A pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy (CIPN).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23067-e23067
Author(s):  
Gabriel Lopez ◽  
Cathy Eng ◽  
Michael J. Overman ◽  
Wenli Liu ◽  
Lorenzo Cohen ◽  
...  
Keyword(s):  
Pilot Study ◽  
Lower Extremity ◽  
Health Care Providers ◽  
Massage Therapy ◽  
Treatment Schedule ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Oncology Massage

e23067 Background: Short- and long-term toxicity of platinum compounds and taxanes includes development of CIPN. Although anti-neuropathic medications are available, there is increased interest by health care providers and patients (pts) regarding the role of complementary approaches for symptom control. Therefore, we explored the role of massage therapy for symptomatic relief of chronic CIPN. Methods: This pilot study evaluated the optimum treatment schedule and initial efficacy of two treatment schedules of a standardized Swedish massage technique to treat lower extremity (LE) CIPN. Inclusion criteria: LE neuropathy attributed to oxaliplatin, paclitaxel, or docetaxel, no other history of attributable causes (concurrent upper extremity neuropathy allowed); self-reported neuropathy score ≥3, 0-10 scale; ≥ 6 months since last chemotherapy treatment; age ≥ 18. Pts were randomized to one of four groups: 1) LE massage 3 times (3X) week for 4 weeks; LE massage 2X week for 6 weeks; 3) head/neck/shoulder (control) massage 3X week for 4 weeks; or 4) control massage 2X week for 6 weeks. Massage completion rate was examined and symptoms of CIPN measured with the Pain Quality Assessment Scale [PQAS (Range: 0-10); subscales of PQAS-SP (surface pain), PQAS-DP (deep pain), and PQAS-PP (paroxysmal pain)] at baseline and at 10 weeks. Results: 71 pts fulfilled inclusion criteria: 77.5% women; 57.7% (breast cancer), and 42.3% (GI cancer); mean age 60.3 y/o (range: 40-77). Average length of time since the end of chemotherapy was > 3 yrs. Mean massage completion rates (max = 12) were 8.9 (SD 4.2) for 3X week and 9.8 (4.0) for 2X week with no statistical differences. There were no statistically significant differences in PQAS scores at follow-up between site-specific massage groups (lower extremity vs controls). Pts who had massage 3X week reported statistically and clinically significantly improved PQAS scores versus those who had massage 2X week (change scores: PQAS-SP: -2.3 vs. -0.6, p = 0.001; PQAS-DP: -2.1 vs. -0.9, p = 0.008; PQAS-PP: -2.3 vs. -1.0, p = 0.025), with sustained improvement maintained in the 3X week group, but minimal change in the 2X week group. Conclusions: We observed sustained reduction in pts with long-term CIPN up to 6 weeks after treatment completion for the more intensive 3X week massage group, regardless of massage treatment site. A large-scale efficacy trial is warranted to validate the role of oncology massage therapy for CIPN. Clinical trial information: NCT02221700.

A pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy (CIPN).

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 111-111
Author(s):  
Gabriel Lopez ◽  
Cathy Eng ◽  
Michael J. Overman ◽  
David Luis Ramirez ◽  
Wenli Liu ◽  
...  
Keyword(s):  
Pilot Study ◽  
Lower Extremity ◽  
Average Length ◽  
Symptom Control ◽  
Massage Therapy ◽  
Treatment Schedule ◽  
Inclusion Criteria ◽  
Oncology Massage

