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Sample records for survivors respond poorly

  1. Testosterone for Poor Ovarian Responders

    DEFF Research Database (Denmark)

    Polyzos, Nikolaos P; Davis, Susan R; Drakopoulos, Panagiotis

    2016-01-01

    Testosterone, an androgen that directly binds to the androgen receptor, has been shown in previous small randomized controlled trials to increase the reproductive outcomes of poor ovarian responders. In most of these studies, transdermal testosterone in relatively high doses was administered before...... ovarian stimulation with a duration varying from 5 to 21 days. Nevertheless, the key question to be asked is whether, based on ovarian physiology and testosterone pharmacokinetics, a short course of testosterone administration of more than 10 mg could be expected to have any beneficial effect...... on reproductive outcome. The rationale for asking this question lies in the existing scientific evidence derived from basic research and animal studies regarding the action of androgens during folliculogenesis, showing that their main effect in follicular development is defined during the earlier developmental...

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

    Science.gov (United States)

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

    2017-04-01

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

  3. Mid-luteal estradiol levels of poor/good responders and intracytoplasmic sperm injection.

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    Rehman, Rehana; Tariq, Sundus; Tariq, Saba; Hashmi, Faisal; Baig, Mukhtiar

    2017-01-01

    To assess mid-luteal estradiol (E2) levels in poor and good responders and determine its effect on the outcome after intracytoplasmic sperm injection (ICSI). The current study was carried out in females who underwent ICSI from June 2011 to September 2013 in "Islamabad Clinic Serving Infertile Couples". They were categorized into good and poor responders on the basis of female age ≤40 years, basal follicle stimulating hormone ≤12 mIU/ml, and antral follicle count >5, respectively. Their mid-luteal E2 measured on the day of embryo transfer was stratified into groups (A-E) on the basis of 20th, 40th, 60th and 80th percentile values. The outcome was categorized into non-pregnant with beta human chorionic Gonadotrophin (hCG) 5-25 m IU/ml, and clinical pregnancy with beta hCG>25 m IU/ml. The conception rate was 12% (63/513) in poor responders and 72% (237/329) in good responders respectively. The mid-luteal E2 levels were higher in conception as compared to non-conception cycles (pgood and poor responders. Maximum pregnancies in poor and good responders (53% and 98% respectively) with mid-luteal E2 levels above 80th percentiles confirm the role of the increase in mid-luteal E2 for augmentation in conception rate of females after ICSI.

  4. Ganirelix for luteolysis in poor responder patients undergoing IVF treatment: a Scandinavian multicenter 'extended pilot study'

    DEFF Research Database (Denmark)

    Nilsson, Lena; Andersen, A.N.; Lindenberg, Svend

    2010-01-01

    To enhance oocyte yield and pregnancy outcome in poor responder women undergoing IVF treatment, daily low dose GnRH antagonist administration was given during the late luteal phase to induce luteolysis and possibly secure a more synchronous cohort of recruitable follicles. An open extended pilot...

  5. Live birth rates in Bologna poor responders treated with ovarian stimulation for IVF/ICSI.

    Science.gov (United States)

    Polyzos, Nikolaos P; Nwoye, Milie; Corona, Roberta; Blockeel, Christophe; Stoop, Dominic; Haentjens, Patrick; Camus, Michel; Tournaye, Herman

    2014-04-01

    This retrospective study determined the efficacy of ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI) in poor ovarian responders fulfilling the Bologna criteria for poor ovarian response and identified predictors of live birth rates. Overall, 485 patients undergoing 823 ovarian stimulation cycles for IVF/ICSI with maximum gonadotrophin dose (≥ 300 IU) between January 2009 and December 2011 were included. Patients were considered eligible, irrespective of the treatment protocol, if they were classified as poor responders based on the recently developed definition for poor ovarian response by the European Society of Human Reproduction and Embryology, the Bologna criteria. Live birth rates did not significantly differ between women aged live births (OR 1.92, 95% CI 1.03-3.55 for >3 versus 1-3 oocytes). Bologna poor responders demonstrate very low live birth rates, irrespective of age and treatment protocol used. An increase in the number of oocytes retrieved is an independent variable related to live birth rates. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. A novel "delayed start" protocol with gonadotropin-releasing hormone antagonist improves outcomes in poor responders.

    Science.gov (United States)

    Cakmak, Hakan; Tran, Nam D; Zamah, A Musa; Cedars, Marcelle I; Rosen, Mitchell P

    2014-05-01

    To investigate whether delaying the start of ovarian stimulation with GnRH antagonist improves ovarian response in poor responders. Retrospective study. Academic medical center. Thirty patients, who responded poorly and did not get pregnant with conventional estrogen priming antagonist IVF protocol. Delayed-start antagonist protocol (estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation). Number of dominant follicles and mature oocytes retrieved, mature oocyte yield, and fertilization rate. The number of patients who met the criteria to proceed to oocyte retrieval was significantly higher in the delayed-start protocol [21/30 (70%)] compared with the previous conventional estrogen priming antagonist cycle [11/30 (36.7%)]. The number of dominant follicles was significantly higher in the delayed-start (4.2 ± 2.7) compared with conventional (2.4 ± 1.3) protocol. In patients who had oocyte retrieval after both protocols (n = 9), the delayed start resulted in shorter ovarian stimulation (9.4 ± 1.4 days vs. 11.1 ± 2.0 days), higher number of mature oocytes retrieved (4.9 ± 2.0 vs. 2.2 ± 1.1), and a trend toward increased fertilization rates with intracytoplasmic sperm injection (ICSI; 86 ± 17% vs. 69 ± 21%) compared with conventional protocol. After delayed start, the average number of embryos transferred was 2.8 ± 1.4 with implantation rate of 9.8% and clinical pregnancy rate of 23.8%. The delayed-start protocol improves ovarian response in poor responders by promoting and synchronizing follicle development without impairing oocyte developmental competence. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Diminished ovarian reserve, premature ovarian failure, poor ovarian responder--a plea for universal definitions.

    Science.gov (United States)

    Cohen, J; Chabbert-Buffet, N; Darai, E

    2015-12-01

    Diminished ovarian reserve (DOR) is characterized by poor fertility outcomes, and it represents a major challenge in reproductive medicine. Although consensus exists on the concept of DOR, its definition remains blurry. DOR has to be distinguished from premature ovarian failure (POF) and poor ovarian responders (POR), who are clearly defined. We performed a PubMed search with the terms "diminished ovarian reserve" and "in vitro fertilization (IVF)" to assess the homogeneity of the definition of DOR. Out of 121 articles, 14 gave a definition for DOR. Only one definition was used by two different teams (basal follicle-stimulating hormone (FSH) value >10 IU/l) and eight teams used 11 different definitions. Among those, four definitions did not include antral follicular count (AFC) and seven studies did. Two definitions included the results from a previous cycle. The heterogeneity in the definition of DOR used in these studies contributes to confusing results. Hence, there is a need for a clear definition of DOR. It appears that AFC and anti-Müllerian hormone (AMH) serum levels are the most relevant criteria. One option could be the use of the following definition: (i) woman with any of the risk factors for POR and/or (ii) an abnormal ovarian reserve test (i.e., antral follicular count (AFC) hypothesis requires validation.

  8. Role of health in predicting moves to poor neighborhoods among Hurricane Katrina survivors.

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    Arcaya, Mariana C; Subramanian, S V; Rhodes, Jean E; Waters, Mary C

    2014-11-18

    In contrast to a large literature investigating neighborhood effects on health, few studies have examined health as a determinant of neighborhood attainment. However, the sorting of individuals into neighborhoods by health status is a substantively important process for multiple policy sectors. We use prospectively collected data on 569 poor, predominantly African American Hurricane Katrina survivors to examine the extent to which health problems predicted subsequent neighborhood poverty. Our outcome of interest was participants' 2009-2010 census tract poverty rate. Participants were coded as having a health problem at baseline (2003-2004) if they self-reported a diagnosis of asthma, high blood pressure, diabetes, high cholesterol, heart problems, or any other physical health problems not listed, or complained of back pain, migraines, or digestive problems at baseline. Although health problems were not associated with neighborhood poverty at baseline, those with baseline health problems ended up living in higher poverty areas by 2009-2010. Differences persisted after adjustment for personal characteristics, baseline neighborhood poverty, hurricane exposure, and residence in the New Orleans metropolitan area, with baseline health problems predicting a 3.4 percentage point higher neighborhood poverty rate (95% confidence interval: 1.41, 5.47). Results suggest that better health was protective against later neighborhood deprivation in a highly mobile, socially vulnerable population. Researchers should consider reciprocal associations between health and neighborhoods when estimating and interpreting neighborhood effects on health. Understanding whether and how poor health impedes poverty deconcentration efforts may help inform programs and policies designed to help low-income families move to--and stay in--higher opportunity neighborhoods.

  9. Prospective study of predictors of poor self-rated health in a 23-year cohort of earthquake survivors in Armenia.

    Science.gov (United States)

    Demirchyan, Anahit; Petrosyan, Varduhi; Armenian, Haroutune K; Khachadourian, Vahe

    2015-09-01

    Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH) - a proven correlate of morbidity and mortality prognosis - was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990-2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23 years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims' health status. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  10. Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study.

    Science.gov (United States)

    La Marca, Antonio; Grisendi, Valentina; Giulini, Simone; Sighinolfi, Giovanna; Tirelli, Alessandra; Argento, Cindy; Re, Claudia; Tagliasacchi, Daniela; Marsella, Tiziana; Sunkara, Sesh Kamal

    2015-06-01

    to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

  11. Corifollitropin alfa followed by rFSH in a GnRH antagonist protocol for poor ovarian responder patients

    DEFF Research Database (Denmark)

    Polyzos, Nikolaos P; Devos, Michel; Humaidan, Peter

    2013-01-01

    OBJECTIVE: To identify whether women with poor ovarian response may benefit from treatment with corifollitropin alfa in a GnRH antagonist protocol. DESIGN: Retrospective pilot study. SETTING: University-based tertiary care center. PATIENT(S): Poor ovarian responders fulfilling the Bologna criteria...... developed by European Society for Human Reproduction and Embryology Consensus Group. INTERVENTION(S): Corifollitropin alfa (150 μg) followed by 300 IU rFSH in a GnRH antagonist protocol. MAIN OUTCOME MEASURE(S): Endocrinologic profile and ongoing pregnancy rates. RESULT(S): Among 43 women treated...... compared with a cohort of patients treated during 2011 with the standard protocol for poor responders in our center (short agonist-hMG) (7% vs. 6.3%). CONCLUSION(S): Treatment of poor ovarian responders, as described by the Bologna criteria, with corifollitropin alfa in a GnRH antagonist protocol results...

  12. Responding to the health needs of survivors of human trafficking: a systematic review.

    Science.gov (United States)

    Hemmings, Stacey; Jakobowitz, Sharon; Abas, Melanie; Bick, Debra; Howard, Louise M; Stanley, Nicky; Zimmerman, Cathy; Oram, Sian

    2016-07-29

    Despite the multiple physical and psychological health consequences associated with human trafficking, there is little evidence-based guidance available for health providers on assessing and meeting the health needs of trafficked people. We aimed to review literature that provided guidance or research on care provision for people who had been trafficked. We conducted a systematic review and qualitative analysis of peer-reviewed and grey literature. Data sources included electronic databases, reference list screening, citation tracking, and expert recommendations. Documents were included if they reported on: 1) male or females (adults or children) who were currently or had previously been trafficked; 2) health interventions or service provision; 3) primary, secondary, tertiary or specialist post-trafficking services; and 4) World Bank high income countries. Two reviewers independently screened and quality appraised documents. Framework analysis was used to analyse extracted data. Forty-four documents were included, 19 of which reported findings of primary studies and nine of which exclusively addressed children. Evidence to inform the identification, referral and care of trafficked people is extremely limited. Within current literature on survivor identification, key indicators included signs of physical and sexual abuse, absence of documentation, and being accompanied by a controlling companion. Findings highlighted the importance of interviewing possible victims in private, using professional interpreters, and building trust. For provision of care, key themes included the importance of comprehensive needs assessments, adhering to principles of trauma-informed care, and cultural sensitivity. Further prominent themes were the necessity of multi-agency working strategies and well-defined referral pathways. Human trafficking survivors require healthcare that is trauma-informed and culturally sensitive to their particular needs. Coordination is needed between health

  13. Bone morphogenetic protein-15 in follicle fluid combined with age may differentiate between successful and unsuccessful poor ovarian responders

    Directory of Open Access Journals (Sweden)

    Wu Yan-Ting

    2012-12-01

    Full Text Available Abstract Background The counselling of poor ovarian responders about the probability of pregnancy remains a puzzle for gynaecologists. The aim of this study was to optimise the management of poor responders by investigating the role of the oocyte-derived factor bone morphogenetic protein-15 (BMP-15 combined with chronological age in the prediction of the outcome of in-vitro fertilisation-embryo transfer (IVF-ET in poor responders. Methods A retrospective study conducted in a university hospital. A total of 207 poor ovarian responders who reached the ovum pick-up stage undergoing IVF/intracytoplasmic sperm injection (ICSI with three or fewer follicles no less than 14 mm on the day of oocyte retrieval were recruited from July 1, 2008 to December 31, 2009. Another 215 coinstantaneous cycles with normal responses were selected as controls. The BMP-15 levels in the follicular fluid (FF of the 207 poor responders were analysed by western blot. Based on the FF BMP-15 level and age, poor responders were sub-divided into four groups. The main outcome measures were the FF BMP-15 level, implantation rate, pregnancy rate, and live birth rate. Results The implantation rate (24.2% vs. 15.3%, chemical pregnancy rate (40% vs. 23.7%, clinical pregnancy rate (36.5% vs. 20.4% and live birth rate (29.4% vs. 15.1% in the high BMP-15 group were significantly higher than those in the low BMP-15 group. Furthermore, poor responders aged less than or equal to 35 years with a higher FF BMP-15 level had the best implantation, pregnancy and live birth rates, which were comparable with those of normal responders. Conclusions Our study suggests a potential role of BMP-15 in the prediction of the IVF outcome. A high FF BMP-15 combined with an age less than or equal to 35 years may be used as a potential indicator for repeating IVF cycles in poor ovarian responders.

  14. Exclusionary health policy: responding to the risk of poor health among sexual minority youth in Canada.

    Science.gov (United States)

    Ylioja, Thomas; Craig, Shelley L

    2014-01-01

    Measuring indicators of health status and demographics are essential in the population health approach. In Canada, sexual minority youth face increased risk for poor health outcomes in behavioral and mental health indicators, yet the health policy response has been severely lacking. The current population health approach exacerbates the social exclusion of a vulnerable, at-risk population. The authors examine health status through the social determinants of health to highlight the need for including sexual identity, attraction, and behavior in youth population health surveys. Additional interventions that address the social determinants of health are needed.

  15. Scratch lottery tickets are a poor incentive to respond to mailed questionnaires

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    Finsen, Vilhjalmur; Storeheier, Andreas H

    2006-01-01

    Background It has been demonstrated that the enclosure of money with a mailed questionnaire increases the response rate significantly. We evaluated scratch lottery tickets as an alternative to cash. Methods 1500 randomly selected Norwegians between the ages of 40 and 65 years were sent a short questionnaire. 250 received one lottery scratch ticket worth 20 Norwegian kroner (approximately 3 US$) together with the questionnaire, 250 received two scratch tickets, and 250 were promised two scratch tickets if they replied within one week. A fourth group of 250 persons received a 50 kroner banknote with the questionnaire. The remaining 500 letters served as controls. Results The overall response rate after 6 weeks was 77%. Logistic regression analysis showed that only the 50 kroner group had a response rate that was statistically significantly higher than the controls (p Lottery scratch tickets are no substitute for cash as an incentive to respond to a questionnaire. PMID:16646970

  16. Scratch lottery tickets are a poor incentive to respond to mailed questionnaires

    Directory of Open Access Journals (Sweden)

    Finsen Vilhjalmur

    2006-04-01

    Full Text Available Abstract Background It has been demonstrated that the enclosure of money with a mailed questionnaire increases the response rate significantly. We evaluated scratch lottery tickets as an alternative to cash. Methods 1500 randomly selected Norwegians between the ages of 40 and 65 years were sent a short questionnaire. 250 received one lottery scratch ticket worth 20 Norwegian kroner (approximately 3 US$ together with the questionnaire, 250 received two scratch tickets, and 250 were promised two scratch tickets if they replied within one week. A fourth group of 250 persons received a 50 kroner banknote with the questionnaire. The remaining 500 letters served as controls. Results The overall response rate after 6 weeks was 77%. Logistic regression analysis showed that only the 50 kroner group had a response rate that was statistically significantly higher than the controls (p Conclusion It is possible that the recipients scratched their cards before completing the questionnaire, and that it was a disincentive for the majority that they did not win anything. Lottery scratch tickets are no substitute for cash as an incentive to respond to a questionnaire.

  17. Poorly differentiated endocrine carcinoma of the pancreas responded to gemcitabine: Case report

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    Nakazuru, Shoichi; Yoshio, Toshiyuki; Suemura, Shigeki; Itoh, Mari; Araki, Manabu; Yoshioka, Chiaki; Ohta, Makiyo; Sueyoshi, Yuka; Ohta, Takashi; Hasegawa, Hiroko; Morita, Kaori; Toyama, Takashi; Kuzushita, Noriyoshi; Kodama, Yoshinori; Mano, Masayuki; Mita, Eiji

    2010-01-01

    Poorly differentiated endocrine carcinoma (PDEC) of the pancreas is a rare and aggressive tumor. First-line treatment is commonly a combination of etoposide and cisplatin, but there is no consensus regarding further treatment recommendations. In this report, we describe a case of pancreatic PDEC treated with gemcitabine as third-line chemotherapy. A 62-year-old man with pancreatic PDEC was administered etoposide plus cisplatin as first-line treatment; he then received irinotecan for tumor relapse. However, because irinotecan induced ileus in this patient, we chose gemcitabine as third-line chemotherapy. After two cycles of gemcitabine (1000 mg/m2 on days 1, 8 and 15 every 4 wk), a partial tumor response was noted by computed tomography (approximately 68% reduction in tumor size). Our patient survived for 15 mo after diagnosis. This is a rare case of unresectable pancreatic PDEC, which showed a partial response to gemcitabine after the failure of two other regimens. Gemcitabine could be an effective treatment option for pancreatic PDEC that is resistant to other treatments. PMID:20698050

  18. What predicts a poor outcome in older stroke survivors? A systematic review of the literature

    NARCIS (Netherlands)

    van Almenkerk, S.; Smalbrugge, M.; Depla, M.F.I.A.; Eefsting, J.A.; Hertogh, C.M.P.M.

    2013-01-01

    Purpose: To identify factors in the early post-stroke period that have a predictive value for a poor outcome, defined as institutionalization or severe disability. Methods: MEDLINE, PSYCINFO, EMBASE and CINAHL were systematically searched for observational cohort studies in which adult and/or

  19. Maternal and neonatal profile of late-preterm survivors in a poorly resourced country.

    Science.gov (United States)

    Olusanya, Bolajoko O; Solanke, Olumuyiwa A

    2012-04-01

    To determine maternal indicators and adverse perinatal outcomes among late-preterm infants during birth hospitalization in a low-income country. Cross-sectional study of late-preterm and term survivors in a tertiary maternity hospital in southwest Nigeria using multivariable logistic regression analysis and population attributable risk (PAR) percentage. Adjusted odds ratios (OR) and 95% confidence intervals (CI) of significant factors are stated. Of 4176 infants enrolled, 731 (17.5%) were late preterm and 3445 (82.5%) were full-term. Late-preterm delivery was independently associated with mothers who were unmarried (OR: 1.71, CI: 1.06-2.75), lacked formal education (OR: 1.75, CI: 1.06-2.89), human immunodeficiency virus positive (OR: 1.61, CI: 1.17-2.20), with hypertensive disorders (OR: 3.07, CI: 2.32-4.08), antepartum hemorrhage (OR: 3.66, CI: 1.97-6.84), and were unlikely to have induced labor (OR: 0.010, CI: 0.01-0.69). Hypertensive disorders and antepartum hemorrhage had a combined PAR of 48.4%. Infants born late preterm were more likely to have low 5-min Apgar scores (OR: 1.70, CI: 1.01-2.83), sepsis (OR: 1.62, CI: 1.05-2.50), hyperbilirubinemia (OR: 1.56, CI: 1.05-2.33), admission into special care baby unit (OR: 1.85, CI: 1.38-2.48), and nonexclusive breast-feeding (OR: 1.49, CI: 1.49, CI: 1.18-1.89). These findings suggest that late-preterm infants in low-resource settings are at risk of severe morbidity and suboptimal feeding. Education and close monitoring of high-risk mothers are warranted to prevent avoidable late-preterm delivery and facilitate the proactive management of unavoidable late-preterm births.

  20. Physical inactivity and risk of poor quality of life among elderly cancer survivors compared to women without cancer: the Iowa Women's Health Study.

    Science.gov (United States)

    Blair, Cindy K; Robien, Kim; Inoue-Choi, Maki; Rahn, Wendy; Lazovich, DeAnn

    2016-02-01

    Few studies have examined lifestyle factors and quality of life (QOL) in cancer survivors compared to a cancer-free group. Compared to active cancer-free women, we examined the association between physical inactivity and QOL in elderly cancer survivors and similar-aged women without cancer. Participants included 1776 cancer survivors and 12,599 cancer-free women enrolled in the Iowa Women's Health Study in 1986 who completed the SF36 QOL assessment in 2004 (ages 73-88 years). The odds of poor QOL were computed for each SF36 subscale (>0.5 SD below mean score of cancer-free women) associated with physical inactivity (moderate-vigorous activity cancer history (no/yes) and physical inactivity (no/yes) (referent group = active cancer-free women). Compared with the referent group, inactive cancer survivors were significantly more likely to report poor QOL for each SF36 subscale (odds ratios 1.8 to 4.7), independent of age, comorbidity, body mass index (BMI), and diet quality. The greatest odds for poor QOL occurred for general health, vitality, and physical function. These increased odds occurred regardless of whether survivors were inactive at both baseline (1986) and follow-up or became inactive sometime after baseline. Among physically active women, cancer survivors had similar QOL as cancer-free women. These findings provide evidence on the importance of leisure-time physical activity in older women and support the need for interventions to help older women maintain or regain a physically active lifestyle. Survivors who remain or become physically active as they age report better mental and physical QOL.

  1. Do poor-responder patients benefit from increasing the daily gonadotropin dose during controlled ovarian hyperstimulation for IVF?

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    Haas, Jigal; Zilberberg, Eran; Machtinger, Ronit; Kedem, Alon; Hourvitz, Ariel; Orvieto, Raoul

    2015-01-01

    We aim to assess the in vitro fertilization-embryo transfer (IVF-ET) outcome in patients receiving an extremely high 450 daily dose (IU) of gonadotropins during controlled ovarian hyperstimulation (COH) for IVF. Moreover, in those who failed to conceive while using 450 daily dose (IU) of gonadotropins, we aim to evaluate whether increasing the daily dose gonadotropins to 600 IU will improve IVF outcome. All consecutive women, admitted to our IVF unit and underwent COH consisting of daily gonadotropin dose of 450 IU were included. Ovarian stimulation characteristics, number of oocytes retrieved, number of embryo transferred and pregnancy rate were assessed. Nine-hundred one consecutive IVF cycles were evaluated. While there was no between-group difference in the duration of COH, patients who conceived were significantly younger, yielded higher number of oocytes retrieved and embryos transferred and had significantly lower cancellations. In a sub-analysis, including only those patients who failed to conceive while using 450 daily dose (IU) of gonadotropins, and who underwent a subsequent IVF cycle attempt with the used of 600 IU daily dose of gonadotropins, no improvements in COH characteristics or cancellation rates were observed with increasing the daily gonadotropin dose to 600 IU. To conclude, in poor responders undergoing COH with an extremely high daily gonadotropin dose (450 IU), the most important factors that predict IVF success are female age and the number of oocytes retrieved. Moreover, patients who failed to conceive on a daily gonadotropin dose of 450 IU will not benefit from increasing the dose to 600 IU and should therefore consider the options of egg donation or adoption.

  2. A multimodal examination of emotional responding to a trauma-relevant film among traumatic motor vehicle accident survivors.

    Science.gov (United States)

    Bujarski, Sarah J; Craig, James T; Zielinski, Melissa J; Badour, Christal L; Feldner, Matthew T

    2015-04-01

    The Facial Action Coding System (Ekman & Friesen) has shown promise as a behavioral measure of emotional experience. The current study examined the degree of (de)synchrony between self-reported and facial expressions of fear, disgust, and sadness in response to a traumatic event-relevant film among individuals who had experienced a traumatic motor vehicle accident. Given high rates of comorbidity between posttraumatic stress symptoms (PTSS) and depressive symptoms, the potential impacts of both PTSS and depressive symptoms on emotional responding were examined. Results demonstrated synchrony between self-reported and facial expressions of disgust and sadness; however, no association between measures of fear was observed. Furthermore, depressive symptoms were associated with greater fear responding and PTSS were associated only with self-reported fear. Together, results support the importance of examining discrete negative emotions, rather than broad valence categories, when examining fear-based responding in traumatic event-exposed populations. Additional research examining the psychometric properties of the Facial Action Coding System as a measure of discrete emotional experiences among traumatic event-exposed individuals is needed to advance multimodal assessment approaches that yield incremental information for understanding emotional responding in this population. © The Author(s) 2014.

  3. Cycle cancellation and pregnancy after luteal estradiol priming in women defined as poor responders: a systematic review and meta-analysis.

    Science.gov (United States)

    Reynolds, Kasey A; Omurtag, Kenan R; Jimenez, Patricia T; Rhee, Julie S; Tuuli, Method G; Jungheim, Emily S

    2013-11-01

    Does a luteal estradiol (LE) stimulation protocol improve outcomes in poor responders to IVF? LE priming is associated with decreased cycle cancellation and increased chance of clinical pregnancy in poor responders Poor responders to IVF are one of the most challenging patient populations to treat. Many standard protocols currently exist for stimulating these patients but all have failed to improve outcomes. Systematic review and meta-analysis including eight published studies comparing assisted reproduction technology (ART) outcomes in poor responders exposed to controlled ovarian hyperstimulation with and without LE priming. A search of the databases MEDLINE, EMBASE and PUBMED was carried out for studies in the English language published up to January 2012. Studies evaluating women defined as poor responders to ART were evaluated. These studies were identified following a systematic review of the literature and data were analyzed using the DerSimonian-Laird random effects model. The main outcomes of interest were cycle cancellation rate and clinical pregnancy. Although the definition of clinical pregnancy varied between studies, the principal definition included fetal cardiac activity as assessed by transvaginal ultrasonography after 5 weeks of gestation. A total of 2249 publications were identified from the initial search, and the bibliographies, abstracts and other sources yielded 11 more. After excluding duplications, 1227 studies remained and 8 ultimately met the inclusion criteria. Compared with women undergoing non-LE primed protocols (n = 621), women exposed to LE priming (n = 468) had a lower risk of cycle cancellation [relative risk (RR): 0.60, 95% confidence interval (CI): 0.45-0.78] and an improved chance of clinical pregnancy (RR: 1.33, 95% CI: 1.02-1.72). There was no significant improvement in the number of mature oocytes obtained or number of zygotes obtained per cycle. These findings are limited by the body of literature currently available. As

  4. Pregnancy outcome of “delayed start” GnRH antagonist protocol versus GnRH antagonist protocol in poor responders: A clinical trial study

    Directory of Open Access Journals (Sweden)

    Abbas Aflatoonian

    2017-08-01

    Full Text Available Background: Management of poor-responding patients is still major challenge in assisted reproductive techniques (ART. Delayed-start GnRH antagonist protocol is recommended to these patients, but little is known in this regards. Objective: The goal of this study was assessment of delayed-start GnRH antagonist protocol in poor responders, and in vitro fertilization (IVF outcomes. Materials and Methods: This randomized clinical trial included sixty infertile women with Bologna criteria for ovarian poor responders who were candidate for IVF. In case group (n=30, delayed-start GnRH antagonist protocol administered estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation with gonadotropin. Control group (n=30 treated with estrogen priming antagonist protocol. Finally, endometrial thickness, the rates of oocytes maturation, , embryo formation, and pregnancy were compared between two groups. Results: Rates of implantation, chemical, clinical, and ongoing pregnancy in delayed-start cycles were higher although was not statistically significant. Endometrial thickness was significantly higher in case group. There were no statistically significant differences in the rates of oocyte maturation, embryo formation, and IVF outcomes between two groups. Conclusion: There is no significant difference between delayed-start GnRH antagonist protocol versus GnRH antagonist protocol.

  5. Live birth rates after modified natural cycle compared with high-dose FSH stimulation using GnRH antagonists in poor responders.

    Science.gov (United States)

    Lainas, Trifon G; Sfontouris, Ioannis A; Venetis, Christos A; Lainas, George T; Zorzovilis, Ioannis Z; Tarlatzis, Basil C; Kolibianakis, Efstratios M

    2015-10-01

    Do live birth rates differ between modified natural cycles (MNCs) and cycles using high-dose follicle stimulating hormone (HDFSH) with gonadotrophin-releasing hormone (GnRH) antagonist in poor responder patients? Live birth rates are significantly higher in MNC compared with HDFSH GnRH antagonist cycles in poor responder patients. Previous data on the efficiency of MNC in poor responders are very limited and suggest that MNC in vitro fertilization (IVF) does not offer a realistic solution for parenthood in these patients, since live birth rates are disappointingly low. To date, no studies exist comparing MNC with HDFSH stimulation protocols in poor responders. The present retrospective study included 161 MNCs (106 women in the MNC group) and 164 HDFSH antagonist cycles (136 women in the HDFSH group) performed between January 2008 and December 2013 at Eugonia Assisted Reproduction Unit. The patients included in the study had to fulfill the Bologna criteria for the definition of poor ovarian response. Irrespective of their age, poor responder patients should have a diminished ovarian reserve as shown by low antral follicle count (≤5) and increased basal FSH (>12 IU/l), and one or more previous failed IVF cycles in which ≤3 oocytes were retrieved using a high gonadotrophin dose. Analysis was performed by adjusting for the non-independence of the data. The probability of live birth was significantly higher in the MNC when compared with the HDFSH group (OR: 4.01, 95% CI: 1.14-14.09), after adjusting for basal FSH, female age and cause of infertility, variables which were shown to be associated with the probability of live birth in univariable analysis. MNCs were characterized by significantly lower total gonadotrophin dose (490.0 ± 35.2 IU versus 2826.1 ± 93.4 IU, P live birth in poor responder patients who fulfill the Bologna criteria. However, MNC-IVF is a more patient-friendly approach, with a higher probability of live birth compared with the HDFSH antagonist

  6. Efficacy and safety of follitropin alfa/lutropin alfa in ART: a randomized controlled trial in poor ovarian responders.

    Science.gov (United States)

    Humaidan, P; Chin, W; Rogoff, D; D'Hooghe, T; Longobardi, S; Hubbard, J; Schertz, J

    2017-03-01

    How does the efficacy and safety of a fixed-ratio combination of recombinant human FSH plus recombinant human LH (follitropin alfa plus lutropin alfa; r-hFSH/r-hLH) compare with that of r-hFSH monotherapy for controlled ovarian stimulation (COS) in patients with poor ovarian response (POR)? The primary and secondary efficacy endpoints were comparable between treatment groups and the safety profile of both treatment regimens was favourable. Although meta-analyses of clinical trials have suggested some beneficial effect on reproductive outcomes with r-hLH supplementation in patients with POR, the definitions of POR were heterogeneous and limit the comparability across studies. Phase III, single-blind, active-comparator, randomized, parallel-group clinical trial. Patients were followed for a single ART cycle. A total of 939 women were randomized (1:1) to receive either r-hFSH/r-hLH or r-hFSH. Randomization, stratified by study site and participant age, was conducted via an interactive voice response system. Women classified as having POR, based on criteria incorporating the ESHRE Bologna criteria, were down-regulated with a long GnRH agonist protocol and following successful down-regulation were randomized (1:1) to COS with r-hFSH/r-hLH or r-hFSH alone. The primary efficacy endpoint was the number of oocytes retrieved following COS. Safety endpoints included the incidence of adverse events, including ovarian hyperstimulation syndrome (OHSS). Post hoc analyses investigated safety outcomes and correlations between live birth and baseline characteristics (age and number of oocytes retrieved in previous ART treatment cycles or serum anti-Müllerian hormone (AMH)). The significance of the treatment effect was tested by generalized linear models (Poisson regression for counts and logistic regression for binary endpoints) adjusting for age and country. Of 949 subjects achieving down-regulation, 939 were randomized to r-hFSH/r-hLH (n = 477) or r-hFSH (n = 462) and received

  7. Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study.

    Science.gov (United States)

    Wiser, A; Gonen, O; Ghetler, Y; Shavit, T; Berkovitz, A; Shulman, A

    2010-10-01

    The aim of this study was to evaluate the effect of dehydroepiandrosterone (DHEA) supplementation on in vitro fertilization (IVF) data and outcomes among poor-responder patients. A randomized, prospective, controlled study was conducted. All patients received the long-protocol IVF. Those in the study group received 75 mg of DHEA once a day before starting the next IVF cycle and during treatment. Thirty-three women with significantly diminished ovarian reserves were enrolled, 17 in the DHEA group and 16 in the control group. The 33 patients underwent 51 IVF cycles. The DHEA group demonstrated a non-significant improvement in estradiol levels on day of hCG (P = 0.09) and improved embryo quality during treatment (P = 0.04) between first and second cycles. Patients in the DHEA group also had a significantly higher live birth rate compared with controls (23.1% versus 4.0%; P = 0.05), respectively. Six of seven deliveries were among patients with secondary infertility (P = 0.006). Dehydroepiandrosterone supplementation can have a beneficial effect on ovarian reserves for poor-responder patients on IVF treatment. Clinicaltrials.gov: NCT01145144.

  8. Successful use of "Hour 1" transfer of sperm microinjected oocytes in natural cycles of poor responder women: a prospective randomized controlled pilot study.

    Science.gov (United States)

    Aragona, Cesare; Linari, Antonella; Micara, Giulietta; Tranquilli, Daniela; Gambaro, Agnese Maria Lourdes; Bezerra Espinola, Maria Salome

    2016-01-01

    The aim of the study is to demonstrate the successful use of "Hour 1" transfer of sperm microinjected oocytes in natural cycles of poor responder women. Seventy women were selected from 92 consecutive poor responders undergoing intracytoplasmatic sperm injection (ICSI) in a natural cycle at our Sterility and Assisted Reproduction Unit from September 2009 to July 2013, and randomly distributed in two homogeneous groups: Group A or B. Women in Group A (35) underwent transfer within 1 h after ICSI; Group B (35, control group) underwent transfer 3 days after ICSI. In Group A, seven clinical pregnancy and one miscarriage occurred; in Group B, eight clinical pregnancies and two miscarriages were observed. Pregnancy, miscarriage, term pregnancy and overall live birth rates' difference between the two groups was not statistically significant (p > 0.05). Difference between the two groups in terms of timing, type of delivery and newborn birthweight was not observed. Neither ectopic pregnancy nor multiple pregnancies occurred. "Hour 1" uterine transfer of ICSI oocytes, still to be considered with caution because of the relatively low number of observations of the pilot study, deserves further attention on a larger scale, and might be evaluated for clinical and financial effectiveness in other clinical settings.

  9. Serum Stem Cell Factor Assay in Elderly Poor Responder Patients Undergoing IVF: A New Biomarker to Customize Follicle Aspiration Cycle by Cycle.

    Science.gov (United States)

    Gizzo, Salvatore; Quaranta, Michela; Andrisani, Alessandra; Bordin, Luciana; Vitagliano, Amerigo; Esposito, Federica; Venturella, Roberta; Zicchina, Cecilia; Gangemi, Michele; Noventa, Marco

    2016-01-01

    In humans, stem cell factor (SCF), produced during follicular phase, may reflect a successful stimulation and oocyte maturation and so it may be a predictor of in vitro fertilization (IVF) outcome. An observational cohort study was conducted on 37 poor responders scheduled for fresh nondonor IVF/intracytoplasmic sperm injection treatment with standard controlled ovarian stimulation (COS) using recombinant follicle-stimulating hormone (rFSH; S-COS group). A total of 35 women received a second treatment using both rFSH and recombinant luteinizing hormone (rLH; LH-COS group). From 144 samples collected at pickup day, serum concentration of SCF (s-SCF) and follicular levels of SCF (f-SCF) were measured by enzyme-linked immunosorbent assay (ELISA) kit. No differences were observed between the 2 protocols in terms of both f-SCF and s-SCF levels. The comparison between f-SCF and s-SCF levels showed a strong linear correlation. The comparison between s-SCF levels and clinical outcomes showed a statistically significant correlation between both the number of metaphase II (MII) oocytes retrieved and the embryos obtained after fertilization. Cases with at least 3 MII oocytes showed s-SCF values >800 pg/mL, 2 MII oocytes >600 pg/mL, and 1 MII oocytes >400 pg/mL. In 100% of cases with s-SCF 1000 pg/mL. The introduction of s-SCF assay in the management of poor-responder patients may contribute to solving the dilemma of whether to cancel or proceed with the stimulation cycle. © The Author(s) 2015.

  10. A comparative study of luteal estradiol pre-treatment in GnRH antagonist protocols and in micro dose flare protocols for poor-responding patients.

    Science.gov (United States)

    Davar, Robab; Rahsepar, Mozhgan; Rahmani, Elham

    2013-01-01

    This study aims to verify if luteal estradiol pre-treatment improves IVF/ICSI outcomes in a GnRH antagonist protocol as compared with a micro dose GnRH agonist protocol in poor-responding patients. A total of 116 IVF/ICSI cycles were included in this prospective randomized single blind clinical trial. The selected women were randomly assigned to receive an estradiol pre-treatment in a GnRH antagonist protocol (daily oral Estradiol Valerate 4 mg preceding the IVF cycle from the 21st day until the first day of the next cycle) or in oral contraceptive pill micro dose GnRH agonist protocol. The patients in the luteal estradiol protocol required more days of stimulation (10.9 ± 1.6 vs. 10.2 ± 1.8) and a greater gonadotropin requirement (3,247.8 ± 634.6 vs. 2,994.8 ± 611 IU), yet similar numbers of oocytes were retrieved and fertilized. There was no significant difference between the two groups in terms of the implantation rates (9.8 vs. 7.9 %) and the clinical pregnancy rates per transfer (16.3 vs. 15.6 %). This study demonstrates that the use of estradiol during a preceding luteal phase in a GnRH antagonist protocol can provide similar IVF outcomes when compared to a micro dose GnRH agonist protocol.

  11. Responding to the need for sleep among survivors of interpersonal violence: A randomized controlled trial of a cognitive-behavioral insomnia intervention followed by PTSD treatment.

    Science.gov (United States)

    Pigeon, Wilfred R; Heffner, Kathi L; Crean, Hugh; Gallegos, Autumn M; Walsh, Patrick; Seehuus, Martin; Cerulli, Catherine

    2015-11-01

    Sleep disturbance is a common feature of posttraumatic stress disorder (PTSD), but is not a focus of standard PTSD treatments. Psychological trauma exposure is associated with considerable physical and mental health morbidity, possibly due to the alterations in neuroendocrine function and inflammation observed in trauma exposed individuals. Although PTSD treatments are efficacious, they are associated with high drop-out rates in clinical trials and clinical practice. Finally, individuals with PTSD stemming from exposure to interpersonal violence represent an especially under-treated population with significant sleep disturbance. Community-based participatory research was utilized to design and prepare a clinical trial that randomizes recent survivors of interpersonal violence who have PTSD, depression, and insomnia to receive either: (1) Cognitive Behavioral Therapy for Insomnia (CBTi) followed by Cognitive Processing Therapy (CPT) for trauma, or (2) attention control followed by CPT. Outcome measures include subjective and objective measures of sleep, clinician-administered PTSD and depression scales, inflammatory cytokines, and salivary cortisol. Assessments are conducted at baseline, following the sleep or control intervention, and again following CPT. The design allows for: (1) the first test of a sleep intervention in this population; (2) the comparison of sequenced CBTi and CPT to attention control followed by CPT, and (3) assessing the roles of neuroendocrine function, inflammatory processes, and objective sleep markers in mediating treatment outcomes. The study's overarching hypothesis is that treating insomnia will produce reduction in insomnia, PTSD, and depression severity, allowing patients to more fully engage in, and derive optimal benefits from, cognitive processing therapy. Published by Elsevier Inc.

