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Sample records for a-bomb survivors

  1. Health examination for A-bomb survivors

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    Ito, Chikako [Hiroshima Atomic Bomb Casualty Council Health Management Center (Japan)

    1996-03-01

    The health examination for A-bomb survivors by national, prefectural and city administrations was described and discussed on its general concept, history, time change of examinee number, improvement of examination, prevalence of individual diseases, significance of cancer examinations, examinees` point of view and future problems. Subjects were the survivors living in Hiroshima city: in 1994, their number was 100,188, whose ages were 63 y in average for males consisting of 39.5% and 67 y for females of 60.5%. The examination was begun in 1957 on the law for medical care for the survivors firstly and then systematically in 1961. From 1965, it was performed 4 times a year, and in 1988, one examination in the four was made for cancer. Authors` Center examined previously 90% but recently 70% of the examinees. The remainder underwent the examination in other medical facilities. Tests are blood analysis, electrocardiography and computed radiography of chest with imaging plate, of which data have been accumulated either in photodisc or in host computer. From 1973 to 1993, the cardiovascular diseases increased from 6.1% to 26.9%, metabolic and endocrinic ones like diabetes, 3.6% to 19.7%, and bowel ones, 0.9% to 12.3%. Correlations of these diseases with A-bomb irradiation are not elucidated and possibly poor. Five classes of cancer examinations are performed but the examinee rate in the survivors is as low as 7.6-21.8% (1993). The cancer of the large intestine is increasing. The overall examinee rates in the survivors were 70.6% in 1965-1967, 69.5% in 1976-1977 and 58.2% in 1990. In conclusion, how to examine the survivors, who are getting older, as many as possible is the future problem. (H.O.)

  2. Mental health for elder A-bomb survivors

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    Mine, Mariko; Honda, Sumihisa; Hata, Tomoko [Nagasaki Univ. (Japan). School of Medicine] [and others

    1994-12-01

    A pilot study was made, based on an interview survey, to improve mental hygiene in A-bomb survivors. The study consisted of General Health Questionnaire (GHQ) 12 items, Composite International Diagnostic Interview (CIDI), Social Disabilities Schedule (SDS), and General Health Questionnaire (GHQ) 30 items. A majority of the subjects were those aged in their fifties, sixties, and seventies. Eighty A-bomb survivors answered GHQ 12 items, consisting of 7, 17, and 41 who were exposed at <2.0 km, 2.0-2.9 km, and {>=}3.0 km from the hypocenter, respectively, and 15 who entered the city early after A-bombing. Thirty-three A-bomb survivors answered CIDI. According to the distance from the hypocenter, the corresponding figures were 2, 10, 15, and 6 A-bomb survivors. The survey for GHQ 12 items revealed that more A-bomb survivors exposed nearer the hypocenter suffered from mental problems. In the survey for CIDI, the most common complaints were found to be physical expression disorder (n=9) and chronic pain (n=8), followed by hypochondria (n=4), panic disorder (n=2), and anxiery (n=one). According to the SDS survey, 85% were judged as having no mental disorder, and the remaining 15% as having merely mild or moderate disorder. (N.K.).

  3. Micronucleus in A-bomb survivors and in thorotrast patients

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    Tanaka, K.; Kawakami, M.; Izumi, T.; Shigeta, C.; Takahashi, H.; Ohkita, T. (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1980-11-01

    Micronucleus and Howell-Jolly (H-J) bodies in bone marrow and in peripheral blood were investigated for 31 a-bomb survivors, and 21 thorotrast injected patients with 7 controls. The rate of micronucleus in myeloerythroblast was 0.263% for a-bomb survivors and 0.288% for thorotrast patients, which were higher than the controls, 0.050%. Correlations of micronucleus appearance with the incidence of chromosome aberrations and with estimated exposure dose were observed, suggesting that the micronucleus appearance could be an indicator of radiation damage. Also the micronucleus appearance in routine examinations could suggest the presence of chromosome aberrations. In the case of thorotrast patients H-J bodies appeared in high rate.

  4. The present state of the medical record data base for the A-bomb survivors in Nagasaki University

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    Mori, Hiroyuki; Mine, Mariko; Kondo, Hisayoshi; Okumura, Yutaka (Nagasaki Univ. (Japan). School of Medicine)

    1992-03-01

    It has been 13 years since the operation of medical record data base for A-bomb survivors was started in the Scientific Data Center for Atomic Bomb Disaster at the Nagasaki University. This paper presents the basic data in handling the data base. The present data base consists of the following 6 items: (1) 'fundamental data' for approximately 120,000 A-bomb survivors having an A-bomb survivors' handbook who have been living in Nagasaki City; (2) 'Nagasaki Atomic Bomb Hospital's data', covering admission medical records in the ward of internal medicine; (3) 'pathological data', covering autopsy records in Nagasaki City; (4) 'household data reconstructed by the survey data'; (5) 'second generation A-bomb survivors data', including the results of mass screening since 1979, and (6) 'address data'. Based on the data, the number of A-bomb survivors, diagnosis records at the time of death, the number of A-bomb survivors' participants in health examination, tumor registration, records of admission to the internal ward in Nagasaki Atomic Bomb Hospital, autopsy records, and household records are tabulated in relation to annual changes, age at the time of A-bombing, distance from the hypocenter, or sex. (N.K.).

  5. Gastric cancer in atomic bomb survivors, 2; In relation to age at the time of A-bomb explosion

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    Oshiro, Hisashi; Odan, Hideki; Hinoi, Takao; Inagaki, Kazuo; Tanaka, Issei (Hiroshima Prefectural Hiroshima Hospital (Japan))

    1992-02-01

    During 22 years from 1968 through 1989, 538 A-bomb survivors were operated on for gastric cancer, accounting for 30.9% of 1,741 surgical cases of gastric cancer during that period. To determine whether age at the time of exposure to A-bombing might influenced the occurrrence of gastric cancer, these A-bomb survivors were compared with 1,138 other non-exposed gastric cancer patients. According to age at the time of exposure, the 538 A-bomb survivors were divided into those under the age of 19 (118), those in their twenties (134), those in their thirties (178), and those over the age of 40 (108). The largest number of gastric cancer was those in their thirties at the time of exposure, followed by the twenties, 19 years or less, and 40 years or more in the exposed group. The younger A-bomb survivors were at the time of exposure, the earlier gastric cancer occurred. These findings were common to the non-exposed group. Postoperative 5-year survival rate was 72.0% in A-bomb survivors aged 19 years or less at the time of exposure, which was better than the other age groups. This may be explained by active participation in health examination for A-bomb survivors. (N.K.).

  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. 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.

  9. Biochemical mutations detected in the children of A-bomb survivors

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    Satoh, Chiyoko; Goriki, Kazuaki; Asakawa, Jun-ichi; Fujita, Mikio; Takahashi, Norio; Hazama, Ryuji; Neel, J.V.

    1988-03-01

    This is a report of the results of a study of biochemical mutations in children of A-bomb survivors. An electrophoretic examination of a series of 30 proteins, undertaken in 13,052 children in the exposed group and 10,609 children in the non-exposed control group, yielded three mutations in each group. These mutations altered the electrophoretic mobility for glutamic pyruvic transaminase, phosphoglucomutase-2, and nucleosidephospholilase in the exposed group; and for haptoglobin, adenosinedeaminase, and 6-phosphogluconate dehydrogenase in the control group. An examination of enzyme activity for 4,989 children in the exposed group yielded one mutation for triose phosphate isomerase; no mutations were encountered in any of the 5,026 children in the control group. Summarizing the results of the two series, the mutation rates observed in the exposed and control groups are thus 0.60 x 10/sup -5/ and 0.64 x 10/sup -5/, respectively, per locus per generation, with 95 % confidence limits of 0.2 - 1.5 x 10/sup -5/ and 0.1 - 1.9 x 10/sup -5/, respectively. (Namekawa, K.).

  10. Chernobyl nuclear power plant accident and thyroid cancer in children; Comparison with cases of Hiroshima A-bomb survivors

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    Takeichi, Nobuo (Hiroshima Univ. (Japan). School of Medicine); Sato, Yukio; Yamada, Hideo (and others)

    1994-03-01

    Since August 1991, six surveys have been made on thyroid cancer in children in Ukraine and Belorussia. The results were compared with those for Hiroshima A-bomb survivors. Children with thyroid cancer were characterized as having the following: (1) frequent occurrence of thyroid cancer; (2) extremely short latency period; (3) poorly differentiated papillary adenocarcinoma; (4) frequent occurrence within the thyroid gland; (5) the association of fibrosis, lymphocyte infiltration, and proliferation of follicular epithelial cells; (6) frequent occurrence of sclerosing variant of papillary cancer associated with fibrosis and lymphocyte infiltration, especially in heavily exposed areas. These findings were supposed to be attributable to Chernobyl nuclear power plant accident. No data has been available on infantile thyroid cancer in Hiroshima A-bomb survivors because of the following reasons: (1) acute death from acute radiation injury, leukemia and cancer other than thyroid cancer; (2) few survey on thyroid cancer during the first 10 years after exposure; (3) the lack of surgical data on thyroid cancer. In the case of Chernobyl survivors, there were few acute death cases; I-131 seemed to have damaged specifically the thyroid gland; heavily exposed areas corresponded to areas with low iodine intake; pediatric thyroid gland is sensitive to I-131, leading to the possibility that infantile thyroid cancer may have been induced by I-131. (N.K.).

  11. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by periodical health examination, (6). Serum ferritin determination of anemic patients

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    Abe, T.; Dohy, H.; Okita, H. (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1980-11-01

    Serum ferritin was determined in A-bomb survivors, and its significance was evaluated. A low-ferritin group included many of the females under the age of 50, who mostly had iron deficient anemia. A high-ferritin group included many older-aged A-bomb survivors who had secondary anemia due to hemochromatosis, paroxismal nocturnal hemoglobinuria (PNH), and multiple myeloma. Secondary anemia due to hemochromatosis, PNH, leukemia, and sideroblastic anemia was detected in those who were old and had underlying moderate or severe anemia with a high ferritin level. As the results of this investigation, blood examination combined with serum ferritin determination is valuable for diagnosis of anemia and detection of underlying diseases.

  12. Low dose radiation and cancer in A-bomb survivors: latency and non-linear dose-response in the 1950–90 mortality cohort

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    Dropkin Greg

    2007-01-01

    Full Text Available Abstract Background Analyses of Japanese A-bomb survivors' cancer mortality risks are used to establish recommended annual dose limits, currently set at 1 mSv (public and 20 mSv (occupational. Do radiation doses below 20 mSv have significant impact on cancer mortality in Japanese A-bomb survivors, and is the dose-response linear? Methods I analyse stomach, liver, lung, colon, uterus, and all-solid cancer mortality in the 0 – 20 mSv colon dose subcohort of the 1950–90 (grouped mortality cohort, by Poisson regression using a time-lagged colon dose to detect latency, while controlling for gender, attained age, and age-at-exposure. I compare linear and non-linear models, including one adapted from the cellular bystander effect for α particles. Results With a lagged linear model, Excess Relative Risk (ERR for the liver and all-solid cancers is significantly positive and several orders of magnitude above extrapolations from the Life Span Study Report 12 analysis of the full cohort. Non-linear models are strongly superior to the linear model for the stomach (latency 11.89 years, liver (36.90, lung (13.60 and all-solid (43.86 in fitting the 0 – 20 mSv data and show significant positive ERR at 0.25 mSv and 10 mSv lagged dose. The slope of the dose-response near zero is several orders of magnitude above the slope at high doses. Conclusion The standard linear model applied to the full 1950–90 cohort greatly underestimates the risks at low doses, which are significant when the 0 – 20 mSv subcohort is modelled with latency. Non-linear models give a much better fit and are compatible with a bystander effect.

  13. Comparison of the risks of cancer incidence and mortality following radiation therapy for benign and malignant disease with the cancer risks observed in the Japanese A-bomb survivors.

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    Little, M P

    2001-04-01

    To compare the radiation-associated relative risks of cancer incidence and mortality in groups exposed to ionizing radiation in the course of treatment for a variety of malignant and non-malignant conditions with those in the Japanese A-bomb survivor cancer incidence and mortality data. Comparison of the excess relative risk coefficients derived from published information for each study with the excess relative risk coefficient in comparable (age at exposure, time since exposure, sex) matched subsets of the Japanese A-bomb survivor cancer incidence and mortality data. Sixty-five studies of persons who have received appreciable doses of ionizing radiation in the course of treatment and for whom there is adequate ascertainment of cancer incidence or mortality are identified, from which 116 cancer-site-specific estimates of excess relative risk are derived. Relative risks tend to be lower in the medical series than in the Japanese A-bomb survivors. The most marked discrepancies between the relative risks in the medical series and in the A-bomb survivors are for leukaemia, where 12 of the 17 medical studies have significantly lower relative risks than those observed in the Japanese data. However, the ratio between the relative risks in the medical studies and in the Japanese data tends to diminish with increasing average or maximal therapy dose. This is observed for all cancer sites and is particularly marked for leukaemia. After taking account of cell sterilization and dose fractionation the apparent differences between the relative risks for leukaemia in the Japanese A-bomb survivors and in the medical series largely disappear. This suggests that cell sterilization largely accounts for the discrepancy between the relative risks in the Japanese data and the medical studies. Other factors, such as the differences in underlying cancer risks between the Japanese A-bomb survivors and the medical series, and dose-fractionation effects, may also contribute. The relative

  14. Independent analysis of the radiation risk for leukaemia in children and adults with mortality data (1950-2003) of Japanese A-bomb survivors

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    Kaiser, Jan Christian [German Research Centre for Environmental Health, Institute of Radiation Protection, Helmholtz Zentrum Muenchen, Oberschleissheim (Germany); Walsh, Linda [Federal Office for Radiation Protection, Department Radiation Protection and Health, Oberschleissheim (Germany); University of Manchester, The Faculty of Medical and Human Sciences, Manchester (United Kingdom)

    2013-03-15

    A recent analysis of leukaemia mortality in Japanese A-bomb survivors has applied descriptive models, collected together from previous studies, to derive a joint excess relative risk estimate (ERR) by multi-model inference (MMI) (Walsh and Kaiser in Radiat Environ Biophys 50:21-35, 2011). The models use a linear-quadratic dose response with differing dose effect modifiers. In the present study, a set of more than 40 models has been submitted to a rigorous statistical selection procedure which fosters the parsimonious deployment of model parameters based on pairwise likelihood ratio tests. Nested models were consequently excluded from risk assessment. The set comprises models of the excess absolute risk (EAR) and two types of non-standard ERR models with sigmoidal responses or two line spline functions with a changing slope at a break point. Due to clearly higher values of the Akaike Information Criterion, none of the EAR models has been selected, but two non-standard ERR models qualified for MMI. The preferred ERR model applies a purely quadratic dose response which is slightly damped by an exponential factor at high doses and modified by a power function for attained age. Compared to the previous analysis, the present study reports similar point estimates and confidence intervals (CI) of the ERR from MMI for doses between 0.5 and 2.5 Sv. However, at lower doses, the point estimates are markedly reduced by factors between two and five, although the reduction was not statistically significant. The 2.5 % percentiles of the ERR from the preferred quadratic-exponential model did not fall below zero risk in exposure scenarios for children, adolescents and adults at very low doses down to 10 mSv. Yet, MMI produced risk estimates with a positive 2.5 % percentile only above doses of some 300 mSv. Compared to CI from a single model of choice, CI from MMI are broadened in cohort strata with low statistical power by a combination of risk extrapolations from several models

  15. Independent analysis of the radiation risk for leukaemia in children and adults with mortality data (1950-2003) of Japanese A-bomb survivors.

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    Kaiser, Jan Christian; Walsh, Linda

    2013-03-01

    A recent analysis of leukaemia mortality in Japanese A-bomb survivors has applied descriptive models, collected together from previous studies, to derive a joint excess relative risk estimate (ERR) by multi-model inference (MMI) (Walsh and Kaiser in Radiat Environ Biophys 50:21-35, 2011). The models use a linear-quadratic dose response with differing dose effect modifiers. In the present study, a set of more than 40 models has been submitted to a rigorous statistical selection procedure which fosters the parsimonious deployment of model parameters based on pairwise likelihood ratio tests. Nested models were consequently excluded from risk assessment. The set comprises models of the excess absolute risk (EAR) and two types of non-standard ERR models with sigmoidal responses or two line spline functions with a changing slope at a break point. Due to clearly higher values of the Akaike Information Criterion, none of the EAR models has been selected, but two non-standard ERR models qualified for MMI. The preferred ERR model applies a purely quadratic dose response which is slightly damped by an exponential factor at high doses and modified by a power function for attained age. Compared to the previous analysis, the present study reports similar point estimates and confidence intervals (CI) of the ERR from MMI for doses between 0.5 and 2.5 Sv. However, at lower doses, the point estimates are markedly reduced by factors between two and five, although the reduction was not statistically significant. The 2.5 % percentiles of the ERR from the preferred quadratic-exponential model did not fall below zero risk in exposure scenarios for children, adolescents and adults at very low doses down to 10 mSv. Yet, MMI produced risk estimates with a positive 2.5 % percentile only above doses of some 300 mSv. Compared to CI from a single model of choice, CI from MMI are broadened in cohort strata with low statistical power by a combination of risk extrapolations from several

  16. Rediscovery of an old article reporting that the area around the epicenter in Hiroshima was heavily contaminated with residual radiation, indicating that exposure doses of A-bomb survivors were largely underestimated.

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    Sutou, Shizuyo

    2017-09-01

    The A-bomb blast released a huge amount of energy: thermal radiation (35%), blast energy (50%), and nuclear radiation (15%). Of the 15%, 5% was initial radiation released within 30 s and 10% was residual radiation, the majority of which was fallout. Exposure doses of hibakusha (A-bomb survivors) were estimated solely on the basis of the initial radiation. The effects of the residual radiation on hibakusha have been considered controversial; some groups assert that the residual radiation was negligible, but others refute that assertion. I recently discovered a six-decade-old article written in Japanese by a medical doctor, Gensaku Obo, from Hiroshima City. This article clearly indicates that the area around the epicenter in Hiroshima was heavily contaminated with residual radiation. It reports that non-hibakusha who entered Hiroshima soon after the blast suffered from severe acute radiation sickness, including burns, external injuries, fever, diarrhea, skin bleeding, sore throat and loss of hair-as if they were real hibakusha. This means that (i) some of those who entered Hiroshima in the early days after the blast could be regarded as indirect hibakusha; (ii) 'in-the-city-control' people in the Life Span Study (LSS) must have been irradiated more or less from residual radiation and could not function properly as the negative control; (iii) exposure doses of hibakusha were largely underestimated; and (iv) cancer risk in the LSS was largely overestimated. Obo's article is very important to understand the health effects of A-bombs so that the essence of it is translated from Japanese to English with the permission of the publisher. © The Author 2017. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  17. The influence of follow-up on DS02 low-dose ranges with a significant excess relative risk of all solid cancer in the Japanese A-bomb survivors

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    Walsh, Linda; Schneider, Uwe [University of Zuerich, Department of Physics, Science Faculty, Zurich (Switzerland)

    2016-11-15

    Determinations of the lowest colon dose, D{sub min}, below which there is a statistically significant excess relative risk of all solid cancer, when analyses are restricted to the range [0, D{sub min}], are of current interest in research related to radiation protection and risk assessment. In reviewing recent cancer mortality reports on the Life Span Study (LSS) of Japanese A-bomb survivors, reported D{sub min} values were found to vary between different reports. The report 12 (follow-up: 1950-1990) found a D{sub min} of 50 mGy, but the most recent report 14 (follow-up: 1950-2003) found a D{sub min} of 200 mGy. There were small dosimetry changes between report 12, which used DS86, and report 14, which used DS02, but these changes are unlikely to account for a difference in D{sub min} of a factor of 4. This short communication examines the reasons for this difference in D{sub min} by presenting further investigations into D{sub min} using different trial values for D{sub min} and various follow-up time spans, all with the same DS02 dosimetry. Magnitudes of the low-dose risks in different dose ranges are also presented. It is shown here that the main influence on D{sub min} comes from the length of follow-up and a D{sub min} of 50 mGy may also be obtained with the most recent LSS mortality data and DS02, if a restricted follow-up is analyzed. A systematic trend was evident of lower D{sub min} values for earlier mortality follow-up periods, consistent with information from earlier LSS reports. Although it may seem surprising that the D{sub min} increases with longer follow-up and better statistics, this systematic trend appears to be a consequence of decreasing mortality risks with longer follow-up, even though the error bars on the risks are getting smaller with increasing follow-up. These systematic trends also persisted after accounting for differences between baseline cancer rates for two groups of survivors who were either proximal or distal to the A-bomb

  18. Neutron relative biological effectiveness for solid cancer incidence in the Japanese A-bomb survivors: an analysis considering the degree of independent effects from γ-ray and neutron absorbed doses with hierarchical partitioning.

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    Walsh, Linda

    2013-03-01

    It has generally been assumed that the neutron and γ-ray absorbed doses in the data from the life span study (LSS) of the Japanese A-bomb survivors are too highly correlated for an independent separation of the all solid cancer risks due to neutrons and due to γ-rays. However, with the release of the most recent data for all solid cancer incidence and the increased statistical power over previous datasets, it is instructive to consider alternatives to the usual approaches. Simple excess relative risk (ERR) models for radiation-induced solid cancer incidence fitted to the LSS epidemiological data have been applied with neutron and γ-ray absorbed doses as separate explanatory covariables. A simple evaluation of the degree of independent effects from γ-ray and neutron absorbed doses on the all solid cancer risk with the hierarchical partitioning (HP) technique is presented here. The degree of multi-collinearity between the γ-ray and neutron absorbed doses has also been considered. The results show that, whereas the partial correlation between the neutron and γ-ray colon absorbed doses may be considered to be high at 0.74, this value is just below the level beyond which remedial action, such as adding the doses together, is usually recommended. The resulting variance inflation factor is 2.2. Applying HP indicates that just under half of the drop in deviance resulting from adding the γ-ray and neutron absorbed doses to the baseline risk model comes from the joint effects of the neutrons and γ-rays-leaving a substantial proportion of this deviance drop accounted for by individual effects of the neutrons and γ-rays. The average ERR/Gy γ-ray absorbed dose and the ERR/Gy neutron absorbed dose that have been obtained here directly for the first time, agree well with previous indirect estimates. The average relative biological effectiveness (RBE) of neutrons relative to γ-rays, calculated directly from fit parameters to the all solid cancer ERR model with both

  19. 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.)

  20. Proceedings of the 43rd Research Society for the Late Effects of the A-Bomb

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    Anon.

    2002-09-01

    This issue is the collection of study papers presented in the meeting in the title, which including the special review lecture concerning the subjects and prospects in studies on the late health effects of A-bomb radiation; symposia concerning the significance and summary of health effects study of the children of A-bomb survivors at Radiation Effects Research Foundation (RERF), the ethical issues on human genome and genetic analyses, and on materials of survivors and their biology in the archive, and the technology (genetic effects of radiation in human mini-satellite loci and microarray-based comparative genome hybridization as its efficient methodology); and 40 general presentations. The general presentations involve 19 clinical health examination studies of A-bomb survivors in Hiroshima and Nagasaki, related to cancer (4 presentations), immunology (4) and other general clinical observations; 7 clinical and basic studies on patients generated in the Tokai criticality accident (1), in Chernobyl (3), Belarus (1) and Nagasaki (2); 5 application studies of histological specimens; and 9 basic radiation biology studies related to carcinogenesis, p53, radio-sensitization or -sensitivity etc. (N.I.)

  1. Experimental derivation of relative biological effectiveness of A-bomb neutrons in Hiroshima and Nagasaki and implications for risk assessment.

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    Sasaki, M S; Nomura, T; Ejima, Y; Utsumi, H; Endo, S; Saito, I; Itoh, T; Hoshi, M

    2008-07-01

    Epidemiological data on the health effects of A-bomb radiation in Hiroshima and Nagasaki provide the framework for setting limits for radiation risk and radiological protection. However, uncertainty remains in the equivalent dose, because it is generally believed that direct derivation of the relative biological effectiveness (RBE) of neutrons from the epidemiological data on the survivors is difficult. To solve this problem, an alternative approach has been taken. The RBE of polyenergetic neutrons was determined for chromosome aberration formation in human lymphocytes irradiated in vitro, compared with published data for tumor induction in experimental animals, and validated using epidemiological data from A-bomb survivors. The RBE of fission neutrons was dependent on dose but was independent of the energy spectrum. The same RBE regimen was observed for lymphocyte chromosome aberrations and tumors in mice and rats. Used as a weighting factor for A-bomb survivors, this RBE system was superior in eliminating the city difference in chromosome aberration frequencies and cancer mortality. The revision of the equivalent dose of A-bomb radiation using DS02 weighted by this RBE system reduces the cancer risk by a factor of 0.7 compared with the current estimates using DS86, with neutrons weighted by a constant RBE of 10.

  2. The risk of ovarian cancer in atomic bomb survivors, Nagasaki city, Japan 1973-1987

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    Nakamura, Tsuguto; Shimokawa, Isao; Higami, Yoshikazu [Nagasaki Univ. (Japan). School of Medicine] [and others

    1994-12-01

    A population based study was conducted to evaluate the risk of ovarian cancer among female atomic bomb (A-bomb) survivors in Nagasaki City by using data from 1973 to 1987 of the Nagasaki Tumor Resistry. The incidence rate of ovarian cancer in the total female population in Nagasaki City decreased at ages 50-59, 60-69, and 70-79 with advancing the periods investigated (1973-1977, 1978-1982, and 1983-1987). A similar trend in the incidence rate was also observed in A-bomb survivors. The summarized risk ratio (SRR) of ovarian cancer was not significantly higher in A-bomb survivors; SRR: 1.30 (95% confidence interval of SRR: 0.64-2.68) in the survivors exposed to the A-bomb radiation within 2 km of the hypocenter, and 1.07 (0.78-1.46) in the total population of A-bomb survivors. There was also no difference in histologic type of ovarian cancer between A-bomb survivors and non-exposed persons. It should be noted, however, that the incidence rate at age 40-49 was higher in A-bomb survivors than in non-exposed persons during the all periods investigated. A follow-up study is, therefore, still necessary to evaluate the risk of ovarian cancer in A-bomb survivors in Nagasaki city. (author).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  4. Gastric cancer in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Oshiro, Hisashi; Itamoto, Toshiyuki; Sumimoto, Ryo [Hiroshima Prefectural Hiroshima Hospital (Japan)] [and others

    1994-10-01

    This is a retrospective review of gastric cancer in A-bomb survivors. Firstly, surgical cases of gastric cancer (1968-88) were compared in 514 A-bomb survivors and 1,092 non-exposed persons. The average age was 63.5 years in the exposed group and 60.0 years in the non-exposed group. Although there were much more men than women in the non-exposed group (67.3% vs 32.7%), there was no great difference in the exposed group (56.0% vs 44.0%). The frequency of early gastric cancer tended to be higher in the exposed group, and thus, both the curative resection and 5-year survival rates were slightly higher. This seems to have been attributed to periodical health examination for A-bomb survivors. Secondly, the frequency of gastric cancer was examined in relation to the age at the time of A-bombing (ATA). According to the ATA, 538 A-bomb survivors (1968-89) were divided into the <19 year group (n=118), 20-29 year group (n=134), 30-39 year group (n=178), and >40 year group (n=108). The <19 year group accounted for more A-bomb survivors directly exposed to A-bombing. Using 1,138 other non-exposed patients as controls, there was no factors specific to the exposed group. Thirdly, the distance from the hypocenter was examined in 569 A-bomb survivors (1966-1990) by dividing them into the {<=}2.0 km group (n=137), >2.1 km group (n=168), and secondarily exposed group (n=264). In all three groups, well-differentiated cancer was predominant. The frequency of poorly differentiated cancer was higher in those exposed nearer the hypocenter; this was significant in both the {<=}2.0 km and >2.1 km groups than the secondarily exposed group. In directly exposed groups, the frequency of poorly differentiated cancer was high in the age group of <50 and the frequency of well differentiated cancer was high in the age group of >60. This suggests the relationship between exposure doses and poorly differentiated gastric cancer. (N.K.).

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

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Chikako (Hiroshima Atomic Bomb Survivors Health Clinic (Japan)); Kodama, Kazunori; Sasaki, Hideo; Ishibashi, Shinzo; Dote, Keigo; Watanabe, Tadaaki; Hirata, Katsumi; Sugimoto, Sumio

    1990-02-01

    During a one-month period from June 13 through July 13, 1989, the seventh medical examination was conducted at five cities, including San Francisco, Los Angeles, Seattle, Wailuku and Honolulu, for A-bomb survivors residents in North America. Nine hundred and eighteen A-bomb survivors, including 21 living in Canada, were confirmed, consisting of 234 men and 684 women as of the end of July 1989. The number was increased by 167, compared with that as of the end of July 1987. During the past three years, there were 40 deaths; and 878 A-bomb survivors (223 men and 655 women) are still alive. Ninety percent of the survivors came from Hiroshima. U.S. nationality was seen in 61% and Japanese nationality with permanent U.S. residency rights was seen in 32%. The majority (39%) of the A-bomb survivors were in their fifties, with an average age of 59.4 years. The survivors were residing in 26 states in the USA and in 3 provinces in Canada. The acquisition rate of the A-bomb survivors' health handbook was 52%. Four hundred and six A-bomb survivors participated in the medical examination, including one male and 8 female children born to A-bomb survivors. Questionnaire survey revealed a history of surgical resection for cancer in 21 survivors. Subjective symptoms included complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness of the body. Overall evaluation revealed the necessity of medical treatment or observation in 71%. This was independent of exposure status. Hypertension was the most common (27%), followed by obesity, hyperlipidemia, heart disease, and diabetes mellitus. Malignant tumors were seen in 9 survivors, consisting of 3 with breast cancer, 2 with colorectal cancer, and single survivors with lung cancer, Hodgkin's disease, cervical cancer, or hepatoma. Only 29% of them have had finantial guarantee for their health management according to the Japanese law. (N.K.).

  6. Case of primary sideroblastic anemia observed among atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Teratani, M.; Suzuki, J.; Kajikawa, M. (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1980-05-01

    A female a-bomb survivor had anemia 18 years after the exposure to a-bomb. She was strongly suspected of developing leukemia, because she showed morphological abnormalities (erythrocytoblasts, megakaryocytes, myeloblasts, eosinocytes, and neutrocytes having 2 or 3 or 5 nuclei) and partial functional disorder extending 3 bone marrow systems and chromosome aberration. She died of hepatitis and atrioventricular block 11 years after the onset.

  7. Details of Nazis' A-Bomb program surface

    CERN Multimedia

    Glanz, J

    2002-01-01

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

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

    Science.gov (United States)

    Dropkin, Greg

    2016-11-24

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

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

    Science.gov (United States)

    Schneider, Uwe; Sumila, Marcin; Robotka, Judith

    2011-07-26

    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. 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. 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. 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 any three-dimensional inhomogenous dose distribution, cancer risk can be compared by

  11. Foreign bodies radiographically-demonstrated in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

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

    1978-08-25

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

  12. Report on results of fourth medical examination of atomic bomb survivors residing in the U. S

    Energy Technology Data Exchange (ETDEWEB)

    Monzen, Tetsuo (Hiroshima Prefectural Medical Association (Japan)); Ito, Chikako; Tanaka, Yoshikiyo; Kodama, Kazunori; Inamizu, Tsutomu

    1984-01-01

    Review was made of the fourth medical examination and the actual state of health of the U.S. atomic-bomb (A-bomb) survivors. The number of survivors registered with the Committee of A-bomb Survivors residing in the U.S. as of the end of June 1983 in 592 (males 154, females 438), of whom 58.8% possess U.S. citizenship. Survivor's health handbooks issued to survivors under the Japanese A-bomb Survivors Medical Treatment Law are possessed by 29.2%, with female holders being about twice as numerous as males. Responses to the health survey questionnaire were received from 306. Complaints of subjective symptoms tended to be higher in the early entrants, and by place of examination, those of Honolulu had the higher rate. Those who underwent health examination numbered 305 (73 males and 232 females). RBC and hemoglobin value were higher in the U.S. survivors than in Hiroshima survivors. No abnormality was observed in 47.5%. The main abnormalities noted were obesity, hypertension, hyperlipidemia, ischemic heart disease, diabetes mellitus, hypothyroidism, and liver disease. Comparison of those who had received examination on two consecutive occasions in 1981 and 1983 and those who were examined for the first time in 1983 showed a decrease in the frequency of obesity and hypertension.

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

    Science.gov (United States)

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

    2012-05-01

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

  14. 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.

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

    Science.gov (United States)

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

    2008-05-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-05-01

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

  18. Reclassification of leukemia among A-bomb survivors in Nagasaki using French-American-British (FAB) classification for acute leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Matsuo, Tatsuki; Tomonaga, Masao; Bennett, J.M. and others

    1988-06-01

    The concordance rate for diagnoses of atomic bomb-related cases of leukemia in Nagasaki was determined using the French-American-British (FAB) classification for acute leukemias and myelodysplastic syndromes (MDS). Two Radiation Effects Research Foundation (RERF) hematologists and one of the members (JMB) of the FAB cooperative group reviewed independently the peripheral blood and/or bone marrow smears from 193 people with leukemia or a related disorder. There was 85 % agreement in the identification of types and subtypes of acute leukemia. There was almost complete agreement for the diagnoses of non-FAB disorders (chronic myeloid leukemia (CML), adult T-cell leukemia (ATL) and others) resulting in overall concordance of 88.2 %. The present study suggest that the previously established leukemia types for about a quarter of the cases of acute leukemia and related disorders except CML should be changed. Considerable numbers of cases of ATL and MDS were involved in this series. The frequency of the former disease was not high in the high-dose irradiated group, but that of the latter was considerably high. All subtypes of AML except M3 and M6 were present in the high-dose group. The striking difference in CML incidence between Nagasaki and Hiroshima may continue to be a problem in relation to biological response to radiation exposure.

  19. Desert Survivors!

    Science.gov (United States)

    Horton, Jessica; Friedenstab, Steve

    2013-01-01

    This article describes a special third-grade classroom unit based on the reality show "Survivor." The goal of this engaging and interactive unit was to teach students about physical and behavioral adaptations that help animals survive in various desert biomes. The activity combines research, argument, and puppet play over one week of…

  20. Mortality of atomic bomb survivors in Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Mine, Mariko; Honda, Sumihisa; Kondo, Hisayoshi; Yokota, Kenichi; Tomonaga, Masao; Okumura, Yutaka [Atomic Bomb Disease Institute, Nagasaki Univ. School of Medicine, Nagasaki (Japan)

    1999-09-01

    We analyzed the risk in 2,743 atomic bomb survivors by using a new dosimetry system. From the database, we selected 2,743 exposed persons and a total of three times 2,743 age-matched controls who were living far from the center of the A-bomb radiation in Nagasaki at the time of the explosion and who were still alive in 1971. The mortalities from all causes for male subjects exposed were slightly lower than, or almost equal to, those of unexposed persons. Death from cancer, however, increased in both sexes after all levels of irradiation except in males exposed to 0.01-0.49 Gy. In males, the risk was showed significant reduction in death from all diseases other than cancer classified according to 0.31-0.40 Gy. (author)

  1. Ph sup 1 chromosomes and bcr gene rearrangements in chronic myelocytic leukemia patients developed from atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Kimio; Takechi, Miho; Shigeta, Chiharu; Sakatani, Keiko; Oguma, Nobuo; Kamada, Nanao; Takimoto, Yasuo; Kuramoto, Atsushi (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1989-01-01

    This study compared findings of chronic myelocytic leukemia (CML) in A-bomb survivors (n=8) developing CML within 10 years after the bombing and in non-exposed CML patients (n=14). Both Ph{sup 1} chromosomes and bcr rearrangement were observed in all patients in both exposed and non-exposed groups. There was no significant difference in distribution sites of bcr rearrangement between the groups. These results suggest that bcr-abl chimera mRNA and chimera protein associated with Ph{sup 1} chromosomes have an important role in the development of CML among A-bomb survivors, as well as among non-exposed patients. (N.K.).

  2. 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

  3. Comprehensive medical research on survivors from the atomic bomb hypocenter. The results of the last ten years

    Energy Technology Data Exchange (ETDEWEB)

    Kamada, Nanao; Yamamoto, Hisashi (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology); Yuzaki, Minoru

    1982-08-01

    The results of medical follow-up of 78 A-bomb survivors who had been exposed to A-bomb at the site within 500 m of the hypocenter were reviewed. In those survivors, who had exposure at an average of 28.6 years old, 75% had very severe, acute radiation-injuries such as trauma, depilation, vomiting, diarrhea, and hemorrhage. Physical examination revealed high incidences of ophthalmologic abnormalities, traumatic scar, and deformation of the lower extremities. Clinical findings included abnormal roentgen pictures of the stomach and the duodenum, and a rather high incidence of PPD negative cases. Functional and morphological abnormalities are often found in the circulatory system, eyeball, digestive organs, and joints. One survivor had an average of 2.5 diseases to be treated. Hematological observation revealed a high incidence of increased EB virus antibody, and a high incidence of abnormalities at the chromosomal level in T and B lymphocytes, and myelocytes. Of 78 survivors, 13 died in the subsequent 10 years, 4 of them had had cancer such as leukemia and lung cancer. Implication of the chromosome in the cancerization process in these cases was discussed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

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

    CERN Document Server

    Rühm, W; Nekolla, E A

    2006-01-01

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

  6. 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…

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

    Science.gov (United States)

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

    2014-12-01

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

  8. Pain in cancer survivors.

    Science.gov (United States)

    Brown, Matthew Rd; Ramirez, Juan D; Farquhar-Smith, Paul

    2014-11-01

    Cancer and its treatment exert a heavy psychological and physical toll. Of the myriad symptoms which result, pain is common, encountered in between 30% and 60% of cancer survivors. Pain in cancer survivors is a major and growing problem, impeding the recovery and rehabilitation of patients who have beaten cancer and negatively impacting on cancer patients' quality of life, work prospects and mental health. Persistent pain in cancer survivors remains challenging to treat successfully. Pain can arise both due to the underlying disease and the various treatments the patient has been subjected to. Chemotherapy causes painful chemotherapy-induced peripheral neuropathy (CIPN), radiotherapy can produce late effect radiation toxicity and surgery may lead to the development of persistent post-surgical pain syndromes. This review explores a selection of the common causes of persistent pain in cancer survivors, detailing our current understanding of the pathophysiology and outlining both the clinical manifestations of individual pain states and the treatment options available.

  9. Micronuclei and chromosome aberrations found in bone marrow cells and lymphocytes form thorotrast patients and atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Kimio; Izumi, Takaki; Ohkita, Takeshi; Kamada, Nanao (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1984-03-01

    As two cytogenetic parameters of radiation exposure, the frequency of micronucleus in erythroblasts, lymphocytes and red cells (Howell-Jolly body) as well as chromosome aberrations in bone marrow cells and in lymphocytes were studied in 24 thorotrast patients and in 32 atomic bomb (A-bomb) survivors who were exposed within one kilometer from the Hiroshima hypocenter. The incidence of both micronucleus and chromosome aberrations in these two exposed groups were significantly higher than that in non-exposed controls. So that these two parameters are useful guide for evaluating the residual effects of radiation, especially on hematopoietic cells. Because of its simple procedures, micronucleus test is also helpful as screening for prediction of chromosome aberrations. The characteristics of lymphocyte chromosome aberrations differed considerably between thorotrast patients and A-bomb survivors; the incidence of unstable type aberrations and intracellular complexity of chromosome aberrations were much higher in the former group. The incidence of micronucleus in erythroblasts and lymphocytes was also higher in thorotrast patients. Such differences are attributable to the differences in the radiation quality (..cap alpha..-ray or ..gamma..-ray+neutron) and in the mode of exposure (persistent or single) of these two groups.

  10. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-06-01

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

  12. Children of Holocaust Survivors.

    Science.gov (United States)

    Segal, Shirley Ann

    As a result of the Holocaust, many survivors developed long term psychosocial impairment known as the Post-traumatic Stress Disorder (PTSD), which is characterized by depression, anxiety, hypocondriasis, inability to concentrate or to express anger, nightmares, insomnia, obsessive thoughts, guilt, mistrust, and alienation. The literature in this…

  13. Survivors on Cancer: the portrayal of survivors in print news.

    Science.gov (United States)

    Kromm, Elizabeth Edsall; Smith, Katherine Clegg; Singer, Rachel Friedman

    2007-12-01

    This study examines the types of news stories that include comments by everyday cancer survivors and the messages or information these individuals provide. Even though these non-celebrity survivors increasingly serve on the front lines of cancer prevention and advocacy efforts and often engage with media, the role they play in the media discourse on cancer has not been a focus of research. We conducted a thematic content analysis of print news articles of non-celebrity cancer survivors in 15 leading national daily newspapers for four consecutive months starting in June 2005 to identify the issues or events that included a survivor perspective and the messages or information conveyed by the everyday survivors. Journalists included survivor commentary primarily when covering cancer fundraising events and when focusing on individual survivorship stories. In overall news coverage involving survivors, breast and prostate cancers received the greatest attention, followed by blood and lung cancers. Survivors spoke mainly about the diagnosis experience and life post-cancer. Our analysis of survivors' comments revealed that discussions of the diagnosis experience often convey fear and a lack of confidence in cancer screening practices, while cancer is portrayed as a positive life event. While evidence of a positive and hopeful portrayal of survivorship is an encouraging finding for continued efforts to decrease stigma associated with a cancer diagnosis and for the public understanding of the disease, it is important to consider potential negative implications of an idealized and restricted media discourse on survivorship. The increasing size and capacity of the survivor community offers opportunities for the cancer advocacy community to consider how news media portrayal of cancer and survivorship may contribute in both positive and potentially detrimental ways to public understanding of this disease, its survivors and life after cancer.

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

    Science.gov (United States)

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

    2017-10-01

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

  15. Who are the cancer survivors?

    DEFF Research Database (Denmark)

    Hovaldt, Hanna Birkbak; 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 co...

  16. 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.

  17. 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.)

  18. Holocaust Child Survivors and Child Sexual Abuse

    Science.gov (United States)

    Lev-Wiesel, Rachel; Amir, Marianne

    2005-01-01

    This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the…

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Conversations with Holocaust survivor residents.

    Science.gov (United States)

    Hirst, Sandra P; LeNavenec, Carole Lynne; Aldiabat, Khaldoun

    2011-03-01

    Traumatic events in one's younger years can have an impact on how an individual copes with later life. One traumatic experience for Jewish individuals was the Holocaust. Some of these people are moving into long-term care facilities. It was within this context that the research question emerged: What are Holocaust survivor residents' perceptions of a life lived as they move into a long-term care facility? For this qualitative study, Holocaust survivors were individually interviewed. Findings emphasize that nursing care needs to ensure that Holocaust survivor residents participate in activities, receive timely health care, and receive recognition of their life experiences. Copyright 2011, SLACK Incorporated.

  1. Ageing Holocaust survivors in Australia.

    Science.gov (United States)

    Paratz, Elizabeth D; Katz, Benny

    2011-02-21

    In recent years, a phenomenon of "late effects of the Holocaust" has emerged, with impacts on the psychological and physical health of ageing Holocaust survivors. As Holocaust survivors age, they may experience heightened anxiety around normal processes of ageing, worsened post-traumatic stress disorder with cognitive decline, and fear of the medical system. Holocaust survivors are at increased risk of osteoporosis, cardiometabolic disease due to hypothalamic-pituitary-adrenal axis dysfunction, cancer, and sequelae of Nazi medical experiments. From existing medical literature on this topic, practical principles of management are derived to create a framework for sensitive medical management of Holocaust survivors in Australia. The issues discussed are also relevant to the wider geriatric refugee or prisoner-of-war experience.

  2. Sexual minority cancer survivors' satisfaction with care.

    Science.gov (United States)

    Jabson, Jennifer M; Kamen, Charles S

    2016-01-01

    Satisfaction with care is important to cancer survivors' health outcomes. Satisfaction with care is not equal for all cancer survivors, and sexual minority (i.e., lesbian, gay, and bisexual) cancer survivors may experience poor satisfaction with care. Data were drawn from the 2010 LIVESTRONG national survey. The final sample included 207 sexual minority cancer survivors and 4,899 heterosexual cancer survivors. Satisfaction with care was compared by sexual orientation, and a Poisson regression model was computed to test the associations between sexual orientation and satisfaction with care, controlling for other relevant variables. Sexual minority cancer survivors had lower satisfaction with care than did heterosexual cancer survivors (B = -0.12, SE = 0.04, Wald χ(2) = 9.25, pSexual minorities experience poorer satisfaction with care compared to heterosexual cancer survivors. Satisfaction with care is especially relevant to cancer survivorship in light of the cancer-related health disparities reported among sexual minority cancer survivors.

  3. Childhood Cancer Survivor Study: An Overview

    Science.gov (United States)

    ... of Childhood Treatment Childhood Cancer Genomics Study Findings Childhood Cancer Survivor Study: An Overview Dr. Greg Armstrong, ... Late Effects of Treatment for Childhood Cancer .) The Childhood Cancer Survivor Study ( CCSS ), funded by the National ...

  4. Detroit Research on Cancer Survivors Study

    Science.gov (United States)

    An NCI press release about the launch of the Detroit Research on Cancer Survivors (ROCS) study, which will look at factors affecting cancer progression, recurrence, mortality, and quality of life among African-American cancer survivors.

  5. Secondhand Smoke Still Plagues Some Cancer Survivors

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_166834.html Secondhand Smoke Still Plagues Some Cancer Survivors Study found they ... number of nonsmoking cancer survivors exposed to secondhand smoke is down significantly in the United States, but ...

  6. 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...... survivors' experiences of rehabilitation in a clinical setting. Data analysis entailed extracting, editing, grouping, and abstracting findings. RESULTS: Twelve studies were included. One theme, "Power and Empowerment" and six subcategories were identified: 1) Coping with a new situation, 2) Informational...... 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...

  7. Cancer survivors' experience of time

    DEFF Research Database (Denmark)

    Rasmussen, Dorte M.; Elverdam, Beth

    2007-01-01

    survivors over time to explore how perceptions and experiences change. METHODS: An exploratory study was carried out in 2002-2004 with a purposive sample of adults who had experienced various forms of cancer. Data collection included 9 weeks of participant observation at a Cancer Rehabilitation Centre...... 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......AIM: This paper reports a study to explore how cancer survivors talk about, experience and manage time in everyday life. BACKGROUND: There is an increasing interest in specific physical and psychosocial aspects of life after cancer diagnosis and treatment, but hardly any research follows cancer...

  8. 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…

  9. Rehabilitation interventions for cancer survivors

    DEFF Research Database (Denmark)

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

    2011-01-01

    BACKGROUND: Today more and more people survive cancer. Cancer survivors need help to recover both from the cancer and the treatment. Rehabilitative interventions have been set up to meet their needs. However, there are studies that report no major effects following careful, targeted intervention...... parameters in rehabilitation courses for cancer survivors in Denmark. METHODS: The study was based on an ethnographic fieldwork with participant observation at nine week-long courses, on in-depth interviews and on written sources. Fieldwork is well-suited for studying interventions in context, such as social...

