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Abstract Background Three types of central venous access devices (CVADs)—peripherally inserted central catheters (PICCs), skin-tunnelled central catheters (Hickman-type devices), and implantable chest wall Ports (Ports)—are routinely used in the intravenous administration of anti-cancer treatment. These devices avoid the need for peripheral cannulation and allow for home delivery of treatment. Assessments of these devices have tended to focus on medical and economic factors, but there is increased interest in the importance of patient experiences and perspectives in this area. The aim of this systematic review is to synthesise existing research regarding patient experiences of these CVADs to help clinicians guide, prepare, and support patients receiving CVADs for the administration of anti-cancer treatment. Method A systematic search of MEDLINE, Embase, and CINAHL research databases will be carried out along with a supplementary reference list search. This review will include quantitative, qualitative, and mixed methods studies published in peer-review journals, reporting some aspect(s) of patient experiences or perspectives regarding the use of PICC, Hickman, or Port CVADs for the administration of anti-cancer drugs. The methodological quality and risk of bias of included papers will be assessed using the Mixed Methods Appraisal Tool (MMAT). Relevant outcome data will be extracted from included studies and analysed using a thematic synthesis approach. Discussion The results section of the review will comprise thematic synthesis of quantitative studies, thematic synthesis of qualitative studies, and the aggregation of the two. Results will aim to offer an account of current understandings of patient experiences and perspective regarding PICC, Hickman-type, and Port devices in the context of anti-cancer treatment. Confidence in cumulative evidence will be assessed using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. Systematic review registration This systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO). Registration number: CRD42017065851. This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols checklist (PRISMA-P) (Shamseer et al., BMJ 349: 2015).

If you have been reading, to date, in the Journal of Applied Hermeneutics, Dr. John Williamson’s PhD thesis-come-novel serialized, then you have read, more or less, four texts: • Guest Editorial: Preface to “A Strange and Earnest Client” Part One of the Case of the Disappearing/Appearing Slow Learner: An Interpretive Mystery by W. John Williamson [January 11, 2016]; • The Case of the Disappearing/Appearing Slow Learner: An Interpretive Mystery. Part One: A Strange and Earnest Client [January 11, 2016]; • Invited Guest Editorial. Lives Worthy of Life: The Everyday Resistance of Disabled People by Nick Hodge [February 22, 2016], and • The Case of the Disappearing/Appearing Slow Learner: An Interpretive Mystery. Part Two: Cells of Categorical Confinement [February 22, 2016]. My name is Jim Paul. I am the Invited Guest Editorial provider for the third installment of John’s work titled - Part Three: All Hell Could Break Loose.

This writing presents our views, as university teacher educators and scholars, concerning some issues pertaining to the readiness of contemporary Canadian education to move forward, well, with confidence and competence, into the mid-21st Century. We posit that all which is possible, educationally, lives in the give and take between Canadian education‘s geo-political, economic and linguistic past, the current functioning of contemporary schools as contested learning and teaching sites, and the increasing impacts of globalisation. We draw from guiding adult education principles in support of an enriched and expanded commitment to teacher professional development as a pathway to sustainable education reform.

Patient–health care practitioner communication is riddled with complexities. In this article the authors initially describe how careful listening to another, the patient, within the context of today's health care system has drifted from being an integral part of the “art” of medicine toward a methodological checklist of standard questions designed to support the “science” of medicine. Then they offer a way and a means for today's biomedically trained health care practitioner to rethink or reimagine the value of authentic listening. They conclude with a critical exploration of a pedagogic speaking-listening relationship located within an understanding of dialogue as a means of gaining health-related, patient-specific evidence. By attending to a patient's story through the health care practitioner's attentive listening, the health care practitioner together with the patient create a place whereby a dialogue exchange actually becomes an indispensable and health-related element fostering a process of mutual learning, knowing, and being.

