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Objective: To test the efficacy of an information booklet to increase the duration of breast feeding.Research Design: Randomised design, stratifying by maternal residence and working activity. Two hundred women were recruited, 103 received the booklet and verbal counselling and 97 verbal counselling only.Population: Infants observed from 15 September 1993 to 15 June 1994 in the well baby outpatient clinic of the Paediatric Institute of the Catholic University of Rome, Italy.Main Results: No statistically significant difference was found between the two groups in the prevalence of exclusive or complementary breast feeding at 6 months of age: 48.5% and 59.2% in the intervention group, 43.7% and 51.5% in the control group. The median duration of exclusive or complementary breast feeding was 24 and 27 weeks in the treated group, 22 and 25 in the control group.Conclusions: The information booklet alone does not seem to increase the duration and the prevalence of breast feeding at 6 months of age. The use of written material with a more individualised support and more extensive use of randomised clinical trials in the evaluation of health promoting programmes is recommended. [ABSTRACT FROM AUTHOR]

Aim: Evaluate real-world patient preferences, experiences and outcomes (health-related quality of life [HRQoL]) from patients with anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer (NSCLC) utilizing the ALKConnect Patient Insight Network., Patients & Methods: Demographics, disease history/status/treatment, patient preferences and HRQoL (MD Anderson Symptom Inventory lung cancer module, reported as symptom severity and interference) were evaluated for US adults with ALK+ NSCLC., Results: Among 104 patients (median age: 53.0 years, 67.3% female, 40.0% employed), HRQoL and 3-month delay in disease progression were important treatment attributes. Burdensome symptoms included fatigue and disturbed sleep. Symptoms interfered most with work and day-to-day activity. Higher HRQoL was associated with ALK tyrosine kinase inhibitor (TKI) treatment and employment., Conclusion: ALKConnect demonstrated that disease progression, HRQoL, fatigue/sleep, ALK TKIs and employment matter in ALK+ NSCLC., Competing Interests: Financial & competing interests disclosure HM Lin, H Huang and F Scipione are employees of Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, and may own stock. At the time of the study X Pan, and A Biller were employees of Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, and may own stock. R Sugarman is an employee of Xcenda LLC., which has received consultancy fees from Takeda Pharmaceutical Company. At the time of study, K Covey was an employee of Invitae Corporation which has received fees from Takeda Pharmaceutical Company Limited. H West discloses receiving advisor/consultant fees from AstraZeneca, Merck & Co., Eli Lilly and Company, Roche and Genentech and Takeda Pharmaceutical Company Limited, and speaker fees from Astra Zeneca, Merck & Co., and Takeda Pharmaceutical Company Limited. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Medical writing support and editorial assistance was provided by Natalie Edwards of Health Services Consulting Corporation and was funded by ARIAD Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited., (© 2020 Huamao Lin.)

Background: Novel, pragmatic, patient-centered strategies are needed to ensure fit-for-purpose patient-reported outcomes (PRO) instruments in clinical trial research for rare diseases such as myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), and chronic myelomonocytic leukemia (CMML). The objective of the current study was to select supplemental items to add to the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life-Core 30 (QLQ-C30) to ensure content coverage of all important clinical concepts in patients with higher-risk (HR) MDS, low-blast count (LB) AML, and CMML, thus, improving the instrument's ability to detect clinically meaningful treatment benefit for this context of use., Methods: Our mixed methods approach comprised literature review, clinician consultation (n = 3), and qualitative and quantitative analysis of two stages of patient interview data (n = 14, n = 18) to select library bank items to supplement a generic cancer PRO, the EORTC QLQ-C30., Results: Unique symptom (n = 54) and impact (n = 72) concepts were organized into conceptual frameworks of treatment benefit, compared with EORTC QLQ-C30 items and conceptual gaps identified. Supplemental items (n = 13) addressing those gaps were selected from the EORTC Item Library and tested with patients. Supplemental item endorsement frequencies met World Health Organization Quality of Life criteria, suggesting good targeting and relevance for this sample. However, three supplemental items were confirmed as problematic based upon cognitive debriefing results, and expert clinical consultations. Ultimately, 10 supplemental items (n = 7 symptom; n = 3 impact) were selected for the MDS/AML/CMML context., Conclusion: Supplemental items were selected to enhance the conceptual coverage of the EORTC QLQ-C30 in the areas of fatigue, shortness of breath, and functioning.

Objective: To explore the nutrition and food habits of toddlers, in order to develop interventions to promote healthy eating starting from the early years of life., Methods: We conducted a cross-sectional study among 204 children aged from 3 months to 3 years, registered in 10 nursery schools in Rome, Italy. Children's diet-related behaviors and parent's food attitudes were evaluated using a 10-item questionnaire for parents. After administering the questionnaire, pediatricians of the local health authority conducted motivational interviews with parents to encourage them to make their children adopt healthy behaviors at home. Descriptive and analytical statistical methods were used to evaluate dietary habits in children, after stratifying by nursery school grade attended., Results: The data showed that unhealthy dietary habits occur even in nursery schoolaged children. In particular, over 50% of children were reported to watch TV while eating meals at home every day and to drink fruit juices at least 1-2 times per week. Unhealthy dietary habits were found to be more common among older children: there were significant differences in the proportions of older and younger children who consumed fruit juices or snacks more than twice per week (35.7% and 8.9% respectively of older children vs 3.3% and 3.3% respectively of younger children), who watched TV during meals (26.8% of older children versus 16.9% of younger children) and whose parents attribute a moral value to food as a reward more than twice a week (almost 14.3% of older children's parents vs 0.0% of small children's parents). On the contrary, older children were found to eat fruit significantly more frequently compared to younger children (51.8% vs 24.6% of young children ate fruit >2 times a week). Parents of children with at least one unhealthy behavior had low awareness of healthy dietary choices: 86.7% believed that their children's diets were healthy., Conclusion: This study showed that unhealthy dietary habits occur among Italian toddlers. These should be prevented by promoting specific interventions. Parents should be made aware of the possible consequences of their own behavior, considering that home food habits influence the development of dietary attitudes in children. Preventive interventions aimed at preschoolers may also be beneficial for parents themselves and for other family members.

The cause of acute and recurrent pericarditis is often a major concern for the clinicians in clinical practice. Several possible causes of pericarditis can be listed, as the pericardium may be involved in a large number of systemic disorders or may be diseased, as an isolated process. The reported diagnostic yield of extensive laboratory evaluation and pericardiocentesis is low in the absence of cardiac tamponade or suspected neoplastic, tuberculous, and purulent pericarditis. Patients with pericarditis can be safely managed on an outpatient basis without a thorough diagnostic evaluation unless a specific cause is suspected or the patient has high-risk features, or both. A targeted aetiological search should be directed to the most common cause on the basis of the clinical background, epidemiological issues or specific presentations. In developed countries the clinicians should rule out neoplastic, tuberculous, and purulent pericarditis, as well as pericarditis related to a systemic disease.