With cancer incidence increasing over time worldwide, attention to the burden of psychiatric and psychosocial consequences of the disease is now mandatory for both cancer and mental health care ...professionals. Psychiatric disorders have been shown to affect at least 30-35% of cancer patients during all phases of the disease trajectory, and differ in nature according to stage and type of cancer. Other clinically relevant distressing psychosocial and existential conditions (e.g. demoralisation, health anxiety, loss of meaning and existential distress) not included as 'disorders' in the usual diagnostic and nosological systems (i.e. meta-diagnostic conditions) have also been shown to be present in another 15-20% of cancer patients. In this editorial, we will present a summary of the extensive literature regarding the epidemiology of the several psychosocial disorders affecting cancer patients as a cause of distress and burden to be taken into consideration and addressed in cancer care through evidence-based intervention.
Starting from the practical viewpoint of, "I would rather be approximately right than perfectly wrong" this book provides a commonsense comprehensive framework for small business valuation that ...offers solutions to common problems faced by valuators and consultants both in performing valuations and providing ancillary advisory services to business owners, sellers, and buyers. If you conduct small business valuations, you may be seeking guidance on topics and problems specific to your work. Focus on What Matters: A Different Way of Valuing a Small Business fills a previous void in valuation resources. It provides a practical and comprehensive framework for small and very small business valuation (Companies under $10 million of revenues and often under $5 million of revenues), with a specialized focus on the topics and problems that confront valuators of these businesses. Larger businesses typically have at least Reviewed Accrual Accounting statements as a valuation starting point. However, smaller businesses rarely have properly reviewed and updated financials. Focus on What Matters looks at the issue of less reliable data, which affects every part of the business valuation. You'll find valuation solutions for facing this challenge. As a small business valuator, you can get direction on working with financial statements of lower quality. You can also consider answers to key questions as you explore how to value each small business. * Is this a small business or a job? * How much research and documentation do you need to comply with standards? * How can you use cash basis statements when businesses have large receivables and poor cutoffs? * Should you use the market method or income method of valuation? * Techniques that improve reliability of the market method multiplier * How might you tax affect using the income method with the advent of the Estate of Jones and Section 199A? * Do you have to provide an opinion of value or will a calculation work? * How do you calculate personal goodwill? * As a valuation professional how can you bring value to owners and buyers preparing to enter into a business sale transaction? * How does the SBA loan process work and why is it essential to current small business values? * What is the business brokerage or sale process and how does it work? * How do owners increase business value prior to a business sale? This book examines these and other questions you may encounter in your valuation process. You'll also find helpful solutions to common issues that arise when a small business is valued.
Although depression and mood-related disorders are common in persons with cancer, these conditions remain frequently overlooked in clinical practice. Negative consequences of depressive disorder ...spectrum have been reported (e.g. suicidal ideation, increase physical complications and somatic symptoms, negative influence on prognosis), indicating the need for routine screening, assessment and management.
A search of the major databases (Medline, Embase, PsycLIT, PsycINFO, and the Cochrane Library) was conducted on the reviews and meta-analyses available in order to summarize relevant data concerning depressive disorders spectrum in terms of prevalence, risk factors, and screening and assessment among patients with cancer across the trajectory of the disease.
The data show a prevalence of depression and depressive disorders between 5% and 60% according to the different diagnostic criteria, the tools used in the studies (e.g. semi-structured psychiatric interview and psychometric questionnaires), as well as the stage and type of cancer. Furthermore, despite the significant health care resources devoted to cancer care and the importance of addressing depressive symptoms, assessment and management of depressive spectrum disorders in cancer patients remains suboptimal.
Routine screening and adequate assessment of depressive spectrum disorders is necessary in patients with cancer in order to effectively manage the multifaceted and complex consequences on cancer care.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Bacterial dysbiosis is associated with Crohn's disease (CD), a chronic intestinal inflammatory disorder thought to result from an abnormal immune response against intestinal bacteria in genetically ...susceptible individuals. However, it is unclear whether dysbiosis is a cause or consequence of intestinal inflammation and whether overall dysbiosis or specific bacteria trigger the disease. Here, we show that the combined deficiency of NOD2 and phagocyte NADPH oxidase, two CD susceptibility genes, triggers early-onset spontaneous T
1-type intestinal inflammation in mice with the pathological hallmarks of CD. Disease was induced by
, a Gram-negative mucus-dwelling anaerobe. NOD2 and CYBB deficiencies led to marked accumulation of
, which was associated with impaired neutrophil recruitment and killing of the bacterium by luminal neutrophils. Maternal immunoglobulins against
protected mutant mice from disease during breastfeeding. Our results indicate that a specific intestinal microbe triggers CD-like disease in the presence of impaired clearance of the bacterium by innate immunity.
The use of psychotropic drugs, namely those with an antidepressant profile (ADs), is a mandatory part of an integrated treatment of psychiatric disorders among cancer patients. We aimed to synthetize ...the most relevant data emerging from published studies to provide tips about the use of ADs in oncology.
A search was made of the major databases over the last 30 years (Embase/Medline, PsycLIT, PsycINFO, the Cochrane Library), including narrative reviews, systematic reviews and meta-analyses summarizing the results from observational studies and randomized clinical trials assessing effectiveness, safety profile, interactions, contraindications and use of ADs in oncology with regard to both psychiatric (depressive spectrum, stress-related, anxiety disorders) and cancer-related symptoms (e.g. pain, hot flashes and fatigue).
