Birthing parent perspectives on measuring the quality of perinatal care: metrics, timing, and process.

Objective: Centering birthing parents is critical for improving reproductive health policies and practices. This study investigates patient perspectives on measuring the quality of perinatal care.

Methods: A cross-sectional qualitative research study was conducted at an academic medical center in the Southeastern United States.

Target trial emulation to evaluate the effect of immune-related adverse events on outcomes in metastatic urothelial cancer.

Background: Immune checkpoint inhibitors (ICIs) are an important therapeutic pillar in metastatic urothelial carcinoma (mUC). The occurrence of immune-related adverse events (irAEs) appears to be associated with improved outcomes in observational studies. However, these associations are likely affected by immortal time bias and do not represent causal effects.

Birthing parent and companion verbal reactions following interactions with inpatient postpartum health care team members: an observational study using naturalistic filming.

Background: Respectful, equitable, and supportive health care team interactions with patients and their companions are a key part of quality health care services. Despite the importance of communication and other aspects of engagement during inpatient postpartum care, little is known about how care is experienced during this period from families' perspectives.

Methods: This study collected video and audio data with 15 birthing families (n = 9 English-speaking and n = 6 Spanish-speaking) and their health care team members during inpatient postpartum care in a southeastern United States academic medical center.

Discrimination of T-stage using tumor weight and size - a potential approach to guide perioperative decision making in patients with bladder cancer.

Introduction: To examine the value of tumor size, weight, and density in predicting pathological tumor stage in patients with suspected bladder cancer (BCa), minimize interobserver variability of estimated tumor size, and thus provide a more objective instrument to describe the extent of local tumor growth.

Methods: An institutional dataset of 588 consecutive patients undergoing TUR-BT for suspected BCa from 05/2016 - 09/2018 was used. Separate Mann-Whitney-U tests examined differences in each unit between non-muscle-invasive (NMIBC) and muscle-invasive BCa (MIBC) and between Ta/CIS and T1 NMIBC.

Adjuvant Immune Checkpoint Inhibitors for Muscle-Invasive Urothelial Carcinoma: An Updated Systematic Review, Meta-analysis, and Network Meta-analysis.

Context: Adjuvant immune checkpoint inhibitors (ICIs) have recently emerged as guideline-recommended treatments of high-risk muscle-invasive urothelial carcinoma (MIUC). However, there is limited evidence regarding the optimal candidates and the differential efficacy of adjuvant ICI regimens.

Objective: To synthesize and compare the efficacy and safety of adjuvant ICIs for high-risk MIUC using updated data from phase III randomized controlled trials.

Feedbacks Regulating the Salinization of Coastal Landscapes.

The impact of saltwater intrusion on coastal forests and farmland is typically understood as sea-level-driven inundation of a static terrestrial landscape, where ecosystems neither adapt to nor influence saltwater intrusion. Yet recent observations of tree mortality and reduced crop yields have inspired new process-based research into the hydrologic, geomorphic, biotic, and anthropogenic mechanisms involved. We review several negative feedbacks that help stabilize ecosystems in the early stages of salinity stress (e.

Postpartum menstrual equity: Video and audio analysis of vaginal bleeding counseling during postpartum inpatient care at a southeastern US tertiary hospital.

Background: Despite the universal nature of postpartum vaginal bleeding after childbirth and the importance of managing vaginal bleeding in the postpartum period to monitor health status, little is known about the information or products that birthing individuals are provided. Investigating current practices may offer insights to enacting more supportive and equitable postpartum care.

Objective: To evaluate the patterns and content of vaginal bleeding counseling provided to birthing parents while on a postnatal inpatient unit.

Effects of changing farming practices in African agriculture.

Information on the effects of changing agricultural management on crop and livestock performance is critical for developing evidence-based policies, investments, and programs. Evidence for Resilient Agriculture (ERA) v1.0.

Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare.

Background: Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical care, which may contribute to a reliance on acute care. One approach to improving postpartum health is to investigate birthing parents' accounts of acute care use in the months after birth, which is what we did in this study.

Urinary continence outcomes, surgical margin status, and complications after radical prostatectomy in 2,141 German patients treated in one high-volume inpatient rehabilitation clinic in 2022.

