Although cancer is a leading cause of death, significant breakthroughs have been made in its treatment in recent years. In particular, increasingly effective cancer vaccines are being developed, including some for colorectal cancer. There are also currently a variety of compounds that can act as adjuvants, such as signalling molecules called cytokines. Other adjuvants target and inhibit the specific mechanisms by which cancers evade the immune system. One of them is a galectin inhibitor, which targets galectins—proteins produced by cancer cells that can cause the death of immune cells. Likewise, immune checkpoint inhibitors affect immune checkpoints—natural host proteins that usually control inflammation but can be exploited by cancers to weaken the body’s defences. Equally, regulatory T cells may contribute to the progression of cancer by inhibiting the functions of other T cells. The main advantages of cancer vaccines include their low toxicity and their ability to strengthen the immune system. Nevertheless, significant limitations include their slow effects and their inability to treat cancer at times due to immunosuppression. Ultimately, ongoing trials provide hope for the development of more effective methods of immunotherapeutic inoculation that can target a greater variety of cancers.
Purpose
Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work.
Methods
Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function).
Results
Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction − 3.654; 95%CI − 5.253, − 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability.
Conclusions
The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.
BackgroundThe mental health of medical students is notoriously poor, and with the additional challenges posed by the COVID-19 pandemic, there has never been greater concern for the wellbeing of the current cohort. This cross-sectional study investigates the impact of coping strategies used by Australian medical students during the COVID-19 pandemic on their mental health improvement, including exercise, using social media, and connecting with family and friends. MethodsAn anonymous questionnaire was shared with medical students from all years via Facebook and General Practice Students Networks’ communications during the COVID-19 pandemic. The impact of a variety of lockdown coping strategies utilised by participants was assessed using SPSS.ResultsThere were 321 participants in this study, 69.6% of whom were females, 54.9% in their pre-clinical years, and 70.5% between the ages of 18-24. The results showed that nearly 80% of participants credited their mental health improvement to peri-lockdown strategies. The logistic regression analysis demonstrated that reading (non-medical books) and spending more time with family were the most notable peri-lockdown strategies associated with mental health improvement. Interestingly, some coping strategies made some participants more “demotivated” and were in fact more “addictive” which “took away from study time”, especially video games, TV series and movies. ConclusionIn quantitatively and qualitatively illustrating the impact of peri-lockdown coping strategies, we hope that medical faculties and mental health support networks within medicine may more appropriately tailor support and resources for students, not only in this time of hardship, but also for the many challenges ahead of all medical students. More specifically, medical faculty leads could explore the possible implementation of small reminders in the course curriculum, i.e. at the end of lecture and study material, to remind students to take breaks from studying, through reading and/or spending more time with family.
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