Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates

ObjectivesTo systematically review the literature pertaining to the prevalence of depression and anxiety in patients with prostate cancer as a function of treatment stage.DesignSystematic review and meta-analysis.Participants4494 patients with prostate cancer from primary research investigations.Primary outcome measureThe prevalence of clinical depression and anxiety in patients with prostate cancer as a function of treatment stage.ResultsWe identified 27 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 4494 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 17.27% (95% CI 15.06% to 19.72%), 14.70% (95% CI 11.92% to 17.99%) and 18.44% (95% CI 15.18% to 22.22%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 27.04% (95% CI 24.26% to 30.01%), 15.09% (95% CI 12.15% to 18.60%) and 18.49% (95% CI 13.81% to 24.31%), respectively.ConclusionsOur findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated

Fabriquer un culte ethnique. \uc9criture rituelle et g\ue9n\ue9alogies mythiques dans le sanctuaire des Paliques en Sicile.

The sanctuary of the gods Palikoi in Sicily offers a rich dossier addressing the role of writing in the definition of ethnicity. Although literary evidence attest to the \u201dnative\u201c nature of the gods, the presence of writing, inbedded in local culture through the Greek colonization, plays a curious role. It invites us to reflect upon contact processes and identity changes due to its appearance. The analysis focuses here on the ordeal oath (ritual writing) and on the mythical genealogies (discursive strategies): this set seems to be a "device" in many ways informed by the model of the "Middle Ground."Le sanctuaire des dieux Paliques en Sicile offre un dossier tr\ue8s riche \ue0 questionner pour ce qui concerne le r\uf4le jou\ue9 par l\u2019\ue9criture dans la d\ue9finition de l\u2019ethnicit\ue9. M\ueame si les t\ue9moignages litt\ue9raires reconnaissent la nature \uab indig\ue8ne \ubb des Paliques, la pr\ue9sence de l\u2019\ue9criture, qui a p\ue9n\ue9tr\ue9 dans les cultures locales par le biais de la colonisation grecque, exerce une fonction troublante et nous oblige \ue0 r\ue9fl\ue9chir sur les processus de contact et les changements identitaires que son existence provoque. L\u2019analyse se concentre ici sur le serment ordalique (\ue9criture rituelle) et sur les g\ue9n\ue9alogies mythiques (strat\ue9gies discursives) : cet ensemble semble constituer un \uab dispositif \ubb que le mod\ue8le du \uab Middle Ground \ubb permet d'\ue9clairer \ue0 bien des \ue9gards

Elite male Flat jockeys display lower bone density and lower resting metabolic rate than their female counterparts: implications for athlete welfare

To test the hypothesis that daily weight-making is more problematic to health in male compared with female jockeys, we compared the bone-density and resting metabolic rate (RMR) in weight-matched male and female Flat-jockeys. RMR (kcal.kg-1 lean mass) was lower in males compared with females as well as lower bone-density Z-scores at the hip and lumbar spine. Data suggest the lifestyle of male jockeys’ compromise health more severely than females, possibly due to making-weight more frequently

Feasibility study for a community based intervention for adults with severe chronic fatigue syndrome/ME

Background: Chronic Fatigue Syndrome/ME (CFS/ME) is characterised by debilitating fatigue with many bedbound patients. The study aims were: to determine whether a new intervention could be successfully delivered; to collect quantitative outcome data to guide the design of future studies; to explore qualitatively the experience of patients, carers and clinicians. Methods: Mixed-methods feasibility study with qualitative and quantitative evaluation. Participants: 12 UK patients who were housebound with severe CFS/ME. Intervention: Based on recovery skills identified through a 2.5 year Patient and Public Involvement development process involving individuals with first-hand experience of recovery from CFS/ME, as well as current patients and clinicians. The resulting one year intervention, delivered by a multi-disciplinary team, included domiciliary therapy visits and optional peer support group. Quantitative outcome measures: Patient-reported and therapist-reported outcome measures (including fatigue, physical function, anxiety, depression and other variables) and electronic activity measurement. Results: The study recruited and engaged twelve participants with no serious adverse events or dropouts. At end of intervention, 5/12 participants had improved in fatigue, physical function. Group mean scores improved overall for fatigue (Chalder fatigue scale), physical function (activity and physical function scale) and anxiety. Qualitative interviews suggested that the intervention was acceptable to patients, whilst also highlighting suggestions for improvement. Participants will be followed up for a further year to find out if improvements are sustained. Conclusion: This is the largest study ever conducted in severe CFS/ME and shows significant recovery suggesting further studies are indicated. Treatment is uniquely based on a patient inspired intervention

Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial

Objective: To assess strategies for advice on analgesia and steam inhalation for respiratory tract infections.Design: Open pragmatic parallel group factorial randomised controlled trial.Setting: Primary care in United Kingdom.Participants: Patients aged ?3 with acute respiratory tract infections.Intervention: 889 patients were randomised with computer generated random numbers in pre-prepared sealed numbered envelopes to components of advice or comparator advice: advice on analgesia (take paracetamol, ibuprofen, or both), dosing of analgesia (take as required v regularly), and steam inhalation (no inhalation v steam inhalation).Outcomes: Primary: mean symptom severity on days 2-4; symptoms rated 0 (no problem) to 7 (as bad as it can be). Secondary: temperature, antibiotic use, reconsultations.Results: Neither advice on dosing nor on steam inhalation was significantly associated with changes in outcomes. Compared with paracetamol, symptom severity was little different with ibuprofen (adjusted difference 0.04, 95% confidence interval ?0.11 to 0.19) or the combination of ibuprofen and paracetamol (0.11, ?0.04 to 0.26). There was no evidence for selective benefit with ibuprofen among most subgroups defined before analysis (presence of otalgia; previous duration of symptoms; temperature >37.5°C; severe symptoms), but there was evidence of reduced symptoms severity benefit in the subgroup with chest infections (ibuprofen ?0.40, ?0.78 to ?0.01; combination ?0.47; ?0.84 to ?0.10), equivalent to almost one in two symptoms rated as a slight rather than a moderately bad problem. Children might also benefit from treatment with ibuprofen (ibuprofen: ?0.47, ?0.76 to ?0.18; combination: ?0.04, ?0.31 to 0.23). Reconsultations with new/unresolved symptoms or complications were documented in 12% of those advised to take paracetamol, 20% of those advised to take ibuprofen (adjusted risk ratio 1.67, 1.12 to 2.38), and 17% of those advised to take the combination (1.49, 0.98 to 2.18). Mild thermal injury with steam was documented for four patients (2%) who returned full diaries, but no reconsultations with scalding were documented.Conclusion: Overall advice to use steam inhalation, or ibuprofen rather than paracetamol, does not help control symptoms in patients with acute respiratory tract infections and must be balanced against the possible progression of symptoms during the next month for a minority of patients. Advice to use ibuprofen might help short term control of symptoms in those with chest infections and in children

Understanding cost of care for patients on renal replacement therapy: looking beyond fixed tariffs.

BACKGROUND: In a number of countries, reimbursement to hospitals providing renal dialysis services is set according to a fixed tariff. While the cost of maintenance dialysis and transplant surgery are amenable to a system of fixed tariffs, patients with established renal failure commonly present with comorbid conditions that can lead to variations in the need for hospitalization beyond the provision of renal replacement therapy. METHODS: Patient-level cost data for incident renal replacement therapy patients in England were obtained as a result of linkage of the Hospital Episodes Statistics dataset to UK Renal Registry data. Regression models were developed to explore variations in hospital costs in relation to treatment modality, number of years on treatment and factors such as age and comorbidities. The final models were then used to predict annual costs for patients with different sets of characteristics. RESULTS: Excluding the cost of renal replacement therapy itself, inpatient costs generally decreased with number of years on treatment for haemodialysis and transplant patients, whereas costs for patients receiving peritoneal dialysis remained constant. Diabetes was associated with higher mean annual costs for all patients irrespective of treatment modality and hospital setting. Age did not have a consistent effect on costs. CONCLUSIONS: Combining predicted hospital costs with the fixed costs of renal replacement therapy showed that the total cost differential for a patient continuing on dialysis rather than receiving a transplant is considerable following the first year of renal replacement therapy, thus reinforcing the longer-term economic advantage of transplantation over dialysis for the health service.<br/

Predatory Grooming and Epistemology with Lauren Leydon-Hardy

Overview & Shownotes Grooming is a practice used to lure victims into an exploitative relationship. The philosopher Lauren Leydon-Hardy explores the ways that predatory grooming can interfere with the very way that a person thinks about themselves and the world. She calls this form of harm “epistemic infringement.” For the episode transcript, download a copy or read it below. Contact us at [email protected] Links to people and ideas mentioned in the show Lauren Leydon-Hardy, “Predatory Grooming and Epistemic Infringement“ Forensic research psychologist Ian Elliott Rachel Denhollander’s testimony in the trial of Larry Nassar Credits Thanks to Evelyn Brosius for our logo. Music featured in the show: “Single Still” by Blue Dot Sessions “Cran Ras” by Blue Dot Session