WorldWideScience

Sample records for survivors additional benefits

  1. 22 CFR 20.5 - Survivor benefits.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Survivor benefits. 20.5 Section 20.5 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR CERTAIN FORMER SPOUSES § 20.5 Survivor benefits. (a) Type of benefits. A former spouse who meets the eligibility requirements of § 20.3 is entitled to...

  2. 22 CFR 19.11 - Survivor benefits.

    Science.gov (United States)

    2010-04-01

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

  3. 31 CFR 29.344 - Survivor benefits.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Survivor benefits. 29.344 Section 29.344 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER CERTAIN DISTRICT OF COLUMBIA RETIREMENT PROGRAMS Split Benefits Calculation of the Amount of Federal...

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

    National Research Council Canada - National Science Library

    DiPuccio, Andrew

    1999-01-01

    The Survivor Benefit Plan (SBP) was created to enable a surviving beneficiary of a retired military service member to continue to receive a portion of the retiree's retirement benefits upon the death of the retiree...

  5. 31 CFR 29.346 - Reduction for survivor benefits.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Reduction for survivor benefits. 29.346 Section 29.346 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER CERTAIN DISTRICT OF COLUMBIA RETIREMENT PROGRAMS Split Benefits Calculation of the Amount of...

  6. Analysis of Survivor Benefit Plan - Acceptance and Comparison with Private Sector

    Science.gov (United States)

    1989-01-01

    I COPY AIU WAR COLLEGE ,.SEARCH REPORT ,YSIS OF SURVIVOR BENEFIT PLAN-__CCEPTANCE ’-U AND COMPARISON WITH PRIVATE SECTOR LIEUENNT COLONEL JOHN R...AAA AIR WAR COLLEGE AIR UNIVERSITY ANALYSIS OF SURVIVOR BENEFIT PLAN--ACCEPTANCE AND COMPARISON WITH PRIVATE SECTOR by John R. Adams Lieutenant...Survivor Benefit Plan (SBP)--Acceptance and Comparison With Private Sector . AUTHORS: John R. Adams, Lieutenant Colonel, USAF; Daniel 3. Kohn

  7. 77 FR 40525 - Dependency and Indemnity Compensation (DIC) Benefits for Survivors of Former Prisoners of War...

    Science.gov (United States)

    2012-07-10

    ... (DIC) Benefits for Survivors of Former Prisoners of War Rated Totally Disabled at Time of Death AGENCY... amending its adjudication regulation regarding benefits for survivors of former prisoners of war who were... criteria for dependency and indemnity compensation (DIC) based on the death of a former prisoner of war...

  8. 5 CFR 831.684 - Second chance elections to provide survivor benefits.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Second chance elections to provide survivor benefits. 831.684 Section 831.684 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Noncodified Statutes § 831.684 Second chance elections to provide survivor benefits. (a) A married retiree who...

  9. Breastfeeding peer support: are there additional benefits?

    Science.gov (United States)

    Wade, Deborah; Haining, Shona; Day, Ann

    2009-12-01

    Anecdotal discussion among breastfeeding peer supporters and the infant-feeding co-ordinator suggested that breastfeeding peer support provided by breastfeeding peer supporters may offer benefits to breastfeeding women and their families other than increasing breastfeeding initiation and sustainability. The aim of this research was to determine whether there was evidence to support this. The research team used focus groups to obtain information from 16 local women who had received breastfeeding peer support from breastfeeding peer supporters. The key themes that emerged were--improved mental health, increased self-esteem or confidence, parenting skills, improved family diet, breastfeeding sustainability and poor hospital experience.The findings suggest that breastfeeding peer supporters supporting mothers to breastfeed, with the intention of increasing both breastfeeding rates and sustainability, may have additional benefits in several aspects of families' lives. Breastfeeding peer support may play an important role in helping to attain targets such as reducing obesity and postnatal depression.

  10. Quality of life of childhood cancer survivors: handicaps and benefits

    Czech Academy of Sciences Publication Activity Database

    Blatný, Marek; Kepák, T.; Vlčková, I.; Jelínek, Martin; Tóthová, K.; Pilát, M.; Slezáčková, Alena; Sobotková, Veronika; Bartošová, Kateřina; Hrstková, H.; Štěrba, J.

    2011-01-01

    Roč. 55, č. 2 (2011), s. 112-125 ISSN 0009-062X R&D Projects: GA ČR GA406/07/1384 Institutional research plan: CEZ:AV0Z70250504 Keywords : childhood cancer survivors * quality of life * psycho-oncology Subject RIV: AN - Psychology Impact factor: 0.087, year: 2011

  11. 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.

  12. 38 CFR 3.405 - Filipino veterans and their survivors; benefits at the full-dollar rate.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Filipino veterans and... 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...

  13. 38 CFR 3.505 - Filipino veterans and their survivors; benefits at the full-dollar rate.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Filipino veterans and... Compensation Reductions and Discontinuances § 3.505 Filipino veterans and their survivors; benefits at the full... compensation for a Filipino veteran or his or her survivor under § 3.42 will be the earliest of the dates...

  14. Context matters: the benefits and costs of expressing positive emotion among survivors of childhood sexual abuse.

    Science.gov (United States)

    Bonanno, George A; Colak, Deniz M; Keltner, Dacher; Shiota, Michelle N; Papa, Anthony; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K

    2007-11-01

    Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific.

  15. Regulations implementing the Byrd Amendments to the Black Lung Benefits Act: determining coal miners' and survivors' entitlement to benefits. Final rule.

    Science.gov (United States)

    2013-09-25

    This final rule revises the Black Lung Benefits Act (BLBA or Act) regulations to implement amendments made by the Patient Protection and Affordable Care Act (ACA). The ACA amended the BLBA in two ways. First, it revived a rebuttable presumption of total disability or death due to pneumoconiosis for certain claims. Second, it reinstituted automatic entitlement to benefits for certain eligible survivors of coal miners whose lifetime benefit claims were awarded because they were totally disabled due to pneumoconiosis. These regulations clarify how the statutory presumption may be invoked and rebutted and the application and scope of the survivor-entitlement provision. The rule also eliminates several unnecessary or obsolete provisions.

  16. The potential role of benefit and burden finding in school engagement of young leukaemia survivors: an exploratory study.

    Science.gov (United States)

    Tougas, A-M; Jutras, S; Bigras, M; Tourigny, M

    2016-01-01

    Childhood cancer may radically change the daily lives of young survivors, particularly in school. Depending on the sense they derive from the experience of illness, survivors may go through profound transformations in the way they approach life. This exploratory study reports on school engagement of cancer survivors by examining their perceptions of benefits and burdens in relation to their illness. Forty-nine young Quebecers, previously diagnosed and treated for leukaemia, completed a questionnaire measuring their school engagement and participated in an interview focusing on the impact of cancer on their lives. Perceptions with regard to the presence and types of benefits and burdens were described and examined in light of participants' characteristics. An analysis of variance explored whether the presence/absence of benefits and burdens were associated with participants' scores regarding school engagement. Most participants mentioned benefits from having had cancer, and in particular benefits at an interpersonal level. Half of the participants mentioned burdens, mainly of a physical and psychological nature. Significant correlations indicated that (i) the older the survivors were, the more likely they were to report benefits in terms of qualities and strengths of character; (ii) the more time had elapsed since their diagnosis, the more survivors were likely to report psychological types of burdens; and (iii) children from single-parent families reported more frequently having appreciated social or recreational activities compared with children from two-parent families. One main effect indicated that school engagement was greater for survivors who perceived the presence of benefits. An interaction effect revealed that the perception of both benefits and burdens predicts the highest scores of school engagement. While the results reveal the promising potential that an optimistic yet realistic disposition has in regard to school engagement, more research is

  17. Benefit finding for Chinese family caregivers of community-dwelling stroke survivors: A cross-sectional study.

    Science.gov (United States)

    Mei, Yongxia; Wilson, Susan; Lin, Beilei; Li, Yingshuang; Zhang, Zhenxiang

    2018-04-01

    To identify whether benefit finding is a mediator or moderator in the relationship between caregiver burden and psychological well-being (anxiety and depression) in Chinese family caregivers of community-dwelling stroke survivors. Family caregivers not only bear a heavy burden, a high level of anxiety and depression, but also experience benefit finding (positive effects result from stressful events). However, the relationships among benefit finding, caregiver burden and psychological well-being in Chinese family caregivers are not well known. This study was a cross-sectional correlational design. Caregivers (n = 145) of stroke survivors were recruited from two communities in Zhengzhou, China. Data were collected by face-to-face interviews with structured questionnaires, examining caregiver burden, benefit finding and psychological well-being of caregivers. A hierarchical regression analysis explored whether caregiver burden and benefit finding were associated with anxiety and depression of caregivers. The moderator role of benefit finding was examined by testing the significance of the interaction between caregiver burden and benefit finding. A mediational model was used to test benefit finding as a mediator between caregiver burden and psychological well-being of caregivers using process in spss 21.0. Caregiver burden and benefit finding were significantly associated with both anxiety and depression of caregivers. Benefit finding did not portray a moderating role, but portrayed the mediator role in the relationship between caregiver burden, anxiety and depression in caregivers. This study provides the preliminary evidence to nurses that intervention focus on benefit finding may help improve the psychological well-being of caregivers. This study offers nurses rational for assessing caregiver's negative emotions and benefit finding. By targeting benefit finding, the nurse may guide caregivers in benefit identification and implement interventions to reduce anxiety

  18. No damaging effect of chemotherapy in addition to radiotherapy on the thyroid axis in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    van Santen, Hanneke M.; Vulsma, Thomas; Dijkgraaf, Marcel G.; Blumer, Regje M. E.; Heinen, Richard; Jaspers, Monique W. M.; Geenen, Maud M.; Offringa, Martin O.; de Vijlder, Jan J. M.; van den Bos, Cor

    2003-01-01

    Late effects of treatment for childhood cancer on the thyroid axis are ascribed predominantly to radiotherapy. Whether chemotherapy has an additional detrimental effect is still unclear. Our aim was to evaluate this effect in young adult survivors of a broad spectrum of childhood cancers. The

  19. 5 CFR Appendix B to Subpart J of... - Guidelines for Interpreting State Court Orders Awarding Survivor Annuity Benefits to Former Spouses

    Science.gov (United States)

    2010-01-01

    ... Personnel Management (OPM) will place on terms and phrases frequently used in awarding survivor benefits... will not be interpreted as affecting Civil Service Retirement System (CSRS) benefits. 1. Orders that mistakenly label CSRS benefits as Federal Employee's Retirement System (FERS) benefits, will be interpreted...

  20. A perspective on complementary/alternative medicine use among survivors of hematopoietic stem cell transplant: Benefits and uncertainties.

    Science.gov (United States)

    Chakraborty, Rajshekhar; Savani, Bipin N; Litzow, Mark; Mohty, Mohamad; Hashmi, Shahrukh

    2015-07-15

    The widespread use of complementary and alternative medicine (CAM) in cancer survivors is well known despite a paucity of scientific evidence to support its use. The number of survivors of hematopoietic stem cell transplant (HCT) is growing rapidly and HCT clinicians are aware that many of their patients use CAM therapies consistently. However, due to a paucity of data regarding the benefits and harms of CAM therapies in these survivors, clinicians are reluctant to provide specific recommendations for or against particular CAM therapies. A systematic literature review was conducted with a search using PubMed, the Cochrane Database of Systematic Reviews, and Ovid online for each CAM therapy as defined by the National Center of Complementary and Alternative Medicine. The search generated 462 references, of which 26 articles were deemed to be relevant for the review. Due to extensive heterogeneity in data and limited randomized trials, a meta-analysis could not be performed but a comprehensive systematic review was conducted with specified outcomes for each CAM therapy. In randomized controlled trials, certain mind and body interventions such as relaxation were observed to be effective in alleviating psychological symptoms in patients undergoing HCT, whereas the majority of the other CAM treatments were found to have mixed results. CAM use is an understudied area in HCT survivorship and clinicians should convey the benefits and uncertainties concerning the role of CAM therapies to their patients. © 2015 American Cancer Society.

  1. 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.

  2. Dietary Supplements Commonly Used by Cancer Survivors: Are There Any Benefits?

    Science.gov (United States)

    Marian, Mary J

    2017-10-01

    Following a cancer diagnosis, dietary supplements are reportedly used by 20%-80% of individuals. Supplements are most commonly used by breast cancer survivors, followed by patients with prostate, colorectal, and lung cancers, which is not surprising since these are the most common types of cancer diagnosed in adults. Reasons cited for such use include improving quality of life, reducing symptoms related to treatment and/or the disease process, and recommendation from medical practitioners; family and friends may also be an influence. However, controversy surrounds the use of dietary supplements, particularly during treatment-specifically, whether supplements affect treatment efficacy is unknown. This article discusses the evidence related to common dietary supplements used to prevent cancer or a recurrence.

  3. Social Security Rulings on Federal Old-Age, Survivors, Disability, Health Insurance, Supplemental Security Income, and Black Lung Benefits. Cumulative Bulletin 1976.

    Science.gov (United States)

    Social Security Administration (DHEW), Washington, DC.

    The purpose of this publication is to make available to the public official rulings relating to the Federal old-age, survivors, disability, health insurance, supplemental security income, and miners' benefit programs. The rulings contain precedential case decisions, statements of policy and interpretations of the law and regulations. Included is a…

  4. Coping Strategies and Benefit-finding in the Relationship between Non-disclosure and Depressive Symptoms among Breast Cancer Survivors in China.

    Science.gov (United States)

    Lee, Minsun; Song, Yuan; Zhu, Lin; Ma, Grace X

    2017-07-01

    Open communication about cancer diagnosis and relevant stress is frequently avoided among breast cancer survivors in China. Non-disclosure behavior may lead to negative psychological consequences. We aimed to examine the relationship between non-disclosure and depressive symptoms, and the role of coping strategies and benefit-finding in that relationship among Chinese breast cancer survivors. Using convenience sampling, we recruited 148 women in an early survivorship phase (up to 6 years post-treatment) in Nanjing, China. Participants were asked to complete a set of questionnaires in Chinese language, regarding sociodemographic characteristics, depressive symptoms, disclosure views, coping strategies, and benefit-finding. A higher level of non-disclosure was associated with more depressive symptoms. This relationship was mediated by self-blame and moderated by benefit-finding. Specifically, non-disclosure was associated with depressive symptoms through self-blame. The impact of non-disclosure was minimized among the women with a higher level of benefit-finding. Unexpressed cancer-related concern may increase self-blame, which leads to emotional distress among Chinese breast cancer survivors. Practicing benefit-finding may reduce the negative impact of non-disclosure. As a culturally appropriate way of disclosure, written expression may be beneficial to Chinese breast cancer patients.

  5. FEDERAL PENSIONS: Judicial Survivors Annuities System Costs

    National Research Council Canada - National Science Library

    2002-01-01

    ...) specifying that we review certain aspects of the Judicial Survivors' Annuities System (JSAS), which is one of several survivor benefit plans applicable to particular groups of federal employees...

  6. The impact of intermittently renewable energy on Italian wholesale electricity prices: Additional benefits or additional costs?

    International Nuclear Information System (INIS)

    Gullì, Francesco; Balbo, Antonio Lo

    2015-01-01

    Most studies of the literature find that the development of renewable energy sources determines a decrease in the wholesale prices. Some authors use this finding to state that the current subsidies for renewable technologies cannot be considered as excessive. By carrying out a hybrid analysis (both simulation and ex-post empirical analyses) of the case of photovoltaic energy in Italy, this article demonstrates that this result cannot be generalised. Under market power, an increase in PV production can provide benefits in terms of a wholesale price decrease only beyond a specific threshold and especially if combined with other effects. Otherwise, it is likely that PV development could imply an increase in prices. Therefore, on the one hand, caution is necessary when using the estimated change in wholesale prices to evaluate the net cost for consumers of the supporting policies for renewables: either the simulation-based models or the full empirical analyses may be misleading. On the other hand, if 'decarbonisation' is the main objective, the energy policies should be designed in order to assure a deep and balanced penetration of the clean technologies, regardless of their estimated transitory impact on wholesale prices (and in the meantime reviewing the organisation of power markets). -- Highlights: •We use a hybrid analysis based on a combined approach (both simulation and ex-post empirical analyses). •There is a critical threshold of RES penetration within which prices may increase. •Price increases are more likely with PV rather than with wind power. •Either the simulation models or the full empirical analyses may be misleading. •Caution is necessary when using the results of these analyses for policy decisions

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

    Directory of Open Access Journals (Sweden)

    Elisabeth Harley

    2010-12-01

    Full Text Available 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.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.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.

  8. Radiation effects on cancer mortality among A-bomb survivors, 1950-72. Comparison of some statistical models and analysis based on the additive logit model

    Energy Technology Data Exchange (ETDEWEB)

    Otake, M [Hiroshima Univ. (Japan). Faculty of Science

    1976-12-01

    Various statistical models designed to determine the effects of radiation dose on mortality of atomic bomb survivors in Hiroshima and Nagasaki from specific cancers were evaluated on the basis of a basic k(age) x c(dose) x 2 contingency table. From the aspects of application and fits of different models, analysis based on the additive logit model was applied to the mortality experience of this population during the 22year period from 1 Oct. 1950 to 31 Dec. 1972. The advantages and disadvantages of the additive logit model were demonstrated. Leukemia mortality showed a sharp rise with an increase in dose. The dose response relationship suggests a possible curvature or a log linear model, particularly if the dose estimated to be more than 600 rad were set arbitrarily at 600 rad, since the average dose in the 200+ rad group would then change from 434 to 350 rad. In the 22year period from 1950 to 1972, a high mortality risk due to radiation was observed in survivors with doses of 200 rad and over for all cancers except leukemia. On the other hand, during the latest period from 1965 to 1972 a significant risk was noted also for stomach and breast cancers. Survivors who were 9 year old or less at the time of the bomb and who were exposed to high doses of 200+ rad appeared to show a high mortality risk for all cancers except leukemia, although the number of observed deaths is yet small. A number of interesting areas are discussed from the statistical and epidemiological standpoints, i.e., the numerical comparison of risks in various models, the general evaluation of cancer mortality by the additive logit model, the dose response relationship, the relative risk in the high dose group, the time period of radiation induced cancer mortality, the difference of dose response between Hiroshima and Nagasaki and the relative biological effectiveness of neutrons.

  9. 20 CFR 10.332 - What additional medical information will OWCP require to support continuing payment of benefits?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What additional medical information will OWCP require to support continuing payment of benefits? 10.332 Section 10.332 Employees' Benefits OFFICE OF... COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT, AS AMENDED Medical and Related Benefits Medical...

  10. 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,…

  11. 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.

  12. 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.

  13. Preliminary benefit-cost analysis of the Fast Flux Test Facility (FFTF) power addition

    International Nuclear Information System (INIS)

    Callaway, J.M.; Lezberg, A.J.; Scott, M.J.; Tawil, J.J.

    1984-07-01

    The primary objective of this report is to conduct a preliminary benefit-cost study for the proposed power addition to FFTF to determine whether the project is cost-effective. If the project is authorized, construction will begin in 1986 and end in 1991. Full power operation is scheduled to begin in 1991 and a project life of 20 years is assumed. The undiscounted cost during the construction period of the FFTF power addition is estimated to be approximately $117 million over the construction period (1984 dollars). An additional $3 million is estimated as the opportunity cost - or value of these resources in their most favorable alternative use - of surplus FFTF equipment and unused CRBR equipment, including materials for steam generator fabrication. The annual operating and maintenance cost of the project is estimated to be about $2.1 million in 1984 dollars. 20 references

  14. 20 CFR 234.33 - Survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Survivor annuities. 234.33 Section 234.33 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Annuities Due but Unpaid at Death § 234.33 Survivor annuities. Any survivor annuity which is...

  15. 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

  16. Focal masses in a non-cirrhotic liver: The additional benefit of CEUS over baseline imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chiorean, L., E-mail: lilichiorean@yahoo.com [Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University (China); Med. Klinik 2, Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim (Germany); Département d’imagerie médicale, Clinique des Cévennes, 07100 Annonay (France); Cantisani, V., E-mail: vito.cantisani@uniroma1.it [Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-patologiche, Policlinico Umberto I, Univ. Sapienza, Roma (Italy); Jenssen, C., E-mail: C.Jenssen@khmol.de [Innere Medizin, Krankenhaus Märkisch Oderland, Prötzeler Chaussee 5, 15433 Strausberg (Germany); Sidhu, P.S., E-mail: paulsidhu@nhs.net [Department of Radiology, King' s College Hospital, Denmark Hill, London SE5 9RS, England (United Kingdom); Baum, U., E-mail: Ulrich.Baum@ckbm.de [Department of Radiology, Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim (Germany); Dietrich, C.F., E-mail: christoph.dietrich@ckbm.de [Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University (China); Med. Klinik 2, Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim (Germany)

    2015-09-15

    Highlights: • Contrast-enhanced ultrasound in detection of focal liver lesions. • Contrast-enhanced ultrasound in characterization of focal liver lesions. • Contrast-enhanced ultrasound in differential diagnosis of focal liver lesions. • Contrast-enhanced ultrasound in final diagnosis of focal liver lesions. • Contrast-enhanced ultrasound in liver metastases screening. • Roles of cross-sectional imaging techniques for focal liver lesions assessment. • Advantages of contrast-enhanced ultrasound over other imaging procedures. - Abstract: Incidentally detected focal liver lesions are commonly encountered in clinical practice presenting a challenge in the daily department work flow. Guidelines for the management of incidental focal liver lesions have been published but comments, illustrations and recommendations regarding practical issues are crucial. The unique features of contrast-enhanced ultrasound in non-invasive assessment of focal liver lesion enhancement throughout the vascular phases in real-time has allowed an impressive improvement in the diagnostic accuracy of ultrasound. We highlight the additional benefit of contrast-enhanced ultrasound over conventional B-mode ultrasound imaging in detection, characterization, differential and final diagnosis of focal liver lesions, as well as for liver metastases screening. The current roles of cross-sectional imaging are explained in detail, with indications and limitations for each procedure. The advantages of CEUS, such as non-ionizing radiation exposure, cost benefits, non-iodinate contrast agents, and repeatability are also described ultimately improving patient management.

  17. 38 CFR 3.22 - DIC benefits for survivors of certain veterans rated totally disabled at time of death.

    Science.gov (United States)

    2010-07-01

    ... benefits under paragraph (a) of this section receives any money or property pursuant to a judicial... amount of money received and the fair market value of the property received. The provisions of this... veteran. The amount to be reported is the total of the amount of money received and the fair market value...

  18. Additive Benefits of Twice Forest Bathing Trips in Elderly Patients with Chronic Heart Failure.

    Science.gov (United States)

    Mao, Gen Xiang; Cao, Yong Bao; Yang, Yan; Chen, Zhuo Mei; Dong, Jian Hua; Chen, Sha Sha; Wu, Qing; Lyu, Xiao Ling; Jia, Bing Bing; Yan, Jing; Wang, Guo Fu

    2018-02-01

    Chronic heart failure (CHF), a clinical syndrome resulting from the consequences of various cardiovascular diseases (CVDs), is increasingly becoming a global cause of morbidity and mortality. We had earlier demonstrated that a 4-day forest bathing trip can provide an adjunctive therapeutic influence on patients with CHF. To further investigate the duration of the impact and the optimal frequency of forest bathing trips in patients with CHF, we recruited those subjects who had experienced the first forest bathing trip again after 4 weeks and randomly categorized them into two groups, namely, the urban control group (city) and the forest bathing group (forest). After a second 4-day forest bathing trip, we observed a steady decline in the brain natriuretic peptide levels, a biomarker of heart failure, and an attenuated inflammatory response as well as oxidative stress. Thus, this exploratory study demonstrated the additive benefits of twice forest bathing trips in elderly patients with CHF, which could further pave the way for analyzing the effects of such interventions in CVDs. Copyright © 2018 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  19. Administration of additional inactive iodide during radioiodine therapy for Graves' disease. Who might benefit?

    International Nuclear Information System (INIS)

    Dietlein, M.; Moka, D.; Reinholz, U.; Schmidt, M.; Schomaecker, K.; Schicha, H.; Wellner, U.

    2007-01-01

    Aim: Graves' hyperthyroidism and antithyroid drugs empty the intrathyroid stores of hormones and iodine. The consequence is rapid 131 I turnover and impending failure of radioiodine therapy. Can administration of additional inactive iodide improve 131I kinetics? Patients, methods: Fifteen consecutive patients, in whom the 48 h post-therapeutically calculated thyroid dose was between 150 and 249 Gy due to an unexpectedly short half-life, received 3 x 200 μg inactive potassium-iodide ( 127 I) daily for 3 days (Group A), while 17 consecutive patients with a thyroid dose of = 250 Gy (Group B) served as the non-iodide group. 48 hours after 131 I administration (M1) and 4 or 5 days later (M2) the following parameters were compared: effective 131 I half-life, thyroid dose, total T3, total T4, 131 I-activity in the T3- and T4-RIAs. Results: In Group A, the effective 131 I half-life M1 before iodine (3.81 ± 0.93 days) was significantly (p 131 I half-life M2 (4.65 ± 0.79 days). Effective 131 I half-life M1 correlated with the benefit from inactive 127 I (r = -0.79): Administration of 127 I was beneficial in patients with an effective 131 I half-life M1 of 131 I activity of T3 and T4 showed lower specific 131 I activity after addition of inactive iodine compared with patients from the same group with a lower initial specific 131 I activity of T3 and T4 and compared with the patient group B who was given no additional inactive iodide. This correlation was mathematically described and reflected in the flatter gradient in Group A (y = 0.5195x + 0.8727 for 131 I T3 and y = 1.0827x - 0.4444 for 131 I T4) and steeper gradient for Group B (y = 0.6998x + 0.5417 for 131 I T3 and y = 1.3191x - 0.2901 for 131 I T4). Radioiodine therapy was successful in all 15 patients from Group A. Conclusion: The administration of 600 μg inactive iodide for three days during radioiodine therapy in patients with Graves' hyperthyroidism and an unexpectedly short half-life of <3 or 4 days was a safe

  20. Benefits of partnered strength training for prostate cancer survivors and spouses: results from a randomized controlled trial of the Exercising Together project.

    Science.gov (United States)

    Winters-Stone, Kerri M; Lyons, Karen S; Dobek, Jessica; Dieckmann, Nathan F; Bennett, Jill A; Nail, Lillian; Beer, Tomasz M

    2016-08-01

    Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver, but interventions rarely target the health of both partners simultaneously. We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors (PCS) and spouse caregivers. Sixty-four couples were randomly assigned to 6 months of partnered strength training (Exercising Together, N = 32) or usual care (UC, N = 32). Objective measures included body composition (lean, fat and trunk fat mass (kg), and % body fat) by DXA, upper and lower body muscle strength by 1-repetition maximum, and physical function by the physical performance battery (PPB). Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS questionnaire. Couple retention rates were 100 % for Exercising Together and 84 % for UC. Median attendance of couples to Exercising Together sessions was 75 %. Men in Exercising Together became stronger in the upper body (p Exercising Together increased muscle mass (p = 0.05) and improved upper (p Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses. A couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners. ClinicalTrials.gov NCT00954044.

  1. [Quantifying the additional clinical benefit of new medicines: little - considerable - significant - 6 remarks from a biometrician's point of view].

    Science.gov (United States)

    Vach, Werner

    2014-11-01

    According to the German Pharmaceutical Market Reorganisation Act [Arzneimittelmarktneuordnungsgesetz (AMNOG)] of 22.12.2010, the benefit assessment of a new drug should include an evaluation of the "degree of additional benefit". A corresponding regulation of the German Ministry of Health states that the quantification of the degree of additional benefit should be made in the terms "major additional benefit", "considerable additional benefit" and "little additional benefit". In September 2011 the IQWiG undertook and explained in appendix A of the dossier evaluation of Ticagrelor an "operationalisation of the extent of additional benefit according to AM-NutzenV". Therein a distinction was made between the target categories "survival time (mortality)", "serious (or, respectively, severe) symptoms", "quality of life", and "not serious (or, respectively, not severe) symptoms". In the operationalisation of the IQWiG, the categorisation of the additional benefit with regard to mortality was addressed by definition of threshold values for the upper limit of the 95% confidence interval for the relative risk (RR). The statutory regulations and the operationalisation of the IQWiG will have direct long-term effects on the provision of medical care since they have a say as to which drugs are to be available at which prices. By introduction of terms such as "major additional benefit", "considerable additional benefit" or "desired effects" and linking them to statistical parameters and algorithms, they also open a series of further fundamental questions as to if and how we should handle these terms in the future and what consequences are inherent to the use of statistical criteria in their "definition". In the present article 6 of the questions that arise in this context are discussed: Can a "considerable additional benefit" be defined with statistical methods? Can a classification of the additional benefit on the basis of an estimated RR be reliable? What are the fundamental

  2. 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

    2018-01-01

    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

  3. How to estimate the health benefits of additional research and changing clinical practice

    OpenAIRE

    Claxton, Karl; Griffin, Susan; Koffijberg, Hendrik; McKenna, Claire

    2015-01-01

    A simple extension of standard meta-analysis can provide quantitative estimates of the potential health benefits of further research and of implementing the findings of existing research, which can help inform research prioritisation and efforts to change clinical practice

  4. How to estimate the health benefits of additional research and changing clinical practice

    OpenAIRE

    Claxton, Karl; Griffin, Susan; Koffijberg, Hendrik; McKenna, Claire

    2015-01-01

    A simple extension of standard metaanalysis can provide quantitative estimates of the potential health benefits of further research and of implementing the findings of existing research, which can help inform research prioritisation and efforts to change clinical practice

  5. Administration of additional inactive iodide during radioiodine therapy for Graves' disease. Who might benefit?

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Moka, D.; Reinholz, U.; Schmidt, M.; Schomaecker, K.; Schicha, H.; Wellner, U. [Koeln Univ. (Germany). Dept. of Nuclear Medicine

    2007-07-01

    Aim: Graves' hyperthyroidism and antithyroid drugs empty the intrathyroid stores of hormones and iodine. The consequence is rapid {sup 131}I turnover and impending failure of radioiodine therapy. Can administration of additional inactive iodide improve 131I kinetics? Patients, methods: Fifteen consecutive patients, in whom the 48 h post-therapeutically calculated thyroid dose was between 150 and 249 Gy due to an unexpectedly short half-life, received 3 x 200 {mu}g inactive potassium-iodide ({sup 127}I) daily for 3 days (Group A), while 17 consecutive patients with a thyroid dose of = 250 Gy (Group B) served as the non-iodide group. 48 hours after {sup 131}I administration (M1) and 4 or 5 days later (M2) the following parameters were compared: effective {sup 131}I half-life, thyroid dose, total T3, total T4, {sup 131}I-activity in the T3- and T4-RIAs. Results: In Group A, the effective {sup 131}I half-life M1 before iodine (3.81 {+-} 0.93 days) was significantly (p <0.01) shorter than the effective {sup 131}I half-life M2 (4.65 {+-} 0.79 days). Effective {sup 131}I half-life M1 correlated with the benefit from inactive {sup 127}I (r = -0.79): Administration of {sup 127}I was beneficial in patients with an effective {sup 131}I half-life M1 of <3 or 4 days. Patients from Group A with high initial specific {sup 131}I activity of T3 and T4 showed lower specific {sup 131}I activity after addition of inactive iodine compared with patients from the same group with a lower initial specific {sup 131}I activity of T3 and T4 and compared with the patient group B who was given no additional inactive iodide. This correlation was mathematically described and reflected in the flatter gradient in Group A (y = 0.5195x + 0.8727 for {sup 131}I T3 and y = 1.0827x - 0.4444 for {sup 131}I T4) and steeper gradient for Group B (y = 0.6998x + 0.5417 for {sup 131}I T3 and y = 1.3191x - 0.2901 for {sup 131}I T4). Radioiodine therapy was successful in all 15 patients from Group A

  6. Benefits from additives and xylanase during enzymatic hydrolysis of bamboo shoot and mature bamboo.

    Science.gov (United States)

    Li, Kena; Wang, Xiao; Wang, Jingfeng; Zhang, Junhua

    2015-09-01

    Effects of additives (BSA, PEG 6000, and Tween 80) on enzymatic hydrolysis of bamboo shoot and mature bamboo fractions (bamboo green, bamboo timber, bamboo yellow, bamboo node, and bamboo branches) by cellulases and/or xylanase were evaluated. The addition of additives was comparable to the increase of cellulase loadings in the conversion of cellulose and xylan in bamboo fractions. Supplementation of xylanase (1 mg/g DM) with cellulases (10 FPU/g DM) in the hydrolysis of bamboo fractions was more efficient than addition of additives in the production of glucose and xylose. Moreover, addition of additives could further increase the glucose release from different bamboo fractions by cellulases and xylanase. Bamboo green exhibited the lowest hydrolyzability. Almost all of the polysaccharides in pretreated bamboo shoot fractions were hydrolyzed by cellulases with the addition of additives or xylanase. Additives and xylanase showed great potential for reducing cellulase requirement in the hydrolysis of bamboo. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. 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

    % in HIGH (P health assessed by questionnaire increased similarly in MOD (P additional 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....

  8. Lignin-derived oak phenolics: a theoretical examination of additional potential health benefits of red wine.

    Science.gov (United States)

    Setzer, William N

    2011-08-01

    Lignin-derived phenolic compounds can be extracted from oak barrels during the aging of red wine, and it is hypothesized that these compounds may contribute to the health benefits of red wine by their antioxidant, radical-scavenging, or chemopreventive activities. Density functional calculations (B3LYP/6-311++G) support the radical-scavenging abilities of the oak phenolics. Sinapaldehyde, syringaldehyde, syringol, and syringylacetone all have bond dissociation energies that are lower than resveratrol and comparable to the flavonoid catechin. Molecular docking studies of the oak phenolics with known resveratrol protein targets also show that these compounds dock favorably to the protein targets. Thus, lignin-derived oak phenolics, although found in small concentrations, may contribute to the beneficial antioxidant, chemopreventive, and cardioprotective effects of red wine.

  9. Does Adjuvant Treatment With Ginkgo Biloba to Statins Have Additional Benefits in Patients With Dyslipidemia?

    Directory of Open Access Journals (Sweden)

    Yu Fan

    2018-06-01

    Full Text Available Objective: Ginkgo biloba are widely used alone or in combination with other lipid-lowering agents in the treatment of dyslipidemia in China. We conducted this meta-analysis to investigate whether adjuvant treatment with ginkgo biloba leaves to statins has incremental benefits in patients with dyslipidemia.Methods: Potential studies were searched from PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang database up to October 2017. Only randomized controlled trials (RCTs comparing the efficacy and safety of ginkgo biloba leaves plus statins versus statins alone in patients with dyslipidemia were included.Results: Eight RCTs involving 664 patients were included. Compared with statins therapy alone, combination of statins and ginkgo biloba leaves therapy achieved greater reductions in triglycerides [mean difference (MD -0.32 mmol/L; 95% confidence interval (CI -0.43 to -0.20], total cholesterol (MD -0.61 mmol/L; 95% CI -0.90 to -0.33, or low-density lipoprotein cholesterol (LDL-C (MD -0.32 mmol/L; 95% CI -0.48 to -0.16, and a greater increment in high-density lipoprotein cholesterol (MD 0.26 mmol/L; 95% CI 0.15 to 0.37. Subgroup analyses showed that ginkgo biloba leaves plus simvastatin appeared to achieve a greater reduction in serum levels of triglycerides, total cholesterol, and LDL-C than in combination with atorvastatin therapy.Conclusion: This meta-analysis suggests that adjuvant treatment with ginkgo biloba leaves appears to improve blood lipid parameters than statins therapy alone. More well-designed RCTs are needed to investigate the benefits of the combination of statins and ginkgo biloba leaves.

  10. 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.

  11. A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD.

    Science.gov (United States)

    Rector, Neil A; Richter, Margaret A; Lerman, Bethany; Regev, Rotem

    2015-01-01

    The majority of "responders" to first-line cognitive-behavioural therapy (CBT) and pharmacological treatments for obsessive-compulsive disorder (OCD) are left with residual symptoms that are clinically relevant and disabling. Therefore, there is pressing need for widely accessible efficacious alternative and/or adjunctive treatments for OCD. Accumulating evidence suggests that physical exercise may be one such intervention in the mood and anxiety disorders broadly, although we are aware of only two positive small-scale pilot studies that have tested its clinical benefits in OCD. This pilot study aimed to test the feasibility and preliminary efficacy of adding a structured physical exercise programme to CBT for OCD. A standard CBT group was delivered concurrently with a 12-week customized exercise programme to 11 participants. The exercise regimen was individualized for each participant based on peak heart rate measured using an incremental maximal exercise test. Reports of exercise adherence across the 12-week regimen exceeded 80%. A paired-samples t-test indicated very large treatment effects in Yale-Brown Obsessive-Compulsive Scale scores from pre- to post-treatment in CBT group cohorts led by expert CBT OCD specialists (d = 2.55) and junior CBT clinician non-OCD specialists (d = 2.12). These treatment effects are very large and exceed effects typically observed with individual and group-based CBT for OCD based on leading meta-analytic reviews, as well as previously obtained treatment effects for CBT using the same recruitment protocol without exercise. As such, this pilot work demonstrates the feasibility and significant potential clinical utility of a 12-week aerobic exercise programme delivered in conjunction with CBT for OCD.

  12. 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.

  13. The benefit of using additional hydrological information from earth observations and reanalysis data on water allocation decisions in irrigation districts

    Science.gov (United States)

    Kaune, Alexander; López, Patricia; Werner, Micha; de Fraiture, Charlotte

    2017-04-01

    Hydrological information on water availability and demand is vital for sound water allocation decisions in irrigation districts, particularly in times of water scarcity. However, sub-optimal water allocation decisions are often taken with incomplete hydrological information, which may lead to agricultural production loss. In this study we evaluate the benefit of additional hydrological information from earth observations and reanalysis data in supporting decisions in irrigation districts. Current water allocation decisions were emulated through heuristic operational rules for water scarce and water abundant conditions in the selected irrigation districts. The Dynamic Water Balance Model based on the Budyko framework was forced with precipitation datasets from interpolated ground measurements, remote sensing and reanalysis data, to determine the water availability for irrigation. Irrigation demands were estimated based on estimates of potential evapotranspiration and coefficient for crops grown, adjusted with the interpolated precipitation data. Decisions made using both current and additional hydrological information were evaluated through the rate at which sub-optimal decisions were made. The decisions made using an amended set of decision rules that benefit from additional information on demand in the districts were also evaluated. Results show that sub-optimal decisions can be reduced in the planning phase through improved estimates of water availability. Where there are reliable observations of water availability through gauging stations, the benefit of the improved precipitation data is found in the improved estimates of demand, equally leading to a reduction of sub-optimal decisions.

  14. Probiotics as Additives on Therapy in Allergic Airway Diseases: A Systematic Review of Benefits and Risks

    Directory of Open Access Journals (Sweden)

    Rashmi Ranjan Das

    2013-01-01

    Full Text Available Background. We conducted a systematic review to find out the role of probiotics in treatment of allergic airway diseases.  Methods. 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 < 0.05 was considered as significant. Results. A total of 12 studies were included. 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. Conclusion. 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.

  15. 5 CFR 831.641 - Division of a survivor annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Division of a survivor annuity. 831.641... REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Eligibility § 831.641 Division of a survivor annuity. (a... annuities (not including any benefits based on an election of an insurable interest annuity) payable based...

  16. 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...

  17. Additional benefit of 18F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer

    International Nuclear Information System (INIS)

    Gillies, R.S.; Middleton, M.R.; Maynard, N.D.; Bradley, K.M.; Gleeson, F.V.

    2011-01-01

    18 F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings. A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV max ), involvement of local lymph nodes and distant metastases. PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV max was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003). Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity. (orig.)

  18. Combination Cancer Therapy Can Confer Benefit via Patient-to-Patient Variability without Drug Additivity or Synergy.

    Science.gov (United States)

    Palmer, Adam C; Sorger, Peter K

    2017-12-14

    Combination cancer therapies aim to improve the probability and magnitude of therapeutic responses and reduce the likelihood of acquired resistance in an individual patient. However, drugs are tested in clinical trials on genetically diverse patient populations. We show here that patient-to-patient variability and independent drug action are sufficient to explain the superiority of many FDA-approved drug combinations in the absence of drug synergy or additivity. This is also true for combinations tested in patient-derived tumor xenografts. In a combination exhibiting independent drug action, each patient benefits solely from the drug to which his or her tumor is most sensitive, with no added benefit from other drugs. Even when drug combinations exhibit additivity or synergy in pre-clinical models, patient-to-patient variability and low cross-resistance make independent action the dominant mechanism in clinical populations. This insight represents a different way to interpret trial data and a different way to design combination therapies. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Rades, D.; Huttenlocher, S.; Evers, J.N.; Bajrovic, A.; Karstens, J.H.; Rudat, V.; Schild, S.E.

    2012-01-01

    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.)

  20. 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.

  1. 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.

  2. 78 FR 64021 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Survivor's...

    Science.gov (United States)

    2013-10-25

    ... for OMB Review; Comment Request; Survivor's Form for Benefits Under the Black Lung Benefits Act ACTION... Black Lung Benefits Act,'' to the Office of Management and Budget (OMB) for review and approval for... ``Survivor's Form for Benefits under the Black Lung Benefits Act,'' Form CM-912, to apply for benefits under...

  3. Addition of meloxicam to the treatment of bovine clinical mastitis results in a net economic benefit to the dairy farmer.

