scholarly journals A qualitative study of dietary discussions as an emerging task for cancer clinicians

2016 ◽  
Vol 4 ◽  
pp. 205031211666593 ◽  
Author(s):  
Katherine C Smith ◽  
Kisha I Coa ◽  
Ann C Klassen
Keyword(s):  
Health Promotion ◽  
Cancer Care ◽  
Dietary Change ◽  
System Capacity ◽  
Clinical Expertise ◽  
Snowball Sampling ◽  
Medical Systems ◽  
Provider Type ◽  
Dietary Counseling ◽  
The Impact

Objectives: Improvements in cancer detection and treatment create a need for care that prioritizes acute treatment and ongoing needs. There have been calls to include health promotion in cancer care, but little empirical consideration of the work involved in such an expansion of services. In this article, we adopt a constructionist position to explore clinicians’ perspectives on capacity for health promotion, specifically dietary counseling. Methods: Our data result from 33 semi-structured qualitative interviews with members of cancer care teams. All interviewees were affiliated with one of two contrasting medical systems located in Baltimore, MD, USA. Interviews focused on professional roles and responsibilities around health promotion for cancer survivors. We employed both purposive and snowball sampling. We conducted a thematic analysis informed by the sociology of professions literature of discussions of dietary change by provider type. Results: We discuss four emergent themes that relate to the work of providing dietary counseling: (1) prioritization of behavior change in survivorship care, (2) evidence base for dietary messaging, (3) available time and clinical priorities and (4) clinical expertise. Interviewees generally expressed support for the importance of diet for healthy cancer survivorship. However, while there was broad support for dietary change and health promotion, we found little evidence of an emerging consensus on how this work should be accomplished, nor an indication of any occupational group expanding their professional remit to prioritize health promotion tasks. Conclusions: Health promotion is the key to any efficient and effective model of cancer care. Careful attention to the impact of the task on key patient outcomes as well as system capacity for the provision of dietary counseling and its fit with a specific professional remit will be critical for successful integration of health promotion into routine cancer care.

Establishing the need for provider education on cancer and nutrition (PECAN): Survey results on nutrition practices at a large community oncology practice.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 49-49
Author(s):  
Karen Smith ◽  
Lance Ortega ◽  
Lalan S. Wilfong ◽  
Sabrina Q. Mikan ◽  
John F. Sandbach ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Cancer Care ◽  
Screening Tool ◽  
Community Practice ◽  
Provider Education ◽  
Provider Type ◽  
Large Community ◽  
Nutrition Practices ◽  
Oncology Practice ◽  
The Impact

49 Background: Oncology providers and patients benefit from evidence-based nutritional resources to support cancer care. For patients, proper nutrition care can prevent inappropriate weight loss, improve treatment tolerance, and improve quality of life. Recent literature has noted the lack of both adequate dietitian resources at outpatient centers and comprehensive nutrition guidelines in cancer care. At a large community practice with 210 locations across Texas and Oklahoma, a survey was developed and administered to assess nutrition practices. Methods: Clinic directors in the practice completed a survey to assess for the presence or absence of a malnutrition screen; how nutrition concerns are addressed; and the availability of a dietitian. Results: A total of 26 responses detailed the nutrition processes at 50 unique locations. At 37 (74%) locations, a malnutrition screening tool was utilized and of these, 30 (81%) locations reported utilizing the Malnutrition Screening Tool (MST), a brief, validated tool for outpatient settings including oncology. Seven (19%) sites did not specify what tool was used. Of the clinics that reported completing a malnutrition screen for patients, the screen was completed by the advanced practice provider (APP)/physician in 18 (49%) clinics, a nurse in 4 (11%) clinics, a dietitian in 4 (11%) clinics and a medical assistant in 1 (3%) clinic. At 10 sites more than one provider type was responsible for completing the screen. Nutrition issues were addressed by physicians, APPs, and nurses in 15 (50%), 35 (70%), and 9 (14%) sites respectively (see table). Twenty-two locations (44%) reported referring patients to a dietitian and 10 sites (20%) had a dietitian available in clinic. Forty-one (82%) clinics employed more than one method for addressing nutrition issues. Sixteen of 26 respondents (62%) reported that increased dietitian access would be helpful; this included respondents whose locations already had a dietitian available. Conclusions: Overall, 74% of reporting locations used a malnutrition screening tool and 20% had access to a dietitian on site. Forty-four percent of sites referred to a dietitian if there was a need. This indicates that multiple providers are involved in the nutritional care of oncology patients. In response to these findings, the multidisciplinary PECAN Taskforce was created to develop comprehensive malnutrition screening, implement a referral process for all at-risk patients, enhance nutrition education, and expand dietitian services. Further study will measure the impact of expanded nutrition access on patient outcomes.[Table: see text]

