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15 results

  • PP150 The Role Of Expert Consensus In UK Guidance: Patient Selection For Hydrogel Spacer Use During Prostate Cancer Radiotherapy

  • Rhodri Saunders, Heather Ann Payne, Suneil Jain, Clive Peedell, Albert Edwards, Andrew Thomas, Prantik Das, Amanda Hansson Hedblom, Emily Woodward, Amit Bahl
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 38 / Issue S1 / December 2022
    Published online by Cambridge University Press:
    23 December 2022, pp. S88-S89
    • Article
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  • Introduction

    In UK males, prostate cancer is the most common cancer, with over 47,500 diagnosed annually. Radiotherapy is a highly effective curative treatment but can be limited by dose to surrounding normal-tissues such as the rectum. Radiation to the rectum can be reduced by increasing the distance between prostate and rectum with a hydrogel spacer. Despite National Institute of Health and Care Excellence guidance, spacers are not widely funded in the UK. Limited funding has necessitated patient prioritization, without any existing consensus on method.

    Studies have shown generally homogenous results in reduction of rectal toxicity across assessed subgroups, but the requirement to prioritize remains. One way of addressing the appropriate use of beneficial health technologies is the inclusion of end-user experts in decision-making. The study aim was to identify consensus among radiation oncologists on patient prioritization for rectal hydrogel spacers.

    Methods

    We conducted a Delphi study where six leading clinical oncologists and one urologist from across the UK experienced in using rectal hydrogel spacers participated in two rounds of online questionnaires and two virtual advisory board meetings.

    Results

    The experts estimated that 83 percent of patients who could potentially benefit from a spacer were denied access. Overall, ten points of consensus were reached. Key ones concerning patient-access were:

    • • Spacer use in eligible patients significantly reduces radiation dose to the rectum and toxicity-related adverse events.

    • • Increased benefit is expected in patients on anticoagulation, with diabetes and with inflammatory bowel disease.

    • • Increased benefit can be expected with ultra-hypofractionated radiotherapy, but radiotherapy modality is not a key consideration for patient selection.

    • • Patients should have the opportunity to actively participate in the discussion regarding the use of a spacer.

    Conclusions

    Currently, not all patients who would benefit can access funding for hydrogel spacers. Consensus in this study indicates that appropriate health policy and funding mechanisms are warranted for patients, to provide equitable access to technologies improving quality of life.

  • Identification of Colonized Patients During an Outbreak of Candida auris Using a Regional Health Information Exchange

  • Richard Brooks, Elisabeth Vaeth, Heather Saunders, Tim Blood, Brittany Grace, David Blythe, Liore Klein, Jacqueline Reuben, Regan Trappler, Preetha Iyengar, Emily Blake, Sarah Lineberger, Rehab Abdelfattah, Kathleen Tully, Kaitlin Forsberg, Maroya Walters, Snigdha Vallabhaneni
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
    Published online by Cambridge University Press:
    02 November 2020, pp. s255-s256
    Print publication:
    October 2020
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  • Background: In June 2019, the Maryland Department of Health (MDH) was notified of a hospitalized patient with Candida auris bloodstream infection. The MDH initiated a contact investigation to identify additional patients with C. auris colonization. Many of the contacts had been discharged home from the hospital and were therefore not available for screening. Healthcare facilities in Maryland, Virginia, and Washington, DC, submit patient data to a regional health information exchange (HIE) called the Chesapeake Regional Information System for our Patients (CRISP). CRISP includes a notification system that alerts providers when flagged patients have healthcare encounters. We aimed to use this system to identify discharged C. auris contacts on their next inpatient encounter to rapidly screen them and to detect new cases. Methods:C. auris contacts were defined as patients located on an inpatient unit on the same day, receiving wound care from the same team, or having a procedure in the same operating room on the same day as the index patient or any patients subsequently identified as having C. auris infection or colonization detected either during the normal course of clinical care or through screening. Contacts who remained hospitalized were screened during inpatient point prevalence surveys (PPSs). Contacts discharged to postacute-care facilities were screened by facility staff. Contacts who had been discharged home were flagged in CRISP, and MDH staff received CRISP encounter alerts when these patients were readmitted. MDH staff then contacted the admitting facilities to recommend screening for C. auris. Axilla and groin swabs were collected and tested by rt-PCR at the Mid-Atlantic Regional Antibiotic Resistance Laboratory Network laboratory. Results: As of October 8, 2019, 4,017 contacts were identified. Among these, 936 (23%) contacts at 56 healthcare facilities (33 acute-care hospitals and 23 postacute-care facilities) were screened for C. auris, and 10 patients with C. auris colonization were identified (1.1% of contacts who underwent C. auris screening). Of these, 6 (60%) were identified through CRISP notification and 4 (40%) were identified by PPSs conducted in acute-care hospitals. Conclusions: In this ongoing C. auris outbreak, a large proportion of colonized patients was identified using an electronic encounter notification system within a regional HIE. This approach was effective for identifying opportunities to screen contacts at their next healthcare encounter and can augment other means of case detection, like PPSs. HIEs should incorporate mechanisms to facilitate contact tracing for public health investigations.