  12. Sexual minority cancer survivors' satisfaction with care.

    Science.gov (United States)

    Jabson, Jennifer M; Kamen, Charles S

    2016-01-01

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

  13. Impact of dehydroepiandrosterone on clinical outcome in poor responders: A pilot study in women undergoing in vitro fertilization, using bologna criteria

    Directory of Open Access Journals (Sweden)

    Padma Rekha Jirge

    2014-01-01

    Full Text Available Objective: To evaluate the role of dehydroepiandrosterone (DHEA supplementation in women with poor ovarian response (POR undergoing in vitro fertilization (IVF. Design: Prospective case-control study. Setting: Private tertiary fertility clinic. MATERIALS AND Methods: 31 infertile women with POR diagnosed as per the Bologna criteria. Interventions: DHEA supplementation for 2 months and a subsequent IVF cycle, after two previous IVF cycles with POR. Main Outcome Measure(S: Dose and duration of gonadotropin therapy, oocyte yield, embryo number and quality, pregnancy and live birth rate. Results: No difference was seen in gonadotropin requirement before and after DHEA supplementation. There was a significant increase in total and metaphase II oocytes (5.9 ± 0.68 vs. 2.73 ± 0.24; 4.45 ± 0.47 vs. 2.09 ± 0.26, fertilization (3.65 ± 0.49 vs. 2.00 ± 0.27, Grade I embryos (1.52 ± 0.25 vs. 0.55 ± 0.18, pregnancy rate (30% vs. 9.1% and live birth rate (25% vs 0% in those who completed the cycle, following DHEA supplementation. Conclusions: Dehydroepiandrosterone supplementation results in an improvement in oocyte yield, embryo quality, and live birth rate in a group of women with POR having undergone at least two previous failures due to POR.

  14. Poor Long-Term Outcome in a Survivor Presenting with the Twin Reversed Arterial Perfusion Sequence In Utero: A Case Report

    Directory of Open Access Journals (Sweden)

    Chih-Chen Chen

    2003-10-01

    Full Text Available The twin reversed arterial perfusion (TRAP sequence is a very rare complication of multiple gestations and is associated with a high mortality rate, reaching more than 50% in pump twins. The four common complications are preterm labor, polyhydramnios, fetal congestive heart failure, and fetal death of the pump twin in utero. Prenatal diagnosis during early pregnancy is possible using detailed ultrasonographic examination. Therapies, including conservative treatment and invasive procedures, are directed toward achieving optimal maintenance of pump twins based on clinical presentation. Risk factors for pump twin mortality include a high twin-to-twin weight ratio, acardiacus anceps, low umbilical artery pulsatility index, and a rapid growth rate in the acardiac twin. Herein, we present a case of TRAP sequence in a patient who underwent conservative treatment and had a poor neurologic outcome during long-term follow-up. Although the experience is still limited, early diagnosis of TRAP sequence and more aggressive treatment, instead of an expectant approach, might be a better option.

  15. Academics respond

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2015-01-01

    Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK......Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK...

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  17. Managing chronic pain in survivors of torture

    DEFF Research Database (Denmark)

    Amris, Kirstine; Williams, Amanda C de C

    2015-01-01

    and welfare problems; persistent pain in the musculoskeletal system is one of the most common. There is little specific evidence on pain in survivors of torture; the guidelines on interdisciplinary specialist management are applicable. Most of the literature on refugee survivors of torture has an exclusive...... focus on psychological disorders, with particularly poor understanding of pain problems. This article summarizes the current status of assessment and treatment of pain problems in the torture survivor....

  18. Pretreatment with oral contraceptive pills to identify poor responders that may benefit from rLH supplementation during GnRH-antagonist treatment for IVF: A pilot perspective study proposal.

    Science.gov (United States)

    Gizzo, Salvatore; Andrisani, Alessandra; Noventa, Marco; Gangemi, Michele; Nardelli, Giovanni Battista; Ambrosini, Guido

    2015-11-01

    Controlled ovarian stimulation, using a gonadotrophin-releasing hormone (GnRH) antagonist protocol, is a potential treatment option for women with a low response to other fertility treatments as it appears to be at least as effective as GnRH agonists (long protocol). However, previous studies have indicated that the administration of GnRH antagonist may cause an excessive reduction in endogenous luteinizing hormone (LH) levels. The use of recombinant LH (rLH) supplementation during ovarian stimulation is controversial. The present article proposes a future study focused on women aged ≥40 years old, with the aim of identifying patients who are poor responders to GnRH-antagonist treatment that may benefit from rLH supplementation. We hypothesize that patients with suppressed hypothalamic-pituitary-axis activity may benefit from rLH supplementation, as GnRH-antagonist administration has the potential to induce a marked reduction in LH levels in such patients compared with that in patients that exhibit a regular recovery following the administration of oral contraceptive pills (OCPs). Furthermore, patients with hyper-responsive hypothalamic-pituitary-axis activity may be affected by 'low-gonadotropin-responsiveness', similar to that observed in patients with any mutation in the follicle-stimulating hormone (FSH) receptor, who are known to benefit from rLH supplementation. The proposed pilot study would include 120 women who are predicted to be poor responders to GnRH-antagonist treatment. All subjects will be allocated at random (using 2:1 computerized randomization) into two study groups: Group A (OCP-treated) and group B (control). For all patients, the serum values of FSH, LH and 17β estradiol (E2) will be detected on day 3 of the menstrual cycle preceding OCP treatment (baseline) and at day 4 following OCP treatment. The Δ-variation from baseline levels for all markers, the FSH/LH ratio and the E2/FSH ratio will be determined. Δ-variation from the baseline of

  19. Recombinant LH supplementation during IVF cycles with a GnRH-antagonist in estimated poor responders: A cross-matched pilot investigation of the optimal daily dose and timing.

    Science.gov (United States)

    Gizzo, Salvatore; Andrisani, Alessandra; Noventa, Marco; Manfè, Serena; Oliva, Alessandra; Gangemi, Michele; Nardelli, Giovanni Battista; Ambrosini, Guido

    2015-09-01

    Although it is widely accepted that patients, who are considered poor responders to in vitro fertilization (IVF) benefit from recombinant luteinizing hormone (rLH) supplementation during an in vitro fertilization cycle, particularly when gonadotropin‑releasing hormone (GnRH)‑antagonist (ant) treatment is used the optimal administration timing and daily dose of rLH remains to be elucidated. The aim of the present study was to investigate the optimal timing of rLH‑supplementation to improve ovarian response, embryo quality, endometrial thickness and pregnancy rate in infertile, estimated poor responders to IVF, undergoing GnRH‑ant treatment. In addition, the present study aimed to evaluate the optimal daily dose to achieve the same outcomes. A prospective‑randomized‑cross‑matched investigation was performed on 40 patients undergoing a GnRH‑ant‑treatment‑cycle The patients were randomly assigned to either group A (rLH‑75 IU/day) or group B (rLH‑150 IU/day) and further randomized into subgroup A1/B1, in which rLH was administered at recombinant follicle stimulating hormone (rFSH) administration, and subgroup A2/B2, in which rLH was administered at GnRH‑ant administration. Patients who did not become pregnant during the first cycle (35 patients), were treated a second time, cross‑matched for groups and subgroups. Improved ovarian response, embryo quality and pregnancy rate were achieved by administering rLH at 150 IU/day, starting from GnRH‑ant administration, independently from the total rLH dose administered. Improved endometrial thickness at oocyte retrieval day was achieved by administering rLH at 150 IU from the start of rFSH administration. These data led to the hypothesis that ovarian responses are affected by the timing of administration more than the total‑dose of rLH. The optimal window to administer rLH appears to be the mid‑to‑late follicular phase, despite the fact that rLH‑supplementation in the early

  20. The effect and safety of highly standardized Ginger (Zingiber officinale) and Echinacea (Echinacea angustifolia) extract supplementation on inflammation and chronic pain in NSAIDs poor responders. A pilot study in subjects with knee arthrosis.

    Science.gov (United States)

    Rondanelli, Mariangela; Riva, Antonella; Morazzoni, Paolo; Allegrini, Pietro; Faliva, Milena Anna; Naso, Maurizio; Miccono, Alessandra; Peroni, Gabriella; Degli Agosti, Irene; Perna, Simone

    2017-06-01

    The study aimed to evaluate the effect of Zingiber officinale and Echinacea angustifolia extract supplementation (25 mg of ginger and 5 mg of Echinacea) for 30 days on inflammation and chronic pain in knee osteoarthritis (OA). Consecutive nonsteroidal anti-inflammatory-drugs (NSAIDs) poor responders with chronic inflammation and pain due to knee arthrosis were assessed (15 subjects, age: 67.2 ± 7.9, body mass index: 30.6 ± 7.1, men/women:2/13). The primary endpoint was to determine pain improvement from baseline to Day 30 by Tegner Lysholm Knee Scoring. The secondary endpoints were the assessment of Visual Analog Scale for Pain, health-related quality of life, by the ShortForm36 (SF-36), anthropometric parameters, hydration. After supplementation, a significant improvement of 12.27 points was observed for Lysholm scale score (p < 0.05), SF-36 (p < 0.05), and a decrease in -0.52 cm in knee circumference (left) (p < 0.01). This pilot study provides feasibility and safety data for the use of highly standardised ginger and Echinacea extract supplementation in people with knee OA.

  1. Desert Survivors!

    Science.gov (United States)

    Horton, Jessica; Friedenstab, Steve

    2013-01-01

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

  2. DBA Survivor

    CERN Document Server

    LaRock, Thomas

    2010-01-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

  4. Sunlight upon a Dark Sky Haiti's Urban Poor Responds to Socio-Political and Socio-Cultural Conflicts: A Case Study of the Grande Ravine Community Human Rights Council

    Science.gov (United States)

    Dimmett, Deborah Lynn

    2010-01-01

    This case study investigates the organizational characteristics of a Haitian grassroots community human rights council (CHRC) that emerged as a response to three politically motivated massacres. The impromptu grassroots response of this poor urban community is at the core of the following research question investigated in this study: "What…

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

    Science.gov (United States)

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

    2009-05-10

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

  6. Poor Sleep Habits = Poor Grades

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_166509.html Poor Sleep Habits = Poor Grades Study of college students finds ... socialize, college life seems geared toward an erratic sleep schedule. But new research suggests that an unpredictable ...

  7. Mirabegron for the treatment of overactive bladder: a review of efficacy, safety and tolerability with a focus on male, elderly and antimuscarinic poor-responder populations, and patients with OAB in Asia.

    Science.gov (United States)

    Chapple, Christopher R; Siddiqui, Emad

    2017-02-01

    Mirabegron is established as an alternative monotherapy to antimuscarinics for the treatment of overactive bladder (OAB) symptoms. Initial studies focused on Western populations, but over the past few years other populations and subpopulations have been evaluated. Areas covered: The authors' knowledge of the literature was used to develop the manuscript alongside a PubMed search ('mirabegron and clinical trial' and 'overactive bladder') to select independent studies of mirabegron. Up-to-date information is provided about the most recent mirabegron clinical trial and real-world efficacy, safety and tolerability data in a variety of patient populations with OAB, including those from different geographic areas, men, the elderly, and those with poor tolerability to antimuscarinics. Expert commentary: Improvements in efficacy parameters in patients with OAB at mirabegron doses approved for clinical use (25 and 50 mg/day) are also associated with clinically meaningful benefits according to patient-reported outcomes. Mirabegron has a favorable safety and tolerability profile, particularly compared with antimuscarinics, for dry mouth, constipation, and many CNS effects, which is maintained over 1 year. A growing body of evidence suggests that mirabegron represents a new treatment option for a broad range of patients with OAB.

  8. Protecting Respondent Confidentiality in Qualitative Research

    Science.gov (United States)

    Kaiser, Karen

    2009-01-01

    For qualitative researchers, maintaining respondent confidentiality while presenting rich, detailed accounts of social life presents unique challenges. These challenges are not adequately addressed in the literature on research ethics and research methods. Using an example from a study of breast cancer survivors, I argue that by carefully considering the audience for one’s research and by re-envisioning the informed consent process, qualitative researchers can avoid confidentiality dilemmas that might otherwise lead them not to report rich, detailed data. PMID:19843971

  9. 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.

  10. Self-reported physical activity among middle-aged cancer survivors in the United States: Behavioral Risk Factor Surveillance System Survey, 2009

    National Research Council Canada - National Science Library

    Nayak, Pratibha; Holmes, Holly M; Nguyen, Hoang T; Elting, Linda S

    2014-01-01

    ...) among cancer survivors. We examined PA adherence among 8,655 cancer survivors and 144,213 control subjects aged 45-64 years who were respondents to the 2009 Behavior Risk Factor Surveillance System survey...

  11. Tsunami survivors' perspectives on vulnerability and vulnerability reduction: evidence from Koh Phi Phi Don and Khao Lak, Thailand.

    Science.gov (United States)

    Steckley, Marylynn; Doberstein, Brent

    2011-07-01

    This paper presents the results of primary research with 40 survivors of the 2004 Indian Ocean tsunami in two communities: Khao Lak (n=20) and Koh Phi Phi Don (n=20), Thailand. It traces tsunami survivors' perceptions of vulnerability, determines whether residents felt that the tsunami affected different communities differently, identifies the populations and sub-community groups that survivors distinguished as being more vulnerable than others, highlights community-generated ideas about vulnerability reduction, and pinpoints a range of additional vulnerability reduction actions. Tsunami survivors most consistently identified the 'most vulnerable' community sub-populations as women, children, the elderly, foreigners, and the poor. In Khao Lak, however, respondents added 'Burmese migrants' to this list, whereas in Koh Phi Phi Don, they added 'Thai Muslims'. Results suggest that the two case study communities, both small, coastal, tourism-dominated communities no more than 100 kilometres apart, have differing vulnerable sub-groups and environmental vulnerabilities, requiring different post-disaster vulnerability reduction efforts. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  12. 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.

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

    Science.gov (United States)

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

    2013-05-01

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

  14. Poor title--poor manuscript?

    Science.gov (United States)

    Gjersvik, Petter; Gulbrandsen, Pål; Aasheim, Erlend T; Nylenna, Magne

    2013-12-10

    The title of a scientific article is important for several reasons. Does the title of a manuscript submitted for publication in a medical journal reflect the quality of the manuscript itself? We prepared criteria for poor, fair and good titles and tested them in pilot studies. All manuscripts submitted to the Journal of the Norwegian Medical Association during the period 1 September 2009-31 August 2011 as original articles (n = 211) or review articles (n = 110) were recorded. The quality of the titles was scored by two former editors. Primary outcome measures were rejection rates and odds ratio for rejection of manuscripts with a poor title compared to those with a good title. For original articles, the rejection rate for manuscripts with a poor, fair or good title amounted to 88%, 73% and 61% (p = 0.002) respectively, and for review articles 83%, 56% and 38% (p title compared to those with a good title was 4.6 (95% CI: 1.7-12.3) for original articles and 8.2 (95% CI: 2.6-26.4) for review articles. In a logistic regression model, the quality of the title explained 14% and 27% of the variance in outcome for original articles and review articles respectively. In this study, a poor manuscript title was significantly associated with manuscript rejection. This indicates that the quality of the title often reflects the quality of the manuscript itself.

  15. Motherhood among Incest Survivors.

    Science.gov (United States)

    Cohen, Tamar

    1995-01-01

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

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

    Science.gov (United States)

    Marshall, Julie; Barrett, Helen

    2017-11-10

    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. Participation in Leisure Activity and Exercise of Chronic Stroke Survivors Using Community-Based Rehabilitation Services in Seongnam City

    Science.gov (United States)

    Yi, Tae Im; Lee, Ko Eun; Ha, Seung A

    2015-01-01

    Objective To clarify how participation in leisure activities and exercise by chronic stroke survivors differs before and after a stroke. Methods Sixty chronic stroke survivors receiving community-based rehabilitation services from a health center in Seongnam City were recruited. They completed a questionnaire survey regarding their demographic characteristics and accompanying diseases, and on the status of their leisure activities and exercise. In addition, their level of function (Korean version of Modified Barthel Index score), risk of depression (Beck Depression Inventory), and quality of life (SF-8) were measured. Results After their stroke, most of the respondents had not returned to their pre-stroke levels of leisure activity participation. The reported number of leisure activities declined from a mean of 3.9 activities before stroke to 1.9 activities post-stroke. In addition, many participants became home-bound, sedentary, and non-social after their stroke. The most common barriers to participation in leisure activities were weakness and poor balance, lack of transportation, and cost. The respondents reported a mean daily time spent on exercise of 2.6±1.3 hours. Pain was the most common barrier to exercise participation. Conclusion Chronic stroke survivors need information on leisure activities and appropriate pain management. PMID:25932420

  18. Mental and physical health-related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey

    National Research Council Canada - National Science Library

    Weaver, Kathryn E; Forsythe, Laura P; Reeve, Bryce B; Alfano, Catherine M; Rodriguez, Juan L; Sabatino, Susan A; Hawkins, Nikki A; Rowland, Julia H

    2012-01-01

    Despite extensive data on health-related quality of life (HRQOL) among cancer survivors, we do not yet have an estimate of the percentage of survivors with poor mental and physical HRQOL compared with population norms...

  19. Management of Crohn's disease in poor responders to adalimumab

    Directory of Open Access Journals (Sweden)

    de Boer NKH

    2014-04-01

    Full Text Available Nanne KH de Boer,1 Mark Löwenberg,2 Frank Hoentjen3 1Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands; 2Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands; 3Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands Abstract: Anti-tumor necrosis factor therapy with adalimumab is an effective therapy for the induction and maintenance of remission in moderate to severe Crohn's disease. Although a large proportion of patients show a favorable clinical response to adalimumab, therapy failure is common. In this review, we provide a practical overview of adalimumab therapy in patients with Crohn's disease, with a specific focus on the clinical management of adalimumab failure. In the case of inadequate efficacy, a thorough assessment is required to confirm inflammatory disease activity and rule out noninflammatory causes. Evaluation may include biomarkers (fecal calprotectin and serum C-reactive protein, colonoscopy, and/or magnetic resonance enterography/enteroclysis. Furthermore, adalimumab trough levels and antibodies to adalimumab are informational after the confirmation of active inflammation. In the case of low or undetectable adalimumab trough levels, dose escalation to 40 mg weekly is recommended, whereas high antibody titers or adverse events frequently require switching to an alternative anti-TNF agent such as infliximab. Active inflammation despite therapeutic adalimumab trough levels requires alternative strategies such as switching to drugs with a different mode of action or surgical intervention. Keywords: anti-TNF, biological, inflammatory bowel disease, loss of response, infliximab

  20. Selective attrition and bias in a longitudinal health survey among survivors of a disaster

    Directory of Open Access Journals (Sweden)

    Stellato Rebecca

    2007-02-01

    Full Text Available Abstract Background Little is known about the response mechanisms among survivors of disasters. We studied the selective attrition and possible bias in a longitudinal study among survivors of a fireworks disaster. Methods Survivors completed a questionnaire three weeks (wave 1, 18 months (wave 2 and four years post-disaster (wave 3. Demographic characteristics, disaster-related factors and health problems at wave 1 were compared between respondents and non-respondents at the follow-up surveys. Possible bias as a result of selective response was examined by comparing prevalence estimates resulting from multiple imputation and from complete case analysis. Analysis were stratified according to ethnic background (native Dutch and immigrant survivors. Results Among both native Dutch and immigrant survivors, female survivors and survivors in the age categories 25–44 and 45–64 years old were more likely to respond to the follow-up surveys. In general, disasters exposure did not differ between respondents and non-respondents at follow-up. Response at follow-up differed between native Dutch and non-western immigrant survivors. For example, native Dutch who responded only to wave 1 reported more depressive feelings at wave 1 (59.7%; 95% CI 51.2–68.2 than Dutch survivors who responded to all three waves (45.4%; 95% CI 41.6–49.2, p p Conclusion Our results indicate that despite selective response, the complete case prevalence estimates were only somewhat biased. Future studies, both among survivors of disasters and among the general population, should not only examine selective response, but should also investigate whether selective response has biased the complete case prevalence estimates of health problems by using statistical techniques such as multiple imputation.

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

    Science.gov (United States)

    Arnberg, Filip K; Melin, Lennart

    2013-01-01

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

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

    Science.gov (United States)

    Arnberg, Filip K.; Melin, Lennart

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-05-15

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

  4. Pain in cancer survivors.

    Science.gov (United States)

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

    2014-11-01

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

  5. Health examination for A-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-01

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

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  8. Life experiences after stroke among Iranian stroke survivors.

    Science.gov (United States)

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

    2010-06-01

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

  9. Development of a Web-Based Psychosocial Intervention for Adolescent and Young Adult Survivors of Pediatric Brain Tumor.

    Science.gov (United States)

    Raj, Stacey P; Narad, Megan E; Salloum, Ralph; Platt, Amber; Thompson, Aimee; Baum, Katherine T; Wade, Shari L

    2017-12-06

    To develop A Survivor's Journey, a web-based psychosocial intervention for adolescent and young adult (AYA) survivors of pediatric brain tumors (PBTs). Stages of development included focus groups with five AYA survivors (ages 16-23 years) and six parents to identify needs and challenges, as well as surveys and interviews with clinical care providers at a survivorship clinic. Concerns reported by AYA survivors, parents, and providers were similar to those reported in the literature, including fatigue, memory deficits, poor mood, health concerns, and challenging peer relationships. However, concerns varied across survivors, underscoring the need for customizable interventions. Survivors and parents were interested in an intervention targeting psychosocial functioning and late effects, and reported a strong preference for web-based interventions that would reduce cost and travel burden on the family. Based on review of the literature, survivor and parent feedback, as well as provider input, a customizable intervention, A Survivor's Journey, was developed consisting of five core sessions (addressing concerns common to AYA survivors such as memory, staying positive, and problem solving) and up to seven supplemental sessions (addressing variable needs of survivors such as managing fatigue, inattention, planning/organization, communication/relationships, and self-care). Despite growing recognition of long-term challenges and late effects, there are few interventions targeting psychosocial well-being of AYA survivors. If efficacious, A Survivor's Journey will be an accessible and cost-effective intervention to improve psychosocial functioning of AYA survivors of PBT.

  10. Gastric cancer in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-10-01

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

  11. The symbolic violence of 'outbreak': A mixed methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing.

    Science.gov (United States)

    Richardson, Eugene T; Kelly, J Daniel; Sesay, Osman; Drasher, Michael D; Desai, Ishaan K; Frankfurter, Raphael; Farmer, Paul E; Barrie, Mohamed Bailor

    2017-12-01

    Despite over 28,000 reported cases of Ebola virus disease (EVD) in the 2013-16 outbreak in West Africa, we are only beginning to trace the complex biosocial processes that have promoted its spread. Important questions remain, including the effects on survivors of clinical sequelae, loss of family and livelihood, and other psychological and social trauma. Another poorly understood question is what effect social protection and job creation programs have had on survivors' wellbeing. Several clinical and social protection programs have been developed to respond to the needs of EVD survivors; however, little in the way of impact evaluation has taken place. We enrolled 200 randomly selected EVD survivors from Port Loko, Kenema, and Kailahun districts in Sierra Leone and stratified them based on the amount of instrumental social protection received post-discharge from an Ebola Treatment Unit. We then conducted a survey and in-depth interviews to assess participants' wellbeing and food security. Social protection categories II-IV (moderate to extensive) were each significantly associated with ∼15-22% higher wellbeing scores compared to minimal social protection (p social protection category IV (extensive) was significantly associated with being food secure (adjusted odds ratio 6.11; 95% confidence interval, 2.85-13.10) when compared to minimal social protection. Qualitative themes included having a sense of purpose during the crisis (work and fellowship helped survivors cope); using cash transfers to invest in business; the value of literacy and life-skills classes; loss of breadwinners (survivors with jobs were able to take over that role); and combating the consequences of stigma. We conclude that, for EVD survivors, short-term social protection during the vulnerable period post-discharge can pay dividends two years later. Based on the empiric evidence presented, we discuss how terms such as "outbreak" and "epidemic" do symbolic violence by creating the illusion that

  12. Interrelationships between Health Behaviors and Coping Strategies among Informal Caregivers of Cancer Survivors

    Science.gov (United States)

    Litzelman, Kristin; Kent, Erin E.; Rowland, Julia H.

    2018-01-01

    Background: Recent research among cancer survivors suggests that health behaviors and coping are intertwined, with important implications for positive behavior change and health. Informal caregivers may have poor health behaviors, and caregivers' health behaviors have been linked to those of survivors. Aims: This hypothesis generating study…

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

    Science.gov (United States)

    Koss, Mary P

    2006-11-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  15. Research Organizations Interview the Poor

    Science.gov (United States)

    Weiss, Carol H.

    1974-01-01

    Researchers who conducted 194 interviews surveys of low income populations returned mail questionnaires about their experiences; the results are interpreted as bearing upon both the ease or difficulty of interviewing poor people and how advisable it may be to employ interviewers matched to respondents by class and race/ethnicity in surveys of the…

  16. Regulatory T Cells in Endemic Burkitt Lymphoma Patients Are Associated with Poor Outcomes: A Prospective, Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Emily Parsons

    addition, we identified the presence of Foxp3-IL10+ regulatory Type 1 cells responding to EBNA-1 in contrast to the malaria antigen tested. These novel findings suggest that poor outcomes in eBL patients are associated with a predominantly immuno-regulatory environment. Therefore, Treg frequencies could be a predictive biomarker of disease progression and manipulation of Treg activity has potential as a therapeutic target to improve eBL survival.

  17. Children of Holocaust Survivors.

    Science.gov (United States)

    Segal, Shirley Ann

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

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Educational and occupational outcomes of childhood cancer survivors 30 years after diagnosis: a French cohort study.

    Science.gov (United States)

    Dumas, Agnes; Berger, Claire; Auquier, Pascal; Michel, Gérard; Fresneau, Brice; Sètchéou Allodji, Rodrigue; Haddy, Nadia; Rubino, Carole; Vassal, Gilles; Valteau-Couanet, Dominique; Thouvenin-Doulet, Sandrine; Casagranda, Léonie; Pacquement, Hélène; El-Fayech, Chiraz; Oberlin, Odile; Guibout, Catherine; de Vathaire, Florent

    2016-04-26

    Although survival from childhood cancer has increased, little is known on the long-term impact of treatment late effects on occupational attainment or work ability. A total of 3512 five-year survivors treated before the age of 19 years in 10 French cancer centres between 1948 and 2000 were identified. Educational level, employment status and occupational class of survivors were assessed by a self-reported questionnaire. These outcome measures were compared with sex-age rates recorded in the French population, using indirect standardisation. Paternal occupational class was also considered to control for the role of survivors' socioeconomic background on their achievement. Multivariable analyses were conducted to explore clinical characteristics associated with the outcomes. A total of 2406 survivors responded to the questionnaire and survivors aged below 25 years were included in the current analysis. Compared with national statistics adjusted on age and sex, male survivors were more likely to be college graduates (39.2% vs 30.9% expected; Phigher achievement was not observed either for leukaemia or central nervous system (CNS) tumour survivors. Health-related unemployment was higher for survivors of CNS tumour (28.1% vs 4.3%; Phigher occupational class than expected. Survivors treated for CNS tumour or leukaemia, especially when treatment included cranial irradiation, might need support throughout their lifespan.

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

    Science.gov (United States)

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

    2015-02-15

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

  1. Maternity care for trafficked women: Survivor experiences and clinicians' perspectives in the United Kingdom's National Health Service.

    Science.gov (United States)

    Bick, Debra; Howard, Louise M; Oram, Sian; Zimmerman, Cathy

    2017-01-01

    Although trafficked women and adolescents are at risk of unprotected or forced sex, there is little research on maternity care among trafficking survivors. We explored health care needs, service use and challenges among women who became pregnant while in the trafficking situation in the United Kingdom (UK) and clinicians' perspectives of maternity care for trafficked persons. Cross-sectional survey and qualitative interviews with trafficking survivors recruited from statutory and voluntary sector organisations in England and qualitative interviews with maternity clinicians and family doctors undertaken to offer further insight into experiences reported by these women. Twenty-eight (29%) of 98 women who took part in a large study of trafficking survivors reported one or more pregnancies while trafficked, whose data are reported here. Twelve (42.8%) of these women reported at least one termination of pregnancy while in the trafficking situation and 25 (89.3%) experienced some form of mental health disorder. Nineteen (67.9%) women experienced pre-trafficking physical abuse and 9 (32.%) sexual abuse. A quarter of women were trafficked for sexual exploitation, six for domestic servitude and two for manual labour. Survivors and clinicians described service challenges, including restrictions placed on women's movements by traffickers, poor knowledge on how to access maternity care, poor understanding of healthcare entitlements and concerns about confidentiality. Maternity care clinicians recognised potential indicators of trafficking, but considered training would help them identify and respond to victims. Main limitations include that findings reflect women who had exited the trafficking situation, however as some had only recently exited the trafficking situation, difficulties with recall were likely to be low. More than one in four women became pregnant while trafficked, indicating that maternity services offer an important contact point for identification and care

  2. Maternity care for trafficked women: Survivor experiences and clinicians' perspectives in the United Kingdom's National Health Service.

    Directory of Open Access Journals (Sweden)

    Debra Bick

    Full Text Available Although trafficked women and adolescents are at risk of unprotected or forced sex, there is little research on maternity care among trafficking survivors. We explored health care needs, service use and challenges among women who became pregnant while in the trafficking situation in the United Kingdom (UK and clinicians' perspectives of maternity care for trafficked persons.Cross-sectional survey and qualitative interviews with trafficking survivors recruited from statutory and voluntary sector organisations in England and qualitative interviews with maternity clinicians and family doctors undertaken to offer further insight into experiences reported by these women.Twenty-eight (29% of 98 women who took part in a large study of trafficking survivors reported one or more pregnancies while trafficked, whose data are reported here. Twelve (42.8% of these women reported at least one termination of pregnancy while in the trafficking situation and 25 (89.3% experienced some form of mental health disorder. Nineteen (67.9% women experienced pre-trafficking physical abuse and 9 (32.% sexual abuse. A quarter of women were trafficked for sexual exploitation, six for domestic servitude and two for manual labour. Survivors and clinicians described service challenges, including restrictions placed on women's movements by traffickers, poor knowledge on how to access maternity care, poor understanding of healthcare entitlements and concerns about confidentiality. Maternity care clinicians recognised potential indicators of trafficking, but considered training would help them identify and respond to victims. Main limitations include that findings reflect women who had exited the trafficking situation, however as some had only recently exited the trafficking situation, difficulties with recall were likely to be low.More than one in four women became pregnant while trafficked, indicating that maternity services offer an important contact point for identification

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

    Science.gov (United States)

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

    2007-12-01

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

  4. The Gesell Institute Responds.

    Science.gov (United States)

    Young Children, 1987

    1987-01-01

    Responding to Dr. Meisels' article concerning the uses and abuses of the Gesell readiness tests, the Gesell Institute of Child development maintains that the Gesell series of assessments are used by schools to gain a fuller developmental understanding of the child and have been predictive of school success. (BB)

  5. Responding to Tragedy

    Science.gov (United States)

    Coopman, J. T.

    2009-01-01

    In this article, the author, a superintendent of Clark-Pleasant School Corporation in Whiteland, Indiana, relates how she and the school community responded to a car accident that killed two students. The author stresses the need to develop a comprehensive crisis plan. It is also important to be sensitive to the needs of family members who are…

  6. Adverse psychological outcomes in long-term survivors of hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study (BMTSS).

    Science.gov (United States)

    Sun, Can-Lan; Francisco, Liton; Baker, K Scott; Weisdorf, Daniel J; Forman, Stephen J; Bhatia, Smita

    2011-10-27

    Little information exists regarding long-term psychological health of hematopoietic cell transplantation (HCT) survivors. Using resources offered by the Bone Marrow Transplant Survivor Study (BMTSS), we evaluated adverse psychological outcomes in 1065 long-term HCT survivors and a healthy comparison group composed of siblings. Psychological health status was evaluated using the Brief Symptom Inventory-18. Twenty-two percent of the HCT survivors reported adverse psychological outcomes, compared with 8% of the siblings. Exposure to prednisone was associated with psychological distress across all domains (anxiety, depression, and somatic distress). Fifteen percent of the HCT survivors reported somatic distress, representing an almost 3-fold higher risk comparing to siblings. Among survivors, in addition to low annual household income and self-reported poor health, having severe/life-threatening conditions and presence of active chronic GVHD were associated with a 2-fold increased risk for somatic distress. Seven percent of the HCT survivors expressed suicidal ideation; patients with higher scores on depression subscale were most vulnerable. This study demonstrates that somatic distress is the biggest challenge faced by survivors long after HCT. These results identify vulnerable subpopulations and provide patients, families, and healthcare providers with necessary information to plan for post-HCT needs many years after HCT.

  7. Responding to Indigenous Australian Sexual Assault

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2014-01-01

    Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.

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

    Science.gov (United States)

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

    2011-01-01

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

  9. Combined associations of physical activity and dietary intake with health status among survivors of the Great East Japan Earthquake.

    Science.gov (United States)

    Nozue, Miho; Nishi, Nobuo; Tsubota-Utsugi, Megumi; Miyoshi, Miki; Yonekura, Yuki; Sakata, Kiyomi; Kobayashi, Seiichiro; Ogawa, Akira

    2017-05-01

    Each of the effects of physical activity and dietary intake on health is well known, but combined associations of physical activity and dietary intake on health has not been reported yet. Physical activity and dietary intake are key factors for maintaining health of survivors of the Great East Japan Earthquake in 2011. This study aimed to examine combined associations of physical activity and dietary intake with survivors' health status. We used data from 6668 participants of a cross-sectional survey taken 3 years (2013) after the disaster. To evaluate combined associations of physical activity and dietary intake, answers to questions regarding these two variables were categorized into four groups: poor physical activity and poor dietary intake (Group 1), poor physical activity and good dietary intake (Group 2), good physical activity and poor dietary intake (Group 3), and good physical activity and good dietary intake (Group 4). Multiple logistic regression analyses were performed by sex, with good self-rated health and good mental health as dependent variables, and age, place of residence, living conditions and physical activity/dietary intake group (with Group 1 as the reference category) as independent variables. Good self-rated health was associated with age in both sexes, and Groups 3 (male: odds ratios (ORs) 1.84 (95% confidence intervals (95% CIs) 1.32-2.57), female: OR 1.82 (95% CI 1.32-2.51)) and 4 (male: OR 1.96 (95% CI 1.39-2.76), female: OR 1.94 (95% CI 1.42-2.64)). Good mental health was associated with Groups 3 (OR 1.48 (95% CI 1.10-1.97)) and 4 (OR 1.86 (95% CI 1.37-1.97)) for male respondents; and living place (other than temporary housing) (OR 1.45 (95% CI 1.26-1.68)) was associated with Group 4 (OR 1.42 (95% CI 1.09-1.85)) for female respondents. Good physical activity alone or combined with good dietary intake was associated with good self-rated health and good mental health. Further interventions regarding physical activity and dietary intake

  10. Poor Slaughterhouse Waste Management: Empirical Evidences ...

    African Journals Online (AJOL)

    The results reveal that the majority of the respondents had poor attitudes (75.6%) and practices (97.4%) of proper waste management, though 51.5% demonstrated good knowledge. While 51.3% knew that slaughterhouse wastes are related to diseases, 75.4% were unconcerned that poor management could be major ...

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

    Science.gov (United States)

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

    2011-01-01

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

  12. Responding to Mechanical Antigravity

    Science.gov (United States)

    Millis, Marc G.; Thomas, Nicholas E.

    2006-01-01

    Based on the experiences of the NASA Breakthrough Propulsion Physics Project, suggestions are offered for constructively responding to proposals that purport breakthrough propulsion using mechanical devices. Because of the relatively large number of unsolicited submissions received (about 1 per workday) and because many of these involve similar concepts, this report is offered to help the would-be submitters make genuine progress as well as to help reviewers respond to such submissions. Devices that use oscillating masses or gyroscope falsely appear to create net thrust through differential friction or by misinterpreting torques as linear forces. To cover both the possibility of an errant claim and a genuine discovery, reviews should require that submitters meet minimal thresholds of proof before engaging in further correspondence; such as achieving sustained deflection of a level-platform pendulum in the case of mechanical thrusters.

  13. Who are the cancer survivors?

    DEFF Research Database (Denmark)

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

    2015-01-01

    Background: No nationwide studies on social position and prevalence of comorbidity among cancer survivors exist. Methods: We performed a nationwide prevalence study defining persons diagnosed with cancer 1943-2010 and alive on the census date 1 January 2011 as cancer survivors. Comorbidity was co...

  14. Poorly Responsive Celiac Disease

    Science.gov (United States)

    ... Celiac Disease › Poorly Responsive Celiac Disease Poorly Responsive Celiac Disease It is estimated that up to 30% of ... continuing to ingest gluten. Causes of Poorly Responsive Celiac Disease Continuing Gluten Ingestion The most common reason for ...

  15. Brain tumor survivors speak out.

    Science.gov (United States)

    Carlson-Green, Bonnie

    2009-01-01

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

  16. Strategies to Prevent Anthracycline-Related Congestive Heart Failure in Survivors of Childhood Cancer

    Directory of Open Access Journals (Sweden)

    Saro H. Armenian

    2012-01-01

    Full Text Available Cardiovascular complications are a leading cause of therapy-related morbidity and mortality in long-term survivors of childhood malignancy. In fact, childhood cancer survivors are at a 15-fold risk of developing CHF compared to age-matched controls. There is a strong dose-dependent association between anthracycline exposure and risk of CHF, and the incidence increases with longer followup. Outcome following diagnosis of CHF is generally poor, with overall survival less than 50% at 5 years. The growing number of childhood cancer survivors makes it imperative that strategies be developed to prevent symptomatic heart disease in this vulnerable population. We present here an overview of the current state of knowledge regarding primary, secondary, and tertiary prevention strategies for childhood cancer survivors at high risk for CHF, drawing on lessons learned from prevention studies in nononcology populations as well as from the more limited experience in cancer survivors.

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

    Science.gov (United States)

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

    2018-02-01

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

  18. Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors.

    Science.gov (United States)

    Forbes, Cynthia C; Blanchard, Chris M; Mummery, W Kerry; Courneya, Kerry

    2015-03-01

    To identify and compare the prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors.
 Cross-sectional, descriptive survey.
 Nova Scotia, Canada.
 741 breast, prostate, and colorectal cancer survivors.
. A stratified sample of 2,063 breast, prostate, and colorectal cancer survivors diagnosed from 2003-2011 were identified and mailed a questionnaire. Descriptive, chi-square, and logistic regression analyses were used to determine any correlations among the main research variables. 
 Strength exercise behavior; medical, demographic, and motivational correlates using the Theory of Planned Behavior.
 Of 741 respondents, 23% were meeting the strength exercise guidelines of two or more days per week. Cancer survivors were more likely to meet guidelines if they were younger, more educated, had a higher income, better perceived general health, fewer than two comorbidities, and a healthy body weight. In addition, those meeting guidelines had significantly more favorable affective attitude, instrumental attitude, injunctive norm, perceived behavioral control, planning, and intention. The correlates of strength exercise did not differ by cancer site.
 The prevalence of strength exercise is low among breast, prostate, and colorectal cancer survivors in Nova Scotia and the correlates are consistent across those survivor groups. 
. Nurses should take an active role in promoting strength exercise among cancer survivors using the Theory of Planned Behavior, particularly among those survivors at higher risk of not performing strength exercise. 


  19. Seeing Roses in the Thorn Bush: Sexual Assault Survivors' Perceptions of Social Reactions.

    Science.gov (United States)

    Dworkin, Emily R; Newton, Emily; Allen, Nicole E

    2018-01-01

    After sexual assault, survivors often reach to others for support and receive a range of reactions. Although these reactions have been characterized by researchers as positive (e.g., emotional support) or negative (e.g., victim blaming), survivors vary in their perceptions in ways that do not always match this framework. The goal of this research was to examine the degree to which designations of reactions as "positive" or "negative" fits across types of reactions and explain instances of mismatch between these designations and survivors' perceptions. We conducted a qualitative analysis of interviews with 26 survivors of sexual assault to identify themes in their perceptions of social reactions. Although social reactions were generally perceived in a manner that matched researcher categorizations, there was significant variation. Perceptions could be characterized in terms of whether the reaction felt comfortable/soothing, consistent with survivors' needs/hopes/expectations, and helpful in the long term. The closeness of survivors' relationships with responders, the degree to which they were impacted by the assault, and the presence of other social reactions explained variation from researcher designations of reaction types. This study clarifies the considerations that survivors make when evaluating social reactions and what accounts for discrepant perceptions of these reactions; in particular, they highlight that there is no "one size fits all" reaction to survivors of sexual assault and the context in which reactions occur may affect how they are seen.

