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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. 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.)

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.).

  12. 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.)

  13. 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.)

  14. 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.

  15. 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.

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

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    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.

  17. Proceedings of 42nd Research Society for the Late Effects of the A-Bomb

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    Sasaki, Hideo [Hiroshima Atomic Bomb Casualty Council Health Management and Promotion Center (Japan); Nakane, Yoshibumi [Nagasaki Univ. Graduate School of Bio-medicine (Japan); Suzuki, Gen [Radiation Effect Research Foundation, Hiroshima (JP)] [and others

    2002-03-01

    This issue is the collection of study papers presented in the meeting in the title: the special review lecture concerning the epidemiological evidences of multiple myeloma examination in A-bomb survivors (12-year study), the symposium concerning the medical care of A-bomb survivors in 21st century (5 presentations of medical care for the aged survivors, psychiatric approach and psychological care, future clinical studies and survivors' children in RERF, epidemiological study on the late effect of A-bomb radiation, and international cooperation of medical care in Semipalatinsk), and 51 general presentations. The general presentations included 1 article concerning external dose estimation in Ust-Kamenogorsk city, 7, the health care and management of the survivors, 9, cancer and its risk assessment (lung, uterine, stomach, liver and bone marrow), 1, arteriosclerosis, 10, health physics studies in relation to Semipalatinsk and/or Chernobyl (mainly on thyroid cancer), 2, experimental animal studies of thyroid cancer and malformation, 9, genomic studies like gene rearrangement, REV1 SNPs, function analysis and regeneration medicine, and 12, histological and cytological studies concerning DNA/RNA extraction, gene expression, signal transduction and immune system. (K.H.)

  18. Health survey of atomic bomb survivors in South Korea

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    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.).

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

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    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.

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

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    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

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

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

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    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.

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

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

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    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.).

  5. Foreign bodies radiographically-demonstrated in atomic bomb survivors

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    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.

  6. Details of Nazis' A-Bomb program surface

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    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).

  7. 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.)

  8. 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.

  9. 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

  10. 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.

  11. 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.).

  12. 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.

  13. 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

  14. 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).

  15. 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…

  16. 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....

  17. 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 ...

  18. 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...

  19. 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.

  20. 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.

  1. 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....

  2. 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.

  3. 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

  4. 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)...

  5. 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...

  6. 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 ...

  7. 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

  8. 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 ...

  9. 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…

  10. 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...

  11. 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...

  12. 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,...

  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. 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...

  15. 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...

  16. 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...

  17. 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)

  18. 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....

  19. 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...

  20. 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…

  1. 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

  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. 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.

  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. Rape Survivors' Agency within the Legal and Medical Systems

    Science.gov (United States)

    Greeson, Megan R.; Campbell, Rebecca

    2011-01-01

    Many rape survivors seek help from the legal and medical systems post-assault. Previous studies have examined how social system personnel treat survivors, but less attention has been paid to how survivors attempt to shape their interactions with these systems. The purpose of this qualitative study was to examine rape survivors' agency--the active…

  10. 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.

  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. 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...

  13. 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)

  14. 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 ...

  15. 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

  16. 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....

  17. 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.

  18. Development of the Cancer Survivor Profile

    Science.gov (United States)

    2014-05-09

    Assessment among breast cancer survivors. Oncology 70:190-202 6. Alhola P, Polo-Kantola P. 2007. Sleep deprivation : Impact on cognitive performance ...MEDICAL AND CLINICAL PSYCHOLOGY GRADUATE PROGRAM Name of Student : Briana Todd Date of Examination: May 9, 2014 Time: 9 :00am Place: G252 DECISION OF...million breast cancer survivors in the United States alone and 6.3 internationally (111; 393). The late and long-term effects of cancer and its treatment

  19. 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

    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...... 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....

  20. 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.

  1. 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

  2. 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...... 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...

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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 ...

  8. 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.

  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. 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...

  11. 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...

  12. 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...

  13. 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,...

  14. 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...

  15. 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.…

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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…

  1. 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…

  2. 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)

  3. 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

  4. 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

  5. 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…

  6. 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.

  7. 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,…

  8. 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,…

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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...

  17. 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.

  18. 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.

  19. Life satisfaction in adult survivors of childhood brain tumors.

    Science.gov (United States)

    Crom, Deborah B; Li, Zhenghong; Brinkman, Tara M; Hudson, Melissa M; Armstrong, Gregory T; Neglia, Joseph; Ness, Kirsten K

    2014-01-01

    Adult survivors of childhood brain tumors experience multiple, significant, lifelong deficits as a consequence of their malignancy and therapy. Current survivorship literature documents the substantial impact such impairments have on survivors' physical health and quality of life. Psychosocial reports detail educational, cognitive, and emotional limitations characterizing survivors as especially fragile, often incompetent, and unreliable in evaluating their circumstances. Anecdotal data suggest some survivors report life experiences similar to those of healthy controls. The aim of our investigation was to determine whether life satisfaction in adult survivors of childhood brain tumors differs from that of healthy controls and to identify potential predictors of life satisfaction in survivors. This cross-sectional study compared 78 brain tumor survivors with population-based matched controls. Chi-square tests, t tests, and linear regression models were used to investigate patterns of life satisfaction and identify potential correlates. Results indicated that life satisfaction of adult survivors of childhood brain tumors was similar to that of healthy controls. Survivors' general health expectations emerged as the primary correlate of life satisfaction. Understanding life satisfaction as an important variable will optimize the design of strategies to enhance participation in follow-up care, reduce suffering, and optimize quality of life in this vulnerable population.

  20. 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

  1. 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...

  2. 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.

  3. 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…

  4. 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

  5. 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…

  6. 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…

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  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. 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.

  18. 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.

  19. 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.

  20. 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 ...

  1. 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 ...

  2. 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...

  3. 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

  4. 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 ...

  5. 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.

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. "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 ...

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  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. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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....

  7. 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

  8. 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

    2015-12-01

    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.

  9. 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.

  10. 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...... at ages 15 to 39 years (1943-2009) and alive in 1977; from the Danish Civil Registration System, we randomly selected a comparison cohort of the same age and sex. Subjects were linked to the Danish Patient Register, and observed numbers of first hospitalizations for cardiovascular disease (International......-sided. RESULTS: During follow-up, 10591 survivors (24.5%) were discharged from the hospital with cardiovascular disease, whereas 8124 were expected (RR = 1.30; 95% confidence interval [CI)] = 1.28 to 1.33; P cardiovascular disease per 100000...

  11. 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.

  12. 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...

  13. 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

  14. 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.

  15. 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…

  16. 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 §...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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,...

  5. 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...

  6. 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....

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  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... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.22 Employee RIB PIA used in survivor annuities....

  12. 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...

  13. 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...

  14. 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…

  15. 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…

  16. 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

  17. 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…

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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…

  5. 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…

  6. Informal Caregiver Burden among Survivors of Prolonged Mechanical Ventilation

    OpenAIRE

    Van Pelt, David C.; Milbrandt, Eric B; Qin, Li; Weissfeld, Lisa A.; Rotondi, Armando J.; Schulz, Richard; Chelluri, Lakshmipathi; Angus, Derek C.; Michael R. Pinsky

    2006-01-01

    Rationale: Although caregiver burden is well described in chronic illness, few studies have examined burden among caregivers of survivors of critical illness. In existing studies, it is unclear whether the observed burden is a consequence of critical illness or of preexisting patient illness.

  7. 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

  8. 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,…

  9. 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

  10. 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

  11. 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

  12. 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…

  13. 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)

  14. 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…

  15. 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…

  16. "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…

  17. 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

  18. 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.…

  19. 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.

  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 lifestyl

  1. 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…

  2. 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

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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…

  12. 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

  13. 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...

  14. 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.

  15. Cancer survivors' experience of exercise-based cancer rehabilitation

    DEFF Research Database (Denmark)

    Midtgaard, Julie; Hammer, Nanna Maria; Andersen, Christina

    2015-01-01

    BACKGROUND: Evidence for the safety and benefits of exercise training as a therapeutic and rehabilitative intervention for cancer survivors is accumulating. However, whereas the evidence for the efficacy of exercise training has been established in several meta-analyses, synthesis of qualitative......, age 28-76 years) exclusively reporting experiences of participation in structured, supervised exercise training resulted in nine themes condensed into three categories: 1) emergence of continuity; 2) preservation of health; and 3) reclaiming the body reflecting the benefits of exercise...... research is lacking. In order to extend healthcare professionals' understanding of the meaningfulness of exercise in cancer survivorship care, this paper aims to identify, appraise and synthesize qualitative studies on cancer survivors' experience of participation in exercise-based rehabilitation. MATERIAL...

  16. 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. The supp......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....... The support was centered on (1) providing information; (2) facilitating social regulation of emotions; (3) supporting a social support network for the patient; (4) focusing coping efforts; and (5) normalization of reactions. Finally it is described how the crisis made values of caring, compassion...

  17. 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.

  18. 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.

  19. 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.

  20. 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.)

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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...

  9. 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...

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  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. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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 ...

  4. 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.

  5. 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.

  6. 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...

  7. 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.

  8. 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....

  9. 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...

  10. 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...

  11. 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...

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. Childhood pheochromocytoma in a survivor of central primitive neuroectodermal tumor.

    Science.gov (United States)

    Nakano, Yoshiko; Fujimaru, Rika; Ishii, Keiichi; Sakamoto, Hiroaki; Inoue, Takeshi; Sako, Masahiro; Yamada, Hiroshi

    2013-08-01

    Pheochromocytoma and central nervous system primitive neuroectodermal tumor are both neural crest-derived tumors. The former is usually benign and develops mainly in adulthood and the latter brain tumor mainly occurs in childhood and has a poor prognosis. We report a case of a 15-year-old boy who developed pheochromocytoma after more than 10 years of complete remission of central primitive neuroectodermal tumor. Thus far, there have been no reports of childhood cancer survivors who developed pheochromocytoma. This quite rare occurrence of two tumors in a single patient may imply some unidentified linkage or common genetic background.

  5. Breast cancer fear in African American breast cancer survivors.

    Science.gov (United States)

    Gibson, Lynette M; Thomas, Sheila; Parker, Veronica; Mayo, Rachel; Wetsel, Margaret Ann

    2014-01-01

    The purpose of this study was to describe breast cancer fear according to phase of survivorship, determine whether breast cancer fear levels differed among survivorship phases, and determine the relationship between fear and age in African-American breast cancer survivors. The study utilized secondary data analysis from the study, Inner Resources as Predictors of Psychological Well-Being in AABCS. A new subscale entitled, "Breast Cancer Fear" was adapted from the Psychological Well Being Subscale by Ferrell and Grant. There was no significant difference between fear and phase of survivorship. There was a significant positive relationship between age and fear.

  6. The cancer empowerment questionnaire: psychological empowerment in breast cancer survivors.

    Science.gov (United States)

    van den Berg, Sanne W; van Amstel, Floortje K Ploos; Ottevanger, Petronella B; Gielissen, Marieke F M; Prins, Judith B

    2013-01-01

    New models of cancer care and survivorship ask for empowered patients. But how do we measure that patients can derive strength from themselves (intrapersonal) and their perceived social support (interpersonal)? The 40-item Cancer Empowerment Questionnaire (CEQ) measures psychological empowerment as an individual outcome measure. The CEQ was validated in 140 nonmetastatic female breast cancer survivors (mean 5.5 years postsurgery). Principal component analysis elicited four factors representing intrapersonal (personal strength) and interpersonal (social support, community, health care) aspects of empowerment. The CEQ provides a reliable (Cronbach's α=0.73-0.94) and valid first attempt to operationalize psychological empowerment in cancer care.

  7. Skin Cancer Surveillance Behaviors Among Childhood Cancer Survivors.

    Science.gov (United States)

    Stapleton, Jerod L; Tatum, Kristina L; Devine, Katie A; Stephens, Sue; Masterson, Margaret; Baig, Amna; Hudson, Shawna V; Coups, Elliot J

    2016-03-01

    The risk of developing skin cancer is elevated among childhood cancer survivors (CCS), particularly among those treated with radiation. This survey study examined the skin cancer surveillance behaviors of 94 CCS. Approximately 48% of CCS had ever conducted skin self-examination (SSE) and 31% had ever received a physician skin examination. Rates of physician skin examination were 2.5 times higher among CCS treated with radiation compared to those without radiation. However, rates of SSEs did not differ based on treatment history. These findings highlight the need to promote skin cancer surveillance as an important aspect of CCS survivorship care.

  8. 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…

  9. 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

  10. 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.

  11. Relational Challenges and Recovery Processes in Male Survivors of Childhood Sexual Abuse

    Science.gov (United States)

    Kia-Keating, Maryam; Sorsoli, Lynn; Grossman, Frances K.

    2010-01-01

    Male survivors of childhood sexual abuse face challenges resolving sexual victimization experiences with the ideals of masculinity, often experiencing intimacy problems, emotional discomfort, alienation, and anger. Little attention has been paid to how male survivors learn to develop long-term connections, disclose emotions in relationship…

  12. 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)…

  13. Coping with the Murder of a Loved One: Counseling Survivors of Murder Victims in Groups

    Science.gov (United States)

    Miranda, Alexis O.; Molina, Bogusia; MacVane, Sandi L.

    2003-01-01

    The survival of the murder of a loved one is a psychologically taxing process. Survivors of murder victims experience stressors that originate from the exigencies of the interpersonal, situational, and the criminal justice system domains. Group facilitators must be aware of the experiences and the mental health dynamics common to survivors, the…

  14. 26 CFR 11.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Qualified joint and survivor annuities. 11.401... SECURITY ACT OF 1974 § 11.401(a)-11 Qualified joint and survivor annuities. (a) In general—(1) General rule... provides that these benefits must be paid in a form having the effect of a qualified joint and...

  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. Sequelae and Other Conditions in Ebola Virus Disease Survivors, Sierra Leone, 2015

    Science.gov (United States)

    Vandy, Alren O.; Stretch, Rebecca; Otieno, David; Prajapati, Mukesh; Calderon, Mauricio; Vandi, Mohamed

    2017-01-01

    We rapidly assessed the health of Ebola virus disease (EVD) survivors in Kenema, Sierra Leone, by reviewing medical charts of all patients attending the Survivor Clinic of Kenema Government Hospital. Data were abstracted on signs and symptoms at every attendance. As of November 2015, a total of 621 attendances by 115 survivors with laboratory-confirmed EVD were made to the Survivor Clinic. Most (60.9%) survivors were women. Survivors’ median age was 28 years (range 0.25–70 years). Survivors attended the clinic a median of 5 times (range 1–21 times) each, and the median time from EVD discharge to attendance was 261 days (range 4–504 days). The most commonly reported signs and symptoms among the 621 attendances were headache (63.1%), fever (61.7%), and myalgia (43.3%). Because health needs of EVD survivors are complex, rapid chart reviews at survivor clinics should be repeated regularly to assess the extent of illness and prioritize service delivery. PMID:27983503

  1. Within the Box: Cross-Cultural Art Therapy with Survivors of the Rwanda Genocide

    Science.gov (United States)

    Chu, Valerie

    2010-01-01

    This article discusses the creative making of boxes as a cross-cultural art therapy intervention in Kigali, Rwanda, with survivors of the 1994 Rwandan genocide. The box as an art form is particularly applicable with young adult survivors, given the nature of their prodigious trauma and the possibility of posttraumatic stress disorder, as well as…

  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. 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…

  4. 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

  5. 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 and t...

  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. 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)

  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. Interrelated Processes toward Quality of Life in Survivors of Childhood Cancer: A Grounded Theory

    Science.gov (United States)

    Tsonis, Miranda; McDougall, Janette; Mandich, Angela; Irwin, Jennifer

    2012-01-01

    Past research has not adequately addressed the quality of life (QOL) of survivors of childhood cancer. The purpose of this study was to understand how QOL is experienced for individuals who have survived childhood cancer. Specific research questions included: (a) How do childhood cancer survivors define the concept of QOL and (b) What processes do…

  10. Home-making after stroke. : A qualitative study among Dutch stroke survivors

    NARCIS (Netherlands)

    Meijering, Louise; Nanninga, Christa S.; Lettinga, Ant T.

    2016-01-01

    Stroke survivors may suffer from physical limitations as well as cognitive and behavioural difficulties. Many survivors work on their recovery in a rehabilitation clinic with the aim to return to their own home again. Since full recovery is often not feasible, they face the challenge of coming to te

  11. 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...

  12. A Meta-Summary of Qualitative Findings about Professional Services for Survivors of Sexual Violence

    Science.gov (United States)

    Martsolf, Donna S.; Draucker, Claire B.; Cook, Christina B.; Ross, Ratchneewan; Stidham, Andrea Warner; Mweemba, Prudencia

    2010-01-01

    Sexual violence occurs at alarming rates in children and adults. Survivors experience myriad negative health outcomes and legal problems, which place them in need of professional services. A meta-summary was conducted of 31 published qualitative studies on adults' responses to sexual violence, with a focus on survivors' use of professional…

  13. Leininger's Ethnonursing Research Methodology and Studies of Cancer Survivors: A Review.

    Science.gov (United States)

    Farren, Arlene T

    2015-09-01

    The purpose of this article is to present the findings of a literature review regarding the use of Leininger's ethnonursing research methodology (ENRM) in studies addressing adult cancer survivors. It is important to learn about differences and similarities among cancer survivors' experiences so that patient-centered, culturally congruent care can be provided. A review of the literature was conducted using databases such as CINAHL and MEDLINE. Search terms included variations on ENRM and cancer survivors. The results were a small number of published studies that used the ENRM examining breast cancer survivors' perceptions and experiences. A review instrument was developed to estimate study quality based on established criteria. The studies are critiqued in relation to the theory-based methodology, evaluation criteria for qualitative research, and study findings are summarized. The author concludes that although there is a paucity of research using ENRM with adult cancer survivors, the preliminary findings of the included studies contribute to what is known about breast cancer survivors. Implications for research include recommendations to increase the use of ENRM to discover the universal and diverse experiences of care practices in adult cancer survivors and use the evidence to develop patient-centered, culturally congruent, quality care for cancer survivors.

  14. Community-Based Career Counseling for Women Survivors of Intimate Partner Violence: A Collaborative Partnership

    Science.gov (United States)

    Chronister, Krista M.; Harley, Eliza; Aranda, Christina L.; Barr, Leah; Luginbuhl, Paula

    2012-01-01

    Intimate partner violence (IPV) costs women nearly 8 million days of paid work annually. Greater attention to violence survivors' employment and career development can facilitate women escaping abusive relationships and promotes their overall rehabilitation and healing. A first step to increasing attention to survivors' career development includes…

  15. 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.

  16. 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)

  17. 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…

  18. Changes in body mass index in long-term childhood cancer survivors

    NARCIS (Netherlands)

    van Santen, HM; Geskus, Ronald B; Raemaekers, Steven; van Trotsenburg, A S Paul; Vulsma, Thomas; van der Pal, Helena J H; Caron, Hubert N; Kremer, Leontien C M

    2015-01-01

    BACKGROUND: Previous studies have reported changes in the body mass index (BMI) with time in childhood cancer survivors (CCSs) during follow-up. The limitations of these studies include that they described only a subgroup of survivors or used questionnaires with self-reported heights and weights. Th

  19. 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…

  20. 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...

  1. 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...

  2. 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

  3. Sexuality and body image in long-term survivors of testicular cancer

    DEFF Research Database (Denmark)

    Rossen, Philip; Pedersen, A F; Zachariae, R

    2012-01-01

    This study explores sexual function and the influence of different treatment modalities on sexual function and body image among long-term survivors of testicular cancer (TCSs).......This study explores sexual function and the influence of different treatment modalities on sexual function and body image among long-term survivors of testicular cancer (TCSs)....

  4. Work ability of survivors of breast, prostate, and testicular cancer in Nordic countries

    DEFF Research Database (Denmark)

    Lindbohm, M-L; Taskila, T; Kuosma, E

    2012-01-01

    Cancer can cause adverse effects on survivors' work ability. We compared the self-assessed work ability of breast, testicular, and prostate cancer survivors to that of people without cancer. We also investigated the association of disease-related and socio-demographic factors and job...

  5. 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

  6. Prolonged use of pancuronium bromide and sensorineural hearing loss in childhood survivors of congenital diaphragmatic hernia.

    Science.gov (United States)

    Cheung, P Y; Tyebkhan, J M; Peliowski, A; Ainsworth, W; Robertson, C M

    1999-08-01

    Sensorineural hearing loss (SNHL) is a significant neurologic morbidity in survivors of neonatal congenital diaphragmatic hernia (CDH), with a reported incidence of up to 60%. In a historical cohort study of 37 neonates with CDH, we investigated the use of pancuronium bromide (PB) and common ototoxic drugs during the neonatal period and their relationship to SNHL in childhood survivors. Survivors with SNHL (n = 23) had significantly higher cumulative dose of PB administered during the neonatal illness than survivors without SNHL (n = 14). The cumulative dose and duration of PB use significantly correlated (r = 0.66-0.81) and independently predicted (adjusted r (2) = 0.42-0.64) the greatest intensity (in decibels) and the widest band (lowest frequency in hertz) loss of SNHL. No differences were identified between survivors with and without SNHL regarding demographic and neonatal characteristics (including oxygenation and ventilation variables and the cumulative dose and duration of therapy with aminoglycosides, vancomycin, and furosemide), although survivors with SNHL had received a modestly higher cumulative dose of ethacrynic acid than survivors without SNHL. Although we show that prolonged administration of PB during the neonatal period is associated with SNHL in childhood survivors of CDH, further multicenter studies are required to investigate the possible etiologies of SNHL in this high-risk population.

  7. Posttraumatic Growth in Youth Survivors of a Disaster: An Arts-Based Research Project

    Science.gov (United States)

    Mohr, Elizabeth

    2014-01-01

    Evidence that posttraumatic growth is a potential outcome in the process of recovery from trauma and natural disaster highlights the importance of social environmental factors that encourage a growth response in survivors. This art-based research project followed up on a group of youth survivors (N = 11) of the 2007 earthquake in the Ica region of…

  8. Return to work of breast cancer survivors: a systematic review of intervention studies

    NARCIS (Netherlands)

    J.L. Hoving; M.L.A. Broekhuizen; M.H.W. Frings-Dresen

    2009-01-01

    ABSTRACT: BACKGROUND: Breast cancer management has improved dramatically in the past three decades and as a result, a population of working age women is breast cancer survivor. Interventions for breast cancer survivors have shown improvements in quality of life and in physical and psychological stat

  9. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  10. A family-based model to predict fear of recurrence for cancer survivors and their caregivers.

    Science.gov (United States)

    Mellon, Suzanne; Kershaw, Trace S; Northouse, Laurel L; Freeman-Gibb, Laurie

    2007-03-01

    Although fear of cancer recurrence is a great concern among survivors and their families, few studies have examined predictors of fear of recurrence. The purpose of this study was to identify factors associated with fear of recurrence in a population-based sample (N = 246) and determine if survivors and family caregivers influenced one another's fear of recurrence. A family framework guided the study and analyses included multilevel modeling using the Actor-Partner Interdependence Model. Results indicated that survivors and family caregivers influenced each other's fear of recurrence and that caregivers had significantly more fear of recurrence than survivors. More family stressors, less positive meaning of the illness, and age were related to elevated fear of cancer recurrence for both survivors and caregivers.

  11. 5 CFR 843.314 - Amount of survivor annuity where service includes credit for service with a nonappropriated fund...

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Amount of survivor annuity where service... Amount of survivor annuity where service includes credit for service with a nonappropriated fund instrumentality. (a) The survivor annuity based on service that includes service with a nonappropriated...

