Unmet supportive care needs of breast, colorectal and testicular cancer survivors in the first 8 months post primary treatment:A prospective longitudinal survey

Objectives To explore the supportive care needs of cancer survivors, the characteristics of patients with high levels of unmet need, changes in unmet need after treatment ends and differences in unmet needs of breast, colorectal and testicular survivors. Methods The method used was a prospective longitudinal mailed survey. Unmet needs, measured by 25-item modified Cancer Survivors Unmet Needs survey at baseline (immediately post-treatment) and 8 months later, were analysed descriptively. Results Of 434 breast, 186 colorectal and 75 testicular patients responding at baseline, 56.2%, 65.6% and 50.7%, respectively, had no unmet needs, the top decile having >= 10 (breast) or seven (colorectal and testicular) different needs and seven different unmet needs. The most frequently reported unmet need (all groups) was fear of cancer recurrence. Unmet needs fell significantly at 8 months for breast patients. Some patients reported new needs. Needs were lowest amongst colorectal survivors and differed between the three groups. Higher levels of unmet needs (breast and colorectal) were associated with having had chemotherapy. Conclusion Most survivors reported few unmet needs, but a small proportion have persisting or emerging needs. Routine or regular monitoring of unmet needs is required so that healthcare professionals can deliver personalised care based on individual needs, preferences and circumstances

Professional Uncertainty and Disempowerment Responding to Ethnic Diversity in Health Care: A Qualitative Study

From a qualitative study, Joe Kai and colleagues have identified opportunities to empower health professionals to respond more effectively to challenges in their work with patients from diverse ethnic communities

Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

BACKGROUND:Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. METHODS AND RESULTS:Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. CONCLUSIONS:Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500

The Spatial and Temporal Patterns of Stick-Nest Rat Middens in Australia

The spatial and temporal distribution of 145 radiocarbon dates on 66 Australian stick-nest rat middens (Muridae: Leporillus spp.) range from modern to 10,900 +/90 BP. As in American packrat middens, age frequency follows a logarithmic decay, both continentally and at major sites. This is probably a result of natural decay processes. Unlike American middens of similar age, relatively few range changes in plant distribution have been detected in Australia. The distribution of 14C ages and the associated midden materials provide important paleoenvironmental information from the arid interior of Australia. The middens record subtle changes in vegetation and dramatic changes in the fauna unlike those interpreted from sites on the coastal rim or the southeastern periphery of the arid zone.This material was digitized as part of a cooperative project between Radiocarbon and the University of Arizona Libraries.The Radiocarbon archives are made available by Radiocarbon and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform February 202

Adding value to remote monitoring: co-design of a health literacy intervention for older people with chronic disease delivered by telehealth - The telehealth literacy project

Objective: To co-design, test and evaluate a health literacy, chronic disease self-management and social support intervention for older people delivered by group videoconferencing into the home. Method: The Telehealth Literacy Project (THLP) was a mixed methods, quasi-experimental, non-randomised trial nested within a telehealth remote monitoring study. An intervention group (n = 52) participated in five, weekly videoconference group meetings lasting for 1.5 h and a control group (n = 60) received remote monitoring only. Outcomes were measured using the nine-scale Health Literacy Questionnaire (HLQ) and two scales of the Health Education Impact Questionnaire (heiQ). Semi-structured interviews and focus group data were thematically analysed. Result: At 3 month follow-up, univariate analysis identified small effects in the intervention group only, with improved health literacy behaviours (five HLQ scales) and self-management skills (two heiQ scales). ANOVA of HLQ scales indicated no significant differences between the two groups over time indicating a contributing effect of the remote monitoring project. Intervention participants reported improved perception of companionship, emotional and informational support. Conclusion: The THLP delivered with telemonitoring indicates potential to improve social support and some health literacy factors in older people. Practice implications: Patient education can be delivered by group videoconferencing

Adding value to remote monitoring: Co-design of a health literacy intervention for older people with chronic disease delivered by telehealth - The telehealth literacy project

