scholarly journals Management of Distress in Patients with Cancer—Are We Doing the Right Thing?

2020 ◽  
Vol 54 (12) ◽  
pp. 978-984
Author(s):  
Joost Dekker ◽  
Kristi D Graves ◽  
Terry A Badger ◽  
Michael A Diefenbach
Keyword(s):  
Emotional Support ◽  
Hybrid Approach ◽  
Psychosocial Care ◽  
Evidence Base ◽  
Case Finding ◽  
Lessons Learned ◽  
Distress Screening ◽  
Underlying Assumption ◽  
Patients With Cancer ◽  
The Right

Abstract Background Screening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding. Purpose In the context of finding innovative solutions to tomorrow’s health challenges, we explore ways to optimize distress management in patients with cancer. Methods and Results We discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology. Conclusions We suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.

scholarly journals The role of implementation science in improving distress assessment and management in oncology: a commentary on “Screening for psychosocial distress among patients with cancer: implications for clinical practice, healthcare policy, and dissemination to enhance cancer survivorship”

2019 ◽  
Vol 9 (2) ◽  
pp. 292-295 ◽  
Author(s):  
Paul B Jacobsen ◽  
Wynne E Norton
Keyword(s):  
Implementation Science ◽  
Psychosocial Care ◽  
Clinical Effectiveness ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Future Research ◽  
Distress Screening ◽  
Screening Programs ◽  
Patients With Cancer ◽  
Pragmatic Clinical Trials

Abstract Despite considerable evidence that psychosocial interventions can effectively relieve distress in patients with cancer, many individuals who could benefit from these interventions do not receive them. A proposed solution to this problem is the establishment of programs in oncology settings that routinely screen for distress and refer patients for appropriate psychosocial care. This commentary addresses a review by Ehlers et al. that describes policies and procedures related to distress screening, summarizes prior research on this topic, and identifies key areas for future research. Among their major conclusions is the need for research to fill the gap in knowledge about how best to implement new distress screening programs as well as optimize the use and efficiency of existing programs. This commentary focuses on how the types of study methods, designs, and outcomes that are commonplace in implementation science to facilitate the integration of research into practice can be applied to distress screening programs. Priorities identified include designing and conducting pragmatic clinical trials, evaluating multilevel interventions, and using hybrid designs to simultaneously evaluate clinical effectiveness and barriers and facilitators of implementation. Use of these approaches holds considerable potential for developing an evidence base that can promote more widespread adoption of effective distress screening programs and inform further development of standards and policies related to the psychosocial care of patients with cancer.

scholarly journals Clinical management of emotions in patients with cancer: introducing the approach “emotional support and case finding”

2020 ◽  
Author(s):  
Joost Dekker ◽  
Jeanet Karchoud ◽  
Annemarie M J Braamse ◽  
Hilde Buiting ◽  
Inge R H M Konings ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Emotional Support ◽  
Clinical Management ◽  
Well Being ◽  
Case Finding ◽  
Health Staff ◽  
Limited Effect ◽  
Patients With Cancer

Abstract The current approach to the management of emotions in patients with cancer is “distress screening and referral for the provision of psychosocial care.” Although this approach may have certain beneficial effects, screening and referral programs have shown a limited effect on patient psychological well-being. We argue that this limited effect is due to a mismatch between patient needs and the provision of care, and that a fundamental reconceptualization of the clinical management of emotions in patients with cancer is needed. We describe the rationale and characteristics of “emotional support and case finding” as the approach to the management of emotions in patients with cancer. The two main principles of the approach are: (1) Emotional support: (a) The treating team, consisting of doctors, nurses, and allied health staff, is responsive to the emotional needs of patients with cancer and provides emotional support. (b) The treating team provides information on external sources of emotional support. (2) Case finding: The treating team identifies patients in need of mental health care by means of case finding, and provides a referral to mental health care as indicated. We present a novel perspective on how to organize the clinical management of emotions in patients with cancer. This is intended to contribute to a fruitful discussion and to inform an innovative research agenda on how to manage emotions in patients with cancer.