  12. 26 CFR 1.691(d)-1 - Amounts received by surviving annuitant under joint and survivor annuity contract.

    Science.gov (United States)

    2010-04-01

    ... joint and survivor annuity contract. 1.691(d)-1 Section 1.691(d)-1 Internal Revenue INTERNAL REVENUE... Decedents § 1.691(d)-1 Amounts received by surviving annuitant under joint and survivor annuity contract. (a... and survivor annuity contract (to the extent indicated in paragraph (b) of this section) are...

  13. 5 CFR Appendix A to Subpart I of... - Recommended Language for Court Orders Awarding Former Spouse Survivor Annuities

    Science.gov (United States)

    2010-01-01

    ... Awarding Former Spouse Survivor Annuities A Appendix A to Subpart I of Part 838 Administrative Personnel... RETIREMENT BENEFITS Terminology Used in Court Orders Awarding Former Spouse Survivor Annuities Pt. 838, Subpt... Spouse Survivor Annuities This appendix provides recommended language for use in court orders...

  14. 76 FR 18811 - Submission for Review: Letter Reply To Request for Information (RI 20-64), Former Spouse Survivor...

    Science.gov (United States)

    2011-04-05

    ... MANAGEMENT Submission for Review: Letter Reply To Request for Information (RI 20-64), Former Spouse Survivor Annuity Election (RI 20-64A), Information on Electing a Survivor Annuity for Your Former Spouse (RI 20-64B... Reply to Request for Information, RI 20-64, and Former Spouse Survivor Annuity Election, RI 20-64A....

  15. 42 CFR 102.53 - Documentation a survivor must submit to be deemed eligible by the Secretary.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Documentation a survivor must submit to be deemed... § 102.53 Documentation a survivor must submit to be deemed eligible by the Secretary. A requester who is a survivor must submit the following documentation in order to be deemed eligible by the...

  16. Health-Related Quality of Life of Adolescent and Young Adult Survivors of Central Nervous System Tumors: Identifying Domains From a Survivor Perspective.

    Science.gov (United States)

    Kuhlthau, Karen; Luff, Donna; Delahaye, Jennifer; Wong, Alicia; Yock, Torunn; Huang, Mary; Park, Elyse R

    2015-01-01

    This article uses qualitative methods to describe the domains of health-related quality of life (HRQoL) that adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors identify as important. Survivors clearly attributed aspects of their current HRQoL to their disease or its treatment. We identified 7 key domains of AYA CNS tumor survivorship: physical health, social well-being, mental health, cognitive functioning, health behaviors, sexual and reproductive health, and support systems. Although most aspects of HRQoL that survivors discussed represented new challenges, there were several areas where survivors pointed out positive outcomes. There is a need for a HRQoL tool designed for this population of survivors, given their unique treatment and survivorship experience. Aspects of HRQoL related to cognition, sexual and reproductive health, health behaviors, and support systems are not typically included in generic HRQoL tools but should be assessed for this population. Developing HRQoL measurement instruments that capture the most significant aspects of HRQoL will improve the ability to track HRQoL in AYA CNS tumor survivors and in the long-term management of common sequelae from CNS tumors and their treatments.

  17. One stop multidisciplinary pain clinic for survivors of torture.

    Science.gov (United States)

    Kuehler, Bianca M; Childs, Susan R

    2016-10-01

    Bianca Kuehler and Susan Childs speak to Jade Parker, Commissioning Editor: Dr Bianca Kuehler initially qualified in Germany as an anesthetist in 1993 and is on the specialist register in the UK. After moving to the UK she obtained a Diploma in Occupational Health to supplement the understanding and implication of chronic pain on the work environment. She is very interested in multidisciplinary approaches in treatment of chronic and acute pain patients and, therefore, working closely with Dr Childs opened a plethora of opportunities to develop new services including a fibromyalgia clinic and a specialist clinic for patients who are survivors of torture. Dr Susan Childs is an experienced clinical psychologist who has worked within health psychology and mental health since 1997. Her particular area of expertise is chronic pain. Alongside this, she has developed expertise in the assessment and treatment of a wide range of psychological issues. She has more recently focused upon co-developing services alongside her medical lead and co-facilitator, Dr Bianca Kuehler, for patients who are survivors of torture. Susan leads therapy services at a major London National Health Service trust in a Consultant capacity and supports a team of physicians, surgeons, pain specialist physicians, physiotherapists and clinical specialist nurses.

  18. Some musculo-skeletal sequelae in cancer survivors.

    Science.gov (United States)

    Aksnes, Liv Hege; Bruland, Øyvind Sverre

    2007-01-01

    This paper deals with some of the musculo-skeletal complication that can occur after cancer treatment. In particular, we focus on Cancer Treatment Induced Bone Loss (CTIBL) and the musculo-skeletal complications that can occur in patients treated for extremity sarcoma. In addition we discuss peripheral neuropathy, musculo-skeletal pain and briefly mention some of the complications related to radiotherapy. CTIBL is mostly studied in breast cancer and prostate cancer survivors. The cause in these groups is mainly due to treatment induced hypogonadism. Other causes of CTIBL are indirect or direct cause of chemotherapy, physical inactivity and inadequate intake of vitamin D and calcium. Treatment of CTIBL consists of diet and lifestyle changes and pharmacological intervention. Extremity bone sarcomas constitute a special group since they often experience mutilating surgery and heavy combination chemotherapy. The treatment results in worse function than the normal population and the amputated usually have lower physical functioning than patients treated with limb sparing surgery (LSS). However, most studies fail to show differences in quality of life between the amputated and LSS. Most of the studies performed on musculo-skeletal sequelae have been done on survivors of childhood cancer, breast cancer or prostate cancer. More studies among the other cancer groups are needed to reveal the extent and prevalence of these complications.

  19. A brief intervention for fatigue management in breast cancer survivors.

    Science.gov (United States)

    Fillion, Lise; Gagnon, Pierre; Leblond, Francine; Gélinas, Céline; Savard, Josée; Dupuis, Réjeanne; Duval, Karine; Larochelle, Marie

    2008-01-01

    The purpose of this randomized control trial was to verify the effectiveness of a brief group intervention that combines stress management psycho-education and physical activity (ie, independent variable) intervention in reducing fatigue and improving energy level, quality of life (mental and physical), fitness (VO 2submax), and emotional distress (ie, dependent variables) in breast cancer survivors. This study applied Lazarus and Folkman stress-coping theoretical framework, as well as Salmon's unifying theory of physical activity. Eighty-seven French-speaking women who had completed their treatments for nonmetastatic breast cancer at a university hospital in Quebec City, Canada, were randomly assigned to either the group intervention (experimental) or the usual-care (control) condition. Data were collected at baseline, postintervention, and at 3-month follow-up. The 4-week group intervention was cofacilitated by 2 nurses. Results showed that participants in the intervention group showed greater improvement in fatigue, energy level, and emotional distress at 3-month follow-up, and physical quality of life at postintervention, compared with the participants in the control group. These results suggest that a brief psycho-educational group intervention focusing on active coping strategies and physical activity is beneficial to cancer survivors after breast cancer treatments.

  20. Osteoporosis is less frequent in endometrial cancer survivors with hypertriglyceridemia.

    Science.gov (United States)

    Hirasawa, Akira; Makita, Kazuya; Akahane, Tomoko; Yamagami, Wataru; Makabe, Takeshi; Yokota, Megumi; Horiba, Yuko; Ogawa, Mariko; Yanamoto, Shigehisa; Deshimaru, Rhota; Tominaga, Eiichiro; Banno, Kouji; Susumu, Nobuyuki; Aoki, Daisuke

    2015-01-01

    We previously reported an association between dyslipidemia and endometrial cancers. Osteoporosis is also reported to relate with some cancers. A common etiologic event has been proposed between dyslipidemia and osteoporosis. However, the pattern of interrelationships among dyslipidemia, osteoporosis and endometrial cancer is not well understood. To improve the quality of life of endometrial cancer survivors, these relationships should be determined. This study included 179 Japanese menopausal women who underwent bilateral salpingo-oophorectomy, including 114 women with incident endometrial cancer and 65 without endometrial cancer. The women were categorized according to dyslipidemia status. Bone mineral density was measured and compared between groups. Osteoporosis was statistically more frequent in women with hypertriglyceridemia who did not have endometrial cancer. In contrast, osteoporosis was statistically less frequent in women with hypertriglyceridemia who had endometrial cancer. In this cross-sectional study in a Japanese population, osteoporosis was associated with hypertriglyceridemia in post-menopausal women without endometrial cancer, but was less frequent in endometrial cancer survivors with hypertriglyceridemia.

  1. Electroretinography and Visual Evoked Potentials in Childhood Brain Tumor Survivors.

    Science.gov (United States)

    Pietilä, Sari; Lenko, Hanna L; Oja, Sakari; Koivisto, Anna-Maija; Pietilä, Timo; Mäkipernaa, Anne

    2016-07-01

    This population-based cross-sectional study evaluates the clinical value of electroretinography and visual evoked potentials in childhood brain tumor survivors. A flash electroretinography and a checkerboard reversal pattern visual evoked potential (or alternatively a flash visual evoked potential) were done for 51 survivors (age 3.8-28.7 years) after a mean follow-up time of 7.6 (1.5-15.1) years. Abnormal electroretinography was obtained in 1 case, bilaterally delayed abnormal visual evoked potentials in 22/51 (43%) cases. Nine of 25 patients with infratentorial tumor location, and altogether 12 out of 31 (39%) patients who did not have tumors involving the visual pathways, had abnormal visual evoked potentials. Abnormal electroretinographies are rarely observed, but abnormal visual evoked potentials are common even without evident anatomic lesions in the visual pathway. Bilateral changes suggest a general and possibly multifactorial toxic/adverse effect on the visual pathway. Electroretinography and visual evoked potential may have clinical and scientific value while evaluating long-term effects of childhood brain tumors and tumor treatment.

  2. Childhood cancer survivors' school (re)entry: Australian parents' perceptions.

    Science.gov (United States)

    McLoone, J K; Wakefield, C E; Cohn, R J

    2013-07-01

    Starting or returning to school after intense medical treatment can be academically and socially challenging for childhood cancer survivors. This study aimed to evaluate the school (re)entry experience of children who had recently completed cancer treatment. Forty-two semi-structured telephone interviews were conducted to explore parents' perceptions of their child's (re)entry to school after completing treatment (23 mothers, 19 fathers, parent mean age 39.5 years; child mean age 7.76 years). Interviews were analysed using the framework of Miles and Huberman and emergent themes were organised using QSR NVivo8. Parents closely monitored their child's school (re)entry and fostered close relationships with their child's teacher to ensure swift communication of concerns should they arise. The most commonly reported difficulty related to aspects of peer socialisation; survivors either displayed a limited understanding of social rules such as turn taking, or related more to older children or teachers relative to their peers. Additionally, parents placed a strong emphasis on their child's overall personal development, above academic achievement alone. Improved parent, clinician and teacher awareness of the importance of continued peer socialisation during the treatment period is recommended in order to limit the ongoing ramifications this may have on school (re)entry post-treatment completion.

  3. Events prior to completed suicide: perspectives of family survivors.

    Science.gov (United States)

    Peters, Kathleen; Murphy, Gillian; Jackson, Debra

    2013-05-01

    Relatively little is known about the experiences of those bereaved by suicide, particularly in the weeks leading to the death of a loved one. This study used a qualitative methodology to explore the perspectives of close survivors of a completed suicide. Ten people who were bereaved by suicide participated in face-to-face interviews that were digitally recorded, transcribed verbatim, and thematically analysed. Analysis revealed the following three themes: He Tried to Hang Himself: Purposeful indications of the intent to end life; They Still Ignored It: Disappointment with health services; and Nobody Talked to Me: Exclusion of family members from treatment information. Prior to the suicide of their loved one, participants had identified that the loved one was at risk and perceived they were unable to acquire appropriate assistance from services. Rather, services were perceived by participants as unsupportive and inadequate. Health and social service professionals could benefit from further specialised education concerning suicide and its sequelae to ensure more effective and sensitive care delivery to suicide survivors.

  4. 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.

  5. Jewish Survivors. Drei Publikationen über das Überleben Jewish Survivors. Three Publications on Survival

    Directory of Open Access Journals (Sweden)

    Sabine Kittel

    2000-11-01

    Full Text Available Drei Bücher aus den USA werden vorgestellt, die sich mit den Erinnerungen und Erzählungen jüdischer Überlebender und dem Leben nach dem Überleben befassen. Alle drei Autoren haben Interviews mit Überlebenden durchgeführt. Jede der Publikationen trägt der Individualität der Erfahrungen der Überlebenden und der Unbeschreibbarkeit ihrer Erlebnisse heute Rechnung. Die Autoren gehen mit unterschiedlichem Blickwinkel an die erzählten Erinnerungen heran: William Helmreich ist Soziologe, Henry Greenspan ist Psychologe und Theater-Schriftsteller, der in der Soziologie lehrt, Jared Stark kommt von der Literaturwissenschaft.Three US-American publications are being discussed, all of them dealing with the memories and narratives of Jewish survivors and their lives after their rescue. All three authors have interviewed survivors and take into account their individual experiences and the ultimate impossibility of describing those experiences. Every author approaches the subject from a different point of view: William Helmreich is a sociologist, Henry Greenspan a consulting psychologist and playwright who also teaches sociology, while Jared’s Stark’s field is American literature.

  6. Social competence in pediatric brain tumor survivors: application of a model from social neuroscience and developmental psychology.

    Science.gov (United States)

    Hocking, Matthew C; McCurdy, Mark; Turner, Elise; Kazak, Anne E; Noll, Robert B; Phillips, Peter; Barakat, Lamia P

    2015-03-01

    Pediatric brain tumor (BT) survivors are at risk for psychosocial late effects across many domains of functioning, including neurocognitive and social. The literature on the social competence of pediatric BT survivors is still developing and future research is needed that integrates developmental and cognitive neuroscience research methodologies to identify predictors of survivor social adjustment and interventions to ameliorate problems. This review discusses the current literature on survivor social functioning through a model of social competence in childhood brain disorder and suggests future directions based on this model. Interventions pursuing change in survivor social adjustment should consider targeting social ecological factors.

  7. Attitudes Toward Sexual Violence Survivors: Differences Across Professional Sectors in Kenya and the Democratic Republic of the Congo.

    Science.gov (United States)

    Ferdowsian, Hope; Kelly, Scott; Burner, Mary; Anastario, Mike; Gohlke, Grace; Mishori, Ranit; McHale, Thomas; Naimer, Karen

    2016-03-27

    Sexual violence survivors who decide to report their assault interact with health care, law enforcement, and legal and judicial professionals. Professionals' attitudes about sexual violence and survivors play an important role in caring for survivors and in the pursuit of justice. Despite evidence showing the relationship between service provider beliefs and survivor outcomes, relatively little is known about professionals' beliefs about sexual violence or their attitudes toward sexual violence survivors. Between June 2012 and December 2014, our study examined the beliefs and attitudes of 181 professionals from the health care, legal, and law enforcement sectors in the Eastern Democratic Republic of the Congo (DRC) and the Rift Valley region of Kenya, areas with a high prevalence of sexual violence. To determine correlates of beliefs and attitudes about sexual violence and sexual violence survivors, multiple logistic regression models were adjusted for demographic and occupational characteristics. Respondents who agreed that survivors got what they deserved (7%) or that survivors should feel ashamed (9%) were the minority, while those who would be willing to care for a family member with a history of sexual violence (94%) were the majority. Profession was significantly associated with beliefs and attitudes about sexual violence and survivors. Law enforcement professionals were more likely than health professionals and lawyers to indicate that survivors should feel ashamed. Our findings suggest a need for interventions that adequately address potentially harmful beliefs and attitudes of some professionals serving sexual violence survivors.

  8. Executive functions and social skills in survivors of pediatric brain tumor.

    Science.gov (United States)

    Wolfe, Kelly R; Walsh, Karin S; Reynolds, Nina C; Mitchell, Frances; Reddy, Alyssa T; Paltin, Iris; Madan-Swain, Avi

    2013-01-01

    Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper-and-pencil measures of social skills and real-world executive skills. Social functioning was related to a specific aspect of executive functions, that is, the survivors' variability in response time, such that inconsistent responding was associated with better parent-reported and survivor-reported social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed.

  9. Pain in long-term adult survivors of childhood cancers and their siblings: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Lu, Qian; Krull, Kevin R; Leisenring, Wendy; Owen, Jason E; Kawashima, Toana; Tsao, Jennie C I; Zebrack, Bradley; Mertens, Ann; Armstrong, Gregory T; Stovall, Marilyn; Robison, Leslie L; Zeltzer, Lonnie K

    2011-11-01

    Little is known about pain among long-term adult survivors of childhood cancers. The study investigated pain prevalence in this population compared with sibling controls and examined pain-related risk factors. Three self-reported pain outcomes including pain conditions, prescription analgesics used, and pain attributed to cancer and treatment were assessed among 10,397 cancer survivors and 3034 sibling controls from the Childhood Cancer Survivor Study. Pain conditions (pain/abnormal sensation, migraines, and other headaches) were reported by 12.3%, 15.5%, and 20.5% of survivors, respectively; 16.7% of survivors reported use of prescription analgesics, and 21% attributed pain to cancer and treatment. Risks of reporting pain conditions and using prescription analgesics were higher among survivors than siblings, adjusting for sociodemographic factors. Younger age at diagnosis and a history of non-Hodgkin lymphoma, Wilms tumor, or neuroblastoma (compared to leukemia) were associated with greater risk of reporting pain conditions. A history of bone cancer or soft tissue sarcoma (compared to leukemia) was associated with greater risks of using prescription analgesics and cancer-related pain attribution. Non-brain-directed scatter irradiation was associated with elevated risk for migraines and cancer-related pain attribution. Female gender and lower educational attainment were associated with increased reports of all 3 pain outcomes; minority status, unemployment, and being single were associated with greater risks for reporting pain conditions. These findings contribute to the understanding of pain and associated risk factors among adult survivors of childhood cancer and suggest areas of focus for pain intervention.

  10. Communicating Tsunami Preparedness Through the Lessons Learned by Survivors

    Science.gov (United States)

    Kerlow, I.

    2015-12-01

    Often times science communication is reactive and it minimizes the perceptions of the general public. The Tsunami of New Dreams is a film with the testimonies of survivors of the 2004 Indian Ocean tsunami in Banda Aceh and Aceh Besar in West Sumatra, Indonesia. Production of the film spanned over five years and dozens of interviews, and is based on a unique geographic, demographic and experiential sampling of the local population. This documentary feature film underscores the importance of Earth science and science communication in building sustainable communities. The film is a lesson in survival and sustainability, and it provides a simple but powerful testimony of what to do and what not to do before and during a tsunami. The film also highlights the direct relationship that exists between disaster survival rates and the knowledge of basic Earth science and preparedness facts. We hope that the human stories presented in the film will serve as a strong motivator for general audiences to learn about natural hazards, preparedness, and Earth science. These engaging narratives can touch the minds and hearts of general audiences much faster than technical lectures in a classroom. Some of the testimonies are happy and others are sad, but they all present the wide range of beliefs that influenced the outcomes of the natural disaster. The interviews with survivors are complemented with unique archival footage of the tsunami and unique footage of daily life in Aceh. Hand-drawn illustrations are used to recreate what survivors did immediately after the earthquake, and during the extreme moments when they faced the tsunami waves. Animated visuals, maps and diagrams enhance the understanding of earthquake and tsunami dynamics. The film is a production of the Earth Observatory of Singapore (EOS) in collaboration with the International Center for Aceh and Indian Ocean Studies (ICAIOS) in Banda Aceh, Indonesia. The film is scheduled for release in late 2015. This is a unique

  11. Physical performance limitations in adolescent and adult survivors of childhood cancer and their siblings.

    Directory of Open Access Journals (Sweden)

    Corina S Rueegg

    Full Text Available PURPOSE: This study investigates physical performance limitations for sports and daily activities in recently diagnosed childhood cancer survivors and siblings. METHODS: 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 <16 years. Siblings received similar questionnaires. We assessed two types of physical performance limitations: 1 limitations in 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. RESULTS: 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, p<0.001, mainly caused by musculoskeletal and neurological problems. Findings were even more pronounced for children diagnosed more recently (OR 4.8, CI 2.4-9.6 and 8.3, CI 3.7-18.8 for those diagnosed <1990 and ≥ 1990, respectively; p=0.025. Mean physical function score for limitations in daily activities was 49.6 (CI 48.9-50.4 in survivors and 53.1 (CI 52.5-53.7 in siblings (p<0.001. Again, differences tended to be larger in children diagnosed more recently. Survivors of bone tumors, CNS tumors and retinoblastoma and children treated with radiotherapy were most strongly affected. CONCLUSION: Survivors of childhood cancer, 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.

  12. Risk Factors, Preventive Practices, and Health Care Among Breast Cancer Survivors, United States, 2010

    Directory of Open Access Journals (Sweden)

    Sherri G. Homan, RN, FNP, PhD

    2016-01-01

    Full Text Available Introduction We compared behavioral risk factors and preventive measures among female breast cancer survivors, female survivors of other types of cancers, and women without a history of cancer. Survivorship health care indicators for the 2 groups of cancer survivors were compared. Methods Using data from the 2010 Behavioral Risk Factor Surveillance System, we calculated the proportion of women with risk factors and their engagement in preventive practices, stratified by cancer status (cancer survivors or women with no history of cancer, and compared the proportions after adjusting for sociodemographic characteristics. Results A significantly higher proportion of breast cancer survivors had mammography in the previous year (79.5%; 95% confidence interval [CI], 76.0%–83.0% than did other cancer survivors (68.1%; 95% CI, 65.6%–70.7% or women with no history of cancer (66.4%; 95% CI, 65.5%–67.3%. Breast cancer survivors were also more likely to have had a Papanicolaou (Pap test within the previous 3 years than women with no history of cancer (89.4%; 95% CI, 85.9%–93.0 vs 85.1%; 95% CI, 84.4%–85.8% and a colonoscopy within the previous 10 years (75.4%; 95% CI, 71.7%–79.0% than women with no history of cancer (60.0%; 95% CI, 59.0%–61.0%. Current smoking was significantly lower among survivors of breast cancer (10.3%; 95% CI, 7.4%–13.2% than other cancer survivors (20.8%; 95% CI, 18.4%–23.3% and women with no history of cancer (18.3%; 95% CI, 17.5%–19.1%. After adjusting for sociodemographic characteristics, we found that breast cancer survivors were significantly more likely to have had mammography, a Pap test, and colonoscopy, and less likely to be current smokers. Conclusion Breast cancer survivors are more likely to engage in cancer screening and less likely to be current smokers than female survivors of other types of cancer or women with no history of cancer.

  13. Assessing Dietary Intake in Childhood Cancer Survivors: Food Frequency Questionnaire Versus 24-Hour Diet Recalls.

    Science.gov (United States)

    Zhang, Fang Fang; Roberts, Susan B; Must, Aviva; Wong, William W; Gilhooly, Cheryl H; Kelly, Michael J; Parsons, Susan K; Saltzman, Edward

    2015-10-01

    Cancer diagnosis and treatment may influence dietary intake. The validity of using self-reported methods to quantify dietary intake has not been evaluated in childhood cancer survivors. We validated total energy intake (EI) reported from Food Frequency Questionnaire (FFQ) and repeated 24-hour diet recalls (24HRs) against total energy expenditure (TEE) measured using the doubly labeled water method in 16 childhood cancer survivors. Dietary underreporting, assessed by (EI-TEE)/TEE × 100%, was 22% for FFQ and 1% for repeated 24HRs. FFQ significantly underestimates dietary intake and should not be used to assess the absolute intake of foods and nutrients in childhood cancer survivors.

