Canadian Resources, Programs, and Models of Care to Support Cancer Survivors' Transition beyond Treatment: A Scoping Review.
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SUBMITTER: Romkey-Sinasac C
PROVIDER: S-EPMC8293069 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Mixed-effect models are frequently used to control for the nonindependence of data points, for example, when repeated measures from the same individuals are available. The aim of these models is often to estimate fixed effects and to test their significance. This is usually done by including random intercepts, that is, intercepts that are allowed to vary between individuals. The widespread belief is that this controls for all types of pseudoreplication within individuals. Here we show that this is not the case, if the aim is to estimate effects that vary within individuals and individuals differ in their response to these effects. In these cases, random intercept models give overconfident estimates leading to conclusions that are not supported by the data. By allowing individuals to differ in the slopes of their responses, it is possible to account for the nonindependence of data points that pseudoreplicate slope information. Such random slope models give appropriate standard errors and are easily implemented in standard statistical software. Because random slope models are not always used where they are essential, we suspect that many published findings have too narrow confidence intervals and a substantially inflated type I error rate. Besides reducing type I errors, random slope models have the potential to reduce residual variance by accounting for between-individual variation in slopes, which makes it easier to detect treatment effects that are applied between individuals, hence reducing type II errors as well.
| S-EPMC2657178 | biostudies-literature
Project description:BackgroundThe unequal representation of women in global health leadership is a prevalent issue laterally across global health fields and vertically down experience levels. Although women compose much of the workforce, gender-based barriers prevent female talent from filling their appropriate leadership roles, which funnels unique expertise and problem-solving skills on a diversity of health topics out of positions of leadership. Currently, many calls to action have been proposed to raise awareness of the lack of women's global health leadership, with Women in Global Health as one of the more prominent movements. This paper evaluates how the priorities and strategies for leadership training and development set forth by such movements have changed the landscape of available programs and resources for women in global health, based on availability, success, and evaluation.ObjectivesThis manuscript maps existing programs and resources that support women's leadership in global health and describes available evaluations and documented outcomes.MethodsWe used a dual approach of a peer-reviewed and gray literature search to build a comprehensive list of existing programs and resources designed to support women's leadership in global health. Out of 54 items included for full-text review and 22 gray literature items screened for inclusion, a total of 31 resources were processed in the final extraction. We used descriptive quantitative analysis for categorical and binary variables, while qualitative data from evaluations were analyzed for outcomes.FindingsResources were in the form of conferences, supplemental resources to conferences, certificate programs, coursework, stand-alone documents, single-focus programs, and mostly multicomponent programs. Most resources did not have a global health focus area, and a third of the total resources identified women first authors from predominantly high-income countries. About half of the resources mention mentorship and networking as activities incorporated as part of the resource. Over half of the resources did not have a target audience, and most resources were free to users.While there is a lack of consistent and meaningful evaluation of the resources, the available captured metrics of success were described as the number of career-advancing opportunities after using the resources. Examples of opportunities include enrollment in graduate school, receiving academic promotions, participating in internships, presenting at conferences, and publications.ConclusionWhile the supply of existing programming and resources to advance women's leadership in the global health field is limited in terms of quantity, it is rich in diverse formats, content, and implementation. This scoping review supports the notion that empowered female leadership in global health requires a complementary support system that encourages the unique needs and talents of female leaders. Such a support system needs inclusive targeting regardless of experience level, academic degree, or location. Furthermore, evaluations of resources will be critical in maintaining meaningful interventions that effectively dismantle the infrastructures that continue to limit the success of women leaders in global health.
