Finding my tribe: a qualitative interview study of how people living with metastatic breast cancer perceive support groups.

PURPOSE: This study explored the value of metastatic breast cancer (MBC) support groups, and factors that affect attendance, from the perspective of people with MBC. METHODS: Semi-structured interviews were conducted with 28 women with MBC (support group attendees n = 16; non-attendees n = 12) between January 2022 and July 2023. Data were analysed using an inductive approach to thematic analysis. RESULTS: Three themes were generated: the value of sharing experiential knowledge, spaces for open and honest conversations, and opportunities to find connection and community. These factors were the main reasons that some participants valued, and chose to attend, an MBC support group. Stage-specificity and professional facilitation were identified as important aspects of group structure. Key reasons for non-attendance were concerns about misinformation, confronting the death of group members, and satisfaction with existing support networks. CONCLUSIONS: MBC support groups are beneficial for some people with MBC, providing opportunities to connect with others with the same diagnosis. For others, different forms of peer support such as online forums or one-on-one support may be preferred. We argue that ensuring those with MBC have equal access to the peer support they need will be essential in supporting people to live as well as possible with MBC. IMPLICATIONS FOR CANCER SURVIVORS: MBC support groups, if appropriately led, can provide emotional and informational benefits for people with MBC. This research may also have relevance to other metastatic cancers where novel therapies are extending survival, resulting in an emerging cancer population with distinct supportive and survivorship needs.

The Experiences of Australian School Mental Health Professionals during COVID-19 Lockdowns.

Young people have emerged as one of the most impacted groups from the COVID-19 pandemic and related restrictions to daily activities, with disruptions to schooling, social interactions, and connections. Simultaneously, students' access to school mental health professionals were restricted or modified. The aim of this paper was to identify how school mental health professionals supported and addressed the mental health needs of young people during COVID-19 restrictions in Australia. School mental health professionals were surveyed during the 2020 lockdowns using a questionnaire designed by researchers in the United States of America. The innovations school mental health staff adopted to support students during lockdowns and remote learning were presented, including telehealth services, digital resources, and the online training and support they received/provided. The barriers and facilitators to providing counselling and assessment services during lockdowns were identified, including issues with providing psychometric assessments during remote learning, and ethical concerns when delivering remote counselling to students. Recommendations have been included, which address how school mental health professionals could be supported to assess and treat young people during future pandemics and school restrictions.

Biomaterial Wettability Affects Fibrin Clot Structure and Fibrinolysis.

Thrombosis on blood-contacting medical devices can cause patient fatalities through device failure and unstable thrombi causing embolism. The effect of material wettability on fibrin network formation, structure, and stability is poorly understood. Under static conditions, fibrin fiber network volume and density increase in clots formed on hydrophilic compared to hydrophobic polystyrene surfaces. This correlates with reduced plasma clotting time and increased factor XIIa (FXIIa) activity. These structural differences are consistent up to 50 µm away from the material surface and are FXIIa dependent. Fibrin forms fibers immediately at the material interface on hydrophilic surfaces but are incompletely formed in the first 5 µm above hydrophobic surfaces. Additionally, fibrin clots on hydrophobic surfaces have increased susceptibility to fibrinolysis compared to clots formed on hydrophilic surfaces. Under low-flow conditions, clots are still denser on hydrophilic surfaces, but only 5 µm above the surface, showing the combined effect of the surface wettability and coagulation factor dilution with low flow. Overall, wettability affects fibrin fiber formation at material interfaces, which leads to differences in bulk fibrin clot density and susceptibility to fibrinolysis. These findings have implications for thrombus formed in stagnant or low-flow regions of medical devices and the design of nonthrombogenic materials.

Clinical Potential of Immobilized Liquid Interfaces: Perspectives on Biological Interactions.

Immobilized liquid (IL) surface coatings are an emerging technology that provide to materials the ability to repel complex biological fluids and hold promise in medical applications to prevent biological fouling, especially in the context of preventing medical device-induced thrombosis, fibrosis, and biofilm formation. However, little is known about the biological interactions of the IL with proteins and cells, and an increased understanding is critical for optimal device application, function, and successful clinical translation. Here, we review existing clinical and biological knowledge of the liquids used in these surface coatings, recent developments in understanding the biological interactions of IL coatings, and future directions and challenges for the clinical translation of this new class of IL surface coatings.

Does weight cycling promote obesity and metabolic risk factors?

BACKGROUND: There remains common belief in the general community that weight cycling or 'yo-yo dieting' is associated with potential adverse effects on obesity and metabolic risk factors. In 1994, a review by the National Task Force on the Prevention and Treatment of Obesity concluded that weight cycling did not impact metabolism, and that weight loss attempts should not be discouraged. This study is an updated review of the literature published since 1994, to determine if weight cycling is associated with metabolic risk factors for obesity and type 2 diabetes. METHODS: A systematic literature search was conducted in PubMed, ISI Web of Science and SCOPUS to identify primary studies that examined weight cycling in relation to obesity and metabolic risk factors. Thirty-one studies with human subjects were retained. RESULTS: Fifty-eight percent (11/19) of publications reported that a history of weight cycling was correlated with increased body fat and central adiposity. Another fifty percent (4/8) of studies reported that the presence of weight cycling increased the likelihood of future weight gain, suggesting that weight cycling is potentially problematic for individuals attempting to lose weight. The majority of studies (13/17; 76%) did not show a detrimental effect of weight cycling on risk of type 2 diabetes. CONCLUSIONS: There is some evidence showing that weight cycling has no effect on risk of type 2 diabetes and inconclusive evidence that a history or presence of weight cycling influences body composition, or predisposes to future obesity. The available evidence so far suggests that there is little detrimental effect of weight cycling on current and future obesity and metabolic risk, and therefore weight loss efforts in individuals with overweight/obesity should continue to be encouraged.