  14. Survivors in the Margins: The Invisibility of Violence Against Older Women.

    Science.gov (United States)

    Crockett, Cailin; Brandl, Bonnie; Dabby, Firoza Chic

    2015-01-01

    Violence against older women exists in the margins between domestic violence and elder abuse, with neither field adequately capturing the experiences of older women survivors of intimate partner violence (IPV). This commentary explores this oversight, identifying how the lack of gender analysis in the elder abuse field exacerbates older survivors' invisibility when the wider violence against women (VAW) field lacks a lifespan approach to abuse. Examining the impact of generational and aging factors on how older women experience IPV, we assert that the VAW field may be overlooking a wider population of survivors than previously thought.

  15. Mindful caring: using mindfulness-based cognitive therapy with caregivers of cancer survivors.

    Science.gov (United States)

    Wood, Andrew W; Gonzalez, Jessica; Barden, Sejal M

    2015-01-01

    Caregivers of cancer survivors face many burdens that often require treatment by mental health professionals. One intervention, mindfulness-based cognitive therapy, aims to help individuals change the ways in which they relate to their thoughts rather than changing their thoughts. In this manuscript, we discuss the use and adaption of mindfulness-based cognitive therapy with caregivers of cancer survivors as a way to decrease caregiver burden and increase caregiver quality of life. A session-by-session breakdown of how to tailor mindfulness-based cognitive therapy to caregivers of cancer survivors is provided.

  16. Economic empowerment of impoverished IPV survivors: a review of best practice literature and implications for policy.

    Science.gov (United States)

    Hahn, Sur Ah; Postmus, Judy L

    2014-04-01

    Best practices in advocating for economic empowerment of impoverished intimate partner violence (IPV) survivors require the comprehensive and holistic organization of program and service delivery systems. This article outlines the best practices literature that addresses IPV in the lives of impoverished women, as well as the literature that specifically examines the interventions to economically empower IPV survivors--whether impoverished or not. This article concludes with suggestions for policy makers on how to incorporate these best practices into the Violence Against Women Act and for practitioners to ensure a comprehensive approach to interventions for impoverished IPV survivors.

  17. Health-related quality of life in long-term survivors of testicular cancer

    DEFF Research Database (Denmark)

    Rossen, Philip Blach; Pedersen, Anette Fischer; Zachariae, Robert

    2009-01-01

    PURPOSE: A growing number of patients with testicular cancer (TC) become long-term survivors. As a consequence, quality-of-life (QOL) issues become increasingly important. The objective of this study was to investigate QOL among Danish TC survivors. METHODS: A long-term follow-up assessment of all...... patients with TC treated at Aarhus University Hospital in Denmark between 1990 and 2000 was conducted. A total of 401 survivors (response rate, 66%) completed questionnaires concerning QOL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30), depression (Beck...

  18. Liver cancer in atomic-bomb survivors. Histological characteristics and relationships to radiation and hepatitis B and C viruses

    Energy Technology Data Exchange (ETDEWEB)

    Fukuhara, Toshiyuki [Hiroshima Prefectural Hospital (Japan); Sharp, G.B.; Mizuno, Terumi (and others)

    2001-06-01

    Histological features of primary liver cancer among atomic-bomb survivors and their relationship to hepatitis B (HBV) and C viral (HCV) infections are of special interest because of the increased risk of liver cancer in persons exposed to ionizing radiation and the high and increasing liver cancer rates in Japan and elsewhere. We conducted a pathology review of liver cancers occurring from 1958 to 1987 among subjects in the 120,321 member cohort of 1945 Hiroshima and Nagasaki residents. A panel of pathologists classified tumor histological types and defined accompanying cirrhotic changes of the liver. Archival tissue samples were assessed for HBV using pathology stains and PCR. Reverse transcriptase (RT) PCR was used to determine HCV status. We used unconditional logistic regression to compare 302 hepatocellular carcinoma (HCC) cases to 53 cholangiocarcinoma (CC) cases, adjusting for age, year of diagnosis, sex and viral status. Cirrhotic changes occurred significantly more often among HCC than CC cases (76% in HCC and 6% in CC). Compared to CC cases, HCC cases were 10.9 times more likely to be HBV-positive (95% confidence interval: 2.1-83.2) and 4.3 times more likely to be HCV-positive (95% confidence interval: 1.1-20.5) No significant differences were found between HCC and CC cases in radiation exposures. The predominance of HCC in the atomic-bomb survivors follows the background liver cancer pattern in Japan. Our findings suggest that HBV and HCV are involved in the pathogenesis of HCC with or without cirrhosis and are significantly less important in that of CC. (author)

  19. (41)Ca in Tooth Enamel. Part II: A means for retrospective biological neutron dosimetry in atomic bomb survivors.

    Science.gov (United States)

    Rühm, W; Wallner, A; Cullings, H; Egbert, S D; El-Faramawy, N; Faestermann, T; Kaul, D; Knie, K; Korschinek, G; Nakamura, N; Roberts, J; Rugel, G

    2010-08-01

    (41)Ca is produced mainly by absorption of low-energy neutrons on stable (40)Ca. We used accelerator mass spectrometry (AMS) to measure (41)Ca in enamel of 16 teeth from 13 atomic bomb survivors who were exposed to the bomb within 1.2 km from the hypocenter in Hiroshima. In our accompanying paper (Wallner et al., Radiat. Res. 174, 000-000, 2010), we reported that the background-corrected (41)Ca/Ca ratio decreased from 19.5 x 10(-15) to 2.8 x 10(-15) with increasing distance from the hypocenter. Here we show that the measured ratios are in good correlation with gamma-ray doses assessed by electron paramagnetic resonance (EPR) in the same enamel samples, and agree well with calculated ratios based on either the current Dosimetry System 2002 (DS02) or more customized dose estimates where the regression slope as obtained from an errors-in-variables linear model was about 0.85. The calculated DS02 neutron dose to the survivors was about 10 to 80 mGy. The low-energy neutrons responsible for (41)Ca activation contributed variably to the total neutron dose depending on the shielding conditions. Namely, the contribution was smaller (10%) when shielding conditions were lighter (e.g., outside far away from a single house) and was larger (26%) when they were heavier (e.g., in or close to several houses) because of local moderation of neutrons by shielding materials. We conclude that AMS is useful for verifying calculated neutron doses under mixed exposure conditions with gamma rays.

  20. Predictors of attrition among rural breast cancer survivors.

    Science.gov (United States)

    Meneses, Karen; Azuero, Andres; Su, Xiaogang; Benz, Rachel; McNees, Patrick

    2014-02-01

    Attrition can jeopardize both internal and external validity. The goal of this secondary analysis was to examine predictors of attrition using baseline data of 432 participants in the Rural Breast Cancer Survivors study. Attrition predictors were conceptualized based on demographic, social, cancer treatment, physical health, and mental health characteristics. Baseline measures were selected using this conceptualization. Bivariate tests of association, discrete-time Cox regression models and recursive partitioning techniques were used in analysis. Results showed that 100 participants (23%) dropped out by Month 12. Non-linear tree analyses showed that poor mental health and lack of health insurance were significant predictors of attrition. Findings contribute to future research efforts to reduce research attrition among rural underserved populations.

  1. Posttraumatic stress in intensive care unit survivors - a prospective study

    DEFF Research Database (Denmark)

    Ratzer, Mette; Brink, Ole; Knudsen, Linda

    2014-01-01

    Aims: This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through...... the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus...... of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21...

  2. Emotional processing in survivors of the Jupiter cruise ship disaster.

    Science.gov (United States)

    Joseph, S; Yule, W; Williams, R

    1995-02-01

    Twenty-three survivors of the Jupiter cruise ship disaster completed the Impact of Events Scale, a measure of intrusion and avoidance, as well as measures of arousal and affect at two points in time: between 3 and 7 months (Time 1) and between 12 and 14 months (Time 2) following the event. The aim of the present study was to explore the relationship between intrusion and avoidance and symptoms of depression and anxiety. The results suggest that although higher scores on intrusion and avoidance are strongly associated with poorer psychological outcome at each point in time, it is only intrusion which may be predictive of later symptoms. Avoidance would seem to be a response to early distress. These data are discussed with reference to a cognitive--emotional processing model of post-traumatic stress disorder.

  3. Active robotic training improves locomotor function in a stroke survivor

    Directory of Open Access Journals (Sweden)

    Krishnan Chandramouli

    2012-08-01

    Full Text Available Abstract Background Clinical outcomes after robotic training are often not superior to conventional therapy. One key factor responsible for this is the use of control strategies that provide substantial guidance. This strategy not only leads to a reduction in volitional physical effort, but also interferes with motor relearning. Methods We tested the feasibility of a novel training approach (active robotic training using a powered gait orthosis (Lokomat in mitigating post-stroke gait impairments of a 52-year-old male stroke survivor. This gait training paradigm combined patient-cooperative robot-aided walking with a target-tracking task. The training lasted for 4-weeks (12 visits, 3 × per week. The subject’s neuromotor performance and recovery were evaluated using biomechanical, neuromuscular and clinical measures recorded at various time-points (pre-training, post-training, and 6-weeks after training. Results Active robotic training resulted in considerable increase in target-tracking accuracy and reduction in the kinematic variability of ankle trajectory during robot-aided treadmill walking. These improvements also transferred to overground walking as characterized by larger propulsive forces and more symmetric ground reaction forces (GRFs. Training also resulted in improvements in muscle coordination, which resembled patterns observed in healthy controls. These changes were accompanied by a reduction in motor cortical excitability (MCE of the vastus medialis, medial hamstrings, and gluteus medius muscles during treadmill walking. Importantly, active robotic training resulted in substantial improvements in several standard clinical and functional parameters. These improvements persisted during the follow-up evaluation at 6 weeks. Conclusions The results indicate that active robotic training appears to be a promising way of facilitating gait and physical function in moderately impaired stroke survivors.

  4. Sixteen-year follow-up of childhood avalanche survivors

    Directory of Open Access Journals (Sweden)

    Edda Bjork Thordardottir

    2016-08-01

    Full Text Available 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, p<0.05. When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001, poor financial status (F=12.21, p<0.001, and unemployment 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.

  5. Knowledge and risk perception of late effects among childhood cancer survivors and parents before and after visiting a childhood cancer survivor clinic.

    Science.gov (United States)

    Cherven, Brooke; Mertens, Ann; Meacham, Lillian R; Williamson, Rebecca; Boring, Cathy; Wasilewski-Masker, Karen

    2014-01-01

    Survivors of childhood cancer are at risk for a variety of treatment-related late effects and require lifelong individualized surveillance for early detection of late effects. This study assessed knowledge and perceptions of late effects risk before and after a survivor clinic visit. Young adult survivors (≥ 16 years) and parents of child survivors (survivor program. Sixty-five participants completed a baseline survey and 50 completed both a baseline and follow-up survey. Participants were found to have a low perceived likelihood of developing a late effect of cancer therapy and many incorrect perceptions of risk for individual late effects. Low knowledge before clinic (odds ratio = 9.6; 95% confidence interval, 1.7-92.8; P = .02) and low perceived likelihood of developing a late effect (odds ratio = 18.7; 95% confidence interval, 2.7-242.3; P = .01) were found to predict low knowledge of late effect risk at follow-up. This suggests that perceived likelihood of developing a late effect is an important factor in the individuals' ability to learn about their risk and should be addressed before initiation of education.

  6. Molecular bio-dosimetry for carcinogenic risk assessment in survivors of Bhopal gas tragedy

    Directory of Open Access Journals (Sweden)

    Pradyumna Kumar Mishra

    2015-12-01

    Full Text Available December 2014 marked the 30th year anniversary of Bhopal gas tragedy. This sudden and accidental leakage of deadly poisonous methyl isocyanate (MIC gas instigated research efforts to understand the nature, severity of health damage and sufferings of 570 000 ailing survivors of this tragedy. In a decade-long period, our systematic laboratory investigations coupled with long-term molecular surveillance studies have comprehensively demonstrated that the risk of developing an environmental associated aberrant disease phenotype, including cancer, involves complex interplay of genomic and epigenetic reprogramming. These findings poised us to translate this knowledge into an investigative framework of “molecular biodosimetry” in a strictly selected cohort of MIC exposed individuals. A pragmatic cancer risk-assessment strategy pursued in concert with a large-scale epidemiological study might unfold molecular underpinnings of host-susceptibility and exposureresponse relationship. The challenges are enormous, but we postulate that the study will be necessary to establish a direct initiation-promotion paradigm of environmental carcinogenesis. Given that mitochondrial retrograde signaling-induced epigenetic reprogramming is apparently linked to neoplasticity, a cutting-edge tailored approach by an expert pool of biomedical researchers will be fundamental to drive these strategies from planning to execution. Validating the epigenomic signatures will hopefully result in the development of biomarkers to better protect human lives in an overburdened ecosystem, such as India, which is continuously challenged to meet population demands. Besides, delineating the mechanistic links between MIC exposure and cancer morbidity, our investigative strategy might help to formulate suitable regulatory policies and measures to reduce the overall burden of occupational and environmental carcinogenesis.

  7. A population-based study of survival and discharge status for survivors after head injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Teasdale, T W

    2004-01-01

    -Meier survival functions were calculated for these two categories. Hospital records for a random sample of 389 survivors in 1997 after cranial fracture, acute brain lesion or chronical subdural haematoma, which occurred in 1982, 1987 and 1992 in patients aged 15 years or more at injury, were reviewed. Survivors...... the decreasing incidence with time, the point prevalence of survivors in 1997 after brain lesions occurring in 1982, 1987 or 1992 was nearly the same, averaging 8.4 per 100 000 of the population above age 14. Half of them were severe, as defined by initial Glasgow Coma Score ... and cerebral lesion was described quantitatively through Kaplan-Meier survival distributions. Besides, patterns of severity, neurophysical and mental sequelae among survivors 5, 10 and 15 years post-injury were described. It was shown by examples how the study has been useful already for the planning...

  8. Pricing Survivor Forwards and Swaps in Incomplete Markets Using Simulation Techniques

    DEFF Research Database (Denmark)

    Boyer, M. Martin; Favaro, Amélie; Stentoft, Lars

    2012-01-01

    This article considers how to manage longevity risk using longevity derivatives products. We review the potential counterparties that naturally have exposure to this type of risk and we provide details on two very simple products, the survivor forward and the survivor swap, that can be used...... to trade this type of risk. We then discuss how such products can be priced using a simulation-based approach that has been shown to be successful in pricing financial derivatives. To illustrate the flexibility of the approach we price survivor forwards and swaps using the simple dynamics of the Lee...... and Carter [1992] mortality model. Our results show that premiums are generally increasing in maturity and in the assumed risk premium. Moreover, prices are more sensible to the future realized survivor index than to the risk premium, making the former more important to assess correctly....

  9. Are cancer survivors at an increased risk for divorce? A Danish cohort study

    DEFF Research Database (Denmark)

    Carlsen, Kathrine; Dalton, Susanne Oksbjerg; Frederiksen, Kirsten;

    2007-01-01

    The purpose of this study was to determine the risk for divorce among cancer survivors. We conducted a nationwide, population-based study of 46,303 persons aged 30-60 years in whom selected cancers were diagnosed in 1981-2000 and 221,028 randomly sampled, cancer-free controls. Information...... for survivors of cervix cancer, who had an increased risk for divorce, we found that cancer survivors were not at greater risk for divorce than the general population (rate ratios (RR), 1.06; 95% confidence interval (CI), 1.0;1.1 and RR, 0.98; 95% CI, 0.9;1.0 for women and men, respectively). This finding shows...... that cancer survivors need not have unnecessary fears for their marriage....

  10. Folate and MMA predict cognitive impairment in elderly stroke survivors: A cross sectional study.

    Science.gov (United States)

    Pascoe, Michaela C; Linden, Thomas

    2016-09-30

    Elderly stroke survivors are at risk of malnutrition and long-term cognitive impairment. Vitamin B-related metabolites, folate and methylmalonic acid, have been implicated in cognitive function. We conducted a study exploring the relationship between blood folate, methylmalonic acid and post-stroke cognitive impairment. This is a cross sectional study of elderly Swedish patients (n=149) 20 months post-stroke, assessed using the Mini Mental State Examination, serum blood levels of methylmalonic acid and red blood cell levels of folate. Linear modeling indicated that low levels of blood folate and elevated methylmalonic acid significantly contributed to cognitive impairment in stroke survivors. Half of the stroke survivors were shown to have folate deficiency at 20 months after stroke. Folate deficiency is common long term after stroke and both low folate and elevated methylmalonic acid appear to be associated with long term cognitive impairment, in elderly Swedish stroke survivors.

  11. Bone mineral density deficits and fractures in survivors of childhood cancer.

    Science.gov (United States)

    Wilson, Carmen L; Ness, Kirsten K

    2013-12-01

    Although substantial increases in survival rates among children diagnosed with cancer have been observed in recent decades, survivors are at risk of developing therapy-related chronic health conditions. Among children and adolescents treated for cancer, acquisition of peak bone mass may be compromised by cancer therapies, nutritional deficiencies, and reduced physical activity. Accordingly, failure to accrue optimal bone mass during childhood may place survivors at increased risk for deficits in bone density and fracture in later life. Current recommendations for the treatment of bone density decrements among cancer survivors include dietary counseling and supplementation to ensure adequate calcium and vitamin D intake. Few strategies exist to prevent or treat bone loss. Moving forward, studies characterizing the trajectory of changes in bone density over time will facilitate the development of interventions and novel therapies aimed at minimizing bone loss among survivors of childhood cancer.

  12. Health promotion for adolescent childhood leukemia survivors: building on prevention science and ehealth.

    Science.gov (United States)

    Elliot, Diane L; Lindemulder, Susan J; Goldberg, Linn; Stadler, Diane D; Smith, Jennifer

    2013-06-01

    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 uses of eHealth components including e-learning, serious video games, exergaming, behavior tracking, individual messaging, and social networking are briefly presented. The health promotion needs of adolescent survivors are aligned with those eHealth aspects to propose a new paradigm to enhance the wellbeing of adolescent ALL survivors.

  13. Dissociative Experiences and Disorders among Women Who Identify Themselves as Sexual Abuse Survivors.

    Science.gov (United States)

    Anderson, Geri; And Others

    1993-01-01

    Interviews with 51 female sexual abuse survivors revealed that over half had a diagnosis of multiple personality disorder, and the vast majority had extensive dissociative symptomatology and related features. (Author/JDD)

  14. LEVY WALK MODELS OF SURVIVOR MOVEMENT IN DISASTER AREAS WITH BARRIERS

    Directory of Open Access Journals (Sweden)

    Socrates E. Akpoyibo

    2014-01-01

    Full Text Available Disasters are catastrophic events that occur unexpectedly in a random manner. It is important that when a disaster occurs, the victims in the disaster area are rescued quickly to avoid massive casualties. Disaster areas may leave victims bereft of food, water, shelter and medical help. The goal of the work outlined in this paper is to study the movement of survivors towards rescue devices when barriers are involved. Barriers are obstacles that prevent both survivors and crewmembers from moving freely in a disaster area thereby slowing down rescue operations. It would therefore be necessary to study movements of survivors with barriers included in the simulations so as to produce more realistic results to be used when rescuing survivors in disaster areas.

  15. Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo.

    Science.gov (United States)

    Albutt, Katherine; Kelly, Jocelyn; Kabanga, Justin; VanRooyen, Michael

    2017-04-01

    Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences.

  16. 75 FR 78806 - Agency Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Science.gov (United States)

    2010-12-16

    ... service-connected compensation benefits and survivors receiving service connected death benefits at the full-dollar rate, actually resides in the United States as United States citizens or as aliens...

  17. Brain volume and cognitive function in adult survivors of childhood acute lymphoblastic leukemia.

    Science.gov (United States)

    Edelmann, Michelle N; Krull, Kevin R

    2013-10-01

    The survival rate for childhood acute lymphoblastic leukemia (ALL) is greater than 80%. However, many of these survivors develop long-term chronic health conditions, with a relatively common late effect being neurocognitive dysfunction. Although neurocognitive impairments have decreased in frequency and severity as treatment has evolved, there is a subset of survivors in the current treatment era that are especially vulnerable to the neurotoxic effects of ALL and its treatment. Additionally, little is known about long-term brain development as survivors mature into adulthood. A recent study by Zeller et al. compared neurocognitive function and brain volume in 130 adult survivors of childhood ALL to 130 healthy adults matched on age and sex. They identified the caudate as particularly sensitive to the neurotoxic effects of chemotherapy. We discuss the implications and limitations of this study, including how their findings support the concept of individual vulnerability to ALL and its treatment.

  18. Immune reactivity of cells from long-term rat renal allograft survivors

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, A.; Stuart, F.P.; Fitch, F.W.

    1978-11-01

    Lewis rats receiving an LBN kidney allograft demonstrate no signs of rejection if they are pretreated with donor spleen cells and antiserum reactive with the donor alloantigen. We examined the cellular reactivity of long-term kidney allograft survivors. Normal proliferative and cytolytic responses were obtained with spleen cells from long-term survivors, in marked contrast to the diminished responses of cells from neonatally tolerant rats or the heightened cytolytic response of cells from rats that had rejected a renal allograft. Serum from long-term renal allograft survivors as well as serum obtained from rats at the time of transplantation did not suppress proliferative or cytolytic responses of normal cells. The results of this study suggest that long-term renal allograft survivors possess the precursors of those cells which are responsible for proliferative and cytolytic responses in mixed leukocyte cultures, but that they have not been sensitized to their renal allograft.

  19. Triathlon training for women breast cancer survivors: feasibility and initial efficacy.

    Science.gov (United States)

    Ng, Alexander V; Cybulski, Alyson N; Engel, Ashley A; Papanek, Paula E; Sheffer, Megan A; Waltke, Leslie J; Tjoe, Judy A

    2016-12-24

    ᅟ: Exercise can improve quality of life (QOL) in breast cancer survivors. In contrast to many group or home-based exercise programs, little is known about the effectiveness of goal-oriented recreational activities.

  20. Many Breast Cancer Survivors Don't Get Life-Extending Therapy

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163387.html Many Breast Cancer Survivors Don't Get Life-Extending Therapy Study ... reduce the likelihood that women diagnosed with certain breast cancers will experience a recurrence of their disease. However, ...

  1. Treatment-associated subsequent neoplasms among long-term survivors of childhood cancer: the experience of the Childhood Cancer Survivor Study

    Energy Technology Data Exchange (ETDEWEB)

    Robison, Leslie L. [St. Jude Children' s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN (United States)

    2009-02-15

    With improvements in survival among individuals diagnosed and treated for cancer there is an increasing recognition of the risk of long-term adverse effects of therapy. Second neoplasms represent one of the more serious late effects of treatment and are associated with a substantial level of morbidity and mortality. Survivors of childhood cancers, because of their potential longevity, are at particular risk for this adverse outcome. The Childhood Cancer Survivor Study is a large cohort consisting of adult survivors of childhood cancer diagnosed and treated between 1970 and 1986. The CCSS has provided important data to quantify radiation-associated risk for subsequent cancers including neoplasms of the breast, thyroid and central nervous system. (orig.)

  2. Employment Situation of Parents of Long-Term Childhood Cancer Survivors.

    Directory of Open Access Journals (Sweden)

    Luzius Mader

    Full Text Available Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment.As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years. Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry.We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers. Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007. However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002, which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07 were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71 increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73 and >2 children (OR = 0.48, CI:0.30-0.75; and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36.Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education

  3. Incident Ischemic Heart Disease After Long-Term Occupational Exposure to Fine Particulate Matter: Accounting for 2 Forms of Survivor Bias.