  20. Poor Americans: How the Poor White Live.

    Science.gov (United States)

    Pilisuk, Marc; Pilisuk, Phyllis

    Contents of this book include the following essays which originally appeared in "Transaction" magazine: (1) "Poor Americans: an introduction," Marc Pilisuk and Phyllis Pilisuk; (2) "How the white poor live," Marc Pilisuk and Phyllis Pilisuk; (3) "The culture of poverty," Oscar Lewis; (4) "Life in Appalachia--the case of Hugh McCaslin," Robert…

  1. Diet quality of cancer survivors and noncancer individuals: Results from a national survey.

    Science.gov (United States)

    Zhang, Fang Fang; Liu, Shanshan; John, Esther M; Must, Aviva; Demark-Wahnefried, Wendy

    2015-12-01

    Patterns of poor nutritional intake may exacerbate the elevated morbidity experienced by cancer survivors. It remains unclear whether cancer survivors adhere to existing dietary guidelines and whether survivors' diets differ from those of individuals without cancer over the long term. The authors evaluated dietary intake and quality in 1533 adult cancer survivors who participated in the National Health and Nutrition Examination Survey from 1999 to 2010 compared with dietary intake and quality in 3075 individuals who had no history of cancer and were matched to the cancer survivors by age, sex, and race/ethnicity. Dietary intake was assessed using 24-hour dietary recalls. The 2010 Healthy Eating Index (HEI-2010) was used to evaluate diet quality. The mean ± standard deviation HEI-2010 total score was 47.2 ± 0.5 in the cancer survivors and 48.3 ± 0.4 in the noncancer group (P = .03). Compared with the noncancer group, cancer survivors had a significantly lower score for empty calories (13.6 vs 14.4; P = .001), which corresponded to worse adherence to dietary intake of calories from solid fats, alcohol, and added sugars. Cancer survivors also had significantly lower dietary intake of fiber than the noncancer group (15.0 vs 15.9 g per day; P = .02). In relation to recommended intake, survivors' mean dietary intake of vitamin D, vitamin E, potassium, fiber, and calcium was 31%, 47%, 55%, 60%, and 73%, respectively; whereas their mean dietary intake of saturated fat and sodium was 112% and 133%, respectively, of the recommended intake. Cancer survivors had poor adherence to the US Department of Agriculture 2010 Dietary Guidelines for Americans, and their intake patterns were worse than those in the general population for empty calories and fiber. © 2015 American Cancer Society.

  2. Holocaust Child Survivors and Child Sexual Abuse

    Science.gov (United States)

    Lev-Wiesel, Rachel; Amir, Marianne

    2005-01-01

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

  3. Profiles of resilient survivors of institutional abuse in Ireland

    OpenAIRE

    Flanagan, Edel; CARR, ALAN; Dooley, Barbara A.; Fitzpatrick, Mark; Flanagan-Howard, Roisín; Shevlin, Mark; Tierney, Kevin; White, Megan; Daly, Margaret; EGAN, Jonathan

    2009-01-01

    In a group of 247 survivors of institutional abuse in Ireland, 45 cases (18%) did not meet the diagnostic criteria for common DSM IV axis I or II disorders. This resilient group was compared with a poorly adjusted group of 119 participants who met the criteria for 1-3 DSM IV axis I or II diagnoses, and a very poorly adjusted group of 83 participants who had 4 or more disorders. Compared with the very poorly adjusted group, the resilient group was older and of higher socio-economic status; had...

  4. The ties that bind: understanding the impact of sexual assault disclosure on survivors' relationships with friends, family, and partners.

    Science.gov (United States)

    Ahrens, Courtney E; Aldana, Erendira

    2012-01-01

    A growing body of research suggests that the type of social reactions sexual assault survivors receive from others can have a profound impact on their health and well-being. Far less is known about the impact of social reactions on the ensuing relationship between survivors and the people to whom they disclose. The current study sought to address this gap in the literature by examining the impact of disclosure on survivors' relationships with friends, family members, and romantic partners. A total of 76 rape survivors described 153 different disclosures to informal support providers. Qualitative analysis suggested that most relationships either were strengthened or remained strong following the disclosure, but a substantial number of survivors described relationships that deteriorated or remained poor following the disclosure. These outcomes were related to the quality of the relationship prior to the disclosure and to survivors' perceptions of the reactions they received during the disclosure. Implications of these findings for research and practice are discussed.

  5. 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.

  6. 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.

  7. 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.

  8. Responding to Marginalization

    Directory of Open Access Journals (Sweden)

    Jie Y. Park

    2017-01-01

    Full Text Available This article offers an analysis of how refugee youths from Africa used and shifted languages and discourses in the United States. Drawing on sociocultural theories of language and utilizing ethnographic discourse and classroom observation data, the author illustrates the varied ways in which three high school–aged refugee youths used languages to make sense of who and where they are; respond to social, religious, and linguistic marginalization in the United States; and challenge narrow perceptions of African Muslims. This article brings to fore a group that, although facing a unique set of challenges in the United States, is rarely included in research on youth language practices and im/migration. Attention to their multilingual practices and the multilayered nature of their identity is central to understanding how refugee youths experience school in their new land, and how they see themselves and others. This understanding can guide school personnel, educational researchers, and community-based youth workers in their respective work with refugee students.

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Nhi-Ha T Trinh

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

  11. Exercise capacity in long-term survivors of pediatric cancer: an analysis from the Cardiac Risk Factors in Childhood Cancer Survivors Study.

    Science.gov (United States)

    Miller, Angela M; Lopez-Mitnik, Gabriela; Somarriba, Gabriel; Lipsitz, Stuart R; Hinkle, Andrea S; Constine, Louis S; Lipshultz, Steven E; Miller, Tracie L

    2013-04-01

    Childhood cancer survivors may have premature symptomatic cardiovascular and non-cardiovascular diseases that contribute to reduced capacity for physical activity. Studies of exercise capacity and identification of risk factors for reduced capacity in survivors are limited. We assessed maximal myocardial oxygen consumption (V(O(2)max), a measure of exercise capacity) in survivors at least 4 years after cancer diagnosis and sibling controls. We evaluated associations between V(O(2)max) and age, sex, treatments, cardiac structure and function, biomarkers, endocrine function, and physical activity. Of 72 survivors (mean age, 22 years; range, 8.0-40 years) and 32 siblings (mean age, 20.2 years; range, 8-46 years), about half were male. Mean time since diagnosis was 13.4 years (range, 4.5-31.6 years). In age- and sibling-pair adjusted analyses, V(O(2)max) was lower in survivors than siblings (males, 28.53 vs. 30.90 ml/kg/minute, P = 0.08; females, 19.81 vs. 23.40 ml/kg/minute, P = 0.03). In males, older age (P = 0.01), higher percent body fat (P survivors and controls was poor and generally lower in survivors, particularly females. Older age, higher body fat, methotrexate exposure, and extremes of LV mass/function were associated with lower V(O(2)max) in survivors. Because physical activity can improve nutritional and cardiac conditions, survivors should be encouraged to exercise regularly with close monitoring. Copyright © 2012 Wiley Periodicals, Inc.

  12. Dyslexia: A Survivor's Story.

    Science.gov (United States)

    Rogers, Trumbull

    1991-01-01

    A successful adult with dyslexia recounts his experiences as a child including poor school reports, emotional problems, clumsiness, as well as the help provided by a special school for boys with dyslexia. (DB)

  13. Circumstances and consequences of falls in polio survivors.

    Science.gov (United States)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-11-01

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

  14. Spirituality in Arab Muslim Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Approach.

    Science.gov (United States)

    Alaloul, Fawwaz; Schreiber, Judith A; Al Nusairat, Taghreed S; Andrykowski, Michael A

    2016-01-01

    A cancer diagnosis and treatment can be a stressful, life-altering experience that can pose a threat to life and raise existential challenges. Spirituality may influence the process of coping with the stress of the cancer experience. Studies of the role of spirituality for Muslim cancer patients and survivors are limited. The aim of this study was to understand the role of spirituality in the cancer experience among Arab Muslim hematopoietic stem cell transplant (HSCT) survivors. In this qualitative, descriptive study, 63 HSCT survivors (mean, 20.2 months) responded to 2 open-ended, self-report questions on the role of spirituality in their HSCT experience. Thematic analysis was used to identify themes related to spirituality. Three dimensions that helped patients cope with their experiences were identified: sickness viewed in light of belief in God, use of religious/spiritual resources, and support from family and community. Two general themes described changes in their faith as a result of having the HSCT procedure: strengthening of faith in God and greater reliance on religious/spiritual activities. Spirituality was important to the Arab Muslim survivors in coping with cancer and HSCT treatment. Muslim cancer survivors are often deeply connected to their religion. Healthcare providers in the United States and other Western countries need to be aware of the unique religious and spiritual needs of Muslim cancer survivors in order to provide them with culturally sensitive care. More research on the spiritual needs of Muslim cancer patients and survivors residing in Western countries is needed.

  15. Cancer survivors' responses to daily stressors: implications for quality of life.

    Science.gov (United States)

    Costanzo, Erin S; Stawski, Robert S; Ryff, Carol D; Coe, Christopher L; Almeida, David M

    2012-05-01

    This study examined cancer survivors' experience of and responses to challenges and stressors associated with everyday living. The impact of daily stressors on quality of life concerns and cortisol patterns was also investigated. Participants included 111 cancer survivors who participated in a national telephone diary study of daily experiences (National Study of Daily Experiences). Their responses were compared with those of 111 sociodemographically matched participants with no cancer history using a multilevel modeling approach. Over an 8-day period, participants completed a daily inventory of the occurrence and impact of stressful events, affect, and physical symptoms. Salivary cortisol was sampled four times per day, and indices of awakening response (cortisol awakening response), diurnal slope, and overall output (area under the curve) were examined. Cancer survivors experienced similar numbers and types of stressful events as the comparison group. Although appraisals were largely comparable, cancer survivors showed a modest tendency to perceive stressors as more severe and disruptive, particularly those involving interpersonal tensions. The occurrence of stressors was associated with increased negative affect, decreased positive affect, and increased physical symptoms, but little change in cortisol. Relative to the comparison group, cancer survivors showed less pronounced changes in positive affect and cortisol output when stressors occurred, but a greater increase in negative affect in response to interpersonal conflicts. Findings indicate that cancer survivors show a resilient ability to respond to day-to-day stressors and challenges. However, daily stressors can have a significant impact on survivors' mood and physical symptoms and therefore may be an important intervention target.

  16. Psychosocial Adjustment Among Cancer Survivors: Findings From a National Survey of Health and Well-Being

    Science.gov (United States)

    Costanzo, Erin S.; Ryff, Carol D.; Singer, Burton H.

    2009-01-01

    Objective The current study examined whether cancer survivors showed impairment, resilience, or growth responses relative to a sociodemographically matched sample in four domains: mental health and mood, psychological well-being, social well-being, and spirituality. The impact of aging on psychosocial adjustment was also investigated. Design Participants were 398 cancer survivors who were participants in the MIDUS survey (Midlife in the United States) and 796 matched respondents with no cancer history. Psychosocial assessments were completed in 1995-96 and 2004-06. Results Findings indicated that cancer survivors demonstrated impairment relative to the comparison group in mental health, mood, and some aspects of psychological well-being. Longitudinal analyses spanning pre- and post-diagnosis clarified that while mental health declined after a cancer diagnosis, poorer functioning in other domains existed prior to diagnosis. However, survivors exhibited resilient social well-being, spirituality, and personal growth. Moreover, age appeared to confer resiliency; older survivors were more likely than younger adults to show psychosocial functioning equivalent to their peers. Conclusion While younger survivors may be at risk for disturbances in mental health and mood, cancer survivors show resilience in other important domains of psychosocial adjustment. PMID:19290706

  17. Quality of life in caregivers of severely disabled war survivors.

    Science.gov (United States)

    Mousavi, Batool; Seyed Hoseini Davarani, Seyed Hosein; Soroush, Mohammadreza; Jamali, Arsia; Khateri, Shahriar; Talebi, Morteza; Montazeri, Ali

    2015-01-01

    To evaluate quality of life (QOL) of caregivers of severely disabled war survivors and identify variables threatening caregivers' QOL. A cross-sectional study was performed on 532 caregivers of Iran-Iraq war related injured survivors by using Persian version of 36-item Short Form Health Survey (SF-36). Caregivers had lower QOL compared to the Iranian female population (p < .001). Caregivers of amputees had better SF-36 scores compared to caregivers of two groups of chemical warfare survivors (p ranging from .01 to <.001). Caregiving to chemical warfare and being married at the time of trauma were the independent predictors of poor QOL in both the physical component summary (OR = 5.08, 95% CI = 3.35-7.7; OR = 0.57, 95% CI = 0.37-0.89) and the mental component summary (OR = 4.12, 95% CI = 2.68-6.32; OR = 0.63, 95% CI = 0.40-0.98). Caregivers of war veterans suffer from poor QOL. Chemical warfare agents contribute to more persistent poor QOL in caregivers than the injuries caused by conventional weapons. © 2014 Association of Rehabilitation Nurses.

  18. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Duun-Henriksen, Anne Katrine; Hansson, Eva Helena

    2016-01-01

    PURPOSE: We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety......, depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence. METHODS: We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical...... and control groups after baseline adjustment. CONCLUSION: We observed higher physical well-being 9 months after randomization in the GSD-GYN-C group, as compared to women receiving usual care. IMPLICATIONS FOR CANCER SURVIVORS: The results suggest that the person-centered intervention GSD-GYN-C may improve...

  19. Resilience, Health, and Quality of Life among long-term survivors of Hematopoietic Cell Transplant

    Science.gov (United States)

    Rosenberg, Abby R.; Syrjala, Karen L.; Martin, Paul J.; Flowers, Mary E.; Carpenter, Paul; Salit, Rachel B.; Baker, Scott; Lee, Stephanie J.

    2015-01-01

    Background Low patient-reported resilience is associated with ongoing risk of poor health and psychosocial outcomes. Using a large cross-sectional sample of survivors of Hematopoietic Cell Transplantation (HCT), we explored associations between patient-reported resilience, psychological distress, post-traumatic growth, and health-related quality of life Methods Between July 1, 2013 and June 30, 2014, the annual Fred Hutchinson Cancer Research Center (FHCRC) post-transplant survivorship survey queried patient-reported health and functional status, and included instruments assessing psychosocial outcomes: the 10-item Connor-Davidson Resilience Scale, the Post-Traumatic Growth Inventory, the Cancer and Treatment Distress measure, and the Medical Outcomes Study Short-Form 12 quality of life scale. Multivariate linear and logistic regression models included demographic and health covariates extracted from the FHCRC research database Results 1,823 (39%) of 4,643 adult survivors of HCT responded after a single mailing and subsequent reminder letter. Participants’ median age was 59 years (IQR 50–66); 52.3% were male, most were non-Hispanic, white. The median time since HCT was 9 years (IQR 3–18). Lower patient-reported resilience was associated with higher severity chronic graft-versus-host disease, lower performance scores, missing work due to health, and permanent disability (all ppatients reporting low resilience scores had higher odds of psychological distress (OR 3.0, 95% CI 2.1–4.3) and being in the lowest quartile of mental health-related quality of life (OR 5.9, 95% CI 4.4–8.0). Conclusions Patient-reported resilience is independently associated with health and psychosocial outcomes. Future studies must determine whether interventions can bolster resilience and improve survivorship outcomes. PMID:26288023

  20. Resilience, health, and quality of life among long-term survivors of hematopoietic cell transplantation.

    Science.gov (United States)

    Rosenberg, Abby R; Syrjala, Karen L; Martin, Paul J; Flowers, Mary E; Carpenter, Paul A; Salit, Rachel B; Baker, K Scott; Lee, Stephanie J

    2015-12-01

    Low patient-reported resilience is associated with an ongoing risk of poor health and psychosocial outcomes. Using a large cross-sectional sample of survivors of hematopoietic cell transplantation (HCT), this study explored associations between patient-reported resilience, psychological distress, posttraumatic growth, and health-related quality of life. Between July 1, 2013 and June 30, 2014, the annual Fred Hutchinson Cancer Research Center (FHCRC) posttransplant survivorship survey queried patient-reported health and functional status and included instruments assessing psychosocial outcomes: the 10-item Connor-Davidson Resilience Scale, the Posttraumatic Growth Inventory, the Cancer and Treatment Distress measure, and the 12-item Medical Outcomes Study Short Form quality-of-life scale. Multivariate linear and logistic regression models included demographic and health covariates extracted from the FHCRC research database. Among 4643 adult survivors of HCT, 1823 (39%) responded after a single mailing and subsequent reminder letter. The participants' median age was 59 years (interquartile range [IQR], 50-66 years); 52.5% were male, and most were non-Hispanic white. The median time since HCT was 9 years (IQR, 3-18 years). Lower patient-reported resilience was associated with chronic graft-versus-host disease of higher severity, lower performance scores, missing work because of health, and permanent disability (all P patients reporting low resilience scores had higher odds of having psychological distress (odds ratio [OR], 3.0; 95% confidence interval [CI], 2.1-4.3) and being in the lowest quartile for mental health-related quality of life (OR, 5.9; 95% CI, 4.4-8.0). Patient-reported resilience is independently associated with health and psychosocial outcomes. Future studies must determine whether interventions can bolster resilience and improve survivorship outcomes. © 2015 American Cancer Society.

  1. Childhood Cancer Survivor Study: An Overview

    Science.gov (United States)

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

  2. Detroit Research on Cancer Survivors Study

    Science.gov (United States)

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

  3. Secondhand Smoke Still Plagues Some Cancer Survivors

    Science.gov (United States)

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

  4. Exploring the relationship between fear of cancer recurrence and sleep quality in cancer survivors.

    Science.gov (United States)

    Berrett-Abebe, Julie; Cadet, Tamara; Pirl, William; Lennes, Inga

    2015-01-01

    Fear of cancer recurrence (FCR) and sleep disturbance are identified as top psychosocial concerns in cancer survivorship, yet few studies have explored the association between these two factors. Using data from a study of 67 cancer survivors, hierarchical logistic regression models examined the relationships between socio-demographic characteristics, FCR, and sleep disturbance. More than half of survivors reported poor sleep quality; those with some college education and those with higher levels of FCR were at greater risk for poor sleep. These findings provide formative data for oncology social workers to implement interventions that target FCR as a strategy for improving sleep.

  5. Long-Term Risk of Dementia among Survivors of Ischemic or Hemorrhagic Stroke

    DEFF Research Database (Denmark)

    Corraini, Priscila; Henderson, Victor; Ording, Anne Gulbech

    2017-01-01

    type did not change during follow-up and was not altered appreciably by age, sex, or preexisting diagnoses of vascular conditions. CONCLUSIONS: Stroke increases dementia risk. Survivors of intracerebral hemorrhage and subarachnoid hemorrhage are at particularly high long-term risk of poststroke......BACKGROUND AND PURPOSE: Stroke is a risk factor for dementia, but the risk of dementia after different stroke types is poorly understood. We examined the long-term risk of dementia among survivors of any first-time stroke and of first-time ischemic stroke, intracerebral hemorrhage, and subarachnoid...... ratios of dementia up to 30 years after stroke. RESULTS: The 30-year absolute risk of dementia among stroke survivors was 11.5% (95% confidence interval, 11.2%-11.7%). Compared with the general population, the hazard ratio (95% confidence interval) for dementia among stroke survivors was 1.80 (1...

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

    Directory of Open Access Journals (Sweden)

    Karen Y. Wonders

    2017-09-01

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

  7. Obesity and Metabolic Syndrome Among Adult Survivors of Childhood Leukemia.

    Science.gov (United States)

    Gibson, Todd M; Ehrhardt, Matthew J; Ness, Kirsten K

    2016-04-01

    Treatment-related obesity and the metabolic syndrome in adult survivors of childhood acute lymphoblastic leukemia (ALL) are risk factors for cardiovascular disease. Both conditions often begin during therapy. Preventive measures, including dietary counseling and tailored exercise, should be initiated early in the course of survivorship, with referral to specialists to optimize success. However, among adults who develop obesity or the metabolic syndrome and who do not respond to lifestyle therapy, medical intervention may be indicated to manage underlying pathology, such as growth hormone deficiency, or to mitigate risk factors of cardiovascular disease. Because no specific clinical trials have been done in this population to treat metabolic syndrome or its components, clinicians who follow adult survivors of childhood ALL should use the existing American Heart Association/National Heart Lung and Blood Institute Scientific Statement to guide their approach.

  8. Stroke survivors' experiences of rehabilitation

    DEFF Research Database (Denmark)

    Peoples, Hanne; Satink, Ton; Steultjens, Esther

    2011-01-01

    INTRODUCTION: The aim was to obtain the best available knowledge on stroke survivors' experiences of rehabilitation. The increase in demands for accountability in health care and acknowledgement of the importance of client participation in health decisions calls for systematic ways of integrating...... survivors' experiences of rehabilitation in a clinical setting. Data analysis entailed extracting, editing, grouping, and abstracting findings. RESULTS: Twelve studies were included. One theme, "Power and Empowerment" and six subcategories were identified: 1) Coping with a new situation, 2) Informational...... needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control. DISCUSSION: The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual...

  9. Cancer survivors' experience of time

    DEFF Research Database (Denmark)

    Rasmussen, Dorte M.; Elverdam, Beth

    2007-01-01

    survivors over time to explore how perceptions and experiences change. METHODS: An exploratory study was carried out in 2002-2004 with a purposive sample of adults who had experienced various forms of cancer. Data collection included 9 weeks of participant observation at a Cancer Rehabilitation Centre...... and ethnographic interviews with 23 informants. Ten men and 13 women were interviewed twice: 2 weeks after their stay and 18 months later. FINDINGS: Data were analysed from a culture-analytical perspective. Three main themes regarding the survivors' handling and perception of time were found: (1) cancer disrupts......AIM: This paper reports a study to explore how cancer survivors talk about, experience and manage time in everyday life. BACKGROUND: There is an increasing interest in specific physical and psychosocial aspects of life after cancer diagnosis and treatment, but hardly any research follows cancer...

  10. 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…

  11. Enterprise Characteristics Affecting Resource Poor Women Food ...

    African Journals Online (AJOL)

    This study examines socio-economic characteristics affecting resource poor women food vendors and their income generation in Imo State, Nigeria. Data were collected from 109 respondents with the aid of structured questionnaire and interview schedule. The study found that low income earners dominate food vending ...

  12. Inference in `poor` languages

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, S.

    1996-10-01

    Languages with a solvable implication problem but without complete and consistent systems of inference rules (`poor` languages) are considered. The problem of existence of finite complete and consistent inference rule system for a ``poor`` language is stated independently of the language or rules syntax. Several properties of the problem arc proved. An application of results to the language of join dependencies is given.

  13. Exploiting the Poor

    DEFF Research Database (Denmark)

    Justesen, Mogens Kamp; Bjørnskov, Christian

    2014-01-01

    While extant research has focused on the causes and consequences of corruption at the macro-level, less effort has been devoted to understanding the micro-foundation of corruption. We argue that poor people are more likely to be victims of corrupt behavior by street-level bureaucrats as the poor...

  14. Correspondence of Neutralizing Humoral Immunity and CD4 T Cell Responses in Long Recovered Sudan Virus Survivors.

    Science.gov (United States)

    Sobarzo, Ariel; Stonier, Spencer W; Herbert, Andrew S; Ochayon, David E; Kuehne, Ana I; Eskira, Yael; Fedida-Metula, Shlomit; Tali, Neta; Lewis, Eli C; Egesa, Moses; Cose, Stephen; Lutwama, Julius Julian; Yavelsky, Victoria; Dye, John M; Lobel, Leslie

    2016-05-11

    Robust humoral and cellular immunity are critical for survival in humans during an ebolavirus infection. However, the interplay between these two arms of immunity is poorly understood. To address this, we examined residual immune responses in survivors of the Sudan virus (SUDV) outbreak in Gulu, Uganda (2000-2001). Cytokine and chemokine expression levels in SUDV stimulated whole blood cultures were assessed by multiplex ELISA and flow cytometry. Antibody and corresponding neutralization titers were also determined. Flow cytometry and multiplex ELISA results demonstrated significantly higher levels of cytokine and chemokine responses in survivors with serological neutralizing activity. This correspondence was not detected in survivors with serum reactivity to SUDV but without neutralization activity. This previously undefined relationship between memory CD4 T cell responses and serological neutralizing capacity in SUDV survivors is key for understanding long lasting immunity in survivors of filovirus infections.

  15. Correspondence of Neutralizing Humoral Immunity and CD4 T Cell Responses in Long Recovered Sudan Virus Survivors

    Directory of Open Access Journals (Sweden)

    Ariel Sobarzo

    2016-05-01

    Full Text Available Robust humoral and cellular immunity are critical for survival in humans during an ebolavirus infection. However, the interplay between these two arms of immunity is poorly understood. To address this, we examined residual immune responses in survivors of the Sudan virus (SUDV outbreak in Gulu, Uganda (2000–2001. Cytokine and chemokine expression levels in SUDV stimulated whole blood cultures were assessed by multiplex ELISA and flow cytometry. Antibody and corresponding neutralization titers were also determined. Flow cytometry and multiplex ELISA results demonstrated significantly higher levels of cytokine and chemokine responses in survivors with serological neutralizing activity. This correspondence was not detected in survivors with serum reactivity to SUDV but without neutralization activity. This previously undefined relationship between memory CD4 T cell responses and serological neutralizing capacity in SUDV survivors is key for understanding long lasting immunity in survivors of filovirus infections.

  16. Coping with Ottoman Turkish Genocide: an exploration of the experience of Armenian survivors.

    Science.gov (United States)

    Kalayjian, A S; Shahinian, S P; Gergerian, E L; Saraydarian, L

    1996-01-01

    This study explored the experiences of the survivors of the Ottoman-Turkish Genocide of the Armenians (1915-1923). Coping strategies, communication patterns and the impact of continuing Turkish denial of the events were the specific research areas. Semi-structured interviews were administered to 40 Genocide survivors, residing at two Armenian homes for older adults in the mid-Atlantic United States. Destruction of life, physical harm, deportation, pillaging, and loss of status were identified by respondents as stressors experienced. Religion, family, work, denial, and resignation were identified as coping methods and sources of survival. Most respondents had not discussed their experiences with others. When asked about their reactions to the Turkish denial, respondents expressed a range of negative affect, including resentment, hatred, and rage. When asked about sources of pride in their lives, respondents cited accomplishments such as surviving the Genocide, surviving as Armenians and procreating. The social, developmental, and psychiatric implications of the findings were discussed.

  17. Rehabilitation interventions for cancer survivors

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  18. Suicide Ideation and Associated Mortality in Adult Survivors of Childhood Cancer

    Science.gov (United States)

    Brinkman, Tara M.; Zhang, Nan; Recklitis, Christopher J.; Kimberg, Cara; Zeltzer, Lonnie K.; Muriel, Anna C.; Stovall, Marilyn; Srivastava, Deo Kumar; Sklar, Charles A.; Robison, Leslie L.; Krull, Kevin R.

    2013-01-01

    Background Adult survivors of childhood cancer are at-risk for suicide ideation, though longitudinal patterns and rates of recurrent suicide ideation are unknown. We investigated the prevalence of late report (i.e. post-initial assessment) and recurrent suicide ideation in adult survivors of childhood cancer, identified predictors of suicide ideation, and examined associations among suicide ideation and mortality. Methods Participants included 9,128 adult survivors of childhood cancer and 3,082 sibling controls enrolled in the Childhood Cancer Survivor Study who completed a survey question assessing suicide ideation on one or more occasions between 1994 and 2010. Suicide ideation was assessed using the Brief Symptom Inventory-18. Mortality data was ascertained from the National Death Index. Results Survivors were more likely to report late (Odds Ratio (OR) =1.9; 95% Confidence Interval (CI) =1.5–2.5) and recurrent suicide ideation (OR=2.6, 95% CI=1.8–3.8) compared to siblings. Poor physical health status was associated with increased risk of suicide ideation in survivors (late report: OR=1.9, 95% CI=1.3–2.7; recurrent: OR=1.9, 95% CI=1.2–2.9). Suicide ideation was associated with increased risk for all-cause mortality (Hazard Ratio (HR) =1.3, 95% CI=1.03–1.6) and death by external causes (HR=2.4, 95% CI=1.4–4.1). Conclusion Adult survivors of childhood cancer are at-risk for late report and recurrent suicide ideation, which is associated with increased risk of mortality. Routine screening for psychological distress in adult survivors appears warranted, especially for survivors who develop chronic physical health conditions. PMID:24122148

  19. Cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult cancer.

    Science.gov (United States)

    Kaul, Sapna; Veeranki, Sreenivas P; Rodriguez, Ana M; Kuo, Yong-Fang

    2016-09-15

    We examined the associations between cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult (AYA) cancer and a comparison group. From the 2012 to 2014 National Health Interview Surveys, we identified 1019 survivors of AYA cancer, defined as individuals who had been diagnosed with cancer between 15 and 39 years of age and were at least 5 years after their initial cancer diagnosis. A noncancer comparison group was matched on age, sex, and other factors. Self-reported smoking status (never smoker, former smoker, or current smoker), comorbidities (eg, asthma and diabetes), and general health status (excellent, very good, or good versus poor or fair) were compared among these groups. Survivors' smoking status before diagnosis and interaction with health care professionals regarding smoking cessation were reported. Multivariable logistic regressions modeled the associations between smoking status and comorbidity and general health. 33% of survivors were current smokers compared with 22% in the comparison group (P health was significantly higher among survivors. Current smokers among survivors were more likely to report greater comorbidities (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.06-2.47; P = .03) and less likely to report at least good health (OR, 0.34; 95% CI, 0.22-0.54; P smoked currently, 92% started smoking before diagnosis, and 37% reported having no smoking-related discussions with health care professionals in the previous year. Smoking among survivors of AYA cancer is associated with greater comorbidities and poorer general health. Younger survivors may need to be targeted for effective smoking cessation interventions. Addressing cigarette smoking during medical visits may encourage survivors to quit smoking. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2895-2905. © 2016 American Cancer Society. © 2016 American Cancer Society.

  20. Postpolio Survivors: Needs for and Access to Social and Health Care Services.

    Science.gov (United States)

    Foster, Larry W.; And Others

    1993-01-01

    Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were…

  1. Daughter's Perceptions of Being Mothered by an Incest Survivor: A Phenomenological Study.

    Science.gov (United States)

    Voth, Peggy Funk; Tutty, Leslie M.

    1999-01-01

    Presents results of an analysis on the experiences of daughters of incest survivors. Reports that daughters responded with a lack of affection toward their mothers, and had complications in differentiation and integration of a negative self-view. Notes that mother's ultimate disclosure of incest history helped the daughter offset difficulties.…

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

    Science.gov (United States)

    Record, Elizabeth O; Meacham, Lillian R

    2015-07-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  4. Health Behaviors of Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Jennifer S. Ford

    2014-10-01

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

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

    Science.gov (United States)

    Lurie, Ido

    2017-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Stefan Essig

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

  7. Psychosexual functioning of childhood cancer survivors.

    Science.gov (United States)

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

    2008-05-01

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

  8. Follow-Up Programs for Childhood Cancer Survivors in Europe: A Questionnaire Survey

    Science.gov (United States)

    Essig, Stefan; Skinner, Roderick; von der Weid, Nicolas X.; Kuehni, Claudia E.; Michel, Gisela

    2012-01-01

    Background For many childhood cancer survivors follow-up care is important long after treatment completion. We aimed to describe the availability and characteristics of long-term follow-up programs (LTFU) across Europe, their content and aims, their problems, and to assess opinions on different models of LTFU. Methodology/Principal Findings We asked 179 pediatric oncology institutions in 20 European countries to complete an online survey on LTFU available at their institution. Of 110 respondents (62% response), 66% reported having LTFU for pediatric survivors, 38% for adult survivors of childhood cancer. Availability varied widely across European regions, from 9% of institutions in Northern Europe reporting LTFU for adult survivors to 83% of institution on the British Isles reporting LTFU for pediatric survivors. Pediatric and adult LTFU were usually located in pediatric hospitals and run by pediatric oncologists. Content of follow-up included screening for adverse outcomes and health education. Important problems included lack of time, personnel and funding. Most institutions without LTFU reported that they would like to offer a program (86%). Conclusion/Significance Despite general agreement on the need of follow-up care, there is still a lack of well-organized LTFU for survivors of childhood cancer across Europe. PMID:23300889

  9. Follow-up programs for childhood cancer survivors in Europe: a questionnaire survey.

    Directory of Open Access Journals (Sweden)

    Stefan Essig

    Full Text Available BACKGROUND: For many childhood cancer survivors follow-up care is important long after treatment completion. We aimed to describe the availability and characteristics of long-term follow-up programs (LTFU across Europe, their content and aims, their problems, and to assess opinions on different models of LTFU. METHODOLOGY/PRINCIPAL FINDINGS: We asked 179 pediatric oncology institutions in 20 European countries to complete an online survey on LTFU available at their institution. Of 110 respondents (62% response, 66% reported having LTFU for pediatric survivors, 38% for adult survivors of childhood cancer. Availability varied widely across European regions, from 9% of institutions in Northern Europe reporting LTFU for adult survivors to 83% of institution on the British Isles reporting LTFU for pediatric survivors. Pediatric and adult LTFU were usually located in pediatric hospitals and run by pediatric oncologists. Content of follow-up included screening for adverse outcomes and health education. Important problems included lack of time, personnel and funding. Most institutions without LTFU reported that they would like to offer a program (86%. CONCLUSION/SIGNIFICANCE: Despite general agreement on the need of follow-up care, there is still a lack of well-organized LTFU for survivors of childhood cancer across Europe.

  10. 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

  11. Poor school performance

    National Research Council Canada - National Science Library

    Karande, Sunil; Kulkarni, Madhuri

    2005-01-01

    Education is one of the most important aspects of human resource development. Poor school performance not only results in the child having a low self-esteem, but also causes significant stress to the parents...

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

    Science.gov (United States)

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

    2007-07-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  14. First Responders and Criticality Accidents

    Energy Technology Data Exchange (ETDEWEB)

    Valerie L. Putman; Douglas M. Minnema

    2005-11-01

    Nuclear criticality accident descriptions typically include, but do not focus on, information useful to first responders. We studied these accidents, noting characteristics to help (1) first responders prepare for such an event and (2) emergency drill planners develop appropriate simulations for training. We also provide recommendations to help people prepare for such events in the future.

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

    Science.gov (United States)

    Hans, Jason D; Gillen, Martie

    2013-01-01

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

  16. Fertility and cancer--a qualitative study of Australian cancer survivors.

    Science.gov (United States)

    Penrose, Rebecca; Beatty, Lisa; Mattiske, Julie; Koczwara, Bogda

    2012-06-01

    This study aims to assess the fertility concerns among cancer survivors aged 50 and under as part of a larger study investigating the survivors' concerns regarding fertility, sexuality and parenting. Cancer survivors who were at least 1 month post-treatment were invited to a recorded interview. The patients were identified from an oncology database and invited to participate via letter or during clinic consultation. The participants were recruited until saturation of themes was achieved. Transcripts were coded thematically, with greater emphasis given to frequently raised themes. Twenty-five survivors (19 women) were interviewed. The median age was 37 (range 24-50). Median time since completion of treatment was 7 months. Twenty were married or in a relationship; 18 had children at the time of diagnosis. Two became pregnant after treatment. Four themes were identified: (1) Fertility represents more than child-bearing capacity: potential fertility loss was a concern for participants, irrespective of their desire for future children; (2) Assumed infertility: There was a tendency for participants to assume that they were infertile; (3) Lack of information regarding decision-making and fertility: The respondents reported a perceived lack of consideration of fertility at diagnosis by medical professionals, and this impacted upon the decision-making process; and (4) Participant recommendations: The respondents wanted more information and for support services to be offered. Fertility is an important concern for young cancer survivors. There is a need for strategies regarding information provision and support for cancer patients with regard to these concerns.

  17. Trends in cancer survivors' experience of patient-centered communication: results from the Health Information National Trends Survey (HINTS).

    Science.gov (United States)

    Blanch-Hartigan, Danielle; Chawla, Neetu; Moser, Richard P; Finney Rutten, Lila J; Hesse, Bradford W; Arora, Neeraj K

    2016-12-01

    Two Institute of Medicine reports almost a decade apart suggest that cancer survivors often feel "lost in transition" and experience suboptimal quality of care. The six core functions of patient-centered communication: managing uncertainty, responding to emotions, making decisions, fostering healing relationships, enabling self-management, and exchanging information, represent a central aspect of survivors' care experience that has not been systematically investigated. Nationally representative data from four administrations of the Health Information National Trends Survey (HINTS) was merged with combined replicate weights using the jackknife replication method. Linear and logistic regression models were used to assess (1) characteristics of cancer survivors (N = 1794) who report suboptimal patient-centered communication and (2) whether survivors' patient-centered communication experience changed from 2007 to 2013. One third to one half of survivors report suboptimal patient-centered communication, particularly on core functions of providers helping manage uncertainty (48 %) and responding to emotions (49 %). In a fully adjusted linear regression model, survivors with more education (Wald F = 2.84, p = .04), without a usual source of care (Wald F = 11.59, p health (Wald F = 9.08, p communication. Although ratings of patient-centered communication improved over time (p trend = .04), this trend did not remain significant in fully adjusted models. Despite increased attention to survivorship, many survivors continue to report suboptimal communication with their health care providers. Survivorship communication should include managing uncertainty about future risk and address survivors' emotional needs. Efforts to improve patient-centered communication should focus on survivors without a usual source of care and in poorer health.

  18. Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings.

    Science.gov (United States)

    Dahl, Alv A; Østby-Deglum, Marie; Oldenburg, Jan; Bremnes, Roy; Dahl, Olav; Klepp, Olbjørn; Wist, Erik; Fosså, Sophie D

    2016-10-01

    The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally. At a mean of 11 years after diagnosis, 1418 TCSs responded to a mailed questionnaire, and at a mean of 19 years after diagnosis, 1046 of them responded again to a modified questionnaire. Posttraumatic symptoms related to testicular cancer were self-rated with the Impact of Event Scale (IES) at the 11-year study only. An IES total score ≥35 defined Full PTSD, and a score 26-34 identified Partial PTSD, and the combination of Full and Partial PTSD defined Probable PTSD. At the 11-year study, 4.5 % had Full PTSD, 6.4 % had Partial PTSD, and 10.9 % Probable had PTSD. At both studies, socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis. In spite of excellent prognosis, 10.9 % of long-term testicular cancer survivors had Probable PTSD at a mean of 11 years after diagnosis. Probable PTSD was significantly associated with a broad range of problems both at that time and was predictive of considerable problems at a mean of 19 year postdiagnosis. Among long-term testicular cancer survivors, 10.9 % have Probable PTSD with many associated problems, and therefore health personnel should explore stress symptoms at follow-up since efficient treatments are available.

  19. Post-traumatic stress disorder and depression among adult survivors 8 years after the 2008 Wenchuan earthquake in China.

    Science.gov (United States)

    Guo, Jing; He, Huan; Qu, Zhiyong; Wang, Xiaohua; Liu, Chengbin

    2017-03-01

    The Wenchuan earthquake was China's worst natural disaster of the past three decades. Although the psychological sequelae of disasters can last for many years, the long-term sequelae and their risk factors tend to receive little research attention. The objectives of the present study were to estimate the prevalences of symptomalogical PTSD and depression among survivors 8 years after the Wenchuan earthquake, and to identify the shared and unshared risk factors associated with PTSD and depression, using data from a cross-sectional survey. 1369 participants were recruited from two different sites in the areas that were severely affected by the earthquake. Symptomalogical PTSD was assessed by the Impact of Event Scale-Revised (IES-R). The Chinese edition of the Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. Traumatic exposure to the Wenchuan earthquake was assessed using an exposure checklist designed by this study. Eight years after the Wenchuan earthquake, 11.8% of the respondents had symptomalogical PTSD, and 24.8% of respondents had probable depression. The results also indicated that female gender, low education, poor perceived health, and traumatic experiences after the earthquake were associated with higher odds of both PTSD and depression among survivors. Direct exposure to the earthquake was associated with comorbid symptomalogical PTSD and depression (OR=1.86; 95% CI=1.42, 2.44). Those having only depression were more likely to be unmarried/divorced/widowed, and to have experienced fear at the time of the earthquake (OR=1.34; 95% CI=1.04, 1.72), while those with only symptomalogical PTSD were likely to be from the township of Yongan as opposed to Guangji (OR=1.86; 95% CI=1.06, 3.31). This is a cross-sectional study, and thus is insufficient for determining causal relationships with regard to chronic PTSD or depression. The results of this study indicate that symptomalogical PTSD and depression persist among many

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2014-10-01

    A high proportion of pediatric cancer patients are now surviving into adulthood, but are at increased risk for late morbidity and premature mortality related to their diagnosis and therapeutic exposures. Little is known about the potential success of recruiting adult survivors of childhood cancer into research projects that would require a risk-based health evaluation within a clinical setting. Pediatric cancer survivors and siblings eligible for the current study were Childhood Cancer Survivor Study participants who lived within 100 miles of one of five Consortium for Pediatric Intervention Research institutions, regardless of where they were initially diagnosed and treated. A short survey was mailed to 829 survivors and 373 siblings to identify factors that predict interest, potential barriers, and motivators, to participation in research including a risk-based clinical evaluation. Overall, 92% of survivors responding to the survey were very interested/interested in participating in a research study requiring a visit to a local hospital clinic. Siblings of survivors were less interested than survivors in participating in such a study, with only 78% indicating that they were very interested/interested. Potential motivators to participation included visiting their treating hospital and receiving health information. The primary barrier to participation was related to taking time off from work. This study demonstrates that a subgroup of survivors would be willing to return to a long-term follow-up center to participate in intervention-based research. Identified motivating factors and perceived barriers need to be considered in determining the feasibility, design and execution of future research. © 2014 Wiley Periodicals, Inc.

