Financial Toxicity in Head and Neck Cancer Survivorship: The Patient Perspective

Financial toxicity describes duress from financial strain due to treatment or disease burden, often impacting outcomes. Head and neck cancer (HNC) patients are at higher risk of financial toxicity (FT) and worse oncologic outcomes regardless of insurance status. To address this and improve our understanding, we look to describe patient experiences with treatment-related financial burden and elucidate mechanisms underlying FT in HNC survivorship. We used a prospective dyadic cohort study of treatment-naïve HNC patients and their primary informal caregivers performed from October 2019-December 2020 at a single, tertiary academic center conducting semi-strucutred intereviews. Caretakers if present, were included in the interviews. Of 74 eligible patients, 41 were interviewed. A range of experiences were reported (Table 1), with most describing high out-of-pocket expenses (OOPE) such as uncovered dental costs, challenges from indirect opportunity costs, such as lost wages and parking, impacts on medical services, and effects on life activities. Narratives from survivors and their caregivers provide insight into mechanisms by which the direct and indirect costs of cancer care impact HNC patient employment, financial coping behaviors, and ultimately quality of care. Our findings highlight patient-identified needs that may be targeted for interventions aimed at reducing FT, such as early financial navigation from the time of diagnosis, revising dental coverage policies, and eliminating unsupported logistical costs

Towards a medical school curriculum for uncertainty in clinical practice

Uncertainty abounds in the clinical environment. Medical students, however, are not explicitly prepared for situations of uncertainty in clinical practice, which can cause anxiety and impact well-being. To address this gap, we sought to capture how students felt in various clinical scenarios and identify programs they found helpful as they worked through uncertainty in their clerkships to better inform curriculum that prepares them to acknowledge and navigate this uncertainty. This is an observational cross-sectional study of third-year medical students surveyed at the end of core clerkships. The survey consisted of the General Self-Efficacy (GSE) Scale and Intolerance of Uncertainty Scale (IUS). Items asked students to rate preparedness, confidence, and comfort with uncertainty in clinical practice. Items on curricular programs asked students to identify training that prepared them for uncertainty in clerkships, and examined correlations with specific clinical practice uncertainty domains (CPUDs). Spearman’s rank-order correlation, Chi-Square, and ANOVA were used to analyze quantitative data. Open responses were analyzed using Braun and Clarke’s Framework. Response rate was 98.9% (287/290). GSE was inversely correlated with IUS (p \u3c 0.001). GSE was positively correlated with all CPUDs (p \u3c 0.005). IUS had an inverse correlation with all CPUDs (p \u3c 0.005). Pedagogies with statistically-significant relationships with preparing students for uncertainty, communicating and building relationships with patients during times of uncertainty, and overall well-being included: team debriefs, role plays, case- and team-based learning, story slams, and sharing narratives with peers and faculty (p \u3c 0.05). Qualitatively, students appreciated storytelling, role-modeling of communication strategies, debriefing, and simulations. Strategically immersing specific educational formats into formal curriculum may help cultivate skills needed to prepare students for uncertainty. Clinical debriefs, interprofessional role plays, simulations, communications skills training, instructor emotional vulnerability, storytelling, and peer-to-peer conversations may have the most impact. Further study is required to evaluate their longitudinal impact

A Comprehensive Study on Technologies of Tyre Monitoring Systems and Possible Energy Solutions

This article presents an overview on the state of the art of Tyre Pressure Monitoring System related technologies. This includes examining the latest pressure sensing methods and comparing different types of pressure transducers, particularly their power consumption and measuring range. Having the aim of this research to investigate possible means to obtain a tyre condition monitoring system (TCMS) powered by energy harvesting, various approaches of energy harvesting techniques were evaluated to determine which approach is the most applicable for generating energy within the pneumatic tyre domain and under rolling tyre dynamic conditions. This article starts with an historical review of pneumatic tyre development and demonstrates the reasons and explains the need for using a tyre condition monitoring system. Following this, different tyre pressure measurement approaches are compared in order to determine what type of pressure sensor is best to consider in the research proposal plan. Then possible energy harvesting means inside land vehicle pneumatic tyres are reviewed. Following this, state of the art battery-less tyre pressure monitoring systems developed by individual researchers or by world leading tyre manufacturers are presented. Finally conclusions are drawn based on the reviewed documents cited in this article and a research proposal plan is presented