This study explores the interaction of responsible leadership,supportive climate,and creative self-efficacy in enhancing knowledge sharing among employees in the banking sector.Data from 314 employees(42%Females,58%Ma...This study explores the interaction of responsible leadership,supportive climate,and creative self-efficacy in enhancing knowledge sharing among employees in the banking sector.Data from 314 employees(42%Females,58%Males)were analyzed using structural equation modeling(SEM)and a time-lagged survey design.The analysis revealed a higher responsible leadership to be associated with both creative self-efficacy and knowledge sharing.Additionally,the study found that supportive climate moderation to significantly,strengthening the relationship between responsible leadership and knowledge sharing.Creative self-efficacy partially mediated this relationship to be stronger.The results indicate that responsible leadership and a supportive climate are crucial socio-cognitive mechanisms for enhancing knowledge sharing in organizations.The banking sector should aim to promote collaborative work partnerships implementing responsible leadership practices and cultivating supportive work environments to bolster organizational growth and competitiveness.展开更多
Objective: To explore the current status and influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery, and to provide a reference for the development of targeted inter...Objective: To explore the current status and influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery, and to provide a reference for the development of targeted intervention strPan ategies. Methods: A general data questionnaire and supportive care needs scale were used to investigate 107 patients with muscle-invasive bladder cancer after surgery. Results: The total score of supportive care needs in patients with muscle-invasive bladder cancer after surgery was (98.48 ± 9.07). Multiple linear regression analysis showed that age, primary caregiver, medical payment method, number of hospitalizations and postoperative time were important influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery (P Conclusion: The supportive care needs of patients with muscle-invasive bladder cancer after surgery are at a low level. Medical staff should identify them early, pay more attention to young patients, patients without medical insurance and patients with multiple hospitalizations, and provide targeted nursing measures to meet their supportive care needs.展开更多
Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many pa...Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs.Even when transplants are successful,for some patients the adjustment to life post-transplant can be challenging and psychological difficulties,economic challenges and social isola-tion have been reported.About 50%of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care.This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation.A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes.We propose the"supportive care in transplantation"care model to operationalize a patient-centered approach in transplantation.This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates.Multi-dimensionality,multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model.We conclude by proposing the potential advantages of this approach to patients and healthcare systems.Core Tip:Kidney transplant recipients and candidates face several uncertainties in their care journey and have several expressed unmet healthcare needs.We recommend a structured and comprehensive approach to transplant care across the entire continuum of a transplant patient’s journey similar to what has been developed in the field of oncology.The supportive care in transplantation model can operationalize patient-centered care and build on the efforts of other researchers in the field.We postulate that such a model would significantly improve care delivery and patients’experiences and outcomes and potentially decrease healthcare utilization and cost.INTRODUCTION Patients with kidney failure benefit from(KT)[1,2],and experience improved survival rates when compared with dialysis[3-6].KT studies,using validated instruments,have also consistently demonstrated that kidney transplant recipients(KTRs)experience better health-related quality of life and several improvements in other disease-specific domains when compared with dialysis[7].In countries where dialysis is out of reach for many,the diagnosis of kidney failure would be futile without KT[8].Thus,increasing KT has been a priority for the nephrology and transplant communities.This priority has been reflected in recent global trends:Of the 79 countries where data were available,the International Society of Nephrology’s Global Kidney Atlas reported that the prevalence of KTRs in 2023 was 279 per million population which represented an increase of 9.4%from the data published four years prior[8].Despite this growth,KT can be a challenging journey for many patients and it is sometimes regarded as a‘cure’,which does not conform with the reality that many patients experience[9-13].KTRs must maintain a life-long treatment regimen of medications,lifestyle changes,self-care and medical appointments[14-17].As poignantly stated by a young female transplant recipient,“I thought everything would change once I got my kidney.I thought I would be healthy again”but after experiencing multiple side effects of immunosuppressive medications and graft loss,she stated,“I am just a different kind of patient now”[18].Indeed,a significant proportion of patients experience graft failure and return to dialysis;it is estimated that over 50%return to dialysis within 10 years of KT[19-23].Patients are often not prepared for this outcome and report several psychosocial and physical ramifications of graft failure[24,25].Overall,high symptom burden,adverse effects of immunosuppressants,risk of graft rejection or failure and mortality,contribute to complex needs,vulnerability and uncertainties for patients,increasing their care needs and treatment burden[26-30].In this paper,we highlight the complex journey that KTRs and candidates undertake that can generate varied outcome trajectories and complex healthcare needs.We highlight the need for a comprehensive patient-centered approach to care and conclude with a proposal for a“supportive care in transplantation”care model.展开更多
Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study...Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study was conducted to assess supportive care needs of women with gynecologic cancer and affecting factors.Methods:This cross-sectional study consisted of 98 women with gynecologic cancer.The data of the study was gathered using“Personal Information Form”and the“James Supportive Care Screening”.Results:The most frequently reported unmet needs of gynecologic cancer patients were emotional issues,including uncertainty(87.6%),fears(85.7%),feeling down(86.7%),worry(87.6%),loss of interest in usual activities(73.3%)and physical symptoms including fatigue/lack of energy(81.9%),weakness(81.9%),lack of appetite(76.2%).The most frequently reported social/practical problems was transportation problems(50%).The mean scores for JSCS was 29.72±15.57.There were a statistically significant difference was found only between family type,stage of the disease,and time of diagnosis,and the total mean scores of the JSCS(p<0.05).Conclusion:It has been determined that patients with gynecological cancer mostly experience emotional and physical problems.Health professionals working in the oncology unit should be aware of unmet needs.Certain programs and services to address the identified unmet needs should be provided.展开更多
Aims:This article aims to explore the interventional and contextual components of smoking cessation support for cancer patients in the context of supportive care in cancer provided by an association,that is viable and...Aims:This article aims to explore the interventional and contextual components of smoking cessation support for cancer patients in the context of supportive care in cancer provided by an association,that is viable and effective in the French context,and to describe the partnership research process in which they were developed.Procedure:The intervention was developed from a dataset collected during a viability study for the development of a smoking cessation intervention carried out at the Ligue Contre le Cancer Gironde,a scoping review of evidence-based interventions and two narrative reviews on the determinants and ethical issues of smoking cessation in cancer.Results:The results confirmed a tangible opportunity to develop smoking cessation services within the relevant case because of the obstacles that can be overcome,the facilitators that can be mobilized,and the gaps existing in this field.In addition,they enabled the design of an intervention adapted to the context,guided by a voluntarist,multidisciplinary approach,and focused on patients’well-being.Conclusion:The associations providing supportive care in cancer can initiate and participate in the process of smoking cessation.They can play a key role in mediating between oncology and addictology.展开更多
Purpose: The purpose of this study was to explore the supportive care needs and health-related quality of life (HRQoL) of lung cancer survivors, and to identify the association between patient characteristics, HRQoL a...Purpose: The purpose of this study was to explore the supportive care needs and health-related quality of life (HRQoL) of lung cancer survivors, and to identify the association between patient characteristics, HRQoL and supportive care needs. Method: This was a sub-study of a larger scale survey of cancer survivors’ supportive care needs. A total of 48 lung cancer survivors were recruited from a regional teaching hospital, and a three-part structured questionnaire was used to collect 1) socio-demographic and clinical characteristics, 2) supportive care needs and 3) health-related quality of life data. Results: The three most commonly reported unmet needs were all in the health-system information domain: 1) being informed about your results as soon as possible (58%), 2) being informed about cancer which is under control or diminishing (50%), and 3) being informed about things you can do to help yourself get well (46%). The second most common unmet need domain was access to healthcare and ancillary support services. The survivors generally reported satisfactory HRQoL. However, household income and unmet physical and psychological needs were independently associated with HRQoL among these survivors. Conclusion: The high unmet needs in the health-system information area call for a review of the content and amount of information provided to lung cancer survivors. In addition, more attention should be given to lung cancer survivors with low incomes but high physical and psychological unmet needs, who require appropriate follow-up and long-term care of a physical, social and psychological kind.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)severity is classified as asymptomatic,mild,moderate,severe,and critical.Mild cases account for a large percentage of cases in the epidemic and typically exhibit a favorabl...BACKGROUND Coronavirus disease 2019(COVID-19)severity is classified as asymptomatic,mild,moderate,severe,and critical.Mild cases account for a large percentage of cases in the epidemic and typically exhibit a favorable prognosis.However,a 49%-67%mortality is noted in critical cases.No COVID-19-specific drug has been reported to date,and symptomatic and optimal supportive care,including oxygenation,anti-coinfection treatments,and ventilation,represent the mainstay of treatment for this disease,especially in critical patients.CASE SUMMARY In the above-mentioned context,we share our experience with the treatment of one critical COVID-19 case and review the relevant literature.CONCLUSION Timely tracheal intubation,reasonable mechanical ventilation support,appropriate anti-infection treatment,and early anticoagulation and immunity support are key factors in the successful treatment of this case.展开更多
