WorldWideScience

Sample records for survivors additional benefits

  1. 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.

  2. 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.

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

    Science.gov (United States)

    Hans, Jason D; Gillen, Martie

    2013-01-01

    Most minor children are eligible for Social Security survivors benefits if a wage-earning parent dies, but eligibility of children not in utero at the time of death is more nuanced. The purpose of this study was to examine attitudes concerning access to Social Security survivors benefits in the context of posthumous reproduction. A probability sample of 540 Florida households responded to a multiple-segment factorial vignette designed to examine the effects of state intestacy laws and five reproductive pathways - normative, posthumous birth, cryopreserved embryo, cryopreserved gametes, and posthumous gamete retrieval - on attitudes toward eligibility for the Social Security survivors benefits. Broad support was found for the survivors benefits following normative and posthumous birth pathways, but attitudes were decidedly less favorable when the child was not in utero at the time of parental death. In addition, in stark contrast to the recent U.S. Supreme Court decision in Astrue v. Capato, the vast majority of respondents did not believe state intestacy laws should determine eligibility for Social Security survivors benefits. © 2013 American Society of Law, Medicine & Ethics, Inc.

  4. 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.

  5. 38 CFR 3.405 - Filipino veterans and their survivors; benefits at the full-dollar rate.

    Science.gov (United States)

    2010-07-01

    ... their survivors; benefits at the full-dollar rate. 3.405 Section 3.405 Pensions, Bonuses, and Veterans... Compensation Effective Dates § 3.405 Filipino veterans and their survivors; benefits at the full-dollar rate... compensation at full-dollar rates to certain Filipino veterans and their survivors, are considered liberalizing...

  6. Rape Aggression Defense: Unique Self-Efficacy Benefits for Survivors of Sexual Trauma.

    Science.gov (United States)

    Pinciotti, Caitlin M; Orcutt, Holly K

    2017-06-01

    Self-defense training is consistently linked to psychological benefits for survivors of sexual trauma, yet little is known about how training may uniquely benefit survivors compared with their nonsurvivor peers enrolled in the same course. Path analysis was used to examine how history of sexual trauma impacts pre- and post-training scores on three domains of self-efficacy using a national sample of Rape Aggression Defense (RAD) participants. All participants reported significant increases in self-efficacy domains, and sexual trauma history significantly predicted pre-training interpersonal self-efficacy and post-training self-defense self-efficacy, suggesting that self-defense training confers benefits for survivors above and beyond benefits for other participants.

  7. Clinically Relevant Physical Benefits of Exercise Interventions in Breast Cancer Survivors.

    Science.gov (United States)

    Kirkham, Amy A; Bland, Kelcey A; Sayyari, Sarah; Campbell, Kristin L; Davis, Margot K

    2016-02-01

    Evidence is currently limited for the effect of exercise on breast cancer clinical outcomes. However, several of the reported physical benefits of exercise, including peak oxygen consumption, functional capacity, muscle strength and lean mass, cardiovascular risk factors, and bone health, have established associations with disability, cardiovascular disease risk, morbidity, and mortality. This review will summarize the clinically relevant physical benefits of exercise interventions in breast cancer survivors and discuss recommendations for achieving these benefits. It will also describe potential differences in intervention delivery that may impact outcomes and, lastly, describe current physical activity guidelines for cancer survivors.

  8. Federal Benefits for Veterans, Dependents and Survivors: 2016 Online Edition

    Science.gov (United States)

    ... AM A... Menu Menu For Veterans Benefit Information Agent Orange Post Traumatic Stress Disorder (PTSD) eBenefits Benefit & Claim ... DVI) Veterans' Mortgage Life Insurance (VMLI) Health Resources Agent Orange Post Traumatic Stress Disorder (PTSD) Dental Care Blue ...

  9. Benefit Finding in Maternal Caregivers of Pediatric Cancer Survivors: A Mixed Methods Approach.

    Science.gov (United States)

    Willard, Victoria W; Hostetter, Sarah A; Hutchinson, Katherine C; Bonner, Melanie J; Hardy, Kristina K

    2016-09-01

    Benefit finding has been described as the identification of positive effects resulting from otherwise stressful experiences. In this mixed methods study, we examined the relations between qualitative themes related to benefit finding and quantitative measures of psychosocial adjustment and coping as reported by maternal caregivers of survivors of pediatric cancer. Female caregivers of survivors of pediatric cancer (n = 40) completed a qualitative questionnaire about their experiences caring for their child, along with several quantitative measures. Qualitative questionnaires were coded for salient themes, including social support and personal growth. Correlation matrices evaluated associations between qualitative themes and quantitative measures of stress and coping. Identified benefits included social support and personal growth, as well as child-specific benefits. Total benefits reported were significantly positively correlated with availability of emotional resources. Coping methods were also associated, with accepting responsibility associated with fewer identified benefits. Despite the stress of their child's illness, many female caregivers of survivors of pediatric cancer reported finding benefits associated with their experience. Benefit finding in this sample was associated with better adjustment. © 2016 by Association of Pediatric Hematology/Oncology Nurses.

  10. 77 FR 40525 - Dependency and Indemnity Compensation (DIC) Benefits for Survivors of Former Prisoners of War...

    Science.gov (United States)

    2012-07-10

    ... Former Prisoners of War Rated Totally Disabled at Time of Death AGENCY: Department of Veterans Affairs... regulation regarding benefits for survivors of former prisoners of war who were rated totally disabled at the... indemnity compensation (DIC) based on the death of a former prisoner of war whose service-connected...

  11. Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors.

    Science.gov (United States)

    Mansky, Patrick; Sannes, Tim; Wallerstedt, Dawn; Ge, Adeline; Ryan, Mary; Johnson, Laura Lee; Chesney, Margaret; Gerber, Lynn

    2006-09-01

    Tai chi chuan (TCC) has been used as a mind-body practice in Asian culture for centuries to improve wellness and reduce stress and has recently received attention by researchers as an exercise intervention. A review of the English literature on research in TCC published from 1989 to 2006 identified 20 prospective, randomized, controlled clinical trials in a number of populations, including elderly participants (7 studies), patients with cardiovascular complications (3 studies), patients with chronic disease (6 studies), and patients who might gain psychological benefit from TCC practice (2 studies). However, only the studies of TCC in the elderly and 2 studies of TCC for cardiovascular disease had adequate designs and size to allow conclusions about the efficacy of TCC. Most (11 studies) were small and provided limited information on the benefit of TCC in the settings tested. There is growing awareness that cancer survivors represent a population with multiple needs related to physical deconditioning, cardiovascular disease risk, and psychological stress. TCC as an intervention may provide benefit to cancer survivors in these multiple areas of need based on its characteristics of combining aspects of meditation and aerobic exercise. However, little research has been conducted to date to determine the benefit of TCC in this population. We propose a model to study the unique characteristics of TCC compared to physical exercise that may highlight characteristic features of this mind-body intervention in cancer survivors.

  12. Are survivors of childhood cancer with an unfavourable psychosocial developmental trajectory more likely to apply for disability benefits?

    Science.gov (United States)

    Maurice-Stam, H; Verhoof, E J; Caron, H N; Grootenhuis, M A

    2013-03-01

    The aim of this study was to investigate whether an unfavourable psychosocial developmental trajectory while growing up with childhood cancer is related to a smaller likelihood of labour participation in adult life. A total of 53 childhood cancer survivors (CCS) with and 313 CCS without disability benefits, and 508 peers from the general Dutch population (reference group) completed the Course of Life Questionnaire (CoLQ) about the achievement of psychosocial developmental milestones. Differences between the three groups were tested by conducting analysis of variance with contrasts (scale scores CoLQ) and logistic regression analysis (individual milestones). Effect sizes and odds ratios were calculated. Compared with the reference group, both CCS with and CCS without benefits reported lower scale scores with respect to social and psychosexual development. CCS with disability benefits had lower social (d = - 0.6; p disability benefits. CCS with disability benefits scored less favourably (p psychosocial milestones whereas the number was only six for those without disability benefits. CCS with an unfavourable developmental trajectory while growing up were more likely to apply for disability benefits in adulthood than CCS with a more favourable development. Early recognition and support are warranted. Further research is needed on risk factors of application for disability benefits. In addition, research should show whether stimulating the achievement of developmental milestones while growing up will create conditions for a better labour market position. Copyright © 2011 John Wiley & Sons, Ltd.

  13. Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia.

    Science.gov (United States)

    Sin, Hyeonhui; Lee, Gyuchang

    2013-10-01

    The aim of this study was to investigate the effects of additional virtual reality training using Xbox Kinect on upper extremity function, including range of motion, motor function, and gross manual dexterity, in stroke survivors with hemiplegia. This study is a randomized controlled trial. Forty participants were randomly allocated to either the experimental or control groups; the experimental group (n = 20) underwent virtual reality training using Xbox Kinect and conventional occupational therapy, and the control group (n = 20) underwent conventional occupational therapy alone. The mean time since the onset of stroke was 7.22 mos in the experimental group and 8.47 mos in the control group. At baseline and after 6 wks of intervention, range of motion of the upper extremity was measured, and the Fugl-Meyer Assessment and the Box and Block Test were performed. After intervention, significant improvements from baseline values in range of motion of the upper extremity, Fugl-Meyer Assessment scores, and Box and Block Test scores were observed in the experimental and control groups (P stroke survivors who received additional virtual reality training using Xbox Kinect showed significantly improved function of the upper extremity. However, the effects of the virtual reality training using Xbox Kinect may have been a result of the greater total intervention time in the training group compared with the control group. Thus, the potential efficacy of Xbox Kinect in the rehabilitation of post-stroke survivors needs to be investigated in greater depth.

  14. The Relationship of Social Security Benefits and the Military Survivors Benefit Plan.

    Science.gov (United States)

    1980-07-09

    The fdct that she is .jtIj cL, to benefits’based on her husband’s earnings iikes the reduction Illanid’iury. There is, however, no reduction in the...nondisabled) and thus would be conservative for a woman . 19 ,g {. PIA - .9(194) + .32 (424.05- 194) (See Appendix C for bend points.) = 174.60 + 73.62...those for a military member (nondisabled) and thus would be conservative for a woman . 12 Some differences in social security benefits attributable to

  15. 38 CFR 3.505 - Filipino veterans and their survivors; benefits at the full-dollar rate.

    Science.gov (United States)

    2010-07-01

    ... their survivors; benefits at the full-dollar rate. 3.505 Section 3.505 Pensions, Bonuses, and Veterans...-dollar rate. The effective date of discontinuance of compensation or dependency and indemnity... full-dollar rate under § 3.42 is physically absent from the U.S. for a total of 183 days or more during...

  16. Potential benefits for caregivers of stroke survivors receiving BTX-A and exercise for upper extremity spasticity.

    Science.gov (United States)

    Clark, Patricia C; Aycock, Dawn M; Reiss, Aimee; Tanner, Dee; Shenvi, Neeta V; Easley, Kirk A; Wolf, Steven L

    2015-01-01

    To explore possible extended benefits to caregivers of stroke survivors receiving a treatment of onabotulinumtoxinA (BTX-A) or saline with a structured exercise program. A comparative, prospective, companion study using a nonrandom sample of 16 caregivers of stroke survivors enrolled in a pilot clinical trial comparing BTX-A or saline and exercise for upper extremity spasticity. The caregiver measures were depressive symptoms, care demands, family conflict surrounding stroke recovery, and mental and physical health status. There were no statistically significant differences between caregiver groups. Caregivers of stroke survivors who received BTX-A had a greater change in depressive symptoms that may reflect a clinically important change. Estimates of effect sizes between the groups, controlling for baseline values, indicate a trend for moderate to large effects (last evaluation) for fewer depressive symptoms (d = 0.52) and less caregiver burden (d = 0.77 time, 0.85 difficulty) for caregivers of the BTX-A group. Receiving BTX-A did not alter caregiving demands or depressive symptoms compared to those receiving saline. Further research with larger sample sizes is needed to better understand the interdependence of stroke survivors and caregivers on the health of each. © 2014 Association of Rehabilitation Nurses.

  17. Increased uptake of social security benefits among long-term survivors of cancer in childhood, adolescence and young adulthood: a Norwegian population-based cohort study.

    Science.gov (United States)

    Ghaderi, S; Engeland, A; Moster, D; Ruud, E; Syse, A; Wesenberg, F; Bjørge, T

    2013-04-16

    As the number of cancer survivors increases, their health and welfare have come into focus. Thus, long-term medical consequences of cancer at a young age (social security benefit records, were studied. Standardised incidence ratios (SIRs) of long-term medical consequences for 5-year cancer survivors, born during 1965-1985, were explored by linking population-based registries in Norway. Among the 5-year cancer survivors (4031 individuals), 29.7% received social security benefits. The survivors had an overall 4.4 times (95% confidence interval (95% CI): 4.1-4.6) higher risk of social security benefit uptake than the cancer-free population. Survivors of malignancies of bone and connective tissues (SIR: 10.8; 95% CI: 9.1-12.9), CNS tumours (SIR: 7.7; 95% CI: 6.9-8.6) and malignancies of the haematopoietic system (SIR: 6.1; 95% CI: 5.3-7.0) had the highest risks of social security benefits uptake. The most notified causes of social security benefit uptake were diseases of the nervous system, and injury and poisoning. The uptake of social security benefits among 5-year cancer survivors increased substantially and it may represent a solid outcome measure for the burden of the most severe late effects, especially in countries with comparable social welfare systems.

  18. Additionality of global benefits and financial additionality in the context of the AIJ negotiations

    Energy Technology Data Exchange (ETDEWEB)

    Puhl, I.

    1996-12-31

    The Conference of the Party at their first meeting (COP1) took a decision regarding criteria for joint implementation as indicated in Art. 4.2 (a) of the FCCC which established a pilot phase for activities implemented jointly (AIJ) under the pilot phase. Besides some more technical issues this decision specified that such measures should bring about real, measurable and long-term environmental benefits related to the mitigation of climate change that would not have occurred in the absence of such activities. It also established that the financing of AIJ shall be additional to the financial obligations of developed country parties. These two requirements are called the additionality criteria for AIJ. The first refers to the realness of GHG emission abatement (which means reduction compared to a baseline) whereas the second describes that funds earmarked for AIJ have no other objective (i.e. profit making, export promotion) but to reduce GHG emissions to avoid the free-riding of investors and subsequently developed country parties. The reporting framework as well as the reporting requirements under national programs do not specify further the two types of additionality and even though research focuses on issues like baseline determination there has been no attempt so far to identify approaches which contribute towards defining strict and practicable methods and guidelines to frame additionality criteria. The first FCCC assessment of pilot project reporting revealed that in the reporting of activities, emissions additionality often remained unclear, especially in cases where AIJ was only a portion of an existing or already planned project, and that there is a point about how to account for financial additionality. It subsequently proposed to develop a uniform approach to baseline determination and the assessment of emission (reduction) additionality and financial additionality.

  19. Who benefits from a psychosocial counselling versus educational intervention to improve psychological quality of life in prostate cancer survivors?

    Science.gov (United States)

    Badger, Terry A; Segrin, Chris; Figueredo, Aurelio J; Harrington, Joanne; Sheppard, Kate; Passalacqua, Stacey; Pasvogel, Alice; Bishop, Maria

    2013-01-01

    We examined selected survivor characteristics to determine what factors might moderate the response to two psychosocial interventions. Seventy-one prostate cancer survivors (PCSs) were randomly assigned to either a telephone-delivered health education (THE) intervention or a telephone-delivered interpersonal counselling (TIP-C) intervention. Psychological quality of life (QOL) outcomes included depression, negative and positive affect, and perceived stress. For three of the psychological outcomes (depression, negative affect and stress), there were distinct advantages from participating in THE. For example, more favourable depression outcomes occurred when men were older, had lower prostate specific functioning, were in active chemotherapy, had lower social support from friends and lower cancer knowledge. Participating in the TIP-C provided a more favourable outcome for positive affect when men had higher education, prostate specific functioning, social support from friends and cancer knowledge. Unique survivor characteristics must be considered when recommending interventions that might improve psychological QOL in PCSs. Future research must examine who benefits most and from what components of psychosocial interventions to enable clinicians to recommend appropriate psychosocial care.

  20. Benefits of the uncertainty management intervention for African American and White older breast cancer survivors: 20-month outcomes.

    Science.gov (United States)

    Gil, Karen M; Mishel, Merle H; Belyea, Michael; Germino, Barbara; Porter, Laura S; Clayton, Margaret

    2006-01-01

    In a 2 x 2 randomized block repeated measure design, this study evaluated the follow-up efficacy of the uncertainty management intervention at 20 months. The sample included 483 recurrence-free women (342 White, 141 African American women; mean age = 64 years) who were 5-9 years posttreatment for breast cancer. Women were randomly assigned to either the intervention or usual care control condition. The intervention was delivered during 4 weekly telephone sessions in which survivors were guided in the use of audiotaped cognitive-behavioral strategies and a self-help manual. Repeated measures MANOVAs evaluating treatment group, ethnic group, and treatment by ethnic interaction effects at 20 months indicated that training in uncertainty management resulted in improvements in cognitive reframing, cancer knowledge, and a variety of coping skills. Importantly, the 20-month outcomes also demonstrated benefits for women in the intervention condition in terms of declines in illness uncertainty and stable effects in personal growth over time.

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

    Science.gov (United States)

    2009-11-01

    Supplemental Security Income TSGLI Servicemembers’ Group Life Insurance Traumatic Injury Protection Program TSP Thrift Savings Plan VA Department...assistance is provided by the Servicemembers’ Group Life Insurance Traumatic Injury Protection Program ( TSGLI ). All servicemembers paying SGLI...premiums are automatically enrolled in TSGLI , and pay an additional $1 per month premium. 195 U.S.C. §§ 8331-8351. 205 U.S.C. §§ 8401-8480. In addition

  2. Cochlear Implantation among Deaf Children with Additional Disabilities: Parental Perceptions of Benefits, Challenges, and Service Provision

    Science.gov (United States)

    Zaidman-Zait, Anat; Curle, Deirdre; Jamieson, Janet R.; Chia, Ruth; Kozak, Frederick K.

    2015-01-01

    Although increasing numbers of children with additional disabilities are receiving cochlear implants (CIs), little is known about family perspectives of the benefits and the challenges of cochlear implantation in this pediatric population. This study examines perceptions among parents of deaf children with additional disabilities regarding…

  3. Effect of Value- Addition on the Benefits of Women Participation in ...

    African Journals Online (AJOL)

    The paper focused on the effect of value- addition on the benefits of women participation in cassava products marketing in Cross River State, Nigeria. Data were collected with the aid of a structured questionnaire from 48 randomly selected respondents. Data were analyzed using both descriptive and marketing margin ...

  4. 42 CFR 417.442 - Risk HMO's and CMP's: Conditions for provision of additional benefits.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Risk HMO's and CMP's: Conditions for provision of... Medicare Contract § 417.442 Risk HMO's and CMP's: Conditions for provision of additional benefits. (a) General rule. Except as provided in paragraph (b) of this section, a risk HMO or CMP must, during any...

  5. Reducing Fuel Volatility - An Additional Benefit From Blending Bio-fuels?

    NARCIS (Netherlands)

    Bailis, R.E.; Koeb, B.S.; Sanders, M.W.J.L.

    Oil price volatility harms economic growth. Diversifying into different fuel types can mitigate this effect by reducing volatility in fuel prices. Producing bio-fuels may thus have additional benefits in terms of avoided damage to macro-economic growth. In this study we investigate trends and

  6. An Investigation of the Additive Benefits of Parent Dialogic Reading Techniques in Older Preschool Children

    Science.gov (United States)

    Switalski, Sarah O'Neill

    2012-01-01

    This study examined the additive benefit of parent dialogic reading techniques in older, high-risk preschool children using multiple baseline design across participants, a single subject research design, as was as well as pre-test and post-test measures. Five preschoolers age-eligible to begin kindergarten the following school year participated.…

  7. Are survivors of childhood cancer with an unfavourable psychosocial developmental trajectory more likely to apply for disability benefits?

    NARCIS (Netherlands)

    Maurice-Stam, H.; Verhoof, E. J.; Caron, H. N.; Grootenhuis, M. A.

    2013-01-01

    The aim of this study was to investigate whether an unfavourable psychosocial developmental trajectory while growing up with childhood cancer is related to a smaller likelihood of labour participation in adult life. A total of 53 childhood cancer survivors (CCS) with and 313 CCS without disability

  8. Additional benefits of reduction mammaplasty: a systematic review of the literature.

    Science.gov (United States)

    Singh, Kimberly A; Losken, Albert

    2012-03-01

    Reduction mammaplasty is commonly described with regard to its qualitative benefits. The authors sought to perform a systematic review of the literature focusing on functional outcomes after reduction mammaplasty with regard to physical and psychological symptom improvement, including weight-related effects, exercise, and eating behaviors, in addition to aesthetic outcomes. A systematic review of the English literature was performed using the PubMed database to evaluate outcomes following reduction mammaplasty from 1977 to 2010. Studies were chosen that addressed the physical and psychological benefits of reduction mammaplasty using a validated questionnaire. Women who undergo reduction mammaplasty have a functional improvement in musculoskeletal pain, headaches, sleep, and breathing. Psychological benefits are vast and include improved self-esteem, sexual function, and quality of life, in addition to less anxiety and depression. After reduction mammaplasty, women appear to exercise more and have a reduction in eating disorders. The authors present a comprehensive review of the literature with regard to the physical and emotional concerns women with macromastia experience and the broad benefits reduction mammaplasty could have for their daily functions and quality of life postoperatively. Therapeutic, III.

  9. Costs, Benefits, and Adoption of Additive Manufacturing: A Supply Chain Perspective

    Science.gov (United States)

    Thomas, Douglas

    2017-01-01

    There are three primary aspects to the economics of additive manufacturing: measuring the value of goods produced, measuring the costs and benefits of using the technology, and estimating the adoption and diffusion of the technology. This paper provides an updated estimate of the value of goods produced. It then reviews the literature on additive manufacturing costs and identifies those instances in the literature where this technology is cost effective. The paper then goes on to propose an approach for examining and understanding the societal costs and benefits of this technology both from a monetary viewpoint and a resource consumption viewpoint. The final section discusses the trends in the adoption of additive manufacturing. Globally, there is an estimated $667 million in value added produced using additive manufacturing, which equates to 0.01 % of total global manufacturing value added. US value added is estimated as $241 million. Current research on additive manufacturing costs reveals that it is cost effective for manufacturing small batches with continued centralized production; however, with increased automation distributed production may become cost effective. Due to the complexities of measuring additive manufacturing costs and data limitations, current studies are limited in their scope. Many of the current studies examine the production of single parts and those that examine assemblies tend not to examine supply chain effects such as inventory and transportation costs along with decreased risk to supply disruption. The additive manufacturing system and the material costs constitute a significant portion of an additive manufactured product; however, these costs are declining over time. The current trends in costs and benefits have resulted in this technology representing 0.02 % of the relevant manufacturing industries in the US; however, as the costs of additive manufacturing systems decrease, this technology may become widely adopted and change the

  10. No detectable fertility benefit from a single additional mating in wild stalk-eyed flies.

    Directory of Open Access Journals (Sweden)

    Elisabeth Harley

    Full Text Available BACKGROUND: Multiple mating by female insects is widespread, and the explanation(s for repeated mating by females has been the subject of much discussion. Females may profit from mating multiply through direct material benefits that increase their own reproductive output, or indirect genetic benefits that increase offspring fitness. One particular direct benefit that has attracted significant attention is that of fertility assurance, as females often need to mate multiply to achieve high fertility. This hypothesis has never been tested in a wild insect population. METHODOLOGY/PRINCIPAL FINDINGS: Female Malaysian stalk-eyed flies (Teleopsis dalmanni mate repeatedly during their lifetime, and have been shown to be sperm limited under both laboratory and field conditions. Here we ask whether receiving an additional mating alleviates sperm limitation in wild females. In our experiment one group of females received a single additional mating, while a control group received an interrupted, and therefore unsuccessful, mating. Females that received an additional mating did not lay more fertilised eggs in total, nor did they lay proportionately more fertilised eggs. Female fertility declined significantly through time, demonstrating that females were sperm limited. However, receipt of an additional mating did not significantly alter the rate of this decline. CONCLUSIONS/SIGNIFICANCE: Our data suggest that the fertility consequences of a single additional mating were small. We discuss this effect (or lack thereof, and suggest that it is likely to be attributed to small ejaculate size, a high proportion of failed copulations, and the presence of X-linked meiotic drive in this species.

  11. The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder

    Science.gov (United States)

    Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Nixon, Reginald D. V.

    2005-01-01

    This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure,…

  12. Reducing Fuel Volatility. An Additional Benefit From Blending Bio-fuels?

    Energy Technology Data Exchange (ETDEWEB)

    Bailis, R. [Yale School of Forestry and Environmental Studies, 195 Prospect Street, New Haven, CT 06511 (United States); Koebl, B.S. [Utrecht University, Science Technology and Society, Budapestlaan 6, 3584 CD Utrecht (Netherlands); Sanders, M. [Utrecht University, Utrecht School of Economics, Janskerkhof 12, 3512 BL Utrecht (Netherlands)

    2011-02-15

    Oil price volatility harms economic growth. Diversifying into different fuel types can mitigate this effect by reducing volatility in fuel prices. Producing bio-fuels may thus have additional benefits in terms of avoided damage to macro-economic growth. In this study we investigate trends and patterns in the determinants of a volatility gain in order to provide an estimate of the tendency and the size of the volatility gain in the future. The accumulated avoided loss from blending gasoline with 20 percent ethanol-fuel estimated for the US economy amounts to 795 bn. USD between 2010 and 2019 with growing tendency. An amount that should be considered in cost-benefit analysis of bio-fuels.

  13. Benefits of additional courses of systemic azithromycin in periodontal disease case report.

    Science.gov (United States)

    Schmidt, Edgard F; Bretz, Walter A

    2007-01-01

    The strong association of subgingival anaerobic bacteria, such as Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, with destructive periodontal disease has been well documented in the literature. Several double-blind studies have also shown the beneficial use of systemic antimicrobials that are active against these microorganisms in conjunction with conventional periodontal treatment, especially when periodontal abscesses and/or suppuration upon probing are present. Four cases with periodontal abscesses were treated with scaling/root planing in conjunction with systemic azithromycin. Partial improvement led to retreatment with two additional courses of azithromycin. Bone formation was noted on periapical radiographs after the patients took additional courses of azithromycin. In view of the benefits of using additional courses of azithromycin in the treatment of destructive periodontal disease, we conclude that the single course of systemic antimicrobials currently used in periodontal therapy may be insufficient to reach necessary therapeutic levels in infected sites.

  14. Calcium and cholecalciferol supplementation provides no added benefit to nutritional counseling to improve bone mineral density in survivors of childhood acute lymphoblastic leukemia (ALL).

    Science.gov (United States)

    Kaste, S C; Qi, A; Smith, K; Surprise, H; Lovorn, E; Boyett, J; Ferry, R J; Relling, M V; Shurtleff, S A; Pui, C H; Carbone, L; Hudson, M M; Ness, K K

    2014-05-01

    We sought to improve lumbar spine bone mineral density (LS-BMD) in long-term survivors of childhood acute lymphoblastic leukemia (ALL) using calcium and cholecalciferol supplementation. This double-blind, placebo-controlled trial randomized 275 participants (median age, 17 [9-36.1] years) with age- and gender-specific LS-BMD Z-scores <0 to receive nutritional counseling with supplementation of 1,000 mg/day calcium and 800 International Unit cholecalciferol or placebo for 2 years. The primary outcome was change in LS-BMD assessed by quantitative computerized tomography (QCT) at 24 months. Linear regression models were employed to identify the baseline risk factors for low LS-BMD and to compare LS-BMD outcomes. Pre-randomization LS-BMD below the mean was associated with male gender (P = 0.0024), White race (P = 0.0003), lower body mass index (P < 0.0001), and cumulative glucocorticoid doses of ≥ 5,000 mg (P = 0.0012). One hundred eighty-eight (68%) participants completed the study; 77% adhered to the intervention. Mean LS-BMD change did not differ between survivors randomized to supplements (0.33 ± 0.57) or placebo (0.28 ± 0.56). Participants aged 9-13 years and those 22-35 years had the greatest mean increases in LS-BMD (0.50 ± 0.66 and 0.37 ± 0.23, respectively). Vitamin D insufficiency (serum 25[OH]D <30 ng/ml) found in 296 (75%), was not associated with LS-BMD outcomes (P = 0.78). Cholecalciferol and calcium supplementation provides no added benefit to nutritional counseling for improving LS-BMD among adolescent and young adult survivors of ALL (93% of whom had LS-BMD Z-scores above the mean at study entry). © 2014 Wiley Periodicals, Inc.

  15. A meta-analysis of the benefits of mindfulness-based stress reduction (MBSR) on psychological function among breast cancer (BC) survivors.

    Science.gov (United States)

    Huang, Hua-Ping; He, Mei; Wang, Hai-Yan; Zhou, Mengjun

    2016-07-01

    Psychological issue is the most common co-morbidity of women with breast cancer (BC) after receiving treatment. Effective coping with this problem is significant importance. The aim of this meta-analysis is to evaluate the benefits of mindfulness-based stress reduction (MBSR) on psychological distress among breast cancer survivors. PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched from their inception to June 30, 2014. Two reviewers independently reviewed and extracted the data. The primary outcomes of interest were psychological domains. Review Manager 5.3 was used to pool collected data. Nine articles involving 964 participants were identified. Compared with those in control group, patients in MBSR group have a significant improvement on psychological domains: depression [mean difference (MD), 5.09; 95 % confidence interval (CI), 3.63-6.55; P MBSR can also improve the overall quality of life (QOL) (MD, -1.16; 95 % CI, -2.21 to -0.12; P = 0.03). On the basis of our findings, MBSR shows a positive effect on psychological function and QOL of breast cancer survivors. This approach can be recommended to breast cancer patients as a part of their rehabilitation.

  16. A laboratory study of the perceived benefit of additional noise attenuation by houses

    Science.gov (United States)

    Flindell, I. H.

    1983-01-01

    Two Experiments were conducted to investigate the perceived benefit of additional house attenuation against aircraft flyover noise. First, subjects made annoyance judgments in a simulated living room while an operative window with real and dummy storm windows was manipulated in full view of those subjects. Second, subjects made annoyance judgments in an anechoic audiometric test chamber of frequency shaped noise signals having spectra closely matched to those of the aircraft flyover noises reproduced in the first experiment. These stimuli represented the aircraft flyover noises in levels and spectra but without the situational and visual cues present in the simulated living room. Perceptual constancy theory implies that annoyance tends to remain constant despite reductions in noise level caused by additional attenuation of which the subjects are fully aware. This theory was supported when account was taken for a reported annoyance overestimation for certain spectra and for a simulated condition cue overreaction.

  17. Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?

    Directory of Open Access Journals (Sweden)

    Hetrick SE

    2011-08-01

    Full Text Available Sarah E Hetrick1, Georgina R Cox1, Sally N Merry21Orygen Youth Health Research Centre, Centre for Youth Mental Health, Melbourne, Parkville, Victoria, Australia; 2Werry Centre for Child and Adolescent Mental Health, Department of Psychological Medicine, The University of Auckland, Auckland, New ZealandBackground: Many young people with major depression fail first-line treatments. Treatment resistant depression has various definitions in the literature but typically assumes nonresponse to medication. In young people, cognitive behavioral therapy (CBT is the recommended firstline intervention, thus the definition of treatment resistance should be expanded. Therefore, our aim was to synthesize the existing evidence of any interventions for treatment-resistant depression, broadly defined, in children and adolescents and to investigate the effectiveness of CBT in this context. Methods: We used Cochrane Collaboration methodology, with electronic searches of Medline, PsycINFO, Embase, and the Cochrane Depression Anxiety and Neurosis Group trials registers. Only randomized controlled trials were included, and were assessed for risk of bias. Meta-analysis was undertaken where possible and appropriate.Results: Of 953 articles retrieved, four trials were eligible for inclusion. For one study, only the trial registration document was available, because the study was never completed. All other studies were well conducted with a low risk of bias, although one study had a high dropout rate. Two studies assessed the effect of adding CBT to medication. While an assertive trial of antidepressants does appear to lead to benefit, when compared with placebo, there was no significant advantage, in either study, or in a meta-analysis of data from these trials, that clearly demonstrated an additional benefit of CBT. The third trial showed little advantage of a tricyclic antidepressant over placebo in the context of an inpatient admission. Conclusion: Few randomized

  18. Additional benefit of higher dose green tea in lowering postprandial blood glucose

    Directory of Open Access Journals (Sweden)

    Rita Lahirin

    2015-07-01

    Full Text Available Background: Green tea contains catechins that have inhibitory effects on amylase, sucrase, and sodium-dependent glucose transporter (SGLT which result in lowering of postprandial blood glucose (PBG. This beneficial effect has been widely demonstrated using the usual dose (UD of green tea preparation. Our study was aimed to explore futher lowering of PBG using high dose (HD of green tea in healthy adolescents.Methods: 24 subjects received 100 mL infusion of either 0.67 or 3.33 grams of green tea with test meal. Fasting, PBG at 30, 60, 120 minutes were measured. Subjects were cross-overed after wash out. PBG and its incremental area under the curve (IAUC difference between groups were analyzed with paired T-test. Cathecin contents of tea were measured using high-performance liquid chromatography (HPLC.Results: The PBG of HD group was lower compared to UD (at 60 minutes =113.70 ± 13.20 vs 124.16 ± 8.17 mg/dL, p = 0.005; at 120 minutes = 88.95 ± 6.13 vs 105.25 ± 13.85 mg/dL, p < 0.001. The IAUC of HD was also found to be lower compared to UD (2055.0 vs 3411.9 min.mg/dL, p < 0.001.Conclusion: Additional benefit of lowering PBG can be achieved by using higher dose of green tea. This study recommends preparing higher dose of green tea drinks for better control of PBG.

  19. [Ketogenic diets: additional benefits to the weight loss and unfounded secondary effects].

    Science.gov (United States)

    Pérez-Guisado, Joaquin

    2008-12-01

    It is also necessary to emphasize that as well as the weight loss, ketogenic diets are healthier because they promote a non-atherogenic lipid profile, lower blood pressure and diminish resistance to insulin with an improvement in blood levels of glucose and insulin. Such diets also have antineoplastic benefits, do not alter renal or liver functions, do not produce metabolic acidosis by Ketosis, have many neurological benefits in central nervous system, do not produce osteoporosis and could increase the perfomance in aerobic sports.

  20. No Benefit in Neurologic Outcomes of Survivors of Out-of-Hospital Cardiac Arrest with Mechanical Compression Device.

    Science.gov (United States)

    Newberry, Ryan; Redman, Ted; Ross, Elliot; Ely, Rachel; Saidler, Clayton; Arana, Allyson; Wampler, David; Miramontes, David

    2018-01-18

    Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA. We conducted a retrospective observational study of OHCA comparing the outcomes of mechanical and manual chest compressions in a fire department based EMS system serving a population of 1.4 million residents. Mechanical CPR devices were geographically distributed on 11 of 33 paramedic ambulances. Data were collected over a 36-month period and outcomes were dichotomized based on utilization of mechanical CPR. The primary outcome measure was survival to hospital discharge with a cerebral performance category (CPC) score of 1 or 2. This series had 3,469 OHCA reports, of which 2,999 had outcome data and met the inclusion criteria. Of these 2,236 received only manual CPR and 763 utilized a mechanical CPR device during the resuscitation. Return of spontaneous circulation (ROSC) was attained in 44% (334/763) of the mechanical CPR resuscitations and in 46% (1,020/2,236) of the standard manual CPR resuscitations (p = 0.32). Survival to hospital discharge was observed in 7% (52/763) of the mechanical CPR resuscitations and 9% (191/2,236) of the manual CPR group (p = 0.13). Discharge with a CPC score of 1 or 2 was observed in 4% (29/763) of the mechanical CPR resuscitation group and 6% (129/2,236) of the manual CPR group (p = 0.036). In our study, use of the mechanical CPR device was associated with a poor neurologic outcome at hospital discharge. However, this difference was no longer evident after logistic regression adjusting for confounding variables

  1. 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.

  2. Benefits of Using a Voice and EMG-Driven Actuated Glove to Support Occupational Therapy for Stroke Survivors.

    Science.gov (United States)

    Thielbar, Kelly O; Triandafilou, Kristen M; Fischer, Heidi C; O'Toole, Jake M; Corrigan, Molly L; Ochoa, Jose M; Stoykov, Mary Ellen; Kamper, Derek G

    2017-03-01

    Many mechatronic devices exist to facilitate hand rehabilitation, however few directly address deficits in muscle activation patterns while also enabling functional task practice. We developed an innovative voice and electromyography-driven actuated (VAEDA) glove, which is sufficiently flexible/portable for incorporation into hand-focused therapy post-stroke. The therapeutic benefits of this device were examined in a longitudinal intervention study. Twenty-two participants with chronic, moderate hand impairment [Chedoke-McMaster Stroke Assessment Stage of Hand (CMSA-H = 4)] enrolled > 8 months post-stroke for 18 1-h training sessions ( 3 × week) employing a novel hand-focused occupational therapy paradigm, either with (VAEDA) or without (No-VAEDA) actuated assistance. Outcome measures included CMSA-H, Wolf Motor Function Test (WMFT), Action Research Arm Test, Fugl-Meyer Upper Extremity Motor Assessment (FMUE), grip and pinch strength and hand kinematics. All outcomes were recorded at baseline and endpoint (immediately after and four weeks post-training). Significant improvement was observed following training for some measures for the VAEDA group (n = 11) but for none of the measures for the No-VAEDA group (n = 11). Specifically, statistically significant gains were observed for CMSA-H (p = 0.038) and WMFT (p = 0.012) as well as maximum digit aperture subset (p = 0.003, n = 7), but not for the FMUE or grip or pinch strengths. In conclusion, therapy effectiveness appeared to be increased by employment of the VAEDA glove, which directly targets deficits in muscle activation patterns.

  3. VA Disability Benefits: Additional Planning Would Enhance Efforts to Improve the Timeliness of Appeals Decisions

    Science.gov (United States)

    2017-03-01

    individual parts of the agency and pieces of the new process rather than overall appeals resolution time from the veterans’ perspective. Without a strategy...Disability Individual Unemployability benefit, equivalent to payment for a 100-percent rating, if the veteran is found unable to obtain or maintain gainful... person at the Board’s central office in Washington D.C.— 4 percent in fiscal 2015 and 6 percent in fiscal year 2016, according to VA—the appeal is

  4. Benefits of Having a CRM System in Addition to an ERP System: Case study: Company X

    OpenAIRE

    Jeng, Isatou

    2017-01-01

    This bachelor’s thesis’ purpose is to investigate what benefits can a wholesale company gain from using a customer relationship management (CRM) system. The investigation aims specifically to identify the advantages that come when implementing a CRM – system into a wholesaling company that already utilizes an enterprise resource planning (ERP) system. By this research the client, a Swedish IT - software company Lundalogik Ab wished to expand their knowledge on customers in the industry. ...

  5. Benefits of neutral electrolyzed oxidizing water as a drinking water additive for broiler chickens

    National Research Council Canada - National Science Library

    Bügener, E; Kump, A. Wilms-Schulze; Casteel, M; Klein, G

    2014-01-01

    .... At each farm, 3 rearing periods were included in the study. With EO water as the water additive, the total viable cell count and the number of Escherichia coli in drinking water samples were reduced compared with the respective control group...

  6. Experimental therapy of epilepsy with transcranial magnetic stimulation: lack of additional benefit with prolonged treatment

    Directory of Open Access Journals (Sweden)

    Brasil-Neto Joaquim P.

    2004-01-01

    Full Text Available OBJECTIVE: To investigate the effect of three months of low-frequency repetitive transcranial magnetic stimulation (rTMS treatment in intractable epilepsy. METHODS: Five patients (four males, one female; ages 6 to 50 years, were enrolled in the study; their epilepsy could not be controlled by medical treatment and surgery was not indicated. rTMS was performed twice a week for three months; patients kept records of seizure frequency for an equal period of time before, during, and after rTMS sessions. rTMS was delivered to the vertex with a round coil, at an intensity 5 % below motor threshold. During rTMS sessions, 100 stimuli (five series of 20 stimuli, with one-minute intervals between series were delivered at a frequency of 0.3 Hz. RESULTS: Mean daily number of seizures (MDNS decreased in three patients and increased in two during rTMS- one of these was treated for only one month; the best result was achieved in a patient with focal cortical dysplasia (reduction of 43.09 % in MDNS. In the whole patient group, there was a significant (p<0.01 decrease in MDNS of 22.8 %. CONCLUSION: Although prolonged rTMS treatment is safe and moderately decreases MDNS in a group of patients with intractable epilepsy, individual patient responses were mostly subtle and clinical relevance of this method is probably low. Our data suggest, however, that patients with focal cortical lesions may indeed benefit from this novel treatment. Further studies should concentrate on that patient subgroup.

  7. Combining neuroprotectants in a model of retinal degeneration: no additive benefit.

    Directory of Open Access Journals (Sweden)

    Fabiana Di Marco

    Full Text Available The central nervous system undergoing degeneration can be stabilized, and in some models can be restored to function, by neuroprotective treatments. Photobiomodulation (PBM and dietary saffron are distinctive as neuroprotectants in that they upregulate protective mechanisms, without causing measurable tissue damage. This study reports a first attempt to combine the actions of PBM and saffron. Our working hypothesis was that the actions of PBM and saffron in protecting retinal photoreceptors, in a rat light damage model, would be additive. Results confirmed the neuroprotective potential of each used separately, but gave no evidence that their effects are additive. Detailed analysis suggests that there is actually a negative interaction between PBM and saffron when given simultaneously, with a consequent reduction of the neuroprotection. Specific testing will be required to understand the mechanisms involved and to establish whether there is clinical potential in combining neuroprotectants, to improve the quality of life of people affected by retinal pathology, such as age-related macular degeneration, the major cause of blindness and visual impairment in older adults.

  8. Combining neuroprotectants in a model of retinal degeneration: no additive benefit.

    Science.gov (United States)

    Di Marco, Fabiana; Di Paolo, Mattia; Romeo, Stefania; Colecchi, Linda; Fiorani, Lavinia; Spana, Sharon; Stone, Jonathan; Bisti, Silvia

    2014-01-01

    The central nervous system undergoing degeneration can be stabilized, and in some models can be restored to function, by neuroprotective treatments. Photobiomodulation (PBM) and dietary saffron are distinctive as neuroprotectants in that they upregulate protective mechanisms, without causing measurable tissue damage. This study reports a first attempt to combine the actions of PBM and saffron. Our working hypothesis was that the actions of PBM and saffron in protecting retinal photoreceptors, in a rat light damage model, would be additive. Results confirmed the neuroprotective potential of each used separately, but gave no evidence that their effects are additive. Detailed analysis suggests that there is actually a negative interaction between PBM and saffron when given simultaneously, with a consequent reduction of the neuroprotection. Specific testing will be required to understand the mechanisms involved and to establish whether there is clinical potential in combining neuroprotectants, to improve the quality of life of people affected by retinal pathology, such as age-related macular degeneration, the major cause of blindness and visual impairment in older adults.

  9. Benefits of neutral electrolyzed oxidizing water as a drinking water additive for broiler chickens.

    Science.gov (United States)

    Bügener, E; Kump, A Wilms-Schulze; Casteel, M; Klein, G

    2014-09-01

    In the wake of discussion about the use of drugs in food-producing farms, it seems to be more and more important to search for alternatives and supportive measures to improve health. In this field trial, the influence of electrolyzed oxidizing (EO) water on water quality, drug consumption, mortality, and performance parameters such as BW and feed conversion rate was investigated on 2 broiler farms. At each farm, 3 rearing periods were included in the study. With EO water as the water additive, the total viable cell count and the number of Escherichia coli in drinking water samples were reduced compared with the respective control group. The frequency of treatment days was represented by the number of used daily doses per population and showed lower values in EO-water-treated groups at both farms. Furthermore, the addition of EO water resulted in a lower mortality rate. In terms of analyzed performance parameters, no significant differences were determined. In this study, the use of EO water improved drinking water quality and seemed to reduce the drug use without showing negative effects on performance parameters and mortality rates. © 2014 Poultry Science Association Inc.

  10. Does Manual Therapy Provide Additional Benefit To Breathing Retraining In The Management Of Dysfunctional Breathing? A Randomised Controlled Trial

    OpenAIRE

    Jones, MO; Troup, F; Nugus, J; Roughton, M; Hodson, ME; Rayner, C.; Bowen, F; Pryor, J

    2015-01-01

    Purpose: Dysfunctional breathing (DB) is associated with an abnormal breathing pattern, unexplained breathlessness and significant patient morbidity. Treatment involves breathing retraining through respiratory physiotherapy. Recently, manual therapy (MT) has also been used, but no evidence exists to validate its use. This study sought to investigate whether MT produces additional benefit when compared with breathing retraining alone in patients with DB. Methods: Sixty subjects with primary...

  11. Probiotics as additives on therapy in allergic airway diseases: a systematic review of benefits and risks.

    Science.gov (United States)

    Das, Rashmi Ranjan; Naik, Sushree Samiksha; Singh, Meenu

    2013-01-01

    We conducted a systematic review to find out the role of probiotics in treatment of allergic airway diseases.   A comprehensive search of the major electronic databases was done till March 2013. Trials comparing the effect of probiotics versus placebo were included. A predefined set of outcome measures were assessed. Continuous data were expressed as standardized mean difference with 95% CI. Dichotomous data were expressed as odds ratio with 95% CI. P value Probiotic intake was associated with a significantly improved quality of life score in patients with allergic rhinitis (SMD -1.9 (95% CI -3.62, -0.19); P = 0.03), though there was a high degree of heterogeneity. No improvement in quality of life score was noted in asthmatics. Probiotic intake also improved the following parameters: longer time free from episodes of asthma and rhinitis and decrease in the number of episodes of rhinitis per year. Adverse events were not significant. As the current evidence was generated from few trials with high degree of heterogeneity, routine use of probiotics as an additive on therapy in subjects with allergic airway diseases cannot be recommended.

