Exploring health system factors related to the quality of life of people with (a history of) cancer: a rapid review.

Simple SummaryDog bites are a major public health problem throughout the world. The different types of information sources that exist in relation to this issue are influencing decision making to control and prevent these incidents. For this reason, the present study aims to compare the main variables of interest in the publications of dog bite accidents in the written and grey press and scientific literature in Chile and Spain, between 2013 and 2017. The results showed that sensationalist variables in dog bite articles are reported more frequently in the press literature compared to the indexed and grey literature. Examples of these variables are involvement of potentially dangerous breeds, articles with death reports, among others. In conclusion, an improvement in the quality of the information that reaches the population about dog bites could be achieved through better and more fluid communication between scientists and journalists who publish on this topic.Dog bites are a major public health problem, with consequences such as physical injury, psychological trauma, transmission of zoonoses, infections, and economic costs. For this reason, it is necessary to develop preventive programs, which require quality information to support the authorities’ decision-making and to raise public awareness about the application of the proposed measures. The objective of this review was to analyze the press, indexed and gray dog bite literature published during the 2013–2017 period. During that period, 385 articles from three sources of information were analyzed: Press literature, scientific literature, and gray literature. Of these, the greatest amount of information corresponding to the context and the aggressor animal was found in the press literature, where it was recorded that the greatest number of records reported in the Chilean articles were caused by potentially dangerous breeds (87.50%), having significant differences with the gray literature (p = 0.030), and in Spain, the greatest number of attacks was also made by potentially dangerous dogs 91.30% (21/23), statistically significant differences with the gray literature (p = 0.002) and with the indexed (p < 0.001). In the case of the scientific and gray literature, the greatest amount of information was found about the victim of the attack and the treatments applied to them. In these cases, the highest percentage of victims included in the reports contained both sexes for the two literatures (44.62% and 87.71%, respectively). Regarding the treatment applied, in the scientific literature in most of the reports, the patients received washings, rabies vaccine, and tetanus vaccine (46.26%) and presented significant differences in Chile with the information contained in the gray literature (p = 0.023), in Spain with the gray (p = 0.017) and with the press (p = 0.023). In conclusion, the press literature differs in multiple variables with the information reported in the scientific literature and, in some cases, with the gray literature. The reason why the material that is being distributed to the population would not coincide in multiple relevant variables in other literature and the representative reality of the problem is the basis for this topic.

Background Prescribing epidemiology in general practice shows gabapentinoid drugs to be independently associated with unexpected, drug-related death. There is an increasing trend of gabapentinoid deaths throughout Europe and North America. Objectives The overall aim of this study was to assess how patient, practice and health system factors might be associated with gabapentinoid prescribing in primary care. Methods Case series following a critical incident of an unexpected death in a patient prescribed a gabapentinoid drug in a single general practice. Unexpected and expected deaths in patients prescribed a gabapentinoid drug deaths over an 11-year period in a single general practice. We examined patient, prescriber and health system factors. Toxicology and post-mortem data were provided by the Coroner. Results There were 36 deaths (four unexpected and 32 expected deaths) during the study period. Of the four patients who suffered an unexpected death, one of these patients’ cause of death could be attributed to drug and alcohol toxicity. Over half of gabapentinoid prescribing (n = 19,53%) was hospital initiated, often ‘off-label’ (n = 6, 17%) and commonly co-prescribed with opiates (n = 15, 42%) and benzodiazepines (n = 11, 31%) to patients with high multi-morbidity. Conclusions Gabapentinoids are often initiated in the outpatient setting in clinically complex patients, often for ‘off label’ indications, with high polypharmacy. Patient, practice and health-system related factors need to be addressed in relation to gabapentinoid associated deaths and reflected in clinical practice guidelines. There is critical value in using toxicology reports from Coroner’s offices in cases of unexplained gabapentinoid death in general practice.

