Objective
Breast cancer is the most commonly diagnosed cancer in women across the world. The majority of women diagnosed with the disease undergo surgery, which is often associated with significant ...psychosocial morbidity. The aim of this meta‐analysis was to identify the efficacy of psychosocial interventions for women following breast cancer surgery.
Method
A comprehensive literature search was undertaken using keyword and subject headings within 7 databases. Included studies employed a quantitative methodology presenting empirical findings focusing on interventions for female breast cancer patients following surgery.
Results
Thirty‐two studies were included and based on conventional values of effect sizes. Small effects emerged for the efficacy of psychosocial interventions in relation to anxiety (Hedges g = 0.31), depression (0.38), quality of life (0.40), mood disturbance (0.31), distress (0.27), body image (0.40), self‐esteem (0.35), and sexual functioning (0.22). A moderate to large effect emerged for the efficacy of interventions in promoting improvements in sleep disturbance (0.67). Clear evidence emerged for the efficacy of cognitive behavioral therapy in promoting improvements in anxiety, depression, and quality of life.
Conclusion
This is the first meta‐analysis to demonstrate the efficacy of interventions on a range of psychosocial outcomes following breast cancer surgery. The meta‐analysis highlighted that cognitive behavioral therapy was consistently the most effective psychosocial intervention promoting improvements in anxiety, depression, and quality of life. However, there are shortcomings in existing studies; the length of the follow‐up period is typically short and the generalizability of findings was limited by small samples, both of which should be addressed in future studies.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Over 600 RCTs have demonstrated the effectiveness of psychosocial interventions for children and young people's mental health, but little is known about the long-term outcomes. This systematic review ...sought to establish whether the effects of selective and indicated interventions were sustained at 12 months.
We conducted a systematic review and meta-analysis focusing on studies reporting medium term outcomes (12 months after end of intervention).
We identified 138 trials with 12-month follow-up data, yielding 165 comparisons, 99 of which also reported outcomes at end of intervention, yielding 117 comparisons. We found evidence of effect relative to control at end of intervention (K = 115, g = 0.39; 95% CI: 0.30-0.47 I2 = 84.19%, N = 13,982) which was maintained at 12 months (K = 165, g = 0.31, CI: 0.25-0.37, I2 = 77.35%, N = 25,652) across a range of diagnostic groups. We explored the impact of potential moderators on outcome, including modality, format and intensity of intervention, selective or indicated intervention, site of delivery, professional/para-professional and fidelity of delivery. We assessed both risk of study bias and publication bias.
Psychosocial interventions provided in a range of settings by professionals and paraprofessionals can deliver lasting benefits. High levels of heterogeneity, moderate to high risk of bias for most studies and evidence of publication bias require caution in interpreting the results. Lack of studies in diagnostic groups such as ADHD and self-harm limit the conclusions that can be drawn. Programmes that increase such interventions' availability are justified by the benefits to children and young people and the decreased likelihood of disorder in adulthood.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The exquisite sensitivity of Raman spectroscopy for detecting the biomolecular changes in skin cancer has previously been explored, however, this mostly required analysis on excised tissue samples ...using bulky, immobile laboratory instrumentation. In this study the technique was translated for clinical use with a portable Raman system and customized fibre optic probe and applied to differentiation of skin cancers from benign lesions and inflammatory dermatoses. The aim was to provide an easy-to-use, easy-to-manage assessment tool for clinicians to use in their daily patient examination routine to perform rapid Raman measurements of skin lesions in vivo. Using this system, more than 867 spectra were measured in vivo from 330 patients of a wide variety of different benign (n=603) skin lesions, inflammatory dermatoses (n=140) and skin cancers (n=124). Ethnicities represented were 70% European, 16% Asian, 6% Māori, 5% Pacific people and 4% Middle east, Latin American and African. Accurate differentiation of skin cancers from benign lesions and inflammatory dermatoses was achieved using PLS-DA (partial least squares discriminant analysis), with AUC (area under curve) for the ROC (receiver operator curves) for external validation sets ranging from 0.916 to 0.958. This study shows evidence for robust clinical translation of Raman spectroscopy for rapid, accurate diagnosis of skin cancer.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background
Previous qualitative research suggests that university students feel that current service provision does not meet their needs. Exploring the reasons for this may help to promote service ...change, encourage the uptake of care, improve outcomes and increase satisfaction within university services.
