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Abstract Objective The aim of this systematic review was to investigate patient-related factors (e.g. depressive symptoms, cognition, mobility, activities of daily living (ADL)) as well as tumor-related factors (e.g. tumor type, chemotherapy regimen) influencing chemotherapy intolerance in cancer patients aged 65 years or older. Methods We included observational studies that reported data on possible predictors of chemotherapy intolerance in older patients with cancer. We studied chemotherapy intolerance using the following outcomes: chemotherapy toxicity grade 3 to 5, unplanned hospitalization, chemotherapy discontinuation, chemotherapy dose reduction, functional decline, and chemotherapy mortality. We searched PubMed, Embase, and PsycInfo for articles between January 1995 and July 2016. The quality of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results The search yielded 1774 articles, and 30 articles from 27 studies were included. The patient-related factors associated with chemotherapy intolerance, in terms of the size of the association and the consistency of the results, were more than one fall in the last six months, mobility problems, poor performance status and the presence of severe comorbid conditions. The tumor-related factors that were associated with chemotherapy intolerance in older patients with cancer were certain regimens of chemotherapy and polychemotherapy, as compared to monochemotherapy. The number of studies on unplanned hospitalization and functional decline was small. Conclusion The included studies were heterogeneous with respect to endpoints and included parameters. Nevertheless, the size of the association and the consistency of results suggest that all these factors are relevant for everyday oncological practice. [ABSTRACT FROM AUTHOR]

Minimizing the number of late jobs on a single machine is a classic scheduling problem, which can be used to model the situation that from a set of potential customers, we have to select as many as possible whom we want to serve, while selling no to the other ones. This problem can be solved by Moore-Hodgson’s algorithm, provided that all data are deterministic. We consider a stochastic variant of this problem, where we assume that there is a small probability that the processing times differ from their standard values as a result of some kind of disturbance. When such a disturbance occurs, then we must apply some recovery action to make the solution feasible again. This leads us to the area of recoverable robustness, which handles this uncertainty by modeling each possible disturbance as a scenario; in each scenario, the initial solution must then be made feasible by applying a given, simple recovery algorithm to it. Since we cannot accept previously rejected customers, our only option is to reject customers that would have been served in the undisturbed case. Our problem therefore becomes to find a solution for the undisturbed case together with a feasible recovery to every possible disturbance. Our goal hereby is to maximize the expected number of served customers; we assume here that we know the probability that a given scenario occurs. In this respect, our problem falls outside the area of the ‘standard’ recoverable robustness, which contains the worst-case recovery cost as a component of the objective. Therefore, we consider our approach as a combination of two-stage stochastic programming and recoverable robustness. We show that this problem is NP-hard in the ordinary sense even if there is only one scenario, and we present some sufficient conditions that allow us to find a part of the optimal solution in polynomial time. We further evaluate several solution methods to find an optimal solution, among which are dynamic programming, branch-and-bound, and branch-and-price. [ABSTRACT FROM AUTHOR]

Copyright of Huisarts En Wetenschap is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Primary care professionals are encouraged to screen patients for alcohol abuse. However, patients with alcohol abuse are often under-diagnosed as well as under-registered in medical records in general practices. This study aims to report on the registration rates of alcohol abuse diagnoses in general practices in comparison to patients' self-reported rates of alcohol use disorder.Research Design and Methods: Data of a total number of 2,349 patients were analyzed from the SMILE study, a large prospective cohort study conducted in The Netherlands. Two data collection strategies were combined: (1) Patient self-report data on alcohol consumption as well as other sociodemographic characteristics; (2) Medical record (ICPC codes) data of diagnoses of chronic and acute alcohol abuse of the same patients. GPs' registrations of diagnoses were compared with the self-report data using descriptive statistics.Results: Based on the results of the patient reported data, 179 (14.8%) male participants had an alcohol use disorder. Of the total number of female patients, 82 (7.2%) had an alcohol use disorder. One of the male and none of the female patients with an alcohol use disorder were registered as such by the GP.Conclusions: This study found that 11.1% of the total patient sample reported an alcohol use disorder, of which a strikingly low number of patients were recorded as such by their GP. It is likely that low recognition due to barriers related to alcohol screening as well as registration avoidance due to the stigma around alcohol abuse play a role in low registration. [ABSTRACT FROM AUTHOR]

