scholarly journals Blood cancer caregiving during COVID-19: understanding caregivers’ needs

2021 ◽  
Vol 11 (5) ◽  
pp. 1187-1197
Author(s):  
Carla L Fisher ◽  
Kevin B Wright ◽  
Chelsea N Hampton ◽  
Taylor S Vasquez ◽  
Amanda Kastrinos ◽  
...  
Keyword(s):  
Management Strategies ◽  
Adult Child ◽  
Uncertainty Management ◽  
Supportive Services ◽  
Health Crisis ◽  
Blood Cancer ◽  
Health Promoting ◽  
Cancer Types ◽  
Caregiver Role ◽  
Cancer Caregiving

Abstract The COVID-19 pandemic likely exacerbated caregiving challenges for caregivers of parents diagnosed with a blood cancer. Providing care during a public health crisis presents a complex web of uncertainties regarding cancer care, personal health, and COVID-19 risk. Identifying caregivers’ uncertainty experiences during the COVID-19 pandemic can be a first step in learning where to direct resources or alter policies to ensure that they can not only perform their caregiver role but also cope in health-promoting ways. Using uncertainty management theory, this study explored how the pandemic has impacted adult child caregivers’ experiences caring for a parent diagnosed with a blood cancer, as well as their experiences of uncertainty and uncertainty management. As part of a larger study on blood cancer caregivers’ needs, a survey was administered from March 30 to June 1, 2020, to recruit caregivers through the Leukemia and Lymphoma Society. A qualitative and quantitative content analysis was conducted on open-ended responses from 84 caregivers. Caregivers described changes illustrating the complexity of providing care during a pandemic: (a) increased fears and uncertainty-related distress, b) reduced in-person care opportunities, (c) increased isolation, and (d) enhanced family communication. Caregivers with parents diagnosed with acute blood cancers used significantly more uncertainty management strategies and had more sources of uncertainty than caregivers with parents living with chronic blood cancer types. Findings highlight the need for supportive services to help caregivers manage uncertainty and improve their capacity to provide care in an unpredictable global health crisis. Such support may reduce poor psychosocial outcomes.

scholarly journals How Physicians Manage Medical Uncertainty: A Qualitative Study and Conceptual Taxonomy

2021 ◽  
pp. 0272989X2199234
Author(s):  
Paul K. J. Han ◽  
Tania D. Strout ◽  
Caitlin Gutheil ◽  
Carl Germann ◽  
Brian King ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Qualitative Study ◽  
Management Strategies ◽  
Acute Care Hospital ◽  
Uncertainty Management ◽  
Care Hospital ◽  
Convenience Sample ◽  
Medical Specialties ◽  
Tolerance Of Uncertainty ◽  
Medical Uncertainty

Background Medical uncertainty is a pervasive and important problem, but the strategies physicians use to manage it have not been systematically described. Objectives To explore the uncertainty management strategies employed by physicians practicing in acute-care hospital settings and to organize these strategies within a conceptual taxonomy that can guide further efforts to understand and improve physicians’ tolerance of medical uncertainty. Design Qualitative study using individual in-depth interviews. Participants Convenience sample of 22 physicians and trainees (11 attending physicians, 7 residents [postgraduate years 1–3), 4 fourth-year medical students), working within 3 medical specialties (emergency medicine, internal medicine, internal medicine–pediatrics), at a single large US teaching hospital. Measurements Semistructured interviews explored participants’ strategies for managing medical uncertainty and temporal changes in their uncertainty tolerance. Inductive qualitative analysis of audio-recorded interview transcripts was conducted to identify and categorize key themes and to develop a coherent conceptual taxonomy of uncertainty management strategies. Results Participants identified various uncertainty management strategies that differed in their primary focus: 1) ignorance-focused, 2) uncertainty-focused, 3) response-focused, and 4) relationship-focused. Ignorance- and uncertainty-focused strategies were primarily curative (aimed at reducing uncertainty), while response- and relationship-focused strategies were primarily palliative (aimed at ameliorating aversive effects of uncertainty). Several participants described a temporal evolution in their tolerance of uncertainty, which coincided with the development of greater epistemic maturity, humility, flexibility, and openness. Conclusions Physicians and physician-trainees employ a variety of uncertainty management strategies focused on different goals, and their tolerance of uncertainty evolves with the development of several key capacities. More work is needed to understand and improve the management of medical uncertainty by physicians, and a conceptual taxonomy can provide a useful organizing framework for this work.

