Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy.

INTRODUCTION: The objectives were: to measure the proportion of aspirated material used to make direct slides for rapid onsite evaluation (ROSE) at endobronchial (EBUS) and endoscopic ultrasound (EUS) in suspected thoracic malignancy; and to correlate pass weights with ROSE category and needle size. METHOD: All EBUS and EUS cases for possible thoracic malignancy October 2018-May 2019 were included. All material from each pass was expelled into a Petri dish. One drop of material was placed on each of two slides; one used for ROSE, the other fixed and remaining material processed to cell block. Dish and slides were weighed before and after this procedure on a sensitive balance and weight of aspirate and slide material calculated. When ROSE identified malignancy, slide production ceased but target sampling for ancillary studies continued. RESULTS: ROSE accuracy was 96.8%. Mean percentage by target of aspirated material used to make direct slides for ROSE was 1.9% in malignant cases and 3.6% in non-malignant cases (P = .027 for difference). Mean percentage by pass was 5.9%. Mean weight of a single aspirate was 128.8 mg. Mean weight of aspirates insufficient on ROSE (175.7 mg) was significantly higher than the mean weight of benign or malignant aspirates (117.1 and 114.0 mg, respectively). Mean weight of aspirates using 22G needles (132.6 mg) was significantly higher than that for 25G needles (87.1 mg). CONCLUSION: Material made into direct slides at EBUS and EUS and used in part for ROSE uses a tiny proportion of aspirated material with over 98% processed to cell block and available for ancillary testing in malignant cases.

Factor Structure of the Brief Coping Orientation to Problems Experienced Inventory in Chinese (Brief-COPE-C) in Caregivers of Children with Chronic Illnesses.

PURPOSE: This study aimed to translate and evaluate the factor structure of the Chinese version of the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE-C) among the caregivers of children with chronic illnesses. DESIGN AND METHODS: In this cross-sectional study, we recruited 217 caregivers, aged 18 years and older and cared for children with chronic illnesses. All participants were recruited from two local hospitals in Hong Kong using convenience sampling. We excluded caregivers diagnosed with major psychiatric diseases, such as major depression or schizophrenia. RESULTS: The Brief-COPE-C had good validity and three factors were identified: active coping, distraction, and dysfunctional coping. The content validity index was 0.97, and the item content validity index ranged from 0.83-1 for all 28 items. The Brief-COPE-C had adequate internal consistency. The Cronbach's alpha for the overall scale was 0.89, while the Intraclass Correlation Coefficient (ICC) was 0.876. CONCLUSIONS: The Brief-COPE-C is a valid, reliable, and culturally appropriate tool for measuring coping in caregivers of children with chronic illnesses. PRACTICE IMPLICATIONS: Use of the Brief-COPE-C to assess coping responses of caregivers can facilitate clinicians' and researchers' understanding of how these individuals cope. Hence, appropriate interventions can be implemented to improve caregivers' physical and psychological outcomes.

Resilience-building module for undergraduate nursing students: A mixed-methods evaluation.

In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.

The effects of psychoeducational interventions on caregivers of children with cancer: A meta-analysis of randomized controlled trials.

This meta-analysis aims to evaluate the best available evidence concerning the effects of psychoeducational interventions (PEIs) on the psychosocial and coping outcomes for caregivers of pediatric oncology patients. A literature search was performed using 11 databases, from inception to June 2017. Keywords such as pediatric, caregiver, parents, cancer, and intervention were used. Only randomized controlled trials (RCTs) were included. Studies with full text available online in English and those conducted of caregivers of children diagnosed with any form of cancer were included. Eleven RCTs were included in the analysis. Our meta-analysis revealed that PEIs have small to large effects on three outcomes, including post-traumatic stress symptoms (PTSSs), mood, and problem-solving skills. However, the outcomes from PEI were not superior to the usual standard of care for anxiety, depression, and social support. Our meta-analysis provided moderate evidence that PEI enhances psychological and coping outcomes. Because coping affects both physical and psychological health, health care professionals could consider including coping as a core component in PEI delivered to caregivers of children with cancer.

Mindfulness-Based Stress Reduction (MBSR) or Psychoeducation for the Reduction of Menopausal Symptoms: A Randomized, Controlled Clinical Trial.

