A preconception cohort study of sugar-sweetened beverage consumption and semen quality.

Background: Dietary factors, including high sugar intake, may have adverse effects on male reproduction. Studies of the association between sugar-sweetened beverage (SSB) intake and semen quality have reported inconsistent results.

Objective: We estimated the effects of SSB consumption on semen quality in a North American preconception cohort study.

Uncovering the Risks of Anticancer Therapy Through Incident Report Analysis Using a Newly Developed Medical Oncology Incident Taxonomy.

Background: Incident reporting systems were developed to identify possible and actual harm in healthcare facilities. They have the potential to capture important safety trends and to enable improvements that can mitigate the risk of future patient harm and suffering. We recently developed and validated a taxonomy specific for medical oncology designed to enhance the identification, tracking, and trending of incidents that may lead to patient harm.

A North American study of anthropometric factors and semen quality.

Objective: To evaluate the association between anthropometric measures and semen parameters.

Design: Cross-sectional study.

Subjects: Male participants aged ≥21 years.

Improving Home Caregiver Independence With Central Line Care for Pediatric Cancer Patients.

Objective: Home caregivers (eg parents) of pediatric patients with cancer with external central lines (CL) must carefully maintain this device to prevent complications. No guidelines exist to support caregiver skill development, assess CL competency, follow-up after initial CL teaching, and support progress over time. We aimed to achieve >90% caregiver independence with CL care within 1 year through a family-centered quality improvement intervention.

Resident-Reported Impact of a Novel Oncology Curriculum for Internal Medicine Residents.

The Accreditation Council of Graduate Medical Education mandates that all internal medicine residents gain exposure to internal medicine subspecialties including hematology and oncology. While many residents meet this criterion through inpatient oncology rotations, the current structure of many inpatient oncology rotations leaves little opportunity for formal education. We therefore designed a novel oncology curriculum consisting of one-page oncology teaching sheets to increase the number, breadth, and quality of formal teaching sessions on our resident inpatient oncology services.

Early Findings on the Use of Clinical Pathways for Management of Unwarranted Variation in Cancer Care.

Clinical pathways have the potential to improve complex clinical decision-making in cancer care. The authors implemented pathways with customized content to assist oncologists to select treatments, aiming for an on-pathway rate of 70%-85%. Treatment decisions were captured as on or off pathway, and metrics were shared monthly with users.

The Future of Teaching Epidemiology.

The rapid pace of technological advancements and the corresponding societal innovations and adaptations make it difficult to predict how teaching epidemiology will look in the coming decades. We discuss changes in the teaching of epidemiology that are currently unfolding. First, typical epidemiology curricula often lack formal instruction in important components of causal thinking, such as the formulation of well-defined research questions.

Role of Adverse Events in Unscheduled Hospitalizations Among Patients With Solid Tumors Who Receive Medical Oncology Treatment.

Purpose: The development of strategies to prevent or mitigate cancer treatment-related adverse events (AEs) is necessary to improve patient experience, safety, and cost containment. To develop a strategy to easily identify and mitigate AEs, we sought to understand the frequency and severity of those that resulted in hospitalizations.

Methods: We retrospectively characterized hospitalizations of ambulatory adult patients with solid tumor cancers within 30 days of chemotherapy administration using medical record data abstraction.

Slow Gait Speed and Risk of Long-Term Nursing Home Residence in Older Women, Adjusting for Competing Risk of Mortality: Results from the Study of Osteoporotic Fractures.

Objectives: To determine whether slow gait speed increases the risk of costly long-term nursing home residence when accounting for death as a competing risk remains unknown.

Design: Longitudinal cohort study using proportional hazards models to predict long-term nursing home residence and subdistribution models with death as a competing risk.

Setting: Community-based prospective cohort study.

Characteristics Associated with In-Hospital Death among Commercially Insured Decedents with Cancer.

Background: A majority of patients with poor-prognosis cancer express a preference for in-home death; however, in-hospital deaths are common.

Objective: We sought to identify characteristics associated with in-hospital death.

Design: Case series.

Novel Data Sharing Between a Comprehensive Cancer Center and a Private Payer to Better Understand Care at the End of Life.

Context: Understanding end-of-life (EOL) care patterns is a prerequisite to improving the experience for cancer patients. EOL measures endorsed by the National Quality Forum (NQF) have been examined in older patients using Medicare claims.

Objectives: To evaluate EOL care for patients treated at a comprehensive cancer center, using private payer claims data.

Feasibility of 24-Hr Urine Collection for Measurement of Biomarkers in Community-Dwelling Older Adults.

Biologic markers are becoming a key part of gerontological research, including their measurement at multiple intervals to detect changes over time. This report examined the feasibility and quality of 24-hr urine collection to measure neuroendocrine biomarkers in a community-based sample of older caregivers and non-caregivers. At each interview, participants were instructed on the correct method to collect and store the sample.

Understanding Oral Chemotherapy Prescribing Patterns at the End of Life at a Comprehensive Cancer Center: Analysis of a Massachusetts Payer Claims Database.

