Prevalence of Depression in Gynecologic and Breast Cancer Patients Authors

Objective Depression has historically been an underdiagnosed and undertreated condition with a large impact on patient quality of life. Screening and diagnosis of depression may differ for various reasons, making proper diagnosis and treatment difficult. Methods In this retrospective cohort study, we analyzed the associations between the prevalence of depression and patient-specific factors in gynecologic and breast cancer patients who had received a palliative care consult. This study was conducted in a single institution that specializes in women and infant care. The primary objective was to quantify the prevalence of depression among palliative care patients. The secondary objective was to determine patient specific factors associated with a diagnosis of depression. Results Over the course of the one year inclusion period, a total of 73 patients met inclusion criteria. The prevalence of depression in this study was found to be 54.8%. A diagnosis of anxiety was associated with the presence of depression (77.5% vs 25%, p \u3c 0. 0001). Cancer of the fallopian tube was also independently associated with depression (12. 5% vs 0, p = 0. 44). Conclusion The prevalence of depression for palliative care patients, specifically for patients with gynecologic and breast malignancies, in this study was higher than estimates of depression prevalence for the general population. The results of this study may indicate that a greater awareness of the need for screening and treatment of depression is necessary in this population, in order to properly diagnose and treat patients with depression

Tapping Environmental History to Recreate America’s Colonial Hydrology

To properly remediate, improve, or predict how hydrological systems behave, it is vital to establish their histories. However, modern-style records, assembled from instrumental data and remote sensing platforms, hardly exist back more than a few decades. As centuries of data is preferable given multidecadal fluxes of both meteorology/climatology and demographics, building such a history requires resources traditionally considered only useful in the social sciences and humanities. In this Feature, Pastore et al. discuss how they have undertaken the synthesis of historical records and modern techniques to understand the hydrology of the Northeastern U.S. from Colonial times to modern day. Such approaches could aid studies in other regions that may require heavier reliance on qualitative narratives. Further, a better insight as to how historical changes unfolded could provide a “past is prologue” methodology to increase the accuracy of predictive environmental models

Evaluation of a text supported weight maintenance programme ‘Lighten Up Plus’ following a weight reduction programme: randomised controlled trial

Background Many overweight people find it difficult to maintain weight loss after attending a weight reduction programme. Self-weighing and telephone support are known to be useful methods for self-monitoring for weight loss. We examined the effectiveness of an SMS-text messaging based weight maintenance programme to encourage regular self-weighing in adults who had completed a 12 week commercial weight loss programme. Methods Randomised controlled trial of 380 obese or overweight men and women. The intervention group (n=190) received a single maintenance support phone call and SMS-text based weight maintenance messages over 12 weeks to encourage regular self-weighing after completing their weight loss programme. The primary outcome was change in weight at nine months follow up. Results Our sample (N=380) had a mean age of 47.4 years (SD 13.4), mean baseline weight and BMI of 93.1kg (16.1) and 34.4 kg/m2 (5.0) respectively, as well as majority female (87.3%) and White British (80.0%). Using intention to treat analysis both groups regained weight at nine months follow up; the intervention group regained an average of 1.36 kg while the control group regained 1.81 kg. Adjusting for covariates resulted in a mean difference of 0.45 kg (95% CI -0.78, 1.67) favouring the intervention group at nine month follow up. Conclusions We found no evidence that an SMS based weight maintenance intervention encouraging adults to weigh themselves weekly prevented weight regain at three or nine months after completing a commercial weight loss programme. <br/

A simulation based difficult conversations intervention for neonatal intensive care unit nurse practitioners: A randomized controlled trial.

BACKGROUND:Neonatal nurse practitioners are often the front line providers in discussing unexpected news with parents. This study seeks to evaluate whether a simulation based Difficult Conversations Workshop for neonatal nurse practitioners leads to improved skills in conducting difficult conversations. METHODS:We performed a randomized controlled study of a simulation based Difficult Conversations Workshop for neonatal nurse practitioners (n = 13) in a regional level IV neonatal intensive care unit to test the hypothesis that this intervention would improve communication skills. A simulated test conversation was performed after the workshop by the intervention group and before the workshop by the control group. Two independent blinded content experts scored each conversation using a quantitative communication skills performance checklist and by assigning an empathy score. Standard statistical analysis was performed. RESULTS:Randomization occurred as follows: n = 5 to the intervention group, n = 7 to the control group. All participants were analyzed in each group. Participation in the simulation based Difficult Conversations Workshop increases participants' empathy score (p = 0.015) and the use of communication skills (p = 0.013) in a simulated clinical encounter. CONCLUSIONS:Our study demonstrates that a lecture and simulation based Difficult Conversations Workshop for neonatal nurse practitioners improves objective communication skills and empathy in conducting difficult conversations