The Potential Role of Symptom Questionnaires in Palliative and Supportive Cancer Care Delivery

The American Society of Clinical Oncology (ASCO) palliative care recommendations have been updated into a full guideline. Symptom questionnaires—completed and reviewed with patients during care delivery—are poised to play a large role in this guideline because they provide a more comprehensive understanding of symptoms. This article provides an overview of the guideline and describes how symptom questionnaires can be used to satisfy the guideline

Soil management: The key to soil quality and sustainable agriculture

Today, after the International Year of Soils in 2015 and the proclamation by the International Union of Soil Sciences of the International Decade of Soils 2015-2020, much attention is paid to soil quality. Often used interchangeably, both terms, soil quality and soil health, refer to dynamic soil properties such as soil organic matter or pH, while soil quality also includes inherent soil properties such as texture or mineral composition. However, it is the dynamic or manageable properties that adequate soil management can influence and thus contribute to a well-functioning soil environment capable to deliver the soil-mediated provisioning, regulating and supporting ecosystem services and soil functions. This contribution intends to highlight the key principles of sustainable soil management and provide evidence that they are compliant with a productive, resource efficient and ecologically friendly agriculture. Paradoxically, and despite benefitting from good soil quality, agriculture itself when based on conventional, especially intensive tillage-based soil management practices contributes decisively to soil degradation and to several of the soil threats as identified by the Soil Thematic Strategy, being soil erosion and soil organic matter decline the most notorious ones. To mitigate soil degradation, the European Union’s Common Agricultural Policy has introduced conservation measures, mainly through cross-compliance measures supposed to guarantee minimum soil cover, to limit soil erosion and to maintain the levels of soil organic matter. However, it remains unclear to what extent EU member states apply these ‘Good Agricultural and Environmental Condition’ (GAEC) measures to their utilized agricultural areas. Effective and cost-efficient soil management systems able to conserve or to restore favourable soil conditions, to minimize soil erosion and to invert soil organic matter and soil biodiversity decline and improve soil structure are those capable to mimic as close as possible natural soil conditions while producing food, feed, fibre and fuel. This means to establish and manage crops while disturbing the soil as least as possible, to maintain the soil permanently covered with plants or their residues and to allow for a diversity of plants either in rotation or in association. These principles also known as Conservation Agriculture have shown to be the most promising approach for a sustainable production intensification and proven to work in a wide range of agro-ecological conditions. Although adopted already on more than 150 Mha worldwide, in Europe it still can be considered a novel soil management practice as it is applied on only around 2% of the annual cropland. A paradigm shift and innovative approaches are needed both to recognise the principles of Conservation Agriculture as the only cost-effective, and thus overall sustainable soil management practices capable to deliver the soil-mediated ecosystem services and to make Conservation Agriculture systems work and accepted as the best compromise to attain better soil quality

Fair and Flexible?! Explanations Can Improve Applicant Reactions Toward Asynchronous Video Interviews

Asynchronous video interviews are used more and more for the preselection of potential job candidates. However, recent research has shown that they are less accepted by applicants than face-to-face interviews. Our study aimed to identify ways to improve perceptions of video interviews by using explanations that emphasize standardization and flexibility. Our results showed that an explanation stressing the higher level of standardization improved fairness perceptions, whereas an explanation stressing the flexibility concerning interview scheduling improved perceptions of usability. Additionally, the improvement of fairness perceptions eventually influenced perceived organizational attractiveness. Furthermore, older participants accepted video interviews less. Practical implications and recommendations for future research are discussed

Electronic Patient Reporting of Adverse Events and Quality of Life: A Prospective Feasibility Study in General Oncology

PURPOSE: Adverse event (AE) reporting is essential in clinical trials. Clinician interpretation can result in under-reporting; therefore, the value of patient self-reporting has been recognized. The National Cancer Institute has developed a Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) for direct patient AE reporting. A nonrandomized prospective cohort feasibility study aimed to explore the compliance and acceptability of an electronic (Internet or telephone) system for collecting patient self-reported AEs and quality of life (QOL). METHODS: Oncology patients undergoing treatment (chemotherapy, targeted agents, hormone therapy, radiotherapy, and/or surgery) at 2 hospitals were sent automated weekly reminders to complete PRO-CTCAE once a week and QOL (for a maximum of 12 weeks). Patients had to speak/understand English and have access to the Internet or a touch-tone telephone. Primary outcome was compliance (proportion of expected questionnaires), and recruitment rate, attrition, and patient/staff feedback were also explored. RESULTS: Of 520 patients, 249 consented (47.9%)—mean age was 62 years, 51% were male, and 70% were married—and 230 remained on the study at week 12. PRO-CTCAE was completed at 2,301 (74.9%) of 3,074 timepoints and QOL at 749 (79.1%) of 947 timepoints. Individual weekly/once every 4 weeks compliance reduced over time but was more than 60% throughout. Of 230 patients, 106 (46.1%) completed 13 or more PRO-CTCAE, and 136 (59.1%) of 230 patients completed 4 QOL questionnaires. Most were completed on the Internet (82.3%; mean age, 60.8 years), which was quicker, but older patients preferred the telephone option (mean age, 70.0 years). Positive feedback was received from patients and staff. CONCLUSION: Self-reporting of AEs and QOL using an electronic home-based system is feasible and acceptable. Implementation of this approach in cancer clinical trials may improve the precision and accuracy of AE reporting

