Patients' Expectations of Physiotherapeutic Treatment for Long-Term Side Effects After Cancer:A Qualitative Study

Objective This study aims to explore the expectations of physiotherapeutic treatment of long-term side effects (LTSEs) after cancer among patients treated in physiotherapy clinics. Methods This a qualitative interview study based on a phenomenological approach. Adult patients with LTSEs after cancer were recruited through The Danish Cancer Society and a private physiotherapy clinic in Denmark. Individual semi-structured interviews were carried out using Microsoft Teams based on an interview guide piloted before the interviews. Interviews were audiotaped and transcribed verbatim. Sampling was conducted with a focus on variation in LTSE. The data were analyzed using Malterud’s principles of systematic text condensation and coded in NVivo 12. Results 2 males and 8 females with an average age of 55.8 years were interviewed for between 40 and 60 minutes from October to November 2020. Four main themes emerged from the interviews 1 : The importance of the physiotherapist’s approach, 2 the benefits of meeting patients with similar symptoms, 3 the importance of receiving knowledge, and 4 patients seeking to maintain their current state more often than aiming to improve their condition. Conclusions Patients consulting a physiotherapy clinic with LTSE after cancer prefer the physiotherapist to have knowledge about cancer and to be emphatic. Furthermore, patients prefer to meet like-minded people and expect support to maintain their current condition rather than improve their condition

Az újraolvasás lehetőségei és az irodalmi kánonok

Meta-analysis of dyspepsia. (PDF 226 kb

A világ mint könyvtár, tehát képzet. (Jorge Luis Borges Bábeli könyvtára)

Trial characteristics. (XLS 88 kb

Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials

Background COVID-19 is rapidly spreading causing extensive burdens across the world. Effective vaccines to prevent COVID-19 are urgently needed. Methods and findings Our objective was to assess the effectiveness and safety of COVID-19 vaccines through analyses of all currently available randomized clinical trials. We searched the databases CENTRAL, MEDLINE, Embase, and other sources from inception to June 17, 2021 for randomized clinical trials assessing vaccines for COVID-19. At least two independent reviewers screened studies, extracted data, and assessed risks of bias. We conducted meta-analyses, network meta-analyses, and Trial Sequential Analyses (TSA). Our primary outcomes included all-cause mortality, vaccine efficacy, and serious adverse events. We assessed the certainty of evidence with GRADE. We identified 46 trials; 35 trials randomizing 219 864 participants could be included in our analyses. Our meta-analyses showed that mRNA vaccines (efficacy, 95% [95% confidence interval (CI), 92% to 97%]; 71 514 participants; 3 trials; moderate certainty); inactivated vaccines (efficacy, 61% [95% CI, 52% to 68%]; 48 029 participants; 3 trials; moderate certainty); protein subunit vaccines (efficacy, 77% [95% CI, -5% to 95%]; 17 737 participants; 2 trials; low certainty); and viral vector vaccines (efficacy 68% [95% CI, 61% to 74%]; 71 401 participants; 5 trials; low certainty) prevented COVID- 19. Viral vector vaccines decreased mortality (risk ratio, 0.25 [95% CI 0.09 to 0.67]; 67 563 participants; 3 trials, low certainty), but comparable data on inactivated, mRNA, and protein subunit vaccines were imprecise. None of the vaccines showed evidence of a difference on serious adverse events, but observational evidence suggested rare serious adverse events. All the vaccines increased the risk of non-serious adverse events. Conclusions The evidence suggests that all the included vaccines are effective in preventing COVID-19. The mRNA vaccines seem most effective in preventing COVID-19, but viral vector vaccines seem most effective in reducing mortality. Further trials and longer follow-up are necessary to provide better insight into the safety profile of these vaccines.Fil: Korang, Steven Kwasi. Copenhagen University Hospital; DinamarcaFil: von Rohden, Elena. Copenhagen University Hospital; DinamarcaFil: Veroniki, Areti Angeliki. Imperial College London; Reino Unido. St. Michael’s Hospital; CanadáFil: Ong, Giok. John Radcliffe Hospital; Reino UnidoFil: Ngalamika, Owen. University of Zambia; ZambiaFil: Siddiqui, Faiza. Copenhagen University Hospital; DinamarcaFil: Juul, Sophie. Copenhagen University Hospital; DinamarcaFil: Nielsen, Emil Eik. Copenhagen University Hospital; DinamarcaFil: Feinberg, Joshua Buron. Copenhagen University Hospital; DinamarcaFil: Petersen, Johanne Juul. Copenhagen University Hospital; DinamarcaFil: Legart, Christian. Universidad de Copenhagen; Dinamarca. Copenhagen University Hospital; DinamarcaFil: Kokogho, Afoke. Henry M. Jackson Foundation Medical Research International; NigeriaFil: Maagaard, Mathias. Copenhagen University Hospital; Dinamarca. Zealand University Hospital; DinamarcaFil: Klingenberg, Sarah. Copenhagen University Hospital; DinamarcaFil: Thabane, Lehana. Mcmaster University; CanadáFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Thomsen, Allan Randrup. Universidad de Copenhagen; DinamarcaFil: Jakobsen, Janus C.. University of Southern Denmark; Dinamarca. Copenhagen University Hospital; DinamarcaFil: Gluud, Christian. Copenhagen University Hospital; Dinamarca. University of Southern Denmark; Dinamarc

