The Functional Assessment of Cancer Therapy-General and five disease-specific subscales have been translated successfully into Spanish using a thorough translation and initial validation methodology. The methods and data provide a model for preparing a health status questionnaire for cross-cultural validation. The questionnaire is available for use in clinical trials and clinical practice.
Context
Lung cancer patients experience multiple, simultaneous symptoms related to their disease and treatment that impair functioning and health-related quality of life (HRQL). Computer technology can reduce barriers to nonsystematic, infrequent symptom assessment and potentially contribute to improved patient care.
Objectives
To evaluate the efficacy of technology-based symptom monitoring and reporting in reducing symptom burden in patients with advanced lung cancer.
Methods
This was a prospective, multisite, randomized controlled trial (RCT). Two hundred fifty-three patients were enrolled at three sites and randomized to monitoring and reporting (MR) or monitoring alone (MA). Patients completed questionnaires at baseline, 3, 6, 9 and 12 weeks and symptom surveys via interactive voice response (IVR) weekly for 12 weeks. MR patients’ clinically significant symptom scores generated an e-mail alert to the site nurse for management. The primary endpoint was overall symptom burden; secondary endpoints included HRQL, treatment satisfaction, symptom management barriers, and self-efficacy.
Results
This RCT failed to demonstrate efficacy of symptom monitoring and reporting in reducing symptom burden compared with monitoring alone in lung cancer. HRQL declined over 12 weeks in both groups (P<0.006 to P<0.025); at week 12, treatment satisfaction was higher in MA than MR patients (P<0.012, P<0.027). Adherence to weekly calls was good (82%) and patient satisfaction was high.
Conclusion
Feasibility of using a technology-based system for systematic symptom monitoring in advanced lung cancer patients was demonstrated. Future research should focus on identifying patients most likely to benefit and other patient, provider and health system factors likely to contribute to the system’s success.
Introduction: Since 2014, autochthonous circulation of Zika virus (ZIKV) in the Americas was detected (Easter Island, Chile). In May 2015, Brazil confirmed autochthonous transmission and in October of that year Colombia reported their first cases. Now more than 52 countries have reported cases, including Mexico. To deal with this contingency in Mexico, several surveillance systems, in addition to systems for vector-borne diseases were strengthened with the participation of all health institutions. Also, the Ministry of Health defined an Action Plan against ZIKV for the whole country.Methods: We analyzed 93 autochthonous cases of ZIKV disease identified by Epidemiological Surveillance System for Zika Virus in Mexico. All autochthonous cases confirmed by laboratory since November 25, 2015 to February 19, 2016 were included. A description of clinical and epidemiological characteristics of 93 cases of ZIKV disease are presenting and, we describe the Action Plan against this public health emergency. Results: The distribution of cases by sex was 61 men and 32 women; mean age was 35 years old (S.D. 15, range 6-90). The main clinical features in the 93 cases were fever (96.6%), rash (93.3%), non-purulent conjunctivitis (88.8%), headache (85.4%), and myalgia (84.3%). No deaths were reported.Conclusion: The ZIKV epidemic poses new challenges to public health systems. The information provided for basic, clinical, and epidemiological research, in addition to the data derived from epidemiological surveillance is essential. However, there are still many unanswered questions regarding mechanisms of transmission, complications, and impact of this virus.
In this large qualitative study we obtained useful insights into the impact of lower urinary tract symptoms from the perspective of the person with the symptoms. Removing barriers and misconceptions about the treatment of lower urinary tract symptoms may increase the number of people who seek clinical care and improve the clinical course of men and women who experience lower urinary tract symptoms.
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