Cardiovascular outcomes in hospitalized patients with COVID-19 and history of cancer: a CORONA-VTE analysis

Short and long term improvements in quality of chronic care delivery predict program sustainability

A comparison of quality of life and resilience in menopausal women with and without a history of gynaecological cancer

ContextThe readability of source code is key for understanding and maintaining software systems and tests. Although several studies investigate the readability of source code, there is limited research specifically on the readability of test code and related influence factors.ObjectiveIn this paper, we aim at investigating the factors that influence the readability of test code from an academic perspective based on scientific literature sources and complemented by practical views, as discussed in grey literature.MethodsFirst, we perform a Systematic Mapping Study (SMS) with a focus on scientific literature. Second, we extend this study by reviewing grey literature sources for practical aspects on test code readability and understandability. Finally, we conduct a controlled experiment on the readability of a selected set of test cases to collect additional knowledge on influence factors discussed in practice.ResultsThe result set of the SMS includes 19 primary studies from the scientific literature for further analysis. The grey literature search reveals 62 sources for information on test code readability. Based on an analysis of these sources, we identified a combined set of 14 factors that influence the readability of test code. 7 of these factors were found in scientific and grey literature, while some factors were mainly discussed in academia (2) or industry (5) with only limited overlap. The controlled experiment on practically relevant influence factors showed that the investigated factors have a significant impact on readability for half of the selected test cases.ConclusionOur review of scientific and grey literature showed that test code readability is of interest for academia and industry with a consensus on key influence factors. However, we also found factors only discussed by practitioners. For some of these factors we were able to confirm an impact on readability in a first experiment. Therefore, we see the need to bring together academic and industry viewpoints to achieve a common view on the readability of software test code.

Significance. Timely identification of defects in the treatment and diagnostic process during internal quality audit of care delivery stimulates evidence-based organizational and management decisions and improves quality of care delivery to mental patients. Material and methods. A retrospective analysis of 270 records of internal quality audit of care to mental patients treated at the Mental Hospital # 4 of the Moscow Healthcare Department has been conducted. A total of 156 inpatient records (57.8%) from 2015 to 2018 were compared with 114 inpatient records (42.2%) in 2019. Results and discussion. Heads of the structural units and deputy heads of the health care facility have evaluated quality of care delivery at the two levels of control. Primary medical documentation was assessed on 12 items (from 0 to 1 point). The arithmetic mean of the assessments for each of the items was calculated - the overall quality factor. At both levels of control, defects in the care delivery were described. The quality factor at the 1st level of control equalled to 0.95 (0.92; 0.96), and 0.86 (0.79; 0.91) at the 2nd level. The quality factor at the 2nd level of control in 2015 - 2018 (1.0 (0.90; 1.00)) was statistically significantly higher than in 2019 (0.86 (0.79; 0.91)) (p = 0.011). Data for the complete 2019, despite the order of the Ministry of Health of the Russian Federation as of June 7, 2019 No. 381n, were observed and obtained in accordance with the requirements of the Moscow Healthcare Department Order No. 932 as of October 30, 2019 “On procedure for implementing internal quality audit and safety performance of health organizations of the state healthcare system of the city of Moscow”. Conclusion. The ongoing monitoring of quality of inpatient health care delivery to mental patients to identify defects in the treatment and diagnostic process using internal quality audit records helps to improve quality of care delivery to patients.

