A mixed-methods study to evaluate a patient-designed tool to reduce harm from cancer-associated thrombosis: The EMPOWER study.

INTRODUCTION: Venous thromboembolism (VTE) is a common and serious complication of systemic anticancer therapies. Delays in presentation increase risk of death or long-term morbidity. BACKGROUND: A patient charity developed an information video for patients receiving systemic anticancer therapy including what to do if they developed symptoms of VTE. This was introduced into clinical practice in a regional cancer center and its impact compared with a district general hospital where the video was not used. METHODS: A mixed-methods approach was used, comprising clinical audit data, patient surveys, and key informant interviews. The time between development of VTE symptoms and seeking medical evaluation was routinely recorded on patients attending a regional cancer-associated thrombosis service with systemic anticancer therapy-provoked VTE. The video was then embedded into clinical practice at the regional cancer center for 3 months. The primary outcome was the difference in time to presentation with VTE symptoms, between patients attending the regional cancer center and the district general hospital (which acted as control). Other outcomes included impact on radiology resources, patient knowledge, and perspectives of chemotherapy nurses. RESULTS: Addition of the video was associated with a lower mean time to presentation from 8.9 to 2.9 days (0.33 hazard ratio; 95% confidence interval, 4.5-7.4; P < .0001). This may reflect greater awareness of VTE, resulting in earlier clinical presentation when they developed attributable symptoms. CONCLUSION: The video was associated with reduced delays in diagnosis of systemic anticancer therapy-associated VTE by 6 days, thereby reducing long-term complications.

Palliative care research centre's move into social media: constructing a framework for ethical research, a consensus paper.

BACKGROUND: Social media (SM) have altered the way we live and, for many, the way we die. The information available on even the rarest conditions is vast. Free from restrictions of mobility, time and distance, SM provides a space for people to share experiences of illness, death and dying, and potentially benefit from the emotional and practical support of others n similar positions. The communications that take place in these spaces also create large amounts of 'data' which, for any research centre, cannot be ignored. However, for a palliative care research centre the use of this 'data' comes with specific ethical dilemmas. METHODS: This paper details the process that we, as a research, went through in constructing a set of ethical guidelines by which to work. This involved conducting two consensus days; one with researchers from within the centre, and one with the inclusion of external researchers with a specific interest in SM. RESULTS: The primary themes that emerged from the consensus meetings includes; SM as a public or private space; the status of open and closed groups; the use of historical data; recruiting participants and obtaining informed consent and problems of anonymity associated with dissemination. CONCLUSIONS: These are the themes that this paper will focus on prior to setting out the guidelines that we subsequently constructed.

Ageism among college students: a comparative study between U.S. and China.

It is often assumed that Chinese people tend to have a more positive attitude toward aging and old age than Americans, due to the cultural generalization of collectivism versus individualism. This study aimed to critically examine this assumption by using first-hand empirical data collected in a Chinese and an American university (standardized surveys and in-depth focus group interviews). Respectively, 980 college students in China and 332 college students in the U.S. were recruited for the standardized surveys; whereas two focus-group interviews in each country (4 participants per group) were conducted to collect more in-depth information. Contrary to the common assumption, this study revealed that Chinese students actually hold more negative attitudes toward aging and older people compared to their American peers. It was also found that females tend to hold more positive attitudes than male students across both cultures, though American female students hold more positive attitudes than Chinese female students. Chinese students' interactions with seniors are often limited to their grandparents whereas American students tend to reach out to non-grandparent seniors in larger communities. Chinese students' more negative attitudes toward aging and older people may be a result of a combination of educational, social, and economic factors-a higher level of age segregation (geographically, socially, and intellectually) and a lack of gerontological curriculum in Chinese educational system, the caregiving burden faced by the one-child generation compounded with lack of governmental support for caregiving, as well as the rising youth-oriented consumerist culture.