Dataset Information

The Desire to Better Understand Older Adults with Solid Tumors to Improve Management: Assessment and Guided Interventions-The French PACA EST Cohort Experience.

ABSTRACT: Todays challenge in geriatric oncology is to screen patients who need geriatric follow-up. The main goal of this study was to analyze factors that identify patients, in a large cohort of patients with solid tumors, who need more geriatric interventions and therefore specific follow-up. Between April 2012 and May 2018, 3530 consecutive patients were enrolled in the PACA EST cohort (France). A total of 3140 patients were finally enrolled in the study. A Comprehensive Geriatric Assessment (CGA) was performed at baseline. We analyzed the associations between factors at baseline (geriatric and oncologic factors) and the need to perform more than three geriatric interventions. The mean age of the population was 82 years old with 59% of patients aged older than 80 years old. A total of 8819 geriatric interventions were implemented for the 3140 patients. The percentage of patients with three or more geriatric interventions represented 31.8% (n = 999) of the population. In multivariate analyses, a Mini Nutritional assessment (MNA) <17, an MNA ?23·5 and ?17, a performans status (PS) >2, a dependence on Instrumental Activities of Daily Living (IADL), a Geriatric Depression Scale (GDS) ?5, a Mini Mental State Examination (MMSE) <24, and a Screening tool G8 ?14 were independent risk factors associated with more geriatric interventions. Factors associated with more geriatric interventions could assist practitioners in selecting patients for specific geriatric follow-up.

SUBMITTER: Boulahssass R

PROVIDER: S-EPMC6406576 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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The Desire to Better Understand Older Adults with Solid Tumors to Improve Management: Assessment and Guided Interventions-The French PACA EST Cohort Experience.

Boulahssass Rabia R Gonfrier Sebastien S Champigny Noémie N Lassalle Sandra S François Eric E Hofman Paul P Guerin Olivier O

Cancers 20190207 2

Todays challenge in geriatric oncology is to screen patients who need geriatric follow-up. The main goal of this study was to analyze factors that identify patients, in a large cohort of patients with solid tumors, who need more geriatric interventions and therefore specific follow-up. Between April 2012 and May 2018, 3530 consecutive patients were enrolled in the PACA EST cohort (France). A total of 3140 patients were finally enrolled in the study. A Comprehensive Geriatric Assessment (CGA) was ...[more]

PMID: 30736406

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Project description:Background and objectiveUnderstanding the patient experience is important for identifying the unmet need in chronic lymphocytic leukemia. The current study aimed to develop a comprehensive chronic lymphocytic leukemia conceptual model.MethodsThe conceptual model was based on literature searches, review of chronic lymphocytic leukemia patient blogs/forums, and interviews with five expert clinicians, with 20 patients who received at most one treatment (first line) for their chronic lymphocytic leukemia, and with 20 patients with relapsed or refractory chronic lymphocytic leukemia. De-identified interviews were transcribed, coded, and evaluated using qualitative data analysis software.ResultsThirty-five prevalent chronic lymphocytic leukemia-related symptom and impact concepts were identified from literature searches, patient blogs/forums, and clinician interviews. Patient interviews confirmed the identified concepts and revealed five additional concepts. Fatigue-related sub-components were identified from how patients described their fatigue, covering symptoms (tiredness/need for sleep, lack of energy, weakness, cognitive fatigue), and impacts (decreased ability to maintain their social, familial, or professional role, decreased physical functioning, frustration). Three versions of the conceptual model were created: an overall model with all concepts; a model highlighting the most prominent concepts in first line; and a model highlighting the most prominent concepts in relapsed or refractory disease. Prominent concepts in both first line and relapsed or refractory disease were fatigue-related symptoms and impacts, muscle/joint aches, night sweats, bruising, fever, recurrent infections/illness, insomnia, decreased cognitive/emotional functioning, anxiety/worry, stress, depression, financial difficulty, and fear of death. Dyspnea and cough were prominent in first line only, and enlarged lymph nodes, headaches, pain/discomfort, weight loss, nausea/vomiting, and infusion reactions were prominent in relapsed or refractory disease only.ConclusionsThe results show that fatigue is a dominant issue affecting patients with chronic lymphocytic leukemia. The three versions of the conceptual model can help researchers to understand patients' unmet needs and guide the patient-reported outcome strategy for clinical trials.

Project description:The evolution of sociality is related to many ecological factors that act on animals as selective forces, thus driving the formation of groups. Group size will depend on the payoffs of group living. The Social Complexity Hypothesis for Communication (SCHC) predicts that increases in group size will be related to increases in the complexity of the communication among individuals. This hypothesis, which was confirmed in some mammal societies, may be useful to trace sociality in the spotted paca (Cuniculus paca), a Neotropical caviomorph rodent reported as solitary. There are, however, sightings of groups in the wild, and farmers easily form groups of spotted paca in captivity. Thus, we aimed to describe the acoustic repertoire of captive spotted paca to test the SCHC and to obtain insights about the sociability of this species. Moreover, we aimed to verify the relationship between group size and acoustic repertoire size of caviomorph rodents, to better understand the evolution of sociality in this taxon. We predicted that spotted paca should display a complex acoustic repertoire, given their social behavior in captivity and group sightings in the wild. We also predicted that in caviomorph species the group size would increase with acoustic repertoire, supporting the SCHC. We performed a Linear Discriminant Analysis (LDA) based on acoustic parameters of the vocalizations recorded. In addition, we applied an independent contrasts approach to investigate sociality in spotted paca following the social complexity hypothesis, independent of phylogeny. Our analysis showed that the spotted paca's acoustic repertoire contains seven vocal types and one mechanical signal. The broad acoustic repertoire of the spotted paca might have evolved given the species' ability to live in groups. The relationship between group size and the size of the acoustic repertoires of caviomorph species was confirmed, providing additional support for the SCHC in yet another group of diverse mammals-caviomorph rodents.

Dataset Information

The Desire to Better Understand Older Adults with Solid Tumors to Improve Management: Assessment and Guided Interventions-The French PACA EST Cohort Experience.

Publications

The Desire to Better Understand Older Adults with Solid Tumors to Improve Management: Assessment and Guided Interventions-The French PACA EST Cohort Experience.

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