Camptranberg1125

The decision as to whether or not a patient should receive radiation therapy as part of their cancer treatment is based on evidence-based practice and on recommended international consensus treatment guidelines. However, the merit of involving the patients' individual preferences and values in the treatment decision is frequently overlooked. Here, we review the current literature pertaining to shared decision making in the field of radiation oncology, including discussion of the patient's perception of radiation therapy as a treatment option and patient involvement in clinical trials. The merit of decision aids during the shared decision making process in radiation oncology is considered, as are patient preferences for active or passive involvement in decisions about their treatment. Clarity of terminology, a better understanding of effective strategies and increased resources will be needed to ensure shared decision making in radiation oncology becomes a reality. This article is protected by copyright. All rights reserved.We duly note the insurance challenges discussed by Eswaran and Chan. Many insurance payers continue to require fixed pre-transplant sobriety periods (i.e. "6-month rules") despite the lack of evidence to support them(1-3). While payers reserve the right to skepticism about any center's evolving policies regarding liver transplantation (LT) for alcohol-associated hepatitis (AH), we anticipate that payers' approach to these patients will progress. As 1) transplant centers update their institutional criteria regarding LT/AH, 2) acceptable outcomes are demonstrated in a transparent manner and 3) professional societies offer guidance, we anticipate that insurance payers' policies will follow suit. This article is protected by copyright. All rights reserved.AIM The aim of the study was to explore the characteristics of nursing work and the correlation with the conditions in nurses' work environment. BACKGROUND Although the correlation between nurses' work characteristics and the safety of healthcare provision has been confirmed, nurses continue to work in discouraging environments. METHOD A cross-sectional study was conducted. A total of 1,744 nurses from 16 Slovenian hospitals participated. Variables included work characteristics, ergonomic conditions at work, the prevalence of low back pain, and self-assessment of conditions in the work environment. RESULTS One nurse was responsible for 17.90 patients per shift (SD=13.615), shifts were understaffed in 42.9% of cases, and technical assistive devices were available in 30% of cases. Job demands were explained with number of patients/shift (p less then 0.001), job satisfaction (p less then 0.001), availability of assistive devices (p=0.001), and the female gender (p=0.001). Decision authority was low and explained with a non-leadership position (p less then 0.001), educational achievement (p less then 0.001), dissatisfaction with the job (p less then 0.001), and the male gender (p=0.008). CONCLUSION A safe patient-to-nurse ratio, job satisfaction, availability of assistive devices, and fostering decision authority turned out to be important in our study. IMPLICATIONS FOR NURSING MANAGEMENT Europe is facing an increasing shortage of nurses, so actions for reducing nurse overload and encouraging decision authority are extremely important both for nurses and patients. Participative leadership and ensuring gender equality in nursing are vital. This article is protected by copyright. All rights reserved.We read with great interest the current issue by De Martin E et al.(1) regarding the analysis of liver transplantation (LT) versus liver resection (LR) on cirrhotic patients with small intrahepatic cholangiocarcinoma (iCCA) and combined hepatocellular-cholangiocarcinoma (cHCC-CCA). The authors retrospectively evaluated a total of 75 cirrhotic patients who were confirmed iCCA/cHCC-CCA ≤5cm and compared them by different operation types of LT or LR0. This article is protected by copyright. All rights reserved.BACKGROUND Transversus abdominis plane (TAP) blocks are useful for adjunctive pain control following laparoscopic live donor nephrectomy (LLDN). The objective was to determine if TAP catheter provides additional analgesia compared with single-injection TAP block alone for kidney donors. METHODS In this prospective, double-blinded, randomized controlled trial, LLDN patients received a single TAP injection of 30 mL 0.2% ropivacaine and had a catheter inserted into the TAP space. Postoperatively, either 0.2% ropivacaine (TAP catheter group; TAP-C) or saline (TAP saline group; TAP-S) was infused at 10 mL/h. Pain scores, narcotic usage, nausea, and sedation were evaluated at 1, 12, 24, 36, 48, and 60 h. RESULTS The study population included 70 patients (35 randomly assigned to each group). No differences in pain scores, narcotic usage, nausea, or sedation were observed at any time point (with the exception of lower median pain score for TAP-S at 60 h; 3.2 versus 3.9 for TAP-C; P = .03). CONCLUSIONS The lower pain score for placebo group at 60 h postoperative is likely clinically insignificant. The TAP catheter infusion provided no benefit over a single-injection TAP block, thus the added risk and cost are not supported. Liposomal bupivacaine should be evaluated in future studies. This article is protected by copyright. All rights reserved.Our research has looked at necessary nursing care that is left undone by registered nurses (RNs) due to lack of time (also termed 'missed care'). The simple yet disturbing finding was that the vast majority - 86% of RNs surveyed in the UK as part of the RN4Cast study - reported that they had missed at least some care that they regarded as being necessary to their patients, on their last shift (Ball et al. 2014). This article is protected by copyright. All rights reserved.BACKGROUND A growing number of studies have demonstrated the effectiveness of acupuncture in preventing and treating postoperative nausea and vomiting. Here, we used meta-analysis to confirm these benefits in children, and to determine the optimal time to perform this treatment. METHODS Four databases (MEDLINE, EMBASE, CENTRAL, and Chinese Database of Biology and Medicine) were searched from inception until January 16, 2019. We included randomized controlled trials for evaluating the effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting during the early stage (0-4 hours) and within 24 hours postoperatively in pediatrics. Control groups received standardized care control or standardized care combined with sham control. Seladelpar RESULTS Sixteen literatures and 1773 patients undergoing general anesthesia were included in the study. The results indicated that acupuncture was effective in reducing postoperative vomiting, both during the first 4 hours (RR=0.47, 95% CI 0.26, 0.84; low quality) and within 24 hours postoperatively (RR=0.