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Mariano C, Willemsma K, Sattar S, Haase K, Bates A, Nunez JJ. Supportive care and healthcare service utilisation in older adults with a new cancer diagnosis: a population-based review. BMJ Support Palliat Care 2023:spcare-2023-004605. [PMID: 38154923 DOI: 10.1136/spcare-2023-004605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/09/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES Older adults have unique needs and may benefit from additional supportive services through their cancer journey. It can be challenging for older adults to navigate the siloed systems within cancer centres and the community. We aimed to document the use of supportive care services in older adults with a new cancer diagnosis in a public healthcare system. METHODS We used population-based databases in British Columbia to document referrals to supportive care services. Patients aged 70 years and above with a new diagnosis of solid tumour in the year 2015 were included. Supportive care services captured were social work, psychiatry, palliative care, nutrition and home care. Chart review was used to assess visits to the emergency room and extra calls to the cancer centre help line. RESULTS 2014 patients were included with a median age of 77, 30% had advanced cancer. 459 (22.8%) of patients accessed one or more services through the cancer centre. The most common service used was patient and family counselling (13%). 309 (15.3%) of patients used community home care services. Patients aged 80 years and above were less likely to access supportive care resources (OR 0.57) compared with those 70-79 years. Patients with advanced cancer, those treated at smaller cancer centres, and patients with colorectal, gynaecological and lung cancer were more likely to have received a supportive care referral. CONCLUSIONS Older adults, particularly those above 80 years, have low rates of supportive care service utilisation. Barriers to access must be explored, in addition to novel ways of holistic care delivery.
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Affiliation(s)
- Caroline Mariano
- BC Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
| | - Kaylie Willemsma
- The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kristen Haase
- The University of British Columbia Faculty of Nursing, Vancouver, British Columbia, Canada
| | - Alan Bates
- BC Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
| | - John Jose Nunez
- The University of British Columbia, Vancouver, British Columbia, Canada
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Low C, Tejero I, Toledano N, Mariano C, Alibhai S, Lemonde M, Haase K, Puts M. Impact of COVID-19 on older adults with cancer and their caregivers' cancer treatment experiences study: The ICE-OLD study. PLoS One 2023; 18:e0291756. [PMID: 37729131 PMCID: PMC10511107 DOI: 10.1371/journal.pone.0291756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
The COVID-19 pandemic and health services impacts related to physical distancing posed many challenges for older adults with cancer. The goal of this study was to examine the impact of the pandemic on cancer treatment plans and cancer treatment experiences of older adults (ie, aged 65 years and older) and their caregiver' experiences of caring for older adults during the pandemic to highlight gaps in care experienced. In this multi-centre qualitative study guided by an interpretive descriptive research approach we interviewed older adults diagnosed with cancer and caregivers caring for them. Participants were recruited via cancer treatment centres in the provinces of British Columbia and Ontario (Vancouver and Toronto), Canada, and through an online ad sent out through patient advocacy organization newsletters. Interviews were recorded and transcribed verbatim and data were analyzed using an interpretive thematic analysis approach. A total of 27 individuals (17 older adults, 52.9% female; 10 caregivers, 90% female) participated in interviews lasting on average 45 minutes. Older adults with cancer described many impacts and pressures created by the pandemic on their cancer experiences, though they generally felt that the pandemic did not impact treatment decisions made and access to care. We grouped our findings into two main themes with their accompanying sub-themes, related to: (1) alterations in the individual and dyadic cancer experience; and (2) navigating health and cancer systems during the pandemic. The additional stressors the pandemic placed on older adults during their treatment and decision-making process and their caregivers expose the need to create or avail additional supports for future disruptions in care.
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Affiliation(s)
- Cydney Low
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Isabel Tejero
- Geriatrics Department, Hospital del Mar, Barcelona, Spain
| | - Nelly Toledano
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Caroline Mariano
- BC Cancer Agency, Vancouver and Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Shabbir Alibhai
- Department of Medicine and Institute of Health Policy, Management, and Evaluation, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Manon Lemonde
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Kristen Haase
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Howell D, Bryant Lukosius D, Avery J, Santaguida A, Powis M, Papadakos T, Addario V, Lovas M, Kukreti V, Haase K, Mayo SJ, Papadakos J, Moradian S, Krzyzanowska MK. A Web-Based Cancer Self-Management Program (I-Can Manage) Targeting Treatment Toxicities and Health Behaviors: Human-Centered Co-design Approach and Cognitive Think-Aloud Usability Testing. JMIR Cancer 2023; 9:e44914. [PMID: 37477968 PMCID: PMC10403801 DOI: 10.2196/44914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/26/2023] [Accepted: 05/23/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Patients with cancer require adequate preparation in self-management of treatment toxicities to reduce morbidity that can be achieved through well-designed digital technologies that are developed in co-design with patients and end users. OBJECTIVE We undertook a user-centered co-design process in partnership with patients and other knowledge end users to develop and iteratively test an evidence-based and theoretically informed web-based cancer self-management program (I-Can Manage). The specific study aims addressed in 2 phases were to (1) identify from the perspective of patients with cancer and clinicians the desired content, features, and functionalities for an online self-management education and support (SMES) program to enable patient self-management of treatment toxicities (phase 1); (2) develop the SMES prototype based on human-centered, health literate design principles and co-design processes; and (3) evaluate usability of the I-Can Manage prototype through user-centered testing (phase 2). METHODS We developed the I-Can Manage program using multiperspective data sources and based on humanistic and co-design principles with end users engaged through 5 phases of development. We recruited adult patients with lung, colorectal, and lymphoma cancer receiving systemic treatments from ambulatory clinics in 2 regional cancer programs for the qualitative inquiry phase. The design of the program was informed by data from qualitative interviews and focus groups, persona and journey mapping, theoretical underpinnings of social cognitive learning theory, and formalized usability testing using a cognitive think-aloud process and user satisfaction survey. A co-design team comprising key stakeholders (human design experts, patients/caregiver, clinicians, knowledge end users, and e-learning and digital design experts) was involved in the developmental process. We used a cognitive think-aloud process to test usability and participants completed the Post-Study System Usability Questionnaire (PSSUQ). RESULTS In the initial qualitative inquiry phase, 16 patients participated in interviews and 19 clinicians participated in interviews or focus groups and 12 key stakeholders participated in a persona journey mapping workshop to inform development of the program prototype. The I-Can Manage program integrates evidence-based information and strategies for the self-management of treatment toxicities and health-promoting behaviors in 6 e-learning modules (lay termed "chapters"), starting with an orientation to self-management. Behavioral exercises, patient written and video stories, downloadable learning resources, and online completion of goals and action plans were integrated across chapters. Patient participants (n=5) with different cancers, gender, and age worked through the program in the human factors laboratory using a cognitive think-aloud process and all key stakeholders reviewed each chapter of the program and approved revisions. Results of the PSSUQ (mean total score: 3.75) completed following the cognitive think-aloud process (n=5) suggest patient satisfaction with the usability of I-Can Manage. CONCLUSIONS The I-Can Manage program has the potential for activating patients in self-management of cancer and treatment toxicities but requires testing in a larger randomized controlled trial.