Climate-driven change in the North Atlantic and Arctic Ocean can greatly reduce the circulation of the North Sea

We demonstrate for the first time a direct oceanic link between climate‐driven change in the North Atlantic and Arctic oceans and the circulation of the northwest European shelf‐seas. Downscaled scenarios show a shutdown of the exchange between the Atlantic and the North Sea, and a substantial decrease in the circulation of the North Sea in the second half of the 21st Century. The northern North Sea inflow decreases from 1.2‐1.3Sv (1Sv=106 m3s‐1) to 0.0‐0.6Sv with Atlantic water largely bypassing the North Sea. This is traced to changes in oceanic haline stratification and gyre structure, and to a newly identified circulation‐salinity feedback. The scenario presented here is of a novel potential future state for the North Sea, with wide‐ranging environmental management and societal impacts. Specifically, the sea would become more estuarine and susceptible to anthropogenic influence with an enhanced risk of coastal eutrophication

Vitamin D-biofortified beef: a comparison of cholecalciferol with synthetic versus UVB-mushroom-derived ergosterol as feed source

This study investigates dietary fortification of heifer feeds with cholecalciferol and ergocalciferol sources and effects on beef total vitamin D activity, vitamer, respective 25-hydroxymetabolite contents, and meat quality. Thirty heifers were allocated to one of three dietary treatments [(1) basal diet + 4000 IU of vitamin D3 (Vit D3); (2) basal diet + 4000 IU of vitamin D2 (Vit D2); and (3) basal diet + 4000 IU of vitamin D2-enriched mushrooms (Mushroom D2)] for a 30 day pre-slaughter period. Supplementation of heifer diets with Vit D3 yielded higher (p  0.05) by the dietary treatments. In conclusion, vitamin D3 biofortification of cattle diets is the most efficacious way to enhance total beef vitamin D activity

The use of synthetic and natural vitamin D sources in pig diets to improve meat quality and vitamin D content

This study investigated the effects of synthetic and natural sources of vitamin D biofortification in pig diets on pork vitamin D activity and pork quality. One hundred and twenty pigs (60 male, 60 female) were assigned to one of four dietary treatments for a 55 d feeding period. The dietary treatments were (1)50 μg vitamin D₃/kg of feed; (2)50 μg of 25-hydroxvitamin D₃/kg of feed (25-OH-D₃); (3)50 μg vitamin D₂/kg of feed; (4)50 μg vitamin D₂-enriched mushrooms/kg of feed (Mushroom D₂). The pigs offered the 25-OH-D₃ diet exhibited the highest (P < 0.001) serum total 25-hydroxyvitamin D concentration and subsequently exhibited the highest (P < 0.05) Longissimus thoracis (LT) total vitamin D activity. Mushroom D2 and 25-OH-D3 supplementation increased pork antioxidant status. The vitamin D₂-enriched mushrooms improved (P < 0.05) pig performance, carcass weight and LT colour. In conclusion, 25-OH-D₃ is the most successful source for increasing pork vitamin D activity, while Mushroom D2 may be a new avenue to improve animal performance and pork quality

Lessons for fisheries management from the EU cod recovery plan

The performance of the EU long-term management plan for cod stocks, in force since 2009, is analysed focusing on the human and institutional factors. The plan operates through landings quotas (TACs) and effort restrictions following a Harvest Control Rule, and deploys a novel instrument allowing Member States to ‘buy back’ or increase fishing effort for fleet segments engaged in cod-avoidance measures. The stipulated fishing mortality reductions have not been achieved. On the positive side, the ‘buy-back’ instrument has led to increased uptake of selective gear and implementation of permanent and real- time temporary closures. On the negative side, ignoring the dimension of fishers as reactive agents in the design, the impact assessment, and the annual implementation of the measures has contributed to the failure to adequately implement the plan and achieve its objectives.JRC.G.4-Maritime affair