Information Received and Usefulness of the Sources of Information to Cancer Patients at a Tertiary Care Centre in Malaysia.

Most people with cancer have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. Providing good quality cancer-related information enables patients to be better prepared for treatment and improves their adherence. This study aimed to determine the level of information received and the perceived usefulness of the sources of information to cancer patients. A 4-month study was conducted at a day care oncology unit and oncology ward of a tertiary care centre in Malaysia using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Information Module (EORTC QLQ-INFO 25). In total, 103 patients successfully completed the questionnaire. Level of information received was moderate. Patients were well-informed about medical tests (mean ± SD = 74.2 ± 17.8) followed by the disease itself (mean ± SD = 68.0 ± 13.6). Patients received less information on both other services (mean ± SD = 47.6 ± 18.1) and different places of care (mean ± SD = 41.3 ± 22.3). Although the correlation between age and level of information received was poor (r = - 0.201; P = .042), younger patients (≤ 65 years old) were found to have higher level of information received than older patients (mean ± SD = 61.5 ± 11.2 versus 57.8 ± 6.6; P = .046). Doctors (mean ± SD = 88.1 ± 17.1), nurses (mean ± SD = 83.7 ± 20.3), and family members (mean ± SD = 81.1 ± 24.9) were the most useful sources of information by cancer patients. There is still a need for improvement in the provision of information by the healthcare team and prioritisation should depend on patients' individual characteristics and their needs of information. More attention is needed in delivering required information especially to older patients.

Quality of Life of Caregivers of Individuals With Parkinson's Disease.

PURPOSE: This study aimed to construct a structural equation model to predict the quality of life of caregivers of individuals with Parkinson's disease. DESIGN: A cross-sectional survey using a structured questionnaire in South Korea. METHODS: A total of 208 subjects participated in this study from August 31 to November 26, 2015. The questionnaire included caregiving appraisal, social support, educational program needs, and the Parkinson's Disease Questionnaire-Carer. FINDINGS: Participants were either spouses (46.2%) or adult children (45.2%) of individuals with Parkinson's disease. The mean score obtained on the caregiver's quality of life was 40.94 ± 25.30. Social support, caregiving appraisal, and educational program needs were the predictors, explaining 67.0% of the variance in caregivers' quality of life. CONCLUSIONS: Predicting the quality of life is useful for the development of support resources for caregivers of individuals with Parkinson's disease. Further studies exploring the multidimensional aspects of caregivers' quality of life are needed. CLINICAL RELEVANCE: Rehabilitation nurses should identify caregivers at high risk in order to improve their quality of life. Nurses should assess education program needs and caregiving appraisal of caregivers of individuals with Parkinson's disease and develop a customized intervention program.

Non-pharmacological therapies for sleep disturbances in people with Parkinson's disease: A systematic review.

AIM: To determine the effectiveness of non-pharmacological therapies for sleep disturbances in people with Parkinson's disease (PD). BACKGROUND: Sleep disturbances, which are common in people with PD, may diminish their quality of life. Non-pharmacological therapies are preferred over pharmacological therapies for improving sleep quality, owing to fewer adverse effects. DESIGN: Systematic literature review. DATA SOURCES: A systematic search of eight databases and hand searching was conducted for papers published between 1 January 2000 - 1 January 2016. REVIEW METHODS: The Cochrane methods were followed. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. RESULTS: Eight studies were identified for data extraction. Therapeutic domains included physical exercise, cognitive behavioural and complementary interventions. Therapies in four of the eight studies significantly improved sleep quality and the unified PD rating scale score. Other studies showed no clear effects on sleep (N = 1), limited effects on sleep (N = 1) or effects in both the intervention and control groups, indicating that the intervention had no distinctive effects (N = 2). CONCLUSIONS: The non-pharmacological intervention types and sleep-related measured outcomes were heterogeneous. Most therapies had inconsistent effects on sleep. The insufficient evidence for non-pharmacological treatments seems related to the unique motor-associated clinical features of PD, which restrict the use of physical exercise therapy, or to individual "wearing-off" periods, which limit group therapy. Further studies on non-pharmacological therapies are required to identify the best interventions for improving sleep quality in people with PD.

Targeting FoxM1 inhibits proliferation, invasion and migration of nasopharyngeal carcinoma through the epithelial­to-mesenchymal transition pathway.

High expression levels of the forkhead box M1 (FoxM1) transcription factor are associated with metastasis and poor prognosis of malignancies. However, little is known concerning its function in nasopharyngeal carcinoma (NPC). The present study aimed to investigate the impact of FoxM1 inhibition on the migration and invasion of NPC cells and the potential mechanisms. The effects of FoxM1 inhibitor treatment and FoxM1 silencing on the proliferation, migration and invasion of NPC CNE-1 and CNE-2 cells were examined by CCK-8, Transwell migration/invasion and colony formation assays. The effects of stable FoxM1 silencing on the growth and lung metastasis of implanted NPC were evaluated. The relative levels of FoxM1, zinc finger E-box binding homeobox 2 (ZEB2), Snail2 and E-cadherin in the different groups of NPC cells and tumors were determined by quantitative real-time PCR, western blotting and immunohistochemical assays. Treatment with thiostrepton, FoxM1 inhibitor, significantly reduced the survival of NPC cells. Treatment with thiostrepton and/or knockdown of FoxM1 inhibited the anchorage-independent proliferation, migration and invasion of NPC cells. Inhibition of FoxM1 also increased the relative levels of E-cadherin, but reduced ZEB2 and Snail2 expression in NPC cells. Stable FoxM1 silencing inhibited the growth and lung metastasis of implanted NPC in vivo, which was associated with increased levels of E-cadherin, but decreased ZEB2 and Snail2 expression in the NPC tumors. In conclusion, our data clearly indicate that knockdown of FoxM1 inhibited the growth and metastasis of human NPC by modulating epithelial-to-mesenchymal transition (EMT), and FoxM1 may be a potential target for the intervention of NPC.