Quarterly published in print and online "Inventi Impact: Cancer Nursing" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal focuses on all the aspects pertaining to caring the cancer patients i.e. prevention and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, psychosocial aspects etc.
Purpose 5-a reductase inhibitors (5-ARI) have been\nsuggested to increase the risk of male breast cancer. The\naim of this study was to study the risk of breast cancer in\nmen on 5-ARI, in men with benign prostatic hyperplasia\n(BPH) not on 5-ARI, and in men without BPH.\nMethods We performed a population-based cohort study\nin Sweden with data from The Prescribed Drug Register,\nThe Patient Register, and The Cancer Register. Men on\n5-ARI, men on a-blockers, or men who had undergone a\ntransurethral resection of the prostate (TUR-P) prior to or\nduring 2006Ã¢â?¬â??2008 were included as exposed to BPH and a\nspecific treatment thereof. For each exposed man, five\nunexposed men were selected. Risk of breast cancer was\ncalculated in Cox proportional hazard models.\nResults There were 124,183 exposed men and 545,293\nunexposed men, and during follow-up (median 6 years), 99\nmen with breast cancer were diagnosed. Compared to\nunexposed men, men on 5-ARI had a hazard ratio (HR) of\nbreast cancer of 0.74 (95 % confidence interval (CI)\n0.27Ã¢â?¬â??2.03), men on a-blockers had HR 1.47 (95 % CI\n0.73Ã¢â?¬â??2.95), and men with a TUR-P had HR 1.99 (95 % CI\n1.05Ã¢â?¬â??3.75).\nConclusion No increased risk of breast cancer was\nobserved for men on 5-ARI. However, the increased risk of\nbreast cancer among men who had undergone a TUR-P, a\nstrong indicator of BPH, suggests that the endocrine milieu\nconducive to BPH is associated with male breast cancer....
Background: Health-related quality of life (HRQoL) is most adversely affected in cancer patients between diagnosis\nand the end of chemotherapy. The aim of the Complementary Nursing in Gynecologic Oncology (CONGO) study is\nto assess the effectiveness of a complex nursing care intervention of CAM to increase HRQoL in cancer patients\nundergoing chemotherapy.\nMethods/design: CONGO is a prospective partially randomized patient preference (PRPP) trial including adult\nwomen diagnosed with breast and gynecologic cancer starting a new chemotherapy regimen. Patients without\nstrong preferences for CAM will be randomized to usual nursing care or complex nursing care; those patients with\nstrong preferences will be allowed their choice. The intervention consists of three interacting and intertwined elements:\nCAM nursing intervention packet, counseling on CAM using a resource-oriented approach and evidence-based\ninformational material on CAM.\nPrimary outcome data on participantsÃ¢â?¬â?¢ HRQoL will be collected from baseline until the end of treatment and long-term\nfollow-up using the EORTC-QLQ-C30. Secondary outcomes include nausea, fatigue, pain, anxiety/depression,\nsocial support, self-efficacy, patient competence, spiritual wellbeing, and satisfaction with care. Accompanying\nresearch on economic outcomes as well as a mixed-methods process evaluation will be conducted.\nA total of 590 patients (236 patients in the randomized part of the study and 354 patients in the observational part of\nthe study) will be recruited in the two outpatient clinics. The first analysis step will be the intention-to-treat (ITT) analysis\nof the randomized part of the trial. A linear mixed model will be used to compare the continuous primary endpoint\nbetween the intervention and control arm of the randomized group. The observational part of the trial will be analyzed\ndescriptively. External validity will be assessed by comparing randomized with nonrandomized patients Discussion: Cancer patients are increasingly using CAM as supportive cancer care, however, a patient-centered\nmodel of care that includes CAM for the patient during chemotherapy still needs to be evaluated. This protocol has\nbeen designed to test if the effects of the intervention go beyond potential benefits in quality-of-life outcomes....