    Science.gov (United States)

    van Soest, Felix J S; Abbeloos, Elke; McDougall, Scott; Hogeveen, Henk

    2018-04-01

    Recently, it has been shown that the addition of meloxicam to standard antimicrobial therapy for clinical mastitis (CM) improves the conception rate of dairy cows contracting CM in the first 120 d in milk. The objective of our study was to assess whether this improved reproduction through additional treatment with meloxicam would result in a positive net economic benefit for the farmer. We developed a stochastic bio-economic simulation model, in which a dairy cow with CM in the first 120 d in milk was simulated. Two scenarios were simulated in which CM cases were treated with meloxicam in conjunction with antimicrobial therapy or with antimicrobial therapy alone. The scenarios differed for conception rates (31% with meloxicam or 21% without meloxicam) and for the cost of CM treatment. Sensitivity analyses were undertaken for the biological and economic components of the model to assess the effects of a wide range of inputs on inferences about the cost effectiveness of meloxicam treatment. Model results showed an average net economic benefit of €42 per CM case per year in favor of the meloxicam scenario. Cows in the no-meloxicam treatment scenario had higher returns on milk production, lower costs upon calving, and reduced costs of treatment. However, these did not outweigh the savings associated with lower feed intake, reduced number of inseminations, and the reduced culling rate. The net economic benefit favoring meloxicam therapy was a consequence of the better reproductive performance in the meloxicam scenario in which cows had a shorter calving to conception interval (132 vs. 143 d), a shorter intercalving interval (405 vs. 416 d), and fewer inseminations per conception (2.9 vs. 3.7) compared with cows in the no-meloxicam treatment scenario. This resulted in a shorter lactation, hence a lower lactational milk production (8,441 vs. 8,517 kg per lactation) with lower feeding costs in the meloxicam group. A lower culling rate (12 vs. 25%) resulted in lower

  4. 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

  5. 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.

  6. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE uniform health maintenance organization (HMO) benefit--Prime enrollment fee exemption for survivors of active duty deceased sponsors and medically retired uniformed services members and their dependents. Final rule.

    Science.gov (United States)

    2014-09-30

    This final rule creates an exception to the usual rule that TRICARE Prime enrollment fees are uniform for all retirees and their dependents and responds to public comments received to the proposed rule published in the Federal Register on June 7, 2013. Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents are part of the retiree group under TRICARE rules. In acknowledgment and appreciation of the sacrifices of these two beneficiary categories, the Secretary of Defense has elected to exercise his authority under the United States Code to exempt Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents enrolled in TRICARE Prime from paying future increases to the TRICARE Prime annual enrollment fees. The Prime beneficiaries in these categories have made significant sacrifices for our country and are entitled to special recognition and benefits for their sacrifices. Therefore, the beneficiaries in these two TRICARE beneficiary categories who enrolled in TRICARE Prime prior to 10/1/2013, and those since that date, will have their annual enrollment fee frozen at the appropriate fiscal year rate: FY2011 rate $230 per single or $460 per family, FY2012 rate $260 or $520, FY2013 rate $269.38 or $538.56, or the FY2014 rate $273.84 or $547.68. The future beneficiaries added to these categories will have their fee frozen at the rate in effect at the time they are classified in either category and enroll in TRICARE Prime or, if not enrolling, at the rate in effect at the time of enrollment. The fee remains frozen as long as at least one family member remains enrolled in TRICARE Prime and there is not a break in enrollment. The fee charged for the dependent(s) of a Medically Retired Uniformed Services Member would not change if the dependent(s) was later re-classified a Survivor.

  7. H.R. 615: A Bill to amend the Black Lung Benefits Act to provide special procedures for certain claims due to pneumoconiosis, and for other purposes. Introduced in the House of Representatives, One Hundred Fourth Congress, First sesssion

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This legislation proposes additions to the Black Lung Benefits Act related to miners submitting claims due to pneumoconiosis. The act describes the provisions for submitting claims, verification, and cause. It also describes the payment of benefits and the process for judicial review. Sections deal with benefits to survivors and dependents, and additional administrative issues.

  8. 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 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.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.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 recommendations.

  9. Improving access to supportive cancer care through an eHealth application: a qualitative needs assessment among cancer survivors.

    Science.gov (United States)

    Lubberding, Sanne; van Uden-Kraan, Cornelia F; Te Velde, Elisabeth A; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

    2015-05-01

    To gain insight into cancer survivors' needs towards an eHealth application monitoring quality of life and targeting personalised access to supportive care. Supportive care in cancer addresses survivors' concerns and needs. However, many survivors are not taking advantage of supportive care provided. To enable cancer survivors to benefit, survivors' needs must be identified timely and effectively. An eHealth application could be a solution to meet patients' individual supportive care needs. A qualitative approach. Thirty cancer survivors (15 head and neck and 15 breast cancer survivors) participated. The majority were female (n = 20·67%). The mean age was 60 (SD 8·8) years. Mean time interval since treatment was 13·5 months (SD 10·5). All interviews were audio-recorded and transcribed verbatim. During the interviews, participants were asked about their unmet needs during follow-up care and a potential eHealth application. Data were analyzed independently by two coders and coded into key issues and themes. Cancer survivors commented that they felt unprepared for the post-treatment period and that their symptoms often remained unknown to care providers. Survivors also mentioned a suboptimal referral pattern to supportive care services. Mentioned advantages of an eHealth application were as follows: insight into the course of symptoms by monitoring, availability of information among follow-up appointments, receiving personalised advice and tailored supportive care. Cancer survivors identified several unmet needs during follow-up care. Most survivors were positive towards the proposed eHealth application and expressed that it could be a valuable addition to follow-up cancer care. Study results provide care providers with insight into barriers that impede survivors from obtaining optimal supportive care. This study also provides insight into the characteristics needed to design, build and implement an eHealth application targeting personalised access to supportive

  10. Thyroid disorders in atomic bomb survivors

    International Nuclear Information System (INIS)

    Tanaka, Yoshikiyo; Inoue, Keisuke; Sugihara, Toru; Oshima, Tetuya; Matsueda, Kazuhiro

    1984-01-01

    There was no difference in blood levels of thyroid stimulating hormones among atomic bomb survivors having normal thyroid function, irrespective of the exposure distance from the explosion. Of 336 atomic bomb survivors admitted to the hospital for health examinations, hyperthyroidism was seen in one patient, hypothyroidism in four, malignant struma in three, and benign tumor in one. The incidence of struma associated with positive antithyroidglobulin antibody tended to be high in atomic bomb survivors living within 1.0 km from the explosion. The overall study in patients visiting the department of internal medicine, in addition to the 336 survivors, revealed that the incidence of thyroid disorders, especially hypothyroidism, was high in survivors directly exposed to atomic bomb. (Namekawa, K.)

  11. 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.

  12. Addition of meloxicam to the treatment of bovine clinical mastitis results in a net economic benefit to the dairy farmer

    NARCIS (Netherlands)

    Soest, van Felix J.S.; Abbeloos, Elke; McDougall, Scott; Hogeveen, Henk

    2018-01-01

    Recently, it has been shown that the addition of meloxicam to standard antimicrobial therapy for clinical mastitis (CM) improves the conception rate of dairy cows contracting CM in the first 120 d in milk. The objective of our study was to assess whether this improved reproduction through additional

  13. 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

  14. 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.

  15. 5 CFR 843.313 - Elections between survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Elections between survivor annuities. 843... Former Spouse Benefits § 843.313 Elections between survivor annuities. (a) A current spouse annuity... current spouse annuity instead of any other payments (except any accrued but unpaid annuity and any unpaid...

  16. 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.

  17. 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 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.

  18. 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...

  19. Quarterly Data for Spoken Language Preferences of Social Security Retirement and Survivor Claimants (2014-2015)

    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 for fiscal...

  20. 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...

  1. 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.

  2. 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.

  3. Pain in cancer survivors

    International Nuclear Information System (INIS)

    Mladosievicova, B.

    2017-01-01

    Pain is a common problem among cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain. Overall prevalence of all types pain is about 40% in some cancer survivors with previous specific diagnosis. Until recently, impact of pain in cancer survivors have largely been unexamined. This complication can be predicted by type of malignancy, its therapy, time elapsed from completion of anticancer treatment and effectivity of previous pain interventions. As the purpose of this article is to update readers on more recent data about prevalence of pain in cancer survivors and common treatment-related chronic pain etiologies in patients with a history of cancer who are beyond the acute diagnosis and treatment phase, previously known information about acute pain, pain in terminally ill patients. Some new studies in certain subpopulations of cancer survivors will be explored in more detail. (author)

  4. The Lifestyle Change Experiences of Cancer Survivors.

    Science.gov (United States)

    Tsay, Shiow-Luan; Ko, Wang-Sheng; Lin, Kuan-Pin

    2017-10-01

    Leading a healthy lifestyle not only alleviates the physical problems but also improves the quality of life of cancer survivors. Healthcare professionals should understand the benefits of altering lifestyle behaviors to provide effective intervention programs to assist cancer survivors to improve their health. The aim of this study was to understand the experiences of cancer survivors in changing their lifestyle after a cancer diagnosis. A qualitative descriptive study was conducted on 13 cancer survivors who were sampled purposively from a regional teaching hospital in central Taiwan. Data were collected using in-depth interviews that were guided by semistructured, open-ended questions and analyzed using content analysis. The analysis of interview data revealed four main themes: motivation of lifestyle change, exploring ways toward a healthy lifestyle, making adjustments in lifestyle, and feeling the benefits of lifestyle changes. In striving for survival, an unwillingness to bear the suffering from treatment and their acceptance of responsibility and gratitude to family members prompted most of the participants to change their lifestyle proactively. They had received inadequate lifestyle guidance and sought health lifestyle information on their own. After a period of research and self-contemplation, most of the participants adopted a consistently healthy lifestyle, changed their dietary consumption habits, abstained from tobacco and alcohol, and managed emotional problems that were caused by the disease. Participants who changed to a healthy lifestyle realized benefits in the physical, emotional, and life domains. It is hoped that these findings help healthcare professionals to better appreciate that a cancer diagnosis is a critical opportunity to link the disease to lifestyle choices in the minds of cancer survivors. Healthcare professionals should ask cancer survivors about their lifestyle and then provide appropriate advice and education on healthy lifestyles

  5. Benefits of carbon addition on the hydrogen absorption properties of Mg-based thin films grown by Pulsed Laser Deposition

    International Nuclear Information System (INIS)

    Darok, X.; Rougier, A.; Bhat, V.; Aymard, L.; Dupont, L.; Laffont, L.; Tarascon, J.-M.

    2006-01-01

    Mg-Ni thin films were grown using Pulsed Laser Deposition. In situ optical changes from shiny metallic to transparent states were observed for films deposited in vacuum and under an Ar/H 2 gas mixture (93/7%), respectively. Optical changes were also achieved by ex situ hydrogenation under hydrogen gas pressure of 15 bars at 200 deg. C. However, after ex situ hydrogenation, the optical transmittance of the Mg-based hydrogenated thin films did not exceed 25%. Such limitation was attributed to oxygen contamination, as deduced by High Resolution Transmission Electron Microscopy observations, showing the co-existence of both Mg-based and MgO phases for as-deposited films. A significant decrease in oxygen contamination was successfully achieved with the addition of carbon, leading to the preparation of (Mg-based)-C x (x < 20%) thin films showing a faster and easier hydrogenation

  6. Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study.

    Science.gov (United States)

    Perez, Giselle K; Kirchhoff, Anne C; Recklitis, Christopher; Krull, Kevin R; Kuhlthau, Karen A; Nathan, Paul C; Rabin, Julia; Armstrong, Gregory T; Leisenring, Wendy; Robison, Leslie L; Park, Elyse R

    2018-04-15

    To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p mental health coverage. Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

  7. Preoperative irradiation and surgery for recurrent rectal cancer. Will intraoperative radiotherapy (IORT) be of additional benefit? A prospective study

    International Nuclear Information System (INIS)

    Wiig, Johan Nicolay; Tveit, Kjell Magne; Poulsen, Jan Peter; Olsen, Dag Rune; Giercksky, Karl-Erik

    2002-01-01

    Background: The therapeutic gain of surgery for recurrent rectal cancer is not clear, particularly with regard to the addition of intraoperative radiotherapy (IORT). Methods: Patients (107) with isolated pelvic recurrence of rectal cancer received preoperative external radiotherapy of 46-50 in 2 Gy fractions. At surgery 59 patients had IORT 12-18 Gy. Survival and local recurrence was analysed with regard to surgical resection stages and IORT. Results: Patients (44) had R0- and 39 R1-resections, 24 R2-resections or exploratory laparotomy. IORT was given most often after R1-resections, least in R0-patients. Estimated 5-year survival was overall around 30%, around 60% in the R0-, around 25% for R1- and 0% in R2-patients. Local recurrence was around 30% in the R0- and around 65% in R1-stage patients. R0-/R1-stage patients survived statistically significantly longer than the R2-group otherwise there was no statistical significant difference between IORT and non-IORT groups in any R-stages regarding overall survival or local recurrence. Conclusions: Macroscopic removal of the recurrence improves survival. Whether R0- is better than R1-resections is not clear. The effect of IORT is not a major one. IORT need be evaluated in randomised controlled trials

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

    Science.gov (United States)

    Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

    2015-01-01

    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 expectations for the implant, and facilitate family adaptation.

  9. 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.

  10. Guidelines Urge Exercise for Cancer Patients, Survivors

    Science.gov (United States)

    The benefits of exercise are well documented in a number of cancers. A panel of experts in cancer, fitness, obesity, and exercise training convened by the American College of Sports Medicine is spreading what they believe to be one of the most important messages for cancer patients and survivors: Avoid inactivity.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

    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 (p < 0.001); age ≤59 years showed a strong trend (p = 0.054). On multivariate analysis, performance status (p < 0.001) and age (p = 0.041) were significant. In breast cancer patients with few brain metastases, radiosurgery plus whole

  12. 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...... established that it is feasible to combine GO with conventional chemotherapy. We now report a large randomized trial testing the addition of GO to induction and/or consolidation chemotherapy in untreated younger patients. PATIENTS AND METHODS: In this open-label trial, 1,113 patients, predominantly younger...... in toxicity. There was no overall difference in response or survival in either induction of consolidation. However, a predefined analysis by cytogenetics showed highly significant interaction with induction GO (P = .001), with significant survival benefit for patients with favorable cytogenetics, no benefit...

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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,

  18. Additional benefit of {sup 18}F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gillies, R.S. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Medical Oncology, Oxford (United Kingdom); Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Middleton, M.R. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Medical Oncology, Oxford (United Kingdom); Maynard, N.D. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Bradley, K.M.; Gleeson, F.V. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

    2011-02-15

    {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings. A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV{sub max}), involvement of local lymph nodes and distant metastases. PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV{sub max} was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003). Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity. (orig.)

  19. 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

  20. Evaluating a nurse-led survivorship care package (SurvivorCare) for bowel cancer survivors: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Jefford, Michael; Aranda, Sanchia; Gough, Karla; Lotfi-Jam, Kerryann; Butow, Phyllis; Krishnasamy, Mei; Young, Jane; Phipps-Nelson, Jo; Russell, Lahiru; King, Dorothy; Schofield, Penelope

    2013-08-19

    Colorectal cancer (CRC) is the most common cancer affecting both men and women in Australia. The illness and related treatments can cause distressing adverse effects, impact on emotional and psychological well-being, and adversely affect social, occupational and relationship functioning for many years after the end of treatment or, in fact, lifelong. Current models of follow-up fail to address the complex needs arising after treatment completion. Strategies to better prepare and support survivors are urgently required. We previously developed a nurse-led supportive care program (SurvivorCare) and tested it in a pilot study involving 10 CRC survivors. The intervention was found to be highly acceptable, appropriate, relevant and useful. This study is a multisite, randomised controlled trial, designed to assess the impact of the addition of the SurvivorCare intervention to usual post-treatment care, for people with potentially cured CRC. SurvivorCare comprises the provision of survivorship educational materials, a tailored survivorship care plan, an individually tailored nurse-led, face-to-face end of treatment consultation and three subsequent telephone calls. Eligible patients have completed treatment for potentially cured CRC. Other eligibility criteria include stage I to III disease, age greater than 18 years and adequate understanding of English. All consenting patients complete questionnaires at three time points over a six-month period (baseline, two and six months). Measures assess psychological distress, unmet needs and quality of life. This supportive care package has the potential to significantly reduce individual suffering, whilst reducing the burden of follow-up on acute cancer services through enhanced engagement with and utilisation of general practitioners and community based services. If the intervention is successful in achieving the expected health benefits, it could be disseminated readily. All training and supporting materials have been developed

  1. 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.

  2. 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.

  3. Benefit of the addition of hormone therapy to neoadjuvant anthracycline-based chemotherapy for breast cancer: comparison of predicted and observed pCR.

    Science.gov (United States)

    Generali, Daniele; Corona, Silvia Paola; Pusztai, Lajos; Rouzier, Roman; Allevi, Giovanni; Aguggini, Sergio; Milani, Manuela; Strina, Carla; Frati, Albane

    2018-03-01

    Neoadjuvant hormonal therapy is generally considered a valid option for hormone receptor positive breast cancer (BC) patients who are unfit for chemotherapy or surgery. Whilst numerous studies analyzed efficacy of neoadjuvant chemotherapy (CT) or endocrine therapy (HT) alone in hormone receptor positive patients, there is a lack of research looking at the usefulness of a preoperative combinatorial approach of CT and HT in this patient subgroup. Using a predictive model previously described in the literature, developed to analyze the probability of benefit from preoperative chemotherapy, we were able to compare pathological complete response (pCR) rates expected with the use of CT alone with the pCR rates reported in a population of 192 patients treated with the combination of tamoxifen plus anthracycline-based CT at Cremona Hospital between 2003 and 2006. Even with a relatively small patient population, this approach provided insightful information for the selection of hormone receptor positive BC patients most likely to benefit from the use of preoperative HT and CT in combination. Whilst no statistically significant benefit was obtained with the addition of tamoxifen to neoadjuvant chemotherapy in the entire population, or in any of the molecular stratification subgroups, the analysis of the calibration curve showed that a combinatorial approach may improve pCR in patients with luminal B tumors. More specific trials should be designed to confirm our initial results. To the best of our knowledge, this is the first report investigating the efficacy of the combination of CT and HT in the neoadjuvant treatment of hormone receptor positive BC.

  4. Who are the cancer survivors?

    DEFF Research Database (Denmark)

    Hovaldt, Hanna Birkbak; Suppli, N P; Olsen, M H

    2015-01-01

    was compared by social position with the non-cancer population. Results: Cancer survivors composed 4% of the Danish population. Somatic comorbidity was more likely among survivors (OR 1.59, 95% CI 1.57-1.60) and associated with higher age, male sex, short education, and living alone among survivors......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....... Conclusions: Among cancer survivors, comorbidity is common and highly associated with social position....

  5. 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;…

  6. 20 CFR 404.1805 - Paying benefits.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Paying benefits. 404.1805 Section 404.1805 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Payment Procedures § 404.1805 Paying benefits. (a) As soon as possible after we have made a determination...

  7. Posttraumatic stress symptoms in adult survivors of childhood cancer.

    Science.gov (United States)

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

    2004-06-01

    Previous research suggests that posttraumatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraumatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic, medical and treatment factors on survivors' posttraumatic stress symptoms was studied. Participants were 500 long-term survivors of childhood cancer. The median age at follow-up was 24 years (age range, 16- 49 years, 47% female). To assess symptoms of posttraumatic stress, all participants completed the Impact of Event Scale (IES), a self-report instrument consisting of two subscales, intrusion and avoidance. Twelve percent of this sample of adult survivors of childhood cancer had scores in the severe range, indicating they are unable to cope with the impact of their disease and need professional help. Twenty percent of the female survivors had scores in the severe range as compared with 6% of the male survivors. Linear regression models revealed that being female, unemployed, a lower educational level, type of diagnosis and severe late effects/health problems were associated with posttraumatic stress symptoms. The results indicate that, although the proportion of survivors reporting symptoms is well within the proportions found in the general population, a substantial subset of survivors report symptoms of posttraumatic stress. This finding supports the outcomes reported previously that diagnosis and treatment for childhood cancer may have significant long-term effects, which are manifested in symptoms of posttraumatic stress. The investigated factors could explain posttraumatic stress symptoms only to a limited extent. Further research exploring symptoms of posttraumatic stress in childhood cancer survivors in more detail is clearly warranted. From a clinical perspective, health care providers must pay attention to these symptoms during evaluations in the follow-up clinic. Early

  8. Innovation in survivor care: group visits.

    Science.gov (United States)

    Trotter, Kathryn; Frazier, Alana; Hendricks, Colleen K; Scarsella, Heidi

    2011-04-01

    The Centering Cancer Survivorship (CCS) follow-up care program is an innovation in healthcare delivery that meets the needs of cancer survivors and cancer centers. Piloted in a breast cancer clinic, the program provides an avenue for provision of psychological support and health-promotion activities, as well as surveillance for recurrence or late effects. The program empowers each survivor by enlisting her to produce a written breast cancer survivorship care plan for personal use and to share with her primary care provider. Concurrently, this innovation should enhance the viability of the primary cancer center by freeing appointment slots for oncologists who provide expensive therapies to newly diagnosed patients. The CCS program's central feature is the implementation of a multidisciplinary clinic designated specifically for breast cancer survivors in which follow-up care is provided through a group visit medical model. This model of care provides opportunities for health assessment, patient empowerment, and patient education within a framework of social support from peers with similar issues. The group visit model may be well suited to addressing the unique chronic healthcare needs of breast cancer survivors. Further evaluation is needed to verify cost-benefit analysis.

  9. Working situation of cancer survivors versus the general population.

    Science.gov (United States)

    Lee, Myung Kyung; Yun, Young Ho

    2015-06-01

    The purposes of this study were to compare the working situation of cancer survivors and the general (cancer-free) population and investigate characteristics associated with the increased likelihood of unemployment between the two groups. We selected 1927 cancer survivors from the 2008 Korean Community Health Survey data less than 65 years of age and used propensity score matching to randomly select 1924 individuals from the general population who closely resembled the cancer survivors. Compared to the general population, cancer survivors were less likely to be engaged in paid work, particularly as permanent workers, and were more likely to work regular hours. Additionally, they tended to do less work that involved lifting or moving heavy objects and uncomfortable postures and were more willing to express their emotions. An increased probability of unemployment among cancer survivors was associated with being over 50 years old, being female, having a lower monthly income, having multiple comorbidities, belonging to a nuclear family, being a National Basic Livelihood Act beneficiary, and having a recent diagnosis. Cancer survivors may want to pursue flexible occupations and improve their working situation. Further, they perceive their workplace more positively compared to the general population. Respecting the cancer survivor's choice to find flexible working conditions that suit their health needs and status, health-care providers involved in managing work-related issues among cancer survivors should be aware of the interaction between work-related concerns and post-cancer disease management.

  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 receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  11. 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...

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

    International Nuclear Information System (INIS)

    Hahn, Seok; Lee, Young Han; Suh, Jin Suck

    2016-01-01

    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

  13. 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.

  14. 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.

  15. 26 CFR 1.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Qualified joint and survivor annuities. 1.401(a...)-11 Qualified joint and survivor annuities. (a) General rule—(1) Required provisions. A trust, to...), which is a part of a plan providing for the payment of benefits in any form of a life annuity (as...

  16. 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).

  17. Pathways to Police Contact for Spousal Violence Survivors: The Role of Individual and Neighborhood Factors in Survivors' Reporting Behaviors.

    Science.gov (United States)

    Barrett, Betty Jo; Peirone, Amy; Cheung, Chi Ho; Habibov, Nazim

    2017-09-01

    Rational choice theory proposes that spousal violence survivors engage in a cost-benefit analysis when determining whether to contact the police in the aftermath of violence. Feminist intersectional frameworks contend that the perceived costs and benefits of police intervention differ among survivors based on their intersecting social identities. Normative theory further posits that it is not solely individual factors but also social norms derived from one's neighborhood context that may be related to reporting practices. Consistent with these perspectives, this study assessed the association between spousal violence survivors' sociodemographic, violence, and neighborhood characteristics and (a) police contact, (b) pathways to police contact, (c) motivations for contacting the police, and (d) motivations for not contacting the police. Data were drawn from the 2009 Canadian General Social Survey-Victimization main file, and included male and female survivors ( N = 890). Survivors most commonly contacted the police to stop the violence (89.4%) and most commonly did not contact the police because they did not believe it was important enough (35.3%). Results of multivariate regression analysis indicate that survivors who were visible minority, those who feared for their lives, and those who were injured were significantly more likely to self-report violence to police. Survivors were more likely to say the violence was not important enough to report if there was a police station in their neighborhood, and were less likely to say that violence was not important enough to report if they had experienced multiple incidents of violence. Implications for policing and criminal justice system engagement with spousal violence survivors are provided.

  18. Design of the Steps to Health Study of Physical Activity in Survivors of Endometrial Cancer: Testing a Social Cognitive Theory Model.

    Science.gov (United States)

    Basen-Engquist, Karen; Carmack, Cindy L; Perkins, Heidi; Hughes, Daniel; Serice, Susan; Scruggs, Stacie; Pinto, Bernardine; Waters, Andrew

    2011-01-01

    Physical activity has been shown to benefit cancer survivors' physical functioning, emotional well-being, and symptoms. Physical activity may be of particular benefit to survivors of endometrial cancer because they are more likely to be obese and sedentary than the general population, as these are risk factors for the disease, and thus experience a number of related co-morbid health problems. However, there is little research systematically studying mechanisms of physical activity adherence in cancer survivor populations. This paper describes the design of the Steps to Health study, which applies a Social Cognitive Theory-based model of endometrial cancer survivors' adoption and maintenance of exercise in the context of an intervention to increase walking or other moderate intensity cardiovascular activity. In Steps to Health we will test the influence of self-efficacy and outcome expectations on adherence to exercise recommendations, as well as studying the determinants of self-efficacy. Endometrial cancer survivors who are at least 6 months post-treatment are provided with an intervention involving print materials and telephone counseling, and complete assessments of fitness, activity, self-efficacy and outcome expectations, and determinants of self-efficacy every two months for a six month period. In addition to testing an innovative model, the Steps to Health study employs multiple assessment methods, including ecological momentary assessment, implicit tests of cognitive variables, and ambulatory monitoring of physical activity. The study results can be used to develop more effective interventions for increasing physical activity in sedentary cancer survivors by taking into account the full complement of sources of self-efficacy information and outcome expectations.

  19. Addition of Everolimus Post VEGFR Inhibition Treatment Failure in Advanced Sarcoma Patients Who Previously Benefited from VEGFR Inhibition: A Case Series

    OpenAIRE

    ElNaggar, Adam C.; Hays, John L.; Chen, James L.

    2016-01-01

    Background Patients with metastatic sarcoma who progress on vascular endothelial growth factor receptor inhibitors (VEGFRi) have limited treatment options. Upregulation of the mTOR pathway has been demonstrated to be a means of resistance to targeted VEGFRi in metastatic sarcoma. Patients and methods Retrospective cohort study to evaluate the clinical benefit at four months of combining mTOR inhibition (mTORi) via everolimus with VEGFRi in patients who have derived benefit from single-agent V...

  20. Benefits of Hot Isostatic Pressure/Powdered Metal (HIP/PM) and Additive Manufacturing (AM) To Fabricate Advanced Energy System Components

    Energy Technology Data Exchange (ETDEWEB)

    Horton, Nancy [Energy Industries of Ohio, Cleveland, OH (United States); Sheppard, Roy [Energy Industries of Ohio, Cleveland, OH (United States)

    2016-12-31

    Advanced Energy systems require large, complex components produced from materials capable of withstanding severe operating environments (high temperature, pressure, corrosivity). Such parts can be difficult to source, as conventional material processing technologies must be tailored to ensure a safe and cost effective approach to large-scale manufacture of quality structural advanced alloy components that meet the performance specifications of AE systems. (HIP/PM) has shown advantages over other manufacturing methods when working with these materials. For example, using HIP’ing in lieu of casting means significant savings in raw material costs, which for expensive, high-nickel alloys can be considerable for large-scale production. Use of HIP/PM also eliminates the difficulties resulting from reactivity of these materials in the molten state and facilitates manufacture of the large size requirements of the AE industry, producing a part that is defect and porosity free, thus further reducing or eliminating time and expense of post processing machining and weld repair. New advances in Additive Manufacturing (AM) techniques make it possible to further expand the benefits of HIP/PM in producing AE system components to create an even more robust manufacturing approach. Traditional techniques of welding and forming sheet metal to produce the HIP canisters can be time consuming and costly, with limitations on the complexity of part which can be achieved. A key benefit of AM is the freedom of design that it offers, so use of AM could overcome such challenges, ultimately enabling redesign of complete energy systems. A critical step toward this goal is material characterization of the required advanced alloys, for use in AM. Using Haynes 282, a high nickel alloy of interest to the Fossil Energy community, particularly for Advanced-UltraSuperCritical (AUSC) operating environments, as well as the crosscutting interests of the aerospace, defense and medical markets, this

  1. 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.

  2. 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

  3. Rehabilitating torture survivors

    DEFF Research Database (Denmark)

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

    2009-01-01

    survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components......, in December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...

  4. Cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Shigematsu, I.; Kagan, A.

    1986-01-01

    This book presents information on the following topics: sampling of atomic bomb survivors and method of cancer detection in Hiroshima and Nagasaki; atomic bomb dosimetry for epidemiological studies of survivors in Hiroshima and Nagasaki; tumor and tissue registries in Hiroshima and Nagasaki; the cancer registry in Nagasaki, with atomic bomb survivor data, 1973-1977; cancer mortality; methods for study of delayed health effects of a-bomb radiation; experimental radiation carcinogenesis in rodents; leukemia, multiple myeloma, and malignant lymphoma; cancer of the thyroid and salivary glands; malignant tumors in atomic bomb survivors with special reference to the pathology of stomach and lung cancer; colorectal cancer among atomic bomb survivors; breast cancer in atomic bomb survivors; and ovarian neoplasms in atomic bomb survirors

  5. Cancer survivors' experience of time

    DEFF Research Database (Denmark)

    Rasmussen, Dorte M.; Elverdam, Beth

    2007-01-01

    , and prioritize how and with whom they want to spend their time. CONCLUSION: With an increasing number of people being cured following a cancer diagnosis, nurses and oncology nurse specialists who work with cancer survivors must be aware of the fact that time is a central theme in understanding cancer survivors......' lives, and they must know how to guide these survivors in their new lives and take care of their well-being....

  6. 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.

  7. Maladaptive behavior in survivors: dysexecutive survivor syndrome.

    Science.gov (United States)

    Leach, John

    2012-12-01

    This paper attempts to answer the question: why does normal, goal-directed, purposeful, and coordinated behavior fragment in a survival situation? Events accompanying the initial impact phase of a survival incident are characterized by speed, danger, violence, and uncontrollability. The following recoil phase is known to produce behavioral and cognitive impairment that leads to a reduced ability to produce a response that is meaningful and may result in tonic immobility. The author argues that the commonly witnessed responses among survivors comprise a subset of known behaviors, including loss of initiative, stereotypy, perseveration of thought and action, hyperkinesia, hypokinesia, and, in extreme cases, akinesia or cognitive paralysis. These behaviors are characteristic of executive dysfunction and a model is given suggesting how this condition may arise under survival conditions. The case is presented that during the initial phase of a survival incident, victims show a transient, nonclinical dysexecutive syndrome. This model should aid survival training and provide a context for conducting behavioral autopsies by accident investigators.

  8. 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.

  9. Japanese Legacy Cohorts: The Life Span Study Atomic Bomb Survivor Cohort and Survivors' Offspring.

    Science.gov (United States)

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

    2018-04-05

    Cohorts of atomic bomb survivors-including those exposed in utero-and children conceived after parental exposure were established to investigate late health effects of atomic bomb radiation and its transgenerational effects by the Atomic Bomb Casualty Commission (ABCC) in the 1950s. ABCC was reorganized to the Radiation Effects Research Foundation (RERF) in 1975, and all work has been continued at RERF. The Life Span Study, the cohort of survivors, consists of about 120,000 subjects and has been followed since 1950. Cohorts of in utero survivors and the survivors' children include about 3,600 and 77,000 subjects, respectively, and have been followed since 1945. Atomic bomb radiation dose was estimated for each subject based on location at the time of the bombing and shielding conditions from exposure, which were obtained through enormous efforts of investigators and cooperation of subjects. Outcomes include vital status, cause of death, and cancer incidence. In addition, sub-cohorts of these three cohorts were constructed to examine clinical features of late health effects, and the subjects have been invited to periodic health examinations at clinics of ABCC and RERF. They were also asked to donate biosamples for biomedical investigations. Epidemiological studies have observed increased radiation risks for malignant diseases among survivors, including those exposed in utero, and possible risks for some non-cancer diseases. In children of survivors, no increased risks due to parental exposure to radiation have been observed for malignancies or other diseases, but investigations are continuing, as these cohorts are still relatively young.

  10. Trafficking in Women in Bangladesh: Experiences of Survivors and Challenges to their Reintegration

    OpenAIRE

    Rosy, Sabiha Yeasmin

    2013-01-01

    This study aims to focus on the challenges behind the reintegration process of trafficking survivors in their families and communities in Bangladesh. In doing so, this research tries to explore the experiences of trafficked survivors in the process of being trafficked, their life in brothel and returning to Bangladesh. In addition, it helps to understand the perception of survivors in their reintegration along with the perceptions of community people and family members. This study also brings...

  11. Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial.

    Science.gov (United States)

    Zachariae, Robert; Amidi, Ali; Damholdt, Malene F; Clausen, Cecilie D R; Dahlgaard, Jesper; Lord, Holly; Thorndike, Frances P; Ritterband, Lee M

    2018-02-20

    Insomnia is two to three times more prevalent in cancer survivors than in the general population, where it is estimated to be 10% to 20%. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, but meeting survivor needs remains a challenge. Internet-delivered CBT-I (iCBT-I) has been shown efficacious in otherwise healthy adults. We tested the efficacy of iCBT-I in breast cancer survivors with clinically significant sleep disturbance. Women from a national sample of Danish breast cancer survivors who experienced clinically significant sleep disturbance were randomly allocated to iCBT-I or waitlist control (55:45). The fully automated iCBT-I program consisted of six cores. Online measures of insomnia severity, sleep quality, and fatigue were collected at baseline, postintervention (nine weeks), and follow-up (15 weeks). Online sleep diaries were completed over two-week periods pre- and postintervention. Intention-to-treat analyses (time × group interactions) were conducted with mixed linear models and corrected for multiple outcomes. All statistical tests were two-sided. A total of 255 women were randomly allocated to iCBT-I (n = 133) or waitlist control (n = 122). Statistically significant (P ≤ .02) time × group interactions were found for all sleep-related outcomes from pre- to postintervention. Effect sizes (Cohen's d) ranged from 0.33 (95% confidence interval [CI] = 0.06 to 0.61) for wake after sleep onset to 1.17 (95% CI = 0.87 to 1.47) for insomnia severity. Improvements were maintained for outcomes measured at follow-up (d = 0.66-1.10). iCBT-I appears to be effective in breast cancer survivors, with additional benefit in terms of reduced fatigue. This low-cost treatment could be incorporated in cancer rehabilitation programs.

  12. 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.

  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. Work related issues.

    Science.gov (United States)

    Schultz, Pamela N; Beck, Martha L; Stava, Charles; Sellin, Rena V

    2002-05-01

    New and more effective treatments for cancer have resulted in individuals living longer with a better quality of life. Many more survivors are employed in the workplace. Cancer is no longer only an issue for survivors and their families; it has become an issue for the employer and the workplace. This article describes survey results of 4,364 long term cancer survivors in which they were asked to respond to items describing their ability to work, job discrimination, and quality of life. Thirty-five percent of survivors were working at the time they completed the survey, and 8.5% considered themselves unable to work. This research has shown that age, gender, ethnic group, and cancer type affected the working status of the survivors. Of survivors continuing to work, 7.3% indicated they had experienced job discrimination. The results indicate most cancer survivors do not perceive employment related problems, and are readily assimilated into the work force. Job discrimination and the ability to work is a quality of life issue.

  16. Standard versus prosocial online support groups for distressed breast cancer survivors: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Golant Mitch

    2011-08-01

    Full Text Available Abstract Background The Internet can increase access to psychosocial care for breast cancer survivors through online support groups. This study will test a novel prosocial online group that emphasizes both opportunities for getting and giving help. Based on the helper therapy principle, it is hypothesized that the addition of structured helping opportunities and coaching on how to help others online will increase the psychological benefits of a standard online group. Methods/Design A two-armed randomized controlled trial with pretest and posttest. Non-metastatic breast cancer survivors with elevated psychological distress will be randomized to either a standard facilitated online group or to a prosocial facilitated online group, which combines online exchanges of support with structured helping opportunities (blogging, breast cancer outreach and coaching on how best to give support to others. Validated and reliable measures will be administered to women approximately one month before and after the interventions. Self-esteem, positive affect, and sense of belonging will be tested as potential mediators of the primary outcomes of depressive/anxious symptoms and sense of purpose in life. Discussion This study will test an innovative approach to maximizing the psychological benefits of cancer online support groups. The theory-based prosocial online support group intervention model is sustainable, because it can be implemented by private non-profit or other organizations, such as cancer centers, which mostly offer face-to-face support groups with limited patient reach. Trial Registration ClinicalTrials.gov: NCT01396174

  17. Standard versus prosocial online support groups for distressed breast cancer survivors: a randomized controlled trial.

    Science.gov (United States)

    Lepore, Stephen J; Buzaglo, Joanne S; Lieberman, Morton A; Golant, Mitch; Davey, Adam

    2011-08-25

    The Internet can increase access to psychosocial care for breast cancer survivors through online support groups. This study will test a novel prosocial online group that emphasizes both opportunities for getting and giving help. Based on the helper therapy principle, it is hypothesized that the addition of structured helping opportunities and coaching on how to help others online will increase the psychological benefits of a standard online group. A two-armed randomized controlled trial with pretest and posttest. Non-metastatic breast cancer survivors with elevated psychological distress will be randomized to either a standard facilitated online group or to a prosocial facilitated online group, which combines online exchanges of support with structured helping opportunities (blogging, breast cancer outreach) and coaching on how best to give support to others. Validated and reliable measures will be administered to women approximately one month before and after the interventions. Self-esteem, positive affect, and sense of belonging will be tested as potential mediators of the primary outcomes of depressive/anxious symptoms and sense of purpose in life. This study will test an innovative approach to maximizing the psychological benefits of cancer online support groups. The theory-based prosocial online support group intervention model is sustainable, because it can be implemented by private non-profit or other organizations, such as cancer centers, which mostly offer face-to-face support groups with limited patient reach. ClinicalTrials.gov: NCT01396174.

  18. Who foregoes survivor protection in employer-sponsored pension annuities?

    Science.gov (United States)

    Johnson, Richard W; Uccello, Cori E; Goldwyn, Joshua H

    2005-02-01

    Retirees in traditional pension plans must generally choose between single life annuities, which provide regular payments until death, and joint and survivor annuities, which pay less each month but continue to make payments to the spouse after the death of the retired worker. This article examines the payout decision and measures the share of married retirees with pension annuities who forego survivor protection. The analysis consists of a probit model of the pension payout decision, based on data from the 1992-2000 waves of the Health and Retirement Study. More than one quarter (28%) of married men and two thirds of married women receiving employer-sponsored retirement annuities declined survivor protection. Men with small pensions and limited household wealth, men in better health than their spouses, and men whose spouses have pension coverage from their own employers are more likely than other men to reject survivor protection. Most workers appear to make payout decisions by rationally balancing the costs and benefits of each type of annuity, suggesting that existing measures to encourage joint and survivor annuities are adequate. However, the growth in 401(k) plans, which are generally not covered by existing laws protecting spousal pension rights, may leave widows vulnerable.

  19. Estimate of the benefits of a population-based reduction in dietary sodium additives on hypertension and its related health care costs in Canada.

    Science.gov (United States)

    Joffres, Michel R; Campbell, Norm R C; Manns, Braden; Tu, Karen

    2007-05-01

    Hypertension is the leading risk factor for mortality worldwide. One-quarter of the adult Canadian population has hypertension, and more than 90% of the population is estimated to develop hypertension if they live an average lifespan. Reductions in dietary sodium additives significantly lower systolic and diastolic blood pressure, and population reductions in dietary sodium are recommended by major scientific and public health organizations. To estimate the reduction in hypertension prevalence and specific hypertension management cost savings associated with a population-wide reduction in dietary sodium additives. Based on data from clinical trials, reducing dietary sodium additives by 1840 mg/day would result in a decrease of 5.06 mmHg (systolic) and 2.7 mmHg (diastolic) blood pressures. Using Canadian Heart Health Survey data, the resulting reduction in hypertension was estimated. Costs of laboratory testing and physician visits were based on 2001 to 2003 Ontario Health Insurance Plan data, and the number of physician visits and costs of medications for patients with hypertension were taken from 2003 IMS Canada. To estimate the reduction in total physician visits and laboratory costs, current estimates of aware hypertensive patients in Canada were used from the Canadian Community Health Survey. Reducing dietary sodium additives may decrease hypertension prevalence by 30%, resulting in one million fewer hypertensive patients in Canada, and almost double the treatment and control rate. Direct cost savings related to fewer physician visits, laboratory tests and lower medication use are estimated to be approximately $430 million per year. Physician visits and laboratory costs would decrease by 6.5%, and 23% fewer treated hypertensive patients would require medications for control of blood pressure. Based on these estimates, lowering dietary sodium additives would lead to a large reduction in hypertension prevalence and result in health care cost savings in Canada.

  20. PP087. Deep trial secondary analysis: Digoxin immune fab fragment treatment has additional benefits in endogenous digitalis-like factor positive preeclamptic women.

