Symptoms, Symptom Clusters and Cytokine Activity in Women with Breast Cancer

Women with breast cancer experience many symptoms resulting from the primary disease and/ or the treatment of the disease. Psychoneuroimmunology, the theory of sickness behaviour and the action of cytokines may explain why the symptoms of fatigue, pain, depression and sleep disturbances are present and cluster. This study investigated symptoms, symptom clusters and cytokine activity pre-surgery, post-surgery and post adjuvant treatment using a prospective longitudinal cohort panel design. The study also examined the symptoms for clustering using Hierarchical cluster analysis (HCA). Symptoms were examined in relation to cytokine activity using microarray technology to measure interleukins (1β, 2, 4, 5, 6, 8,10,12,13,17), TNF-a and IFN-y The final sample comprised of thirty women, ages ranging from 30-77 years. Levels of fatigue, pain and depression differed significantly between the time points. HCA found that the symptoms of fatigue, depression, pain and sleep disturbance formed distinct clusters differing on the level of the symptoms present in the cluster. Although all time points had 4 clusters as the optimal clustering solution, the levels of these symptoms within the clusters were dissimilar across the time points. Only IL-8 showed a statistically significant difference over time. IL-5 and IL-13 failed to show any relationships to symptoms at any time point. Pain severity was significantly associated with IL-4, IL-6, IL-17, IL-10 and IFN-y. Fatigue was found to be significantly associated with IL-2, IL-4, IL-6 and IL-10. Depression was found to be significantly associated with IL-6, IL-8, IL-10, TNF-a and IFN-y. Sleep disturbance was found to be significantly associated with IL-ip, IL-2, IL-10 and TNF-a. No significant relationships were identified between levels of cytokines and the symptom clusters. From a clinical perspective, this identification of distinct clusters at time points in the cancer journey is important as it highlights the need for thorough symptom assessment and management to alleviate these symptoms and thus enhance quality of life and levels of functioning. The relationships between symptoms and cytokines in women with breast cancer can be built on in further studies and may lead to the identification of biomarkers for symptoms in the future

Exploring Community Attitudes to People with Learning Disabilities: Using a Micro-Neighbourhood Design

People with learning disabilities living in the community strive for meaningful social inclusion and integration. The attitudes of society to such individuals living in communities continues to be the catalyst that will enable them to achieve genuine social inclusion and integration. Identified barriers to social inclusion are a lack of change in societal attitudes towards people with learning disabilities. People with learning disabilities should live in a socially, not just functionally, integrated manner in community settings. Hence, attitudes of the community are extremely influential in achieving social integration and inclusion. It is important therefore to plan how best to capture attitudes in fact. An exemplar of a completed comparative study in Ireland, which used a micro-neighbourhood design combined with a random survey, illustrates how attitudes can be researched effectively. Study findings show that while attitudes were generally positive towards people with learning disabilities, there was no evidence of social integration, only functional integration. These findings reflect the challenges of achieving authentic social inclusion and integration and warrant further exploration by government agencies and service providers for people with learning disabilities. The study design outlined can contribute to gaining a true insight of societal attitudes

Exploring breast cancer and screening awareness among Irish women with intellectual disabilities

Accessible Summary: We asked women with intellectual disabilities what they knew about breast cancer and screening programmes. We asked women what would put them off going to see a doctor whether they found something wrong with their breast. Most of those we asked knew that a lump was a warning sign for breast cancer. Most of those we asked did not know about the risk factors for breast cancer. Many women did not know much about the breast screening programme. Many women said they would be worried about what the doctor might find. Improving breast cancer and screening awareness is important for women with intellectual disabilities. Women with intellectual disabilities need to be taught more about breast cancer and screening. Abstract: Background: Internationally, it is known that there are gaps in cancer and screening awareness among women with intellectual disabilities. Little is known about this awareness among Irish women with intellectual disabilities. The aim of this study was to explore this awareness among these women. Materials and Methods: The study design incorporated a cross‐sectional descriptive survey using an accessible version of the Cancer Research UK Cancer Awareness Measure. The questionnaire was administered to women with mild to moderate intellectual disabilities (n = 45, age range 20–59 years) living in the South East of Ireland. Results: Almost three quarters of the women (77.8%) recognised a breast lump as a breast cancer warning sign. Knowledge about nonlump warning signs was much lower; 40% of the women did not feel confident that they would notice a change in their breast; 80% of the women could not recall a breast cancer risk factor. Overall, there was poor awareness of the national breast screening programme in Ireland. Worry and embarrassment about talking about their breasts would put women off seeking early medical intervention. Conclusion: There was poor awareness about breast cancer warning signs, risk factors and the breast screening programme among the women. Where women with intellectual disabilities are lacking this knowledge, breast cancer warning may be missed. Carers and intellectual disability services need to ensure that theoretically based cancer and screening education interventions are undertaken which will enable these women to identify warning signs and seek attention promptly