Financial Relationships With Industry Among National Comprehensive Cancer Network Guideline Authors

Financial conflicts of interest (FCOIs) among authors of clinical practice guidelines have the potential to influence treatment recommendations. To quantify FCOIs with industry among authors of the National Comprehensive Cancer Network (NCCN) guidelines. We assessed FCOIs occurring during 2014 among NCCN guideline authors in the United States. All were physician members of the NCCN guideline committees for lung, breast, prostate, and colorectal cancer as of the end of 2014. The data source for FCOIs was Open Payments, which is publically reported by the Centers for Medicare and Medicaid Services. This study was cross-sectional. The proportion of NCCN authors having FCOIs with industry; the average amount received from industry sources per author. Of 125 guideline authors, 108 (86%) had at least 1 reported FCOI. Authors received an average of $10 011 (range,$0-$106 859) in general payments (GPs), which include consulting, meals, lodging, and similar transfers of value, and$236 066 (range $0-$2 756 713) in industry research payments (RPs), including funding associated with clinical trials. Approximately 84% of authors received GPs, while 47% received RPs. Eight (6%) had FCOIs in excess of the $50 000 net and/or$20 000 single-company maximums stipulated by NCCN. Among NCCN guideline authors, FCOIs involving RPs were of greater value, while those involving GPs were more prevalent. Although FCOIs may result from engaging in important scholarship, FCOIs may still influence guideline authors in counterproductive ways. Research is needed to understand how best to manage author FCOIs during guideline creation

Validation study of a web-based assessment of functional recovery after radical prostatectomy

<p>Abstract</p> <p>Background</p> <p>Good clinical care of prostate cancer patients after radical prostatectomy depends on careful assessment of post-operative morbidities, yet physicians do not always judge patient symptoms accurately. Logistical problems associated with using paper questionnaire limit their use in the clinic. We have implemented a web-interface ("STAR") for patient-reported outcomes after radical prostatectomy.</p> <p>Methods</p> <p>We analyzed data on the first 9 months of clinical implementation to evaluate the validity of the STAR questionnaire to assess functional outcomes following radical prostatectomy. We assessed response rate, internal consistency within domains, and the association between survey responses and known predictors of sexual and urinary function, including age, time from surgery, nerve sparing status and co-morbidities.</p> <p>Results</p> <p>Of 1581 men sent an invitation to complete the instrument online, 1235 responded for a response rate of 78%. Cronbach's alpha was 0.84, 0.86 and 0.97 for bowel, urinary and sexual function respectively. All known predictors of sexual and urinary function were significantly associated with survey responses in the hypothesized direction.</p> <p>Conclusions</p> <p>We have found that web-based assessment of functional recovery after radical prostatectomy is practical and feasible. The instrument demonstrated excellent psychometric properties, suggested that validity is maintained when questions are transferred from paper to electronic format and when patients give responses that they know will be seen by their doctor and added to their clinic record. As such, our system allows ready implementation of patient-reported outcomes into routine clinical practice.</p

Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan

Objectives: We evaluated the feasibility and efficacy of a program to promote colorectal cancer screening (CRC) among uninsured Latinas receiving mammography through a cancer screening clinic in northern Manhattan. Methods: Between August 2009 and March 2010, unscreened, average CRC risk, uninsured Latinas, aged 50–64 years, undergoing mammography received a screening recommendation, education, and fecal immunochemical test (FIT). Socio-demographic information and level of acculturation was collected. Screening compliance was assessed. Results: Of 651 Latinas evaluated, 210 were eligible and, of these, 94% (n = 197) consented to participate; 441 were excluded because they were up-to-date with CRC screening (n = 130), less than 50 (n = 285) or greater than 64 (n = 26) years of age. After intervention, 177 (90%) completed FIT. Within 2 weeks, 87% completed the FIT, and 69% did so with no reminder calls. Acculturation was significantly lower among screeners (p = 0.014). Compared with non-screeners, screeners were more likely to be foreign-born (p = 0.009), to speak only Spanish (p = 0.043), and to prefer to read (p = 0.037), and think (p = 0.015) in Spanish. Conclusion: This study suggests that pairing CRC education and screening with mammography is both feasible and efficacious