Co-designing Healthy Living after Cancer Online: an online nutrition, physical activity, and psychosocial intervention for post-treatment cancer survivors

PURPOSE

The aim of the present study was to co-design Healthy Living after Cancer Online (HLaC Online), an online intervention supporting cancer survivors to set and meet their healthy living goals.

METHODS

Adapted from an initial telephone-delivered Healthy Living after Cancer program, wireframes (PDF black and white mock-ups) of the proposed online program were presented in a series of focus groups and interviews to our stakeholder group, which consisted of cancer survivors, oncology healthcare professionals, and representatives from cancer support organisations. Stakeholders were prompted for feedback on the wireframe and given end-user scenarios to encourage deeper engagement with the co-design process. Transcriptions underwent thematic analysis to determine which features of the program needed change or expansion.

RESULTS

27 participants took part in one of 8 focus groups or 10 interviews. Five themes were identified relating to (a) website design elements, (b) promoting and maintaining long-term engagement, (c) relatability and relevance, (d) navigating professional support, and (e) family and peer support. Recommended changes, such as simple activities and guidance videos, were integrated into the HLaC Online prototype.

CONCLUSIONS

Involving end-users in the co-design process ensured the intervention's relevance and specificity to the needs of cancer survivors. Next steps include feasibility testing the prototype, prior to commencing a national randomised control trial of HLaC Online.

IMPLICATIONS FOR CANCER SURVIVORS

HLaC Online aims to support cancer survivors to improve their quality of life by making healthy lifestyle changes in their physical activity, healthy eating, weight management, mental health, and fatigue management.

Stigma, risks, and benefits of medicinal cannabis use among Australians with cancer

PURPOSE

People with cancer who use medicinal cannabis do so despite risks associated with limited clinical evidence, legalities, and stigma. This study investigated how Australians with cancer rationalise their medicinal cannabis use despite its risks.

METHODS

Ten adults (5 males and 5 females; mean age of 53.3) who used cannabis medicinally for their cancer were interviewed in 2021-2022 about how they used and accessed the substance, attitudes and beliefs underpinning their use, and conversations with others about medicinal cannabis.

RESULTS

Participants had cancer of the bowel, skin, oesophagus, stomach, thyroid, breast, and Hodgkin lymphoma for which they were receiving treatment (n = 5) or under surveillance (n = 5), with most (n = 6) encountering metastatic disease. Cannabis was used to treat a variety of cancer-related symptoms such as pain, poor sleep, and low mood. Cannabis was perceived as natural and thus less risky than pharmaceuticals. Participants legitimised their medicinal cannabis use by emphasising its natural qualities and distancing themselves from problematic users or riskier substances. Cost barriers and a lack of healthcare professional communication impeded prescription access. Similarly, participants navigated medicinal cannabis use independently due to a lack of guidance from healthcare professionals.

CONCLUSION

Findings highlight the need for robust data regarding the harms and efficacy of medicinal cannabis and dissemination of such information among healthcare professionals and to patients who choose to use the substance. Ensuring healthcare professionals are equipped to provide non-judgmental and evidence-based guidance may mitigate potential safety and legal risks.

South Australia's tobacco retail landscape and its intersection with socioeconomic factors and smoking prevalence

ISSUES ADDRESSED

Tobacco product availability is higher in socioeconomically disadvantaged areas, which can further widen tobacco-related health and disease burden inequities. This study aimed to describe retail availability of tobacco products in South Australia and examine the association between tobacco vendor location, population's socioeconomic status (SES) and tobacco smoking prevalence.

METHODS

Cross-sectional 2022 tobacco vendor licence data and 2021-2022 state-wide population health survey data from the South Australian Department of Health were used. Tobacco vendors were enumerated by Statistical Area 2 (SA2) using geocoding software, with SA2s assigned health survey derived smoking prevalence, SES, remoteness category, area size, and population size.