Leveraging the Scaling Up Nutrition Movement to Operationalize Stunting Prevention Activities: Implementation Lessons From Rural Malawi

2021 ◽  
pp. 037957212110461
Author(s):  
Stephen R. Kodish ◽  
Arghanoon Farhikhtah ◽  
Trust Mlambo ◽  
Mutinta Nseluke Hambayi ◽  
Vanessa Jones ◽  
...  
Keyword(s):  
Prevention Program ◽  
Program Planning ◽  
Scaling Up ◽  
Evidence Base ◽  
Lessons Learned ◽  
Government Policies ◽  
Team Members ◽  
High Prevalence ◽  
The Government ◽  
The Right

Background: The rural district of Ntchisi is in the central region of Malawi. Among children aged 6 to 23 months, the stunting prevalence is 40% to 50%. To address this high prevalence, the World Food Programme, with cooperating partners, supported the Government of Malawi to implement an integrated stunting prevention program entitled The Right Foods at the Right Time from 2013 to 2018. Objective: To provide implementation lessons learned from systematic documentation of how the Scaling Up Nutrition (SUN) movement, combined with other international and national initiatives and policies, was translated into tailored programming. Methods: During program conception, early design, and implementation, this descriptive study systematically documented the process of translating SUN principles and government policies into an operational stunting prevention program in rural Malawi. Results: We identified 8 factors that contributed to successful translation of policy into program activities: (1) well-structured National SUN framework, (2) reliable coordination platforms and district ownership, (3) systematic and evidence-informed program design, (4) multiple forms of data used to inform program planning, (5) multisectoral implementation approaches to stunting prevention, (6) innovation in technology to improve overall program efficiency, (7) systematic collaboration among diverse stakeholders, and (8) strong public health nutrition capacity of program team members. Conclusions: Lessons from this nutrition program in Ntchisi, Malawi, provide one case illustrating how the SUN movement, government policies, and global evidence base can be operationalized into tailored programming for improving nutrition.

Delayed Closure of Multiple Muscular Ventricular Septal Defects in an Infant after Coarctation Repair and a Hybrid Procedure�A Case Report

2011 ◽  
Vol 14 (1) ◽  
pp. 67 ◽  
Author(s):  
Ireneusz Haponiuk ◽  
Maciej Chojnicki ◽  
Radosaw Jaworski ◽  
Jacek Juciski ◽  
Mariusz Steffek ◽  
...  
Keyword(s):  
Septal Defect ◽  
Color Doppler ◽  
Hybrid Approach ◽  
Ventricular Septal Defects ◽  
Color Doppler Echocardiography ◽  
Septal Defects ◽  
Coarctation Repair ◽  
Step Procedure ◽  
The Right ◽  
Delayed Closure

There are several strategies of surgical approach for the repair of multiple muscular ventricular septal defects (mVSDs), but none leads to a fully predictable, satisfactory therapeutic outcome in infants. We followed a concept of treating multiple mVSDs consisting of a hybrid approach based on intraoperative perventricular implantation of occluding devices. In this report, we describe a 2-step procedure consisting of a final hybrid approach for multiple mVSDs in the infant following initial coarctation repair with pulmonary artery banding in the newborn. At 7 months, sternotomy and debanding were performed, the right ventricle was punctured under transesophageal echocardiographic guidance, and the 8-mm device was implanted into the septal defect. Color Doppler echocardiography results showed complete closure of all VSDs by 11 months after surgery, probably via a mechanism of a localized inflammatory response reaction, ventricular septum growth, and implant endothelization.

WITHWomen: User Centered Approach to the Design and Development of a suite of Intimate Partner Violence Screening and Safety Planning Web-Applications (Preprint)

2020 ◽  
Author(s):  
Patricia O'Campo ◽  
Alisa Velonis ◽  
Pearl Buhariwala ◽  
Janisha Kamalanathan ◽  
Maha Awaiz Hassan
Keyword(s):  
Partner Violence ◽  
Web Applications ◽  
Lessons Learned ◽  
Evidence Based ◽  
Safety Planning ◽  
Future Design ◽  
Mhealth Technology ◽  
The Right ◽  
Safe Access ◽  
Health Applications

