Josephholder1229

A strong physician-patient relationship is the foundation of providing excellent patient care, as it improves providers' job satisfaction and patients' confidence, which influences their health outcomes.1,2 Strong relationships also prompt more accurate identification of patients' needs and perceptions, which may be used as an indicator of physician competence.3 Given the diverse racial, cultural, and religious backgrounds of patients, it is imperative for physicians to have a fundamental understanding of different cultures in order to provide the best care for patients.Recognizing that the past does not necessarily pass of its own accord but rather is made to pass is crucial for understanding relationships between collective memory, temporality and the past. Analyzing processes of temporal negotiation reveals that changing the ending (or, in some cases creating one at all) requires re-envisioning the entire sequence of events. Thus, the ending (if there is one) depends on the beginning. British prime ministers' references to 9/11 in public addresses demonstrate this process of temporal negotiation about whether and how to create an ending. Tony Blair constructed the attacks as a legacy, thus sustaining the past as part of the present. To unwind this construction and consign 9/11 to the past, Gordon Brown and David Cameron needed to disrupt the flow of contingent incidents in which Blair had embedded 9/11. By redefining the narrative's beginning, they made it possible to bring 9/11 to an end.Among the various forms of response bias that can emerge with self-report rating scale assessments are those related to anchoring, the tendency for respondents to select categories in close proximity to the rating category used for the immediately preceding item. In this study we propose a psychometric model based on a multidimensional nominal model for response style that also simultaneously accommodates a respondent-level anchoring tendency. The model is estimated using a fully Bayesian estimation procedure. By applying this model to a real test data set measuring extraversion, we explore a theory that both response styles and anchoring might be viewed as evidence of a lack of effortful responding. Empirical results show that there is a positive correlation between the strength of midpoint response style and the anchoring effect; further, responses indicative of either anchoring or response style both negatively correlate with response time, consistent with a theory that both phenomena reflect reduced respondent effort. The results support attending to both anchoring and midpoint response style as ways of assessing respondent engagement.How do sexual minorities navigate and negotiate with nationalism? While some scholars consider nationalism as a primarily exclusionary force against sexual minorities, how might we understand sexual minorities' engagement with nationalism? I address these questions by exploring the strategic deployment of sexual and national identities of LGBT movements through the case study of Singapore's annual LGBT-inclusive event, Pink Dot. In response to the authoritarian and heteronormative state's construction of sexual minorities as non-national Others, Pink Dot mobilizes both sexual and national identities in an effort to forge a space of inclusion while ensuring its survival. By portraying itself as a uniquely Singaporean event and espousing national identity and belonging through symbolic and performative practices, Pink Dot leverages national identity to minimize differences from and foreground similarities to the majority. read more In this way, sexual minorities in Singapore endeavor to embed themselves within the narratives of the nation and claim their legitimate belonging while simultaneously projecting a nation more inclusive of sexual difference. The aspirational inclusion of sexual minorities in the national imagery, however, inevitably elicits the state's backlash that narrowly defines the physical and symbolic boundaries of the political project. This analysis advances our understanding of the interactions between the state and social movements in shaping the relationship among the nation, sexuality, and citizenship.

Degarelix is a gonadotropin-releasing hormone antagonist that leads to medical castration used to treat men with advanced or metastatic prostate cancer, or both. It is unclear how its effects compare to standard androgen suppression therapy.

To assess the effects of degree compared with standard androgen suppression therapy for men with advanced hormone-sensitive prostate cancer.

We searched multiple databases (CENTRAL, MEDLINE, Embase, Scopus, Web of Science, LILACS until September 2020), trial registries (until October 2020), and conference proceedings (until December 2020). We identified other potentially eligible trials by reference checking, citation searching, and contacting study authors.

We included randomized controlled trials comparing degarelix with standard androgen suppression therapy for men with advanced prostate cancer.

Three review authors independently classified studies and abstracted data from the included studies. The primary outcomes were overall survival and serious adverse evdegarelix to standard androgen suppression, but serious adverse events and quality of life may be similar between groups. The effects of degarelix on cardiovascular events are very uncertain as the only eligible study had limitations, was small with few events, and was conducted in a high-risk population. Degarelix likely results in an increase in injection site pain compared to standard androgen suppression therapy. Maximum follow-up of included studies was 14 months, which is short. There is a need for methodologically better designed and executed studies with long-term follow-up evaluating men with metastatic prostate cancer.

This is an update of the original Cochrane Review first published in Issue 10, 2016. For people with advanced cancer, the prevalence of pain can be as high as 90%. Cancer pain is a distressing symptom that tends to worsen as the disease progresses. Evidence suggests that opioid pharmacotherapy is the most effective of these therapies. Hydromorphone appears to be an alternative opioid analgesic which may help relieve these symptoms.