    Science.gov (United States)

    Graves, S W; Hopoate-Sitake, M; Johnston, A; Buckalew, V; Lam, G; Mason, L; Adair, D

    2012-07-01

    A double blinded placebo controlled clinical trial of a commercial digoxin immune Fab fragment (DIF) in preeclamptic (PE) women provided some benefit to treated subjects (1). In that study DIF, relative to placebo, prevented a decline in CrCl and lowered levels of endogenous digitalis-like factor (EDLF) activity as measured by sodium pump inhibition (SPI). However, some PE subjects had undetectable EDLF. The hypothesis tested was that only PE women with measureable EDLF would respond to DIF treatment and analysis of EDLF positive women might reveal treatment effects masked by inclusion of EDLF negative, and hence non-responding, PE women. Accordingly, analyses of DIF effects in EDLF positive PE women were conducted. Patient characteristics and study design have been published (1). In these subanalyses, subjects were considered to be EDLF positive if their plasma inhibited red cell sodium pump mediated Rb uptake. All analyses were redone for the EDLF positive subgroup by Covance Inc as in the original trial. Continuous data were analyzed by ANCOVA. Categorical data were analyzed by Barnard Exact Test. 45 subjects (23 DIF, 22 placebo) had baseline SPI evaluated. Of these 22% had undetectable SPI. EDLF positive PE women showed greater and more significant reductions of SPI in response to DIF at each time point (12, 24, 48 hr treatment) than in the original analysis. Subjects with undetectable EDLF showed no significant change in response to DIF or placebo. For CrCl, EDLF positive PE women showed greater and more significant preservation of CrCl compared with original analyses. Subjects absent EDLF showed deterioration of CrCl with or without DIF. Among EDLF positive PE women DIF treated women had significantly less maternal pulmonary edema (p=0.035) and significantly less intraventricular hemorrhage in their infants (p=0.015). There was the suggestion of reductions in the incidence of other maternal and neonatal abnormalities. These data indicate that EDLF positive PE

  1. 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.

  2. Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

    Directory of Open Access Journals (Sweden)

    Mehrdad Bakhshayeshkaram

    2016-01-01

    Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

  3. Intensified hyperfractionated accelerated radiotherapy limits the additional benefit of simultaneous chemotherapy--results of a multicentric randomized German trial in advanced head-and-neck cancer.

    Science.gov (United States)

    Staar, S; Rudat, V; Stuetzer, H; Dietz, A; Volling, P; Schroeder, M; Flentje, M; Eckel, H E; Mueller, R P

    2001-08-01

    To demonstrate the efficacy of radiochemotherapy (RCT) as the first choice of treatment for advanced unresectable head-and-neck cancer. To prove an expected benefit of simultaneously given chemotherapy, a two-arm randomized study with hyperfractionated accelerated radiochemotherapy (HF-ACC-RCT) vs. hyperfractionated accelerated radiotherapy (HF-ACC-RT) was initiated. The primary endpoint was 1-year survival with local control (SLC). Patients with Stage III and IV (UICC) unresectable oro- and hypopharyngeal carcinomas were randomized for HF-ACC-RCT with 2 cycles of 5-FU (600 mg/m(2)/day)/carboplatinum (70 mg/m(2)) on days 1--5 and 29--33 (arm A) or HF-ACC-RT alone (arm B). In both arms, there was a second randomization for testing the effect of prophylactically given G-CSF (263 microg, days 15--19) on mucosal toxicity. Total RT dose in both arms was 69.9 Gy in 38 days, with a concomitant boost regimen (weeks 1--3: 1.8 Gy/day, weeks 4 and 5: b.i.d. RT with 1.8 Gy/1.5 Gy). Between July 1995 and May 1999, 263 patients were randomized (median age 56 years; 96% Stage IV tumors, 4% Stage III tumors). This analysis is based on 240 patients: 113 patients with RCT and 127 patients with RT, qualified for protocol and starting treatment. There were 178 oropharyngeal and 62 hypopharyngeal carcinomas. Treatment was tolerable in both arms, with a higher mucosal toxicity after RCT. Restaging showed comparable nonsignificant different CR + PR rates of 92.4% after RCT and 87.9% after RT (p = 0.29). After a median observed time of 22.3 months, l- and 2-year local-regional control (LRC) rates were 69% and 51% after RCT and 58% and 45% after RT (p = 0.14). There was a significantly better 1-year SLC after RCT (58%) compared with RT (44%, p = 0.05). Patients with oropharyngeal carcinomas showed significantly better SLC after RCT (60%) vs. RT (40%, p = 0.01); the smaller group of hypopharyngeal carcinomas had no statistical benefit of RCT (p = 0.84). For both tumor locations

  4. Intensified hyperfractionated accelerated radiotherapy limits the additional benefit of simultaneous chemotherapy--results of a multicentric randomized German trial in advanced head-and-neck cancer

    International Nuclear Information System (INIS)

    Staar, Susanne; Rudat, Volker; Stuetzer, Hartmut; Dietz, Andreas; Volling, Peter; Schroeder, Michael; Flentje, Michael; Eckel, Hans Edmund; Mueller, Rolf-Peter

    2001-01-01

    Purpose: To demonstrate the efficacy of radiochemotherapy (RCT) as the first choice of treatment for advanced unresectable head-and-neck cancer. To prove an expected benefit of simultaneously given chemotherapy, a two-arm randomized study with hyperfractionated accelerated radiochemotherapy (HF-ACC-RCT) vs. hyperfractionated accelerated radiotherapy (HF-ACC-RT) was initiated. The primary endpoint was 1-year survival with local control (SLC). Methods and Materials: Patients with Stage III and IV (UICC) unresectable oro- and hypopharyngeal carcinomas were randomized for HF-ACC-RCT with 2 cycles of 5-FU (600 mg/m 2 /day)/carboplatinum (70 mg/m 2 ) on days 1-5 and 29-33 (arm A) or HF-ACC-RT alone (arm B). In both arms, there was a second randomization for testing the effect of prophylactically given G-CSF (263 μg, days 15-19) on mucosal toxicity. Total RT dose in both arms was 69.9 Gy in 38 days, with a concomitant boost regimen (weeks 1-3: 1.8 Gy/day, weeks 4 and 5: b.i.d. RT with 1.8 Gy/1.5 Gy). Between July 1995 and May 1999, 263 patients were randomized (median age 56 years; 96% Stage IV tumors, 4% Stage III tumors). Results: This analysis is based on 240 patients: 113 patients with RCT and 127 patients with RT, qualified for protocol and starting treatment. There were 178 oropharyngeal and 62 hypopharyngeal carcinomas. Treatment was tolerable in both arms, with a higher mucosal toxicity after RCT. Restaging showed comparable nonsignificant different CR + PR rates of 92.4% after RCT and 87.9% after RT (p=0.29). After a median observed time of 22.3 months, l- and 2-year local-regional control (LRC) rates were 69% and 51% after RCT and 58% and 45% after RT (p=0.14). There was a significantly better 1-year SLC after RCT (58%) compared with RT (44%, p=0.05). Patients with oropharyngeal carcinomas showed significantly better SLC after RCT (60%) vs. RT (40%, p=0.01); the smaller group of hypopharyngeal carcinomas had no statistical benefit of RCT (p=0.84). For both

  5. Whole-exome sequencing gives additional benefits compared to candidate gene sequencing in the molecular diagnosis of children with growth hormone or IGF-1 insensitivity.

    Science.gov (United States)

    Shapiro, Lucy; Chatterjee, Sumana; Ramadan, Dina G; Davies, Kate M; Savage, Martin O; Metherell, Louise A; Storr, Helen L

    2017-12-01

    GH insensitivity (GHI) is characterised by short stature, IGF-1 deficiency and normal/elevated serum GH. IGF-1 insensitivity results in pre- and post-natal growth failure with normal/high IGF-1 levels. The prevalence of genetic defects is unknown. To identify the underlying genetic diagnoses in a paediatric cohort with GH or IGF-1 insensitivity using candidate gene (CGS) and whole-exome sequencing (WES) and assess factors associated with the discovery of a genetic defect. We undertook a prospective study of 132 patients with short stature and suspected GH or IGF-1 insensitivity referred to our centre for genetic analysis. 107 (96 GHI, 88 probands; 11 IGF-1 insensitivity, 9 probands) underwent CGS. WES was performed in those with no defined genetic aetiology following CGS. A genetic diagnosis was discovered 38/107 (36%) patients (32% probands) by CGS. WES revealed 11 patients with genetic variants in genes known to cause short stature. A further 2 patients had hypomethylation in the H19/IGF2 region or mUPD7 consistent with Silver-Russell Syndrome (total with genetic diagnosis 51/107, 48% or 41/97, 42% probands). WES also identified homozygous putative variants in FANCA and PHKB in 2 patients. Low height SDS and consanguinity were highly predictive for identifying a genetic defect. Comprehensive genetic testing confirms the genetic heterogeneity of GH/IGF-1 insensitivity and successfully identified the genetic aetiology in a significant proportion of cases. WES is rapid and may isolate genetic variants that have been missed by traditional clinically driven genetic testing. This emphasises the benefits of specialist diagnostic centres. © 2017 European Society of Endocrinology.

  6. Recruiting Colorectal Cancer Survivors to a Surveillance Study: Barriers and Successful Strategies

    Science.gov (United States)

    Ford, Marvella E.; Sterba, Katherine R.; Bearden, James; Gansauer, Lucy; Moore, Leslie A.; Zapka, Jane

    2018-01-01

    Background Colorectal cancer (CRC) survival rates are increasing. Effective strategies to recruit CRC survivors to surveillance studies are needed. Objective We analyzed the barriers encountered while recruiting CRC survivors to a study assessing their surveillance care experiences. Methods The study included three phases: (I) focus groups/key informant interviews; (II) cognitive interviews; and (III) a statewide population-based telephone survey. Participants In Phases I-II, clinic-based data and cancer center registries were used to identify CRC survivors who had received CRC resection within the past 18 months. In Phase III, survivors who had received CRC resection within the past two years were identified via a statewide, population-based cancer registry. Results In Phase I, 16 survivors participated in focus groups at two National Cancer Center-affiliated sites (response rate=29.6%). Eighteen additional survivors participated in individual interviews (response rate=50%). In Phase II, 11 survivors participated in cognitive interviews (response rate=81.8%). In Phase III, 150 survivors participated in the statewide survey (response rate=62.2%). Conclusions Group-based/ in-person recruitment efforts were unsuccessful due to scheduling barriers, lack of transportation, and remaining discomfort from previous resection surgery. Telephone-based data collection strategies produced higher response rates. Practice Implications To enhance CRC surveillance research, future studies could incorporate CRC survivor-centered recruitment strategies. PMID:28277291

  7. Phoenix Society for Burn Survivors

    Science.gov (United States)

    ... in 2018! Learn More For Loved Ones A burn injury doesn't just impact the survivor. Families ... to support longterm recovery, improve the quality of burn care, and prevent burn injury. Explore articles on ...

  8. 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.

  9. 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.

  10. Impact of Preoperative Radiotherapy on General and Disease-Specific Health Status of Rectal Cancer Survivors: A Population-Based Study

    International Nuclear Information System (INIS)

    Thong, Melissa S.Y.; Mols, Floortje; Lemmens, Valery E.P.P.; Rutten, Harm J.T.; Roukema, Jan A.; Martijn, Hendrik; Poll-Franse, Lonneke V. van de

    2011-01-01

    Purpose: To date, few studies have evaluated the impact of preoperative radiotherapy (pRT) on long-term health status of rectal cancer survivors. Using a population-based sample, we assessed the impact of pRT on general and disease-specific health status of rectal cancer survivors up to 10 years postdiagnosis. The health status of older (≥75 years old at diagnosis) pRT survivors was also compared with that of younger survivors. Methods and Materials: Survivors identified from the Eindhoven Cancer Registry treated with surgery only (SU) or with pRT between 1998 and 2007 were included. Survivors completed the Short Form-36 (SF-36) health survey questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal 38 (EORTC QLQ-CR38) questionnaire. The SF-36 and EORTC QLQ-CR38 (sexuality subscale) scores of the survivors were compared to an age- and sex-matched Dutch normal population. Results: A total of 340 survivors (response, 85%; pRT survivors, 71%) were analyzed. Overall, survivors had similar general health status. Both short-term (<5 years) and long-term (≥5 years) pRT survivors had significantly poorer body image and more problems with gastrointestinal function, male sexual dysfunction, and defecation than SU survivors. Survivors had comparable general health status but greater sexual dysfunction than the normal population. Older pRT survivors had general and disease-specific health status comparable to that of younger pRT survivors. Conclusions: For better survivorship care, rectal cancer survivors could benefit from increased clinical and psychological focus on the possible long-term morbidity of treatment and its effects on health status.

  11. Senior Benefits

    Science.gov (United States)

    Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program GovDelivery Skip Navigation Links Health and Social Services > Public Assistance > Senior Benefits Page Content Senior Benefits Senior Benefits Logo Senior Benefits Fact Sheet - June, 2016 Reduction Information

  12. No Evidence for the Benefit of Gonadotropin-Releasing Hormone Agonist in Preserving Ovarian Function and Fertility in Lymphoma Survivors Treated With Chemotherapy: Final Long-Term Report of a Prospective Randomized Trial.

    Science.gov (United States)

    Demeestere, Isabelle; Brice, Pauline; Peccatori, Fedro A; Kentos, Alain; Dupuis, Jehan; Zachee, Pierre; Casasnovas, Olivier; Van Den Neste, Eric; Dechene, Julie; De Maertelaer, Viviane; Bron, Dominique; Englert, Yvon

    2016-08-01

    We have reported previously that after 1-year follow up, gonadotropin-releasing hormone agonist (GnRHa) did not prevent chemotherapy-induced premature ovarian failure (POF) in patients with lymphoma, but may provide protection of the ovarian reserve. Here, we report the final analysis of the cohort after 5 years of follow up. A total of 129 patients with lymphoma were randomly assigned to receive either triptorelin plus norethisterone (GnRHa group) or norethisterone alone (control group) during chemotherapy. Ovarian function and fertility were reported after 2, 3, 4, and 5 to 7 years of follow up. The primary end point was POF, defined as at least one follicle-stimulating hormone value of > 40 IU/L after 2 years of follow up. Sixty-seven patients 26.21 ± 0.64 years of age had available data after a median follow-up time of 5.33 years in the GnRHa group and 5.58 years in the control group (P = .452). Multivariate logistic regression analysis showed a significantly increased risk of POF in patients according to age (P = .047), the conditioning regimen for hematopoietic stem cell transplant (P = .002), and the cumulative dose of cyclophosphamide > 5 g/m(2) (P = .019), but not to the coadministration of GnRHa during chemotherapy (odds ratio, 0.702; P = .651). The ovarian reserve, evaluated using anti-Müllerian hormone and follicle-stimulating hormone levels, was similar in both groups. Fifty-three percent and 43% achieved pregnancy in the GnRHa and control groups, respectively (P = .467). To the best of our knowledge, this is the first long-term analysis confirming that GnRHa is not efficient in preventing chemotherapy-induced POF in young patients with lymphoma and did not influence future pregnancy rate. These results reopen the debate about the drug's benefit in that it should not be recommended as standard for fertility preservation in patients with lymphoma. © 2016 by American Society of Clinical Oncology.

  13. Managing work and cancer treatment: Experiences among survivors of hematological cancer.

    Science.gov (United States)

    Thomson, Maria D; Siminoff, Laura A

    2018-04-16

    The current study was performed to characterize the employment status of survivors of hematological cancer who have an informal caregiver from the time of diagnosis through the first 6 months of treatment. Using a mixed methods approach, semistructured interviews with survivors of hematological cancer were conducted within 6 months of the initiation of cancer treatment. Interviews assessed cancer treatment status, barriers and facilitators to employment, financial and insurance status, and relationship with the primary caregiver. These results are part of a longitudinal study of cancer survivors and informal caregivers. A total of 171 patients were enrolled. Within 6 months of beginning cancer treatments, approximately 35% were no longer employed. Reasons to remain employed included financial need, employee benefits, and a sense of purpose and normalcy. Employer accommodations and supportive colleagues facilitated continued employment. Logistic regression analysis demonstrated that having a higher household income, a desire to work, nonphysical job tasks, and congruent survivor-caregiver communication were associated with greater odds of remaining employed. Within 6 months of initiating cancer treatment, the majority of survivors of hematological cancer had maintained employment. Because of the limitations imposed by the physical stress of cancer treatments, as well as the need to maintain employment to continue receiving employee benefits to cover such treatments, survivors of hematological cancer likely would benefit from employment accommodations that are sensitive to their unique needs. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  14. 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

  15. 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

  16. 20 CFR 10.6 - What special statutory definitions apply to dependents and survivors?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What special statutory definitions apply to dependents and survivors? 10.6 Section 10.6 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...' COMPENSATION ACT, AS AMENDED General Provisions Definitions and Forms § 10.6 What special statutory definitions...

  17. 20 CFR 30.500 - What special statutory definitions apply to survivors under EEOICPA?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What special statutory definitions apply to survivors under EEOICPA? 30.500 Section 30.500 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR...

  18. 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.

  19. Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review.

    Science.gov (United States)

    Peikert, Mona Leandra; Inhestern, Laura; Bergelt, Corinna

    2018-01-01

    The survival rate of childhood cancer patients increased over the past decades. However, even after successful treatment the transition back to normalcy is often a major challenge for the whole family. Therefore, this study aims to provide an overview of psychosocial interventions for childhood cancer survivors and their families in the first years after the end of cancer treatment. We conducted a systematic review following the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO registration number: CRD42017059782). In November 2016 and September 2017, we searched the databases CINAHL, MEDLINE, PSYNDEX, and Web of Science. We included studies investigating psychosocial interventions for childhood cancer survivors diagnosed under the age of 21, their family members or the family as a whole. Further, we summarized the study characteristics and conducted a narrative synthesis of the results. Finally, we assessed the study quality with the Effective Public Health Practice Project Quality Assessment Tool. We identified a total of 8215 records based on our database searches and 17 additional records through hand searches. We included 33 articles in the qualitative synthesis. Most of the studies described interventions for the cancer survivor (n = 15). Nine studies investigated interventions for the whole family, and two studies interventions for siblings. The interventions mainly take place in an outpatient group setting (n = 15). Overall, most of the studies reported a significant psychosocial benefit of the interventions. However, the quality of the included studies was limited. In summary, we identified a broad range of different interventions and thus could give a comprehensive overview of existing interventions for childhood cancer survivors and their families. However, there is a necessity for high quality studies. The results may help to optimize health care services that support families with the re-entry into daily

  20. Perceived barriers to physical activity among Nigerian stroke survivors.

    Science.gov (United States)

    Idowu, Opeyemi Ayodiipo; Adeniyi, Ade Fatai; Ogwumike, Omoyemi Olubunmi; Fawole, Henrietta Oluwafunmilola; Akinrolie, Olayinka

    2015-01-01

    Benefits of physical activity in the prevention and management of stroke are well documented in the literature. There is increasing evidence that stroke survivors in South-West Nigeria are physically inactive. 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. The Exercise Benefits and Barrier Scale and the International Physical Activity Questionnaire were administered on 121 stroke survivors to determine their perceived barriers to physical activity and physical activity levels respectively. Information on socio-demographic data and clinical variables were also collected. The sample included 70.2% males, with majority of the participants reporting low physical activity levels (80.2%) and high perceived barriers (Mean = 48.13, SD = 7.88). The four most reported common barriers among stroke survivors were access to exercise facilities (95.0%), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2%) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers to physical activity between gender (U = 1471.00, P = 0.74) and across each of: occupational status (H = 4.37, P = 0.22), age group (H = 0.82, P = 0.84) and educational levels (H = 4.56, P = 0.33). Significant difference however existed in perceived barriers across marital status categories (H = 12.87, P = 0.05). Stroke survivors indicated high perceived barriers to physical activity and these barriers were associated with marital status.

  1. Promoting Exercise in Young Cancer Survivors

    Science.gov (United States)

    In children and adolescent cancer survivors, an online game helped them get regular exercise, as this NCI Cancer Currents post explains. A NCI-funded trial is testing the approach for acute lymphoblastic leukemia (ALL) survivors.

  2. Childhood Cancer Survivors Are Living Longer

    Science.gov (United States)

    New data from the Childhood Cancer Survivor Study suggest that refinements in pediatric cancer treatment over the last few decades have helped to extend the lifespans of many survivors of childhood cancer.

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

    International Nuclear Information System (INIS)

    Wattson, Daniel A.; Hunink, M.G. Myriam; DiPiro, Pamela J.; Das, Prajnan; Hodgson, David C.; Mauch, Peter M.; Ng, Andrea K.

    2014-01-01

    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. 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

  5. Low-dose chest computed tomography for lung cancer screening among Hodgkin lymphoma survivors: a cost-effectiveness analysis.

    Science.gov (United States)

    Wattson, Daniel A; Hunink, M G Myriam; DiPiro, Pamela J; Das, Prajnan; Hodgson, David C; Mauch, Peter M; Ng, Andrea K

    2014-10-01

    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. 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). 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. 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 may be cost effective for all smokers but possibly not

  6. Physical activity and lower limb lymphedema among uterine cancer survivors.

    Science.gov (United States)

    Brown, Justin C; John, Gabriella M; Segal, Saya; Chu, Christina S; Schmitz, Kathryn H

    2013-11-01

    Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported trend trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

  7. Who is a survivor? Perceptions from individuals who experienced pediatric cancer and their primary support persons.

    Science.gov (United States)

    Molinaro, Monica L; Fletcher, Paula C

    2018-04-01

    The purpose of this research was to examine the lived experiences of individuals who had cancer as children, as well as lived experiences of their current primary support persons. Based on van Manen's "new" interpretive phenomenology, interviews were conducted with ten pediatric cancer survivors and nine of their support persons to gain a more holistic understanding of the pediatric cancer experiences of children and their families. Four themes emerged from the data; however, only the topic of the use of the term "survivor" and identification with the term will be discussed. All participants in the study described their personal definition of the term survivor and what it meant to be a survivor. Additionally, all individuals in the study discussed the concept of being a survivor and if they would consider themselves, or their loved ones, to be "survivors." The results of this study provide health care professionals, family members, and individuals fundraising or advocating for cancer causes with insights on how the term survivor may be interpreted. This study may provide insight to individuals who had cancer as children, in showing that their personal perspective shapes their identity; although "survivor" is common cancer vernacular, individuals can choose not to identify with their illness experiences.

  8. 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.

  9. 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.

  10. Outcome and status of microsatellite stability in Japanese atomic bomb survivors with early gastric carcinoma.

    Science.gov (United States)

    Yamamoto, Manabu; Taguchi, Kenichi; Yamanaka, Takeharu; Matsuyama, Ayumi; Yoshinaga, Keiji; Tsutsui, Shinichi; Ishida, Teruyoshi

    2013-03-01

    In the decade after the 1945 atomic bombing of Hiroshima, a high incidence of leukemia was observed among atomic bomb survivors. However, the incidence of other cancers gradually increased, while that of leukemia decreased after this period. We evaluated the clinical outcome of early gastric cancer and microsatellite stability over a long-term period in atomic bomb survivors. The results of surgical treatment for early gastric cancer were reviewed for 117 atomic bomb survivors and 394 control patients between 1995 and 2006. In addition, immunohistochemical staining for hMSH2 and hMLH1 expression was performed to evaluate the status of microsatellite stability in 57 atomic bomb survivors and 82 control patients. The long-term survival rate for early gastric cancer in atomic bomb survivors was significantly lower than that in control patients (p bomb survivorship was related to defective hMSH2 and/or hMLH1 expression. The prognosis of early gastric cancer in atomic bomb survivors was poor and was related to age and sex, rather than to being an atomic bomb survivor. Furthermore, a higher rate of defective hMSH2 and/or hMLH1 expression was observed in the survivors.

  11. Return to work and its relation to financial distress among Iranian cancer survivors.

    Science.gov (United States)

    Ghasempour, Mostafa; Rahmani, Azad; Davoodi, Arefeh; Sheikhalipour, Zahra; Ziaeei, Jamal Evazie; Abri, Fariba

    2015-01-01

    Return to work after treatment completion is important for both cancer survivors and society. Financial distress is one of the factors that may influence the return to work in cancer survivors. However, this relationship has not been well investigated. This study aimed to determine the rate of return to work and its relation to financial distress among Iranian cancer survivors. This descriptive-correlational study was undertaken among 165 cancer survivors who completed their initial treatments and had no signs of active cancer. The Return to Work questionnaire and Financial Distress/Financial Well-Being Scale were used for data collection. Data were analyzed using SPSS statistical software. After initial treatments, 120 cancer survivors (72%) had returned to work, of which 50 patients (42%) had returned to full-time work and 70 (58%) reduced their work hours and returned to part-time work. Cancer survivors also reported high levels of financial distress. In addition, the financial distress was lower among patients who had returned completely to work, in comparison to patients who had quit working for cancer-related reasons (p=0.001) or returned to work as part-time workers (p=0.001). The findings showed that a high percent of Iranian cancer survivors had not returned to their jobs or considerably reduced working hours after treatment completion. Accordingly, due to high levels of financial distress experienced by participants and its relation to return to work, designing rehabilitation programs to facilitate cancer survivor return to work should be considered.

  12. 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…

  13. Rectal Cancer Survivors' Participation in Productive Activities.

    Science.gov (United States)

    Hornbrook, Mark C; Grant, Marcia; Wendel, Christopher; Bulkley, Joanna E; Mcmullen, Carmit K; Altschuler, Andrea; Temple, Larissa Kf; Herrinton, Lisa J; Krouse, Robert S

    2017-01-01

    Rectal cancer and its treatment impair survivors' productivity. To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. Productive activities, functional health status, and bowel management at the time of the survey. Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.

  14. Retraining moderately impaired stroke survivors in driving-related visual attention skills.

    Science.gov (United States)

    Akinwuntan, Abiodun E; Devos, Hannes; Verheyden, Geert; Baten, Guido; Kiekens, Carlotte; Feys, Hilde; De Weerdt, Willy

    2010-01-01

    Visual inattention is a major cause of road accidents and is a problem commonly experienced after stroke. This study investigated the effects of 2 training programs on performance in the Useful Field of View (UFOV), a validated test of driving-related visual attention skills. Data from 69 first-ever, moderately impaired stroke survivors who participated in a randomized controlled trial (RCT) to determine the effects of simulator training on driving after stroke were analyzed. In addition to regular interventions at a rehabilitation center, participants received 15 hours of either simulator-based driving-related training or non-computer-based cognitive training over 5 weeks. Total percentage reduction in UFOV and performance in divided and selective attention and speed of processing subtests were documented at 6 to 9 weeks (pretraining), 11 to 15 weeks (posttraining), and 6 months post stroke (follow-up). Generalized estimating equation (GEE) model revealed neither group effects nor significant interaction effects of group with time in the UFOV total score and the 3 subtests. However, there were significant within-group improvements from pre- through posttraining to follow-up for all the UFOV parameters. Post-hoc GEE analysis revealed that most improvement in both groups occurred from pre- to posttraining. Both training programs significantly improved visual attention skills of moderately impaired stroke survivors after 15 hours of training and retention of benefit lasted up to 6 months after stroke. Neither of the training programs was better than the other.

  15. Screening for psychological late effects in childhood, adolescent and young adult cancer survivors: a systematic review.

    Science.gov (United States)

    Michel, Gisela; Vetsch, Janine

    2015-07-01

    In the past years, increasing evidence showed that many childhood cancer survivors suffer from psychological distress long after treatment ended. However, psychosocial issues are often neglected during follow-up care. Including screening for psychological distress before follow-up appointments might help addressing the topic in survivors who need support. Our aim was to systematically review the available evidence on screening for psychological distress in childhood cancer survivors. We found eight studies that investigated different screening tools for their utility in detecting psychological distress in childhood cancer survivors. The Brief Symptom Inventory-18 with an adapted cutoff score for childhood cancer survivors, and the newly developed short form of the Beck Depression Index were both shown to be of a potential benefit as brief screening tools in follow-up care. We identified promising screening tools to be used to detect psychological distress in childhood cancer survivors. However, there is still a lack of studies addressing applicability and effectiveness when screening is routinely implemented into follow-up care. To improve quality of follow-up care, and identify and treat survivors with psychological distress, screening tools should now be implemented and their adequacy further tested in day-to-day clinic life.

  16. 20 CFR 404.480 - Paying benefits in installments: Drug addiction or alcoholism.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Paying benefits in installments: Drug addiction or alcoholism. 404.480 Section 404.480 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Deductions; Reductions; and Nonpayments of Benefits § 404.480 Paying benefits in installments:...

  17. Leukemia in Hiroshima atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Heyssel, R; Brill, A B; Woodbury, L A; Nishimura, Edwin T; Ghose, Tarunendu; Hoshino, Takashi; Yamasaki, Mitsuru

    1959-03-01

    This report is intended to provide the basic data pertinent to the leukemia experience observed in the survivors of the Hiroshima atomic explosion. Many of the conclusions in this report are tentative. The one clear fact to emerge is that radiation increases the occurrence rate of leukemia and that the magnitude of increase is dependent on dose received. Additional observations can be made, which, while not definitive in themselves, seem to complement each other, and are corroborated by other experiences in radiation biology. From the data a linear relationship between dose and incidence of leukemia is found. The shape of the relation in the lower dose range is not known with certainty. An approximate minimum time for the appearance of leukemia following radiation is 3 years or less. The data suggest that the time of maximum risk of leukemia may be dependent on the dose of radiation received. In this group the mean latent period is found to lie in the interval between 4 and 8 years following exposure. The length of time during which the increased incidence of leukemia persists is not known. The incidence of the acute leukemias and of chronic granulocytic leukemia is increased in the exposed survivors. The chronic granulocytic variety is disproportionately increased in Japanese survivors of the atomic bomb. No effect of radiation on monocytic or chronic lymphatic leukemia incidence is noted. Aplastic anemia, polycythemia vera, and myelofibrosis have been investigated. Myelofibrosis is the only one of this group of diseases in which a suggestive relation to radiation exposure is apparent. The natural history of leukemia following radiation does not seem to differ from that of the spontaneously occurring variety. 17 references, 5 figures, 38 tables.

  18. Endometrial cancer survivors' assessment of the benefits of exercise.

    Science.gov (United States)

    Lukowski, Jessica; Gil, Karen M; Jenison, Eric; Hopkins, Michael; Basen-Engquist, Karen

    2012-03-01

    The majority of women who have had endometrial cancer remain at risk for obesity related diseases. The social cognitive theory was used to explore their beliefs about exercise to aid in the development of effective interventions. Women who had been treated for Stage I endometrial cancer were asked about their level of exercise to determine if they had been exercising regularly for more than 6 months (exercisers vs non-exercisers). They were asked to rate the likelihood that exercise would result in various health outcomes (expectations) and to rate the importance of these outcomes (expectancies). Scores for how likely exercise would result in an outcome of importance were calculated. Height and weight were obtained from nurses for calculation of BMI. Statistics were conducted using SPSS v 15. There were 106 valid questionnaires (86% participation rate); 41% were exercisers. Mean BMI was significantly lower in exercisers (31.6 ± 1.2 vs. 37.3 ± 1.2, p=0.001); a significantly greater proportion reported not having diabetes, heart disease or hypertension (69.8% vs. 49.2%, p=0.035). Exercisers were significantly more likely to report that feeling better physically and emotionally versus reducing the risk of diseases were likely and important outcomes of exercise (18.2 ± 0.8 vs 15.0 ± 1.0, p=0.002). Exercisers identified outcomes of exercise that are more immediate and subjective as being important and likely outcomes of exercise. Focusing on these aspects of exercise (feeling better physically and emotionally) may aid in the development of effective interventions for non-exercisers. Copyright © 2011. Published by Elsevier Inc.

  19. Federal Benefits for Veterans, Dependents and Survivors: 2017 Online Edition

    Science.gov (United States)

    ... Business with VA Acquisition, Logistics, & Construction Small & Veteran Business Programs VetBiz.gov Financial & Asset Enterprise Management Security Investigation Center/Background Clearances Freedom of Information ...

  20. Illness perceptions among cancer survivors.

    Science.gov (United States)

    Zhang, Na; Fielding, Richard; Soong, Inda; Chan, Karen K K; Tsang, Janice; Lee, Victor; Lee, Conrad; Ng, Alice; Sze, Wing Kin; Tin, Pamela; Lam, Wendy Wing Tak

    2016-03-01

    The purpose of the study is to document in Hong Kong Chinese cancer survivors cross-sectional associations between illness perceptions, physical symptom distress and dispositional optimism. A consecutive sample of 1036 (response rate, 86.1%, mean age 55.18 years, 60% female) survivors of different cancers recruited within 6 months of completion of adjuvant therapy from Hong Kong public hospitals completed the Brief Illness Perception Questionnaire (B-IPQ), Chinese version of the Memorial Symptom Assessment Scale Short-Form (MSAS-SF), and the revised Chinese version of Life Orientation Test (C-LOT-R), respectively. Stepwise multiple regression analyses examined adjusted associations. IPQ seriousness, symptom identity, illness concern, and emotional impact scores varied by cancer type (p Stress-related, lifestyle, environment, psychological/personality, and health-related factors were most frequently attributed causes of cancer. After adjustment for sample differences, physical symptom distress was significantly associated with all illness perception dimensions (p differences by cancer type were eliminated by adjustment for sample characteristics. Illness perceptions did not differ by cancer type. Greater physical symptom distress and lower levels of optimism were associated with more negative illness perceptions. Understanding how cancer survivors make sense of cancer can clarify an important aspect of adaptation. This in turn can inform interventions to facilitate adjustment. Knowledge contributions include evidence of physical symptom distress correlating with most dimensions of illness perception. Optimism was also associated with cancer survivors' illness perceptions.

  1. 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.

  2. Effects of Growth Hormone Therapy on Bone Mass, Metabolic Balance, and Well-Being in Young Adult Survivors of Childhood Acute Lymphoblastic Leukemia

    NARCIS (Netherlands)

    van den Heijkant, Silvia; Hoorweg-Nijman, Gera; Huisman, Jaap; Drent, Madeleine; van der Pal, Heleen; Kaspers, Gert-Jan; Delemarre-van de Waal, Henriette

    2011-01-01

    Growth hormone deficiency (GHD), mostly after cranial radiotherapy (CRT), may lead to several negative effects. Young adult survivors of acute lymphoblastic leukemia (ALL) could benefit from GH therapy in different ways. Twenty ALL survivors (17.1 +/- 4.3 y after diagnosis) with low bone mineral

  3. Discrimination in same-sex survivor amendments to the Canada Pension Plan.

    Science.gov (United States)

    Carey, Ruth

    2002-12-01

    On 31 July 2002, the British Columbia Supreme Court granted certification of a class proceeding involving same-sex surviving spouses who were denied survivor's benefits under the Canada Pension Plan (CPP) due to their sexual orientation. On 10 July 2002, a similar proceeding in Ontario survived a motion to strike by the government and is headed to trial. If successful, thousands of gay men and women whose same-sex partners died between 17 April 1985 and 1 January 1998 may finally be eligible for monthly survivor's benefits.

  4. Predictors of exercise frequency in breast cancer survivors in Taiwan.

    Science.gov (United States)

    Hsu, Hsin-Tien; Dodd, Marylin J; Guo, Su-Er; Lee, Kathryn A; Hwang, Shiow-Li; Lai, Yu-Hung

    2011-07-01

    To apply social cognitive theory to elucidate factors that motivate change in exercise frequency in breast cancer survivors during the six months after completing cancer treatment. Exercise is now a well-recognised quality-of-life intervention in breast cancer survivors. However, only regular exercise yields long-term benefits. Motivations for exercise have not been analysed in Taiwan patients with cancer. A prospective, longitudinal and repeated measures design was used. A convenience sample of 196 breast cancer survivors was recruited from hospitals in metropolitan areas of north and south Taiwan. Study participants were allowed to select their preferred exercised activities. Exercise behaviour and other factors were then recorded using various standardised instruments. Medical charts were also reviewed. Data were analysed by a linear mixed model and by hierarchical multiple regression equations. Exercise frequency significantly changed over time. Explained variance in exercise frequency change was modest. Baseline exercise frequency was the best significant predictor of exercise frequency during the six-month study. The study also identified possible age-related differences in the effect of social support on exercise. The effect of social support for exercise on exercise frequency was apparently larger in older subjects, especially those over 40 years old, than in younger subjects. Mental health, exercise barriers and exercise outcome expectancy significantly contributed to change in exercise frequency during the six-month study. The analytical results revealed several ways to increase exercise frequency in breast cancer survivors: (1) encourage exercise as early as possible; (2) improve health status and provide social support for exercise, especially in women aged 40 years or older; (3) reduce exercise barriers and promote mental health; (4) reinforce self-efficacy and positive expectations of exercise outcomes and (5) provide strategies for minimising fatigue

  5. Physical Activity in Puerto Rican Breast Cancer Survivors.

    Science.gov (United States)

    Tirado-Gómez, Maribel; Hughes, Daniel C; González-Mercado, Velda; Treviño-Whitaker, Rose A; Basen-Engquist, Karen

    2016-06-01

    Breast cancer survivors do not engage in appropriate levels of physical activity, despite the known benefits of such activity. This study aims to describe physical-activity levels and the barriers to it in a group of Puerto Rican breast cancer survivors, as well as detailing their preferences for an intervention. Participants who finished their chemotherapy and/or radiotherapy for breast cancer at least 4 months prior to the study were included. Demographic, anthropometric, and clinical data were obtained. The Godin Leisure-Time Exercise Questionnaire (GLTEQ) and questionnaires on exercise self-efficacy, barriers to self-efficacy, modeling, and social support were filled out by study participants. Data on access to exercise equipment and preferences regarding a physical-activity intervention were collected. Descriptive statistics and correlation analyses were performed. Fifty breast cancer survivors were recruited. Almost all the participants reported that they did not engage in any kind of strenuous physical activity (94%), with more than three fourths (76%) reporting that they did not even participate in any kind of moderate physical activity. The GLTEQ score was associated with barriers to selfefficacy, while the association with exercise self-efficacy approached significance (p = 0.055). Nearly half of the patients (44%) had access to exercise equipment. Preferred methods for the delivery of physical-activity interventions were participating in group settings (72%) and receiving material in the postal mail (44%). The study described herein reports on the low levels of physical activity being practiced by a group of Puerto Rican breast cancer survivors, despite the fact that many of them had access to exercise equipment and facilities. Further studies aimed at understanding breast cancer survivors' barriers to physical activity and at developing culturally competent interventions to increase the levels of such activity are warranted.

  6. 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.

  7. Mentoring programme for adolescent survivors of acquired brain injury.

    Science.gov (United States)

    Fraas, Michael; Bellerose, Amanda

    2010-01-01

    To report the findings of a mentor-adolescent relationship between two survivors of acquired brain injury (ABI). Case study report. The adolescent, a survivor of Eastern Equine Encephalitis, was paired with an adult mentor, a survivor of a TBI. Baseline scores on the Youth Quality of Life (YQOL), Wisconsin Quality of Life Index (WQLI) and the Mayo-Portland Adaptability Index-4 (MPAI-4) were recorded. The mentor provided support to the adolescent during the 10-week relationship conducted as a community-based programme for adults with acquired brain injury. In addition, both participants attended group activities that address the long-term needs of survivors of ABI. Post-programme scores were recorded on the YQOL, WQLI, MPAI-4 and a retrospective questionnaire. The adolescent demonstrated improved quality of life on the YQOL and improved ability, adjustment and participation on the MPAI-4. The mentor demonstrated improved quality of life on the WQLI and improved adjustment and participation on the MPAI-4. Both participants indicated satisfaction with the programme on the retrospective questionnaire. The mentor programme provided enhanced quality of life and psycho-social support to both participants. The authors do caution, however, that these findings are preliminary and examination of the efficacy of such programming is ongoing.

  8. Malignant Lymphoma in an Atomic-bomb Survivor

    Directory of Open Access Journals (Sweden)

    Cheng-Chia Lee

    2009-07-01

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

  9. Workplace experiences and turnover intention among adult survivors of childhood cancer.

    Science.gov (United States)

    Crom, Deborah B; Ness, Kirsten K; Martinez, Larry R; Hebl, Michelle R; Robison, Leslie L; Hudson, Melissa M; Brinkman, Tara M

    2018-03-17

    The purpose of this study was to investigate workplace experiences and turnover intention (consideration of leaving or changing a job) and to examine factors associated with turnover intention among survivors. Adult survivors of childhood cancer with a history of employment (n = 289) completed measures of workplace experiences (n = 50, 18-29 years; n = 183, 30-44 years; n = 56; > 45 years of age at follow-up). Turnover intention was assessed using three items from the Job Satisfaction Scale. Responses were dichotomized as reflecting high vs. low turnover intention. Path analysis was used to estimate the influence of demographic characteristics, treatment exposures (cranial radiation therapy [CRT]), and workplace experiences on turnover intention. Thirty percent of survivors reported high turnover intention (95% CL, 25 to 36%). Exposure to CRT (P = 0.003), older attained age (P workplace discrimination (P = 0.008), and having lower continuance (P discrimination, mediated through job satisfaction, also influenced survivors' reported intent to leave their jobs. One third of adult survivors of childhood cancer report turnover intention, which is related to their cancer treatment, but more temporally proximal, workplace discrimination. Additional research is needed to understand the consequences of turnover intention among survivors. Survivors and their health care providers should be aware of legislative policies related to workplace discrimination (e.g., American with Disabilities Act) and related implications for job turnover.

  10. 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.

  11. 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

    2018-03-01

    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.

  12. A Randomized Controlled Trial of a Nurse-Led Supportive Care Package (SurvivorCare) for Survivors of Colorectal Cancer.

