RadioActive101-Learning through radio, learning for life: an international approach to the inclusion and non-formal learning of socially excluded young people

This article describes an original international approach to inclusion and non-formal learning of socially excluded young people, through participatory internet radio - RadioActive101. First, we critically discuss the social and digital exclusion of young people. We then describe our approach - that includes partic-ipatory action research methods that are influenced by the work of Dewey and Freire, and operate as a process of complex intervention. This supports the inclusive co-production of radio content in ways that support non-formal learning in two EU contexts – the UK and Portugal. We then summarise and compare a qualitative investigation of RadioActive101. This showed positive results, with important similarities and differences between the two contexts. Participants reported that RadioActive101 was motivating and contributed to the development of contemporary skills, and also stimulated improvements in psychosocial dimensions such as confidence (self-efficacy) and self-esteem. This investigation informed the development of an original recog-nition system for non-formal learning that maps EU Key Competences for Lifelong Learning to radio practic-es and activities that are recognised through electronic badges. Our final reflections emphasise that in order to support the non-formal learning of socially excluded young people we must foreground our attention to foster-ing psychosocial dimensions alongside developing contemporary competences

Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis

Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95 % CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95 % CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95 % CI 2.5, 4.8; and n = 10; RR 2.2, 95 % CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95 % CI 0.7, 3.0; and n = 4; RR 1.3, 95 % CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour

Shared decision making in cancer treatment: a Dutch national survey on patients' preferences and perceptions

Objective: Shared decision making (SDM) for cancer treatment yields positive results. However, it appears that discussing essential topics for SDM is not fully integrated into treatment decision making yet. Therefore, we aim to explore to what extent discussion of therapy options, treatment consequences, and personal priorities is preferred and perceived by (former) cancer patients.Methods: An online questionnaire was distributed by the Dutch Federation of Cancer Patient Organisations among (former) cancer patients in 2018.Results: Among 3785 (former) cancer patients, 3254 patients (86%) had discussed treatments with their health care provider (HCP) and were included for analysis. Mean age was 62.1 +/- 11.5; 55% were female. Discussing the option to choose no (further) treatment was rated by 2751 (84.5%) as very important (median score 9/10-IQR 8-10). Its occurrence was perceived by 28% (N = 899), and short- and long-term treatment consequences were discussed in 81% (N = 2626) and 53% (N = 1727), respectively. An unmet wish to discuss short- and long-term consequences was reported by 22% and 26%, respectively. Less than half of the (former) cancer patients perceived that personal priorities (44%) and future plans (34%) were discussed.Conclusion: In the perception of (former) cancer patients, several essential elements for effective SDM are insufficiently discussed during cancer treatment decision making.Analysis and support of clinical decision makin

The Paradox and Continuum of Digital Disengagement: Denaturalising Digital Sociality and Technological Connectivity

This theoretical intervention puts forward a concept of ‘digital disengagement’ to discuss new socio-cultural, economic and political demarcations and implications surrounding the relationship between digital media, culture and society. At present, despite a proliferation of calls to reduce both the range of digital devices and communication platforms, and the time spent using them, and despite a growing body of academic work on disconnection or opt-out, disengagement from the digital is still conceptualised by media research as a spatiotemporal or an ideological aberration. To challenge this framework, we propose a paradigmatic shift. We invite digital media scholarship to denaturalise the digital by centring digital disengagement both as a complex phenomenon currently unfolding and as a conceptual entry point into thinking about sociality, agency, rights and everyday life more broadly. Mobilising digital disengagement as a theoretical lens, our piece provides the following: first, we critically assess the prevalent conflation of digitality with social networking, which leads to a limited understanding of disengagement as being only about disconnecting from social media platforms. Second, we challenge the normalisation of the technological in practices of disconnection, arguing instead that disengagement might be structured, but should not be determined, by the technological. Third, we demonstrate that digital disengagement is not a single phenomenon but a complex continuum of practices, motivations and effects. Understood as such, it has the potential to open new ways of imagining relations between technologies and freedoms, engagement and digitality and sociality and refusal

What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data meta-analysis

This study was supported by the Dutch Cancer Society (KWF) grant number 10936.Objective Care for fear of cancer recurrence (FCR) is considered the most common unmet need among cancer survivors. Yet the prevalence of FCR and predisposing factors remain inconclusive. To support targeted care, we provide a comprehensive overview of the prevalence and severity of FCR among cancer survivors and patients, as measured using the short form of the validated Fear of Cancer Recurrence Inventory (FCRI-SF). We also report on associations between FCR and clinical and demographic characteristics. Methods This is a systematic review and individual participant data (IPD) meta-analysis on the prevalence of FCR. In the review, we included all studies that used the FCRI-SF with adult (≥18 years) cancer survivors and patients. Date of search: 7 February 2020. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. Results IPD were requested from 87 unique studies and provided for 46 studies comprising 11,226 participants from 13 countries. 9311 respondents were included for the main analyses. On the FCRI-SF (range 0–36), 58.8% of respondents scored ≥13, 45.1% scored ≥16 and 19.2% scored ≥22. FCR decreased with age and women reported more FCR than men. FCR was found across cancer types and continents and for all time periods since cancer diagnosis. Conclusions FCR affects a considerable number of cancer survivors and patients. It is therefore important that healthcare providers discuss this issue with their patients and provide treatment when needed. Further research is needed to investigate how best to prevent and treat FCR and to identify other factors associated with FCR. The protocol was prospectively registered (PROSPERO CRD42020142185).Publisher PDFPeer reviewe

