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Bariatric surgery could reduce the risk of specific types of breast cancer

Por: Kerin · U.

Commentary on: Feigelson HS, Caan B, Weinmann S, et al. Bariatric surgery is associated with reduced risk of breast cancer in both premenopausal and postmenopausal women. Ann Surg 2019 https://doi.org/0.1097/SLA.0000000000003331. [Epub ahead of print 13 Apr 2019].

Implications for practice and research

  • Preliminary evidence suggests that bariatric surgery reduces the risk of postmenopausal oestrogen-positive and premenopausal oestrogen-negative breast cancer.

  • International, prospective, longitudinal studies using power calculations are required.

  • Context

    Obesity influences the development, prognosis and mortality rates of many types of cancer including that of the breast.1 Research correlates weight gain in adulthood with an increased risk of breast cancer.2 The International Agency for Research on Cancer contends that the relationship between intentional weight loss and cancer risk is yet to be determined.1 Winder and colleagues3 suggest that bariatric surgery (an intentional weight loss...

    Professional socialisation processes help facilitate the transition from student to qualified nurse

    Por: Kerin · U.

    Commentary on: Frögéli E, Rudman A, Gustavsson P. The relationship between task mastery, role clarity, social acceptance, and stress: an intensive longitudinal study with a sample of newly registered nurses. Int J Nurs Stud 2019;91:60–9. doi: 10.1016/j.ijnurstu.2018.10.007

    Implications

  • Socialisation processes are needed to enhance role transition and improve the integration of newly qualified nurses (NQNs). A particular emphasis should be placed on fostering social acceptance.

  • This study provides a theoretical basis on which an intervention could be generated to minimise NQN stress.

  • Future studies investigating stress in NQN should also consider the influence of organisational work factors including staffing levels, skill-mix and workload allocations.

  • Context

    The transition from student to newly qualified nurse (NQN) is a vulnerable time period.1 2 The challenges of increased clinical responsibility and settling into the clinical work environment can increase stress levels and cause some...

    Womens experiences of breast cancer reveal the need for a holistic person-centred approach to breast cancer care

    Por: Kerin · U.

    Commentary on: Smit A, Coetzee BJ, Roomaney R, et al. Women’s stories of living with breast cancer: a systematic review and meta-synthesis of qualitative evidence. Soc Sci Med 2019; 222:231–45. doi: 10.1016/j.socscimed.2019.01.020

    Implications for practice and research

  • Findings illustrate the physical, psychosocial and emotional impact of breast cancer on women.

  • A holistic, person-centred approach to breast cancer care is required before, during and after active cancer treatment has been terminated.

  • The proposed trajectory of breast cancer framework will enable future researchers to consider breast cancer experiences relative to particular breast cancer time-points.

  • Context

    Breast cancer is reported to be the most common type of cancer in women.1 There are distinct histological subtypes; luminal A, luminal B, basal-like and human epidermal growth factor receptor 2 (HER2) enriched.2 Improved molecular understanding has facilitated the development of targeted treatments. Disease stage and...

    Select groups of older adults may benefit from emergency-based short-stay unit admission, as compared to standard medical admission

    Por: Kerin · U.

    Commentary on: Strøm C, Rasmussen LS, Löwe AS, et al. Short-stay unit hospitalisation vs. standard care outcomes in older internal medicine patients-a randomised clinical trial. Age Ageing 2018;47:810-817. doi: 10.1093/ageing/afy090.

    Implications

  • Preliminary data suggests emergency-based, short-stay units reduced: functional decline, adverse events, readmission rates and hospital stays.

  • Short-stay units reported similar 90-day mortality rates to standard medical admissions.

  • Multicentre international studies are required.

  • Future research should include a cost-analysis and powered studies to detect minimal differences in 90-day mortality.

  • Context

    In most countries, demand exceeds availability of acute healthcare resources.1 An aged population with complex biopsychosocial needs are an increasing healthcare challenge.2 Older adults regularly require extended periods of hospitalisation, and are more at risk of developing adverse, hospital-acquired sequelae.2 3

    Short-stay units (SSU) are speculated to be cost-effective facilities with the potential to...

    Exposure-based cognitive behavioural therapy is effective in reducing post-traumatic stress disorder severity in emergency service personnel

    Por: Kerin · U.

    Commentary on: Bryant RA, Kenny L, Rawson N et al. Efficacy of exposure-based cognitive behaviour therapy for post-traumatic stress disorder in emergency service personnel: a randomised clinical trial. Psychol Med 2018:1–9. doi: 10.1017/S0033291718002234.

    Implications for practice and research

  • Preliminary evidence suggests that ‘brief’ and ‘prolonged’ exposure-based therapy yield similar reductions in post-traumatic stress disorder symptoms in emergency service personnel.

  • Future research should include female participants, conduct a comparative cost analysis and power studies to account for the often high attrition rate encountered in studies investigating psychiatric interventions.

  • Context

    Post-traumatic stress disorder (PTSD) is a mental health condition which can occur with traumatic exposure.1 Occupational predilection to trauma places emergency service personnel at risk. Trauma-focused exposure-based therapy (EBT) is understood to improve PTSD symptoms.2 Contemporary research investigates the efficacy of ‘prolonged’ and ‘brief’ EBT within specific PTSD populations.3 Extant research primarily studies...

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