To identify factors associated with climacteric symptoms and quality of life in women with and without a history of gynecological cancer. A cross-sectional study was conducted from November 2022 to May 2024 in a tertiary hospital's menopause clinic in Campinas, Brazil. Women aged 30 years or above with climacteric symptoms were included, excluding those undergoing treatment for these symptoms or with debilitating conditions. Climacteric symptoms were assessed using the Menopause Rating Scale (MRS), and quality of life by the Women's Health Questionnaire (WHQ). Statistical analyses included descriptive tests, χ 2 , Mann-Whitney, and Poisson regression ( P <0.05). A total of 184 women (mean age 49.6±9.5y) were included, of whom 54.3% had a history of cancer (29.3% breast, 14.1% cervical, 7.6% ovarian, 2.7% endometrial, 0.5% vulvar). The mean age at menopause was 44.2±6.7 years; 58.5% had treatment-induced menopause. Median MRS and WHQ scores were 27 and 0.58, respectively. No association was found between a history of cancer and overall symptom severity or reduced quality of life. In multivariate analysis, worse quality of life was independently associated with higher severity of somatovegetative symptoms (PR: 2.10; 95% CI: 1.16-3.79) and psychological symptoms (PR: 1.90; 95% CI: 1.07-3.36). A history of gynecological cancer was not associated with increased climacteric symptoms or poorer quality of life. Menopausal symptoms, especially vasomotor and psychological domains, were the main factors related to lower quality of life.

Regionalized care delivery purportedly optimizes care to vulnerable very low birth weight (VLBW; <1500 g) infants. However, a comprehensive assessment of quality of care delivery across different levels of NICUs has not been done. We conducted a cross-sectional analysis of 21,051 VLBW infants in 134 California NICUs. NICUs designated their level of care according to 2012 American Academy of Pediatrics guidelines. We assessed quality of care delivery via the Baby-MONITOR, a composite indicator, which combines 9 risk-adjusted measures of quality. Baby-MONITOR scores are measured as observed minus expected performance, expressed in standard units with a mean of 0 and an SD of 1. Wide variation in Baby-MONITOR scores exists across California (mean [SD] 0.18 (1.14), range -2.26 to 3.39). However, level of care was not associated with overall quality scores. Subcomponent analysis revealed trends for higher performance of Level IV NICUs on several process measures, including antenatal steroids and any human milk feeding at discharge, but lower scores for several outcomes including any health care associated infection, pneumothorax, and growth velocity. No other health system or organizational factors including hospital ownership, neonatologist coverage, urban or rural location, and hospital teaching status, were significantly associated with Baby-MONITOR scores. The comprehensive assessment of the effect of level of care on quality reveals differential opportunities for improvement and allows monitoring of efforts to ensure that fragile VLBW infants receive care in appropriate facilities.

BackgroundThere is strong evidence of the multiple benefits of physical activity on health in primary, secondary and tertiary prevention (WHO, 2020). However, economic evaluations are still needed to estimate direct and indirect costs that could be saved from various Health-Enhancing Physical Activity (HEPA) promotion strategies (Ding et al., 2020). Moreover, these savings might be influenced by specificities of the national health system. The aim of this study is to explore the economic impact of HEPA from different settings in France.MethodsA systematic scoping review of grey and scientific literature was conducted. Relevant articles were identified through searching from PubMed, ScienceDirect, SportDiscus databases and from google. Searches were conducted in English and French between January 2000 and December 2020. A data extraction template was used to collect, organize and summarize data regarding the following variables: aim of the study, study population, study settings, methods, and main results.ResultsA total of 17 studies were included from the grey literature (n = 10) and the scientific peer-reviewed literature (n = 7). Data from each variables of interest were heterogeneous, making comparisons difficult. Studies were categorized in 5 types: studies aiming to estimate the cost of physical inactivity or the cost that could be saved from HEPA promotion in general population (n = 8); studies aiming to evaluate the medico-economic impact of a physical activity adapted program (n = 5); studies aiming to assess the economic benefit of active travel in a city (n = 3); study aiming to estimate the economic impact of physical activity from a company and its employee's perspectives (n = 1). Whatever the methods, the study population or the study setting, several tens of millions of euros to several billions of euros could be saved each year by investing in HEPA promotion.ConclusionsHEPA promotion can lead to substantial saving. Methods should be standardized to more precisely estimate its extent in different settings in France. This could help policy-makers in their decision to invest in HEPA promotion, especially in phases of epidemics, where sedentarity and physical inactivity account for major health risks.