    Science.gov (United States)

    Costello, Sadie; Neophytou, Andreas M; Brown, Daniel M; Noth, Elizabeth M; Hammond, S Katharine; Cullen, Mark R; Eisen, Ellen A

    2016-05-01

    Little is known about the heart disease risks associated with occupational, rather than traffic-related, exposure to particulate matter with aerodynamic diameter of 2.5 µm or less (PM2.5). We examined long-term exposure to PM2.5 in cohorts of aluminum smelters and fabrication workers in the United States who were followed for incident ischemic heart disease from 1998 to 2012, and we addressed 2 forms of survivor bias. Left truncation bias was addressed by restricting analyses to the subcohort hired after the start of follow up. Healthy worker survivor bias, which is characterized by time-varying confounding that is affected by prior exposure, was documented only in the smelters and required the use of marginal structural Cox models. When comparing always-exposed participants above the 10th percentile of annual exposure with those below, the hazard ratios were 1.67 (95% confidence interval (CI): 1.11, 2.52) and 3.95 (95% CI: 0.87, 18.00) in the full and restricted subcohorts of smelter workers, respectively. In the fabrication stratum, hazard ratios based on conditional Cox models were 0.98 (95% CI: 0.94, 1.02) and 1.17 (95% CI: 1.00, 1.37) per 1 mg/m(3)-year in the full and restricted subcohorts, respectively. Long-term exposure to occupational PM2.5 was associated with a higher risk of ischemic heart disease among aluminum manufacturing workers, particularly in smelters, after adjustment for survivor bias.

  4. School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011

    Directory of Open Access Journals (Sweden)

    Ida Frugård Strøm

    2016-05-01

    Full Text Available Background: The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. Objective: This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. Method: Data from a longitudinal interview study were linked to officially registered grades of students (N=64 who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors’ registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. Results: The students’ grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001. However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. Conclusion: The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching.

  5. Yoga as Treatment for Insomnia Among Cancer Patients and Survivors: A Systematic Review

    OpenAIRE

    Karen M. Mustian

    2013-01-01

    Many cancer patients and survivors, between 15 to 90%, report some form of insomnia or sleep quality impairment during and post-treatment, such as excessive daytime napping, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia and sleep quality impairment are among the most prevalent and distressing problems reported by cancer patients and survivors, and can be severe enough to increase cancer mortality. Despite the ubiquity of insomnia and sleep quality imp...

  6. Low heart rate variability and cancer-related fatigue in breast cancer survivors

    OpenAIRE

    2014-01-01

    Cancer-related fatigue is a common and often long lasting symptom for many breast cancer survivors. Fatigued survivors show evidence of elevated inflammation, but the physiological mechanisms driving inflammatory activity have not been determined. Alterations in the autonomic nervous system, and particularly parasympathetic nervous system activity, are a plausible, yet understudied contributor to cancer-related fatigue. The goal of this study was to replicate one previous study showing an ass...

  7. Lower heart rate variability is associated with cancer-related fatigue in breast cancer survivors

    OpenAIRE

    2012-01-01

    Background : Fatigue is the most common and distressing symptom reported by breast cancer survivors and yet the pathophysiology of cancer-related fatigue remains largely unknown. Fatigue is associated with lower parasympathetic and higher sympathetic nervous system activity in non-cancer samples, but only one study has demonstrated this same relationship in breast cancer survivors. This study evaluates the relationship between fatigue and basal autonomic nervous system activity as measured by...

  8. Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia

    OpenAIRE

    Robien, Kim; Ness, Kirsten K.; Klesges, Lisa M.; Baker, K. Scott; Gurney, James G.

    2008-01-01

    Recent studies indicate that survivors of childhood acute lymphocytic leukemia (ALL) are at increased risk of obesity and cardiovascular disease, conditions that healthy dietary patterns may help ameliorate or prevent. To evaluate the usual dietary intake of adult survivors of childhood ALL, food frequency questionnaire data were collected from 72 participants, and compared with the 2007 WCRF/AICR Cancer Prevention recommendations, the DASH diet, and the 2005 USDA Food Guide. Mean daily energ...

  9. Problem Solving and Emotional Distress Among Brain and Breast Cancer Survivors

    Science.gov (United States)

    2007-03-30

    with neurological disorders (e. g. head injury, aneurysm , tumor, side effects of cancer treatment) have been shown to experience problems. These...long-term adult survivors of pediatric solid tumors. International Journal of Cancer, 12, 25-31. Cull, A., Hay, C., Love, S. B., et al. (1994...term survivors of cancer. Pediatrics , 83, 18-25. Mullan, F. (1985). Seasons of survival: Reflections of a physician with cancer. New England

  10. Rehabilitation of torture survivors in five countries: common themes and challenges

    Directory of Open Access Journals (Sweden)

    Zuñiga Arely PA

    2010-06-01

    Full Text Available Abstract Background Torture continues to be a global problem and there is a need for prevention and rehabilitation efforts. There is little available data on torture survivors from studies designed and conducted by health professionals in low income countries. This study is a collaboration between five centres from Gaza, Egypt, Mexico, Honduras and South Africa who provide health, social and legal services to torture survivors, advocate for the prevention of torture and are part of the network of the International Rehabilitation Council for Torture Victims (IRCT. Methods Socio-demographic, clinical and torture exposure data was collected on the torture survivors attending the five centres at presentation and then at three and six month follow-up periods. This sample of torture survivors is presented using a range of descriptive statistics. Change over time is demonstrated with repeated measures analysis of variance. Results Of the 306 torture survivors, 23% were asylum seekers or refugees, 24% were socially isolated, 11% in prison. A high level of traumatic events was experienced. 64% had suffered head injury whilst tortured and 24% had ongoing torture injury problems. There was high prevalence of symptoms of anxiety, depression, post traumatic stress as well as medically unexplained somatic symptoms. The analysis demonstrates a modest drop in symptoms over the six months of the study. Conclusions Data showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions.

  11. Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse

    OpenAIRE

    Ehring, T.; Welboren, R; Morina, N; Wicherts, J.M.; J. Freitag; Emmelkamp, P.M.G.

    2014-01-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusively focused on studies evaluating the efficacy of psychological interventions for PTSD in adult survivors of childhood abuse. Sixteen randomized controlled trials meeting inclusion criteria could b...

  12. Current evidence supporting fertility and pregnancy among young survivors of breast cancer.

    Science.gov (United States)

    Meneses, Karen; Holland, Aimee Chism

    2014-01-01

    Approximately 6% of invasive breast cancer is diagnosed in women younger than age 40 of age childbearing potential. Cancer-directed therapies can cause hormonal and anatomical changes that negatively affect the reproductive potential of young survivors of breast cancer. Recent national guidelines on fertility preservation are widely available. However, gaps in care exist in the interdisciplinary evidence-based management of young survivors of breast cancer with fertility and parenting concerns after cancer treatment.

  13. Imagery, Metaphor and Perceived Outcome in Six Cancer Survivor's BMGIM Therapy

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    2007-01-01

    Results from a qualitative research study of BMGIM therapy with six Danish cancer survivors: an interview study of the participants' perceived outcome, and a grounded theory study of imagery and metaphor in the musical experiences of the participants.......Results from a qualitative research study of BMGIM therapy with six Danish cancer survivors: an interview study of the participants' perceived outcome, and a grounded theory study of imagery and metaphor in the musical experiences of the participants....

  14. Fertility concerns among child and adolescent cancer survivors and their parents: A qualitative analysis.

    Science.gov (United States)

    Ellis, Sarah J; Wakefield, Claire E; McLoone, Jordana K; Robertson, Eden G; Cohn, Richard J

    2016-01-01

    Cancer diagnoses and treatment may have long-term effects on fertility. Semistructured interviews were administered to young cancer survivors (self-esteem, and miscommunications/confusion about fertility status; access to fertility testing; and preservation options. Parents also reported challenges regarding how and when it was developmentally appropriate to talk to their children about fertility. The development of comprehensive consumer-driven approaches to managing the fertility concerns of young survivors and their families is essential.

  15. Mental Health of Survivors of the 2010 Haitian Earthquake Living in the United States

    Centers for Disease Control (CDC) Podcasts

    2010-04-16

    Thousands of survivors of the 2010 Haitian Earthquake are currently living in the United States. This podcast features a brief non-disease-specific interview with Dr. Marc Safran, CDC's longest serving psychiatrist, about a few of the mental health challenges such survivors may face.  Created: 4/16/2010 by CDC Center of Attribution: Mental and Behavioral Health Team, 2010 CDC Haiti Earthquake Mission, CDC Emergency Operations Center.   Date Released: 5/6/2010.

  16. SEXUAL FUNCTIONING AND QUALITY OF LIFE IN CERVICAL CANCER SURVIVORS AFTER SURGERY AND RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Prashant R Kumbhaj

    2014-04-01

    Conclusion: Cervical cancer survivors treated with radiotherapy had worse sexual functioning than did those treated with radical hysterectomy and lymph node dissection. Appropriate measures like Pelvic exercises, Yoga, vaginal dilators, vaginal cream should be used to decrease radiotherapy related side effects on sexual functioning. Cervical cancer survivors treated with surgery alone can expect overall quality of life and sexual function not unlike that of peers without a history of cancer. [Natl J Med Res 2014; 4(2.000: 116-118

  17. Quality of life and symptoms in pediatric brain tumor survivors: a systematic review.

    Science.gov (United States)

    Macartney, Gail; Harrison, Margaret B; VanDenKerkhof, Elizabeth; Stacey, Dawn; McCarthy, Patricia

    2014-01-01

    Little is known about the quality of life of children and youth under the age of 20 who have completed treatment for a pediatric brain tumor. This systematic review was conducted to (a) describe the health-related quality of life (HRQL) outcomes in pediatric brain tumor survivors, (b) identify instruments used to measure HRQL, and (c) determine the relationship between symptoms and HRQL. Using a systematic search and review methodology, databases searched included CINAHL, Medline, Embase, and PsycInfo. No date restrictions were used. Search results elicited 485 articles, of which16 met the inclusion criteria. Compared with their healthy peers, pediatric brain tumor survivors did worse on most measures of physical, psychosocial, social, and cognitive domains of HRQL. Compared with other cancer patients, survivors scored themselves significantly lower on the Pediatric Quality of Life Inventory (PedsQL) social functioning scale, and parents of brain tumor survivors reported lower PedsQL social and total functioning scores for their children. Other variables that were associated with decreased HRQL were degree of hypothalamic tumor involvement, osteopenia, need for special education, older age at diagnosis, greater than 1 year since treatment, and radiation treatment. In these studies, pediatric brain tumor survivors fared worse compared with other cancer survivors or healthy peers on several HRQL domains. Only 3 studies explored the relationship between symptoms, including pain or fatigue, and HRQL in pediatric brain tumor survivors. The relationship between symptoms and HRQL was not well elucidated. More research is needed to explore the multidimensional symptom experience and HRQL outcomes in pediatric brain tumor survivors.

  18. Outcomes of a Weight Loss Intervention among Rural Breast Cancer Survivors

    OpenAIRE

    Befort, Christie A.; Klemp, Jennifer R.; Austin, Heather; Perri, Michael G.; Schmitz, Kathryn H.; Sullivan, Debra K.; Fabian, Carol J.

    2011-01-01

    Obese breast cancer survivors have increased risk of recurrence and death compared to their normal weight counterparts. Rural women have significantly higher obesity rates, thus weight control intervention may be a key strategy for prevention of breast cancer recurrence in this population. This one arm treatment study examined the impact of a group-based weight control intervention delivered through conference call technology to obese breast cancer survivors living in remote rural locations. ...

  19. Quality of life and sexuality comparison between sexually active ovarian cancer survivors and healthy women

    Science.gov (United States)

    Kim, Se Ik; Lee, Yumi; Joo, Jungnam; Park, KiByung; Lee, Dong Ock; Park, Sang-Yoon

    2015-01-01

    Objective compare quality of life (QoL) and sexual functioning between sexually active ovarian cancer survivors and healthy women. Methods A cross-sectional study was performed in 103 successfully treated ovarian cancer survivors and 220 healthy women. All women had engaged in sexual activity within the previous 3 months, and ovarian cancer survivors were under surveillance after primary treatment without evidence of disease. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), Ovarian Cancer Module (EORTC QLQ-OV28), and the Female Sexual Function Index (FSFI). Propensity score matching was used to adjust covariates between the ovarian cancer survivor and healthy women groups. In total, 73 ovarian cancer survivors and 73 healthy women were compared. Results Poorer social functioning (mean, 82.4 vs. 90.9; p=0.010) and more financial difficulties (mean, 16.4 vs. 7.8; p=0.019) were observed among ovarian cancer survivors than among healthy women. Sexuality, both in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain and in terms of interest in sex, sexual activity, and enjoyment of sex (EORTC QLQ-OV28) were similar between the groups. However, vaginal dryness was more problematic in ovarian cancer survivors, with borderline statistical significance (p=0.081). Conclusion Sexuality was not impaired in ovarian cancer survivors who were without evidence of disease after primary treatment and having sexual activities, compared with healthy women, whereas social functioning and financial status did deteriorate. Prospective cohort studies are needed. PMID:25686396

  20. Birth outcomes among offspring of adult cancer survivors: a population-based study.

    Science.gov (United States)

    Stensheim, Hanne; Klungsøyr, Kari; Skjaerven, Rolv; Grotmol, Tom; Fosså, Sophie D

    2013-12-01

    Do cancer and cancer treatment influence patients' subsequent pregnancies and outcomes for the offspring? In this study, we compared birth outcomes in 3,915 female and male survivors and 144,653 controls from the general population with similar parity, by merging data from the Cancer Registry and the Medical Birth Registry of Norway. The cancer survivors were diagnosed at age 16-45 in the period 1967-2004. Subgroups of nulliparous survivors (childless before cancer) and primiparous (one pregnancy before and one after cancer) were analyzed, using logistic regression to compare birth outcomes with controls, focusing perinatal death, congenital anomalies, preterm birth (offspring had increased risk of preterm birth (OR = 1.30 [95% CI 1.05-1.61]) but similar risks of LBW and perinatal death as their controls. Primiparous female survivors differed from their controls, with higher frequency of preterm birth (OR = 1.89 [95% CI 1.40-2.56]) and LBW at term (OR = 2.02 [95% CI 1.15-3.55]). A borderline significant increase of perinatal death was seen among offspring of primiparous female survivors, with OR = 1.92 (95% CI 0.98-3.76). Offspring of male survivors did not differ from their controls. For all cancer types combined, no increased risk of congenital anomalies was seen among either female or male survivors' offspring. Pregnant female cancer survivors should be offered close follow-up, as there is an increased risk of adverse birth outcomes, in particular among those with higher parities.

  1. Developing a Web-Based Weight Management Program for Childhood Cancer Survivors: Rationale and Methods

    OpenAIRE

    2016-01-01

    Background Due to advances in the field of oncology, survival rates for children with cancer have improved significantly. However, these childhood cancer survivors are at a higher risk for obesity and cardiovascular diseases and for developing these conditions at an earlier age. Objective In this paper, we describe the rationale, conceptual framework, development process, novel components, and delivery plan of a behavioral intervention program for preventing unhealthy weight gain in survivors...

  2. Factors associated with recruiting adult survivors of childhood cancer into clinic-based research

    Science.gov (United States)

    Mertens, Ann C; Liu, Wen; Ness, Kirsten K; McDonald, Aaron; Hudson, Melissa M; Wasilewski-Masker, Karen; Bhatia, Smita; Nathan, Paul C; Leonard, Marcia; Srivastava, Kumar; Robison, Leslie L; Green, Daniel M

    2014-01-01

    Background A high proportion of pediatric cancer patients are now surviving into adulthood, but are at increased risk for late morbidity and premature mortality related to their diagnosis and therapeutic exposures. Little is known about the potential success of recruiting adult survivors of childhood cancer into research projects that would require a risk-based health evaluation within a clinical setting. Procedures Pediatric cancer survivors and siblings eligible for the current study were Childhood Cancer Survivor Study participants who lived within 100 miles of one of five Consortium for Pediatric Intervention Research institutions, regardless of where they were initially diagnosed and treated. A short survey was mailed to 829 survivors and 373 siblings to identify factors that predict interest, potential barriers, and motivators, to participation in research including a risk-based clinical evaluation. Results Overall, 92% of survivors responding to the survey were very interested/interested in participating in a research study requiring a visit to a local hospital clinic. Siblings of survivors were less interested than survivors in participating in such a study, with only 78% indicating that they were very interested/ interested. Potential motivators to participation included visiting their treating hospital and receiving health information. The primary barrier to participation was related to taking time off from work. Conclusions This study demonstrates that a subgroup of survivors would be willing to return to a long-term follow-up center to participate in intervention-based research. Identified motivating factors and perceived barriers need to be considered in determining the feasibility, design and execution of future research. PMID:24976622

  3. Life events, coping, and posttraumatic stress symptoms among Chinese adolescents exposed to 2008 Wenchuan Earthquake, China.

    Directory of Open Access Journals (Sweden)

    Yuhong Zheng

    Full Text Available PURPOSE: To examine the relationship between negative life events, coping styles, and symptoms of post-traumatic stress disorder (PTSD among adolescent survivors exposed to 2008 Wenchuan Earthquake, China. METHODS: A survey was conducted in a sample of 2250 adolescent students from two schools in Dujiangyan District, a seriously damaged area, 20 kilometers away from the epicenter, 6 months after the earthquake. Participants completed a self-administered questionnaire including demographics, negative life events, coping styles, and PTSD symptoms. RESULTS: Academic pressure was the strongest predictor of adolescents' PTSD symptoms among all negative life events. Main effects of negative life events, positive coping and negative coping on PTSD symptoms were significant in both younger adolescents and older adolescents, while the moderator effects of two coping styles were found significant only within older adolescents. CONCLUSIONS: Coping may play a role to moderate the relationship between post-earthquake negative life events and PTSD symptom, but the function seems to depend on the age of participants. Psychosocial coping skills training may be important in the prevention and intervention of mental health problems in adolescent survivors of traumatic earthquake.

  4. Late morbidity leading to hospitalization among 5-year survivors of young adult cancer: a report of the childhood, adolescent and young adult cancer survivors research program.

    Science.gov (United States)

    Zhang, Yang; Lorenzi, Maria F; Goddard, Karen; Spinelli, John J; Gotay, Carolyn; McBride, Mary L

    2014-03-01

    To estimate the risk of late morbidity leading to hospitalization among young adult cancer 5-year survivors compared to the general population and to examine the long-term effects of demographic and disease-related factors on late morbidity, a retrospective cohort of 902 five-year survivors of young adult cancer diagnosed between 1981 and 1999 was identified from British Columbia (BC) Cancer Registry. A matched comparison group (N = 9020) was randomly selected from the provincial health insurance plan. All hospitalizations until the end of 2006 were determined from the BC health insurance plan hospitalization records. The Poisson regression model was used to estimate the rate ratios for late morbidity leading to hospitalization except pregnancy after adjusting for sociodemographic and clinical risk factors. Overall, 455 (50.4%) survivors and 3,419 (37.9%) individuals in the comparison group had at least one type of late morbidity leading to hospitalization. The adjusted risk of this morbidity for survivors was 1.4 times higher than for the comparison group (95% CI = 1.22-1.54). The highest risks were found for hospitalization due to blood disease (RR = 4.2; 95% CI = 1.98-8.78) and neoplasm (RR = 4.3; 95% CI = 3.41-5.33). Survivors with three treatment modalities had three-fold higher risk of having any type of late morbidity (RR = 3.22; 95% CI = 2.09-4.94) than the comparators. These findings emphasize that young adult cancer survivors still have high risks of a wide range of late morbidities.

  5. Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: A systematic review.

    Science.gov (United States)

    Kantor, Viktoria; Knefel, Matthias; Lueger-Schuster, Brigitte

    2017-03-01

    Many trauma survivors seem to be reluctant to seek professional help. The aim of the current review was to synthesize relevant literature, and to systematically classify trauma survivors' perceived barriers and facilitators regarding mental health service utilization. The systematic search identified 19 studies addressing military personnel and 17 studies with trauma survivors of the general population. The data analysis revealed that the most prominent barriers included concerns related to stigma, shame and rejection, low mental health literacy, lack of knowledge and treatment-related doubts, fear of negative social consequences, limited resources, time, and expenses. Perceived facilitators lack attention in research, but can be influential in understanding mental health service use. Another prominent finding was that trauma survivors face specific trauma-related barriers to mental health service use, especially concerns about re-experiencing the traumatic events. Many trauma survivors avoid traumatic reminders and are therefore concerned about dealing with certain memories in treatment. These perceived barriers and facilitators were discussed regarding future research and practical implications in order to facilitate mental health service use among trauma survivors.

  6. Speaking legibly: Qualitative perceptions of altered voice among oral tongue cancer survivors

    Directory of Open Access Journals (Sweden)

    Genevieve Philiponis

    2015-01-01

    Full Text Available Objective: Treatment for oral tongue cancer poses unique challenges to restoring and maintaining personally acceptable, intelligible speech. Methods: We report how oral tongue cancer survivors describe their speech after treatment in a qualitative descriptive approach using constant comparative technique to complete a focal analysis of interview data from a larger grounded theory study of oral tongue cancer survivorship. Interviews were completed with 16 tongue cancer survivors 3 months to 12 years postdiagnosis with stage I-IV disease and treated with surgery alone, surgery and radiotherapy, or chemo-radiation. All interview data from the main study were analyzed for themes describing perceptions of speech as oral tongue cancer survivors. Results: Actual speech impairments varied among survivors. None experienced severe impairments that inhibited their daily lives. However, all expressed some level of concern about speech. Concerns about altered speech began when survivors heard their treatment plans and continued through to survivorship without being fully resolved. The overarching theme, maintaining a pattern and character of speech acceptable to the survivor, was termed "speaking legibly" using one survivor′s vivid in vivo statement. Speaking legibly integrate the sub-themes of "fears of sounding unusual," "learning to talk again," "problems and adjustments," and "social impact." Conclusions: Clinical and scientific efforts to further understand and address concerns about speech, personal presentation, and identity among those diagnosed with oral tongue are important to improving care processes and patient-centered experience.

  7. Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

    Directory of Open Access Journals (Sweden)

    Oshima Sumiko

    2013-01-01

    Full Text Available Abstract Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively. Results Survivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking. Conclusions Post-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care.

  8. Effects of Child Sexual Abuse on the Parenting of Male Survivors.

    Science.gov (United States)

    Wark, Joe; Vis, Jo-Ann

    2016-10-21

    Research shows that child sexual abuse (CSA) can have detrimental effects on adult functioning. While much research regarding the effects of CSA on parenting of mothers is available, there is a dearth of information on how CSA impacts fatherhood. This literature review finds that the parenting experiences of male survivors are characterized by self-perceptions as adequate parents, deficient parenting as measured by standardized instruments, conceptualization of parenting as an intergenerational legacy and potential healing experience, fear of becoming an abuser, and physical and emotional distance from their children. These themes are strongly related to social discourses on intergenerational cycle of violence theories. Fatherhood is not exclusively problematic for male survivors and can be a healing experience and a source of strength for some survivors. Based on literature concerning male survivors who are parents, narrative therapy is recommended as a therapeutic model to explore how fathers who are survivors challenge dominant discourses around legacies of family violence, intergenerational parenting deficiencies, and victimization. Restorying fatherhood as a healing opportunity is essential when working with fathers who are male survivors and their families.

