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Background@#The early stage of cancer can be asymptomatic. Thus, different strategies were utilized to increase breast screening attendance which resulted in better treatment outcomes. Therefore, this review aimed to provide evidence on the effectiveness of the different approaches of breast screening uptake in improving screening attendance.@*Objectives@#The primary objective of this systematic review was to determine the effectiveness of the different approaches to breast screening uptake in improving screening attendance. The secondary objective was to identify the socio-geographic profile that affects the screening uptake.@*Methods@#Online databases, such as PubMed and Cochrane Central Register of Controlled Trials, were searched for studies published between January 2010 to December 2020. This review only included comparative randomized clinical trials involving humans as the research participants. In addition, reference lists of included studies were reviewed to identify additional relevant papers.@*Results@#The study included the review of 12 randomized controlled trials. Seven studies were conducted in a European setting, two in the United States of America, another two studies in Asia, and one study conducted in Canada. The intervention strategy to increase screening uptake were diverse in different studies. Ten of these studies used multiple strategies, while the remaining two studies utilized individualized strategies. Most of the studies were individual-based interventions. One study was a group-based intervention. The results showed that these interventions increase the uptake of breast cancer screening than no intervention at all.@*Conclusions@#The review confirmed that any interventions to increase breast screening uptake showed favorable outcomes in increasing breast screening attendance. However, the effectiveness of any one specific intervention cannot be made as these interventional studies greatly varied in terms of their intervention, study population, and geographical area.
Subject(s)
Systematic ReviewABSTRACT
Background@#Colorectal cancer is highly preventable through early screening, but disparities in screening create a negative impact on the lives of those at risk. One approach to address this is patient navigation. This systematic review and meta-analysis therefore aimed to provide evidence of the effectiveness of patient navigation in increasing colorectal cancer screening uptake.@*Objectives@#This study aimed to determine the effectiveness of patient navigation on colorectal cancer screening uptake. Specifically, it aimed to study the effects of different methods of navigation on the uptake of initial screening tests among persons with average risk.@*Methods@#The studies included were randomized clinical trials conducted within 2011-2021 and involving only humans as participants. Data were analyzed by calculating the risk ratio and 95% confidence intervals of each successful outcome, and the investigators independently appraised each study’s risk of bias. Subgroup analysis was conducted to assess consistency of study effects. Certainty of evidence was assessed using the GRADE standard.@*Results@#Eleven (11) studies were included in this systematic review and meta-analysis. All studies encompassed health systems of different countries, and they utilized different means of navigation to achieve outcome measure of colorectal cancer screening uptake. Results show a statistically significant increase in screening uptake with patient navigation in a forest plot. However, there is a high level of heterogeneity among the studies, hence a subgroup analysis was conducted among these studies according to navigation method.@*Conclusion@#This systematic review and meta-analysis show an increase in screening rates in those who were navigated. Results in favor of patient navigation was consistent when all studies were analyzed together and when they were analyzed according to navigation method. Increase in screening uptake is more statistically significant among patients navigated via face-to-face and via phone call, but data is more consistent for patient navigation via phone call alone.
Subject(s)
Colorectal Neoplasms , Patient NavigationABSTRACT
Background@#Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China in December 2019. This has rapidly spread worldwide, causing a pandemic. The Philippines ranks 3rd in Southeast Asia with more than 15,000 confirmed cases, and a case fatality rate of 6.01%, close to the global average of 6.33%.@*Objective and Methods@#This review aims to provide Family and Community Physicians the latest updates on epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment options, and prognosis of COVID-19. Online literature search was done with WHO and DOH websites prioritized for epidemiologic data, and MEDLINE for the most recent and relevant journal articles.@*Pathogenesis@#SARS-CoV-2, the etiologic agent of COVID-19, is an enveloped, positive sense single-stranded RNA virus which triggers immune-mediated responses responsible for most of the clinical manifestations of the disease. Angiotensin Converting Enzyme 2 appears to play a critical role in viral entry and disease severity.@*Clinical Manifestations@#There have been reports of asymptomatic cases. Majority have mild illness, with common symptoms of fever, cough, headache and fatigue. Those who progress to the critical stage of the disease present with Severe Acute Respiratory Syndrome, sepsis or Multiple Organ Dysfunction.@*Diagnostic Evaluation@#The definitive diagnosis of SARS-CoV-2 requires an analysis of respiratory specimens collected through oropharyngeal and nasopharyngeal swabs. The reverse transcriptase-polymerase chain reaction (RT-PCR) is considered the confirmatory test. Serological rapid detection test (RDT) for SARS-CoV-2 IgM and IgG may be done, but as an adjunct only because antibodies appear later in the course of disease. Imaging studies and other tests are used to monitor the severity of the condition, but not for diagnosis.@*Treatment and Prognosis@#Supportive therapy is the cornerstone of management. Currently, there is no FDA-approved drug or agent specifically for the treatment of COVID-19. Drugs being investigated for treatment are those that are currently used for other viral infections or indicated for other conditions. A vaccine is yet to be developed. Old age, the presence of comorbidities such as hypertension, diabetes, cardiovascular and lung diseases, and smoking history are risk factors that lead to severe complications and death.@*Conclusion@#COVID-19 has caused a global public health crisis. In the Philippines, cases are still on the rise. Majority of cases are mild. More severe and fatal disease is associated with old age and the presence of comorbidities. Definitive diagnosis is through RT-PCR. Supportive therapy is the cornerstone of management. The search continues for a proven, effective drug for treatment and vaccine for prevention of COVID-19.