  10. Survivor care for pediatric cancer survivors: a continuously evolving discipline.

    Science.gov (United States)

    Record, Elizabeth O; Meacham, Lillian R

    2015-07-01

    This article summarizes recent findings regarding the prevalence of chronic health conditions, cardiovascular and pulmonary late effects, and second malignancies in childhood cancer survivors (CCSs), and examines facilitators and barriers to survivor care. The estimated cumulative prevalence for a serious chronic disease in CCSs is 80% by age 45. The crude prevalence for cardiac conditions is 56.4% and for pulmonary dysfunction is 65.2%. Research in cardio-oncology is focused on better methods of predicting risk for cardiac dysfunction, and better methods of detection and interventions to prevent cardiac late effects. Pulmonary late effects, recognized to be a significant cause of late mortality, were detected by surveillance tests in more than 50% of CCSs but are often subclinical. Rates of subsequent malignant neoplasm continue to increase as the population ages. All of these factors make it clear that life-long surveillance is required and models of care should consider risk for late effects and socioeconomic and patient-specific factors. It is becoming clear that there is no age after which the occurrence of late effects plateaus and surveillance can be reduced. Survivors should be empowered to advocate for their survivor care and options for follow-up should be tailored to their needs.

  11. Health Behaviors of Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Jennifer S. Ford

    2014-10-01

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

  12. Psychosexual functioning of childhood cancer survivors.

    Science.gov (United States)

    van Dijk, E M; van Dulmen-den Broeder, E; Kaspers, G J L; van Dam, E W C M; Braam, K I; Huisman, J

    2008-05-01

    The objective of the study is to explore psychosexual functioning and its relationship with quality of life in survivors of cancer in childhood. Sixty childhood cancer survivors completed two questionnaires: psychosexual and social functioning questionnaire and MOS-SF-36. Psychosexual problems were frequent. About 20% of the survivors felt a limitation in their sexual life due to their illness. Older survivors (> or =25 years) had significantly less experience with sexual intercourse than their age-matched peers in the Dutch population (p = 0.010). Survivors treated in adolescence had a delay in achieving psychosexual milestones compared with those treated in childhood: dating (ppsychosexual problems compared with survivors without these problems. In this cohort of childhood cancer survivors, psychosexual problems were frequent. Treatment in adolescence is a risk factor for a delay in psychosexual development. (c) 2007 John Wiley & Sons, Ltd.

  13. Survivor-Victim Status, Attachment, and Sudden Death Bereavement.

    Science.gov (United States)

    Reed, Mark D.; Greenwald, Jason Y.

    1991-01-01

    Examined significance of survivor-victim relationship in understanding grief following sudden death bereavement by suicide or accident. Results showed that survivor-victim attachment was more important than survivor status (parent versus sibling/child) in explaining grief reactions. Compared to accident survivors, suicide survivors experienced…

  14. Psychosocial Outcomes in Adult Survivors of Retinoblastoma

    Science.gov (United States)

    Ford, Jennifer S.; Chou, Joanne F.; Sklar, Charles A.; Oeffinger, Kevin C.; Novetsky Friedman, Danielle; McCabe, Mary; Robison, Leslie L.; Kleinerman, Ruth A.; Li, Yuelin; Marr, Brian P.; Abramson, David H.; Dunkel, Ira J.

    2015-01-01

    Purpose Survival rates for individuals diagnosed with retinoblastoma (RB) exceed 95% in the United States; however, little is known about the long-term psychosocial outcomes of these survivors. Patients and Methods Adult RB survivors, diagnosed from 1932 to 1994 and treated in New York, completed a comprehensive questionnaire adapted from the Childhood Cancer Survivor Study (CCSS), by mail or telephone. Psychosocial outcomes included psychological distress, anxiety, depression, somatization, fear of cancer recurrence, satisfaction with facial appearance, post-traumatic growth, and post-traumatic stress symptoms; noncancer CCSS siblings served as a comparison group. Results A total of 470 RB survivors (53.6% with bilateral RB; 52.1% female) and 2,820 CCSS siblings were 43.3 (standard deviation [SD], 11) years and 33.2 (SD, 8.4) years old at the time of study, respectively. After adjusting for sociodemographic factors, RB survivors did not have significantly higher rates of depression, somatization, distress, or anxiety compared with CCSS siblings. Although RB survivors were more likely to report post-traumatic stress symptoms of avoidance and/or hyperarousal (both P < .01), only five (1.1%) of 470 met criteria for post-traumatic stress disorder. Among survivors, having a chronic medical condition did not increase the likelihood of psychological problems. Bilateral RB survivors were more likely than unilateral RB survivors to experience fears of cancer recurrence (P < .01) and worry about their children being diagnosed with RB (P < .01). However, bilateral RB survivors were no more likely to report depression, anxiety, or somatic complaints than unilateral survivors. Conclusion Most RB survivors do not have poorer psychosocial functioning compared with a noncancer sample. In addition, bilateral and unilateral RB survivors seem similar with respect to their psychological symptoms. PMID:26417002

  15. Managing chronic pain in survivors of torture

    DEFF Research Database (Denmark)

    Amris, Kirstine; Williams, Amanda C de C

    2015-01-01

    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....

  16. Outcome of paediatric intensive care survivors

    NARCIS (Netherlands)

    Knoester, Hendrika; Grootenhuis, Martha A.; Bos, Albert P.

    2007-01-01

    The development of paediatric intensive care has contributed to the improved survival of critically ill children. Physical and psychological sequelae and consequences for quality of life (QoL) in survivors might be significant, as has been determined in adult intensive care unit (ICU) survivors.

  17. Increased health care use in cancer survivors.

    NARCIS (Netherlands)

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

    2012-01-01

    Background: As the number of cancer survivors increases and these patients often experience long-lasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. We aimed to determine how often and for which reasons do adult cancer patients

  18. Increases health care use in cancer survivors.

    NARCIS (Netherlands)

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

    2012-01-01

    Background: As the number of cancer survivors increases and these patients often experience longlasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. Research question: How often and for which reasons do adult cancer patients

  19. Orthostatic intolerance in survivors of childhood cancer

    NARCIS (Netherlands)

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

    2007-01-01

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

  20. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  1. 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...

  2. Stigma and psychological distress in suicide survivors.

    Science.gov (United States)

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

    2017-03-01

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

  3. Unemployment among adult survivors of childhood cancer: a report from the childhood cancer survivor study.

    Science.gov (United States)

    Kirchhoff, Anne C; Leisenring, Wendy; Krull, Kevin R; Ness, Kirsten K; Friedman, Debra L; Armstrong, Gregory T; Stovall, Marilyn; Park, Elyse R; Oeffinger, Kevin C; Hudson, Melissa M; Robison, Leslie L; Wickizer, Thomas

    2010-11-01

    Adult childhood cancer survivors report high levels of unemployment, although it is unknown whether this is because of health or employability limitations. We examined 2 employment outcomes from 2003 in the Childhood Cancer Survivor Study (CCSS): (1) health-related unemployment and (2) unemployed but seeking work. We compared survivors with a nearest-age CCSS sibling cohort and examined demographic and treatment-related risk groups for each outcome. We studied 6339 survivors and 1967 siblings ≥25 years of age excluding those unemployed by choice. Multivariable generalized linear models evaluated whether survivors were more likely to be unemployed than siblings and whether certain survivors were at a higher risk for unemployment. Survivors (10.4%) reported health-related unemployment more often than siblings (1.8%; Relative Risk [RR], 6.07; 95% Confidence Interval [CI], 4.32-8.53). Survivors (5.7%) were more likely to report being unemployed but seeking work than siblings (2.7%; RR, 1.90; 95% CI, 1.43-2.54). Health-related unemployment was more common in female survivors than males (Odds Ratio [OR], 1.73; 95% CI, 1.43-2.08). Cranial radiotherapy doses ≥25 Gy were associated with higher odds of unemployment (health-related: OR, 3.47; 95% CI, 2.54-4.74; seeking work: OR, 1.77; 95% CI, 1.15-2.71). Unemployed survivors reported higher levels of poor physical functioning than employed survivors, and had lower education and income and were more likely to be publicly insured than unemployed siblings. Childhood cancer survivors have higher levels of unemployment because of health or being between jobs. High-risk survivors may need vocational assistance.

  4. Outdoor Leadership Considerations with Women Survivors of Sexual Abuse.

    Science.gov (United States)

    Mitten, Denise; Dutton, Rosalind

    1993-01-01

    Emphasizes the importance of leader awareness of the discomfort and need for emotional safety that may surface for women survivors of sexual abuse during an outdoor experience. Discusses survivor's self-perception and how this affects the outdoor experience; the impact of natural elements on survivors; and how to help survivors develop coping…

  5. 20 CFR 225.21 - Survivor Tier I PIA.

    Science.gov (United States)

    2010-04-01

    ... 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 I component of a survivor annuity. This PIA is determined in accordance with section 215 of the Social...

  6. 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.

  7. 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.

  8. 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...

  9. 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)

  10. Symptomatic and Palliative Care for Stroke Survivors

    National Research Council Canada - National Science Library

    Creutzfeldt, Claire J; Holloway, Robert G; Walker, Melanie

    2012-01-01

    ... care needs of stroke survivors. Some of the most common and disabling post-stroke symptoms that are reviewed here include central post-stroke pain, hemiplegic shoulder pain, painful spasticity, fatigue, incontinence, post-stroke...

  11. Hopelessness Experience among Stroke Survivor in Semarang

    Directory of Open Access Journals (Sweden)

    Sawab Sawab

    2015-04-01

    Full Text Available Introduction: Hopelessness was a negative feelings about goal achievement and powerlessness feeling against an expectation. Hopelessness in stroke survivors can occur due to prolonged disability and neurologic defi cit. This condition can lead to emotional and mental disorders even a suicide action. Therefore, it was a need to explore hopelessness experience in stroke survivors. Method: This study was a qualitative descriptive phenomenology with 6 participants. Results: 7 themes were revealed in this study, (1 Physical changes as a response on hopelessness, (2 Loss response as a hopelessness stressor, (3 Dysfunction of the family process, (4 Loss of meaning of life, (5 Self support and motivation as a coping resource against hopelessness, (6 The spiritual meaning behind hopelessness, (7 Can go through a better life. Discussion: This study suggests to develop a nursing care standards in hopelessness, encourage a family support and family psychoeducation for stroke survivors. Keywords: Stroke survivor, hopelessness experiences, qualitative

  12. Outcome of paediatric intensive care survivors

    OpenAIRE

    Knoester, Hendrika; Grootenhuis, Martha A; Bos, Albert P.

    2007-01-01

    The development of paediatric intensive care has contributed to the improved survival of critically ill children. Physical and psychological sequelae and consequences for quality of life (QoL) in survivors might be significant, as has been determined in adult intensive care unit (ICU) survivors. Awareness of sequelae due to the original illness and its treatment may result in changes in treatment and support during and after the acute phase. To determine the current knowledge on physical and ...

  13. Increased health care use in cancer survivors.

    OpenAIRE

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

    2012-01-01

    Background: As the number of cancer survivors increases and these patients often experience long-lasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. We aimed to determine how often and for which reasons do adult cancer patients contact their Primary Care Physician (PCP) 2-5 years after diagnosis. Methods: Using data from the Netherlands Information Network of Primary Care (LINH), we determined the volume and diagnoses made...

  14. Increases health care use in cancer survivors.

    OpenAIRE

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

    2012-01-01

    Background: As the number of cancer survivors increases and these patients often experience longlasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. Research question: How often and for which reasons do adult cancer patients contact their Primary Care Physician (PCP) 2-5 years after diagnosis. Methods: Using data from the Netherlands Information Network of Primary Care (LINH), we determined the volume and diagnoses made dur...

  15. Survivor-Reaktionen im Downsizing-Kontext

    OpenAIRE

    Dietrich, Kristina

    2013-01-01

    Diese Arbeit untersucht die Reaktionen der nach einem Personalabbau (Downsizing) verbleibenden Mitarbeiter (Survivors) eines Unternehmens. Dabei werden die für die Ausbildung von positiven und negativen Survivor-Reaktionen als relevant angenommenen Antezedenzien in einem integrativen Rahmenmodell dargestellt und in ihren Zusammenhängen untersucht. Besonders ist dabei der metaanalytische Untersuchungsansatz, der statistisch fundierte und verlässliche Aussagen zu zentralen Zusammenhängen von Ev...

  16. Hopelessness Experience Among Stroke Survivor in Semarang

    OpenAIRE

    Sawab Sawab; Moch Bahrudin; Novy Helena Catharina Daulima

    2015-01-01

    Introduction: Hopelessness was a negative feelings about goal achievement and powerlessness feeling against an expectation. Hopelessness in stroke survivors can occur due to prolonged disability and neurologic defi cit. This condition can lead to emotional and mental disorders even a suicide action. Therefore, it was a need to explore hopelessness experience in stroke survivors. Method: This study was a qualitative descriptive phenomenology with 6 participants. Results: 7 themes were revealed...

  17. 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.

  18. Proteomic Profiles in Acute Respiratory Distress Syndrome Differentiates Survivors from Non-Survivors

    Science.gov (United States)

    Bhargava, Maneesh; Becker, Trisha L.; Viken, Kevin J.; Jagtap, Pratik D.; Dey, Sanjoy; Steinbach, Michael S.; Wu, Baolin; Kumar, Vipin; Bitterman, Peter B.; Ingbar, David H.; Wendt, Christine H.

    2014-01-01

    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. PMID:25290099

  19. Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study.

    Science.gov (United States)

    Reulen, Raoul C; Bright, Chloe J; Winter, David L; Fidler, Miranda M; Wong, Kwok; Guha, Joyeeta; Kelly, Julie S; Frobisher, Clare; Edgar, Angela B; Skinner, Roderick; Wallace, W Hamish B; Hawkins, Mike M

    2017-11-01

    Female survivors of childhood cancer treated with abdominal radiotherapy who manage to conceive are at risk of delivering premature and low-birthweight offspring, but little is known about whether abdominal radiotherapy may also be associated with additional complications during pregnancy and labor. We investigated the risk of developing pregnancy and labor complications among female survivors of childhood cancer in the British Childhood Cancer Survivor Study (BCCSS). Pregnancy and labor complications were identified by linking the BCCSS cohort (n = 17 980) to the Hospital Episode Statistics (HES) for England. Relative risks (RRs) of pregnancy and labor complications were calculated by site of radiotherapy treatment (none/abdominal/cranial/other) and other cancer-related factors using log-binomial regression. All statistical tests were two-sided. A total of 2783 singleton pregnancies among 1712 female survivors of childhood cancer were identified in HES. Wilms tumor survivors treated with abdominal radiotherapy were at threefold risk of hypertension complicating pregnancy (relative risk = 3.29, 95% confidence interval [CI] = 2.29 to 4.71), while all survivors treated with abdominal radiotherapy were at risk of gestational diabetes mellitus (RR = 3.35, 95% CI = 1.41 to 7.93) and anemia complicating pregnancy (RR = 2.10, 95% CI = 1.27 to 3.46) compared with survivors treated without radiotherapy. Survivors treated without radiotherapy had similar risks of pregnancy and labor complications as the general population, except survivors were more likely to opt for an elective cesarean section (RR = 1.39, 95% CI = 1.16 to 1.70). Treatment with abdominal radiotherapy increases the risk of developing hypertension complicating pregnancy in Wilms tumor survivors, and diabetes mellitus and anemia complicating pregnancy in all survivors. These patients may require extra vigilance during pregnancy.

  20. Psychosocial aspects of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Jong Jin Seo

    2010-04-01

    Full Text Available The majority of childhood cancer survivors and their families will be psychologically healthy, but may desire and benefit from preventive care. A significant portion of the survivor population will be psychosocially distressed in various aspects by their harsh experience of long cancer treatment, and may warrant professional intervention and treatment. Pediatricians should be aware of the late psychological effects that can occur a year or 2 after treatment, possibly in many aspects of a survivor's life. Not only the cancer diagnosis, but also treatments such as chemotherapy, irradiation, and surgical intervention may exert different long-term effects on the psychosocial outcomes of survivors. Pediatricians need to be more concerned with maintaining and improving the psychological health of this growing number of childhood cancer survivors through long-term follow-up clinics, community support, or self-help groups. Research on all of the psychosocial aspects of childhood cancer survivors is important to recognize the reality and problems they face in Korea.

  1. Health Behaviors of Minority Childhood Cancer Survivors

    Science.gov (United States)

    Stolley, Melinda R.; Sharp, Lisa K.; Tangney, Christy; Schiffer, Linda; Arroyo, Claudia; Kim, Yoonsang; Campbell, Richard; Schmidt, Mary Lou; Breen, Kathleen; Kinahan, Karen E.; Dilley, Kim; Henderson, Tara; Korenblit, Allen D.; Seligman, Katya

    2015-01-01

    Background Available data suggest that childhood cancer survivors (CCSs) are comparable to the general population on many lifestyle parameters. However, little is known about minority CCSs. This cross-sectional study describes and compares the body mass index (BMI) and health behaviors of African-American, Hispanic and White survivors to each other and to non-cancer controls. Methods Participants included 452 adult CCS (150 African-American, 152 Hispanic, 150 white) recruited through four childhood cancer treating institutions and 375 ethnically-matched non-cancer controls (125 in each racial/ethnic group) recruited via targeted digit dial. All participants completed a 2-hour in-person interview. Results Survivors and non-cancer controls reported similar health behaviors. Within survivors, smoking and physical activity were similar across racial/ethnic groups. African-American and Hispanic survivors reported lower daily alcohol use than whites, but consumed unhealthy diets and were more likely to be obese. Conclusions This unique study highlights that many minority CCSs exhibit lifestyle profiles that contribute to increased risk for chronic diseases and late effects. Recommendations for behavior changes must consider the social and cultural context in which minority survivors may live. PMID:25564774

  2. Mental health status of adolescent cancer survivors

    Directory of Open Access Journals (Sweden)

    Mertens AC

    2015-09-01

    Full Text Available Ann C Mertens, Jordan Gilleland Marchak Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA Abstract: Due to the successful treatment of children with cancer, overall 5-year survival rates now exceed 80%. Because of this success in treating childhood cancer, concerns are now focusing on the potential risk of both physical and psychosocial late effects in these cancer survivors. There is limited data available for clinicians and researchers on the mental health of adolescent survivors of childhood cancers. The goal of this review is to provide a concise evaluation of the content and attributes of literature available on this often overlooked, yet vulnerable, population. Overall, studies on psychological outcomes in adolescent survivors of pediatric cancer suggest that the majority are mentally healthy and do not report significant levels of psychological distress. Several factors were recognized as playing an important role in adverse psychosocial outcomes in these adolescent cancer survivors: to include the diagnosis of a tumor in the central nervous system, central nervous system-directed cancer treatment, and physical late effects. To identify the subset of survivors who may benefit from systematic psychological services, systematic psychological screening of all adolescent cancer survivors during follow-up oncology visits is recommended. Further research into this critical area is needed to help identify other potential risk factors and guide the development of evidence-based support for these vulnerable adolescents. Keywords: adolescents, psychological, psychosocial, screening recommendations

  3. Recurrent trauma: Holocaust survivors cope with aging and cancer.

    Science.gov (United States)

    Hantman, Shira; Solomon, Zahava

    2007-05-01

    The current study aims to determine whether elderly Holocaust survivors are affected differently from non-survivors by the adversity of aging and cancer. Holocaust survivors and non-survivors suffering from cancer, were assessed tapping PTSD, psychiatric symptomatology, psychosocial adjustment to illness and coping with the aftermath of the Holocaust. Findings indicate a significant difference between survivors and non-survivors in post-traumatic symptoms and their intensity, survivors endorsing significantly more PTSD symptoms. Survivors were classified into 3 sub-groups, namely "Victims," "Fighters," and "Those who made it". "Victims" reported the highest percentage of persons who met PTSD, psychiatric symptomatology and difficulty coping with the problems of old age. The diversity of responses points to heterogeneity of long-term adaptation and adjustment among Holocaust survivors and similar response to subsequent adversity.

  4. Psychological outcomes of siblings of cancer survivors: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Buchbinder, David; Casillas, Jacqueline; Krull, Kevin R; Goodman, Pam; Leisenring, Wendy; Recklitis, Christopher; Alderfer, Melissa A; Robison, Leslie L; Armstrong, Gregory T; Kunin-Batson, Alicia; Stuber, Margaret; Zeltzer, Lonnie K

    2011-12-01

    To identify risk factors for adverse psychological outcomes among adult siblings of long-term survivors of childhood cancer. Cross-sectional, self-report data from 3083 adult siblings (mean age 29 years, range 18-56 years) of 5 + year survivors of childhood cancer were analyzed to assess psychological outcomes as measured by the Brief Symptom Inventory-18 (BSI-18). Sociodemographic and health data, reported by both the siblings and their matched cancer survivors, were explored as risk factors for adverse sibling psychological outcomes through multivariable logistic regression. Self-reported symptoms of psychological distress, as measured by the global severity index of the BSI-18, were reported by 3.8% of the sibling sample. Less than 1.5% of siblings reported elevated scores on two or more of the subscales of the BSI-18. Risk factors for sibling depression included having a survivor brother (OR 2.22, 95% CI 1.42-3.55), and having a survivor with impaired general health (OR 2.15, 95% CI 1.18-3.78). Siblings who were younger than the survivor reported increased global psychological distress (OR 1.81, 95% CI 1.05-3.12), as did siblings of survivors reporting global psychological distress (OR 2.32, 95% CI 1.08-4.59). Siblings of sarcoma survivors reported more somatization than did siblings of leukemia survivors (OR 2.07, 95% CI 1.05-3.98). These findings suggest that siblings of long-term childhood cancer survivors are psychologically healthy in general. There are, however, small subgroups of siblings at risk for long-term psychological impairment who may benefit from preventive risk-reduction strategies during childhood while their sibling with cancer is undergoing treatment. Copyright © 2010 John Wiley & Sons, Ltd.

  5. Unemployment among breast cancer survivors.

    Science.gov (United States)

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

    2014-05-01

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

  6. Health and well-being in adolescent survivors of early childhood cancer: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Mertens, Ann C; Brand, Sarah; Ness, Kirsten K; Li, Zhenghong; Mitby, Pauline A; Riley, Anne; Patenaude, Andrea Farkas; Zeltzer, Lonnie

    2014-03-01

    With the growing number of childhood cancer survivors in the US, it is important to assess the well-being of these individuals, particularly during the transitional phase of adolescence. Data about adolescent survivors' overall health and quality of life will help identify survivor subgroups most in need of targeted attention to successfully transition to adulthood. This ancillary study to the Childhood Cancer Survivor Study focused on children 15-19 years of age who had been diagnosed with cancer before the age of 4 years. A cohort of siblings of pediatric cancer survivors of the same ages served as a comparison sample. Adolescent health was assessed using the Child Health and Illness Profile-Adolescent Edition (CHIP-AE) survey. The teen survey was sent to 444 survivor teens and 189 siblings. Of these, 307(69%) survivors and 97 (51%) siblings completed and returned the survey. The overall health profiles of siblings and survivors were similar. Among survivors, females scored significantly below males on satisfaction, discomfort, and disorders domains. Survivors diagnosed with central nervous system tumors scored less favorably than leukemia survivors in the global domains of satisfaction and disorders. In general, adolescent survivors fare favorably compared to healthy siblings. However, identification of the subset of pediatric cancer survivors who are more vulnerable to medical and psychosocial disorders in adolescence provides the opportunity for design and implementation of intervention strategies that may improve quality of life. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Recovering from Opioid Overdose: Resources for Overdose Survivors & Family Members

    Science.gov (United States)

    SAMHSA Opioid Overdose Prevention TOOLKIT: Recovering From Opioid Overdose – Resources for Overdose Survivors & Family Members TABLE OF CONTENTS Recovering From Opioid Overdose Recovering from Opioid Overdose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Resources for Overdose Survivors ...

  8. Breast cancer survivors of different sexual orientations: which factors explain survivors' quality of life and adjustment?

    Science.gov (United States)

    Boehmer, U; Glickman, M; Winter, M; Clark, M A

    2013-06-01

    Little is known about differences by sexual orientation in explanatory factors of breast cancer survivors' quality of life, anxiety, and depression. Survivors were recruited from a cancer registry and additional survivors recruited through convenience methods. Data were collected via telephone survey from all 438 survivors, who were disease free and diagnosed with non-metastatic breast cancer an average of 5 years earlier. To explain quality of life, anxiety, and depression, we focused on sexual orientation as the primary independent factors, in addition, considering demographic, psychosocial, clinical, and functional factors as correlates. Sexual orientation had indirect associations with each of the outcomes, through disease-related and demographic factors as well as psychosocial and coping resources. The various explanatory models explain between 36% and 50% of the variance in outcomes and identified areas of strengths and vulnerabilities in sexual minority compared with heterosexual survivors. This study's findings of strengths among specific subgroups of sexual minority compared with heterosexual survivors require further explorations to identify the reasons for this finding. Most of the identified vulnerabilities among sexual minority compared with heterosexual survivors of breast cancer are amenable to change by interventions.

  9. Psychological status in childhood cancer survivors: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Zeltzer, Lonnie K; Recklitis, Christopher; Buchbinder, David; Zebrack, Bradley; Casillas, Jacqueline; Tsao, Jennie C I; Lu, Qian; Krull, Kevin

    2009-05-10

    Psychological quality of life (QOL), health-related QOL (HRQOL), and life satisfaction outcomes and their associated risk factors are reviewed for the large cohort of survivors and siblings in the Childhood Cancer Survivor Study (CCSS). This review includes previously published manuscripts that used CCSS data focused on psychological outcome measures, including the Brief Symptom Inventory (BSI-18), the Medical Outcomes Survey Short Form-36 (SF-36), the Cantril Ladder of Life, and other self-report questionnaires. Comparisons and contrasts are made between siblings and survivors, and to normative data when available, in light of demographic/health information and abstracted data from the medical record. These studies demonstrate that a significant proportion of survivors report more symptoms of global distress and poorer physical, but not emotional, domains of HRQOL. Other than brain tumor survivors, most survivors report both good present and expected future life satisfaction. Risk factors for psychological distress and poor HRQOL are female sex, lower educational attainment, unmarried status, annual household income less than $20,000, unemployment, lack of health insurance, presence of a major medical condition, and treatment with cranial radiation and/or surgery. Cranial irradiation impacted neurocognitive outcomes, especially in brain tumor survivors. Psychological distress also predicted poor health behaviors, including smoking, alcohol use, fatigue, and altered sleep. Psychological distress and pain predicted use of complementary and alternative medicine. Overall, most survivors are psychologically healthy and report satisfaction with their lives. However, certain groups of childhood cancer survivors are at high risk for psychological distress, neurocognitive dysfunction, and poor HRQOL, especially in physical domains. These findings suggest targeting interventions for groups at highest risk for adverse outcomes and examining the positive growth that remains

  10. Implementing the Exercise Guidelines for Cancer Survivors

    Science.gov (United States)

    Wolin, Kathleen Y.; Schwartz, Anna L.; Matthews, Charles E.; Courneya, Kerry S.; Schmitz, Kathryn H.

    2013-01-01

    In 2009, the American College of Sports Medicine convened an expert roundtable to issue guidelines on exercise for cancer survivors. This multidisciplinary group evaluated the strength of the evidence for the safety and benefits of exercise as a therapeutic intervention for survivors. The panel concluded that exercise is safe and offers myriad benefits for survivors including improvements in physical function, strength, fatigue, quality of life (QOL), and possibly recurrence and survival. Recommendations for situations in which deviations from the US Physical Activity Guidelines for Americans are appropriate were provided. Here, we outline a process for implementing the guidelines in clinical practice, and provide recommendations for how the oncology care provider can interface with the exercise and physical therapy community. PMID:22579268

  11. Holocaust survivors: three waves of resilience research.

    Science.gov (United States)

    Greene, Roberta R; Hantman, Shira; Sharabi, Adi; Cohen, Harriet

    2012-01-01

    Three waves of resilience research have resulted in resilience-enhancing educational and therapeutic interventions. In the first wave of inquiry, researchers explored the traits and environmental characteristics that enabled people to overcome adversity. In the second wave, researchers investigated the processes related to stress and coping. In the third wave, studies examined how people grow and are transformed following adverse events, often leading to self-actualize, client creativity and spirituality. In this article the authors examined data from a study, "Forgiveness, Resiliency, and Survivorship among Holocaust Survivors" funded by the John Templeton Foundation ( Greene, Armour, Hantman, Graham, & Sharabi, 2010 ). About 65% of the survivors scored on the high side for resilience traits. Of the survivors, 78% engaged in processes considered resilient and felt they were transcendent or had engaged in behaviors that help them grow and change over the years since the Holocaust, including leaving a legacy and contributing to the community.

  12. Daily physical activity patterns in cancer survivors: a pilot study

    NARCIS (Netherlands)

    Timmerman, Josien; Kurvers, R.; Bloo, H.; Hermens, Hermanus J.; Vollenbroek-Hutten, Miriam Marie Rosé

    2011-01-01

    In cancer survivors physical activity levels are measured primarily with questionnaires. As a result, insight in actual physical activity patterns of cancer survivors is lacking. Activity monitoring with accelerometers revealed that cancer survivors have lower levels of physical activity in the

  13. 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.…

  14. Counseling Survivors of Suicide: Implications for Group Postvention.

    Science.gov (United States)

    Moore, Maureen M.; Freeman, Stephen J.

    1995-01-01

    Discusses bereavement and mourning and reviews group applications for the resolution of uncomplicated grief. Presents studies that describe grief experiences of suicide survivors and community reaction to survivors. Argues that a structured group experience, where support is provided by other survivors, gives optimal help to people bereaved by…

  15. 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.

  16. Specialized survivor clinic attendance increases adherence to cardiomyopathy screening guidelines in adult survivors of childhood cancer.

    Science.gov (United States)

    Marr, Kristin C; Agha, Mohammad; Sutradhar, Rinku; Pole, Jason D; Hodgson, David; Guttmann, Astrid; Greenberg, Mark; Nathan, Paul C

    2017-10-01

    To determine if attendance at a specialized clinic for adult survivors of childhood cancer is associated with better rates of adherence to the Children's Oncology Group (COG) Long-term Follow-up (LTFU) guidelines for cardiomyopathy screening. We conducted a retrospective population-based study using administrative data in Ontario, Canada of 5-year survivors diagnosed between 1986 and 2005 at risk of therapy-related late cardiomyopathy. Patients were classified into three groups based on the recommended frequency of screening: annual, every 2 years, and every 5 years. Of 1811 eligible survivors followed for median 7.8 years (range 0-14.0), patients were adherent to screening for only 8.6% of their period of follow-up. Survivor clinic utilization had the strongest association with increased rates of adherence: when compared to no attendance, ≥ 5 clinic visits/10-year period had RR of adherence of 10.6 (95% CI 5.7-19.5) in the annual group, 3.3 (95% CI 2.3-4.8) in the every 2-year group, and 2.3 (95% CI 1.6-3.2) in the every 5-year group. Additional factors associated with increased adherence after adjusting for clinic attendance included annual assessment by a general practioner, female sex, diagnosis prior to 2003, and living in a rural area. In a model of specialized survivor care, increased clinic utilization is associated with improved patient adherence to COG LTFU cardiomyopathy screening guidelines. Specialized survivor clinics may improve health outcomes in survivors through improved adherence to screening. However, rates of adherence remain suboptimal and further multifacetted strategies need to be explored to improve overall rates of screening in adult survivors of childhood cancer.

  17. Holocaust survivors: the pain behind the agony. Increased prevalence of fibromyalgia among Holocaust survivors.

    Science.gov (United States)

    Ablin, J N; Cohen, H; Eisinger, M; Buskila, D

    2010-01-01

    To assess the frequency of fibromyalgia among a population of Holocaust survivors in Israel as well as the occurrence of post-traumatic stress disorder (PTSD) and concurrent psychiatric symptoms, including depression and anxiety among survivors. Eighty-three survivors of the Nazi Holocaust and 65 age-matched individuals not exposed to Nazi occupation were recruited. Physical examination and manual tender point assessment was performed for the establishment of the diagnosis of fibromyalgia and information was collected regarding quality of life (SF-36), physical function and health (FIQ), psychiatric symptoms (SCL-90) and PTSD symptoms (CAPS). Significantly increased rates of fibromyalgia were identified among Holocaust survivors compared with controls (23.81% vs. 10.94, p<0.05). Significantly increased rates of posttraumatic symptoms and measures of mental distress were also identified among survivors. The results indicate a significantly increased prevalence of fibromyalgia among Holocaust survivors six decades after the end of the Second World War. This finding furthers our knowledge regarding the long-term effect of stress on the development of fibromyalgia.

  18. Adult survivors of childhood sexual abuse: survivor's disclosure and nurse therapist's response.

    Science.gov (United States)

    Weaver, P L; Varvaro, F F; Connors, R; Regan-Kubinski, M J

    1994-12-01

    Recent literature pertinent to adult survivors suggests that childhood sexual abuse is a serious problem, and that disclosure is on the rise. The aftereffects of childhood sexual abuse can cause dysfunction in various aspects of the survivor's physical and mental health. Understanding the traumagenic dynamics of childhood sexual abuse and its aftereffects provides direction for the nurse therapist during both the client's disclosure and intervention planning. This knowledge assists the therapist in promoting mental health and healing, as well as providing comfort for the therapist. The nurse therapist's reactions to the client's disclosure can affect the way the client feels about disclosure and the therapeutic relationship. If a negative message is conveyed to the survivor at the time of disclosure, the feelings of betrayal, stigmatization, and powerlessness that the survivor experienced as a child will be replicated. This can damage the therapeutic relationship and delay the healing process. When disclosure is received and acted upon in a sensitive, therapeutic manner, the survivor is empowered and can enter with the nurse therapist into an effective therapeutic alliance. Nurse therapists should gain awareness of the types of emotional responses that can be engendered in the health professional during disclosure. Awareness of these emotional reactions can lead to the identification of coping strategies useful to both the therapist and the adult survivor. Coping strategies useful to the therapist include maintaining adequate boundaries, understanding oneself and one's responses to sexual-abuse issues, utilizing ongoing consultation or supervision, and preventing burnout.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Nipp, Ryan D; Kirchhoff, Anne C; Fair, Douglas; Rabin, Julia; Hyland, Kelly A; Kuhlthau, Karen; Perez, Giselle K; Robison, Leslie L; Armstrong, Gregory T; Nathan, Paul C; Oeffinger, Kevin C; Leisenring, Wendy M; Park, Elyse R

    2017-10-20

    Purpose Survivors of childhood cancer may experience financial burden as a result of health care costs, particularly because these patients often require long-term medical care. We sought to evaluate the prevalence of financial burden and identify associations between a higher percentage of income spent on out-of-pocket medical costs (≥ 10% of annual income) and issues related to financial burden (jeopardizing care or changing lifestyle) among survivors of childhood cancer and a sibling comparison group. Methods Between May 2011 and April 2012, we surveyed an age-stratified, random sample of survivors of childhood cancer and a sibling comparison group who were enrolled in the Childhood Cancer Survivor Study. Participants reported their household income, out-of-pocket medical costs, and issues related to financial burden (questions were adapted from national surveys on financial burden). Logistic regression identified associations between participant characteristics, a higher percentage of income spent on out-of-pocket medical costs, and financial burden, adjusting for potential confounders. Results Among 580 survivors of childhood cancer and 173 siblings, survivors of childhood cancer were more likely to have out-of-pocket medical costs ≥ 10% of annual income (10.0% v 2.9%; P report spending a higher percentage of their income on out-of-pocket medical costs, which may influence their health-seeking behavior and potentially affect health outcomes. Our findings highlight the need to address financial burden in this population with long-term health care needs.

  20. Community reintegration among stroke survivors in Osun ...

    African Journals Online (AJOL)

    Background Stroke is a major neurological problem and a leading cause of disability in the elderly in Nigeria. The incidence is increasing due to increasing risk factors, but many stroke victims now survive because of improved medical care. These survivors become community-dwellers after inpatient rehabilitation. Aims To ...

  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. Esophageal atresia: comparison between survivors and mortality ...

    African Journals Online (AJOL)

    The places of study were Bahrami Hospital and Children's Medical Center, two referral centers for pediatric surgery in Tehran. The duration of the study was 2 years, starting from April 1999. Survivors and mortality cases were compared with regard to sex, type of surgery, suture material, and technique of anastomosis.

  3. Subsequent Reproductive Performance in Survivors of Complicated ...

    African Journals Online (AJOL)

    There were 2 cases of postpartum hemorrhage. 103 (44%) of the subjects who still desired pregnancy were yet unable to conceive. Conclusions The subsequent reproductive performance in survivors of complicated abortion appears to be largely characterized by a high rate of sub-fertility, fetal wastage and preterm ...

  4. The survivors of childhood solid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Carter, M.C.; Thompson, E.I.; Simone, J.V. (St. Jude Children' s Research Hospital, Memphis, TN (USA))

    1991-04-01

    With the improvement in cancer therapy in recent years, the number of cancer survivors is rapidly increasing. Potential late medical and psychosocial sequelae of cancer therapy are reviewed. A practical guide for the primary health care giver is provided. 161 refs.

  5. Differentiating incest survivors who self-mutilate.

    Science.gov (United States)

    Turell, S C; Armsworth, M W

    2000-02-01

    This study was an exploratory analysis of the variables which differentiated incest survivors who self-mutilate from those who do not. A sample of women incest survivors (N = 84) were divided into two groups based on the presence or absence of self-mutilation. Participants included both community and clinical populations. A packet consisting of a demographic questionnaire, Sexual Attitudes Survey, Diagnostic Inventory of Personality and Symptoms, Dissociative Events Scale and the Beck Depression Inventory was completed by each participant. Demographic, incest, and family of origin variables distinguished the self-mutilating women from those who did not. These include ethnicity and educational experiences; duration, frequency, and perpetrator characteristics regarding the incest; and multiple abuses, instability, birth order, and loss of mother in one's family of origin. Psychological and physical health concerns also differentiated between the two groups. Many variables may differentiate between women incest survivors who self-mutilate from those who do not. A rudimentary checklist to describe the lives of incest survivors who self-mutilate resulted from these findings. The importance of the concept of embodiment is also discussed.

  6. 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…

  7. Endocrine sequelae in childhood cancer survivors.

    Science.gov (United States)

    Casano Sancho, Paula

    2017-11-01

    Thanks to the advances in cancer treatment, the five-year survival rate after childhood cancer has increased up to 80%. Therefore 1/500 young adults will be a survivor. Endocrine sequelae are most common, affecting 40-60% of survivors. The most frequent sequelae include growth failure and gonadal and thyroid diseases. Sequelae occur more frequently in survivors from central nervous system tumors, leukemia, and lymphoma. Their development will depend on the type of cancer, its location, age at diagnosis, and treatment administered. Treatments associated to more endocrine sequels are cranial radiotherapy and hematopoietic cell transplantation. Because of the high prevalence of endocrine sequelae, international guidelines recommend endocrinologists to prospectively evaluate the survivors. As some of these endocrine changes will not develop until adult life, transition programs should be implemented, and active investigation should be made to decrease the endocrine consequences of cancer treatment. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Sexual dysfunction in Nigerian stroke survivors

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Objectives: This survey reports sexual dysfunction in Nigerian stroke survivors, and determines the influence of socio- ... Participants completed the Beck Depression Inventory, Stroke Specific Quality of Life Scale and post-stroke sexual function ..... Medical. Aspects of Human Sexuality 1979; 13: 16-30. 25.

  9. 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.

  10. Specialized survivor clinic attendance is associated with decreased rates of emergency department visits in adult survivors of childhood cancer.

    Science.gov (United States)

    Sutradhar, Rinku; Agha, Mohammad; Pole, Jason D; Greenberg, Mark; Guttmann, Astrid; Hodgson, David; Nathan, Paul C

    2015-12-15

    Survivors of childhood cancer are at considerable risk of experiencing treatment-related adverse health outcomes. To provide survivors with specialized care focused on these risks during adulthood, the government of Ontario funded a provincial network of specialized survivor clinics in 1999. The aim of this study was to determine whether prior attendance at survivor clinics by adult survivors of childhood cancer was associated with rates of emergency department (ED) visits. This was a population-based, retrospective cohort study using multiple linked administrative health databases. The cohort consisted of all adult survivors of childhood cancer diagnosed between January 1, 1986 and December 31, 2005 in Ontario, Canada. A recurrent event regression model was used to evaluate the association between prior attendance at survivor clinics and the rate of ED visits; adjustments were made for individual, demographic, treatment, and provider characteristics. The study consisted of 3912 adult survivors of childhood cancer. Individuals who had at least 1 prior visit to a survivor clinic had a 19% decreased rate of ED visits in comparison with individuals who had not visited a survivor clinic (adjusted relative rate, 0.81; 95% confidence interval, 0.78-0.85). Each additional prior visit to a survivor clinic was associated with a 5% decrease in the rate of ED visits (adjusted relative rate, 0.95; 95% confidence interval, 0.93-0.96). These results were independent of whether or not survivors received care from a primary care physician. Attendance at a specialized survivor clinic was significantly associated with decreased ED visits among adult survivors of childhood cancer. © 2015 American Cancer Society.

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

    Science.gov (United States)

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

    2010-08-18

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

  12. Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study.

    Science.gov (United States)

    Frobisher, Clare; Lancashire, Emma R; Jenkinson, Helen; Winter, David L; Kelly, Julie; Reulen, Raoul C; Hawkins, Michael M

    2017-06-15

    The British Childhood Cancer Survivor Study (BCCSS) provides the first detailed investigation of employment and occupation to be undertaken in a large population-based cohort. Previous studies have been limited by design issues such as using small numbers of survivors with specific diagnoses, and involved limited assessment of employment status and occupational level. The BCCSS includes 17,981 5-year survivors of childhood cancer. Employment status and occupational level were ascertained by questionnaire from eligible survivors (n = 14,836). Multivariate logistic regression was used to explore factors associated with employment and occupation, and to compare survivors to their demographic peers in the general population. Employment status was available for 10,257 survivors. Gender, current age, cancer type, radiotherapy, age at diagnosis and epilepsy were consistently associated with being: employed; unable to work; in managerial or non-manual occupations. Overall, survivors were less likely to be working than expected (OR (99% CI): 0.89 (0.81-0.98)), and this deficit was greatest for irradiated CNS neoplasm survivors (0.34 (0.28-0.41)). Compared to the general population, survivors were fivefold more likely to be unable to work due to illness/disability; the excess was 15-fold among CNS neoplasm survivors treated with radiotherapy. Overall survivors were less likely to be in managerial occupations than expected (0.85 (0.77-0.94)). However, bone sarcoma survivors were more likely to be in these occupations than expected (1.37 (1.01-1.85)) and also similarly for non-manual occupations (1.90 (1.37-2.62)). Survivors of retinoblastoma (1.55 (1.20-2.01)) and 'other' neoplasm group (1.62 (1.30-2.03)) were also more likely to be in non-manual occupations than expected. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  13. Who are happy survivors? Physical, psychosocial, and spiritual factors associated with happiness of breast cancer survivors during the transition from cancer patient to survivor.

    Science.gov (United States)

    Kang, Danbee; Kim, Im-Ryung; Choi, Eun-Kyung; Yoon, Jung Hee; Lee, Se-Kyung; Lee, Jeong Eon; Nam, Seok Jin; Han, Wonshik; Noh, Dong-Young; Cho, Juhee

    2017-02-24

    This study aims to evaluate physical, psychosocial, and spiritual factors associated with happiness in breast cancer survivors during the reentry period. It is a cross-sectional study with 283 nonmetastatic breast cancer survivors who completed treatment within 1 year. We included survivors who completed questionnaires on happiness and health-related quality of life (QoL) 2 years after cancer diagnosis. Happiness and QoL was measured using the Subjective Happiness Scale and EORTC QLQ-C30, respectively. Multivariable logistic regression was used to find factors associated with happiness. The mean age of the study participants was 48.5 ± 7.8 years. Among the 283 survivors, 14.5%, 43.8%, 32.5%, and 2.1% reported being "very happy," "happy," "neutral," and "not happy at all," respectively. Happy survivors reported a better general health status and QoL (67.6 vs 49.6; P Happy survivors were more likely to feel certain about the future (27.2% vs 11.9%, P happiness. During the reentry period, breast cancer survivors who are hopeful and have a clear purpose in life are more likely to be happy than those who are not. Setting proper life goals might be beneficial to help breast cancer survivors who experience persistent QoL issues. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Management of Unexplained Symptoms in Survivors of Cancer

    Science.gov (United States)

    Feuerstein, Michael; Bruns, Gina L.; Pollman, Courtney; Todd, Briana L.

    2010-01-01

    Quality health care for survivors of cancer must evaluate and manage symptoms that are reported at the surveillance visit but are not linked to a cancer recurrence or a new cancer. At present, this does not always occur. This article analyzes quality of health care for survivors of cancer, taking empirical evidence and clinical expertise into consideration. Although emotional distress on the part of the survivor of cancer may exacerbate or even explain the presence of experienced symptoms, there are other potential explanations as well. When survivors present with persistent symptoms (even if unexplained) after cancer diagnosis and treatment, the symptoms can impact the survivor's function and well-being. Oncologists and other providers need to assess and directly target these symptoms for appropriate triage to those who can best help these survivors reduce the symptoms and their impact. PMID:21358961

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

    DEFF Research Database (Denmark)

    Jarlbæk, Lene; Christensen, Linda; Bruera, Eduardo

    2014-01-01

    , 2.4% lung cancer. Short-term survivors: 21% lung cancer, 7.2% breast cancer. Chemotherapy was provided to 15% of all patients, and to 10% of the 60 + year olds. Discussion. The epidemiology of long- and short-term survivors shows significant differences with regard to age at TOCD, cancer types......' difference in age at TOCD was seen between long- and short-term survivors, with median ages of 60 versus 72 years, respectively. Females comprised 64% of long-term, and 46% of short-term survivors. The proportion of breast and lung cancers differed between the groups: Long-term survivors: 31% breast cancer......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...

  17. Providing services to trafficking survivors: Understanding practices across the globe.

    Science.gov (United States)

    Steiner, Jordan J; Kynn, Jamie; Stylianou, Amanda M; Postmus, Judy L

    2018-01-01

    Human trafficking is a global issue, with survivors representing all genders, ages, races, ethnicities, religions, and countries. However, little research exists that identifies effective practices in supporting survivors of human trafficking. The research that does exist is Western-centric. To fill this gap in the literature, the goal of this research was to understand practices used throughout the globe with adult human trafficking survivors. A qualitative approach was utilized. Providers from 26 countries, across six different continents, were interviewed to allow for a comprehensive and multi-faceted understanding of practices in working with survivors. Participants identified utilizing an empowerment-based, survivor, and human life-centered approach to working with survivors, emphasized the importance of engaging in community level interventions, and highlighted the importance of government recognition of human trafficking. Findings provide information from the perspective of advocates on best practices in the field that can be used by agencies to enhance human trafficking programming.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  19. Reduced male fertility in childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Sun Hee Lee

    2013-12-01

    Full Text Available With advances in cancer treatment, more pediatric cancer patients have increased their life expectancy. Because cancer-related therapy causes various physical and psychological problems, many male survivors experience later problems with thyroid and sexual functions, and with growth. As outcomes have improved, more survivors need to maintain their reproductive function to maximize their long-term quality of life. Cancer and cancer-related treatment can impair fertility by damage to the testes, to the hypothalamic-pituitary-gonadal axis, or to the genitourinary organs. Prior radiation therapy to the testes, the use of alkylating agents, and central hypogonadism further impair fertility in male survivors of childhood cancer. Following any course of chemotherapy, peripubertal maturation, any testicular volume changes, and symptoms of androgen deficiency should be monitored systematically. If patients request fertility testing, spermatogenesis status can be evaluated either directly by semen analysis or indirectly by determination of the levels of testosterone/gonadotropins and by monitoring any changes in testicular volume. According to the patient's condition, semen cryopreservation, hormonal therapy, or assisted reproduction technologies should be provided.