    Science.gov (United States)

    Jefford, Michael; Gough, Karla; Drosdowsky, Allison; Russell, Lahiru; Aranda, Sanchia; Butow, Phyllis; Phipps-Nelson, Jo; Young, Jane; Krishnasamy, Mei; Ugalde, Anna; King, Dorothy; Strickland, Andrew; Franco, Michael; Blum, Robert; Johnson, Catherine; Ganju, Vinod; Shapiro, Jeremy; Chong, Geoffrey; Charlton, Julie; Haydon, Andrew; Schofield, Penelope

    2016-08-01

    Colorectal cancer (CRC) and its treatments can cause distressing sequelae. We conducted a multicenter randomized controlled trial aiming to improve psychological distress, supportive care needs (SCNs), and quality of life (QOL) of patients with CRC. The intervention, called SurvivorCare (SC), comprised educational materials, needs assessment, survivorship care plan, end-of-treatment session, and three follow-up telephone calls. At the end of treatment for stage I-III CRC, eligible patients were randomized 1:1 to usual care (UC) or to UC plus SC. Distress (Brief Symptom Inventory 18), SCNs (Cancer Survivors' Unmet Needs measure), and QOL (European Organization for Research and Treatment of Cancer [EORTC] QOL questionnaires C30 and EORTC CRC module CR29) were assessed at baseline and at 2 and 6 months (follow-up 1 [FU1] and FU2, respectively). The primary hypothesis was that SC would have a beneficial effect on distress at FU1. The secondary hypotheses were that SC would have a beneficial effect on (a) SCN and QOL at FU1 and on (b) distress, SCNs, and QOL at FU2. A total of 15 items assessed experience of care. Of 221 patients randomly assigned, 4 were ineligible for the study and 1 was lost to FU, leaving 110 in the UC group and 106 in the SC group. Patients' characteristics included the following: median age, 64 years; men, 52%; colon cancer, 56%; rectal cancer, 35%; overlapping sites of disease, 10%; stage I disease, 7%; stage II, 22%; stage III, 71%. Baseline distress and QOL scores were similar to population norms. Between-group differences in distress at FU1 (primary outcome) and at FU2, and SCNs and QOL at FU1 and FU2 were small and nonsignificant. Patients in the SC group were more satisfied with survivorship care than those in the UC group (significant differences on 10 of 15 items). The addition of SC to UC did not have a beneficial effect on distress, SCNs, or QOL outcomes, but patients in the SC group were more satisfied with care. Some survivors of

  13. Tuberculosis among atomic bomb survivors

    International Nuclear Information System (INIS)

    Hamada, Tadao; Matsushita, Hiroshi.

    1980-01-01

    Effects of atomic bomb on tuberculosis among atomic bomb survivors necropsied after 1956 when Atomic Bomb Hospital was opened were observed statistically and the following results were obtained. The morbidity of tuberculosis in the group exposed within 2 km from the hypocenter was higher than that of the control group, but there was not a significant difference between the both groups. The morbidity of all types of tuberculosis was significantly higher in the group exposed within 2 km from the hypocenter than in the control group. The morbidity of tuberculosis tended to decrease in both exposed and non-exposed groups with time. However, the morbidity of miliary or active tuberculosis has tended to rise in the exposed since 1975. The morbidity in young a-bomb survivors exposed within 2 km was higher than that in those of other groups, but there was not a difference in the morbidity among the aged. The higher the rate of complication of active tuberculosis with stomach cancer or acute myelocytic leukemia or liver cirrhosis, the nearer the places of exposure were to the hypocenter. Out of 26 patients with miliary tuberculosis, 6 were suspected to have leukemia while they were alive and were suggested to have leukemoid reaction by autopsy. They all were a-bomb survivors, and 4 of them were exposed within 2 km from the hypocenter. (Tsunoda, M.)

  14. Lucky or Unlucky people: Layoff Survivors

    OpenAIRE

    Muhammad Imran Malik; Dr. Mehboob Ahmad

    2011-01-01

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

  15. 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.

  16. Early work patterns for gynaecological cancer survivors in the USA.

    Science.gov (United States)

    Nachreiner, N M; Ghebre, R G; Virnig, B A; Shanley, R

    2012-01-01

    Little is known about the balance between work demands and treatment plans for >4.3 million working-age cancer survivors in the USA. To describe changes in work status for gynaecological cancer survivors during the first 6 months following diagnosis and their experience with their employers' programmes and policies. One hundred and ten gynaecological cancer survivors who were working at the time of their cancer diagnosis completed a survey. Case record reviews documented their clinical characteristics and treatment details. Ninety-five women (86%) had surgery; 81 (74%) received chemotherapy, radiotherapy or both in addition to surgery. Nine per cent of women said that they changed their treatment plan because of their jobs; in contrast, 62% of women said that they changed their work situation to accommodate their treatment plan. Overall, the most common month for women to stop working was Month 1 (41%), to decrease hours was Month 2 (32%) and to increase hours was Month 6 (8%). Twenty-eight per cent of women were aware of employer policies that assisted the return to work process; 70% of women were familiar with the Family and Medical Leave Act (FMLA) and 56% with the Americans with Disabilities Act (ADA). Only 26% completed a formal request for work accommodations. After 6 months, 56 of 83 women (67%) remained working or had returned to work. Work patterns varied for these gynaecological cancer survivors over the first 6 months following diagnosis. Opportunities exist to improve communication about work and treatment expectations between cancer survivors, occupational health professionals, employers and treating clinicians.

  17. STARS experiential group intervention: a complex trauma treatment approach for survivors of human trafficking.

    Science.gov (United States)

    Hopper, Elizabeth K; Azar, Naomi; Bhattacharyya, Sriya; Malebranche, Dominique A; Brennan, Kelsey E

    2018-01-01

    This is the abstract that was submitted online with the paper: Despite the fact that many survivors of human trafficking have experienced complex trauma, there are no established interventions designed to specifically address these impacts. Leaders in the field of complex trauma have advocated for the need for somatic approaches to intervention. This paper presents STARS Experiential Group treatment, the first structured bodybased group intervention that has been designed to address complex trauma in survivors of human trafficking. Three pilot groups were run in residential settings with adolescent and adult survivors of sex trafficking. Two adaptations were utilized, with one focusing on application of expressive arts modalities and the other incorporating theater games. Qualitative results, using thematic analysis, identified several themes related to challenges and potential benefits of these groups. Potential benefits of the STARS groups were found in the areas of Interpersonal Relationships, Regulation, and Self/ Identity, with fourteen sub-themes further describing positive impacts. Challenges within these areas are explored, to inform the development of group interventions for trafficking survivors. The results of this paper suggest that experiential, somatically-oriented group treatment shows promise as an important element of holistic intervention with trafficking survivors.

  18. 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)

  19. The addition of tramadol to the standard of i.v. acetaminophen and morphine infusion for postoperative analgesia in neonates offers no clinical benefit: a randomized placebo-controlled trial.

    Science.gov (United States)

    Olischar, Monika; Palmer, Greta M; Orsini, Francesca; Davidson, Andrew J; Perkins, Elizabeth J; Lee, Katherine J; Everest, Neil J; Cranswick, Noel E; Hunt, Rod W

    2014-11-01

    Tramadol is used following neonatal cardiac and general surgery. However, its ability to opioid-spare or facilitate earlier extubation in postoperative neonates is unquantified. This randomized placebo-controlled trial aimed to assess whether tramadol's addition to standard analgesia resulted in earlier extubation or reduced analgesic/sedative requirements in postsurgical neonates. Neonates born ≥32 weeks postmenstrual age received either tramadol [T] 2 mg·kg(-1) or placebo [P] 6-hourly for up to 5 days postthoracoabdominal surgery in addition to morphine (commenced at 20 mcg·kg(-1) ·h(-1)) and 6-hourly i.v. acetaminophen. Time to extubation, morphine and midazolam amounts, hourly pain scores, and seizure activity were compared using an intention-to-treat and per-protocol analysis. Seventy-one neonates participated. Median survival time to extubation was similar between the groups (T 67 h [95% CI 51, 84] vs P 52 h [95%CI 43, 65]; P = 0.4), and similar numbers were extubated by 96 h (T 69% vs P 77%; difference -8%, 95%CI -28, 13%). Morphine and midazolam exposure was similar, with low pain scores in both groups (mean percentage of time with a pain score >5/20 during the 5 days: T 13% vs P 11%, difference in means 2.8 [95% CI -1.8, 7.6], P = 0.20). Most participants had normal cranial ultrasounds (T 86% vs P 86%); no seizures occurred clinically or electroencephalographically. Tramadol's addition to standard analgesia in this small group of postsurgical neonates did not appear to have any positive effect on time to extubation, morphine or midazolam exposure, or pain scores. This questions the benefit of tramadol for postsurgical neonates. Importantly, no seizures occurred in these ill neonates who may potentially be at greater risk of tramadol toxicity compared with adults. © 2014 John Wiley & Sons Ltd.

  20. Message Framing and Physical Activity Promotion in Colorectal Cancer Survivors.

    Science.gov (United States)

    Hirschey, Rachel; Lipkus, Isaac; Jones, Lee; Mantyh, Christopher; Sloane, Richard; Demark-Wahnefried, Wendy

    2016-11-01

    To test effects of gain-framed versus loss-framed mailed brochures on increasing physical activity (PA) among colorectal cancer (CRC) survivors.
. Randomized trial with repeated measures at baseline, 1 month, and 12 months postintervention.
. Mail recruitment from tumor registries.
. 148 inactive CRC survivors who had completed primary therapy. 
. PA and constructs from the Theory of Planned Behavior (TPB) were assessed at baseline, 1 month, and 12 months. Participants were randomized to receive pamphlets describing PA benefits (gain framed) or disadvantages of not being physically active (loss framed). Baseline characteristics were compared using descriptive statistics. Repeated measures linear models were used to test PA changes.
. Minutes of PA and TPB constructs.
. Significant PA increases were observed in both study arms. Results did not differ by message frame. At one month, about 25% of previously inactive participants increased activity to national recommendations. Those who increased PA compared to those who did not had higher baseline scores on subjective norms, perceived behavioral control, and PA intentions. 
. Independent of message framing, mailed brochures are highly effective in producing within-subject short- and long-term increases in PA.
. CRC survivors may increase short- and long-term levels of PA by receiving inexpensive print brochures.

  1. Explanatory Model of Resilience in Pediatric Burn Survivors.

    Science.gov (United States)

    Quezada, Lucía; González, Mónica T; Mecott, Gabriel A

    2016-01-01

    Identifying factors of adjustment in pediatric burn patients may facilitate appropriate mental health interventions postinjury. The aim of this is study was to explore the roles of both the patient's and caregivers' resilience and posttraumatic stress in pediatric burn survivor adjustment. For the purposes of the study, "51 patient-parent/guardian" dyads participated. Patients answered the Resilience Questionnaire for Children and Adolescents, and caregivers answered the Mexican Resilience Scale and the Davidson Trauma Scale. The roles of patient age, time since the burn, and size of burn injury were also considered. Statistical analyses included Spearman's ρ for correlations and structural equation modeling. P less than .05 was considered significant. Patients and caregivers reported high levels of resilience, and the majority of caregivers reported low severity of posttraumatic stress disorder symptoms. Pediatric burn survivors' resilience was associated with being younger at the time of the burn and less severity of intrusive and avoidance symptoms in caregivers; it was also associated with a higher resilience in caregivers. It can be concluded that psychological responses of caregivers of pediatric burn survivors affect the well being and positive adjustment of patients; thus psychological services for caregivers would likely have a double benefit for both caregivers and patients.

  2. '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.

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

    Science.gov (United States)

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

    2011-10-05

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

  4. Follow-up Care Education and Information: Identifying Cancer Survivors in Need of More Guidance.

    Science.gov (United States)

    O'Malley, Denalee M; Hudson, Shawna V; Ohman-Strickland, Pamela A; Bator, Alicja; Lee, Heather S; Gundersen, Daniel A; Miller, Suzanne M

    2016-03-01

    Cancer survivors engage in cancer screenings and protective health behaviors at suboptimal rates despite their increased risk for future illness. Survivorship care plans and other educational strategies to prepare cancer survivors to adopt engaged roles in managing long-term follow-up care and health risks are needed. In a sample of cancer survivors, we identified patient characteristics and psychosocial predictors associated with increased follow-up care informational needs. Cross-sectional surveys were administered to early-stage breast and prostate survivors (N = 278; 68 % breast) at least 2 years post treatment from four community hospital programs in New Jersey between May 2012 and July 2013. Patient demographics, medical history, psychosocial characteristics (i.e., worries about the future, fear of disease recurrence, and patient activation), and perceptions of oncology and primary care were assessed. African-American survivors (AOR = 2.69, 95 % confidence interval [CI] 1.27-5.68) and survivors with higher comorbidity (AOR =1.16, CI 1.01-1.33) were more likely to want additional information to guide follow-up care. Adjusting for race and comorbidities, survivors who wanted more information to guide their follow-up care reported greater worries about the future (p < 0.05) and fears about disease recurrence (p < 0.05) compared to those who did not want additional information. Results emphasize the need to develop cancer survivorship educational strategies that are both responsive to the needs of specific populations (e.g., African-American survivors and patients with multiple comorbidities) and the psychosocial profiles that motivate requests for more extensive follow-up guidance.

  5. Nutritional interventions for survivors of childhood cancer.

    Science.gov (United States)

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

    2016-08-22

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

  6. Osteoporosis in survivors of early life starvation.

    Science.gov (United States)

    Weisz, George M; Albury, William R

    2013-01-01

    The objective of this study was to provide evidence for the association of early life nutritional deprivation and adult osteoporosis, in order to suggest that a history of such deprivation may be an indicator of increased risk of osteoporosis in later life. The 'fetal programming' of a range of metabolic and cardiovascular disorders in adults was first proposed in the 1990s and more recently extended to disorders of bone metabolism. Localised famines during World War II left populations in whom the long-term effects of maternal, fetal and infantile nutritional deprivation were studied. These studies supported the original concept of 'fetal programming' but did not consider bone metabolism. The present paper offers clinical data from another cohort of World War II famine survivors - those from the Holocaust. The data presented here, specifically addressing the issue of osteoporosis, report on 11 Holocaust survivors in Australia (five females, six males) who were exposed to starvation in early life. The cases show, in addition to other metabolic disorders associated with early life starvation, various levels of osteoporosis, often with premature onset. The cohort studied is too small to support firm conclusions, but the evidence suggests that the risk of adult osteoporosis in both males and females is increased by severe starvation early in life - not just in the period from gestation to infancy but also in childhood and young adulthood. It is recommended that epidemiological research on this issue be undertaken, to assist planning for the future health needs of immigrants to Australia coming from famine affected backgrounds. Pending such research, it would be prudent for primary care health workers to be alert to the prima facie association between early life starvation and adult osteoporosis, and to take this factor into account along with other indicators when assessing a patient's risk of osteoporosis in later life.

  7. Darwinism determines technological survivors

    International Nuclear Information System (INIS)

    Bevc, F.; Harkness, S.

    1996-01-01

    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

  8. Sexual Abuse Trauma Among Chinese Survivors.

    Science.gov (United States)

    Luo, Tsun-yin Echo

    1998-01-01

    This study conducted interviews with 19 survivors of sexual abuse and three social workers in Taiwan. It found sexual stigmatization and feelings of disempowerment and betrayal as the most pervasive trauma complex among the abuse survivors. Effects of cultural attitudes toward sexual victimization of women and Chinese patriarchal familialism are…

  9. Endocrinopathies in Survivors of Childhood Neoplasia

    Directory of Open Access Journals (Sweden)

    NICOLE S BARNES

    2014-09-01

    Full Text Available Advancements in cancer treatments have increased the number of childhood cancer survivors. Endocrinopathies are common complications following cancer therapy and may occur decades later. The objective of the review is to address the main endocrine abnormalities detected in childhood cancer survivors including disorders of the hypothalamic-pituitary axis, thyroid, puberty, gonads, bone, body composition, and glucose metabolism.

  10. Neuropsychological Functioning in Survivors of Childhood Leukemia.

    Science.gov (United States)

    Reeb, Roger N.; Regan, Judith M.

    1998-01-01

    Examined neuropsychological functioning of survivors of acute lymphoblastic leukemia who underwent central-nervous-system prophylactic treatment. Findings replicated past research in showing survivors perform poorly on visual-motor integration tasks and develop a Nonverbal Learning Disability. Findings offer recommendations for future research and…

  11. 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...

  12. The impact of immigration detention on the mental health of torture survivors is poorly documented--a systematic review.

    Science.gov (United States)

    Storm, Tania; Engberg, Marianne

    2013-11-01

    Torture has enduring mental and physical health consequences for survivors. Detention of asylum seekers is an integrated part of the immigration systems in many countries. Among the asylum seekers are vulnerable groups such as survivors of torture and severely traumatized refugees. The aim of the present study is to review the scientific evidence on the mental health consequences of immigration detention for adult survivors of torture. The review was conducted according to a modified version of the PRISMA guidelines. A systematic search was made in: PubMed (Medline), PsychINFO, PILOTS and IBSS, and reference lists were screened. The search yielded 241 results and two records came from additional sources. A total of 15 studies were included. Merely two case studies focused on survivors of torture. Both reported severe effects of detention on the detainees' mental health. High levels of psychological problems were found in studies identifying torture survivors among the asylum seekers. The impact of detention on the mental health of torture survivors is poorly documented, and the available data are insufficient to allow analysis of any specific effects. The studies do report severe mental health issues among detained torture survivors. In general, serious mental health problems are found among the detainees and formerly detained asylum seekers. Systematically identifying torture survivors and other vulnerable groups, and assessing and monitoring mental health issues is crucial. The health risks that detention may pose to the wellbeing of each individual should be carefully considered.

  13. Stroke survivors' experiences of rehabilitation

    DEFF Research Database (Denmark)

    Peoples, Hanne; Satink, Ton; Steultjens, Esther

    2011-01-01

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

  14. 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.

  15. Hormone replacement therapy in cancer survivors: Utopia?

    Science.gov (United States)

    Angioli, Roberto; Luvero, Daniela; Armento, Grazia; Capriglione, Stella; Plotti, Francesco; Scaletta, Giuseppe; Lopez, Salvatore; Montera, Roberto; Gatti, Alessandra; Serra, Giovan Battista; Benedetti Panici, Pierluigi; Terranova, Corrado

    2018-04-01

    As growing of old women population, menopausal women will also increase: an accurate estimation of postmenopausal population is an essential information for health care providers considering that with aging, the incidence of all cancers is expected to increase. Hormone replacement therapy (HRT) has proven to be highly effective in alleviating menopausal symptoms such as hot flashes, night sweats, dyspareunia, sexual disorders, and insomnia and in preventing osteoporosis. According to preclinical data, estrogen and progesterone are supposed to be involved in the induction and progression of breast and endometrial cancers. Similarly, in epithelial ovarian cancer (EOC), the pathogenesis seems to be at least partly hormonally influenced. Is HRT in gynecological cancer survivors possible? The literature data are controversial. Many clinicians remain reluctant to prescribe HRT for these patients due to the fear of relapse and the risk to develop coronary heart disease or breast cancer. Before the decision to use HRT an accurate counselling should be mandatory in order to individualizing on the basis of potential risks and benefits, including a close follow-up. Nevertheless, we do believe that with strong informed consent doctors may individually consider to prescribe some course of HRT in order to minimize menopausal symptoms and disease related to hormonal reduction. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. 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

  17. American Indian Women Cancer Survivor's Needs and Preferences: Community Support for Cancer Experiences.

    Science.gov (United States)

    Burnette, Catherine E; Roh, Soonhee; Liddell, Jessica; Lee, Yeon-Shim

    2018-03-15

    Cancer (the focus of this inquiry) is the leading cause of death among American Indian and Alaska Native women. The purpose of this study was to identify American Indian women cancer survivors' needs and preferences related to community supports for their cancer experience. This qualitative study examined female American Indian cancer survivors' needs and preferences about community support. The sample included 43 American Indian women cancer survivors (the types of cancer survivors included cervical cancer: n = 14; breast cancer: n = 14; and colon and other types: n = 15) residing in the Northern Plains region, in the state of South Dakota. Data were analyzed using qualitative content analysis and were collected between June of 2014 and February of 2015. When asked about their needs and preferences, 82% of participants (n = 35) of female American Indian cancer survivors reported at least one of the following most commonly reported themes: cancer support groups (n = 31, 72%), infrastructure for community support (n = 17, 40%), and cancer education (n = 11, 26%). In addition to the aforementioned themes, 33% of participants (n = 14) indicated the need for an improved healthcare system, with 11% (n = 5) of participants expressly desiring the integration of spirituality and holistic healing options. The majority of American Indian women cancer survivor participants of this study identified a need for more community-based support systems and infrastructures to aid with the cancer survivor experience. Results warrant a community approach to raise awareness, education, and support for American Indian cancer survivors.

  18. Decline in physical activity level in the Childhood Cancer Survivor Study cohort.

    Science.gov (United States)

    Wilson, Carmen L; Stratton, Kayla; Leisenring, Wendy L; Oeffinger, Kevin C; Nathan, Paul C; Wasilewski-Masker, Karen; Hudson, Melissa M; Castellino, Sharon M; Stovall, Marilyn; Armstrong, Gregory T; Brinkman, Tara M; Krull, Kevin R; Robison, Leslie L; Ness, Kirsten K

    2014-08-01

    We aimed to identify demographic and health-related predictors of declining physical activity levels over a four-year period among participants in the Childhood Cancer Survivor Study. Analyses included 7,287 ≥5-year childhood cancer survivors and 2,107 siblings who completed multiple follow-up questionnaires. Participants were classified as active if they met the Centers for Disease Control and Prevention guidelines for physical activity. Generalized linear models were used to compare participants whose physical activity levels declined from active to inactive over the study to those who remained active. In addition, selected chronic conditions (CTCAE v4.03 Grade 3 and 4) were evaluated as risk factors in an analysis limited to survivors only. The median age at last follow-up among survivors and siblings was 36 (range, 21-58) and 38 (range, 21-62) years, respectively. The rate of decline did not accelerate over time among survivors when compared with siblings. Factors that predicted declining activity included body mass index ≥30 kg/m(2) [RR = 1.32; 95% confidence interval (CI), 1.19-1.46, P physical activity levels were associated with the presence of chronic musculoskeletal conditions (P = 0.034), but not with the presence of cardiac (P = 0.10), respiratory (P = 0.92), or neurologic conditions (P = 0.21). Interventions designed to maximize physical activity should target female, obese, and less educated survivors. Survivors with chronic musculoskeletal conditions should be monitored, counseled, and/or referred for physical therapy. Clinicians should be aware of low activity levels among subpopulations of childhood cancer survivors, which may heighten their risk for chronic illness. ©2014 American Association for Cancer Research.

  19. Elevated cancer risk in Holocaust survivors residing in Israel: A retrospective cohort study.

    Science.gov (United States)

    Ben David, Ran; Biderman, Aya; Sherf, Michael; Zamstein, Omri; Dreiher, Jacob

    2018-05-01

    The purpose of this study was to examine the incidence of malignant diseases among Holocaust survivors in Israel compared with European and American immigrants who did not experience the Holocaust. Study subjects included Holocaust survivors born in European countries under Nazi occupation before 1945, who immigrated to Israel after 1945 and were alive as of the year 2000. Living survivors were identified based on recognition criteria in accordance with the Holocaust Survivor Benefits Law. The comparison group consisted of Clalit enrollees who were born before 1945 in European countries not under Nazi occupation and were alive in 2000 or were born in any European country or America, immigrated to Israel before 1939 and were alive in 2000. The incidence of malignant diseases was compared in univariate and Poisson regression models analyses, controlling for age, smoking, obesity, diabetes and place of residence. The study included 294,543 Holocaust survivors, and the mean age at the beginning of follow-up was 74 ± 8.7 years; 43% males. In multivariable analyses, the rate ratio (RR) values for males and females were 1.9 and 1.3 for colon cancer, 1.9 and 1.4 for lung cancer, 1.6 and 1.4 for bladder cancer and 1.2 and 1.3 for melanoma, respectively. For prostate cancer in males, the RR was 1.4, while for breast cancer in females, it was 1.2. The incidence of malignant diseases among Holocaust survivors residing in Israel was higher than that among non-Holocaust survivors. These associations remained statistically significant in a multivariable analysis and were stronger for males. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. A qualitative theory guided analysis of stroke survivors' perceived barriers and facilitators to physical activity.

    Science.gov (United States)

    Nicholson, Sarah L; Donaghy, Marie; Johnston, Marie; Sniehotta, Falko F; van Wijck, Frederike; Johnston, Derek; Greig, Carolyn; McMurdo, Marion E T; Mead, Gillian

    2014-01-01

    After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke. Thus, our aim was to explore stroke survivors' perceived barriers and facilitators to physical activity. Semi-structured interviews with 13 ambulatory stroke survivors exploring perceived barriers and facilitators to physical activity post stroke were conducted in participants' homes, audio-recorded and transcribed verbatim. The Theoretical Domains Framework (TDF) informed content analysis of the interview transcripts. Data saturation was reached after interviews with 13 participants (median age of 76 years (inter-quartile range (IQR) = 69-83 years). The median time since stroke was 345 d (IQR = 316-366 d). The most commonly reported TDF domains were "beliefs about capabilities", "environmental context and resources" and "social influence". The most commonly reported perceived motivators were: social interaction, beliefs of benefits of exercise, high self-efficacy and the necessity of routine behaviours. The most commonly reported perceived barriers were: lack of professional support on discharge from hospital and follow-up, transport issues to structured classes/interventions, lack of control and negative affect. Stroke survivors perceive several different barriers and facilitators to physical activity. Stroke services need to address barriers to physical activity and to build on facilitators to promote physical activity after stroke. Physical activity post stroke can improve physical fitness and function, yet physical activity remains low among stroke survivors. Understanding stroke survivors' perceived barriers and facilitators to physical activity is essential to develop targeted interventions to increase physical activity. Beliefs about capabilities, environmental

  1. 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

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

    International Nuclear Information System (INIS)

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

  3. 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

  4. 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

  5. Rape Survivors' Agency within the Legal and Medical Systems

    Science.gov (United States)

    Greeson, Megan R.; Campbell, Rebecca

    2011-01-01

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

  6. 5 CFR 838.711 - Maximum former spouse survivor annuity.

    Science.gov (United States)

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Luzius Mader

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

  8. 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

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

  9. 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.

  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. 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

  12. 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.

  13. 77 FR 19455 - Regulations Implementing the Byrd Amendments to the Black Lung Benefits Act: Determining Coal...

    Science.gov (United States)

    2012-03-30

    ... Programs 20 CFR Parts 718 and 725 Regulations Implementing the Byrd Amendments to the Black Lung Benefits... Implementing the Byrd Amendments to the Black Lung Benefits Act: Determining Coal Miners' and Survivors... amendments to the Black Lung Benefits Act (BLBA or Act) made by the Patient Protection and Affordable Care...

  14. 78 FR 60686 - Regulations Implementing the Byrd Amendments to the Black Lung Benefits Act: Determining Coal...

    Science.gov (United States)

    2013-10-02

    ...-AA04 Regulations Implementing the Byrd Amendments to the Black Lung Benefits Act: Determining Coal... correcting the preamble to a final rule implementing amendments to the Black Lung Benefits Act that appeared... the Byrd Amendments to the Black Lung Benefits Act: Determining Coal Miners' and Survivors...

  15. Dysfunctional Pain Modulation in Torture Survivors

    DEFF Research Database (Denmark)

    Defrin, Ruth; Lahav, Yael; Solomon, Zahava

    2017-01-01

    Trauma survivors, and particularly torture survivors, suffer from high rates of chronic pain and posttraumatic stress disorder (PTSD) for years afterward, along with alterations in the function of the pain system. On the basis of longitudinal data on PTSD symptomatology, we tested whether exposure...... resultant distress are measurable, their evaluation seems particularly important in the management of pain among trauma survivors. The results may be generalized to other instances in which chronic pain persists after traumatic events. Perspective This article presents the mediation effect of PTSD...

  16. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

    Directory of Open Access Journals (Sweden)

    Joanne Lester

    2015-03-01

    Full Text Available Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors.

  17. Individual Prediction of Heart Failure Among Childhood Cancer Survivors

    Science.gov (United States)

    Chow, Eric J.; Chen, Yan; Kremer, Leontien C.; Breslow, Norman E.; Hudson, Melissa M.; Armstrong, Gregory T.; Border, William L.; Feijen, Elizabeth A.M.; Green, Daniel M.; Meacham, Lillian R.; Meeske, Kathleen A.; Mulrooney, Daniel A.; Ness, Kirsten K.; Oeffinger, Kevin C.; Sklar, Charles A.; Stovall, Marilyn; van der Pal, Helena J.; Weathers, Rita E.; Robison, Leslie L.; Yasui, Yutaka

    2015-01-01

    Purpose To create clinically useful models that incorporate readily available demographic and cancer treatment characteristics to predict individual risk of heart failure among 5-year survivors of childhood cancer. Patients and Methods Survivors in the Childhood Cancer Survivor Study (CCSS) free of significant cardiovascular disease 5 years after cancer diagnosis (n = 13,060) were observed through age 40 years for the development of heart failure (ie, requiring medications or heart transplantation or leading to death). Siblings (n = 4,023) established the baseline population risk. An additional 3,421 survivors from Emma Children's Hospital (Amsterdam, the Netherlands), the National Wilms Tumor Study, and the St Jude Lifetime Cohort Study were used to validate the CCSS prediction models. Results Heart failure occurred in 285 CCSS participants. Risk scores based on selected exposures (sex, age at cancer diagnosis, and anthracycline and chest radiotherapy doses) achieved an area under the curve of 0.74 and concordance statistic of 0.76 at or through age 40 years. Validation cohort estimates ranged from 0.68 to 0.82. Risk scores were collapsed to form statistically distinct low-, moderate-, and high-risk groups, corresponding to cumulative incidences of heart failure at age 40 years of 0.5% (95% CI, 0.2% to 0.8%), 2.4% (95% CI, 1.8% to 3.0%), and 11.7% (95% CI, 8.8% to 14.5%), respectively. In comparison, siblings had a cumulative incidence of 0.3% (95% CI, 0.1% to 0.5%). Conclusion Using information available to clinicians soon after completion of childhood cancer therapy, individual risk for subsequent heart failure can be predicted with reasonable accuracy and discrimination. These validated models provide a framework on which to base future screening strategies and interventions. PMID:25287823

  18. Post-treatment problems of African American breast cancer survivors.

    Science.gov (United States)

    Barsevick, Andrea M; Leader, Amy; Bradley, Patricia K; Avery, Tiffany; Dean, Lorraine T; DiCarlo, Melissa; Hegarty, Sarah E

    2016-12-01

    African American breast cancer survivors (AABCS) have a lower survival rate across all disease stages (79 %) compared with White survivors (92 %) and often have more aggressive forms of breast cancer requiring multimodality treatment, so they could experience a larger burden of post-treatment quality of life (QOL) problems. This paper reports a comprehensive assessment of the number, severity, and domains of problems faced by AABCS within 5 years after treatment completion and identifies subgroups at risk for these problems. A population-based random sample was obtained from the Pennsylvania Cancer Registry of African American females over 18 years of age who completed primary treatment for breast cancer in the past 5 years. A mailed survey was used to document survivorship problems. Two hundred ninety-seven AABCS completed the survey. The median number of survivor problems reported was 15. Exploratory factor analysis of the problem scale revealed four domains: emotional problems, physical problems, lack of resources, and sexuality problems. Across problem domains, younger age, more comorbid conditions, and greater medical mistrust were risk factors for more severe problems. The results demonstrated that AABCS experienced significant problem burden in the early years after diagnosis and treatment. In addition to emotional and physical problem domains that were documented in previous research, two problem domains unique to AABCS included lack of resources and sexuality concerns. At risk groups should be targeted for intervention. The study results reported in this manuscript will inform future research to address problems of AABCS as they make the transition from cancer patient to cancer survivor.

  19. 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...

  20. 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

    2018-01-01

    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.

  1. Multiple Benefits.

    Science.gov (United States)

    Kreider, Beth

    1997-01-01

    Discusses the benefits of dome architecture for a community's middle- and high-school multi-purpose facility. The dome construction is revealed as being cost effective in construction and in maintenance and energy costs. (GR)

  2. Smoking habits among atomic-bomb survivors

    International Nuclear Information System (INIS)

    Akiba, Suminori; Kimura, Masafumi

    1992-01-01

    The Radiation Effects Research Foundation made a research through mailing, the smoking habits among the A-bomb survivors in 1978-79. Statistic analysis was made on the smoking habits and radiation doses. (J.P.N.)

  3. Effects of Downsizing Strategies on Survivors' Organizational ...

    African Journals Online (AJOL)

    Journal of Business and Administrative Studies ... Effects of Downsizing Strategies on Survivors' Organizational Commitment: The Case of Ethio Telecom ... do human resource planning industriously, set clear selection criteria, make the ...

  4. Childhood Cancer Survivor Study: An Overview

    Science.gov (United States)

    ... To address this issue, the Children’s Oncology Group ( COG ) has prepared a resource for physicians called “ Long- ... of American Medical Association; see the journal article ) Breast cancer risk in childhood cancer survivors without a history ...

  5. 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.

  6. Chemotherapy-Induced Neuropathy in Cancer Survivors.

    Science.gov (United States)

    Miaskowski, Christine; Mastick, Judy; Paul, Steven M; Topp, Kimberly; Smoot, Betty; Abrams, Gary; Chen, Lee-May; Kober, Kord M; Conley, Yvette P; Chesney, Margaret; Bolla, Kay; Mausisa, Grace; Mazor, Melissa; Wong, Melisa; Schumacher, Mark; Levine, Jon D

    2017-08-01

    Evidence suggests that chemotherapy-induced neuropathy (CIN) is a significant problem for cancer survivors. However, a detailed phenotypic characterization of CIN in cancer survivors is not available. To evaluate between-group differences in demographic and clinical characteristics, as well as in measures of sensation, function, and postural control, in a sample of cancer survivors who received a platinum and/or a taxane-based CTX regimen and did (n = 426) and did not (n = 197) develop CIN. Survivors completed self-report questionnaires and underwent objective testing (i.e., light touch, pain sensation, cold sensation, vibration, muscle strength, grip strength, Purdue Pegboard test, Timed Get Up and Go test, Fullerton Advanced Balance test). Parametric and nonparametric statistics were used to compare between-group differences in study outcomes. Of the 426 survivors with CIN, 4.9% had CIN only in their upper extremities, 27.0% only in their lower extremities, and 68.1% in both their upper and lower extremities. Demographic and clinical characteristics associated with CIN included the following: older age, lower annual income, higher body mass index, a higher level of comorbidity, being born prematurely, receipt of a higher cumulative dose of chemotherapy, and a poorer functional status. Survivors with CIN had worse outcomes for all of the following objective measures: light touch, pain, temperature, vibration, upper and lower extremity function, and balance. This study is the first to provide a detailed phenotypic characterization of CIN in cancer survivors who received a platinum and/or a taxane compound. These data can serve as a benchmark for future studies of CIN in cancer survivors. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. Imbalanced Nutrient Intake in Cancer Survivors from the Examination from the Nationwide Health Examination Center-Based Cohort

    Directory of Open Access Journals (Sweden)

    Boyoung Park

    2018-02-01

    Full Text Available This study was conducted to examine the nutrient intake status of cancer survivors. A total of 5224 cancer survivors, 19,926 non-cancer individuals without comorbidities (non-cancer I, and 20,622 non-cancer individuals with comorbidities, matched by age, gender, and recruitment center location were included in the analysis. Generally, the proportion of total energy from carbohydrates was higher and the proportion from fat was lower in cancer survivors. The odds ratios (ORs for total energy (OR = 0.92, 95% confidence interval (CI = 0.86–0.99, proportion of total energy from fat (OR = 0.54, 95% CI = 0.35–0.83, and protein (OR = 0.85, 95% CI = 0.79–0.90 were significantly lower, and the OR for the proportion of total energy from carbohydrates was higher (OR = 1.21, 95% CI = 1.10–1.33 in the cancer survivors than in non-cancer I. Additionally, the cancer survivors’ protein, vitamin B1, vitamin B2, niacin, and phosphorus intakes were lower, whereas their vitamin C intake was higher. When divided by cancer type, the ORs for the carbohydrate percentages were significantly higher in the colon and breast cancer survivors, whereas protein intake was lower in gastric, breast, and cervical cancer survivors. The nutrient intake patterns in Asian cancer survivors are poor, with higher carbohydrate and lower fat and protein intakes.

  9. Self-efficacy mediates the relationship between behavioral processes of change and physical activity in older breast cancer survivors.

    Science.gov (United States)

    Loprinzi, Paul D; Cardinal, Bradley J

    2013-01-01

    The degree to which breast cancer survivors use behavioral processes of change has not been investigated. Additionally, the relationship between behavioral processes and other theory-based mediators of adult physical activity behavior has not been extensively studied among breast cancer survivors. The objectives of this study were to: (1) determine the extent to which breast cancer survivors use behavioral processes associated with physical activity behavior change, and (2) examine the inter-relationships between behavioral processes, self-efficacy, and physical activity behavior among breast cancer survivors. Sixty-nine breast cancer survivors completed surveys examining behavioral processes and exercise-specific self-efficacy. Six months later they completed a self-report physical activity questionnaire. Findings showed the majority of breast cancer survivors did not use approximately half of the behavioral processes on a regular basis, and self-efficacy completely mediated the relationship between behavioral processes and physical activity. Health care professionals may help enhance self-efficacy and ultimately increase physical activity behavior in breast cancer survivors by teaching behavior skills such as enlisting social support.

  10. Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

    Science.gov (United States)

    Brauer, Sandra G.; Kuys, Suzanne S.; Lord, Matthew; Hayward, Kathryn S.

    2014-01-01

    Aim. To explore factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient rehabilitation. Method. One-on-one, in-depth interviews with stroke survivors (n = 7) and their main carer (n = 6), along with two focus groups with clinical staff (n = 20). Data was thematically analysed according to group. Results. Stroke survivors perceived “dealing with loss,” whilst concurrently “building motivation and hope” for recovery affected their ability to drive their own recovery outside of therapy. In addition, they reported a “lack of opportunities” outside of therapy, with subsequent time described as “dead and wasted.” Main carers perceived stroke survivors felt “out of control … at everyone's mercy” and lacked knowledge of “what to do and why” outside of therapy. Clinical staff perceived the stroke survivor's ability to drive their own recovery was limited by the lack of “another place to go” and the “passive rehab culture and environment.” Discussion. To enable the stroke survivor to drive their own recovery outside of therapy, there is a need to increase opportunities for practice and promote active engagement. Suggested strategies include building the stroke survivor's motivation and knowledge, creating an enriched environment, and developing daily routines to provide structure outside of therapy time. PMID:24800104

  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. Gastric cancer in atomic bomb survivors, 2

    International Nuclear Information System (INIS)

    Oshiro, Hisashi; Odan, Hideki; Hinoi, Takao; Inagaki, Kazuo; Tanaka, Issei

    1992-01-01

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

  13. Development of A-bomb survivor dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, G.D.

    1995-12-31

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

  14. Development of A-bomb survivor dosimetry

    International Nuclear Information System (INIS)

    Kerr, G.D.

    1995-01-01

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

  15. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    International Nuclear Information System (INIS)

    Michaelson, Evan M.; Chen, Yu-Hui; Silver, Barbara; Tishler, Roy B.; Marcus, Karen J.; Stevenson, Mary Ann; Ng, Andrea K.

    2014-01-01

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

  16. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-01

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

  17. Fertility in female survivors of Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Irene Biasoli

    2012-01-01

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

  18. Nurse experiences as cancer survivors: part II--professional.

    Science.gov (United States)

    Picard, Carol; Agretelis, Joan; DeMarco, Rosanna F

    2004-05-01

    To uncover dimensions of nurses' professional experiences of cancer survivorship. Interpretive, phenomenologic. Metropolitan area in the northeastern United States. 25 RNs diagnosed with cancer. Average age was 50 years, and 20 participants were less than five years from initial diagnosis. Interviews. Data were analyzed using the methodology of Newman (1994, 1999) and VanManen (1990). Nurses' professional experiences of cancer survivorship. Professional experiences of cancer survivorship fell into five themes: (a) role ambiguity, (b) a deepening level of compassion for patients and others, (c) self-disclosure as a therapeutic intervention, (d) becoming an advocate for change, and (e) volunteerism. Cancer survivorship was a factor in reshaping participants' clinical practice. Experiencing the role of the patient affirmed the necessity of compassionate care for these participants. Nurses experienced a deepening level of compassion for patients and used self-disclosure as a therapeutic intervention. During and shortly after treatment, role ambiguity (being both patient and nurse) could cause difficulties. Nurses took action to change their clinical environment through their influence on colleagues and the healthcare system and by working through other organizations to improve patient care. Nurse cancer survivors can benefit from the support of colleagues and healthcare providers and an appreciation of the challenge of being both a professional and a patient. The invitation for dialogue as they return to work may help with the challenges of role ambiguity as nurse cancer survivors. Based on this study, nurses value the opportunity to enhance care environments with their two-world knowledge through compassionate care, disclosure, advocacy, and volunteering, and coworkers need to appreciate each nurse's unique response to this potentially life-changing process. Nurses in all settings can learn from their cancer survivor colleagues who have been the recipients of care to

  19. Predictors of fatigue and work ability in cancer survivors.

    Science.gov (United States)

    van Muijen, P; Duijts, S F A; Bonefaas-Groenewoud, K; van der Beek, A J; Anema, J R

    2017-12-30

    Workers diagnosed with cancer are at risk for job loss or work disability. To determine predictors of fatigue and work ability at 36 months after diagnosis in a population of cancer survivors. Individuals diagnosed with cancer and who applied for work disability benefit at 24 months of sick leave were surveyed at the time of application and again 12 months later. Fatigue was measured using the Functional Assessment of Chronic Illness-Fatigue scale questionnaire and work ability was measured using the work ability index. Linear regression analyses were applied to identify predictors. There were 336 participants. Participants who were divorced or widowed had more physical limitations, more depressive symptoms and were more fatigued at baseline, and who worked in health care demonstrated higher levels of fatigue. Lower fatigue was predicted by having received chemotherapy. A higher level of work ability was predicted by having received chemotherapy, better global health and better work ability at baseline. Lower work ability was predicted by being principal wage earner, insecurity about being free of disease, having more physical limitations and having greater wage loss. Socio-demographic, health- and work-related factors were associated with fatigue and work ability in cancer survivors on long-term sick leave. As fatigue and poor work ability are important risk factors for work disability, addressing the identified predictive factors may assist in mitigation of work disability in cancer survivors. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  20. 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.