Purpose: To identify independent predictors of urinary continence and report early complications after radical prostatectomy (RP) in a large, contemporary German cohort.

Methods: Urinary incontinence data of patients undergoing 3-week inpatient rehabilitation (IR) after RP were prospectively assessed by 24-hr pad test and uroflowmetry at the beginning and the end of IR, respectively. Lymphoceles were assessed prospectively by ultrasound.

Immune-Related Adverse Events Can Predict Progression-Free and Overall Survival In Patients With Metastatic Renal Cell Carcinoma Treated With Immune Checkpoint Inhibitors.

Background: Different combination therapies using anti - PD-1 / PD-L1 or CTLA-4 immune checkpoint inhibition (ICI) are widely used in patients with metastatic renal cell carcinoma (mRCC). In the absents of established biomarkers, immune-related adverse events (irAEs) have been discussed as potential predictors of response.

Methods: In this retrospective cohort study, data of 134 patients with mRCC undergoing ICI treatment (Nivolumab, Ipilimumab and Nivolumab, Pembrolizumab and Axitinib or Avelumab and Axitinib) between 2015 and 2021 were analyzed.

Birthing Parent Experiences of Postpartum at-Home Blood Pressure Monitoring Versus Office-Based Follow up After Diagnosis of Hypertensive Disorders of Pregnancy.

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7-10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy.

Identification of postpartum symptom informedness and preparedness typologies and their associations with psychological health: A latent class analysis.

Background: Birthing parents, defined as postpartum women and people with various gender identities who give birth, commonly experience challenging postpartum symptoms. However, many report feeling uninformed and unprepared to navigate their postpartum health.

Objective: To identify typologies of postpartum symptom informedness and preparedness using latent class analysis (LCA) and to examine the associated patient and healthcare characteristics.

Psychosocial distress after radical prostatectomy, radical cystectomy, or (partial) nephrectomy - a comprehensive analysis of 4,290 German cancer patients during the COVID-19 pandemic.

Aim: To evaluate and identify predictors of psychosocial distress (PD) in patients after surgical treatment for prostate cancer (PC), bladder cancer (BC), or kidney cancer (KC) during the COVID-19 pandemic in a large, multi-institutional cohort.

Material And Methods: Patients undergoing inpatient rehabilitation (IR) after radical prostatectomy (RP), radical cystectomy (RC), or (partial) nephrectomy in one IR center in 2021 were included. PD was evaluated by the Questionnaire on Stress in Cancer Patients (QSC-R23) at the beginning (T1) and the end (T2) of IR.

Thromboprophylaxis during neoadjuvant chemotherapy for bladder cancer reduces thromboembolism and bleeding.

Objectives: To assess the risk of venous thromboembolic events (VTEs) and bleeding with or without thromboprophylaxis during neoadjuvant chemotherapy in bladder cancer patients scheduled for radical cystectomy.

Materials And Methods: We conducted a retrospective cohort study in 4886 patients with non-metastatic bladder cancer undergoing cystectomy across 28 centres in 13 countries between 1990 and 2021. Inverse probability weighting analyses were performed to estimate the effect of thromboprophylaxis on VTE and bleeding.

Side effects of drug-antibody conjugates enfortumab-vedotin and sacituzumab-govitecan in targeted therapy in cancer.

Objective: Antibody-drug conjugates (ADC), enfortumab-vedotin (EV) and sacituzumab-govitecan are new drugs in the treatment of urologic tumors, whose safety profile has not been fully investigated. Therefore, the aim of our study was to evaluate adverse events related to both agents reported to VigiBase, the World Health Organization's global pharmacovigilance database.

Methods: We employed Bayesian disproportionality analysis based on the information component (IC) to explore the safety profile associated with both therapies.

Treating BCG-Induced Cystitis with Combined Chondroitin and Hyaluronic Acid Instillations in Bladder Cancer.

In non-muscle invasive bladder cancer, Bacillus Calmette-Guérin (BCG) responders benefit from strong Th1-type inflammatory and T cell responses mediating tumor rejection. However, the corresponding lack of anti-inflammatory Th2-type immunity impairs tissue repair in the bladder wall and facilitates the development of cystitis, causing urinary pain, urgency, incontinence, and frequency. Mechanistically, the leakage of the glycosaminoglycan (GAG) layer enables an influx of potassium ions, bacteria, and urine solutes towards the underlying bladder tissue, promoting chronic inflammation.

