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Sample records for a-bomb survivors exposed

  1. Reanalysis of cancer mortality in Japanese A-bomb survivors exposed to low doses of radiation: bootstrap and simulation methods

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    Dropkin Greg

    2009-12-01

    Full Text Available Abstract Background The International Commission on Radiological Protection (ICRP recommended annual occupational dose limit is 20 mSv. Cancer mortality in Japanese A-bomb survivors exposed to less than 20 mSv external radiation in 1945 was analysed previously, using a latency model with non-linear dose response. Questions were raised regarding statistical inference with this model. Methods Cancers with over 100 deaths in the 0 - 20 mSv subcohort of the 1950-1990 Life Span Study are analysed with Poisson regression models incorporating latency, allowing linear and non-linear dose response. Bootstrap percentile and Bias-corrected accelerated (BCa methods and simulation of the Likelihood Ratio Test lead to Confidence Intervals for Excess Relative Risk (ERR and tests against the linear model. Results The linear model shows significant large, positive values of ERR for liver and urinary cancers at latencies from 37 - 43 years. Dose response below 20 mSv is strongly non-linear at the optimal latencies for the stomach (11.89 years, liver (36.9, lung (13.6, leukaemia (23.66, and pancreas (11.86 and across broad latency ranges. Confidence Intervals for ERR are comparable using Bootstrap and Likelihood Ratio Test methods and BCa 95% Confidence Intervals are strictly positive across latency ranges for all 5 cancers. Similar risk estimates for 10 mSv (lagged dose are obtained from the 0 - 20 mSv and 5 - 500 mSv data for the stomach, liver, lung and leukaemia. Dose response for the latter 3 cancers is significantly non-linear in the 5 - 500 mSv range. Conclusion Liver and urinary cancer mortality risk is significantly raised using a latency model with linear dose response. A non-linear model is strongly superior for the stomach, liver, lung, pancreas and leukaemia. Bootstrap and Likelihood-based confidence intervals are broadly comparable and ERR is strictly positive by bootstrap methods for all 5 cancers. Except for the pancreas, similar estimates of

  2. Development of A-bomb survivor dosimetry

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    Kerr, G.D.

    1995-12-31

    An all important datum in risk assessment is the radiation dose to individual survivors of the bombings in Hiroshima and Nagasaki. The first set of dose estimates for survivors was based on a dosimetry system developed in 1957 by the Oak Ridge National Laboratory (ORNL). These Tentative 1957 Doses (T57D) were later replaced by a more extensive and refined set of Tentative 1965 Doses (T65D). The T65D system of dose estimation for survivors was also developed at ORNL and served as a basis for risk assessment throughout the 1970s. In the late 1970s, it was suggested that there were serious inadequacies with the T65D system, and these inadequacies were the topic of discussion at two symposia held in 1981. In early 1983, joint US- Japan research programs were established to conduct a thorough review of all aspects of the radiation dosimetry for the Hiroshima and Nagasaki A-bomb survivors. A number of important contributions to this review were made by ORNL staff members. The review was completed in 1986 and a new Dosimetry System 1986 (DS86) was adopted for use. This paper discusses the development of the various systems of A-bomb survivor dosimetry, and the status of the current DS86 system as it is being applied in the medical follow-up studies of the A-bomb survivors and their offspring.

  3. Medical examination of A-bomb survivors on Nagasaki A-bomb Casualty

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    Tagawa, Masuko [Nagasaki Atomic Bomb Casualty Council (Japan)

    1996-03-01

    Medical examination of A-bomb survivors was described and discussed on history, time change of examinee number, action for subjects not examined, change of prevalence, cancer examination, examination for the second generation, and education and enlightenment. Free examination of the survivors was begun in 1953 and the present casualty was made in 1958 on the law for medical care for the survivors. Systematic examination started from 1967 and the examination for the 2nd generation, from 1974. Cancer examination was from 1988. The number of the survivors was the maximum of 82,439 in 1974 and decreased to 61,388 in 1994, when the actual number of examinees, which being rather settled recently, was 32,294 and their average age was 64 y. The examination is done by tour or at the Center. Subjects receive the information of the examination twice by mail. Hematopoietic diseases like anemia, hepatic ones, metabolic and endocrinic ones like diabetes, renal impairment and others (mostly hyperlipidemia) are increasing recently. The number of examinees for cancer is increasing. Lung cancer is examined by the direct roentgenography, gastric cancer by transillumination, and other cancers like myeloma, those in large bowel, uterus and mammary gland, by the respective suitable methods. Health education and enlightenment have been conceivably effective. (H.O.)

  4. Factors Determining Satisfaction with Daily Life of Elderly A-bomb Survivors

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    Mine, Mariko; Okumura, Yutaka; Kondo, Hisayoshi; Yokota, Kenichi

    1993-01-01

    From the analysis of questionnaires to elderly A-bomb survivors of over 65 years old, we analysed factors which determined satisfaction with daily life. Analysed categories were housing condition, life style, occupational status, health condition and family status. From the analysis, to be an A-bomb survivor was not a factor for satisfaction with daily life, and it became clear that living in a rented room, not satisfying one's job and low income were serious factors which kept elderly people...

  5. Perspectives on radiation dose estimates for A-bomb survivors

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    Loewe, W.E.

    1986-12-01

    Four decades after the actual events, quantitative characterization of the radiation fields at Hiroshima and Nagasaki continues to be sought, with high accuracy a goal justified by the unique contribution to radiation protection standards that is represented by the medical records of exposed survivors. The most recent effort is distinguished by its reliance on computer modeling and concomitant detail, and by its decentralized direction, both internationally and internally to the US and Japan, with resultant ongoing peer review and wide scope of inquiry. A new system for individual dose estimation has been agreed upon, and its scientific basis has been elaborated in the literature as well as in a comprehensive treatise to be published in the Spring of 1987. In perspective, this new system appears to be an unusually successful achievement that offers the expectation of reliable estimates with the desired accuracy. Some aspects leading to this expectation, along with a caveat, are discussed here. 4 refs., 8 figs., 3 tabs.

  6. Parathyroid gland tumors in A-bomb survivors, autopsy cases, Hiroshima. Preliminary report

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    Takeichi, Nobuo; Fujikura, Toshio (Radiation Effects Research Foundation, Hiroshima (Japan)); Nishida, Toshihiro

    1984-03-01

    Parathyroid gland tumors were observed in 16 of 4,136 autopsy cases (0.4%) based on the life span survey for the population including A-bomb survivors and the control group. All of the cases (5 males and 11 females) had adenoma. The incidence of parathyroid gland tumors tended to increase with increasing the dose.

  7. A-BOMB SURVIVOR SITE-SPECIFIC RADIOGENIC CANCER RISKS ESTIMATES

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    A draft manuscript is being prepared that describes ways to improve estimates of risk from radiation that have been derived from A-bomb survivors. The work has been published in the journal Radiation Research volume 169, pages 87-98.

  8. Radiation effect on non-cancer diseases among a-bomb survivors

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    Suzuki, G.; Akahoshi, M.; Fujiwara, S.; Neriishi, K.; Yamada, M.; Hakoda, M. [Radiation Effect Research Foundation, Hiroshima (Japan)

    2002-07-01

    It has been well documented in the literature that radiation induces DNA damages and increases cancer risk. Besides cancer risk, the Life Span Study (LSS) on A-bomb survivors in Hiroshima and Nagasaki that has been conducted since 1950 by RERF demonstrated an increase in non-cancer death by cardiovascular diseases and chronic liver diseases (1). Since LSS analysis depends on death certificate, a physiological mechanism has not been elucidated how radiation increases the incidence of non-cancer diseases. In order to elucidate radiation effect on non-fatal disorders, RERF has conducted the Adult Health Study (AHS) since 1958 where 23,000 A-bomb survivors have been examined every other year. This study suggested that radiation exposure about 55 years before reduced the immune response to pathogens such as HB virus and Chlamydia pneumoniae, increased the levels of serum inflammatory markers, the prevalence of chronic hepatitis/liver cirrhosis and senile cataract, and the incidence of cardiovascular diseases. Our colleagues reported a dose-dependent decrease in the CD4 T cell number among A-bomb survivors (2,3). Since chronic inflammation and oxidative stress are causative of atherogenic cardiovascular diseases or cataract, we speculate a decrease in the immune response to pathogens, at least in part, is one of the mechanisms that A-bomb exposure increased non-cancer diseases. When the levels of inflammatory marker, C-reactive protein (CRP), were analyzed among subjects with evidence of Chlamydia pneumoniae infection, significantly higher levels of CRP were associated with antibodies to Chlamydia pneumoniae in those subjects receiving >1Gy than those receiving <5mGy. It is well known that high CRP is one of the risk factors of arteriosclerosis (4,5). Thus, A-bomb exposure seems to augment inflammatory response to pathogens, though of which mechanisms are not clear now.

  9. Cancer mortality among atomic bomb survivors exposed as children.

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    Goto, Hitomi; Watanabe, Tomoyuki; Miyao, Masaru; Fukuda, Hiromi; Sato, Yuzo; Oshida, Yoshiharu

    2012-05-01

    To compare cancer mortality among A-bomb survivors exposed as children with cancer mortality among an unexposed control group (the entire population of Japan, JPCG). The subjects were the Hiroshima and Nagasaki A-bomb survivor groups (0-14 years of age in 1945) reported in life span study report 12 (follow-up years were from 1950 to 1990), and a control group consisting of the JPCG. We estimated the expected number of deaths due to all causes and cancers of various causes among the exposed survivors who died in the follow-up interval, if they had died with the same mortality as the JPCG (0-14 years of age in 1945). We calculated the standardized mortality ratio (SMR) of A-bomb survivors in comparison with the JPCG. SMRs were significantly higher in exposed boys overall for all deaths, all cancers, leukemia, and liver cancer, and for exposed girls overall for all cancers, solid cancers, liver cancer, and breast cancer. In boys, SMRs were significantly higher for all deaths and liver cancer even in those exposed to very low doses, and for all cancers, solid cancers, and liver cancer in those exposed to low doses. In girls, SMRs were significantly higher for liver cancer and uterine cancer in those exposed to low doses, and for leukemia, solid cancers, stomach cancer, and breast cancer in those exposed to high doses. We calculated the SMRs for the A-bomb survivors versus JPCG in childhood and compared them with a true non-exposed group. A notable result was that SMRs in boys exposed to low doses were significantly higher for solid cancer.

  10. Radiation dose, reproductive history, and breast cancer risk among Japanese A-bomb survivors

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    Land, C.E. [National Cancer Institute, Bethesda, MD (United States)

    1992-06-01

    Excess risk of female breast cancer is among the most comprehensively documented late effects of exposure to substantial doses of ionizing radiation, based on studies of medically irradiated populations and the survivors of the A-bombings of Hiroshima and Nagasaki. This study looks at the interaction of dose with epidemiological factors like age at first full-term pregnancy and family history of breast cancer, most closely associated with risk in epidemiological studies of non-irradiatied populations. 1 fig., 2 tabs.

  11. Genomic instability in the epidermis induced by atomic bomb (A-bomb) radiation: a long-lasting health effect in A-bomb survivors.

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    Naruke, Yuki; Nakashima, Masahiro; Suzuki, Keiji; Kondo, Hisayoshi; Hayashi, Tomayoshi; Soda, Midori; Sekine, Ichiro

    2009-08-15

    Radiation etiology is suggested in the occurrence of basal cell carcinoma (BCC) of the skin among atomic bomb (A-bomb) survivors. Any genotoxicity, including ionizing radiation, can induce a DNA damage response (DDR), leading to genomic instability (GIN), which allows the accumulation of mutations during tumorigenesis. In this study, the authors evaluated the presence of GIN in the epidermis of survivors as a late effect of A-bomb radiation. In total, 146 BCCs, including 23 cases arising from nonexposed skin, were identified in survivors from 1968 to 1999. The incidence rate (IR) of BCC was calculated with stratification by distance in kilometers from the hypocenter ( or =3 km). Nineteen epidermal samples surrounding BCC at the nonexposed sites were collected and tested for p53 binding protein 1 (53BP1) expression with immunofluorescence. 53BP1 rapidly forms nuclear foci at the sites of DNA double strand breaks (DSBs). Because 1 manifestation of GIN is the induction of endogenous DSBs, the level of 53BP1-focus formation (DDR type) can be considered as a marker for GIN. : The incidence rate of BCC increased significantly as exposure distance approached the hypocenter. Of the 7 epidermal samples from the proximal group ( or =3 km) and all samples from the control group predominantly expressed the stable type of 53BP1 expression in the epidermis. : The current results demonstrated the endogenous activation of DDR in the epidermis surrounding BCC in the proximal group, suggesting the presence of a GIN in the survivors as a late effect of A-bomb radiation, which may indicate a predisposition to cancer.

  12. Multiple endocrine tumors in A-bomb survivors, autopsy cases, Hiroshima. Preliminary report

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    Takeichi, Nobuo; Fujikura, Toshio (Radiation Effects Research Foundation, Hiroshima (Japan)); Ezaki, Haruo

    1984-03-01

    Multiple endocrine tumors (MET) were observed in 27 of 4,136 autopsy cases (0.3%) of the fixed population including Hiroshima atomic bomb survivors and the control group. The thyroid was the most common organ in which MET occurred, followed by the ovary. Thirteen cases, including two cases of three MET, had MET in both the tyroid and the ovary, 11 of which had been exposed to one rad or more of atomic bomb.

  13. A two-phase Poisson process model and its application to analysis of cancer mortality among A-bomb survivors.

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    Ohtaki, Megu; Tonda, Tetsuji; Aihara, Kazuyuki

    2015-10-01

    We consider a two-phase Poisson process model where only early successive transitions are assumed to be sensitive to exposure. In the case where intensity transitions are low, we derive analytically an approximate formula for the distribution of time to event for the excess hazard ratio (EHR) due to a single point exposure. The formula for EHR is a polynomial in exposure dose. Since the formula for EHR contains no unknown parameters except for the number of total stages, number of exposure-sensitive stages, and a coefficient of exposure effect, it is applicable easily under a variety of situations where there exists a possible latency time from a single point exposure to occurrence of event. Based on the multistage hypothesis of cancer, we formulate a radiation carcinogenesis model in which only some early consecutive stages of the process are sensitive to exposure, whereas later stages are not affected. An illustrative analysis using the proposed model is given for cancer mortality among A-bomb survivors.

  14. Personality and Major Depression among Directly Exposed Survivors of the Oklahoma City Bombing

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    Carol S. North

    2012-01-01

    Full Text Available Background. Few disaster studies have specifically examined personality and resilience in association with disaster exposure, posttraumatic stress disorder (PTSD, and major depression. Methods. 151 directly-exposed survivors of the Oklahoma City bombing randomly selected from a bombing survivor registry completed PTSD, major depression, and personality assessments using the Diagnostic Interview Schedule for DSM-IV and the Temperament and Character Inventory, respectively. Results. The most prevalent postdisaster psychiatric disorder was bombing-related PTSD (32%; major depression was second in prevalence (21%. Bombing-related PTSD was associated with the combination of low self-directedness and low cooperativeness and also with high self-transcendence and high harm avoidance in most configurations. Postdisaster major depression was significantly more prevalent among those with (56% than without (5% bombing-related PTSD (P<.001 and those with (72% than without (14% predisaster major depression (P<.001. Incident major depression was not associated with the combination of low self-directedness and low cooperativeness. Conclusions. Personality features can distinguish resilience to a specific life-threatening stressor from general indicators of well-being. Unlike bombing-related PTSD, major depression was not a robust marker of low resilience. Development and validation of measures of resilience should utilize well-defined diagnoses whenever possible, rather than relying on nonspecific measures of psychological distress.

  15. A-bomb radiation and diseases; M proteinemia

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    Fujimura, Kingo (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology); Ito, Chikako

    1994-03-01

    Mass health screening was conducted in 65,483 A-bomb survivors (23,153 men and 42,336 women). Among them, 553 (0.84%) was found to have M proteinemia. The incidence of M proteinemia was higher in men (1.1%) than women (0.72%). M proteinemia was simply classified as benign monoclonal gammopathy (BMG) in 372 A-bomb survivors (67.3%), pre-myeloma (PreMM) in 81 (14.6%), myeloma (MM) in 77 (13.9%), and macroglobulinemia in 23 (4.2%). A higher incidence of M proteinemia was associated with aging; it was rapidly increased in the age-group of 70. Death was seen in 45 (8%) of all cases, frequently due to vascular disorder and cancer. Some of the BMG cases had a long process or developed either PreMM or MM. The incidence of BMG was significantly higher in the group of A-bomb survivors exposed to 100 rad or more than the control group. (N.K.).

  16. Radiation May Indirectly Impair Growth Resulting in Reduced Standing Height via Subclinical Inflammation in Atomic-Bomb Survivors Exposed at Young Ages

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    Eiji Nakashima

    2015-01-01

    Full Text Available For young atomic-bomb (A-bomb survivors, A-bomb radiation’s (total effect on standing height is thought to comprise the sum of direct effect and indirect effect via inflammation. With the data of five inflammatory markers—white blood cell count, sialic acid, corrected erythrocyte sedimentation rate (ESR, α1 globulin, and α2 globulin—obtained in adulthood during the period 1988 to 1992, a summary inflammatory index was constructed as a surrogate for the five subclinical inflammatory markers. For 3,327 A-bomb survivors exposed at ages of less than 25 years, a structural equation model was analyzed to measure direct radiation effects on adult height as well as mediating effect of radiation via inflammation on the height after adjustment for other risk factors, smoking, cancer, inflammatory disease, obesity, and diabetes mellitus. The mediation proportion of the radiation effect on height via inflammation was approximately 5% for both sexes for all ages, and indirect dose effects via inflammation were statistically significant for both sexes combined and for females exposed at ages 0 to 5 years. Indirect dose effects for all ages via sialic acid, corrected ESR, and α2 globulin were marginally significant for both sexes combined and for females. These proportions are likely underestimated.

  17. Late effects of radiation: Neglected aspects of A-bomb data

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    Stewart, A.M.; Kneale, G.W. [Dept. of Public Health and Epidemiology, Birmingham Univ., Edgbaston (United Kingdom)

    2001-07-01

    Both from the Oxford Survey of Childhood Cancers, and from recent surveys of nuclear workers at Hanford and Oak Ridge, have come risk estimates for cancer effects of radiation that are much higher than the ones based on a life span study cohort of A-bomb survivors. Furthermore, relations between the age when exposed and the cancer risk were radically different for workers and survivors. Therefore, there was clearly a need to discover whether the LSS cohort was a normal homogeneous population or, alternatively, whether persons who had shown signs of acute radiation effects constituted a special, radiosensitive subgroup of survivors. Statistical tests of the alternative hypotheses revealed significant differences between 63,072 survivors who denied having any of the following injuries and 2,601 survivors who claimed two or more of them: radiation, burns, purpura, oropharyngeal lesions and epilation. The tests also showed that the group differences were largely the result of exposures before 10 or after 55 years of age being exceptionally dangerous; that cancer was not the only late effect of the A-bomb radiation, and that it was only among the survivors with multiple injuries that the leukaemia death rate was exceptionally high. (orig.)

  18. Radiation Effects on Cognitive Function Among Atomic Bomb Survivors Exposed at or After Adolescence.

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    Yamada, Michiko; Landes, Reid D; Mimori, Yasuyo; Nagano, Yoshito; Sasaki, Hideo

    2016-06-01

    The objective of this study was to investigate radiation effects on longitudinal pre-dementia cognitive decline among participants who developed dementia as well as on those who did not develop dementia during follow-up. Measuring cognitive function with the Cognitive Abilities Screening Instrument approximately every 2 years, we followed 1844 atomic bomb survivors participating in the Adult Health Study of the Radiation Effects Research Foundation from 1992 to 2011. Participants were adolescents or older when exposed to between 0 and 4 Gy. Approximately 15% and 40% of participants were exposed to ≥1 Gy and atomic bomb survivors exposed at or after adolescence. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Genetic effect of A-bomb radiation- Analysis of minisatellite regions detected by DNA fingerprint probe

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    Kodaira, Mieko [Radiation Effects Research Foundation, Hiroshima (Japan)

    1999-06-01

    In author's laboratory, screening of mutation in germ cells of A-bomb survivors is under investigation with use of 8 single-locus minisatellite probes and no increase in mutation rate has been detected hitherto. This paper reported results of screening on the minisatellite region, which consisting of short repeated base sequence, using a DNA fingerprint probe for 33.15 core sequence. Subjects were 50 A-bomb survivor families exposed to mean dose of 1.9 Sv (exposed group) or 0 Gy (control), having 64 or 60 children, respectively. DNA was extracted from their B cells established by EB virus and subjected to agarose-gel electrophoresis followed by southern blotting with some improvements for fingerprinting. On the fingerprints, numbers of the band detected in regions of >3.5 kb were 1080 in children of the exposed group (16.9/child) and 1024 (17.1) in the control group, indicating no detectable effect of exposure on the germ cell mutation rate in the region.(K.H.)

  20. Non-cancer Diseases of Korean Atomic Bomb Survivors in Residence at Hapcheon, Republic of Korea

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    Ju, Young-Su; Kim, Jung-Bum; Kim, Jin-Kook

    2006-01-01

    Many Koreans, in addition to Japanese, were killed or injured by the atomic bombs detonated over Hiroshima and Nagasaki, Japan, in 1945. Our study examined non-cancer diseases of Korean A-bomb survivors in residence at Hapcheon, Republic of Korea and evaluated whether they had significantly higher prevalence of non-cancer diseases than non-exposed people. We evaluated a number of tests, including anthropometric measurements, blood pressure, blood chemistry, hepatitis B surface antigen, and urinalysis, of survivors (n=223) and controls (n=372). Univariate analysis revealed significantly lower fasting glucose and creatinine, and higher diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase, and blood urea nitrogen levels in the survivors than in the controls. The calculation of crude prevalence ratios (PRs) revealed that A-bomb survivors had a significantly higher prevalence of hypertension (PR, 1.16; 95% CI, 1.00-1.35) and chronic liver disease (2.20; 1.59-3.06) than controls. After adjusting for covariates (age, sex, body mass index, marital status, education, alcohol consumption, and smoking), A-bomb survivors had a significantly higher prevalence of hypertension (1.24; 1.06-1.44), chronic liver disease (2.07; 1.51-2.84), and hypercholesterolemia (1.79; 1.11-2.90) than controls. This study suggests that A-bomb exposure is associated with a higher prevalence of non-cancer diseases in Korean survivors. PMID:16778377

  1. Attention bias in earthquake-exposed survivors: an event-related potential study.

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    Zhang, Yan; Kong, Fanchang; Han, Li; Najam Ul Hasan, Abbasi; Chen, Hong

    2014-12-01

    The Chinese Wenchuan earthquake, which happened on the 28th of May in 2008, may leave deep invisible scars in individuals. China has a large number of children and adolescents, who tend to be most vulnerable because they are in an early stage of human development and possible post-traumatic psychological distress may have a life-long consequence. Trauma survivors without post-traumatic stress disorder (PTSD) have received little attention in previous studies, especially in event-related potential (ERP) studies. We compared the attention bias to threat stimuli between the earthquake-exposed group and the control group in a masked version of the dot probe task. The target probe presented at the same space location consistent with earthquake-related words was the congruent trial, while in the space location of neutral words was the incongruent trial. Thirteen earthquake-exposed middle school students without PTSD and 13 matched controls were included in this investigation. The earthquake-exposed group showed significantly faster RTs to congruent trials than to incongruent trials. The earthquake-exposed group produced significantly shorter C1 and P1 latencies and larger C1, P1 and P2 amplitudes than the control group. In particular, enhanced P1 amplitude to threat stimuli was observed in the earthquake-exposed group. These findings are in agreement with the prediction that earthquake-exposed survivors have an attention bias to threat stimuli. The traumatic event had a much greater effect on earthquake-exposed survivors even if they showed no PTSD symptoms than individuals in the controls. These results will provide neurobiological evidences for effective intervention and prevention to post-traumatic mental problems. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Significance of genomic instability in breast cancer in atomic bomb survivors: analysis of microarray-comparative genomic hybridization.

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    Oikawa, Masahiro; Yoshiura, Koh-ichiro; Kondo, Hisayoshi; Miura, Shiro; Nagayasu, Takeshi; Nakashima, Masahiro

    2011-12-07

    It has been postulated that ionizing radiation induces breast cancers among atomic bomb (A-bomb) survivors. We have reported a higher incidence of HER2 and C-MYC oncogene amplification in breast cancers from A-bomb survivors. The purpose of this study was to clarify the effect of A-bomb radiation exposure on genomic instability (GIN), which is an important hallmark of carcinogenesis, in archival formalin-fixed paraffin-embedded (FFPE) tissues of breast cancer by using microarray-comparative genomic hybridization (aCGH). Tumor DNA was extracted from FFPE tissues of invasive ductal cancers from 15 survivors who were exposed at 1.5 km or less from the hypocenter and 13 calendar year-matched non-exposed patients followed by aCGH analysis using a high-density oligonucleotide microarray. The total length of copy number aberrations (CNA) was used as an indicator of GIN, and correlation with clinicopathological factors were statistically tested. The mean of the derivative log ratio spread (DLRSpread), which estimates the noise by calculating the spread of log ratio differences between consecutive probes for all chromosomes, was 0.54 (range, 0.26 to 1.05). The concordance of results between aCGH and fluorescence in situ hybridization (FISH) for HER2 gene amplification was 88%. The incidence of HER2 amplification and histological grade was significantly higher in the A-bomb survivors than control group (P = 0.04, respectively). The total length of CNA tended to be larger in the A-bomb survivors (P = 0.15). Correlation analysis of CNA and clinicopathological factors revealed that DLRSpread was negatively correlated with that significantly (P = 0.034, r = -0.40). Multivariate analysis with covariance revealed that the exposure to A-bomb was a significant (P = 0.005) independent factor which was associated with larger total length of CNA of breast cancers. Thus, archival FFPE tissues from A-bomb survivors are useful for genome-wide aCGH analysis. Our results suggested that A-bomb

  3. Significance of genomic instability in breast cancer in atomic bomb survivors: analysis of microarray-comparative genomic hybridization

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    Oikawa Masahiro

    2011-12-01

    Full Text Available Abstract Background It has been postulated that ionizing radiation induces breast cancers among atomic bomb (A-bomb survivors. We have reported a higher incidence of HER2 and C-MYC oncogene amplification in breast cancers from A-bomb survivors. The purpose of this study was to clarify the effect of A-bomb radiation exposure on genomic instability (GIN, which is an important hallmark of carcinogenesis, in archival formalin-fixed paraffin-embedded (FFPE tissues of breast cancer by using microarray-comparative genomic hybridization (aCGH. Methods Tumor DNA was extracted from FFPE tissues of invasive ductal cancers from 15 survivors who were exposed at 1.5 km or less from the hypocenter and 13 calendar year-matched non-exposed patients followed by aCGH analysis using a high-density oligonucleotide microarray. The total length of copy number aberrations (CNA was used as an indicator of GIN, and correlation with clinicopathological factors were statistically tested. Results The mean of the derivative log ratio spread (DLRSpread, which estimates the noise by calculating the spread of log ratio differences between consecutive probes for all chromosomes, was 0.54 (range, 0.26 to 1.05. The concordance of results between aCGH and fluorescence in situ hybridization (FISH for HER2 gene amplification was 88%. The incidence of HER2 amplification and histological grade was significantly higher in the A-bomb survivors than control group (P = 0.04, respectively. The total length of CNA tended to be larger in the A-bomb survivors (P = 0.15. Correlation analysis of CNA and clinicopathological factors revealed that DLRSpread was negatively correlated with that significantly (P = 0.034, r = -0.40. Multivariate analysis with covariance revealed that the exposure to A-bomb was a significant (P = 0.005 independent factor which was associated with larger total length of CNA of breast cancers. Conclusions Thus, archival FFPE tissues from A-bomb survivors are useful for

  4. A-bomb radiation effects digest

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    Shigematsu, Itsuzo; Akiyama, Mitoshi; Sasaki, Hideo (Radiation Effects Research Foundation, Hiroshima (Japan)); Ito, Chikako; Kamada, Nanao.

    1993-01-01

    This publication is the digest of the book 'Genbaku Hoshasen no Jintai Eikyo (Effects of A-bomb Radiation on the Human Body)' (365p.), published in Japanese by Hiroshima International Council for Medical Care of the Radiation-Exposed. Following a brief description on the damage of the atomic bomb, the subjects of malignant tumors, endocrine and metabolic deseases, ocular lesions, dermatologic effects, prenatal exposure, chromosoal aberrations, mutations, sensitivity to radiation, immune function, genetic effects and other effects of radiation are summarized. (J.P.N.).

  5. Thyroid Dysfunction and Autoimmune Thyroid Diseases Among Atomic Bomb Survivors Exposed in Childhood.

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    Imaizumi, Misa; Ohishi, Waka; Nakashima, Eiji; Sera, Nobuko; Neriishi, Kazuo; Yamada, Michiko; Tatsukawa, Yoshimi; Takahashi, Ikuno; Fujiwara, Saeko; Sugino, Keizo; Ando, Takao; Usa, Toshiro; Kawakami, Atsushi; Akahoshi, Masazumi; Hida, Ayumi

    2017-07-01

    The risk of thyroid cancer increases and persists for decades among individuals exposed to ionizing radiation in childhood, although the long-term effects of childhood exposure to medium to low doses of radiation on thyroid dysfunction and autoimmune thyroid diseases have remained unclear. To evaluate radiation dose responses for the prevalence of thyroid dysfunction and autoimmune thyroid disease among atomic bomb survivors exposed in childhood. Hiroshima and Nagasaki atomic bomb survivors who were younger than 10 years old at exposure underwent thyroid examinations at the Radiation Effects Research Foundation between 2007 and 2011, which was 62 to 66 years after the bombing. Data from 2668 participants (mean age, 68.2 years; 1455 women) with known atomic bomb thyroid radiation doses (mean dose, 0.182 Gy; dose range, 0 to 4.040 Gy) were analyzed. Dose-response relationships between atomic bomb radiation dose and the prevalence of hypothyroidism, hyperthyroidism (Graves' disease), and positive for antithyroid antibodies. Prevalences were determined for hypothyroidism (129 cases, 7.8%), hyperthyroidism (32 cases of Graves' disease, 1.2%), and positive for antithyroid antibodies (573 cases, 21.5%). None of these was associated with thyroid radiation dose. Neither thyroid antibody-positive nor -negative hypothyroidism was associated with thyroid radiation dose. Additional analyses using alternative definitions of hypothyroidism and hyperthyroidism found that radiation dose responses were not significant. Radiation effects on thyroid dysfunction and autoimmune thyroid diseases were not observed among atomic bomb survivors exposed in childhood, at 62 to 66 years earlier. The cross-sectional design and survival bias were limitations of this study.

  6. Tsunami-exposed tourist survivors: signs of recovery in a 3-year perspective.

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    Johannesson, Kerstin Bergh; Lundin, Tom; Fröjd, Thomas; Hultman, Christina M; Michel, Per-Olof

    2011-03-01

    Long-term follow-up after disaster exposure indicates increased rates of psychological distress. However, trajectories and rates of recovery in large samples of disaster-exposed survivors are largely lacking. A group of 3457 Swedish survivors temporarily on vacation in Southeast Asia during the 2004 tsunami were assessed by postal questionnaire at 14 months and 3 years after the tsunami regarding post-traumatic stress reactions (IES-R) and general mental health (GHQ-12). There was a general pattern of resilience and recovery 3 years postdisaster. Severe exposure and traumatic bereavement were associated with increased post-traumatic stress reactions and heightened risk for impaired mental health. The rate of recovery was lower among respondents exposed to life threat and among bereaved. Severe trauma exposure and bereavement seem to have considerable long-term impact on psychological distress and appear to slow down the recovery process. Readiness among health agencies for identification of symptoms and provision of interventions might facilitate optimal recovery.

  7. Intensely Exposed Oklahoma City Terrorism Survivors: Long-term Mental Health and Health Needs and Posttraumatic Growth.

    Science.gov (United States)

    Tucker, Phebe; Pfefferbaum, Betty; Nitiéma, Pascal; Wendling, Tracy L; Brown, Sheryll

    2016-03-01

    In this study, we explore directly exposed terrorism survivors' mental health and health status, healthcare utilization, alcohol and tobacco use, and posttraumatic growth 18½ years postdisaster. Telephone surveys compared terrorism survivors and nonexposed community control subjects, using Hopkins Symptom Checklist, Breslau's PTSD screen, Posttraumatic Growth Inventory, and Health Status Questionnaire 12. Statistical analyses included multivariable logistic regression and linear modeling. Survivors, more than 80% injured, reported more anxiety and depression symptoms than did control subjects, with survivors' anxiety and depression associated with heavy drinking (≥5 drinks) and worse mental health and social functioning. While survivors had continued posttraumatic stress disorder symptoms (32 [23.2%] met probable posttraumatic stress disorder threshold), they also reported posttraumatic growth. Survivors had more care from physical, speech, respiratory, and occupational therapists. In this unprecedented long-term assessment, survivors' psychiatric symptoms, alcohol use, and ancillary health service utilization suggest unmet mental health and health needs. Extended recovery efforts might benefit from maximizing positive growth and coping.

  8. Longitudinal trends of total white blood cell and differential white blood cell counts of atomic bomb survivors.

    Science.gov (United States)

    Hsu, Wan-Ling; Tatsukawa, Yoshimi; Neriishi, Kazuo; Yamada, Michiko; Cologne, John; Fujiwara, Saeko

    2010-01-01

    In studying the late health effects of atomic-bomb (A-bomb) survivors, earlier findings were that white blood cell (WBC) count increased with radiation dose in cross-sectional studies. However, a persistent effect of radiation on WBC count and other risk factors has yet to be confirmed. The objectives of the present study were 1) to examine the longitudinal relationship between A-bomb radiation dose and WBC and differential WBC counts among A-bomb survivors and 2) to investigate the potential confounding risk factors (such as age at exposure and smoking status) as well as modification of the radiation dose-response. A total of 7,562 A-bomb survivors in Hiroshima and Nagasaki were included in this study from 1964-2004. A linear mixed model was applied using the repeated WBC measurements. During the study period, a secular downward trend of WBC count was observed. Radiation exposure was a significant risk factor for elevated WBC and differential WBC counts over time. A significant increase of WBC counts among survivors with high radiation dose (> 2 Gy) was detected in men exposed below the age of 20 and in women regardless of age at exposure. Effects on WBC of low dose radiation remain unclear, however. Cigarette smoking produced the most pronounced effect on WBC counts and its impact was much larger than that of radiation exposure.

  9. Longitudinal trajectories and predictors of anxiety symptoms among adolescent survivors exposed to Wenchuan earthquake.

    Science.gov (United States)

    Shi, Xuliang; Zhou, Ya; Fan, Fang

    2016-12-01

    This study aimed to investigate the developmental trajectories and associated predictors of anxiety symptoms among Chinese adolescents exposed to Wenchuan earthquake. 1573 adolescent survivors were followed up at 6, 12, 18, and 24 months post-earthquake. Self-report measures were used to evaluate earthquake exposure, anxiety symptoms, negative life events, social support, and trait resilience. Growth mixture modeling (GMM) and multi-nominal logistic regression were used to analyze data. The results showed that 45.6%, 50.9%, 39.2%, and 39.9% of participants showed clinical levels of anxiety symptoms at 6, 12, 18, and 24 months post-earthquake, respectively. Four developmental trajectories were identified: resistance, recovery, delayed-onset anxiety, and chronic anxiety. Gender, injury of family members, negative life events, social support, and trait resilience were significant predictors for distinct anxiety trajectories. Individualized and appropriate psychosocial interventions should be provided for adolescents affected by natural disasters, especially those at higher risk for chronic or delayed mental problem symptoms. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  10. Risk of myelodysplastic syndromes in people exposed to ionizing radiation: a retrospective cohort study of Nagasaki atomic bomb survivors.

    Science.gov (United States)

    Iwanaga, Masako; Hsu, Wan-Ling; Soda, Midori; Takasaki, Yumi; Tawara, Masayuki; Joh, Tatsuro; Amenomori, Tatsuhiko; Yamamura, Masaomi; Yoshida, Yoshiharu; Koba, Takashi; Miyazaki, Yasushi; Matsuo, Tatsuki; Preston, Dale L; Suyama, Akihiko; Kodama, Kazunori; Tomonaga, Masao

    2011-02-01

    The risk of myelodysplastic syndromes (MDS) has not been fully investigated among people exposed to ionizing radiation. We investigate MDS risk and radiation dose-response in Japanese atomic bomb survivors. We conducted a retrospective cohort study by using two databases of Nagasaki atomic bomb survivors: 64,026 people with known exposure distance in the database of Nagasaki University Atomic-Bomb Disease Institute (ABDI) and 22,245 people with estimated radiation dose in the Radiation Effects Research Foundation Life Span Study (LSS). Patients with MDS diagnosed from 1985 to 2004 were identified by record linkage between the cohorts and the Nagasaki Prefecture Cancer Registry. Cox and Poisson regression models were used to estimate relationships between exposure distance or dose and MDS risk. There were 151 patients with MDS in the ABDI cohort and 47 patients with MDS in the LSS cohort. MDS rate increased inversely with exposure distance, with an excess relative risk (ERR) decay per km of 1.2 (95% CI, 0.4 to 3.0; P atomic bomb survivors 40 to 60 years after radiation exposure. Clinicians should perform careful long-term follow-up of irradiated people to detect MDS as early as possible.

  11. Low dose radiation risks for women surviving the a-bombs in Japan: generalized additive model.

    Science.gov (United States)

    Dropkin, Greg

    2016-11-24

    Analyses of cancer mortality and incidence in Japanese A-bomb survivors have been used to estimate radiation risks, which are generally higher for women. Relative Risk (RR) is usually modelled as a linear function of dose. Extrapolation from data including high doses predicts small risks at low doses. Generalized Additive Models (GAMs) are flexible methods for modelling non-linear behaviour. GAMs are applied to cancer incidence in female low dose subcohorts, using anonymous public data for the 1958 - 1998 Life Span Study, to test for linearity, explore interactions, adjust for the skewed dose distribution, examine significance below 100 mGy, and estimate risks at 10 mGy. For all solid cancer incidence, RR estimated from 0 - 100 mGy and 0 - 20 mGy subcohorts is significantly raised. The response tapers above 150 mGy. At low doses, RR increases with age-at-exposure and decreases with time-since-exposure, the preferred covariate. Using the empirical cumulative distribution of dose improves model fit, and capacity to detect non-linear responses. RR is elevated over wide ranges of covariate values. Results are stable under simulation, or when removing exceptional data cells, or adjusting neutron RBE. Estimates of Excess RR at 10 mGy using the cumulative dose distribution are 10 - 45 times higher than extrapolations from a linear model fitted to the full cohort. Below 100 mGy, quasipoisson models find significant effects for all solid, squamous, uterus, corpus, and thyroid cancers, and for respiratory cancers when age-at-exposure > 35 yrs. Results for the thyroid are compatible with studies of children treated for tinea capitis, and Chernobyl survivors. Results for the uterus are compatible with studies of UK nuclear workers and the Techa River cohort. Non-linear models find large, significant cancer risks for Japanese women exposed to low dose radiation from the atomic bombings. The risks should be reflected in protection standards.

  12. Comparison of medical data of atomic-bomb survivors resident in the U. S. and Hiroshima

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Chikako (Hiroshima Atomic-Bomb Survivors Health Clinic (Japan)); Matsubara, Hiroomi; Yamakido, Michio; Yamada, Hiroaki

    1982-06-01

    The third medical examination of A-bomb survivors residing in the U.S. was performed in San Francisco, Los Angeles, Seattle and Honolulu during the period 6 - 28 May 1981. The test results were studied and the actual state of the survivors in the U.S., was reviewed as explained hereunder. 1) The number of survivors actually registered with the Committee of A-bomb Survivors in the U.S. is 491 (133 males and 358 females) of whom 57.2% are U.S. citizens. Those exposed in Hiroshima accounted for 91.8%. The mean age was 53.3 +- 8.9, thus they were more than 3 years younger than their counterparts in Hiroshima. The present addresses of the survivors are distributed over 15 states, but those in California constitute 77.6% of the total, and when those residing in the states along the west coast and Hawaii are added the rate increases to 95.9%. 2) Those who underwent health examination numbered 166 (45 males and 121 females), and comparison of the U.S. survivors against the Hiroshima survivors showed there to be a difference in the following points. The prevalence of hypertension was lower among the U.S. survivors, but RBC counts and hemoglobin concentration were significantly higher. The same was observed for blood lipids with hypercholesterolemia and hypertriglyceridemia being found at a significantly higher rate in the U.S. survivors. 3) Those free of clinical abnormalities in this survey were 37.3%, and the rest required dietary guidance, follow-up observation, detailed examination of treatment. Those with diseases which are considered would make them eligible for health management allowance if in Japan, accounted for 18.7%.

  13. Health survey of atomic bomb survivors in South Korea

    Energy Technology Data Exchange (ETDEWEB)

    Arita, Ken-ichi; Iwamori, Hiroshi; Kishi, Akihiro; Koutoku, Michiya.

    1988-05-01

    Health survey was undertaken among Korea survivors exposed to atomic bomb in Japan who now reside in South Korea. Of 232 A-bomb survivors on whom raditation exposure information was available, all were exposed to atomic bomb in Hiroshima. According to the distance from the hypocenter, one (0.4 %) A-bomb survior was exposed at < 1,000 m, 60 (25.9 %) at 1,000 - 2,000 m, 124 (53.4 %) at > 2,000 - 3,000 m, and 43 (18.5 %) at < 3,000 m. In the four remaining, it was unknown. According to age, 14.7 % were in their forties, 33.6 % in their fifties, 32.6 % in their sixties, 16.0 % in their severties, and 3.1 % in their eighties, indicating the tendency for the aging of older persons. Common subjective symptoms were lumbar pain and joint pain, which seemed atributable to osteoarthritis. Other diseases included hypertension, chronic obstructive pulmonary disease, sequelae of cerebral stroke, eczema, and mycosis. (Namekawa, K.).

  14. The story of an A-bomb by Oppenheimer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Eun Yeong

    2005-06-15

    This book concentrates on an A-bomb by Oppenheimer. It is divided into eleven class, which are exile of excellent scientists, uranium atomic fission, situation the U.S. and Germany I, situation the U.S. and Germany II, air strike in pearl Harbor, plan for development of an A-bomb, military action to blow up heavy water plant, select on spot to drop an A-bomb, surrender and drop for an A-bomb and science of an A-bomb. This book is written to explain an A-bomb with form of storytelling.

  15. Association of radiation dose with prevalence of thyroid nodules among atomic bomb survivors exposed in childhood (2007-2011).

    Science.gov (United States)

    Imaizumi, Misa; Ohishi, Waka; Nakashima, Eiji; Sera, Nobuko; Neriishi, Kazuo; Yamada, Michiko; Tatsukawa, Yoshimi; Takahashi, Ikuno; Fujiwara, Saeko; Sugino, Keizo; Ando, Takao; Usa, Toshiro; Kawakami, Atsushi; Akahoshi, Masazumi; Hida, Ayumi

    2015-02-01

    Few studies have evaluated the association of radiation dose with thyroid nodules among adults exposed to radiation in childhood. To evaluate radiation dose responses on the prevalence of thyroid nodules in atomic bomb survivors exposed in childhood. This survey study investigated 3087 Hiroshima and Nagasaki atomic bomb survivors who were younger than 10 years at exposure and participated in the thyroid study of the Adult Health Study at the Radiation Effects Research Foundation. Thyroid examinations including thyroid ultrasonography were conducted between October 2007 and October 2011, and solid nodules underwent fine-needle aspiration biopsy. Data from 2668 participants (86.4% of the total participants; mean age, 68.2 years; 1213 men; and 1455 women) with known atomic bomb thyroid radiation doses (mean dose, 0.182 Gy; median dose, 0.018 Gy; dose range, 0-4.040 Gy) were analyzed. The prevalence of all thyroid nodules having a diameter of 10 mm or more (consisting of solid nodules [malignant and benign] and cysts), prevalence of small thyroid nodules that were less than 10 mm in diameter detected by ultrasonography, and atomic bomb radiation dose-responses. Thyroid nodules with a diameter of 10 mm or more were identified in 470 participants (17.6%): solid nodules (427 cases [16.0%]), malignant tumors (47 cases [1.8%]), benign nodules (186 cases [7.0%]), and cysts (49 cases [1.8%]), and all were significantly associated with thyroid radiation dose. Excess odds ratios per gray unit were 1.65 (95% CI, 0.89-2.64) for all nodules, 1.72 (95% CI, 0.93-2.75) for solid nodules, 4.40 (95% CI, 1.75-9.97) for malignant tumors, 2.07 (95% CI, 1.16-3.39) for benign nodules, and 1.11 (95% CI, 0.15-3.12) for cysts. The interaction between age at exposure and the dose was significant for the prevalence of all nodules (P = .003) and solid nodules (P atomic bomb survivors 62 to 66 years after their exposure in childhood. However, radiation exposure is not associated with small

  16. The cohort of the atomic bomb survivors major basis of radiation safety regulations

    CERN Document Server

    Rühm, W; Nekolla, E A

    2006-01-01

    Since 1950 about 87 000 A-bomb survivors from Hiroshima and Nagasaki have been monitored within the framework of the Life Span Study, to quantify radiation-induced late effects. In terms of incidence and mortality, a statistically significant excess was found for leukemia and solid tumors. In another major international effort, neutron and gamma radiation doses were estimated, for those survivors (Dosimetry System DS02). Both studies combined allow the deduction of risk coefficients that serve as a basis for international safety regulations. As an example, current results on all solid tumors combined suggest an excess relative risk of 0.47 per Sievert for an attained age of 70 years, for those who were exposed at an age of 30 years. After exposure to an effective dose of one Sievert the solid tumor mortality would thus be about 50% larger than that expected for a similar cohort not exposed to any ionizing radiation from the bombs.

  17. Improved method for analysis of RNA present in long-term preserved thyroid cancer tissue of atomic bomb survivors.

    Science.gov (United States)

    Hamatani, Kiyohiro; Eguchi, Hidetaka; Mukai, Mayumi; Koyama, Kazuaki; Taga, Masataka; Ito, Reiko; Hayashi, Yuzo; Nakachi, Kei

    2010-01-01

    Since many thyroid cancer tissue samples from atomic bomb (A-bomb) survivors have been preserved for several decades as unbuffered formalin-fixed, paraffin-embedded specimens, molecular oncological analysis of such archival specimens is indispensable for clarifying the mechanisms of thyroid carcinogenesis in A-bomb survivors. Although RET gene rearrangements are the most important targets, it is a difficult task to examine all of the 13 known types of RET gene rearrangements with the use of the limited quantity of RNA that has been extracted from invaluable paraffin-embedded tissue specimens of A-bomb survivors. In this study, we established an improved 5' rapid amplification of cDNA ends (RACE) method using a small amount of RNA extracted from archival thyroid cancer tissue specimens. Three archival thyroid cancer tissue specimens from three different patients were used as in-house controls to determine the conditions for an improved switching mechanism at 5' end of RNA transcript (SMART) RACE method; one tissue specimen with RET/PTC1 rearrangement and one with RET/PTC3 rearrangement were used as positive samples. One other specimen, used as a negative sample, revealed no detectable expression of the RET gene tyrosine kinase domain. We established a 5' RACE method using an amount of RNA as small as 10 ng extracted from long-term preserved, unbuffered formalin-fixed, paraffin-embedded thyroid cancer tissue by application of SMART technology. This improved SMART RACE method not only identified common RET gene rearrangements, but also isolated a clone containing a 93-bp insert of rare RTE/PTC8 in RNA extracted from formalin-fixed, paraffin-embedded thyroid cancer specimens from one A-bomb survivor who had been exposed to a high radiation dose. In addition, in the papillary thyroid cancer of another high-dose A-bomb survivor, this method detected one novel type of RET gene rearrangement whose partner gene is acyl coenzyme A binding domain 5, located on chromosome 10p

  18. Age at exposure and attained age variations of cancer risk in the Japanese A-bomb and radiotherapy cohorts

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Uwe, E-mail: uwe.schneider@uzh.ch [Institute of Physics, Science Faculty, University of Zürich, Zürich 8057, Switzerland and Radiotherapy Hirslanden, Uwe Schneider Institute of Radiotherapy, Witellikerstr. 40, Zürich 8032 (Switzerland); Walsh, Linda [Institute of Physics, Science Faculty, University of Zürich, Zürich 8057, Switzerland and BfS - Federal Office for Radiation Protection, Radiation Protection and Health, Neuherberg 85764 (Germany)

    2015-08-15

    Purpose: Phenomenological risk models for radiation-induced cancer are frequently applied to estimate the risk of radiation-induced cancers at radiotherapy doses. Such models often include the effect modification, of the main risk to radiation dose response, by age at exposure and attained age. The aim of this paper is to compare the patterns in risk effect modification by age, between models obtained from the Japanese atomic-bomb (A-bomb) survivor data and models for cancer risks previously reported for radiotherapy patients. Patterns in risk effect modification by age from the epidemiological studies of radiotherapy patients were also used to refine and extend the risk effect modification by age obtained from the A-bomb survivor data, so that more universal models can be presented here. Methods: Simple log-linear and power functions of age for the risk effect modification applied in models of the A-bomb survivor data are compared to risks from epidemiological studies of second cancers after radiotherapy. These functions of age were also refined and fitted to radiotherapy risks. The resulting age models provide a refined and extended functional dependence of risk with age at exposure and attained age especially beyond 40 and 65 yr, respectively, and provide a better representation than the currently available simple age functions. Results: It was found that the A-bomb models predict risk similarly to the outcomes of testicular cancer survivors. The survivors of Hodgkin’s disease show steeper variations of risk with both age at exposure and attained age. The extended models predict solid cancer risk increase as a function of age at exposure beyond 40 yr and the risk decrease as a function of attained age beyond 65 yr better than the simple models. Conclusions: The standard functions for risk effect modification by age, based on the A-bomb survivor data, predict second cancer risk in radiotherapy patients for ages at exposure prior to 40 yr and attained ages

  19. Rearranged anaplastic lymphoma kinase (ALK) gene found for the first time in adult-onset papillary thyroid cancer cases among atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Hamatani, K.; Mukai, M.; Takahashi, K.; Nakachi, K.; Kusunoki, Y. [Radiobiology/Molecular Epidemiology, Radiation Effects Research Foundation, Hiroshima (Japan); Hayashi, Y. [Geriatric Health Service Facility Hidamari, Hiroshima (Japan)

    2012-07-01

    Full text of the publication follows: Thyroid cancer is one of the malignancies most strongly associated with ionizing radiation in humans. Epidemiology studies of atomic bomb (A-bomb) survivors have indicated that excess relative risk of papillary thyroid cancer per Gy was remarkably high in the survivors. We therefore aim to clarify mechanisms linking A-bomb radiation exposure and development of papillary thyroid cancer. Toward this end, we intend to clarify characteristics of gene alterations occurring in radiation-associated adult-onset papillary thyroid cancer from the Life Span Study cohort of A-bomb survivors. We have thus far found that with increased radiation dose, papillary thyroid cancer cases with chromosomal rearrangements (mainly RET/PTC rearrangements) significantly increased and papillary thyroid cancer cases with point mutations (mainly BRAF-V600E) significantly decreased. Papillary thyroid cancer cases with non-detected gene alterations that carried no mutations in RET, NTRK1, BRAF or RAS genes tended to increase with increased radiation dose. In addition, we found that relative frequency of these papillary thyroid cancer cases significantly decreased with time elapsed since exposure. Through analysis of papillary thyroid cancer cases with non-detected gene alterations, we recently discovered a new type of rearrangement for the first time in papillary thyroid cancer, i.e., rearranged anaplastic lymphoma kinase (ALK) gene, although identification of any partner gene(s) is needed. Specifically, rearrangement of ALK was found in 10 of 19 exposed papillary thyroid cancer cases with non-detected gene alterations but not in any of the six non-exposed papillary thyroid cancer cases. Furthermore, papillary thyroid cancer with ALK rearrangement was frequently found in the cases with high radiation dose or with short time elapsed since A-bomb exposure. These results suggest that chromosomal rearrangement, typically of RET and ALK, may play an important

  20. Radiation risk of individual multifactorial diseases in offspring of the atomic-bomb survivors: a clinical health study.

    Science.gov (United States)

    Tatsukawa, Yoshimi; Cologne, John B; Hsu, Wan-Ling; Yamada, Michiko; Ohishi, Waka; Hida, Ayumi; Furukawa, Kyoji; Takahashi, Norio; Nakamura, Nori; Suyama, Akihiko; Ozasa, Kotaro; Akahoshi, Masazumi; Fujiwara, Saeko; Shore, Roy

    2013-06-01

    There is no convincing evidence regarding radiation-induced heritable risks of adult-onset multifactorial diseases in humans, although it is important from the standpoint of protection and management of populations exposed to radiation. The objective of the present study was to examine whether parental exposure to atomic-bomb (A-bomb) radiation led to an increased risk of common polygenic, multifactorial diseases-hypertension, hypercholesterolaemia, diabetes mellitus, angina pectoris, myocardial infarction or stroke-in the first-generation (F1) offspring of A-bomb survivors. A total of 11,951 F1 offspring of survivors in Hiroshima or Nagasaki, conceived after the bombing, underwent health examinations to assess disease prevalence. We found no evidence that paternal or maternal A-bomb radiation dose, or the sum of their doses, was associated with an increased risk of any multifactorial diseases in either male or female offspring. None of the 18 radiation dose-response slopes, adjusted for other risk factors for the diseases, was statistically significantly elevated. However, the study population is still in mid-life (mean age 48.6 years), and will express much of its multifactorial disease incidence in the future, so ongoing longitudinal follow-up will provide increasingly informative risk estimates regarding hereditary genetic effects for incidence of adult-onset multifactorial disease.

  1. Relationship between spontaneous γH2AX foci formation and progenitor functions in circulating hematopoietic stem and progenitor cells among atomic-bomb survivors

    Science.gov (United States)

    Kajimura, Junko; Kyoizumi, Seishi; Kubo, Yoshiko; Misumi, Munechika; Yoshida, Kengo; Hayashi, Tomonori; Imai, Kazue; Ohishi, Waka; Nakachi, Kei; Weng, Nan-ping; Young, Lauren F.; Shieh, Jae-Hung; Moore, Malcolm A.; van den Brink, Marcel R.M.; Kusunoki, Yoichiro

    2016-01-01

    Accumulated DNA damage in hematopoietic stem cells is a primary mechanism of aging-associated dysfunction in human hematopoiesis. About 70 years ago, atomic-bomb (A-bomb) radiation induced DNA damage and functional decreases in the hematopoietic system of A-bomb survivors in a radiation dose-dependent manner. The peripheral blood cell populations then recovered to a normal range, but accompanying cells derived from hematopoietic stem cells still remain that bear molecular changes possibly caused by past radiation exposure and aging. In the present study, we evaluated radiation-related changes in the frequency of phosphorylated (Ser-139) H2AX (γH2AX) foci formation in circulating CD34-positive/lineage marker-negative (CD34 + Lin−) hematopoietic stem and progenitor cells (HSPCs) among 226Hiroshima A-bomb survivors. An association between the frequency of γH2AX foci formation in HSPCs and the radiation dose was observed, but the γH2AX foci frequency was not significantly elevated by past radiation. We found a negative correlation between the frequency of γH2AX foci formation and the length of granulocyte telomeres. A negative interaction effect between the radiation dose and the frequency of γH2AX foci was suggested in a proportion of a subset of HSPCs as assessed by the cobblestone area-forming cell assay (CAFC), indicating that the self-renewability of HSPCs may decrease in survivors who were exposed to a higher radiation dose and who had more DNA damage in their HSPCs. Thus, although many years after radiation exposure and with advancing age, the effect of DNA damage on the self-renewability of HSPCs may be modified by A-bomb radiation exposure. PMID:27169377

  2. Relationship between spontaneous γH2AX foci formation and progenitor functions in circulating hematopoietic stem and progenitor cells among atomic-bomb survivors.

    Science.gov (United States)

    Kajimura, Junko; Kyoizumi, Seishi; Kubo, Yoshiko; Misumi, Munechika; Yoshida, Kengo; Hayashi, Tomonori; Imai, Kazue; Ohishi, Waka; Nakachi, Kei; Weng, Nan-Ping; Young, Lauren F; Shieh, Jae-Hung; Moore, Malcolm A; van den Brink, Marcel R M; Kusunoki, Yoichiro

    2016-05-01

    Accumulated DNA damage in hematopoietic stem cells is a primary mechanism of aging-associated dysfunction in human hematopoiesis. About 70 years ago, atomic-bomb (A-bomb) radiation induced DNA damage and functional decreases in the hematopoietic system of A-bomb survivors in a radiation dose-dependent manner. The peripheral blood cell populations then recovered to a normal range, but accompanying cells derived from hematopoietic stem cells still remain that bear molecular changes possibly caused by past radiation exposure and aging. In the present study, we evaluated radiation-related changes in the frequency of phosphorylated (Ser-139) H2AX (γH2AX) foci formation in circulating CD34-positive/lineage marker-negative (CD34+Lin-) hematopoietic stem and progenitor cells (HSPCs) among 226Hiroshima A-bomb survivors. An association between the frequency of γH2AX foci formation in HSPCs and the radiation dose was observed, but the γH2AX foci frequency was not significantly elevated by past radiation. We found a negative correlation between the frequency of γH2AX foci formation and the length of granulocyte telomeres. A negative interaction effect between the radiation dose and the frequency of γH2AX foci was suggested in a proportion of a subset of HSPCs as assessed by the cobblestone area-forming cell assay (CAFC), indicating that the self-renewability of HSPCs may decrease in survivors who were exposed to a higher radiation dose and who had more DNA damage in their HSPCs. Thus, although many years after radiation exposure and with advancing age, the effect of DNA damage on the self-renewability of HSPCs may be modified by A-bomb radiation exposure. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Report on the results of the twelfth medical examination of atomic bomb survivors residing in North America

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasuji [Hiroshima Prefectural Medical Association (Japan); Ohama, Koso; Fujiwara, Saeko (and others)

    2000-06-01

    The twelfth medical examination of atomic bomb survivors residing in North America, was conducted in San Francisco and Seattle from May 20 through June 2 1999, and in Los Angeles and Hawaii from June 9 through 23 1999, The examination included an interview, measurement of height, weight, and blood pressure, an ECG, urine and stool tests, blood tests, a physical examination, examination of the breast, thyroid, and rectum by a surgeon, and screening for uterine cancer and a gynecological interview and examination by an obstetrician and gynecologist. The total confirmed number of A-bomb survivors residing in North America as of the end of June 1999 was 1076. Of the 1062 survivors that remained after excluding the 14 subjects whose survey was incomplete, 279 males and 654 females had been exposed in Hiroshima, and 10 males and 119 females in Nagasaki. The peak age at the time of exposure in both sexes was 15-19 years, followed by 10-14 years. The number of survivors exposed <2000 m from the hypocenter was 236, accounting for 21.9% of the total. The confirmed number of survivors exposed in utero was 26. The survivors' age (mean {+-}S.D.) was: 69.0{+-}8.69 years; males, 68.4{+-}80.5 years; females, 69.2{+-}8.91 years. A total of 414 survivors were examined (male 129; female 285; mean age 68.0 years). Approximately 80% of the examinees had experienced at least one general symptom. Many still complain of symptoms that suggest possible posttraumatic stress disorder as a result of exposure to the A-bomb. It will be necessary to consider providing mental health care by psychiatrists beginning with the next examination. The prevalence of life-style diseases has been gradually increased with age. A previous history of cancer was found in 9.2% of the examinees. The most prevalent was of breast cancer, followed by malignant tumors of the colon, rectum, uterus, brain, stomach, and thyroid. The need for cancer screening and promotion of life-style education was keenly felt. (K.H.)