Supportive learning plays a substantial role in providing a quality edu-cation system.The evaluation of students’performance impacts their deeper insight into the subject knowledge.Specifically,it is essential to mai...Supportive learning plays a substantial role in providing a quality edu-cation system.The evaluation of students’performance impacts their deeper insight into the subject knowledge.Specifically,it is essential to maintain the baseline foundation for building a broader understanding of their careers.This research concentrates on establishing the students’knowledge relationship even in reduced samples.Here,Synthetic Minority Oversampling TEchnique(SMOTE)technique is used for pre-processing the missing value in the provided input dataset to enhance the prediction accuracy.When the initial processing is not done substantially,it leads to misleading prediction accuracy.This research concentrates on modelling an efficient classifier model to predict students’perfor-mance.Generally,the online available student dataset comprises a lesser amount of sample,and k-fold cross-validation is performed to balance the dataset.Then,the relationship among the students’performance(features)is measured using the auto-encoder.The stacked Long Short Term Memory(s-LSTM)is used to learn the previous feedback connection.The stacked model handles the provided data and the data sequence for understanding the long-term dependencies.The simula-tion is done in the MATLAB 2020a environment,and the proposed model shows a better trade-off than the existing approaches.Some evaluation metrics like pre-diction accuracy,sensitivity,specificity,AUROC,F1-score and recall are evalu-ated using the proposed model.The performance of the s?LSTM model is compared with existing approaches.The proposed model gives 89% accuracy,83% precision,86%recall,and 87%F-score.The proposed model outperforms the existing systems in terms of the earlier metrics.展开更多
The Annual Symposium of the Multinational Association of Supportive Care in Cancer （MASCC）/International Society of Oral Oncology （ISOO） was held in Vancouver, Canada,June 24-26, 2010. The symposium brought togeth...The Annual Symposium of the Multinational Association of Supportive Care in Cancer （MASCC）/International Society of Oral Oncology （ISOO） was held in Vancouver, Canada,June 24-26, 2010. The symposium brought together health care professionals from many countries and many fields of expertise for an excellent forum of ideas, lectures and collegial interactions,and discussed methods to minimize cancer-induced side effects, the symptoms and complications of its treatment, and psychosocial issues facing cancer patients and their families. Some ideas and studies selected from the presentations of different fields of supportive care in cancer presented in this symposium are introduced in this paper.展开更多
Health Products and Technologies (HPTs) are pivotal for an efficient health system. Availability and accessibility to affordable health products are critical indicators towards achieving universal health coverage. Rou...Health Products and Technologies (HPTs) are pivotal for an efficient health system. Availability and accessibility to affordable health products are critical indicators towards achieving universal health coverage. Routine supportive supervision, performance monitoring, recognition of efforts and client feedback are vital activities toward health supply chain system strengthening. This is a descriptive paper that describes a model of integrated commodity supportive supervision, and mentorship and its impact on various outcomes of health commodity management. Data were abstracted from the standardized scored checklists used during integrated commodity supportive supervision and supply chain audit in public health facilities in Vihiga County. Scores for the period 2020 to 2022 were analyzed on the eight key areas of interest. The analysis was done using Statistical Package for Social Sciences (SPSS version 26). Results are interpreted at 95% Confidence interval. This paper also shares findings from both quantitative and qualitative data from client exit and facility managers’ interviews. Six complete rounds of supervisions, three clients and service providers’ interviews, and three annual award events have been conducted. We observed trends across six data collections points and compared the results at first point or baseline (January-June 2020) to the results at the last point or end line (April-June 2022). Findings show significant improvements on the eight parameters in terms of mean scores as follows: resolution of issues from previous visits by 35.06% (46.75% - 81.81%);storage of HPTs by 17.41% (68.72% - 86.13%);inventory management by 28.16% (42.67% - 70.83%);availability and use of commodity data management information systems (MIS) tools by 22.39% (74.40% - 96.79%);verification of commodity data by 25.61% (65.56% - 91.17%);availability of guidelines and job aids for commodity management by 46.28% (36.65% - 82.93%). There was an improvement on the mean score on accountability by 20.22% (58.58% - 83.51%). The composite (final) score improved by 28.33% (56.19% - 84.52%). There was progressive narrowing of the standard deviations on all the indicators across the study period. This demonstrates that there is standardization of practices and positive competition among all the public health facilities. There were significant improvements on all the eight indicators. Routine integrated commodity supportive supervision has proven to be an effective high impact intervention in improving management of health products and technologies in Vihiga County, Kenya.展开更多
Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was cond...Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was conducted at obstetric wards and intrapartum units at Nasser Institute Hospital. Sample: All nurses provide guided direct care, there were 40 nurses included in the study. Tools: Three tools were used to collect data named self-administered questionnaire sheet, labor supportive measures’ observational checklists, and nurses’ satisfaction sheet. Results: There was a highly significant improvement in total knowledge and total practical skills among the studied sample pre-intervention compared to immediate post and follow-up intervention (p ≤ 0.01). Additionally, 95% of the studied sample was satisfied with the advanced knowledge included in the guidelines. Conclusion: The supportive measures guidelines had an efficient improving nurses’ knowledge and practices post-intervention. Also, the majority of the studied sample was satisfied with the implemented guidelines. Recommendations: Implementation of labor supportive measure guidelines in different childbirth units to improve nurses’ practice. Further research is required to investigate parturient woman’s satisfaction with the childbirth process after implementing labor supportive measures and the effect of labor supportive measures on childbirth process outcome.展开更多