111 Background: Short- and long-term toxicity of platinum compounds and taxanes includes development of CIPN. With an increased interest regarding the role of complementary approaches for symptom control, we investigated massage therapy for symptomatic relief of chronic CIPN. Methods: This pilot study evaluated the optimum treatment schedule and initial efficacy of a standardized Swedish massage technique to treat lower extremity (LE) CIPN. Inclusion criteria: LE neuropathy attributed to oxaliplatin, paclitaxel, or docetaxel, no other history of attributable causes; self-reported neuropathy score ≥3, 0-10 scale; ≥ 6 months since last chemotherapy treatment; age ≥ 18. Patients (pts) were randomized to one of four groups: 1) LE massage 3 times (3X) week for 4 weeks; LE massage 2X week for 6 weeks; 3) head/neck/shoulder (control) massage 3X week for 4 weeks; or 4) control massage 2X week for 6 weeks. Massage completion rate was examined and symptoms of CIPN measured with the Pain Quality Assessment Scale [PQAS (Range: 0-10); subscales of SP (surface pain), DP (deep pain), and PP (paroxysmal pain)] at baseline and at 10 weeks. Results: 71 pts fulfilled inclusion criteria: 77.5% women; 57.7% (breast cancer), and 42.3% (GI cancer); mean age 60.3 y/o (range: 40-77). Average length of time since the end of chemotherapy was > 3 yrs. Mean massage completion rates (max = 12) were 8.9 (SD 4.2) for 3X week and 9.8 (4.0) for 2X week with no statistical differences. There were no statistically significant differences in PQAS scores at follow-up between site-specific massage groups (lower extremity vs controls). Pts who had massage 3X week reported statistically and clinically significantly improved PQAS scores versus those who had massage 2X week (change scores: PQAS-SP: -2.3 vs. -0.6, p = 0.001; PQAS-DP: -2.1 vs. -0.9, p = 0.008; PQAS-PP: -2.3 vs. -1.0, p = 0.025), with sustained improvement in the 3X week group, but minimal change in the 2X week group. Conclusions: We observed sustained reduction in pts with long-term CIPN up to 6 weeks after treatment completion for the more intensive 3X week massage group, regardless of treatment site. A large-scale efficacy trial is warranted to validate the role of oncology massage therapy for CIPN. Clinical trial information: NCT02221700.

Family, Friends and Neighbors: The Role of Primary Groups in Preventing the Misuse of Drugs

1989 ◽  
Vol 19 (2) ◽  
pp. 261-281 ◽  
Author(s):  
Barbara Lynn Kail ◽  
Eugene Litwak
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theoretical Framework ◽  
Prescription Medicine ◽  
Care Providers ◽  
Minority Woman ◽  
Term Basis ◽  
Primary Groups

Primary groups such as relatives, neighbors and friends are a source of support that health care providers overlook. We present a theoretical framework which suggests primary groups can help prevent the misuse of prescription medicine. Kin are especially helpful in assisting elderly to take medications on a long-term basis where the regimens are fairly simple. It may also be especially important to engage kin in helping the older minority woman to understand the doctor. Even at a distance, kin may be able to provide such assistance and should not be discounted as a resource. Neighbors can be helpful in getting a medicine needed unexpectedly and might assist with relatively complex routines that last for only a brief period. Friends who have had similar experiences are especially helpful when the medicine is prescribed on an as needed basis by teaching the client how to judge when a dose is needed.

scholarly journals Longitudinal Health Care for Girls and Women With Turner Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A733-A734
Author(s):  
Priyanka Ghosh ◽  
Zorkot Zeinab ◽  
Selma Feldman Witchel ◽  
Meredith Snook ◽  
Svetlana Yatsenko
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Health Outcomes ◽  
Turner Syndrome ◽  
Health Care Providers ◽  
Medical Records ◽  
Delayed Puberty ◽  
Care Providers ◽  
Monosomy X