  4. A lifelong journey of moving beyond wartime trauma for survivors from Hiroshima and Pearl Harbor.

    Science.gov (United States)

    Liehr, Patricia; Nishimura, Chie; Ito, Mio; Wands, Lisa Marie; Takahashi, Ryutaro

    2011-01-01

    This study examines 51 stories of health, shared by people who survived the wartime trauma of Hiroshima and Pearl Harbor, seeking to identify turning points that moved participants along over their lifetime. The central turning point for Hiroshima survivors was "becoming Hibabusha (A-bomb survivor)" and for Pearl Harbor survivors was "honoring the memory and setting it aside." Wartime trauma was permanently integrated into survivors' histories, surfacing steadily over decades for Hiroshima survivors and intermittently over decades for Pearl Harbor survivors. Regardless of experience or nationality, participants moved through wartime trauma by connecting with others, pursuing personal and global peace.

  5. Prevalence of cerebral small-vessel disease in long-term breast cancer survivors exposed to both adjuvant radiotherapy and chemotherapy.

    Science.gov (United States)

    Koppelmans, Vincent; Vernooij, Meike W; Boogerd, Willem; Seynaeve, Caroline; Ikram, M Arfan; Breteler, Monique M B; Schagen, Sanne B

    2015-02-20

    Adjuvant radiotherapy and chemotherapy for breast cancer have been related to transient ischemic attacks and stroke. To date, no studies have investigated the relationship between these adjuvant therapies and subclinical cerebral small-vessel disease in survivors of breast cancer. We compared white matter lesion (WML) volume and prevalence of brain infarctions and cerebral microbleeds (CMBs) between breast cancer survivors exposed to adjuvant radiotherapy and chemotherapy (aRCeBCSs) for primary disease and a population-based reference group. Multimodal magnetic resonance imaging (1.5 T) was performed in 187 aRCeBCSs who received primary breast cancer treatment on average more than 20 years before this study and 374 age-matched reference women without a history of cancer. WML volume was segmented using fully automated software. Experienced raters reviewed all scans for cortical infarctions, lacunar infarctions, strictly lobar CMBs, and deep/infratentorial CMBs with or without lobar CMBs. Within the aRCeBCS group, we also analyzed the association between relative radiotherapy exposure to the carotid artery and prevalence of WML volume and CMBs. The aRCeBCS group had a higher prevalence of both total CMBs and CMBs in a deep/infratentorial region than the reference group. No between-group differences were observed in the prevalence of infarctions or WML volume. Exposure of the carotid artery to radiation was not associated with WML volume or CMBs. More CMBs were found in the aRCeBCS group than in the population-based controls. These vascular lesions potentially mark cerebrovascular frailty that could partially explain the well-documented association between chemotherapy and cognitive dysfunction. No support was found for a radiotherapy-related origin of CMBs. © 2015 by American Society of Clinical Oncology.

  6. Report on results of third medical examination of Atomic Bomb Survivors residing in the U. S

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, H. (Hiroshima Prefectural Medical Association (Japan)); Yamakido, M.; Ito, C.; Yamada, H.

    1982-01-01

    The number of survivors actually registered with the Committee of A-bomb survivors in the U.S. is 491 (133 males and 358 females) of whom 57.3% are U.S. citizens. Those exposed in Hiroshima accounted for 91.8%. The mean age was 53.3 +- 8.9, thus they were more than 3 years younger than their counterparts in Hiroshima. Responses to the Health Survey Questionnaires numbered 255, and those with symptoms which appeared to be related to diseases were found at a high rate among the early entrants, but as the number of those receiving examination in this group was few, it is considered that many of those in poor health had come in for the examination. No association could be demonstrated between psychological complaints and exposure status. Those who underwent health examination numbered 166 (45 males and 121 females), and comparison of the U.S. survivors against the Hiroshima survivors showed there to be a difference in the following points. The prevalence of hypertension was lower among the U.S. survivors, but RBC counts and hemoglobin values were significantly higher. The same was observed for blood lipids with hypercholesterolemia and hypertriglyceridemia being found at a significantly higher rate in the U.S. survivors, the cause being considered to be the larger intake of animal fat and sugar by those of Japanese ancestry than the indigenous Japanese. Those free of clinical abnormalities in this survey were 37.3%, and the rest required dietary guidance, follow-up observation, detailed examination or treatment. Those with diseases which are considered would make them eligible for health management allowance if in Japan, accounted for 18.7%.

  7. Report on the results of the tenth medical examination of atomic bomb survivors resident in North America

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Jun [Hiroshima Prefectural Medical Association (Japan); Ohta, Nobuhiro; Sasaki, Hideo [and others

    1996-01-01

    The 10th medical examination of A-bomb survivors resident in North America was conducted from 6 June to 6 July 1995 in L.A., S.F., Seattle, Wailuku, and Honolulu. Since this is the 10th medical examination, results of the previous examination are summarized. With the exclusion of 55 whose death has been confirmed, the total registered number of A-bomb survivors resident in North America is 1,043. The examinees in the present examination amounted to 463 (48 of them are the children of A-bomb survivors), 26 of whom are newly registered survivors. The mean age of the examinees in 64 years. The proportion of those having US nationality gradually increased and reached 62% at the time of the 10th examination, while that of those who have Japanese nationality and permanent US residency rights decreased to 30%. When the examination program was initiated, A-bomb survivors resident in 15 states of the US, but now, in Canada and 31 states of the US. About 90% of these survivors reside along the west coast of the US including Hawaii. The number of holders of A-bomb survivor`s health handbook has increased year after year, reaching 612. When the holders in North-America visit Japan for medical treatment, they are treated similarly with their counterparts in Japan. The major subjective symptoms are complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness or tingling. The prevalence of obesity, hypertension, and diabetes mellitus and the proportion of abnormal ECG findings has been increasing with the age. The prevalence of hypercholesterolemia was high and that of low HDL cholesterolemia was low. A significant difference was observed between the A-bomb survivors in Hiroshima and North America. Hypertension, hyperlipidemia, obesity, ischemic heart disease, and diabetes mellitus were observed mainly. Diseased of specific places were not observed. (H.O.).

  8. A comparison of clinicopathological features and prognosis in prostate cancer between atomic bomb survivors and control patients.

    Science.gov (United States)

    Shoji, Koichi; Teishima, Jun; Hayashi, Tetsutaro; Shinmei, Shunsuke; Akita, Tomoyuki; Sentani, Kazuhiro; Takeshima, Yukio; Arihiro, Koji; Tanaka, Junko; Yasui, Wataru; Matsubara, Akio

    2017-07-01

    An atomic bomb (A-bomb) was dropped on Hiroshima on 6th August 1945. Although numerous studies have investigated cancer incidence and mortality among A-bomb survivors, only a small number have addressed urological cancer in these survivors. The aim of the present study was to investigate the clinicopathological features of prostate cancer (PCa) in A-bomb survivors. The clinicopathological features and prognosis of PCa were retrospectively reviewed in 212 survivors and 595 control patients between November 1996 and December 2010. The histopathological and clinical outcomes of surgical treatment of PCa were also evaluated in 69 survivors and 162 control patients. Despite the higher age at diagnosis compared with the control group (P=0.0031), survivors were more likely to have been diagnosed with PCa from a health check compared with the control group (Pbomb exposure was not found to be an independent predictor for prognosis by multivariate analysis (OS, P=0.7800; CS, P=0.8688). The clinicopathological features of patients who underwent a prostatectomy were similar except for the diagnosis opportunity between the two groups. Progression-free survival rates were similar between the two groups (P=0.5630). A-bomb exposure was not a significant and independent predictor for worsening of progression-free prognosis by multivariate analysis (P=0.3763). A-bomb exposure does not appear to exert deleterious effects on the biological aggressiveness of PCa and the prognosis of patients with PCa.

  9. Details of Nazis' A-Bomb program surface

    CERN Multimedia

    Glanz, J

    2002-01-01

    Werner Heisenberg, leader of the Nazi atomic bomb program, revealed the projects existence to Niels Bohr in a meeting in Copenhagen in 1941. But contrary to several historical accounts of the meeting, Heisenberg never expressed moral qualms about building a bomb for Hitler nor hinted that he might be willing to sabotage the project, according to secret documents cited in a London newspaper yesterday (2 pages).

  10. Foreign bodies radiographically-demonstrated in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, S.; Onitsuka, H.; Lee, K.; Shimizu, Y.; Russell, W.J.

    1978-08-25

    The prevalence of roentgenologically-detected foreign bodies among atomic bomb (A-bomb) survivors was studied as an indicator of the A-bomb blast effects. Acupuncture was studied as an indicator of A-bomb-related abnormalities for which it was administered. All Adult Health Study subjects' roentgenograms demonstrating foreign bodies were reviewed. The frequency of glass and metal, and acupuncture needles were analyzed by distance from hypocenters, sex, age, body sites involved; and the subjects' shielding at the times of the A-bombs. The presence of glass fragments correlated closely with distance from hypocenter, heavy shielding from the A-bombs, and with adulthood, and they were more frequent in the chest than hand and wrist. Metal foreign bodies were more frequent in the hand and wrist than in the chest, and not associated with distance from hypocenter or heavy shielding. The prevalence of acupuncture needles increased with age, but did not correlate with A-bomb dose.

  11. Accounting for neutron exposure in the Japanese atomic bomb survivors.

    Science.gov (United States)

    Cullings, Harry M; Pierce, Donald A; Kellerer, Albrecht M

    2014-12-01

    The Japanese atomic bomb survivors that were directly exposed to both γ rays and neutrons have been followed by the Radiation Effects Research Foundation (RERF). The estimation of the γ-ray risks requires some adjustment for the greater biological effect of the neutrons per unit dose. Because the small neutron doses and the predominant γ-ray doses are highly correlated, the neutron relative biological effectiveness (RBE) cannot be reliably estimated from the survivors' data and information from radiobiology must be invoked. As data became available on neutron doses, RERF has used a constant neutron RBE value of 10, even though radiobiological studies indicate that the RBE values appear to have considerably larger values at low doses. The approximation RBE = 10 assumes that if the RBE is variable it takes roughly this value in the range of total dose most relevant for linear risk estimation, namely about 1 Gy. We consider some possible RBE functions to explain the correct use and the impact of a dose-dependent RBE. However, we do not advocate any particular choice or even that a variable RBE be employed. Rather we show that the assumed neutron RBE, within a wide range of choices, is far less important to the outcome of risk assessment of the RERF data than generally believed. Some of these misperceptions have been related to the consideration of variable RBE functions, and without due attention to the fact that in the case of the A-bomb survivors' data, the mixed field of neutrons and γ rays must be considered. Therefore, the RBE value of neutrons is much lower than the RBE in pure neutron fields that are used in radiobiological experiments. Thus, applying the pure neutron field RBE to the mixed-field A-bomb radiation can lead to an overestimation of the actual neutron RBE for moderate total dose levels of 1 Gy by a factor of more than four. While in a pure neutron exposure the RBE depends on the neutron dose, in the mixed field it depends on both components of

  12. Neutron spectrum and yield of the Hiroshima A-bomb deduced from radionuclide measurements at one location.

    Science.gov (United States)

    Rühm, W; Kato, K; Korschinek, G; Morinaga, H; Nolte, E

    1995-07-01

    In this paper measurements of the radionuclides of 36Cl, 41Ca, 60Co, 152Eu and 154Eu in samples from Hiroshima, which were exposed to neutrons of the A-bomb explosion, are interpreted. In order to calculate the neutron spectrum at the sample site, neutron transport calculations using Monte Carlo techniques were carried out. Activation profiles in a granite mock-up irradiated with reactor neutrons could be reproduced by this method using DS86 input parameters. The calculated neutron spectrum at the sample site for non-thermal neutrons is identical to that obtained in DS86, but contains some 50% more thermal neutrons. The influence of parameters like soil composition, source terms and air humidity on the activation of these radioisotopes is discussed. The granite-covered earth at the sample site, for example, hardens the spectrum in comparison with DS86 values. Even when using a fission spectrum pointing downward and neglecting air humidity one cannot explain our 36Cl measurements. If the effective thermal neutron fluences, that have a similar ratio of resonance integral to thermal neutron capture cross sections obtained from 36Cl, 41Ca and 152Eu, are averaged, a bomb yield of about 16 kt is deduced in agreement with a bomb yield of (15 +/- 3) kt estimated in DS86.

  13. Site-specific dose-response relationships for cancer induction from the combined Japanese A-bomb and Hodgkin cohorts for doses relevant to radiotherapy

    Directory of Open Access Journals (Sweden)

    Sumila Marcin

    2011-07-01

    Full Text Available Abstract Background and Purpose Most information on the dose-response of radiation-induced cancer is derived from data on the A-bomb survivors. Since, for radiation protection purposes, the dose span of main interest is between zero and one Gy, the analysis of the A-bomb survivors is usually focused on this range. However, estimates of cancer risk for doses larger than one Gy are becoming more important for radiotherapy patients. Therefore in this work, emphasis is placed on doses relevant for radiotherapy with respect to radiation induced solid cancer. Materials and methods For various organs and tissues the analysis of cancer induction was extended by an attempted combination of the linear-no-threshold model from the A-bomb survivors in the low dose range and the cancer risk data of patients receiving radiotherapy for Hodgkin's disease in the high dose range. The data were fitted using organ equivalent dose (OED calculated for a group of different dose-response models including a linear model, a model including fractionation, a bell-shaped model and a plateau-dose-response relationship. Results The quality of the applied fits shows that the linear model fits best colon, cervix and skin. All other organs are best fitted by the model including fractionation indicating that the repopulation/repair ability of tissue is neither 0 nor 100% but somewhere in between. Bone and soft tissue sarcoma were fitted well by all the models. In the low dose range beyond 1 Gy sarcoma risk is negligible. For increasing dose, sarcoma risk increases rapidly and reaches a plateau at around 30 Gy. Conclusions In this work OED for various organs was calculated for a linear, a bell-shaped, a plateau and a mixture between a bell-shaped and plateau dose-response relationship for typical treatment plans of Hodgkin's disease patients. The model parameters (α and R were obtained by a fit of the dose-response relationships to these OED data and to the A-bomb survivors. For

  14. Report on the results of the eleventh medical examination of atomic bomb survivors resident in North America

    Energy Technology Data Exchange (ETDEWEB)

    Yamakido, Michio [Hiroshima Univ. (Japan). School of Medicine; Dohy, Hiroo; Neriishi, Kazuo [and others

    1998-01-01

    The 11th medical examination of A-bomb survivors was conducted in 1997. Two medical teams conducted health examinations in Los Angeles and Seattle, and in San Francisco and Hawaii, respectively. The total number of A-bomb survivors resident in North America as of the end of July 1997 was 1,060, an increase of 17 over that confirmed in 1995. The number of survivors exposed <2,000-m from the hypocenter was 234, accounting for 22.1% of the total. The confirmed number of in-utero exposed survivors was 26. As to the past medical history information, breast cancer, thyroid cancer, and heart disease were frequently observed in the <2,000-m group. Frequent subjective symptoms include complete exhaustion or fatigue, loss of vigor, blurring of vision, itching of the skin, which were reported in more than 40% of the survivors. The frequencies of nocturia, nervousness, severe headache, and excessive sweating in cold weather were higher in the <2,000-m group. Chest pain was seen frequently in the <2,000-m group for males, but no difference was observed in females. Nocturia was observed in more than half of the males in the <2,000-m group. There were 99 cases (22.8%) with fasting plasma glucose level of 110 mg/dl or above, consisting of 39 males (32.0%) and 60 females (19.2%). Abnormal HbA1c levels were observed in 33 cases (7.6%), including 12 males (9.8%) and 11 females (6.7%). The proportion of cases with abnormal HbA1c levels was higher in males. No difference by exposure status was observed either for fasting plasma glucose or HbA1c. The disease of the highest prevalence was hyperlipidemia (57.4%), followed by hypertension (35.0%), obesity (27.2%), liver disease (21.9%), thyroid disease (20.0%), gastrointestinal disease (20.7%), heart disease (13.4%) and urological disease (12.9%). Malignant tumors were observed in two cases in L.A., two in Seattle, and one in S.F. Cancer will be important issue in the future examinations. (K.H.)

  15. Long-term follow-up of atomic bomb survivors.

    Science.gov (United States)

    Sakata, Ritsu; Grant, Eric J; Ozasa, Kotaro

    2012-06-01

    The Life Span Study (LSS) is a follow-up study of atomic bomb (A-bomb) survivors to investigate the radiation effects on human health and has collected data for over 60 years. The LSS cohort consists of 93,741 A-bomb survivors and another 26,580 age and sex-matched subjects who were not in either city at the time of the bombing. Radiation doses have been computed based on individual location and shielding status at the time of the bombings. Age at death and cause of death are gathered through the Japanese national family registry system and cancer incidence data have been collected through the Hiroshima and Nagasaki cancer registries. Noncancer disease incidence and health information are collected through biannual medical examinations among a subset of the LSS. Radiation significantly increases the risks of death (22% at 1 Gy), cancer incidence (47% at 1 Gy), death due to leukemia (310% at 1 Gy), as well as the incidence of several noncancer diseases (e.g. thyroid nodules, chronic liver disease and cirrhosis, uterine myoma, and hypertension). Significant effects on maturity (e.g. growth reduction and early menopause) were also observed. Long-term follow-up studies of the A-bomb survivors have provided reliable information on health risks for the survivors and form the basis for radiation protection standards for workers and the public. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Glaucoma in atomic bomb survivors.

    Science.gov (United States)

    Kiuchi, Yoshiaki; Yokoyama, Tomoko; Takamatsu, Michiya; Tsuiki, Eiko; Uematsu, Masafumi; Kinoshita, Hirofumi; Kumagami, Takeshi; Kitaoka, Takashi; Minamoto, Atsushi; Neriishi, Kazuo; Nakashima, Eiji; Khattree, Ravindra; Hida, Ayumi; Fujiwara, Saeko; Akahoshi, Masazumi

    2013-10-01

    Radiation has been associated with increases in noncancerous diseases. An effect of low-dose radiation on the prevalence of clinically detected glaucoma has not been previously reported. We therefore investigated the prevalence of glaucoma in A-bomb survivors and its possible association with radiation dose. A total of 1,589 people who participated in the clinical examination program for A-bomb survivors at the Radiation Effects Research Foundation (RERF) between October 2006 and September 2008 and who had reconstructed radiation doses, were recruited into this cross-sectional screening study. The prevalence of glaucoma and its dose-response relationship to A-bomb radiation were measured. Each subject underwent an initial screening consisting of an interview and ophthalmological examination. Questionable cases with any indication of ocular disease, including glaucoma, were referred to local hospitals for more comprehensive evaluation. A diagnosis of glaucoma was made based on specific optic disc appearance, perimetric results and other ocular findings. Of 1,589 eligible people, we detected 284 (17.9%) cases of glaucoma overall, including 36 (2.3%) cases of primary open-angle glaucoma with intraocular pressure levels greater than 21 mmHg, 226 (14.2%) cases of normal-tension glaucoma and 25 (1.6%) cases of primary angle-closure glaucoma. Seven glaucoma risk factors were examined as potential confounders but only two needed to be included in the final model. Binary regression using a generalized estimating equation method, with adjustment for gender, age, city, cataract surgery or diabetes mellitus, revealed an odds ratio at 1 Gy of 1.31 (95% confidence interval 1.11-1.53, P = 0.001) in the case of normal-tension glaucoma, but no association for other types of glaucoma. The prevalence of normal-tension glaucoma may increase with A-bomb radiation dose, but uncertainties associated with nonparticipation (59% participation) suggest caution in the interpretation of these

  17. The association between chronic kidney disease and cardiovascular disease risk factors in atomic bomb survivors.

    Science.gov (United States)

    Sera, Nobuko; Hida, Ayumi; Imaizumi, Misa; Nakashima, Eiji; Akahoshi, Masazumi

    2013-01-01

    Atomic bomb (A-bomb) radiation is associated with cardiovascular disease (CVD) and metabolic CVD risk factors. Chronic kidney disease (CKD) is also known to be a risk factor for CVD and little is known whether CKD is associated with A-bomb radiation. To examine whether CKD is associated with CVD risk factors or with A-bomb radiation in A-bomb survivors, we classified renal dysfunction in 1,040 A-bomb survivors who were examined in 2004-2007 as normal [n = 121; estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m(2)]; mild (n = 686; eGFR 60-89 ml/min/1.73 m(2)); moderate (n = 217; eGFR 30-59 ml/min/1.73 m(2)); or severe (n = 16; eGFR bomb radiation. Hypertension [odds ratio (OR), 1.57; 95% confidence interval (CI), 1.12-2.20, P = 0.009]; DM (OR, 1.79; 95% CI, 1.23-2.61, P = 0.002); hyperlipidemia (OR, 1.55; 95% CI, 1.12-2.14, P = 0.008); and MetS (OR, 1.86; 95% CI, 1.32-2.63, P bomb survivors.

  18. Foreign bodies radiographically demonstrated in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, S.; Onitsuka, H.; Lee, K.K.; Shimizu, Y.; Russell, W.J.

    1978-02-01

    The prevalence of roentgenologically-detected foregin bodies among atomic bomb survivors was studied as an indicator of the A-bomb blast effects. Acupuncture was studied as an indicator of possible A-bomb-related abnormalities for which it was administered. All available roentgenograms of Adult Health Study (AHS) subjects which demonstrated foreign bodies were reviewed. The frequency of glass and metal foreign bodies and of acupuncture needles was analyzed in detail. Analyses were made by distance from the hypocenter, sex, age, body sites involved, and shielding at the time of the A-bomb (ATB). The presence of glass fragments correlated closely with distance from the hypocenter, with heavy shielding from the A-bombs, and with adulthood, and they were more frequent in the chest than in the hand and wrist. On the contrary, metal foreign bodies were more frequent in the hand and wrist than in the chest, and were not associated with distance from hypocenter or heavy shielding. The prevalence of acupuncture needles increased with age, but did not correlate with A-bomb dose.

  19. Report on the results of the sixth medical examination of atomic bomb survivors resident in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Hiroaki [Hiroshima Univ. (Japan). School of Medicine; Hirata, Katsumi; Taguchi, Atsushi; Sakamoto, Fumio; Nawachi, Sadahiro; Terada, Kensaku

    1995-11-01

    The medical examination of A-bomb survivors was carried out in Brazil, Argentina, Bolivia, Republic of Peru, and Paraguay from October 25th to November 11th 1994. The survivors were 191 persons, and 98 (51.3%) of them received health consultation. Sixty-two persons were exposured in Hiroshima and 36 in Nagasaki. Average age of the medical examinee was 65.0{+-}8.5-year-old. The holding rate of A-bomb survivor`s handbook was 55.1%. The lowered physical vitality and the involution of the mental vitality with increased age were observed from interview sheets. This first orthopedic examination revealed abnormal findings in 12 persons. Sixty-five persons required further examinations. Cardiovascular risk factors of such as hypertension, obesity, hyperlipidemia and diabetes mellitus were observed. (H.O.).

  20. Significance of HER2 and C-MYC oncogene amplifications in breast cancer in atomic bomb survivors: associations with radiation exposure and histologic grade.

    Science.gov (United States)

    Miura, Shiro; Nakashima, Masahiro; Ito, Masahiro; Kondo, Hisayoshi; Meirmanov, Serik; Hayashi, Tomayoshi; Soda, Midori; Matsuo, Takeshi; Sekine, Ichiro

    2008-05-15

    It has been postulated that radiation induces breast cancers in atomic bomb (A-bomb) survivors. Oncogene amplification is an important mechanism during breast carcinogenesis and also serves as an indicator of genomic instability (GIN). The objective of this study was to clarify the association of oncogene amplification in breast cancer in A-bomb survivors with radiation exposure. In total, 593 breast cancers were identified in A-bomb survivors from 1968 to 1999, and the association between breast cancer incidence and A-bomb radiation exposure was evaluated. Invasive ductal cancers from 67 survivors and 30 nonsurvivors were analyzed for amplification of the HER2 and C-MYC genes by fluorescence in situ hybridization, and expression levels of hormone receptors were analyzed by immunostaining. The incidence rate increased significantly as exposure distance decreased from the hypocenter (hazard ratio per 1-km decrement, 1.47; 95% confidence interval [95% CI], 1.30-1.66). The incidence of HER2 and C-MYC amplification was increased significantly in the order of the control group, the distal group (P = .0238), and the proximal group (P = .0128). Multivariate analyses revealed that distance was a risk factor for the coamplification of C-MYC and HER2 in breast cancer in survivors (odds ratio per 1-km increment, 0.17; 95% CI, 0.01-0.63). The histologic grade of breast cancers became significantly higher in the order of the control group, the distal group, and the proximal group and was associated with oncogene amplifications. The current results suggested that A-bomb radiation may affect the development of oncogene amplification by inducing GIN and may be associated with a higher histologic grade in breast cancer among A-bomb survivors. (c) 2008 American Cancer Society.

  1. Long-lasting alterations of the immune system by ionizing radiation exposure: implications for disease development among atomic bomb survivors.

    Science.gov (United States)

    Kusunoki, Yoichiro; Hayashi, Tomonori

    2008-01-01

    The immune systems of the atomic-bomb (A-bomb) survivors were damaged proportionately to irradiation levels at the time of the bombing over 60 years ago. Although the survivor's immune system repaired and regenerated as the hematopoietic system has recovered, significant residual injury persists, as manifested by abnormalities in lymphoid cell composition and function. This review summarizes the long-lasting alterations in immunological functions associated with atomic-bomb irradiation, and discusses the likelihood that damaging effects of radiation on the immune system may be involved partly in disease development so frequently observed in A-bomb survivors. Significant immunological alterations noted include: (i) attrition of T-cell functions, as reductions in mitogen-dependent proliferation and interleukin-2 (IL-2) production; (ii) decrease in helper T-cell populations; and (iii) increase in blood inflammatory cytokine levels. These findings suggest that A-bomb radiation exposure perturbed one or more of the primary processes responsible for T-cell homeostasis and the balance between cell renewal and survival and cell death among naive and memory T cells. Such perturbed T-cell homeostasis may result in acceleration of immunological aging. Persistent inflammation, linked in some way to the perturbation of T-cell homeostasis, is key in addressing whether such noted immunological changes observed in A-bomb survivors are in fact associated with disease development.

  2. Report on the results of the second medical examination of atomic bomb survivors resident in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Kamitsuna, Akimitsu; Monzen, Tetsuo; Oguma, Nobuo; Sakuma, Saburo; Takata, Yoshiki; Nakashima, Yoshiaki; Sakata, Morimitsu.

    1987-06-01

    In October 9 - 31, 1986, the second medical examination for A-bomb survivors was undertaken in Brazil, Argentina, Paraguay, Bolivia, and Peru. Among 173 recognized A-bomb survivors in the five countries, 126 (73 %) participated in the examination, consisting of 61 men and 65 women. Seventy-eight A-bomb survivors came from Hiroshima and 48 from Nagasaki. The average age was 55.6 +- 9.7 years for men and 56.5 +- 9.8 years for women. The acquisition rate of ''Survivor's Health Handbook'' was 34 %. Gastric cancer was observed in two survivors and cervical cancer in one survivor. Major subjective symptoms were: fatigue, sensation of paralysis, heat intolerance, decreased physical strength, and itching. None of the abnormal findings were observed in 33 %. The incidence of hypertension, obesity, cardiac disease, and liver disease was high. The incidence of hypercholesteremia and diabetes mellitus was lower than that in the USA. (Namekawa, K.).

  3. Cigarette smoking and pulmonary function in adult survivors of childhood cancer exposed to pulmonary-toxic therapy: results from the St. Jude lifetime cohort study.

    Science.gov (United States)

    Oancea, S Cristina; Gurney, James G; Ness, Kirsten K; Ojha, Rohit P; Tyc, Vida L; Klosky, James L; Srivastava, DeoKumar; Stokes, Dennis C; Robison, Leslie L; Hudson, Melissa M; Green, Daniel M

    2014-09-01

    Treatments for childhood cancer can impair pulmonary function. We assessed the potential impact of cigarette smoking on pulmonary function in 433 adult childhood cancer survivors (CCS) who received pulmonary-toxic therapy, using single breath diffusion capacity for carbon monoxide corrected for hemoglobin (DLCOcorr), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and total lung capacity (TLC). FEV1/FVC median values among current [1.00; interquartile range (IQR): 0.94-1.04] and former smokers (0.98; IQR: 0.93-1.04) were lower than those who had never smoked (1.02; IQR: 0.96-1.06; P = 0.003). Median FEV1/FVC values were lower among those who smoked ≥ 6 pack-years (0.99; IQR: 0.92-1.03) and those who smoked <6 pack-years (1.00; IQR: 0.94-1.04), than among those who had never smoked (P = 0.005). Our findings suggest that CCSs have an increased risk for future obstructive and restrictive lung disease. Follow-up is needed to determine whether smoking imparts more than additive risk. Smoking prevention and cessation need to be a priority in this population.

  4. TRANSFERABLE CLASTOGENIC ACTIVITY IN PLASMA FROM PERSONS EXPOSED AS SALVAGE PERSONNEL OF THE CHERNOBYL REACTOR

    NARCIS (Netherlands)

    EMERIT, [No Value; LEVY, A; CERNJAVSKI, L; ARUTYUNYAN, R; OGANESYAN, N; POGOSIAN, A; MEJLUMIAN, H; SARKISIAN, T; GULKANDANIAN, M; QUASTEL, M; GOLDSMITH, J; RIKLIS, E; KORDYSH, E; POLIAK, S; MERKLIN, L

    Clastogenic factors were first described in the plasma of people who had been accidentally or therapeutically irradiated. They were found also in A-bomb survivors, where they persisted for many years after the irradiation. The present study searched for these factors in the plasma of 32 civil

  5. Report on the results of the thirteenth medical examination of atomic bomb survivors resident in north america

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasuji; Ohta, Michiya [Hiroshima Prefectural Medical Association (Japan); Urabe, Takeshi [Hiroshima Prefectural Hospital (Japan)] [and others

    2002-05-01

    The thirteenth medical examination of A-bomb survivors resident in North America was carried out from June 13th through June 27th and from July 12th through July 26th, 2001, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the thirteenth medical examination was 399, 53 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 69.5 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 39.3%. Previous history of malignant tumors was observed in 13.6% of the survivors examined, with major sites being the mammary gland, uterine, and colon. As a result of the blood test, 9.5% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 32.1% of the survivors examined. Latent hypothyroidism was found in 18.5% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  6. A novel RET rearrangement (ACBD5/RET) by pericentric inversion, inv(10)(p12.1;q11.2), in papillary thyroid cancer from an atomic bomb survivor exposed to high-dose radiation.

    Science.gov (United States)

    Hamatani, Kiyohiro; Eguchi, Hidetaka; Koyama, Kazuaki; Mukai, Mayumi; Nakachi, Kei; Kusunoki, Yoichiro

    2014-11-01

    During analysis of RET/PTC rearrangements in papillary thyroid cancer (PTC) among atomic bomb survivors, a cDNA fragment of a novel type of RET rearrangement was identified in a PTC patient exposed to a high radiation dose using the improved 5' RACE method. This gene resulted from the fusion of the 3' portion of RET containing tyrosine kinase domain to the 5' portion of the acyl-coenzyme A binding domain containing 5 (ACBD5) gene, by pericentric inversion inv(10)(p12.1;q11.2); expression of the fusion gene was confirmed by RT-PCR. ACBD5 gene is ubiquitously expressed in various human normal tissues including thyroid. Full-length cDNA of the ACBD5-RET gene was constructed and then examined for tumorigenicity. Enhanced phosphorylation of ERK proteins in the MAPK pathway was observed in NIH3T3 cells transfected with expression vector encoding the full-length ACBD5/RET cDNA, while this was not observed in the cells transfected with empty expression vector. Stable NIH3T3 transfectants with ACBD5-RET cDNA induced tumor formation after their injection into nude mice. These findings suggest that the ACBD5-RET rearrangement is causatively involved in the development of PTC.

  7. Effect of radiation on age at menopause among atomic bomb survivors.

    Science.gov (United States)

    Sakata, Ritsu; Shimizu, Yukiko; Soda, Midori; Yamada, Michiko; Hsu, Wan-Ling; Hayashi, Mikiko; Ozasa, Kotaro

    2011-12-01

    Exposure to ionizing radiation has been thought to induce ovarian failure and premature menopause. Proximally exposed female atomic bomb survivors were reported to experience menopause immediately after the exposure more often than those who were distally exposed. However, it remains unclear whether such effects were caused by physical injury and psychological trauma or by direct effects of radiation on the ovaries. The objective of this study was to see if there are any late health effects associated with the exposure to atomic bomb radiation in terms of age at menopause in a cohort of 21,259 Life Span Study female A-bomb survivors. Excess absolute rates (EAR) of natural and artificial menopause were estimated using Poisson regression. A linear threshold model with a knot at 0.40 Gy [95% confidence interval (CI): 0.13, 0.62] was the best fit for a dose response of natural menopause (EAR at 1 Gy at age of 50 years = 19.4/1,000 person-years, 95% CI: 10.4, 30.8) and a linear threshold model with a knot at 0.22 Gy (95% CI: 0.14, 0.34) was the best fit for artificial menopause (EAR at 1 Gy at age of 50 years for females who were exposed at age of 20 years = 14.5/1,000 person-years, 95% CI: 10.2, 20.1). Effect modification by attained age indicated that EARs peaked around 50 years of age for both natural and artificial menopause. Although effect modification by age at exposure was not significant for natural menopause, the EAR for artificial menopause tended to be larger in females exposed at young ages. On the cumulative incidence curve of natural menopause, the median age at menopause was 0.3 years younger in females exposed to radiation of 1 Gy compared with unexposed females. The median age was 1 year younger for combined natural and artificial menopause in the same comparison. In conclusion, age at menopause was thought to decrease with increasing radiation dose for both natural and artificial menopause occurring at least 5 years after the exposure.

  8. DBA Survivor

    CERN Document Server

    LaRock, Thomas

    2010-01-01

    DBA Survivor is a book to help new DBAs understand more about the world of database administration. More and more people are moving into the DBA profession, and many are looking for a getting-started guide. Blogs are written about how to be an exceptional DBA and what to do in your first 100 days. This book takes a different approach, injecting some humor into helping you understand how to hit the ground running, and most importantly how to survive as a DBA. And it's not just survival that matters. Author Thomas LaRock wants much more for you than mere survival. He wants you to have excellence

  9. Mutations detected in the repetitive sequences in the children of the atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, Chiyoko; Kodaira, Mieko [Radiation Effects Research Foundation, Hiroshima (Japan)

    1994-03-01

    We have been examining genetic effects of radiation in the children of the atomic bomb survivors. In a pilot study, 50 exposed families with 64 children and 50 control families with 60 children were examined for trinucleotide repeat expansion mutations at 3 loci and mutations at 6 minisatellite loci. Average dose of the 51 exposed parents was 1.8 Sv. By examining 124 children of 100 families, 65 germ cells derived from exposed parents and 183 germ cells of non-exposed parents were examined. The trinucleotide repeat expansions in genes of certain human genetic diseases show remarkable variation both within the cells of a single individual and among affected members of a single family which have been interpreted as mitotic and meiotic instability. We examined the regions with triplet repeats in the FMR-1, AR and DM genes causative for fragile X syndrome, spinobulbar muscular atrophy and myotonic dystrophy. No mutations were detected in 177 regions derived from 65 germ cells of exposed parents and 443 regions from 183 germ cells of non-exposed parents. No effects on the instability of the triplet repeats in the germ cells derived from exposed or unexposed individuals were observed. In the examinations of the 6 minisatellite loci of Pc-1, {lambda}TM-18, ChdTC-15, p{lambda}g3, {lambda}MS-1, and CEB-1, we detected single mutations at each of the p{lambda}g3 and {lambda}MS-1, and 4 mutations at the CEB-1 locus which had occurred in the 65 gametes in the exposed parents. Thus, mutation rates per gamete at the p{lambda}g3, {lambda}MS-1 and CEB-1 were 1.5%, 1.5% and 6.2%. On the other hand, mutations in these 3 loci in the 183 gametes of non-exposed parents were 0, 11 and 11, that is, the mutation rates per gamete were 0%, 6.0% and 6.0%. No significant difference was observed in the mutation rate at each of the 3 loci between 2 groups of parents. These preliminary results suggest that A-bomb exposure seems not to affect the germline instability at these 3 loci. (J.P.N).

  10. Rearranged anaplastic lymphoma kinase (ALK) gene in adult-onset papillary thyroid cancer amongst atomic bomb survivors.

    Science.gov (United States)

    Hamatani, Kiyohiro; Mukai, Mayumi; Takahashi, Keiko; Hayashi, Yuzo; Nakachi, Kei; Kusunoki, Yoichiro

    2012-11-01

    We previously noted that among atomic bomb survivors (ABS), the relative frequency of cases of adult papillary thyroid cancer (PTC) with chromosomal rearrangements (mainly RET/PTC) was significantly greater in those with relatively higher radiation exposure than those with lower radiation exposure. In contrast, the frequency of PTC cases with point mutations (mainly BRAF(V600E)) was significantly lower in patients with relatively higher radiation exposure than those with lower radiation exposure. We also found that among ABS, the frequency of PTC cases with no detectable gene alterations in RET, neurotrophic tyrosine kinase receptor 1 (NTRK1), BRAF, or RAS was significantly higher in patients with relatively higher radiation exposure than those with lower radiation exposure. However, in ABS with PTC, the relationship between the presence of the anaplastic lymphoma kinase (ALK) gene fused with other gene partners and radiation exposure has received little study. In this study, we tested the hypothesis that the relative frequency of rearranged ALK in ABS with PTC, and with no detectable gene alterations in RET, NTRK1, BRAF, or RAS, would be greater in those having relatively higher radiation exposures. The 105 subjects in the study were drawn from the Life Span Study cohort of ABS of Hiroshima and Nagasaki who were diagnosed with PTC between 1956 and 1993. Seventy-nine were exposed (>0 mGy), and 26 were not exposed to A-bomb radiation. In the 25 ABS with PTC, and with no detectable gene alterations in RET, NTRK1, BRAF, or RAS, we examined archival, formalin-fixed, paraffin-embedded PTC specimens for rearrangement of ALK using reverse transcription-polymerase chain reaction and 5' rapid amplification of cDNA ends (5' RACE). We found rearranged ALK in 10 of 19 radiation-exposed PTC cases, but none among 6 patients with PTC with no radiation exposure. In addition, solid/trabecular-like architecture in PTC was closely associated with ALK rearrangements, being observed in

  11. Neutron relative biological effectiveness in Hiroshima and Nagasaki atomic bomb survivors: a critical review.

    Science.gov (United States)

    Sasaki, Masao S; Endo, Satoru; Hoshi, Masaharu; Nomura, Taisei

    2016-11-01

    The calculated risk of cancer in humans due to radiation exposure is based primarily on long-term follow-up studies, e.g. the life-span study (LSS) on atomic bomb (A-bomb) survivors in Hiroshima and Nagasaki. Since A-bomb radiation consists of a mixture of γ-rays and neutrons, it is essential that the relative biological effectiveness (RBE) of neutrons is adequately evaluated if a study is to serve as a reference for cancer risk. However, the relatively small neutron component hampered the direct estimation of RBE in LSS data. To circumvent this problem, several strategies have been attempted, including dose-independent constant RBE, dose-dependent variable RBE, and dependence on the degrees of dominance of intermingled γ-rays. By surveying the available literature, we tested the chromosomal RBE of neutrons as the biological endpoint for its equivalence to the microdosimetric quantities obtained using a tissue-equivalent proportional counter (TEPC) in various neutron fields. The radiation weighting factor, or quality factor, Qn, of neutrons as expressed in terms of the energy dependence of the maximum RBE, RBEm, was consistent with that predicted by the TEPC data, indicating that the chromosomally measured RBE was independent of the magnitude of coexisting γ-rays. The obtained neutron RBE, which varied with neutron dose, was confirmed to be the most adequate RBE system in terms of agreement with the cancer incidence in A-bomb survivors, using chromosome aberrations as surrogate markers. With this RBE system, the cancer risk in A-bomb survivors as expressed in unit dose of reference radiation is equally compatible with Hiroshima and Nagasaki cities, and may be potentially applicable in other cases of human radiation exposure. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  12. Evaluation of systemic markers of inflammation in atomic-bomb survivors with special reference to radiation and age effects.

    Science.gov (United States)

    Hayashi, Tomonori; Morishita, Yukari; Khattree, Ravindra; Misumi, Munechika; Sasaki, Keiko; Hayashi, Ikue; Yoshida, Kengo; Kajimura, Junko; Kyoizumi, Seishi; Imai, Kazue; Kusunoki, Yoichiro; Nakachi, Kei

    2012-11-01

    Past exposure to atomic bomb (A-bomb) radiation has exerted various long-lasting deleterious effects on the health of survivors. Some of these effects are seen even after >60 yr. In this study, we evaluated the subclinical inflammatory status of 442 A-bomb survivors, in terms of 8 inflammation-related cytokines or markers, comprised of plasma levels of reactive oxygen species (ROS), interleukin (IL)-6, tumor necrosis factor α (TNF-α), C-reactive protein (CRP), IL-4, IL-10, and immunoglobulins, and erythrocyte sedimentation rate (ESR). The effects of past radiation exposure and natural aging on these markers were individually assessed and compared. Next, to assess the biologically significant relationship between inflammation and radiation exposure or aging, which was masked by the interrelationship of those cytokines/markers, we used multivariate statistical analyses and evaluated the systemic markers of inflammation as scores being calculated by linear combinations of selected cytokines and markers. Our results indicate that a linear combination of ROS, IL-6, CRP, and ESR generated a score that was the most indicative of inflammation and revealed clear dependences on radiation dose and aging that were found to be statistically significant. The results suggest that collectively, radiation exposure, in conjunction with natural aging, may enhance the persistent inflammatory status of A-bomb survivors.

  13. Motherhood among Incest Survivors.

    Science.gov (United States)

    Cohen, Tamar

    1995-01-01

    Mothers (n=26) who were incest survivors were compared with 28 mothers with no such history for 7 areas of parenting skills: role-image, objectivity, expectations, rapport, communication, limit-setting, and role-support. Significant differences were found on all seven scales, characterized by a tendency for the incest survivors to be less skillful…

  14. Resilience among Japanese atomic bomb survivors.

    Science.gov (United States)

    Knowles, A

    2011-03-01

    The purpose of the study was to explore the experience of atomic bomb survivors from Hiroshima and Nagasaki. Never has the world experienced such extreme devastation as with the atomic bombings of Hiroshima and Nagasaki, Japan, in August 1945. Although significant quantitative research has been completed about the medical effects following radiation, the literature lacks qualitative exploration from a holistic health perspective. This was a qualitative descriptive study, using methods of narrative analysis, oral history and ethnography. The sample for this research included eight individuals who were exposed to the atomic bombings in Japan and currently reside in the United States. Findings provide insight to the resilience that the survivors exhibited immediately following the bomb, as well as throughout the 65 years following the event. From ethnographic data and interviews with survivors, a thematic structure was developed that depicts the essential elements of the atomic bomb experience. Two ways of being in the world followed the bombing: surviving and thriving, with resilience serving as a lever, allowing for fluid movement over time across the continuum. Individuals experiencing surviving exhibited anxiety about their personal and family members' health, expressed mistrust, and felt a stigma associated with being a survivor. For those who were thriving, peace activism, overcoming and forgiveness were typically displayed. Findings from this study add to the disaster nursing literature and highlight the role resilience plays in the atomic bomb survivors' life perspective. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.

  15. Alterations of body mass index and body composition in atomic bomb survivors.

    Science.gov (United States)

    Tatsukawa, Y; Misumi, M; Yamada, M; Masunari, N; Oyama, H; Nakanishi, S; Fukunaga, M; Fujiwara, S

    2013-08-01

    Obesity, underweight, sarcopenia and excess accumulation of abdominal fat are associated with a risk of death and adverse health outcomes. Our aim was to determine whether body mass index (BMI) and body composition, assessed with dual-energy X-ray absorptiometry (DXA), are associated with radiation exposure among atomic bomb (A-bomb) survivors. This was a cross-sectional study conducted in the Adult Health Study of the Radiation Effects Research Foundation. We examined 2686 subjects (834 men and 1852 women), aged 48-89 years (0-40 years at A-bomb exposure), for BMI analysis. Among them, 550 men and 1179 women underwent DXA in 1994-1996 and were eligible for a body composition study. After being adjusted for age and other potential confounding factors, A-bomb radiation dose was associated significantly and negatively with BMI in both sexes (P=0.01 in men, P=0.03 in women) and appendicular lean mass (Pbomb radiation exposure. We will need to conduct further studies to evaluate whether these alterations affect health status.

  16. Effects of A-bomb radiation on the human body. Genbaku hoshasen no jintai eikyo 1992

    Energy Technology Data Exchange (ETDEWEB)

    Shigematsu, Itsuzo; Akiyama, Mitoshi; Sasaki, Hideo (Radiation Effects Research Foundation, Hiroshima (Japan)); Ito, Chikato; Kamada, Nanao (eds.)

    1992-01-01

    This publication consists of contributions by 39 authors in Hiroshima who are active in the forefront of research, diagnosis and treatment concerning atomic bomb survivors. Following a brief description on the damage of the atomic bomb, the subjects of malignant tumors, endocrine and metabolic diseases, ocular lesions, dermatologic effects, prenatal exposure, chromosomal aberrations, mutations, sensitivity to radiation, immune function, genetic effects and other effects of radiation are described. All of the 45 chapters are indexed individually. (J.P.N.).

  17. Circulating Hematopoietic Stem and Progenitor Cells in Aging Atomic Bomb Survivors.

    Science.gov (United States)

    Kyoizumi, Seishi; Kubo, Yoshiko; Misumi, Munechika; Kajimura, Junko; Yoshida, Kengo; Hayashi, Tomonori; Imai, Kazue; Ohishi, Waka; Nakachi, Kei; Young, Lauren F; Shieh, Jae-Hung; Moore, Malcolm A; van den Brink, Marcel R M; Kusunoki, Yoichiro

    2016-01-01

    It is not yet known whether hematopoietic stem and progenitor cells (HSPCs) are compromised in the aging population of atomic bomb (A-bomb) survivors after their exposure nearly 70 years ago. To address this, we evaluated age- and radiation-related changes in different subtypes of circulating HSPCs among the CD34-positive/lineage marker-negative (CD34(+)Lin(-)) cell population in 231 Hiroshima A-bomb survivors. We enumerated functional HSPC subtypes, including: cobblestone area-forming cells; long-term culture-initiating cells; erythroid burst-forming units; granulocyte and macrophage colony-forming units; and T-cell and natural killer cell progenitors using cell culture. We obtained the count of each HSPC subtype per unit volume of blood and the proportion of each HSPC subtype in CD34(+)Lin(-) cells to represent the lineage commitment trend. Multivariate analyses, using sex, age and radiation dose as variables, showed significantly decreased counts with age in the total CD34(+)Lin(-) cell population and all HSPC subtypes. As for the proportion, only T-cell progenitors decreased significantly with age, suggesting that the commitment to the T-cell lineage in HSPCs continuously declines with age throughout the lifetime. However, neither the CD34(+)Lin(-) cell population, nor HSPC subtypes showed significant radiation-induced dose-dependent changes in counts or proportions. Moreover, the correlations of the proportions among HSPC subtypes in the survivors properly revealed the hierarchy of lineage commitments. Taken together, our findings suggest that many years after exposure to radiation and with advancing age, the number and function of HSPCs in living survivors as a whole may have recovered to normal levels.

  18. [Cohort studies of the atomic bomb survivors at the Radiation Effects Research Foundation].

    Science.gov (United States)

    Ozasa, Kotaro

    2012-03-01

    The Radiation Effects Research Foundation has been evaluating the risk of atomic bomb radiation for various diseases since the beginning of its former organization, the Atomic Bomb Casualty Commission. Cohorts of atomic-bomb survivors, in-utero survivors, and survivors' offspring have been followed up. The risk of all solid cancers at 1 Gy was estimated as ERR = 0.47 and EAR = 52/10,000 person-years for people who were exposed at 30 years of age and had reached 70 years of age, based on the cancer incidence during 1958-1998. The risk seemed to be increased in the in-utero survivors, but was rather lower than the risk for the survivors exposed at a young age. Effects on the offspring of survivors have not been shown to be significant. Continuing the research is important in order to more accurately estimate and understand radiation-induced health effects.

  19. Who are the cancer survivors?

    DEFF Research Database (Denmark)

    Hovaldt, H. B.; Suppli, N. P.; Olsen, M. H.;

    2015-01-01

    Background: No nationwide studies on social position and prevalence of comorbidity among cancer survivors exist. Methods: We performed a nationwide prevalence study defining persons diagnosed with cancer 1943-2010 and alive on the census date 1 January 2011 as cancer survivors. Comorbidity...... was compared by social position with the non-cancer population. Results: Cancer survivors composed 4% of the Danish population. Somatic comorbidity was more likely among survivors (OR 1.59, 95% CI 1.57-1.60) and associated with higher age, male sex, short education, and living alone among survivors....... Conclusions: Among cancer survivors, comorbidity is common and highly associated with social position....

  20. Phoenix Society for Burn Survivors

    Science.gov (United States)

    ... Medical Professionals Phoenix Society is the leader in connecting the burn recovery community and creating resources for survivors. Since 1977, we have partnered with survivors, families, health care professionals, burn centers, and the fire ...

  1. Rehabilitating torture survivors

    DEFF Research Database (Denmark)

    Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith;

    2009-01-01

    , "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...... to rehabilitation, but scientifically rigorous studies of comprehensive rehabilitation programmes for torture survivors are lacking. Therefore, effect studies are urgently warranted. Nevertheless, by combining expertise from different scientific and professional areas, important elements in the problems of torture...... survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components...

  2. Musculoskeletal problems in stroke survivors.

    Science.gov (United States)

    Kendall, Richard

    2010-01-01

    Musculoskeletal problems in stoke survivors are common reasons for disability and pain. Shoulder pain is present in 24% of stroke survivors among all complications, second only to depression in 26%. Diagnosis and treatment of the various shoulder pain etiologies can significantly improve quality of life in these patients. This article reviews the common etiologies and treatments of shoulder and hip pain in stroke survivors.

  3. Risk of thyroid cancer in survivors of childhood cancer: results from the British Childhood Cancer Survivor Study.

    Science.gov (United States)

    Taylor, Aliki J; Croft, Adam P; Palace, Aimee M; Winter, David L; Reulen, Raoul C; Stiller, Charles A; Stevens, Michael C G; Hawkins, Mike M

    2009-11-15

    Second primary neoplasms (SPNs) are a recognised late effect of treatment for childhood cancer. Thyroid SPNs can develop after exposure to low-dose radiation, due to the radio-sensitivity of the thyroid gland. The British Childhood Cancer Survivor Study (BCCSS) was set up to directly monitor the late effects of treatment, including risk of SPNs, in childhood cancer survivors and includes 17,980 5-year survivors. We carried out a cohort analysis to determine the risk of thyroid SPNs in the BCCSS, and estimated risk using standardised incidence ratios (SIRs), relative risk (RR) using multivariate Poisson regression and cumulative incidence curves. There were 340,202 person years at risk subsequent to a 5-year survival, median follow-up 17.4 years per survivor. We identified 50 thyroid SPNs including 31 (62%) papillary carcinomas, 15 (30%) follicular carcinomas and 4 (8%) other types. 88% of thyroid SPNs developed after exposure to radiotherapy in or around the thyroid gland. SIR overall was 18.0 (95% confidence interval 13.4-23.8). Risk of thyroid cancer was highest after Hodgkin's disease: RR 3.3 (1.1-10.1) and Non Hodgkin's Lymphoma: RR 3.4 (1.1-10.7) relative to leukaemia (RR 1.0) (p Survivors treated with radiotherapy in childhood had a RR of 4.6 (1.4-15.1) relative to survivors not treated with radiotherapy (RR 1.0), p = 0003. In conclusion, the risk of thyroid cancer in childhood cancer survivors is relatively high in this cohort of childhood cancer survivors. These results will be of use in counselling survivors of childhood cancer exposed to radiation in or around the thyroid area.

  4. survivors in Lagos, Nigeria

    African Journals Online (AJOL)

    2008-07-23

    Jul 23, 2008 ... Risk factors of PSD studied were gender, laterality of stroke, post stroke functional ... Among survivors, over 50% have significant disabilities; and in clinical practice ... evaluation; and due to logistic problems and high cost only a few cases from ..... public health education on the need for early presentation of.

  5. CD14 and IL18 gene polymorphisms associated with colorectal cancer subsite risks among atomic bomb survivors.

    Science.gov (United States)

    Hu, Yiqun; Yoshida, Kengo; Cologne, John B; Maki, Mayumi; Morishita, Yukari; Sasaki, Keiko; Hayashi, Ikue; Ohishi, Waka; Hida, Ayumi; Kyoizumi, Seishi; Kusunoki, Yoichiro; Tokunaga, Katsushi; Nakachi, Kei; Hayashi, Tomonori

    2015-01-01

    Colorectal cancer (CRC) is a common malignancy worldwide, and chronic inflammation is a risk factor for CRC. In this study, we carried out a cohort study among the Japanese atomic bomb (A-bomb) survivor population to investigate any association between immune- and inflammation-related gene polymorphisms and CRC. We examined the effects of six single-nucleotide polymorphisms of CD14 and IL18 on relative risks (RRs) of CRC. Results showed that RRs of CRC, overall and by anatomic subsite, significantly increased with increasing radiation dose. The CD14-911A/A genotype showed statistically significant higher risks for all CRC and distal CRC compared with the other two genotypes. In addition, the IL18-137 G/G genotype showed statistically significant higher risks for proximal colon cancer compared with the other two genotypes. In phenotype-genotype analyses, the CD14-911A/A genotype presented significantly higher levels of membrane and soluble CD14 compared with the other two genotypes, and the IL18-137 G/G genotype tended to be lower levels of plasma interleukin (IL)-18 compared with the other two genotypes. These results suggest the potential involvement of a CD14-mediated inflammatory response in the development of distal CRC and an IL18-mediated inflammatory response in the development of proximal colon cancer among A-bomb survivors.

  6. Hepatitis virus infection and chronic liver disease among atomic-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, S.; Cologne, J.; Akahoshi, M. [Radiation Effects Research Foundation, Hiroshima (Japan); Kusumi, S.; Kodama, K.; Yoshizawa, H.

    2000-05-01

    The purpose of this study is to analyze various laboratory indicators of inflammation measured in atomic bomb survivors. Subjects are 6304 survivors who underwent inflammatory tests at RERF between 1998 and 1992 and whose radiation doses (DS86) are available. Inflammatory tests include leukocyte counts, neutrophil counts, erythrocyte sedimentation rate, corrected erythrocyte sedimentation rate, alpha 1 globulin, alpha 2 globulin, and sialic acid. Adjusting for age, sex, smoking, and city of residence, regression analysis was conducted. Regression analysis, adjusted for age, sex, smoking, and city of residence showed statistically significant associations with radiation dose for leukocyte counts (71.0 /mm{sup 3}/Gy, p=0.00151), erythrocyte sedimentation rate (1.58 mm/hour/Gy, p=0.0001), corrected erythrocyte sedimentation rate (1.14 mm/hour/Gy, p=0.0001), alpha 1 globulin (0.0057 g/dl/Gy, p=0.0001), alpha 2 globulin (0.0128 g/dl/Gy, p=0.0001), and sialic acid (1.2711 mg/dl/Gy, p=0.0001), but not for neutrophil counts (29.9 /mm{sup 3}/Gy, p=0.1729). Standardized scores combining results from these seven inflammatory tests showed significant associations with radiation dose both for persons with and without inflammatory disease, and for two inflammatory conditions in particular, chronic thyroiditis and chronic liver disease. In analyses of data from 403 AHS patients, in whom both inflammation indicators and T-cell ratios were measured, increased inflammation correlates with decreases in CD4 T-cells. Since the laboratory indicators of inflammation that we studied are not specific for particular clinical diseases, the implication of their dose-response-pattern is hard to interpret. The general occurrence of infectious diseases in survivors is not related to radiation dose. Such a relationship does exist, however, for other diseases in which infection may play an etiologic role. Virologic studies in A-bomb survivors have suggested dose-response alterations in immune

  7. Radiation-related risks of non-cancer outcomes in the atomic bomb survivors.

    Science.gov (United States)

    Ozasa, K; Takahashi, I; Grant, E J

    2016-06-01

    Risks of non-cancer outcomes after exposure to atomic bomb (A-bomb) radiation have been evaluated among the Life Span Study (LSS) cohort and its subcohort, the Adult Health Study (AHS). Information regarding non-cancer outcomes in the LSS is obtained from death certificates. In the AHS, members undergo clinical examinations biennially to determine their health status. Many AHS studies have been limited to participants attending the clinic over a limited period, and therefore have varying degrees of inferential utility; as such, care is required for comparison with the LSS results. Disease structure of non-cancer diseases in Japan has changed over the long follow-up period since the end of World War II. The health status of the A-bomb survivors may be associated with the hardships of living in a devastated city and impoverished country following the prolonged war effort, in addition to the direct effects of radiation exposure. Radiation-related risk of cardiovascular disease may have increased due to radiation-related increased risk of hypertension and other secondary associations, and the risk of atherosclerotic disorders has also been reported recently. These results should be interpreted with caution because of changes in disease definitions over the follow-up period. The radiation-related risk of non-cancer respiratory diseases also appears to have increased over the follow-up period, but the shapes of the dose-response curves have shown little consistency. © The International Society for Prosthetics and Orthotics.

  8. Rehabilitation interventions for cancer survivors

    DEFF Research Database (Denmark)

    Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine; Johansen, Christoffer

    2011-01-01

    The present study examines the influence of three contextual parameteres in rehabilitation courses for cancer survivors in Denmark. It is based on ethonographic fieldwork.......The present study examines the influence of three contextual parameteres in rehabilitation courses for cancer survivors in Denmark. It is based on ethonographic fieldwork....

  9. Brain tumor survivors speak out.

    Science.gov (United States)

    Carlson-Green, Bonnie

    2009-01-01

    Although progress has been made in the treatment of childhood brain tumors,work remains to understand the complexities of disease, treatment, and contextual factors that underlie individual differences in outcome. A combination of both an idiographic approach (incorporating observations made by adult survivors of childhood brain tumors) and a nomothetic approach (reviewing the literature for brain tumor survivors as well as childhood cancer survivors) is presented. Six areas of concern are reviewed from both an idiographic and nomothetic perspective, including social/emotional adjustment, insurance, neurocognitive late effects, sexuality and relationships, employment, and where survivors accessed information about their disease and treatment and possible late effects. Guidelines to assist health care professionals working with childhood brain tumor survivors are offered with the goal of improving psychosocial and neurocognitive outcomes in this population.

  10. Cancer Patients Versus Cancer Survivors

    Science.gov (United States)

    Mosher, Catherine E.; Danoff-Burg, Sharon

    2013-01-01

    Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants in Study 1 reported greater willingness to interact with cancer survivors compared with cancer patients. Positive perceptions of prognosis did not appear to account for favorable attitudes toward cancer survivors; most participants in Study 2 did not assume that cancer survivors were beyond the treatment phase of their illness or cured of their disease. Findings point to a potentially powerful effect of word choice on reactions to individuals with cancer. PMID:24371366

  11. 20 CFR 234.33 - Survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Survivor annuities. 234.33 Section 234.33... PAYMENTS Annuities Due but Unpaid at Death § 234.33 Survivor annuities. Any survivor annuity which is unpaid at the death of the survivor is paid in the same order and amounts as described in § 234.31(a)...

  12. Cancer survivors' experience of time

    DEFF Research Database (Denmark)

    Rasmussen, Dorte M.; Elverdam, Beth

    2007-01-01

    time and life; (2) awareness of time increases, time is verbalized and reflected; and (3) the informants appropriate time. A diagnosis of cancer, even for a survivor, means a confrontation with death. It means a disruption of continuous clock and calendar time. Survivors appropriate time...... and ethnographic interviews with 23 informants. Ten men and 13 women were interviewed twice: 2 weeks after their stay and 18 months later. FINDINGS: Data were analysed from a culture-analytical perspective. Three main themes regarding the survivors' handling and perception of time were found: (1) cancer disrupts...