    Funding: None

    Disclosures: None

Sol Plaatje's Native Life in South Africa
  • Past and present
  • Edited by Janet Remmington, Brian Willan, Bhekizizwe Peterson
  • Sabata-mpho Mokae, Nhlanhla Maake, Peter Limb, Albert Grundlingh, Khwezi Mkhize, André Odendaal, Christopher Saunders, Heather Hughes, Keith Breckenridge, Jacob Dlamini, Sean O’Toole
  • Published by:
    Wits University Press
    Published online:
    21 April 2018
    Print publication:
    31 October 2016
  • First published in 1916, Sol Plaatje’s Native Life in South Africa was written by one of the South Africa’s most talented early twentieth-century black leaders and journalists. Plaatje’s pioneering book arose out of an early African National Congress campaign to protest against the discriminatory1913 Natives Land Act. Native Life vividly narrates Plaatje’s investigative journeying into South Africa’s rural heartlands to report on the effects of the Act and his involvement in the deputation to the British imperial government. At the same time it tells the bigger story of the assault on black rights and opportunities in the newly consolidated Union of South Africa – and the resistance to it. Originally published in war-time London, but about South Africa and its place in the world, Native Life travelled far and wide, being distributed in the United States under the auspices of prominent African-American W E B Du Bois. South African editions were to follow only in the late apartheid period and beyond. The aim of this multi-authored volume is to shed new light on how and why Native Life came into being at a critical historical juncture, and to reflect on how it can be read in relation to South Africa’s heightened challenges today. Crucial areas that come under the spotlight in this collection include land, race, history, mobility, belonging, war, the press, law, literature, language, gender, politics, and the state.

  • Editions of Native Life in South Africa: 1916 to the present

  • Edited by Janet Remmington, Brian Willan, Bhekizizwe Peterson
  • Sabata-mpho Mokae, Nhlanhla Maake, Peter Limb, Albert Grundlingh, Khwezi Mkhize, André Odendaal, Christopher Saunders, Heather Hughes, Keith Breckenridge, Jacob Dlamini, Sean O’Toole
  • Book:
    Sol Plaatje's Native Life in South Africa
    Published by:
    Wits University Press
    Published online:
    21 April 2018
    Print publication:
    31 October 2016, pp xxxv-xxxvi

  • Summary

    S T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (London: P S King & Son, Ltd, May 1916). First edition. 1000 copies printed, 500 bound up for sale.

    S T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (London: P S King & Son, Ltd, October 1916). Second edition.

    Consisted of the remaining 500 copies from the first printing. Includes a new chapter entitled ‘Report of the Lands Commission: An Analysis’, bound in at the beginning of the book. Also adds two pages with ‘Some Opinions of the Press on the First Edition’, along with advertisements for Plaatje's Sechuana Proverbs and A Sechuana Reader, the latter co-authored with Daniel Jones.

    S T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (London: P S King & Son, Ltd, February 1917). Third edition. Separate impressions for P S King & Son, London; Tsala ea Batho, Kimberley; and The Crisis, New York. ‘Report of the Lands Commission’ chapter moved to the end of the book. Folded map added as insert.

    S T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (Kimberley: Tsala ea Batho, and New York: The Crisis, 1920).

    Fourth edition.

    No impression by P S King & Son located.

    S T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (London: P S King & Son, Ltd, 1921). Fifth edition. No impression for Tsala ea Batho and The Crisis located.

    S T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (New York: Negro Universities Press, 1969). Facsimile of Third edition.

    Sol T Plaatje, Native Life in South Africa, Before and Since the European War and the Boer Rebellion (Johannesburg: Ravan Press, 1982).

    Paperback edition. Foreword by Bessie Head, Introduction by Brian Willan. Sol T Plaatje, Native Life in South Africa (Harlow: Longman, 1987). African Classics Series.

    Abbreviated paperback edition, omitting chapters 22–24. Introduction by Brian Willan.