A group of oncologists have revealed in a new study by Ben-Gurion University of the Negev (BGU) researchers that communicating about death and dying with their patients is one of the most difficult and stressful parts of their work.
In the United States, 577,190 deaths from cancer occurred in 2012, according to the American Cancer Society.
The paper reported that despite this important element of their work, oncologists receive little training in this area, and many do not communicate well with patients. The research included interviews with doctors about what they found difficult and what they believed they did well.
‘To our knowledge, this is the first qualitative exploration of communication about the end of life from an oncologist

Researchers at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) have found that a weekly yoga class provided similar lower back pain relief and reduced the need for pain medication as twice weekly classes in lower income minority patients. The results of the study indicate that patients interested in trying yoga for lower back pain could benefit from attending a medically appropriate weekly yoga class.

While previous studies have shown that yoga can be an effective treatment for chronic lower back pain, few studies have studied this among specific populations.

‘Lower income patients often have worse lower back pain due to limited access to both mainstream health care treatments and complementary treatments such as yoga, massage and acupuncture,’ said Saper.

In this 12-week randomised trial, 95 predominantly low-income adults suffering from moderate to severe lower back pain were divided into two groups. One group attended yoga class once a week and the other attended twice a week, and both groups were encouraged to practice the poses and techniques at home. At the end of the 12 weeks, both groups of participants experienced similar and substantial decreases in their pain level and need for pain medications, but there was no additional benefit seen in those attending twice a week. Also, their ability to perform daily functions improved.

‘Given the similar improvement seen in once weekly yoga classes, and that once a week is more convenient and less expensive, we recommend patients suffering from lower back pain who want to pursue yoga attend a weekly therapeutic yoga class,’ said Saper. Boston University School of Medicine

A device that trains the brain to turn sounds into images could be used as an alternative to invasive treatment for blind and partially-sighted people researchers in the Department of Psychology have found.
The vOICe sensory substitution device is a revolutionary tool that helps blind people to use sounds to build an image in their minds of the things around them.
A research team, led by Dr Michael Proulx looked at how blindfolded sighted participants responded to an eye test using the device.
They were asked to perform a standard eye chart test called the Snellen Tumbling E test, which asked participants to view the letter E turned in four different directions and in various sizes. Normal, best-corrected visual acuity is considered 20/20, calculated in terms of the distance (in feet) and the size of the E on the eye chart.
The participants, even without any training in the use of the device, were able to perform the best performance possible, nearly 20/400. This limit appears to be the highest resolution currently possible with the ever-improving technology.
Dr Michael Proulx said:

Nitrous oxide

Even though patients receiving an implantable cardioverter-defibrillator (ICD) for primary prevention often receive a dual-chamber ICD, an analysis that included more than 32,000 patients receiving an ICD without indications for pacing finds that the use of a dual-chamber device compared with a single-chamber device was associated with a higher risk of device-related complications and similar 1-year mortality and hospitalisation outcomes, according to a study.
‘The central decision regarding ICD therapy is whether to use a single- or dual-chamber device,’ according to background information in the article. More complex dual-chamber devices may offer theoretical benefits beyond single-chamber devices for patients without an indication for pacing, but may also have greater risks. In a national sample, more than two-thirds of patients receiving an ICD received a dual-chamber device. ‘The outcomes of dual- vs. single-chamber devices are uncertain.’
Pamela N. Peterson, M.D., M.S.P.H., of the Denver Health Medical Center, and colleagues conducted a study to compare outcomes, including mortality, hospitalisations, and longer-term implant-related complications between single- and dual-chamber devices. The study included admissions in the National Cardiovascular Data Registry’s (NCDR) ICD registry from 2006-2009 that could be linked to Centers for Medicare & Medicaid Services fee-for-service Medicare claims data. Patients were included if they received an ICD for primary prevention and did not have a documented indication for pacing.
Among 32,034 patients, 12,246 (38 percent) received a single-chamber device and 19,788 (62 percent) received a dual-chamber device. After analysis of the data, the researchers found that rates of complications were lower for single-chamber devices (3.51 percent vs. 4.72 percent), but device type was not significantly associated with 1-year mortality (unadjusted rate, 9.85 percent vs. 9.77 percent), 1-year all-cause hospitalization (unadjusted rate, 43.86 percent vs. 44.83 percent), or hospitalisation for heart failure (unadjusted rate, 14.73 percent vs. 15.38 percent).
The authors suggest that their study advances the understanding of the risks of dual-chamber devices. ‘Because implanting a dual-chamber ICD is a more complex and time-consuming procedure than implanting a single-chamber device, the possibility of device-related complications such as infection and lead displacement requiring device revision is likely to increase. Indeed, we observed a greater risk of complications among patients receiving dual-chamber devices.’
‘Many patients receiving primary prevention ICDs receive dual-chamber devices. Dual-chamber devices do not appear to offer any clinical benefit over single-chamber devices with regard to death, all-cause readmission, or heart failure readmission in the year following implant. However, dual-chamber ICDs are associated with higher rates of complications. Therefore, among patients without clear pacing indications, the decision to implant a dual-chamber ICD for primary prevention should be considered carefully.’ EurekAlert