Conectar
The MD Anderson Oropharynx Cancer (MDA-OPC) cohort is a unique single-institution, prospective longitudinal cancer cohort. The cohort aims to enhance the therapeutic index of OPC management by supporting data needs for independent investigators to conduct rigorous observational studies examining exposures and factors associated with acute and late toxicities, cancer progression, recurrence, new malignancies and quality of life in OPC survivors.
A total of 1811 patients with OPC with a minimum follow-up of 6 months have been consented to our prospective registry between 18 March 2015 and 29 December 2023. Clinical and treatment (Tx) data are available on all patients, including previously untreated patients (1443, 80%). Most previously untreated patients (97%) consented to longitudinal patient-reported outcomes and functional assessments for critical time points including pre-Tx, during-Tx and post-Tx at 3–6 months, 12 months, 18–24 months and annually up to 5 years.
The median age for the MDA-OPC cohort is 66 years (range, 25–96) with the majority being male (89%), white (92%) and with human papillomavirus (HPV)/p16-associated OPC (88%) primarily located in the tongue base or tonsil (90%). For previously untreated patients, 79% were diagnosed with stage I/II disease, and nearly half underwent curative intent chemoradiation. Overall survival was significantly higher for HPV/p16-associated OPC at 1 year (98% vs 93%) and 5 years (83% vs 54%; p
Future work includes expansion of the MDA-OPC cohort and survivorship surveillance to 10 years under the recently funded OPC-SURVIVOR research programme (P01CA285249), which aims to identify non-invasive, clinic-ready biomarkers and examine novel phenotypes and mechanistically matched mitigation strategies for latent OPC sequelae. Additionally, we aim to expand our advanced data infrastructure by integrating large data streams from parallel clinical trials and imaging registries.
Vaccinations are essential to ensure protection for healthcare professionals, patients and communities. However, vaccination hesitancy has been reported among healthcare professionals. Nurses are the main, first and direct point of contact for patients and citizens in most healthcare services, but only a minority of studies investigated vaccination hesitancy and uptake specifically in this population. Thus, this study aimed to explore the determinants and motivations of vaccination hesitancy and uptake among nurses.
Systematic review with a narrative synthesis approach.
We included primary research exploring determinants or motivations of vaccination hesitancy or uptake among nurses. No time or geographical limit was applied. Generalised random-effects linear models with a logit link were used to calculate the pooled estimated proportions for vaccine uptake among nurses.
We explored nine databases (2023).
The initial search identified 3452 records; 42 records were eventually included in this review. Older age, longer professional experience, lack of confidence in vaccine safety and effectiveness and cost associated with the vaccine were among the most common determinants of vaccine hesitancy. Safety concerns, complacency (e.g., beliefs of not needing the vaccine), and accessibility (e.g., logistics) were among the most common motivations for being vaccine hesitant. Having strong confidence in the vaccine, a high sense of collective responsibility, previous vaccination uptake/positive intentions towards future vaccination, weaker vaccine complacency, and older age were among the most common determinants of vaccine uptake. Willingness to protect themselves and/or others, contribute to the herd immunity, and comply with recommendations were among the most common motivations for vaccine uptake. The pooled prevalence of influenza vaccine uptake among nurses was 44% (95% CI: 35–73).
The findings of this systematic review with meta-analysis could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
This study contributes to further understanding nurses' beliefs, barriers, and facilitators towards vaccination. By doing so, these results could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
We have adhered to relevant EQUATOR guidelines, in particular to the PRISMA checklist.
No patient or public contribution.
PROSPERO number: CRD42020212252
This study aims to describe disease-specific self-care behaviours in patients with heart failure (HF), diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) in various combinations; to compare these self-care behaviours within patient groups; and to evaluate differences across these groups.
Cross-sectional study.
A total sample of 1079 older patients was recruited from outpatient clinics and home settings. Eligible patients were aged ≥ 65 years and had a diagnosis of HF and/or DM, and/or COPD, along with at least one additional chronic condition. Data were collected using validated tools: the Self-Care of Heart Failure Index, Self-Care of Diabetes Inventory and Self-Care of Chronic Obstructive Pulmonary Disease Inventory. Descriptive statistics were used to analyse disease-specific self-care behaviours. Group comparisons were performed using Student's t-test and univariate, followed by multivariate analyses of variance.
The analysis focused on a subset of 223 patients who had a combination of at least two chronic conditions between HF, DM and/or COPD. The mean age of participants was 77.3 (SD 7.5) years, with a majority being female (53.4%). Self-care maintenance, monitoring and management for HF and COPD were found to be inadequate across all patient groups. Adequate self-care was only observed in DM management among those with HF and DM and in DM maintenance for those with DM and COPD treated with insulin. Significant differences in all self-care dimensions were observed across groups, particularly in patients managing all three conditions (HF, DM and COPD).
The findings provide valuable insights into the complexities of self-care in patients with multiple chronic conditions, underscoring the need for tailored, integrated and patient-centred interventions. Healthcare strategies should focus on enhancing patient education and developing personalised approaches to improve health outcomes and quality of life in this population.
All the authors have adhered to the EQUATOR guidelines STROBE Statement.
A convenience sample of patients was recruited in outpatient clinics and their homes. Data were collected between March 2017 and August 2022, by face-to-face during routine outpatient visits or directly at the patient's home.
FreshRSS 