Patients making potentially life threatening delays in reporting neutropenic sepsis: Grounded theory study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21560-e21560 ◽  
Author(s):  
Catherine Mary Oakley ◽  
Cath Taylor ◽  
Emma Ream ◽  
Alison Metcalfe
Keyword(s):  
Breast Cancer ◽  
Grounded Theory ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Highly Educated ◽  
Neutropenic Sepsis ◽  
The United Kingdom ◽  
Life Threatening ◽  
Degree Level

e21560 Background:Internationally the mortality rate for neutropenic sepsis (NS) is 2-21% (in patients who develop it). Within the United Kingdom NS causes around 700 deaths annually. Clinicians are concerned about patient delayed reporting of NS which may increase healthcare costs, mortality and chemotherapy delays, which can affect prognosis. Methods: Constructivist grounded theory was used to gain insight into the reasons for patient delays. Observations (n = 13 hours) of women with breast cancer being provided with information about NS by oncology doctors and nurses and 31 in-depth interviews. Analysis (and development of categories and supporting properties) commenced with the earliest data gathered and a rich theoretical picture was built through comparing perspectives, pursuing areas of inquiry and recruiting participants who became of interest. Data were collected until saturation. A coding framework was applied to examine and explain connections between categories. Results: 35 participants. 13 women with breast cancer (median age, 56 years, 8 Caucasian, 9 adjuvant, 4 metastatic), 9 carers (partners, family or friends, 50% lived with patients) and 13 clinicians (4 oncologists, 7 chemotherapy nurses, 2 emergency department clinicians, most doctors were male, most nurses were female). The majority of patients and carers were highly educated ( > degree level). All patients except 1, delayed reporting NS symptoms (2.5 hours - 8 days), sometimes repeatedly. The final grounded theory suggests patient delays are due to an interplay of behaviours between clinicians, patients and carers where they subconsciously collude to underplay the seriousness and possibility of NS occurring.Moderators of delay included metastatic disease, bereavement, fatalism, religious beliefs and quality of relationships with clinicians. Conclusions: Relationships with clinicians directly impacted on delayed patient reporting of NS.Findings have implications for health risk communication, development of holistic service models and the design of future research to develop interventions, to promote earlier recognition and treatment for this important chemotherapy complication.

Inspirational Teachers’ Model: A Constructivist Grounded Theory Study in Gifted Education

2021 ◽  
pp. 016235322110235
Author(s):  
Claudia A. Cornejo-Araya ◽  
Leonie Kronborg
Keyword(s):  
Grounded Theory ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Theory Approach ◽  
Positive Attitudes ◽  
Safe Learning Environment ◽  
Contextual Determinants ◽  
Developmental Characteristics ◽  
Highly Able ◽  
Grounded Theory Approach

Adopting a constructivist grounded theory approach, 91 students from Years 9 to 11, in gifted educational programs from three schools in Melbourne, nominated their inspiring teachers. Eleven teachers, who received the highest number of nominations, were invited to an interview and an observation of their teaching. The emerged theoretical construct was identified as “Opening new possibilities: Inspiring teachers of gifted and highly able students,” which is further explained through three main categories: Being a knowledgeable and passionate teacher, creating an academically safe learning environment, and teaching beyond and above the regular curriculum. In addition, the theoretical process was explained through three phases: Expanding knowledge and understanding, Fostering positive attitudes, and Encouraging students to take action. Contextual determinants were considered to analyze and report the findings: students’ developmental characteristics, school culture, curriculum, and gifted educational provisions. Findings are discussed in the light of existing literature, as well as study limitations and ideas for future research.

scholarly journals A common goal to CARE: Cancer Advocates, Researchers, and Clinicians Explore current treatments and clinical trials for breast cancer brain metastases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Natalie S. Joe ◽  
Christine Hodgdon ◽  
Lianne Kraemer ◽  
Kristin J. Redmond ◽  
Vered Stearns ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Brain Metastases ◽  
Detection Methods ◽  
Future Research ◽  
Breast Cancer Brain Metastasis ◽  
Patient Advocates ◽  
Breast Cancer Brain Metastases ◽  
The Brain

