https://www.commed.vcu.edu/Chronic_Disease/2012/cochranrvwrschbias.pdf

The Cochrane Collaboration's tool for assessing risk of bias in randomised trials

Writing and Identity. The Discoursal Construction of Identity in Academic Writing: Roz Ivanic. Amsterdam: Benjamins, 1998. ISBN: 90 272 1798 X (Eur) /1-556 19-323-8 (US)

Objective Cancer treatment is a particularly stressful period for the patient. The reasons vary and include fear of treatment outcome as well as treatment induced side effects. The patient frequently experiences simultaneously various side effects resulting in a diminishing of the patient’s health-related quality of life (HRQoL). The study provides evidence on the co-occurrence and inter-relations between pain, anxiety, depression and fatigue in patients with breast and prostate cancer. Design This paper presents a secondary analysis of the data from a randomised control trial designed to test the effectiveness of guided imagery and progressive muscle relaxation on pain, fatigue, anxiety and depression. Non-parametric bootstrapping analyses were used to test the mediational model of anxiety, fatigue and depression as parallel mediators of the relationship between pain and HRQoL. Setting The study was undertaken at the home setting. Participants In total 208 patients were included in the study (assigned equally in two groups), referred at the outpatient clinics of the three participating cancer care centres. Results The three mediators fully mediate the relationship between pain and HRQoL indirect effect (IE overall =−0.3839, 95% CI: lower limit (LL)=−0.5073 to upper limit (UL)=−0.2825) indicating that patients with increased pain are likely to have higher levels of anxiety, fatigue and depression. Gender significantly moderated the mediational effect of Fatigue Index of Moderated Mediation (IMM=−0.2867 SE=0.1526, LL=−0.6127, UL=−0.0226) but did not moderate mediational effect of anxiety (IMM=−0.0709, SE=0.1414, LL=−0.3459, UL=+0.2089). The results show that the three mediators in a serial causal order fully mediate the relationship between pain and HRQoL (IE overall =−0.384, 95% CI: LL=−0.51 to UL=−0.284) and the ratio of the overall indirect effect to the total effect is 0.8315 (95% CI: LL=0.5683 to UL=1.1718). Conclusion This work provides evidence that targeting fatigue, anxiety and depression may have a meaningful effect on pain as a related symptom and potentially have a positive impact on HRQoL of patients with breast and prostate cancer Trial registration number NCT01275872; Post-results.

https://bmjopen.bmj.com/content/bmjopen/9/1/e026809.full.pdf

Parallel and serial mediation analysis between pain, anxiety, depression, fatigue and nausea, vomiting and retching within a randomised controlled trial in patients with breast and prostate cancer

Background Pain is a common issue for patients with cancer and can be challenging to manage effectively Healthcare professionals need to be knowledgeable about evidence-based nonpharmacologic interventions  Objectives This systematic review critically appraises the strength and quality of the empirical evidence for nonpharmacologic interventions in reducing chronic cancer pain  Methods Intervention studies were critically appraised and summarized by an Oncology Nursing Society Putting Evidence Into Practice team of RNs, advanced practice nurses, and nurse scientists A level of evidence and a practice recommendation was assigned to each intervention  Findings Based on evidence, recommended interventions to reduce chronic cancer pain are celiac plexus block for pain related to pancreatic and abdominal cancers and radiation therapy for bone pain Although psychoeducational interventions are considered likely to be effective, the effective components of these interventions and their dose and duration need to be determined through additional research

Nonpharmacologic Pain Interventions: A Review of Evidence-Based Practices for Reducing Chronic Cancer Pain