The constructs of health, well-being and quality of life are not routinely understood or measured for people accessing aged care services. This study aimed to identify and validate theoretical domains of health, well-being and quality of life for recipients of care, their informal carers and staff, and inform the development of a person-centred outcomes measurement framework. First, a rapid review to identify recurrent domains of health, well-being and quality-of-life in aged care, using systematic searches of electronic databases, and review of grey literature, following the PRISMA guidelines. Second, establish content validity of identified domains using (a) Delphi technique with n=134 aged care staff, care recipients and caregivers, and (b) comparability with categories within the International Classification of Functioning, Disability and Health (ICF) and ICF Geriatric Core Set. From 972 records detected in the rapid review, 19 peer-reviewed research articles and 27 grey literature sources were included in the content analysis. Twenty-four domains and 109 concepts were identified, and health, quality of life, security and food and nutrition were ranked as the most important. One domain, cognition, linked to both the Geriatric Core Set and ICF, and 37% of domains and 39% of concepts were evident within the ICF. This study identified and validated 24 important domains of health, well-being and quality of life for the older person receiving care, their informal carers and staff. These domains can be used to guide the selection of outcome measures and facilitate person-centred care and care planning.

The purpose of this study is to examine the association of individual, community, and health system factors on quality of life among inner-city African Americans with type 2 diabetes. Primary data from a cross-sectional study with a community sample of 241 inner-city African Americans with type 2 diabetes were analyzed. Paper-based surveys were administered in which the SF-12 was used to capture the physical component (PCS) and mental component (MCS) of quality of life. Four regression approaches (sequential, stepwise with backward and forward selection, and all possible subsets regression) were used to examine the influence of individual, community, and health system factors on PCS and MCS after adjusting for relevant covariates using a conceptual framework. In fully adjusted models, having less than a high school education and having major depression were associated with lower quality-of-life scores for MCS across all 4 regression approaches. Being employed was positively associated with better quality-of-life scores for PCS across all 4 regression approaches. PCS was higher across all 4 regression approaches for those reporting a history of trauma. At the health systems level, usual source of care was associated with better PCS across 3 regression approaches. These results highlight key factors that influence quality of life among inner-city African Americans with type 2 diabetes that could be targets for interventions in this population. However, additional research is needed to understand existing pathways that may be driving many of these relationships.

Certified nursing assistants’ quality of caregiving for older adults exerts a positive impact on their occupational careers. Hygiene status of certified nursing assistants in nursing facilities may protect QOCD from positive working achievement. The impact of hygiene status of certified nursing assistants on QOCD for older adults were proved in the observational cross-sectional study. Care giving appraisal were used to survey 104 certified nursing assistants. Arbitrating effects were in-depth analyzed by SPSS 25.0 and Process V3.5. Hygiene status definitely unraveled quality of care delivery. Meanwhile, it was also found that hygiene status, and quality of care delivery were arbitrated in parallel by occupational ethics and working attitudes. Value of 0.469 was total indirect, explaining 49.5%. The innovative study introduces how hygiene status influences caregivers’ quality of care delivery in pension apartment. Hygiene status could provide certified nursing assistants with a favorable supervising and assessing positive occupational quality, enhance the occupational ethics and working attitudes, ultimately improve their quality of care delivery.