| S-EPMC10120609 | biostudies-literature
Project description:BackgroundPeer-led support models have gained increasing popularity in suicide prevention. While previous reviews show positive effects of peer-led support for people with mental health problems and those bereaved by suicide, little is known about the types of lived experience peer support programs in suicide prevention and whether these are effective in improving the health and wellbeing of people at risk of suicide. The aim of this paper is to provide an overview of peer support programs that aim to reduce suicidality and are led by people with lived experience of suicide.MethodWe conducted a systematic scoping review, involving a search of three academic (Medline, PsycINFO, Embase) and selected grey literature databases (Google Scholar, WHO Clinical Trials Registry) for publications between 2000 and 2019. We also contacted suicide prevention experts and relevant internet sites to identify peer support programs that exist but have not been evaluated. The screening of records followed a systematic two-stage process in alignment with PRISMA guidelines.ResultsWe identified 8 records accounting for 7 programs focussed on peer-led support programs in suicide prevention. These programs employed a range of different designs and included a variety of settings (schools, communities, rural and online). Only 3 of the 7 programs contained data on effectiveness. With the small number of eligible programs the findings from this review are limited and must be interpreted with caution.ConclusionsDespite the increased focus of policymakers on the importance of peer support programs in suicide prevention, our scoping review confirms an evidence gap in research knowledge regarding program design, implementation, and effectiveness. More rigour is required in reporting peer-led support initiatives to clarify the underlying definition of peer support and lived experience and to enhance our understanding of the types of current peer support programs available to those experiencing suicidality. Further, we need formal and high-quality evaluations of peer support suicide prevention programs led by people with lived experience to better understand their effectiveness on participant health across different settings and delivery modalities and to allow for comprehensive systematic reviews and meta-analysis in future.
| S-EPMC7425132 | biostudies-literature
Project description:BackgroundBreast cancer (BC) is the most common invasive cancer in women, and exercise can significantly improve the outcomes of BC survivors. MoviS (Movement and Health Beyond Care) is a randomized controlled trial aimed to evaluate the potential health benefits of exercise and proper nutritional habits. This study aims to assess the efficacy of aerobic exercise training in improving quality of life (QoL) and health-related factors in high-risk BC.MethodsOne hundred seventy-two BC survivor women, aged 30-70 years, non-metastatic, stage 0-III, non-physically active, 6-12 months post-surgery, and post chemo- or radiotherapy, will be recruited in this study. Women will be randomly allocated to the intervention arm (lifestyle recommendations and MoviS Training) or control arm (lifestyle recommendations). The MoviS training consists of 12 weeks of aerobic exercise training (2 days/week of supervised and 1 day/week of unsupervised exercise) with a progressive increase in exercise intensity (40-70% of heart rate reserve) and duration (20-60 min). Both arms will receive counseling on healthy lifestyle habits (nutrition and exercise) based on the World Cancer Research Fund International (WCRF) 2018 guidelines. The primary outcome is the improvement of the QoL. The secondary outcomes are improvement of health-related parameters such as Mediterranean diet adherence, physical activity level, flexibility, muscular fitness, fatigue, cardiorespiratory fitness (estimated maximal oxygen uptake), echocardiographic parameters, heart rate variability (average of the standard deviations of all 5 min normal to normal intervals (ASDNN/5 min) and 24 h very low and low frequency), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein).DiscussionThis trial aims to evaluate if supervised exercise may improve QoL and health-related factors of BC survivors with a high risk of recurrence. Findings from this project could provide knowledge improvement in the field of exercise oncology through the participation of a multidisciplinary team that will provide a coordinated program of cancer care to improve healthcare quality, improve prognosis, increase survival times and QoL, and reduce the risk of BC recurrence.Trial registrationClinicalTrials.gov NCT04818359 . Retrospectively registered on March 26, 2021.
| S-EPMC9946288 | biostudies-literature
Project description:IntroductionCannabis use in Canada is becoming more prevalent across all demographic groups due to increases in accessibility and lowered perceptions of harm. These patterns are mirrored among women of reproductive age, including women who are pregnant. Given increasing evidence for detrimental short- and long-term impacts of cannabis exposure on fetal, newborn and child outcomes, there is a need for high-quality, accessible resources providing reliable guidance and recommendations on this topic for both the public and healthcare providers. We will conduct a scoping review to identify and characterise all publicly available online educational resources discussing cannabis use related to fertility, pregnancy and breastfeeding developed by Canadian organisations.Methods and analysisUsing Arksey and O'Malley's scoping review methodology as a guide, we will search Medline (Ovid), Medline in Process (Ovid), Embase (Ovid), ERIC (Ovid), CINAHL (EBSCOhost) and Education Source (EBSCOhost). We will also conduct a grey literature search targeting the websites of national and independent Canadian obstetrical societies and networks, and government and public health offices that provide recommendations or guidance to individuals and their healthcare providers seeking information on cannabis use related to fertility, pregnancy or breastfeeding.Ethics and disseminationResearch ethics approval is not required for scoping review studies. We anticipate that this review's findings will be disseminated through traditional channels, including preprint and peer-reviewed publications and presentations at academic conferences. In addition, the resources and guidelines identified in the study will be gathered and made available online on a single comprehensive public repository. PROTOCOL REGISTRATION NUMBER: osf.io/p24y5.