  20. 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.

  1. School attendance in childhood cancer survivors and their siblings.

    Science.gov (United States)

    French, Amy E; Tsangaris, Elena; Barrera, Maru; Guger, Sharon; Brown, Robert; Urbach, Stacey; Stephens, Derek; Nathan, Paul C

    2013-01-01

    To investigate school absenteeism among childhood cancer survivors and their siblings and examine factors related to absenteeism in survivors. A cross-sectional study was conducted among consecutive cancer survivors attending a large pediatric cancer survivor clinic. Absenteeism rates were obtained for survivors and their closest in age sibling from school report cards. Absenteeism was compared with a population control group of 167752 students using 1-sample t tests. The Child Vulnerability Scale, Pediatric Quality of Life Inventory, and Behavior Assessment System for Children were administered to survivors. Univariate and multiple regression analyses assessed variables associated with days absent. One hundred thirty-one survivors (median age at assessment: 13.4 years, range 8.0-19.2; median age at diagnosis: 9.4 years, range 4.3-17.3) and 77 siblings (median age at assessment: 13 years, age range 7-18) participated. Survivors and siblings missed significantly more school days than the population control group (mean ± SD: 9.6 ± 9.2 and 9.9 ± 9.8 vs 5.0 ± 5.6 days, respectively, P sibling pairs (N = 77), there was no difference in absenteeism (9.6 ± 9.2 vs 9.9 ± 9.8 days, P = .85). Absenteeism in survivors was significantly associated with a low Pediatric Quality of Life Inventory Physical Health Summary Score (P = .01). Parents' perception of their child's vulnerability and emotional and social functioning were not associated with absenteeism. Childhood cancer survivors and siblings miss more school than the general population. The only predictor of absenteeism in survivors is poor physical quality of health. More research should be devoted to school attendance and other outcomes in siblings of childhood cancer survivors. Copyright © 2013 Mosby, Inc. All rights reserved.

  2. Hospitalization Rates Among Survivors of Young Adult Malignancies.

    Science.gov (United States)

    Richardson, Devon P; Daly, Corinne; Sutradhar, Rinku; Paszat, Lawrence F; Wilton, Andrew S; Rabeneck, Linda; Baxter, Nancy N

    2015-08-20

    There are limited data on health care use among survivors of young adult cancers. We aimed to describe patterns of hospitalization among a cohort of long-term survivors compared with noncancer controls. Persons diagnosed between the ages of 20 and 44 years with malignancies in Ontario, Canada, from 1992 to 1999, who lived at least 5 years recurrence free, were identified using the Ontario Cancer Registry and matched to noncancer controls. Hospitalizations were determined using hospital discharges, and rates were compared between survivors and controls. The absolute excess rate of hospitalizations was determined for each type of malignancy in survivors per 100 person-years of follow-up. The cohort included 20,275 survivors and 101,344 noncancer controls. During the study period, 6,948 (34.3%) survivors were admitted to the hospital and the adjusted relative rate (ARR) of hospitalizations in survivors compared with controls was 1.51 (95% CI, 1.48 to 1.54). The rate of hospitalization was highest for survivors of upper GI, leukemia, and urologic malignancies. The hospitalization rate (per person) for survivors significantly decreased from 0.22 in the first time period examined (5 to 8 years after diagnosis) to 0.15 in the last time period examined (18 to 20 years after diagnosis, P < .0001). However, at all time periods, survivors were more likely to be hospitalized than controls (ARR at 5 to 8 years, 1.67 [95% CI, 1.57 to 1.81]; ARR at 18 to 20 years, 1.22 [95% CI, 1.08 to 1.37]). Survivors of young adult cancers have an increased rate of hospitalization compared with controls. The rate of hospitalization for 20-year survivors did not return to baseline, indicating a substantial and persistent burden of late effects among this generally young population. © 2015 by American Society of Clinical Oncology.

  3. Physical Activity in Child and Adolescent Cancer Survivors: A Review

    OpenAIRE

    Gilliam, Margaux B.; Schwebel, David C.

    2013-01-01

    Childhood cancer survivors are at increased risk for future health problems. As such, physical activity (PA) has been targeted as a health promotion priority in child and adolescent cancer survivors. Research indicates that a large portion of pediatric survivors do not meet PA recommendations. Using Bronfenbrenner’s ecological theory as a framework, this review presents a conceptual model to explain child and adolescent survivors’ PA. The model considers predictors of PA across six domains: (...

  4. Rehabilitation in cancer survivors - with focus on physical activity

    OpenAIRE

    Gjerset, Gunhild Maria

    2012-01-01

    The number of cancer survivors in the Western world has markedly increased over the last few decades. With the growing number of survivors, it has become relevant to address the health of cancer survivors and how to improve it. The malignancy, and more often the cancer treatment, might have negative effects upon physical and psychological aspects of the survivors’ health. For those who experience such adverse effects, professional assistance in addition to their own efforts might be needed in...

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

    OpenAIRE

    Korobeynikov G.V.; Drojjin V.U.

    2013-01-01

    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...

  6. Lost Productivity in Stroke Survivors: An Econometrics Analysis.

    Science.gov (United States)

    Vyas, Manav V; Hackam, Daniel G; Silver, Frank L; Laporte, Audrey; Kapral, Moira K

    2016-01-01

    Stroke leads to a substantial societal economic burden. Loss of productivity among stroke survivors is a significant contributor to the indirect costs associated with stroke. We aimed to characterize productivity and factors associated with employability in stroke survivors. We used the Canadian Community Health Survey 2011-2012 to identify stroke survivors and employment status. We used multivariable logistic models to determine the impact of stroke on employment and on factors associated with employability, and used Heckman models to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages). We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted OR 0.39, 95% CI 0.33-0.46) and had hourly wages 17.5% (95% CI 7.7-23.7) lower compared to the general population, although there was no association between work hours and being a stroke survivor. We found that factors like older age, not being married, and having medical comorbidities were associated with lower odds of employment in stroke survivors in our sample. Stroke survivors are less likely to be employed and they earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies targeting return to work could be considered to address this lost productivity among stroke survivors. © 2016 S. Karger AG, Basel.

  7. SECONDARY GASTROINTESTINAL MALIGNANCIES IN CHILDHOOD CANCER SURVIVORS: A COHORT STUDY

    Science.gov (United States)

    Henderson, Tara O.; Oeffinger, Kevin C.; Whitton, John; Leisenring, Wendy; Neglia, Joseph; Meadows, Anna; Crotty, Catherine; Rubin, David T.; Diller, Lisa; Inskip, Peter; Smith, Susan A.; Stovall, Marilyn; Constine, Louis S.; Hammond, Sue; Armstrong, Greg T.; Robison, Leslie L.; Nathan, Paul C.

    2012-01-01

    Background Childhood cancer survivors develop gastrointestinal malignancies more frequently and at a younger age than the general population, but risk factors for their development have not been well characterized. Objective To determine the risk and associated risk factors for gastrointestinal subsequent malignant neoplasms (SMN) in childhood cancer survivors. Design Retrospective cohort study. Setting The Childhood Cancer Survivor Study, a multi-center study of childhood cancer survivors diagnosed between 1970 and 1986. Patients 14,358 survivors of a malignancy diagnosed at cancer survivors than the general population (95% confidence interval [CI]: 3.5-6.1). Colorectal cancer SIR was 4.2 (95% CI: 2.8-6.3). The highest gastrointestinal SMN risk was associated with abdominal radiation (SIR=11.2, 95% CI: 7.6-16.4). However, survivors not exposed to radiation had a significantly increased risk (SIR=2.4, 95% CI-1.4-3.9). In addition to abdominal radiation, high dose procarbazine (RR=3.2, 95% CI 1.1-9.4) and platinum drugs (RR 7.6, 95% CI: 2.3-25.5) independently increased the gastrointestinal SMN risk. Limitations This cohort has not yet attained an age at which gastrointestinal malignancy risk is greatest. Conclusions Childhood cancer survivors, particularly those exposed to abdominal radiation, are at increased risk for gastrointestinal SMN. These findings suggest that surveillance of at-risk childhood cancer survivors should commence at a younger age than recommended for the general population. PMID:22665813

  8. 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. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

  9. Intensive care survivor-reported symptoms: a longitudinal study of survivors' symptoms.

    Science.gov (United States)

    Langerud, Anne Kathrine; Rustøen, Tone; Småstuen, Milada Cvancarova; Kongsgaard, Ulf; Stubhaug, Audun

    2018-01-01

    There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms. To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay. Exploratory, longitudinal cohort of intensive care survivors from two mixed ICUs in a tertiary referral hospital in Norway. Intensive care survivors completed surveys at 3 months (n = 118) and 1 year (n = 89) after ICU discharge. Clinical Trials: NCT02279212. Prevalence rates of intensive care survivors' symptoms were pain 58 (49·2%), anxiety/depression 24/118 (20·8%), fatigue 18/118(15·3%), PTSS 15 (12·8%) and sleep disturbance 58/118 (49·2%) at 3 months after ICU discharge (n = 118). Prevalence rates at 1 year (n = 89) changed only slightly to pain 34 (38·2%), anxiety/depression 17 (20·0%), fatigue 12 (13·8%), PTSS 13 (15·1%) and sleep disturbance 40/89 (46·5%). Associations were strong between pain and presence of sleep disturbance, anxiety/depression, PTSS and fatigue. Intensive care survivors have multiple symptoms and the prevalence rates of these symptoms remained almost unchanged from 3 months to 1 year after ICU discharge. The presence of pain was associated with high odds for the presence of sleep disturbance, anxiety/depression, PTSS and fatigue, compared to a no-pain group. ICU survivors may benefit from targeted interventions designed to alleviate the symptom burden. Knowledge about ICU survivor's prevalence and risk for having multiple symptoms may help health care professionals to give better care, if needed, to the ICU survivors. © 2017 British Association of Critical Care

  10. Survivorship education for Latina breast cancer survivors: Empowering Survivors through education.

    Science.gov (United States)

    Juarez, Gloria; Mayorga, Lina; Hurria, Arti; Ferrell, Betty

    2013-01-01

    Nueva Luz is an English and Spanish quality of life (QOL) intervention developed to address the educational needs of Latina breast cancer survivors and provide strategies to assist in their transition into survivorship. A qualitative approach was used to evaluate the English and Spanish educational intervention (Nueva Luz). A purposive sample of eight Latina breast cancer survivors was selected from the group who received the intervention to participate in a digitally recorded interview. Data was analyzed using thematic analysis. Findings provide evidence that the one-on-one tailored approach is a feasible and acceptable method of providing a bilingual psychosocial intervention. The provision of printed bilingual information along with the verbal instruction from a bilingual and culturally competent health care provider can be effective in helping Latina breast cancer survivor's transition successfully into survivorship, improve QOL and contribute to better patient outcomes. The study informs our understanding of the cultural context in patient education content and delivery of psychosocial interventions. The findings may also have relevance for other ethnic minority cancer survivors.

  11. Understanding the Early Support Needs of Survivors of Traumatic Events: The Example of Severe Injury Survivors.

    Science.gov (United States)

    Brand, Rachel M; Chisholm, Katherine; Terhaag, Sonia; Lau, Winnie; Forbes, David; Holmes, Alex; O'Donnell, Meaghan

    2017-05-29

    In the aftermath of a potentially traumatic event, people may experience a range of mental health outcomes, including subclinical symptoms and distress. There is growing evidence that trauma survivors with subclinical symptoms are at increased risk of developing later psychiatric disorders, and this is especially the case with severe injury survivors. There is a need to develop evidence-based, early, brief interventions for those who are at risk of developing trauma-related psychopathology. To date, interventions for this at-risk group have largely been derived from expert consensus. This study therefore aimed to understand the early psychosocial difficulties and perceived needs from the perspective of trauma survivors to further inform intervention development. Forty-three survivors of a serious injury, identified as high risk for developing trauma-related psychopathology, were interviewed and qualitative methods (Thematic Analysis) were used to synthesize the data gathered. Participants described 5 main stressors: trauma-related psychological reactions, relationship stress, unsatisfactory services and support systems, reduced functioning, and negative thoughts and emotions in relation to recovery. In addition, participants described 3 main factors that were helpful in recovery: positive coping, professional support, and social support. These findings can inform posttrauma intervention development for those at risk of later psychological symptoms. In particular, the results support approaches focusing on promoting activity, supporting social relationships, stress and arousal management, and cognitive restructuring. In addition, future interventions might helpfully target rumination, worry, and reexperiencing symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Gibson, Todd M; Liu, Wei; Armstrong, Gregory T; Srivastava, Deo Kumar; Hudson, Melissa M; Leisenring, Wendy M; Mertens, Ann C; Klesges, Robert C; Oeffinger, Kevin C; Nathan, Paul C; Robison, Leslie L

    2015-11-15

    Survivors of pediatric cancer have elevated risks of mortality and morbidity. Many late adverse effects associated with cancer treatment (eg, second cancers and cardiac and pulmonary disease) are also associated with cigarette smoking, and this suggests that survivors who smoke may be at high risk for these conditions. This study examined the self-reported smoking status for 9397 adult survivors of childhood cancer across 3 questionnaires (median time interval, 13 years). The smoking prevalence among survivors was compared with the smoking prevalence among siblings and the prevalence expected on the basis of age-, sex-, race-, and calendar time-specific rates in the US population. Multivariable regression models examined characteristics associated with longitudinal smoking patterns across all 3 questionnaires. At the baseline, 19% of survivors were current smokers, whereas 24% of siblings were current smokers, and 29% were expected to be current smokers on the basis of US rates. Current smoking among survivors dropped to 16% and 14% on follow-up questionnaires, with similar decreases in the sibling prevalence and the expected prevalence. Characteristics associated with consistent never-smoking included a higher household income (relative risk [RR], 1.16; 95% confidence interval [CI], 1.08-1.25), higher education (RR, 1.32; 95% CI, 1.22-1.43), and receipt of cranial radiation therapy (RR, 1.08; 95% CI, 1.03-1.14). Psychological distress (RR, 0.86; 95% CI, 0.80-0.92) and heavy alcohol drinking (RR, 0.64; 95% CI, 0.58-0.71) were inversely associated. Among ever-smokers, a higher income (RR, 1.17; 95% CI, 1.04-1.32) and education (RR, 1.23; 95% CI, 1.10-1.38) were associated with quitting, whereas cranial radiation (RR, 0.86; 95% CI, 0.76-0.97) and psychological distress (RR, 0.80; 95% CI, 0.72-0.90) were associated with not having quit. The development of adverse health conditions was not associated with smoking patterns. Despite modest declines in smoking prevalence

  13. Survivors of Political Violence: Conceptualizations, Empirical Findings, and Ecological Interventions

    Science.gov (United States)

    Stanciu, Elena Amalia; Rogers, Jennifer L.

    2011-01-01

    There is a vast body of literature on survivors of political violence that has emerged over the past several decades. Most studies focus on the psychological effects of political violence on survivors, as understood within the Western framework of mental health. Studies that conceptualize and examine models that account for the complexity of the…

  14. Comparison of trauma on survivors of sexual assault and intimate ...

    African Journals Online (AJOL)

    2014-06-20

    Jun 20, 2014 ... 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 ...

  15. Daily physical activity patterns in cancer survivors: a pilot study

    NARCIS (Netherlands)

    Timmerman, Josien; van Weering, Marit; Kurvers, Roel; Tönis, Thijs; Hermens, Hermanus J.; Vollenbroek-Hutten, Miriam Marie Rosé

    2013-01-01

    In cancer survivors activity levels have been studied primarily by means of questionnaires, while objective information on actual daily activity levels and their distribution throughout the day is lacking. The findings of this study suggest that especially cancer survivors who received chemotherapy

  16. Rape survivor care crisis – mines the worst?

    African Journals Online (AJOL)

    The dire need for better healthcare worker training in rape forensics and safe survivor care has never been better illustrated than by the horrifying rape statistics Médecins. Sans Frontières (MSF) presented last month from the platinum-mining boom town of. Rustenburg. Promising to increase its rape survivor care and ...

  17. Gait characteristics of hemiparetic stroke survivors in Osun State ...

    African Journals Online (AJOL)

    Stroke is one of the leading causes of severe handicap. Deficiencies in walking may present significant challenges to mobility, resulting in abnormal and inefficient gait patterns in stroke survivors. This study compared the gait characteristics of hemiparetic stroke survivors and those of healthy individuals and determined the ...

  18. Comparison of trauma on survivors of sexual assault and intimate ...

    African Journals Online (AJOL)

    2014-06-20

    Jun 20, 2014 ... a psychologist by the survivor support officer (SSO), who is a trauma counsellor. Within the context of Limpopo Province, survivors who reported sexual assault at the clinic had experienced stranger rape and rape by non-strangers who were not intimate partners, whilst those who reported physical assault ...

  19. Adult height and age at menarche in childhood cancer survivors

    NARCIS (Netherlands)

    Noorda, E. M.; Somers, R.; van Leeuwen, F. E.; Vulsma, T.; Behrendt, H.

    2001-01-01

    The aim of this study was to assess the long-term effects of cancer treatments on adult height and age at menarche in survivors of various types of childhood cancer. 285 childhood cancer survivors (161 men and 124 women), at least 18 years old and having been off treatment for at least 5 years, were

  20. Impact of cardiovascular counseling and screening in Hodgkin lymphoma survivors

    NARCIS (Netherlands)

    Daniëls, L.A.; Krol, S.D.G.; de Graaf, M.A.; Scholte, A.J.H.A.; van 't Veer, M.B.; Putter, H.; de Roos, A.; Schalij, M.J.; van de Poll-Franse, L.; Creutzberg, C.L.

    2014-01-01

    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

  1. Ethical Issues in Counseling Adult Survivors of Incest.

    Science.gov (United States)

    Daniluk, Judith C. and Haverkamp, Beth E.

    1993-01-01

    Counseling adult survivors of childhood sexual abuse raises ethical issues which include maintaining client confidentiality when the situations have been both immoral and illegal or working with survivors without appropriate training. Principles such as autonomy, fidelity, justice, beneficence and nonmaleficence, and self-interest are examined, as…

  2. Projective drawings: helping adult survivors of childhood abuse recognize boundaries.

    Science.gov (United States)

    Glaister, J A

    1994-10-01

    1. Boundary issues for adult childhood trauma survivors are complex, problematic, difficult to resolve, and occur on a level of unawareness. 2. Boundary concepts can be found in all types of projective drawings. 3. Projective drawings can facilitate awareness and understanding of boundary problems experienced by adult childhood trauma survivors.

  3. Posttraumatic stress symptoms in adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.

    2004-01-01

    Background. Previous research suggests that posttraurnatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraurnatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic,

  4. Quality of life in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Stam, H.; Grootenhuis, M. A.; Last, B. F.

    2002-01-01

    In recent years the necessity of measuring quality of life in childhood cancer survivors has been stressed. This paper gives an overview of the results of studies into the quality of life (QL) of young adult survivors of childhood cancer and suggest areas for future research. The review located 30

  5. No excess fatigue in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.; van den Bos, C.

    2003-01-01

    Clinical reports suggest that many survivors of childhood cancer experience fatigue as a long-term effect of their treatment. To investigate this issue further, we assessed the level of fatigue in young adult survivors of childhood cancer. We compared the results with a group of young adults with no

  6. Learning Profiles of Survivors of Pediatric Brain Tumors

    Science.gov (United States)

    Barkon, Beverly

    2009-01-01

    By 2010 it is predicted that one in 900 adults will be survivors of some form of pediatric cancer. The numbers are somewhat lower for survivors of brain tumors, though their numbers are increasing. Schools mistakenly believe that these children easily fit pre-existing categories of disability. Though these students share some of the…

  7. 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, ...

  8. Emergency mental health and psychosocial support for survivors of ...

    African Journals Online (AJOL)

    Objective: To describe the design and delivery of emergency mental health and psychosocial support services for the survivors of Post-Election Violence in Eldoret, Kenya. Design: A longitudinal intervention. Setting: The North Rift Valley region in western Kenya. Subjects: A total of 80,772 survivors received mental health ...

  9. Family Survivors of Suicide and Accidental Death: Consequences for Widows.

    Science.gov (United States)

    McNiel, Dale E.; And Others

    1988-01-01

    Examined the impact of completed suicide on the surviving family, comparing widows (N=13) whose husbands had died through suicide to widows (N=13) whose husbands had died in accidents. Found suicide survivors showed no more family dysfunction, life stress, or psychiatric symptomatology than accident survivors. (Author/ABL)

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

    Science.gov (United States)

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

    2013-01-15

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

  11. Health Information Needs of Childhood Cancer Survivors and Their Family

    NARCIS (Netherlands)

    Knijnenburg, Sebastiaan L.; Kremer, Leontien C.; van den Bos, Cor; Braam, Katja I.; Jaspers, Monique W. M.

    2010-01-01

    Background. Knowledge about past disease, treatment, and possible late effects has previously been shown to be low in survivors of childhood cancer and their relatives. This study investigated the information needs of childhood cancer survivors and their parents and explored possible determinants

  12. Work disability assessment of cancer survivors: insurance physicians ' perspectives

    NARCIS (Netherlands)

    van Muijen, P.; Duijts, S.F.A.; van der Aa, D.A.; van der Beek, A.J.; Anema, J.R.

    2015-01-01

    Background: Assessing work disability in cancer survivors is a complex decision-making process. In the Netherlands, physicians employed by the Dutch Social Security Agency (SSA) play a key role in assessing work disability of cancer survivors on long-term sick leave. Aims: To investigate the aspects

  13. 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…

  14. Perceived control, adjustment, and communication problems in laryngeal cancer survivors.

    Science.gov (United States)

    Blood, G W; Dineen, M; Kauffman, S M; Raimondi, S C; Simpson, K C

    1993-12-01

    Health locus of control, adjustment to cancer, and communication experiences after a laryngectomy were investigated in 63 laryngeal cancer survivors. Survivors who showed internal control also scored as better adjusted and had fewer communication problems. Scales were intercorrelated (.68 to .92).

  15. CIRCUMSTANCES AND CONSEQUENCES OF FALLS IN POLIO SURVIVORS

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-01-01

    Objectives: Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. Methods: A survey was conducted among 376 polio

  16. Why Rape Survivors Participate in the Criminal Justice System

    Science.gov (United States)

    Patterson, Debra; Campbell, Rebecca

    2010-01-01

    After a rape, survivors may seek help from multiple community organizations including the criminal justice system (CJS). Research has found that few survivors report their assaults to the police and of those who do report, many withdraw their participation during the investigation. However, relatively little is known about the factors that lead…

  17. ECHN honors cancer survivors with fun, food and inspirational stories.

    Science.gov (United States)

    Botvin, Judith D

    2005-01-01

    A nostalgia theme was fully explored by Eastern Connecticut Health Network (ECHN), Manchester, Conn., in its celebration of Cancer Survivors Day, June 6. The observance is sponsored by the national Cancer Survivors Day organization. This year more than 700 facilities across the country observed the occasion.

  18. Executive function and coping in stroke survivors.

    Science.gov (United States)

    Kegel, Jessica; Dux, Moira; Macko, Richard

    2014-01-01

    Stroke is a leading cause of disability and sequelae may include physical, emotional, and cognitive impairments. The methods employed to cope with distress, both emotional and cognitive, have not been evaluated in individuals post-stroke. However, research in traumatic brain injury (TBI) suggests that executive function is positively correlated with adaptive coping and negatively correlated with maladaptive coping strategies (Krpan et al., 2007). Examination of these constructs post-stroke may assist with enriching our understanding of cognitive and emotional symptomatology and optimize rehabilitation strategies. The present study aimed to assess the association between executive function and coping strategies in a sample of chronic stroke survivors. The researchers hypothesized that executive function would be positively correlated with adaptive coping strategies and negatively correlated with maladaptive coping strategies. Fifteen stroke survivors were administered a battery of cognitive tests assessing executive function and also completed the Ways of Coping Questionnaire (WAYS), a self-report coping measure. Analyses indicated that executive function deficits were related to increased avoidant coping. Contrary to expectations, executive function was not significantly related to active coping. In addition, post hoc analyses revealed that executive function was a significant predictor of avoidant coping after controlling for demographics. Our data, in accordance with prior work in TBI, suggests that executive function and aspects of coping are associated. Rehabilitation strategies that improve executive function may also lead to utilization of adaptive coping strategies. Research has shown that aerobic exercise increases activation in the frontal lobe and improves executive function (Colcombe & Kramer, 2003; Colcombe et al., 2004). Future studies should examine whether aerobic exercise positively affects executive function and coping in stroke survivors.

  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

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

  20. Peer Support Services for Bereaved Survivors: A Systematic Review.

    Science.gov (United States)

    Bartone, Paul T; Bartone, Jocelyn V; Violanti, John M; Gileno, Zaneta M

    2017-01-01

    This systematic literature review assesses the evidence regarding benefits of peer support services for bereaved survivors of sudden or unexpected death. Reports were included that addressed peer support services for adults who experienced death of a family member, close friend, or coworker. Of the 32 studies meeting all inclusion criteria, most showed evidence that peer support was helpful to bereaved survivors, reducing grief symptoms and increasing well-being and personal growth. Studies also showed benefits to providers of peer support, including increased personal growth and positive meaning in life. Several studies addressed the growing trend of Internet-based peer support programs, finding that these are beneficial in part due to their easy accessibility. Peer support appears to be especially valuable for survivors of suicide loss, a result that may be related to stigma and lack of support from family and friends experienced by many suicide survivors. The reviewed studies provide consistent evidence that peer support is beneficial to bereaved survivors.

  1. Second-generation Holocaust survivors: Psychological, theological, and moral challenges.

    Science.gov (United States)

    Juni, Samuel

    2016-01-01

    Drawing from trauma theory, psychodynamic conceptualization, developmental psychology, clinical data, and personal experience, this article portrays a life haunted by tragedy predating its victims. Healthy child development is outlined, with particular attention to socialization and theological perspectives. Key characteristics of trauma are delineated, highlighting the nuances of trauma that are most harmful. As is the case with general trauma, Holocaust survivors are described as evincing survivor's guilt and paranoia in response to their experiences. Divergent disorders resulting from the Holocaust are described for 1st-generation and 2nd-generation survivors, respectively. Primary trauma responses and pervasive attitudes of survivors are shown to have harmful ramifications on their children's personality and worldview as well as on their interpersonal and theistic object relations. These limitations translate into problems in the adult lives of second generation survivors.

  2. Cognitive problems among breast cancer survivors: loneliness enhances risk.

    Science.gov (United States)

    Jaremka, Lisa M; Peng, Juan; Bornstein, Robert; Alfano, Catherine M; Andridge, Rebecca R; Povoski, Stephen P; Lipari, Adele M; Agnese, Doreen M; Farrar, William B; Yee, Lisa D; Carson, William E; Kiecolt-Glaser, Janice K

    2014-12-01

    Cancer survivors often experience cognitive difficulties after treatment completion. Although chemotherapy enhances risk for cognitive problems, it is likely only one piece of a complex puzzle that explains survivors' cognitive functioning. Loneliness may be one psychosocial risk factor. The current studies included both subjective and objective cognitive measures and tested whether lonelier breast cancer survivors would have more concentration and memory complaints and experience more concentration difficulties than their less lonely counterparts. The relationship between loneliness and cognitive function was tested among three samples of breast cancer survivors. Study 1 was a sample of breast cancer survivors (n = 200) who reported their concentration and memory problems. Study 2a was a sample of breast cancer survivors (n = 185) and noncancer controls (n = 93) who reported their concentration and memory problems. Study 2b was a subsample of Study 2a breast cancer survivors (n = 22) and noncancer controls (n = 21) who completed a standardized neuropsychological test assessing concentration. Studies 1 and 2a revealed that lonelier women reported more concentration and memory problems than less lonely women. Study 2b utilized a standardized neuropsychological continuous performance test and demonstrated that lonelier women experienced more concentration problems than their less lonely counterparts. These studies demonstrated that loneliness is linked to concentration and memory complaints and the experience of concentration problems among breast cancer survivors. The results were also highly consistent across three samples of breast cancer survivors. These data suggest that loneliness may be a risk factor for cognitive difficulties among cancer survivors. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Higher prevalence of osteoporosis among female Holocaust survivors.

    Science.gov (United States)

    Marcus, E-L; Menczel, J

    2007-11-01

    The prevalence of osteoporosis was statistically significantly higher among female Holocaust survivors than among those who were not exposed to the Holocaust. These findings support the importance of nutrition and environmental conditions during childhood and adolescence on BMD in older adults. Holocaust survivors during childhood and adolescence experienced undernutrition and lack of exercise and sunlight. The study aimed to establish if Holocaust survivors have higher prevalence of osteoporosis than subjects who were not Holocaust survivors. Seventy-three female Jewish Holocaust survivors > or = 60 years old and 60 female European-born Jews > or =60 years old who were not in the Holocaust were examined. BMD was measured using DXA of the lumbar spine and hips. The Cochran-Armitage trend test was used to test for an increasing trend in decreased BMD in the Holocaust survivors versus controls. Among Holocaust survivors 54.8% had osteoporosis, 39.7% osteopenia, and 5.5% normal BMD, whereas among controls 25.0% had osteoporosis, 55.0% osteopenia, and 20.0% normal BMD (p = 0.0001). In those who were Holocaust survivors 58.0% had osteoporosis, 34.0% osteopenia, and 8.0% normal BMD, whereas among controls 20.0% had osteoporosis, 57.8% osteopenia, and 22.2% normal BMD (p = 0.0003). In those > or =17 years old in 1945, among Holocaust survivors 47.8% had osteoporosis, 52.2% osteopenia and none had normal BMD, whereas among controls 40.0% had osteoporosis, 46.7% osteopenia, and 13.3% normal BMD (p = 0.28). The prevalence of osteoporosis was significantly higher among Holocaust survivors.

  4. Cardiopulmonary exercise performance is reduced in congenital diaphragmatic hernia survivors.

    Science.gov (United States)

    Bojanić, Katarina; Grizelj, Ruža; Dilber, Daniel; Šarić, Dalibor; Vuković, Jurica; Pianosi, Paolo T; Driscoll, David J; Weingarten, Toby N; Pritišanac, Ena; Schroeder, Darrell R; Sprung, Juraj

    2016-12-01

    Congenital diaphragmatic hernia (CDH) is associated with lung hypoplasia. CDH survivors may have pulmonary morbidity that can decrease cardiopulmonary exercise. We aimed to examine whether cardiopulmonary exercise testing (CPET) results differ in CDH survivors versus healthy age-matched controls and whether CPET results among CDH survivors differ according to self-reported daily activity. In one medical center in Croatia, CDH survivors-patients with surgically corrected CDH who were alive at age 5 years-were invited to participate in spirometry and CPET. Values were compared with those of controls matched 2:1 by age and sex for each CDH survivor aged 7 years or older. Among 27 CDH survivors aged 5-20 years, 13 (48%) had continued symptoms or spirometric evidence of pulmonary disease. Compared with controls (n = 44), survivors (n = 22) had lower peak oxygen consumption (V˙O2 mean [SD], 35.7 [6.9] vs. 45.3 [8.2] ml/kg per min; P exercise, V˙O2/heart rate (P different (P = 0.72). Among survivors, mean (SD) V˙O2peak (ml/kg per min) differed by self-reported activity level: athletic, 40.3 (5.0); normal, 35.8 (6.5); and sedentary, 32.1 (6.8) (by ANOVA, P = 0.10 across three groups and P = 0.04 athletic vs. sedentary). More than half of CDH survivors continue to have chronic pulmonary disease. CDH survivors had lower aerobic exercise capacity than controls. Self-reporting information on daily activities may identify CDH patients with low V˙O2max who may benefit from physical training. Pediatr Pulmonol. 2016;51:1320-1329. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Nutritional interventions for survivors of childhood cancer.

    Science.gov (United States)

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

    2016-08-22

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

  6. Psychological Adjustment in Breast Cancer Survivors.

    Science.gov (United States)

    Stanton, Annette L; Bower, Julienne E

    2015-01-01

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

  7. "We are survivors and not a virus:" Content analysis of media reporting on Ebola survivors in Liberia.

    Science.gov (United States)

    Mayrhuber, Elisabeth Anne-Sophie; Niederkrotenthaler, Thomas; Kutalek, Ruth

    2017-08-01

    The Ebola virus disease epidemic between 2013 and 2016 in West Africa was unprecedented. It resulted in approximately 28.000 cases and 10.000 Ebola survivors. Many survivors face social, economic and health-related predicaments and media reporting is crucially important in infectious disease outbreaks. However, there is little research on reporting of the social situation of Ebola survivors in Liberia. The study used a mixed methods approach and analysed media reports from the Liberian Daily Observer (DOL), a daily newspaper available online in English. We were interested to know how the situation of Ebola survivors was portrayed; in what way issues such as stigma and discrimination were addressed; and which stigma reduction interventions were covered and how. We included all articles on the situation of Ebola survivors in the quantitative and in-depth qualitative analysis published between April 2014 and March 2016. The DOL published 148 articles that portrayed the social situation of Ebola survivors between the 24 months observation period. In these articles, Ebola survivors were often defined beyond biological terms, reflecting on a broader social definition of survivorship. Survivorship was associated with challenges such as suffering from after-effects, social and economic consequences and psychological distress. Almost 50% of the articles explicitly mentioned stigmatisation in their reporting on Ebola survivors. This was contextualised in untrustworthiness towards international responses and the local health care system and inconclusive knowledge on cures and transmission routes. In the majority of DOL articles stigma reduction and engaging survivors in the response was reported as crucially important. Reporting in the DOL was educational-didactical and well-balanced in terms of disseminating available medical knowledge and reflecting the social situation of Ebola survivors. While the articles contextualised factors contributing to stigmatisation throughout

  8. "We are survivors and not a virus:" Content analysis of media reporting on Ebola survivors in Liberia.

    Directory of Open Access Journals (Sweden)

    Elisabeth Anne-Sophie Mayrhuber

    2017-08-01

    Full Text Available The Ebola virus disease epidemic between 2013 and 2016 in West Africa was unprecedented. It resulted in approximately 28.000 cases and 10.000 Ebola survivors. Many survivors face social, economic and health-related predicaments and media reporting is crucially important in infectious disease outbreaks. However, there is little research on reporting of the social situation of Ebola survivors in Liberia.The study used a mixed methods approach and analysed media reports from the Liberian Daily Observer (DOL, a daily newspaper available online in English. We were interested to know how the situation of Ebola survivors was portrayed; in what way issues such as stigma and discrimination were addressed; and which stigma reduction interventions were covered and how. We included all articles on the situation of Ebola survivors in the quantitative and in-depth qualitative analysis published between April 2014 and March 2016.The DOL published 148 articles that portrayed the social situation of Ebola survivors between the 24 months observation period. In these articles, Ebola survivors were often defined beyond biological terms, reflecting on a broader social definition of survivorship. Survivorship was associated with challenges such as suffering from after-effects, social and economic consequences and psychological distress. Almost 50% of the articles explicitly mentioned stigmatisation in their reporting on Ebola survivors. This was contextualised in untrustworthiness towards international responses and the local health care system and inconclusive knowledge on cures and transmission routes. In the majority of DOL articles stigma reduction and engaging survivors in the response was reported as crucially important.Reporting in the DOL was educational-didactical and well-balanced in terms of disseminating available medical knowledge and reflecting the social situation of Ebola survivors. While the articles contextualised factors contributing to

  9. Meaningful Use of an Electronic Personal Health Record (ePHR) among Pediatric Cancer Survivors.

    Science.gov (United States)

    Williamson, Rebecca S; Cherven, Brooke O; Gilleland Marchak, Jordan; Edwards, Paula; Palgon, Michael; Escoffery, Cam; Meacham, Lillian R; Mertens, Ann C

    2017-03-15

    Background and Objectivs: Survivors of pediatric and adolescent cancer are at an increased risk of chronic and debilitating health conditions and require life-long specialized care. Stand-alone electronic personal health records (ePHRs) may aid their self-management. This analysis characterizes young adult survivors and parents who meaningfully use an ePHR, Cancer SurvivorLink TM , designed for survivors of pediatric and adolescent cancer. This was a retrospective observational study of patients seen at a pediatric survivor clinic for annual survivor care. Young adult survivors and/or parent proxies for survivors survivors/parents registered and 38% of registrants used SurvivorLink meaningfully. Young adult registrants who transferred to adult care during the study period were more likely to be meaningful users (aOR: 2.6 (95% CI: 1.1, 6.1)) and used the ePHR twice as frequently as those who continued to receive care in our institution's pediatric survivor clinic. Among survivors who continued to receive care at our institution, being a registrant was associated with having an annual follow-up visit (aOR: 2.6 (95% CI: 1.2, 5.8)). While ePHRs may not be utilized by all survivors, SurvivorLink is a resource for a subset and may serve as an important bridge for patients who transfer their care. Using SurvivorLink was also associated with receiving recommended annual survivor care.

  10. Subsequent Neoplasms in 5-Year Survivors of Childhood Cancer: The Childhood Cancer Survivor Study

    Science.gov (United States)

    Whitton, John; Leisenring, Wendy; Mertens, Ann C.; Hammond, Sue; Stovall, Marilyn; Donaldson, Sarah S.; Meadows, Anna T.; Robison, Leslie L.; Neglia, Joseph P.

    2010-01-01

    Background The occurrence of subsequent neoplasms has direct impact on the quantity and quality of life in cancer survivors. We have expanded our analysis of these events in the Childhood Cancer Survivor Study (CCSS) to better understand the occurrence of these events as the survivor population ages. Methods The incidence of and risk for subsequent neoplasms occurring 5 years or more after the childhood cancer diagnosis were determined among 14 359 5-year survivors in the CCSS who were treated from 1970 through 1986 and who were at a median age of 30 years (range = 5–56 years) for this analysis. At 30 years after childhood cancer diagnosis, we calculated cumulative incidence at 30 years of subsequent neoplasms and calculated standardized incidence ratios (SIRs), excess absolute risks (EARs) for invasive second malignant neoplasms, and relative risks for subsequent neoplasms by use of multivariable Poisson regression. Results Among 14 359 5-year survivors, 1402 subsequently developed 2703 neoplasms. Cumulative incidence at 30 years after the childhood cancer diagnosis was 20.5% (95% confidence interval [CI] = 19.1% to 21.8%) for all subsequent neoplasms, 7.9% (95% CI = 7.2% to 8.5%) for second malignant neoplasms (excluding nonmelanoma skin cancer), 9.1% (95% CI = 8.1% to 10.1%) for nonmelanoma skin cancer, and 3.1% (95% CI = 2.5% to 3.8%) for meningioma. Excess risk was evident for all primary diagnoses (EAR = 2.6 per 1000 person-years, 95% CI = 2.4 to 2.9 per 1000 person-years; SIR = 6.0, 95% CI = 5.5 to 6.4), with the highest being for Hodgkin lymphoma (SIR = 8.7, 95% CI = 7.7 to 9.8) and Ewing sarcoma (SIR = 8.5, 95% CI = 6.2 to 11.7). In the Poisson multivariable analysis, female sex, older age at diagnosis, earlier treatment era, diagnosis of Hodgkin lymphoma, and treatment with radiation therapy were associated with increased risk of subsequent neoplasm. Conclusions As childhood cancer survivors progress through adulthood, risk of subsequent neoplasms

  11. Increased risk of attempted suicide among aging holocaust survivors.

    Science.gov (United States)

    Barak, Yoram; Aizenberg, Dov; Szor, Henry; Swartz, Marnina; Maor, Rachel; Knobler, Haim Y

    2005-08-01

    Suicide rates are higher in elderly persons than in those at other phase of the life-cycle. The majority of World War II (WWII) veterans and Holocaust survivors still define their war experiences as being the "most significant stressor" of their lives. Aging of survivors is frequently associated with depression, reactivation of traumatic syndromes, physical disorders, loss, and psychological distress, possibly increasing the risk of suicide. The aim of the present study was to investigate, among a large cohort of elderly Holocaust survivors, whether their WWII experiences confer an increased risk of suicidal behavior. All medical records of elderly patients admitted to a psychiatric hospital in Israel during a 5-year period were retrospectively evaluated. Suicidal patients were compared with patients who had not attempted suicide. Of 921 eligible patients, 374 were Holocaust survivors; 135 (14.6%) had attempted suicide in the month before admission. Ninety Holocaust survivors (24%) had attempted suicide, versus 45 of the 502 patients (8.2%) with no WWII experience. The risk of attempted suicide among Holocaust survivors was significantly increased. Although these findings are from a highly selected sample, we suggest that aging Holocaust survivors are at increased risk of attempting suicide. The growth of the elderly population, of whom many had had traumatic life experiences, emphasizes the need to implement preventive strategies so that suicidal risk may be contained.

  12. Life experiences after stroke among Iranian stroke survivors.

    Science.gov (United States)

    Dalvandi, A; Heikkilä, K; Maddah, S S B; Khankeh, H R; Ekman, S L

    2010-06-01

    Stroke is a major cause of disability worldwide. It is a life-threatening and life-altering event, which leaves many physical and mental disabilities, thus creating major social and economic burdens. Experiencing a stroke and its aftermath can be devastating for patients and their families. In Iran, many services are not available for those who lack property; this may result in many difficulties and long-term problems for stroke survivors and their family members who are usually the main caregivers in Iranian cultural. Despite its effect on their lives, little is known about how the survivors perceive stroke in the Iranian context, therefore, knowing more about this process may enhance problem identification and problem solving. To illuminate how stroke survivors experience and perceive life after stroke. A grounded theory approach was recruited using semi-structured interviews with 10 stroke survivors. The survivors perceived that inadequate social and financial support, lack of an educational plan, lack of access to rehabilitative services, physical and psychological problems led them to functional disturbances, poor socio-economical situation and life disintegration. The core concept of life after stroke was functional disturbances. The study shows the need to support the stroke survivors in their coping process with their new situation by providing appropriate discharge plans, social and financial support, social insurances and training programmes for the stroke survivors and their families.

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

    Science.gov (United States)

    Hebdon, Megan; Foli, Karen; McComb, Sara

    2015-08-01

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

  14. Accelerated aging among cancer survivors: from pediatrics to geriatrics.

    Science.gov (United States)

    Henderson, Tara O; Ness, Kirsten K; Cohen, Harvey Jay

    2014-01-01

    There are almost 14-million cancer survivors in the United States and the population is growing. Almost two-thirds of these survivors are age 65 or older. Given this, it is imperative to understand the impact of cancer and its therapies on the aging process. Childhood cancer survivors, diagnosed with cancer at age 21 or younger, particularly females, have rates of frailty similar to rates in older adults. This phenomenon appears to start early, suggesting an aging phenotype. Frailty among childhood cancer survivors increases risk for chronic disease and mortality. Adults diagnosed with cancer are faced with the effects of cancer and its therapies compounded by the issues of multiple morbidities that occur with the typical aging process. Intervention studies to date have focused on smoking cessation, diet, and exercise, as well as improving rates of late effects surveillance in childhood cancer survivors. No intervention studies have specifically addressed the issue of frailty or multiple morbidities in cancer survivors. Concerted efforts must continue to create and disseminate survivorship care plans to all cancer survivors.

  15. Obesity in Childhood Cancer Survivors: Call for Early Weight Management.

    Science.gov (United States)

    Zhang, Fang Fang; Parsons, Susan K

    2015-09-01

    A high prevalence of obesity and cardiometabolic conditions has been increasingly recognized in childhood cancer survivors. In particular, survivors of pediatric acute lymphoblastic leukemia have been found to be at risk of becoming overweight or obese early in treatment, with increases in weight maintained throughout treatment and beyond. Nutrition plays an important role in the etiology of obesity and cardiometabolic conditions and is among the few modifiable factors that can prevent or delay the early onset of these chronic conditions. However, nutritional intake in childhood cancer survivors has not been adequately examined and the evidence is built on data from small cohorts of survivors. In addition, the long-term impact of cancer diagnosis and treatment on survivors' nutritional intake as well as how survivors' nutritional intake is associated with chronic health conditions have not been well quantified in large-scale studies. Promoting family-based healthy lifestyles, preferably at a sensitive window of unhealthy weight gain, is a priority for preventing the early onset of obesity and cardiometabolic conditions in childhood cancer survivors. © 2015 American Society for Nutrition.

  16. Screening for vitamin D insufficiency in pediatric cancer survivors.

    Science.gov (United States)

    Esbenshade, Adam J; Sopfe, Jenna; Zhao, Zhiguo; Li, Zeda; Campbell, Kristin; Simmons, Jill H; Friedman, Debra L

    2014-04-01

    Corticosteroids increase risk for decreased bone mineral density, which can be worsened by vitamin D insufficiency (VDI) or deficiency (VDD). In the Vanderbilt cancer survivorship clinic, we obtained screening total 25-hydroxy vitamin D levels (VDL) in 171 cancer survivors cancer, and compared this group to a control group of 97 healthy pediatric patients. VDD was diagnosed in 15.8% and VDI in 34.5% of cancer survivors and VDD/VDI combined was associated with body mass index (BMI) >85th percentile (Odds ratio [OR] = 5.4; P survivor/control group multivariable analysis, cancer diagnosis did not increase VDI/VDD risk, but significant associations persisted with elevated BMI (P pediatric cancer survivors treated with corticosteroids and healthy children. The impact of VDD/VDI in cancer survivors may be greater due to risk for impaired bone health superimposed on that conferred from corticosteroid exposure. Thus, screening VDLs should be obtained in pediatric cancer survivors treated with corticosteroids, particularly in those with elevated BMI, older age, or non-Caucasian race. Prospective studies evaluating the impact of interventions to minimize VDD/VDI on long-term bone health in survivors are required. © 2013 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Ray, Heather; Jakubec, Sonya L

    2014-11-01

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

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

    Science.gov (United States)

    Davis, Sharon Watkins; Oakley-Girvan, Ingrid

    2017-08-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

  20. Adoption consideration and concerns among young adult female cancer survivors.

    Science.gov (United States)

    Gorman, Jessica R; Whitcomb, Brian W; Standridge, Daniel; Malcarne, Vanessa L; Romero, Sally A D; Roberts, Samantha A; Su, H Irene

    2017-02-01

    We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children. After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups. We assessed characteristics and concerns related to adoption consideration among cancer survivors. Among cancer survivors, 81.6 % (95 % CI 75.7-87.6) reported that they would consider adoption compared to 40.3 % (95 % CI 40.3-40.3) of women in the general population. While over 80 % of the cancer survivor sample reported that they would consider adoption, only 15 % of cancer survivors reported no concerns about adoption. The most common concerns were desire for a biological child (48 %), expense (45 %), adoption agency candidacy (41 %), and needing more information (39 %). We observed a twofold higher interest in adoption when comparing the cancer survivor with the general population, suggesting that adoption is a consideration for many young women who have survived cancer. Adoption is an important family-building option for those who want to have a child but are unable to or choose not to have a biological child. However, young adult survivors may need more support to understand and navigate this process.