For this research,we examined the influence of access to domestic and international financing on sustainability performance with a mediating role of innovative performance and a moderating role of access to government...For this research,we examined the influence of access to domestic and international financing on sustainability performance with a mediating role of innovative performance and a moderating role of access to government support.Data were collected from 317 small and medium-sized enterprises(SMEs)through structured questionnaires.The results indicated that access to domestic and international financing significantly contributes to sustainability and innovative performances.Accordingly,we found a partial mediating role of innovative performance between access to domestic financing and sustainability performance as well as between access to international financing and sustainability performance.Access to government support significantly moderates the relationship between access to domestic finances and innovative performance as well as between access to international finances and innovative performance.Practitioners and policymakers should encourage national and international financial institutions and banks to facilitate SMEs by lending them funds for innovative activities and sustainability performance.Moreover,the government should support SMEs,so that they can contribute to economic growth and the gross domestic product.The implications from these matters will be further discussed in this paper.展开更多
Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at re...Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at relatives’ of a person with schizophrenia to alleviate daily life. Aim: The aim of the present study was to explore participants’ use of the web based tool with focus on the forum and its potential health and psychosocial benefits. Methods: Nineteen persons participated in this explorative open trial. The forum posts were analyzed using content analysis. Self-rating instruments assessing caregiver burden, stigma and the tool’s usability were analyzed with descriptive statistics. Results: The qualitative analysis resulted in four main categories and subcategories describing relatives’ situation and interaction in the forum: Caring for a Person with Schizophrenia, Crisis and Care, Secrecy vs Openness, and Interaction and Social Support. Experiences of caregiver burden, but also fulfillment with caregiving tasks were reported. Concealing or hiding the family’s mental illness was common, but also the ability to use inner strength to cope with stigma and discrimination. The mean usability score was 59 (70 = good). Conclusion: Web based support can help address some of the families’ needs of support, although it encompasses certain limitations. Patient rights and the availability of resources, especially in cases of emergency, need to be made easily visible and accessible to alleviate families’ burden.展开更多
1.Introduction In 2001,the American Cancer Society(ACS)published the first guidelines referencing the potential importance of regular exercise for symptom control benefit for cancer patients.1 Notably,the report also ...1.Introduction In 2001,the American Cancer Society(ACS)published the first guidelines referencing the potential importance of regular exercise for symptom control benefit for cancer patients.1 Notably,the report also stated,“researchers have not been able to determine whether activity can prevent recurrence of cancer or slow the progression of disease….”1 Research interest in the field known as exercise‒oncology has grown substantially over the past∼25 years with exercise now endorsed as a legitimate supportive adjunct strategy by multiple oncology agencies.2-5 But where are we with exercise and cancer outcomes?Despite significant progress,the 2022 American Society of Clinical Oncology(ASCO)guidelines concluded“evidence was not sufficient to recommend for or against exercise during treatment to improve cancer control outcomes(recurrence or survival).”展开更多
Exercise is established as a supportive care intervention during and after various cancer treatment modalities.1,2 Documented benefits include improvements in health-related fitness,physical functioning,some symptoms/...Exercise is established as a supportive care intervention during and after various cancer treatment modalities.1,2 Documented benefits include improvements in health-related fitness,physical functioning,some symptoms/side effects,psychosocial functioning,and quality of life.1,2 Exercise has not been established,however,as a treatment for any type of cancer in any clinical oncology setting.2 This special topic of the Journal of Sport and Health Science(JSHS)is dedicated to research on“Exercise as a cancer treatment”.The special topic sought preclinical,observational,or clinical studies examining the effects of exercise after a cancer diagnosis on a cancer outcome(e.g.,cell/tumor growth,tumor response,disease recurrence,progression,death from cancer).It includes 6 original articles and an invited opinion article.展开更多
The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly f...The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.展开更多
This article comments on the letter by Lowell et al,which addresses the next generation of combination therapy for inflammatory bowel disease(IBD).As the understanding of the pathogenesis of IBD continues to improve,t...This article comments on the letter by Lowell et al,which addresses the next generation of combination therapy for inflammatory bowel disease(IBD).As the understanding of the pathogenesis of IBD continues to improve,treatment strategies are evolving rapidly.The letter examines the current status and future directions of combination therapy for IBD,focusing on approaches that combine biologics with immunomodulators and the emerging dual-biologic therapy(DBT).The traditional combination of biologics and immunomodulators has demonstra-ted preliminary efficacy by enhancing the effects of biologics through immunomo-dulation.However,concerns regarding long-term safety warrant careful evalua-tion.Recent trials,including DUET-Crohn's disease and DUET-ulcerative colitis,have shown promising potential for the broader adoption of DBT.Nevertheless,comprehensive data on efficacy and safety,as well as the effective integration of supportive treatments,remain essential to establish new paradigms for the next generation of IBD care.展开更多
The national weight management campaign,part of the broader Healthy China strategy,enhances public health literacy,fosters healthy living habits,and creates supportive environments for sustained weight control.
