Providing a nurse-led complex nursing INtervention FOcused on quality of life assessment on advanced cancer patients: The INFO-QoL pilot trial.

PURPOSE Unmet needs for advanced-disease cancer patients are fatigue, pain, and emotional support. Little information is available about the feasibility of interventions focused on patient-reported outcome measurement developed according to the Medical Research Council (MRC) Framework in advanced-disease cancer patients. We aimed to pilot a nurse-led complex intervention focused on QoL assessment in advanced-disease cancer patients. METHODS The INFO-QoL study was based on an exploratory, nonequivalent comparison group, pre-test-post-test design. Study sites received either the INFO-QoL intervention or usual care. Adult advanced-disease cancer patients admitted to hospice inpatient units that gave their informed consent were included in the study. Subjects were 187 patients and their families and 19 healthcare professionals. We evaluated feasibility, acceptability, and patients' outcomes using the Integrated Palliative Care Outcome Scale. RESULTS Nineteen healthcare professionals were included. The mean competence score increased significantly over time (p < 0.001) and the mean usefulness score was high 8.63 (±1.36). In the post-test phase, 54 patients were allocated to the experimental unit and 36 in the comparison unit. Compared to the comparison unit, in the experimental unit anxiety (R2 = 0.07; 95% CI = -0.06; 0.19), family anxiety (R2 = 0.22; 95% CI = -0.03; 0.41), depression (R2 = 0.31; 95% CI = -0.05; 0.56) and sharing feelings (R2 = 0.09; 95% CI = -0.05; 0.23), were improved between pre-test and post-test phase. CONCLUSIONS The INFO-QoL was feasible and potentially improved psychological outcomes. Despite the high attrition rate, the INFO-QoL improved the quality and safety culture for patients in palliative care settings

West-East Laboratories on Geographical Information Systems (WELL-GIS)

peer reviewe

Radiation dose to the operator during fluoroscopically guided spine procedures

Purpose: Fluoroscopy is widely used to guide diagnostic and therapeutic spine procedures. The purpose of this study was to quantify radiation incident on the operator (operator Air Kerma) during a wide range of fluoroscopy-guided spine procedures and its correlation with the amount of radiation incident on the patient (Kerma Area Product\ue2\u80\u94KAP). Methods: We retrospectively included 57 consecutive fluoroscopically guided spine procedures. KAP [Gy\uc2\ua0cm2] and total fluoroscopy time were recorded for each procedure. An electronic dosimeter recorded the operator Air Kerma [\uce\ubcGy] for each procedure. Operator Air Kerma for each procedure, correlation between KAP and operator Air Kerma, and between KAP and fluoroscopy time was obtained. Results: Operator Air Kerma was widely variable across procedures, with median value of 6.4\uc2\ua0\uce\ubcGy per procedure. Median fluoroscopy time and median KAP per procedure were 2.6\uc2\ua0min and 4.7\uc2\ua0Gy\uc2\ua0cm2, respectively. There was correlation between operator Air Kerma and KAP (r2\uc2\ua0=\uc2\ua00.60), with a slope of 1.6\uc2\ua0\uce\ubcGy Air Kerma per unit Gy\uc2\ua0cm2KAP incident on the patient and between fluoroscopy time and KAP (r2\uc2\ua0=\uc2\ua00.63). Conclusion: Operator Air Kerma during individual fluoroscopy-guided spine procedures can be approximated from the commonly and readily available information of the total amount of radiation incident on the patient, measured as KAP

A Bottom-up Approach for the Identification of Requirements and ICT solutions for Environmental Information Sharing

European directives and policy communications have been launched with the objective of simplify the sharing of environmental data. The paper proposes a method for comparing heterogeneous information systems to provide input to the development of ICT solutions and best practices for a high level policy. The approach starts by referring to the priorities of the current initiatives that should be supported by a bottom-up collection of good practices and existing systems. High level models of the business processes that are supported by these systems are created to allow compari-son and giving, at the same time, a bottom-up vision on the policy. The ap-proach has been applied in the context of the European project NESIS to provide input for a proposal of ICT guidelines for SEIS initiative.JRC.H.6-Digital Earth and Reference Dat

A Bottom up Approach for the Identification of Requirements and ICT solutions for Environmental Information Sharing

European guidance and policy for the development of information infrastructures recommends that new data and information handling resources should be based on existing examples, as proposed by the European Interoperability Strategy (EIS1) and the Interoperability Solutions for European Public Administrations (ISA2). In addition, the recent Communication on a European Shared Environmental Information System (SEIS3) outlines the need to modernize and simplify the collection, exchange and use of data and information required for the design, implementation and monitoring of environmental policy. These policy drivers present challenges in the actual identification and comparison of often heterogeneous systems within the environmental information sharing domain; including the processes and resources which support the capture/discovery, processing, validation, analysis and dissemination of data/information about the environment. To address this challenge, we present a method to gather and analyze the components of environmental information systems that can contribute to the development of information infrastructures such as SEIS. Our approach is described as (principally) \u27bottom-up\u27: a community of practitioners propose candidate systems for analysis, illustrating what approaches are currently adopted to create, manage, use environmental data/information that aim to meet the goals/principles (or \u27top-down\u27 setting) of the SEIS policy arena, while also informing this policy\u27s development itself

Biometry extraction and probabilistic anatomical atlas of the anterior Visual Pathway using dedicated high-resolution 3-D MRI

: Anterior Visual Pathway (aVP) damage may be linked to diverse inflammatory, degenerative and/or vascular conditions. Currently however, a standardized methodological framework for extracting MRI biomarkers of the aVP is not available. We used high-resolution, 3-D MRI data to generate a probabilistic anatomical atlas of the normal aVP and its intraorbital (iOrb), intracanalicular (iCan), intracranial (iCran), optic chiasm (OC), and tract (OT) subdivisions. We acquired 0.6&nbsp;mm3 steady-state free-precession images from 24 healthy participants using a 3&nbsp;T scanner. aVP masks were obtained by manual segmentation of each aVP subdivision. Mask straightening and normalization with cross-sectional area (CSA) preservation were obtained using scripts developed in-house. A probabilistic atlas ("aVP-24") was generated by averaging left and right sides of all subjects. Leave-one-out cross-validation with respect to interindividual variability was performed employing the Dice Similarity Index (DSI). Spatially normalized representations of the aVP subdivisions were generated. Overlapping CSA values before and after normalization demonstrate preservation of the aVP cross-section. Volume, length, CSA, and ellipticity index (ε) biometrics were extracted. The aVP-24 morphology followed previous descriptions from the gross anatomy. Atlas spatial validation DSI scores of 0.85 in 50% and 0.77 in 95% of participants indicated good generalizability across the subjects. The proposed MRI standardization framework allows for previously unavailable, geometrically unbiased biometric data of the entire aVP and provides the base for future spatial-resolved, group-level investigations