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Affiliation(s)
- Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Research Institute, Toronto, ON, Canada
| | - Denise Bryant Lukosius
- School of Nursing, McMaster University, Hamilton, ON, Canada
- Department of Medical Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
| | - Jonathan Avery
- School of Nursing, University of British Columbia, Vancouver, ON, Canada
| | - Athina Santaguida
- Ontario College of Art and Design, University of Toronto, Toronto, ON, Canada
| | - Melanie Powis
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Tina Papadakos
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | | | - Mike Lovas
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Vishal Kukreti
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Kristen Haase
- School of Nursing, University of British Columbia, Vancouver, ON, Canada
| | - Samantha J Mayo
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Janet Papadakos
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Saeed Moradian
- Faculty of Nursing, York University, Toronto, ON, Canada
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Cook S, Munteanu C, Papadopoulos E, Abrams H, Stinson JN, Pitters E, Stephens D, Lumchick M, Emmenegger U, Koneru R, Papadakos J, Shahrokni A, Durbano S, Menjak I, Mehta R, Haase K, Jang R, Krzyzanowska MK, Dale C, Jones J, Lemonde M, Alibhai S, Puts M. The development of an electronic geriatric assessment tool: Comprehensive health assessment for my plan (CHAMP). J Geriatr Oncol 2023; 14:101384. [PMID: 36216760 DOI: 10.1016/j.jgo.2022.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Geriatric assessment (GA) provides information on key health domains of older adults and is recommended to help inform cancer treatment decisions and cancer care. However, GA is not feasible in many health institutions due to lack of geriatric staff and/or resources. To increase accessibility to GA and improve treatment decision making for older adults with cancer (≥65 years), we developed a self-reported, electronic geriatric assessment tool: Comprehensive Assessment for My Plan (CHAMP). MATERIALS AND METHODS Older adults with cancer were invited to join user-centered design sessions to develop the layout and content of the tool. Subsequently, they participated in usability testing to test the usability of the tool (ease of use, acceptability, etc.). Design sessions were also conducted with oncology clinicians (oncologists and nurses) to develop the tool's clinician interface. GA assessment questions and GA recommendations were guided by a systematic review and Delphi expert panel. RESULTS A total of seventeen older adults participated in the study. Participants were mainly males (82.4%) and 75% were aged 75 years and older. Nine oncology clinicians participated in design sessions. Older adults and clinicians agreed that the tool was user-friendly. Domains in the final CHAMP tool (with questions and recommendations) included functional status, falls risk, cognitive impairment, nutrition, medication review, social supports, depression, substance use disorder, and miscellaneous items. DISCUSSION CHAMP was designed for use by older adults and oncologists and may enhance access to GA for older adults with cancer. The next phase of the CHAMP study will involve field validation in oncology clinics.
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Affiliation(s)
- Simon Cook
- Technologies for Aging Gracefully Lab, University of Toronto, Toronto, Canada
| | - Cosmin Munteanu
- Technologies for Aging Gracefully Lab, University of Toronto, Toronto, Canada
| | | | - Howard Abrams
- Openlab, Toronto General Hospital, University Health Network, Toronto, Canada; Department of Medicine, University Health Network, University of Toronto, Canada
| | - Jennifer N Stinson
- Research Institute, The Hospital for Sick Children, Toronto, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | | | | | | | - Urban Emmenegger
- Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Rama Koneru
- Department of Medical Oncology, R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health, Oshawa, Ontario, Canada
| | - Janet Papadakos
- Cancer Education, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Armin Shahrokni
- Department of Geriatrics and Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, United States of America
| | - Sara Durbano
- Openlab, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Ines Menjak
- Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Rajin Mehta
- Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kristen Haase
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Raymond Jang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Monika K Krzyzanowska
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Jennifer Jones
- ELLICSR: Health, Wellness and Cancer Survivorship Centre, University Health Network, Toronto, Canada
| | - Manon Lemonde
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Shabbir Alibhai
- Department of Medicine, University Health Network, University of Toronto, Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
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Pilleron S, Sun V, Hannan M, Haase K, Kenis C, Arthur E, Krok-Schoen J, Monginot S, Navarrete E, Nikita N, Roggendorf S, Schmidt H, Trevino K, Ayala A, Puts M. Loneliness in older adults with cancer: A scoping review. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dhari R, Haase K, Ranger M, Tan E, Affleck F, Bailey E, Wong ST. Engaging nursing students in a COVID-19 Point-of-Care rapid screening clinic. Nurs Open 2022; 9:2518-2524. [PMID: 35686659 PMCID: PMC9348001 DOI: 10.1002/nop2.1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/26/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background The COVID‐19 pandemic has globally impacted nursing education, particularly clinical learning opportunities for undergraduate nursing students. Purpose In this paper, we report on an educational activity wherein students participated in a COVID‐19 Rapid Antigen Testing (RAT) clinic on a Canadian university campus. Methods Between February–April 2021, in the second term of a five‐term accelerated program, nursing students (n = 60) participated in a nurse‐led COVID‐19 RAT clinic for students and staff living or working in congregate housing. Students participated in education activities which exposed nursing students to the full range of community health nursing roles in a pandemic. Results From clinical, research, policy, and public health, this educational activity acted as a microcosm of the critical roles that nurses employ in the health ecosystem. Conclusion We offer lessons learned about implementing this activity, and how these lessons can be applied to routine and exceptional nursing curriculum.
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Affiliation(s)
- Ranjit Dhari
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kristen Haase
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Manon Ranger
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Elsie Tan
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Frances Affleck
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elisabeth Bailey
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sabrina T Wong
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Health Services and Policy Research, Vancouver, British Columbia, Canada
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Ndateva I, Schwandt M, Saewyc E, Sin D, Tobias E, Wong S, Haase K, Ranger M. Participants' experience in using a point of Care Rapid Antigen Test (RAT) for SARS-CoV-2. Ann Fam Med 2022; 20:3104. [PMID: 36706377 PMCID: PMC10548943 DOI: 10.1370/afm.20.s1.3104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Learning objectives: On completion of this presentation, participant should be able to: Understand the feasibility of RAT for SARS-CoV-2 screening in primary care Understand the role of RAT for SARS-CoV-2 screening in prevention of COVID-19 transmission in community Context: The COVID-19 pandemic has paralyzed human interactions worldwide. At least half of COVID-19 transmissions could originate from asymptomatic individuals. Rapid Antigen Testing (RAT) with nasal sampling at the point of care is inexpensive, fast and less invasive than PCR testing. Objective: The overall study objective was to examine the feasibility of point-of-care RAT for detecting SARS-CoV-2 amongst an asymptomatic population living in congregate housing. Design: Cross-sectional survey. Setting: This study was conducted at the University of British Columbia (UBC). Approximately 1500 undergraduate student were at the study site during February-April 2021. Population: Students living in UBC housing and staff working in the UBC housing sites were eligible. People testing positive for COVID-19 in the prior 90 days were excluded from the study. Intervention: The BD Veritor testing kit was used to test bilateral nasal specimens. Results were ready by the small BD Veritor reader. Outcome measures: Experiences of surveyed participants completing RAT. The survey was conducted during the last three weeks the site was open. Results: A total of 223 participants consisting of 134 (60%) females and 89 (40%) males completed the survey for a 37% response rate. Participants were mainly of European descent (45%), though there were East Asians (18%), African/ Caribbean (5%) and Indigenous (3%) people who also completed the survey. Almost all (98%) reported that RAT was acceptable/very acceptable and 97% would take another test. Participants believed they would test negative given their careful observation of public health measures such as hand washing, mask wearing and restricting contacts to their small "bubble". Their expectation of testing negative was based on having no or minimal interactions with any person who had tested positive. More than two thirds of participants reported RAT provide them peace of mind and reduced anxiety levels. Participants found the RAT to be safe, easy, accessible and rapid. Conclusions: Rapid antigen testing for detecting COVID-19 is well accepted and could support the detection of infection at an early stage amongst asymptomatic individuals while easing their worries.
