiding the recurrence of the harms in the future. Originality/value This study proposes solutions and approaches to improve the post-flood settlement process for possible floods in the future such as equipped camps, proper temporary housing, monitoring the reconstruction and the price of the materials. If these approaches are used by authorities and people in similar rural areas, the long-term effects of inadequate post-flood shelter can be reduced.

scholarly journals Communicating Risks of Adjuvant Chemotherapy for Breast Cancer: Getting Beyond the Laundry List

2019 ◽  
Vol 15 (2) ◽  
pp. e98-e109 ◽  
Author(s):  
Eden R. Brauer ◽  
Elisa F. Long ◽  
Joy Melnikow ◽  
Peter M. Ravdin ◽  
Patricia A. Ganz
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Focus Groups ◽  
Cancer Survivors ◽  
Late Effects ◽  
Breast Cancer Survivors ◽  
Theoretical Domains Framework ◽  
Long Term Effects ◽  
Medical Oncologists

PURPOSE: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists’ communication with patients with breast cancer about the long-term and late effects of adjuvant therapy. RESULTS: Eight key informant interviews with medical oncologists and two focus groups with breast cancer survivors provided data. Both oncologists and patients perceived information on long-term effects as valuable in terms of improved clinical communication but had concerns about the feasibility of inclusion before treatment. They described the current approaches to communication of therapy risks as a brief laundry list that emphasized acute adverse effects and minimized more long-term issues. We describe the barriers to communication about potential long-term effects from the perspectives of both groups. CONCLUSION: This study provides insight into oncologists’ communication with patients with breast cancer regarding the potential long-term and late effects of adjuvant chemotherapy and about setting realistic expectations for life after treatment. Opportunities to improve oncologists’ communication about the potential toxicities of therapy, particularly regarding long-term and late effects, should be examined further.

scholarly journals Phenotypic plasticity in the common snapping turtle (Chelydra serpentina): long-term physiological effects of chronic hypoxia during embryonic development

2016 ◽  
Vol 310 (2) ◽  
pp. R176-R184 ◽  
Author(s):  
Oliver H. Wearing ◽  
John Eme ◽  
Turk Rhen ◽  
Dane A. Crossley
Keyword(s):  
Chronic Hypoxia ◽  
Common Garden ◽  
Physiological Effects ◽  
Chelydra Serpentina ◽  
Long Term Effects ◽  
Snapping Turtle ◽  
Snapping Turtles ◽  
The Common ◽  
Hypoxic Incubation

Studies of embryonic and hatchling reptiles have revealed marked plasticity in morphology, metabolism, and cardiovascular function following chronic hypoxic incubation. However, the long-term effects of chronic hypoxia have not yet been investigated in these animals. The aim of this study was to determine growth and postprandial O2 consumption (V̇o2), heart rate ( fH), and mean arterial pressure ( Pm, in kPa) of common snapping turtles ( Chelydra serpentina) that were incubated as embryos in chronic hypoxia (10% O2, H10) or normoxia (21% O2, N21). We hypothesized that hypoxic development would modify posthatching body mass, metabolic rate, and cardiovascular physiology in juvenile snapping turtles. Yearling H10 turtles were significantly smaller than yearling N21 turtles, both of which were raised posthatching in normoxic, common garden conditions. Measurement of postprandial cardiovascular parameters and O2 consumption were conducted in size-matched three-year-old H10 and N21 turtles. Both before and 12 h after feeding, H10 turtles had a significantly lower fH compared with N21 turtles. In addition, V̇o2 was significantly elevated in H10 animals compared with N21 animals 12 h after feeding, and peak postprandial V̇o2 occurred earlier in H10 animals. Pm of three-year-old turtles was not affected by feeding or hypoxic embryonic incubation. Our findings demonstrate that physiological impacts of developmental hypoxia on embryonic reptiles continue into juvenile life.