Engagement, Innovation, and Impact in a Dietitian Contact Centre: The EatRight Ontario Experience

2020 ◽  
Vol 81 (3) ◽  
pp. 106-111
Author(s):  
Cameron D. Norman ◽  
Helen Haresign ◽  
Barry Forer ◽  
Christine Mehling ◽  
Judith Krajnak ◽  
...  
Keyword(s):  
Health Promotion ◽  
Healthy Eating ◽  
Professional Support ◽  
Service Access ◽  
Nutritional Knowledge ◽  
Dietary Changes ◽  
The Public ◽  
Contact Centre ◽  
The Impact

Purpose: EatRight Ontario (ERO), a multi-modal dietitian service (phone, email, web), provided the public and health intermediaries with healthy eating advice, professional support, and health promotion tools from 2007 to 2018. An evaluation of ERO was conducted to assess the impact of the model on knowledge, attitudes, and behaviour for consumers, utilization, and support levels and satisfaction provided to health intermediaries. Methods: Consumer clients were sent a survey 1–4 weeks after using the ERO service to capture self-reported dietary changes, intentions, nutritional knowledge, and satisfaction. Health intermediaries were recruited through an electronic ERO newsletter and asked about how ERO supported their practice. Results: Of the 867 consumer respondents, 92% had either made a change or indicated that information from ERO confirmed their present behaviour, and 96% indicated they would recommend the services to others. Of the 337 health intermediaries who responded 71% indicated that ERO provided services they could not deliver. Conclusions: ERO’s multi-modal dietitian contact centre provides a model for implementing successful remote service access for consumers and professionals to support healthy eating across diverse demographics and geographies, including those in geographically underserved areas.

Role of Nutraceuticals in Health Promotion and Disease Prevention: A Review in the Indian Context

2020 ◽  
Vol 19 (2) ◽  
pp. 139-145
Author(s):  
Sheena Chhabra ◽  
Apurva Bakshi ◽  
Ravineet Kaur
Keyword(s):  
Health Promotion ◽  
Disease Prevention ◽  
Human Health ◽  
Health Issues ◽  
Scholarly Literature ◽  
Indian Context ◽  
The Impact ◽  
Immense Potential ◽  
Specific Health

Nutraceuticals have been around for quite some time. As the nomenclature suggests, they are placed somewhere between food (nutra-) and medicine (-ceuticals) in terms of their impact on human health. Researches have focused on the impact of various types of nutraceuticals on health, their efficacy in health promotion and disease prevention, and often on suitable uses of certain categories of nutraceuticals for specific health issues. However, we are still far from utilizing the immense potential of nutraceuticals for benefiting human health in a substantial manner. We review the available scholarly literature regarding the role of nutraceuticals in health promotion, their efficacy in disease prevention and the perception of nutraceuticals' health benefits by consumers. Thereafter we analyze the need for regulation of nutraceuticals and various provisions regarding the same.

scholarly journals Availability of Services and Caregiver Burden: Supporting Individuals With Neurogenetic Conditions During the COVID-19 Pandemic

2021 ◽  
pp. 088307382110012
Author(s):  
Michelle Kowanda ◽  
Lindsey Cartner ◽  
Catherine Kentros ◽  
Alexa R. Geltzeiler ◽  
Kaitlyn E. Singer ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Educational Programs ◽  
Medical Systems ◽  
Medical Needs ◽  
Neurodevelopmental Disabilities ◽  
Delivery Of Services ◽  
The Impact ◽  
The Relationship

Because of the COVID-19 pandemic, in-person services for individuals with neurodevelopmental disabilities were disrupted globally, resulting in a transition to remote delivery of services and therapies. For individuals with neurogenetic conditions, reliance on nonclinical caregivers to facilitate all therapies and care was unprecedented. The study aimed to (1) describe caregivers’ reported impact on their dependent’s services, therapies, medical needs, and impact on themselves as a result of the COVID-19 pandemic and (2) assess the relationship between the extent of disruption of services and the degree of self-reported caregiver burden. Two online questionnaires were completed by caregivers participating in Simons Searchlight in April and May 2020. Surveys were completed by caregivers of children or dependent adults with neurodevelopmental genetic conditions in Simons Searchlight. Caregivers reported that the impact of the COVID-19 pandemic moderately or severely disrupted services, therapies, or medical supports. The majority of caregivers were responsible for providing some aspect of therapy. Caregivers reported “feeling stressed but able to deal with problems as they arise,” and reported lower anxiety at follow-up. Caregivers reported that telehealth services were not meeting the needs of those with complex medical needs. Future surveys will assess if and how medical systems, educational programs, therapists, and caregivers adapt to the challenges arising during the COVID-19 pandemic.