  12. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Buffart, L.M.; van Uffelen, J.G.; Riphagen, I.; Brug, J.; van Mechelen, W.; Brown, W.J.; Chin A Paw, M.J.M.

    2012-01-01

    Background: This study aimed to systematically review the evidence from randomized controlled trials (RCTs) and to conduct a meta-analysis of the effects of yoga on physical and psychosocial outcomes in cancer patients and survivors.Methods: A systematic literature search in ten databases was

  13. Does manual therapy provide additional benefit to breathing retraining in the management of dysfunctional breathing? A randomised controlled trial.

    Science.gov (United States)

    Jones, Mandy; Troup, Fiona; Nugus, John; Roughton, Michael; Hodson, Margaret; Rayner, Charlotte; Bowen, Frances; Pryor, Jennifer

    2015-01-01

    Dysfunctional breathing (DB) is associated with an abnormal breathing pattern, unexplained breathlessness and significant patient morbidity. Treatment involves breathing retraining through respiratory physiotherapy. Recently, manual therapy (MT) has also been used, but no evidence exists to validate its use. This study sought to investigate whether MT produces additional benefit when compared with breathing retraining alone in patients with DB. Sixty subjects with primary DB were randomised into either breathing retraining (standard treatment; n = 30) or breathing retraining plus MT (intervention; n = 30) group. Both the groups received standardised respiratory physiotherapy, which included: DB education, breathing retraining, home regimen, and audio disc. Intervention group subjects additionally received MT following further assessment. Data from 57 subjects were analysed. At baseline, standard treatment group subjects were statistically younger (41.7 + 13.5 versus 50.8 + 13.0 years; p = 0.001) with higher Nijmegen scores (38.6 + 9.5 versus 31.5 + 6.9; p = 0.001). However, no significant difference was found between the groups for primary outcome Nijmegen score (95% CI (-1.1, 6.6) p = 0.162), or any secondary outcomes (Hospital Anxiety & Depression Score, spirometry or exercise tolerance). Breathing retraining is currently the mainstay of treatment for patients with DB. The results of this study suggest MT provides no additional benefit in this patient group. Dysfunctional breathing (DB) is associated with significant patient morbidity but often goes unrecognised, leading to prolonged investigation and significant use of health care resources. Breathing retraining remains the primary management of this condition. However, physiotherapists are also using manual therapy (MT) as an adjunctive treatment for patients with DB. However, the results of this study suggest that MT provides no further benefit and cannot be recommended in

  14. Social Security and Medicare Benefits

    Data.gov (United States)

    Social Security Administration — Cash benefits and rehabilitation benefits paid in each year from the Old-Age and Survivors Insurance, and Disability Insurance Trust Funds, and benefits paid from...

  15. Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?

    Energy Technology Data Exchange (ETDEWEB)

    Rades, D.; Huttenlocher, S.; Evers, J.N. [Luebeck Univ. (Germany). Dept. of Radiation Oncology; Bajrovic, A. [Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Radiation Oncology; Karstens, J.H. [Medical Univ. Hannover (Germany). Dept. of Radiation Oncology; Rudat, V. [Saad Specialist Hospital Al Khobar, Al Khobar (Saudi Arabia). Dept. of Radiation Oncology; Schild, S.E. [Mayo Clinic Scottsdale, Scottsdale, AZ (United States). Dept. of Radiation Oncology

    2012-05-15

    Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45). Improvement of motor function occurred in 21% after S + RT and 24% after RT (p = 0.39). The 1-year local control rates were 81% and 91% (p = 0.44), while the 1-year survival rates were 46% and 39% (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22% after DDSS + RT and 24% after RT alone (p = 0.92). The 1-year local control rates were 95% and 89% (p = 0.62), and the 1-year survival rates were 54% and 43% (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20% after LE + RT and 23% after RT alone (p = 0.06). The 1-year local control rates were 50% and 92% (p = 0.33). The 1-year survival rates were 32% and 32% (p = 0.55). Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival. (orig.)

  16. Addition of low dose hCG to rFSh benefits older women during ovarian stimulation for IVF.

    Science.gov (United States)

    Gomaa, Hala; Casper, Robert F; Esfandiari, Navid; Chang, Paul; Bentov, Yaakov

    2012-08-06

    To compare the outcome of IVF cycles in women receiving controlled ovarian stimulation with recFSH or recFSH plus low dose hCG. A retrospective case control study, performed at a private practice affiliated with an academic institute. Patients were infertile women who were treated with IVF/ICSI and controlled ovarian stimulation in a long GnRH agonist protocol using either low dose hCG in addition to recFSH [N = 88] or recFSH alone [N = 99]. Primary outcomes were mean FSH dose, number of mature eggs, number of fertilized eggs, and serum levels of estradiol. Secondary outcomes were endometrial thickness, cycle cancellations and pregnancy rates. A significant increase in number of mature and fertilized eggs was observed in women over 40 years of age using low dose hCG in addition to recFSH. The estradiol level was significantly higher on the day of hCG administration and the serum level of FSH on cycle day 7 and on the day of hCG administration were lower. Addition of low dose hCG to recFSH compared with recFSH alone significantly modified cycle characteristics in patients >/= 40 years and could be of potential benefit for IVF cycles in older infertile women.

  17. Addition of low dose hCG to rFSh benefits older women during ovarian stimulation for IVF

    Directory of Open Access Journals (Sweden)

    Gomaa Hala

    2012-08-01

    Full Text Available Abstract Background To compare the outcome of IVF cycles in women receiving controlled ovarian stimulation with recFSH or recFSH plus low dose hCG. Methods A retrospective case control study, performed at a private practice affiliated with an academic institute. Patients were infertile women who were treated with IVF/ICSI and controlled ovarian stimulation in a long GnRH agonist protocol using either low dose hCG in addition to recFSH [N = 88] or recFSH alone [N = 99]. Primary outcomes were mean FSH dose, number of mature eggs, number of fertilized eggs, and serum levels of estradiol. Secondary outcomes were endometrial thickness, cycle cancellations and pregnancy rates. Results A significant increase in number of mature and fertilized eggs was observed in women over 40 years of age using low dose hCG in addition to recFSH. The estradiol level was significantly higher on the day of hCG administration and the serum level of FSH on cycle day 7 and on the day of hCG administration were lower. Conclusion Addition of low dose hCG to recFSH compared with recFSH alone significantly modified cycle characteristics in patients >/= 40 years and could be of potential benefit for IVF cycles in older infertile women.

  18. Can Homeopathy Bring Additional Benefits to Thalassemic Patients on Hydroxyurea Therapy? Encouraging Results of a Preliminary Study

    Directory of Open Access Journals (Sweden)

    Antara Banerjee

    2010-01-01

    Full Text Available Several homeopathic remedies, namely, Pulsatilla Nigricans (30th potency, Ceanothus Americanus (both mother tincture and 6th potency and Ferrum Metallicum (30th potency selected as per similia principles were administered to 38 thalassemic patients receiving Hydroxyurea (HU therapy for a varying period of time. Levels of serum ferritin (SF, fetal hemoglobin (HbF, hemoglobin (Hb, platelet count (PC, mean corpuscular volume (MCV, mean corpuscular hemoglobin concentration (MCHC, mean corpuscular hemoglobin (MCH, white blood cell (WBC count, bilirubin content, alanine amino transferase (ALT, aspartate amino transferase (AST and serum total protein content of patients were determined before and 3 months after administration of the homeopathic remedies in combination with HU to evaluate additional benefits, if any, derived by the homeopathic remedies, by comparing the data with those of 38 subjects receiving only HU therapy. Preliminary results indicated that there was a significant decrease in the SF and increase in HbF levels in the combined, treated subjects. Although the changes in other parameters were not so significant, there was a significant decrease in size of spleen in most patients with spleenomegaly and improvement in general health conditions along with an increased gap between transfusions in most patients receiving the combined homeopathic treatment. The homeopathic remedies being inexpensive and without any known side-effects seem to have great potentials in bringing additional benefits to thalassemic patients; particularly in the developing world where blood transfusions suffer from inadequate screening and fall short of the stringent safety standards followed in the developed countries. Further independent studies are encouraged.

  19. Atorvastatin Plus Metformin Confer Additive Benefits on Subjects with Dyslipidemia and Overweight/Obese via Reducing ROCK2 Concentration.

    Science.gov (United States)

    Hao, Z; Liu, Y; Liao, H; Zheng, D; Xiao, C; Li, G

    2016-04-01

    Atorvastatin and metformin both have pleiotropic effects. Whether atorvastatin combined with metformin could provide additive benefits on subjects with dyslipidemia and overweight/obese is unknown. And the mechanism is also not fully clear yet. A cross-sectional research was performed and 130 subjects with dyslipidemia and overweight/obese were enrolled and randomly assigned into combined group (20 mg of atorvastatin daily plus 500 mg of metformin twice daily) and control group (20 mg of atorvastatin daily). At baseline and 8 weeks later, parameters of interest were recorded and fasting venous blood was drawn for laboratory examination. The rates of overweight (76.9% vs. 73.8%) and obese (23.1% vs. 26.2%) in both group were comparable. Dyslipidemia in both groups were featured by increased serum levels of triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). Serum level of high sensitivity C-reactive protein (Hs-CRP) was comparably elevated in both groups at baseline, and leukocyte rho-associated kinase 2 (ROCK2) and serum nitric oxide (NO) concentrations were also comparable. Generally, the baseline characteristics between these 2 groups were no significant differences. 8 weeks later, compared to baseline, body mass index (BMI), the rates of overweight and obese, daily exercise time, smoking status, lipid profiles, Hs-CRP level, leukocyte ROCK2 and serum NO concentrations in both groups were improved. Notably, compared to control group, the rate of obese, Hs-CRP level, leukocyte ROCK2 and serum NO concentrations were improved more profoundly in the combined group (pdyslipidemia and overweight/obese, atorvastatin plus metformin may confer additive benefits through reducing leukocyte ROCK2 concentration. © Georg Thieme Verlag KG Stuttgart · New York.

  20. 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…

  1. Do children with stable asthma benefit from addition of montelukast to inhaled corticosteroids: randomized, placebo controlled trial.

    Science.gov (United States)

    Stelmach, Iwona; Ożarek-Hanc, Agata; Zaczeniuk, Magdalena; Stelmach, Wlodzimierz; Smejda, Katarzyna; Majak, Pawel; Jerzynska, Joanna; Anna, Janas

    2015-04-01

    To determine the effects of montelukast added to maintenance inhaled steroids (ICS) therapy during the school year in children with stable asthma on the ICS use, frequency of exacerbations, lung function, asthma symptoms, fractional exhaled nitric oxide (FeNO) level and exercise-induced bronchoconstriction (EIB). Seventy six asthmatic children aged 6-14 years, allergic to house dust mites were randomized to a double-blinded trial comparing montelukast therapy to a matching placebo. We studied following end-points: the reduction in the ICS dose, the frequency of exacerbations, lung function, asthma control test score, and the change from baseline in FEV1 during a standardized exercise treadmill challenge. ICS dose was adjusted in a stepwise fashion to determine the lowest dose necessary to control asthma symptoms. We showed that children with baseline value of FeNO above 31 ppb and well controlled asthma symptoms on low doses of ICS, benefit the most from additive therapy with montelukast; their cumulative ICS dose is lower than in children treated with ICS only. Also, the addition of montelukast to regular treatment in asthmatic children resulted in a significant reduction in the frequency of exacerbations and EIB protection. It is reasonable to add montelukast to ICS therapy in asthmatic children during the school year, to lower cumulative ICS dose in children with well controlled asthma symptoms, as well as to reduce number of exacerbations, and to achieve better control of EIB. NCT01266772. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Successful implementation of biochar carbon sequestration in European soils requires additional benefits and close collaboration with the bioenergy sector

    Science.gov (United States)

    Hauggaard-Nielsen, Henrik; Müller-Stöver, Dorette; Bruun, Esben W.; Petersen, Carsten T.

    2014-05-01

    Biochar soil application has been proposed as a measure to mitigate climate change and on the same time improve soil fertility by increased soil carbon sequestration. However, while on tropical soils the beneficial effects of biochar application on crop growth often become immediately apparent, it has been shown to be more difficult to demonstrate these effects on the more fertile soils in temperate regions. Therefore and because of the lack of carbon credits for farmers, it is necessary to link biochar application to additional benefits, both related to agricultural as well as to bioenergy production. Thermal gasification of biomass is an efficient (95% energy efficiency) and flexible way (able to cope with many different and otherwise difficult-to-handle biomass fuels) to generate bioenergy, while producing a valuable by-product - gasification biochar, containing recalcitrant carbon and essential crop nutrients. The use of the residual char product in agricultural soils will add value to the technology as well as result in additional soil benefits such as providing plant nutrients and improving soil water-holding capacity while reducing leaching risks. From a soil column (30 x 130 cm) experiment with gasification straw biochar amendment to coarse sandy subsoil increased root density of barley at critical depths in the soil profile reducing the mechanical resistance was shown, increasing yields, and the soil's capacity to store plant available water. Incorporation of residuals from a bioenergy technology like gasification show great potentials to reduce subsoil constraints increasing yield potentials on poor soils. Another advantage currently not appropriately utilized is recovery of phosphorus (P). In a recent pot experiments char products originating from low-temperature gasification of various biofuels were evaluated for their suitability as P fertilizers. Wheat straw gasification biochar generally had a low P content but a high P plant availability. To improve

  3. The additional benefit of weighted subjective global assessment (SGA) for the predictability of mortality in incident peritoneal dialysis patients

    Science.gov (United States)

    Yun, Taeyoung; Ko, Ye Eun; Kim, Seung-Jung; Kang, Duk-Hee; Choi, Kyu Bok; Oh, Hyung Jung; Ryu, Dong-Ryeol

    2017-01-01

    Abstract Although subjective global assessment (SGA) is a widely used tool for nutritional investigation, the scores are dependent on the inspectors’ subjective opinions, and there are only few studies that directly assessed the usefulness of SGA and modified SGA in incident peritoneal dialysis (PD) patients. A total of 365 incident PD patients between 2009 and 2015 were enrolled and measured with SGA and calculated using serum albumin and total iron binding capacity (TIBC) levels for weighted SGA. Cox analyses were performed to delineate the association between SGA or weighted SGA and all-cause mortality, and a receiver-operating characteristic was conducted to reveal the additional benefit of weighted SGA on predicting adverse clinical outcomes. The Kaplan–Meier curve showed that the cumulative survival rate in patients with “Good nutrition” (G1) was significantly higher compared to those with “Mild to severe malnutrition” (G2). G2 was significantly associated with an increase in the mortality even after adjusting for several covariates compared with G1. Moreover, a 1-unit increase in weighted SGA was also significantly correlated with mortality after adjustment of the same covariates, while G2 was not significantly associated with an increase in the mortality among young-aged (under 65 years) groups. Meanwhile, a 1-unit increase in weighted SGA was significantly related to an increase in mortality in all the subgroup analyses. Furthermore, the AUCs of weighted SGAs in all groups were significantly increased compared with those of SGA alone. In conclusions, the evaluation of nutritional status based on SGA in incident PD patients might be useful for predicting mortality. However, weighted SGA with serum albumin and TIBC can provide additional predictive power for mortality compared with SGA alone in incident PD patients. PMID:29095278

  4. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Buffart Laurien M

    2012-11-01

    Full Text Available Abstract Background This study aimed to systematically review the evidence from randomized controlled trials (RCTs and to conduct a meta-analysis of the effects of yoga on physical and psychosocial outcomes in cancer patients and survivors. Methods A systematic literature search in ten databases was conducted in November 2011. Studies were included if they had an RCT design, focused on cancer patients or survivors, included physical postures in the yoga program, compared yoga with a non-exercise or waitlist control group, and evaluated physical and/or psychosocial outcomes. Two researchers independently rated the quality of the included RCTs, and high quality was defined as >50% of the total possible score. Effect sizes (Cohen’s d were calculated for outcomes studied in more than three studies among patients with breast cancer using means and standard deviations of post-test scores of the intervention and control groups. Results Sixteen publications of 13 RCTs met the inclusion criteria, of which one included patients with lymphomas and the others focused on patients with breast cancer. The median quality score was 67% (range: 22–89%. The included studies evaluated 23 physical and 20 psychosocial outcomes. Of the outcomes studied in more than three studies among patients with breast cancer, we found large reductions in distress, anxiety, and depression (d = −0.69 to −0.75, moderate reductions in fatigue (d = −0.51, moderate increases in general quality of life, emotional function and social function (d = 0.33 to 0.49, and a small increase in functional well-being (d = 0.31. Effects on physical function and sleep were small and not significant. Conclusion Yoga appeared to be a feasible intervention and beneficial effects on several physical and psychosocial symptoms were reported. In patients with breast cancer, effect size on functional well-being was small, and they were moderate to large for psychosocial outcomes.

  5. 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

  6. 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

  7. A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions.

    Directory of Open Access Journals (Sweden)

    Andrea C Villanti

    Full Text Available BACKGROUND: A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64 at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program. METHODS AND FINDINGS: The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses. CONCLUSIONS: The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical

  8. Dopexamine has no additional benefit in high-risk patients receiving goal-directed fluid therapy undergoing major abdominal surgery.

    Science.gov (United States)

    Davies, Simon J; Yates, David; Wilson, R Jonathan T

    2011-01-01

    . Complication rates, mortality, and hospital length of stay were similar between the 2 groups; however, administration of dopexamine was associated with earlier return of tolerating an enteral diet. With the effective use of goal-directed fluid therapy in elective surgical patients, the routine use of dopexamine does not confer an additional clinical benefit.

  9. Natural antioxidants as food and feed additives to promote health benefits and quality of meat products: A review.

    Science.gov (United States)

    Jiang, Jiang; Xiong, Youling L

    2016-10-01

    Fresh and processed meats offer numerous nutritional and health benefits and provide unique eating satisfaction in the lifestyle of the modern society. However, consumption of red meat including processed products is subjected to increasing scrutiny due to the health risks associated with cytotoxins that potentially could be generated during meat preparation. Evidence from recent studies suggests free radical pathways as a plausible mechanism for toxin formation, and antioxidants have shown promise to mitigate process-generated chemical hazards. The present review discusses the involvements of lipid and protein oxidation in meat quality, nutrition, safety, and organoleptic properties; animal production and meat processing strategies which incorporate natural antioxidants to enhance the nutritional and health benefits of meat; and the application of mixed or purified natural antioxidants to eliminate or minimize the formation of carcinogens for chemical safety of cooked and processed meats. Copyright © 2016. Published by Elsevier Ltd.

  10. OASDI Beneficiaries and Benefits by State-2014

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population- people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits- at the state...

  11. Benefits of dominance over additive models for the estimation of average effects in the presence of dominance

    NARCIS (Netherlands)

    Duenk, Pascal; Calus, Mario P.L.; Wientjes, Yvonne C.J.; Bijma, Piter

    2017-01-01

    In quantitative genetics, the average effect at a single locus can be estimated by an additive (A) model, or an additive plus dominance (AD) model. In the presence of dominance, the AD-model is expected to be more accurate, because the A-model falsely assumes that residuals are independent and

  12. Nutritional, Health, and Technological Functionality of Lupin Flour Addition to Bread and Other Baked Products: Benefits and Challenges.

    Science.gov (United States)

    Villarino, C B J; Jayasena, V; Coorey, R; Chakrabarti-Bell, S; Johnson, S K

    2016-01-01

    Lupin is an undervalued legume despite its high protein and dietary fiber content and potential health benefits. This review focuses on the nutritional value, health benefits, and technological effects of incorporating lupin flour into wheat-based bread. Results of clinical studies suggest that consuming lupin compared to wheat bread and other baked products reduce chronic disease risk markers; possibly due to increased protein and dietary fiber and bioactive compounds. However, lupin protein allergy has also been recorded. Bread quality has been improved when 10% lupin flour is substituted for refined wheat flour; possibly due to lupin-wheat protein cross-linking assisting bread volume and the high water-binding capacity (WBC) of lupin fiber delaying staling. Above 10% substitution appears to reduce bread quality due to lupin proteins low elasticity and the high WBC of its dietary fiber interrupting gluten network development. Gaps in understanding of the role of lupin flour in bread quality include the optimal formulation and processing conditions to maximize lupin incorporation, role of protein cross-linking, antistaling functionality, and bioactivity of its γ-conglutin protein.

  13. Breast Cancer Survivors, Common Markers of Inflammation, and Exercise: A Narrative Review

    Science.gov (United States)

    Mills, Robert Coleman

    2017-01-01

    Exercise may help positively improve inflammatory marker levels, therefore promoting better outcomes in breast cancer survivors. This narrative review is intended to provide an overview between inflammation and breast cancer, in addition to the effects exercise may have on common inflammatory markers that have been examined in both healthy populations and breast cancer survivors throughout the literature. The inconsistencies and gaps in the literature addressed may be important for future research to further understand the relationship between exercise and inflammation, as well as the underlying biological mechanisms that are responsible for these changes. For the purpose of organization, this review is structured into the following sections: (1) Breast Cancer Facts, Treatment-Related Side Effects, and General Exercise Benefits; (2) Effects of Exercise on Markers of Inflammation in Cancer-Free Populations; (3) Cancer and Markers of Inflammation; (4) Effects of Exercise on Markers of Inflammation in Breast Cancer Survivors; and (5) Conclusions. PMID:29434469

  14. Only minor additional metabolic health benefits of high as opposed to moderate dose physical exercise in young, moderately overweight men

    DEFF Research Database (Denmark)

    Reichkendler, M H; Larsen, Mads Rosenkilde; Auerbach, P L

    2014-01-01

    OBJECTIVE: The dose-response effects of exercise training on insulin sensitivity, metabolic risk, and quality of life were examined. METHODS: Sixty-one healthy, sedentary (VO₂max: 35 ± 5 ml/kg/min), moderately overweight (BMI: 27.9 ± 1.8), young (age: 29 ± 6 years) men were randomized to sedentary...... living (sedentary control group; n = 18), moderate (moderate dose training group [MOD]: 300 kcal/day, n = 21), or high (high dose training group [HIGH]: 600 kcal/day, n = 22) dose physical exercise for 11 weeks. RESULTS: The return rate for post-intervention testing was 82-94% across groups. Weekly......% in HIGH (P benefits were found when exercising ∼3,800 as opposed to ∼2,000 kcal/week in young moderately overweight men. This finding may have important...

  15. The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI.

    Science.gov (United States)

    Lobbes, Marc B I; Lalji, Ulrich C; Nelemans, Patty J; Houben, Ivo; Smidt, Marjolein L; Heuts, Esther; de Vries, Bart; Wildberger, Joachim E; Beets-Tan, Regina G

    2015-01-01

    Background - Contrast-enhanced spectral mammography (CESM) is a promising new breast imaging modality that is superior to conventional mammography for breast cancer detection. We aimed to evaluate correlation and agreement of tumor size measurements using CESM. As additional analysis, we evaluated whether measurements using an additional breast MRI exam would yield more accurate results. Methods - Between January 1(st) 2013 and April 1(st) 2014, 87 consecutive breast cancer cases that underwent CESM were collected and data on maximum tumor size measurements were gathered. In 57 cases, tumor size measurements were also available for breast MRI. Histopathological results of the surgical specimen served as gold standard in all cases. Results - The Pearson's correlation coefficients (PCC) of CESM versus histopathology and breast MRI versus histopathology were all >0.9, p1 cm between the two imaging modalities and histopathological results, we did not observe any advantage of performing an additional breast MRI after CESM in any of the cases. Conclusion - Quality of tumor size measurement using CESM is good and matches the quality of these measurement assessed by breast MRI. Additional measurements using breast MRI did not improve the quality of tumor size measurements.

  16. Only minor additional metabolic health benefits of high as opposed to moderate dose physical exercise in young, moderately overweight men.

    Science.gov (United States)

    Reichkendler, M H; Rosenkilde, M; Auerbach, P L; Agerschou, J; Nielsen, M B; Kjaer, A; Hoejgaard, L; Sjödin, A; Ploug, T; Stallknecht, B

    2014-05-01

    The dose-response effects of exercise training on insulin sensitivity, metabolic risk, and quality of life were examined. Sixty-one healthy, sedentary (VO₂max: 35 ± 5 ml/kg/min), moderately overweight (BMI: 27.9 ± 1.8), young (age: 29 ± 6 years) men were randomized to sedentary living (sedentary control group; n = 18), moderate (moderate dose training group [MOD]: 300 kcal/day, n = 21), or high (high dose training group [HIGH]: 600 kcal/day, n = 22) dose physical exercise for 11 weeks. The return rate for post-intervention testing was 82-94% across groups. Weekly exercise amounted to 2,004 ± 24 and 3,774 ± 68 kcal, respectively, in MOD and HIGH. Cardiorespiratory fitness increased (P exercise groups (MOD: 32 ± 1 to 29 ± 1%; HIGH: 30 ± 1 to 27 ± 1%). Peripheral insulin sensitivity increased (P health assessed by questionnaire increased similarly in MOD (P health benefits were found when exercising ∼3,800 as opposed to ∼2,000 kcal/week in young moderately overweight men. This finding may have important public health implications. Copyright © 2012 The Obesity Society.

  17. Use of vascularised cartilage as an additional interposition in temporomandibular ankylosis surgery: Rationale, advantages and potential benefits

    Directory of Open Access Journals (Sweden)

    Jagannathan Mukund

    2008-01-01

    Full Text Available Context: Surgery for the release of temporomandibular joint (TMJ ankylosis is a commonly performed procedure. Various interposition materials have been tried with varying success rates. However, none of these procedures attempt to recreate the architecture of the joint as the glenoid surface is usually left raw. Aims: We aimed to use a vascularised cartilage flap and to line the raw surface of the bone to recreate the articular surface of the joint. Settings and Design: There is a rich blood supply in the region of the helical root, based on branches from the Superficial Temporal Artery (STA, which enables the harvest of vascularised cartilage from the helical root for use in the temporomandibular joint. Materials and Methods: Two cases, one adult and the other a child, of unilateral ankylosis were operated upon using this additional technique. The adult patient had a bony segment excised along with a vascularised cartilage flap for lining the glenoid. The child was managed with an interposition graft of costochondral cartilage following the release of the ankylosis, in addition to the vascularised cartilage flap for lining the glenoid. Results: The postoperative mouth opening was good in both the cases with significant reduction in pain. However, the long-term results of this procedure are yet to be ascertained. Conclusions: The vascularised cartilage flap as an additional interposition material in temporomandibular joint surgery enables early and painless mouth-opening with good short-term results. The potential applicability of this flap in various pathologies of the temporomandibular joint is enormous.

  18. Benefits of Dominance over Additive Models for the Estimation of Average Effects in the Presence of Dominance

    Directory of Open Access Journals (Sweden)

    Pascal Duenk

    2017-10-01

    Full Text Available In quantitative genetics, the average effect at a single locus can be estimated by an additive (A model, or an additive plus dominance (AD model. In the presence of dominance, the AD-model is expected to be more accurate, because the A-model falsely assumes that residuals are independent and identically distributed. Our objective was to investigate the accuracy of an estimated average effect (α^ in the presence of dominance, using either a single locus A-model or AD-model. Estimation was based on a finite sample from a large population in Hardy-Weinberg equilibrium (HWE, and the root mean squared error of α^ was calculated for several broad-sense heritabilities, sample sizes, and sizes of the dominance effect. Results show that with the A-model, both sampling deviations of genotype frequencies from HWE frequencies and sampling deviations of allele frequencies contributed to the error. With the AD-model, only sampling deviations of allele frequencies contributed to the error, provided that all three genotype classes were sampled. In the presence of dominance, the root mean squared error of α^ with the AD-model was always smaller than with the A-model, even when the heritability was less than one. Remarkably, in the absence of dominance, there was no disadvantage of fitting dominance. In conclusion, the AD-model yields more accurate estimates of average effects from a finite sample, because it is more robust against sampling deviations from HWE frequencies than the A-model. Genetic models that include dominance, therefore, yield higher accuracies of estimated average effects than purely additive models when dominance is present.

  19. A comparison of the additional protocols of the five nuclear weapon states and the ensuing safeguards benefits to international nonproliferation efforts

    Energy Technology Data Exchange (ETDEWEB)

    Uribe, Eva C [Los Alamos National Laboratory; Sandoval, M Analisa [Los Alamos National Laboratory; Sandoval, Marisa N [Los Alamos National Laboratory; Boyer, Brian D [Los Alamos National Laboratory; Leitch, Rosalyn M [Los Alamos National Laboratory

    2009-01-01

    With the 6 January 2009 entry into force of the Additional Protocol by the United States of America, all five declared Nuclear Weapon States that are part of the Nonproliferation Treaty have signed, ratified, and put into force the Additional Protocol. This paper makes a comparison of the strengths and weaknesses of the five Additional Protocols in force by the five Nuclear Weapon States with respect to the benefits to international nonproliferation aims. This paper also documents the added safeguards burden to the five declared Nuclear Weapon States that these Additional Protocols put on the states with respect to access to their civilian nuclear programs and the hosting of complementary access activities as part of the Additional Protocol.

  20. Do patients with very few brain metastases from breast cancer benefit from whole-brain radiotherapy in addition to radiosurgery?

    Science.gov (United States)

    Rades, Dirk; Huttenlocher, Stefan; Hornung, Dagmar; Blanck, Oliver; Schild, Steven E; Fischer, Dorothea

    2014-12-04

    An important issue in palliative radiation oncology is the whether whole-brain radiotherapy should be added to radiosurgery when treating a limited number of brain metastases. To optimize personalized treatment of cancer patients with brain metastases, the value of whole-brain radiotherapy should be described separately for each tumor entity. This study investigated the role of whole-brain radiotherapy added to radiosurgery in breast cancer patients. Fifty-eight patients with 1-3 brain metastases from breast cancer were included in this retrospective study. Of these patients, 30 were treated with radiosurgery alone and 28 with radiosurgery plus whole-brain radiotherapy. Both groups were compared for local control of the irradiated metastases, freedom from new brain metastases and survival. Furthermore, eight additional factors were analyzed including dose of radiosurgery, age at radiotherapy, Eastern Cooperative Oncology Group (ECOG) performance score, number of brain metastases, maximum diameter of all brain metastases, site of brain metastases, extra-cranial metastases and the time from breast cancer diagnosis to radiotherapy. The treatment regimen had no significant impact on local control in the univariate analysis (p=0.59). Age ≤59 years showed a trend towards improved local control on univariate (p=0.066) and multivariate analysis (p=0.07). On univariate analysis, radiosurgery plus whole-brain radiotherapy (p=0.040) and ECOG 0-1 (p=0.012) showed positive associations with freedom from new brain metastases. Both treatment regimen (p=0.039) and performance status (p=0.028) maintained significance on multivariate analysis. ECOG 0-1 was positively correlated with survival on univariate analysis (pbreast cancer patients with few brain metastases, radiosurgery plus whole-brain radiotherapy resulted in significantly better freedom from new brain metastases than radiosurgery alone. However, this advantage did not lead to significantly better survival.

  1. Contrast-enhanced spectral mammography: Does mammography provide additional clinical benefits or can some radiation exposure be avoided?

    Science.gov (United States)

    Fallenberg, Eva Maria; Dromain, Clarisse; Diekmann, Felix; Renz, Diane M; Amer, Heba; Ingold-Heppner, Barbara; Neumann, Avidan U; Winzer, Klaus J; Bick, Ulrich; Hamm, Bernd; Engelken, Florian

    2014-07-01

    The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) with mammography (MG) and combined CESM + MG in terms of detection and size estimation of histologically proven breast cancers in order to assess the potential to reduce radiation exposure. A total of 118 patients underwent MG and CESM and had final histological results. CESM was performed as a bilateral examination starting 2 min after injection of iodinated contrast medium. Three independent blinded radiologists read the CESM, MG, and CESM + MG images with an interval of at least 4 weeks to avoid case memorization. Sensitivity and size measurement correlation and differences were calculated, average glandular dose (AGD) levels were compared, and breast densities were reported. Fisher's exact and Wilcoxon tests were performed. A total of 107 imaging pairs were available for analysis. Densities were ACR1: 2, ACR2: 45, ACR3: 42, and ACR4: 18. Mean AGD was 1.89 mGy for CESM alone, 1.78 mGy for MG, and 3.67 mGy for the combination. In very dense breasts, AGD of CESM was significantly lower than MG. Sensitivity across readers was 77.9 % for MG alone, 94.7 % for CESM, and 95 % for CESM + MG. Average tumor size measurement error compared to postsurgical pathology was -0.6 mm for MG, +0.6 mm for CESM, and +4.5 mm for CESM + MG (p < 0.001 for CESM + MG vs. both modalities). CESM alone has the same sensitivity and better size assessment as CESM + MG and was significantly better than MG with only 6.2 % increase in AGD. The combination of CESM + MG led to systematic size overestimation. When a CESM examination is planned, additional MG can be avoided, with the possibility of saving up to 61 % of radiation dose, especially in patients with dense breasts.

  2. 20 CFR 725.227 - Time of determination of relationship and dependency of survivors.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Time of determination of relationship and dependency of survivors. 725.227 Section 725.227 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION... Benefits) § 725.227 Time of determination of relationship and dependency of survivors. The determination as...

  3. 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...

  4. 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...

  5. 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.

  6. 22 CFR 20.5 - Survivor benefits.

    Science.gov (United States)

    2010-04-01

    ... the principal, in the case of a principal who dies while in active service, including service on recall or reemployment while annuity is suspended or reduced; or, (4) 55 percent of the full annuity...

  7. 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

  8. Non-additive benefit or cost? Disentangling the indirect effects that occur when plants bearing extrafloral nectaries and honeydew-producing insects share exotic ant mutualists

    Science.gov (United States)

    Savage, Amy M.; Rudgers, Jennifer A.

    2013-01-01

    Background and Aims In complex communities, organisms often form mutualisms with multiple different partners simultaneously. Non-additive effects may emerge among species linked by these positive interactions. Ants commonly participate in mutualisms with both honeydew-producing insects (HPI) and their extrafloral nectary (EFN)-bearing host plants. Consequently, HPI and EFN-bearing plants may experience non-additive benefits or costs when these groups co-occur. The outcomes of these interactions are likely to be influenced by variation in preferences among ants for honeydew vs. nectar. In this study, a test was made for non-additive effects on HPI and EFN-bearing plants resulting from sharing exotic ant guards. Preferences of the dominant exotic ant species for nectar vs. honeydew resources were also examined. Methods Ant access, HPI and nectar availability were manipulated on the EFN-bearing shrub, Morinda citrifolia, and ant and HPI abundances, herbivory and plant growth were assessed. Ant-tending behaviours toward HPI across an experimental gradient of nectar availability were also tracked in order to investigate mechanisms underlying ant responses. Key Results The dominant ant species, Anoplolepis gracilipes, differed from less invasive ants in response to multiple mutualists, with reductions in plot-wide abundances when nectar was reduced, but no response to HPI reduction. Conversely, at sites where A. gracilipes was absent or rare, abundances of less invasive ants increased when nectar was reduced, but declined when HPI were reduced. Non-additive benefits were found at sites dominated by A. gracilipes, but only for M. citrifolia plants. Responses of HPI at these sites supported predictions of the non-additive cost model. Interestingly, the opposite non-additive patterns emerged at sites dominated by other ants. Conclusions It was demonstrated that strong non-additive benefits and costs can both occur when a plant and herbivore share mutualist partners. These

  9. 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.

  10. The 2016 HIGh Heels: Health effects And psychosexual BenefITS (HIGH HABITS) study: systematic review of reviews and additional primary studies.

    Science.gov (United States)

    Barnish, Max; Morgan, Heather May; Barnish, Jean

    2017-08-01

    High-heeled shoes (high heels) are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels. We searched seven major bibliographic databases up to November 2016, in addition to supplementary searches. We initially identified all review articles of any design that assessed either the psychosexual benefits or negative musculoskeletal health effects of high heels, the latter looking at both the epidemiological and biomechanical perspectives. We additionally considered additional primary studies on areas that had not been reviewed before or in which a marked lack of evidence had been noted. Data were extracted onto standardised forms. Proportionate second review was conducted. A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies) were included in our evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men's behaviour associated with high heel wear. With regard to second-party injury, evidence is limited to one descriptive

  11. The 2016 HIGh Heels: Health effects And psychosexual BenefITS (HIGH HABITS study: systematic review of reviews and additional primary studies

    Directory of Open Access Journals (Sweden)

    Max Barnish

    2017-08-01

    Full Text Available Abstract Background High-heeled shoes (high heels are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels. Methods We searched seven major bibliographic databases up to November 2016, in addition to supplementary searches. We initially identified all review articles of any design that assessed either the psychosexual benefits or negative musculoskeletal health effects of high heels, the latter looking at both the epidemiological and biomechanical perspectives. We additionally considered additional primary studies on areas that had not been reviewed before or in which a marked lack of evidence had been noted. Data were extracted onto standardised forms. Proportionate second review was conducted. Results A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies were included in our evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men’s behaviour associated with high heel wear. With regard to second

  12. 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.

  13. 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.

  14. 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

  15. A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Additional Benefit of a Multistrain Synbiotic (Prodefen® in the Clinical Management of Acute Viral Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    Emilia García-Menor MD

    2016-11-01

    Full Text Available This randomized, open-label study evaluated the additional benefits of the synbiotic Prodefen® in the clinical management of acute diarrhea of suspected viral origin in children between 6 months and 12 years of age. Study outcomes included the duration of diarrhea, the recovery from diarrhea, and the tolerability and acceptance of the treatment. The proportion of patients without diarrhea over the study period was greater in the synbiotic group than in the control group at all study time points, showing a statistically significant difference on the fifth day (95% vs 79%, p < 0.001. The duration of diarrhea (median and interquartile range was reduced by 1 day in the synbiotic-treated patients (3 [2-5] vs 4 [3-5], p = 0.377. The tolerability of the treatment regimen, as evaluated by the parents, was significantly better in those receiving the synbiotic than in the control group. Overall, 96% of the parents of children receiving the synbiotic reported being satisfied to very satisfied with the treatment regimen. The results of this study indicate that the addition of the synbiotic Prodefen® is a well-tolerated and well-accepted approach that provides an additional benefit to the standard supportive therapy in the management of acute viral diarrhea in children.

  16. The choice of strategy of development of the enterprise entering into the integrated structure on the basis of obtaining additional competitive benefits by the enterprise

    Directory of Open Access Journals (Sweden)

    A. I. Khorev

    2017-01-01

    Full Text Available In article process of the choice of strategy of development of the enterprise, entering into the integrated structure (IS taking into account a possibility of obtaining additional competitive benefits by the enterprise from this occurrence is considered. The enterprises as a part of IS has to use a possibility of realization of effect of a synergy. In relation to the enterprise which is in IS, the synergy has not one concept, but three interrelations, different according to types, between the enterprises, namely: material, non-material and competitive. Such opinion of M. Porter shares most of the experts working in the sphere of strategic management. Realization of a synergy allows to improve overall performance not only IS (2 + 2 = 5 in general, but also and separately the enterprises entering IS. Overall performance of the enterprises improves thanks to obtaining additional competitive benefits by the enterprises in the form of decrease in expenses and differentiation of production that is realized by means of competitive strategy. Realization of effect of a synergy thanks to establishment of interrelations, as a rule, is followed also by increase in production of the enterprises entering IS that can be realized by means of growth strategy. Thus, it is desirable to develop strategy of development of the enterprise entering IS as the combined strategy consisting of two strategy: competitive and growth. The matrix of alternative strategy of development of the enterprise entering IS in the form of combinations competitive and strategy of growth, and also model of the choice of the similar combined strategy taking into account a possibility of obtaining additional competitive benefits by the enterprise is given in article. For an assessment of competitive advantages of the enterprise as a part of IS by means of ball estimates of experts the technique of a similar assessment, and a matrix of the arising interrelations of the enterprises in IS is

  17. Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes

    Directory of Open Access Journals (Sweden)

    Cejas I

    2015-05-01

    Full Text Available Ivette Cejas,1 Michael F Hoffman,2 Alexandra L Quittner21Department of Otolaryngology, University of Miami Miller School of Medicine, 2Department of Psychology, University of Miami, Miami, FL, USAAbstract: The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome. In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. Pomegranate extract and exercise provide additive benefits on improvement of immune function by inhibiting inflammation and oxidative stress in high-fat-diet-induced obesity in rats.

    Science.gov (United States)

    Zhao, Fei; Pang, Wentao; Zhang, Ziyi; Zhao, Jialong; Wang, Xin; Liu, Ye; Wang, Xun; Feng, Zhihui; Zhang, Yong; Sun, Wenyan; Liu, Jiankang

    2016-06-01

    Obesity is reported to be associated with immune dysfunction and a state of low-grade, chronic inflammation. Either pomegranate extract (PomE) or exercise (Ex) has been shown to have antiobesity, anti-inflammatory and antioxidant effects. Nevertheless, no study has addressed the additive benefits of PomE and Ex on the restoration of obesity-induced immune defects. The present work aims to study the effect of PomE and Ex as a combined intervention on immune function and the underlying mechanism involved in inflammation and oxidative stress in rats with high-fat-diet (HFD)-induced obesity. Our results demonstrate that the combination of PomE and Ex showed additive benefits on inhibition of HFD-induced body weight increase and improvement of HFD-induced immune dysfunction, including (a) attenuating the abnormality of histomorphology of the spleen, (b) increasing the ratio of the CD4+:CD8+ T cell subpopulations in splenocytes and peripheral blood mononuclear cells (PBMC), (c) inhibition of apoptosis in splenocytes and PBMC, (d) normalizing peritoneal macrophage phenotypes and (e) restoring immunomodulating factors in serum. We also find that immune dysfunction in HFD-fed rats was associated with increased inflammatory cytokine secretion and oxidative stress biomarkers, and that the combination of PomE and Ex effectively inhibited the inflammatory response and decreased oxidative damage. The effect of PomE and Ex as a combined intervention is greater than the effect of either PomE or Ex alone, showing that PomE and Ex may be additively effective in improving immune function in HFD-fed rats by inhibiting inflammation and decreasing oxidative stress. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. 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…

  4. Lack of benefit for the addition of androgen deprivation therapy to dose-escalated radiotherapy in the treatment of intermediate- and high-risk prostate cancer.

    LENUS (Irish Health Repository)

    Krauss, Daniel

    2012-02-01

    PURPOSE: Assessment of androgen deprivation therapy (ADT) benefits for prostate cancer treated with dose-escalated radiotherapy (RT). METHODS AND MATERIALS: From 1991 to 2004, 1,044 patients with intermediate- (n = 782) or high-risk (n = 262) prostate cancer were treated with dose-escalated RT at William Beaumont Hospital. Patients received external-beam RT (EBRT) alone, brachytherapy (high or low dose rate), or high dose rate brachytherapy plus pelvic EBRT. Intermediate-risk patients had Gleason score 7, prostate-specific antigen (PSA) 10.0-19.9 ng\\/mL, or Stage T2b-T2c. High-risk patients had Gleason score 8-10, PSA >\\/=20, or Stage T3. Patients were additionally divided specifically by Gleason score, presence of palpable disease, and PSA level to further define subgroups benefitting from ADT. RESULTS: Median follow-up was 5 years; 420 patients received ADT + dose-escalated RT, and 624 received dose-escalated RT alone. For all patients, no advantages in any clinical endpoints at 8 years were associated with ADT administration. No differences in any endpoints were associated with ADT administration based on intermediate- vs. high-risk group or RT modality when analyzed separately. Patients with palpable disease plus Gleason >\\/=8 demonstrated improved clinical failure rates and a trend toward improved survival with ADT. Intermediate-risk patients treated with brachytherapy alone had improved biochemical control when ADT was given. CONCLUSION: Benefits of ADT in the setting of dose-escalated RT remain poorly defined. This question must continue to be addressed in prospective study.

  5. Benzodiazepine and opioid sedation attenuate the sympathetic response to fiberoptic bronchoscopy. Prophylactic labetalol gave no additional benefit. Results of a randomized double-blind placebo-controlled study.

    Science.gov (United States)

    Fox, Benjamin D; Krylov, Yuri; Leon, Perla; Ben-Zvi, Ilan; Peled, Nir; Shitrit, David; Kramer, Mordechai R

    2008-07-01

    Hypertension and tachycardia are common during fiber-optic bronchoscopy (FOB), and this may lead to cardiac ischemia. The prophylactic addition of a beta-adrenergic anatagonist might mask this response and prevent the deleterious cardiovascular effects of FOB. We performed a randomized double-blind placebo-controlled trial of labetalol 10mg iv given with midazolam-alfentanil sedation. We monitored heart rate (HR) and systolic/diastolic blood pressure (SBP/DBP) throughout the bronchoscopy and calculated the rate-pressure product (RPP=(HRxSBP)/100). One-hundred twenty patients were enrolled. In the placebo group, there was no rise in HR, SBP, DBP or RPP, and there was no difference between the placebo and labetalol groups. Adverse events during bronchoscopy were similar in both groups. In a subgroup of patients undergoing interventional bronchoscopy, there was a trend towards lower SBP (p=0.06). Patients undergoing FOB under adequate midazolam-alfentanil sedation do not develop excessive sympathetic drive that may lead to cardiac stress. The addition of labetalol did not confer additional benefit or risk to the patients. (ClinicalTrials.gov number, NCT00394537).