scholarly journals Five-Year Follow-Up of a Cordotomy

2008 ◽  
Vol 13 (6) ◽  
pp. 506-510 ◽  
Author(s):  
Jan J Meeuse ◽  
Arnoud CM Vervest ◽  
Johannes H van der Hoeven ◽  
An KL Reyners
Keyword(s):  
Cancer Pain ◽  
Present Report ◽  
Invasive Procedure ◽  
The Body ◽  
Long Term Effects ◽  
Limited Life Expectancy ◽  
Qualitative And Quantitative ◽  
Limited Life

Percutaneous cervical cordotomy is an invasive procedure to treat severe, opioid-resistant cancer pain. It is usually proposed for patients with a limited life expectancy. As a consequence, objective quantification of the long-term effects of this procedure is lacking. The present report describes a patient who was treated with a right-sided percutaneous cervical cordotomy for refractory cancer pain. Afterward, disseminated seminoma was diagnosed, which was cured with chemotherapy. Five years after the procedure, a qualitative and quantitative evaluation of the long-term effects was performed. Sensory dysfunction was observed in the left side of the body, but no motor neuron or autonomic dysfunction was observed. The influence of these long-term effects on the patient’s daily activities was limited.

scholarly journals Cardiac Effects of Anticancer Therapy in the Elderly

2014 ◽  
Vol 32 (24) ◽  
pp. 2654-2661 ◽  
Author(s):  
Melissa K. Accordino ◽  
Alfred I. Neugut ◽  
Dawn L. Hershman
Keyword(s):  
Clinical Trial ◽  
Elderly Patients ◽  
Clinical Trial Data ◽  
The Elderly ◽  
Cardiac Risk ◽  
Long Term Effects ◽  
Cardiac Events ◽  
Long Term Follow Up ◽  
Clinical Trial Evidence

Cancer incidence increases with age, and as life expectancy increases, the number of elderly patients with cancer is increasing. Cancer treatments, including chemotherapy and radiotherapy, have significant short- and long-term effects on cardiovascular function. These cardiotoxic effects can be acute, such as changes in electrocardiogram (ECG), arrhythmias, ischemia, and pericarditis and/or myocarditis-like syndromes, or they can be chronic, such as ventricular dysfunction. Anticancer therapies can also have indirect effects, such as alterations in blood pressure, or can cause metabolic abnormalities that subsequently increase risk for cardiac events. In this review, we explore both observational and clinical trial evidence of cardiac risk in the elderly. In both observational and clinical trial data, risk of cardiotoxicity with anthracycline-based chemotherapy increases with age. However, it is less clear whether the association between age and cardiotoxicity exists for newer treatments. The association may not be well demonstrated as a result of under-representation of elderly patients in clinical trials and avoidance of these therapies in this population. In addition, we discuss strategies for surveillance and prevention of cardiotoxicity in the elderly. In the elderly, it is important to be aware of the potential for cardiotoxicity during long-term follow-up and to consider both prevention and surveillance of these late effects.

scholarly journals The effect of canine therapy on the development of social and emotional areas in children with learning disabilities in school age

2020 ◽  
Vol 18 (3-4) ◽  
pp. 28-40
Author(s):  
Márta Gelencsérné Bakó ◽  
Dóra Ullmann
Keyword(s):  
Learning Disabilities ◽  
Research Question ◽  
Test Method ◽  
Long Term Effects ◽  
Qualitative And Quantitative ◽  
Social And Emotional ◽  
Positive Effects ◽  
The Impact ◽  
Canine Therapy

The goal of our research is to investigate the impact of canine therapy on the development of children with learning disabilities, with special regard to social and emotional competence. The research question was: to what extent does intensive animal-assisted therapy influence the behaviour of the pupils enrolled in the sample, and can the long-term effects of the therapy be demonstrated and justified? To explore the longitudinal study over six months, a qualitative and quantitative test method was used. As a research tool, we used the Conners Questionnaire on Child Behaviour, which was revealed by descriptive and mathematical statistical analysis. Owing to the multi-focus study, the positive effects of canine therapy were confirmed from several sides. Based on the results we can prove that the canine therapy positively and lastingly influenced the behaviour of the examined children, which showed a positive change in several areas.

