Prognosis Discussion and Referral to Community Palliative Care Services in Patients with Advanced Pancreatic Cancer Treated in a Tertiary Cancer Centre.

Advanced pancreatic cancer is associated with a poor prognosis, often less than 1 year. Honest prognosis discussions guide early community palliative care services input, facilitating timely advance care planning and improving quality of life. The aims were to assess if patients were offered prognosis discussions and community palliative care services referral.

Relevant Study: Patient and Clinician Perspectives on Clinically-Meaningful Outcomes in Advanced Pancreatic Cancer.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a poor prognosis and significant symptom burden. This prospective observational study aimed to evaluate expectations and priorities of patients with advanced PDAC and their clinicians through a study survey and two quality of life (QoL) questionnaires (QLQ-C30 and PAN26) at three time-points: baseline (T1), before (T2) and after (T3) their 1st on-treatment CT scan. Over a 1-year period, 106 patients were approached, 71 patients and 12 clinicians were recruited.

Interventions pathways to reduce tuberculosis-related stigma: a literature review and conceptual framework.

Background: Prevention of tuberculosis (TB)-related stigma is vital to achieving the World Health Organisation's End TB Strategy target of eliminating TB. However, the process and impact evaluation of interventions to reduce TB-stigma are limited. This literature review aimed to examine the quality, design, implementation challenges, and successes of TB-stigma intervention studies and create a novel conceptual framework of pathways to TB-stigma reduction.

The Impact of Gallium DOTA PET/CT in Managing Patients With Sporadic and Familial Pancreatic Neuroendocrine Tumours.

Objective: Pancreatic neuroendocrine tumours (panNETs) arise sporadically or as part of a genetic predisposition syndrome. CT/MRI, endoscopic ultrasonography and functional imaging using Octreoscan localise and stage disease. This study aimed to evaluate the complementary role of Gallium (Ga)-DOTA PET/CT in managing patients with panNETs.

Knowledge, attitudes, and perceptions of nurse practitioners about antibiotic stewardship.

Background: Antibiotic stewardship (ABS) is a set of strategies to optimize antimicrobial use while reducing antibiotic resistance, improving patient outcomes, and decreasing unnecessary costs. Nurse practitioners (NPs) play an essential role in health care education and represent a valuable potential resource for ABS efforts.

Purpose: The purpose of this study was to describe the knowledge, attitudes, and perceptions of NPs toward ABS.

Clinical nursing care guidance for management of patient with COVID-19.

COVID-19 is a highly contagious disease, which has human-to-human transmission through droplet and contact. It is commonly manifested as fever, dry cough, myalgia, and dyspnoea; the severity of this disease may range from mild, severe to a critical-illness. Currently, there is no definitive treatment or vaccine for COVID-19.

Educating Patients About Opioid Disposal: A Key Role for Perianesthesia Nurses.

Purpose: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication.

Design: Mixed methods design with a chart review and structured phone interview.

Methods: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them.

Identification of patients with pancreatic adenocarcinoma due to inheritable mutation: Challenges of daily clinical practice.

Background: Identification of germ-line mutations in pancreatic ductal adenocarcinoma (PDAC) could impact on patient/family.

Aim: To assess the referral pathways for genetic consultations in PDAC.

Methods: Electronic records of PDAC patients were reviewed retrospectively.

Carboplatin in Combination with Oral or Intravenous Etoposide for Extra-Pulmonary, Poorly-Differentiated Neuroendocrine Carcinomas.

Background: Carboplatin-etoposide (CarboEtop) is a 1st-line option for patients with advanced extra-pulmonary (EP), poorly-differentiated (PD) neuroendocrine carcinoma (NEC). Different schedules are used in clinical practice and randomised evidence is lacking.

Objectives: To provide real-life outcomes of carboplatin combined with oral or intravenous (IV) etoposide (Etop) in advanced EP-PD-NEC, from 2 specialist centres.

Alcohol Withdrawal Syndrome: Improving Recognition and Treatment in the Emergency Department.

Alcoholism continues to be a persistent health problem in the United States, accounting for up to 62% of emergency department (ED) visits. This quality improvement (QI) project examined whether identifying the benefit for early use of Alcohol Use Disorders Identification Test (AUDIT C) and Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIW-ar) in the ED would avoid escalation of care and offset poor outcomes of alcohol withdrawal syndrome (AWS). A preimplementation chart review (N = 99) showed an average of 12%-15% of patients requiring escalation of care at the project site.

Sorafenib as first-line therapy in patients with advanced Child-Pugh B hepatocellular carcinoma-a meta-analysis.

Background: Sorafenib has demonstrated survival benefit in first-line treatment of advanced hepatocellular carcinoma (HCC); utility of sorafenib in patients with advanced HCC and Child-Pugh B (CP-B) liver function remains a subject of debate.