  6. 20 CFR 30.509 - Under what circumstances may a survivor claiming under Part E of the Act choose to receive the...

    Science.gov (United States)

    2010-04-01

    ... claiming under Part E of the Act choose to receive the benefits that would otherwise be payable to a... Certain Payments § 30.509 Under what circumstances may a survivor claiming under Part E of the Act choose... survivor can choose to receive either the survivor benefits payable on account of the death of that covered...

  7. A Pilot Study of Expressive Writing Intervention among Chinese Speaking Breast Cancer Survivors

    Science.gov (United States)

    Lu, Qian; Zheng, Dianhan; Young, Lucy; Kagawa-Singer, Marjorie; Loh, Alice

    2013-01-01

    Objective Little attention has been focused on Asian American breast cancer survivor's psychological needs. No outcome based psychosocial interventions have been reported to target at this population. Expressive writing interventions have been previously shown to improve health outcomes among non-Hispanic white breast cancer populations. This pilot study aimed to test the cultural sensitivity, feasibility, and potential health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors. Methods Participants (N=19) were asked to write about their deepest thoughts and feelings, their coping efforts, and positive thoughts and feelings regarding their experience with breast cancer each week for three weeks. Health outcomes were assessed at baseline, three, and six months after the intervention. A Community-Based Participatory Research Approach (CBPR) is used. Results Expressive writing was associated with medium and large effect sizes (ηp2= 0.066~0.208) in improving multiple health outcomes (quality of life, fatigue, posttraumatic stress, intrusive thoughts, and positive affect) at follow-ups. Participants perceived the study to be valuable. The study yielded high compliance and completion rates. Conclusion Expressive writing is associated with long-term improvement of health outcomes among Chinese breast cancer survivors and has the potential to be utilized as a support strategy for minority cancer survivors. In addition, CBPR is valuable in improving feasibility and cultural sensitivity of the intervention in understudied populations. Future studies employing randomized controlled trial designs are warranted. PMID:22229930

  8. A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors.

    Science.gov (United States)

    Lu, Qian; Zheng, Dianhan; Young, Lucy; Kagawa-Singer, Marjorie; Loh, Alice

    2012-09-01

    Little attention has been focused on Asian American breast cancer survivor's psychological needs. No outcome-based psychosocial interventions have been reported to target at this population. Expressive writing interventions have been previously shown to improve health outcomes among non-Hispanic White breast cancer populations. This pilot study aimed to test the cultural sensitivity, feasibility, and potential health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors. Participants (N = 19) were asked to write about their deepest thoughts and feelings, their coping efforts, and positive thoughts and feelings regarding their experience with breast cancer each week for 3 weeks. Health outcomes were assessed at baseline, 3, and 6 months after the intervention. A Community-Based Participatory Research Approach (CBPR) is used. Expressive writing was associated with medium and large effect sizes (η(p)² = 0.066∼0.208) in improving multiple health outcomes (quality of life, fatigue, posttraumatic stress, intrusive thoughts, and positive affect) at follow-ups. Participants perceived the study to be valuable. The study yielded high compliance and completion rates. Expressive writing is associated with long-term improvement of health outcomes among Chinese breast cancer survivors and has the potential to be utilized as a support strategy for minority cancer survivors. In addition, CBPR is valuable in improving feasibility and cultural sensitivity of the intervention in understudied populations. Future studies employing randomized, controlled trial designs are warranted. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  9. Ontario Universities Benefits Survey, 1990-91: Part I, Benefits Excluding Pensions.

    Science.gov (United States)

    Council of Ontario Universities, Toronto.

    The report details, in tabular form, non-pension benefits offered by each of 17 Ontario universities. These include: supplementary health insurance; long term disability; sick leave entitlement; sick leave-benefits continuance; long term disability-benefits continuance; life insurance; survivor benefit; dental plan; post-retirement benefits;…

  10. 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,

  11. 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

  12. 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.

  13. The additional benefit of weighted subjective global assessment (SGA) for the predictability of mortality in incident peritoneal dialysis patients: A prospective study.

    Science.gov (United States)

    Yun, Taeyoung; Ko, Ye Eun; Kim, Seung-Jung; Kang, Duk-Hee; Choi, Kyu Bok; Oh, Hyung Jung; Ryu, Dong-Ryeol

    2017-11-01

    Although subjective global assessment (SGA) is a widely used tool for nutritional investigation, the scores are dependent on the inspectors' subjective opinions, and there are only few studies that directly assessed the usefulness of SGA and modified SGA in incident peritoneal dialysis (PD) patients. A total of 365 incident PD patients between 2009 and 2015 were enrolled and measured with SGA and calculated using serum albumin and total iron binding capacity (TIBC) levels for weighted SGA. Cox analyses were performed to delineate the association between SGA or weighted SGA and all-cause mortality, and a receiver-operating characteristic was conducted to reveal the additional benefit of weighted SGA on predicting adverse clinical outcomes. The Kaplan-Meier curve showed that the cumulative survival rate in patients with "Good nutrition" (G1) was significantly higher compared to those with "Mild to severe malnutrition" (G2). G2 was significantly associated with an increase in the mortality even after adjusting for several covariates compared with G1. Moreover, a 1-unit increase in weighted SGA was also significantly correlated with mortality after adjustment of the same covariates, while G2 was not significantly associated with an increase in the mortality among young-aged (under 65 years) groups. Meanwhile, a 1-unit increase in weighted SGA was significantly related to an increase in mortality in all the subgroup analyses. Furthermore, the AUCs of weighted SGAs in all groups were significantly increased compared with those of SGA alone. In conclusions, the evaluation of nutritional status based on SGA in incident PD patients might be useful for predicting mortality. However, weighted SGA with serum albumin and TIBC can provide additional predictive power for mortality compared with SGA alone in incident PD patients.

  14. 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.

  15. No additional benefit of shortwave diathermy over exercise program for knee osteoarthritis in peri-/post-menopausal women: an equivalence trial.

    Science.gov (United States)

    Rattanachaiyanont, M; Kuptniratsaikul, V

    2008-07-01

    To evaluate the benefit of shortwave diathermy (SWD) supplemented to an exercise program for knee osteoarthritis (OA) in peri-/post-menopausal women. A double-blind randomized placebo-controlled equivalence trial was conducted in a university hospital. Participants including 113 women aged 50-85 years with primary knee OA were instructed to do regular quadriceps exercise, and randomized to control (n=60) and treatment (n=53) groups receiving sham SWD and therapeutic SWD, respectively. The treatment being evaluated was continuous SWD, 20 min/session, 3 sessions/week for 3 weeks. The outcomes including Thai Western Ontario and McMaster Universities OA (WOMAC) index, 100-m walking speed, stair ascent-and-descent time, global assessment, patient's satisfaction, and adverse events were assessed at baseline and end of treatment. At the end of treatment, both groups had trivial but statistical improvement in all outcomes. Intention-to-treat analysis showed no statistically significant difference between the two groups in all outcomes. Per protocol analysis demonstrated the equivalence in Thai WOMAC total score, as the 95% confidence interval of difference (-0.62, 0.92) was within confidence limits of +/-1cm. The addition of SWD to an exercise program for knee OA in peri-/post-menopausal women is not superior to the exercise program alone.

  16. Discrepancy between fluoroscopic arthrography and magnetic resonance arthrography in patients with arthroscopically confirmed supraspinatus tendon tears: The additional benefit of cine fluoroscopic arthrography images

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seok; Lee, Young Han; Suh, Jin Suck [Dept. Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    To determine the additional diagnostic benefits of fluoroscopic arthrography (FA) in patients with full-thickness supraspinatus tendon (SST) tears by comparing FA images with magnetic resonance arthrography (MRA) images. This study included FA and MRA images of 53 patients who were confirmed to have full-thickness SST tears by arthroscopy. In the FA analysis, the presence of contrast leakage into the subacromial-subdeltoid bursa was recorded. In the MRA analysis, contrast leakage, retraction of a torn tendon, width and length of the tear, and supraspinatus atrophy were evaluated. Patients were divided into the concordant group or the discordant group based on the presence of contrast leakage to compare the characteristics of SST tears. We used Fisher's exact test and two-sample t-test for the comparison. Of the 53 patients, 34 were included in the concordant group and 19 were included in the discordant group. In the concordant group, the grades of retraction were higher than those in the discordant group; the width and length of the tears were larger. Muscle atrophy was more severe in the concordant group. A full-thickness SST tear did not always exhibit contrast leakage on FA, particularly small SST tears or tears with low-grade retraction. FA can provide diagnostic information regarding the severity of full-thickness SST tears by itself.

  17. OASDI Beneficiaries and Benefits by State- 2015

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  18. Kinesio Taping Does Not Provide Additional Benefits in Patients With Chronic Low Back Pain Who Receive Exercise and Manual Therapy: A Randomized Controlled Trial.

    Science.gov (United States)

    Added, Marco Aurélio Nemitalla; Costa, Leonardo Oliveira Pena; de Freitas, Diego Galace; Fukuda, Thiago Yukio; Monteiro, Renan Lima; Salomão, Evelyn Cassia; de Medeiros, Flávia Cordeiro; Costa, Lucíola da Cunha Menezes

    2016-07-01

    Study Design Randomized controlled trial. Background Many clinical practice guidelines endorse both manual therapy and exercise as effective treatment options for patients with low back pain. To optimize the effects of the treatments recommended by the guidelines, a new intervention known as Kinesio Taping is being widely used in these patients. Objectives To determine the effectiveness of Kinesio Taping in patients with chronic nonspecific low back pain when added to a physical therapy program consisting of exercise and manual therapy. Methods One hundred forty-eight patients with chronic nonspecific low back pain were randomly allocated to receive 10 (twice weekly) sessions of physical therapy, consisting of exercise and manual therapy, or the same treatment with the addition of Kinesio Taping applied to the lower back. The primary outcomes were pain intensity and disability (5 weeks after randomization) and the secondary outcomes were pain intensity, disability (3 months and 6 months after randomization), global perceived effect, and satisfaction with care (5 weeks after treatment). Data were collected by a blinded assessor. Results No between-group differences were observed in the primary outcomes of pain intensity (mean difference, -0.01 points; 95% confidence interval [CI]: -0.88, 0.85) or disability (mean difference, 1.14 points; 95% CI: -0.85, 3.13) at 5 weeks' follow-up. In addition, no between-group differences were observed for any of the other outcomes evaluated, except for disability 6 months after randomization (mean difference, 2.01 points; 95% CI: 0.03, 4.00) in favor of the control group. Conclusion Patients who received a physical therapy program consisting of exercise and manual therapy did not get additional benefit from the use of Kinesio Taping. Level of Evidence Therapy, level 1b. Prospectively registered May 28, 2013 at www.ClinicalTrials.gov (NCT01866332). J Orthop Sports Phys Ther 2016;46(7):506-513. Epub 6 Jun 2016. doi:10.2519/jospt.2016.6590.

  19. 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.

  20. 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.

  1. No Additional Benefit of Repeat-Sprint Training in Hypoxia than in Normoxia on Sea-Level Repeat-Sprint Ability

    Directory of Open Access Journals (Sweden)

    Paul S.R. Goods, Brian Dawson, Grant J. Landers, Christopher J. Gore, Peter Peeling

    2015-09-01

    Full Text Available To assess the impact of ‘top-up’ normoxic or hypoxic repeat-sprint training on sea-level repeat-sprint ability, thirty team sport athletes were randomly split into three groups, which were matched in running repeat-sprint ability (RSA, cycling RSA and 20 m shuttle run performance. Two groups then performed 15 maximal cycling repeat-sprint training sessions over 5 weeks, in either normoxia (NORM or hypoxia (HYP, while a third group acted as a control (CON. In the post-training cycling RSA test, both NORM (13.6%; p = 0.0001, and 8.6%; p = 0.001 and HYP (10.3%; p = 0.007, and 4.7%; p = 0.046 significantly improved overall mean and peak power output, respectively, whereas CON did not change (1.4%; p = 0.528, and -1.1%; p = 0.571, respectively; with only NORM demonstrating a moderate effect for improved mean and peak power output compared to CON. Running RSA demonstrated no significant between group differences; however, the mean sprint times improved significantly from pre- to post-training for CON (1.1%, NORM (1.8%, and HYP (2.3%. Finally, there were no group differences in 20 m shuttle run performance. In conclusion, ‘top-up’ training improved performance in a task-specific activity (i.e. cycling; however, there was no additional benefit of conducting this ‘top-up’ training in hypoxia, since cycle RSA improved similarly in both HYP and NORM conditions. Regardless, the ‘top-up’ training had no significant impact on running RSA, therefore the use of cycle repeat-sprint training should be discouraged for team sport athletes due to limitations in specificity.

  2. Atomic Bomb Health Benefits

    OpenAIRE

    Luckey, T. D.

    2008-01-01

    Media reports of deaths and devastation produced by atomic bombs convinced people around the world that all ionizing radiation is harmful. This concentrated attention on fear of miniscule doses of radiation. Soon the linear no threshold (LNT) paradigm was converted into laws. Scientifically valid information about the health benefits from low dose irradiation was ignored. Here are studies which show increased health in Japanese survivors of atomic bombs. Parameters include decreased mutation,...

  3. 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.

  4. STUDY TO EVALUATE THE ADDITIONAL BENEFIT OF THE HYDROLIC CAPSULAR DISTENTION USING NORMAL SALINE AND STEROID IN THE MANAGEMENT OF THE FROZEN SHOULDERS TREATED WITH CONVENTIONAL PHYSIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Mandar S

    2015-02-01

    Full Text Available Although many treatment options have been advocated for the self - limiting disease of the frozen shoulder, there is no robust evidence of the superiority of one over other . This study intended to evaluate the outcome of hydrolic capsular distension followed by physiotherapy and its comparison with only physiotherapy regime in treatment of frozen shoulder. AIMS AND OBJECTIVES : Evaluate the additional benefit of the hydrolic capsular distension using normal saline and steroid in the management of the frozen shoulder treated with conventional physiotherapy . MATERIALS AND METHODS: In this randomized prospective study we have studied total 50 cases within the age group of 40 - 70 years with idiopathic frozen shoulder. They were divided into two groups of 25 patients each. Patients in the first group were treated with shoulder joint capsular distension using normal saline and steroid under local anesthesia at outpatient department followed by physiotherapy and the patients in second group were treated with physiotherapy only. The aim was to obtain earlier pain relief and earlier relief from functional disability. Shoulder pain and disability index (SPADI & Visual analogue scale (VAS score was used as a tool for evaluation and comparison. RESULTS: After confounding all the demographic factors it was found that the intra as well as inter group change in SPADI score revealed statistically extremely significant difference (p value - <0.0001 at the end of 12 th week. Hydrotherapy group being superior than the only physiotherapy group. VAS score showed statistically extremely significant improvement in hydrotherapy group at the end of 1 st week (p value - <0.0001 as compared to not much improvement in only physiotherapy group (p value - 0.0830. Similar results were observed with the SPADI score values at the end of first week, where 80% patient in hydrotherapy group felt some improvement in performing daily activities at the same time no one was quoted

  5. 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.

  6. 5 CFR 838.921 - Determining the amount of a former spouse survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... rate of $1 per month plus all cost-of-living increases occurring after the later of— (i) The date of... maintain” the survivor annuity to which he or she was entitled at the time of the divorce satisfies the... divorce. For example, a former spouse of an employee would be entitled to a maximum survivor benefit; a...

  7. 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.

  8. 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.

  9. Expressive writing among Chinese American breast cancer survivors: A randomized controlled trial.

    Science.gov (United States)

    Lu, Qian; Wong, Celia Ching Yee; Gallagher, Matthew W; Tou, Reese Y W; Young, Lucy; Loh, Alice

    2017-04-01

    Despite the significant size of the Asian American population, few studies have been conducted to improve cancer survivorship in this underserved group. Research has demonstrated that expressive writing interventions confer physical and psychological benefits for a variety of populations, including Non-Hispanic White cancer survivors. The study aims to evaluate the health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors in the U.S. It was hypothesized that expressive writing would increase health-related quality of life (HRQOL). Ninety-six Chinese breast cancer survivors were randomly assigned to 1 of 3 writing conditions: a self-regulation group, an emotional disclosure group, or a cancer-fact group. The self-regulation group wrote about one's deepest feelings and coping efforts in addition to finding benefits from their cancer experience. The emotional disclosure group wrote about one's deepest thoughts and feelings. The cancer-fact group wrote about facts relevant to their cancer experience. HRQOL was assessed by FACT-B at baseline, 1, 3, and 6-month follow-ups. Effect sizes and residual zed change models were used to compare group differences in HRQOL. Contrary to expectations, the cancer-fact group reported the highest level of overall quality of life at the 6-month follow-up. The self-regulation group had higher emotional well-being compared to the emotional disclosure group. The study challenges the implicit assumption that psychosocial interventions validated among Non-Hispanic Whites could be directly generalized to other populations. It suggests that Asians may benefit from writing instructions facilitating more cognitive than emotional processes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Identification of patients with acute myeloblastic leukemia who benefit from the addition of gemtuzumab ozogamicin: results of the MRC AML15 trial

    DEFF Research Database (Denmark)

    Burnett, Alan K; Hills, Robert K; Milligan, Donald

    2011-01-01

    PURPOSE: Antibody-directed chemotherapy for acute myeloid leukemia (AML) may permit more treatment to be administered without escalating toxicity. Gemtuzumab ozogamicin (GO) is an immunoconjugate between CD33 and calicheamicin that is internalized when binding to the epitope. We previously...... for patients with poor-risk disease, and a trend for benefit in intermediate-risk patients. An internally validated prognostic index identified approximately 70% of patients with a predicted benefit of 10% in 5-year survival. CONCLUSION: A substantial proportion of younger patients with AML have improved...

  11. 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…

  12. 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.

  13. 20 CFR 404.1363 - Treatment of social security benefits or payments where Federal benefit payable other than by...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Treatment of social security benefits or... Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950... Social Security Benefits and Payments § 404.1363 Treatment of social security benefits or payments where...

  14. Yearly Data for Asian & Pacific Islander Language Preferences of Social Security Retirement and Survivor Claimants (FY 2016, including 53rd week)

    Data.gov (United States)

    Social Security Administration — This dataset provides annual volumes for API language preferences at the national level of individuals filing claims for Retirement and Survivor benefits for federal...

  15. Different types of additional somatosensory information do not promote immediate benefits on gait in patients with Parkinson's disease and older adults

    Directory of Open Access Journals (Sweden)

    Ellen Lirani-Silva

    2015-09-01

    Full Text Available AbstractPlantar cutaneous stimulation has been shown to improve gait in Parkinson's disease (PD, but the effects of different types of insoles have not been tested. We evaluated the immediate effect of different types of insoles on gait in PD patients and healthy older adults. Nineteen PD patients and nineteen healthy older adults performed and performed a walking task at their self-selected speed in three conditions: conventional insole, insole with a raised ridge around the foot perimeter, and insole with half-spheres. Plantar sensation was evaluated before and after the walking protocol. There were no differences between groups for plantar sensation before and after the walking task. PD patients demonstrated reduced stride length and stride velocity. There were no immediate benefits offered by the insoles on gait of either group. The increased plantar cutaneous stimulation does not promote immediate benefits on gait in PD patients and healthy older adults.

  16. Randomized Trial of a Hypnosis Intervention for Treatment of Hot Flashes Among Breast Cancer Survivors

    Science.gov (United States)

    Elkins, Gary; Marcus, Joel; Stearns, Vered; Perfect, Michelle; Rajab, M. Hasan; Ruud, Christopher; Palamara, Lynne; Keith, Timothy

    2008-01-01

    Purpose Hot flashes are a significant problem for many breast cancer survivors. Hot flashes can cause discomfort, disrupted sleep, anxiety, and decreased quality of life. A well-tolerated and effective mind-body treatment for hot flashes would be of great value. On the basis of previous case studies, this study was developed to evaluate the effect of a hypnosis intervention for hot flashes. Patients and Methods Sixty female breast cancer survivors with hot flashes were randomly assigned to receive hypnosis intervention (five weekly sessions) or no treatment. Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least 1 month. The major outcome measure was a bivariate construct that represented hot flash frequency and hot flash score, which was analyzed by a classic sums and differences comparison. Secondary outcome measures were self-reports of interference of hot flashes on daily activities. Results Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency × average severity) decreased 68% from baseline to end point in the hypnosis arm (P hypnosis intervention (P Hypnosis appears to reduce perceived hot flashes in breast cancer survivors and may have additional benefits such as reduced anxiety and depression, and improved sleep. PMID:18809612

  17. 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.

  18. 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

  19. DHEA Supplementation Confers No Additional Benefit to that of Growth Hormone on Pregnancy and Live Birth Rates in IVF Patients Categorized as Poor Prognosis.

    Science.gov (United States)

    Keane, Kevin N; Hinchliffe, Peter M; Rowlands, Philip K; Borude, Gayatri; Srinivasan, Shanti; Dhaliwal, Satvinder S; Yovich, John L

    2018-01-01

    In vitro fertilization (IVF) patients receive various adjuvant therapies to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) and dehydroepiandrosterone (DHEA) supplementation were assessed in women undergoing fresh IVF transfer cycles and categorized as poor prognosis from five criteria. Data were retrospectively analyzed from 626 women undergoing 626 IVF cycles, where they received no adjuvant, GH alone, or GH-DHEA in combination. A small group received DHEA alone. The utilization of adjuvants was decided between the attending clinician and the patient depending on various factors including cost. Despite patients being significantly older with lower ovarian reserve, live birth rates were significantly greater with GH alone (18.6%) and with GH-DHEA (13.0%) in comparison to those with no adjuvant ( p  birth chance. Following adjustment for patient age, antral follicle count, and quality of transferred embryo, GH alone and GH-DHEA led to a 7.1-fold and 5.6-fold increase in live birth chance, respectively ( p  births, particularly in younger women, and importantly, the positive effects of GH treatment were still observed even if DHEA was also used in combination. However, supplementation with DHEA did not indicate any potentiating benefit or modify the effects of GH treatment. Due to the retrospective design, and the risk of a selection bias, caution is advised in the interpretation of the data.

  20. 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.

  1. 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…

  2. 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 ...

  3. 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.

  4. Navigating cancer using online communities: a grounded theory of survivor and family experiences.

    Science.gov (United States)

    Harkin, Lydia Jo; Beaver, Kinta; Dey, Paola; Choong, Kartina

    2017-12-01

    People affected by cancer often have unmet emotional and social support needs. Online cancer communities are a convenient channel for connecting cancer survivors, allowing them to support one another. However, it is unclear whether online community use makes a meaningful contribution to cancer survivorship, as little previous research has examined the experience of using contemporary cancer communities. We aimed to explore the experiences of visitors to online cancer communities. Twenty-three in-depth interviews were conducted with online cancer community visitors, including cancer survivors (n = 18), family members (n = 2), and individuals who were both a survivor and family member (n = 3). Interviews were analysed using a grounded theory approach. A theory developed explaining how individuals 'navigated' the experience of cancer using online cancer communities. Online advice and information led participants on a 'journey to become informed'. Online friendships normalised survivorship and cast participants on a 'journey to recreate identity'. Participants navigated a 'journey through different worlds' as they discovered relevant and hidden communities. This theory highlights virtual paths people affected by cancer can take to self-manage their experience of the disease. Online community experiences can be improved by promoting online evaluation skills and signposting visitors to bereavement support. Cancer survivors can benefit through both lurking and posting in online communities. However, individuals risk becoming distressed when they befriend individuals who may soon die. Additionally, people affected by rarer cancers can struggle to find shared experiences online and may need to look elsewhere for support.

  5. DHEA Supplementation Confers No Additional Benefit to that of Growth Hormone on Pregnancy and Live Birth Rates in IVF Patients Categorized as Poor Prognosis

    Directory of Open Access Journals (Sweden)

    Kevin N. Keane

    2018-01-01

    Full Text Available BackgroundIn vitro fertilization (IVF patients receive various adjuvant therapies to enhance success rates, but the true benefit is actively debated. Growth hormone (GH and dehydroepiandrosterone (DHEA supplementation were assessed in women undergoing fresh IVF transfer cycles and categorized as poor prognosis from five criteria.MethodsData were retrospectively analyzed from 626 women undergoing 626 IVF cycles, where they received no adjuvant, GH alone, or GH–DHEA in combination. A small group received DHEA alone. The utilization of adjuvants was decided between the attending clinician and the patient depending on various factors including cost.ResultsDespite patients being significantly older with lower ovarian reserve, live birth rates were significantly greater with GH alone (18.6% and with GH-DHEA (13.0% in comparison to those with no adjuvant (p < 0.003. No significant difference was observed between the GH groups (p = 0.181. Overall, patient age, quality of the transferred embryo, and GH treatment were the only significant independent predictors of live birth chance. Following adjustment for patient age, antral follicle count, and quality of transferred embryo, GH alone and GH–DHEA led to a 7.1-fold and 5.6-fold increase in live birth chance, respectively (p < 0.000.ConclusionThese data indicated that GH adjuvant may support more live births, particularly in younger women, and importantly, the positive effects of GH treatment were still observed even if DHEA was also used in combination. However, supplementation with DHEA did not indicate any potentiating benefit or modify the effects of GH treatment. Due to the retrospective design, and the risk of a selection bias, caution is advised in the interpretation of the data.

  6. 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.

  7. 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.

  8. 20 CFR 404.1406 - Eligibility to railroad retirement benefits as a bar to payment of social security benefits.

    Science.gov (United States)

    2010-04-01

    ... as a bar to payment of social security benefits. 404.1406 Section 404.1406 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Interrelationship of... Eligibility to railroad retirement benefits as a bar to payment of social security benefits. Notwithstanding...

  9. 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).

  10. 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...

  11. 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.

  12. Additional effects of taurine on the benefits of BCAA intake for the delayed-onset muscle soreness and muscle damage induced by high-intensity eccentric exercise.

    Science.gov (United States)

    Ra, Song-Gyu; Miyazaki, Teruo; Ishikura, Keisuke; Nagayama, Hisashi; Suzuki, Takafumi; Maeda, Seiji; Ito, Masaharu; Matsuzaki, Yasushi; Ohmori, Hajime

    2013-01-01

    Taurine (TAU) has a lot of the biological, physiological, and pharmocological functions including anti-inflammatory and anti-oxidative stress. Although previous studies have appreciated the effectiveness of branched-chain amino acids (BCAA) on the delayed-onset muscle soreness (DOMS), consistent finding has not still convinced. The aim of this study was to examine the additional effect of TAU with BCAA on the DOMS and muscle damages after eccentric exercise. Thirty-six untrained male volunteers were equally divided into four groups, and ingested a combination with 2.0 g TAU (or placebo) and 3.2 g BCAA (or placebo), thrice a day, 2 weeks prior to and 4 days after elbow flexion eccentric exercise. Following the period after eccentric exercise, the physiological and blood biochemical markers for DOMS and muscle damage showed improvement in the combination of TAU and BCAA supplementation rather than in the single or placebo supplementations. In conclusion, additional supplement of TAU with BCAA would be a useful way to attenuate DOMS and muscle damages induced by high-intensity exercise.

  13. 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.

  14. 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...

  15. 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.

  16. 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

  17. 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.

  18. Cancer survivors' experience of exercise-based cancer rehabilitation - a meta-synthesis of qualitative research.

    Science.gov (United States)

    Midtgaard, Julie; Hammer, Nanna Maria; Andersen, Christina; Larsen, Anders; Bruun, Ditte-Marie; Jarden, Mary

    2015-05-01

    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. Five electronic databases (PubMed, PsychINFO, EMBASE, Cinahl and Scopus) were searched systematically for articles published up to May 2014 using keywords and MeSH terms. To be included, studies had to contain primary data pertaining to patient experiences from participation in supervised, structured moderate to vigorous-intensity exercise. In total 2447 abstracts were screened and 37 papers were read in full. Of these, 19 studies (n = 390) were selected for inclusion and critically appraised. Synthesis of data extracted from eight studies including in total 174 patients (77% women, age 28-76 years) exclusively reporting experiences of participation in structured, supervised exercise training resulted in nine themes condensed into three categories: 1) emergence of continuity; 2) preservation of health; and 3) reclaiming the body reflecting the benefits of exercise-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 to the understanding of the meaningfulness of exercise-based rehabilitation from the perspective of patients. In addition to the accumulating evidence for the efficacy of exercise training in cancer rehabilitation, it is incumbent upon

  19. 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

  20. Primary mental health care for survivors of collective sexual violence in Rwanda.

    Science.gov (United States)

    Zraly, Maggie; Rubin-Smith, Julia; Betancourt, Theresa

    2011-01-01

    This paper draws attention to the obligation and opportunity to respond to the mental health impacts of collective sexual violence (CSV) among genocide-rape survivors in post-genocide Rwanda. Qualitative data gathered from CSV survivors who were members of Rwandan women's genocide survivor associations are presented to illustrate how they strive to overcome adversity while seeking access to quality mental health care and using informal community mental health services. The results reveal that a system of high quality, holistic health and mental health care is yet needed to meet Rwandan CSV survivors' complex and serious health and mental health needs. Given that a rural health system, modelled on community-based, comprehensive HIV/AIDS care and treatment, is currently being implemented in Rwanda, we recommend enhancements to this model that would contribute to meeting the mental health care needs of CSV survivors while benefiting the health and mental health system as a whole within Rwanda.

  1. 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…

  2. The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications.

    Science.gov (United States)

    Szymusik, Iwona; Kosinski, Przemyslaw; Kosinska-Kaczynska, Katarzyna; Warzecha, Damian; Karwacka, Anetta; Kaczynski, Bartosz; Wielgos, Miroslaw

    2017-12-07

    The aim of this study was to determine if the levels of biochemical aneuploidy markers in in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) pregnancies differ from those in spontaneous pregnancies and to verify if biochemical markers could predict pregnancy outcome in IVF/ICSI gestations. This was a prospective observational study performed in a group of 551 patients who underwent a combined first trimester prenatal screening (ultrasound scan and serum markers). All patients were divided into two groups according to the mode of conception: IVF/ICSI pregnancies (study group) and spontaneous conceptions (control group). The concentrations of first trimester biochemical markers were presented as multiples of median (MoM) and were compared between the study and control groups. Analysed pregnancy complications included: preterm delivery (PTD), small for gestational age (SGA), gestational hypertension (GH), preeclampsia (PE) and gestational diabetes (GDM). The analysis was performed on 183 IVF/ICSI and 368 spontaneously conceived gestations, with complete data regarding obstetric outcome. There were no significant differences in the concentrations of biochemical markers between the analysed groups. Pregnancy-associated plasma protein-A (PAPP-A) levels were lower in hypertensive than in normotensive patients, although the difference was not significant. Twenty-three patients had GDM (12.5%), 16 had GH or PE (8.7%), SGA was diagnosed in 18 (9.8%) and 25 delivered preterm (13.6%). The trend for lower PAPP-A MoM was visible in all affected patients, although the results did not reach statistical significance. The first trimester biochemical markers in assisted reproduction technique (ART) pregnancies do not seem to have additional effect on predicting the risk of pregnancy complications.

  3. Medicaid Benefits

    Science.gov (United States)

    ... Policy and Program Topics Alternative Benefit Plan Coverage Autism Services Behavioral Health Services Dental Care Early and Periodic Screening, Diagnostic, and Treatment Hospice Benefits List of Medicaid Benefits ...

  4. 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)

    Hobbie, Wendy L.; Deatrick, Janet A.; Hardie, Thomas L.; Barakat, Lamia P.

    2015-01-01

    Purpose: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:25852971

  5. 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.

  6. The role of psychological functioning in the use of complementary and alternative methods among disease-free colorectal cancer survivors: a report from the American Cancer Society's studies of cancer survivors.

    Science.gov (United States)

    Stein, Kevin D; Kaw, Chiewkwei; Crammer, Corinne; Gansler, Ted

    2009-09-15

    The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood. By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors. Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements. Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation. Copyright (c) 2009 American Cancer Society.

  7. 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.

  8. 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.

  9. 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.

  10. 20 CFR Appendix III to Subpart C... - Benefit Table

    Science.gov (United States)

    2010-04-01

    ... of Part 404 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Pt. 404, Subpt. C, App. III Appendix III to... their benefit computed from this table. However, the minimum benefit provision was repealed for other...

  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. 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.

  13. 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.

  14. Addition of Rice Bran Arabinoxylan to Curcumin Therapy May Be of Benefit to Patients With Early-Stage B-Cell Lymphoid Malignancies (Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma, or Stage 0/1 Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    Golombick, Terry; Diamond, Terrence H.; Manoharan, Arumugam; Ramakrishna, Rajeev

    2016-01-01

    Hypothesis. Prior studies on patients with early B-cell lymphoid malignancies suggest that early intervention with curcumin may lead to delay in progressive disease and prolonged survival. These patients are characterized by increased susceptibility to infections. Rice bran arabinoxylan (Ribraxx) has been shown to have immunostimulatory, anti-inflammatory, and proapoptotic effects. We postulated that addition of Ribraxx to curcumin therapy may be of benefit. Study design. Monoclonal gammopathy of undetermined significance (MGUS)/smoldering multiple myeloma (SMM) or stage 0/1 chronic lymphocytic leukemia (CLL) patients who had been on oral curcumin therapy for a period of 6 months or more were administered both curcumin (as Curcuforte) and Ribraxx. Methods. Ten MGUS/SMM patients and 10 patients with stage 0/1 CLL were administered 6 g of curcumin and 2 g Ribraxx daily. Blood samples were collected at baseline and at 2-month intervals for a period of 6 months, and various markers were monitored. MGUS/SMM patients included full blood count (FBC); paraprotein; free light chains/ratio; C-reactive protein (CRP)and erythrocyte sedimentation rate (ESR); B2 microglobulin and immunological markers. Markers monitored for stage 0/1 CLL were FBC, CRP and ESR, and immunological markers. Results. Of 10 MGUS/SMM patients,5 (50%) were neutropenic at baseline, and the Curcuforte/Ribraxx combination therapy showed an increased neutrophil count, varying between 10% and 90% among 8 of the 10 (80%) MGUS/SMM patients. An additional benefit of the combination therapy was the potent effect in reducing the raised ESR in 4 (44%) of the MGUS/SMM patients. Conclusion. Addition of Ribraxx to curcumin therapy may be of benefit to patients with early-stage B-cell lymphoid malignancies. PMID:27154182

  15. 20 CFR 410.458 - Irrebuttable presumption of death due to pneumoconiosis-survivor's claim.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Irrebuttable presumption of death due to... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.458 Irrebuttable presumption of death due to pneumoconiosis—survivor's...

  16. The efficacy of problem solving therapy to reduce post stroke emotional distress in younger (18-65) stroke survivors.

    Science.gov (United States)

    Chalmers, Charlotte; Leathem, Janet; Bennett, Simon; McNaughton, Harry; Mahawish, Karim

    2017-11-26

    To investigate the efficacy of problem solving therapy for reducing the emotional distress experienced by younger stroke survivors. A non-randomized waitlist controlled design was used to compare outcome measures for the treatment group and a waitlist control group at baseline and post-waitlist/post-therapy. After the waitlist group received problem solving therapy an analysis was completed on the pooled outcome measures at baseline, post-treatment, and three-month follow-up. Changes on outcome measures between baseline and post-treatment (n = 13) were not significantly different between the two groups, treatment (n = 13), and the waitlist control group (n = 16) (between-subject design). The pooled data (n = 28) indicated that receiving problem solving therapy significantly reduced participants levels of depression and anxiety and increased quality of life levels from baseline to follow up (within-subject design), however, methodological limitations, such as the lack of a control group reduce the validity of this finding. The between-subject results suggest that there was no significant difference between those that received problem solving therapy and a waitlist control group between baseline and post-waitlist/post-therapy. The within-subject design suggests that problem solving therapy may be beneficial for younger stroke survivors when they are given some time to learn and implement the skills into their day to day life. However, additional research with a control group is required to investigate this further. This study provides limited evidence for the provision of support groups for younger stroke survivors post stroke, however, it remains unclear about what type of support this should be. Implications for Rehabilitation Problem solving therapy is no more effective for reducing post stroke distress than a wait-list control group. Problem solving therapy may be perceived as helpful and enjoyable by younger stroke survivors. Younger stroke

  17. CPR in medical schools: learning by teaching BLS to sudden cardiac death survivors – a promising strategy for medical students?

    Directory of Open Access Journals (Sweden)

    Herkner Harald

    2006-04-01

    Full Text Available Abstract Background Cardiopulmonary resuscitation (CPR training is gaining more importance for medical students. There were many attempts to improve the basic life support (BLS skills in medical students, some being rather successful, some less. We developed a new problem based learning curriculum, where students had to teach CPR to cardiac arrest survivors in order to improve the knowledge about life support skills of trainers and trainees. Methods Medical students who enrolled in our curriculum had to pass a 2 semester problem based learning session about the principles of cardiac arrest, CPR, BLS and defibrillation (CPR-D. Then the students taught cardiac arrest survivors who were randomly chosen out of a cardiac arrest database of our emergency department. Both, the student and the Sudden Cardiac Death (SCD survivor were asked about their skills and knowledge via questionnaires immediately after the course. The questionnaires were then used to evaluate if this new teaching strategy is useful for learning CPR via a problem-based-learning course. The survey was grouped into three categories, namely "Use of AED", "CPR-D" and "Training". In addition, there was space for free answers where the participants could state their opinion in their own words, which provided some useful hints for upcoming programs. Results This new learning-by-teaching strategy was highly accepted by all participants, the students and the SCD survivors. Most SCD survivors would use their skills in case one of their relatives goes into cardiac arrest (96%. Furthermore, 86% of the trainees were able to deal with failures and/or disturbances by themselves. On the trainer's side, 96% of the students felt to be well prepared for the course and were considered to be competent by 96% of their trainees. Conclusion We could prove that learning by teaching CPR is possible and is highly accepted by the students. By offering a compelling appreciation of what CPR can achieve in using

  18. Peer Connect for African American breast cancer survivors and caregivers: a train-the-trainer approach for peer support.

    Science.gov (United States)

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Johnson, La-Shell; Carpenter, William R; Vines, Anissa I; Belle, Denise G; Phillips, Ray; Cherry, Michele W

    2017-09-01

    Racial disparities in breast cancer survivorship are a major concern nationally. How survivors cope with cancer and re-frame their lives is a critical part of survivorship. Community-academic research partnerships may facilitate access to much-needed psychosocial support for African American survivors and caregivers in rural areas, but drivers of successful intervention implementation are not well understood. The purpose of this study was to describe the training and evaluation of Community Coaches and Guides (i.e., peer supporters) using the Peer Connect program for African American breast cancer survivors and caregivers. Community engagement strategies were used to implement the training component of Peer Connect, an evidence-based program grounded in the Diffusion of Innovation Theory utilizing motivational interviewing techniques (MI) and a "train-the-trainer" model. Quantitative and qualitative methods examined implementation outcomes of feasibility, MI fidelity, and acceptability-precursor outcomes that must be achieved before examining intervention impact vis-à-vis changes in support care. Training was feasible to implement and replicable by the trained Community Coaches. Beyond feasibility and replicability, success was modest regarding MI fidelity. Benefits (e.g., serving as role models and having safe sources of support) and lessons learned (e.g., need for additional quality control) were identified as both facilitators and barriers to implementation and as factors that could impact the effectiveness of community-engaged programs to improve survivorship outcomes. Peer Connect, like other programs that employ community-engagement strategies, holds promise to meet the psychosocial support needs of diverse rural cancer survivor populations.

  19. Short-Term Trajectories of Depressive Symptoms in Stroke Survivors and Their Family Caregivers.

    Science.gov (United States)

    Malhotra, Rahul; Chei, Choy-Lye; Menon, Edward; Chow, Wai Leng; Quah, Stella; Chan, Angelique; Matchar, David Bruce

    2016-01-01

    We utilize group-based trajectory modeling (GBTM) to delineate depressive symptom trajectories among stroke survivor-caregiver dyads, to identify predictors of the delineated trajectories, and to assess the influence of time-varying covariates (stroke survivor depressive symptoms and functional disability, caregiver depressive symptoms, and foreign domestic worker [FDW] assistance) on the level of the depressive symptom trajectories. Data on 172 stroke survivor-caregiver dyads in Singapore, for whom depressive symptoms were assessed thrice (baseline/3 months/6 months), were utilized. GBTM was applied to delineate depressive symptom trajectories, and to identify their predictors and time-varying covariates. Three stroke survivor depressive symptom trajectories (low and decreasing [47.6%], low and increasing [43.1%], and high and increasing [9.3%]) and 2 caregiver depressive symptom trajectories (low and stable [71.5%] and high and decreasing [28.5%]) were delineated. Caregivers with chronic diseases were more likely (odds ratio [95% confidence interval]: 8.09[2.04-32.07]) and those caring for older stroke survivors (0.94[0.90-0.98]) were less likely to follow the high and decreasing than the low and stable depressive symptom trajectory. An increase in stroke survivor functional disability and caregiver depressive symptoms led to a rise (~worsening) in stroke survivor depressive symptom trajectories. Whereas an increase in stroke survivor depressive symptoms led to a rise in caregiver depressive symptom trajectories, FDW assistance led to a decline (~improvement). Care professionals should be mindful of heterogeneity in depressive symptom patterns over time among stroke survivor-caregiver dyads. Reciprocal association of depressive symptoms in the stroke survivor-caregiver dyad suggests that addressing mood problems in 1 member may benefit the other member, and calls for dyadic mental health interventions. Copyright © 2015 National Stroke Association. Published by

  20. 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.

  1. Potlining Additives

    Energy Technology Data Exchange (ETDEWEB)

    Rudolf Keller

    2004-08-10

    In this project, a concept to improve the performance of aluminum production cells by introducing potlining additives was examined and tested. Boron oxide was added to cathode blocks, and titanium was dissolved in the metal pool; this resulted in the formation of titanium diboride and caused the molten aluminum to wet the carbonaceous cathode surface. Such wetting reportedly leads to operational improvements and extended cell life. In addition, boron oxide suppresses cyanide formation. This final report presents and discusses the results of this project. Substantial economic benefits for the practical implementation of the technology are projected, especially for modern cells with graphitized blocks. For example, with an energy savings of about 5% and an increase in pot life from 1500 to 2500 days, a cost savings of $ 0.023 per pound of aluminum produced is projected for a 200 kA pot.

  2. 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.

  3. Low-Dose Chest Computed Tomography for Lung Cancer Screening Among Hodgkin Lymphoma Survivors: A Cost-Effectiveness Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wattson, Daniel A., E-mail: dwattson@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Hunink, M.G. Myriam [Departments of Radiology and Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands and Center for Health Decision Science, Harvard School of Public Health, Boston, Massachusetts (United States); DiPiro, Pamela J. [Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Das, Prajnan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hodgson, David C. [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Mauch, Peter M.; Ng, Andrea K. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2014-10-01

    Purpose: Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Methods and Materials: Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (>10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs. LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life year (QALY). Results: Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. Conclusions: HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening

  4. The Relationship Between Cancer Survivors' Socioeconomic Status and Reports of Follow-up Care Discussions with Providers.

    Science.gov (United States)

    DiMartino, Lisa D; Birken, Sarah A; Mayer, Deborah K

    2017-12-01

    Socioeconomically disadvantaged cancer survivors are less likely to have adequate follow-up care. In this study, we examined whether socioeconomically disadvantaged survivors are at risk for not having follow-up care discussions with providers, a critical determinant of access to follow-up care and desirable health outcomes. Using the 2011 Medical Expenditure Panel Survey and Experiences with Cancer Survivorship Supplement, we used a binary logit model with sample weights to examine associations between 1320 cancer survivors' socioeconomic status (SES) and reports of follow-up care discussions with providers, controlling for clinical and demographic characteristics. The multivariable model indicated survivors with incomes ≤200 % Federal Poverty Level (FPL) had a lower probability of reporting a follow-up care discussion than survivors with incomes >400 % FPL (p  0.05). Socioeconomically disadvantaged cancer survivors are at risk for not having follow-up care discussions with providers, particularly those who report lower income and education. The development of educational interventions targeting provider communication with socioeconomically disadvantaged cancer survivors, and survivors' understanding of the benefits of follow-up care discussions, may promote access to these services. Future research assessing mechanisms underlying relationships between survivors' SES indicators and reports of follow-up care discussions with providers is also warranted.

  5. 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 ...

  6. 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.

  7. 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 ...

  8. "Survivor" torches "Who Wants to Be a Physician?" in the educational games ratings war.

    Science.gov (United States)

    Howard, Mary G; Collins, Heidi L; DiCarlo, Stephen E

    2002-12-01

    We recently developed an educational game for reviewing respiratory physiology in a large classroom. The "Who Wants to be a Physician?" game encouraged medical students to be active participants in the learning process. An evaluation of the game documented that students enjoyed the active format, and the students reported that the game enhanced their ability to understand and retain information. However, the evaluation also revealed that the game had limitations. Specifically, the students recommended the use of multiple-choice questions to match the Medical Board Examination format and to speed up the game (i.e., cover more topics). The students also wanted to increase their level of participation and interaction. Finally, we wanted to emphasize the benefits of peer instruction as a collaborative learning tool. To address these limitations, we designed a new game, "Survivor." Survivor incorporated multiple-choice questions and emphasized peer instruction and a capacity to gather information and solve novel problems. In addition, participation was increased by including the student audience in the game. Finally, an evaluation instrument was utilized to assess the effectiveness of this instructional tool in an academic setting. As a result of these improvements, the evaluation documents that the newly developed tool is a more effective educational game that couples fun and creative excitement with proven and effective educational concepts.