  13. Exposing diversity

    DEFF Research Database (Denmark)

    Nørtoft, Kamilla; Nordentoft, Helle Merete

    . A prominent research theme in health care studies is, therefore, to explicate the gap between theory and practice. The question this paper addresses is how a learning environment can be designed to bridge this theory-practice gap, expose the differences in situated interactions and qualify health...... in the homes of older people and in pedagogical institutions targeting older people. In the paper we look at the potentials and challenges in working with ethnographic video narratives as a pedagogical tool. Our findings indicate that the use of video narratives has the potential to expose the diversity...

  14. Cytogenetic Reconstruction of Gamma-Ray Doses Delivered to Atomic Bomb Survivors: Dealing with Wide Distributions of Photon Energies and Contributions from Hematopoietic Stem/Progenitor Cells.

    Science.gov (United States)

    Nakamura, Nori; Hirai, Yuko; Kodama, Yoshiaki; Hamasaki, Kanya; Cullings, Harry M; Cordova, Kismet A; Awa, Akio

    2017-08-11

    Retrospective estimation of the doses received by atomic bomb (A-bomb) survivors by cytogenetic methods has been hindered by two factors: One is that the photon energies released from the bomb were widely distributed, and since the aberration yield varies depending on the energy, the use of monoenergetic (60)Co gamma radiation to construct a calibration curve may bias the estimate. The second problem is the increasing proportion of newly formed lymphocytes entering into the lymphocyte pool with increasing time intervals since the exposures. These new cells are derived from irradiated precursor/stem cells whose radiosensitivity may differ from that of blood lymphocytes. To overcome these problems, radiation doses to tooth enamel were estimated using the electron spin resonance (ESR; or EPR, electron paramagnetic resonance) method and compared with the cytogenetically estimated doses from the same survivors. The ESR method is only weakly dependent on the photon energy and independent of the years elapsed since an exposure. Both ESR and cytogenetic doses were estimated from 107 survivors. The latter estimates were made by assuming that although a part of the cells examined could be lymphoid stem or precursor cells at the time of exposure, all the cells had the same radiosensitivity as blood lymphocytes, and that the A-bomb gamma-ray spectrum was the same as that of the (60)Co gamma rays. Subsequently, ESR and cytogenetic endpoints were used to estimate the kerma doses using individual DS02R1 information on shielding conditions. The results showed that the two sets of kerma doses were in close agreement, indicating that perhaps no correction is needed in estimating atomic bomb gamma-ray doses from the cytogenetically estimated (60)Co gamma-ray equivalent doses. The present results will make it possible to directly compare cytogenetic doses with the physically estimated doses of the survivors, which would pave the way for testing whether or not there are any systematic

  15. The case for establishing a Holocaust survivors cohort in Israel

    OpenAIRE

    Fall, Caroline H. D.; Kumaran, Kalyanaraman

    2014-01-01

    In this issue, Keinan-Boker summarises the main studies that have followed up offspring of women exposed to famine during pregnancy and calls for the establishment of a national cohort of Holocaust survivors and their offspring to study inter-generational effects. She suggests that the study would consolidate the fetal origins theory and lead to translational applications to deal with the inter-generational effects of the Holocaust. Barker suggested that alterations in the nutritional supply ...

  16. Exposing diversity

    DEFF Research Database (Denmark)

    Nørtoft, Kamilla; Nordentoft, Helle Merete

    in the homes of older people and in pedagogical institutions targeting older people. In the paper we look at the potentials and challenges in working with ethnographic video narratives as a pedagogical tool. Our findings indicate that the use of video narratives has the potential to expose the diversity...

  17. Pregnancy-Associated Cardiomyopathy in Survivors of Childhood Cancer

    Science.gov (United States)

    Hines, Melissa R.; Mulrooney, Daniel A.; Hudson, Melissa M.; Ness, Kirsten K.; Green, Daniel M.; Howard, Scott C.; Krasin, Matthew; Metzger, Monika L.

    2015-01-01

    Purpose Current information regarding pregnancy-associated cardiomyopathy among women treated for childhood cancer is insufficient to appropriately guide counseling and patient management. This study aims to characterize its prevalence within a large cohort of females exposed to cardiotoxic therapy. Methods Retrospective cohort study of female cancer survivors treated at St. Jude Children’s Research Hospital between 1963 and 2006, at least 5 years from diagnosis, ≥ 13 years old at last follow-up, and with at least one successful pregnancy. Pregnancy-associated cardiomyopathy was defined as shortening fraction < 28% or ejection fraction < 50% or treatment for cardiomyopathy during or up to 5 months after completion of pregnancy. Results Among 847 female cancer survivors with 1554 completed pregnancies only 3 (0.3%) developed pregnancy-associated cardiomyopathy, 40 developed non-pregnancy-associated cardiomyopathy either 5 months post-partum (n=14), or prior to pregnancy (n=26). Among those with cardiomyopathy prior to pregnancy (n=26), cardiac function deteriorated during pregnancy in 8 patients (3 patients with normalization of cardiac function prior to pregnancy, 3 with persistently abnormal cardiac function, and 2 for whom resolution of cardiomyopathy was unknown prior to pregnancy). Patients that developed cardiomyopathy recevied a higher median dose of anthracyclines compared to those that did not (321 mg/m2 versus 164 mg/m2; p< 0.01). Conclusions Pregnancy-associated cardiomyopathy in childhood cancer survivors is rare. Implications for cancer survivors Most female childhood cancer survivors will have no cardiac complications during or after childbirth, however those with a history of cardiotoxic therapies should be followed carefully during pregnancy particularly those with a history of anthracycline exposures and if they had documented previous or current subclinical or symptomatic cardiomyopathy. Female childhood cancer survivors with a history of

  18. Cardiovascular disease among atomic bomb survivors.

    Science.gov (United States)

    Ozasa, Kotaro; Takahashi, Ikuno; Grant, Eric J; Kodama, Kazunori

    2017-02-24

    The profile of cardiovascular disease in Japan has been different from that in Western countries. Hypertension was the major cause not only for hemorrhagic stroke but also for ischemic stroke and heart disease in the past, and the influence of hypertension has decreased with calendar years because of reduced salt intake and westernization of lifestyle, and also improved medical care. The health status of atomic bomb survivors has reflected this profile as well as radiation effects. It is also likely that this cohort has been affected by the difficult conditions experienced in the aftermath of the war and atomic bombings. In this article, we tried to make a consistent interpretation of epidemiological findings of atomic bomb radiation effects on cardiovascular disease. Among the atomic bomb survivors, radiation exposure was associated with some cardiovascular diseases that are often associated with hypertension, and dose response appeared to be primarily non-linear among those who were exposed at younger ages. These effects are thought to reflect the nature of whole body irradiation. But, some findings remain inconsistent, possibly because of possible misclassification in death certificate diagnoses in the Life Span Study as well as selected information from the Adult Health Study which was limited to participants, focused on specific outcomes, and gathered in selected periods of follow-up. Therefore, a comprehensive and balanced interpretation of the results from both groups is necessary.

  19. Stroke Survivors Often Struggle with Depression

    Science.gov (United States)

    ... fullstory_160835.html Stroke Survivors Often Struggle With Depression Risk was 8 times higher for those who ... Stroke survivors face an increased risk of developing depression, a new study suggests. In the first three ...

  20. 22 CFR 20.5 - Survivor benefits.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Survivor benefits. 20.5 Section 20.5 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR CERTAIN FORMER SPOUSES § 20.5 Survivor benefits. (a... survivor benefits equal to one of the following; whichever is applicable: (1) 55 percent of the...

  1. 31 CFR 29.344 - Survivor benefits.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Survivor benefits. 29.344 Section 29... Benefit Payments § 29.344 Survivor benefits. (a) The general rule that Federal Benefit Payments are... months of total service at retirement (for elected survivor benefits) or death (for...

  2. 5 CFR 850.202 - Survivor elections.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Survivor elections. 850.202 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Applications for Benefits; Elections § 850.202 Survivor elections. (a) A survivor election under subsection (j) or (k) of section 8339, or under section 8416,...

  3. Internet Use and Breast Cancer Survivors

    Science.gov (United States)

    Muhamad, Mazanah; Afshari, Mojgan; Mohamed, Nor Aini

    2011-01-01

    A survey was administered to 400 breast cancer survivors at hospitals and support group meetings in Peninsular Malaysia to explore their level of Internet use and factors related to the Internet use by breast cancer survivors. Findings of this study indicated that about 22.5% of breast cancer survivors used Internet to get information about breast…

  4. Incidence of dementia among atomic-bomb survivors--Radiation Effects Research Foundation Adult Health Study.

    Science.gov (United States)

    Yamada, Michiko; Kasagi, Fumiyoshi; Mimori, Yasuyo; Miyachi, Takafumi; Ohshita, Tomohiko; Sasaki, Hideo

    2009-06-15

    Radiotherapy has been reported to cause neuropsychological dysfunction. Here we examined whether exposure to atomic bomb radiation affected the incidence of dementia among 2286 atomic bomb survivors and controls - all members of the Adult Health Study cohort. Study subjects were non-demented and aged >or=60 years at baseline examination and had been exposed in 1945 at >or=13 years of age to a relatively low dose (or=500 mGy group. Alzheimer disease was the predominant type of dementia in each dose category. After adjustment for potential risk factors, radiation exposure did not affect the incidence rate of either all dementia or any of its subtypes. No case of dementia had a history of therapeutic cranial irradiation. Although we found no relationship between radiation exposure and the development of dementia among atomic bomb survivors exposed at >or=13 years old in this longitudinal study, effects on increased risk of early death among atomic bomb survivors will be considered.

  5. Income in Adult Survivors of Childhood Cancer

    Science.gov (United States)

    Wengenroth, Laura; Sommer, Grit; Schindler, Matthias; Spycher, Ben D.; von der Weid, Nicolas X.; Stutz-Grunder, Eveline; Michel, Gisela; Kuehni, Claudia E.

    2016-01-01

    Introduction Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income. Methods As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age 4’500 CHF), even after we adjusted for socio-demographic and educational factors (OR = 0.46, psocio-demographic characteristics, education and working hours, survivors of various diagnostic groups have lower incomes than siblings. Further research needs to identify the underlying causes. PMID:27213682

  6. Health Behaviors of Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Jennifer S. Ford

    2014-10-01

    Full Text Available There has been a dramatic increase in the number of childhood cancer survivors living to an old age due to improved cancer treatments. However, these survivors are at risk of numerous late effects as a result of their cancer therapy. Engaging in protective health behaviors and limiting health damaging behaviors are vitally important for these survivors given their increased risks. We reviewed the literature on childhood cancer survivors’ health behaviors by searching for published data and conference proceedings. We examine the prevalence of a variety of health behaviors among childhood cancer survivors, identify significant risk factors, and describe health behavior interventions for survivors.

  7. Secondary malignant neoplasms in testicular cancer survivors.

    Science.gov (United States)

    Curreri, Stephanie A; Fung, Chunkit; Beard, Clair J

    2015-09-01

    Testicular cancer is the most common cancer among men aged 15 to 40 years, and the incidence of testicular cancer is steadily increasing. Despite successful treatment outcomes and the rate of survival at 5 to 10 years being 95%, survivors can experience late effects of both their cancer and the treatment they received, including secondary malignant neoplasms (SMNs). We discuss the development of non-germ cell SMNs that develop after diagnosis and treatment of testicular cancer and their effect on mortality. Patients diagnosed with testicular cancer frequently choose postoperative surveillance if they are diagnosed with clinical stage I disease. These patients may experience an increased risk for developing SMNs following radiation exposure from diagnostic imaging. Similarly, radiotherapy for testicular cancer is associated with increased risks of developing both solid tumors and leukemia. Studies have reported that patients exposed to higher doses of radiation have an increased risk of developing SMNs when compared with patients who received lower doses of radiation. Patients treated with chemotherapy also experience an increased risk of developing SMNs following testicular cancer, though the risk following chemotherapy and radiation therapy combined is not well described. A large population-based study concluded that the rate ratios for both cancer-specific and all-cause mortality for SMNs among testicular cancer survivors were not significantly different from those of matched first cancers. Although it is known that patients who receive adjuvant chemotherapy or radiotherapy or who undergo routine diagnostic or follow-up imaging for a primary testicular cancer are at an increased risk for developing SMNs, the extent of this risk is largely unknown. It is critically important that research be conducted to determine this risk and its contributing factors as accurately as possible. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Cancer risk among Holocaust survivors in Israel-A nationwide study.

    Science.gov (United States)

    Sadetzki, Siegal; Chetrit, Angela; Freedman, Laurence S; Hakak, Nina; Barchana, Micha; Catane, Raphael; Shani, Mordechai

    2017-09-01

    Holocaust survivors during World War II were exposed to various factors that are associated with cancer risk. The objective of this study was to determine whether Holocaust survivors had an increased risk for developing cancer. The study population included 152,622 survivors. The main analysis was based on a comparison between individuals who were entitled to compensation for suffering persecution during the war and individuals who were denied such compensation. A complementary analysis compared survivors who were born in countries governed by Nazi Germany with survivors born in nonoccupied countries. A Cox proportional hazards model was used, with the time at risk of cancer development starting on either January 1, 1960, or the date of immigration to the date of cancer diagnosis or death or the date of last follow-up (December 31, 2006). Cancer was diagnosed in 22.2% of those who were granted compensation versus 16% of those who were denied compensation (P cancer in those who were exposed. For those who were granted versus denied compensation, the hazard ratios were 1.06 (P cancer, and 1.37 (P = .008) for lung cancer. For those born in occupied countries versus nonoccupied countries, the hazard ratios were 1.08 (P cancer development. Cancer 2017;123:3335-45. © 2017 American Cancer Society. © 2017 American Cancer Society.

  9. Mortality of atomic bomb survivors predicted from laboratory animals

    Science.gov (United States)

    Carnes, Bruce A.; Grahn, Douglas; Hoel, David

    2003-01-01

    Exposure, pathology and mortality data for mice, dogs and humans were examined to determine whether accurate interspecies predictions of radiation-induced mortality could be achieved. The analyses revealed that (1) days of life lost per unit dose can be estimated for a species even without information on radiation effects in that species, and (2) accurate predictions of age-specific radiation-induced mortality in beagles and the atomic bomb survivors can be obtained from a dose-response model for comparably exposed mice. These findings illustrate the value of comparative mortality analyses and the relevance of animal data to the study of human health effects.

  10. Radiation and cancer risk in atomic-bomb survivors.

    Science.gov (United States)

    Kodama, K; Ozasa, K; Okubo, T

    2012-03-01

    With the aim of accurately assessing the effects of radiation exposure in the Japanese atomic-bomb survivors, the Radiation Effects Research Foundation has, over several decades, conducted studies of the Life Span Study (LSS) cohort, comprising 93 000 atomic-bomb survivors and 27 000 controls. Solid cancer: the recent report on solid cancer incidence found that at age 70 years following exposure at age 30 years, solid cancer rates increase by about 35%  Gy(-1) for men and 58% Gy(-1) for women. Age-at-exposure is an important risk modifier. In the case of lung cancer, cigarette smoking has been found to be an important risk modifier. Radiation has similar effects on first-primary and second-primary cancer risks. Finally, radiation-associated increases in cancer rates appear to persist throughout life. Leukaemia: the recent report on leukaemia mortality suggests that radiation effects on leukaemia mortality persisted for more than 50 years. Moreover, significant dose-response for myelodysplastic syndrome was observed in Nagasaki LSS members even 40-60 years after radiation exposure. Future perspective: given the continuing solid cancer increase in the survivor population, the LSS will likely continue to provide important new information on radiation exposure and solid cancer risks for another 15-20 years, especially for those exposed at a young age.

  11. Stroke survivors' experiences of rehabilitation

    DEFF Research Database (Denmark)

    Peoples, Hanne; Satink, Ton; Steultjens, Esther

    2011-01-01

    INTRODUCTION: The aim was to obtain the best available knowledge on stroke survivors' experiences of rehabilitation. The increase in demands for accountability in health care and acknowledgement of the importance of client participation in health decisions calls for systematic ways of integrating...... this perspective. METHODS AND MATERIALS: A systematic review of qualitative studies was performed. A literature search in MEDLINE, CINAHL, PsycINFO, and EMBASE was conducted. Suitability for inclusion was based on selected criteria: published qualitative studies written in English from 1990 to 2008 on stroke...... needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control. DISCUSSION: The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual...

  12. 26 CFR 1.401(a)-20 - Requirements of qualified joint and survivor annuity and qualified preretirement survivor annuity.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Requirements of qualified joint and survivor annuity and qualified preretirement survivor annuity. 1.401(a)-20 Section 1.401(a)-20 Internal Revenue... survivor annuity and qualified preretirement survivor annuity. Q-1: What are the survivor...

  13. Lucky or Unlucky people: Layoff Survivors

    OpenAIRE

    Muhammad Imran Malik; Dr. Mehboob Ahmad

    2011-01-01

    Perceived workloads after downsizing eradicate the commitment and productivity among layoff survivors. Up to some extent provision of work - life balance opportunities can save the situation. The current study is carried out among layoff survivors of the two giant organizations in Pakistan. A cross - sectional study based on a stratified random sample of 450 survivors assisted to test the relationship. In the first step the relationship of perceived work load increase (WLI), commitment of lay...

  14. The mental health state of atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Nakane, Yoshibumi; Imamura, Yoshihiro; Yoshitake, Kazuyasu; Honda, Sumihisa; Mine, Mariko; Hatada, Keiko; Tomonaga, Masao [Nagasaki Univ. (Japan). School of Medicine; Tagawa, Masuko

    1997-03-01

    Our department of Neuropsychiatry has clarified the clinical features of several mental disorders and surveyed the causes of those disorders from the psychosocial aspect using the methodology of epidemiological psychiatric approach. Using this previous research experience, we began a long-planned study to examine the mental health state of atomic bomb survivors. Fifty-one years have passed since the atomic bombing, and the survivors must have suffered various psychosocial stresses, other than any direct effect on the central nervous system from exposure to radiation, and it is assumed that victims` mental state has been affected in various ways as a result. The subjects of the survey were 7,670 people who had regular health examinations for atomic bomb survivors during the study period of three years and who consented to participate in the study. Of the total, 226 subjects were selected for a second phase according to the results of the General Health Questionnaire 12-item Version which was used in the first phase of the survey. The results were as follows: 1. The distance from the hypocenter was related to the degree of ill health, and the percentage of people with a high score was greater among those exposed to the atomic bomb in proximity to the hypocenter. 2. 14.6% of the subjects were diagnosed as having some kind of mental disorders according to clinical interviews by trained psychiatrists. These results had not expected prior to the study. On the based of the study, we will try to establish a mental health support system for atomic bomb survivors. (author)

  15. Stigma and psychological distress in suicide survivors.

    Science.gov (United States)

    Scocco, Paolo; Preti, Antonio; Totaro, Stefano; Ferrari, Alessandro; Toffol, Elena

    2017-03-01

    Suicide bereavement is frequently related to clinically significant psychological distress and affected by stigma. This study was designed to evaluate the relationship between psychological distress by psychopathological domains and stigma, in a sample of individuals bereaved by suicide (suicide survivors). The data were collected between January 2012 and December 2014 and included information on sociodemographic variables (gender, age, marital status and education level) and responses to the Stigma of Suicide Survivor scale (STOSSS) and the Brief Symptom Inventory (BSI). One hundred and fifty-five suicide survivors completed the evaluation and were included in the study. Levels of psychological distress in suicide survivors, as measured by BSI, were positively related to levels of perceived stigma toward suicide survivors, as measured by STOSSS. The association was not affected by age and gender, or by marital status, education level, days from suicide or a personal history of suicide attempt. Participants with higher scores on almost all subscales of the BSI, particularly the interpersonal sensitivity and paranoid ideation subscales, reported the highest levels of perceived stigma toward suicide survivors. Levels of distress in subjects bereaved by the suicide of a relative or friend were positively associated with levels of perceived stigma toward suicide survivors. Specific interventions dedicated to the bereavement of suicide survivors might help to alleviate not only psychological distress but also stigma towards loss by suicide. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Incest Survivor Mothers: Protecting the Next Generation.

    Science.gov (United States)

    Kreklewetz, Christine M.; Piotrowski, Caroline C.

    1998-01-01

    A study involving 16 incest-survivor mothers with daughters between the ages of 9-14 found the mothers described themselves as very protective and often overly-protective parents, wanting to parent differently, and better, than they were parented. Many survivors strive to be the "perfect mother" including over-protecting and over-nurturing…

  17. 22 CFR 19.11 - Survivor benefits.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Survivor benefits. 19.11 Section 19.11 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.11 Survivor benefits....

  18. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda

    2011-01-01

    Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cance...

  19. Orthostatic intolerance in survivors of childhood cancer

    NARCIS (Netherlands)

    Terlou, Annelinde; Ruble, Kathy; Stapert, Anne F.; Chang, Ho-Choong; Rowe, Peter C.; Schwartz, Cindy L.

    2007-01-01

    Purpose: To compare the prevalence and severity of orthostatic intolerance in survivors of childhood cancer and in healthy controls, and to correlate results of self-reported measures of health status with orthostatic testing in survivors of childhood cancer. Patient and methods: Thirty-nine survivo

  20. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda

    2011-01-01

    Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer...

  1. Estimation of radiation doses for atomic-bomb survivors in the Hiroshima University Registry

    Energy Technology Data Exchange (ETDEWEB)

    Hoshi, M.; Matsuura, M.; Hayakawa, N.; Kamada, N. [Hiroshima Univ., Kasumi (Japan); Ito, C. [Hiroshima A-bomb Casualty Council Health Management Promotion Center, Senda-machi Naka-ku (Japan)

    1996-05-01

    The present study presents the Hiroshima University Registry of atomic bomb survivors, of which the total number is about 270,000, and application of absorbed doses. From this registry, we picked up 49,102 survivors and applied organ doses based on the dosimetry system 1986 (DS86), which is named the Atomic Bomb Survivor 1993 Dose (ABS93D). The applied dose data are based on the tables listed in the DS86 final report such as the free-in-air kermas, the house shielding factors, and organ dose factors for the active bone marrow and the breast. Calculations for the 13 other organs provided in DS86 are possible. To obtained the organ doses for each survivor, it is necessary to obtain information concerning (1) place exposed, (2) whether they were shielded or not, and (3) age. ABS93D body transmission factors for active bone marrow for neutrons and gamma rays agreed with DS 86 to within a few percent. Of the survivors studied, 35, 123 of them were used for the relative risk estimation of leukemia mortality, adopting the same method as the Radiation Effects Research Foundation (RERF) for comparison. For the observation period from 1968 to 1989, the analyzed relative risks for leukemia mortality at 1 Gy by shielded kerm and by active bone marrow dose are 2.01 and 2.37, respectively, which are consistent with the RERF results. 11 refs., 1 fig., 3 tabs.

  2. The case for establishing a Holocaust survivors cohort in Israel.

    Science.gov (United States)

    Fall, Caroline Hd; Kumaran, Kalyanaraman

    2014-01-01

    In this issue, Keinan-Boker summarises the main studies that have followed up offspring of women exposed to famine during pregnancy and calls for the establishment of a national cohort of Holocaust survivors and their offspring to study inter-generational effects. She suggests that the study would consolidate the fetal origins theory and lead to translational applications to deal with the inter-generational effects of the Holocaust. Barker suggested that alterations in the nutritional supply during critical stages of intra-uterine development permanently alter the structure and metabolism of fetal organs which he termed 'fetal programming' (now known as developmental origins of health and disease). The famine studies have played an important role in refining the hypothesis by allowing a 'quasi-experimental' setting that would otherwise have been impossible to recreate. The developmental origins hypothesis provides a framework to link genetic, environmental and social factors across the lifecourse and offers a primordial preventive strategy to prevent non-communicable disease. Although the famine studies have provided valuable information, the results from various studies are inconsistent. It is perhaps unsurprising given the problems with collecting and interpreting data from famine studies. Survival bias and information bias are key issues. With mortality rates being high, survivors may differ significantly from non-survivors in factors which influence disease development. Most of the data is at ecological level; a lack of individual-level data and poor records make it difficult to identify those affected and assess the severity of effect. Confounding is also possible due to the varying periods and degrees of food deprivation, physical punishment and mental stress undergone by famine survivors. Nonetheless, there would be value in setting up a cohort of Holocaust survivors and their offspring and Keinan-Boker correctly argues that they deserve special attention

  3. Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors.

    Science.gov (United States)

    Segal, Saya; John, Gabriella; Sammel, Mary; Andy, Uduak Umoh; Chu, Christina; Arya, Lily A; Brown, Justin; Schmitz, Kathryn

    2017-03-18

    To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors. We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation. Of the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01). Local or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. 5 CFR 838.711 - Maximum former spouse survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Maximum former spouse survivor annuity... Orders Awarding Former Spouse Survivor Annuities Limitations on Survivor Annuities § 838.711 Maximum former spouse survivor annuity. (a) Under CSRS, payments under a court order may not exceed the...

  5. 20 CFR 225.21 - Survivor Tier I PIA.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Survivor Tier I PIA. 225.21 Section 225.21... INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.21 Survivor Tier I PIA. The Survivor Tier I PIA is used in computing the tier...

  6. 5 CFR 831.645 - Elections between survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Elections between survivor annuities. 831... REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Eligibility § 831.645 Elections between survivor...” does not include Survivor Benefit Payments from a military retirement system or social...

  7. 5 CFR 831.641 - Division of a survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Division of a survivor annuity. 831.641... REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Eligibility § 831.641 Division of a survivor annuity. (a... comply with a court order under subpart Q, a survivor annuity may be divided into a combination of...

  8. 5 CFR 837.702 - Offset from supplemental survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Offset from supplemental survivor annuity... survivor annuity. (a) OPM will reduce a supplemental survivor annuity (an annuity under 5 U.S.C. 8341) based on the service of an individual who performed CSRS-Offset service, if the survivor annuitant...

  9. Marriage and divorce among childhood cancer survivors.

    Science.gov (United States)

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda; Møller, Henrik; Johansen, Christoffer; Schmiegelow, Kjeld

    2011-10-01

    Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer was diagnosed between 1965 and 1996 before they were 20 years of age. A sex-matched and age-matched population-based control cohort was used for comparison (n=45,449). Demographic and socioeconomic data were obtained from national registers and explored by discrete-time Cox regression analyses. Childhood cancer survivors had a reduced rate of cohabitation [rate ratio (RR) 0.78; 95% confidence interval (CI): 0.73-0.83], owing to lower rates among survivors of both noncentral nervous system (CNS) tumors (RR 0.88; 95% CI: 0.83-0.95) and CNS tumors (RR 0.52; 95% CI: 0.45-0.59). Male CNS tumor survivors had a nonsignificantly lower rate (RR 0.47; 95% CI: 0.38-0.58) than females (RR 0.56; 95% CI: 0.47-0.68). The rates of separation were almost identical to those of controls. In conclusion, the rate of cohabitation was lower for all childhood cancer survivors than for the population-based controls, with the most pronounced reduction among survivors of CNS tumors. Mental deficits after cranial irradiation are likely to be the major risk factor.

  10. Survivor

    Directory of Open Access Journals (Sweden)

    Jacques Marblé

    2014-10-01

    Full Text Available Every crime becomes a collectivecrime when indifference is added tohorror. When no help from others ispossible, the question becomes oneof survival, which, in turn, gives riseto the different ways of thinking thesurvivor. The article examines thelatter on the basis of a clinical caseand of various paradigmatic works.

  11. STUDI KOMITMEN ORGANISASIONAL: PEKERJA CONTINGENT DAN SURVIVOR

    Directory of Open Access Journals (Sweden)

    Fenika Walani

    2015-08-01

    Full Text Available In recent years, contingent and survivor workers have emerged as a common reality in business activities. Unfortunately, contingent worker has high job insecurity on his employment status. On the other side, downsizing activities can result in decreasing job security of survivor worker. As a consequence, both contingent and survivor workers very potential have low organizational commitment. However, organizations still have an opportunity to give their workers an exclusive treatment for building organizational commitment without ignoring the fact that workers have other commitment foci.

  12. Impact of late radiation effects on cancer survivor children: an integrative review

    Energy Technology Data Exchange (ETDEWEB)

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2016-07-01

    We aimed to identify the late effects of radiation exposure in pediatric cancer survivors. An integrated literature review was performed in the databases MEDLINE and LILACS and SciELO. Included were articles in Portuguese and English, published over the past 10 years, using the following keywords: “neoplasias/neoplasms” AND “radioterapia/radiotherapy” AND “radiação/radiation”. After analysis, 14 articles - published in nine well-known journals - met the inclusion criteria. The publications were divided into two categories: “Late endocrine effects” and “Late non-endocrine effects”. Considering the increased survival rates in children who had cancer, the impact of late effects of exposure to radiation during radiological examinations for diagnosis and treatment was analyzed. Childhood cancer survivors were exposed to several late effects and should be early and regularly followed up, even when exposed to low radiation doses.

  13. Impact of late radiation effects on cancer survivor children: an integrative review

    Science.gov (United States)

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia

    2016-01-01

    ABSTRACT We aimed to identify the late effects of radiation exposure in pediatric cancer survivors. An integrated literature review was performed in the databases MEDLINE and LILACS and SciELO. Included were articles in Portuguese and English, published over the past 10 years, using the following keywords: “neoplasias/neoplasms” AND “radioterapia/radiotherapy” AND “radiação/radiation”. After analysis, 14 articles - published in nine well-known journals - met the inclusion criteria. The publications were divided into two categories: “Late endocrine effects” and “Late non-endocrine effects”. Considering the increased survival rates in children who had cancer, the impact of late effects of exposure to radiation during radiological examinations for diagnosis and treatment was analyzed. Childhood cancer survivors were exposed to several late effects and should be early and regularly followed up, even when exposed to low radiation doses. PMID:26313432

  14. Impact of late radiation effects on cancer survivor children: an integrative review.

    Science.gov (United States)

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia

    2016-01-01

    We aimed to identify the late effects of radiation exposure in pediatric cancer survivors. An integrated literature review was performed in the databases MEDLINE and LILACS and SciELO. Included were articles in Portuguese and English, published over the past 10 years, using the following keywords: "neoplasias/neoplasms" AND "radioterapia/radiotherapy" AND "radiação/radiation". After analysis, 14 articles - published in nine well-known journals - met the inclusion criteria. The publications were divided into two categories: "Late endocrine effects" and "Late non-endocrine effects". Considering the increased survival rates in children who had cancer, the impact of late effects of exposure to radiation during radiological examinations for diagnosis and treatment was analyzed. Childhood cancer survivors were exposed to several late effects and should be early and regularly followed up, even when exposed to low radiation doses.

  15. Impact on the Japanese atomic bomb survivors of radiation received from the bombs.

    Science.gov (United States)

    Cullings, Harry M

    2014-02-01

    The Radiation Effects Research Foundation (RERF) studies various cohorts of Japanese atomic bomb survivors, the largest being the Life Span Study (LSS), which includes 93,741 persons who were in Hiroshima or Nagasaki at the times of the bombings; there are also cohorts of persons who were exposed in utero and survivors' children. This presentation attempts to summarize the total impact of the radiation from the bombs on the survivors from both an individual perspective (both age-specific and integrated lifetime risk, along with a measure of life expectancy that describes how the risk affects the individual given age at exposure) and a group perspective (estimated numbers of excess occurrences in the cohort), including both early and late effects. As survivors' doses ranged well into the acutely lethal range at closer distances, some of them experienced acute signs and symptoms of radiation exposure in addition to being at risk of late effects. Although cancer has always been a primary concern among late effects, estimated numbers of excess cancers and hematopoietic malignancies in the LSS are a small fraction of the total due to the highly skewed dose distribution, with most survivors receiving small doses. For example, in the latest report on cancer incidence, 853 of 17,448 incident solid cancers were estimated to be attributable to radiation from the bombs. RERF research indicates that risk of radiation-associated cancer varies among sites and that some benign tumors such as uterine myoma are also associated with radiation. Noncancer late effects appear to be in excess in proportion to radiation dose but with an excess relative risk about one-third that of solid cancer and a correspondingly small overall fraction of cases attributable to radiation. Specific risks were found for some subcategories, particularly circulatory disease, including stroke and precedent conditions such as hypertension. Radiation-related cataract in the atomic bomb survivors is well known

  16. Unemployment among breast cancer survivors

    DEFF Research Database (Denmark)

    Carlsen, Kathrine; Ewertz, Marianne; Dalton, Susanne Oksbjerg

    2014-01-01

    AIM: Though about 20% of working age breast cancer survivors do not return to work after treatment, few studies have addressed risk factors for unemployment. The majority of studies on occupational consequences of breast cancer focus on non-employment, which is a mixture of sickness absence......, unemployment, retirement pensions and other reasons for not working. Unemployment in combination with breast cancer may represent a particular challenge for these women. The aim of the present study is therefore to analyze the risk for unemployment in the years following diagnosis and treatment for breast...... cancer. METHOD: This study included 14,750 women diagnosed with breast cancer in Denmark 2001-2009 identified through a population-based clinical database and linked with information from Danish administrative population based registers for information on labour market affiliation, socio...

  17. Epidemiological research on radiation-induced cancer in atomic bomb survivors.

    Science.gov (United States)

    Ozasa, Kotaro

    2016-08-01

    The late effects of exposure to atomic bomb radiation on cancer occurrence have been evaluated by epidemiological studies on three cohorts: a cohort of atomic bomb survivors (Life Span Study; LSS), survivors exposed IN UTERO : , and children of atomic bomb survivors (F1). The risk of leukemia among the survivors increased remarkably in the early period after the bombings, especially among children. Increased risks of solid cancers have been evident since around 10 years after the bombings and are still present today. The LSS has clarified the dose-response relationships of radiation exposure and risk of various cancers, taking into account important risk modifiers such as sex, age at exposure, and attained age. Confounding by conventional risk factors including lifestyle differences is not considered substantial because people were non-selectively exposed to the atomic bomb radiation. Uncertainty in risk estimates at low-dose levels is thought to be derived from various sources, including different estimates of risk at background levels, uncertainty in dose estimates, residual confounding and interaction, strong risk factors, and exposure to residual radiation and/or medical radiation. The risk of cancer in subjects exposed IN UTERO : is similar to that in LSS subjects who were exposed in childhood. Regarding hereditary effects of radiation exposure, no increased risk of cancers associated with parental exposure to radiation have been observed in the F1 cohort to date. In addition to biological and pathogenetic interpretations of the present results, epidemiological investigations using advanced technology should be used to further analyze these cohorts. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  18. Living as a Colorectal Cancer Survivor

    Science.gov (United States)

    ... Cancer Colorectal Cancer After Treatment Living as a Colorectal Cancer Survivor For many people with colorectal cancer, treatment ... cancer screening tests. Typical follow-up schedules after colorectal cancer Even if you have completed treatment, you will ...

  19. Survivorship conference highlights research for survivor care

    Science.gov (United States)

    More than 400 leading experts in cancer survivorship convened today for a conference, Cancer Survivorship Research: Translating Science to Care, to focus on such current concerns as how obesity might not have the same effects on all cancer survivors, and

  20. Managing chronic pain in survivors of torture

    DEFF Research Database (Denmark)

    Amris, Kirstine; Williams, Amanda C de C

    2015-01-01

    All generalist and specialist clinicians are likely to encounter torture survivors among refugees and asylum seekers. A minority of people survive torture and a smaller minority reach a developed country; those who do tend to be the more resilient and resourceful. They have many health, social...... and welfare problems; persistent pain in the musculoskeletal system is one of the most common. There is little specific evidence on pain in survivors of torture; the guidelines on interdisciplinary specialist management are applicable. Most of the literature on refugee survivors of torture has an exclusive...... focus on psychological disorders, with particularly poor understanding of pain problems. This article summarizes the current status of assessment and treatment of pain problems in the torture survivor....

  1. Utilizing Data from Cancer Patient & Survivor Studies

    Science.gov (United States)

    Utilizing Data from Cancer Patient & Survivor Studies and Understanding the Current State of Knowledge and Developing Future Research Priorities, a 2011 workshop sponsored by the Epidemiology and Genomics Research Program.

  2. The Survivor Syndrome: Aftermath of Downsizing.

    Science.gov (United States)

    Appelbaum, Steven H.; Delage, Claude; Labib, Nadia; Gault, George

    1997-01-01

    Downsizing can result in remaining staff developing "survivor syndrome," experiencing low morale, stress, and other psychosocial problems. If downsizing is necessary, precautions include managing perceptions and communications and empowering employees to take career ownership. (SK)

  3. Living as a Thyroid Cancer Survivor

    Science.gov (United States)

    ... Working Thyroid Cancer After Treatment Living as a Thyroid Cancer Survivor For many people with thyroid cancer, treatment ... Cancer Treatments Are No Longer Working More In Thyroid Cancer About Thyroid Cancer Causes, Risk Factors, and Prevention ...

  4. Secondhand Smoke Still Plagues Some Cancer Survivors

    Science.gov (United States)

    ... the study published June 22 in the journal Cancer Epidemiology, Biomarkers & Prevention . "Cancer patients and survivors must be ... Akinboro said in a journal news release. SOURCE: Cancer Epidemiology, Biomarkers & Prevention , news release, June 22, 2017 HealthDay ...

  5. Depression among caregivers of stroke survivors

    National Research Council Canada - National Science Library

    Berg, Anu; Palomäki, Heikki; Lönnqvist, Jouko; Lehtihalmes, Matti; Kaste, Markku

    2005-01-01

    We aimed to assess the prevalence of depressive symptoms among caregivers of stroke survivors and to determine which patient- or stroke-related factors are associated with and can be used to predict...

  6. Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review.

    Science.gov (United States)

    Bowers, Daniel C; Nathan, Paul C; Constine, Louis; Woodman, Catherine; Bhatia, Smita; Keller, Karen; Bashore, Lisa

    2013-07-01

    Childhood cancer survivors are at risk for development of subsequent neoplasms of the CNS. Better understanding of the rates, risk factors, and outcomes of subsequent neoplasms of the CNS among survivors of childhood cancer could lead to more informed screening guidelines. Two investigators independently did a systematic search of Medline and Embase (from January, 1966, through March, 2012) for studies examining subsequent neoplasms of the CNS among survivors of childhood cancer. Articles were selected to answer three questions: what is the risk of CNS tumours after radiation to the cranium for a paediatric cancer, compared with the risk in the general population; what are the outcomes in children with subsequent neoplasms of the CNS who received CNS-directed radiation for a paediatric cancer; and, are outcomes of subsequent neoplasms different from primary neoplasms of the same histology? Our search identified 72 reports, of which 18 were included in this Review. These studies reported that childhood cancer survivors have an 8·1-52·3-times higher incidence of subsequent CNS neoplasms compared with the general population. Nearly all cancer survivors who developed a CNS neoplasm had been exposed to cranial radiation, and some studies showed a correlation between radiation dose and risk of subsequent CNS tumours. 5-year survival ranged from 0-19·5% for subsequent high-grade gliomas and 57·3-100% for meningiomas, which are similar rates to those observed in patients with primary gliomas or meningiomas. The quality of evidence was limited by variation in study design, heterogeneity of details regarding treatment and outcomes, limited follow-up, and small sample sizes. We conclude that survivors of childhood cancer who received cranial radiation therapy have an increased risk for subsequent CNS neoplasms. The current literature is insufficient to comment about the potential harms and benefits of routine screening for subsequent CNS neoplasms.

  7. Lebanese medical students' exposure to domestic violence: does it affect helping survivors?

    Science.gov (United States)

    Usta, Jinan; Hlais, Sani; Farhat, Hala Abou; Romani, Maya; Bzeih, Hiba; Abdo, Lynn

    2014-02-01

    Our purpose was to assess medical students' willingness to help women survivors of intimate partner violence (IPV) and its relation to past exposure to violence. A cross-sectional study of medical students enrolled in three major universities in Beirut was carried out: 545 students filled out a self-administered questionnaire. The Inventory of Beliefs About Wife Beating, the Attitudes Toward Women's scale, the Marriage Role Expectations Inventory, the Conflict Tactics scale, and the Trauma Symptoms scale were used. The majority (93.6%) of medical students believed that battered wives should be helped by either social or governmental agencies, but only 48% showed readiness to provide help themselves. Female medical students were significantly more likely to be willing to help survivors of violence, whereas students exposed to domestic violence in childhood were significantly less likely to do so. Female medical students previously exposed to violence had significantly higher scores on the Briere and Runtz's Trauma Symptom Checklist, indicating more negative trauma-related symptoms. Multivariate analysis revealed that the students' exposure to verbal aggression, their marital role expectations, attitudes toward women, and parents' marital status accounted for 26% of the variability in the Helping Battered Wives score. The results of this study suggest that the medical students' past exposure to DV impacts their psychological well-being and their willingness to help abuse survivors. Given the multitude of stresses medical students are exposed to, careful attention and attendance to the effect of abuse on their well-being may be warranted.

  8. Proteomic profiles in acute respiratory distress syndrome differentiates survivors from non-survivors.

    Directory of Open Access Journals (Sweden)

    Maneesh Bhargava

    Full Text Available Acute Respiratory Distress Syndrome (ARDS continues to have a high mortality. Currently, there are no biomarkers that provide reliable prognostic information to guide clinical management or stratify risk among clinical trial participants. The objective of this study was to probe the bronchoalveolar lavage fluid (BALF proteome to identify proteins that differentiate survivors from non-survivors of ARDS. Patients were divided into early-phase (1 to 7 days and late-phase (8 to 35 days groups based on time after initiation of mechanical ventilation for ARDS (Day 1. Isobaric tags for absolute and relative quantitation (iTRAQ with LC MS/MS was performed on pooled BALF enriched for medium and low abundance proteins from early-phase survivors (n = 7, early-phase non-survivors (n = 8, and late-phase survivors (n = 7. Of the 724 proteins identified at a global false discovery rate of 1%, quantitative information was available for 499. In early-phase ARDS, proteins more abundant in survivors mapped to ontologies indicating a coordinated compensatory response to injury and stress. These included coagulation and fibrinolysis; immune system activation; and cation and iron homeostasis. Proteins more abundant in early-phase non-survivors participate in carbohydrate catabolism and collagen synthesis, with no activation of compensatory responses. The compensatory immune activation and ion homeostatic response seen in early-phase survivors transitioned to cell migration and actin filament based processes in late-phase survivors, revealing dynamic changes in the BALF proteome as the lung heals. Early phase proteins differentiating survivors from non-survivors are candidate biomarkers for predicting survival in ARDS.

  9. Unemployment among breast cancer survivors.

    Science.gov (United States)

    Carlsen, Kathrine; Ewertz, Marianne; Dalton, Susanne Oksbjerg; Badsberg, Jens Henrik; Osler, Merete

    2014-05-01

    Though about 20% of working age breast cancer survivors do not return to work after treatment, few studies have addressed risk factors for unemployment. The majority of studies on occupational consequences of breast cancer focus on non-employment, which is a mixture of sickness absence, unemployment, retirement pensions and other reasons for not working. Unemployment in combination with breast cancer may represent a particular challenge for these women. The aim of the present study is therefore to analyze the risk for unemployment in the years following diagnosis and treatment for breast cancer. This study included 14,750 women diagnosed with breast cancer in Denmark 2001-2009 identified through a population-based clinical database and linked with information from Danish administrative population based registers for information on labour market affiliation, socio-demography and co-morbid conditions. Multivariable analyses were performed by Cox's proportional hazard models. Two years after treatment, 81% of patients were still part of the work force, 10% of which were unemployed. Increasing duration of unemployment before breast cancer was associated with an adjusted HR = 4.37 (95% CI: 3.90-4.90) for unemployment after breast cancer. Other risk factors for unemployment included low socioeconomic status and demography, while adjuvant therapy did not increase the risk of unemployment. Duration of unemployment before breast cancer was the most important determinant of unemployment after breast cancer treatment. This allows identification of a particularly vulnerable group of patients in need of rehabilitation.

  10. Psychological distress in adult survivors of childhood cancer: the Swiss Childhood Cancer Survivor study.

    Science.gov (United States)

    Michel, Gisela; Rebholz, Cornelia E; von der Weid, Nicolas X; Bergstraesser, Eva; Kuehni, Claudia E

    2010-04-01

    To evaluate the degree of psychological distress in adult childhood cancer survivors in Switzerland and to characterize survivors with significant distress. Childhood cancer survivors who were age younger than 16 years when diagnosed between 1976 and 2003, had survived more than 5 years, and were currently age 20 years or older received a postal questionnaire. Psychological distress was assessed using the Brief Symptom Inventory (BSI). Raw scores were transformed into T scores according to the German norm sample, and the proportion of participants being at increased risk for psychological distress was calculated (case rule: T > or = 63). t tests and univariable and multivariable logistic regressions were used for statistical analyses. One thousand seventy-six survivors (63.% of eligible survivors, 71.9% of contacted survivors) returned the questionnaire, 987 with complete data on BSI. Comparison with the norm populations showed lower T scores (T < 50) in the Global Severity Index (GSI; T = 46.2), somatization (T = 47.6), obsessive-compulsive tendencies (T = 46.9), and anxiety (T = 48.4). However, more childhood cancer survivors (especially women) had increased distress for GSI (14.4%), interpersonal sensitivity (16.5%), depression (13.4%), aggression (16.9%), and psychotic tendencies (15.6%) than the expected 10% from the norm population. Caseness was associated with female sex, being a single child, older age at study, and self-reported late effects, especially psychological problems. Results show that childhood cancer survivors, on average, have less psychological distress than a norm population but that the proportion of survivors at risk for high psychological distress is disproportionally large. Monitoring psychological distress in childhood cancer survivors may be desirable during routine follow-up, and psychological support should be offered as needed.

  11. Prevalence of monoclonal gammopathy of undetermined significance in Asia: a viewpoint from nagasaki atomic bomb survivors.

    Science.gov (United States)

    Iwanaga, Masako; Tomonaga, Masao

    2014-02-01

    Exposure to ionizing radiation is a known environmental risk factor for a variety of cancers including hematological malignancies, such as leukemia, myelodysplastic syndromes, and multiple myeloma. Therefore, for Hiroshima and Nagasaki atomic bomb survivors (surviving victims who were exposed to ionizing radiation emitted from the nuclear weapons), several cancer-screening tests have been provided annually, with government support, to detect the early stage of malignancies. An M-protein screening test has been used to detect multiple myeloma at an early stage among atomic bomb survivors. In the screening process, a number of patients with monoclonal gammopathy of undetermined significance (MGUS), in addition to multiple myeloma, have been identified. In 2009 and 2011, we reported the age- and sex-specific prevalence of MGUS between 1988 and 2004 and the possible role of radiation exposure in the development of MGUS using the screening data of more than 1000 patients with MGUS among approximately 52,000 Nagasaki atomic bomb survivors. The findings included: (1) a significant lower overall prevalence (2.1%) than that observed in Caucasian or African-origin populations; (2) a significantly higher prevalence in men than in women; (3) an age-related increase in the prevalence; (4) a significantly higher prevalence in people exposed to higher radiation doses only among those exposed at age 20 years or younger; and (5) a lower frequency of immunoglobulin M MGUS in Japanese patients than in patients in Western countries. The large study of MGUS among Nagasaki atomic bomb survivors has provided important findings for the etiology of MGUS, including a possible role of radiation exposure on the cause of MGUS and an ethnicity-related difference in the characteristics of MGUS. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Survivors of Intimate Partner Violence Speak Out

    Science.gov (United States)

    Battaglia, Tracy A; Finley, Erin; Liebschutz, Jane M

    2003-01-01

    OBJECTIVE To identify characteristics that facilitate trust in the patient-provider relationship among survivors of intimate partner violence (IPV). DESIGN Semistructured, open-ended interviews were conducted to elicit participants' beliefs and attitudes about trust in interactions with health care providers. Using grounded theory methods, the transcripts were analyzed for common themes. A community advisory group, composed of advocates, counselors and IPV survivors, helped interpret themes and interview exerpts. Together, key components of trust were identified. SETTING Eastern Massachusetts. PARTICIPANTS Twenty-seven female survivors of IPV recruited from community-based IPV organizations. MAIN RESULTS Participants' ages ranged from 18 to 56 years, 36% were African American, 32% Hispanic, and 18% white. We identified 5 dimensions of provider behavior that were uniquely important to the development of trust for these IPV survivors: 1) communication about abuse: provider was willing to openly discuss abuse; 2) professional competency: provider asked about abuse when appropriate and was familiar with medical and social histories; 3) practice style: provider was consistently accessible, respected confidentiality, and shared decision making; 4) caring: provider demonstrated personal concern beyond biomedical role through nonjudgmental and compassionate gestures, empowering statements, and persistent, committed behaviors; 5) emotional equality: provider shared personal information and feelings and was perceived by the participant as a friend. CONCLUSIONS These IPV survivors identified dimensions of provider behavior that facilitate trust in their clinical relationship. Strengthening these provider behaviors may increase trust with patients and thus improve disclosure of and referral for IPV. PMID:12911643

  13. Comprehensive Care Model for Sex Trafficking Survivors.

    Science.gov (United States)

    Twigg, Naomi M

    2017-05-01

    The purpose of this study was to identify aftercare services for domestic minor of sex trafficking (DMST) survivors provided by U.S. residential treatment centers. A qualitative research study was conducted with aftercare program personnel from five U.S. residential treatment centers for DMST survivors. Interviews were conducted with staff from five different residential treatment centers providing services exclusively to domestic minor sex trafficking survivors. Participants described the range of services offered to address survivors' posttrafficking needs. Participants' responses assisted in expanding an existing care model to include education re-entry, family reunification, family reconciliation, and emergency substance use services. This study led to the refinement of an aftercare service delivery model and laid the foundation to develop best practice guidelines for providing aftercare services to DMST survivors. Sex trafficking is a global health problem affecting our youth today. Nurses have a vital role in combatting sex trafficking by raising awareness about the problem and restoring the lives of sex trafficking victims by implementing innovative care programs. © 2017 Sigma Theta Tau International.

  14. Health Management of Breast Cancer Survivors

    Institute of Scientific and Technical Information of China (English)

    Min Li; Juan Chen; Zhendong Chen

    2009-01-01

    Breast cancer is defined as a chronic disease.Increasing amounts of attention have been paid to the health management of breast cancer survivors. An important issue is how to find the most appropriate method of follow-up in order to detect long-term complications of treatment, local recurrence and distant metastasis and to administer appropriate treatment to the survivors with recurrence in a timely fashion. Different oncology organizations have published guidelines for following up breast cancer survivors. However, there are few articles on this issue in China. Using the published follow-up guidelines,we analyzed their main limitations and discussed the content,follow-up interval and economic benefits of following up breast cancer survivors in an effort to provide suggestions to physicians.Based on a large number of clinical trials, we discussed the role of physical examination, mammography, liver echograph, chest radiography, bone scan and so on. We evaluated the effects of the above factors on detection of distant disease, survival time,improvement in quality of life and time to diagnosis of recurrence.The results of follow-up carried out by oncologists and primary health care physicians were compared. We also analyzed the correlation factors for the cost of such follow-up. It appears that follow-up for breast cancer survivors can be carried out effectively by trained primary health care physicians. If anything unusual arises, the patients should be transferred to specialists.

  15. For Stroke Survivors, Exercise Is Good for The Brain

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163721.html For Stroke Survivors, Exercise Is Good for the Brain: Review ... HealthDay News) -- A structured exercise program can help stroke survivors recover not only physically but mentally as ...

  16. Characteristic miR-24 Expression in Gastric Cancers among Atomic Bomb Survivors.

    Science.gov (United States)

    Naito, Yutaka; Oue, Naohide; Pham, Trang T B; Yamamoto, Manabu; Fujihara, Megumu; Ishida, Teruyoshi; Mukai, Shoichiro; Sentani, Kazuhiro; Sakamoto, Naoya; Hida, Eisuke; Sasaki, Hiroki; Yasui, Wataru

    2015-01-01

    To elucidate the mechanism of radiation-induced cancers, we analyzed the expression profiles of microRNAs extracted from formalin-fixed paraffin-embedded (FFPE) gastric cancer (GC) tissue samples from atomic bomb survivors. The expression levels of miR-21, miR-24, miR-34a, miR-106a, miR-143, and miR-145 were measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of microRNAs was measured by qRT-PCR in a Hiroshima University Hospital cohort comprising 32 patients in the high-dose-exposed group and 18 patients in the low-dose-exposed group who developed GC after the bombing. The GC cases showing high expression of miR-24, miR-143, and miR-145 were more frequently found in the high-dose-exposed group than in the low-dose-exposed group. We next performed qRT-PCR of miR-24, miR-143, and miR-145 in a cohort from the Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital comprising 122 patients in the high-dose-exposed group and 48 patients in the low-dose-exposed group who developed GC after the bombing. High expressions of miR-24 and miR-143 were more frequently found in the high-dose-exposed group than in the low-dose-exposed group. Multivariate analysis demonstrated that only high expression of miR-24 was an independent predictor for the exposure status. These results suggest that the measurement of miR-24 expression from FFPE samples is useful to identify radiation-associated GC.

  17. Evaluation of adverse events in atomic bomb survivors receiving curative-intent radiation therapy from 2005 to 2010.

    Science.gov (United States)

    Doi, Yoshiko; Murakami, Yuji; Kenjo, Masahiro; Imano, Nobuki; Kimura, Tomoki; Nagata, Yasushi

    2016-01-01

    To evaluate the safety of radiation therapy (RT) in atomic bomb (A-bomb) survivors (ABS), we evaluated the frequency of RT-associated adverse events (AEs) in ABS. We selected patients who underwent curative external-beam RT (EBRT) at Hiroshima University Hospital between January 2005 and December 2010 and were born before August 1946; the patients were divided into ABS and non-ABS groups, which groups received identical treatments without stratification. We retrospectively reviewed the medical records of 220 ABS and 753 non-ABS patients. The median age was 72 years. The median observation durations were 41 and 37 months for the ABS and non-ABS groups, respectively. The ABS group had higher frequencies of women, breast cancer patients, and concurrent chemotherapy and had a lower incidence of only acute hematological AEs. However this tendency disappeared when breast cancer patients were excluded, and no significant differences were observed between the ABS and non-ABS groups regarding Grade ⩾ 3 other acute and late AEs. The overall cumulative incidence of Grade ⩾ 3 late AEs did not significantly differ between the ABS and non-ABS groups. Notable increases in AEs were not observed during or after RT among ABS. This study clarified that stratification is not required when treating ABS with RT. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Characteristic expression of fukutin in gastric cancer among atomic bomb survivors.

    Science.gov (United States)

    Pham, Trang T B; Oue, Naohide; Yamamoto, Manabu; Fujihara, Megumu; Ishida, Teruyoshi; Mukai, Shoichiro; Sakamoto, Naoya; Sentani, Kazuhiro; Yasui, Wataru

    2017-02-01

    Approximately 70 years have passed since the atomic bombs were dropped on Nagasaki and Hiroshima. To elucidate potential biomarkers and possible mechanisms of radiation-induced cancer, the expression of FKTN, which encodes fukutin protein and causes Fukuyama-type congenital muscular dystrophy, was analyzed in gastric cancer (GC) tissue samples from atomic bomb survivors. Expression of cluster of differentiation (CD) 10 was also evaluated, as it has previously been observed that positive fukutin expression was frequently noted in CD10-positive GC cases. In the first cohort from Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital (Hiroshima, Japan; n=92), 102 (53%) of the GC cases were positive for fukutin. Expression of fukutin was not associated with exposure status, but was associated with CD10 expression (P=0.0001). The second cohort was from Hiroshima University Hospital (Hiroshima, Japan; n=86), and these patients were also in the Life Span Study cohort, in which atomic bomb radiation doses were precisely estimated using the DS02 system. Expression of fukutin was detected in 58 (67%) of GC cases. GC cases positive for fukutin were observed more frequently in the low dose-exposed group than in the high dose-exposed group (P=0.0001). Further studies with a larger cohort, including precise radiation dose estimation, may aid in clarifying whether fukutin could serve as a potential biomarker to define radiation-induced GC in atomic-bomb survivors.

  19. Survivors' perspective of life after stroke

    Directory of Open Access Journals (Sweden)

    Jaine Kareny da Silva

    2016-03-01

    Full Text Available This aim of this interpretive case study was to understand meanings of the experience of illness from the perspective of eight survivors of stroke. Data were collected by means of semi-structured interviews and qualitative thematic analysis. The experience of stroke generated negative feelings such as fear of death, disability, loss of autonomy and inability to work. Social support of family and religion was essential to cope with the changes in everyday life and inefficiency of the health care network experienced by the participants. Lack of guidance was identified, especially from nurses, for home care of patients. The results of the study suggest the need to strengthen health education on predictive symptoms of stroke, awareness of the impacts of this disease on the life of survivors, and the need for multidisciplinary health care teams to encourage proactivity of survivors' family members.

  20. (41)Ca in tooth enamel. Part I: a biological signature of neutron exposure in atomic bomb survivors.

    Science.gov (United States)

    Wallner, A; Rühm, W; Rugel, G; Nakamura, N; Arazi, A; Faestermann, T; Knie, K; Maier, H J; Korschinek, G

    2010-08-01

    The detection of (41)Ca atoms in tooth enamel using accelerator mass spectrometry is suggested as a method capable of reconstructing thermal neutron exposures from atomic bomb survivors in Hiroshima and Nagasaki. In general, (41)Ca atoms are produced via thermal neutron capture by stable (40)Ca. Thus any (41)Ca atoms present in the tooth enamel of the survivors would be due to neutron exposure from both natural sources and radiation from the bomb. Tooth samples from five survivors in a control group with negligible neutron exposure were used to investigate the natural (41)Ca content in tooth enamel, and 16 tooth samples from 13 survivors were used to estimate bomb-related neutron exposure. The results showed that the mean (41)Ca/Ca isotope ratio was (0.17 +/- 0.05) x 10(-14) in the control samples and increased to 2 x 10(-14) for survivors who were proximally exposed to the bomb. The (41)Ca/Ca ratios showed an inverse correlation with distance from the hypocenter at the time of the bombing, similar to values that have been derived from theoretical free-in-air thermal-neutron transport calculations. Given that gamma-ray doses were determined earlier for the same tooth samples by means of electron spin resonance (ESR, or electron paramagnetic resonance, EPR), these results can serve to validate neutron exposures that were calculated individually for the survivors but that had to incorporate a number of assumptions (e.g. shielding conditions for the survivors).

  1. Pregnancy after chemotherapy in male and female survivors of childhood cancer treated between 1970 and 1999: a report from the Childhood Cancer Survivor Study cohort

    Science.gov (United States)

    Chow, Eric J; Stratton, Kayla L; Leisenring, Wendy M; Oeffinger, Kevin C; Sklar, Charles A; Donaldson, Sarah S; Ginsberg, Jill P; Kenney, Lisa B; Levine, Jennifer M; Robison, Leslie L; Shnorhavorian, Margarett; Stovall, Marilyn; Armstrong, Gregory T; Green, Daniel M

    2016-01-01

    Summary Background The effect of many contemporary chemotherapeutic drugs on pregnancy and livebirth is not well established. We aimed to establish the effects of these drugs on pregnancy in male and female survivors of childhood cancer not exposed to pelvic or cranial radiotherapy. Methods We used data from a subset of the Childhood Cancer Survivor Study cohort, which followed 5-year survivors of the most common types of childhood cancer who were diagnosed before age 21 years and treated at 27 institutions in the USA and Canada between 1970 and 1999. We extracted doses of 14 alkylating and similar DNA interstrand crosslinking drugs from medical records. We used sex-specific Cox models to establish the independent effects of each drug and the cumulative cyclophosphamide equivalent dose of all drugs in relation to pregnancies and livebirths occurring between ages 15 years and 44 years. We included siblings of survivors as a comparison group. Findings We included 10 938 survivors and 3949 siblings. After a median follow-up of 8 years (IQR 4–12) from cohort entry or at age 15 years, whichever was later, 4149 (38%) survivors reported having or siring a pregnancy, of whom 3453 (83%) individuals reported at least one livebirth. After a median follow-up of 10 years (IQR 6–15), 2445 (62%) siblings reported having or siring a pregnancy, of whom 2201 (90%) individuals reported at least one livebirth. In multivariable analysis, survivors had a decreased likelihood of siring or having a pregnancy versus siblings (male survivors: hazard ratio [HR] 0·63, 95% CI 0·58–0·68; p<0·0001; female survivors: 0·87, 0·81–0·94; p<0·0001) or of having a livebirth (male survivors: 0·63, 0·58–0·69; p<0·0001; female survivors: 0·82, 0·76–0·89; p<0·0001). In male survivors, reduced likelihood of pregnancy was associated with upper tertile doses of cyclophosphamide (HR 0·60, 95% CI 0·51–0·71; p<0·0001), ifosfamide (0·42, 0·23–0·79; p=0·0069), procarbazine

  2. 26 CFR 1.417(a)(3)-1 - Required explanation of qualified joint and survivor annuity and qualified preretirement survivor...