The purpose of this study was to examine potential differences in select objective and subjective measures of cognitive function in women with and without a history of breast cancer. Study participants included 25 women between the ages of 40–75 years, 14 of whom had completed treatments for Stage I–III invasive breast cancer (breast cancer survivors) and 11 of whom who did not have a history of cancer diagnosis or treatment (controls) Participants completed the Functional Assessment of Cancer Therapy‐Cognitive Function (FACT‐Cognitive Function), a 37‐item instrument which assesses self‐reported perceptions of cognitive impairments, abilities, comments from others, and impact on quality of life over the past 7 days. Participants also completed two computerized tests of attention: the Digit Span Test and the Flanker Task (Inquisit, Millisecond Software, LLC, Seattle, WA). Performance on the Digit Span was assessed by examining the mean forward and backward digit spans achieved. Performance on the Flanker Task was assessed by examining the error proportion and mean reaction times for mixed trial and blocked trial stimuli. Serum brain derived neurotrophic factor (BDNF) levels were measured from whole blood samples using enzyme‐linked immunosorbent assay (ELISA) techniques (R&amp;D Systems Inc., Minneapolis, MN). Outcome measures were compared between the two study groups using independent samples t‐tests. Physical characteristics (i.e. age, height, body mass, BMI, percent body fat, and VO2peak) were similar between breast cancer survivors and controls (55.9 ± 7.4 years vs. 55.5 ± 7.0 years; 163.3 ± 4.8 cm vs. 165.1 ± 5.8 cm; 69.6 ± 11.7 kg vs. 75.8 ± 18.3 kg; 26.1 ± 4.4 kg/m2 vs. 27.9 ± 7.0 kg/m2; 32.8 ± 6.0% vs. 33.0 ± 6.4%; and 20.9 ± 6.3 mL/kg/min vs. 25.0 ± 9.6 mL/kg/min, respectively, p = 0.209–0.896). For the FACT‐Cognitive Function, breast cancer survivors reported a significantly lower total score as well as significantly lower subscale scores for Perceived Cognitive Impairments and Perceived Cognitive Abilities compared to controls (Table 1, p = 0.038, 0.039, and 0.036). Breast cancer survivors also performed significantly worse on both the forward and backward Digit Spans compared to controls (Table 2, p = 0.016 and 0.003), and displayed somewhat longer reaction times on both the blocked and mixed trial stimuli for the Flanker Task compared to controls (Table 2, p = 0.053 and 0.085). Serum BDNF levels were similar between breast cancer survivors and controls (63695.7 ± 51661.0 pg/mL vs. 105307.3 ± 71037.1 pg/mL, p = 0.121). These results suggest that although physical characteristics (i.e. age, BMI, body composition, and peak aerobic fitness) and serum BDNF levels may be similar between women with a history of breast cancer and women with no history of cancer, some decrements may exist in self‐reported cognitive function abilities and performance on computerized tests of attention and memory in women with a history of breast cancer. Understanding similarities and differences in responses between individuals with and without a history of cancer may yield more precise insight into devising therapies for cancer survivors that aim to mitigate the effects of treatments on cognitive function in this population.Support or Funding InformationThis work was supported by Elon University Faculty Research and Development funds.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

BackgroundPopulation ageing, changes to the profiles of life-limiting illnesses and evolving societal attitudes prompt a critical evaluation of models of palliative care. We set out to identify evidence-based models of palliative care to inform policy reform in Australia.MethodA rapid review of electronic databases and the grey literature was undertaken over an eight week period in April-June 2012. We included policy documents and comparative studies from countries within the Organisation for Economic Co-operation and Development (OECD) published in English since 2001. Meta-analysis was planned where >1 study met criteria; otherwise, synthesis was narrative using methods described by Popay et al. (2006).ResultsOf 1,959 peer-reviewed articles, 23 reported systematic reviews, 9 additional RCTs and 34 non-randomised comparative studies. Variation in the content of models, contexts in which these were implemented and lack of detailed reporting meant that elements of models constituted a more meaningful unit of analysis than models themselves. Case management was the element most consistently reported in models for which comparative studies provided evidence for effectiveness. Essential attributes of population-based palliative care models identified by policy and addressed by more than one element were communication and coordination between providers (including primary care), skill enhancement, and capacity to respond rapidly to individuals’ changing needs and preferences over time.ConclusionModels of palliative care should integrate specialist expertise with primary and community care services and enable transitions across settings, including residential aged care. The increasing complexity of care needs, services, interventions and contextual drivers warrants future research aimed at elucidating the interactions between different components and the roles played by patient, provider and health system factors. The findings of this review are limited by its rapid methodology and focus on model elements relevant to Australia’s health system.