scholarly journals Perceptions of Patients With Breast and Colon Cancer of the Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology

2019 ◽  
Vol 37 (19) ◽  
pp. 1666-1676 ◽  
Author(s):  
Tenbroeck G. Smith ◽  
Alyssa N. Troeschel ◽  
Kathleen M. Castro ◽  
Neeraj K. Arora ◽  
Kevin Stein ◽  
...  
Keyword(s):  
Emotional Distress ◽  
The United States ◽  
Curative Treatment ◽  
Cancer Centers ◽  
Logistic Regression Models ◽  
Patients With Cancer ◽  
Community Oncology ◽  
Experienced Pain ◽  
High Prevalence ◽  
Prevalence Of Pain

PURPOSE Pain, fatigue, and distress are common among patients with cancer but are often underassessed and undertreated. We examine the prevalence of pain, fatigue, and emotional distress among patients with cancer, as well as patient perceptions of the symptom care they received. PATIENTS AND METHODS Seventeen Commission on Cancer–accredited cancer centers across the United States sampled patients with local/regional breast (82%) or colon (18%) cancer. We received 2,487 completed surveys (61% response rate). RESULTS Of patients, 76%, 78%, and 59% reported talking to a clinician about pain, fatigue, and distress, respectively, and 70%, 61%, and 54% reported receiving advice. Sixty-one percent of patients experienced pain, 74% fatigue, and 46% distress. Among those patients experiencing each symptom, 58% reported getting the help they wanted for pain, 40% for fatigue, and 45% for distress. Multilevel logistic regression models revealed that patients experiencing symptoms were significantly more likely to have talked about and received advice on coping with these symptoms. In addition, patients who were receiving or recently completed curative treatment reported more symptoms and better symptom care than did those who were further in time from curative treatment. CONCLUSION In our sample, 30% to 50% of patients with cancer in community cancer centers did not report discussing, getting advice, or receiving desired help for pain, fatigue, or emotional distress. This finding suggests that there is room for improvement in the management of these three common cancer-related symptoms. Higher proportions of talk and advice among those experiencing symptoms imply that many discussions may be patient initiated. Lower rates of talk and advice among those who are further in time from treatment suggest the need for more assessment among longer-term survivors, many of whom continue to experience these symptoms. These findings seem to be especially important given the high prevalence of these symptoms in our sample.

Direct-to-Consumer Advertising for Cancer Centers and Institutes: Ethical Dilemmas and Practical Implications

2020 ◽  
pp. e207-e217 ◽  
Author(s):  
Fay J. Hlubocky ◽  
Daniel F. McFarland ◽  
Patricia A. Spears ◽  
Laura Smith ◽  
Bonnie Patten ◽  
...  
Keyword(s):  
Treatment Options ◽  
Treatment Success ◽  
Eligible Patient ◽  
The United States ◽  
Fiduciary Duty ◽  
Cancer Center ◽  
Ethical Guidelines ◽  
Cancer Centers ◽  
Inappropriate Use ◽  
Patients With Cancer

In the United States, many cancer centers advertise their clinical services directly to the public. Although there are potential public benefits from such advertising, including increased patient awareness of treatment options and improved access to care and clinical trials, there is also potential for harm through misinformation, provision of false hope, inappropriate use of health care resources, and disruption in doctor–patient relationships. Although patient education through advertising is appropriate, misleading patients in the name of gaining market share, boosting profits, or even boosting trial accrual is not. It is critical that rigorous ethical guidelines are adopted and that oversight is introduced to ensure that cancer center marketing supports good patient care and public health interests. Patients with cancer have been identified as an especially vulnerable population because of fears and anxiety related to their diagnosis and the very real need to identify optimal sources of care. Cancer organizations have a fiduciary duty and a moral and legal obligation to provide truthful information to avoid deceptive, inaccurate claims associated with treatment success. In this article, actionable recommendations are provided for both the oncologist and the cancer center’s marketing team to promote ethical marketing of services to patients with cancer. This tailored guidance for the oncology community includes explicit communication on (1) ensuring fair and balanced promotion of cancer services, (2) avoiding exaggeration of claims in the context of reputational marketing, (3) providing data and statistics to support direct and implied assertions of treatment success, and (4) defining eligible patient groups in the context of marketing for research. These recommendations for cancer centers are designed to promote ethical quality marketing information to patients with cancer.

