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Despite a growing literature on entrepreneurial intentions, there remain gaps in the understanding of how these are affected by the age of later working-life social entrepreneurs. This research examined the 'over-50s' social entrepreneur understandings of age as an antecedent of their social entrepreneurial intentions. In-depth interviews were conducted with 28 UK-based social entrepreneurs. Our findings demonstrate that social entrepreneurial intentions in later working-life are influenced by an interplay of necessity, fulfilment and experienced later life, age being perceived as a positive construct rather than as a barrier. Our research contributes to the social entrepreneurship and small business literature by enhancing and advancing current knowledge and theorisation of the social entrepreneurial intentions of the over-50s. We reveal first, how social entrepreneurs make sense of their older age and the influence of their social entrepreneurial intentions; and second, how these social entrepreneurial intentions are formed by the intertwining of necessity, fulfilment and experienced later life. [ABSTRACT FROM AUTHOR]

Simple Summary: The COVID-19 pandemic has resulted in unprecedented changes to the life of patients with cancer. In this study, we aim to evaluate the impact of the COVID-19 pandemic on the mental health and general well-being of patients with colorectal cancer by carrying out a prospective longitudinal questionnaire. We found that around one in four participants reported symptoms of anxiety and poor well-being, with 15% at risk of moderate to severe depression. Amongst others, those who were worried that the COVID-19 pandemic would have an effect on their mental health were most at risk of anxiety, depression, and poor well-being. Screening for the mental health impact of the COVID-19 pandemic on patients is essential to allow timely action from all key stakeholders in order to avoid potentially longer-term detrimental consequences. The COVID-19 pandemic has resulted in unprecedented changes to the lives of patients with cancer. To evaluate the impact of the COVID-19 pandemic on the mental health and well-being of patients with colorectal cancer, we conducted a prospective longitudinal questionnaire study at a UK tertiary cancer centre. In total, 216 participants were included: mean age 65 years, 57% (n = 122) male, 92% (n = 198) of white ethnicity. Amongst participants who completed the screening psychometric questionnaire, 24% (n = 48/203) reported anxiety (GAD-7 ≥ 5), 15% (n = 31/204) depressive symptoms (PHQ-9 ≥ 10), 3% (n = 5/190) probable post-traumatic stress disorder (PC-PTSD-5 ≥ 4), and 31% (n = 66/213) poor well-being (WHO-5 < 50). In the subgroup (n = 95/216, 44%) who consented to and completed a follow-up survey 6 months later, there was a significant increase in the number of participants at risk of depression (4% vs. 13%, p = 0.021). Self-reported concern about the COVID-19 pandemic impacting one's mental health is associated with increased likelihood of anxiety, depression, and poor well-being, in respective multivariate analyses. In conclusion, screening for the mental health impact of the COVID-19 pandemic is essential to ensure timely action from all key stakeholders and to avoid potentially longer-term detrimental consequences. [ABSTRACT FROM AUTHOR]

Background: Metastatic colorectal cancer is one of the commonest causes of cancer and cancer-related deaths.1 The prognosis remains poor and successive treatment options remain limited.2 Many patients will run out of treatment options before they become medically unfit for therapy.3 Cancer drug innovation presents both opportunities and dilemmas as access to innovative cancer medications can be limited by a significant delay between clinical trials, licensing, and positive drug guidance.4,5 Consequently, where no commissioned alternative medicine exists some pharmaceutical companies operate compassionate usage access schemes (Figure 1). These allow cancer treatment with investigational, unlicensed, or off-label medicines as soon as early evidence of potential benefit emerges.6 There is a paucity of information regarding compassionate schemes. This analysis was performed to ascertain real-world data on patients enrolled in these schemes. Methods: Single-centre study conducted at The Christie Hospital, Manchester, UK. We reviewed the process of pharmacy drug set-up and maintenance by undertaking a survey of disease group pharmacists. We undertook a retrospective audit using an electronic patient record of patients who entered into a compassionate scheme between 2018 and 2020. This analysis focused on 27 patients with a diagnosis of metastatic colorectal cancer receiving compassionate medication who possessed the BRAF mutation (mBRAF V600E) or MSI-H status. We analysed 17 mBRAF patients treated with a triplet combination (encorafenib, binimetinib and cetuximab), and subsequently, doublet (encorafenib and cetuximab), as defined by the BEACON study, and 10 MSI-high patients on compassionate nivolumab.7,8 Results: Our survey of compassionate medication across 14 disease groups demonstrated the approval process is lengthy and resource intensive. The average approval time was variable, but pharmacy set-up time could take several days depending on the drug or regimen. However, this is countered by our analysis of 27 meta-static colorectal cancer patients. Most patients were fit (> 88% PS ≤ 1, 50% had no known co-morbidities) and for 62% this represented third- line therapy, in a cancer setting with limited or no treatment options. Patients received 10 cycles of treatment on average before progression or unsuitability, with a mean duration on the treatment of 120 days (15–317) on the triplet/doublet combination and 205 days on nivolumab (range: 1–663), demonstrating benefit. Patient demand was uninhibited by geographical distance (> 30% of patients lived 20+ miles away from the treatment centre) and the possibility of hope and life extension with further treatment. Conclusion: Our audit demonstrates that patients received compassionate drugs that were subsequently commissioned by NHSE, with some benefiting from treatment for a considerable period. This suggests there was both a moral gain and a survival advantage over best supportive care; however, there remains limited real-world data and further research is required. Access to compassionate schemes is controversial and limited as they can be seen to promote healthcare inequity, creating a post-code lottery, as they may not be available in some regions, circumvent existing guidelines or benefit pharmaceutical companies by allowing early data and market access. Compassionate usage recognises a human side to drug development which requires a moral balance between patients. [ABSTRACT FROM AUTHOR]