Validation of the production process of core-equipment HYNIC-Bombesin-Sn

International Nuclear Information System (INIS)

Rubio C, N. I.

2008-01-01

The validation process is establishing documented evidence that provides a high degree of assurance that a specific process consistently will produce a product that will meet specifications and quality attributes preset and, therefore, ensures the efficiency and effectiveness of a product. The radiopharmaceutical 99m Tc-HYNlC-Bombesin is part of the gastrin-releasing peptide (GRP) analogues of bombesin that are radiolabelled with technetium 99 metastable for molecular images obtention. Is obtained from freeze-dry formulations kits (core- equipment)) and has reported a very high stability in human serum, specific binding to receptors and rapid internalization. Biodistribution data in mice showed rapid blood clearance with predominant renal excretion and specific binding to tissues with positive response to GRP receptors. According to biokinetics studies performed on patients with breast cancer, breast show a marked asymmetry with increased uptake in neoplastic breast in healthy women and the uptake of radiopharmaceuticals is symmetrical in both breasts. No reported adverse reactions. In this paper, the prospective validation core-equipment HYNlC-Bombesin-Sn, which was shown consistently that the product meets the specifications and quality, attributes to preset from the obtained from the diagnostic radiopharmaceutical third generation: 99m Tc-HYNlC-Bombesin. The process was successfully validated and thereby ensuring the efficiency and effectiveness of this agent as a preliminary diagnostic for approval to be marketed. (Author)

Worst-case study for cleaning validation of equipment in the radiopharmaceutical production of lyophilized reagents: Methodology validation of total organic carbon

International Nuclear Information System (INIS)

Porto, Luciana Valeria Ferrari Machado

2015-01-01

Radiopharmaceuticals are defined as pharmaceutical preparations containing a radionuclide in their composition, mostly intravenously administered, and therefore compliance with the principles of Good Manufacturing Practices (GMP) is essential and indispensable. Cleaning validation is a requirement of the current GMP, and consists of documented evidence, which demonstrates that the cleaning procedures are able to remove residues to pre-determined acceptance levels, ensuring that no cross contamination occurs. A simplification of cleaning processes validation is accepted, and consists in choosing a product, called 'worst case', to represent the cleaning processes of all equipment of the same production area. One of the steps of cleaning validation is the establishment and validation of the analytical method to quantify the residue. The aim of this study was to establish the worst case for cleaning validation of equipment in the radiopharmaceutical production of lyophilized reagent (LR) for labeling with 99m Tc, evaluate the use of Total Organic Carbon (TOC) content as indicator of equipment cleaning used in the LR manufacture, validate the method of Non-Purgeable Organic Carbon (NPOC), and perform recovery tests with the product chosen as worst case. Worst case product's choice was based on the calculation of an index called 'Worst Case Index' (WCI), using information about drug solubility, difficulty of cleaning the equipment and occupancy rate of the products in line production. The products indicated 'worst case' was the LR MIBI-TEC. The method validation assays were performed using carbon analyser model TOC-Vwp coupled to an autosampler model ASI-V, both from Shimadzu®, controlled by TOC Control-V software. It was used the direct method for NPOC quantification. The parameters evaluated in the validation method were: system suitability, robustness, linearity, detection limit (DL) and quantification limit (QL), precision

Measuring financial strain in the lives of survivors of intimate partner violence.

Science.gov (United States)

Hetling, Andrea; Stylianou, Amanda Mathisen; Postmus, Judy L

2015-03-01

Agencies serving survivors of intimate partner violence (IPV) often include economic empowerment programs and approaches as a way to assist survivors struggling with avoiding poverty and gaining financial independence. Understanding and addressing the economic needs of IPV survivors are more complex than just knowing their income. Indeed, survivors' ability to manage their finances and any financial stress or strain should also be assessed to fully understand their needs. The Financial Strain Survey (FSS) provides a useful tool for screening and understanding survivors' complex financial needs. Using data from 457 IPV survivors from seven U.S. states and Puerto Rico, the current study evaluates the factor structure, reliability, and validity of using the FSS with IPV survivors. Findings indicate that the FSS is a reliable instrument for use with IPV survivors. The conclusion discusses the FSS as a practical tool for both practice and research with this population. © The Author(s) 2014.

