The demand for genetic counseling will grow as advances in cancer genomics reveal genes that may contribute to cancer predisposition. Innovative delivery models are necessary to ensure that all people have access to care.
Background: COVID-19 pandemic has strained human and material resources around the world. Practices in surgical oncology had to change in response to these resource limitations, triaging based on acuity, expected oncologic outcomes, availability of supportive resources, and safety of health care personnel.Methods: The MD Anderson Head and Neck Surgery Treatment Guidelines Consortium devised the following to provide guidance on triaging head and neck cancer (HNC) surgeries based on multidisciplinary consensus. HNC subsites considered included aerodigestive tract mucosa, sinonasal, salivary, endocrine, cutaneous, and ocular.Recommendations: Each subsite is presented separately with diseasespecific recommendations. Options for alternative treatment modalities are provided if surgical treatment needs to be deferred. Conclusion: These guidelines are intended to help clinicians caring for patients with HNC appropriately allocate resources during a health care crisis, such as the COVID-19 pandemic. We continue to advocate for individual consideration of cases in a multidisciplinary fashion based on individual patient circumstances and resource availability. K E Y W O R D S oncology, otolaryngology, SARS-CoV-2
BackgroundThis study reports long‐term head and neck cancer (HNC) patient‐reported symptoms using the MD Anderson Symptom Inventory Head and Neck Cancer Module (MDASI‐HN) in a large cohort of HNC survivors.MethodsMDASI‐HN results were prospectively collected from an institutional survivorship database. Associations with clinicopathologic data were analyzed using χ2, Mann‐Whitney, and univariate regression.ResultsNine hundred and twenty‐eight patients were included. Forty‐six percent had oropharyngeal primary tumors. Eighty‐two percent had squamous cell carcinoma. Fifty‐six percent of patients had ablative surgery and 81% had radiation therapy as a component of treatment. The most severe symptoms were xerostomia and dysphagia. Symptom scores were worst for hypopharynx and varied by subsite. Patients treated with chemoradiation or surgery followed by radiation ± chemotherapy reported the worst symptoms while patient treated with surgery plus radiation ± chemotherapy reported the worst interference.ConclusionHNC survivors describe their long‐term symptom burden and inform efforts to improve care many years into survivorship.
Fournier, D, Feeney, G, and Mathieu, M-E. Outcomes of exercise training following the use of a birthing ball during pregnancy and delivery. J Strength Cond Res 31(7): 1941-1947, 2017- Using a birthing ball (BB) is an exercise form that is growing in popularity. Improved delivery outcomes have been recently reported with as little a 6-8 hours of training per week; however, little is known regarding lower and higher training levels. The aim of this study was to document whether more time spent training with a BB resulted in improved delivery outcomes for the mother and the newborn. This quasi-experimental study was conducted with a sample of women who participated in 1 to 28 supervised exercise classes during pregnancy according to the Ballon Forme program offered in nonclinical settings (http://ballonforme.com), with the option of completing the supervised BB exercises performed at home. Thirty women who gave birth naturally were included in the study. Mean BB training time was 22.3 hours (SD = 16.6 hours). A greater BB training time was significantly associated with shorter labor duration (r = -0.408; p = 0.031) and specific stages of labor (stage 1 [dilatation/active stage] [r = -0.372; p = 0.043] and stage 2 [expulsion] [r = -0.415; p = 0.028]). Increased participation in BB supervised classes was more closely associated with quicker deliveries than those of home based BB exercises. No associations between training time and adverse effects of labor parameters or the baby's health were noted. Greater involvement in BB training seems to lead to quicker deliveries than lower levels of involvement; it also has the benefit of supervised practice.
This article explores a paradox revealed by our research on the democratic practices of women's groups in Québec. In focus groups and interviews, grassroots members active in these groups suggested that formal decision making structures had little meaning to most grassroots members. Workers and board members also identified a significant distance between members' participation and formal democratic structures. However, these same informants spoke eloquently of the meaning of democracy and its importance in these groups. This article analyses the meaning of democracy and democratic structures for the members of these women's groups. The analysis sits at the intersection of feminist theory on democracy and Alain Touraine's theory of the emergence of the subject through participation in democratic processes. The article explores the nuances, contradictions and richness of the different meanings of democracy for the members of these women's groups.
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