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Journal of Cancer Survivorship :... Feb 2024The St. Jude's After Completion of Therapy (ACT) Clinic was established in 1984 to address the needs of long-term survivors treated at St. Jude Children's Research... (Review)
Review
The St. Jude's After Completion of Therapy (ACT) Clinic was established in 1984 to address the needs of long-term survivors treated at St. Jude Children's Research Hospital. Survivors eligible for transfer to ACT Clinic include those treated at St. Jude who are cancer-free, 5 years from diagnosis (5 years after completion of relapse therapy), and 2 years after completion of therapy. Services provided to clinic attendees include transportation, housing, and medical care costs not covered by insurance. The clinic's mission is to improve the quality of life of survivors by facilitating their access to resources that optimize physical and emotional health, social functioning, and educational and vocational achievement. ACT evaluations are undertaken by a multidisciplinary team comprised of nurses, advanced practice providers, physicians, social workers, psychologists, and other medical subspecialists as needed. ACT interventions include the organization of a survivorship care plan/treatment summary, risk-based health screening, counseling about health risks/risk mitigation, comprehensive psychosocial assessment, assistance with care transitions, and case management for identification of local resources. The ACT Clinic offers educational opportunities to graduate medical trainees and precepts national and international visitors seeking guidance in the development of survivorship programs. The ACT Clinic also provides a robust infrastructure for research investigations that have aimed to characterize health outcomes in long-term survivors and test interventions to prevent/remediate adverse effects of childhood cancer and its therapy. Findings from research facilitated by the ACT Clinic have informed health surveillance recommendations for long-term survivors and guided interventions to promote healthy aging among this growing population. IMPLICATIONS FOR CANCER SURVIVORS: This review describes a model of care that addresses the medical and psychosocial challenges of survivorship while integrating research investigations to improve health outcomes among childhood cancer survivors.
Topics: Child; Humans; Cancer Survivors; Quality of Life; Survivors; Neoplasms; Hospitals
PubMed: 38294599
DOI: 10.1007/s11764-023-01519-6 -
Journal of Injury & Violence Research Oct 2020Injury has become the leading cause of death among adolescents. This study aimed to understand the prevalence of risk-taking behaviors and exposures and injuries among...
BACKGROUND
Injury has become the leading cause of death among adolescents. This study aimed to understand the prevalence of risk-taking behaviors and exposures and injuries among vocational school students and to provide guidance for further injury intervention.
METHODS
A cluster sampling method was used to conduct a questionnaire survey of all grade one and grade two students in a vocational school in Jiangsu Province in April 2018. A self-administered questionnaire was designed to investigate information on basic demographic information, risk-taking behaviors and exposures, and injuries.
RESULTS
A total of 1079 students were investigated, 490(45.41%) were boys; the mean age was 16.80±0.80 years; 560(51.90%) were grade one students. There were 57 injuries in the past 12 months. The overall injury incidence was 5.28%. The total proportions of risk behaviors ranged from 1.4% for playing on the street to 68.6% for not wearing reflective devices while walking at night. Behaviors of not using traffic safety protection devices were highly prevalent, including not using seat-belts in the back seat of cars (19.7%), not wearing helmet while taking/ riding an electric car (15.8%/13.0%), not wearing reflective devices while walking/riding at night (68.6% for pedestrians and 62.8% for two-wheelers riders). Girls generally had more negative mood exposures compared to boys. Boys generally had more traffic risk behaviors and bullying and violence experiences compared with girls. The average number of risk-taking behaviors and exposures was 8.73±8.06. The number of risk-taking behaviors and exposures was positively associated with injury, with OR of 1.07(1.04-1.10).
CONCLUSIONS
Risk-taking behaviors and exposures were prevalent among vocational school students and increased the risk of injury. Traffic safety, bullying and violence, and sports safety were the aspects need more attention. The intervention of such risk behaviors should aim at the characteristics of the population and their special behavior problems.
