Conference Presentations by Getulio Yuzo Okuma
Background/Purpose: Studies have shown a clear difference among minority and economically disadva... more Background/Purpose: Studies have shown a clear difference among minority and economically disadvantaged patients. Less is known about marginalized populations in Brazil, a country that possesses a two-tiered healthcare system, based on socioeconomic status. We sought to explore differences in quality of life (QOL) and distress among patients receiving care within these systems.
Methods: 270 patients were assessed for distress (DT), anxiety/depression (HADS) and QOL (FACT-G). Half of them was recruited at a private institution (PRI) and the other at a public institution (PUB) (each group: n=135; 68.9% breast and 31.1% gynecological cancers). We calculated descriptive statistics and examined QOL and distress using T-test and ANOVA.
Results: We found ethnic differences between PUB (50.4% white, 32.6% mulato and 14.1% black) and PRI patients (82.9% white), and income disparities (PUB patients report almost a third less monthly income than PRI patients). PUB patients were mostly late-stage diagnosed 70.4% compared to PRI counterpart 42.2% (p<.001). In general PUB patients reported higher rates of distress and anxiety/depression (p<.03); and poorer QoL outcomes (p<.01).
Conclusions: This preliminary study is one of the first to investigate inequities in cancer outcomes among patients in Brazilian healthcare settings. Analyses revealed notable differences between groups across demographic characteristics, while individuals of lower socioeconomic status reported significantly poorer psychosocial outcomes. These results suggest a complex interaction between ethnicity, access to care and cancer outcomes, and warrants further research to better understand and address these inequities. Further discussion of the role of psycho-oncology research and clinical practice in reducing disparate outcomes among Brazilian cancer patients is warranted.
Papers by Getulio Yuzo Okuma
Psicologia: Teoria e Pesquisa
Resumo Estudo prospectivo e transversal, para determinar a prevalência de prejuízo cognitivo deco... more Resumo Estudo prospectivo e transversal, para determinar a prevalência de prejuízo cognitivo decorrente da quimioterapia e explorar fatores preditores e mediadores em sobreviventes de câncer de mama. Utilizou-se o Termômetro de Distress, Escala de Ansiedade e Depressão, Functional Assessment of Chronic Illness Therapy-General e Cognitive Function. As sobreviventes (N = 62) reportaram uma alta prevalência de distress (46,8%) e de ansiedade (24,2%), com baixos escores nas subescalas déficit cognitivo e habilidades cognitivas percebidos. O funcionamento cognitivo esteve associado à idade (β = 1,42; p = 0,002), atuação profissional (β = -23,12; p = 0,004), depressão (β = -5,43; p = 0,001) e qualidade de vida (β = 1,24; p = 0,001). Prejuízo cognitivo deve ser considerado no serviço de Psico-Oncologia.
Designing a lightweight semantic segmentation network often requires researchers to find a trade-... more Designing a lightweight semantic segmentation network often requires researchers to find a trade-off between performance and speed, which is always empirical due to the limited interpretability of neural networks. In order to release researchers from these tedious mechanical trials, we propose a Graph-guided Architecture Search (GAS) pipeline to automatically search real-time semantic segmentation networks. Unlike previous works that use a simplified search space and stack a repeatable cell to form a network, we introduce a novel search mechanism with a new search space where a lightweight model can be effectively explored through the cell-level diversity and latencyoriented constraint. Specifically, to produce the cell-level diversity, the cell-sharing constraint is eliminated through the cell-independent manner. Then a graph convolution network (GCN) is seamlessly integrated as a communication mechanism between cells. Finally, a latency-oriented constraint is endowed into the search process to balance the speed and performance. Extensive experiments on Cityscapes and CamVid datasets demonstrate that GAS achieves the new state-of-the-art trade-off between accuracy and speed. In particular, on Cityscapes dataset, GAS achieves the new best performance of 73.5% mIoU with speed of 108.4 FPS on Titan Xp.