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O'Connell M, Haase K, Cammer A, Peacock S, Cosco T, Holtslander L. Older Adults’ Acceptance of Technology During the Pandemic: The COVID Technology Acceptance Model (TAM). Innov Aging 2021. [PMCID: PMC8682372 DOI: 10.1093/geroni/igab046.3628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
During the pandemic, technology-mediated communication was one of the few ways to maintain social and community connections. We explored how the pandemic impacted older adults’ use and appraisal of technology. In a random sample of 407 older adults (M age = 81.1 years; range 65-105 years) almost half (n = 161) reported they changed how they used technology to virtually connect with others during the pandemic, and 78 of these reported that this was new technology for them. We adapted the technology acceptance model (TAM) for the pandemic, the COVID-TAM, and describe how physical distancing led to new acceptance of technology due to an increased perception of usefulness of technology for maintaining community and social connections. The 71 older adults who denied using technology were asked about the reasons underlying their reluctance to use technology to access social networks and community events during the pandemic. Thematic analysis revealed factors consistent with a double-digital divide; lack of physical exposure to technology creates an additional psychological barrier to adoption of new technology. Of the technology-reluctant subgroup of older adults, few reported lack of perceived usefulness of technology during the pandemic. Instead, most reported lack of self-efficacy or fear of technology underlying their lack of technology use for social and community connections during the pandemic, which we incorporate into the COVID-TAM. Findings indicate that technology training can help mitigate this fear and increase social and community connections that are technology-mediated in circumstances where physical distancing is necessary.
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Affiliation(s)
| | - Kristen Haase
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Allison Cammer
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Theodore Cosco
- Simon Fraser University, Vancouver, British Columbia, Canada
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Haase K, Sattar S, Pilleron S, Lambrechts Y, Hannan M, Navarrete E, Kantilal K, Newton L, Kantilal K, Jin R, van der Wal-Huisman H, Strohschein F, Pergolotti M, Read K, Kenis C, Puts M. Ageism in cancer care: A scoping review by the International Society of Geriatric Oncology (SIOG) Nursing and Allied Health Interest Group. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sattar S, Haase K, Kaur A, Ahmed S. Impact of the COVID-19 pandemic on physical activities in older adults with cancer in a Canadian central province. J Geriatr Oncol 2021. [PMCID: PMC8675175 DOI: 10.1016/s1879-4068(21)00376-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sattar S, Alibhai S, Haase K, Effa C, Nedeljak J, Amir E, Campbell D, McNeely M. Feasibility of a virtual hybrid exercise program for older adults with cancer and its effects on lower body strength and balance. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Strohschein FJ, Newton L, Puts M, Jin R, Haase K, Plante A, Loucks A, Kenis C, Fitch M. Optimiser les soins des adultes âgés atteints de cancer et l'accompagnement de leurs proches: énoncé de position et contribution des infirmières canadiennes en oncologie. Can Oncol Nurs J 2021; 31:357-362. [PMID: 34395844 PMCID: PMC8320801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
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Strohschein FJ, Newton L, Puts M, Jin R, Haase K, Plante A, Loucks A, Kenis C, Fitch M. Optimizing the Care of Older Canadians with Cancer and their Families: A Statement Articulating the Position and Contribution of Canadian Oncology Nurses. Can Oncol Nurs J 2021; 31:352-356. [PMID: 34395843 PMCID: PMC8320798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
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McLean B, Hossain N, Donison V, Gray M, Durbano S, Haase K, Alibhai SMH, Puts M. Providing Medical Information to Older Adults in a Web-Based Environment: Systematic Review. JMIR Aging 2021; 4:e24092. [PMID: 33560228 PMCID: PMC8294635 DOI: 10.2196/24092] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/10/2020] [Accepted: 01/06/2021] [Indexed: 01/16/2023] Open
Abstract
Background Cancer is a disease that predominantly affects older adults, and several organizations recommend the completion of a geriatric assessment to help with cancer treatment decision-making. Owing to a shortage of geriatric teams and the vast number of older adults diagnosed with cancer each year, a web-based geriatric assessment may improve access to geriatric assessment for older adults. We systematically reviewed the literature to obtain the latest evidence for the design of our web-based geriatric assessment tool Comprehensive Health Assessment for My Plan. Objective This review aimed to probe the following questions: what is the impact of providing health test results to older adults in a web-based environment without the presence of a health care provider for patient-centered outcomes, including satisfaction, perceived harm, empowerment, quality of life, and health care use (eg, hospitalization, physician visits, emergency room visits, and costs), and what recommendations do older adults and developers have for designing future apps or websites for older adults? Methods This systematic review was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement. Studies were limited to publications in English that examined a web-based tool that provided test results to older adults (aged ≥65 years) without the presence of a health care provider. A health sciences librarian performed the search on November 29, 2019, on the following electronic databases: MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Library. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool Version 2018. The findings are summarized narratively and in tabular format. Results A total of 26,898 titles and abstracts were screened by 2 independent reviewers, of which 94 studies were selected for a full-text review, and 9 studies were included in this review. There were only 2 randomized controlled trials of high quality that explored the effects of receiving health care results on the web via eHealth tools for older adults or provided evidence-based recommendations for designing such tools. Older adults were generally satisfied with receiving screening results via eHealth tools, and several studies suggested that receiving health screening results electronically improved participants’ quality of life. However, user interfaces that were not designed with older adults in mind and older adults’ lack of confidence in navigating eHealth tools proved challenging to eHealth uptake and use. All 9 studies included in this systematic review made recommendations on how to design eHealth tools that are intuitive and useful for older adults. Conclusions eHealth tools should incorporate specific elements to ensure usability for older adults. However, more research is required to fully elucidate the impact of receiving screening and results via eHealth tools without the presence of a health care provider for patient-centered outcomes in this target population.
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Affiliation(s)
- Bianca McLean
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nazia Hossain
- Department of Internal Medicine, University of Toronto, Toronto, ON, Canada
| | - Valentina Donison
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Mikaela Gray
- Gerstein Science Information Centre, University of Toronto, Toronto, ON, Canada
| | | | - Kristen Haase
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Shabbir Muhammad Husayn Alibhai
- Department of Medicine, Institute for Health Policy, Management and Evaluation, University of Toronto, University Health Network, Toronto, ON, Canada
| | - Martine Puts
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Galica J, Saunders S, Haase K, Maheu C. Writing between the lines: A secondary analysis of unsolicited narratives from cancer survivors regarding their fear of cancer recurrence. Can Oncol Nurs J 2021. [DOI: 10.5737/236880763118391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Fear of cancer recurrence (FCR) is a common concern for posttreatment cancer survivors. In this secondary analysis we explore cancer survivors’ unsolicited narratives on a survey about FCR. Methods: We used an interpretive descriptive approach and statistical analyses to explore these narratives and determine the characteristics of survivors who did and did not provide narratives. Findings: We developed three themes based on our analysis: describe posttreatment experiences; elaborate or contextualize FCR responses and use their voice toward change in cancer care. Those who provided narratives had lower overall FCR. Most narratives were used to provide context to responses or to indicate that some survey items were irrelevant. Conclusion: Our results highlight potential reasons for unsolicited narratives on a survey and illuminate the potential value of expressive interventions for cancer survivors. Results indicate the usefulness of mixed methods approaches where survey respondents are offered space to provide open text.