Purpose: Receipt of chemotherapy in the last 14 days of life is a measure of potential overuse of care. Specific measures defining appropriate end-of-life use of oral agents have not yet been described, and little is known about prescribing patterns.

Methods: We conducted an exploratory analysis of 371 patients at Dana-Farber Cancer Institute who were covered by the Blue Cross Blue Shield of Massachusetts pharmacy benefit and died during 2012 to 2013.

Longitudinal and Reciprocal Relationships Between Depression and Disability in Older Women Caregivers and Noncaregivers.

Purpose Of The Study: Depressive symptoms and disability each increase the risk of the other, yet few studies have examined reciprocal associations between these conditions in a single study, or over periods longer than 3 years. These associations may differ in older caregivers due to chronic stress, health characteristics, or factors related to caregiving.

Design And Methods: Structural equation models were used to investigate relationships between depressive symptoms and disability over 3 interviews spanning 6 years among 956 older women (M = 81.

Assessing the agreement between 3-meter and 6-meter walk tests in 136 community-dwelling older adults.

Objective: Walking speed is an important marker of functionality that is measured over courses of varying lengths, but it is unclear if course length affects measured pace.

Method: A total of 136 older adults completed two consecutive trials each of 3-m and 6-m walking courses, the order of which was randomly assigned. We calculated concordance correlation coefficients (CCC) and created Bland-Altman plots to evaluate the relationship between the two course distances.

Impact of a single nucleotide polymorphism upstream of the IL28B gene in patients positive for anti-HCV antibody in an HCV hyperendemic area in Japan.

The influence of genetic variation at the interleukin-28B (IL28B) locus on the natural course of hepatitis C virus (HCV) infection has not been fully investigated. The goal of this study was to examine whether an IL28B polymorphism (rs8099917) is associated with natural clearance of HCV and with disease parameters of HCV infection in an HCV hyperendemic area of Japan. The patients were 502 anti-HCV antibody-positive residents who participated in liver disease screening program from 2002 to 2004.

Perceptions of medical errors in cancer care: an analysis of how the news media describe sentinel events.

Objective: To analyze the print news media's coverage of sentinel events involving cancer patients.

Methods: Using LexisNexis, we identified English-language newspaper articles covering medical errors in cancer care between January 1, 2000, and December 31, 2010. Articles were coded for 3 major themes using a standardized abstraction instrument: narrative statements and point of view most prominently represented, attribution of blame, and orientation toward patient safety.

Positive affect is associated with fewer sleep problems in older caregivers but not noncaregivers.

Purpose Of The Study: Older adults who are depressed or are caregivers experience more sleep problems, whereas recent studies suggest that adults with high positive affect (PA) have fewer sleep problems. This study examined whether the associations of PA and depressive symptoms with sleep problems differed between caregivers and noncaregivers.

Design And Methods: Face-to-face interviews were conducted with 92 caregivers to a relative or friend with Alzheimer's disease or Parkinson's disease, and 137 noncaregivers aged 60 years and older (mean 73.

Impact of antibody to hepatitis B core antigen on the clinical course of hepatitis C virus carriers in a hyperendemic area in Japan: A community-based cohort study.

Aim: Subjects positive for antibody to hepatitis B core antigen (HBcAb) and negative for hepatitis B surface antigen (HBsAg) are considered to have occult hepatitis B virus (HBV) infection. The aim of this study was to determine the impact of occult HBV infection on aggravation of the clinical course in hepatitis C virus (HCV) carriers.

Methods: A prospective cohort study was performed in 400 subjects who were positive for anti-HCV antibody and negative for HBsAg.

Factors associated with pain among ambulatory patients with cancer with advanced disease at a comprehensive cancer center.

Purpose: The prevalence and severity of pain have not been well described among oncology patients in ambulatory care. To better understand the burden of pain among patients with advanced cancer, we examined the prevalence of pain reported during office and treatment visits.

Methods: A retrospective study of 4,014 patients with advanced disease (stage 4 at diagnosis or metastatic progression) who completed an ambulatory visit between 2004 and 2006 was conducted at a comprehensive cancer center in Boston, Massachusetts.

Comparing clinicians' use of an anticoagulation management service and usual care in ambulatory oncology.

Purpose: There is no consensus in the oncology community about the optimal model for anticoagulation management of ambulatory cancer patients. To understand oncologists' preferences regarding anticoagulation management, we compared the characteristics of patients referred to an oncology-oriented anticoagulation management service with "usual care" patients managed by the patient's primary oncologist.

Methods: We performed a retrospective medical record review of ambulatory oncology patients' anticoagulation care at a comprehensive cancer center.

Job strain and incident metabolic syndrome over 5 years of follow-up: the coronary artery risk development in young adults study.

Background: Theories of stress-induced metabolic syndrome predict that job strain would increase risk. Few studies have evaluated this association.

Objective: To evaluate the association between job strain and the risk of metabolic syndrome.