ABSTRACT
AIM: To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-naïve patients. METHODS: Colonoscopy-naïve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation. Survey items included clinical pathway (direct or consult), procedure indication (cancer screening or symptom investigation), telephone and written contact from the physician endoscopist office, information sources, and pre-procedure anxiety. Participants reported pre-procedure anxiety using a 10 point scale anchored by "very relaxed" (1) and "very nervous" (10). At least three months following the procedure, patient medical records were reviewed to determine sedative dose, procedure indications and any adverse events. The primary comparison was between the direct and consult pathways. Given the very different implications, a secondary analysis considering the patient-reported indication for the procedure (symptoms or screening). Effects of pathway (direct vs consult) were compared both within and between the screening and symptom subgroups. RESULTS: Of 409 patients who completed the survey, 34% followed a direct pathway. Indications for colonoscopy were similar in each group. The majority of the participants were women (58%), married (61%), and internet users (81%). The most important information source was family physicians (Direct) and specialist physicians (Consult). Use of other information sources, including the internet (20% vs 18%) and Direct family and friends (64% vs 53%), was similar in the Direct and Consult groups, respectively. Only 31% of the 81% who were internet users accessed internet health information. Most sought fundamental information such as what a colonoscopy is or why it is done. Pre-procedure anxiety did not differ between care pathways. Those undergoing colonoscopy for symptoms reported greater anxiety [mean 5.3, 95%CI: 5.0-5.7 (10 point Likert scale)] than those for screening colonoscopy (4.3, 95%CI: 3.9-4.7). CONCLUSION: Procedure indication (cancer screening or symptom investigation) was more closely associated with information seeking behaviors and pre-procedure anxiety than care pathway.
ABSTRACT
Stem cells hold great promise for treatment of various degenerative diseases. However, clinical studies have only shown very moderate benefits of cell therapy. We believe that insufficiency of therapeutic benefits is due to limited homing of implanted stem cells to targeted organs. Microfluidic devices are a very useful research tool for quantitative characterizations of stem cells. The present study therefore was to assess the effects of epidermal growth factor (EGF) and direct current electric field (dcEF) on the growth and trafficking of adipose-derived stem cells (ASC). It was found that EGF did not affect cell proliferation in cell-culture flasks. However, ASC proliferated at a higher rate in microfluidic devices with continuous infusion of EGF. Furthermore, we found that ASC migrated toward an EGF gradient in microfluidic devices. Moreover, we found that ASC tended to position perpendicularly to dcEF. The results suggest that EGF and dcEF may be effective in guiding homing and trafficking of implanted ASC.
