Health professionals have been identified as a high risk group for job-related stress and burnout. This study builds on the existing literature to examine the links between burnout and the development of professional values as well as the broad scope of occupational therapy, which may act as a hindrance to establishing a concise and well recognized professional identity. One hundred and twenty six occupational therapists completed the Maslach Burnout Inventory and the Professional Identity Questionnaire. The factors that contribute to the relationship between a lack of professional identity in the field of occupational therapy and the levels of burnout among occupational therapists are identified and implications for establishing a strong and healthy workforce in occupational therapy are discussed.
The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.
Background: EBRT in resected, nonmetastatic anaplastic thyroid cancer (ATC) remains undefined. We evaluated patterns/outcomes with EBRT and chemotherapy in this setting. Methods: This retrospective analysis included patients identified from the National Cancer Database with nonmetastatic ATC from 2004 to 2014 who underwent non-palliative resection.Results: Our analysis included 496 patients, including 375 who underwent adjuvant EBRT (among whom 198 received concurrent chemotherapy). The median age was 68 years. On MVA, EBRT was associated with sex (OR 0.5, 95% CI 0.3-0.8, P = .002) and income (OR 2.2, 95% CI 1.4-3.3, P < .001). EBRT was associated with longer OS on UVA (12.3 vs 9.1 months, P = .004) and MVA (HR 0.7 [CI 0.6-0.9], P = .004). Concurrent chemoradiation was associated with longer OS on UVA (14.0 vs 9.1 months, P = .003) and MVA (HR 0.6 [CI 0.5-0.8], P < .001).Conclusion: Adjuvant EBRT is associated with longer OS in resected, nonmetastatic ATC, with additional improved survival with concurrent chemotherapy.adjuvant chemotherapy, anaplastic thyroid carcinoma, combined modality therapy, head and neck cancer, radiation therapy
Objectives/Hypothesis
Follow‐up care in head and neck cancers (HNC) is critical in managing patient health. However, social determinants of health (SDOH) can create difficulties in maintaining follow‐up care. The study goal is to explore how SDOH impacts maintenance of HNC follow‐up care appointments.
Methods
A systematic retrospective chart review of 877 HNC patients diagnosed in the past 10 years a safety‐net tertiary care hospital with systems to help reduce care disparities. Cohort groups were identified and compared against protocols for follow‐up. Data were analyzed using analysis of variance, chi‐square tests, Fisher's exact tests, two‐sample t‐tests, and simple linear regression.
Results
The average length of follow‐up time in months and average total number of follow‐ups over 5 years were 32.96 (34.60) and 9.24 (7.87), respectively. There was no significant difference in follow‐up care between United States (US) versus non‐US born and English versus non‐English speaking patients. Race/ethnicity, county median household income, insurance status, and county educational attainment were not associated with differences in follow‐up. However, living a greater distance from the hospital was associated with lower follow‐up length and less frequency in follow‐up (P < .0001).
Conclusion
While income, primary language, country of birth, race/ethnicity, insurance status, and markers of educational attainment do not appear to impact HNC follow‐up at our safety‐net, tertiary care institution, and distance from hospital remains an important contributor to disparities in care. This study shows that many barriers to care can be addressed in a model that addresses SDOH, but there are barriers that still require additional systems and resources. Laryngoscope, 132:1022–1028, 2022
In this article Heather Edwards relates how Music Mirrors, simple digital resources, can be used to help and stimulate those with dementia, whether by encouraging engagement or by sparking personal memories
Objective: Head and neck squamous cell carcinoma (HNSCC) describes a set of malignancies of the head and neck that continue to inflict considerable morbidity and mortality. Because HNSCC often presents at an advanced stage, patients frequently undergo intensive multi-modal therapy with an intent to cure. Vitamin D is a precursor to the biologically active hormone calcitriol which governs bone and calcium physiology that is obtained from diet and UV-B exposure. Vitamin D is known to have pleiotropic effects on health and disease. In this review, we examine the role of vitamin D in cancer with emphasis on HNSCC and discuss potential avenues for further research that might better elucidate the role of vitamin D in the management of HNSCC. Review methods: A review of MEDLINE database indexed literature concerning the role and biology of vitamin D in HNSCC was conducted, with special consideration of recently published work and research involving immunobiology and HNSCC. Conclusions: The available evidence suggests that vitamin D may play a role in protecting against HNSCC, particularly in persons who smoke, although conflicting and limited data exists. Promising initial work encourages the pursuit of further study. Implications for practice: The significant morbidity and mortality that HNSCC brings warrants continued research in available and safe interventions that improve patient outcomes. With the rise of immunotherapy as an effective modality for treatment, continued research of vitamin D as an adjunct in the treatment of HNSCC is supported.
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