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joi, 15 decembrie 2011

Shift Workers And Older People Experience Social Exclusion

Main Category: Psychology / Psychiatry
Also Included In: Seniors / Aging;  Public Health
Article Date: 15 Dec 2011 - 0:00 PST

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Older people and those who work non-standard hours are less likely to feel integrated into society, according to a study funded by the Economic and Social Research Council (ESRC).

"Feeling part of society usually involves participating in certain activities such as sports, the arts, volunteering or social networking," says Dr Matt Barnes who led the research. "Our research shows that older people and those who work unusual hours face particular barriers to participating in such activities."

The study points out that the Government promotes work as the best route to personal well-being, with worklessness going hand in hand with low income and social exclusion. Yet, Dr Barnes' research shows that working uncommon hours can also have implications for people's opportunities to engage and feel integrated in society.

Two-thirds of workers work at unusual times. Although shops and other facilities are beginning to adapt, such workers still find their leisure time constrained by the limited availability of services, as well as other people with whom to spend their free time.

Compared with people who work a standard week (Monday to Friday, between 8am and 7pm), these workers spend less time on face-to-face social and relational activities, particularly if they work in the evening or at the weekend. On average, evening workers spend six hours 43 minutes on participatory activities per week and Sunday workers just over five hours, compared with over eight hours for those who work normal hours.

"By getting people to keep a diary and analysing the way they spend their time over a 24 hour period," says Dr Barnes, "we have been able to understand how they 'participate' and what might be done to create greater social inclusion."

The study also found that older people face barriers to participatory activities. Over one million older people experience poor social relations and social exclusion.

Spending time with friends is an important way of building social networks and support. They can be crucial for older people dealing with life-changing events such as retirement, bereavement or illness - each of which can pose an increased risk of social isolation. Spending time with people outside the household can also provide the elderly with a sense of independence.

The study found that older people who live alone spend a lot of time with friends and acquaintances, but on average, they can also spend eleven hours alone on a week day and ten and a half hours alone at weekends (excluding sleep).

Over a third of the time that older people spend with their friends is devoted to participatory activities - most often social networking such as visiting or receiving visitors, celebrating birthdays and catching up over the phone. Religious activity and doing acts of kindness involving friends are also important participatory activities.

The research also showed that women are more likely than men to spend time with friends on social networking activities. Their ability to participate, however, is limited by housework, caring for others and personal care.

"It is clear that social participation is important for an improved quality of life, both in older age and among those still working," says Dr Barnes. "Improving the accessibility of public transport and other facilities and services would go a long way towards increasing social inclusion in Britain."

These results suggest that local government and charities need to recognise that social participation is important to improve people's quality of life. "Local governments can encourage public leisure complexes and public transport services to operate wider hours or 24/7. Charities could be more aware of these groups when arranging social clubs targeting shift workers and elderly people", Dr Barnes concludes.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our psychology / psychiatry section for the latest news on this subject. The study 'Making time use explicit in an investigation of social exclusion in the UK' was carried out by Dr Matt Barnes, Lizzie Becker, John d'Souza and Andreas Cebulla of the National Centre for Social Research.
The project focused on peoples' participation in a wide range of social and civic activities to explore various aspects of exclusion. The project used the 2000 UK Time Use Survey (UKTUS) to explore the time that people spent on these activities. The UKTUS also collects a wide range of socio-demographic and economic information on individuals and their households via standard questionnaires. This information was used to identify different subgroups of the UK population.
Economic & Social Research Council Please use one of the following formats to cite this article in your essay, paper or report:

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15 Dec. 2011. APA

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marți, 13 decembrie 2011

Outpatients Experience The Most Cancer-Related Blood Clots

Main Category: Blood / Hematology
Also Included In: Vascular;  Cancer / Oncology
Article Date: 13 Dec 2011 - 3:00 PST

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In a study of nearly 18,000 cancer patients, University of Rochester Medical Center researchers found that when blood clots develop - a well-known and serious complication of cancer treatment - 78 percent of the time they occur when a person is out of the hospital, at home or elsewhere, while on chemotherapy.