文摘This study explores the interaction of responsible leadership,supportive climate,and creative self-efficacy in enhancing knowledge sharing among employees in the banking sector.Data from 314 employees(42%Females,58%Males)were analyzed using structural equation modeling(SEM)and a time-lagged survey design.The analysis revealed a higher responsible leadership to be associated with both creative self-efficacy and knowledge sharing.Additionally,the study found that supportive climate moderation to significantly,strengthening the relationship between responsible leadership and knowledge sharing.Creative self-efficacy partially mediated this relationship to be stronger.The results indicate that responsible leadership and a supportive climate are crucial socio-cognitive mechanisms for enhancing knowledge sharing in organizations.The banking sector should aim to promote collaborative work partnerships implementing responsible leadership practices and cultivating supportive work environments to bolster organizational growth and competitiveness.
文摘Objective: To explore the current status and influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery, and to provide a reference for the development of targeted intervention strPan ategies. Methods: A general data questionnaire and supportive care needs scale were used to investigate 107 patients with muscle-invasive bladder cancer after surgery. Results: The total score of supportive care needs in patients with muscle-invasive bladder cancer after surgery was (98.48 ± 9.07). Multiple linear regression analysis showed that age, primary caregiver, medical payment method, number of hospitalizations and postoperative time were important influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery (P Conclusion: The supportive care needs of patients with muscle-invasive bladder cancer after surgery are at a low level. Medical staff should identify them early, pay more attention to young patients, patients without medical insurance and patients with multiple hospitalizations, and provide targeted nursing measures to meet their supportive care needs.
文摘Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs.Even when transplants are successful,for some patients the adjustment to life post-transplant can be challenging and psychological difficulties,economic challenges and social isola-tion have been reported.About 50%of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care.This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation.A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes.We propose the"supportive care in transplantation"care model to operationalize a patient-centered approach in transplantation.This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates.Multi-dimensionality,multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model.We conclude by proposing the potential advantages of this approach to patients and healthcare systems.Core Tip:Kidney transplant recipients and candidates face several uncertainties in their care journey and have several expressed unmet healthcare needs.We recommend a structured and comprehensive approach to transplant care across the entire continuum of a transplant patient’s journey similar to what has been developed in the field of oncology.The supportive care in transplantation model can operationalize patient-centered care and build on the efforts of other researchers in the field.We postulate that such a model would significantly improve care delivery and patients’experiences and outcomes and potentially decrease healthcare utilization and cost.INTRODUCTION Patients with kidney failure benefit from(KT)[1,2],and experience improved survival rates when compared with dialysis[3-6].KT studies,using validated instruments,have also consistently demonstrated that kidney transplant recipients(KTRs)experience better health-related quality of life and several improvements in other disease-specific domains when compared with dialysis[7].In countries where dialysis is out of reach for many,the diagnosis of kidney failure would be futile without KT[8].Thus,increasing KT has been a priority for the nephrology and transplant communities.This priority has been reflected in recent global trends:Of the 79 countries where data were available,the International Society of Nephrology’s Global Kidney Atlas reported that the prevalence of KTRs in 2023 was 279 per million population which represented an increase of 9.4%from the data published four years prior[8].Despite this growth,KT can be a challenging journey for many patients and it is sometimes regarded as a‘cure’,which does not conform with the reality that many patients experience[9-13].KTRs must maintain a life-long treatment regimen of medications,lifestyle changes,self-care and medical appointments[14-17].As poignantly stated by a young female transplant recipient,“I thought everything would change once I got my kidney.I thought I would be healthy again”but after experiencing multiple side effects of immunosuppressive medications and graft loss,she stated,“I am just a different kind of patient now”[18].Indeed,a significant proportion of patients experience graft failure and return to dialysis;it is estimated that over 50%return to dialysis within 10 years of KT[19-23].Patients are often not prepared for this outcome and report several psychosocial and physical ramifications of graft failure[24,25].Overall,high symptom burden,adverse effects of immunosuppressants,risk of graft rejection or failure and mortality,contribute to complex needs,vulnerability and uncertainties for patients,increasing their care needs and treatment burden[26-30].In this paper,we highlight the complex journey that KTRs and candidates undertake that can generate varied outcome trajectories and complex healthcare needs.We highlight the need for a comprehensive patient-centered approach to care and conclude with a proposal for a“supportive care in transplantation”care model.
