scholarly journals A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2452 ◽  
Author(s):  
Alberto Zaniboni ◽  
Michele Ghidini ◽  
Francesco Grossi ◽  
Alice Indini ◽  
Francesca Trevisan ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cancer Care ◽  
English Language ◽  
Cooperative Groups ◽  
Cancer Centers ◽  
Practice Recommendations ◽  
Group Position ◽  
Health Authorities ◽  
Systemic Therapies

The COVID-19 pandemic has inevitably caused those involved in cancer care to change clinical practice in order to minimize the risk of infection while maintaining cancer treatment as a priority. General advice during the pandemic suggests that most patients continue with ongoing therapies or planned surgeries, while follow-up visits may instead be delayed until the resolution of the outbreak. We conducted a literature search using PubMed to identify articles published in English language that reported on care recommendations for cancer patients during the COVID-19 pandemic from its inception up to 1st June 2020, using the terms “(cancer or tumor) AND (COVID 19)”. Articles were selected for relevance and split into five categories: (1) personal recommendations of single or multiple authors, (2) recommendations of single authoritative centers, (3) recommendations of panels of experts or of multiple regional comprehensive centers, (4) recommendations of multicenter cooperative groups, (5) official guidelines or recommendations of health authorities. Of the 97 included studies, 10 were personal recommendations of single or multiple independent authors, 16 were practice recommendations of single authoritative cancer centers, 35 were recommendations provided by panel of experts or of multiple regional comprehensive centers, 19 were cooperative group position papers, and finally, 17 were official guidelines statements. The COVID-19 pandemic is a global emergency, and has rapidly modified our clinical practice. Delaying unnecessary treatment, minimizing toxicity, and identifying care priorities for surgery, radiotherapy, and systemic therapies must be viewed as basic priorities in the COVID-19 era.

Acceptance and commitment therapy (ACT)-enhanced communication skills: development and evaluation of a novel training programme

2021 ◽  
pp. bmjspcare-2020-002786
Author(s):  
Nicholas J Hulbert-Williams ◽  
Lee Hulbert-Williams ◽  
Pandora Patterson ◽  
Sahil Suleman ◽  
Lesley Howells
Keyword(s):  
Clinical Practice ◽  
Acceptance And Commitment Therapy ◽  
Cancer Care ◽  
Psychological Flexibility ◽  
Training Programme ◽  
Free Text ◽  
Evaluation Data ◽  
Commitment Therapy ◽  
Acceptance And Commitment

BackgroundPsychological suffering is ubiquitous with cancer and frequently presents as an unmet supportive care need. In clinical practice, distress-related needs are often addressed by nurses and non-psychologist allied healthcare professionals who may have limited training in psychological therapeutic frameworks, particularly more recently developed interventions such as Acceptance and Commitment Therapy (ACT).AimsWe developed a single-day training programme for professionals working in supportive and palliative cancer care settings to change the nature of clinical communication about psychological distress and suffering towards an ACT-consistent approach.MethodWe report on experiences of training delivery, and evaluation data about training satisfaction and intention to apply the training to clinical practice, from three training iterations in British and Australian, government-funded and charitable sectors. One hundred and sixteen cancer care professionals participated in the training. Evaluation data were collected from 53 participants (at either 2-week or 3-month follow-ups, or both) using self-report survey, including both quantitative and free-text questions.ResultsAt 2 week follow-up, 73% of trainees rating our course as having relevance to their work, and at 3 month follow-up, 46% agreed that they were better placed to provide improved clinical services. Qualitative feedback supported the inclusion of experiential learning and theoretical explanations underpinning ACT techniques. Undertaking this training did not significantly increase trainees’ stress levels, nor did implementation of this new way of working negatively affect staff well-being. Positive, ACT-consistent, changes in communication behaviours and attitudes were reported, however there was a lack of significant change in psychological flexibility.DiscussionAcceptability and applicability of this training to supportive and palliative healthcare is positive. The lack of change in psychological flexibility suggests a potential need for more experiential content in the training programme. Logistical challenges in one training group suggests the need for more robust train-the-trainer models moving forward.

Cost of Cancer Care: Issues and Implications

2007 ◽  
Vol 25 (2) ◽  
pp. 180-186 ◽  
Author(s):  
Neal J. Meropol ◽  
Kevin A. Schulman
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Clinical Practice ◽  
Cancer Care ◽  
Medical Technology ◽  
Clinical Medicine ◽  
Scientific Progress ◽  
Medical Spending ◽  
Cost Of Health Care

Medical technology is increasingly costly in most fields of clinical medicine. Oncology has not been spared from issues related to cost, in part resulting from the tremendous scientific progress that has lead to new tools for diagnosis, treatment, and follow-up of our patients. The increasing cost of health care in general (and cancer care in particular) raises complex questions related to its effects on our economy and the citizens of our society. This article reviews the macroeconomic principles and individual behaviors that govern medical spending, and examines how cost disproportionately affects various populations. Our overall goal is to frame debate about health policy concerns that influence the clinical practice of oncology.