  9. A qualitative exploration of fear of cancer recurrence (FCR) amongst Australian and Canadian breast cancer survivors.

    Science.gov (United States)

    Thewes, B; Lebel, S; Seguin Leclair, C; Butow, P

    2016-05-01

    Few studies have explored coping strategies used by cancer survivors to deal with fear of cancer recurrence (FCR), and little research has been conducted on the specific content of recurrence fears. This study aims to qualitatively explore the strategies used by younger breast cancer survivors to cope with FCR and whether women with low, medium and high levels of FCR employ different coping strategies. An additional aim was to understand the specific content of worst recurrence fears. Twenty Australian and 10 Canadian women aged ≤ 45 years diagnosed with stages 0-II disease at least 1 year prior completed telephone interviews. The transcripts of audio-taped interviews were analysed using the qualitative methodology of transcendental realism. Women with higher FCR described using distraction and avoidance and fewer coping skills. The fear of death was a common worst fear at all levels of FCR. However, participants with higher FCR described more elaborate fears of death often involving themes of pain and suffering. Cross-cultural differences were not observed. Women with higher FCR report using fewer and more avoidance-based coping techniques. Whilst many participants feared death, those with higher FCR reported more elaborate death fears. Women with high levels of FCR may benefit from learning a greater repertoire of coping skills. Understanding the specific content of FCR can help refine existing psychological treatment protocols for FCR. Implications for FCR treatment are discussed.

  10. The Survivor Benefit Plan (SBP): Assessing Retirees' Cost Share

    National Research Council Canada - National Science Library

    DiPuccio, Andrew

    1999-01-01

    .... The cost of the plan was to be paid by both the retiree and the government, with the retiree paying 60 percent of the cost and the government paying 40 percent, for an indefinite period of time...

  11. The Benefits of Dragon Boat Participation for Breast Cancer Survivors

    National Research Council Canada - National Science Library

    Cherie Blanzola; Paige O'Sullivan; Kendra Smith; Rhonda Nelson

    2016-01-01

    .... Since dragon boating is growing in popularity around the country, a dragon boat program may already exist in the community that offers an opportunity for collaboration by sharing equipment, trained coaches, and/ or participants.

  12. 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.

  13. Association between Body Mass Index and Physical Function among Endometrial Cancer Survivors.

    Science.gov (United States)

    Zhang, Xiaochen; Brown, Justin C; Schmitz, Kathryn H

    2016-01-01

    We sought to quantify the relationship between body mass index (BMI) and physical function among endometrial cancer survivors. Understanding this relationship would help healthcare providers target efforts to refer obese endometrial cancer survivors to weight loss and exercise interventions. We conducted a survey of 213 endometrial cancer survivors who received cancer care at an academic l health system between 2006 and 2010. Physical function subscale was quantified using physical functional component score from the SF-12 questionnaire. We compared physical function of endometrial cancer survivors to population-based age-standardized normative values. Among the 213 patients, 16% were normal weight (BMI ≤25 kg/m2), and 52% were obese (≥30 kg/m2). Higher BMI categories were associated with lower physical function (Ptrend = 0.003), as a continuous variable each 5kg/m2 higher BMI, physical function score was lower by 0.15 points (β = -0.15; P = 0.045). Compared to population-based age-standardized normative values, patients endometrial cancer survivors, higher BMI is associated with lower physical function. Younger endometrial cancer survivors report lower physical function compared to age-standardized normative values. Healthcare providers should be aware that younger, obese endometrial cancer survivors may particularly benefit from interventions such as exercise and weight loss to increase or preserve physical function.

  14. Older adult stroke survivors discussing poststroke depressive symptoms with a healthcare provider: a preliminary analysis.

    Science.gov (United States)

    Klinedinst, N Jennifer; Clark, Patricia C; Dunbar, Sandra B

    2013-08-01

    The purposes of this study were to examine the relationship between the poststroke depressive symptoms, older adult stroke survivors' perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the health care provider with whether or not older stroke survivors discussed their depressive symptoms with a health care provider. A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the health care provider via one time interview. Thirty-seven percent (n = 16) of all older stroke survivors reported depressive symptoms to their health care provider. Of the stroke survivors who had high levels of depressive symptoms (CESD ≥ 16; n = 11), seven reported the depressive symptoms to their health care provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a health care provider. (c) 2013 APA, all rights reserved.

  15. 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. 


  16. 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.

  17. 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.

  18. Comparison of resilience in adolescent survivors of brain tumors and healthy adolescents.

    Science.gov (United States)

    Chen, Chin-Mi; Chen, Yueh-Chih; Wong, Tai-Tong

    2014-01-01

    Resilience is essential for the psychological adjustment of adolescents experiencing difficulty. Comparing differences in resilience between adolescent survivors of brain tumors and healthy adolescents may help identify factors related to resilience in adolescents. The purpose of this study was to clarify how illness impacts the normative development of adolescent survivors of brain tumors by comparing them to healthy adolescents in terms of resilience and how it is affected by various health problems. This cross-sectional, case-control study used convenience sampling to recruit 13- to 18-year-old adolescent survivors of brain tumors and healthy adolescents matched by school level, gender, and living area. Data were collected by structured questionnaires. The sample included 60 adolescent survivors and 120 healthy adolescents. Participants in both groups were predominantly male adolescents (63.3%) and junior high school students (55%). The 2 groups did not differ significantly in resilience, but survivors without emotional problems had a higher mean resilience score than did healthy adolescents and survivors with emotional problems (F = 8.65, P adolescent survivors of brain tumors and healthy adolescents. In addition, the impact of emotional problems on resilience was more severe in brain tumor survivors than in healthy adolescents. Our results suggest that pediatric oncology nurses design interdisciplinary school-based interventions to reduce the impact of emotional problems on resilience in both healthy adolescents and those who survived brain tumors.

  19. 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

  20. 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...

  1. 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...

  2. 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…

  3. 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

  4. 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...

  5. 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.

  6. Effectiveness of physical, psychological, social, and spiritual intervention in breast cancer survivors: An integrative review

    Directory of Open Access Journals (Sweden)

    Di Wei

    2016-01-01

    Full Text Available Factors affecting the health outcomes of cancer patients have gained extensive research attention considering the increasing number and prolonged longevity of cancer survivors. Breast cancer survivors experience physical, psychological, social, and spiritual challenges. This systematic literature review aims to present and discuss an overview of main issues concerning breast cancer survivors after treatment. Treatment-related symptoms as well as psychosocial and spiritual aspects of breast cancer survivors are evaluated. Moreover, the benefits of intervention for emotional, physical, social, and spiritual needs of the patient during the survivorship are investigated. This review also proposes avenues for future studies in this field and develops a new, integrated, and complete interpretation of findings on the holistic well-being of women with breast cancer. Thus, this study provides clinicians with a more comprehensive source of information compared with individual studies on symptom experiences.

  7. 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.

  8. The feasibility and benefit of a brief psychosocial intervention in addition to early palliative care in patients with advanced cancer to reduce depressive symptoms: a pilot randomized controlled clinical trial.

    Science.gov (United States)

    do Carmo, Thamires Monteiro; Paiva, Bianca Sakamoto Ribeiro; de Oliveira, Cleyton Zanardo; Nascimento, Maria Salete de Angelis; Paiva, Carlos Eduardo

    2017-08-23

    The aim of this study was to assess the feasibility and potential benefit of a brief psychosocial intervention based on cognitive-behavioral therapy performed in addition to early palliative care (PC) in the reduction of depressive symptoms among patients with advanced cancer. An open-label randomized phase II clinical trial with two intervention arms and one control group. Patients with advanced cancer starting palliative chemotherapy and who met the selection criteria were included. The participants were randomly allocated to three arms: arm A, five weekly sessions of psychosocial intervention combined with early PC; arm B, early PC only; and arm C, standard cancer treatment. Feasibility was investigated by calculating rates (%) of inclusion, attrition, and contamination (% of patients from Arm C that received PC). Scores of depression (primary aim), anxiety, and quality of life were measured at baseline and 45, 90, 120, and 180 days after randomization. From the total of 613 screened patients (10.3% inclusion rate), 19, 22, and 22 patients were allocated to arms A, B, and C, respectively. Contamination and attrition rates (180 days) were 31.8% and 38.0%, respectively. No interaction between the arms and treatments were found. Regarding effect sizes, there was a moderate benefit in arm A over arms B and C in emotional functioning (-0.66 and -0.61, respectively) but a negative effect of arm A over arm C in depression (-0.74). Future studies to be conducted with this population group need to revise the eligibility criteria and make them less restrictive. In addition, the need for arm C is questioned due to high contamination rate. The designed psychosocial intervention was not able to reduce depressive symptoms when combined with early PC. Further studies are warrant to evaluate the intervention on-demand and in subgroups of high risk of anxiety/depression. Clinical Trials identifier NCT02133274 . Registered May 6, 2014.

  9. 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.

  10. Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity.

    Science.gov (United States)

    McGowan, Erin L; Speed-Andrews, Amy E; Rhodes, Ryan E; Blanchard, Chris M; Culos-Reed, S Nicole; Friedenreich, Christine M; Courneya, Kerry S

    2013-01-01

    Physical activity improves health outcomes in colorectal cancer (CRC) survivors, but participation rates are low. One understudied strategy for increasing physical activity in CRC survivors may be sport participation. Here, we report the sport participation rate, sport preferences, and correlates of sport participation among CRC survivors. A provincial, population-based mailed survey of CRC survivors in Alberta, Canada was performed and included measures of sport participation, sport preferences, sport benefits and barriers, and medical and demographic variables. A total of 600 CRC survivors completed the survey (34 % response rate). Almost a quarter (23.0 %) of CRC survivors reported participating in a sport in the past month, with the most common sport being golf (58.7 %). In multivariate regression analysis, 33.0 % (p = 0.001) of the variance in sport participation was explained by being male (β = 0.12; p = 0.006), in better general health (β = 0.12; p = 0.006), and ≥ 5 years post-diagnosis (β = 0.09; p = 0.031). The most common barriers to sport participation were time, age/agility, and no interest/dislike of sports. The most common anticipated benefits of sport participation were improved physical fitness, meeting people, and improved health. Over half (57.2 %) of CRC survivors were possibly interested in learning about sport participation opportunities. Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.

  11. 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.

  12. 20 CFR 228.19 - Reduction for a social security benefit.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Reduction for a social security benefit. 228... RETIREMENT ACT COMPUTATION OF SURVIVOR ANNUITIES The Tier I Annuity Component § 228.19 Reduction for a social security benefit. The tier I annuity component is reduced for the amount of any social security benefit to...

  13. Core benefits

    National Research Council Canada - National Science Library

    Keith, Brian W

    2010-01-01

    This SPEC Kit explores the core employment benefits of retirement, and life, health, and other insurance -benefits that are typically decided by the parent institution and often have significant governmental regulation...

  14. 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.

  15. Are There Any Additional Benefits to Performing Positron Emission Tomography/Computed Tomography Scans and Brain Magnetic Resonance Imaging on Patients with Ground-Glass Nodules Prior to Surgery?

    Science.gov (United States)

    Song, Jae Uk; Song, Junwhi; Lee, Kyung Jong; Kim, Hojoong; Kwon, O Jung; Choi, Joon Young; Kim, Jhingook; Han, Joungho; Um, Sang Won

    2017-10-01

    A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.

  16. Incidental Detection of Late Subsequent Intracranial Neoplasms with Magnetic Resonance Imaging Among Adult Survivors of Childhood Cancer

    Science.gov (United States)

    Sabin, Noah D.; Santucci, Aimee K.; Klimo, Paul; Hudson, Melissa M.; Srivastava, Deokumar; Zhang, Nan; Kun, Larry E.; Krasin, Matthew J.; Pui, Ching-Hon; Patay, Zoltan; Reddick, Wilburn E.; Ogg, Robert J.; Hillenbrand, Claudia M.; Robison, Leslie L.; Krull, Kevin R.; Armstrong, Gregory T.

    2014-01-01

    Purpose Survivors of childhood cancer are at increased risk of developing subsequent neoplasms. In long term survivors of childhood malignancies treated with and without cranial radiation therapy (CRT), undergoing unenhanced magnetic resonance imaging (MRI) of the brain, we estimated detection of intracranial neoplasms. Methods To investigate neurocognitive outcomes, 219 survivors of childhood cancer underwent unenhanced screening MRI of the brain. 164 of the survivors had been treated for acute lymphoblastic leukemia (ALL) (125 received CRT), and 55 for Hodgkin lymphoma (HL) (none received CRT). MRI examinations were reviewed and systematically coded by a single neuroradiologist. Demographic and treatment characteristics were compared for survivors with and without subsequent neoplasms. Results Nineteen of the 219 survivors (8.7%) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years (range 12-46 years) from diagnosis. All neoplasms occurred after CRT, except for a single vestibular schwannoma within the cervical radiation field in a HL survivor. The prevalence of subsequent neoplasms after CRT exposure was 14.4% (18 of 125). By noncontrast MRI, intracranial neoplasms were most suggestive of meningiomas. Most patients presented with no specific, localizing neurological complaints. In addition to the schwannoma, six tumors were resected based on results of MRI screening, all of which were meningiomas on histologic review. Conclusion Unenhanced brain MRI of long-term survivors of childhood cancer detected a substantial number of intracranial neoplasms. Screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received CRT should be evaluated. Implications for Cancer Survivors The high prevalence of incidentally detected subsequent intracranial neoplasms after CRT in long-term survivors of childhood cancer and the minimal symptoms reported by those with intracranial

  17. 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…

  18. 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.

  19. Factors Associated With Noncompliance With Long-term Follow-up Care Among Pediatric Cancer Survivors.

    Science.gov (United States)

    Devine, Katie A; Viola, Adrienne; Capucilli, Peter; Sahler, Olle Jane Z; Andolina, Jeffrey R

    2017-04-01

    Most childhood cancer survivors do not receive risk-based care through a survivorship program, but factors associated with dropping out of care are unclear. This study aimed to identify characteristics of pediatric cancer survivors who do not return to a cancer center survivorship program for recommended care after at least 1 visit compared with those who continue to attend. Patient characteristics (demographics, school functioning, psychiatric history) and treatment characteristics (diagnosis, treatment) were abstracted from medical records for all eligible patients. Unadjusted and multivariable logistic regression analyses examined the associations among patient and treatment characteristics and nonattendance. The charts of 400 eligible patients (children below 18, n=123; adults, n=277) were reviewed. Of these, 60.3% of patients had not been seen in clinic within 1 year of their last recommended follow-up appointment. Adult-aged survivors were less likely to return to clinic than child-aged survivors (Psurvivors, longer time off treatment was associated with noncompliance with follow-up. For adult survivors, current age, nonwhite race, and longer time off treatment were associated with noncompliance. Additional methods to identify survivors at risk for noncompliance with follow-up and interventions for at-risk survivors are needed to improve survivorship care.

  20. The dyadic effects of coping and resilience on psychological distress for cancer survivor couples.

    Science.gov (United States)

    Lim, Jung-Won; Shon, En-Jung; Paek, Minso; Daly, Barbara

    2014-12-01

    This study aimed to examine the actor and partner effects of coping and resilience characteristics on psychological distress in cancer survivors and their spouses and to examine the mediating role of resilience characteristics in the relationship between coping and psychological distress. A total of 91 breast, colorectal, and prostate cancer survivor-spouse dyads were recruited from the University Hospital Registry in Cleveland, Ohio. Standardized questionnaires that assessed psychological distress, reframing and acquiring social support coping, and resilience characteristics were used. The actor-partner interdependence mediation model demonstrated that the resilience of the survivors and spouses was a strong predictor of their personal psychological distress. Survivors' and spouses' own resilience mediated the association between their reframing coping and psychological distress. However, only the survivor model confirmed the mediating effect of resilience characteristics in the relationship between social support coping and psychological distress. In addition, spouse psychological distress was influenced by survivor resilience, indicating a spouse-partner effect in the relationship between resilience characteristics and psychological distress. Our findings provide insight into the relationships between coping, resilience characteristics, and psychological distress at the individual and dyadic levels. Enhancing cancer survivors' and their spouses' positive thoughts and available external resources can improve resilience and, in turn, reduce their psychological distress of couples coping with cancer.

  1. A qualitative exploration of fear of cancer recurrence (FCR) amongst Australian and Canadian breast cancer survivors

    OpenAIRE

    Thewes, B; LEBEL, S.; Seguin Leclair, C.; Butow, P

    2015-01-01

    Purpose Few studies have explored coping strategies used by cancer survivors to deal with fear of cancer recurrence (FCR), and little research has been conducted on the specific content of recurrence fears. This study aims to qualitatively explore the strategies used by younger breast cancer survivors to cope with FCR and whether women with low, medium and high levels of FCR employ different coping strategies. An additional aim was to understand the specific content of worst recurrence fears....

  2. Cancer survivors' uptake and adherence in diet and exercise intervention trials: an integrative data analysis.

    Science.gov (United States)

    Adams, Rebecca N; Mosher, Catherine E; Blair, Cindy K; Snyder, Denise C; Sloane, Richard; Demark-Wahnefried, Wendy

    2015-01-01

    The health benefits of diet and exercise interventions for cancer survivors are well documented. However, little is known regarding demographic and medical predictors of survivors' willingness to participate in diet and exercise intervention trials, study enrollment, intervention adherence, and study completion. To assist in interpreting the generalizability of trial findings and to improve the design of future trials, this study examined predictors of these process measures. An integrative data analysis was performed on data from 3 of the largest home-based diet and exercise intervention trials for cancer survivors (n = 23,841). Demographic and medical factors (ie, sex, race, age, time since diagnosis, and cancer type) were examined as predictors of willingness to participate, study enrollment, intervention adherence, and study completion in the pooled sample. A 99% confidence interval was used to determine statistical significance. Across trials, 11.1% of contacted survivors were willing to participate, and 5.7% were eligible and enrolled. Among enrollees, 53.4% demonstrated ≥75% adherence to the intervention, and 91.1% completed the study. Race (Caucasian vs others), age, time since diagnosis, and cancer type predicted survivors' willingness to participate (P Cancer survivors' demographic and medical characteristics predicted their interest and participation in diet and exercise intervention trials. These findings have implications for the generalizability of results and can help to guide procedures used in future trials to enhance patient representation. © 2014 American Cancer Society.

  3. Communication about sexual health with breast cancer survivors: Variation among patient and provider perspectives.

    Science.gov (United States)

    Canzona, Mollie Rose; Garcia, David; Fisher, Carla L; Raleigh, Meghan; Kalish, Virginia; Ledford, Christy J W

    2016-11-01

    Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care. Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method. Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices. Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention. SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Costs of an ostomy self-management training program for cancer survivors.

    Science.gov (United States)

    Hornbrook, Mark C; Cobb, Martha D; Tallman, Nancy J; Colwell, Janice; McCorkle, Ruth; Ercolano, Elizabeth; Grant, Marcia; Sun, Virginia; Wendel, Christopher S; Hibbard, Judith H; Krouse, Robert S

    2017-11-14

    To measure incremental expenses to an oncologic surgical practice for delivering a community-based, ostomy nurse-led, small-group, behavior skills-training intervention to help bladder and colorectal cancer survivors understand and adjust to their ostomies and improve their health-related quality of life, as well as assist family caregivers to understand survivors' needs and provide appropriate supportive care. The intervention was a 5-session group behavior skills training in ostomy self-management following the principles of the Chronic Care Model. Faculty included Wound, Ostomy, and Continence Nurses (WOCNs) using an ostomy care curriculum. A gender-matched peer-in-time buddy was assigned to each ostomy survivor. The 4-session survivor curriculum included the following: self-management practice and solving immediate ostomy concerns; social well-being; healthy lifestyle; and a booster session. The single family caregiver session was coled by a WOCN and an ostomy peer staff member and covered relevant caregiver and ostomate support issues. Each cohort required 8 weeks to complete the intervention. Nonlabor inputs included ostomy supplies, teaching materials, automobile mileage for WOCNs, mailing, and meeting space rental. Intervention personnel were employed by the University of Arizona. Labor expenses included salaries and fringe benefits. The total incremental expense per intervention cohort of 4 survivors was $7246 or $1812 per patient. A WOCN-led group self-help ostomy survivorship intervention provided affordable, effective, care to cancer survivors with ostomies. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Is there any additional benefit of contrast-enhanced CT as part of routine PET/CT protocols for the differentiation of suspicious incidental gastrointestinal 2-deoxy-{sup 18}F-FDG uptake?

    Energy Technology Data Exchange (ETDEWEB)

    Brendle, Cornelia Bettina; Aschoff, Phillip; Kratt, Thomas; Schraml, Christina; Reimold, Matthias; Claussen, Claus Detlef; Pfannenberg, Christina Anna [University Hospital Tuebingen, Tuebingen (Germany)

    2013-12-15

    Suspicious incidental gastrointestinal FDG uptake during positron-emission tomography/computed tomography (PET/CT) examinations can be caused by different diseases, including malignancies. However, differentiation with PET alone is difficult. The aim of this study was to investigate the potential of PET alone, contrast-enhanced CT (ceCT), and low-dose CT (ldCT) in routine PET/CT protocols for differentiation of incidental gastrointestinal lesions. Sixty patients with incidental gastrointestinal lesions who underwent a routine PET/CT protocol with ldCT and ceCT were retrospectively analysed. The PET lesions were evaluated regarding their FDG uptake patterns and the standard uptake value. The anatomical correlates in both CT protocols were compared in regard to the correct lesion classification with the reference standard endoscopy. Sixty-two lesions were found in 60 patients (17 malignant, 10 premalignant, 5 benign, 13 inflammatory, 17 physiological). The differentiation of the FDG uptake patterns did not enable reliable lesion classification. The positive predictive value for pathology was 0.81 for ceCT in PET/CT and 0.70 for ldCT. Malignancies were detected in 100% of the patients by ceCT vs. 29.4% by ldCT. The false negative rate of ceCT for all pathologies was 31.1%, vs. 68.9% for ldCT. False positive results (17/62) could not be excluded sufficiently by either CT protocol. PET/ceCT protocols provide additional benefit especially in detecting gastrointestinal malignancies as a cause of suspicious incidental gastrointestinal FDG uptake. However, since follow-up endoscopy cannot be forgone due to the considerable false negative rate even with ceCT, the addition of ceCT to a routine PET/ldCT protocol cannot be recommended for this purpose.

  6. Non-valvular atrial fibrillation patients with none or one additional risk factor of the CHA2DS2-VASc score. A comprehensive net clinical benefit analysis for warfarin, aspirin, or no therapy.

    Science.gov (United States)

    Lip, Gregory Y H; Skjøth, Flemming; Nielsen, Peter B; Larsen, Torben Bjerregaard

    2015-10-01

    Oral anticoagulation (OAC) to prevent stroke has to be balanced against the potential harm of serious bleeding, especially intracranial haemorrhage (ICH). We determined the net clinical benefit (NCB) balancing effectiveness and safety of no antithrombotic therapy, aspirin and warfarin in AF patients with none or one stroke risk factor. Using Danish registries, we determined NCB using various definitions intrinsic to our cohort (Danish weights at 1 and 5 year follow-up), with risk weights which were derived from the hazard ratio (HR) of death following an event, relative to HR of death after ischaemic stroke. When aspirin was compared to no treatment, NCB was neutral or negative for both risk strata. For warfarin vs no treatment, NCB using Danish weights was neutral where no risk factors were present and using five years follow-up. For one stroke risk factor, NCB was positive for warfarin vs no treatment, for one year and five year follow-up. For warfarin vs aspirin use in patients with no risk factors, NCB was positive with one year follow-up, but neutral with five year follow-up. With one risk factor, NCB was generally positive for warfarin vs aspirin. In conclusion, we show a positive overall advantage (i.e. positive NCB) of effective stroke prevention with OAC, compared to no therapy or aspirin with one additional stroke risk factor, using Danish weights. 'Low risk' AF patients with no additional stroke risk factors (i.e.CHA2DS2-VASc 0 in males, 1 in females) do not derive any advantage (neutral or negative NCB) with aspirin, nor with warfarin therapy in the long run.

  7. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections.

    Science.gov (United States)

    Creaney, Leon; Wallace, Andrew; Curtis, Mark; Connell, David

    2011-09-01

    Growth factor technologies are increasingly used to enhance healing in musculoskeletal injuries, particularly in sports medicine. Two such products; platelet-rich plasma (PRP) and autologous blood, have a growing body of supporting evidence. No previous trial has directly compared the efficacy of these two methods. Growth factor administration improves tissue regeneration in patients who have failed to respond to conservative therapy. A prospective, double-blind, randomised trial. Elbow tendinopathy patients who had failed conservative physical therapy were divided into two patient groups: PRP injection (N=80) and autologous blood injection (ABI) (N=70). Each patient received two injections at 0 and 1 month. Patient-related tennis elbow evaluation (PRTEE) was recorded by a blinded investigator at 0, 1, 3 and 6 months. The main outcome measure was PRTEE, a validated composite outcome for pain, activities of daily living and physical function, utilising a 0-100 scale. At 6 months the authors observed a 66% success rate in the PRP group versus 72% in the ABI group, p=NS. There was a higher rate of conversion to surgery in the ABI group (20%) versus the PRP group (10%). In patients who are resistant to first-line physical therapy such as eccentric loading, ABI or PRP injections are useful second-line therapies to improve clinical outcomes. In this study, up to seven out of 10 additional patients in this difficult to treat cohort benefit from a surgery-sparing intervention.

  8. Adoption and cancer survivors: Findings from a learning activity for oncology nurses.

    Science.gov (United States)

    Quinn, Gwendolyn P; Zebrack, Bradley J; Sehovic, Ivana; Bowman, Meghan L; Vadaparampil, Susan T

    2015-09-01

    To the authors' knowledge, little is known regarding the rate at which cancer survivors successfully adopt a child or about their experiences negotiating a costly, and perhaps discriminatory, process regarding the prospective parent's health history. The current study describes the results of a learning activity in which nurses contacted an adoption agency to learn more about the process for survivors with the goal of helping nurses provide patients with accurate information for making a well-informed decision regarding adoption. Training program participants identified an adoption agency (local, state, or international) and conducted an interview using a semistructured guide. After the interview, participants created a summary of responses to the questions. The authors examined responses to each question using qualitative content analysis. A total of 77 participants (98% completion rate) across 15 states provided a summary. Responses were distributed across the following categories: adoption costs, steps required for survivors seeking adoption, challenges for survivors seeking adoption, birth parents' reservations, and planned institutional changes to increase adoption awareness. The majority of respondents reported improving their knowledge of adoption and cancer, increased challenges for survivors, and the need to educate patients concerning the realities of adoption policies. The need for a letter stating the survivor was 5 years cancer free was identified as a significant obstacle for survivors. Nurses are charged with following practice guidelines that include recommendations for appropriate reproductive health referrals. Cancer survivors would benefit from a health care provider who can provide education and concrete information when patients are making a decision about fertility and adoption. © 2015 American Cancer Society.

  9. Knowledge of hepatitis C virus screening in long-term pediatric cancer survivors: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Lansdale, Meagan; Castellino, Sharon; Marina, Neyssa; Goodman, Pamela; Hudson, Melissa M; Mertens, Ann C; Smith, Stephanie M; Leisenring, Wendy; Robison, Leslie L; Oeffinger, Kevin C

    2010-02-15

    Pediatric cancer survivors who were treated before routine hepatitis C virus (HCV) screening of blood donors in 1992 have an elevated risk of transfusion-acquired HCV. To assess long-term pediatric cancer survivors' knowledge of HCV testing and blood transfusion history, a questionnaire was administered to 9242 participants in the Childhood Cancer Survivor Study who are at risk for transfusion-acquired HCV after cancer therapy from 1970 to 1986. More than 70% of survivors reported either no prior HCV testing (41%) or uncertainty about testing (31%), with only 29% reporting prior testing. One half recalled having a treatment-related blood transfusion; those who recalled a transfusion were more likely to report HCV testing (39%) than those who did not (18%) or were unsure (20%). In multivariate models, survivors who reported no prior HCV testing were more likely to be older (odds ratio [OR] per 5-year increase, 1.1; 95% confidence interval [CI], 1.0-1.1) and to report no care at a cancer center within the past 2 years (OR, 1.2; 95% CI, 1.0-1.4), no cancer treatment summary (OR, 1.3; 95% CI, 1.2-1.5), and no transfusions (OR, 2.6; 95% CI, 2.3-3.0) or uncertainty about transfusions (OR, 2.2; 95% CI, 1.9-2.6), and less likely to be racial/ethnic minorities (OR, 0.9; 95% CI, 0.8-1.0) or survivors of acute myeloid leukemia (OR, 0.7; 95% CI, 0.5-1.0). Many pediatric cancer survivors at risk for transfusion-acquired HCV are unaware of their transfusion history and prior testing for HCV and would benefit from programs to increase HCV knowledge and screening.

  10. 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

  11. A comparison between Lynch syndrome and sporadic colorectal cancer survivors' satisfaction with their healthcare providers.

    Science.gov (United States)

    Burton-Chase, Allison M; Parker, Wendy M; Polivka, Katrina M; Gritz, Ellen R; Amos, Christopher I; Lu, Karen H; Lynch, Patrick M; Rodriguez-Bigas, Miguel A; Nancy You, Y; Peterson, Susan K

    2017-03-01

    This study evaluated provider satisfaction in a sample of colorectal cancer (CRC) survivors with and without Lynch syndrome (LS). Participants were case-case-matched CRC survivors with (n = 75) or without (n = 75) LS (mean age of 55; range: 27-93). Participants completed a mailed questionnaire assessing demographics, clinical characteristics, healthcare utilization, psychosocial variables, and provider satisfaction. LS CRC survivors reported lower provider satisfaction scores on three subscales of the Primary Care Assessment Survey: communication (78.14 vs. 83.96; P < 0.05), interpersonal treatment (78.58 vs. 85.30; P < 0.05), and knowledge of the patient (60.34 vs. 69.86; P < 0.01). Among LS CRC survivors, predictors for mean communication and trust subscale scores were location of treatment and socioeconomic status. Higher mean depression scores also were associated with trust, while social support predicted higher satisfaction with communication. Sporadic CRC survivor satisfaction is driven largely by age (communication, interpersonal treatment) and patient anxiety (communication), while seeing a provider more often was associated with increased satisfaction with knowledge of the patient. LS CRC survivors reported lower levels of provider satisfaction than sporadic CRC survivors. LS survivors who received care at The University of Texas MD Anderson Cancer Center, a comprehensive cancer center (CCC), reported higher satisfaction than those receiving care at other institutions. Depressive symptoms and socioeconomic status may impact provider satisfaction ratings. Exploration of other potential predictors of provider satisfaction should be examined in this population. Additionally, further research is needed to examine the potential impact of provider satisfaction on adherence to medical recommendations in LS CRC survivors, particularly those being treated outside of CCCs. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  12. Health-related quality of life in pediatric cancer survivors: a multifactorial assessment including parental factors.

    Science.gov (United States)

    Yağci-Küpeli, Begül; Akyüz, Canan; Küpeli, Serhan; Büyükpamukçu, Münevver

    2012-04-01

    We aimed to evaluate the health-related quality of life (HRQOL) and the effect of associated factors such as cancer type, treatment strategies, sex, age, and parental factors like education and psychopathology in pediatric cancer survivors and make a comparison with healthy children. "Pediatric Quality of Life Inventory (PedsQL) 4.0 TM, Generic Core Scale" for children and parents, and "Brief Symptom Inventory" for parents were used. Three hundred and two survivors without major mental or motor deficit and 272 healthy controls of 8 to 18 years of age were enrolled to study. Comparison of scores according to child self-report between survivor and control groups revealed lower points in physical and school subscale of survivor group (Psurvivors had reported significantly worse HRQOL in physical and emotional subscales of PedsQL than male survivors (Psurvivors of ≥16 years of age had reported worse scores in school subscale than females of younger age groups and male survivors of same age group. Parents of control group reported better results in school subscales (Psurvivor group. Brief Symptom Inventory score had significant effect on child self-report and parent proxy-report of physical functioning (Psurvivors whose parents are university graduate than the survivors whose parents are primary school graduate were detected (Psurvivors with central nervous system tumors had reported lower scores in the social, emotional, physical, and school functioning subscales of PedsQL than patients with non-Hodgkin and Hodgkin lymphoma (Psurvivors treated with radiotherapy in combination or as sole therapy than survivors in whom radiotherapy was not given (Pcancer survivors. Future research can build on this evidence to obtain additional factors other than well-known medical and treatment-related factors.

  13. Quality of life in long-term survivors of adult-onset cancers.

    Science.gov (United States)

    Gotay, C C; Muraoka, M Y

    1998-05-06

    The long-term survival of cancer patients has risen dramatically during the last few decades, yet little is known about the quality of life experienced by these survivors. This paper reviews research on the quality of life in long-term cancer survivors to identify quality-of-life concerns in this population, to provide a critical evaluation of the literature, and to suggest areas for future research. Searches of computerized literature databases were conducted to identify all studies of quality of life in cancer survivors that were published in English language journals during the period from January 1, 1980, through February 12, 1998, and that were based on responses from individuals who have survived 5 or more years after the diagnosis of adult-onset cancers. Thirty-four papers were identified. Most studies utilized self-report questionnaires to measure quality of life. Although methodologies and cancer patient populations varied greatly, most studies showed that many survivors continue to experience negative effects of cancer and/or treatment on their daily lives well beyond the completion of therapy. Sexual functioning and/or satisfaction and psychological functioning were found to be concerns for many survivors. Several reports documented positive coping strategies and enhanced quality of life in long-term cancer survivors, supporting the need to measure positive aspects of quality of life as well as problems in this population. Study designs that more accurately measure quality of life among survivors of cancer by adjusting for the effects of aging and long-term therapy and the impact of second cancers should be utilized. Additional data are needed to understand the needs of long-term survivors, especially of those in groups underrepresented in published quality-of-life studies, and to determine what kinds of support survivors want.

  14. 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....

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

    Science.gov (United States)

    2010-01-01

    ... annuities. (a) A current or former spouse annuity under this subpart commences on the day after the death of... in the initial month if the survivor's (of a deceased employee) annuity commences on the 31st day... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND...

  16. 5 CFR 841.703 - Increases on basic annuities and survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-GENERAL ADMINISTRATION Cost-of-Living... percentage change. (b) After survivor annuities commence, they are subject to COLA's computed under paragraph... disability benefit and the social security offset (it any) are increased by COLA's. Disability retirees...

  17. Predictors of Posttraumatic Stress and Posttraumatic Growth in Childhood Cancer Survivors

    Czech Academy of Sciences Publication Activity Database

    Koutná, Veronika; Jelínek, Martin; Blatný, Marek; Kepák, T.

    2017-01-01

    Roč. 9, č. 3 (2017), s. 1-11, č. článku 26. ISSN 2072-6694 R&D Projects: GA ČR(CZ) GAP407/11/2421 Institutional support: RVO:68081740 Keywords : posttraumatic stress * posttraumatic growth * benefit finding * childhood cancer survivors Subject RIV: AN - Psychology OBOR OECD: Psychology (including human - machine relations)

  18. 'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': A feasibility study PEACH Trial: Prescribed exercise after chemotherapy

    Directory of Open Access Journals (Sweden)

    Guinan Emer

    2010-02-01

    Full Text Available Abstract Background Many cancer survivors suffer a range of physical and psychological symptoms which may persist for months or years after cessation of treatment. Despite the known benefits of exercise and its potential to address many of the adverse effects of treatment, the role of exercise as well as optimum duration, frequency, and intensity in this population has yet to be fully elucidated. Many cancer rehabilitation programmes presented in the literature are very long and have tight eligibility criteria which make them non-applicable to the majority of cancer survivors. This paper presents the protocol of a novel 8-week intervention which aims to increase fitness, and address other physical symptoms in a heterogeneous cancer survivor population. Methods/design The aim is to recruit 64 cancer survivors 2-6 months after completion of chemotherapy, usually adjuvant, with curative intent. Subjects will be recruited through oncology clinics in a single institution and randomised to usual care or an exercise intervention. The exercise intervention consists of two specifically tailored supervised moderate intensity aerobic exercise sessions weekly over 8-weeks. All participants will be assessed at baseline (0 weeks, at the end of the intervention (8 weeks, and at 3-month follow-up. The primary outcome measure is fitness, and secondary patient-related outcome measures include fatigue, quality of life, and morphological outcomes. A further secondary outcome is process evaluation including adherence to and compliance with the exercise program. Discussion This study will provide valuable information about the physical outcomes of this 8-week supervised aerobic programme. Additionally, process information and economic evaluation will inform the feasibility of implementing this program in a heterogeneous population post cessation of chemotherapy. Trial Registration NCT01030887

  19. Barriers and facilitators to healthy lifestyle and acceptability of a dietary and physical activity intervention among African Caribbean prostate cancer survivors in the UK: a qualitative study.

    Science.gov (United States)

    Er, Vanessa; Lane, J Athene; Martin, Richard M; Persad, Raj; Chinegwundoh, Frank; Njoku, Victoria; Sutton, Eileen

    2017-10-15

    Diet and lifestyle may have a role in delaying prostate cancer progression, but little is known about the health behaviours of Black British prostate cancer survivors despite this group having a higher prostate cancer mortality rate than their White counterparts. We explored the barriers and facilitators to dietary and lifestyle changes and the acceptability of a diet and physical activity intervention in African Caribbean prostate cancer survivors. We conducted semistructured in-depth interviews and used thematic analysis to code and group the data. We recruited 14 African Caribbean prostate cancer survivors via letter or at oncology follow-up appointments using purposive and convenience sampling. A prostate cancer diagnosis did not trigger dietary and lifestyle changes in most men. This lack of change was underpinned by five themes: precancer diet and lifestyle, evidence, coping with prostate cancer, ageing, and autonomy. Men perceived their diet and lifestyle to be healthy and were uncertain about the therapeutic benefits of these factors on prostate cancer recurrence. They considered a lifestyle intervention as unnecessary because their prostate-specific antigen (PSA) level was kept under control by the treatments they had received. They believed dietary and lifestyle changes should be self-initiated and motivated, but were willing to make additional changes if they were perceived to be beneficial to health. Nonetheless, some men cited advice from health professionals and social support in coping with prostate cancer as facilitators to positive dietary and lifestyle changes. A prostate cancer diagnosis and ageing also heightened men's awareness of their health, particularly in regards to their body weight. A dietary and physical activity intervention framed as helping men to regain fitness and aid post-treatment recovery aimed at men with elevated PSA may be appealing and acceptable to African Caribbean prostate cancer survivors. © Article author(s) (or their

  20. 'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': a feasibility study PEACH trial: prescribed exercise after chemotherapy.

    LENUS (Irish Health Repository)

    Walsh, Julie M

    2010-01-01

    BACKGROUND: Many cancer survivors suffer a range of physical and psychological symptoms which may persist for months or years after cessation of treatment. Despite the known benefits of exercise and its potential to address many of the adverse effects of treatment, the role of exercise as well as optimum duration, frequency, and intensity in this population has yet to be fully elucidated. Many cancer rehabilitation programmes presented in the literature are very long and have tight eligibility criteria which make them non-applicable to the majority of cancer survivors. This paper presents the protocol of a novel 8-week intervention which aims to increase fitness, and address other physical symptoms in a heterogeneous cancer survivor population. METHODS\\/DESIGN: The aim is to recruit 64 cancer survivors 2-6 months after completion of chemotherapy, usually adjuvant, with curative intent. Subjects will be recruited through oncology clinics in a single institution and randomised to usual care or an exercise intervention. The exercise intervention consists of two specifically tailored supervised moderate intensity aerobic exercise sessions weekly over 8-weeks. All participants will be assessed at baseline (0 weeks), at the end of the intervention (8 weeks), and at 3-month follow-up. The primary outcome measure is fitness, and secondary patient-related outcome measures include fatigue, quality of life, and morphological outcomes. A further secondary outcome is process evaluation including adherence to and compliance with the exercise program. DISCUSSION: This study will provide valuable information about the physical outcomes of this 8-week supervised aerobic programme. Additionally, process information and economic evaluation will inform the feasibility of implementing this program in a heterogeneous population post cessation of chemotherapy.

  1. Additive Manufacturing Infrared Inspection

    Science.gov (United States)

    Gaddy, Darrell; Nettles, Mindy

    2015-01-01

    The Additive Manufacturing Infrared Inspection Task started the development of a real-time dimensional inspection technique and digital quality record for the additive manufacturing process using infrared camera imaging and processing techniques. This project will benefit additive manufacturing by providing real-time inspection of internal geometry that is not currently possible and reduce the time and cost of additive manufactured parts with automated real-time dimensional inspections which deletes post-production inspections.

  2. Positive aspects of having had cancer: A mixed-methods analysis of responses from the American Cancer Society Study of Cancer Survivors-II (SCS-II).

    Science.gov (United States)

    Adorno, Gail; Lopez, Ellen; Burg, Mary Ann; Loerzel, Victoria; Killian, Michael; Dailey, Amy B; Iennaco, Joanne D; Wallace, Cara; Sharma, Dinghy Kristine B; Stein, Kevin

    2017-06-21

    This study focused on understanding positive aspects of cancer among a large, national sample of survivors, 2, 5, and 10 years' postcancer diagnosis, who responded to the American Cancer Society Study of Cancer Survivors - II (SCS-II) survey "Please tell us about any positive aspects of having cancer." A sequential mixed methods approach examined (1) thematic categories of positive aspects from cancer survivors (n = 5149) and (2) variation in themes by sociodemographics, cancer type, stage of disease, and length of survivorship. Themes comprised 21 positive aspects within Thornton's typology of benefits that cancer survivors attribute to their illness: life perspectives, self, and relationships. New themes pertaining to gratitude and medical support during diagnosis and treatment, health-related changes, follow-up/surveillance, and helping others emerged that are not otherwise included in widely used existing benefit finding cancer scales. Gratitude and appreciation for life were the most frequently endorsed themes. Sociodemographics and stage of disease were associated with positive aspect themes. Themes were not associated with survivor cohorts. No differences in perceived positive aspects across survivor cohorts suggest that positive aspects of cancer may exist long after diagnosis for many survivors. However, variation across sociodemographics and clinical variables suggests cancer survivors differentially experience positive aspects from their cancer diagnosis. This analysis provides new information about cancer survivors' perceptions of positive aspects from their cancer and factors associated with benefit finding and personal growth. This information can be useful in further refining quality-of-life measures and interventions for cancer survivors. Copyright © 2017 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2016-03-01

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

  4. The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors.

    Science.gov (United States)

    Chung, O K Joyce; Li, Ho Cheung William; Chiu, Sau Ying; Ho, Ka Yan Eva; Lopez, Violeta

    2014-01-01

    Research indicates that regular physical activity is associated with numerous physiological and psychological health benefits for childhood cancer survivors. A review of the literature reveals that no study has so far examined the physical activity levels and behavior of Hong Kong Chinese childhood cancer survivors, and how the cancer and its treatment affect the physical activity and other behavior of these children remains unclear. The aims of this study were to assess the physical activity levels of Hong Kong Chinese childhood cancer survivors and to explore the factors that affect their adherence to and maintenance of regular physical activity. A cross-sectional study was used. A total of 128 childhood cancer survivors (9-16-year-olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. There was a significant decline in physical activity levels among childhood cancer survivors. Most of them did not take physical exercise regularly. Concern about academic performance, fatigue, and a decrease in physical strength and endurance after remission prevented them from engaging in regular physical activity. This study indicates that many childhood cancer survivors did not engage in regular physical activity and that they overlooked or underestimated its importance. It is essential for nurses to correct misconceptions about physical activity among childhood cancer survivors and their parents and, most importantly, to advocate the principle of regular physical activity for these children, with the aim of enhancing their physical and psychological well-being.

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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...

  10. 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...

  11. 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.

  12. Darwinism determines technological survivors

    Energy Technology Data Exchange (ETDEWEB)

    Bevc, F.; Harkness, S.

    1996-10-01

    In an industry where new power plant planning and budgeting cycles stretch from one to three years, where a typical new generation product takes from five to 10 years to successfully enter the market and where some plants have a 30- to 50-year economic life, change is an evolutionary process. However, that change, driven by the application of new technologies, is inevitable. Twenty-five years ago, in 1971, gas turbines were perceived to have limited applications and were primarily used for part-time peaking duty. Today, they are the baseload, new power generation technology of choice. Nevertheless, more than 55% of the US`s electricity is still generated by coal-fired steam turbine plants, the technology of choice 25 years ago. Power generation technologies will evolve further, but it`s doubtful there will be any new concepts that are not evident in today`s laboratories. Twenty-five years from now, today`s coal-fires team turbine plants will still provide the majority of the electricity generated in the US. However, new natural gas or syngas-fired combined-cycle plants will make up the majority of the new additions, perhaps as much as 20% of the overall installed capacity in 2021. Still, during the next 25 years, a number of new generation technologies should become economically competitive and enter the market. Technologies moving from today`s demonstrations to widespread applications include: gasification, pressurized fluidized bed combustion, fuel cell hybrid cycles, and solar photovoltaics.

  13. Sharing power and knowledge: professional and mental health consumer/survivor researchers working together in a participatory action research project.

    Science.gov (United States)

    Ochocka, Joanna; Janzen, Rich; Nelson, Geoffrey

    2002-01-01

    In this article we document and reflect on the process and outcomes of consumer/survivor researchers' involvement in a community mental health research project. The study used a participatory action research approach that challenges traditional assumptions of how to conduct research. Research roles and relationships were reexamined by both professional and consumer/survivor researchers. Four values were central to the research process: consumer/survivor empowerment, supportive relationships, learning as an ongoing process, and social justice. The benefits of this value-driven approach were seen in terms of positive impacts on the lives of individual researchers and also in the quality of the research itself. Our reflections on the research process have led us to see the importance of building relationships as a means to share power and knowledge among professional and consumer/survivor researchers.