Brazilian Journal of Oncology, 2017
Objetivo: Cuidado paliativo (CP) é essencial para a identificação e manejo dos sintomas reportado... more Objetivo: Cuidado paliativo (CP) é essencial para a identificação e manejo dos sintomas reportados por pacientes com câncer metastático. Essa assistência promove uma maior qualidade de vida à pacientes e familiares ao longo do continuum da doença, por meio da antecipação, prevenção e alívio do sofrimento. No Brasil, o CP ainda é incipiente no âmbito da assistência oncológica. Sendo assim, o presente estudo objetiva caracterizar as principais demandas de pacientes com câncer em estadio IV, bem como, identificar os fatores associados aos sintomas a fim de determinar aqueles de maior risco psicológico. Métodos: Trata-se de um estudo descritivo e prospectivo realizado com 253 pacientes diagnosticados com câncer metastático, em tratamento quimioterápico paliativo em um hospital público universitário, localizado em São Paulo. Para tanto, os pacientes foram avaliados quanto ao distress (Termômetro de Distress-TD), a ansiedade e a depressão (Escala de Ansiedade e Depressão-HADS) e a qualidade de vida (Functional Assessment of Chronic Illness Therapy-FACT-G). Os procedimentos de análise de dados incluíram na análise descritiva, correlação linear simples e regressão logística. Resultados: A média da idade dos pacientes avaliados foi de 56,6 anos, sendo 64,4% do sexo feminino, 51% casados e 54,2% com Ensino Fundamental. Os cânceres de mama (29,2%) e gastrointestinal (28,9%) foram os mais frequentes. Quase metade dos pacientes (44,7%) reportou um distress moderado a severo, sendo que 21,7% apresentaram sintomas de ansiedade e 16,6% de depressão. A correlação foi significativa entre esses sintomas psicossociais (ps<0,001), sendo que maiores escores de distress estiveram associados a uma pior qualidade de vida global, com consequente impacto negativo no bem-estar físico, social/familiar, emocional e funcional (ps<0,001). Ademais, idade jovem, medo, preocupação, fadiga, dor, sono, ansiedade e depressão foram os fatores associados a um maior risco psicológico. Conclusão: Pacientes com câncer metastático reportaram inúmeros sintomas físicos e psicossociais. Essa alta prevalência impactou significativamente na qualidade de vida desses pacientes, reforçando a relevância da inserção precoce do CP. Constata-se que a assistência precisa considerar a inserção de uma rotina de avaliação sistemática que auxilie na identificação dos sintomas, para proposição de tratamentos adequados e direcionados às necessidades dos pacientes, de maneira a reduzir, antecipar e prevenir o sofrimento desses pacientes. Descritores: Cuidados paliativos; Psico-oncologia, Distress; Qualidade de vida; Serviço público
Estudos de Psicologia, 2017
The development of international guidelines for distress assessment gave greater visibility to th... more The development of international guidelines for distress assessment gave greater visibility to the importance of psychosocial issues within Oncology services. This study sought to identify the instruments used in Brazil, to describe the procedures for implementing this program and to present the preliminary results of a public hospital. In Brazil these recommendations are little broadcast. However, the feasibility and benefits of this new model of care were proved. There was a substantial increased number of patients seen, suggesting agility for distress identification. This program organized and optimized the cancer care, facilitated interprofessional communication, and ensured the identification of patients' needs.
Journal of Clinical Oncology, 2017
31 Background: Studies have shown a clear difference among minority and economically disadvantage... more 31 Background: Studies have shown a clear difference among minority and economically disadvantaged patients. Less is known about marginalized populations in Brazil, a country that possesses a two-tiered healthcare system, based on socioeconomic status. We sought to explore differences in quality of life (QOL) and distress among patients receiving care within these systems. Methods: 270 patients were assessed for distress (DT), anxiety/depression (HADS) and QOL (FACT-G). Half of them was recruited at a private institution (PRI) and the other at a public institution (PUB) (each group: n=135; 68.9% breast and 31.1% gynecological cancers). We calculated descriptive statistics and examined QOL and distress using T-test and ANOVA. Results: We found ethnic differences between PUB (50.4% white, 32.6% mulato and 14.1% black) and PRI patients (82.9% white), and income disparities (PUB patients report almost a third less monthly income than PRI patients). PUB patients were mostly late-stage di...