文摘Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study was conducted to assess supportive care needs of women with gynecologic cancer and affecting factors.Methods:This cross-sectional study consisted of 98 women with gynecologic cancer.The data of the study was gathered using“Personal Information Form”and the“James Supportive Care Screening”.Results:The most frequently reported unmet needs of gynecologic cancer patients were emotional issues,including uncertainty(87.6%),fears(85.7%),feeling down(86.7%),worry(87.6%),loss of interest in usual activities(73.3%)and physical symptoms including fatigue/lack of energy(81.9%),weakness(81.9%),lack of appetite(76.2%).The most frequently reported social/practical problems was transportation problems(50%).The mean scores for JSCS was 29.72±15.57.There were a statistically significant difference was found only between family type,stage of the disease,and time of diagnosis,and the total mean scores of the JSCS(p<0.05).Conclusion:It has been determined that patients with gynecological cancer mostly experience emotional and physical problems.Health professionals working in the oncology unit should be aware of unmet needs.Certain programs and services to address the identified unmet needs should be provided.
文摘Aims:This article aims to explore the interventional and contextual components of smoking cessation support for cancer patients in the context of supportive care in cancer provided by an association,that is viable and effective in the French context,and to describe the partnership research process in which they were developed.Procedure:The intervention was developed from a dataset collected during a viability study for the development of a smoking cessation intervention carried out at the Ligue Contre le Cancer Gironde,a scoping review of evidence-based interventions and two narrative reviews on the determinants and ethical issues of smoking cessation in cancer.Results:The results confirmed a tangible opportunity to develop smoking cessation services within the relevant case because of the obstacles that can be overcome,the facilitators that can be mobilized,and the gaps existing in this field.In addition,they enabled the design of an intervention adapted to the context,guided by a voluntarist,multidisciplinary approach,and focused on patients’well-being.Conclusion:The associations providing supportive care in cancer can initiate and participate in the process of smoking cessation.They can play a key role in mediating between oncology and addictology.
文摘Purpose: The purpose of this study was to explore the supportive care needs and health-related quality of life (HRQoL) of lung cancer survivors, and to identify the association between patient characteristics, HRQoL and supportive care needs. Method: This was a sub-study of a larger scale survey of cancer survivors’ supportive care needs. A total of 48 lung cancer survivors were recruited from a regional teaching hospital, and a three-part structured questionnaire was used to collect 1) socio-demographic and clinical characteristics, 2) supportive care needs and 3) health-related quality of life data. Results: The three most commonly reported unmet needs were all in the health-system information domain: 1) being informed about your results as soon as possible (58%), 2) being informed about cancer which is under control or diminishing (50%), and 3) being informed about things you can do to help yourself get well (46%). The second most common unmet need domain was access to healthcare and ancillary support services. The survivors generally reported satisfactory HRQoL. However, household income and unmet physical and psychological needs were independently associated with HRQoL among these survivors. Conclusion: The high unmet needs in the health-system information area call for a review of the content and amount of information provided to lung cancer survivors. In addition, more attention should be given to lung cancer survivors with low incomes but high physical and psychological unmet needs, who require appropriate follow-up and long-term care of a physical, social and psychological kind.
基金Supported by the Health and Family Planning Commission of Shenzhen Municipality,No.SZLY2018024and Sanming Project of Medicine in Shenzhen,No.SZSM201512031.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)severity is classified as asymptomatic,mild,moderate,severe,and critical.Mild cases account for a large percentage of cases in the epidemic and typically exhibit a favorable prognosis.However,a 49%-67%mortality is noted in critical cases.No COVID-19-specific drug has been reported to date,and symptomatic and optimal supportive care,including oxygenation,anti-coinfection treatments,and ventilation,represent the mainstay of treatment for this disease,especially in critical patients.CASE SUMMARY In the above-mentioned context,we share our experience with the treatment of one critical COVID-19 case and review the relevant literature.CONCLUSION Timely tracheal intubation,reasonable mechanical ventilation support,appropriate anti-infection treatment,and early anticoagulation and immunity support are key factors in the successful treatment of this case.