Psychological and behavioural interventions may be effective in reducing menopause-related symptoms. This randomized controlled trial aimed to evaluate the effectiveness of Mindfulness-based Stress Reduction (MBSR) in reducing menopause-related symptoms by comparing with an active control group, the menopause education control (MEC). Symptomatic peri-menopausal and post-menopausal women with mild to moderate symptoms were recruited. The primary outcome was overall menopausal symptoms measured by modified Greene Climacteric Scale (GCS). Secondary outcomes include subscales of the GCS perceived stress, mindfulness and health related Quality of Life. All outcome measures were collected at baseline, 2 months (immediately post intervention), 5 and 8 months (3 and 6 months post intervention respectively). Both MBSR (n = 98) and MEC (n = 99) groups reported a reduction in total GCS score at 8 months. Between group analysis show significant symptom score reduction in MBSR group on Anxiety and Depression subscales of GCS. No differences were found between groups on other GCS subscales and majority of the secondary outcome measures. The findings show that menopausal symptoms in both MBSR and MEC significantly reduced over the study period. MBSR show a greater reduction of psychological symptoms of depression and anxiety above active controls but do not reduce other somatic, urogenital and vasomotor symptoms.

A Systematic Review and Meta-Analysis of Acupressure for Postoperative Gastrointestinal Symptoms among Abdominal Surgery Patients.

Postoperative ileus is a common and often life-threatening gastrointestinal complication with few management methods available for patients. Integrating acupressure into perioperative care promises to bring benefits into preventing postoperative ileus. This systematic review and meta-analysis aims to evaluate the efficacy of acupressure in identifying the signs and symptoms of postoperative ileus among patients undergoing abdominal surgery. The MEDLINE, EMBASE, Web of Science, CINAHL, China Journal Net and Wanfang databases were searched for high-quality RCTs using keywords such as acupressure, postoperative ileus, abdominal surgery, etc. A total of six studies ([Formula: see text]) were included in this review and meta-analysis. The quality of the literature was found to be uniformly moderate by the Effective Public Health Practice Project (EPHPP) assessment tool. The results of meta-analyses revealed that acupressure could significantly reduce risks for postoperative nausea (OR 0.52, 95% CI 0.39-0.70, [Formula: see text]) and vomiting (OR 0.54, 95% CI 0.39-0.75, [Formula: see text]) compared with the control group, without significant heterogeneity among studies. Meta-analysis of the need for antiemetic drugs suggested that the OR was 0.39 (95% CI 0.20-0.78, [Formula: see text]) with significant heterogeneity among studies. Our results suggested that acupressure might be effective in reducing the incidence of postoperative nausea and vomiting and the need for antiemetic drugs among patients undergoing abdominal surgery. Considering the substantial risk of bias in the articles included, future high-quality RCTs with a rigorous methodology are desirable to provide solid evidence. Furthermore, other signs and symptoms of postoperative ileus should be explored in future.

Environmental Factors Associated with Altered Gut Microbiota in Children with Eczema: A Systematic Review.

Eczema is a common skin condition that impairs children's daily life activities and quality of life. Previous research shows that gut microbiome composition plays an important role in the development of eczema. The present review summarizes evidence on environmental factors related to altered gut microbiota in children with eczema. We searched Medline, PubMed, Embase, and the Cochrane database of Systematic Reviews through October 2015. The search strategy focused on articles published in peer-reviewed, English-language journals with no publication year limit. Only original studies and review articles that reported environmental factors on gut microbiome specific to eczema were included in this review. We selected six studies (total 1990 participants) for full review and identified that the composition of gut microbiota specific to eczema could be influenced by the following environmental factors: length of gestation, mode of delivery, type of feeding, method of treatment, number of older siblings, and other lifestyle factors. There has been inconsistent empirical evidence as to the modulatory effects of gut microbiota on immunological functions in children with eczema. Further research on the environmental-host-microbial interaction is needed to develop a strong base of knowledge for the development and implementation of prevention strategies and policies for eczema.

Feasibility of psychoeducational interventions in managing chemotherapy-associated nausea and vomiting (CANV) in pediatric oncology patients.

