Reddit and Brain Cancer: A Content Analysis of Online Communication on the Brain Tumor Subreddit (Preprint)

BACKGROUND Many brain tumor patients commonly utilize online resources such as Reddit as avenues for self-management and support outside of the clinical setting. OBJECTIVE We aimed to examine trends from Reddit discussion treads on brain tumors to identify areas of need in patient care. METHODS We used a qualitative, descriptive design to understand patient and caregivers unmet and met needs. We analyzed the top 100 posts from the ‘braincancer’ subreddit to identify common themes. RESULTS The qualitative content analysis revealed three major topic areas: (1) harnessing hope; (2) moving through the grief process; and (3) expressing gratitude toward other Reddit users. Most of the authors of the posts were patients with brain tumors (n = 32; 36.4%) who used Reddit as a reflective journaling tool to process associated emotions of a challenging diagnosis. CONCLUSIONS This study shows the potential of Reddit to serve as unique group therapy platform for patients affected by brain tumors. Additionally, the results highlight the importance of recommending Reddit as a therapeutic virtual community. Our results highlight the support provided by the Reddit community members as a unique mechanism to assist cancer survivors and caregivers with the emotional processing of living with brain tumors.

Met and Unmet Needs of Cognitively Impaired Older Adults and Burden and Benefits of Their Caregivers

Previous studies typically assess caregiver needs when trying to interpret caregiver burden. We propose that both met and unmet needs of care recipients translate into different caregiving experiences with varying levels of benefits and burden combined. We use data on 263 caregivers of community-dwelling Singaporean older adults with cognitive impairment who participated in a community-based dementia care study conducted in 2018-2020. Our analysis produces three major findings. First, latent class analysis identifies three distinct types of caregiving experience based on caregiver-reported burden and benefits of caregiving: intensive (high burden and high benefits, 11% of caregivers), satisfied (low burden and high benefits; 54%), and dissatisfied (low burden and low benefits; 35%). Second, multinomial logistic regression shows that both met and unmet needs of care recipients are positively associated with the intensive caregiving experience, while only met needs are positively associated with the satisfied caregiving experience, in comparison to dissatisfied caregiving experience. Third, met needs in the areas of daytime activities, memory assistance, and mobility are positively related to the satisfied caregiving experience, compared to the dissatisfied caregiving experience. In other words, caregivers are more likely to be satisfied in their caregiving experiences (i.e., low burden and high benefits) if their care recipients’ problems with memory, mobility, and finding suitable and adequate daytime activities are properly managed. Our findings thus call for interventions to fulfill care recipients’ needs in a more tailored manner in order to increase satisfaction among caregivers.

Unmet need for family planning and factors associated among women living with HIV in Oromia regional state, Ethiopia

Objectives The purpose of this study was to determine the prevalence of the unmet need and identifying factors associated with the unmet need among women of reproductive age living with HIV in Oromia regional state, Ethiopia. One critical component of both a full range of contraceptives and satisfying demand for family planning with HIV services all women living with HIV is the appropriate model for HIV therapy, HIV prevention, and care with family planning services in a resource-limiting area like Ethiopia. Methods Health facility-based cross-sectional study design was conducted among women living with HIV attending ART clinics in the special zone of, Oromia regional state, by simple random sampling was used to select 654 respondents. Both bivariate and multivariable logistic regressions analysis was used to identify at adjusted odds ratio (AOR) with 95% CI in the final model. Result The study assessed the magnitude of demand for family planning among HIV-infected women and established that the demand was 630 (96.3%), of which 100 (16%) of women of reproductive age living with HIV had unmet needs for family planning while attending monthly ART clinic drug refilling and follow up. This study identified that factors found to be associated with met needs for family planning among women of reproductive age living with HIV attending ART/PMTC were discussions with healthcare providers (AOR = 4.33, 95% CI 2.56–7.32), previous pregnancy (AOR = 3.07, 95% CI 1.84–5.12); future fertility desire (AOR = 2.15, 95% CI 1.31–3.51); having sexual partners (AOR = 5.26, 95% CI 1.79–15.5) and the number of the sexual partner (one) (AOR = 7.24, 95% CI 1.82–28.74) were identified independent predictors of met needs for family planning. Conclusion The overall demand for family planning was 96% among the women living with HIV, and that 16% of women had an unmet need for family planning. The authors conducted a logistic regression and find various dependent variables that are associated with the met need for family planning services, such as having discussions with healthcare providers, having a partner and previous pregnancy; future fertility desire, the last pregnancy being intended. These results are interpreted to suggest that clear policy implications of family planning must be better integrated into ART clinics.

QOLP-26. ANALYSIS OF REDDIT USERS' PERSPECTIVES OF BRAIN TUMORS

BACKGROUND Reddit, ranking 6th in worldwide Internet site traffic, is a commonly used forum among patients and caregivers affected by brain tumors to discuss diagnoses, treatment, and self-care management. The use of the online forum may suggest patients and caregivers have unmet needs and are seeking further support outside of the clinical setting. We aimed to examine trends from Reddit discussion treads on brain tumors to identify areas of need in patient care. METHODS We used a qualitative, descriptive design to understand patient and caregivers unmet and met needs. We analyzed the top 100 posts and accompanying 271 comments from the ‘braincancer’ subreddit to identify common themes. RESULTS The qualitative content analysis revealed three major topic areas: (1) moving through the grief process; (2) processing diagnostic pathway; and (3) expressing gratitude toward other Reddit users. Most of the authors of the posts were patients with brain tumors (n = 32; 38.5%) who used Reddit as a reflective journaling tool to move through the grief process for themselves or loved ones. About 47% of theses posts discussed the diagnostic process of glioblastoma multiforme (GBM) brain tumors, where users requested an inclusive/welcoming environment in the clinic by their healthcare professionals (HPs). Users also solicited and gave support for other members in the online community. CONCLUSIONS This study highlights the need of implementing social media as a part of HPs’ repertoire for patient outreach/needs. Furthermore, social media outlets like Reddit can help HPs understand the level of support they can give to their patients. Plans of action for physicians seeking to meet the needs of brain tumor patients include monitoring the concerns of patients, becoming verified on the platform/openly identifying themselves online, or conducting ‘Ask Me Anything’ discussions to educate patients.