  9. 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...... of 33 °C or 36 °C within the Target Temperature Management trial (TTM-trial) attended a follow-up after 6 months that included the questionnaire Hospital Anxiety and Depression Scale (HADS). A control group with ST-elevation myocardial infarction (STEMI) completed the same follow-up. Correlations...... to variables assumed to be associated with anxiety and depression in OHCA-survivors were tested. RESULTS: At follow-up 278 OHCA-survivors and 119 STEMI-controls completed the HADS where 24% of OHCA-survivors (28% in 33 °C group/22% in 36 °C group, p=0.83) and 19% of the STEMI-controls reported symptoms...

  10. Psychosocial status of childhood cancer survivors who develop one or more secondary malignancies

    Directory of Open Access Journals (Sweden)

    Roman Korenjak

    2011-11-01

    Full Text Available Objective. Childhood cancer survivors can develop physical, emotionaland psychosocial adversities, a secondary malignancy (SM beingone of the most serious among them. Th e aim of our research was tostudy whether the development of SM was related to the psychosocialfunctioning of survivors, especially whether any psychic trauma fromthe first experience would be aggravated by SM. Patients and methods.Seventy – five childhood cancer survivors with SM were matched with75 survivors who did not develop SM, by sex, age, living environment,diagnosis, year of diagnosis and treatment of the first malignancy. They were compared regarding education, employment, marital status and, in the 35 women, childbirth data. Seventeen childhood survivors with an SM had had psychological evaluations at diagnosis of both their first and secondary cancers; the results of the two were compared. Results. Th ere were no differences in the schooling, education, social, marital status or birth specifics between survivors with SM and their controls, nor were there marked differences in measures of social or psychological status. Conclusions. The socioeconomic status of these 75 subjects was not found to be related to the development of SM. Psychological evaluations showed no marked differences between those conducted aft er the first and the secondary malignancies.

  11. DEPRESSION, ANXIETY AND QUALITY OF LIFE OF CANCER SURVIVORS

    Directory of Open Access Journals (Sweden)

    Koijam Shantibala

    2016-05-01

    Full Text Available BACKGROUND Cancer of any type is a serious and life-threatening illness, not uncommon in the general population. Cancer survivor can mean any person diagnosed with cancer from the time of initial diagnosis until his or her death. It includes people who are dying from untreatable cancer. Cancer survivor also includes those patients who are receiving or have received treatment with no active disease process and those who are not in the terminal stage of the illness. Cancer survivors tend to develop anxiety, depression and change in their quality of life as they have to make adjustment to many psychological and physical changes as well as financial constraint. MATERIALS AND METHODS Fifty (50 cancer survival patients visiting Department of Radiotherapy, Regional Institute of Medical Sciences (RIMS, Imphal, during February 2015 to December 2015 were enrolled in this study. The study forms including the questions regarding the patient’s demographic characteristics, Becks Depression Inventory (BDI, State and Trait Anxiety Inventory (STAI and WHOQOL BREF were completed during face-to-face interviews for the determination of the psychological status of the patients. And the data were analysed using SPSS version 20.0. RESULTS All the dimensions of the Quality of Life (QoL except D3= Domain 3 (Social Relationship are negatively correlated with both the sub-types of STAI (State and Trait Anxiety. The state anxiety score is negatively correlated with D1=Domain 1 (Physical health; p=.001, D2= Domain 2 (Psychological; p=.001, D4= Domain 4 (Environment; p=.000. Also, the trait anxiety scores of the patients are negatively correlated with D1=Domain 1 (Physical health; p=.001, D2= Domain 2 (Psychological; p=.000, D4= Domain 4 (Environment; p=.000. However, there is no significant difference in terms of D3= Domain 3 (Social Relationship; state anxiety p=.142 and trait anxiety p=.220 and STAI scores. On the other hand, there is positive correlation between Becks

  12. Character strengths of adolescent survivors of childhood cancer

    Directory of Open Access Journals (Sweden)

    Gloria Eracleous

    2011-02-01

    Full Text Available There is increased interest in possible positive outcomes for survivors of childhood cancer. This study investigated the manifestation of character strengths in adolescents who have survived cancer compared to that seen in healthy adolescents. The aim was to establish whether specific character strengths may be more prominent in adolescents who have survived cancer than in healthy adolescents. Two groups of participants, consisting of adolescents who have survived childhood cancer (n = 21 and a group of healthy adolescents (n = 21, were obtained through convenience sampling. They completed the Values in Action Inventory for Youth (VIAYouth(Park & Peterson 2006 as a measure of character strengths. No significant differences were found between the character strengths of adolescents who have survived cancer and their healthy peers, unlike the findings of a similar earlier study with adults (Peterson, Park & Seligman 2006. It is concluded that the experience of serious illness such as cancer neither hindered nor enhanced the development of character strengths in this group of adolescent survivors. More research is needed to understand positive psychological functioning in the aftermath of childhood cancer.

    Opsomming
    Daar is toenemende belangstelling in moontlike positiewe uitkomste vir kinders wat kanker oorleef het. Hierdie studie het ondersoek hoe karaktersterktes na vore kom in adolessente wat as kinders met kanker gediagnoseer is in vergelyking met dié in ‘n groep gesonde adolessente. Die studie het ten doel gehad om vas te stel of spesifieke karaktersterktes meer opvallend na vore kom in adolessente wat kanker oorleef het. Die deelnemers is deur middel van gerieflikheidsteekproefneming gekies. Die twee groepe het bestaan uit adolessente wat as kinders met kanker gediagnoseer is (n = 21 en ‘n groep gesonde adolessente (n = 21.Deelnemers het die Values in Action Inventory for Youth

  13. 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.

  14. 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...

  15. Diffusion tensor imaging and neurocognition in survivors of childhood acute lymphoblastic leukaemia.

    Science.gov (United States)

    Edelmann, Michelle N; Krull, Kevin R; Liu, Wei; Glass, John O; Ji, Qing; Ogg, Robert J; Sabin, Noah D; Srivastava, Deo Kumar; Robison, Leslie L; Hudson, Melissa M; Reddick, Wilburn E

    2014-11-01

    Survivors of childhood acute lymphoblastic leukaemia are at risk for neurocognitive impairment, though little information is available on its association with brain integrity, particularly for survivors treated without cranial radiation therapy. This study compares neurocognitive function and brain morphology in long-term adult survivors of childhood acute lymphoblastic leukaemia treated with chemotherapy alone (n = 36) to those treated with cranial radiation therapy (n = 39) and to healthy control subjects (n = 23). Mean (standard deviation) age at evaluation was 24.9 (3.6) years for the chemotherapy group and 26.7 (3.4) years for the cranial radiation therapy group, while time since diagnosis was 15.0 (1.7) and 23.9 (3.1) years, respectively. Brain grey and white matter volume and diffusion tensor imaging was compared between survivor groups and to 23 healthy controls with a mean (standard deviation) age of 23.1 (2.6) years. Survivors treated with chemotherapy alone had higher fractional anisotropy in fibre tracts within the left (P < 0.05), but not in the right, hemisphere when compared to controls. Survivors of acute lymphoblastic leukaemia, regardless of treatment, had a lower ratio of white matter to intracranial volume in frontal and temporal lobes (P < 0.05) compared with control subjects. Survivors of acute lymphoblastic leukaemia treated with chemotherapy alone performed worse in processing speed (P < 0.001), verbal selective reminding (P = 0.01), and academics (P < 0.05) compared to population norms and performed better than survivors treated with cranial radiation therapy on verbal selective reminding (P = 0.02), processing speed (P = 0.05) and memory span (P = 0.009). There were significant associations between neurocognitive performance and brain imaging, particularly for frontal and temporal white and grey matter volume. Survivors of acute lymphoblastic leukaemia treated with chemotherapy alone demonstrated significant long-term differences in

  16. Epidemiologic Study of One Million American Workers and Military Veterans Exposed to Ionizing Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Boice, John D. [International Epidemiology Inst. Ltd., Rockville, MD (United States)

    2015-02-27

    A pilot study was completed demonstrating the feasibility of conducting an epidemiologic study assessing cancer and other disease mortality among nearly one million US veterans and workers exposed to ionizing radiation, a population 10 times larger than atomic bomb survivor study with high statistical power to evaluate low dose rate effects. Among the groups enumerated and/or studied were: (1) 194,000 Department of Energy Uranium Workers; (2) 6,700 Rocketdyne Radiation Workers; (3) 7,000 Mound Radiation Workers; (4) 156,000 DOE Plutonium Workers; (5) 212,000 Nuclear Power Plant Workers; (6) 130,000 Industrial Radiography Workers; (7) 1.7 million Medical Workers and (8) 135,000 Atomic Veterans.

  17. Powerful Silences: Becoming a Survivor Through the Construction of Story

    Directory of Open Access Journals (Sweden)

    Arlene Voski Avakian

    2006-09-01

    Full Text Available Survivors’ accounts of traumatic events function on many levels for both the teller and the hearer. By giving voice to what has been silenced, testimonies to the lived experience of trauma challenge dominant perspectives on the meaning and significance of both historical and contemporary events. The construction of these stories and their telling may also provide a means of countering the devastating psychological effects of the trauma. This paper will explore one story about the Turkish genocide of Armenians in 1915 as told to me by my grandmother, Elmas Tutuian. Remarkably consistent over the years of its telling, Tutuian’s story omits as much as it tells. Examining this narrative from both a psychological and a textual perspective, I suggest that by choosing to be silent about parts of her experience, Tutuian constructed herself as a survivor rather than a victim. In choosing to tell her narrative to me, she also shaped my sense of resistance to oppression. The article references works analyzing survivors’ accounts of trauma from a literary, psychological, sociological, theological, and historical perspective.

  18. Primary lung sarcomas: long survivors obtained with iterative complete surgery.

    Science.gov (United States)

    Magné, N; Porsin, B; Pivot, X; Tchiknavorian, X; Marcy, P Y; Foa, C; Otto, J; Schneider, M; Thyss, A

    2001-01-01

    Primary lung sarcomas are uncommon histologic types of primary lung cancer and presents a wide spectrum of clinical behaviour. Nine patients treated at Antoine Lacassagne Cancer Center between 1982 and 1995 were studied. The median age was 63 years (range, 35-73 years) and the most common histologic types were malignant fibrous histiocytoma (four) and leiomyosarcoma (three). All of them underwent surgery, six patients had a complete surgery and three patients incomplete resections. The median overall survival for all patients was 36 months. In the subgroup of patients with initial complete resection, the median survival was significantly longer (47 months) than in the subgroup of patients with incomplete resection (6 months) (Prank test). Moreover, two patients had a second complete resection for ipsilateral lung relapse and were long survivors (overall survival of 58 and 83 months, respectively). The ability to achieve a complete second surgery stress the possible benefit of an early detection of local recurrence. Because no specific symptom was linked with the local relapse, a systematic CT scan every 2 or 3 months could be required.

  19. Acute respiratory distress syndrome (ARDS): HRCT findings in survivors

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jung Im; Park, Seog Hee; Lee, Jae Mun; Song, Jeong Sup; Lee, Kyo Young [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-08-01

    The purpose of this report is to describe the high-resolution computed tomography (HRCT) findings of the lung in survivors of acute respiratory distress syndrome (ARDS). Among eleven patients who survived ARDS for one year, chest radiography and HRCT revealed pulmonary fibrosis in four. Causes of ARDS included pneumonia during pregnancy, near drowning, pneumonia during liver cirrhosis, and postoperative sepsis. Thoracoscopic biopsy and histopathologic correlation were available in one patient. HRCT showed diffuse interlobular septal thickening, ground glass opacity, parenchymal distortion, and traction bronchiectasis. Fuzzy centrilobular nodules were seen in two patients and one patient had multiple, large bullae in the left hemithorax. In all patients, lesions affected the upper and anterior zones of the lung more prominently. The distribution of pulmonary fibrosis was characteristic and reflected the pathogenesis of lung injury; fibrosis was largely due to hyperoxia caused by ventilator care. In one patient, histopathologic correlation showed that imaging findings were accounted for by thickening of the alveolar septum along with infiltration of chronic inflammatory cells and fibrosis. Fuzzy centrilobular nodules corresponded with bronchiolitis.

  20. HMGB1 mediates anemia of inflammation in murine sepsis survivors.

    Science.gov (United States)

    Valdés-Ferrer, Sergio I; Papoin, Julien; Dancho, Meghan E; Olofsson, Peder; Li, Jianhua; Lipton, Jeffrey M; Avancena, Patricia; Yang, Huan; Zou, Yong-Rui; Chavan, Sangeeta S; Volpe, Bruce T; Gardenghi, Sara; Rivella, Stefano; Diamond, Betty; Andersson, Ulf; Steinberg, Bettie M; Blanc, Lionel; Tracey, Kevin J

    2015-12-29

    Patients surviving sepsis develop anemia but the molecular mechanism is unknown. Here we observed that mice surviving polymicrobial Gram-negative sepsis develop hypochromic, microcytic anemia with reticulocytosis. The bone marrow of sepsis survivors accumulates polychromatophilic and orthochromatic erythroblasts. Compensatory extramedullary erythropoiesis in the spleen is defective during terminal differentiation. Circulating TNF and IL-6 are elevated for five days after the onset of sepsis, and serum HMGB1 levels are increased from day seven until at least day 28. Administration of recombinant HMGB1 to healthy mice mediates anemia with extramedullary erythropoiesis and significantly elevated reticulocyte counts. Moreover, administration of anti-HMGB1 monoclonal antibodies after sepsis significantly ameliorates the development of anemia (hematocrit 48.5±9.0% versus 37.4±6.1%, p<0.01, hemoglobin 14.0±1.7g/dL versus 11.7±1.2g/dL, p<0.01). Together, these results indicate that HMGB1 mediates anemia by interfering with erythropoiesis, suggesting a potential therapeutic strategy for anemia in sepsis.

  1. Subsequent pregnancy and prognosis in breast cancer survivors.

    Science.gov (United States)

    Kasum, Miro; Beketić-Orešković, Lidija; Orešković, Slavko

    2014-09-01

    An increase in the incidence of breast cancer in women aged breast cancer in women of childbearing age has significantly improved, they are often concerned whether subsequent pregnancy will alter their risk of disease recurrence. In the modern era, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer and women can bear children after breast cancer treatment without compromising their survival. Therefore, they should not be discouraged from becoming pregnant, and currently the usual waiting time of at least 2 years after the diagnosis of breast cancer is recommended. However, a small, nonsignificant adverse effect of pregnancy on breast carcinoma prognosis among women who conceive within 12 months of breast cancer diagnosis and a higher risk of relapse in women younger than 35 up to 5 years of the diagnosis may be found. Fortunately, for women with localized disease, earlier conception up to six months after completing their treatment seems unlikely to reduce their survival. Ongoing and future prospective studies evaluating the risks associated with pregnancy in young breast cancer survivors are required.

  2. Near-death experiences in cardiac arrest survivors.

    Science.gov (United States)

    French, Christopher C

    2005-01-01

    Near-death experiences (NDEs) have become the focus of much interest in the last 30 years or so. Such experiences can occur both when individuals are objectively near to death and also when they simply believe themselves to be. The experience typically involves a number of different components including a feeling of peace and well-being, out-of-body experiences (OBEs), entering a region of darkness, seeing a brilliant light, and entering another realm. NDEs are known to have long-lasting transformational effects upon those who experience them. An overview is presented of the various theoretical approaches that have been adopted in attempts to account for the NDE. Spiritual theories assume that consciousness can become detached from the neural substrate of the brain and that the NDE may provide a glimpse of an afterlife. Psychological theories include the proposal that the NDE is a dissociative defense mechanism that occurs in times of extreme danger or, less plausibly, that the NDE reflects memories of being born. Finally, a wide range of organic theories of the NDE has been put forward including those based upon cerebral hypoxia, anoxia, and hypercarbia; endorphins and other neurotransmitters; and abnormal activity in the temporal lobes. Finally, the results of studies of NDEs in cardiac arrest survivors are reviewed and the implications of these results for our understanding of mind-brain relationships are discussed.

  3. Impairments that Influence Physical Function among Survivors of Childhood Cancer

    Directory of Open Access Journals (Sweden)

    Carmen L. Wilson

    2015-01-01

    Full Text Available Children treated for cancer are at increased risk of developing chronic health conditions, some of which may manifest during or soon after treatment while others emerge many years after therapy. These health problems may limit physical performance and functional capacity, interfering with participation in work, social, and recreational activities. In this review, we discuss treatment-induced impairments in the endocrine, musculoskeletal, neurological, and cardiopulmonary systems and their influence on mobility and physical function. We found that cranial radiation at a young age was associated with a broad range of chronic conditions including obesity, short stature, low bone mineral density and neuromotor impairments. Anthracyclines and chest radiation are associated with both short and long-term cardiotoxicity. Although numerous chronic conditions are documented among individuals treated for childhood cancer, the impact of these conditions on mobility and function are not well characterized, with most studies limited to survivors of acute lymphoblastic leukemia and brain tumors. Moving forward, further research assessing the impact of chronic conditions on participation in work and social activities is required. Moreover, interventions to prevent or ameliorate the loss of physical function among children treated for cancer are likely to become an important area of survivorship research.

  4. Ungendering and Regendering Shelters for Survivors of Human Trafficking

    Directory of Open Access Journals (Sweden)

    Daphna Hacker

    2015-02-01

    Full Text Available This article is based on intensive fieldwork in the two Israeli shelters designated for victims of human trafficking and slavery. The shelters, one for women and one for men, are a refuge for survivors of sex trafficking; labor migrants subjected to severe exploitation by their employers; and asylum seekers who arrived in Israel after experiencing severe physical and emotional abuse at the hands of kidnappers and smugglers en route to Israel. The study included interviews with policy makers and professionals, and with women and men who resided at the shelters, as well as an analysis of the relevant legislation and official reports. The article explores the problematic gendered differentiations between the two shelters. Most significantly, while support for residents of the shelter for women is anchored by emotional and psychological rehabilitation, residents of the shelter for men do not receive any therapeutic support. At the same time, while staff in the shelter for men put significant effort into the reintegration of the men into the labor force, the women’s employment prospects receive less attention. Based on these and other findings, the article cautions against gender-biased rehabilitation services for victims of human trafficking and slavery, and calls for a gender-sensitive rehabilitation theory and practice.

  5. Social Security Administration - Quarterly 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 quarterly volumes for language preferences at the national level of individuals filing claims for Retirement and Survivor benefits from fiscal...

  6. Psychological sequelae of the station nightclub fire: Comparing survivors with and without physical injuries using a mixed-methods analysis.

    Directory of Open Access Journals (Sweden)

    Nhi-Ha T Trinh

    Full Text Available Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised and depressive (Beck Depression Inventory symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.

  7. Rape as an Economic Crime: The Impact of Sexual Violence on Survivors' Employment and Economic Well-Being.

    Science.gov (United States)

    Loya, Rebecca M

    2015-10-01

    This article examines how isolated instances of sexual violence affect adult female survivors' employment and economic well-being. This study draws on data from 27 in-depth, qualitative interviews with sexual assault survivors and rape crisis service providers. The findings suggest that sexual assault and the related trauma response can disrupt survivors' employment in several ways, including time off, diminished performance, job loss, and inability to work. By disrupting income or reducing earning power, all of these employment consequences have implications for survivors' economic well-being in the months or years following the assault. In addition, I argue that for many survivors, these employment consequences compound one another and ultimately shift survivors' long-term economic trajectories. By highlighting survivors' lived experiences of the financial aftermath of sexual assault, these findings help to illuminate the processes by which sexual violence decreases survivors' income over the life course. Understanding the financial effects of sexual violence can help researchers better understand and predict the recovery process, while helping practitioners to design more effective interventions for survivors.

  8. 76 FR 50744 - Notice To Announce the Award of an Urgent Single-Source Grant to Survivors of Torture...

    Science.gov (United States)

    2011-08-16

    ... provide medical, psychological, social, and legal services to Iraqis who have suffered torture and are... possesses the clinical and programmatic expertise to serve survivors of torture. For Further...

  9. The Domestic Violence Survivor Assessment (DVSA): a tool for individual counseling with women experiencing intimate partner violence.

    Science.gov (United States)

    Dienemann, Jacqueline; Glass, Nancy; Hanson, Ginger; Lunsford, Kathleen

    2007-08-01

    The Domestic Violence Survivor Assessment (DVSA) was developed to measure survivor movement toward a violence free life over time. This paper reports our testing of the validity and reliability of the DVSA. Exploratory factor analysis (n = 162) found a single factor explaining 66% of the variance. Hierarchical multiple regression indicated that physical abuse severity, survivor and perpetrator substance abuse, economic and citizenship dependency, and children under 18 at home explained 10% of the variance p > .05. A second model examined the strength of interventions for survivors, controlling for influencing factors; R(2) was.24 (p evaluated its programs using the DVSA change scores and used this evaluation for program improvement.

  10. Humidifier disinfectant-associated children's interstitial lung disease: Computed tomographic features, histopathologic correlation and comparison between survivors and non-survivors

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hee Mang; Lee, Jin Seong; Do, Kyung-Hyun; Jung, Ah Young; Yoon, Chong Hyun; Cho, Young Ah [Asan Medical Center, University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Songpa-gu, Seoul (Korea, Republic of); Lee, Eun; Hong, Soo-Jong [Asan Medical Center, University of Ulsan College of Medicine, Department of Pediatrics, Songpa-gu, Seoul (Korea, Republic of); Kim, Seon-Ok [Asan Medical Center, University of Ulsan College of Medicine, Department of Clinical Epidemiology and Biostatistics, Songpa-gu, Seoul (Korea, Republic of); Jang, Se-Jin [Asan Medical Center, University of Ulsan College of Medicine, Departments of Pathology, Songpa-gu, Seoul (Korea, Republic of)

    2016-01-15

    To report radiologic findings with histopathologic correlations of humidifier disinfectant-associated children's interstitial lung disease (HD-chILD) and to compare computed tomography (CT) findings between survivors and non-survivors. Forty-seven children with HD-chILD (27.4 ± 12.4 months old) were categorized as survivors (n = 25) and non-survivors (n = 22). The patterns, distributions, and chronological changes in lung lesions at follow-up CT were investigated. Histopathologic correlations were performed in 23 patients. CT features were characterized by chronological changes, from consolidation to centrilobular opacities, and lesions eventually became faint centrilobular nodules. Histopathologic features were bronchocentric-distributed fibro-inflammatory lesions, which were more profound in the advanced stage than the early stage. Consolidation ≥30 % [hazard ratio (HR), 2.932], centrilobular opacities ≥60 % of the total lung volume (TLV; HR, 0.206) and spontaneous air leaks (HR, 3.457) were significant factors associated with patient survival, as per univariate analysis. Consolidation ≥30 % (HR, 3.519), centrilobular opacities ≥60 % (HR, 0.205) and diffuse ground glass opacity (GGO) ≥70 % of the TLV (HR, 3.521) were significant factors associated with patient survival, as determined via multivariate analysis. Distinctive chronological CT features were observed in the HD-chILD images. Spontaneous air leaks, consolidation, GGO, and centrilobular opacities were prognostic factors. (orig.)