scholarly journals Effectiveness and Safety in Remote Monitoring of Patients with Pacemakers Five Years after an Implant: The Poniente Study

2020 ◽  
Vol 17 (4) ◽  
pp. 1431
Author(s):  
Remedios López-Liria ◽  
Antonio López-Villegas ◽  
César Leal-Costa ◽  
Salvador Peiró ◽  
Emilio Robles-Musso ◽  
...  
Keyword(s):  
Functional Capacity ◽  
Remote Monitoring ◽  
Clinical Trial Data ◽  
Clinic Visit ◽  
Long Term Effects ◽  
Related Quality ◽  
Duke Activity Status Index ◽  
Health Related ◽  
Euroqol 5D

Health-related quality of life (HRQoL) and functional capacity values immediately after pacemaker (PM) implantation have been well established; however, not much has been known about its long-term effects. The present study compared the long-term effectiveness and safety of remote monitoring plus a clinic visit versus clinic visits alone during follow-up of adults implanted with PMs. This study was a single-centre, controlled, non-randomised, non-blinded clinical trial. Data were collected pre-implantation and after 60 months. The patients in the PONIENTE study were assigned to two different groups: remote monitoring (RM) and conventional monitoring (CM). The EuroQol-5D (EQ-5D) questionnaire was used to assess HRQoL and Duke Activity Status Index was used for the functional capacity. After five years, 55 patients completed the study (RM = 21; CM = 34). EuroQol-5D and functional capacity values were improved; however, significant differences were observed only in the EQ5D visual analogue scale (p < 0.001). Remote monitoring was equally feasible, reliable, safe, and clinically useful as CM. The frequencies of rehospitalisations and emergency visits did not differ between the groups. RM was found to be safe and effective in early detection and treatment of medical- and device-related events and in reducing hospital visits. Improved HRQoL was described not only immediately after PM implantation but also extended over a long time.

scholarly journals The Long-Term Effects of Developmental Hypoxia on Cardiac Mitochondrial Function in Snapping Turtles

2021 ◽  
Vol 12 ◽  
Author(s):  
Gina L. J. Galli ◽  
Ilan M. Ruhr ◽  
Janna Crossley ◽  
Dane A. Crossley
Keyword(s):  
Embryonic Development ◽  
Mitochondrial Function ◽  
Hypoxia Tolerance ◽  
Breath Hold ◽  
Ros Production ◽  
Long Term Effects ◽  
Anoxic Environments ◽  
The Common ◽  
Mitochondrial Remodeling

It is well established that adult vertebrates acclimatizing to hypoxic environments undergo mitochondrial remodeling to enhance oxygen delivery, maintain ATP, and limit oxidative stress. However, many vertebrates also encounter oxygen deprivation during embryonic development. The effects of developmental hypoxia on mitochondrial function are likely to be more profound, because environmental stress during early life can permanently alter cellular physiology and morphology. To this end, we investigated the long-term effects of developmental hypoxia on mitochondrial function in a species that regularly encounters hypoxia during development—the common snapping turtle (Chelydra serpentina). Turtle eggs were incubated in 21% or 10% oxygen from 20% of embryonic development until hatching, and both cohorts were subsequently reared in 21% oxygen for 8 months. Ventricular mitochondria were isolated, and mitochondrial respiration and reactive oxygen species (ROS) production were measured with a microrespirometer. Compared to normoxic controls, juvenile turtles from hypoxic incubations had lower Leak respiration, higher P:O ratios, and reduced rates of ROS production. Interestingly, these same attributes occur in adult vertebrates that acclimatize to hypoxia. We speculate that these adjustments might improve mitochondrial hypoxia tolerance, which would be beneficial for turtles during breath-hold diving and overwintering in anoxic environments.

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