  2. Parenthood in survivors of Hodgkin lymphoma: an EORTC-GELA general population case-control study.

    Science.gov (United States)

    van der Kaaij, Marleen A E; Heutte, Natacha; Meijnders, Paul; Abeilard-Lemoisson, Edwige; Spina, Michele; Moser, Lotte C; Allgeier, Anouk; Meulemans, Bart; Dubois, Brice; Simons, Arnold H M; Lugtenburg, Pieternella J; Aleman, Berthe M P; Noordijk, Evert M; Fermé, Christophe; Thomas, José; Stamatoullas, Aspasia; Fruchart, Christophe; Brice, Pauline; Gaillard, Isabelle; Doorduijn, Jeanette K; Sebban, Catherine; Smit, Wilma G J M; Bologna, Serge; Roesink, Judith M; Ong, Francisca; André, Marc P E; Raemaekers, John M M; Henry-Amar, Michel; Kluin-Nelemans, Hanneke C

    2012-11-01

    We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls. A Life Situation Questionnaire was sent to 3,604 survivors treated from 1964 to 2004 in successive clinical trials. Responders were matched with controls (1:3 or 4) for sex, country, education, and year of birth (10-year groups). Controls were given an artificial date of start of treatment equal to that of their matched case. The main end point was presence of biologic children after treatment, which was evaluated by using conditional logistic regression analysis. Logistic regression analysis was used to analyze factors influencing spontaneous post-treatment parenthood. In all, 1,654 French and Dutch survivors were matched with 6,414 controls. Median follow-up was 14 years (range, 5 to 44 years). After treatment, the odds ratio (OR) for having children was 0.77 (95% CI, 0.68 to 0.87; P < .001) for survivors compared with controls. Of 898 survivors who were childless before treatment, 46.7% achieved post-treatment parenthood compared with 49.3% of 3,196 childless controls (OR, 0.87; P = .08). Among 756 survivors with children before treatment, 12.4% became parents after HL treatment compared with 22.2% of 3,218 controls with children before treatment (OR, 0.49; P < .001). Treatment with alkylating agents, second-line therapy, and age older than 35 years at treatment appeared to reduce the chances of spontaneous post-treatment parenthood. Survivors of HL had slightly but significantly fewer children after treatment than matched general population controls. The difference concerned only survivors who had children before treatment and appears to have more personal than biologic reasons. The chance of successful post-treatment parenthood was 76%.

  3. Complementary and Alternative Medicine Use Among Overweight and Obese Cancer Survivors in the United States.

    Science.gov (United States)

    Ojukwu, Mary; Mbizo, Justice; Leyva, Bryan; Olaku, Oluwadamilola; Zia, Farah

    2015-11-01

    The purpose of the study was to determine the prevalence of complementary and alternative medicine (CAM) use among US cancer survivors; examine whether use varies by underweight/normal weight, overweight, and obese body mass index status; determine reasons for use; and document disclosure rates of CAM use to medical professionals. Data for 1785 cancer survivors were obtained from the 2007 National Health Interview Survey and CAM supplement. The prevalence and associations of CAM use in the previous 12 months were compared among underweight/normal weight, overweight, and obese adult cancer survivors. Nearly 90% of cancer survivors used at least one type of CAM therapy in the 12 months preceding the survey. Those who were overweight, but not obese, were more likely to use a CAM modality compared to normal/underweight respondents. Over two thirds (71%) reported using CAM therapy for general health and wellness and 39.3% used CAM because a health care provider recommended it. Disclosure rates of CAM use to conventional medical professionals varied widely by CAM modality. An overwhelming majority of US cancer survivors use CAM for a variety of reasons. Overweight cancer survivors may be more likely to use CAM than those who are underweight, normal weight, or obese. Cancer survivors should be screened by medical providers for the use of CAM therapies; furthermore, prospective clinical research evaluating the efficacy and safety of biologically based CAM therapies, often used by cancer survivors, is important and necessary for the well-being of this population. © The Author(s) 2015.

  4. Beliefs in karma and reincarnation among survivors of violent trauma--a community survey.

    Science.gov (United States)

    Davidson, Jonathan R T; Connor, Kathryn M; Lee, Li-Ching

    2005-02-01

    This survey was designed to examine beliefs in karma and reincarnation among survivors of violent trauma in the general US population. Two community surveys were conducted in 2001. From a sample of 1,969 respondents, two groups were created based on level of agreement with karmic belief. This sample forms the basis of this report. Information was obtained as to mental and physical health, resilience, exposure to violent trauma, and posttraumatic stress disorder (PTSD) symptom severity, and the cohorts were compared on these variables. Five percent of the sample admitted strong agreement to a belief in karma and reincarnation (n=99), while 77% strongly disagreed with these beliefs (n=1,511). Characteristics associated with agreement included being non-white, unmarried, and in poor physical and mental health. Moreover, agreement was associated with more extensive traumatization, including abuse, rape, and loss of a family member through violent death, as well as more severe posttraumatic stress symptoms. Few people subscribe strongly to a belief in karma and reincarnation in the US population, but personal experience of trauma may be associated with greater acceptance, as well as certain demographic and health-associated variables. The importance of holding such beliefs, which may represent an important way of coping following violent trauma, deserves further study.

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

    Directory of Open Access Journals (Sweden)

    Oshima Sumiko

    2013-01-01

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

  6. Responder Technology Alert (February 2015)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-04-10

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

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

    Science.gov (United States)

    Reed, Mark D.; Greenwald, Jason Y.

    1991-01-01

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

  8. Adult survivors of invasive pneumococcal disease exhibit defective B cell function.

    Science.gov (United States)

    Darton, Tom C; Wing, James B; Lees, Andrew; Heath, Andrew W; Read, Robert C

    2011-05-01

    Adults who have recovered from an episode of invasive pneumococcal disease demonstrate defective B cell activation in response to αδ-dex, a polyclonal polysaccharide mimic, compared with matched control subjects. The defect is not overcome by CD4(+) T cell assistance and may explain the relatively poor response to pneumococcal vaccination in survivors of invasive pneumococcal disease.

  9. Psychosocial Outcomes in Adult Survivors of Retinoblastoma

    Science.gov (United States)

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

    2015-01-01

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

  10. Poor school performance.

    Science.gov (United States)

    Karande, Sunil; Kulkarni, Madhuri

    2005-11-01

    Education is one of the most important aspects of human resource development. Poor school performance not only results in the child having a low self-esteem, but also causes significant stress to the parents. There are many reasons for children to under perform at school, such as, medical problems, below average intelligence, specific learning disability, attention deficit hyperactivity disorder, emotional problems, poor socio-cultural home environment, psychiatric disorders and even environmental causes. The information provided by the parents, classroom teacher and school counselor about the child's academic difficulties guides the pediatrician to form an initial diagnosis. However, a multidisciplinary evaluation by an ophthalmologist, otolaryngologist, counselor, clinical psychologist, special educator, and child psychiatrist is usually necessary before making the final diagnosis. It is important to find the reason(s) for a child's poor school performance and come up with a treatment plan early so that the child can perform up to full potential.

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

    Directory of Open Access Journals (Sweden)

    Xuji Jia

    2017-07-01

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

  12. Developing Countries Debt Relief Initiative for Poor Countries Faces Challenges Debt Relief Initiative for Poor Countries Faces Challenges

    National Research Council Canada - National Science Library

    Leach, James

    2000-01-01

    This report responds to your request that we (1) assess whether the enhanced Heavily Indebted Poor Countries Initiative is likely to free up resources for poverty reduction and achieve the goal of debt sustainability, (2...

  13. 9. Poor medication

    African Journals Online (AJOL)

    Sitwala

    previous diagnosis of essential hypertension receiving out patient care in the University Teaching. Hospital (UTH) were ... self report and 70% using modified Hill-Bone scale. The mean age was ... Factors Associated With Poor Medication Adherence .... DM. Yes. No. 51. 183. 42(83). 151(83). 9(17). 32(17). 1. 1 (0. 5 -2. 4).

  14. Morphosyntax in Poor Comprehenders

    Science.gov (United States)

    Adlof, Suzanne M.; Catts, Hugh W.

    2015-01-01

    Children described as "poor comprehenders" (PCs) have reading comprehension difficulties in spite of adequate word reading abilities. PCs are known to display weakness with semantics and higher-level aspects of oral language, but less is known about their grammatical skills, especially with regard to morphosyntax. The purpose of this…

  15. to the poor?

    African Journals Online (AJOL)

    2006-03-01

    Mar 1, 2006 ... than better-off ones, the differences are relatively modest and arc generally high enough to confer immunity through the herd immunity effect. As elsewhere in ... with herd immunity in force, protecting all children, howev- er rich or poor ... by a medical professional (doctor, nurse, or trained midwife) at delivery ...

  16. A poor deal

    NARCIS (Netherlands)

    Breman, J.

    2010-01-01

    The proposed upward revision of the poverty line has failed to capture the Janus-faced deprivation experienced by the poor. The methodological foundation of the proposed poverty line fails to overcome the discrepancy between the macro-statistics and the micro-reality. The proposed report on the

  17. Health and functional status and utilization of health care services among holocaust survivors and their counterparts in Israel.

    Science.gov (United States)

    Iecovich, Esther; Carmel, Sara

    2010-01-01

    To examine differences in health and functional status and in utilization of health services between holocaust survivors and their counterparts; and (b) to investigate if holocaust survivor status is a significant predictor of health status, functional status, and utilization of health services. The study included 1255 respondents of whom 272 were holocaust survivors. Interviews were conducted face-to-face at the respondents' homes. Participants were asked about their health (self-rated health and comorbidity) and functional (ADL and IADL) status, utilization of inpatient and outpatient health care services, age, gender, education, marital status, length of residence in Israel, and if they were holocaust survivors. Holocaust survivors, who were frailer and more chronically ill compared to their counterparts, visited their family physician and the nurse at the health care clinic more often than their counterparts did, and received more homecare services. Yet, there were no differences between them in the utilization of other health care services such as visits to specialists, emergency department, and hospitalizations. Holocaust survivors are more homebound due to more morbidity and functional limitations and therefore receive more health home care services that offset the utilization of other health services. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. A Comparison of Physical Activity Preferences Among Breast, Prostate, and Colorectal Cancer Survivors in Nova Scotia, Canada.

    Science.gov (United States)

    Forbes, Cynthia C; Blanchard, Chris M; Mummery, W Kerry; Courneya, Kerry S

    2015-06-01

    Physical activity (PA) preferences may vary by cancer survivor group, but few studies have made direct comparisons. The purpose of this study was to compare the PA preferences of breast, prostate, and colorectal cancer survivors in Nova Scotia (NS), Canada. Two thousand sixty-two breast, prostate, and colorectal cancer survivors diagnosed between 2003 to 2011 were identified by the Nova Scotia Cancer Registry and mailed a questionnaire assessing PA preferences and standard demographic and medical variables. Based on 741 respondents, numerous differences emerged among the cancer sites. Some of the larger differences (>20% difference) among breast, prostate, and colorectal cancer survivors, respectively, were identified for engaging in PA with other cancer survivors (42% vs. 22% vs. 30%; P < .001) and with their friends (65% vs. 40% vs. 64%; P < .001); engaging in PA at a community fitness center (59% vs. 39% vs. 45%; P < .001); and preferring supervised (60% vs. 34% vs. 45%; P < .001) and group (53% vs. 24% vs. 41%; P < .001) sessions. Differences were also found within each survivor group based on demographic and medical variables including PA behavior, age, and perceived general health. Breast, prostate, and colorectal cancer survivors have some differences in PA preferences that may inform targeted PA program interventions.

  20. Childhood Trauma, Social Networks, and the Mental Health of Adult Survivors.

    Science.gov (United States)

    Schneider, F David; Loveland Cook, Cynthia A; Salas, Joanne; Scherrer, Jeffrey; Cleveland, Ivy N; Burge, Sandra K

    2017-03-01

    The purpose of this study was to investigate the relationship of childhood trauma to the quality of social networks and health outcomes later in adulthood. Data were obtained from a convenience sample of 254 adults seen in one of 10 primary care clinics in the state of Texas. Standardized measures of adverse childhood experiences (ACEs), stressful and supportive social relationships, medical conditions, anxiety, depression, and health-related quality of life were administered. Using latent class analysis, subjects were assigned to one of four ACE classes: (a) minimal childhood abuse (56%), (b) physical/verbal abuse of both child and mother with household alcohol abuse (13%), (c) verbal and physical abuse of child with household mental illness (12%), and (d) verbal abuse only (19%). Statistically significant differences across the four ACE classes were found for mental health outcomes in adulthood. Although respondents who were physically and verbally abused as children reported compromised mental health, this was particularly true for those who witnessed physical abuse of their mother. A similar relationship between ACE class and physical health was not found. The quality of adult social networks partly accounted for the relationship between ACE classes and mental health outcomes. Respondents exposed to ACEs with more supportive social networks as adults had diminished odds of reporting poor mental health. Conversely, increasing numbers of stressful social relationships contributed to adverse mental health outcomes. Although efforts to prevent childhood trauma remain a critical priority, the treatment of adult survivors needs to expand its focus on both strengthening social networks and decreasing the negative effects of stressful ones.

  1. The association between postdiagnosis dietary supplement use and total mortality differs by diet quality among older female cancer survivors.

    Science.gov (United States)

    Inoue-Choi, Maki; Greenlee, Heather; Oppeneer, Sarah J; Robien, Kim

    2014-05-01

    Dietary supplements are widely used by cancer survivors. However, health effects among older cancer survivors are unclear. We used the Iowa Women's Health Study, a prospective cohort study with 2,118 postmenopausal women with a confirmed cancer diagnosis (1986-2002), to evaluate the association between postdiagnosis dietary supplement use assessed in 2004 and subsequent all-cause mortality. Risk of death was evaluated using multivariable-adjusted Cox proportional hazards regression. We performed stratified analyses by diet quality score, dietary micronutrient intake, and perceived general health. Through 2010, 608 deaths were identified. Approximately 85% of the cancer survivors used dietary supplements. Overall supplement use and multivitamin use were not associated with mortality. Iron supplement use was associated with 39% higher risk of death [95% confidence interval (CI), 1.09-1.77]. This association was stronger among survivors with deteriorating general health. Folic acid supplement use was associated with higher risk of death, only among survivors reporting low-quality diets (HR, 2.33; 95% CI, 1.33-4.08; P interaction = 0.006). Multivitamin use and using a greater number of supplements was associated with a trend towards higher mortality only among those with poor diet quality. Using vitamin E supplements in combination with multivitamin was associated with lower risk of death only among survivors with higher dietary vitamin E intake (HR, 0.61; 95% CI, 0.39-0.94; P interaction = 0.02). Postdiagnosis supplement use was associated with higher mortality among older female cancer survivors with poor general health and/or poor dietary intake. The association between postdiagnosis dietary supplement use and mortality may differ by diet quality and health status among older female cancer survivors. ©2014 AACR.

  2. Agreement among response to intervention criteria for identifying responder status.

    Science.gov (United States)

    Barth, Amy E; Stuebing, Karla K; Anthony, Jason L; Denton, Carolyn A; Mathes, Patricia G; Fletcher, Jack M; Francis, David J

    2008-09-01

    In order to better understand the extent to which operationalizations of response to intervention (RTI) overlap and agree in identifying adequate and inadequate responders, an existing database of 399 first grade students was evaluated in relation to cut-points, measures, and methods frequently cited for the identification of inadequate responders to instruction. A series of 543 2x2 measures of association (808 total comparisons) were computed to address the agreement of different operationalizations of RTI. The results indicate that agreement is generally poor and that different methods tend to identify different students as inadequate responders, although agreement for identifying adequate responders is higher. Approaches to the assessment of responder status must use multiple criteria and avoid formulaic decision making.

  3. "Making My Own Decisions Sometimes": A Pilot Study of Young Adult Cancer Survivors' Perspectives on Medical Decision-Making.

    Science.gov (United States)

    Shay, L Aubree; Schmidt, Susanne; Cornell, Stephanie D; Parsons, Helen M

    2017-07-27

    This study aimed to provide a better understanding of the medical decision-making preferences and experiences of young adult survivors of pediatric, adolescent, and young adult cancers. We conducted key informant interviews and a cross-sectional mailed survey with young adult survivors (currently aged 18-39 years) of pediatric, adolescent, and young adult cancers in South Texas. Of the responding survivors, almost all wanted to be actively involved in medical decision-making, but preferences regarding family and doctor involvement varied. In open-ended responses, the most commonly reported concerns related to medical decision-making were feelings of uncertainty and fear of receiving bad news. Survivors reported that they desired more information in order to feel better about medical decision-making. Due to the variety of preferences regarding decision-making and who to include in the process, physicians should be prepared to ask and accommodate patients regarding their decision-making preferences.

  4. On-scene crisis intervention: psychological guidelines and communication strategies for first responders.

    Science.gov (United States)

    Miller, Laurence

    2010-01-01

    Effective emergency mental health intervention for victims of crime, natural disaster or terrorism begins the moment the first responders arrive. This article describes a range of on-scene crisis intervention options, including verbal communication, body language, behavioral strategies, and interpersonal style. The correct intervention in the first few moments and hours of a crisis can profoundly influence the recovery course of victims and survivors of catastrophic events.

  5. Dietary intake after treatment in child cancer survivors.

    Science.gov (United States)

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

    2012-05-01

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

  6. 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.

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

    DEFF Research Database (Denmark)

    Ratzer, Mette; Brink, Ole; Knudsen, Linda

    2014-01-01

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

  8. Health-related quality of life and psychological distress in young adult survivors of childhood cancer and their association with treatment, education, and demographic factors.

    Science.gov (United States)

    Halvorsen, Janne F; Sund, Anne Mari; Zeltzer, Lonnie; Ådnanes, Marian; Jensberg, Heidi; Eikemo, Terje A; Lund, Bendik; Hjemdal, Odin; Reinfjell, Trude

    2017-10-31

    This study investigated health-related quality of life (HRQOL) and psychological distress among young adult (YA) survivors of childhood cancer and the association of these measures with treatment, education, and demographic factors ≥ 5 years post diagnosis. Participants included cancer survivors (n = 91) recruited through the Cancer Registry of Norway (CRN) and healthy controls (n = 223) recruited from a student population. All participants completed self-report questionnaires, and the Pediatric Quality of Life Inventory (PedsQL™) 4.0 and the Hopkins Symptom Checklist-10 (HSCL-10) as a measure of HRQOL and distress, respectively. Survivors reported HRQOL at the same level as controls, except for poorer physical functioning. Survivors in general, and female survivors specifically, had higher odds than controls of reporting symptoms of distress above cut-off, but survivors did not have higher mean levels of distress compared to controls. Survivors reporting distress levels above the cut-off had significantly poorer HRQOL regarding physical functioning and lower total PedsQL scores than controls scoring above the cut-off. Age (for HRQOL only), female gender, low educational level, and perceived low economic status significantly predicted HRQOL and distress. Education interacted with the effect of cranial radiation in predicting HRQOL. Survivors reported similar mean levels of HRQOL and distress as controls, except for physical functioning. For cancer survivors, demographic variables predicted HRQOL and distress. Some groups of survivors require closer follow-up, and more attention should be paid to factors associated with poor HRQOL and psychological distress in survivors, including female gender, lower education level, and lower income. Survivors treated with cranial radiation may be particular vulnerable in combination with low education regarding HRQOL.

  9. Greatest Challenges of Rectal Cancer Survivors: Results of a Population-Based Survey

    Science.gov (United States)

    McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Wendel, Christopher S.; Grant, Marcia; Hornbrook, Mark C.; Sun, Virginia; Krouse, Robert S.

    2016-01-01

    Background Eliciting cancer survivors’ priorities is essential to address the specific needs of cancer survivor subgroups. Objective To describe long-term rectal cancer survivors’ greatest challenges related to treatment. Design Observational study with cross-sectional survey. Setting Members of Kaiser Permanente, Northern California and Northwest health plans. Patients A survey was mailed to long-term (≥5 years post diagnosis) rectal cancer survivors who had an anastomosis, temporary ostomy, or permanent ostomy. Main Outcome Measures An open-ended question about the greatest challenge related to cancer surgery. We categorized responses using a grounded theory approach with double coding for reliability. Bonferroni-adjusted X2 values were used to assess differences in the proportions of subgroups who mentioned challenges within each response category. Results The survey completion rate was 61% (577/953); 76% (440/577) of participants responded to the greatest challenge question. Respondents’ greatest challenges were bowel/ostomy management (reported by 44%), negative psychosocial effects (37%), late effects of treatment (21%), comorbidities and aging (13%), postoperative recovery (5%), and negative health care experiences (5%). Survivors with temporary ostomy or anastomosis were more likely than survivors with permanent ostomy to report late effects (postomy to report negative psychosocial impacts (p=0.0001). Conclusions Our results reveal the need for bowel/ostomy management, psychosocial services and surveillance for late effects in survivorship and supportive care services for all rectal cancer survivors, regardless of ostomy status. The perspective of long-term survivors with anastomosis reveals challenges that may not be anticipated during treatment decision-making. Limitations Generalizability is restricted by the lack of ethnically and racially diverse, uninsured (non-Medicare-eligible population), and non-English-speaking participants. Because the

  10. Attitudes among medical and nonmedical university students toward the survivors of childhood abuse.

    Science.gov (United States)

    Kandemir, Eyup; Yilmaz, Yasin; Ozmansur, Elif Nurdan; Gunaydin, Hilal; Demirel, Omer Faruk; Berber, Gurol; Kantarci, Nabi; Aliustaoglu, Suheyla; Emul, Murat

    2012-08-01

    Childhood sexual abuse (CSA) is increasing, and current studies should address issues such as stigmas and casual attitudes that may be amenable to intervention. Thus, we aimed to investigate the effects of education on the attitudes of medical students toward CSA survivors. We divided medical students into 2 groups: preclinical and clinical medical students. We compare the attitudes of nonmedical students with the attitudes of medical students with respect to survivors of CSA. All participants were asked to complete a questionnaire about stigmatization. There were 572 students in our study, 347 of whom were enrolled in medical school. Of the 347 medical students, 151 were from the preclinical group, and 196 were from the clinical practice group. The remainder of the participants (n = 225) were in other fields of university. Of the medical students, 68.3% responded negatively about "asking a survivor of abuse to supervise their child for a few hours," whereas 62.7% of the nonmedical students responded negatively. When asked, "What would you think if your child wanted to marry a survivor of sexual abuse?", 72.9% of the medical students and 59.1% of the nonmedical students displayed negative attitudes toward that idea. Our research also found that significantly more preclinical students than clinical students would not want to be in a companionship/friendship with a CSA survivor at work (P = .015) or in their neighborhoods (P = .034). Both medical and nonmedical students seem to have negative thoughts about sexual abuse survivors, particularly when the issue involves their own children and/or social situations. Thus, the medical professionals must be careful and should avoid over interpretations of findings on childhood abuse studies that may lead to stigmatization. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  11. Physical Injury and Somatic Complaints: The Mediating Role of Posttraumatic Stress Symptoms in Young Survivors of a Terror Attack.

    Science.gov (United States)

    Bugge, Ingrid; Dyb, Grete; Stensland, Synne Øien; Ekeberg, Øivind; Wentzel-Larsen, Tore; Diseth, Trond H

    2017-06-01

    Physically injured trauma survivors have particularly high risk for later somatic complaints and posttraumatic stress symptoms (PTSS). However, the potential mediating role of PTSS linking injury to later somatic complaints has been poorly investigated. In this study, survivors (N = 255) were interviewed longitudinally at 2 timepoints after the terror attack on Utøya Island, Norway, in 2011. Assessments included injury sustained during the attack, PTSS (after 4-5 months), somatic complaints (after 14-15 months), and background factors. Causal mediation analysis was conducted to evaluate the potential mediating role of PTSS in linking injury to somatic complaints comparing 2 groups of injured survivors with noninjured survivors. For the nonhospitalized injured versus the noninjured survivors, the mediated pathway was significant (average causal mediation effect; ACME = 0.09, p = .028, proportion = 55.8%). For the hospitalized versus the noninjured survivors, the mediated pathway was not significant (ACME = 0.04, p = .453, proportion = 11.6%). PTSS may play a significant mediating role in the development of somatic complaints among nonhospitalized injured trauma survivors. Intervening health professionals should be aware of this possible pathway to somatic complaints. Copyright © 2017 International Society for Traumatic Stress Studies.

  12. Outcome of poor response Paediatric AML using early SCT

    DEFF Research Database (Denmark)

    Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas

    2013-01-01

    BACKGROUND: Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients...... treated with SCT. MATERIAL AND METHODS: Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17......, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%). CONCLUSIONS: The poor responders in the NOPHO-AML 2004 protocol had...

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

    Science.gov (United States)

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

    2017-05-01

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

  14. Responding to the Invisible Student.

    Science.gov (United States)

    Callahan, Susan

    2000-01-01

    Investigates what constitutes good reflection. Describes how one instructor used the Myers-Briggs type indicator (MBTI) to explore her responses to the reflective writing produced by preservice English teachers. Concludes that the MBTI can provide insight into and improve how instructors assign, respond to, and evaluate student reflection.…

  15. CORRUPTION: HOW SHOULD CHRISTIANS RESPOND?

    African Journals Online (AJOL)

    CHRISTIANS RESPOND? ABSTRACT. The results of the 2010 Corruption Perceptions Index of Transparency International indicate the seriousness of the worldwide corruption problem. Although recent decades have witnessed a global public awareness and an increase in attempts to eradicate corruption, it is an ongoing ...

  16. Responding To An Income Shock Through Increasing Forest ...

    African Journals Online (AJOL)

    Responding To An Income Shock Through Increasing Forest Extraction: Survey Evidence From Ethiopian Coffee Farmers. ... There is however inadequate knowledge with respect to mechanisms used by resource poor coffee farmers to stave off situations of economic hardship. Using cross-sectional household survey data ...

  17. Sixty years of lithium responders.

    Science.gov (United States)

    Grof, Paul

    2010-01-01

    It has been 60 years since Cade first described patients who responded to antimanic lithium treatment. Two decades later, responders to lithium stabilization emerged in larger numbers. The responses of many severely ill bipolar patients to lithium were striking and called for an explanation. Remarkable reactions to a simple ion generated hope for an uncomplicated laboratory test of response and an extensive search for suitable biological markers ensued. But despite promising reports, particularly from molecular genetics, we are still waiting for a biological elucidation of the stabilizing effects of lithium. The most useful predictor of lithium stabilization has to date been the patient's clinical profile, based on a comprehensive clinical assessment: complete remissions and other characteristics of episodic clinical course, bipolar family history, low psychiatric comorbidity and a characteristic presenting psychopathology. In brief, the responders approximate the classical Kraepelinian description of a manic-depressive patient. But the most intriguing findings have recently emerged from prospective observations of the next generation: the children of lithium responders, their counterparts coming from parents who did not respond to lithium and controls. Overall, they indicate that parents and offspring suffer from a comparable brain dysfunction that manifests clinically in distinct stages. If the child's predicament starts early in childhood, it presents with varied, nonaffective or subclinical manifestations that are usually nonresponsive to standard treatments prescribed according to the symptoms. The next stage then unfolds in adolescence, first with depressive and later with activated episodes. The observations have a potential to markedly enrich the prevailing understanding and management of mood disorders. Copyright 2010 S. Karger AG, Basel.

  18. Outcome of paediatric intensive care survivors

    NARCIS (Netherlands)

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

    2007-01-01

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

  19. Increased health care use in cancer survivors.

    NARCIS (Netherlands)

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

    2012-01-01

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

  20. Increases health care use in cancer survivors.

    NARCIS (Netherlands)

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

    2012-01-01

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

  1. Orthostatic intolerance in survivors of childhood cancer

    NARCIS (Netherlands)

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

    2007-01-01

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

  2. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  3. 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...

  4. Stigma and psychological distress in suicide survivors.

    Science.gov (United States)

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

    2017-03-01

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

  5. Mental Health Service Use Among Hurricane Katrina Survivors in the Eight Months After the Disaster

    Science.gov (United States)

    Wang, Philip S.; Gruber, Michael J.; Powers, Richard E.; Schoenbaum, Michael; Speier, Anthony H.; Wells, Kenneth B.; Kessler, Ronald C.

    2007-01-01

    Objective This study examined use of mental health services among adult survivors of Hurricane Katrina in order to improve understanding of the impact of disasters on persons with mental disorders. Methods A geographically representative telephone survey was conducted between January 19 and March 31, 2006, with 1,043 displaced and nondisplaced English-speaking Katrina survivors aged 18 and older. Survivors who reported serious and mild-moderate mood and anxiety disorders in the past 30 days and those with no such disorders were identified by using the K6 scale of nonspecific psychological distress. Use of services, system sectors, and treatments and reasons for not seeking treatment or dropping out were recorded. Correlates of using services and dropping out were examined. Results An estimated 31% of respondents (N=319) had evidence of a mood or anxiety disorder at the time of the interview. Among these only 32% had used any mental health services since the disaster, including 46% of those with serious disorders. Of those who used services, 60% had stopped using them. The general medical sector and pharmacotherapy were most commonly used, although the mental health specialty sector and psychotherapy played important roles, especially for respondents with serious disorders. Many treatments were of low intensity and frequency. Undertreatment was greatest among respondents who were younger, older, never married, members of racial or ethnic minority groups, uninsured, and of moderate means. Structural, financial, and attitudinal barriers were frequent reasons for not obtaining care. Conclusions Few Katrina survivors with mental disorders received adequate care; future disaster responses will require timely provision of services to address the barriers faced by survivors. PMID:17978249

  6. Transition and transfer of childhood cancer survivors to adult care: A national survey of pediatric oncologists.

    Science.gov (United States)

    Kenney, Lisa B; Melvin, Patrice; Fishman, Laurie N; O'Sullivan-Oliveira, Joanne; Sawicki, Gregory S; Ziniel, Sonja; Diller, Lisa; Fernandes, Susan M

    2017-02-01

    Pediatric oncologists are responsible for ensuring that adolescent and young adult (AYA) childhood cancer survivors have the knowledge and skills necessary to manage their follow-up care in adult healthcare systems. To describe transition practices and barriers to transfer, we electronically surveyed U.S. Children's Oncology Group members: 507/1449 responded (35%) and 347/507 (68%) met eligibility criteria. Of 347 respondents, 50% are male, median years in practice 10 (range 5-22), 37% practice in freestanding children's hospitals. Almost all care for survivors up to age 21 years (96%), 42% care for survivors over age 25 years, and only 16% over age 30 years. While 66% of oncologists reported providing transition education to their patients, very few (8%) reported using standardized transition assessments. The most frequent barriers to transfer were perceived attachment to provider (91%), lack of adult providers with cancer survivor expertise (86%), patient's cognitive delay (81%), or unstable social situation (80%). Oncologists who continue to care for patients older than 25 years are more likely to perceive parents' attachment to provider (P = 0.037) and patients' social situation as barriers to transfer (P = 0.044).  Four themes emerged from a content analysis of 75 respondents to the open-ended question inviting comments on transition/transfer practices: desire for flexible transfer criteria; providers as barriers; provider lack of transition knowledge, skills, and resources; and desire for collaboration. Although most pediatric oncologists reported transferring AYA cancer survivors to adult care and providing some transition education, they endorse deficits in transition skills, emotional readiness, and institutional resources. © 2016 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2015-12-01

    Survivors of out-of-hospital cardiac arrest (OHCA) may experience psychological distress but the actual prevalence is unknown. The aim of this study was to investigate anxiety and depression within a large cohort of OHCA-survivors. OHCA-survivors randomized to targeted temperature of 33 °C or 36 °C within the Target Temperature Management trial (TTM-trial) attended a follow-up after 6 months that included the questionnaire Hospital Anxiety and Depression Scale (HADS). A control group with ST-elevation myocardial infarction (STEMI) completed the same follow-up. Correlations to variables assumed to be associated with anxiety and depression in OHCA-survivors were tested. At follow-up 278 OHCA-survivors and 119 STEMI-controls completed the HADS where 24% of OHCA-survivors (28% in 33 °C group/22% in 36 °C group, p=0.83) and 19% of the STEMI-controls reported symptoms of anxiety (OR 1.32; 95% CI (0.78-2.25), p=0.30). Depressive symptoms were reported by 13% of OHCA-survivors (equal in both intervention groups, p=0.96) and 8% of STEMI-controls (OR 1.76; 95% CI (0.82-3.79), p=0.15). Anxiety and depression among OHCA-survivors correlated to Health-Related Quality-of-Life, and subjectively reported cognitive deterioration by patient or observer. In addition, depression was associated with a poor neurological outcome. One fourth of OHCA-survivors reported symptoms of anxiety and/or depression at 6 months which was similar to STEMI-controls and previous normative data. Subjective cognitive problems were associated with an increased risk for psychological distress. Since psychological distress affects long-term prognosis of cardiac patients in general it should be addressed during follow-up of survivors with OHCA due to a cardiac cause. ClinicalTrials.gov NCT01020916/NCT01946932. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-07-01

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

  9. [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.

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

    Science.gov (United States)

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

    2008-06-01

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

  11. Saddleworth, Responding to a Landscape

    OpenAIRE

    Murray, Matthew

    2017-01-01

    Matthew Murray's Landscape publication Saddleworth, Responding To A Landscape. Forward by Martin Barnes Senior Curator of Photographs at The Victoria and Albert Museum, London, Artist Richard Billingham and Maartje van den Heuvel Curator Photography and Media Culture -Leiden Institute. \\ud \\ud ‘Every trip I have taken to Saddleworth Moor over four years has encapsulated each season, weather and cloud pattern, rain, sunshine, snow, early morning clear skies and the sense of the bitter cold of ...

  12. Why do some wood-adhesive bonds respond poorly to accelerated moisture-resistant tests?

    Science.gov (United States)

    Charles R. Frihart; James M. Wescott

    2008-01-01

    The most challenging part of developing acceptable adhesives for wood bonding often is to create a bond that will withstand exposure to wet conditions or wet/dry cycles. Products that pass these tests have been developed empirically, but the aspects that make it difficult for adhesives to pass these tests and systematically ways to develop more durable adhesive bonds...

  13. Ganirelix for luteolysis in poor responder patients undergoing IVF treatment: a Scandinavian multicenter 'extended pilot study'

    DEFF Research Database (Denmark)

    Nilsson, Lena; Andersen, A.N.; Lindenberg, Svend

    2010-01-01

    before expected start of menstruation and continued for 4-7 days. On cycle day 2-3 a starting dose of rFSH (300-400 IU/day) was given. At a leading follicle diameter of 14 mm, ganirelix administration was resumed until final oocyte maturation was induced with 10,000 IU hCG. GnRH antagonist only...

  14. Factors associated with physical activity among adolescent and young adult survivors of early childhood cancer: A report from the childhood cancer survivor study (CCSS).

    Science.gov (United States)

    Devine, Katie A; Mertens, Ann C; Whitton, John A; Wilson, Carmen L; Ness, Kirsten K; Gilleland Marchak, Jordan; Leisenring, Wendy; Oeffinger, Kevin C; Robison, Leslie L; Armstrong, Gregory T; Krull, Kevin R

    2018-02-01

    To evaluate concurrent and longitudinal associations between psychosocial functioning and physical activity in adolescent and young adult survivors of early childhood cancer. Adolescent survivors of early childhood cancer (diagnosed before age four) participating in the Childhood Cancer Survivor Study completed the Coping Health and Illness Profile-Adolescent Edition (CHIP-AE; n = 303; mean age at survey: 17.6 years). A subset of these survivors (n = 248) completed a follow-up survey an average of 6.0 years later (range: 4-10). Logistic regression identified associations between psychosocial functioning in adolescence and physical activity levels in adolescence and young adulthood. Survivors reported low physical activity as adolescents (46.1% scored below CHIP-AE cut-point) and young adults (40.8% below Centers for Disease Control guidelines). Poor physical activity during adolescence was associated with female sex (OR = 2.06, 95% CI, 1.18-3.68), parents with less than a college education (OR = 1.91, 95% CI, 1.11-3.32), previous treatment with cranial radiation (OR = 3.35, 95% CI, 1.69-6.88), TV time (OR = 1.77, 95% CI, 1.00-3.14), and limitations of activity due to health or mobility restrictions (OR = 8.28, 95% CI, 2.87-30.34). Poor diet (OR = 1.84, 95% CI, 1.05-3.26) and low self-esteem (OR = 1.80, 95% CI, 0.99-3.31) during adolescence were associated with lower odds of meeting Centers for Disease Control physical activity guidelines in young adulthood. These findings provide targets for future interventional studies to improve physical activity in this high-risk population. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Sleep complaints in survivors of pediatric brain tumors.

    Science.gov (United States)

    Brimeyer, Chasity; Adams, Leah; Zhu, Liang; Srivastava, Deo Kumar; Wise, Merrill; Hudson, Melissa M; Crabtree, Valerie McLaughlin

    2016-01-01

    Pediatric brain tumor survivors have increased risk of sleep problems, particularly excessive daytime sleepiness (EDS). Few studies have examined sleep disturbances in this population. 153 children and adolescents ages 8-18 and their parents completed questionnaires (Modified Epworth Sleepiness Scale, Kosair Children's Hospital Sleep Questionnaire, Children's Report of Sleep Patterns, Children's Sleep Hygiene Scale) during clinic visits. Participants were at least 5 years from diagnosis and 2 years post-treatment. Group differences in age at diagnosis, body mass index, type of treatment received, and tumor location were examined. One-third of adolescents and one-fifth of children reported EDS. Children and parents had fair concordance (kappa coefficient = .64) in their report of EDS, while adolescents and parents had poor concordance (kappa coefficient = .37). Per parents, most children slept 8 to 9 h per night. Poor bedtime routines were reported for children, while adolescents endorsed poor sleep stability. Extended weekend sleep was reported across age groups. A BMI in the obese range was related to higher parent-reported EDS in children. Sleep-disordered breathing was associated with elevated BMI in adolescents. While survivors reported achieving recommended amounts of sleep each night, 20 to 30% reported EDS. Poor concordance among parent and adolescent report highlights the importance of obtaining self-report when assessing sleep concerns. Obesity is a modifiable factor in reducing symptoms of EDS in this population. Finally, the lack of association between EDS and brain tumor location, BMI, or treatment received was unexpected and warrants further investigation.

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

    Science.gov (United States)

    Fall, Caroline Hd; Kumaran, Kalyanaraman

    2014-01-01

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

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

    Mitten, Denise; Dutton, Rosalind

    1993-01-01

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

  19. 20 CFR 225.21 - Survivor Tier I PIA.

    Science.gov (United States)

    2010-04-01

    ... INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.21 Survivor Tier I PIA. The Survivor Tier I PIA is used in computing the tier I component of a survivor annuity. This PIA is determined in accordance with section 215 of the Social...

  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

    2017-10-20

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

  1. 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.

  2. Helping Survivors of Human Trafficking: A Systematic Review of Exit and Postexit Interventions.

    Science.gov (United States)

    Dell, Nathaniel A; Maynard, Brandy R; Born, Kara R; Wagner, Elizabeth; Atkins, Bonnie; House, Whitney

    2017-01-01

    Human trafficking is a global problem and results in deleterious psychological, social, and physical effects on the lives of those who are trafficked; however, it is not clear how to best intervene with survivors. The purpose of this review was to synthesize the evidence of exit and postexit intervention programs for survivors of human trafficking to inform practice and research. Systematic review methods were used to search, select, and extract data from published and unpublished experimental, quasi-experimental, and preexperimental studies that assessed the effects of any exit or postexit interventions for victims of human trafficking. The authors searched eight databases, reviewed bibliographies, and conducted forward citation searches from relevant reports and prior reviews to find studies authored between 2005 and 2015. The search yielded six eligible studies that included 155 female and 6 male survivors from four countries. Interventions were diverse, with three using a trauma-informed approach. Authors measured a myriad of outcomes, including mental health, social network, community reintegration, and employment; however, the quality of most studies was poor. Evidence of effects of exit and postexit interventions is sparse, and much of the research is poorly designed and executed; however, the needs of trafficking survivors are complex and effective interventions are desperately needed. Implications for practice and research are discussed.