    Science.gov (United States)

    2010-04-01

    ... survivor annuity and qualified preretirement survivor annuity. 1.417(a)(3)-1 Section 1.417(a)(3)-1 Internal... joint and survivor annuity and qualified preretirement survivor annuity. (a) Written explanation requirement—(1) General rule. A plan meets the survivor annuity requirements of section 401(a)(11) only if...

  3. Participants' Perception of Therapeutic Factors in Groups for Incest Survivors.

    Science.gov (United States)

    Wheeler, Inese; And Others

    1992-01-01

    Investigated member-perceived curative factors in an incest-survivor group, comparing therapeutic factors reported in closed, time-limited incest survivor group to those in Bonney et al.'s open, long-term survivor group and to Yalom's therapy groups. Findings suggest that relative importance of curative factors may be related to group stages.…

  4. 22 CFR 19.11-1 - Kinds of survivor benefits.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Kinds of survivor benefits. 19.11-1 Section 19... PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.11-1 Kinds of survivor benefits. If a participant or former participant dies in active service or after retirement, regular survivor annuities...

  5. 5 CFR 842.613 - Division of a survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Division of a survivor annuity. 842.613... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-BASIC ANNUITY Survivor Elections § 842.613 Division of a survivor annuity. (a) The maximum combined total of all current and former spouse...

  6. 5 CFR 843.313 - Elections between survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Elections between survivor annuities. 843... Former Spouse Benefits § 843.313 Elections between survivor annuities. (a) A current spouse annuity... retirement system for Government employees” does not include Survivor Benefit Payments from a...

  7. 31 CFR 29.346 - Reduction for survivor benefits.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Reduction for survivor benefits. 29... Federal Benefit Payments § 29.346 Reduction for survivor benefits. (a) If a retiree designates a base for a survivor annuity that is greater than or equal to the unreduced Federal Benefit Payment,...

  8. 5 CFR 837.603 - Increased survivor benefits.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Increased survivor benefits. 837.603... REGULATIONS (CONTINUED) REEMPLOYMENT OF ANNUITANTS Death Benefits § 837.603 Increased survivor benefits. (a) Supplemental survivor annuity. (1) If an annuitant reemployed subject to the provisions of this part dies...

  9. Cancer survivor identity shared in a social media intervention.

    Science.gov (United States)

    Song, Hayeon; Nam, Yujung; Gould, Jessica; Sanders, W Scott; McLaughlin, Margaret; Fulk, Janet; Meeske, Kathleen A; Ruccione, Kathleen S

    2012-01-01

    This study investigates how cancer survivors construct their identities and the impact on their psychological health, as measured by depression and survivor self-efficacy. Fourteen young adult survivors of pediatric cancer participated in a customized social networking and video blog intervention program, the LIFECommunity, over a 6-month period. Survivors were asked to share their stories on various topics by posting video messages. Those video blog postings, along with survey data collected from participants, were analyzed to see how cancer survivors expressed their identities, and how these identities are associated with survivors' psychosocial outcomes. In survivors who held negative stereotypes about cancer survivors, there was a positive relationship with depression while positive stereotypes had a marginal association with cancer survivor efficacy. Findings indicate that although pediatric cancer survivors often do not publicly discuss a "cancer survivor identity," they do internalize both positive and negative stereotypes about cancer survivorship. It is important for practitioners to be aware of the long-term implications of cancer survivor identity and stereotypes.

  10. The Survivor Master Narrative in Sexual Assault.

    Science.gov (United States)

    Muldoon, Shane D; Taylor, S Caroline; Norma, Caroline

    2016-04-01

    This article is based on data drawn from 90 Victoria Police operational files covering the period 2004-2008. Several thematic responses by sexual assault survivors are described as forming a master narrative of "identity shock." It is argued that the "minor/serious" sexual assault legal distinction is meaningless to survivors and conceals a shared felt experience. It is also argued that sexual assault is fundamentally a "public issue" of betrayal of citizen trust--not just a collection of "private troubles"--and that effective resolutions require more than individualized therapeutic and criminal justice measures.

  11. Long-term effects of conflict-related sexual violence compared with non-sexual war trauma in female World War II survivors: a matched pairs study.

    Science.gov (United States)

    Kuwert, Philipp; Glaesmer, Heide; Eichhorn, Svenja; Grundke, Elena; Pietrzak, Robert H; Freyberger, Harald J; Klauer, Thomas

    2014-08-01

    The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.

  12. Against all odds: genocidal trauma is associated with longer life-expectancy of the survivors.

    Directory of Open Access Journals (Sweden)

    Abraham Sagi-Schwartz

    Full Text Available Does surviving genocidal experiences, like the Holocaust, lead to shorter life-expectancy? Such an effect is conceivable given that most survivors not only suffered psychosocial trauma but also malnutrition, restriction in hygienic and sanitary facilities, and lack of preventive medical and health services, with potentially damaging effects for later health and life-expectancy. We explored whether genocidal survivors have a higher risk to die younger than comparisons without such background. This is the first population-based retrospective cohort study of the Holocaust, based on the entire population of immigrants from Poland to Israel (N = 55,220, 4-20 years old when the World War II started (1939, immigrating to Israel either between 1945 and 1950 (Holocaust group or before 1939 (comparison group; not exposed to the Holocaust. Hazard of death - a long-term outcome of surviving genocidal trauma - was derived from the population-wide official data base of the National Insurance Institute of Israel. Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95% = 0.910-0.960, suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10-15 (HR = 0.900, CI (95% = 0.842-0.962, i.e., reduced by 10 months or 16-20 years at the onset of the Holocaust (HR = 0.820, CI (95% = 0.782-0.859, i.e., reduced by18 months. We found that against all odds genocidal survivors were likely to live longer. We suggest two explanations: Differential mortality during the Holocaust and "Posttraumatic Growth" associated with protective factors in Holocaust survivors or in their environment after World War II.

  13. A comparison study on mental health status between suicide survivors and survivors of accidental deaths in rural China.

    Science.gov (United States)

    Xu, G; Li, N

    2014-12-01

    Suicide has become a major public health problem worldwide. For every suicide there are six suicide survivors, a term referring to family members or friends of a person who has died by suicide. Within the literature there has been ongoing debate regarding the bereavement process and if it differs in survivors of suicide as opposed to survivors of those who have died from accidental death. There are scarcely any published reports on comparison between these two groups of survivors in China. In this study, we aimed to explore the difference of mental health status between suicide survivors and survivors of accidental deaths in China. We used a cross-sectional study design to collect data of survivors. Consecutive sampling was used and 92 suicide survivors and 64 survivors of accidental deaths were interviewed. The Symptom Checklist-90-Revised was used to assess the survivors' mental health status. After controlling for demographic variables and time interval between death and interview, no significant differences were found on mental health status between these two groups of survivors. Several explanations might account for the lack of differences. Further studies employing qualitative measures and suicide-specific instruments are needed to explore the bereavement of Chinese suicide survivors.

  14. Mortality in the Children of Atomic Bomb Survivors and Controls

    Science.gov (United States)

    Neel, James V.; Kato, Hiroo; Schull, William J.

    1974-01-01

    A continuing study of mortality rates among children born to survivors of the atomic bombings and a suitable group of controls has been updated; the average interval between birth and verification of death or survival is 17 years. The mortality experience is now based on 18,946 children liveborn to parents one or both of whom were proximally exposed, receiving jointly an estimated dose of 117 rem; 16,516 children born to distally exposed parents receiving essentially no radiation; and 17,263 children born to parents not in Hiroshima or Nagasaki at the time of the bombings. No clearly significant effect of parental exposure on child's survival can be demonstrated either by a contingency χ2 type of analysis or regression analysis. On the basis of the regression data, the minimal gametic doubling dose of radiation of this type for mutations resulting in death during (on the average) the first 17 years of life among liveborn infants conceived 0–13 years after parental exposure is estimated at 46 rem for fathers and 125 rem for mothers. On the basis of experimental data, the gametic doubling dose for chronic, low-level radiation would be expected to be three to four times this value for males and as much as 1000 rem for females. PMID:4822470

  15. Child Survivor of War: A Case Study

    Science.gov (United States)

    Roysircar, Gargi

    2004-01-01

    This article examines the history of a Bosnian survivor of war living in the U.S. using the extended case method. Clinical issues related to acculturative stress, posttraumatic stress disorder, and identity are analyzed. Suggested treatment includes existential therapy and its cognitive--behavioral applications, didactic education on trauma,…

  16. Imminent ovarian failure in childhood cancer survivors

    NARCIS (Netherlands)

    Lantinga, G. M.; Simons, A. H. M.; Kamps, W. A.; Postma, A.

    2006-01-01

    The aim of this study was to investigate reproductive history and the prevalence of imminent ovarian failure (IOF) in female childhood cancer survivors. Reproductive history and ovarian function were evaluated by questionnaires (n = 124) and by measurement of follicle stimulating hormone (FSH) and o

  17. Examining the Personal Resources of Layoff Survivors

    Science.gov (United States)

    Cotter, Elizabeth W.

    2011-01-01

    This study investigated the process of burnout and engagement in layoff survivors. Job demands (job insecurity and work overload) and resources (social support, optimism, career adaptability, and career management self-efficacy) were examined as predictors of burnout and engagement. The sample consisted of 203 adults currently working at…

  18. Fertility in Female Childhood Cancer Survivors

    NARCIS (Netherlands)

    Bruin, de M.; Broeder, den E.; Berg, van den M.H.; Lambalk, C.B.

    2009-01-01

    Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly enlarging group of childhood cancer survivors. There is much concern, however, about the effects of treatment on reproductive potential. In women there is evidence that both

  19. A Spiritual Framework in Incest Survivors Treatment

    Science.gov (United States)

    Beveridge, Kelli; Cheung, Monit

    2004-01-01

    Through an examination of recent incest treatment development, this article emphasizes the theoretical concept of "integration" within the treatment process for female adult incest survivors. Spirituality as a therapeutic foundation is discussed with examples of therapeutic techniques. A case study illustrates the psycho-spiritual process of…

  20. Ebola Survivor and Her Pregnancy Outcome

    Centers for Disease Control (CDC) Podcasts

    2016-12-14

    Dr. Moon Kim, a medical epidemiologist at the Los Angeles County Department of Public Health, discusses an Ebola virus disease survivor and the delivery of her baby.  Created: 12/14/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/14/2016.

  1. Cartel (In)Stability on "Survivor" Island.

    Science.gov (United States)

    Mixon, Franklin G., Jr.

    2001-01-01

    Illustrates the use of popular culture in business education by examining cartel behavior of contestants in the television show "Survivor." Examples depict incentives to form cartels and to cheat on cartel decisions. Ways to integrate the material into business courses are described. (SK)

  2. Survivors of Downsizing: Helpful and Hindering Experiences

    Science.gov (United States)

    Amundson, Norman E.; Borgen, William A.; Jordan, Sharalyn; Erlebach, Anne C.

    2004-01-01

    Thirty-one downsizing survivors from both the private and public sector were interviewed to determine incidents that either helped or hindered their transition through 1 or more organizational downsizings. A critical incident technique was used to analyze and organize the data around themes that emerged, themes were represented by both positive…

  3. Cartel (In)Stability on "Survivor" Island.

    Science.gov (United States)

    Mixon, Franklin G., Jr.

    2001-01-01

    Illustrates the use of popular culture in business education by examining cartel behavior of contestants in the television show "Survivor." Examples depict incentives to form cartels and to cheat on cartel decisions. Ways to integrate the material into business courses are described. (SK)

  4. Fertility in Female Childhood Cancer Survivors

    NARCIS (Netherlands)

    Bruin, de M.; Broeder, den E.; Berg, van den M.H.; Lambalk, C.B.

    2009-01-01

    Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly enlarging group of childhood cancer survivors. There is much concern, however, about the effects of treatment on reproductive potential. In women there is evidence that both chem

  5. Work productivity in brain tumor survivors.

    Science.gov (United States)

    Feuerstein, Michael; Hansen, Jennifer A; Calvio, Lisseth C; Johnson, Leigh; Ronquillo, Jonne G

    2007-07-01

    To determine the association of symptom burden to work limitation among working survivors of malignant brain tumors. Working adults with malignant brain tumors (n = 95) and a non-cancer comparison (n = 131) group completed a web-based questionnaire. Measures of demographics, tumor type and treatment, fatigue, emotional distress, cognitive limitations, and factors that can positively impact work, including health behaviors and problem solving, were obtained. Survivors of malignant brain tumors reported higher levels of work limitations and time off from work than the non-cancer group. Higher levels of symptom burden, lower levels of health behaviors, and more negative problem solving orientation were characteristic of the brain tumor survivor group. These variables were not differentially associated with work limitations among brain cancer survivors or the comparison group. Depressive symptoms, fatigue, cognitive limitations, sleep, and negative problem solving orientation were independently associated with work limitations, accounting for 65% of the variance in work limitations. Despite higher levels of burden, poorer health behaviors, and negative problem solving coping style, modifiable factors account for most of the variance in work limitations for both groups. Efforts to modify these variables should be evaluated.

  6. Suicide Survivors' Perceptions of the Treating Clinician.

    Science.gov (United States)

    Peterson, Erin M.; Luoma, Jason B.; Dunne, Edward

    2002-01-01

    Examines survivors' attitudes and perceptions of the clinicians who treated their loved one at the time of death. The 71 respondents were relatives or friends of individuals who had died of suicide. Only 11% reported that clinicians attempted to contact them before the death. Discusses implications of findings for clinical practice, legal issues,…

  7. The Risk of Cataract among Survivors of Childhood and Adolescent Cancer: A Report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Chodick, Gabriel; Sigurdson, Alice J; Kleinerman, Ruth A; Sklar, Charles A; Leisenring, Wendy; Mertens, Ann C; Stovall, Marilyn; Smith, Susan A; Weathers, Rita E; Veiga, Lene H S; Robison, Leslie L; Inskip, Peter D

    2016-04-01

    With therapeutic successes and improved survival after a cancer diagnosis in childhood, increasing numbers of cancer survivors are at risk of subsequent treatment-related morbidities, including cataracts. While it is well known that the lens of the eye is one of the most radiosensitive tissues in the human body, the risks associated with radiation doses less than 2 Gy are less understood, as are the long- and short-term cataract risks from exposure to ionizing radiation at a young age. In this study, we followed 13,902 five-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort an average of 21.4 years from the date of first cancer diagnosis. For patients receiving radiotherapy, lens dose (mean: 2.2 Gy; range: 0-66 Gy) was estimated based on radiotherapy records. We used unconditional multivariable logistic regression models to evaluate prevalence of self-reported cataract in relationship to cumulative radiation dose both at five years after the initial cancer diagnosis and at the end of follow-up. We modeled the radiation effect in terms of the excess odds ratio (EOR) per Gy. We also analyzed cataract incidence starting from five years after initial cancer diagnosis to the end of follow-up using Cox regression. A total of 483 (3.5%) cataract cases were identified, including 200 (1.4%) diagnosed during the first five years of follow-up. In a multivariable logistic regression model, cataract prevalence at the end of follow-up was positively associated with lens dose in a manner consistent with a linear dose-response relationship (EOR per Gy = 0.92; 95% CI: 0.65-1.20). The odds ratio for doses between 0.5 and 1.5 Gy was elevated significantly relative to doses <0.5 Gy (OR = 2.2; 95% CI: 1.3-3.7). The results from this study indicate a strong association between ocular exposure to ionizing radiation and long-term risk of pre-senile cataract. The risk of cataract increased with increasing exposure, beginning at lens doses as low as 0.5 Gy. Our

  8. Long-term survivors of childhood Ewing sarcoma: report from the childhood cancer survivor study.

    Science.gov (United States)

    Ginsberg, Jill P; Goodman, Pamela; Leisenring, Wendy; Ness, Kirsten K; Meyers, Paul A; Wolden, Suzanne L; Smith, Stephanie M; Stovall, Marilyn; Hammond, Sue; Robison, Leslie L; Oeffinger, Kevin C

    2010-08-18

    The survival of Ewing sarcoma (ES) patients has improved since the 1970s but is associated with considerable future health risks. The study population consisted of long-term (> or =5-year) survivors of childhood ES diagnosed before age 21 from 1970 to 1986. Cause-specific mortality was evaluated in eligible survivors (n = 568), and subsequent malignant neoplasms, chronic health conditions, infertility, and health status were evaluated in the subset participating in the Childhood Cancer Survivor Study (n = 403). Outcomes were compared with the US population and sibling control subjects (n = 3899). Logistic, Poisson, or Cox proportional hazards models, with adjustments for sex, age, race/ethnicity, and potential intrafamily correlation, were used. Statistical tests were two-sided. Cumulative mortality of ES survivors was 25.0% (95% confidence interval [CI] = 21.1 to 28.9) 25 years after diagnosis. The all-cause standardized mortality ratio was 13.3 (95% CI = 11.2 to 15.8) overall, 23.1 (95% CI = 17.6 to 29.7) for women, and 10.0 (95% CI = 7.9 to 12.5) for men. The nonrecurrence-progression non-external cause standardized mortality ratio (subsequent non-ES malignant neoplasms and cardiac and pulmonary causes potentially attributable to ES treatment) was 8.7 (95% CI = 6.2 to 12.0). Twenty-five years after ES diagnosis, cumulative incidence of subsequent malignant neoplasms, excluding nonmelanoma skin cancers, was 9.0% (95% CI = 5.8 to 12.2). Compared with siblings, survivors had an increased risk of severe, life-threatening, or disabling chronic health conditions (relative risk = 6.0, 95% CI = 4.1 to 9.0). Survivors had lower fertility rates (women: P = .005; men: P < .001) and higher rates of moderate to extreme adverse health status (P < .001). Long-term survivors of childhood ES exhibit excess mortality and morbidity.

  9. Cancer and non-cancer effects in Japanese atomic bomb survivors.

    Science.gov (United States)

    Little, M P

    2009-06-01

    The survivors of the atomic bombings in Hiroshima and Nagasaki are a general population of all ages and sexes and, because of the wide and well characterised range of doses received, have been used by many scientific committees (International Commission on Radiological Protection (ICRP), United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), Biological Effects of Ionizing Radiations (BEIR)) as the basis of population cancer risk estimates following radiation exposure. Leukaemia was the first cancer to be associated with atomic bomb radiation exposure, with preliminary indications of an excess among the survivors within the first five years after the bombings. An excess of solid cancers became apparent approximately ten years after radiation exposure. With increasing follow-up, excess risks of most cancer types have been observed, the major exceptions being chronic lymphocytic leukaemia, and pancreatic, prostate and uterine cancer. For most solid cancer sites a linear dose response is observed, although in the latest follow-up of the mortality data there is evidence (p = 0.10) for an upward curvature in the dose response for all solid cancers. The only cancer sites which exhibit (upward) curvature in the dose response are leukaemia, and non-melanoma skin and bone cancer. For leukaemia the dose response is very markedly upward curving, indeed largely describable as a pure quadratic dose response, particularly in the low dose (0-2 Sv) range. Even 55 years after the bombings over 40% of the Life Span Study cohort remain alive, so continued follow-up of this group is vital for completing our understanding of long-term radiation effects in people. In general, the relative risks per unit dose among the Japanese atomic bomb survivors are greater than those among comparable subsets in studies of medically exposed individuals. Cell sterilisation largely accounts for the discrepancy in relative risks between these two populations, although other

  10. Cancer and non-cancer effects in Japanese atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Little, M P [Department of Epidemiology and Public Health, Imperial College, London W2 1PG (United Kingdom)], E-mail: mark.little@imperial.ac.uk

    2009-06-01

    The survivors of the atomic bombings in Hiroshima and Nagasaki are a general population of all ages and sexes and, because of the wide and well characterised range of doses received, have been used by many scientific committees (International Commission on Radiological Protection (ICRP), United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), Biological Effects of Ionizing Radiations (BEIR)) as the basis of population cancer risk estimates following radiation exposure. Leukaemia was the first cancer to be associated with atomic bomb radiation exposure, with preliminary indications of an excess among the survivors within the first five years after the bombings. An excess of solid cancers became apparent approximately ten years after radiation exposure. With increasing follow-up, excess risks of most cancer types have been observed, the major exceptions being chronic lymphocytic leukaemia, and pancreatic, prostate and uterine cancer. For most solid cancer sites a linear dose response is observed, although in the latest follow-up of the mortality data there is evidence (p = 0.10) for an upward curvature in the dose response for all solid cancers. The only cancer sites which exhibit (upward) curvature in the dose response are leukaemia, and non-melanoma skin and bone cancer. For leukaemia the dose response is very markedly upward curving, indeed largely describable as a pure quadratic dose response, particularly in the low dose (0-2 Sv) range. Even 55 years after the bombings over 40% of the Life Span Study cohort remain alive, so continued follow-up of this group is vital for completing our understanding of long-term radiation effects in people. In general, the relative risks per unit dose among the Japanese atomic bomb survivors are greater than those among comparable subsets in studies of medically exposed individuals. Cell sterilisation largely accounts for the discrepancy in relative risks between these two populations, although other

  11. Distinguishing distress and psychopathology among survivors of the Oakland/Berkeley firestorm.

    Science.gov (United States)

    North, Carol S; Hong, Barry A; Suris, Alina; Spitznagel, Edward L

    2008-01-01

    Disaster mental health research has historically focused on assessment of psychopathology, using measures of psychiatric symptoms and disorders. The Oakland/Berkeley firestorm provided an opportunity to explore resilience among highly exposed survivors through consideration of psychiatric variables in the context of personality. The Diagnostic Interview Schedule/Disaster Supplement was administered to 62 firestorm survivors at approximately 4, 16, and 39 months and the Temperament and Character Inventory administered at 16 months postdisaster. Few individuals had postdisaster psychopathology (16% with any diagnosis, 5%with PTSD). There was considerable evidence of distress, however, indicated by an abundance of reported posttraumatic symptoms, functional impairments, and endorsement of emotional upset, all of which decreased substantially over time. Group C (avoidance/numbing) posttraumatic symptoms were relatively uncommon and were specifically associated with elevated Self-Transcendence. Groups B (intrusion) and D (hyperarousal) symptoms were prevalent and were associated with high Harm Avoidance and low Self-Directedness. The generally healthy personality profiles of these firestorm survivors reflected their psychological resilience. Examination of symptoms and distress in the context of psychiatric disorders after this disaster demonstrated that symptomatic distress is not inconsistent with psychological resilience. The choice of research focus and methods can provide very different portraits of outcomes post-disaster.

  12. New DSM-5 PTSD guilt and shame symptoms among Italian earthquake survivors: Impact on maladaptive behaviors.

    Science.gov (United States)

    Carmassi, Claudia; Bertelloni, Carlo Antonio; Gesi, Camilla; Conversano, Ciro; Stratta, Paolo; Massimetti, Gabriele; Rossi, Alessandro; Dell'Osso, Liliana

    2017-05-01

    Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  13. Quality of life in osteosarcoma survivors.

    Science.gov (United States)

    Greenberg, D B; Goorin, A; Gebhardt, M C; Gupta, L; Stier, N; Harmon, D; Mankin, H

    1994-11-01

    Charts of 89 osteosarcoma survivors from Massachusetts General Hospital and The Children's Hospital/Dana Farber Cancer Center, who had received primary treatment more than 1 year previously and had no evidence of disease, were reviewed. Sixty-two patients, mean 12 years from diagnosis, agreed to structured interviews. Rates of psychopathology did not differ significantly from the general population. High distress was noted in 13%. Twenty-three normal progeny had been born postchemotherapy to eight women and the wives of five male patients. One pregnancy was complicated by doxorubicin-induced cardiac toxicity. Only two with previous childhood tumors believed themselves infertile. All felt the effort to save the limb was worthwhile. In most, ongoing pain was mild; phantom pain and neuralgia common. Most survivors were in good mental and physical health with the capacity to bear children.

  14. Ethics of research on survivors of trauma.

    Science.gov (United States)

    Seedat, Soraya; Pienaar, Willem P; Williams, David; Stein, Daniel J

    2004-08-01

    Essential elements of all research include balance of risks and benefits, unbiased selection of research samples, and assurance of the rights of individual participants. This paper highlights some key ethical issues and summarizes recent evidence relating to participation in, and conduct of, trauma-focused studies with special reference to vulnerable populations (eg, women and children, refugees, survivors of human rights violations, and survivors of trauma in the developing world). A concise ethical framework, rather than rigid guidelines (that may not be applicable to all trauma studies), may be a more useful point of reference for investigators and ethics committees or institutional review boards. Despite the increased empiric data available to inform ethical dilemmas regarding trauma research, more cost-burden analysis research in varying trauma populations and careful investigation of factors that contribute to risk and benefit is required.

  15. Survivors' experiences from a train crash.

    Science.gov (United States)

    Forsberg, Rebecca; Saveman, Britt-Inger

    2011-01-01

    Rarely described are people's lived experiences from severe injury events such as train crashes. The number of train crashes named disasters with ≥10 killed and/or ≥100 nonfatally injured grows globally and the trend shows that more people survive these disasters today than did so in the past. This results in an increased number of survivors needing care. The aim of the study was to explore survivors' experiences from a train crash. Narrative interviews were performed with 14 passengers 4 years after a train crash event. Qualitative content analysis was used to analyse the interviews. Experiences were captured in three main themes: (1) Living in the mode of existential threat describes how the survivors first lost control, then were thrown into a state of unimaginable chaos as they faced death. (2) Dealing with the unthinkable described how survivors restored control, the central role of others, and the importance of reconstructing the event to move forward in their processing. (3) Having cheated death shows how some became shackled by their history, whereas others overcame the haunting of unforgettable memories. Furthermore, the result shows how all experienced a second chance in life. Experiencing a train crash meant that the passengers experienced severe vulnerability and a threat to life and interdependence turned out to play a crucial role. Focusing on helping other passengers on site was one way to regain the loss of control and kept the chaos at bay. Family, friends, and fellow passengers turned out to be extremely important during the recovery process why such closeness should be promoted and facilitated.

  16. THE PREVENTION PROGRAMS OF PHYSICAL REHABILITATION FOR CHERNOBYL DISASTER SURVIVORS

    Directory of Open Access Journals (Sweden)

    Korobeynikov G.V.

    2013-01-01

    Full Text Available The purpose of the study: approbation of the prevention program of physical rehabilitation for Chernobyl disaster survivors in lifestyle aspects. Sixty persons who were disaster survivors and workers of Chernobyl Nuclear Power Plant aged 32-60 have rehabilitation during 21 days. The complex of training prevention programs of physical and psycho-emotional rehabilitation methods was elaborated. The study of efficacy of training prevention programs among Chernobyl disaster survivors. The results showed the improvement of psycho-emotional status and normalization of cardiovascular vegetative regulation after training prevention programs in Chernobyl disasters survivors. The studies show that the preventive programs for Chernobyl disaster survivors in lifestyle aspects had the high effect. This displays the decrease of tempo of aging and the improving of physical and psychological health status of Chernobyl disaster survivors during preventive course.

  17. Suicide among childhood cancer survivors in Slovenia

    Directory of Open Access Journals (Sweden)

    Mojca Čižek Sajko

    2012-11-01

    Full Text Available Objective. Suicide is one of the causes of late mortality among childhood cancer survivors. The aim of our study was to analyse the risk of suicide among childhood cancer survivors compared with that ofthe general population of Slovenia. Patients and methods. This retrospective study included patients with childhood cancer registeredat the Cancer Registry of Slovenia between 1978-2008, with an observation period of 1978-2010. Childhood cancer patients and controlsubjects from the general population of Slovenia were matched by sex,year and age at the beginning of follow-up and time of follow-up inyears. Data on the general population of Slovenia were obtained fromthe Statistical Office of the Republic of Slovenia. Results. A total of 1647 patients were recorded in the Cancer Registry as having cancerduring childhood, with 3 patients committing suicide. All three weremale. Their age at diagnosis of cancer was 12, 13 and 2 years old; their age at suicide was 19, 32 and 28 years old. The mechanism of death was asphyxiation in all three deaths. The calculation of the expected number of suicides in the group of individuals with childhood cancer from the general Slovene population revealed the number of 3.16persons. Conclusion. The comparison of the observed and expectedprobability showed that there was no statistically significant difference in the suicide rate between childhood cancer survivors and the general population of Slovenia.

  18. Genetic counseling of the cancer survivor

    Energy Technology Data Exchange (ETDEWEB)

    Mulvihill, J.J.; Byrne, J.

    1989-02-01

    Each year, tens of thousands of persons are diagnosed with cancer, are treated, and become survivors while still in their reproductive years. Their concerns about possible germ-cell damage as a result of life-saving radiation, chemotherapy, or both are plausible, based on evidence from animal models and from somatic cell mutations in human beings. A 40-year follow-up of survivors of the atomic bomb blasts in Japan showed no detectable genetic damage and suggested that the human gonad is more resistant to radiogenic mutation than the laboratory mouse. The pooled results of studying 12 series of offspring of cancer patients showed a 4% rate of major birth defects (similar to that of the general population) and an excess of fetal loss and low birth weight in offspring of women who received abdominal radiotherapy. According to preliminary evaluation of a new National Cancer Institute collaboration with five cancer registries, offspring of survivors of childhood cancers had no more birth defects than expected and, beyond an increase in probably familial cancers in children younger than 5, no overall increase in childhood cancer. Ideally, genetic and reproductive counseling should take place as soon as cancer is diagnosed (before therapy starts) and again when pregnancy is contemplated. 28 references.

  19. Process theology's relevance for older survivors of domestic violence.

    Science.gov (United States)

    Bowland, Sharon

    2011-01-01

    Pastoral work with survivors of domestic violence may reveal theological struggles. Understandings of scripture that reinforce a sense of powerlessness and alienation from God may contribute to an impaired relationship and limit resources for healing. One framework for re-imaging a relationship with God is process theology. This framework was applied to a case study for one survivor. The application resulted in a line of inquiry that may assist survivors in their healing process.

  20. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

    OpenAIRE

    Nam, Kiyeun; Lee, Seungyeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2016-01-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional...

  1. Fire exposed aluminium structures

    NARCIS (Netherlands)

    Maljaars, J.; Fellinger, J.H.H.; Soetens, F.

    2006-01-01

    Material properties and mechanical response models for fire design of steel structures are based on extensive research and experience. Contrarily, the behaviour of aluminium load bearing structures exposed to fire is relatively unexplored. This article gives an overview of physical and mechanical pr

  2. Fire exposed aluminium structures

    NARCIS (Netherlands)

    Maljaars, J.; Fellinger, J.H.H.; Soetens, F.

    2006-01-01

    Material properties and mechanical response models for fire design of steel structures are based on extensive research and experience. Contrarily, the behaviour of aluminium load bearing structures exposed to fire is relatively unexplored. This article gives an overview of physical and mechanical

  3. Future population of atomic bomb survivors in Nagasaki.

    Science.gov (United States)

    Yokota, Kenichi; Mine, Mariko; Shibata, Yoshisada

    2013-01-01

    The Nagasaki University Atomic Bomb Survivor Database, which was established in 1978 for elucidating the long-term health effects of the atomic bombing, has registered since 1970 about 120,000 atomic bomb survivors with a history of residence in Nagasaki city. Since the number of atomic bomb survivors has steadily been decreasing, prediction of future population is important for planning future epidemiologic studies, and we tried to predict the population of atomic bomb survivors in Nagasaki city from 2008 to 2030. In addition, we evaluated our estimated population comparing with the actual number from 2008 to 2011.

  4. Family doctor-driven follow-up for adult childhood cancer survivors supported by a web-based survivor care plan

    NARCIS (Netherlands)

    Blaauwbroek, R.; Barf, H. A.; Groenier, K. H.; Kremer, L. C.; van der Meer, K.; Tissing, W. J. E.; Postma, A.

    2012-01-01

    To facilitate family doctor-driven follow-up for adult childhood cancer survivors, we developed a survivor care plan (SCP) for adult survivors and their family doctors. The SCP was accessible for survivors and their family doctors on a secure website and as a printed booklet. It included data on dia

  5. Breast cancer risk in female survivors of Hodgkin's lymphoma

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Sparidans, Judith; van't Veer, Mars B

    2009-01-01

    PURPOSE: We assessed the long-term risk of breast cancer (BC) after treatment for Hodgkin's lymphoma (HL). We focused on the volume of breast tissue exposed to radiation and the influence of gonadotoxic chemotherapy (CT). PATIENTS AND METHODS: We performed a cohort study among 1,122 female 5-year...... survivors treated for HL before the age of 51 years between 1965 and 1995. We compared the incidence of BC with that in the general population. To assess the risk according to radiation volume and hormone factors, we performed multivariate Cox regression analyses. RESULTS: After a median follow-up of 17.......8 years, 120 women developed BC (standardized incidence ratio [SIR], 5.6; 95% CI, 4.6 to 6.8), absolute excess risk 57 per 10,000 patients per year. The overall cumulative incidence 30 years after treatment was 19% (95% CI, 16% to 23%); for those treated before age 21 years, it was 26% (95% CI, 19% to 33...

  6. Adult social outcomes of extremely low birth weight survivors of childhood sexual abuse.

    Science.gov (United States)

    Lund, J I; Day, K L; Schmidt, L A; Saigal, S; Van Lieshout, R J

    2016-12-01

    Preterm birth and exposure to childhood sexual abuse (CSA) are early physiological and psychological adversities that have been linked to reduced social functioning across the lifespan. However, the joint effects of being born preterm and being exposed to CSA on adult social outcomes remains unclear. We sought to determine the impact of exposure to both preterm birth and CSA on adult social functioning in a group of 179 extremely low birth weight (ELBW; 2500 g) participants in the fourth decade of life. Social outcome data from a prospective, longitudinal, population-based Canadian birth cohort initiated between the years of 1977 and 1982 were examined. At age 29-36 years, ELBW survivors who experienced CSA reported poorer relationships with their partner, worse family functioning, greater loneliness, lower self-esteem and had higher rates of avoidant personality problems than those who had not experienced CSA. Birth weight status was also found to moderate associations between CSA and self-esteem (P=0.032), loneliness (P=0.021) and family functioning (P=0.060), such that the adverse effects of CSA were amplified in ELBW survivors. Exposure to CSA appears to augment the adult social risks associated with perinatal adversity. Individuals born preterm and exposed to CSA appear to be a group at particularly high risk for adverse social outcomes in adulthood.

  7. Cardiorespiratory fitness in breast cancer survivors.

    Science.gov (United States)

    Burnett, David; Kluding, Patricia; Porter, Charles; Fabian, Carol; Klemp, Jennifer

    2013-12-01

    Maximal oxygen uptake (VO2max) has been used to assess risk for all-cause mortality and cardiovascular disease (CVD), and low VO2max has recently been associated with increased mortality from breast cancer. The purpose of this study was to determine the proportion of breast cancer survivors with 2 or more risk factors for CVD exhibiting a low VO2max and to determine whether sub-maximal endpoints which could be applied more readily to intervention research would correlate with the maximal treadmill test. We performed a single VO2max test on a treadmill with 30 breast cancer survivors age 30-60 (mean age 50.5 ± 5.6 years) who had 2 or more cardiac risk factors for CVD not related to treatment and who had received systemic therapy and or left chest radiation. Submaximal VO2 endpoints were assessed during the VO2max treadmill test and on an Arc trainer. Resting left ventricular ejection fraction (LVEF) was also assessed by echocardiogram (ECHO) or multi-gated acquisition scan (MUGA). A majority (23/30) of women had a VO2max below the 20th percentile based on their predicted normal values. The group mean resting LVEF was 60.5 ± 5.0%. Submaximal VO2 measures were strongly correlated with the maximal test including; 1) 85% age predicted maximum heart rate VO2 on treadmill, (r = .89; p testing endpoints showed a strong correlation with the VO2max test in breast cancer survivors and is a good candidate for testing interventions to improve cardiorespiratory fitness.

  8. Working with Victims of Persecution: Lessons from Holocaust Survivors.

    Science.gov (United States)

    Levine, Joanne

    2001-01-01

    Among populations experiencing the trauma and stress of persecution, most is known about Holocaust survivors. Through examining the long-term effects of massive psychic trauma gleaned from research on Holocaust survivors and their children, this article addresses the skills, techniques, and insights about current refugee populations that can be…

  9. Female Intimate Partner Violence Survivors' Experiences with Accessing Resources

    Science.gov (United States)

    McLeod, Amy L.; Hays, Danica G.; Chang, Catherine Y.

    2010-01-01

    This phenomenological study investigates the types of personal and community resources that female intimate partner violence (IPV) survivors used when leaving an abusive male partner. Three African American and 2 European American IPV survivors, ages 24 to 38 years, described positive and negative experiences with social support, personal…

  10. Adult Adjustment of Survivors of Institutional Child Abuse in Ireland

    Science.gov (United States)

    Carr, Alan; Dooley, Barbara; Fitzpatrick, Mark; Flanagan, Edel; Flanagan-Howard, Roisin; Tierney, Kevin; White, Megan; Daly, Margaret; Egan, Jonathan

    2010-01-01

    Objective: To document the adult adjustment of survivors of childhood institutional abuse. Method: Two hundred and forty-seven adult survivors of institutional abuse with a mean age of 60 were interviewed with a protocol that included the Childhood Trauma Questionnaire, modules from the Structured Clinical Interview for Axis I Disorders of DSM IV…

  11. A Model Psychoeducational Group for Survivors of Organizational Downsizing.

    Science.gov (United States)

    Foley, Pamela F.; Smith, John E.

    1999-01-01

    Describes a one-day psychoeducational group for survivors of a recent organizational downsizing. Principal goal of the group is to prevent "Layoff Survivor Syndrome" through instruction and group exercises designed to normalize common responses and increase awareness of positive coping strategies. Provides descriptions of group…

  12. Early myocardial deformation abnormalities in breast cancer survivors

    NARCIS (Netherlands)

    Bulten, B.F.; Mavinkurve-Groothuis, A.M.C.; Geus-Oei, L.F. de; Haan, A.F.J. de; Korte, C.L. de; Bellersen, L.; Laarhoven, H.W.M. van; Kapusta, L.

    2014-01-01

    To evaluate the role of 2D myocardial strain (rate) imaging in the detection of early subclinical cardiotoxicity in breast cancer survivors treated with an anthracycline-based chemotherapeutic regimen. 57 adult breast cancer survivors were analyzed 1 year after therapy. All patients underwent biomar

  13. Poststroke spasticity: sequelae and burden on stroke survivors and caregivers.

    Science.gov (United States)

    Zorowitz, Richard D; Gillard, Patrick J; Brainin, Michael

    2013-01-15

    Among the estimated 20% to 40% of stroke survivors who develop spasticity, the burden of this condition on patients, caregivers, and society is substantial. Stroke survivors with spasticity may experience reductions in their ability to perform activities of daily living and in their health-related quality of life. The occurrence of spasticity in stroke survivors may also result in an increased burden on their caregivers, who exhibit poorer physical and emotional health as compared with the general population. The responsibilities that caregivers have to the stroke survivor--in terms of providing medical care, protecting from falls, and assisting with feeding and hygiene, among other tasks of daily living--must be balanced with their responsibilities to other family members and to themselves. Caregivers of stroke survivors often report a feeling of confinement with little opportunity for relief, and although social support can be helpful, it is frequently limited in its availability. In terms of the socioeconomic burden of spasticity after stroke, recent data point to a 4-fold increase in health care costs associated with stroke survivors with spasticity compared with stroke survivors without spasticity. Thus, it is important to reduce the burden of spasticity after stroke. Consequently, effective spasticity treatment that reduces spasticity and the level of disability experienced by stroke survivors will likely increase their functioning and their health-related quality of life and will also result in a diminished burden on their caregivers.

  14. Breast cancer risk in atomic bomb survivors from multi-model inference with incidence data 1958-1998.

    Science.gov (United States)

    Kaiser, J C; Jacob, P; Meckbach, R; Cullings, H M

    2012-03-01

    Breast cancer risk from radiation exposure has been analyzed in the cohort of Japanese a-bomb survivors using empirical models and mechanistic two-step clonal expansion (TSCE) models with incidence data from 1958 to 1998. TSCE models rely on a phenomenological representation of cell transition processes on the path to cancer. They describe the data as good as empirical models and this fact has been exploited for risk assessment. Adequate models of both types have been selected with a statistical protocol based on parsimonious parameter deployment and their risk estimates have been combined using multi-model inference techniques. TSCE models relate the radiation risk to cell processes which are controlled by age-increasing rates of initiating mutations and by changes in hormone levels due to menopause. For exposure at young age, they predict an enhanced excess relative risk (ERR) whereas the preferred empirical model shows no dependence on age at exposure. At attained age 70, the multi-model median of the ERR at 1 Gy decreases moderately from 1.2 Gy(-1) (90% CI 0.72; 2.1) for exposure at age 25 to a 30% lower value for exposure at age 55. For cohort strata with few cases, where model predictions diverge, uncertainty intervals from multi-model inference are enhanced by up to a factor of 1.6 compared to the preferred empirical model. Multi-model inference provides a joint risk estimate from several plausible models rather than relying on a single model of choice. It produces more reliable point estimates and improves the characterization of uncertainties. The method is recommended for risk assessment in practical radiation protection.

  15. Breast cancer risk in atomic bomb survivors from multi-model inference with incidence data 1958-1998

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, J.C.; Jacob, P.; Meckbach, R. [Institute of Radiation Protection, Helmholtz-Zentrum Muenchen, German Research Centre for Environmental Health, Neuherberg (Germany); Cullings, H.M. [Radiation Effects Research Foundation, Department of Statistics, Hiroshima (Japan)

    2012-03-15

    Breast cancer risk from radiation exposure has been analyzed in the cohort of Japanese a-bomb survivors using empirical models and mechanistic two-step clonal expansion (TSCE) models with incidence data from 1958 to 1998. TSCE models rely on a phenomenological representation of cell transition processes on the path to cancer. They describe the data as good as empirical models and this fact has been exploited for risk assessment. Adequate models of both types have been selected with a statistical protocol based on parsimonious parameter deployment and their risk estimates have been combined using multi-model inference techniques. TSCE models relate the radiation risk to cell processes which are controlled by age-increasing rates of initiating mutations and by changes in hormone levels due to menopause. For exposure at young age, they predict an enhanced excess relative risk (ERR) whereas the preferred empirical model shows no dependence on age at exposure. At attained age 70, the multi-model median of the ERR at 1 Gy decreases moderately from 1.2 Gy{sup -1} (90% CI 0.72; 2.1) for exposure at age 25 to a 30% lower value for exposure at age 55. For cohort strata with few cases, where model predictions diverge, uncertainty intervals from multi-model inference are enhanced by up to a factor of 1.6 compared to the preferred empirical model. Multi-model inference provides a joint risk estimate from several plausible models rather than relying on a single model of choice. It produces more reliable point estimates and improves the characterization of uncertainties. The method is recommended for risk assessment in practical radiation protection. (orig.)

  16. Fertility in female childhood cancer survivors

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Van Dulmen-den Broeder, Eline; Van den Berg, Marleen H

    2009-01-01

    chemotherapy and radiotherapy may have an adverse effect on ovarian function, ovarian reserve and uterine function, clinically leading to sub-fertility, infertility, premature menopause and/or adverse pregnancy outcomes. Here we will first address normal female fertility and methods to detect decreased...... fertility. Hence we will focus on direct effects as well as late fertility-related adverse effects caused by chemotherapy and radiotherapy, and we will conclude with a summary of current options for fertility preservation in female childhood cancer survivors....

  17. Helping survivors to adjust after cancer.

    Science.gov (United States)

    Harmer, Victoria

    The concept of "cancer survivorship" has received considerable attention over the past three years as increasing numbers of people live with and beyond cancer. Previously, attention may have focused more on treatments for cancer and the likelihood of their success. In recent years, interest has moved to the after-effects of treatment, and how people can return to their lives while recovering. This article discusses the various ways in which cancer and its treatment may affect survivors, and how nurses, in both hospital and the community, can help them to adjust and recover.

  18. The epidemiology of long- and short-term cancer survivors

    DEFF Research Database (Denmark)

    Jarlbæk, Lene; Christensen, Linda; Bruera, Eduardo;

    2014-01-01

    Introduction. In this study, we present data from a population-based cohort of incident cancer patients separated in long- and short-term survivors. Our aim was to procure denominators for use in the planning of rehabilitation and palliative care programs. Material and methods. A registry......-linkage cohort study. All cancer patients, diagnosed from 1993 to 2003 from a 470 000 large population, were followed individually from diagnosis to death or until 31 December 2008. Long-term survivors lived five years or more after the time of the cancer diagnosis (TOCD). Short-term survivors died less than...... five years after TOCD. Results. The cohort comprised 24 162 incident cancer patients with 41% long-term survivors (N = 9813). Seventy percent of the cohort was 60 + years at TOCD. The 14 349 short-term survivors' median survival was 0.6 year, and 78% died less than two years after TOCD. A 12 years...

  19. Older breast cancer survivors' views and preferences for physical activity.

    Science.gov (United States)

    Whitehead, Sarah; Lavelle, Katrina

    2009-07-01

    Evidence suggests that physical activity improves quality of life and physical functioning among breast cancer patients and survivors. However, previous studies have tended to focus on younger patients, despite higher incidence and lower survival among older breast cancer survivors. In this study we explored physical activity preferences of older breast cancer survivors to inform the development of future targeted interventions. Twenty-nine female breast cancer survivors (1 to 5 years postdiagnosis) aged 59 to 86 (mean 66.54, SD 6.50) took part in either a semistructured interview or a focus group exploring physical activity patterns, motivators, facilitators, barriers, and preferences. The main factors influencing physical activity were body image, weight issues, vitality, mood, and the desire to carry on as normal. Preference was expressed for activities that were gentle, tailored to age and cancer-related abilities, holistic, involving other older breast cancer survivors, and with an instructor who was knowledgeable about both breast cancer and aging.

  20. Health Promotion Among Older Cancer Survivors With Prior Disabling Conditions

    Science.gov (United States)

    Becker, Heather; Kang, Sook Jung

    2013-01-01

    Older cancer survivors, who often cope with multiple disabling conditions, can find health promotion challenging. This study's purpose was to explore predictors of health promotion for older cancer survivors with a disabling condition that existed prior to their cancer diagnosis. The 92 cancer survivors were predominantly women with preexisting neuromuscular impairments and an average age of 69 years. Half were breast cancer survivors, and 58% were 6 or more years since their cancer diagnosis. In hierarchical regression analyses, self-efficacy for health promotion and social support were the strongest predictors of the total HPLPII and its subscales. The findings suggest that nursing interventions to assist older cancer survivors with multiple chronic conditions in building their social support and perceived self-efficacy may help them lead more healthy lives. PMID:22765516

  1. Social support and Quality of Life: a cross-sectional study on survivors eight months after the 2008 Wenchuan earthquake

    Science.gov (United States)

    2010-01-01

    Background The 2008 Wenchuan earthquake resulted in extensive loss of life and physical and psychological injuries for survivors. This research examines the relationship between social support and health-related quality of life for the earthquake survivors. Methods A multistage cluster sampling strategy was employed to select participants from 11 shelters in nine counties exposed to different degrees of earthquake damage, for a questionnaire survey. The participants were asked to complete the Short Form 36 and the Social Support Rating Scale eight months after the earthquake struck. A total of 1617 participants returned the questionnaires. The quality of life of the survivors (in the four weeks preceding the survey) was compared with that of the general population in the region. Multivariate logistic regression analysis and canonical correlation analysis were performed to determine the association between social support and quality of life. Results The earthquake survivors reported poorer quality of life than the general population, with an average of 4.8% to 19.62% reduction in scores of the SF-36 (p social support were more likely to have better quality of life. The canonical correlation analysis found that there was a discrepancy between actual social support received and perceived social support available, and the magnitude of this discrepancy was inversely related to perceived general health (rs = 0.467), and positively related to mental health (rs = 0.395). Conclusion Social support is associated with quality of life in the survivors of the earthquake. More attention needs to be paid to increasing social support for those with poorer mental health. PMID:20863410

  2. Sexual Functioning in Young Adult Survivors of Childhood Cancer

    Science.gov (United States)

    Zebrack, Brad J.; Foley, Sallie; Wittmann, Daniela; Leonard, Marcia

    2009-01-01

    Background Studies of sexuality or sexual behavior in childhood cancer survivors tend to examine relationships or achievement of developmental milestones but not physiological response to cancer or treatment. The purpose of this study is to (1) identify prevalence and risk factors for sexual dysfunction in childhood cancer survivors, and (2) examine the extent to which sexual dysfunction may be associated with health-related quality of life (HRQOL) and psychosocial outcomes. Methods Five hundred ninety-nine survivors age 18-39 years completed standardized measures of sexual functioning, HRQOL, psychological distress and life satisfaction. Descriptive statistics assessed prevalence of sexual symptoms. Bivariate analyses identified correlates of sexual symptoms and examined associations between symptoms and HRQOL/psychosocial outcomes. Results Most survivors appear to be doing well, although 52% of female survivors and 32% of male survivors reported at least “a little of a problem” in one or more areas of sexual functioning. Mean symptom score for females was more than twice that of males. Sexual symptoms were associated with reporting health problems. Significant associations between sexual functioning and HRQOL outcomes were observed, with gender differences in strengths of association suggesting that males find sexual symptoms more distressing than do females. Conclusions While most survivors appear to be doing well in this important life domain, some young adult survivors report sexual concerns. While female survivors may report more sexual symptoms than male survivors, males may experience more distress associated with sexual difficulties. Better specified measures of sexual function, behavior and outcomes are needed for this young adult population. PMID:19862693

  3. Survivor identity after colorectal cancer: antecedents, prevalence and outcomes.

    Science.gov (United States)

    Chambers, Suzanne K; Baade, Peter; Meng, Xingqiong; Youl, Pip; Aitken, Joanne; Dunn, Jeff

    2012-09-01

    Cancer survivor identity has become a dominant paradigm in describing people with cancer and in driving the focus of programmes and research in supportive care. This study investigated antecedents of survivor identity adoption and population-based prevalence. A prospective survey of a population-based sample of 1966 (57% response) patients with colorectal cancer assessed socio-demographic variables, health behaviours, optimism, benefit finding, cancer threat appraisal, psychological distress and satisfaction with life at 5 months post-diagnosis as predictors of survivor identity 5 years subsequently. Prevalence of survivor identity at 5 years post-diagnosis and psychological and lifestyle outcomes (n = 786) were later assessed. Fifty-five per cent of people identified as a cancer survivor, 39.4% as a person who had had (or has) cancer, 1.4% as a cancer patient and 1.2% as a cancer victim. People who were older and who reported higher personal growth after diagnosis were more likely to assume a survivor identity at 5 years. At 5 years, survivors had higher benefit finding and better satisfaction with life. Cancer survivors uniquely reported a significant decrease in somatization and acceptance, and increases in satisfaction with life and physical activity over time. For patients with colorectal cancer, the cancer survivor identity is common but not universal 5 years after diagnosis; and may evolve from looking for benefit after cancer through personal growth. People who adopt a cancer survivor identity report more positive adjustment outcomes after cancer and this has implications for the design of clinical and community support interventions. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

  4. ANUITAS LAST SURVIVOR UNTUK KASUS TIGA ORANG TERTANGGUNG

    Directory of Open Access Journals (Sweden)

    D. P. Sari

    2016-11-01

    Full Text Available Pada asuransi multiple life, terdapat dua istilah berdasarkan status kematian dari kumpulan tertanggung yaitu joint life dan last survivor. Perbedaan status multiple life ini pada asuransi adalah waktu pemberian uang pertanggungannya. Suatu status dikatakan joint life jika pemberian uang pertanggungan dilakukan pada saat orang pertama meninggal dan status dikatakan life survivor jika pemberian uang pertanggungan dilakukan pada saat semuanya telah meninggal. Untuk mendapatkan uang pertanggungan, tertanggung haruslah membayarkan sejumlah premi. Jika ingin mengkonversikan premi tunggal menjadi premi berkala diperlukan anuitas. Untuk kasus asuransi last survivor kita akan menggunakan anuitas last survivor. Hasil akhir dari proses penelitian penulis akan menghasilkan rumusan matematika nilai sekarang anuitas awal dan anuitas akhir  untuk kasus dua orang dan tiga orang pada status last survivor.In multiple life insurance, there are two terms based on the status of the death of the insured is a collection of joint life and last survivor. The difference is in the status of multiple life insurance is the timing of cash coverage. A status is said to be a joint life insurance money if provision was made during the first die and life survivor status if the provision of insurance money made at the time are all dead. To get the sum insured, the insured must pay a premium. If you want to convert into a single premium be regular premium, annuity required. For the last survivor insurance cases we will use the last survivor annuity. The end result of the research process will generate mathematical formulas of present value due annuity and immediate annuity for the case of two and three people in the last survivor status.

  5. Nutritional interventions for survivors of childhood cancer.

    Science.gov (United States)

    Cohen, Jennifer E; Wakefield, Claire E; Cohn, Richard J

    2016-08-22

    Childhood cancer survivors are at a higher risk of developing health conditions such as osteoporosis, and cardiovascular disease than their peers. Health-promoting behaviour, such as consuming a healthy diet, could lessen the impact of these chronic issues, yet the prevalence rate of health-protecting behaviour amongst survivors of childhood cancer is similar to that of the general population. Targeted nutritional interventions may prevent or reduce the incidence of these chronic diseases. The primary aim of this review was to assess the efficacy of a range of nutritional interventions designed to improve the nutritional intake of childhood cancer survivors, as compared to a control group of childhood cancer survivors who did not receive the intervention. Secondary objectives were to assess metabolic and cardiovascular risk factors, measures of weight and body fat distribution, behavioural change, changes in knowledge regarding disease risk and nutritional intake, participants' views of the intervention, measures of health status and quality of life, measures of harm associated with the process or outcomes of the intervention, and cost-effectiveness of the intervention We searched the electronic databases of the Cochrane Central Register of Controlled Trials (CENTRAL; 2013, Issue 3), MEDLINE/PubMed (from 1945 to April 2013), and Embase/Ovid (from 1980 to April 2013). We ran the search again in August 2015; we have not yet fully assessed these results, but we have identified one ongoing trial. We conducted additional searching of ongoing trial registers - the International Standard Randomised Controlled Trial Number register and the National Institutes of Health register (both screened in the first half of 2013) - reference lists of relevant articles and reviews, and conference proceedings of the International Society for Paediatric Oncology and the International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer (both 2008 to

  6. Psychological Adjustment in Breast Cancer Survivors.

    Science.gov (United States)

    Stanton, Annette L; Bower, Julienne E

    2015-01-01

    Women living with a diagnosis of breast cancer constitute more than 20 % of the cancer survivor population in the United States. Research on trajectories of psychological adjustment in women recently diagnosed with breast suggests that the largest proportion of women evidences relatively low psychological distress either from the point of diagnosis or after a period of recovery. Substantial heterogeneity exists, however, and some women are at risk for lingering depression, anxiety, fear of cancer recurrence and other long-term psychological effects. Most women diagnosed with breast cancer also report a number of benefits that arise from their experience of cancer. Longitudinal studies have illuminated risk and protective factors for psychological adjustment in breast cancer survivors, which we describe in this chapter. Effective psychosocial interventions, as evidenced in randomized controlled trials, also are available for bolstering breast cancer-related adjustment. We offer directions for research to deepen the understanding of biological, psychological, and social contributors to positive adjustment in the context of breast cancer, as well as suggestions for the development of optimally efficient evidence-based psychosocial interventions for women living with the disease.

  7. Bone density in survivors of childhood cancer.

    Science.gov (United States)

    Mulder, Jean E; Bilezikian, John P

    2004-01-01

    Advances in combination chemotherapy, radiation therapy, surgery, and bone marrow transplantation have resulted in markedly improved survival rates for many children with cancer. Advancements in therapy, however, have led to new concerns, namely long-term consequences of effective treatments. Young adult and adult survivors of childhood cancer are at risk for a number of disorders related to therapy. Specifically, the young adult who has survived cancer, attendant treatments, and their complications is at risk for factors that can lead to suboptimal acquisition of peak bone mass. These factors include chronic illness, nutritional deficiencies, limited physical activity, and treatment with glucocorticoids, multiagent chemotherapy, and radiation. The long-term adverse effects of these therapies on endocrine systems, especially sex steroid and growth hormone deficiencies, are additional risk factors for some patients. After a brief review of the processes associated with acquisition of peak bone mass in the young adult, this article examines the impact of cancer and cancer therapy on bone mineral density in survivors of childhood cancer.

  8. Sexual and reproductive health in cancer survivors.

    Science.gov (United States)

    Goldfarb, Shari; Mulhall, John; Nelson, Christian; Kelvin, Joanne; Dickler, Maura; Carter, Jeanne

    2013-12-01

    As patients live longer after cancer diagnosis and treatment, attention to symptoms and quality of life (QoL) are of increasing importance both during treatment and throughout survivorship. Two complications of multi-modal cancer treatment that can profoundly affect both men and women are sexual dysfunction and infertility. Survivors at highest risk for treatment-related sexual dysfunction are those with tumors that involve the sexual or pelvic organs and those whose treatment affects the hormonal systems mediating sexual function. Sexual dysfunction may not abate without appropriate intervention. Therefore, early identification and treatment strategies are essential. Likewise, multiple factors contribute to the risk of infertility from cancer treatment and many cancer patients of reproductive age would prefer to maintain their fertility, if possible. Fortunately, advances in reproductive technology have created options for young newly diagnosed patients to preserve their ability to have a biologic child. This paper will focus on the sexual and reproductive problems encountered by cancer survivors and discuss some treatment options. © 2013 Published by Elsevier Inc.

  9. Unusual MRI Findings in a Polio Survivor

    Directory of Open Access Journals (Sweden)

    Masaaki Sakamoto

    2016-01-01

    Full Text Available A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors.

  10. Clinical features and prognosis of patients with myelodysplastic syndromes who were exposed to atomic bomb radiation in Nagasaki.

