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Haase KR, Cosco T, Kervin L, Riadi I, O'Connell ME. Older Adults' Experiences With Using Technology for Socialization During the COVID-19 Pandemic: Cross-sectional Survey Study. JMIR Aging 2021; 4:e28010. [PMID: 33739929 PMCID: PMC8074950 DOI: 10.2196/28010] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Technology use has become the most critical approach to maintaining social connectedness during the COVID-19 pandemic. Older adults (aged >65 years) are perceived as the most physiologically susceptible population to developing COVID-19 and are at risk of secondary mental health challenges related to the social isolation that has been imposed by virus containment strategies. To mitigate concerns regarding sampling bias, we analyzed a random sample of older adults to understand the uptake and acceptance of technologies that support socialization during the pandemic. OBJECTIVE We aimed to conduct a population-based assessment of the barriers and facilitators to engaging in the use of technology for web-based socialization among older adults in the Canadian province of British Columbia during the COVID-19 pandemic. METHODS We conducted a cross-sectional, population-based, regionally representative survey by using the random-digit dialing method to reach participants aged >65 years who live in British Columbia. Data were analyzed using SPSS (IBM Corporation), and open-text responses were analyzed via thematic analysis. RESULTS Respondents included 400 older adults aged an average of 72 years, and 63.7% (n=255) of respondents were female. Most respondents (n=358, 89.5%) were aware of how to use technology to connect with others, and slightly more than half of the respondents (n=224, 56%) reported that, since the beginning of the pandemic, they used technology differently to connect with others during the pandemic. Additionally, 55.9% (n=223) of respondents reported that they adopted new technology since the beginning of the pandemic. Older adults reported the following key barriers to using technology: (1) a lack of access (including finance-, knowledge-, and age-related issues); (2) a lack of interest (including a preference for telephones and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults also reported the following facilitators: (1) a knowledge of technologies (from self-teaching or external courses); (2) reliance on others (family, friends, and general internet searches); (3) technology accessibility (including appropriate environments, user-friendly technology, and clear instructions); and (4) social motivation (everyone else is doing it). CONCLUSIONS Much data on older adults' use of technology are limited by sampling biases, but this study, which used a random sampling method, demonstrated that older adults used technology to mitigate social isolation during the pandemic. Web-based socialization is the most promising method for mitigating potential mental health effects that are related to virus containment strategies. Providing telephone training; creating task lists; and implementing the facilitators described by participants, such as facilitated socialization activities, are important strategies for addressing barriers, and these strategies can be implemented during and beyond the pandemic to bolster the mental health needs of older adults.
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Journal Article |
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101 |
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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: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [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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Research Support, Non-U.S. Gov't |
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100 |
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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] [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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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. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 579:1781-1793. [PMID: 27939081 DOI: 10.1016/j.scitotenv.2016.11.157] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [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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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. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2000; 164:5626-34. [PMID: 10820237 DOI: 10.4049/jimmunol.164.11.5626] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [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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73 |
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Nightingale G, Battisti NML, Loh KP, Puts M, Kenis C, Goldberg A, Haase KR, Krok-Schoen J, Liposits G, Sattar S, Stolz-Baskett P, Pergolotti M. Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG. J Geriatr Oncol 2021; 12:658-665. [PMID: 33172805 PMCID: PMC8102651 DOI: 10.1016/j.jgo.2020.10.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Most adults with cancer are over 65 years of age, and this cohort is expected to grow exponentially. Older adults have an increased burden of comorbidities and risk of experiencing adverse events on anticancer treatments, including functional decline. Functional impairment is a predictor of increased risk of chemotherapy toxicity and shorter survival in this population. Healthcare professionals caring for older adults with cancer should be familiar with the concept of functional status and its implications because of the significant interplay between function, cancer, anticancer treatments, and patient-reported outcomes. In this narrative review, we provide an overview of functional status among older patients with cancer including predictors, screening, and assessment tools. We also discuss the impact of functional impairment on patient outcomes, and describe the role of individual members of an interprofessional team in addressing functional impairment in this population, including the use of a collaborative approach aiming to preserve function.
