Background For pragmatic clinical research comparing commonly used treatments, questions exist about if and how to notify participants about it and secure their authorization for participation. Objective To determine how patients react when they seek clinical care and encounter one of several different pragmatic clinical research studies. Research Design In an online survey using a between-subjects experimental design, respondents read and responded to one of 24 hypothetical research scenarios reflecting different types of studies and approaches to notification and authorization (eg, general notification, oral consent, written consent). Subjects English-speaking US adults 18 years and older. Measures Willingness to participate in the hypothetical study, acceptability of the notification and authorization approach, understanding of the study, perceptions of benefit/harm, trust, and perception of amount of study information received. Results Willingness to participate did not differ by notification and authorization approach. Some (21% to 36%) of the patients randomized to general notification with an explicit opt-out provision were not aware they would be enrolled by default. Acceptability was greatest for and similar among notification and authorization approaches that actively engaged the patient (eg, oral or written consent) and lower for approaches with less engagement (e.g., general notification). Problems of understanding were found among 20% to 55% of respondents, depending on the particular scenario. Most respondents (77% to 94%) felt that participation in the hypothetical study posed no risks of harm to their health or privacy. Conclusions Current attitudes about notification and authorization approaches and difficulties understanding pragmatic clinical research pose significant challenges for pragmatic research. Data from this study provide a starting point to developing solutions to these surprisingly complex issues.

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Nutritional status is considered a significant factor determining the post‐operative outcomes after RC. The aim of this literature review is to describe the impact of early oral nutrition on functional outcomes in patients underwent cystectomy. Usually, these patients are not fed orally until the return of gastrointestinal function, because early oral nutrition is often perceived as detrimental for the anastomosis integrity and is believed to cause nausea and vomiting. This phase of nutritional deprivation may vary from a few days to a few weeks, depending on the return of bowel movements. In clinical practice, patients are fed on a substitutive nutritional support based on the use of total parenteral nutrition or enteral nutrition, which have not demonstrated positive effects on bowel function recovery time, infection complication rates or length of hospital stay. The early introduction of oral feeding seems to allow early mobilization and to lead to an improvement of post‐operative outcomes: bowel functions, pain, complications, patient's comfort and length of hospital stay. The early implementation of oral diet after cystectomy is associated with an improvement of considered outcomes, allowing an early recovery of patient's general conditions and reducing length of hospital stay.

What is the degree of knowledge and awareness regarding testicular cancer and what interventions may improve information about testicular cancer in the male population? Testicular cancer incidence rates are increasing among young men, who typically demonstrate poor awareness and a lack of knowledge about this disease. Although testicular self‐examination might be an effective method for early detection, few people know about this process or regularly perform it. This lack of examination could delay the diagnosis, which would affect treatment outcomes and mortality rates. A literature review was conducted starting from a bibliographic research in the major databases, and 450 documents were identified. The final analysis included 19 studies and found that men feel anxious about testicular cancer, which leads to a delay in their diagnosis and treatment, especially in developing countries. A widespread lack of awareness and knowledge about testicular cancer and self‐examination exists in these nations. Few males performed testicular self‐examination; most considered this procedure to be an invasion of their privacy and masculinity. The most effective tools to disseminate awareness about testicular cancer prevention were television, radio and YouTube. It is important to educate young males to spread information and improve awareness and knowledge about testicular cancer and self‐examination. However, the support of regular self‐examination is controversial, as this practice might also produce more harm than benefits due to the resulting false positives, fear and anxiety. Regular testicular cancer screening is therefore recommended in limited populations, including patients with risk factors, such as cryptorchidism or a family history of this cancer.

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