Women Caring for Retired Men: A Continuation of Inequality in the Sport Marriage

2020 ◽  
pp. 1-9
Author(s):  
Steven M. Ortiz
Keyword(s):  
Gender Inequality ◽  
Emotional Health ◽  
Management Strategies ◽  
Self Management ◽  
Use Of Self ◽  
Health Issues ◽  
Women's Voices ◽  
Continued Use ◽  
Caregiver Role ◽  
Longitudinal Qualitative Research

Drawing from longitudinal qualitative research on the heteronormative sport marriage that primarily featured interviews with women married to male professional athletes, this article focuses on how women were affected by and managed their retired husbands’ physical and mental–emotional health issues. It explores the women’s continued use of self-management strategies they developed during their husband’s career as they offered increasingly challenging care work to their husbands and examines how long-held expectations about their caregiver role continued to contribute to post-career gender inequality in their marriages. It captures the women’s voices as they discovered that they were not sufficiently prepared for the emerging personal and relational complexities that emerged in retirement.

scholarly journals Oxidative Stress and Marine Carotenoids: Application by Using Nanoformulations

Marine Drugs ◽  
2020 ◽  
Vol 18 (8) ◽  
pp. 423 ◽  
Author(s):  
Yasin Genç ◽  
Hilal Bardakci ◽  
Çiğdem Yücel ◽  
Gökçe Şeker Karatoprak ◽  
Esra Küpeli Akkol ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Properties ◽  
Chemical Diversity ◽  
Biologically Active ◽  
Bioactive Molecules ◽  
Photosynthetic Organisms ◽  
Stress Markers ◽  
Potential Applications ◽  
Health Promoting ◽  
Cancer Types

Carotenoids are natural fat-soluble pigments synthesized by plants, algae, fungi and microorganisms. They are responsible for the coloration of different photosynthetic organisms. Although they play a role in photosynthesis, they are also present in non-photosynthetic plant tissues, fungi, and bacteria. These metabolites have mainly been used in food, cosmetics, and the pharmaceutical industry. In addition to their utilization as pigmentation, they have significant therapeutically applications, such as improving immune system and preventing neurodegenerative diseases. Primarily, they have attracted attention due to their antioxidant activity. Several statistical investigations indicated an association between the use of carotenoids in diets and a decreased incidence of cancer types, suggesting the antioxidant properties of these compounds as an important factor in the scope of the studies against oxidative stress. Unusual marine environments are associated with a great chemical diversity, resulting in novel bioactive molecules. Thus, marine organisms may represent an important source of novel biologically active substances for the development of therapeutics. Marine carotenoids (astaxanthin, fucoxanthin, β-carotene, lutein but also the rare siphonaxanthin, sioxanthin, and myxol) have recently shown antioxidant properties in reducing oxidative stress markers. Numerous of bioactive compounds such as marine carotenoids have low stability, are poorly absorbed, and own very limited bioavailability. The new technique is nanoencapsulation, which can be used to preserve marine carotenoids and their original properties during processing, storage, improve their physiochemical properties and increase their health-promoting effects. This review aims to describe the role of marine carotenoids, their potential applications and different types of advanced nanoformulations preventing and treating oxidative stress related disorders.

scholarly journals Conceptualizing the ‘whole university’ approach: an international qualitative study

2019 ◽  
Vol 35 (4) ◽  
pp. 730-740 ◽  
Author(s):  
Mark Dooris ◽  
Sue Powell ◽  
Alan Farrier
Keyword(s):  
Qualitative Study ◽  
Mental Health Crisis ◽  
Structured Interviews ◽  
Single Issue ◽  
Health Crisis ◽  
Global Movement ◽  
Health Promoting ◽  
Vice Chancellors ◽  
The Uk ◽  
Health Promoting University