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

    Science.gov (United States)

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

    2015-12-01

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

  2. Association Between Sarcopenia and Metabolic Syndrome in Cancer Survivors.

    Science.gov (United States)

    Lee, Su Jung; Kim, Nam Cho

    Advanced cancer treatments have improved survival from cancer, but the incidence of cardiovascular disease in survivors has recently increased. Sarcopenia and metabolic syndrome (MetS) are related to cancer survival, and sarcopenia is an emerging risk factor for cardiovascular disease. However, evidence of a relationship between sarcopenia and MetS in cancer survivors is lacking. The aims of this study were to determine the prevalence of sarcopenia and MetS in cancer survivors and to investigate independent predictors of MetS in cancer survivors. From the fourth and fifth Korea National Health and Nutritional Exam Survey (2008-2011), 798 consecutive cancer survivors were analyzed. Sarcopenia was defined as the appendicular skeletal muscle mass divided by weight less than 1 SD below the sex-specific healthy population aged 20 to 39 years. Metabolic syndrome was defined using the National Cholesterol Education Program definition. Among 798 cancer survivors, the prevalence rates of sarcopenia and MetS were 23.1% and 30.0%, respectively. Survivors with sarcopenia were more likely to have a higher waist circumference, body mass index, triglyceride level, and blood pressure and to have a lower high-density lipoprotein cholesterol level compared with those without sarcopenia. In multivariable analysis, sarcopenia was an independent predictor of MetS (odds ratio, 2.76; 95% confidence interval, 1.92-3.97). In addition, age and type of cancer were independent predictors of MetS. Sarcopenia was associated with an increased prevalence of MetS in cancer survivors. Interventions to prevent sarcopenia may be necessary to improve cardiovascular outcome in cancer survivors.

  3. Complementary and alternative medicine use among US cancer survivors.

    Science.gov (United States)

    John, Gabriella M; Hershman, Dawn L; Falci, Laura; Shi, Zaixing; Tsai, Wei-Yann; Greenlee, Heather

    2016-10-01

    US cancer survivors commonly use vitamins/minerals and complementary and alternative medicine (CAM). We compare use of vitamins/minerals and CAM between adult cancer survivors and cancer-free adults and estimate annual out-of-pocket expenses. Data on self-reported vitamin/mineral and CAM use in the past 12 months from the cross-sectional 2012 US National Health Interview Survey were used to estimate prevalence of use and out-of-pocket expenditures. The cohort included adults with (n = 2977) and without (n = 30,551) a self-reported cancer diagnosis. Approximately 79 % of cancer survivors and 68 % of cancer-free adults reported using ≥1 vitamins/minerals and/or CAM modality in the past year. Compared to cancer-free adults, cancer survivors were more likely to report use of vitamin/minerals (75 vs. 61 %, P alternative medical systems (5 vs. 4 %, P = 0.04). Adult cancer survivors and cancer-free adults spent an annual estimated $6.7 billion and $52 billion out-of-pocket, respectively, on vitamins/minerals and CAM. Survivors spent 60 % of the total on vitamins/minerals ($4 billion), 18 % ($1.2 billion) on non-vitamin/mineral natural products, and 7 % ($0.5 billion) on massage. Compared with cancer-free adults, a higher proportion of cancer survivors report vitamin/mineral and CAM use. Cancer survivors, who accounted for 6.9 % of the total population, accrued more than 11.4 % of the annual out-of-pocket costs on vitamins/minerals and CAM spent by US adults. Given the high use of vitamins/minerals and CAM in cancer survivors, studies are needed to analyze health outcomes and the cost/benefit ratio of such use.

  4. Total antioxidant status (TAS in childhood cancer survivors Total antioxidant status (TAS in childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Maryna Krawczuk-Rybak

    2012-10-01

    Full Text Available Total antioxidant status (TAS, and the influence of treatment and correlation between TAS and parameters
    involved in metabolic syndrome (MS in pediatric cancer survivors were evaluated. One hundred children
    and adolescents were studied. Twenty-five survivors received radiotherapy, 12 were obese or overweight.
    Additionally, we analyzed TAS in eight children with acute lymphoblastic leukemia (ALL at diagnosis and
    during treatment after remission induction. The control group consisted of 22 healthy children. Serum concentrations
    of TAS, glucose, cholesterol, HDL-cholesterol, triglycerides, fibrinogen and insulin were measured. In
    cancer survivors, independently of diagnosis and kind of treatment (radiotherapy anthracyclines administration,
    the mean serum TAS did not differ significantly from the control group. No correlations were observed
    with age at the time of diagnosis or interval after the end of treatment. TAS values did not correlate with traits of
    the metabolic syndrome. In a group of eight patients with ALL at diagnosis and after induction of remission,
    TAS values were lower than in the control and cancer survivor groups. Antioxidant status was not found to be
    deteriorated in children after anticancer treatment, irrespective of diagnosis or kind of treatment, which might
    indicate sufficient antioxidant prevention. However, the possibility of the development of MS and cardiovascular
    disease in adulthood indicates the need for future studies.Total antioxidant status (TAS, and the influence of treatment and correlation between TAS and parameters
    involved in metabolic syndrome (MS in pediatric cancer survivors were evaluated. One hundred children
    and adolescents were studied. Twenty-five survivors received radiotherapy, 12 were obese or overweight.
    Additionally, we analyzed TAS in eight children with acute lymphoblastic leukemia (ALL at diagnosis and
    during

  5. Predictors of successful use of a web-based healthcare document storage and sharing system for pediatric cancer survivors: Cancer SurvivorLink™.

    Science.gov (United States)

    Williamson, Rebecca; Meacham, Lillian; Cherven, Brooke; Hassen-Schilling, Leann; Edwards, Paula; Palgon, Michael; Espinoza, Sofia; Mertens, Ann

    2014-09-01

    Cancer SurvivorLink™, www.cancersurvivorlink.org , is a patient-controlled communication tool where survivors can electronically store and share documents with healthcare providers. Functionally, SurvivorLink serves as an electronic personal health record-a record of health-related information managed and controlled by the survivor. Recruitment methods to increase registration and the characteristics of registrants who completed each step of using SurvivorLink are described. Pediatric cancer survivors were recruited via mailings, survivor clinic, and community events. Recruitment method and Aflac Survivor Clinic attendance was determined for each registrant. Registration date, registrant type (parent vs. survivor), zip code, creation of a personal health record in SurvivorLink, storage of documents, and document sharing were measured. Logistic regression was used to determine the characteristics that predicted creation of a health record and storage of documents. To date, 275 survivors/parents have completed registration: 63 were recruited via mailing, 99 from clinic, 56 from community events, and 57 via other methods. Overall, 66.9 % registrants created a personal health record and 45.7 % of those stored a health document. There were no significant predictors for creating a personal health record. Attending a survivor clinic was the strongest predictor of document storage (p survivor clinic is the biggest predictor of registering and using SurvivorLink. Many survivors must advocate for their survivorship care. Survivor Link provides educational material and supports the dissemination of survivor-specific follow-up recommendations to facilitate shared clinical care decision making.

  6. Second Neoplasms in Survivors of Childhood Cancer: Findings From the Childhood Cancer Survivor Study Cohort

    Science.gov (United States)

    Meadows, Anna T.; Friedman, Debra L.; Neglia, Joseph P.; Mertens, Ann C.; Donaldson, Sarah S.; Stovall, Marilyn; Hammond, Sue; Yasui, Yutaka; Inskip, Peter D.

    2009-01-01

    Purpose To review the reports of subsequent neoplasms (SNs) in the Childhood Cancer Survivor Study (CCSS) cohort that were made through January 1, 2006, and published before July 31, 2008, and to discuss the host-, disease-, and therapy-related risk factors associated with SNs. Patients and Methods SNs were ascertained by survivor self-reports and subsequently confirmed by pathology findings or medical record review. Cumulative incidence of SNs and standardized incidence ratios for second malignant neoplasms (SMNs) were calculated. The impact of host-, disease-, and therapy-related risk factors was evaluated by Poisson regression. Results Among 14,358 cohort members, 730 reported 802 SMNs (excluding nonmelanoma skin cancers). This represents a 2.3-fold increase in the number of SMNs over that reported in the first comprehensive analysis of SMNs in the CCSS cohort, which was done 7 years ago. In addition, 66 cases of meningioma and 1,007 cases of nonmelanoma skin cancer were diagnosed. The 30-year cumulative incidence of SMNs was 9.3% and that of nonmelanoma skin cancer was 6.9%. Risk of SNs remains elevated for more than 20 years of follow-up for all primary childhood cancer diagnoses. In multivariate analyses, risks differ by SN subtype, but include radiotherapy, age at diagnosis, sex, family history of cancer, and primary childhood cancer diagnosis. Female survivors whose primary childhood cancer diagnosis was Hodgkin's lymphoma or sarcoma and who received radiotherapy are at particularly increased risk. Analyses of risk associated with radiotherapy demonstrated different dose-response curves for specific SNs. Conclusion Childhood cancer survivors are at a substantial and increasing risk for SNs, including nonmelanoma skin cancer and meningiomas. Health care professionals should understand the magnitude of these risks to provide individuals with appropriate counseling and follow-up. PMID:19255307

  7. Tobacco Use Among Siblings of Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Buchbinder, David; Oeffinger, Kevin; Franco-Villalobos, Conrado; Yasui, Yutaka; Alderfer, Melissa A; Armstrong, Gregory T; Casillas, Jacqueline; Ford, Jennifer; Krull, Kevin R; Leisenring, Wendy; Recklitis, Christopher; Robison, Leslie L; Zeltzer, Lonnie K; Lown, E Anne

    2016-02-01

    Having a brother or sister with childhood cancer may influence health behaviors during adulthood. The aim of this study was to compare tobacco use in siblings of survivors with peers and to identify factors associated with sibling tobacco use. A retrospective cohort study was conducted using adult siblings (N = 1,974) of 5+ year cancer survivors in the Childhood Cancer Survivor Study (CCSS) and participants (N = 24,105, weighted to match CCSS) in the 2007 National Health Interview Survey. Self-reported tobacco use, sociodemographic, and cancer-related risk factors were analyzed. Siblings were equally likely to have ever smoked compared to their peers (odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.12). Siblings were less likely to be current smokers (OR 0.83, 95%CI 0.73-0.94), but more likely to be former smokers (OR 1.21, 95%CI 1.08-1.35). Siblings with low education were more likely to ever smoke (OR 1.51, 95%CI 1.15-2.00) and be current smokers (OR 1.67, 95%CI 1.24-2.26) compared to their peers. Among siblings, risk factors for current tobacco use included the following: low income Siblings of survivors take up smoking at similar rates to their peers, but are more likely to quit. Efforts are needed to address disparities by providing greater psychosocial support and education for the lowest socioeconomic status families facing childhood cancer. © 2015 Wiley Periodicals, Inc.

  8. Thyroid abnormalities in survivors of childhood cancer.

    Science.gov (United States)

    Çağlar, Ayla Akca; Oğuz, Aynur; Pınarlı, Faruk Güçlü; Karadeniz, Ceyda; Okur, Arzu; Bideci, Aysun; Koçak, Ülker; Bora, Hüseyin

    2014-09-01

    To investigate the late side effects of childhood cancer therapy on the thyroid gland and to determine the risk factors for development of thyroid disorder among childhood cancer survivors. One hundred and twenty relapse-free survivors of childhood cancer (aged 6-30 years) were included in this study. The diagnoses of patients were lymphoma, leukemia, brain tumor, rhabdomyosarcoma and nasopharyngeal carcinoma (NPC). The patients were divided into two groups depending on the treatment: group 1-chemotherapy (ChT) only (n=52) and group 2-combination therapy of ChT + radiotherapy (RT) (head/neck/thorax) (n=68). Thyroid function tests, urinary iodine levels, and thyroid gland ultrasound examinations were evaluated in both groups. Incidence of thyroid disease was 66% (n=79) in the survivors. The thyroid abnormalities were: hypothyroidism (HT) (n=32, 27%), thyroid nodules (n=27, 22%), thyroid parenchymal heterogeneity (n=40, 33%), autoimmune thyroiditis (n=36, 30%), and thyroid malignancy (n=3, 2%). While the incidence of HT and thyroid nodules in group 2 was significantly higher than in group 1, the incidence of thyroid parenchymal heterogeneity and autoimmune thyroiditis was similar in the two patient groups. HT and thyroid malignancy were seen only in group 2. In multivariate logistic regression analysis, a history of Hodgkin lymphoma (HL), brain tumor and NPC, as well as cervical irradiation and 5000-5999 cGy doses of radiation were found to constitute risk factors for HT. History of HL and 4000-5999 cGy doses of radiation were risk factors for thyroid nodules. Head/neck irradiation and treatment with platinum derivatives were risk factors for autoimmune thyroiditis. In univariate analysis, a history of NPC, cervical + nasopharyngeal irradiation, and treatment with platinum derivatives were risk factors for thyroid parenchymal heterogeneity. Our results indicate that there is especially an increased risk of HT and thyroid nodules in patients treated with combination

  9. Cancer Survivors: The Success Story That's Straining Health Care.

    Science.gov (United States)

    Allen, Summer E

    2017-01-01

    Since President Richard Nixon declared a "War on Cancer" in 1971, the number of cancer survivors in the United States has quadrupled [1] and is still rising. Thanks to advance in cancer detection and treatment, the almost 15 million cancer survivors in the United States today could grow to some 19 million by 2024 [2]. Increasing survival rates have resulted in a shift: cancer is often treated as a chronic illness rather than a death sentence. However, having so many cancer survivors to monitor, track, and treat has led to growing pains for healthcare providers-forcing them to develop new ways to treat this increasing yet still vulnerable population.

  10. Noncancer-related mortality risks in adult survivors of pediatric malignancies: the childhood cancer survivor study.

    Science.gov (United States)

    Cox, Cheryl L; Nolan, Vikki G; Leisenring, Wendy; Yasui, Yutaka; Ogg, Susan W; Mertens, Ann C; Neglia, Joseph P; Ness, Kirsten K; Armstrong, Gregory T; Robison, Les L

    2014-09-01

    We sought to identify factors, other than cancer-related treatment and presence/severity of chronic health conditions, which may be associated with late mortality risk among adult survivors of pediatric malignancies. Using the Childhood Cancer Survivor Study cohort and a case-control design, 445 participants who died from causes other than cancer recurrence/progression or non-health-related events were compared with 7,162 surviving participants matched for primary diagnosis, age at baseline questionnaire, time from diagnosis to baseline questionnaire, and time at-risk. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for overall/cause-specific mortality. Independent measures included number/severity of chronic conditions, medical care, health-related behaviors, and health perceptions/concerns. Adjusting for education, income, chemotherapy/radiation exposures, and number/severity of chronic health conditions, an increased risk for all-cause mortality was associated with exercising fewer than 3 days/week (OR = 1.72, CI 1.27-2.34), being underweight (OR = 2.58, CI 1.55-4.28), increased medical care utilization (P cancer treatment and chronic health conditions modify the risk of death among adult survivors of pediatric cancer. Continued cohort observation may inform interventions to reduce mortality.

  11. Predictors of attendance at specialized survivor clinics in a population-based cohort of adult survivors of childhood cancer.

    Science.gov (United States)

    Nathan, Paul C; Agha, Mohammad; Pole, Jason D; Hodgson, David; Guttmann, Astrid; Sutradhar, Rinku; Greenberg, Mark L

    2016-08-01

    The purpose of the present study is to determine predictors of attendance at a network of publicly funded specialized survivor clinics by a population-based cohort of adult survivors of childhood cancer. We conducted a retrospective study linking data on eligible patients identified in a provincial pediatric cancer registry with health administrative databases to determine attendance at five specialized survivor clinics in the Canadian province of Ontario between 1999 and 2012. Eligible survivors were treated for cancer at ≤18 years between 1986 and 2005, had survived ≥5 years from their most recent pediatric cancer event, and contributed ≥1 year of follow-up after age 18 years. We assessed the impact of cancer type, treatment intensity, cumulative chemotherapy doses, radiation, socioeconomic status, distance to nearest clinic, and care from a primary care physician (PCP) on attendance using recurrent event multivariable regression. Of 7482 children and adolescents treated for cancer over the study period, 3972 were eligible for study inclusion, of which 3912 successfully linked to administrative health data. After a median of 7.8 years (range 0.2-14.0) of follow-up, 1695/3912 (43.3 %) had attended at least one adult survivor clinic visit. Significantly increased rates of attendance were associated with female gender, higher treatment intensity, radiation, higher alkylating agent exposure, higher socioeconomic status, and an annual exam by a PCP. Distance significantly impacted attendance with survivors living >50 km away less likely to attend than those living within 10 km (relative rate 0.77, p = 0.003). Despite free access to survivor clinics, the majority of adult survivors of childhood cancer do not attend. Alternate models of care need to be developed and assessed, particularly for survivors living far from a specialized clinic and those at lower risk of developing late effects.

  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

    2014-09-01

    The purpose of this study was to assess the prevalence of male infertility and treatment-related risk factors in childhood cancer survivors. Within the Childhood Cancer Survivor Study, 1,622 survivors and 274 siblings completed the Male Health Questionnaire. The analysis was restricted to survivors (938/1,622; 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. 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 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 (AAD) score ≥3 (RR = 2.13, 95 % CI 1.69-2.68 for AAD ≥3 versus AAD 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. Though infertility is common, male survivors reporting infertility often father their own children. Bleomycin may pose some fertility risk.

  13. Survivors speak: a qualitative analysis of motivational factors influencing breast cancer survivors' participation in a sprint distance triathlon.

    Science.gov (United States)

    Robinson, Karen M; Piacentine, Linda B; Waltke, Leslie J; Ng, Alexander V; Tjoe, Judy A

    2016-01-01

    To examine motivational factors influencing breast cancer survivors to participate in triathlon training, complete a triathlon and maintain an exercise thereafter. Routine exercise has been shown to improve quality of life and reduce recurrence for breast cancer survivors. Yet physical and psychological factors present barriers for initiating and maintaining an exercise routine. Research is limited in exploring factors of exercise motivation from the survivor's perspective. Qualitative design using focus groups and individual follow-up phone interviews to explore motivation for exercise initiation and maintenance. One to two weeks after completing a triathlon, 11 breast cancer survivors who trained together participated in one of three focus groups to discuss their experience. Five months post triathlon 6 of the 11 participants were successfully contacted and phone interviews were conducted to explore exercise maintenance. Focus groups and interviews were analysed using content and thematic analysis. Five themes emerged (1) Champion for Exercise, (2) Part of a Team, (3) Everyone Had a Story, (4) Not Really Exercise and (5) What Do We Do Now? Overall, survivors recognised their need for lifestyle change (e.g. moving from a sedentary lifestyle to a more active one). More importantly, they identified the team approach to exercise initiation was crucial in their success in sustaining a behavioural change. Emphasis needed on developing team exercise training programmes for survivors. Nurses can play a critical role in discussing with survivors, the benefits of exercise initiation and maintenance. Breast cancer survivors are hesitant to initiate routine exercise. Training with women who share a common lived experience increases the likelihood of success. Nurses are in a position to encourage breast cancer survivors to participate in group exercise programmes as a way to improve quality of life. © 2015 John Wiley & Sons Ltd.

  14. 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.

  15. Resilience in Elderly Survivors of Child Maltreatment

    Directory of Open Access Journals (Sweden)

    Danielle Rodin

    2012-06-01

    Full Text Available Resilience is a multifaceted construct that refers to the positive adaptation of individuals, despite exposure to adversity. This study of resilience in older individuals who have experienced adversity was conducted to deepen the understanding of the factors that contribute to resilience in this population. This qualitative study used purposive and homogeneous sampling criteria to recruit nine participants above the age of 65 with a past history of childhood maltreatment who were judged by their health care professionals to be unusually resilient. Resilience was found to be highly evident in this sample, despite earlier trauma and the subsequent challenges of old age. The authors found active engagement in relationships and in valued activities to be the most often mentioned contributors to resilience in these older survivors of childhood maltreatment. These findings have important implications for public policy and social interventions to preserve the well-being of older individuals who have experienced adversity.

  16. "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 ...

  17. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2006-01-01

    The goals of this project were: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  18. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2004-01-01

    The goals of this project are: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  19. 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.

  20. Correlates of Return to Work for Breast Cancer Survivors

    National Research Council Canada - National Science Library

    Reynard R. Bouknight; Cathy J. Bradley; Zhehui Luo

    2006-01-01

    To identify correlates of return to work for employed breast cancer survivors. Patients included 416 employed women with newly diagnosed breast cancer identified from the Metropolitan Detroit Cancer Surveillance System...

  1. Attentional bias to violent images in survivors of dating violence.

    Science.gov (United States)

    Lee, Jeong-Ha; Lee, Jang-Han

    2012-01-01

    This study investigated the time-course characteristics of attentional bias, such as vigilance and maintenance, towards violent stimuli in dating violence (DV) survivors. DV survivors with PTSD symptoms (DV-PTSD group; n=14), DV survivors without PTSD symptoms (Trauma Control group; n=14), and individuals who were never exposed to dating violence (NDV group; n=15) viewed slides that presented four categories of images (violent, dysphoric, positive, and neutral) per slide, for ten seconds. Our results revealed that the DV-PTSD group spent more time on violent stimuli than did the Trauma Control or NDV groups. The DV survivors, both with and without PTSD symptoms, spent more time on dysphoric stimuli and less time on happy stimuli than did the NDV group. In addition to the effects of PTSD, researchers should also be considering the effects of simple traumatic exposure.

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

    Science.gov (United States)

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

    2017-04-01

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

  3. Cardiovascular Effects in Childhood Cancer Survivors Treated with Anthracyclines

    Directory of Open Access Journals (Sweden)

    Vivian I. Franco

    2011-01-01

    Full Text Available Anthracyclines are commonly used to treat childhood leukemias and lymphomas, as well as other malignancies, leading to a growing population of long-term childhood cancer survivors. However, their use is limited by cardiotoxicity, increasing survivors' vulnerability to treatment-related complications that can markedly affect their quality of life. Survivors are more likely to suffer from heart failure, coronary artery disease, and cerebrovascular accidents compared to the general population. The specific mechanisms of anthracycline cardiotoxicity are complex and remain unclear. Hence, determining the factors that may increase susceptibility to cardiotoxicity is of great importance, as is monitoring patients during and after treatment. Additionally, treatment and prevention options, such as limiting cumulative dosage, liposomal anthracyclines, and dexrazoxane, continue to be explored. Here, we review the cardiovascular complications associated with the use of anthracyclines in treating malignancies in children and discuss methods for preventing, screening, and treating such complications in childhood cancer survivors.

  4. Chromosomal Abnormalities in Offspring of Young Cancer Survivors

    DEFF Research Database (Denmark)

    Nielsen, Betina Frydenlund; Schmidt, Anne Aarslev; Mulvihill, John J

    2018-01-01

    Danish cancer survivors and 40 859 offspring (40 794 live-born children and 65 fetuses) of 19 536 siblings. Chromosomal abnormalities include numeric and structural abnormalities. Odds ratios were estimated by multiple logistic regression models comparing the risk of chromosomal abnormalities among...... compared with their siblings' offspring (odds ratio = 0.99, 95% confidence interval = 0.67 to 1.44, two-sided P = .94), with similar risk between male and female survivors. Cancer survivors were not more likely than their siblings to have children with a chromosomal abnormality.......To examine whether cancer survivors diagnosed before age 35 years are more likely to have offspring with chromosomal abnormalities than their siblings, chromosomal abnormalities were determined in a population-based cohort of 14 611 offspring (14 580 live-born children and 31 fetuses) of 8945...

  5. What Prostate Cancer Survivors Need to Know about Osteoporosis

    Science.gov (United States)

    ... What Prostate Cancer Survivors Need to Know About Osteoporosis The Impact of Prostate Cancer The National Cancer ... Management Strategies Resources For Your Information Facts About Osteoporosis Osteoporosis is a condition in which bones become ...

  6. Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors

    DEFF Research Database (Denmark)

    Handberg, Charlotte; Midtgaard, Julie; Nielsen, Claus Vinther

    2017-01-01

    Purpose: The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Design: Ethnographic fieldwork was conducted, consisting of participant...

  7. Restoring rape survivors: justice, advocacy, and a call to action.

    Science.gov (United States)

    Koss, Mary P

    2006-11-01

    Rape results in mental and physical health, social, and legal consequences. For the latter, restorative justice-based programs might augment community response, but they generate controversy among advocates and policy makers. This article identifies survivors' needs and existing community responses to them. Survivors feel their legal needs are most poorly met due to justice system problems that can be summarized as attrition, retraumatization, and disparate treatment across gender, class, and ethnic lines. Empirical data support each problem and the conclusion that present justice options are inadequate. The article concludes by identifying common ground in advocacy and restorative justice goals and calls for a holistic approach to the needs of rape survivors that includes advocating for expanded justice alternatives. A call to action is issued to implement restorative alternatives to expand survivor choice and offender accountability. Conventional and restorative justice are often viewed as mutually exclusive whereas the author argues they are complementary.

  8. Family function and health behaviours of stroke survivors

    Directory of Open Access Journals (Sweden)

    Si-Si Jiang

    2014-09-01

    Conclusions: Family function and health behaviours in stroke survivors are related, and need further improvement. Healthcare workers should pay close attention to patients' family function and health behaviours and find the reasons which may be influence their level.

  9. Relationships and Recovery for Young Adult Lymphoma Survivors

    Science.gov (United States)

    ... Donate Donate Now Fundraise for LRF Planned Giving Relationships and Recovery for Young Adult Lymphoma Survivors By ... like this? The simple answer is with: "I love you..." and then go from there; because if ...

  10. Cancer Survivors: Managing Your Emotions After Cancer Treatment

    Science.gov (United States)

    ... self-conscious about your body. Changes in skin color, weight gain or loss, the loss of a ... other cancer survivors who are having the same emotions you are. Contact your local chapter of the ...

  11. Class, race and ethnicity and information avoidance among cancer survivors

    OpenAIRE

    McCloud, R F; Jung, M.; Gray, S W; Viswanath, K.

    2013-01-01

    Background: Information seeking may increase cancer survivors' ability to make decisions and cope with the disease, but many also avoid cancer information after diagnosis. The social determinants and subsequent communication barriers that lead to avoidance have not been explored. The purpose of this study is to examine the influence of social determinants on information avoidance among cancer survivors. Methods: We examined how health information avoidance is associated with structural and in...

  12. Interact: A Mixed Reality Virtual Survivor for Holocaust Testimonies

    OpenAIRE

    Ma, Minhua; Coward, Sarah; Walker, Chris

    2015-01-01

    In this paper we present Interact---a mixed reality virtual survivor for Holocaust education. It was created to preserve the powerful and engaging experience of listening to, and interacting with, Holocaust survivors, allowing future generations of audience access to their unique stories. Interact demonstrates how advanced filming techniques, 3D graphics and natural language processing can be integrated and applied to specially-recorded testimonies to enable users to ask questions and receive...

  13. Marriage and divorce among young adult cancer survivors.

    Science.gov (United States)

    Kirchhoff, Anne C; Yi, Jaehee; Wright, Jennifer; Warner, Echo L; Smith, Ken R

    2012-12-01

    We examined marital outcomes among cancer survivors diagnosed during early adulthood from the 2009 Behavioral Risk Factor Surveillance System dataset. Eligible participants were ages 20-39 years. Of the 74,433 eligible, N = 1,198 self-reported a cancer diagnosis between the ages of 18 and 37, were ≥2 years past diagnosis, and did not have non-melanoma skin cancer. The remaining N = 67,063 were controls. Using generalized linear models adjusted for age, gender, race, and education, we generated relative risks (RR) and 95 % confidence intervals (95 % CI) to examine survivor status on indicators of ever married, currently married, and divorced/separated. Survivors were slightly older than controls [33.0 (SD = 3.8) vs. 30.0 (SD = 4.0); p divorce/separation than controls (18 % vs. 10 %; RR = 1.77, 95 % CI 1.43-2.19). Divorce/separation risk persisted for female survivors (RR 1.83, 95 % CI 1.49-2.25), survivors ages 20-29 (RR 2.57, 95 % CI 1.53-4.34), and survivors ages 30-39 (RR 1.62, 95 % CI 1.29-2.04). The emotional and financial burdens of cancer may lead to marital stress for younger cancer survivors. Young survivors may face a higher risk of divorce; support systems are needed to assist them in the years following diagnosis.

  14. Sexual Function in Cervical Cancer Survivors after Concurrent Chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Dhiraj Daga

    2017-07-01

    Full Text Available Background: This study evaluated sexual function in cervical cancer survivors after concurrent chemoradiotherapy. Methods: Study participants comprised survivors of locally advanced cervical cancer (stages IIB-IVA who completed concurrent chemoradiotherapy along with intracavitary brachytherapy at least two years prior at Dr S.N.Medical College, Jodhpur, Rajasthan, India. We used the Female Sexual Function Index questionnaire to assess sexual function. The cut-off score of the Female Sexual Function Index that identified female sexual arousal disorder was 26.55. A score less than 26.55 indicated the presence of female sexual arousal disorder. Results:A total of 48 locally advanced cervical cancer survivors enrolled in the study. Survivors had a mean age of 46.5 years. All received chemoradiotherapy along with intracavitary brachytherapy. The average time for treatment was 53.5 days. Patients had an average score for sexual desire of 2, 2.3 for arousal, 2.3 for sexual satisfaction, and 2.1 for pain during intercourse. The overall average score was 11.84 (range: 3.2-19.5 with a cut-off of 26.55. All survivors suffered from female sexual arousal disorder. Conclusion: Cervical cancer survivors had decreased sexual function which indicated female sexual arousal disorder. Patient education and active treatment of complications related to cancer treatments is a must for improvement of sexual function among survivors. Long-term complications should be considered in terms of treatment planning and follow-up treatment to improve the quality of life of cancer survivors.

  15. Assessing Walking Strategies Using Insole Pressure Sensors for Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Mario Munoz-Organero

    2016-10-01

    Full Text Available Insole pressure sensors capture the different forces exercised over the different parts of the sole when performing tasks standing up such as walking. Using data analysis and machine learning techniques, common patterns and strategies from different users to achieve different tasks can be automatically extracted. In this paper, we present the results obtained for the automatic detection of different strategies used by stroke survivors when walking as integrated into an Information Communication Technology (ICT enhanced Personalised Self-Management Rehabilitation System (PSMrS for stroke rehabilitation. Fourteen stroke survivors and 10 healthy controls have participated in the experiment by walking six times a distance from chair to chair of approximately 10 m long. The Rivermead Mobility Index was used to assess the functional ability of each individual in the stroke survivor group. Several walking strategies are studied based on data gathered from insole pressure sensors and patterns found in stroke survivor patients are compared with average patterns found in healthy control users. A mechanism to automatically estimate a mobility index based on the similarity of the pressure patterns to a stereotyped stride is also used. Both data gathered from stroke survivors and healthy controls are used to evaluate the proposed mechanisms. The output of trained algorithms is applied to the PSMrS system to provide feedback on gait quality enabling stroke survivors to self-manage their rehabilitation.

  16. Cancer survivors' experiences of discharge from hospital follow-up.

    Science.gov (United States)

    Harrison, S E; Watson, E K; Ward, A M; Khan, N F; Turner, D; Adams, E; Forman, D; Roche, M F; Rose, P W

    2012-05-01

    Discharge from hospital follow-up is a key time point in the cancer journey. With recommendations for earlier discharge of cancer survivors, attention to the discharge process is likely to become increasingly important. This study explored cancer survivors' experiences of discharge from hospital follow-up. Survivors of breast, colorectal and prostate cancer (n= 1275), 5-16 years post diagnosis were approached to take part in a questionnaire survey. The questionnaire included questions about discharge status, provision of time/information prior to discharge, feelings at discharge and satisfaction with how discharge was managed. Completed questionnaires were returned by 659 survivors (51.7%). Approximately one-third of respondents were not discharged from follow-up 5-16 years post diagnosis. Of those discharged, a substantial minority reported insufficient time (27.9%), information (24.5-45.0%) or adverse emotions (30.9%) at the time of discharge. However, 90.6% of respondents reported satisfaction with how discharge from hospital follow-up was managed. Despite high levels of satisfaction, discharge of cancer survivors from hospital follow-up could be improved with the provision of additional time, information and support. Better structuring of the final hospital appointment or a review appointment in primary care at this time could help to ensure that discharge from hospital follow-up is managed optimally for cancer survivors. © 2011 Blackwell Publishing Ltd.

  17. Surveillance and Care of the Gynecologic Cancer Survivor.

    Science.gov (United States)

    Faubion, Stephanie S; MacLaughlin, Kathy L; Long, Margaret E; Pruthi, Sandhya; Casey, Petra M

    2015-11-01

    Care of the gynecologic cancer survivor extends beyond cancer treatment to encompass promotion of sexual, cardiovascular, bone, and brain health; management of fertility, contraception, and vasomotor symptoms; and genetic counseling. This is a narrative review of the data and guidelines regarding care and surveillance of the gynecologic cancer survivor. We searched databases including PubMed, Cochrane, and Scopus using the search terms gynecologic cancer, cancer surveillance, and cancer survivor and reached a consensus for articles chosen for inclusion in the review based on availability in the English language and publication since 2001, as well as key older articles, consensus statements, and practice guidelines from professional societies. However, we did not undertake an extensive systematic search of the literature to identify all potentially relevant studies, nor did we utilize statistical methods to summarize data. We offer clinical recommendations for the management of gynecologic cancer survivors based on review of evidence and our collective clinical experience. Key messages include the limitations of laboratory studies, including CA-125, and imaging in the setting of gynecologic cancer surveillance, hormonal and non-hormonal management of treatment-related vasomotor symptoms and genitourinary syndrome of menopause, as well as recommendations for general health screening, fertility preservation, and contraception. A holistic approach to care extending beyond cancer treatment alone benefits gynecologic cancer survivors. In addition to surveillance for cancer recurrence and late treatment side effects, survivors benefit from guidance on hormonal, contraceptive, and fertility management and promotion of cardiovascular, bone, brain, and sexual health.

  18. Infertility Education: Experiences and Preferences of Childhood Cancer Survivors.

    Science.gov (United States)

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

    2016-07-01

    The majority of children diagnosed with cancer will become long-term survivors; however, many will suffer late effects of treatment, including infertility. Educating patients about potential risk for infertility is important, yet little is known regarding when patients would like to hear this information. The purpose of this study was to assess young adult survivors' previous experience in receiving education about their risk for infertility and determine their preferences for infertility education at various time points during and after treatment. Only 36% of survivors report receiving education about risk for infertility at diagnosis, 39% at end of therapy, and 72% in long-term follow-up/survivor clinic visits. Survivors consistently identified their oncologist as a preferred educator at each time point. Although almost all participants identified wanting education at diagnosis, this time point alone may not be sufficient. End of therapy and survivorship may be times this message should be repeated and adapted for the survivor's needs and developmental stage: conversations about the impact of cancer treatment on future fertility should be ongoing. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  19. Objectively assessed physical activity levels in Spanish cancer survivors.

    Science.gov (United States)

    Ruiz-Casado, Ana; Verdugo, Ana Soria; Solano, María J Ortega; Aldazabal, Itziar Pagola; Fiuza-Luces, Carmen; Alejo, Lidia Brea; del Hierro, Julio R Padilla; Palomo, Isabel; Aguado-Arroyo, Oscar; Garatachea, Nuria; Cebolla, Héctor; Lucia, Alejandro

    2014-01-01

    To objectively assess physical activity (PA) levels in a cohort of Spanish cancer survivors. Descriptive, cross-sectional. The Hospital Universitario de Fuenlabrada and two healthcare centers in Madrid, Spain. 204 cancer survivors and 115 adults with no history of cancer. Participants wore a triaxial accelerometer for seven or more consecutive days to assess PA levels. Body mass index (BMI), indirect indicators of adiposity (waist circumference, waist-to-hip ratio), and cardiorespiratory fitness also were determined. Light, moderate, vigorous, and total PA (sum of the former). Most (94%) of the cancer survivors met international recommendations for moderate PA, but very few (3%) fulfilled those (75 minutes or more per week) for vigorous PA. Except for lower total (minute per day, p=0.048) and vigorous PA levels (p0.05). A high percentage of the survivors (33%) were obese (BMI greater than 30 kg/m2), and many also showed poor cardiorespiratory fitness (45% were below the 8 metabolic equivalent threshold). Although cancer survivors overall met international PA recommendations for a healthy lifestyle, their BMI and cardiorespiratory profiles were not within the healthy range. Cancer survivors need to be informed about healthy lifestyle habits and should be regularly monitored.

  20. Home-Based Psychoeducational Intervention for Breast Cancer Survivors.

    Science.gov (United States)

    Şengün İnan, Figen; Üstün, Besti

    2017-03-15

    It is important to manage psychological distress and improve the quality of life (QOL) in patients after breast cancer treatment. The aim of this study was to evaluate the effects of a home-based, psychoeducational program on distress, anxiety, depression, and QOL in breast cancer survivors. The study was a single-group pretest and posttest quasi-experimental design. The data were collected using the Distress Thermometer, the Hospital Anxiety and Depression Scale, and the Turkish version of the World Health Organization Quality of Life Instrument, short form. The home-based, individual, face-to-face psychoeducational program was structured according to breast cancer survivors' needs and the Neuman Systems Model. A total of 32 Turkish breast cancer survivors participated in this study. There were statistically significant differences in the mean scores for distress, anxiety, and depression in the breast cancer survivors over 4 measurements. The mean scores for all subscales of the QOL at 6 months postintervention were significantly higher than the mean scores at baseline. The results indicated that the psychoeducational program may be effective in reducing distress, anxiety, and depression and in improving the QOL in breast cancer survivors. Psychoeducational programs may be effective and should be considered as part of the survivorship care for breast cancer survivors.

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

    Science.gov (United States)

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

    2012-11-01

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

  2. Social, demographic, and medical influences on physical activity in child and adolescent cancer survivors.

    Science.gov (United States)

    Gilliam, Margaux B; Madan-Swain, Avi; Whelan, Kimberly; Tucker, Diane C; Demark-Wahnefried, Wendy; Schwebel, David C

    2012-03-01

    This study evaluated associations between social, environmental, demographic, and medical predictors, and child and adolescent survivors' physical activity (PA). A structured telephone survey was conducted with 105 caregiver-survivor (aged 8-16 years) pairs and 36 caregivers of younger survivors (aged 6-7 years) alone. Participants completed measures assessing survivor PA and proposed predictors of PA including demographic, medical, social, and environmental influences. Social influences, including family PA, family support for PA, and peer support for PA, emerged as unique predictors of survivor PA. These variables predicted PA after controlling for demographic and medical factors. Child survivors' PA was more strongly predicted by family influences while adolescent survivors' PA was more strongly influenced by family and peer influences. Child and adolescent survivors' PA is strongly influenced by social factors. This finding parallels results with healthy children. PA interventions should focus on family and peer support to increase survivors' PA behaviors.

  3. Psychosexual development and satisfaction in long-term survivors of childhood cancer : Neurotoxic treatment intensity as a risk indicator

    NARCIS (Netherlands)

    Lehmann, Vicky; Tuinman, Marrit; Keim, Madelaine C.; Winning, Adrien M.; Olshefski, Randal S.; Bajwa, Rajinder P. S.; Hagedoorn, Mariet; Gerhardt, Cynthia A.

    2017-01-01

    BACKGROUNDRisk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at-risk survivors can be identified by 1)

  4. Searching for maintenance in exercise interventions for cancer survivors.

    Science.gov (United States)

    Jankowski, Catherine M; Ory, Marcia G; Friedman, Daniela B; Dwyer, Andrea; Birken, Sarah A; Risendal, Betsy

    2014-12-01

    Translating evidence-based exercise interventions into practice is important for expanding the capacity to support cancer survivors. Using the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework and scoping study methodology, we addressed the research question, "What is known about the maintenance of exercise interventions for cancer survivors that would inform translation from research to practice and community settings?" Maintenance was investigated at the individual and setting level. Literature searches were performed in the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Sport Discus databases for articles published from January 2009 to June 2012. Abstracts were judged using a priori criteria for the survivor population, exercise intervention, and maintenance on the individual or setting level. We included completed and planned randomized controlled trials (RCTs) and other study designs. Publications meeting the criteria were reviewed and coded. Of the 211 abstracts meeting patient and exercise criteria, 24 (19 RCTs) met the maintenance criteria. Nine of the 12 completed RCTs demonstrated maintenance of intervention outcomes after 3 to 14 months of follow-up. The planned RCTs described interventions lasting 2 to 4.5 months and maintenance intervals lasting 3 to 12 months following the active intervention. Maintenance at the setting level was reported in one publication. On the individual level, intervention outcomes were maintained in most studies, in a variety of settings and survivor subpopulations. Maintenance on the setting level was scarcely addressed. This scoping study suggests several strategies that could be taken by agencies, clinicians, and researchers to develop more effective and sustainable exercise programs for cancer survivors. Many benefits of exercise training are maintained for months after cancer survivors complete controlled research studies but relatively little is

  5. Exploration of Exercise Outcome Expectations Among Breast Cancer Survivors.

    Science.gov (United States)

    Hirschey, Rachel; Docherty, Sharron L; Pan, Wei; Lipkus, Isaac

    Exercise is associated with decreased recurrence risk and improved survival and quality of life for breast cancer survivors. However, only an estimated 17% to 37% of survivors adhere to the American Cancer Society exercise guidelines. A critical first step to increase exercise among survivors is to understand how they believe exercise will affect them. The aim of this study is to explore common exercise outcome expectations among 20 female survivors of stage IA to IIB breast cancer who completed adjuvant treatment and an exercise intervention. A mixed-method descriptive study consisting of semistructured telephone interviews assessed exercise outcome expectations and how the experience of cancer and its treatment influenced the expected outcomes of exercise. The qualitative data were analyzed using a summative content analysis procedure; means were calculated for each item of the exercise outcome questionnaire. The qualitative and quantitative data were compared and contrasted. The sample was 70% white and 30% African American, with a mean (SD) age of 62 (8.5) years, and mean (SD) time since treatment completion of 4.2 (1.3) years. Three themes emerged from the interviews: (1) prevalence of common expectations, (2) pervasive impact of fatigue, and (3) a brighter future. Overall, findings revealed that breast cancer survivors have low levels of agreement that exercise may mitigate late and long-term cancer and treatment effects. In general, breast cancer survivors (even those who are motivated to exercise) do not hold strong beliefs that exercise will decrease late and long-term treatment effects. Clinicians can educate survivors about exercise benefits.

  6. 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.

  7. Emotional distress among adult survivors of childhood cancer.

    Science.gov (United States)

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

    2014-06-01

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

  8. Fear of cancer recurrence in prostate cancer survivors.

    Science.gov (United States)

    van de Wal, Marieke; van Oort, Inge; Schouten, Joost; Thewes, Belinda; Gielissen, Marieke; Prins, Judith

    2016-07-01

    Background High fear of cancer recurrence (FCR) is an understudied topic in prostate cancer (PCa) survivors. This study aimed to detect the prevalence, consequences and characteristics associated with high FCR in PCa survivors. Material and methods This cross-sectional study included patients diagnosed with localized PCa and treated with curative radical prostatectomy between 1992 and 2012. We administered the Cancer Worry Scale (CWS) to assess FCR severity (primary outcome measure). Secondary outcomes included distress, quality of life (QOL), post-traumatic symptoms, and multidimensional aspects of FCR. χ(2)-tests, t-tests and Pearson's correlations examined the relationship between FCR and medical/demographic characteristics. MANOVA analyses and χ2-tests identified differences between PCa survivors with high and low FCR. Results Two hundred eighty-three PCa survivors (median age of 70.0 years) completed the questionnaires a median time of 7.1 years after surgery. About a third (36%) of all PCa survivors experienced high FCR. High FCR was associated with lower QOL, more physical problems, higher distress and more post-traumatic stress symptoms. PCa survivors with high FCR reported disease-related triggers (especially medical examinations), felt helpless and experienced problems in social relationships. High FCR was associated with a younger age and having received adjuvant radiotherapy. Conclusions Results illustrate that FCR is a significant problem in PCa survivors. Younger men and those treated with adjuvant radiotherapy are especially at risk. Those with high FCR experience worse QOL and higher symptom burden. Health care providers should pay specific attention to this problem and provide appropriate psychosocial care when needed.

  9. Yield of Urinalysis Screening in Pediatric Cancer Survivors.

    Science.gov (United States)

    Ramirez, Matthew D; Mertens, Ann C; Esiashvili, Natia; Meacham, Lillian R; Wasilewski-Masker, Karen

    2016-05-01

    The Children's Oncology Group (COG) publishes consensus guidelines with screening recommendations for early identification of treatment-related morbidities among childhood cancer survivors. We sought to estimate the yield of recommended yearly urinalysis screening for genitourinary complications as per Version 3.0 of the COG Long-Term Follow-Up Guidelines and identify possible risk factors for abnormal screening in a survivor population. A database of pediatric cancer survivors evaluated between January 2008 and March 2012 at Children's Healthcare of Atlanta was queried for survivors at risk for genitourinary late effects. The frequency of abnormal urinalyses (protein ≥1+ and/or presence of glucose and/or ≥5 red blood cells per high power field) was estimated. Risk factors associated with abnormal screening were identified. Chart review identified 773 survivors (57% male; 67% Caucasian; 60% leukemia/lymphoma survivors; mean age at diagnosis, 5.7 years [range: birth to 17.7 years]; time from diagnosis to initial screening, 7.6 years [range: 2.3 to 21.5 years]) who underwent urinalysis. Abnormal results were found in 78 (5.3%) of 1,484 total urinalyses. Multivariable analysis revealed higher dose ifosfamide (odds ratio [OR] = 6.8, 95% confidence interval [CI] 2.9-16.0) and total body irradiation (TBI, OR = 3.0, 95% CI 1.0-8.4) as significant risk factors for abnormal initial urinalysis screening. Pediatric cancer survivors exposed to higher dose ifosfamide or TBI may be at higher risk of abnormal findings on urinalysis screening. Targeted screening of these higher risk patients should be considered. © 2016 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2017-02-01

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

  11. Concentration, working speed and memory: cognitive problems in young childhood cancer survivors and their siblings.

    Science.gov (United States)

    Wengenroth, L; Rueegg, C S; Michel, G; Gianinazzi, M E; Essig, S; von der Weid, N X; Grotzer, M; Kuehni, Claudia E

    2015-05-01

    Cognitive problems can have a negative effect on a person's education, but little is known about cognitive problems in young childhood cancer survivors (survivors). This study compared cognitive problems between survivors and their siblings, determined if cognitive problems decreased during recent treatment periods and identified characteristics associated with the presence of a cognitive problem in survivors. As part of the Swiss Childhood Cancer Survivor Study, a questionnaire was sent to all survivors, aged 8-20 years, registered in the Swiss Childhood Cancer Registry, diagnosed at age siblings. Multivariable logistic regression was used to identify characteristics associated with cognitive problems in survivors. Data from 840 survivors and 247 siblings were analyzed. More often than their siblings, survivors reported problems with concentration (12% vs. 6%; P = 0.020), slow working speed (20% vs. 8%; P = 0.001) or memory (33% vs. 15%; P siblings. Survivors of CNS tumors (OR = 2.82 compared to leukemia survivors, P < 0.001) and those who had received cranial irradiation (OR = 2.10, P = 0.010) were most severely affected. Childhood cancer survivors, even those treated recently (2001-2005), remain at risk to develop cognitive problems, suggesting a need to improve therapies. Survivors with cognitive problems should be given the opportunity to enter special education programs. © 2015 Wiley Periodicals, Inc.

