Dignity and psychosocial related variables in elderly advanced cancer patients

Abstract Introduction: Most cancers occur in older individuals, who are more vulnerable due to functional impairment, multiple comorbidities, cognitive impairment, and lack of socio‑familial support. These can undermine patients' sense of dignity. This study seeks to compare dignity scores in older patients with advanced cancer on sociodemographic and clinical variables and analyze the predictive value of anxiety, depression, functional limitations, and social support on dignity scores. Methods: A prospective, multicenter, observational study conducted with participation of 15 hospitals in Spain from February 2020 to October 2021. Patients with newly‑diagnosed, advanced cancer completed the dignity (PPDS), anxiety and depression (BSI), Social Support (Duke-UNC‑11), and functional limitations (EORTC‑C30) scales. Lineal regression analyses explored the effects of anxiety, depression, functional status, and social support on dignity, adjusting for sociodemographic and clinical variables. Results: A total of 180 subjects participated in this study. The results of the correlation analysis revealed that dignity correlated negatively with anxiety, depression, and sex, and positively with social support, functional status, and longer estimated survival. Thus, women, and more anxious and depressed individuals scored lower on the dignity scale, whereas patients with more social support, fewer functional limitations, and longer estimated survival scored higher. Conclusion: In conclusion, being female, having a lower educational level, lower estimated survival, depression, anxiety, less social support, and limited functionality are correlated with less dignity in the elderly with advanced cancer. It is a priority to manage both physical and psychological symptoms in patients with unresectable advanced cancer to mitigate psychological distress and increase their sense of dignit

A multi-stakeholder multicriteria decision analysis for the reimbursement of orphan drugs (FinMHU-MCDA study)

Background: Patient access to orphan medicinal products (OMPs) is limited and varies between countries, reimbursement decisions on OMPs are complex, and there is a need for more transparent processes to know which criteria should be considered to inform these decisions. This study aimed to determine the most relevant criteria for the reimbursement of OMPs in Spain, from a multi-stakeholder perspective, and using multicriteria decision analysis (MCDA). Methods: An MCDA was developed in 3 phases and included 28 stakeholders closely related to the field of rare diseases (6 physicians, 5 hospital pharmacists, 7 health economists, 4 patient representatives and 6 members from national and regional health authorities). Initially [phase A], a bibliographic review was conducted to identify the potential reimbursement criteria. Then, a reduced advisory board (8 members) proposed, selected, and defined the final list of criteria that could be relevant for reimbursement. A discrete choice experiment (DCE) [phase B] was developed to determine the relevance and relative importance weight of such criteria according to the stakeholders’ preferences by choosing between pairs of hypothetical financing scenarios. A multinomial logit model was fitted to analyze the DCE responses. Finally [phase C], the advisory board review the results using a deliberative process. Results: Thirteen criteria were selected, related to 4 dimensions: patient population, disease, treatment, and economic evaluation. Nine criteria were deemed relevant for decision-making and associated with a higher relative importance: Health-related quality of life (HRQL) (23.53%), treatment efficacy (14.64%), availability of treatment alternatives (13.51%), disease severity (12.62%), avoided costs (11.21%), age of target population (7.75%), safety (seriousness of adverse events) (4.72%), quality of evidence (3.82%) and size of target population (3.12%). The remaining criteria had a < 3% relative importance: economic burden of disease (2.50%), cost of treatment (1.73%), cost-effectiveness (0.83%) and safety (frequency of adverse events) (0.03%). Conclusion: The reimbursement of OMPs in Spain should be determined by its effect on patient’s HRQL, the extent of its therapeutic benefit from efficacy and the availability of other therapeutic options. Furthermore, the severity of the rare disease should also influence the decision along with the potential of the treatment to avoid associated costs

Expert range maps of global mammal distributions harmonised to three taxonomic authorities

AimComprehensive, global information on species' occurrences is an essential biodiversity variable and central to a range of applications in ecology, evolution, biogeography and conservation. Expert range maps often represent a species' only available distributional information and play an increasing role in conservation assessments and macroecology. We provide global range maps for the native ranges of all extant mammal species harmonised to the taxonomy of the Mammal Diversity Database (MDD) mobilised from two sources, the Handbook of the Mammals of the World (HMW) and the Illustrated Checklist of the Mammals of the World (CMW).LocationGlobal.TaxonAll extant mammal species.MethodsRange maps were digitally interpreted, georeferenced, error-checked and subsequently taxonomically aligned between the HMW (6253 species), the CMW (6431 species) and the MDD taxonomies (6362 species).ResultsRange maps can be evaluated and visualised in an online map browser at Map of Life (mol.org) and accessed for individual or batch download for non-commercial use.Main conclusionExpert maps of species' global distributions are limited in their spatial detail and temporal specificity, but form a useful basis for broad-scale characterizations and model-based integration with other data. We provide georeferenced range maps for the native ranges of all extant mammal species as shapefiles, with species-level metadata and source information packaged together in geodatabase format. Across the three taxonomic sources our maps entail, there are 1784 taxonomic name differences compared to the maps currently available on the IUCN Red List website. The expert maps provided here are harmonised to the MDD taxonomic authority and linked to a community of online tools that will enable transparent future updates and version control

New species of Paraphiomys (Rodentia, Thryonomyidae) from the Lower Miocene of As-Sarrar (Saudi Arabia).

International audienc

The vertebrate fauna from the “stipite” layers of the Grands Causses (Middle Jurassic, France)

International audienceThe “stipites” are Bathonian (Middle Jurassic) coals that formed in an everglades-like environment and are now exposed in the Grands Causses (southern France). The vertebrate assemblage of the “stipites” and of the transitional layers to the carbonates in which they are interspersed are reviewed. To date, only small-sized and isolated vertebrate bones, teeth, and scales have been recovered. These record the presence of sharks (Hybodus, Asteracanthus), bony fishes (Lepidotes, Pycnodontiformes, Caturus, Aspidorhynchus), amphibians (Anura, Albanerpetontidae), and reptiles (Crocodylomorpha, Ornithischia, Theropoda). Despite its relatively limited taxonomic diversity, the vertebrate assemblage from the “stipites” and from their associated layers is notable for being one of the few of this age with both terrestrial and marine influences. Compared to other approximately coeval formations in Western Europe, the “stipites” vertebrate assemblage is surpassed in diversity only by those from the British Isles

El otro dragón de Aragón

National audienceEs bien conocido que san Jorge es el patrón de Aragón y es recomendable asistir a la fiesta del Vencimiento del Dragón que se representa en Alcañiz (Teruel) para celebrar el Día de Aragón. Pero en Zaragoza habita otro "dragón" que puede visitarse todos los días del año

El otro dragón de Aragón

National audienceEs bien conocido que san Jorge es el patrón de Aragón y es recomendable asistir a la fiesta del Vencimiento del Dragón que se representa en Alcañiz (Teruel) para celebrar el Día de Aragón. Pero en Zaragoza habita otro "dragón" que puede visitarse todos los días del año

New palaeontological data from the organic-rich layers of the Bathonian of the Grands Causses (France)

International audienc

Presence of Karydomys (Rodentia, Cricetidae) in the Miocene of Chios.

International audienc