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Aim: To examine the treatment practices for cancer pain relief and adverse event management, and the factors related to patient outcomes in the participating countries/regions. Methods: The study was a cross-sectional survey conducted between September and December 2013 in 10 countries/regions across Asia. Adult patients with a history of cancer pain at least 1 month before study entry completed the survey questionnaire. Results: A total of 1190 patients were included. The mean Box Scale-11 (BS-11) pain score was 6.0 (SD 2.1), with 86.2% experiencing moderate-to-severe pain and 53.2% receiving opioids at time of the survey. The mean BS-11 scores were 5.3 (SD 2.1) in the "others" (single non-opioid medication or untreated) group, 6.3 (SD 2.0) in the ≥2 non-opioids group and 6.7 (SD 1.9) in the opioid group. The proportions of patients experiencing moderate-to-severe pain were 79.1%, 87.3% and 93.7%, respectively. About 70% of patients reported adverse events due to their pain medications, about half had received medications to manage these symptoms. Adverse events were negatively associated with activities of daily living (P < 0.0001). Pain and hindrance to activities of daily living were negatively associated with employment status (P = 0.003 and 0.021). Unemployment was significantly associated with poorer quality of life (P < 0.0001). Conclusion: This analysis demonstrates inadequate management of cancer pain and treatment-related adverse events in the participating cohort. Pain and inadequate management of adverse events were negatively associated with patients' overall well-being. More collaborative efforts should be taken to optimize pain treatment and increase awareness of adverse event management in physicians. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate barriers to treatment and screening related to depression and anxiety and the diagnostic and treatment practices of primary care advanced practice nurses (APNs) in the state of Wyoming. Every primary care APN in Wyoming received a mailed questionnaire asking them about treatment barriers, screening and treatment practices, and attitudes toward depression and anxiety. Wyoming APNs in primary care routinely identify, evaluate, and treat patients with both depression and anxiety. APNs generally felt positive about treating these patients, although they reported that their patients encounter a number of financial barriers in accessing treatment. Routine screening practices for depression and anxiety were relatively low among the APNs, and they used a wide variety of interventions for these patients. The findings identify a lack of standardized approaches to assessment, referral, and treatment, especially pharmacologic intervention, and may indicate the need for alterations in the educational preparation of primary providers in order to improve clinical outcomes of treatment for depression and anxiety. [ABSTRACT FROM AUTHOR]

Objectives Obesity is an increasingly prevalent condition and many obese individuals binge eat. It is unclear how much knowledge physicians possess regarding binge eating, but the limited existing data suggest that primary care physicians frequently do not identify obesity as a clinical problem. The objective of this study was to examine physician knowledge and treatment recommendations regarding binge eating and obesity. Method A survey on binge eating and obesity assessment and treatment was mailed to 700 licensed physicians. The survey was returned by 272 (38.9%) respondents. Results Greater than 40% of physicians never assessed binge eating. Body mass index (BMI) was calculated “often or always” by 36.2% of physicians and “rarely or never” by 39.7%. The pattern of obesity treatment methods offered by providers was quite different from the pattern of treatment requested by their patients. Physicians who made higher estimates of binge eating prevalence were more likely to make treatment referrals. Discussion In this study, physicians frequently did not assess binge eating. Only a minority of physicians utilize BMI in the assessment and management of obesity. Also, physicians report that the obesity treatments they recommend differ from the treatments patients request of them. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 348–353, 2004. [ABSTRACT FROM AUTHOR]

Objective: To evaluate caries-preventive treatment practices in relation to caries state and eruption of first permanent molars(FPMs) among 6-year-olds (n=3489) examined and treated in public dental clinics in Helsinki during 1992 Methods: The study subjects were selected on the basis of their caries state using a two-point study design the high-caries group (n=99) had the greatest number of DT+dt, the cavity-free group (n=32) had neither past nor present caries Evaluation of dentists' caries-preventive treatment decisions was based on data from detailed personal oral health records. Results: In total, 22% of the high-caries patients (mean DT+dt 8 7; range 4-18) had been judged by their dentists as high-risk patients. Eruption of FPMs had no influence on dentists' judgement on caries risk. A subject's number of DT+dt had no influence on the intensity of preventive treatment given, but those with a high-risk judgement from a dentist received mote preventive measures per visit than did other high-caries patients For high-caries patients with erupting FPMs, three visits in 10 included preventive intervention other than sealants, compared to nine in the cavity-free group. Intensity of oral hygiene instruction. correlated with presence of erupting FPMs, yet 86% of the patients with erupting FPMs had received no oral hygiene instruction. Conclusions: Dentists should be encouraged to use standardized criteria, including data on caries state and eruption stage, in judging each patient's risk of caries to provide intensified caries-preventive treatment to those most in need. [ABSTRACT FROM AUTHOR]