  12. Does caregiver well-being predict stroke survivor depressive symptoms? A mediation analysis.

    Science.gov (United States)

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

    2013-01-01

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

  13. Hormone replacement therapy in cancer survivors.

    Science.gov (United States)

    Biglia, Nicoletta; Gadducci, Angelo; Ponzone, Riccardo; Roagna, Riccardo; Sismondi, Piero

    2004-08-20

    Thousands of women are treated each year for cancer; many of these are already in menopause, while other younger patients will go into early menopause due to surgery, or chemotherapy, or the need for radiotherapy to the pelvic region. In most cases the oncologist and the gynaecologist would advise these women against the use of HRT. The purpose of this paper is to review biological and clinical evidences in favour and against HRT use in the different tumours and to propose an algorithm that can help choosing the treatment for the single woman. We performed a systematic literature review through April 2002 concerning: (1) biological basis of hormonal modulation of tumour growth; (2) epidemiological data on the impact of HRT on different cancers risk in healthy women; (3) safety of HRT use in cancer survivors; (4) alternatives to HRT. With the exception of meningioma, breast and endometrial cancer, there is no biological evidence that HRT may increase recurrence risk. In women with previous breast and endometrial cancer HRT is potentially hazardous on a biological basis, even if published data do not show any worsening of prognosis. Even if a cautious approach to hormonal-dependent neoplasias is fully comprehensible and the available alternative treatment should be taken into greater consideration, the reticence to prescribe HRT in women previously treated for other non hormone-related tumours has neither a biological nor a clinical basis. An algorithm based on present knowledge is proposed.

  14. Weight Trajectories of Israeli Pediatric Cancer Survivors.

    Science.gov (United States)

    Stern, Marilyn; Bachar, Eytan; Ronen Ackerman, Eyal; Rancourt, Diana; Bonne, Omer; Weintraub, Michael

    2017-06-01

    Cross-national replication of the high rates of overweight/obesity among U.S. pediatric cancer survivors (PCS) is limited. Predictors of weight trajectories of Israeli PCS were examined from diagnosis and end of active cancer treatment to 3 years posttreatment. World Health Organization-derived body mass index (z-BMI) values were calculated at each time point from medical records of 135 Israeli PCS ( M diagnosis age = 11.4). A three-section piecewise multilevel model including age, ethnicity, gender, treatment length, and diagnosis as predictors was used to estimate z-BMI trajectories. Most participants remained at a healthy weight at all time points. Differing weight trajectories emerged for PCS diagnosed with lymphoma/leukemia versus other cancer diagnoses from diagnosis to end of treatment, but similar weight change patterns were observed posttreatment. Replication of U.S. PCS weight trajectories was not observed in Israeli PCS, suggesting the importance of exploring environmental risk factors contributing to obesity among PCS.

  15. Healthy Lifestyle Behaviors of Breast Cancer Survivors.

    Science.gov (United States)

    DeNysschen, Carol; Brown, Jean K; Baker, Mark; Wilding, Gregory; Tetewsky, Sheldon; Cho, Maria H; Dodd, Marylin J

    2015-10-01

    The purpose of this secondary analysis was to describe the extent to which women with breast cancer, who participated in a randomized control trial on exercise, adopted American Cancer Society (ACS) guidelines for healthy lifestyle behaviors. Women in the study exercised during cancer treatment and for 6 months after completion of treatment. The sample included 106 women, average age 50.7 years (SD = 9.6). Adherence to guidelines for 5 servings of fruits and vegetables ranged from 36% (n = 28) to 39% (n = 36). Adherence with alcohol consumption guidelines was 71% (n = 28) to 83% (n = 30). Adherence with meeting a healthy weight ranged from 52% (n = 33) to 61% (n = 31). Adherence with physical activity guidelines ranged from 13% (n = 30) to 31% (n = 35). Alcohol and healthy weight guidelines were followed by more than half of the participants, but physical activity and dietary guidelines were followed by far fewer women. Further prospective clinical studies are indicated to determine whether interventions are effective in producing a healthy lifestyle in cancer survivors. © The Author(s) 2014.

  16. Twenty-year survivors of kidney transplantation.

    LENUS (Irish Health Repository)

    Traynor, C

    2012-12-01

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

  17. 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.

  18. Radiation, atherosclerotic risk factors, and stroke risk in survivors of pediatric cancer: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Mueller, Sabine; Fullerton, Heather J; Stratton, Kayla; Leisenring, Wendy; Weathers, Rita E; Stovall, Marilyn; Armstrong, Gregory T; Goldsby, Robert E; Packer, Roger J; Sklar, Charles A; Bowers, Daniel C; Robison, Leslie L; Krull, Kevin R

    2013-07-15

    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. 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. 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). 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. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Benefits of Attending a Weekend Childhood Cancer Survivor Family Retreat.

    Science.gov (United States)

    Bashore, Lisa; Bender, Joyce

    2017-09-01

    To explore the long-term benefits to families of childhood cancer survivors who attended a weekend childhood cancer survivor family retreat. Descriptive-qualitative study including families who had attended the weekend retreat at least once but not in the past 12 months, and who attend a large pediatric hematology and oncology cancer survivorship program in Texas. A semistructured interview guide was used during three audio-taped focus groups to explore the benefits of having attended a weekend retreat. Descriptive qualitative analysis was used to analyze the focus groups' transcripts. Seven families participated in the focus groups, and the themes identified were reconnecting (with others or family), putting life in perspective, and changing outlook on life. Retreats offer families of cancer survivors opportunities to reconnect with others and their own family members in a therapeutic environment. These reconnections in a therapeutic environment enriched the families' positive outlooks on life and changed their perspectives. Families of childhood cancer survivors report a lack of support following the completion of therapy. Retreats in a nonclinical therapeutic setting optimize family-perceived support, relationship building, and reconnecting survivor families. © 2017 Sigma Theta Tau International.

  20. Pursuing Normality: Reflections on Cancer Survivorship Care of Lymphoma Survivors.

    Science.gov (United States)

    Madsen, Louise S; Handberg, Charlotte

    2018-01-16

    The present study explored the reflections on cancer survivorship care of lymphoma survivors in active treatment. Lymphoma survivors have survivorship care needs, yet their participation in cancer survivorship care programs is still reported as low. The aim of this study was to understand the reflections on cancer survivorship care of lymphoma survivors to aid the future planning of cancer survivorship care and overcome barriers to participation. Data were generated in a hematological ward during 4 months of ethnographic fieldwork, including participant observation and 46 semistructured interviews with 9 lymphoma survivors. Interpretive description methodology and social practice theory guided the analytical framework. "Pursuing normality" was an overall finding and was comprised of 2 overarching patterns, "future prospects" and "survivorship care perceptions," both implying an influence on whether to participate in cancer survivorship care programs. Because of "pursuing normality," 8 of 9 participants opted out of cancer survivorship care programming due to prospects of "being cured" and perceptions of cancer survivorship care as "a continuation of the disease." The findings add to our understanding of possible barriers for participation in cancer survivorship care and outline important aspects to account for in the practice of health professionals. The study findings may guide practice to establish a systematic approach for providing information to cancer survivors regarding the possible management of their symptoms and of the content and purpose of cancer survivorship care.

  1. 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. Copyright © 2014 International Society for Traumatic Stress Studies.

  2. [A childhood and adolescence cancer survivors' association: Les Aguerris].

    Science.gov (United States)

    Ly, Kai Yan; Vélius, Élodie; Pitot, Maxime; Rivieri, Lionel; Dupont, Morvan

    2015-01-01

    In France, we can estimate that 50,000 adults are childhood or adolescence cancer survivors. Not all of them will experience late effects but they should be informed about their previous disease and should get a detailed summary of treatment information including a personal plan for late effects screening. They also should have access to appropriate follow-up care including detection and treatment of late effects and provision of support and advice. From a follow-up clinic experience, the need of a survivor association has emerged and "Les Aguerris" has been created with several objectives: to improve the quality of life of survivors providing them information about the possible physical, social and psychological consequences of childhood cancer, to raise awareness of public authorities and other actors on questions regarding the need of long-term follow-up of the patients in dedicated clinics, to support researches about late effects of cancer and treatments and to create a network of adult survivors of childhood cancer in relation with other European survivors or parents associations. This paper describes the activities of the association to fulfill its objectives and the annual national meetings they are organizing. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

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

    Science.gov (United States)

    Ding, Qinglan; Whittemore, Robin; Redeker, Nancy

    2016-07-01

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

  4. Class, race and ethnicity and information avoidance among cancer survivors.

    Science.gov (United States)

    McCloud, R F; Jung, M; Gray, S W; Viswanath, K

    2013-05-28

    Information seeking may increase cancer survivors' ability to make decisions and cope with the disease, but many also avoid cancer information after diagnosis. The social determinants and subsequent communication barriers that lead to avoidance have not been explored. The purpose of this study is to examine the influence of social determinants on information avoidance among cancer survivors. We examined how health information avoidance is associated with structural and individual factors in a mail-based survey of 519 cancer survivors. Factor analysis was conducted to determine barriers to obtaining cancer information, and multivariable logistic regression models by gender were run to analyze social determinants of avoidance from an intersectional approach. Participants who were younger, female, had greater debt and lower income, and had difficulty finding suitable information were more likely to avoid information. The probability of information avoidance increased when survivors reported barriers to information use or comprehension. These results indicate that survivors' information avoidance may be driven, in part, by social determinants, particularly among those at the intersection of multiple social status categories. Customized strategies are needed that maximize the likelihood that information will be used by vulnerable groups such as those from a lower socioeconomic position.

  5. Pain in Survivors of Pediatric Cancer: Applying a Prevention Framework.

    Science.gov (United States)

    Stone, Amanda L; Karlson, Cynthia W; Heathcote, Lauren C; Rosenberg, Abby R; Palermo, Tonya M

    2017-08-31

    To apply a biopsychosocial framework to understand factors influencing pain in survivors of pediatric cancer to inform pain prevention efforts and highlight the need for interdisciplinary care. This topical review draws from both pediatric cancer survivorship research and chronic noncancer pain research to illustrate how components of a preventative model can be applied to pain in survivorship. Pain is a common experience among long-term survivors of pediatric cancer. The pain experience in survivorship can be conceptualized in terms of biological disease and treatment factors, cognitive and affective factors, and social and contextual factors. We review literature pertinent to each of these biopsychosocial factors and tailor an existing public health prevention framework for pain in survivors of pediatric cancer. Classifying survivors of pediatric cancer into pain risk categories based on their daily experiences of pain, pain-related functional impairment, and distress could help guide the implementation of pain-related prevention and intervention strategies in this population. Future research is needed to establish the efficacy of screening measures to identify patients in need of psychosocial pain and pain-related fear management services, and interdisciplinary pediatric chronic pain management programs in survivors of pediatric cancer.

  6. Satisfaction of Nigerian stroke survivors with outpatient physiotherapy care.

    Science.gov (United States)

    Olaleye, Olubukola A; Hamzat, Talhatu K; Akinrinsade, Marvellous A

    2017-01-01

    To investigate the satisfaction of stroke survivors with outpatient physiotherapy care. Sixty stroke survivors were surveyed using the European Physiotherapy Treatment Outpatient Satisfaction Survey (EPTOPS). Focus group discussion (FGD) was also conducted with four stroke survivors from the same sample. Data were analyzed using the Kruskal Wallis test and Spearman's correlation coefficients at p = 0.05. FGD was transcribed and thematically analyzed. Nearly all the participants (98.3%) indicated one of good, very good, and excellent improvement in their clinical conditions with physiotherapy. Majority expressed satisfaction with their physiotherapy care, the modal response being very good (59.3%). Patients' satisfaction and socio-demographics were not significantly correlated (p > 0.05). Overarching themes from FGD were physiotherapy in stroke rehabilitation, satisfaction with physiotherapy care, cost, and lack of continuity of care as sources of dissatisfaction. Physiotherapists' demeanor was a facilitator of satisfaction. The stroke survivors were generally satisfied with outpatient physiotherapy care. However, lack of continuity and cost of care were sources of dissatisfaction among patients. Delivery of physiotherapy to stroke survivors in Nigeria should be structured to allow for continuity of care as this may enhance satisfaction. Implementation of inexpensive rehabilitation strategies may help reduce cost of physiotherapy.

  7. Perceived health benefits from yoga among breast cancer survivors.

    Science.gov (United States)

    Van Puymbroeck, Marieke; Burk, Brooke N; Shinew, Kimberly J; Cronan Kuhlenschmidt, Megan; Schmid, Arlene A

    2013-01-01

    The purpose of this paper is to describe the health benefits reported by breast cancer survivors following an 8-week yoga intervention. This phenomenological study employed three focus groups with six breast cancer survivors each (n = 18) following the yoga intervention. The focus groups and yoga classes were conducted in a large hospital in a midsized town in the Midwest. Eighteen female breast cancer survivors who were at least 9 months posttreatment participated in the focus groups following the 8-week yoga intervention. An 8-week yoga intervention designed specifically for this population was led by a yoga therapist. A semistructured interview guide was utilized to guide each focus group. Interpretative phenomenological analysis methods were employed to explore breast cancer survivors' experiences after participating in an 8-week yoga intervention. The findings revealed that the women in the study found health promoting benefits in the areas of physical health and healing, mental health and healing, and social health and healing. Yoga may be an important tool in the healing process for breast cancer survivors.

  8. Physical Activity in Child and Adolescent Cancer Survivors: A Review

    Science.gov (United States)

    Gilliam, Margaux B.; Schwebel, David C.

    2014-01-01

    Childhood cancer survivors are at increased risk for future health problems. As such, physical activity (PA) has been targeted as a health promotion priority in child and adolescent cancer survivors. Research indicates that a large portion of pediatric survivors do not meet PA recommendations. Using Bronfenbrenner’s ecological theory as a framework, this review presents a conceptual model to explain child and adolescent survivors’ PA. The model considers predictors of PA across six domains: (1) demographic; (2) medical; (3) cognitive/emotional; (4) behavioral; (5) social/cultural; and (6) environmental. A structured literature review found 14 empirical articles examining those predictors of PA among child and adolescent cancer survivors. Much existing research is cross-sectional, but suggests multiple factors work together to encourage or discourage PA among survivors of child/adolescent cancer. The conceptual model, which is based in empirical findings to date, can be used to understand the process through which PA is promoted and maintained, to inform the development of empirically-supported clinical interventions, and to guide future research objectives and priorities. PMID:25484907

  9. 75 FR 78806 - Agency Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Science.gov (United States)

    2010-12-16

    ... AFFAIRS Agency Information Collection (Residency Verification Report-- Veterans and Survivors) Activity.... 2900-0655.'' SUPPLEMENTARY INFORMATION: Title: Residency Verification Report--Veterans and Survivors... submit the collection of information abstracted below to the Office of Management and Budget (OMB) for...

  10. Anxiety and depression in working-age cancer survivors: a register-based study

    National Research Council Canada - National Science Library

    Laura Inhestern; Volker Beierlein; Johanna Christine Bultmann; Birgit Moller; Georg Romer; Uwe Koch; Corinna Bergelt

    2017-01-01

    Background Anxiety and depression can be a long-term strain in cancer survivors. Little is known about the emotional situation of cancer survivors who have to deal with work- and family-related issues...

  11. Transgenerational Effects of the Holocaust: Externalization of Aggression in Second Generation of Holocaust Survivors.

    Science.gov (United States)

    Nadler, Arie; And Others

    1985-01-01

    Interviewed 38 sons and daughters of holocaust survivors and 19 controls to evaluate their psychological characteristics. Results showed survivors' children were less likely than controls to externalize aggression. (BH)

  12. 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....

  13. Demographic, clinical, psychosocial, and environmental correlates of objectively assessed physical activity among breast cancer survivors

    NARCIS (Netherlands)

    Kampshoff, C.S.; Stacey, F.; Short, C.E.; van Mechelen, W.; Chinapaw, M.J.M.; Brug, J.; Plotnikoff, R.; James, E.L.; Buffart, L.M.

    Purpose The aim of this study was to identify demographic, clinical, psychosocial, and environmental correlates of objectively assessed physical activity among breast cancer survivors. Methods Baseline data were utilized from 574 female breast cancer survivors who participated in three different

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

    NARCIS (Netherlands)

    Fridman, Ayala

    2011-01-01

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

  15. 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.

  16. Worse quality of life in young and recently diagnosed breast cancer survivors compared with female survivors of other cancers: A cross-sectional study.

    Science.gov (United States)

    Li, Jingmei; Humphreys, Keith; Eriksson, Mikael; Dar, Huma; Brandberg, Yvonne; Hall, Per; Czene, Kamila

    2016-12-01

    Literature focusing on health-related quality of life (HRQoL) by cancer site among women only is scarce. This study examines HRQoL of breast cancer (BC) survivors compared with female survivors of other cancers, and to understand which subgroups of BC survivors were particularly at risk of reduced HRQoL. We placed emphasis on young (cancer controls and 2,205 other cancer survivors in the Karma study. We examined HRQoL differences using linear regression analyses in the whole cohort and in a subset of young and recently diagnosed BC survivors (n = 242) and female survivors of other cancers (n = 140) with comparable ages at diagnosis (43.6 vs 43.6, p = 0.917) and time since diagnosis (2.3 vs 2.8 years, p cancers when women of all ages were included, young BC survivors reported significantly lower HRQoL on multiple functional scales (global quality of life, emotional, role, social and cognitive functioning) and experienced more fatigue and insomnia. BC survivors with any prior medical history of mental disorders reported poorer HRQoL than those without such a history. We also observed a close-knit relationship between tumor and treatment characteristics. BC survivors perform poorly in HRQoL in comparison with female survivors of other cancers. Our results emphasize the importance of age- and gender-appropriate comparison groups. © 2016 UICC.

  17. [Early endocrine complications in childhood cancer survivors].

    Science.gov (United States)

    Sánchez González, Cristina; Andrades Toledo, Mónica; Cárdeno Morales, Álvaro; Gutiérrez Carrasco, Ignacio; Ramírez Villar, Gema Lucía; Pérez Hurtado, José María; García García, Emilio

    2016-10-21

    The treatment of childhood cancers has increased survival rates, but also the risk of sequelae, such as endocrine complications. The objective of this study is to evaluate the endocrine disorders in survivors of childhood malignant tumors within the first years after treatment and analyze the variables related to their appearance. A retrospective medical record review of patients referred to pediatric endocrinology after treatment of malignancy. Outcome measures were frequency and types of endocrine dysfunction and new-onset obesity. Clinical and laboratory evaluations were performed every 6 months. Statistics tests were: chi square and multiple logistic regression. Fifty five patients (26 women) were included with an age at diagnosis of tumour (mean±standard deviation) 6.0±4.4 years and followed up for 6.8±3.6 years. Thirty endocrine disorders were diagnosed in 26 patients (47.3%), 17 women (P=.01). Eleven adolescents had primary hypogonadism (26.2% to 0.6±0.5 years of follow-up) in relation to local irradiation (adjusted odds ratio [OR] 3.99, P=.005). Eleven patients had a pituitary disorder (20.0%) 5.2±2.4 years after diagnosis in relation to brain irradiation (OR 1.54, P=.039). Six children (10.9%) had primary hypothyroidism from 3.2±1.0 years of follow-up. Two children developed obesity. Endocrine disorders are frequently seen within the first years after diagnosis of a childhood cancer, so hormonal evaluation should start early and be repeated periodically. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  18. Suicide in stroke survivors: epidemiology and prevention.

    Science.gov (United States)

    Pompili, Maurizio; Venturini, Paola; Lamis, Dorian A; Giordano, Gloria; Serafini, Gianluca; Belvederi Murri, Martino; Amore, Mario; Girardi, Paolo

    2015-01-01

    Stroke is a dramatic event and is associated with potentially severe consequences, including disability, mortality, and social costs. Stroke may occur at any age; however, most strokes occur in individuals aged 65 years and older. Previous research has found that stroke increases suicide risk, especially among women and younger patients. The aim of the current review is to investigate the relationship between suicide and stroke in order to determine which stroke patients are at elevated risk for suicide. Moreover, we review the literature in order to provide pharmacological treatment strategies for stroke patients at high risk of suicide. We performed a careful search to identify articles and book chapters focused on this issue, selecting only English-language articles published from 1990 to 2014 that addressed the issue of suicide after stroke and its pharmacological management. We found 12 clinical trials that explored the relationship between stroke and suicidal ideation and/or suicidal plans and 11 investigating suicide as the cause of death after stroke. We identified stroke as a significant risk factor for both suicide and suicidal ideation, especially among younger adult depressed patients in all articles, providing further support for the association between post-stroke and suicidality. Suicide risk is particularly high in the first 5 years following stroke. Depression, previous mood disorder, prior history of stroke, and cognitive impairment were found to be the most important risk factors for suicide. Selective serotonin reuptake inhibitors (SSRIs) represent the treatment of choice for stroke survivors with suicide risk, and studies in rats have suggested that carbolithium is a promising treatment in these patients. Early identification and treatment of post-stroke depression may significantly reduce suicide risk in stroke patients.

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

    Science.gov (United States)

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

    2015-12-09

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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......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......-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...

  1. 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...... 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......-based rehabilitation according to cancer survivors. Accordingly, the potential of rebuilding structure in everyday life, creating a normal context and enabling the individual to re-establish confidentiality and trust in their own body and physical potential constitute substantial qualities fundamental...

  2. 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...... on the association between childhood cancer and antidepressant use indicated no modifying effect. CONCLUSION: Childhood cancer survivors should be followed-up for depression. Our results indicate an increasing need for follow-up especially in survivors treated by more recent, intensive anticancer treatment....... to the National Prescription Drug Database, which worldwide is the oldest nationwide registry of prescription medication. Hazard ratios (HRs) for antidepressant use were estimated in a Cox proportional hazards model stratified on sex, with population comparisons as referents. RESULTS: Overall, childhood cancer...

  3. Learning and memory in Holocaust survivors with posttraumatic stress disorder.

    Science.gov (United States)

    Yehuda, Rachel; Golier, Julia A; Halligan, Sarah L; Harvey, Philip D

    2004-02-01

    Impairments in explicit memory have been observed in Holocaust survivors with posttraumatic stress disorder. To evaluate which memory components are preferentially affected, the California Verbal Learning Test was administered to Holocaust survivors with (n = 36) and without (n = 26) posttraumatic stress disorder, and subjects not exposed to the Holocaust (n = 40). Posttraumatic stress disorder subjects showed impairments in learning and short-term and delayed retention compared to nonexposed subjects; survivors without posttraumatic stress disorder did not. Impairments in learning, but not retention, were retained after controlling for intelligence quotient. Older age was associated with poorer learning and memory performance in the posttraumatic stress disorder group only. The most robust impairment observed in posttraumatic stress disorder was in verbal learning, which may be a risk factor for or consequence of chronic posttraumatic stress disorder. The negative association between performance and age may reflect accelerated cognitive decline in posttraumatic stress disorder.

  4. The distress thermometer in survivors of gynaecological cancer

    DEFF Research Database (Denmark)

    Olesen, Mette L.; Hansen, Merete K.; Hansson, Helena

    2017-01-01

    Purpose: Unrecognised psychological distress among cancer survivors may be identified using short screening tools. We validated the accuracy of the distress thermometer (DT) to detect psychological distress on the Hospital Anxiety and Depression Scale (HADS) among early stage gynaecological cancer...... survivors and whether the women’s DT and HADS scores were associated with the need of an individualised supportive intervention. Methods: One hundred sixty-five gynaecological cancer survivors answered DT and HADS before randomisation in a trial testing a nurse-led, person-centred intervention using...... supportive conversations. The number of conversations was decided in the woman-nurse dyad based on the woman’s perceived need. Nurses were unaware of the women’s DT and HADS scores. We validated DT’s accuracy for screening using HADS as gold standard and receiver operating characteristic curves. Associations...

  5. 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…

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  7. Perspectives on Self-Advocacy: Comparing Perceived Uses, Benefits, and Drawbacks Among Survivors and Providers

    Science.gov (United States)

    Hagan, Teresa; Rosenzweig, Margaret; Zorn, Kristin; van Londen, Josie; Donovan, Heidi

    2017-01-03

    To describe and compare survivors' and providers' views of the uses of and perceived benefits and drawbacks of survivor self-advocacy. A cross-sectional, two-group, mixed-methods survey. Survivors were recruited from local and national registries and advocacy organizations. Providers were recruited from the University of Pittsburgh Medical Center Cancer Center and a regional Oncology Nursing Society chapter. 122 female cancer survivors and 39 providers involved in their direct care. Quantitative survey data were summarized using descriptive statistics, including means and frequencies. Qualitative survey data were collected and analyzed using content analysis techniques, and main themes were counted and summarized. Perceptions of the uses, benefits, and drawbacks of female cancer survivor self-advocacy. Survivors and providers perceived similar but distinct uses of self-advocacy. Survivors and providers generally agreed on the potential benefits of self-advocacy but had different views of the potential drawbacks. Survivors were most concerned with finding and making sense of information, that their questions would not be answered, and having a worse relationship with their provider; providers were concerned with increases in clinic time and difficulties developing treatment plans. Although survivors and providers recognized similar benefits to survivor self-advocacy, they had different views of the uses and drawbacks of female cancer survivor self-advocacy. Attempts to increase self-advocacy among female cancer survivors must address survivors’ and providers’ views and apprehensions about self-advocacy.

  8. 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…

  9. 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

  10. 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…

  11. Breast cancer survivors' preferences for technology-supported exercise interventions.

    Science.gov (United States)

    Phillips, Siobhan M; Conroy, David E; Keadle, Sarah Kozey; Pellegrini, Christine A; Lloyd, Gillian R; Penedo, Frank J; Spring, Bonnie

    2017-05-03

    The purpose of this study was to explore breast cancer survivors' interest in and preferences for technology-supported exercise interventions. Post-treatment survivors [n = 279; M age = 60.7 (SD = 9.7)] completed a battery of online questionnaires in August 2015. Descriptive statistics were calculated for all data. Logistic regression analyses were conducted to examine relationships between survivors' interest in a technology-supported exercise interventions and demographic, disease, and behavioral factors. These same factors were examined in relation to perceived effectiveness of such interventions using multiple regression analyses. About half (53.4%) of survivors self-reported meeting public health recommendations for physical activity. Fewer than half reported using an exercise or diet mobile app (41.2%) or owning an activity tracker (40.5%). The majority were interested in receiving remotely delivered exercise counseling (84.6%), participating in a remotely delivered exercise intervention (79.5%), and using an exercise app or website (68%). Survivors reported that the most helpful technology-supported intervention components would be an activity tracker (89.5%), personalized feedback (81.2%), and feedback on how exercise is influencing mood, fatigue, etc. (73.6%). Components rated as least helpful were social networking integration (31.2%), group competitions (33.9%), and ability to see others' progress (35.1%). Preferences for technology-supported exercise interventions varied among breast cancer survivors. Nonetheless, data indicate that technology-supported interventions may be feasible and acceptable. Engaging stakeholders may be important in developing and testing potential intervention components.

  12. 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 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; pcardiomyopathy 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 cardiotoxic therapies should be followed carefully during pregnancy particularly those with a

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

    Science.gov (United States)

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

    2017-06-01

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

  14. Working with cancer: health and employment among cancer survivors.

    Science.gov (United States)

    Clarke, Tainya C; Christ, Sharon L; Soler-Vila, Hosanna; Lee, David J; Arheart, Kristopher L; Prado, Guillermo; Martinez, Alberto Caban; Fleming, Lora E

    2015-11-01

    Cancer affects a growing proportion of US workers. Factors contributing to whether they continue or return to work after cancer diagnosis include: age, physical and mental health, health insurance, education, and cancer site. The purpose of this study was to assess the complex relationships between health indicators and employment status for adult cancer survivors. We analyzed pooled data from the 1997-2012 US National Health Interview Survey (NHIS). Our sample included adults with a self-reported physician diagnosis of cancer (n = 24,810) and adults with no cancer history (n = 382,837). Using structural equation modeling (SEM), we evaluated the relationship between sociodemographic factors, cancer site, and physical and mental health indicators on the overall health and employment status among adults with a cancer history. The overall model for cancer survivors fit the data well (χ(2) (374) = 3654.7, P black cancer survivors were less likely to report good-to-excellent health, along with Hispanic survivors, they were more likely to continue to work after diagnosis compared with their white counterparts. Health insurance status and educational level were strongly and positively associated with health status and current employment. Age and time since diagnosis were not significantly associated with health status or employment, but there were significant differences by cancer site. A proportion of cancer survivors may continue to work because of employment-based health insurance despite reporting poor health and significant physical and mental health limitations. Acute and long-term health and social support are essential for the continued productive employment and quality of life of all cancer survivors. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Obesity management in gynecologic cancer survivors: provider practices and attitudes.

    Science.gov (United States)

    Jernigan, Amelia M; Tergas, Ana I; Satin, Andrew J; Fader, Amanda N

    2013-05-01

    Obesity is associated with the development and risk of death from several women's cancers. The study objective was to describe and compare oncologic providers' attitudes and practices as they relate to obesity counseling and management in cancer survivors. Society of Gynecologic Oncology members (n = 924) were surveyed with the use of a web-based, electronic questionnaire. χ(2) and Fisher exact tests were used to analyze responses. Of the 240 respondents (30%), 92.9% were practicing gynecologic oncologists or fellows, and 5.1% were allied health professionals. Median age was 42 years; 50.8% of the respondents were female. Of the respondents, 42.7% reported that they themselves were overweight/obese and that ≥50% of their survivor patients were overweight/obese. Additionaly, 82% of the respondents believed that discussing weight would not harm the doctor-patient relationship. Most of the respondents (95%) agreed that addressing lifestyle modifications with survivors is important. Respondents believed that gynecologic oncologists (85.1%) and primary care providers (84.5%) were responsible for addressing obesity. More providers who were ≤42 years old reported undergoing obesity management training (P 42 years old (P = .017). After initial counseling, 81.5% of the respondents referred survivors to other providers for obesity interventions. Oncology provider respondents believe that addressing obesity with cancer survivors is important. Providers believed themselves to be responsible for initial counseling but believed that obesity interventions should be directed by other specialists. Further research is needed to identify barriers to care for obese cancer survivors and to improve physician engagement with obesity counseling in the "teachable moment" that is provided by a new cancer diagnosis. Copyright © 2013 Mosby, Inc. All rights reserved.

  16. Influenza vaccination coverage among adult survivors of pediatric cancer.

    Science.gov (United States)

    Ojha, Rohit P; Offutt-Powell, Tabatha N; Gurney, James G

    2014-06-01

    A large proportion of long-term survivors of childhood cancer have treatment-related adverse cardiac and pulmonary late-effects, with related mortality. Consequently, this population of approximately 379,000 individuals in the U.S. is at high risk of complications from influenza infections. To estimate influenza vaccination coverage overall and among subgroups of adult survivors of pediatric cancer aged 18-64 years and to compare coverage with the general adult U.S. population. Data from the 2009 Behavioral Risk Factor Surveillance System were analyzed in 2013 using binomial regression to estimate influenza vaccination coverage differences (CDs) and corresponding 95% confidence limits (CLs) between adult survivors of pediatric cancer and the general U.S. population. Analyses were stratified by demographic characteristics and adjusted for design effects, non-coverage, and non-response. Influenza vaccination coverage was 37% for adult pediatric cancer survivors overall and 31% for the general adult U.S. population (CD=6.3%, 95% CL=0.04%, 13%). Dramatically lower coverage was observed for non-Hispanic black survivors (6%) than for non-Hispanic blacks in the general U.S. population (26%; CD=-18%, 95% CL=-25%, -11%). Although influenza vaccination coverage was modestly higher among adult survivors of pediatric cancer than the general U.S. population, coverage was less than desirable for a population with a high prevalence of cardiopulmonary conditions and early mortality, and far lower than the Healthy People 2010 goal of 60% or Healthy People 2020 goal of 80% for the general population. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Human Papillomavirus Vaccination Rates in Young Cancer Survivors.

    Science.gov (United States)

    Klosky, James L; Hudson, Melissa M; Chen, Yanjun; Connelly, James A; Wasilewski-Masker, Karen; Sun, Can-Lan; Francisco, Liton; Gustafson, Laura; Russell, Kathryn M; Sabbatini, Gina; Flynn, Jessica S; York, Jocelyn M; Giuliano, Anna R; Robison, Leslie L; Wong, F Lennie; Bhatia, Smita; Landier, Wendy

    2017-11-01

    Purpose Cancer survivors are at high risk for human papillomavirus (HPV)-related morbidities; we estimated the prevalence of HPV vaccine initiation in cancer survivors versus the US population and examined predictors of noninitiation. Methods Participants included 982 cancer survivors (9 to 26 years of age; 1 to 5 years postcompletion of therapy); we assessed HPV vaccine initiation, sociodemographic and clinical characteristics, and vaccine-specific health beliefs; age-, sex-, and year-matched US population comparisons were from the National Immunization Survey-Teen and the National Health Interview Survey (2012-2015). Results The mean age at the time of the study was 16.3 ± 4.7 years; the mean time off therapy was 2.7 ± 1.2 years; participants were 55% male and 66% non-Hispanic white; 59% had leukemia/lymphoma. Vaccine initiation rates were significantly lower in cancer survivors versus the general population (23.8%; 95% CI, 20.6% to 27.0% v 40.5%; 95% CI, 40.2% to 40.7%; P P P young adult survivors and peers (ages 18 to 26 years) was comparably low (25.3%; 95% CI, 20.9% to 29.7% v 24.2%; 95% CI, 23.6% to 24.9%). Predictors of noninitiation included lack of provider recommendation (OR, 10.8; 95% CI, 6.5 to 18.0; P P P P P < .001; comparison, 13 to 17 years). Conclusion HPV vaccine initiation rates in cancer survivors are low. Lack of provider recommendation and barriers to vaccine receipt should be targeted in vaccine promotion efforts.

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

    DEFF Research Database (Denmark)

    Thordardottir, E.B.; Valdimarsdóttir, Unnur A; Hansdottir, Ingunn

    2016-01-01

    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 PosttraumaticDiagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors...

  19. Nutrition, metabolism, and integrative approaches in cancer survivors.

    Science.gov (United States)

    Sierpina, Victor; Levine, Lyuba; McKee, Juliet; Campbell, Christina; Lian, Sungmi; Frenkel, Moshe

    2015-02-01

    To review emerging issues about metabolic changes occurring in cancer survivors during and as a result of therapy, the role of nutrition, weight control, stress management, nutritional supplements, and other complementary diet therapies, methods of mitigating side effects of treatment affecting dietary intake, and to suggest future research directions. Literature review and professional clinical experience with oncology patients. Enhancing cancer survivorship requires knowledge and application of nutritional science and integrative health care approaches. Reliable, personalized, team-generated nutritional advice must be provided to cancer patients and cancer survivors to reduce risk of recurrence, optimize energy balance, and improve quality of life. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Touched by suicide: bridging the perspectives of survivors and clinicians.

    Science.gov (United States)

    Myers, Michael F; Fine, Carla

    2007-04-01

    This article is a revised version of an invited plenary address given at the 39th Annual Conference of the American Association of Suicidology. The authors, a psychiatrist and a writer survivor, outline and summarize the different ways in which professionals and survivors come to an understanding of suicide. They explain how each group often exists independently and separate from the other--by cognitive and emotional dissonance, by private language, by psychological defenses and miscommunication--and call for dialog. They argue that both perspectives are essential to advance the science of suicidology and to give hope and meaning to those bereaved by suicide.

  1. Metabolic syndrome in pediatric cancer survivors: a mechanistic review.

    Science.gov (United States)

    Rosen, Galit P; Nguyen, Hoai-Trinh; Shaibi, Gabriel Q

    2013-12-01

    Pediatric cancer survivors have increased risk of obesity, hypertension, dyslipidemia, and type 2 diabetes, leading to premature cardiovascular disease (CVD). Multiple tissues that are involved in glucose homeostasis and lipid metabolism are adversely affected by chemotherapy. This review highlights the relevant tissue and molecular end-organ effects of therapy exposures and synthesizes the current understanding of the mechanisms underlying CVD risk in this vulnerable population. The review also approaches the topic from a developmental perspective, with the goal of providing a translational approach to identifying the antecedents of overt CVD among survivors of pediatric cancer. © 2013 Wiley Periodicals, Inc.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    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......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...

  3. 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...

  4. Ovarian and Uterine Functions in Female Survivors of Childhood Cancers.

    Science.gov (United States)

    Oktem, Ozgur; Kim, Samuel S; Selek, Ugur; Schatmann, Glenn; Urman, Bulent

    2018-02-01

    Adult survivors of childhood cancers are more prone to developing poor reproductive and obstetrical outcomes than their siblings and the general population as a result of previous exposure to chemotherapy and radiation during childhood. Chemotherapy drugs exert cytotoxic effects systemically and therefore can damage the ovaries, leading to infertility, premature ovarian failure, and, to a lesser extent, spontaneous abortions. They have very limited or no deleterious effects on the uterus that can be recognized clinically. By contrast, radiation is detrimental to both the ovaries and the uterus, thereby causing a greater magnitude of adverse effects on the female reproductive function. These include infertility, premature ovarian failure, miscarriage, fetal growth restrictions, perinatal deaths, preterm births, delivery of small-for-gestational-age infants, preeclampsia, and abnormal placentation. Regrettably, the majority of these adverse outcomes arise from radiation-induced uterine injury and are reported at higher incidence in the adult survivors of childhood cancers who were exposed to uterine radiation during childhood in the form of pelvic, spinal, or total-body irradiation. Recent findings of long-term follow-up studies evaluating reproductive performance of female survivors provided some reassurance to female cancer survivors by documenting that pregnancy and live birth rates were not significantly compromised in survivors, including those who had been treated with alkylating agents and had not received pelvic, cranial, and total-body irradiation. We aimed in this narrative review article to provide an update on the impact of chemotherapy and radiation on the ovarian and uterine function in female survivors of childhood cancer. Adult survivors of childhood cancers are more prone to developing a number of poor reproductive and obstetrical outcomes than their siblings and the general population as a result of previous exposure to chemotherapy and radiation

  5. Thoughts on representation in therapy of Holocaust survivors.

    Science.gov (United States)

    Moore, Yael

    2009-12-01

    This paper presents the problems of representation and lack of representation in treating Holocaust survivors, through clinical vignettes and various theoreticians. The years of Nazi persecution and murder brought about a destruction of symbolization and turning inner and external reality into the Thing itself, the concrete, or, in Lacan's words, 'The Thing'. The paper presents two ideas related to praxis as well as theory in treating Holocaust survivors: the first is related to the therapist's treatment of the Holocaust nightmare expressing the traumatic events just as they happened 63 years previously; the second deals with the attempt at subjectification, in contrast to the objectification forced by the Nazis on their victims.

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

    Science.gov (United States)

    2002-06-01

    Trends in History of Technology," American Historical Review 95 (June 1990): 720. 2 about the values, technologies, social relations, and intellectual ...the implication here is not that Word’s team plagiarized earlier ideas but only that without the benefit of such built-up constituent technologies...with the " intellectualization " of weapons.29 Until recently, specific details of the Soviet and Russian arsenals were simply inaccessible to the

  7. The Holocaust after 70 years: Holocaust survivors in the United States(.).

    Science.gov (United States)

    Prince, Robert M

    2015-09-01

    Over 70 years, there have been different narratives of the Holocaust survivors coming to the United States. Survivors' stories begin with an event of major historical significance. Difficulties in conceptualizing historical trauma, along with common distortions and myths about Holocaust survivors and their children are examined. This article proposes that it is impossible to discuss the consequences of extreme suffering without consideration of historical meaning and social context with which they are entwined. The evolution of the social representation of the Holocaust and the contradictions in clinical attributions to survivors and their children with consideration of the future is described. Attributions to survivors and their children with consideration of the future is described.

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

    Science.gov (United States)

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

    2016-10-01

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

  9. A call for research: the need to better understand the impact of support groups for suicide survivors.

    Science.gov (United States)

    Cerel, Julie; Padgett, Jason H; Conwell, Yeates; Reed, Gerald A

    2009-06-01

    Support groups for suicide survivors (those individuals bereaved following a suicide) are widely used, but little research evidence is available to determine their efficacy. This paper outlines the pressing public health need to conduct research and determine effective ways to identify and meet the needs of suicide survivors, particularly through survivor support groups. After describing the various approaches to survivor support groups, we explain the need for further research, despite the inherent challenges. Finally, we pose several questions for researchers to consider as they work with survivors to develop a research agenda that sheds more light on the experiences of survivors and the help provided by survivor support groups.

  10. Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Kirchhoff, Anne C; Kuhlthau, Karen; Pajolek, Hannah; Leisenring, Wendy; Armstrong, Greg T; Robison, Leslie L; Park, Elyse R

    2013-02-01

    The Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the USA. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI. We conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8. Uninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their preexisting health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care. Childhood cancer survivors face barriers to obtaining ESI. While ACA provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support.

  11. African American Stroke Survivors: More Caregiving Time, but Less Caregiving Burden.

    Science.gov (United States)

    Skolarus, Lesli E; Freedman, Vicki A; Feng, Chunyang; Burke, James F

    2017-02-01

    Blacks have higher stroke incidence and experience greater poststroke disability than whites. To optimize care for stroke survivors, it is important to understand the amount of care that they receive and the implications for stroke caregivers. Data from 2 nationally representative, population-based studies, the NHATS (National Health and Aging Trends Study) linked to the NSOC (National Study of Caregiving), were used to identify elderly stroke survivors and their caregivers. We compared hours of care received and unmet activity need among the 581 white and 225 black stroke survivors. We then performed racial comparisons of positive and negative aspects of caregiving reported by caregivers of black and white stroke survivors. Black stroke survivors were more likely than white stroke survivors to have a caregiver (62.5% versus 49.7%; PCaregivers of black stroke survivors reported more positive aspects of caregiving than caregivers of white stroke survivors (6.8 versus 6.0; Pcaregiving, depression, or anxiety. Black stroke survivors received an average of ≈11 more hours of care than white stroke survivors without substantial differences in unmet need. Despite providing more hours of care, caregivers of black stroke were more positive about their caregiver role than caregivers of white stroke survivors. © 2017 American Heart Association, Inc.

  12. Early and late complications among long-term colorectal cancer survivors with ostomy or anastomosis.

    Science.gov (United States)

    Liu, Liyan; Herrinton, Lisa J; Hornbrook, Mark C; Wendel, Christopher S; Grant, Marcia; Krouse, Robert S

    2010-02-01

    Among long-term (>or=5 y) colorectal cancer survivors with permanent ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life. The incidence and effects of complications on long-term health-related quality of life among colorectal cancer survivors are not adequately understood. Participants (284 survivors with ostomies and 395 survivors with anastomoses) were long-term colorectal cancer survivors enrolled in an integrated health plan. Health-related quality of life was assessed via mailed survey questionnaires from 2002 to 2005. Information on colorectal cancer, surgery, comorbidities, and complications was obtained from computerized data and analyzed by use of survival analysis and logistic regression. Ostomy and anastomosis survivors were followed up for an average of 12.1 and 11.2 years, respectively. Within 30 days of surgery, 19% of ostomy survivors and 10% of anastomosis survivors experienced complications (P Ostomy was associated with long-term fistula (odds ratio, 5.4; 95% CI 1.4-21.2), and among ostomy survivors, fistula was associated with reduced health-related quality of life (P ostomy have more complications early in their survivorship period, but complications among anastomosis survivors catch up after 20 years, when the 2 groups have convergent complication rates. Among colorectal cancer survivors with ostomy, fistula has especially important implications for health-related quality of life.

  13. Neurocognitive and Family Functioning and Quality of Life Among Young Adult Survivors of Childhood Brain Tumors

    Science.gov (United States)

    Hocking, Matthew C.; Hobbie, Wendy L.; Deatrick, Janet A.; Lucas, Matthew S.; Szabo, Margo M.; Volpe, Ellen M.; Barakat, Lamia P.

    2012-01-01

    Many childhood brain tumor survivors experience significant neurocognitive late effects across multiple domains that negatively affect quality of life. A theoretical model of survivorship suggests that family functioning and survivor neurocognitive functioning interact to affect survivor and family outcomes. This paper reviews the types of neurocognitive late effects experienced by survivors of pediatric brain tumors. Quantitative and qualitative data from three case reports of young adult survivors and their mothers are analyzed according to the theoretical model and presented in this paper to illustrate the importance of key factors presented in the model. The influence of age at brain tumor diagnosis, family functioning, and family adaptation to illness on survivor quality of life and family outcomes are highlighted. Future directions for research and clinical care for this vulnerable group of survivors are discussed. PMID:21722062

  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. Factors That Predict Persistent Smoking of Cancer Survivors.

    Science.gov (United States)

    Kim, Hyoeun; Kim, Mi-Hyun; Park, Yong-Soon; Shin, Jin Young; Song, Yun-Mi

    2015-07-01

    We conducted this cross-sectional study to elucidate factors that predict persistent smoking of the Korean cancer survivors. The subjects were 130 adult (≥19 yr old) cancer survivors who were smokers at the diagnosis of cancer and have participated in the Korean National Health and Nutrition Examination Surveys conducted from 2007 to 2011. We categorized them into the persistent smokers and the quitters, according to change in smoking status between the time of cancer diagnosis and the time of the survey. Factors associated with persistent smoking were evaluated using the multiple logistic regression analysis. During 7.52 yr (standard deviation = 0.34) after the cancer diagnosis, 59.6% of the 130 cancer survivors have continued to smoke. After adjusting for covariates, following factors were independently associated with the risk of persistent smoking: female, low income, high-risk alcohol use, high body mass index (≥ 25 kg/m(2)), presence of household members who smoke, and longer duration of smoking. Alcohol Use Disorders Identification Test showed a positive association with the risk of persistent smoking (P for trend = 0.012). In conclusion, more efforts for smoking cessation should be in place for the cancer survivors with those risk factors associated with the persistent smoking.

  16. Lifelong posttraumatic stress disorder: evidence from aging Holocaust survivors

    Science.gov (United States)

    Barak, Yoram; Szor, Henry

    2000-01-01

    Despite the fact that 50 years have passed since the Nazi regime and the Holocaust the psychic sequelae are far from being overcome. The majority of Holocaust survivors and World War II veterans still list their experiences as the “most significant stressors” of their lives. The literature provides ample evidence that posttraumatic stress disorder among survivors persists into old age. However, there is still a need to define the differences in frequency, clinical presentation, severity, and comorbid conditions among aging Holocaust survivors. Age at the time of trauma, cumulative lifetime stress, and physical illness are reported to have a positive association with more severe posttraumatic symptomatology. The presence of comorbid Axis i psychiatric disorders (Diagnostic and Statistical Manual [DSIVI]), has been the focus of research by our group, demonstrating that their interaction with earlier trauma leads to a course of chronic, debilitating disease. Despite reactivation of traumatic symptoms during aging and continuous mental suffering, the majority of Holocaust survivors show good instrumental coping and preserved functioning. PMID:22033740

  17. Associations between exercise and posttraumatic growth in gynecologic cancer survivors.

    Science.gov (United States)

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

    2015-03-01

    Exercise improves numerous psychosocial outcomes in cancer survivors; however, few studies have examined posttraumatic growth. The primary objective of this study was to examine the association between exercise and posttraumatic growth in gynecologic cancer survivors (GCS). Using the Alberta Cancer Registry, a random sample of endometrial, ovarian, and cervical cancer survivors were mailed a self-report survey that assessed demographic and medical variables, aerobic and strength exercise, and posttraumatic growth using the posttraumatic growth inventory, impact of cancer scale, and benefit finding scale. Completed surveys were received from 621 (38 %) of the 1,626 eligible survivors. One-third (32.9 %) of GCS were meeting aerobic exercise guidelines and 19.0 % were meeting strength exercise guidelines. Multivariate analyses of covariance showed significant differences in the posttraumatic growth scales for aerobic exercise guidelines (p exercise guidelines (p exercise guidelines for the negative impact of cancer scale (p exercise guidelines reported higher scores for the posttraumatic growth inventory (p = 0.014), the negative impact of cancer scale (p exercise and posttraumatic growth with only unmarried GCS demonstrating the associations. Exercise is a modifiable lifestyle factor that is associated with posttraumatic growth in GCS. Randomized controlled trials testing the effects of exercise interventions on posttraumatic growth in this population are warranted.