The weight of evidence supports the ef cacy of ADs for more severe major depression in individuals with cancer and as an adjuvant treatment in cancer-related symptoms, although the methodological limitations of reported randomized controlled trials do not permit definite conclusions. Data also indicate that there should be caution in the use of ADs in cancer patients in terms of their safety profile and potential clinically significant interactions with other prescribed medications. Practical recommendations that have been made for the use of ADs in cancer patients, in the context of a multimodal approach to depression treatment, have been summarized here.
ADs are a relatively safe and effective treatment for more severe major depression in cancer patients. However, more research is urgently needed regarding the efficacy of ADs in different cancer types and cancer settings, their interactions with anticancer agents and their additive benefit when integrated with psychosocial interventions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The Probe Of Extreme Multi-Messenger Astrophysics (POEMMA) is designed to accurately observe ultra-high-energy cosmic rays (UHECRs) and cosmic neutrinos from space with sensitivity over the full ...celestial sky. POEMMA will observe the air fluorescence produced by extensive air showers (EASs) from UHECRs and potentially UHE neutrinos above 20 EeV. Additionally, POEMMA has the ability to observe the Cherenkov signal from upward-moving EASs induced by Earth-interacting tau neutrinos above 20 PeV. The POEMMA spacecraft are designed to quickly re-orientate to follow up transient neutrino sources and obtain currently unparalleled neutrino flux sensitivity. Developed as a NASA Astrophysics Probe-class mission, POEMMA consists of two identical satellites flying in loose formation in 525 km altitude orbits. Each POEMMA instrument incorporates a wide field-of-view (45°) Schmidt telescope with an optical collecting area of over 6 sq. m. The hybrid focal surface of each telescope includes a fast (1 μs) near-ultraviolet camera for EAS fluorescence observations and an ultrafast (10 ns) optical camera for Cherenkov EAS observations. In a 5-year mission, POEMMA will provide measurements that open new multi-messenger windows onto the most energetic events in the universe, enabling the study of new astrophysics and particle physics at these extreme energies.
Acute GvHD (aGvHD) is a life-threatening complication of hematopoietic stem cell transplantation. Frontline therapy for aGvHD consists of corticosteroid administration. However, ∼25% of the patients ...have a steroid-refractory disease, a sign of poor prognosis. An alternative therapy for steroid-refractory aGvHD is infusion of mesenchymal stromal cells (MSCs). Herein, we report the results of 46 patients treated with MSC infusion as salvage therapy for steroid-refractory aGvHD III/IV (78% grade IV). Patients received a median cumulative dose of MSCs of 6.81 × 10
/kg (range, 0.98-29.78 × 10
/kg) in a median of 3 infusions (range, 1-7). Median time between the onset of aGvHD and the first MSC infusion was 25.5 days (range, 6-153). Of the patients, 50% (23/46) presented clinical improvement. Of these, 3 patients (13%) had complete response, 14 (61%) had partial response and 6 (26%) had transient partial response. The estimated probability of survival at 2s year was 17.4%. Only 2 patients (4.3%) presented acute transient side effects (nausea/vomiting and blurred vision) during cell infusion. No patient had late or severe side effects because of MSC infusion. These results suggest that this therapeutic modality is safe and should be considered for steroid-refractory aGvHD, especially in countries where other second-line agents are less available.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Aim
This study describes the development and validation of the Nursing Profession Self‐Efficacy Scale.
Background
Self‐efficacy can be useful in predicting performance, job satisfaction or ...well‐being. In the nursing field, there is a shortage of studies on self‐efficacy with regard to nurses’ global confidence in coping ability across a range of everyday, challenging work situations.
Methods
To define the theoretical framework of nursing professional self‐efficacy, two focus groups and a literature review were performed. An empirical study was then conducted to test validity and reliability. Face and content validity, construct validity, concurrent validity, internal consistency and test–retest reliability were examined. The content validity index was evaluated by 12 experts who suggested deleting 11 redundant items. The final developed tool was tested for construct analysis using a cross‐validation approach, randomly splitting the overall sample of 917 nurses in two sub‐groups.
Findings
The construct validity indicated two dimensions. The face and content validity were adequate. Test–retest reliability displayed a good stability, and internal consistency (Cronbach's α) was acceptable. Moreover, concurrent validity using the Generalized Self‐Efficacy Scale was in line with the theoretical framework.
Conclusion
The scale showed evidence of validity and reliability. The major limitation is the strong influence of the Italian context in the tool development.
Implications for nursing and health policy
The Nursing Profession Self‐Efficacy Scale could be a fruitful tool that facilitates the application of theories (i.e. social‐cognitive theory) in the nursing field and even development of interventions. Furthermore, a measurement of self‐efficacy could be used to predict nursing clinical performance.
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Objectives Disclosing information on diagnosis, prognosis and treatment is a delicate process in oncology, although awareness levels have over time increased in people with cancer. However, ...individual characteristics should be considered when communicating difficult information. We conducted a multicentric study to explore the moderating role of coping styles on the relationship between information about cancer, quality of life and psychological distress. Methods In the period between October 2015 and February 2016, 288 patients with a diagnosis of a solid tumor were recruited from seven Italian oncology units. All participants were administered the Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC), the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), and the EORTC QLQ 25-item information module (INFO25). We explored the moderating effect of coping style with quality of life (QoL) and distress (DT) as dependent variables and information on cancer treatment as independent variable. Results Low levels of anxious preoccupation significantly moderated the relationship between information on treatment and QoL (R2 6%, p < 0.001), while low and medium levels of hopelessness significantly moderated the relationship between information on treatment and DT (R2 = 14%, p = 0.033). Adaptive coping strategies, such as fighting spirit and fatalism, and borderline strategies such as avoidance, did not play a role in this relationship. Conclusion Taking into account and evaluating coping mechanisms in cancer care is a priority when disclosing information on treatments, in order to tailor communication style to individual features.
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