Aims
This study aimed to improve the understanding of how students experience the process of accessing and using mental health support, barriers and facilitators to treatment, and how students would adapt provision to improve experiences.
Method
Semi-structured interviews were conducted with 16 full-time students who had used mental health services at university. Data were analysed using thematic analysis.
Results
Five higher-order themes were identified: personalisation and informed choice, simplifying the process, feeling abandoned ignored or invisible, stigma, and superiority of private and external services. Sixteen subthemes were identified within these themes.
Conclusions
Findings indicate that access to mental health support should be simplified, with collaboration across university and external health and care services, to prevent students feeling lost or abandoned when seeking care. An inclusive approach to support access and provision of services for all presentations of mental health problems should be developed.
Introduction
Clinical settings are being encouraged to identify and address patients’ social needs within the clinic or through partner organizations. The purpose of this qualitative study was to ...describe the current practice of social needs-targeted care in 3 Texas safety net clinics, and facilitators and barriers to adopting new social needs-targeted care tools and practices.
Methods
Interviews were conducted with staff at 3 safety net clinics serving small and mid-sized communities. Analysis focused on perspectives and decisions around adopting new tools or practices related to social needs-targeted care, including standardized screening tools and community resource referral platforms.
Results
Nine staff across 3 organizations were interviewed. Two organizations were currently using a standard social needs screening tool in their routine practice, and a third was considering doing so. One organization had adopted a community resource referral platform in partnership with a large community collaboration. Three case studies illustrate a range of facilitators, barriers, perceived benefits, and drawbacks influencing social needs-targeted practices. Benefits of systematic data collection on social needs included the generation of data for community action. Drawbacks include concerns about data privacy. Community resource referral platforms were seen as valuable for creating accountability, but required an influential community partner and adequate community resources. Concerns about disempowering clients and blurring roles were voiced, and potential to increase provider job satisfaction was identified.
Conclusions
Benefits and drawbacks of adopting new tools and practices related to social needs-targeted care are strongly influenced by the community context. For the adoption of community resource referral platforms, the outer setting is particularly relevant; adoption readiness is best assessed at the community or regional level rather than the clinic system level. While screening tools are much easier than referral platforms for clinics to adopt, the ability to address identified needs remains heavily based on the outer setting.
Raman spectroscopy has long been suggested as a potentially fast and sensitive method to monitor phytoplankton abundance and composition in marine environments. However, the pitfalls of visible ...detection methods in pigment-rich biological material and the complexity of their spectra have hindered their application as reliable in situ detection methods. In this study we combine 1064 nm confocal Raman spectroscopy with multivariate statistical analysis techniques (principle component analysis and partial leas-squares discriminant analysis) to reliably measure differences in the cell viability of a diatom species (Chaetoceros muelleri) and two haptophyte species (Diacronema lutheri and Tisochrysis lutea) of phytoplankton. The low fluorescence background due to this combined approach of NIR Raman spectroscopy and multivariate data analysis allowed small changes in the overall spectral profiles to be reliably monitored, enabling the identification of the specific spectral features that could classify cells as viable or nonviable regardless of their species. The most significant differences upon cell death were shown by characteristic shifts in the carotenoid bands at 1527 and 1158 cm–1. The contributions from other biomolecules were less pronounced but revealed changes that could be identified using this combination of techniques.
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IJS, KILJ, NUK, PNG, UL, UM, UPUK
Aims
The aim of this study was to explore breast cancer patients’ experiences during survivorship. Particular attention is given to the role of specialist breast care nurses in supporting women ...throughout this phase.