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

    Science.gov (United States)

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

    2002-01-01

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

  19. Physical exercise and return to work: cancer survivors' experiences

    NARCIS (Netherlands)

    Groeneveld, Iris F.; de Boer, Angela G. E. M.; Frings-Dresen, Monique H. W.

    2013-01-01

    In this qualitative study, we aimed to explore cancer survivors' experiences with (1) return to work (RtW) and work performance, (2) a physical exercise program after treatment, and (3) the perceived link between physical exercise and work. Semi-structured individual interviews were held with ten

  20. 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

  1. Strengthening Women Survivors of Violence in Post-Conflict ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    By working with civil society and sexual violence survivors, researchers will examine why and how sexual violence impunity persists, with the goal of developing an evidence base that will help victims' organizations and governments address these crimes. The research team will document incidents of sexual violence and ...

  2. Informal education and health promoting approaches in adult cancer survivors.

    Science.gov (United States)

    Argyriou, A A; Ifanti, A A; Kalofonos, H

    2011-01-01

    This review looks at the available data relating to the informal education aspects and other health promoting approaches applied by adult cancer survivors to reduce the risk of cancer. The implications of such behavioral interventions on oncology practice are discussed. We also highlight areas of future research to pursue. Available data show that many cancer survivors remain engaged in risky health behaviors post-diagnosis, which are associated with an increased risk of disease's recurrence. However, over the last years patients seem to increasingly receive adequate risk-based medical care. The application of appropriate informal education approaches, such as diet, exercise, and cessation of former unhealthy habits, such as smoking and alcohol has facilitated behavioral changes in cancer survivors, thoroughly improving their well being and overall quality of life (QOL). Most of the research studies published to date have applied structured lifestyle interventions on intensive, individualized counseling sessions delivered by trained personnel or psychosocial-based mediations and reported that these approaches are largely effective in promoting the adoption of a healthier lifestyle in cancer survivors. These interventions have been reported to reduce the risk of cancer recurrence and thus to obtain an obvious positive impact on their well-being and overall QOL. However, there is still insufficient evidence to conclude and support with confidence the effectiveness of any of these behavioral interventions and therefore future interventions should be initiated to assess the long-term effects and validating outcomes of lifestyle and other psychosocial interventions.

  3. Return to work among breast cancer survivors: A literature review.

    Science.gov (United States)

    Sun, Yuanlu; Shigaki, Cheryl L; Armer, Jane M

    2017-03-01

    Breast cancer survivors in their employment years are likely to try to go back to work after the primary treatment. Because the literature on return to work among breast cancer survivors is limited, we have undertaken a review of the literature to summarize what is known, including identifying important contributing variables and outcomes. This knowledge may be used to develop hypotheses and potential interventions to support breast cancer survivors who wish to return to work. We searched the following databases: CINAHL, MEDLINE, SCOUP, and PUBMED, within a 10-year timeframe (2004 to 2014). The majority of reviewed articles (N = 25) focused on three outcomes: return-to-work period, work ability, and work performance. The most frequently studied independent variables were collapsed into the following groups: health and well-being, symptoms and functioning, work demands and work environment, individual characteristics, and societal and cultural factors. Gaps in the literature include evidence of effective interventions to support return to work among breast cancer survivors and research to better understand the roles of government and business-related policy. All the studies reported a reduced work engagement and work ability. Employment status and work performance is associated with a combination of individual factors, work environment, culture, and resources. Significant gaps are apparent in the literature addressing breast cancer survivorship and return to work. This is a complex problem and it will likely require interdisciplinary research teams to develop effective and feasible interventions for this population.

  4. The need of making cancer survivors special' patients.

    NARCIS (Netherlands)

    Geelen, E.; Akker, M. van den; Krumeich, A.; Boom, H.A. van der; Schellevis, F.G.

    2011-01-01

    Introduction: Last decades the number of people with a history of cancer has increased enormously. Not only has the number of cancer diagnoses grown, there is also a growing number of cancer survivors as a result of improved treatment. Although most follow-up still takes place in specialized medical

  5. 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.

  6. "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…

  7. Coronary artery calcium in breast cancer survivors after radiation therapy

    NARCIS (Netherlands)

    Takx, Richard A P; Vliegenthart, Rozemarijn; Schoepf, U Joseph; Pilz, Lothar R; Schoenberg, Stefan O; Morris, Pamela B; Henzler, Thomas; Apfaltrer, Paul

    The purpose of the current study is to investigate whether breast cancer survivors after radiation therapy have a higher burden of coronary artery calcium as a potential surrogate of radiation-induced accelerated coronary artery disease. 333 patients were included. 54 patients underwent chest CT ae

  8. Domestic violence survivors and their experiences during legal process.

    Science.gov (United States)

    Özçakar, Nilgün; Yeşiltepe, Gözde; Karaman, Gökçe; Ergönen, Akça Toprak

    2016-05-01

    Many victims of domestic violence do not seek recourse to the needed medical and legal services. The aim of this study was to determine the difficulties faced by and experiences of female survivors of domestic violence during their medical and legal proceedings. We designed our study using a qualitative approach to understand the experiences of survivors during the legal process as well as their feelings and attitudes towards domestic violence through in-depth interviews. The data obtained from the participants were analyzed and synthesized using a thematic analysis procedure. Most of our participants reported different types of domestic violence, citing feelings of fear and loneliness during these experiences. They reported feeling dissatisfied with their complaints being ignored by the police and the perpetrators remaining unpunished. They complained of the complex procedures and negligence of staff in health-care centers such as hospitals, and they reported being shifted to several different places. We believe that an assessment of such female survivors in terms of specific standards set by specialists will help make improvements to the legal process. Education programs should be organized for professionals dealing with survivors of domestic violence. Special health-care services with fast proceedings must be established in health-care centers. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  9. Evaluation of a patient information website for childhood cancer survivors

    NARCIS (Netherlands)

    Knijnenburg, Sebastiaan L.; Kremer, Leontien C.; Versluys, A. Birgitta; Braam, Katja I.; Mud, Minke S.; van der Pal, Heleen J.; Caron, Huib N.; Jaspers, Monique W.

    2013-01-01

    Childhood cancer survivors (CCS) are in need of specialized information about late effects of treatment. In the current study, we assessed the perceived usability and satisfaction with the content of a national website with information on late effects and analyzed possible determinants related to

  10. Platelet hyperreactivity and prognosis in survivors of myocardial infarction

    NARCIS (Netherlands)

    Trip, M. D.; Cats, V. M.; van Capelle, F. J.; Vreeken, J.

    1990-01-01

    We tested the hypothesis that an increase in spontaneous aggregability of platelets in vitro predicts mortality and coronary events in patients who have survived a recent myocardial infarction. A cohort of 149 survivors of infarction entered our study three months after the index infarction and was

  11. Considerations for the long term treatment of pediatric sarcoma survivors

    Directory of Open Access Journals (Sweden)

    Kurt R Weiss

    2018-01-01

    Full Text Available Sarcomas are primary malignancies of the connective tissues. They are exceedingly rare in adults, but much more common in children. The historically recent advent of cytotoxic chemotherapy for pediatric sarcomas has revolutionized the treatment of these diseases and dramatically improved their prognoses. There is thus a population of pediatric sarcoma survivors that are “coming of age” as adults. However, this progress is not without consequences. Due to aggressive treatment protocols that include various combinations of surgery, chemotherapy, and radiation therapy, pediatric sarcoma survivors are at risk of myriad physical, medical, and psychological difficulties as they enter adulthood. These include but are not limited to physical disabilities, chemotherapy-induced cardiac issues, second malignancies, and anxiety. These patients pose unique challenges to their adult primary care physicians. One possible solution to these challenges is multidisciplinary sarcoma survivorship clinics. By paying greater attention to the unique issues of pediatric sarcoma survivors, involved physicians can maximize the physical and emotional health of pediatric sarcoma survivors.

  12. Alexithymia in long-term survivors of childhood cancer

    NARCIS (Netherlands)

    van Dijk, Marieke; Grootenhuis, Martha A.; de Boer, Marieke; Bermond, Bob; Last, Bob F.

    2002-01-01

    OBJECTIVE: To investigate the incidence of alexithymia (difficulties in describing or recognizing one's own emotions, a limited fantasy life, and general constriction in the affective life) in a group of childhood cancer survivors and to explore medical determinants which predict alexithymia.

  13. Post-stroke depression among stroke survivors attending two ...

    African Journals Online (AJOL)

    Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a ...

  14. 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…

  15. 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)

  16. Strengthening Women Survivors of Violence in Post-Conflict ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The research team will document incidents of sexual violence and map out survivor strategies to overcome trauma, meet practical needs, and seek justice. They will also hold focused dialogues to collect and share evidence on what works and what does not work to address impunity on issues of sexual violence. Through ...

  17. 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…

  18. Neurological sequelae in survivors of cerebral malaria | Oluwayemi ...

    African Journals Online (AJOL)

    Methods: This is a prospective study describing persisting neurological impairments post discharge among children treated for cerebral malaria. ... The persisting neurologic deficits among survivors at follow up were: memory impairment (1.5%), seizure disorders (0.8%), visual impairment (0.8%), speech impairment (0.8%), ...

  19. 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…

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

    NARCIS (Netherlands)

    Clement, S.C.

    2016-01-01

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

  1. Metabolic syndrome induced by anticancer treatment in childhood cancer survivors.

    Science.gov (United States)

    Chueh, Hee Won; Yoo, Jae Ho

    2017-06-01

    The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered. Brain surgery or radiotherapy may induce metabolic syndrome by damaging the hypothalamic-pituitary axis, which may induce pituitary hormone deficiencies. Local therapy administered to particular endocrine organs directly damages the organs and causes hormone deficiencies, which induce obesity and dyslipidemia leading to metabolic syndrome. Chemotherapeutic agents interfere with cell generation and growth, damage the vascular endothelial cells, and increase the cardiovascular risk. Moreover, chemotherapeutic agents induce oxidative stress, which also induces metabolic syndrome. Physical inactivity caused by cancer treatment or the cancer itself, dietary restrictions, and the frequent use of antibiotics may also be risk factors for metabolic syndrome. Since childhood cancer survivors with metabolic syndrome have higher risks of cardiovascular events at an earlier age, early interventions should be considered. The optimal timing of interventions and drug use has not been established, but lifestyle modifications and exercise interventions that begin during cancer treatment might be beneficial and tailored education and interventions that account for individual patients' circumstances are needed. This review evaluates the recent literature that describes metabolic syndrome in cancer survivors, with a focus on its pathophysiology.

  2. 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

  3. 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

  4. Improving the Career Resilience of a Survivor of Sexual Abuse

    Science.gov (United States)

    Maree, Jacobus G.; Venter, Cobus J.

    2018-01-01

    This study examined whether life design counselling can enhance the career resilience of a sexual abuse survivor. One participant was selected through purposive sampling. Five life design sessions occurred over a period of three months. Various (postmodern) qualitative and quantitative techniques were used to gather data while data analysis was…

  5. Perceived barriers to physical activity among Nigerian stroke survivors

    African Journals Online (AJOL)

    Data on barriers to the achievement of the recommended physical activity levels including its differences along socio-demographic characteristics among stroke survivors in South-West Nigeria are needed. Methods: The Exercise Benefits and Barrier Scale and the International Physical Activity Questionnaire were ...

  6. Parental knowledge of fertility in male childhood cancer survivors

    NARCIS (Netherlands)

    van den Berg, Henk; Langeveld, Nelia E.

    2008-01-01

    BACKGROUND: In childhood, cancer survivors fertility is a major point of concern. In boys, only semen analysis and impregnation confirm fertility. Since parents constitute a major source of information for children, we investigated recall and assumptions on their child's fertility. PROCEDURE: One

  7. Depression among female survivors of domestic violence in ...

    African Journals Online (AJOL)

    Depression among female survivors of domestic violence in thohoyandou,South Africa. ... The questionnaire used has items on demographic variables of the participants such as age, marital status, level of education, employment status, number of years married, number of children and also items on depression. A topic ...

  8. Circumstances and consequences of falls in polio survivors.

    Science.gov (United States)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-11-01

    Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. A survey was conducted among 376 polio survivors. Participants completed a falls history questionnaire and additional information was obtained from their medical files. Of the 305 respondents, 74% reported at least one fall in the past year and 60% two or more. Sixteen percent of fallers described a major injury after a fall in the last year and 69% reported fear of falling. One-third of fallers had reduced the amount they walked because of their fear of falling. Most reported falls in a familiar environment (86%), during ambulation (72%) and in the afternoon (50%). Quadriceps weakness of the weakest leg (Medical Research Council (MRC) ≤ 3), fear of falling and complaints of problems maintaining balance were independently associated with both falls and recurrent falls, while increasing age and medication use were not. The high rate of falls and consequences thereof, merit the implementation of fall intervention strategies. To maximize effect, they should be tailor-made and target the fall mechanisms specific to polio survivors.

  9. Cancer mortality in long-term survivors of retinoblastoma

    NARCIS (Netherlands)

    Marees, T.; van Leeuwen, F.E.; de Boer, M.R.; Imhof, S.M.; Ringens, P.J.; Moll, A.C.

    2009-01-01

    This study examined long-term cause-specific mortality among 998 Dutch retinoblastoma survivors, diagnosed from 1862 to 2005, according to follow-up time, treatment and heredity. After a median follow-up of 30.8 years, only cause-specific mortality for second malignancies among hereditary

  10. Cancer mortality in long-term survivors of retinoblastoma.

    NARCIS (Netherlands)

    Marees, T.; Leeuwen, F.E. van; Boer, M. de; Imhof, S.M.; Ringens, P.J.; Moll, A.C.

    2009-01-01

    This study examined long-term cause-specific mortality among 998 Dutch retinoblastoma survivors, diagnosed from 1862 to 2005, according to follow-up time, treatment and heredity. After a median follow-up of 30.8 years, only cause-specific mortality for second malignancies among hereditary

  11. Genocide Rape Trauma Management: An Integrated Framework for Supporting Survivors.

    Science.gov (United States)

    Mukamana, Donatilla; Brysiewicz, Petra; Collins, Anthony; Rosa, William

    2017-06-13

    During the 1994 Rwandan genocide, rape was widely used as a strategic weapon against Tutsi women. More than 20 years later, many of these women are still suffering devastating psychological, social, and physical effects of these experiences and remain in need of effective interventions that address their complex trauma. This article develops the theory of genocide rape trauma management as a conceptual framework for promoting the holistic health and recovery of female genocide rape survivors. A qualitative study using grounded theory explored the lived experiences of genocide rape survivors and led to the development of this model. The need for a contextually appropriate model is highlighted, with historical and current data regarding the Rwandan context and the experiences of genocide rape survivors. The research details the complex dynamics of emotional, physical, existential, and psychosocial sequelae related to genocide rape trauma, and how these interact with both local community and broader political attitudes toward survivors, as well as the serious interrelated economic challenges and limitations in current public health and welfare services. The research demonstrates the necessary elements of a holistic approach encompassing a synergistic combination of skilled psychological care, self-help strategies, collaborative support groups, community education, social reintegration, advocacy, accessible medical care, and economic empowerment. These interacting elements form the basis of the theory of genocide rape trauma management, offering an encompassing integrated framework that can be adapted to, and evaluated in, other similar contexts.

  12. Metabolic syndrome induced by anticancer treatment in childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hee Won Chueh

    2017-06-01

    Full Text Available The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered. Brain surgery or radiotherapy may induce metabolic syndrome by damaging the hypothalamic-pituitary axis, which may induce pituitary hormone deficiencies. Local therapy administered to particular endocrine organs directly damages the organs and causes hormone deficiencies, which induce obesity and dyslipidemia leading to metabolic syndrome. Chemotherapeutic agents interfere with cell generation and growth, damage the vascular endothelial cells, and increase the cardiovascular risk. Moreover, chemotherapeutic agents induce oxidative stress, which also induces metabolic syndrome. Physical inactivity caused by cancer treatment or the cancer itself, dietary restrictions, and the frequent use of antibiotics may also be risk factors for metabolic syndrome. Since childhood cancer survivors with metabolic syndrome have higher risks of cardiovascular events at an earlier age, early interventions should be considered. The optimal timing of interventions and drug use has not been established, but lifestyle modifications and exercise interventions that begin during cancer treatment might be beneficial and tailored education and interventions that account for individual patients' circumstances are needed. This review evaluates the recent literature that describes metabolic syndrome in cancer survivors, with a focus on its pathophysiology.

  13. Exploring Meaning in the Life of Chinese Breast Cancer Survivors.

    Science.gov (United States)

    Xia, Hao-Zhi; Gao, Lei; Yue, Hong; Shi, Bao-Xin

    2016-12-30

    Breast cancer is the most common cancer among women worldwide, and spiritual fulfillment such as experiencing meaning in life plays an important role in coping with the disease. The objectives of this study were to explore and understand Chinese breast cancer survivors' perspective on meaning in life. This study used Grounded Theory; 23 participants were recruited using convenience sampling, purposive sampling, and theoretical sampling. Semistructured interviews were conducted, and the data were analyzed using open coding, axial coding, and selective coding. A core category emerged as "satisfaction with my life" to explain Chinese breast cancer survivors' perspective of meaning in life, and 4 subcategories described the core category including (1) living a healthy and peaceful life, (2) having a good relationship with others, (3) achieving purpose in life, and (4) fulfilling responsibility. Chinese breast cancer survivors value physical health as well as spiritual fulfillment. The experience of adapting to life with cancer, having a good relationship with others, pursuing life goals, and fulfilling responsibility consists of a satisfying life, which makes life more meaningful. Health providers should pay more attention to survivors' experience of meaning in life and help them enhance meaning in life and improve their quality of life through building good relationship with others, achieving purpose in life, and fulfilling responsibility for family and society.

  14. Guidelines: Medical management of a survivor of sexual assault ...

    African Journals Online (AJOL)

    Guidelines: Medical management of a survivor of sexual assault/abuse: Including Post-Exposure Prophylaxis and the Forensic Kit. Adrienne Wulfsohn. Abstract. No Abstract Southern African Journal of HIV Medicine Vol. 5 (1) 2004: 21-27. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL ...

  15. Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers.

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    Warner, Echo L; Nam, Gina E; Zhang, Yingying; McFadden, Molly; Wright, Jennifer; Spraker-Perlman, Holly; Kinney, Anita Y; Oeffinger, Kevin C; Kirchhoff, Anne C

    2016-04-01

    Survivors of adolescent and young adult (AYA) cancer may engage in unhealthy lifestyles (e.g., smoking), potentially heightening their risk for long-term health problems. We assessed health behaviors and constructs including quality of life (QOL) and psychosocial well-being among survivors of AYA cancer compared to the general population. We used 2009 Behavioral Risk Factor Surveillance System data to evaluate health behaviors for survivors of AYA cancer compared to AYAs without cancer. Multivariable regressions assessed health behaviors (smoking, binge drinking, physical inactivity, and low fruit/vegetable intake) by sex and age between AYA survivors and controls, and among survivors to determine the effects of demographic, QOL, psychosocial, and cancer factors on behaviors. A greater proportion of female survivors of AYA cancer smoked than controls (currently aged 20-39: 27 vs. 14.3%, respectively; currently aged 40-64: 29.3 vs. 18.4%, respectively). Generally, survivors and controls were non-adherent to national health behavior guidelines. Uninsured survivors were at greater risk of smoking vs. insured (females, Relative Risk (RR) = 1.64, 95% confidence interval (CI) 1.43-1.90; males, RR = 2.62, 95% CI 1.71-4.02). Poor social/emotional support was associated with smoking (RR = 1.26, 95% CI 1.07-1.48) among female survivors and was associated with low fruit/vegetable intake among male (RR = 1.12, 95% CI 1.01-1.23) and female (RR= 1.12, 95% CI 1.05-1.19) survivors. Female survivors >10 years from diagnosis had higher risk of smoking (RR = 1.26-1.91, all p < 0.01) than survivors 5-10 years from diagnosis. Unhealthy lifestyle behaviors are common in survivors of AYA cancer. AYA survivors require health behavior support.

  16. Healthcare experience among older cancer survivors: Analysis of the SEER-CAHPS dataset.

    Science.gov (United States)

    Halpern, Michael T; Urato, Matthew P; Lines, Lisa M; Cohen, Julia B; Arora, Neeraj K; Kent, Erin E

    2017-12-14

    Little is known about factors affecting medical care experiences of cancer survivors. This study examined experience of care among cancer survivors and assessed associations of survivors' characteristics with their experience. We used a newly-developed, unique data resource, SEER-CAHPS (NCI's Surveillance Epidemiology and End Results [SEER] data linked to Medicare Consumer Assessment of Healthcare Providers and Systems [CAHPS] survey responses), to examine experiences of care among breast, colorectal, lung, and prostate cancer survivors age >66years who completed CAHPS >1year after cancer diagnosis and survived ≥1year after survey completion. Experience of care was assessed by survivor-provided scores for overall care, health plan, physicians, customer service, doctor communication, and aspects of care. Multivariable logistic regression models assessed associations of survivors' sociodemographic and clinical characteristics with care experience. Among 19,455 cancer survivors with SEER-CAHPS data, higher self-reported general-health status was significantly associated with better care experiences for breast, colorectal, and prostate cancer survivors. In contrast, better mental-health status was associated with better care experience for lung cancer survivors. College-educated and Asian survivors were less likely to indicate high scores for care experiences. Few differences in survivors' experiences were observed by sex or years since diagnosis. The SEER-CAHPS data resources allows assessment of factors influencing experience of cancer among U.S. cancer survivors. Higher self-reported health status was associated with better experiences of care; other survivors' characteristics also predicted care experience. Interventions to improve cancer survivors' health status, such as increased access to supportive care services, may improve experience of care. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. A study of chronic fatigue in Norwegian cervical cancer survivors.

    Science.gov (United States)

    Steen, Rita; Dahl, Alv A; Hess, Siri Lothe; Kiserud, Cecilie E

    2017-09-01

    Chronic fatigue after treatment is a common adverse event in cancer patients, but there are few studies in long-term survivors of cervical cancer. The aim of this investigation was to explore the prevalence of chronic fatigue and its association with various clinical and treatment-related factors in a population-based cohort of Norwegian cervical cancer survivors treated by any modality. All patients, treated for cervical cancer from 2000 through 2007 in the Health Region of South-Eastern Norway, cancer-free, alive and aged ≤75years by the end 2013 (n=822) received a questionnaire covering chronic fatigue and other clinical variables. 461 of 822 survivors (56%) completed the questionnaire and 382 entered the analyses. Chronic fatigue was reported by 23% (95% confidence interval 19%-27%) with a median age of 52years (range 32-75) at survey, 11years (range 7-15) after diagnosis. Among survivors treated by minimal invasive- or radical surgery, 19% had chronic fatigue, while the prevalence was 28% in those treated with radiation and concomitant chemotherapy (chemoradiation). The chronic fatigue group reported significantly more cardiovascular disease, obesity, less physical activity, more treatment-related symptom experience, more menopausal symptoms, higher levels of anxiety and depressive symptoms, and poorer quality of life than the non-fatigued group. In multivariate analysis only increased level of depression and poorer global quality of life were significantly associated with chronic fatigue. Chronic fatigue was reported by 23% of long-term survivors after cervical cancer at a mean of 11years after treatment. Some of the associated factors are amenable to prevention and/or treatment and should be subjects of attention at follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Feasibility of Mind-Body Movement Programs for Cancer Survivors.

    Science.gov (United States)

    Browning, Kristine K; Kue, Jennifer; Lyons, Felisha; Overcash, Janine

    2017-07-01

    To evaluate mind-body movement exercise (MBME) classes (yoga, tai chi, and Qigong) for cancer survivors. 
. A single-group, repeated-measures design.
. The Ohio State University Wexner Medical Center-Arthur G. James Cancer Hospital in Columbus.
. 33 adult cancer survivors, with any cancer diagnosis, participating in MBME classes.
. The researchers sought to examine feasibility of multiple data collection time points and data collection measures; acceptability; and changes to physical, emotional, and biometric measures over time, as a result of participation in MBME classes.
. Quality of life, sleep, depressive symptomatology, fatigue, stress, upper body strength, gait and balance, body mass index, heart rate, and blood pressure.
. The current study was feasible because survivors were willing to participate and completed most of the questionnaires. Participants found these classes to be beneficial not only for exercise, but also for social support and social connectedness. Poor sleep quality was consistently reported by participants. MBME classes should be recommended to survivors and are beneficial for oncology practices to offer.
. Conducting MBME research with cancer survivors is feasible, and participants find the MBME acceptable and a way of addressing health and managing cancer-related symptoms.
. Nurses should help patients and caregivers identify locations and times when MBME class participation is possible, assess MBME class participation during each clinic visit to promote continued involvement and to understand if positive effects are occurring, and continue to provide support for MBME classes throughout the survivorship experience.

  19. 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.

  20. Cognitive and Occupational Function in Survivors of Adolescent Cancer.

    Science.gov (United States)

    Nugent, Bethany D; Bender, Catherine M; Sereika, Susan M; Tersak, Jean M; Rosenzweig, Margaret

    2017-08-07

    Adolescents with cancer have unique developmental considerations. These include brain development, particularly in the frontal lobe, and a focus on completing education and entering the workforce. Cancer and treatment at this stage may prove to uniquely affect survivors' experience of cognitive and occupational function. An exploratory, cross-sectional, descriptive comparative study was employed to describe cognitive and occupational function in adult survivors of adolescent cancer (diagnosed between the ages of 15 and 21 years) and explore differences in age- and gender-matched controls. In total, 23 survivors and 14 controls participated in the study. While significant differences were not found between the groups on measures of cognitive and occupational function, several small and medium effect sizes were found suggesting that survivors may have greater difficulty than controls. Two small effect sizes were found in measures of neuropsychological performance (the Digit Vigilance test [d = 0.396] and Stroop test [d = 0.226]). Small and medium effect sizes ranging from 0.269 to 0.605 were found for aspects of perceived and total cognitive function. A small effect size was also found in work output (d = 0.367). While we did not find significant differences in cognitive or occupational function between survivors and controls, the effect sizes observed point to the need for future research. Future work using a larger sample size and longitudinal design are needed to further explore cognitive and occupational function in this vulnerable and understudied population and assist in the understanding of patterns of change over time.

  1. Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function.

    Science.gov (United States)

    Chaddha, Ashish; Kline-Rogers, Eva; Braverman, Alan C; Erickson, Steven R; Jackson, Elizabeth A; Franklin, Barry A; Woznicki, Elise M; Jabara, Justin T; Montgomery, Daniel G; Eagle, Kim A

    2015-11-01

    Currently no research exists assessing lifestyle modifications and emotional state of acute aortic dissection (AAD) survivors. We sought to assess activity, mental health, and sexual function in AAD survivors. Physical and sexual activity will decrease in AAD survivors compared to pre-dissection. Incidence of anxiety and depression will be significant after AAD. A cross sectional survey was mailed to 197 subjects from a single academic medical center (part of larger IRAD database). Subjects were ≥18 years of age surviving a type A or B AAD between 1996 and 2011. 82 surveys were returned (overall response rate 42%). Mean age ± SD was 59.5 ± 13.7 years, with 54.9% type A and 43.9% type B patients. Walking remained the most prevalent form of physical activity (49 (60%) pre-dissection and 47 (57%) post-dissection). Physical inactivity increased from 14 (17%) before AAD to 20 (24%) after AAD; sexual activity decreased from 31 (38%) to 9 (11%) mostly due to fear. Most patients (66.7%) were not exerting themselves physically or emotionally at AAD onset. Systolic blood pressure (SBP) at 36 months post-discharge for patients engaging in ≥2 sessions of aerobic activity/week was 126.67 ± 10.30 vs. 141.10 ± 11.87 (p-value 0.012) in those who did not. Self-reported new-onset depression after AAD was 32% and also 32% for new-onset anxiety. Alterations in lifestyle and emotional state are frequent in AAD survivors. Clinicians should screen for unfounded fears or beliefs after dissection that may reduce function and/or quality of life for AAD survivors. © 2015 Wiley Periodicals, Inc.

  2. Work adjustment of cancer survivors: An organisational support framework

    Directory of Open Access Journals (Sweden)

    Loraine Clur

    2017-01-01

    Full Text Available Orientation: Medical advancements increase incidents of cancer survivors returning to work. Work adjustment of cancer survivors is essential for job satisfaction and productivity and should be supported and facilitated by the organisation.Research purpose: The purpose of the study was to explore cancer survivors’ return to work experience in order to explicate organisational support needed to facilitate their successful work adjustment.Motivation for the study: Despite the growing awareness of cancer survivorship, the challenges, expectations and management of the return to work process remain under researched.Research approach, design and method: Heidegger’s hermeneutic phenomenology formed the methodological foundation to the study. Purposive sampling was used to select eight participants from an oncology unit and cancer support organisation in the Southern Cape and Little Karoo regions. Participants, diagnosed with various types of cancer, were regarded as cancer survivors as they completed treatment and have returned to work. Data were collected using unstructured interviews and analysed through thematic analysis based on Ricoeur’s hermeneutic phenomenological theory of interpretation.Main findings: Results highlight four themes representing cancer survivors’ needs for organisational support. The support needs are presented in the context of the theory of work adjustment in a hierarchical schema that evolves from a basic need for emotion-focussed support to the need for knowledge and for practical guidance. Support needs culminate in the need for self-actualisation through meaning-making. An organisational support framework is proposed consisting of four integrated functions aimed at addressing the needs that emerged from the data.Practical and managerial implications: The organisational support framework provides guidance to develop an organisational policy and intervention strategy aimed at managing the successful work adjustment

  3. Breaking up Sedentary Behavior: Perceptions from Cancer Survivors

    Science.gov (United States)

    Paxton, Raheem J.; Anderson, Alexandra; Sakar, Sonali; Taylor, Wendell C.

    2015-01-01

    Background Limited data exist on the benefits of, barriers to, and potential strategies to break up time spent sitting in cancer survivors. Such data will be meaningful given the consequences of prolonged sitting. Objectives To conduct a mixed method research study consisting of semi-structured telephone interviews to identify recurrent themes associated with prolonged sitting in cancer survivors. Methods African American breast cancer survivors (N = 31) were recruited from a local tumor registry. Telephone interviews were conducted and group consensus processes were used to identify recurrent themes. The a priori categories were benefits, barriers, and potential strategies to breaking up prolonged periods of sitting. Results Recurrent themes contributing most to prolonged sitting were leisure time interest (45%: e.g., watching television and reading) and health challenges (27%: e.g., pain and fatigue). Most (66%) women perceived improved health as benefits to breaking up time spent sitting. Nonetheless, many (41%) survivors reported health (e.g., pain and fatigue) as the biggest challenge to breaking up time spent sitting. Engaging in light intensity activities (e.g., staying active, keep moving) was the most commonly reported strategy for breaking up prolonged sitting. Conclusions African American breast cancer survivors identified the benefits and barriers to breaking up time spent sitting as well as potential strategies to breaking up time-spent sitting. Implications for practice Clinicians are integral in promoting breaks from prolonged sitting throughout the initial phases of the cancer continuum. Successful studies will begin with early intervention in the clinical setting, following with interventions during the recovery phase. PMID:26713501

  4. 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

    2015-01-01

    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. PMID:26690215

  5. Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS)

    Science.gov (United States)

    Nathan, Paul Craig; Ness, Kirsten Kimberlie; Mahoney, Martin Christopher; Li, Zhenghong; Hudson, Melissa Maria; Ford, Jennifer Sylene; Landier, Wendy; Stovall, Marilyn; Armstrong, Gregory Thomas; Henderson, Tara Olive; Robison, Leslie L; Oeffinger, Kevin Charles

    2011-01-01

    Background Childhood cancer survivors may develop a second malignant neoplasm during adulthood and therefore require regular surveillance. Objective To examine adherence to population cancer screening guidelines by survivors at average risk of developing a second malignant neoplasm, and to cancer surveillance guidelines by survivors at high risk of developing a second malignant neoplasm. Design Retrospective cohort study. Setting The Childhood Cancer Survivor Study (CCSS), a 26 center study of long-term survivors of childhood cancer who were diagnosed between 1970 and 1986. Patients 4,329 male and 4,018 female survivors of childhood cancer who completed a CCSS questionnaire assessing screening and surveillance for new cancers. Measurements Patient-reported receipt and timing of mammography, Papanicolaou smear, colonoscopy, or skin examination was categorized as adherent to the United States Preventive Services Task Force guidelines for survivors at average risk for breast or cervical cancer, or the Children’s Oncology Group guidelines for survivors at high risk for developing breast, colorectal or skin cancer as a result of their therapy. Results Among average risk female survivors, 2,743/3,392 (80.9%) reported a Papanicolaou smear within the recommended period, and 140/209 (67.0%) reported a mammogram within the recommended period. Among high risk survivors, rates of recommended mammography among females, and colonoscopy and complete skin exams among both genders were only 241/522 (46.2%), 91/794 (11.5%) and 1,290/4,850 (26.6%), respectively. Limitations Data were self report. CCSS participants are a select group of survivors and their compliance may not be representative of all childhood cancer survivors. Conclusions Female survivors at average risk for developing a second malignant neoplasm demonstrate reasonable rates of screening for cervical and breast cancer. However, surveillance for new cancers is very poor amongst survivors at highest risk for colon

  6. Cognitive, behaviour, and academic functioning in adolescent and young adult survivors of childhood acute lymphoblastic leukaemia: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Jacola, Lisa M; Edelstein, Kim; Liu, Wei; Pui, Ching-Hon; Hayashi, Robert; Kadan-Lottick, Nina S; Srivastava, Deokumar; Henderson, Tara; Leisenring, Wendy; Robison, Leslie L; Armstrong, Gregory T; Krull, Kevin R

    2016-10-01

    Survivors of childhood acute lymphoblastic leukaemia (ALL) are at risk for neurocognitive deficits that affect development in adolescence and young adulthood, and influence educational attainment and future independence. We examined a large and diverse cohort of survivors to identify risk predictors and modifiers of these outcomes. In this cohort study, cognitive and behaviour symptoms were assessed via a standardised parent questionnaire for 1560 adolescent survivors of ALL diagnosed between 1970 and 1999. Clinically significant symptoms (≥90th percentile) and learning problems were compared between survivors and a sibling cohort. Multivariable regression models were used to examine associations with demographic and treatment characteristics. Models were adjusted for inverse probability of sampling weights to reflect undersampling of ALL survivors in the expansion cohort. In a subset of survivors with longitudinal data (n=925), we examined associations between adolescent symptoms or problems and adult educational attainment. Compared with siblings, survivors treated with chemotherapy only were more likely to demonstrate headstrong behaviour (155 [19%] of 752 survivors vs 88 [14%] of 610 siblings, p=0·010), inattention-hyperactivity (15 [19%] vs 86 [14%], p4·3 g/m2) conferred increased risk of inattention-hyperactivity (relative risk [RR] 1·53, 95% CI 1·13-2·08). Adolescent survivors with cognitive or behaviour problems and those with learning problems were less likely to graduate from college as young adults than adolescent survivors without cognitive or behaviour problems. Although modern therapy for childhood ALL has eliminated the use of cranial radiation therapy, adolescent survivors treated with chemotherapy only remain at increased risk for cognitive, behaviour, and academic problems that adversely affect adult education outcomes. National Cancer Institute, American Lebanese-Syrian Associated Charities. Copyright © 2016 Elsevier Ltd. All rights

  7. Current unmet needs of cancer survivors: analysis of open-ended responses to the American Cancer Society Study of Cancer Survivors II.

    Science.gov (United States)

    Burg, Mary Ann; Adorno, Gail; Lopez, Ellen D S; Loerzel, Victoria; Stein, Kevin; Wallace, Cara; Sharma, Dinghy Kristine B

    2015-02-15

    Cancer survivors may continue to experience psychosocial and physical needs related to their cancer experience for many years after treatment. The specification of these needs across cancer types and by survivor characteristics may lead to better prevention approaches and clinical responses. Mixed methods were used to examine responses to an open-ended question about current unmet needs from a survey of 2-, 5-, and 10-year cancer survivors. Qualitative techniques were used to code themes of unmet needs from open-ended responses. These themes were then examined with quantitative techniques to describe the frequency of unmet needs across disease subgroups and demographic subgroups of survivors. There were 1514 responses to the open-ended question on unmet needs. Respondents ranged in age from 24 to 97 years and included proportionately more women, and 18% were minorities (black and Hispanic). Sixteen themes of unmet needs were identified. The number and type of unmet needs were not associated with the time since cancer treatment. Breast cancer survivors identified more unmet needs than other survivors. Male survivors and especially prostate cancer survivors identified personal control problems as current needs. Older cancer survivors identified fewer unmet needs on average than younger survivors. This analysis of an open-ended question on unmet needs extends our understanding of how cancer survivors perceive problems related to cancer. How cancer-related needs change over time and differ by sex, race, and ethnicity and how problems with personal control become manifest are areas of inquiry requiring further research. © 2015 American Cancer Society.

  8. Perceptions of body mass index (BMI) in pediatric cancer survivors and their providers.

    Science.gov (United States)

    Elchuri, Swati V; Patterson, Briana C; Wasilewski-Masker, Karen; Mertens, Ann C; Record, Elizabeth; Meacham, Lillian R

    2014-08-01

    Abnormalities in BMI are well documented in childhood cancer survivors. Perceptions of BMI status in cancer survivors have been understudied. This study determines the accuracy of parent/survivor and provider reporting of BMI status in a cancer survivor program. This is a retrospective study. Parent/survivor assessment of BMI status was obtained from a baseline questionnaire of subjects enrolled in Children's Healthcare of Atlanta-Childhood, Adolescent, and Young Adult Cancer Survivor Study (CHOA-CAYACSS). Provider reporting of BMI was obtained from a clinic visit close in date to completion of the survey. Perceptions of BMI were compared to actual BMI status calculated from clinic visits and categorized based on the Centers for Disease Control and Prevention (CDC) BMI guidelines. Perceptions of BMI were collected from 290 survivors of pediatric cancer or their parents (range, 4.3-22.9 years). Nearly 5% of survivors were underweight, 19.7% overweight and 16.2% obese. High BMI was the BMI state least likely to be correctly identified by parents, survivors, and providers. Among survivors with high BMI, parents, survivors, and providers failed to identify the problem 49.4%, 66.7%, and 26.9% of the time, respectively. Providers were less likely to correctly identify overweight compared to obese status (P survivor, ethnicity, or primary cancer diagnosis. Abnormal BMI states, especially overweight, are frequently not correctly perceived by parents/survivors or providers. Assessment of BMI status and discussion about steps to normalize BMI is needed to prevent weight related morbidities in this population. © 2014 Wiley Periodicals, Inc.

  9. Long-Term Quality of Life in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma.

    Science.gov (United States)

    Nies, Marloes; Klein Hesselink, Mariëlle S; Huizinga, Gea A; Sulkers, Esther; Brouwers, Adrienne H; Burgerhof, Johannes G M; van Dam, Eveline W C M; Havekes, Bas; van den Heuvel-Eibrink, Marry M; Corssmit, Eleonora P M; Kremer, Leontien C M; Netea-Maier, Romana T; van der Pal, Heleen J H; Peeters, Robin P; Plukker, John T M; Ronckers, Cécile M; van Santen, Hanneke M; Tissing, Wim J E; Links, Thera P; Bocca, Gianni

    2017-04-01

    Little is known about long-term quality of life (QoL) of survivors of pediatric differentiated thyroid carcinoma. Therefore, this study aimed to evaluate generic health-related QoL (HRQoL), fatigue, anxiety, and depression in these survivors compared with matched controls, and to evaluate thyroid cancer-specific HRQoL in survivors only. Survivors diagnosed between 1970 and 2013 at age ≤18 years, were included. Exclusion criteria were a follow-up Survivors and controls were asked to complete 3 questionnaires [Short-Form 36 (HRQoL), Multidimensional Fatigue Inventory 20 (fatigue), and Hospital Anxiety and Depression Scale (anxiety/depression)]. Survivors completed a thyroid cancer-specific HRQoL questionnaire. Sixty-seven survivors and 56 controls. Median age of survivors at evaluation was 34.2 years (range, 18.8 to 61.7). Median follow-up was 17.8 years (range, 5.0 to 44.7). On most QoL subscales, scores of survivors and controls did not differ significantly. However, survivors had more physical problems (P = 0.031), role limitations due to physical problems (P = 0.021), and mental fatigue (P = 0.016) than controls. Some thyroid cancer-specific complaints (e.g., sensory complaints and chilliness) were present in survivors. Unemployment and more extensive disease or treatment characteristics were most frequently associated with worse QoL. Overall, long-term QoL in survivors of pediatric DTC was normal. Survivors experienced mild impairment of QoL in some domains (physical problems, mental fatigue, and various thyroid cancer-specific complaints). Factors possibly affecting QoL need further exploration.

  10. 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…

  11. 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.

  12. Fertility in male medulloblastoma survivors: closing the gaps in counseling

    Directory of Open Access Journals (Sweden)

    Nahata L

    2013-12-01

    Full Text Available Leena Nahata,1 Richard N Yu,2 Ian P Dumont,3,4 Peter E Manley,3,4 Laurie E Cohen1,3,4 1Division of Endocrinology, 2Department of Urology, Department of Medicine, Boston Children's Hospital, 3Division of Hematology/Oncology, Department of Medicine, Boston Children's Hospital, 4Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Background: Pediatric medulloblastoma patients have high survival rates and are at risk for treatment-related sequelae, including infertility, emphasizing the need for fertility counseling. This cohort is less likely to pursue higher education, marry, and live independently, which may impact fertility counseling. Our goal was to explore fertility-related concerns in medulloblastoma survivors and counseling practices among providers. Methods: This study was performed at the Dana-Farber/Children's Hospital Cancer Center in Boston, Massachusetts. Surveys were administered to male pediatric medulloblastoma survivors aged 18 years and older and pediatric neuro-oncology practitioners. Medical records were reviewed to determine treatment protocols and documentation of fertility counseling. Data analysis was descriptive. Results: Fourteen male medulloblastoma survivors and six neuro-oncology practitioners completed the study. All patients had received central nervous system irradiation and adjuvant chemotherapy with at least one alkylating agent. Five (83% practitioners stated that they discussed fertility with all survivors at most visits. Eight (57% medulloblastoma survivors stated that they had received fertility counseling at initial diagnosis. Six (43% stated that fertility had been discussed since treatment had ended. The majority (>70% of survivors reported a desire to have children and were open to learning more about their fertility status. Fertility counseling was documented in survivorship visits in only 46% of subjects. Conclusion: Most of our subjects had no documented fertility

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

    Science.gov (United States)

    Groen, Wim G; Kuijpers, Wilma; Oldenburg, Hester Sa; Wouters, Michel Wjm; Aaronson, Neil K; van Harten, Wim H

    2015-11-27

    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 to empowerment of cancer survivors. We aim to define the conceptual components of patient empowerment of chronic disease patients, especially cancer survivors, and to explore the contribution of existing and new IT services to promote empowerment. Electronic databases were searched to identify theoretical and empirical articles regarding empowerment. We extracted and synthesized conceptual components of patient empowerment (ie, attributes, antecedents, and consequences) according to the integrated review methodology. We identified recent IT services for cancer survivors by examining systematic reviews and a proposed inventory of new services, and we related their features and effects to the identified components of empowerment. Based on 26 articles, we identified five main attributes of patient empowerment: (1) being autonomous and respected, (2) having knowledge, (3) having psychosocial and behavioral skills, (4) perceiving support from community, family, and friends, and (5) perceiving oneself to be useful. The latter two were specific for the cancer setting. Systematic reviews of IT services and our additional inventory helped us identify five main categories: (1) educational services, including electronic survivorship care plan services, (2) patient-to-patient services, (3) electronic patient-reported outcome (ePRO) services, (4) multicomponent services, and (5) portal services. Potential impact on empowerment included knowledge enhancement and, to a lesser extent, enhancing autonomy and skills. Newly developed services offer promising and exciting opportunities to empower cancer survivors, for instance, by providing tailored advice for supportive or follow-up care based on

  14. Predictors of Posttraumatic Stress Symptoms Among Adolescent and Young Adult Survivors of Childhood Cancer: Importance of Monitoring Survivors' Experiences of Family Functioning.

    Science.gov (United States)

    Kamibeppu, Kiyoko; Murayama, Shiho; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Okamura, Jun; Horibe, Keizo; Ishida, Yasushi

    2015-11-01

    The purpose of this study was to identify factors associated with posttraumatic stress symptoms (PTSS) among Japanese long-term childhood cancer survivors (CCSs). Subjects comprised 185 adolescent and young adult (AYA) CCSs who completed anonymous self-report questionnaires. Attending physicians also completed an anonymous disease/treatment data sheet. Mean age of survivors was approximately 8 years at diagnosis and 23 years at participation. Multiple regression analysis showed that family functioning, satisfaction with social support, being female, and interactions between family functioning and gender and age at the time of diagnosis were associated with PTSS among survivors. This study revealed family functioning as the most predictive factor of PTSS among AYA CCSs in Japan. Even when the survivor may have unchangeable risk factors, family functioning can potentially moderate the effects on PTSS. Thus, it is crucial for health professionals to carefully monitor and attend to survivors' experiences of family functioning to mitigate PTSS. © The Author(s) 2015.

  15. Psychosexual development and satisfaction in long-term survivors of childhood cancer: Neurotoxic treatment intensity as a risk indicator.

    Science.gov (United States)

    Lehmann, Vicky; Tuinman, Marrit A; Keim, Madelaine C; Winning, Adrien M; Olshefski, Randal S; Bajwa, Rajinder P S; Hagedoorn, Mariët; Gerhardt, Cynthia A

    2017-05-15

    Risk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at-risk survivors can be identified by 1) treatment neurotoxicity or 2) diagnosis. A total of 144 young adult survivors of childhood cancer and 144 matched controls completed questionnaires regarding psychosexual development, sexual satisfaction, and satisfaction with relationship status. Survivors were aged 20 to 40 years and were 5 to 34 years after diagnosis. Using medical chart data, survivors were divided into non-neurotoxic (48 survivors), low-dose (36 survivors), and high-dose (58 survivors) neurotoxic treatment groups. Apart from having fewer lifetime sex partners, survivors did not appear to differ from controls. However, survivors of brain tumors and any survivor who received high-dose neurotoxic treatment reported the lowest rates of achieving milestones of psychosexual development, whereas sexual and relationship status satisfaction were found to be related to relationship status. Neurotoxic treatment intensity further distinguished between survivors of brain tumors with and without psychosexual impairment. The intensity of neurotoxic treatment may be a valuable indicator of risk for psychosexual impairment relative to diagnosis alone. Health care providers should assess romantic/sexual problems among survivors at risk and make referrals if needed. Cancer 2017;123:1869-1876. © 2017 American Cancer Society. © 2017 American Cancer Society.

  16. 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.