Objective: To co-design, test and evaluate a health literacy, chronic disease self-management and social support intervention for older people delivered by group videoconferencing into the home. Method: The Telehealth Literacy Project (THLP) was a mixed methods, quasi-experimental, non-randomised trial nested within a telehealth remote monitoring study. An intervention group (n = 52) participated in five, weekly videoconference group meetings lasting for 1.5 h and a control group (n = 60) received remote monitoring only. Outcomes were measured using the nine-scale Health Literacy Questionnaire (HLQ) and two scales of the Health Education Impact Questionnaire (heiQ). Semi-structured interviews and focus group data were thematically analysed. Result: At 3 month follow-up, univariate analysis identified small effects in the intervention group only, with improved health literacy behaviours (five HLQ scales) and self-management skills (two heiQ scales). ANOVA of HLQ scales indicated no significant differences between the two groups over time indicating a contributing effect of the remote monitoring project. Intervention participants reported improved perception of companionship, emotional and informational support. Conclusion: The THLP delivered with telemonitoring indicates potential to improve social support and some health literacy factors in older people. Practice implications: Patient education can be delivered by group videoconferencing. © 2019 Elsevier B.V

Increasing the understanding and use of natural archives of ecosystem services, resilience and thresholds to improve policy, science and practice

Despite the great potential of palaeo-environmental information to strengthen natural resource policy, science and practical outcomes naturally occurring archives of palaeo-environmental and ecosystem service information have not been fully recognised or utilised to inform the development of environmental policy. In this paper, we describe how Australian palaeo-environmental science is improving environmental understanding through local studies and regional syntheses that inform us about past conditions, extreme conditions and altered ecosystem states. Australian innovations in ecosystem services research and palaeo-environmental science contribute in five important contexts: discussions about environmental understanding and management objectives, improving access to information, improved knowledge about the dynamics of ecosystem services, increasing understanding of environmental processes and resource availability, and engaging interdisciplinary approaches to manage ecosystem services. Knowledge of the past is an important starting point for setting present and future resource management objectives, anticipating consequences of trade-offs, sharing risk and evaluating and monitoring the ongoing availability of ecosystem services. Palaeo-environmental information helps reframe discussions about desirable futures and collaborative efforts between scientists, planners, managers and communities. However, further steps are needed to translate the ecosystem services concept into ecosystem services policy and tangible management objectives and actions that are useful, feasible and encompass the range of benefits to people from ecosystems. We argue that increased incorporation of palaeo-environmental information into policy and decision-making is needed for evidence-based adaptive management to enhance sustainability of ecosystem functions and reduce long-term risks

Unmet supportive care needs of breast, colorectal and testicular cancer survivors in the first 8 months post primary treatment: A prospective longitudinal survey

Objectives: To explore the supportive care needs of cancer survivors, the characteristics of patients with high levels of unmet need, changes in unmet need after treatment ends and differences in unmet needs of breast, colorectal and testicular survivors. Methods: The method used was a prospective longitudinal mailed survey. Unmet needs, measured by 25-item modified Cancer Survivors Unmet Needs survey at baseline (immediately post-treatment) and 8 months later, were analysed descriptively. Results: Of 434 breast, 186 colorectal and 75 testicular patients responding at baseline, 56.2%, 65.6% and 50.7%, respectively, had no unmet needs, the top decile having ≥10 (breast) or seven (colorectal and testicular) different needs and seven different unmet needs. The most frequently reported unmet need (all groups) was fear of cancer recurrence. Unmet needs fell significantly at 8 months for breast patients. Some patients reported new needs. Needs were lowest amongst colorectal survivors and differed between the three groups. Higher levels of unmet needs (breast and colorectal) were associated with having had chemotherapy. Conclusion: Most survivors reported few unmet needs, but a small proportion have persisting or emerging needs. Routine or regular monitoring of unmet needs is required so that healthcare professionals can deliver personalised care based on individual needs, preferences and circumstances.</p