High prevalence of pain in patients with cancer in a large population-based study in The Netherlands

Pain ◽  
2007 ◽  
Vol 132 (3) ◽  
pp. 312-320 ◽  
Author(s):  
Marieke H.J. van den Beuken-van Everdingen ◽  
Janneke M. de Rijke ◽  
Alfons G. Kessels ◽  
Harry C. Schouten ◽  
Maarten van Kleef ◽  
...  
Keyword(s):  
The Netherlands ◽  
Large Population ◽  
Population Based ◽  
Population Based Study ◽  
Patients With Cancer ◽  
High Prevalence ◽  
Prevalence Of Pain

Undertreatment of pain with metastatic cancer

2018 ◽  
Author(s):  
Matthew J. Allsop ◽  
Michael Bennett
Keyword(s):  
Pain Management ◽  
Health Professional ◽  
Metastatic Cancer ◽  
Good Practice ◽  
Epidemiological Studies ◽  
Innovative Strategies ◽  
Patients With Cancer ◽  
Minority Ethnic Groups ◽  
High Prevalence ◽  
Prevalence Of Pain

The landmark paper discussed in this chapter is ‘Pain and its treatment in outpatients with metastatic cancer’, published by Cleeland et al. in 1994. Cleeland and colleagues provide one of the first epidemiological studies outlining the prevalence of cancer pain in outpatients with metastatic cancer. The study drew attention to the undertreatment of pain and identified predictors of poor pain management, such as discrepancies between patient and health professional judgements regarding the degree of pain-induced interference. Issues highlighted by Cleeland and colleagues persist, including high prevalence of pain reported in patients with metastatic cancer, a lack of clarity on good practice guidelines for assessing pain in patients with cancer, and substandard quality of palliative and end-of-life services by minority ethnic groups. Pain management in outpatients with cancer remains a complex issue, but innovative strategies are emerging to support the role of the health professional and encouraging self-management in patients.

scholarly journals Pain in Parkinson's Disease Associated withCOMTGene Polymorphisms

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Wanjun Li ◽  
Yongqian Chen ◽  
Bowen Yin ◽  
Limei Zhang
Keyword(s):  
Disease Severity ◽  
Direct Sequencing ◽  
Pain Scale ◽  
Depression Score ◽  
Onset Age ◽  
Psychogenic Pain ◽  
Experienced Pain ◽  
High Prevalence ◽  
High Incidence ◽  
Prevalence Of Pain

Background. PD patients present high incidence of pain with unknown pathogenesis.Objective. We investigated the relation ofCOMTpolymorphismsrs4633andrs6267with PD pain.Subjects and Methods. One hundred PD patients and 105 controls were evaluated with simplified Mc GILL pain scale and VAS scale. PD patients were assessed with H&Y grade, UPDRS score, and HAMD scale. Polymorphismsrs4633andrs6267were detected by PCR and direct sequencing.Results. Fifty-seven percent of PD patients experienced pain, consisting of PD-related pain (64.91%) (the majority was dystonia pain) and non-PD-related pain (35.09%) (psychogenic pain was most frequent). The frequency ofrs6267genotype “GT/TT” and allele “T” was higher in PD pain. No difference was observed in frequencies ofrs4633between PD pain and without pain. UPDRS and depression score were higher in PD pain. The onset age was earlier in PD-related pain (57.43 ± 19.71) than non-PD-related pain (63.36 ± 6.88).Conclusion. PD patients possess a high prevalence of pain. Dystonia pain was the most frequent type of PD-related pain.COMTgeners6267allele “T” associated with PD pain. PD pain was influenced by disease severity and depression. PD onsets earlier in patients with PD-related pain than non-PD-related pain.

scholarly journals Face Covered and Six Feet Apart: Behavioral Awareness Predicts Greater Adherence to Public Health Guidelines during the COVID-19 Pandemic

