1,720,967 research outputs found
The Experience of Adult Lymphoma Patients Referred for Cardiac Rehabilitation Following Autologous Hematopoietic Stem Cell Transplantation
Get PDFBackground: Current therapy for relapsed lymphoma includes high-dose chemotherapy (HDCT) as part of autologous hematopoietic stem cell transplantation (HSCT). This life saving treatment has a 50%-70% cure rate at 10 years; however, patients who undergo HSCT are at an increased risk for both direct (i.e. cardio-toxicity) and indirect (i.e. decreased functional status) negative effects. Due to the known detrimental cardiovascular (CV) effects of treatment, lymphoma patients from a tertiary cancer centre are referred to an eight-week multidisciplinary cardiac rehabilitation (CR) program following HSCT. This innovative approach to HSCT patients has not been documented in the literature. Aim: The aim of this qualitative study is to gain understanding of lymphoma patients’ experiences of being referred to a multidisciplinary CR program following HSCT. Research Question: What is the experience of adult lymphoma patients who are referred to a cardiac rehabilitation program after treatment with HDCT and HSCT? Methods: A qualitative research approach (interpretive description) was used to guide data collection and analysis. A total of 10 semi-structured interviews were collected. Findings: Four major themes highlighting HSCT recipients’ prioritization of CR in recovery; impact of HSCT on the CR experience; coping and resiliency during recovery; and information uptake were found. The experiences of HSCT patients in CR shares similarities to other CR literature, however the added burden of HSCT presents unique experiences that influence patient perceptions regarding CV health and risks. Outcomes: The results of this research will inform and improve the delivery of CR, a necessary and urgent need in this complex patient population. This study allows researchers, program developers, and multidisciplinary care teams to better understand the experiences of lymphoma patients referred to a CR program and adjust program delivery
A Novel Comparative Analysis Approach to Personalize Chemotherapy Dose Calculation in Early Breast Cancer
Get PDFBackground
Worldwide, body surface area [BSA] is used to calculate chemotherapy dose. The BSA formula was originally developed in 1916, derived from height and weight, with no consideration of other patient characteristics. Most chemotherapy agents have a narrow therapeutic index and are distributed in lean body mass [LBM], leading to under- or over-dosing and deleterious effects to major organs, including the cardiovascular system, when body composition is not considered. While experts worldwide acknowledge the limitations and risks of BSA dosing, no practical approach to personalizing chemotherapy dose has been developed to this date. Ideally, body composition would be assessed by tests already routinely performed, avoiding unnecessary radiation exposure, clinic visits, discomfort to the patient, and cost. For example, most breast cancer patients undergo cardiac imaging prior to chemotherapy as per our clinical guidelines. We hypothesized that clinical parameters routinely performed prior to chemotherapy could predict LBM in early breast cancer patients.
Method
Early stage breast cancer patients (n = 45) enrolled in the Multidisciplinary Team Intervention in Cardio-Oncology (TITAN) study underwent pre-treatment cardiac MRI, body composition (iDEXA) and laboratory (complete blood cell count and chemistry). Cardiac MRI and iDEXA are considered 'gold standard' imaging modalities. The Pearson correlation was calculated to find the relationship between cardiac MRI values, total lean body mass, and routine chemistry.
Our modeling approach, which is novel in this area, aimed to select the best combination of parameters with the most predictive ability of total lean mass (iDEXA). The parameters included in this study were: cardiac MRI metrics (Left Ventricle (LV) mass, cardiac output), and laboratory parameters associated with major organ function (albumin, creatinine, bilirubin). All parameters were tested using univariate, multivariate and subset selection approach. Akaike's Information Criterion (AIC) was used to measure model quality, with lower AIC values indicating closer prediction.
Results
The univariate analysis of each parameter independently showed LV mass is most predictive with AIC 857.8, while combination of all parameter in multivariate fashion show improvement in prediction with AIC 851. The subset selection approach shows, Adjusted R2 with 4 parameters had AIC 849.14, Schwartz's information criterion (BIC) with 2 parameters had AIC 849.66 and Mallows' C Selection (Cp) model with 3 parameters had the least AIC 848.71 value (P < 0.001).
Conclusion
Our comparative analysis showed that the Cp model with 3 parameters (LV mass, cardiac output and bilirubin) has high prediction ability of LBM. This model can form the basis of a personalized formula for chemotherapy dose calculation. We expect this work to result in optimal cancer-specific outcomes while reducing short and long-term toxicities associated with necessary
Care Transitions of Colorectal Cancer Patients from Hospital to Community: Systematic Review and Meta-analysis Protocol
No full textObjective: To evaluate the effectiveness of care transition strategies from hospital-to-community compared to usual care for patients with colorectal cancer to reduce hospital stay, 30-day readmissions, and emergency room visits up to 30 days. Methods: Systematic review and meta‐analysis protocol that followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The protocol was registered on PROSPERO (CRD42020162249). We will include studies available in the electronic databases PubMed/Medline, Embase, Cochrane CENTRAL and LILACS with care transition strategies/actions from hospital to community as the primary outcome. Eligible studies will be selected, and data will be combined and synthesized using Review Manager (RevMan 5.4) software. We will combine risk ratios or odds ratios for dichotomous data and mean differences for continuous data using a random effects model. Discussion: This review will contribute to the practice and development of effective and safe care transition strategies from hospital to community for colorectal cancer patients. There is an expectation that this review will provide much needed evidence that effective care transitions could reduce short term hospital readmission, and may thus provide added value in the care of colorectal cancer patients. Conclusion: The results of the review will be used to provide clear recommendations for hospital and primary care management to improve care transitions and, as a result, also improve integration in the healthcare system.
