Objectives: To develop a digital intervention to prompt, support, and respond to the outcomes of total skin self-examinations (TSSEs) at home by people treated for cutaneous melanoma.
Design: A complex intervention development study.
Setting: Northeast Scotland.
Participants: Semistructured scoping interviews; people previously treated for cutaneous melanoma (n=21). Pilot testing: people treated for melanoma stages 0-2C (n=20); general practitioners (n=6); and a nurse specialist in dermatology (n=1).
Intervention: A tablet-based digital intervention designed to prompt and support TSSEs comprising instructional videos and electronic reporting (including photographs) to a clinical nurse specialist in dermatology, with subsequent clinical triage.
Primary And Secondary Outcome Measures: Qualitative assessment of intervention feasibility and acceptability, and quantitative assessment of intentions and confidence to perform TSSEs in pilot participants.
Results: The majority of pilot participants were strongly positive and adhered well to the intervention (n=15), with 7 of these reporting symptoms of concern at some point during the 6-month pilot. 4 patients complied intermittently, 3 reporting skin problems at least once during the pilot, and 1 withdrew. 2 patients underwent skin surgery as a result of participating in the pilot, with 1 diagnosed as having a recurrent melanoma and the other, a benign lesion. A number of practical issues to improve the usability of the intervention were identified. The proportion of participants reporting intention to check their skin at least monthly increased during the intervention as did confidence to conduct a skin check.
Conclusions: People previously treated for cutaneous melanoma are prepared to use digital technology to support them in conducting TSSE. An intervention has been developed which is practical, effective and safe, and after addressing minor practical issues, could now be evaluated for clinical outcomes in a randomised clinical trial.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538247 | PMC |
http://dx.doi.org/10.1136/bmjopen-2015-007993 | DOI Listing |
JBJS Case Connect
October 2024
Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
Case: A pediatric patient with focal fibrocartilaginous dysplasia (FFCD) developed angular deformity and growth arrest despite standard guided growth management. The patient underwent implant-mediated guided growth for proximal tibia varus deformity which recurred; subsequently, a physeal bar of the medial proximal tibia was diagnosed, which progressed to physeal arrest.
Conclusion: Treatment options for FFCD-associated angular deformity include observation and guided growth.
Neurology
January 2025
Faculty of Medicine, University of Geneva, Switzerland.
Early detection of focal cortical dysplasia (FCD) using brain MRI in young children presenting with drug-resistant epilepsy may facilitate prompt surgical treatment, resulting in better control of seizures and decreased associated cognitive difficulties. Characteristics of FCD described in the literature are predominantly based on MRI findings in a fully myelinated brain; therefore, changes occurring during early brain maturation are not well known. In this case report, we describe distinct MRI features of a FCD visualized best before completion of myelination of the cortex and subcortical white matter.
View Article and Find Full Text PDFBlood Coagul Fibrinolysis
October 2024
Hematology Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Nowadays, direct oral anticoagulants (DOACs) represent the gold standard for venous thromboembolism (VTE) treatment and VTE secondary prophylaxis; nevertheless, the percentage of elderly patients in major trials and literature data about DOACs usage for VTE secondary prophylaxis in the elderly are scant. Our retrospective study tried to evaluate low-dose DOACs efficacy and safety for elderly VTE secondary prophylaxis in a real-life setting. A cohort of 73 patients (≥ 75 years) considered at high risk of VTE recurrence was treated with apixaban 2.
View Article and Find Full Text PDFInt J Methods Psychiatr Res
March 2025
Mental Health, Health Care and Social Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Objectives: We implemented the first national patient experience survey, with novel patient-reported experience measures (PREMs), in out- and inpatient mental health and substance use services in Finland.
Methods: The Outpatient Experience Scale (OPES) and the Inpatient Experience Scale (IPES) were co-designed with experts by experience and professionals. The survey was carried out in 2021 in 435 treatment facilities.
Purpose: The purpose of this study was to describe labor and delivery nurses' experiences in caring for patients during the COVID-19 pandemic.
Methods: We used a descriptive phenomenological design and purposeful sampling to recruit experienced labor and delivery nurses for flexible semi-structured face-to-face audiotaped interviews. Constant comparison was used to analyze data.
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