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Galica J, Saunders S, Haase K, Maheu C. Écrire entre les lignes : analyse secondaire des commentaires non sollicités de survivants du cancer sur la peur d’une récidive. Can Oncol Nurs J 2021. [DOI: 10.5737/2368807631192101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Contexte : La peur de récidive du cancer (PRC) survient couramment chez les survivants du cancer après leur traitement. La présente analyse secondaire explore les commentaires non sollicités de survivants du cancer dans le cadre d’un sondage sur la PRC. Méthodologie : La présente étude a fait appel à la méthode descriptive interprétative et aux analyses statistiques pour explorer les commentaires non sollicités et déterminer les caractéristiques respectives des survivants ayant étoffé leurs réponses et de ceux ne l’ayant pas fait. Résultats : Trois thèmes sont ressortis de l’analyse : description de l’expérience post-traitement, approfondissement ou contextualisation des réponses sur la PRC, et expression de la nécessité d’améliorer les soins oncologiques. De façon générale, chez les personnes ayant fourni des commentaires non sollicités, la PRC était moindre. La plupart du temps, les commentaires visaient à contextualiser certaines réponses ou à signaler la non-pertinence de certaines questions. Conclusion : L’étude met de l’avant, d’une part, diverses raisons expliquant les commentaires non sollicités dans le cadre d’un sondage et, d’autre part, la valeur potentielle de la prise de parole des survivants du cancer. Les résultats témoignent de l’efficacité d’une approche méthodologique mixte qui intégrerait au sondage un espace où les répondants peuvent s’exprimer librement.
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Baxter MAJ, Madureira T, Haase K, Battisti NML. Perspectives on geriatric oncology research presented at the 2020 ESMO Science Congress. J Geriatr Oncol 2021; 12:489-497. [PMID: 33353855 DOI: 10.1016/j.jgo.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Mark A J Baxter
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom; Tayside Cancer Centre, Ninewells Hospital, Dundee, United Kingdom.
| | - Tânia Madureira
- Department of Medical Oncology, University Hospital Centre of Algarve, Faro, Portugal
| | - Kristen Haase
- School of Nursing, University of British Columbia, Vancouver, BC V6S 0K3, Canada
| | - Nicolò Matteo Luca Battisti
- Department of Medicine - Breast Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London SM2 5PT, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, 15 Cotswold Road, Sutton, London SM2 5NG, United Kingdom
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Sattar S, Haase K, Kuster S, Puts M, Spoelstra S, Bradley C, Wildes TM, Alibhai S. Falls in older adults with cancer: an updated systematic review of prevalence, injurious falls, and impact on cancer treatment. Support Care Cancer 2020; 29:21-33. [PMID: 32671565 DOI: 10.1007/s00520-020-05619-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/07/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE This update of our 2016 systematic review answers the following questions: (1) How often do older adults with cancer fall? (2) What are the predictors for falls? (3) What are the rates and predictors of injurious falls? (4) What are the circumstances and outcomes of falls? (5) How do falls in older patients affect subsequent cancer treatment? and a new research question, (6) Which fall reduction interventions are efficacious in this population? METHODS MEDLINE, PubMed, CINAHL, and Embase were searched (September 2015-January 25, 2019). Eligible studies included clinical trials and cohort, case-control, and cross-sectional studies published in English in which the sample (or subgroup) included adults aged ≥ 60, with cancer, in whom falls were examined as an outcome. RESULTS A total of 2521 titles were reviewed, 67 full-text articles were screened for eligibility, and 30 new studies were identified. The majority involved the outpatient setting (n = 19) utilizing cross-sectional method (n = 18). Sample size ranged from 21 to 17,958. Fall rates ranged from 1.52 to 3.41% per 1000 patient days (inpatient setting) and from 39%/24 months to 64%/12 months (outpatient setting). One out of the 6 research questions contributed to a new finding: one study reported that 1 in 20 older patients experienced impact on cancer treatment due to falls. No consistent predictors for falls/fall injuries and no studies on fall reduction interventions in the geriatric oncology setting were identified. CONCLUSION This updated review highlights a new gap in knowledge pertaining to interventions to prevent falls. Additionally, new knowledge also emerged in terms of impact of falls on cancer treatment; however, further research may increase generalizability. Falls and fall-related injuries are common in older adults with cancer and may affect subsequent cancer treatment. Further studies on predictors of falls, subsequent impacts, and fall reduction in the oncology setting are warranted.
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Affiliation(s)
- S Sattar
- College of Nursing, University of Saskatchewan, 4400 4th Avenue, Room 108, Regina, Saskatchewan, S4T 0H8, Canada.
| | - K Haase
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - S Kuster
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Canada
| | - M Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - S Spoelstra
- Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, USA
| | - C Bradley
- Library, University of Regina, Regina, Canada
| | - T M Wildes
- Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA
| | - S Alibhai
- Department of Medicine, Institute of Health Policy, Management, and Evaluations, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
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Rath B, Swenshon S, Haase K, Szeles T, Jung C, Jacobi F, Myles P. Using a mobile application to detect health needs among children and adolescents who are newly arrived migrants in Europe. J Public Health (Oxf) 2020; 41:840-849. [PMID: 30423143 DOI: 10.1093/pubmed/fdy191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/15/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Unprecedented numbers of migrants have arrived in Europe, including children and adolescents. Little is known about their unique health needs. Prospective data collection has been sparse. Mobile applications may help to facilitate global health surveillance. METHODS A pre-validated survey instrument was converted into a mobile application covering self-reported exposures and disruptions of healthcare before/during migration, communicable and non-communicable diseases. Participation was voluntary, anonymous and confidential. RESULTS Data were obtained from 405 migrant children and adolescents in Berlin, Germany, between 7 October 2015 and 15 March 2016 (median age 19 years, range: 1-24; 80.7% males) with the majority from Syria (62.5%), Afghanistan (9.1%) and Iraq (8.2%). In total, 55% were without family, 64% registered asylum-seekers with access to healthcare; 54% had seen a doctor since arrival, with colds or respiratory complaints (37.5 and 13.6%), followed by pain (26.7%) gastrointestinal (12.4%) and skin problems (11.1%). Underlying conditions were reported in 15.6%, predominantly asthma. Overall, 73% reported being up-to date on immunizations, but only 22% held a vaccination record with 46.4% having lost it during migration. CONCLUSIONS The lack of medical and immunization records among newly arrived migrants provides a challenge to healthcare systems. Mobile applications offer rapid screening tools in times of crisis, helping stakeholders with timely information.
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Affiliation(s)
- B Rath
- Department of Public Health, Vienna Vaccine Safety Initiative, Berlin, Germany.,Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, UK
| | - S Swenshon
- Department of Clinical Psychology, Psychologische Hochschule Berlin, Berlin, Germany
| | - K Haase
- Department of Clinical Psychology, Psychologische Hochschule Berlin, Berlin, Germany
| | - T Szeles
- Department of Clinical Psychology, Psychologische Hochschule Berlin, Berlin, Germany
| | - C Jung
- Department of Clinical Psychology, Psychologische Hochschule Berlin, Berlin, Germany
| | - F Jacobi
- Department of Clinical Psychology, Psychologische Hochschule Berlin, Berlin, Germany
| | - P Myles
- Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, UK
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Sattar S, Haase K, Wildes T. Research priorities on falls in older adults with cancer. J Geriatr Oncol 2020; 12:157-159. [PMID: 32540129 DOI: 10.1016/j.jgo.2020.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Schroder Sattar
- College of Nursing, University of Saskatchewan, Regina, Canada.
