This collaborative training promoted significant improvement in resident compassionate communication skills. The curriculum was highly valued by the learners and resulted in sustained application of learned skills with patients and families. Our novel approach was feasible with promising results that warrant further investigation and could be reproduced in other institutions with similar programs. (PsycINFO Database Record

No abstract

The main objective of this work was to determine the optimum level of pruning in pitaya. In addition, we want to establish the relationship between pruning levels and the intensity of flowering, and between flowering levels and heavy flower bud drop that affects this species. With these aims, two experiments were performed on Hylocereus undatus [(Haw.) Britton and Rose] cultivated in greenhouses and trained in a trellis system. Our results conclude that cane pruning leaving 15 cladodes per meter in a trellis system is the most productive, as it yielded more fruit of similar weight. Positive relationships between flowering and setting, regardless of pruning levels, justify less severe pruning. Fruit set and size did not depend on pruning levels, although we found a fruit weight reduction when a single cladode developed more than one fruit. Flower buds drop was proportionally higher in cladodes forming more flowers, suggesting that bud competition plays a role in their drop. However, flower bud thinning seems unnecessary, although if a flower is to be chosen, it is better to select those formed at the apex of the cladode since they produce larger fruits.

Objective Evaluate women’s anxiety and experience undergoing screening mammography during the COVID-19 pandemic. Methods An IRB-approved anonymous survey was administered to women receiving screening mammography across six sites in the U.S. and Singapore from October 7, 2020, to March 11, 2021. Using a 1–5 Likert scale, women rated their pre- and post-visit anxiety regarding having their mammogram during the COVID-19 pandemic, importance of observed COVID-19 precautions, and personal risk factors for breast cancer and severe COVID-19 illness. Post-visit change in anxiety was evaluated. Multivariable logistic regression was used to test associations of pre-visit anxiety with breast cancer and COVID-19 risk factors. Results In total, 1086 women completed the survey. Of these, 59% (630/1061) had >1 breast cancer risk factor; 27% (282/1060) had >1 COVID-19 risk factors. Forty-two percent (445/1065) experienced pre-visit anxiety. Pre-visit anxiety was independently associated with risk factors for severe COVID-19 (OR for >2 vs 0 risk factors: 2.04, 95% confidence interval [CI]: 1.11–3.76) and breast cancer (OR for >2 vs 0 risk factors: 1.71, 95% CI: 1.17–2.50), after adjusting for age and site. Twenty-six percent (272/1065) of women reported post-visit anxiety, an absolute 16% decrease from pre-visit anxiety (95% CI: 14%–19%, P < 0.001). Provider masking (941/1075, 88%) and physical distancing (861/1085, 79%) were rated as the most important precautions. Conclusion Pre-visit anxiety was associated with COVID-19 or breast cancer risk factors and declined significantly after screening mammography. Provider masking and physical distancing were rated the most important precautions implemented by imaging clinics.

Carcinoma basocelular nodular. Cáncer de piel más frecuente, derivado de los queratinocitos de la capa basal. El subtipo nodular representa entre el 50% y el 80% del total. Carcinoma espinocelular diferenciado acantolítico. Neoplasia que se origina por proliferación anormal de los queratinocitos del estrato espinoso de la epidermis. Clínicamente se presenta como una pápula o placa queratósica, dura, eritematocostrosa, indolora. Condrodermatitis nodular del hélix. Patología inflamatoria benigna que afecta la piel y el cartílago auricular. La etiopatogenia se desconoce, aunque se ha relacionado con un traumatismo repetido sobre el cartílago.