RESULTS

As of 2022, there were 1723 tobacco vendors in South Australia and the overall tobacco smoking prevalence across the state was 11.8%. Regression analyses indicated that tobacco vendor density increased with socioeconomic disadvantage and geographic remoteness, and that smoking prevalence was higher in low SES areas. Vendor density was not related to smoking prevalence.

CONCLUSIONS

Findings are consistent with existing research indicating greater tobacco availability in socially disadvantaged areas. This supports that tobacco vendor saturation may be directed to areas in a way that promotes tobacco availability for vulnerable populations. Our finding that smoking prevalence was unrelated to tobacco availability contrasts existing literature and should be carefully interpreted. SO WHAT?: This is the first study to map tobacco retailers across South Australia, contributing needed evidence on the intersection of tobacco vendor density, social disadvantage, and smoking prevalence.

Diet and physical activity practices of South Australian adolescents

Adequate nutrition and physical activity are integral to health across the life course, with adolescence a crucial time for establishing health behaviours. This report describes self-reported dietary and physical activity behaviours of South Australian adolescents aged 12–17 years (N = 1324) surveyed in 2017. Healthy lifestyle behaviour engagement was low, with most (90.3%) adolescents not meeting Australia's recommended dietary or physical activity guidelines. Almost three-quarters (73.8%) of adolescents consumed the recommended daily amount of fruit. However, only 10.8% of adolescents met the recommended daily intake of vegetables, and large proportions regularly consumed unhealthy snacks (64.5%), fast foods, (30.7%) and sugary drinks (65.8%). Combined with the low adherence to physical activity guidelines, these findings highlight the need for effective targeted health promotion campaigns to improve adolescent's public health outcomes in South Australia.

Wound cleansing: ritualistic or research-based practice?

Wound cleansing is an important component of wound management. When carried out correctly it can improve healing, but when undertaken unnecessarily it can impede wound progress. Literature suggests that nurses continue to rely on ritualistic practice rather than using research or best evidence to inform patient care. The rationale and implications for wound cleansing are examined in relation to cleansing solutions, technique and equipment.

Are research ethics committees behaving unethically? Some suggestions for improving performance and accountability

The results of recent empirical investigations in research synthesis imply that research ethics committees are behaving unethically by endorsing new research which is unnecessary and by acquiescing in biased under-reporting of research which they have approved. The performance and accountability of research ethics committees would be improved if they required those proposing research to present systematic reviews of relevant previous research in support of their applications; to summarise the results of these reviews in the information prepared for potential participants; to register new controlled trials at inception; and to ensure that the results of these trials are made publicly available within a reasonable period of time after completion of data collection.

Critical IT (information technology) issues: the next ten years

In 1982, Robert Benjamin published a forecast of the state of information technology in the year 1990. He wrote that the information systems environment was in "a considerable state of flux" and information systems managers could benefit from a prediction of the "end-point scenario [in order to] focus major planning strategies." Ten years later, it's time to provide a new set of landmarks for another decade of flux. Benjamin and his coauthor, Jon Blunt, envision the information technology world of 2000. What can we expect? What should we not expect? And what can we not even begin to guess?

A human monoclonal antibody to rhG

Hybridomas secreting a human monoclonal IgG1 antibody against a variant of the rhG antigen were produced from B lymphocytes of an Rh-negative donor with serum antibodies to D and G [correction of C] antigens. The antibody reacts by indirect hemagglutination with nearly all C- or D-positive cells, confirming the strong association in the expression of G with D or C antigens. The lack of antibody reactivity to C-negative Du cells suggests a particular epitope on the D complex associated with the G antigen.

Carbon-13 N.M.R. Analysis of Tutin and Related Substances: Application to the Identification of Minor Components of Toxic Honey

The application of carbon-13 N.M.R. microsample probe techniques has been employed to show the presence of dihydrotutin and dihydrohyenanchin as trace components of a range of toxic honeydew honeys. The 13C N.M.R. spectra of a series of compounds related to tutin, hyenanchin and picrotin have been assigned.