RESUMEN
PROBLEM IDENTIFICATION: A systematic review and meta-analysis was conducted to inform the development of guidelines on the management of radiodermatitis among patients with cancer. LITERATURE SEARCH: The authors updated a systematic review to include available literature published through September 30, 2019. DATA EVALUATION: Two investigators assessed risk of bias using the Cochrane Collaboration risk-of-bias tool and certainty of the evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. SYNTHESIS: The use of deodorant/antiperspirant had no effect on development of radiodermatitis. Aloe vera and emu oil were equivalent or less effective than standard care. Oral curcumin had a minimal beneficial effect. Nonsteroidal topical interventions had a minimal beneficial effect on the development of moist desquamation and relief of itching while causing a small increase for grade 2 radiodermatitis. Topical calendula increased risk for the development of radiodermatitis. Topical steroids and dressings each showed benefits to minimize the development of radiodermatitis and moist desquamation while lowering rates of patient-reported symptoms, such as pain and pruritus. IMPLICATIONS FOR RESEARCH: Symptom management strategies for radiodermatitis among patients with cancer that are likely to be effective include topical nonsteroidals, topical steroids, and dressings. SUPPLEMENTAL MATERIAL CAN BE FOUND AT HTTPS: //bit.ly/2FWj3Kp.
Asunto(s)
Neoplasias , Radiodermatitis , Vendajes , Humanos , Neoplasias/complicaciones , Neoplasias/radioterapia , Radiodermatitis/tratamiento farmacológico , Radiodermatitis/etiologíaRESUMEN
PURPOSE: Current evidence-based research suggests that early evaluation, comprehensive care plans, and appropriate referrals for childhood and adolescent behavioral and development needs is critical for successful family-centered outcomes. The overall purpose of this study was to conduct an assessment of a state public health program that offers diagnostic evaluation and coordination for children with behavioral and developmental disorders in the state of Virginia (Child Development Center programs, or CDC). A secondary purpose was to provide translational policy and advocacy targets based on key findings. DESIGN AND METHOD: The evaluation of the scope of services of the CDC programs was done using qualitative interviews with a focus group interview (n = 23), interviews from representatives from individual centers ( n = 5 centers), and descriptive quantitative data elements for the fiscal year 2015. RESULTS: After conducting the state public health evaluation, several translational health policy priorities emerged, including: (a) the need for integrated data standards, (b) Lack of developmental pediatric workforce, particularly in rural sectors of the state, and (c) Need for enhanced program support for care coordination. CONCLUSION: Academic nurse and public health partnerships can aid in translation from research to policy among vulnerable populations and assist in communication to key stakeholders and legislators for iterative action and reassessment.
Asunto(s)
Trastornos de la Conducta Infantil/terapia , Servicios de Salud del Niño/organización & administración , Discapacidades del Desarrollo/terapia , Niños con Discapacidad/estadística & datos numéricos , Adolescente , Niño , Trastornos de la Conducta Infantil/prevención & control , Preescolar , Discapacidades del Desarrollo/prevención & control , Política de Salud , Humanos , Evaluación de Necesidades , Calidad de la Atención de Salud , Factores Socioeconómicos , VirginiaRESUMEN
PURPOSE/OBJECTIVES: To gain a unique perspective of young women with cancer aged 20-39 years who are experiencing challenges with fertility and parenting through analysis of cancer blogs.â©. RESEARCH APPROACH: A secondary analysis of online narratives using a focused thematic analysis approach, comparing women who were mothers prior to diagnosis with women who are exploring the possibility of motherhood after diagnosis.â©. SETTING: Blogs found through websites and social media venues for young adults with cancer.â©. PARTICIPANTS: 10 women aged 20-39 who maintained blogs about their cancer experiences.â©. METHODOLOGIC APPROACH: Thematic analysis using line-by-line coding. Construction of comparative themes and meanings were guided by the analytic framework of the stages of grief.â©. FINDINGS: Themes emerged along the grieving trajectory of denial (maintaining routines and discussing "eggs"), depression (losing motherhood and anticipatory grief), and acceptance (finding joy moment to moment and hope for pregnancy).â©. CONCLUSIONS: Motherhood and infertility are unique experiences for young women with cancer but are expressed similarly through the stages of grief. INTERPRETATION: Understanding the grief trajectories of young women with cancer will help nurses to develop screening tools and supportive interventions.