BACKGROUND The popularity of mHealth technology has resulted in the development of numerous applications for almost every type of self-improvement or disease management. M- and e-health solutions for increasing awareness about and safety around partner violence is no exception. OBJECTIVE These applications allow women to control access to these resources and provide unlimited, and with the right design features, safe access when these resources are needed. Few applications, however, have been designed in close collaboration with intended users to ensure relevance and effectiveness. METHODS We report here on the design of a pair of evidence-based m- and e-health applications to facilitate early identification of unsafe relationship behaviors and tailored safety planning to reduce harm from violence including the methods by which we collaborated with and sought input from population of intended users. RESULTS The demographic characteristics of those who participated in the various surveys and interviews to inform the development of our screening and safety-decision support app are presented in (Table 2). CONCLUSIONS Finally, we share challenges we faced and lessons learned that might inform future design efforts of m- and e-health evidence-based applications.

scholarly journals A Human Machine Hybrid Approach for Systematic Reviews and Maps in International Development and Social Impact Sectors

Forests ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1027
Author(s):  
Murat Sartas ◽  
Sarah Cummings ◽  
Alessandra Garbero ◽  
Akmal Akramkhanov
Keyword(s):  
International Development ◽  
Systematic Reviews ◽  
Digital Literacy ◽  
Social Impact ◽  
Semantic Analysis ◽  
Hybrid Approach ◽  
Evidence Base ◽  
Societal Relevance ◽  
Lexical Databases ◽  
Very High

The international development and social impact evidence community is divided about the use of machine-centered approaches in carrying out systematic reviews and maps. While some researchers argue that machine-centered approaches such as machine learning, artificial intelligence, text mining, automated semantic analysis, and translation bots are superior to human-centered ones, others claim the opposite. We argue that a hybrid approach combining machine and human-centered elements can have higher effectiveness, efficiency, and societal relevance than either approach can achieve alone. We present how combining lexical databases with dictionaries from crowdsourced literature, using full texts instead of titles, abstracts, and keywords. Using metadata sets can significantly improve the current practices of systematic reviews and maps. Since the use of machine-centered approaches in forestry and forestry-related reviews and maps are rare, the gains in effectiveness, efficiency, and relevance can be very high for the evidence base in forestry. We also argue that the benefits from our hybrid approach will increase in time as digital literacy and better ontologies improve globally.

scholarly journals Reinforcement Learning to Send Reminders at Right Moments in Smartphone Exercise Application: A Feasibility Study

2021 ◽  
Vol 18 (11) ◽  
pp. 6059
Author(s):  
Shihan Wang ◽  
Karlijn Sporrel ◽  
Herke van Hoof ◽  
Monique Simons ◽  
Rémi D. D. de Boer ◽  
...  
Keyword(s):  
Reinforcement Learning ◽  
Physical Activities ◽  
Lessons Learned ◽  
Just In Time ◽  
Healthcare Intervention ◽  
Adaptive Intervention ◽  
Mobile Healthcare ◽  
Crucial Component ◽  
Application Data ◽  
The Right

Just-in-time adaptive intervention (JITAI) has gained attention recently and previous studies have indicated that it is an effective strategy in the field of mobile healthcare intervention. Identifying the right moment for the intervention is a crucial component. In this paper the reinforcement learning (RL) technique has been used in a smartphone exercise application to promote physical activity. This RL model determines the ‘right’ time to deliver a restricted number of notifications adaptively, with respect to users’ temporary context information (i.e., time and calendar). A four-week trial study was conducted to examine the feasibility of our model with real target users. JITAI reminders were sent by the RL model in the fourth week of the intervention, while the participants could only access the app’s other functionalities during the first 3 weeks. Eleven target users registered for this study, and the data from 7 participants using the application for 4 weeks and receiving the intervening reminders were analyzed. Not only were the reaction behaviors of users after receiving the reminders analyzed from the application data, but the user experience with the reminders was also explored in a questionnaire and exit interviews. The results show that 83.3% reminders sent at adaptive moments were able to elicit user reaction within 50 min, and 66.7% of physical activities in the intervention week were performed within 5 h of the delivery of a reminder. Our findings indicated the usability of the RL model, while the timing of the moments to deliver reminders can be further improved based on lessons learned.

scholarly journals Interdisciplinary Management of a Perforated Aneurysmal Arteria Lusoria: A Case Report