| | - Kristen Haase
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Tanya Wildes
- Washington University School of Medicine, St Louis, MO, USA
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Haase K, Drury A, Puts M. Supportive Care and eHealth: A Narrative Review of Technologies, Interventions, and Opportunities for Optimizing Care in Patients With Cancer. Clin J Oncol Nurs 2020; 24:32-41. [DOI: 10.1188/20.cjon.s1.32-41] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Hall S, Lee V, Haase K. Exploring the challenges of ethical conduct in quality improvement projects. Can Oncol Nurs J 2020; 30:64-68. [PMID: 33118977 PMCID: PMC7585708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- Steven Hall
- Candidate, University of Saskatchewan, College of Nursing, Saskatoon, SK,
| | - Virginia Lee
- Senior Nursing Research Consultant (interim), Nursing Directorate, Professional Practice, Education, Workforce Organization and Research, McGill University Health Centre (MUHN), Montreal, QC,
| | - Kristen Haase
- Assistant Professor, College of Nursing, University of Saskatchewan, Saskatoon, SK,
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Sattar S, Puts M, Spoelstra S, Yokom D, Haase K, Kuster S, Bradley C, Fazalzad R, Wildes T, Alibhai S. FALLS IN OLDER ADULTS WITH CANCER: PRELIMINARY ANALYSIS OF AN UPDATED SYSTEMATIC REVIEW OF PREVALENCE, INJURIOUS FALLS, AND IMPACT ON CANCER TREATMENT. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31283-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Haase K, Putts M, Sattar S, Gray M, Kenis C, Donison V, Mclean B, Willis A, Howell D. A SYSTEMATIC REVIEW OF SELF-MANAGEMENT INTERVENTIONS FOR OLDER ADULTS WITH CANCER. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31256-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Sattar S, Haase K, Bradley C, Papadopoulos E, Kuster S, Mina D, Joshua A, Souied O, Rediger C, Alibhai S. PERCEPTION OF STRUCTURED EXERCISE PROGRAMS AND FACTORS ASSOCIATED WITH PARTICIPATION AND ADHERENCE AMONG MEN WITH PROSTATE CANCER: A SCOPING REVIEW. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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DuMontier C, Sedrak MS, Soo WK, Kenis C, Williams GR, Haase K, Harneshaug M, Mian H, Loh KP, Rostoft S, Dale W, Cohen HJ. Arti Hurria and the progress in integrating the geriatric assessment into oncology: Young International Society of Geriatric Oncology review paper. J Geriatr Oncol 2019; 11:203-211. [PMID: 31451439 DOI: 10.1016/j.jgo.2019.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/11/2019] [Accepted: 08/13/2019] [Indexed: 12/18/2022]
Abstract
Until recently, the progress in the diagnosis and management of cancer has not been matched by similar progress in the assessment of the increasing numbers of older and more complex patients with cancer. Dr. Arti Hurria identified this gap at the outset of her career, which she dedicated toward studying the geriatric assessment (GA) as an improvement over traditional methods used in oncology to assess vulnerability in older patients with cancer. This review documents the progress of the GA and its integration into oncology. First, we detail the GA's origins in the field of geriatrics. Next, we chronicle the early rise of geriatric oncology, highlighting the calls of early thought-leaders to meet the demands of the rapidly aging cancer population. We describe Dr. Hurria's early efforts toward meeting these calls though the implementation of the GA in oncology research. We then summarize some of the seminal studies constituting the evidence base supporting GA's implementation. Finally, we lay out the evolution of cancer-focused guidelines recommending the GA, concluding with future needs to advance the next steps toward more widespread implementation in routine cancer care. Throughout, we describe Dr. Hurria's vision and its execution in driving progress of the GA in oncology, from her fellowship training to her co-authored guidelines recommending GA for all older adults with cancer-published in the year of her untimely death.
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Affiliation(s)
- Clark DuMontier
- Brigham and Women's Hospital, Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States of America.
| | - Mina S Sedrak
- City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Wee Kheng Soo
- Eastern Health Clinical School, Monash University, 5 Arnold St, Box Hill, VIC, Australia; Department of Aged Medicine, Eastern Health, 8 Arnold St, Box Hill, VIC, Australia; Department of Cancer Services, Eastern Health, 8 Arnold St, Box Hill, VIC, Australia
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Grant R Williams
- Division of Hematology/Oncology, Geriatrics, and Palliative Care, Institute of Cancer Outcomes and Survivorship, O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, UK
| | - Kristen Haase
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, Canada
| | - Magnus Harneshaug
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, P.O. box 68, 2313 Ottestad, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. box 4956, Nydalen, 0424 Oslo, Norway
| | - Hira Mian
- Juravinski Cancer Center, Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Kah Poh Loh
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Siri Rostoft
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - William Dale
- City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Harvey Jay Cohen
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States of America
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Sattar S, Kenis C, Haase K, Burhenn P, Stolz-Baskett P, Milisen K, Ayala AP, Puts MTE. Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper. J Geriatr Oncol 2019; 11:1-7. [PMID: 30956135 DOI: 10.1016/j.jgo.2019.03.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/21/2019] [Accepted: 03/27/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Falls are a major health issue in older adults and are of greater concern among those with cancer due to effects of cancer and its treatments. This paper provides an overview of current literature on fall screening/assessment and interventions and a succinct summary of recommendations for oncology nurses to support this vulnerable population. METHODS A comprehensive search for literature reviews on falls was conducted in Medline and CINAHL. A comprehensive Internet search was also performed for known guidelines on fall prevention and/or management published within the past 10 years. Search results were compared, contrasted, and summarized to develop clinical recommendations for nurses working with older adults with cancer. Levels of evidence were reported based on the Oxford Centre for Evidence-based Medicine. RESULTS Six guidelines and 17 systematic reviews were identified. Having a history of falls was the most commonly identified fall risk factor/predictor. Multifactorial intervention and exercise appear to be the most commonly recommended. No fall assessment tools were consistently recommended as a reliable means of identifying those at risk for falls. CONCLUSION Assessing older patients for falls and fall risks is an important first step to identify those who may require further follow-up and intervention. Oncology nurses play a key role in optimizing health outcomes of older adults with cancer - through the use of evidence-based information, such as presented in this publication - and have the capacity to help reduce fall risks during and after treatment through information provision, advocacy, support, and promotion of physical activity.
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Affiliation(s)
- Schroder Sattar
- College of Nursing, University of Saskatchewan, Regina, Canada.
