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23 results

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  • Communicating with families of young people with hard-to-treat cancers: Healthcare professionals’ perspectives on challenges, skills, and training

  • Lauren Kelada, Eden G. Robertson, Skye McKay, Brittany C. McGill, Rebecca Daly, Carolyn Mazariego, Natalie Taylor, Elijah Tyedmers, Nicole Armitage, Holly E. Evans, Claire E. Wakefield, David S. Ziegler
  • Journal:
    Palliative & Supportive Care / Volume 22 / Issue 3 / June 2024
    Published online by Cambridge University Press:
    24 January 2024, pp. 539-545
  • Objectives

    Hard-to-treat childhood cancers are those where standard treatment options do not exist and the prognosis is poor. Healthcare professionals (HCPs) are responsible for communicating with families about prognosis and complex experimental treatments. We aimed to identify HCPs’ key challenges and skills required when communicating with families about hard-to-treat cancers and their perceptions of communication-related training.

    Methods

    We interviewed Australian HCPs who had direct responsibilities in managing children/adolescents with hard-to-treat cancer within the past 24 months. Interviews were analyzed using qualitative content analysis.

    Results

    We interviewed 10 oncologists, 7 nurses, and 3 social workers. HCPs identified several challenges for communication with families including: balancing information provision while maintaining realistic hope; managing their own uncertainty; and nurses and social workers being underutilized during conversations with families, despite widespread preferences for multidisciplinary teamwork. HCPs perceived that making themselves available to families, empowering them to ask questions, and repeating information helped to establish and maintain trusting relationships with families. Half the HCPs reported receiving no formal training for communicating prognosis and treatment options with families of children with hard-to-treat cancers. Nurses, social workers, and less experienced oncologists supported the development of communication training resources, more so than more experienced oncologists.

    Significance of results

    Resources are needed which support HCPs to communicate with families of children with hard-to-treat cancers. Such resources may be particularly beneficial for junior oncologists and other HCPs during their training, and they should aim to prepare them for common challenges and foster greater multidisciplinary collaboration.

  • Pathogens causing central-line–associated bloodstream infections in acute-care hospitals—United States, 2011–2017

  • Shannon A. Novosad, Lucy Fike, Margaret A. Dudeck, Katherine Allen-Bridson, Jonathan R. Edwards, Chris Edens, Ronda Sinkowitz-Cochran, Krista Powell, David Kuhar
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 41 / Issue 3 / March 2020
    Published online by Cambridge University Press:
    09 January 2020, pp. 313-319
    Print publication:
    March 2020
  • Objective:

    To describe pathogen distribution and rates for central-line–associated bloodstream infections (CLABSIs) from different acute-care locations during 2011–2017 to inform prevention efforts.

    Methods:

    CLABSI data from the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) were analyzed. Percentages and pooled mean incidence density rates were calculated for a variety of pathogens and stratified by acute-care location groups (adult intensive care units [ICUs], pediatric ICUs [PICUs], adult wards, pediatric wards, and oncology wards).

    Results:

    From 2011 to 2017, 136,264 CLABSIs were reported to the NHSN by adult and pediatric acute-care locations; adult ICUs and wards reported the most CLABSIs: 59,461 (44%) and 40,763 (30%), respectively. In 2017, the most common pathogens were Candida spp/yeast in adult ICUs (27%) and Enterobacteriaceae in adult wards, pediatric wards, oncology wards, and PICUs (23%–31%). Most pathogen-specific CLABSI rates decreased over time, excepting Candida spp/yeast in adult ICUs and Enterobacteriaceae in oncology wards, which increased, and Staphylococcus aureus rates in pediatric locations, which did not change.

    Conclusions:

    The pathogens associated with CLABSIs differ across acute-care location groups. Learning how pathogen-targeted prevention efforts could augment current prevention strategies, such as strategies aimed at preventing Candida spp/yeast and Enterobacteriaceae CLABSIs, might further reduce national rates.