    Science.gov (United States)

    Matsuo, Masatoshi; Iwanaga, Masako; Kondo, Hisayoshi; Soda, Midori; Jo, Tatsuro; Horio, Kensuke; Takasaki, Yumi; Kawaguchi, Yasuhisa; Tsushima, Hideki; Imaizumi, Yoshitaka; Imanishi, Daisuke; Taguchi, Jun; Sawayama, Yasushi; Hata, Tomoko; Miyazaki, Yasushi

    2016-10-01

    There is evidence that radiation exposure is a causative factor of myelodysplastic syndromes (MDS). However, little is known about whether radiation exposure is also a prognostic factor of MDS. We investigated the impact of radiation exposure on the prognosis of MDS in Nagasaki atomic bomb survivors using the International Prognostic Scoring System (IPSS) and the revised version (IPSS-R). Subjects were 140 patients with primary MDS diagnosed between 1985 and 2011 and evaluable for IPSS, IPSS-R, and exposure distance. Of those, 31 were exposed at atomic bomb survivors, but exposure distance was not associated with any poor outcomes. These suggest that exposure to the greater dose of atomic bomb radiation is associated with developing poor cytogenetic abnormalities in MDS, which might consequently lead to overt leukemia among atomic bomb survivors. © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  11. Male infertility in long-term survivors of pediatric cancer: A report from the Childhood Cancer Survivor Study

    Science.gov (United States)

    Wasilewski-Masker, K; Seidel, K D; Leisenring, W; Mertens, A C; Shnorhavorian, M; Ritenour, C W; Stovall, M; Green, D M; Sklar, C A; Armstrong, G T; Robison, L L; Meacham, L R

    2014-01-01

    Purpose The purpose of this study was to assess the prevalence of male infertility and treatment-related risk factors in childhood cancer survivors. Methods Within the Childhood Cancer Survivor Study, 1622 survivors and 274 siblings completed the Male Health Questionnaire. The analysis was restricted to survivors (938/1622; 57.8%) and siblings (174/274; 63.5%) who tried to become pregnant. Relative risks (RR) and 95% confidence intervals (CI) for the prevalence of self-reported infertility were calculated using generalized linear models for demographic variables and treatment-related factors to account for correlation among survivors and siblings of the same family. All statistical tests were two-sided. Results Among those who provided self-report data, the prevalence of infertility was 46.0% in survivors versus 17.5% in siblings (RR=2.64, 95% CI 1.88-3.70, p < 0.001). Of survivors who met the definition for infertility, 37% had reported at least one pregnancy with a female partner that resulted in a live birth. In a multivariable analysis, risk factors for infertility included an alkylating agent dose score (AAD) ≥ 3 (RR= 2.13, 95% CI 1.69-2.68 for AAD ≥ 3 versus AAD<3), surgical excision of any organ of the genital tract (RR=1.63, 95% CI 1.20-2.21), testicular radiation ≥ 4Gy (RR=1.99, 95% CI 1.52-2.61), and exposure to bleomycin (RR=1.55, 95% CI 1.20-2.01). Conclusion Many survivors who experience infertility father their own children suggesting episodes of both fertility and infertility. This and the novel association of infertility with bleomycin warrant further investigation. Implications for Cancer Survivors Though infertility is common, male survivors reporting infertility often father their own children. Bleomycin may pose some fertility risk. PMID:24711092

  12. Aging effect of 137Cs obtained from 137Cs in the Kanto loam layer from the Fukushima nuclear power plant accident and in the Nishiyama loam layer from the Nagasaki A-bomb explosion.

    Science.gov (United States)

    Ohta, Tomoko; Mahara, Yasunori; Kubota, Takumi; Igarashi, Toshifumi

    2013-01-01

    We measured (134)Cs and (137)Cs in the surface soil of the Kanto loam in the eastern Tokyo metropolitan area and the Nishiyama loam in Nagasaki, Japan. The observed (137)Cs deposition in the Kanto loam from the Fukushima nuclear power plant (NPP) accident ranged from 4.0 to 77 kBq m(-2), which corresponds to 0.3-5 times of that in the Nishiyama loam. The (137)Cs retardation factor in the Kanto loam obtained seven months after the Fukusima NPP accident and in the Nishiyama loam after 36 and 38 years from the detonation of the Pu atomic bomb (A-bomb) ranged from 180 to 260 and 2000 to 10,000, respectively. This difference in the retardation factors is attributed to an aging effect that corresponds to seven months and 36 to 38 years after the deposition of (137)Cs occurred on the soil minerals.

  13. 78 FR 64021 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Survivor's...

    Science.gov (United States)

    2013-10-25

    ...; Survivor's Form for Benefits Under the Black Lung Benefits Act ACTION: Notice. SUMMARY: The Department of... collection request (ICR) titled, ``Survivor's Form for Benefits under the Black Lung Benefits Act,'' to the... INFORMATION: A survivor of a deceased miner files the ``Survivor's Form for Benefits under the Black...

  14. 22 CFR 19.11-8 - Required elections between survivor benefits.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Required elections between survivor benefits... elections between survivor benefits. (a) Bar against concurrent payment under this Act and Workers' Compensation Act. Except as stated below, survivor annuities and survivors' compensation for work...

  15. 5 CFR 831.651 - Commencing and terminating dates of survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... survivor annuities. 831.651 Section 831.651 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Payment of Survivor Annuities § 831.651 Commencing and terminating dates of survivor annuities. (a) Except as provided in paragraph...

  16. 20 CFR 228.22 - Entitlement to more than one survivor annuity.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Entitlement to more than one survivor annuity... RETIREMENT ACT COMPUTATION OF SURVIVOR ANNUITIES The Tier I Annuity Component § 228.22 Entitlement to more than one survivor annuity. If an individual is entitled to more than one survivor annuity, only...

  17. The evidence of radiation effects in embryos and fetuses exposed to Chernobyl fallout and the question of dose response.

    Science.gov (United States)

    Busby, Chris; Lengfelder, Edmund; Pflugbeil, Sebastian; Schmitz-Feuerhake, Inge

    2009-01-01

    Current legal frameworks for radiation exposure limits are based on the risk models of the International Commission on Radiological Protection (ICRP). In Publication 90 (2003), ICRP presents a safe (threshold) dose range of up to 100 mSv for radiogenic effects resulting from in utero exposure and bases this conclusion on the findings in Hiroshima and Nagasaki. However, a variety of observations of congenital malformations, fetal loss, stillbirths and infant deaths, as well as of Down's syndrome and other health defects in children after the Chernobyl accident exposures suggest that the A-bomb survivor data are incomplete. The Chernobyl findings are generally marginalized or even denied because of the low values of the estimated human exposures and the inconsistency of the results with the accepted risk models. One explanation for the observations is that physical dosimetric models have underestimated the effective exposure. This possibility is supported by biological dosimetry in the contaminated regions. The assumptions about effects after in utero exposure by incorporated radionuclides need to be revised.

  18. Survivor in the cancer context: a concept analysis.

    Science.gov (United States)

    Hebdon, Megan; Foli, Karen; McComb, Sara

    2015-08-01

    The aim of this analysis was to define survivor in the cancer context. Cancer survivor has been used in the cancer lexicon, but may not represent the individuals it defines. This concept analysis was completed according to Walker and Avant's method. PubMed, PsychInfo, CINAHL, JSTOR, Google and medical and public health websites. Thirty sources from multiple disciplines, published between 1987-2013, were analysed for recurrent themes and conceptual meaning. Critical attributes, antecedents and consequences were extrapolated. Model, related and contrary cases were developed based on an amalgamation of clinical observations. Illegitimate, borderline and invented cases were excluded for this reason. Survivor in the cancer context is an individual with a history of malignancy, who has lived through a personalized challenge and has ongoing positive and negative consequences. Not all cancer survivors would identify themselves using the term survivor. This contributes to the paradigm shift of cancer as a chronic disease as it establishes the unique nature of the cancer experience while highlighting the long-term concerns related to this set of diseases. The Theory of Uncertainty in Illness provides a framework to understand the individualized nature of being a cancer survivor. Nursing research and practice should address the personal experiences of cancer survivors while still focusing on general survivorship needs. © 2015 John Wiley & Sons Ltd.

  19. Achieving value in mobile health applications for cancer survivors.

    Science.gov (United States)

    Davis, Sharon Watkins; Oakley-Girvan, Ingrid

    2017-08-01

    This study aimed to identify appropriate development and testing strategies for mobile health applications for cancer survivors. In January of 2016, we conducted a PubMed search for mobile applications for cancer survivors. A total of 32 articles were selected for inclusion, including 13 review articles, and 19 articles describing an mHealth application or intervention. We assessed mobile app development and testing strategies and standards as described in these articles. We identified seven elements of patient empowerment applications for cancer survivors, strategies for application development that take advantage of smartphone capabilities, issues for consideration in developing new applications, and steps for creating user-centered mobile health applications that provide meaningful value for cancer survivors. However, few mobile health apps implemented empowerment elements, underwent rigorous design approaches, or included assessment of use in the cancer survivor population. There is tremendous potential for mobile health apps to benefit cancer survivors. However, there are specific issues for consideration in developing new applications and steps for creating user-centered applications which are not routinely used. This diminishes the value for the cancer survivor population but could be easily addressed through standardized development and testing procedures. Smartphone applications have the potential to improve the cancer survivorship experience, but users should look for evidence that the application was appropriately developed and tested.

  20. Worries of childhood cancer survivors in young adulthood.

    Science.gov (United States)

    Yi, Jaehee; Kim, Min Ah; Sang, Jina

    2016-04-01

    Childhood cancer survivors worry about many issues related to their cancer history. As they grow older, additional issues may emerge. This study of a sample of Korean young adults aims to understand childhood cancer survivors' worries. A purposeful sample of 28 childhood cancer survivors was recruited through survivor and parent-advocacy foundations and support groups in Korea. Qualitative in-depth interviews were conducted over the phone or in person. Participants ranged in age from 20 to 36, were diagnosed before age 19, and had completed treatment at the time of the study. Through qualitative interviews, survivors' worries were identified in the following five themes: romantic relationships and marriage, fertility and the health of future children, work and social life, family, and physical health. The study's findings support the importance of understanding the worries of childhood cancer survivors in young adulthood and the need for developing services and programs to help survivors acquire the appropriate social skills and coping strategies to mitigate their worries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Romantic relationships of emerging adult survivors of childhood cancer.

    Science.gov (United States)

    Thompson, Amanda L; Marsland, Anna L; Marshal, Michael P; Tersak, Jean M

    2009-07-01

    To assess whether childhood cancer survivors experience difficulties in their romantic relationships during emerging adulthood (18-25 years) and to identify who may be at risk for long-term social sequelae. Emerging adult survivors of childhood cancer (n=60) and controls without a history of chronic illness (n=60) completed an online assessment of their romantic relationships, including perceived relationship satisfaction. Severity of initial treatment was rated by healthcare providers for participants with cancer. Although survivors of childhood cancer do not differ from demographically similar controls in satisfaction with, conflict in, and duration of romantic relationships, they reported fewer romantic relationships and greater distress at relationship end. Within the survivor group, higher trait anxiety, older age at diagnosis, and more severe treatment intensity increased risk for relationship difficulties, including lower relationship satisfaction and more distress at break-up. Findings appear to support the overall social resilience of survivors of childhood cancer. Certain subsets of survivors, however, may be at greater risk for difficulties in their close relationships as adults and therefore may be appropriate targets for intervention. Healthcare providers should routinely assess developmentally salient issues like love/romance that are important markers of identity development and ultimately impact long-term quality of life for survivors. (c) 2008 John Wiley & Sons, Ltd.

  2. Long-term health effects among testicular cancer survivors.

    Science.gov (United States)

    Hashibe, Mia; Abdelaziz, Sarah; Al-Temimi, Mohammed; Fraser, Alison; Boucher, Kenneth M; Smith, Ken; Lee, Yuan-Chin Amy; Rowe, Kerry; Rowley, Braden; Daurelle, Micky; Holton, Avery E; VanDerslice, James; Richiardi, Lorenzo; Bishoff, Jay; Lowrance, Will; Stroup, Antoinette

    2016-12-01

    Testicular cancer is diagnosed at a young age and survival rates are high; thus, the long-term effects of cancer treatment need to be assessed. Our objectives are to estimate the incidence rates and determinants of late effects in testicular cancer survivors. We conducted a population-based cohort study of testicular cancer survivors, diagnosed 1991-2007, followed up for a median of 10 years. We identified 785 testicular cancer patients who survived ≥5 years and 3323 men free of cancer for the comparison group. Multivariate Cox regression analysis was used to compare the hazard ratio between the cases and the comparison group and for internal analysis among case patients. Testicular cancer survivors experienced a 24 % increase in risk of long-term health effects >5 years after diagnosis. The overall incidence rate of late effects among testicular cancer survivors was 66.3 per 1000 person years. Higher risks were observed among testicular cancer survivors for hypercholesterolemia, infertility, and orchitis. Chemotherapy and retroperitoneal lymph node dissection appeared to increase the risk of late effects. Being obese prior to cancer diagnosis appeared to be the strongest factor associated with late effects. Testicular cancer survivors were more likely to develop chronic health conditions when compared to cancer-free men. While the late effects risk was increased among testicular cancer survivors, the incidence rates of late effects after cancer diagnosis was fairly low.

  3. Extreme Sport/Adventure Activity Correlates in Gynecologic Cancer Survivors.

    Science.gov (United States)

    Crawford, Jennifer J; Vallance, Jeff K; Holt, Nicholas L; Courneya, Kerry S

    2016-03-01

    We examined the demographic, medical and behavioral correlates of participation and interest in extreme sport/adventure activities (ESAA) in gynecologic cancer survivors. A random sample of 621 gynecologic cancer survivors in Alberta, Canada, completed a mailed self-report questionnaire assessing medical, demographic, and behavioral variables and participation and interest in ESAA. Multivariate analyses revealed that gynecologic cancer survivors were more likely to participate in ESAA if they met aerobic exercise guidelines (OR=1.75 [95%CI:1.02-2.99]), had better general health (OR=1.71 [95%CI: 1.01-2.90]), had cervical or ovarian cancer (OR=1.95 [95%CI:0.97-3.93]), were employed (OR=1.71 [95%CI:0.95-3.08]), and were of healthy weight (OR=1.58 [95%CI:0.93-2.68]). Moreover, gynecologic cancer survivors were more likely to be interested in trying an ESAA if they had cervical or ovarian cancer (OR=1.76 [95%CI:0.94-3.27]) and were meeting the strength exercise guidelines (OR=1.68 [95%CI:0.95-2.98]). Medical, demographic, and behavioral variables correlate with participation and interest in ESAA in gynecologic cancer survivors. The pattern of correlates suggests that gynecologic cancer survivors are more likely to participate in ESSA if they have the physical capability and financial resources. Interventions to promote ESAA in gynecologic cancer survivors need to address these 2 key barriers.

  4. Nature-based experiences and health of cancer survivors.

    Science.gov (United States)

    Ray, Heather; Jakubec, Sonya L

    2014-11-01

    Although exposure to, and interaction with, natural environments are recognized as health-promoting, little is understood about the use of nature contact in treatment and rehabilitation for cancer survivors. This narrative review summarizes the literature exploring the influence of nature-based experiences on survivor health. Key databases included CINAHL, EMBASE, Medline, Web of Science, PubMed, PsycArticles, ProQuest, and Cancerlit databases. Sixteen articles met inclusion criteria and were reviewed. Four major categories emerged: 1) Dragon boat racing may enhance breast cancer survivor quality of life, 2) Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors, 3) Adventure programs provide a positive experience for children and adolescent survivors, fostering a sense of belonging and self-esteem, and 4) Therapeutic landscapes may decrease state-anxiety, improving survivor health. This review contributes to a better understanding of the therapeutic effects of nature-based experiences on cancer survivor health, providing a point of entry for future study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Awareness of Dietary and Alcohol Guidelines Among Colorectal Cancer Survivors.

    Science.gov (United States)

    Hawkins, Nikki A; Berkowitz, Zahava; Rodriguez, Juan L

    2015-12-01

    Although dietary habits can affect colorectal cancer (CRC) survivors' health, it is unclear how familiar survivors are with dietary guidelines, what they believe about healthy eating and alcohol consumption, and what hinders healthy dietary habits after cancer. This study assessed CRC survivors' familiarity with dietary guidelines, their eating and drinking habits, and perceived facilitators and barriers to healthy eating after cancer, including social support and self-efficacy for maintaining a healthy diet and limiting alcohol. A total of 593 individuals (50% female; mean age, 74 years) diagnosed with CRC approximately 6 years prior to study entry in early 2010 were identified through California Cancer Registry records and participated in a cross-sectional mailed survey assessing health behavior after cancer (46% adjusted response rate). Analyses were conducted in 2014-2015. Survivors were most familiar with-and most likely to follow-recommendations to choose low-fat foods; 15% had never heard of recommendations to limit alcohol. Survivors were more aware of recommendations involving messages to limit/avoid versus approach/choose certain foods. The most common barrier to a healthy diet involved the effort required (26%). Survivors received more family/friend support and provider recommendations for healthy eating than limiting alcohol. Results provide an overview of awareness of and adherence to dietary recommendations among CRC survivors, highlighting the need for increasing awareness of recommendations that are especially relevant for survivors. Suggestions are made for modifying diet-related messages to facilitate comprehension and recall among CRC survivors, and increasing awareness among groups with the lowest awareness levels. Published by Elsevier Inc.

  6. Cardiovascular Disease in Survivors of Adolescent and Young Adult Cancer

    DEFF Research Database (Denmark)

    Rugbjerg, Kathrine; Mellemkjaer, Lene; Boice, John D

    2014-01-01

    BACKGROUND: Cardiovascular disease has emerged as a serious late effect in survivors of adolescent and young adult cancer, but risk has not been quantified comprehensively in a population-based setting. METHODS: In the Danish Cancer Registry, we identified 43153 1-year survivors of cancer diagnosed...... Classification of Diseases, Tenth Revision codes I10-I79) were compared with the expected numbers derived from the comparison cohort. We calculated the absolute excess risks attributable to status as a survivor of cancer and standardized hospitalization rate ratios (RRs). All statistical tests were two-sided...

  7. Posttraumatic stress disorder in survivors of the Brooklyn Bridge shooting.

    Science.gov (United States)

    Trappler, B; Friedman, S

    1996-05-01

    The authors documented the frequency of posttraumatic stress disorder (PTSD) in civilian victims of urban terrorism. A recent shooting attack on a van of Hasidic students provided a unique opportunity to document responses of survivors in this targeted group. Eleven of 14 survivors were compared with age-matched subjects on a variety of questionnaires and clinical evaluations. Of the 11 survivors, four were diagnosed with PTSD (all of whom also had concurrent major depressive disorder), one with major depressive disorder, and two with adjustment disorder. Findings are interpreted in the context of unique factors contributing to the heightened vulnerability of this group.

  8. Spirituality expressed by caregivers of stroke survivors.

    Science.gov (United States)

    Pierce, Linda L; Steiner, Victoria; Havens, Heidi; Tormoehlen, Karen

    2008-08-01

    Thirty-six caregivers of stroke survivors who are new to that role participate in a Web-based support and education intervention over the course of a year. The authors use a secondary analysis of a total of 2,148 e-mail messages that these caregivers posted to the intervention's discussion group. Rigorous content analysis is used to analyze the narrative data coded to spirituality (n = 230 e-mails). Four themes emerge and are drawn to Friedemann's (1995) framework of systemic organization: (a) feeling the presence of a greater power, (b) practicing rituals, (c) being one with nature, and (d) interacting with family and friends. Spirituality gives these caregivers hope and sustenance, but it also helps them express themselves more fully during a difficult time of change. The e-mail discussion data presented here highlight the importance of increased awareness of addressing spirituality in nurse-client encounters and designing interventions to support the caregivers.

  9. Survivor from asphyxiation due to helium inhalation

    Directory of Open Access Journals (Sweden)

    Massimiliano Etteri

    2016-06-01

    Full Text Available In this rare case report we describe a 27- year-old white man survived to suicide by asphyxiation using the so-called suicide bag (or exit bag filled with helium supplied through a plastic tube. He had no previous psychiatric or organic illnesses. At the time of presentation to our Emergency Department he was awake and reported severe dyspnea with a clinical pattern of acute respiratory failure. Imaging studies showed pulmonary edema and the patient was treated with non-invasive ventilation in Intensive Care Unit. After 15 days the patient was discharged from hospital in optimal conditions. These rare cases of survivor might suggest the possible causes of death from inhaling helium.

  10. Medical hospitalizations in prostate cancer survivors.

    Science.gov (United States)

    Gnanaraj, Jerome; Balakrishnan, Shobana; Umar, Zarish; Antonarakis, Emmanuel S; Pavlovich, Christian P; Wright, Scott M; Khaliq, Waseem

    2016-07-01

    The objectives of the study were to explore the context and reasons for medical hospitalizations among prostate cancer survivors and to study their relationship with obesity and the type of prostate cancer treatment. A retrospective review of medical records was performed at an academic institution for male patients aged 40 years and older who were diagnosed and/or treated for prostate cancer 2 years prior to the study's observation period from January 2008 to December 2010. Unpaired t test, ANOVA, and Chi-square tests were used to compare patients' characteristics, admission types, and medical comorbidities by body mass index (BMI) and prostate cancer treatment. Mean age for the study population was 76 years (SD = 9.2). Two hundred and forty-five prostate cancer survivors were stratified into two groups: non-obese (BMI obese (BMI ≥ 30 kg/m(2)). The study population's characteristics analyzed by BMI were similar including Gleason score, presence of metastatic disease and genitourinary-related side effects. Only 13 % of admissions were for complaints related to their genitourinary system. Neither the specific treatment that the patients had received for their prostate cancer, nor obesity was associated with the reasons for their medical admission. Survivorship after having a diagnosis of prostate cancer is often lengthy, and these men are at risk of being hospitalized, as they get older. From this inquiry, it has become clear that neither body mass index nor prior therapy is associated with specific admission characteristics, and only a minority of such admissions was directly related to prostate cancer or the genitourinary tract.

  11. For Heart Attack Survivors, a Risk of Suicide?

    Science.gov (United States)

    ... html For Heart Attack Survivors, a Risk of Suicide? Study findings underscore importance of depression screening, researcher ... may face a higher-than-normal risk of suicide, a new study suggests. Researchers in Taiwan found ...

  12. Most Adult Survivors of Childhood Cancers Enjoy Good Sexual Health

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163439.html Most Adult Survivors of Childhood Cancers Enjoy Good Sexual ... toxic treatments were tied to later issues, but most rated sex lives as positive To use the ...

  13. What Breast Cancer Survivors Need to Know about Osteoporosis

    Science.gov (United States)

    ... What Breast Cancer Survivors Need to Know About Osteoporosis Publication available in: PDF (81 KB) Related Resources ... Management Strategies Resources For Your Information Facts About Osteoporosis Osteoporosis is a condition in which the bones ...

  14. What Prostate Cancer Survivors Need to Know about Osteoporosis

    Science.gov (United States)

    ... What Prostate Cancer Survivors Need to Know About Osteoporosis Publication available in: PDF (86 KB) Related Resources ... Management Strategies Resources For Your Information Facts About Osteoporosis Osteoporosis is a condition in which bones become ...

  15. "To All Stroke Survivors - Never, Ever Give Up"

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation "To All Stroke Survivors – Never, Ever Give Up." Past Issues / Spring ... have for other Americans who are recovering from strokes and other serious health challenges? What about their ...

  16. Some Melanoma Survivors Still Seek Out the Sun

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163887.html Some Melanoma Survivors Still Seek Out the Sun 1 in ... Even after surviving the potentially deadly skin cancer melanoma, some people continue to go out in the ...

  17. Salivary Alpha-Amylase Reactivity in Breast Cancer Survivors

    National Research Council Canada - National Science Library

    Wan, Cynthia; Couture-Lalande, Marie-Ève; Narain, Tasha A; Lebel, Sophie; Bielajew, Catherine

    2016-01-01

    .... To fully understand the integrity of the stress response in this population, this paper explored the diurnal and acute alpha-amylase profiles of 22 breast cancer survivors and 26 women with no history of cancer...

  18. Early Brain Stimulation May Help Stroke Survivors Recover Language Function

    Science.gov (United States)

    ... survivors with several types of aphasia at the rehabilitation hospital Rehanova and the Max-Planck-Institute for neurological research in Cologne, Germany. Thirteen received transcranial magnetic stimulation (TMS) and 11 got sham stimulation. The TMS ...

  19. Cancer survivors' rehabilitation needs in a primary health care context

    DEFF Research Database (Denmark)

    Mikkelsen, Thorbjørn; Søndergaard, Jens; Sokolowski, Ineta;

    2009-01-01

    BACKGROUND: Studies of cancer survivors' rehabilitation needs have mostly addressed specific areas of needs, e.g. physical aspects and/or rehabilitation needs in relation to specific cancer types. OBJECTIVE: To assess cancer survivors' perceived need for physical and psychosocial rehabilitation......, whether these needs have been presented to and discussed with their GP. METHODS: A survey among a cohort of cancer survivors approximately 15 months after diagnosis. The questionnaire consisted of an ad hoc questionnaire on rehabilitation needs and the two validated questionnaires, the SF-12...... and the Research and Treatment of Cancer quality of life questionnaire, the QLQ C-30 version 3. RESULTS: Among 534 eligible patients, we received 353 (66.1%) answers. Two-thirds of the cancer survivors had discussed physical rehabilitation needs with their GPs. Many (51%) feared cancer relapse, but they rarely...

  20. Quality of Life in Younger Leukemia and Lymphoma Survivors

    Science.gov (United States)

    2011-08-23

    Anxiety Disorder; Cancer Survivor; Fatigue; Leukemia; Long-term Effects Secondary to Cancer Therapy in Adults; Lymphoma; Lymphoproliferative Disorder; Pain; Psychosocial Effects of Cancer and Its Treatment; Small Intestine Cancer

  1. The Right Balance: Helping Cancer Survivors Achieve a Healthy Weight

    Science.gov (United States)

    An article about interventions that aim to help survivors maintain a healthy weight to reduce the risk of cancer recurrence and death and decrease the likelihood of chronic and late effects of cancer treatment.

  2. Need For Improved Skin Cancer Surveillance in Pediatric Cancer Survivors.

    Science.gov (United States)

    Sharma, Divya; Lee, Thomas; Friedman, Adam J; Redbord, Kelley Pagliai

    2017-04-01

    Survivors of pediatric cancer are at increased risk of developing secondary malignancies, with non-melanoma skin cancer being the most common. These patients are also at increased risk of melanoma. Currently, guidelines provided by the National Cancer Institute and Children's Oncology Group emphasize the importance of annual clinical examination for skin cancer screening; however, the literature reports that less than one-third of survivors of pediatric cancer have ever had a clinical skin exam by a physician. In this article, we review the risk factors for skin cancer in survivors of pediatric cancer as well as the current evidence and recommendations for their care. We suggest that dermatologists collectively establish guidelines for skin cancer surveillance in survivors of pediatric cancer.

  3. Actual 10-year survivors following resection of adrenocortical carcinoma.

    Science.gov (United States)

    Tran, Thuy B; Postlewait, Lauren M; Maithel, Shishir K; Prescott, Jason D; Wang, Tracy S; Glenn, Jason; Phay, John E; Keplinger, Kara; Fields, Ryan C; Jin, Linda X; Weber, Sharon M; Salem, Ahmed; Sicklick, Jason K; Gad, Shady; Yopp, Adam C; Mansour, John C; Duh, Quan-Yang; Seiser, Natalie; Solorzano, Carmen C; Kiernan, Colleen M; Votanopoulos, Konstantinos I; Levine, Edward A; Hatzaras, Ioannis; Shenoy, Rivfka; Pawlik, Timothy M; Norton, Jeffrey A; Poultsides, George A

    2016-12-01

    Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options beyond surgical resection. The characteristics of actual long-term survivors following surgical resection for ACC have not been previously reported. Patients who underwent resection for ACC at one of 13 academic institutions participating in the US Adrenocortical Carcinoma Group from 1993 to 2014 were analyzed. Patients were stratified into four groups: early mortality (died within 2 years), late mortality (died within 2-5 years), actual 5-year survivor (survived at least 5 years), and actual 10-year survivor (survived at least 10 years). Patients with less than 5 years of follow-up were excluded. Among the 180 patients available for analysis, there were 49 actual 5-year survivors (27%) and 12 actual 10-year survivors (7%). Patients who experienced early mortality had higher rates of cortisol-secreting tumors, nodal metastasis, synchronous distant metastasis, and R1 or R2 resections (all P year survivors. Ten of twelve actual 10-year survivors were women, and of the seven 10-year survivors who experienced disease recurrence, five had undergone repeat surgery to resect the recurrence. Surgery for ACC can offer a 1 in 4 chance of actual 5-year survival and a 1 in 15 chance of actual 10-year survival. Long-term survival was often achieved with repeat resection for local or distant recurrence, further underscoring the important role of surgery in managing patients with ACC. J. Surg. Oncol. 2016;114:971-976. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Genetic effects of radiation in atomic-bomb survivors and their children: past, present and future.

    Science.gov (United States)

    Nakamura, Nori

    2006-01-01

    Genetic studies in the offspring of atomic bomb survivors have been conducted since 1948 at the Atomic Bomb Casualty Commission and its successor, the Radiation Effects Research Foundation, in Hiroshima and Nagasaki. Past studies include analysis of birth defects (untoward pregnancy outcome; namely, malformation, stillbirth, and perinatal death), chromosome aberrations, alterations of plasma and erythrocyte proteins as well as epidemiologic study on mortality (any cause) and cancer incidence (the latter study is still ongoing). There is, thus far, no indication of genetic effects in the offspring of survivors. Recently, the development of molecular biological techniques and human genome sequence databases made it possible to analyze DNA from parents and their offspring (trio-analysis). In addition, a clinical program is underway to establish the frequency of adult-onset multi-factorial diseases (diabetes mellitus, high blood pressure, and cardiovascular disease etc) in the offspring. The complementary kinds of data that will emerge from this three-pronged approach (clinical, epidemiologic, and molecular aspects) promise to shed light on health effects in the offspring of radiation-exposed people.

  5. Risk of posttraumatic stress disorder and depression in survivors of the floods in Bihar, India

    Directory of Open Access Journals (Sweden)

    Telles Shirley

    2009-08-01

    Full Text Available Background: Following a natural disaster, survivors are vulnerable to develop posttraumatic stress disorder (PTSD and/ or depression. Objectives: (i To screen survivors of the Bihar floods a month after the event to determine their scores in a screening questionnaire for PTSD and/ or depression and (ii to correlate these scores with age and gender. Materials and Methods: One thousand two hundred eighty-nine persons (645 females who had been directly exposed to the floods in Bihar, India, in August 2008 were assessed. The Screening Questionnaire for Disaster Mental Health (SQD was used to screen for PTSD and depression. Statistical Analysis: Separate two-factor ANOVAs were used to compare persons of both sexes and 5 different age groups for PTSD and depression scores. This was followed by post-hoc analysis for multiple comparisons. Results: People over the age of 60 years had significantly higher scores for PTSD and depression compared to all groups (P< 0.05 for all comparisons. Conclusion: Following a natural disaster, older people appear more vulnerable to develop PTSD and depression. This should be taken into account in devising strategies for disaster relief.

  6. Use of Health Care Services Before and After a Natural Disaster Among Survivors With and Without PTSD

    DEFF Research Database (Denmark)

    Rosendal, Susanne; Mortensen, Erik Lykke; Andersen, Henrik Steen

    2014-01-01

    OBJECTIVE This study used a questionnaire to identify individuals who met criteria for posttraumatic stress disorder (PTSD) ten months after surviving a disaster and compared their use of health care services before and after the disaster with that of survivors who did not meet criteria for PTSD....... METHODS Ten months after the December 26, 2004, Southeast Asian tsunami, Danish tourists who had been in areas exposed to the disaster were mailed a questionnaire asking about demographic characteristics and exposure to the tsunami. The questionnaire included the PTSD Checklist, which measures symptoms...... of PTSD itself. Associations between PTSD and subsequent health problems must be interpreted with caution....

  7. Childhood cancer survivor care: development of the Passport for Care.

    Science.gov (United States)

    Poplack, David G; Fordis, Michael; Landier, Wendy; Bhatia, Smita; Hudson, Melissa M; Horowitz, Marc E

    2014-12-01

    Survivors of childhood cancer are at risk of long-term adverse effects and late effects of the disease and/or its treatment. In response to national recommendations to improve evidence-based follow-up care, a web-based support system for clinical decision making, the Passport for Care (PFC), was developed for use at the point of care to produce screening recommendations individualized to the survivor. To date, the PFC has been implemented in over half of the nearly 200 clinics affiliated with the Children's Oncology Group across the USA. Most clinician users report that the PFC has been integrated into clinic workflows, and that it fosters improved conversations with survivors about the potential late effects a survivor might experience and about the screening and/or behavioural interventions recommended to improve health status. Furthermore, clinicians using the PFC have indicated that they adhered more closely to follow-up care guidelines. Perspectives on the challenges encountered and lessons learned during the development and deployment of the PFC are reviewed and contrasted with other nationwide approaches to the provision of guidance on survivor follow-up care; furthermore, the implications for the care of childhood cancer survivors are discussed.

  8. Sexual violence in post-conflict Liberia: survivors and their care.

    Science.gov (United States)

    Tayler-Smith, K; Zachariah, R; Hinderaker, S G; Manzi, M; De Plecker, E; Van Wolvelaer, P; Gil, T; Goetghebuer, S; Ritter, H; Bawo, L; Davis-Worzi, C

    2012-11-01

    Using routine data from three clinics offering care to survivors of sexual violence (SV) in Monrovia, Liberia, we describe the characteristics of SV survivors and the pattern of SV and discuss how the current approach could be better adapted to meet survivors' needs. There were 1500 survivors seeking SV care between January 2008 and December 2009. Most survivors were women (98%) and median age was 13 years (Interquartile range: 9-17 years). Sexual aggression occurred during day-to-day activities in 822 (55%) cases and in the survivor's home in 552 (37%) cases. The perpetrator was a known civilian in 1037 (69%) SV events. Only 619 (41%) survivors sought care within 72 h. The current approach could be improved by: effectively addressing the psychosocial needs of child survivors, reaching male survivors, targeting the perpetrators in awareness and advocacy campaigns and reducing delays in seeking care. © 2012 Blackwell Publishing Ltd.

  9. Hepatitis virus infection and chronic liver disease among atomic-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Saeko; Cologne, John; Akahoshi, Masazumi [Radiation Effects Research Foundation, Hiroshima (Japan); Kusumi, Shizuyo [Institute of Radiation Epidemiology, Radiation Effects Association, Tokyo (Japan); Kodama, Kazunori; Yoshizawa, Hiroshi [Hiroshima University School of Medicine, Hiroshima (Japan)

    2000-05-01

    Hepatitis C and B virus (HCV, HBV) infection plays a crucial role in the etiology of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma, which have been reported to increase with radiation dose among the atomic bomb survivors. The purpose of this study is to investigate whether radiation exposure altered the prevalence of hepatitis virus infection or accelerated the progress toward chronic hepatitis after hepatitis virus infection. Levels of serum antibody to hepatitis C virus (anti-HCV), HBs antigen (HBsAg), and anti-HBs antibody (anti-HBs) were measured for 6,121 participants in the Adult Health Study of atomic bomb survivors in Hiroshima and Nagasaki. No relationship was found between anti-HCV prevalence and radiation dose, after adjusting for age, sex, city, history of blood transfusion, acupuncture, and family history, but prevalence of anti-HCV was significantly lower overall among the radiation-exposed people (relative prevalence 0.84, p=0.022) compared to people with estimated radiation dose 0 Gy. No significant interaction was found between any of the above mentioned risk factors and radiation dose. People with anti-HCV positive had 13 times higher prevalence of chronic liver disease than those without anti-HCV. However, the radiation dose response for chronic liver disease among anti-HCV positive survivors may be greater than that among anti-HCV negative survivors (slope ratio 20), but the difference was marginally significant (p=0.097). Prevalence of HBsAg increased with whole-body kerma. However, no trend with radiation dose was found in the anti-HBs prevalence. In the background, prevalence of chronic liver disease in people with HBsAg-positive was approximately three times higher that in those without HBsAg. No difference in slope of the dose was found among HBsAg positive and negative individuals (slope: HBsAg positive 0.91/Gy, HBsAg negative 0.11/Gy, difference p=0.66). In conclusion, no dose-response relationship was found between

  10. Risk and impact of pulmonary complications in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Dietz, Andrew C; Chen, Yan; Yasui, Yutaka; Ness, Kirsten K; Hagood, James S; Chow, Eric J; Stovall, Marilyn; Neglia, Joseph P; Oeffinger, Kevin C; Mertens, Ann C; Robison, Leslie L; Armstrong, Gregory T; Mulrooney, Daniel A

    2016-12-01

    Pulmonary complications after cancer therapy are varied. This study describes pulmonary outcomes among childhood cancer survivors and evaluates their impact on daily activities. The incidence of pulmonary outcomes (asthma, chronic cough, emphysema, lung fibrosis, oxygen need, and recurrent pneumonia) reported among 5-year cancer survivors (n = 14,316) and the incidence of death due to pulmonary causes among all eligible survivors (n = 20,690) in the Childhood Cancer Survivor Study were compared with those for sibling controls (n = 4027) with cumulative incidence, standardized mortality ratio (SMR), and piecewise exponential models. Logistic regression with random effects was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for activity limitations with pulmonary complications. By the age of 45 years, the cumulative incidence of any pulmonary condition was 29.6% (95% CI, 29.1%-30.0%) for cancer survivors and 26.5% (95% CI, 24.9%-28.0%) for siblings. Fewer survivors reported ever smoking (23.6% vs 36.4%, P cancer and can affect daily activities. Cancer 2016;122:3687-96. © 2016 American Cancer Society. © 2016 American Cancer Society.

  11. Exercise training in childhood cancer survivors with subclinical cardiomyopathy who were treated with anthracyclines.

    Science.gov (United States)

    Smith, Webb A; Ness, Kirsten K; Joshi, Vijaya; Hudson, Melissa M; Robison, Leslie L; Green, Daniel M

    2013-11-06

    Childhood cancer survivors (CCS) treated with anthracyclines are at risk for cardiomyopathy. This case series evaluated the response of anthracycline exposed CCS with subclinical cardiomyopathy to aerobic and strength training. Body composition, strength and cardiopulmonary fitness were evaluated before and after the 12-week intervention. All equipment and materials were provided to five 10+ year CCS (3 males, mean age 38.0 ± 3.3 years) for a guideline-based home exercise program. All five completed the study with no adverse events. Compliance with exercise was 86%. These results suggest that exercise training may improve exercise capacity of CCS with subclinical cardiomyopathy. Pediatr Blood Cancer. © 2013 Wiley Periodicals, Inc. © 2013 Wiley Periodicals, Inc.

  12. Non-pharmacological interventions for caregivers of stroke survivors.

    Science.gov (United States)

    Legg, Lynn A; Quinn, Terry J; Mahmood, Fahd; Weir, Christopher J; Tierney, Jayne; Stott, David J; Smith, Lorraine N; Langhorne, Peter

    2011-10-05

    A substantial component of care is provided to stroke survivors by informal caregivers. However, providing such care is often a new and challenging experience and has been linked to a number of adverse outcomes. A range of interventions targeted towards stroke survivors and their family or other informal caregivers have been tested in randomised controlled trials (RCTs).  To evaluate the effect of interventions targeted towards informal caregivers of stroke survivors or targeted towards informal caregivers and the care recipient (the stroke survivor). We searched the Cochrane Stroke Group Trials Register (March 2011), CENTRAL (The Cochrane Library Issue 2010, Issue 4), MEDLINE (1950 to August 2010), EMBASE (1980 to December 2010), CINAHL (1982 to August 2010), AMED (1985 to August 2010), PsycINFO (1967 to August 2010) and 11 additional databases. In an effort to identify further published, unpublished and ongoing studies, we searched conference proceedings and trials registers, scanned reference lists of relevant articles and contacted authors and researchers. There were no language restrictions. We included RCTs if they evaluated the effect of non-pharmacological interventions (compared with no care or routine care) on informal caregivers of stroke survivors. We included trials of interventions delivered to stroke survivors and informal caregivers only if the stroke survivor and informal caregiver were randomised as a dyad. We excluded studies which included stroke survivors and caregivers if the stroke survivors were the primary target of the intervention. Two review authors selected studies for inclusion, independently extracted data and assessed methodological quality. We sought original data from trialists. We categorised interventions into three groups: support and information, teaching procedural knowledge/vocational training type interventions, and psycho-educational type interventions. The primary outcome was caregivers' stress or strain. We resolved

  13. Long-Term Effect of Cranial Radiotherapy on Pituitary-Hypothalamus Area in Childhood Acute Lymphoblastic Leukemia Survivors.

    Science.gov (United States)

    Follin, Cecilia; Erfurth, Eva Marie

    2016-09-01

    Survival rates of childhood cancer have improved markedly, and today more than 80 % of those diagnosed with a pediatric malignancy will become 5-year survivors. Nevertheless, survivors exposed to cranial radiotherapy (CRT) are at particularly high risk for long-term morbidity, such as endocrine insufficiencies, metabolic complications, and cardiovascular morbidity. Deficiencies of one or more anterior pituitary hormones have been described following therapeutic CRT for primary brain tumors, nasopharyngeal tumors, and following prophylactic CRT for childhood acute lymphoblastic leukemia (ALL). Studies have consistently shown a strong correlation between the total radiation dose and the development of pituitary deficits. Further, age at treatment and also time since treatment has strong implications on pituitary hormone deficiencies. There is evidence that the hypothalamus is more radiosensitive than the pituitary and is damaged by lower doses of CRT. With doses of CRT hypothalamus and this usually causes isolated GH deficiency (GHD). Higher doses (>50 Gy) may produce direct anterior pituitary damage, which contributes to multiple pituitary deficiencies. The large group of ALL survivors treated with CRT in the 70-80-ties has now reached adulthood, and these survivors were treated mainly with 24 Gy, and the vast majority of these patients suffer from GHD. Further, after long-term follow-up, insufficiencies in prolactin (PRL) and thyroid stimulating hormone (TSH) have also been reported and a proportion of these patients were also adrenocoticotrophic hormone (ACTH) deficient. CRT to the hypothalamus causes neuroendocrine dysfunction, which means that the choice of GH test is crucial for the diagnosis of GHD.

  14. Genetic Markers for PTSD Risk and Resilience Among Survivors of the World Trade Center Attacks

    Directory of Open Access Journals (Sweden)

    Casey Sarapas

    2011-01-01

    Full Text Available We have previously reported the differential expression of 17 probe sets in survivors of the 9/11 attacks with current posttraumatic stress disorder (PTSD compared to similarly exposed survivors with no lifetime PTSD. The current study presents an expanded analysis of these subjects, including genotype at FKBP5, a modulator of glucocorticoid receptor (GR sensitivity. It includes data from additional subjects who developed PTSD following 9/11 but then recovered, distinguishing expression profiles associated with risk for developing PTSD, resilience, and symptom recovery. 40 Caucasians (20 with and 20 without PTSD, matched for exposure, age, and gender were selected from a population-representative sample of persons exposed to the 9/11 attacks from which longitudinal data had been collected in four previous waves. Whole blood gene expression and cortisol levels were obtained and genome-wide gene expression was analyzed. 25 probe sets were differentially expressed in PTSD. Identified genes were generally involved in hypothalamic-pituitary-adrenal axis, signal transduction, or in brain and immune cell function. STAT5B, a direct inhibitor of GR, and nuclear factor I/A, both showed reduced expression in PTSD. Comparison of lifetime versus current PTSD identified overlapping genes with altered expression suggesting enduring markers, while some markers present only in current PTSD may reflect state measures. As a follow-up, direct comparisons of expression in current PTSD, lifetime-only PTSD, and control groups identified FKBP5 and MHC Class II as state markers, and also identified several trait markers. An analysis of indirect effects revealed that homozygosity for any of 4 PTSD risk-related polymorphisms at FKBP5 predicted FKBP5 expression, which mediated indirect effects of genotype on plasma cortisol and PTSD severity.

  15. Fertility in female survivors of Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Irene Biasoli

    2012-01-01

    Full Text Available Currently, Hodgkin's lymphoma is one of the most curable types of cancer. Patients are often young and so the long-term morbidities of treatment have become of increasing concern. Among these, infertility is one of the most challenging consequences for patients in reproductive age. Premature ovarian failure in premenopausal women is a serious long-term sequel of the toxicity of chemotherapy. The main consequence of this syndrome is infertility, but women also present other symptoms related to estrogen deprivation. Different rates of impaired gonadal function are reported, depending on the patient's age, stage of disease, dose and intensity of chemotherapy and the use of radiation therapy. The most established strategy in female infertility is cryopreservation of embryos after in vitro fertilization. Additionally, the use of oral contraceptives or gonadotropinreleasing hormone analogs (GnRH-a during treatment is under study. This review will provide a general overview of the main studies conducted to evaluate the infertility rate among female Hodgkin's lymphoma survivors and risk factors associated to treatment, different end-point definitions for evaluating fertility and also a brief description of the available strategies for fertility preservation.

  16. Twenty-year survivors of kidney transplantation.

    LENUS (Irish Health Repository)

    Traynor, C

    2012-12-01

    There have been few studies of patients with renal allografts functioning for more than 20 years. We sought to identify clinical factors associated with ultra long-term (>20 year) renal allograft survival and to describe the clinical features of these patients. We performed a retrospective analysis of the Irish Renal Transplant Database and included 1174 transplants in 1002 patients. There were 255 (21.74%) patients with graft function for 20 years or more. Multivariate analysis identified recipient age (HR 1.01, CI 1.01-1.02), gender (male HR 1.25, CI 1.08-1.45), acute rejection (HR 1.26, CI 1.09-1.45) and transplant type (living related donor vs. deceased donor) (HR 0.52, CI 0.40-0.66) as significantly associated with long-term graft loss. Median serum creatinine was 115 μmol\\/L. The 5-year graft survival in 20-year survivors was 74.7%. The mean age at death was 62.7 years (±10.6). The most common causes of death were cardiovascular disease and malignancy. The two major causes of graft loss were death (with function) and interstitial fibrosis\\/tubular atrophy. Comorbidities included skin cancer (36.1%), coronary heart disease (17.3%) and other malignancies (14.5%). This study identifies factors associated with long-term allograft survival and a high rate of morbidity and early mortality in long-term transplant recipients.

  17. Emotional distress among adult survivors of childhood cancer.

    Science.gov (United States)

    Oancea, S Cristina; Brinkman, Tara M; Ness, Kirsten K; Krull, Kevin R; Smith, Webb A; Srivastava, D Kumar; Robison, Leslie L; Hudson, Melissa M; Gurney, James G

    2014-06-01

    The purposes of this study were to estimate the prevalence of emotional distress in a large cohort of adult survivors of childhood cancer and to evaluate the interrelationship of risk factors including cancer-related late effects. Adult survivors of childhood cancer (N = 1,863), median age of 32 years at follow-up, completed comprehensive medical evaluations. Clinically relevant emotional distress was assessed using the Brief Symptom Inventory 18 and was defined as T-scores ≥63. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression models to identify risk factors for distress. Path analysis was used to examine associations among identified risk factors. Elevated global distress was reported by 15.1% of survivors. Cancer-related pain was associated with elevated distress (OR 8.72; 95% CI, 5.32-14.31). Survivors who reported moderate learning or memory problems were more likely to have elevated distress than survivors who reported no learning or memory problems (OR 3.27; 95% CI, 2.17-4.93). Path analysis implied that cancer-related pain has a direct effect on distress symptoms and an indirect effect through socioeconomic status and learning or memory problems. Similar results were observed for learning or memory problems. Childhood cancer-related morbidities including pain and learning or memory problems appear to be directly and indirectly associated with elevated distress symptoms decades after treatment. Understanding these associations may help inform intervention targets for survivors of childhood cancer experiencing symptoms of distress. A subset of long-term childhood cancer survivors experience significant emotional distress. Physical and cognitive late effects may contribute to these symptoms.

  18. Quality of life of adult retinoblastoma survivors in the Netherlands

    Directory of Open Access Journals (Sweden)

    Cohen-Kettenis Peggy T

    2007-06-01

    Full Text Available Abstract Background To assess the quality of life (QoL and predictors thereof in Dutch adult hereditary and non-hereditary retinoblastoma (RB survivors. Methods In this population-based cross-sectional study, a generic QoL questionnaire (SF-36 and a disease-specific interview were administered to 87 adult RB survivors aged 18 to 35 years. Their QoL data were compared with those of a Dutch healthy reference group. Among the RB hereditary/non-hereditary survivors, the QoL was compared and predictors for QoL were identified by linear multiple regression analyses. Results As a group, RB survivors scored significantly lower than the reference group on the SF-36 subscale 'mental health' (t = -27, df = 86, p Conclusion In this exploratory study, it appears that the group of adult RB survivors experience a relatively good overall but slightly decreased QoL compared with the reference group. However, they report more problems with regard to their mental health (anxiety, feelings of depression, and loss of control. Hereditary RB survivors differ significantly from non-hereditary RB survivors only in 'general health'. Bullying in childhood and subjective experience of impairment are the main predictors of a worse QoL. In order to prevent worsening of QoL, or perhaps to improve it, clinicians should make an inventory of these issues at an early stage. We recommend further research to assess the specific psychological factors that may lead to mental health problems in this population.

  19. The impact of childhood cancer: Perceptions of adult survivors.

    Science.gov (United States)

    Willard, Victoria W; Klosky, James L; Li, Chenghong; Srivastava, Deo Kumar; Brinkman, Tara M; Robison, Leslie L; Hudson, Melissa M; Phipps, Sean

    2017-05-01

    The objective of this study was to describe perceptions and associated risk factors of the impact of cancer on functional outcomes, including social relationships, exercise, finances, and religion, among adult survivors of childhood cancer. Evaluable participants included 3001 adult survivors (mean age, 32.5 years; range, 18.3-63.8 years; 24.1 years from diagnosis; 50.8% male; 84.9% Caucasian) who were enrolled in the St. Jude Lifetime Cohort study. Perceptions of the impact of cancer were assessed using the Brief Cancer Impact Assessment (BCIA). Regression models were used to evaluate risk factors for functional outcomes. The median response on the BCIA was a perception that cancer had minimal impact on the domains assessed. Approximately 33.1% to 46.6% of survivors indicated this response across the 4 subscales, although responses ranged from very positive to very negative impact. Other than diagnosis (with survivors of brain tumors generally indicating a more negative impact of cancer, with subscale estimates of -1.25 for caregiving and finance and -1.01 for social and emotional and an odds ratio of 1.83 for exercise and diet), most variability was because of demographic factors, including sex, age, race, education, and employment. The current findings highlight that many long-term adult survivors perceive minimal impact of childhood cancer on functional aspects of adulthood, including caregiving, finances, exercise, social-emotional relationships, and religion. This suggests that survivors may not be focusing on the influence of likely physical and psychological late effects of their disease in their day-to-day lives. For those who do perceive a negative impact, variability in responses suggests that there are of survivors who may benefit from interventions focused on the achievement of functional goals. Cancer 2017;123:1625-1634. © 2017 American Cancer Society. © 2016 American Cancer Society.

  20. Financial Hardships Experienced by Cancer Survivors: A Systematic Review.

    Science.gov (United States)

    Altice, Cheryl K; Banegas, Matthew P; Tucker-Seeley, Reginald D; Yabroff, K Robin

    2017-02-01

    With rising cancer care costs, including high-priced cancer drugs, financial hardship is increasingly documented among cancer survivors in the United States; research findings have not been synthesized. We conducted a systematic review of articles published between 1990 and 2015 describing the financial hardship experienced by cancer survivors using PubMed, Embase, Scopus, and CINAHL databases. We categorized measures of financial hardship into: material conditions (eg, out-of-pocket costs, productivity loss, medical debt, or bankruptcy), psychological responses (eg, distress or worry), and coping behaviors (eg, skipped medications). We abstracted findings and conducted a qualitative synthesis. Among 676 studies identified, 45 met the inclusion criteria and were incorporated in the review. The majority of the studies (82%, n = 37) reported financial hardship as a material condition measure; others reported psychological (7%, n = 3) and behavioral measures (16%, n = 7). Financial hardship measures were heterogeneous within each broad category, and the prevalence of financial hardship varied by the measure used and population studied. Mean annual productivity loss ranged from $380 to $8236, 12% to 62% of survivors reported being in debt because of their treatment, 47% to 49% of survivors reported experiencing some form of financial distress, and 4% to 45% of survivors did not adhere to recommended prescription medication because of cost. Financial hardship is common among cancer survivors, although we found substantial heterogeneity in its prevalence. Our findings highlight the need for consistent use of definitions, terms, and measures to determine the best intervention targets and inform intervention development in order to prevent and minimize the impact of financial hardship experienced by cancer survivors. Published by Oxford University Press 2016. This work is written by US Government employees and is in the public domain in the US.

  1. Neurologic Evaluations of Patients Exposed to the World Trade Center Disaster.

    Science.gov (United States)

    Stecker, Mark M; Yu, Huiying; Barlev, Renee; Marmor, Michael; Wilkenfeld, Marc

    2016-11-01

    The aim of this study was to describe the clinical phenotype of a limited group of responders and survivors of the World Trade Center (WTC) disaster who were referred for the evaluation of neuropathic symptoms. Sixteen patients with WTC exposure were referred to a neurologist for evaluation. All had a neurologic examination. Most had electromyogram and nerve conduction testing/nerve conduction studies as well as appropriate imaging and blood tests. There was a higher probability of a neuropathy diagnosis in WTC-exposed patients than other patients referred for EMG testing. Two WTC-exposed patients had motor neuron disease and not neuropathy. This study provides objective evidence of neuropathy in a relatively high fraction of WTC-exposed patients with neuropathic symptoms. It also emphasizes that the scope of neurologic problems following WTC exposure may include other diagnoses such as motor neuron disease.

  2. Does Caregiver Well-Being Predict Stroke Survivor Depressive Symptoms? A Mediation Analysis

    Science.gov (United States)

    Grant, Joan S.; Clay, Olivio J.; Keltner, Norman L.; Haley, William E.; Wadley, Virginia G.; Perkins, Martinique M.; Roth, David L.

    2013-01-01

    Background and Purpose Studies suggest that family caregiver well-being (ie,, depressive symptoms and life satisfaction) may affect stroke survivor depressive symptoms. We used mediation analysis to assess whether caregiver well-being might be a factor explaining stroke survivor depressive symptoms, after controlling for demographic factors and stroke survivor impairments and problems. Methods Caregiver/stroke participant dyads (N=146) completed measures of stroke survivor impairments and problems and depressive symptoms and caregiver depressive symptoms and life satisfaction. Mediation analysis was used to examine whether caregiver well-being mediated the relationship between stroke survivor impairments and problems and stroke survivor depressive symptoms. Results As expected, more stroke survivor problems and impairments were associated with higher levels of stroke survivor depressive symptoms (P caregiver life satisfaction (29.29%) and caregiver depressive symptoms (32.95%). Although these measures combined to account for 40.50% of the relationship between survivor problems and impairments and depressive symptoms, the direct effect remained significant. Conclusions Findings indicate that stroke survivor impairments and problems may affect family caregivers and stroke survivors and a high level of caregiver distress may result in poorer outcomes for stroke survivors. Results highlight the likely importance of intervening with both stroke survivors and family caregivers to optimize recovery after stroke. PMID:23340070

  3. Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Sabine, E-mail: muellers@neuropeds.ucsf.edu [Department of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco, San Francisco, California (United States); Fullerton, Heather J. [Department of Neurology and Pediatrics, University of California, San Francisco, San Francisco, California (United States); Stratton, Kayla; Leisenring, Wendy [Fred Hutchinson Cancer Research Center, Seattle, Washington (United States); Weathers, Rita E.; Stovall, Marilyn [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Armstrong, Gregory T. [St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Goldsby, Robert E. [Department of Pediatrics, University of California, San Francisco, San Francisco, California (United States); Packer, Roger J. [Children' s National Medical Center, Washington, District of Columbia (United States); Sklar, Charles A. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bowers, Daniel C. [University of Texas Southwestern Medical School, Dallas, Texas (United States); Robison, Leslie L.; Krull, Kevin R. [St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2013-07-15

    Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292 survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively.

  4. Increased risk of antidepressant use in childhood cancer survivors

    DEFF Research Database (Denmark)

    Lund, Lasse Wegener; Winther, J F; Cederkvist, L;

    2015-01-01

    AIM: Childhood cancer survivors are at risk of both somatic and mental late effects, but large population-based studies of depression are lacking. METHODS: Risk of antidepressant use was evaluated in a population-based cohort of 5452 Danish children treated for cancer in 1975-2009 by linkage...... survivors were at increased risk of having antidepressants prescribed (HR, 1.4; 95% confidence interval (CI), 1.3-1.5). The excess absolute risk of antidepressant use was 2.5 per 1000 person-years (95% CI, 1.7-3.3), equivalent to an excess of 2.5 survivors for every 100 survivors followed for 10years....... Increased HRs of 30-50% were seen for survivors of cancers of all main groups (haematological malignancies, central nervous system (CNS) and solid tumors); the highest risk was among children treated with haematopoietic stem cell transplantation (HR, 1.9; 95% CI, 1.2-3.1). Our data suggested that the risk...

  5. Media participation and mental health in terrorist attack survivors.

    Science.gov (United States)

    Thoresen, Siri; Jensen, Tine K; Dyb, Grete

    2014-12-01

    Terrorism and disasters receive massive media attention, and victims are often approached by reporters. Not much is known about how terror and disaster victims perceive the contact with media and whether such experiences influence mental health. In this study, we describe how positive and negative experiences with media relate to posttraumatic stress (PTS) reactions among survivors of the 2011 Utøya Island terrorist attack in Norway. Face-to-face interviews were conducted with 285 survivors (47.0% female and 53.0% male) 14-15 months after the terrorist attack. Most survivors were approached by reporters (94%), and participated in media interviews (88%). The majority of survivors evaluated their media contact and participation as positive, and media participation was unrelated to PTS reactions. Survivors who found media participation distressing had more PTS reactions (quite distressing: B = 0.440, extremely distressing: B = 0.611, p = .004 in adjusted model). Perceiving media participation as distressing was slightly associated with lower levels of social support (r = -.16, p = .013), and regretting media participation was slightly associated with feeling let down (r = .18, p = .004). Reporters should take care when interviewing victims, and clinicians should be aware of media exposure as a potential additional strain on victims.

  6. Survivor Perspectives on IPV Perpetrator Interventions: A Systematic Narrative Review.

    Science.gov (United States)

    McGinn, Tony; Taylor, Brian; McColgan, Mary; Lagdon, Susan

    2016-07-01

    More effective work with perpetrators of intimate partner violence (IPV) can be built upon a better understanding of how and why they change their behavior. This article presents a systematic narrative review of female IPV survivor perspectives on the changes brought about by IPV perpetrator programs. Fourteen databases and web search engines were searched and 16 articles reporting relevant qualitative findings were identified. Survivors often reported some level of positive change through their partner's engagement with a program, but the sustainability of this change is unclear and there was also some negative feedback. From the survivors' perspective, key barriers to perpetrator change include alcohol dependency, mental health challenges, relationship dynamics, and their family of origin. Mechanisms by which perpetrators are held to account, namely, survivor validation and judicial measures, were seen as central to the change process. Survivors perceived changes in perpetrator behavior (the use of conflict interruption techniques and new communication skills) and changes in perpetrators' belief systems (adopting new perspectives). Changes in belief systems were associated with more complete desistence from violence and would appear more difficult to effect. The review highlights the complexity in this field, which is discussed by the authors with reference to practice, policy, and research.

  7. Excessive Daytime Sleepiness in Stroke Survivors: An Integrative Review.

    Science.gov (United States)

    Ding, Qinglan; Whittemore, Robin; Redeker, Nancy

    2016-07-01

    Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors' quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946-April; Week 2, 2015), Embase (OvidSP 1974-March; Week 1, 2015), and PsycINFO (OvidSP 1967-April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors. © The Author(s) 2016.

  8. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS scale for long-term cancer survivors in a sample of breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Foley Kristie

    2006-12-01

    Full Text Available Abstract Background This paper evaluates psychometric properties of a recently developed measure focusing on the health-related quality of life (HRQL of long-term cancer survivors, the Quality of Life in Adult Survivors scale (QLACS, in a sample of breast cancer survivors. This represents an important area of study, given the large number of breast cancer patients surviving many years post diagnosis. Methods Analyses are based on an 8-year follow-up of a sample of breast cancer survivors who participated in an earlier study conducted in 1995. Participants were re-contacted in 2003 and those who were reachable and agreed to participate (n = 94 were surveyed using a variety of measures including the QLACS. Additional follow-up surveys were conducted 2 weeks and one year later. Psychometric tests of the QLACS included test-retest reliability, concurrent and retrospective validity, and responsiveness. Results The QLACS domain and summary scores showed good test-retest reliability (all test-retest correlations were above .7 and high internal consistency. The Generic Summary Score showed convergent validity with other measures designed to assess generic HRQL. The Cancer-Specific Summary score exhibited divergent validity with generic HRQL measures, but not a cancer-related specific measure. The QLACS Cancer-Specific Summary Score demonstrated satisfactory predictive validity for factors that were previously shown to be correlated with HRQL. The QLACS generally demonstrated a high level of responsiveness to life changes. Conclusion The QLACS may serve as a useful measure for assessing HRQL among long-term breast cancer survivors that are not otherwise captured by generic measures or those specifically designed for newly diagnosed patients.

