Psychosocial Distress Screening in a Community Cancer Center: An Examination of Gender Differences

Objective: The aim of this study was to gain a better understanding of the needs of male and female oncology patients within a community cancer setting to inform the provision of psychosocial services. Data obtained from 835 single-page measures of oncology patient distress were collected and analyzed to examine the relationship between gender and reported level of distress, the source of this distress, and requests for follow-up from psychosocial service providers.Method: Patients in medical and radiation oncology were given a distress screener tool that included a distress thermometer, a problem checklist, and a list of psychosocial service providers with whom the patient could request to speak.Results: Women reported higher levels of distress than men (p=.003). Women were also more likely than men to endorse practical problems as the cause of their distress (p=.003). A marginally significant relationship between gender and requesting the cancer resource navigator was also found (p=. 059)Conclusion: Gender is a salient factor in reported distress among cancer patients. Although no single variable can entirely explain an individual's response to cancer, male and female patients do appear to have distinctive, gender-specific needs. Psychosocial interventions that account for differences related to gender-role may be particularly beneficial. These results also illustrate the utility of consistent screening practices to better understand and meet the psychosocial needs of oncology

Do Things Change in Therapy That Are Not Measured By Self-report Instruments?

This study investigates a new way of assessing change in psychotherapy, with the goal of decreasing the schism in the field of psychology between research and clinical practice. Change in psychotherapy was assessed in clients presenting with depressive symptoms who were seeking therapy at the Professional Psychology Center (PPC) at the University of Denver. Prior to beginning treatment, the subjects completed the Beck Depression Inventory- II (BDI-II) and the Symptom Checklist-90-R (SCL-90), and were also assessed by independent clinicians using the Shedler-Westen Assessment Procedure II (SWAP-II). Six to nine months later, after completing at least 12 psychotherapy sessions (range 12-21 sessions), the assessment procedure was repeated.There were no significant differences pre- to post-treatment on any measure. However, two subjects in the sample appeared to benefit from treatment, as assessed by both the self-report measures and the SWAP-II. The findings for these two subjects suggest that the SWAP-II can provide a greater depth of understanding about what can change in therapy than self-report measures alone. Possible reasons for the lack of treatment effects in the larger sample are discussed.

Fracking/Takings

As the use of fracking has spread during the recent oil and gas boom, inevitable conflicts have arisen between industry and its neighbors, particularly as fracking has moved into densely populated urban and suburban areas. Concerned over the impacts of fracking – such as risks to health and safely, diminished property values, air and water pollution, as well as noise, traffic, and other annoyances – many people have demanded a government response. Government regulation of fracking has struggled to catch up, although in recent years many state and local governments have taken steps to reduce the impacts of fracking in their communities. This article focuses on government restrictions in New York and Colorado, two of the key battlegrounds in the fight over fracking. New York recently prohibited fracking across the entire state, after several towns had enacted their own bans. In Colorado, the people have used the ballot initiative process to enact restrictions on fracking directly. The industry has responded not only with public relations spending to improve the fracking’s damaged reputation, but also legal challenges to these efforts to rein in oil and gas development. In addition to suing local governments, often arguing they do not have authority to regulate fracking, industry threatens to bring costly takings claims for compensation due to alleged economic harms. This Article examines the numerous legal and factual issues that should make it difficult for industry to succeed on fracking/takings claims. First, regulation of fracking, even including outright bans, can almost always be defended as necessary to prevent a nuisance or other background principle of law that justifies government regulation. Even if a nuisance defense could be overcome, industry would have difficulty proving that regulation has destroyed all economic value in their property, unless courts take a narrow view of property that would highlight the arbitrary nature of the “denominator problem.” When fracking/takings claims are considered under the default balancing of the Penn Central case, takings are unlikely to be found except in rare outlier cases. Finally, because requiring governments to pay compensation in fracking/takings cases would likely create a windfall for industry, particularly if the oil and gas eventually is extracted in the future, courts should resist the temptation to rule against government restrictions to protect public health, safety, and the environment.