Attitudes of Nursing Students Towards Learning Communication Skills

Introduction: Attitudes of nursing students towards learning nurse-patient communication skills have for long been a concern of lecturers, planners and policy-makers. The objectives of our study were to explore the attitudes of nursing students towards learning communication skills

First Responders\u27 Narratives of Drowning: Perceptions of Family and Community Impacts and Policy Implications

This is an exploratory study of the impacts of drowning death on local communities and families in the Republic of Ireland as perceived by first responders. The impact of a death may be particularly stressful. The identified population of interest were members of the Garda and first responders from Community Rescue Boats Ireland. The principal data collection method was one-to-one narrative interviews followed by a focus group. Questioning involved asking interviewees to talk about specific events rather than providing general opinions. Community identity was a source of impact, an urban or rural setting was a significant factor, social media was clearly an issue, and once the immediate incident was dealt with families did not receive much formal support. Families require the support of counseling professionals. Participants identified the need for support for search and rescue personnel and improved inter-agency collaboration. There is a need for national guidelines

Pushing Boundaries through Borderless Education- The Power of Internationalisation at Home : Preparing for the Changing Context of Higher Education in Ireland

This poster aims to captivate a broader audience and shed light on a ground-breaking research project focused on the untapped potential of Internationalisation at Home (IaH). It explores how this innovative approach pushes the boundaries of conventional learning methods. The poster effectively utilises an 'IaH funnel' as a compelling visual metaphor to depict the research project's journey and its intended outcomes. The funnel illustrates the transformative process of integrating internationalisation into the curriculum, thereby enriching the learning experience. The impact section of the poster showcases a cup with a globe depicted as a tea bag, symbolising the infusion of internationalisation into the Irish Higher Education system. This imagery effectively conveys the positive effects and benefits that arise from embracing IaH. By disseminating the significance of IaH through this thought-provoking poster, the research team endeavors to raise awareness about the potential of borderless education and inspire a wider audience to explore new horizons in education

Evaluation of ‘The Exercise Effect’: A pilot project integrating an exercise practitioner into outpatient mental health services in Ireland

In April 2019, a submission for funding was made to the Sláintecare Integration Fund (2019) to establish the ‘Exercise Effect’ project, including an independent evaluation of the project. The Exercise Effect builds on a longstanding collaborative partnership between key stakeholders, Health Service Executive (HSE) South East Wexford Mental Health Services, Sports Active Wexford (SAW) (a Local Sports Partnership) and Waterford Institute of Technology (WIT). Exercise is well recognised as a therapeutic tool that can benefit a range of mental health symptoms and cognitive function among trans-diagnostic mental health populations. Exercise interventions are also a valuable resource for improving the disproportionately poor physical health states of people with mental disorders. This report presents a detailed account of the Exercise Effect project and the findings from the research evaluation undertaken

Designing effective exercise intervention trials for prostate cancer cohorts: a qualitative study on experiences and views of exercise oncology researchers

Abstract Background Exercise intervention research has shown promising results in preventing and reversing the side effects caused by prostate cancer and its’ treatment. However, there are still unanswered questions and the need for additional research. As the field of exercise oncology in the context of prostate cancer presents unique challenges and complexities, seeking the advice of experienced exercise oncology researchers before initiating a similar trial could help to design more effective and efficient studies and help avoid pitfalls. Methods A qualitative descriptive study design and a nonprobability, purposive sampling method was employed. An interview guide was developed and included topics such as recruitment, retention, programme goals, research design, health considerations, treatment considerations, adverse events, exercise prescription and outcome tools. Individual semi-structured interviews were conducted and interviews were transcribed and analysed using thematic analysis. Results Eight individuals with extensive experience working with prostate cancer patients in exercise oncology research settings were interviewed. Four main themes and seven subthemes were generated and supported by the data. Theme 1 highlighted the critical role of recruitment, with associated subthemes on recruitment barriers and recruitment methods. Theme 2 explored the positives and negatives of home-based programmes. Theme 3 focused on specific health characteristics, exercise prescription and outcome measure factors that must be considered when working with prostate cancer cohorts. Finally, theme 4 centered around the emotional dimensions present in exercise oncology trials, relating to both researchers and study participants. Conclusion Exercise oncology remains a challenging area in which to conduct research. Learning from experienced personnel in the field offers valuable information and guidance that could impact the success of future trials