  3. Urban poor program launched.

    Science.gov (United States)

    1991-01-01

    The government of the Philippines has launched a program to deal with the rapidly growing urban poor population. 60 cities (including Metro Manila) are expected to increase their bloated population by 3.8% over 1990 which would be 27.7 million for 1991. Currently there is an exodus of people from the rural areas and by 2000 half the urban population will be squatters and slum dwellers. Basic services like health and nutrition are not expected to be able to handle this type of volume without a loss in the quality of service. The basic strategy of the new program is to recruit private medical practitioners to fortify the health care delivery and nutrition services. Currently the doctor/urban dweller ration is 1:9000. The program will develop a system to pool the efforts of government and private physicians in servicing the target population. Barangay Escopa has been chosen as the pilot city because it typifies the conditions of a highly populated urban area. The projects has 2 objectives: 1) demonstrate the systematic delivery of health and nutrition services by the private sector through the coordination of the government, 2) reduce mortality and morbidity in the community, especially in the 0-6 age group as well as pregnant women and lactating mothers.

  4. Biodetection Technologies for First Responders

    Energy Technology Data Exchange (ETDEWEB)

    Baird, Cheryl L.; Seiner, Derrick R.; Ozanich, Richard M.; Bartholomew, Rachel A.; Colburn, Heather A.; Straub, Tim M.; Bruckner-Lea, Cindy J.

    2012-10-24

    In a white powder scenario, there are a large number of field-deployable assays that can be used to determine if the suspicious substance contains biological material and warrants further investigation. This report summarizes commercially available technologies that are considered hand portable and can be used by first responders in the field. This is not meant to be an exhaustive list, nor do the authors endorse any of the technologies described herein. Rather, it is meant to provide useful information about available technologies to help end-users make informed decisions about biodetection technology procurement and use.

  5. Dishonest responding or true virtue?

    DEFF Research Database (Denmark)

    Zettler, Ingo; Hilbig, Benjamin E.; Moshagen, Morten

    2015-01-01

    management scores indeed reflect true virtues rather than dishonesty under such conditions. We found support for this idea by replicating previous correlations between impression management scores and virtue-related basic personality traits (including honesty-humility), and additionally provided conclusive...... behavioral evidence: We linked scores on an impression management scale administered under typical low demand condition to behavior in an incentivized, anonymous cheating task. The results clearly indicate that low scores in impression management are associated with more cheating. That is, high—and not low......—scores on the Impression Management scale of the Balanced Inventory of Desirable Responding are aligned with more virtuous, honest behavior....

  6. The perceived impact of downsizing and organisational transformation on survivors

    Directory of Open Access Journals (Sweden)

    N. Ndlovu

    2005-10-01

    Full Text Available Change is a way of life and the ability to manage change is a key factor in organisational survival and effectiveness. This article evaluates the ‘survivor syndrome’ and assesses the impact of the process of downsizing and transformation on communication, trust, survivor commitment and loyalty, morale and career advancement opportunities. The study was conducted using a stratified random sample of 361 employees/survivors in a branch of a motor manufacturer that had undergone major transformation. Data was collected using a self-developed questionnaire and analysed using descriptive and inferential statistics. The study generates a framework/model of critical change implementation factors and recommendations that will enable change managers to sense, adjust, respond and implement change timeously so as to gain strategic and competitive advantage. Opsomming Verandering is ’n lewenswyse en die vermoë om te verander is ’n kernaspek in organisasieverandering en -oorlewing. In hierdie artikel word die ‘oorlewingsindroom’ beoordeel en word die impak van die afskalingsproses en transformasie op kommunikasie, vertroue, ‘oorlewende’ toewyding en lojaliteit, moraal en loopbaanvorderingsgeleenthede takseer. Die studie is uitgevoer, met die gebruik van ’n gestratifiseerde ewekansige steekproef van 361 werknemers/’oorlewendes’ in ’n afdeling van ’n motorvervaardiger wat ingrypende transformasie ondergaan het. Data is ingesamel by wyse van ’n selfontwikkelde vraelys en ontleed aan die hand van beskrywende en inferensiële statistiek. Die studie het ’n raamwerk/model van kritieke veranderingsimplementeringsfaktore en aanbevelings gegenereer wat veranderingsbestuurders in staat sal stel om die gewaarwording, aanpassing, reaksie en implementering van verandering tydig te doen sodat strategiese en mededingingsvoordeel behaal kan word.

  7. STUDI KOMITMEN ORGANISASIONAL: PEKERJA CONTINGENT DAN SURVIVOR

    Directory of Open Access Journals (Sweden)

    Fenika Walani

    2015-08-01

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

  8. The unmet emotional, care/support, and informational needs of adult survivors of pediatric malignancies.

    Science.gov (United States)

    Cox, Cheryl L; Zhu, Liang; Ojha, Rohit P; Li, Chenghong; Srivastava, Deo Kumar; Riley, Barth B; Hudson, Melissa M; Robison, Les L

    2016-08-01

    This study describes the prevalence and predisposing factors for potentially modifiable unmet emotional, care/support, and information needs among adult survivors of childhood malignancies. A randomly selected/stratified sample of participants in the Childhood Cancer Survivor Study (CCSS) responded to the CCSS-Needs Assessment Questionnaire (CCSS-NAQ) (n = 1189; mean [SD] current age, 39.7 [7.7], range = 26-61 years; 60.9 % women; mean [SD] years since diagnosis, 31.6 [4.7]). Survivors self-reported demographic information, health concerns, and needs; diagnosis/treatment data were obtained from medical records. Adjusted proportional risk ratios (prevalence ratios, PRs) were used to evaluate 77 separate needs. Fifty-four percent of survivors reported unmet psycho-emotional, 41 % coping, and 35 % care/support needs; 51, 35, and 33 %, respectively, reported unmet information needs related to cancer/treatment, the health care system, and surveillance. Female sex and annual income cancer-related anxiety/fear was associated with all needs, including a >6-fold increased prevalence for help dealing with "worry" (PR = 6.06; 95 % confidence interval [CI], 3.79-9.69) and anxiety (PR = 6.10; 95 % CI, 3.82-9.72) and a >5-fold increased prevalence for "needing to move on with life" (PR = 5.56; 95 % CI, 3.34-9.25) and dealing with "uncertainty about the future" (PR = 5.50; 95 % CI, 3.44-8.77). Radiation exposure and perceived health status were related to 42 and 29 needs, respectively. Demographic factors, disease/treatment characteristics, and intrapersonal factors can be used to profile survivors' unmet emotional, care/support, and information needs. These data can be used to enhance provider-survivor communication, identify at-risk subsamples, and appraise core intervention content.

  9. Follow-up care of young childhood cancer survivors: attendance and parental involvement.

    Science.gov (United States)

    Vetsch, Janine; Rueegg, Corina S; Mader, Luzius; Bergstraesser, Eva; Rischewski, Johannes; Kuehni, Claudia E; Michel, Gisela

    2016-07-01

    Despite recommendations, only a proportion of long-term childhood cancer survivors attend follow-up care. We aimed to (1) describe the follow-up attendance of young survivors aged 11-17 years; (2) describe the parental involvement in follow-up, and (3) investigate predictors of follow-up attendance and parental involvement. As part of the Swiss Childhood Cancer Survivor Study, a follow-up questionnaire was sent to parents of childhood cancer survivors aged 11-17 years. We assessed follow-up attendance of the child, parents' involvement in follow-up, illness perception (Brief IPQ), and sociodemographic data. Clinical data was available from the Swiss Childhood Cancer Registry. Of 309 eligible parents, 189 responded (67 %; mean time since diagnosis 11.3 years, range 6.8-17.2) and 75 % (n = 141) reported that their child still attended follow-up. Of these, 83 % (n = 117) reported ≥1 visit per year and 17 % (n = 23) reported survivors saw pediatric oncologists (n = 111; 79 % of 141), followed by endocrinologists (n = 24, 17 %) and general practitioners (n = 22, 16 %). Most parents (92 %) reported being involved in follow-up (n = 130). In multivariable and Cox regression analyses, longer time since diagnosis (p = 0.025) and lower perceived treatment control (assessed by IPQ4: how much parents thought follow-up can help with late effects; p = 0.009) were associated with non-attendance. Parents' overall information needs was significantly associated with parental involvement in the multivariable model (p = 0.041). Educating survivors and their parents on the importance and effectiveness of follow-up care might increase attendance in the longer term.

  10. 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

  11. 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...

  12. PTSD prevalence among Polish World War II survivors.

    Science.gov (United States)

    Lis-Turlejska, Maja; Łuszczyńska, Aleksandra; Szumiał, Szymon

    2016-10-31

    Over the past decade research has been published in several Western European countries on the prevalence of PTSD among World War II survivors, mostly civilians. Prevalence rates ranged from 1.9% to 10.8 %. The aim of the study was to measure the frequency of PTSD occurrence among Polish WWII survivors. Data from 96 persons: 59 women and 37 men, aged 70-96 were analyzed. All participants were born before 1945. They completed Polish adaptations of: Posttraumatic Diagnostic Scale (PDS), Impact of Events Scale (IES), Beck's Depression Inventory (BDI) and WWII trauma related questionnaire. Prevalence rate of potential PTSD was 32,3% Mean values of both number and severity of symptoms of PTSD were significantly higher for respondents with at least one war related trauma comparing to the participants who did note relate any such trauma. Comparing to other studies on WWII related PTSD the prevalence rate of possible PTSD was very high. Looking for possible explanation of such results seems to be an important challenge.

  13. Social Support for Chamorro Breast Cancer Survivors on Guam.

    Science.gov (United States)

    Perez, Lilli Ann; Natividad, Lisalinda; Chung, William; Haddock, Robert L; Wenzel, Lari; Hubbell, F Allan

    2010-12-01

    The purpose of this study was to assess the types of social support used by Chamorro (indigenous) breast cancer survivors on Guam. We assessed social support use among 25 self-reported Chamorro women with a diagnosis of breast cancer through interviews and construction of genograms and ecomaps -pictorial displays of the women's family relationships, medical history, and their social networks. The mean age of the participants was 54.5 years. The average number of years since the diagnosis of breast cancer was 7.8 years. Respondents indicated that the nuclear family was the most important form of social support (34.2%). Indeed, nuclear family and other types of informal systems were the most common type of social support used by the women (60.2%). Formal support services, clubs, and organizations were reported by 17.9% of participants while spiritual and/or religious resources were reported by 21.9% of them. These Chamorro breast cancer survivors depended largely on family for social support. Support from family, although informal, should be recognized as a pivotal factor in recovery and survivorship. Future directions could incorporate formal and informal mechanisms to utilize this natural support resource.

  14. Social Support for Chamorro Breast Cancer Survivors on Guam

    Science.gov (United States)

    Perez, Lilli Ann; Natividad, Lisalinda; Chung, William; Haddock, Robert L.; Wenzel, Lari; Hubbell, F. Allan

    2015-01-01

    Purpose The purpose of this study was to assess the types of social support used by Chamorro (indigenous) breast cancer survivors on Guam. Methods We assessed social support use among 25 self-reported Chamorro women with a diagnosis of breast cancer through interviews and construction of genograms and ecomaps -pictorial displays of the women's family relationships, medical history, and their social networks. Results The mean age of the participants was 54.5 years. The average number of years since the diagnosis of breast cancer was 7.8 years. Respondents indicated that the nuclear family was the most important form of social support (34.2%). Indeed, nuclear family and other types of informal systems were the most common type of social support used by the women (60.2%). Formal support services, clubs, and organizations were reported by 17.9% of participants while spiritual and/or religious resources were reported by 21.9% of them. Conclusion These Chamorro breast cancer survivors depended largely on family for social support. Support from family, although informal, should be recognized as a pivotal factor in recovery and survivorship. Future directions could incorporate formal and informal mechanisms to utilize this natural support resource. PMID:25866489

  15. Criticism by community people and poor workplace communication as risk factors for the mental health of local welfare workers after the Great East Japan Earthquake: A cross-sectional study

    National Research Council Canada - National Science Library

    Ikki Ueda; Atsushi Sakuma; Yoko Takahashi; Wataru Shoji; Ayami Nagao; Mikika Abe; Yuriko Suzuki; Hiroo Matsuoka; Kazunori Matsumoto

    2017-01-01

    ... as support providers and disaster survivors. We examined whether work-related social stressors, including criticism by community people and poor workplace communication, were associated with increased risk of post-traumatic stress disorder (PTSD...

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

    Science.gov (United States)

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

    2017-06-21

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

  17. The Survivor Syndrome: Aftermath of Downsizing.

    Science.gov (United States)

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

    1997-01-01

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

  18. Symptomatic and Palliative Care for Stroke Survivors

    National Research Council Canada - National Science Library

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

    2012-01-01

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

  19. Hopelessness Experience among Stroke Survivor in Semarang

    Directory of Open Access Journals (Sweden)

    Sawab Sawab

    2015-04-01

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

  20. Measured versus self-reported physical function in adult survivors of childhood cancer.

    Science.gov (United States)

    Smith, Webb A; Li, Zhenghong; Loftin, Mark; Carlyle, Brent E; Hudson, Melissa M; Robison, Leslie L; Ness, Kirsten K

    2014-02-01

    Childhood cancer survivors (CCS) experience late effects that interfere with physical function. Limitations in physical function can affect CCS abilities to actively participate in daily activities. The purpose of this investigation was to evaluate the concordance between self-reported physical performance and clinically evaluated physical performance among adult CCS. CCS 18 yr or older and 10 yr or older from diagnosis who are participants in the St. Jude Lifetime cohort study responded to the physical function section of the Medical Outcome Survey Short Form (SF-36). Measured physical performance was evaluated using the Physical Performance Test and the 6-Minute Walk Test. Individuals (N = 1778, 50.8% female) with a median time since diagnosis of 24.9 yr (range = 10.9-48.2) and a median age of 32.4 yr (range = 19.1-48.2) completed testing. Limitations in physical performance were self-reported by 14.1% of participants. The accuracy of self-report physical performance was 0.87 when the SF-36 was compared with the 6-Minute Walk Test or the Physical Performance Test. Reporting inaccuracies most often involved reporting a physical performance limitation. Poor accuracy was associated with previous diagnosis of a bone or CNS tumor, lymphoma, older age, and large body size. These results suggest that self-report, using the physical performance subscale of the SF-36, correctly identifies CCS who do not have physical performance limitations. In contrast, this same measure is less able to identify individuals who have performance limitations.

  1. Outcome of paediatric intensive care survivors

    OpenAIRE

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

    2007-01-01

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

  2. Increased health care use in cancer survivors.

    OpenAIRE

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

    2012-01-01

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

  3. Increases health care use in cancer survivors.

    OpenAIRE

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

    2012-01-01

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

  4. Survivor-Reaktionen im Downsizing-Kontext

    OpenAIRE

    Dietrich, Kristina

    2013-01-01

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

  5. Hopelessness Experience Among Stroke Survivor in Semarang

    OpenAIRE

    Sawab Sawab; Moch Bahrudin; Novy Helena Catharina Daulima

    2015-01-01

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

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

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    Lise Eilin Stene

    2016-11-01

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

  7. Sleep quality in long-term survivors of head and neck cancer: preliminary findings.

    Science.gov (United States)

    Li, Na; Otomaru, Takafumi; Taniguchi, Hisashi

    2017-12-01

    This preliminary study evaluated sleep quality in long-term head and neck cancer survivors, using demographic data and clinical features of the cancers as assessment criteria. In addition, a possible correlation was examined between scores on self-rated questionnaires of sleep quality and assessments of quality of life and oral health status. Subjects were 77 head and neck cancer survivors. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Oral and general health status was assessed using The Oral Health Impact Profile (OHIP-14) and the Short-Form Health Survey (SF-36), respectively, and correlated with clinical parameters. Spearman's correlation coefficients were calculated to examine relationships between variables. Logistic regression analysis was performed to identify independent variables associated with poor sleep quality. Eighty-three percent of patients had poor sleep quality (global scores ≥5) and 40% had a global Pittsburgh Sleep Quality Index score ≥8, indicating significantly poor sleep quality. Nocturnal enuresis, daytime sleepiness, and early morning awakening were the most common complaints. Extensive neck dissection, a lower SF-36 mental component score, and a higher OHIP-14 psychological disability score were independently associated with poor sleep quality. OHIP-14 global score was linked independently with daytime sleepiness. This is the first study to demonstrate a high prevalence of poor sleep quality in long-term head and neck cancer survivors. Extensive neck dissection, poor mental health, and psychological disability may contribute to poor sleep quality. Maintaining good oral health-related quality of life could promote better sleep in these patients.

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

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    Maneesh Bhargava

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

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

    Science.gov (United States)

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

    2014-01-01

    Acute Respiratory Distress Syndrome (ARDS) continues to have a high mortality. Currently, there are no biomarkers that provide reliable prognostic information to guide clinical management or stratify risk among clinical trial participants. The objective of this study was to probe the bronchoalveolar lavage fluid (BALF) proteome to identify proteins that differentiate survivors from non-survivors of ARDS. Patients were divided into early-phase (1 to 7 days) and late-phase (8 to 35 days) groups based on time after initiation of mechanical ventilation for ARDS (Day 1). Isobaric tags for absolute and relative quantitation (iTRAQ) with LC MS/MS was performed on pooled BALF enriched for medium and low abundance proteins from early-phase survivors (n = 7), early-phase non-survivors (n = 8), and late-phase survivors (n = 7). Of the 724 proteins identified at a global false discovery rate of 1%, quantitative information was available for 499. In early-phase ARDS, proteins more abundant in survivors mapped to ontologies indicating a coordinated compensatory response to injury and stress. These included coagulation and fibrinolysis; immune system activation; and cation and iron homeostasis. Proteins more abundant in early-phase non-survivors participate in carbohydrate catabolism and collagen synthesis, with no activation of compensatory responses. The compensatory immune activation and ion homeostatic response seen in early-phase survivors transitioned to cell migration and actin filament based processes in late-phase survivors, revealing dynamic changes in the BALF proteome as the lung heals. Early phase proteins differentiating survivors from non-survivors are candidate biomarkers for predicting survival in ARDS. PMID:25290099

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

    Science.gov (United States)

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

    2017-11-01

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

  11. Factors associated with return to work of breast cancer survivors: a systematic review.

    Science.gov (United States)

    Islam, Tania; Dahlui, Maznah; Majid, Hazreen Abd; Nahar, Azmi Mohamed; Mohd Taib, Nur Aishah; Su, Tin Tin

    2014-01-01

    The breast cancer survival rate is the highest among all types of cancers, and survivors returning to work after completing treatment is extremely important in regards to economy and rehabilitation. The aim of this systematic review study is to identify the prevalence of breast cancer survivors who return to work (RTW) and the factors associated to RTW. A computer based literature search was carried out. "PubMed, Cochrane Library, Embase, Web of Science, and Science Direct" databases were searched systematically. Our search strategy identified a total of 12,116 papers of which 26 studies met the inclusion criteria and quality assessment. These were original papers published between January 2003 and January 2013. The trends in RTW differ among countries for the breast cancer survivors. The time to RTW after successful cancer treatment also varies among the countries and by ethnicity. The prevalence of the RTW varies from 43% to 93% within one year of diagnosis. The prevalence of the RTW for the Netherland is the lowest in the world (43%). The United States survivors showed the highest RTW (93%) within 12 months of the diagnosis. Numerous barriers and facilitators were identified as factors that affect RTW. For instance, socio-demographic factors such as education and ethnicity; treatment oriented factors such as chemotherapy; work related factors such as heavy physical work; disease related factors such as poor health condition and fatigue; and psychological factors such as depression and emotional distress, act as barriers of RTW. In contrast, social, family, employer support, and financial independency emerge as key facilitators in enabling breast cancer survivors to return and continue work. Minimising these identified barriers and strengthening these facilitators could further improve the work condition and increase the percentage of RTW among the breast cancer survivors.

  12. Impact of healthy eating practices and physical activity on quality of life among breast cancer survivors.

    Science.gov (United States)

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

    2013-01-01

    Following breast cancer diagnosis, women often attempt to modify their lifestyles to improve their health and prevent recurrence. These behavioral changes typically involve diet and physical activity modification. The aim of this study was to determine association between healthy eating habits and physical activity with quality of life among Iranian breast cancer survivors. A total of 100 Iranian women, aged between 32 to 61 years were recruited to participate in this cross-sectional study. Eating practices were evaluated by a validated questionnaire modified from the Women's Healthy Eating and Living (WHEL) study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). A standardized questionnaire by the European Organization of Research and Treatment of Cancer Quality of Life and its breast cancer module (EORTC QLQ-C30/+BR-23) were applied to determine quality of life. Approximately 29% of the cancer survivors were categorized as having healthy eating practices, 34% had moderate eating practices and 37% had poor eating practices based on nutrition guidelines. The study found positive changes in the decreased intake of fast foods (90%), red meat (70%) and increased intake of fruits (85%) and vegetables (78%). Generally, breast cancer survivors with healthy eating practices had better global quality of life, social, emotional, cognitive and role functions. Result showed that only 12 women (12%) met the criteria for regular vigorous exercise, 22% had regular moderate-intensity exercise while the majority (65%) had low-intensity physical activity. Breast cancer survivors with higher level of physical activity had better emotional and cognitive functions. Healthy eating practices and physical activity can improve quality of life of cancer survivors. Health care professionals should promote good dietary habits and physical activity to improve survivors' health and quality of life.

  13. Psychosocial aspects of childhood cancer survivors

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    Jong Jin Seo

    2010-04-01

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

  14. Health Behaviors of Minority Childhood Cancer Survivors

    Science.gov (United States)

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

    2015-01-01

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

  15. Mental health status of adolescent cancer survivors

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    Mertens AC

    2015-09-01

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

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

    Science.gov (United States)

    Hantman, Shira; Solomon, Zahava

    2007-05-01

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

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

    Science.gov (United States)

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

    2013-06-01

    In this qualitative study, we aimed to explore cancer survivors' experiences with (1) return to work (RtW) and work performance, (2) a physical exercise program after treatment, and (3) the perceived link between physical exercise and work. Semi-structured individual interviews were held with ten cancer survivors of working age who had been treated with chemotherapy and had afterwards completed a group-based supervised physical exercise program. The interviews were audio-taped and transcribed verbatim. MaxQDA was used for coding and analysis. A second assessor was involved in coding two of the interviews. Eight participants returned to work. Most said that they had suffered cognitive deficits that impaired their work performance. According to half of the participants, the support in RtW from their occupational physician had been insufficient. Overall, the majority of participants enjoyed the exercise program. The main perceived effects were "improved fitness" and "renewed energy." Most participants thought that physical exercise had likely contributed to their ability to return to work, primarily by increasing energy levels. Some believed that physical exercise had enhanced their work performance by improving their ability to cope with demanding work. Some respondents found that a supportive work environment stimulated their continuation of physical exercise. Cancer survivors experienced a positive influence of physical exercise on RtW and work performance and a positive influence of RtW on physical exercise. By stimulating and facilitating physical exercise during and after RtW, the time to lasting RtW may be shortened, work performance may be optimized, and sustained participation in physical exercise may be achieved. Stimulating and facilitating physical exercise before and during the process of RtW may enhance fitness and energy levels and may lower fatigue and cognitive symptoms during work. An integrated rehabilitation strategy combining physical exercise and

  18. Endometrial Cancer Survivors' Perceptions of Provider Obesity Counseling and Attempted Behavior Change: Are We Seizing the Moment?

    Science.gov (United States)

    Clark, Leslie H; Ko, Emily M; Kernodle, Amber; Harris, Ariel; Moore, Dominic T; Gehrig, Paola A; Bae-Jump, Victoria

    2016-02-01

    To determine patients' perceptions of provider-based counseling and behavior changes made by endometrial cancer survivors. Endometrial cancer survivors (diagnosed from 2011 to 2012) from a single institution were surveyed. Exclusion criteria included persistent or recurrent disease or those actively undergoing treatment. Information collected included demographics, weight assessments, health behaviors, and physician counseling. Statistical analysis was performed using descriptive statistics, Fisher exact test, McNemar test, and the κ statistic as a measure of agreement. Of 233 surveys sent, 46% were returned. Median body mass index was 29.8 kg/m (range, 17.1-64.8 kg/m). Comparing primary care providers with gynecologic oncologists (GOs), 47% (n = 46) versus 25% (n = 23) provided dietary counseling and 62% (n = 60) versus 37% (n = 34) provided physical activity counseling (Fisher exact test, P = 0.001 and P endometrial cancer and obesity. Fifty-two percent of responders attempted weight loss after their diagnosis. Fifty-nine percent of responders reported making changes in their diet. Fifty-six percent of patients made dietary changes within 3 months of diagnosis. Forty-eight percent of responders increased physical activity, with 62% implementing changes within 3 to 6 months of their diagnosis. The responders most likely to attempt weight loss were those who received counseling by a provider. All patients reporting attempted weight loss after their cancer diagnosis report being counseled by either a primary care provider or a GO to lose weight. Weight loss counseling was significantly associated with attempting weight loss (P endometrial cancer survivors report counseling by their GO to lose weight. One half of endometrial cancer survivors reported attempted weight loss. All patients reporting weight loss counseling from their oncologist reported attempted weight loss. Most behavioral change occurred 3 to 6 months after a cancer diagnosis. Obesity in endometrial

  19. Experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood lymphoma.

    Science.gov (United States)

    Lie, Hanne C; Mellblom, Anneli V; Brekke, Mette; Finset, Arnstein; Fosså, Sophie D; Kiserud, Cecilie E; Ruud, Ellen; Loge, Jon H

    2017-08-01

    Given childhood cancer survivors' risk of treatment-induced late effects, long-term follow-up care is recommended. We explored experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood malignant lymphoma in Norway. We conducted five focus group interviews with 34 survivors (19 females; 21 Hodgkin/13 non-Hodgkin lymphoma survivors; mean age 39 years; mean time from diagnosis 26 years). Data was analyzed using principles of thematic analysis. Two main themes were identified: (1) the survivors' experiences with late effects-related care and (2) their preferences for long-term follow-up care. Most of the survivors were dissatisfied with their late effects-related care due to perceptions of poor coordination of healthcare needs in a fragmented system, combined with a perceived lack of knowledge of late effects among themselves and general practitioners (GPs). All survivors valued long-term follow-up care. Oncologists were the preferred care providers, but GPs were considered acceptable providers if they had sufficient knowledge of late effects and routine examinations, short waiting times, and improved GP-oncologist collaboration. Our results suggest that a shared care model of long-term follow-up care involving specialists, GPs, and the survivors themselves is likely to fulfill several of the currently unmet needs among adult survivors of childhood cancers. Improved patient education about late effects and follow-up care would aid self-management. The survivors' concerns regarding lack of sufficient knowledge of late effects among GPs suggest a need for improving access to, and dissemination of, information of late effects.

  20. Lifestyle behaviors of African American breast cancer survivors: a Sisters Network, Inc. study.

    Directory of Open Access Journals (Sweden)

    Raheem J Paxton

    Full Text Available African American breast cancer survivors experience poor cancer outcomes that may, in part, be remedied by healthy lifestyle choices. Few studies have evaluated the health and lifestyle behaviors of this population. The purpose of this study was to characterize the health and lifestyle habits of African American breast cancer survivors and evaluate the socio-demographic and medical correlates of these behaviors.A total of 470 African American breast cancer survivors (mean age = 54 years participated in an online survey. All participants completed measures assessing medical and demographic characteristics, physical activity, and sedentary behavior. Chi-square tests for association, nonparametric tests, and logistic regression models were used to assess associations. All statistical tests were two sided.Almost half (47% of the women met the current guidelines for physical activity, almost half (47% were obese, and many reported having high blood pressure (53% or diabetes (21%. The prevalence of high blood pressure, diabetes, and high cholesterol increased by age (P<0.001, and obese women had a higher prevalence of high blood pressure (63% vs. 44% and diabetes (21% vs. 12% than did non-obese women (all P<0.05. Obese women participated in significantly fewer total minutes of physical activity per week (100 minutes/week than did non-obese women (150 minutes/week; P<0.05. The number of comorbid conditions was associated with increased odds for physical inactivity (odds ratio = 1.40 and obesity (odds ratio = 2.22.Many African American breast cancer survivors had chronic conditions that may be exacerbated by poor lifestyle choices. Our results also provide evidence that healthy lifestyle interventions among obese African American breast cancer survivors are urgently needed.

  1. Sexual violence in the protracted conflict of DRC programming for rape survivors in South Kivu

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    Schmitz K Peter

    2009-03-01

    Full Text Available Abstract Background Despite international acknowledgement of the linkages between sexual violence and conflict, reliable data on its prevalence, the circumstances, characteristics of perpetrators, and physical or mental health impacts is rare. Among the conflicts that have been associated with widespread sexual violence has been the one in the Democratic Republic of the Congo (DRC. Methods From 2003 till to date Malteser International has run a medico-social support programme for rape survivors in South Kivu province, DRC. In the context of this programme, a host of data was collected. We present these data and discuss the findings within the frame of available literature. Results Malteser International registered 20,517 female rape survivors in the three year period 2005–2007. Women of all ages have been targeted by sexual violence and only few of those – and many of them only after several years – sought medical care and psychological help. Sexual violence in the DRC frequently led to social, especially familial, exclusion. Members of military and paramilitary groups were identified as the main perpetrators of sexual violence. Conclusion We have documented that in the DRC conflict sexual violence has been – and continues to be – highly prevalent in a wide area in the East of the country. Humanitarian programming in this field is challenging due to the multiple needs of rape survivors. The easily accessible, integrated medical and psycho-social care that the programme offered apparently responded to the needs of many rape survivors in this area.

  2. Emotional approach coping: gender differences on psychological adjustment in young to middle-aged cancer survivors.

    Science.gov (United States)

    Cho, Dalnim; Park, Crystal L; Blank, Thomas O

    2013-01-01

    The effect of emotional approach coping (EAC) varies by gender. However, this gender difference has not yet been investigated in cancer survivors. We investigated whether the effects of two kinds of EAC--emotional processing (EP) and emotional expression (EE)--vary by gender and whether EAC has effects above and beyond the effect of other coping strategies. EAC and other coping strategies were assessed at baseline in a sample of 248 young to middle-aged adult (between the age of 22 and 55) cancer survivors. One hundred and sixty-six survivors responded to psychological adjustment one year later. EAC had different relationships with Time 2 adjustment in men and women. Hierarchical regression analyses showed that for men, EE predicted lower intrusive thoughts and, for women, EP was associated with higher positive affect when other coping strategies and EE were controlled. Gender differences held true in cancer survivors, and EAC was effective when other coping strategies were controlled. Further, EE was effective in reducing negative adjustment in men while EP was helpful in promoting positive adjustment in women.

  3. Professional services for child rape survivors: A child-centred perspective on helpful and harmful experiences.

    Science.gov (United States)

    Collings, Steven J

    2011-06-01

    The aim of this study was to explore child rape survivors' perceptions of helpful and harmful experiences at the hands of professional service providers. Focused interviews were conducted with a convenience sample of 20 child rape survivors who had presented for counselling services at a non-governmental organisation located in the coastal region of KwaZulu-Natal, South Africa. For each case, information was obtained regarding children's perceptions of helpful and harmful experiences at the hands of police, medical and criminal justice system personnel. A thematic analysis of children's responses indicated that the concerns expressed by respondents reflected four basic inter-related needs and rights including the need and right: to be given a voice, to be informed and consulted, to be protected from harm, and for competent and efficient service provision. Study findings provided little support to the view that the medico-legal examination or the adversarial nature of legal proceedings are likely to be experienced as particularly distressing or traumatising for the child. Study findings indicate that the professional services provided to some child rape survivors fail to adequately address the child's basic needs and rights, with there being an associated need for improved codes of practice designed to better serve the interests of child rape survivors.

  4. Interest in Health Behavior Intervention Delivery Modalities Among Cancer Survivors: A Cross-Sectional Study.

    Science.gov (United States)

    Martin, Emily C; Basen-Engquist, Karen; Cox, Matthew G; Lyons, Elizabeth J; Carmack, Cindy L; Blalock, Janice A; Demark-Wahnefried, Wendy

    2016-02-11

    Effective, broad-reaching channels are important for the delivery of health behavior interventions in order to meet the needs of the growing population of cancer survivors in the United States. New technology presents opportunities to increase the reach of health behavior change interventions and therefore their overall impact. However, evidence suggests that older adults may be slower in their adoption of these technologies than the general population. Survivors' interest for more traditional channels of delivery (eg, clinic) versus new technology-based channels (eg, smartphones) may depend on a variety of factors, including demographics, current health status, and the behavior requiring intervention. The aim of this study was to determine the factors that predict cancer survivors' interest in new technology-based health behavior intervention modalities versus traditional modalities. Surveys were mailed to 1871 survivors of breast, prostate, and colorectal cancer. Participants' demographics, diet and physical activity behaviors, interest in health behavior interventions, and interest in intervention delivery modalities were collected. Using path analysis, we explored the relationship between four intervention modality variables (ie, clinic, telephone, computer, and smartphone) and potential predictors of modality interest. In total, 1053 respondents to the survey (56.3% response rate); 847 provided complete data for this analysis. Delivery channel interest was highest for computer-based interventions (236/847, 27.9% very/extremely interested) and lowest for smartphone-based interventions (73/847, 8.6%), with interest in clinic-based (147/847, 17.3%) and telephone-delivered (143/847, 16.9%) falling in between. Use of other technology platforms, such as Web cameras and social networking sites, was positively predictive of interest in technology-based delivery channels. Older survivors were less likely to report interest in smartphone-based diet interventions

  5. Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008-2012.

    Science.gov (United States)

    Shoemaker, Meredith L; White, Mary C; Hawkins, Nikki A; Hayes, Nikki S

    2016-07-01

    To describe smoking and obesity prevalence among male and female cancer survivors in the United States.
. Cross-sectional survey.
. Household interviews.
. 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. 
. Data from the National Health Interview Survey (2008-2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts.
. Cancer history, smoking status, obesity status, gender, age, and age at diagnosis.
. Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. 
. The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors.
. Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another.

  6. Psychosocial and Neurocognitive Outcomes in Adult Survivors of Adolescent and Early Young Adult Cancer: A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Prasad, Pinki K; Hardy, Kristina K; Zhang, Nan; Edelstein, Kim; Srivastava, Deokumar; Zeltzer, Lonnie; Stovall, Marilyn; Seibel, Nita L; Leisenring, Wendy; Armstrong, Gregory T; Robison, Leslie L; Krull, Kevin

    2015-08-10

    To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95% CIs. Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7% v 8.0%, respectively; OR, 1.55; 95% CI, 1.04 to 2.30) and anxiety (7.4% v 4.4%, respectively; OR, 2.00; 95% CI, 1.17 to 3.43) and more problems with task efficiency (17.2% v 10.8%, respectively; OR, 1.72; 95% CI, 1.21 to 2.43), emotional regulation (19.1% v 14.1%, respectively; OR, 1.74; 95% CI, 1.26 to 2.40), and memory (25.9% v 19.0%, respectively; OR, 1.44; 95% CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95% CI, 2.28 to 3.77), somatization (OR, 2.29; 95% CI, 1.77 to 2.98), and depression (OR, 1.94; 95% CI, 1.43 to 2.63). We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment. © 2015 by American Society of Clinical Oncology.

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Susanne Schaal

    2011-06-01

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

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

    Science.gov (United States)

    Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Elbert, Thomas

    2011-01-01

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

  10. How annotated visualizations in self-care technology supported a stroke survivor in goal setting and reflection

    DEFF Research Database (Denmark)

    Ilsø Hougaard, Bastian; Knoche, Hendrik Ole

    2017-01-01

    findings from interviews with a health care professional and three stroke survivors on goal setting and reflection in a clinical setting with insights from a field study with one of the stroke survivors using a tablet application for self-care. Free text annotations of point plot score visualizations......Self-management in health contexts requires patients to manage their own goal setting. Time series visualizations improve understanding of time-oriented data. But how they and interactions with them can support reflection and goal setting in self- management is poorly understood. We compare...

  11. Drug use among complete responders, partial responders and non-responders in a longitudinal survey of nonagenarians

    DEFF Research Database (Denmark)

    Wastesson, Jonas W; Rasmussen, Lotte; Oksuzyan, Anna

    2017-01-01

    PURPOSE: In observational studies, non-response can limit representativity and introduce bias. We aimed to investigate the longitudinal changes in the number of used drugs among complete responders, partial responders, and non-responders in a whole birth cohort of Danish nonagenarians participati...

  12. 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.

  13. Testimonial therapy. A pilot project to improve psychological wellbeing among survivors of torture in India.

    Science.gov (United States)

    Agger, Inger; Raghuvanshi, Lenin; Shabana, Shirin; Polatin, Peter; Laursen, Laila K

    2009-01-01

    In developing countries where torture is perpetrated, there are few resources for the provision of therapeutic assistance to the survivors. The testimonial method represents a brief cross-cultural psychosocial approach to trauma, which is relatively easy to master. The method was first described in Chile in 1983 and has since been used in many variations in different cultural contexts. In this project the method has been supplemented by culture-specific coping strategies (meditation and a delivery ceremony). A pilot training project was undertaken between Rehabilitation and Research Centre for Torture victims (RCT) in Copenhagen, Denmark, and People's Vigilance Committee for Human Rights (PVCHR) in Varanasi, India, to investigate the usefulness of the testimonial method. The project involved the development of a community-based testimonial method, training of twelve PVCHR community workers, the development of a manual, and a monitoring and evaluation (M&E) system comparing results of measures before the intervention and two to three months after the intervention. Twenty-three victims gave their testimonies under supervision. In the two first sessions the testimony was written and in the third session survivors participated in a delivery ceremony. The human rights activists and community workers interviewed the survivors about how they felt after the intervention. After testimonial therapy, almost all survivors demonstrated significant improvements in overall WHO-five Well-being Index (WHO-5) score. Four out of the five individual items improved by at least 40%. Items from the International Classification of Functioning, Disability and Health (ICF) showed less significant change, possibly because the M&E questionnaire had not been well understood by the community workers, or due to poor wording, formulation and/or validation of the questions. All survivors expressed satisfaction with the process, especially the public delivery ceremony, which apparently became a

  14. Reproductive Late Effects in Female Survivors of Childhood Cancer

    Directory of Open Access Journals (Sweden)

    Shivany Gnaneswaran

    2012-01-01

    Full Text Available Childhood cancer treatments can cause female reproductive late effects. Radiation to the hypothalamic-pituitary-ovarian axis is associated with altered menarche, miscarriage, and implantation failure. Patients who receive chemotherapy and/or ovarian radiation are at risk of premature ovarian failure; the risk increases with increasing radiation dose, alkylating agent score, combination therapy, and older age at treatment. Ovarian reserve may be assessed using antimullerian hormone assay and ultrasound measurements of ovarian volume and antral follicle count; however, their efficacy is poorly established in this cohort. Fertility preservation options including cryopreservation, oophoropexy, and gonadotropin-releasing hormone analogues may be initiated prior to treatment, although most are still considered experimental. Uterine radiation has been linked to pregnancy complications including miscarriage, premature delivery, stillbirth, low-birth-weight and small-for-gestational-age infants. This paper summarises the literature on female reproductive late effects. The information should facilitate counseling and management of female survivors throughout their reproductive lives.

  15. Relationship of Self-reported Attentional Fatigue to Perceived Work Ability in Breast Cancer Survivors.

    Science.gov (United States)

    Von Ah, Diane; Storey, Susan; Crouch, Adele; Johns, Shelley A; Dodson, Jill; Dutkevitch, Sarah

    Breast cancer survivors (BCSs) have identified attentional fatigue, a decrease in the ability to focus, as a persistent daily challenge; however, little is known regarding its impact on work ability. The purpose of this study was to examine the relationship between attentional fatigue and perceived work ability in BCSs controlling for the known covariates of age, education, household income, and time posttreatment. A cross-sectional, descriptive design was used. Breast cancer survivors who were currently employed and at least 1 year post-adjuvant treatment participated. Breast cancer survivors completed the Attentional Function Index and Work Ability Index questionnaires. Descriptive statistics, linear regression, and Fisher exact test were used for analysis. Sixty-eight female BCSs, ranging from 29 to 68 years of age (mean, 52.1 [SD, 8.6]) and on average 4.97 (SD, 3.36) years posttreatment, participated. More than one-fourth of BCSs (26.5%) reported poor to moderate perceived work ability, indicating substantial concerns regarding work performance. Attentional fatigue was found to significantly predict perceived work ability (P work ability. Attentional fatigue is a prevalent symptom posttreatment that is negatively related to perceived work ability in BCSs. Nurses are in a prime position to assess and intervene to alleviate attentional fatigue to improve work ability. Findings suggest a need for individual, comprehensive survivorship care plans to effectively address symptoms that impact work ability and, ultimately, the quality of life of cancer survivors.

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

    Science.gov (United States)

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

    2016-11-01

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

  17. Social welfare and legal constraints associated with work among breast and prostate cancer survivors: experiences from Ireland.