Abstract Focusing on the conceptualization of a whole university approach, this paper reports on an international qualitative study that explored vice-chancellors’ and network members’ understanding of and commitment to Health Promoting Universities, examined perspectives on leadership and investigated the Okanagan Charter’s potential to catalyse whole university leadership and change. A multi-method qualitative approach was used: semi-structured interviews and focus groups were conducted face-to-face with vice-chancellors (n = 12) and Health Promoting University co-ordinators who were members of the UK Healthy Universities Network (n = 8); telephone interviews were conducted with a mix of UK and non-UK Health Promoting University co-ordinators (n = 5) and two online questionnaires were distributed to non-UK network co-ordinators (n = 6) and non-UK Health Promoting University co-ordinators (n = 10). Through thematic analysis, a number of key themes emerged that build a new conceptualization of the whole university approach (see Figure 1): building a broad understanding and framing of health; developing a supportive ethos and culture; embedding health into the university and joining up areas of work; focusing on the whole population and facing challenges and seizing opportunities. The study elicited rich and wide-ranging views from multiple stakeholders from universities and networks across four continents, confirming Health Promoting Universities as a truly global movement. Looking ahead, there are clear opportunities and challenges. First, the media narrative of a student mental health ‘crisis’ has focused universities’ attention on ‘health’, but from a single issue ‘illness’ perspective. This risks detracting from the whole system Health Promoting Universities approach. Second, even with the Okanagan Charter inspiring individuals and universities, there are still major challenges in translating the rhetoric of whole system approaches into meaningful action within large, complex and culturally diverse organizations.

Uncertainty management strategies and the export performance of cultural goods: The case of the Korean movie industry from 2000 to 2004

2013 ◽  
Vol 19 (6) ◽  
pp. 689-705
Author(s):  
Sunhyuk Kim
Keyword(s):  
Vertical Integration ◽  
Export Performance ◽  
Management Strategies ◽  
Uncertainty Management ◽  
Movie Industry ◽  
Cultural Industry ◽  
Cultural Goods ◽  
Inherent Characteristic ◽  
Market Signaling

AbstractUncertainty, which is an inherent characteristic of cultural industry in the sense that no one can accurately predict the success or failure of cultural goods, increases greatly when organizations export cultural goods overseas. Then, when exporting cultural goods, how can organizations manage the risks of uncertainty to improve their export performance? Focusing on the case of the Korean movie industry, this study shows that strategies such as market signaling, generalist strategy and vertical integration can contribute to improving the export performance of movies, and thereby help organizations effectively manage the risks of uncertainty arising from the export of movies. For the analysis, this study uses the data of all Korean movies released from 2000 to 2004, and analyzes them on the basis of negative binominal regression. The findings of this study help us understand what strategies are needed for organizations in cultural industry to manage the risks of uncertainty arising from the export of cultural goods.

Uncertainty management strategies: Lessons from the regional implementation of the Water Framework Directive in the Netherlands

2011 ◽  
Vol 14 (1) ◽  
pp. 64-75 ◽  
Author(s):  
G.T. Raadgever ◽  
C. Dieperink ◽  
P.P.J. Driessen ◽  
A.A.H. Smit ◽  
H.F.M.W. van Rijswick
Keyword(s):  
The Netherlands ◽  
Water Framework Directive ◽  
Management Strategies ◽  
Uncertainty Management

scholarly journals How our homes impact our health: using a COVID-19 informed approach to examine urban apartment housing

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Terri Peters ◽  
Anna Halleran
Keyword(s):  
Quality Of Life ◽  
Natural Ventilation ◽  
Environmental Design ◽  
Design Principles ◽  
Health Crisis ◽  
Content Type ◽  
Housing Design ◽  
High Rise ◽  
Health Promoting

