Front Genet. 2019 Jan 9;9:704. doi: 10.3389/fgene.2018.00704. eCollection 2018.

Predicting Public Attitudes Toward Gene Editing of Germlines: The Impact of Moral and Hereditary Concern in Human and Animal Applications.

Critchley C1,2, Nicol D1, Bruce G2, Walshe J2, Treleaven T3, Tuch B3.

Author information

1

Centre for Law and Genetics, School of Law, University of Tasmania, Hobart, TAS, Australia.

2

Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia.

3

Discipline of Physiology, Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia.

Abstract

Background and Objective: New and more efficient methods of gene editing have intensified the ethical and legal issues associated with editing germlines. Yet no research has separated the impact of hereditary concern on public attitudes from moral concern. This research compares the impact these two concerns have on public attitudes across five applications including, the prevention of human disease, human and animal research, animals for the use of human food and the enhancement of human appearance. 

Methods: A sample of 1004 Australians responded to either a telephone (n = 501; randomly selected) or online survey (n = 503; sourced by Qualtrics). Both samples were representative in terms of States and Territories as well as gender (51% female), though the online sample was younger (M = 40.64, SD= 16.98; Range = 18-87) than the telephone sample (M = 54.79, SD = 18.13; Range = 18-96). A 5 (application) by 3 (type of cell) within groups design was utilized, where all respondents reported their level of approval with scientists editing genes across the 15 different contexts. Multilevel modeling was used to examine the impact of moral (embryo vs. germ) and hereditary (germ vs. somatic) concern on attitudes across all applications. 

Results: Australians were comfortable with editing human and animal embryos, but only for research purposes and to enhance human health. The effect of moral concern was stronger than hereditary concern, existing in all applications except for the use of animals for human purposes. Hereditary concern was only found to influence attitudes in two applications: improving human health and human research. Moral concern was found to be accentuated amongst, women, more religious individuals and those identifying as Australian, while hereditary concern was strongest amongst non-Australians, those with stronger trust in scientists, and more religious respondents. 

Conclusion: Moral and hereditary concerns are distinct, and require different approaches to public education, engagement and possibly regulation. Further research needs to explore hereditary concern in relation to non-human applications, and the reasons underlying cultural and gender differences.

Boz Scaggs - Miss Sun

Miss Sun -- Boz Scaggs

From Greatest Hits Live, 2004

BOZ SCAGGS ❖ miss sun 【HD】

From Hits! 1980

"Having a relationship is a lot like writing: To be good at it, you have to be interested in other people and believe you have something interesting to offer them in return. Many people who pursue either do so poorly because they are actually interested only in themselves."

Nice for What

A comic’s look at dating now

LAUREN OYLER

Having a relationship is a lot like writing: To be good at it, you have to be interested in other people and believe you have something interesting to offer them in return. Many people who pursue either do so poorly because they are actually interested only in themselves. Roberson doesn’t seem to realize that attempting to harmonize her heterosexuality with her feminist-writerly impulses could improve both her love life and her work. (Reconsidering The Sorrows of Young Werther might help your writing and your relationship.) Even if the idea of taking a man’s feelings into account is too distasteful, the book Roberson envisioned could have been situated among several recent attempts to reckon with heterosexuality’s relationship to social shifts—Kate Bolick’s Spinster, Moira Weigel’s Labor of Love, Kelli María Korducki’s Hard to Do: The Surprising, Feminist History of Breaking Up—but in shying away from analysis of how, exactly, she sees her personal life as political, Roberson seems to be acknowledging that the feminist basics are common knowledge, the specifics covered better elsewhere.

J Health Soc Behav. 2019 Jan 30:22146519825749. doi: 10.1177/0022146519825749. [Epub ahead of print]

Gender and Health: Beyond Binary Categorical Measurement.

Hart CG1, Saperstein A1, Magliozzi D1, Westbrook L2.