    Science.gov (United States)

    Sharp, Linda; Timmons, Aileen

    2011-12-01

    Around 40% of cancer survivors are of working age. We investigated employment outcomes among survivors in Ireland where sick leave and sick pay are at the employers' discretion and the law affords no protection against dismissal following extended absence. A questionnaire was mailed to 1,373 survivors, identified from the National Cancer Registry, 6-24 months post-diagnosis. The analysis included breast and prostate cancer respondents who were working at diagnosis. Factors associated with work continuation post-diagnosis and work resumption after cancer-related absence were identified using logistic regression. The response rate was 54%. Three hundred forty-six respondents were working at diagnosis (breast cancer = 246; prostate cancer = 100). Sixty-two (18%) continued working post-diagnosis. Factors significantly associated with work continuation were: self-employment, prostate cancer, lower pre-diagnosis household income, and not having surgery. Two hundred eighty-four took time off work post-diagnosis; of these, 51 (18%) had left the workforce, 187 (66%) had resumed working, and 46 (16%) planned to resume working. Factors significantly associated with work resumption were: tertiary education, not having chemotherapy, receiving sick pay, and not having a medical card (which provides free access to public health services). Among those who resumed working, the median absence was 30.1 weeks (inter-quartile range = 12.9-51.6). The length of absence varied significantly by socio-demographic, financial, medical, and job- and social welfare-related factors. Median working hours pre- and post-diagnosis differed significantly (pre-diagnosis = 38/week; post-diagnosis = 30/week; psocial welfare and legal provisions are important determinants of the survivors' workforce participation. IMPLICATIONS FOR SURVIVORS: In formulating strategies to optimise survivors' employment outcomes, it is important that policy- and decision-makers are aware of the influence

  18. 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

  19. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-12-01

    Full Text Available http://dx.doi.org/10.5007/1984-784X.2013v13n19p13 Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube.   Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  20. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-06-01

    Full Text Available Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube. Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2017-03-01

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

  4. Challenges experienced by service providers in the delivery of medico-legal services to survivors of sexual violence in Kenya.

    Science.gov (United States)

    Ajema, C; Mukoma, W; Kilonzo, N; Bwire, B; Otwombe, K

    2011-05-01

    While much discussion has been devoted to defining the standards of care required when offering services to survivors of sexual violence, much less attention has been given to procedures for evidence collection to allow the successful prosecution of perpetrators. In Kenya there are no comprehensive guidelines that outline the roles of the survivor, the community, health care workers, and the police with regard to the handling of forensic evidence, a deficit that contributes to delays in prosecuting, or even a failure to prosecute sex offenders. This study examines some of the obstacles in Kenya to the adequate handling of forensic evidence in sexual violence cases. It was based on in-depth interviews with respondents drawn from health facilities, police stations, civil society organizations and with the Government Chemist in three Kenyan provinces. The study's objective was to examine the existing policy requirements regarding the maintenance of an evidence chain by the health and criminal justice systems, and how effectively they are being implemented. The findings indicate that the quality of the evidence obtained by the health care workers was often deficient, depending on the time elapsed before the rape survivor reports to the health facility; the equipment available at the health facility; the age of the survivor; and the level of knowledge of the service provider regarding the types of evidence to be collected from survivors of sexual violence. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

    Science.gov (United States)

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

    2013-06-01

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

  6. I Keep my Problems to Myself: Negative Social Network Orientation, Social Resources, and Health-Related Quality of Life in Cancer Survivors

    Science.gov (United States)

    Symes, Yael; Campo, Rebecca A.; Wu, Lisa M.; Austin, Jane

    2016-01-01

    Background Cancer survivors treated with hematopoietic stem cell transplant rely on their social network for successful recovery. However, some survivors have negative attitudes about using social resources (negative social network orientation) that are critical for their recovery. Purpose We examined the association between survivors’ social network orientation and health-related quality of life (HRQoL) and whether it was mediated by social resources (network size, perceived support, and negative and positive support-related social exchanges). Methods In a longitudinal study, 255 survivors completed validated measures of social network orientation, HRQoL, and social resources. Hypotheses were tested using path analysis. Results More negative social network orientation predicted worse HRQoL (p social exchanges. Conclusions Survivors with negative social network orientation may have poorer HRQoL in part due to deficits in several key social resources. Findings highlight a subgroup at risk for poor transplant outcomes and can guide intervention development. PMID:26693932

  7. Association between race and physical functioning limitations among breast cancer survivors.

    Science.gov (United States)

    Gallicchio, Lisa; Calhoun, Carla; Helzlsouer, Kathy J

    2014-04-01

    The goal of this study was to examine differences in physical functioning limitations among African-American and white breast cancer survivors. Data were analyzed from 115 African-American and 712 white breast cancer survivors who responded to a hospital registry-based survey. Physical functioning limitations were assessed using a series of eight questions in which individuals were asked about their ability to perform a physical task such as walking a quarter of a mile. A four-category summary score, representing overall severity of limitation, was created using participant responses to the eight questions. Ordinal logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association between race and physical functioning limitation adjusted for potential confounders. In the unadjusted model, the African-American breast cancer survivors were more than twice as likely to have a greater degree of physical functioning limitation compared to their white counterparts (OR 2.31; 95% CI 1.59, 3.38). After adjustment for covariates, including body mass index (BMI), the race OR was attenuated and no longer statistically significant (OR 1.44; 95% CI 0.92, 2.27). Findings from this study showed that African-American breast cancer survivors were more likely to have worse physical functioning limitations than their white counterparts; however, much of this disparity was due to racial differences in other variables such as BMI. Future research should focus on effective interventions targeting modifiable risk factors of physical functioning limitations among breast cancer survivors with the goal of improving quality of life.

  8. Needs assessment of primary care physicians in the management of chronic pain in cancer survivors.

    Science.gov (United States)

    Chow, Ronald; Saunders, Kevin; Burke, Howard; Belanger, Andre; Chow, Edward

    2017-06-07

    Cancer patients live longer with effective anti-cancer therapy and supportive care. About 30% of cancer survivors (non-palliative cancer patients who completed treatment) suffer from chronic pain, which will be managed by their primary care physician (PCP). The aim of this study was to assess practice patterns and treatment barriers in the management of chronic pain in cancer survivors among PCPs. A survey using a 16-item questionnaire was sent to PCPs across Canada. A total of 162 responses were collected. The majority of participants were in group (59%) or solo (33%) practice, with an average of 25 years of clinical experience. Seventy-one percent of PCPs were practicing in communities of 10,000 to 100,000 people. Respondents were treating approximately 10 cancer survivors with chronic pain per month. The majority of PCPs (59%) reported having "little knowledge" or "some understanding" of chronic pain management in cancer survivors. They did not usually refer these patients to other specialists. Patient comorbidities (79%), pain medication side effects (78%), previous pain treatment (76%), effect of pain on daily functioning (75%), and drug interactions (71%) were identified as factors that guided PCP treatment choices. Major barriers included medication cost (54%), concerns about opioid abuse (51%), and patient non-compliance (46%). PCPs indicated that treatment guidelines (74%) and knowledge of pharmacological (64%) and non-pharmacological (62%) treatment options would help their chronic pain management. Most PCPs report a lack of knowledge in the management of chronic pain in cancer survivors but are keen to receive medical education on treatment options and clinical practice guidelines.

  9. Proactive Aging Among Holocaust Survivors: Striving for the Best Possible Life.

    Science.gov (United States)

    Elran-Barak, Roni; Barak, Adi; Lomranz, Jacob; Benyamini, Yael

    2016-10-14

    To investigate methods that older Holocaust survivors and their age peers use in order to maintain the best possible life and to examine associations between these methods and subjective well-being. Participants were 481 older Israelis (mean age 77.4 ± 6.7 years): Holocaust survivors (n = 164), postwar immigrants (n = 183), and prewar immigrants (n = 134). Measures included sociodemographics and indicators of health and well-being. Respondents were asked to answer an open-ended question: "What are the methods you use to maintain the best possible life?". Answers were coded into eight categories. Holocaust survivors were significantly less likely to mention methods coded as "Enjoyment" (32.3%) relative to postwar (43.7%) and prewar (46.2%) immigrants and significantly more likely to mention methods coded as "Maintaining good health" (39.0%) relative to postwar (27.9%) and prewar (21.6%) immigrants. Controlling for sociodemographics and health status, Holocaust survivors still differed from their peers. Aging Holocaust survivors tended to focus on more essential/fundamental needs (e.g., health), whereas their peers tended to focus on a wider range of needs (e.g., enjoyment) in their effort to maintain the best possible life. Our findings may add to the proactivity model of successful aging by suggesting that aging individuals in Israel use both proactive (e.g., health) and cognitive (e.g., accepting the present) adaptation methods, regardless of their reported history during the war. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Self-reported poor oral hygiene among in-school adolescents in Zambia

    Directory of Open Access Journals (Sweden)

    Rudatsikira Emmanuel

    2011-07-01

    Full Text Available Abstract Background Dental health is a neglected aspect of adolescent health globally but more so in low-income countries. Secondary analysis using the 2004 Zambia Global School-Based Health Survey (GSHS was conducted in which we estimated frequencies of relevant socio-demographic variables and explored associations between selected explanatory variables and self-reported poor oral hygiene (not cleaning or brushing teeth within the last 30 days of the completion of questionnaire. Findings Most of the 2257 respondents were males (53.9% and went hungry (82.5%. More than 4 in 10 respondents drank alcohol (42.2% while 37.2% smoked cannabis. Overall 10.0% of the respondents reported to have poor oral hygiene. Male respondents were 7% less likely to report to have poor oral hygiene compared to females. Compared to respondents who never drank alcohol, those who drank alcohol were 27% more likely to report to have poor oral hygiene. Respondents who smoked cannabis were 4% more likely to report to have poor oral hygiene compared to those who did not smoke cannabis. Finally, respondents who went hungry were 35% more likely to report to have poor oral hygiene compared to those who did not go hungry. Conclusions Results from this study indicate that female gender, alcohol drinking, cannabis smoking, and going hungry were associated with self-reported poor oral hygiene. The identification of these factors should guide the design and implementation of programs aimed to improve oral health among adolescents.

  11. Implementing the Exercise Guidelines for Cancer Survivors

    Science.gov (United States)

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

    2013-01-01

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

  12. 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.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Science.gov (United States)

    Wheeler, Inese; And Others

    1992-01-01

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

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

    Science.gov (United States)

    Moore, Maureen M.; Freeman, Stephen J.

    1995-01-01

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

  16. 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.

  17. Health related quality of life among myocardial infarction survivors in the United States: a propensity score matched analysis.

    Science.gov (United States)

    Mollon, Lea; Bhattacharjee, Sandipan

    2017-12-04

    Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls. This retrospective, cross-sectional matched case-control study examined differences in health-related quality of life (HRQoL) among MI survivors of myocardial infarction compared to propensity score matched controls using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. Propensity scores were generated via logistic regression for MI survivors and controls based on gender, race/ethnicity, age, body mass index (BMI), smoking status, and comorbidities. Chi-square tests were used to compare differences between MI survivors to controls for demographic variables. A multivariate analysis of HRQoL domains estimated odds ratios. Life satisfaction, sleep quality, and activity limitations were estimated using binary logistic regression. Social support, perceived general health, perceived physical health, and perceived mental health were estimated using multinomial logistic regression. Significance was set at p 15 days in the month (AOR = 1.63, 95% CI: 1.46-1.83) and poor mental health >15 days in the month (AOR = 1.25, 95% CI: 1.07-1.46) compared to matched controls. There was no difference in survivors compared to controls in level of emotional support (rarely/never: AOR = 0.75, 95% CI: 0.48-1.18; sometimes: AOR = 0.73, 95% CI: 0.41-1.28), hours of recommended sleep (AOR = 1.14, 95% CI: 0.94-1.38), or life satisfaction (AOR = 1.62, 95% CI: 0.99-2.63). MI survivors experienced lower HRQoL on domains of general health, physical health, daily activity, and mental health compared to the general population.

  18. SPIRITUAL WELL-BEING IN LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMIES

    Science.gov (United States)

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

    2014-01-01

    Objective Spiritual well-being (SpWB) is integral to health-related quality of life (HRQOL). The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods Two-hundred-eight-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents’ greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the 3-item SpWB sub-scale. Results Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as “positive attitude”, “I am fortunate”, “appreciate life more”, and “strength through religious faith”. Negative themes, expressed by only 29% of respondents, included “struggling to cope”, “not feeling ‘normal’”, and “loss”. Fifty-five percent of respondents expressed ambivalent themes including “learning acceptance”, “an ostomy is the price for survival”, “reason to be around despite suffering”, and “continuing to cope despite challenges”. The majority (64%) had a high SpWB sub-scale score. Conclusions While CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes often were mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter-connectedness, and belonging. PMID:23749460

  19. 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

  20. Young adult cancer survivors' follow-up care expectations of oncologists and primary care physicians.

    Science.gov (United States)

    Hugh-Yeun, Kiara; Kumar, Divjot; Moghaddamjou, Ali; Ruan, Jenny Y; Cheung, Winson Y

    2017-06-01

    Young adult cancer survivors face unique challenges associated with their illness. While both oncologists and primary care physicians (PCPs) may be involved in the follow-up care of these cancer survivors, we hypothesized that there is a lack of clarity regarding each physician's roles and responsibilities. A self-administered survey was mailed to young adult cancer survivors in British Columbia, Canada, who were aged 20 to 39 years at the time of diagnosis and alive at 2 to 5 years following the diagnosis to capture their expectations of oncologists and PCPs in various important domains of cancer survivorship care. Multivariate logistic regression models that adjusted for confounders were constructed to examine for predictors of the different expectations. Of 722 young cancer survivors surveyed, 426 (59%) responded. Among them, the majority were White women with breast cancer. Oncologists were expected to follow the patient's most recent cancer and treatment-related side effects while PCPs were expected to manage ongoing and future cancer surveillance as well as general preventative care. Neither physician was perceived to be responsible for addressing the return to daily activities, reintegration to interpersonal relationships, or sexual function. Older survivors were significantly less likely to expect oncologists (p = 0.03) and PCPs (p = 0.01) to discuss family planning when compared to their younger counterparts. Those who were White were significantly more likely to expect PCPs to discuss comorbidities (p = 0.009) and preventative care (p = 0.001). Young adult cancer survivors have different expectations of oncologists and PCPs with respect to their follow-up care. Physicians need to better clarify their roles in order to further improve the survivorship phase of cancer care for young adults. Young adult cancer survivors have different expectations of their oncologists and PCPs. Clarification of the roles of each physician group during follow-up can

  1. A comprehensive assessment of family caregivers of stroke survivors during inpatient rehabilitation.

    Science.gov (United States)

    Young, Mary Ellen; Lutz, Barbara J; Creasy, Kerry Rae; Cox, Kim J; Martz, Crystal

    2014-01-01

    Stroke caregivers have been identified as a group at high risk for poor outcomes as a result of the suddenness of stroke and a potentially high level of care needed due to significant functional limitations of the patient. However, there is little research on the assessment of family members who will assume the caregiving role prior to patient discharge from rehabilitation. The purpose of this article is to delineate critical assessment domains identified by a subset of spousal stroke caregivers. Semi-structured interviews were conducted pre- and post-discharge from rehabilitation as part of a larger study that focused on identifying caregiver and stroke survivor needs as they transitioned home from inpatient rehabilitation. For this study, two semi-structured interviews with 14 spousal caregivers were analyzed using grounded theory methods. Long-term stroke survivor outcomes were dependent upon the commitment, capacity and preparedness of the family caregiver. Twelve domains of assessment were identified and presented. A comprehensive, systematic caregiver assessment to understand the caregiver's concerns about stroke should be conducted during rehabilitation to help the team to develop a plan to address unmet needs and better prepare family caregivers to take on the caregiving role. Stroke is a sudden event that often leaves stroke survivors and their families in crisis. The needs of stroke family caregivers are not often systematically assessed as part of inpatient rehabilitation. Long-term stroke survivor outcomes are dependent upon the commitment, capacity and preparedness of the family caregiver. Stroke caregiver assessment should include the commitment, capacity and preparedness to provide care, and the overall impact of stroke in order to develop discharge plans that will adequately address the needs of the stroke survivor/caregiver dyad.

  2. A qualitative study of the experience of obstetric fistula survivors in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Gebresilase YT

    2014-12-01

    Full Text Available Yenenesh Tadesse Gebresilase Programme Quality Department, Vita, Addis Ababa, Ethiopia Abstract: Research on obstetric fistula has paid limited attention to the lived experiences of survivors. This qualitative study explored the evolution of survivors' perceptions of their social relationships and health since developing this obstetric complication. In-depth interviews were conducted with eight survivors who were selected based on purposive and snowball sampling techniques. Thematic categorization and content analysis was used to analyze the data. The resultant themes included participants' understanding of factors predisposing to fistula, challenges they encounter, their coping responses, and the meaning of their experiences. First, the participants had a common understanding of the factors that predisposed them to obstetric fistula. They mentioned poor knowledge about pregnancy, early marriage, cultural practices, and a delay in or lack of access to emergency obstetric care. Second, the participants suffered from powerlessness experienced during their childhood and married lives. They also faced prolonged obstructed labor, physical injury, emotional breakdown, depression, erosion of social capital, and loss of healthy years. Third, to control their negative emotions, participants reported isolating themselves, having suicidal thoughts, positive interpretation about the future, and avoidance. To obtain relief from their disease, the women used their family support, sold their properties, and oriented to reality. Fourth, the participants were struggling to keep going, to accept their changed reality, and to change their perspectives on life. In conclusion, obstetric fistula has significant physical, psychosocial, and emotional consequences. The study participants were not passive victims but rather active survivors of these challenges. Adequate support was not provided by their formal or informal support systems. To prevent and manage obstetric

  3. Nutritional Characteristics of the Diets of Child and Adolescent Cancer Survivors.

    Science.gov (United States)

    Teixeira, Julia Ferrari Carneiro; Maia-Lemos, Priscila Dos Santos; Pisani, Luciana Pellegrini

    2017-10-12

    Diseases associated with prior treatment, such as obesity, have been described in cancer survivors. Recent studies have shown that current estimates of overweight do not differ from that in the general population, suggesting the influence of environmental factors, such as dietary intake. In this context, there is increasing interest in the examination of health behaviors that may modify and reduce the risk of overweight and obesity. This study aimed to evaluate the characteristics of dietary intake among child cancer survivors living in a developing country. This retrospective cross-sectional study included children and adolescents up to 18 years of age. Dietary intake of the patients was assessed using 24-hour dietary recall. All age groups showed sufficient carbohydrate and protein consumption levels. The mean percentages of carbohydrate and protein consumption were 54% and 20.8%, respectively. Regarding lipid quality, survivors showed low consumption levels of polyunsaturated and monounsaturated fats. The consumption level of saturated fats was close to the upper limit. Fiber intake was below the recommended level in all patient categories, and its mean was 11.5 g/day. The average daily intake of some vitamins and minerals was below the recommended intake levels for all sexes and age groups, with values below 50% of suitability. The imbalance of lipids quality and low consumption of micronutrients demonstrated that the diet quality is poor in child cancer survivors. This favors the development of not only obesity but also other chronic diseases, and potentially predisposes such patients to secondary cancers. this is a relevant issue due to the increased number of childhood cancer survivors who develop obesity and chronic and metabolic complications due to inadequate food consumption. Our study may help understand, prevent, or minimize public health problems.

  4. Medium-term assessment of cardiac function in pediatric cancer survivors. Comparison of different echocardiographic methods, cardiac MRI and cardiac biomarker testing in adolescent cancer survivors.

    Science.gov (United States)

    Shah, Sanket S; McClellan, Wendy; Knowlton, Joshua Q; Mehta, Jeet; Goudar, Suma; Ferguson, Angela; Sherman, Ashley; Shirali, Girish; Fulbright, Joy

    2017-02-01

    To evaluate the feasibility and correlation of 3D echocardiography (echo) and cardiac biomarkers with cardiac MRI, in surveillance of cardiac function for cancer survivors. Subjects ≥10 years of age who have survived >2 years after completion of cancer treatment from a single center were enrolled. Cardiac MRI and 3D echo images were obtained on the same day when routine echo was obtained. On the same day, along with annual routine blood test, cardiac biomarkers N-terminal pro-B-type natriuretic peptide levels (NT-proBNP) and troponin-I levels were also measured. Cardiac MRI was feasible in all 50 subjects. Three-dimensional echo and 2D echo images were of poor quality in four subjects. With a median duration of remission of 10 years, there were four subjects with mild LV dysfunction (cardiac MRI LV EF ofcancer survivors, and it correlates well with MRI. Further large-scale research is required in assessing utility of cardiac biomarkers in pediatric cancer survivors. © 2016, Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2017-10-01

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

  6. Differences in change in coping styles between good responders, moderate responders and non-responders to pulmonary rehabilitation.

    Science.gov (United States)

    Stoilkova-Hartmann, Ana; Janssen, Daisy J A; Franssen, Frits M E; Wouters, Emiel F M

    2015-12-01

    Pulmonary rehabilitation (PR) improves exercise tolerance and health status in patients with chronic obstructive pulmonary disease (COPD). Data on the effects of PR on coping styles are limited. Aim of the present study was to compare changes in coping styles between patients who had a good, moderate and no improvement in either exercise tolerance or health status after PR. Coping styles of 439 COPD patients undergoing PR were assessed by the Utrecht Coping List (UCL) at baseline and after PR. Patients' pulmonary function, six-minute walking distance (6MWD), St. George's Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS-A and HADS-D) were recorded. Good, moderate and non-responders were defined on the basis of minimally clinically important difference (MCID) for SGRQ total score and/or 6MWD. Overall, 54.0% of the patients fulfilled the criteria for good responders, while 22.1% were moderate responders. Change in passive reaction pattern coping style differed significantly between good responders and non-responders following PR (p coping styles after PR occurred among the good responders, whereas the majority of moderate responders' and non-responders' coping styles were not significantly influenced by PR. Good responders decreased their passive reaction pattern coping style in contrast to non-responders after PR. In general, PR did not change the coping among moderate and non-responders. Further research is warranted to determine whether including interventions targeting coping styles may modify coping behaviour of COPD patients, as well as improvement in exercise tolerance or health status after PR. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. 24 CFR 103.202 - Notification of respondent; joinder of additional or substitute respondents.

    Science.gov (United States)

    2010-04-01

    ... of additional or substitute respondents. 103.202 Section 103.202 Housing and Urban Development... Procedures § 103.202 Notification of respondent; joinder of additional or substitute respondents. (a) Within... may be joined as an additional or substitute respondent by service of a notice on the person under...

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    1994-12-01

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

  10. 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.

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

    African Journals Online (AJOL)

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

  12. 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…

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  15. The survivors of childhood solid tumors

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-04-01

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

  16. Differentiating incest survivors who self-mutilate.

    Science.gov (United States)

    Turell, S C; Armsworth, M W

    2000-02-01

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

  17. A Spiritual Framework in Incest Survivors Treatment

    Science.gov (United States)

    Beveridge, Kelli; Cheung, Monit

    2004-01-01

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

  18. Endocrine sequelae in childhood cancer survivors.

    Science.gov (United States)

    Casano Sancho, Paula

    2017-11-01

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

  19. Sexual dysfunction in Nigerian stroke survivors

    African Journals Online (AJOL)

    EB

    2013-09-03

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

  20. Ebola Survivor and Her Pregnancy Outcome

    Centers for Disease Control (CDC) Podcasts

    2016-12-14

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

  1. Sleep quality and health-related quality of life among long-term survivors of (non-) Hodgkin lymphoma in Germany.

    Science.gov (United States)

    Hammersen, Friederike; Lewin, Philip; Gebauer, Judith; Kreitschmann-Andermahr, Ilonka; Brabant, Georg; Katalinic, Alexander; Waldmann, Annika

    2017-01-01

    This study investigated sleep quality and health-related quality of life (HRQOL) among long-term survivors of Hodgkin (HL) and non-Hodgkin lymphoma (NHL). The aim was to explore the impact of personal and health-related factors on sleep quality as well as associations between sleep quality and HRQOL. For the postal survey, participants with a minimum age of 18 years initially treated between 1998 and 2008 were recruited via the population-based cancer registry in Schleswig-Holstein, Northern Germany. Questionnaires included amongst others the Pittsburg Sleep Quality Index (PSQI) and the 36-Item Short Form Health Survey (SF-36v1). Descriptive and comparative statistics were performed. Additionally, a regression analysis was conducted to identify predictors of sleep quality. In total, we recruited 515 participants (398 NHL, 117 HL) with a mean age of 63.1 years. Approximately half of the survivors were classified as good sleepers. HRQOL scores differed between good and poor sleepers with lower scores in poor sleepers. In a prediction model, self-reported depression, exhaustion, higher age, inability to work, endocrinological disorders and female gender classified as predictors of sleep quality. This study highlights the impact of sleep quality on HRQOL in long-term survivors of NHL and HL. Thus, sleep quality should be routinely assessed during follow-up of cancer survivors with special attention to patients with potential risk factors.

  2. The Psychosocial Impact of Lymphedema-related Distress among Breast Cancer Survivors in the WHEL Study

    Science.gov (United States)

    Dominick, Sally A.; Natarajan, Loki; Pierce, John P.; Madanat, Hala; Madlensky, Lisa

    2014-01-01

    Objective Lymphedema is a distressing and chronic condition affecting up to 30% of breast cancer survivors. Using a cross-sectional study design, we examined the impact of self-reported lymphedema-related distress on psychosocial functioning among breast cancer survivors in the Women’s Healthy Eating and Living (WHEL) Study. The WHEL Study has a dataset that includes self-report data on lymphedema status, symptoms and distress. Methods Chi-square tests and binary logistic regression models were used to examine how specific participant characteristics, including lymphedema-related distress, were associated with physical health and mental health as measured by the SF-36 and depressive symptoms assessed by the CES-Dsf. Results Of the 2,431 participants included in the current study population, 692 (28.5%) self-reported ever having lymphedema. A total of 335 (48.9%) women reported moderate to extreme distress as a result of their lymphedema and were classified as having lymphedema-related distress. The logistic regression models showed that women with lymphedema-related distress had 50% higher odds of reporting poor physical health (p=0.01) and 73% higher odds of having poor mental health (plymphedema. In contrast, even though lymphedema-related distress was significantly associated (p=0.03) with elevated depressive symptoms in the bivariate analyses, it was not significant in the logistic regression models. Conclusion Breast cancer survivors with lymphedema-related distress had worse physical and mental health outcomes than women with lymphedema who were not distressed and women with no lymphedema. Our findings provide further evidence of the relationship between lymphedema and psychosocial outcomes in breast cancer survivors. PMID:24615880

  3. Neurocognitive outcome in survivors of childhood acute lymphoblastic leukemia: experience at a tertiary care hospital in Korea.

    Science.gov (United States)

    Kim, Seong Joon; Park, Min Hyun; Lee, Jae Wook; Chung, Nak Gyun; Cho, Bin; Lee, In Goo; Chung, Seung Yun

    2015-04-01

    This study was conducted to investigate long-term neurocognitive outcomes and to determine associated risk factors in a cohort of Korean survivors of childhood acute lymphoblastic leukemia (ALL). Forty-two survivors of ALL were compared with 42 healthy controls on measures of a neurocognitive test battery. We analysed potential risk factors (cranial irradiation, sex, age at diagnosis, elapsed time from diagnosis, and ALL risk group) on neurocognitive outcomes. ALL patients had lower, but non-significant full-scale intelligence quotient (FSIQ, 107.2±12.2 vs. 111.7±10.2), verbal intelligence quotient (VIQ, 107.7±13.6 vs. 112.2±11.4), and performance intelligence quotient (PIQ, 106.3±14.2 vs. 110.1±10.7) scores than healthy controls. However, patients treated with cranial irradiation performed significantly lower on FSIQ (102.2±8.1), VIQ (103.3±11.7), and PIQ (101.4±13.2) compared to non-irradiated patients and healthy controls. ALL patients also had poor attention, concentration, and executive functions. Among ALL survivors, cranial irradiation was a risk factor for poor FSIQ, being male was a risk factor for poor PIQ, and younger age was a risk factor for poor attention. Therefore, the delayed cognitive effects of ALL treatment and its impact on quality of life require continuing monitoring and management.

  4. Information Lives: of the Poor

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

    Research ICT Africa, a South Africa-based network of researchers in 19 African countries, conducts research on ICT policy and regulation. It advocates improved access to ICTs and conducts research on policies and regulations that responds to national, regional, and continental needs. The RIA network has built up a ...

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

    Directory of Open Access Journals (Sweden)

    Edda Bjork Thordardottir

    2016-08-01

    Full Text Available Background: Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD can provide a gateway to recovery as well as enhancement of preventive measures. Objective: Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES and PTSD symptoms in adulthood. Methods: Childhood survivors (aged 2–19 at the time of exposure of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis. Results: Response rate was 66% (108/163. Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05. When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001, poor financial status (F=12.21, p<0.001, and unemployment and/or disability (F=3.04, p<0.05. In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001 and traumatic reactions of caregivers (t=2.49, p<0.05 in the aftermath of the disaster independently predicted PTSD 16 years post-trauma. Conclusions: Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.

  6. Unmet Supportive Care Needs among Breast Cancer Survivors of Community-Based Support Group in Kuching, Sarawak

    Directory of Open Access Journals (Sweden)

    Emmanuel Joseph Fong

    2016-01-01

    Full Text Available Background. Recognizing the needs of cancer survivors is one of the important aspects in healthcare delivery. This study aimed to determine the prevalence of unmet supportive care needs and its associated factors among the breast cancer survivors of community-based support group in Kuching, Sarawak. Materials and Methods. This was a cross-sectional study using Supportive Care Needs Survey (SCNS-SF34. All the members of community-based breast cancer support groups in Kuching were invited. A total of 101 respondents were face-to-face interviewed after the consent was obtained. Data was entered and analyzed using SPSS version 20. Results. The respondents endorsed health system and information domain with the highest mean score (2.48; 95% CI: 2.32–2.64. Top 10 items with “moderate to high” level unmet needs had a prevalence of 14.9% to 34.7% of respondents indicating need. Significantly higher level of unmet needs was associated with survivors who were younger (less than 60 years old, had higher education attainment, were unemployed, had survival duration of up to 5 years, and were undergoing active treatment. Conclusion. Systematic delivery of health information which is targeted, culturally sensitive, and linguistically appropriate for addressing younger age, education level, employment status, length of survivorship, and treatment stage should be considered not only at hospital-based setting but also at the community-based support groups.

  7. Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease.

    Science.gov (United States)

    Holmlund, A; Lampa, E; Lind, L

    2017-07-01

    Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P 4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

  8. Are Poor Chinese Text Comprehenders Also Poor in Written Composition?

    Science.gov (United States)

    Guan, Connie Qun; Ye, Feifei; Meng, Wanjin; Leong, Che Kan

    2013-01-01

    We studied the performance in three genres of Chinese written composition (narration, exposition, and argumentation) of 158 grade 4, 5, and 6 poor Chinese text comprehenders compared with 156 good Chinese text comprehenders. We examined text comprehension and written composition relationship. Verbal working memory (verbal span working memory and…

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

    Science.gov (United States)

    Ferro, Tàrsila; Aliste, Luisa; Valverde, Montserrat; Fernández, M Paz; Ballano, Concepción; Borràs, Josep M

    2014-01-01

    The growing number of long-term cancer survivors poses a new challenge to health care systems. In Spain, follow-up is usually carried out in oncology services, but knowledge of cancer survivors' health care needs in this context is limited. The purpose of this study was to ascertain the health status of long-term survivors of breast, prostate, and colorectal cancer and to characterize their use of health care services. Retrospective multicenter cohort study. We collected data from patients' clinical histories and through telephone interviews, using a specially designed questionnaire that included the SF-36v2 Quality of Life and Nottingham Health Profile scales. The questionnaire was completed by 51.2% (n= 583) of the potential sample. No significant differences were observed between 5-year and 10-year survivors. Overall, more than 80% of respondents were undergoing drug treatment for morbidity related to advanced age. Quality of life was good in most patients, and cancer-related morbidity was low and of little complexity. For the most part, participants reported using primary care services for care of chronic diseases and opportunistic treatment of sequelae related to the cancer treatment. Oncological follow-up was centralized at the hospital. Survivors of breast, prostate and colorectal cancer with tumoral detection at an early stage and without recurrences or second neoplasms experienced little morbidity and enjoyed good quality of life. This study proposes exploration of a follow-up model in the Spanish health system in which primary care plays a more important role than is customary in cancer survivors in Spain. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Job resignation after cancer diagnosis among working survivors in Japan: timing, reasons and change of information needs over time.

    Science.gov (United States)

    Takahashi, Miyako; Tsuchiya, Miyako; Horio, Yoshitsugu; Funazaki, Hatsumi; Aogi, Kenjiro; Miyauchi, Kazue; Arai, Yasuaki

    2017-09-28

    Despite advances in work-related policies for cancer survivors, support systems for working survivors in healthcare settings in Japan remain underdeveloped. We aimed to reveal (i) the present situation of cancer survivors' job resignation, the timing of resignation, and reasons for resignation; (ii) healthcare providers' screening behaviors of cancer survivors' work-related difficulties and (iii) changes to cancer survivors' information/support needs over time since diagnosis. We conducted an anonymous, cross-sectional survey using a convenience sample of re-visiting outpatients at three cancer centers in Japan in 2015. The questionnaire covered participants' demographic and clinical characteristics, change to job status, timing of and reasons for job resignation, screening experience regarding work-related difficulties by healthcare providers, and information/support needs at four distinct timings (at diagnosis, between diagnosis and initial treatment, between initial treatment and return-to-work, and after return-to-work). The results of 950 participants were eligible for statistical analysis. Only 23.5% of participants were screened about work-related issues by healthcare providers despite 21.3% participants reporting resigning at least once. Among participants who resigned, 40.2% decided to do so before initial treatment began. Regarding reasons for resignation, self-regulating and pessimistic reasons were ranked highly. Respondents' work-related information and support needs were observed to change over time. While treatment-related information (schedule and cost) was ranked highly at diagnosis, the need for more individually tailored information and support on work increased after treatment began. This study provides important basic data for developing effective support systems for working survivors of cancer in hospital settings.

  11. Are Survivors Who Report Cancer-Related Financial Problems More Likely to Forgo or Delay Medical Care?

    Science.gov (United States)

    Kent, Erin E.; Forsythe, Laura P.; Yabroff, K. Robin; Weaver, Kathryn E.; de Moor, Janet S.; Rodriguez, Juan L.; Rowland, Julia H.

    2015-01-01

    BACKGROUND Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. METHODS The authors identified cancer survivors diagnosed as adults (n = 1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. RESULTS Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%–34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. PMID:23907958

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

    Science.gov (United States)

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

    2015-12-15

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

  13. Socio Economic Assessment of Urban Forestry Respondents ...

    African Journals Online (AJOL)

    The paper investigates the socio economic assessment of urban forestry respondents' income in Okitipupa, Nigeria. Data were collected using structured questionnaires and these were administered to 200 urban forestry respondents. Data were collected on socioeconomic characteristics viz: age, gender, marital status, ...

  14. Empathy-related responding and prosocial behaviour.

    Science.gov (United States)

    Eisenberg, Nancy

    2007-01-01

    In this paper I differentiate among empathy, sympathy and personal distress and discuss the central role of empathy-related responding in positive (including moral) development. Empathy-related responding, especially sympathy, is likely an important source of prosocial, other-oriented motivation. In fact, empathy-related responding, especially sympathy, has been associated with prosocial behaviour (voluntary behaviour intended to benefit another, e.g. helping, sharing); this relation has been obtained for both specific instances of empathy-related responding and for dispositional sympathy. In addition, sympathy (or sometimes empathy) has been linked to relatively high levels of moral reasoning and social competence, and to low levels of aggression and antisocial behaviour. In my talk, I will review research on the relation of empathy-related responding to prosocial behaviour, the consistency of costly prosocial behaviour over time and the possible role of sympathy in its consistency, and the relation of empathy-related responding to moral reasoning, antisocial behaviour and social competence. Examples of research, including longitudinal research in our laboratory, are provided to illustrate these relations. Because of its close relations to social and prosocial responding, an understanding of empathy-related responding contributes to efforts to promote children's moral development.

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

    Science.gov (United States)

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

    2010-08-18

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

  16. Childhood life events and psychological symptoms in adult survivors of the 2004 tsunami.

    Science.gov (United States)

    Wahlström, Lars; Michélsen, Hans; Schulman, Abbe; Backheden, Magnus

    2010-08-01

    Negative life events in childhood have an adverse influence on adult psychological health, and increase vulnerability to subsequent potential traumas. It remains unclear whether this is also true in the case of disasters. This study investigates whether the experience of negative life events in childhood and adolescence was associated with psychological symptoms in groups of Swedish survivors with different types of exposure to the tsunami. 1505 survivors from Stockholm responded to a questionnaire on psychological distress, which was sent by post 14 months after the 2004 Indian Ocean tsunami. Psychological distress was measured by General Health Questionnaire-12 and suicidal ideation, and post-traumatic stress was measured by Impact of Event Scale-Revised. Life events prior to age 16 were collected and categorized under the indices accident, violence, loss and interpersonal events. Exposure to the tsunami was categorized in different types, and controlled for in the analyses. With the adjustment for confounders, significant odds ratios were found for all indices on at least one outcome measure, despite the powerful effect of the tsunami. We could not discern any distinct difference in the distribution of the tendency to report the different outcomes depending on types of prior life events. The implication of the study is that, for adult survivors of disaster, the reporting of adverse life events from childhood may influence future decisions regarding therapy.

  17. Urban Sprawl and Body Mass Index Among Displaced Hurricane Katrina Survivors

    Science.gov (United States)

    Arcaya, Mariana; James, Peter; Rhodes, Jean; Waters, Mary C; Subramanian, S V

    2014-01-01

    Objective Existing research suggests that walkable environments are protective against weight gain, while sprawling neighborhoods may pose health risks. Using prospective data on displaced Hurricane Katrina survivors, we provide the first natural experimental data on sprawl and body mass index (BMI). Methods The analysis uses prospectively collected pre- (2003–2005) and post-hurricane (2006–2007) data from the Resilience in Survivors of Katrina (RISK) project on 280 displaced Hurricane Katrina survivors who had little control over their neighborhood placement immediately after the disaster. The county sprawl index, a standardized measure of built environment, was used to predict BMI at follow-up, adjusted for baseline BMI and sprawl; Hurricane-related trauma; and demographic and economic characteristics. Results Respondents from 8 New Orleans-area counties were dispersed to 76 counties post-Katrina. Sprawl increased by an average of 1.5 standard deviations (30 points) on the county sprawl index. Each one point increase in sprawl was associated with approximately .05 kg/m2 higher BMI in unadjusted models (95%CI: .01–.08), and the relationship was not attenuated after covariate adjustment. Conclusions We find a robust association between residence in a sprawling county and higher BMI unlikely to be caused by self-selection into neighborhoods, suggesting that the built environment may foster changes in weight. PMID:24732717

  18. Assessment of knowledge of cancer and lymphoedema among breast cancer survivors

    Science.gov (United States)

    Ochałek, Katarzyna; Krzywonos-Zawadzka, Anna; Pitala, Kamil

    2014-01-01

    Aim To evaluate the knowledge of breast cancer and lymphoedema symptoms among mastectomy survivors. Material and methods The research was carried out in the Centre of Oncology Branch in Cracow. The survey comprised 60 hospitalized patients as well as 30 healthy subjects from the Małopolska region. The scientific method used was a specially designed questionnaire. Results Women with a history of cancer demonstrate a health-oriented approach. The subjects known as the experimental group perform breast self-examinations, regularly visit a gynaecologist, are aware of the most severe mastectomy complication – lymphoedema, and recognize the impact of physical activity on it. Breast cancer operation survivors have a good knowledge of breast cancer and lymphoedema, however, existing shortcomings in practical issues are worrying. On the contrary, the control group neglects regular check-ups, evaluates its own knowledge as negligible and, most surprisingly, is not interested in the subject of breast cancer and lymphoedema, even though the subjects of the group believe that arm swelling is connected to all types of breast cancer surgeries. Conclusions Breast cancer survivors have a good knowledge of their disorder but are still lacking some essential information. Respondents from the control group have a limited knowledge in the field of cancer and lymphoedema, are not interested in breast cancer matters and are not encouraged by gynaecologists to perform breast self-examinations. Educational prevention programs should develop a health-oriented approach among all women and emphasize their basic role in therapy. PMID:26327866

  19. Unmet needs of gynaecological cancer survivors: implications for developing community support services.

    Science.gov (United States)

    Beesley, Vanessa; Eakin, Elizabeth; Steginga, Suzanne; Aitken, Joanne; Dunn, Jeff; Battistutta, Diana

    2008-04-01

    After treatment completion, gynaecological cancer survivors may face long-term challenges and late effects, specific to this disease. Available research on supportive care needs of women with gynaecological cancer is limited. This study aimed to determine the prevalence and correlates of unmet needs within a population of gynaecological cancer survivors. Eight hundred and two women participated in a population-based mail survey in 2004 (56% response rate). The questionnaire included a validated instrument to assess 45 need items across multiple supportive care domains, and a range of measures to evaluate related correlates consistent with a social-ecological perspective. Forty-three per cent of respondents reported having at least one moderate- or high-level unmet need. The five highest included needing help with fear about the cancer spreading (17%), concerns about the worries of those close to them (15%), uncertainty about the future (14%), lack of energy/tiredness (14%), and not being able to do things they used to do (14%). Subgroups of women with higher odds of reporting 'some' unmet needs across multiple supportive care domains include those who, are not in remission, live with lymphoedema or are unable to work due to illness. Odds were also higher for women who had undergone more recent treatment, and who lived in rural or remote locations. Further assistance with the top specific concerns of gynaecological cancer survivors is recommended. Identified subgroups with higher needs are important targets for support. Copyright 2007 John Wiley & Sons, Ltd.