  1. Comprehensive visualization of paresthesia in breast cancer survivors.

    Science.gov (United States)

    Jud, Sebastian M; Hatko, Reinhard; Maihöfner, Christian; Bani, Mayada R; Schrauder, Michael G; Lux, Michael P; Beckmann, Matthias W; Bani, Gassan; Eder, Irina; Fasching, Peter A; Loehberg, Christian R; Rauh, Claudia; Hein, Alexander

    2014-07-01

    As breast cancer survivors are benefiting increasingly from advanced forms of therapy, the side effects of locoregional treatment in the adjuvant setting are becoming more and more important. This article presents a new method of assessing the spatial distribution of paresthesia in breast cancer survivors after different locoregional treatments. A structured questionnaire assessing paresthesia, with body pictograms for marking paresthesia areas, was completed by 343 breast cancer survivors. The image information was digitized, generating gray-scale summation images with numbers from 0, indicating black (100 % of the patients had paresthesia), to 255, indicating white (none had paresthesia). The resulting map visualization showed the locations of paresthesia on body pictograms. The group included patients who had undergone breast-conserving surgery (BCS) and mastectomy, and also patients who had received percutaneous and interstitial radiation. A total of 56.5 % of the patients stated that they had paresthesia. The paresthesia areas were distributed within the range suggested by clinical experience. Most patients stated that they had paresthesia in the upper outer quadrant and axilla. Patients who had undergone mastectomy or percutaneous radiotherapy appeared to have more paresthesia on some areas of the body surface. Patients who had undergone mastectomy indicated larger areas of paresthesia than those with BCS-4,066 pixels (px) vs. 2,275 px. Radiotherapy did not appear to influence the spatial distribution of paresthesia. Paresthesia is a common symptom after breast cancer treatment. This paper describes a new method of assessing this side effect to improve and individualize treatment for it in the future.

  2. Determinants of Health-Related Quality of Life in Taiwanese Middle-Aged Women Stroke Survivors.

    Science.gov (United States)

    Pai, Hsiang-Chu; Wu, Ming-Hsiu; Chang, Mei-Yueh

    Female stroke victims have a higher survival rate and experience a greater loss of quality of life than do male stroke victims. The aim of this study was to evaluate the determinants of health-related quality of life in middle-aged women stroke survivors. This study is a cross-sectional design. This cross-sectional research uses a descriptive, prospective, and correlational study design to investigate the associations between latent variables. Participants included women stroke survivors, aged 45-65 years, who were patients at a medical center in Taiwan. Participants completed an interview and a six-part questionnaire comprising the Short-Form Health Survey (SF-36), National Institutes of Health Stroke Scale, Modified Rankin Scale, Burden Scale, Chinese Health Questionnaire, and five items that pertain to the survivor's cognitive appraisal of coping. Structural equation modeling (SEM), with the use of the partial least squares (PLS) method, was used to examine the proposed conceptual model. A total of 48 dyad samples (48 female stroke survivors, mean age = 55.29; 48 caregivers, mean age = 42.71) participated in the study. Overall, women's physical functioning (PF; stroke severity), cognitive appraisal of coping, and caregiver's psychosocial functioning were the predictors, explaining 43.3% of the variance in women's health-related quality of life. We found that female stroke survivors' level of stroke severity and negative appraisal-impact of stroke are significant predictors of the stroke survivor's quality of life. In addition to assisting women in their PF rehabilitation, rehabilitation nurses also should help to develop survivors' self-care confidence as a means to avoid the recurrence of stroke.

  3. 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.

  4. Tendency of socio-psychological aftereffects on aged survivors in Hiroshima A-bomb survivors home

    International Nuclear Information System (INIS)

    Shimizu, Kiyoshi; Mishima, Tetsuo; Watanabe, Michiko

    1984-01-01

    Psychosomatic status at the time of A-bomb explosion, behavior and impression immediately after the explosion, aftereffects on life, and mental changes were sought through interview for 80 aged survivors in Hiroshima A-bomb survivor home by psychiatric social workers. (Namekawa, K.)

  5. [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.

  6. 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 divorce or 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.

  7. Cancer-related identity and positive affect in survivors of prostate cancer.

    Science.gov (United States)

    Bellizzi, Keith M; Blank, Thomas O

    2007-03-01

    Despite a shift in the cancer culture and language used to describe individuals diagnosed with this disease, the extent to which individuals with cancer adopt a particular cancer-related identity and the impact of these identities in relation to their well-being is virtually unknown. Using a cross-sectional study design and a metropolitan tumor registry, a mail questionnaire to examine post-treatment quality of life was sent to prostate cancer (PCa) survivors. The sample consisted of 490 PCa survivors, ranging in age from 49-88 (M = 69.7; SD = 7.8), one to eight years after diagnosis. The outcome measure used in these analyses was the PANAS to assess positive and negative affect. The most frequently reported cancer-related identity was "someone who has had PCa" (57%). The least reported self view was "victim" (1%). Twenty-six percent of men self-identified as "survivors" while 6% thought of themselves as "cancer conquerors." Only 9% self-identified as a "patient." Multivariate analyses, adjusted for potential confounders, show respondents who identified themselves as "survivors" or "cancer conquerors" reported significantly higher scores on positive affect than men who self-identified as "patients" (p < .001). Although the majority of respondents identified themselves as "someone who has had cancer," identifying as a "survivor" or "someone who has conquered cancer" appears to have adaptive value for positive mood. Those who perceive themselves as survivors of prostate cancer may derive some benefit in well-being associated with this self assessment.

  8. 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

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

    Science.gov (United States)

    Cullings, Harry M

    2014-02-01

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

  10. 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, pHolocaust 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.

  11. Benefits | NREL

    Science.gov (United States)

    flexible work environment that enables and encourages a good work/life balance A growing, changing exceptional work. A woman riding her bike past the NREL entrance sign. Hundreds of NREL employees opt out of their cars, cycling to work, to take part in Bike To Work Day each year. Benefits Package NREL's

  12. Fringe Benefits.

    Science.gov (United States)

    Podgursky, Michael

    2003-01-01

    Uses statistics from the National Center for Education Statistics and the Bureau of Labor Statistics to examine teacher salaries and benefits. Discusses compensation of teachers compared with nonteachers. Asserts that statistics from the American Federation of Teachers and the National Education Association underestimate teacher compensation…

  13. 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.

  14. Barriers to exercise: perspectives from multiethnic cancer survivors in Malaysia.

    Science.gov (United States)

    Loh, Siew Yim; Chew, Shin-Lin; Lee, Shing-Yee

    2011-01-01

    Many cancer survivors are still not active enough to reap the benefits of physical activity. This study aimed to explore the correlation between perceived barriers and participation in exercise among multi- ethnic Malaysian women with breast cancer. A cross-sectional study using a pre-post questionnaire and a media-clip as a cancer control strategy was conducted on a random sample of women with breast cancer. The tools were structured questionnaires to collect socio-medical demographic and physical activity data (e.g. barriers, exercise self-efficacy). A statistically significant relationship between level of physical activity before and after diagnosis of breast cancer (n=51, χ2=70.14, pexercise after diagnosis, r(49)=0.73, pexercise participation. Lack of time is the main barrier amongst those survivors who are predominantly 40-50 year old housewives juggling with household chores, childcare and/or job commitments. Public health messages stressing that short bouts of exercise or some exercise are better than no exercise needs to be emphasised consistently.

  15. 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

  16. 5 CFR 892.402 - I am a survivor annuitant as well as an active Federal employee; am I eligible for premium...

    Science.gov (United States)

    2010-01-01

    ... Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENT OF HEALTH BENEFITS PREMIUMS Reemployed Annuitants and Survivor Annuitants... employed in a position that conveys FEHB eligibility and is covered by the premium conversion plan, you are...

  17. Additive manufacturing.

    Science.gov (United States)

    Mumith, A; Thomas, M; Shah, Z; Coathup, M; Blunn, G

    2018-04-01

    Increasing innovation in rapid prototyping (RP) and additive manufacturing (AM), also known as 3D printing, is bringing about major changes in translational surgical research. This review describes the current position in the use of additive manufacturing in orthopaedic surgery. Cite this article: Bone Joint J 2018;100-B:455-60.

  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. Whole-blood phagocytic and bactericidal activities of atomic bomb survivors, Hiroshima and Nagasaki

    International Nuclear Information System (INIS)

    Sasagawa, Sumiko; Yoshimoto, Yasuhiko; Toyota, Emiko; Neriishi, Shotaro; Yamakido, Michio; Matsuo, Miyo; Hosoda, Yutaka; Finch, S.C.

    1989-04-01

    This in vitro study evaluated the phagocytic and bactericidal activities of leukocytes in aliquots of whole blood from Hiroshima and Nagasaki atomic bomb survivors for Staphylococcus aureus. The data were analyzed by multiple linear regression. Any significant effects of exposure to A-bomb radiation could not be detected for both phagocytic and bactericidal activities of whole blood from A-bomb survivors. In addition, there were no significant effects of age categories, sex or city, except in neutrophil counts. (J.P.N.)

  20. The impact of neighborhood factors on the well-being of survivors of intimate partner violence over time.

    Science.gov (United States)

    Beeble, Marisa L; Sullivan, Cris M; Bybee, Deborah

    2011-06-01

    Intimate partner violence (IPV) is a pervasive social problem impacting the psychological well-being of millions of US women annually. The extant literature draws our attention to the devastating mental health effects of IPV, but largely overlooks how ecological factors may further explain survivors' well-being. This study examined how neighborhood disadvantage may contribute to survivors' compromised well-being, in addition to the abuse women experienced. Neighborhood disorder and fear of victimization significantly impacted survivors' well-being, over and above abuse. Although between-women effects of neighborhood disorder and fear were unrelated to change in women's depression or quality of life (QOL), significant within-woman effects were detected. Change in neighborhood disorder was negatively associated with change in QOL, and this relationship was fully mediated by fear. While no direct relationship between change in neighborhood disorder and depression was detected, an indirect effect through survivors' fear was revealed. Implications for future research and practice are discussed.

  1. 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.

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

    Science.gov (United States)

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

    2017-06-01

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

  3. A-bomb survivor dosimetry update

    International Nuclear Information System (INIS)

    Loewe, W.E.

    1982-06-01

    A-bomb survivor data have been generally accepted as applicable. Also, the initial radiations have tended to be accepted as the dominant radiation source for all survivors. There was general acceptance of the essential reliability of both the biological effects data and the causative radiation dose values. There are considerations casting doubt on these acceptances, but very little quantification of th implied uncertainties has been attempted. The exception was A-bomb survivor dosimetry, where free-field kerma values for initial radiations were thought to be accurate to about 30%, and doses to individual survivors were treated as effectively error-free. In 1980, a major challenge to the accepted A-bomb survivor dosimetry was announced, and was quickly followed by a succession of explanations and displays showing the soundness of that challenge. In fact, a complete replacement set of free-field kerma values was provided which was suitable for use in constructing an entire new dosimetry for Hiroshima and Nagasaki. The new values showed many changes greater than the accepted 30% uncertainty. An approximate new dosimetry was indeed constructed, and used to convert existing leukemia cause-and-effect data from the old to the new dose values, by way of assessing the impact

  4. Anxiety Among Adolescent Survivors of Pediatric Cancer.

    Science.gov (United States)

    McDonnell, Glynnis A; Salley, Christina G; Barnett, Marie; DeRosa, Antonio P; Werk, Rachel S; Hourani, Allison; Hoekstra, Alyssa B; Ford, Jennifer S

    2017-10-01

    The purpose of this review was to synthesize current knowledge about anxiety among adolescent survivors of pediatric cancer and highlights areas for future research. Systematic literature searches were conducted in five databases for articles published anytime before December 28, 2015. Manuscripts were reviewed by a team of six coders. Included manuscripts reported outcomes relevant to anxiety, worry, and post-traumatic stress in survivors of pediatric cancer (age at the time of study: 10-22 years) who were off treatment. Twenty-four articles met inclusion criteria. Included results were categorized into the following domains: post-traumatic stress, anxiety, cancer-related worry, and interventions. With the exception of post-traumatic stress, there was little research about anxiety in this population; however, studies generally indicated that adolescent survivors of pediatric cancer are at elevated risk for anxiety, post-traumatic stress symptoms, and cancer-related worry. This review provides preliminary evidence that anxiety is a relevant, but understudied, psychosocial outcome for adolescent survivors of pediatric cancer. More research is needed to better understand the presentation of anxiety in this population, its effect on survivors' quality of life, and possible areas for intervention. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Some hematological disorders among atomic bomb survivors. Presidential Address

    International Nuclear Information System (INIS)

    Watanabe, Susumu

    1977-01-01

    Focusing on their hematological disorders, the late radiation effects among Hiroshima and Nagasaki A-bomb survivors, including cytogenetic and cytological studies, are summarized and discussed. Because of personal research experience, the data were concentrated on the Hiroshima survivors

  6. Food additives

    Science.gov (United States)

    ... GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Food additives URL of this page: //medlineplus.gov/ency/article/ ...

  7. 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 benefici...... 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....

  8. 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

  9. Should community health workers offer support healthcare services to survivors of sexual violence? a systematic review.

    Science.gov (United States)

    Gatuguta, Anne; Katusiime, Barbra; Seeley, Janet; Colombini, Manuela; Mwanzo, Isaac; Devries, Karen

    2017-10-12

    Sexual violence is widespread, yet relatively few survivors receive healthcare or complete treatment. In low and middle-income countries, community health workers (CHWs) have the potential to provide support services to large numbers of survivors. The aim of this review was to document the role of CHWs in sexual violence services. We aimed to: 1) describe existing models of CHWs services including characteristics of CHWs, services delivered and populations served; 2) explore acceptability of CHWs' services to survivors and feasibility of delivering such services; and 3) document the benefits and challenges of CHW-provided sexual violence services. Quantitative and qualitative studies reporting on CHWs and other community-level paraprofessional volunteer services for sexual violence were eligible for inclusion. CHWs and sexual violence were defined according to WHO criteria. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Quality of included studies was assessed using two quality assessment tools for quantitative, and, the methodology checklist by the National Institute for Health and Clinical Excellence for qualitative studies. Data were extracted and analysed separately for quantitative and qualitative studies and results integrated using a framework approach. Seven studies conducted in six countries (Democratic Republic of Congo, Rwanda, Burma, United States of America, Scotland, Israel) met the inclusion criteria. Different models of care had diverse CHWs roles including awareness creation, identifying, educating and building relationships with survivors, psychosocial support and follow up. Although sociocultural factors may influence CHWs' performance and willingness of survivors to use their services, studies often did not report on CHWs characteristics. Few studies assessed acceptability of CHWs' to survivors or feasibility of delivery of services. However, participants mentioned a range

  10. Blood carboxyhaemoglobin and cyanide levels in fire survivors

    Energy Technology Data Exchange (ETDEWEB)

    Clark, C.J.; Campbell, D.; Reid, W.H.

    1981-06-20

    Blood carboxyhaemoglobin and cyanide concentrations were measured in 53 fire survivors, 36 of whom had clinical evidence of smoke inhalation. Carboxyhaemoglobin and cyanide levels were raised only in patients with smoke inhalation. Blood carboxyhaemoglobin measurement can be used to confirm the diagnosis of severe smoke inhalation in cases in which the clinical data are inconclusive, provided that the time of sampling after exposure is taken into account. A nomogram has been constructed for this purpose. There is no quick method of measuring blood cyanide levels, but the close relation between cyanide and carboxyhaemoglobin levels suggests that carboxyhaemoglobin concentrations, which can be rapidly and easily measured, could be used to identify those who might benefit from treatment with cyanide antidotes.

  11. 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.

  12. 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.

  13. Identification of PTSD in cancer survivors.

    Science.gov (United States)

    Alter, C L; Pelcovitz, D; Axelrod, A; Goldenberg, B; Harris, H; Meyers, B; Grobois, B; Mandel, F; Septimus, A; Kaplan, S

    1996-01-01

    The authors measured the rate and determinants of posttraumatic stress disorder (PTSD) in a group of cancer survivors. Patients who had a history of cancer diagnosis with at least 3 years since diagnosis, receiving no active treatment, such as chemotherapy or radiation, were interviewed (N = 27). Patients, who were part of the DSM-IV PTSD field trial, were compared with a community-based control group matched for age and socioeconomic status. One member of the survivor group (4%) and no members of the control group met criteria for current PTSD (NS). Six of the survivors (22%) and no control subjects met lifetime criteria (P Cancer patients have a higher rate of PTSD than found in the community. Symptoms closely resemble those of individuals who have experienced other traumatic events.

  14. Survivors' perspective of life after stroke

    Directory of Open Access Journals (Sweden)

    Jaine Kareny da Silva

    2016-03-01

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

  15. Survivorship care needs among LGBT cancer survivors.

    Science.gov (United States)

    Seay, Julia; Mitteldorf, Darryl; Yankie, Alena; Pirl, William F; Kobetz, Erin; Schlumbrecht, Matthew

    2018-05-23

    To better understand survivorship care needs among LGBT cancer survivors. We administered an anonymous online survey. LGBT cancer survivors living in the United States. Participants were recruited via the National LGBT Cancer Project. The survey measured sociodemographic characteristics, social support, posttraumatic stress, and survivorship care needs. Approximately 72% of our 114 participants were cisgender male and 87% were white. Almost all participants reported at least some unmet survivorship care needs (73%), with over half of participants reporting unmet psychological and sexuality care needs. Participants who reported their oncologist was not LGBT-competent had greater unmet needs (t(82) = 2.5, p = 0.01) and greater posttraumatic stress (t(91) = 2.1, p = 0.035). LGBT cancer survivors have significant unmet survivorship care needs, and lack of oncologist LGBT-competence is associated with unmet needs. Implications for Psychosocial Providers: Our results suggest the need for LGBT competency training for providers.

  16. Cancer Survivor Responses to Socratic Dialogue

    DEFF Research Database (Denmark)

    Knox, Jeanette Bresson Ladegaard

    2017-01-01

    Objective: This article is based on an anonymous, open-ended written questionnaire of cancer survivors. Prior to answering the questionnaire, these survivors participated in a Socratic Dialogue Group (SDG) that philosophically addressed the fundamental life questions triggered by their cancer...... experience. The responses aim to cast light on whether SDG is suitable and beneficial for cancer survivors. Methods: The study is based on two similar interventions: a pilot project from 2008-2010 and a research project from 2012-2015 involving a total of 50 participants divided into 9 SDGs. The projects...... included a questionnaire filled out by 26 out of 50 rehabilitating cancer patients aged 36 to 72 who had just completed participation in a SDG. The questionnaire consisted of seven questions. The seven questions were identical in the two projects. The projects were carried out at the Center for Cancer...

  17. 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.

  18. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

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

    2011-01-01

    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......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...... 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...

  19. Pancreatic exocrine secretion in atomic bomb survivors

    International Nuclear Information System (INIS)

    Hiraoka, Masataka; Kawanishi, Masahiro; Ohtaki, Megu

    1989-01-01

    This study was designed to examine the effect of A-bombing on pancreatic exocrine secretion in 6 A-bomb survivors (an average age of 57 years) and the age- and sex-matched non-exposed 6 persons (an average age of 58 years). Six A-bomb survivors consisted of: three who had been directly exposed to A-bombing, one who had entered the city within 3 days after bombing, one who had worked in caring for A-bomb survivors, and one who had later entered the city. Caerulein-Secretin test revealed no significant difference in the total secretion of lipase, maximum bicarbonate, amylase output, or lipase output between the exposed and non-exposed groups. The concentration of lipase ten min after stimulation was significantly decreased in the exposed group than the control group. This suggests that radiation may be responsible for abnormality in the ability of pancreatic exocrine secretion. (N.K.)

  20. 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.

  1. Individual Prediction of Heart Failure Among Childhood Cancer Survivors

    NARCIS (Netherlands)

    Chow, Eric J.; Chen, Yan; Kremer, Leontien C.; Breslow, Norman E.; Hudson, Melissa M.; Armstrong, Gregory T.; Border, William L.; Feijen, Elizabeth A. M.; Green, Daniel M.; Meacham, Lillian R.; Meeske, Kathleen A.; Mulrooney, Daniel A.; Ness, Kirsten K.; Oeffinger, Kevin C.; Sklar, Charles A.; Stovall, Marilyn; van der Pal, Helena J.; Weathers, Rita E.; Robison, Leslie L.; Yasui, Yutaka

    2015-01-01

    Purpose To create clinically useful models that incorporate readily available demographic and cancer treatment characteristics to predict individual risk of heart failure among 5-year survivors of childhood cancer. Patients and Methods Survivors in the Childhood Cancer Survivor Study (CCSS) free of

  2. 5 CFR 831.645 - Elections between survivor annuities.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Elections between survivor annuities. 831... REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Eligibility § 831.645 Elections between survivor annuities. (a) A current spouse annuity cannot be reinstated under § 831.644 unless— (1) The surviving...

  3. 5 CFR 842.613 - Division of a survivor annuity.

    Science.gov (United States)

    2010-01-01

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

  4. 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 meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.

  5. Health examination for A-bomb survivors

    International Nuclear Information System (INIS)

    Ito, Chikako

    1996-01-01

    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.)

  6. Cataracts in A-bomb survivors

    International Nuclear Information System (INIS)

    Neriishi, Kazuo

    2013-01-01

    Described is the process leading to the revision of ICRP recommendation for the threshold dose of cataracts (CA) to be 0.5 Sv (2011). The threshold for CA, posterior subcapsular (ps), was defined to be 2 Gy. However, recent investigations for 837 A-bomb survivors by slit lamp test revealed that, in addition to the CA above, the cortical CA was found to have also responded to the dose. The reanalysis afterward of their stored images showed for the estimated threshold of cortical CA to be 0.6 Sv, and significant dose response with Odds ratio (OR)/Sv of 1.30. For ps-CA, the threshold to be 0.7 Sv and OR/Sv, 1.44 were found. These thresholds were not significantly different from zero. Also found was the dose effect to be significantly decreased with increase of the age at exposure. Similar results had been suggested in cases of Swedish infants, of astronauts, and of Chernobyl clean-up workers. The dose response was further investigated for prevalence and incidence by spreading the criterion of patients to those undergone the operation to remove the lens assuming it had been derived from CA. Analysis of the dose-incidence revealed that the threshold was 0.5 Gy as estimated by the excess relative risk model and 0.45 Gy, by the excess absolute risk model. Findings above indicate that thresholds of CA found recently is much lower than the past 2-5 Gy and can be absent from the statistic aspect, which lead to the revision of the recommendation. The difference between the past and recent threshold is due to the difference of CA tissue types, of the age at exposure and of estimation. (T.T.)

  7. Exact nonparametric confidence bands for the survivor function.

    Science.gov (United States)

    Matthews, David

    2013-10-12

    A method to produce exact simultaneous confidence bands for the empirical cumulative distribution function that was first described by Owen, and subsequently corrected by Jager and Wellner, is the starting point for deriving exact nonparametric confidence bands for the survivor function of any positive random variable. We invert a nonparametric likelihood test of uniformity, constructed from the Kaplan-Meier estimator of the survivor function, to obtain simultaneous lower and upper bands for the function of interest with specified global confidence level. The method involves calculating a null distribution and associated critical value for each observed sample configuration. However, Noe recursions and the Van Wijngaarden-Decker-Brent root-finding algorithm provide the necessary tools for efficient computation of these exact bounds. Various aspects of the effect of right censoring on these exact bands are investigated, using as illustrations two observational studies of survival experience among non-Hodgkin's lymphoma patients and a much larger group of subjects with advanced lung cancer enrolled in trials within the North Central Cancer Treatment Group. Monte Carlo simulations confirm the merits of the proposed method of deriving simultaneous interval estimates of the survivor function across the entire range of the observed sample. This research was supported by the Natural Sciences and Engineering Research Council (NSERC) of Canada. It was begun while the author was visiting the Department of Statistics, University of Auckland, and completed during a subsequent sojourn at the Medical Research Council Biostatistics Unit in Cambridge. The support of both institutions, in addition to that of NSERC and the University of Waterloo, is greatly appreciated.

  8. Survivor shielding. Part A. Nagasaki factory worker shielding

    International Nuclear Information System (INIS)

    Santoro, Robert T.; Barnes, John M.; Azmy, Yousry Y.; Kerr, George D.; Egbert, Stephen D.; Cullings, Harry M.

    2005-01-01

    Recent investigations based on conventional chromosome aberration data by the RERF suggest that the DS86 doses received by many Nagasaki factory workers may have been overestimated by as much as 40% relative to those for other survivors in Japanese-type houses and other shielding configurations (Kodama et al. 2001). Since the factory workers represent about 25% of the Nagasaki survivors with DS86 doses in excess of 0.5 Gy (50 rad), systematic errors in their dose estimates can have a major impact on the risk coefficients from RERF studies. The factory worker doses may have been overestimated for a number of reasons. The calculation techniques, including the factory building modeling, weapon source spectra and cross-section data used in the DS86 shielding calculations were not detailed enough to replicate actual conditions. The models used did not take into account local shielding provided by machinery, tools, and the internal structure in the buildings. In addition, changes in the disposition of shielding following collapse of the building by the blast wave were not considered. The location of large factory complexes may be uncertain, causing large numbers of factory survivors, correctly located relative to each other, to be uniformly too close to the hypocenter. Any or all of these reasons are sufficient to result in an overestimate of the factory worker doses. During the DS02 studies, factory worker doses have been reassessed by more carefully modeling the factory buildings, incorporating improved radiation transport methods and cross-section data and using the most recent bomb leakage spectra (Chapter 2). Two-dimensional discrete ordinates calculations were carried out initially to estimate the effects of workbenches and tools on worker doses to determine if the inclusion of these components would, in fact, reduce the dose by amounts consistent with the RERF observations (Kodama et al. 2001). (author)

  9. The comparative effectiveness of a team-based versus group-based physical activity intervention for cancer survivors.

    Science.gov (United States)

    Carter, Cindy L; Onicescu, Georgiana; Cartmell, Kathleen B; Sterba, Katherine R; Tomsic, James; Alberg, Anthony J

    2012-08-01

    Physical activity benefits cancer survivors, but the comparative effectiveness of a team-based delivery approach remains unexplored. The hypothesis tested was that a team-based physical activity intervention delivery approach has added physical and psychological benefits compared to a group-based approach. A team-based sport accessible to survivors is dragon boating, which requires no previous experience and allows for diverse skill levels. In a non-randomized trial, cancer survivors chose between two similarly structured 8-week programs, a dragon boat paddling team (n = 68) or group-based walking program (n = 52). Three separate intervention rounds were carried out in 2007-2008. Pre-post testing measured physical and psychosocial outcomes. Compared to walkers, paddlers had significantly greater (all p team cohesion, program adherence/attendance, and increased upper-body strength. For quality-of-life outcomes, both interventions were associated with pre-post improvements, but with no clear-cut pattern of between-intervention differences. These hypothesis-generating findings suggest that a short-term, team-based physical activity program (dragon boat paddling) was associated with increased cohesion and adherence/attendance. Improvements in physical fitness and psychosocial benefits were comparable to a traditional, group-based walking program. Compared to a group-based intervention delivery format, the team-based intervention delivery format holds promise for promoting physical activity program adherence/attendance in cancer survivors.

  10. 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.

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

    International Nuclear Information System (INIS)

    Ito, Chikako; Neriishi, Kazuo; Hirabayashi, Naoki; Sato, Reiko; Kawamoto, Hirofumi; Watanabe, Tadaaki; Nishihara, Yoji; Yamane, Kiyoaki; Fukuhara, Teruaki.

    1994-01-01

    The 9th medical examination of A-bomb survivors resident in the North America was conducted from June 16 to July 15, 1993 at Los Angeles, San Francisco, Seattle, Wailuku and Honolulu. As of the end of July 1993, the number of A-bomb survivors registered in the North America was 1073, including 23 in Canada. Of these survivors, 53 deaths were confirmed. Thus, the total number of living survivors was 1020, being composed of 268 men and 752 women, with an average age of 62.8 years. Those exposed in Hiroshima accounted for 88.5%. U.S. nationality was seen in 62.1%; Japanese nationality with permanent U.S. residency rights in 30.6%. The most common residential state was California (61.6%), followed by Hawaii (18.8%) and Washington (5.6%). The rate of A-bomb survivors' health handbook possession was 58.5%, which was 3.9 times higher than that 10 years ago. Four hundreds and seventy-one A-bomb survivors (46.2%) participated in the present examination. In addition, 78 offsprings (F 1 ) of A-bomb survivors also participated in it, consisting of 35 men and 43 women. The most common disease requiring treatment and follow-up was hyperlipidemia (33.7%), followed by hypertension, liver disease, heart disease, thyroid disease and diabetes mellitus in that order. Cancer was seen in 4 survivors, consisting of colon cancer (2), leukemia (one) and Hodgkin's disease (one). (N.K.)

  12. 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.

  13. Fall-related experiences of stroke survivors: a meta-ethnography.

    Science.gov (United States)

    Walsh, Mary; Galvin, Rose; Horgan, N Frances

    2017-04-01

    Health professionals view falls after stroke as common adverse events with both physical and psychological consequences. Stroke survivors' experiences are less well understood. The aim of this systematic review was to explore the perception of falls-risk within the stroke recovery experience from the perspective of people with stroke. A systematic literature search was conducted. Papers that used qualitative methods to explore the experiences of individuals with stroke around falls, falls-risk and fear of falling were included. Two reviewers independently assessed the methodological quality of papers. Meta-ethnography was conducted. Concepts from each study were translated into each other to form theories that were combined through a "lines-of-argument" synthesis. Four themes emerged from the six included qualitative studies: (i) Fall circumstances, (ii) perception of fall consequences, (iii) barriers to community participation and (iv) coping strategies. The synthesis revealed that stroke survivors' perceived consequences of falls exist on a continuum. Cognitive and emotional adjustment may be required in the successful adoption of coping strategies to overcome fall-related barriers to participation. Stroke survivors' fall-related experiences appear to exist within the context of activity and community participation. Further research is warranted due to the small number of substantive studies available for synthesis. Implications for Rehabilitation Health care professionals should recognize that cognitive and emotional adjustment may berequired for stroke survivors to accept strategies for overcoming falls-risk, including dependenceon carers and assistive devices. Several factors in addition to physical interventions may be needed to minimize falls-risk whileincreasing activity participation. These factors could include increasing public awareness about the effects of stroke and falls-risk,and ensuring access to psychological services for stroke survivors

  14. Effects of treatment on fertility in long-term survivors of childhood or adolescent cancer

    International Nuclear Information System (INIS)

    Byrne, J.; Mulvihill, J.J.; Myers, M.H.

    1987-01-01

    In a retrospective cohort study of survivors of cancer and of controls, we estimated the risk of infertility after treatment for cancer during childhood or adolescence. We interviewed 2283 long-term survivors of childhood or adolescent cancer diagnosed in the period from 1945 through 1975, who were identified at five cancer centers in the United States. Requirements for admission to the study were diagnosis before the age of 20, survival for at least five years, and attainment of the age of 21. In addition, 3270 controls selected from among the survivors' siblings were interviewed. Cox regression analysis showed that cancer survivors who married and were presumed to be at risk of pregnancy were less likely than their sibling controls to have ever begun a pregnancy (relative fertility, 0.85; 95 percent confidence interval, 0.78 to 0.92). Radiation therapy directed below the diaphragm depressed fertility in both sexes by about 25 percent. Chemotherapy with alkylating agents, with or without radiation to sites below the diaphragm, was associated with a fertility deficit of about 60 percent in the men. Among the women, there was no apparent effect of alkylating-agent therapy administered alone (relative fertility, 1.02) and only a moderate fertility deficit when alkylating-agent therapy was combined with radiation below the diaphragm (relative fertility, 0.81). Relative fertility in the survivors varied considerably according to sex, site of cancer, and type of treatment; these factors should be taken into consideration in counseling survivors about the long-term consequences of disease

  15. Acceptability and satisfaction of project MOVE: A pragmatic feasibility trial aimed at increasing physical activity in female breast cancer survivors.

    Science.gov (United States)

    Pullen, Tanya; Sharp, Paul; Bottorff, Joan L; Sabiston, Catherine M; Campbell, Kristin L; Ellard, Susan L; Gotay, Carolyn; Fitzpatrick, Kayla; Caperchione, Cristina M

    2018-04-01

    Despite the physical and psychological health benefits associated with physical activity (PA) for breast cancer (BC) survivors, up to 70% of female BC survivors are not meeting minimum recommended PA guidelines. The objective of this study was to evaluate acceptability and satisfaction with Project MOVE, an innovative approach to increase PA among BC survivors through the combination of microgrants and financial incentives. A mixed-methods design was used. Participants were BC survivors and support individuals with a mean age of 58.5 years. At 6-month follow-up, participants completed a program evaluation questionnaire (n = 72) and participated in focus groups (n = 52) to explore their experience with Project MOVE. Participants reported that they were satisfied with Project MOVE (86.6%) and that the program was appropriate for BC survivors (96.3%). Four main themes emerged from focus groups: (1) acceptability and satisfaction of Project MOVE, detailing the value of the model in developing tailored group-base PA programs; (2) the importance of Project MOVE leaders, highlighting the value of a leader that was organized and a good communicator; (3) breaking down barriers with Project MOVE, describing how the program helped to address common BC related barriers; and (4) motivation to MOVE, outlining how the microgrants enabled survivors to be active, while the financial incentive motivated them to increase and maintain their PA. The findings provide support for the acceptability of Project MOVE as a strategy for increasing PA among BC survivors. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

  16. Return to work in sick-listed cancer survivors with job loss: design of a randomised controlled trial.

    Science.gov (United States)

    van Egmond, Martine P; Duijts, Saskia F A; Vermeulen, Sylvia J; van der Beek, Allard J; Anema, Johannes R

    2015-02-18

    Despite long-term or permanent health problems, cancer survivors are often motivated to return to work. For cancer survivors who have lost their job, return to work can be more challenging compared to employed survivors, as they generally find themselves in a more vulnerable social and financial position. Cancer survivors with job loss may therefore be in need of tailored return to work support. However, there is a lack of return to work intervention programs specifically targeting these cancer survivors. The number of cancer survivors with job loss in developed countries is rising due to, amongst others, increases in the incidence and survivor rate of cancer, the retirement age and the proportion of flexible employment contracts. Hence, we consider it important to develop a tailored return to work intervention program for cancer survivors with job loss, and to evaluate its effectiveness compared to usual care. This study employs a two-armed randomised controlled trial with a follow-up period of 12 months. The study population (n = 164) will be recruited from a national sample of cancer survivors (18-60 years), who have been sick-listed for 12-36 months. Participants will be randomised by using computerized blocked randomisation (blocks of four). All participants will receive usual care as provided by the Dutch Social Security Agency. Additionally, participants in the intervention group will receive a tailored return to work intervention program, which includes vocational rehabilitation and supportive psychosocial components, as well as (therapeutic) placement at work. The primary outcome measure is duration until sustainable return to work; the secondary outcome measure is rate of return to work. Other parameters include, amongst others, fatigue, coping strategy and quality of life. We will perform Cox regression analyses to estimate hazard ratios for time to sustainable return to work. The hypothesis of this study is that a tailored approach for cancer

  17. Health Practice in Long-Term Survivors of Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Ng, Andrea K.; Li Sigui; Recklitis, Christopher; Diller, Lisa R.; Neuberg, Donna; Silver, Barbara; Mauch, Peter M.

    2008-01-01

    Purpose: To compare the health practice of Hodgkin's lymphoma (HL) survivors and their siblings, and to assess the impact of socioeconomic status and disease history on health practice of HL survivors. Methods and Materials: We conducted a questionnaire study on long-term HL survivors and their siblings on health care utilization, health habits, and screening behavior. Results: A total of 511 HL survivors (response rate of 50%, including survivors lost to contact) and 224 siblings (response rate, 58%) participated. Median time from HL diagnosis was 15 years. Significantly more survivors than siblings had a physical examination in the past year (63% vs. 49%, p = 0.0001). Male survivors were significantly more likely than siblings to perform monthly self-testicular examinations (19% vs. 9%, p = 0.02). Among survivors, higher household income (p = 0.01) independently predicted for having had a physical examination in the past year. Lower educational level (p = 0.0004) and history of relapsed HL (p = 0.03) were independent predictors for smoking, moderate/heavy alcohol use, and/or physical inactivity. Conclusions: Compared with siblings, long-term HL survivors have a higher level of health care utilization and better screening practice. Survivors from lower socioeconomic background had lower adherence to routine health care and greater report of unhealthy habits. Survivors with history of relapsed HL were also more likely to engage in unhealthy habits

  18. 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

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

    Science.gov (United States)

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

    2017-10-20

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

  20. 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…

  1. Childhood cancer survivor cohorts in Europe

    NARCIS (Netherlands)

    Winther, Jeanette F.; Kenborg, Line; Byrne, Julianne; Hjorth, Lars; Kaatsch, Peter; Kremer, Leontien C. M.; Kuehni, Claudia E.; Auquier, Pascal; Michel, Gérard; de Vathaire, Florent; Haupt, Riccardo; Skinner, Roderick; Madanat-Harjuoja, Laura M.; Tryggvadottir, Laufey; Wesenberg, Finn; Reulen, Raoul C.; Grabow, Desiree; Ronckers, Cecile M.; van Dulmen-den Broeder, Eline; van den Heuvel-Eibrink, Marry M.; Schindler, Matthias; Berbis, Julie; Holmqvist, Anna S.; Gudmundsdottir, Thorgerdur; de Fine Licht, Sofie; Bonnesen, Trine G.; Asdahl, Peter H.; Bautz, Andrea; Kristoffersen, Anja K.; Himmerslev, Liselotte; Hasle, Henrik; Olsen, Jørgen H.; Hawkins, Mike M.

    2015-01-01

    With the advent of multimodality therapy, the overall five-year survival rate from childhood cancer has improved considerably now exceeding 80% in developed European countries. This growing cohort of survivors, with many years of life ahead of them, has raised the necessity for knowledge concerning

  2. Fertility in Female Childhood Cancer Survivors

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    African Journals Online (AJOL)

    Objective To study the subsequent reproductive performance of women who had undergone complicated abortions. Materials and Methods Attempts were made to trace 299 survivors of complicated abortions from an earlier study. Their contact telephone numbers and addresses had been recorded at the time of initial ...

  4. Development of the Cancer Survivor Profile

    Science.gov (United States)

    2014-05-09

    electronic assessment tools ................................................................. 102 Limitations...illness, and 19 registries to plan for individual care and perform population-based care. Electronic medical records are integral to the... cigars ) (144). Providers have the opportunity to play an important role in educating cancer survivors on protective health behaviors. In a

  5. Sam Donaldson: Tips From a Cancer Survivor

    Science.gov (United States)

    ... from all forms of cancer. But the survivors club is growing. The second point is obvious: Get a second opinion, maybe a third. Someone once said to me, "You may not get to play this hand more than once, so you want the best cards." No offense to the experts, but we've ...

  6. Ebola Survivor and Her Pregnancy Outcome

    Centers for Disease Control (CDC) Podcasts

    2016-12-14

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

  7. 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

    Objective Evaluate the acceptability, feasibility, and preliminary outcomes of a peer-mediated intervention to improve social competence of brain tumor survivors and classmates. Methods 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 two 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 ANCOVA. Results 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. Conclusions 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. PMID:27355881

  8. 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.

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

    Science.gov (United States)

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

    2013-07-01

    Starting or returning to school after intense medical treatment can be academically and socially challenging for childhood cancer survivors. This study aimed to evaluate the school (re)entry experience of children who had recently completed cancer treatment. Forty-two semi-structured telephone interviews were conducted to explore parents' perceptions of their child's (re)entry to school after completing treatment (23 mothers, 19 fathers, parent mean age 39.5 years; child mean age 7.76 years). Interviews were analysed using the framework of Miles and Huberman and emergent themes were organised using QSR NVivo8. Parents closely monitored their child's school (re)entry and fostered close relationships with their child's teacher to ensure swift communication of concerns should they arise. The most commonly reported difficulty related to aspects of peer socialisation; survivors either displayed a limited understanding of social rules such as turn taking, or related more to older children or teachers relative to their peers. Additionally, parents placed a strong emphasis on their child's overall personal development, above academic achievement alone. Improved parent, clinician and teacher awareness of the importance of continued peer socialisation during the treatment period is recommended in order to limit the ongoing ramifications this may have on school (re)entry post-treatment completion. © 2013 John Wiley & Sons Ltd.

  10. Malignant lymphoma in survivors of the atomic bomb, Hiroshima

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, R E; Ishida, Kenzo

    1964-02-01

    The present study demonstrates an increased prevalence of Hodgkin's disease, lymphosarcoma and multiple myeloma in survivors within 1400 m from the hypocenter in Hiroshima who had surgical or post-mortem examinations at ABCC. Reticulum cell sarcoma appears to have decreased prevalence in this same group. The pathologic material demonstrating these relationships consists of 91 cases of unequivocal malignant lymphoma and is drawn from two essentially independent ABCC sources, the autopsy series and diagnostic lymph node biopsies. A consideration of the epidemiologic characteristics of this material supports the view that the increase in prevalence is a reflection of the occurrence of lymphoma in the general population of survivors within 1400 m of the hypocenter. In addition, among such persons autopsied at ABCC there appears to be a shift to death at an earlier age than is found in the other comparison groups. The possible implications of this are discussed. A comparison of the lymphomas examined shows no morphologic differences in the corresponding diagnostic categories between the various comparison groups. 21 references, 3 figures, 3 tables.

  11. Skin cancer of Nagasaki atomic bomb survivors, 3

    International Nuclear Information System (INIS)

    Sadamori, Naoki; Mine, Mariko; Hori, Makoto; Noda, Yoshinori; Fujiwara, Naoko; Takahara, Osamu; Sadamori, Michiko; Nishimoto, Katsutaro; Ota, Hisahiro.