Author information

1

1 Stanford University, Stanford, CA, USA.

2

2 Grand Valley State University, Allendale, MI, USA.

Abstract

This study leverages multiple measures of gender from a US national online survey (N = 1,508) to better assess how gender is related to self-rated health. In contrast to research linking feminine behaviors with good health and masculine behaviors with poor health, we find that masculinity is associated with better self-rated health for cisgender men, whereas femininity is associated with better self-rated health for cisgender women. The patterns are similar whether we consider self-identification or how people feel others perceive their gender, though reflected appraisals are most strongly associated with health for cisgender women. We also find that people who report they are seen as gender nonconforming report worse health, but only when this perception does not match their gender identification. Our results demonstrate that multiple measures of gender allow researchers to disentangle how health is not only shaped by gender enactments but also shapes perceptions of gender and gender difference.

Conservatism predicts lapses from vegetarian/vegan diets to meat consumption

Appetite. 2018 Jan 1;120:75-81. doi: 10.1016/j.appet.2017.08.027. Epub 2017 Aug 30.

Conservatism predicts lapses from vegetarian/vegan diets to meat consumption (through lower social justice concerns and social support).

Hodson G1, Earle M2.

Author information

1

Brock University, Canada. Electronic address: ghodson@brocku.ca.

2

Brock University, Canada.

Abstract

Lapses from vegetarian and vegan (i.e., veg*n) food choices to meat consumption are very common, suggesting that sustaining veg*nism is challenging. But little is known about why people return to eating animals after initially deciding to avoid meat consumption. Several potential explanatory factors include personal inconvenience, meat cravings, awkwardness in social settings, or health/nutrition concerns. Here we test the degree to which political ideology predicts lapsing to meat consumption. Past research demonstrates that political ideology predicts present levels of meat consumption, whereby those higher in right-wing ideologies eat more animals, even after controlling for their hedonistic liking of meat (e.g., Dhont & Hodson, 2014). To what extent might political ideology predict whether one has lapsed from veg*n foods back to meat consumption? In a largely representative US community sample (N = 1313) of current and former veg*ns, those higher (vs. lower) in conservatism exhibited significantly greater odds of being a former than current veg*n, even after controlling for age, education, and gender. This ideology-lapsing relation was mediated (i.e., explained) by those higher (vs. lower) in conservatism: (a) adopting a veg*n diet for reasons less centered in justice concerns (animal rights, environment, feeding the poor); and (b) feeling socially unsupported in their endeavor. In contrast, factors such as differential meat craving or lifestyle inconvenience played little mediational role. These findings demonstrate that ideology and justice concerns are particularly relevant to understanding resilience in maintaining veg*n food choices. Implications for understanding why people eat meat, and how to develop intervention strategies, are discussed.

Curr Oncol Rep. 2019 Jan 18;21(1):3. doi: 10.1007/s11912-019-0756-8.

Colon Cancer in Young Adults: Trends and Their Implications.

Weinberg BA1, Marshall JL2.

Author information

1

Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, D.C, 20007, USA. baw12@gunet.georgetown.edu.

2

Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, D.C, 20007, USA.

Abstract

PURPOSE OF REVIEW:

The recent rise of young individuals under age 50 with colorectal cancer (CRC) is a startling trend in need of greater focus and research. The etiology of young-onset CRC is unexplained as efforts to blame obesity or diabetes as causative factors are simplistic and inadequate.

RECENT FINDINGS:

We describe the epidemiologic shifts of CRC incidence and mortality across age groups as well as the differences in clinicopathologic, molecular, treatment, and survival characteristics between young and older patients. Novel studies of the microbiome may elucidate bacterial causes of CRC carcinogenesis in younger individuals. Moving up the colonoscopy screening to age 45 in normal-risk individuals should prove beneficial in detecting more patients with early-onset CRC. We favor the development of risk-adaptive screening decision algorithms and flexible sigmoidoscopy screening at age 40 given the predilection for left-sided primaries in this age group. More awareness and attention to young-onset CRC will be critical to improve outcomes in this patient population.

N Engl J Med. 2019 Jan 31;380(5):410-411. doi: 10.1056/NEJMp1811304.

Coordination of Care or Conflict of Interest? Exempting ACOs from the Stark Law.

