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Objectives: We sought to evaluate a universal mental health screening program for undergraduate students using graduate student clinicians and online interviewing tools. Participants: Participants included 455 undergraduate students. Data were collected from October 2017 through January 2018. Methods: Participants completed a self-report mental health screening questionnaire. Students scoring "at risk" on any subscale were invited to participate in individual online follow-up interviews to assess risk level and provide referral information. Results: A majority of participants scored in an "at risk" range on at least one subscale. Follow-up interviews were conducted for 40% of students "at risk" and 33% of those interviewed were referred to the university counseling center. Participants' perceptions of campus mental health priorities improved over a three-month period. Conclusions: A pilot universal campus mental health screening using graduate student clinicians resulted in a meaningful number of referrals and enhanced perception that the university cared about student mental health.

We sought to evaluate a universal mental health screening program for undergraduate students using graduate student clinicians and online interviewing tools. Participants: Participants included 455 undergraduate students. Data were collected from October 2017 through January 2018. Methods: Participants completed a self-report mental health screening questionnaire. Students scoring "at risk" on any subscale were invited to participate in individual online follow-up interviews to assess risk level and provide referral information. Results: A majority of participants scored in an "at risk" range on at least one subscale. Follow-up interviews were conducted for 40% of students "at risk" and 33% of those interviewed were referred to the university counseling center. Participants' perceptions of campus mental health priorities improved over a three-month period. Conclusions: A pilot universal campus mental health screening using graduate student clinicians resulted in a meaningful number of referrals and enhanced perception that the university cared about student mental health. [ABSTRACT FROM AUTHOR]

Abstract: Background: Patients with severe thrombocytopenia are considered at risk for bleeding during invasive procedures as thoracentesis. The use of ultrasound (US) significantly reduces the rate of pneumothorax from thoracentesis, but there is a lack of data on safety and efficacy of US guidance in reducing bleeding complications in thoracentesis performed on patients with severe thrombocytopenia. Methods: We retrospectively analysed the efficacy and safety of thoracentesis in cancer patients with severe thrombocytopenia. From January 2005 to December 2011, 462 patients underwent thoracentesis. Procedures were divided into 2 groups: performed without or with US guidance. All procedures were evaluated for bleeding complications as defined by the National Institutes of Health Common Terminology Criteria for Adverse Events. Results: A total of 436 consecutive evaluable thoracentesis were analysed. Thoracentesis was performed with US guidance in 310 cases. Forty‐one patients (9.40%) had severe thrombocytopenia. In 32 of these 41 patients, thoracentesis was performed under US guidance while in 9 cases the procedure was performed without US guidance. Three mild haemorrhagic complications (0.69% of the procedures performed) were observed and all occurred in group of the 9 (33.33%) patients with severe thrombocytopenia who underwent thoracentesis without US guidance. No haemorrhagic complications were recorded in the 427 patients, including the 32 patients with severe thrombocytopenia, in whom thoracentesis was performed with US guidance. Conclusions: US guided thoracentesis is a safe and effective approach in cancer patients with severe thrombocytopenia. Our results indicate that this procedure, when US‐guided, can be safety performed even in patients with platelet count below 30 × 109/L. [ABSTRACT FROM AUTHOR]

