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Primary care providers (PCPs) have been given the responsibility of managing the follow-up care of low-risk cancer survivors after they are discharged from the oncology center. Survivorship Care Plans (SCPs) were developed to facilitate this transition, but research indicates inconsistencies in how they are implemented. A detailed examination of enablers and barriers that influence their use by PCPs is needed to understand how to improve SCPs and ultimately facilitate cancer survivors’ transition to primary care. An interview guide was developed based on the second version of the Theoretical Domains Framework (TDF-2). PCPs participated in semi-structured interviews. Qualitative content analysis was used to develop a codebook to code text into each of the 14 TDF-2 domains. Thematic analysis was also used to generate themes and subthemes. Thirteen PCPs completed the interview and identified the following barriers to SCP use: unfamiliarity with the side effects of cancer treatment (Knowledge), lack of clarity on the roles of different healthcare professionals (Social Professional Role and Identity), follow-up tasks being outside of scope of practice (Social Professional Role and Identity), increased workload, lack of options for psychosocial support for survivors, managing different electronic medical records systems, logistical issues with liaising with oncology (Environmental Context and Resources), and patient factors (Social Influences). PCPs value the information provided in SCPs and found the follow-up guidance provided to be most helpful. However, SCP use could be improved through streamlining methods of communication and collaboration between oncology centres and community-based primary care settings.

ObjectiveTo co-create expert guidelines for the management of pregnancy, birth, and postpartum recovery in the context of hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD).DesignScoping Review and Expert Co-creation.SettingUnited Kingdom, United States of America, Canada, France, Sweden, Luxembourg, Germany, Italy, and the Netherlands.SampleCo-creators (n = 15) included expertise from patients and clinicians from the International Consortium on the Ehlers-Danlos syndromes and Hypermobility Spectrum Disorders, facilitated by the Ehlers-Danlos Society.MethodsA scoping review using Embase, Medline, the Cochrane Central Register of Controlled Trials and CINHAL was conducted from May 2022 to September 2023. Articles were included if they reported primary research findings in relation to childbearing with hEDS/HSD, including case reports. No language limitations were placed on our search, and our team had the ability to translate and screen articles retrieved in English, French, Spanish, Italian, Russian, Swedish, Norwegian, Dutch, Danish, German, and Portuguese. The Mixed Methods Appraisal Tool was used to assess bias and quality appraise articles selected. The co-creation of guidelines was based on descriptive evidence synthesis along with practical and clinical experience supported by patient and public involvement activities.ResultsPrimary research studies (n = 14) and case studies (n = 21) including a total of 1,260,317 participants informed the co-creation of guidelines in four overarching categories: 1) Preconceptual: conception and screening, 2) Antenatal: risk assessment, management of miscarriage and termination of pregnancy, gastrointestinal issues and mobility, 3) Intrapartum: risk assessment, birth choices (mode of birth and intended place of birth), mobility in labor and anesthesia, and 4) Postpartum: wound healing, pelvic health, care of the newborn and infant feeding. Guidelines were also included in relation to pain management, mental health, nutrition and the common co-morbidities of postural orthostatic tachycardia syndrome, other forms of dysautonomia, and mast cell diseases.ConclusionsThere is limited high quality evidence available. Individualized strategies are proposed for the management of childbearing people with hEDS/HSD throughout pregnancy, birth, and the postpartum period. A multidisciplinary approach is advised to address frequently seen issues in this population such as tissue fragility, joint hypermobility, and pain, as well as common comorbidities, including dysautonomia and mast cell diseases.

The Wellness Beyond Cancer Program provides survivorship care plans (SCPs) to cancer survivors, as they transition from cancer centres back to their primary care provider (PCP) upon treatment completion. A program evaluation examined whether standardized SCPs resulted in comparable outcomes on perceived knowledge and patient activation as personalized SCPs. Breast cancer survivors who received either standardized or personalized SCPs completed pre- and post-surveys during their discharge appointment, which included an in-house measure on perceived knowledge, The Perceived Efficacy in Patient-Physician Interactions, and The Patient Activation Measure. Eighty-seven breast cancer survivors completed the surveys (personalized SCP n = 43; standardized SCP n = 44). Standardized SCPs resulted in comparable knowledge and activation outcomes as personalized SCPs. Cost-efficient standardized SCPs may help alleviate human resource constraints and may be considered for further evaluation and implementation in cancer centres.

