Development of a best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours in the UK

Bleomycin, a cytotoxic chemotherapy agent, forms a key component of curative regimens for lymphoma and germ cell tumours. It can be associated with severe toxicity, long-term complications and even death in extreme cases. There is a lack of evidence or consensus on how to prevent and monitor bleomycin toxicity. We surveyed 63 germ cell cancer physicians from 32 cancer centres across the UK to understand their approach to using bleomycin. Subsequent guideline development was based upon current practice, best available published evidence and expert consensus. We observed heterogeneity in practice in the following areas: monitoring; route of administration; contraindications to use; baseline and follow-up investigations performed, and advice given to patients. A best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours has been developed and includes recommendations regarding baseline investigations, the use of pulmonary function tests, route of administration, monitoring and patient advice. It is likely that existing heterogeneity in clinical practice of bleomycin prescribing has significant economic, safety and patient experience implications. The development of an evidence-based consensus guideline was supported by 93% of survey participants and aims to address these issues and homogenise practice across the UK

The Association of English Functional Health Literacy and the Receipt of Mammography among Hispanic Women Compared to Non-Hispanic U.S.-Born White Women

Breast cancer is a leading cause of cancer death among Hispanic women in the U.S., and mammography is the recommended screening for early diagnosing and preventing breast cancer. Several barriers exist to influence mammography utilization including poor health literacy. However, it is unclear whether the effect of health literacy on mammography utilization is consistent between Hispanic women and non-Hispanic White women. The main objective of this study was to examine association between functional health literacy and the receipt of mammography among Hispanic women compared to non-Hispanic White women in the U.S.A cross-sectional design using participants engaged in the National Assessment of Adult Literacy. Study sample comprised of 4,249 Hispanic and non-Hispanic U.S.-born White women ≥ 40 years of age who completed the functional health literacy assessment. Regression analyses were performed to test the association between health literacy and receipt of mammography. Among Hispanic women, analyses considered the influence of language-preference acculturation.Equal percentages of Hispanic (59.3%) and non-Hispanic White (60.6%) women received mammography. After adjusting for covariates, health literacy was positively associated with receiving mammography among U.S.-born White women (β = 0.14, p<0.001), but negatively associated with mammography among Hispanic women (β = -0.13, p<0.001). Analyses stratified by acculturation status revealed that higher health literacy was associated with lower mammography among language-preference acculturated Hispanic women (β = -0.48, p<0.001), yet an opposite result among less acculturated Hispanic women (β = 0.08, p<0.001).Functional health literacy has different associations with mammography depending upon ethnicity. Language-preference acculturation may explain the differing association

Desired and Undesired Effects of Energy Labels—An Eye-Tracking Study

<div><p>Saving energy is an important pillar for the mitigation of climate change. Electric devices (e.g., freezer and television) are an important player in the residential sector in the final demand for energy. Consumers’ purchase decisions are therefore crucial to successfully reach the energy-efficiency goals. Putting energy labels on products is often considered an adequate way of empowering consumers to make informed purchase decisions. Consequently, this approach should contribute to reducing overall energy consumption. The effectiveness of its measurement depends on consumers’ use and interpretation of the information provided. Despite advances in energy efficiency and a mandatory labeling policy, final energy consumption per capita is in many countries still increasing. This paper provides a systematic analysis of consumers’ reactions to one of the most widely used eco-labels, the European Union (EU) energy label, by using eye-tracking methodology as an objective measurement. The study’s results partially support the EU’s mandatory policy, showing that the energy label triggers attention toward energy information in general. However, the energy label’s effect on consumers’ actual product choices seems to be rather low. The study’s results show that the currently used presentation format on the label is insufficient. The findings suggest that it does not facilitate the integration of energy-related information. Furthermore, the current format can attract consumers to focus more on energy-efficiency information, leading them to disregard information about actual energy consumption. As a result, the final energy consumption may increase because excellent ratings on energy efficiency (e.g., A⁺⁺) do not automatically imply little consumption. Finally, implications for policymakers and suggestions for further research are discussed.</p></div