Living with adversity: A qualitative study of families with multiple and complex needs

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Living with and beyond cancer: the role of Holistic Needs Assessment and care planning.

Due to earlier diagnosis and more effective treatment, increasing numbers of people can be expected to live with and beyond cancer. Yet for many, survival might be characterised by physical and psychological morbidity, decreased functional status and disability, which may increase as the length of time from the completion of treatment extends. However, careful integrated assessment and relevant and acceptable care planning can mitigate these effects; people can be helped and supported in self-management and ultimately enabled to live full and productive lives in a manner that is acceptable to them.

Supporting delivery of the recovery package for people living with and beyond cancer

Survivorship is an important issue in cancer care in the UK. More people are being diagnosed with the disease and many more are living for longer after diagnosis. The National Cancer Survivorship Initiative recommends that patients with cancer have a package of care designed to improve outcomes and support for those living with and beyond the disease. The recovery package consists of a holistic needs assessment, treatment summary, cancer care review and health and wellbeing event. Although these interventions are recommended as a way to improve care, many people do not have access to the combined package, or even some of its components. The Cancer Nursing Partnership (CNP), a collaboration of cancer nursing organisations and communities of influence, has been established to support nurses with delivery of the recovery package in practice. This article describes the package and its components, introduces the CNP and outlines the work it has carried out to date.

Desire for fertility and associated factors among people living with HIV/AIDS (PLWHA) in selected antiretroviral therapy (ART) clinics of Horro Guduru Wollega Zone, North West Oromia, Ethiopia- A cross sectional study

Background: Most recently fertility issues in HIV positive men and women are becoming increasingly important. Because of ART access and its good life effect, it is expected that the need and desire to get married, to have children and to have sexual partners for PLWHA would change with the regard to reproductive health. In Ethiopia HIV positive individuals may or may not have desire to have children. And the extent of this desire and how it varies by individual, health and demographic characteristics is not well known.

Objective: the aim of the study was to assess desire for fertility and associated factors among PLWHA in selected ART clinics of Horro Guduru Wollega Zone, Oromia National Regional State, Ethiopia.

Methods: A cross-sectional, institutional-based study that employed quantitative and qualitative in-depth interviews was conducted. Three hundred twenty one study subjects were selected using systematic random sampling technique and the data was collected using interviewer administered structured questionnaire. Data entry and analysis were performed using EPI Info version 3.5.1 and SPSS version 16. P-value <0.05 was taken as statistically significant and logistic regression was used to control potential confounding factors.

Results: Seventy three (57.9%) of the males and seventy six (39%) of the females desired to have children, giving a total of 149(46.4%) of all study participants. PLWHA who desired children were younger (AOR:3.3, 95%CI: 1.3-8.9), married (AOR: 5.8, 95%CI: 2.7-12.8), had no children (AOR: 75, 95%CI: 20.1-273.3) and males (AOR; 1.9, 95%CI: 1.02-3.62) compared with their counter parts. The major reason for those people who did not desire children were having desired number of children 80 (46.5%) followed by fear of HIV transmission to child reported by 42 (24.4%) of them.

Conclusion: A considerable number of PLWHA wants to have a child currently or in the near future. Many variables like socio demography, partner related, number of alive children and HIV related disease condition were significantly associated with fertility desire.

The validation of Fibit ZipTM physical activity monitor as a measure of free-living physical activity

BACKGROUND: The new generation of activity monitors allow users to upload their data to the internet and review progress. The aim of this study is to validate the Fitbit Zip as a measure of free-living physical activity.

FINDINGS: Participants wore a Fitbit Zip, ActiGraph GT3X accelerometer and a Yamax CW700 pedometer for seven days. Participants were asked their opinion on the utility of the Fitbit Zip. Validity was assessed by comparing the output using Spearman's rank correlation coefficients, Wilcoxon signed rank tests and Bland-Altman plots. 59.5% (25/47) of the cohort were female. There was a high correlation in steps/day between the Fitbit Zip and the two reference devices (r = 0.91, p < 0.001). No statistically significant difference between the Fitbit and Yamax steps/day was observed (Median (IQR) 7477 (3597) vs 6774 (3851); p = 0.11). The Fitbit measured significantly more steps/day than the Actigraph (7477 (3597) vs 6774 (3851); p < 0.001). Bland-Altman plots revealed no systematic differences between the devices.

CONCLUSIONS: Given the high level of correlation and no apparent systematic biases in the Bland Altman plots, the use of Fitbit Zip as a measure of physical activity. However the Fitbit Zip recorded a significantly higher number of steps per day than the Actigraph.