Revista Psicologia e Saúde, 2021
O presente estudo teve o objetivo de avaliar a relação entre o distress, a qualidade de vida e a ... more O presente estudo teve o objetivo de avaliar a relação entre o distress, a qualidade de vida e a prática espiritual e religiosa (ER) em pacientes recém-diagnosticados com câncer, na primeira linha de tratamento quimioterápico. Trata-se de um estudo transversal, que avaliou 100 pacientes quanto ao distress (Termômetro de Distress), qualidade de vida (Functional Assessment of Chronic Illness Therapy – General) e espiritualidade (Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale e Escala de Religiosidade da Universidade de Duke). Os resultados sugerem que a prática ER é uma importante estratégia no enfrentamento do diagnóstico e tratamento do câncer, estando associada significativamente a um menor nível de distress, melhor qualidade de vida e melhor bem-estar espiritual.
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Conference Presentations by Getulio Yuzo Okuma
Methods: 270 patients were assessed for distress (DT), anxiety/depression (HADS) and QOL (FACT-G). Half of them was recruited at a private institution (PRI) and the other at a public institution (PUB) (each group: n=135; 68.9% breast and 31.1% gynecological cancers). We calculated descriptive statistics and examined QOL and distress using T-test and ANOVA.
Results: We found ethnic differences between PUB (50.4% white, 32.6% mulato and 14.1% black) and PRI patients (82.9% white), and income disparities (PUB patients report almost a third less monthly income than PRI patients). PUB patients were mostly late-stage diagnosed 70.4% compared to PRI counterpart 42.2% (p<.001). In general PUB patients reported higher rates of distress and anxiety/depression (p<.03); and poorer QoL outcomes (p<.01).
Conclusions: This preliminary study is one of the first to investigate inequities in cancer outcomes among patients in Brazilian healthcare settings. Analyses revealed notable differences between groups across demographic characteristics, while individuals of lower socioeconomic status reported significantly poorer psychosocial outcomes. These results suggest a complex interaction between ethnicity, access to care and cancer outcomes, and warrants further research to better understand and address these inequities. Further discussion of the role of psycho-oncology research and clinical practice in reducing disparate outcomes among Brazilian cancer patients is warranted.
Papers by Getulio Yuzo Okuma
Methods: 270 patients were assessed for distress (DT), anxiety/depression (HADS) and QOL (FACT-G). Half of them was recruited at a private institution (PRI) and the other at a public institution (PUB) (each group: n=135; 68.9% breast and 31.1% gynecological cancers). We calculated descriptive statistics and examined QOL and distress using T-test and ANOVA.
Results: We found ethnic differences between PUB (50.4% white, 32.6% mulato and 14.1% black) and PRI patients (82.9% white), and income disparities (PUB patients report almost a third less monthly income than PRI patients). PUB patients were mostly late-stage diagnosed 70.4% compared to PRI counterpart 42.2% (p<.001). In general PUB patients reported higher rates of distress and anxiety/depression (p<.03); and poorer QoL outcomes (p<.01).
Conclusions: This preliminary study is one of the first to investigate inequities in cancer outcomes among patients in Brazilian healthcare settings. Analyses revealed notable differences between groups across demographic characteristics, while individuals of lower socioeconomic status reported significantly poorer psychosocial outcomes. These results suggest a complex interaction between ethnicity, access to care and cancer outcomes, and warrants further research to better understand and address these inequities. Further discussion of the role of psycho-oncology research and clinical practice in reducing disparate outcomes among Brazilian cancer patients is warranted.