| | - Cindy Kenis
- University Hospitals Leuven, Leuven, Belgium
| | - Kristen Haase
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | | | | | - Koen Milisen
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Ana Patricia Ayala
- Gerstein Information Science Centre, University of Toronto Libraries, Toronto, Canada
| | - Martine T E Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Haase K, Dentro S, Leshchiner I, Wintersinger J, Deshwar A, Tarabichi M, Morris Q, Wedge D, Loo PV. 33 PAN-cancer whole genome sequencing reveals patterns of subclonal mutations, signature changes and selection. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Myles P, Swenshon S, Haase K, Szeles T, Jung C, Jacobi F, Rath B. A comparative analysis of psychological trauma experienced by children and young adults in two scenarios: evacuation after a natural disaster vs forced migration to escape armed conflict. Public Health 2018; 158:163-175. [PMID: 29628203 DOI: 10.1016/j.puhe.2018.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Little is known about the psychological trauma experienced by children and young adults (CYAs) following displacement after natural disasters vs migration from conflict zones. In both instances, the decision to leave is usually cast by the family, and the life of CYAs is suddenly disrupted by external circumstances. STUDY DESIGN An anonymous survey. METHODS The same survey instrument, provided by the National Child Traumatic Stress Network (NCTSN), was used to survey self-reported health needs among CYAs during the aftermath of Hurricane Katrina (Health Survey for Children and Adolescents After Katrina) in October 2005-February 2006 and again during the peak of refugee arrivals in Berlin between October 2015 and March 2016. A weighted index to measure cumulative exposure to traumatic stresses during migration was developed along with an unweighted psychological impact score based on the 22-item NCTS psychological impact questionnaire. Spearman's correlation coefficient (rho) was used to assess the correlation between age and the two psychological impact indices. The two-tailed t-test was used to investigate differences in trauma experienced and psychological impact by gender. Logistic regression was used to investigate differences in types of traumatic stress experienced and psychological impact among CYAs displaced because of Hurricane Katrina and those seeking asylum in Berlin. RESULTS The Katrina cohort included a total of 1133 CYAs, the Berlin cohort, a total of 405 CYAs. The median age in the Katrina cohort was 6.73 years (standard deviation [SD] 5.67, range 0-24; 50.13% males) compared with 17.64 years (SD, range 0-24; 83% males) in the Berlin cohort. Comparative analyses were adjusted to age and gender and revealed significant differences between the two cohorts, both with regards to the amount of trauma experienced and the psychological impact. A statistically significant and moderate positive correlation was observed between trauma experienced and psychological impact of migration in the refugee population (rho = 0.4955, P < 0.001); the correlation was less pronounced but still significant in the Katrina cohort (rho = 0.0942, P = 0.0015). Free-text responses revealed that in addition to common concerns about health, housing and safety, refugees were also pre-occupied with language acquisition and the adaptation to a new culture. CONCLUSIONS The observed differences in the experience and the consequences of trauma in displaced CYAs warrant additional investigation. It was replicated that human-made disaster seems to show more traumatising potential than natural disaster. Stakeholders need to be aware of the potential medium and long-term consequences of migration/evacuation and allocate resources accordingly.
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Affiliation(s)
- P Myles
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - S Swenshon
- Psychologische Hochschule, Berlin, Germany
| | - K Haase
- Psychologische Hochschule, Berlin, Germany
| | - T Szeles
- Psychologische Hochschule, Berlin, Germany
| | - C Jung
- Psychologische Hochschule, Berlin, Germany
| | - F Jacobi
- Psychologische Hochschule, Berlin, Germany
| | - B Rath
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK; Vienna Vaccine Safety Initiative, Berlin, Germany; Tulane Hospital for Children, New Orleans, LA, USA.
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Haase K, Kröger-Lui N, Pucci A, Schönhals A, Petrich W. Advancements in quantum cascade laser-based infrared microscopy of aqueous media. Faraday Discuss 2018; 187:119-34. [PMID: 27032367 DOI: 10.1039/c5fd00177c] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The large mid-infrared absorption coefficient of water frequently hampers the rapid, label-free infrared microscopy of biological objects in their natural aqueous environment. However, the high spectral power density of quantum cascade lasers is shifting this limitation such that mid-infrared absorbance images can be acquired in situ within signal-to-noise ratios of up to 100. Even at sample thicknesses well above 50 μm, signal-to-noise ratios above 10 are readily achieved. The quantum cascade laser-based microspectroscopy of aqueous media is exemplified by imaging an aqueous yeast solution and quantifying glucose consumption, ethanol generation as well as the production of carbon dioxide gas during fermentation.
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Affiliation(s)
- K Haase
- Heidelberg University, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
| | - N Kröger-Lui
- Heidelberg University, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
| | - A Pucci
- Heidelberg University, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
| | - A Schönhals
- Heidelberg University, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
| | - W Petrich
- Heidelberg University, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany.
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Boussommier-Calleja A, Atiyas Y, Haase K, Headley M, Lewis C, Kamm RD. The effects of monocytes on tumor cell extravasation in a 3D vascularized microfluidic model. Biomaterials 2018; 198:180-193. [PMID: 29548546 DOI: 10.1016/j.biomaterials.2018.03.005] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/17/2018] [Accepted: 03/02/2018] [Indexed: 02/07/2023]
Abstract
Metastasis is the leading cause of cancer-related deaths. Recent developments in cancer immunotherapy have shown exciting therapeutic promise for metastatic patients. While most therapies target T cells, other immune cells, such as monocytes, hold great promise for therapeutic intervention. In our study, we provide primary evidence of direct engagement between human monocytes and tumor cells in a 3D vascularized microfluidic model. We first characterize the novel application of our model to investigate and visualize at high resolution the evolution of monocytes as they migrate from the intravascular to the extravascular micro-environment. We also demonstrate their differentiation into macrophages in our all-human model. Our model replicates physiological differences between different monocyte subsets. In particular, we report that inflammatory, but not patrolling, monocytes rely on actomyosin based motility. Finally, we exploit this platform to study the effect of monocytes, at different stages of their life cycle, on cancer cell extravasation. Our data demonstrates that monocytes can directly reduce cancer cell extravasation in a non-contact dependent manner. In contrast, we see little effect of monocytes on cancer cell extravasation once monocytes transmigrate through the vasculature and are macrophage-like. Taken together, our study brings novel insight into the role of monocytes in cancer cell extravasation, which is an important step in the metastatic cascade. These findings establish our microfluidic platform as a powerful tool to investigate the characteristics and function of monocytes and monocyte-derived macrophages in normal and diseased states. We propose that monocyte-cancer cell interactions could be targeted to potentiate the anti-metastatic effect we observe in vitro, possibly expanding the milieu of immunotherapies available to tame metastasis.
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Affiliation(s)
| | - Y Atiyas
- Biological Engineering, Massachussetts Institute of Technology, USA
| | - K Haase
- Mechanical Engineering, Massachussetts Institute of Technology, USA
| | - M Headley
- Department of Pathology, University of California, San Francisco, CA, USA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - C Lewis
- Department of Oncology & Metabolism, University of Sheffield, UK
| | - R D Kamm
- Mechanical Engineering, Massachussetts Institute of Technology, USA; Biological Engineering, Massachussetts Institute of Technology, USA.
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Cozzarelli IM, Skalak KJ, Kent DB, Engle MA, Benthem A, Mumford AC, Haase K, Farag A, Harper D, Nagel SC, Iwanowicz LR, Orem WH, Akob DM, Jaeschke JB, Galloway J, Kohler M, Stoliker DL, Jolly GD. Environmental signatures and effects of an oil and gas wastewater spill in the Williston Basin, North Dakota. Sci Total Environ 2017; 579:1781-1793. [PMID: 27939081 DOI: 10.1016/j.scitotenv.2016.11.157] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 05/17/2023]
Abstract
Wastewaters from oil and gas development pose largely unknown risks to environmental resources. In January 2015, 11.4ML (million liters) of wastewater (300g/L TDS) from oil production in the Williston Basin was reported to have leaked from a pipeline, spilling into Blacktail Creek, North Dakota. Geochemical and biological samples were collected in February and June 2015 to identify geochemical signatures of spilled wastewaters as well as biological responses along a 44-km river reach. February water samples had elevated chloride (1030mg/L) and bromide (7.8mg/L) downstream from the spill, compared to upstream levels (11mg/L and <0.4mg/L, respectively). Lithium (0.25mg/L), boron (1.75mg/L) and strontium (7.1mg/L) were present downstream at 5-10 times upstream concentrations. Light hydrocarbon measurements indicated a persistent thermogenic source of methane in the stream. Semi-volatile hydrocarbons indicative of oil were not detected in filtered samples but low levels, including tetramethylbenzenes and di-methylnaphthalenes, were detected in unfiltered water samples downstream from the spill. Labile sediment-bound barium and strontium concentrations (June 2015) were higher downstream from the Spill Site. Radium activities in sediment downstream from the Spill Site were up to 15 times the upstream activities and, combined with Sr isotope ratios, suggest contributions from the pipeline fluid and support the conclusion that elevated concentrations in Blacktail Creek water are from the leaking pipeline. Results from June 2015 demonstrate the persistence of wastewater effects in Blacktail Creek several months after remediation efforts started. Aquatic health effects were observed in June 2015; fish bioassays showed only 2.5% survival at 7.1km downstream from the spill compared to 89% at the upstream reference site. Additional potential biological impacts were indicated by estrogenic inhibition in downstream waters. Our findings demonstrate that environmental signatures from wastewater spills are persistent and create the potential for long-term environmental health effects.