    1990-01-01

    In Report 1 of this series, we suspected that the incidence of skin cancer in Nagasaki A-bomb survivors might have increased based on evidence of chromosomal aberrations and clonal formations in cultured skin cells. In Report 2, we described the results of a preliminary study using 110 cases of skin cancer collected from the three major hospitals in Nagasaki City (Nagasaki University Hospital, A-bomb Hospital and Citizens Hospital). In that study a high correlation was observed between the incidence of skin cancer and exposure distance in the analysis of all 110 cases and of the 50 male cases (p<0.01), but no such correlation was noted in a separate analysis of the 60 female cases. In this report, 140 cases of skin cancer collected from 31 hospitals in Nagasaki City and adjacent districts were statistically analyzed in respect to the estimated distance from the hypocenter, using the data of a total of 66,276 A-bomb survivors recorded in the Scientific Data Center of the Atomic Bomb Disaster, Nagasaki University School of Medicine. The results disclosed a high correlation between the incidence of skin cancer and the exposure distance (p<0.01). In addition, this correlation was the same even when the cases were analyzed separately according to sex. (author)

  12. 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

  13. Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care.

    Science.gov (United States)

    Zimmermann-Schlegel, Verena; Hartmann, Mechthild; Sklenarova, Halina; Herzog, Wolfgang; Haun, Markus W

    2017-06-01

    As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care. Community-based physicians providing survivorship care for cancer

  14. Benefit of high-dose daunorubicin in AML induction extends across cytogenetic and molecular groups.

    Science.gov (United States)

    Luskin, Marlise R; Lee, Ju-Whei; Fernandez, Hugo F; Abdel-Wahab, Omar; Bennett, John M; Ketterling, Rhett P; Lazarus, Hillard M; Levine, Ross L; Litzow, Mark R; Paietta, Elisabeth M; Patel, Jay P; Racevskis, Janis; Rowe, Jacob M; Tallman, Martin S; Sun, Zhuoxin; Luger, Selina M

    2016-03-24

    The initial report of the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Cancer Research Group trial E1900 (#NCT00049517) showed that induction therapy with high-dose (HD) daunorubicin (90 mg/m(2)) improved overall survival in adults cytogenetics or aFLT3-ITD mutation. Here, we update the results of E1900 after longer follow-up (median, 80.1 months among survivors), focusing on the benefit of HD daunorubicin on common genetic subgroups. Compared with standard-dose daunorubicin (45 mg/m(2)), HD daunorubicin is associated with a hazard ratio (HR) for death of 0.74 (P= .001). Younger patients (cytogenetics (HR, 0.51;P= .03 and HR, 0.68;P= .01, respectively). Patients with unfavorable cytogenetics were shown to benefit from HD daunorubicin on multivariable analysis (adjusted HR, 0.66;P= .04). Patients with FLT3-ITD (24%),DNMT3A(24%), and NPM1(26%) mutant AML all benefited from HD daunorubicin (HR, 0.61,P= .009; HR, 0.62,P= .02; and HR, 0.50,P= .002; respectively). HD benefit was seen in the subgroup of older patients (50-60 years) with the FLT3-ITD or NPM1 mutation. Additionally, the presence of an NPM1 mutation confers a favorable prognosis only for patients receiving anthracycline dose intensification during induction. © 2016 by The American Society of Hematology.

  15. 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.

  16. Obesity in pediatric ALL survivors: a meta-analysis.

    Science.gov (United States)

    Zhang, Fang Fang; Kelly, Michael J; Saltzman, Edward; Must, Aviva; Roberts, Susan B; Parsons, Susan K

    2014-03-01

    Previous studies of survivors of pediatric acute lymphoblastic leukemia (ALL) have drawn heterogeneous conclusions regarding the prevalence of obesity and risk factors for developing obesity in pediatric ALL survivors. We sought to determine the prevalence of obesity in pediatric ALL survivors and examine risk factors for obesity through a systematic review and meta-analysis. A MEDLINE search was performed from its inception through 2013. Studies met the inclusion criteria if they (1) included at least 10 survivors of pediatric ALL; (2) assessed the prevalence or indicators of obesity; and (3) compared obesity among ALL survivors to a reference population or external control group. Extracted data included patient and treatment characteristics, study design, population used for comparison, and prevalence of obesity. Forty-seven studies met the inclusion criteria. Despite significant heterogeneity among the studies (I(2) = 96%), the mean BMI z score in 1742 pediatric ALL survivors was 0.83 (95% confidence interval: 0.60-1.06), which corresponds to the 80th BMI percentile, indicating a significantly higher BMI in pediatric ALL survivors than the reference population. Subgroup analyses found a high prevalence of obesity in ALL survivors regardless of survivors' receipt of cranial irradiation, gender, or age at diagnosis. Obesity is prevalent in pediatric ALL survivors and is independent of patient- and treatment-related characteristics. Clinicians need to screen for obesity and its associated health conditions early in survivorship.

  17. Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan.

    Science.gov (United States)

    Kukihara, Hiroko; Yamawaki, Niwako; Uchiyama, Kumi; Arai, Shoichi; Horikawa, Etsuo

    2014-07-01

    A mega-earthquake and tsunami struck the northeastern coast of Japan, and many survivors were forced to evacuate to temporary housing due to rising radiation levels. The aims of this study were to investigate the prevalence of symptoms of post-traumatic stress disorder (PTSD), depression, and poor general health among survivors, to test the predictive roles of resilience on mental and physical health, and to examine the predictive sociodemographic factors on resilience. Two hundred and forty-one evacuees (men/women: 116/125) from Hirono, Fukushima participated in the study. They were asked to complete the Connor-Davidson Resilience Scale, the Zung Self-Rating Depression Scale, the Impact of Events Scale-Revised, and a demographic questionnaire. Among all participants, 53.5% exhibited the clinically concerning symptoms of PTSD, and among them 33.2% indicated clinical PTSD symptoms. Additionally, 66.8% reported symptoms of depression, and among them 33.2% showed mildly depressive symptoms, while 19.1% and 14.5% demonstrated moderate and severe depressive symptoms, respectively. Resilience was a significant buffer for depression, PTSD, and general health. Additionally, employment status, eating/exercise habits, and drinking habits predicted resilience. The results indicated that depression and PTSD are prevalent among the survivors of massive earthquakes, tsunamis, and accidents from nuclear power plants. However, the results also showed that some survivors managed to endure the traumatic events relatively well, and resilience was a significant protective factor in dealing with such events. Therefore, it is crucial to assist survivors in improving their resilience by providing job opportunities and encouraging a healthy lifestyle. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  18. Post-Traumatic Stress Outcomes in Non-Hodgkin’s Lymphoma Survivors

    Science.gov (United States)

    Smith, Sophia K.; Zimmerman, Sheryl; Williams, Christianna S.; Preisser, John S.; Clipp, Elizabeth C.

    2011-01-01

    Purpose A large body of evidence suggests that being diagnosed with and treated for cancer adversely affects functioning and quality of life, yet less is known about longer term outcomes. Therefore, this study aims to estimate the prevalence of post-traumatic stress disorder (PTSD) symptoms in survivors of adult non-Hodgkin’s lymphoma (NHL) who are at least 2 years postdiagnosis and identify the risk factors associated with PTSD symptoms, with a focus on those that are amenable for screening and modifiable. Patients and Methods A total of 886 NHL survivors identified from the cancer registries of two hospitals in North Carolina participated, ranging in age from 25 to 92 years old and ranging from 2 to 44 years postdiagnosis. Survivors were mailed a survey that assessed PTSD symptoms and quality of life. Results Participants averaged 10.2 years postdiagnosis, and most (61%) reported no PTSD symptoms. The adjusted prevalence for full PTSD was 7.9%, with an additional 9.1% meeting criteria for partial PTSD. Modifiable risk factors that were independently associated with PTSD in multiple linear regression included less social support, negative appraisals of life threat and treatment intensity, and more employment and insurance issues. Additionally, several demographic characteristics (nonwhite race, less education, and younger age) and clinical or health-related factors (active disease, more recent diagnosis, and more comorbidity) were independently associated with PTSD. Conclusion Although only 8% of survivors met PTSD diagnostic criteria, the impact of a cancer diagnosis and treatment persists for many survivors, as evidenced in 39% of this sample. Early identification of those at risk could enable treatment to minimize PTSD symptomatology. PMID:18281667

  19. Post-traumatic stress outcomes in non-Hodgkin's lymphoma survivors.

    Science.gov (United States)

    Smith, Sophia K; Zimmerman, Sheryl; Williams, Christianna S; Preisser, John S; Clipp, Elizabeth C

    2008-02-20

    A large body of evidence suggests that being diagnosed with and treated for cancer adversely affects functioning and quality of life, yet less is known about longer term outcomes. Therefore, this study aims to estimate the prevalence of post-traumatic stress disorder (PTSD) symptoms in survivors of adult non-Hodgkin's lymphoma (NHL) who are at least 2 years postdiagnosis and identify the risk factors associated with PTSD symptoms, with a focus on those that are amenable for screening and modifiable. A total of 886 NHL survivors identified from the cancer registries of two hospitals in North Carolina participated, ranging in age from 25 to 92 years old and ranging from 2 to 44 years postdiagnosis. Survivors were mailed a survey that assessed PTSD symptoms and quality of life. Participants averaged 10.2 years postdiagnosis, and most (61%) reported no PTSD symptoms. The adjusted prevalence for full PTSD was 7.9%, with an additional 9.1% meeting criteria for partial PTSD. Modifiable risk factors that were independently associated with PTSD in multiple linear regression included less social support, negative appraisals of life threat and treatment intensity, and more employment and insurance issues. Additionally, several demographic characteristics (nonwhite race, less education, and younger age) and clinical or health-related factors (active disease, more recent diagnosis, and more comorbidity) were independently associated with PTSD. Although only 8% of survivors met PTSD diagnostic criteria, the impact of a cancer diagnosis and treatment persists for many survivors, as evidenced in 39% of this sample. Early identification of those at risk could enable treatment to minimize PTSD symptomatology.

  20. 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

  1. 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

    2017-01-01

    Background 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. Objective 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. Methods 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. Results 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

  2. An online randomized controlled trial, with or without problem-solving treatment, for long-term cancer survivors after hematopoietic cell transplantation.

    Science.gov (United States)

    Syrjala, Karen L; Yi, Jean C; Artherholt, Samantha B; Romano, Joan M; Crouch, Marie-Laure; Fiscalini, Allison S; Hegel, Mark T; Flowers, Mary E D; Martin, Paul J; Leisenring, Wendy M

    2018-05-05

    This randomized controlled trial examines the efficacy of INSPIRE, an INternet-based Survivorship Program with Information and REsources, with or without problem-solving treatment (PST) telehealth calls, for survivors after hematopoietic cell transplantation (HCT). All adult survivors who met eligibility criteria were approached for consent. Participants completed patient-reported outcomes at baseline and 6 months. Those with baseline impaired scores on one or more of the outcomes were randomized to INSPIRE, INSPIRE + PST, or control with delayed INSPIRE access. Outcomes included Cancer and Treatment Distress, Symptom Checklist-90-R Depression, and Fatigue Symptom Inventory. Planned analyses compared arms for mean change in aggregated impaired outcomes and for proportion of participants improved on each outcome. Of 1306 eligible HCT recipients, 755 (58%) participated, and 344 (45%) had one or more impaired scores at baseline. We found no reduction in aggregated outcomes for either intervention (P > 0.3). In analyses of individual outcomes, participants randomized to INSPIRE + PST were more likely to improve in distress than controls (45 vs. 20%, RR 2.3, CI 1.0, 5.1); those randomized to INSPIRE alone were marginally more likely to improve in distress (40 vs. 20%, RR 2.0, CI 0.9, 4.5). The INSPIRE online intervention demonstrated a marginal benefit for distress that improved with the addition of telehealth PST, particularly for those who viewed the website or were age 40 or older. Online and telehealth programs such as INSPIRE offer opportunities to enhance HCT survivorship outcomes, particularly for mood, though methods would benefit from strategies to improve efficacy.

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

    International Nuclear Information System (INIS)

    Ozasa, Kotaro

    2016-01-01

    The late effects of exposure to atomic bomb radiation on cancer occurrence have been evaluated by epidemiological studies on three cohorts: a cohort of atomic bomb survivors (Life Span Study; LSS), survivors exposed in utero, and children of atomic bomb survivors (F 1 ). The risk of leukemia among the survivors increased remarkably in the early period after the bombings, especially among children. Increased risks of solid cancers have been evident since around 10 years after the bombings and are still present today. The LSS has clarified the dose–response relationships of radiation exposure and risk of various cancers, taking into account important risk modifiers such as sex, age at exposure, and attained age. Confounding by conventional risk factors including lifestyle differences is not considered substantial because people were non-selectively exposed to the atomic bomb radiation. Uncertainty in risk estimates at low-dose levels is thought to be derived from various sources, including different estimates of risk at background levels, uncertainty in dose estimates, residual confounding and interaction, strong risk factors, and exposure to residual radiation and/or medical radiation. The risk of cancer in subjects exposed in utero is similar to that in LSS subjects who were exposed in childhood. Regarding hereditary effects of radiation exposure, no increased risk of cancers associated with parental exposure to radiation have been observed in the F 1 cohort to date. In addition to biological and pathogenetic interpretations of the present results, epidemiological investigations using advanced technology should be used to further analyze these cohorts

  4. 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.

  5. Advancing career counseling and employment support for survivors: an intervention evaluation.

    Science.gov (United States)

    Davidson, M Meghan; Nitzel, Camie; Duke, Alysondra; Baker, Cynthia M; Bovaird, James A

    2012-04-01

    The purpose of this research was to conduct a replication-based and extension study examining the effectiveness of a 5-week career group counseling intervention, Advancing Career Counseling and Employment Support for Survivors (ACCESS; Chronister, 2008). The present study was conducted in a markedly different geographic region within a larger community as compared with the original investigation conducted by Chronister and McWhirter (2006). Women survivors of intimate partner violence (N = 73) participated in ACCESS, with career-search self-efficacy, perceived career barriers, perceived career supports, anxiety, and depression assessed at preintervention, postintervention, and 8-week follow-up. Women survivors demonstrated significant improvements in career-search self-efficacy and perceived career barriers at postintervention. Moreover, these same improvements were maintained at the 8-week follow-up assessment with the addition of significant improvements in perceived future financial supports, anxiety, and depression compared with preintervention scores. This work replicates the initial findings regarding the effectiveness of ACCESS with respect to career-search self-efficacy (Chronister & McWhirter, 2006) as well as extends the initial research to include improvements in perceived career barriers and perceived career supports. Moreover, the present study extends the work to include the mental health outcomes of anxiety and depression; results demonstrated improvements in these areas at 8-week follow-up. This investigation begins to fill a critical need for evaluated career-focused interventions for the underserved population of women survivors of intimate partner violence.

  6. Family functioning is associated with depressive symptoms in caregivers of acute stroke survivors.

    Science.gov (United States)

    Epstein-Lubow, Gary P; Beevers, Christopher G; Bishop, Duane S; Miller, Ivan W

    2009-06-01

    To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke. Cross-sectional data from the baseline assessment of an intervention study for stroke survivors and their families. Neurology inpatient service of a large urban hospital. Stroke survivors (n=192), each with a primary caregiver. The mean age of stroke survivors was 66 years, and most, 57%, were men (n=110). The mean age of caregivers was 57 years, and 73% (n=140) of the caregivers were women. Eighty-five percent of caregivers were white. Not applicable. Measures were chosen to assess caregivers' depressive symptoms (Centers for Epidemiologic Studies Depression Scale), family functioning (Family Assessment Device), and additional factors such as health status (Medical Outcomes Study 36-Item Short-Form Health Survey) and stroke survivors' cognitive abilities (modified Mini-Mental State Examination) and functional impairments (FIM and Frenchay Activities Index). Depressive symptoms were mild to moderate in 14% and severe in 27% of caregivers. Family functioning was assessed as unhealthy in 34% of caregiver-patient dyads. In statistical regression models, caregiver depression was associated with patients' sex, caregivers' general health, and family functioning. Forty-one percent of caregivers experienced prominent depressive symptoms after their family member's stroke. Higher depression severity in caregivers was associated with caring for a man, and having worse health and poor family functioning. After stroke, the assessment of caregivers' health and family functioning may help determine which caregivers are most at risk for a depressive syndrome.

  7. 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.

  8. 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.

  9. Health education needs of intimate partner violence survivors: Perspectives from female survivors and social service providers.

    Science.gov (United States)

    Ferranti, Dina; Lorenzo, Dalia; Munoz-Rojas, Derby; Gonzalez-Guarda, Rosa M

    2018-03-01

    To explore the health education needs and learning preferences of female intimate partner violence (IPV) survivors in a social service agency located in South Florida, United States. An exploratory two-phase sequential mixed-methods study was completed through semistructured interviews with social service providers (n = 10), followed by a survey with predominately female IPV survivors (n = 122, 98.4%). Data obtained from interviews with social service providers were analyzed through conventional thematic content analysis. Data from interviews were used in developing a health survey completed by IPV survivors and analyzed utilizing descriptive statistics, chi-square tests and t tests. Three themes emerged from interviews including multidimensional health needs, navigating barriers to health care, and self-improvement specific to survivors of intimate partner violence. Survey results indicated that depression and self-esteem were the health education needs of highest priority. Demographic characteristics, including age and language use, were significantly associated to preferred methods of learning, p education needs. Current study findings can inform public health nurses in developing interventions or health-based programs for female IPV survivors in social service agency settings. © 2017 Wiley Periodicals, Inc.

  10. 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.

  11. Cancer risk among atomic bomb survivors

    International Nuclear Information System (INIS)

    Schull, W.J.

    1992-01-01

    Continued mortality surveillance and incidence studies have revealed the risk of cancer among the survivors of the atomic bombings of Hiroshima and Nagasaki to increase with increasing dose. Among the sites where the frequency of cancer can be clearly shown to be dose-related are the following: female breast, colon, esophagus, lung, ovary, stomach, thyroid, urinary bladder and leukemia. Although the evidence is less compelling, cancers of the liver, salivary glands, and skin as well as multiple myeloma appear increased too. This increase generally manifests itself when the survivors reach those ages where the natural incidence of cancer begins to rise. Risk is, however, related to the age of the individual at the time of the bombing; the highest risks are associated with individuals who were exposed in the first two decades of life. Current evidence suggests these higher risks decline with increasing time since exposure

  12. Aging studies in atomic bomb survivors

    International Nuclear Information System (INIS)

    Belsky, J.L.; Moriyama, I.M.; Fujita, Seiichiro; Kawamoto, Sadahisa.

    1980-01-01

    Though acceleration of aging induced by radiation could not be demonstrated in many investigations on delayed effects of ionizing radiation on a-bomb survivors, studies on acceleration of aging after the exposure to ionizing radiation in human and animals have been carried out. To investigate whether physiological function was related to the exposure to ionizing radiation, a series of examinations concerning age was carried out at the time of general health examinations at ABCC. Simple examinations concerning aging were carried out on 11,351 a-bomb survivors, but the result was essentially negative. If biological or physiological age was defined clearly, the results of functional test would be used as criterion of aging. (Tsunoda, M.)

  13. Fertility in female childhood cancer survivors

    DEFF Research Database (Denmark)

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

    2009-01-01

    chemotherapy and radiotherapy may have an adverse effect on ovarian function, ovarian reserve and uterine function, clinically leading to sub-fertility, infertility, premature menopause and/or adverse pregnancy outcomes. Here we will first address normal female fertility and methods to detect decreased...... fertility. Hence we will focus on direct effects as well as late fertility-related adverse effects caused by chemotherapy and radiotherapy, and we will conclude with a summary of current options for fertility preservation in female childhood cancer survivors.......Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly enlarging group of childhood cancer survivors. There is much concern, however, about the effects of treatment on reproductive potential. In women there is evidence that both...

  14. Preleukemic state in atomic bomb survivors

    International Nuclear Information System (INIS)

    Mikami, Motoko

    1980-01-01

    Hematology data before onset of leukemia were available for 55 of the 1462 acute leukemia cases (as of the end of June 1976) collected by RERF. Among these, 8 showed preleukemic state and 2 were polycythemia. In content, preleukemic state comprised anemia, leukopenia and morphological abnormalities of RBC, platelets and WBC. Leukemia cases presenting preleukemic state were, by type, mostly erythroleukemia and monocytic leukemia. Preleukemic state was not necessarily frequent among cases of leukemia in A-bomb survivors exposed to high dose. The prevalence of the 5 items, prescribed as preleukemic state, i.e., anemia (female =50%), and relative monocytosis (>=10%), could not be said to be high in the survivors exposed to high dose. Anemia in males and leukopenia in males and females were increased significantly with age. Leukemia prevalence was significantly high especially in those cases that had presented leukopenia, relative neutropenia or relative lymphocytosis among the 5 items prescribed as preleukemic state. (author)

  15. 'They're survivors physically but we want them to survive mentally as well': health care professionals' views on providing potential late effect information.

    Science.gov (United States)

    Cox, Anna; Faithfull, Sara

    2013-09-01

    The concept of providing personalised care plans for cancer survivors is receiving increasing attention; a recognised element of a care plan is to provide an indication of the risks and consequences of treatment. This paper reports health care professional (HCP) response to providing cancer survivors with information on potential late effects of their cancer treatment. Eighteen HCPs from five cancer centres and three general practices in the UK completed semi-structured interviews which were digitally recorded, transcribed and qualitatively analysed using framework analysis. HCPs' view of health care was that it is currently focused on acute care and needs are responded to as they may arise, including those which are late effects of cancer treatments. The concept of pre-empting a discussion of potential late effects during the survivorship phase was felt to be discordant with this approach and could impact on adjustment to life after cancer treatment. Providing cancer survivors with information on potential late effects requires further consideration. Evidence for survivor preference for late effect information and the benefit afforded to survivors who receive it could inform the practice of HCPs. If a culture of proactivity is to be encouraged regarding discussions of future potential risk, HCPs may need support in considering ways of presenting survivors with reality whilst being mindful of their need to retain hope during the survivorship phase.

  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. THE PREVENTION PROGRAMS OF PHYSICAL REHABILITATION FOR CHERNOBYL DISASTER SURVIVORS

    Directory of Open Access Journals (Sweden)

    G.V. Korobeynikov

    2013-02-01

    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.

  18. Proximally exposed A-bomb survivors. 2

    International Nuclear Information System (INIS)

    Kamada, Nanao

    1992-01-01

    Methods for observing chromosomes can be chronologically divided into the era of non-differential staining technique (1962-1975) and the era of differential staining method (since 1976). This paper reviews the literature of chromosomal aberrations in bone marrow cells found in the two eras. Findings during the era of 1962-1975 include the frequency of chromosomal aberrations in bone marrow cells, comparison of chromosomal aberrations in bone marrow cells and T lymphocytes, and annual variation of chromosomal aberrations. The frequency of chromosomal aberrations was high in proximally exposed A-bomb survivors (90.5% and 52.6% in A-bomb survivors exposed within 500 m and at 501-1,000 m, respectively); on the contrary, it was low in those exposed far from 1,000 m (6.2% or less). The frequency of chromosomal aberrations in bone marrow cells was lower than that in T lymphocytes (21.5% vs 27.1% in those exposed within 500 m and 14.1% vs 23% in those exposed at 501-1,000 m). Annual analysis for chromosomal aberrations has shown the somewhat dependence upon medullary hematopoiesis and virus infection. The advent of differential staining technique since 1976 has made it possible to clarify the type of chromosomal aberrations and site of breakage. Of 710 bone marrow cells taken from 13 A-bomb survivors exposed within 1,000 m, 121 cells (from 11 A-bomb survivors) exhibited chromosomal aberrations. In differential staining analysis, all 121 cells but one were found to be of stable type, such as translocation and inversion. Furthermore, the site of breakage was found to be non-randomly distributed. Analysis of chromosomal aberrations in bone marrow cells has advantages of reflecting dynamic condition of these cells and determining gradual progression into leukemia. (N.K.)

  19. Compound risk: History of traumatic stress predicts posttraumatic stress disorder symptoms and severity in sudden cardiac arrest survivors.

    Science.gov (United States)

    Rosman, Lindsey; Ford, Jessica; Whited, Amanda; Cahill, John; Lampert, Rachel; Mosesso, Vincent N; Lawless, Christine; Sears, Samuel F

    2016-08-01

    Sudden cardiac arrest (SCA) survivors can develop posttraumatic stress disorder (PTSD) which is associated with worse clinical outcomes. The purpose of this study was to evaluate the prevalence and predictors of PTSD in a large sample of SCA survivors. Prior history of psychological trauma and the effects of repeated trauma exposure on subsequent PTSD and symptom severity after SCA were also explored. A retrospective, cross-sectional study of 188 SCA survivors from the Sudden Cardiac Arrest Association patient registry completed an online questionnaire that included measures of PTSD, trauma history, sociodemographics, general health, and cardiac history. Sixty-three (36.2%) SCA survivors in this sample scored above the clinical cutoff for PTSD. Female gender, worse general health, and younger age predicted PTSD symptoms after SCA. Additionally, 50.2% of SCA survivors (n = 95) reported a history of trauma exposure and 25.4% (n = 48) of the total sample endorsed a traumatic stress response to a historic trauma. Results indicated that a traumatic stress response to a historic trauma was a stronger predictor of PTSD after SCA (odds ratio = 4.77) than all other variables in the model. PTSD symptoms are present in over one-third of SCA survivors. While demographic or health history variables predicted PTSD after SCA, a history of traumatic stress response to a previous trauma emerged as the strongest predictor of these symptoms. Routine assessment and interdisciplinary management are discussed as potential ways to expedite survivors' recovery and return to daily living. © The European Society of Cardiology 2015.

  20. 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

  1. Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study.

    Directory of Open Access Journals (Sweden)

    Annette Weiss

    Full Text Available Hearing loss is a potential late effect after childhood cancer. Questionnaires are often used to assess hearing in large cohorts of childhood cancer survivors and it is important to know if they can provide valid measures of hearing loss. We therefore assessed agreement and validity of questionnaire-reported hearing in childhood cancer survivors using medical records as reference.In this validation study, we studied 361 survivors of childhood cancer from the Swiss Childhood Cancer Survivor Study (SCCSS who had been diagnosed after 1989 and had been exposed to ototoxic cancer treatment. Questionnaire-reported hearing was compared to the information in medical records. Hearing loss was defined as ≥ grade 1 according to the SIOP Boston Ototoxicity Scale. We assessed agreement and validity of questionnaire-reported hearing overall and stratified by questionnaire respondents (survivor or parent, sociodemographic characteristics, time between follow-up and questionnaire and severity of hearing loss.Questionnaire reports agreed with medical records in 85% of respondents (kappa 0.62, normal hearing was correctly assessed in 92% of those with normal hearing (n = 249, and hearing loss was correctly assessed in 69% of those with hearing loss (n = 112. Sensitivity of the questionnaires was 92%, 74%, and 39% for assessment of severe, moderate and mild bilateral hearing loss; and 50%, 33% and 10% for severe, moderate and mild unilateral hearing loss, respectively. Results did not differ by sociodemographic characteristics of the respondents, and survivor- and parent-reports were equally valid.Questionnaires are a useful tool to assess hearing in large cohorts of childhood cancer survivors, but underestimate mild and unilateral hearing loss. Further research should investigate whether the addition of questions with higher sensitivity for mild degrees of hearing loss could improve the results.

  2. Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study

    Science.gov (United States)

    Scheinemann, Katrin; Grotzer, Michael; Kompis, Martin; Kuehni, Claudia E.

    2017-01-01

    Background Hearing loss is a potential late effect after childhood cancer. Questionnaires are often used to assess hearing in large cohorts of childhood cancer survivors and it is important to know if they can provide valid measures of hearing loss. We therefore assessed agreement and validity of questionnaire-reported hearing in childhood cancer survivors using medical records as reference. Procedure In this validation study, we studied 361 survivors of childhood cancer from the Swiss Childhood Cancer Survivor Study (SCCSS) who had been diagnosed after 1989 and had been exposed to ototoxic cancer treatment. Questionnaire-reported hearing was compared to the information in medical records. Hearing loss was defined as ≥ grade 1 according to the SIOP Boston Ototoxicity Scale. We assessed agreement and validity of questionnaire-reported hearing overall and stratified by questionnaire respondents (survivor or parent), sociodemographic characteristics, time between follow-up and questionnaire and severity of hearing loss. Results Questionnaire reports agreed with medical records in 85% of respondents (kappa 0.62), normal hearing was correctly assessed in 92% of those with normal hearing (n = 249), and hearing loss was correctly assessed in 69% of those with hearing loss (n = 112). Sensitivity of the questionnaires was 92%, 74%, and 39% for assessment of severe, moderate and mild bilateral hearing loss; and 50%, 33% and 10% for severe, moderate and mild unilateral hearing loss, respectively. Results did not differ by sociodemographic characteristics of the respondents, and survivor- and parent-reports were equally valid. Conclusions Questionnaires are a useful tool to assess hearing in large cohorts of childhood cancer survivors, but underestimate mild and unilateral hearing loss. Further research should investigate whether the addition of questions with higher sensitivity for mild degrees of hearing loss could improve the results. PMID:28333999

  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. Emotional control in Chinese female cancer survivors.

    Science.gov (United States)

    Ho, Rainbow T H; Chan, Cecilia L W; Ho, Samuel M Y

    2004-11-01

    Chinese persons are not known as strong in expressing emotions, especially negative ones. However, being diagnosed with cancer and going through treatment can be an emotionally traumatic experience and cancer patients are supposed to have a stronger need to express these negative feelings. The control of expression of negative emotions such as anger, anxiety and depression in Chinese female cancer survivors (n=139) was examined in the present study using the Chinese version of the Courtauld Emotional Control Scale (CECS). The reliability, internal consistency and validity of the Chinese CECS were comparable to the original English scale. Correlation analyses suggested that cancer survivors with higher emotional control tended to have higher stress, anxiety and depression levels and to adopt negative coping with cancer. Regression analysis showed that emotional control would positively predict stress level even after the effect of depressed mood was under control. Further investigations are suggested in order to elucidate the causal relationships and specific cultural factors affecting emotional control in Chinese cancer survivors and, most importantly, its effect on health outcomes. Copyright (c) 2004 John Wiley & Sons, Ltd.

  5. Genetic counseling of the cancer survivor

    International Nuclear Information System (INIS)

    Mulvihill, J.J.; Byrne, J.

    1989-01-01

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

  6. Aging study on atomic bomb survivors

    International Nuclear Information System (INIS)

    Okajima, Shunzo; Aoyama, Takashi; Norimura, Toshiyuki; Nishimori, Issei; Shiomi, Toshio

    1976-01-01

    This is an ad interim report on the survey which is being performed at the Atomic Disease Institute, Nagasaki University School of Medicine for the acceleration of aging in atomic bomb survivors. The survivors group consisted of 50 females between 40 and 49 years of age who were exposed somewhere within 1.4 km where exposure dose could be estimated accurately and whose mean estimated exposure dose was 225.9+-176.8 rads. The control group consisted of females of the same age group who were exposed at sites more than 2.5 km apart (atmospheric dose 2.9 rads). The items for the judgement of aging included physical measurements, external findings, functional findings, and special tests (urine, blood, pattern of serum protein fraction, and chromosome aberrations). As far as chromosome aberrations were concerned, the number of cells with stable aberrations, Cs, showed differences between the two groups, and the number of cells with exchange-type aberrations was large in the survivors group. No significant differences were observed in the other tests. (Serizawa, K.)

  7. Suicide among childhood cancer survivors in Slovenia.

    Science.gov (United States)

    Cižek Sajko, Mojca; Cižek, Niko; Jareb, Berta

    2012-01-01

    Suicide is one of the causes of late mortality among childhood cancer survivors. The aim of our study was to analyse the risk of suicide among childhood cancer survivors compared with that of the general population of Slovenia. This retrospective study included patients with childhood cancer registered at the Cancer Registry of Slovenia between 1978-2008, with an observation period of 1978-2010. Childhood cancer patients and control subjects from the general population of Slovenia were matched by sex, year and age at the beginning of follow-up and time of follow-up in years. Data on the general population of Slovenia were obtained from the Statistical Office of the Republic of Slovenia. A total of 1647 patients were recorded in the Cancer Registry as having cancer during childhood, with 3 patients committing suicide. All three were male. Their age at diagnosis of cancer was 12, 13 and 2 years old; their age at suicide was 19, 32 and 28 years old. The mechanism of death was asphyxiation in all three deaths. The calculation of the expected number of suicides in the group of individuals with childhood cancer from the general Slovene population revealed the number of 3.16 persons. The comparison of the observed and expected probability showed that there was no statistically significant difference in the suicide rate between childhood cancer survivors and the general population of Slovenia. Copyright © 2012 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  8. Cancer developing among atom-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, T [Radiation Effect Research Foundation, Hiroshima (Japan)

    1975-12-01

    Cancer (with the exception of leukemia) which had often been observed among atom bomb survivors was discussed. Prevalence of thyroid carcinoma was high in the people who had been exposed to more than 50 rad of the atomic radiation. A great difference in prevalence of cancer was seen between irradiated people whose age had been under 20 years at the time of exposure and non-irradiated. More women than men had papillary adenocarcinoma. The highest prevalence was seen 16 to 20 years after exposure to atomic radiation, but there was no difference in prevalence between those from Hiroshima and from Nagasaki. Lung cancer comprised 89% of all cancers of the people whose age was 50 years and over. Most of them had been exposed to atomic radiation of more than 300 rad. The type was cellular retrograde cancer. The prevalence of gastric carcinoma was low, and breast cancer occurred at an early age before menopause. The occurrence of cancer in juvenile survivors was several times higher in the patients who had been exposed to atomic radiation of more than 100 rad than in non-irradiated. These values indicate that cancer occurs more frequently than leukemia does in such survivors.

  9. Radiation standards and A-bomb survivors

    International Nuclear Information System (INIS)

    Alvarez, R.

    1984-01-01

    For more than 33 years, the US government has supported the Life Span Study of Japanese survivors as a follow-up of the 1945 nuclear bombings of Hiroshima and Nagasaki. Since 1975, the study has been funded jointly by the United States and Japan under the auspices of the Radiation Effects Research Foundation. In the May issue of this bulletin radiation epidemiologists Dr. Alice Stewart and George Kneale raise perhaps the most fundamental question of all: Does the Japanese A-bomb survivor study have any value in deriving risk estimates for low-level radiation. On the basis of data published by the Radiation Effects Research Foundation in 1978, Stewart and Kneale suggest that Foundation analysts have confused long-term effects of tissue-destructive high doses with single-cell low-dose effects. If they are correct, the method of linear extrapolation from high-dose studies for low-level radiation risk estimates is invalid. The author feels the A-bomb survivors study should be opened up to an independent peer review process

  10. 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.

  11. 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.

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

    OpenAIRE

    G.V. Korobeynikov; V.U. Drojjin

    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...

  13. Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo.

    Science.gov (United States)

    Bartels, Susan A; Scott, Jennifer A; Leaning, Jennifer; Kelly, Jocelyn T; Joyce, Nina R; Mukwege, Denis; Vanrooyen, Michael J

    2012-12-01

    One of the most striking features of the ongoing conflict in the Democratic Republic of Congo (DRC) is the use of sexual violence. In spite of the brutality of these crimes, the experiences of women affected by sexual violence in Eastern DRC remain poorly characterized. This analysis aimed to (1) provide detailed demographics of sexual violence survivors presenting to Panzi Hospital; (2) examine how demographic factors might impact patterns of sexual violence; and (3) describe care-seeking behavior among sexual violence survivors. The demographics and care-seeking behavior of sexual violence survivors in South Kivu Province were described from a retrospective registry-based study of sexual violence survivors presenting to Panzi Hospital (2004-2008). A total of 4311 records were reviewed. The mean age of survivors was 35 years. Most women (53%) were married, self-identified with the Bashi tribe (65%), and reported agriculture as their livelihood (74%). The mean time delay between sexual assault and seeking care was 10.4 months. Five reasons were identified to help explain the lengthy delays to seeking care: waiting for physical symptoms to develop or worsen before seeking medical attention, lack of means to access medical care, concerns that family would find out about the sexual assault, stigma surrounding sexual violence, and being abducted into sexual slavery for prolonged periods of time. Many sexual assault survivors have very delayed presentations to medical attention. Promoting timely access of medical care may best be facilitated by reducing stigma and by educating women about the benefits of early medical care, even in the absence of injuries or symptoms.

  14. 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.

  15. 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.

  16. Trajectories of social isolation in adult survivors of childhood cancer.

    Science.gov (United States)

    Howard, A Fuchsia; Tan de Bibiana, Jason; Smillie, Kirsten; Goddard, Karen; Pritchard, Sheila; Olson, Rob; Kazanjian, Arminee

    2014-03-01

    Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isolation experienced by adult survivors of a childhood cancer. Data from 30 in-depth interviews with survivors (9 to 38 years after diagnosis, currently 22 to 43 years of age, 60 % women) were analyzed using qualitative, constant comparative methods. Experiences of social isolation evolved over time as survivors grew through childhood, adolescence and young adulthood. Eleven survivors never experienced social isolation after their cancer treatment, nor to the present day. Social isolation among 19 survivors followed one of three trajectories; (1) diminishing social isolation: it got somewhat better, (2) persistent social isolation: it never got better or (3) delayed social isolation: it hit me later on. Knowledge of when social isolation begins and how it evolves over time for different survivors is an important consideration for the development of interventions that prevent or mitigate this challenge. Assessing and addressing social outcomes, including isolation, might promote comprehensive long-term follow-up care for childhood cancer survivors.

  17. H.R. 754: A Bill to make improvements in the Black Lung Benefits Act. Introduced in the House of Representatives, One Hundred Fourth Congress, First session

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This bill proposes changes in the Black Lung Benefits Act with the intent of improving the existing legislation. Changes are proposed in sections of the act referring to: benefit overpayment; evidence; survivor benefits; responsible operator; attorney fees; administration; refilling; construction; and effective dates.

  18. Self-advocacy training for cancer survivors. The Cancer Survival Toolbox.

    Science.gov (United States)

    Walsh-Burke, K; Marcusen, C

    1999-01-01

    professionals. Future plans include training oncology professionals to teach these skills and to work collaboratively with survivors in advocacy efforts. Additional programs designed to address the needs of the uninsured as well as older adult and pediatric survivor populations are in development.

  19. Conceptual model of acid attacks based on survivor's experiences: Lessons from a qualitative exploration.

    Science.gov (United States)

    Sabzi Khoshnami, Mohammad; Mohammadi, Elham; Addelyan Rasi, Hamideh; Khankeh, Hamid Reza; Arshi, Maliheh

    2017-05-01

    Acid attack, a worldwide phenomenon, has been increasing in recent years. In addition to severe injuries to the face and body, such violence leads to psychological and social problems that affect the survivors' quality of life. The present study provides a more in-depth understanding of this phenomenon and explores the nature and dimensions of acid attacks based on survivors' experiences. A grounded theory study using semi-structured, recorded interviews and applying purposeful theoretical sampling was conducted with 12 acid attack survivors in Iran. Data were analysed using constant comparison in open, axial and selective coding stages. A conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory study. Physical and psychological wounds emerged as a core category. Traditional context and extreme beauty value in society acted as the context of the physical and psychological wounds experienced. Living with a drug abuser with behavioural disorders and lack of problem-solving skills in interpersonal conflict were found to be causal conditions. Action strategies to deal with this experience were found to be composed of individual, interpersonal and structural levels. Education, percentage and place of burning acted as intervening conditions that influenced survivors' strategies. Finally, adverse consequences of social deprivation and feeling helpless and hindered were found to have an important impact. Acid attack lead to physical and psychological wounds in survivors. This is a multi-dimensional phenomenon involving illness, disability, and victimization, and requires a wide range of strategies at different levels. The conceptual model derived through this study can serve as a good basis for intervention programs. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  20. Patterns of family management for adolescent and young adult brain tumor survivors.

    Science.gov (United States)

    Deatrick, Janet A; Barakat, Lamia P; Knafl, George J; Hobbie, Wendy; Ogle, Sue; Ginsberg, Jill P; Fisher, Michael J; Hardie, Thomas; Reilly, Maureen; Broden, Elizabeth; Toth, Jennifer; SanGiacomo, Nicole; Knafl, Kathleen A

    2018-04-01

    Little is known about how families systemically incorporate the work of caring for adolescent and young adult (AYA) survivors of childhood brain tumors who often remain dependent on their families well into adulthood. The primary aim of this study was to develop a typology of family management (FM) patterns for AYA survivors. The secondary aims were to compare them with FM patterns previously described for children with chronic health conditions and to validate the patterns using quantitative and qualitative data. Guided by the Family Management Styles Framework, a sequential, mixed-methods design was used to gather quantitative data from 186 mothers (primary caregivers) and 134 AYA survivors. FM patterns (family focused; somewhat family focused; somewhat condition focused; and condition focused) were identified using cluster analysis of data from the Family Management Measure. FM patterns were found to be similar to those for children with chronic health physical conditions and were significantly related to maternal quality of life, survivor quality of life (health-related quality of life [self- and mother proxy report]), cancer-related variables (treatment intensity, medical late effects), and family functioning in theoretically meaningfully ways. Significant demographic characteristics included private insurance and AYA survivors' engagement in school or employment. Qualitative analysis of data from 45 interviews with mothers from the larger sample provided additional support for and elaborated descriptions of FM patterns. Identification of FM patterns moves the science of family caregiving forward by aggregating data into a conceptually based typology, thereby taking into account the complex intersection of the condition, the family, and condition management. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. Balancing satisfaction and stress: carer burden among White and British Asian Indian carers of stroke survivors.

