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Background: Approximately one-half of adult cancer patients experience clinically significant psychological distress. Distress diminishes quality of life (QOL) and may interfere with patients' treatment compliance and outcomes. Objectives: To prospectively assess the effect of a navigation program on both distress and health-related QOL in a population of cancer patients. Methods: Cancer patients who had navigators were evaluated at enrollment and again at 3, 6, 12, and 18 months. At each time point patients were administered the National Comprehensive Cancer Network Distress Thermometer (DT) and the Functional Assessment of Cancer Therapy -- General (FACT-G). Results: Of 297 evaluable patients enrolled between February 2012 and February 2015, 71% received chemotherapy, 8% radiotherapy, and 13% hormonal therapy. DT scores, FACT-G total scores, subscales physical well-being, functional well-being, and emotional well-being all significantly improved from 6 to 18 months after enrollment. Both high and low users of the program had improved DT scores, total FACT-G scores, and various FACT-G subscale scores. Patients expressed high satisfaction with navigation. Discussion: This investigation found that distress and QOL improved over a period of 18 months while patients were in a navigation program after a diagnosis of cancer. DT and FACT-G scores improved whether patients were high or low users of the program. Lack of a control group makes definitive conclusions difficult. Conclusion: This navigation program may have positively impacted both distress and QOL in this cohort of cancer patients during and after treatment over a period longer than previously reported. [ABSTRACT FROM AUTHOR]

Introduction Intensivist involvement for patients with sepsis is associated with decreased complications and mortality, and lower hospital resource utilization, but few studies have evaluated outcomes for patients exposed to electronic intensive care unit (eICU) telemedicine sepsis management in the emergency department (ED). In this study, we assess whether eICU cart exposure in the ED improved compliance with components of the 2010 Surviving Sepsis Campaign bundles, length of stay (LOS), disposition and hospital costs. Methods An institutional review board-approved, retrospective cohort study was completed on patients with confirmed sepsis who presented to our ED from July 2010 through February 2013. Results Of 711 patient ED encounters, 314 cases met criteria for analysis (95 exposed and 219 non-exposed). Patient cohorts had similar demographics and comorbid International Classification of Diseases, Ninth Edition (ICD-9) diagnoses. The exposed cohort received antibiotics more quickly (122.3 minutes ±83.3 versus 163.4 minutes ±204.4, p = 0.043) and were more likely to have lactic acid levels drawn within six hours (98.9% vs. 90%, p = 0.019). The exposed cohort had a shortened ED LOS (in days) 0.08 ± 0.28 versus 0.16 ± 0.37, p = 0.036. Hospital LOS, disposition and death were similar in both cohorts. Total hospital costs for the exposed cohort were lower and less variable (US$19,713 ± 16,550 vs. US$24,364 ± 25068), but this was not significant ( p = 0.274). Discussion Our findings suggest that in individuals with confirmed sepsis, ED exposure to a telemedicine-based eICU cart impacted adherence to aspects of the Surviving Sepsis Campaign recommended bundle, but did not impact overall survival and medical costs. [ABSTRACT FROM AUTHOR]

Background: Use of the electronic cigarette for nicotine delivery has increased dramatically in recent years. Information continues to emerge on its role as a smoking cessation aid, but little is known about resident physician use of the device in clinical practice.Methods: In 2015, an electronic survey was administered to resident physicians in one healthcare system in Columbus, Ohio. The survey included questions about personal smoking exposure, knowledge, beliefs, attitudes about electronic cigarettes and early adoption of electronic cigarettes with patients. Data were dichotomised based on a 'stages of change' model that assessed resident physician adoption of electronic cigarettes for therapeutic use. Data were analysed through χ2 tests and logistic regression using ORs and 95% CIs.Results: Of 338 residents, 142 (42%) responded. Of all residents, 25 (17.7%) reported that they have been recommending electronic cigarettes to their patients for the past 6 months or longer. In the multivariate model, residents ≥postgraduate year (PGY)-3 (OR=3.68, 95% CI 1.20 to 11.29), peer-reviewed article exposure (OR=6.65, 95% CI 1.56 to 28.38) and the view that addictive potential is definitely or somewhat less than traditional cigarettes (OR=5.05, 95% CI 1.48 to 17.24) were associated with recommendation of electronic cigarettes.Conclusions: Few residents report recommending electronic cigarettes to patients who smoke. These residents consider the electronic cigarette less addicting than traditional cigarettes, supporting harm reduction strategies over strict abstinence. Most residents require further evidence-based education on efficacy and long-term safety of electronic cigarettes before recommending to their patients. [ABSTRACT FROM AUTHOR]