  9. Exercise echocardiography in asymptomatic survivors of childhood cancer treated with anthracyclines

    DEFF Research Database (Denmark)

    Sieswerda, Elske; Kremer, Leontien C M; Vidmar, Suzanna

    2010-01-01

    BACKGROUND: Exercise echocardiography reveals abnormalities in asymptomatic childhood cancer survivors who previously have been treated with anthracyclines. We determined the added value of monitoring childhood cancer survivors with exercise echocardiography compared to monitoring with resting ec...

  10. Surviving early childhood trauma : effects of the holocaust on survivors' psychological and physiolocial well-being

    NARCIS (Netherlands)

    Fridman, Ayala

    2011-01-01

    Psychological, neurobiological and genetics characteristics of Holocaust child survivors and their daughters were studied in population-wide demographic sample in comparison to matched control groups. Sixty years following the occurrence of the trauma, survivors still report more dissociative

  11. Long-term prognosis for transplant-free survivors of paracetamol-induced acute liver failure

    DEFF Research Database (Denmark)

    Jepsen, P; Schmidt, L E; Larsen, F S

    2010-01-01

    The prognosis for transplant-free survivors of paracetamol-induced acute liver failure remains unknown.......The prognosis for transplant-free survivors of paracetamol-induced acute liver failure remains unknown....

  12. Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review

    National Research Council Canada - National Science Library

    Edmondson, Donald; Richardson, Safiya; Fausett, Jennifer K; Falzon, Louise; Howard, Virginia J; Kronish, Ian M

    2013-01-01

    Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke and transient ischemic attack (TIA...

  13. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Michaelson, Evan M. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Silver, Barbara; Tishler, Roy B.; Marcus, Karen J. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States); Stevenson, Mary Ann [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose: To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes. Methods and Materials: Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model. Results: With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively. Conclusions: Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time.

  14. Treatment Summaries and Follow-Up Care Instructions for Cancer Survivors: Improving Survivor Self-Efficacy and Health Care Utilization

    Science.gov (United States)

    Kvale, Elizabeth A.; Rocque, Gabrielle B.; Demark-Wahnefried, Wendy; Martin, Michelle Y.; Jackson, Bradford E.; Meneses, Karen; Partridge, Edward E.; Pisu, Maria

    2016-01-01

    Background. Treatment summaries and follow-up care plan information should be provided to cancer survivors. This study examines the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management, and whether self-efficacy was associated with health care utilization. Methods. Four hundred forty-one cancer survivors (≥2 years from diagnosis and had completed treatment) ≥65 years old from 12 cancer centers across 5 states completed telephone surveys. Survivors responded to three questions about receiving a written treatment summary, written follow-up plan, and an explanation of follow-up care plans. Respondents completed the Stanford Chronic Illness Management Self-Efficacy Scale and reported emergency room visits and hospitalizations in the past year. Three multiple linear regression models estimated the association of written treatment summary, written follow-up care plan, and verbal explanation of follow-up plan with total self-efficacy score. Log-binomial models estimated the association of self-efficacy scores with emergency room visits and hospitalizations (yes/no). Results. Among survivors, 40% and 35% received a written treatment summary and follow-up care plan, respectively. Seventy-nine percent received an explanation of follow-up care plans. Receiving a verbal explanation of follow-up care instructions was significantly associated with higher self-efficacy scores (β = 0.72, p = .009). Higher self-efficacy scores were significantly associated with lower prevalence ratios of emergency room visits (prevalence ratio, 0.92; 95% confidence interval, 0.88–0.97) and hospitalizations (prevalence ratio, 0.94; 95% confidence interval, 0.89–0.99). Conclusion. Explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition—an important mediator for improving health care utilization outcomes. Implications for Practice: Older

  15. Social Participation after Stroke: One-Year Follow-Up of Stroke Survivors in Nigeria

    OpenAIRE

    Grace O. Vincent-Onabajo

    2013-01-01

    Background. Stroke may negatively affect social participation in survivors. Aims. This study assessed the pattern of social participation in a sample of Nigerian stroke survivors across the first 12 months after stroke. Methods. Stroke survivors were consecutively recruited while on admission at a tertiary health institution. The London handicap scale was used to assess social participation at 1, 3, 6, 9, and 12 months at the homes of the stroke survivors. Overall and domain-specific patterns...

  16. Military and Veterans’ Benefits: Analysis of VA Compensation Levels for Survivors of Veterans and Servicemembers

    Science.gov (United States)

    2009-11-01

    pensions , and life insurance. Lastly, GAO interviewed officials from VA and groups representing veterans, servicemembers, and their survivors. GAO is...in our analysis other sources of income survivors may receive, such as Social Security, private pensions , or life insurance. For additional context...with survivors receiving a percentage of the employee’s calculated retirement annuity .31 FERS offers similar survivor benefits, but the maximum is 50

  17. Adherence to Guidelines for Cancer Survivors and Health-Related Quality of Life among Korean Breast Cancer Survivors.

    Science.gov (United States)

    Song, Sihan; Hwang, Eunkyung; Moon, Hyeong-Gon; Noh, Dong-Young; Lee, Jung Eun

    2015-12-09

    There is limited evidence on the association between adherence to guidelines for cancer survivors and health-related quality of life (HRQoL). In a cross-sectional study of Korean breast cancer survivors, we examined whether adherence to the guidelines of the American Cancer Society (ACS) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) for cancer survivors was related to levels of HRQoL, assessed by the Korean version of Core 30 (C30) and Breast cancer module 23 (BR23) of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ). We included a total of 160 women aged 21 to 79 years who had been diagnosed with breast cancer according to American Joint Committee on Cancer (AJCC) stages I to III and had breast cancer surgery at least six months before the interview. Increasing adherence to ACS guidelines was associated with higher scores of social functioning (p for trend = 0.05), whereas increasing adherence to WCRF/AICR recommendations was associated with higher scores of arm symptoms (p for trend = 0.01). These associations were limited to those with stage II or III cancer. Diet may be an important factor in relation to quality of life among Korean breast cancer survivors, however our findings warrant further prospective studies to evaluate whether healthy diet improves survivors' quality of life.

  18. Sexual Assault in Bisexual and Heterosexual Women Survivors.

    Science.gov (United States)

    Sigurvinsdottir, Rannveig; Ullman, Sarah E

    Social support is related to sexual minority status and negative psychological impact among sexual assault survivors. We compared bisexual and heterosexual survivors on how different types of social support are connected to symptoms of posttraumatic stress disorder (PTSD) and depression. A community sample of bisexual and heterosexual (N = 905) women sexual assault survivors completed three annual surveys. Heterosexual women reported greater perceived social support and fewer negative reactions to disclosure of sexual assault than bisexual women, but there were no differences in frequency of social contact. Perceived social support and frequency of social contact were related to fewer psychological symptoms of PTSD and depression for all women. Heterosexual women had fewer psychological symptoms than bisexual women. Finally, perceived social support mediated the relationship of sexual orientation with depressive symptoms but not with PTSD symptoms. These findings suggest that social support and sexual orientation may explain women's post-assault adjustment.

  19. Violent, caring, unpredictable: public views on survivors of brain injury.

    Science.gov (United States)

    Linden, M A; Crothers, I R

    2006-12-01

    The purpose of the present work was to investigate how members of the public perceived survivors of brain injury. A 20-item list of attributes that could be used to describe characteristics of survivors of brain injury were given to 323 participants. One hundred and sixty-nine psychology students and 154 members of the public agreed to take part in the study. The effects of group (student and public), gender and socioeconomic status (low, moderate and high) on the attributes were assessed. Multivariate analysis of variance showed a statistically significant difference between the two groups with students holding more positive perceptions on 15 out of the 20 attributes. No effects of gender or socioeconomic status were found. The research suggests that members of the public hold less positive views on survivors of brain injury in respect to intellectual competency, ability to care and trustworthiness when compared to students.

  20. Social work with trauma survivors: collaboration with interpreters.

    Science.gov (United States)

    Berthold, S Megan; Fischman, Yael

    2014-04-01

    Scant attention has been given to the emotional plight, lack of training, and stressful working conditions of interpreters serving survivors of severe human-perpetrated trauma from different parts of the world. This article addresses the critical need for effective collaboration between social workers and interpreters when the provider and survivor do not speak the same language. The careful selection of interpreters; the training, support, and promotion of self-care of interpreters; the training needs for social workers related to their work with interpreters; and the impact of secondary trauma and organizational support on the work of social workers and interpreters are explored. Proposed curriculum components for training interpreters and the importance of therapy and ongoing supervision for interpreters are highlighted. It is essential to prepare interpreters and social workers for the various challenges they will face in their collaborative efforts to serve survivors of severe human-perpetrated trauma, and organizational support is vital to the success of this work.

  1. A dance intervention for cancer survivors and their partners (RHYTHM).

    Science.gov (United States)

    Pisu, Maria; Demark-Wahnefried, Wendy; Kenzik, Kelly M; Oster, Robert A; Lin, Chee Paul; Manne, Sharon; Alvarez, Ronald; Martin, Michelle Y

    2017-06-01

    The purpose of this study was to assess the feasibility, acceptability, and impact of a ballroom dance intervention on improving quality of life (QOL) and relationship outcomes in cancer survivors and their partners. We conducted a pilot randomized controlled trial with two arms (Restoring Health in You (and Your Partner) through Movement, RHYTHM): (1) immediate dance intervention and (2) delayed intervention (wait-list control). The intervention consisted of 10 private weekly dance lessons and 2 practice parties over 12 weeks. Main outcomes were physical activity (Godin Leisure-Time Exercise Questionnaire), functional capacity (6 Minute Walk Test), QOL (SF-36), Couples' trust (Dyadic Trust Scale), and other dyadic outcomes. Exit interviews were completed by all participating couples. Thirty-one women survivors (68% breast cancer) and their partners participated. Survivors were 57.9 years old on average and 22.6% African American. Partners had similar characteristics. RHYTHM had significant positive effects on physical activity (p = 0.05), on the mental component of QOL (p = 0.04), on vitality (p = 0.03), and on the dyadic trust scale (p = 0.04). Couples expressed satisfaction with the intervention including appreciating the opportunity to spend time and exercise together. Survivors saw this light-intensity physical activity as easing them into becoming more physically active. Light intensity ballroom dancing has the potential to improve cancer survivors' QOL. Larger trials are needed to build strong support for this ubiquitous and acceptable activity. Ballroom dance may be an important tool for cancer survivors to return to a physically active life and improve QOL and other aspects of their intimate life.

  2. Child Sexual Abuse Survivors with Dissociative Amnesia: What's the Difference?

    Science.gov (United States)

    Wolf, Molly R.; Nochajski, Thomas H.

    2013-01-01

    Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and…

  3. Factors Related to Willingness to Help Survivors of Intimate Partner Violence

    Science.gov (United States)

    Beeble, Marisa L.; Post, Lori A.; Bybee, Deborah; Sullivan, Cris M.

    2008-01-01

    Although researchers have found that survivors of intimate partner violence seek support from a multitude of sources, ranging from professionals to informal support networks, little is known about the extent to which community members reach out to help survivors. This study explored the type of support provided to survivors and various factors…

  4. Child Sexual Abuse Survivors with Dissociative Amnesia: What's the Difference?

    Science.gov (United States)

    Wolf, Molly R.; Nochajski, Thomas H.

    2013-01-01

    Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and…

  5. Rising incidence of breast cancer among female cancer survivors: implications for surveillance.

    NARCIS (Netherlands)

    I. Soerjomataram (Isabelle); W.J. Louwman; L.E.M. Duijm (Lucien); J.W.W. Coebergh (Jan Willem)

    2009-01-01

    textabstractThe number of female cancer survivors has been rising rapidly. We assessed the occurrence of breast cancer in these survivors over time. We computed incidence of primary breast cancer in two cohorts of female cancer survivors with a first diagnosis of cancer at ages 30+ in the periods 19

  6. 5 CFR 838.912 - Specifying an award of a former spouse survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... survivor annuity. 838.912 Section 838.912 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... in Court Orders Awarding Former Spouse Survivor Annuities Identification of Benefits § 838.912 Specifying an award of a former spouse survivor annuity. (a) To satisfy the requirements of §...

  7. 5 CFR 831.684 - Second chance elections to provide survivor benefits.

    Science.gov (United States)

    2010-01-01

    ... survivor benefits. 831.684 Section 831.684 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Regulations Pertaining to Noncodified Statutes § 831.684 Second chance elections to provide survivor benefits. (a) A married retiree...

  8. 22 CFR 19.11-2 - Regular survivor annuity for a former spouse.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Regular survivor annuity for a former spouse... survivor annuity for a former spouse. (a) Divorce prior to retirement. If a participant or former... share of such a principal's maximum regular survivor annuity (based on service performed prior to...

  9. 5 CFR 838.734 - Payment of lump-sum awards by survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Payment of lump-sum awards by survivor... Orders Awarding Former Spouse Survivor Annuities Payment Procedures § 838.734 Payment of lump-sum awards by survivor annuity. OPM will not honor court orders awarding lump-sum payments (other than the...

  10. 5 CFR 838.933 - Payment of the cost of a former spouse survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... survivor annuity. 838.933 Section 838.933 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... in Court Orders Awarding Former Spouse Survivor Annuities Miscellaneous Provisions § 838.933 Payment of the cost of a former spouse survivor annuity. (a) A court order that unequivocally awards a...

  11. 20 CFR 216.93 - Entitlement to more than one survivor annuity.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Entitlement to more than one survivor annuity. 216.93 Section 216.93 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD... than one survivor annuity. If an individual is entitled to more than one survivor annuity, only...

  12. 20 CFR 225.25 - RR Earnings PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false RR Earnings PIA used in survivor annuities... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.25 RR Earnings PIA used in survivor annuities. The...

  13. 5 CFR 831.1006 - Offset from disability or survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Offset from disability or survivor... survivor annuity. (a) OPM will reduce the disability annuity (an annuity under 5 U.S.C. 8337) of an... has been provided. (c) OPM will reduce a survivor annuity (an annuity under 5 U.S.C. 8341) based...

  14. 20 CFR 216.92 - Entitlement as a spouse or divorced spouse and as a survivor.

    Science.gov (United States)

    2010-04-01

    ... and as a survivor. 216.92 Section 216.92 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS....92 Entitlement as a spouse or divorced spouse and as a survivor. If an individual is entitled to both a spouse or divorced spouse and survivor annuity, only the larger annuity will be paid. However,...

  15. 5 CFR 843.304 - Commencing and terminating dates of survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... survivor annuities. 843.304 Section 843.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.304 Commencing and terminating dates of survivor... may be restored under § 843.305. (d) A survivor annuity accrues on a daily basis, one-thirtieth of...

  16. 5 CFR 838.931 - Court orders that provide temporary awards of former spouse survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... awards of former spouse survivor annuities. 838.931 Section 838.931 Administrative Personnel OFFICE OF... BENEFITS Terminology Used in Court Orders Awarding Former Spouse Survivor Annuities Miscellaneous Provisions § 838.931 Court orders that provide temporary awards of former spouse survivor annuities....

  17. 26 CFR 1.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Qualified joint and survivor annuities. 1.401(a...)-11 Qualified joint and survivor annuities. (a) General rule—(1) Required provisions. A trust, to... a qualified joint and survivor annuity (as defined in paragraph (b)(2) of this section) with...

  18. 20 CFR 228.21 - Entitlement as a spouse or divorced spouse and as a survivor.

    Science.gov (United States)

    2010-04-01

    ... and as a survivor. 228.21 Section 228.21 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT COMPUTATION OF SURVIVOR ANNUITIES The Tier I Annuity Component § 228.21 Entitlement as a spouse or divorced spouse and as a survivor. If an individual is entitled to...

  19. 20 CFR 30.101 - In general, how is a survivor's claim filed?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false In general, how is a survivor's claim filed... Benefits Under Eeoicpa § 30.101 In general, how is a survivor's claim filed? (a) A survivor of an employee... writing. Form EE-2 should be used for this purpose, but any written communication that requests...

  20. 20 CFR 225.24 - SS Earnings PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false SS Earnings PIA used in survivor annuities... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.24 SS Earnings PIA used in survivor annuities. The...

  1. 20 CFR 216.91 - Entitlement as an employee and spouse, divorced spouse, or survivor.

    Science.gov (United States)

    2010-04-01

    ..., divorced spouse, or survivor. 216.91 Section 216.91 Employees' Benefits RAILROAD RETIREMENT BOARD... § 216.91 Entitlement as an employee and spouse, divorced spouse, or survivor. (a) General. If an individual is entitled to an annuity as a spouse, divorced spouse or survivor, and is also entitled to...

  2. 5 CFR 838.921 - Determining the amount of a former spouse survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... survivor annuity. 838.921 Section 838.921 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... in Court Orders Awarding Former Spouse Survivor Annuities Computation of Benefit § 838.921 Determining the amount of a former spouse survivor annuity. (a) A court order that contains no...

  3. Suicide Survivors' Mental Health and Grief Reactions: A Systematic Review of Controlled Studies

    Science.gov (United States)

    Sveen, Carl-Aksel; Walby, Fredrik A.

    2008-01-01

    There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified…

  4. Exercise Preference Patterns, Resources, and Environment among Rural Breast Cancer Survivors

    Science.gov (United States)

    Rogers, Laura Q.; Markwell, Stephen J.; Courneya, Kerry S.; McAuley, Edward; Verhulst, Steven

    2009-01-01

    Context: Rural breast cancer survivors may be at increased risk for inadequate exercise participation. Purpose: To determine for rural breast cancer survivors: (1) exercise preference "patterns," (2) exercise resources and associated factors, and (3) exercise environment. Methods: A mail survey was sent to rural breast cancer survivors identified…

  5. Candidate predictors of Health-Related quality of life of colorectal cancer survivors

    NARCIS (Netherlands)

    Bours, Martijn J.L.; Linden, van der Bernadette W.A.; Winkels, Renate M.; Duijnhoven, van Fränzel J.; Mols, Floortje; Roekel, van Eline H.; Kampman, Ellen; Beijer, Sandra; Weijenberg, Matty P.

    2016-01-01

    The population of colorectal cancer (CRC) survivors is growing and many survivors experience deteriorated health-related quality of life (HRQoL) in both early and late post-treatment phases. Identification of CRC survivors at risk for HRQoL deterioration can be improved by using prediction

  6. Rising incidence of breast cancer among female cancer survivors: implications for surveillance.

    NARCIS (Netherlands)

    I. Soerjomataram (Isabelle); W.J. Louwman; L.E.M. Duijm (Lucien); J.W.W. Coebergh (Jan Willem)

    2009-01-01

    textabstractThe number of female cancer survivors has been rising rapidly. We assessed the occurrence of breast cancer in these survivors over time. We computed incidence of primary breast cancer in two cohorts of female cancer survivors with a first diagnosis of cancer at ages 30+ in the periods

  7. Sleep and quality of life in long-term lung cancer survivors

    NARCIS (Netherlands)

    Gooneratne, Nalaka S.; Dean, Grace E.; Rogers, Ann E.; Nkwuo, J. Emeka; Coyne, James C.; Kaiser, Larry R.

    2007-01-01

    Background: Steep problems are common in lung cancer survivors, yet little is known about the prevalence, determinants, and effects on quality of life (QoL) of these steep problems in tong-term Lung cancer survivors. Methods: A case-control study design comparing 76 elderly lung cancer survivors

  8. Risk for unemployment of cancer survivors: A Danish cohort study

    DEFF Research Database (Denmark)

    Carlsen, Kathrine; Dalton, Susanne Oksbjerg; Diderichsen, Finn;

    2008-01-01

    AIM: To investigate whether cancer survivors are at an increased risk for unemployment after cancer. MATERIALS AND METHODS: A cohort of 65,510 patients who were part of the workforce in the year before diagnosis and a random sample of 316,925 age and gender-matched controls were followed for up...... to 20 years in a longitudinal register-based cohort study. Demographic, socioeconomic and health-related information were obtained through Danish administrative registers. RESULTS: Cancer survivors had a small but significantly increased risk for unemployment following cancer. Stratified analyses showed...

  9. How to develop a clinic for sudden cardiac arrest survivors and families of non-survivors.

    Science.gov (United States)

    Abrams, Dominic J

    2017-01-01

    The investigation of the aetiology of sudden cardiac arrest or death in a young person combines features of a traditional clinical medical examination with those of forensic medicine. Nuances of the immediate peri-event history, when available, can be paramount. New genetic tools have greatly improved the yield of such investigations, but they must be carefully interpreted by genetic specialists. The approach to surviving patients, their family members, and to family members of non-survivors is best achieved in a structured programme that includes all appropriate specialists and support personnel. As an example, this may include all appropriate paediatric and internal medicine specialists, a geneticist, a genetic counsellor, a clinical psychologist, nurse specialist(s), and a programme coordinator. This family-centred strategy affords the patient, if surviving, and all family members the necessary emotional and medical support while at the same time providing the necessary diagnostic and therapeutic approaches.

  10. Burden of morbidity in 10+ year survivors of hematopoietic cell transplantation: report from the bone marrow transplantation survivor study.

    Science.gov (United States)

    Sun, Can-Lan; Kersey, John H; Francisco, Liton; Armenian, Saro H; Baker, K Scott; Weisdorf, Daniel J; Forman, Stephen J; Bhatia, Smita

    2013-07-01

    Long-term morbidity after hematopoietic cell transplantation (HCT) is unknown. The risk of physical and psychological health in 324 patients who had survived 10 or more years after HCT and a sibling comparison group (n = 309) was evaluated. Using the Common Terminology Criteria for Adverse Events, the 15-year cumulative incidence of severe/life-threatening/fatal conditions was 41% (95% confidence interval, 34% to 48%). HCT survivors were 5.7 times as likely to develop a severe/life-threatening condition (P survivors returned to the transplantation center for their cancer-related care. The burden of long-term physical and emotional morbidity borne by survivors remains substantial, even beyond 10 years after HCT; however, specialized health care is underused. Patients, families, and healthcare providers need to be made aware of the high burden, so they can plan for post-HCT care, even many years after HCT.

  11. "I Am Not A Victim. I Am A Survivor": Resilience as a Journey for Female Survivors of Child Sexual Abuse.

    Science.gov (United States)

    Newsom, Kimmery; Myers-Bowman, Karen

    2017-08-31

    This study was designed to expand our understanding of the positive aspects of coping and resilience in female survivors of child sexual abuse. Research questions focused on women's lived experiences of being survivors of child sexual abuse and how they have experienced resilience, developed healthy intimate relationships, and viewed themselves as sexual beings. Using a qualitative research lens of phenomenology, we captured the essence of survivors' experiences of resilience. Although each woman's experience was unique, similar patterns of processes and outcomes emerged as meaningful in their development of resilient and healthy sexuality and relationship functioning. However, participants emphasized resilience as a process or journey-recovery from trauma, reconceptualization of self, and development of healthy sexuality included deliberate efforts occurring over time. Implications for future research and practice using a positive lens of resilience are provided.

  12. Laser-based flow cytometric analysis of genotoxicity of humans exposed to ionizing radiation during the Chernobyl accident

    Science.gov (United States)

    Jensen, Ronald H.; Bigbee, William L.; Langlois, Richard G.; Grant, Stephen G.; Pleshanov, Pavel G.; Chirkov, Andre A.; Pilinskaya, Maria A.

    1991-05-01

    An analytical technique has been developed that allows laser-based flow cytometric measurement of the frequency of red blood cells that have lost allele-specific expression of a cell surface antigen due to genetic toxicity in bone marrow precursor cells. Previous studies demonstrated a correlation of such effects with the exposure of each individual to mutagenic phenomena, such as ionizing radiation, and the effects can persist for the lifetime of each individual. During the emergency response to the nuclear power plant accidert at Chemobyl, Ukraine, USSR, a number of people were exposed to whole body doses of ioniing radiation. Some of these individuals were tested with this laser-based assay and found to express a dose-dependent increase in the frequency of variant red blood cells that appears to be a persistent biological effect. This effect is similar to that which was previously observed in individuals who were exposed to ionizing radiation at Hiroshima in 1945 because of the A-bomb explosion. All data indicate that this assay might well be used as a biodosimeter to estimate radiation dose and also as an element to be used for estimating the risk of each individual to develop cancer due to radiation exposure.

  13. Fear of cancer recurrence in survivor and caregiver dyads: differences by sexual orientation and how dyad members influence each other.

    Science.gov (United States)

    Boehmer, Ulrike; Tripodis, Yorghos; Bazzi, Angela R; Winter, Michael; Clark, Melissa A

    2016-10-01

    The purpose of this study was to identify explanatory factors of fear of recurrence (FOR) in breast cancer survivors of different sexual orientations and their caregivers and to assess the directionality in the survivor and caregiver dyads' FOR. We recruited survivors of non-metastatic breast cancer of different sexual orientations and invited their caregivers into this study. Using a telephone survey, we collected data from 167 survivor and caregiver dyads. Using simultaneous equation models and a stepwise selection process, we identified the significant determinants of survivors' and caregivers' FOR and determined the directionality of survivors' and caregivers' FOR. Weighting the model by the inverse propensity score ensured that differences by sexual orientation in age and proportion of life in the caregiver-survivor relationship were accounted for. Caregivers' FOR predicted survivors' FOR, and sexual orientation had a significant effect on survivors' FOR, in that sexual minority women reported less FOR than heterosexual women. Other determinants of survivors' FOR included their medical characteristics, coresidence with caregivers, and caregivers' social support and use of counseling. Caregivers' FOR was related to their social support and survivors' medical characteristics. This study suggests a need for caregiver interventions. Because survivors' FOR is affected by caregivers' FOR, caregiver interventions will likely benefit survivors' FOR. Both sexual minority and heterosexual breast cancer survivors' FOR are affected by their caregivers' FOR, which suggests that the caregivers of breast cancer survivors are central for the survivors' well-being and shall therefore be integrated into the care process.

  14. 5 CFR 831.664 - Post-retirement survivor election deposits that were partially paid before October 1, 1993.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Post-retirement survivor election... OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Survivor Election Deposits § 831.664 Post-retirement survivor election deposits that...

  15. Attitudes toward Death in Adolescent Offspring of Holocaust Survivors.

    Science.gov (United States)

    Schneider, Stanley

    1978-01-01

    This article describes three American adolescents in an Israeli residential treatment program. Biographical data, diagnostic categories, projective test responses, relationships with parents, and some examples of dreams are presented. A final section analyzes some underlying concepts: survivor guilt, repressed aggression, and isolation of affect.…

  16. Use of mental health services among disaster survivors: predisposing factors.

    NARCIS (Netherlands)

    Ouden, D.J. den; Velden, P.G. van der; Grievink, L.; Morren, M.; Dirkzwager, A.J.E.; Yzermans, C.J.

    2007-01-01

    BACKGROUND: Given the high prevalence of mental health problems after disasters it is important to study health services utilization. This study examines predictors for mental health services (MHS) utilization among survivors of a man-made disaster in the Netherlands (May 2000). METHODS: Electronic

  17. Attributes of Spirituality Described by Survivors of Sexual Violence

    Science.gov (United States)

    Knapik, Gregory P.; Martsolf, Donna S.; Draucker, Claire B.; Strickland, Karen D.

    2010-01-01

    This study focuses on what aspects of attributes of spirituality as defined by Martsolf and Mickley (1998) are most salient for female and male survivors of sexual violence. Content analysis of secondary narrative data, provided by 50 participants in a study of women's and men's responses to sexual violence, was coded to the five attributes of…

  18. "Survivor" Math: Using Pop Culture to Enhance Learning Mathematics

    Science.gov (United States)

    Burks, Robert

    2011-01-01

    This article describes a modification of the popular TV game show, "Survivor," as conducted in an undergraduate first semester mathematics precalculus course. The objective of this game is a group-based competitive drill and practice activity to help students prepare and review for the fundamental concepts exam. The results of this activity…

  19. Evaluation of a Spiritually Focused Intervention with Older Trauma Survivors

    Science.gov (United States)

    Bowland, Sharon; Edmond, Tonya; Fallot, Roger D.

    2012-01-01

    This study evaluated the effectiveness of an 11-session, spiritually focused group intervention with older women survivors (age 55 years and older) of interpersonal trauma (child abuse, sexual assault, or domestic violence) in reducing trauma-related depressive symptoms, posttraumatic stress, and anxiety. Forty-three community-dwelling women…

  20. Endocrine disorders in childhood cancer survivors: More answers, more questions

    NARCIS (Netherlands)

    Clement, S.C.

    2016-01-01

    Treatment of pediatric malignancies has advanced substantially over the past several decades, resulting in a rapidly growing group of long-term childhood cancer survivors (CCS). Improved survival leads to an increasing number of individuals who may be at increased risk of substantial morbidity and

  1. Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria

    Directory of Open Access Journals (Sweden)

    Grace Vincent-Onabajo

    2016-01-01

    Full Text Available Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke—whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk factor was assessed using open-ended questionnaire. Data were treated with descriptive statistics and logistic regression analysis. Results. Sixty-nine stroke survivors (male = 72.5%; mean ± SD age = 49.7±10.6 years participated in the study. Thirty-four (49.4% participants had knowledge of stroke risk factors. Only educational level was significantly associated with knowledge and participants with tertiary educational qualification were about 48 times (odds ratio = 48.5; CI = 7.6–309.8; P<0.0001 more likely to be knowledgeable than those with no education. Conclusion. Less than half of the participants had knowledge of stroke risk factors. Participants with tertiary education were significantly more knowledgeable than those with lower educational qualifications. Effective means of educating stroke survivors on stroke risk factors should be identified and adopted.

  2. Endocrine disorders in childhood cancer survivors: More answers, more questions

    NARCIS (Netherlands)

    Clement, S.C.

    2016-01-01

    Treatment of pediatric malignancies has advanced substantially over the past several decades, resulting in a rapidly growing group of long-term childhood cancer survivors (CCS). Improved survival leads to an increasing number of individuals who may be at increased risk of substantial morbidity and e

  3. Empowerment of cancer survivors through information technology: an integrative review

    NARCIS (Netherlands)

    Groen, W.G.; Kuijpers, W.; Oldenburg, H.S.A.; Wouters, M.W.J.M.; Aaronson, N.K.; van Harten, W.H.

    2015-01-01

    Background: Patient empowerment may be an effective approach to strengthen the role of cancer survivors and to reduce the burden on health care. However, it is not well conceptualized, notably in oncology. Furthermore, it is unclear to what extent information technology (IT) services can contribute

  4. Empowerment of Cancer Survivors Through Information Technology: An Integrative Review

    NARCIS (Netherlands)

    Groen, Wim G.; Kuijpers, Wilma; Oldenburg, Hester S.A.; Wouters, Michel W.J.M.; Aaronson, Neil K.; Harten, van Wim H.

    2015-01-01

    Background: Patient empowerment may be an effective approach to strengthen the role of cancer survivors and to reduce the burden on health care. However, it is not well conceptualized, notably in oncology. Furthermore, it is unclear to what extent information technology (IT) services can contribute

  5. Malignant Lymphoma in an Atomic-bomb Survivor

    Directory of Open Access Journals (Sweden)

    Cheng-Chia Lee

    2009-07-01

    Full Text Available Atomic bomb survivors outside of Japan are few and often hard to follow-up. Spinal malignant lymphoma among these survivors is rare in established studies from Japan or the United States. Here, we report an 81-year-old woman, who experienced the atomic bomb explosion in Nagasaki when she was 19 years old, who presented with papillary thyroid carcinoma when she was 70 years old. Both follicular lymphoma over the right elbow region and vertebral malignant lymphoma were found when she turned 81 years old. Bone scan did not show any increased uptake of isotope. However, thoracolumbar spine magnetic resonance imaging showed multiple infiltrative soft tissue masses involving vertebral bodies at the T10–11 level. Computed tomography-guided biopsy further showed lymphocyte infiltration. Fortunately, the neurological deficit was improved after chemotherapy. The diagnosis of malignant lymphoma in atomic bomb survivors should be more careful and aggressive, even when their bone scan results show negative findings. In addition, the authors suggest that atomic bomb survivors should be followed-up carefully throughout their entire life.

  6. Determinants of increased primary health care use in cancer survivors.

    NARCIS (Netherlands)

    Heins, M.; Schellevis, F.; Rijken, M.; Hoek, L. van der; Korevaar, J.

    2012-01-01

    Purpose: The number of cancer survivors is increasing, and patients with cancer often experience long-lasting consequences of cancer and its treatment. Because of the variety of health problems and high prevalence of comorbidity, primary care physicians (PCPs) seem obvious candidates to take care of

  7. Immediate psycho-social support for disaster survivors

    DEFF Research Database (Denmark)

    Berliner, Peter; Navarro Gongóra, José; Espaillat, Vanessa

    2011-01-01

    The article describes how psychosocial support in the immediate and mid-term disaster response for Haitian earthquake survivors in hospitals in the Dominican Republic could ameliorate some of the suffering and prevent the crisis from becoming crystallized into symptoms and complex grief...

  8. Friends of Survivors: The Community Impact of Unwanted Sexual Experiences

    Science.gov (United States)

    Banyard, Victoria L.; Moynihan, Mary M.; Walsh, Wendy A.; Cohn, Ellen S.; Ward, Sally

    2010-01-01

    Since sexual assault survivors are most likely to disclose their experiences to a friend; prevention efforts increasingly focus on friends as informal helpers. The current study examined friends' perceptions of the disclosure experience. Undergraduates (N = 1,241) at the University of New Hampshire completed a shortened version of the Ahrens and…

  9. Adult Attachment and Longterm Effects in Survivors of Incest.

    Science.gov (United States)

    Alexander, Pamela C.; Anderson, Catherine L.; Brand, Bethany; Schaeffer, Cindy M.; Grelling, Barbara Z.; Kretz, Lisa

    1998-01-01

    Ninety-two adult female incest survivors were interviewed and completed measures of current functioning. Hierarchical regression analyses suggested that adult attachment behavior was significantly associated with personality structure, depression, and distress; and abuse severity was associated with posttraumatic stress disorder symptoms and…

  10. Adult Attachment and Longterm Effects in Survivors of Incest.

    Science.gov (United States)

    Alexander, Pamela C.; Anderson, Catherine L.; Brand, Bethany; Schaeffer, Cindy M.; Grelling, Barbara Z.; Kretz, Lisa

    1998-01-01

    Ninety-two adult female incest survivors were interviewed and completed measures of current functioning. Hierarchical regression analyses suggested that adult attachment behavior was significantly associated with personality structure, depression, and distress; and abuse severity was associated with posttraumatic stress disorder symptoms and…

  11. Sibling Incest: Reports from Forty-One Survivors

    Science.gov (United States)

    Carlson, Bonnie E.; Maciol, Katherine; Schneider, Joanne

    2006-01-01

    An exploratory study was conducted with a convenience sample of 41 adult survivors of sibling incest using a retrospective survey design. Participants were interviewed about their childhood sexual experiences with a sibling. Most participants reported vaginal or oral intercourse and coercive experiences. Half of the sample reported sexual…

  12. Parenting Difficulties among Adult Survivors of Father-Daughter Incest.

    Science.gov (United States)

    Cole, Pamela M.; And Others

    1992-01-01

    This study examined the self-reported parenting experience and practices of women who were either incest victims of their fathers as children (n=20), whose fathers were alcoholic but not sexually abusive (n=25), or who had no known risk in childhood (n=39). Incest survivors reported less confidence and sense of control as parents. (Author/DB)

  13. A qualitative investigation of breast cancer survivors' experiences with breastfeeding.

    Science.gov (United States)

    Gorman, Jessica R; Usita, Paula M; Madlensky, Lisa; Pierce, John P

    2009-09-01

    This is an exploratory, qualitative investigation of breast cancer survivors' experiences with breastfeeding. Previous studies have focused on the physiology of lactation after surgery and treatment, but have not explored factors influencing breastfeeding decisions and behavior. We used purposeful sampling to identify 11 breast cancer survivors who had a child after their diagnosis and treatment. Participants were recruited from among those in the Women's Healthy Eating and Living (WHEL) study and a Young Survival Coalition (YSC) affiliate. We conducted semi-structured, open-ended telephone interviews lasting 45-75 min. We used social cognitive theory (SCT) to structure questions regarding influences on breastfeeding behavior. We transcribed interviews and used cross-case, inductive analysis to identify themes. Ten of 11 participants initiated breastfeeding. The following main themes emerged: 1) Cautiously hopeful, 2) Exhausting to rely on one breast, 3) Motivated despite challenges, 4) Support and lack of support, and 5) Encouraging to others. Study participants were highly motivated to breastfeed but faced considerable challenges. Participants described problems that are not unique to women with breast cancer, but experienced these to a much greater degree because they relied mostly or entirely on one lactating breast. This study revealed a need for improved access to information and support and greater sensitivity to the obstacles faced by breast cancer survivors. Results of this qualitative analysis indicate that interventions to support the efforts of breast cancer survivors who are interested in breastfeeding are warranted. Additional research would aid in the development of such interventions.

  14. Counselor Meaning-Making: Working with Childhood Sexual Abuse Survivors

    Science.gov (United States)

    Viviani, Anna Michele

    2011-01-01

    Childhood sexual abuse is a prevalent but taboo topic in society. Conservatively 80,000 new cases are reported each year with many more either unreported or unsubstantiated within the legal system. Survivors of childhood sexual abuse often times seek counseling assistance to manage the variety of short-and long-term emotional issues that may arise…

  15. Psychometric Properties of the Fatigue Severity Scale in Polio Survivors

    Science.gov (United States)

    Burger, Helena; Franchignoni, Franco; Puzic, Natasa; Giordano, Andrea

    2010-01-01

    The objective of this study was to evaluate by means of classical test theory and Rasch analysis the scaling characteristics and psychometric properties of the Fatigue Severity Scale (FSS) in polio survivors. A questionnaire, consisting of five general questions (sex, age, age at time of acute polio, sequelae of polio, and new symptoms), the FSS,…

  16. Downsizing and social cohesion: the case of downsizing survivors.

    Science.gov (United States)

    Campbell, Richard; Pepper, Lewis

    2006-01-01

    Organizational downsizing was a pervasive feature of the U.S. economy during the 1980s and 1990s. A long-standing public health literature recognizes that unemployment and job loss may adversely affect health, but there has been little attention to date on the impact of downsizing upon those who survive job cuts and continue to work in downsized firms. Drawing on research with survivors of downsizing carried out by the U.S. Department of Energy, this article identifies a variety of social and psychological consequences of downsizing that fundamentally destabilize the work environment and work experience for remaining employees. Evidence from this research suggests that the work climate of the post-downsizing environment is laden with suspicion and conflict, and that survivors show feelings of demoralization, sadness, anxiety, and disorientation. A critical factor influencing these responses, we argue, is not downsizing - which is the exposure faced by those who lose their jobs - but the loss of social cohesion that downsizing ultimately represents to survivors. We conclude that addressing the trauma of downsizing for survivors will require providing employees with more genuine opportunities to participate in workplace governance.

  17. Late cardiovascular and neurological complications in Hodgkin lymphoma survivors

    NARCIS (Netherlands)

    van Leeuwen-Segarceanu, E.M.

    2013-01-01

    This thesis focuses on the early detection of cardiovascular and neurological abnormalities in Hodgkin Lymphoma Survivors (HLS) in a population of 82 patients and 40 controls and in a cross-sectional setting. Several screening test were performed for the assessment of these late effects of treatment

  18. Exercise for Breast Cancer Survivors: Research Evidence and Clinical Guidelines.

    Science.gov (United States)

    Courneya, Kerry S.; Mackey, John R.; McKenzie, Donald C.

    2002-01-01

    Exercise can significantly benefit breast cancer survivors during and after treatment. Moderate intensity aerobic exercise as well as resistance training are important. Psychological health is optimized by enjoyable exercise that develops new skills, incorporates social interaction, and occurs in a stimulating environment. Several conditions…

  19. Empowerment of Cancer Survivors Through Information Technology: An Integrative Review

    NARCIS (Netherlands)

    Groen, Wim G.; Kuijpers, Wilma; Oldenburg, Hester S.A.; Wouters, Michel W.J.M.; Aaronson, Neil K.; van Harten, Willem H.

    2015-01-01

    Background: Patient empowerment may be an effective approach to strengthen the role of cancer survivors and to reduce the burden on health care. However, it is not well conceptualized, notably in oncology. Furthermore, it is unclear to what extent information technology (IT) services can contribute

  20. Determinants of newly diagnosed comorbidities among breast cancer survivors

    NARCIS (Netherlands)

    Obi, N.; Gornyk, D.; Heinz, J.; Vrieling, A.; Seibold, P.; Chang-Claude, J.; Flesch-Janys, D.

    2014-01-01

    PURPOSE: Comorbid conditions have become increasingly relevant for breast cancer care given the large numbers of long-term survivors. Our aim was to identify potential determinants associated with the development of comorbidities after breast cancer. METHODS: Self-reported comorbidities and

  1. "Survivor" Math: Using Pop Culture to Enhance Learning Mathematics

    Science.gov (United States)

    Burks, Robert

    2011-01-01

    This article describes a modification of the popular TV game show, "Survivor," as conducted in an undergraduate first semester mathematics precalculus course. The objective of this game is a group-based competitive drill and practice activity to help students prepare and review for the fundamental concepts exam. The results of this activity…

  2. Increasing Breast Cancer Surveillance among African American Breast Cancer Survivors

    Science.gov (United States)

    2005-07-01

    Madam , The project entitled INCREASING BREAST CANCER SURVEILLANCE AMONG AFRICAN AMERICAN BREAST CANCER SURVIVORS includes activities involving human...B b- d § fr. Thomisonwill Work e .y .With’Dra) Vdldf naTir, W and y Bo • rganif Janidorf on data a"_`l- ssi reatihfiutfor pres~entatidns and publi

  3. Effects of Cognitive Status on Life Participation of Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Mary F. Baxter PhD, OT, FAOTA

    2014-04-01

    Full Text Available The purposes of this study were to identify the cognitive status of cancer survivors, determine the effect of cognitive status on function and participation in daily activities, and explore how cancer survivors perceive changes in their cognition. The study used a quantitative nonexperimental cross-sectional design. The participants included 35 cancer survivors from two different sites. Instruments included the Montreal Cognitive Assessment (MoCA and the Reintegration to Normal Index-Postal Version (RNLI-P in the measurement of cognitive impairment and functional performance respectively. Data were also collected with a supplemental questionnaire to explore participants’ perspectives on their cognitive difficulties and current function. The participant scores on the MoCA indicated cognitive impairment (μ= 25 and their scores on the RNLI-P demonstrated subpar reintegration (μ=9.64. Twenty-one participants answered the supplemental questionnaire. In content analysis of questionnaire responses, 17/21 participants reported some level of cognitive change related to cancer and cancer treatment. Data from an open-ended question were organized into four categories: decreased participation, more selective in activities, balance in activities, and cognitive changes. Study results indicate a large percentage of cancer survivors demonstrate mild cognitive impairment as well as changes in participation in instrumental activities of daily living.

  4. Endothelial damage in long-term survivors of childhood cancer

    NARCIS (Netherlands)

    Brouwer, Cornelia A J; Postma, Aleida; Hooimeijer, H Louise H; Smit, Andries J; Vonk, Judith M; van Roon, A. M.; van den Berg, Maarten P; Dolsma, W.; Lefrandt, Johan; Bink - Boelkens, Margaretha; Zwart, Nynke; de Vries, Elisabeth G. E.; Tissing, Wim J E; Gietema, Jourik A

    2013-01-01

    PURPOSE: To evaluate the presence of vascular damage in long-term childhood cancer survivors (CCS) and sibling controls, and to evaluate the association between vascular damage parameters and cancer treatment and influence of cardiovascular risk factors. PATIENTS AND METHODS: Vascular assessment was

  5. Analysis of balance during functional walking in stroke survivors

    NARCIS (Netherlands)

    van Meulen, Fokke; Weenk, D.; van Asseldonk, Edwin H.F.; Schepers, H. Martin; Veltink, Petrus H.; Buurke, Jaap

    2016-01-01

    Background An important objective of rehabilitation care is to regain adequate balance function to safely ambulate in community. However, in rehabilitation practice, it remains unclear if a stroke survivor functionally recovers by restitution or by learning to compensate for the lack of restoration

  6. Determinants of newly diagnosed comorbidities among breast cancer survivors

    NARCIS (Netherlands)

    Obi, N.; Gornyk, D.; Heinz, J.; Vrieling, A.; Seibold, P.; Chang-Claude, J.; Flesch-Janys, D.

    2014-01-01

    PURPOSE: Comorbid conditions have become increasingly relevant for breast cancer care given the large numbers of long-term survivors. Our aim was to identify potential determinants associated with the development of comorbidities after breast cancer. METHODS: Self-reported comorbidities and lifestyl

  7. Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Kirchhoff, Anne C; Kuhlthau, Karen; Pajolek, Hannah; Leisenring, Wendy; Armstrong, Greg T; Robison, Leslie L; Park, Elyse R

    2013-02-01

    The Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the USA. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI. We conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8. Uninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their preexisting health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care. Childhood cancer survivors face barriers to obtaining ESI. While ACA provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support.

  8. Radiation dose and cataract surgery incidence in atomic bomb survivors, 1986-2005.

    Science.gov (United States)

    Neriishi, Kazuo; Nakashima, Eiji; Akahoshi, Masazumi; Hida, Ayumi; Grant, Eric J; Masunari, Naomi; Funamoto, Sachiyo; Minamoto, Atsushi; Fujiwara, Saeko; Shore, Roy E

    2012-10-01

    To examine the incidence of clinically important cataracts in relation to lens radiation doses between 0 and approximately 3 Gy to address risks at relatively low brief doses. Informed consent was obtained, and human subjects procedures were approved by the ethical committee at the Radiation Effects Research Foundation. Cataract surgery incidence was documented for 6066 atomic bomb survivors during 1986-2005. Sixteen risk factors for cataract, such as smoking, hypertension, and corticosteroid use, were not confounders of the radiation effect on the basis of Cox regression analysis. Radiation dose-response analyses were performed for cataract surgery incidence by using Poisson regression analysis, adjusting for demographic variables and diabetes mellitus, and results were expressed as the excess relative risk (ERR) and the excess absolute risk (EAR) (ie, measures of how much radiation multiplies [ERR] or adds to [EAR] the risk in the unexposed group). Of 6066 atomic bomb survivors, 1028 underwent a first cataract surgery during 1986-2005. The estimated threshold dose was 0.50 Gy (95% confidence interval [CI]: 0.10 Gy, 0.95 Gy) for the ERR model and 0.45 Gy (95% CI: 0.10 Gy, 1.05 Gy) for the EAR model. A linear-quadratic test for upward curvature did not show a significant quadratic effect for either the ERR or EAR model. The linear ERR model for a 70-year-old individual, exposed at age 20 years, showed a 0.32 (95% CI: 0.09, 0.53) [corrected] excess risk at 1 Gy. The ERR was highest for those who were young at exposure. These data indicate a radiation effect for vision-impairing cataracts at doses less than 1 Gy. The evidence suggests that dose standards for protection of the eye from brief radiation exposures should be 0.5 Gy or less. © RSNA, 2012.

  9. Appropriateness of cardiovascular care in elderly adult cancer survivors.

    Science.gov (United States)

    Cheung, Winson Y; Levin, Raisa; Setoguchi, Soko

    2013-01-01

    Research suggests that the quality of non-cancer-related care among cancer survivors (CS) is suboptimal. Secondary disease prevention is an important component of survivorship care that has not been previously evaluated. Our aims were (1) to assess the utilization of and adherence to medications and treatments for the secondary prevention of myocardial infarction (MI) in CS versus non-cancer patients (NCP) and (2) to compare temporal trends in cardiovascular care between these two patient cohorts. Linking data from Medicare, pharmacy assistance programs, and cancer registries, we calculated the percentage of individuals receiving preventive medications (statins, β-blockers, angiotensin-converting enzyme inhibitors) and revascularization interventions (angioplasty, stent, bypass surgery) within 90 days after acute MI in CS and propensity score-matched NCP. We assessed trends over time and determined predictors of appropriate preventive care using modified Poisson regression. We identified 1,119 CS and 7,886 NCP. Compared to NCP, more survivors received statins (38 vs. 31 %) and β-blockers (67 vs. 59 %), but fewer underwent bypass surgery (1.5 vs. 2.8 %) after MI. From 1997 to 2004, both survivors and NCP were increasingly prescribed medications to prevent future coronary events. Over the same time period, receipt of bypass surgery was significantly lower among survivors. Co-morbidities, such as depression and lung disease, and demographic factors, such as advanced age and female, were associated with underuse of preventive care among survivors when compared to NCP. Use of preventive medications and procedures has generally improved, but uptake of bypass surgery among CS still lags behind NCP.

  10. Suboptimal Vitamin D levels among adult survivors of childhood cancers

    Directory of Open Access Journals (Sweden)

    Denise A. Rokitka

    2016-07-01

    Full Text Available Purpose: Vitamin D plays an important role in many bodily systems, with increasing evidence suggesting its importance for the prevention of chronic diseases and cancer. The identification of vitamin D levels in childhood cancer survivors becomes, therefore, particularly relevant, given that optimizing levels may contribute to the prevention of secondary malignancies and chronic diseases.Methods: A cross - sectional analysis of serum 25 - hydroxyvitamin D levels among adult survivors of childhood cancers living in New York State and surrounding areas (n = 139 was performed. Independent variables included gender, race/ethnicity, cancer site, year of diagnosis, past medical and surgical history, prior radiation therapy; prior chemotherapy, age at diagnosis, age at last clinic visit, year of last clinic visit, height, weight, body mass index, and vitamin D supplementation.Results: Overall, 34% of survivors were vitamin D deficient (< 20 ng/ml, 39% were classified as insufficient (20 - 29 ng/ml and 27% (≥ 30 ng/ml were classified as having sufficient levels. Despite vitamin D supplementation among 41 patients, 68.3% continued to have insufficient or deficient levels. Participants with a BMI > 25 demonstrated lower levels of vitamin D (p < 0.05. Vitamin D levels did not vary by age group, race, ethnicity, diagnosis, or years since diagnosis.Conclusion: Given the growing awareness of the role of vitamin D and the documented late effects of treatment for childhood cancers, the high prevalence of vitamin D deficiency within the childhood cancer survivor population is of concern. Vitamin D represents an important target for surveillance and intervention to help improve long - term outcomes of childhood cancer survivors.

  11. Early work patterns for gynaecological cancer survivors in the USA.

    Science.gov (United States)

    Nachreiner, N M; Ghebre, R G; Virnig, B A; Shanley, R

    2012-01-01

    Little is known about the balance between work demands and treatment plans for >4.3 million working-age cancer survivors in the USA. To describe changes in work status for gynaecological cancer survivors during the first 6 months following diagnosis and their experience with their employers' programmes and policies. One hundred and ten gynaecological cancer survivors who were working at the time of their cancer diagnosis completed a survey. Case record reviews documented their clinical characteristics and treatment details. Ninety-five women (86%) had surgery; 81 (74%) received chemotherapy, radiotherapy or both in addition to surgery. Nine per cent of women said that they changed their treatment plan because of their jobs; in contrast, 62% of women said that they changed their work situation to accommodate their treatment plan. Overall, the most common month for women to stop working was Month 1 (41%), to decrease hours was Month 2 (32%) and to increase hours was Month 6 (8%). Twenty-eight per cent of women were aware of employer policies that assisted the return to work process; 70% of women were familiar with the Family and Medical Leave Act (FMLA) and 56% with the Americans with Disabilities Act (ADA). Only 26% completed a formal request for work accommodations. After 6 months, 56 of 83 women (67%) remained working or had returned to work. Work patterns varied for these gynaecological cancer survivors over the first 6 months following diagnosis. Opportunities exist to improve communication about work and treatment expectations between cancer survivors, occupational health professionals, employers and treating clinicians.

  12. A study of chronic fatigue in Norwegian cervical cancer survivors.

    Science.gov (United States)

    Steen, Rita; Dahl, Alv A; Hess, Siri Lothe; Kiserud, Cecilie E

    2017-09-01

    Chronic fatigue after treatment is a common adverse event in cancer patients, but there are few studies in long-term survivors of cervical cancer. The aim of this investigation was to explore the prevalence of chronic fatigue and its association with various clinical and treatment-related factors in a population-based cohort of Norwegian cervical cancer survivors treated by any modality. All patients, treated for cervical cancer from 2000 through 2007 in the Health Region of South-Eastern Norway, cancer-free, alive and aged ≤75years by the end 2013 (n=822) received a questionnaire covering chronic fatigue and other clinical variables. 461 of 822 survivors (56%) completed the questionnaire and 382 entered the analyses. Chronic fatigue was reported by 23% (95% confidence interval 19%-27%) with a median age of 52years (range 32-75) at survey, 11years (range 7-15) after diagnosis. Among survivors treated by minimal invasive- or radical surgery, 19% had chronic fatigue, while the prevalence was 28% in those treated with radiation and concomitant chemotherapy (chemoradiation). The chronic fatigue group reported significantly more cardiovascular disease, obesity, less physical activity, more treatment-related symptom experience, more menopausal symptoms, higher levels of anxiety and depressive symptoms, and poorer quality of life than the non-fatigued group. In multivariate analysis only increased level of depression and poorer global quality of life were significantly associated with chronic fatigue. Chronic fatigue was reported by 23% of long-term survivors after cervical cancer at a mean of 11years after treatment. Some of the associated factors are amenable to prevention and/or treatment and should be subjects of attention at follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Simple strategies for vaginal health promotion in cancer survivors.

    Science.gov (United States)

    Carter, Jeanne; Goldfrank, Deborah; Schover, Leslie R

    2011-02-01

    With the population of cancer survivors nearing 12 million, an ever-increasing number of women will face vaginal health issues related to their disease and/or treatment. Abrupt menopause triggered by cancer treatment, for example, can cause intense and prolonged estrogen deprivation symptoms, including vaginal dryness and discomfort. Simple strategies to promote vaginal health are available. To provide a comprehensive overview of vaginal health issues caused by estrogen deprivation in female cancer patients/survivors and provide recommendations to identify, treat, and promote vaginal health. We describe a treatment algorithm, based on scientific literature and supported by clinical experience, found to be effective in treating these patients at two major cancer centers. We also provide examples of handouts for patient education on vaginal health promotion. Evidence-based medicine and psychosocial literature, in addition to clinical experience at two major cancer centers. Simple, non-hormonal interventions for sexual dysfunction are often overlooked. Several studies show that education on vaginal lubricants, moisturizers, and dilator use (as needed) can decrease the morbidity of vaginal atrophy. These studies also provide support for our clinical treatment recommendations. Our goal in this article is to increase awareness of these strategies and to provide assistance to general gynecologists and oncologists caring for cancer patients and survivors. Dedicating a small amount of time to educate female cancer survivors about methods to promote vaginal health can result in the reduction or elimination of vaginal discomfort. Non-hormonal vaginal health strategies often appear sufficient to remedy these issues. However, large randomized trials are needed, varying the format and components of the treatment program and exploring efficacy in various groups of female cancer survivors. © 2010 International Society for Sexual Medicine.

  14. Ocular Complications in Survivors of the Ebola Outbreak in Guinea.

    Science.gov (United States)

    Hereth-Hebert, Esther; Bah, Mamadou Oury; Etard, Jean François; Sow, Mamadou Saliou; Resnikoff, Serge; Fardeau, Christine; Toure, Abdoulaye; Ouendeno, Alexis Niouma; Sagno, Isaac Ceougna; March, Laura; Izard, Suzanne; Lama, Pierre Louis; Barry, Moumié; Delaporte, Eric

    2017-03-01

    The Ebola outbreak of 2013-2016 severely affected West Africa and resulted in 2544 deaths and 1270 survivors in Guinea, the country where it began. This Ebola virus was the Zaire strain of the virus family Filoviridae. In this outbreak the case fatality rate was about 67%. The survivors, declared cured after 2 negative blood polymerase chain reaction (PCR) results, face psychosocial disorders and rheumatic, ear-nose-throat, neurocognitive, and ophthalmologic complications. The goal of this study was to detect and describe ocular complications afflicting these survivors and to observe their occurrence and recurrences. Prospective observational cohort study. This prospective observational multicenter cohort study was initiated in March 2015. The cohort study included 341 survivors followed up in the infectious disease ward of Conakry, Forecariah, and Nzérékoré as of May 2016. The patients received multidisciplinary medical follow-up expected to last at least 1 year that included an eye examination as part of complete, free treatment. Systematic examination of 341 patients revealed 46 cases of uveitis (13.5%), 6 cases of episcleritis (1.8%), and 3 cases of interstitial keratitis (0.9%). Uveitis was most frequently unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months after discharge from the Ebola treatment center. Moreover, uveitis relapses were found up to 13 months after the negative PCR result for Ebola in the blood. Nearly 1 out of 6 survivors presented ocular disorders after discharge from the Ebola treatment center. An ophthalmologic follow-up for Ebola-infected patients should start, if possible, during the acute phase of the disease and last more than 1 year. Treatment guidelines need to be urgently developed and implemented. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Long-term health-related outcomes in survivors of childhood cancer treated with HSCT versus conventional therapy: a report from the Bone Marrow Transplant Survivor Study (BMTSS) and Childhood Cancer Survivor Study (CCSS).

    Science.gov (United States)

    Armenian, Saro H; Sun, Can-Lan; Kawashima, Toana; Arora, Mukta; Leisenring, Wendy; Sklar, Charles A; Baker, K Scott; Francisco, Liton; Teh, Jennifer Berano; Mills, George; Wong, F Lennie; Rosenthal, Joseph; Diller, Lisa R; Hudson, Melissa M; Oeffinger, Kevin C; Forman, Stephen J; Robison, Leslie L; Bhatia, Smita

    2011-08-04

    HSCT is being increasingly offered as a curative option for children with hematologic malignancies. Although survival has improved, the long-term morbidity ascribed to the HSCT procedure is not known. We compared the risk of chronic health conditions and adverse health among children with cancer treated with HSCT with survivors treated conventionally, as well as with sibling controls. HSCT survivors were drawn from BMTSS (N = 145), whereas conventionally treated survivors (N = 7207) and siblings (N = 4020) were drawn from CCSS. Self-reported chronic conditions were graded with CTCAEv3.0. Fifty-nine percent of HSCT survivors reported ≥ 2 conditions, and 25.5% reported severe/life-threatening conditions. HSCT survivors were more likely than sibling controls to have severe/life-threatening (relative risk [RR] = 8.1, P survivors, BMTSS survivors demonstrated significantly elevated risks (severe/life-threatening conditions: RR = 3.9, P survivors carry a significantly greater burden of morbidity not only compared with noncancer populations but also compared with conventionally treated cancer patients, providing evidence for close monitoring of this high-risk population.

  16. Adherence to Guidelines for Cancer Survivors and Health-Related Quality of Life among Korean Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Sihan Song

    2015-12-01

    Full Text Available There is limited evidence on the association between adherence to guidelines for cancer survivors and health-related quality of life (HRQoL. In a cross-sectional study of Korean breast cancer survivors, we examined whether adherence to the guidelines of the American Cancer Society (ACS and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR for cancer survivors was related to levels of HRQoL, assessed by the Korean version of Core 30 (C30 and Breast cancer module 23 (BR23 of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ. We included a total of 160 women aged 21 to 79 years who had been diagnosed with breast cancer according to American Joint Committee on Cancer (AJCC stages I to III and had breast cancer surgery at least six months before the interview. Increasing adherence to ACS guidelines was associated with higher scores of social functioning (p for trend = 0.05, whereas increasing adherence to WCRF/AICR recommendations was associated with higher scores of arm symptoms (p for trend = 0.01. These associations were limited to those with stage II or III cancer. Diet may be an important factor in relation to quality of life among Korean breast cancer survivors, however our findings warrant further prospective studies to evaluate whether healthy diet improves survivors’ quality of life.

