La recherche au service de la performance en Santé
U.INSERM 1290 - La recherche au service de la performance en Santé
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Université Claude Bernard Lyon 1
U.INSERM 1290 - La recherche au service de la performance en Santé

Actualités du laboratoire Hesper

Dedicated Program for Adolescent and Young Adults With Cancer: A Better Way to Inform About Sexual and Fertility Issues.

Bertrand A, Aho S, Rousset-Jablonski C, Cessot M, Christophe V, Marec-Bérard P, Ray-Coquard I.

Abstract:

It is well recognised that adolescents and young adults (AYA) with cancer have inequitable access to oncology services that provide expert cancer care and consider their unique needs. Subsequently, survival gains in this patient population have improved only modestly compared with older adults and children with cancer. In 2015, the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE) established the joint Cancer in AYA Working Group in order to increase awareness among adult and paediatric oncology communities, enhance knowledge on specific issues in AYA and ultimately improve the standard of care for AYA with cancer across Europe. This manuscript reflects the position of this working group regarding current AYA cancer care, the challenges to be addressed and possible solutions. Key challenges include the lack of specific biological understanding of AYA cancers, the lack of access to specialised centres with age-appropriate multidisciplinary care and the lack of available clinical trials with novel therapeutics. Key recommendations include diversifying interprofessional cooperation in AYA care and specific measures to improve trial accrual, including centralising care where that is the best means to achieve trial accrual. This defines a common vision that can lead to improved outcomes for AYA with cancer in Europe.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103533/

General practitioners' views on cognitive disorders diagnosis: a qualitative study.

Sanlaville C, Loiseau Médecin Généraliste A, Colin C, Salmon PK, Letrilliart L.

Abstract:                                                                                                                                                                                                                                              

Diagnosis of cognitive disorders is at medical and ethical stake. The aim of an qualitative study based on interviews was to explore the views of general practitioners on this diagnosis. General practitioners are ambivalent about the relevance and temporality of the diagnosis of cognitive disorders, which could be resolved by a shared decision making at each stage of the diagnostic approach.

https://pubmed.ncbi.nlm.nih.gov/34304810/

Réunion Scientifique 1er octobre 2021 à 12h30

- Cyrille Colin, Asma Fares, Pascale Guerre : « Realist Evaluation »

"Realist evaluation is an increasingly popular methodology in health qervuces research" said Trisha Greenalgh in BMJ 2015. It is a form of theory-driven evaluation, that aims to understand why complex interventions in health services research work, how, for whom, in what context and to what extent. We will explore the context-mechanism-outcome relation using ethnographic observation, semi-structured interviews, and srutiny of documents and other contemporaneous materials. Examples of french innovations aiming at redesigning health care will be given.

 

Impact of a Geriatric Intervention to Improve Screening and Management of Undernutrition in Older Patients Undergoing Surgery for Colorectal Cancer: Results of the ANC Stepped-Wedge Trial.

Gilbert T, Bernard L, Alexandre M, Bin-Dorel S, Villeneuve L, Decullier E, Bonnefoy M, Anc Working Group.

Abstract:

Almost two in three patients who are aged 75 years and older and scheduled for surgery for colorectal cancer (CRC) are undernourished. Despite evidence that perioperative nutritional management can improve patients outcomes, international guidelines are still insufficiently applied in current practice. In this stepped-wedge cluster-randomized study of five surgical hospitals, we included 147 patients aged 70 years or older with scheduled abdominal surgery for CRC between October 2013 and December 2016. In the intervention condition, an outreach team comprising a geriatrician and a dietician visited patients and staff in surgical wards to assist with the correct application of guidelines. Evaluation, diagnosis, and prescription (according to nutritional status) were considered appropriate and strictly consistent with guidelines in 39.2% of patients in the intervention group compared to only 1.4% in the control group (p = 0.0002). Prescription of oral nutritional supplements during the perioperative period was significantly improved (41.9% vs. 4.1%; p < 0.0001). However, there were no benefits of the intervention on surgical complications or adverse events. A possible benefit of hospital stay reduction will need to be confirmed in further studies. This study highlights the importance of the implementation of quality improvement interventions into current practice for the perioperative nutritional management of older patients with CRC.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308889/