  11. Cancer Survivors in the United States: A Review of the Literature and a Call to Action

    Directory of Open Access Journals (Sweden)

    Manuel Valdivieso, Ann M. Kujawa, Tisha Jones, Laurence H. Baker

    2012-01-01

    Full Text Available Background: The number of cancer survivors in the U.S. has increased from 3 million in 1971, when the National Cancer Act was enacted, to over 12 million today. Over 70% of children affected by cancer survive more than 10 years, and most are cured. Most cancer survivors are adults, with two-thirds of them 65 years of age or older and two-thirds alive at five years. The most common cancer diagnoses among survivors include breast, prostate and colorectal cancers. This review was conducted to better appreciate the challenges associated with cancer survivors and the opportunities healthcare providers have in making a difference for these patients.Methods: Comprehensive review of literature based on PubMed searches on topics related to cancer survivorship, and associated physical, cognitive, socio-economic, sexual/behavioral and legal issues.Results: At least 50% of cancer survivors suffer from late treatment-related side effects, often including physical, psychosocial, cognitive and sexual abnormalities, as well as concerns regarding recurrence and/or the development of new malignancies. Many are chronic in nature and some are severe and even life-threatening. Survivors also face issues involving lack of appropriate health maintenance counseling, increased unemployment rate and workplace discrimination.Conclusions: Advances in the diagnosis and treatment of cancer will lead to more survivors and better quality of life. However, tools to recognize potentially serious long-lasting side effects of cancer therapy earlier in order to treat and/or prevent them must be developed. It is incumbent upon our health care delivery systems to make meeting these patients' needs a priority.

  12. The metabolic syndrome in survivors of childhood acute lymphoblastic leukemia in Isfahan, Iran

    Science.gov (United States)

    Reisi, Nahid; Azhir, Afshin; Hashemipour, Mahin; Raeissi, Pouran; Amini, Abasgholi; Moafi, Alireza

    2009-01-01

    BACKGROUND: To determine the prevalence of metabolic syndrome in survivors of childhood leukemia in Isfahan, Iran. METHODS: During a 4-year period (2003 to 2007), 55 children (33 male and 22 female) diagnosed with ALL at Unit of Hematology/ Oncology, Department of Pediatrics, Isfahan University of Medical Science, were enrolled in this cross-sectional study. Metabolic syndrome was defined using the modified version of Adult Treatment Panel (ATP III) crite-ria. Insulin resistance was defined based on the homeostasis model assessment index (HOMA-IR). RESULTS: The mean age of participates was 10.4 years (range 6-19 years) and the mean interval since completion of chemotherapy was 35 months. Twenty percent (11/55) of survivors (10 male, 1 female) met criteria for diagnosis of metabolic syndrome. Obesity was observed in one forth of patients and nearly 3/4 of obese patients had metabolic syndrome. High serum insulin levels were found in 16% of participants and in 63% of obese survivors. The mean insulin levels in survivors with metabolic syndrome was three-times more than those without (28.3 mu/l vs. 9.57 mu/l, p = 0.004). Insulin resistance was detected in 72.7% of survivors with metabolic syndrome and it was positively correlated with serum triglycerides (0.543, p ≤ 0.001), systolic and diastolic BP (0.348, p = 0.01 and 0.368, p = 006 respectively), insulin levels (0.914, p < 0.001) and blood sugar (0.398, p = 003). CONCLUSIONS: The prevalence of metabolic syndrome in survivors of childhood leukemia in Iran is higher than developed countries. Nearly all of the obese patients had metabolic syndrome. Weight control and regular physical exercise are recommended to the survivors. PMID:21772869

  13. Return to work of breast cancer survivors: a systematic review of intervention studies

    Directory of Open Access Journals (Sweden)

    Frings-Dresen MHW

    2009-04-01

    Full Text Available Abstract Background Breast cancer management has improved dramatically in the past three decades and as a result, a population of working age women is breast cancer survivor. Interventions for breast cancer survivors have shown improvements in quality of life and in physical and psychological states. In contrast, efforts aimed at stimulating re-employment and return-to-work interventions for breast cancer survivors have not kept pace. The objective of this review was to study the effects and characteristics of intervention studies on breast cancer survivors in which the outcome was return to work. Methods The Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2006, Medline, Ovid, EMBASE and PsychInfo were systematically searched for studies conducted between 1970 to February 2007. Intervention studies for female breast cancer survivors that were focused on return to work were included. Results Our search strategy identified 5219 studies. Four studies out of 100 potentially relevant abstracts were selected and included 46–317 employed women who had had mastectomy, adjuvant therapy and rehabilitation, with the outcome return to work. The intervention programs focused on improvement of physical, psychological and social recovery. Although a substantial percentage (between 75% to 85% of patients included in these studies returned to work after rehabilitation, it is not clear whether this proportion would have been lower for patients without counseling or exercise, or any other interventions, as three out of four studies did not include a comparison group. Conclusion The most important finding of this review is the lack of methodologically sound intervention studies on breast cancer survivors with the outcome return to work. Using evidence from qualitative and observational studies on cancer and the good results of intervention studies on return to work programs and vocational rehabilitation, return to work interventions for breast

  14. Precision Guided Munitions: Constructing a Bomb More Potent Than the A-Bomb

    Science.gov (United States)

    2002-06-01

    military advantage is hardly unique to the American experience. Technology has shaped warfare in important ways since Herodotus first historicized armed...as today, likely took for granted the then-current state of the art, without feeling compelled to historicize it. However, even a cursory review of

  15. Control for occupationally exposed personnels

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Hiroyuki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Momose, Takuma

    1999-03-01

    The present status of the technology for the measurement of personnel exposure dose was reviewed based on the basic concept of ICRP Recommendation on new assessment of exposure dose. The personnel dosimeter which has been mostly used by occupationally exposed personnels in Japan is film badge or thermoluminescence dosimeter. Now, photoluminescent glass dosimeter has been paid attention because pulse excitation method by UV laser has been developed. Measurement at an accuracy of 0.1 mSv or more became possible by using this dosimeter at present. In addition, characteristic studies for practical application of electronic, photostimulated luminescence and neutron dosimeters are progressing now. Revision of kinetic model of in vivo metabolism of radioactive substances is progressing based on the recent findings since ICRP Recommendation in 1990. Monitoring an individual internal exposure is made by two methods; direct measurement of the radiation emitted from the body and indirect one by radioanalysis of excretes etc. The latter is inferior to the former in respect of the accuracy of dose assessment, but the direct method is more suitable to detect a little amount of radioactive substance incorporated because of its high sensitivity. In future, it is needed to provide a considerable number of whole body counters against a large-scale nuclear accident. (M.N.)

  16. Health-related quality of life of child and adolescent retinoblastoma survivors in the Netherlands

    Directory of Open Access Journals (Sweden)

    Bezemer Pieter D

    2007-12-01

    Full Text Available Abstract Background To assess health-related quality of life (HRQoL in children (8–11 years and adolescents (12–18 years who survived retinoblastoma (RB, by means of the KIDSCREEN self-report questionnaire and the proxy-report version. Methods This population-based cross-sectional study (participation rate 70% involved 65 RB survivors (8–18 years and their parents. Child/adolescents' and parents' perception of their youth's HRQoL was assessed using the KIDSCREEN, and the results were compared with Dutch reference data. Relations with gender, age, marital status of the parents, and visual acuity were analyzed. Results RB survivors reported better HRQoL than did the Dutch reference group on the dimensions "moods and emotions" and "autonomy". Increased ratings of HRQoL in RB survivors were mainly seen in perceptions of the younger children and adolescent girls. RB survivors with normal visual acuity scored higher on "physical well-being" than visually impaired survivors. Age was negatively associated with the dimensions "psychological well-being", "self-perception" (according to the child and parent reports and "parent relations and home life" (according to the child. "Self-perception" was also negatively associated with visual acuity (according to the child. Only parents of young boys surviving RB reported lower on "autonomy" than the reference group, and parents of low visual acuity and blind RB survivors reported higher on "autonomy" than parents of visually unimpaired survivors. Survivors' perceptions and parents' perceptions correlated poorly on all HRQoL dimensions. Conclusion RB survivors reported a very good HRQoL compared with the Dutch reference group. The perceptions related to HRQoL differ substantially between parents and their children, i.e. parents judge the HRQoL of their child to be relatively poorer. Although the results are reassuring, additional factors of HRQoL that may have more specific relevance, such as psychological

  17. Socioeconomic and sociodemographic predictors of cancer-related information sources used by cancer survivors.

    Science.gov (United States)

    Blanch-Hartigan, Danielle; Viswanath, Kasisomayajula

    2015-01-01

    With 14 million cancer survivors in the United States, identifying and categorizing their use of sources of cancer-related information is vital for targeting effective communications to this growing population. In addition, recognizing socioeconomic and sociodemographic differences in the use of cancer-related information sources is a potential mechanism for reducing health disparities in survivorship. Fourteen sources of information survivors (N = 519) used for cancer-related information were factor-analyzed to create a taxonomy of source use. The association between social determinants and use of these source types was analyzed in regression models. Factor analysis revealed 5 categories of information source use (mass media; Internet and print; support organizations; family and friends; health care providers), and use varied based on sociodemographic and socioeconomic characteristics. Higher education predicted increased use of all source categories except mass media. African American cancer survivors turned to health care providers as a source for cancer-related information less often than did White survivors. Social determinants predicted differences in the type of cancer-related information sources used. Providers and health communicators should target communication platforms based on the demographic profile of specific survivor audiences.

  18. Yoga as Treatment for Insomnia Among Cancer Patients and Survivors: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Karen M. Mustian

    2013-10-01

    Full Text Available Between 15-90% of cancer patients and survivors report some form of insomnia or sleep quality impairment during and post-treatment, such as excessive daytime napping, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia and sleep quality impairment are among the most prevalent and distressing problems reported by cancer patients and survivors, and can be severe enough to increase cancer mortality. Despite the ubiquity of insomnia and sleep quality impairment, they are under-diagnosed and under-treated in cancer patients and survivors. When sleep problems are present, providers and patients are often hesitant to prescribe or take pharmaceuticals for sleep problems due to polypharmacy concerns, and cognitive behavioural therapy for insomnia can be very difficult and impractical for patients to adhere to throughout the cancer experience. Research suggests yoga is a well-tolerated exercise intervention with promising evidence for its efficacy in improving insomnia and sleep quality impairment among survivors. This article provides a systematic review of existing clinical research on the effectiveness of yoga for treating insomnia and sleep quality impairment among cancer patients and survivors.

  19. Yoga as Treatment for Insomnia Among Cancer Patients and Survivors: A Systematic Review.

    Science.gov (United States)

    Mustian, Karen M

    2013-11-01

    Many cancer patients and survivors, between 15 to 90%, report some form of insomnia or sleep quality impairment during and post-treatment, such as excessive daytime napping, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia and sleep quality impairment are among the most prevalent and distressing problems reported by cancer patients and survivors, and can be severe enough to increase cancer mortality. Despite the ubiquity of insomnia and sleep quality impairment, they are under-diagnosed and under-treated in cancer patients and survivors. When sleep problems are present, providers and patients are often hesitant to prescribe or take pharmaceuticals for sleep problems due to poly pharmacy concerns, and cognitive behavioral therapy for insomnia can be very difficult and impractical for patients to adhere to throughout the cancer experience. Research suggests yoga is a well-tolerated exercise intervention with promising evidence for its efficacy in improving insomnia and sleep quality impairment among survivors. This article provides a systematic review of existing clinical research on the effectiveness of yoga for treating insomnia and sleep quality impairment among cancer patients and survivors.

  20. Balance Performance in Irradiated Survivors of Nasopharyngeal Cancer with and without Tai Chi Qigong Training.

    Science.gov (United States)

    Fong, Shirley S M; Chung, Louisa M Y; Tsang, William W N; Leung, Joyce C Y; Charm, Caroline Y C; Luk, W S; Chow, Lina P Y; Ng, Shamay S M

    2014-01-01

    This cross-sectional exploratory study aimed to compare the one-leg-stance time and the six-minute walk distance among TC Qigong-trained NPC survivors, untrained NPC survivors, and healthy individuals. Twenty-five survivors of NPC with TC Qigong experience, 27 survivors of NPC without TC Qigong experience, and 68 healthy individuals formed the NPC-TC Qigong group, NPC-control group, and healthy-control group, respectively. The one-leg-stance (OLS) timed test was conducted to assess the single-leg standing balance performance of the participants in four conditions: (1) standing on a stable surface with eyes open, (2) standing on a compliant surface with eyes open, (3) standing on a stable surface with eyes closed, and (4) standing on a compliant surface with eyes closed. The six-minute walk test (6MWT) was used to determine the functional balance performance of the participants. Results showed that the NPC-control group had a shorter OLS time in all of the visual and supporting surface conditions than the healthy control group (P Qigong-NPC group was comparable to that of the healthy control group in the somatosensory-challenging condition (condition 3) (P = 0.168) only. Additionally, there was no significant difference in the 6MWT distance among the three groups (P > 0.05). TC Qigong may be a rehabilitation exercise that improves somatosensory function and OLS balance performance among survivors of NPC.

  1. Balance Performance in Irradiated Survivors of Nasopharyngeal Cancer with and without Tai Chi Qigong Training

    Directory of Open Access Journals (Sweden)

    Shirley S. M. Fong

    2014-01-01

    Full Text Available This cross-sectional exploratory study aimed to compare the one-leg-stance time and the six-minute walk distance among TC Qigong-trained NPC survivors, untrained NPC survivors, and healthy individuals. Twenty-five survivors of NPC with TC Qigong experience, 27 survivors of NPC without TC Qigong experience, and 68 healthy individuals formed the NPC-TC Qigong group, NPC-control group, and healthy-control group, respectively. The one-leg-stance (OLS timed test was conducted to assess the single-leg standing balance performance of the participants in four conditions: (1 standing on a stable surface with eyes open, (2 standing on a compliant surface with eyes open, (3 standing on a stable surface with eyes closed, and (4 standing on a compliant surface with eyes closed. The six-minute walk test (6MWT was used to determine the functional balance performance of the participants. Results showed that the NPC-control group had a shorter OLS time in all of the visual and supporting surface conditions than the healthy control group (P0.05. TC Qigong may be a rehabilitation exercise that improves somatosensory function and OLS balance performance among survivors of NPC.

  2. Untreated peristomal skin complications among long-term colorectal cancer survivors with ostomies.

    Science.gov (United States)

    McMullen, Carmit K; Wasserman, Joseph; Altschuler, Andrea; Grant, Marcia L; Hornbrook, Mark C; Liljestrand, Petra; Briggs, Catherine; Krouse, Robert S

    2011-12-01

    This ethnography of family caregiving explored why peristomal skin complications are common and undertreated among colorectal cancer survivors with intestinal ostomies. Data were collected through in-depth interviews with 31 cancer survivors and their family caregivers, fieldwork, structured assessments, and medical records review, and analyzed with qualitative theme and matrix analyses. Survivors who received help changing the skin barrier around their stoma had fewer obstacles to detection and treatment of peristomal skin complications. Half of the survivors received unpaid help with ostomy care, and all such help came from spouses. Married couples who collaborated in ostomy care reported that having assistance in placing the ostomy appliance helped with preventing leaks, detecting skin changes, and modifying ostomy care routines. In addition, survivors who struggled to manage ostomy care independently reported more obstacles to alleviating and seeking treatment for skin problems. Oncology nurses can improve treatment of peristomal skin problems by asking patients and caregivers about ostomy care and skin problems, examining the peristomal area, and facilitating routine checkups with a wound, ostomy, and continence nurse.

  3. Association of nutritional status with quality of life in breast cancer survivors.

    Science.gov (United States)

    Mohammadi, Shooka; Sulaiman, Suhaina; Koon, Poh Bee; Amani, Reza; Hosseini, Seyed Mohammad

    2013-01-01

    Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

  4. Weight Loss and Mortality in Overweight and Obese Cancer Survivors: A Systematic Review

    Science.gov (United States)

    Heinrich, Malgorzata; Beeken, Rebecca J.

    2017-01-01

    Background Excess adiposity is a risk factor for poorer cancer survival, but there is uncertainty over whether losing weight reduces the risk. We conducted a critical review of the literature examining weight loss and mortality in overweight or obese cancer survivors. Methods We systematically searched PubMed and EMBASE for articles reporting associations between weight loss and mortality (cancer-specific or all-cause) in overweight/obese patients with obesity-related cancers. Where available, data from the same studies on non-overweight patients were compared. Results Five articles describing observational studies in breast cancer survivors were included. Four studies reported a positive association between weight loss and mortality in overweight/obese survivors, and the remaining study observed no significant association. Results were similar for non-overweight survivors. Quality assessment indicated high risk of bias across studies. Conclusions There is currently a lack of observational evidence that weight loss improves survival for overweight and obese cancer survivors. However, the potential for bias in these studies is considerable and the results likely reflect the consequences of disease-related rather than intentional weight loss. There is a need for stronger study designs, incorporating measures of intentionality of weight loss, and extended to other cancers. PMID:28060948

  5. Couples therapy with childhood sexual abuse survivors (CSA) and their partners: establishing a context for witnessing.

    Science.gov (United States)

    Nasim, Ron; Nadan, Yochay

    2013-09-01

    This article proposes a clinical practice for therapy with couples in which one partner suffered sexual abuse in childhood. Such couples often encounter unique difficulties with physical contact, intimacy, sexuality, communication, and trust, and their relationship dynamic may be marked by reenactments of past traumatic relational patterns. This clinical practice is founded on the assumption that establishing the witnessing lacking during the traumatic event in childhood can break the traumatic reenactments in adulthood, and spur recovery. The suggested practice may facilitate twofold witnessing: the couple's therapist witnesses the reenactments of the trauma in the couple's relationship; and the survivor's partner witnesses the trauma's effect on the survivor's personal life and relationship. Twofold witnessing can help break the cycle of traumatic reenactment and help the survivor integrate the events of her life into a more coherent, continuous narrative. The partner's presence also facilitates acknowledgement of what happened to the survivor, and helps the survivor elaborate on her stories of resistance, survival, and strength. Finally, each of the partners is able to appear more wholly and fully, and together to tell the preferred stories of their life as a couple, replete with the multiple relational patterns they wish to live, which may contradict the characteristics of the original trauma.

  6. Health Related Quality of Life, Lifestyle Behaviors, and Intervention Preferences of Survivors of Childhood Cancer

    Science.gov (United States)

    Badr, Hoda; Chandra, Joya; Paxton, Raheem J.; Ater, Joann L.; Urbauer, Diana; Cruz, Cody Scott; Demark-Wahnefried, Wendy

    2013-01-01

    PURPOSE Childhood cancer survivors (CCSs) are at increased risk for poor health-related quality of life (HRQOL) and chronic health conditions -- both of which can be exacerbated by unhealthy lifestyle behaviors. Developing a clearer understanding of the associations between HRQOL, lifestyle behaviors, and medical and demographic variables (e.g., age/developmental stage at time of diagnosis) is an important step toward developing more targeted behavioral interventions for this population. METHOD Cross-sectional questionnaires were completed by 170 CCSs who were diagnosed with leukemia, lymphoma, sarcoma, or a cancer of the central nervous system (CNS) and treated at a comprehensive cancer center between 1992 and 2007. Questionnaires addressed weight status, lifestyle behaviors, aspects of HRQOL, and intervention preferences. RESULTS Adolescent and young adult survivors (AYAs) and survivors of CNS tumors or lymphoma reported significantly (pexercise interventions. CONCLUSION Findings support the premise that females, AYAs, and survivors of cancers of the CNS or lymphoma are “at risk” subgroups within the CCS population for poor dietary practices, sedentary behaviors, and poor HRQOL. Future research should focus on developing diet and PA interventions to improve HRQOL that target these groups. IMPLICATIONS FOR SURVIVORS Greater consideration of the role of gender, developmental stage, and the HRQOL challenges facing CCSs may help researchers to develop targeted behavioral interventions for those who stand to benefit the most. PMID:23749663

  7. A clinical practice model for treatment of college-aged incest survivors.

    Science.gov (United States)

    Barney, E E

    1990-05-01

    Adult incest survivors frequently exhibit signs and symptoms of posttraumatic stress disorder. Many clinicians have geared their group treatment of incest survivors to address these manifestations. Given the nature of the sexual abuse, the early developmental periods in which some trauma occurs, the past and current relationship between the victim and the perpetrator, and the dynamics inherent in this violation and betrayal of trust, love, and power within the family unit, additional clinical concerns and safeguards must be considered. In addition, the struggles of college-aged incest survivors to come to terms with their history of sexual abuse often mirror the developmental tasks faced by their peers--autonomy, intimacy, sexuality, and formation of personal values and ethics. To focus solely on the incest without also considering these developmental issues may solidify a gridlock between inadequate resolution of the developmental issues and the continued victimization of the student incest survivor. The author discusses a time-limited group treatment for college-aged incest survivors that uses a modified posttraumatic stress disorder model as a conceptual framework and addresses both sets of concerns.

  8. Dimensions and correlates of negative attitudes toward female survivors of sexual violence in Eastern DRC.

    Science.gov (United States)

    Babalola, Stella O

    2014-06-01

    The aim of the study described in this article is to examine the dimensions and correlates of attitudes toward survivors of sexual violence (SV) in Eastern Democratic Republic of the Congo (DRC). Four dimensions of attitudes were identified: victim responsibility, victim denigration, victim credibility, and deservingness. Gender roles attitudes represented the most significant correlate of attitudes toward survivors in this population. Other significant correlates of overall attitudes toward survivors included current employment, province of residence, knowledge about the SV law, awareness about where to go for information on sexual and gender-based violence (SGBV), and the perceived prevalence of SV in own community. There are differences and communalities in the variables associated with the various dimensions of attitudes. For example, sex of the respondent and discussion of SGBV with others were only significantly associated with the tendency to ascribe responsibility to the victim. The findings indicate that changing negative gender norms should be central to efforts aimed at promoting accepting attitudes toward survivors. Furthermore, addressing the various dimensions of attitudes toward survivors may require different strategies.

  9. Social security survivors benefits: the effects of reproductive pathways and intestacy law on attitudes.

    Science.gov (United States)

    Hans, Jason D; Gillen, Martie

    2013-01-01

    Most minor children are eligible for Social Security survivors benefits if a wage-earning parent dies, but eligibility of children not in utero at the time of death is more nuanced. The purpose of this study was to examine attitudes concerning access to Social Security survivors benefits in the context of posthumous reproduction. A probability sample of 540 Florida households responded to a multiple-segment factorial vignette designed to examine the effects of state intestacy laws and five reproductive pathways - normative, posthumous birth, cryopreserved embryo, cryopreserved gametes, and posthumous gamete retrieval - on attitudes toward eligibility for the Social Security survivors benefits. Broad support was found for the survivors benefits following normative and posthumous birth pathways, but attitudes were decidedly less favorable when the child was not in utero at the time of parental death. In addition, in stark contrast to the recent U.S. Supreme Court decision in Astrue v. Capato, the vast majority of respondents did not believe state intestacy laws should determine eligibility for Social Security survivors benefits.

  10. Characterization of genomic alterations in radiation-associated breast cancer among childhood cancer survivors, using comparative genomic hybridization (CGH arrays.

    Directory of Open Access Journals (Sweden)

    Xiaohong R Yang

    Full Text Available Ionizing radiation is an established risk factor for breast cancer. Epidemiologic studies of radiation-exposed cohorts have been primarily descriptive; molecular events responsible for the development of radiation-associated breast cancer have not been elucidated. In this study, we used array comparative genomic hybridization (array-CGH to characterize genome-wide copy number changes in breast tumors collected in the Childhood Cancer Survivor Study (CCSS. Array-CGH data were obtained from 32 cases who developed a second primary breast cancer following chest irradiation at early ages for the treatment of their first cancers, mostly Hodgkin lymphoma. The majority of these cases developed breast cancer before age 45 (91%, n = 29, had invasive ductal tumors (81%, n = 26, estrogen receptor (ER-positive staining (68%, n = 19 out of 28, and high proliferation as indicated by high Ki-67 staining (77%, n = 17 out of 22. Genomic regions with low-copy number gains and losses and high-level amplifications were similar to what has been reported in sporadic breast tumors, however, the frequency of amplifications of the 17q12 region containing human epidermal growth factor receptor 2 (HER2 was much higher among CCSS cases (38%, n = 12. Our findings suggest that second primary breast cancers in CCSS were enriched for an "amplifier" genomic subgroup with highly proliferative breast tumors. Future investigation in a larger irradiated cohort will be needed to confirm our findings.