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Research Support, N.I.H., Extramural |
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53 |
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Verma R, Saldanha C, Ellis U, Sattar S, Haase KR. eHealth literacy among older adults living with cancer and their caregivers: A scoping review. J Geriatr Oncol 2022; 13:555-562. [PMID: 34810146 DOI: 10.1016/j.jgo.2021.11.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/20/2021] [Accepted: 11/05/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Over 90% of people living with cancer access information online to inform healthcare decisions. Older adults with cancer are also increasingly adopting electronic healthcare services, or eHealth, particularly with the rapid transition to virtual care amidst the pandemic. Therefore, the purpose of this review is to understand the level of eHealth literacy among older adults with cancer and their caregivers, as well as any barriers and facilitators in terms of accessing, comprehending, and implementing eHealth information. METHODS This scoping review was guided by Arksey and O'Malley methodology and PRISMA ScR guidelines. Comprehensive searches for the concepts of "eHealth Literacy" and "cancer" were performed in MEDLINE, Scopus, CINAHL, PsycINFO, AMED and EMBASE, from 2000 to 2021. We used descriptive quantitative and thematic analysis to analyze the literature. RESULTS Of the 6076 articles screened by two reviewers, eleven articles were included. Quantitative findings suggest older adults with cancer and their caregivers have low self-perceived eHealth literacy and less confidence evaluating online health information for cancer decision-making. Low socioeconomic status, lower education levels, rapid expansion of digital applications, broadband access, reduced familiarity, and frequency of use were cited as prominent barriers. eHealth literacy appears to be positively correlated with caregivers seeking a second opinion, awareness of treatment options, shared decision making, and trust in the health care system. CONCLUSION With the growing reliance on eHealth tools, developing credible digital health applications that require minimal internet navigation skills, patient education, and collaborative efforts to address access and affordability are urgently warranted.
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Scoping Review |
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38 |
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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: 3.5] [Reference Citation Analysis] [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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Research Support, Non-U.S. Gov't |
10 |
35 |
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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: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [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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Systematic Review |
5 |
34 |
10
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Pilleron S, Alqurini N, Ferlay J, Haase KR, Hannan M, Janssen-Heijnen M, Kantilal K, Katanoda K, Kenis C, Lu-Yao G, Matsuda T, Navarrete E, Nikita N, Puts M, Strohschein FJ, Morris EJA. International trends in cancer incidence in middle-aged and older adults in 44 countries. J Geriatr Oncol 2022; 13:346-355. [PMID: 34866023 DOI: 10.1016/j.jgo.2021.11.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/24/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We examine international incidence trends of lung, colorectal, prostate, and breast cancers, as well as all cancers combined excluding non-melanoma skin cancer (NMSC) in adults aged 50 and older, over a fifteen-year period using data from 113 high quality population-based cancer registries included in the Cancer in Five Continents (CI5) series and NORDCAN. MATERIALS AND METHODS We calculated annual incidence rates between 1998 and 2012 for ages 50-64, 65-74, and 75+, by sex and both sexes combined. We estimated average annual percentage change (AAPC) in rates using quasi-Poisson regression models. RESULTS From 1998 to 2012, incidence trends for all cancers (excluding NMSC) have increased in most countries across all age groups, with the greatest increase observed in adults aged 75+ in Ecuador (AAPC = +3%). Colorectal cancer incidence rates increased in the majority of countries, across all age groups. Lung cancer rates among females have increased but decreased for males. Prostate cancer rates have sharply increased in men aged 50-64 with AAPC between 5% and 15% in 24 countries, while decreasing in the 75+ age group in 21 countries, by up to -7% in Bahrain. Female breast cancer rates have increased across all age groups in most countries, especially in the 65-74 age group and in Asia with AAPC increasing to 7% in the Republic of Korea. CONCLUSIONS These findings assist with anticipating changing patterns and needs internationally. Due to the specific needs of older patients, it is urgent that cancer systems adapt to address their growing number.
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O'Connell ME, Haase KR, Grewal KS, Panyavin I, Kortzman A, Flath ME, Cammer A, Cosco TD, Peacock S. Overcoming Barriers for Older Adults to Maintain Virtual Community and Social Connections during the COVID-19 Pandemic. Clin Gerontol 2022; 45:159-171. [PMID: 34233600 DOI: 10.1080/07317115.2021.1943589] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We describe the evaluation of remote training, an innovative use of technology to maintain older adults' virtual connection with their community and socialization, which were disrupted by the pandemic. Remote training was conducted via telephone using principles of cognitive rehabilitation and delivered by trained clinicians. METHODS We thematically analyzed trainer reflection notes and interviews with older adult participants. RESULTS The main facilitators were technology training with exposure, and the main barrier was fear of technology. CONCLUSIONS We describe how telephone-based training grounded in principles of cognitive rehabilitation can be used to remotely train older adults to use new technology and to help them maintain their community-based connections and engage in socialization. CLINICAL IMPLICATIONS Fear of technology during the pandemic can cause significant impairment in social functioning for older adults, at least when the only method for socialization is technology mediated such as during the COVID-19 pandemic. Empathically delivered remote training in an understanding manner can reduce fear and increase social and community connections in the era of physical distancing.
