Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil.

BACKGROUND: This study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health-related quality of life (HR-QOL) outcomes 3 months after initiating treatment. METHODS: This is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient-centered outcomes (HR-QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage. RESULTS: Fifty-six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy - General FACT-G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, -0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found. CONCLUSION: Remote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR-QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient-reported outcomes in low-resource environments.

Psycho-Oncology and the Relevance of a Biopsychosocial Screening Program.

A 40-year-old unmarried Brazilian woman, Ms A, received a diagnosis of papillary renal cell carcinoma (RCC) in February 2020; she underwent nephrectomy the following month. In August, she began to experience generalized pain with subsequent scans revealing metastatic disease to the supraclavicular lymph node, liver, and vagina. In October 2020, Ms A started first-line systemic combination treatment with nivolumab (Opdivo; 3 mg/kg) plus ipilimumab (Yervoy; 1 mg/kg) every 3 weeks for 4 doses, followed by nivolumab (3 mg/kg) every 2 weeks, to be taken for 2 years. In April 2021, follow-up testing revealed a partial response to therapy, and a complete response was evident in August 2021. Ms A was first screened for biopsychosocial distress by the supportive care team in October 2020, and she completed the Edmonton Symptom Assessment System (ESAS) evaluation.During her fourth cycle of treatment in October 2020, the patient was assessed with the ESAS. During her medical visits, Ms A also expressed concern regarding her physical symptoms and admitted frequent self-monitoring for signs of recurrence or progression. Her oncologist prescribed tramadol for pain and the supportive care team recommended increased engagement in physical activity. Upon further assessment, the patient reported a belief that her psychosocial symptoms, worry about recurrence or progression, and time spent self-monitoring were a normal part of her cancer experience.

Lanthanide sorbent based on magnetite nanoparticles functionalized with organophosphorus extractants.

In this work, an adsorbent was prepared based on the attachment of organophosphorus acid extractants, namely, D2EHPA, CYANEX 272, and CYANEX 301, to the surface of superparamagnetic magnetite (Fe3O4) nanoparticles. The synthesized nanoparticles were coated with oleic acid, first by a chemisorption mechanism and later by the respective extractant via physical adsorption. The obtained core-shell functionalized magnetite nanoparticle composites were characterized by dynamic light scattering, scanning electron microscopy, transmission electron microscopy, thermogravimetry, infrared absorption and vibrating sample magnetometry. All the prepared nanoparticles exhibited a high saturation magnetization capacity that varied between 72 and 46 emu g-1 and decreased as the magnetite nanoparticle was coated with oleic acid and functionalized. The scope of this study also included adsorption tests for lanthanum, cerium, praseodymium, and neodymium and the corresponding analysis of their results. Sorption tests indicated that the functionalized nanoparticles were able to extract the four studied lanthanide metal ions, although the best extraction performance was observed when the sorbent was functionalized with CYANEX 272, which resulted in a loading capacity of approximately 12-14 mgLa/gMNP. The magnetization of the synthesized nanoparticles was verified during the separation of the lanthanide-loaded sorbent from the raffinate by using a conventional magnet.

Impact of a Biopsychosocial Screening Program on Clinical and Hospital-Based Outcomes in Cancer.

BACKGROUND: The integration of a biopsychosocial screening (BPS) program has been proposed by international agencies to better identify and effectively manage unmet needs among patients with cancer. We sought to evaluate the effect of a BPS program on hospital admissions and length of stay (LOS) among a diverse sample of patients with cancer and receiving treatment in Brazil. METHODS: A retrospective analysis was performed from March 2020 to December 2021. Eligible patients were diagnosed with cancer and were receiving treatment at a private practice in Brazil. Clinical characteristics, participation in the BPS program, hospital admissions, reason, and LOS in hospital were evaluated. We compared the number of hospital admissions and LOS between groups (participation v no participation). T test and Chi-square test were used to test for differences between groups. RESULTS: A total of 1,014 patients were included in the analysis. Baseline clinical characteristics were well balanced between groups (n = 459 patients who participated and n = 555 patients who did not). The median age of patients was 63 years. Breast and hematological cancers were the most common types of cancer; 60% were diagnosed at an advanced disease stage. A smaller proportion of patients who participated in the BPS program were hospitalized compared with patients who did not participate (8% v 32%, P = .001). Patients who participated in the program also spent less days in the hospital compared with patients who did not participate in the program (M = 4.2 days v 9.8 days, P = .001). CONCLUSION: Engagement in a BPS program was associated with reduced hospital admissions and LOS. This study provides novel insight into the potential broader implications of BPS programs for clinical care systems. Future studies are needed to explore the mechanisms behind such associations.