  17. Final height and body mass index among adult survivors of childhood brain cancer: childhood cancer survivor study.

    Science.gov (United States)

    Gurney, James G; Ness, Kirsten K; Stovall, Marilyn; Wolden, Suzanne; Punyko, Judy A; Neglia, Joseph P; Mertens, Ann C; Packer, Roger J; Robison, Leslie L; Sklar, Charles A

    2003-10-01

    The objectives of this study were 1) to compare final height and body mass index (BMI) between adult survivors of childhood brain cancer and age- and sex-matched population norms, 2) to quantify the effects of treatment- and cancer-related factors on the risk of final height below the 10th percentile (adult short stature) or having a BMI of 30 kg/m(2) or more (obesity). Treatment records were abstracted and surveys completed by 921 adults aged 20-45 yr who were treated for brain cancer as children and were participants in the multicenter Childhood Cancer Survivor Study. Nearly 40% of childhood brain cancer survivors were below the 10th percentile for height. The strongest risk factors for adult short stature were young age at diagnosis and radiation treatment involving the hypothalamic-pituitary axis (HPA). The multivariate odds ratio for adult short stature among those 4 yr of age or younger at diagnosis, relative to ages 10-20 yr, was 5.67 (95% confidence interval, 3.6-8.9). HPA radiation exposure increased the risk of adult short stature in a dose-response fashion (trend test, P obesity. Except for patients treated with surgery only, survivors of childhood brain cancer are at very high risk for adult short stature, and this risk increases with radiation dose involving the HPA. We did not find a corresponding elevated risk for obesity.

  18. Antioxidant enzyme polymorphisms and neuropsychological outcomes in medulloblastoma survivors: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Brackett, Julienne; Krull, Kevin R; Scheurer, Michael E; Liu, Wei; Srivastava, Deo Kumar; Stovall, Marilyn; Merchant, Thomas E; Packer, Roger J; Robison, Leslie L; Okcu, M Fatih

    2012-08-01

    Psychological or neurocognitive impairment is often seen in medulloblastoma survivors after craniospinal radiation; however, significant variability in outcomes exists. This study investigated the role of antioxidant enzyme polymorphisms in moderating this outcome and hypothesized that patients who had polymorphisms associated with lower antioxidant enzyme function would have a higher occurrence of impairment. From the Childhood Cancer Survivor Study (CCSS) cohort, 109 medulloblastoma survivors and 143 siblings were identified who completed the CCSS Neurocognitive Questionnaire (NCQ) and the Brief Symptom Inventory-18 (BSI-18) and who provided buccal DNA samples. Real-time polymerase chain reaction (PCR) allelic discrimination was used for SOD2 (rs4880), GPX1 (rs1050450), and GSTP1 (rs1695 and rs1138272) genotyping and PCR for GSTM1 and GSTT1 gene deletions. Outcomes on NCQ and BSI-18 subscale scores were examined in association with genotypes and clinical factors, including age at diagnosis, sex, and radiation dose, using univariate and multivariate analysis of variance. Patients survivors across multiple domains, suggesting that this genotype may predispose patients for increased emotional late effects.

  19. Differential survival of mosquitofish exposed to radionuclides is dependent on RAPD genotype

    Energy Technology Data Exchange (ETDEWEB)

    Theodorakis, C.W. [Oak Ridge Associated Universities, TN (United States); Shugart, L.R. [Oak Ridge National Lab., TN (United States)

    1995-12-31

    In previous studies, it was found that certain RAPD (Randomly Amplified Polymorphic DNA) markers were present at higher frequencies in radionuclide-contaminated mosquitofish (Gambusia affinis) populations than in reference populations. These markers will be referred to as contaminant specific markers. In the present study, fish with and without these markers were collected from non-contaminated populations and exposed in situ to radionuclides by caging them in one of the contaminated sites. Forty fish were exposed for 1--6 weeks, after which the survivors were collected and DNA was extracted for genotypic analysis. In one experiment, the frequencies of contaminant specific markers in the survivors were compared to the frequencies of these markers in the native contaminated and uncontaminated (the source of the caged fish) populations. It was found that the genotypic distributions were more similar to the native contaminated population. In another experiment, samples of caudal fin tissue were collected for DNA extraction before and after placing fish in the cages, in order to compare survival rates of different genotypes. It was found that fish with the contaminant indicative bands had higher percent survival than the other fish. Experiments are underway or are being planned in order to determine the molecular identity of these bands and the ecological significance of altered band frequencies in hopes of developing population-level biomarkers of contaminant exposure and ecological affects.

  20. What can be learned from epidemiologic studies of persons exposed to low doses of radiation?

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, E.S.

    1993-04-01

    The main objective of radiation risk assessment is to determine the risk of various adverse health effects associated with exposure to low doses and low dose rates. Extrapolation of risks from studies of persons exposed at high doses (generally exceeding 1 Sv) and dose rates has been the primary approach used to achieve this objective. The study of Japanese atomic bomb survivors in Hiroshima and Nagasaki has played an especially important role in risk assessment efforts. A direct assessment of the dose-response function based on studies of persons exposed at low doses and dose rates is obviously desirable. This paper focuses on the potential of both current and future nuclear workers studies for investigating the dose-response functions at low doses, and also discusses analyses making use of the low dose portion of the atomic bomb survivor data. Difficulties in using these data are the statistical imprecision of estimated dose-response parameters, and potential bias resulting from confounding factors and from uncertainties in dose estimates.

  1. Melanoma as a Subsequent Neoplasm in Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study

    Science.gov (United States)

    Pappo, AS; Armstrong, GT; Liu, W; Srivastava, DK; McDonald, A; Leisenring, WM; Hammond, S; Stovall, M; Neglia, JP; Robison, LL

    2012-01-01

    Background Childhood cancer survivors have a six fold increased risk of developing subsequent neoplasms when compared to the general population. We sought to describe the occurrence of melanoma as a subsequent neoplasm among adult survivors of childhood cancer. Patients and Methods Among 14,358 5-year survivors of childhood cancer diagnosed between 1970–86, we calculated the cumulative incidence, standardized incidence ratio (SIR), and absolute excess risk (AER) of subsequent melanoma. Potential risk factors were assessed using a cause-specific hazards model. Results 57 melanomas (46 invasive, 2 ocular and 9 in situ) occurred in 51 survivors. The median time to the development of melanoma was 21.0 years (range 5.6–35.4 years) and the median age at melanoma was 32.3 years (range 10.9 – 49.0 years). Initial cancer diagnoses included soft tissue and bone sarcoma (n=15), leukemia (13), lymphoma (14), central nervous system malignancy (5), Wilms’ tumor (3), and neuroblastoma (1). The cumulative incidence of first subsequent melanoma at 35 years from initial cancer diagnosis was 0.55% (95% CI 0.37–0.73). The SIR of subsequent invasive malignant melanoma of the skin was 2.42 (95% CI 1.77 – 3.23), and the AER was 0.10 (95% CI 0.05 – 0.15) per 1,000 person years. No statistically significant associations were found between melanoma risk and family history of cancer, demographic, or treatment-related factors. Conclusion Survivors of childhood cancer have an approximate 2.5-fold increased risk of melanoma. Early screening and prevention strategies are warranted. PMID:22887858

  2. Principles of medical rehabilitation of survivors of acute radiation sickness induced by gamma and beta and gumma and neutron radiation

    Energy Technology Data Exchange (ETDEWEB)

    Nedejina, N.M.; Galstian, I.A.; Savitsky, A.A.; Sachkov, A.V.; Rtisheva, J.N.; Uvatcheva, I.V.; Filin, S.V. [State Research Center of Russia, Moscow (Russian Federation). Inst. of Biophysics

    2000-05-01

    The purpose of this study is to reveal the principles of medical rehabilitation different degree acute radiation syndrome (ARS) survivors, who exposed {gamma}{beta}- and {gamma}{eta}-irradiation in different radiation accidents. The main reasons of working disability in the late consequences of ARS period are consequences of local radiation injures (LRI) and joining somatic diseases. Its revealing and treatment considerably improves quality of life of the patients. The heaviest consequence of LRI of a skin at {gamma}{beta}- radiation exposure is the development of late radiation ulcers and radiation fibrosis, which require repeated plastic surgery. LRI at {gamma}{eta}-radiation exposure differ by the greater depth of destruction of a underlying tissues and similar defects require the early amputations. Last 10 years microsurgery methods of plastic surgery allow to save more large segments of extremities and to decrease expression of the late consequences (radiation fibrosis and late radiation ulcers) LRI severe and extremely severe degrees. Medical rehabilitation of radiation cataract (development at doses more than 2.0 Gy) includes its extraction and artificial lens implantation, if acuity of vision is considerably decreased. Changes of peripheral blood, observed at the period of the long consequences, as a rule, different, moderate, transient and not requiring treatment. Only one ARS survivor dead from chronic myeloid leukemia. Thyroid nodes, not requiring operative intervention, are found out in Chernobyl survivors. Within the time course the concurrent somatic disease become the major importance for patients disability growth, which concurrent diseases seem to be unrelated to radiation dose and their structure does not differ from that found in general public of Russia. The rehabilitation of the persons who have transferred ARS as a result of radiating failure, should be directed on restoration of functions critical for ionizing of radiation of bodies and

  3. Educational and occupational outcomes of childhood cancer survivors 30 years after diagnosis: a French cohort study.

    Science.gov (United States)

    Dumas, Agnes; Berger, Claire; Auquier, Pascal; Michel, Gérard; Fresneau, Brice; Sètchéou Allodji, Rodrigue; Haddy, Nadia; Rubino, Carole; Vassal, Gilles; Valteau-Couanet, Dominique; Thouvenin-Doulet, Sandrine; Casagranda, Léonie; Pacquement, Hélène; El-Fayech, Chiraz; Oberlin, Odile; Guibout, Catherine; de Vathaire, Florent

    2016-04-26

    Although survival from childhood cancer has increased, little is known on the long-term impact of treatment late effects on occupational attainment or work ability. A total of 3512 five-year survivors treated before the age of 19 years in 10 French cancer centres between 1948 and 2000 were identified. Educational level, employment status and occupational class of survivors were assessed by a self-reported questionnaire. These outcome measures were compared with sex-age rates recorded in the French population, using indirect standardisation. Paternal occupational class was also considered to control for the role of survivors' socioeconomic background on their achievement. Multivariable analyses were conducted to explore clinical characteristics associated with the outcomes. A total of 2406 survivors responded to the questionnaire and survivors aged below 25 years were included in the current analysis. Compared with national statistics adjusted on age and sex, male survivors were more likely to be college graduates (39.2% vs 30.9% expected; Punemployment was higher for survivors of CNS tumour (28.1% vs 4.3%; P<0.001) but not for survivors of other diagnoses. Survivors of non-CNS childhood cancer had a similar or a higher occupational class than expected. Survivors treated for CNS tumour or leukaemia, especially when treatment included cranial irradiation, might need support throughout their lifespan.

  4. 5 CFR 847.912 - If an employee who elects to credit NAFI service under subpart H of this part elects a survivor...

    Science.gov (United States)

    2010-01-01

    ... service under subpart H of this part elects a survivor annuity will the monthly survivor annuity rate be... elects to credit NAFI service under subpart H of this part elects a survivor annuity will the monthly survivor annuity rate be subject to reduction? (a) The monthly survivor annuity benefit of an employee...

  5. Perceptions of Childhood Sexual Abuse Survivors: Development and Initial Validation of a New Scale to Measure Stereotypes of Adult Survivors of Childhood Sexual Abuse

    Science.gov (United States)

    Zafar, Sadia; Ross, Erin C.

    2013-01-01

    The Childhood Sexual Abuse Stereotypes Scale was developed to assess stereotypes of adult survivors of childhood sexual abuse. Scale items were derived from two studies that elicited cultural and personal beliefs about, and emotions experienced towards adult childhood sexual abuse survivors among university undergraduates. Two scales, Emotions and…

  6. Adverse psychological outcomes in long-term survivors of hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study (BMTSS).

    Science.gov (United States)

    Sun, Can-Lan; Francisco, Liton; Baker, K Scott; Weisdorf, Daniel J; Forman, Stephen J; Bhatia, Smita

    2011-10-27

    Little information exists regarding long-term psychological health of hematopoietic cell transplantation (HCT) survivors. Using resources offered by the Bone Marrow Transplant Survivor Study (BMTSS), we evaluated adverse psychological outcomes in 1065 long-term HCT survivors and a healthy comparison group composed of siblings. Psychological health status was evaluated using the Brief Symptom Inventory-18. Twenty-two percent of the HCT survivors reported adverse psychological outcomes, compared with 8% of the siblings. Exposure to prednisone was associated with psychological distress across all domains (anxiety, depression, and somatic distress). Fifteen percent of the HCT survivors reported somatic distress, representing an almost 3-fold higher risk comparing to siblings. Among survivors, in addition to low annual household income and self-reported poor health, having severe/life-threatening conditions and presence of active chronic GVHD were associated with a 2-fold increased risk for somatic distress. Seven percent of the HCT survivors expressed suicidal ideation; patients with higher scores on depression subscale were most vulnerable. This study demonstrates that somatic distress is the biggest challenge faced by survivors long after HCT. These results identify vulnerable subpopulations and provide patients, families, and healthcare providers with necessary information to plan for post-HCT needs many years after HCT.

  7. Perceptions of Childhood Sexual Abuse Survivors: Development and Initial Validation of a New Scale to Measure Stereotypes of Adult Survivors of Childhood Sexual Abuse

    Science.gov (United States)

    Zafar, Sadia; Ross, Erin C.

    2013-01-01

    The Childhood Sexual Abuse Stereotypes Scale was developed to assess stereotypes of adult survivors of childhood sexual abuse. Scale items were derived from two studies that elicited cultural and personal beliefs about, and emotions experienced towards adult childhood sexual abuse survivors among university undergraduates. Two scales, Emotions and…

  8. Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis.

    Science.gov (United States)

    Cao, Xing; Wang, Li; Cao, Chengqi; Zhang, Jianxin; Liu, Ping; Zhang, Biao; Wu, Qi; Zhang, Hong; Zhao, Zhihong; Fan, Gaolin; Elhai, Jon D

    2015-11-01

    Posttraumatic stress disorder (PTSD) and depression are highly comorbid in association with serious clinical consequences. Nevertheless, to date, no study using latent class or latent profile analysis (LCA/LPA) has examined patterns of co-occurring PTSD and depression symptoms among natural disaster survivors, nor has the distinctiveness of DSM-5 PTSD and depression symptoms been clarified in the aftermath of trauma. This study was primarily aimed at filling these gaps. LPA was used to examine self-reported PTSD and depression symptoms in an epidemiological sample of 1196 Chinese earthquake survivors. A 4-class solution characterized by low symptoms (53.9%), predominantly depression (18.2%), predominantly PTSD (18.9%) and combined PTSD-depression (9.0%) patterns fit the data best. Demographic characteristics and earthquake-related exposures were specifically or consistently associated with the non-parallel profiles varying in physical health impairment. A sample exposed to specific traumatic events was assessed by self-report measures. The distinctiveness of DSM-5 PTSD and depression symptoms following an earthquake suggests that PTSD and depression may be independent sequelae of psychological trauma rather than a manifestation of a single form of psychopathology. The current findings support the distinction between PTSD and depression constructs, and highlight the need for identifications of natural disaster survivors at high risk for PTSD and/or depression, and interventions individually tailored to one's symptom presentations. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Study on acute burn injury survivors and the associated issues

    Institute of Scientific and Technical Information of China (English)

    Jonathan Bayuo; Pius Agbenorku; Richcane Amankwa

    2016-01-01

    Objective: To explore the phenomenon of surviving burn injury and its associated issues and concerns. Methods: A cross sectional survey approach was utilized to obtain data from one hundred burn survivors who were purposely selected. Descriptive statistics and content analysis were used to analyze data. Results: Findings from the study indicate that burns from flames stood out as a major cause of burns. Physical discomfort/pain, anxiety, needing assistance in meeting self-care needs, financial and social limitations were identified as the major impact of the injury. Furthermore, participants perceived the existence of societal stigma. In addition, hope in God or a spiritual being as well as family support were the two key resources participants relied on to cope effectively. Conclusions: Surviving burn injury is associated with varied physical, social and psy-chological factors and survivors may need professional assistance to fully adjust after discharge.

  10. Increased relative risk of myelodysplastic syndrome in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Kenji [Hiroshima City Hospital (Japan); Kimura, Akiro; Matsuo, Tatsuki; Tomonaga, Masao; Kodama, Kazunori; Mabuchi, Kiyohiko

    1998-12-01

    It was investigated what blood disorders except leukemia increased the relative risk with dose dependency in atomic bomb survivors. Subjects were 217 patients of atomic bomb survivors in Hiroshima and Nagasaki, who had blood disorders except leukemia and died between 1950 and 1990. Their medical records were analyzed and their diagnoses were reevaluated. Sixteen cases were diagnosed as the aplastic anemia and 12 as the myelodysplastic syndrome (MDS). In the aplastic anemia, there was no correlation between the exposure dose and the mortality. In MDS, the excess relative risk (ERR)/bone marrow exposure dose of 1 Sv was very high (13.0). These results supports the hypothesis that MDS would be broken out by the clonal abnormality of the hematopoietic stem cell and radiation exposure could cause the appearance of the abnormal stem cell clone. (K.H.)

  11. Obesity and Metabolic Syndrome Among Adult Survivors of Childhood Leukemia.

    Science.gov (United States)

    Gibson, Todd M; Ehrhardt, Matthew J; Ness, Kirsten K

    2016-04-01

    Treatment-related obesity and the metabolic syndrome in adult survivors of childhood acute lymphoblastic leukemia (ALL) are risk factors for cardiovascular disease. Both conditions often begin during therapy. Preventive measures, including dietary counseling and tailored exercise, should be initiated early in the course of survivorship, with referral to specialists to optimize success. However, among adults who develop obesity or the metabolic syndrome and who do not respond to lifestyle therapy, medical intervention may be indicated to manage underlying pathology, such as growth hormone deficiency, or to mitigate risk factors of cardiovascular disease. Because no specific clinical trials have been done in this population to treat metabolic syndrome or its components, clinicians who follow adult survivors of childhood ALL should use the existing American Heart Association/National Heart Lung and Blood Institute Scientific Statement to guide their approach.

  12. Organized Abuse in Adulthood: Survivor and Professional Perspectives.

    Science.gov (United States)

    Salter, Michael

    2017-02-23

    This paper reports on the preliminary findings of a qualitative study of Australian women disclosing organized abuse in adulthood and the mental health professionals who treat them. Drawing on interviews with survivors and mental health professionals, the paper analyses the fraught relationship between mental health and physical safety for adults subject to organized abuse. The therapeutic progress of adult organized abuse victims can be disrupted by ongoing threats, stalking, and group violence, which in turn reinforces the dissociative responses and pathological attachments that render them vulnerable to revictimization. The paper argues that breaking this cycle requires intervention from multiple agencies, and describes the responses of police, medical services, and child protection services to adult organized abuse from the perspective of survivors and mental health practitioners. Highlighting systemic failures but also opportunities, the paper calls for a coordinated response to organized abuse in adulthood, including inter-agency partnerships to support safety and bolster the efficacy of therapeutic interventions.

  13. Creating an interdisciplinary medical home for survivors of human trafficking.

    Science.gov (United States)

    McNiel, Melinda; Held, Theodore; Busch-Armendariz, Noël

    2014-09-01

    Health care providers play an important role in identifying victims of human trafficking and addressing their unique medical needs. In response to a recently published call to action in Obstetrics & Gynecology, an interdisciplinary medical home has been created in central Texas to serve as a model for delivery of care to survivors of human trafficking that is sensitive to their history of trauma, or "trauma-informed." An overview of the topic is provided along with a description of the stakeholders involved and the steps that were taken to create the clinic. This information is presented with the intention of educating health care providers on the long-term medical needs of survivors and on how they can establish a similar clinic in other parts of the country.

  14. Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors

    DEFF Research Database (Denmark)

    Handberg, Charlotte; Midtgaard, Julie; Nielsen, Claus Vinther

    2016-01-01

    Purpose: The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Design: Ethnographic fieldwork was conducted, consisting of participant...... observation and 9 semi-structured focus group interviews with 58 hospital HCPs. Methods: Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. Findings: Attitudes about both gender...... and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men's participation in cancer rehabilitation. Conclusions: Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors' rehabilitation outcomes may...

  15. Psychic loss in adult survivors of father-daughter incest.

    Science.gov (United States)

    Wingerson, N

    1992-08-01

    Studies show that adult survivors of childhood incest comprise a significant percentage of female psychiatric patients. The varied and multidetermined presenting symptomatology of these patients frequently leads to misdiagnosis and treatment interventions that fail to address core issues of the incest experience. One such issue is the child's experience of the psychic loss of a physically present parent that is part of the emotional trauma of incest. The goal of this paper is to discuss psychic loss as a core element of the incest experience, particularly in father-daughter incest, and to describe the conditions of childhood mourning that inhibit successful resolution of this loss. Attention is addressed to the psychoanalytic understanding of mourning as a basis for interventions in the treatment of adult survivors.

  16. César Vallejo and the shame of the survivor

    Directory of Open Access Journals (Sweden)

    Ana Carolina Cernicchiaro

    2008-07-01

    Full Text Available The present essay proposes to reflect about the César Vallejo poem “El pan nuestro”, as an openness to alterity, reading in his shame a guilt for living, similar to the one that the survivors of the Shoah felt. Once exclusion is a fundamental structure of our culture and Auschwitz and its victims repeat eternally, the shame continuous to hound the survivors. For these, the words failure, of course, since the true witness is the one that can’t give testimony and since the words are unbearable. But is because of that, because they lack, that the poetic word, situated always in a position of rest, can testify, can talk.

  17. Quality of life and symptoms in male breast cancer survivors.

    Science.gov (United States)

    Ruddy, Kathryn J; Giobbie-Hurder, Anita; Giordano, Sharon H; Goldfarb, Shari; Kereakoglow, Sandra; Winer, Eric P; Partridge, Ann H

    2013-04-01

    Little is known about quality of life and symptoms of male breast cancer survivors. We recruited men with stage 0-4 breast cancer for an on-line survey through www.outoftheshadowofpink.com, www.malebreastcancer.org, and www.malebreastcancer.ca. Surveys included expanded prostate cancer index composite (EPIC) hormonal/sexual scales, hospitalized anxiety and depression scale (HADS), Functional Assessment of Cancer Therapy-Breast (FACT-B), sociodemographic/disease-related, genetic, and fertility-related items. Forty-two responded. Mean EPIC Sexual and Hormonal scores were 44.5 and 81.3, respectively, suggesting symptom burden. Mean FACT-B score was 111.1, consistent with impaired overall quality of life. Male survivors experience substantial sexual and hormonal symptoms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Procedural justice and layoff survivors' commitment: a quantitative review.

    Science.gov (United States)

    Grubb, W Lee

    2006-10-01

    Layoffs are common in today's organizations. Most studies that have examined the correlation between procedural justice and the organizational commitment of layoff survivors have yielded positive correlations, but the magnitude of the correlations varies widely. This study is the first to estimate the population correlation and to identify the primary sources that cause variation in the correlation across studies. The results indicated that justice and commitment correlations can always be expected to be positive. Based on a total sample size of 9080 individuals, the estimated mean population correlation was .34. Variation was primarily explained by attributes of the justice measure where multiple items scales and scales composed of both interactional and procedural justice items yielded higher correlations than single item measures. Therefore, it is important that employers recognize the substantial assuaging affect that procedural and interactional justice can have on survivors' organizational commitment.

  19. Understanding topics and sentiment in an online cancer survivor community.

    Science.gov (United States)

    Portier, Kenneth; Greer, Greta E; Rokach, Lior; Ofek, Nir; Wang, Yafei; Biyani, Prakhar; Yu, Mo; Banerjee, Siddhartha; Zhao, Kang; Mitra, Prasenjit; Yen, John

    2013-12-01

    Online cancer communities help members support one another, provide new perspectives about living with cancer, normalize experiences, and reduce isolation. The American Cancer Society's 166000-member Cancer Survivors Network (CSN) is the largest online peer support community for cancer patients, survivors, and caregivers. Sentiment analysis and topic modeling were applied to CSN breast and colorectal cancer discussion posts from 2005 to 2010 to examine how sentiment change of thread initiators, a measure of social support, varies by discussion topic. The support provided in CSN is highest for medical, lifestyle, and treatment issues. Threads related to 1) treatments and side effects, surgery, mastectomy and reconstruction, and decision making for breast cancer, 2) lung scans, and 3) treatment drugs in colon cancer initiate with high negative sentiment and produce high average sentiment change. Using text mining tools to assess sentiment, sentiment change, and thread topics provides new insights that community managers can use to facilitate member interactions and enhance support outcomes.

  20. Measurement of balance function and community participation in stroke survivors.

    Science.gov (United States)

    Ahn, Sinae

    2016-08-01

    [Purpose] This study aimed to investigate the relationship between balance function and community participation in stroke survivors. [Subjects and Methods] Sixty-three patients diagnosed with hemiparetic stroke participated in this study (36 males, 27 females, aged 58.6 ± 15.2 years). The participants were assessed for balance function and their level of participation in the community, using activity card sorting and the Berg Balance Scale. A regression analysis was used to identify the influence of balance function on instrumental activities of daily living and leisure and social activities. [Results] The results of the regression analysis indicated that balance function measured by using the Berg Balance Scale affected community participation of patients with hemiparetic stroke. Participation in instrumental activities of daily living and leisure and social activities was affected by balance function. [Conclusion] This study provides useful information for designing efficient programs and identifying their effectiveness for enhancement of community participation in stroke survivors.

  1. Quality of life in cancer survivors: an integrative review

    Directory of Open Access Journals (Sweden)

    Bruna Knob Pinto

    2013-09-01

    Full Text Available This study aims at identifying factors related to the quality of life of cancer survivors. The databases PubMed, LILACS and SciELO were used, being quality of life, survival and neoplasms the main keywords entered. Sixty-eight articles were found and ten that approached aspects related to quality of life of cancer survivors were selected. The results analysis was performed in stages. Several factors were identified and grouped into physical (chewing, pain and others, psychological (disease conception, social, financial (high cost of treatment and miscellaneous (age, treatment performance among others. It is believed that the analysis of the different areas that comprise the quality of life of patients can assist health professionals in the implementation of assistance practices that consider the multidimensionality of cancer survival.

  2. Perceived employer-related barriers and facilitators for work participation of cancer survivors: A systematic review of employers' and survivors' perspectives.

    Science.gov (United States)

    Greidanus, M A; de Boer, A G E M; de Rijk, A E; Tiedtke, C M; Dierckx de Casterlé, B; Frings-Dresen, M H W; Tamminga, S J

    2017-07-28

    To identify employer-related barriers and facilitators for work participation of cancer survivors from the perspective of both employers and cancer survivors, and to synthesise these perceived barriers and facilitators to understand their perceived consequences. A systematic review of qualitative studies focusing on employers' and cancer survivors' perspectives on the work participation of cancer survivors was performed. Four databases (MEDLINE, EMBASE, PsycINFO, and Business Source Premier) were systematically searched, and the quality of studies included was assessed using the CASP checklist. Perceived barriers and facilitators were extracted and synthesised to conduct a content analysis. Five studies representing the employers' perspectives and 47 studies representing the cancer survivors' perspectives were included. Employers perceived barriers and facilitators related to support, communication, RTW policies, knowledge about cancer, balancing interests and roles, and attitude. Survivors perceived barriers and facilitators related to support, communication, work environment, discrimination, and perception of work ability. The synthesis found that the employers' willingness to support can be understood by perceptions they have of the survivor, goals of the employer, and national or organisational policies. Employers require knowledge about cancer and RTW policies to be able to support survivors. This review identified a plurality of and a large variety in perceived employer-related barriers and facilitators for work participation of cancer survivors, which can be understood to be related to both employers' willingness and ability to support. There is a need for interventions targeting employers, with the aim of enhancing the sustainable work participation of cancer survivors. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Psychosomatic status, personality traits, and coping styles of bereaved and non-bereaved survivors of the 2008 Wenchuan Earthquake, China

    Directory of Open Access Journals (Sweden)

    Yanhui eXiang

    2016-03-01

    Full Text Available Objectives: This study examined personality, coping styles, and psychosomatic characteristics and their relationships in bereaved and non-bereaved earthquake survivors. Study design: Cross-sectional surveyMethods: A survey was conducted with a sample of 102 non-bereaved survivors and 79 bereaved survivors from Mianyang, Anyang, and similar districts 2 weeks after Wenchuan earthquake. Survivors completed questionnaires including items about demographics, personality characteristics, coping styles, and psychosomatic status. Results: Bereaved survivors had lower scores for gregariousness, trust, and optimism, but higher scores for depressed mood, loneliness, becoming easily fearful, irritation, and anxiety than non-bereaved survivors. In addition, bereaved participants scored higher for avoiding problems, self-blame, and fantasy coping styles than non-bereaved ones. Personality and coping styles significantly correlated with psychosomatic status in bereaved and non-bereaved survivors. Optimism and openness to feelings personality characteristics, and self-blame, avoiding problems, and rationalization coping styles significantly predicted psychosomatic status of bereaved survivors, while openness to fantasy, optimism, order, and trust personality characteristics, and self-blame and avoiding problems coping styles significantly predicted psychosomatic status of non-bereaved survivors. Conclusion: Earthquake survivors experienced PTSD symptoms and negative emotions. Bereaved survivors experienced more serious PTSD symptoms and negative emotions relative to non-bereaved survivors. Appropriate psychological crisis interventions should be conducted for earthquake survivors, especially bereaved survivors.

  4. Fertility, gonadal and sexual function in survivors of testicular cancer

    OpenAIRE

    Huddart, R A; Norman, A.; Moynihan, C; Horwich, A; Parker, C; Nicholls, E; Dearnaley, D. P.

    2005-01-01

    Modern treatments cure most testicular cancer patients, so an important goal is to minimise toxicity. Fertility and sexual functioning are key issues for patients. We have evaluated these outcomes in a cross-sectional study of long-term survivors of testicular cancer. In total, 680 patients treated between 1982 and 1992 completed the EORTC Qly-C-30(qc30) questionnaire, the associated testicular cancer specific module and a general health and fertility questionnaire. Patients have been subdivi...

  5. Taste and smell dysfunction in childhood cancer survivors.

    Science.gov (United States)

    Cohen, Jennifer; Laing, David G; Wilkes, Fiona J; Chan, Ada; Gabriel, Melissa; Cohn, Richard J

    2014-04-01

    Reduced or altered taste and smell function may occur as a side-effect of cancer therapy. This can lead to altered nutrient and energy intake. Some studies have suggested that taste and smell dysfunction can persist many years after treatment completion but this has not been previously assessed in survivors of childhood cancer. The aim of this study is to determine if taste and smell dysfunction is present in childhood cancer survivors (CCS). Food preference and Quality of Life was also assessed. Fifty-one child cancer survivors (mean age: 19.69±7.09years), more than five years since treatment completion, (mean: 12.4years) were recruited from the long term follow-up clinics at two Sydney-based children's hospitals. Taste function was assessed using a 25 sample taste identification test comprising five concentrations each of sweet, salty, sour and bitter tastes and water. Smell function was assessed by determining the ability of participants to identify 16 common odorants. The participants' Quality of Life was assessed using the Functional Assessment of Anorexia Cachexia scale and food preferences were assessed using a 94-item food liking tool. Taste dysfunction was found in 27.5% of participants (n=14), and smell dysfunction in 3.9% (n=2) of participants. The prevalence of taste dysfunction was higher than that seen in the non-cancer population. The child cancer survivors' appeared to "like" the less healthy food groups such as flavoured beverages, takeaway and snacks over healthier food groups such as vegetables and salad. No correlation was found between those with a taste dysfunction and their food "likes". A high level of taste dysfunction was found in CCS though there did not appear to be an issue with smell dysfunction. Further work is also needed to assess whether a taste dysfunction do play a role in the dietary habits of CCS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Physical Exercise and Quality of Life in Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Marco VALENTI, Giampiero PORZIO, Federica AIELLI, Lucilla VERNA, Katia CANNITA, Renato MANNO, Francesco MASEDU, Paolo MARCHETTI, Corrado FICORELLA

    2008-01-01

    Full Text Available An important goal for cancer patients is to improve the quality of life (QOL by maximising functions affected by the disease and its therapy. Preliminary research suggests that exercise may be an effective intervention for enhancing QOL in cancer survivors. Research has provided preliminary evidence for the safety, feasibility, and efficacy of exercise training in breast cancer survivors. The aim of this study was to assess the association between physical exercise and quality of life in a population of female breast cancer survivors, followed up from diagnosis to the off-treatment time period, and investigated about their exercise habits in pre-diagnosis. A total of 212 female breast cancer survivors consecutively registered from January 2003 to December 2006 at a Supportive Care Unit in an Italian Oncology Department were enrolled. Exercise behaviour was assessed by the Leisure Score Index (LSI of the Godin Leisure-Time Exercise Questionnaire. Patients were asked to report their average weekly exercise for three cancer-related time periods, i.e. pre-diagnosis, during active treatment and off-treatment. Quality of life was assessed by the Italian version of the WHOQOL-BREF standardised instrument. Statistical analysis indicated significant differences across the cancer-relevant time-periods for all exercise behaviour outcomes: the exercise behaviour was significantly lower during both on- and off- treatment than during prediagnosis; exercise during active treatment was significantly lower than during off-treatment. QOL strongly decreases during active treatment. Significant correlations were found between total exercise on- and off-treatment and all QOL indicators. Strenuous exercise is strongly correlated with QOL. Absent/mild exercise seems to be inversely correlated with a positive perception of disease severity and with quality of life on all axes. Need clearly results for inclusion of physical activity programs in comprehensive

  7. Healing through reflective writing: Breast cancer survivors' experience.

    Science.gov (United States)

    Baggs, Colleen; McKhann, Lisa; Gessert, Charles E; Johnson, Brian P

    2013-07-01

    This article describes an intervention for breast cancer survivors called Journal of My Medical Experiences in which participants engaged in reflective writing over six weeks. The 107 participants were encouraged to explore concerns and issues in a safe online environment. About half of the women posted writings to a website once a week or more; others logged on solely to read what others had written. A number of themes emerged as the women explored their feelings. We share some of those.

  8. Re-authoring life narratives of trauma survivors: Spiritual perspective

    OpenAIRE

    Charles Manda

    2015-01-01

    Traditionally, the exploration of the impact of trauma on trauma survivors in South Africa has been focused mainly on the bio-psychosocial aspects. The bio-psychosocial approach recognises that trauma affects people biologically, socially and psychologically. In this article, the author explores a holistic understanding of the effects of trauma on people from communities historically affected by political violence in KwaZulu-Natal, South Africa. Using a participatory action research design (P...

  9. Survivors' Discursive Construction of Organizational Identification after a Downsizing

    DEFF Research Database (Denmark)

    Aggerholm, Helle Kryger; Andersen, Mona Agerholm

    This study examines how surviving employees discursively construct organizational identifications after a downsizing in a large Scandinavian telecommunications company. Further, the analysis reveals which factors in survivors´ discourse are determining for the creation of their organizational...... identifications. Discourse analysis of the interview data indicate four types of employee identification response categories: 1) non-identification caused by indifference, 2) identification fuelled by job identification, consensus as to the downsizing strategy, sense of procedural justice and acceptance...

  10. Navigating stroke care: the experiences of younger stroke survivors.

    Science.gov (United States)

    Sadler, Euan; Daniel, Katie; Wolfe, Charles D A; McKevitt, Christopher

    2014-01-01

    Although stroke is associated with ageing, a significant proportion of strokes occur in younger people. Younger stroke survivors have experienced care available as inappropriate to their needs. However, insufficient attention has been paid to how the social context shapes their experiences of care. We investigated this question with younger stroke survivors in Greater London, UK. We conducted in-depth interviews with individuals aged between 24 and 62 years. Interviews were analysed thematically, with interpretation informed by Bourdieu's concepts of field, capital and habitus. In the acute care setting it was implicit for participants that expertise and guidance was to be prioritised and largely this was reported as what was received. Individuals' cultural capital shaped expectations to access information, but health care professionals' symbolic capital meant they controlled its provision. After discharge, professional guidance was still looked for, but many felt it was limited or unavailable. It was here that participants' social, cultural and economic capital became more important in experiences of care. The field of stroke shaped younger stroke survivors' experiences of care. Navigating stroke care was contingent on accessing different forms of capital. Differences in access to these resources influenced longer term adjustment after stroke. Stroke care can be conceptualised as a temporal field of social activity and relationships which shapes variations in experiences of care among younger stroke survivors, and differences in expectations of support at different time points after stroke. On entering the field of stroke participants reported needing health care professional guidance and expertise to manage the acute event, yet difficulties accessing information in hospital limited the agency of some individuals wanting to take an active role in their recovery. After discharge from hospital variations in experiences of care among participants were more evident

  11. Social media for breast cancer survivors: a literature review.

    Science.gov (United States)

    Falisi, Angela L; Wiseman, Kara P; Gaysynsky, Anna; Scheideler, Jennifer K; Ramin, Daniel A; Chou, Wen-Ying Sylvia

    2017-06-10

    Social media may offer support to individuals who are navigating the complex and challenging experience of cancer. A growing body of literature has been published over the last decade exploring the ways cancer survivors utilize social media. This study aims to provide a systematic synthesis of the current literature in order to inform cancer health communication practice and cancer survivorship research. Using PRISMA guidelines, four electronic databases were searched to retrieve publications on breast cancer and social media published between 2005 and 2015. The final sample included 98 publications (13 commentaries and reviews, 47 descriptive studies, and 38 intervention studies). Intervention studies were assessed for key features and outcome measures. Studies utilizing content analysis were further evaluated qualitatively. Online support groups were the most commonly studied platform, followed by interactive message boards and web forums. Limited research focuses on non-Caucasian populations. Psychosocial well-being was the most commonly measured outcome of interest. While social media engagement was assessed, few standardized measures were identified. Content analyses of social media interactions were prevalent, though few articles linked content to health outcomes. The current literature highlights the impact and potential utility of social media for breast cancer survivors. Future studies should consider connecting social media engagement and content to psychosocial, behavioral, and physical health outcomes. Online groups and communities may improve the well-being of breast cancer survivors by providing opportunities to engage with wider social networks, connect with others navigating similar cancer experiences, and obtain cancer-related information. Researchers should consider the potential role of social media in addressing the unmet needs of breast cancer survivors, and particularly the implications for clinical and public health practice.

  12. Physical performance limitations in adolescent and adult survivors of childhood cancer and their siblings.

    Science.gov (United States)

    Rueegg, Corina S; Michel, Gisela; Wengenroth, Laura; von der Weid, Nicolas X; Bergstraesser, Eva; Kuehni, Claudia E

    2012-01-01

    This study investigates physical performance limitations for sports and daily activities in recently diagnosed childhood cancer survivors and siblings. The Swiss Childhood Cancer Survivor Study sent a questionnaire to all survivors (≥ 16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2003 aged sports; 2) limitations in daily activities (using SF-36 physical function score). We compared results between survivors diagnosed before and after 1990 and determined predictors for both types of limitations by multivariable logistic regression. The sample included 1038 survivors and 534 siblings. Overall, 96 survivors (9.5%) and 7 siblings (1.1%) reported a limitation in sports (Odds ratio 5.5, 95%CI 2.9-10.4, pcancer, even those diagnosed recently and treated with modern protocols, remain at high risk for physical performance limitations. Treatment and follow-up care should include tailored interventions to mitigate these late effects in high-risk patients.

  13. Executive function late effects in survivors of pediatric brain tumors and acute lymphoblastic leukemia.

    Science.gov (United States)

    Winter, Amanda L; Conklin, Heather M; Tyc, Vida L; Stancel, Heather; Hinds, Pamela S; Hudson, Melissa M; Kahalley, Lisa S

    2014-01-01

    Survivors of pediatric brain tumors (BT) and acute lymphoblastic leukemia (ALL) are at risk for neurocognitive late effects related to executive function. Survivors of BT (48) and ALL (50) completed neurocognitive assessment. Executive function was compared to estimated IQ and population norms by diagnostic group. Both BT and ALL demonstrated relative executive function weaknesses. As a group, BT survivors demonstrated weaker executive functioning than expected for age. Those BT survivors with deficits exhibited a profile suggestive of global executive dysfunction, while affected ALL survivors tended to demonstrate specific rapid naming deficits. Findings suggest that pediatric BT and ALL survivors may exhibit different profiles of executive function late effects, which may necessitate distinct intervention plans.

  14. The invisible family: a qualitative study of suicide survivors in Taiwan.

    Science.gov (United States)

    Tzeng, Wen-Chii; Su, Pi-Yu; Chiang, Hsien-Hsien; Kuan, Ping-Yin; Lee, Jia-Fu

    2010-03-01

    The purpose of this interpretive phenomenological study is to describe the commonality of the lived experience of suicide survivors and how it influences their family relationships in Taiwan from a sociocultural perspective. Thirteen suicide survivors have participated in this study. Study results reveal that some survivors blame themselves, some blame others, and some are blamed by their family as part of their need to find a reason for the death. Consequently, family members ignore each other and treat each other as if they are invisible. These Chinese suicide survivors, unlike Western survivors, maintain their strained family connections because of strong cultural influences. Therefore, health professionals should acknowledge the experiences of living with an invisible family when supporting Chinese suicide survivors.

  15. Media Use and the Cancer Communication Strategies of Cancer Survivors

    Science.gov (United States)

    Yoon, Heesoo; Sohn, Minsung; Jung, Minsoo

    2016-01-01

    Communication related to health not only substantially affects perceptions and behaviors related to health but is also positively associated with the extent of health-information seeking and the practice of preventive behavior. Despite the fact that the number of cancer survivors has increased dramatically, there are few studies of the lack of health information, factors which act as barriers, and the difficulties in follow-up care experienced by cancer survivors. Therefore, we reviewed media utilization and the types of media used by cancer survivors with regard to risk communication and suggested appropriate strategies for cancer communication. According to the results, health communication contributed to health promotion by providing health-related information, consolidating social support factors such as social solidarity and trust, and reducing anxiety. In particular, participatory health communication may establish preventive programs which reflect the needs of communities, expand accessibility to better quality healthcare, and intensify healthy living by reducing health inequalities. Therefore, when people do not have an intention to obtain cancer screening, we need to intervene to change their behavior, norms, and degrees of self-efficacy. The findings of this study may help those involved in building partnerships by assisting in their efforts to understand and communicate with the public.

  16. Quality of life among non-hodgkin lymphoma survivors

    Directory of Open Access Journals (Sweden)

    B. B. Samura

    2015-04-01

    Full Text Available Aim. Little is known about change in quality of life among lymphoma survivors. We examined change over time in quality of life among long-term survivors of non-Hodgkin lymphoma and identified demographic, clinical and psychosocial risk factors for poor outcomes depending on the appearance of cardiovascular events. Methods and results. Fifty three cumulative clinical events occurred in 21 (25.6% patients. Patients who had cardiovascular events reported significantly worse psychological well-being, general health, less vitality and health-related quality of life than patients who had not cardiovascular events. Chemotherapy was associated with quality of lives outcomes. Patients who were not diagnosed with cardiovascular events reported better social well-being than patients who were diagnosed with cardiovascular events. The observed differences in quality of life were significant only when they were measured with the QOL-CS, and not with the SF-36. Conclusion. The general health perceptions and vitality levels of non-Hodgkin lymphoma survivors with cardiovascular events remained significantly lower than those of patients without cardiovascular events.

  17. Coping strategies of long-term cancer survivors.

    Science.gov (United States)

    Halstead, M T; Fernsler, J I

    1994-04-01

    Cancer survival is a stressful experience requiring coping for the maintenance of equilibrium. Lazarus' Theory of Stress and Coping was the framework for this descriptive study of the use and effectiveness of coping strategies as assessed by long-term survivors of cancer. The Jalowiec Coping Scale (JCS) and a subject information sheet (SIS) were mailed to 128 potential subjects, identified by the snowball technique, who survived cancer for > 5 years, were not currently receiving therapy, and were not in a terminal stage of disease. Fifty-nine subjects with a mean survival of 13.03 years correctly completed and returned the questionnaire and were included in data analysis. Respondents were predominantly white (88.1%), female (83.7%), married (72.8%), employed as professionals (57.8%), 41-65 years of age (59.3%), and diagnosed with breast cancer (50.8%). Subjects rated optimistic, supportive, and confrontive strategies as most often used and effective. Length of survival did not result in different choices of strategies. Statistically significant differences were found in coping styles between elderly and middle-aged survivors. Results of this study increase nurses' awareness of effective coping strategies and the importance of assessment of coping in long-term survivors of cancer. The importance of social support, spirituality, and helping others is emphasized.

  18. Use of complementary and alternative medicine among breast cancer survivors.

    Science.gov (United States)

    Saibul, Nurfaizah; Shariff, Zalilah Mohd; Rahmat, Asmah; Sulaiman, Suhaina; Yaw, Yong Heng

    2012-01-01

    Complementary and alternative medicine (CAM) use is prevalent among individuals with cancer, especially breast cancer survivors. This study was conducted among 394 breast cancer survivors in selected regions of Peninsular Malaysia to identify the pattern and factors associated with CAM use. About 51% of the respondents reported CAM use as complementary treatment. Vitamins (47.2%), spiritual activities (33.2%) and other dietary supplements (30.7%) were the most commonly used CAM therapies. Common reasons for CAM use were to increase the body's ability to perform daily activities (70.9%), enhance immune function (58.3%) and improve emotional well-being (31.7%). Users obtained CAM information mainly from friends and family members (62.5%), physicians (25.0%) and mass media (13.9%). Ethnicity and years of education were significantly associated with CAM use. Although no adverse effects of CAM were reported, breast cancer survivors should discuss their CAM use with health professionals to prevent potential adverse effects of these therapies.

  19. Exercise training improves mean arterial pressure in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Robert C. Mills

    2014-09-01

    Full Text Available Currently, many breast cancer survivors worldwide live with treatment-related side effects, including cardiovascular health problems. This study examined effects of a 5-month exercise intervention on non-invasive markers of cardiovascular health in breast cancer survivors. Relationships between these markers and commonly used markers of overall health were also explored. Fifty-two survivors completed the exercise training at a rehabilitation center at the University of North Carolina at Chapel Hill between 2008-2011. A combined aerobic and resistance exercise intervention (3 times/week for 1h at intensities progressing from low (40% to moderate (65-70% of VO2max for aerobic and 8-12 repetitions max for the resistance exercise were implemented. Significant reduction in mean arterial pressure (MAP was observed from baseline to final assessment. A significant correlation was found between MAP and Body Mass Index (BMI. In conclusion, 5-months combined aerobic and resistance exercise intervention positively improved MAP which was, in part, attributed to changes in BMI.

  20. Re-authoring life narratives of trauma survivors: Spiritual perspective

    Directory of Open Access Journals (Sweden)

    Charles Manda

    2015-02-01

    Full Text Available Traditionally, the exploration of the impact of trauma on trauma survivors in South Africa has been focused mainly on the bio-psychosocial aspects. The bio-psychosocial approach recognises that trauma affects people biologically, socially and psychologically. In this article, the author explores a holistic understanding of the effects of trauma on people from communities historically affected by political violence in KwaZulu-Natal, South Africa. Using a participatory action research design (PAR as a way of working through trauma, a longitudinal study was conducted in Pietermaritzburg from 2009–2013. At the end of the study, life narratives were documented and published. The textual analysis of these life narratives reveals that, besides the bio-psychosocial effects that research participants experienced during and after the trauma, they also sustained moral and spiritual injuries. Trauma took its toll in their lives emotionally, psychologically, spiritually, morally and in their relationships with themselves, others and God. From these findings, the author argues that the bio-psychosocial approach is incomplete for understanding the holistic effects of trauma on the whole person. Therefore, he recommends the integration of the moral and spiritual aspects of trauma to come up with a holistic model of understanding the effects of trauma on traumatised individuals. The holistic model will enhance the treatment, healing and recovery of trauma survivors. This, in turn, will alleviate the severe disruption of many aspects of psychological functioning and well-being of trauma survivors caused by the effects of trauma.

  1. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

    Directory of Open Access Journals (Sweden)

    Joanne Lester

    2015-03-01

    Full Text Available Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors.

  2. Lifestyle modification in cervical cancer survivors: an ongoing need.

    Science.gov (United States)

    Schlumbrecht, Matthew P; Sun, Charlotte C; Huang, Marilyn S; Zandstra, Fran; Bodurka, Diane C

    2014-03-01

    With the introduction of multimodality therapy for cervical cancer, many women will be long-term survivors in need of comprehensive surveillance care. Our goals were to evaluate patterns of obesity and smoking in a cohort of cervical cancer survivors and to assess the potential influence of these comorbidities on subsequent follow-up. We reviewed the records of patients treated for invasive cervical cancer at our institution from 2000 to 2003 who had no evidence of disease for 3 or more years. Demographic and clinical data were collected, including smoking history and anthropometric measurements. Body mass index (BMI) was categorized according to World Health Organization criteria. Logistic regression and Wilcoxon rank sum analyses were performed. Two hundred ninety-eight women had complete follow-up data at 3 years. The median age at diagnosis was 43.5 years (range, 17.6-87.1 years). At diagnosis, 31.9% had a normal BMI, 28.2% were overweight, and 34.6% were obese compared with 31.7%, 21.1%, and 30.2% at 3 years, respectively. Of the 51 women whose BMI categorization changed, 33 (64.7%) had weight gain, and 18 (35.3%) had weight loss. By paired analyses, increase in BMI was significant over the 3-year interval (P Obesity and smoking are significant comorbidities that may complicate care in cervical cancer survivors. Interventions aimed at modifying these risk factors should be routinely undertaken in this population.

  3. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

    Science.gov (United States)

    Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

    2015-01-01

    Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors. PMID:25815692

  4. Salivary Alpha-Amylase Reactivity in Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Cynthia Wan

    2016-03-01

    Full Text Available The two main components of the stress system are the hypothalamic-pituitary-adrenal (HPA and sympathetic-adrenal-medullary (SAM axes. While cortisol has been commonly used as a biomarker of HPA functioning, much less attention has been paid to the role of the SAM in this context. Studies have shown that long-term breast cancer survivors display abnormal reactive cortisol patterns, suggesting a dysregulation of their HPA axis. To fully understand the integrity of the stress response in this population, this paper explored the diurnal and acute alpha-amylase profiles of 22 breast cancer survivors and 26 women with no history of cancer. Results revealed that breast cancer survivors displayed identical but elevated patterns of alpha-amylase concentrations in both diurnal and acute profiles relative to that of healthy women, F (1, 39 = 17.95, p < 0.001 and F (1, 37 = 7.29, p = 0.010, respectively. The average area under the curve for the diurnal and reactive profiles was 631.54 ± 66.94 SEM and 1238.78 ± 111.84 SEM, respectively. This is in sharp contrast to their cortisol results, which showed normal diurnal and blunted acute patterns. The complexity of the stress system necessitates further investigation to understand the synergistic relationship of the HPA and SAM axes.

  5. Cardiac Function in Long-Term Survivors of Childhood Lymphoma

    Directory of Open Access Journals (Sweden)

    Mark K. Friedberg

    2011-01-01

    Full Text Available Objectives. We studied long-term effects of therapy for childhood lymphoma on cardiac function. Design and patients. We prospectively evaluated 45 survivors of childhood lymphoma, using clinical parameters, electrocardiography and echocardiography. Further comparisons were made between lymphoma subgroups and between males and females. Results. Mean age at diagnosis was 9.1 years. Mean followup duration was 10.9 years. The NYHA functional class was I in 43 patients and II in 2 patients. A prolonged QTc interval (>0.44 msec was found in 8 patients. Left ventricular (LV systolic function and compliance were normal (LV shortening fraction 40±5.6%; cardiac index 2.84±1.13 L/min/m2; E/A wave ratio 2.5±1.3; mean ± S.D., LV mass was normal (97±40 grams/m2, mean ± S.D.. Mitral regurgitation was observed in 7/45 patients (16%. Asymptomatic pericardial effusions were found in 3/45 (7% patients. Conclusions. Long-term follow-up shows that most parameters of cardiac function are normal in survivors of childhood lymphoma. This is likely due to relatively low doses of anthracyclines in modern protocol modalities. Abnormalities in mitral valve flow, QTc prolongation and in a small proportion of survivors, and functional capacity necessitate long-term cardiac follow-up of these patients.

  6. Writing Workshop and Emotions in senior Holocaust survivors

    Directory of Open Access Journals (Sweden)

    Diego Borisonik

    2015-07-01

    Full Text Available The goal of this research is to evaluate and describe the kind of emotions that emerge in senior Holocaust survivors over 73 years old at the writing workshop held at Tzedaka Foundation. For this purpose, the goals have been divided into three. Firstly, the description of the emotions the participants claim to feel before, during and after performing their writing task, and at the moment of sharing it with their peers. Secondly, the description of the observed emotions of the participants at the moment of sharing their writing task with their workshop peers. Lastly, the description of the emotions that emerge from the writing itself. In order to carry out this descriptive study, seven Holocaust survivors living in the City of Buenos Aires have been interviewed: one man and six women of Polish, Russian, French, Lithuanian and German nationalities, ranging from 73 to 92 years of age, all part of the above mentioned writing workshop. By the same token, the detached observation of each subject in the workshop and the analysis of the emotions arising from the text have been carried out. The analysis of the resulting data has shown that writing and sharing their writing tasks, whatever the topic or genre, is beneficial and it generates positive emotions in this senior adults’ group, and more specifically, highly traumatic situations’ survivors

  7. Healing pathways: art therapy for American Indian cancer survivors.

    Science.gov (United States)

    Warson, Elizabeth

    2012-04-01

    There is a paucity of research addressing quality of life factors for American Indian and Alaska Native cancer survivors. Complementary forms of therapy, such as art therapy, are beginning to address quality of life factors through the "healing" arts for cancer survivors. The purpose of this mixed methods pilot was to explore the effects of culturally relevant art interventions on stress reduction for American Indian cancer survivors and their family members. Forty-six adult participants attended one of three workshops held within two settlements of the Coharie tribe and one southeastern urban tribal center. The data collected consisted of a pretest and posttest State-Trait Personality Inventory (STPI) and artwork resulting from three directed interventions. The artwork was analyzed using qualitative coding methods; however, the scores from the STPI were inconclusive because the inventory was determined to be culturally biased. While statistical significance was not achieved, the findings from qualitative coding reinforced a native concept of wellness focusing on the complex interaction between mind, body, spirit, and context. This pilot study also demonstrated how a community-driven approach was instrumental in the development of the overall workshop format. An expansion of the pilot study is also presented with preliminary results available in 2012.

  8. Trends in Radiation Therapy among Cancer Survivors in the United States, 2000-2030.

    Science.gov (United States)

    Bryant, Alex K; Banegas, Matthew P; Martinez, Maria Elena; Mell, Loren K; Murphy, James D

    2017-06-01

    Background: Although the number of cancer survivors has increased substantially over the past several decades, the composition of survivors treated with radiotherapy is not well defined. Radiotherapy carries unique long-term toxicity risks for cancer survivors. This study describes the current estimates and future projections of the epidemiology of 5-year cancer survivors who receive radiation therapy.Methods: We used cancer incidence and survival data from the Surveillance, Epidemiology, and End-Results (SEER) database linked to U.S. Census data to estimate the number of 5-year cancer survivors treated with radiation between 2000 and 2030. Future projections assumed continuing incidence and survival trends based on historical rates.Results: In 2016, there were an estimated 3.05 million cancer survivors treated with radiation, accounting for 29% of all cancer survivors. The number of radiation-treated cancer survivors is projected to reach 3.38 million by 2020 and 4.17 million by 2030. In 2016, breast (40%) and prostate cancer (23%) composed the majority of radiation-treated survivors, followed by head and neck cancer (5.8%), lymphoma (5.6%), uterine (3.9%), and rectal cancer (3.8%). The percentage of 70 years or older radiation-treated survivors steadily increased between 2000 and 2030.Conclusions: The next several years are projected to see a large increase in the number of cancer survivors treated with radiation.Impact: This group of cancer survivors has unique needs given the long-term risks of radiation, and increased research and awareness are required to optimize health of this growing population. Cancer Epidemiol Biomarkers Prev; 26(6); 963-70. ©2017 AACR. ©2017 American Association for Cancer Research.

  9. Motivational readiness for physical activity and quality of life in long-term lung cancer survivors

    OpenAIRE

    Clark, Matthew M.; Novotny, Paul J.; Patten, Christi A.; Rausch, Sarah M.; Garces, Yolanda I.; Jatoi, Aminah; Sloan, Jeff A.; Yang, Ping

    2008-01-01

    Little is known about the relationship between motivational readiness for physical activity and quality of life (QOL) in long-term lung cancer survivors. Long-term survivors are considered those who are living 5 years or more following a cancer diagnosis. This project examined the relationship between a self-report measure of motivational readiness for physical activity and QOL in a sample of 272 long-term lung cancer survivors. Participants (54% male, average age 70 years old) completed the ...

  10. Trends in adherence to recommended cancer screening: The US population and working cancer survivors

    Directory of Open Access Journals (Sweden)

    Tainya C. Clarke

    2012-12-01

    Full Text Available Introduction: Over the past decade the United States has seen a decrease in advanced cancer diagnoses. There has also been an increase in the number of cancer survivors returning to work. Cancer screening behaviors among survivors may play an important role in their return-to-work process. Adherence to a post-treatment cancer screening protocol increases early detection of secondary tumors and reduces potentially limiting side-effects. We compared screening trends among all cancer survivors, working survivors, and the general population over the last decade.Methods: Trends in adherence to recommended screening were analyzed by site-specific cancer. We used the Healthy People goals as a measure of desired adherence. We selected participants 18+ years from 1997 to 2010 National Health Interview Survey (NHIS for years where detailed cancer screening information was available. Using the recommendations of the American Cancer Society as a guide, we assessed adherence to cancer screening across the decade. There were 174,393 participants. Analyses included 7,528 working cancer survivors representing 3.8 million US workers, and 119,374 adults representing more than 100 million working Americans with no cancer history.Results: The US population met the Healthy People 2010 goal for colorectal screening, but declined in all other recommended cancer screening. Cancer survivors met and maintained the HP2010 goal for all, except cervical cancer screening. Survivors had higher screening rates than the general population. Among survivors, white-collar and service occupations had higher screening rates than blue-collar survivors.Conclusions: Cancer survivors report higher screening rates than the general population. Nevertheless, national screening rates are lower than desired, and disparities exist by cancer history and occupation. Understanding existing disparities, and the impact of cancer screening on survivors is crucial as the number of working survivors

  11. Are long-term cancer survivors and physicians discussing health promotion and healthy behaviors?

    Science.gov (United States)

    Kenzik, Kelly M; Fouad, Mona N.; Pisu, Maria; Martin, Michelle Y.