AbstractBreast cancer is the most commonly diagnosed cancer in women worldwide. Approximately one-tenth of all patients with advanced breast cancer develop brain metastases resulting in an overall survival rate of fewer than 2 years. The challenges lie in developing new approaches to treat, monitor, and prevent breast cancer brain metastasis (BCBM). This review will provide an overview of BCBM from the integrated perspective of clinicians, researchers, and patient advocates. We will summarize the current management of BCBM, including diagnosis, treatment, and monitoring. We will highlight ongoing translational research for BCBM, including clinical trials and improved detection methods that can become the mainstay for BCBM treatment if they demonstrate efficacy. We will discuss preclinical BCBM research that focuses on the intrinsic properties of breast cancer cells and the influence of the brain microenvironment. Finally, we will spotlight emerging studies and future research needs to improve survival outcomes and preserve the quality of life for patients with BCBM.

scholarly journals Natural product like “shikonin” might be a hope for Breast cancer cure

2019 ◽  
Vol 2 (2) ◽  
pp. 14-18
Author(s):  
Md. Niuz Morshed Khan ◽  
Maidul Islam
Keyword(s):  
Breast Cancer ◽  
Effective Treatment ◽  
Estrogen Therapy ◽  
Future Research ◽  
Breast Cancer Patients ◽  
Developed Country ◽  
Estrogen Receptor Signaling ◽  
Life Threatening ◽  
Effective Treatment Regimen ◽  
Less Developed Country

AbstractAmong all cancers, breast cancer is the most commonly occurring cancer in women and the second most common cancer overall, both in the developed and less developed country. It is a matter of concern worldwide, that there is no effective drug is available for cancer treatment. Although, Surgery, radiation, hormonal (anti-estrogen) therapy, and chemotherapy are being used for treatment of breast cancer in recent years, due to life threatening side effects, these treatment approaches becoming more vulnerable. However, researchers from across the world searching a safe and effective treatment approach that can be a breakthrough for this situation, as it is evident that natural compounds like shikonin from Lithospermum erythrorhizon can fight against aggressiveness of breast cancer by regulating apoptosis, necroptosis and estrogen receptor signaling pathway. In this review, we discussed about potential green chemical compounds with their mechanisms of actions, which can be very effective treatment regimen for breast cancer and can be more potent by their proper modifications and further molecular research. Hopefully in future, research focusing on the “shikonin” will open a new door for increasing the survival rate of breast cancer patients as well as cancer cure.

scholarly journals Electrochemotherapy in Breast Cancer - Discussion of the Method and Literature Review

Breast Care ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. 409-414 ◽  
Author(s):  
Mateusz Wichtowski ◽  
Dawid Murawa ◽  
Katarzyna Kulcenty ◽  
Karolina Zaleska
Keyword(s):  
Breast Cancer ◽  
Cancer Recurrence ◽  
Locoregional Treatment ◽  
Electric Pulses ◽  
Non Invasive ◽  
Life Threatening ◽  
Late Stages ◽  
Methods Of Treatment ◽  
Cause Of Pain

Breast cancer is the most common cause of skin metastases in women. The probability of their occurrence ranges from about 5% in the entire population to as much as 30% in the late stages of the disease. Although rarely life-threatening, they have a major impact on the quality of life of patients with this diagnosis, being the cause of pain, effusion, ulceration, infection, and psychological discomfort. Available methods of treatment, both local and systemic, often fail to provide adequate control of the disease. A particular challenge seems to be the treatment of those patients with cutaneous metastases who, due to the extent of their metastases, are not eligible for resection, in whom the possibility of radiation therapy has already been used, and in whom systemic therapy is ineffective or contraindicated. A new method providing the opportunity for effective treatment is electrochemotherapy (ECT). ECT combines electropulsation of tumor cells (by local application of electric pulses) and administration of antineoplastic drugs such as cisplatin or bleomycin (either intravenous or intratumoral). Several clinical studies have demonstrated that ECT provides safe, efficient, and non-invasive locoregional treatment for chest wall breast cancer recurrence.