Fear of cancer recurrence among Brazilian patients with cancer: Translation and cultural adaptation of FCR4/7 and FCRI-SF measures.

OBJECTIVE: Fear of cancer recurrence or progression (FCR) is considered one of the most common unmet needs among patients with cancer. This study sought to translate and evaluate the psychometric properties of the Fear of Cancer Recurrence scale (FCR4/7) and Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF). METHODS: This study involved three phases: (1) translation and cultural adaptation of the FCR4/7 and FCRI-SF measures, (2) validity and reliability testing of the Portuguese version of these measures, and (3) examining patient's perceptions of these measures. Eligible patients were diagnosed with localized breast cancer, and patients with metastatic cancer. Descriptive analyses were collated, and psychometric analysis were conducted (confirmatory factor analysis). RESULTS: A total of 200 patients were recruited (100 patients with localized and 100 patients with metastatic cancer). A significant proportion of patients reported moderate to severe FCR (FCR7: 32.0% and FCRI-SF: 43.0%). Female gender, younger age and metastatic cancer were associated with higher levels of FCR. Psychometric analyses suggested that the Portuguese versions of the FCR4/7 and FCRI-SF were valid, unidimensional in nature, with acceptable reliability coefficients across all scales. In a sub-sample qualitative analysis (n = 75), most patients were satisfied with the relevance of both measures. CONCLUSION: Our findings suggest the Portuguese versions of the FCR4/7 and FCRI-SF are valid tools to assess FCR among patients with localized and metastatic cancer. Future research can now extend our understanding of FCR and assess this construct among Portuguese speaking patients, to guide the development of effective and targeted interventions for patients globally.

Nursing interventions in adult patients with oropharyngeal dysphagia: a systematic review.

BACKGROUND: Oropharyngeal dysphagia is a geriatric syndrome of high prevalence. It requires screening, diagnosis and specific care to avoid possible complications. The objective of this study is to perform a systematic review of the literature to know what interventions are performed by nursing professionals in the care of adult patients with OD. METHODS: A systematic literature review was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration guideline. Included are observational and analytical scientific studies on the interventions nurses made in the assessment and screening of OD secondary to age and/or neurodegenerative diseases, as well as nursing interventions in patient's care and diagnosis in the electronic databases of Medline, SCOPUS and CINALH. RESULTS: A total of 51 articles were included: 10 observational studies, 29 experimental studies and 12 systematic reviews. 66.7% studies talked about the interventions to patients with OD secondary to ICTUS. 82.05% was performed in a hospital setting. In 49.01% of the articles, nurses are mentioned as participants in the interventions. CONCLUSION: Screening and clinical assessment of OD for an early diagnosis are the interventions performed by the most prevalent nursing professionals found in the literature, mainly in the OD, due to ICTUS and in the hospital setting. Further research on interventions by nursing professionals is needed in this area.

Significados y prácticas de consumo conspicuo asociados a la posesión de perros criollos o de raza / Meanings and practices of conspicuous consumption associated with the possession of creole or pedigree dogs

Resumen Esta investigación tuvo como objetivo identificar las representaciones sociales y las prácticas de consumo conspicuo en propietarios de perros en Colombia. Por tanto, se realizó un estudio mixto en una muestra de 96 hombres y mujeres mayores de 18 años, con, primero, una fase cualitativa en la que se exploraron las asociaciones dadas a las representaciones sociales de perros criollos y de raza por parte de propietarios de mascotas y se abordaron los significados atribuidos a las prácticas de consumo conspicuo; y, segundo, una fase cuantitativa en la que se hicieron análisis descriptivos, con lo cual se confirmó la estructura de las representaciones sociales. Como resultados se encontró que se reconoce a los perros criollos y de raza con alto valor afectivo, y que el perro criollo se asocia a condiciones de vulnerabilidad y se reconoce como perro "todo terreno", mientras que el perro de raza involucra cuidado e inversión económica y se identifica como un perro "visible" en la sociedad. Al final se discute respecto a cómo las representaciones sociales acerca de la tenencia de un perro, además del valor afectivo, involucran actividades exhibitorias, de demostración social y, a su vez, un estatus social y moral.