PubMed: 33070145
DOI: 10.5249/jivr.v12i3.1278 -
Journal of Occupational Rehabilitation Jun 2019Purpose There are substantial costs associated with sickness absence and struggling at work however existing services in the UK are largely restricted to those absent... (Randomized Controlled Trial)
Randomized Controlled Trial
Purpose There are substantial costs associated with sickness absence and struggling at work however existing services in the UK are largely restricted to those absent from work for greater than 6 months. This paper details the development of an early Vocational Advice Intervention (VAI) for adult primary care consulters who were struggling at work or absent due to musculoskeletal pain, and the structure and content of the training and mentoring package developed to equip the Vocational Advisors (VAs) to deliver the VAI, as part of the Study of Work and Pain (SWAP) cluster randomised trial. Methods In order to develop the intervention, we conducted a best-evidence literature review, summarised evidence from developmental studies and consulted with stakeholders. Results A novel early access, brief VAI was developed consisting of case management and stepped care (three steps), using the Psychosocial Flags Framework to identify and overcome obstacles associated with the health-work interface. Four healthcare practitioners were recruited to deliver the VAI; three physiotherapists and one nurse (all vocational advice was actually delivered by the three physiotherapists). They received training in the VA role during a 4-day course, with a refresher day 3 months later, along with monthly group mentoring sessions. Conclusions The process of development was sufficient to develop the VAI and associated training package. The evidence underpinning the VAI was drawn from an international perspective and key components of the VAI have the potential to be applied to other settings or countries, although this has yet to be tested.
Topics: Adult; Case Management; Employment; Humans; Musculoskeletal Pain; Rehabilitation, Vocational; Vocational Guidance
PubMed: 29982957
DOI: 10.1007/s10926-018-9799-1 -
Journal of Occupational Rehabilitation Jun 2021Purpose The present study aimed to understand the roles, effective strategies and facilitators, and challenges of employment support specialists (ESS) in assisting young...
Purpose The present study aimed to understand the roles, effective strategies and facilitators, and challenges of employment support specialists (ESS) in assisting young people with mental health conditions (MHCs) gain and sustain employment in Singapore. Methods An interpretative qualitative design using an inductive approach was adopted for this study. Using a semi-structured interview guide, in-depth interviews were conducted with twenty ESS employed with mental health service providers or other community-based centers. Verbatim transcripts of the interviews were thematically analyzed using inductive methods. ESS were broadly classified as "any professionals providing employment-related support to people with MHCs". Results Majority of the ESS were employed at a tertiary psychiatric institute. Participants included vocational and occupational specialists, case managers and other clinical professionals. Three key themes emerged from the data: (i) descriptions of roles undertaken by the ESS depicting a wide range of services and requisite skillsets; (ii) facilitators that benefit young people with MHCs' in terms of job placement, for example, ESS' attitudes and attributes, and their clients' disposition; and (iii) challenges that deter effective job placements, such as factors pertaining to the ESS themselves, their clients, and clients' employers. Under this theme, ESS also proposed ways to improve employment opportunities of people with MHCs. Conclusions This study provided insight into a range of tasks performed and challenges faced by ESS in Singapore while assisting their clients. There is a need to address ESS' challenges and expectations in order to enhance their efficiency and aid reintegration of young people with MHCs into the workforce and the society.
Topics: Adolescent; Employment; Female; Humans; Male; Mental Disorders; Mental Health; Specialization
PubMed: 33090356
DOI: 10.1007/s10926-020-09930-x -
International Journal of Environmental... Jan 2023COVID-19 accelerated the growth of the digital economy and digital transformation across the globe. Meanwhile, it also created a higher demand for productivity in the...
COVID-19 accelerated the growth of the digital economy and digital transformation across the globe. Meanwhile, it also created a higher demand for productivity in the real economy. Hence, the correlation between the digital economy and green productivity is worth studying as COVID-19 prevention becomes the norm. The digital economy overcomes the limitations imposed by traditional factors of production on economic growth and empowers innovative R&D and resource allocation in all aspects. This study delved into the digital economy by focusing on its green value at different levels of development. The study gathered the green-productivity indices and the principal components of the digital economy for each prefecture-level city in China from 2011 to 2019 and meticulously portrayed their trends in spatial and temporal figures. Meanwhile, regression models were used to verify the mechanism through which digital-economy development influences the changes in green productivity. The results showed that: (1) a higher level of digital economy helps to increase urban green total-factor productivity (GTFP) and that the conclusions of this paper still held after potential endogeneity problems were solved through the instrumental-variables approach; (2) the digital economy will drive an increase in urban GTFP by upgrading firms' production technologies and that digital-economy development encourages green patent applications from firms; and (3) as the digital economy develops, it will also drive urban GTFP increases by removing polluting enterprises from the market and that the higher the level of digital-economy development, the greater the number and probability of polluting enterprises exiting the market. In view of this study's results, the government should increase the importance of the digital economy, strengthen the role of the digital economy in promoting urban green development, and provide more guidance on regional green development with the help of the digital economy.