  14. Physical activity and obesity in endometrial cancer survivors: associations with pain, fatigue, and physical functioning.

    Science.gov (United States)

    Basen-Engquist, Karen; Scruggs, Stacie; Jhingran, Anuja; Bodurka, Diane C; Lu, Karen; Ramondetta, Lois; Hughes, Daniel; Carmack Taylor, Cindy

    2009-03-01

    This study aims to determine the prevalence of physical activity and obesity and their relationship to physical functioning (PF), fatigue, and pain in endometrial cancer survivors. Surveys were mailed to 200 survivors of endometrial cancer diagnosed within the last 5 years; 61% were returned. Surveys assessed physical activity, height and weight, comorbid health problems, PF, fatigue, and pain. In all, 22% exercised in the past month at the level of current public health recommendations, 41% reported no physical activity, and 38% reported some activity. A total of 16% were overweight and 50% were obese. Both lower body mass index (BMI) and higher physical activity were related to better PF. Higher physical activity was related to less fatigue, primarily for patients of normal BMI. Results suggest endometrial cancer survivors' obesity and inactivity contributes to poorer quality of life. This population could benefit from quality-of-life interventions incorporating physical activity.

  15. Perceptions of parenting versus parent-child interactions among incest survivors.

    Science.gov (United States)

    Fitzgerald, Monica M; Shipman, Kimberly L; Jackson, Joan L; McMahon, Robert J; Hanley, Honora M

    2005-06-01

    Although women with histories of child sexual abuse (CSA) perceive themselves as less competent mothers and report greater parenting difficulties than nonabused women, few investigators have actually observed the parenting behaviors of CSA survivors. The primary aim of this study was to examine whether incest history was related to maternal perceptions of parenting efficacy and interactional patterns with their children. The secondary aim of this study was to explore the constructs of internal working models of relationships and maternal psychological adjustment as potential mediators of the relation between incest history and parenting. A community sample of 17 incest survivors, 18 nonabused women and their 3-6 year-old children participated. Mothers completed self-report measures of parenting efficacy, parental bonding (i.e., internal working models of relationships), and psychological adjustment. In addition, mothers interacted with their children in a problem-solving task. Although incest survivors reported less parenting self-efficacy than did nonabused mothers, their interactional styles with their children were positive overall and comparable to those of nonabused mothers. Specifically, survivors displayed moderate to high levels of support, assistance, and confidence, and their children showed high levels of affection towards their mothers. Incest survivors reported less bonding with their own mothers in childhood and poorer current psychological adjustment. Findings suggest that incest survivors' perceptions of their parenting abilities may be more negative than their actual parenting behaviors.

  16. Neural Underpinnings of Working Memory in Adult Survivors of Childhood Brain Tumors.

    Science.gov (United States)

    King, Tricia Z; Na, Sabrina; Mao, Hui

    2015-08-01

    Adult survivors of childhood brain tumors are at risk for cognitive performance deficits that require the core cognitive skill of working memory. Our goal was to examine the neural mechanisms underlying working memory performance in survivors. We studied the working memory of adult survivors of pediatric posterior fossa brain tumors using a letter n-back paradigm with varying cognitive workload (0-, 1-, 2-, and 3-back) and functional magnetic resonance imaging as well as neuropsychological measures. Survivors of childhood brain tumors evidenced lower working memory performance than demographically matched healthy controls. Whole-brain analyses revealed significantly greater blood-oxygen level dependent (BOLD) activation in the left superior / middle frontal gyri and left parietal lobe during working memory (2-back versus 0-back contrast) in survivors. Left frontal BOLD response negatively correlated with 2- and 3-back working memory performance, Auditory Consonant Trigrams (ACT), and Digit Span Backwards. In contrast, parietal lobe BOLD response negatively correlated with 0-back (vigilance task) and ACT. The results revealed that adult survivors of childhood posterior fossa brain tumors recruited additional cognitive control resources in the prefrontal lobe during increased working memory demands. This increased prefrontal activation is associated with lower working memory performance and is consistent with the allocation of latent resources theory.

  17. Executive Functions and Social Skills in Survivors of Pediatric Brain Tumor

    Science.gov (United States)

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

    2012-01-01

    Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper and pencil measures of social skills and real world executive skills. Social functioning was related to a specific aspect of executive functions, i.e., the survivors’ variability in response time, such that inconsistent responding was associated with better parent-report and survivor-report social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed. PMID:22420326

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

    Science.gov (United States)

    Daniëls, Laurien A; Krol, Stijn D G; de Graaf, Michiel A; Scholte, Arthur J H A; van 't Veer, Mars B; Putter, Hein; de Roos, Albert; Schalij, Martin J; van de Poll-Franse, Lonneke V; Creutzberg, Carien L

    2014-09-01

    Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction. Patients who participated in the screening study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening. Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (Pinformation between patients with and without screen-detected CVD. Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by means of CTA and subsequent cardiac intervention was highly valued, and the benefits were felt to outweigh the emotional and practical

  19. Impact of Cardiovascular Counseling and Screening in Hodgkin Lymphoma Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Daniëls, Laurien A., E-mail: l.a.daniels@lumc.nl [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Krol, Stijn D.G. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Graaf, Michiel A. de [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Interuniversity Cardiology Institute of the Netherlands, Utrecht (Netherlands); Scholte, Arthur J.H.A. [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Veer, Mars B. van ' t [Department of Hematology, Leiden University Medical Center, Leiden (Netherlands); Putter, Hein [Department of Medical Statistics and Bio-informatics, Leiden University Medical Center, Leiden (Netherlands); Roos, Albert de [Department of Radiology, Leiden University Medical Center, Leiden (Netherlands); Schalij, Martin J. [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Poll-Franse, Lonneke V. van de [Research Department Comprehensive Cancer Center South, Eindhoven (Netherlands); Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg (Netherlands); Creutzberg, Carien L. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands)

    2014-09-01

    Purpose: Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction. Methods and Materials: Patients who participated in the screening study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening. Results: Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (P<.01). Differences were clinically relevant. There were no differences in perceived information between patients with and without screen-detected CVD. Conclusions: Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by

  20. 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.

  1. 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

  2. General health status and late effects among adolescent and young adult survivors of childhood cancer in Japan.

    Science.gov (United States)

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

    2014-10-01

    We sought to investigate general health status and late effects among adolescent and young adult survivors of childhood cancer. We conducted a cross-sectional survey, using self-rated questionnaires on current and past health problems. Questionnaires were provided to childhood cancer survivors, a comparison group of siblings and a general population control group that was recruited online. χ(2) tests were used to compare responses to the 72 survey items. The final sample included 185 childhood cancer survivors (72% response rate), 72 siblings and 1000 general population controls. In the childhood cancer survivors group, the median age of diagnosis was 8 years and the median age at survey was 23 years. According to the physicians' reports, 56% of the childhood cancer survivors experienced at least one late effect. In descending order of prevalence, the current symptoms in the childhood cancer survivors group were (i) impaired visual acuity (45%), (ii) dizziness (36%) and (iii) any allergy (34%). The three most common symptoms had similar prevalence rates in each of the groups. As compared with the control group, the following physical symptoms were significantly more common in the childhood cancer survivors group: mental retardation (odds ratio: 48.6, P < 0.01); cataract (odds ratio: 29.7); suspected infertility (odds ratio: 25.1); delayed puberty (odds ratio 24.9); growth hormone deficiency (odds ratio: 23.0); and other audiovisual, urinary, endocrine, infertility, cardiovascular, respiratory, gastrointestinal, spinal, extremity and neuromuscular problems. Many adolescent/young adult childhood cancer survivors could be suffering from ongoing late effects that stem from cancer and its treatment. Overall health monitoring for childhood cancer survivors can provide indispensable benefits. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

    Mader, Luzius; Rueegg, Corina S.; Vetsch, Janine; Rischewski, Johannes; Ansari, Marc; Kuehni, Claudia E.; Michel, Gisela

    2016-01-01

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

  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. Recommendations for Obesity Clinical Trials in Cancer Survivors: American Society of Clinical Oncology Statement.

    Science.gov (United States)

    Ligibel, Jennifer A; Alfano, Catherine M; Hershman, Dawn; Ballard, Rachel M; Bruinooge, Suanna S; Courneya, Kerry S; Daniels, Elvan C; Demark-Wahnefried, Wendy; Frank, Elizabeth S; Goodwin, Pamela J; Irwin, Melinda L; Levit, Laura A; McCaskill-Stevens, Worta; Minasian, Lori M; O'Rourke, Mark A; Pierce, John P; Stein, Kevin D; Thomson, Cynthia A; Hudis, Clifford A

    2015-11-20

    Observational evidence has established a relationship between obesity and cancer risk and outcomes. Interventional studies have demonstrated the feasibility and benefits of lifestyle change after cancer diagnosis, and guidelines recommend weight management and regular physical activity in cancer survivors; however, lifestyle interventions are not a routine part of cancer care. The ASCO Research Summit on Advancing Obesity Clinical Trials in Cancer Survivors sought to identify the knowledge gaps that clinical trials addressing energy balance factors in cancer survivors have not answered and to develop a roadmap for the design and implementation of studies with the potential to generate data that could lead to the evidence-based incorporation of weight management and physical activity programs into standard oncology practice. Recommendations highlight the need for large-scale trials evaluating the impact of energy balance interventions on cancer outcomes, as well as the concurrent conduct of studies focused on dissemination and implementation of interventions in diverse populations of cancer survivors, including answering critical questions about the degree of benefit in key subgroups of survivors. Other considerations include the importance of incorporating economic metrics into energy balance intervention trials, the need to establish intermediate biomarkers, and the importance of integrating traditional and nontraditional funding sources. Establishing lifestyle change after cancer diagnosis as a routine part of cancer care will require a multipronged effort to overcome barriers related to study development, funding, and stakeholder engagement. Given the prevalence of obesity and inactivity in cancer survivors in the United States and elsewhere, energy balance interventions hold the potential to reduce cancer morbidity and mortality in millions of patients, and it is essential that we move forward in determining their role in cancer care with the same care and

  7. Factors Influencing Amount of Weekly Exercise Time in Colorectal Cancer Survivors.

    Science.gov (United States)

    Chou, Yun-Jen; Lai, Yeur-Hur; Lin, Been-Ren; Liang, Jin-Tung; Shun, Shiow-Ching

    Performing regular exercise of at least 150 minutes weekly has benefits for colorectal cancer survivors. However, barriers inhibit these survivors from performing regular exercise. The aim of this study was to explore exercise behaviors and significant factors influencing weekly exercise time of more than 150 minutes in colorectal cancer survivors. A cross-sectional study design was used to recruit participants in Taiwan. Guided by the ecological model of health behavior, exercise barriers were assessed including intrapersonal, interpersonal, and environment-related barriers. A multiple logistic regression was used to explore the factors associated with the amount of weekly exercise. Among 321 survivors, 57.0% of them had weekly exercise times of more than 150 minutes. The results identified multiple levels of significant factors related to weekly exercise times including intrapersonal factors (occupational status, functional status, pain, interest in exercise, and beliefs about the importance of exercise) and exercise barriers related to environmental factors (lack of time and bad weather). No interpersonal factors were found to be significant. Colorectal cancer survivors experienced low levels of physical and psychological distress. Multiple levels of significant factors related to exercise time including intrapersonal factors as well as exercise barriers related to environmental factors should be considered. Healthcare providers should discuss with their patients how to perform exercise programs; the discussion should address multiple levels of the ecological model such as any pain problems, functional status, employment status, and time limitations, as well as community environment.

  8. Healthcare Needs, Experiences and Satisfaction after Terrorism: A Longitudinal Study of Survivors from the Utøya Attack.

    Science.gov (United States)

    Stene, Lise E; Wentzel-Larsen, Tore; Dyb, Grete

    2016-01-01

    Background: Public health outreach programs have been developed in order to ensure that needs are met after disasters. However, little is known about survivors' experiences with post-terror healthcare. In the present study, our objectives were to (1) describe survivors' experiences with post-terror healthcare, (2) identify factors associated with reports of unmet healthcare needs, and (3) examine the relationship between socio-demographic characteristics, healthcare experiences and satisfaction. Methods: Our study comprised three waves of semi-structured interviews with 261/490 (53%) survivors of the Utøya mass shooting. We applied Pearson's chi-squared tests (categorical variables) and independent t-tests (continuous variables) to compare survivors by whether or not they reported higher perceived needs than received help for psychological reactions and physical health problems, respectively. Ordinal regression analyses were applied to examine whether socio-demographic characteristics and healthcare experiences were associated with dissatisfaction. Results: Altogether 127 (49%) survivors reported very high/high help needs for psychological reactions, and 43 (17%) for attack-related physical health problems. Unmet healthcare needs were associated with higher levels of posttraumatic stress, psychological distress, somatic symptoms and less social support. Survivors with immigrant backgrounds and injured survivors who were not admitted to hospital reported unmet needs for physical health problems more often. After adjustments for socio-demographic characteristics, immigrant origin was associated with dissatisfaction with post-terror healthcare. After additionally adjusting for healthcare experiences, poor rating of the overall organization and accessibility of healthcare remained significantly associated with dissatisfaction. Conclusions: Most survivors were satisfied with the post-terror healthcare they received, yet our findings indicate that increased attention to

  9. Socioeconomic benefits

    African Journals Online (AJOL)

    User

    Coffea Arabica is extensively cultivated by households under a variety of shade trees in southwestern Ethiopia. The main purpose of this study was to assess the overall farmers' perception on the benefits of shade trees in coffee production systems in southwestern part of Ethiopia. Semistructured questionnaires were ...

  10. Marriage and divorce among childhood cancer survivors.

    Science.gov (United States)

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

    2011-10-01

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

  11. 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

  12. 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.

  13. 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.

  14. Exercise program design considerations for head and neck cancer survivors.

    Science.gov (United States)

    Midgley, Adrian W; Lowe, Derek; Levy, Andrew R; Mepani, Vishal; Rogers, Simon N

    2017-10-20

    The present study aimed to establish exercise preferences, barriers, and perceived benefits among head and neck cancer survivors, as well as their level of interest in participating in an exercise program. Patients treated for primary squamous cell carcinoma of the head and neck between 2010 and 2014 were identified from the hospital database and sent a postal questionnaire pack to establish exercise preferences, barriers, perceived benefits, current physical activity levels, and quality of life. A postal reminder was sent to non-responders 4 weeks later. The survey comprised 1021 eligible patients of which 437 (43%) responded [74% male, median (interquartile range) age, 66 (60-73) years]. Of the respondents, 30% said 'Yes' they would be interested in participating in an exercise program and 34% said 'Maybe'. The most common exercise preferences were a frequency of three times per week, moderate-intensity, and 15-29 min per bout. The most popular exercise types were walking (68%), flexibility exercises (35%), water activites/swimming (33%), cycling (31%), and weight machines (19%). Home (55%), outdoors (46%) and health club/gym (33%) were the most common preferred choices for where to regularly exercise. Percieved exercise benefits relating to improved physical attributes were commonly cited, whereas potential social and work-related benefits were less well-acknowledged. The most commonly cited exercise barriers were dry mouth or throat (40%), fatigue (37%), shortness of breath (30%), muscle weakness (28%) difficulty swallowing (25%), and shoulder weakness and pain (24%). The present findings inform the design of exercise programs for head and neck cancer survivors.

  15. 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.

  16. 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.

  17. 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...

  18. Do Holocaust survivors show increased vulnerability or resilience to post-Holocaust cumulative adversity?

    Science.gov (United States)

    Shrira, Amit; Palgi, Yuval; Ben-Ezra, Menachem; Shmotkin, Dov

    2010-06-01

    Prior trauma can hinder coping with additional adversity or inoculate against the effect of recurrent adversity. The present study further addressed this issue by examining whether a subsample of Holocaust survivors and comparison groups, drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe, were differentially affected by post-Holocaust cumulative adversity. Post-Holocaust cumulative adversity had a stronger effect on the lifetime depression of Holocaust survivors than on that of comparisons. However, comparisons were more negatively affected by post-Holocaust cumulative adversity when examining markers of physical and cognitive functioning. Our findings suggest that previous trauma can both sensitize and immunize, as Holocaust survivors show general resilience intertwined with specific vulnerability when confronted with additional cumulative adversity.

  19. The experience and insight of survivors who have engaged in a restorative justice meeting with their assailant

    Directory of Open Access Journals (Sweden)

    Wager Nadia

    2013-01-01

    Full Text Available This review study explores the experiences of survivors of sexual violence who engaged in a restorative justice (RJ meeting with their assailant to ascertain whether the process contributes to, or further compounds, their recovery. This paper forms a small part of a more extensive scoping review employing Arksey and O’Malley’s (2002 framework. The search was confined to articles/reports published in English. Initially, 58 sources were identified as suitable for inclusion and each of these sources were then scrutinised to identify accounts of survivors of sexual violence who have taken part in RJ initiatives that have involved a face-to-face meeting with the assailant. This revealed 10 applicable cases, from across four different countries. The findings suggest that under certain circumstances survivors of sexual violence might receive significant benefit from participating in RJ. The specific conditions under which the benefits appear to be forthcoming and areas for future research are discussed.

  20. 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)

  1. 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...

  2. 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

  3. Cancer and heart attack survivors' expectations of employment status: results from the English Longitudinal Study of Ageing.

    Science.gov (United States)

    Duijts, Saskia F A; van der Beek, Allard J; Bleiker, Eveline M A; Smith, Lee; Wardle, Jane

    2017-08-07

    to consider. While expectation of being at work did not show any significant influence in cancer survivors, in heart attack survivors, it should not be disregarded though, when developing interventions to affect their employment status. Future research should focus on more specific measures for expectation, and additional behavioural factors, such as self-efficacy, and their effect on employment status.

  4. Psychological Distress among Ebola Survivors Discharged from an Ebola Treatment Unit in Monrovia, Liberia - A Qualitative Study.

    Science.gov (United States)

    Rabelo, Ionara; Lee, Virginia; Fallah, Mosoka P; Massaquoi, Moses; Evlampidou, Iro; Crestani, Rosa; Decroo, Tom; Van den Bergh, Rafael; Severy, Nathalie

    2016-01-01

    A consequence of the West Africa Ebola outbreak 2014-2015 was the unprecedented number of Ebola survivors discharged from the Ebola Treatment Units (ETUs). Liberia alone counted over 5,000 survivors. We undertook a qualitative study in Monrovia to better understand the mental distress experienced by survivors during hospitalization and reintegration into their community. Purposively selected Ebola survivors from ELWA3, the largest ETU in Liberia, were invited to join focus group discussions. Verbal-informed consent was sought. Three focus groups with a total of 17 participants were conducted between February and April 2015. Thematic analysis approach was applied to analyze the data. The main stressors inside the ETU were the daily exposure to corpses, which often remained several hours among the living; the patients' isolation from their families and worries about their well-being; and sometimes, the perception of disrespect by ETU staff. However, most survivors reported how staff motivated patients to drink, eat, bathe, and walk. Additionally, employing survivors as staff fostered hope, calling patients by their name increased confidence and familiarity, and organizing prayer and singing activities brought comfort. When Ebola virus disease survivors returned home, the experience of being alive was both a gift and a burden. Flashbacks were common among survivors. Perceived as contagious, many were excluded from their family, professional, and social life. Some survivors faced divorce, were driven out of their houses, or lost their jobs. The subsequent isolation prevented survivors from picking up daily life, and the multiple losses affected their coping mechanisms. However, when available, the support of family, friends, and prayer enabled survivors to cope with their mental distress. For those excluded from society, psychosocial counseling and the survivor's network were ways to give a meaning to life post-Ebola. Exposure to death in the ETU and stigma in the

  5. 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 ...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. Anxiety and depression among out-of-hospital cardiac arrest survivors.

    Science.gov (United States)

    Lilja, G; Nilsson, G; Nielsen, N; Friberg, H; Hassager, C; Koopmans, M; Kuiper, M; Martini, A; Mellinghoff, J; Pelosi, P; Wanscher, M; Wise, M P; Östman, I; Cronberg, T

    2015-12-01

    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. OHCA-survivors randomized to targeted temperature of 33 °C or 36 °C within the Target Temperature Management trial (TTM-trial) attended a follow-up after 6 months that included the questionnaire Hospital Anxiety and Depression Scale (HADS). A control group with ST-elevation myocardial infarction (STEMI) completed the same follow-up. Correlations to variables assumed to be associated with anxiety and depression in OHCA-survivors were tested. At follow-up 278 OHCA-survivors and 119 STEMI-controls completed the HADS where 24% of OHCA-survivors (28% in 33 °C group/22% in 36 °C group, p=0.83) and 19% of the STEMI-controls reported symptoms of anxiety (OR 1.32; 95% CI (0.78-2.25), p=0.30). Depressive symptoms were reported by 13% of OHCA-survivors (equal in both intervention groups, p=0.96) and 8% of STEMI-controls (OR 1.76; 95% CI (0.82-3.79), p=0.15). Anxiety and depression among OHCA-survivors correlated to Health-Related Quality-of-Life, and subjectively reported cognitive deterioration by patient or observer. In addition, depression was associated with a poor neurological outcome. One fourth of OHCA-survivors reported symptoms of anxiety and/or depression at 6 months which was similar to STEMI-controls and previous normative data. 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/NCT01946932. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Early outreach to survivors of the shootings in Norway on the 22nd of July 2011

    Directory of Open Access Journals (Sweden)

    Grete Dyb

    2014-07-01

    Full Text Available Background: Under-treatment and unmet needs among survivors have been documented years after terror attacks. Improved early and proactive outreach strategies, including targeted interventions for individuals in need, are required. After the terrorist attacks in Norway on 22 July 2011, a national, proactive outreach strategy was developed and implemented to help those who were directly affected. Objectives: The aims of this study were threefold: (1 to investigate whether the survivors at the island of Utøya had received proactive outreach from the municipalities, (2 to examine the relationships between received health services and the survivors’ level of exposure and post-trauma health problems, and (3 to explore the level of unmet needs among survivors 5 months post-terror. Methods: Three hundred and twenty five survivors (M age=19.4, SD=4.6, 47.1% females, response rate 66% of the 2011 massacre on Utøya Island, Norway, were interviewed face-to-face 4–5 months post-terror. The survivors were asked if they had received proactive outreach from their municipality, and what type of health services they had received. Survivors’ level of peri-trauma exposure, loss and injury, posttraumatic stress reactions, symptoms of anxiety and depression, somatic health problems, and sick leave, were assessed. Results: Most participants (87% reported that they had received early and proactive outreach, and most (84% had a contact person. In addition a majority of the survivors has received support from their general practitioner (63%, or other municipal help services (66%. Specialized mental health services by psychiatrists or psychologists had been provided to 73.1% of the survivors. Survivors who had been referred to specialized mental health services reported higher levels of exposure to trauma, posttraumatic stress reactions, depression and anxiety, and somatic health problems, compared to non-receivers of such services. Forty-three survivors (14

  12. Clinical evaluation of unselected cardiac arrest survivors in a tertiary center over a 1-year period (the LAZARUZ study)

    DEFF Research Database (Denmark)

    Marstrand, Peter; Corell, Pernille; Henriksen, Finn Lund

    2016-01-01

    and supplemental electrocardiograms were evaluated for additional diagnostic information. RESULTS: 43 cardiac arrest survivors were included, 34 (79%) were male and the average age was 48years (range 23-64, SD 13.0). The most common etiologies identified in cardiac arrest survivors were ischemic heart disease (33...... of the electrocardiogram. We suggest that these ECG derived clues be investigated in future studies including genetic test results and data from relatives....

  13. Older Adult Stroke Survivors Discussing Post-stroke Depressive Symptoms with a Healthcare Provider: A Preliminary Analysis

    Science.gov (United States)

    Klinedinst, N. Jennifer; Clark, Patricia C.; Dunbar, Sandra B.

    2014-01-01

    Purpose The purposes of this study were to examine the relationship between the post-stroke depressive symptoms, older adult stroke survivors’ perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the healthcare provider with whether or not older stroke survivors discussed their depressive symptoms with a healthcare provider. Method A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the healthcare provider via one time interview. Results Thirty-seven percent (n=16) of all older stroke survivors reported depressive symptoms to their healthcare provider. Of the stroke survivors who had high levels of depressive symptoms (CESD≥16; n=11), seven reported the depressive symptoms to their healthcare provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. Conclusions High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a healthcare provider. PMID:23855380

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. Survey of survivors' perspective on return to work after stroke.

    Science.gov (United States)

    Hartke, Robert J; Trierweiler, Robert

    2015-10-01

    To describe the development and results of a detailed survey on return to work (RTW) after stroke completed by survivors at various stages of recovery. This study used a multi-method qualitative and quantitative research strategy to design and implement a 39-item survey for stroke survivors. Individual interviews, focus groups, and working committees were used to conceptualize the issues and translate them into a survey format. Surveys were distributed in regular and electronic mail. Groups of rehabilitation professionals, employers, and stroke survivors were assembled to review findings and obtain feedback to aide in interpretation. Overall 715 surveys were completed. The respondents were on average 54 years of age, mostly white, well-educated, urban dwelling, and in skilled occupations. Results are described in seven areas: financial, stroke impairments, organizational, work and psychological issues, interpersonal support, and therapy. Several salient findings are described including the role of fatigue, under utilization of vocational rehabilitation (VR) services, and motivational factors related to finances, self-esteem, work, and workplace relationships. Although earning an income is a strong motivation to RTW, salary decreases in importance when compared with other psychological benefits. Fatigue was rated as the second highest impairment barrier to RTW and persisted as a relevant impediment over time. Attitudes of co-workers and flexibility in work schedule were viewed as most helpful to the RTW process, whereas work stress was viewed as the greatest impediment to return. Only 24% of the sample received VR counseling with more respondents receiving counseling if they returned 6 months or longer after their stroke. Other trends and clinical and research implications are discussed.

  19. Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender.

    Science.gov (United States)

    Israelsson, Johan; Bremer, Anders; Herlitz, Johan; Axelsson, Åsa B; Cronberg, Tobias; Djärv, Therese; Kristofferzon, Marja-Leena; Larsson, Ing-Marie; Lilja, Gisela; Sunnerhagen, Katharina S; Wallin, Ewa; Ågren, Susanna; Åkerman, Eva; Årestedt, Kristofer

    2017-05-01

    To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender. This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS). Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found. Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Are the Psychological Needs of Adolescent Survivors of Pediatric Cancer Adequately Identified and Treated?

    Science.gov (United States)

    Kahalley, Lisa S.; Wilson, Stephanie J.; Tyc, Vida L.; Conklin, Heather M.; Hudson, Melissa M.; Wu, Shengjie; Xiong, Xiaoping; Stancel, Heather H.; Hinds, Pamela S.

    2012-01-01

    Objectives To describe the psychological needs of adolescent survivors of acute lymphoblastic leukemia (ALL) or brain tumor (BT), we examined: (a) the occurrence of cognitive, behavioral, and emotional concerns identified during a comprehensive psychological evaluation, and (b) the frequency of referrals for psychological follow-up services to address identified concerns. Methods Psychological concerns were identified on measures according to predetermined criteria for 100 adolescent survivors. Referrals for psychological follow-up services were made for concerns previously unidentified in formal assessment or not adequately addressed by current services. Results Most survivors (82%) exhibited at least one concern across domains: behavioral (76%), cognitive (47%), and emotional (19%). Behavioral concerns emerged most often on scales associated with executive dysfunction, inattention, learning, and peer difficulties. CRT was associated with cognitive concerns, χ2(1,N=100)=5.63, psurvivors, t(47)=3.28, psurvivors, t(48)=2.93, psurvivors with concerns, 38% were referred for psychological follow-up services. Lower-income ALL survivors received more referrals for follow-up, χ2(1,N=41)=8.05, psurvivors had more concerns across domains than non-referred survivors, ALL: t(39)=2.96, psurvivors may be at risk for experiencing unaddressed cognitive needs. Conclusions Many adolescent survivors of cancer experience psychological difficulties that are not adequately managed by current services, underscoring the need for long-term surveillance. In addition to prescribing regular psychological evaluations, clinicians should closely monitor whether current support services appropriately meet survivors’ needs, particularly for lower-income survivors and those treated with CRT. PMID:22278930

  1. Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance).

    Science.gov (United States)

    Bluethmann, Shirley M; Alfano, Catherine M; Clapp, Jonathan D; Luta, George; Small, Brent J; Hurria, Arti; Cohen, Harvey J; Sugarman, Steven; B Muss, Hyman; Isaacs, Claudine; Mandelblatt, Jeanne S

    2017-10-01

    To investigate the effects of cognitive function on discontinuation of hormonal therapy in breast cancer survivors ages 65+ ("older"). Older breast cancer survivors with invasive, non-metastatic disease, and no reported cognitive difficulties were recruited from 78 Alliance sites between 2004 and 2011. Eligible survivors (n = 1280) completed baseline interviews; follow-up was conducted annually for up to 7 years. Survivors with estrogen-receptor-positive (ER+) cancers who initiated hormonal therapy (n = 990) were included. Self-reported cognitive function was measured using the EORTC-QLQ30 scale; a difference of eight points on the 0-100 scale was considered clinically significant. Based on varying rates of discontinuation over time, discontinuation was evaluated separately for three time periods: early (3-5 years). Cox models for each time period were used to evaluate the effects of cognition immediately preceding discontinuation, controlling for age, chemotherapy, and other covariates. Survivors were 65-91 years old (mean 72.6 years), and 79% had stages 1 or 2A disease. Overall, 43% discontinued hormonal therapy before 5 years. Survivors who reported lower cognitive function in the period before discontinuation had greater hazards of discontinuing therapy at the treatment midpoint (HR 1.22 per 8-point difference, CI 1.09-1.40, p cognition was not related to discontinuation in the other periods. Self-reported cognitive problems were a significant risk factor for discontinuation of hormonal therapy 1-3 years post-initiation. Additional research is needed on the temporality of cognitive effects and hormonal therapy to support survivorship care needs of older survivors.

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

    Science.gov (United States)

    Zhang, Fang Fang; Meagher, Susan; Scheurer, Michael; Folta, Sara; Finnan, Emily; Criss, Kerry; Economos, Christina; Dreyer, ZoAnn; Kelly, Michael

    2016-11-18

    Due to advances in the field of oncology, survival rates for children with cancer have improved significantly. However, these childhood cancer survivors are at a higher risk for obesity and cardiovascular diseases and for developing these conditions at an earlier age. In this paper, we describe the rationale, conceptual framework, development process, novel components, and delivery plan of a behavioral intervention program for preventing unhealthy weight gain in survivors of childhood acute lymphoblastic leukemia (ALL). A Web-based program, the Healthy Eating and Active Living (HEAL) program, was designed by a multidisciplinary team of researchers who first identified behaviors that are appropriate targets for weight management in childhood ALL survivors and subsequently developed the intervention components, following core behavioral change strategies grounded in social cognitive and self-determination theories. The Web-based HEAL curriculum has 12 weekly self-guided sessions to increase parents' awareness of the potential impact of cancer treatment on weight and lifestyle habits and the importance of weight management in survivors' long-term health. It empowers parents with knowledge and skills on parenting, nutrition, and physical activity to help them facilitate healthy eating and active living soon after the child completes intensive cancer treatment. Based on social cognitive theory, the program is designed to increase behavioral skills (goal-setting, self-monitoring, and problem-solving) and self-efficacy and to provide positive reinforcement to sustain behavioral change. Lifestyle interventions are a priority for preventing the early onset of obesity and cardiovascular risk factors in childhood cancer survivors. Intervention programs need to meet survivors' targeted behavioral needs, address specific barriers, and capture a sensitive window for behavioral change. In addition, they should be convenient, cost-effective and scalable. Future studies are needed

  3. SUBSEQUENT NEOPLASMS OF THE CENTRAL NERVOUS SYSTEM AMONG SURVIVORS OF CHILDHOOD CANCER: A SYSTEMATIC REVIEW

    Science.gov (United States)

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

    2015-01-01

    Childhood cancer survivors are at risk for development of subsequent neoplasms of the central nervous system (CNS). Better understanding of the rates, risk factors for and outcomes of subsequent neoplasms of the CNS among survivors of childhood cancer may lead to the development of more informed screening guidelines. Two independent investigators independently performed a systematic search of studies from the MEDLINE and EMBASE databases (1966 – 2012) for studies examining subsequent neoplasms of the CNS among childhood cancer survivors. Articles were selected to answer 3 questions: What is the risk of CNS tumors following radiation to the cranium for a pediatric cancer as compared with the general population? What are the outcomes in children with subsequent neoplasms of the CNS who have been treated with CNS directed radiation for a pediatric cancer? Are outcomes of subsequent neoplasms different from primary neoplasms of the same histology? Our search identified 72 reports, of which 18 publications were included in this review. These studies reported that childhood cancer survivors have an 8.1 – 52.3 times higher incidence of subsequent CNS neoplasms compared with the general population. Nearly all cancer survivors who developed a CNS neoplasm had been exposed to cranial radiation; some studies demonstrate a correlation between radiation dose and risk of subsequent CNS tumors. Five year survival rates for subsequent high-grade gliomas and meningiomas range from 0 – 19.5% and 73 – 100%, respectively, which are similar to those observed in patients with primary gliomas or meningiomas. The quality of evidence was limited by variation in study design, heterogeneity of details regarding treatment and outcomes, limited follow-up and relatively small sample sizes. We concluded that survivors of childhood cancer who were treated with cranial radiation therapy have an elevated risk for subsequent CNS neoplasms. The current literature is insufficient to comment

  4. Somatic and GermlineTP53Alterations in Second Malignant Neoplasms from Pediatric Cancer Survivors.

    Science.gov (United States)

    Sherborne, Amy L; Lavergne, Vincent; Yu, Katharine; Lee, Leah; Davidson, Philip R; Mazor, Tali; Smirnoff, Ivan V; Horvai, Andrew E; Loh, Mignon; DuBois, Steven G; Goldsby, Robert E; Neglia, Joseph P; Hammond, Sue; Robison, Leslie L; Wustrack, Rosanna; Costello, Joseph F; Nakamura, Alice O; Shannon, Kevin M; Bhatia, Smita; Nakamura, Jean L

    2017-04-01

    Purpose: Second malignant neoplasms (SMNs) are severe late complications that occur in pediatric cancer survivors exposed to radiotherapy and other genotoxic treatments. To characterize the mutational landscape of treatment-induced sarcomas and to identify candidate SMN-predisposing variants, we analyzed germline and SMN samples from pediatric cancer survivors. Experimental Design: We performed whole-exome sequencing (WES) and RNA sequencing on radiation-induced sarcomas arising from two pediatric cancer survivors. To assess the frequency of germline TP53 variants in SMNs, Sanger sequencing was performed to analyze germline TP53 in 37 pediatric cancer survivors from the Childhood Cancer Survivor Study (CCSS) without any history of a familial cancer predisposition syndrome but known to have developed SMNs. Results: WES revealed TP53 mutations involving p53's DNA-binding domain in both index cases, one of which was also present in the germline. The germline and somatic TP53- mutant variants were enriched in the transcriptomes for both sarcomas. Analysis of TP53- coding exons in germline specimens from the CCSS survivor cohort identified a G215C variant encoding an R72P amino acid substitution in 6 patients and a synonymous SNP A639G in 4 others, resulting in 10 of 37 evaluable patients (27%) harboring a germline TP53 variant. Conclusions: Currently, germline TP53 is not routinely assessed in patients with pediatric cancer. These data support the concept that identifying germline TP53 variants at the time a primary cancer is diagnosed may identify patients at high risk for SMN development, who could benefit from modified therapeutic strategies and/or intensive posttreatment monitoring. Clin Cancer Res; 23(7); 1852-61. ©2016 AACR . ©2016 American Association for Cancer Research.

  5. Gender differences in associations between cancer-related problems and relationship dissolution among cancer survivors.

    Science.gov (United States)

    Stephens, Cristina; Westmaas, J Lee; Kim, Jihye; Cannady, Rachel; Stein, Kevin

    2016-10-01

    Research suggests that a cancer diagnosis predicts marital dissolution more strongly for women survivors than men, but there is a paucity of research on potential processes underlying this vulnerability. The present cross-sectional study examined whether specific cancer-related problems were associated with the odds of relationship breakup following diagnosis and whether these relationships differed between male and female cancer survivors. A national cross-sectional quality of life study assessed self-reported cancer-related problems and relationship change among survivors who were either 2, 6, or 10 years post-diagnosis (n = 6099). Bivariate analyses indicated that cancer-related problems (e.g., emotional distress) were greater for divorced/separated survivors compared to those with intact relationships and were greater for women versus men. Logistic regressions indicated that for both male and female survivors, lower income, younger age, and longer time since diagnosis were associated with greater odds of divorce or separation after diagnosis (ORs > 2.14, p emotional distress (OR = 1.14, p separation. For men only, fear of cancer recurrence was associated with greater odds of divorce or separation (OR = 1.32, p emotional or financial/employment problems attributed to the cancer diagnosis were associated with the likelihood of reporting relationship dissolution. Although directions of causality could not be ascertained, results suggest the possibility that helping male and female cancer survivors cope with specific cancer-related problems may benefit the quality and stability of their relationships with significant others following diagnosis.

  6. Barriers and facilitators to work reintegration and burn survivors' perspectives on educating work colleagues.

    Science.gov (United States)

    Nguyen, Ngoc Tram; Lorrain, Mélyssa; Pognon-Hanna, Joe Nayima; Elfassy, Caroline; Calva, Valerie; de Oliveira, Ana; Nedelec, Bernadette

    2016-11-01

    Work reintegration constitutes a major milestone in the rehabilitation process of adults who have sustained a burn. Research studies with other conditions demonstrated that open, explicit communication about the worker's condition and potential limitations may facilitate this transition. However, the best approach to enable this discussion to occur has yet to be described. The aim of this exploratory qualitative study was to investigate burn survivors' and clinicians' perspectives of the barriers and facilitators to work reintegration that could be addressed through education of work colleagues, which information to communicate to the workplace and the most effective method to disseminate this knowledge. Five semi-structured focus groups were conducted with three groups of informants including: (1) 13 burn survivors who had already returned to work; (2) 7 who were planning on returning; and (3) 9 burn care professionals. Qualitative data were inductively analyzed employing constant comparative techniques. Key barriers and facilitators that were identified included residual impairments, individual characteristics, support from the social environment, work accommodations and resources from the healthcare and compensation systems. Burn survivors agreed that return to work efforts were not adequately supported and that education should be provided to work colleagues about the burn and rehabilitation process, but that information on residual impairments should be communicated judiciously as it may be used prejudiciously against those seeking new employment. In the latter case, it is preferable to inform the workplace of their strengths and abilities. Extensive literature demonstrating the benefits of educational programs for the peers and teachers of pediatric burn survivors when they return to school already exists. This study provides evidence that there is a need for a similar process for adult burn survivors returning to work. The educational material must be

  7. Changes in motivational outcomes after a supervised resistance exercise training intervention in lung cancer survivors.

    Science.gov (United States)

    Peddle-McIntyre, Carolyn J; Bell, Gordon; Fenton, David; McCargar, Linda; Courneya, Kerry S

    2013-01-01

    Short-term supervised exercise interventions improve health-related fitness in lung cancer survivors; however, sustained exercise is required to maintain the health benefits. The impact of exercise interventions on motivational outcomes may be important for long-term exercise adoption. The objective of this study was to examine the effects of a 10-week supervised progressive resistance exercise training program on lung cancer survivors' motivational outcomes based on the Theory of Planned Behavior (TPB). Posttreatment lung cancer survivors were recruited to undergo a 10-week supervised resistance exercise training intervention. The 2-component model of the TPB was measured at baseline and after intervention. Fifteen participants completed assessments of TPB measures. Significant increases in self-efficacy (P = .022) and perceived controllability (P = .032) and a nonsignificant increase in affective attitude (P = .090) were observed after intervention. Intention was significantly lower at postintervention (P = .044). Significant correlates of postintervention intention were instrumental attitude (P = .001), self-efficacy (P = .004), perceived behavioral control (P = .009), and affective attitude (P = .044). At postintervention, self-efficacy was significantly correlated with planning (P resistance exercise training may improve some motivational outcomes for lung cancer survivors. Intentions appeared to be weakened after the intervention, but there are methodological explanations for this finding. Participation in short-term supervised resistance exercise may be an effective method to improve some motivational factors related to exercise in lung cancer survivors. More research is needed to examine the long-term effects of supervised resistance exercise on motivational outcomes in lung cancer survivors. Strategies to maintain motivational changes that occur following a supervised resistance exercise intervention need to be investigated.

  8. Disruption of White Matter Integrity in Adult Survivors of Childhood Brain Tumors: Correlates with Long-Term Intellectual Outcomes.

    Science.gov (United States)

    King, Tricia Z; Wang, Liya; Mao, Hui

    2015-01-01

    Although chemotherapy and radiation treatment have contributed to increased survivorship, treatment-induced brain injury has been a concern when examining long-term intellectual outcomes of survivors. Specifically, disruption of brain white matter integrity and its relationship to intellectual outcomes in adult survivors of childhood brain tumors needs to be better understood. Fifty-four participants underwent diffusion tensor imaging in addition to structural MRI and an intelligence test (IQ). Voxel-wise group comparisons of fractional anisotropy calculated from DTI data were performed using Tract Based Spatial Statistics (TBSS) on 27 survivors (14 treated with radiation with and without chemotherapy and 13 treated without radiation treatment on average over 13 years since diagnosis) and 27 healthy comparison participants. Whole brain white matter fractional anisotropy (FA) differences were explored between each group. The relationships between IQ and FA in the regions where statistically lower FA values were found in survivors were examined, as well as the role of cumulative neurological factors. The group of survivors treated with radiation with and without chemotherapy had lower IQ relative to the group of survivors without radiation treatment and the healthy comparison group. TBSS identified white matter regions with significantly different mean fractional anisotropy between the three different groups. A lower level of white matter integrity was found in the radiation with or without chemotherapy treated group compared to the group without radiation treatment and also the healthy control group. The group without radiation treatment had a lower mean FA relative to healthy controls. The white matter disruption of the radiation with or without chemotherapy treated survivors was positively correlated with IQ and cumulative neurological factors. Lower long-term intellectual outcomes of childhood brain tumor survivors are associated with lower white matter integrity

  9. Disruption of White Matter Integrity in Adult Survivors of Childhood Brain Tumors: Correlates with Long-Term Intellectual Outcomes.

    Directory of Open Access Journals (Sweden)

    Tricia Z King

    Full Text Available Although chemotherapy and radiation treatment have contributed to increased survivorship, treatment-induced brain injury has been a concern when examining long-term intellectual outcomes of survivors. Specifically, disruption of brain white matter integrity and its relationship to intellectual outcomes in adult survivors of childhood brain tumors needs to be better understood.Fifty-four participants underwent diffusion tensor imaging in addition to structural MRI and an intelligence test (IQ. Voxel-wise group comparisons of fractional anisotropy calculated from DTI data were performed using Tract Based Spatial Statistics (TBSS on 27 survivors (14 treated with radiation with and without chemotherapy and 13 treated without radiation treatment on average over 13 years since diagnosis and 27 healthy comparison participants. Whole brain white matter fractional anisotropy (FA differences were explored between each group. The relationships between IQ and FA in the regions where statistically lower FA values were found in survivors were examined, as well as the role of cumulative neurological factors.The group of survivors treated with radiation with and without chemotherapy had lower IQ relative to the group of survivors without radiation treatment and the healthy comparison group. TBSS identified white matter regions with significantly different mean fractional anisotropy between the three different groups. A lower level of white matter integrity was found in the radiation with or without chemotherapy treated group compared to the group without radiation treatment and also the healthy control group. The group without radiation treatment had a lower mean FA relative to healthy controls. The white matter disruption of the radiation with or without chemotherapy treated survivors was positively correlated with IQ and cumulative neurological factors.Lower long-term intellectual outcomes of childhood brain tumor survivors are associated with lower white

  10. [Why were they numb again? About the psychological condition of Holocaust survivors and attitudes of society and therapists].

    Science.gov (United States)

    Steier, Shmuel Tommy

    2009-04-01

    During the first year after Israel's declaration of independence, 350,000 Holocaust survivors immigrated to Israel, about 1/3 of the country's population at that time. Their poor public image ("soap", "avac adam"--shadow of a man) and the Zionist--pioneer attitude of rejecting the "diasporal mentality", led to arrogance and disrespect towards the survivors. The attitude of therapists towards the victims has been influenced by the public atmosphere and their problems did not receive the attention they deserved. This fact caused an additional trauma--"secondary victimization", which, in turn, was one of the causes for the "conspiracy of silence". This silence lasted for many years and caused HoLocaust survivors to become more vulnerable at an older age. A review of the complex psychological condition of Holocaust survivors in the community is characterized by a combination of toughness and vulnerability and other aspects such as: the frequency of PTSD among Holocaust survivors and its characteristics as well as therapists' difficulties in coping with the post-traumatic state. The sequence of traumatic events in their Lives caused a feeling of vulnerability in some survivors. Furthermore, insult and fear of exposure, that throughout the years prevented them from demanding their rights, was contrary to the normative behaviour in Israeli society. The interest and the number of studies concerning the Holocaust and Holocaust survivors increases as the number of survivors decreases and as we move further in time from the horrors of that war. To implement a policy of positive discrimination (affirmative action) for survivors in the Israeli health system.

  11. Walking, bicycling, and sports in postmenopausal breast cancer survivors-results from a German patient cohort study

    NARCIS (Netherlands)

    Bock, C.; Schmidt, M.E.; Vrieling, A.; Chang-Claude, J.; Steindorf, K.