Introduction: Reliable venous access is essential in providing effective care for many patients. Various vascular access devices (VAD) are available, and are placed by a specialized team using ultrasound guidance in a dedicated room of the hospital; however, during the pandemic covid-19 many not autonomous or bedridden patients were unable to reach the hospital for VAD insertion, because the unavailability of ambulance for the transport. For this reason the specialized team organized a modality for positioning the VAD at bedside at home., Methods: In 2012 a VAD-team was established by the health authority in the oncology-hematology Department at the hospital of Piacenza. This team was dedicated in positioning ultrasound-guided vascular access. During the covid-19 pandemic the VAD-team modified its organization to reach patients at home to position VAD, initially for oncologic people unable to go to the hospital; this procedure was subsequently extended to other bedridden patients with non-oncologic disease. The positioning of the VAD was performed under ultrasound guidance, according to the same modalities used in hospital. The primary endpoin was the suitability of the VAD to allow the planned treatment. The secondary endpoint was complications of the use of VADs., Results: Between March 2020 to December 2020 and January 2021 to December 2021, VAD were positioned in 118 and 134 patients respectively. The VAD utilized were midlines for each patient. The mean age of the patients was 88 years, the majority were female (>60%). The majority of the patients had neurodegenerative disease (>60%) or advanced cancers (>25%). The VAD allowed the planned treatment in 94% of the patients. The complications were infrequent: VAD dislocation (<1%), thrombosis (<2%). No infection was registered., Discussion and Conclusion: During covid-19 pandemic, the VAD-team demonstrated the feasibility of VADs home positioning, for patients that need to be transported by ambulance to the hospital for a venous catheter insertion. This procedure allows saving of economic and human resources both for patients and caregivers, in addiction can leave the ambulance free for other use. Due to this study, this procedure has become routine practice in our health district for patients bedridden or not autonomous.

Introduction: The natural history of cancer has radically changed in the last decade. The burden of travel from patient's residence to health care providers is an important issue that can influence access to diagnosis and treatment of cancer; however this issue is quite neglect by the medical community and by the national health system. In addition, community care in the oncology field is actually debated., Methods: In the district of Piacenza an innovative model to deliver onco-hematologic treatment near the residence of patients was initiated some years ago. The oncologic and hematologic treatments are delivered by specialized nurses under supervision of medical oncologists or hematologists at the 3 community hospital and at 1 house of health in the district of Piacenza. We conducted a retrospective study involving 1,339 cancer patients (CPs) managed and treated near their residence, CPs were on active medical treatment at the oncology and hematology department Azienda sanitaria (ASL) of Piacenza (North Italy). The electronic data base of the antiblastic drug unit (UFA) of the ASL Piacenza, provided: the number of patients treated each year, number of treatments and the accesses to the territorial medical structure each year. The kms saved to reach the nearest territorial structures instead of the oncologic unit of the city hospital, were registered and recorded., Results: During a 4 years period, from January 2017 to December 2020, 1,339 CPs were treated near their residence, 278 in the year 2017, 347 in 2018, 354 in 2019 and 360 in 2020. The total accesses for treatment in 4 years were 10,003: 2,214 in the year 2017, 2,652 in 2018, 2,524 in 2019 and 2,613 in 2020. The mean distance saved for each patient was 937 kms in the year 2017, 891 in 2018, 879 in 2019, 920 in 2020, totally a mean of 3,627 kms in the 4 years., Discussion and Conclusion: We believe that the results of our retrospective study highlight the possibility of treating cancer patients in territorial structures near their residence, with advantages for patients themselves, their caregivers and for the entire community.

Background: Cancer patients are considered a highly fragile group in the current coronavirus disease 2019 (COVID-19) pandemic., Material & Methods: In this study, patients with COVID-19 and cancer, hospitalized in Piacenza, Italy, from 4 April to 4 May 2020 were included. Risk factors for death were analyzed., Results: Fifty-one COVID-19 cancer patients were included, of which the median age was 71.02 years (range: 51-86) and 70.59% were male. Cancer types included gastrointestinal (25.49%), genitourinary (25.49%) and lung (23.53%). Forty-five (88.24%) patients received hydroxychloroquine-based therapy. In addition, 25 of 51 patients died (49%): 12 of 51 (23.53%) owing to cancer and 13 of 51 (25.49%) owing to COVID-19., Conclusion: The risks for death were related to later onset of treatment for COVID-19, severe/critical COVID-19, age, elevated basal CRP and elevated lactate dehydrogenase., Competing Interests: Financial & competing interests disclosure L Cavanna holds a consulting or advisory role for AstraZeneca and Merck, and received travel and accommodation expenses from Celgene, Pfizer and Ipsen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript., (© 2020 Luigi Cavanna.)