Background: Although determining the recurrence of cutaneous squamous cell carcinoma (cSCC) is important, currently
suggested systems and single biomarkers have limited power for predicting recurrence.
Objective: In this study, combinations of clinical factors and biomarkers were adapted into a nomogram to construct
a powerful risk prediction model.
Methods: The study included 145 cSCC patients treated with Mohs micrographic surgery. Clinical factors were
reviewed, and immunohistochemistry was performed using tumor tissue samples. A nomogram was constructed by
combining meaningful clinical factors and protein markers.
Results: Among the various factors, four clinical factors (tumor size, organ transplantation history, poor differentiation,
and invasion into subcutaneous fat) and two biomarkers (Axin2 and p53) were selected and combined into
a nomogram. The concordance index (C-index) of the nomogram for predicting recurrence was 0.809, which was
higher than that for the American Joint Committee on Cancer (AJCC) 7th, AJCC 8th, Brigham and Women’s Hospital,
and Breuninger staging systems in the patient data set.
Conclusion: A nomogram model that included both clinical factors and biomarkers was much more powerful than
previous systems for predicting cSCC recurrence....
Formulae of estimated glomerular filtration rate (eGFR) based on serum creatinine (Scr) are routinely\nused in oncology patients, however, they are inaccurate in some populations. Our aim was to assess the agreement\nof eGFR formulae and thereby build a nomogram to predict the reliability of estimates.\nMethods: Measured GFR (mGFR) using isotope from 445 oncology patients were compared with eGFR from six\nformulae (Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), modified MDRD formulae for Chinese (CMDRD),\nChronic Kidney Disease Epidemiology (CKD-EPI) Collaboration, Wright and full age spectrum (FAS)). Bias,\nprecision and accuracy of eGFR formulae were examined. We also evaluated statistics of agreement: the total\ndeviation index (TDI), the concordance correlation coefficient (CCC) and the coverage probability (CP). Multivariate\nlogistic regression was applied to identify characteristics associated with inaccurate eGFR and construct a predictive\nnomogram.\nResults: All eGFR formulae tended to overestimate the eGFR. The percentage of patients with eGFR within 30% the\nmGFR ranged from 38.0 to 62.8%. Cockcroft-Gault and MDRD showed low bias and high precision. The MDRD\nformula exhibited lowest TDI, meaning that 90% of estimations ranged from -36 to 36% of mGFR. Multivariate\nlogistic regression showed that inaccuracy of MDRD was found in elderly patients or in patients with eGFR greater\nthan 120 ml/min. A nomogram was constructed to help oncologists to predict the risk of inaccuracy of eGFR. The\ncalibration curve showed good agreement.\nConclusions: Our results suggest that the error of eGFR by any formulae was common and wide in Chinese\noncology patients. Our nomogram may assist oncologists in decision-making when mGFR is needed....
Background: Cervical screening saves approximately 5000 lives annually in England. However, screening rates
have been falling continuously, and coverage in London is particularly low (64.7%). While demographic predictors of
uptake have been well researched, there has been less thorough investigation of the individual barriers and facilitators
which predict cervical screening attendance. Understanding modifiable factors influencing attendance can guide the
design of effective interventions to increase cervical screening uptake. The aim of this study was to understand the
demographic, and individual factors associated with self-reported attendance at cervical screening in London.
Methods: The study used an online survey of 500 women in London (June-July 2017). The survey included selfreported
measures of past attendance, demographic variables (including age, household income, ethnicity), past
experience variables, and individual variables (list of potential barriers and facilitators developed based on the Theoretical
Domains Framework and existing literature, which included: environmental context and resources, perceived
risk, anticipated pain/embarrassment). Participants were categorised into regular attenders and non-regular attenders.