  11. Health-related quality of life in long-term survivors of relapsed childhood acute lymphoblastic leukemia.

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    Stefan Essig

    Full Text Available BACKGROUND: Relapses occur in about 20% of children with acute lymphoblastic leukemia (ALL. Approximately one-third of these children can be cured. Their risk for late effects is high because of intensified treatment, but their health-related quality of life (HRQOL was largely unmeasured. Our aim was to compare HRQOL of ALL survivors with the general population, and of relapsed with non-relapsed ALL survivors. METHODOLOGY/PRINCIPAL FINDINGS: As part of the Swiss Childhood Cancer Survivor Study (SCCSS we sent a questionnaire to all ALL survivors in Switzerland who had been diagnosed between 1976-2003 at age <16 years, survived ≥5 years, and were currently aged ≥16 years. HRQOL was assessed with the Short Form-36 (SF-36, which measures four aspects of physical health and four aspects of mental health. A score of 50 corresponded to the mean of a healthy reference population. We analyzed data from 457 ALL survivors (response: 79%. Sixty-one survivors had suffered a relapse. Compared to the general population, ALL survivors reported similar or higher HRQOL scores on all scales. Survivors with a relapse scored lower in general health perceptions (51.6 compared to those without (55.8;p=0.005, but after adjusting for self-reported late effects, this difference disappeared. CONCLUSION/SIGNIFICANCE: Compared to population norms, ALL survivors reported good HRQOL, even after a relapse. However, relapsed ALL survivors reported poorer general health than non-relapsed. Therefore, we encourage specialists to screen for poor general health in survivors after a relapse and, when appropriate, specifically seek and treat underlying late effects. This will help to improve patients' HRQOL.

  12. EXPOSE-R2, the 3rd successful EXPOSE mission – a mission and mission ground reference overview

    OpenAIRE

    2016-01-01

    For nearly 2 years the 3rd ESA EXPOSE mission, the 2nd on the Russian Zvezda module of the ISS, exposed a variety of astrobiological samples to space and simulated Mars environmental conditions. Various chemical compounds and organisms like bacteria, archaea, fungi, plant seeds, lychens, mosses and animal eggs and larvae from the international experiments BIOMEX, BOSS, P.S.S. and the IBMP-experiment were exposed to space vacuums dryness, extraterrestrial short wavelength UV, radiation and tem...

  13. School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011

    Science.gov (United States)

    Strøm, Ida Frugård; Schultz, Jon-Håkon; Wentzel-Larsen, Tore; Dyb, Grete

    2016-01-01

    Background The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. Objective This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. Method Data from a longitudinal interview study were linked to officially registered grades of students (N=64) who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors’ registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. Results The students’ grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. Conclusion The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching. Highlights of the article School functioning among high school students following a terrorist attack. The findings showed a decline in school performance and increased absence after the event. For students who successfully completed high school

  14. Plasma protein characteristics of long-term hemodialysis survivors.

    Directory of Open Access Journals (Sweden)

    Yao-Ping Lin

    Full Text Available Hemodialysis (HD patients are under recurrent circulatory stress, and hemodialysis has a high mortality rate. The characteristics of plasma proteomes in patients surviving long-term HD remain obscure, as well as the potential biomarkers in predicting prognoses. This study reports the proteome analyses of patient plasma from non-diabetic long-term HD (LHD, dialysis vintage 14.9±4.1 years, n = 6 and the age/sex/uremic etiology-comparable short-term HD (SHD, dialysis vintage 5.3±2.9 years, n = 6 using 2-DE and mass spectrometry. In addition, a 4-year longitudinal follow-up of 60 non-diabetic HD patients was subsequently conducted to analyze the baseline plasma proteins by ELISA in predicting prognosis. Compared to the SHD, the LHD survivors had increased plasma vitamin D binding proteins (DBP and decreased clusterin, apolipoprotein A-IV, haptoglobin, hemopexin, complement factors B and H, and altered isoforms of α1-antitrypsin and fibrinogen gamma. During the 45.7±15 months for follow-up of the 60 HD patient cases, 16 patients died. Kaplan-Meier analysis demonstrated that HD patients with the lowest tertile of the baseline plasma DBP level have a significantly higher mortality rate. Multivariate Cox regression analysis further indicated that DBP is an independent predictor of mortality. In summary, the altered plasma proteins in LHD implicated accelerated atherosclerosis, defective antioxidative activity, increased inflammation/infection, and organ dysfunction. Furthermore, lower baseline plasma DBP in HD patients is related to mortality. The results suggest that the proteomic approach could help discover the potential biomarker in HD prognoses.

  15. Rates of trauma spectrum disorders and risks of posttraumatic stress disorder in a sample of orphaned and widowed genocide survivors

    Directory of Open Access Journals (Sweden)

    Susanne Schaal

    2011-06-01

    Full Text Available During the Rwandan genocide of 1994, nearly one million people were killed within a period of 3 months.The objectives of this study were to investigate the levels of trauma exposure and the rates of mental health disorders and to describe risk factors of posttraumatic stress reactions in Rwandan widows and orphans who had been exposed to the genocide.Trained local psychologists interviewed orphans (n=206 and widows (n=194. We used the PSS-I to assess posttraumatic stress disorder (PTSD, the Hopkins Symptom Checklist to assess depression and anxiety symptoms, and the M.I.N.I. to assess risk of suicidality.Subjects reported having been exposed to a high number of different types of traumatic events with a mean of 11 for both groups. Widows displayed more severe mental health problems than orphans: 41% of the widows (compared to 29% of the orphans met symptom criteria for PTSD and a substantial proportion of widows suffered from clinically significant depression (48% versus 34% and anxiety symptoms (59% versus 42% even 13 years after the genocide. Over one-third of respondents of both groups were classified as suicidal (38% versus 39%. Regression analysis indicated that PTSD severity was predicted mainly by cumulative exposure to traumatic stressors and by poor physical health status. In contrast, the importance given to religious/spiritual beliefs and economic variables did not correlate with symptoms of PTSD.While a significant portion of widows and orphans continues to display severe posttraumatic stress reactions, widows seem to constitute a particularly vulnerable survivor group. Our results point to the chronicity of mental health problems in this population and show that PTSD may endure over time if not addressed by clinical intervention. Possible implications of poor mental health and the need for psychological intervention are discussed.

  16. Goodbye or Identify: Detrimental Effects of Downsizing on Identification and Survivor Performance.

    Science.gov (United States)

    van Dick, Rolf; Drzensky, Frank; Heinz, Matthias

    2016-01-01

    Research shows that after layoffs, employees often report decreased commitment and performance which has been coined the survivor syndrome. However, the mechanisms underlying this effect remain underexplored. The purpose of the paper is to show that reduced organizational identification can serve as an explanation for the survivor syndrome. We conducted a laboratory experiment, in which participants work as a group of employees for another participant who acts as employer. In the course of the experiment, the employer decides whether one of his or her employees should be laid off or not. Mediation analysis supports a social identity-based explanation for the emergence of the survivor syndrome: downsizing causes lower identification with the employer which in turn relates to lower performance of employees.

  17. Older women breast cancer survivors: decision making, sources of information and wellness activities in Malaysia.

    Science.gov (United States)

    Mohamed, Nor Aini; Muhamad, Mazanah

    2013-01-01

    The purpose of this study ??s to profile older breast cancer survivors in Malaysia. In a survey study, ? custom made questionnaire was administered to 69 breast cancer patients and survivors between 60 and 84 years of age in Peninsular Malaysia. The main ethnic group recorded was Chinese, followed by Malay and Indian. The majority of women were married (87%) and had children (84.1%). Just over half (53.6%) had primary and secondary education, whereas 24.7% had higher education. Fifty five percent of the study participants made their own decision on treatment, 60.8% exercised at least 3 times in a week, and 56.6% sought information from specialists. Our study suggests that older breast cancer survivors are aware of the importance of exercise in their daily lives and make attempts to be cancer free (e.g. doing exercise, recreational activity and have good relationships with friends and family).

  18. Knowledge, Awareness, Perceptions, and Use of Emergency Contraceptives among Survivors of Intimate Partner Violence

    Directory of Open Access Journals (Sweden)

    Kathleen J. Wilder

    2009-01-01

    Full Text Available The study examines emergency contraception (EC knowledge, awareness, perceptions, and prior use and identifies predictors of EC use among a sample of survivors of intimate partner violence (IPV. The majority (66.2% of 154 survivors at risk of pregnancy reported EC awareness, only 15.3% reported prior EC use. Logistic regression identified perceived abusive intimate partner approval (OR = 2.25; 95% CI = 1.15–4.41 and lack of moral/religious objections (OR = 12.83; 95% CI = 5.48–30.03 as the strongest predictors of EC use. Health care provider interventions acknowledging barriers to EC use, such as partner approval, and education that improves awareness of and knowledge about EC, may have the impact of empowering survivors in their reproductive choices, reducing unwanted pregnancies.

  19. Posttraumatic stress disorder: protective and risk factors in 18 survivors of a plane crash.

    Science.gov (United States)

    Catanesi, Roberto; Martino, Vito; Candelli, Chiara; Troccoli, Giuseppe; Grattagliano, Ignazio; Di Vella, Giancarlo; Carabellese, Felice

    2013-09-01

    The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician-Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self-efficacy represented protective factors against developing PTSD.

  20. Gonadal damage and options for fertility preservation in female and male cancer survivors

    Institute of Scientific and Technical Information of China (English)

    Theodoros Maltaris; Heinz Koelbl; Rudolf Seufert; Franklin Kiesewetter; Matthias W. Beckmann; Andreas Mueller; Ralf Dittrich

    2006-01-01

    It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery,radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today thanks to advances in assisted-reproduction technology for maintaining fertility in male and female patients undergoing this type of treatment. The various diagnostic methods of assessing the fertility potential and the efficacy of in vitro fertilization (IVF) after cancer treatment are also presented.

  1. Evidence of Change in Brain Activity among Childhood Cancer Survivors Participating in a Cognitive Remediation Program

    Science.gov (United States)

    Zou, Ping; Li, Yimei; Conklin, Heather M.; Mulhern, Raymond K.; Butler, Robert W.; Ogg, Robert J.

    2012-01-01

    Increased understanding of the underlying mechanisms of cognitive remediation is needed to facilitate development of intervention strategies for childhood cancer survivors experiencing cognitive late effects. Accordingly, a pilot functional magnetic resonance imaging (fMRI) study was conducted with 14 cancer survivors (12.02 ± 0.09 years old), who participated in a cognitive remediation clinical trial, and 28 healthy children (12.7 ± 0.6 years old). The ventral visual areas, cerebellum, supplementary motor area, and left inferior frontal cortex were significantly activated in the healthy participants during a continuous performance task. In survivors, brain activation in these regions was diminished at baseline, and increased upon completion of remediation and at a 6-month follow-up. The fMRI activation index for each region of interest was inversely associated with the Conners' Clinical Competence Index (p<.01). The pilot study suggests that fMRI is useful in evaluating neural responses to cognitive remediation. PMID:23079152

  2. How ineffective family environments can compound maldevelopment of critical thinking skills in childhood abuse survivors.

    Science.gov (United States)

    Kostolitz, Alessandra C; Hyman, Scott M; Gold, Steven N

    2014-01-01

    The high stress of childhood abuse is associated with neurobiological detriments to executive function. Child abuse survivors may also be cognitively and relationally disadvantaged as a result of being raised in emotionally impoverished families that lack cohesion, organization, flexibility, self-expression, and moral and ethical values and fail to provide opportunities for effective learning. A review of literature demonstrates how dysfunctional family of origin environments common to child abuse survivors, concomitant with the extreme stress of overt acts of abuse, can act as a barrier to the development of higher-order critical thinking skills. The article concludes by discussing ramifications of critical thinking skill deficits in child abuse survivors and highlights the importance of integrating and prioritizing critical thinking skills training in treatment.

  3. 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...... survivors, who had undergone cardiac tests including exercise echocardiography 10.5 years earlier, for new cardiac evaluation. Each subject underwent a resting echocardiogram at both evaluations. At first evaluation a repeat echocardiogram was performed following peak exercise. Resting echocardiographic......) decreased from -0.18 to -0.93. Higher cumulative anthracycline dose was a risk factor for a lower RFSz at late follow-up (P = 0.0002). Adding exercise fractional shortening (XFS) to a model containing RFSz did not improve prediction of abnormal RFSz at late follow-up. CONCLUSIONS: Monitoring with exercise...

  4. A pilot study of a weekend retreat intervention for family survivors of homicide.

    Science.gov (United States)

    Tuck, Inez; Baliko, Beverly; Schubert, Christine M; Anderson, Lorraine

    2012-10-01

    Homicide causes negative unintended consequences for family survivors. Family survivors face complicated grief and overwhelming loss with minimal support from others. The authors offered a retreat intervention as a way to ameliorate the effects of the homicidal death for family survivors of homicide. An exploratory longitudinal pilot study examined the feasibility and acceptability of the intervention and explored the impact of the TOZI© Healing intervention on participants' distress symptoms. Eight family members participated in the 2-day retreat and completed surveys at five time intervals over 30 months. Descriptive statistics and correlations were used to analyze the data. Although sample sizes were too small to achieve statistical significance, changes on selected holistic health outcomes, supported by overwhelmingly positive focus group responses to the intervention, affirm the need for further study.

  5. Mental health survey among landmine survivors in Siem Reap province, Cambodia.

    Science.gov (United States)

    Lopes Cardozo, Barbara; Blanton, Curtis; Zalewski, Tami; Tor, Svang; McDonald, Laura; Lavelle, James; Brooks, Robert; Anderson, Mark; Mollica, Richard

    2012-01-01

    Many survivors of the Khmer Rouge period in Cambodia and the subsequent war with Vietnam have now returned to Cambodia. In this two-stage household cluster survey in Siem Reap Province in Cambodia, we explored the mental health consequences on 166 landmine injury survivors selected from 1000 household in 50 clusters and an oversample of all landmine survivors. We found a prevalence of anxiety of 62% for all respondents, 74% for depression, and 34% for post-traumatic stress disorder (PTSD). These prevalences were statistically significantly higher than among the adult population who had not been injured by landmines. These data underscore the importance of providing mental health care services for the people in Siem Reap Province in Cambodia who have been injured by landmines.

  6. Vulnerability and Post-Stroke Experiences of Working-Age Survivors During Recovery

    Directory of Open Access Journals (Sweden)

    Barbara Wolfenden

    2015-10-01

    Full Text Available Survivors who experience stroke of mild to moderate severity are typically discharged home quickly, with only minimal referral for rehabilitation follow-up or support to meet specific needs in recovery. Particular vulnerabilities of younger, higher functioning stroke survivors have received some recognition in international literature in recent years. This article reports on findings of a small Australian qualitative study focusing on recovery and return to work experiences of young higher functioning female stroke survivors, in particular exploring experiences of post-stroke vulnerability from participants’ own perspectives. Our research adds depth and nuance to this developing area of interest and research. Our findings include survivors’ reflections on the consequences of delayed diagnosis, the impacts of empowering and disempowering interactions with health care professionals, a general lack of access to psychosocial rehabilitation, and frustrations of financial hardship. Implications for health professionals, service systems, and income support provision are discussed, along with directions for future research.

  7. Quality of life and perceived educational needs among older cancer survivors.

    Science.gov (United States)

    Schlairet, Maura C; Benton, Melissa J

    2012-03-01

    The purpose of this study was to evaluate perceived educational needs regarding nutrition and exercise in older cancer survivors. One hundred ninety survivors, age 70.7 (7.5), completed a Survey of Needs developed from the City of Hope Quality of Life model. Fifty percent reported distress related to poor appetite, 60% reported distress related to weight change, 64% reported distress related to balance/walking/mobility difficulty, and 79% reported distress related to fatigue. Weight change, poor appetite, balance/walking/mobility difficulty, and fatigue were significantly associated with distress related to (a) managing household activities, (b) caring for family, (c) maintaining a sense of well-being, (d) coping with grief and loss, and (e) managing stress. Despite distress associated with weight change, poor appetite, mobility difficulty, and fatigue, respondents did not recognize a need for education regarding nutrition and exercise. Findings suggest that evaluating older survivors' perceptions of needs may be necessary prior to designing interventions for care.

  8. Association of Attention Deficit Disorder With Bedside Anti-saccades in Survivors of Childhood Leukemia.

    Science.gov (United States)

    Khan, Raja B; Hudson, Melissa M; Ness, Kirsten K; Liang, Zhu; Srivastava, Deokumar; Krull, Kevin R

    2016-02-01

    Impaired attention is well recognized in childhood cancer survivors. We prospectively evaluated 162 long-term survivors of childhood acute lymphoblastic leukemia to study an association between presence of neurologic soft signs as measured by Zurich Neuromotor Scale, bedside evaluation of anti-saccades, and attention deficit disorder. Attention deficit disorder was recognized in 10.5% of the study cohort. We did not find an association of attention deficit with presence of any soft sign. However, there was an association between presence of abnormal anti-saccades and attention deficit (P = .04). These results will require further validation and if confirmed may introduce a quick bedside method of assessing impaired attention in cancer survivors.

  9. Towards malecentric communication: sensitizing health professionals to the realities of male childhood sexual abuse survivors.

    Science.gov (United States)

    Teram, Eli; Stalker, Carol; Hovey, Angela; Schachter, Candice; Lasiuk, Gerri

    2006-06-01

    This article extends earlier reports of an ongoing qualitative inquiry on childhood sexual abuse survivors' experiences with health professionals. In this paper, we aim to enhance understanding of male survivors' experience. While male and female participants express similar anxieties and fears about their encounters with health professionals, there are gender-based differences related to the perceptions of victimhood and manhood; guilt and shame; homophobia; disclosure of abuse; and the expression of vulnerability. The implications of these differences for sensitive health care practice are analyzed within the context of gender relationships and the differential socialization of men. Malecentric communication is proposed as a method for addressing the specific experiences of male survivors in their encounters with health professionals.

  10. Why did they "choose" to stay? Perspectives of Hurricane Katrina observers and survivors.

    Science.gov (United States)

    Stephens, Nicole M; Hamedani, Maryam G; Markus, Hazel Rose; Bergsieker, Hilary B; Eloul, Liyam

    2009-07-01

    Models of agency--powerful implicit assumptions about what constitutes normatively "good" action--shaped how observers and survivors made meaning after Hurricane Katrina. In Study 1, we analyzed how 461 observers perceived survivors who evacuated (leavers) or stayed (stayers) in New Orleans. Observers described leavers positively (as agentic, independent, and in control) and stayers negatively (as passive and lacking agency). Observers' perceptions reflected the disjoint model of agency, which is prevalent in middle-class White contexts and defines "good" actions as those that emanate from within the individual and proactively influence the environment. In Study 2, we examined interviews with 79 survivors and found that leavers and stayers relied on divergent models of agency. Leavers emphasized independence, choice, and control, whereas stayers emphasized interdependence, strength, and faith. Although both leavers and stayers exercised agency, observers failed to recognize stayers' agency and derogated them because observers assumed that being independent and in control was the only way to be agentic.

  11. Contribution of problem-solving skills to fear of recurrence in breast cancer survivors.

    Science.gov (United States)

    Akechi, Tatuo; Momino, Kanae; Yamashita, Toshinari; Fujita, Takashi; Hayashi, Hironori; Tsunoda, Nobuyuki; Iwata, Hiroji

    2014-05-01

    Although fear of recurrence is a major concern among breast cancer survivors after surgery, no standard strategies exist that alleviate their distress. This study examined the association of patients' problem-solving skills and fear of recurrence and psychological distress among breast cancer survivors. Randomly selected, ambulatory, female patients with breast cancer participated in this study. They were asked to complete the Concerns about Recurrence Scale (CARS) and the Hospital Anxiety and Depression Scale. Multiple regression analyses were used to examine their associations. Data were obtained from 317 patients. Patients' problem-solving skills were significantly associated with all subscales of fear of recurrence and overall worries measured by the CARS. In addition, patients' problem-solving skills were significantly associated with both their anxiety and depression. Our findings warrant clinical trials to investigate effectiveness of psychosocial intervention program, including enhancing patients' problem-solving skills and reducing fear of recurrence among breast cancer survivors.

  12. Body Image Discomfort of Adolescent and Young Adult Hematologic Cancer Survivors.

    Science.gov (United States)

    Zucchetti, Giulia; Bellini, Simona; Bertolotti, Marina; Bona, Francesca; Biasin, Eleonora; Bertorello, Nicoletta; Tirtei, Elisa; Fagioli, Franca

    2017-01-23

    This study focuses on body image discomfort (BID) of 50 adolescent and young adult (AYA) hematologic cancer survivors (age range 15-23; 52% males). The study results were obtained through data from a self-report questionnaire: the Body Uneasiness Test. Findings differed according to gender: a greater proportion of females were in the Risk category of impaired body image than males (χ(2) = 5.258, p < 0.05). No significant body image differences were found according to the type of diagnosis or to the length of survival. To manage survivors' BIDs and to improve their quality of life, assessing BID in AYA cancer survivors is important for identifying those who might be in need of additional supportive care or a program.

  13. Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

    OpenAIRE

    Mandelblatt, Jeanne S.; Clapp, Jonathan D.; Luta, Gheorghe; Faul, Leigh Anne; Tallarico, Michelle D.; McClendon, Trina D.; Whitley, Jessica A.; Cai, Ling; Ahles, Tim A.; Stern, Robert A.; Jacobsen, Paul B.; Small, Brent J.; Pitcher, Brandelyn N.; Dura‐Fernandis, Estrella; Muss, Hyman B.

    2016-01-01

    BACKGROUND The number of survivors of breast cancer aged ≥65 years (“older”) is growing, but to the authors' knowledge, little is known regarding the cognitive outcomes of these individuals. METHODS A cohort of cognitively intact older survivors with nonmetastatic, invasive breast cancer was recruited from 78 sites from 2004 through 2011; approximately 83.7% of the survivors (1280 survivors) completed baseline assessments. Follow‐up data were collected at 6 months and annually for up to 7 yea...

  14. Shoulder Mobility, Muscular Strength, and Quality of Life in Breast Cancer Survivors with and without Tai Chi Qigong Training

    Directory of Open Access Journals (Sweden)

    Shirley S. M. Fong

    2013-01-01

    Full Text Available Objectives. To compare the shoulder mobility, muscular strength, and quality of life (QOL among breast cancer survivors with and without Tai Chi (TC Qigong training to those of healthy individuals and to explore the associations between shoulder impairments and QOL in breast cancer survivors with regular TC Qigong training. Methods. Eleven breast cancer survivors with regular TC Qigong training, 12 sedentary breast cancer survivors, and 16 healthy participants completed the study. Shoulder mobility and rotator muscle strength were assessed by goniometry and isokinetic dynamometer, respectively. QOL was assessed using the Functional Assessment of Cancer Therapy-Breast (FACT-B questionnaire. Results. Goniometric measurements of the active range of motion in the flexion, abduction, and hand-behind-the-back directions were similar among the three groups. The TC Qigong-trained breast cancer survivors had significantly higher isokinetic peak torques of the shoulder rotator muscles (at than untrained survivors, and their isokinetic shoulder muscular strength reached the level of healthy individuals. Greater shoulder muscular strength was significantly associated with better functional wellbeing in breast cancer survivors with TC Qigong training. However, no significant between-group difference was found in FACT-B total scores. Conclusions. TC Qigong training might improve shoulder muscular strength and functional wellbeing in breast cancer survivors.

