Malignant pleural mesothelioma(MPM)is a rare tumor with poor prognosis and rising incidence.Palliative care is common in MPM as radical treatment with curative intent is often not possible due to metastasis or extensi...Malignant pleural mesothelioma(MPM)is a rare tumor with poor prognosis and rising incidence.Palliative care is common in MPM as radical treatment with curative intent is often not possible due to metastasis or extensive locoregional involvement.Numerous therapeutic advances have been made in recent years,including the use of less aggressive surgical techniques associated with lower morbidity and mortality(e.g.,pleurectomy/decortication),technological advancements in the field of radiotherapy(intensity-modulated radiotherapy,image-guided radiotherapy,stereotactic body radiotherapy,proton therapy),and developments in systemic therapies(chemotherapy and immunotherapy).These improvements have had as yet only a modest effect on local control and survival.Advances in the management of MPM and standardization of care are hampered by the evidence to date,limited by high heterogeneity among studies and small sample sizes.In this clinical guideline prepared by the oncological group for the study of lung cancer of the Spanish Society of Radiation Oncology,we review clinical,histologic,and therapeutic aspects of MPM,with a particular focus on all aspects relating to radiotherapy,including the current evidence base,associations with chemotherapy and surgery,treatment volumes and planning,technological advances,and reradiation.展开更多
This research aims to deepen knowledge on the role of fear on ART adherence of patients who live in Maputo district in Mozambique, including differences on age, gender and schooling level, on their previous knowledge ...This research aims to deepen knowledge on the role of fear on ART adherence of patients who live in Maputo district in Mozambique, including differences on age, gender and schooling level, on their previous knowledge about HIV and ART and on the impact of the discrimination experiences on the ART adherence. The participants are 602 ART patients living in Maputo district between 21 and 56 years old. The findings reveal that more men than women have interrupted the treatment. Those who did it at least once have more than 39 years old. There are more reports of non-interruption of the treatment on patients who have never been to school or who have been in the high school or more advanced studies. Those who reported that have never interrupted the treatment have more previous knowledge about HIV and the treatment;have never been discriminated and have less fear of being marginalized by being HIV+. Most of those who have interrupted the treatment have already been discriminated by nurses or friends. As fear is automatically processed in our brain, specific contexts of fear related to ART where studied as well as the impact of the fear of those contexts on the behaviors of adherence or of treatment interruption. The results reflect the need to develop national educational policies regarding emotional awareness, adequate emotional support and coping strategies in the context of Fear and of ART adherence. New policies need to address gender and age differences as well as health education access to ART patients, attempting to the stigma and the fear of discrimination as a present element of influence on ART adherence. The study also validates the role of health professionals as high responsible elements on the health of the ART individuals.展开更多
文摘Malignant pleural mesothelioma(MPM)is a rare tumor with poor prognosis and rising incidence.Palliative care is common in MPM as radical treatment with curative intent is often not possible due to metastasis or extensive locoregional involvement.Numerous therapeutic advances have been made in recent years,including the use of less aggressive surgical techniques associated with lower morbidity and mortality(e.g.,pleurectomy/decortication),technological advancements in the field of radiotherapy(intensity-modulated radiotherapy,image-guided radiotherapy,stereotactic body radiotherapy,proton therapy),and developments in systemic therapies(chemotherapy and immunotherapy).These improvements have had as yet only a modest effect on local control and survival.Advances in the management of MPM and standardization of care are hampered by the evidence to date,limited by high heterogeneity among studies and small sample sizes.In this clinical guideline prepared by the oncological group for the study of lung cancer of the Spanish Society of Radiation Oncology,we review clinical,histologic,and therapeutic aspects of MPM,with a particular focus on all aspects relating to radiotherapy,including the current evidence base,associations with chemotherapy and surgery,treatment volumes and planning,technological advances,and reradiation.
文摘This research aims to deepen knowledge on the role of fear on ART adherence of patients who live in Maputo district in Mozambique, including differences on age, gender and schooling level, on their previous knowledge about HIV and ART and on the impact of the discrimination experiences on the ART adherence. The participants are 602 ART patients living in Maputo district between 21 and 56 years old. The findings reveal that more men than women have interrupted the treatment. Those who did it at least once have more than 39 years old. There are more reports of non-interruption of the treatment on patients who have never been to school or who have been in the high school or more advanced studies. Those who reported that have never interrupted the treatment have more previous knowledge about HIV and the treatment;have never been discriminated and have less fear of being marginalized by being HIV+. Most of those who have interrupted the treatment have already been discriminated by nurses or friends. As fear is automatically processed in our brain, specific contexts of fear related to ART where studied as well as the impact of the fear of those contexts on the behaviors of adherence or of treatment interruption. The results reflect the need to develop national educational policies regarding emotional awareness, adequate emotional support and coping strategies in the context of Fear and of ART adherence. New policies need to address gender and age differences as well as health education access to ART patients, attempting to the stigma and the fear of discrimination as a present element of influence on ART adherence. The study also validates the role of health professionals as high responsible elements on the health of the ART individuals.