Contraception needs and pregnancy termination in sub-Saharan Africa: a multilevel analysis of demographic and health survey data

Background Women in sub-Saharan Africa (SSA) have a higher risk of unintended pregnancies that are more likely to be terminated, most of which are unsafe with associated complications. Unmet need for contraception is highest in SSA and exceeds the global average. This study investigates the association between unmet/met need for contraception and pregnancy termination SSA. Methods We used pooled data from Demographic and Health Surveys conducted from January 2010 to December 2018 in 32 countries in SSA. Our study involved 265,505 women with diverse contraception needs and with complete data on all variables of interest. Multilevel logistic regression at 95% CI was used to investigate the association between individual and community level factors and pregnancy termination. Results We found an overall pregnancy termination rate of 16.27% ranging from 9.13% in Namibia to 38.68% in Gabon. Intriguingly, women with a met need for contraception were more likely to terminate a pregnancy [aOR = 1.11; 95% CI 1.07–1.96] than women with unmet needs. Women with secondary education were more likely to terminate a pregnancy as compared to those without education [aOR = 1.23; 95% CI 1.19–1.27]. With regards to age, we observed that every additional age increases the likelihood of terminating a pregnancy. At the contextual level, the women with female household heads were less likely to terminate a pregnancy [aOR = 0.95; 95% CI 0.92–0.97]. The least socio-economically disadvantaged women were less likely to terminate a pregnancy compared to the moderately and most socio-economically disadvantaged women. Conclusions Our study contributes towards the discussion on unmet/met need for contraception and pregnancy termination across SSA. Women with met need for contraception have higher odds of terminating a pregnancy. The underlying cause of this we argued could be poor adherence to the protocols of contraceptives or the reluctance of women to utilise contraceptives after experiencing a failure. Governments of SSA and non-governmental organisations need to take pragmatic steps to increase met needs for contraception and also utilise mass media to encourage women to adhere to the prescription of contraceptives in order to reduce the incidence of unplanned pregnancies and unsafe abortions.

New Biological Treatment Options in CSU

Chronic spontaneous urticaria (CSU) is a devastating disease and is associated with many co-morbidities and long-lasting suffering. Therefore, patients always look for a most efficient therapeutic approach to achieve a full remission. In many patients, CSU remain refractory to off-label doses of antihistamines and short courses of steroids, and therefore are treated with omalizumab. However, 15–20% of severe CSU patients will stay unresponsive to omalizumab and are defined as being of un-met needs. In this review we will shed light on the many new drugs which are assessed in ongoing clinical trials.

Unmet Supportive Care Needs of General Cancer

Purpose Aside from their oncology condition, cancer patients often experience many ancillary problems, including negative physical symptoms, social isolation, spiritual suffering, and often psychological distress. Supportive care services can be defined as services designed to help patients, their families, and caregivers with their experiences during the diagnosis, treatment, follow-up, and palliative stages of the cancer journey. In an extensive review of the literature, we identified no previous studies that have investigated the SCNs of cancer patients in Iraq or any other Middle Eastern countries. Therefore, this study aims to determine the SCNs of cancer patients in Iraq. Methods The present cross-sectional study and data was conducted in Rezgary teaching and Nankaly Oncology Hospital in the Kurdistan Federal Region of Iraq. A total of 300 eligible cancer patients were invited to participate in the study from February to August, 2018. Eligibility criteria included: 18 years or above; having a definite diagnosis of any type of cancer; physically or mentally able to participate in the study; and being aware of exact diagnosis for at least three months. Results In 15 items of the SCNs, more than 60% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to health system and information, physical and daily living, psychological, and patient care and support domains, and most met needs were related to physical and daily activity domains. Conclusions Kurdish cancer patients had many unmet needs and there is a need for establishing additional supportive care services and educational programs to increase quality of life in Kurdistan Region- Iraq.

Met and unmet needs of homeless individuals at different stages of housing reintegration: A mixed-method investigation

This study aimed to identify and compare major areas of met and unmet needs reported by 455 homeless or recently housed individuals recruited from emergency shelters, temporary housing, and permanent housing in Quebec (Canada). Mixed methods, guided by the Maslow framework, were used. Basic needs were the strongest needs category identified, followed by health and social services (an emergent category), and safety; very few participants expressed needs in the higher-order categories of love and belonging, self-esteem, and self-actualization. The only significant differences between the three housing groups occurred in basic needs met, which favored permanent housing residents. Safety was the only category where individuals reported more unmet than met needs. The study results suggested that increased overall access to and continuity of care with family physicians, MD or SUD clinicians and community organizations for social integration should be provided to help better these individuals. Case management, stigma prevention, supported employment programs, peer support and day centers should particularly be more widely implemented as interventions that may promote a higher incidence of met needs in specific needs categories.