Lung cancer patients are travelling to Cuba.
Lung cancer patients are travelling to Cuba.
As cancer therapies improve, the number of women surviving or living long lives with cancer continues to increase. Treatment modalities, including surgery, chemotherapy, radiotherapy, and hormonal therapy, affect sexual function and may cause sexual pain through a variety of mechanisms, depending on treatment type. Adverse sexual effects resulting from ovarian damage, anatomic alterations, and neurologic, myofascial, or pelvic organ injury may affect more than half of women affected by cancer. Despite the fact that no specialty is better qualified to render care for this consequence of cancer treatments, many obstetrician–gynecologists (ob-gyns) feel uncomfortable or ill-equipped to address sexual pain in women affected by cancer. Asking about sexual pain and dyspareunia and performing a thorough physical examination are essential steps to guide management, which must be tailored to individual patient goals. Understanding the cancer treatment-related pathophysiology of sexual pain aids in providing this care. Effective mechanism-based treatments for sexual pain and dyspareunia are available, and by using them, knowledgeable ob-gyns can enhance the quality of life of potentially millions of women affected by cancer.
Deborah Coady, MD, and Vanessa Kennedy, MD
Obstet Gynecol 2016;128:775–91 DOI: 10.1097/AOG.0000000000001621
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Modern approaches for research with human biospecimens employ a variety of substantially different types of ethics approval and informed consent. In most cases, standard ethics reporting such as “consent and approval was obtained” is no longer meaningful. A structured analysis of 120 biospecimen studies recently published in top journals revealed that more than 85% reported on consent and approval, but in more than 90% of cases, this reporting was insufficient and thus potentially misleading. Editorial policies, reporting guidelines, and material transfer agreements should include recommendations for meaningful ethics reporting in biospecimen research. Meaningful ethics reporting is possible without higher word counts and could support public trust as well as networked research.
Chin, W. W. L., Wieschowski, S., Prokein, J., Illig, T., & Strech, D. (2016). Ethics Reporting in Biospecimen and Genetic Research: Current Practice and Suggestions for Changes. PLoS Biology, 14(8), e1002521. http://doi.org/10.1371/journal.pbio.1002521
Perspective: What’s Wrong with Human/Nonhuman Chimera Research?
The National Institutes of Health (NIH) is poised to lift its funding moratorium on research involving chimeric human/nonhuman embryos, pending further consideration by an NIH steering committee. The kinds of ethical concerns that seem to underlie this research and chimera research more generally can be adequately addressed.
Hyun I (2016) What’s Wrong with Human/ Nonhuman Chimera Research? PLoS Biol 14(8): e1002535. doi:10.1371/journal.pbio.1002535
ABSTRACT Introduction Gender disparities in income continue to exist, and many studies have quantified the gap between male and female workers. These studies paint an incomplete picture of gender income disparity because of their reliance on notoriously inaccurate or incomplete surveys. We quantified gender reimbursement disparity between female and male healthcare providers using objective, non-self-reported data and attempted to adjust the disparity against commonly held beliefs as to why it exists. Methods We analysed over three million publicly available Medicare reimbursement claims for calendar year 2012 and compared the reimbursements received by male and female healthcare providers in 13 medical specialties. We adjusted these reimbursement totals against how hard providers worked, how productive each provider was, and their level of experience. We calculated a reimbursement differential between male and female providers by primary medical specialty. Results The overall adjusted reimbursement differential against female providers was −US$18 677.23 (95% CI −US$19 301.94 to −US$18 052.53). All 13 specialties displayed a negative reimbursement differential against female providers. Only two specialties had reimbursement differentials that were not statistically significant. Conclusions After adjustment for how hard a physician works, his/her years of experience and his/her productivity, female healthcare providers are still reimbursed less than male providers. Using objective, non-survey data will provide a more accurate understanding of this reimbursement inequity and perhaps lead the medical profession (as a whole) towards a solution that can reverse this decades-old injustice.
Desai T, et al. Postgrad Med J 2016;0:1–5. doi:10.1136/postgradmedj-2016-134094 1
Original article PGMJ Online First, published on August 15, 2016 as 10.1136/postgradmedj-2016-134094
Produced by BMJ Publishing Group
The poor mental health of residents, characterized by high rates of burnout, depression, and suicidal ideation, is a growing concern in graduate medical education. Research is needed to gain a deeper understanding of the sources of distress as well as the sources of sustenance in residency training. The study by Mata and colleagues contributes significantly to this understanding. In addition to this line of research, however, studies are needed that assess the impact of interventions to help residents deal more effectively with the stress of training and find meaning in their work. Given the stresses of residency training, this approach may not make a dramatic difference in mental health outcomes. Efforts directed at changing the educational and clinical environments are also needed to reduce unnecessary stressors and create more positive settings for learning and clinical care. Since 2011, Saint Louis University School of Medicine has been pursuing a multipronged strategy to address these issues in the preclinical years. These efforts have led to dramatic decreases in depression and anxiety symptoms in students. An essential component of these interventions is the ongoing measurement of mental health outcomes across all four years of the curriculum. Leaders of residency programs, medical schools, and hospitals need to have the courage to measure these kinds of outcomes to spur change and track the efficacy of programs.
Slavin, Stuart J. MD, MEd; Chibnall, John T. PhD
On Saturday, August 20, 2016, ProQuest will be upgrading its systems infrastructure. ProQuest platforms (including Refworks and Digital Dissertations) will be unavailable beginning at at 10:00 PM Eastern Standard Time and will last for 8 hours.
The PCOM Library is pleased to provide access to the new APA Style CENTRAL®!
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1. Digital library of APA Style quick guides and tutorials to refine your writing, and searches the APA Manual of Style by topic area.
2. Plan sound research with the research tools, and build a reference library with customized APA Style reference templates.
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In the phase 3 Evaluating Nilotinib Efficacy and Safety in Clinical Trials–Newly Diagnosed Patients (ENESTnd) study, nilotinib resulted in earlier and higher response rates and a lower risk of progression to accelerated phase/blast crisis (AP/BC) than imatinib in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP). Here, patients’ long-term outcomes in ENESTnd are evaluated after a minimum follow-up of 5 years. By 5 years, more than half of all patients in each nilotinib arm (300 mg twice daily, 54%; 400 mg twice daily, 52%) achieved a molecular response 4.5 (MR4.5; BCR-ABL ⩽0.0032% on the International Scale) compared with 31% of patients in the imatinib arm. A benefit of nilotinib was observed across all Sokal risk groups. Overall, safety results remained consistent with those from previous reports. Numerically more cardiovascular events (CVEs) occurred in patients receiving nilotinib vs imatinib, and elevations in blood cholesterol and glucose levels were also more frequent with nilotinib. In contrast to the high mortality rate associated with CML progression, few deaths in any arm were associated with CVEs, infections or pulmonary diseases. These long-term results support the positive benefit-risk profile of frontline nilotinib 300 mg twice daily in patients with CML-CP.
A Hochhaus, G Saglio, TP Hughes, RA Larson, D-W Kim, S Issaragrisil, PD le Coutre, G Etienne , PE Dorlhiac-Llacer, RE Clark, IW Flinn, H Nakamae, B Donohue, W Deng, D Dalal, HD Menssen and HM Kantarjian
Leukemia (2016) 30, 1044–1054; doi:10.1038/leu.2016.5