Early detection and progression in the treatment of cancer patient have improved the prognosis of many patients. In view of this improvement, cancer should be considered less as a terminal illness, but as a chronic disease, and the number of cancer survivors continues to increase in the West countries. Work coud be very important for cancer patients and for society; however studies on this topic from Italy are fragmentary and very poor., Material and Methods: A prospective observational study started at the Medical oncology unit, Hospital of Piacenza (North Italy). All the patients between 18 and 65 years of age, diagnosed with early or metastatic cancer, admitted to the outpatient clinic, were analyzed for employment and work-related issues (job interruption, returning to work, job loss). A questionnaire with socio-demographic and job related information was submitted to each patient., Results: From January 2015 to June 2017, 2,187 patients with a new diagnosis of cancer were admitted to the outpatient clinic, 550 patients (25.15%) were be-tween 18 and 65 year old, and 416 patients (75.64%) participated to the study. 278 (66.83%) women and 138 (33.17%) men, mean age 50.32±7.90 years (range 18-65), 39.18% were employees, 29.81% workers, 328 (78.85%) with subordinate job, the majority of patients had an high school or academic degree (63.46%). 196 (47.12%) patients had breast cancer, 85 (20.43%) gas-trointestinal cancer, 41 (9.86%) lung cancer, and 94 pa-tients (22.59%) had other cancer; 105 patients (25.24%) showed metastatic cancer and 134 (32.21%) had comor-bidity. After 6 months 178 patients (42.79%) interrupted their work, of these, 99 were women, 35.61% of the 278 female and 79 men, 57.25% of the 138 males, 69 worker (38.76%), 94 with low level of education (52.81%). The majority of patients (86.67%) with metastatic cancer, or treated with chemotherapy (61.60%), or with comorbidity (50.75%), left their work after 6 months from diagnosis. Only 22 of 178 patients (12.36%) in our series returned to work, of these, 20 (90.90%) were women, 17 with breast cancer (85%)., Discussion: Our findings suggest that there is a significant association between job loss and gender (male), low level of education/heavy works, advanced stage of cancer, chemotherapy and comorbidity. It is important that clinicians and institutions consider work-related issue in cancer patients and perform adequate organizational and normative interventions.

Introduction: In the field of oncology, we are all stimulated by the desire to improve the lives of patients with cancer; however little data are available about the amount of time and travel discomfort that patients and families typically spend for clinical examinations and for antitumoral/supportive treatments. The purpose of this study was to determine the advantages for cancer patients to receive clinical, test examinations, and anticancer treatment near their residence in a territorial clinical structure called "Casa della Salute" (CdS)., Methods: Since July 2016 to all the cancer patients treated at the Oncology Unit of the General Hospital in Piacenza, was offered the possibility to be treated near their residence at the CdS located in the mid valley (Val Nure), or to continue the treatment at the Oncology Unit of the General Hospital in Piacenza. The treatments were delivered by an oncology nurse under the supervision of a medical oncologist., Results: From 18 July 2016 to 20 July 2017, 54 patients with cancer were managed in the CdS in Bettola, province of Piacenza in North Italy. All these patients received the planned antitumoral and supportive treatments. The average distance from the patient's residence to the Oncology Unit in Piacenza was 81,65 km (range 31,6-131 km), while it was 21,06 km (range 3-54,2 km) to the CdS (p<0,001). The average time for the round trip to the Oncology Unit in Piacenza was 93,35 minutes (range 40-162) while it took 16,35 minutes (range 10-78) to reach the CdS (p<0,001). 98,5% of patients were very satisfied to receive oncological treatment at the CdS, and 65% of patients who needed a caregiver to reach the Oncology Unit in Piacenza, could travel alone to the CdS., Discussion: The increase in the incidence of cancer, especially in elderly patients with comorbidity, has been accompanied by an increase in the overall survival rate of these patients thus requiring organizational innovations. The results of this study hightlight the possibility of treating cancer patients in territorial structures near their residence, with advantages for the patients, their caregivers and for the entire community.