Le Programme de bien-être au-delà du cancer fournit des plans de soins de suivi (PSS) aux survivants qui passent du centre de cancérologie à leur médecin traitant une fois leurs traitements terminés. L’évaluation de ce programme a permis de vérifier si les PSS normalisés stimulent autant les connaissances et l’activation des patients que les PSS personnalisés. Les survivantes d’un cancer du sein qui ont reçu un PSS (normalisé ou personnalisé) ont répondu à un premier sondage avant le « rendez-vous de transition » puis à un autre à la fin de la rencontre. On leur demandait alors d’autoévaluer leurs connaissances et de répondre aux questions sur l’Efficacité perçue de la relation médecin-patient (PEPPI) et la Mesure d’activation du patient (MAP). Au total, quatre-vingt-sept survivantes du cancer du sein ont répondu aux sondages (PSS personnalisé, n = 43; PSS normalisé, n = 44). Dans les deux cas, les résultats sur les connaissances et l’activation des patientes étaient comparables. Les PSS normalisés, plus rentables, pourraient donc contribuer à alléger les contraintes relatives aux ressources humaines et faire l’objet d’évaluations plus poussées en vue d’être intégrés dans les centres de cancérologie.

Offert dans un hôpital de soins tertiaires en Ontario, au Canada, le Programme de bien-être au-delà du cancer procure aux survivants du cancer l’information et les ressources nécessaires pour l’autogestion de leurs soins de suivi (ex. acquérir les notions et compétences pertinentes pour s’adapter à une maladie chronique) après un traitement actif contre le cancer (chimiothérapie, radiothérapie, etc.). Une évaluation a été menée sur la séance de deux heures (composante de l’ensemble du Programme de bien-être au-delà du cancer) destinée aux survivants afin de déterminer si le fait d’y participer avait augmenté les connaissances et suscité l’adhésion au principe d’autogestion des soins de suivi. Les survivantes du cancer du sein (n = 107) et les survivants du cancer colorectal (n = 38) qui étaient présents ont répondu avant et après la séance à des questionnaires portant sur les besoins informationnels et l’intention d’assurer son propre suivi de santé. L’augmentation perçue des connaissances et l’intention d’autogérer ses soins de suivi ne dépendait ni de l’âge, ni du sexe, ni du temps écoulé depuis le diagnostic. Après la séance, les survivants ont dit en connaître davantage (F(1,11) = 144,6, p (1,103) = 57,3, p 2 = .64; F(4,86) = 38,5, p β = .14, t = 2,2, p Version corrigée publiée en avril 2021

The Wellness Beyond Cancer Program is part of a tertiary care hospital in Ontario, Canada. It provides cancer survivors with information and resources needed to self-manage their follow-up care (i.e., learn relevant information and skills to adapt to life with a chronic illness) after active cancer treatment (i.e., chemotherapy, radiation). A program evaluation was conducted on the two-hour survivorship education class (one component of the overall Wellness Beyond Cancer Program) with the purpose of evaluating whether attendance increased survivors’ perceived knowledge and intent to self-manage follow-up care. Breast (n = 107) and colorectal (n = 38) cancer survivors who attended classes completed questionnaires on information needs and intent to self-manage pre- and postclass. Perceived increase in knowledge and intent to self-manage follow-up care were unrelated to age, gender, or time since diagnosis. After attending the class, survivors reported increased knowledge (F(1,11) = 144.6, p (1,103) = 57.3, p 2 = .64; F(4,86) = 38.5, p β = .14, t = 2.2, p Corrected version published April 2021

Many residents evaluate their landscape professionals on price alone; however, quality landscaping is an investment in your property. Knowing what to look for in a landscape professional will help you get the most for your investment, ensure your yard reaches its greatest potential and protect Florida’s water and other natural resources. This new 7-page document, published by the UF/IFAS Environmental Horticulture Department, is intended to provide guidance to residents and entities such as HOA community associations when hiring a landscape professional. https://edis.ifas.ufl.edu/ep614

Purpose: This paper describes women’s opinions of the attributes of the ideal body image program to inform the design, development, and implementation of future programs for those diagnosed with breast cancer.Methods: Deductive-inductive content analysis of semi-structured interviews with 26 women diagnosed with breast cancer (mean age = 55.96 years; mean time since diagnosis = 2.79 years) was performed.Findings: Participants’ opinions regarding the ideal body image program are summarized into five themes, mapping the where (community-based, hospital-based, or online), when (across the cancer continuum or at specific points), how (peer-led programs, professional help, events, presentations/workshops, resources, support groups), what (self-care, counseling and education for one self, education for others, support for addressing sexuality/sexual health concerns, and concealing treatment-related changes), and who (team approach or delivered by women, health professionals, make-up artists).Conclusion: This study provides useful data on what women believe are the attributes of the ideal body image program, which can contribute to efforts aimed at developing and delivering body image programs for women diagnosed with breast cancer that prioritize their needs and preferences.