Health inequalities, worse health associated with social and economic disadvantage, are reported by a minority of research articles. Locating these studies when conducting an equity-focused systematic review is challenging due to a deficit in standardised terminology, indexing, and lack of validated search filters. Current reporting guidelines recommend not applying filters, meaning that increased resources are needed at the screening stage. We aimed to design and test search filters to locate studies that reported outcomes by a social determinant of health. We developed and expanded a ‘specific terms strategy’ using keywords and subject headings compiled from recent systematic reviews that applied an equity filter. A ‘non-specific strategy’ was compiled from phrases used to describe equity analyses that were reported in titles and abstracts, and related subject headings. Gold standard evaluation and validation sets were compiled. The filters were developed in MEDLINE, adapted for Embase and tested in both. We set a target of 0.90 sensitivity (95% CI; 0.84, 0.94) in retrieving 150 gold standard validation papers. We noted the reduction in the number needed to screen in a proposed equity-focused systematic review and the proportion of equity-focused reviews we assessed in the project that applied an equity filter to their search strategy. The specific terms strategy filtered out 93-95% of all records, and retrieved a validation set of articles with a sensitivity of 0.84 in MEDLINE (0.77, 0.89), and 0.87 (0.81, 0.92) in Embase. When combined (Boolean ‘OR’) with the non-specific strategy sensitivity was 0.92 (0.86, 0.96) in MEDLINE (Embase 0.94; 0.89, 0.97). The number needed to screen was reduced by 77% by applying the specific terms strategy, and by 59.7% (MEDLINE) and 63.5% (Embase) by applying the combined strategy. Eighty-one per cent of systematic reviews filtered studies by equity. A combined approach of using specific and non-specific terms is recommended if systematic reviewers wish to filter studies for reporting outcomes by social determinants. Future research should concentrate on the indexing standardisation for equity studies and further development and testing of both specific and non-specific terms for accurate study retrieval.

/pdf/development-and-validation-of-a-search-filter-to-identify-56x07bolla.pdf

Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen

Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances. A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender. Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled. The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts. Results show the need to examine supportive care interventions particularly in populations with social disparities.

https://www.mascc.org/assets/Pain_Center/2015_November/nov2015-2.pdf

Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis.

Difficulties with academic writing tasks, such as the literature review, impact students’ timely completion of graduate degrees. A better understanding of graduate students’ perceptions of writing the literature review could enable supervisors, administrators, service providers, and graduate students themselves to overcome these difficulties. This paper presents a case study of graduate students at a secondary campus of a Canadian research university. It describes survey data and results from focus groups conducted between 2014 and 2015 by communications faculty, writing centre staff, and librarians. The focus group participants were Master’s and Doctoral students, including students situated within one discipline and those in interdisciplinary programs. The questions focused on the students’ experiences of writing the literature review as well as the supports both accessed and desired. Data analysis revealed four themes: (a) literature review as a new and fundamental genre; (b) literature review for multiple purposes, in multiple forms, and during multiple stages of a graduate program; (c) difficulties with managing large amounts of information; and (d) various approaches and tools are used for research and writing. Using an academic literacies approach, the paper addresses implications for campus program development and writing centre interventions and furthers research into graduate students’ experiences of writing literature reviews.

/pdf/writing-the-literature-review-graduate-student-experiences-29ys8vii45.pdf

Writing the Literature Review: Graduate Student Experiences.

This exploratory study researches the experiences of Canadian graduate students as they pursue writing tasks for their degree. It also explores the supports currently utilized by such students and the need for additional supports. The research uses a case study design based on qualitative focus group interviews to provide detailed information regarding graduate students' perceived experiences with their academic writing tasks and available supports. The approach is informed by academic literacy theory. Graduate students who participated in this study identified a transition in voice, increased pressure to publish and professionalize, and misalignments between their own and supervisory and institutional expectations, which resulted in some interrogation of institutional norms. They utilized Writing Centre, online and supervisory supports, but called for additional ongoing and peer support. The study has implications for the development of new, collaborative and peer-based writing supports, as well as identifying future research areas related to interdisciplinary degrees.

/pdf/graduate-transitions-canadian-master-s-and-phd-writing-5bstfl2afq.pdf

Lori Walter

Papers

Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis.

Writing the Literature Review: Graduate Student Experiences.

Graduate transitions: Canadian master's and PhD writing experiences