Cervical cancer treatment policy in urban Saskatchewan : a feminist case study

iv, 99 leaves : ill. ; 29 cm.Includes abstract and appendices.Includes bibliographical references (leaves 88-95).Treatment based on biomedical principles has become the normative structure for medical practice in Canada. This model, however, imposes on patients rather than involves them as active agents in care. This feminist case study assesses the extent of a women's health approach within cervical cancer treatment at a cancer clinic in western Canada. It critically examines the rationale for and implementation of the clinic's policies drawing from semi-structured interviews with nine professionals working in cervical cancer treatment as well as from relevant information distributed to patients. Of the nine participants in the study, few were aware of women's health approaches and among those who were, it is apparent that the program does an inadequate job of representing women's needs. The recommendations of this project direct attention towards raising the profile of women's health and incorporating gender-based analysis into the biomedical treatment setting. The research identifies a need to raise the awareness of healthcare professionals who work in the area of women's health by emphasizing the importance of involving women directly in the formation of clinic policies in an attempt to prize experience as much as evidence

eHealth literacy among older adults living with cancer and their caregivers: A scoping review

Introduction Over 90% of people living with cancer access information online to inform healthcare decisions. Older adults with cancer are also increasingly adopting electronic healthcare services, or eHealth, particularly with the rapid transition to virtual care amidst the pandemic. Therefore, the purpose of this review is to understand the level of eHealth literacy among older adults with cancer and their caregivers, as well as any barriers and facilitators in terms of accessing, comprehending, and implementing eHealth information. Methods This scoping review was guided by Arksey and O'Malley methodology and PRISMA ScR guidelines. Comprehensive searches for the concepts of “eHealth Literacy” and “cancer” were performed in MEDLINE, Scopus, CINAHL, PsycINFO, AMED and EMBASE, from 2000 to 2021. We used descriptive quantitative and thematic analysis to analyze the literature. Results Of the 6076 articles screened by two reviewers, eleven articles were included. Quantitative findings suggest older adults with cancer and their caregivers have low self-perceived eHealth literacy and less confidence evaluating online health information for cancer decision-making. Low socioeconomic status, lower education levels, rapid expansion of digital applications, broadband access, reduced familiarity, and frequency of use were cited as prominent barriers. eHealth literacy appears to be positively correlated with caregivers seeking a second opinion, awareness of treatment options, shared decision making, and trust in the health care system. Conclusion With the growing reliance on eHealth tools, developing credible digital health applications that require minimal internet navigation skills, patient education, and collaborative efforts to address access and affordability are urgently warranted

Cortisol as an Acute Stress Biomarker in Young Hematopoietic Cell Transplant Patients/Caregivers: Active Music Engagement Protocol

Objective: Primary aims of the proposed protocol are to determine the feasibility/acceptability of the active music engagement intervention protocol during hematopoietic stem cell transplantation (HSCT) and clinical feasibility/acceptability of the biological sample collection schedule. Design: The authors propose a single-case, alternating treatment design to compare levels of child and caregiver cortisol in blood and saliva collected on alternating days, when the dyad receives and does not receive AME sessions. Included are the scientific rationale for this design and detailed intervention and sample collection schedules based on transplant type. Setting/Location: Pediatric inpatient HSCT unit. Subjects: Eligible participants are dyads of children 3-8 years old, hospitalized for HSCT, and their caregiver. Children with malignant and nonmalignant conditions will be eligible, regardless of transplant type. Intervention: AME intervention is delivered by a board-certified music therapist who tailors music-based play experiences to encourage active engagement in, and independent use of, music play to manage the inter-related emotional distress experienced by children and their caregivers during HSCT. Dyads will receive two 45-min AME sessions each week during hospitalization. Outcome Measures: Eight collections of blood (child) and saliva (child/caregiver) will be performed for cortisol measurement. The authors will also collect self-report and caregiver proxy measures for dyad emotional distress, quality of life, and family function. At study conclusion, qualitative caregiver interviews will be conducted. Results: Planned analyses will be descriptive and evaluate the feasibility of participant recruitment, cortisol collection, planned evaluations, and AME delivery. Analysis of qualitative interviews will be used to gain an understanding about the ease/burden of biological sample collection and any perceived benefit of AME. Conclusions: Behavioral intervention studies examining biological mechanisms of action in pediatric transplant populations are rare. Findings will provide important information about the feasibility/acceptability of collecting cortisol samples during a high-intensity treatment and advance understanding about the use of active music interventions to mitigate child/caregiver distress during the transplant period

Collaborating to co-produce educational content to champion dementia care in acute settings:Lessons learned

Enhancing dementia care to benefit people with dementia and their family carers requires both global and local initiatives. The purpose of this presentation is to share how we adapted a successful Scottish initiative (known as the Scottish National Dementia Champions Programme) to our local Canadian context with the ultimate aim to ‘champion’ dementia care provided by healthcare professionals in acute care settings. To guide our co-production, we are employing Hawkins et al.’s three-phase framework: (1) evidence review and stakeholder consultation, (2) co-production of intervention content, and (3) prototyping. After phase one was completed (in February 2020) we embarked on phase two and learned several key lessons from the co-production of the program content. These include the importance of (a) partnering with those with lived experience to infuse their voices in all aspects of the program; (b) learning and benefitting from our Scottish colleagues’ rich experiences; (c) capitalizing on long-standing Pan-Canadian relationships and launching new ones; (d) meeting virtually, on a consistent basis over 12 months, with established agendas and precise minute-taking; and (e) building consensus on what and how to prioritize program content and resources to align with the Canadian Charter of Rights for People with Dementia, within the foundation of person-/family-centred care. The results of our work in phase two enables us to proceed with phase three to pilot the co-produced program’s content and resources in the Canadian province of Saskatchewan

Educating healthcare professionals as change agents to champion dementia care in acute care settings

Persons with dementia and family carers identify several challenges when hospitalized including poor communication with professionals and loss of independence. Acute healthcare professionals cite understaffing and lack of dementia education as barriers to optimal care. To address these issues, the purpose of this project is to co-produce an educational program based on the Scottish National Dementia Champions Programme

Regionalized tissue fluidization is required for epithelial gap closure during insect gastrulation

Many animal embryos pull and close an epithelial sheet around the ellipsoidal egg surface during a gastrulation process known as epiboly. The ovoidal geometry dictates that the epithelial sheet first expands and subsequently compacts. Moreover, the spreading epithelium is mechanically stressed and this stress needs to be released. Here we show that during extraembryonic tissue (serosa) epiboly in the insect Tribolium castaneum, the non-proliferative serosa becomes regionalized into a solid-like dorsal region with larger non-rearranging cells, and a more fluid-like ventral region surrounding the leading edge with smaller cells undergoing intercalations. Our results suggest that a heterogeneous actomyosin cable contributes to the fluidization of the leading edge by driving sequential eviction and intercalation of individual cells away from the serosa margin. Since this developmental solution utilized during epiboly resembles the mechanism of wound healing, we propose actomyosin cable-driven local tissue fluidization as a conserved morphogenetic module for closure of epithelial gaps