    Science.gov (United States)

    Katbamna, Savita; Manning, Lisa; Mistri, Amit; Johnson, Mark; Robinson, Thompson

    2017-08-01

    This paper presents the findings of a qualitative study exploring White and British Indian informal stroke carers' experiences of caring, factors contributing to their stress, and strategies used to overcome stress. A qualitative approach involving in-depth interviews was used to explore informal carers' experiences of caring for stroke survivors and the stress of caring at one and three to six months from the onset of stroke. Interviewers bilingual in English and Gujarati or Punjabi conducted interviews with carers. Socio-demographic data of carers and stroke survivors were collected at one, and three to six months by dedicated stroke research nurses. A total of 37 interviews with carers caring for stroke survivors with a wide range of physical and mental impairments were completed. A majority of carers had assumed the task of caring within a few weeks of the stroke. Irrespective of ethnicity, carers' emotional and physical well-being was undermined by the uncertainty and unpredictability of caring for stroke survivors, and meeting their expectations and needs. The strain of managing social obligations to care was common to all carers irrespective of gender and ethnicity, but the higher levels of anxiety and depression reported by Indian British female carers appeared to stem from the carers' pre-existing physical ailments, their cultural and religious beliefs, and household arrangements. Carers' strain in extended households was exacerbated by the additional responsibility of caring for other dependent relatives. Since the role of carers is clearly indispensable in the successful rehabilitation of survivors, it is vital to ensure that their well-being is not undermined by a lack of information and training, and that their need for professional support is prioritised.

  2. 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.

  3. Survivor of that time, that place: clinical uses of violence survivors' narratives.

    Science.gov (United States)

    Bhuvaneswar, Chaya; Shafer, Audrey

    2004-01-01

    Narratives by survivors of abuse offer compelling entries into the experiences of abuse and its effects on health. Reading such stories can enlarge the clinician's understanding of the complexities of abuse. Furthermore, attention to narrative can enhance the therapeutic options for abuse victims not only in mental health arenas, but also in other medical contexts. In this article we define the genre of survivor narratives, examine one such narrative in particular (Push by Sapphire, 1996), and explore the clinical implications of narrative in abuse victims' clinical care.

  4. 26 CFR 1.415(a)-1 - General rules with respect to limitations on benefits and contributions under qualified plans.

    Science.gov (United States)

    2010-04-01

    ... and disability benefits); (vii) Section 1.415(b)-1(g)(3) (regarding adjustments to applicable... survivor and disability benefits under governmental plans); (viii) Section 1.415(c)-1(b)(2)(ii) and (3)(iii...)(5) (providing an alternative rule for inclusion of compensation after a severance from employment...

  5. 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...

  6. Olive Oil: What Are the Health Benefits?

    Science.gov (United States)

    ... polyunsaturated fats (PUFAs), you may gain certain health benefits. MUFA s and PUFA s may help lower your risk ... In addition, some research shows that MUFA s may benefit insulin levels and blood sugar control, which can ...

  7. Effects of continuous visual feedback during sitting balance training in chronic stroke survivors.

    Science.gov (United States)

    Pellegrino, Laura; Giannoni, Psiche; Marinelli, Lucio; Casadio, Maura

    2017-10-16

    Postural control deficits are common in stroke survivors and often the rehabilitation programs include balance training based on visual feedback to improve the control of body position or of the voluntary shift of body weight in space. In the present work, a group of chronic stroke survivors, while sitting on a force plate, exercised the ability to control their Center of Pressure with a training based on continuous visual feedback. The goal of this study was to test if and to what extent chronic stroke survivors were able to learn the task and transfer the learned ability to a condition without visual feedback and to directions and displacement amplitudes different from those experienced during training. Eleven chronic stroke survivors (5 Male - 6 Female, age: 59.72 ± 12.84 years) participated in this study. Subjects were seated on a stool positioned on top of a custom-built force platform. Their Center of Pressure positions were mapped to the coordinate of a cursor on a computer monitor. During training, the cursor position was always displayed and the subjects were to reach targets by shifting their Center of Pressure by moving their trunk. Pre and post-training subjects were required to reach without visual feedback of the cursor the training targets as well as other targets positioned in different directions and displacement amplitudes. During training, most stroke survivors were able to perform the required task and to improve their performance in terms of duration, smoothness, and movement extent, although not in terms of movement direction. However, when we removed the visual feedback, most of them had no improvement with respect to their pre-training performance. This study suggests that postural training based exclusively on continuous visual feedback can provide limited benefits for stroke survivors, if administered alone. However, the positive gains observed during training justify the integration of this technology-based protocol in a well

  8. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners.

    Science.gov (United States)

    Hummel, Susanna B; Hahn, Daniela E E; van Lankveld, Jacques J D M; Oldenburg, Hester S A; Broomans, Eva; Aaronson, Neil K

    2017-10-01

    and their partners experience sexual problems after BC treatment. This suggests that not only the BC survivor but also her partner could benefit from sexual counseling. This is the first study focusing on BC survivors with a DSM-IV sexual dysfunction and their partners. The results cannot necessarily be generalized to women experiencing milder sexual problems or who have no interest in receiving sexual counseling. Endocrine therapy and immunotherapy are relevant risk factors for HSDD and dyspareunia in BC survivors. The sexual functioning of women and their partners is affected, underscoring the importance of involving both partners in sexual counseling after BC treatment. Hummel SB, Hahn DEE, van Lankveld JJDM, et al. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners. J Sex Med 2017;14:1248-1259. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  9. Rural Disparities in Treatment-Related Financial Hardship and Adherence to Surveillance Colonoscopy in Diverse Colorectal Cancer Survivors.

    Science.gov (United States)

    McDougall, Jean A; Banegas, Matthew P; Wiggins, Charles L; Chiu, Vi K; Rajput, Ashwani; Kinney, Anita Y

    2018-03-28

    Cancer survivors increasingly report financial hardship as a consequence of the high cost of cancer care, yet the financial experience of rural cancer survivors remains largely unstudied. The purpose of this study was to investigate potential rural disparities in the likelihood of financial hardship and nonadherence to surveillance colonoscopy. Individuals diagnosed with localized or regional colorectal cancer (CRC) between 2004-2012 were ascertained by the population-based New Mexico Tumor Registry. Participants completed a mailed questionnaire or telephone survey about their CRC survivorship experience, including treatment-related financial hardship and receipt of surveillance colonoscopy. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Compared to urban CRC survivors (n=168), rural CRC survivors (n=109) were slightly older, more likely to be married (65% v. 59%) and have an annual income financial hardship (OR 1.86, 95% CI 1.06-3.28) and nonadherence to surveillance colonoscopy guidelines (OR 2.28, 95% CI 1.07-4.85). In addition, financial hardship was independently associated with nonadherence to surveillance colonoscopy (OR 2.17, 95% CI 1.01-4.85). Substantial rural disparities in the likelihood of financial hardship and nonadherence to surveillance colonoscopy exist. Treatment-related financial hardship among rural CRC survivors may negatively impact adherence to guideline recommended follow-up care. Copyright ©2018, American Association for Cancer Research.

  10. Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Xue Wen Eng

    2014-01-01

    Full Text Available Aim. To explore factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient rehabilitation. Method. One-on-one, in-depth interviews with stroke survivors (n=7 and their main carer (n=6, along with two focus groups with clinical staff (n=20. Data was thematically analysed according to group. Results. Stroke survivors perceived “dealing with loss,” whilst concurrently “building motivation and hope” for recovery affected their ability to drive their own recovery outside of therapy. In addition, they reported a “lack of opportunities” outside of therapy, with subsequent time described as “dead and wasted.” Main carers perceived stroke survivors felt “out of control … at everyone’s mercy” and lacked knowledge of “what to do and why” outside of therapy. Clinical staff perceived the stroke survivor’s ability to drive their own recovery was limited by the lack of “another place to go” and the “passive rehab culture and environment.” Discussion. To enable the stroke survivor to drive their own recovery outside of therapy, there is a need to increase opportunities for practice and promote active engagement. Suggested strategies include building the stroke survivor’s motivation and knowledge, creating an enriched environment, and developing daily routines to provide structure outside of therapy time.

  11. 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.

  12. Clinico-pathological investigation of resectable gastric cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Tanaka, Takashi; Saeki, Toshiaki; Hirai, Toshihiro; Toge, Tetuya; Niimoto, Minoru; Hattori, Takao; Ootaki, Megu; Munaka, Masaki

    1989-01-01

    This is a review of 1074 patients with resectable gastric cancer who have satisfied the following criteria: primary cancer, histological confirmation, the description of exposed or non-exposed patients, and certification of atomic bomb survivor's health handbook in exposed patients. There were 250 men and 162 women in the exposed group, and 460 men and 203 women in the non-exposed group. Gastric cancer was detected in 29.6% for the exposed group and 7.4% for the non-exposed group, although the patients had not complained of any symptoms. These figures tended to increase annually, probably benefiting from health examination. The difference between the exposed and non-exposed patients tended to be smaller when preoperative stages and the percentage of macroscopic early cancer were adjusted by age and the presence of complaints. The difference in histology between the groups also tended to be smaller. In the exposed group, however, men and women tended to have well differentiated cancer and poorly differentiated cancer, respectively. Since A-bomb survivors consist of radiation exposed population and are managed under intensive medical care, adjustment of some factors is necessary in comparing A-bomb survivors with general population. (Namekawa, K)

  13. Quantitative data analysis of perceived barriers and motivators to physical activity in stroke survivors.

    Science.gov (United States)

    Nicholson, S L; Greig, C A; Sniehotta, F; Johnston, M; Lewis, S J; McMurdo, M E; Johnston, D; Scopes, J; Mead, G E

    2017-09-01

    Levels of physical activity after stroke are low, despite multiple health benefits. We explored stroke survivors' perceived barriers, motivators, self-efficacy and intention to physical activity. Fifty independently mobile stroke survivors were recruited prior to hospital discharge. Participants rated nine possible motivators and four possible barriers based on the Mutrie Scale, as having 'no influence', 'some influence' or 'a major influence' on physical activity. Participants also rated their self-efficacy and intention to increasing walking. The most common motivator was 'physical activity is good for health' [34 (68%)]. The most common barrier was 'feeling too tired' [24 (48%)]. Intention and self-efficacy were high. Self-efficacy was graded as either 4 or 5 (highly confident) on a five-point scale by [34 (68%)] participants, while 42 (84%) 'strongly agreed' or 'agreed' that they intended to increase their walking. Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity. This needs to be considered when encouraging stroke survivors to be more active.

  14. Second primary cancers in survivors of cervical cancer in the Netherlands: Implications for prevention and surveillance

    International Nuclear Information System (INIS)

    Arnold, Melina; Liu, Lifang; Kenter, Gemma G.; Creutzberg, Carien L.; Coebergh, Jan Willem; Soerjomataram, Isabelle

    2014-01-01

    Background and purpose: We investigated the effects of socio-demographic, treatment- and tumor-specific determinants on the risk of developing a second malignancy among patients treated for cervical cancer. Material and methods: We included patients with a first cervical cancer (N = 12,048) from the Netherlands Cancer Registry (NCR), 1989–2008. Standardized incidence ratios (SIR) and absolute excess risks (AER) per 10,000 person-years were calculated to estimate the burden of second cancers in cervical cancer survivors. Incidence rate ratios (IRR) were computed to identify predictors for second cancers among cervical cancer survivors. Results: During the study period, 676 (5.6%) patients were diagnosed with a second cancer. Smoking-related cancers contributed the most to the overall burden of second cancers (AER = 21) and risks remained elevated after 10 years of follow-up (SIR = 1.8, 95% CI: 1.4–2.2), yet it decreased markedly in the younger birth cohorts. Cervical cancer survivors who underwent radiotherapy were at higher risk for a second tumor when compared to those without radiotherapy, especially at smoking-related sites (IRR = 1.6 (1.2–2.3)). Conclusion: Patients with cervical cancer had a significantly increased risk for a second cancer compared to the general population, especially for smoking- and irradiation-related tumors. Long-term follow-up suggested the importance of smoking cessation and the benefits of counseling cervical cancer patients accordingly, particularly those who received radiotherapy

  15. 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.

  16. The Mediating Role of Posttraumatic Stress Disorder with Tendency to Forgive, Social Support, and Psychosocial Functioning of Terror Survivors.

    Science.gov (United States)

    Weinberg, Michael

    2018-06-12

    The study reported in this article examined the relationship between psychosocial functioning and tendency to forgive, social support, and posttraumatic stress disorder (PTSD) symptoms of terror survivors (N = 108). Structural equation modeling was used to examine whether PTSD symptoms mediated the association between tendency to forgive, social support, and psychosocial functioning. The findings demonstrated that the association between tendency to forgive and psychosocial functioning was mediated exclusively by PTSD symptoms, whereas the association between social support and psychosocial functioning was partially mediated by PTSD symptoms. The study reinforces the importance of addressing trauma survivors' psychosocial functioning as an emotional state associated with tendency to forgive, social support, and PTSD symptoms. In addition, the findings suggest that when treating trauma survivors, therapists should be aware of PTSD not only as an emotional consequence of trauma, but also as a mediator of numerous emotional and cognitive coping mechanisms.

  17. Do prehospital discharge pacemaker checks provide any additional clinical benefit?

    Science.gov (United States)

    Wheelan, Kevin R; Legge, Darlene M; Sakowski, Brent C; Bruce, Susan S; Roberts, David C; Johnston, L Murphy; Moore, B Jane; Beveridge, Thomas P; Wells, Peter J; Vallabahn, Ravi; Donsky, Michael S; Franklin, Jay O

    2005-08-01

    We performed a retrospective analysis of 250 records of consecutive, newly implanted, pacemaker patients from a single center to determine the rate of postimplant complications and observations discovered before and during the prehospital discharge evaluation. No observations occurred in 246 of 250 patients (98.4%) (1-sided 95% confidence interval 96.4%). Of the 250 patients, 4 had observations that were discovered at the prehospital discharge check and required reprogramming to increase the sensitivity safety margin (3 atrial and 1 ventricular). We documented only 1 complication that was discovered before the predischarge evaluation through telemetry and resulted in an atrial lead revision.

  18. 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

  19. 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

  20. In their own words: the experience of mothering as a survivor of childhood sexual abuse.

    Science.gov (United States)

    O'Dougherty Wright, Margaret; Fopma-Loy, Joan; Oberle, Katherine

    2012-05-01

    This article reviews past research on the parenting characteristics of childhood sexual abuse survivors and presents the results of a qualitative study exploring the women's perspectives on mothering as a survivor. Grounded theory was used in the collection and analysis of the data. Data sources included the narrative responses of 79 women (mean age = 38.2 years) and in-depth interviews of a purposive sample of 15 women (mean age = 39 years). They had an average of 2.2 children, ranging in age from 5 months to young adulthood. The theoretical model identified through analysis of data using the constant comparison method was entitled "The Hard Work of Mothering as a Survivor." Processes emerged that described the ways participants managed the work of mothering in light of memories of the abuse and attempts to heal from this earlier trauma. The conditions for committing to the work included becoming aware of and accepting the reality of the abuse and how it affected one's life, and taking on the hard work of developing a mothering self. This included expanding awareness, developing and evaluating a personal model of mothering, navigating typical and abuse salient parenting challenges, mothering through the pain of recovery, and battling for balance. The findings highlighted the dynamic, multifaceted nature of recovery and resilience for these mothers and the need for an increased focus on parenting in counseling with childhood sexual abuse survivors. Provision of anticipatory guidance regarding commonly experienced stressors at varying stages of the child's development and the mother's stage of recovery and methods for coping with these challenges, would benefit these mothers and promote parenting competence. Specific implications for psychotherapy and directions for future research are discussed.

  1. Cancer survivors in the workplace: sleep disturbance mediates the impact of cancer on healthcare expenditures and work absenteeism.

    Science.gov (United States)

    Gonzalez, Brian D; Grandner, Michael A; Caminiti, Courtney B; Hui, Siu-Kuen Azor

    2018-06-05

    History of cancer is significantly associated with increases in healthcare costs, worse work performance, and higher absenteeism in the workplace. This is particularly important as most cancer survivors return to employment. Sleep disturbance is a largely overlooked potential contributor to these changes. Data from 9488 state employees participating in the Kansas State employee wellness program were used to assess cancer history, sleep disturbance, healthcare expenditures, work performance ratings, and absenteeism. Participants were categorized as having had no history of breast or prostate cancer, a past history only with no current cancer treatment, or current treatment for breast or prostate cancer. Indirect mediation analyses determined whether sleep disturbance mediated the influence of cancer status on outcomes. Employees receiving treatment for breast or prostate cancer had significantly greater healthcare expenditures and absenteeism than those with a past history or no history of cancer (ps accounting for 2 and 8% of the impact of cancer on healthcare expenditure and missed full days of work, respectively. The worse outcomes observed among employees receiving treatment for breast and prostate cancer, the most common forms of cancer among women and men, were partially explained by the impacts of cancer and treatment for cancer on sleep disturbance. These findings suggest that preventing or addressing sleep disturbance may result in economic benefits in addition to improvements in health and quality of life.

  2. 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.

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

    International Nuclear Information System (INIS)

    Anderson, B.; McLosky, J.; Wasilevich, E.; Callo, S. L.; Duquette, D.; Copeland, G.

    2012-01-01

    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.

  4. Serum melatonin levels in survivor and non-survivor patients with traumatic brain injury.

    Science.gov (United States)

    Lorente, Leonardo; Martín, María M; Abreu-González, Pedro; Pérez-Cejas, Antonia; Ramos, Luis; Argueso, Mónica; Solé-Violán, Jordi; Cáceres, Juan J; Jiménez, Alejandro; García-Marín, Victor

    2017-07-19

    Circulating levels of melatonin in patients with traumatic brain injury (TBI) have been determined in a little number of studies with small sample size (highest sample size of 37 patients) and only were reported the comparison of serum melatonin levels between TBI patients and healthy controls. As to we know, the possible association between circulating levels of melatonin levels and mortality of patients with TBI have not been explored; thus, the objective of our current study was to determine whether this association actually exists. This multicenter study included 118 severe TBI (Glasgow Coma Scale melatonin, malondialdehyde (to assess lipid peroxidation) and total antioxidant capacity (TAC) at day 1 of severe TBI. We used mortality at 30 days as endpoint. We found that non-survivor (n = 33) compared to survivor (n = 85) TBI patients showed higher circulating levels of melatonin (p melatonin levels predicted 30-day mortality (Odds ratio = 1.334; 95% confidence interval = 1.094-1.627; p = 0.004), after to control for GCS, CT findings and age. We found a correlation between serum levels of melatonin levels and serum levels of TAC (rho = 0.37; p melatonin levels in patients with severe TBI. The main findings were that non-survivors had higher serum melatonin levels than survivors, and the association between serum levels of melatonin levels and mortality, peroxidation state and antioxidant state.

  5. 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.

  6. 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 ...

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

    Science.gov (United States)

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

    2010-01-01

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

  8. 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

  9. Understanding How Domestic Violence Shelter Rules May Influence Survivor Empowerment.

    Science.gov (United States)

    Gregory, Katie; Nnawulezi, Nkiru; Sullivan, Cris M

    2017-10-01

    Domestic violence shelters have historically gone beyond providing emergency residential space for survivors by assisting in obtaining future housing, employment, health care, child care, or legal services. Domestic violence shelters are expected to operate within an empowerment philosophy, with an understanding that survivors are self-determining, can identify their needs, and know what it takes to meet those needs. Recent research has indicated that, as many shelters have become more rigid in creating rules that survivors must follow to access and retain free temporary housing, the result has been survivors' feelings of disempowerment, the complete opposite of what was originally intended. This study builds on the small amount of research conducted regarding survivors' experiences of shelter rules by specifically examining how rules were perceived to affect empowerment. Seventy-three survivors from two domestic violence shelters were asked about their experiences around specific shelter rules relating to curfew, parenting, chores, time limits, food, alcohol, drugs, and medications. A transcendental phenomenological approach was used to analyze the qualitative data, seeking explanations of how survivors made meaning of the rules and how those rules influenced their empowerment. Among those survivors who found the rules problematic, three major themes emerged: (a) rules acted as barriers to carrying out their normal, day-to-day activities; (b) the shelter staff's flexibility with rules was based on contingencies; and (c) rules negatively affected their psychological well-being, and required them to engage in protective behaviors. Recommendations are made for the reexamination and restructuring of rules within domestic violence shelters.

  10. Why Rape Survivors Participate in the Criminal Justice System

    Science.gov (United States)

    Patterson, Debra; Campbell, Rebecca

    2010-01-01

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

  11. 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

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

    African Journals Online (AJOL)

    Caring for the survivors of both forms of violence is critical for ensuring their speedy recovery. ... stress disorder and coping styles three months after the incident. Semi-structured interviews were conducted with the survivors of both types of ...

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

    African Journals Online (AJOL)

    This study aimed to investigate depression among female survivors of domestic violence. 112 female survivors of domestic violence who came to a trauma centre in Thohoyandou, Limpopo Province to seek help were selected as participants in the study. The participants‟ ages ranged from 15 to 65 years.

  14. 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

  15. Risk of cancer among atomic bomb survivors

    International Nuclear Information System (INIS)

    Shimizu, Yukiko; Kato, Hiroo; Schull, W.J.

    1991-01-01

    This report describes the risk of cancer and in particular cancers other than leukemia among the survivors of the atomic bombing of Hiroshima and Nagasaki. Attention focuses primarily on the risk of death from cancer among individuals in the Life Span Study sample of the Radiation Effect Research Foundation in the period 1950-1985 based on the recently revised dosimetry, termed the DS86 doses. Mortality from malignant tumors is increased among A-bomb survivors as a late effect of A-bomb radiation. Basides the well-known increase of leukemia, there also has been demonstrated increase of cancer of the lung, breast, esophagus, stomach, colon, ovary, urinary bladder, thyroid, and of multiple myeloma, but no increase has yet been observed in mortality from cancer of the rectum, gallbladder, pancreases, prostate and uterus, and of malignant lymphoma. The pattern of appearance over time of radiation-induced cancer other than leukemia differs from that of leukemia. In general, radiation-induced solid cancer begins to appear after attaining the age at which the cancer is normally prone to develop (so-called cancer age), and countinues to increase proportionally with the increase in mortality of the control group as it ages. Sensitivity to radiation, in terms of cancer induction, is higher for persons who were young at the time of the bomb (ATB) in general than for those who were older ATB. Furthermore, susceptibility to radiation-induced cancer tends to be higher in pre- than in post-natally exposed survivors (at least those exposed as adults). Other radiation effect modifiers and the shape of the dose response curve will also be discussed. (author)

  16. Study of apoprotein among atomic bomb survivors

    International Nuclear Information System (INIS)

    Takayama, Sadamatsu; Tokunaga, Yutaka; Ishibashi, Shinzo; Mito, Kazuyo; Ito, Chikako; Kato, Masafumi.

    1988-01-01

    In an effort to examine the relationship between A-bomb exposure and arteriosclerosis, the serum concentrations of apoproteins (Apo) were measured in a total of 192 A-bomb survivors, consisting of 28 A-bomb survivors exposed at ≤2,000 m from the hypocenter (the exposed group) and 110 A-bomb survivors exposed at ≥3,000 m and entering the city 9 days or later after A-bombing (the control group). No definitive difference in average serum concentrations of Apo A-I and A-II was found between the exposed and control groups; nor did average serum concentrations of Apo B and B/A-I differ between the groups. According to the age group, Apo A-I was significantly higher in men over the age of 70 in the exposed group than the control group. Apo B tended to be higher in men over the age of 50 in the exposed group than the control group. As for men in the control group, there was a significant negative correlation between age group and both Apo A-I and A-II; however, this tendency was not seen in the exposed group. For women, no correlation between Apo and age group was found in either the exposed or control group. There was a tendency among men towards a higher incidence of hypoapoproteinemia A-I in the exposed group than the control group. The incidence of hyperapoproteinemia B was significantly higher as well for men in the exposed group than the control group. (Namekawa, K.)

  17. The balanced survivor average causal effect.

    Science.gov (United States)

    Greene, Tom; Joffe, Marshall; Hu, Bo; Li, Liang; Boucher, Ken

    2013-05-07

    Statistical analysis of longitudinal outcomes is often complicated by the absence of observable values in patients who die prior to their scheduled measurement. In such cases, the longitudinal data are said to be "truncated by death" to emphasize that the longitudinal measurements are not simply missing, but are undefined after death. Recently, the truncation by death problem has been investigated using the framework of principal stratification to define the target estimand as the survivor average causal effect (SACE), which in the context of a two-group randomized clinical trial is the mean difference in the longitudinal outcome between the treatment and control groups for the principal stratum of always-survivors. The SACE is not identified without untestable assumptions. These assumptions have often been formulated in terms of a monotonicity constraint requiring that the treatment does not reduce survival in any patient, in conjunction with assumed values for mean differences in the longitudinal outcome between certain principal strata. In this paper, we introduce an alternative estimand, the balanced-SACE, which is defined as the average causal effect on the longitudinal outcome in a particular subset of the always-survivors that is balanced with respect to the potential survival times under the treatment and control. We propose a simple estimator of the balanced-SACE that compares the longitudinal outcomes between equivalent fractions of the longest surviving patients between the treatment and control groups and does not require a monotonicity assumption. We provide expressions for the large sample bias of the estimator, along with sensitivity analyses and strategies to minimize this bias. We consider statistical inference under a bootstrap resampling procedure.

  18. 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.

  19. 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.

  20. 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

    2018-03-01

    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.

  1. BWR zinc addition Sourcebook

    International Nuclear Information System (INIS)

    Garcia, Susan E.; Giannelli, Joseph F.; Jarvis, Alfred J.

    2014-01-01

    Boiling Water Reactors (BWRs) have been injecting zinc into the primary coolant via the reactor feedwater system for over 25 years for the purpose of controlling primary system radiation fields. The BWR zinc injection process has evolved since the initial application at the Hope Creek Nuclear Station in 1986. Key transitions were from the original natural zinc oxide (NZO) to depleted zinc oxide (DZO), and from active zinc injection of a powdered zinc oxide slurry (pumped systems) to passive injection systems (zinc pellet beds). Zinc addition has continued through various chemistry regimes changes, from normal water chemistry (NWC) to hydrogen water chemistry (HWC) and HWC with noble metals (NobleChem™) for mitigation of intergranular stress corrosion cracking (IGSCC) of reactor internals and primary system piping. While past reports published by the Electric Power Research Institute (EPRI) document specific industry experience related to these topics, the Zinc Sourcebook was prepared to consolidate all of the experience gained over the past 25 years. The Zinc Sourcebook will benefit experienced BWR Chemistry, Operations, Radiation Protection and Engineering personnel as well as new people entering the nuclear power industry. While all North American BWRs implement feedwater zinc injection, a number of other BWRs do not inject zinc. This Sourcebook will also be a valuable resource to plants considering the benefits of zinc addition process implementation, and to gain insights on industry experience related to zinc process control and best practices. This paper presents some of the highlights from the Sourcebook. (author)

  2. Medical problems of survivors of nuclear war

    International Nuclear Information System (INIS)

    Abrams, H.L.; Von Kaenel, W.E.

    1981-01-01

    The nature of the medical problems that may confront survivors of a nuclear war are discussed with emphasis on infection and the spread of communicable disease. Factors which will increase the risk and severity of infection include: radiation, trauma and burns, malnutrition and starvation, dehydration, exposure, and hardship. Factors which will increase the spread of disease include: crowded shelter conditions, poor sanitation, insects, corpses, free-roaming diseased animals. Shortages of physicians, the destruction of laboratories, and the general disorganization sure to follow the attack will also contribute to the problems. The authors recommend further study in this area

  3. Nutritional advice to breast cancer survivors.

    Science.gov (United States)

    Pasanisi, Patrizia; Villarini, Anna; Bruno, Eleonora; Raimondi, Milena; Gargano, Giuliana; Berrino, Franco

    2010-05-01

    Breast cancer (BC) survivors are constantly increasing, and research investment for the identification of modifiable factors associated with BC recurrences is increasing too. The Western lifestyle, characterized by low levels of physical activity and a diet rich in refined carbohydrates, animal fats, and protein, is associated with high prevalence of metabolic syndrome, insulin resistance, and high serum levels of sex hormones and growth factors. The present work summarizes the association between all these metabolic and hormonal factors with the risk of BC and BC recurrences. Since metabolic syndrome and endocrine imbalance may be favorably modified through comprehensive change in lifestyle, dietary changes should be recommended both for BC prevention and treatment.

  4. Hearing Loss in Cryptococcal Meningitis Survivors

    OpenAIRE

    Lofgren, Sarah; Montgomery, Martha; Yueh, Nathan; Namudde, Alice; Rhein, Joshua; Abassi, Mahsa; Musubire, Abdu; Meya, David; Boulware, David

    2017-01-01

    Abstract Background Hearing loss is a known complication cryptococcal meningitis (CM); however, there is a paucity of data. We aimed to describe hearing loss in CM survivors. Methods We assessed hearing via audiometry 8 and 18 weeks after diagnosis of CM in Kampala, Uganda from 2015-2016. We measured at 0.5, 1, 2, 4 Hz. Normal hearing was defined as minimum hearing level at 25 cm H2O 113 24 (71%) 28 (45%) 0.017 Average Opening Pressure >20 cm H20 96 34 (81%) 43 (61%) 0.025 Quantitative Cultur...

  5. Hiroshima and Nagasaki: the survivors. The reckoning

    International Nuclear Information System (INIS)

    Barnaby, F.

    1977-01-01

    At a recently held meeting of 44 scientists from 14 countries organised by the International Peace Bureau a great deal of information on the physical, biological, medical, genetic, social and psychological effects of the atomic bombs was made specially available by Japanese scientists including the results of comprehensive surveys of the personal and social disabilities of the survivors. The immediate fire, blast and radiation effects are here summarized and the causes of death upto the end of 1945 are considered. The delayed effects are perhaps the most terrifying and these are examined. (U.K.)

  6. Sister chromatoid exchanges in atomic bomb survivors

    International Nuclear Information System (INIS)

    Nakano, Mimako; Awa, Akio

    1980-01-01

    Sister chromatoid exchange (SCE) frequencies in the peripheral lymphocyte with and without mitomycin-C (MMC) were studied, in the age of tens and thirties for an atomic-bomb survivor group and in thirties, fifties, and seventies for an unexposed group. The observation of 100 cells showed no statistically significant difference of SCE frequencies with aging or irradiation. The increasing rates of SCE frequencies by MMC showed no difference among the groups. The average increasing ratio by MMC was 3.6. (Nakanishi, T.)

  7. A review of colorectal cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Nakao, Susumu; Sawai, Terumitsu; Ishii, Toshiyo; Eida, Kazuyuki; Noguchi, Kyoichi; Takahara, Osamu

    1989-01-01

    Clinical and pathological characteristics of patients with colorectal cancer amongst atomic bomb survivors, who had undergone operations from 1971∼1984, have been reviewed and compared with that of a control group. The survival rate of the atomic bomb survivors over the age of 60 years was statistically better than that of the same age group in the controls. In this age bracket, the control group were in a more advanced stage of the disease than were the survivors, this accounting for the reason why the survivors had better prognosis. Further, the fact that the survivors continually have received more medical attention than have the aged in the control group affects this statistic. (author)

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

    Science.gov (United States)

    Juni, Samuel

    2016-01-01

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

  9. Neoplasms among atomic bomb survivors in Hiroshima City. First report

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Tomin; Ishida, Morihiro

    1960-04-01

    The 1957-1958 incidence of neoplasms among the survivors of the Hiroshima A-bomb, varies directly with radiation dose insofar as it may be inferred from distance from the hypocenter at exposure. The incidence of all malignant neoplasms among the survivors who were within 1000 meters is more than 4 times that of the non-exposed population. The incidence of benign neoplasms among the survivors exposed within 1500 meters is also significantly higher than that among the non-exposed. For survivors under 1500 meters significant differences are seen between the numbers of observed cancers of the lung, stomach, uterus and ovary and the expected cases calculated from the age-specific rates of the non-exposed portion of the Hiroshima population. The increased incidence among survivors within 1500 meters is not related to sex or age. 18 references, 2 figures, 14 tables.

  10. QUANTIFYING BENEFITS FOR COST-BENEFIT ANALYSIS

    OpenAIRE

    Attila GYORGY; Nicoleta VINTILA; Florian GAMAN

    2014-01-01

    Cost Benefit Analysis is one of the most widely used financial tools to select future investment projects in public and private sector. This method is based on comparing costs and benefits in terms of constant prices. While costs are easier to predict and monetize, the benefits should be identified not only in direct relation with the investment, but also widening the sphere of analysis to indirect benefits experienced by the community from the neighbourhood or the whole society. During finan...

  11. FEMALE SURVIVORS IN THOMAS HARDY‘S THE WITHERED ARM

    Directory of Open Access Journals (Sweden)

    Yulistiyanti Yulistiyanti

    2017-12-01

    Full Text Available This article discusses women position in society that Thomas Hardy portrays in his short story entitled The Withered Arm. This short story tells about two female character have closerelationship to the same man. The man comes from upper class. The first woman from lower class has a son of his, but they do not live together. Then, the second one is his new young wife. This short story takes rural area, Dorset as the setting of place where the society has intimate relationships and setting of time is in Victorian era. It applied feminism theory that focuses on male and female positions in society. Beauvoir (1949 considered that the male in French and Western societies defines what it means to be human and what it means to be female. The female becomes subordinate to the male. It applies qualitative analysis method. The text is analyzed relating to the female characters‘ position in society. Their positions make them get discrimination which society created. Thomas Hardy‘s short story will be analyzed on discrimination to female characters. The data shows that the two female characters are oppressed on their conditions. Although they do not get physical harassment, the oppression comes from social injustice that women do not get equal benefit and opportunities. Both of them survive to obtain what they need. These characters use their ways as the survivors because of unfair condition.

  12. Practitioner Views on the Impacts, Challenges, and Barriers in Supporting Older Survivors of Sexual Violence.

    Science.gov (United States)

    Bows, Hannah

    2018-07-01

    Despite half a century of research on both sexual violence and elder abuse, the intersection between the two remains largely unexplored. Using theoretical lenses of feminist criminology and critical feminist gerontology, this article explores the intersection between age and sexual violence drawing on interviews with 23 practitioners supporting older survivors (aged 60 and over). They reported physical and emotional effects of sexual violence leading to limited lifestyles, disengagement from social networks, and reliance on pathogenic coping strategies. Provision of effective support was complicated by challenges associated with aging bodies and the social stigma associated with both sexual victimhood and older age. Additional challenges lay in supporting older male survivors and those living with dementia. The article ends by discussing implications for practice and an agenda for future research.

  13. Is there a genetic instability in A-bomb survivors' lymphocytes?

    International Nuclear Information System (INIS)

    Nakamura, Nori; Kodama, Yoshiaki; Awa, Akio

    1997-01-01

    Based on the reports that the genetic instability can be induced even by low LET radiation and that the instability can be essentially the cause of radiation carcinogenicity, data accumulated hitherto on the chromosome aberrations in A-bomb survivors were re-evaluated since it can be conceivable that there is still remaining a genetic instability in them. For a measure of biological radiation dose, translocation frequency was used and for genetic instability, dicentrics frequency. The relationship between those frequencies was analyzed in about 2500 survivors and showed either a saturable or linear one. For clear conclusion, additional studies on dicentrics frequency occurring in cultured lymphocytes from subjects who received various radiation doses would be necessary. (K.H.)

  14. 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

    incidence ratios (SIR) was 2.4-fold increased (95% confidence interval (95%CI) 1.8-3.2), leading to 5.7 excess cases per 10 000 patient-years. Risk was still increased 30 years after HL treatment (SIR: 2.8; 95%CI: 1.6-4.6). The highest (SIR: 6.5, 95%CI: 3.3-11.3) was seen for transverse colon cancer (15......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...

  15. Young adult cancer survivors and work: a systematic review.

    Science.gov (United States)

    Stone, Dawn S; Ganz, Patricia A; Pavlish, Carol; Robbins, Wendie A

    2017-12-01

    Sixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established. The purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings. A narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English. Twenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors. More research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care. While young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of occupation, employment appears to enhance overall quality of life.

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

    Science.gov (United States)

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

    2014-01-01

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

  17. Benefits of transmission interconnections

    International Nuclear Information System (INIS)

    Lyons, D.

    2006-01-01

    The benefits of new power transmission interconnections from Alberta were discussed with reference to the challenges and measures needed to move forward. Alberta's electricity system has had a long period of sustained growth in generation and demand and this trend is expected to continue. However, no new interconnections have been built since 1985 because the transmission network has not expanded in consequence with the growth in demand. As such, Alberta remains weakly interconnected with the rest of the western region. The benefits of stronger transmission interconnections include improved reliability, long-term generation capability, hydrothermal synergies, a more competitive market, system efficiencies and fuel diversity. It was noted that the more difficult challenges are not technical. Rather, the difficult challenges lie in finding an appropriate business model that recognizes different market structures. It was emphasized that additional interconnections are worthwhile and will require significant collaboration among market participants and governments. It was concluded that interties enable resource optimization between systems and their benefits far exceed their costs. tabs., figs

  18. Eliminating Survivor Bias in Two-stage Instrumental Variable Estimators.

    Science.gov (United States)

    Vansteelandt, Stijn; Walter, Stefan; Tchetgen Tchetgen, Eric

    2018-07-01

    Mendelian randomization studies commonly focus on elderly populations. This makes the instrumental variables analysis of such studies sensitive to survivor bias, a type of selection bias. A particular concern is that the instrumental variable conditions, even when valid for the source population, may be violated for the selective population of individuals who survive the onset of the study. This is potentially very damaging because Mendelian randomization studies are known to be sensitive to bias due to even minor violations of the instrumental variable conditions. Interestingly, the instrumental variable conditions continue to hold within certain risk sets of individuals who are still alive at a given age when the instrument and unmeasured confounders exert additive effects on the exposure, and moreover, the exposure and unmeasured confounders exert additive effects on the hazard of death. In this article, we will exploit this property to derive a two-stage instrumental variable estimator for the effect of exposure on mortality, which is insulated against the above described selection bias under these additivity assumptions.

  19. Ongoing ostomy self-care challenges of long-term rectal cancer survivors.

    Science.gov (United States)

    Bulkley, Joanna E; McMullen, Carmit K; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Krouse, Robert S

    2018-05-29

    Surgical treatment for rectal cancer (RC) can result in an intestinal ostomy that requires lifelong adaptation and investment of physical, cognitive, and financial resources. However, little is known about the extent of ongoing challenges related to ostomy self-care among long-term RC survivors. We analyzed the prevalence of self-reported ostomy self-care challenges and the physical and environmental factors that can support or undermine ostomy self-care. We mailed surveys to long-term (≥ 5 years post-diagnosis) RC survivors, including 177 adults with ostomies who were members of integrated health systems in northern California, Oregon, and Washington State. Potential participants were identified through tumor registries. Data were also extracted from electronic health records. The response rate was 65%. The majority of respondents were male (67%), and the mean age was 75 years. Sixty-three percent of respondents reported at least one ostomy self-care challenge. The most common challenges were leakage or skin problems around the ostomy and needing to change the pouching system too frequently. Twenty-two percent reported difficulty caring for their ostomy. Younger age and higher BMI were consistently related to ostomy self-care challenges. The majority of RC survivors reported ostomy-related self-care challenges, and 31% experienced problems across multiple domains of ostomy self-care. In addition, most survivors reported significant physical challenges that could lead to ostomy-related disability. Although the participants surveyed had access to ostomy care nurses, the care gaps we found suggest that additional work is needed to understand barriers to ostomy care, reduce unmet needs, and improve well-being among this group.

  20. Chromosome abnormalities in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Tomonaga, Y [Nagasaki Univ. (Japan). School of Medicine

    1976-09-01

    Chromosome abnormalities in bone marrow cells were recognized in 6 cases which consisted of one case of chronic myelogenous leukemia, two cases of acute myelogenous leukemia, one case of sideroblastic anemia, and two cases of myelodysplasis. Frequency of stable type chromosome abnormalities in bone marrow cells was investigated in 45 atomic bomb survivors without hematologic disorders and 15 controls. It was 1.4% (15 cases) in the group exposed to atomic bomb within 1 km from the hypocenter, which was significantly higher as compared with 0.1% (15 cases) in the group exposed to atomic bomb over 2.5 km from the hypocenter and 0.2% in normal controls. Examination of chromosome was also made on 2 of 3 cases which were the seconds born of female with high chromosome abnormality, who was exposed to within 1 km from the hypocenter, and healthy male exposed 3 km from the hypocenter. These two cases showed chromosome of normal male type, and balanced translocation was not recognized. There was not a significant difference in chromosome abnormalities between the seconds of atomic bomb survivors and controls.

  1. Colorectal cancer among atomic bomb survivors

    International Nuclear Information System (INIS)

    Nakatsuka, H.; Ezaki, H.

    1986-01-01

    Studies on autopsied and surgical cases of colorectal cancer in Hiroshima and Nagasaki atomic bomb (A-bomb) survivors have not shown a relationship to radiation. In a recent epidemiologic study made on a fixed population at the Radiation Effects Research Foundation (RERF), the risk of colon cancer was found to increase significantly with increasing radiation dose in both Hiroshima and Nagasaki, and also in both males and females. The dose effect for the cities and sexes combined was especially pronounced for cancer of the sigmoid colon. The effect of radiation was found to vary by age at the time of the bomb (ATB) and the effect was remarkable among those under age 20 ATB. The risk of rectal cancer was not found to increase significantly with radiation and the distribution of histological types for cancer of either the colon or rectum was unrelated to radiation dose. The effect of A-bomb exposure on the postoperative survival rate for colorectal cancer patients was studied. No difference by radiation dose could be demonstrated. In Japan, the incidence of colorectal cancer, and of colon cancer in particular, has been increasing. Therefore, close attention should be paid to changes occuring in A-bomb survivors

  2. Chromosome abnormalities in atomic bomb survivors

    International Nuclear Information System (INIS)

    Tomonaga, Yu

    1976-01-01

    Chromosome abnormalities in bone marrow cells were recognized in 6 cases which consisted of one case of chronic myelogenous leukemia, two cases of acute myelogenous leukemia, one case of sideroblastic anemia, and two cases of myelodysplasis. Frequency of stable type chromosome abnormalities in bone marrow cells was investigated in 45 atomic bomb survivors without hematologic disorders and 15 controls. It was 1.4% (15 cases) in the group exposed to atomic bomb within 1 km from the hypocenter, which was significantly higher as compared with 0.1% (15 cases) in the group exposed to atomic bomb over 2.5 km from the hypocenter and 0.2% in normal controls. Examination of chromosome was also made on 2 of 3 cases which were the seconds born of female with high chromosome abnormality, who was exposed to within 1 km from the hypocenter, and healthy male exposed 3 km from the hypocenter. These two cases showed chromosome of normal male type, and balanced translocation was not recognized. There was not a significant difference in chromosome abnormalities between the seconds of atomic bomb survivors and controls. (Kanao, N.)