Backwards stepwise logistic regression investigated the barriers and facilitators predicting past attendance. Demographic
variables with significant differences between regular and non-regular attenders were added to the final
Results: Of women who had previously been invited (n = 461, age range: 25–65), 34.5% (n = 159) were classified
as non-regular attenders, and 65.5% (n = 302) as regular attenders. The individual barriers and facilitators predicting
attendance were: cervical screening priority, memory, environmental context and resources, and intention. The only
demographic variables related to regular attendance were relationship status (married/civil partnership having higher
rates than single) and higher household income. Relationship status was not significant when adjusting for barriers
and facilitators. Those who have ever been sexually active or who have had an STI in the past were significantly more
likely to be regular attenders.
Conclusions: The study shows the importance of individual barriers and facilitators in predicting self-reported
cervical screening attendance. Household income was the only significant demographic variable when combined with the individual variables. Interventions targeting priority, memory, and practical barriers affecting environmental
context may be expected to be effective an increasing attendance....
Background: The incidence of cancer in the Kingdom of Saudi Arabia (KSA) is increasing. Whilst meeting the growing\ndemand for health care services in oncology, organisations must ensure they provide high quality care. Despite patient\nsatisfaction being an important metric in assessing quality of care, there is a dearth of literature in this field in the KSA,\nparticularly in oncology hospital wards. The aim of this study was to examine how interpersonal aspects of care and\nsocio-cultural communication impact upon patient satisfaction in an oncology ward setting in the Saudi Regional Cancer\nCentre (SRCC), in Riyadh.\nMethods: A sequential, explanatory, mixed methods design was employed. This paper presents the findings of the\nqualitative phase of the research, when semi-structured telephone and face-to-face interviews were conducted with 22\nadult oncology inpatients admitted to the SRCC in Riyadh.\nFindings: Three primary themes emerged from the interview data: doctor-patient relationship, nurse-patient\nrelationship, and contextual factors of cancer in the KSA. The findings indicated that patient satisfaction levels were\nsignificantly influenced by the interpersonal aspects of care. Doctor-patient and nurse-patient relationships were deemed\ncore to patientsÃ¢â?¬â?¢ experiences, with person-centered, interpersonal skills being especially important. In addition, sociocultural\nissues such as language barriers and non-disclosure negatively impacted on levels of satisfaction. Attention to\nsuch factors is necessary to improve quality of care in oncology ward settings in the Kingdom. Improvements in care\narising from enhanced interpersonal skills of staff, contextualised against a backdrop of social and cultural factors, would\npositively influence patient satisfaction in the KSA.\nConclusion: This study has provided new evidence supporting the need for stronger interpersonal relations and a more\npatient-centred approach in the oncology health system in the KSA. This research will assist policy makers and hospital\nmanagement teams wanting to improve patient satisfaction in oncology wards in the KSA....
Breast cancer is themost frequently diagnosed cancer inwomen.However, the exact cause(s) of breast cancer still remains unknown.\nEarly detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the\nmost effective way to tackle breast cancer.There aremore than 70 common genetic susceptibility factors included in the current nonimage-\nbased risk prediction models (e.g., the Gail and the Tyrer-Cuzickmodels). Image-based risk factors, such asmammographic\ndensities and parenchymal patterns, have been established as biomarkers but have not been fully incorporated in the risk prediction\nmodels used for risk stratification in screening and/or measuring responsiveness to preventive approaches. Within computer\naided mammography, automatic mammographic tissue segmentation methods have been developed for estimation of breast tissue\ncomposition to facilitate mammographic risk assessment. This paper presents a comprehensive reviewof automatic mammographic\ntissue segmentation methodologies developed over the past two decades and the evidence for risk assessment/density classification\nusing segmentation. The aim of this review is to analyse how engineering advances have progressed and the impact automatic\nmammographic tissue segmentation has in a clinical environment, as well as to understand the current research gaps with respect\nto the incorporation of image-based risk factors in non-image-based risk prediction models....