    2013-01-01

    OBJECTIVES: Physical activity (PA) is increasingly discussed as a means to achieve both physical and psychological benefits for breast cancer patients and survivors. However, little is known about activity-specific PA behavior following diagnosis. Our objectives were to describe sports and active

  12. A review of nia as an exercise option for cancer survivors.

    Science.gov (United States)

    Reis, Debra; Walsh, M Eileen; Jones, Tisha; Young-McCaughan, Stacey

    2014-12-01

    Nia is a fusion fitness program that blends elements from the dance arts, martial arts, and healing arts, creating a workout that is adaptable to all ages and fitness levels. As a nontraditional form of exercise, Nia integrates body, mind, and spirit as well as the five sensations of flexibility, agility, mobility, strength, and stability. Nia incorporates both cardiovascular and whole-body conditioning and is adaptable to those with a sedentary or active lifestyle, making it useful for the varying abilities of cancer survivors. Oncology nurses are in a key position to educate individuals with cancer on the benefits of exercise, such as improved physical functioning and quality of life, and decreased cancer-related fatigue. The purpose of this article is to familiarize oncology nurses with the potential benefits of Nia for cancer survivors.

  13. Mixed reality rehabilitation for stroke survivors promotes generalized motor improvements.

    Science.gov (United States)

    Duff, Margaret; Chen, Yinpeng; Attygalle, Suneth; Sundaram, Hari; Rikakis, Thanassis

    2010-01-01

    This paper presents results from a clinical study of stroke survivors using an adaptive, mixed-reality rehabilitation (AMRR) system for reach and grasp therapy. The AMRR therapy provides audio and visual feedback on the therapy task, based on detailed motion capture, that places the movement in an abstract, artistic context. This type of environment promotes the generalizability of movement strategies, which is shown through kinematic improvements on an untrained reaching task and higher clinical scale scores, in addition to kinematic improvements in the trained task.

  14. Who benefits?

    DEFF Research Database (Denmark)

    Hjorth, Frederik Georg

    2016-01-01

    Cross-border welfare rights for citizens of European Union member states are intensely contested, yet there is limited research into voter opposition to such rights, sometimes denoted ‘welfare chauvinism’. We highlight an overlooked aspect in scholarly work: the role of stereotypes about...... beneficiaries of cross-border welfare. We present results from an original large-scale survey experiment (N=2525) among Swedish voters, randomizing exposure to cues about recipients' country of origin and family size. Consistent with a model emphasizing the role of stereotypes, respondents react to cues about...... recipient identity. These effects are strongest among respondents high in ethnic prejudice and economic conservatism. The findings imply that stereotypes about who benefits from cross-border welfare rights condition public support for those rights....

  15. 20 CFR 404.1586 - Why and when we will stop your cash benefits.

    Science.gov (United States)

    2010-04-01

    ... entitled to disability cash benefits on the basis of your work activity but your visual impairment is..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Blindness § 404.1586 Why... entitled to disability cash benefits as a statutorily blind person, we will find that you are no longer...

  16. 20 CFR Appendix Vii to Subpart C... - “Old-Law” Contribution and Benefit Base

    Science.gov (United States)

    2010-04-01

    ... Appendix VII to Subpart C of Part 404 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Pt. 404, Subpt. C, App. VII... appendix IV). This is the contribution and benefit base that would have been effective under the Social...

  17. Physical sequelae and depressive symptoms in gynecologic cancer survivors: meaning in life as a mediator.

    Science.gov (United States)

    Simonelli, Laura E; Fowler, Jeffrey; Maxwell, G Larry; Andersen, Barbara L

    2008-06-01

    Continuing symptoms and poor health following cancer treatments may alter meaning in life for cancer survivors. Gynecologic cancer survivors are particularly troubled with physical sequelae. In addition, for the most common sites of disease, such as breast and gynecologic cancers, the prevalence of depression is also high. This study tests meaning in life as a mechanism for the relationship between physical symptoms and depressive symptoms. Gynecologic cancer survivors (N = 260) participated. Measures of physical sequelae (nurse rated symptoms/signs, patient-reported gynecologic symptoms), meaning in life (harmony, life purpose, spirituality, and conversely, confusion and loss), and depressive symptoms were obtained at the time of a routine clinical follow-up visit 2-10 years following the completion of treatment. Latent variables were defined, and structural equation modeling tested a mediator model. Analyses support partial mediation. That is, survivors with more physical sequelae also reported lower levels of meaning in life, which was associated with higher levels of depressive symptoms. Gynecologic cancer patients have been neglected in psychosocial research, and findings highlight the importance of existential issues in their lives. While many adjust well, those with persistent physical functioning deficits may experience depressive symptoms. By appreciating the role of meaning in their experience, we may help survivors foster their own growth and perspectives important for their future.

  18. Optimism, well-being, depressive symptoms, and perceived physical health: a study among Stroke survivors.

    Science.gov (United States)

    Shifren, Kim; Anzaldi, Kristen

    2018-01-01

    The investigation of the relation of positive personality characteristics to mental and physical health among Stroke survivors has been a neglected area of research. The purpose of this study was to examine the relationship between optimism, well-being, depressive symptoms, and perceived physical health among Stroke survivors. It was hypothesized that Stroke survivors' optimism would explain variance in their physical health above and beyond the variance explained by demographic variables, diagnostic variables, and mental health. One hundred seventy-six Stroke survivors (97 females, 79 males) completed the Revised Life Orientation Test, the Center for Epidemiological Studies Depression Scale, two items on perceived physical health from the 36-item Short Form of the Medical Outcomes study, and the Identity scale of the Illness Perception Questionnaire. Pearson correlations, hierarchical regression analyses, and the PROCESS approach to determining mediators were used to assess hypothesized relations between variables. Stroke survivors' level of optimism explained additional variance in overall health in regression models controlling for demographic and diagnostic variables, and mental health. Analyses revealed that optimism played a partial mediator role between mental health (well-being, depressive symptoms and total score on CES-D) variables and overall health.

  19. Obesity in Childhood Cancer Survivors: Call for Early Weight Management123

    Science.gov (United States)

    Zhang, Fang Fang; Parsons, Susan K

    2015-01-01

    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. PMID:26374183

  20. A Review of Risk Factors for Cognitive Impairment in Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Mohd Faizal Mohd Zulkifly

    2016-01-01

    Full Text Available In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors.

  1. Lottery ticket was more effective than a prize draw in increasing questionnaire response among cancer survivors.

    Science.gov (United States)

    Drummond, Frances J; O'Leary, Eamonn; Sharp, Linda

    2015-07-01

    Compare the effect of financial incentives on response to a cancer survivors' postal questionnaire. Prostate cancer survivors in Ireland, 1.5-18 years after diagnosis, were randomized to the (1) "lottery" arm [a € 1 lottery scratch card sent with the questionnaire (n = 2,413)] or (2) "prize" arm [entry into a draw on return of a completed questionnaire (n = 2,407)]. Impact of interventions on response overall and by survival period ("short term": lottery compared with the prize arm [multivariate relative risk (RR) = 1.06; 95% confidence interval (CI): 1.00, 1.11]. When stratified by survival period, higher response in the lottery arm was only observed among long-term survivors (multivariate RR = 1.10; 95% CI: 1.02, 1.19; short-term survivors: RR = 1.01; 95% CI: 0.94, 1.09). Costs per completed questionnaire were € 4.54 and € 3.57 for the lottery and prize arms, respectively. Compared with the prize arm, cost per additional questionnaire returned in the lottery arm was € 25.65. Although more expensive, to optimize response to postal questionnaires among cancer survivors, researchers might consider inclusion of a lottery scratch card. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Updated evidence in support of diet and exercise interventions in cancer survivors.

    Science.gov (United States)

    Pekmezi, Dorothy W; Demark-Wahnefried, Wendy

    2011-02-01

    A growing body of evidence suggests that diet and exercise behaviors and body weight status influence health-related outcomes after a cancer diagnosis. This review synthesizes the recent progress in lifestyle interventions in light of current guidelines put forth by the American Cancer Society (ACS), the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and the American College of Sports Medicine (ACSM). The PubMed database was searched for terms of cancer survivor(s) or neoplasms/survivor, cross-referenced with MeSH terms of lifestyle, health behavior, physical activity, exercise, body weight, obesity, weight loss, diet, nutrition, and intervention studies and limited to randomized controlled trials (RCTs) that had retention rates exceeding 75%. There has been an increase in the number and methodological rigor of the studies in this area, with 21 RCTs identified in the past three years. Results suggest that physical activity interventions are safe for cancer survivors and produce improvements in fitness, strength, physical function, and cancer-related psychosocial variables, whereas dietary interventions improve diet quality, nutrition-related biomarkers and body weight. Preliminary evidence also suggests that diet and exercise may positively influence biomarkers associated with progressive disease and overall survival (e.g., insulin levels, oxidative DNA damage, tumor proliferation rates). The evidence base regarding health-related benefits of increased physical activity, an improved diet, and weight control continues to expand. Due to the large (and increasing) number of cancer survivors, more research is needed that tests the impact of lifestyle change on health-related outcomes in this population, especially research that focuses on high-reach, sustainable interventions that recruit diverse, representative samples to help increase the generalizability of findings to the population at large. Concurrent research also needs to address

  3. Polio survivors perceptions of a multi-disciplinary rehabilitation programme.

    Science.gov (United States)

    Atwal, Anita; Duncan, Helen; Queally, Claire; Cedar, S H

    2017-10-03

    Post-polio syndrome refers to a late complication of the poliovirus infection. Management of post-polio syndrome is complex due to the extensive symptomology. European and United Kingdom guidelines have advised the use of rehabilitation programmes to manage post-polio syndrome. There is a paucity of research in relation to the effectiveness of rehabilitation interventions. The objective of this study is to explore polio survivor's perceptions of an in-patient multi-disciplinary rehabilitation programme. Semi-structured interviews of community dwelling polio survivors who attended in-patient rehabilitation programme in the United Kingdom. Thematic analysis was used to describe and interpret interview data. Participants' experiences were influenced by past experiences of polio and their self-concept. Participants generally had a positive experience and valued being with other polio survivors. Positive strategies, such as pacing and reflection changed their mind-sets into their lives after the programme, though they still faced challenges in daily living. Some participants supported others with post-polio syndrome after completing the programme. Our research identified that participants experienced long term positive benefits from attending a rehabilitation programme. Strategies that users found helpful that explored the effectiveness of interventions to manage polio are not cited within a Cochrane review. If we are to recognise the lived experience and service user empowerment within a model of co- production it is essential that patient preferences are evaluated and used as evidence to justify service provision. Further research is required with polio survivors to explore how best rehabilitation programmes can adopt the principles of co-production. Implications for Rehabilitation The patients' expertise and lived experience must be at the centre of a rehabilitation programme. Strategies such as pacing and reflection are perceived as important strategies to enable

  4. Longitudinal Relationships between Social Support and Posttraumatic Growth among Adolescent Survivors of the Wenchuan Earthquake

    Directory of Open Access Journals (Sweden)

    Xuji Jia

    2017-07-01

    Full Text Available This study aimed to explore the longitudinal relationships between social support and posttraumatic growth (PTG among adolescent survivors of the Wenchuan earthquake. Follow-up assessments were conducted with 452 participants at 12, 18, and 24 months after the earthquake. The results showed that the level of social support at 12 and 18 months following the earthquake predicted subsequent PTG, but not vice versa. In addition, multi-group analyses of gender showed no gender differences between social support and PTG in the cross-lagged model. Thus, psychological interventions and care for survivors should focus on improving adolescent perceptions of social support when responding to stressful experiences.

  5. Thai nurses' perspectives on the use of complementary and alternative medicine among Thai breast cancer survivors in northern Thailand.

    Science.gov (United States)

    Wanchai, Ausanee; Armer, Jane M; Stewart, Bob R

    2015-04-01

    Breast cancer survivors are more likely to seek complementary and alternative medicine (CAM) for their health and well-being than other cancer patients. The purpose of the study was to describe how Thai nurses perceive the use of CAM in Thai breast cancer survivors. An ethno-nursing research method was used. Fifteen Thai nurses who had experience in taking care of Thai breast cancer survivors who used CAM from a tertiary care referral and resource centre in the lower northern part of Thailand were interviewed. Two major themes emerged from this study: Meaning of care practices in CAM was seen as: (i) an additional beneficial choice for health; and (ii) emotional and psychological healing. Nurses should be concerned about CAM use in Thai breast cancer survivors. Open communication about CAM helps ensure that safe and holistic care is provided. Further research to enhance integration of CAM into health care is needed. © 2013 Wiley Publishing Asia Pty Ltd.

  6. 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.

  7. Effect of Population Socioeconomic and Health System Factors on Medical Care of Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Caplin, Deirdre A; Smith, Ken R; Ness, Kirsten K; Hanson, Heidi A; Smith, Stephanie M; Nathan, Paul C; Hudson, Melissa M; Leisenring, Wendy M; Robison, Leslie L; Oeffinger, Kevin C

    2017-03-01

    To determine the independent contribution of population socioeconomic and health system factors on childhood cancer survivors' medical care and screening. 7899 childhood cancer survivors in the United States and Canada enrolled in the Childhood Cancer Survivor Study (CCSS). Population-level factors were derived from U.S. Area Health Resource File or 201 Canadian Census. Health service utilization and individual-level factors were self-reported. Multivariable logistic regression was used to calculate the effect of population factors on medical care (any care vs. no care; risk-based care vs. general care) and indicated echocardiogram or mammogram, adjusting for individual sociodemographic and health status. After adjusting for individual factors, population factors had a nominal impact on childhood cancer survivors' medical care and screening. Higher population median income was associated with risk-based survivor-focused care versus general care (odds ratio [OR] 1.05, 95% confidence interval [CI], 1.01-1.09) among all participants, but not among U.S. residents only (OR 1.03, 95% CI, 0.99-1.07). For U.S. residents, the number of CCSS centers within the geographic area was associated with greater odds of receiving risk-based survivor-focused medical care (OR 1.12, 95% CI, 1.04-1.20). Areas with higher median income had higher rates of echocardiogram screening among survivors at risk of cardiomyopathy (for every $10,000 increase in median income, there is a 12% increase in odds of echocardiogram screening; 95% CI 1.05-1.20). A positive relationship was identified between greater number of physicians and surgeons in the county of residence and recommended echocardiogram (for every additional 1000 physicians and surgeons: OR 1.12, 95% CI, 1.01-1.23). We found no association between population-level factors and mammography screening. Population socioeconomic disparities moderately affect childhood cancer survivors' risk-based medical care and screening after accounting

  8. Relational Outcomes of Childhood Sexual Trauma in Female Survivors: A Longitudinal Study

    Science.gov (United States)

    Liang, Belle; Williams, Linda M.; Siegel, Jane A.

    2006-01-01

    This longitudinal study examines the effects of childhood sexual abuse (CSA) on the intimate and marital relationships of adult survivors from a sample composed primarily of African American women. In addition, the authors explore the protective role of maternal support. Interview data are collected on 136 women with documented histories of CSA…

  9. Keeping Survivors Alive: Security and Humanitarian Aid Operations During Natural-Disaster Response in Conflicts

    Science.gov (United States)

    2017-03-01

    INTENTIONALLY LEFT BLANK vii TABLE OF CONTENTS I. INTRODUCTION ... INTRODUCTION In the aftermath of a natural disaster, populations are displaced and additional burdens are placed on affected governments to aid the survivors...reducing the spread of HIV/AIDS, malaria , and tuberculosis. The RCRC Societies’ relationships with their respective governments vary from

  10. Multiple Losses: The Psychological and Economic Well-Being of Survivors of Intimate Partner Violence.

    Science.gov (United States)

    Sauber, Elizabeth W; O'Brien, Karen M

    2017-05-01

    This study advanced knowledge regarding the mechanisms through which intimate partner violence relates to psychological and financial distress with a sample of diverse low-income women. Data were collected from 147 female domestic violence survivors who were abused by a male partner within the past 6 months. Three hierarchical regression analyses revealed that psychological, physical, and economic abuse were predictive of posttraumatic stress, depression, and economic self-sufficiency among survivors. Guided by the Conservation of Resources Theory, the loss of financial, work, and interpersonal resources also predicted these three outcomes, above and beyond abuse experiences (i.e., economically controlling behaviors, economic sabotage, and interpersonal resource loss were unique predictors). In addition, bootstrap mediation analyses showed that interpersonal resource loss partially mediated the relationship between psychological abuse and mental health outcomes. Together, these findings can be used to inform future interventions to promote the financial and psychological well-being of survivors.

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

    Science.gov (United States)

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

    2014-05-01

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

  12. Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

    DEFF Research Database (Denmark)

    van Eggermond, Anna M; Schaapveld, Michael; Janus, Cécile Pm

    2017-01-01

    BACKGROUND: Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. METHODS...... a hazard ratio of 6.8 (95%CI: 3.0-15.6) compared with patients receiving neither treatment, which is significantly higher than an additive joint effect (Padditivity=0.004). CONCLUSIONS: Colorectal cancer surveillance should be considered for HL survivors who received Infradiaphragmatic radiotherapy......: In a Dutch cohort of 3121 5-year HL survivors treated between 1965 and 1995, subsite-specific CRC incidence was compared with general population rates. Treatment effects were quantified by Cox regression analyses. RESULTS: After a median follow-up of 22.9 years, 55 patients developed CRC. The standardized...

  13. Does self monitoring of blood glucose as opposed to urinalysis provide additional benefit in patients newly diagnosed with type 2 diabetes receiving structured education? The DESMOND SMBG randomised controlled trial protocol

    Science.gov (United States)

    2012-01-01

    Background The benefit of self-monitoring of blood glucose (SMBG) in people with type 2 diabetes on diet or oral agents other than sulphonylureas remains uncertain. Trials of interventions incorporating education about self-monitoring of blood glucose have reported mixed results. A recent systematic review concluded that SMBG was not cost-effective. However, what was unclear was whether a cheaper method of self-monitoring (such as urine glucose monitoring) could produce comparable benefit and patient acceptability for less cost. Methods/Design The DESMOND SMBG trial is comparing two monitoring strategies (blood glucose monitoring and urine testing) over 18 months when incorporated into a comprehensive self-management structured education programme. It is a multi-site cluster randomised controlled trial, conducted across 8 sites (7 primary care trusts) in England, UK involving individuals with newly diagnosed Type 2 diabetes. The trial has 80% power to demonstrate equivalence in mean HbA1c (the primary end-point) at 18 months of within ± 0.5% assuming 20% drop out and 20% non-consent. Secondary end-points include blood pressure, lipids, body weight and psychosocial measures as well as a qualitative sub-study. Practices were randomised to one of two arms: participants attend a DESMOND programme incorporating a module on self-monitoring of either urine or blood glucose. The programme is delivered by accredited educators who received specific training about equipoise. Biomedical data are collected and psychosocial scales completed at baseline, and 6, 12, and 18 months post programme. Qualitative research with participants and educators will explore views and experiences of the trial and preferences for methods of monitoring. Discussion The DESMOND SMBG trial is designed to provide evidence to inform the debate about the value of self-monitoring of blood glucose in people with newly diagnosed type 2 diabetes. Strengths include a setting in primary care, a cluster

  14. The association between physical activity and health-related quality of life among breast cancer survivors.

    Science.gov (United States)

    Shin, Woo-Kyoung; Song, Sihan; Jung, So-Youn; Lee, Eunsook; Kim, Zisun; Moon, Hyeong-Gon; Noh, Dong-Young; Lee, Jung Eun

    2017-06-30

    The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy. The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life (HRQOL) in breast cancer survivors. We conducted a cross-sectional study of breast cancer survivors. A total of 231 women aged 21-78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study. We asked participants about their HRQOL and engagement in physical activity using structured questionnaires. We examined the association between HRQOL levels and physical activity using a generalized linear model. Breast cancer survivors in the high physical activity group (3rd tertile) were more likely to have lower scores for fatigue (p for trend = 0.001) and pain (p for trend = 0.02) and higher scores for sexual function (p for trend = 0.007) than those in the low physical activity group (1st tertile). When we stratified participants by stage, we found increasing scores for physical functioning (p for trend =0.01) and decreasing scores for fatigue (p for trend = 0.02) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer. In survivors with stages II and III, we found statistically significant associations with fatigue (p for trend = 0.02) and sexual functioning (p for trend = 0.001). In conclusion, engagement in physical activity was related to better health-related quality of life among breast cancer survivors. Our findings may warrant further prospective and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors.

  15. 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.

  16. 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 ...

  17. A focus group study exploring gynecological cancer survivors' experiences and perceptions of participating in a RCT testing the efficacy of a home-based physical activity intervention.

    Science.gov (United States)

    Donnelly, C M; Lowe-Strong, A; Rankin, J P; Campbell, A; Blaney, J M; Gracey, J H

    2013-06-01

    This study aims to explore gynecological cancer survivors' perceptions and experiences following participation in a randomised controlled trial (RCT) testing the efficacy of a home-based physical activity behavioral change intervention (Donnelly et al., Gynecol Oncol 122:618-624, 2011). All participants completing a two-armed parallel RCT were invited to participate in the study (31/33) (Donnelly et al., Gynecol Oncol 122:618-624, 2011). Sixteen participants took part (16/31; physical activity (PA) group n = 9, contact control (CC) group n = 7). Four qualitative group interviews were conducted (focus group size 3-5). A structured interview guide was followed by an independent moderator. Groups were audio recorded, transcribed verbatim, and analyzed using the framework approach (Ritchie and Spencer 2001), a five-stage qualitative method of analysis. One of the most unanimously perceived benefits of taking part in the programme regarded participants' psychological well-being. Additional benefits included improved physical fitness and functioning. Important programme features included the weekly telephone calls from a physiotherapist, the patient-professional relationship, and goal setting. Participants' own motivation and programme timing were also identified as important factors. Suggestions for improvements include: opportunities for social interaction with other gynecological cancer survivors and greater exercise choice. Findings suggest that women diagnosed with gynecological cancer perceive participation in physical activity as important and participation provides benefits in terms of psychological well-being and improved physical functioning. Support for continuation of many of the current features of the home-based programme was provided. Findings provide insight and rationale for the selection of components for future home-based physical activity interventions. Findings also support further research into the development of multidimensional

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

    Directory of Open Access Journals (Sweden)

    Bezemer Pieter D

    2007-12-01

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

  19. Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness.

    Science.gov (United States)

    Liao, Kelly Yu-Hsin; Yeung, Nelson C Y; Wong, Celia C Y; Warmoth, Krystal; Lu, Qian

    2017-04-01

    The degree to which conscientiousness contributes to well-being in Chinese cancer survivors and the mechanisms through which conscientiousness is associated with well-being remain unclear. Based on Lent's restorative well-being model [1], the current study tested a mediation model of the contribution of conscientiousness, positive reappraisal, and hopelessness to fear of cancer recurrence (FCR), and physical well-being in a sample of 238 Chinese cancer survivors. Participants completed self-report questionnaires. Path analysis was used to analyze the linear relationships between the variables. The empirical model supported the mediator roles of positive reappraisal and hopelessness. Specifically, the results indicated that conscientiousness was first associated with positive reappraisal, which in turn was associated with decreased hopelessness, resulting in decreased FCR and improved physical well-being. In addition, the results showed that conscientiousness was associated with decreased hopelessness, which was then associated with decreased FCR and greater physical well-being. Conscientiousness confers benefits on FCR and physical well-being through the mechanisms of positive reappraisal and decreased hopelessness.

  20. Personal resilience resources predict post-stem cell transplant cancer survivors' psychological outcomes through reductions in depressive symptoms and meaning-making.

    Science.gov (United States)

    Campo, Rebecca A; Wu, Lisa M; Austin, Jane; Valdimarsdottir, Heiddis; Rini, Christine

    2017-01-01

    This longitudinal study examined whether post-transplant cancer survivors (N = 254, 9 months to 3 years after stem cell transplant treatment) with greater personal resilience resources demonstrated better psychological outcomes and whether this could be attributed to reductions in depressive symptoms and/or four meaning-making processes (searching for and finding reasons for one's illness; searching for and finding benefit from illness). Hierarchical linear regression analyses examined associations of survivors' baseline personal resilience resources (composite variable of self-esteem, mastery, and optimism), which occurred an average of 1.7 years after transplant, and 4-month changes in psychological outcomes highly relevant to recovering from this difficult and potentially traumatic treatment: post-traumatic stress disorder (PTSD) symptoms and purpose in life. Boot-strapped analyses tested mediation. Greater personal resilience resources predicted decreases in PTSD stress symptoms (b = -0.07, p = 0.005), mediated by reductions in depressive symptoms (b = -0.01, 95% CI: -0.027, -0.003) and in searching for a reason for one's illness (b = -0.01, 95% CI: -0.034, -0.0003). In addition, greater resilience resources predicted increases in purpose in life (b = 0.10, p personal resilience resources may promote better psychological adjustment after a difficult cancer treatment, largely because of improvements in depressive symptoms, although decreased use of a potentially maladaptive form of meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.

  1. Participation in leisure activities after stroke: A survey of community-residing stroke survivors in Nigeria.

    Science.gov (United States)

    Vincent-Onabajo, Grace; Blasu, Cephas

    2016-01-01

    Leisure provides pleasure and relaxation, and has health benefits even after a stressful and life-changing event such as a stroke. This study examined leisure participation among a sample of community-residing stroke survivors in Nigeria. Fifty-five stroke survivors undergoing rehabilitation were consecutively recruited from two government hospitals in Northern Nigeria. Data on pre- and post-stroke participation, and socio-demographic (age, sex, marital, employment, and educational status) and clinical (level of disability, post-stroke duration, stroke type and side of hemiplegia/hemiparesis) attributes of the stroke survivors were obtained. Leisure participation was assessed in four domains of recreational, social, cognitive, and productive/creative activities. Associations between leisure participation and the socio-demographic and clinical variables were examined using bivariate analysis. Mean (SD) age of the stroke survivors was 53.55 (14.39) years. Prevalence of leisure participation was 89.1%. Participation in specific leisure domains however varied thus: social (83.6%), cognitive (60%), recreational (41.8%), productive/creative activities (30.9%). Significant associations were observed between participation in cognitive, productive/creative, and recreational leisure activities, and specific socio-demographic and clinical attributes. Leisure participation was high in a general sense but marginal in recreational and productive/creative activities. The observed socio-demographic and clinical associations with post-stroke leisure participation may assist in providing effective leisure rehabilitation strategies.

  2. Supplemental security income and social security disability insurance coverage among long-term childhood cancer survivors.

    Science.gov (United States)

    Kirchhoff, Anne C; Parsons, Helen M; Kuhlthau, Karen A; Leisenring, Wendy; Donelan, Karen; Warner, Echo L; Armstrong, Gregory T; Robison, Leslie L; Oeffinger, Kevin C; Park, Elyse R

    2015-06-01

    Supplemental security income (SSI) and social security disability insurance (DI) are federal programs that provide disability benefits. We report on SSI/DI enrollment in a random sample of adult, long-term survivors of childhood cancer (n = 698) vs a comparison group without cancer (n = 210) from the Childhood Cancer Survivor Study who completed a health insurance survey. A total of 13.5% and 10.0% of survivors had ever been enrolled on SSI or DI, respectively, compared with 2.6% and 5.4% of the comparison group. Cranial radiation doses of 25 Gy or more were associated with a higher risk of current SSI (relative risk [RR] = 3.93, 95% confidence interval [CI] = 2.05 to 7.56) and DI (RR = 3.65, 95% CI = 1.65 to 8.06) enrollment. Survivors with severe/life-threatening conditions were more often enrolled on SSI (RR = 3.77, 95% CI = 2.04 to 6.96) and DI (RR = 2.73, 95% CI = 1.45 to 5.14) compared with those with mild/moderate or no health conditions. Further research is needed on disability-related financial challenges after childhood cancer. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Breast cancer survivors' perspectives on a weight loss and physical activity lifestyle intervention.

    Science.gov (United States)

    Balneaves, Lynda G; Van Patten, Cheri; Truant, Tracy L O; Kelly, Mary T; Neil, Sarah E; Campbell, Kristin L

    2014-08-01

    The purpose of this study is to qualitatively describe the experiences of breast cancer survivors who took part in a successful 24-week lifestyle intervention aimed at weight loss. The aim was to inform future study designs and lifestyle interventions. Nine women who completed the lifestyle intervention took part in either a focus group or telephone interviews with trained facilitators who were not involved in the delivery of the intervention. Interviews were transcribed verbatim and thematic analysis was conducted. Women appreciated the group-based nature of the program, the presence of other breast cancer survivors, and the safe and supportive environment provided by program leaders. The intervention supported women in reframing their dietary habits, and the exercise component had unexpected benefits on their psychological wellbeing. The logistics of fitting the intervention into busy work and family schedules was a challenge experienced by most women. Recommendations for future programming included offering the intervention to all survivors immediately following adjuvant treatment, integrating participants' social networks into the program and including a maintenance phase for sustainability of healthy behaviors. This qualitative study provides insight into breast cancer survivors' experiences in a group-based lifestyle intervention and offers suggestions for the development of future lifestyle programming in cancer care.

  4. Preventive care receipt and office visit use among breast and colorectal cancer survivors relative to age- and gender-matched cancer-free controls.

    Science.gov (United States)

    Lafata, Jennifer Elston; Salloum, Ramzi G; Fishman, Paul A; Ritzwoller, Debra Pearson; O'Keeffe-Rosetti, Maureen C; Hornbrook, Mark C

    2015-06-01

    We compare breast and colorectal cancer survivors' annual receipt of preventive care and office visits to that of age- and gender-matched cancer-free controls. Automated data, including tumor registries, were used to identify insured individuals aged 50+ at the time of breast or colorectal cancer diagnosis between 2000 and 2008 as well as cancer-free controls receiving care from four integrated delivery systems. Those with metastatic or un-staged disease, or a prior cancer diagnosis were excluded. Annual visits to primary care, oncology, and surgery as well as receipt of mammography, colorectal cancer, Papanicolaou, bone densitometry, and cholesterol screening were observed for 5 years. We used generalized estimating equations that accounted for repeated observations over time per person to test annual service use differences by cancer survivor/cancer-free control status and whether survivor/cancer-free status associations were moderated by patient age breast and 1530 colorectal cancer survivors were identified, representing 12,923 and 5103 patient-years of follow-up, respectively. Compared to cancer-free controls, breast and colorectal cancer survivors were equally or more likely to use all types of office visits and to receive cancer screenings and bone densitometry testing. Both breast and colorectal cancer survivors were less likely than cancer-free controls to receive cholesterol testing, regardless of age, year of diagnosis, or use of primary care. Programs targeting cancer survivors may benefit from addressing a broad range of primary preventive care needs, including recommended cardiovascular disease screening.

  5. 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

  6. 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.

  7. 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

  8. 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.…

  9. 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…

  10. 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.

  11. Health examination for A-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. Neurocognitive and behavioral outcomes in Latino childhood cancer survivors.

    Science.gov (United States)

    Patel, Sunita K; Lo, Tracy T Y; Dennis, Jessica M; Bhatia, Smita

    2013-10-01

    Children with brain tumors and leukemia are at risk for neurocognitive and behavioral late effects due to central nervous system-directed therapies. Few studies have examined these outcomes in ethnic minority samples, despite speculation that socio-demographic factors may increase vulnerability for adverse neurobehavioral outcomes. We evaluated the neurocognitive and behavioral outcomes and their impact on the health-related quality of life in survivors of childhood cancer drawn from Latino families in the Los Angeles region. Using culturally-relevant recruitment strategies, 73 predominantly Spanish-speaking parents of pediatric brain tumor or leukemia survivors completed standardized questionnaires, including the Conners parent-report and the Bidimensional Acculturation Scales. Clinical and socio-demographic factors influencing the development of neurocognitive and behavioral dysfunction were examined. Approximately 50% of the children placed at or above the "elevated" level for difficulties with attention, school-based learning, and peer relations. Younger age at diagnosis significantly predicted dysfunction in inattention, learning problems, and hyperactivity/impulsivity. Children whose parents were less adherent to the non-Hispanic white culture were more likely to have problems with peer relations and executive functioning. HRQL was significantly lower in survivors with neurocognitive and behavioral dysfunction relative to those with normal range scores on the Conners scale. In addition to the child's age at diagnosis, acculturation appears to predict select neurocognitive and behavioral outcomes in this socio-demographically homogeneous sample of Latino families. Further research is needed to understand the interaction of ethnic and cultural factors with therapeutic exposures in determining the adverse neurobehavioral outcomes, so as to optimally design interventions. Copyright © 2013 Wiley Periodicals, Inc.

  13. Clinical Use of Magnetic Resonance Imaging for the Diagnosis of Acute Myocardial Infarction in the Survivors of Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Miroslav Solař

    2007-01-01

    Full Text Available The ventricular arrhythmias with underlying coronary artery disease are a leading cause of sudden cardiac death (SCD. While the SCD survivors with proven AMI are considered to be at low risk of SCD recurrence, those without the evidence of AMI represent a high risk group that benefits from implantable cardioverter defibrillator. Therefore, the evaluation of SCD survivors for the presence of acute myocardial infarction (AMI as a triggering factor of cardiac arrest is essential. In SCD survivors, the use of the standard diagnostic criteria of AMI may be difficult, as both serum cardiac biomarkers and electrocardiogram can be influenced by previous cardiac arrest. A novel technique that may be used for the diagnosis of AMI is magnetic resonance imaging (MRI. We report its use in four patients after cardiopulmonary resuscitation where the diagnosis of AMI could not be definitely established or excluded by means of other diagnostic procedures.

  14. Burden and Cognitive Appraisal of Stroke Survivors' Informal Caregivers: An Assessment of Depression Model With Mediating and Moderating Effects.

    Science.gov (United States)

    Tsai, Yi-Chen; Pai, Hsiang-Chu

    2016-04-01

    This study proposes and evaluates a model of depression that concerns the role of burden and cognitive appraisal as mediators or moderators of outcomes among stroke survivor caregivers. A total of 105 informal caregivers of stroke survivor completed the self-report measures of Caregiver Burden Inventory, Center for Epidemiologic Studies Depression Scale, and Cognitive Impact of Appraisal Scale. The Glasgow Coma Scale and Barthel Index were used by the researcher to examine the physical functional status of the survivor. Partial least squares (PLS) path modeling was used to estimate the parameters of a depression model that included mediating or moderating effects. The model shows that burden and impact of cognitive appraisal have a significant direct and indirect impact on depression, while survivor physical functional status does not have a direct impact. The model also demonstrates that burden and impact of cognitive appraisal separately play a mediating role between survivor physical functional status and caregiver depression. In addition, cognitive appraisal has a moderating influence on the relationship between burden and depression. Overall, survivor physical functional status, burden, and cognitive appraisal were the predictors of caregiver depression, explaining 47.1% of the variance. This study has shown that burden and cognitive appraisal are mediators that more fully explain the relationship between patient severity and caregiver depression. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Type of tumour, gender and time since diagnosis affect differently health-related quality of life in adolescent survivors.

    Science.gov (United States)

    Pérez-Campdepadrós, M; Castellano-Tejedor, C; Sábado-Álvarez, C; Gros-Subías, L; Capdevila, L; Blasco-Blasco, T

    2015-09-01

    Research findings about health-related quality of life (HRQoL) of childhood cancer survivors are mixed and the features which could modulate these results have not been investigated rigorously. This research aims to improve the knowledge on these topics. Thus, HRQoL between central nervous system (CNST) and non-central nervous system (non-CNST) adolescent cancer survivors was compared. The influence of selected factors (gender and years since diagnosis) on HRQoL was also analysed. In a cross-sectional design, 78 survivors (12-20 years) who were ≥ 1 year free of oncological treatment answered the self-reported version of the KIDSCREEN-52. HRQoL mean scores of CNST survivors were lower in comparison with non-CNST in physical well-being and social support and peers dimensions. Furthermore, female gender was also related to lower HRQoL scores for both types of tumours in physical well-being and autonomy dimensions. Additionally, scores on psychological well-being, social support and peers, parent relations and home life and school environment dimensions decrease with length of time from diagnosis. Therefore, diagnosis of CNST and gender were related to lower HRQoL among survivors in some dimensions, whereas time from diagnosis was related to impaired HRQoL in other features. These results can help to design tailored interventions and psychosocial guidelines to follow-up survivors. © 2014 John Wiley & Sons Ltd.

  16. Healthcare Needs, Experiences and Satisfaction after Terrorism: A Longitudinal Study of Survivors from the Utøya Attack

    Directory of Open Access Journals (Sweden)

    Lise Eilin Stene

    2016-11-01

    Full Text Available Background: Public health outreach programs have been developed in order to ensure that needs are met after disasters. However, little is known about survivors’ experiences with post-terror healthcare. In the present study, our objectives were to 1 describe survivors’ experiences with post-terror healthcare, 2 identify factors associated with reports of unmet healthcare needs, and 3 examine the relationship between socio-demographic characteristics, healthcare experiences and satisfaction.Methods: Our study comprised three waves of semi-structured interviews with 261/490 (53% survivors of the Utøya mass shooting. We applied Pearson’s chi-squared tests (categorical variables and independent t-tests (continuous variables to compare survivors by whether or not they reported higher perceived needs than received help for psychological reactions and physical health problems, respectively. Ordinal regression analyses were applied to examine whether socio-demographic characteristics and healthcare experiences were associated with dissatisfaction. Results: Altogether 127 (49% survivors reported very high/high help needs for psychological reactions, and 43 (17% for attack-related physical health problems. Unmet healthcare needs were associated with higher levels of posttraumatic stress, psychological distress, somatic symptoms and less social support. Survivors with immigrant backgrounds and injured survivors who were not admitted to hospital reported unmet needs for physical health problems more often. After adjustments for socio-demographic characteristics, immigrant origin was associated with dissatisfaction with post-terror healthcare. After additionally adjusting for healthcare experiences, poor rating of the overall organization and accessibility of healthcare remained significantly associated with dissatisfaction.Conclusions: Most survivors were satisfied with the post-terror healthcare they received, yet our findings indicate that increased

  17. Oral and dental late effects in survivors of childhood cancer: a Children's Oncology Group report.

    Science.gov (United States)

    Effinger, Karen E; Migliorati, Cesar A; Hudson, Melissa M; McMullen, Kevin P; Kaste, Sue C; Ruble, Kathy; Guilcher, Gregory M T; Shah, Ami J; Castellino, Sharon M

    2014-07-01

    Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children's Oncology Group. An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network "Categories of Consensus" system. The Children's Oncology Group oral-dental panel selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Additionally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent malignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life.

  18. Adolescent survivors: a secondary analysis of a clinical trial targeting behavior change.

    Science.gov (United States)

    Cox, Cheryl L; McLaughlin, Rosemary A; Rai, Shesh N; Steen, Brenda D; Hudson, Melissa M

    2005-08-01

    The late effects of radiation and chemotherapy increase childhood cancer survivors' risk of chronic health problems. Survivors' behavior is important in modifying this risk, yet adolescent and young adult survivors fail to engage in important health-promoting behaviors and frequently practice high-risk behaviors. This secondary analysis re-evaluated a multi-component behavior-change intervention that had previously demonstrated no impact in adolescent survivors of childhood cancer. The parent trial compared 132 adolescent survivors in the intervention arm with 135 in the standard-care arm at baseline and at 1 year for disease and treatment knowledge, perception of late effects risk, and the frequency of health-risk and health-protective behaviors (combined as a single summative measure). In contrast, the secondary analysis examined each of the 14 behaviors separately. Additionally, an analysis of covariance (ANCOVA) was conducted to examine the change in health behaviors while statistically controlling for age, gender, and the wide variation in baseline behaviors. Knowledge (P = 0.038), breast self-examination (BSE) (P junk food consumption decreased (P = 0.052) and smoking abstinence was maintained (P = 0.088). Significant interactions between gender and treatment group were demonstrated. Health-risk and health-protective behaviors cannot be effectively combined in a one-dimensional measure. Gender and age influence the impact of interventions targeting health behavior in survivors. Future trials should include observation of the patient-clinician encounter, more complex sampling methods, and pre-trial knowledge of the distribution of the study behaviors.

  19. Perceptions of the role of general practice and practical support measures for carers of stroke survivors: a qualitative study

    Directory of Open Access Journals (Sweden)

    Harris Ruth

    2011-06-01

    Full Text Available Abstract Background Informal carers frequently suffer adverse consequences from caring. General practice teams are well positioned to support them. However, what carers of stroke survivors want and expect from general practice, and the practical support measures they might like, remain largely unexplored. The aims of this study are twofold. Firstly it explores both the support stroke carers would like from general practice and their reactions to the community based support proposed in the New Deal. Secondly, perceptions of a general practice team are investigated covering similar topics to carer interviews but from their perspective. Methods Semi-structured interviews were conducted with 13 stroke carers and 10 members of a general practice team. Carers' experiences and expectations of general practice and opinions of support measures from recent government policy were explored. General practice professionals were asked about their perceived role and their perceptions of carers' support needs. Interviews were content analysed. Results Carers' expectations of support from general practice were low and they neither received nor expected much support for themselves. General practice was seen as reactive primarily because of time constraints. Some carers would appreciate emotional support but others did not want additional services. Responses to recent policy initiatives were mixed with carers saying these might benefit other carers but not themselves. General practice professionals' opinions were broadly similar. They recognise carers' support needs but see their role as reactive, focussed on stroke survivors, rather than carers. Caring was recognised as challenging. Providing emotional support and referral were seen as important but identification of carers was considered difficult. Time constraints limit their support. Responses to recent policy initiatives were positive. Conclusions Carers' expectations of support from general practice for

  20. Comparison of Intake of Animal and Plant Foods and Related Nutrients in Postmenopausal Breast Cancer Survivors and Controls.

    Science.gov (United States)

    Lay, Whitney A; Vickery, Courtney R; Ward-Ritacco, Christie L; Johnson, Kristen B; Berg, Alison C; Evans, Ellen M; Johnson, Mary Ann

    2016-01-01

    This study's objective is to assess differences in dietary intakes in breast cancer survivors (n = 13) and women without a history of breast cancer (controls, n = 71). In a cross-sectional design, intake of foods, food groups, nutrients, and non-nutritive sweeteners was assessed using participant-completed three-day food records. All women were postmenopausal (mean age (SD) 58.5 (±3.8) y, 95% White, 2.4% Asian Pacific, and 2.4% Black). The two groups did not differ in age, energy intake, or body mass index (p > 0.05). Compared to controls, survivors consumed less dairy products, animal protein, total protein, and calcium, but more legumes, noncitrus fruit, and carbohydrates (p ≤ 0.05). Calcium intakes were of particular concern in survivors who consumed an average of 686 mg calcium/d, which is cancer survivors may benefit from consultation with a Registered Dietitian or other health professional knowledgeable in nutritional recommendations for postmenopausal breast cancer survivors.

  1. Social Competence in Childhood Brain Tumor Survivors: Feasibility and Preliminary Outcomes of a Peer-Mediated Intervention.

    Science.gov (United States)

    Devine, Katie A; Bukowski, William M; Sahler, Olle Jane Z; Ohman-Strickland, Pamela; Smith, Tristram H; Lown, E Anne; Patenaude, Andrea Farkas; Korones, David N; Noll, Robert B

    2016-01-01

    Evaluate the acceptability, feasibility, and preliminary outcomes of a peer-mediated intervention to improve social competence of brain tumor survivors and classmates. Twelve childhood brain tumor survivors and 217 classroom peers in intervention (n = 8) or comparison (n = 4) classrooms completed measures of social acceptance and reputation at 2 time points in the year. The intervention (5-8 sessions over 4-6 weeks) taught peer leaders skills for engaging classmates. Individual and classroom outcomes were analyzed with analysis of covariance. Recruitment rates of families of brain tumor survivors (81%) and schools (100%) were adequate. Peer leaders reported satisfaction with the intervention. Preliminary outcome data trended toward some benefit in increasing the number of friend nominations for survivors of brain tumors but no changes in other peer-reported metrics. Preliminary results also suggested some positive effects on classroom levels of victimization and rejection. A peer-mediated intervention was acceptable to families of brain tumor survivors and feasible to implement in schools. Findings warrant a larger trial to evaluate improvements for children with brain tumors and their peers.

  2. Working memory training in survivors of pediatric cancer: a randomized pilot study.

    Science.gov (United States)

    Hardy, Kristina K; Willard, Victoria W; Allen, Taryn M; Bonner, Melanie J

    2013-08-01

    Survivors of pediatric brain tumors and acute lymphoblastic leukemia (ALL) are at increased risk for neurocognitive deficits, but few empirically supported treatment options exist. We examined the feasibility and preliminary efficacy of a home-based, computerized working memory training program, CogmedRM, with survivors of childhood cancer. Survivors of brain tumors or ALL (n = 20) with identified deficits in attention and/or working memory were randomized to either the success-adapted computer intervention or a non-adaptive, active control condition. Specifically, children in the adaptive condition completed exercises that became more challenging with each correct trial, whereas those in the non-adaptive version trained with exercises that never increased in difficulty. All participants were asked to complete 25 training sessions at home, with weekly, phone-based coaching support. Brief assessments were completed pre-intervention and post-intervention; outcome measures included both performance-based and parent-report measures of working memory and attention. Eighty-five percent of survivors were compliant with the intervention, with no adverse events reported. After controlling for baseline intellectual functioning, survivors who completed the intervention program evidenced significant post-training improvements in their visual working memory and in parent-rated learning problems compared with those in the active control group. No differences in verbal working memory functioning were evident between groups, however. Home-based, computerized cognitive training demonstrates good feasibility and acceptability in our sample. Children with higher intellectual functioning at baseline appeared to benefit more from the training, although further study is needed to clarify the strength, scope, and particularly the generalizability of potential treatment effects. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Short communication: Sensory analysis of a kefir product designed for active cancer survivors.