文摘Supportive learning plays a substantial role in providing a quality edu-cation system.The evaluation of students’performance impacts their deeper insight into the subject knowledge.Specifically,it is essential to maintain the baseline foundation for building a broader understanding of their careers.This research concentrates on establishing the students’knowledge relationship even in reduced samples.Here,Synthetic Minority Oversampling TEchnique(SMOTE)technique is used for pre-processing the missing value in the provided input dataset to enhance the prediction accuracy.When the initial processing is not done substantially,it leads to misleading prediction accuracy.This research concentrates on modelling an efficient classifier model to predict students’perfor-mance.Generally,the online available student dataset comprises a lesser amount of sample,and k-fold cross-validation is performed to balance the dataset.Then,the relationship among the students’performance(features)is measured using the auto-encoder.The stacked Long Short Term Memory(s-LSTM)is used to learn the previous feedback connection.The stacked model handles the provided data and the data sequence for understanding the long-term dependencies.The simula-tion is done in the MATLAB 2020a environment,and the proposed model shows a better trade-off than the existing approaches.Some evaluation metrics like pre-diction accuracy,sensitivity,specificity,AUROC,F1-score and recall are evalu-ated using the proposed model.The performance of the s?LSTM model is compared with existing approaches.The proposed model gives 89% accuracy,83% precision,86%recall,and 87%F-score.The proposed model outperforms the existing systems in terms of the earlier metrics.
文摘The Annual Symposium of the Multinational Association of Supportive Care in Cancer （MASCC）/International Society of Oral Oncology （ISOO） was held in Vancouver, Canada,June 24-26, 2010. The symposium brought together health care professionals from many countries and many fields of expertise for an excellent forum of ideas, lectures and collegial interactions,and discussed methods to minimize cancer-induced side effects, the symptoms and complications of its treatment, and psychosocial issues facing cancer patients and their families. Some ideas and studies selected from the presentations of different fields of supportive care in cancer presented in this symposium are introduced in this paper.
文摘Health Products and Technologies (HPTs) are pivotal for an efficient health system. Availability and accessibility to affordable health products are critical indicators towards achieving universal health coverage. Routine supportive supervision, performance monitoring, recognition of efforts and client feedback are vital activities toward health supply chain system strengthening. This is a descriptive paper that describes a model of integrated commodity supportive supervision, and mentorship and its impact on various outcomes of health commodity management. Data were abstracted from the standardized scored checklists used during integrated commodity supportive supervision and supply chain audit in public health facilities in Vihiga County. Scores for the period 2020 to 2022 were analyzed on the eight key areas of interest. The analysis was done using Statistical Package for Social Sciences (SPSS version 26). Results are interpreted at 95% Confidence interval. This paper also shares findings from both quantitative and qualitative data from client exit and facility managers’ interviews. Six complete rounds of supervisions, three clients and service providers’ interviews, and three annual award events have been conducted. We observed trends across six data collections points and compared the results at first point or baseline (January-June 2020) to the results at the last point or end line (April-June 2022). Findings show significant improvements on the eight parameters in terms of mean scores as follows: resolution of issues from previous visits by 35.06% (46.75% - 81.81%);storage of HPTs by 17.41% (68.72% - 86.13%);inventory management by 28.16% (42.67% - 70.83%);availability and use of commodity data management information systems (MIS) tools by 22.39% (74.40% - 96.79%);verification of commodity data by 25.61% (65.56% - 91.17%);availability of guidelines and job aids for commodity management by 46.28% (36.65% - 82.93%). There was an improvement on the mean score on accountability by 20.22% (58.58% - 83.51%). The composite (final) score improved by 28.33% (56.19% - 84.52%). There was progressive narrowing of the standard deviations on all the indicators across the study period. This demonstrates that there is standardization of practices and positive competition among all the public health facilities. There were significant improvements on all the eight indicators. Routine integrated commodity supportive supervision has proven to be an effective high impact intervention in improving management of health products and technologies in Vihiga County, Kenya.
文摘Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was conducted at obstetric wards and intrapartum units at Nasser Institute Hospital. Sample: All nurses provide guided direct care, there were 40 nurses included in the study. Tools: Three tools were used to collect data named self-administered questionnaire sheet, labor supportive measures’ observational checklists, and nurses’ satisfaction sheet. Results: There was a highly significant improvement in total knowledge and total practical skills among the studied sample pre-intervention compared to immediate post and follow-up intervention (p ≤ 0.01). Additionally, 95% of the studied sample was satisfied with the advanced knowledge included in the guidelines. Conclusion: The supportive measures guidelines had an efficient improving nurses’ knowledge and practices post-intervention. Also, the majority of the studied sample was satisfied with the implemented guidelines. Recommendations: Implementation of labor supportive measure guidelines in different childbirth units to improve nurses’ practice. Further research is required to investigate parturient woman’s satisfaction with the childbirth process after implementing labor supportive measures and the effect of labor supportive measures on childbirth process outcome.