Topics: Humans; Cities; COVID-19; Economic Development; Resource Allocation; China; Efficiency
PubMed: 36674198
DOI: 10.3390/ijerph20021442 -
BMC Public Health Sep 2023People living with cardiovascular diseases (CVD) often experience work participation problems. Good work-focused healthcare, defined as the received advice, treatment,...
BACKGROUND
People living with cardiovascular diseases (CVD) often experience work participation problems. Good work-focused healthcare, defined as the received advice, treatment, and guidance focusing on work participation, can support the patient and work place. However, experiences with work-focused healthcare are generally not always positive which is a barrier for work participation. Therefore, the objective of this study is to gain insight into the work-focused healthcare journey from the perspective of patients with work participation problems due to CVD, to understand their experiences and needs, and to derive opportunities for improving work-focused healthcare service at a system level.
METHODS
Semi-structured interviews, preceded by preparatory assignments, were conducted with 17 patients who experience(d) work participation problems due to CVD. The patient experience journey map (PEJM) approach was used to visualize the patients' work-focused healthcare journey, including experiences and needs over time and place, from which opportunities to improve work-focused healthcare from the patient's perspective were derived.
RESULTS
An aggregated PEJM consisting of six phases was composed and graphically mapped. The first phase, working, represents a period in which CVD health problems and subsequent functional limitations occur. The next two phases, short- and long-term sick leave, represent a period of full sick leave. The last three phases, start-, partial-, and full vocational reintegration, focus on the process of return to work that takes place ranging from a few months up to several years after sick-listing. For each phase the touchpoints, timespan, stakeholders, activities, experiences and needs from the perspective of the patients were identified. Finally, for better work-focused healthcare nine opportunities for improvement were derived from the PEJM, e.g. emphasize the need for work adjustment prior to the medical intervention, provide more personalized advice on handling work limitations, and putting more compelling pressure on the employer to create suitable work positions for their employees.
DISCUSSION/CONCLUSION
This paper contributes insights to provide a more patient-centered work-focused healthcare trajectory for patients employed in paid jobs when living with CVD. The PEJM provides an understanding of the patients' perspectives throughout their work-focused healthcare journey and highlights opportunities for improvement towards a better suited and seamless patient journey, Although this research was conducted within the Dutch healthcare system, it can be assumed that the findings on integrated work-focused healthcare are largly transferable to other healthcare systems.
Topics: Humans; Cardiovascular Diseases; Health Facilities; Ethnicity; Delivery of Health Care; Patient Outcome Assessment
PubMed: 37697261
DOI: 10.1186/s12889-023-16486-x -
Anatolian Journal of Cardiology Oct 2020Coronavirus disease 2019 (COVID-19) caused by 'Severe Acute Respiratory Syndrome Coronavirus-2' (SARS-CoV-2) infection emerged in Wuhan, a city of China, and spread to... (Review)
Review
Coronavirus disease 2019 (COVID-19) caused by 'Severe Acute Respiratory Syndrome Coronavirus-2' (SARS-CoV-2) infection emerged in Wuhan, a city of China, and spread to the entire planet in early 2020. The virus enters the respiratory tract cells and other tissues via ACE2 receptors. Approximately 20% of infected subjects develop severe or critical disease. A cytokine storm leads to over inflammation and thrombotic events. The most common clinical presentation in COVID-19 is pneumonia, typically characterized by bilateral, peripheral, and patchy infiltrations in the lungs. However multi-systemic involvement including peripheral thromboembolic skin lesions, central nervous, gastrointestinal, circulatory, and urinary systems are reported. The disease has a higher mortality compared to other viral agents causing pneumonia and unfortunately, no approved specific therapy, nor vaccine has yet been discovered. Several clinical trials are ongoing with hydroxychloroquine, remdesivir, favipiravir, and low molecular weight heparins. This comprehensive review aimed to summarize coagulation abnormalities reported in COVID-19, discuss the thrombosis, and inflammation-driven background of the disease, emphasize the impact of thrombotic and inflammatory processes on the progression and prognosis of COVID-19, and to provide evidence-based therapeutic guidance, especially from antithrombotic and anti-inflammatory perspectives.
