Evaluation of patients' needs to design and assess a patient education program in cancer pain.

Purpose: Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation. Patients and methods: Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE. Results: Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined. Conclusion: Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants. Practice implications: Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.

A cross-sectional comparison between the perception of physicians and pharmacists concerning the role of the pharmacist in physician training.

OBJECTIVES: This study aimed to identify and compare physician-pharmacist perceptions concerning drug teaching to physicians by pharmacists in Swiss hospital settings. MATERIAL AND METHODS: Questionnaires were emailed to all French-speaking physicians (survey A) and pharmacists (survey B) working in Swiss hospitals where medical directors/chief-pharmacists had approved the study. Questions were developed based on previous physician interviews. Most questions used four Likert-type response alternatives. A Mann-Whitney U test was used to compare answers to survey A and B. RESULTS: Fourteen out of 18 medical directors and 16/16 chief-pharmacists gave permission for the study. In total, 244 (11%) physicians answered survey A, and 115 (74%) pharmacists answered survey B. Nearly all participants agreed that pharmacists should take part in both medical student and physician postgraduate training. Most physicians answered wanting additional training and pharmacists are unaware of this need. Only two thirds of physicians reported having acquired knowledge about drugs thanks to pharmacists; document diffusion and direct answers to their questions having contributed the most to their training. Participants agreed that physician training by pharmacists needs a clearer delineation regarding the type of training, its aim, its targeted public, when and what pharmaceutical benefits are used. Physicians' priority-training topics are high-risk drugs, novelties and areas in which they consider their basic training was insufficient. Methods preferred for training are: case studies; exercises with individual corrections; and group work. CONCLUSION: Improved resources and planning are needed to meet physicians' expectations. Training is often carried out implicitly, through activities with various other aims, and needs to be better defined and formalized collaboratively.

Performance comparison of wavefront reconstruction and control algorithms for Extremely Large Telescopes.

Extremely Large Telescopes (ELTs) are very challenging with respect to their adaptive optics (AO) requirements. Their diameters and the specifications required by the astronomical science for which they are being designed imply a huge increment in the number of degrees of freedom in the deformable mirrors. Faster algorithms are needed to implement the real-time reconstruction and control in AO at the required speed. We present the results of a study of the AO correction performance of three different algorithms applied to the case of a 42-m ELT: one considered as a reference, the matrix-vector multiply (MVM) algorithm; and two considered fast, the fractal iterative method (FrIM) and the Fourier transform reconstructor (FTR). The MVM and the FrIM both provide a maximum a posteriori estimation, while the FTR provides a least-squares one. The algorithms are tested on the European Southern Observatory (ESO) end-to-end simulator, OCTOPUS. The performance is compared using a natural guide star single-conjugate adaptive optics configuration. The results demonstrate that the methods have similar performance in a large variety of simulated conditions. However, with respect to system misregistrations, the fast algorithms demonstrate an interesting robustness.