  • 1 - Savoy opera and its discontents: the theatrical background to a quarrel

  • from Part I - Background
  • Edited by David Eden, Meinhard Saremba
  • Book:
    The Cambridge Companion to Gilbert and Sullivan
    Published online:
    28 September 2011
    Print publication:
    06 August 2009, pp 1-21

  • Summary

    The West End theatre as we know it is a Victorian in heritance. Many theatre buildings still stand from this period, but more importantly the methods of production and patterns of audience behaviour which we take for granted were established then. Those who work in the contemporary theatre often take exception to this state of affairs. They look on theatre-land as hideously bourgeois and seek, albeit in vain, to reclaim it for the working class. The Victorians experienced the same problem in reverse. For them the challenge was to overcome the disrepute of working-class association and establish the theatre as a domain of the respectable bourgeoisie. The Savoy operas have their full share of this ambition; but they are end products rather than prime movers. Their roots lie deep in the eighteenth century, or earlier, and we regard them as ‘entirely original’ only because we have ceased to be aware of those roots. Above all it should be understood that their ancestry does not lie in ‘opera’ as the term is generally used, but in the popular London alternatives to it.

    Theatre regulation

    Following the Puritan interregnum, which banned all forms of public entertainment, King Charles II in 1662 granted letters patent to Thomas Killigrew and William Davenant for the performance of ‘tragedies, comedies, plays, operas, music, scenes and all other entertainments of the stage’. One patent became established at the Theatre Royal, Drury Lane, while the other eventually devolved upon the Theatre Royal, Covent Garden. In 1766 George III granted a summer patent to Samuel Foote at the Little Theatre in the Haymarket, which duly became the third Theatre Royal. Theatres operating outside the patents were technically illegal, and ran under constant threat of interference by the authorities.

  • Appendix 1 - Who wrote the overtures?

  • Edited by David Eden, Meinhard Saremba
  • Book:
    The Cambridge Companion to Gilbert and Sullivan
    Published online:
    28 September 2011
    Print publication:
    06 August 2009, pp 243-243

  • Summary

    Not all Sullivan’s operas have overtures. Victorian audiences showed little regard for these orchestral preludes, chatting over and generally paying little attention to them. Sometimes, therefore, when time was short, Sullivan delegated the task of arranging an overture from the music of the opera to others. In some – possibly all – cases he set out his structural and thematic requirements and usually made some alterations to his assistants’ work.

    For a long time, the question of authorship of several overtures remained unresolved and a number of incorrect attributions were widely accepted. Roger Harris went a good way towards producing a definitive list and my own later researches finally settled the issue in the case of the works marked ∗.

    Overtures by Sullivan: The Sapphire Necklace, Cox and Box, Iolanthe, Princess Ida, The Yeomen of the Guard, The Gondoliers, Utopia Limited, The Grand Duke. The overture to Thespis is lost. Because, thematically, it seems to have been significantly independent of the opera, it is likely to have been Sullivan’s own work.

    Alfred Cellier arranged the overtures to HMS Pinafore and The Pirates of Penzance, and Eugene D’Albert the overture to Patience∗. Hamilton Clarke was responsible for the overtures to The Mikado, Ruddigore and The Sorcerer∗ – the last having been written for the 1884 revival to replace the ‘Graceful Dance’ from Sullivan’s Henry VIII music pressed into service for the original production.

    David Rusell Hulme

The Cambridge Companion to Gilbert and Sullivan
  • Edited by David Eden, Meinhard Saremba
  • Published online:
    28 September 2011
    Print publication:
    06 August 2009
  • Memorable melodies and fanciful worlds – the comic operas of Gilbert and Sullivan remain as popular today as when they were first performed. This Companion provides a timely guide to the history and development of the collaboration between the two men, including a fresh examination of the many myths and half-truths surrounding their relationship. Written by an international team of specialists, the volume features a personal account from film director Mike Leigh on his connection with the Savoy Operas and the creation of his film Topsy-Turvy. Starting with the early history of the operatic stage in Britain, the Companion places the operas in their theatrical and musical context, investigating the amateur performing tradition, providing new perspectives on the famous patter songs and analysing their dramatic and operatic potential. Perfect for enthusiasts, performers and students of Gilbert and Sullivan's enduring work, the book examines their legacy and looks forward to the future.

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