文摘For this research,we examined the influence of access to domestic and international financing on sustainability performance with a mediating role of innovative performance and a moderating role of access to government support.Data were collected from 317 small and medium-sized enterprises(SMEs)through structured questionnaires.The results indicated that access to domestic and international financing significantly contributes to sustainability and innovative performances.Accordingly,we found a partial mediating role of innovative performance between access to domestic financing and sustainability performance as well as between access to international financing and sustainability performance.Access to government support significantly moderates the relationship between access to domestic finances and innovative performance as well as between access to international finances and innovative performance.Practitioners and policymakers should encourage national and international financial institutions and banks to facilitate SMEs by lending them funds for innovative activities and sustainability performance.Moreover,the government should support SMEs,so that they can contribute to economic growth and the gross domestic product.The implications from these matters will be further discussed in this paper.
文摘Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at relatives’ of a person with schizophrenia to alleviate daily life. Aim: The aim of the present study was to explore participants’ use of the web based tool with focus on the forum and its potential health and psychosocial benefits. Methods: Nineteen persons participated in this explorative open trial. The forum posts were analyzed using content analysis. Self-rating instruments assessing caregiver burden, stigma and the tool’s usability were analyzed with descriptive statistics. Results: The qualitative analysis resulted in four main categories and subcategories describing relatives’ situation and interaction in the forum: Caring for a Person with Schizophrenia, Crisis and Care, Secrecy vs Openness, and Interaction and Social Support. Experiences of caregiver burden, but also fulfillment with caregiving tasks were reported. Concealing or hiding the family’s mental illness was common, but also the ability to use inner strength to cope with stigma and discrimination. The mean usability score was 59 (70 = good). Conclusion: Web based support can help address some of the families’ needs of support, although it encompasses certain limitations. Patient rights and the availability of resources, especially in cases of emergency, need to be made easily visible and accessible to alleviate families’ burden.
文摘1.Introduction In 2001,the American Cancer Society(ACS)published the first guidelines referencing the potential importance of regular exercise for symptom control benefit for cancer patients.1 Notably,the report also stated,“researchers have not been able to determine whether activity can prevent recurrence of cancer or slow the progression of disease….”1 Research interest in the field known as exercise‒oncology has grown substantially over the past∼25 years with exercise now endorsed as a legitimate supportive adjunct strategy by multiple oncology agencies.2-5 But where are we with exercise and cancer outcomes?Despite significant progress,the 2022 American Society of Clinical Oncology(ASCO)guidelines concluded“evidence was not sufficient to recommend for or against exercise during treatment to improve cancer control outcomes(recurrence or survival).”
基金supported by the Canada Research Chairs Programa Foundation Grant from the Canadian Institutes of Health Research (No. 159927)
文摘Exercise is established as a supportive care intervention during and after various cancer treatment modalities.1,2 Documented benefits include improvements in health-related fitness,physical functioning,some symptoms/side effects,psychosocial functioning,and quality of life.1,2 Exercise has not been established,however,as a treatment for any type of cancer in any clinical oncology setting.2 This special topic of the Journal of Sport and Health Science(JSHS)is dedicated to research on“Exercise as a cancer treatment”.The special topic sought preclinical,observational,or clinical studies examining the effects of exercise after a cancer diagnosis on a cancer outcome(e.g.,cell/tumor growth,tumor response,disease recurrence,progression,death from cancer).It includes 6 original articles and an invited opinion article.
基金supported by European Union Funding Programme,PNRR,No. 760058(to DMH)the UEFISCDI Project,No. PN-III-P4-IDPCE-2020-059(to APW)
文摘The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.
基金Supported by the National Natural Science Foundation of China,No.82400591(to Wu FF).
文摘This article comments on the letter by Lowell et al,which addresses the next generation of combination therapy for inflammatory bowel disease(IBD).As the understanding of the pathogenesis of IBD continues to improve,treatment strategies are evolving rapidly.The letter examines the current status and future directions of combination therapy for IBD,focusing on approaches that combine biologics with immunomodulators and the emerging dual-biologic therapy(DBT).The traditional combination of biologics and immunomodulators has demonstra-ted preliminary efficacy by enhancing the effects of biologics through immunomo-dulation.However,concerns regarding long-term safety warrant careful evalua-tion.Recent trials,including DUET-Crohn's disease and DUET-ulcerative colitis,have shown promising potential for the broader adoption of DBT.Nevertheless,comprehensive data on efficacy and safety,as well as the effective integration of supportive treatments,remain essential to establish new paradigms for the next generation of IBD care.
文摘The national weight management campaign,part of the broader Healthy China strategy,enhances public health literacy,fosters healthy living habits,and creates supportive environments for sustained weight control.