Kanter GP1, Pauly MV1.

Author information

1

From the Division of General Internal Medicine, Department of Medicine, and the Department of Medical Ethics and Health Policy, Perelman School of Medicine (G.P.K.), and the Department of Health Care Management, Wharton School (M.V.P.), University of Pennsylvania, Philadelphia.

Care coordination has become a central theme of new payment and delivery systems. There is, however, at least one downside to care coordination arrangements: they clash with existing regulations on financial conflicts of interest in medicine.

Federal court blocks San Francisco warning on soda ads

"The law violates constitutionally protected commercial speech, the 9th U.S. Circuit Court of Appeals said in a unanimous ruling."

"The NHS says adults should consume no more than seven teaspoons of sugar and 1,600 calories a day." #NannyState

Drinks packed with sugar leave vegans feeling bitter

TRENDY coffee chains were accused of fuelling obesity and tooth decay last night after it was revealed some vegan-friendly drinks contain up to 14 teaspoons of sugar.

By DOMINIK LEMANSKI

"Starbucks's vegan-friendly chai tea latte, served in a venti size 20oz cup with oat milk, includes 14 teaspoons of sugar and 389 calories.

Its recently-released venti size gingerbread latte has 11 teaspoons of sugar and 432 calories - and the same size vanilla latte has 12 teaspoons of sugar and 438 calories.

The NHS says adults should consume no more than seven teaspoons of sugar and 1,600 calories a day."

"The most immediate answer to why socialism is popular could be answered in one word: 2008."

It Turns Out That Socialism is Very Popular in America

"The most immediate answer to why socialism is popular could be answered in one word: 2008. The global crisis that year, engineered by forces of greed, corruption and narcissism in a hyper-charged banking sector and a complacent, if not encouraging, bipartisan political elite, shook the confidence in American capitalism to its very core. 40% of the American median income family’s wealth was destroyed from 2007 to 2010. The unemployment rate soared to nearly 10% in 2008, and it did not fall to its pre-recession 5% until 2015. Even as that number shrank, the number of demoralized Americans dropping out of the workforce completely, and thus not being counted in unemployment statistics, grew dramatically. In 2016, the Brookings Instituteestimated that roughly 12% of men, that’s 7 million Americans, were not working. The once classic ideal of the average middle class American working 9 to 5 is becoming less mainstream and more irrelevant as people retreat to their living rooms or parent’s basement for the comforts of TV, computer screens, Netflix, pornography, marijuana, junk food and video games. In other words, the calamity of 2008 wreaked not only economic pain, but it also frayed American societal fabric."

Aging and exercise: Loss of muscle mass and bone density can be reversed

“Sarcopenia is the term for muscle wasting and that means loss of muscle and bone,” said Kuehl. “We lose about one percent of our muscle and bone mass a year after age 30. So between 30 and 40 we lose about 10 percent of our lean body mass. That triples when we’re 70.”

That loss can lead to an increase in hip fractures, falls and premature death.

The best way to slow the process and reverse it is strength training, Kuehl said.

Cancer Cell Int. 2019 Jan 8;19:12. doi: 10.1186/s12935-019-0726-0. eCollection 2019.

CRISPR-Cas9 a boon or bane: the bumpy road ahead to cancer therapeutics.

Ghosh D1, Venkataramani P1, Nandi S1, Bhattacharjee S1.

Author information

1

Cold Spring Harbor Laboratory, Cold Spring Harbor, NY USA.

Abstract

Genome editing allows for the precise manipulation of DNA sequences in a cell making this technology essential for understanding gene function. CRISPR/Cas9 is a targeted genome-editing platform derived from bacterial adaptive immune system and has been repurposed into a genome-editing tool. The RNA-guided DNA endonuclease, Cas9 can be easily programmed to target new sites by altering its guide RNA sequence, making this technology easier, more efficient, scalable and an indispensable tool in biological research. This technology has helped genetically engineer animal models to understand disease mechanisms and elucidate molecular details that can be exploited for improved therapeutic outcomes. In this review, we describe the CRISPR-Cas9 gene-editing mechanism, CRISPR-screening methods, therapeutic targeting of CRISPR in animal models and in cancer immunotherapy. We also discuss the ongoing clinical trials using this tool, limitations of this tool that might impede the clinical applicability of CRISPR-Cas9 and future directions for developing effective CRISPR-Cas9 delivery systems that may improve cancer therapeutics.