Anaerobic Digestion Project Working Guide: A Case Study Analysis and Procedural Summary of Anaerobic Digester Projects for the United States Agricultural Sector

Renewable energy such as biomass has given markets, including dairy farms, an effective approach to reducing the costs of sustaining a profitable business. Anaerobic digestion systems offer dairy farms a very effective way to reduce manure odor, comply with soil and water pollution regulations, manufacture compost for general market sales, produce irrigation capacity and generate on-site electricity as well as the ability to sell excess electricity back to the local utilities. This project defines anaerobic digestion technologies and practices, analyzes case studies and presents a step-by-step anaerobic digestion project startup checklist. The result is an anaerobic digestion project working guide that acts as a tool to aid dairy farmers in their own potential anaerobic digestion project.

Gender sensitivity in national health plans in Latin America and the European Union

Objectives: To evaluate the situation regarding gender sensitivity in national health plans in Latin America and the European Union for the decade 2000–2010. Methods: A systematic search and content analysis of national health plans were carried out within 37 countries. Gender sensitivity, defined as the extent to which a health plan considers gender as a central category and develops measures to reduce any gender-related inequalities, was analysed through an ad hoc checklist. Results: The description of health problems by sex was more frequent than intervention proposals aimed at reducing gender health disparities. The greatest number of specific intervention proposals targeted at overcoming gender-based health inequalities were associated with sexual and/or reproductive health, gender based violence, the working environment and human resources training. Compared to the European Union member states, Latin American health plans were found to be generally more gender sensitive. Conclusions: National health plans are still generally lacking in gender sensitivity. Disparities exist in health policy formulation in favour of men, whilst women's health continues to be identified mainly with reproductive health. If gender sensitivity is not taken into account, efforts to improve the quality of clinical care will be insufficient as gender inequalities will persist.

La divulgación de la Ciencia española en la Web 2.0: el caso del Consejo Superior de Investigaciones Científicas en Andalucía y Cataluña

El sistema ciencia, tecnología y sociedad no está consolidado en España por el desequilibrio que existe entre el desarrollo de la investigación y su divulgación. Además, la cultura científica de la sociedad está por debajo de la media europea y en la última década han descendido las vocaciones científicas entre los más jóvenes. En este contexto, se ha analizado si las instituciones de investigación utilizan las herramientas de la Web 2.0, principal canal de comunicación de los jóvenes entre 15 y 24 años, para mostrar a la sociedad los resultados de sus trabajos. Para ello, se han seleccionado como objeto de estudio los centros de investigación del Consejo Superior de Investigaciones Científicas en Andalucía y Cataluña. Entre los principales resultados obtenidos, a través del diseño de una checklist ad hoc, destaca el escaso uso que hacen de este canal de comunicación, ya que solo un 4,5% de los centros analizados utilizan todas las herramientas estudiadas. La efectividad de la comunicación ha sido otro de los valores observados, en este caso, en función de la conectividad (seguidores en sus perfiles sociales) e intensidad (número de publicaciones). Ambos ítems presentan también valores muy bajos. Por otro lado se observa un escaso nivel de popularidad de sus sitios web (número de enlaces que reciben) y una casi inexistente relación entre los mismos a través de hipervínculos que los conecten. Este último aspecto, se ha determinado con las herramientas webmétricas Webometric Analyst y ScoSciBot.

Compromiso político y feminismo en el universo comunista de la Transición

En el proceso de Transición a la democracia, las culturas políticas comunistas ocuparon una posición muy destacada, con diversos horizontes, desde la vía democrática al socialismo del PCE a las propuestas revolucionarias maoístas y trotskistas. Las mujeres que militaron en estos partidos, que también participaron en el movimiento feminista, reformularon las identidades de género de la izquierda con debates teóricos muy intensos y nuevas prácticas políticas y sociales. Aunque no alcanzaron sus objetivos políticos y feministas, ni un reconocimiento en las urnas, contribuyeron de forma decisiva a la consolidación de la democracia y la difusión de discursos y valores igualitarios en España.

Coleópteros y sírfidos saproxílicos (Coleoptera; Diptera: Syrphidae) de las dehesas del oeste ibérico: la Reserva Biológica de Campanarios de Azaba (Salamanca)

Se aporta la relación de especies de coleópteros y sírfidos saproxílicos que habitan en ecosistemas de dehesa del oeste ibérico. Se ha estudiado la Reserva Biológica de Campanarios de Azaba, provincia de Salamanca, designada en 2013 como primera Reserva Entomológica de España por la Asociación española de Entomología. Durante los 19 meses de muestreo se registraron 9.603 ejemplares de coleópteros saproxílicos pertenecientes a 157 especies (40 familias) y 477 ejemplares de sírfidos saproxílicos pertenecientes a 18 especies. Para la recolección del material se utilizaron trampas de emergencia y trampas de ventana. Entre los insectos capturados hay diez especies amenazadas, ya sea a nivel europeo o de España, que, a la vista de los resultados, mantienen poblaciones abundantes en este ecosistema de dehesa del oeste ibérico.