To determine the analgesic efficacy of hydromorphone in relieving cancer pain, as well as the incidence and severity of any adverse events.

We searched CENTRAL, MEDLINE, Embase and clinical trials registers in November 2020. We applied no language, document type or publication status limitations to the search.

We included randomised controlled trials (RCTs) that compared hydromorphone with placebo, an alternative opioid or another active control, for cancer pain in adults and children. Primary outcomes were participant-reported pain intensity and pain relief; secondary outcis very uncertain. The studies reported some adverse events, such as nausea, vomiting, dizziness and constipation, but generally there was no clear evidence of a difference between hydromorphone and morphine, oxycodone or fentanyl for this outcome. There is insufficient evidence to support or refute the use of hydromorphone for cancer pain in comparison with other analgesics on the reported outcomes. Further research with larger sample sizes and more comprehensive outcome data collection is required.

To assess the circulating micro-RNA-150 (miR-150) expression in patients with chronic myeloid leukemia (CML) in relation to imatinib response.

Sixty patients with CML and 20 age- and sex-matched control subjects were enrolled. Circulating miR-150 levels were assessed by quantitative real-time polymerase chain reaction on days 0, 14, and 90 of imatinib therapy for patients and once for control subjects.

The baseline miR-150 expression was significantly lower in patients with CML than in control subjects with subsequent elevation at 14 and 90 days after the start of imatinib treatment. Early treatment response (ETR) at 90 days was the main study outcome. The miR-150 expression had a significantly higher level in patients with CML with ETR. On multivariate analysis, miR-150 on day 14 was significantly related to ETR in patients with CML with predictive efficacy (area under the curve = 0.838, 72.9% sensitivity, and 84.2% specificity).

We found that miR-150 expression on day 14 of imatinib treatment is a useful early predictive candidate for imatinib response in patients with CML.

We found that miR-150 expression on day 14 of imatinib treatment is a useful early predictive candidate for imatinib response in patients with CML.Total body irradiation (TBI) with ovarian shielding is expected to preserve fertility among hematopoietic stem cell transplant (HSCT) patients with myeloablative TBI-based regimens. However, the radiation dose to the ovaries that preserves ovarian function in TBI remains poorly understood. Furthermore, it is uncertain whether the dose to the shielded organs is associated with relapse risk. Here, we retrospectively evaluated the relationship between fertility and the dose to the ovaries, and between relapse risk and the dose to the pelvic bones. A total of 20 patients (median age, 23 years) with standard-risk hematologic diseases were included. Median follow-up duration was 31.9 months. The TBI prescribed dose was 12 Gy in six fractions for three days. Patients' ovaries were shielded with cylinder-type lead blocks. The dose-volume parameters (D98% and Dmean) in the ovaries and the pelvic bones were extracted from the dose-volume histogram (DVH). The mean ovary Dmean for all patients was 2.4 Gy, and 18 patients recovered menstruation (90%). The mean ovary Dmean for patients with menstrual recovery and without recovery were 2.4 Gy and 2.4 Gy, respectively, with no significant difference (P = 0.998). Hematological relapse was observed in five patients. The mean pelvis Dmean and pelvis D98% for relapse and non-relapse patients were 11.6 Gy and 11.7 Gy and 5.6 Gy and 5.3 Gy, respectively. Both parameters showed no significant difference (P = 0.827, 0.807). In conclusion, TBI with ovarian shielding reduced the radiation dose to the ovaries to 2.4 Gy, and preserved fertility without increasing the risk of relapse.

The current study examined the roles of constructive and dysfunctional problem-solving strategies in the relationships between illness uncertainty and adjustment outcomes (i.e., anxious, depressive, and posttraumatic stress symptoms) in caregivers of children newly diagnosed with cancer.

Two hundred thirty-eight caregivers of children (0-19 years of age) newly diagnosed with cancer (2-14 weeks since diagnosis) completed measures of illness uncertainty, problem-solving strategies, and symptoms of anxiety, depression, and posttraumatic stress.

A mediation model path analysis assessed constructive and dysfunctional problem-solving strategies as mediators between illness uncertainty and caregiver anxious, depressive, and posttraumatic stress symptoms. Dysfunctional problem-solving scores partially mediated the relationships between illness uncertainty and anxious, depressive, and posttraumatic stress symptoms. Constructive problem-solving scores did not mediate these relationships.

The current findings suggest that illness uncertainty and dysfunctional problem-solving strategies, but not constructive problem-solving strategies, may play a key role in the adjustment of caregivers of children newly diagnosed with cancer.