J R Army Med Corps. 2019 Jan 24. pii: jramc-2018-001062. doi: 10.1136/jramc-2018-001062. [Epub ahead of print]

US military medical ethics in the War on Terror.

Annas GJ1, Crosby S2,3.

Author information

1

Center for Health Law, Ethics and Human Rights, Boston University School of Public Health, Boston, Massachusetts, USA annasgj@bu.edu.

2

Center for Health Law, Ethics and Human Rights, Boston University School of Public Health, Boston, Massachusetts, USA.

3

Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.

Abstract

Military medical ethics has been challenged by the post-11 September 2001 'War on Terror'. Two recurrent questions are whether military physicians are officers first or physicians first, and whether military physicians need a separate code of ethics. In this article, we focus on how the War on Terror has affected the way we have addressed these questions since 2001. Two examples frame this discussion: the use of military physicians to force-feed hunger strikers held in Guantanamo Bay prison camp, and the uncertain fate of the Department of Defense's report on 'Ethical Guidelines and Practices for US Military Medical Professionals'.

Update on emerging biomarkers in lung cancer

Update on emerging biomarkers in lung cancer 


There has been considerable progress made in identifying oncogenic driver mutations in advanced lung cancer. The recognition that lung cancer is actually an umbrella classification that is comprised of multiple molecular subgroups has had a profound impact on how medical oncologists make treatment decisions. These mutations are clinically important as available targeted therapies can achieve significant responses and prolonged disease control. This review will summarize the current guidelines for biomarker testing and available therapeutic agents.

"A sedentary lifestyle can be dangerous, as it is associated with higher rates of obesity, heart disease, diabetes, and shortened life span."

Help kids be more physically active with these simple tips

A sedentary lifestyle can be dangerous, as it is associated with higher rates of obesity, heart disease, diabetes, and shortened life span. It's necessary to teach children the importance of leading a healthy and active lifestyle at an early age.

Many factors contribute to an increase in sedentary lifestyles, including a lack of resources and access to opportunities to participate in physical activities and the amount of time children spend with screens.

@pathologistmag discusses diversity and inclusion

 "Although pathology currently has measurable diversity, it doesn’t reflect the community."


"How can we expect departments to hire more black pathologists when we’re not entering the specialty in the first place?"

"Veterans who used VA services were more likely to be black, younger, female, unmarried, and less educated[,] and to have lower household incomes."

Prim Care Companion CNS Disord. 2019 Jan 17;21(1). pii: 18m02350. doi: 10.4088/PCC.18m02350.

US Veterans Who Do and Do Not Utilize Veterans Affairs Health Care Services: Demographic, Military, Medical, and Psychosocial Characteristics.

Meffert BN1, Morabito DM1, Sawicki DA1, Hausman C2, Southwick SM3, Pietrzak RH#3, Heinz AJ#4,1,5.

Author information

1

Dissemination and Training Division, National Center for PTSD, Veterans Affairs Palo Alto Healthcare System, Menlo Park, California, USA.

2

Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, California, USA.

3

Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs Connecticut Healthcare System and Department of Psychiatry, Yale School of Medicine, West Haven, Connecticut, USA.

4

795 Willow Rd (152-MPD), Menlo Park, CA 94025. adrienne.heinz@va.gov.

5

Center for Innovation to Implementation, Veterans Affairs Palo Alto Healthcare System, Menlo Park, California, USA.

#

Contributed equally

Abstract

OBJECTIVE:

To examine sociodemographic and military characteristics of US veterans who do and do not utilize Veterans Affairs (VA) health care services as their primary source of health care and examine the relationship between VA utilization and medical and psychosocial characteristics.