2021 ◽  
Vol 18 (16) ◽  
pp. 8247
Author(s):  
Alyssa Schneider ◽  
Emily B. Kroska
Keyword(s):  
Public Health ◽  
Psychological Flexibility ◽  
The United States ◽  
Future Research ◽  
Physical And Mental Health ◽  
Logistic Regression Models ◽  
Demographic Correlates ◽  
Amazon's Mechanical Turk ◽  
Predictors Of Adherence ◽  
Close Contacts

The COVID-19 pandemic has deleteriously impacted physical and mental health. Guidelines to limit the spread of COVID-19 include wearing a face covering in public, limiting close contacts, and physical distancing. In combatting this and future pandemics, it is essential to understand predictors of adherence, such as psychological flexibility. We hypothesized higher psychological flexibility would relate to greater adherence to public health guidelines. Participants (n = 265) were English-reading/speaking adults in the United States and were recruited through Amazon’s Mechanical Turk. Included in the present analyses are data from June (n = 360) and July 2020 (n = 265). Measures included the Comprehensive Assessment of ACT Processes (CompACT), which measured psychological flexibility. Outcome measures included mask-wearing and number of close contacts, which were operationalized categorically (100% mask-wearing in public, ≤10 close contacts in past week). Two logistic regression models examined psychological flexibility and distress as predictors of adherence to mask-wearing and limiting close contacts, while controlling for demographic correlates. Results indicated that greater behavioral awareness predicted greater odds of mask-wearing and limiting close contacts. Psychological flexibility, and behavioral awareness specifically, should be investigated in future research as targets for intervention amidst global disasters.

Examination of Sleep and Obesity in Children and Adolescents in the United States

2021 ◽  
pp. 089011712110291
Author(s):  
Puneet Kaur Chehal ◽  
Livvy Shafer ◽  
Solveig Argeseanu Cunningham
Keyword(s):  
Body Mass Index ◽  
Children And Adolescents ◽  
Sleep Duration ◽  
Body Mass ◽  
The United States ◽  
Weight Category ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Child Height ◽  
Nationally Representative

Purpose: This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US. Design: Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children’s Health. Setting: US, national. Subjects: Children ages 10-17 years (n = 34,640) Measures: Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts. Analysis: Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics. Results: An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time. Conclusion: Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.

Psychology Staffing at Cancer Centers: Data From National Comprehensive Cancer Network Member Institutions

2020 ◽  
Vol 16 (11) ◽  
pp. e1343-e1354
Author(s):  
Laura Melton ◽  
Diana Krause ◽  
Jessica Sugalski
Keyword(s):  
National Comprehensive Cancer Network ◽  
Patient Care ◽  
Clinical Care ◽  
The United States ◽  
Direct Patient Care ◽  
Cancer Center ◽  
Network Member ◽  
Full Time ◽  
Cancer Centers ◽  
Cancer Network

PURPOSE: The field of psycho-oncology is relatively undeveloped, with little information existing regarding the use of psychologists at cancer centers. Comprising 30 leading cancer centers across the United States, the National Comprehensive Cancer Network (NCCN) set out to understand the trends in its Member Institutions. METHODS: The NCCN Best Practices Committee surveyed NCCN Member Institutions regarding their use of psychologists. The survey was administered electronically in the spring/summer of 2017. RESULTS: The survey was completed by 18 cancer centers. Across institutions, 94% have psychologists appointed to provide direct care to their cancer center patients. The number of licensed psychologist full-time equivalents (FTEs) on staff who provide direct patient care ranged from < 1.0 FTE (17%) to 17.0-17.9 FTEs (6%). Regarding psychologist appointments, 41% have both faculty and staff appointments, 41% have all faculty appointments, and 18% have all staff appointments. Forty-three percent of institutions indicated that some licensed psychologists at their centers (ranging from 1%-65%) do not provide any direct clinical care, and 57% indicated that all licensed psychologist on staff devote some amount of time to direct clinical care. The percent of clinical care time that is spent on direct clinical care ranged from 15%-90%. CONCLUSION: There is great variability in psychology staffing, academic appointments, and the amount of direct patient care provided by on-staff psychologists at cancer centers.