The Virtuous Circle: A Grounded Theory Exploration of the Good Lives Model

Sexual Abuse ◽  
2018 ◽  
Vol 31 (8) ◽  
pp. 908-929
Author(s):  
Miriam Ryan ◽  
Mathew McCauley ◽  
Davina Walsh
Keyword(s):  
Grounded Theory ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Theory Approach ◽  
Structured Interviews ◽  
Community Based ◽  
Good Lives Model ◽  
Sexual Offenses ◽  
Grounded Theory Approach ◽  
Good Lives

Sexual offenses evoke strong emotional responses and frequently elicit demands from society that offenders be indefinitely incarcerated or treated until they are deemed safe, which may impact the provision of therapeutic treatment for offenders. However, in recent years, there has been a proposal to move toward a positive, strengths-based treatment approach, namely the Good Lives Model (GLM). The present study used semi-structured interviews and a constructivist grounded theory approach to examine the experience of 13 men who were voluntarily engaging in or had completed a GLM community-based treatment program. A conceptual model emerged which outlines the process the men underwent, the factors they identified as crucial for change, and the perceived gains. The model extends previous work by exploring the process from the clients’ perspective. Implications for future research, prevention, and treatment are discussed.

Feminist-Informed Protective Factors for Subthreshold Eating Disorders

2020 ◽  
Vol 30 (10) ◽  
pp. 1546-1560
Author(s):  
Emily C. Wacker ◽  
Megan L. Dolbin-MacNab
Keyword(s):  
Eating Disorders ◽  
Grounded Theory ◽  
Eating Disorder ◽  
Protective Factors ◽  
Theory Model ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Sociocultural Context ◽  
Research And Practice ◽  
Tangible Support

Despite knowledge that the larger sociocultural context contributes to the development of eating disorders, few studies have examined protective factors for women with subthreshold eating disorders. Using feminist-informed constructivist grounded theory methodology, 15 women (ages 18–25 years) with subthreshold eating disorders were interviewed. Results suggest that participants spoke of their subthreshold eating disorders in an externalized way and used protective factors to guide decision making toward their preferred values. A grounded theory model was developed to illustrate this process. Protective factors included (a) people who provide emotional and tangible support, (b) support people who challenge the eating disorder, (c) personal sense of agency, and (d) community activism and involvement. Participants experiencing subthreshold eating disorders demonstrated a capacity to distinguish their own thoughts and values from those of the “eating disorder voice,” and protective factors facilitated this process. Implications for future research and practice are discussed.

scholarly journals Heterocyclic Compounds: Pharmacology of Pyrazole Analogs From Rational Structural Considerations

2021 ◽  
Vol 12 ◽  
Author(s):  
Rafael Fernades Costa ◽  
Larissa Córdova Turones ◽  
Keilah Valéria Naves Cavalcante ◽  
Ismael Aureliano Rosa Júnior ◽  
Carlos Henrique Xavier ◽  
...  
Keyword(s):  
Heterocyclic Compounds ◽  
Rational Design ◽  
Pyrazole Ring ◽  
Future Research ◽  
Therapeutic Activity ◽  
Pharmacological Activities ◽  
Lead Compounds ◽  
Life Threatening ◽  
Pharmacological Screening

Low quality of life and life-threatening conditions often demand pharmacological screening of lead compounds. A spectrum of pharmacological activities has been attributed to pyrazole analogs. The substitution, replacement, or removal of functional groups on a pyrazole ring appears consistent with diverse molecular interactions, efficacy, and potency of these analogs. This mini-review explores cytotoxic, cytoprotective, antinociceptive, anti-inflammatory, and antidepressant activities of some pyrazole analogs to advance structure-related pharmacological profiles and rational design of new analogs. Numerous interactions of these derivatives at their targets could impact future research considerations and prospects while offering opportunities for optimizing therapeutic activity with fewer adverse effects.

scholarly journals A pan-Canadian prospective study of young women with breast cancer: the rationale and protocol design for the RUBY study

2020 ◽  
Vol 27 (5) ◽  
Author(s):  
M.L. Quan ◽  
I.A. Olivotto ◽  
N.N. Baxter ◽  
C.M. Friedenreich ◽  
K. Metcalfe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Treatment Quality ◽  
Future Research ◽  
Delivery Of Care ◽  
Younger Women ◽  
Core Dataset ◽  
Patient Reported ◽  
Treatment Data