The impact of COVID-19 quarantine measures on the mental health of families

2021 ◽  
pp. 146801732110117
Author(s):  
Fakir Al Gharaibeh ◽  
Laura Gibson
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Digital Media ◽  
Mental Health Problems ◽  
Eating Habits ◽  
Strong Shock ◽  
Psychosocial Interventions ◽  
Snowball Sampling ◽  
Long Term Effects ◽  
The Impact

Summary COVID-19 is shaping all aspects of life throughout the world. The unexpected number of people who have been infected with and died from coronavirus disease (COVID-19) is evidence that the pandemic has affected families and societies. The strong shock wave that has resulted in the international response has focused more on medical rather than psychosocial interventions. Little has been written or studied about the impact of COVID-19 on families. This article explores the impact of the COVID-19 quarantine on the mental health of families. We conducted 20 in-depth interviews with Jordanian families through snowball sampling. Findings The results show that 20 interviewees described varied and new experiences. Many of the families we interviewed displayed symptoms of mental health problems, including disrupted sleep patterns, changes in eating habits, excessive digital media use, anxiety, depression, excessive smoking, stomach aches, bedwetting among children, and persistent headaches. The study also demonstrated the psychological stress partners felt during the lockdown due to their worries about job security. They also communicated their hope that renewed family commitments might bring more stability to their relationships. During the lockdown, family members spent more time together, and it became harder to conceal any issues from each other. Applications The findings of this research demonstrate a critical need for social workers, and it is hoped that future legislation will include a role for social workers in various fields of crisis. Moreover, social workers should encourage families to ask for intervention to overcome the long-term effects that may result from COVID-19.

scholarly journals Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

2021 ◽  
pp. 1-11
Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan
Keyword(s):  
Cancer Care ◽  
Healthcare Professionals ◽  
Negative Impact ◽  
System Level ◽  
Care Continuum ◽  
Cancer Services ◽  
Number Of Patients ◽  
Prevention Programmes ◽  
Screening And Prevention ◽  
The Impact

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.

Building Evidence to Prevent Childhood Obesity: Lessons from the Portland Healthy Eating Active Living (Heal) Coalition

2009 ◽  
Vol 31 (4) ◽  
pp. 21-26 ◽  
Author(s):  
Margaret Everett ◽  
Angie Mejia ◽  
Olivia Quiroz
Keyword(s):  
Health Promotion ◽  
Childhood Obesity ◽  
Healthy Eating ◽  
Ecological Model ◽  
Health Promotion Program ◽  
Grocery Stores ◽  
Active Living ◽  
Healthy Foods ◽  
Social Scientists ◽  
The Impact

The Healthy Eating Active Living (HEAL) Coalition is a community-based health promotion program begun in 2006 in North Portland's Portsmouth neighborhood. The program seeks to promote community health and prevent childhood obesity by addressing barriers at local, regional and policy levels, with particular attention to the built environment. This article describes the findings of a program evaluation based on interviews with school staff and Latino parents. Important themes include the impact of the closure of a neighborhood school, access to grocery stores with affordable healthy foods, and concern about school meals. The comprehensive approach of programs like HEAL, which uses the socio-ecological model of health promotion, lends itself well to the participation of applied social scientists.

scholarly journals Systematic Review of Intervention Studies Aiming at Reducing Inequality in Dental Caries among Children

2021 ◽  
Vol 18 (3) ◽  
pp. 1300
Author(s):  
Anqi Shen ◽  
Eduardo Bernabé ◽  
Wael Sabbah
Keyword(s):  
Health Promotion ◽  
Dental Caries ◽  
Intervention Studies ◽  
Preventive Intervention ◽  
Socioeconomic Inequalities ◽  
Cochrane Library ◽  
Water Fluoridation ◽  
Qualitative Synthesis ◽  
Oral Health Promotion ◽  
The Impact