Seguridad quirúrgica y cumplimentación del registro de información intraquirúrgica en España: Un análisis comparativo de dos instrumentos de registro

El objetivo del presente estudio es describir y comparar los porcentajes de no cumplimentación de dos instrumentos de registro: hoja circulante (HC) y lista de verificación quirúrgica (LVQ), en un mismo entorno quirúrgico para una muestra de pacientes de características similares. Metodología: Estudio descriptivo realizado sobre registros intraquirúrgicos de 3024 pacientes de Cirugía de Ortopedia y Traumatología. 1732 pacientes intervenidos en 2009 con modelo de hoja circulante, cumplimentada al finalizar la intervención y 1292 en 2010 intervenidos con modelo de registro lista de verificación quirúrgica (checklist) cumplimentado durante la intervención en tres tiempos. Se han calculado características descriptivas (media, desviación típica, mínimo y máximo) del porcentaje de no cumplimentación global en ambos registros y el porcentaje de no cumplimentación (intervalo de confianza al 95%) de cada ítem de los registros estudiados. Resultados: Se observa mayor porcentaje de cumplimentación global y, en general, también individual, en la hoja circulante que en la lista de verificación quirúrgica. Conclusiones: El registro intraquirúrgico que mayor porcentaje de cumplimentación ha tenido de manera global ha sido la hoja de circulante y se evidencia la necesidad de implantar estrategias para mejorar el grado de cumplimentación de la LVQ por su relación con la seguridad de pacientes.

Patient safety in the operating room and documentary quality related to infection and hospitalization

Objective: To describe the documentary quality of two records related to patient safety in the operating room and to identify differences between information related to infection and hospitalization. Methods: Comparative study based on two cross sections, conducted with 3,033 patients who had been hospitalized for more than 24 hours in an Orthopedics and Traumatology Center. Sociodemographic and clinical data, as well as information provided in forms were compared. Postoperative infection was identified as an adverse event. Results: There was a significant correlation between hospitalization days and the total number of diagnoses collected (Pearson=0.328; p<0.001). When diagnoses and infections were grouped together, a significant value was found between closed fractures and infection (p=0.001). Conclusion: Differences in the degree of completion were observed between the two records. There were no differences between adverse events.

Challenges, Strengths and Opportunities Related to Implementing Comprehensive Evidence-Based Guidelines on Breast Cancer Survivorship Care by Primary Care Physicians and Nurse Practitioners in Southeastern Ontario

Background Many breast cancer survivors continue to have a broad range of physical and psychosocial problems after breast cancer treatment. As cancer centres move forward with earlier discharge of stable breast cancer survivors to primary care follow-up it is important that comprehensive evidence-based breast cancer survivorship care is implemented to effectively address these needs. Research suggests primary care providers are willing to provide breast cancer survivorship care but many lack the knowledge and confidence to provide evidence-based care. Purpose The overall purpose of this thesis was to determine the challenges, strengths and opportunities related to implementing comprehensive evidence-based breast cancer survivorship guidelines by primary care physicians and nurse practitioners in southeastern Ontario. Methods This mixed-methods research was conducted in three phases: (1) synthesis and appraisal of clinical practice guidelines relevant to provision of breast cancer survivorship care within the primary care practice setting; (2) a brief quantitative survey of primary care providers to determine actual practices related to provision of evidence-based breast cancer survivorship care; and (3) individual interviews with primary care providers about the challenges, strengths and opportunities related to provision of comprehensive evidence-based breast cancer survivorship care. Results and Conclusions In the first phase, a comprehensive clinical practice framework was created to guide provision of breast cancer survivorship care and consisted of a one-page checklist outlining breast cancer survivorship issues relevant to primary care, a three-page summary of key recommendations, and a one-page list of guideline sources. The second phase identified several knowledge and practice gaps, and it was determined that guideline implementation rates were higher for recommendations related to prevention and surveillance aspects of survivorship care and lowest related to screening for and management of long-term effects. The third phase identified three major challenges to providing breast cancer survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden; and three major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles. A better understanding of these challenges, strengths and opportunities will inform development of targeted knowledge translation interventions to provide support and education to primary care providers.