  20. Anxiety and depression associated with caregiver burden in caregivers of stroke survivors with spasticity.

    Science.gov (United States)

    Denno, Melissa S; Gillard, Patrick J; Graham, Glenn D; DiBonaventura, Marco D; Goren, Amir; Varon, Sepi F; Zorowitz, Richard

    2013-09-01

    To investigate the relationship between anxiety/depression and caregiver burden in informal caregivers of stroke survivors with spasticity. Data were collected via online surveys from informal caregivers 18 years or older who cared for stroke survivors. Internet-based survey. 2007 through 2009 U.S. National Health and Wellness Survey database or Lightspeed Research general panel respondents (N=153). Not applicable. Anxiety and depression were self-reported by the caregiver as a physician diagnosis. Depression severity was measured by the Patient Health Questionnaire-9 (PHQ-9). Caregiver burden was measured by the Oberst Caregiving Burden Scale (OCBS) and the Bakas Caregiving Outcomes Scale (BCOS). Logistic regression analyses were conducted with anxiety, depression, and the PHQ-9 depression severity categories as a result of each caregiver burden scale. Data were analyzed for 153 informal caregivers; they were mostly women (70.6%) and white (78.4%), with a mean age of 51.6 years. For every 1-point increase in the OCBS Difficulty Scale, the odds of anxiety or depression were 2.57 times as great (Pcaregiver burden increases, caregivers are more likely to have anxiety and depression. Depression severity also increases. Providing treatment to stroke survivors with spasticity that lessens the time and more importantly, the difficulty of caregiving may lead to a reduction in caregiver anxiety and depression. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Urban sprawl and body mass index among displaced Hurricane Katrina survivors.

    Science.gov (United States)

    Arcaya, Mariana; James, Peter; Rhodes, Jean E; Waters, Mary C; Subramanian, S V

    2014-08-01

    Existing research suggests that walkable environments are protective against weight gain, while sprawling neighborhoods may pose health risks. Using prospective data on displaced Hurricane Katrina survivors, we provide the first natural experimental data on sprawl and body mass index (BMI). The analysis uses prospectively collected pre- (2003-2005) and post-hurricane (2006-2007) data from the Resilience in Survivors of Katrina (RISK) project on 280 displaced Hurricane Katrina survivors who had little control over their neighborhood placement immediately after the disaster. The county sprawl index, a standardized measure of built environment, was used to predict BMI at follow-up, adjusted for baseline BMI and sprawl; hurricane-related trauma; and demographic and economic characteristics. Respondents from 8 New Orleans-area counties were dispersed to 76 counties post-Katrina. Sprawl increased by an average of 1.5 standard deviations (30 points) on the county sprawl index. Each one point increase in sprawl was associated with approximately .05kg/m(2) higher BMI in unadjusted models (95%CI: .01-.08), and the relationship was not attenuated after covariate adjustment. We find a robust association between residence in a sprawling county and higher BMI unlikely to be caused by self-selection into neighborhoods, suggesting that the built environment may foster changes in weight. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Validation of Malaysian translated distress thermometer with problem checklist among the breast cancer survivors in Malaysia.

    Science.gov (United States)

    Yong, H W; Zubaidah, J; Saidi, M; Zailina, H

    2012-03-01

    Distress thermometer (DT) is a single-item measure generated to assess the psychological distress among cancer patients. The aim of this study was to validate the translated DT as a tool to determine the psychological distress level and assess the factors associated with distress among the working breast cancer survivors and also to compare with the Hospital Anxiety and Depression Scale (HADS). 150 working breast cancer survivors were interviewed using the Malay and Chinese language translated version of DT and HADS. Based on HADS, 23.3% were anxious, 19.3% were depressed whereas 15.3% experienced both anxiety and depression. About 14.7% of the respondents reported distress (cutoff≥5) on DT. A significant association was found between the DT and HADS which indicated that both were measuring the same construct, Hospital Anxiety and Depression Scale-T (F=71.34, pMalaysian breast cancer survivors. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Causal thinking after a tsunami wave: karma beliefs, pessimistic explanatory style and health among Sri Lankan survivors.

    Science.gov (United States)

    Levy, Becca R; Slade, Martin D; Ranasinghe, Padmini

    2009-03-01

    In 2004, one of the largest earthquakes ever recorded led to a tsunami devastating two-thirds of the Sri Lankan coastline. We examined whether certain causal beliefs (attributional style and karma, a Buddhist concept used to explain bad events) are associated with tsunami survivors experiencing PTSD and poor health about six months later. Previous studies of causal beliefs associated with illness following the same traumatic event have focused on Western countries and none have considered the role of karma. We interviewed 264 Sri Lankan tsunami survivors. As predicted, we found that belief in karma and a pessimistic explanatory style are independently associated with poor health and a pessimistic explanatory style is associated with PTSD, after adjusting for relevant factors. Thus, both universal and more culturally specific beliefs may contribute to coping following a natural disaster.

  4. Jesus: Born Poor or Rich?

    African Journals Online (AJOL)

    First Lady

    Abstract. Over the centuries in Christendom, the clergy has consistently drummed it into the ears and consciousness of the laity that Jesus was born poor; this has been phenomenal and the adherents of Christian religion have accepted and imbibed it without question. Drawing from anecdotes and accounts that.

  5. Caring for survivors of breast cancer: perspective of the primary care physician.

    Science.gov (United States)

    Smith, S L; Wai, E S; Alexander, C; Singh-Carlson, S

    2011-10-01

    Increasing numbers of women are surviving breast cancer, and survivorship care is becoming more complex. Primary care physicians provide care for most survivors of breast cancer in the Canadian province of British Columbia. The present study offers insight into the confidence of primary care physicians in their abilities to provide such care. It also explores potential ways to assist those providers in enhancing this aspect of their practice. A questionnaire was mailed to 1000 primary care physicians caring for survivors of breast cancer. The questionnaire explored the perspectives of the responding physicians on their ability to manage various aspects of survivorship care for breast cancer patients, identified preferences for the content and format of communication from oncologists at the time of transition from active oncology treatment to survivorship, and determined the means most commonly used to obtain knowledge about breast cancer. This 1-page, 31-item checkbox and open-answer questionnaire assessed the perceptions of primary care physicians about the care of breast cancer survivors after completion of active treatment and their personal preferences for resources providing information about breast cancer. The questionnaire response rate was 59%. Primary care physicians reported being most confident in screening for recurrence and managing patient anxiety; they were least confident in managing lymphedema and providing psychosocial counselling. Compared with physicians following fewer survivors of breast cancer, those who followed more breast cancer survivors had higher confidence in managing the biomedical aspects of follow-up and in providing counselling about nutrition and exercise. Most physicians found discharge letters from oncologists to be useful. Point-form discharge information was preferred by 43%; detailed description, by 19%; and both formats, by 38%. The most useful information items identified for inclusion in a discharge letter were a diagnosis

  6. Mediators of the effect of neighborhood poverty on physical functioning among breast cancer survivors: a longitudinal study.

    Science.gov (United States)

    Pruitt, Sandi L; McQueen, Amy; Deshpande, Anjali D; Jeffe, Donna B; Schootman, Mario

    2012-09-01

    Female breast cancer survivors, a large and growing population, experience impaired physical functioning after treatment. Survivors living in impoverished neighborhoods may suffer even greater impairment, but the mechanisms linking neighborhood poverty and individual outcomes are poorly understood. This study sought to identify mediators of the effect of neighborhood poverty on physical functioning using longitudinal data from a Missouri cancer registry-based sample of 909 female breast cancer survivors. Survivors were recruited 1 year after diagnosis (Y1) and completed two telephone interviews, at Y1 and 1 year later (Y2). The association between census-tract-level poverty and physical functioning (RAND SF-36) was tested using a multilevel a priori path model with 19 hypothesized mediators, demographic and socioeconomic confounders, and covariates. Hypothesized mediators included clinical and treatment variables, psychosocial factors (depression, stress, social support), perceived neighborhood characteristics, behavioral risk factors (physical activity, smoking, body mass index, alcohol use), and comorbidity. In unadjusted analysis, women living in neighborhoods with higher poverty were more likely to report lower physical functioning at Y2 (β = -.19, p poverty on physical functioning was fully mediated by physical activity and body mass index. Breast cancer survivors living in neighborhoods with greater poverty reported lower physical functioning, but this effect was fully explained by physical activity and body mass index. Community-based lifestyle interventions sensitive to the unique challenges faced by cancer survivors and the challenges of living in a high-poverty neighborhood are needed to ameliorate neighborhood socioeconomic disparities in physical functioning.

  7. Criticality Safety Basics for INL Emergency Responders

    Energy Technology Data Exchange (ETDEWEB)

    Valerie L. Putman

    2012-08-01

    This document is a modular self-study guide about criticality safety principles for Idaho National Laboratory emergency responders. This guide provides basic criticality safety information for people who, in response to an emergency, might enter an area that contains much fissionable (or fissile) material. The information should help responders understand unique factors that might be important in responding to a criticality accident or in preventing a criticality accident while responding to a different emergency.

    This study guide specifically supplements web-based training for firefighters (0INL1226) and includes information for other Idaho National Laboratory first responders. However, the guide audience also includes other first responders such as radiological control personnel.

    For interested readers, this guide includes clearly marked additional information that will not be included on tests. The additional information includes historical examples (Been there. Done that.), as well as facts and more in-depth information (Did you know …).

    INL criticality safety personnel revise this guide as needed to reflect program changes, user requests, and better information. Revision 0, issued May 2007, established the basic text. Revision 1 incorporates operation, program, and training changes implemented since 2007. Revision 1 increases focus on first responders because later responders are more likely to have more assistance and guidance from facility personnel and subject matter experts. Revision 1 also completely reorganized the training to better emphasize physical concepts behind the criticality controls that help keep emergency responders safe. The changes are based on and consistent with changes made to course 0INL1226.

  8. Responder Technology Alert Monthly (January 2015)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-01

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

  9. Responder Technology Alert Monthly (December 2014)

    Energy Technology Data Exchange (ETDEWEB)

    Upton, Jaki F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stein, Steven L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-13

    As part of technology foraging for the Responder Technology Alliance, established by the Department of Homeland Science and Technologies First Responders Group, this report summarizes technologies that are relevant in the area of “wearables,” with the potential for use by first responders. The content was collected over the previous month(s) and reproduced from a general Internet search using the term wearables. Additional information is available at the websites provided. This report is not meant to be an exhaustive list nor an endorsement of any technology described herein. Rather, it is meant to provide useful information about current developments in the areas wearable technology.

  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. Coping with incest: the relationship between recollections of childhood coping and adult functioning in female survivors of incest.

    Science.gov (United States)

    Brand, Bethany L; Alexander, Pamela C

    2003-06-01

    One hundred and one adult female survivors' recollections of coping with childhood incest, abuse characteristics, and current functioning in adulthood were studied. Analyses controlling for characteristics of the trauma indicated that recollections of using avoidance coping and seeking social support were related to poor adult functioning whereas recollections of using distancing coping were related to better functioning. As a set of variables, abuse characteristics also predicted a significant amount of variance in adult functioning. Implications for future research were discussed.

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

    Science.gov (United States)

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

    2017-02-24

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

  13. Assessment of Cancer Survivors' Experiences of Using a Publicly Available Physical Activity Mobile Application.

    Science.gov (United States)

    Puszkiewicz, Patrycja; Roberts, Anna L; Smith, Lee; Wardle, Jane; Fisher, Abigail

    2016-05-31

    Regular participation in physical activity (PA) is associated with improved physical and psychosocial outcomes in cancer survivors. However, PA levels are low during and after cancer treatment. Interventions to promote PA in this population are needed. PA mobile apps are popular and have potential to increase PA participation, but little is known about how appropriate or relevant they are for cancer survivors. This study aims to (1) assess recruitment, study uptake, and engagement for a publicly available PA mobile app (GAINFitness) intervention in cancer survivors; (2) assess cancer survivors' attitudes towards the app; (3) understand how the app could be adapted to better meet the needs of cancer survivors; and (4) to determine the potential for change in PA participation and psychosocial outcomes over a 6-week period of using the app. The present study was a one-arm, pre-post design. Cancer survivors (N=11) aged 33 to 62 years with a mean (SD) age of 45 (9.4), and 82% (9/11) female, were recruited (via community/online convenience sampling to use the app for 6 weeks). Engagement with the app was measured using self-reported frequency and duration of usage. Qualitative semi-structured telephone interviews were conducted after the 6-week study period and were analyzed using thematic analysis. PA, well-being, fatigue, quality of life (QOL), sleep quality, and anxiety and depression were self-reported at baseline and at a 6-week follow-up using the Godin Leisure Time Exercise Questionnaire (GLTEQ), the Functional Assessment of Cancer Therapy-General (FACT-G), the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale Questionnaire, the Health and Quality of Life Outcomes (EQ5D) Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS), respectively. Of the people who responded to the study advertisement, 73% (16/22) agreed to participate and 100% (11/11) of the participants who started the study

  14. The psychosocial impact of the environmental damage caused by the MT Merapi eruption on survivors in Indonesia.

    Science.gov (United States)

    Warsini, Sri; Buettner, Petra; Mills, Jane; West, Caryn; Usher, Kim

    2014-12-01

    The eruption of Indonesia's Mount Merapi volcano in 2010 caused extensive environmental degradation. Settlements and hundreds of hectares of farmlands were buried under volcanic ash. Until now, there has been no research on the psychosocial impact of living in an environment damaged by a volcanic eruption. We studied and compared the psychosocial impact of environmental damage on volcano survivors from two subdistricts-Cangkringan and Pakem. Cangkringan survivors affected by the 2010 eruption continue to live in a damaged environment. The Pakem subdistrict was damaged by eruptions of Mt Merapi in the 1990s but there is no recent damage to their environment. The Indonesian-Environmental Distress Scale (I-EDS), a translated revision of the original Environmental Distress Scale (EDS), was used to collect data. Exploratory statistical methods and multivariate linear regression analyses were performed to examine the relative contributions of demographic variables on the psychosocial impact of living in an environment damaged by volcanic eruption. A total of 348 survivors of the Mt Merapi eruption participated in the survey. The mean I-EDS score for Cangkringan district was 15.8 (SD 1.6; range 11.8-19.8) compared to 14.6 (SD 1.3; range 11.8-18.3) for Pakem district (P < 0.001). This result was confirmed by multiple linear regression analysis showing further that older respondents (P < 0.001), unemployed and retired respondents (P = 0.007), and respondents with no formal school education (P = 0.037) had lower I-EDS scores compared to the respective reference groups. Survivors of the Mt Merapi eruption who continue to live in the environment damaged by the 2010 volcanic eruption experience environmental distress. Relevant interventions should target those from low sosioeconomic groups to deal with the distress.

  15. Management of Unexplained Symptoms in Survivors of Cancer

    Science.gov (United States)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Korobeynikov G.V.

    2013-01-01

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

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

    DEFF Research Database (Denmark)

    Jarlbæk, Lene; Christensen, Linda; Bruera, Eduardo

    2014-01-01

    , 2.4% lung cancer. Short-term survivors: 21% lung cancer, 7.2% breast cancer. Chemotherapy was provided to 15% of all patients, and to 10% of the 60 + year olds. Discussion. The epidemiology of long- and short-term survivors shows significant differences with regard to age at TOCD, cancer types......' difference in age at TOCD was seen between long- and short-term survivors, with median ages of 60 versus 72 years, respectively. Females comprised 64% of long-term, and 46% of short-term survivors. The proportion of breast and lung cancers differed between the groups: Long-term survivors: 31% breast cancer......Introduction. In this study, we present data from a population-based cohort of incident cancer patients separated in long- and short-term survivors. Our aim was to procure denominators for use in the planning of rehabilitation and palliative care programs. Material and methods. A registry...

  18. 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.

  19. Factors Associated with Resilience of Adult Survivors Five Years after the 2008 Sichuan Earthquake in China

    Science.gov (United States)

    Ni, Cuiping; Chow, Meyrick Chum Ming; Jiang, Xiaolian; Li, Sijian; Pang, Samantha Mei Che

    2015-01-01

    Given the paucity of quantitative empirical research on survivors’ resilience and its predictors in the context of long-term recovery after disasters, we examined how resilience predictors differed by gender among adult survivors five years after the Sichuan earthquake. This was a cross-sectional survey study of adult survivors (N = 495; aged 18–60) living in reconstructed communities five years into the recovery process after the Wenchuan earthquake. The instruments we used included assessments of sociodemographic characteristics and earthquake exposure level, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Support-seeking behaviors emerged as a significant predictor of male survivors’ resilience, while subjective support and marital status were found to be predictors of female survivors’ resilience. Annual household income and chronic disease were predictors for both male and female groups. The findings of this study can be used in devising methods to boost survivors’ resilience by promoting their satisfaction with social support and their ability to obtain effective support. Additionally, the results suggest how to assist survivors who may have relatively poor resilience. PMID:25811775

  20. Psychological health and coping strategy among survivors in the year following the 2008 Wenchuan earthquake.

    Science.gov (United States)

    Xu, Jiuping; He, Yuan

    2012-04-01

    The powerful earthquake of 12 May 2008 wrought incalculable havoc on lives and properties in Wenchuan, Sichuan Province, China. The catastrophic earthquake not only created tremendous changes in the external environment, but also caused stress and difficulties for the people in the affected areas which were felt long after the event. In this study, we attempt to clarify the correlation between coping strategies and psychological well-being among survivors across sex and levels of exposure. A total of 2080 survivors from 19 counties freely participated in the survey which used self-report psychological questionnaires, the Short Form-12, version 2 Scale and Coping Scales. We estimated regression models to identify the coping factors associated with the presence of mental symptoms after the disaster. Four main factors (middle-age, low educational level, low monthly income, and high exposure) were significantly related to poor health. Highly exposed survivors tended to problem-avoidance, fantasy, self-blame and seeking assistance, which was significantly different to those lowly exposed. Women tended to be more vulnerable than men and exhibited problem-avoidance and self-blame. Six coping styles were significant determinants and predicted 64.2% of health. Post-disaster mental health recovery intervention, including early identification, ongoing monitoring, sustained psychosocial support and more mental health services, are required for the high-risk population, especially for women. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  1. 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.

  2. 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.

  3. Hospitalization Rates Among Survivors of Young Adult Malignancies.

    Science.gov (United States)

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

    2015-08-20

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

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

    OpenAIRE

    Gilliam, Margaux B.; Schwebel, David C.

    2013-01-01

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

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

    OpenAIRE

    Gjerset, Gunhild Maria

    2012-01-01

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

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

    OpenAIRE

    Korobeynikov G.V.; Drojjin V.U.

    2013-01-01

    The purpose of the study: approbation of the prevention program of physical rehabilitation for Chernobyl disaster survivors in lifestyle aspects. Sixty persons who were disaster survivors and workers of Chernobyl Nuclear Power Plant aged 32-60 have rehabilitation during 21 days. The complex of training prevention programs of physical and psycho-emotional rehabilitation methods was elaborated. The study of efficacy of training prevention programs among Chernobyl disaster survivors. The results...

  7. Challenges to Leadership: Responding to Biological Threats

    Science.gov (United States)

    2011-10-01

    Challenges to Leadership : Responding to Biological Threats Paul Rosenzweig Center for Technology and National Security Policy...Challenges to Leadership : Responding to Biological Threats 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT... theory , two other components to any program to reduce the threat of a biological attack: limiting access to source materials and technology and

  8. Poor Theatre: goal or path?

    Directory of Open Access Journals (Sweden)

    Lidia Olinto

    2013-03-01

    Full Text Available This article is a critical review of the book Towards a Poor Theatre by Jerzy Grotowski, recently published in Brazil with a new Portuguese version by Ivan Chagas. This book is considered one of the most important works ever written in the field of the Performing Arts, having contributed to setting new standards for theatre as a practice in the late twentieth century. In this review a brief background of the book is presented and its main ideas are briefly described, such as the notions of: ‘poor theater’, ‘holy actor’ and ‘via negativa’. Ivan Chagas’s translation is critically discussed, especially his change of title.

  9. Health solutions for the poor.

    Science.gov (United States)

    Castro, J L; Fujiwara, P I; Bhambal, P; Emaille-Léotard, N; Harries, A D

    2014-03-21

    The International Union Against Tuberculosis and Lung Disease (The Union) is the oldest international non-governmental organisation involved in the fight against tuberculosis. In 2008, the Institute of The Union was challenged to think boldly about the future and to develop a diverse work portfolio covering a wide spectrum of lung health and other disease-related problems. The vision adopted by The Union at that time was 'Health solutions for the poor'. More recently, there has been lengthy debate about the need for the Union to concentrate just on its core mandate of tuberculosis and lung health and for the Union's vision to reflect this narrower spectrum of activity as 'Lung health solutions for the poor'. In this viewpoint article we outline our reasons for believing that this narrower vision is incompatible with The Union's mission statement, and we argue that making such a change would be a mistake.

  10. Factors Affecting Poor Strategy Implementation

    Directory of Open Access Journals (Sweden)

    Muh. Darmin Ahmad Pella

    2013-06-01

    Full Text Available Research on strategy implementation has been developed for three decades, yet only a few studies focus on factors affecting poor strategy implementation. This research evaluates the influence of strategy implementation problems on strategy implementation success and firm performance. This survey was conducted in 60 Indonesian companies and the data were statistically analysed using Structural Equation Modeling Partial Least Square (SEM PLS. The results show significant influence of strategy implementation problems on the degree of successful strategy implementation and perceived firm performance. The seven major obstacles that have impact on poor strategy implementation are: problems related to corporate scorecard, key performance indicators, information technology, competence, performance appraisal, strategy management office, and financial support.

  11. Preschool Needle Pain Responding: Establishing 'Normal'.

    Science.gov (United States)

    Waxman, Jordana A; DiLorenzo, Miranda G; Pillai Riddell, Rebecca R; Flora, David B; Greenberg, Saul; Garfield, Hartley

    2017-06-01

    The current study sets forth to provide descriptive data for preschool vaccination pain responding as well as examine longitudinal relationships over early childhood. Growth mixture modeling was first used to describe stable subgroups of preschoolers on the basis of their pain response patterns over 2-minutes post-needle. Secondly, a parallel-process growth curve model was used to assess the stability of acute pain responding from 12 months of age to preschool age. Specifically, we examined whether preschool pain-related distress or regulation could be predicted from 12-month acute pain responding. Preschool participants were part of a Canadian longitudinal cohort (The Opportunities to Understand Childhood Hurt [OUCH] cohort; N = 302). Growth mixture modeling analyses discerned 3 distinct groups of preschoolers, with an important minority not regulating to low-no pain by 2 minutes post-needle. There were no significant associations between 12-month and preschool pain responding. These results highlight the steep trajectory of development between these different stages of early childhood and the variability of pain responding at the preschool vaccination. This study provides descriptive data for preschool vaccination pain responding as well as examines longitudinal relationships over early childhood. Demonstrating significantly different pain patterns from infancy, 25% of preschoolers are displaying suboptimal regulation trajectories. This considerable minority poses a significant concern because of the established trajectory of phobia onset in middle childhood. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2012-01-01

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

  13. 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.

  14. Latina breast cancer survivors informational needs: information partners.

    Science.gov (United States)

    Sorensen, Lena; Gavier, Maria; Hellesø, Ragnhild

    2009-01-01

    The ability to access and understand health information is becoming more critical to managing one's own health and illness. Informatics tools are increasingly the central resources for responding to these needs. But just as information is culturally bound, so are the tools used to access it; both are bounded by the contexts in which they are situated. Latinas face more barriers in accessing needed information due to cultural, linguistic and health access inequities in the US. Although breast cancer rates for Latinas are lower than for non-Latina white women, they are more likely to have a more advanced stage at diagnosis and poorer quality of survivorship. Few studies have explored Latina breast cancer survivors' information needs & strategies. This community-based study focused on Mexican American women with breast cancer and explored their health information experiences, needs, and strategies; it examined their perceptions of how their relationships with providers influenced how information was accessed and utilized. Managing information was not an individual responsibility for any of these women. All of these women had access and used the Internet either directly or through their support networks. All emphasized the importance of having a select support network of people (information partners) for receiving, searching, and interpreting all health information about their illness. If information partners are strategies preferred by Latinas, then we must refocus our assessment of e-health literacy competencies on networks rather than individuals.

  15. Transcriptional changes induced by bevacizumab combination therapy in responding and non-responding recurrent glioblastoma patients

    DEFF Research Database (Denmark)

    Urup, Thomas; Staunstrup, Line Maersk; Michaelsen, Signe Regner

    2017-01-01

    expression profiling of formalin-fixed paraffin-embedded tumor tissue was performed using RNA-sequencing.Results: By comparing pretreatment samples of responders with those of non-responders no significant difference was observed. In a paired comparison analysis of pre- and posttreatment samples of non...... distinct gene expression changes while responding tumors adaptively respond or progress by means of the same transcriptional changes. In conclusion, we hypothesize that the identified gene expression changes of responding tumors are associated to bevacizumab response or resistance mechanisms....

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

    Science.gov (United States)

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

    2018-01-01

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

  17. Periodontal health, perceived oral health, and dental care utilization of breast cancer survivors.

    Science.gov (United States)

    Taichman, L Susan; Griggs, Jennifer J; Inglehart, Marita R

    2015-01-01

    This population-based analysis examined the prevalence of periodontal diseases along with the self-perceived oral health and patterns of dental care utilization of breast cancer survivors in the United States. Data from the 1999-2004 National Health and Nutrition Surveys were utilized, examining information from 3,354 women between 50 and 85 years of age. Primary outcomes were gingivitis and periodontitis, self-perceived oral health, and dental care utilization. Logistic regression analyses were used to estimate relationships of breast cancer diagnosis and primary outcomes while controlling for confounding factors. Breast cancer survivors were more likely to be older than 55 years, white, nonsmokers, have higher levels of education and income, and a higher prevalence of osteoporosis. Breast cancer survivors were significantly less likely to have dental insurance (P = 0.04). Utilization of dental services and reason for last dental visit did not significantly differ between groups. A history of a breast cancer diagnosis did not increase the odds of gingivitis [odds ratio (OR):  1.32; 95 percent confidence interval (CI): 0.53-3.63], periodontitis (OR: 1.82; 95 percent CI:  0.89-4.01), or poor self-perceived oral health (OR: 0.89; 95 percent CI: 0.61-1.33) after adjusting for age, race, education, dental care utilization, and smoking status. In this sample, a history of breast cancer does not significantly impact periodontal health, self-perceived oral health, and dental care utilization. However, efforts should be made to assure that breast cancer survivors have dental insurance. © 2015 American Association of Public Health Dentistry.

  18. Experiences of breast cancer survivors participating in a tailored exercise intervention -a qualitative study.

    Science.gov (United States)

    Luoma, Minna-Liisa; Hakamies-Blomqvist, Liisa; Blomqvist, Carl; Nikander, Riku; Gustavsson-Lilius, Mila; Saarto, Tiina

    2014-03-01

    The aim of the study was to investigate how tailored exercise is experienced by cancer survivors. Twenty-five breast cancer survivors who were recently treated with systemic adjuvant treatments attended tailored exercise classes as a part of a randomized controlled exercise intervention study (Breast Cancer and Exercise, BREX). Focus group discussions with a median of four (range 3-6) participants in each group were conducted to capture their individual experiences of their course of illness, taking part in the exercise trial, the personal meaning of tailored exercise classes and the group. Attending the intervention in which the focus of attention was on physical rehabilitation was highly valued, since the participants experienced both improved physical fitness and improved coping. Due to altered physical appearance and poor physical fitness, the participants felt that tailored exercise for patients with breast cancer reduced their barrier to start exercising. Peer support from the group was valued, especially that of sharing experiences, receiving psychological support and gaining a sense of normality. A sense of mastery over their disease through participating in the intervention, i.e. better psychological functioning and improved mood, was a consequence of better physical fitness and of meeting other breast cancer survivors. Also participating in the study per se increases a sense of comfort and security with extra medical examinations and follow-up. Participating in the tailored exercise group for breast cancer survivors helped patients gain a sense of mastery, restoring their self-esteem and constructing a meaning for their cancer experience and its impact on their lives.

  19. Effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy.

    Science.gov (United States)

    Gautam, Sital; Poudel, Anju

    2016-12-01

    Stoma can pose extensive challenges for colorectal cancer survivors. Identifying the psychological and social adjustment among them and how it differs by gender will aid in identifying those particularly at risk of having poor adjustment and in planning programs to improve their adjustment. The purpose of this study was to determine the effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy. A descriptive cross sectional study was carried out in the stoma clinic of B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal. A purposive sample of 122 patients with ostomy was taken from the above mentioned setting. Selection criteria included colorectal cancer survivors having ostomy for at least 6 months. Data on socio-demographic and clinical variables were collected. Psychosocial adjustment was measured using Ostomy Adjustment Inventory-23 (OAI-23). A total of 122 patients were included in the study. Mean time since ostomy surgery was 2.53 and 1.98 years for men and women respectively. Both men and women had significant impairment in the psychosocial adjustment, however, men had significantly lower psychosocial adjustment score (37.68±12.96 vs. 43.45±12.81, t=-2.47, P=0.015) at 95% CI as compared to women and they reported more negative emotions. Furthermore, men significantly predicted low acceptance {β=-3.078, P=0.023, ΔR2=0.036, F [4,117] =7.90, Postomy should be monitored for psychosocial concerns in regular basis and health care providers should tailor care based on their need. Approaches of survivorship care and psychosocial interventions in colorectal cancer survivors with ostomy should take into account gender specific concerns and requirements to aid adjustment.

  20. Coping support factors among Australians affected by terrorism: 2002 Bali bombing survivors speak.

    Science.gov (United States)

    Stevens, Garry J; Dunsmore, Julie C; Agho, Kingsley E; Taylor, Melanie R; Jones, Alison L; Raphael, Beverley

    2013-12-16

    To examine terrorism survivors' perceptions of factors likely to promote coping and recovery, and to determine whether coping supports vary according to demographic, physical and mental health, incident-exposure and bereavement variables. Individuals directly exposed to and/or bereaved by the 2002 Bali bombings and who had participated in a New South Wales Health therapeutic support program completed cross-sectional telephone interviews during July-November 2010. Spoken passages were categorised into coping support themes. Advocated supports were then examined by demographic, physical and mental health, incident-exposure and bereavement variables. Based on their experiences, respondents identified personal, social and service-related factors that they believed would optimally support future survivors of terrorism. Of the 81 people contacted, 55 (68%) participated, providing a total of 114 comments. Thirty-two respondents were women, and 54 had lost relatives or friends in the bombing. Mean age was 50 years (range, 20-73 years). Four meaningful coping support themes emerged, with excellent inter-rater reliability: professional help and counselling; social support; proactive government response and policy; and personal coping strategies. Women were significantly more likely to advocate the need for proactive government response (P = 0.03). Men were more likely to endorse the use of personal coping strategies (P terrorism-affected groups. Male survivors may benefit more from mental health interventions that initially build on problem-focused forms of coping, including brief education about reactions and periodic check-ups. Proactive government health and support services that allow simplified and longer-term access were consistently identified as priority areas.

  1. Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies.

    Science.gov (United States)

    Choi, Jiyeon; Donahoe, Michael P; Hoffman, Leslie A

    2016-04-01

    This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research. Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors. In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking. Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.

  2. "I just googled and read everything": Exploring breast cancer survivors' use of the internet to find information on complementary medicine.

    Science.gov (United States)

    Holmes, Michelle M; Bishop, Felicity L; Calman, Lynn

    2017-08-01

    Breast cancer survivors often turn to the internet as an information resource when deciding whether to use complementary and alternative medicine (CAM) but their use of online CAM-related resources is poorly understood. The objective was to explore breast cancer survivors' use of the internet when making decisions about CAM use. A purposive sample of 11 breast cancer survivors (mean age=56) completed a quantitative questionnaire and a qualitative telephone interview. The theory of planned behaviour (TPB) was used to guide interview questions. Framework analysis and descriptive statistics were used. United Kingdom. All participants found information on CAM using the internet and used some form of CAM after their diagnosis. Themes from the interviews went beyond the standard definitions of the TPB areas. Despite the lack of approval from their social network and healthcare team, participants used the internet to find information on CAM. Further, participants' cancer diagnosis changed their needs, transforming how they perceived and experienced the internet CONCLUSIONS: Participants' use of the internet was more complex than can easily be explained by the TPB and was inherently connected to the experience of self-management for the consequences of cancer and its treatment. As breast cancer survivors may not disclose their use of the internet to their healthcare team, healthcare professionals need to be aware that the information available on the internet plays a factor in the decision-making process to use CAM. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The taste of trauma: reflections of ageing Shoah survivors on food and how they (reinscribe it with meaning

    Directory of Open Access Journals (Sweden)

    Ben Kasstan

    2015-01-01

    Full Text Available Drawing on ethnographic research in the UK’s only support facility for ageing Jewish Shoah survivors, this paper charts the ‘foodways’ in a Centre where satiety is experienced as an emotional as well as a physical need. How the experience of genocidal violence and displacement give rise to particular tastes of trauma is explored, firstly through the symbolism of bread which is metaphorically leavened with meanings and memories of survival – both in Judaism and for the survivors interviewed. Bread is positioned as a true reflection of lived experience for survivors of both ghettoes and concentration camps, who construct a specific and salient relationship with food. This illustrates the perceived difference between them and members of the Centre who escaped the Nazi regime as refugees or by the Kindertransport. Foods associated with the concentration or extermination camps are (reinscribed with new meanings, as a steaming bowl of Polish barley soup ultimately embodies the ingredients of memory but also the recipe of survival. It can also stew the nostalgia of pre-war lives for Eastern European Jews and their recollections of the heym (Yiddish, home. Food is a conscious strategy of care in the Centre that mediates the embodied trauma of participants, and this paper draws on comparative examples to argue that refugee and survivor communities more generally may possess culturally-significant relationships with food that remain poorly understood.

  4. Prevalence and risk factors for depressive reaction among resident survivors after the tsunami following the Great East Japan Earthquake, March 11, 2011.

    Directory of Open Access Journals (Sweden)

    Chieko Matsubara

    Full Text Available The Great East Japan Earthquake caused a gigantic tsunami which devastated coastal areas of northern Japan on 11 March 2011. Despite the large number of 'resident survivors' who continued to reside in their damaged houses on the second or upper floors, research on the mental health of these individuals has been limited. This study explored the prevalence of depressive reaction and risk factors for depressive reaction among these resident survivors.A cross-sectional household health support needs screening was conducted for resident survivors in Higashi-Matsushima city, Miyagi prefecture, two to four months after the tsunami. The health interview that was conducted including mental status, assessed by the Patient Health Questionnaire-2 (PHQ-2.Of 5,454 respondents, 8.1% had depressive reaction. After adjustment by the number of weeks from the tsunami and the mortality rate at each respondent's place of residence, depressive reaction was significantly associated with house flooding below or above the ground floor (odds ratios of 1.92, 2.36, respectively, the unavailability of gas supply (odds ratio, 1.67, being female (odds ratio, 1.47, middle aged or elderly (odds ratios of 2.41, 2.42, respectively, regular intake of psychotropic medicine(s since before the tsunami (odds ratio, 2.53 and the presence of one to five or more than six cohabiters (odds ratios of 0.61, 0.52, respectively.The results suggest a considerable psychological burden (depressive reaction following the tsunami among resident survivors. Special supports for families with psychiatric problems need to be considered among resident survivors. Restoration of lifeline utilities and the strengthening of social ties of persons living alone may help prevent depressive reaction among resident survivors after a tsunami.

  5. Dependent Interviewing and Sub-Optimal Responding

    Directory of Open Access Journals (Sweden)

    Johannes Eggs

    2015-02-01

    Full Text Available With proactive dependent interviewing (PDI respondents are reminded of the answer they gave in the previous interview, before being asked about their current status. PDI is used in panel surveys to assist respondent recall and reduce spurious changes in responses over time. PDI may however provide scope for new errors if respondents falsely accept the previous information as still being an accurate description of their current situation. In this paper we use data from the German Labour Market and Social Security panel study, in which an error was made with the preload data for a PDI question about receipt of welfare benefit. The survey data were linked to individual administrative records on receipt of welfare benefit. A large proportion of respondents accepted the false preload. This behaviour seems mainly driven by the difficulty of the response task: respondents with a more complex history of receipt according to the records were more likely to confirm the false preload. Personality also seemed related to the probability of confirming. Predictors of satisficing, indicators of satisficing on other items in the survey, and characteristics of the survey and interviewer were not predictive of confirming the false preload.

  6. 78 FR 22794 - World Trade Center Health Program; Certification of Breast Cancer in WTC Responders and Survivors...

    Science.gov (United States)

    2013-04-17

    ... disruption, as a 9/11 exposure, could be associated with breast cancer.\\3\\ For that reason, the Administrator... HUMAN SERVICES 42 CFR Part 88 World Trade Center Health Program; Certification of Breast Cancer in WTC... Federal Register adding certain types of cancer to the List of World Trade Center (WTC)-Related Health...

  7. An adjustment to improve the bivariate survivor function repaired NPMLE.

    Science.gov (United States)

    Moodie, F Zoe; Prentic, Ross L

    2005-09-01

    We recently proposed a representation of the bivariate survivor function as a mapping of the hazard function for truncated failure time variates. The representation led to a class of estimators that includes van der Laan's repaired nonparametric maximum likelihood estimator (NPMLE) as an important special case. We proposed a Greenwood-like variance estimator for the repaired NPMLE but found somewhat poor agreement between the empirical variance estimates and these analytic estimates for the sample sizes and bandwidths considered in our simulation study. The simulation results also confirmed those of others in showing slightly inferior performance for the repaired NPMLE compared to other competing estimators as well as a sensitivity to bandwidth choice in moderate sized samples. Despite its attractive asymptotic properties, the repaired NPMLE has drawbacks that hinder its practical application. This paper presents a modification of the repaired NPMLE that improves its performance in moderate sized samples and renders it less sensitive to the choice of bandwidth. Along with this modified estimator, more extensive simulation studies of the repaired NPMLE and Greenwood-like variance estimates are presented. The methods are then applied to a real data example.

  8. Mischievous responding in Internet Gaming Disorder research.

    Science.gov (United States)

    Przybylski, Andrew K

    2016-01-01

    The most recent update to the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder as a new potential psychiatric condition that merited further scientific study. The present research was conducted in response to the APA Substance-Related Disorders Working Group's research call to estimate the extent to which mischievous responding-a known problematic pattern of participant self-report responding in questionnaires-is relevant to Internet Gaming Disorder research. In line with a registered sampling and analysis plan, findings from two studies (n tot = 11,908) provide clear evidence that mischievous responding is positively associated with the number of Internet Gaming Disorder indicators participants report. Results are discussed in the context of ongoing problem gaming research and the discussion provides recommendations for improving the quality of scientific practice in this area.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-05-29

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

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

    Science.gov (United States)

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

    2015-11-15

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

  12. The importance of nutrition, diet and lifestyle advice for cancer survivors - the role of nursing staff and interprofessional workers.

    Science.gov (United States)

    Murphy, Jane L; Girot, Elizabeth A

    2013-06-01

    To examine current guidelines and the evidence base to illustrate the importance of nutrition, diet and lifestyle advice to support people who have survived cancer and help them integrate back into normal life, improve their quality of life and potentially improve their chance of long-term survival. Cancer survivors need to know about nutrition and other lifestyle behaviour changes to help them recover and potentially reduce the risk of the same cancer recurring or a new cancer developing. From this perspective, frontline registered nurses are in a prime position to support cancer survivors who are in their care. Discursive paper. On the basis of the international research evidence and a critical analysis of recent policy and practice literature, themes emerged, which illustrate the importance of nutrition, diet and lifestyle advice for cancer survivors. This paper discusses the need for more focused education and greater interprofessional working for quality care delivery. New professional guidance for emerging frontline nurses indicates they should be able to provide appropriate and more consistent advice on nutritional issues, physical activity and weight management, although more research is needed to understand the right mode of nutrition training. Additionally, interprofessional working needs improving as well as encouraging cancer survivors to respond. High-quality nutrition education and training is required for nurses working across both the acute and primary care sectors. They require this to effectively monitor and advise patients and to know when, where and from whom they can access more specialist help. Interprofessional collaborative working across multi-centre settings (National Health Service and non-National Health Service) is key to provide the best effective care and support for cancer survivors. © 2013 Blackwell Publishing Ltd.