Presence of cave bears in western Austria before the onset of the Last Glacial Maximum: new radiocarbon dates and palaeoclimatic considerations

Tischoferhohle and Pendling-Barenhohle near Kufstein, Tyrol, are among the only locations where remains of cave bear, Ursus spelaeus-group, were found in the western part of Austria. One sample from each site was radiocarbon-dated four decades ago to ca. 28 C-14 ka BP. Here we report that attempts to date additional samples from Pendling-Barenhohle have failed due to the lack of collagen, casting doubts on the validity of the original measurement. We also unsuccessfully tried to date flowstone clasts embedded in the bone-bearing sediment to provide maximum constraints on the age of this sediment. Ten cave bear bones from Tischoferhohle showing good collagen preservation were radiocarbon-dated to 31.1-39.9 C-14 ka BP, again pointing towards an age underestimation by the original radiocarbon-dated sample from this site. These new dates from Tischoferhohle are therefore currently the only reliable cave bear dates in western Austria and constrain the interval of cave occupation to 44.3-33.5 cal ka BP. We re-calibrate and re-evaluate dates of alpine cave bear samples in the context of available palaeoclimate information from the greater alpine region covering the transition into the Last Glacial Maximum, eventually leading to the demise of this megafauna.

Report on the 2014 UKONS Annual Conference Belfast, 14–15 November 2014: focus on living with and beyond cancer, patient information and support, and innovations in treatment and care

The UK Oncology Nursing Society’s (UKONS) annual conference focused on three major themes. These were ‘Living With and Beyond Cancer’, ‘Patient Information and Support’, and ‘Innovations in Treatment and Care’. It featured a wide range of presentations, industry satellites, exhibitions, poster discussions. and workshops. Presenters ranged from those eminent in their particular field to those gracing the speaker’s podium for the first time. The rich variety of presentations covered policy, cancer trends, clinical developments, care initiatives, personal development, and advances in practice. There was a strong emphasis on skills, knowledge, values, and attitudes, with the most junior and novice nurses mixing with experienced and highly esteemed practitioners.

“A quiet still voice that just touches”: music’s relevance for adults living with life-threatening cancer diagnoses.

Purpose
Music has historically aided health and loss-adaptation, however, cancer patients’ experience of music for self-care is not well understood. This study examines adult cancer patients’ views about music’s role before and after diagnosis.
Methods
Constructivist approach, with grounded theory informed design using convenience, snowball and theoretical sampling. Patients from Australian metropolitan cancer and hospice settings completed demographic questionnaires and participated in semi-structured interviews. Qualitative inter-rater reliability was applied.
Results
Fifty-two patients reported comparable time spent experiencing music pre-post diagnosis. Music may remain incidental; however, many patients adapt music usage to ameliorate cancer’s aversive effects. Patients often draw from their musical lives and explore unfamiliar music to: remain connected with pre-illness identities; strengthen capacity for enduring treatment, ongoing survival (even when knowing “you’re going to die”), or facing death; reframe upended worlds; and live enriched lives. Patients can ascribe human or physical properties to music when describing its transformative effects. Familiar lyrics maybe reinterpreted, and patients’ intensified emotional reactions to music can reflect their threatened mortality. Sometimes music becomes inaccessible, elusive, and/or intensifies distress and is avoided. Families’, friends’ and professionals’ recognition of patients’ altered musical lives and music-based suggestions can extend patients’ use of music for self-care.
Conclusion
Health professionals can support patients by inquiring about their music behaviours and recognising that altered music usage may signify vulnerability. Although commonly recommended, hospital concerts and music broadcasts need sensitive delivery. Patients’ preferred music should be available in diagnostic, treatment and palliative settings because it can promote endurance and life enrichment.

The Modern Ordinary: Changing culture of living in Egypt’s traditional quarters at the turn of the twentieth Century

Having experienced social and political structures of the 19th century Europe, Western- educated Egyptian elite used public institutions to force legislative structures and procedures that ruled out traditional housing forms and spatial systems. This essay detects direct and indirect impact of these changes that informed the spatial change of modern living in Egypt in the first quarter of the twentieth century. It offers analysis of socio-spatial practices and change in ordinary Cairenes’ modes of everyday living, using social routine and interaction to explain spatial systems and changing house forms during the first quarter of the 20th century. In doing so, the essay utilized archival documents, accounts, formal decrees, and novels of the time as well as conducting survey of house forms and spatial organizations in Old Cairo.

Meeting the needs of visually impaired people living in Lifetime Homes

This article explores perceptions on the suitability and effectiveness of Lifetime Homes Standards (LTHS) for those with visual impairment in Northern Ireland.
LTHS are a series of mandatory United Kingdom (UK) public sector housing design interventions, providing a model for ensuring accessible and adaptable homes throughout an occupant's lifespan. An ageing demographic with increasing incidence of diabetes, has led to rising numbers of elderly visually impaired people wanting to remain in their homes for longer.
Qualitative semi structured interviews were conducted with thirteen key stakeholders and thematically analysed. Although findings show that employing LTHS offers benefits to visually impaired residents, short-comings were also identified. Evidence indicates a need for Policy Makers, Health Care Professionals and Housing Associations to modify practices to better meet the housing needs of visually impaired people. Findings may also be applicable to those with other impairments and disabilities in relation to housing for elderly residents.