Gastrointestinal lymphomas: French Intergroup clinical practice recommendations for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFH)

2018 ◽  
Vol 50 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Tamara Matysiak-Budnik ◽  
Bettina Fabiani ◽  
Christophe Hennequin ◽  
Catherine Thieblemont ◽  
Georgia Malamut ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Practice Recommendations ◽  
Gastrointestinal Lymphomas

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Automatic Remote Monitoring of Implantable Cardiac Devices in Clinical Practice – The Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) Trial

2010 ◽  
Vol 6 (3) ◽  
pp. 87
Author(s):  
Niraj Varma ◽  
Keyword(s):  
Clinical Practice ◽  
Remote Monitoring ◽  
Home Monitoring ◽  
Implantable Devices ◽  
Cardiac Device ◽  
Cardiac Devices ◽  
Enhance Patient Safety ◽  
Implantable Cardiac Devices ◽  
Post Implantation

The use of implantable electronic cardiac devices is increasing. Post-implantation follow-up is important for monitoring both device function and patient condition; however, clinical practice is inconsistent. For example, implantable cardioverter–defibrillator follow-up schedules vary from every three months to yearly according to facility and physician preference and the availability of resources. Importantly, no surveillance occurs between follow-up visits. By contrast, implantable devices with automatic remote monitoring capability provide a means for performing constant surveillance, with the ability to identify salient problems rapidly. The Lumos-T Reduces Routine Office Device Follow-up Study (TRUST) demonstrated that remote home monitoring reduced clinic burden and allowed early detection of patient and/or system problems, enabling efficient monitoring and an opportunity to enhance patient safety. The results of the trial have significant implications for the management of patients receiving all forms of implantable electronic cardiac device.

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Economic Growth ◽  
Developing Countries ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Secondary Prevention ◽  
Health Authorities ◽  
Overwhelming Evidence ◽  
Core Components ◽  
Interventional Therapies ◽  
Limited Period

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major healthcare and socio-economic burden both in western and developing countries, in which this burden is increasing in closecorrelation to economic growth. Health authorities and the general population have started to recognize that the fightagainst these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestylechanges and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives includingcardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorlyimplemented in clinical practice, often only on selected populations and over a limited period of time. The developmentof systematic and full comprehensive preventive programmes is warranted, integrated in the organization ofnational health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity.

The Language of New Terrorism: Differences in Psychological Dimensions of Communication in Dabiq and Inspire

2017 ◽  
Author(s):  
Matteo Vergani ◽  
Ana-Maria Bliuc
Keyword(s):  
Experimental Study ◽  
English Language ◽  
Terrorist Attacks ◽  
Al Qaeda ◽  
Positive Attitudes ◽  
Terrorist Groups ◽  
The Usa ◽  
Psychological Dimensions ◽  
New Terrorism

We investigate differences in the psychological aspects underpinning Western mobilisation of two terrorist groups by analysing their English-language propaganda. Based on a computerized analysis of the language used in two English-language online magazines circulated by ISIS and al-Qaeda (i.e., Dabiq and Inspire), we found significant differences in their language - the ISIS’ language being higher in authoritarianism and its level of religiousness. In a follow-up experimental study, we found that being high in religiousness and authoritarianism predicts more positive attitudes towards the language used by ISIS, but not towards the language used by al-Qaeda. The results suggest that ISIS’ propaganda may be more effective in mobilising individuals who are more authoritarian and more focused on religion than that of al-Qaeda. These findings are consistent with the behaviour observed in recent homegrown terrorist attacks in the USA and Europe.

scholarly journals P34 Characteristics, diagnosis and management of Cushing’s disease - A systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Danyal Z Khan ◽  
Ronneil Digpal ◽  
Hugo Layard Horsfall ◽  
Hani J Marcus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
A Priori ◽  
Pituitary Surgery ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Diagnosis And Management ◽  
Over Time

Abstract Introduction The clinical practice and research in the diagnosis and management of Cushing’s disease remains heterogeneous and challenging to this day. We sought to establish the characteristics of Cushing’s disease, and the trends in diagnosis, management and reporting in this field. Methods Searches of PubMed and Embase were conducted. Study protocol was registered a-priori. Random-effects analyses were conducted to establish numerical estimates. Results Our screening returned 159 papers. The average age of adult patients with Cushing’s disease was 39.3, and 13.6 for children. The male:female ratio was 1:3. 8% of patients had undergone previous transsphenoidal resection. The ratio of macroadenomas: microadenomas:imaging-undetectable adenomas was 18:53:29. The most commonly reported preoperative biochemical investigations were serum cortisol (average 26.4µg/dL) and ACTH (77.5pg/dL). Postoperative cortisol was most frequently used to define remission (74.8%), most commonly with threshold of 5µg/dL (44.8%). Average remission rates were 77.8% with recurrence rate of 13.9%. Median follow-up was 38 months. Majority of papers reported age (81.9%) and sex (79.4%). Only 56.6% reported whether their patients had previous pituitary surgery. 45.3% reported whether their adenomas were macroadenoma, microadenoma or undetectable. Only 24.1% reported preoperative cortisol, and this did not improve over time. 60.4% reported numerical thresholds for cortisol in defining remission, and this improved significantly over time (p = 0.004). Visual inspection of bubbleplots showed increasing preference for threshold of 5µg/dL. 70.4% reported the length of follow up. Conclusion We quantified the characteristics of Cushing’s disease, and analysed the trends in investigation and reporting. This review may help to inform future efforts in forming guidelines for research and clinical practice.

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