Pediatric Oncology Nurses’ Perceptions of Prognosis-Related Communication

Background Disclosure of prognosis-related information is an essential aspect of communication with pediatric patients with cancer and their families. The nurse is believed to play an important role in this process, but nurse perceptions and experiences have not been well-described. Purpose Provide an exploration of pediatric oncology nurses’ experiences with prognosis-related communication (PRC). Method Mixed-methods, multiphase design. This paper highlights the qualitative portion of the study. Findings Three themes were identified: Importance of collaboration, impact of PRC, and delivery of prognostic information. Discussion Collaboration is a critical element of PRC. Nurses are often not included in the disclosure process, which limits the ability of nurses to fully function in their roles, compromising patient, family, and nurse outcomes. A paradigm shift is required to empower nurses to be more active participants. More education of physicians and nurses is necessary to consistently engage nurses in PRC and prepare nurses for critical conversations

The RAG Model: a new paradigm for genetic risk stratification in multiple myeloma

Molecular studies have shown that multiple myeloma is a highly genetically heterogonous disease which may manifest itself as any number of diverse subtypes each with variable clinicopathological features and outcomes. Given this genetic heterogeneity, a universal approach to treatment of myeloma is unlikely to be successful for all patients and instead we should strive for the goal of personalised therapy using rationally informed targeted strategies. Current DNA sequencing technologies allow for whole genome and exome analysis of patient myeloma samples that yield vast amounts of genetic data and provide a mutational overview of the disease. However, the clinical utility of this information currently lags far behind the sequencing technology which is increasingly being incorporated into clinical practice. This paper attempts to address this shortcoming by proposing a novel genetically based “traffic-light” risk stratification system for myeloma, termed the RAG (Red, Amber, Green) model, which represents a simplified concept of how complex genetic data may be compressed into an aggregate risk score. The model aims to incorporate all known clinically important trisomies, translocations, and mutations in myeloma and utilise these to produce a score between 1.0 and 3.0 that can be incorporated into diagnostic, prognostic, and treatment algorithms for the patient

A critical literature review exploring the challenges of delivering effective palliative care to older people with dementia in the acute hospital setting

Aim. This paper considers the challenges of delivering effective palliative care to older people with dementia and the possible strategies to overcome barriers to endof-life care in these patients. Background. In UK alone, approximately 100 000 people with dementia die each year and as the number of older people increases, dementia is set to become even more prevalent. Dementia is a progressive terminal illness for which there is currently no cure. Patients dying with dementia have significant health-care needs and in recent years it has been recognised that palliative care should be made available to everyone regardless of diagnosis, as this improves comfort and quality of life. Despite this, patients dying with dementia are often still not given access to palliative care services. Method. A review of English language literature published after 1996 to the present day relating to older people with dementia during the terminal phase of their illness. Results. Twenty-nine articles met inclusion criteria for the review. Most originated from North America and UK and were mostly quantitative in nature. Four key themes were identified: difficulties associated with diagnosing the terminal phase of the illness (prognostication); issues relating to communication; medical interventions; and the appropriateness of palliative care intervention. Conclusions.This review reinforces the importance of providing appropriate palliative care to individuals suffering from end-stage dementia and identifies some of the barriers to extending such specialist palliative care provision. Relevance to practice. There is an urgent need to improve palliative care provision for older people with end-stage dementia and, in addition, more research is required on the needs of patients entering the terminal phase of dementia to assist the allocation of appropriate resources and training to ensure quality and equality in the provision of end-of-life care

Управління знаннями як основа інноваційного розвитку підприємства

The article contains elaboration of conceptual bases of production management, accumulation and commercialization of current knowledge as the basis for innovative development of the company. The types of knowledge that allow to choose effective strategies for company’s innovative growth are defined and codified. Strategies of innovative development were systematized depending on the degree of novelty of the product innovation for the industry, as well as the type of business of the innovator enterprise. The approach to providing coordinated interaction of different knowledge types was offered to follow in the process of enterprise’s innovative development.Розроблено концептуальні засади системи управління продукуванням, накопиченням і комерціалізацією актуальних знань як основи інноваційного розвитку підприємства. Визначено і систематизовано види знань, які дозволяють обрати ефективні стратегії інноваційного зростання підприємства. Виконано систематизацію стратегій інноваційного розвитку залежно від ступеня новизни продуктових інновацій для галузі, а також типу інноваційного бізнесу підприємства-інноватора. Розроблено підхід до забезпечення узгодженої взаємодії знань різних видів в процесі управління інноваційним розвитком підприємства

Prognostication Events and Phenomena in Sport by the Spreadsheets of Мicrosoft Excel.

У статті розкрито зміст понять “ прогноз” і “ прогнозування”. Охарактеризовано основні методи прогнозування. Наведено прості та доступні прийоми прогнозування за допомогою електронних таблиць Мicrosoft Excel. Maintenance of concepts “prognosis” and “prognostication” is exposed in the article. The basic methods of prognostication are described. The simple and accessible receptions of prognostication are resulted by the spreadsheets of Мicrosoft Excel