  13. Poor ovarian response to stimulation for in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Spremović-Rađenović Svetlana

    2015-01-01

    Full Text Available The term “poor respond (POR patients” is used for the group of women who respond badly to usual doses of gonadotropins in in vitro fertilization (IVF treatments; the consequence is low pregnancy rate. A consensus was reached on the minimal criteria needed to define POR. At least two of the following three features must be present: 1. advanced maternal age (40 years or more 2. previous POR (3 or less oocytes with a conventional stimulation protocol 3. abnormal ovarian reserve (AMH 0.5-1.1 ng/ml or AFC 5-7. The aim is to find better therapeutic options for these patients. Increased levels of day 3 follicle stimulating hormone (FSH and estradiol (E2, as well as decreased levels of anti-Mьllerian hormone (AMH and antral follicle count (AFC, can be used to assess ovarian reserve, as indirect predictive tests. A larger number of well designed, large scale, randomized, controlled trials are needed to assess the efficacy of different management strategies for poor responders: flare up gonadotropin releasing hormone (GnRH agonist protocols, modified long GnRH agonist mini-dose protocols, luteal initiation GnRH agonist stop protocol, pretreatment with estradiol - GnRH antagonist in luteal phase, natural cycle aspiration or natural cycle aspiration GnRH antagonist controlled, adjuvant therapy with growth hormone or dehydroepiandrosterone (DHEA. The results of up to now used protocols are unsatisfactory and stimulation of the ovulation in poor responders remains a challenge, especially when bearing in mind that in the majority of cases the patients will be menopausal in relatively short period of time.

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

    Science.gov (United States)

    Stanciu, Elena Amalia; Rogers, Jennifer L.

    2011-01-01

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

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

    African Journals Online (AJOL)

    2014-06-20

    Jun 20, 2014 ... Background: Gender-based violence is a challenge in South Africa, despite available interventions. Caring for the survivors of both forms of violence is critical for ensuring their speedy recovery. Objectives: To compare the effects of trauma on female survivors of sexual assault versus those experienced by ...

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  17. Rape survivor care crisis – mines the worst?

    African Journals Online (AJOL)

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

  18. 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 ...

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

    African Journals Online (AJOL)

    2014-06-20

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  1. 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

  2. Ethical Issues in Counseling Adult Survivors of Incest.

    Science.gov (United States)

    Daniluk, Judith C. and Haverkamp, Beth E.

    1993-01-01

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

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

    Science.gov (United States)

    Glaister, J A

    1994-10-01

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

  4. 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,

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

    NARCIS (Netherlands)

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

    2002-01-01

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

  6. 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

  7. Learning Profiles of Survivors of Pediatric Brain Tumors

    Science.gov (United States)

    Barkon, Beverly

    2009-01-01

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

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

    DEFF Research Database (Denmark)

    Mikkelsen, Thorbjørn; Søndergaard, Jens; Sokolowski, Ineta

    2009-01-01

    BACKGROUND: Studies of cancer survivors' rehabilitation needs have mostly addressed specific areas of needs, e.g. physical aspects and/or rehabilitation needs in relation to specific cancer types. OBJECTIVE: To assess cancer survivors' perceived need for physical and psychosocial rehabilitation, ...

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

    McNiel, Dale E.; And Others

    1988-01-01

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

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

    Science.gov (United States)

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

    2013-01-15

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    1993-12-01

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

  16. 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

  17. 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…

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

    Science.gov (United States)

    Botvin, Judith D

    2005-01-01

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

  19. Impairments in quality of life and cognitive functions in long-term survivors of glioblastoma

    Directory of Open Access Journals (Sweden)

    Chirag Solanki

    2017-01-01

    Full Text Available Background: The incidence of long-term survival in glioblastoma (GBM, i.e., >3 years, ranges from 3% to 5%. Although extensive research is performed in novel therapies for prolonging survival, there is a scarcity of research focusing on the impact of tumor and treatment on cognitive, psychological, and social status of survivors. This study is an attempt to look into this poorly addressed important issue. Materials and Methods: Nine patients (six adults and three children with GBM who had survived >3 years were included in the study. The quality of life (QOL functions were assessed with the World Health Organization QOL Questionnaire BREF questionnaire. The neuropsychological assessment was done using the National Institute of Mental Health and Neurosciences neuropsychology battery for adults and children. The scores were compared with normative data. Results: The physical and psychological health-related QOL of long-term GBM survivors were affected considerably due to fatigue, poor quality of sleep, inability to concentrate, presence of depression, financial burden with impaired personal and social relationships (P < 0.05. Different domains of cognitions such as motor speed (P = 0.0173, mental speed (P = 0.0022, sustained attention (P = 0.0001, long-term memory (P = 0.0431, mental flexibility (P < 0.05, and planning and executive functions (P < 0.05 were significantly impaired affecting personal, social, and professional lives. Conclusion: The health-related QOL and cognition are significantly impaired in GBM long-term survivors. As the incidence of long-term survival is very less, there is a need for larger multicenter studies to come up with definitive results, which in turn can help in formatting the rehabilitative and support programs for these patients.

  20. Executive function and coping in stroke survivors.

    Science.gov (United States)

    Kegel, Jessica; Dux, Moira; Macko, Richard

    2014-01-01

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

  1. Transcriptional changes induced by bevacizumab combination therapy in responding and non-responding recurrent glioblastoma patients

    DEFF Research Database (Denmark)

    Urup, Thomas; Staunstrup, Line Maersk; Michaelsen, Signe Regner

    2017-01-01

    and resistance to bevacizumab combination therapy.Methods: Recurrent glioblastoma patients who had biomarker-accessible tumor tissue surgically removed both before bevacizumab treatment and at time of progression were included. Patients were grouped into responders (n = 7) and non-responders (n = 14). Gene...... expression profiling of formalin-fixed paraffin-embedded tumor tissue was performed using RNA-sequencing.Results: By comparing pretreatment samples of responders with those of non-responders no significant difference was observed. In a paired comparison analysis of pre- and posttreatment samples of non...

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

    Science.gov (United States)

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

    2018-01-01

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

  3. Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

    Science.gov (United States)

    Grieve, Brian; Shapiro, Gabriel D; Wibbenmeyer, Lucy; Acton, Amy; Lee, Austin; Marino, Molly; Jette, Alan; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M

    2017-10-31

    To examine differences in long-term social reintegration outcomes for burn survivors with and without peer support attendance. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area (TBSA) or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Burn support group attendance was reported by 330 (55%) of 596 respondents who responded to this item. Attendees had larger burn size (43.4%±23.6% vs 36.8%±23.4% TBSA burned, P10 years from injury (50% vs 42.5%, Preintegration in burn survivors. This cross-sectional study prompts further exploration into the potential benefits of peer support groups on burn recovery with future intervention studies. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Feasibility of a mobile phone application to promote physical activity in cancer survivors

    Directory of Open Access Journals (Sweden)

    Anna Roberts

    2016-01-01

    Full Text Available Background: Regular participation in physical activity is associated with improved physical and psychosocial outcomes in cancer survivors. However, physical activity levels are low during and after cancer treatment. Interventions to promote physical activity in this population are needed. Mobile technology has potential, but currently, there is no mobile phone application designed to promote physical activity in cancer survivors. Objectives: The first aim is to assess feasibility and acceptability of an existing physical activity mobile application (‘app’ designed for the general population, in a sample of breast, colorectal and prostate cancer survivors. A further aim is to understand how the application could be adapted to overcome barriers to physical activity participation in this population. Methods: A feasibility study was carried out that investigated acceptability of and participants’ opinions on the application. A total of 11 cancer survivors tested the application for 6 weeks. Physical activity (Godin Leisure Time Exercise Questionnaire, wellbeing (FACT-G, fatigue (FACIT-Fatigue scale, quality of life (EQ5D, sleep quality (Pittsburgh Sleep Quality Index, anxiety and depression (Hospital Anxiety and Depression Scale were self-reported at baseline and at 6-week follow-up. Participants completed qualitative telephone interviews about their experiences of using the app, and these were coded using thematic analysis. Results: The application was acceptable among the participants; 73% of people who responded to the study advertisement agreed to participate, and 100% of participants who started the study completed. There was a significant increase in participants’ mean strenuous physical activity of 51.91 minutes per week from baseline to 6-week follow-up (P=0.005. There was also a significant reduction in reported sleep problems from baseline (mean=9.27, SD=6.72 to 6-week follow-up (mean=6.72, SD=5.50; P=0.01. There were no other

  5. 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....

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

    Science.gov (United States)

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

    2017-01-01

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

  7. 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.

  8. Responding to Loneliness: Counseling the Elderly.

    Science.gov (United States)

    France, M. Honore

    1984-01-01

    Describes the development and implementation of a group on "Responding to Loneliness" for the elderly. Focuses on building positive self-esteem; learning social and personal skills; managing stress and anxiety; developing problem-solving strategies; and building a social network. (Author/JAC)

  9. Responding to Misinformation about Climate Change

    Science.gov (United States)

    Lawrence, Eva K.; Estow, Sarah

    2017-01-01

    This study examined responses to climate change misinformation and messages designed to counter misinformation. Participants (N = 406) first responded to a social media post denying the existence of global warming and then were randomly assigned to read one of three responses to the original post (correction, collaboration, control). Participants…

  10. Hemicrania continua: who responds to indomethacin?

    Science.gov (United States)

    Marmura, M J; Silberstein, S D; Gupta, M

    2009-03-01

    Hemicrania continua (HC) is a primary headache disorder characterized by a continuous, moderate to severe, unilateral headache and defined by its absolute responsiveness to indomethacin. However, some patients with the clinical phenotype of HC do not respond to indomethacin. We reviewed the records of 192 patients with the putative diagnosis of HC and divided them into groups based on their headaches' response to indomethacin. They were compared for age, gender, presence or absence of specific autonomic symptoms, medication overuse, rapidity of headache onset, and whether or not the headaches met criteria for migraine when severe. Forty-three patients had an absolute response and 122 patients did not respond to adequate doses of indomethacin. The two groups did not differ significantly in terms of age, sex, presence of rapid-onset headache, or medication overuse. Autonomic symptoms, based on a questionnaire, did not predict response. Eighteen patients could not complete a trial of indomethacin due to adverse events. Nine patients could not be included in the HC group despite improvement with indomethacin: one patient probably had primary cough headache, another paroxysmal hemicrania; three patients improved but it was uncertain if they were absolutely pain free, and four patients dramatically improved but still had a baseline headache. We found no statistically significant differences between patients who did and did not respond to indomethacin. All patients with continuous, unilateral headache should receive an adequate trial of indomethacin. Most patients with unilateral headache suggestive of HC did not respond to indomethacin.

  11. Porphyria cutanea tarda responding to spirulina

    Directory of Open Access Journals (Sweden)

    Pavithran K

    1992-01-01

    Full Text Available A male patient of porphyria cutanea tarda responded to oral spirulina - an alga rich in beta - carotene. The beta - carotene in the spirulina quenches the singlet oxygen which is responsible for the tissue damage in porphyria-associated photosensitivity.

  12. What is wrong with non-respondents?

    DEFF Research Database (Denmark)

    Christensen, Anne Illemann; Ekholm, Ola; Gray, Linsay

    2015-01-01

    AIM: Response rates in health surveys have diminished over the last two decades, making it difficult to obtain reliable information on health and health-related risk factors in different population groups. This study compared cause-specific mortality and morbidity among survey respondents and dif...

  13. Responding to organised environmental crimes: Collaborative ...

    African Journals Online (AJOL)

    Responding to organised environmental crimes: Collaborative approaches and capacity building. ... helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link above.

  14. Learning Games for Active Student Responding.

    Science.gov (United States)

    Wesson, Caren; And Others

    1988-01-01

    Instructional games can be used effectively when they require active student participation and high rates of student responding. The article describes principles of such games and suggests ways to turn typical games (such as "Bingo,""War,""Scrabble,""Boggle," paper/pencil games, and question/answer games) into active, high-response games. (JDD)

  15. School Principals and Racism: Responding to Aveling

    Science.gov (United States)

    Charles, Claire; Mahoney, Caroline; Fox, Brandi; Halse, Christine

    2016-01-01

    This study responds to Nado Aveling's call in "Anti-racism in Schools: A question of leadership?" ("Discourse: Studies in the Cultural Politics of Education," 2007, 28(1), 69-85) for further investigation into racism in Australian schools. Aveling's interview study concluded that an overwhelming number of school principals…

  16. Tufted puffins (Fratercula cirrhata) respond to predation danger during colony approach flights

    NARCIS (Netherlands)

    Addison, B.; Ydenberg, R.C.; Smith, B.D.

    2007-01-01

    In spite of their putative importance in the evolution of certain traits (e.g., nocturnality, coloniality, cliff nesting), the effects of aerial predators on behavior of adult seabirds at colonies have been poorly investigated. We hypothesized that Tufted Puffins (Fratercula cirrhata) respond to

  17. Pregabalin and placebo responders show different effects on central pain processing in chronic pancreatitis patients

    NARCIS (Netherlands)

    Bouwense, S.A.; Olesen, S.S.; Drewes, A.M.; Goor, H. van; Wilder-Smith, O.H.G.

    2015-01-01

    BACKGROUND: Pain control in chronic pancreatitis is a major challenge; the mechanisms behind analgesic treatment are poorly understood. This study aims to investigate the differences in pain sensitivity and modulation in chronic pancreatitis patients, based on their clinical response (responders vs

  18. Bacterial susceptibility to amoxicillin and potassium clavulanate in advanced periodontitis patients not responding to mechanical therapy

    NARCIS (Netherlands)

    Kleinfelder, JW; Muller, RF; Lange, DE

    2000-01-01

    Background, aims: Between 4 and 8% of periodontitis patients are reported to respond poorly to conventional therapy. In these cases, adjunctive use of systemic antibiotics might be a reasonable therapeutic approach. The purpose of this study was to evaluate the effects of systemic

  19. Alphav integrin expression is a novel marker of poor prognosis in advanced-stage ovarian carcinoma.

    Science.gov (United States)

    Goldberg, I; Davidson, B; Reich, R; Gotlieb, W H; Ben-Baruch, G; Bryne, M; Berner, A; Nesland, J M; Kopolovic, J

    2001-12-01

    To analyze the possible correlation between expression of the alphav and beta1 integrin chains and survival in advanced-stage ovarian carcinomas, studying two patient groups with extremely different disease outcome. Sections from 56 primary ovarian carcinomas and metastatic lesions from 34 patients diagnosed with advanced-stage ovarian carcinoma (Fédération Internationale des Gynaecologistes et Obstetristes stages III-IV), divided into long-term (16) and short-term (18) survivors, were evaluated for expression of alphav and beta1 integrin chains using mRNA in situ hybridization. Protein expression was additionally studied in 52 specimens using immunohistochemistry. The mean values for disease-free survival and overall survival were 115 and 132 months for long-term survivors, as compared with 4 and 23 months for short-term survivors, respectively. Expression of alphav integrin mRNA was observed in carcinoma (18 of 56; 32%) and stromal (17 of 56; 30%) cells. beta1 integrin mRNA was similarly detected in carcinoma (25 of 56; 47%) and stromal (19 of 56; 34%) cells. No significant differences were observed when primary and metastatic lesions were compared (P > 0.05). Alphav integrin mRNA was present more often in carcinoma cells in tumors of short-term survivors (P = 0.017 for carcinoma cells). In univariate survival analysis for all cases, alphav integrin mRNA expression in tumor cells correlated with poor survival (P = 0.012). This finding retained its predictive power in a multivariate survival analysis, in which all of the molecules studied previously in this patient cohort were included (P = 0.031). Immunohistochemistry confirmed the differences in alphav integrin expression in tumor cells of short-term as compared with long-term survivors, whereas beta1 integrin protein expression was comparable in the two groups. To our best knowledge, this is the first evidence associating integrin expression with poor survival in ovarian carcinoma. Alphav integrin is, thus, a

  20. Perceptions of psychological first aid among providers responding to Hurricanes Gustav and Ike.

    Science.gov (United States)

    Allen, Brian; Brymer, Melissa J; Steinberg, Alan M; Vernberg, Eric M; Jacobs, Anne; Speier, Anthony H; Pynoos, Robert S

    2010-08-01

    Psychological First Aid (PFA), developed by the National Child Traumatic Stress Network and the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, has been widely disseminated both nationally and internationally, and adopted and used by a number of disaster response organizations and agencies after major catastrophic events across the United States. This study represents a first examination of the perceptions of providers who utilized PFA in response to a disaster. Study participants included 50 individuals who utilized PFA in their response to Hurricane Gustav or Ike. Findings indicated that participation in PFA training was perceived to increase confidence in working with adults and children. PFA was not seen as harmful to survivors, and was perceived as an appropriate intervention for responding in the aftermath of hurricanes.

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

    Science.gov (United States)

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

    2014-12-01

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

  2. Higher prevalence of osteoporosis among female Holocaust survivors.

    Science.gov (United States)

    Marcus, E-L; Menczel, J

    2007-11-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  4. Psychological distress among Bam earthquake survivors in Iran: a population-based study

    Directory of Open Access Journals (Sweden)

    Garmaroudi Gholamreza

    2005-01-01

    Full Text Available Abstract Background An earthquake measuring 6.3 on the Richter scale struck the city of Bam in Iran on the 26th of December 2003 at 5.26 A.M. It was devastating, and left over 40,000 dead and around 30,000 injured. The profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. A study was carried out to assess psychological distress among Bam earthquake survivors and factors associated with severe mental health in those who survived the tragedy. Methods This was a population-based study measuring psychological distress among the survivors of Bam earthquake in Iran. Using a multi-stage stratified sampling method a random sample of individuals aged 15 years and over living in Bam were interviewed. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12. Results In all 916 survivors were interviewed. The mean age of the respondents was 32.9 years (SD = 12.4, mostly were males (53%, married (66% and had secondary school education (50%. Forty-one percent reported they lost 3 to 5 members of their family in the earthquake. In addition the findings showed that 58% of the respondents suffered from severe mental health as measured by the GHQ-12 and this was three times higher than reported psychological distress among the general population. There were significant differences between sub-groups of the study sample with regard to their psychological distress. The results of the logistic regression analysis also indicated that female gender; lower education, unemployment, and loss of family members were associated with severe psychological distress among earthquake victims. Conclusion The study findings indicated that the amount of psychological distress among earthquake survivors was high and there is an urgent need to deliver mental health care to disaster victims in local medical settings and to reduce negative health impacts of the earthquake

  5. Inherited mutations in cancer susceptibility genes are common among survivors of breast cancer who develop therapy-related leukemia.

    Science.gov (United States)

    Churpek, Jane E; Marquez, Rafael; Neistadt, Barbara; Claussen, Kimberly; Lee, Ming K; Churpek, Matthew M; Huo, Dezheng; Weiner, Howard; Bannerjee, Mekhala; Godley, Lucy A; Le Beau, Michelle M; Pritchard, Colin C; Walsh, Tom; King, Mary-Claire; Olopade, Olufunmilayo I; Larson, Richard A

    2016-01-15

    Risk factors for the development of therapy-related leukemia (TRL), an often lethal late complication of cytotoxic therapy, remain poorly understood and may differ for survivors of different malignancies. Survivors of breast cancer (BC) now account for the majority of TRL cases, making the study of TRL risk factors in this population a priority. Subjects with TRL after cytotoxic therapy for a primary BC were identified from the TRL registry at The University of Chicago. Those with an available germline DNA sample were screened with a comprehensive gene panel covering known inherited BC susceptibility genes. Clinical and TRL characteristics of all subjects and those with identified germline mutations were described. Nineteen of 88 survivors of BC with TRL (22%) had an additional primary cancer and 40 of the 70 survivors with an available family history (57%) had a close relative with breast, ovarian, or pancreatic cancer. Of the 47 subjects with available DNA, 10 (21%) were found to carry a deleterious inherited mutation in BRCA1 (3 subjects; 6%), BRCA2 (2 subjects; 4%), TP53 (tumor protein p53) (3 subjects; 6%), CHEK2 (checkpoint kinase 2) (1 subject; 2%), and PALB2 (partner and localizer of BRCA2) (1 subject; 2%). Survivors of BC with TRL have personal and family histories suggestive of inherited cancer susceptibility and frequently carry germline mutations in BC susceptibility genes. The data from the current study support the role of these genes in TRL risk and suggest that long-term follow-up studies of women with germline mutations who are treated for BC and functional studies of the effects of heterozygous mutations in these genes on bone marrow function after cytotoxic exposures are warranted. Cancer 2016;122:304-311. © 2015 American Cancer Society. © 2015 American Cancer Society.

  6. The Childhood Cancer Survivor Study-Neurocognitive Questionnaire (CCSS-NCQ) Revised: Item Response Analysis and Concurrent Validity

    Science.gov (United States)

    Kenzik, Kelly M.; Huang, I-Chan; Brinkman, Tara M.; Baughman, Brandon; Ness, Kirsten K.; Shenkman, Elizabeth A.; Hudson, Melissa M.; Robison, Leslie L.; Krull, Kevin R.

    2014-01-01

    Objective Childhood cancer survivors are at risk for neurocognitive impairment related to cancer diagnosis or treatment. This study refined and further validated the Childhood Cancer Survivor Study Neurocognitive Questionnaire (CCSS-NCQ), a scale developed to screen for impairment in long-term survivors of childhood cancer. Method Items related to task efficiency, memory, organization and emotional regulation domains were examined using item response theory (IRT). Data were collected from 833 adult survivors of childhood cancer in the St. Jude Lifetime Cohort Study who completed self-report and direct neurocognitive testing. The revision process included: 1) content validity mapping of items to domains, 2) constructing a revised CCSS-NCQ, 3) selecting items within specific domains using IRT, and 4) evaluating concordance between the revised CCSS-NCQ and direct neurocognitive assessment. Results Using content and measurement properties, 32 items were retained (8 items in 4 domains). Items captured low to middle levels of neurocognitive concerns. The latent domain scores demonstrated poor convergent/divergent validity with the direct assessments. Adjusted effect sizes (Cohen's d) for agreement between self-reported memory and direct memory assessment were moderate for total recall (ES=0.66), long-term memory (ES=0.63), and short-term memory (ES=0.55). Effect sizes between self-rated task efficiency and direct assessment of attention were moderate for focused attention (ES=0.70) and attention span (ES=0.50), but small for sustained attention (ES=0.36). Cranial radiation therapy and female gender were associated with lower self-reported neurocognitive function. Conclusion The revised CCSS-NCQ demonstrates adequate measurement properties for assessing day-to-day neurocognitive concerns in childhood cancer survivors, and adds useful information to direct assessment. PMID:24933482

  7. 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

  8. Psychological Adjustment in Breast Cancer Survivors.

    Science.gov (United States)

    Stanton, Annette L; Bower, Julienne E

    2015-01-01

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

  9. Better postdiagnosis diet quality is associated with less cancer-related fatigue in breast cancer survivors.

    Science.gov (United States)

    George, Stephanie M; Alfano, Catherine M; Neuhouser, Marian L; Smith, Ashley W; Baumgartner, Richard N; Baumgartner, Kathy B; Bernstein, Leslie; Ballard-Barbash, Rachel

    2014-12-01

    A comprehensive understanding of the role of modifiable health behaviors in effective management of cancer-related fatigue is needed. Among breast cancer survivors, we examined how postdiagnosis diet quality, independently and jointly with physical activity, is related to fatigue, and the potential mediating role of inflammation. Seven hundred seventy women diagnosed with stage 0-IIIA breast cancer in the Health, Eating, Activity, and Lifestyle study completed food frequency and physical activity questionnaires 30 months postdiagnosis. We scored diet quality using the Healthy Eating Index 2010 (HEI-2010). Serum concentrations of C-reactive protein (CRP) were measured in fasting 30-ml blood samples. Multidimensional fatigue was measured 41 months postdiagnosis using the 22-item revised Piper Fatigue Scale. In multivariate linear models, we determined whether fatigue was associated HEI-2010 quartiles (Q1-Q4), and a variable jointly reflecting HEI quartiles and physical activity levels. Survivors with better-quality diets (Q4 vs. Q1) had lower total fatigue (4.1 vs. 4.8, p-contrast = 0.003) and subscale scores (behavioral severity 3.4 vs. 4.2, p-contrast = 0.003; affective meaning 3.9 vs. 4.8, p-contrast = 0.007; sensory 4.4 vs. 5.2, p-contrast = 0.003; cognitive 4.6 vs. 5.0, p-contrast = 0.046). Least squares estimates of fatigue were similar in models including CRP. Compared to survivors with poor-quality diets and no physical activity, survivors with better-quality diets and meeting physical activity recommendations had significantly lower behavioral severity (3.2 vs. 4.7, p-contrast = 0.002) and sensory (3.8 vs. 4.8. p-contrast = 0.006) fatigue scores. In this large breast cancer survivor cohort, postdiagnosis diet quality was inversely and independently associated with fatigue. Future interventions designed to improve multiple energy balance behaviors can provide insight into their associations with fatigue.

  10. Uncovering and responding to needs for sexual and reproductive health care among poor urban female adolescents in Nicaragua.

    NARCIS (Netherlands)

    Meuwissen, L.E.; Gorter, A.C.; Segura, Z.; Kester, A.D.M.; Knottnerus, J.A.

    2006-01-01

    BACKGROUND: To meet the needs of female adolescents from low-income urban areas for sexual and reproductive health (SRH) care, vouchers providing free-of-charge access to SRH care at 19 primary care clinics were distributed in Managua, Nicaragua. These vouchers substantially increased the use of

  11. Brief Report: CD4+ T Cells From Patients With Systemic Lupus Erythematosus Respond Poorly to Exogenous Interleukin-2.

    Science.gov (United States)

    Comte, Denis; Karampetsou, Maria P; Kis-Toth, Katalin; Yoshida, Nobuya; Bradley, Sean J; Kyttaris, Vasileios C; Tsokos, George C

    2017-04-01

    Imbalanced cytokine production by T cells characterizes both patients with systemic lupus erythematosus (SLE) and lupus-prone mice and contributes to immune dysregulation. This study was undertaken to further investigate in detail the production of interleukin-2 (IL-2), interferon-γ (IFNγ), IL-4, and IL-17A by CD4+ cell subsets in healthy subjects and patients with SLE, and the signaling response of CD4+ T cells in response to exogenous IL-2. Cytokine production by differentiated subsets of CD4+ T cells was assessed by intracellular staining following stimulation with phorbol myristate acetate and ionomycin and by enzyme-linked immunosorbent assay after anti-CD3/anti-CD28 stimulation. The IL-2 signaling pathway was examined by assessing JAK-3/STAT-5 phosphorylation. Cell proliferation in response to IL-2 was examined by carboxyfluorescein succinimidyl ester dilution. Production of IL-2 was defective primarily among naive CD4+ T cells, whereas the production of IFNγ, IL-4, and IL-17A was not significantly different between patients with SLE and healthy subjects. JAK-3/STAT-5 phosphorylation and proliferation of CD4+ T cells from SLE patients in response to exogenous IL-2 were impaired compared to cells from healthy subjects. These data suggest that altered IL-2 production, as well as impaired IL-2-mediated signaling and proliferative responses, characterize SLE CD4+ T cells. Our data demonstrate the need for caution in designing IL-2 treatment trials for patients with SLE. Approaches to restore CD4+ T cell sensitivity to IL-2 should be considered. © 2016, American College of Rheumatology.

  12. First aid skill retention of first responders within the workplace

    Directory of Open Access Journals (Sweden)

    Masse Jeff

    2011-02-01

    Full Text Available Abstract Background Recent literature states that many necessary skills of CPR and first aid are forgotten shortly after certification. The purpose of this study was to determine the skill and knowledge decay in first aid in those who are paid to respond to emergency situations within a workplace. Methods Using a choking victim scenario, the sequence and accuracy of events were observed and recorded in 257 participants paid to act as first responders in large industrial or service industry settings. A multiple choice exam was also written to determine knowledge retention. Results First aid knowledge was higher in those who were trained at a higher level, and did not significantly decline over time. Those who had renewed their certificate one or more times performed better than those who had learned the information only once. During the choking scenario many skills were performed poorly, regardless of days since last training, such as hand placement and abdominal thrusts. Compressions following the victim becoming unconscious also showed classic signs of skill deterioration after 30 days. Conclusions As many skills deteriorate rapidly over the course of the first 90 days, changing frequency of certification is not necessarily the most obvious choice to increase retention of skill and knowledge. Alternatively, methods of regularly "refreshing" a skill should be explored that could be delivered at a high frequency - such as every 90 days.

  13. "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

  14. "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

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

    Science.gov (United States)

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

    2017-03-15

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

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

    Science.gov (United States)

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

    2010-01-01

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

  17. The health and human rights of survivors of gun violence: charting a research and policy agenda.

    Science.gov (United States)

    Buchanan, Cate

    2011-12-15

    The health and human rights implications of violently acquired impairments (VAI), specifically gun-related injuries and trauma resulting in disability, represent an overlooked public policy concern. For several decades, detailed attention has been committed to better understanding of the international arms trade and its consequences. A discursive shift in the last decade from "small arms control" as the core objective (a "hardware" focus on the weapons themselves) to "armed violence prevention" (a focus on impacts, wider drivers, and solutions) still requires a rigorous set of objectives that respond to the rights and needs of survivors of such violence. This article seeks to chart some of the challenges of responding to gun violence survivors and identify entry points for contributions from health, social science and human rights researchers and practitioners. Efforts to address armed violence typically pivot around two goals: reduction and prevention. But what of those already injured? This article argues that a third goal is overdue for attention: response to those injured, impaired, and disabled from gun violence. This would allow a clear pathway for progress (conceptual, political, policy, and practice) to be defined related to gun violence under the ambit of three overarching goals: reducing existing gun violence; responding to those already injured, traumatized, and impaired by such violence; and preventing future violence from occurring. Copyright © 2011 Buchanan. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License(http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  18. The Peruvian Truth Commission's mental health reparations: empowering survivors of political violence to impact public health policy.

    Science.gov (United States)

    Laplante, Lisa J; Holguin, Miryam Rivera

    2006-01-01

    The Peruvian Truth and Reconciliation Commission (TRC), formed in 2001, turned national attention toward the serious mental health consequences of the country's 20-year internal armed conflict. The TRC prioritized reparations in mental health, using a legal justification that provided victims-survivors of the war with a rights-based framework for demanding that the public sector attend to their mental health needs. Since the majority of victims-survivors come from historically poor, rural, and marginalized populations and have tended to not exercise their right to health for a variety of social, economic, and cultural reasons, framing mental health in terms of rights helps to empower these people to impact the development of appropriate policies in mental health. The authors suggest that this process contributes directly to improving the mental health of this population.

  19. Interventions for treating persistent pain in survivors of torture.

    Science.gov (United States)

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

    2017-08-18

    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. To assess the efficacy of interventions for treating persistent pain and associated problems in survivors of torture. We searched for randomised controlled trials (RCTs) published in any language in CENTRAL, MEDLINE, Embase, Web of Science, CINAHL, LILACS, and PsycINFO, from database inception to 1 February 2017. We also searched trials registers and grey literature databases. RCTs of interventions of any type (medical, physical, psychological) compared with any alternative intervention or no intervention, and with a pain outcome. Studies needed to have at least 10 participants in each arm for inclusion. We identified 3578 titles in total after deduplication; we selected 24 full papers to assess for eligibility. We requested data from two completed trials without published results.We used standard methodological procedures expected by Cochrane. We assessed risk of bias and extracted data. We calculated standardised mean difference (SMD) and effect sizes with 95% confidence intervals (CI). We assessed the evidence using GRADE and created a 'Summary of findings' table. Three small published studies (88 participants) met the inclusion criteria, but one had been retracted from publication because of ethical problems concerned with confidentiality and financial irregularities. Since these did not affect the data, the study was retained in this review. Despite the search including any intervention, only two

  20. RESPONDING PROFESSIONALLY TO REQUESTS FOR CESAREAN DELIVERY.

    Science.gov (United States)

    Chervenak, F; McCullough, L

    2017-01-01

    Patients' requests for non-indicated cesarean delivery challenge the professionalism of obstetricians. This is because physicians should not provide clinical management in the absence of an evidence-based indication for it. The ethics of responding professionally to requests for non-indicated cesarean delivery would appear to be simple: just say "No." This paper presents an ethically and clinically more nuanced approach, on the basis of the professional responsibility model of obstetric ethics, emphasizinga preventive ethics approach. Preventive ethics deploys the informed consent process to minimize ethical conflict in clinical practice. This process should focus on when to recommend against cesarean delivery - rather than simply saying no. There is no evidence of net clinical benefit for pregnant, fetal, and neonatal patients from non-indicated cesarean delivery. Obstetricians should therefore respond to such requests by recommending against cesarean delivery, recommending vaginal delivery, and explaining the evidence base for these recommendations.

  1. Mischievous responding in Internet Gaming Disorder research

    Directory of Open Access Journals (Sweden)

    Andrew K. Przybylski

    2016-09-01

    Full Text Available The most recent update to the American Psychiatric Association’s (APA Diagnostic and Statistical Manual of Mental Disorders (DSM-5 included Internet Gaming Disorder as a new potential psychiatric condition that merited further scientific study. The present research was conducted in response to the APA Substance-Related Disorders Working Group’s research call to estimate the extent to which mischievous responding—a known problematic pattern of participant self-report responding in questionnaires—is relevant to Internet Gaming Disorder research. In line with a registered sampling and analysis plan, findings from two studies (ntot = 11,908 provide clear evidence that mischievous responding is positively associated with the number of Internet Gaming Disorder indicators participants report. Results are discussed in the context of ongoing problem gaming research and the discussion provides recommendations for improving the quality of scientific practice in this area.

  2. Responding to the Housing and Financial Crises

    DEFF Research Database (Denmark)

    Scanlon, Kathleen; Lunde, Jens; Whitehead, Christine

    2011-01-01

    The long period of house price growth in markets across the world ended with the US and global financial crisis of 2007/08. The crisis and the consequent recession had profound effects on mortgage market actors – including households, institutions and governments – in most advanced economies......, whether or not they participated in this rapid house price growth. Many of the trends observed during the boom, especially the innovations in financial instruments, were reversed. This paper presents evidence on how mortgage markets and stakeholders responded in the initial period after the crash....... In particular it reports on a 2009 survey of housing experts from 16 industrialised countries, which concentrated on how each country's mortgage system responded to the crisis and how governments addressed the problems of borrowers....

  3. Empathic Responding in Children of Battered Mothers.

    Science.gov (United States)

    Hinchey, Frances S.; Gavelek, James R.

    1982-01-01

    Sixteen preschoolers from homes with conjugal violence were compared with 16 controls from nonabusive homes. Children of abused mothers performed more poorly than controls on three of four measures of empathy (role enactment, social inference, and role taking). Implications for social development were noted. (CL)

  4. Nuclear Fallout Decision Tool for First Responders

    Energy Technology Data Exchange (ETDEWEB)

    Archibald, E. J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Buddemeier, B. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2010-08-11

    If terrorists detonated an improvised nuclear device (IND) in an urban area, thousands of people would die from the blast, and many more would become sick or die from exposure to fallout radiation. Proper sheltering and evacuation can protect people from fallout and save lives. This project provides guidance to first responders as to when to evacuate and what route to take to protect themselves against fallout radiation.

  5. Preventing and responding to medical identity theft.

    Science.gov (United States)

    Amori, Geraldine

    2008-01-01

    Medical identity theft is a crime with two victims: patients and providers. It is easy to commit and lucrative because healthcare record keeping and business interactions are complex and mainly electronic. Patients whose identity has been stolen are vulnerable to both medical error and financial loss. Providers may suffer both reputation loss and financial loss. There are steps to help prevent and to respond appropriately to medical identity theft.

  6. Amitriptyline Intoxication Responded to Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    Güldem Turan

    2012-04-01

    Full Text Available The most severe effects in amitriptiline intoxications are related with central nervous system and cardiovascular system. Amitriptiline intoxication especially with high doses has severe cardiac effects and can result in cardiac arrest. Most favorable responses can be achieved with efficient and prolonged cardiopulmonary resuscitation. We wanted to present a case ingested high dose of amitriptiline for attempt to suicide and responded to prolonged cardiopulmonary resuscitation.

  7. Physician preferences and knowledge gaps regarding the care of childhood cancer survivors: a mailed survey of pediatric oncologists.

    Science.gov (United States)

    Henderson, Tara O; Hlubocky, Fay J; Wroblewski, Kristen E; Diller, Lisa; Daugherty, Christopher K

    2010-02-10

    PURPOSE Little is known about physicians' attitudes and knowledge regarding the health care needs of childhood cancer survivors (CCS). We sought to obtain pediatric cancer physicians' self-reported attitudes and knowledge regarding this population. METHODS A mailed survey was sent to 1,159 pediatric oncologists in the United States. Results A total of 655 surveys were returned (ie, 57% response rate). Median age of respondents was 47 years (range, 31 to 82 years); 57% were men. Respondents practiced for a median 14 years (range, 1 to 50 years) and reported seeing a median of 21 patients per week (range, 0 to 250 patients per week). When comfort levels in caring for CCS were described (ie, 1 = very uncomfortable; 7 = very comfortable), respondents were most comfortable with survivors or = 30 years (2.9 +/- 1.7 level). In response to a clinical vignette of a 29-year-old woman treated with mantle radiation for Hodgkin's lymphoma at 16 years of age, and on the basis of available guidelines, 34% of respondents did not appropriately recommend yearly breast cancer surveillance; 43% of respondents did not appropriately recommend cardiac surveillance; and 24% of respondents did not appropriately recommend yearly thyroid surveillance. Those with greater self-reported familiarity with available long-term follow-up (LTFU) guidelines (odds ratio [OR], 1.33; 95% CI, 1.15 to 1.54) and with receipt of training in the care of CCS (OR, 1.73; 95% CI, 1.18 to 2.52) were more likely to have answered all three questions correctly. CONCLUSION Pediatric oncologists express a range of preferences with regard to LTFU of CCS. Many appear unfamiliar with LTFU surveillance guidelines.

  8. 77 GHz radar for first responders

    Science.gov (United States)

    Kosowsky, L. H.; Aronoff, A. D.; Ferraro, R.; Alland, S.; Fleischman, E.

    2017-02-01

    First responders have the dangerous task of responding to emergency situations in firefighting scenarios involving homes and offices. The importance of this radar is its ability to see through walls and into adjacent areas to provide the first responder with information to assess the status of a building fire, its occupants, and to supplement his thermal camera which is obstructed by the wall. For the firefighter looking into an adjacent room containing unknown objects including humans, the challenge is to recognize what is in that room, the configuration of the room, and potential escape routes. We have just concluded a series of experiments to illustrate the performance of 77GHz radar in buildings. The experiments utilized the Delphi Automotive radar as the mm wave sensor and included display software developed by L. H. Kosowsky and Associates. The system has demonstrated the capability of seeing through walls consisting of sheetrock separated by two by four pieces of wood. It has demonstrated the ability to see into the adjacent room and to display the existence of persons and furniture Based on published data, the radar will perform well in a smoke, haze, and/or fog environment.

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

    Science.gov (United States)

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

    2005-08-01

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

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

    Science.gov (United States)

    Hebdon, Megan; Foli, Karen; McComb, Sara

    2015-08-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  12. 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.

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

    Science.gov (United States)

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

    2014-04-01

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

  14. 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.

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

    Science.gov (United States)

    Davis, Sharon Watkins; Oakley-Girvan, Ingrid

    2017-08-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

  17. Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

    Science.gov (United States)

    Kusambiza-Kiingi, Adrian; Maleka, Douglas; Ntsiea, Veronica

    2017-01-01

    Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p reintegration and caregiver strain (r = -0.37, p reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  18. 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.

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

    Lee, Su Jung; Kim, Nam Cho

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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Maryna Krawczuk-Rybak

    2012-10-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  6. Thyroid abnormalities in survivors of childhood cancer.

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

    Allen, Summer E

    2017-01-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  12. Survivor from asphyxiation due to helium inhalation

    Directory of Open Access Journals (Sweden)

    Massimiliano Etteri

    2016-06-01

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

  13. Resilience in Elderly Survivors of Child Maltreatment

    Directory of Open Access Journals (Sweden)

    Danielle Rodin

    2012-06-01

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

  14. Mortality of atomic bomb survivors in Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-01

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

  15. Infant differential behavioral responding to discrete emotions.

    Science.gov (United States)

    Walle, Eric A; Reschke, Peter J; Camras, Linda A; Campos, Joseph J

    2017-10-01

    Emotional communication regulates the behaviors of social partners. Research on individuals' responding to others' emotions typically compares responses to a single negative emotion compared with responses to a neutral or positive emotion. Furthermore, co