83 Background: For colorectal cancer patients treated with the chemotherapy drug oxaliplatin, oxaliplatin-induced peripheral neuropathy (OIPN) is a serious side effect. We conducted an observational comparative effectiveness study to evaluate whether several potential preventives reduced the rate of OIPN diagnosis in the two years following chemotherapy initiation. Methods: This was a retrospective cohort study that utilized the Surveillance, Epidemiology, and End Results database combined with Medicare claims (SEER-Medicare). Eligible patients were diagnosed with colorectal cancer between 2007-2015, 66 years of age or older, and received at least two cycles of oxaliplatin. We used two definitions to denote diagnosis of OIPN: OIPN 1 (diagnosis codes specific to CIPN) and OIPN 2 (additional codes for peripheral neuropathy). Multinomial propensity score weighting was used to balance potential confounders. The Fine-Gray subdistribution hazards model was used to perform a competing risk, time to event analysis for diagnosis of OIPN. Results: There were 4,482 subjects analyzed for the outcome of OIPN 1 (n = 477, 10.1%), and 4,561 for OIPN 2 (n = 1,191, 26.1%). Duloxetine, venlafaxine (marginally significant for OIPN 1), opioids, and minocycline were associated with a decreased rate of OIPN according to both definitions. In addition, memantine and neuromuscular therapy were associated with a decreased rate of OIPN 1 but not OIPN 2. Gabapentin and pregabalin exposure was associated with an increased rate of OIPN diagnosis according to both definitions. Mixed results were obtained for nortriptyline and cannabinoids. Conclusions: This study revealed several potentially effective preventive options for OIPN in colorectal cancer patients receiving oxaliplatin. A limitation of this study is the observational design which cannot directly inform treatment guidelines. However, evidence from this study may serve as preliminary data to support a future randomized clinical trial.[Table: see text]
Background Postsecondary education can provide opportunities for students from traditionally hidden populations like those who have experienced foster care or homelessness. To assist these students, campus support programs (CSPs) provide a wide range of services and activities. Objective Evidence of the impact of CSPs is limited, and little is known about how students who were involved in CSPs fare at or after graduation. This study seeks to address these gaps in knowledge. Methods: This mixed-methods study surveyed 56 young people involved in a CSP for college students who have experienced foster care, relative care, or homelessness. Participants completed surveys at graduation, 6 months post-graduation, and one-year post-graduation. Results At graduation, over two-thirds of the students felt completely (20.4%) or fairly (46.3%) prepared for life after graduation. Most felt completely (37.0%) or fairly confident (25.9%) that they would get a job after graduation. Six months after graduation, 85.0% of the graduates were employed, with 82.2% working at least full-time. 45% of the graduates were enrolled in graduate school. These numbers were similar a year after graduation. Postgraduation, participants described areas of their lives that were going well, obstacles and hardships faced, changes they would like to see in their lives, and post-graduation needs. Across these areas themes were present in the areas of finances, work, relationships, and resilience. Conclusions Institutions of higher education and CSP should assist students with a history of foster care, relative care, and homelessness to ensure that after graduation, they have adequate money, employment, and support. Keywords Campus support program • Foster youth • Foster care alumni • Homelessness • Postsecondary educationStudents who have experienced homelessness and non-traditional family care arrangements (e.g., foster care, relative care, and ward of the state status) are often hidden populations in postsecondary education settings and may experience lower rates of access to and success
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