  17. Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Rach, Amanda M; Crabtree, Valerie McLaughlin; Brinkman, Tara M; Zeltzer, Lonnie; Marchak, Jordan Gilleland; Srivastava, Deokumar; Tynes, Brooklee; Lai, Jin-Shei; Robison, Leslie L; Armstrong, Gregory T; Krull, Kevin R

    2017-04-01

    Survivors of pediatric Hodgkin's lymphoma (HL) are at risk for a number of debilitating late effects. Excessive fatigue and poor sleep quality are primary complaints of HL survivors. Understanding the emotional and physical factors that influence fatigue and sleep quality may provide opportunities for intervention to improve health-related quality of life for HL survivors. Data from 751 adult survivors of childhood HL who participated in the Childhood Cancer Survivor Study (CCSS) from 2000-2002 were analyzed. Multivariable logistic regression analyses investigated the demographic, psychological, and physical variables that predicted clinically significant levels of poor sleep quality, fatigue, and excessive daytime sleepiness. Survivors' self-reported level of emotional distress, pain, and physical functioning limitations did not differ from population norms. Clinically elevated levels of emotional distress (OR 8.38, 95% CI 4.28-16.42) and pain (OR 3.73, 95% CI 2.09-6.67) increased the risk for endorsing elevated levels of fatigue. Survivors with elevated levels of emotional distress (OR 6.83, 95% CI 2.71-15.90) and pain (OR 5.27, 95% CI 1.78-15.61) were more likely to report poor sleep quality. Pain (OR 2.11, 95% CI 1.39-3.34) was related to excessive daytime sleepiness. Emotional and physical factors are associated with elevated levels of fatigue, excessive daytime sleepiness, and poor sleep quality in survivors of pediatric HL. This is consistent with findings from research conducted with non-cancer survivors. These results suggest that interventions designed to target sleep and fatigue difficulties in the general population may be well suited for pediatric HL survivors as well.

  18. Erectile Dysfunction in Male Survivors of Childhood Cancer-A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Ritenour, Chad W M; Seidel, Kristy D; Leisenring, Wendy; Mertens, Ann C; Wasilewski-Masker, Karen; Shnorhavorian, Margarett; Sklar, Charles A; Whitton, John A; Stovall, Marilyn; Constine, Louis S; Armstrong, Gregory T; Robison, Leslie L; Meacham, Lillian R

    2016-06-01

    With survival rates higher than 80%, the number of survivors from pediatric cancer continues to increase. Late effects resulting from cancer and cancer therapy are being characterized, but little information exists on sexual health for men who have survived childhood cancer. To assess erectile dysfunction (ED) in men who survived childhood and adolescent cancers and to identify potential risk factors for ED. In total, 1,622 men and 271 eligible brothers in the Childhood Cancer Survivor Study cohort completed the Male Health Questionnaire, which provided information on sexual practices and sexual function. Combined with demographic, cancer, and treatment information from medical record abstraction, results of the Male Health Questionnaire were analyzed using multivariable modeling. The International Index of Erectile Function was used to identify ED in subjects. International Index of Erectile Function. Survivors (mean age = 37.4 years, SD = 7.3 years) reported significantly lower sexual activity in the year before the survey than the brothers (mean age = 38.8 years, SD = 8.5 years) without cancer. ED was reported by 12.3% (95% CI = 10.4-14.3) of survivors and 4.2% (95% CI = 2.0-7.9) of brothers. Survivors showed significantly higher relative risk (RR) for ED (RR = 2.63, 95% CI = 1.40-4.97). In addition to older age, survivors who were exposed to higher-dose (≥10 Gy) testicular radiation (RR = 3.55, 95% CI = 1.53-8.24), had surgery on the spinal cord or nerves (RR = 2.87, 95% CI = 1.36-6.05), prostate surgery (RR = 6.56, 95% CI = 3.84-11.20), or pelvic surgery (RR = 2.28, 95% CI = 1.04-4.98) were at higher risk for ED. Men who have survived childhood cancer have a greater than 2.6-fold increased risk for ED and certain cancer-specific treatments are associated with increased risk. Attention to sexual health, with its physical and emotional implications, and opportunities for early detection and intervention in these individuals could be important

  19. Recruiting young adult cancer survivors for behavioral research.

    Science.gov (United States)

    Rabin, Carolyn; Horowitz, Santina; Marcus, Bess

    2013-03-01

    Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies.

  20. Formalized exercise program for paediatric and young adult cancer survivors

    Directory of Open Access Journals (Sweden)

    Karen Y. Wonders

    2017-09-01

    Full Text Available Survival rates of childhood cancer patients has steadily increased through the years, making it necessary to develop strategies aimed at long term improvements to quality of life. This paper presents a formalized exercise program for paediatric cancer survivors, based on current risk-based exercise recommendations, with the primary goal of helping families return to a normal life that emphasizes overall wellness and physical activity. Background Children tend to respond better to anti-cancer treatments, including chemotherapy. Research indicates that proper nutrition and regular physical activity will help a paediatric cancer survivor continue to grow and develop properly, however, at present, there is no standard of care with regards to this subject. Aims To create a fun and supportive atmosphere that encourages movement and healthy eating for the participants while increasing participant knowledge regarding proper nutrition and exercise.

  1. 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.

  2. 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.

  3. The Disclosure Experiences of Male Child Sexual Abuse Survivors.

    Science.gov (United States)

    Gagnier, Charlotte; Collin-Vézina, Delphine

    2016-01-01

    This article explores the diversity in the disclosure process of male survivors of child sexual abuse. Disclosure is a complex process for victims of both genders, however masculine norms and stereotypes have contributed to an environment that often negates the experiences of men. The disclosure process of 17 adult male survivors of child sexual abuse was explored using transcripts of telephone interviews. A combination of two qualitative methodologies, the phenomenological method and interpretive description approach, was used to analyze this secondary data. The results indicated that the majority of the men in the study waited until adulthood to disclose their abuse, with negative stereotypes contributing to their delayed disclosures. In terms of specific experiences with disclosure, the participants found they received both positive and negative responses. These results were consistent with the literature.

  4. Interventions for treating persistent pain in survivors of torture

    DEFF Research Database (Denmark)

    Baird, Emma; Williams, Amanda C de C; Amris, Kirstine

    2017-01-01

    in the eligible studies: two trials used cognitive behavioural therapy (CBT) with biofeedback versus waiting list on unspecified persistent pain (58 participants completed treatment), and one examined the effect of complex manual therapy versus self-treatment on low back pain (30 participants completed treatment......). Excluded studies were largely either not RCTs or did not report pain as an outcome.There was no difference for the outcome of pain relief at the end of treatment between CBT and waiting list (two trials, 58 participants; SMD -0.05, 95% CI -1.23 to 1.12) (very low quality evidence); one of these reported......BACKGROUND: Persistent (chronic) pain is a frequent complaint in survivors of torture, particularly but not exclusively pain in the musculoskeletal system. Torture survivors may have no access to health care; where they do, they may not be recognised when they present, and the care available often...

  5. 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.

  6. Clinical Guidelines for the Care of Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Emily S. Tonorezos

    2014-09-01

    Full Text Available The Long-Term Follow-Up Guidelines for survivors of childhood, adolescent, and young adult cancers are evidence- and consensus-based guidelines that have been developed and published by the Children’s Oncology Group (COG Late Effects Committee, Nursing Discipline, and the Patient Advocacy Committee. Originally published in 2004, the guidelines are currently in version 3.0. While the COG guidelines have been praised as a model for providing risk-based survivorship care, adherence has not been uniform. Reasons for this gap include unawareness on the part of the survivor and/or care team as well as disagreement about the individual recommendations. In some cases, the burden of testing (such as annual echocardiography or repeat pulmonary function testing may be too great. A small number of intervention studies have documented improved adherence to guideline recommendations with dissemination of informational material. Future studies should focus on individualizing screening recommendations, as well as identifying unnecessary testing.

  7. Sleep Disturbance, Inflammation and Depression Risk in Cancer Survivors

    Science.gov (United States)

    Irwin, Michael R.; Olmstead, Richard E.; Ganz, Patricia A.; Haque, Reina

    2012-01-01

    Over two-thirds of the 11.4 million cancer survivors in the United States can expect long-term survival, with many others living with cancer as a chronic disease controlled by ongoing therapy. However, behavioral co-morbidities often arise during treatment and persist long-term to complicate survival and reduce quality of life. In this review, the inter-relationships between cancer, depression, and sleep disturbance are described, with a focus on the role of sleep disturbance as a risk factor for depression. Increasing evidence also links alterations in inflammatory biology dynamics to these long-term effects of cancer diagnosis and treatment, and the hypothesis that sleep disturbance drives inflammation, which together contribute to depression, is discussed. Better understanding of the associations between inflammation and behavioral co-morbidities has the potential to refine prediction of risk and development of strategies for the prevention and treatment of sleep disturbance and depression in cancer survivors. PMID:22634367

  8. Disorganizing experiences in second- and third-generation holocaust survivors.

    Science.gov (United States)

    Scharf, Miri; Mayseless, Ofra

    2011-11-01

    Second-generation Holocaust survivors might not show direct symptoms of posttraumatic stress disorder or attachment disorganization, but are at risk for developing high levels of psychological distress. We present themes of difficult experiences of second-generation Holocaust survivors, arguing that some of these aversive experiences might have disorganizing qualities even though they do not qualify as traumatic. Based on in-depth interviews with 196 second-generation parents and their adolescent children, three themes of disorganizing experiences carried across generations were identified: focus on survival issues, lack of emotional resources, and coercion to please the parents and satisfy their needs. These themes reflect the frustration of three basic needs: competence, relatedness, and autonomy, and this frustration becomes disorganizing when it involves stability, potency, incomprehensibility, and helplessness. The findings shed light on the effect of trauma over the generations and, as such, equip therapists with a greater understanding of the mechanisms involved.

  9. Sleep Disorders Among Holocaust Survivors: A Review of Selected Publications.

    Science.gov (United States)

    Lurie, Ido

    2017-09-01

    After World War II, traumatic after effects often caused persistent sleep disorders for Holocaust survivors (HSs). This is a review of studies reporting on sleep disturbances and nightmares (as primary or secondary outcomes) among HSs between 1939 and 2015, conducted in various countries and contexts (clinical settings, pension claims, community surveys, sleep laboratories). Most studies revealed various sleep disturbances among HSs. Some studies found those disturbances in the absence of clinical disorders. Both men and women reported similar frequencies of sleep disturbances, although posttraumatic stress disorder and depression were more frequent in women. Sleep laboratory studies provided the single most direct and detailed sources of information. Findings included a) long-standing changes in sleep architecture, for example, decreased rapid eye movement (REM) sleep, and b) contrasting patterns of dreaming and recall among better versus poorly adjusted survivors. These results are of importance to both HSs and their families and for medical and mental health professionals.

  10. Personality disorders in young adult survivors of pediatric burn injury.

    Science.gov (United States)

    Thomas, Christopher R; Russell, William; Robert, Rhonda S; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2012-04-01

    Life experience shapes personality and chronic trauma in childhood has been associated with risk for development of subsequent personality disorder. The purpose of this study is to determine the prevalence and character of personality disorders and traits in young adult survivors of severe pediatric burn injury. METHOD.: SCID-II and 16PF were completed by 98 young adult survivors of pediatric burn trauma. 48 (49%) met criteria for one or more personality disorders. The most frequent personality disorders were Paranoid (19.4%), Passive Aggressive (18.4%), Antisocial (17.3%), Depressive (11.2%), and Borderline (9.2%). Diagnosis with a personality disorder was associated with comorbid Axis I diagnoses and strongly correlated with personality traits as measured by the 16PF. Pediatric burn trauma is similar to other chronic traumas of childhood in significant correlation with subsequent personality disorder.

  11. The impact of rape acknowledgment on survivor outcomes: The moderating effects of rape myth acceptance.

    Science.gov (United States)

    Wilson, Laura C; Newins, Amie R; White, Susan W

    2017-11-13

    Little is known about how rape acknowledgment relates to posttrauma functioning; recent research suggests the effect may depend on additional factors. In the current study, the moderating effect of rape myth acceptance (RMA) on the relationships between rape acknowledgment and mental health outcomes was examined. A sample of 181 female rape survivors recruited from a university completed an online survey assessing RMA, rape acknowledgment, depression symptoms, and alcohol use. Generally, the results supported that RMA moderated the influence of rape acknowledgment on depression symptoms and average quantity per drinking episode, but not frequency of alcohol use. The findings demonstrated that when individuals endorsed high levels of RMA, acknowledged rape survivors reported worse outcomes than unacknowledged rape survivors. Among individuals low on RMA, unacknowledged rape survivors reported worse outcomes than acknowledged rape survivors. It is recommended that clinicians recognize the role of survivor beliefs, such as RMA, in the relationship between labeling sexual assault experiences and mental health consequences. © 2017 Wiley Periodicals, Inc.

  12. Leydig cell dysfunction, systemic inflammation and metabolic syndrome in long-term testicular cancer survivors

    DEFF Research Database (Denmark)

    Bandak, M; Jørgensen, N; Juul, A

    2017-01-01

    BACKGROUND: Twenty to thirty percent of testicular cancer (TC) survivors have elevated serum levels of luteinising hormone (LH) with or without corresponding low testosterone levels (Leydig cell dysfunction) during clinical follow-up for TC. However, it remains to be clarified if this subgroup...... of TC survivors has an increased long-term risk of systemic inflammation and metabolic syndrome (MetS) when compared with TC survivors with normal Leydig cell function during follow-up. PATIENTS AND METHODS: TC survivors with Leydig cell dysfunction and a control group of TC survivors with normal Leydig...... was higher in TC survivors with uncompensated Leydig cell dysfunction during follow-up, there was no evidence of increased systemic inflammation in patients with Leydig cell dysfunction during clinical follow-up. Total testosterone at follow-up was significantly associated with MetS, whereas...

  13. [Guidelines on life-style modification for Chinese breast cancer survivors].

    Science.gov (United States)

    2017-02-01

    Existing evidences proved that healthy life style after diagnosis contributes to better overall survival and quality of life for breast cancer survivors. The healthy life style includes maintaining healthy weight, regular physical activity and healthy diet. In order to address the concerns of the breast cancer survivors in their disease free and long-term survival period, and provide instruction to the clinical and public health professionals, breast cancer survivors and their families, Breast Health Group(BEST: Breast Education Screening Diagnosis and Treatment Group), the Branch of Women Health of Chinese Preventive Medicine Association convened experts to systematically evaluate the existing evidences and the characteristics of Chinese breast cancer survivors, developed guidelines on the life-style modification for breast cancer survivors. The suggestion and recommendation in the guideline aim to help the breast cancer survivors to take healthy diet, keep regular physical activity and maintain healthy weight, for improving overall health, prognosis, and quality of life over their long term survivorship.

  14. Cardiac dysfunction in cancer survivors unmasked during exercise.

    Science.gov (United States)

    Kearney, Maria C; Gallop-Evans, Eve; Cockcroft, John R; Stöhr, Eric J; Lee, Eveline; Backx, Karianne; Haykowsky, Mark; Yousef, Zaheer; Shave, Rob

    2017-03-01

    The cardiac dysfunction associated with anthracycline-based chemotherapy cancer treatment can exist subclinically for decades before overt presentation. Stress echocardiography, the measurement of left ventricular (LV) deformation and arterial haemodynamic evaluation, has separately been used to identify subclinical cardiovascular (CV) dysfunction in several patient groups including those with hypertension and diabetes. The purpose of the present cross-sectional study was to determine whether the combination of these techniques could be used to improve the characterisation of subclinical CV dysfunction in long-term cancer survivors previously treated with anthracyclines. Thirteen long-term cancer survivors (36 ± 10 years) with prior anthracycline exposure (11 ± 8 years posttreatment) and 13 age-matched controls were recruited. Left ventricular structure, function and deformation were assessed using echocardiography. Augmentation index was used to quantify arterial haemodynamic load and was measured using applanation tonometry. Measurements were taken at rest and during two stages of low-intensity incremental cycling. At rest, both groups had comparable global LV systolic, diastolic and arterial function (all P > 0·05); however, longitudinal deformation was significantly lower in cancer survivors (-18 ± 2 vs. -20 ± 2, P exercise, this difference between groups persisted and further differences were uncovered with significantly lower apical circumferential deformation in the cancer survivors (-24 ± 5 vs. -29 ± 5, -29 ± 5 vs. 35 ± 8 for first and second stage of exercise respectively, both P exercise provides a more comprehensive characterisation of subclinical LV dysfunction. Larger studies are required to determine the clinical relevance of these preliminary findings. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  15. Navigating stroke care: the experiences of younger stroke survivors.

    Science.gov (United States)

    Sadler, Euan; Daniel, Katie; Wolfe, Charles D A; McKevitt, Christopher

    2014-01-01

    Although stroke is associated with ageing, a significant proportion of strokes occur in younger people. Younger stroke survivors have experienced care available as inappropriate to their needs. However, insufficient attention has been paid to how the social context shapes their experiences of care. We investigated this question with younger stroke survivors in Greater London, UK. We conducted in-depth interviews with individuals aged between 24 and 62 years. Interviews were analysed thematically, with interpretation informed by Bourdieu's concepts of field, capital and habitus. In the acute care setting it was implicit for participants that expertise and guidance was to be prioritised and largely this was reported as what was received. Individuals' cultural capital shaped expectations to access information, but health care professionals' symbolic capital meant they controlled its provision. After discharge, professional guidance was still looked for, but many felt it was limited or unavailable. It was here that participants' social, cultural and economic capital became more important in experiences of care. The field of stroke shaped younger stroke survivors' experiences of care. Navigating stroke care was contingent on accessing different forms of capital. Differences in access to these resources influenced longer term adjustment after stroke. Stroke care can be conceptualised as a temporal field of social activity and relationships which shapes variations in experiences of care among younger stroke survivors, and differences in expectations of support at different time points after stroke. On entering the field of stroke participants reported needing health care professional guidance and expertise to manage the acute event, yet difficulties accessing information in hospital limited the agency of some individuals wanting to take an active role in their recovery. After discharge from hospital variations in experiences of care among participants were more evident

  16. The metabolic syndrome and body composition in childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Jae Hoon Chung

    2011-06-01

    Full Text Available Purpose : Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods : We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results : A total of 19 (19.4% patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P&lt;0.001 and r=0.44, P&lt;0.00, respectively. Sixty-one (62.2% patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03. The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03. Conclusion : Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.

  17. Long-term psychiatric outcomes in pediatric brain tumor survivors.

    Science.gov (United States)

    Shah, Sumedh Subodh; Dellarole, Anna; Peterson, Eric Cecala; Bregy, Amade; Komotar, Ricardo; Harvey, Philip D; Elhammady, Mohamed Samy

    2015-05-01

    The increased efficacy of cancer treatments has led to a greater survival rate of patients with pediatric brain cancers. Therefore, it is imperative to explore the long-term consequences of therapies employed to treat pediatric brain tumors. The goal of this study was to provide a review of literature regarding the downstream psychological and psychiatric consequences experienced by adult survivors of pediatric brain cancer as a result of treatment, tumor type, or tumor location. A PubMed MeSH search and additional online database searches were conducted to include pertinent studies that discussed psychological deficits in childhood brain cancer survivors. The studies included were subjected to data extraction to quantify relevant information for further analysis. A total of 17 papers with 5320 pediatric brain tumor patients were incorporated in our review. Mean age at diagnosis (8.13 ± 0.77 years), mean follow-up time (9.98 ± 3.05 years), and male-to-female ratios (1.08:1) were compiled from studies reporting this information. Incidences of depression (19 %), anxiety (20 %), suicidal ideation (10.9 %), schizophrenia and its related psychoses (9.8 %), and behavioral problem (28.7 %) were higher among pediatric brain cancer survivors than in the normal population. Craniospinal radiotherapy and/or surgery corresponded to an increased likelihood of developing adverse deficits. Astrocytomas or other glial tumors were linked to poorer outcomes. Physicians treating pediatric brain tumor patients should be aware of the possible consequences associated with treatment. Psychiatric monitoring is warranted in survivors of pediatric brain tumors, but further investigation is needed to elucidate late outcomes regarding tumor type and location.

  18. The mental health state of atomic bomb survivors

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    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)

  19. Coping and caring: support for family caregivers of stroke survivors.

    Science.gov (United States)

    Chow, Susan K Y; Wong, Frances K Y; Poon, Christopher Y F

    2007-07-01

    This study examines the physical and emotional burden experienced by caregivers of stroke survivors, compared with caregivers of patients having neurological diseases. Stroke survivors have residual neurological impairment, which requires long-term support and care. Anxiety, depression and poor physical health are common sequelae among family caregivers of stroke survivors. There is a reasonably consistent association between patients' levels of disability and emotional state and the emotional distress of their caregivers. A convenience sample of 47 families was recruited: of the 47 families, 23 had a member who suffered from stroke and 24 had a member with neurological disease. Two interviews were conducted at three and six months after the occurrence of the index stroke or neurological disease. When the two groups of caregivers were compared for anxiety, depression and physical health status after care giving, the caregivers of stroke patients demonstrated higher levels of anxiety and depression than their counterparts in the neurological disease group (p caregivers, while their age and level of depression contributed significantly to their physical health status. The physical and emotional well-being of two groups of family caregivers in a neurosurgical unit were compared in the caring context. The caregivers of stroke survivors are at a greater risk of developing poor physical and emotional health than the caregivers of patients having neurological diseases. The results illustrated that enhanced discharge planning and nurse follow-up sessions are considered essential in maintaining the well-being of the stroke caregivers and bridging the gap between the hospital and the community.

  20. Symptom Clusters and Work Limitations in Employed Breast Cancer Survivors

    Science.gov (United States)

    2011-11-16

    common syndrome ” (Cleeland, et al., 2003). The growing recognition of the importance of patterns of symptoms in impairing the function and well-being...cancer patients (Stein, Jacobsen , Blanchard, & Thors, 2004; Stein, Martin, Hann, & Jacobsen , 1998). The MFSI-SF comprises 30 items using a 5-point...Tunceli, K. (2005). Employment pathways in a large cohort of adult cancer survivors. Cancer, 103, 1292-1301. Stein, K., Jacobsen , P., Blanchard, C

  1. Dietary intake after treatment in child cancer survivors.

    Science.gov (United States)

    Cohen, Jennifer; Wakefield, Claire E; Fleming, Catharine A K; Gawthorne, Rebecca; Tapsell, Linda C; Cohn, Richard J

    2012-05-01

    Childhood cancer survivors (CCS) are at increased risk of complications such as obesity, diabetes, and osteoporosis which have the potential to, in part, be controlled with dietary interventions. To allow the development of appropriate dietary interventions for younger cancer survivors data on their dietary intake as well as information on parental nutrition views and practices need to be assessed. Dietary intake of 50 CCS was assessed with a 3-day food diary (parent report). Parent child feeding practices were assessed with the Child Feeding Questionnaire (CFQ). Historical and anthropometric data was extracted from medical records. Survivors were less than 13 years old and less than 5 years after treatment completion. Twenty percent of participating CCS was overweight or obese and 54% were consuming above their estimated energy requirements. Fifty, 32% and 44% of children did not meet requirements for folate, calcium, and iron respectively. There was a significant trend for increasing BMI percentiles from diagnosis to time of assessment (56.29 vs. 67.17, P = 0.01). Results from the CFQ showed that parents were more likely to monitor (3.99) and use a restrictive form of parenting (3.43) to control their child's food intake rather than pressure their child to eat (2.77) (P = 0.001). This group displayed excessive energy intake (kilojoules) and poor dietary habits. Parents' restrictive feeding style may be contributing to these habits. Early interventions targeting the dietary intake of young survivors and associated parent feeding practices may prevent some of the deleterious long-term effects associated with childhood cancer therapy. Copyright © 2011 Wiley Periodicals, Inc.

  2. Taste and smell dysfunction in childhood cancer survivors.

    Science.gov (United States)

    Cohen, Jennifer; Laing, David G; Wilkes, Fiona J; Chan, Ada; Gabriel, Melissa; Cohn, Richard J

    2014-04-01

    Reduced or altered taste and smell function may occur as a side-effect of cancer therapy. This can lead to altered nutrient and energy intake. Some studies have suggested that taste and smell dysfunction can persist many years after treatment completion but this has not been previously assessed in survivors of childhood cancer. The aim of this study is to determine if taste and smell dysfunction is present in childhood cancer survivors (CCS). Food preference and Quality of Life was also assessed. Fifty-one child cancer survivors (mean age: 19.69±7.09years), more than five years since treatment completion, (mean: 12.4years) were recruited from the long term follow-up clinics at two Sydney-based children's hospitals. Taste function was assessed using a 25 sample taste identification test comprising five concentrations each of sweet, salty, sour and bitter tastes and water. Smell function was assessed by determining the ability of participants to identify 16 common odorants. The participants' Quality of Life was assessed using the Functional Assessment of Anorexia Cachexia scale and food preferences were assessed using a 94-item food liking tool. Taste dysfunction was found in 27.5% of participants (n=14), and smell dysfunction in 3.9% (n=2) of participants. The prevalence of taste dysfunction was higher than that seen in the non-cancer population. The child cancer survivors' appeared to "like" the less healthy food groups such as flavoured beverages, takeaway and snacks over healthier food groups such as vegetables and salad. No correlation was found between those with a taste dysfunction and their food "likes". A high level of taste dysfunction was found in CCS though there did not appear to be an issue with smell dysfunction. Further work is also needed to assess whether a taste dysfunction do play a role in the dietary habits of CCS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Analysis of Balance during Functional Walking in Stroke Survivors.

    Directory of Open Access Journals (Sweden)

    Fokke B van Meulen

    Full Text Available An important objective of rehabilitation care is to regain adequate balance function to safely ambulate in community. However, in rehabilitation practice, it remains unclear if a stroke survivor functionally recovers by restitution or by learning to compensate for the lack of restoration of body function. Aim of this study is to propose and evaluate methods for the objective evaluation of balance during functional walking in stroke survivors.Stroke survivors performed twice a Timed "Up & Go" (TUG test. Ground reaction forces and position changes of both feet were measured using instrumented shoes and used to estimate the position of the center of mass (CoM. Balance control and efficiency metrics were defined to evaluate functional walking under variable conditions. Metrics were corrected based on the instantaneous velocity direction of CoM. Intra- and inter-participant variations for different phases of the TUG test were examined. Metrics were related to the Berg balance scale (BBS.Participants with higher BBS scores show a more efficient walking pattern. Their walking velocity and walking direction is less variable and they are more frequently unstable when walking in a straight line or when turning. Furthermore, the less affected participants are able to move their CoM more towards their affected side.We developed and demonstrated a method to assess walking balance of stroke survivors. System design and evaluation methods allow balance evaluation during functional walking in daily life. Some presented metrics show correlations with BBS scores. Clear inter- and intra-patient variations in metric values are present that cannot be explained by BBS scores, which supports the additional value of the presented system. Presented methods may be used for objective evaluation of restitution and compensation of walking balance and have a potential application in individual evidence-based therapy.

  4. Predictors of depressive symptoms among community-dwelling stroke survivors.

    Science.gov (United States)

    Taylor-Piliae, Ruth E; Hepworth, Joseph T; Coull, Bruce M

    2013-01-01

    Depression is a common yet often unrecognized consequence of stroke, affecting between 25% and 70% of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78%), college educated (79%), and retirees (77%). Annual income was $50 000 or greater for 32%. Hemiparesis was common (right side, 39%; left side, 42%); 35% had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21% had a history of major depression. Approximately 64% of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P symptoms among these stroke survivors. Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation

  5. Holocaust survivors in old age: the Jerusalem Longitudinal Study.

    Science.gov (United States)

    Stessman, Jochanan; Stesssman, Jochanan; Cohen, Aaron; Hammerman-Rozenberg, Robert; Bursztyn, Michael; Azoulay, Daniel; Maaravi, Yoram; Jacobs, Jeremy M

    2008-03-01

    To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival. A longitudinal cohort study of the natural history of an age-homogenous representative sample born in 1920/21 and living in Jerusalem. Community-based home assessments. Four hundred fifty-eight subjects of European origin aged 70 at baseline and 77 at follow-up. Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7-year mortality data from the National Death Registry. Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support (P=.01), less physical activity (P=.03), greater difficulty in basic activities of daily living (P=.009), poorer self-rated health (P=.04), and greater usage of psychiatric medication (P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow-up period, and 7-year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greater 7-year mortality. Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality.

  6. Social media for breast cancer survivors: a literature review.

    Science.gov (United States)

    Falisi, Angela L; Wiseman, Kara P; Gaysynsky, Anna; Scheideler, Jennifer K; Ramin, Daniel A; Chou, Wen-Ying Sylvia

    2017-12-01

    Social media may offer support to individuals who are navigating the complex and challenging experience of cancer. A growing body of literature has been published over the last decade exploring the ways cancer survivors utilize social media. This study aims to provide a systematic synthesis of the current literature in order to inform cancer health communication practice and cancer survivorship research. Using PRISMA guidelines, four electronic databases were searched to retrieve publications on breast cancer and social media published between 2005 and 2015. The final sample included 98 publications (13 commentaries and reviews, 47 descriptive studies, and 38 intervention studies). Intervention studies were assessed for key features and outcome measures. Studies utilizing content analysis were further evaluated qualitatively. Online support groups were the most commonly studied platform, followed by interactive message boards and web forums. Limited research focuses on non-Caucasian populations. Psychosocial well-being was the most commonly measured outcome of interest. While social media engagement was assessed, few standardized measures were identified. Content analyses of social media interactions were prevalent, though few articles linked content to health outcomes. The current literature highlights the impact and potential utility of social media for breast cancer survivors. Future studies should consider connecting social media engagement and content to psychosocial, behavioral, and physical health outcomes. Online groups and communities may improve the well-being of breast cancer survivors by providing opportunities to engage with wider social networks, connect with others navigating similar cancer experiences, and obtain cancer-related information. Researchers should consider the potential role of social media in addressing the unmet needs of breast cancer survivors, and particularly the implications for clinical and public health practice.

  7. Does psychological adjustment of melanoma survivors differs between genders?

    Science.gov (United States)

    Hamama-Raz, Y

    2012-03-01

    Survival rates of cancer have significantly increased. However, cancer survivors face physical, psychological and social difficulties, while adjusting to post-illness status. We examined between-gender differences in the psychological adjustment (mental well-being, distress and subjective level of functioning), the putative origin of those differences, and the roles of cognitive appraisal, hardiness and attachment style in the psychological adjustment of melanoma survivors.   Our sample included 300 malignant melanoma survivors (182 women and 118 men). Most were diagnosed in stages IA and IB of the disease, and had no evidence of disease for 5 years or more. Participants completed self-report questionnaires regarding personal data, adjustment measured by sense of well-being, distress and subjective functioning, cognitive appraisal (primary and secondary) and personal resources (hardiness and attachment style).   Between-gender differences were revealed in psychological adjustment and in various components of cognitive appraisal and attachment styles. Women revealed more distress, less secondary cognitive appraisal and were more secure in attachment styles. Men showed higher secondary appraisal and were more dismissing-avoidant in attachment. No between-group differences were found in mental well-being, subjective functioning, and primary cognitive appraisal or in the global measure of hardiness.   We present social processes that seem to account for gender differences in behavior and response to stress, and psychological explanations for these findings. This study contributes to the field of psycho-oncology by identifying factors that promote adjustment among melanoma survivors. Copyright © 2010 John Wiley & Sons, Ltd.

  8. Lifestyle modification in cervical cancer survivors: an ongoing need.

    Science.gov (United States)

    Schlumbrecht, Matthew P; Sun, Charlotte C; Huang, Marilyn S; Zandstra, Fran; Bodurka, Diane C

    2014-03-01

    With the introduction of multimodality therapy for cervical cancer, many women will be long-term survivors in need of comprehensive surveillance care. Our goals were to evaluate patterns of obesity and smoking in a cohort of cervical cancer survivors and to assess the potential influence of these comorbidities on subsequent follow-up. We reviewed the records of patients treated for invasive cervical cancer at our institution from 2000 to 2003 who had no evidence of disease for 3 or more years. Demographic and clinical data were collected, including smoking history and anthropometric measurements. Body mass index (BMI) was categorized according to World Health Organization criteria. Logistic regression and Wilcoxon rank sum analyses were performed. Two hundred ninety-eight women had complete follow-up data at 3 years. The median age at diagnosis was 43.5 years (range, 17.6-87.1 years). At diagnosis, 31.9% had a normal BMI, 28.2% were overweight, and 34.6% were obese compared with 31.7%, 21.1%, and 30.2% at 3 years, respectively. Of the 51 women whose BMI categorization changed, 33 (64.7%) had weight gain, and 18 (35.3%) had weight loss. By paired analyses, increase in BMI was significant over the 3-year interval (P Obesity and smoking are significant comorbidities that may complicate care in cervical cancer survivors. Interventions aimed at modifying these risk factors should be routinely undertaken in this population.

  9. Fear of cancer recurrence in colorectal cancer survivors.

    Science.gov (United States)

    Custers, José A E; Gielissen, Marieke F M; Janssen, Stephanie H V; de Wilt, Johannes H W; Prins, Judith B

    2016-02-01

    Although long-term colorectal cancer (CRC) survivors generally report a good quality of life, fear of cancer recurrence (FCR) remains an important issue. This study investigated whether the Cancer Worry Scale (CWS) can detect high FCR, the prevalence, and characteristics of FCR in CRC survivors. Two hundred and eleven patients who had undergone successful CRC surgery in the period 2003-2010 in the Radboud University Medical Center in the Netherlands were asked to participate. All patients were sent an information letter plus questionnaires for collecting information on demographic and medical variables, FCR, distress, and quality of life. Seventy-six patients (36 %; median age of 67.7 years range 41-88 years) completed the questionnaires a median of 5.1 years after surgery. A cut-off score of 14 or higher on the CWS was optimal to detect high FCR. Twenty-nine patients (38 %) experienced high levels of FCR, characterized by higher levels of distress, post-traumatic stress symptoms, and lower quality of life. These individuals particularly reacted to disease-related triggers, felt helpless, were worried, and experienced limitations in daily functioning. High FCR was not associated with demographic or medical variables. Long after successful CRC surgery, FCR is a serious problem that impairs the quality of life for a substantial proportion of patients. With the CWS, it is possible to detect high FCR and thereby assist survivors in receiving appropriate care.

  10. 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.

  11. Media Use and the Cancer Communication Strategies of Cancer Survivors.

    Science.gov (United States)

    Yoon, Heesoo; Sohn, Minsung; Jung, Minsoo

    2016-09-01

    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.

  12. Spiritual well-being and depressive symptoms among cancer survivors.

    Science.gov (United States)

    Gonzalez, Patricia; Castañeda, Sheila F; Dale, Jennifer; Medeiros, Elizabeth A; Buelna, Christina; Nuñez, Alicia; Espinoza, Rebeca; Talavera, Gregory A

    2014-09-01

    Depression is common among patients diagnosed with cancer and may be inversely associated with spiritual well-being. While numerous strategies are employed to manage and cope with illness, spiritual well-being has become increasingly important in cancer survivorship research. This study examined the association between spiritual well-being and depressive symptoms. This cross-sectional study utilized self-report data from 102 diverse cancer survivors recruited from peer-based cancer support groups in San Diego County. Depression was measured with the Patient Health Questionnaire-8 (PHQ-8) and spiritual well-being was measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) comprised of two subscales (Meaning/Peace and Faith). Hierarchal regression analysis indicated that Meaning/Peace significantly predicted depressive symptoms after adjusting for socio-demographics, cancer stage, time since diagnosis, and Faith (p Meaning/Peace has a unique advantage over Faith in protecting cancer survivors from the effects of depression symptoms; therefore, turning to Faith as source of strength may improve psychological well-being during survivorship. Future programs and healthcare providers should be cognizant of the influential role of spiritual well-being in depression symptoms in an effort to improve psychological well-being among cancer survivors.

  13. Telephone intervention with family caregivers of stroke survivors after rehabilitation.

    Science.gov (United States)

    Grant, Joan S; Elliott, Timothy R; Weaver, Michael; Bartolucci, Alfred A; Giger, Joyce Newman

    2002-08-01

    Social problem-solving therapy shows promise as an intervention to improve the well-being of family caregivers. There is some evidence that training in problem solving may be effectively delivered by telephone. The purpose of this study was to quantify the impact of social problem-solving telephone partnerships on primary family caregiver outcomes after stroke survivors are discharged home from a rehabilitation facility. Using a randomized 3-group repeated-measures experimental design, 74 stroke survivors with an admitting diagnosis of ischemic stroke and their primary family caregivers were entered into the study. The intervention consisted of an initial 3-hour home visit between a trained nurse and the family caregiver within 1 week after discharge to begin problem-solving skill training. This initial session was followed by weekly (the first month) and biweekly (the second and third month) telephone contacts. Compared with the sham intervention and control groups, family caregivers who participated in the social problem-solving telephone partnership intervention group had better problem-solving skills; greater caregiver preparedness; less depression; and significant improvement in measures of vitality, social functioning, mental health, and role limitations related to emotional problems. There were no significant differences among the groups in caregiver burden. Satisfaction with healthcare services decreased over time in the control group while remaining comparable in the intervention and sham intervention groups. These results indicate that problem-solving training may be useful for family caregivers of stroke survivors after discharge from rehabilitative facilities.

  14. 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.

  15. Nonalcoholic fatty liver disease and mortality among cancer survivors.

    Science.gov (United States)

    Brown, Justin C; Harhay, Michael O; Harhay, Meera N

    2017-06-01

    Nonalcoholic fatty liver disease (NAFLD) may foster a tumor microenvironment that promotes cancer recurrence and progression. We examined the relationship between NAFLD and mortality among a sample of cancer survivors. Ultrasonography was used to assess hepatic steatosis, and standardized algorithms were used to define NAFLD. Study endpoints included all-cause, cancer-specific, and cardiovascular-specific mortality. Among 387 cancer survivors, 17.6% had NAFLD. During a median of 17.9 years of follow up, we observed 196 deaths from all causes. In multivariable-adjusted regression models, NAFLD was associated with an increased risk of all-cause mortality [HR: 2.52, 95% CI: 1.47-4.34; P=0.001]. We observed 86 cancer-specific deaths. In multivariable-adjusted regression models, NAFLD was associated with an increased risk of cancer-specific mortality [HR: 3.21, 95% CI: 1.46-7.07; P=0.004]. We observed 46 cardiovascular-specific deaths. In multivariable-adjusted regression models, NAFLD was not associated with an increased risk of cardiovascular-specific mortality [HR: 1.04, 95% CI: 0.30-3.64, P=0.951]. NAFLD is associated with an increased risk of all-cause and cancer-specific mortality among cancer survivors. This novel observation warrants replication. Evaluating the efficacy of interventions, such as lifestyle modification through weight loss and exercise, to improve NAFLD in this population may be considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Executive functioning deficits in young adult survivors of bronchopulmonary dysplasia.

    Science.gov (United States)

    Gough, Aisling; Linden, Mark A; Spence, Dale; Halliday, Henry L; Patterson, Christopher C; McGarvey, Lorcan

    2015-01-01

    To assess long-term impairments of executive functioning in adult survivors of bronchopulmonary dysplasia (BPD). Participants were assessed on measures of executive functioning, health-related quality of life (HRQoL) and social functioning. Survivors of BPD (n = 63; 34 males; mean age 24.2 years) were compared with groups comprising preterm (without BPD) (executive functioning relating to problem solving (OR: 5.1, CI: 1.4-19.3), awareness of behavior (OR: 12.7, CI: 1.5-106.4) and organization of their environment (OR: 13.0, CI: 1.6-107.1). Birth weight, HRQoL and social functioning were predictive of deficits in executive functioning. This study represents the largest sample of survivors into adulthood of BPD and is the first to show that deficits in executive functioning persist. Children with BPD should be assessed to identify cognitive impairments and allow early intervention aimed at ameliorating their effects. Implications for Rehabilitation Adults born preterm with very-low birth weight, and particularly those who develop BPD, are at increased risk of exhibiting defects in executive functioning. Clinicians and educators should be made aware of the impact that BPD can have on the long-term development of executive functions. Children and young adults identified as having BPD should be periodically monitored to identify the need for possible intervention.

  17. Exercise training improves mean arterial pressure in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Robert C. Mills

    2014-09-01

    Full Text Available Currently, many breast cancer survivors worldwide live with treatment-related side effects, including cardiovascular health problems. This study examined effects of a 5-month exercise intervention on non-invasive markers of cardiovascular health in breast cancer survivors. Relationships between these markers and commonly used markers of overall health were also explored. Fifty-two survivors completed the exercise training at a rehabilitation center at the University of North Carolina at Chapel Hill between 2008-2011. A combined aerobic and resistance exercise intervention (3 times/week for 1h at intensities progressing from low (40% to moderate (65-70% of VO2max for aerobic and 8-12 repetitions max for the resistance exercise were implemented. Significant reduction in mean arterial pressure (MAP was observed from baseline to final assessment. A significant correlation was found between MAP and Body Mass Index (BMI. In conclusion, 5-months combined aerobic and resistance exercise intervention positively improved MAP which was, in part, attributed to changes in BMI.

  18. 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.

  19. Survivorship resources for post-treatment cancer survivors.

    Science.gov (United States)

    Tesauro, Gina M; Rowland, Julia H; Lustig, Craig

    2002-01-01

    The purpose of this project was to determine the scope of services and resources available to cancer survivors who have completed active treatment and their families at National Cancer Institute (NCI)-designated comprehensive cancer centers. Patient education program contacts from the 37 NCI-designated comprehensive cancer centers participated in a telephone interview. Program contacts were asked to identify the types of medical and psychosocial services that their respective cancer center offered. Telephone interviews were completed by patient education program contacts from all NCI-designated comprehensive cancer centers for a total response rate of 100%. Services pertaining to lymphedema management were identified in 70% of cancer centers. Other common services identified specifically for post-treatment cancer survivors at cancer centers were professionally led support groups (49% of cancer centers), long-term medical care (38% of cancer centers), school re-entry programs (19% of cancer centers), nutrition counseling (14% of cancer centers), and counseling addressing fertility and sexual concerns (14% of cancer centers). Results from this project outline the range of services and resources that are provided to post-treatment cancer survivors by NCI-designated comprehensive cancer centers, and can be used to develop standards of care for future cancer control programs.

  20. Secondary salutogenic effects in veterans whose parents were Holocaust survivors?

    Science.gov (United States)

    Dekel, Sharon; Solomon, Zahava; Rozenstreich, Eyal

    2013-02-01

    Addressing the ongoing controversy over inter-generational transmission of trauma, we examined the impact of the Nazi Holocaust on PTSD course and co-morbid symptoms (e.g., depression, anxiety) among offspring of survivors following their own adversity in two longitudinal studies. Two samples of Israeli war veterans included Second Generation Holocaust (i.e., SGH) survivors and comparable veterans with no such family history (i.e., not-SGH). Study I: 1982 Lebanon War veterans (N = 669) were assessed 1, 3, and 20 years after the war. Study II: 1973 Yom Kippur War veterans (N = 343) were followed up 18, 30, and 35 years after the war. Results indicated that SGH endorsed higher PTSD and co-morbid symptoms criteria rates than not-SGH veterans in the initial post-war years but this pattern was reversed in the long-term, that is, lower rates were evident among SGH in later follow-ups. These findings suggest the development of a complex trauma reaction among offspring of trauma survivors. Possibly there is a transmission of positive trauma outcomes from one generation to the next rather than merely negative ones. Future studies are therefore warranted to re-evaluate the notion of inter-generational transmission of trauma and examine its components. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. The aging of Holocaust survivors: myth and reality concerning suicide.

    Science.gov (United States)

    Barak, Yoram

    2007-03-01

    The association between the Holocaust experience and suicide has rarely been studied systematically. The dearth of data in this area of old-age psychiatry does not necessarily imply that Holocaust survivors are immune from suicide. Recent work on the aging of survivors seems to suggest that as a group they are at high risk for self-harm. Published reports on suicide and the Holocaust identified by means of a MEDLINE literature search were reviewed. A similar search was performed on the Internet using the Google search engine. Thirteen studies were uncovered, 9 of which addressed the association of suicide and the Holocaust experience and 4 focused on suicide in the concentration camps during the genocide. Eleven of the 15 studies explicitly reported on the association of suicide, suicidal ideation or death by suicide with the Holocaust experience, or reported findings suggesting such an association. The Internet search yielded three sites clearly describing increased suicide rates in the concentration camps. An increased rate of suicidal ideation and suicide attempts among the elderly who were exposed to the Holocaust experience is confirmed. There is a need for further study, intervention and resource allocation among the growing numbers of elderly persons who suffered traumatic events in earlier phases of their lives. This is especially critical for Holocaust survivors.

  2. Balancing psychache and resilience in aging Holocaust survivors.

    Science.gov (United States)

    Ohana, Irit; Golander, Hava; Barak, Yoram

    2014-06-01

    Psychache can and does co-exist alongside resilience and coping amongst trauma survivors. This has been the center of the a-integrative theory of aging demonstrating an attitude to life based on cognitive and emotional dimensions. Aging of Holocaust survivors (HS) is especially difficult when focus is brought to the issue of integrating their life history. The present study aimed to investigate the interplay between psychache and resilience amongst aging HS. Cross-sectional study of HS and a matched comparison group recruited from the general population was carried out. All underwent a personal interview and endorsed quantifiable psychache and resilience scales. We enrolled 214 elderly participants: 107 HS and 107 comparison participants. Mean age for the participants was 80.7± years; there were 101 women and 113 men in each group. Holocaust survivors did not differ in the level of resilience from comparisons (mean: 5.82 ± 0.68 vs. 5.88 ± 0.55, respectively). Psychache was significantly more intense in the HS group (F(8,205) = 2.21; p < 0.05). The present study demonstrates the complex interplay between psychache and resilience. Aging HS still have to cope with high levels of psychache while realizing a life-long process of development through resilience.

  3. The lived experience of genocide rape survivors in Rwanda.

    Science.gov (United States)

    Mukamana, Donatilla; Brysiewicz, Petra

    2008-01-01

    The purpose of this study was to explore the lived experience of women who were raped during the 1994 genocide in Rwanda. A phenomenological approach was used and this study was carried out in Rwanda in three different locations. The 7 participants took part in three semi-structured, individual interviews which were audiotaped. Participants reported many themes unique to Rwandan women survivors of genocide. These themes included violation by perceived inferiors, loss of dignity and respect, loss of identity, social isolation, loss of hope for the future (i.e., HIV/AIDS), the ongoing torture of rape babies, and developing a sense of community. Rwandan women survivors of the 1994 genocide have lived through unimaginable suffering. Limited information is available regarding the experiences of these rape survivors and this information could create awareness and some understanding of what these women endured. This study can help nurses to understand the sequelae of war and rape and thus have needed information which can be used to offer assistance to women in these circumstances.

  4. Cognitive tasks challenging brain tumor survivors at work.

    Science.gov (United States)

    Collins, Courtney; Gehrke, Amanda; Feuerstein, Michael

    2013-12-01

    To identify problematic work tasks involving cognitive function in employed brain tumor survivors. Work tasks involving cognitive functions were compared between employed brain tumor survivors (n = 137) and a disease-free group (n = 96). Multivariable logistic regressions were conducted. In the brain tumor survivors, 44% (26/59) of work tasks were more likely to be problematic. Top five problematic work tasks included were as follows: following the flow of events (odds ratio [OR] = 11.72; 95% confidence interval [CI] = 3.19 to 43.07), remembering train of thought while speaking (OR = 11.70; 95% CI = 5.25 to 26.10), putting together materials for a task (OR = 10.90; 95% CI = 2.80 to 42.38), shifting between tasks (OR = 10.71; 95% CI = 3.62 to 31.74), and following written instructions (OR = 9.96; 95% CI = 2.65 to 37.41). Findings identified problematic work tasks involving major domains of cognitive function.