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Affiliation(s)
- I M Cozzarelli
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA.
| | - K J Skalak
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
| | - D B Kent
- U.S. Geological Survey, National Research Program, Menlo Park, CA 94025, USA
| | - M A Engle
- U.S. Geological Survey, Eastern Energy Resources Science Center, Reston, VA 20192, USA
| | - A Benthem
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
| | - A C Mumford
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
| | - K Haase
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
| | - A Farag
- U.S. Geological Survey, Columbia Environmental Research Center, Jackson Field Research Station, Jackson, WY 83001, USA
| | - D Harper
- U.S. Geological Survey, Columbia Environmental Research Center, Jackson Field Research Station, Jackson, WY 83001, USA
| | - S C Nagel
- Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO 65211, USA
| | - L R Iwanowicz
- U.S. Geological Survey, Leetown Science Center, Kearneysville, WV 25430, USA
| | - W H Orem
- U.S. Geological Survey, Eastern Energy Resources Science Center, Reston, VA 20192, USA
| | - D M Akob
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
| | - J B Jaeschke
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
| | - J Galloway
- U.S. Geological Survey, North Dakota Water Science Center, Bismarck, ND 58503, USA
| | - M Kohler
- U.S. Geological Survey, National Research Program, Menlo Park, CA 94025, USA
| | - D L Stoliker
- U.S. Geological Survey, National Research Program, Menlo Park, CA 94025, USA
| | - G D Jolly
- U.S. Geological Survey, National Research Program, Reston, VA 20192, USA
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Kröger-Lui N, Gretz N, Haase K, Kränzlin B, Neudecker S, Pucci A, Regenscheit A, Schönhals A, Petrich W. Rapid identification of goblet cells in unstained colon thin sections by means of quantum cascade laser-based infrared microspectroscopy. Analyst 2015; 140:2086-92. [PMID: 25649324 DOI: 10.1039/c4an02001d] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Changes in the volume covered by mucin-secreting goblet cell regions within colon thin sections may serve as a means to differentiate between ulcerative colitis and infectious colitis. Here we show that rapid, quantum cascade laser-based mid-infrared microspectroscopy might be able to contribute to the differential diagnosis of colitis ulcerosa, an inflammatory bowel disease. Infrared hyperspectral images of mouse colon thin sections were obtained within 7.5 minutes per section with a pixel size of 3.65 × 3.65 μm(2) and a field of view of 2.8 × 3.1 mm(2). The spectra were processed by training a random decision forest classifier on the basis of k-means clustering on one thin section. The trained algorithm was then applied to 5 further thin sections for a blinded validation and it was able to identify goblet cells in all sections. The rapid identification of goblet cells within these unstained, paraffinized thin sections of colon tissue was enabled by the high content of glycopeptides within the goblet cells as revealed by the pronounced spectral signatures in the 7.6 μm-8.6 μm and the 9.2 μm-9.7 μm wavelength ranges of the electromagnetic spectrum. More so, the simple calculation of the ratio between the absorbance values at 9.29 μm and 8.47 μm provides the potential to further shorten the time for measurement and analysis of a thin section down to well below 1 minute.
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Affiliation(s)
- N Kröger-Lui
- Heidelberg University, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, Heidelberg, 69120 Germany.
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Haase K, Stacey D. Where to start with research. Can Oncol Nurs J 2015; 25:138-141. [PMID: 26638283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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Gagnon AJ, Merry L, Haase K. Predictors of emergency cesarean delivery among international migrant women in Canada. Int J Gynaecol Obstet 2013; 121:270-4. [DOI: 10.1016/j.ijgo.2012.12.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 12/19/2012] [Accepted: 02/14/2013] [Indexed: 10/27/2022]
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Habermehl D, Lindel K, Rieken S, Haase K, Goeppert B, Büchler MW, Schirmacher P, Welzel T, Debus J, Combs SE. Chemoradiation in patients with unresectable extrahepatic and hilar cholangiocarcinoma or at high risk for disease recurrence after resection : Analysis of treatment efficacy and failure in patients receiving postoperative or primary chemoradiation. Strahlenther Onkol 2012; 188:795-801. [PMID: 22526232 DOI: 10.1007/s00066-012-0099-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 02/22/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND The purpose of this work was to determine efficacy, toxicity, and patterns of recurrence after concurrent chemoradiation (CRT) in patients with extrahepatic bile duct cancer (EHBDC) and hilar cholangiocarcinoma (Klatskin tumours) in case of incomplete resection or unresectable disease. PATIENTS AND METHODS From 2003-2010, 25 patients with nonmetastasized EHBDC and hilar cholangiocarcinoma were treated with radiotherapy and CRT at our institution in an postoperative setting (10 patients, 9 patients with R1 resections) or in case of unresectable disease (15 patients). Median age was 63 years (range 38-80 years) and there were 20 men and 5 women. Median applied dose was 45 Gy in both patient groups. RESULTS Patients at high risk (9 times R1 resection, 1 pathologically confirmed lymphangiosis) for tumour recurrence after curative surgery had a median time to disease progression of 8.7 months and an estimated mean overall survival of 23.2 months (6 of 10 patients are still under observation). Patients undergoing combined chemoradiation in case of unresectable primary tumours are still having a poor prognosis with a progression-free survival of 7.1 months and a median overall survival of 12.0 months. The main site of progression was systemic (liver, peritoneum) in both patient groups. CONCLUSION Chemoradiation with gemcitabine is safe and can be applied safely in either patients with EHBDC or Klatskin tumours at high risk for tumour recurrence after resection and patients with unresectable tumours. Escalation of systemic and local treatment should be investigated in future clinical trials.
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Affiliation(s)
- D Habermehl
- Department of Radiation Oncology, University Hospital of Heidelberg, Germany.
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Haase K, Duggleby W. Research hot topic: research mentorship part one. Can Oncol Nurs J 2010; 20:2-4. [PMID: 20369639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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Abstract
In case of the co-occurrence of facial palsy and inflammation-like symptoms of the same ear, the differential diagnosis is focused on viral (herpes zoster) or bacterial diseases. We report a patient for whom the surgical exploration of the middle ear revealed a benign tumor: a myxoma. These neoplasias are rare tumors in the head and neck region. The typical tumor site is the atrium of heart. In the ear, the tumor grows slowly and remains asymptomatic unless it irritates structures such as the facial nerve or the vestibular organ. Histologically, the tumor presents a "myxoid" matrix that is rich in acid mucopolysaccarides. The treatment of choice is complete surgical resection. Using the case presented, we discuss the causality between the tumor and the facial palsy, although during the operation the bony canal of the nerve was found to be intact. In any cases with clinically and radiologically unclear findings of the ear in connection with facial palsy, surgical exposure should be considered.
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Affiliation(s)
- T Zehlicke
- Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie Otto Körner, Doberaner Strasse 137-139, 18057 Rostock.