(1) Background: The objective is to systematically review the evidence on intervention programs aiming at reducing inequality in dental caries among children. (2) Methods: Two independent investigators searched MEDLINE, Cochrane library, and Ovid up to December 2020 to identify intervention studies assessing the impact on socioeconomic inequalities in dental caries among children. The interventions included any health promotion/preventive intervention aiming at reducing caries among children across different socioeconomic groups. Comparison groups included children with alternative or no intervention. Cochrane criteria were used to assess interventional studies for risk of bias. (3) Results: After removal of duplicate studies, 1235 articles were retained. Out of 43 relevant papers, 13 articles were identified and used in qualitative synthesis, and reported quantifiable outcomes. The included studies varied in measurements of interventions, sample size, age groups, and follow-up time. Five studies assessed oral health promotion or health-education, four assessed topical fluorides, and four assessed water fluoridation. Interventions targeting the whole population showed a consistent reduction of socioeconomic inequalities in dental caries among children. (4) Conclusion: The quality of included papers was moderate. High heterogeneity did not allow aggregation of the findings. The overall findings suggest that whole population interventions such as water fluoridation are more likely to reduce inequalities in children’s caries than target population and individual interventions.

scholarly journals Alcohol Hand Rub Significantly Reduces Overall Bacterial Bioburden on Stethoscopes in a Real-World Clinical Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s114-s115
Author(s):  
Alexandra Johnson ◽  
Bobby Warren ◽  
Deverick John Anderson ◽  
Melissa Johnson ◽  
Isabella Gamez ◽  
...  
Keyword(s):  
Real World ◽  
Medical Center ◽  
Academic Medical Center ◽  
Randomized Study ◽  
Healthcare Providers ◽  
Clinical Workflow ◽  
Provider Type ◽  
Academic Medical ◽  
Rn Students ◽  
The Impact

Background: Stethoscopes are a known vector for microbial transmission; however, common strategies used to clean stethoscopes pose certain barriers that prevent routine cleaning after every use. We aimed to determine whether using readily available alcohol-based hand rub (ABHR) would effectively reduce bacterial bioburden on stethoscopes in a real-world setting. Methods: We performed a randomized study on inpatient wards of an academic medical center to assess the impact of using ABHR (AlcareExtra; ethyl alcohol, 80%) on the bacterial bioburden of stethoscopes. Stethoscopes were obtained from healthcare providers after routine use during an inpatient examination and were randomized to control (no intervention) or ABHR disinfection (2 pumps applied to tubing and bell or diaphragm by study personnel, then allowed to dry). Cultures of the tubing and bell or diaphragm were obtained with premoistened cellulose sponges. Sponges were combined with 1% Tween20-PBS and mixed in the Seward Stomacher. The homogenate was centrifuged and all but ~5 mL of the supernatant was discarded. Samples were plated on sheep’s blood agar and selective media for clinically important pathogens (CIPs) including S. aureus, Enterococcus spp, and gram-negative bacteria (GNB). CFU count was determined by counting the number of colonies on each plate and using dilution calculations to calculate the CFU of the original ~5 mL homogenate. Results: In total, 80 stethoscopes (40 disinfection, 40 control) were sampled from 46 physicians (MDs) and MD students (57.5%), 13 advanced practice providers (16.3%), and 21 nurses (RNs) and RN students (26.3%). The median CFU count was ~30-fold lower in the disinfection arm compared to control (106 [IQR, 50–381] vs 3,320 [986–4,834]; P < .0001). The effect was consistent across provider type, frequency of recent usual stethoscope cleaning, age, and status of pet ownership (Fig. 1). Overall, 26 of 80 (33%) of stethoscopes harbored CIP. The presence of CIP was lower but not significantly different for stethoscopes that underwent disinfection versus controls: S. aureus (25% vs 32.5%), Enterococcus (2.5% vs 10%), and GNB (2.5% vs 5%). Conclusions: Stethoscopes may serve as vectors for clean hands to become recontaminated immediately prior to performing patient care activities. Using ABHR to clean stethoscopes after every use is a practical and effective strategy to reduce overall bacterial contamination that can be easily incorporated into clinical workflow. Larger studies are needed to determine the efficacy of ABHR at removing CIP from stethoscopes as stethoscopes in both arms were frequently contaminated with CIP. Prior cleaning of stethoscopes on the study day did not seem to impact contamination rates, suggesting the impact of alcohol foam disinfection is short-lived and may need to be repeated frequently (ie, after each use).Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

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