  5. Quality of life in caregivers of severely disabled war survivors.

    Science.gov (United States)

    Mousavi, Batool; Seyed Hoseini Davarani, Seyed Hosein; Soroush, Mohammadreza; Jamali, Arsia; Khateri, Shahriar; Talebi, Morteza; Montazeri, Ali

    2015-01-01

    To evaluate quality of life (QOL) of caregivers of severely disabled war survivors and identify variables threatening caregivers' QOL. A cross-sectional study was performed on 532 caregivers of Iran-Iraq war related injured survivors by using Persian version of 36-item Short Form Health Survey (SF-36). Caregivers had lower QOL compared to the Iranian female population (p < .001). Caregivers of amputees had better SF-36 scores compared to caregivers of two groups of chemical warfare survivors (p ranging from .01 to <.001). Caregiving to chemical warfare and being married at the time of trauma were the independent predictors of poor QOL in both the physical component summary (OR = 5.08, 95% CI = 3.35-7.7; OR = 0.57, 95% CI = 0.37-0.89) and the mental component summary (OR = 4.12, 95% CI = 2.68-6.32; OR = 0.63, 95% CI = 0.40-0.98). Caregivers of war veterans suffer from poor QOL. Chemical warfare agents contribute to more persistent poor QOL in caregivers than the injuries caused by conventional weapons. © 2014 Association of Rehabilitation Nurses.

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

    OpenAIRE

    Kim, Se Ik; Lee, Yumi; Lim, Myong Cheol; 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...

  7. Predicting fear of breast cancer recurrence and self-efficacy in survivors by age at diagnosis.

    Science.gov (United States)

    Ziner, Kim Wagler; Sledge, George W; Bell, Cynthia J; Johns, Shelley; Miller, Kathy D; Champion, Victoria L

    2012-05-01

    To determine the effect that age at diagnosis has on fear of breast cancer recurrence and to identify the predictors of fear of recurrence using self-efficacy as a mediator. Cross-sectional survey. Two university cancer centers and one cooperative group in the midwestern United States. 1,128 long-term survivors. Survivors were eligible if they were aged 18-45 years (younger group) or 55-70 years (older group) at cancer diagnosis, had received chemotherapy, and were three to eight years postdiagnosis. Fear of recurrence was compared between younger and older groups. Multiple regression analyses were used to test variables' prediction of fear of recurrence and breast cancer survivor self-efficacy, as well as breast cancer survivor self-efficacy mediation effects. Fear of recurrence, breast cancer survivor self-efficacy, and age at diagnosis. Survivors diagnosed at a younger age had significantly higher fear of recurrence, as well as health, role, womanhood, death, and parenting worries. Perceived risk of recurrence, trait anxiety, and breast cancer reminders explained significant variance in fear of recurrence and breast cancer survivor self-efficacy. Breast cancer survivor self-efficacy partially mediated the effects of variables on fear of recurrence. The findings suggest that breast cancer survivor self-efficacy may have a protective effect for survivors who are younger at diagnosis and have higher perceived risk of recurrence, higher trait anxiety, and more breast cancer reminders. Oncology nurses already use the skills required to support self-efficacy. Additional research is needed to define and test breast cancer survivor self-efficacy interventions. Oncology nurses are in a key role to assess fear of recurrence and provide self-efficacy interventions to reduce it in breast cancer survivors. Strategies to efficiently address fear of recurrence to reduce psychological distress in survivorship follow-up care are warranted.

  8. 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

  9. Quality of life and burden of informal caregivers of stroke survivors

    OpenAIRE

    Ogunlana, Michael O; Olumide O. Dada; Oyewo, Olajire S.; Odole, Adesola C.; Ogunsan, Morenike O.

    2014-01-01

    Stroke rehabilitation has concentrated on patient-focused intervention, which has reduced the level of disabilities and has increased the number of stroke survivors being managed at home by caregivers. This study was aimed at determining the level of strain experienced by the caregivers of stroke survivors and the quality of life (QoL) of these caregivers. The QoL and caregiving burden among informal caregivers of stroke survivors seen at the physiotherapy outpatient clinic of two hospitals i...

  10. Atherogenic low density lipoprotein phenotype in long-term survivors of childhood acute lymphoblastic leukemia

    OpenAIRE

    Malhotra, Jyoti; Tonorezos, Emily S.; Rozenberg, Marina; Vega, Gloria L.; Sklar, Charles A.; Chou, Joanne; Moskowitz, Chaya S.; Eshelman-Kent, Debra A.; Janiszewski, Peter; Ross, Robert; Oeffinger, Kevin C.

    2012-01-01

    Survivors of childhood acute lymphoblastic leukemia (ALL) have an increased risk of cardiovascular disease. Small density lipoproteins are atherogenic but have not been studied in this population. We conducted a cross-sectional analysis of 110 ALL survivors (mean age, 24.3 years) to determine prevalence of small dense LDL (pattern B) phenotype in ALL survivors and identify associated factors. Lipid subfractions were measured using Vertical Auto Profile-II. Participants with greater than 50% o...

  11. 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-related reso......-related resources (organizational climate, social support, and avoidance behavior) with work ability and looked at whether these associations were different for the survivors and reference subjects....

  12. 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...

  13. Medicaid expansion and access to care among cancer survivors: a baseline overview.

    Science.gov (United States)

    Tarazi, Wafa W; Bradley, Cathy J; Harless, David W; Bear, Harry D; Sabik, Lindsay M

    2016-06-01

    Medicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act. We use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states. Cancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95 % confidence interval [CI] 0.63-0.92, p Care Act, cancer survivors living in expansion states had better access to care than survivors living in non-expansion states. Failure to expand Medicaid could potentially leave many cancer survivors with limited access to routine care. Existing disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.

  14. Perceived control and hot flashes in treatment-seeking breast cancer survivors and menopausal women.

    Science.gov (United States)

    Carpenter, Janet S; Wu, Jingwei; Burns, Debra S; Yu, Menggang

    2012-01-01

    Lower perceived control over hot flashes has been linked to fewer coping strategies, more catastrophizing, and greater hot flash severity and distress in midlife women, yet this important concept has not yet been studied in breast cancer survivors. The aim of this study was to explore perceived control over hot flashes and hot flashes in breast cancer survivors compared with midlife women without cancer. Ninety-nine survivors and 138 midlife women completed questionnaires and a prospective, electronic hot flash diary. All data were collected at a baseline assessment before randomization in a behavioral intervention study. Both groups had moderate perceived control over hot flashes. Control was not significantly related to hot flash frequency but was significantly related to hot flash severity, bother, and interference in both groups. A significantly stronger association between control and hot flash interference was found for survivors than for midlife women. Survivors using hot flash treatments perceived less control than did survivors not using hot flash treatments, whereas the opposite was true in midlife women. Findings extend our knowledge of perceived control over hot flashes in both survivors and midlife women. Findings emphasize the importance of continued menopausal symptom assessment and management, support the importance of continuing nursing care even for survivors who are already using hot flash treatment, and suggest that nursing interventions aimed at improving perceived control over hot flashes may be more helpful for survivors than for midlife women.

  15. Anxiety and depression among out-of-hospital cardiac arrest survivors

    DEFF Research Database (Denmark)

    Lilja, G; Nilsson, G; Nielsen, N

    2015-01-01

    AIM: Survivors of out-of-hospital cardiac arrest (OHCA) may experience psychological distress but the actual prevalence is unknown. The aim of this study was to investigate anxiety and depression within a large cohort of OHCA-survivors. METHODS: OHCA-survivors randomized to targeted temperature....... Subjective cognitive problems were associated with an increased risk for psychological distress. Since psychological distress affects long-term prognosis of cardiac patients in general it should be addressed during follow-up of survivors with OHCA due to a cardiac cause. ClinicalTrials.gov NCT01020916/NCT...

  16. Educational and occupational outcomes of childhood cancer survivors 30 years after diagnosis: a French cohort study.

    Science.gov (United States)

    Dumas, Agnes; Berger, Claire; Auquier, Pascal; Michel, Gérard; Fresneau, Brice; Sètchéou Allodji, Rodrigue; Haddy, Nadia; Rubino, Carole; Vassal, Gilles; Valteau-Couanet, Dominique; Thouvenin-Doulet, Sandrine; Casagranda, Léonie; Pacquement, Hélène; El-Fayech, Chiraz; Oberlin, Odile; Guibout, Catherine; de Vathaire, Florent

    2016-04-26

    Although survival from childhood cancer has increased, little is known on the long-term impact of treatment late effects on occupational attainment or work ability. A total of 3512 five-year survivors treated before the age of 19 years in 10 French cancer centres between 1948 and 2000 were identified. Educational level, employment status and occupational class of survivors were assessed by a self-reported questionnaire. These outcome measures were compared with sex-age rates recorded in the French population, using indirect standardisation. Paternal occupational class was also considered to control for the role of survivors' socioeconomic background on their achievement. Multivariable analyses were conducted to explore clinical characteristics associated with the outcomes. A total of 2406 survivors responded to the questionnaire and survivors aged below 25 years were included in the current analysis. Compared with national statistics adjusted on age and sex, male survivors were more likely to be college graduates (39.2% vs 30.9% expected; Phigher achievement was not observed either for leukaemia or central nervous system (CNS) tumour survivors. Health-related unemployment was higher for survivors of CNS tumour (28.1% vs 4.3%; Phigher occupational class than expected. Survivors treated for CNS tumour or leukaemia, especially when treatment included cranial irradiation, might need support throughout their lifespan.

  17. 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...

  18. Educational and career goal attainments in young adult childhood cancer survivors.

    Science.gov (United States)

    Bashore, Lisa; Breyer, Emma

    2017-04-01

    Examine the educational and career outcomes of young adult childhood cancer survivors. Descriptive study design using a survey sent to 336 survivors. Quantitative and qualitative data were analyzed separately. Only 50 completed surveys were returned. Having a central nervous system tumor and radiation were associated with physical impairments. Four themes also emerged: future as medical professionals, dreams fallen short, peer relationships, and positive outlook on life. Pediatric nurses caring for survivors should partner with oncology professionals to support survivors to enrich their educational and career opportunities. © 2017 Wiley Periodicals, Inc.

  19. The Effect of Diabetic Peripheral Neuropathy on Ground Reaction Forces during Straight Walking in Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Amirah Mustapa

    2017-01-01

    Full Text Available Purpose. The aim of this present study was to investigate the ground reaction forces (GRFs alterations in stroke survivors with diabetic peripheral neuropathy (DPN. Methods. Ten stroke survivors with DPN, 10 stroke survivors without DPN, and 10 healthy controls with matched body weight between groups participated in this case-control cross-sectional study. Three-dimensional GRFs (anterior-posterior, medial-lateral, and vertical were collected at a comfortable walking speed using the Nexus Vicon motion analysis system and force plate. The Kruskal–Wallis test was used to analyze GRFs parameters. Results. We found significant alterations of medial-lateral forces of the nonparetic side and vertical forces of the paretic side in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. In addition, there were smaller braking and lower propulsion peak in anterior-posterior forces, smaller magnitude of medial-lateral forces, and lower first and second peak of vertical forces in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. Conclusion. The study findings identified that GRFs were affected in stroke survivors with DPN on both the paretic and the nonparetic sides. Further investigations are warranted to explore the impact of DPN on the kinematics and muscle activity related to the gait performance in stroke survivors with DPN.

  20. Genetic Effect of Chemotherapy Exposure in Children of Testicular Cancer Survivors

    National Research Council Canada - National Science Library

    Kryukov, Gregory V; Bielski, Craig M; Samocha, Kaitlin; Fromer, Menachem; Seepo, Sara; Gentry, Carleen; Neale, Benjamin; Garraway, Levi A; Sweeney, Christopher J; Taplin, Mary-Ellen; Van Allen, Eliezer M

    2016-01-01

    .... Epidemiologic studies have not demonstrated a significant increase in congenital abnormalities in posttreatment children of cancer survivors, but the inherited genome-wide effect of chemotherapy...

  1. A probabilistic version of the game of Zombies and Survivors on graphs

    OpenAIRE

    Bonato, Anthony; Mitsche, Dieter; Pérez-Giménez, Xavier; Pralat, Pawel

    2015-01-01

    International audience; We consider a new probabilistic graph searching game played on graphs, inspired by the familiar game of Cops and Robbers. In Zombies and Survivors, a set of zombies attempts to eat a lone survivor loose on a given graph. The zombies randomly choose their initial location, and during the course of the game, move directly toward the survivor. At each round, they move to the neighbouring vertex that minimizes the distance to the survivor; if there is more than one such ve...

  2. 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...

  3. A theory for aftercare of human trafficking survivors for nursing practice in low resource settings.

    Science.gov (United States)

    Curran, R L; Naidoo, J R; Mchunu, G

    2017-06-01

    Research on aftercare for human trafficking survivors highlights the limited knowledge of the needs of survivors; the evaluation of current aftercare; and the process of recovery navigated by the survivor in aftercare (Oram et al., 2012; Locke, 2010; Hacker & Cohen, 2012). Furthermore there has been a transition in aftercare where the victim or survivor, who before was seen as a passive victim of circumstance of their life and in need of therapeutic intervention, is now seen as having an active role in their recovery, thus facilitating recovery (Hacker & Cohen, 2012). The need for a theory grounded in survivor's voices therefore motivated this grounded theory study underpinned by Freire's (1970) Pedagogy of the oppressed. The aim of the theory is to inform nursing care of human trafficking survivors in low resource settings. The findings elicit a theoretical model of the renewed self, and the conditions that facilitate this process in care of human trafficking survivors. The recommendations of this paper may improve the nursing care provided to human trafficking survivors and equip nurses and other health professionals with the knowledge and skills to promote the renewing of human trafficking survivors. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study

    Science.gov (United States)

    Geiger, Ann M.; Mertens, Ann C.; Leisenring, Wendy M.; Tooze, Janet A.; Goodman, Pam; Stovall, Marilyn; Robison, Leslie L.; Hudson, Melissa M.

    2011-01-01

    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. PMID:21037086

  5. Multiple behavioral risk factors among adolescent survivors of childhood cancer in the Survivor Health and Resilience Education (SHARE) program.

    Science.gov (United States)

    Tercyak, Kenneth P; Donze, Jessica R; Prahlad, Sowmya; Mosher, Revonda B; Shad, Aziza T

    2006-11-01

    Health-compromising behaviors among survivors of childhood cancer may increase their risks of cancer recurrence and the onset of chronic disease in adulthood. Regardless of whether such behaviors occur singly or in combination with one another, multiple behavioral risk factors must be identified and addressed early to promote better health outcomes within this special population. Adolescent survivors may be especially vulnerable, as reported rates of smoking and other risky behaviors are at or near levels of their healthy peers. The psychological literature suggests stress may play a role in risk behavior initiation and maintenance, including multiple behavioral risks, and that adolescent survivors are stress-prone. This report focuses on the prevalence and co-occurrence of three behavioral risk factors (cigarette use, insufficient physical activity, and non-adherence to sun protection recommendations) and describes stress-health behavior relationships in this special population. All patients in this study (n = 75) were adolescent survivors of childhood cancer and completed a baseline assessment of their health behaviors and stress as part of a randomized controlled trial of health promotion. Twenty-eight percent of the patients reported one of three risk factors, 12% reported two of three risk factors, and 7% reported all three risk factors. Non-adherence to sun protection was the single most common risk factor; physical inactivity and non-adherent sun protection were the most common co-occurring risk factors. Greater age and stress were significantly associated with the presence of more behavioral risk factors. The evidence suggests interventions to reduce multiple health-compromising behaviors in these patients are warranted, and that efforts to address these patients' personal and family stress levels are important as well. (c) 2005 Wiley-Liss, Inc.

  6. 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

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

    Science.gov (United States)

    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

  8. Development of a Web-Based Psychosocial Intervention for Adolescent and Young Adult Survivors of Pediatric Brain Tumor.

    Science.gov (United States)

    Raj, Stacey P; Narad, Megan E; Salloum, Ralph; Platt, Amber; Thompson, Aimee; Baum, Katherine T; Wade, Shari L

    2017-12-06

    To develop A Survivor's Journey, a web-based psychosocial intervention for adolescent and young adult (AYA) survivors of pediatric brain tumors (PBTs). Stages of development included focus groups with five AYA survivors (ages 16-23 years) and six parents to identify needs and challenges, as well as surveys and interviews with clinical care providers at a survivorship clinic. Concerns reported by AYA survivors, parents, and providers were similar to those reported in the literature, including fatigue, memory deficits, poor mood, health concerns, and challenging peer relationships. However, concerns varied across survivors, underscoring the need for customizable interventions. Survivors and parents were interested in an intervention targeting psychosocial functioning and late effects, and reported a strong preference for web-based interventions that would reduce cost and travel burden on the family. Based on review of the literature, survivor and parent feedback, as well as provider input, a customizable intervention, A Survivor's Journey, was developed consisting of five core sessions (addressing concerns common to AYA survivors such as memory, staying positive, and problem solving) and up to seven supplemental sessions (addressing variable needs of survivors such as managing fatigue, inattention, planning/organization, communication/relationships, and self-care). Despite growing recognition of long-term challenges and late effects, there are few interventions targeting psychosocial well-being of AYA survivors. If efficacious, A Survivor's Journey will be an accessible and cost-effective intervention to improve psychosocial functioning of AYA survivors of PBT.

  9. Family Functioning Mediates the Association Between Neurocognitive Functioning and Health-Related Quality of Life in Young Adult Survivors of Childhood Brain Tumors.

    Science.gov (United States)

    Hocking, Matthew C; Hobbie, Wendy L; Deatrick, Janet A; Hardie, Thomas L; Barakat, Lamia P

    2015-03-01

    Childhood brain tumor (BT) survivors experience significant neurocognitive sequelae that affect health-related quality of life (HRQOL). A model of neurodevelopmental late effects and family functioning in childhood cancer survivors suggests associations between survivor neurocognitive functioning, family functioning, and survivor HRQOL. This study examines the concurrent associations between survivor neurocognitive functioning, family functioning, and survivor emotional HRQOL, and the indirect effects of neurocognitive functioning on survivor emotional HRQOL through family functioning. Participants included young adult-aged childhood BT survivors (18-30 years old; N=34) who were on average 16 years post-diagnosis, and their mothers. A brief neuropsychological battery assessed working and verbal memory, processing speed, and executive functioning. Survivors and mothers completed measures of family functioning, and mothers completed a proxy-report measure of survivor HRQOL. Spearman bivariate correlations examined the associations between indices of survivor neurocognitive functioning and concurrent family functioning and survivor emotional HRQOL. Poorer survivor processing speed, working memory, verbal memory, and executive function were significantly associated with worse survivor- and mother-reported family functioning (r's range: 0.36-0.58). Additionally, worse survivor processing speed and executive function were significantly associated with poorer survivor emotional HRQOL (r's range: 0.44-0.48). Bootstrapping analyses provided evidence for the indirect effects of neurocognitive functioning on survivor emotional HRQOL through family functioning. These findings suggest that family functioning is an important variable that might mitigate the negative influence of neurocognitive late effects on survivors and is a potential target in future interventions.

  10. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort

    Science.gov (United States)

    Barton, Sara E.; Najita, Julie S.; Ginsburg, Elizabeth S.; Leisenring, Wendy M.; Stovall, Marilyn; Weathers, Rita E.; Sklar, Charles A.; Robison, Leslie L.; Diller, Lisa

    2013-01-01

    Background Prior studies have documented decreased pregnancy rates and early menopause in female cancer survivors; however, infertility rates and reproductive interventions have not been studied. This study investigates infertility and time to pregnancy among female childhood cancer survivors, and analyzes treatment characteristics associated with infertility and subsequent pregnancy. Methods The Childhood Cancer Survivor Study (CCSS) is a cohort study including five-year cancer survivors from 26 institutions who were infertility, medical treatment for infertility, the time to first pregnancy in survivors and siblings, and the risk of infertility in survivors by demographic, disease, and treatment variables were analyzed. Findings Survivors had an increased risk of clinical infertility (>1 year of attempts at conception without success) compared to siblings which was most pronounced at early reproductive ages (≤24 years Relative Risk (RR)=2·92, 95% Confidence Interval (CI) 1·18–7·20; 25–29 years RR=1·61, 95% CI 1·05–2·48; 30–39 years RR=1·37, 95% CI 1·11–1·69). Despite being equally likely to seek treatment for infertility, survivors were less likely to be prescribed medication for treatment of infertility (RR=0·57, 95% CI 0·46–0·70). Increasing doses of uterine radiation and alkylating agent chemotherapy were most strongly associated with infertility. Although survivors had an increased time to pregnancy interval (p=0·032), 64·2% (292/455) with infertility achieved a pregnancy. Interpretation A more comprehensive understanding of infertility after cancer is critical for counseling and decision-making regarding future attempts at conception as well as fertility preservation. PMID:23856401

  11. Exercise capacity in long-term survivors of pediatric cancer: an analysis from the Cardiac Risk Factors in Childhood Cancer Survivors Study.

    Science.gov (United States)

    Miller, Angela M; Lopez-Mitnik, Gabriela; Somarriba, Gabriel; Lipsitz, Stuart R; Hinkle, Andrea S; Constine, Louis S; Lipshultz, Steven E; Miller, Tracie L

    2013-04-01

    Childhood cancer survivors may have premature symptomatic cardiovascular and non-cardiovascular diseases that contribute to reduced capacity for physical activity. Studies of exercise capacity and identification of risk factors for reduced capacity in survivors are limited. We assessed maximal myocardial oxygen consumption (V(O(2)max), a measure of exercise capacity) in survivors at least 4 years after cancer diagnosis and sibling controls. We evaluated associations between V(O(2)max) and age, sex, treatments, cardiac structure and function, biomarkers, endocrine function, and physical activity. Of 72 survivors (mean age, 22 years; range, 8.0-40 years) and 32 siblings (mean age, 20.2 years; range, 8-46 years), about half were male. Mean time since diagnosis was 13.4 years (range, 4.5-31.6 years). In age- and sibling-pair adjusted analyses, V(O(2)max) was lower in survivors than siblings (males, 28.53 vs. 30.90 ml/kg/minute, P = 0.08; females, 19.81 vs. 23.40 ml/kg/minute, P = 0.03). In males, older age (P = 0.01), higher percent body fat (P survivors and controls was poor and generally lower in survivors, particularly females. Older age, higher body fat, methotrexate exposure, and extremes of LV mass/function were associated with lower V(O(2)max) in survivors. Because physical activity can improve nutritional and cardiac conditions, survivors should be encouraged to exercise regularly with close monitoring. Copyright © 2012 Wiley Periodicals, Inc.

  12. Screening survivors of childhood acute lymphoblastic leukemia for obesity, metabolic syndrome, and insulin resistance.

    Science.gov (United States)

    Karakurt, Hasan; Sarper, Nazan; Kılıç, Suar Çakı; Gelen, Sema Aylan; Zengin, Emine

    2012-09-01

    Acute lymphoblastic leukemia (ALL) survivors were screened for risk factors of cardiovascular disease. Forty-four ALL survivors in first remission were enrolled. Twenty-six also received 12-18 Gy cranial radiotherapy (RT). Patients' body mass indexes (BMIs) at dignosis and during the study were compared. Metabolic syndrome (MS) evaluation was performed in patients, parents, and siblings older than 6 years. Homeostasis Model Assessment (HOMA) index of the survivors was also calculated. In survivors with impaired fasting glucose levels, oral glucose tolerance test (OGTT) was performed. Thyroid functions and IGF-1 and/or IGFBP-3 levels of the survivors who received cranial RT were evaluated. Median age of the survivors was 11.5 years (6-23). At diagnosis, mean BMI percentile was 46.7 (3-95) and mean z-score was -0.09 ± 1.14; during the study, these values rose to 71.1 ± 25.6 (3-100) and 0.8 ± 0.94, respectively (P obese at diagnosis and during the study, respectively (P = .005). Survivors had significantly higher BMI percentile and BMI z-score compared to their siblings (P = .006 and P = .011, respectively). The study group was small and we could not show a correlation of the patients' obesity with RT, thyroid functions, IGF-1, and IGFBP-3 levels. In three survivors (6.8%), there was MS. Maternal and paternal MS was not found as a risk factor for MS of the survivors (P = .1, P = .5, respectively). The HOMA index revealed insulin resistance (IR) in 12 (27.2%) of the survivors, whereas OGTT revealed abnormal glucose regulation and/or IR in four. As a conclusion, ALL survivors have high risk for obesity and MS.

  13. Quality of Working Life of cancer survivors: associations with health- and work-related variables.

    Science.gov (United States)

    de Jong, Merel; Tamminga, Sietske J; Frings-Dresen, Monique H W; de Boer, Angela G E M

    2017-05-01

    This study aimed to (1) describe the Quality of Working Life (QWL) of cancer survivors and (2) explore associations between the QWL of cancer survivors and health- and work-related variables. Employed and self-employed cancer survivors were recruited through hospitals and patient organizations. They completed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) and health- and work-related variables in this cross-sectional study. The QWL scores of cancer survivors were described, and associations between QWL and health- and work-related variables were assessed. The QWLQ-CS was completed by 302 cancer survivors (28% male) with a mean age of 52 ± 8 years. They were diagnosed between 0 and 10 years ago with various types of cancer, such as breast cancers, gastrointestinal cancers, urological cancers, and haematological cancers. The QWL mean score of cancer survivors was 75 ± 12 (0-100). Cancer survivors had statistically significant lower QWL scores when they had been treated with chemotherapy or when they reported co-morbidity (p ≤ 0.05). Cancer survivors without managerial positions, with low incomes or physically demanding work, and who worked a proportion of their contract hours had statistically significantly lower QWL scores (p ≤ 0.05). This study described the QWL of cancer survivors and associations between QWL and health- and work-related variables. Based on these variables, it is possible to indicate groups of cancer survivors who need more attention and support regarding QWL and work continuation.

  14. Serum chemerin levels are independently associated with quality of life in colorectal cancer survivors: A pilot study

    National Research Council Canada - National Science Library

    Jee-Yon Lee; Mi-Kyung Lee; Nam-Kyu Kim; Sang-Hui Chu; Duk-Chul Lee; Hye-Sun Lee; Ji-Won Lee; Justin Y Jeon

    2017-01-01

    ...); therefore, it is important to identify clinical markers related with CRC survivor QOL. Here we investigated the relationship between serum chemerin levels, a newly identified proinflammatory adipokine, and QOL in CRC survivors...

  15. Exercise Echocardiography in Asymptomatic Survivors of Childhood Cancer Treated With Anthracyclines: A Prospective Follow-Up Study

    NARCIS (Netherlands)

    Sieswerda, Elske; Kremer, Leontien C. M.; Vidmar, Suzanna; de Bruin, Marie L.; Smibert, Elizabeth; Sjöberg, Gunnar; Cheung, Michael M. H.; Weintraub, Robert G.

    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

  16. Correlates of physical activity among colorectal cancer survivors: results from the longitudinal population-based profiles registry

    NARCIS (Netherlands)

    Putten, M van; Husson, O.; Mols, F.; Luyer, M.D.; Poll-Franse, L.V. van de; Ezendam, N.P.

    2016-01-01

    PURPOSE: Physical activity can improve health of cancer survivors. To increase physical activity levels among colorectal cancer (CRC) survivors, we need to understand which factors affect physical activity. Therefore, this study examined the longitudinal relationship between symptom-related,

  17. Rumination and avoidance as predictors of prolonged grief, depression, and posttraumatic stress in female widowed survivors of war

    NARCIS (Netherlands)

    Morina, N.

    2011-01-01

    This study examined independent contributions of rumination and experiential avoidance in predicting symptoms of psychological distress among female widowed survivors of war. A decade after the war in Kosovo, 100 widowed survivors of war completed measures of rumination, experiential avoidance,

  18. 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…

  19. Long-term psychological distress in parents of child survivors of severe meningococcal disease

    NARCIS (Netherlands)

    Ehrlich, Tirtsa R.; Von Rosenstiel, Ines A.; Grootenhuis, Martha A.; Gerrits, Astrid I.; Bos, Albert P.

    2005-01-01

    OBJECTIVE: To study psychological distress in parents of child survivors of Severe Meningococcal Disease (SMD) after discharge of their child from the Paediatric Intensive Care Unit (PICU). METHODS: This study approached parents of child survivors of SMD treated on the PICU between 1993-2001. Five

  20. Primary cutaneous cryptococcosis caused by Cryptococcus gattii VGII in a tsunami survivor from Thailand

    Directory of Open Access Journals (Sweden)

    Manoon Leechawengwongs

    2014-10-01

    Full Text Available Skin and soft tissue fungal infections with Apophysomyces elegans, Fusarium solani, Cladophialophora bantiana have been reported in survivors from 2004 Indian ocean Tsunami. We report the first case of primary cutaneous cryptococcosis caused by Cryptococcus gattii VGII in a Tsunami survivor from Thailand.

  1. Primary cutaneous cryptococcosis caused by Cryptococcus gattii VGII in a tsunami survivor from Thailand.

    Science.gov (United States)

    Leechawengwongs, Manoon; Milindankura, Samaniya; Sathirapongsasuti, Kriengkrai; Tangkoskul, Teerawit; Punyagupta, Sompone

    2014-10-01

    Skin and soft tissue fungal infections with Apophysomyces elegans, Fusarium solani, Cladophialophora bantiana have been reported in survivors from 2004 Indian ocean Tsunami. We report the first case of primary cutaneous cryptococcosis caused by Cryptococcus gattii VGII in a Tsunami survivor from Thailand.

  2. Fertility-related knowledge and reproductive goals in childhood cancer survivors : Short communication

    NARCIS (Netherlands)

    Lehmann, V; Keim, M C; Nahata, L; Shultz, E L; Klosky, J L; Tuinman, M A; Gerhardt, C A

    2017-01-01

    STUDY QUESTION: Do young adult survivors of childhood cancer know their fertility status, in the context of their parenthood goals and screening for gonadal functioning? SUMMARY ANSWER: While 80% of survivors (who were without children) wanted children in the future, most did not know their

  3. eHealth to support cancer survivors: development, implementation and evaluation of an interactive portal

    NARCIS (Netherlands)

    Kuijpers, W.

    2016-01-01

    Many cancer survivors suffer from physical and psychosocial problems due to cancer itself and cancer treatment. Patient empowerment and eHealth offer opportunities to support cancer survivors. This thesis describes the development, implementation and evaluation of MijnAVL, an eHealth application.

  4. Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors.

    Science.gov (United States)

    Forbes, Cynthia C; Blanchard, Chris M; Mummery, W Kerry; Courneya, Kerry

    2015-03-01

    To identify and compare the prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors.
 Cross-sectional, descriptive survey.
 Nova Scotia, Canada.
 741 breast, prostate, and colorectal cancer survivors.
. A stratified sample of 2,063 breast, prostate, and colorectal cancer survivors diagnosed from 2003-2011 were identified and mailed a questionnaire. Descriptive, chi-square, and logistic regression analyses were used to determine any correlations among the main research variables. 
 Strength exercise behavior; medical, demographic, and motivational correlates using the Theory of Planned Behavior.
 Of 741 respondents, 23% were meeting the strength exercise guidelines of two or more days per week. Cancer survivors were more likely to meet guidelines if they were younger, more educated, had a higher income, better perceived general health, fewer than two comorbidities, and a healthy body weight. In addition, those meeting guidelines had significantly more favorable affective attitude, instrumental attitude, injunctive norm, perceived behavioral control, planning, and intention. The correlates of strength exercise did not differ by cancer site.
 The prevalence of strength exercise is low among breast, prostate, and colorectal cancer survivors in Nova Scotia and the correlates are consistent across those survivor groups. 
. Nurses should take an active role in promoting strength exercise among cancer survivors using the Theory of Planned Behavior, particularly among those survivors at higher risk of not performing strength exercise. 


  5. 75 FR 20893 - National Day of Service and Remembrance for Victims and Survivors of Terrorism, 2010

    Science.gov (United States)

    2010-04-21

    ... and Survivors of Terrorism, 2010 By the President of the United States of America A Proclamation There... Remembrance for Victims and Survivors of Terrorism, we pause to remember victims of terrorism at home and... terrorism and their families, though bound at first by anguish and loss, are united by extraordinary acts of...

  6. Efficacy of meaning-centered group psychotherapy for cancer survivors : a randomized controlled trial

    NARCIS (Netherlands)

    van der Spek, N; Vos, J; van Uden-Kraan, C F; Breitbart, W.; Cuijpers, P; Holtmaat, K; Witte, B I; Tollenaar, R.A.E.M.; Verdonck-de Leeuw, I M

    BACKGROUND: The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). METHOD: A total of 170 cancer survivors were randomly assigned

  7. Identification and evaluation of the salient physical activity beliefs of colorectal cancer survivors.

    Science.gov (United States)

    Speed-Andrews, Amy E; McGowan, Erin L; Rhodes, Ryan E; Blanchard, Chris M; Culos-Reed, S Nicole; Friedenreich, Christine M; Courneya, Kerry S

    2014-01-01

    Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.

  8. The Efficacy of Exposure-Based Cognitive Therapy with Survivors of Childhood Sexual Abuse.

    Science.gov (United States)

    Gardner, Yun Hui

    Recent research has revealed the efficacy of cognitive behavioral interventions with sexual abuse survivors. Cognitive behavioral treatment (CBT) interventions require trauma survivors to confront their painful memories directly. This allows for assessment of cognitive distortions that need to be challenged and reframed. The extent and amount of…

  9. 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…

  10. Seeing Roses in the Thorn Bush: Sexual Assault Survivors' Perceptions of Social Reactions.

    Science.gov (United States)

    Dworkin, Emily R; Newton, Emily; Allen, Nicole E

    2018-01-01

    After sexual assault, survivors often reach to others for support and receive a range of reactions. Although these reactions have been characterized by researchers as positive (e.g., emotional support) or negative (e.g., victim blaming), survivors vary in their perceptions in ways that do not always match this framework. The goal of this research was to examine the degree to which designations of reactions as "positive" or "negative" fits across types of reactions and explain instances of mismatch between these designations and survivors' perceptions. We conducted a qualitative analysis of interviews with 26 survivors of sexual assault to identify themes in their perceptions of social reactions. Although social reactions were generally perceived in a manner that matched researcher categorizations, there was significant variation. Perceptions could be characterized in terms of whether the reaction felt comfortable/soothing, consistent with survivors' needs/hopes/expectations, and helpful in the long term. The closeness of survivors' relationships with responders, the degree to which they were impacted by the assault, and the presence of other social reactions explained variation from researcher designations of reaction types. This study clarifies the considerations that survivors make when evaluating social reactions and what accounts for discrepant perceptions of these reactions; in particular, they highlight that there is no "one size fits all" reaction to survivors of sexual assault and the context in which reactions occur may affect how they are seen.

  11. 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

  12. 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

  13. 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

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

    NARCIS (Netherlands)

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

    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

  15. Moderators of the effects of group-based physical exercise on cancer survivors' quality of life

    NARCIS (Netherlands)

    Kalter, Joeri; Buffart, Laurien M.; Korstjens, Irene; van Weert, Ellen; Brug, Johannes; Verdonck-de Leeuw, Irma M.; Mesters, Ilse; van den Borne, Bart; Hoekstra-Weebers, Josette E. H. M.; Ros, Wynand J. G.; May, Anne M.

    This study explored demographic, clinical, and psychological moderators of the effect of a group-based physical exercise intervention on global quality of life (QoL) among cancer survivors who completed treatment. Cancer survivors were assigned to a 12-week physical exercise (n = 147) or a wait-list

  16. Moderators of the effects of group-based physical exercise on cancer survivors' quality of life.

    NARCIS (Netherlands)

    Kalter, J.; Buffart, L.M.; Korstjens, I.; van Weert, E.; Brug, J.; Verdonck-de Leeuw, I.M.; Mesters, I.; van den Borne, B.; Hoekstra-Weebers, J.E.H.M.; Ros, W.J.G.; May, A.M.

    2015-01-01

    Purpose: This study explored demographic, clinical, and psychological moderators of the effect of a group-based physical exercise intervention on global quality of life (QoL) among cancer survivors who completed treatment. Methods: Cancer survivors were assigned to a 12-week physical exercise (n =

  17. 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…

  18. 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,

  19. Interrelationships between Health Behaviors and Coping Strategies among Informal Caregivers of Cancer Survivors

    Science.gov (United States)

    Litzelman, Kristin; Kent, Erin E.; Rowland, Julia H.

    2018-01-01

    Background: Recent research among cancer survivors suggests that health behaviors and coping are intertwined, with important implications for positive behavior change and health. Informal caregivers may have poor health behaviors, and caregivers' health behaviors have been linked to those of survivors. Aims: This hypothesis generating study…

  20. 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.

  1. 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…

  2. 20 CFR 225.23 - Combined Earnings PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... section 215 of the Social Security Act as in effect on December 31, 1974. It is computed using the... RAILROAD RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities... annuities. The Combined Earnings PIA used in survivor annuities may be used in computing the tier II...

  3. 20 CFR 225.24 - SS Earnings PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... the Social Security Act as in effect on December 31, 1974. It is computed using the deceased employee... 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 Social...

  4. 20 CFR 225.25 - RR Earnings PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... Social Security Act as in effect on December 31, 1974. It is computed using the deceased employee's... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the... Earnings PIA (RR Earnings PIA) used in survivor annuities may be used in computing the tier II component...

  5. Quality of life, self-esteem and worries in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.; van den Bos, C.

    2004-01-01

    This study assessed quality of life, self-esteem and worries in young adult survivors of childhood cancer compared to a group of young adults with no history of cancer. The impact of demographic, medical and treatment factors and self-esteem on survivors' quality of life and worries was studied.

  6. Long-Term Quality of Life in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma

    NARCIS (Netherlands)

    Nies, M.; Klein Hesselink, M.S.; Huizinga, G.A.; Sulkers, E.; Brouwers, A.H.; Burgerhof, J.G.; Dam, E. van; Havekes, B.; Heuvel-Eibrink, M.M. van den; Corssmit, E.P.; Kremer, L.C.; Netea-Maier, R.T.; Pal, H.J. van der; Peeters, R.P.; Plukker, J.T.; Ronckers, C.M.; Santen, H.M. van; Tissing, W.J.; Links, T.P.; Bocca, G.

    2017-01-01

    Context: Little is known about long-term quality of life (QoL) of survivors of pediatric differentiated thyroid carcinoma. Therefore, this study aimed to evaluate generic health-related QoL (HRQoL), fatigue, anxiety, and depression in these survivors compared with matched controls, and to evaluate

  7. Factors supporting cardiomyopathy screening among at-risk adult survivors of pediatric malignancies.

    Science.gov (United States)

    Cox, Cheryl L; Zhu, Liang; Ojha, Rohit P; Steen, Brenda D; Ogg, Susan; Robison, Leslie L; Hudson, Melissa M

    2017-04-01

    Anthracyclines and chest irradiation place adult survivors of childhood cancer at risk of cardiomyopathy; many survivors do not obtain the recommended screening. Based on our recent clinical trial, the addition of telephone counseling to a printed survivorship care plan more than doubled survivors' risk-based screening. Here, we sought to measure the impact of specific factors targeted in the intervention for their impact on survivors' screening participation. Study population-survivors participating in a randomized longitudinal intervention trial. Survivor questionnaires and medical records at baseline and 1-year follow-up provided the data. Within- and between-group differences in factors were assessed at baseline and follow-up; structural equation modeling (SEM) identified direct and indirect effects on screening participation. Of the 411 survivors, 55.3% were female, 89.3% white, 38.9% college graduates, and age 26-59 years (mean = 41 years, SD = 7.68 years). At follow-up, the counseling group demonstrated higher scores for intent to undergo screening (p survivors' screening participation. This finding challenges providers to reach beyond the disease treatment focus and embrace these strategies in their behavior change efforts.

  8. Challenges after curative treatment for childhood cancer and long-term follow up of survivors

    NARCIS (Netherlands)

    Oeffinger, Kevin C.; Nathan, Paul C.; Kremer, Leontien C. M.

    2008-01-01

    Childhood cancer survivors are at increased risk of serious morbidity, premature mortality, and diminished health status. Proactive and anticipatory risk-based health care of survivors and healthy lifestyles can reduce these risks. In this article, the authors first briefly discuss four common

  9. 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.

  10. Who are the support persons of haematological cancer survivors and how is their performance perceived?

    Science.gov (United States)

    Hall, Alix; Lynagh, Marita; Carey, Mariko; Sanson-Fisher, Rob; Mansfield, Elise

    2017-12-01

    To explore: (1) how haematological cancer survivors and their support persons perceive the overall performance of the support person; (2) disagreement between survivor and support person ratings; and (3) characteristics associated with support persons rating their performance poorly. This is a substudy of a larger project of Australian haematological cancer survivors and their support persons. For this substudy, haematological cancer survivors were recruited from 4 Australian population-based cancer registries and asked to pass on a questionnaire package to their support persons. Survivors who passed on a questionnaire package to their support person were asked to answer questions about the support person and how they perceived the support person's performance. Similarly, support persons answered questions on their own performance as a support person. A total of 924 haematological cancer survivors and 821 support persons were eligible for this study. Most survivors rated their support person as performing very well (84%) while less than half (48%) of support persons rated their own performance as very well. There was significant disagreement between survivor and their support person (dyad) ratings of the support person's performance. Support persons with above normal levels of depression (vs those with normal levels) had significantly higher odds of rating their own performance as "not well/somewhat well." Health care providers should consider providing additional education and skills-based interventions to support persons who experience increased symptoms of depression. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Response to an exercise intervention after endometrial cancer: differences between obese and non-obese survivors.

    Science.gov (United States)

    Basen-Engquist, K; Carmack, C; Brown, J; Jhingran, A; Baum, G; Song, J; Scruggs, S; Swartz, M C; Cox, M G; Lu, K H

    2014-04-01

    The objective of this paper is to describe baseline differences between obese and non-obese endometrial cancer survivor in anthropometrics, exercise behavior, fitness, heart rate and blood pressure, and quality of life, and to analyze whether the effect of a home-based exercise intervention on these outcomes differed for obese and non-obese participants. One hundred post-treatment Stage I-IIIa endometrial cancer survivors participated in a single arm 6month study in which they received a home-based exercise intervention. Cardiorespiratory fitness, anthropometrics, and exercise behavior were measured every two months, and quality of life (QOL) and psychological distress were measured at baseline and 6months. Adjusting for potential confounders, at baseline obese survivors had poorer cardiorespiratory fitness (p=.002), higher systolic blood pressure (p=.018), and lower physical functioning (pObese survivors had less improvement in exercise behavior and cardiorespiratory fitness than non-obese survivors, but there were no differences with regard to improvements in QOL and stress. Home based exercise interventions are beneficial to endometrial cancer survivors, including those whose BMI is in the obese range. While obese survivors have lower levels of physical activity and fitness, they experienced similar activity, fitness, quality of life and mental health benefits. Exercise should be encouraged in endometrial cancer survivors, including those who are obese. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age

    NARCIS (Netherlands)

    Eeltink, C.M.; Incrocci, L.; Witte, B.I.; Meurs, S.; Visser, O.; Huijgens, P.C.; de Leeuw, I.M.

    2013-01-01

    Aims and objectives: To assess the perceived fertility status and to determine the association between perceived fertility status and sexual function, as reported by young female Hodgkin lymphoma survivors. Background: Young female Hodgkin lymphoma survivors are at risk of infertility and impaired

  13. 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)

  14. 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....

  15. 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)…

  16. Practical Ways Psychotherapy Can Support Physical Healthcare Experiences for Male Survivors of Childhood Sexual Abuse

    Science.gov (United States)

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

    2011-01-01

    Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the "Handbook on Sensitive Practice for Health Care Practitioners: Lessons…

  17. The EKZ/AMC childhood cancer survivor cohort: methodology, clinical characteristics, and data availability

    NARCIS (Netherlands)

    Sieswerda, E.; Mulder, R. L.; van Dijk, I. W. E. M.; van Dalen, E. C.; Knijnenburg, S. L.; van der Pal, H. J. H.; Mud, M. S.; Heinen, R. C.; Caron, H. N.; Kremer, L. C. M.

    2013-01-01

    Childhood cancer survivors are at high risk of late adverse effects of cancer treatment, but there are still many gaps in evidence about these late effects. We described the methodology, clinical characteristics, data availability, and outcomes of our cohort study of childhood cancer survivors. The

  18. Quality of Life in Adult Survivors of Childhood Sexual Abuse Who Have Undergone Therapy.

    Science.gov (United States)

    Lev-Wiesel, Rachel

    2000-01-01

    Examines perception of past sexual abuse experiences and quality of life among adult survivors of childhood sexual abuse. Interviews (N=52) reveal three types of explanations for the offenders' behavior. Results indicate that survivors who attributed the abuse to the offenders' characteristics managed to keep their self esteem fairly intact and…

  19. Parenthood in Survivors of Hodgkin Lymphoma : An EORTC-GELA General Population Case-Control Study

    NARCIS (Netherlands)

    van der Kaaij, Marleen A. E.; Heutte, Natacha; Meijnders, Paul; Abeilard-Lemoisson, Edwige; Spina, Michele; Moser, Lotte C.; Allgeier, Anouk; Meulemans, Bart; Dubois, Brice; Simons, Arnold H. M.; Lugtenburg, Pieternella J.; Aleman, Berthe M. P.; Noordijk, Evert M.; Ferme, Christophe; Thomas, Jose; Stamatoullas, Aspasia; Fruchart, Christophe; Brice, Pauline; Gaillard, Isabelle; Doorduijn, Jeanette K.; Sebban, Catherine; Smit, Wilma G. J. M.; Bologna, Serge; Roesink, Judith M.; Ong, Francisca; Andre, Marc P. E.; Raemaekers, John M. M.; Henry-Amar, Michel; Kluin-Nelemans, Hanneke C.

    2012-01-01

    Purpose We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls. Patients and Methods A Life Situation Questionnaire was sent to 3,604 survivors treated from

  20. Parenthood in survivors of Hodgkin lymphoma: An EORTC-GELA general population case-control study

    NARCIS (Netherlands)

    M.A.E. van der Kaaij (Marleen A.); N. Heutte (Natacha); P. Meijnders (Paul); E. Abeilard-Lemoisson (Edwige); M. Spina (Michele); L.C. Moser (Lotte); A. Allgeier (Anouk); B. Meulemans (Bart); B. Dubois (Brice); A.H.M. Simons; P.J. Lugtenburg (Pieternella); B.M.P. Aleman (Berthe); E.M. Noordijk (Evert); C. Fermé (Christophe); J. Thomas (Jose); A. Stamatoullas (Aspasia); C. Fruchart (Christophe); P. Brice (Pauline); I. Gaillard (Isabelle); J.K. Doorduijn (Jeanette); C. Sebban (Catherine); W.G. Smit (Wilma); S. Bologna (Serge); J.M. Roesink (Judith); F. Ong (Francisca); J.-L. André (Jean-Luc); J. Raemaekers (John); M. Henry-Amar (Michel); J.C. Kluin-Nelemans (Hanneke)

    2012-01-01

    textabstractPurpose: We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls. Patients and Methods: A Life Situation Questionnaire was sent to 3,604 survivors