Development, implementation and evaluation of a cancer survivor self-management care plan

Aim There is a growing population of people with cancer who experience physiological and psychological effects that persist long after treatment is complete. Interventions that enhance survivors’ self-management abilities might help offset these effects. The aim of this pilot study was to develop, implement and evaluate interventions tailored to assist patients to manage post-treatment health issues effectively. Method In this pre-post intervention cohort study, participants were recruited on completion of cancer treatment. Participants recruited preimplementation, who received usual care, comprised the control group. Participants recruited later formed the intervention group. In the intervention group, the Cancer Care Coordinator developed an individualised, structured Cancer Survivor Self-management Care Plan. Participants were interviewed on completion of treatment (baseline) and at three months. Assessments concerned health needs (CaSUN), self-efficacy in adjusting and coping with cancer and health-related quality of life (FACIT-B or FACT-C). The impact of the intervention was determined by independent t-tests of change scores. Results The intervention (n = 32) and control groups (n = 35) were comparable on demographic and clinical characteristics. Sample mean age was 54 + 10 years. Cancer diagnoses were breast (82%) and colorectal (18%). Statistically significant differences (p < 0.05) indicated improvement in the intervention group for: (a) functional well-being, from the FACIT, (Control: M = −0.69, SE = 0.91; Intervention: M = 3.04, SE = 1.13); and (b) self-efficacy in maintaining social relationships, (Control: M = −0.333, SE = 0.33; Intervention: M = 0.621, SE = 0.27). No significant differences were found in health needs, other subscales of quality of life, the extent and number of strategies used in coping and adjusting to cancer and in other domains of self-efficacy. Conclusions While the results should be interpreted with caution, due to the non-randomised nature of the study and the small sample size, they indicate the potential benefits of tailored self-management interventions warrant further investigation in this context.

Genetic structure of invasive weed Parthenium hysterophorus in Australia and Pakistan

Understanding the patterns of genetic structure in the introduced range of invasive species can help elucidate invasion histories and levels of gene flow among populations. Parthenium weed (Parthenium hysterophorus L.; PW) is native to the Gulf of Mexico and central South America but has become globally invasive during the last three decades and little is known about the genetics of this species in its invasive range. The present study was conducted to determine the genetic structure of 95 individual samples from 11 populations (9 from Pakistan and 2 from Australia) of PW using ISSR fingerprinting. A total of 30 ISSR primers were screened; of which eight were selected due to their high polymorphism and reproducibility. In toto 147 bands were amplified, which ranged in size from 200-2000 bp; among which 97 were polymorphic. Genetic diversity within the populations both from Pakistan and Australia ranged between 0.193-0.278. Approximately 18% of genetic variation occurred among and 82% within populations. Principal Coordinate Analysis showed that within the 95 samples two groups were present: one contained samples collected mainly from Pakistan and the second group included the Australian samples along with two populations from Pakistan. Overall, there was limited gene flow among PW populations in Pakistan, although the genetic diversity within populations was high. The degree of genetic variation inferred from various population diversity measures can predict different events of founding populations, which have passed through complicated processes of invasion, experiencing genetic bottlenecks. Taken together, results showed that PW in Pakistan is genetically heterogeneous and may have been the result of multiple introductions.