Topics: Betacoronavirus; Blood Coagulation Disorders; COVID-19; Coronavirus Infections; Cytokines; Hemostatic Disorders; Humans; Immunomodulation; Inflammation; Pandemics; Pneumonia, Viral; Prognosis; SARS-CoV-2; Thrombosis
PubMed: 33001051
DOI: 10.14744/AnatolJCardiol.2020.56727 -
Journal of Career Development Aug 2023Veterans living with mental health conditions have ambitious career goals and want support to find employment that meets their interests and preferences. Despite calls...
Veterans living with mental health conditions have ambitious career goals and want support to find employment that meets their interests and preferences. Despite calls from researchers to "invest" and "commit" to career development research and practice for individuals living with psychiatric conditions, we still do not have empirically tested models for facilitating career development among individuals with mental health conditions, especially veterans. This qualitative study investigates the career development needs and recommended intervention strategies of veterans living with mental health conditions. Vocational counselors from the Veterans Health Administration (VHA) and veterans receiving vocational rehabilitation services ( = 13) participated in semi-structured focus groups. Findings illuminate the tasks, barriers, interventions, implementation strategies, and transitional work context that hinder and support career development of veterans with mental health conditions. Findings offer theoretical and applied guidance to researchers and counselors regarding career development of veterans living with mental health conditions.
PubMed: 37463233
DOI: 10.1177/08948453221137344 -
RSC Advances Mar 2024Nanoparticle (NP) drug delivery systems have shown promise in tumor therapy. However, limitations such as susceptibility to immune clearance and poor targeting in a... (Review)
Review
Nanoparticle (NP) drug delivery systems have shown promise in tumor therapy. However, limitations such as susceptibility to immune clearance and poor targeting in a complex intercellular environment still exist. Recently, cancer cell membrane-encapsulated nanoparticles (CCM-NPs) constructed using biomimetic nanotechnology have been developed to overcome these problems. Proteins on the membrane surface of cancer cells can provide a wide range of activities for CCM-NPs, including immune escape and homologous cell recognition properties. Meanwhile, the surface of the cancer cell membrane exhibits obvious antigen enrichment, so that CCM-NPs can transmit tumor-specific antigen, activate a downstream immune response, and produce an effective anti-tumor effect. In this review, we first provided an overview of the functions of cancer cell membranes and summarized the preparation techniques and characterization methods of CCM-NPs. Then, we focused on the application of CCM-NPs in tumor therapy. In addition, we summarized the functional modifications of cancer cell membranes and compiled the patent applications related to CCM-NPs in recent years. Finally, we proposed the future challenges and directions of this technology in order to provide guidance for researchers in this field.
PubMed: 38567339
DOI: 10.1039/d4ra01026d -
Clinical & Experimental Optometry May 2007Colour vision deficiency (CVD) has a high prevalence and is often a handicap in everyday life. Those who have CVD will be better able to adapt and make more informed... (Review)
Review
BACKGROUND
Colour vision deficiency (CVD) has a high prevalence and is often a handicap in everyday life. Those who have CVD will be better able to adapt and make more informed career choices, if they know about their deficiency. The fact that from 20 to 30 per cent of adults with abnormal colour vision do not know they have CVD suggests that colour vision is not tested as often as it should be. This may be because of practitioner uncertainty about which tests to use, how to interpret them and the advice that should be given to patients on the basis of the results. The purpose of this paper is to recommend tests for primary care assessment of colour vision and provide guidance on the advice that can be given to patients with CVD.
METHODS
The literature on colour vision tests and the relationship between the results of the tests and performance at practical colour tasks was reviewed.
RESULTS
The colour vision tests that are most suitable for primary care clinical practice are the Ishihara test, the Richmond HRR 4th edition 2002 test, the Medmont C-100 test and the Farnsworth D15 test. These tests are quick to administer, give clear results and are easy to interpret. Tables are provided summarising how these tests should be interpreted, the advice that can be given to CVD patients on basis of the test results, and the occupations in which CVD is a handicap.
CONCLUSION
Optometrists should test the colour vision of all new patients with the Ishihara and Richmond HRR (2002) tests. Those shown to have CVD should be assessed with the Medmont C-100 test and the Farnsworth D15 test and given appropriate advice based on the test results.
Topics: Color Perception Tests; Color Vision Defects; Directive Counseling; Humans; Optometry; Practice Guidelines as Topic; Professional Practice; Vocational Guidance
PubMed: 17425762
DOI: 10.1111/j.1444-0938.2007.00135.x