ABSTRACT
Background: In Japan, a nation-wide education program for primary palliative care (the Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education: PEACE) was established in 2008. In 2018, this program was revised from a two-day workshop to a hybrid program combining e-learning with a one-day workshop. This study aimed to assess the changes in participant knowledge and difficulties after having completed the revised education program. Methods: The subjects of this study were all participants who completed the revised program from April 2018 to March 2019. We conducted a pre-post survey via the e-learning system, and measured scores on the palliative care knowledge questionnaire to evaluate PEACE (PEACE-Q) and Palliative Care Difficulties Scale (PCDS). Results: A total of 11,124 participants completed the revised program from June 2018 to March 2019. Participants’ knowledge improved significantly according to the PEACE-Q with a total score of 24.1 and 30.0 (p<0.0001), and difficulties diminished as indicated by the PCDS with a total score of 45.2 and 39.2 (p<0.0001). Participants in different professions obtained similar results. Conclusion: Participants’ knowledge and difficulties improved after the revised nationwide primary palliative care education program. Similar results were obtained by participants in different professions.
ABSTRACT
OBJECTIVES@#The purpose of this study is to evaluate the efficacy of annual zoledronic acid treatment in Japanese patients with nonmetastatic prostate cancer during androgen deprivation therapy (ADT).@*METHODS@#This is a single institution 12-month study. Between 2016 and 2019, patients aged 70 years or older on ADT for nonmetastatic prostate cancer had bone mineral density (BMD) measured and 10-year probability of fracture calculated using fracture risk assessment tool (FRAX). Patients who showed osteopenia or had a 10-year hip fracture risk ≥ 3% or a 10-year probability of major osteoporotic fracture ≥ 20% were offered treatment with zoledronic acid 5 mg intravenously (ZA group). The patients who did not receive treatment were set as the control group. Lumbar and hip BMD were measured 6 and 12 months after treatment in the ZA group and 12 months after baseline in the control group. The yearly BMD change of both groups was compared.@*RESULTS@#The mean ages of the ZA group (n = 26) and control group (n = 12) were 80.5 ± 9.1 and 76.1 ± 6.7 years, respectively. In the ZA group, lumbar and hip BMD changes at 12 months were +2.1% and +0.8%, respectively. In the control group, lumbar and hip BMD changes were −0.9% and −4.9%, respectively. There were statistically significant differences between the 2 groups in BMD percent changes (P < 0.05).@*CONCLUSIONS@#Without intervention, BMD tends to continue to decrease during ADT. Our findings suggest that administration of zoledronic acid enables maintenance of BMD in the older adults.
ABSTRACT
The purpose of this study was to clarify feasibility of a booklet for families of children dying with incurable cancer. Of 267 pediatric oncology specialists, 76 (28%) participated in this cross-sectional survey. Ninety-three percent of participants answered that they were “likely to use” the booklet, and 86% percent answered that they believed the booklet was “helpful” for families. Some participants described various advantages of its use as follows: “able to communicate something that is difficult to put into words,” “easy to understand for families,” “families can read whenever they choose to,” and “able to grasp the direction of dying.” In contrast, other participants described points of attention of use as follows: “optimal timing to bring out,” “acceptance of families,” “direction as interdisciplinary team,” “confidential relationship between families and interdisciplinary team,” “disinclination among health care providers,” and “information volume of the booklet.” Thus, our results validated feasibility of the booklet. In conclusion, pediatric oncology specialists should provide their support of utilizing the booklet for families and assessing each family condition and advantage/attention of using the booklet.