Introduction The understanding of the biology and epidemiology of, and the optimal therapeutic strategies for, breast cancer (bca) in younger women is limited. We present the rationale, design, and initial recruitment of Reducing the Burden of Breast Cancer in Young Women (ruby), a unique national prospective cohort study designed to examine the diagnosis, treatment, quality of life, and outcomes from the time of diagnosis for young women with bca. Methods Over a 4-year period at 33 sites across Canada, the ruby study will use a local and virtual recruitment model to enrol 1200 women with bca who are 40 years of age or younger at the time of diagnosis, before initiation of any treatment. At a minimum, comprehensive patient, tumour, and treatment data will be collected to evaluate recurrence and survival. Patients may opt to complete patient-reported questionnaires, to provide blood and tumour samples, and to be contacted for future research, forming the core dataset from which 4 subprojects evaluating genetics, lifestyle factors, fertility, and local management or delivery of care will be performed. Summary The ruby study will be the most comprehensive repository of data, biospecimens, and patient-reported outcomes ever collected with respect to young women with bca from the time of diagnosis, enabling research unique to that population now and into the future. This research model could be used for other oncology settings in Canada.

Women Breast Cancer Survivors: Stories of Change and Meaning

2010 ◽  
Vol 32 (3) ◽  
pp. 265-282 ◽  
Author(s):  
Claudia Sadler-Gerhardt ◽  
Cynthia Reynolds ◽  
Paula Britton ◽  
Sharon Kruse
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Posttraumatic Growth ◽  
Breast Cancer Survivors ◽  
Meaning Making ◽  
Future Research ◽  
Qualitative Investigation ◽  
Health Counseling

Breast cancer research has addressed prevention, early treatment, and quality of life, but research from the perspective of survivors has been limited. This is a qualitative investigation of the experience of eight women breast cancer survivors, ranging in age from 28 to 80 at diagnosis, six of whom were Caucasian and two African American. The research consisted of a phenomenological and case study examination of change and meaning-making during their experience. The findings support a posttraumatic growth model of change as part of survivorship for the participants, as well as the presence of negative changes and a state of new normal in their lives. Recommendations are made for mental health counseling and for future research.

scholarly journals Orientation of medical trainees to a new clinical environment (the ready-steady-go model): a constructivist grounded theory study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anél Wiese ◽  
Deirdre Bennett
Keyword(s):  
Grounded Theory ◽  
Faculty Development ◽  
Curriculum Design ◽  
Postgraduate Medical Education ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Clinical Team ◽  
Clinical Environment ◽  
Medical Specialties ◽  
Clinical Workplace

Abstract Background High-quality orientation of trainees entering a new clinical workplace is essential to support education and patient safety. However, few consultants receive extensive formal training to support new trainees and must create their own ways of integrating newcomers into their clinical team and work environment. We aim to conceptualise the strategies consultants use in the early stages of working with new trainees that will be useful for future faculty development in this area. Methods We used constructivist grounded theory (CGT) methodology by interviewing fifteen consultants in three medical specialties, to explore how trainees are integrated into a new clinical environment. We used CGT principles and procedures (iteration, constant comparison, and theoretical sampling) to analyse and construct a conceptual interpretation of the empirical data. Results Consultants’ central concern when introduced to a new cohort of trainees was that they had the required knowledge and skills (ready), were adapted and integrated into the new workplace and clinical team (steady), and safely participating in practice (go). Consultants used two broad strategies: formal orientation and informal orientation. Both these approaches had the common goal of intensifying interaction between consultants and trainees to get trainees to a position where they were ready, adapted, integrated, and participating safely and efficiently in practice. Several disruptors were identified by participants that delayed and sometimes completely inhibited the orientation process. Conclusions The model of orientation constructed through this research could be a valuable tool to support faculty development initiatives, the reflective learning practice of clinical supervisors, and curriculum design. The disruptors were identified as valid priorities for improving trainee orientation in postgraduate medical education. Future research should involve a longitudinal approach to explore trainee engagement with orientation upon entering a new clinical workplace.

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