How to cite this article: Boell, Julia Estela Willrich; Trindade, Letícia Flores; Kolankiewicz, Adriane Cristina Bernat; Cañon-Montañez, Wilson; Pituskin, Edith; Lorenzini, Elisiane. Care Transitions of Colorectal Cancer Patients from Hospital to Community: Systematic Review and Meta-analysis Protocol. 2021;12(3):e2285. http://dx.doi.org/10.15649/cuidarte.2285Objetivo: Avaliar a efetividade de estratégias de transição do cuidado do hospital para a comunidade comparada aos cuidados habituais para pacientes com câncer colorretal para diminuir tempo de permanência hospitalar, readmissões aos 30 dias e visita ao setor de emergência até 30 dias. Métodos: Protocolo de revisão sistemática e meta-análise que seguiu as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). O protocolo foi registrado no PROSPERO (CRD42020162249). Incluiremos estudos disponíveis nas bases de dados eletrônicas PubMed/Medline, Embase, Cochrane CENTRAL e LILACS tendo como desfecho primário as estratégias/ações de transição do cuidado do hospital para a comunidade. Os estudos elegíveis serão selecionados e os dados serão combinados e sintetizados usando o software Review Manager (RevMan 5.4). Serão combinados os riscos relativos ou odds ratios para dados dicotômicos e diferenças de médias para dados contínuos usando um modelo de efeitos aleatórios. Discussão: Esta revisão contribuirá para a prática e desenvolvimento de estratégias de transição de cuidados efetivas e seguras do hospital para a comunidade para pacientes com câncer colorretal. Espera-se que esta revisão forneça evidências muito necessárias de que as transições de cuidados efetivas podem reduzir a readmissão hospitalar de curto prazo e podem, assim, fornecer valor agregado no cuidado de pacientes com câncer colorretal. Conclusão: Os resultados da revisão serão usados para fornecer recomendações claras para a gestão hospitalar e de cuidados primários para melhorar as transições de cuidados e, como resultado, também melhorar a integração no sistema de saúde.
Como citar este artigo: Boell, Julia Estela Willrich; Trindade, Letícia Flores; Kolankiewicz, Adriane Cristina Bernat; Cañon-Montañez, Wilson; Pituskin, Edith; Lorenzini, Elisiane. Care Transitions of Colorectal Cancer Patients from Hospital to Community: Systematic Review and Meta-analysis Protocol. 2021;12(3):e2285. http://dx.doi.org/10.15649/cuidarte.2285 Objetivo: Evaluar la efectividad de estrategias de transición de cuidados del hospital a la comunidad en comparación con el cuidado usual en pacientes con cáncer colorrectal para reducir el tiempo de estancia hospitalaria, readmisiones a los 30 días y visitas al departamento de emergencias dentro de los 30 días. Métodos: Protocolo de revisión sistemática y metaanálisis que siguió las recomendaciones de Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). El protocolo se registró en PROSPERO (CRD42020162249). Se incluirán estudios disponibles en las bases de datos electrónicas PubMed/Medline, Embase, Cochrane CENTRAL y LILACS con estrategias/acciones de transición del cuidado del hospital a la comunidad como desenlace principal. Se seleccionarán los estudios elegibles y los datos se combinarán y sintetizarán mediante el software Review Manager (RevMan 5.4). Serán combinados los riesgos relativos u odds ratios para los datos dicotómicos y las diferencias de medias para los datos continuos mediante un modelo de efectos aleatorios. Discusión: Esta revisión contribuirá a la práctica y el desarrollo de estrategias de transición de cuidado efectivas y seguras del hospital a la comunidad para los pacientes con cáncer colorrectal. Se espera que esta revisión proporcione evidencias muy necesarias de que las transiciones de cuidado efectivas podrían reducir la readmisión hospitalaria a corto plazo y, por lo tanto, pueden proporcionar un valor agregado en el cuidado de los pacientes con cáncer colorrectal. Conclusión: Los resultados de la revisión se utilizarán para proporcionar recomendaciones claras para la gestión hospitalaria y de cuidado primario para mejorar las transiciones de cuidado y, como resultado, también mejorar la integración en el sistema de salud.
Como citar este artículo: Boell, Julia Estela Willrich; Trindade, Letícia Flores; Kolankiewicz, Adriane Cristina Bernat; Cañon-Montañez, Wilson; Pituskin, Edith; Lorenzini, Elisiane. Care Transitions of Colorectal Cancer Patients from Hospital to Community: Systematic Review and Meta-analysis Protocol. 2021;12(3):e2285. http://dx.doi.org/10.15649/cuidarte.228
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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