Objective: To evaluate dispositional coping strategies as predictors for changes in well-being after 1 year in older patients with cancer (OCP) and 2 control groups.Methods: OCP were compared with 2 control groups: middle-aged patients with cancer (MCP) (aging effect) and older patients without cancer (ONC) (cancer effect). Patients were interviewed shortly after a cancer diagnosis and 1 year later. Dispositional coping was measured with the Short Utrecht Coping List. For well-being, we considered psychological well-being (depression, loneliness, distress) and physical health (fatigue, ADL, IADL). Logistic regression analyses were performed to study baseline coping as predictor for subsequent well-being while controlling for important baseline covariates.Results: A total of 1245 patients were included in the analysis at baseline: 263 OCP, 590 ONC, and 392 MCP. Overall, active tackling was employed most often. With the exception of palliative reacting, OCP utilized each coping strategy less frequently than MCP. At 1-year follow-up, 833 patients (66.9%) were interviewed. Active coping strategies (active tackling and seeking social support) predicted subsequent well-being only in MCP. Avoidance coping strategies did not predict well-being in any of the patient groups. Palliative reacting predicted distress in OCP; depression and dependency for ADL in MCP.Conclusions: Coping strategies influence subsequent well-being in patients with cancer, but the impact is different in the age groups. Palliative reacting was the only coping strategy that predicted well-being (ie, distress) in OCP and is therefore, especially in this population, a target for coping skill interventions. [ABSTRACT FROM AUTHOR]

Objectives: In older adults, nutritional health is essential for good quality of life and living independently at home. Especially in cancer patients, malnutrition is common and known to complicate treatment. This study aims to evaluate the nutritional status and its associated factors in community-dwelling older adults with and without cancer.Design: This is an observational study.Setting: This study focuses on older community-dwelling people.Participants: This study included older people with and without cancer (≥70 years). Cancer patients included patients with a new diagnosis of breast, lung, prostate, or colorectal cancer.Measurements: Data collection included measures of nutritional status, quality of life, depression, fatigue, distress and functional status. We used multivariate logistic regression analysis to assess the association between personal characteristics and malnutrition.Results: Data were available for 657 people; 383 people without cancer and 274 with a cancer diagnosis. Overall, malnutrition was detected in 245 (37.5%) people; in cancer patients this was 66.1%. Multivariate analysis showed that having cancer (OR 14.4, 95% CI: 8.01 - 23.3), being male (OR 2.38, 95% CI: 1.49–3.70), having depression (OR 13.5, 95% CI: 6.02-30.0), distress (OR 2.60, 95% CI: 1.55–4.37) and impaired instrumental activities of daily living (IADL) (OR 2.63, 95% CI: 1.63–4.24) were associated with a higher risk of malnutrition.Conclusion: The prevalence of malnutrition in community-dwelling older people is high, particularly in patients with cancer. Benchmarking and routine screening of older patients may be helpful strategies to increase awareness of (risk of) malnutrition among professionals. [ABSTRACT FROM AUTHOR]

Introduction: Prevalence of multimorbidity has risen in recent years and increases with age. However, over 50% of individuals affected are under 65 years old and experience lower quality of life, higher mortality and make greater use of healthcare services. Still, research has not yet focused on the impact of multimorbidity on the everyday lives of middle age people. While pursuing professional careers, raising children, caring for elderly parents and preserving their leisure time, middle-aged persons with multimorbidity need to self-manage multiple chronic conditions during their daily lives, sometimes on very tight schedules. Aims, Objectives, Theory or Methods: To determine how middle-aged persons (30-60 age group) with multimorbidity experience care in the context of their individual leisure time, families, and working lives. Perspectives of healthcare providers may help to identify potential barriers to caring for middle-aged persons with multimorbidity. A qualitative research approach is applied including interviews with multimorbid middle-aged adults and their principal healthcare providers, followed by an interdisciplinary workshop with healthcare providers. Data obtained in the interviews will be transcribed and coded inductively and deductively, and analyzed using content analysis. Workshop outputs will be interpreted and evaluated by the authors. Highlights: This project will give insights into patients' and healthcare providers' views on living with multimorbidity in middle age. Using a qualitative approach, we expect to determine a wide range of barriers patients perceive related to their health activities, personal, social and professional lives. In addition, we expect to identify challenges described by healthcare providers. We will further synthesize ideas and approaches for improvement mentioned by both groups during the interviews. The outcomes of the project will be prevention recommendations on a patient, healthcare provider as well as system level that will reflect the experiences of middle-aged persons living with multimorbidity. Conclusions: This study is the first to gather information on the care experiences of middle-aged adults with multimorbidity, and the key players in their care networks. The project will generate prevention recommendations that reflect the experiences of middle-aged persons living with multimorbidity and the views of their principal healthcare providers. Implications for applicability / transferability, sustainability, and limitation: Multiple burdens (disease, treatment, family-life, paid-work) may hinder patient recruitment. Digital technologies, that need not be conducted face-to-face, will facilitate recruitment and data collection. Workshops will enrich the data and permit inter-professional dialogue. As the selection of healthcare professionals will be based on patient interviews, it may not be representative. [ABSTRACT FROM AUTHOR]