    2017-01-01

    Purpose This study aimed to 1) describe the proportion of survivors reporting that a physician discussed strategies to improve health and 2) identify which groups are more likely to report these discussions Methods Lung and colorectal cancer (CRC) survivors (>5 years from diagnosis) (n=874) completed questionnaires, including questions on whether in the previous year a physician discussed 1) strategies to improve health, 2) exercise, and 3) diet habits. Chi-square tests and logistic regression models were used to examine whether the likelihood of these discussions varied by demographic and clinical characteristics. Results Approximately 59% reported a physician discussed strategies to improve health and exercise, 44% discussed diet, and 24% reported no discussions. Compared to their counterparts, survivors with lower education were less likely report discussing all three areas, while survivors with diabetes were more likely. Survivors ≥65 were less likely to report discussing strategies to improve health and diet. Males and CRC survivors reported discussing diet more than their female and lung cancer counterparts, respectively Conclusion The frequency of health promotion discussions varies across survivor characteristics. While discussions were more frequently reported by some groups, e.g., survivors with diabetes, or among individuals less likely to engage in healthy behaviors, e.g., males, older and less educated survivors were less likely to have these discussions. Implications for survivors Decreasing physician barriers and activating patients to discuss health promotion especially in the context of clinical care for older survivors and those with low education, is critical to promoting the overall well-being of cancer survivors. PMID:26210659

  12. Risk Factors Associated With Secondary Sarcomas in Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, Tara O., E-mail: thenderson@peds.bsd.uchicago.edu [University of Chicago, Chicago, IL (United States); Rajaraman, Preetha [National Cancer Institute, Bethesda, MD (United States); Stovall, Marilyn [M.D. Anderson Cancer Center, University of Texas, Houston, TX (United States); Constine, Louis S. [University of Rochester, Rochester, NY (United States); Olive, Aliza [Drexel University, Philadelphia, PA (United States); Smith, Susan A. [M.D. Anderson Cancer Center, University of Texas, Houston, TX (United States); Mertens, Ann [Emory University, Atlanta, GA (United States); Meadows, Anna [Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Neglia, Joseph P. [University of Minnesota, Minneapolis, MN (United States); Hammond, Sue [Nationwide Children' s Hospital, Columbus, OH (United States); Whitton, John [Fred Hutchinson Cancer Research Center, Seattle, WA (United States); Inskip, Peter D. [National Cancer Institute, Bethesda, MD (United States); Robison, Leslie L. [St. Jude Children' s Research Hospital, Memphis, TN (United States); Diller, Lisa [Dana-Farber Cancer Institute/Children' s Hospital Cancer Center, Boston, MA (United States)

    2012-09-01

    Purpose: Childhood cancer survivors have an increased risk of secondary sarcomas. To better identify those at risk, the relationship between therapeutic dose of chemotherapy and radiation and secondary sarcoma should be quantified. Methods and Materials: We conducted a nested case-control study of secondary sarcomas (105 cases, 422 matched controls) in a cohort of 14,372 childhood cancer survivors. Radiation dose at the second malignant neoplasm (SMN) site and use of chemotherapy were estimated from detailed review of medical records. Odds ratios (ORs) and 95% confidence intervals were estimated by conditional logistic regression. Excess odds ratio (EOR) was modeled as a function of radiation dose, chemotherapy, and host factors. Results: Sarcomas occurred a median of 11.8 years (range, 5.3-31.3 years) from original diagnosis. Any exposure to radiation was associated with increased risk of secondary sarcoma (OR = 4.1, 95% CI = 1.8-9.5). A dose-response relation was observed, with elevated risks at doses between 10 and 29.9 Gy (OR = 15.6, 95% CI = 4.5-53.9), 30-49.9 Gy (OR = 16.0, 95% CI 3.8-67.8) and >50 Gy (OR = 114.1, 95% CI 13.5-964.8). Anthracycline exposure was associated with sarcoma risk (OR = 3.5, 95% CI = 1.6-7.7) adjusting for radiation dose, other chemotherapy, and primary cancer. Adjusting for treatment, survivors with a first diagnosis of Hodgkin lymphoma (OR = 10.7, 95% CI = 3.1-37.4) or primary sarcoma (OR = 8.4, 95% CI = 3.2-22.3) were more likely to develop a sarcoma. Conclusions: Of the risk factors evaluated, radiation exposure was the most important for secondary sarcoma development in childhood cancer survivors; anthracycline chemotherapy exposure was also associated with increased risk.

  13. Multiple behavioral risk factors among adolescent survivors of childhood cancer in the Survivor Health and Resilience Education (SHARE) program.

    Science.gov (United States)

    Tercyak, Kenneth P; Donze, Jessica R; Prahlad, Sowmya; Mosher, Revonda B; Shad, Aziza T

    2006-11-01

    Health-compromising behaviors among survivors of childhood cancer may increase their risks of cancer recurrence and the onset of chronic disease in adulthood. Regardless of whether such behaviors occur singly or in combination with one another, multiple behavioral risk factors must be identified and addressed early to promote better health outcomes within this special population. Adolescent survivors may be especially vulnerable, as reported rates of smoking and other risky behaviors are at or near levels of their healthy peers. The psychological literature suggests stress may play a role in risk behavior initiation and maintenance, including multiple behavioral risks, and that adolescent survivors are stress-prone. This report focuses on the prevalence and co-occurrence of three behavioral risk factors (cigarette use, insufficient physical activity, and non-adherence to sun protection recommendations) and describes stress-health behavior relationships in this special population. All patients in this study (n = 75) were adolescent survivors of childhood cancer and completed a baseline assessment of their health behaviors and stress as part of a randomized controlled trial of health promotion. Twenty-eight percent of the patients reported one of three risk factors, 12% reported two of three risk factors, and 7% reported all three risk factors. Non-adherence to sun protection was the single most common risk factor; physical inactivity and non-adherent sun protection were the most common co-occurring risk factors. Greater age and stress were significantly associated with the presence of more behavioral risk factors. The evidence suggests interventions to reduce multiple health-compromising behaviors in these patients are warranted, and that efforts to address these patients' personal and family stress levels are important as well. (c) 2005 Wiley-Liss, Inc.

  14. Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Castellino, Sharon M; Geiger, Ann M; Mertens, Ann C; Leisenring, Wendy M; Tooze, Janet A; Goodman, Pam; Stovall, Marilyn; Robison, Leslie L; Hudson, Melissa M

    2011-02-10

    The contribution of specific cancer therapies, comorbid medical conditions, and host factors to mortality risk after pediatric Hodgkin lymphoma (HL) is unclear. We assessed leading morbidities, overall and cause-specific mortality, and mortality risks among 2742 survivors of HL in the Childhood Cancer Survivor Study, a multi-institutional retrospective cohort study of survivors diagnosed from 1970 to 1986. Excess absolute risk for leading causes of death and cumulative incidence and standardized incidence ratios of key medical morbidities were calculated. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of risks for overall and cause-specific mortality. Substantial excess absolute risk of mortality per 10,000 person-years was identified: overall 95.5; death due to HL 38.3, second malignant neoplasms 23.9, and cardiovascular disease 13.1. Risks for overall mortality included radiation dose ≥ 3000 rad ( ≥ 30 Gy; supra-diaphragm: HR, 3.8; 95% CI, 1.1-12.6; infradiaphragm + supradiaphragm: HR, 7.8; 95% CI, 2.4-25.1), exposure to anthracycline (HR, 2.6; 95% CI, 1.6-4.3) or alkylating agents (HR, 1.7; 95% CI, 1.2-2.5), non-breast second malignant neoplasm (HR, 2.6; 95% CI 1.4-5.1), or a serious cardiovascular condition (HR, 4.4; 95% CI 2.7-7.3). Excess mortality from second neoplasms and cardiovascular disease vary by sex and persist > 20 years of follow-up in childhood HL survivors.

  15. Yearly Data for Spoken Language Preferences of Social Security Retirement and Survivor Claimants (2016 Onwards)

    Data.gov (United States)

    Social Security Administration — This data set provides annual volumes for language preferences at the national level of individuals filing claims for Retirement and Survivor benefits from federal...

  16. Anxiety and depression among out-of-hospital cardiac arrest survivors

    DEFF Research Database (Denmark)

    Lilja, G; Nilsson, G; Nielsen, N

    2015-01-01

    AIM: Survivors of out-of-hospital cardiac arrest (OHCA) may experience psychological distress but the actual prevalence is unknown. The aim of this study was to investigate anxiety and depression within a large cohort of OHCA-survivors. METHODS: OHCA-survivors randomized to targeted temperature....... Subjective cognitive problems were associated with an increased risk for psychological distress. Since psychological distress affects long-term prognosis of cardiac patients in general it should be addressed during follow-up of survivors with OHCA due to a cardiac cause. ClinicalTrials.gov NCT01020916/NCT...

  17. Japanese Undergraduates' Attitudes Toward Students Survivors of Parental Suicide: A Comparison With Other Stigmatized Deaths.

    Science.gov (United States)

    Yamanaka, Akira

    2015-01-01

    This study investigated Japanese undergraduates' attitudes toward a fellow student whose parent has died by suicide. One hundred thirty-four participants responded to four versions of a brief fictional case describing a male undergraduate whose father had died. These presented fictional cases described the cause of the death as being suicide, cancer, AIDS, or murder. Results indicated that participants had more negative attitudes toward the suicide survivor student than the nonstigmatized death (cancer) survivor. Further, results indicated that participants viewed suicide survivors as more to blame for the death and had a more negative image of them than of the other stigmatized death (AIDS and murder) survivors.

  18. 78 FR 76411 - Agency Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Science.gov (United States)

    2013-12-17

    ... guerilla groups receiving service-connected compensation benefits and survivors receiving service connected... or as aliens lawfully admitted for permanent residence. The information is needed to...

  19. Group cognitive behavioural therapy for stroke survivors with depression and their carers.

    Science.gov (United States)

    K Ward, Susan; Turner, Alyna; A Hambridge, John; A Halpin, Sean; E Valentine, Megan; L Sweetapple, Anne; H White, Jennifer; Hackett, Maree L

    2016-10-01

    Depression in stroke survivors is common, leads to poorer outcomes and often not treated. A group cognitive behavioural therapy (CBT) program (Brainstorm) for stroke survivors with depression, and their carers has been running as part of usual care since 2007. To evaluate the implementation and acceptability of Brainstorm, a closed group intervention consisting of up to 10 sessions of education, activity planning, problem solving and thought challenging. Participating stroke survivors and their carers complete assessment measures at baseline, post-treatment and 1-month and 6-months follow-up. A mixed models for repeated measures data was conducted with depression and anxiety scores for stroke survivors (Beck Depression Inventory-II; Hospital Anxiety and Depression Scale) and the assessment of depression, anxiety and carer burden for carers. Acceptability was assessed by session attendance and written and open participant feedback upon completion of the program. Forty-eight community dwelling stroke survivors and 34 carers attended Brainstorm, with a median attendance of 88% of sessions. Follow-up assessments were completed by 77% (post-treatment), 46% (1-month) and 38% (6-month) of stroke survivors. Stroke survivors' depression scores decreased from baseline to post-treatment (pBrainstorm group intervention for depression in stroke survivors appears to have been effectively implemented and is acceptable to stroke survivors and carers.

  20. 75 FR 25271 - Office of Refugee Resettlement; Urgent Single Source Grant to Survivors of Torture International...

    Science.gov (United States)

    2010-05-07

    ... for the rehabilitation of victims of torture, including treatment of the physical and psychological... and programmatic expertise to serve the survivors. FOR FURTHER INFORMATION CONTACT: Ronald...

  1. Social Security Administration Retirement, Survivors, and Disability Insurance (RSDI) Improper Payments

    Data.gov (United States)

    Social Security Administration — This dataset shows improper payment experience for the Social Security Retirement, Survivors, and Disability Insurance program paid to workers, their dependents, and...

  2. Pubertal development and fertility in survivors of childhood acute myeloid leukemia treated with chemotherapy only

    DEFF Research Database (Denmark)

    Molgaard-Hansen, Lene; Skou, Anne-Sofie; Juul, Anders

    2013-01-01

    More than 60% of children with acute myeloid leukemia (AML) become long-term survivors. Most are cured using chemotherapy without hematopoietic stem cell transplantation (HSCT). We report on pubertal development and compare self-reported parenthood among AML survivors and their siblings.......More than 60% of children with acute myeloid leukemia (AML) become long-term survivors. Most are cured using chemotherapy without hematopoietic stem cell transplantation (HSCT). We report on pubertal development and compare self-reported parenthood among AML survivors and their siblings....

  3. Late effects in survivors of acute leukemia treated with hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study.

    Science.gov (United States)

    Baker, K S; Ness, K K; Weisdorf, D; Francisco, L; Sun, C-L; Forman, S; Bhatia, S

    2010-12-01

    The Bone Marrow Transplant Survivor Study is a retrospective cohort study in which participants who received hematopoietic cell transplantation (HCT) between 1974 and 1998 and survived for 2 years completed a 255-item questionnaire on late effects occurring after HCT. There were 281 survivors with acute myeloid leukemia (AML) and 120 with acute lymphoblastic leukemia (ALL). Siblings of participants (n=319) were recruited for comparison. Median age at interview was 36.5 years for survivors and 44 years for siblings. Median follow-up after HCT was 8.4 years. Conditioning included total body irradiation in 86% of AML and 100% of ALL subjects. The frequencies of late effects did not differ between ALL and AML survivors. Compared with siblings, survivors had a higher frequency of diabetes, hypothyroidism, osteoporosis, exercise-induced shortness of breath, neurosensory impairments and problems with balance, tremor or weakness. In multivariable analysis, the risk of these outcomes did not differ by diagnosis. Survivors after allogeneic HCT had higher odds of diabetes (odds ratio (OR)=3.9, P=0.04), osteoporosis (OR=3.1, P=0.05), abnormal sense of touch (OR=2.6, P=0.02) and reported their overall health as fair or poor (OR=2.2, P=0.03). Ongoing surveillance for these late effects and appropriate interventions are required to improve the health status of ALL and AML survivors after HCT.

  4. Survivors and scientists: Hiroshima, Fukushima, and the Radiation Effects Research Foundation, 1975-2014.

    Science.gov (United States)

    Lindee, Susan

    2016-04-01

    In this article, I reflect on the Radiation Effects Research Foundation and its ongoing studies of long-term radiation risk. Originally called the Atomic Bomb Casualty Commission (1947-1975), the Radiation Effects Research Foundation has carried out epidemiological research tracking the biomedical effects of radiation at Hiroshima and Nagasaki for almost 70 years. Radiation Effects Research Foundation scientists also played a key role in the assessment of populations exposed at Chernobyl and are now embarking on studies of workers at the Fukushima Daiichi Nuclear Power Plant. I examine the role of estimating dosimetry in post-disaster epidemiology, highlight how national identity and citizenship have mattered in radiation risk networks, and track how participants interpreted the relationships between nuclear weapons and nuclear energy. Industrial interests in Japan and the United States sought to draw a sharp line between the risks of nuclear war and the risks of nuclear power, but the work of the Radiation Effects Research Foundation (which became the basis of worker protection standards for the industry) and the activism of atomic bomb survivors have drawn these two nuclear domains together. This is so particularly in the wake of the Fukushima disaster, Japan's 'third atomic bombing'. The Radiation Effects Research Foundation is therefore a critical node in a complex global network of scientific institutions that adjudicate radiation risk and proclaim when it is present and when absent. Its history, I suggest, can illuminate some properties of modern disasters and the many sciences that engage with them.

  5. Tripping over the Dead: Hungarian-Israeli Holocaust Survivor Women's Narratives of Immigration, Restoration, and Remembrance

    Directory of Open Access Journals (Sweden)

    Ilana Rosen

    2012-01-01

    Full Text Available This essay focuses on the post-Holocaust, Israeli life of five female narrators of Hungarian origin as expressed in their inclusive life histories. A close reading of the later period in the life histories of the five women exposes how they experienced and view their post-Holocaust life as Holocaust survivors and new immigrants in a newly founded State. The women's narratives of finding housing, work, and starting new families show that despite practical hardship they look back on it all with humor, acceptance, and optimism. The women's narratives about the recurrence of Holocaust-related bad memories, nightmares, fears, and worries illustrate that the past is always present and shakes the stability of their post-Holocaust, seemingly rehabilitated lives. This instability or proneness to belated agony is even stronger for two women, who embark on journeys to their past Hungarian hometowns (accompanied by their husbands, likewise of Hungarian origin. The hometown visit narratives are compelling, bothering, and carry a nightmarish quality. Seen against the background of the five women's former Hungarian lives and identity, the narratives of emigration, remembering, and re-visiting clarify that all these experiences are shadowed by the women's Holocaust experiences. Yet, while their later lives offer them some consolation, the memory of the Nazi camps as that of the Hungarian scenes/sites of deportation to Auschwitz, are forever painful and poignant.

  6. Persons with cancer diagnosis as victims/survivors: Patterns of victimization, empowering support and posttraumatic growth

    Directory of Open Access Journals (Sweden)

    Nikolić-Ristanović Vesna

    2015-01-01

    Full Text Available The paper deals with the analyses of primary and secondary victimisation patterns to which cancer diagnosed persons are exposed, as well as an analyses of their needs and the adequacy of the support they receive from persons from their close surrounding, from professionals as well as from state institutions and nongovernmental organizations. The main aim of the paper is to examine applicability of basic victimological concepts such as the notion of victim-survivor, victimization, victim needs, agency v. passivity, self help, social support, posttraumatic disorder/ growth, to the experiences of persons with cancer diagnosis. Consequently the experiences of persons with cancer diagnosis are compared with the experiences of crime victims. On the basis of this analyses, recommendations regarding the possible exchange of experiences and unification of knowledge about crime victims’ and cancer diagnosed persons’ needs, as the basis for the improvement of existing and the development of new mechanisms of support and (self help beneficial for both groups are presented. [Projekat Ministarstva nauke Republike Srbije, br. 179044: Razvoj metodologije evidentiranja kriminaliteta kao osnova kreiranja efikasnih mera za njegovo suzbijanje i prevenciju

  7. Impact of exposure to trauma on posttraumatic stress disorder symptomatology in Swedish tourist tsunami survivors.

    Science.gov (United States)

    Johannesson, Kerstin Bergh; Michel, Per-Olof; Hultman, Christina M; Lindam, Anna; Arnberg, Filip; Lundin, Tom

    2009-05-01

    The aim was to examine long-term mental health and posttraumatic stress symptomatology in a Swedish tourist population after exposure to the 2004 Southeast Asian tsunami. Data from 4822 returned questionnaires 14 months after the disaster were analyzed. Respondents were categorized into 3 subgroups: (1) danger-to-life exposure group (having been caught or chased by the waves), (2) nondanger-to-life exposure group (exposed to other disaster-related stressors), and (3) low exposure group. Main outcome measures were General Health Questionnaire-12 and Impact of Event Scale-22-Revised. Danger-to-life exposure was an important factor in causing more severe posttraumatic stress symptoms and in affecting mental health. Female gender, single status, and former trauma experiences were associated with greater distress. Other factors related to more severe symptoms were loss of relatives, physical injuries, viewing many dead bodies, experiencing life threat, and showing signs of cognitive confusion. Disaster exposure has a substantial impact on survivors, which stresses the need for long-lasting support.

  8. Self-reported depression and perceived financial burden among long-term rectal cancer survivors.

    Science.gov (United States)

    Chongpison, Yuda; Hornbrook, Mark C; Harris, Robin B; Herrinton, Lisa J; Gerald, Joe K; Grant, Marcia; Bulkley, Joanna E; Wendel, Christopher S; Krouse, Robert S

    2016-11-01

    Types of surgery for rectal cancer (RC), including permanent ostomy (PO) or temporary ostomy followed by anastomosis (TO) or initial anastomosis (AN), can affect psychological and financial well-being during active treatment. However, these relationships have not been well studied among long-term survivors (≥5 years post-diagnosis). A mailed survey with 576 long-term RC survivors who were members of Kaiser Permanente was conducted in 2010-2011. Prevalence of current depression was ascertained using a score of ≤45.6 on the Short Form-12 version 2 mental component summary. Perceived financial burden was assessed using a Likert scale ranging from 0 (none) to 10 (severe). Regression analyses were used to measure associations after adjustment for covariates. The overall prevalence of depression was 24% among RC survivors with the highest prevalence among those with a history of PO (31%). The adjusted odds of depression among TO and AN survivors were lower than that among PO survivors, 0.42 (CI95% 0.20-0.89) and 0.59 (CI95% 0.37-0.93), respectively. Twenty-two percent perceived moderate-to-high current financial burden (≥4 points). PO survivors also reported higher mean financial burden than AN survivors (2.6 vs. 1.6, respectively; p = 0.002), but perceived burden comparably to TO survivors (2.3). Self-reported depression was associated with higher perceived financial burden (p < 0.001); surgical procedure history did not modify this relationship. Depression was reported frequently among these long-term RC survivors, particularly among PO survivors. Depression was associated with greater perception of financial burden. Screening for depression and assessing financial well-being might improve care among long-term RC survivors.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Quality of Working Life of cancer survivors: associations with health- and work-related variables.

    Science.gov (United States)

    de Jong, Merel; Tamminga, Sietske J; Frings-Dresen, Monique H W; de Boer, Angela G E M

    2017-05-01

    This study aimed to (1) describe the Quality of Working Life (QWL) of cancer survivors and (2) explore associations between the QWL of cancer survivors and health- and work-related variables. Employed and self-employed cancer survivors were recruited through hospitals and patient organizations. They completed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) and health- and work-related variables in this cross-sectional study. The QWL scores of cancer survivors were described, and associations between QWL and health- and work-related variables were assessed. The QWLQ-CS was completed by 302 cancer survivors (28% male) with a mean age of 52 ± 8 years. They were diagnosed between 0 and 10 years ago with various types of cancer, such as breast cancers, gastrointestinal cancers, urological cancers, and haematological cancers. The QWL mean score of cancer survivors was 75 ± 12 (0-100). Cancer survivors had statistically significant lower QWL scores when they had been treated with chemotherapy or when they reported co-morbidity (p ≤ 0.05). Cancer survivors without managerial positions, with low incomes or physically demanding work, and who worked a proportion of their contract hours had statistically significantly lower QWL scores (p ≤ 0.05). This study described the QWL of cancer survivors and associations between QWL and health- and work-related variables. Based on these variables, it is possible to indicate groups of cancer survivors who need more attention and support regarding QWL and work continuation.

  10. Chronic hepatitis C virus infection and neurocognitive function in adult survivors of childhood cancer.

    Science.gov (United States)

    Studaway, Adrienne; Ojha, Rohit P; Brinkman, Tara M; Zhang, Nan; Baassiri, Malek; Banerjee, Pia; Ehrhardt, Matthew J; Srivastava, Deokumar; Robison, Leslie L; Hudson, Melissa M; Krull, Kevin R

    2017-07-25

    Cancer survivors transfused with blood products before reliable screening for hepatitis C virus (HCV) are at risk for infection. This study examined the impact of HCV on neurocognitive function and health-related quality of life (HRQOL) among adult survivors of childhood cancer. Neurocognitive testing was conducted for 836 adult survivors of childhood cancer (mean age, 35 years [standard deviation, 7.4 years]; time since diagnosis, 29 years [standard deviation, 6.2 years]) who received blood products before universal HCV screening. No differences were observed between confirmed HCV-seropositive survivors (n = 79) and HCV-seronegative survivors (n = 757) in the primary diagnosis or neurotoxic therapies. Multivariate regression models were used to compare functional outcomes between seropositive and seronegative survivors. Compared with seronegative survivors, seropositive survivors demonstrated lower performance on measures of attention (P function (P = .001). After adjustments for sex, age at diagnosis, and treatment exposures, seropositive survivors had a higher prevalence of impairment in processing speed (prevalence ratio [PR], 1.3; 95% confidence interval [CI], 1.1-1.6) and executive functioning (PR, 1.3; 95% CI, 1.1-1.6). Differences were not associated with the treatment of HCV or the presence of liver cirrhosis. Seropositive survivors reported worse general HRQOL (PR, 1.6; 95% CI, 1.2-2.1), which was associated with the presence of liver cirrhosis (P = .001). Survivors of childhood cancer with a history of HCV infection are at risk for neurocognitive impairment and reduced HRQOL beyond the known risks associated with neurotoxic cancer therapies. Cancer 2017. © 2017 American Cancer Society. © 2017 American Cancer Society.

  11. Long-term health-related quality of life of stroke survivors and their spousal caregivers.

    Science.gov (United States)

    Godwin, Kyler M; Ostwald, Sharon K; Cron, Stanley G; Wasserman, Joan

    2013-06-01

    Because treatment for stroke has improved, individuals are living longer with the effects of a stroke. The resulting long-term impairment can affect both stroke survivors' and their caregivers' health-related quality of life (HRQOL). Few studies have examined the HRQOL of stroke survivors and their caregivers greater than 2 years poststroke. The stroke survivors and their spousal caregivers (n = 30 dyads) who had previously completed a 12-month study after discharge from inpatient rehabilitation were assessed at 3-5 years poststroke. The HRQOL and related outcomes were measured for stroke survivors and caregivers. Data from baseline to 12 months were used in conjunction with data from this study. Linear mixed models were used to analyze the change in repeated measures over time. Multiple linear regression was used to analyze the relationship of generic HRQOL to related psychosocial outcomes. The stroke survivors were an average of 4.68 years poststroke. The mean age for stroke survivors and caregivers was 70.8 and 64.9 years, respectively. Most stroke survivors were men (80%) and non-Hispanic White (70%). Among stroke survivors, depression decreased from baseline to 12 months (p = .04) but increased from 12 months to the end of follow-up (p = .003). The caregivers' depression decreased from baseline to all time points (p = .015). Stroke-specific HRQOL showed statistically significant (p caregivers' lower physical HRQOL score (p = .004). Higher depression was associated with lower mental HRQOL score for both caregivers and stroke survivors (p = .003 and p = .011, respectively). Both stroke survivors and caregivers continue to experience negative stroke-related health outcomes for many years after the initial stroke; some of these outcomes even worsen over time. These findings illustrate the need for ongoing psychological and medical evaluation for both long-term stroke survivors and caregivers. Development and testing of targeted behavioral interventions are also

  12. Risk of death among children of atomic bomb survivors after 62 years of follow-up: a cohort study.

    Science.gov (United States)

    Grant, Eric J; Furukawa, Kyoji; Sakata, Ritsu; Sugiyama, Hiromi; Sadakane, Atsuko; Takahashi, Ikuno; Utada, Mai; Shimizu, Yukiko; Ozasa, Kotaro

    2015-10-01

    No clear epidemiological hereditary effects of radiation exposure in human beings have been reported. However, no previous studies have investigated mortality into middle age in a population whose parents were exposed to substantial amounts of radiation before conception. We assessed mortality in children of the atomic bomb survivors after 62 years of follow-up. In this prospective cohort study, we assessed 75 327 singleton children of atomic bomb survivors in Hiroshima and Nagasaki and unexposed controls, born between 1946 and 1984, and followed up to Dec 31, 2009. Parental gonadal doses of radiation from the atomic bombings were the primary exposures. The primary endpoint was death due to cancer or non-cancer disease, based on death certificates. Median follow-up was 54·3 years (IQR 45·4-59·3). 5183 participants died from disease. The mean age of the 68 689 surviving children at the end of follow-up was 53·1 years (SD 7·9) with 15 623 (23%) older than age 60 years. For parents who were exposed to a non-zero gonadal dose of radiation, the mean dose was 264 mGy (SD 463). We detected no association between maternal gonadal radiation exposure and risk of death caused by cancer (hazard ratio [HR] for 1 Gy change in exposure 0·891 [95% CI 0·693-1·145]; p=0·36) or risk of death caused by non-cancer diseases (0·973 [0·849-1·115]; p=0·69). Likewise, paternal exposure had no effect on deaths caused by cancer (0·815 [0·614-1·083]; p=0·14) or deaths caused by non-cancer disease (1·103 [0·979-1·241]; p=0·12). Age or time between parental exposure and delivery had no effect on risk of death. Late effects of ionising radiation exposure include increased mortality risks, and models of the transgenerational effects of radiation exposure predict more genetic disease in the children of people exposed to radiation. However, children of people exposed to the atomic bombs in Hiroshima and Nagasaki had no indications of deleterious health effects after 62

  13. Quenched Reinforcement Exposed to Fire

    DEFF Research Database (Denmark)

    Hertz, Kristian Dahl

    2006-01-01

    Idealized data are derived for the tensile strength of quenched and tempered prestressing steel and of quenched and self-tempered reinforcing bars for fire safety design. 0.2% stresses are derived as a function of the maximum temperature and in addition, 2.0% stresses are provided. A strain of 2.......0% is seldom found in “slack” (not prestressed) reinforcement, but 2.0% stresses might be relevant for reinforcement in T shaped cross sections and for prestressed structures, where large strains can be applied. All data are provided in a “HOT” condition during a fire and in a “COLD” condition after a fire....... The COLD condition is relevant for analyses of residual load bearing capacity of a structure after a fire exposure. It is also relevant for analyses of concrete structures exposed to fully developed fire courses. The reason is that compression zones of concrete are always the weakest in the cooling phase...

  14. Advances in treating exposed fractures.

    Science.gov (United States)

    Nogueira Giglio, Pedro; Fogaça Cristante, Alexandre; Ricardo Pécora, José; Partezani Helito, Camilo; Lei Munhoz Lima, Ana Lucia; Dos Santos Silva, Jorge

    2015-01-01

    The management of exposed fractures has been discussed since ancient times and remains of great interest to present-day orthopedics and traumatology. These injuries are still a challenge. Infection and nonunion are feared complications. Aspects of the diagnosis, classification and initial management are discussed here. Early administration of antibiotics, surgical cleaning and meticulous debridement are essential. The systemic conditions of patients with multiple trauma and the local conditions of the limb affected need to be taken into consideration. Early skeletal stabilization is necessary. Definitive fixation should be considered when possible and provisional fixation methods should be used when necessary. Early closure should be the aim, and flaps can be used for this purpose.

  15. Quenched Reinforcement Exposed to Fire

    DEFF Research Database (Denmark)

    Hertz, Kristian Dahl

    2006-01-01

    Idealized data are derived for the tensile strength of quenched and tempered prestressing steel and of quenched and self-tempered reinforcing bars for fire safety design. 0.2% stresses are derived as a function of the maximum temperature and in addition, 2.0% stresses are provided. A strain of 2.......0% is seldom found in “slack” (not prestressed) reinforcement, but 2.0% stresses might be relevant for reinforcement in T shaped cross sections and for prestressed structures, where large strains can be applied. All data are provided in a “HOT” condition during a fire and in a “COLD” condition after a fire....... The COLD condition is relevant for analyses of residual load bearing capacity of a structure after a fire exposure. It is also relevant for analyses of concrete structures exposed to fully developed fire courses. The reason is that compression zones of concrete are always the weakest in the cooling phase...

  16. Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review: e66435

    National Research Council Canada - National Science Library

    Donald Edmondson; Safiya Richardson; Jennifer K Fausett; Louise Falzon; Virginia J Howard; Ian M Kronish

    2013-01-01

      Background and Purpose Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke and transient ischemic attack (TIA...

  17. Health Behaviors and Associated Sociodemographic Factors in Cervical Cancer Survivors Compared with Matched Non-Cancer Controls

    OpenAIRE

    Park, Boyoung; Kim, Se Ik; Seo, Sang-Soo; Kang, Sokbom; Park, Sang-yoon; Lim, Myong Cheol

    2016-01-01

    We explored the prevalence of smoking, alcohol consumption, physical activity, and obesity in cervical cancer survivors and examined associations between sociodemographic factors and each health behavior. We studied 448 cervical cancer survivors ≥2 years after their initial diagnosis who had completed treatment. The total sample consisted of these survivors, and 4,480 cancer-free controls who were grouped into 5-year age cohorts and matched to the survivors in terms of both education and mont...

  18. Physical resilience of older cancer survivors: An emerging concept.

    Science.gov (United States)

    Duan-Porter, Wei; Cohen, Harvey J; Demark-Wahnefried, Wendy; Sloane, Richard; Pendergast, Jane F; Snyder, Denise C; Morey, Miriam C

    2016-11-01

    To characterize factors contributing to physical resilience in older cancer survivors, as demonstrated by resistance to decline or recovery (resilience). We conducted a secondary analysis of data from a randomized controlled trial of cancer survivors ≥65years old and ≥5years from cancer diagnoses. Physical function was assessed quarterly over 2years, with Short-Form 36 physical function subscale. Participants with ≥2 follow-up assessments (n=594) were evaluated for physical resilience: 1) Resistance was defined as lack of any decline, where decline was a drop of ≥13 points, and 2) resilience (i.e., recovery) was defined as regaining ≥50% of lost function, subsequent to decline. Mean age was 73.1years and 89.1% were Caucasian. Forty-nine percent (n=289) were resistant to decline in function; these individuals were younger, had higher education and income, were more likely to be Caucasian, and had higher baseline physical function (mean difference [MD] 7.8 points, 95% CI 5.0-10.8) and general health (MD 7.5 points, 95% CI 4.9-10.1). Fifty-seven percent (n=137 of 239) demonstrated resilience, with 91.2% (n=125) recovering within 6months of declines; these participants had higher baseline physical function (MD 6.6 points, 95% CI 1.8-11.4), but similar pre-decline function. More participants who were resistant, and more who showed resilience, reported high self-efficacy and social support. The majority of older cancer survivors exhibited physical resilience; this was associated with high baseline health, physical function, self-efficacy, and social support. Assessing and targeting psychosocial factors may be important for interventions seeking to promote physical resilience. Published by Elsevier Ltd.

  19. Psychosocial aspects of survivors of childhood cancer or leukemia.

    Science.gov (United States)

    Massimo, L; Zarri, D; Caprino, D

    2005-12-01

    The majority of childhood cancer patients can expect nowadays to be cured and the percentage is now between 70% and 80%. The number of long-term survivors, off- threatment for at least 5 years, is rising rapidly and is becoming a new population, which needs a special care. It is becoming increasingly important to know how to prevent and treat the physical late effects as well as the psychosocial ones. The oldest among these patients are now in their 40's. How will their old age be like? Are they really cured? The aim of this study is to present a detailed survey of the literature on this topic as well as the authors' personal experience. Several techniques of psychological investigation for this population are highlighted. The semistructured interviews are mostly used for mono-institutional research, while the narrative dialogues are useful for small groups of patients. Questionnaires are usually conducted by epidemiologists for large groups of survivors. Tests are used for specific items such as defense mechanisms, self-esteem, relationships within the family, fear, and panic. The evaluation of the post-traumatic stress disorder is considered and the most important literature data are reported. It is also stressed the need of prevention of any type of psychosocial distress. In conclusion, most of the survivors appear to lead normal adult lives, to have obtained high school degrees, good jobs, and several have families and children. Nevertheless, a small percentage show some psychological or social problems, such as anxiety, depression, fear over the future or over relapse, a second primary, or sterility. The most vulnerable among them are females, people in poor financial conditions, the unemployed and those with poor educations.

  20. The perceived impact of downsizing and organisational transformation on survivors

    Directory of Open Access Journals (Sweden)

    N. Ndlovu

    2005-10-01

    Full Text Available Change is a way of life and the ability to manage change is a key factor in organisational survival and effectiveness. This article evaluates the ‘survivor syndrome’ and assesses the impact of the process of downsizing and transformation on communication, trust, survivor commitment and loyalty, morale and career advancement opportunities. The study was conducted using a stratified random sample of 361 employees/survivors in a branch of a motor manufacturer that had undergone major transformation. Data was collected using a self-developed questionnaire and analysed using descriptive and inferential statistics. The study generates a framework/model of critical change implementation factors and recommendations that will enable change managers to sense, adjust, respond and implement change timeously so as to gain strategic and competitive advantage. Opsomming Verandering is ’n lewenswyse en die vermoë om te verander is ’n kernaspek in organisasieverandering en -oorlewing. In hierdie artikel word die ‘oorlewingsindroom’ beoordeel en word die impak van die afskalingsproses en transformasie op kommunikasie, vertroue, ‘oorlewende’ toewyding en lojaliteit, moraal en loopbaanvorderingsgeleenthede takseer. Die studie is uitgevoer, met die gebruik van ’n gestratifiseerde ewekansige steekproef van 361 werknemers/’oorlewendes’ in ’n afdeling van ’n motorvervaardiger wat ingrypende transformasie ondergaan het. Data is ingesamel by wyse van ’n selfontwikkelde vraelys en ontleed aan die hand van beskrywende en inferensiële statistiek. Die studie het ’n raamwerk/model van kritieke veranderingsimplementeringsfaktore en aanbevelings gegenereer wat veranderingsbestuurders in staat sal stel om die gewaarwording, aanpassing, reaksie en implementering van verandering tydig te doen sodat strategiese en mededingingsvoordeel behaal kan word.

  1. Complementary Therapy for Cancer Survivors: Integrative Nursing Care

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2016-01-01

    Full Text Available Objective: The number of cancer patients who survive more than 5 years after the completion of their initial treatment is increasing. Oncology nurses must consider the needs of long-term cancer survivors in addition to those of cancer patients undergoing treatment because cancer survivors experience anxiety over several issues, including the risk of recurrence and progression of cancer status and symptom management. Methods: We tried to examine the effect of complementary therapy (CT to reduce anxiety. The experimental study compared an intervention group (5 males and 68 females that underwent four CTs and a control group (5 males and 56 females that received no intervention. The intervention group practiced the CTs in their home for 20 min/day, 2 days/week, for 8 weeks, for a total of 16 times, whereas the control group performed their usual routines. Stress response scale-18 (SRS-18 scores consisting of three subscales (depression-anxiety, temper-anger, and lethargy were compared between the groups and across time within each group. Results: The intervention group reduced depression and anxiety significantly than the control group. Furthermore, the intervention group expressed the following positive feedback: "being able to relax," "being distracted from their worries and anxieties," "being able to sleep," "feeling more in-touch with reality," and "wanting to continue the practice." Conclusions: The study might accurately reflect the perspectives of women with cancer because the majority of the patients were women. Meanwhile, the result suggests that CTs might be useful for long-term cancer survivors who experience anxiety that influence their quality of life.

  2. Black breast cancer survivors experience greater upper extremity disability.

    Science.gov (United States)

    Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

    2015-11-01

    Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95 % confidence interval 0.18-8.01) higher QuickDASH score (p = 0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

  3. Body Image in Younger Breast Cancer Survivors: A Systematic Review

    Science.gov (United States)

    Paterson, Carly; Lengacher, Cecile A.; Donovan, Kristine A.; Kip, Kevin E.; Tofthagen, Cindy S.

    2015-01-01

    Background Body image is a complex issue with the potential to impact many aspects of cancer survivorship, particularly for the younger breast cancer survivor. Objective The purpose of this review is to synthesize the current state of the science for body image in younger women with breast cancer. Intervention/Methods Combinations of the terms “body image,” “sexuality intervention,” “women,” “younger women,” and “breast cancer” were searched in the PubMed, PsycInfo, CINAHL, Web of Knowledge and Science Direct databases through January 2014. Inclusion criteria for this review were: 1) original research; 2) published in English from the year 2000 forward; 3) measuring body image as an outcome variable; and 4) results included reporting of age-related outcomes. Results Thirty-six articles met the inclusion criteria. The majority of studies were cross-sectional, with extensive variation in body image assessment tools. Age and treatment type had a significant impact on body image, and poorer body image was related to physical and psychological distress, sex and intimacy, and the partnered relationship among younger women. Only one intervention study found a significant improvement in body image post-intervention. Conclusions Findings suggest body image is a complex post-treatment concern for breast cancer survivors, particularly younger women. The findings of this review are limited by the high level of variation in the methods for assessing body image. Implications for Practice Further research of interventions to address body image concerns following treatment for breast cancer is warranted. Improvement of body image may improve the quality of life of younger breast cancer survivors. PMID:25881807

  4. Impact of Cardiovascular Counseling and Screening in Hodgkin Lymphoma Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Daniëls, Laurien A., E-mail: l.a.daniels@lumc.nl [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Krol, Stijn D.G. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Graaf, Michiel A. de [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Interuniversity Cardiology Institute of the Netherlands, Utrecht (Netherlands); Scholte, Arthur J.H.A. [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Veer, Mars B. van ' t [Department of Hematology, Leiden University Medical Center, Leiden (Netherlands); Putter, Hein [Department of Medical Statistics and Bio-informatics, Leiden University Medical Center, Leiden (Netherlands); Roos, Albert de [Department of Radiology, Leiden University Medical Center, Leiden (Netherlands); Schalij, Martin J. [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Poll-Franse, Lonneke V. van de [Research Department Comprehensive Cancer Center South, Eindhoven (Netherlands); Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg (Netherlands); Creutzberg, Carien L. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands)

    2014-09-01

    Purpose: Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction. Methods and Materials: Patients who participated in the screening study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening. Results: Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (P<.01). Differences were clinically relevant. There were no differences in perceived information between patients with and without screen-detected CVD. Conclusions: Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by

  5. Sixteen-year follow-up of childhood avalanche survivors

    Science.gov (United States)

    Thordardottir, Edda Bjork; Valdimarsdottir, Unnur Anna; Hansdottir, Ingunn; Hauksdóttir, Arna; Dyregrov, Atle; Shipherd, Jillian C.; Elklit, Ask; Resnick, Heidi; Gudmundsdottir, Berglind

    2016-01-01

    Background Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures. Objective Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood. Methods Childhood survivors (aged 2–19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis. Results Response rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, punemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma. Conclusions Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms. Highlights of the article PTSD symptoms following avalanche exposure during childhood were associated with poorer socioeconomic status in adulthood. Lack of social support and traumatic reactions of caregivers in the aftermath of avalanches predicted PTSD symptoms among childhood

  6. Sexual Abuse Survivors' Perceptions of the Effectiveness of EMDR and Eclectic Therapy

    Science.gov (United States)

    Edmond, Tonya; Sloan, Lacey; McCarty, Dawn

    2004-01-01

    Objective: This article examines survivor perspectives of the effectiveness of two different treatments for trauma symptoms among adult female survivors of childhood sexual abuse--Eye movement Desensitization and Reprocessing (EMDR) and eclectic therapy. Method: Qualitative interviews obtained in the context of a mixed-methods study were conducted…

  7. Hospital contact for mental disorders in survivors of childhood cancer and their siblings in Denmark

    DEFF Research Database (Denmark)

    Lund, Lasse Wegener; Winther, Jeanette; Dalton, Susanne Oksbjerg

    2013-01-01

    Survivors of childhood cancer are known to be at risk for long-term physical and mental effects. However, little is known about how cancers can affect mental health in the siblings of these patients. We aimed to assess the long-term risks of mental disorders in survivors of childhood cancer...

  8. Body image in cancer survivors : a systematic review of case-control studies

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariët; Tuinman, Marrit A

    2014-01-01

    PURPOSE: There is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether

  9. Enhancing Employment Outcomes for Survivors of Intimate Partner Violence: A Developmental Work Personality Perspective

    Science.gov (United States)

    Keim, Jeanmarie; Strauser, David R.; Olguin, David L.

    2009-01-01

    Rates of intimate partner violence (IPV) are high. Many survivors elect to leave abusive relationships and seek treatment to address the abusive cycle and psychiatric symptoms that may result. Programs to assist survivors often include an employment component. This article discusses the use of the Developmental Work Personality Scale (D. R.…

  10. Body image in cancer survivors : a systematic review of case-control studies

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariet; Tuinman, Marrit A.

    2015-01-01

    There is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether body ima

  11. 20 CFR 225.22 - Employee RIB PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Employee RIB PIA used in survivor annuities... Amount of the Residual Lump-Sum Payable § 225.22 Employee RIB PIA used in survivor annuities. The Employee Retirement Insurance Benefit PIA (Employee RIB PIA) is used to compute the employee RIB amount...

  12. Health Promotion for Adolescent Childhood Leukemia Survivors: Building on Prevention Science and eHealth

    OpenAIRE

    Elliot, Diane L.; Lindemulder, Susan J; Goldberg, Linn; Stadler, Diane D.; Smith, Jennifer

    2012-01-01

    Teenage survivors of childhood acute lymphoblastic leukemia (ALL) have increased morbidity likely due to their prior multicomponent treatment. Habits established in adolescence can impact individuals’ subsequent adult behaviors. Accordingly, healthy lifestyles, avoiding harmful actions, and appropriate disease surveillance are of heightened importance among teenage survivors. We review the findings from prevention science and their relevance to heath promotion. The capabilities and current us...

  13. Long-term cardiac follow-up in survivors of a malignant bone tumour

    NARCIS (Netherlands)

    Brouwer, C. A. J.; Gietema, J. A.; van den Berg, M. P.; Bink-Boelkens, M. T. E.; Elzenga, N. J.; Haaksma, J.; Kamps, W. A.; Vonk, J. M.; de Vries, E. G. E.; Postma, A.

    2006-01-01

    Background: Longitudinal studies of cardiac function in long-term childhood cancer survivors are scarce and frequently concern a median follow-up shorter than 13 years. Patients and methods: Cardiac assessment was performed in 22 doxorubicin-treated long-term survivors of a malignant bone tumour at

  14. Identification and evaluation of the salient physical activity beliefs of colorectal cancer survivors.

    Science.gov (United States)

    Speed-Andrews, Amy E; McGowan, Erin L; Rhodes, Ryan E; Blanchard, Chris M; Culos-Reed, S Nicole; Friedenreich, Christine M; Courneya, Kerry S

    2014-01-01

    Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.

  15. Relational Factors Associated with Depressive Symptoms among Stroke Survivor-Spouse Dyads

    Science.gov (United States)

    McCarthy, Michael J.; Lyons, Karen S.; Powers, Laurie E.

    2012-01-01

    Depression following stroke is a major problem for survivors and spouses, but few studies have focused on the experiences of couples. This study investigates associations between perceived relationship quality, communication and coping patterns, interpersonal misunderstandings and expectations, and survivors' and spouses' depressive symptoms after…

  16. Outcome and status of microsatellite stability in Japanese atomic bomb survivors with early gastric carcinoma.

    Science.gov (United States)

    Yamamoto, Manabu; Taguchi, Kenichi; Yamanaka, Takeharu; Matsuyama, Ayumi; Yoshinaga, Keiji; Tsutsui, Shinichi; Ishida, Teruyoshi

    2013-03-01

    In the decade after the 1945 atomic bombing of Hiroshima, a high incidence of leukemia was observed among atomic bomb survivors. However, the incidence of other cancers gradually increased, while that of leukemia decreased after this period. We evaluated the clinical outcome of early gastric cancer and microsatellite stability over a long-term period in atomic bomb survivors. The results of surgical treatment for early gastric cancer were reviewed for 117 atomic bomb survivors and 394 control patients between 1995 and 2006. In addition, immunohistochemical staining for hMSH2 and hMLH1 expression was performed to evaluate the status of microsatellite stability in 57 atomic bomb survivors and 82 control patients. The long-term survival rate for early gastric cancer in atomic bomb survivors was significantly lower than that in control patients (p atomic bomb survivorship was related to defective hMSH2 and/or hMLH1 expression. The prognosis of early gastric cancer in atomic bomb survivors was poor and was related to age and sex, rather than to being an atomic bomb survivor. Furthermore, a higher rate of defective hMSH2 and/or hMLH1 expression was observed in the survivors.

  17. The long-term outcome of atomic bomb survivors with gastric carcinoma.

    Science.gov (United States)

    Yamamoto, Manabu; Matsuyama, Ayumi; Kameyama, Toshifumi; Okamoto, Masahiro; Okazaki, Jin; Utsunomiya, Tohru; Tsutsui, Shinichi; Ishida, Teruyoshi

    2009-12-01

    During the decade following the 1945 atomic bombing of Hiroshima, a high incidence of leukemia was observed among atomic bomb survivors. Subsequently, the incidence of other cancers gradually increased while that of leukemia decreased. We examined the long-term clinical outcome of gastric cancer and second primary cancer in atomic bomb survivors. Results of surgical treatment of gastric cancer were reviewed in 231 atomic bomb survivors and 759 control patients between 1995 and 2006. Long-term prognosis of gastric cancer in atomic bomb survivors was significantly poorer than that in control patients (P < 0.05). In a multivariate analysis, age, depth of tumor invasion, lymph node metastases, and curability were found to be significant and independent prognostic factors for gastric cancer. The incidence of second primary cancer after gastric cancer was significantly higher in survivors than in control patients (P < 0.01), because the number of elderly patients in the survivors was higher. Gastric cancer in survivors had a significantly poorer prognosis. Although the frequency of second primary cancer after gastric cancer in survivors was higher than that in control patients, it did not influence the prognosis.

  18. Physical symptoms that are frequently unexplained among survivors of the Enschede fireworks disaster

    NARCIS (Netherlands)

    Berg, B. van den

    2007-01-01

    Most studies after disasters have focused on mental health problems such as post-traumatic stress disorder (PTSD), depression and anxiety among survivors. Besides mental health problems, survivors may develop physical health symptoms that are frequently unexplained such as headache, fatigue and stom

  19. Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors.

    Science.gov (United States)

    Forbes, Cynthia C; Blanchard, Chris M; Mummery, W Kerry; Courneya, Kerry

    2015-03-01

    To identify and compare the prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors.
 Cross-sectional, descriptive survey.
 Nova Scotia, Canada.
 741 breast, prostate, and colorectal cancer survivors.
. A stratified sample of 2,063 breast, prostate, and colorectal cancer survivors diagnosed from 2003-2011 were identified and mailed a questionnaire. Descriptive, chi-square, and logistic regression analyses were used to determine any correlations among the main research variables. 
 Strength exercise behavior; medical, demographic, and motivational correlates using the Theory of Planned Behavior.
 Of 741 respondents, 23% were meeting the strength exercise guidelines of two or more days per week. Cancer survivors were more likely to meet guidelines if they were younger, more educated, had a higher income, better perceived general health, fewer than two comorbidities, and a healthy body weight. In addition, those meeting guidelines had significantly more favorable affective attitude, instrumental attitude, injunctive norm, perceived behavioral control, planning, and intention. The correlates of strength exercise did not differ by cancer site.
 The prevalence of strength exercise is low among breast, prostate, and colorectal cancer survivors in Nova Scotia and the correlates are consistent across those survivor groups. 
. Nurses should take an active role in promoting strength exercise among cancer survivors using the Theory of Planned Behavior, particularly among those survivors at higher risk of not performing strength exercise. 


  20. Physical Activity and Sedentary Behavior in Breast and Colon Cancer Survivors Relative to Adults Without Cancer.

    Science.gov (United States)

    Shi, Joyce W; MacInnis, Robert J; Boyle, Terry; Vallance, Jeff K; Winkler, Elisabeth A H; Lynch, Brigid M

    2017-03-01

    To assess differences in accelerometer-assessed moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity, and sedentary time between cancer survivors and adults without cancer. Accelerometer data collected from 241 breast cancer survivors (ACCEL-Breast study, 2013) and 171 colon cancer survivors (ACCEL-Colon study, 2012-2013) were pooled with data collected from adults without cancer (Australian Diabetes, Obesity and Lifestyle accelerometer substudy, 2011-2012). Linear regression was used to estimate differences in physical activity and sedentary behavior levels between cancer survivors and adults without cancer, adjusted for potential confounding factors. The mean MVPA was significantly higher among breast cancer survivors than among females who had not had cancer (29 vs 22 min/d; PColon cancer survivors had significantly lower levels of light activity than did adults without cancer (311 vs 338 min/d; Pcancer survivors engaged in more (breast) or equivalent (colon) MVPA compared with adults without cancer. Differences between colon cancer survivors and adults without cancer for light activity and sedentary behavior highlight the importance of considering the full activity spectrum in the context of cancer control. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  1. Ebola Virus RNA in Semen from an HIV-Positive Survivor of Ebola

    Science.gov (United States)

    Rogers, Emerson; Baller, April; White, Stephen; Soka, Moses; Choi, Mary J.; Mahmoud, Nuha; Wasunna, Christine; Massaquoi, Moses; Kollie, Jomah; Dweh, Straker; Bemah, Philip; Ladele, Victor; Kpaka, Jonathan; Jawara, Mary; Mugisha, Margaret; Subah, Onyekachi; Faikai, Mylene; Bailey, Jeff A.; Rollin, Pierre; Marston, Barbara; Nyenswah, Tolbert; Gasasira, Alex; Knust, Barbara; Nichol, Stuart; Williams, Desmond

    2017-01-01

    Ebola virus is known to persist in semen of male survivors of Ebola virus disease (EVD). However, maximum duration of, or risk factors for, virus persistence are unknown. We report an EVD survivor with preexisting HIV infection, whose semen was positive for Ebola virus RNA 565 days after recovery from EVD. PMID:28287374

  2. Quality of Working Life of cancer survivors : Development and evaluation of a measurement instrument

    NARCIS (Netherlands)

    de Jong, M.

    2016-01-01

    Cancer survivors can experience difficulties in return-to-work or work continuation. Current outcomes in research describing the working life of cancer survivors offer little insight into cancer survivors’ experiences and perceptions of work, that is to say, the Quality of Working Life (QWL) of canc

  3. Examining Burnout and Engagement in Layoff Survivors: The Role of Personal Strengths

    Science.gov (United States)

    Cotter, Elizabeth W.; Fouad, Nadya A.

    2013-01-01

    This study investigates burnout and work engagement in layoff survivors. Layoff survivors are defined as individuals who remain working at organizations that have recently had layoffs. Job demands (job insecurity and work overload) and job and personal resources (social support, optimism, career adaptability, and career management self-efficacy)…

  4. Finding Your New Normal: Outcomes of a Wellness-Oriented Psychoeducational Support Group for Cancer Survivors

    Science.gov (United States)

    Shannonhouse, Laura; Myers, Jane; Barden, Sejal; Clarke, Philip; Weimann, Rochelle; Forti, Allison; Moore-Painter, Terry; Knutson, Tami; Porter, Michael

    2014-01-01

    Group interventions have been useful for survivors to overcome the challenges of cancer. This study employed a pre/post, mixed-methods design to explore the influence of an 8-week support group on the holistic wellness of 14 breast cancer survivors. Pairing experiential activities with wellness-centered psychoeducation was viewed positively by…

  5. 75 FR 20893 - National Day of Service and Remembrance for Victims and Survivors of Terrorism, 2010

    Science.gov (United States)

    2010-04-21

    ... and Survivors of Terrorism, 2010 By the President of the United States of America A Proclamation There... Remembrance for Victims and Survivors of Terrorism, we pause to remember victims of terrorism at home and... terrorism and their families, though bound at first by anguish and loss, are united by extraordinary acts of...

  6. Perceived causes of prostate cancer among prostate cancer survivors in the Netherlands

    NARCIS (Netherlands)

    Kok, D.E.G.; Cremers, R.G.H.M.; Aben, K.K.H.; Oort, van I.M.; Kampman, E.; Kiemeney, L.A.L.M.

    2013-01-01

    Introduction The aim of this study was to evaluate self-reported causes of prostate cancer among prostate cancer survivors in the Netherlands to obtain insight into the common beliefs and perceptions of risk factors for prostate cancer. Materials and methods A total of 956 prostate cancer survivors,

  7. Predictors of adherence to an Iyengar yoga program in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Amy E Speed-Andrews

    2012-01-01

    Conclusions: Adherence to Iyengar yoga in breast cancer survivors was strongly related to motivational variables from the theory of planned behaviour. Researchers attempting to improve yoga adherence in breast cancer survivors may benefit from targeting the key constructs in the theory of planned behaviour.

  8. 20 CFR 225.36 - Effect of DRC's on survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Effect of DRC's on survivor annuities. 225.36... PRIMARY INSURANCE AMOUNT DETERMINATIONS Delayed Retirement Credits § 225.36 Effect of DRC's on survivor... surviving divorced spouse annuity. All DRC's, including credits earned in the year of death, can be used...

  9. Common Themes in the Experiences of Mother-Daughter Incest Survivors: Implications for Counseling.

    Science.gov (United States)

    Ogilvie, Beverly; Daniluk, Judith

    1995-01-01

    Studied mother-daughter incest. Common themes were extracted from in-depth interviews with survivors of mother-perpetrated sexual abuse, some of which parallel the experience of survivors of other forms of child sexual abuse, and some of which are more specific to mother-daughter incest. Discusses themes and counseling implications. (JBJ)

  10. Quality of life in ovarian cancer survivors: the influence of obesity

    NARCIS (Netherlands)

    Smits, A.; Lopes, A.; Das, N.; Bekkers, R.L.; Galaal, K.

    2015-01-01

    OBJECTIVE: In this study, we evaluated the effect of body mass index (BMI) on the quality of life of ovarian cancer survivors. METHODS: Women diagnosed with ovarian cancer at the Royal Cornwall Hospital Trust between January 2008 and May 2013 were identified. Ovarian cancer survivors were invited to

  11. Scope of Justice in the Workplace: How Survivors React to Co-Worker Layoffs.

    Science.gov (United States)

    Brockner, Joel

    1990-01-01

    Explores the effects of layoffs on work behavior and attitude of employees not laid off. Study results indicate that survivors become more withdrawn from their jobs if they believe management handled the layoff unfairly, and these tendencies are more evident if layoff victims were included in survivors' scope of justice. (JS)

  12. Survivors' Reactions to Layoffs: We Get By with a Little Help for Our Friends.

    Science.gov (United States)

    Brockner, Joel; And Others

    1987-01-01

    Describes a multimethod approach to investigating survivors' reactions after a job layoff has occurred. The study hypothesized that survivors would exhibit the most negative reactions when they identified with the layoff victims and when they felt these victims had been poorly compensated. Results corroborate this basic justice theory. Includes 18…

  13. Group Work with Survivors of the 2004 Asian Tsunami: Reflections of an American-Trained Counselor

    Science.gov (United States)

    Fernando, Delini M.

    2009-01-01

    This article describes a support group for Sri Lankan women survivors of the 2004 Asian Tsunami. The article discusses unique leader challenges in doing group work in a diverse and foreign setting, and presents leader reflections, recommendations, and implications for group workers who may work with disaster survivors.

  14. Final height and IGF1 in adult survivors of Wilms tumour

    NARCIS (Netherlands)

    K. Blijdorp (Karin); M.M. van den Heuvel-Eibrink (Marry); R. Pieters (Rob); S. Pluijm (Saskia); A. Wagner (Anja); H. Segers (Heidi); A-J. van der Lely (Aart-Jan); S.J.C.M.M. Neggers (Bas)

    2013-01-01

    textabstractObjective: One-sided nephrectomy is followed by increased levels of IGF1, associated with linear growth during childhood. The aim was to evaluate final height and IGF1 levels in nephrectomized Wilms tumour survivors when compared with healthy Dutch references and survivors of other cance

  15. 20 CFR 225.23 - Combined Earnings PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Combined Earnings PIA used in survivor... RAILROAD RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.23 Combined Earnings PIA used in...

  16. 20 CFR 410.456 - Determining origin of pneumoconiosis, including statutory presumption-survivor's claim.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Determining origin of pneumoconiosis, including statutory presumption-survivor's claim. 410.456 Section 410.456 Employees' Benefits SOCIAL..., including statutory presumption—survivor's claim. (a) If a miner was employed for 10 years or more in...

  17. 5 CFR 841.707 - COLA's affecting computation of survivor supplements.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false COLA's affecting computation of survivor supplements. 841.707 Section 841.707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... Adjustments § 841.707 COLA's affecting computation of survivor supplements. For purposes of computing...

  18. 5 CFR 841.703 - Increases on basic annuities and survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Increases on basic annuities and survivor... Adjustments § 841.703 Increases on basic annuities and survivor annuities. (a) Except as provided in §§ 841.704, 841.706, and 841.707, and paragraph (e) of this section, COLA's on basic annuities and...

  19. Constructing the meaning of survivor with former pediatric brain tumor patients.

    Science.gov (United States)

    Zwiers, Angela; Campbell, Craig; Evans, Marilyn; Kirkwood, Ken

    2015-01-01

    Although the term survivor is frequently used in cancer discourse, the meaning of survivor and how people identify with this term can be difficult to understand. The purpose of this qualitative study is to explore the meaning of the term survivor from the perspective of young adults who have experienced a pediatric brain tumor (PBT). A constructivist grounded theory was utilized in this study with 6 young adults who had a PBT. This study also used semistructured interviews with participants who also completed reflective journals, which were focused on the survivor concept. Data were analyzed through coding strategies and constant comparative methods. Findings present 4 major themes of process: (a) reviewing the illness experience, (b) qualifying as a survivor, (c) thinking positive, and (d) being changed. These themes are important to consider in the construction, interpretation, and understanding of how the majority of this population do not identify with the current social use of the term survivor. Clearly, there is a need for a clearer understanding of survivor and how it specifically applies to those who have had a PBT. Everyone should remain conscious and consider how a broad, generalizing term such as survivor may influence a person's attitude and advocacy toward their health.

  20. The Aftermath of Road Trauma: Survivors' Perceptions of Trauma and Growth

    Science.gov (United States)

    Harms, Louise; Talbot, Michelle

    2007-01-01

    For many survivors of serious road trauma, the physical and psychological consequences are complex and lifelong. The longer-term psychosocial recovery experience for survivors, however, is rarely documented in the social work literature. This article reports on findings from a study of road trauma recovery experiences. The findings are presented…