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Background@#Organ donation (OD) is the major component for transplant programs. The need for the transplants is high and the gap between organs available for transplantation and the number of patients waiting for a transplant is widening globally. Nurses can play a vital role in promoting organ donation process that may influence the decision-making of donors and their families@*Objective@#This study sought to determine the knowledge and attitudes of nurses in Southern Philippines Medical Center on organ donation.@*Methodology@#A descriptive survey design was used in this study. Sample size computation was done in Epi Info version 7.1.4.0. A modified Organ Donor Attitude Questionnaire based on the previous study by Bishop was utilized.@*Results@#The mean score for question pertaining to knowledge of the 268 participants was 6.34 ± 1.99 out of total of 10 points. A total of 138/268 (51.49%) participants have scores above the average score accumulated by the participants of the study. The overall mean attitude of respondents towards organ donation was 3.25 which is interpreted as undecided.@*Conclusion@#Nurses do not have adequate knowledge and attitude towards their role in OD process. There is a need to increase the nurses’ level of knowledge by exposing them to nursing courses to improve knowledge and attitudes.
Subject(s)
Knowledge , Attitude , Tissue and Organ Procurement , NursesABSTRACT
Background@#An insight on the association of psychosocial factors with postmastectomy pain syndrome (PMPS) can help in the holistic management of patients with PMPS. @*Objective@#To determine the proportion of patients with PMPS among those who underwent mastectomy for breast cancer and identify factors associated with the syndrome. @*Design@#Cross-sectional study. @*Setting@#Outpatient Unit in Southern Philippines Medical Center. @*Participants@#45 women who had mastectomy for breast cancer. @*Main outcome measures@#Proportion of patients with PMPS; prevalence odds ratios (POR) of having PMPS for selected factors. @*Main results@#The patients had a mean age of 53.18 ± 8.09 years, mean BMI of 23.57 ± 2.65, and--on average--were 27.09 ± 35.76 months postmastectomy upon entry into the study. Of the 45 patients, 22 (48.89%) had PMPS. Univariate POR of having PMPS were significantly high for patients who: had distant metastasis (POR=5.56; 95% CI 1.27 to 24.29; p=0.0227), experienced premastectomy breast pain (POR=35.70; 95% CI 6.14 to 207.52; p<0.0001), were in late-stage family life cycle (POR=9.18; 95% CI 1.02 to 82.22; p=0.0476), and were in late-stage family illness trajectory (POR=4.96; 95% CI 1.39 to 17.70; p=0.0137). @*Conclusion@#In this study, 48.89% of patients had PMPS. Factors associated with PMPS include: having distant metastases, having premastectomy breast pain, being in late-stage family life cycle, and being in late-stage family illness trajectory.
Subject(s)
FamilyABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Evidence-based medicine is the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients. Several studies have emphasized its value and how its practice can translate into tangible patient outcomes. However, despite its undeniable role in improving patient outcomes, various multinational studies have also shown that very few medical practitioners are aware of or practice evidence-based medicine.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to determine the level of perceived knowledge, attitude and practice of evidence-based medicine among resident physicians in various private training institutions in Davao City.</p><p style="text-align: justify;"><strong>METHODS:</strong> This study used a descriptive cross-sectional research approach. Resident physicians from various private training hospitals in Davao City were surveyed.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A total of 174 respondents were recruited, of which 124 agreed to participate and be included in the study. The over-all mean for the level of knowledge and skills was 4.70 (+/-0.32), for the attitude and practice of EBM were 5.28 (+/-0.59) and 4.98 (+/-0.27) respectively.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The results of this study demonstrated that the level of knowledge and skills on EBM among resident physicians in various training institutions in Davao City is higher as compared to those cited in the literature, although it is lower than the acceptable level set by the proponents based on best assumption. The level of attitude towards EBM is also lower and only the practice of EBM is above the set acceptable level.</p>