  3. Colorectal cancer among atomic bomb survivors

    International Nuclear Information System (INIS)

    Nakatsuka, Hirofumi; Ezaki, Haruo.

    1986-01-01

    Studies on autopsied and surgical cases of colorectal cancer in Hiroshima and Nagasaki atomic bomb (A-bomb) survivors have not shown a relationship to radiation. In a recent epidemiologic study made on a fixed population at the Radiation Effects Research Foundation (RERF), the risk of colon cancer was found to increase significantly with increasing radiation dose in both Hiroshima and Nagasaki, and also in both males and females. The dose effect for the cities and sexes combined was especially pronounced for cancer of the sigmoid colon. The effect of radiation was found to vary by age at the time of the bomb (ATB) and the effect was remarkable among those under age 20 ATB. The risk of rectal cancer was not found to increase significantly with radiation and the distribution of histological types for cancer of either the colon or rectum was unrelated to radiation dose. The effect of A-bomb exposure on the postoperative survival rate for colorectal cancer patients was studied. No difference by radiation dose could be demonstrated. In Japan, the incidence of colorectal cancer, and of colon cancer in particular, has been increasing. Therefore, close attention should be paid to changes occurring in A-bomb survivors. (author)

  4. Nutritional survey of atomic bomb survivors, 1

    International Nuclear Information System (INIS)

    Murakami, Fumiyo; Tanigawa, Junko; Ito, Chikako

    1978-01-01

    136 cases in which mild anemia was recognized but stomach disease was not recognized by the examination for a-bomb survivors, were investigated concerning living conditions, the habit of food, and the intake amount of nutrition, and the following results were obtained. 1. The mean intake amount of nutritive substances in a-bomb survivors almost reached the level as compared to the necessary amount of nutritive substances in control. 2. Shortage in intake of protein and iron which seemed to be a factor of occurrence of anemia (protein: 50% in men and 19.7% in women, iron: 25% in men and 22.5% in women), much and frequent intake of confectioneries and luxuries, and the rate of going without meal (33.3% of men went without meal one to 6 times a week) were recongized in each case of anemia with high rate. These tendency was marked in men. 3. Anemia was recognized in some of women, although they took all nutritive substances. This seemed to be caused by physiological loss of iron. Accordingly, it was desirable to take an excess amount of iron. (Tsunoda, M.)

  5. Cardiovascular disease among atomic bomb survivors.

    Science.gov (United States)

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

    2017-10-01

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

  6. Love and load--the lived experience of the mother-child relationship among young adult traumatic brain-injured survivors.

    Science.gov (United States)

    Kao, Hsueh-Fen S; Stuifbergen, Alexa K

    2004-04-01

    This study aims to describe the meaning of the experience of the relationship between young adult traumatic brain injury (TBI) survivors and their mothers using a phenomenological approach. Informants included 9 males and 3 females who were at least 2 years post-TBI, and their mothers, who were their primary caregivers after the injury. TBI informants were 18 to 25 years of age, had motor vehicle accident-induced injury, experienced post-traumatic amnesia longer than 24 hours, and were able to participate in a verbal interview. In addition, all informants currently were living with their mothers, who also participated in this study. Survivors acquired the sense of being abnormal from various sources, including social pressures, dynamics within the family, and intrapersonal changes. Mothers adopted both positive and negative actions during the period of uncertainty and often struggled to balance protecting their children and letting them become independent. They also struggled to maintain harmonious relationships with people both inside and outside of the family. Sometimes, survivors' parents marital relationships were at risk. Health professionals should design more appropriate long-term community interventions to help TBI survivors and their families decrease the burden of injury and the resulting stress, increase survivors' self-esteem, and improve quality of life of both survivors and their families, serving as a foundation for further TBI care.

  7. C-C4-02: Improving Survivorship Care for Long-Term Colorectal Cancer Survivors: Key Findings of a 5-Year Study

    Science.gov (United States)

    McMullen, Carmit K; Hornbrook, Mark C; Herrinton, Lisa J; Altschuler, Andrea; Grant, Marcia; Wendel, Christopher; Coons, Stephen Joel; Green, Sylvan B; Mohler, M Jane; Baldwin, Carol M; Ramirez, Michelle; Krouse, Robert S

    2010-01-01

    Aims: Understand the determinants of health related quality of life (HRQOL) and the lived experiences among colorectal cancer (CRC) survivors, and identify strategies to help maintain or enhance CRC survivors’ HRQOL. Methods: Mail survey and focus groups. Subjects were 283 ostomy and 392 anastomosis long-term CRC survivors within an HMO. Focus groups for subjects with ostomy were divided by gender and high and low HRQOL. Outcome measures were the modified City of Hope Quality of Life (mCOH-QOL)-Ostomy (abridged for anastomosis) and SF-36v2 questionnaires. The SF-6D scoring algorithm was used to calculate an overall HRQOL score from SF-36v2 data. Focus groups were conducted to explore ostomy-related barriers to effective self-care and adaptation strategies. Results: CRC survivors with an ostomy experienced multiple persistent HRQOL losses that differ between men and women. Women CRC survivors with ostomies, for example, reported more sleep disruption and fatigue than men. Living with an ostomy, co-morbidities, socioeconomic status, self-reported depression, and employment status were independent predictors of SF-6D scores. Among CRC survivors with ostomy, fistulas had important implications for HRQOL. Psychological wellbeing among CRC survivors was positively associated with income. Intestinal stomas significantly influenced spiritual HRQOL. Provision or withdrawal of a partners’ support affected both short- and long-term psychosocial adjustment of female CRC ostomy patients. Focus group participants identified dietary changes to control bowel output and odor, demands of coping and adjustment, and the time it took to accept the reality of daily living with an ostomy as significant challenges. Conclusions: The greatest challenges reported by CRC survivors confirmed the IOMs findings that survivorship is a distinct, chronic phase of cancer care, and that cancer effects are broad and pervasive. CRC survivors could benefit from dietary and behavioral interventions

  8. Dietary patterns differ between urban and rural older, long-term survivors of breast, prostate, and colorectal cancer and are associated with body mass index.

    Science.gov (United States)

    Miller, Paige E; Morey, Miriam C; Hartman, Terry J; Snyder, Denise C; Sloane, Richard; Cohen, Harvey Jay; Demark-Wahnefried, Wendy

    2012-06-01

    Older adult cancer survivors are at greater risk of cancer recurrence and other comorbidities that can be prevented through improved diet and weight management. The tertiary prevention needs of rural-dwelling survivors can be even greater, yet little is known about rural and urban differences in lifestyle factors among this high-risk population. To compare dietary patterns of urban and rural cancer survivors and to examine associations of dietary patterns with body mass index (BMI). A secondary analysis was performed of baseline data from the Reach Out to Enhance Wellness (RENEW) trial, a diet and exercise intervention among overweight, long-term (≥5 years), older survivors of colorectal, breast, and prostate cancer. Survivors in the present analysis (n=729) underwent two 45- to 60-minute telephone surveys, which included two 24-hour dietary recalls. Principal components analysis and multivariable general linear models were used to derive dietary patterns and to evaluate associations between dietary patterns and BMI, respectively. Principal components analysis identified three primary dietary patterns among rural dwellers (high sweets and starches, high reduced-fat dairy, cereal, nuts, and fruits, and mixed) and three among urban dwellers (high fruits and vegetables, high meat and refined grains, and high sugar-sweetened beverages). Among rural survivors, greater adherence to the high reduced-fat dairy, cereal, nuts, and fruits pattern was positively associated with lower BMI (P trend pattern was associated with greater BMI (P trend pattern among urban survivors was inversely associated with BMI (P trend dietary intake behavior should be considered in designing public health interventions among the increasing population of older cancer survivors. In addition, targeting overall dietary patterns might be one approach to help reduce the burden of obesity among this population. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All

  9. Implementation of a National Semen Testing and Counseling Program for Male Ebola Survivors - Liberia, 2015-2016.

    Science.gov (United States)

    Purpura, Lawrence J; Soka, Moses; Baller, April; White, Stephen; Rogers, Emerson; Choi, Mary J; Mahmoud, Nuha; Wasunna, Christine; Massaquoi, Moses; Vanderende, Kristin; Kollie, Jomah; Dweh, Straker; Bemah, Philip; Christie, Athalia; Ladele, Victor; Subah, Onyekachi; Pillai, Satish; Mugisha, Margaret; Kpaka, Jonathan; Nichol, Stuart; Ströher, Ute; Abad, Neetu; Mettee-Zarecki, Shauna; Bailey, Jeff A; Rollin, Pierre; Marston, Barbara; Nyenswah, Tolbert; Gasasira, Alex; Knust, Barbara; Williams, Desmond

    2016-09-16

    According to World Health Organization (WHO) data, the Ebola virus disease (Ebola) outbreak that began in West Africa in 2014 has resulted in 28,603 cases and 11,301 deaths (1). In March 2015, epidemiologic investigation and genetic sequencing in Liberia implicated sexual transmission from a male Ebola survivor, with Ebola virus detected by reverse transcription-polymerase chain reaction (RT-PCR) 199 days after symptom onset (2,3), far exceeding the 101 days reported from an earlier Ebola outbreak (4). In response, WHO released interim guidelines recommending that all male survivors, in addition to receiving condoms and sexual risk reduction counseling at discharge from an Ebola treatment unit (ETU), be offered semen testing for Ebola virus RNA by RT-PCR 3 months after disease onset, and every month thereafter until two consecutive semen specimens collected at least 1 week apart test negative for Ebola virus RNA (5). Male Ebola survivors should also receive counseling to promote safe sexual practices until their semen twice tests negative. When these recommendations were released, testing of semen was not widely available in Liberia. Challenges in establishing and operating the first nationwide semen testing and counseling program for male Ebola survivors included securing sufficient resources for the program, managing a public health semen testing program in the context of ongoing research studies that were also collecting and screening semen, identification of adequate numbers of trained counselors and appropriate health communication messages for the program, overcoming Ebola survivor-associated stigma, identification and recruitment of male Ebola survivors, and operation of mobile teams.

  10. Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

    International Nuclear Information System (INIS)

    Dijk, Irma W.E.M. van; Cardous-Ubbink, Mathilde C.; Pal, Helena J.H. van der; Heinen, Richard C.; Leeuwen, Flora E. van; Oldenburger, Foppe; Os, Rob M. van; Ronckers, Cécile M.; Schouten–van Meeteren, Antoinette Y.N.; Caron, Huib N.; Koning, Caro C.E.; Kremer, Leontien C.M.

    2013-01-01

    Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD 2 ). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 years after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD 2 in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD 2 , we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD 2 instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience

  11. Can the theory of planned behavior help explain attendance to follow-up care of childhood cancer survivors?

    Science.gov (United States)

    Baenziger, Julia; Roser, Katharina; Mader, Luzius; Christen, Salome; Kuehni, Claudia E; Gumy-Pause, Fabienne; Tinner, Eva Maria; Michel, Gisela

    2018-06-01

    Childhood cancer survivors are at high risk for late effects. Regular attendance to long-term follow-up care is recommended and helps monitoring survivors' health. Using the theory of planned behavior, we aimed to (1) investigate the predictors of the intention to attend follow-up care, and (2) examine the associations between perceived control and behavioral intention with actual follow-up care attendance in Swiss childhood cancer survivors. We conducted a questionnaire survey in Swiss childhood cancer survivors (diagnosed with cancer aged theory of planned behavior-related predictors (attitude, subjective norm, perceived control), intention to attend follow-up care, and actual attendance. We applied structural equation modeling to investigate predictors of intention, and logistic regression models to study the association between intention and actual attendance. Of 299 responders (166 [55.5%] females), 145 (48.5%) reported attending follow-up care. We found that subjective norm, ie, survivors' perceived social pressure and support (coef = 0.90, P < 0.001), predicted the intention to attend follow-up; attitude and perceived control did not. Perceived control (OR = 1.58, 95%CI:1.04-2.41) and intention to attend follow-up (OR = 6.43, 95%CI:4.21-9.81) were positively associated with attendance. To increase attendance, an effort should be made to sensitize partners, friends, parents, and health care professionals on their important role in supporting survivors regarding follow-up care. Additionally, interventions promoting personal control over the follow-up attendance might further increase regular attendance. Copyright © 2018 John Wiley & Sons, Ltd.

  12. Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Dijk, Irma W.E.M. van, E-mail: i.w.vandijk@amc.uva.nl [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Cardous-Ubbink, Mathilde C. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Pal, Helena J.H. van der [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Heinen, Richard C. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Leeuwen, Flora E. van [Department of Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Oldenburger, Foppe; Os, Rob M. van [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Ronckers, Cécile M. [Dutch Childhood Oncology Group, Long-term Effects after Childhood Cancer, The Hague (Netherlands); Schouten–van Meeteren, Antoinette Y.N. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Caron, Huib N. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Koning, Caro C.E. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Kremer, Leontien C.M. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands)

    2013-03-01

    Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 years after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD{sub 2} in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD{sub 2}, we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD{sub 2} instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience.

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

    Science.gov (United States)

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

    2014-01-01

    Purpose 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. Methods 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. Results The Children’s Oncology Group oral-dental pan el 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. Addition ally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent ma lignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. Conclusions 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. PMID:24781353

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

    Science.gov (United States)

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

    2017-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Elisabeth Anne-Sophie Mayrhuber

    2017-08-01

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

  16. The effects of extraversion, social support on the posttraumatic stress disorder and posttraumatic growth of adolescent survivors of the Wenchuan earthquake.

    Science.gov (United States)

    Jia, Xuji; Ying, Liuhua; Zhou, Xiao; Wu, Xinchun; Lin, Chongde

    2015-01-01

    The aim of this study was to examine the relationships among extraversion, social support, posttraumatic stress disorder and posttraumatic growth among adolescent survivors of the Wenchuan earthquake. Six hundred thirty-eight participants were selected from the survivors of the 2008 Wenchuan earthquake. Participants completed four main questionnaires, including the Extraversion Subscale, the Social Support Scale, the Child PTSD Symptom Scale, and the Posttraumatic Growth Inventory. A bivariate correlation analysis revealed significant correlations among extraversion, social support, posttraumatic stress disorder and posttraumatic growth. Extraversion had significant indirect effects on posttraumatic stress disorder (β = -.037, p posttraumatic growth (β = .077, p posttraumatic growth and a nonsignificant direct effect on posttraumatic stress disorder. Social support fully mediates the relationship between extraversion and posttraumatic stress disorder and partially mediates the relationship between extraversion and posttraumatic growth. Psychological interventions and care for survivors of the earthquake should include the various functions and sources of social support and how they serve to benefit individuals.

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

    DEFF Research Database (Denmark)

    Bandak, M; Jørgensen, N; Juul, A

    2017-01-01

    of TC survivors has an increased long-term risk of systemic inflammation and metabolic syndrome (MetS) when compared with TC survivors with normal Leydig cell function during follow-up. PATIENTS AND METHODS: TC survivors with Leydig cell dysfunction and a control group of TC survivors with normal Leydig...

  18. Benefits of Java

    Science.gov (United States)

    ... Wellness Preventing Illness Benefits of Coffee Print Email Benefits of Coffee Reviewed by Taylor Wolfram, MS, RDN, ... your daily cup (or three) provides some health benefits as well. Drinking moderate amounts of coffee (including ...

  19. Benefits of quitting tobacco

    Science.gov (United States)

    ... your risk of many serious health problems . THE BENEFITS OF QUITTING You may enjoy the following when ... about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, ...

  20. Health status of atomic bomb survivors in South Korea, 2

    International Nuclear Information System (INIS)

    Ishida, Sadamu; Kawamura, Torataro; Kurihara, Minoru; Watanabe, Masaharu; Cheong, Chang-Saeng.

    1980-01-01

    Investigation was made on 405 A-bomb survivors in Hap Cheon Gun who received health examinations from December 1973 to December 1977. Excepting 16 exposed in Nagasaki, they were exposed in Hiroshima. The distribution of their age at the time of exposure showed its peak at the age between 25 and 29 years, and it decreased before and after that age. The percentage of A-bomb survivors exposed directly was 93.3%, and that of A-bomb survivors exposed within 2 km from the center of explosion was 51.8%. Seventeen A-bomb survivors were exposed within 1 km. Acute disturbances such as loss of hair (over one second loss), tiredness, fever, vomiting on the day of exposure, and diarrhea were found with high incidence, but incidences of lesions in the oral cavity and the pharynx were low. Incidences of burn and bruise were high, but those of wound and injuries were low. Loss of hair, vomiting, hemorrhage, tiredness, and dairrhea appeared with high incidence in A-bomb survivors whose age advanced at the time of exposure. Most of A-bomb survivors who were young at the time of exposure had not these acute disturbances. These acute symptoms appeared frequently in a short-distance group, and burn, wound and injuries, and bruise also appeared frequently in A-bomb survivors exposed within 2 km. (Tsunoda, M.)

  1. Marital status and optimism score among breast cancer survivors.

    Science.gov (United States)

    Croft, Lindsay; Sorkin, John; Gallicchio, Lisa

    2014-11-01

    There are an increasing number of breast cancer survivors, but their psychosocial and supportive care needs are not well-understood. Recent work has found marital status, social support, and optimism to be associated with quality of life, but little research has been conducted to understand how these factors relate to one another. Survey data from 722 breast cancer survivors were analyzed to estimate the association between marital status and optimism score, as measured using the Life Orientation Test-Revised. Linear regression was used to estimate the relationship of marital status and optimism, controlling for potential confounding variables and assessing effect modification. The results showed that the association between marital status and optimism was modified by time since breast cancer diagnosis. Specifically, in those most recently diagnosed (within 5 years), married breast cancer survivors had a 1.50 higher mean optimism score than unmarried survivors (95 % confidence interval (CI) 0.37, 2.62; p = 0.009). The difference in optimism score by marital status was not present more than 5 years from breast cancer diagnosis. Findings suggest that among breast cancer survivors within 5 years since diagnosis, those who are married have higher optimism scores than their unmarried counterparts; this association was not observed among longer-term breast cancer survivors. Future research should examine whether the difference in optimism score among this subgroup of breast cancer survivors is clinically relevant.

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

    Science.gov (United States)

    Ray, Heather; Jakubec, Sonya L

    2014-11-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  4. Sleep disturbances in survivors of the Nazi Holocaust.

    Science.gov (United States)

    Rosen, J; Reynolds, C F; Yeager, A L; Houck, P R; Hurwitz, L F

    1991-01-01

    Sleep disturbances are commonly reported by victims of extraordinary stress and can persist for decades. This study was designed to test the hypothesis that survivors of the Nazi Holocaust would have significantly more and different sleep problems than depressed and healthy comparison subjects and that the severity of the survivors' problems would be correlated with length of time spent in a concentration camp. Forty-two survivors, 37 depressed patients, and 54 healthy subjects of about the same age, all living in the community, described their sleep patterns over the preceding month on the Pittsburgh Sleep Quality Index, a self-rating instrument that inquires about quality, latency, duration, efficiency, and disturbances of sleep, use of sleep medication, and daytime dysfunction. The survivors had significantly greater sleep impairment than the healthy comparison subjects, as measured by all subscales of the index, but had less impairment than the depressed patients except on the sleep disturbances and daytime dysfunction subscales. However, for specific items within these subscales, survivors had significantly more frequent awakenings due to bad dreams and had less loss of enthusiasm than the depressed subjects. Sleep disturbances and frequency of nightmares were significantly and positively correlated with the duration of the survivors' internment in concentration camps. These findings suggest that for some Holocaust survivors, impaired sleep and frequent nightmares are considerable problems even 45 years after liberation.

  5. Mandatory Reporting of Human Trafficking: Potential Benefits and Risks of Harm.

    Science.gov (United States)

    English, Abigail

    2017-01-01

    Human trafficking, including both sex and labor trafficking, has profound consequences for the safety, health, and well-being of victims and survivors. Efforts to address human trafficking through prevention, protection, and prosecution are growing but remain insufficient. Mandatory reporting has the potential to bring victims and survivors to the attention of social service and law enforcement agencies but may discourage trafficked persons from seeking help, thereby limiting the ability of health care professionals to establish trust and provide needed care. States' experience in implementing child abuse laws can be useful in assessing the potential risks and benefits of mandatory reporting of human trafficking. © 2017 American Medical Association. All Rights Reserved.

  6. 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,...

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Science.gov (United States)

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

    2014-09-01

    Cancer SurvivorLink™, www.cancersurvivorlink.org , is a patient-controlled communication tool where survivors can electronically store and share documents with healthcare providers. Functionally, SurvivorLink serves as an electronic personal health record-a record of health-related information managed and controlled by the survivor. Recruitment methods to increase registration and the characteristics of registrants who completed each step of using SurvivorLink are described. Pediatric cancer survivors were recruited via mailings, survivor clinic, and community events. Recruitment method and Aflac Survivor Clinic attendance was determined for each registrant. Registration date, registrant type (parent vs. survivor), zip code, creation of a personal health record in SurvivorLink, storage of documents, and document sharing were measured. Logistic regression was used to determine the characteristics that predicted creation of a health record and storage of documents. To date, 275 survivors/parents have completed registration: 63 were recruited via mailing, 99 from clinic, 56 from community events, and 57 via other methods. Overall, 66.9 % registrants created a personal health record and 45.7 % of those stored a health document. There were no significant predictors for creating a personal health record. Attending a survivor clinic was the strongest predictor of document storage (p document stored, 21.4 % shared with a provider. Having attended survivor clinic is the biggest predictor of registering and using SurvivorLink. Many survivors must advocate for their survivorship care. Survivor Link provides educational material and supports the dissemination of survivor-specific follow-up recommendations to facilitate shared clinical care decision making.

  9. Tobacco Use Among Siblings of Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

    Science.gov (United States)

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

    2015-01-01

    Background Having a brother or sister with childhood cancer may influence health behaviors during adulthood. The aim of this study was to compare tobacco use in siblings of survivors with peers and to identify factors associated with sibling tobacco use. Procedures A retrospective cohort study was conducted using adult siblings (N=1,974) of 5+ year cancer survivors in the Childhood Cancer Survivor Study (CCSS) and participants (N=24,105, weighted to match CCSS) in the 2007 National Health Interview Survey. Self-reported tobacco use, sociodemographic, and cancer-related risk factors were analyzed. Results Siblings were equally likely to have ever smoked compared to their peers, (Odds Ratio [OR] 1.02, 95% Confidence Interval [CI] 0.93–1.12). Siblings were less likely to be current smokers (OR 0.83, 95% CI 0.73–0.94), but more likely to be former smokers (OR 1.21, 95% CI 1.08–1.35). Siblings with low education were more likely to ever smoke (OR 1.51, 95% CI 1.15–2.00) and be current smokers (OR 1.67, 95% CI 1.24–2.26) compared to their peers. Among siblings, risk factors for current tobacco use included: low income Siblings of survivors take up smoking at similar rates to their peers, but are more likely to quit. Efforts are needed to address disparities by providing greater psychosocial support and education for the lowest socio-economic status families facing childhood cancer. PMID:26305712

  10. Novel Retinal Lesion in Ebola Survivors, Sierra Leone, 2016.

    Science.gov (United States)

    Steptoe, Paul J; Scott, Janet T; Baxter, Julia M; Parkes, Craig K; Dwivedi, Rahul; Czanner, Gabriela; Vandy, Matthew J; Momorie, Fayiah; Fornah, Alimamy D; Komba, Patrick; Richards, Jade; Sahr, Foday; Beare, Nicholas A V; Semple, Malcolm G

    2017-07-01

    We conducted a case-control study in Freetown, Sierra Leone, to investigate ocular signs in Ebola virus disease (EVD) survivors. A total of 82 EVD survivors with ocular symptoms and 105 controls from asymptomatic civilian and military personnel and symptomatic eye clinic attendees underwent ophthalmic examination, including widefield retinal imaging. Snellen visual acuity was Ebola virus, permitting cataract surgery. A novel retinal lesion following the anatomic distribution of the optic nerve axons occurred in 14.6% (97.5% CI 7.1%-25.6%) of EVD survivors and no controls, suggesting neuronal transmission as a route of ocular entry.

  11. Radiation dosimetry in Hiroshima and Nagasaki atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Arakawa, E T

    1959-01-01

    This report summarizes the present state of knowledge in dosimetry of the Hiroshima-Nagasaki A-bomb survivors. Data have been presented on the physical factors involved in the two cities and on attenuation of radiation by various shielding situations. This information is being used to estimate a tentative radiation dose to individual A-bomb survivors. It should be emphasized that many important problems remain to be solved before accurate doses can be assigned to individual survivors. Such information will greatly strengthen investigation of biological consequences of instantaneous doses of gamma and neutron irradiation in men. 18 references, 9 figures.

  12. Some aspects of readaptation of atomic survivors in Hiroshima

    International Nuclear Information System (INIS)

    Vasconcelos, L.A.

    1992-01-01

    An overview of some aspects of psycho social readaptation of the atomic bomb survivors in Hiroshima is presented. Reports from 31 survivors, 8 men and 23 women, were used as data for the analysis. The reports were collected individually through a structured interview, in one of the two hospitals in Hiroshima which deliver services to the survivors. The data were grouped according to the following areas: family, work, health and psychological readaptation. These data were analysed considering the psycho social aspects of disasters and the characteristics of the japanese culture. (M.A.C.)

  13. Motivations associated with physical activity in young breast cancer survivors.

    Science.gov (United States)

    Voege, Patricia; Bower, Julienne E; Stanton, Annette L; Ganz, Patricia A

    2015-01-01

    Physical activity is associated with positive health outcomes in breast cancer survivors. However, factors that promote or discourage physical activity in this population are not fully understood. This cross-sectional study was designed to examine approach and avoidance motivations, barriers for exercise, and their association with physical activity in breast cancer survivors younger than 50 years old at time of diagnosis. Current physical activity levels, approach and avoidance motivations, and barriers to exercise were assessed through self-report questionnaires in young breast cancer survivors (N = 156). Results indicated that barriers to exercise were negatively associated with physical activity (p physical activity (p barriers (p physical activity (p = .91).

  14. Interventions for treating persistent pain in survivors of torture

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND: Persistent (chronic) pain is a frequent complaint in survivors of torture, particularly but not exclusively pain in the musculoskeletal system. Torture survivors may have no access to health care; where they do, they may not be recognised when they present, and the care available often...... falls short of their needs. There is a tendency in state and non-governmental organisations' services to focus on mental health, with poor understanding of persistent pain, while survivors may have many other legal, welfare, and social problems that take precedence over health care. OBJECTIVES...

  15. Leukemia incidence in the atomic bomb survivor Life Span Study, 1950 - 87

    International Nuclear Information System (INIS)

    Preston, D.L.; Mabuchi, K.; Kusumi, S.; Izumi, S.

    1992-01-01

    The Radiation Effects Research Foundation (RERF) is currently preparing a series of reports on cancer incidence in the Life Span Study (LSS) cohort of atomic bomb survivors for the period from 1950 to 1987. One of these reports will present analyses of the data on the risk of hematopoietic cancers including leukemia, malignant lymphoma, and multiple myeloma. These analyses add an additional 11 years of follow-up to the previous comprehensive analysis of the LSS leukemia data. In this presentation, these data are presented and the methods being used modeling the leukemia risks are outlined. An analysis of the leukemia data pooled over subtypes will be used to illustrate these methods. It is shown that the data suggest a non-linear, concave upward dose response and that the temporal pattern of the radiation-induced excess absolute risks (EARs) depends on age-at-exposure and sex. There is no evidence of city differences in the EAR in this pooled analysis. The results suggest that the EARs for the youngest survivors were initially much higher and have declined more rapidly than those for older survivors. The same general pattern is seen both sexes, but the initial peak incidence is somewhat lower and the rate of decline less rapid for women than for men. (author)

  16. Human rights of refugee-survivors of sexual and gender-based violence with communication disability.

    Science.gov (United States)

    Marshall, Julie; Barrett, Helen

    2018-02-01

    Article 19 of the Universal Declaration of Human Rights (United Nations, 1948 ) states that all people have the right to seek, receive and impart information using any means. Ensuring that people with communication disability achieve this right is inherently challenging. For people with communication disability, who are refugee-survivors of sexual and gender-based violence (SGBV), additional human rights are challenged, including the right to education, protection from discrimination, a safe place to live, security of person and legal protection. Their experiences and needs, however, are poorly understood. This paper reports on a literature review of the intersectionality between SGBV, being a refugee and having a communication disability, and a preliminary investigation of the situation of refugee-survivors of SGBV with communication disability, in Rwanda. The project involved 54 participants, including 50 humanitarian and partner organisation staff and four carers of refugees with communication disabilities, from two locations (camp-based and urban refugees). Findings from both revealed that, for people with communication disability, barriers are likely to occur at each step of preventing and responding to SGBV. Moreover, stigmatisation of people with communication disability challenges SGBV prevention/support and people with communication disability may be targeted by SGBV perpetrators. SGBV service providers acknowledge their lack of knowledge and skills about communication disability, but wish to learn. Findings highlight the need for increased knowledge and skill development, in order to improve the situation for refugee-survivors of SGBV with communication disability.

  17. Understanding the social and community support networks of American Indian women cancer survivors.

    Science.gov (United States)

    Burnette, Catherine E; Liddell, Jessica; Roh, Soonhee; Lee, Yeon-Shim; Lee, Hee Yun

    2018-04-02

    Cancer is the leading cause of death among American Indian and Alaska Native (AI/AN) women, and although cancer disparities among AI women are alarming, there is little research focused on the topic of social support and cancer treatment and outcomes. A community advisory board was used to develop and administer the project, and a qualitative descriptive study methodology was used. This research was conducted in partnership with two community-based hospitals in the Northern Plains. The sample included 43 AI female cancer survivors who were interviewed with a semi-structured interview guide. The data were analyzed using content analysis. Emergent themes revealed that AI cancer survivors' non-familial support systems included friends (n = 12), support groups (n = 6), churches (n = 10), co-workers (n = 5), communities (n = 4), support from health practitioners (n = 3) and additional forms of support. Results indicate that survivors' networks are diverse, and support broad prevention programs that reach out to churches, community groups, and online forums. These sources of supports can be enhanced through sustainable community-based infrastructures.

  18. Developing a healthy web-based cookbook for pediatric cancer patients and survivors: rationale and methods.

    Science.gov (United States)

    Li, Rhea; Raber, Margaret; Chandra, Joya

    2015-03-31

    Obesity has been a growing problem among children and adolescents in the United States for a number of decades. Childhood cancer survivors (CCS) are more susceptible to the downstream health consequences of obesity such as cardiovascular disease, endocrine issues, and risk of cancer recurrence due to late effects of treatment and suboptimal dietary and physical activity habits. The objective of this study was to document the development of a Web-based cookbook of healthy recipes and nutrition resources to help enable pediatric cancer patients and survivors to lead healthier lifestyles. The Web-based cookbook, named "@TheTable", was created by a committee of researchers, a registered dietitian, patients and family members, a hospital chef, and community advisors and donors. Recipes were collected from several sources including recipe contests and social media. We incorporated advice from current patients, parents, and CCS. Over 400 recipes, searchable by several categories and with accompanying nutritional information, are currently available on the website. In addition to healthy recipes, social media functionality and cooking videos are integrated into the website. The website also features nutrition information resources including nutrition and cooking tip sheets available on several subjects. The "@TheTable" website is a unique resource for promoting healthy lifestyles spanning pediatric oncology prevention, treatment, and survivorship. Through evaluations of the website's current and future use, as well as incorporation into interventions designed to promote energy balance, we will continue to adapt and build this unique resource to serve cancer patients, survivors, and the general public.

  19. Mortality statistics among atomic bomb survivors in Hiroshima Prefecture. 1968-1972

    Energy Technology Data Exchange (ETDEWEB)

    Kurihara, M; Munaka, M; Hayakawa, N; Yamamoto, H; Ueoka, H; Ohtaki, M [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1981-12-01

    In a comparative analysis of mortality among atomic bomb survivors versus the non-exposed, both resident in Hiroshima Prefecture, it was found that in addition to leukaemia, malignant lymphoma, multiple myeloma, and cancers of the thyroid gland, breast, lung, esophagus, stomach, urinary organs and salivary gland which have been reported from the past to be elevated in risk among atomic bomb survivors, cancers of the colon, larynx, accessory sinuses, uterus, ovary and testis, diseases of the blood, cirrhosis of liver, hypertensive disease and diabetes mellitus were elevated in risk, but the risk of cerebrovascular disease, heart disease, peptic ulcer, gastroenteritis, senility, and accidents was lower than the non-exposed. The relationship of atomic bomb exposure to the relative risk of cancers of the lung, breast, uterus, and testis could be readily explained, but the relationship between atomic bomb exposure and the relative risk of cancers of many other sites, diseases of the blood, and other causes of death was inconsistent. One of the reasons why the risk of senility was low and the risk of diseases of the blood, malignant neoplasms, diabetes mellitus, and hypertensive disease was high is considered to be the higher diagnostic accuracy in atomic bomb survivors.

  20. Web-based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial.

    Science.gov (United States)

    Mihuta, Mary E; Green, Heather J; Shum, David H K

    2018-04-01

    Cognitive dysfunction associated with cancer is frequently reported and can reduce quality of life. This study evaluated a Web-based cognitive rehabilitation therapy program (eReCog) in cancer survivors compared with a waitlist control group. Adult cancer survivors with self-reported cognitive symptoms who had completed primary treatment at least 6 months prior were recruited. Participants completed telephone screening and were randomly allocated to the 4-week online intervention or waitlist. Primary outcome was perceived cognitive impairment assessed with the Functional Assessment of Cancer Therapy-Cognitive Function version 3. Secondary outcomes were additional measures of subjective cognitive functioning, objective cognitive functioning, and psychosocial variables. Seventy-six women were allocated to the intervention (n = 40) or waitlist (n = 36). A significant interaction was found on the instrumental activities of daily living measure of self-reported prospective memory whereby the intervention group reported a greater reduction in prospective memory failures than the waitlist group. Interaction trends were noted on perceived cognitive impairments (P = .089) and executive functioning (P = .074). No significant interactions were observed on other measures of objective cognitive functioning or psychosocial variables. The Web-based intervention shows promise for improving self-reported cognitive functioning in adult cancer survivors. Further research is warranted to better understand the mechanisms by which the intervention might contribute to improved self-reported cognition. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Male infertility in long-term survivors of pediatric cancer: a report from the childhood cancer survivor study.

    Science.gov (United States)

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

    2014-09-01

    The purpose of this study was to assess the prevalence of male infertility and treatment-related risk factors in childhood cancer survivors. Within the Childhood Cancer Survivor Study, 1,622 survivors and 274 siblings completed the Male Health Questionnaire. The analysis was restricted to survivors (938/1,622; 57.8 %) and siblings (174/274; 63.5 %) who tried to become pregnant. Relative risks (RR) and 95 % confidence intervals (CI) for the prevalence of self-reported infertility were calculated using generalized linear models for demographic variables and treatment-related factors to account for correlation among survivors and siblings of the same family. All statistical tests were two-sided. Among those who provided self-report data, the prevalence of infertility was 46.0 % in survivors versus 17.5 % in siblings (RR = 2.64, 95 % CI 1.88-3.70, p infertility, 37 % had reported at least one pregnancy with a female partner that resulted in a live birth. In a multivariable analysis, risk factors for infertility included an alkylating agent dose (AAD) score ≥3 (RR = 2.13, 95 % CI 1.69-2.68 for AAD ≥3 versus AAD infertility father their own children, suggesting episodes of both fertility and infertility. This and the novel association of infertility with bleomycin warrant further investigation. Though infertility is common, male survivors reporting infertility often father their own children. Bleomycin may pose some fertility risk.

  2. A systematic review of sexual concerns reported by gynecological cancer survivors.

    Science.gov (United States)

    Abbott-Anderson, Kristen; Kwekkeboom, Kristine L

    2012-03-01

    To identify physical, psychological and social sexual concerns reported by gynecological (GYN) cancer survivors. A systematic review of the literature was conducted using CINAHL, PubMed and PsycInfo databases. Reference lists from articles provided additional relevant literature. Only research articles from peer-reviewed journals were included. A total of 37 articles were located; 34 explored women's sexual concerns following gynecological cancer diagnosis and treatment and 3 tested interventions for sexual concerns in women with gynecological cancer. Sexual concerns were identified across all dimensions of sexuality. Common concerns in the physical dimension were dyspareunia, changes in the vagina, and decreased sexual activity. In the psychological dimension, common concerns were decreased libido, alterations in body image, and anxiety related to sexual performance. And in the social dimension, common concerns were difficulty maintaining previous sexual roles, emotional distancing from the partner, and perceived change in the partner's level of sexual interest. Of the three psychoeducational intervention studies, two reported improvements in physical aspects of sexual function, and one reported improved knowledge, but without resolution of sexual concerns. Gynecological cancer survivors experience a broad range of sexual concerns after diagnosis and treatment, but the majority of studies emphasized physical aspects of sexuality, and may not adequately represent women's psychological and social sexual concerns. Health care providers should remain mindful of psychological and social sexual concerns when caring for gynecologic cancer survivors. Future research should systematically evaluate the full range of sexual concerns in large, representative samples of GYN cancer survivors and develop and test interventions to address those concerns. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Japanese Legacy Cohorts: The Life Span Study Atomic Bomb Survivor Cohort and Survivors’ Offspring

    Directory of Open Access Journals (Sweden)

    Kotaro Ozasa

    2018-04-01

    Full Text Available Cohorts of atomic bomb survivors—including those exposed in utero—and children conceived after parental exposure were established to investigate late health effects of atomic bomb radiation and its transgenerational effects by the Atomic Bomb Casualty Commission (ABCC in the 1950s. ABCC was reorganized to the Radiation Effects Research Foundation (RERF in 1975, and all work has been continued at RERF. The Life Span Study, the cohort of survivors, consists of about 120,000 subjects and has been followed since 1950. Cohorts of in utero survivors and the survivors’ children include about 3,600 and 77,000 subjects, respectively, and have been followed since 1945. Atomic bomb radiation dose was estimated for each subject based on location at the time of the bombing and shielding conditions from exposure, which were obtained through enormous efforts of investigators and cooperation of subjects. Outcomes include vital status, cause of death, and cancer incidence. In addition, sub-cohorts of these three cohorts were constructed to examine clinical features of late health effects, and the subjects have been invited to periodic health examinations at clinics of ABCC and RERF. They were also asked to donate biosamples for biomedical investigations. Epidemiological studies have observed increased radiation risks for malignant diseases among survivors, including those exposed in utero, and possible risks for some non-cancer diseases. In children of survivors, no increased risks due to parental exposure to radiation have been observed for malignancies or other diseases, but investigations are continuing, as these cohorts are still relatively young.

  4. Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care.

    Science.gov (United States)

    Lopez-Class, Maria; Perret-Gentil, Monique; Kreling, Barbara; Caicedo, Larisa; Mandelblatt, Jeanne; Graves, Kristi D

    2011-12-01

    Breast cancer is the most common cancer among Latinas. This study examined social, cultural, and health care system factors that impact the quality of life and survivorship experiences of Latina immigrant breast cancer survivors. We interviewed Latina breast cancer survivors (n = 19) and, based on the interview findings, conducted two focus groups (n = 9). Research staff translated transcripts from Spanish into English. Two trained raters reviewed the content and identified themes. Thematic content analysis was used to categorize and organize data. Participants were largely monolingual in Spanish, predominantly from Central and South America and most (68%) had lived in the U.S. for ten or more years. All women were diagnosed and treated in the U.S. and were an average of 3.1 years from diagnosis. Women's survivorship experiences appeared to be shaped by cultural beliefs and experiences as immigrants such as secrecy/shame about a breast cancer diagnosis, feelings of isolation, importance of family support (familism), challenges with developing social relationships in the U.S. (less personalismo), and, for some, their partner's difficulty with showing emotional support (machismo). Navigating the U.S. medical system and language barriers were additional challenges in the participants' health care interactions. Latina breast cancer survivors adhere to certain cultural values and face unique issues as immigrants, potentially influencing overall quality of life and doctor-patient communication. Efforts to improve Latina immigrant breast cancer survivors' quality of life could include increased assessment of psychosocial functioning and referral to social support services, culturally sensitive navigation programs, and consistent use of appropriately trained interpreters.

  5. Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study.

    Science.gov (United States)

    Williams, Faustine; Jeanetta, Stephen C

    2016-06-01

    The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond. To understand the lived experiences of women who are breast cancer survivors. A purposive sampling strategy was used to recruit participants from two Missouri cancer centres. A total of 15 women breast cancer survivors were interviewed. Three major themes emerged that described the lived experiences of the women. These were factors from the diagnosis and treatment management impacting survivorship, relationship and support system and implication of survivorship. Participants noted that coping with the diagnosis and treatment was a stressful journey and required lots of adjustment and changes. Some developed various techniques such as journaling their activities which provided comfort. In addition, support from family was shared as the key which gave them strength and courage through the different stages of treatment. However, they found it difficult to articulate what survivorship meant. Using in-depth interview techniques, this study shed light on the experiences of women who were diagnosed with breast cancer and have completed treatment. They acknowledged frustration with their diagnosis and body changes. Support received from family and friends helped them cope through their treatment. However, they felt abandoned once the treatment phase was over and were uncertain what survivorhood meant to them. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.