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König B, Kluge H, Haase K, Brandsch C, Stangl GI, Eder K. Effects of Clofibrate Treatment in Laying Hens. Poult Sci 2007; 86:1187-95. [PMID: 17495091 DOI: 10.1093/ps/86.6.1187] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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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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: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [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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Review |
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28 |
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Haase KR, Kain D, Merchant S, Booth C, Koven R, Brundage M, Galica J. Older survivors of cancer in the COVID-19 pandemic: Reflections and recommendations for future care. J Geriatr Oncol 2020; 12:461-466. [PMID: 33303410 PMCID: PMC7713572 DOI: 10.1016/j.jgo.2020.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/13/2020] [Accepted: 11/30/2020] [Indexed: 02/08/2023]
Abstract
Purpose Although the year after cancer treatment is challenging for all cancer survivors, older adults (≥60 years) face additional challenges due to age-related decline and high rates of comorbidity. There is a paucity of research on how health service interruptions from the COVID-19 pandemic have impacted the experience of older cancer survivors. In this study we explore older cancer survivors' reflections on the pandemic and their suggestions for future care delivery when traditionally offered resources are not available. Methods We conducted 1:1 telephone interviews with adults 60 years and older previously diagnosed with breast and colorectal cancer and recently (≤12 months) discharged from their cancer care team. We analyzed the data using descriptive thematic analysis. Results The mean sample (n = 30) age was 72.1 years (SD 5.8, Range 63–83) of whom 57% identified as female. Participants described personal and societal implications of the pandemic. that affected their ability to navigate social support, and public and clinical landscapes. These reflections informed their suggestions for future health care delivery, such as how they could have been better prepared to self-manage their post-cancer treatment journey. Participants recommendations were grouped into four sub-themes: 1) enhanced baseline information; 2) facilitate caregiver support and engagement; 3) greater technology integration; and 4) sustained use and public appreciation of personal protective equipment. Conclusion Older cancer survivors appreciate the needed shift to virtual appointments and services during the COVID-19 pandemic. Specific strategies to bolster older adults existing strengths and improve their readiness to engage in these measures are critical.
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Research Support, Non-U.S. Gov't |
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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: 1.7] [Reference Citation Analysis] [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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Journal Article |
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22 |
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Haase KR, Sattar S, Pilleron S, Lambrechts Y, Hannan M, Navarrete E, Kantilal K, Newton L, Kantilal K, Jin R, van der Wal-Huisman H, Strohschein FJ, Pergolotti M, Read KB, Kenis C, Puts M. A scoping review of ageism towards older adults in cancer care. J Geriatr Oncol 2023; 14:101385. [PMID: 36244925 DOI: 10.1016/j.jgo.2022.09.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/11/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Ageism towards older adults with cancer may impact treatment decisions, healthcare interactions, and shape health/psychosocial outcomes. The purpose of this review is twofold: (1) To synthesize the literature on ageism towards older adults with cancer in oncology and (2) To identify interventions that address ageism in the healthcare context applicable to oncology. MATERIALS AND METHODS We conducted a scoping review following Arksey and O'Malley and Levac methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted an exhaustive multi-database search, screening 30,926 titles/abstracts. Following data abstraction, we conducted tabular, narrative, and textual synthesis. RESULTS We extracted data on 133 papers. Most (n = 44) were expert opinions, reviews, and letters to editors highlighting the negative impacts of ageism, expressing the need for approaches addressing heterogeneity of older adults, and calling for increased clinical trial inclusion for older adults. Qualitative studies (n = 3) described healthcare professionals' perceived influence of age on treatment recommendations, whereas quantitative studies (n = 32) were inconclusive as to whether age-related bias impacted treatment recommendations/outcomes or survival. Intervention studies (n = 54) targeted ageism in pre/post-licensure healthcare professionals and reported participants' improvement in knowledge and/or attitudes towards older adults. No interventions were found that had been implemented in oncology. DISCUSSION Concerns relating to ageism in cancer care are consistently described in the literature. Interventions exist to address ageism; however, none have been developed or tested in oncology settings. Addressing ageism in oncology will require integration of geriatric knowledge/interventions to address conscious and unconscious ageist attitudes impacting care and outcomes. Interventions hold promise if tailored for cancer care settings. 249/250.
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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: 1.6] [Reference Citation Analysis] [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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Colomer‐Lahiguera S, Steimer M, Ellis U, Eicher M, Tompson M, Corbière T, Haase KR. Patient and public involvement in cancer research: A scoping review. Cancer Med 2023; 12:15530-15543. [PMID: 37329180 PMCID: PMC10417078 DOI: 10.1002/cam4.6200] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) in research emphasizes the importance of doing research with, rather than for people with lived health/illness experience(s). The purpose of this scoping review is to investigate the breadth and depth of scientific literature on PPI in cancer research and to identify how is PPI applied and reported in cancer research. METHODS We searched MEDLINE, Embase, CINAHL, and PsycInfo up to March 2022. All titles/abstracts and full-text results were screened by two reviewers. Data were analyzed and are presented in both narrative and tabular format. RESULTS We screened 22,009 titles/abstract, reviewed 375 full-text articles, of which 101 studies were included in this review. 66 papers applied PPI; 35 used co-design methodologies. PPI in cancer research in published research has increased steadily since 2015 and often includes those with a past diagnosis of cancer or relatives/informal caregivers. The most common applied methods were workshops or interviews. PPI was generally used at the level of consultation/advisor and occurred mainly in early stages of research. Costs related to PPI were mentioned in 25 papers and four papers described training provided for PPI. CONCLUSIONS Results of our review demonstrate the nature and extent of PPI expansion in cancer research. Researchers and research organizations entering the fray of PPI should consider planning and reporting elements such as the stage, level, and role type of PPI, as well as methods and strategies put in place to assure diversity. Furthermore, a thorough evaluation of whether all these elements meet the stated PPI purpose will help to grasp its impact on research outcomes. PATIENT OR PUBLIC CONTRIBUTION Two patients participated in the stakeholder consultation as part of the scoping review methodology, contributed to the discussion on refining the results, and critically reviewed the manuscript. Both are co-authors of this manuscript.
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Sattar S, Haase KR, Bradley C, Papadopoulos E, Kuster S, Santa Mina D, Tippe M, Kaur A, Campbell D, Joshua AM, Rediger C, Souied O, Alibhai S. Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review. Prostate Cancer Prostatic Dis 2021; 24:1007-1027. [PMID: 34108646 DOI: 10.1038/s41391-021-00399-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Prostate cancer (PC) and its treatments lead to significant acute, chronic, or latent adverse effects that result in declines in patients' physical functions, quality of life and reduced sense of masculinities. Robust evidence shows that physical activity (PA) can improve many health outcomes in men with PC; however, less is known about the facilitators, preferences, and barriers to PA engagement in this population. The purpose of this scoping review is to document the nature and extent of literature related to these aspects of PA participation among men with PC. METHODS We conducted a scoping review of PA among men with PC. Databases searched included Medline, CINAHL, Embase, Rehabilitation & Sports Medicine Source, and SportDiscus from inception to June 30, 2020. Multiple reviewers were used in all screening and data abstractions. RESULTS The search yielded 2788 individual citations after duplicates were removed. Following title and abstract screening, 129 underwent full-text review, and 46 articles were included. Quantitative data related to our research question showed that structured group exercise was the most commonly reported facilitator/preference among men with PC, whereas treatment-related effects and lack of time are the most common barriers. In terms of qualitative data, the most prominent theme noted related to masculinities and gender-specific needs within the context of having PC. CONCLUSION Men with PC have unique facilitators and barriers concerning PA. More work is needed from the research and clinical practice perspectives to enable this population to engage and remain in regular PA.
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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: 2.1] [Reference Citation Analysis] [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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Research Support, Non-U.S. Gov't |
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Hall S, Sattar S, Ahmed S, Haase KR. Exploring Perceptions of Technology Use to Support Self-Management Among Older Adults with Cancer and Multimorbidities. Semin Oncol Nurs 2021; 37:151228. [PMID: 34753638 DOI: 10.1016/j.soncn.2021.151228] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Our objective was to explore and describe how older adults engage with technology to support cancer self-management behaviors, particularly as they live with multimorbidity. DATA SOURCES We used a qualitative descriptive approach and semi-structured interviews with older adults with cancer who had at least one other chronic condition. Two authors analyzed the data using a descriptive thematic analysis approach using NVivo 12 software. CONCLUSION We found that older adults are interested in, if not already, engaging with technology and internet searching to manage their cancer diagnosis and treatment. Data were grouped into three themes: (1) Using technology to take control; (2) Confidence in technology supports competence in self-management; and (3) Desired features for future interventions. Participants felt they might need extra support learning how to craft a search, filter facts, and digest information from the internet to manage their cancer. Those who reported using technology to keep records about their health made more statements reflecting confidence in their technology usage. IMPLICATION FOR NURSING PRACTICE Older adults are interested in engaging technology to support self-management. The specific implications that arise from this study are that (1) older adults' interest in engaging with technology has a unique potential to support foundations for self-management behaviors and activities and (2) empowering self-management behaviors and attitudes through technology may result in better treatment outcomes, as evidenced by increased capabilities in the six core self-management skills.
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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: 2.0] [Reference Citation Analysis] [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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Loiselle CG, Peters O, Haase KR, Girouard L, Körner A, Wiljer D, Fitch M. Virtual navigation in colorectal cancer and melanoma: an exploration of patients’ views. Support Care Cancer 2013; 21:2289-96. [DOI: 10.1007/s00520-013-1771-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 02/19/2013] [Indexed: 11/28/2022]
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Haase KR, Sattar S, Hall S, McLean B, Wills A, Gray M, Kenis C, Donison V, Howell D, Puts M. Systematic review of self-management interventions for older adults with cancer. Psychooncology 2021; 30:989-1008. [PMID: 33724608 DOI: 10.1002/pon.5649] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 12/26/2022]
Abstract
AIM The purpose of this systematic review was to determine the effectiveness of self-management interventions for older adults with cancer and to determine the effective components of said interventions. METHODS We conducted a systematic review of self-management interventions for older adults (65+) with cancer guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We conducted an exhaustive search of the following databases: Ageline, AMED, ASSIA, CINAHL, Cochrane, Embase, Medline, PsychINFO, and Sociological Abstracts. We assessed for quality using the Cochrane Risk of Bias tool and Down & Black for quasi-experimental studies, with data synthesized in a narrative and tabular format. RESULTS Sixteen thousand nine hundred and eight-five titles and abstracts were screened, subsequently 452 full-text papers were reviewed by two independent reviewers, of which 13 full-text papers were included in the final review. All self-management interventions included in this review measured Quality of Life; other outcomes included mood, self-care activity, supportive care needs, self-advocacy, pain intensity, and analgesic intake; only one intervention measured frailty. Effective interventions were delivered by a multidisciplinary teams (n = 4), nurses (n = 3), and mental health professionals (n = 1). Self-management core skills most commonly targeted included: problem solving; behavioural self-monitoring and tailoring; and settings goals and action planning. CONCLUSIONS Global calls to action argue for increased emphasize on self-management but presently, few interventions exist that explicitly target the self-management needs of older adults with cancer. Future work should focus on explicit pathways to support older adults and their caregivers to prepare for and engage in cancer self-management processes and behaviours.
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Haase KR, Sattar S, Holtslander L, Thomas R. The role of Internet cancer information for older adults with cancer: Perspectives of older adults and healthcare professionals. Int J Older People Nurs 2020; 15:e12303. [PMID: 31922334 DOI: 10.1111/opn.12303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 11/29/2019] [Accepted: 12/03/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Older adults with cancer have unique information and supportive care needs. There is a growing body of literature regarding the use of Internet health information, but less is known about the use of the Internet for cancer information amongst older adults with cancer. MATERIALS AND METHODS This is a secondary analysis of qualitative data from a mixed-methods study of the use of cancer-related Internet information amongst adults with cancer. In the present study, we include transcripts from two samples: 34 interviews with adults over age 55 (n = 17) with cancer, and interviews and focus groups with healthcare professionals (n = 21). Data were analysed using thematic analysis with an interest in age-related themes. RESULTS Our findings are grouped into three main themes: (a) independently augmenting healthcare services and supports; (b) supporting and situating information; and (c) mobilising family and support networks. Patients and healthcare providers described cancer-related Internet information as a beneficial resource to address gaps in information and supplement information from healthcare professionals from diagnosis and throughout treatment. Older adults reported using cancer-related Internet information to manage their cancer experience, although sometimes feeling technologically hesitant. However, healthcare professionals felt older adults were less likely than younger patients to seek cancer information from the Internet. CONCLUSION The use of cancer-related Internet information is growing amongst older adults with cancer. Older adults mobilise technology uniquely. Healthcare professionals can support these efforts by being aware and through initiating dialogue about information preferences.
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