| S-EPMC7925897 | biostudies-literature
Project description:BackgroundAs the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education.ObjectiveWith a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs' curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs' effectiveness.MethodsAfter the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career).ResultsOf the 10,094 unique citations scanned, 41 (0.41%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24%) described 13 unique programs and 31 (76%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective.ConclusionsThis review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction.
| S-EPMC8713099 | biostudies-literature
Project description:BackgroundThe focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources.MethodWe employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered.ResultsThe district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities.DiscussionThe plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention.
| S-EPMC4427185 | biostudies-literature
Project description:ContextThe transition to clinical training within medical school is often seen as a struggle and students remain in distress despite numerous efforts to minimise threats. Efforts to change this may be misdirected if they are based on narrow conceptualisations of transitions. The authors conducted a scoping review to explore existing conceptual perspectives regarding the transition within medical school from pre-clinical training to clinical training to suggest a research agenda and practical implications.MethodsBetween October 2017 and February 2018 the authors searched PubMed, MEDLINE, ERIC, PsycINFO, Web of Science and CINAHL for English language literature with no date limits and retrieved 1582 articles; 46 were included in this review. Two reviewers independently screened articles and extracted data. Data were then charted, analysed and discussed with the research team.ResultsThe transition to clinical training was often described negatively as 'difficult', 'a problem' and 'a struggle'. Our analysis found that researchers in medical education conducted studies on the transition to clinical training from three conceptual perspectives: educational; social, and developmental. Most research approached the transition to clinical training as a problem to be addressed from an educational perspective through transition to clerkship courses and curriculum innovations. Some research was conducted from a social perspective, focusing on building relationships. Regarding development, authors found a few articles highlighting opportunities for personal and professional development by nurturing transferrable learning strategies and reflection.ConclusionsThis review provides an empirical base on which future research can be built to better understand and support medical students' ability to navigate change. Finding new perspectives to approach the transition to clinical training could allow researchers to look beyond preparing students for struggles.
| S-EPMC6593677 | biostudies-literature
Project description:Purposein this scoping review, previously reported data were described and synthesized to document transition interventions in CCSs, and the features of intervention components of the current transition studies for CCSs were summarized.MethodsA literature search was conducted in PubMed, Web of Science, EMBASE, PsycINFO, CINAHL, Ovid, and the Cochrane Library following the PRISMA-ScR statement. All original studies (n = 9) investigating transition interventions in CCSs were included.ResultsThe current studies identified essential elements for transition programs, such as delivering knowledge, developing skills for coordination of care, and addressing psychosocial needs. However, the current transition interventions were generally in their infancy, and major deficits were found, including poorly reported intervention components and procedures, a limited number of relevant validated outcomes, and a failure to incorporate conceptual frameworks and international consensus statements.ConclusionsThis scoping review mapped current evidence of transition interventions for CCSs and highlighted the paucity of data in this area. More high-quality and well-reported randomized controlled trials are needed for the enrichment and standardization of future transition interventions.
| S-EPMC10814357 | biostudies-literature
Project description:Systematic reviews of self-management programs for osteoarthritis suggest minimal evidence of benefit and indicate substantial heterogeneity in interventions. The purpose of this scoping review was to describe the nature of self-management interventions provided to patients with osteoarthritis focusing on the inclusion and type of education and social support components. We searched PsycINFO, EMBASE, MEDLINE, and Cochrane Library databases from 1990 to 2016 to identify studies addressing community-based management strategies for osteoarthritis that included aspects of disease-specific education and ongoing social support. Results are presented as a narrative synthesis to facilitate integration of diverse evidence. Data were extracted from 23 studies that met our inclusion and exclusion criteria, describing complex, multicomponent interventions for osteoarthritis. All studies included education components, and 18 of these were osteoarthritis-specific. Social support was most often offered through peers and health care professionals, but also through exercise trainers/instructors and researchers, and lasted between 5 and 52 weeks. We charted positive social interaction offered by peers in group settings and emotional/informational support offered by health care professionals. Overall, descriptions of self-management provided limited documentation of the rationale or content of the programs. This suggests that more precise definitions of the theoretical underpinnings, components, and mechanisms would be useful for greater insight into best practices for osteoarthritis self-management programs.
| S-EPMC5964569 | biostudies-literature