Cancer Care Ontario's Systematic Symptom Screening Strategy: A Human-Centred Design Approach to Exploring System Gaps and Defining Strategies for the Future.

Cancer patients experience a high symptom burden throughout their illness. Quality cancer symptom management has been shown to improve patient quality of life and prevent emergency department use. Cancer Care Ontario introduced standardized symptom screening in Ontario, using the Edmonton Symptom Assessment System (ESAS) to facilitate patient reporting and management of symptoms. However, patient symptom information is not always sufficiently addressed. To address these gaps, patient and family advisors collaborated with clinicians, administrators and health system leaders from across the Province in a Symptom Management Summit to share perspectives and co-design context-specific solutions to improve care in their region.

Tom McHugh.

Tom McHugh studies the circuit mechanisms of memory in mice at the RIKEN Center for Brain Science in Japan. In an interview with Neuron, he talks about early influences at MIT, the joy of listening to place cells in a converted closet, and personal and scientific adjustments he's made since coming to Japan.

Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery.

OBJECT: The authors' goal was to determine whether the incidence of postoperative sore throat, hoarseness, and dysphagia associated with anterior spine surgery is reduced by maintaining endotracheal tube cuff pressure (ETCP) at 20 mm Hg during the period of neck retraction. METHODS: Fifty-one patients scheduled for anterior cervical spine surgery were enrolled. After intubation, ETCP was adjusted to 20 mm Hg in all patients. Following placement of neck retractors, ETCP was measured. Patients were randomized to a control (no adjustment) or treatment group (ETCP adjusted to 20 mm Hg). A blinded observer questioned the patients about the presence of sore throat, dysphagia, and hoarseness at 1 hour, 24 hours, and 1 week postoperatively. No differences between groups at 1 hour postoperatively were demonstrated. At 24 hours, 51% of patients in the treatment group complained of sore throat compared with 74% of control patients (p < 0.05). Sixty-five percent of the women experienced sore throat compared with 35% of the men (p < 0.05). At 24 hours, longer retraction time correlated with development of dysphagia (p < 0.05, r2 = 0.61). At 24 hours, hoarseness was present in 65% of women and 20% of men (p < 0.05). CONCLUSIONS: The results of this study suggest the following three predictors of postoperative throat discomfort following anterior cervical spine surgery in which neck retraction is performed: increased ETCP during neck retraction (sore throat), neck retraction time (dysphagia), and female sex (sore throat and hoarseness). The simple maneuver of decreasing ETCP to 20 mm Hg may be helpful in improving patient comfort following anterior cervical spine surgery.