Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Nurses’ experiences of palliative care in home care

Bakgrund: När ett beslut om att patientens vård ska övergå från kurativ vård till palliativ vård är målet med vården att främja livskvalitet. Den palliativa vården bygger på fyra hörnstenar, symtomkontroll i vid bemärkelse, samarbete av ett mångprofessionellt arbetslag, kommunikation och relation samt stöd till närstående. För att möjliggöra en bra vård för patienter behöver sjuksköterskors erfarenheter av palliativ vård i hemsjukvården lyftas för att öka förståelsen för området.  Syfte: Att beskriva sjuksköterskors erfarenheter av palliativ vård i hemsjukvården. Metod: En kvalitativ litteraturöversikt med induktiv ansats. Tolv kvalitativa artiklar användes för att sammanställa resultatet. Databaserna som användes var Cinahl, PubMed, PsychINFO och ProQuest. Dataanalysen har gjorts i överenstämmelse med Fribergs fyrstegsmodell (2022).  Resultat: Två teman framkom: patientnära arbete och teamarbete. Sjuksköterskor lyfte vårdrelationer och närhet till patienter. De upplevde utmaningar i sitt arbete och hur de kunde bemöta dem. Samarbete beskrevs som en del av det dagliga arbetet.  Slutsats: Sjuksköterskor ansåg djupa vårdrelationer med patienter som viktiga. De mötte utmaningar som stress vilket påverkade det dagliga arbetet. Samarbete med patient, familj och andra professioner beskrevs som viktigt, samt att respektera och anpassa sig efter det privata hemmet. Mer djupgående forskning gällande stress och utmaningar inom palliativ hemsjukvård kan bidra till att sjuksköterskor arbetar mer personcentrerat.  Title: Nurses’ experiences of palliative care in home care  Background: When the patient's care crosses from curative care to palliative care, the goal is to encourage quality of life. Palliative care is constructed on four cornerstones, symptom control, teamwork, communication and relationship and support to relatives.  To enable good care for patients, nurses' experiences of palliative care in home health care need to be highlighted in order to increase understanding of the area. Aim: To describe nurses' experiences of palliative care in home care.  Method: A qualitative literature review with an inductive approach was conducted. Twelve qualitative articles were used to compile the result. The databases used were Cinahl, PubMed, PsycINFO and ProQuest. The data were analyzed according to Friberg's four step analysis process. Results: Two themes emerged: close patient work and teamwork. Nurses highlighted care relationships and closeness to patients. They experienced challenges in their work and how they could manage them. Collaboration was described as part of the daily work.  Conclusion: Nurses believed that deep caring relationships with patients were important. They faced challenges such as stress which affected their daily work. Cooperation with the patient, family and other professions was described as important, as well as respecting and adapting to the private home. Further research regarding stress and challenges in palliative home care can contribute to nurses working towards more person-centered care.

Hållbarhetsrapportering och företagsvärde : En studie om sambandet mellan integrerad respektive separat hållbarhetsrapportering och företagsvärde.

Samhällets intresse för hållbarhet har vuxit under de senaste decennierna och det har kommit att ställas stora krav på företags hållbarhetsrapportering. I Sverige är hållbarhetsredovisning lagstadgat för stora företag och regleras av årsredovisningslagen. Årsredovisningslagen redogör bland annat för två möjligheter för företag att publicera sin hållbarhetsrapport, integrerat i årsredovisningen eller som en från årsredovisningen skild rapport. Tidigare forskning har fokuserat på integrerad rapportering på den sydafrikanska marknaden och där är forskningen enig och menar att integrerad rapportering har ett positivt förhållande till företagsvärde. Liknande forskning på den asiatiska marknaden finner inget samband mellan integrerad rapportering och företagsvärde. Denna studie undersöker hur hållbarhetsrapportens form, integrerad respektive separat, påverkar företagsvärdet på den svenska marknaden. Studien består av 313 observationer på Nasdaq Stockholm under åren 2017, 2018 och 2019. Vi finner inget signifikant samband mellan formen på hållbarhetsrapporten och företagsvärde, vilket antyder att intressenter på den svenska marknaden är indifferenta gällande hållbarhetsrapportens form

Development of an Indirect ELISA and Dot-Blot Assay for Serological Detection of Rice Tungro Disease

Rice tungro disease (RTD) is one of the most destructive diseases of rice in South and Southeast Asia. RTD is routinely detected based on visual observation of the plant. However, it is not always easy to identify the disease in the field as it is often confused with other diseases or physiological disorders. Here we report the development of two serological based assays for ease of detection of RTD. In this study we had developed and optimized an indirect ELISA and dot-blot assay for detection of RTD. The efficiency of both assays was evaluated by comparing the specificity and sensitivity of the assays to PCR assay using established primer sets.The indirect ELISA showed 97.5% and 96.6%, while the dot-blot assay showed 97.5% and 86.4% sensitivity and specificity, respectively, when compared to established PCR method. The high sensitivity and specificity of the two assays merit the use of both assays as alternative methods to diagnose RTD. Furthermore, the dot-blot assay is a simple, robust, and rapid diagnostic assay that is suitable for field test for it does not require any specialized equipment.This is a great advantage for diagnosing RTD in paddy fields, especially in the rural areas

Effects of Fenbendazole on the Murine Humoral Immune System

Pinworms are highly contagious parasites that have been effectively treated in laboratory rodents with fenbendazole (FBZ). Whether FBZ has any detrimental side effects that may compromise experimental results is unknown. Here we asked whether the immune systems from young and aged mice are altered under FBZ treatment. We compared control and FBZ-treated groups of young (age, 2 to 4 mo) and old (age, 22 to 24 mo) BALB/cN mice. The treated mice received a total of 4 wk (alternating-week treatment regimen) of FBZ-medicated feed. Spleen and bone marrow were collected for immunologic assays, and heart, stomach, intestines, kidneys, and liver were evaluated by histopathology. Our results indicate that FBZ treatment has significant effects on the immune systems of mice; these effects are greater in aged mice. FBZ treatment adversely affected mRNA and protein expression of E2A (a transcription factor crucial for B lymphocytes) in activated precursor B lymphocytes obtained from the bone marrow of young and old mice. These effects were reversed by 6 wk on regular feed after the end of treatment. Activated B lymphocytes from the spleens of young and old mice showed decreased function (cell proliferation, E2A mRNA and protein expression) through the last time point of FBZ treatment but recovered by 2 to 4 wk after treatment. Our findings suggest that FBZ treatment may alter sensitive immune and molecular measures as presented here, and postponing the experimental use of mice until at least 6 wk after treatment should be considered