Activity

This article aims to update nurses on the incidence, diagnosis, and treatment of neutropenic sepsis and septic shock.

A search of electronic databases, including PubMed and CINAHL, and e-books was performed, as was a search of clinically focused and point-of-care resources from the National Cancer Institute and UpToDate until December 2020.

Neutropenic sepsis and septic shock are oncological emergencies and can be fatal for patients undergoing anticancer treatment. Prompt and targeted treatment based on clinical signs is necessary to minimize further sequela, including morbidity and mortality.

The oncology nurse must possess an understanding of the risk factors, presenting signs, and initial management of a neutropenic fever, sepsis, and septic shock. Early identification and initiation of treatments in patients in sepsis and septic shock will allow the oncology nurse to intervene with speed, skill, and confidence while working within the multidisciplinary team to provide the best outcome based on current evidence.

The oncology nurse must possess an understanding of the risk factors, presenting signs, and initial management of a neutropenic fever, sepsis, and septic shock. Early identification and initiation of treatments in patients in sepsis and septic shock will allow the oncology nurse to intervene with speed, skill, and confidence while working within the multidisciplinary team to provide the best outcome based on current evidence.

To develop and evaluate the psychometric properties of an instrument assessing beliefs in physical activity based on the integration of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) among (pre)frail older adults.

A literature review and semi-structured interviews were conducted to generate the initial item pool of the instrument. A rural sample of 611 (pre)frail older adults was enrolled to examine the validity and reliability of the instrument.

The exploratory factor analysis extracted eight factors for this instrument, explaining 71.3% of the variance in beliefs in physical activity. The confirmatory factor analysis confirmed the eight-factor structure. Linear regression models found that the integrated HBM-TPB constructs explained 65.9% of the variance in physical activity intention and 13.6% in physical activity. The Cronbach’s alpha coefficients for the factors ranged from 0.80 to 0.98, and ICCs ranged from 0.71 to 0.85.

This instrument has satisfactory construct validity, predictive validity, internal consistency reliability and test-retest reliability, and it can be used in (pre)frail older adults to measure beliefs in physical activity.

This instrument may help health care providers understand beliefs in physical activity and facilitate targeted interventions among (pre)frail older adults.

This instrument may help health care providers understand beliefs in physical activity and facilitate targeted interventions among (pre)frail older adults.

Poor patient-provider communication, among other reasons, is a notable barrier to contraceptive decision-making among Latinas. Patient-centered approaches to contraceptive counseling that optimize communication align with shared decision-making (SDM) -which is associated with satisfaction and continued contraceptive use among various populations.

To examine associations of patient-provider communication and importance of SDM tenets with consistent contraceptive use among a population of Latinas.

Formative work for this study included prior qualitative and quantitative research with Latinas who expressed the importance of patient-provider communication during contraceptive counseling and therefore were instrumental in problem definition.

Cross-sectional surveys were administered to Latinas ages 15-29 years. Patient-provider communication, patient-reported importance of specific SDM tenets, and consistent contraception use were measured and analyzed for associations.

103 Latinas (mean age=21.4) particng techniques such as SDM as they seek to provide patient-centered care during contraceptive counseling for this patient population.

Results from this research demonstrate that patient-centered communication is highly valued by Latina study participants and is an important consideration in their contraceptive counseling. MM-102 price Clinicians should consider employing techniques such as SDM as they seek to provide patient-centered care during contraceptive counseling for this patient population.

The main treatment of primary cutaneous melanoma is surgery. This review aims to assess the width of excision margin that minimises the risk of adverse outcome from surgery, locoregional recurrence, distant recurrence, and death.

PRISMA guidelines were followed. MEDLINE, EMBASE, and four other databases were searched by using the term “melanoma”, “margin”, and limiting the search to randomised clinical trials (RCTs).

Seven RCTs involving 4579 patients data were analysed. No statistically significant difference was found in locoregional recurrence RR 1.09 (95%CI 0.98-1.22, p=0.12), local recurrence RR 1.20 (95%CI 0.66-2.21, p=0.55), in-transit metastasis RR1.30 (95%CI 0.86-1.97, p=0.21), regional nodal metastasis RR 1.04 (95%CI 0.91-1.18, p=0.56), distant metastasis RR 0.95 (95%CI 0.72-1.24, p=0.68), death RR 1.00 (95%CI 0.93-1.07, p=0.97), death from melanoma RR 1.11 (95%CI 0.96-1.28, p=0.16), wound infection RR 1.22 (95%CI 0.68-2.17, p=0.50), and wound dehiscence RR 0.96 (95%CI 0.54-1.71, p=0.88) when regards to Breslow thickness and other prognostic factors and are in progress.The phase 3 PROfound trial led to the recent approval of the PARP inhibitor olaparib for men with metastatic castration-resistant prostate cancer and mutations in homologous recombination repair genes. We raise methodological concerns about the trial, including a suboptimal control arm, problematic use of crossover, use of radiographic progression-free survival as the primary endpoint, and ambiguous benefit for patients with mutations in homologous recombination repair genes other than BRCA1, BRCA2, and ATM.Men with metastatic germ cell tumors undergoing chemotherapy are at high risk of venous thromboembolic events and low risk of bleeding. A central venous-access device should be avoided whenever possible. Thromboprophylaxis may be prescribed after balancing the risks and benefits for each individual patient.