METHODS:

Participants were a nationally representative sample of 3,152 military veterans (89.8% male, 83.5% white, 6.0% black, mean age = 62.0 [SD = 13.1] years) who completed a survey in 2011 assessing health care utilization, sociodemographic, military service, medical, and psychosocial characteristics. Receiver operator characteristic analyses and logistic and linear regressions were conducted to provide a comprehensive and multivariate examination of factors associated with VA utilization.

RESULTS:

Veterans who used VA services were more likely to be black, younger, female, unmarried, and less educated and to have lower household incomes. They were also more likely to have served longer in the military and in combat. VA users were more likely to screen positive for lifetime psychopathology, endorse current suicidality, and report enduring more traumas. VA users were also more likely to report more medical conditions, endorse a disability, and score lower on measures of functioning. The primary factor differentiating VA users from those that did not use VA services was presence of lifetime psychopathology.

CONCLUSIONS:

Results provide a comprehensive profile of veterans who do and do not utilize VA services and suggest that veterans who use VA services have a substantially elevated health burden compared to other veterans. Results may help inform outreach and engagement initiatives targeting the unique health care needs of veterans who do and do not utilize VA services.

"If all 'real' people think the same way about the things that matter most in politics, then the idea of institutional protections for a dissenting minority are are at best superfluous and at worst nefarious."

‘We the people’: the battle to define populism

Because populism, as described by the ideological definition, involves a moralised conception of an absolutely sovereign “people” – whose verdicts are regarded as practically unanimous – it is inevitable that populist movements will come into conflict with the liberal aspects of liberal democracy.

If all “real” people think the same way about the things that matter most in politics, then the idea of institutional protections for a dissenting minority are are at best superfluous and at worst nefarious. For the populists, they are just another wall that the corrupt elite has built to keep real power away from the people. The same is true for the independence of judges or regulators, or checks and balances between branches of government – especially when they appear to stymie the plans of a populist leader. In this account, the most basic elements of liberal democracy become both kindling and fuel for the populist fire.

"Pathologists also ranked among the highest groups of physicians in reporting happiness at work and among the lowest groups reporting burnout."

Acad Pathol. 2016 Aug 7;3:2374289516661559. doi: 10.1177/2374289516661559. eCollection 2016 Jan-Dec.

Pathology: A Satisfying Medical Profession.

Xu H1, Remick DG1.

Author information

1

Department of Pathology and Laboratory Medicine, Boston University Medical School, Boston, MA, USA.

Abstract

Medical students are often unsure about the viability of a career as a physician in pathology. In particular, they are concerned that pathologists may not have a gratifying lifestyle or be well compensated. These worries may cause angst among medical students considering pathology and among junior pathology residents wondering if they made the correct career choice. A 2016 survey of nearly 20 000 physicians including nearly 400 pathologists provides reassuring data about compensation and career choice. This survey showed that 52% of pathologists are satisfied with their career choice and 63% are satisfied with their compensation. Among the 26 specialties that were surveyed, pathologists ranked 2 in believing that they were fairly compensated. Moreover, 66% of pathologists find that making diagnostic decisions, a core aspect of our discipline, is the most rewarding aspect of their career. Pathologists also ranked among the highest groups of physicians in reporting happiness at work and among the lowest groups reporting burnout. Overall, these 2016 surveys show that the majority of pathologists find deep satisfaction in their careers as pathologists.

How The Stigma Against Obesity Harms People’s Health

And stigma creates a vicious cycle. People who report experiencing weight stigma are more likely to gain weight in the future and attain a BMI categorized as “obese.” Behavior likely contributes to this trend: When people get stressed out, they tend to soothe themselves with comfort food and are more likely to fail at attempts to self-regulate — meaning that, among other things, they are less likely to stick to a healthful diet. But there is also some evidence that physiological factors contribute to weight gain among people who experience stigma. A. Janet Tomiyama, a psychology professor at UCLA, is studying the relationship between weight stigma and cortisol, a hormone that responds strongly to stress. Cortisol signals the body to store more fat, especially in the abdominal area, and it increases appetite and makes the brain’s reward centers more sensitive in response to treats like sugar and fatty foods. And that’s what makes weight stigma doubly pernicious, she said. In addition to the pain and stress it causes, “experiencing it makes the original condition more exacerbated.”

Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled tria

Thorax. 2019 Jan 19. pii: thoraxjnl-2018-212380. doi: 10.1136/thoraxjnl-2018-212380. [Epub ahead of print]

Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial.

Brims F1,2, Gunatilake S3, Lawrie I4, Marshall L5, Fogg C6, Qi C7, Creech L8, Holtom N9, Killick S10, Yung B11, Cooper D12, Stadon L13, Cook P14, Fuller E15, Walther J16, Plunkett C17, Bates A18, Mackinlay C19, Tandon A20, Maskell NA21,22, Forbes K23, Rahman NM24, Gerry S25, Chauhan AJ26; RESPECT-Meso investigators.

Collaborators (13)

Author information

1

Respiratory Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

2

Curtin Medical School, Curtin University, Perth, Western Australia, Australia.

3

Department of Respiratory Medicine, Portsmouth Hospitals NHS Trust, Portsmouth, UK.

4

Department of Palliative Medicine, North Manchester General Hospital, Manchester, Manchester, UK.

5

Research and Innovation Department, Portsmouth Hospitals NHS Trust, Portsmouth, UK.

6

School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.

7

Centre for Statistics in Medicine, University of Oxford, Oxford, UK.

8

University Hospital of South Manchester NHS Foundation Trust, Manchester, Manchester, UK.

9

Department of Palliative Care, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK.

10

Department of Palliative Care, Hampshire Hospitals NHS Foundation Trust, Winchester, Hampshire, UK.

11

Department of Respiratory Medicine, Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, Essex, UK.

12

Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.

13

North Bristol Lung Centre, North Bristol NHS Trust, Bristol, UK.

14

Department of Respiratory Medicine, County Durham and Darlington NHS Foundation Trust, Darlington, UK.

15

Department of Respiratory Medicine, South Tyneside NHS Foundation Trust, South Shields, South Tyneside, UK.

16

Haematology, Oncology and Palliative Care, Taunton and Somerset NHS Foundation Trust, Taunton, UK.

17

Department of Palliative Medicine, Mid Essex Hospital Services NHS Trust, Chelmsford, UK.

18

Department of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK.

19

Great Western Hospitals NHS Foundation Trust, Swindon, Swindon, UK.

20

Department of Palliative Care, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

21

North Bristol Lung Centre, Southmead Hospital, Bristol, UK.

22

Academic Respiratory Unit, Department of Clinical Sciences, Bristol University, Bristol, UK.

23

Department of Palliative Medicine, Bristol University, Bristol, UK.

24

Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.

25

Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

26

Department of Respiratory, Queen Alexandra Hospital, Portsmouth, Hampshire, UK.

Abstract

PURPOSE:

Malignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.

METHODS:

We performed a multicentre, randomised, parallel group controlled trial comparing early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia. Participants had newly diagnosed MPM; main carers were additionally recruited.

INTERVENTION:

review by SPC within 3 weeks of allocation and every 4 weeks throughout the study. HRQoL was assessed at baseline and every 4 weeks with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30.

PRIMARY OUTCOME:

change in EORTC C30 Global Health Status 12 weeks after randomisation.

RESULTS:

Between April 2014 and October 2016, 174 participants were randomised. There was no significant between group difference in HRQoL score at 12 weeks (mean difference 1.8 (95% CI -4.9 to 8.5; p=0.59)). HRQoL did not differ at 24 weeks (mean difference -2.0 (95% CI -8.6 to 4.6; p=0.54)). There was no difference in depression/anxiety scores at 12 weeks or 24 weeks. In carers, there was no difference in HRQoL or mood at 12 weeks or 24 weeks, although there was a consistent preference for care, favouring the intervention arm.

CONCLUSION:

There is no role for routine referral to SPC soon after diagnosis of MPM for patients who are cared for in centres with good access to SPC when required.