PURPOSE: Childhood cancer patients often suffer from Chemotheraphy-Associated Nausea and Vomiting (CANV). To alleviate CANV, relaxation techniques and patient education were combined to develop a multidimensional psychoeducational intervention package. The aim of this pilot study was to assess the feasibility of the two major components, namely, (1) relaxation, and (2) patient education, of a psychoeducational intervention, prior to the commencement of the main study. METHODS: A pre-test-post-test control group design was adopted. Twenty patients were allocated equally to the relaxation group (10 participants) and to the educational group (10 participants). Twenty historical matched control cases were identified to form the control groups. Besides, a process evaluation was adopted to assess the feasibility of the study. RESULTS: In relation to episodes of vomiting on day 3, a significant difference was detected from the results (X(2) = 8.54, p = 0.036), in that fewer patients in the relaxation group experienced vomiting. A significant difference was not found in both the use of antiemetics and body weight between the groups. All subjects in the intervention groups adhered to the intervention and completed the questionnaire without difficulty. Patients and parents perceived the intervention as being moderately useful. CONCLUSIONS: Although the beneficial effect of relaxation and education in alleviating CANV was not well-supported statistically, the findings from descriptive data suggest that these interventions promoted the intake of antiemetics as a preventive method. Both interventions and instruments were well-received by the patients and also by their parents.

Uptake of prostate cancer screening and associated factors among Chinese men aged 50 or more: a population-based survey.

OBJECTIVE: To investigate the uptake rate of prostate specific antigen (PSA) testing among Hong Kong Chinese males aged 50 or above, and identify factors associated with the likelihood of undergoing a PSA test. METHODS: A population-based telephone survey was conducted in Hong Kong in 2007. The survey covered demographic information, perceived health status, use of complementary therapy, cancer screening behavior, perceived susceptibility to cancer and family history of cancer. Descriptive statistics, percentages and logistic regression analysis were used for data analysis. RESULTS: A total of 1,002 men aged 50 or above took part in the study (response rate =67%), and the uptake rate of PSA testing was found to be 10%. Employment status, use of complementary therapy, perceiving regular visits to a doctor as good for health and the recommendations of health professionals were significant factors associated with PSA testing. CONCLUSION: The uptake rate of PSA testing in the study population was very low. Among all the factors identified, recommendations from health professionals had the strongest association with the uptake of PSA testing, and they should therefore take an active role in educating this population about cancer prevention and detection.

Web-based interventions for caregivers of cancer patients: A review of literatures.

Diagnosed with cancer is a traumatic event; it does not only affect the diagnosed patients, but also their caregivers. It brings along negative impacts on biopsychosocial health to the caregivers. Supportive interventions are essential for the caregivers to go through the cancer trajectory. In the past, interventions were being delivered in either face-to-face format or delivering written documents. Although Internet becomes a popular platform for delivering interventions given its substantial growth in usage, the effectiveness of this mode of intervention delivery is unclear. The aim of this review is to review existing literatures regarding efficacy of web-based interventions in psychological outcomes of cancer caregivers. A Literature search was performed in December 2012 from seven databases, including, Ovid MEDLINE, EMBASE, PsycINFO, CINHAL, ERIC, British Nursing Index and EBM Reviews. The following keywords were used in the search but were not limited to "paediatric", "parent", "caregiver", "cancer", "web-based", and "psycho education". Totally 4668 citations were identified, after excluding the duplicated and irrelevant citations; finally six studies were included in this review. A review of the literatures identified that the web-based interventions including either online support group only or a combination of informational website and online support group significantly improved coping skills, in a way reduced anxiety, stress, depression, burden, as well as negative mood and perceived bonding in cancer caregivers. It is concluded that a web-based format as a potential platform for delivering intervention to the caregivers of cancer patients for its unique advantage of easy accessibility, and no geographic or time barriers.

Perceived unmet supportive care needs and determinants of quality of life among head and neck cancer survivors: a research protocol.

AIM: To describe a study protocol designed to explore the associations among the perceived unmet supportive care needs, quality of life and the demographic and clinical characteristics of head and neck cancer survivors. BACKGROUND: The prognoses for people with head and neck cancer are improving with medical advances. However, studies have reported that such cancer survivors experience poor quality of life. Current studies mainly focus on Western populations and there is limited research investigating the needs of head and neck cancer survivors. DESIGN: A mixed-design method is proposed, which will include two phases. Phase I will use a quantitative cross-sectional design and Phase II a qualitative descriptive approach. METHODS: The participants will be recruited from the outpatient departments of three public hospitals in Hong Kong. In Phase I, a questionnaire will be used to collect demographic and clinical characteristics, supportive care needs, necessary access to various supportive services and quality of life. Semi-structured interviews will be conducted in Phase II. The study is supported by a grant from the Health and Health Services Research Fund, Hong Kong, September 2011. DISCUSSION: The study will generate in-depth information on the needs of head and neck cancer survivors, to help healthcare professionals allocate resources better and develop new services, which can be more person-centred, to meet the needs of the these survivors.