Methods: A systematic review identified studies using first-line sorafenib in patients with advanced HCC and CP-A/B liver function. Meta-regression analysis comprising linear regression was conducted to explore the association between the baseline factors and overall survival (OS).

Somatostatin analogue-induced pancreatic exocrine insufficiency in patients with neuroendocrine tumors: results of a prospective observational study.

Background: Patients with advanced well-differentiated neuroendocrine tumours (Wd-NETs) are commonly treated with somatostatin analogues (SSAs). Some patients may develop SSA-related side effects such as pancreatic exocrine insufficiency (PEI).

Methods: In this prospective, observational study, the frequency of SSA-induced PEI in 50 sequential patients with advanced Wd-NETs treated with SSAs was investigated.

Properties of a New Nanofiber Restorative Composite.

A new nanofiber-reinforced hybrid composite (NovaPro Fill, Nanova) was recently introduced with reportedly improved mechanical properties. The purpose of this study was to compare the properties (flexural strength/modulus, degree of conversion [DC], depth of cure, and polymerization shrinkage) of the nanofiber composite to those of traditional hybrid composites (Filtek Z250, 3M ESPE; Esthet-X HD, Dentsply). To determine flexural strength and modulus, composite was placed in a rectangular mold, light-cured, stored for 24 hours, and then fractured in a universal testing machine.

Bond strength of silorane- and methacrylate-based composites to resin-modified glass ionomers.

This study evaluated the shear-bond strength of a resin-modified glass ionomer (RMGI) restorative material to a new silorane-based composite and a methacrylate-based composite in a sandwich technique with various combinations of surface treatments and bonding agents. Two composites, 2 bonding agents and 4 surface preparations were used to create 16 groups with 10 specimens each. After 24 hours storage at 37°C in 100% humidity, the specimens were tested for shear bond strength; means and standard deviations were determined per group.

The structure, thermal properties and phase transformations of the cubic polymorph of magnesium tetrahydroborate.

The structure of the cubic polymorph of magnesium tetrahydroborate (γ-Mg(BH(4))(2)) has been determined in space group Ia3d from a structural database of the isoelectronic compound SiO(2); this has been corroborated by DFT calculations. The structure is found to concur with that recently determined by Filinchuk et al. (Y.

A multidisciplinary combinatorial approach for tuning promising hydrogen storage materials towards automotive applications.

HyStorM is a multidisciplinary hydrogen-storage project aiming to synthesise and tune materials hydrogen storage properties for automotive applications. Firstly, unique high-throughput combinatorial thin-film technologies are used to screen materials' hydrogen storage properties. Then promising thin-film candidate compositions are synthesised and examined in the bulk.

Conscientious objection: justified or just refusal to care?

In general terms, healthcare professionals are not at liberty to refuse to care for any patient (UKCC 2004). However, as the law permits patients to do what is morally and ethically right for them with regard to termination of pregnancy, it must also extend this right to the healthcare professional. The Abortion Act (1967, Section 4 (i)) permits healthcare professionals to refuse participation on the grounds of conscientious objection.

A new series of sodium cobalt oxyhydrates.

We report a new series of sodium cobalt oxyhydrates that contains the same two dimensional building blocks as superconducting NaxCoO2.yH2O. The absence of superconductivity emphasises the importance of the CoO2 stacking arrangement on the resultant electronic properties.

Hydrochemical stratification in flooded underground mines: an overlooked pitfall.

The fact that flooded underground mines are commonly hydrochemically stratified is often not appreciated. Water samples taken from the water surface in partly flooded shafts are often wrongly assumed to represent the water quality existing throughout the entire water column. In some cases, treatment systems have been designed on the basis of these often misleading water surface samples.

The Home Office and random allocation experiments.

By examining the history of the random experiment in the Home Office in the United Kingdom, this article demonstrates that research is not an altogether rational process and that fashion, personality, and politics are at least as important as science and evidence when setting research and policy programs and determining methodologies. The article also shows that even in 1970, the research world was a village and that issues and fashions on one side of it could determine the outcome of decisions on the other side, even though they had no direct relevance. On a more optimistic note, the article shows how the fashions go in cycles so that if you could not get the research funded in the last cycle, just wait 20 years for the cycle to come around and try again.

Techniques for hazard analysis and their use at CERN.

CERN, The European Organisation for Nuclear Research is situated near Geneva and has its accelerators and experimental facilities astride the Swiss and French frontiers attracting physicists from all over the world to this unique laboratory. The main accelerator is situated in a 27 km underground ring and the experiments take place in huge underground caverns in order to detect the fragments resulting from the collision of subatomic particles at speeds approaching that of light. These detectors contain many hundreds of tons of flammable materials, mainly plastics in cables and structural components, flammable gases in the detectors themselves, and cryogenic fluids such as helium and argon.