PurposeThe COVID-19 global health crisis is undeniably a global housing crisis. Our study focuses on quality of life in urban mid- and high-rise apartment housing, the fastest growing housing types in many cities around the world. This housing typology presents unique challenges relating to connection to nature, daylight and fresh air.Design/methodology/approachThis multi-disciplinary literature review analyzes more than 100 published papers from peer-reviewed sources from environmental psychology, building science and architecture relevant to quality of life in high-rise housing, as well as more than 40 recent newspaper and magazine articles about the possible impacts of COVID-19 on housing. We identify synergies between passive design strategies and health-promoting architecture or “restorative environmental design” principles.FindingsPost-pandemic, health-promoting apartment housing design must prioritize (1) window placement and views that support stress recovery and restoration; (2) lighting levels based on spaces that can satisfy multiple uses and users; (3) bedrooms designed for restful sleep that contribute to circadian regulation; (4) living rooms with better indoor air quality, with a focus on natural ventilation; (5) access to nature, through the purposeful design of balconies and (6) unit sizes and layouts that enable physical distancing and prevent crowding.Originality/valueWe identify new social and environmental design priorities in the form of evidence-based design principles to inform and promote healthy and restorative living environments for residents in apartment housing.

scholarly journals INCLUDING FAMILY CAREGIVERS IN SERIOUSLY ILL VETERANS' CARE: A MIXED-METHODS STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S207-S207
Author(s):  
Nina R Sperber ◽  
Nathan A Boucher ◽  
Roxana Delgado ◽  
Megan Shepherd-Banigan ◽  
Kevin McKenna ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Mixed Methods Study ◽  
Veterans Administration ◽  
Supportive Services ◽  
Community Based ◽  
Definition Of ◽  
Caregiver Role ◽  
Seriously Ill ◽  
Formal Recognition ◽  
Caregiver Capacity

Abstract Family caregivers often serve as unpaid members of the home- and community-based care workforce for individuals with serious illness; as key partners in the home-clinic continuum, they should be included in healthcare teams. Without formal recognition, inconsistent identification of caregivers will remain, engendering communication gaps between caregivers and providers and difficulty connecting with supportive services. The Campaign for Inclusive Care is an initiative within the Veterans Administration Health Care System to improve practices for including caregivers in treatment planning and decisions. We define inclusive care using literature review, provider interviews, and a caregiver survey. We found that inclusive care involves clear definition of caregiver role, system policies for inclusion, assessment of caregiver capacity, explicit involvement of caregivers, and mutuality in caregiver/provider communication. We recommend solutions based on the definition, informative for development of a national caregiver strategy, required by the 2018 Recognize, Assist, Include, Support, and Engage Family Caregivers Act.

Current advances in novel SARS-CoV-2 disease (COVID-19) treatment and intervention strategies

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Mohammad Khalid Parvez ◽  
Kartika Padhan
Keyword(s):  
Clinical Trials ◽  
Ebola Virus ◽  
Management Strategies ◽  
Intervention Strategies ◽  
Phase Iii ◽  
World Health ◽  
Plasma Therapy ◽  
Health Crisis ◽  
Vaccine Candidates ◽  
Poor Countries

Background: Down the seven months of the novel SARS-CoV-2 disease (COVID-19) outbreak in China and its global spread, there is a remarkable understanding of its epidemiology, pathobiology and clinical management strategies. While countering a heavy toll on health and economy, world’s regional authorities are enforcing safety guidelines and providing patient care. Currently, there is no globally approved treatment or intervention for COVID-19. Methods: A structured online literature search for peer-reviewed articles was conducted on the PubMed, Europe PMC, Google, WHO, CDC, FDA and ClinicalTrials portals, using phrases such as COVID-19 treatment and intervention, COVID-19 drugs and COVID-19 vaccines. Results: Analysis of the retrieved data showed that as a part of ‘Solidarity Clinical Trials’, hundreds of treatment and intervention strategies, including antiviral drugs, cytokine antagonists, convalescent plasma therapy and vaccine candidates have been registered, worldwide. Of these, while remdesivir the anti-Ebola virus drug has been granted approval as ‘emergency use’ drug in USA, favipiravir, the anti-flu drug has been recently approved in Russia. Tocilizumab and sarilumab, the cytokine (IL-6) antagonists have entered Phase-II/III clinical trials in hospitalized COVID-19 patients. Among the leading vaccine candidates, an mRNA-1273 vaccine along with Pfizer mRNA candidate and Oxford ChAdOx1vaccine have entered Phase-III trial. Conclusion: The world health authorities have strongly and quickly responded to COVID-19 pandemic. Nonetheless, it is imperative for world bodies to unite in combating this health crisis by developing costeffective drugs and vaccines, and making them accessible to resource-poor countries.

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