Background
There is a relative lack of research involving long‐term breast cancer survivors. Yet, many survivors experience substantial psychosocial and iatrogenic harms created by diagnosis, symptoms of disease and treatment. A more comprehensive understanding may assist in supporting the needs of breast cancer survivors.
Design
An exploratory qualitative approach was used to collect data on breast cancer survivors’ experiences during 2013.
Methods
Semi‐structured interview data were collected from seven British women aged 38–80 years exploring the support received during survivorship. Data were analysed using Interpretive Phenomenological Analysis.
Findings
Breast cancer survivors perceived a systemic absence in support from oncology teams and rapid deterioration of support from personal support networks. Despite this, survivors were able to find benefits from the cancer experience. This allowed for adjustment and enabled patients to assume a new identity as a breast cancer survivor. We recommend specialist breast care nurses would be suitably placed to provide extended support allowing for a salient transition from treatment to survivorship.
Conclusion
This study yields insights into breast cancer survivorship and specifically the role of specialist breast care nurses. Given the growing cohort of breast cancer survivors and the increased importance on promoting and supporting optimal psychosocial adjustment, we advise the cost‐effectiveness of providing continuing nursing support and the mode of administration requires further research.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
This essay engages with life writing in Janet Frame's 1957 novel, Owls Do Cry and Jane Campion's 1990 film biopic of Frame's autobiographies, An Angel At My Table. It aims to consider the physical ...and socio-political constraints on women's writing, and how these may be deconstructed through non-conventional forms of intellectual exploration. Communication between women is explored in the formats used in both Frame's novel and Campion's film. With a primary focus on letter writing, this essay also considers diary entries, published literary work, the film text, and silence as areas of interest. This essay employs the form of letter writing in attempt to explore the medium used by Frame and the characters in Owls Do Cry as an alternative form of intellectual scholarly practice. In doing so, it aims to consider Frame's literary legacy as a paradigm for academic study, in which women's varied creative practices can be considered for academic exploration. The letter form also signifies an attempt to recontextualise the letter form, in order to compare the constraints on women's writing in 1940s and 1950s New Zealand with twenty-first-century concerns about gender equality in academia and creative writing.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Aim
To extend our understanding of how healthcare assistants construct and manage demanding situations in a secure mental health setting and to explore the effects on their health and well‐being, to ...provide recommendations for enhanced support.
Background
Contemporary literature acknowledges high rates of occupational stress and burnout among healthcare assistants, suggesting the context in which they work places them at elevated risk of physical harm and psychological distress. Yet, there is a deficit of qualitative research exploring the experiences of healthcare assistants in adolescent inpatient facilities.
Design
An exploratory multi‐method qualitative approach was used to collect data about the challenges faced by healthcare assistants working on secure adolescent mental health wards in an independent hospital during 2014.
Method
Fifteen sets of data were collected. Ten participants completed diary entries and five participants were also interviewed allowing for triangulation. Data were analysed using Interpretive Phenomenological Analysis.
Findings
The findings illustrated how inpatient mental healthcare is a unique and distinctive area of nursing, where disturbing behaviour is often normalized and detached from the outside world. Healthcare assistants often experienced tension between their personal moral code which orientate them towards empathy and support and the emotional detachment and control expected by the organization, contributing to burnout and moral distress.
Conclusions
This study yielded insights into mental health nursing and specifically the phenomenon of moral distress. Given the ever‐increasing demand for healthcare professionals, the effects of moral distress on both the lives of healthcare assistants and patient care, merits further study.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Chop, DelRio, and GrandSlam are phage with a
morphotype isolated from soil in Arkansas using the host Gordonia terrae 3612. All three are temperate, and their genomes share at least 96% nucleotide ...identity. These phage are assigned to cluster DI based on gene content similarity to other sequenced actinobacteriophage.
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