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White ML, Russo RS, Zhou Y, Mao H, Varner RK, Ambrose J, Veres P, Wingenter OW, Haase K, Stutz J, Talbot R, Sive BC. Volatile organic compounds in northern New England marine and continental environments during the ICARTT 2004 campaign. ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2007jd009161] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Expression of peroxisome proliferator-activated receptor-alpha (PPARalpha) has been shown in liver of chicks, but effects of its activation have not yet been investigated. In this study, laying hens were treated with clofibrate, a synthetic PPARalpha agonist, to investigate the effects of PPARalpha activation on liver lipid metabolism. Hens receiving a diet containing 5 g of clofibrate/kg had a lower food intake and higher liver mRNA concentrations of typical PPARalpha target genes (carnitine palmitoyltransferase 1A, acyl-coenzyme A oxidase, bifunctional enzyme, lipoprotein lipase) involved in hepatic mitochondrial and peroxisomal beta-oxidation and plasma triglyceride clearance than control hens that received the same diet without clofibrate (P<0.05). Hens treated with clofibrate also had lower mRNA concentrations of fatty acid synthase, 3-hydroxy-3-methylglutaryl-coenzyme A reductase, and low-density lipoprotein receptor, proteins involved in fatty acid biosynthesis and cholesterol biosynthesis and uptake, than hens fed the control diet (P<0.05). These changes in clofibrate-treated hens were accompanied by reduced liver triglyceride concentrations, strongly diminished very low density triglyceride and cholesterol concentrations (P<0.05), a disturbed maturation of egg follicles, a complete stop of egg production, and a markedly reduced plasma 17-beta-estradiol concentration (P<0.05). In conclusion, it is shown that clofibrate has complex effects on hepatic lipid metabolism in laying hens that mimic PPARalpha activation in mammals, affect maturation of egg follicles, and lead to a stop of egg production. Because clofibrate treatment strongly reduced food intake in the hens, some of these effects (i.e., egg production) may have been due to a low energy and nutrient intake.
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Affiliation(s)
- B König
- Institute of Agricultural and Nutritional Sciences, Martin-Luther-University Halle-Wittenberg, D-06108 Halle (Saale), Germany
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Haase K, Wendlandt KD, Gräber A, Stottmeister U. Cometabolic Degradation of MTBE Using Methane-Propane- and Butane-Utilizing Enrichment Cultures andRhodococcus sp. BU3. Eng Life Sci 2006. [DOI: 10.1002/elsc.200520144] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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42
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Hauffa B, Haase K, Range I, Unger N, Mann K, Petersenn S. The effects of growth hormone therapy on the response of plasma ghrelins to an oral glucose load and on body mass index in children and adolescents with Prader-Willi syndrome. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schönhoff F, Kayhan N, Thomas G, Haase K, Borggrefe M, Katus H, Hagl S, Vahl C. Bridge-to-operation with the GPIIb/IIIa-antagonist Abciximab in high-risk coronary patients: ‘altering the rules'. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-861961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hoffmann U, Brückmann M, Liebetrau C, Lang S, Bertsch T, Borggrefe M, Putensen C, Schröder S, Haase K. Crit Care 2004; 8:P113. [DOI: 10.1186/cc2580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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45
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Reay PA, Matsui K, Haase K, Wulfing C, Chien YH, Davis MM. Determination of the relationship between T cell responsiveness and the number of MHC-peptide complexes using specific monoclonal antibodies. J Immunol 2000; 164:5626-34. [PMID: 10820237 DOI: 10.4049/jimmunol.164.11.5626] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We describe the generation of three mAbs that recognize the complex of the class II MHC molecule IEk bound to a peptide derived from the carboxyl terminus of moth cytochrome c (residues 95-103). Reactivities of these mAbs are sensitive to single alterations in the sequence of both helices of the MHC molecule and to the bound peptide. The epitopes of these reagents are distinct but overlap substantially. One of these mAbs specifically blocks lymphokine release by T cells responsive to this complex but not others. We have used another to examine how the number of complexes on an APC is related to its ability to stimulate T cells. We find that 200-400 complexes per cell are necessary and sufficient to induce a degree of stimulation, whereas maximum stimulation is achieved only if more than 5000 complexes are present. The analysis indicates that T cell activation is a stochastic process.
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Affiliation(s)
- P A Reay
- Howard Hughes Medical Institute and Department of Microbiology and Immunology, Stanford University, Stanford, CA 94305, USA.
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Brand RM, Haase K, Hannah TL, Iversen PL. An experimental model for interpreting percutaneous penetration of oligonucleotides that incorporates the role of keratinocytes. J Invest Dermatol 1998; 111:1166-71. [PMID: 9856834 DOI: 10.1046/j.1523-1747.1998.00453.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Oligonucleotides have been extensively studied for their potential as therapeutic agents. Phosphorothioate oligonucleotides have been demonstrated to be particularly useful due to their stability against nucleases, their ability to be internalized by many cell types, and the ease with which they hybridize with target mRNA. These compounds have previously been delivered across the skin with the aid of iontophoresis. During transdermal delivery, the first viable cells exposed to the oligonucleotides are the keratinocytes. The purpose of this study was to determine the relationship between internalization of these compounds by keratinocytes and their transport across the skin. The in vitro uptake of 15 different fluorescently labeled phosphorothioate oligonucleotides into human keratinocytes was quantitatively measured with a fluorometer. Photomicrographs of keratinocytes indicate diffuse cytoplasmic and nuclear localization. The ability of these molecules to enter cells was linearly related to size. Cellular uptake data were inversely correlated with previously reported steady-state transport levels of oligonucleotides that had been transdermally delivered by iontophoresis across hairless mouse skin. Oligonucleotides that readily entered keratinocytes had a decreased ability to penetrate skin under iontophoretic conditions. The results indicate that oligonucleotide sequences may be designed for treating skin diseases (high uptake, low transport) or systemic disorders (low uptake, high transport).
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Affiliation(s)
- R M Brand
- Department of Biological Systems Engineering, University of Nebraska, Lincoln 68583-0726, USA
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Abstract
The authors present two cases of resultant hallux hammer toe secondary to the definitive treatment of hallux sesamoidal osteomyelitis. Pseudomonas osteomyelitis developed in both cases following puncture wounds to the first metatarsophalangeal joint complex. The authors also review the literature on pseudomonas osteomyelitis secondary to puncture wounds and the development of hallux hammer toe after removal of the involved sesamoid bones.
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Affiliation(s)
- L A Lavery
- Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78284-7776
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Kratochwil K, von der Mark K, Kollar EJ, Jaenisch R, Mooslehner K, Schwarz M, Haase K, Gmachl I, Harbers K. Retrovirus-induced insertional mutation in Mov13 mice affects collagen I expression in a tissue-specific manner. Cell 1989; 57:807-16. [PMID: 2541924 DOI: 10.1016/0092-8674(89)90795-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In the Mov13 mouse mutant, transcription of the alpha 1 (1) collagen gene is blocked by a retroviral insert in the first intron. We now report that teeth derived from homozygous embryos produce a dentin layer containing normal amounts of collagen 1. In situ hybridization and RNAase protection experiments indicate that the mutant allele is efficiently transcribed in odontoblasts, in contrast to other cell types. Correct splicing of the primary transcript containing the viral sequence results in a functional alpha 1 (1) collagen mRNA. The absence of a mutagenic effect in odontoblasts, as opposed to fibroblasts, suggests that the retroviral insert interferes with tissue-specific transcriptional control of the alpha 1 (1) collagen gene, most likely by inactivating cell-type-specific cis-acting regulatory elements.
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Affiliation(s)
- K Kratochwil
- Institute of Molecular Biology, Austrian Academy of Sciences, Salzburg
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