    Science.gov (United States)

    O'Brien, K; Boeneke, C; Prinyawiwatkul, W; Lisano, J; Shackelford, D; Reeves, K; Christensen, M; Hayward, R; Ordonez, K Carabante; Stewart, L K

    2017-06-01

    Kefir is a fermented milk product that is a good source of protein and health-promoting bacteria. It has the potential to improve recovery from exercise and the health and well-being of cancer survivors. The purpose of this study was to explore cancer survivor attitudes about and acceptance of a kefir recovery beverage made from cultured milk, whole fruit, natural sweeteners, and other natural ingredients. Kefir was made by inoculating and fermenting milk with kefir grains. The kefir was then mixed with a fruit base and given to cancer survivors (n = 52) following a bout of exercise. Participants evaluated the acceptability of the beverage samples (overall appearance, aroma, taste, mouthfeel, and overall liking) using a 9-point hedonic scale, and they evaluated the smoothness using a 3-category just-about-right scale (not enough, just about right, and too much). They also expressed their physical and psychological feelings about the beverage using a 5-point scale (1 = not at all to 5 = extremely) and indicated their purchase intent using a binomial (yes/no) response. The health benefits of kefir were then explained, and participants sampled a second beverage (the same product), answering the same questions related to overall liking, feeling, and intent to purchase. We used a paired Student's t-test to compare beverage liking and emotion scores before and after participants learned about the health benefits of kefir. Data are presented as mean ± standard deviations. The beverage scored significantly higher for overall liking after the health benefits were explained (6.5 ± 1.8 and 7.0 ± 1.7 out of 9 before and after the explanation of health benefits, respectively). Participants showed a high intent to purchase before they learned about the health benefits (75% of participants indicated an intent to purchase, and 89% after they learned about the health benefits). The beverage received high scores overall and, except for an improvement in overall liking, we

  4. Do blood growth factors offer additional benefit in refractory lateral epicondylitis? A prospective, randomized pilot trial of dry needling as a stand-alone procedure versus dry needling and autologous conditioned plasma.

    Science.gov (United States)

    Stenhouse, Gregor; Sookur, Paul; Watson, Martin

    2013-11-01

    To evaluate whether autologous conditioned plasma offers any therapeutic advantage over ultrasound-guided dry needling as a stand-alone procedure in the treatment of refractory lateral epicondylitis. Prospective, randomized pilot study of 28 patients (11 men, 17 women, mean age, 49.1  years) with refractory lateral epicondylitis (mean symptom duration, 19.1 months) who underwent either dry needling (n = 13) or dry needling combined with autologous conditioned plasma (ACP) injection (n = 15). Each patient received two separate injections (0 weeks and 1 month) and analysis of visual analogue pain scores (VAS) and Nirschl scores were performed pre-procedure, at 2 months and final evaluation at 6 months. Successful treatment was defined as more than a 25 % reduction in pain scores without re-intervention. Data was analyzed using the Mann-Whitney test and local research ethics committee approval was obtained. At 2 months, the mean VAS improvement was 0.85 (12.3 %) in the dry needling group compared to 2.19 (27.1 %) in the ACP group (p = 0.76) and there was a 5.83-point and 20.3-point Nirschl score improvement respectively (p = 0.72). At the final follow-up of 6 months, the mean VAS improvement was 2.37 (34 %) in the dry needling group compared to 3.92 (48.5 %) in the ACP group (p = 0.74) and there was a 22.5-point and 40-point Nirschl score improvement, respectively (p = 0.82). There is a trend to greater clinical improvement in the short term for patients treated with additional ACP, however no significant difference between the two treatment groups was demonstrated at each follow-up interval. A larger, multicenter, randomized controlled trial is required to corroborate the results of this pilot study.

  5. 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.

  6. 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)

  7. 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.

  8. 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 ...

  9. 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…

  10. 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.

  11. 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 ...

  12. 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.

  13. 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.

  14. 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…

  15. 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.

  16. 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.

  17. 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.

  18. A Congolese community-based health program for survivors of sexual violence

    Directory of Open Access Journals (Sweden)

    Kohli Anjalee

    2012-08-01

    Full Text Available Abstract Many survivors of gender based violence (GBV in the Democratic Republic of Congo (DRC report barriers to access health services including, distance, cost, lack of trained providers and fear of stigma. In 2004, Foundation RamaLevina (FORAL, a Congolese health and social non-governmental organization, started a mobile health program for vulnerable women and men to address the barriers to access identified by GBV survivors and their families in rural South Kivu province, Eastern DRC. FORAL conducted a case study of the implementation of this program between July 2010-June 2011 in 6 rural villages. The case study engaged FORAL staff, partner health care providers, community leaders and survivors in developing and implementing a revised strategy with the goal of improving and sustaining health services. The case study focused on: (1 Expansion of mobile clinic services and visit schedule; (2 Clinical monitoring and evaluation system; and (3 Recognition, documentation and brief psychosocial support for symptoms suggestive of anxiety, depression and PTSD. During this period, FORAL treated 772 women of which 85% reported being survivors of sexual violence. Almost half of the women (45% reported never receiving health services after the last sexual assault. The majority of survivors reported symptoms consistent with STI. Male partner adherence to STI treatment was low (41%. The case study demonstrated areas of strengths in FORAL’s program, including improved access to health care by survivors and their male partner, enhanced quality of health education and facilitated regular monitoring, follow-up care and referrals. In addition, three critical areas were identified by FORAL that needed further development: provision of health services to young, unmarried women in a way that reduces possibility of future stigma, engaging male partners in health education and clinical care and strengthening linkages for referral of survivors and their partners

  19. Forebrain Cholinergic Dysfunction and Systemic and Brain Inflammation in Murine Sepsis Survivors

    Directory of Open Access Journals (Sweden)

    Nahla Zaghloul

    2017-12-01

    Full Text Available Sepsis, a complex disorder characterized by immune, metabolic, and neurological dysregulation, is the number one killer in the intensive care unit. Mortality remains alarmingly high even in among sepsis survivors discharged from the hospital. There is no clear strategy for managing this lethal chronic sepsis illness, which is associated with severe functional disabilities and cognitive deterioration. Providing insight into the underlying pathophysiology is desperately needed to direct new therapeutic approaches. Previous studies have shown that brain cholinergic signaling importantly regulates cognition and inflammation. Here, we studied the relationship between peripheral immunometabolic alterations and brain cholinergic and inflammatory states in mouse survivors of cecal ligation and puncture (CLP-induced sepsis. Within 6 days, CLP resulted in 50% mortality vs. 100% survival in sham-operated controls. As compared to sham controls, sepsis survivors had significantly lower body weight, higher serum TNF, interleukin (IL-1β, IL-6, CXCL1, IL-10, and HMGB1 levels, a lower TNF response to LPS challenge, and lower serum insulin, leptin, and plasminogen activator inhibitor-1 levels on day 14. In the basal forebrain of mouse sepsis survivors, the number of cholinergic [choline acetyltransferase (ChAT-positive] neurons was significantly reduced. In the hippocampus and the cortex of mouse sepsis survivors, the activity of acetylcholinesterase (AChE, the enzyme that degrades acetylcholine, as well as the expression of its encoding gene were significantly increased. In addition, the expression of the gene encoding the M1 muscarinic acetylcholine receptor was decreased in the hippocampus. In parallel with these forebrain cholinergic alterations, microglial activation (in the cortex and increased Il1b and Il6 gene expression (in the cortex, and Il1b gene expression (in the hippocampus were observed in mouse sepsis survivors. Furthermore, microglial

  20. Implementation of a Psychoeducational Program for Cancer Survivors and Family Caregivers at a Cancer Support Community Affiliate: A Pilot Effectiveness Study.

    Science.gov (United States)

    Dockham, Bonnie; Schafenacker, Ann; Yoon, Hyojin; Ronis, David L; Kershaw, Trace; Titler, Marita; Northouse, Laurel

    2016-01-01

    Psychoeducational interventions, tested for efficacy in randomized clinical trials, are seldom implemented in clinical practice where cancer survivors and their family caregivers can benefit from them. This study examined the effectiveness of the FOCUS Program on cancer survivors' and their family caregivers' outcomes when implemented at a Cancer Support Community (CSC) affiliate by agency social workers. Study aims were to (1) test effects of the program on survivor and caregiver outcomes as a unit and (2) determine program feasibility in terms of enrollment, retention, intervention fidelity, and satisfaction. A preintervention and postintervention pilot effectiveness study was conducted with 34 cancer survivor-caregiver dyads (ie, pairs). The FOCUS Program, originally delivered by nurses in dyads' homes, was modified to a small-group format and delivered by CSC social workers. The primary outcome was quality of life (QOL). Intermediary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included repeated-measures analysis of variance. Dyads had significant improvements in total QOL; physical, emotional, and functional QOL; benefits of illness; and self-efficacy. Effect sizes were similar to prior randomized clinical trial findings. Although dyads were difficult to recruit (enrollment, 60%), both retention (92%) and intervention fidelity (94%) were high. It was possible to implement the FOCUS Program at a CSC affiliate by agency staff, obtain positive intervention effects, and maintain intervention fidelity. Researchers and clinicians need to collaborate to implement more evidence-based interventions in practice settings for cancer survivors and their family caregivers.

  1. Exploring stroke survivor experience of participation in an enriched environment: a qualitative study.

    Science.gov (United States)

    White, Jennifer H; Bartley, Emma; Janssen, Heidi; Jordan, Louise-Anne; Spratt, Neil

    2015-01-01

    Data highlight the importance of undertaking intense and frequent repetition of activities within stroke rehabilitation to maximise recovery. An enriched environment (EE) provides a medium in which these activities can be performed and enhanced recovery achieved. An EE has been shown to promote neuroplasticity in animal models of stroke, facilitating enhanced recovery of motor and cognitive function. However, the benefit of enriching the environment of stroke survivors remains unknown. To qualitatively explore stroke survivors' experience of implementation of exposure to an EE within a typical stroke rehabilitation setting, in order to identify facilitators and barriers to participation. Semi-structured interviews with 10 stroke survivors (7 females and 3 males, mean age of 70.5 years) exposed to an EE for a 2-week period following exposure to routine rehabilitation within a stroke rehabilitation ward. An inductive thematic approach was utilised to collect and analyse data. Qualitative themes emerged concerning the environmental enrichment paradigm including: (1) "It got me moving" - perceived benefits of participation in an EE; (2) "You can be bored or you can be busy." - Attenuating factors influencing participation in an EE; (3) "I don't like to make the staff busier" - limitations to use of the EE. This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective. Reported benefits included (1) increased motor, cognitive and sensory stimulation, (2) increased social interaction, (3) alleviation of degree of boredom and (4) increased feelings of personal control. However, participants also identified a number of barriers affecting implementation of the EE. We have previously published findings on perceptions of nursing staff working with stroke survivors in this enriched rehabilitation environment who identified that patients benefited from having better access to physical, cognitive

  2. Informal caregivers' burden and stress in caring for stroke survivors with spatial neglect: an exploratory mixed-method study.

    Science.gov (United States)

    Chen, Peii; Fyffe, Denise C; Hreha, Kimberly

    2017-01-01

    Spatial neglect prolongs stroke survivors' recovery to independence. However, little is known about the impact of spatial neglect on caregivers of stroke survivors. To explore the factors associated with burden and stress among informal caregivers of stroke survivors with spatial neglect. Following the previous study of 108 stroke survivors, we reached 24 stroke survivors' caregivers, and 20 caregivers (age: M±SD=56.9±12.7 years; 12 females) completed the study. 10 survivors had symptoms of spatial neglect, and 10 did not (i.e., SN+ or SN-, respectively) at the time when discharged from inpatient rehabilitation, which was 9.3±6.2 months before the present study. Via a semi-structured telephone interview, we assessed caregivers' burden and stress qualitatively and quantitatively. No difference was observed across caregiver groups in cognitive function, depressive mood, or community mobility. In comparison, caregivers of the SN+ group allocated more time to care, controlling for survivors' disability (adjusted effective size d = 1.80). Their self-perceived burden and stress were more severe than the other group (adjusted d = .99). Qualitative analysis indicated caregivers of the SN+ group were more likely to describe economic stressors and undesirable changes in career and vacation planning. While 80% of participants preferred their care recipients to receive additional motor or mobility therapy, caregivers of the SN+ group were more likely to suggest additional therapy for cognitive impairment. This exploratory study suggests that spatial neglect may heighten caregivers' burden and stress levels. Future studies with a large sample size are required.

  3. Characterizing neurocognitive late effects in childhood leukemia survivors using a combination of neuropsychological and cognitive neuroscience measures.

    Science.gov (United States)

    Van Der Plas, Ellen; Erdman, Lauren; Nieman, Brian J; Weksberg, Rosanna; Butcher, Darci T; O'connor, Deborah L; Aufreiter, Susanne; Hitzler, Johann; Guger, Sharon L; Schachar, Russell J; Ito, Shinya; Spiegler, Brenda J

    2017-10-10

    Knowledge about cognitive late effects in survivors of childhood acute lymphoblastic leukemia (ALL) is largely based on standardized neuropsychological measures and parent reports. To examine whether cognitive neuroscience paradigms provided additional insights into neurocognitive and behavioral late effects in ALL survivors, we assessed cognition and behavior using a selection of cognitive neuroscience tasks and standardized measures probing domains previously demonstrated to be affected by chemotherapy. 130 ALL survivors and 158 control subjects, between 8 and 18 years old at time of testing, completed the n-back (working memory) and stop-signal (response inhibition) tasks. ALL survivors also completed standardized measures of intelligence (Wechsler Intelligence Scales [WISC-IV]), motor skills (Grooved Pegboard), math abilities (WIAT-III), and executive functions (Delis-Kaplan Executive Function System). Parents completed behavioral measures of executive functions (Behavior Rating Inventory of Executive Function [BRIEF]) and attention (Conners-3). ALL survivors exhibited deficiencies in working memory and response inhibition compared with controls. ALL survivors also exhibited deficits on WISC-IV working memory and processing speed, Grooved Pegboard, WIAT-III addition and subtraction fluency, and numerical operations, as well as DKEFS number-letter switching. Parent reports suggested more attention deficits (Conners-3) and behavioral difficulties (BRIEF) in ALL survivors compared with referenced norms. Low correspondence between standardized and experimental measures of working memory and response inhibition was noted. The use of cognitive neuroscience paradigms complements our understanding of the cognitive deficits evident after treatment of ALL. These measures could further delineate cognitive processes involved in neurocognitive late effects, providing opportunities to explore their underlying mechanisms.

  4. Chronic pain in breast cancer survivors: comparison of psychosocial, surgical, and medical characteristics between survivors with and without pain.

    Science.gov (United States)

    Schou Bredal, Inger; Smeby, Nina A; Ottesen, Stig; Warncke, Torhild; Schlichting, Ellen

    2014-11-01

    According to the literature, 25%-60% of women treated for breast cancer, regardless of the stage, experience pain. Many risk factors have been suggested, with many possible confounding factors. The aim was to investigate psychosocial, surgical, and medical factors associated with chronic pain by comparing breast cancer survivors with chronic pain with survivors without chronic pain. In addition, we investigated the prevalence, intensity, and body location of chronic pain after breast cancer treatment nationwide. A nationwide postal survey of 1332 women who received surgery and adjuvant therapy for breast cancer in Norway two to six years before the onset of this study. A total of 832 women (63%) returned the questionnaires, and 41% reported pain, of which 51% had mild, 41% moderate, and 8% severe pain. Among the women who experienced pain, 33.8% reported symptoms and signs of neuropathic pain. Young age (odds ratio [OR], 0.95; 95% CI, 0.93-0.98; P pain (OR, 2.37; 95% CI, 1.72-3.26; P chronic pain. Young age, previous comorbidities (such as back pain, arthritis, arthrosis, and fibromyalgia), and combined treatment with axillary lymph node dissection, chemotherapy, and radiotherapy were risk factors for chronic pain. Whether depression or anxiety is a risk factor for chronic pain remains unclear. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Can demographic and exposure characteristics predict levels of social support in survivors from a natural disaster?

    Science.gov (United States)

    Arnberg, Filip K; Melin, Lennart

    2013-01-01

    Lack of social support is a strong predictor for poor mental health after disasters. Psychosocial post-disaster interventions may benefit from targeting survivors at risk of low support, yet it is unknown whether demographic and disaster exposure characteristics are associated with social support. This study assessed if age, gender, educational status, cohabitation, and disaster exposure severity predicted aspects of informal social support in a cohort of Swedish survivors from the 2004 Southeast Asian tsunami. The participants were 3,536 disaster survivors who responded to a mail survey 14 months after the disaster (49% response rate). Their perceptions of present emotional support, contact with others, tangible support, negative support and overall satisfaction with informal support were assessed with the Crisis Support Scale and analysed in five separate ordinal regressions. Demographic factors and exposure severity explained variation in social supports although the effect size and predictive efficiency were modest. Cohabitation and female gender were associated with both more positive and more negative support. Single-household men were at risk for low emotional support and younger women were more likely to perceive negative support. Higher education was associated with more positive support, whereas no clear pattern was found regarding age as a predictor. Disaster exposure severity was associated with more negative support and less overall support satisfaction. After a disaster that entailed little disruptions to the community the associations between demographic characteristics and social support concur with findings in the general population. The findings suggest that psychosocial disaster interventions may benefit from targeting specific groups of survivors.

  6. Can Demographic and Exposure Characteristics Predict Levels of Social Support in Survivors from a Natural Disaster?

    Science.gov (United States)

    Arnberg, Filip K.; Melin, Lennart

    2013-01-01

    Objective Lack of social support is a strong predictor for poor mental health after disasters. Psychosocial post-disaster interventions may benefit from targeting survivors at risk of low support, yet it is unknown whether demographic and disaster exposure characteristics are associated with social support. This study assessed if age, gender, educational status, cohabitation, and disaster exposure severity predicted aspects of informal social support in a cohort of Swedish survivors from the 2004 Southeast Asian tsunami. Methods The participants were 3,536 disaster survivors who responded to a mail survey 14 months after the disaster (49% response rate). Their perceptions of present emotional support, contact with others, tangible support, negative support and overall satisfaction with informal support were assessed with the Crisis Support Scale and analysed in five separate ordinal regressions. Results Demographic factors and exposure severity explained variation in social supports although the effect size and predictive efficiency were modest. Cohabitation and female gender were associated with both more positive and more negative support. Single-household men were at risk for low emotional support and younger women were more likely to perceive negative support. Higher education was associated with more positive support, whereas no clear pattern was found regarding age as a predictor. Disaster exposure severity was associated with more negative support and less overall support satisfaction. Conclusions After a disaster that entailed little disruptions to the community the associations between demographic characteristics and social support concur with findings in the general population. The findings suggest that psychosocial disaster interventions may benefit from targeting specific groups of survivors. PMID:23776531

  7. Smartphone-Enabled Health Coaching Intervention (iMOVE) to Promote Long-Term Maintenance of Physical Activity in Breast Cancer Survivors: Protocol for a Feasibility Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Ritvo, Paul; Obadia, Maya; Santa Mina, Daniel; Alibhai, Shabbir; Sabiston, Catherine; Oh, Paul; Campbell, Kristin; McCready, David; Auger, Leslie; Jones, Jennifer Michelle

    2017-08-24

    Although physical activity has been shown to contribute to long-term disease control and health in breast cancer survivors, a majority of breast cancer survivors do not meet physical activity guidelines. Past research has focused on promoting physical activity components for short-term breast cancer survivor benefits, but insufficient attention has been devoted to long-term outcomes and sustained exercise adherence. We are assessing a health coach intervention (iMOVE) that uses mobile technology to increase and sustain physical activity maintenance in initially inactive breast cancer survivors. This pilot randomized controlled trial (RCT) is an initial step in evaluating the iMOVE intervention and will inform development of a full-scale pragmatic RCT. We will enroll 107 physically inactive breast cancer survivors and randomly assign them to intervention or control groups at the University Health Network, a tertiary cancer care center in Toronto, Canada. Participants will be women (age 18 to 74 years) stratified by age (55 years and older/younger than 55 years) and adjuvant hormone therapy (AHT) exposure (AHT vs no AHT) following breast cancer treatment with no metastases or recurrence who report less than 60 minutes of preplanned physical activity per week. Both intervention and control groups receive the 12-week physical activity program with weekly group sessions and an individualized, progressive, home-based exercise program. The intervention group will additionally receive (1) 10 telephone-based health coaching sessions, (2) smartphone with data plan, if needed, (3) supportive health tracking software (Connected Wellness, NexJ Health Inc), and (4) a wearable step-counting device linked to a smartphone program. We will be assessing recruitment rates; acceptability reflected in selective, semistructured interviews; and enrollment, retention, and adherence quantitative intervention markers as pilot outcome measures. The primary clinical outcome will be directly

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

    Science.gov (United States)

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

    2010-08-18

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

  9. The Effect of the Move More Pack on the Physical Activity of Cancer Survivors: Protocol for a Randomized Waiting List Control Trial with Process Evaluation.

    Science.gov (United States)

    Webb, Justin; Fife-Schaw, Chris; Ogden, Jane; Foster, Jo

    2017-11-09

    Physical activity can improve many common side effects of cancer treatment as well as improve physical function and quality of life (QOL). In addition, physical activity can improve survival rate and reduce cancer recurrence. Despite these benefits, only 23% of cancer survivors in England are active to recommended levels. Cancer survivors are interested in lifestyle behavior change. Home-based interventions offer a promising means for changing physical activity behavior. Prediagnosis levels of physical activity and self-efficacy have been reported to be predictors of physical activity behavior change. The Move More Pack, which has undergone revision, is a printed resource with supporting Internet-based tools that aims to increase the physical activity of cancer survivors in the United Kingdom. The revised Move More Pack is underpinned by the theory of planned behavior and the social cognitive theory. The aim of this proposed study was to investigate the effect of the revised Move More Pack, supported by Internet-based tools, on physical activity, self-efficacy, and health-related QOL (HRQOL) of cancer survivors in the United Kingdom. This study is a two-arm waiting list randomized control trial with embedded process evaluation. A sample of 99 participants per arm will be recruited by invitation through an email database of cancer survivors held by UK charity Macmillan Cancer Support and an advert placed on the Macmillan Cancer Support Facebook page. Each participant is randomized to receive brief physical activity information and the UK guidelines for physical activity, or brief physical activity information and the revised Move More Pack with supporting Internet-based tools. The intervention and control arm will be followed up at 12 weeks to identify changes in self-reported physical activity, self-efficacy, and HRQOL based on Web-based questionnaires. The control arm will receive the revised Move More Pack at 12 weeks with follow-up at 24 weeks. The intervention

  10. 20 CFR 404.222 - Use of benefit table in finding your primary insurance amount from your average monthly wage.

    Science.gov (United States)

    2010-04-01

    ... insurance amount from your average monthly wage. 404.222 Section 404.222 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Average-Monthly-Wage Method of Computing Primary Insurance Amounts § 404.222 Use of benefit table in...

  11. 20 CFR 404.469 - Nonpayment of benefits where individual has not furnished or applied for a Social Security number.

    Science.gov (United States)

    2010-04-01

    ... not furnished or applied for a Social Security number. 404.469 Section 404.469 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Deductions... or applied for a Social Security number. No monthly benefits will be paid to an entitled individual...

  12. 20 CFR 404.408b - Reduction of retroactive monthly social security benefits where supplemental security income (SSI...

    Science.gov (United States)

    2010-04-01

    ....408b Section 404.408b Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... retroactive monthly social security benefits where supplemental security income (SSI) payments were received for the same period. (a) When reduction is required. We will reduce your retroactive social security...

  13. Statistics: Number of Cancer Survivors

    Science.gov (United States)

    ... 5 million), gynecologic (8%, 1.3 million) and melanoma (8%, 1.2 million).* 2, 3 For additional ... For Researchers For Health Care Professionals For Advocates Definitions, Statistics and Graphs Definitions Statistics Graphs Funding History ...

  14. Clinical evaluation of unselected cardiac arrest survivors in a tertiary center over a 1-year period (the LAZARUZ study).

    Science.gov (United States)

    Marstrand, Peter; Corell, Pernille; Henriksen, Finn Lund; Pehrson, Steen; Bundgaard, Henning; Theilade, Juliane

    2016-01-01

    When the cause of an aborted cardiac arrest is unclear the initiation of therapy, counseling and family screening is challenging. We included 43 unselected, prospectively identified cardiac arrest survivors with or without a diagnosis. Family history for cardiac disease and supplemental electrocardiograms were evaluated for additional diagnostic information. 43 cardiac arrest survivors were included, 34 (79%) were male and the average age was 48years (range 23-64, SD 13.0). The most common etiologies identified in cardiac arrest survivors were ischemic heart disease (33%), cardiomyopathies (14%), miscellaneous (e.g. drug induced arrhythmias, coronary spasms) (12%) and channelopathies (5%). Family history of cardiac disease - even inheritable conditions - was not indicative of etiology in cardiac arrest survivors. Supplemental ECGs were abnormal in 10 of 43 patients; in the majority of these patients (7) no conclusive diagnosis was reached. In this study 16/43 (37%) of unselected, prospectively included cardiac arrest survivors remained without a diagnosis despite exhaustive investigations. We may extract additional diagnostic information from simple maneuvers during the recording of the electrocardiogram. We suggest that these ECG derived clues be investigated in future studies including genetic test results and data from relatives. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.

    Science.gov (United States)

    Carson, James W; Carson, Kimberly M; Porter, Laura S; Keefe, Francis J; Seewaldt, Victoria L

    2009-10-01

    Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB). Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.

  16. School Competence and Fluent Academic Performance: Informing Assessment of Educational Outcomes in Survivors of Pediatric Medulloblastoma.

    Science.gov (United States)

    Holland, Alice Ann; Hughes, Carroll W; Stavinoha, Peter L

    2015-01-01

    Academic difficulties are widely acknowledged but not adequately studied in survivors of pediatric medulloblastoma. Although most survivors require special education services and are significantly less likely than healthy peers to finish high school, measured academic skills are typically average. This study sought to identify potential factors associated with academic difficulties in this population and focused on school competence and fluent academic performance. Thirty-six patients (ages 7-18 years old) were recruited through the Departments of Neurosurgery and Neuro-Oncology at Children's Medical Center Dallas and Cook Children's Medical Center in Fort Worth, TX. Participants completed a neuropsychological screening battery including selected Woodcock-Johnson III Tests of Achievement subtests. Parents completed the Child Behavior Checklist. School competence was significantly correlated with measured academic skills and fluency. Basic academic skill development was broadly average, in contrast to significantly worse fluent academic performance. School competence may have utility as a measure estimating levels of educational success in this population. Additionally, academic difficulties experienced by childhood medulloblastoma survivors may be better captured by measuring deficits in fluent academic performance rather than skills. Identification of these potential factors associated with educational outcomes of pediatric medulloblastoma survivors has significant implications for research, clinical assessment, and academic services/interventions.

  17. Quality of life concerns and depression among hematopoietic stem cell transplant survivors.

    Science.gov (United States)

    Mosher, Catherine E; DuHamel, Katherine N; Rini, Christine; Corner, Geoffrey; Lam, Joanne; Redd, William H

    2011-09-01

    This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT). HSCT survivors (N=406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms. The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status. Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship.

  18. Effects of Offspring-Related Characteristics on Depressive Disorder among Cancer Patients and Survivors.

    Science.gov (United States)

    Kim, Jae-Hyun; Park, Eun-Cheol; Yeom, Hyungseon; Kwon, Jeoung A; Lee, Sang Gyu

    2015-01-01

    To investigate the influence of offspring-related characteristics on the prevalence of depressive disorders among cancer patients and those who survived cancer for at least 45 years. Data were obtained from the Korean Longitudinal Study of Aging (KLoSA). To investigate the association between offspring and depressive disorder among cancer patients and survivors, we analyzed data from 292 cancer patients and survivors drawn from a total subject pool of 16,613 individuals at baseline. According to our results, the odds ratio (OR) for subjects with five or more offspring developing depressive disorder was -0.794 (p-value: 0.039, SE: 0.329) compared with that of those with two offspring. In addition, the adjusted effect of the number of male and female offspring on the presence of depressive disorder showed that the OR for those with three or more female offspring for developing depressive disorder was -0.958 lower (SE: 0.305, p-value: 0.012) than it was for those with no female offspring. This article provides evidence for an association between offspring-related characteristics and depressive disorders among cancer patients and survivors. Therefore, offspring may be important contributors to the emotional status of cancer patients and survivors. Further study should precisely need to measure depressive disorders because of self-reported data.

  19. Chronic pain has a negative impact on sexuality in testis cancer survivors.

    Science.gov (United States)

    Pühse, Gerald; Wachsmuth, Julia Urte; Kemper, Sebastian; Husstedt, Ingo W; Evers, Stefan; Kliesch, Sabine

    2012-01-01

    Testis cancer is a disease that directly affects a man's sense of masculinity and involves treatments compromising sexual function. The aim of this study was to investigate the prevalence of sexual dysfunction and the influence of chronic pain on sexuality in long-term testis cancer survivors. Thus, we examined 539 patients after they had one testis removed because of a testicular germ cell tumor. Having completed oncologic therapy, all patients received a detailed questionnaire asking about the occurrence and clinical presentation of testis pain before and after orchiectomy. In addition, items from the abridged International Index of Erectile Function and Brief Sexual Function Inventory were used to gain precise information on individual sexual function. Overall, 34.5% of our testicular cancer survivors complained of reduced sexual desire, and sexual activity was reduced in 41.6%. Erectile dysfunction was present in up to 31.5% of patients. In 24.4%, the ability to maintain an erection during intercourse was impaired. Ejaculatory disorders (premature, delayed, retrograde, or anejaculation) occurred in 84.9% of our testis cancer survivors. A total of 32.4% of our participants experienced a reduced intensity of orgasm, and 95.4% experienced reduced overall sexual satisfaction. There was a significant correlation between the occurrence of chronic pain symptoms and the relative frequency and intensity of erectile dysfunction, inability to maintain an erection, ejaculation disorders, and reduced intensity of orgasm. In conclusion, chronic pain has a negative impact on sexuality in testis cancer survivors.

  20. Effect of motivation on academic fluency performance in survivors of pediatric medulloblastoma.

    Science.gov (United States)

    Holland, Alice Ann; Hughes, Carroll W; Harder, Lana; Silver, Cheryl; Bowers, Daniel C; Stavinoha, Peter L

    2016-01-01

    It has been proposed previously that extrinsic motivation may enable survivors of childhood medulloblastoma to significantly improve aspects of neurocognitive performance. In healthy populations, enhanced motivation has been shown to promote academic fluency, a domain likely more relevant to the educational outcomes of pediatric medulloblastoma survivors than academic skill development. The present study investigates the effect of enhanced extrinsic motivation on fluent (i.e., accurate and efficient) academic performance in pediatric medulloblastoma survivors. Participants were 36 children, ages 7-18, who had completed treatment for medulloblastoma. Participants completed a neuropsychological battery that included administration of equivalent tasks on Forms A and B of the Woodcock-Johnson III Tests of Achievement. Half were randomly assigned to an incentive condition prior to the administration of Form B. Provision of a performance-based incentive resulted in statistically significant improvement, but not normalization of function, in performance on measures of academic fluency. No demographic, treatment-related, academic, neuropsychological, or self-perception variables predicted response to incentive. Findings suggest that academic performance of survivors may significantly improve under highly motivating conditions. In addition to implications for educational services, this finding raises the novel possibility that decreased motivation represents an inherent neuropsychological deficit in this population and provides a rationale for further investigation of factors affecting individual differences in motivational processes. Further, by examining effort in a context where effort is not inherently suspect, present findings also significantly contribute to the debate regarding the effects of effort and motivation on neuropsychological performance.

  1. The Benefit of Experiencing Risk in Addition to Friluftsliv.

    Science.gov (United States)

    Cusack, Andrew

    2002-01-01

    The best way to reach self-realization, an ever-widening identification with nature, is through the Norwegian tradition of friluftsliv, a nonaggressive, environmentally sensitive approach to being in nature. When risk is associated with friluftsliv and not pursued for its own sake, it helps one achieve self-realization. Reliance on technology for…

  2. Geothermal energy combined with CO2 sequestration : An additional benefit

    NARCIS (Netherlands)

    Salimi, H.; Wolf, K.H.A.A.; Bruining, J.

    2012-01-01

    In this transition period from a fossil-fuel based society to a sustainable-energy society, it is expected that CO2 capture and subsequent sequestration in geological formations plays a major role in reducing greenhouse gas emissions. An alternative for CO2 emission reduction is to partially replace

  3. [Porphyria cutanea tarda: the benefit of additional diagnostics].

    Science.gov (United States)

    Vossen, Allard R J V; Boesten, Lianne S M; Siersema, Peter D; Nellen, Ruud G L

    2016-01-01

    The porphyrias are a clinically and genetically heterogeneous group of relatively rare metabolic diseases that result from disorders in the biosynthesis of haeme. Porphyria cutanea tarda (PCT) is the most common type, accounting for 80-90% of all porphyrias, and is essentially an acquired disease, although PCT can also occur on a familial basis. We describe a 71-year-old female and a 62-year-old male patient, both of whom had several risk factors for developing PCT, ranging from iron overload due to a mutation in the hereditary haemochromatosis protein (HFE) gene, alcohol use, smoking, and exogenous oestrogen, to persistent hepatitis C infection. The clinical relevance of the several diagnostic modalities is important in PCT. Diagnostic evaluation is important in order to confirm the diagnosis, but also to evaluate the treatment response in the context of long-term follow-up in the prevention of late complications of PCT, i.e. hepatocellular carcinoma.

  4. Does betahistine treatment have additional benefits to vestibular rehabilitation?

    Science.gov (United States)

    Karapolat, Hale; Celebisoy, Nese; Kirazli, Yesim; Bilgen, Cem; Eyigor, Sibel; Gode, Sercan; Akyuz, Aycan; Kirazli, Tayfun

    2010-08-01

    The aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n = 24) and the VR + betahistine group (group 2, n = 23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p VR and betahistine + VR have a positive effect on disability and balance in patients with unilateral vestibular disorder. Betahistine treatment added to VR was effective in increasing postural stability.

  5. HPV vaccine cross-protection: Highlights on additional clinical benefit.

    Science.gov (United States)

    De Vincenzo, Rosa; Ricci, Caterina; Conte, Carmine; Scambia, Giovanni

    2013-09-01

    Prophylactic human papillomavirus (HPV) vaccines are administered in vaccination programs, targeted at young adolescent girls before sexual exposure, and in catch-up programs for young women in some countries. All the data indicate that HPV-virus-like particles (VLPs) effectively prevent papillomavirus infections with a high level of antibodies and safety. Since non-vaccine HPV types are responsible for about 30% of cervical cancers, cross-protection would potentially enhance primary cervical cancer prevention efforts. High levels of specific neutralizing antibodies can be generated after immunization with HPV VLPs. Immunity to HPV is type-specific. However, if we consider the phylogenetic tree including the different HPV types, we realize that a certain degree of cross-protection is possible, due to the high homology of some viral types with vaccine ones. The assessment of cross-protective properties of HPV vaccines is an extremely important matter, which has also increased public health implications and could add further value to their preventive potential. The impact of cross-protection is mostly represented by a reduction of cervical intraepithelial neoplasia CIN2-3 more than what expected. In this article we review the mechanisms and the effectiveness of Bivalent (HPV-16/-18) and Quadrivalent (HPV-6/-11/-16/-18) HPV vaccine cross-protection, focusing on the critical aspects and the potential biases in clinical trials, in order to understand how cross-protection could impact on clinical outcomes and on the new perspectives in post-vaccine era. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. 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.).

  7. Addition of Rice Bran Arabinoxylan to Curcumin Therapy May Be of Benefit to Patients With Early-Stage B-Cell Lymphoid Malignancies (Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma, or Stage 0/1 Chronic Lymphocytic Leukemia): A Preliminary Clinical Study.

    Science.gov (United States)

    Golombick, Terry; Diamond, Terrence H; Manoharan, Arumugam; Ramakrishna, Rajeev

    2016-06-01

    Hypothesis Prior studies on patients with early B-cell lymphoid malignancies suggest that early intervention with curcumin may lead to delay in progressive disease and prolonged survival. These patients are characterized by increased susceptibility to infections. Rice bran arabinoxylan (Ribraxx) has been shown to have immunostimulatory, anti-inflammatory, and proapoptotic effects. We postulated that addition of Ribraxx to curcumin therapy may be of benefit. Study design Monoclonal gammopathy of undetermined significance (MGUS)/smoldering multiple myeloma (SMM) or stage 0/1 chronic lymphocytic leukemia (CLL) patients who had been on oral curcumin therapy for a period of 6 months or more were administered both curcumin (as Curcuforte) and Ribraxx. Methods Ten MGUS/SMM patients and 10 patients with stage 0/1 CLL were administered 6 g of curcumin and 2 g Ribraxx daily. Blood samples were collected at baseline and at 2-month intervals for a period of 6 months, and various markers were monitored. MGUS/SMM patients included full blood count (FBC); paraprotein; free light chains/ratio; C-reactive protein (CRP)and erythrocyte sedimentation rate (ESR); B2 microglobulin and immunological markers. Markers monitored for stage 0/1 CLL were FBC, CRP and ESR, and immunological markers. Results Of 10 MGUS/SMM patients,5 (50%) were neutropenic at baseline, and the Curcuforte/Ribraxx combination therapy showed an increased neutrophil count, varying between 10% and 90% among 8 of the 10 (80%) MGUS/SMM patients. An additional benefit of the combination therapy was the potent effect in reducing the raised ESR in 4 (44%) of the MGUS/SMM patients. Conclusion Addition of Ribraxx to curcumin therapy may be of benefit to patients with early-stage B-cell lymphoid malignancies. © The Author(s) 2016.

  8. The effect of complementary and alternative medicine on the quality of life of cancer survivors: a systematic review and meta-analyses.

    Science.gov (United States)

    Shneerson, Catherine; Taskila, Taina; Gale, Nicola; Greenfield, Sheila; Chen, Yen-Fu

    2013-08-01

    To assess whether quality of life (QOL) improved in cancer survivors who had undertaken a complementary and alternative medicine (CAM) intervention, compared to cancer survivors who had not. A systematic review of randomised controlled trials (RCTs) was undertaken. Electronic databases including MEDLINE, Cochrane CENTRAL, CINAHL, PSYCHINFO, EMBASE, and ClinicalTrials.gov were searched from 1990 to 2012. Search terms incorporating the concepts of cancer survivors, QOL and various types of CAM were used. From 1767 records retrieved and screened 13 full text articles were included in the review. Nine studies were deemed to have a high risk, one a low risk, and three an unclear risk of bias. CAM interventions used incorporated yoga, meditation or mindfulness, energy healing, medical qigong, homoeopathy, or mistletoe therapy. Ten of the studies used breast cancer survivors, whilst the remaining three included other cancer types. The studies had mixed results either showing a significantly greater improvement in QOL in the intervention group compared to the control group, or no significant difference between groups. However, twelve studies were of low to moderate quality, limiting the robustness of findings. This review has identified significant gaps in the evidence base for the effectiveness of CAM on QOL in cancer survivors. Further work in this field needs to adopt more rigorous methodology to help support cancer survivors to actively embrace self-management and effective CAMs, without recommending inappropriate interventions which are of no proven benefit. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. 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.

  10. 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.

  11. Body mass index and the quality of life of endometrial cancer survivors--a systematic review and meta-analysis.

    Science.gov (United States)

    Smits, Anke; Lopes, Alberto; Bekkers, Ruud; Galaal, Khadra

    2015-04-01

    Obesity is a risk factor for developing endometrial cancer and known to negatively affect outcomes and survival. However, the association between obesity and quality of life of endometrial cancer survivors (ECS) remains unclear. To assess the association between body mass index (BMI) and the quality of life of endometrial cancer survivors. In addition we assessed the associations between BMI and anxiety, depression and sexual function of endometrial cancer survivors. The review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the Cochrane Handbook for Systematic Reviews of Interventions. We performed a search of Medline (1946-2014), Embase (1980-2014), Cinahl (1981-2014), and PsycInfo (1806-2014) to identify studies that reported on the association between BMI and quality of life outcomes in endometrial cancer survivors. Seven studies fulfilled the inclusion criteria, of which four studies could be included in the analysis. The four studies which included 1362 patients, showed that obese survivors had a significantly poorer physical functioning (P=0.001, MD: -11.61, 95% CI: -18.66 to -4.55), social functioning (P=0.01, MD: -4.37, 95% CI: -7.75 to -1.00) and role functioning (P=0.002, MD: -5.44 95% CI: -8.90 to -1.98) when compared to non-obese women. Emotional functioning and cognitive functioning did not show significant differences (P=0.18, P=0.21). Obesity is associated with poorer quality of life outcomes in endometrial cancer survivors, including poorer physical, role and social functioning. Future research should be directed at lifestyle interventions aiming to enhance the quality of life of this group of survivors. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Original research: Giving sexual assault survivors time to decide: an exploration of the use and effects of the nonreport option.

    Science.gov (United States)

    Heffron, Laurie Cook; Busch-Armendariz, Noël Bridget; Vohra, Shetal S; Johnson, Regina Jones; Camp, Victoria

    2014-03-01

    Forensic nurses, sexual assault nurse examiners (SANEs), and victim advocates have long recognized the trauma of sexual assault crimes and the significance of survivors' decisions around reporting these crimes to law enforcement agencies. Until recently, survivors who didn't report the crime were not entitled to a free medical forensic examination. In a significant policy shift, the Violence Against Women and Department of Justice Reauthorization Act of 2005 provided an additional decision option with regard to the medical examination for survivors of sexual assault. This provision, referred to here as the nonreport option, was established to offer survivors a full range of reporting options and to ensure exemplary health care, with evidence collection as an important secondary goal. This study sought to examine the implementation of the nonreport option in Texas; explore its impact on SANEs, survivors, and the criminal justice system; and identify strengths and challenges of the nonreport process. A mixed-method approach was used that included qualitative interviews with 79 professionals who regularly respond to sexual assault crimes, a Web-based survey questionnaire of such professionals that yielded 131 completed surveys, and a review of existing data. The step-by-step process involved in a nonreport case was described, and findings in three descriptive areas emerged: confidentiality processes, storage and shipment of evidence, and the use of the nonreport option. Beneficial effects of the nonreport option were identified in five areas: the role of SANEs, the impact on survivors, collaborative relationships, collateral crimes, and anonymous reporting strategies. Seven areas of remaining dilemmas were also identified. Findings indicate that the nonreport option has had a considerable positive impact on SANEs, survivors of sexual assault, and the criminal justice system. But challenges remain if this option is to be fully utilized in the future; further research

  13. 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

  14. 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.

  15. 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...

  16. 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.

  17. Peer Victimization in Extremely Low Birth Weight Survivors.

    Science.gov (United States)

    Day, Kimberly L; Van Lieshout, Ryan J; Vaillancourt, Tracy; Saigal, Saroj; Boyle, Michael H; Schmidt, Louis A

    2015-12-01

    Extremely low birth weight (ELBW; peer victimization. We examined retrospectively reported peer victimization in ELBW and control children in the oldest known, prospectively followed, population-based birth cohort of ELBW survivors. We compared levels of verbal and physical peer victimization in ELBW and control children. We also predicted peer victimization in the ELBW sample from child characteristics. ELBW children, especially girls, were at an increased risk for verbal, but not physical victimization. In addition, ELBW children with a higher IQ reported higher levels of verbal victimization, although ELBW females who had a lower body mass index in childhood reported higher levels of physical victimization. Findings highlight the need for parents and clinicians to be aware that ELBW girls, especially those with a lower body mass index in childhood, may be at increased risk of peer victimization, as are ELBW children with a higher IQ. © The Author(s) 2015.

  18. A retrospective comparison of survivors and non-survivors of massive pulmonary embolism receiving veno-arterial extracorporeal membrane oxygenation support.

    Science.gov (United States)

    George, Bennet; Parazino, Marc; Omar, Hesham R; Davis, George; Guglin, Maya; Gurley, John; Smyth, Susan

    2018-01-01

    While the optimal care of patients with massive pulmonary embolism (PE) is unclear, the general goal of therapy is to rapidly correct the physiologic derangements propagated by obstructive clot. Extracorporeal membrane oxygenation (ECMO) in this setting is promising, however the paucity of data limits its routine use. Our institution expanded the role of ECMO as an advanced therapy option in the initial management of massive PE. The purpose of this project was to evaluate ECMO-treated patients with massive PE at an academic medical center and report shortterm mortality outcomes. Thirty-two patients placed on ECMO for confirmed, massive PE from January 2012 to December 2015 were retrospectively analyzed. All patients had PE confirmed by computerized tomography and/or invasive pulmonary angiography. In our population of patients managed with ECMO, 21 (65.6%) patients survived to decannulation and 17 (53.1%) survived index hospitalization. Baseline characteristics and clinical variables showed no difference in age, gender, right ventricular-to-left ventricular ratios, or peak troponin-T between survivors and non-survivors. Non-survivors tended to have a previous history of malignancy. Cardiac arrest prior to ECMO cannulation was associated with worse outcomes. All 5 patients who received concomitant systemic thrombolysis died, while 11 of 15 patients who received catheter-directed thrombolysis survived. A lactic acid level ≤6mmol/L had an 82.4% sensitivity and 84.6% specificity for predicting survival to discharge. The practical approach of utilizing ECMO for massive PE is to reserve it for those who would receive the greatest benefit. Patients with poor perfusion, for example from cardiac arrest, may gain less benefit from ECMO. Our findings indicate that a serum lactate >6mmol/L may be an indicator of worse prognosis. Finally, in our patient population, catheter-directed thrombolytics was effectively combined with ECMO. Copyright © 2017 Elsevier B.V. All rights

  19. Impact of a brief exercise program on the physical and psychosocial health of prostate cancer survivors: A pilot study.

