Exploration of the factors that influence perceived quality of patient centered care among cancer survivors: A systematic review.

PURPOSE: The purpose of this study was the estimation of the quality of patient centered care among cancer survivors. METHODS: Following the PRISMA guidelines, MEDLINE and Google Scholar were systematically searched using the keywords "quality of patient centered care" and "cancer" from 2012 to 2022. RESULTS: In this systematic review 7 articles were included, from which 5557 patients were derived, 3050 of them being females. The majority of them (2553 patients) suffered from haematological malignancies, while a considerable amount of them suffered from breast cancer. Three studies were conducted in Australia and four studies in Mexico. Factors, such as respect to patients' values and preferences, emotional support, management of psychological needs and integrated and coordinated care received a lower score. The characteristics that were statistically significantly related to the dimensions of person-centered care were numerous and were grouped into two major categories: a) socio-demographic such as gender, age, marital status, professional status, level of education, place of residence, type of insurance and b) clinical factors such as type of malignancy, psychiatric comorbidities, time interval of diagnosis, follow-up center, type of treatment. CONCLUSIONS: The literature showed that there is a lack of comparative data regarding the perceived quality of patient centered care among cancer survivors. More psychometric tools of quality of patient centered care, or validation of the existed ones among all types of cancer survivors are needed, in order to identify and further improve the aspects of care that are not delivered successfully.

Respiratory resistance during anaesthesia with isoflurane, sevoflurane, and desflurane: a randomized clinical trial.

BACKGROUND: To investigate whether the effects of desflurane on inspiratory resistance are similar to those of isoflurane and sevoflurane during 30 min administration at 1 and 1.5 MAC in patients with healthy lungs. METHODS: Seventy-one patients undergoing elective surgery were randomly assigned to receive isoflurane, sevoflurane, or desflurane. Baseline inspiratory resistance was obtained after intubation and establishment of volume control ventilation. Anaesthesia was maintained with desflurane, isoflurane, or sevoflurane at 1 MAC for 30 min followed by 1.5 MAC for another 30 min. Tidal volume, flow, and inspiratory pressures were continuously recorded with a pneumotachograph. Total inspiratory resistance (R(rs)), minimal resistance (R(min)), and effective resistance (D(Rrs)) were calculated every 5 min using the end-inspiratory occlusion technique. RESULTS: No significant differences of the evaluated parameters (R(rs), R(min) and D(Rrs)) were observed during administration of the three agents at 1 MAC for 30 min. At 1.5 MAC, desflurane caused a maximum increase in R(rs) by 26% and in R(min) by 30% above baseline, in contrast to isoflurane and sevoflurane which did not display a significant effect on R(rs) (+3.7% by isoflurane and +7.6% by sevoflurane) and R(min) (+4.7% by isoflurane and +9.6% by sevoflurane). All parameters returned to baseline after discontinuation of the volatile agent. CONCLUSIONS: In healthy adults, neither sevoflurane nor isoflurane produced bronchodilation at 1 and 1.5 MAC. Desflurane did not affect respiratory resistance at 1 MAC, but at 1.5 MAC caused significant increase in both total and airway resistance with return to near baseline values after discontinuation of the agent.

Control of enteric pathogens in ready-to-eat vegetable crops in organic and 'low input' production systems: a HACCP-based approach.

Risks from pathogens such as Salmonella, Yersinia, Campylobacter and Escherichia coli O157 have been identified as a particular concern for organic and 'low input' food production systems that rely on livestock manure as a nutrient source. Current data do not allow any solid conclusions to be drawn about the level of this risk, relative to conventional production systems. This review describes six Risk Reduction Points (RRPs) where risks from enteric pathogens can be reduced in ready-to-eat vegetables. Changes can be made to animal husbandry practices (RRP1) to reduce inoculum levels in manure. Outdoor livestock management (RRP2) can be optimized to eliminate the risk of faecal material entering irrigation water. Manure storage and processing (RRP3), soil management practices (RRP4) and timing of manure application (RRP5), can be adjusted to reduce the survival of pathogens originating from manure. During irrigation (RRP6), pathogen risks can be reduced by choosing a clean water source and minimizing the chances of faecal material splashing on to the crop. Although preventive measures at these RRPs can minimize enteric pathogen risk, zero risk can never be obtained for raw ready-to-eat vegetables. Good food hygiene practices at home are essential to reduce the incidence of food-borne illnesses.