Managing nontraditional risk factors to improve outcomes after cancer surgery

first_imgReviewed by James Ives, M.Psych. (Editor)Mar 12 2019In a study of 142 patients preparing for cancer surgery, Johns Hopkins Medicine researchers say they have evidence that psychological or social risk factors such as depression, limited resilience and lack of emergency resources along with standard medical risk factors such as high blood pressure or diabetes are linked with higher risks of surgical complications.”When it comes to cancer surgery, the conventional strategy has always been to treat the cancer as fast as you can,” says Ira Leeds, M.D., M.B.A., a research fellow in the Department of Surgery at the Johns Hopkins University School of Medicine. “But our study suggests that there are things related to their psychosocial lives that we could and should be managing ahead of time, and that would help our patients have better outcomes after their surgery.”The researchers caution that their study wasn’t designed to determine cause and effect, but to identify associations between risk factors and outcomes.In a report on the study, published Jan. 7 in Annals of Surgical Oncology, the researchers said such psychological and social factors as mood, the ability to handle stress, resources patients can pull together in a pinch, and a history of drug, alcohol or smoking addiction were tied observationally to poor surgical outcomes in their study population. Taking note of them, and perhaps taking some time to address them, may help reduce complications and improve outcomes.Leeds said his study was prompted in part by the better outcomes documented in other kinds of surgery where there may be less of a sense of immediate urgency, such as weight reduction and orthopaedic operations. In those fields, he noted, surgeons generally require that their patients have a good psychosocial safety net and plan before surgery, because such things as quitting smoking and having a plan for after-surgery care can result in fewer adverse events.To see whether that might be the case for cancer surgery patients, the researchers compiled a special questionnaire based on well-known terms and concepts used to measure psychosocial risk factors. For example, the questions ask a patient how well they bounce back from a difficult event, or how likely they could cope with and care for a minor infection from home after surgery.Related StoriesStudy: Nearly a quarter of low-risk thyroid cancer patients receive more treatment than necessaryHow cell-free DNA can be targeted to prevent spread of tumorsNew protein target for deadly ovarian cancerBetween March and October 2017, they gave the survey to 142 patients before they had abdominal cancer surgery at The Johns Hopkins Hospital or its local affiliates. Each survey took an average of 10 minutes to complete and asked patients to rank their answers to about 20 questions on a 1 to 5 scale.The patients were an average of 65 years old; 56 percent were men and 23 percent were nonwhite. More than half the patients had a liver or pancreatic tumor, and the rest had primarily colorectal tumors. The researchers assessed patient outcomes 30 days after surgery, using medical records to count such complications after surgery as infections, blood clots, bleeding from surgery, heart attack, kidney problems, stroke and spending excessive time on a ventilator.Of those who had operations, 43 percent had other medical risk factors prior to surgery, such as high blood pressure, diabetes, lung disease or heart failure, all of which may lead to post-operative complications. Almost three-quarters had at least one psychosocial risk factor, with the most frequent reported as smoking (43 percent) and limited resourcefulness (29 percent).The researchers found that one psychosocial risk factor alone did not make a person more likely to have complications after cancer surgery. However, they found that if people had medical risk factors and a single psychosocial risk factor, it made them 28 percent more likely than those without those factors to have complications after surgery, even after accounting for the extra complications tied to medical risk factors.Those patients who had a medical risk factor and two or more psychosocial risk factors were 3.4 times more likely to develop a complication after surgery than those with no risk factors.”Our results suggest that there is an opportunity to test new interventions focused on managing psychosocial risks before surgery in order to improve outcomes, and that is what we plan to do next,” says Leeds. Source:https://www.hopkinsmedicine.org/news/newsroom/news-releases/potential-way-to-improve-cancer-surgery-outcomes-by-managing-nontraditional-risk-factorslast_img read more

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Workplace messaging startup Slack to go public

first_imgWorkplace messaging startup Slack has become the latest of the richly valued tech startups to file for an initial public offering Explore further This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. © 2019 AFP Citation: Workplace messaging startup Slack to go public (2019, February 4) retrieved 17 July 2019 from https://phys.org/news/2019-02-workplace-messaging-startup-slack.htmlcenter_img Workplace messaging startup Slack said Monday it had filed a confidential registration for an initial public offering, becoming the latest of a group of richly valued tech enterprises to look to Wall Street. California-based Slack’s filing comes under a special provision of securities laws enabling startups to begin the IPO process without disclosing details of their financing.The statement offered no information on the date or amount of money expected to be raised. Some reports say Slack will use the direct listing, a method used by Spotify, that allows insiders to sell existing shares without issuing new stock, streamlining the IPO process and avoiding big investment banking fees.Slack, which claims some 10 million users in 150 countries, has raised more than $1 billion from investors with the latest valuing the company at $7.1 billion, making it one of the most richly valued “unicorns”—startups with private funding worth at least $1 billion.Slack, which offers real-time messaging for the workplace, is used to help improve communication and help companies get around email overload. It offers free services for small teams and paid plans with additional options.Created in 2013, Slack has been a leader in the new segment but faces competition from the likes of Microsoft, Facebook and others offering workplace collaboration tools.Analysts say Slack has found a niche, especially among small- and medium-sized businesses.Other richly valued unicorns aiming for an IPO in 2019 include ridesharing giants Uber and Lyft, and lodging startup Airbnb. Other potential IPOs in the sector include the social platform Pinterest and coworking sector leader WeWork.Slack’s CEO and founder Stewart Butterfield was part of the team that started the photo-sharing service Flickr. Workplace messaging startup Slack eyes 2019 IPO: reportlast_img read more

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