Abstract This research aimed to identify social representations and conspicuous consumption practices in dog owners in the city of Bogotá, Colombia. The sample included 96 men and women over the age of 18. A mixed study was carried out including first, a qualitative phase in which the social representations of dogs' owners - both creole and breed- were explored, as well as the meanings attributed to conspicuous consumption practices. Secondly, in the quantitative phase, descriptive analyses were carried out and thus the structure of social representations was confirmed. The results showed that the affective value of both the creole and breed dogs was acknowledged and that the creole dog is associated with conditions of vulnerability and regarded as an all-terrain dog, whereas breed dogs imply care and economic investment and are identified as "visible" dogs in society. It is discussed how social representations about dog ownership, in addition to the affective value, involve exhibition activities, social demonstration, and in turn, social and moral status.

Creencias y prácticas pedagógicas alrededor del clima en el aula frente al problema de las drogas / Beliefs and pedagogical practices around climate in the classroom facing the problem of drugs / Crenças e práticas pedagógicas em torno do clima na sala de aula diante do problema das drogas

Resumen Introducción: En el campo de la educación se aborda actualmente el problema del consumo, tenencia y micro-tráfico de drogas como uno de los mayores desafíos que enfrentan los docentes. El clima en el aula se construye a través de la interacción entre el docente y sus estudiantes y de las condiciones tanto físicas como emocionales que se presentan dentro del espacio físico donde se imparten las clases. La valoración de esta construcción conceptual denominada clima en el aula aborda un sistema de creencias complejo, comprensiones, desafíos y prácticas pedagógicas multivariadas. Objetivo: El presente estudio, realizado en dos instituciones de educación pública de Ecuador, busca conocer las creencias y prácticas pedagógicas de los docentes frente a las situaciones de riesgo y vulnerabilidad que se presentan dentro del salón de clases por la presencia de las drogas. En toda institución educativa, la expresión de las percepciones que tienen sus integrantes, la forma en que estudiantes y docentes piensan, sienten e interactúan tiene un efecto inmediato dentro del proceso de aprendizaje. Materiales y métodos: A través de un enfoque metodológico cuantitativo, los encuestados en esta investigación comparten sus creencias y prácticas pedagógicas alrededor del concepto clima en el aula. Resultados: Los resultados subrayan que el 31% de la muestra dice estar directamente amenazados por la presencia de la droga en el aula. Conclusión: Se evidencia un gran temor por parte de los docentes, tensiones en sus respuestas, y un marco legal que regula estos contextos con el que no todos están de acuerdo.

Abstract Introduction: In the field of education, the problem of drug consumption, possession and micro-trafficking is currently addressed as one of the greatest challenges faced by teachers. Classroom climate is built through the interaction between the teacher and his students and the physical and emotional conditions that are presented within the physical space where the classes are taught. The assessment of this conceptual construction called climate in the classroom addresses a complex belief system, understandings, challenges and multivariate pedagogical practices. Objective: The present study, carried out in two institutions of public education of Ecuador, seeks to know the beliefs and pedagogical practices of the teachers in front of the situations of risk and vulnerability that appear in the classroom due to the presence of drugs. In every educational institution, the expression of the perceptions that its members have, the way in which students and teachers think, feel and interact has an immediate effect within the learning process. Materials and methods: Through a quantitative methodological approach, the respondents in this research share their beliefs and pedagogical practices around the concept of climate in the classroom. Results: The results highlight that 31% of the sample said to be directly threatened by the presence of the drug in the classroom. Conclusion: There is great fear on the part of teachers, tensions in their responses, and a legal framework that regulates these contexts with which not everyone agrees.

Resumó Introdução: No campo da educação, o problema do consumo de drogas, posse e microtráfico é atualmente abordado como um dos maiores desafios enfrentados pelos professores. O clima de sala de aula é construído através da interação entre o professor e seus alunos e as condições físicas e emocionais que são apresentadas dentro do espaço físico onde as aulas são ministradas. A avaliação dessa construção conceitual chamada clima na sala de aula aborda um complexo sistema de crenças, entendimentos, desafios e práticas pedagógicas multivariadas. Objetivo: Este estudo, realizado em duas instituições de ensino público do Equador, procura entender as crenças e práticas pedagógicas de professores enfrentar situações de risco e vulnerabilidade apresentado em sala de aula pela presença de drogas. Em todas as instituições educacionais, a expressão das percepções que seus membros têm, o modo como os alunos e professores pensam, sentem e interagem tem um efeito imediato no processo de aprendizagem. Materiais e métodos: Por meio de uma abordagem metodológica quantitativa, os entrevistados nesta pesquisa compartilham suas crenças e práticas pedagógicas em torno do conceito de clima em sala de aula. Resultados: Os resultados apontam que 31% da amostra disseram estar diretamente ameaçados pela presença do medicamento na sala de aula. Conclusão: Há um grande receio por parte dos professores, tensões nas suas respostas e um quadro legal que regula esses contextos com os quais nem todos concordam.