Abstract Background Turner Syndrome (TS) is the most common chromosomal abnormality seen in females and is often diagnosed in childhood. The transition of patients with TS from pediatric to adult providers is characterized by inconsistency. As such, limited data are available to assess long term health outcomes of women with TS. Objectives: 1) To evaluate the long term health outcomes in women with TS followed at a single academic institution and 2) to establish clinical recommendations for evaluation, counseling, and planned transition of this population. Methods: A retrospective pilot study was performed by examining medical records of women with TS who presented with short stature or delayed puberty and were diagnosed with TS on the basis of cytogenetic analysis. Patients with monosomy X, mosaic monosomy X, or X chromosome structural abnormalities consistent with TS or mosaic TS diagnosis were included. Medical records from an academic children’s hospital and an affiliated women’s hospital were reviewed. Results: To date, 15 females aged 26-32 years were identified. Electronic records were available for 12/15 with age at diagnosis ranging from in utero to 15 years of age. Those with pediatric information available had documentation addressing use of growth hormone and pubertal hormone replacement therapies. Of the 12 patients, 11 had cardiac imaging performed; only one had an MRI. Consistent planned transition to adult health care providers was not evident. Of the 12 patients, 3 had consultation with a Reproductive Endocrinology and Infertility specialist; 3 had a diagnosis of anxiety or depression; 3 had a DEXA scan done (1 had osteopenia); 5 had dyslipidemia; and 2 developed insulin resistance. Conclusions: This pilot study confirms heterogeneity in practice patterns and variable interactions of women with TS with the healthcare system, especially as patients enter adulthood. Although some women were referred to subspecialists, our initial data uncover patient uncertainty about healthcare and transition recommendations. Our preliminary data indicate the need for early patient education in a collaborative, multi-disciplinary fashion. We plan to validate and extend our initial findings by reviewing additional medical records. Ultimately, we plan for expanded education, consistent surveillance recommendations, and planned transition of patients with TS from pediatrics to adult caregivers.

The Role of Health Care Providers in Long Term and Complicated Workers’ Compensation Claims

2011 ◽  
Vol 21 (4) ◽  
pp. 582-590 ◽  
Author(s):  
Agnieszka Kosny ◽  
Ellen MacEachen ◽  
Sue Ferrier ◽  
Lori Chambers
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Workers Compensation ◽  
Care Providers ◽  
Compensation Claims

Red Cell Membrane Disorders

Hematology ◽  
2005 ◽  
Vol 2005 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Patrick G. Gallagher
Keyword(s):  
Health Care Providers ◽  
Hereditary Spherocytosis ◽  
Laparoscopic Approach ◽  
Red Cell ◽  
Care Providers ◽  
Red Cell Membrane ◽  
Management Guidelines ◽  
Private Mutation

Abstract Disorders of the erythrocyte membrane, including hereditary spherocytosis, hereditary elliptocytosis, hereditary pyropoikilocytosis, and hereditary stomatocytosis, comprise an important group of inherited hemolytic anemias. These syndromes are characterized by marked clinical and laboratory heterogeneity. Recent molecular studies have revealed that there is also significant genetic heterogeneity in these disorders. This is particularly true for the spherocytosis syndromes where each kindred has a private mutation in one of the spherocytosis genes. Treatment with splenectomy is curative in most patients. Splenectomy via a laparoscopic approach has become the surgical method of choice. Growing recognition and understanding of the long-term risks and complications of splenectomy, including cardiovascular disease, thrombotic disorders, and pulmonary hypertension, and the emergence of penicillin-resistant pneumococci, a concern for infection in overwhelming postsplenectomy infection, have led to reevaluation of the role of splenectomy. Recent management guidelines acknowledge these important considerations when entertaining splenectomy and recommend detailed discussion between health care providers, patient, and family.

Parents’ Experience When Present During a Child’s Resuscitation: An Integrative Review

2019 ◽  
Vol 41 (9) ◽  
pp. 1282-1305 ◽  
Author(s):  
Stephanie A. Stewart
Keyword(s):  
Health Care Providers ◽  
Parent Stress ◽  
Stress And Coping ◽  
Integrative Review ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Long Term Effects ◽  
And Coping ◽  
Parent Presence

Understanding perceptions of parents is necessary to meet parents’ needs during a child’s resuscitation. Parent presence at pediatric resuscitations has been slow to become consistent practice in all hospital settings and remains controversial. The purpose of this integrative review was to synthesize research on parents’ experience while present during a child’s resuscitation to improve understanding for health care providers and to facilitate application in practice. Nine studies met inclusion criteria, identifying four major themes. Parents experienced conflicting emotions, articulated a need for communication and support, reported that being physically present was comforting, and described their reactions to the experience. The available research on parents’ experience during presence at their child’s resuscitation offers a foundation for further detailed study. Further study is needed about parents’ perspective of support needed while present during a child’s resuscitation, as well as about any long-term effects of presence on parent stress and coping.