Population-based impact of COVID-19 on incidence, treatment, and survival of patients with pancreatic cancer

Background: The COVID-19 pandemic has put substantial strain on the healthcare system of which the effects are only partly elucidated. This study aimed to investigate the impact on pancreatic cancer care. Methods: All patients diagnosed with pancreatic cancer between 2017 and 2020 were selected from the Netherlands Cancer Registry. Patients diagnosed and/or treated in 2020 were compared to 2017–2019. Monthly incidence was calculated. Patient, tumor and treatment characteristics were analyzed and compared using Chi-squared tests. Survival data was analyzed using Kaplan–Meier and Log-rank tests. Results: In total, 11019 patients were assessed. The incidence in quarter (Q)2 of 2020 was comparable with that in Q2 of 2017–2019 (p = 0.804). However, the incidence increased in Q4 of 2020 (p = 0.031), mainly due to a higher incidence of metastatic disease (p = 0.010). Baseline characteristics, surgical resection (15% vs 16%; p = 0.466) and palliative systemic therapy rates (23% vs 24%; p = 0.183) were comparable. In 2020, more surgically treated patients received (neo)adjuvant treatment compared to 2017–2019 (73% vs 67%; p = 0.041). Median overall survival was comparable (3.8 vs 3.8 months; p = 0.065). Conclusion: This nationwide study found a minor impact of the COVID-19 pandemic on pancreatic cancer care and outcome. The Dutch health care system was apparently able to maintain essential care for patients with pancreatic cancer

Just married: the synergy between feminist criminology and the Tripartite Cybercrime Framework

This article is a theoretical treatment of feminist epistemology of crime, which advocates the centrality of gender as a theoretical starting point for the investigating of digital crimes. It does so by exploring the synergy between the feminist perspectives and the Tripartite Cybercrime Framework (TCF) (which argues that three possible factors motivate cybercrimes – socioeconomic, psychosocial, and geopolitical) to critique mainstream criminology and the meaning of the term “cybercrime”. Additionally, the article examines gender gaps in online harassment, cyber‐bullying, cyber‐fraud, revenge porn, and cyber‐stalking to demonstrate that who is victimised, why, and to what effect are the critical starting points for the analysis of the connections between gender and crimes. In turn, it uses the lens of intersectionality to acknowledge that, while conceptions of gender and crime interact, they intersect with other categories (e.g., sexuality) to provide additional layers of explanation. To nuance the utilitarian value of the synergy between the TCF and the feminist perspectives, the focus shifts to a recent case study (which compared socioeconomic and psychosocial cybercrimes). The article concludes that, while online and offline lives are inextricably intertwined, the victimisations in psychosocial cybercrimes may be more gendered than in socioeconomic cybercrimes. These contributions align the TCF to the feminist epistemology of crime in their attempt to move gender analysis of digital crimes “from margin to centre”

Effects of structured involvement of the primary care team versus standard care after a cancer diagnosis on patient satisfaction and healthcare use: the GRIP randomised controlled trial

Background: The growing number of cancer survivors and treatment possibilities call for more personalised and integrated cancer care. Primary care seems well positioned to support this. We aimed to assess the effects of structured follow-up of a primary care team after a cancer diagnosis. Methods: We performed a multicentre randomised controlled trial enrolling patients curatively treated for breast, lung, colorectal, gynaecologic cancer or melanoma. In addition to usual cancer care in the control group, patients randomized to intervention were offered a “Time Out consultation” (TOC) with the general practitioner (GP) after diagnosis, and subsequent follow-up during and after treatment by a home care oncology nurse (HON). Primary outcomes were patient satisfaction with care (questionnaire: EORTC-INPATSAT-32) and healthcare utilisation. Intention-to-treat linear mixed regression analyses were used for satisfaction with care and other continuous outcome variables. The difference in healthcare utilisation for categorical data was calculated with a Pearson Chi-Square or a Fisher exact test and count data (none versus any) with a log-binomial regression. Results: We included 154 patients (control n = 77, intervention n = 77) who were mostly female (75%), mainly diagnosed with breast cancer (51%), and had a mean age of 61 (SD ± 11.9) years. 81% of the intervention patients had a TOC and 68% had HON contact. Satisfaction with care was high (8 out of 10) in both study groups. At 3 months after treatment, GP satisfaction was significantly lower in the intervention group on 3 of 6 subscales, i.e., quality (− 14.2 (95%CI -27.0;-1.3)), availability (− 15,9 (− 29.1;-2.6)) and information provision (− 15.2 (− 29.1;-1.4)). Patients in the intervention group visited the GP practice and the emergency department more often ((RR 1.3 (1.0;1.7) and 1.70 (1.0;2.8)), respectively). Conclusions: In conclusion, the GRIP intervention, which was designed to involve the primary care team during and after cancer treatment, increased the number of primary healthcare contacts. However, it did not improve patient satisfaction with care and it increased emergency department visits. As the high uptake of the intervention suggests a need of patients, future research should focus on optimizing the design and implementation of the intervention. Trial registration: GRIP is retrospectively (21/06/2016) registered in the ‘Netherlands Trial Register’ (NTR5909)