Abstract The occurrence of post-radioactive iodine thyroid storm among patients with hyperthyroidism is relatively rare and only a few cases have been reported. We conducted a literature review of cases reported from 1951 to 2023 and determined the risk factors and clinical characteristics of patients who developed thyroid storm. A total of 19 cases were documented and reviewed. The mean age was 51.2 ± 20.1 years (range 7.5 to 75). Approximately two-thirds were females. Major etiologies were diffuse toxic goiter (57.9%) and nodular disease (36.8%). Mean dose was 11.3 ± 7.7 mCi (range 3.3 to 35), with 52.6% receiving less than 10 mCi. Mean interval time from administration to development of thyroid storm was 6.6 ± 5.5 days (range 0.5 to 20). The most common preexisting conditions were weight loss, heart failure, atrial fibrillation, hypertension and coronary artery disease. Thyroxine levels were not routinely measured prior to and during storm. Among those with available data, only 26.3% had hormone levels prior to and during storm. Thyroxine levels during storm (range 19.8 to 65 µg/dL) were higher than levels prior to storm (range 9.6 to 45 µg/dL). Pretreatment regimens varied consisting of no intervention, beta blockers, steroids, reserpine, phenobarbital and anti-thyroid drugs. Treatment regimens are more uniform and consistent with American Thyroid Association recommendations. The mortality rate remains high at ~ 26.3%. Statistical analyses did not show any significant differences. Even though the frequency of this condition is quite rare, it is an important and potentially prognostic condition underscoring the value of this review. The inclusion of this severe adverse effect should be part of patient discussion with emphasis on the need to seek early consultation when severe symptoms appear.

Binge-like ethanol exposure during adolescence has been shown to produce long lasting effects in animal models including anxiety-like behavior that can last into young adulthood and impairments in cognition that can last throughout most of the lifespan. However, little research has investigated if binge-like ethanol exposure during adolescence produces persistent anxiety-like behavior and concomitantly impairs cognition late in life. Furthermore, few studies have investigated such behavioral effects in both female and male rats over the lifespan. Finally, it is yet to be determined if binge-like ethanol exposure during adolescence alters microglia activation in relevant brain regions late in life. In the present study female and male adolescent rats were exposed to either 3.0 or 5.0 g/kg ethanol, or water control, in a chronic intermittent pattern before being tested in the elevated plus maze and open field task over the next ∼18 months. Animals were then trained in a spatial reference task via the Morris water maze before having their behavioral flexibility tested. Finally, brains were removed, sectioned and presumptive microglia activation determined using autoradiography for [3H]PK11195 binding. Males, but not females, displayed an anxiety-like phenotype initially following the chronic intermittent ethanol exposure paradigm which resolved in adulthood. Further, males but not females had altered spatial reference learning and impaired behavioral flexibility late in life. Conversely, [3H]PK11195 binding was significantly elevated in females compared to males late in life and the level of microglia activation interacted as a function of sex and brain regions, but there was no long-term outcome related to adolescent alcohol exposure. These data further confirm that binge-like ethanol exposure during adolescence produces alterations in behavior that can last throughout the lifespan. In addition, the data suggest that microglia activation late in life is not exacerbated by prior binge-like ethanol exposure during adolescence but the expression is sex- and brain region-dependent across the lifespan.

This chapter is the first contribution in this volume which approaches the EU-Asia ‘inter-continental dialogue’ by means of a detailed and focussed policy-analysis. The authors argue that a number of the European Union's policies towards Asia can be conceptualised using the term ‘constructive engagement’, a policy-method which is here defined as the ‘opposite of confrontation’. Anchoring their main argument in liberal and idealist theoretical approaches to international relations, the authors of this contribution offer an analysis of the EU as a ‘normative power’ and as a ‘symbolic presence’ in Asia, especially in the areas of security and conflict-prevention. To underscore this, this section offers a number of case studies relating to the Union's policies towards The Democratic People's Republic of Korea (DPRK), the People's Republic of China (PRC) and the Indonesian province of Aceh. These examples show that the EU's policy arsenal towards its Asian interlocutors can be characterised in terms of a flexible and pragmatic range of roles, and by what the authors call the ‘policy of disposition’. [ABSTRACT FROM AUTHOR]