The Role of Unobtrusive Continuous Sensing in the Diagnosis and Management of Post-Acute Sequelae of SARS CoV-2 (Preprint)

2021 ◽  
Author(s):  
Benjamin Harris Peterson Corman ◽  
Sritha Rajupet ◽  
Fan Ye ◽  
Elinor Randi Schoenfeld
Keyword(s):  
Health Care Providers ◽  
Mitigation Strategies ◽  
Sensor Data ◽  
Symptom Presentation ◽  
Care Providers ◽  
Activity Measurements ◽  
Management Plans ◽  
Physical Sensor

UNSTRUCTURED Amid the COVID-19 pandemic, it has been reported that greater than 10% of patients with confirmed or suspected COVID-19 develop post-acute sequelae of SARS CoV-2 (PASC). PASC is still a disease for which preliminary medical data is being collected and pathophysiological understanding is yet in its infancy. The disease is notable for its prevalence and its variable symptom presentation and as such, diagnoses and management plans could be more holistically made if health care providers had access to unobtrusive continuous physiologic and physical sensor data at home. Such sensors would be able to provide vital sign and activity measurements that correlate directly or by proxy to documented PASC symptoms. These data can be collected at time points between hospital visits and can give care providers contextualized information from which symptom exacerbation or relieving factors may be classified. Such data can also improve the collective academic understanding of PASC by providing temporally and activity-associated symptom cataloging. In this viewpoint, we make a case for the utilization of sensor technologies that can serve as a foundation from which medical professionals and engineers may develop and pursue long-term mitigation strategies in conjunction with those ongoing in the acute setting.

scholarly journals Typhoon eye effect versus ripple effect: the role of family size on mental health during the COVID-19 pandemic in Pakistan

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Tooba Lateef ◽  
Jiyao Chen ◽  
Muhammad Tahir ◽  
Teba Abdul Lateef ◽  
Bryan Z. Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorders ◽  
Family Size ◽  
Health Care Providers ◽  
Vulnerable Groups ◽  
Ripple Effect ◽  
Health Issues ◽  
Care Providers ◽  
Populous Country

Abstract Background The recent outbreak of COVID-19 has impacted adversely upon the mental health of millions of people worldwide. Impacts on the mental health conditions and the associated predictors relating to adults in Pakistan, the fifth most populous country in the world, during the COVID-19 remain understudied. Our aim was to investigate distress, anxiety, and overall mental health and their associated predictors among Pakistani adults in this pandemic. We specifically examine mental health issues based on the distance from the epicenter, (a predictor that has revealed opposing evidence in other countries) based on the theories of typhoon eye effect and ripple effect. The sample consisted of 601 adults who were surveyed online about 2.5 months into the outbreak across Pakistan with varying distances from the epicenter of COVID-19 of Karachi. Results The results showed that 9.2 and 19.0% of the participants surpassed the cut-off criteria for distress and anxiety disorders, respectively. Overall, the distance from the epicenter positively predicted the mental health of adults in Pakistan, and family size negatively moderated this effect. The distance from the epicenter negatively predicted distress and anxiety disorders for adults in large families, which are quite common in Pakistan. Conclusion The evidence of the study interestingly finds that the prediction of the mental health of people by their distance from the epicenter depends on family size. The evidence of this study can help to provide initial indicators for mental health care providers to screen vulnerable groups in Pakistan, a populous country that continues struggling to cope with the COVID-19 pandemic.

Breastfeeding Experiences of Baccalaureate Nursing Students: A Qualitative Study

2020 ◽  
pp. 089033442097998
Author(s):  
Cheryl Langford ◽  
Marcella Gowan ◽  
Monica Haj
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Baccalaureate Nursing ◽  
Community Support ◽  
Baccalaureate Nursing Students ◽  
Care Providers ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional

Background Students returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes. Research aim To explore the breastfeeding experience of baccalaureate nursing students. Methods Our study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants ( N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software. Results An overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts. Conclusion Breastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

Commentary on “Diabetes and people with learning disabilities: issues for policy, practice and education”

2020 ◽  
Vol 25 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Brianne Redquest ◽  
Yona Lunsky
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Health Care Providers ◽  
Diabetes Care ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
Content Type ◽  
Policy Practice

Purpose There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes. Design/methodology/approach This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD. Findings It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones. Originality/value Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.

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