The quality of cancer care may be compromised in the near future because of\nwork force issues. Several factors will impact the oncology health provider work\nforce: an aging population, an increase in the number of cancer survivors, and\nexpansion of health care coverage for the previously uninsured. Between October\n2014 and March 2015, an electronic literature search of English language articles\nwas conducted using PubMedÃ?Â®, the Cumulative Index to Nursing and Allied\nHealth Sciences (CINAHLÃ?Â®), Web of Science, Journal Storage (JSTORÃ?Â®), Google\nScholar, and SCOPUSÃ?Â®. Using the scoping review criteria, the research question\nwas identified Ã¢â?¬Å?How much care in oncology is provided by nurse practitioners\n(NPs)?Ã¢â?¬Â Key search terms were kept broad and included: Ã¢â?¬Å?NPÃ¢â?¬Â AND Ã¢â?¬Å?oncologyÃ¢â?¬Â\nAND Ã¢â?¬Å?workforceÃ¢â?¬Â. The literature was searched between 2005 and 2015, using\nthe inclusion and exclusion criteria, 29 studies were identified, further review\nresulted in 10 relevant studies that met all criteria. Results demonstrated that\nNPs are utilized in both inpatient and outpatient settings, across all malignancy\ntypes and in a variety of roles. Academic institutions were strongly represented\nin all relevant studies, a finding that may reflect the Accreditation Council for\nGraduate Medical Education (ACGME) duty work hour limitations. There was\nno pattern associated with state scope of practice and NP representation in this\nscoping review. Many of the studies reviewed relied on subjective information,\nor represented a very small number of NPs. There is an obvious need for an\nobjective analysis of the amount of care provided by oncology NPs....
When a person is diagnosed to have cancer, that he has reached the terminal stages of his illness, he suffers the most. Adding to this stress patient and the family members have a difficult time to decide over the care of the patient with advanced cancer, to prefer a hospice or care at home. Assessment of the quality of life (QOL) of advanced cancer patients can provide helpful information on disease and treatment related effects and also on patients own experiences. Hence the investigator felt the need to do the study to compare the quality of life of the advanced cancer patients in hospice vs. home care. The study was conducted among 90 (30 in each group) advanced cancer patients in Shanti Avedna Hospice in Delhi and Follow up patients of CANSUPPORT in their own residence. Longitudinal follow up research design was used and the samples were selected by purposive sampling. The demographic variables were used to assess the sample characteristics and European Organization of research and the Treatment of Cancer Quality of Life Questionnaire -Cancer 30 to measure quality of life on advanced cancer patients. The study revealed that in Global Health Scale (GHS), the higher score (63.43) was in hospice and when hospice (p<0.05) and NGO assisted home care (p<0.05) were compared with home care alone GHS score had significant difference. In symptom scales, Hospice had lower score. Hence the study concluded that Patients who were in Hospice scored significantly better in Quality of Life, as compared to NGO assisted home care and home care alone....
Aim\nTo explore the role of the Australian breast care nurse in the provision of information\nand support to women with breast cancer, with a focus on the differences\nexperienced depending on geographic work context.\nDesign\nA cross-sectional study.\nMethods\nThis study conducted in 2013, involved surveying BCNs currently working in\nAustralia, using a newly developed self-report online survey.\nResults\nFifty breast care nurses completed the survey, 40% from major cities, 42% from\ninner regional Australia and 18% from outer regional, remote and very remote\nAustralia. Patterns of service indicated higher caseloads in urban areas, with\nfewer kilometres served. Breast care nurses in outer regional, remote and very\nremote areas were less likely to work in multi-disciplinary teams and more\nlikely to spend longer consulting with patients. Breast care nurses reported they\nundertook roles matching the competency standards related to the provision of\neducation, information and support; however, there were barriers to fulfilling\ncompetencies including knowledge based limitations, time constraints and\nservicing large geographical areas.\nConclusions\nThis was the first Australian study to describe the role of the breast care nurse\nnationally and the first study to investigate breast care nurses perceived ability\nto meet a selection of the Australian Specialist Breast Nurse Competency Standards.\nImportant differences were found according to the geographical location\nof breast care nurses....
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