Couple Religiosity and Well-Being Among Older Adults in the United States

2021 ◽  
pp. 089826432110421
Author(s):  
Laura Upenieks ◽  
Jeremy E. Uecker ◽  
Markus H. Schafer
Keyword(s):  
Social Life ◽  
Latent Class ◽  
Well Being ◽  
The United States ◽  
Older Couples ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Individual Trait ◽  
The Us ◽  
Married Men

Objectives: This article evaluates whether couples’ religious similarity is consequential for the health of older married men and women. Alternatively, we examine whether women’s religiosity alone is health-protective to their husbands . Methods: Using dyadic data from the US National Social Life, Health, and Aging Project, a representative sample of 913 individuals ages 62–91 plus their marital partners, we perform latent-class analysis to separate older couples into classes based on religious characteristics. Ordered logistic regression models are then used to assess whether different combinations of religious (dis)similarity are associated with married men and women’s well-being. Results: We find that older women in highly religious, homogamous marriages report better mental and physical health relative to women in heterogamous and secular (non-religious) marriages. No significant associations were observed for men. Discussion: Our results emphasize that religiosity is not only an individual trait—dis/similarities within a couple have important implications for older women’s well-being.

Abstract P211: Single High Na + Ingestion Leads To An Increase In Oxidative Stress And Triggers Inflammation.

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Ginette Bordcoch ◽  
Ivan Tavera Busso ◽  
Juan Masjoan Juncos ◽  
Luis I Juncos
Keyword(s):  
Oxidative Stress ◽  
The United States ◽  
Male Rats ◽  
Control Group ◽  
Aortic Tissue ◽  
Tissue Samples ◽  
Extracellular Signal ◽  
High Prevalence ◽  
Markers Of Oxidative Stress ◽  
The Difference

Hypertension has been linked to a progressive increased in oxidative stress and inflammation. The high prevalence of hypertension poses a great risk to public health as 108 million adults in the United States have the condition. For that reason, a better understanding of the link between a high Na+ intake and the development of hypertension is of crucial importance. We hypothesize that a single ingestion of a high Na+ solution leads to increased oxidative stress and triggers an inflammatory response. Wistar 200-250 g male rats had gastric infusions through the esophagus. Groups were infused with 8 mL liquid Vaseline (Control), 8 mL of NaCl 0.684 M (4% m/v), and 8 mL of NaCl 1.368 M (8% m/v). After infusion, blood was collected at different time points during the first hour. Tissue samples were obtained from the aorta, heart, and kidney. Electron Microscopy (EM) was performed on all tissues, which were also analyzed for molecular markers of oxidative stress: Superoxide Dismutase (SOD) and Malondialdehyde (MDA), and an inflammation marker: Extracellular Signal-Regulated Kinase (ERK). At 2 and a half minutes, serum Na+ concentration was unchanged in the control group compared to an increase observed in animals receiving 4% and 8% Na+ with concentrations of 135±1.4 mEq/L, 141±2.0 mEq/L, and 140±1.2 mEq/L respectively. At the 1-hour time point after infusion, the difference was further increased in the 8% group with serum concentrations of 135±1.8 mEq/L, 140±1.5 mEq/L, and 152±1mEq/L respectively (p<0.05). There was an increase in oxidative stress in the aorta from values of 36.22±4.64 mU/mg SOD and 0.131±0.013 pg/mL MDA in the control group, to 47.11±4.89 mU/mg SOD and 0.291±0.022 pg/mL MDA in the 8% group (p<0.05 in both cases). The same was observed in the heart, where values were: 174.6125.26 mU/mg SOD, 0.026±0.007 pg/mL MDA in controls, and 259.22±21.98 mU/mg SOD, 0.215±0.073 pg/mL MDA in 8% group (p<0.05 both cases). Increased ERK in aortic tissue, values of 0.29±0.03 pg/mL in controls, 2.68±0.18 pg/mL in 4% group and 3.97±0.68pg/mL in 8% group (p<0.05) suggest increased inflammation. We conclude that the elevation in serum Na+ concentration that follows Na+ ingestion leads to increased oxidative stress and inflammation.

Sign in / Sign up

Export Citation Format

Share Document