2017 ◽  
Vol 06 (01) ◽  
pp. e15-e17 ◽  
Author(s):  
Mina Rouman ◽  
Alexander Petrovitch ◽  
Eva-Maria Gey ◽  
Thomas Kuntze
Keyword(s):  
Congenital Abnormality ◽  
Hybrid Approach ◽  
Aberrant Right Subclavian Artery ◽  
Interdisciplinary Management ◽  
Pulsatile Blood Flow ◽  
Acute Bleeding ◽  
Concomitant Lesions ◽  
Arteria Lusoria ◽  
Endovascular Approach ◽  
The Right

Background An aberrant right subclavian artery (RSA) or arteria lusoria is the most common congenital abnormality of the aortic arch with an incidence of 0.3 to 3.0%. Case Description We report a case of a perforated aneurysmal aberrant RSA, managed using a hybrid approach. Conclusion In emergency cases with acute bleeding, we recommend an endovascular approach to avoid the lethal sequel of arterial leakage. Whenever possible, the pulsatile blood flow to the right arm should be restored. Management should be tailored to the nature of the aneurysmal aberrant RSA, patient's comorbidities, and concomitant lesions.

The Right to Be Right: Civil-Military Relations and the Iraq Surge Decision

2011 ◽  
Vol 35 (4) ◽  
pp. 87-125 ◽  
Author(s):  
Peter D. Feaver
Keyword(s):  
Hybrid Approach ◽  
Interesting Case ◽  
Civil Military Relations ◽  
Military Commanders ◽  
The Right ◽  
Military Relations ◽  
The Military ◽  
President Bush ◽  
Primary Problem ◽  
Better Than

President George W. Bush's Iraq surge decision in late 2006 is an interesting case for civil-military relations theory, in particular, the debate between professional supremacists and civilian supremacists over how much to defer to the military on decisions during war. The professional supremacists argue that the primary problem for civil-military relations during war is ensuring the military an adequate voice and keeping civilians from micromanaging and mismanaging matters. Civilian supremacists, in contrast, argue that the primary problem is ensuring that well-informed civilian strategic guidance is authoritatively directing key decisions, even when the military disagrees with that direction. A close reading of the available evidence—both in published accounts and in new, not-for-attribution interviews with the key players—shows that the surge decision vindicates neither camp. If President Bush had followed the professional supremacists, there would have been no surge because his key military commanders were recommending against that option. If Bush had followed the civilian supremacists to the letter, however, there might have been a revolt of the generals, causing the domestic political props under the surge to collapse. Instead, Bush's hybrid approach worked better than either ideal type would have.

Enhancing Collaboration during Humanitarian Response: An Interim Report from Stakeholders Survey

2007 ◽  
Vol 22 (5) ◽  
pp. 414-417 ◽  
Author(s):  
Shivani Parmar ◽  
Ano Lobb ◽  
Susan Purdin ◽  
Sharon McDonnell
Keyword(s):  
Working Group ◽  
Evidence Base ◽  
Lessons Learned ◽  
World Health ◽  
Interim Report ◽  
Structured Interviews ◽  
Humanitarian Response ◽  
Non Governmental Organizations ◽  
Health Organization ◽  
Coordination And Collaboration

AbstractThe effectiveness of humanitarian response efforts has long been hampered by a lack of coordination among responding organizations. The need for increased coordination and collaboration, as well as the need to better understand experiences with coordination, were recognized by participants of a multilateral Working Group convened to examine the challenges of coordination in humanitarian health responses. This preliminary study is an interim report of an ongoing survey designed by the Working Group to describe the experiences of coordination and collaboration in greater detail, including factors that promote or discourage coordination and lessons learned, and to determine whether there is support for a new consortium dedicated to coordination. To date, 30 key informants have participated in 25-minute structured interviews that were recorded and analyzed for major themes. Participants represented 21 different agencies and organizations: nine non-governmental organizations, eight academic institutions, two donor organizations, the US Centers for Disease Control and Prevention, and the World Health Organization.Common themes that emerged included the role of donors in promoting coordination, the need to build an evidence base, the frequent occurrence of field-level coordination, and the need to build new partnerships. Currently, there is no consensus that a new consortium would be helpful.Addressing the underlying structural and professional factors that currently discourage coordination may be a more effective method for enhancing coordination during humanitarian responses.

Sign in / Sign up

Export Citation Format

Share Document