    Science.gov (United States)

    Skinner, Tina L; Peeters, Gmme Geeske; Croci, Ilaria; Bell, Katherine R; Burton, Nicola W; Chambers, Suzanne K; Bolam, Kate A

    2016-09-01

    It is well established that exercise is beneficial for prostate cancer survivors. The challenge for health professionals is to create effective strategies to encourage survivors to exercise in the community. Many community exercise programs are brief in duration (e.g. exercise sessions); whilst evidence for the efficacy of exercise within the literature are derived from exercise programs ≥8 weeks in duration, it is unknown if health benefits can be obtained from a shorter program. This study examined the effect of a four-session individualized and supervised exercise program on the physical and psychosocial health of prostate cancer survivors. Fifty-one prostate cancer survivors (mean age 69±7 years) were prescribed 1 h, individualized, supervised exercise sessions once weekly for 4 weeks. Participants were encouraged to increase their physical activity levels outside of the exercise sessions. Objective measures of muscular strength, exercise capacity, physical function and flexibility; and self-reported general, disease-specific and psychosocial health were assessed at baseline and following the intervention. Improvements were observed in muscle strength (leg press 17.6 percent; P exercise capacity (400-m walk 9.3 percent; P exercise program. A four-session exercise program significantly improved the muscular strength, exercise capacity, physical function and positive well-being of prostate cancer survivors. This short-duration exercise program is safe and feasible for prostate cancer survivors and a randomized controlled trial is now required to determine whether a similar individualized exercise regimen improves physical health and mental well-being over the short, medium and long term. © 2016 John Wiley & Sons Australia, Ltd.

  20. Theory-Based Predictors of Follow-Up Exercise Behavior After A Supervised Exercise Intervention in Older Breast Cancer Survivors

    Science.gov (United States)

    Loprinzi, Paul D.; Cardinal, Bradley J.; Si, Qi; Bennett, Jill A.; Winters-Stone, Kerri

    2014-01-01

    Purpose Supervised exercise interventions can elicit numerous positive health outcomes in older breast cancer survivors. However, to maintain these benefits, regular exercise needs to be maintained long after the supervised program. This may be difficult, as in this transitional period (i.e., time period immediately following a supervised exercise program), breast cancer survivors are in the absence of on-site direct supervision from a trained exercise specialist. The purpose of the present study was to identify key determinants of regular exercise participation during a 6-month follow-up period after a 12-month supervised exercise program among women aged 65+ years who had completed adjuvant treatment for breast cancer. Methods At the conclusion of a supervised exercise program, and 6-months later, 69 breast cancer survivors completed surveys examining their exercise behavior and key constructs from the Transtheoretical Model. Results After adjusting for weight status and physical activity at the transition point, breast cancer survivors with higher self-efficacy at the point of transition were more likely to be active 6-months after leaving the supervised exercise program (OR [95% CI]: 1.10 [1.01–1.18]). Similarly, breast cancer survivors with higher behavioral processes of change use at the point of transition were more likely to be active (OR [95% CI]: 1.13 [1.02–1.26]). Conclusion These findings suggest that self-efficacy and the behavioral processes of change, in particular, play an important role in exercise participation during the transition from a supervised to a home-based program among older breast cancer survivors. PMID:22252545

  1. Prevalence and correlates of fear of recurrence among adolescent and young adult versus older adult post-treatment cancer survivors.

    Science.gov (United States)

    Shay, L Aubree; Carpentier, Melissa Y; Vernon, Sally W

    2016-11-01

    We sought to (1) assess prevalence of fear of recurrence among cancer survivors diagnosed as adolescent and young adults (AYA; 15-39 years) versus those diagnosed at a later age (40+ years) and (2) identify factors associated with fear of recurrence in each group. We used logistic regression to determine the correlates of fear of recurrence by age group at diagnosis among survivors responding to the 2010 LIVESTRONG survey. Prevalence of fear of recurrence was significantly higher among AYA survivors (85.2 %) than those diagnosed at an older age (79.7 %). Among AYA respondents, being employed and less than 5 years off treatment were positively associated with fear of recurrence while those with thyroid cancer and those who participated in a clinical trial were less likely to experience fear of recurrence. Among older adults, receipt of surgery was associated with fear of recurrence whereas having insurance coverage through Medicare or Medicaid and positive patient-provider communication were negatively associated with fear of recurrence. For both AYA and older adult survivors, changeable factors such as having a more positive cancer care experience may impact fear of recurrence. Our findings highlight the need to identify and understand aspects of the communication process that can be targeted in future interventions with survivors and healthcare providers to ensure that fear of recurrence is being appropriately managed. Factors associated with fear of recurrence differ for AYA and older adult survivors; thus, interventions would likely benefit from tailoring based on age at diagnosis.

  2. The experience of treatment barriers and their influence on quality of life in American Indian/Alaska Native breast cancer survivors.

    Science.gov (United States)

    Goodwin, Elizabeth A; Burhansstipanov, Linda; Dignan, Mark; Jones, Katherine L; Kaur, Judith Salmon

    2017-03-01

    American Indian and Alaska Native (AI/AN) breast cancer survivors experience disparities in breast cancer incidence and age-adjusted mortality compared with non-Hispanic white (NHW) breast cancer survivors. In addition, mortality-to-incidence rates indicate that AI/ANs continue to have the poorest survival from breast cancer compared with other racial groups. "Native American Cancer Education for Survivors" (NACES) is a cultural education and support intervention for AI/AN patients with cancer that collects data from voluntary participants through the NACES quality-of-life (QOL) survey regarding their cancer experience and survivor journey. Data from the NACES QOL survey were analyzed to determine whether barriers accessing and during initial cancer treatment impacted QOL domains for AI/AN cancer survivors. Exploratory analyses of selected variables were conducted and were followed by Kruskal-Wallis tests to determine whether these barriers influenced survivorship QOL for AI/AN breast cancer survivors. AI/AN breast cancer survivors' social QOL was significantly affected by barriers to accessing cancer treatment. Many respondents experienced barriers, including a lack of cancer care at local clinics and the distance traveled to receive cancer care. During treatment, too much paperwork and having to wait too long in the clinic for cancer care were the most frequently reported barriers. Treatment barriers influence AI/AN breast cancer survivors' social QOL. Mediating these barriers is crucial to ameliorating AI/AN survivors' disparities when accessing and completing cancer treatment and improving survivorship QOL. Cancer 2017;123:861-68. © 2016 American Cancer Society. © 2016 American Cancer Society.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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: (...

  8. 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...

  9. Unconventional cytokine profiles and development of T cell memory in long-term survivors after cancer vaccination

    DEFF Research Database (Denmark)

    Kyte, Jon Amund; Trachsel, Sissel; Risberg, Bente

    2009-01-01

    Cancer vaccine trials frequently report on immunological responses, without any clinical benefit. This paradox may reflect the challenge of discriminating between effective and pointless immune responses and sparse knowledge on their long-term development. Here, we have analyzed T cell responses...... in long-term survivors after peptide vaccination. There were three main study aims: (1) to characterize the immune response in patients with a possible clinical benefit. (2) To analyze the long-term development of responses and effects of booster vaccination. (3) To investigate whether the Th1/Th2...... display unconventional cytotoxicity and specifically kill tumor cells expressing mutated TGFbeta receptor II. Cytokine profiling on the long-term survivors demonstrates high IFN gamma/IL10-ratios, favoring immunity over tolerance, and secretion of multiple chemokines likely to mobilize the innate...

  10. Revictimization as a moderator of psychosocial risk factors for problem drinking in female sexual assault survivors.

    Science.gov (United States)

    Ullman, Sarah E; Najdowski, Cynthia J

    2009-01-01

    Adult sexual assault (ASA) survivors report greater levels of problem drinking than do other women, and research suggests that their coping strategies, reactions from their social networks, and traumatic life events affect their problem drinking. The links between these factors and problem drinking may be moderated by whether survivors are revictimized, yet research has not examined this possibility. Therefore, the current study examined psychosocial factors, problem drinking, and revictimization in women ASA survivors. Community-dwelling urban women (n = 555) who had experienced an ASA completed a mail survey at Time 1 (T1) and were resurveyed 1 year later to examine how revictimization between survey waves moderated the effects of coping strategies, social reactions to assault disclosures, and traumatic life events on problem drinking at Time 2 (T2). The findings showed that recent revictimization that occurred between surveys was related to increased problem drinking at T2, after T1 problem drinking was controlled for. Moderated hierarchical multiple regressions showed that survivors who engaged in drinking to cope with distress, who received negative social reactions in response to recent assault disclosures, or who experienced additional traumatic events had increased T2 problem drinking only if they were revictimized since T1. Psychosocial factors relate to increases in problem drinking for sexually revictimized women but not for nonrevictimized women. Interventions to reduce problem drinking in women ASA survivors should target drinking to cope with assault-related symptomatology, informal social networks to improve their supportiveness, and safety issues through risk-reduction education and self-defense training for women when appropriate.

  11. Revictimization as a Moderator of Psychosocial Risk Factors for Problem Drinking in Female Sexual Assault Survivors*

    Science.gov (United States)

    Ullman, Sarah E.; Najdowski, Cynthia J.

    2009-01-01

    Objective: Adult sexual assault (ASA) survivors report greater levels of problem drinking than do other women, and research suggests that their coping strategies, reactions from their social networks, and traumatic life events affect their problem drinking. The links between these factors and problem drinking may be moderated by whether survivors are revictimized, yet research has not examined this possibility. Therefore, the current study examined psychosocial factors, problem drinking, and revictimization in women ASA survivors. Method: Community-dwelling urban women (n = 555) who had experienced an ASA completed a mail survey at Time 1 (T1) and were resurveyed 1 year later to examine how revictimization between survey waves moderated the effects of coping strategies, social reactions to assault disclosures, and traumatic life events on problem drinking at Time 2 (T2). Results: The findings showed that recent revictimization that occurred between surveys was related to increased problem drinking at T2, after T1 problem drinking was controlled for. Moderated hierarchical multiple regressions showed that survivors who engaged in drinking to cope with distress, who received negative social reactions in response to recent assault disclosures, or who experienced additional traumatic events had increased T2 problem drinking only if they were revictimized since T1. Conclusions: Psychosocial factors relate to increases in problem drinking for sexually revictimized women but not for nonrevictimized women. Interventions to reduce problem drinking in women ASA survivors should target drinking to cope with assault-related symptomatology, informal social networks to improve their supportiveness, and safety issues through risk-reduction education and self-defense training for women when appropriate. PMID:19118390

  12. Core Domains for Clinical Research in Acute Respiratory Failure Survivors: An International Modified Delphi Consensus Study.

    Science.gov (United States)

    Turnbull, Alison E; Sepulveda, Kristin A; Dinglas, Victor D; Chessare, Caroline M; Bingham, Clifton O; Needham, Dale M

    2017-06-01

    To identify the "core domains" (i.e., patient outcomes, health-related conditions, or aspects of health) that relevant stakeholders agree are essential to assess in all clinical research studies evaluating the outcomes of acute respiratory failure survivors after hospital discharge. A two-round consensus process, using a modified Delphi methodology, with participants from 16 countries, including patient and caregiver representatives. Prior to voting, participants were asked to review 1) results from surveys of clinical researchers, acute respiratory failure survivors, and caregivers that rated the importance of 19 preliminary outcome domains and 2) results from a qualitative study of acute respiratory failure survivors' outcomes after hospital discharge, as related to the 19 preliminary outcome domains. Participants also were asked to suggest any additional potential domains for evaluation in the first Delphi survey. Web-based surveys of participants representing four stakeholder groups relevant to clinical research evaluating postdischarge outcomes of acute respiratory failure survivors: clinical researchers, clinicians, patients and caregivers, and U.S. federal research funding organizations. None. None. Survey response rates were 97% and 99% in round 1 and round 2, respectively. There were seven domains that met the a priori consensus criteria to be designated as core domains: physical function, cognition, mental health, survival, pulmonary function, pain, and muscle and/or nerve function. This study generated a consensus-based list of core domains that should be assessed in all clinical research studies evaluating acute respiratory failure survivors after hospital discharge. Identifying appropriate measurement instruments to assess these core domains is an important next step toward developing a set of core outcome measures for this field of research.

  13. Access to HIV prevention services among gender based violence survivors in Tanzania

    Science.gov (United States)

    Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

    2012-01-01

    Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278

  14. Ostomy telehealth for cancer survivors: Design of the Ostomy Self-management Training (OSMT) randomized trial.

    Science.gov (United States)

    Sun, Virginia; Ercolano, Elizabeth; McCorkle, Ruth; Grant, Marcia; Wendel, Christopher S; Tallman, Nancy J; Passero, Frank; Raza, Sabreen; Cidav, Zuleyha; Holcomb, Michael; Weinstein, Ronald S; Hornbrook, Mark C; Krouse, Robert S

    2018-01-01

    An ostomy adversely affects health-related quality of life (HRQOL) in a diverse population of cancer survivors and their caregivers. Hit-or-miss ostomy care, nurse counseling, and community referral have been the primary modes of self-management education and support in the peri-operative setting. Few evidence-based, systematic ostomy self-management programs are available to ensure optimal post-operative care. This paper describes the study design of a telehealth-based Ostomy Self-management Training (OSMT) program for cancer survivors and their caregivers. The study is a three-year, randomized trial that tests the effectiveness of the OSMT program on survivor activation, self-efficacy, and HRQOL. The intervention integrates goal setting and problem-solving approaches to enhance survivor activation and self-efficacy to carry out ostomy care. The curriculum is delivered via four group sessions administered by trained ostomy certified nurses (WOCNs) and peer ostomates. An additional session is offered to caregivers to address their needs in relation to ostomy care. Telehealth approaches through videoconferencing are used to enhance program delivery to participants in three different geographic areas across two time zones. Participants join sessions via real-time videoconferencing from their homes. The OSMT program has high potential to make a positive impact on the unique physical, psychological, social, and spiritual needs of cancer survivors living with a permanent ostomy. The study design, process, and telehealth approach contributes to the success of future dissemination efforts of the intervention into diverse clinical and community settings. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. 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.

  16. 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.

  17. Ocular injuries in survivors of improvised explosive devices (IED) in commuter trains

    OpenAIRE

    Agarwal Vinay; Mehta Salil; Jiandani Prakash

    2007-01-01

    Abstract Background Ocular injuries are common in survivors of terror incidents that involve the use of explosive materials. These explosives are commonly of a High Explosive type (HE) and may be fashioned into improvised explosive devices (IED) that incorporate additional materials to maximise trauma and injuries. Serial IED explosions have occurred in commuter trains in several cities including London and Madrid but data on ocular injuries is limited. We report the ocular injuries of the su...

  18. Ankle-foot orthoses that restrict dorsiflexion improve walking in polio survivors with calf muscle weakness.

    Science.gov (United States)

    Ploeger, Hilde E; Bus, Sicco A; Brehm, Merel-Anne; Nollet, Frans

    2014-07-01

    In polio survivors with calf muscle weakness, dorsiflexion-restricting ankle-foot orthoses (DR-AFOs) aim to improve gait in order to reduce walking-related problems such as instability or increased energy cost. However, evidence on the efficacy of DR-AFOs in polio survivors is lacking. We investigated the effect of DR-AFOs on gait biomechanics, walking energy cost, speed, and perceived waking ability in this patient group. Sixteen polio survivors with calf muscle weakness underwent 3D-gait analyses to assess gait biomechanics when walking with a DR-AFOs and with shoes only. Ambulant registration of gas-exchange during a 6 min walk test determined walking energy cost, and comfortable gait speed was calculated from the walked distance during this test. Perceived walking ability was assessed using purposely-designed questionnaires. Compared with shoes-only, walking with the DR-AFOs significantly increased forward progression of the center of pressure (CoP) in mid-stance and it reduced ankle dorsiflexion and knee flexion in mid- and terminal stance (p muscle weakness, DR-AFOs improved gait biomechanics, speed, and perceived walking ability, compared to shoes-only. Effects may depend on the shoes-only gait pattern, therefore further study is needed to determine which patients benefit most from the DR-AFO. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Interval versus continuous aerobic exercise training in breast cancer survivors--a pilot RCT.

    Science.gov (United States)

    Dolan, Lianne B; Campbell, Kristin; Gelmon, Karen; Neil-Sztramko, Sarah; Holmes, Daniel; McKenzie, Donald C

    2016-01-01

    Exercise therapy is being explored in a variety of cancer populations to counteract treatment-related deconditioning. Higher intensity interval protocols are being prescribed to improve physical function and attenuate surrogates of comorbidity in non-cancer populations. The purpose of this study is to explore the safety of higher intensity exercise stimuli on cardiorespiratory fitness (VO2peak) in breast cancer survivors. Postmenopausal breast cancer survivors were randomized into three groups: supervised aerobic interval training (AIT), supervised continuous moderate exercise training (CMT), and an unsupervised control group (CON). For 6 weeks, AIT exercised between 70 and 100% VO2peak, while CMT exercised between 60 and 70% VO2peak. Both groups followed a matched-work design. Thirty-three participants completed the study (age, 57.2 (9) years; weight, 67.6 (12) kg) with no adverse advents. Between-group baseline values were non-significant. VO2peak at baseline (25.3 (5.4) mL·kg(-1)·min(-1)) was below population norms. Compared to CON, cardiorespiratory fitness improved in AIT and CMT by 12% (P exercise groups. AIT had a greater influence on lower extremity strength (P = 0.026) and body weight (P = 0.031). This pilot study provides evidence that similar to CMT, AIT can safely increase VO2peak in a small group of breast cancer survivors. Further exploration of the benefits of implementing higher intensity training protocols is warranted.

  20. The Evolution of Mindfulness-Based Physical Interventions in Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Daniela L. Stan

    2012-01-01

    Full Text Available Survivors of breast cancer are faced with a multitude of medical and psychological impairments during and after treatment and throughout their lifespan. Physical exercise has been shown to improve survival and recurrence in this population. Mind-body interventions combine a light-moderate intensity physical exercise with mindfulness, thus having the potential to improve both physical and psychological sequelae of breast cancer treatments. We conducted a review of mindfulness-based physical exercise interventions which included yoga, tai chi chuan, Pilates, and qigong, in breast cancer survivors. Among the mindfulness-based interventions, yoga was significantly more studied in this population as compared to tai chi chuan, Pilates, and qigong. The participants and the outcomes of the majority of the studies reviewed were heterogeneous, and the population included was generally not selected for symptoms. Yoga was shown to improve fatigue in a few methodologically strong studies, providing reasonable evidence for benefit in this population. Improvements were also seen in sleep, anxiety, depression, distress, quality of life, and postchemotherapy nausea and vomiting in the yoga studies. Tai chi chuan, Pilates, and qigong were not studied sufficiently in breast cancer survivors in order to be implemented in clinical practice.

  1. Predictors of Posttraumatic Stress and Posttraumatic Growth in Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Veronika Koutná

    2017-03-01

    Full Text Available This longitudinal study aims to analyze predictors of posttraumatic stress symptoms (PTSS and posttraumatic growth (PTG among gender, age, objective factors of the disease and its treatment, family environment factors and negative emotionality. The sample consisted of 97 childhood cancer survivors (50 girls and 47 boys aged 11–25 years who were in remission 1.7 to seven years at T1 and four to 12.5 years at T2. Survivors completed a set of questionnaires including the Benefit Finding Scale for Children and the University of California at Los Angeles Posttraumatic Stress Disorder Index. Regression and correlation analyses were performed. The relation between PTSS and PTG was not proven. A higher level of PTSS (T2 was associated with higher levels of negative emotionality (T1. A higher level of PTG (T2 was connected to a higher level of warmth in parenting (T1, female gender and older age at assessment. Medical variables such as the severity of late effects and the time from treatment completion did not play a significant role in the prediction of PTSS and PTG. PTG and PTSS are more influenced by factors of parenting and emotional well-being of childhood cancer survivors than by objective medical data.

  2. Yoga & Cancer Interventions: A Review of the Clinical Significance of Patient Reported Outcomes for Cancer Survivors

    Directory of Open Access Journals (Sweden)

    S. Nicole Culos-Reed

    2012-01-01

    Full Text Available Limited research suggests yoga may be a viable gentle physical activity option with a variety of health-related quality of life, psychosocial and symptom management benefits. The purpose of this review was to determine the clinical significance of patient-reported outcomes from yoga interventions conducted with cancer survivors. A total of 25 published yoga intervention studies for cancer survivors from 2004–2011 had patient-reported outcomes, including quality of life, psychosocial or symptom measures. Thirteen of these studies met the necessary criteria to assess clinical significance. Clinical significance for each of the outcomes of interest was examined based on 1 standard error of the measurement, 0.5 standard deviation, and relative comparative effect sizes and their respective confidence intervals. This review describes in detail these patient-reported outcomes, how they were obtained, their relative clinical significance and implications for both clinical and research settings. Overall, clinically significant changes in patient-reported outcomes suggest that yoga interventions hold promise for improving cancer survivors' well-being. This research overview provides new directions for examining how clinical significance can provide a unique context for describing changes in patient-reported outcomes from yoga interventions. Researchers are encouraged to employ indices of clinical significance in the interpretation and discussion of results from yoga studies.

  3. 20 CFR Appendix II to Subpart C of... - Benefit Formulas Used With Average Indexed Monthly Earnings

    Science.gov (United States)

    2010-04-01

    ... Monthly Earnings II Appendix II to Subpart C of Part 404 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts... Indexed Monthly Earnings As explained in § 404.212, we use one of the formulas below to compute your...

  4. Self-blame, self-forgiveness, and spirituality in breast cancer survivors in a public sector setting.

    Science.gov (United States)

    Friedman, Lois C; Barber, Catherine R; Chang, Jenny; Tham, Yee Lu; Kalidas, Mamta; Rimawi, Mothaffar F; Dulay, Mario F; Elledge, Richard

    2010-09-01

    Cognitive appraisal affects adjustment to breast cancer. A self-forgiving attitude and spirituality may benefit breast cancer survivors who blame themselves for their cancer. One hundred and eight women with early breast cancers completed questionnaires assessing self-blame, self-forgiveness, spirituality, mood and quality of life (QoL) in an outpatient breast clinic. Women who blamed themselves reported more mood disturbance (p self-forgiveness and spirituality could promote better adjustment to breast cancer.

  5. Physical activity, bowel function, and quality of life among rectal cancer survivors.

    Science.gov (United States)

    Krouse, Robert S; Wendel, Christopher S; Garcia, David O; Grant, Marcia; Temple, Larissa K F; Going, Scott B; Hornbrook, Mark C; Bulkley, Joanna E; McMullen, Carmit K; Herrinton, Lisa J

    2017-11-01

    Physical activity (PA) is positively associated with numerous health benefits among cancer survivors. This study examined insufficiently investigated relationships among PA, health-related quality of life (HRQOL), and bowel function (BF) in rectal cancer survivors. RC survivors (n = 1063) ≥5 years from diagnosis in two Kaiser permanente regions were mailed a multidimensional survey to assess HRQOL and BF. PA was assessed by a modified Godin Leisure-Time Exercise Questionnaire. PA minutes were categorized into weighted categories based on guidelines: (1) not active (zero PA minutes); (2) insufficiently active (1-149 PA minutes); (3) meeting guidelines (150-299 PA minutes); and (4) above guidelines (≥300 PA minutes). Relationships of PA with HRQOL and BF were evaluated using multiple linear regression, stratified by sex and ostomy status for BF. Types of PA identified as helpful for BF and symptoms addressed were summarized. Response rate was 60.5%. Of 557 participants, 40% met or exceeded PA guidelines, 34% were not active, and 26% were insufficiently active. Aerobic activities, specifically walking and cycling, were most commonly reported to help BF. Higher PA was associated with better psychological wellbeing and multiple SF12 scales, worse BF scores in men with ostomies, and better BF scores in women. Meeting or exceeding PA guidelines was associated with higher HRQOL. Although the BF findings are exploratory, they suggest women may benefit from increased PA, whereas men with ostomies may face challenges that require more study. Identifying PA strategies that will lead to improved patient compliance and benefit are needed.

  6. Psychological Outcomes among Lesbian Sexual Assault Survivors: An Examination of the Roles of Internalized Homophobia and Experiential Avoidance

    Science.gov (United States)

    Gold, Sari D.; Dickstein, Benjamin D.; Marx, Brian P.; Lexington, Jennifer M.

    2009-01-01

    This study explored the relations among internalized homophobia (IH), experiential avoidance, and psychological symptom severity in a community sample of 72 lesbian sexual assault survivors. Results indicated that IH is associated with both experiential avoidance and posttraumatic stress disorder (PTSD) symptom severity. In addition, experiential…

  7. Neurodevelopmental Outcome of ECMO Survivors at Five Years of Age: The Potential for Academic and Motor Difficulties.

    Science.gov (United States)

    Langenbacher, Deborah; Nield, Toni; Poulsen, Marie Kanne

    2001-01-01

    This study examined the cognitive and motor functioning of 52 survivors of neonatal extracorporeal membrane oxygenation (ECMO) at age 5. Ten percent were diagnosed with mental retardation, while an additional 12 percent presented other disabilities. A common pattern of specific vulnerabilities in cognitive, gross motor, fine motor, and motor…

  8. Barriers and Facilitators for Utilization of Genetic Counseling and Risk Assessment Services in Young Female Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Beth Anderson

    2012-01-01

    Full Text Available Introduction. Women diagnosed with breast cancer at a young age are more likely to carry a cancer predisposing genetic mutation. Per the current NCCN recommendations, women diagnosed under age 50 should be referred to cancer genetic counseling for further risk evaluation. This study seeks to assess patient-reported barriers and facilitators to receiving genetic counseling and risk assessment among a community-based population of young breast cancer survivors (YBCS. Methods. Through the Michigan Cancer Surveillance Program, a state-based cancer registry, 488 women diagnosed with breast cancer before age 50 in 2006-2007 were identified. They received a mail survey regarding family history and facilitators and barriers to receiving genetic counseling and risk assessment. Results. Responses were received from 289 women (59.2%. One hundred twenty-two (42.2% reported having received cancer genetic counseling. The most frequent reason identified for receiving services was to benefit their family's future. The top reasons for not attending were “no one recommended it” and “medical insurance coverage issues.” Discussion. This study is the first published report using a state cancer registry to determine facilitators and barriers to receiving genetic counseling and risk assessment among YBCS. These findings demonstrate the need for additional awareness and education about appropriate indications for genetic services.

  9. Electronics Environmental Benefits Calculator

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Electronics Environmental Benefits Calculator (EEBC) was developed to assist organizations in estimating the environmental benefits of greening their purchase,...

  10. Learning and memory performance in breast cancer survivors 2 to 6 years post-treatment: the role of encoding versus forgetting.

    Science.gov (United States)

    Root, James C; Andreotti, Charissa; Tsu, Loretta; Ellmore, Timothy M; Ahles, Tim A

    2016-06-01

    Our previous retrospective analysis of clinically referred breast cancer survivors' performance on learning and memory measures found a primary weakness in initial encoding of information into working memory with intact retention and recall of this same information at a delay. This suggests that survivors may misinterpret cognitive lapses as being due to forgetting when, in actuality, they were not able to properly encode this information at the time of initial exposure. Our objective in this study was to replicate and extend this pattern of performance to a research sample to increase the generalizability of this finding in a sample in which subjects were not clinically referred for cognitive issues. We contrasted learning and memory performance between breast cancer survivors on endocrine therapy 2 to 6 years post-treatment with age- and education-matched healthy controls. We then stratified lower- and higher-performing breast cancer survivors to examine specific patterns of learning and memory performance. Contrasts were generated for four aggregate visual and verbal memory variables from the California Verbal Learning Test-2 (CVLT-2) and the Brown Location Test (BLT): Single-trial Learning: Trial 1 performance, Multiple-trial Learning: Trial 5 performance, Delayed Recall: Long-delay Recall performance, and Memory Errors: False-positive errors. As predicted, breast cancer survivors' performance as a whole was significantly lower on Single-trial Learning than the healthy control group but exhibited no significant difference in Delayed Recall. In the secondary analysis contrasting lower- and higher-performing survivors on cognitive measures, the same pattern of lower Single-trial Learning performance was exhibited in both groups, with the additional finding of significantly weaker Multiple-trial Learning performance in the lower-performing breast cancer group and intact Delayed Recall performance in both groups. As with our earlier finding of weaker initial

  11. Self-defense training as clinical intervention for survivors of trauma.

    Science.gov (United States)

    Rosenblum, Gianine D; Taska, Lynn S

    2014-03-01

    A well-designed self-defense curriculum, congruent with psychophysiologically informed trauma research and treatment, and integrated with input from therapists, can serve as an important adjunctive treatment. We provide a detailed description of such a program modified to be an experiential, psychoeducational intervention for female survivors of trauma. Recent research on the role of blocked motor responses in the development of pathology post-trauma is explored as a potential explanatory mechanism for the therapeutic benefits of self-defense training. Through specific examples and descriptions of teaching methods, we examine how this intervention compliments and augments traditional psychotherapeutic treatment of trauma sequelae.

  12. Delayed family reunification of pediatric disaster survivors increases mortality and inpatient hospital costs: a simulation study.

    Science.gov (United States)

    Barthel, Erik R; Pierce, James R; Speer, Allison L; Levin, Daniel E; Goodhue, Catherine J; Ford, Henri R; Grikscheit, Tracy C; Upperman, Jeffrey S

    2013-09-01

    Disasters occur randomly and can severely tax the health care delivery system of affected and surrounding regions. A significant proportion of disaster survivors are children, who have unique medical, psychosocial, and logistical needs after a mass casualty event. Children are often transported to specialty centers after disasters for a higher level of pediatric care, but this can also lead to separation of these survivors from their families. In a recent theoretical article, we showed that the availability of a pediatric trauma center after a mass casualty event would decrease the time needed to definitively treat the pediatric survivor cohort and decrease pediatric mortality. However, we also found that if the pediatric center was too slow in admitting and discharging patients, these benefits were at risk of being lost as children became "trapped" in the slow center. We hypothesized that this effect could result in further increased mortality and greater costs. Here, we expand on these ideas to test this hypothesis via mathematical simulation. We examine how a delay in discharge of part of the pediatric cohort is predicted to affect mortality and the cost of inpatient care in the setting of our model. We find that mortality would increase slightly (from 14.2%-16.1%), and the cost of inpatient care increases dramatically (by a factor of 21) if children are discharged at rates consistent with reported delays to reunification after a disaster from the literature. Our results argue for the ongoing improvement of identification technology and logistics for rapid reunification of pediatric survivors with their families after mass casualty events. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial.

    Science.gov (United States)

    Derry, Heather M; Jaremka, Lisa M; Bennett, Jeanette M; Peng, Juan; Andridge, Rebecca; Shapiro, Charles; Malarkey, William B; Emery, Charles F; Layman, Rachel; Mrozek, Ewa; Glaser, Ronald; Kiecolt-Glaser, Janice K

    2015-08-01

    Cancer survivors often report cognitive problems. Furthermore, decreases in physical activity typically occur over the course of cancer treatment. Although physical activity benefits cognitive function in noncancer populations, evidence linking physical activity to cognitive function in cancer survivors is limited. In our recent randomized controlled trial, breast cancer survivors who received a yoga intervention had lower fatigue and inflammation following the trial compared with a wait list control group. This secondary analysis of the parent trial addressed yoga's impact on cognitive complaints. Posttreatment stage 0-IIIA breast cancer survivors (n = 200) were randomized to a 12-week, twice-weekly Hatha yoga intervention or a wait list control group. Participants reported cognitive complaints using the Breast Cancer Prevention Trial Cognitive Problems Scale at baseline, immediately postintervention, and 3-month follow-up. Cognitive complaints did not differ significantly between groups immediately postintervention (p = 0.250). However, at 3-month follow-up, yoga participants' Breast Cancer Prevention Trial Cognitive Problems Scale scores were an average of 23% lower than wait list participants' scores (p = 0.003). These group differences in cognitive complaints remained after controlling for psychological distress, fatigue, and sleep quality. Consistent with the primary results, those who practiced yoga more frequently reported significantly fewer cognitive problems at 3-month follow-up than those who practiced less frequently (p complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging.

    Science.gov (United States)

    Tieu, Minh Thi; Cigsar, Candemir; Ahmed, Sameera; Ng, Andrea; Diller, Lisa; Millar, B-A; Crystal, Pavel; Hodgson, David C

    2014-08-15

    Female survivors of pediatric Hodgkin lymphoma (HL) who have received chest radiotherapy are at increased risk of breast cancer. Guidelines for early breast cancer screening among these survivors are based on little data regarding clinical outcomes. This study reports outcomes of breast cancer screening with MRI and mammography (MMG) after childhood HL. We evaluated the results of breast MRI and MMG screening among 96 female survivors of childhood HL treated with chest radiotherapy. Outcomes measured included imaging sensitivity and specificity, breast cancer characteristics, and incidence of additional imaging and breast biopsy. Median age at first screening was 30 years, and the median number of MRI screening rounds was 3. Ten breast cancers were detected in 9 women at a median age of 39 years (range, 24-43 years). Half were invasive and half were preinvasive. The median size of invasive tumors was 8 mm (range, 3-15 mm), and none had lymph node involvement. Sensitivity and specificity of the screening modalities were as follows: for MRI alone, 80% and 93.5%, respectively; MMG alone, 70% and 95%, respectively; both modalities combined, 100% and 88.6%, respectively. All invasive tumors were detected by MRI. Additional investigations were required in 52 patients, (54%), and 26 patients (27%) required breast biopsy, with 10 patients requiring more than 1 biopsy. Screening including breast MRI with MMG has high sensitivity and specificity in pediatric HL survivors, with breast cancers detected at an early stage, although it is associated with a substantial rate of additional investigations. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  15. Psychosocial Care Needs of Melanoma Survivors: Are They Being Met?

    Science.gov (United States)

    Fischbeck, Sabine; Imruck, Barbara H; Blettner, Maria; Weyer, Veronika; Binder, Harald; Zeissig, Sylke R; Emrich, Katharina; Friedrich-Mai, Peter; Beutel, Manfred E

    2015-01-01

    Patients who have survived malignant melanoma for more than five years may lack the opportunity to talk about their burden. As a consequence their psychosocial care needs remain undetected and available supportive interventions may not be utilised. Therefore, the psychosocial burden of this patient group needs to be assessed using specific screening instruments. The aim of this study was to investigate the psychosocial burden of long-term melanoma survivors, their psychosocial care needs and the determinants of these needs. We wanted to find out if the use of professional support corresponds to the care needs defined by experts. Using the cancer registry of Rhineland-Palatinate, melanoma patients diagnosed at least 5 years before the survey were contacted by physicians. N = 689 former patients completed the Hornheide Questionnaire (short form HQ-S) to identify psychosocial support need (scale cut off ≥ 16 or item-based cut-off score) and the potential psychosocial determinants of these needs. Additionally, they were asked about their utilisation of the professional support system. More than one third (36%) of them was in need for professional psychosocial support. The highest burden scores concerned worry about tumour progression. Younger age (health, negative social interactions and unfulfilled information needs were significant predictors of the need for psychosocial intervention. Related to the percentage of survivors identified as 'in need', the professional support system was underused. Further studies should investigate whether using the HQ-S to routinely identify burdened melanoma patients could lead to better fulfilment of their intervention needs, ultimately enhancing health-related quality of life.

  16. Psychosocial Care Needs of Melanoma Survivors: Are They Being Met?

    Directory of Open Access Journals (Sweden)

    Sabine Fischbeck

    Full Text Available Patients who have survived malignant melanoma for more than five years may lack the opportunity to talk about their burden. As a consequence their psychosocial care needs remain undetected and available supportive interventions may not be utilised. Therefore, the psychosocial burden of this patient group needs to be assessed using specific screening instruments. The aim of this study was to investigate the psychosocial burden of long-term melanoma survivors, their psychosocial care needs and the determinants of these needs. We wanted to find out if the use of professional support corresponds to the care needs defined by experts. Using the cancer registry of Rhineland-Palatinate, melanoma patients diagnosed at least 5 years before the survey were contacted by physicians. N = 689 former patients completed the Hornheide Questionnaire (short form HQ-S to identify psychosocial support need (scale cut off ≥ 16 or item-based cut-off score and the potential psychosocial determinants of these needs. Additionally, they were asked about their utilisation of the professional support system. More than one third (36% of them was in need for professional psychosocial support. The highest burden scores concerned worry about tumour progression. Younger age (< 50, higher general fatigue, higher symptom burden, lower general health, negative social interactions and unfulfilled information needs were significant predictors of the need for psychosocial intervention. Related to the percentage of survivors identified as 'in need', the professional support system was underused. Further studies should investigate whether using the HQ-S to routinely identify burdened melanoma patients could lead to better fulfilment of their intervention needs, ultimately enhancing health-related quality of life.

  17. "What about diet?" A qualitative study of cancer survivors' views on diet and cancer and their sources of information.

    Science.gov (United States)

    Beeken, R J; Williams, K; Wardle, J; Croker, H

    2016-09-01

    Given the abundance of misreporting about diet and cancer in the media and online, cancer survivors are at risk of misinformation. The aim of this study was to explore cancer survivors' beliefs about diet quality and cancer, the impact on their behaviour and sources of information. Semi-structured interviews were conducted with adult cancer survivors in the United Kingdom who had been diagnosed with any cancer in adulthood and were not currently receiving treatment (n = 19). Interviews were analysed using Thematic Analysis. Emergent themes highlighted that participants were aware of diet affecting risk for the development of cancer, but were less clear about its role in recurrence. Nonetheless, their cancer diagnosis appeared to be a prompt for dietary change; predominantly to promote general health. Changes were generally consistent with healthy eating recommendations, although dietary supplements and other non-evidence-based actions were mentioned. Participants reported that they had not generally received professional advice about diet and were keen to know more, but were often unsure about information from other sources. The views of our participants suggest cancer survivors would welcome guidance from health professionals. Advice that provides clear recommendations, and which emphasises the benefits of healthy eating for overall well-being, may be particularly well-received. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  18. Posttraumatic growth, social acknowledgment as survivors, and sense of coherence in former German child soldiers of World War II.

    Science.gov (United States)

    Forstmeier, Simon; Kuwert, Philipp; Spitzer, Carsten; Freyberger, Harald J; Maercker, Andreas

    2009-12-01

    To examine posttraumatic growth (PTG) and its predictors social acknowledgment as survivors, sense of coherence (SOC), trauma severity, and further factors in former child soldiers more than 60 years after deployment. Cross-sectional. University-based geropsychiatric center in Germany. One hundred three former German child soldiers of World War II, mean age 78 years in which 96% experienced at least one war trauma. Subjects completed the Posttraumatic Growth Inventory, Social Acknowledgment Questionnaire (SAQ), and SOC Scale. Trauma exposure and posttraumatic stress disorder (PTSD) symptoms were assessed by the Posttraumatic Diagnostic Scale. Depression, anxiety, and somatization were assessed using the Brief Symptom Inventory. Number of traumas, recognition by significant others, and general disapproval as facets of social acknowledgment as a survivor, and meaningfulness as a dimension of SOC correlated significantly with PTG. In a multiple hierarchical regression analysis, recognition as a survivor by significant others (SAQ) and meaningfulness (SOC) remained the only significant predictors of PTG. Social acknowledgment as a survivor by significant others and the belief that the world is meaningful are among the most important factors contributing to PTG. Further research should investigate whether treatments of PTSD in people who experienced war traumas recently or many years ago might benefit from a focus on the belief system and the role of family and social support.

  19. Mobile-based patient-provider communication in cancer survivors: The roles of health literacy and patient activation.

    Science.gov (United States)

    Jiang, Shaohai; Hong, Y Alicia

    2017-11-28

    Thanks to rapid penetration of mobile tools, more and more cancer survivors have adopted mobile-based patient-provider communication (MBPPC). The relationship between MBPPC and patients' health outcomes, however, remains unclear; how health literacy and patient activation interact with such relationship is unexplored. Data were drawn from National Cancer Institute's Health Information National Trends Survey 4 Cycle 3. A sample of 459 cancer survivors were included in the analysis. Based on the 3-stage model of health promotion using interactive media, this study empirically tested a moderated mediation model. MBPPC (eg, patient use of email, text message, mobile app, and social media to communicate with providers) had no direct effect on cancer survivors' emotional health. Instead, health literacy completely mediated this path. Patient activation positively moderated the effect of health literacy on emotional health and further increased the indirect effect of MBPPC on emotional health. MBPPC alone does not directly result in better emotional health outcomes; health literacy is the key to realize its health benefits; patient activation significantly strengthens the effects of MBPPC. As we embrace the mHealth movement, innovative programs are needed to promote MBPPC, and improve health literacy and activation of cancer survivors, particularly in underserved communities, to reduce health disparities. Copyright © 2017 John Wiley & Sons, Ltd.

  20. A qualitative evaluation of breast cancer survivors' acceptance of and preferences for consumer wearable technology activity trackers.

    Science.gov (United States)

    Nguyen, Nga H; Hadgraft, Nyssa T; Moore, Melissa M; Rosenberg, Dori E; Lynch, Chris; Reeves, Marina M; Lynch, Brigid M

    2017-11-01

    Physical inactivity and sedentary behaviour are common amongst breast cancer survivors. These behaviours are associated with an increased risk of comorbidities such as heart disease, diabetes and other cancers. Commercially available, wearable activity trackers (WATs) have potential utility as behavioural interventions to increase physical activity and reduce sedentary behaviour within this population. The purpose of the study is to explore the acceptability and usability of consumer WAT amongst postmenopausal breast cancer survivors. Fourteen participants tested two to three randomly assigned trackers from six available models (Fitbit One, Jawbone Up 24, Garmin Vivofit 2, Garmin Vivosmart, Garmin Vivoactive and Polar A300). Participants wore each device for 2 weeks, followed by a 1-week washout period before wearing the next device. Four focus groups employing a semi-structured interview guide explored user perceptions and experiences. We used a thematic analysis approach to analyse focus group transcripts. Five themes emerged from our data: (1) trackers' increased self-awareness and motivation, (2) breast cancer survivors' confidence and comfort with wearable technology, (3) preferred and disliked features of WAT, (4) concerns related to the disease and (5) peer support and doctor monitoring were possible strategies for WAT application. WATs are perceived as useful and acceptable interventions by postmenopausal breast cancer survivors. Effective WAT interventions may benefit from taking advantage of the simple features of the trackers paired with other behavioural change techniques, such as specialist counselling, doctor monitoring and peer support, along with simple manual instructions.

  1. Emotion Language in Trauma Narratives is Associated with Better Psychological Adjustment among Survivors of Childhood Sexual Abuse.

    Science.gov (United States)

    Wardecker, Britney M; Edelstein, Robin S; Quas, Jodi A; Cordon, Ingrid M; Goodman, Gail S

    2017-12-01

    Traumatized individuals are often encouraged to confront their experiences by talking or writing about them. However, survivors of childhood sexual abuse (CSA) might find it especially difficult to process abuse experiences, particularly when the abuse is more severe, which could put them at greater risk for mental health problems. The current study examined whether CSA survivors who use emotion language when describing their abuse experiences exhibit better mental health. We analyzed the trauma narratives of 55 adults who, as children, were part of a larger study of the long-term emotional effects of criminal prosecutions on CSA survivors. Abuse narratives were analyzed using the Linguistic Inquiry and Word Count (LIWC) program. We examined whether positive and negative emotion language in participants' abuse narratives were associated with self- and caregiver-reported mental health symptoms and whether these associations differed according to the severity of the abuse. As hypothesized, participants who used more positive and negative emotion language had better psychological outcomes, especially when the abuse was severe. Our findings suggest that survivors of more severe abuse might benefit from including emotion language, whether positive or negative in valence, when describing the abuse.

  2. An evaluation of combined narrative exposure therapy and physiotherapy for comorbid PTSD and chronic pain in torture survivors.

    Science.gov (United States)

    Dibaj, Iselin; Øveraas Halvorsen, Joar; Edward Ottesen Kennair, Leif; Inge Stenmark, Håkon

    2017-01-01

    Torture is associated with adverse health consequences, with especially high rates of PTSD, depression and chronic pain. Despite increased awareness of the relationship between pain and posttraumaticsymptoms, and the accompanying need for effective treatment strategies, few studies have examined an integrated treatment of comorbid PTSD and pain. In this study, using an A-B case series design with three and six month follow-up, six refugee torture survivors with comorbid PTSD, depression and chronic pain received 20 sessions of Narrative Exposure Therapy (NET) and 10 sessions of physiotherapy. Outcome variables included symptoms of PTSD and depression, pain intensity, physical functioning and quality of life. Symptoms of PTSD and pain were also rated after each treatment session. Two patients achieved clinically significant reduction in symptoms of PTSD. Only one patient achieved clinically significant change in depressive symptoms, and two experienced clinically significant reduction in pain intensity. Clinical descriptions of the course of treatment for all patients are provided. Despite its limitations, the study suggests that some torture survivors who suffer high symptom loads may benefit from a combined treatment of NET and physiotherapy. Appreciating individual differences and how they affect treatment can provide valuable insight and inform clinicians working with torture survivors. Directions for future researchregarding the improvement of rehabilitation strategies of torture survivors are discussed, and highlighted through descriptions from the six therapy cases.

  3. 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.

  4. 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

  5. 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…

  6. 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 ...

  7. 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

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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

  12. 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

  13. 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…

  14. 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.

  15. 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

  16. 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

  17. 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…

  18. 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, ...

  19. 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 ...

  20. 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)

  1. 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.

  2. 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

  3. 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

  4. 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…

  5. 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).

  6. 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

  7. Why Rape Survivors Participate in the Criminal Justice System

    Science.gov (United States)

    Patterson, Debra; Campbell, Rebecca

    2010-01-01<