Cultivating Vital Conditions For Perinatal Well-Being And A Sustained Commitment To Reproductive Justice.

Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.

Postpartum Hospital Discharge: Birthing Parent Perspectives on Supportive Practices and Areas for Improvement.

Background: Postpartum hospital care and individualized discharge preparedness should be part of person-focused health services. Yet, there are limited descriptions of birthing parents' experiences to identify clinical practice strengths and opportunities to improve systems of care.

Objective: To explore birthing parents' perspectives on supportive healthcare practices and areas for improvement around postpartum hospital discharge.

Postpartum care in a cardio-obstetric clinic after preterm preeclampsia: patient and healthcare provider perspectives.

Background: Despite the significant disruption and health implications of preterm preeclampsia with severe features for birthing people, little is known about how the system of postpartum care might be strengthened for affected families. Multidisciplinary cardio-obstetric clinics are emerging; however, there is limited research on patient and healthcare provider perspectives.

Objective: To describe patient and healthcare provider perspectives of services in a cardio-obstetric clinic following preterm preeclampsia with severe features.

The optimal number of induction chemotherapy cycles in clinically lymph node-positive bladder cancer.

Objective: To investigate the optimal number of induction chemotherapy cycles needed to achieve a pathological response in patients with clinically lymph node-positive (cN+) bladder cancer (BCa) who received three or four cycles of induction chemotherapy followed by consolidative radical cystectomy (RC) with pelvic lymph node dissection.

Patients And Methods: We included 388 patients who received three or four cycles of cisplatin/gemcitabine or (dose-dense) methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC), followed by consolidative RC for cTanyN1-3M0 BCa. We compared pathological complete (pCR = ypT0N0) and objective response (pOR = yp ≤T1N0) between treatment groups.

Development and implementation of a pregnancy heart team at a Southeastern United States tertiary hospital: a qualitative study.

Background: The United States has seen a significant rise in maternal mortality and morbidity associated with cardiovascular disease over the past 4 decades. Contributing factors may include an increasing number of parturients with comorbid conditions, a higher rate of pregnancy among women of advanced maternal age, and more patients with congenital heart disease who survive into childbearing age and experiencing pregnancy. In response, national medical organizations have recommended the creation of multidisciplinary obstetric-cardiac teams, also known as pregnancy heart teams, to provide comprehensive preconception counseling and coordinated pregnancy management that extend through the postpartum period.

Use of Postpartum Hemorrhage Checklist during Vaginal Deliveries: A Quality Improvement Study.

Objective:  Postpartum hemorrhage (PPH) protocols improve patient safety and reduce utilization of blood products; however, few data exist on sustainability of PPH checklist use, how use affects care delivery, and variation of use among patient subgroups. This study aimed to (1) examine compliance with PPH checklist use during vaginal deliveries, (2) evaluate whether checklist use varied by patient and/or care team characteristics, and (3) evaluate whether checklist use was associated with increased use of recommended medications/interventions.

Study Design:  This was a quality improvement study performed from April 2021 through June 2023.

Improvements in urinary symptoms, health-related quality of life, and psychosocial distress in the early recovery period after radical cystectomy and urinary diversion in 842 German bladder cancer patients: data from uro-oncological rehabilitation.

Purpose: This study aims to investigate urinary symptoms (continence and stoma care), health-related quality of life (HRQoL) and psychosocial distress (PD) in the early postoperative period after radical cystectomy (RC) and urinary diversion for ileal conduit (IC) and ileal neobladder (INB) to obtain a better basis for patient counseling.

Methods: Data for 842 bladder cancer patients, who underwent 3 weeks of inpatient rehabilitation (IR) after RC and urinary diversion (447 IC, 395 INB) between April 2018 and December 2019 were prospectively collected. HRQoL, PD, and urinary symptoms were evaluated by validated questionnaires at the beginning (T1) and the end of IR (T2).

Community responses to persons with aphasia participating in CoActive therapeutic theatre: A pilot study.

Background: Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised.

Aims: The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy.