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Abstract Purpose The patient–provider relationship has been understudied in adolescents with cancer. The current study describes an exploratory factor analysis of a patient–provider relationship self-report measure developed for use in adolescent oncology. Methods A self-report measure was included in an iPad/tablet survey delivered to 102 adolescent cancer patients (diagnosed between the ages of 10 and 20). Principal factor analysis with promax rotation and a three-factor structure was specified. Results The final solution identified three underlying dimensions of the patient–provider relationship—Supporting Independence (69.7% variance explained; Cronbach's α =.89), Family-Centered Com munication (50.0% variance explained; Cronbach's α =.73), and Respectful Relationships (40.1% variance; Cronbach's α =.66). Discussion The current measure highlights the unique developmental place of adolescent cancer patients in their preference for aspects of both patient-centered and family-centered care. The current analysis begins to fill the need for adolescent-tailored measurement to assess the patient–provider relationship in this population. [ABSTRACT FROM AUTHOR]

Children with serious, complex medical or life-threatening conditions and their families often fail to receive effective, consistent, timely, and competent care that meets their physical, emotional, and spiritual needs. Enhancing both basic education and advanced skills in pediatric palliative and end-of-life care education is recommended so that health care providers will enter practice with some form of formal preparation. In this quantitative descriptive study, we used the End-of-Life Professional Caregiver Survey to assess unmet palliative and end-of-life educational needs of pediatric health care providers in the state of Connecticut. Participants who received palliative care education in the past 5 years had higher mean scores on all 3 factors of the End-of-Life Professional Caregiver Survey, which may reflect the evolvement and depth of current pediatric palliative care education. Future palliative educational programs for pediatric providers in Connecticut should include sharing pediatric palliative care principles and national guidelines, describing services provided by pediatric hospice and timing of referral, developing systems to ensure continuity of care crossing all settings, addressing request for assisted suicide, meeting needs of staff and providers caring for the dying child (self-care), and describing cultural and ethical values specific to diverse populations in Connecticut. [ABSTRACT FROM AUTHOR]

Purpose Describe the development and evolution of a primary-care-based, multidisciplinary clinic to support the ongoing care of adult survivors of childhood cancer. Methods A consultative clinic for adult survivors of childhood cancer has been developed that is located in an adult, academic internal medicine setting and is based on a long-term follow-up clinic model available at Children's Hospital Colorado. Results The clinic opened in July 2008. One hundred thirty-five patients have been seen as of April 2014. Referrals and clinic capacity have gradually increased over time, and a template has been developed in the electronic medical record to help facilitate completion of individualized care plan letters. Conclusions A primary care-based, multidisciplinary consultative clinic for adults with a history of childhood cancer survivor is feasible and actively engages adult primary care resources to provide risk-based care for long-term pediatric cancer survivors. This model of care planning can help support adult survivors of pediatric cancer and their primary care providers in non-academic, community settings as well. [ABSTRACT FROM AUTHOR]

Only 12% of the world's published plastic research includes references to Africa despite it being a significant contributor to the global plastic waste and mismanagement problem (~88.5% of Africa's plastic waste is mismanaged). Ocean plastics are transported from land by rivers to the sea. However, source contextualization is complex. Many African rivers predominantly run alongside human settlements that host informal waste dumpsites. In this study a simple cost effective, easily deployed, consistent and replicable survey methodology was employed. The study quantified macroplastic in three rivers discharging into Algoa Bay, South Africa. The results indicated that industrial Swartkops and metropolitan Baakens Rivers both illustrate moderate plastic pollution (>3000 plastic particles/day), with the relatively natural Sundays River to showing minimal evidence of river macro plastic (<100 plastic particles/day). The types of plastic were noted using the RIMMEL app (premier African implementation), enabling proportional comparison of different plastic litter types to be completed. • Many rivers in significant plastic pollution contributing countries are unsurveyed • RIMMEL provides a simple, consistent method to quantify river macroplastic • Provision of the first plastic counts for 3 Port Elizabeth rivers, South Africa [ABSTRACT FROM AUTHOR]