The place of DPP-4 inhibitors in the treatment algorithm of diabetes type 2 : a systematic review of cost-effectiveness studies

Tese de mestrado, Epidemiologia, Universidade de Lisboa, Faculdade de Medicina, 2015

Between Apathy and Anger: Challenges to the Union from the 2014 Elections to the European Parliament. EPIN [Working] Paper No. 39, 20 May 2014

This EPIN study brings together contributions from a ​broad selection of member states ​and ​provid​es ​insightful analysis ​into the 2014 elections to the European Parliament on the ground. The report reveals the different factors that impede the development of genuine European elections and the consequences of the ballot in the member states covered by the study​, namely Bulgaria, Finland, France, Germany, Greece, Italy, the Netherlands, Poland, Romania, Spain and the UK​,​ and at EU level. The report finds that: • The EP Resolution to encourage European parties to nominate candidates for the next Commission President has not really increased public interest in the EU and voter turnout will probably remain low. • Visibility of the European top candidates in most member states has been quite limited. • National manifestos do not coincide – and sometimes event conflict with – the European parties’ manifestos. • Election debates focus on national issues; EU issues are only brought to public debate when they are relevant for domestic politics. • Again, we will see a protest vote against governments and large parties. The EP elections are still perceived as a test ahead of local and national elections, or as a vote of confidence in national governments. • This year the protest vote also concerns the EU. The report predicts a more eurosceptic ballot that might complicate decision-making in the EU, exacerbate the conflict between the national and European levels and increase tensions among member states.

Turkey votes: Part III - President Erdoğan - A foregone conclusion? EPC Commentary, 10 July 2014

On 1 July, after months of speculation, Turkey’s Prime Minister, Recep Tayyip Erdoğan, announced he would run in the country’s first direct presidential elections on 10 August. Erdoğan, who has dominated Turkish politics for over a decade, is viewed as the clear favourite. With current polls suggesting he could take as much as 52% of the vote, an outright victory in the first round is possible. His main rival, Ekmeleddin İhsanoğlu, is very much the underdog. Until recently, an international diplomat with no experience in politics, he is the joint candidate of Turkey’s two main opposition parties, the Republican People’s Party (CHP) and the Nationalist Movement Party (MHP). Selahattin Demirtaş, the Co-Chairman of the Kurdish Peoples Democratic Party (HDP) is also in the race, but is not expected to make it into double digits. The Kurdish vote however, could prove to be crucial if the ballot goes to a second round on 24 August. With Erdoğan wanting to increase Presidential powers, the stakes are high. With his belief in majoritarian rule, and increasingly authoritarian style of governance there has been an erosion of democracy and civil liberties. Many observers fear this trend may increase.

Gagauzia: growing separatism in Moldova? OSW Commentary No. 129, 10.03.2014

On 2 February, the regional authorities in Gagauzia - an autonomous region of the Republic of Moldova - carried out two simultaneous referenda. In the first, local residents were asked to declare their support for the country’s integration either with the EU or with the Moscow-led Customs Union (CU); the second referendum sought their opinion on the draft law “On the deferred status of the Autonomous Region of Gagauzia”. Under the proposed legislation, if Moldova were to lose its sovereignty (for example, through the unification of Moldova and Romania, or even as some politicians have argued, through Moldova’s further integration with the EU), the autonomous region would automatically become the independent Republic of Gagauzia. As expected, the outcome of the vote has shown overwhelming support for both the CU and for the draft law. According to the figures released by Gagauzia’s Central Electoral Commission, 98.5% of the voters supported Moldova’s integration with the Customs Union, while 98% voted in favour of the ‘deferred independence’ bill. Support for closer integration with the EU was marginal, reaching just over 2%. Despite the one-sided outcome of the referendum, there is no reliable evidence to suggest that the ballot was rigged. It should also be noted that voter turnout was very high, reaching about 70%. Representatives of the Moldovan Central Electoral Commission, however, believe that the figure may have been artificially inflated by excluding many of the voters currently residing abroad from the count.