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BACKGROUND A glioblastoma is a fatal type of brain tumour for which the standard of care is maximum surgical resection followed by chemoradiotherapy, when possible. Age is an important consideration in this disease, as older age is associated with shorter survival and a higher risk of treatment-related toxicity. OBJECTIVES To determine the most effective and best-tolerated approaches for the treatment of elderly people with newly diagnosed glioblastoma. To summarise current evidence for the incremental resource use, utilities, costs and cost-effectiveness associated with these approaches. SEARCH METHODS We searched electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase to 3 April 2019, and the NHS Economic Evaluation Database (EED) up to database closure. We handsearched clinical trial registries and selected neuro-oncology society conference proceedings from the past five years. SELECTION CRITERIA Randomised trials (RCTs) of treatments for glioblastomacancer treatments TMZ and BEV carry a higher risk of severe haematological and thromboembolic events and CRT is probably associated with a higher risk of these events. Current evidence provides little justification for using BEV in elderly patients outside a clinical trial setting. Whilst the novel TTF device appears promising, evidence on QoL and tolerability is needed in an elderly population. QoL and economic assessments of CRT versus TMZ and RT are needed. More high-quality economic evaluations are needed, in which a broader scope of costs (both direct and indirect) and outcomes should be included. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.AIM To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses. BACKGROUND Seasonal influenza causes significant mortality and morbidity among older people and high risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low. DESIGN An explanatory sequential mixed methods study design. DATA SOURCES Qualified nurses attending mandatory training in two large acute hospitals in Ireland. METHODS A paper-based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 and February 2018. A self-selected sample of thirty five nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practamong nurses and will inform the development of specific tailored interventions for nurses. This article is protected by copyright. All rights reserved.AIM To examine 1) whether nativity status was associated with workplace discrimination, 2) whether this association was mediated through psychosocial work characteristics (job strain, job demands and job control) among registered female nurses. DESIGN Cross-sectional survey with a self-report questionnaire was conducted. METHODS A random sample of 610 native Registered Nurses and a total sample of 188 foreign-born Registered Nurses working in Finland were used. Data were collected between September - November of 2017 and analyzed using a counterfactual approach in the causal mediation framework. RESULTS After adjusting for several potential confounders, foreign-born nurses scored higher on workplace discrimination than native nurses. Approximately 20% of the association between nativity status and workplace discrimination was mediated through job control. Job demands and job strain were unlikely to mediate this association. CONCLUSION The study provides further evidence that migrant status is associated with a higher risk of workplace discrimination among nurses. Lower levels of control over one's own job may partly contribute to the higher risk of workplace discrimination in foreign-born women nurses. IMPACT Our study addresses the relationship between nativity status and workplace discrimination among female nurses and its mediating factors. The findings suggest that health care organization leaders need to be aware of the increased risk of workplace discrimination among migrant nurses. Moreover, health care organizations need to consider psychosocial work characteristics, including job control, in the efforts aimed to prevent and reduce discrimination against their foreign-born employees. This article is protected by copyright. All rights reserved.AIMS Benefits of a transtheoretical model-based exercise program on exercise adherence (primary outcome) and secondary outcomes (self-efficacy, decisional balance, knee osteoarthritis symptoms and physical function) were assessed among older adults with knee osteoarthritis. DESIGN A two-arm, superiority, assessor-blinded, cluster randomized trial with randomization at the community level. selleck METHODS Participants were recruited from 14 communities in Beijing between April and October 2018 (N = 189). The intervention was a 24-week transtheoretical model-based exercise program and the control group underwent a non-theory-based exercise program. Exercise adherence was collected every four weeks and secondary outcomes were measured at baseline, 12 and 24 weeks. An independent t-test and repeated measures ANOVA were the main statistical tests. RESULTS Most participants were women (92.5%), married (81.4%), with high-school education (36.0%), with both knees affected (50.3%) and did not make use of a walker (93.8%). Thethritis to improve their symptoms and knee function. This article is protected by copyright. All rights reserved.Lack of health insurance coverage is strongly associated with poor cancer outcomes in the United States. The uninsured are less likely to have access to timely and effective cancer prevention, screening, diagnosis, treatment, survivorship, and end-of-life care than their counterparts with health insurance coverage. On March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law, representing the largest change to health care delivery in the United States since the introduction of the Medicare and Medicaid programs in 1965. The primary goals of the ACA are to improve health insurance coverage, the quality of care, and patient outcomes, and to maintain or lower costs by catalyzing changes in the health care delivery system. In this review, we describe the main components of the ACA, including health insurance expansions, coverage reforms, and delivery system reforms, provisions within these components, and their relevance to cancer screening and early detection, care, and outcomes. We then highlight selected, well-designed studies examining the effects of the ACA provisions on coverage, access to cancer care, and disparities throughout the cancer control continuum.
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