This data is striking because, until now, outpatients had not been systematically studied and previous data gathered on the incidence of blood clots was mostly from hospitalized patients, who tend to be sicker. However, with a shift toward outpatient cancer treatment, future efforts to prevent blood clots should focus on helping patients to avoid complications so they can continue to live fully, by working, raising children, and exercising, during cancer care, said Alok Khorana, M.D., associate professor in the James P. Wilmot Cancer Center at URMC, and an international authority on venous thromboembolism or VTE.

"One in five patients develops blood clots after a cancer diagnosis and we believe that number is rising," Khorana said. "The Surgeon General recently issued a Call to Action to reduce VTE. At this point public health efforts have focused on inpatient prophylaxis. These new data suggest that to reduce the burden of VTE in cancer patients, prevention efforts will have to shift to the outpatient arena as well."

The cost of care for patient with blood clots was twice as high compared to patients who did not have that complication, Khorana also reported.

Khorana was invited to present his data at the 2011 ASH (American Society of Hematology) annual meeting in San Diego, attended by approximately 20,000 physicians and scientists. The scientific abstracts with the highest impact, including Khorana's, were selected for platform talks.

Khorana and his research team conducted a retrospective, observational study between 2005 and 2009 from healthcare claims databases, which they believe is the largest population study of this kind. The databases provided both inpatient and outpatient information. Of the 17, 784 cancer patients identified, 5.6 percent developed blood clots, the study said. Of those who suffered from the complication, 21 percent had recently been hospitalized but 78.3 percent were being treated on an outpatient basis. The medical term venous thromboembolism is a mass of red blood cells, clotting proteins and platelets that block the normal flow of blood. Clots form most often in the legs, lungs, or abdomen, and are life-threatening if not treated.

Cancer patients are more prone to blood clots for many reasons: the malignancy itself can secrete proteins associated with blood clots; several treatments (including surgery, chemotherapy, and hormonal therapy) raise the clot risk; decreased mobility due to active disease or hospitalization; a genetic predisposition; or having other health problems, such as infections, obesity, anemia, and lung disorders. And once a blood clot occurs, a cancer patient is much more likely to have other clots later.

"Ongoing public health issues that we must address are how to educate patients on the importance of blood clot prevention, and improving compliance to preventive treatment," he said. Patients should immediately report to their physicians any unusual symptoms such as swelling or redness in limbs, or shortness of breath, even if they are otherwise feeling well.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our blood / hematology section for the latest news on this subject. For years Khorana and colleagues at URMC have been at the forefront of studying cancer-related blood clots, which is the second leading cause of death in this population.
The Rochester group published a risk model in the journal, Blood, and based partly on that article the American Society of Clinical Oncology in 2007 issued its first set of guidelines for clinicians for the prevention of blood clots in cancer patients. Chief collaborators include Charles W. Francis, M.D., professor of Medicine in Hematology/Oncology at the James P. Wilmot Cancer Center, and Mark B. Taubman, M.D., a cardiologist, researcher, and dean of the UR School of Medicine and Dentistry.
Disclosure: Khorana is a consultant for and receives cancer-related research funding from several drug companies, including Roche/Genentech, Eisai Co., Johnson and Johnson, Bristol Myers-Squibb, Boehringer Ingelheim, Leo Pharma, Sanofi-Aventis, Bayer, and Daiichi-Sankyo. Sanofi-Aventis funded this study.
University of Rochester Medical Center Please use one of the following formats to cite this article in your essay, paper or report:

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University of Rochester Medical Center. "Outpatients Experience The Most Cancer-Related Blood Clots." Medical News Today. MediLexicon, Intl., 13 Dec. 2011. Web.
13 Dec. 2011. APA

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View the original article here