  15. Shoulder Mobility, Muscular Strength, and Quality of Life in Breast Cancer Survivors with and without Tai Chi Qigong Training.

    Science.gov (United States)

    Fong, Shirley S M; Ng, Shamay S M; Luk, W S; Chung, Joanne W Y; Chung, Louisa M Y; Tsang, William W N; Chow, Lina P Y

    2013-01-01

    Objectives. To compare the shoulder mobility, muscular strength, and quality of life (QOL) among breast cancer survivors with and without Tai Chi (TC) Qigong training to those of healthy individuals and to explore the associations between shoulder impairments and QOL in breast cancer survivors with regular TC Qigong training. Methods. Eleven breast cancer survivors with regular TC Qigong training, 12 sedentary breast cancer survivors, and 16 healthy participants completed the study. Shoulder mobility and rotator muscle strength were assessed by goniometry and isokinetic dynamometer, respectively. QOL was assessed using the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Results. Goniometric measurements of the active range of motion in the flexion, abduction, and hand-behind-the-back directions were similar among the three groups. The TC Qigong-trained breast cancer survivors had significantly higher isokinetic peak torques of the shoulder rotator muscles (at 180°/s) than untrained survivors, and their isokinetic shoulder muscular strength reached the level of healthy individuals. Greater shoulder muscular strength was significantly associated with better functional wellbeing in breast cancer survivors with TC Qigong training. However, no significant between-group difference was found in FACT-B total scores. Conclusions. TC Qigong training might improve shoulder muscular strength and functional wellbeing in breast cancer survivors.

  16. Body issues, sexual satisfaction, and relationship status satisfaction in long-term childhood cancer survivors and healthy controls

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariet; Gerhardt, Cynthia A.; Fults, Marci; Olshefski, Randal S.; Sanderman, Robbert; Tuinman, Marrit A.

    2016-01-01

    ObjectiveResearch on body image and sexual satisfaction after adult onset cancer has shown significant and lasting impairments regarding survivors' sexuality and romantic relationships. However, knowledge about these topics and their associations in adult survivors of childhood cancer is largely lac

  17. Fostering Growth in the Survivorship Experience: Investigating Breast Cancer Survivors' Lived Experiences Scaling Mt. Kilimanjaro from a Posttraumatic Growth Perspective

    Science.gov (United States)

    Burke, Shaunna M.; Sabiston, Catherine M.

    2012-01-01

    The aim of this study was to use an ethnographic case study approach to explore breast cancer survivors' experiences scaling Mt. Kilimanjaro from a posttraumatic growth perspective. Three breast cancer survivors who participated in interviews and observations during a nine-day climb on the mountain were included in this study. Findings are…

  18. Enhancing Psychosocial Outcomes for Young Adult Childhood CNS Cancer Survivors: Importance of Addressing Vocational Identity and Community Integration

    Science.gov (United States)

    Strauser, David R.; Wagner, Stacia; Wong, Alex W. K.

    2012-01-01

    The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years…

  19. ''A Burden in Your Heart'': Lessons of Disclosure from Female Preadolescent and Adolescent Survivors of Sexual Abuse

    Science.gov (United States)

    Staller, Karen M.; Nelson-Gardell, Debra

    2005-01-01

    Objectives: To enhance understanding of the sexual abuse disclosure process from the perspective of preteen and teenage survivors. To reconsider prominent models of the disclosure process in light of our findings. Methods: We conducted a secondary analysis of data from four focus groups in which 34 preadolescent and adolescent female survivors of…

  20. 20 CFR 30.105 - What must DOE do after an employee or survivor files a claim?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What must DOE do after an employee or survivor files a claim? 30.105 Section 30.105 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... Alleged Employment § 30.105 What must DOE do after an employee or survivor files a claim? (a) After...

  1. Inpatient peer support for adult burn survivors-a valuable resource: a phenomenological analysis of the Australian experience.

    Science.gov (United States)

    Kornhaber, R; Wilson, A; Abu-Qamar, M; McLean, L; Vandervord, J

    2015-02-01

    Peer support has long been recognised as an essential component of a supportive network for people facing adversity. In particular, burn survivor peer support is a valuable and credible resource available to those rehabilitating from a severe burn. The aim of this study was to explore burn survivors' experiences of providing and receiving inpatient peer support to develop an in-depth understanding of the influence during the rehabilitation journey. In 2011, twenty-one burn survivors were recruited from four severe burn units across Australia. A qualitative phenomenological methodology was used to construct themes depicting survivors' experiences. Participants were selected through purposeful sampling, and data collected through in-depth individual semi-structured interviews. Data were analysed using Colaizzi's phenomenological method of data analysis. Central to burn rehabilitation was the notion of peer support having a significant impact on burn survivors' psychosocial rehabilitation. The emergent theme 'Burn Survivor Peer Support' identified five cluster themes: (1) Encouragement, inspiration and hope (2) Reassurance (3) The Importance of Timing (4) The Same Skin (5) Appropriate Matching. These findings demonstrate that peer support assists with fostering reassurance, hope and motivation in burn rehabilitation. A national network based on a clinician led inpatient burn survivor peer support programme could provide burn survivors across Australia, and in particular remote access locations, with the benefits of peer support necessary to endure the rehabilitation journey.

  2. Health status and health resource use among long-term survivors of breast, colorectal and prostate cancer

    Directory of Open Access Journals (Sweden)

    Tàrsila Ferro

    2014-03-01

    Conclusions: Survivors of breast, prostate and colorectal cancer with tumoral detection at an early stage and without recurrences or second neoplasms experienced little morbidity and enjoyed good quality of life. This study proposes exploration of a follow-up model in the Spanish health system in which primary care plays a more important role than is customary in cancer survivors in Spain.

  3. Birth rates among male cancer survivors and mortality rates among their offspring : a population-based study from Sweden

    NARCIS (Netherlands)

    Tang, Siau-Wei; Liu, Jenny; Juay, Lester; Czene, Kamila; Miao, Hui; Salim, Agus; Verkooijen, Helena M; Hartman, Mikael

    2016-01-01

    BACKGROUND: With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring. METHODS: From the Swedish Multi-generation Register and Cancer Register, we identified

  4. Vitamin D and bone minerals status in the long-term survivors of childhood acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Nahid Reisi

    2015-01-01

    Conclusions: ALL treatment is associated with the increase in prevalence of vitamin D insufficiency in the childhood ALL survivors and since the low vitamin D level potentially increases the risk of low bone density, subsequent malignancies, and cardiovascular disease in the survivors, close follow-up of such patients are highly recommended to prevent the stated complications.

  5. Impostorism as a Mediator between Survivor Guilt and Depression in a Sample of African American College Students

    Science.gov (United States)

    Austin, Chammie C.; Clark, Eddie M.; Ross, Michael J.; Taylor, Matthew J.

    2009-01-01

    The purpose of the current study was to explore the mediating effects of impostorism on the association between survivor guilt feelings and self-report depressive symptomatology. Ninety-seven African American college students were asked to complete measures of empathy based survivor guilt, impostor feelings, and depression. Results indicated that…

  6. Myocardial strain and strain rate in monitoring subclinical heart failure in asymptomatic long-term survivors of childhood cancer.

    NARCIS (Netherlands)

    Mavinkurve-Groothuis, A.M.C.; Groot-Loonen, J.J.; Marcus, K.A.; Bellersen, L.; Feuth, T.; Bokkerink, J.P.M.; Hoogerbrugge, P.M.; Korte, C.L. de; Kapusta, L.

    2010-01-01

    We studied the role of global myocardial strain and strain rate in monitoring subclinical heart failure in a large group of asymptomatic long-term survivors of childhood cancer. Global strain (rate) parameters of survivors were compared with those in healthy controls and were related to conventional

  7. Genetic Moderation of Cortisol Secretion in Holocaust Survivors: A Pilot Study on the Role of ADRA2B

    Science.gov (United States)

    Fridman, Ayala; van IJzendoorn, Marinus H.; Sagi-Schwartz, Abraham; Bakermans-Kranenburg, Marian J.

    2012-01-01

    In the current study we tested whether "ADRA2B" moderates stress regulation of Holocaust survivors as indexed by their diurnal cortisol secretion and cortisol reactivity to a stressor. Salivary cortisol levels of 54 female Holocaust survivors and participants in the comparison group were assessed during a routine day and in response to a…

  8. The Prevalence of Vitamin D Deficiency among Cancer Survivors in a Nationwide Survey of the Korean Population.

    Directory of Open Access Journals (Sweden)

    Myueng Guen Oh

    Full Text Available Recent studies have shown that inadequate vitamin D levels are associated with a poor cancer prognosis, but data regarding actual vitamin D levels in cancer survivors are limited. This study investigated the vitamin D levels and prevalence of vitamin D deficiency among Korean cancer survivors compared with non-cancer controls, and identified the factors associated with vitamin D deficiency.Using the Korea National Health and Nutrition Examination Survey (KNHANES, 915 cancer survivors and 29,694 controls without a history of cancer were selected. Serum 25(OHD levels were measured; vitamin D deficiency was defined as 25(OHD levels less than 20 ng/mL. Chi-square tests and multiple logistic regression analyses were used to evaluate the prevalence of vitamin D deficiency and associated factors.Vitamin D deficiency was observed in 62.7% of cancer survivors and 67.1% of controls. Among cancer survivors, vitamin D deficiency was most prevalent among 19-44 year olds (76.2% and among managers, professionals, and related workers (79.3%. Multiple logistic regression analysis revealed that younger cancer survivors and those who work indoors were predisposed to vitamin D deficiency.Vitamin D deficiency was prevalent among both cancer survivors and controls in Korea. The regular evaluation and management of vitamin D levels is needed for both bone health and general health in cancer survivors.

  9. A population-based study of the quality of life of cancer survivors and their family caregivers.

    Science.gov (United States)

    Mellon, Suzanne; Northouse, Laurel L; Weiss, Linda K

    2006-01-01

    Although survival rates for all cancers continue to increase, few studies have examined the quality of life of both cancer survivors and family caregivers during the survivorship period after treatment has ended. Information is lacking on the stressors, resources, meaning, and quality of life reported by survivors and family caregivers and the interrelationship between survivors' and family caregivers' quality of life. A stratified, random sample of 123 cancer survivors and 123 family caregivers (N = 246) were interviewed in an exploratory, cross-sectional design 1-6 years after cancer treatment had ended. Approximately half (N = 62) of the dyads were white and half (N = 61) were African American. Results indicated that cancer survivors reported significantly higher quality of life, less fear of cancer recurrence, and more support than their family caregivers. The strongest predictors for cancer survivors' quality of life were family stressors, social support, meaning of the illness, and employment status, whereas the strongest predictors for family caregivers' quality of life were fear of recurrence and social support. Both the survivor's and family caregiver's quality of life independently contributed to the other's quality of life. Findings from this study suggest the importance of including both survivors and family caregivers in programs of care.

  10. 22 CFR 19.10-2 - Reduced annuity with regular survivor annuity to spouse or former spouse.

    Science.gov (United States)

    2010-04-01

    ...'s reduced annuity would then be further reduced by this pension ($13,220-$4,957.50) to provide an... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Reduced annuity with regular survivor annuity... SYSTEM § 19.10-2 Reduced annuity with regular survivor annuity to spouse or former spouse. (a)...

  11. Shattered Vision: Disenchantment of Couplehood among Female Survivors of Violence in the Shadow of Their Family-of-Origin Experiences

    Science.gov (United States)

    Buchbinder, Eli; Goldblatt, Hadass

    2011-01-01

    This article describes and analyzes the relationship disenchantment of couplehood among female survivors of violence and their family-of-origin experiences of abuse. Twenty Israeli women who were survivors of violence participated in this qualitative research. Each woman underwent three in-depth interviews, two for data collection and one for…

  12. Perceptions of Young Adult Central Nervous System Cancer Survivors and Their Parents Regarding Career Development and Employment

    Science.gov (United States)

    Strauser, David R.; Wagner, Stacia; Chan, Fong; Wong, Alex W. K.

    2014-01-01

    Purpose: Identify barriers to career development and employment from both the survivor and parent perspective. Method: Young adult survivors (N = 43) and their parents participated in focus groups to elicit information regarding perceptions regarding career development and employment. Results: Perceptions of both the young adults and parents…

  13. Health-related quality of life and health care use in cancer survivors compared with patients with chronic diseases.

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Hopman, E.P.C.; Donker, G.A.; Schellevis, F.G.; Rijken, P.M.

    2016-01-01

    BACKGROUND: The number of cancer survivors is steadily increasing and these patients often experience long-lasting health problems. To make care for cancer survivors sustainable for the future, it would be relevant to put the effects of cancer in this phase into perspective. Therefore, the authors c

  14. The work life and career development of young breast cancer survivors.

    Science.gov (United States)

    Raque-Bogdan, Trisha L; Hoffman, Mary Ann; Ginter, Amanda C; Piontkowski, Sarah; Schexnayder, Kelci; White, Rachel

    2015-10-01

    Breast cancer survivors represent the largest proportion of cancer survivors, and the rate of young breast cancer survivors who are diagnosed before the age of 40 is increasing. Cancer survivorship scholarship has begun to address many aspects of survivors' quality of life, yet the role of work and career issues have been understudied, particularly for young survivors. To explore the work lives and career development of young breast cancer survivors, this study used consensual qualitative research methodology (Hill, Thompson, & Williams, 1997) to analyze data from qualitative interviews with 13 young women diagnosed with breast cancer before the age of 40. The 4 career-related domains that emerged from the data were (a) cancer-related work challenges, (b) coping with cancer-related work challenges, (c) reappraisal of career development after cancer, and (d) components of career and life satisfaction after cancer. Experiencing breast cancer at a young age was viewed by participants as contributing to an increased desire for work to provide a sense of meaning as well as financial security and insurance. Cancer was further viewed as contributing to lost control over career success and work choices, treatment side effects that interfere with work self-efficacy and capabilities, and interpersonal difficulties connecting within and outside of work. Women with more extensive cancer treatment and side effects reported greater work struggles. Despite this, participants' cancer narratives were characterized by a range of coping strategies, including reframing and seeking control, and by evidence of persistence, resilience, and hope. Implications for research and practice are discussed.

  15. Comparison of trauma on survivors of sexual assault and intimate partner violence in Limpopo

    Directory of Open Access Journals (Sweden)

    Mashudu Davhana-Maselesele

    2014-06-01

    Full Text Available Background:Gender-based violence is a challenge in South Africa, despite available interventions. Caring for the survivors of both forms of violence is critical for ensuring their speedy recovery. Objectives:To compare the effects of trauma on female survivors of sexual assault versus those experienced by survivors of physical assault by their intimate partners. Method:A quantitative cross-sectional comparative study design was used to compare 30 sexually-assaulted women and 30 physically-assaulted women regarding depressive symptoms, posttraumatic stress disorder and coping styles three months after the incident. Semi-structured interviews were conducted with the survivors of both types of assault and the Beck Depression Inventory posttraumatic stress disorder checklist and Brief COPE Inventory were administered in order to obtain quantitative data. Both parametric and non-parametric statistics were employed. Ethical measures were adhered to throughout the research process. Results:A significantly-higher proportion of sexually-assaulted women disclosed the incident to family (p = 0.021. The majority of sexually- (90% and physically- (86% assaulted women were likely to recall the incident. Sexually-assaulted women had a significantly-higher mean for avoidance/numbness (p 0.051. About 41%of sexually-assaulted participants reported severe depression. Findings confirmed that sexual assault is more personal whilst physical assault is more interpersonal. If physically-assaulted women were removed from the perpetrators they recovered faster than sexually-assaulted women. Their stay with the perpetrators may perpetuate the violence. Conclusion:The need for counselling and support for the survivors of both traumas was recommended. All stakeholders should be educated to provide support to survivors of both traumas.

  16. Innate Multigene Family Memories Are Implicated in the Viral-Survivor Zebrafish Phenotype.

    Directory of Open Access Journals (Sweden)

    Amparo Estepa

    Full Text Available Since adaptive features such as memory were discovered in mammalian innate immunity, interest in the immunological status of primitive vertebrates after infections has grown. In this context, we used zebrafish (Danio rerio, a primitive vertebrate species suited to molecular and genetic studies to explore transcriptional memories of the immune system in long-term survivors of viral haemorrhagic septicemia virus infections. Immune-gene targeted microarrays designed in-house, multipath genes, gene set enrichment, and leading-edge analysis, reveal unexpected consistent correlations between the viral-survivor phenotype and several innate multigene families. Thus, here we describe in survivors of infections the upregulation of the multigene family of proteasome subunit macropains, zebrafish-specific novel gene sets, mitogen activated protein kinases, and epidermal growth factor. We also describe the downregulation of the multigene families of c-reactive proteins, myxovirus-induced proteins and novel immunoglobulin-type receptors. The strength of those immunological memories was reflected by the exceptional similarity of the transcriptional profiles of survivors before and after re-infection compared with primary infected fish. On the other hand, the high levels of neutralizing antibodies in the blood plasma of survivors contrasted with the depletion of transcripts specific for most cell types present in lymphoid organs. Therefore, long-term survivors maintained unexpected molecular/cellular memories of previous viral encounters by modulating the expression levels of innate multigene families as well as having specific adaptive antibodies. The implications of the so-called "trained immunity" for future research in this field are also discussed.

  17. Innate Multigene Family Memories Are Implicated in the Viral-Survivor Zebrafish Phenotype.

    Science.gov (United States)

    Estepa, Amparo; Coll, Julio

    2015-01-01

    Since adaptive features such as memory were discovered in mammalian innate immunity, interest in the immunological status of primitive vertebrates after infections has grown. In this context, we used zebrafish (Danio rerio), a primitive vertebrate species suited to molecular and genetic studies to explore transcriptional memories of the immune system in long-term survivors of viral haemorrhagic septicemia virus infections. Immune-gene targeted microarrays designed in-house, multipath genes, gene set enrichment, and leading-edge analysis, reveal unexpected consistent correlations between the viral-survivor phenotype and several innate multigene families. Thus, here we describe in survivors of infections the upregulation of the multigene family of proteasome subunit macropains, zebrafish-specific novel gene sets, mitogen activated protein kinases, and epidermal growth factor. We also describe the downregulation of the multigene families of c-reactive proteins, myxovirus-induced proteins and novel immunoglobulin-type receptors. The strength of those immunological memories was reflected by the exceptional similarity of the transcriptional profiles of survivors before and after re-infection compared with primary infected fish. On the other hand, the high levels of neutralizing antibodies in the blood plasma of survivors contrasted with the depletion of transcripts specific for most cell types present in lymphoid organs. Therefore, long-term survivors maintained unexpected molecular/cellular memories of previous viral encounters by modulating the expression levels of innate multigene families as well as having specific adaptive antibodies. The implications of the so-called "trained immunity" for future research in this field are also discussed.

  18. Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report.

    Science.gov (United States)

    Chow, Eric J; Anderson, Lynnette; Baker, K Scott; Bhatia, Smita; Guilcher, Gregory M T; Huang, Jennifer T; Pelletier, Wendy; Perkins, Joanna L; Rivard, Linda S; Schechter, Tal; Shah, Ami J; Wilson, Karla D; Wong, Kenneth; Grewal, Satkiran S; Armenian, Saro H; Meacham, Lillian R; Mulrooney, Daniel A; Castellino, Sharon M

    2016-05-01

    Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies, solid tumors, and, increasingly, nonmalignant diseases. Given improvements in care, there are a growing number of long-term survivors of pediatric HCT. Compared with childhood cancer survivors who did not undergo transplantation, HCT survivors have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pretransplantation treatment exposures and organ dysfunction, the transplantation conditioning regimen, and any post-transplantation graft-versus-host disease (GVHD). In response, the Children's Oncology Group (COG) has created long-term follow-up guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those who were treated with HCT. Guideline task forces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other health care professionals, and patient advocates systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided herein is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those who underwent transplantation for nonmalignant diseases, and those with a history of chronic GVHD.

  19. Early maladaptive schemas in adult survivors of interpersonal trauma: foundations for a cognitive theory of psychopathology

    Science.gov (United States)

    Karatzias, Thanos; Jowett, Sally; Begley, Amelie; Deas, Suzanne

    2016-01-01

    Background Although the association between psychological trauma and early maladaptive schemas (EMS) is well established in the literature, no study to date has examined the relationship of EMS to PTSD and psychopathologies beyond depression and anxiety in a sample of adult survivors of interpersonal trauma. This information may be useful in helping our understanding on how to best treat interpersonal trauma. Objective We set out to investigate the association between EMS and common forms of psychopathology in a sample of women with a history of interpersonal trauma (n=82). We have hypothesised that survivors of interpersonal trauma will present with elevated EMS scores compared to a non-clinical control group (n=78). We have also hypothesised that unique schemas will be associated with unique psychopathological entities and that subgroups of interpersonal trauma survivors would be present in our sample, with subgroups displaying different profiles of schema severity elevations. Method Participants completed measures of trauma, psychopathology, dissociation, self-esteem, and the Young Schema Questionnaire. Results It was found that survivors of interpersonal trauma displayed elevated EMS scores across all 15 schemas compared to controls. Although the pattern of associations between different psychopathological features and schemas appears to be rather complex, schemas in the domains of Disconnection and Impaired Autonomy formed significant associations with all psychopathological features in this study. Conclusions Our findings support the usefulness of cognitive behavioural interventions that target schemas in the domains of Disconnection and Impaired Autonomy in an effort to modify existing core beliefs and decrease subsequent symptomatology in adult survivors of interpersonal trauma. Highlights of the article Interpersonal trauma survivors are distinguished primarily by a generalised elevation of their maladaptive schemas, rather than a unique schema profile

  20. Surviving Sudden Cardiac Arrest: A Pilot Qualitative Survey Study of Survivors.

    Science.gov (United States)

    Sawyer, Kelly N; Brown, Frances; Christensen, Roxanne; Damino, Colleen; Newman, Mary M; Kurz, Michael C

    2016-06-01

    Research describing survivors of sudden cardiac arrest (SCA) has centered on quantifying functional ability, perceived quality of life, and neurocognitive assessment. Many gaps remain, however, regarding survivors' psychosocial perceptions of life in the aftermath of cardiac arrest. An important influence upon those perceptions is the presence of support and its role in a survivor's life. An Internet-based pilot survey study was conducted to gather data from SCA survivors and friends and/or family members (FFMs) representing their support system. The survey was distributed to members of the Sudden Cardiac Arrest Foundation (SCAF) via the Internet by SCAF leadership. Questions included both discrete multiple-choice and open-ended formats. Inductive thematic analyses were completed by three independent researchers trained in qualitative research methodology to identify primary themes consistent among study participants until thematic saturation was achieved. No statistical inferences were made. A total of 205 surveys were returned over the 5-month study period (July to November 2013); nine were received blank, leaving 196 surveys available for review. Major themes identified for survivors (N = 157) include the significance of and desire to share experiences with others; subculture identification (unique experience from those suffering a heart attack); and the need to seek a new normal, both personally and inter-personally. Major themes identified for FFMs (N = 39) include recognition of loved one's memory loss; a lack of information at discharge, including expectations after discharge; and concern for the patient experiencing another cardiac arrest. This pilot, qualitative survey study suggests several common themes important to survivors, and FFMs, of cardiac arrest. These themes may serve as a basis for future patient-centered focus groups and the development of patient-centered guidelines for patients and support persons of those surviving cardiac arrest.