Perceptions of Childhood Sexual Abuse Survivors: Development and Initial Validation of a New Scale to Measure Stereotypes of Adult Survivors of Childhood Sexual Abuse

Science.gov (United States)

Zafar, Sadia; Ross, Erin C.

2013-01-01

The Childhood Sexual Abuse Stereotypes Scale was developed to assess stereotypes of adult survivors of childhood sexual abuse. Scale items were derived from two studies that elicited cultural and personal beliefs about, and emotions experienced towards adult childhood sexual abuse survivors among university undergraduates. Two scales, Emotions and…

A theory for aftercare of human trafficking survivors for nursing practice in low resource settings.

Science.gov (United States)

Curran, R L; Naidoo, J R; Mchunu, G

2017-06-01

Research on aftercare for human trafficking survivors highlights the limited knowledge of the needs of survivors; the evaluation of current aftercare; and the process of recovery navigated by the survivor in aftercare (Oram et al., 2012; Locke, 2010; Hacker & Cohen, 2012). Furthermore there has been a transition in aftercare where the victim or survivor, who before was seen as a passive victim of circumstance of their life and in need of therapeutic intervention, is now seen as having an active role in their recovery, thus facilitating recovery (Hacker & Cohen, 2012). The need for a theory grounded in survivor's voices therefore motivated this grounded theory study underpinned by Freire's (1970) Pedagogy of the oppressed. The aim of the theory is to inform nursing care of human trafficking survivors in low resource settings. The findings elicit a theoretical model of the renewed self, and the conditions that facilitate this process in care of human trafficking survivors. The recommendations of this paper may improve the nursing care provided to human trafficking survivors and equip nurses and other health professionals with the knowledge and skills to promote the renewing of human trafficking survivors. Copyright © 2017 Elsevier Inc. All rights reserved.

Test-Retest Reliability of the Short-Form Survivor Unmet Needs Survey.

Science.gov (United States)

Taylor, Karen; Bulsara, Max; Monterosso, Leanne

2018-01-01

Reliable and valid needs assessment measures are important assessment tools in cancer survivorship care. A new 30-item short-form version of the Survivor Unmet Needs Survey (SF-SUNS) was developed and validated with cancer survivors, including hematology cancer survivors; however, test-retest reliability has not been established. The objective of this study was to assess the test-retest reliability of the SF-SUNS with a cohort of lymphoma survivors ( n = 40). Test-retest reliability of the SF-SUNS was conducted at two time points: baseline (time 1) and 5 days later (time 2). Test-retest data were collected from lymphoma cancer survivors ( n = 40) in a large tertiary cancer center in Western Australia. Intraclass correlation analyses compared data at time 1 (baseline) and time 2 (5 days later). Cronbach's alpha analyses were performed to assess the internal consistency at both time points. The majority (23/30, 77%) of items achieved test-retest reliability scores 0.45-0.74 (fair to good). A high degree of overall internal consistency was demonstrated (time 1 = 0.92, time 2 = 0.95), with scores 0.65-0.94 across subscales for both time points. Mixed test-retest reliability of the SF-SUNS was established. Our results indicate the SF-SUNS is responsive to the changing needs of lymphoma cancer survivors. Routine use of cancer survivorship specific needs-based assessments is required in oncology care today. Nurses are well placed to administer these assessments and provide tailored information and resources. Further assessment of test-retest reliability in hematology and other cancer cohorts is warranted.

Cancer survivors and their partners: the assessment of unmet supportive care needs

International Nuclear Information System (INIS)

Smith, K.; Pendlebury, S.; Butow, P.; Hobbs, K.; Wain, G.

2003-01-01

Our understanding of unmet supportive care needs of cancer survivors and their partners is limited. Most studies have focused on needs of patients undergoing treatment and on Quality of life or patient satisfaction. For the purpose of this research, cancer survivors are defined as persons who received a cancer diagnosis at least one year previously and are disease free. The aim of this study is to develop measures to assess unmet needs in survivors and their partners. After developing the questionnaire items it was piloted for validity in a wide sample of cancer patients from the radiation oncology department. 105 patients, all women, 101 with breast cancer and 40 partners participated. Psychological morbidity of depression and anxiety was recorded and was low. Quality of life for both survivors and partners was close to the US population mean. For patients top 4 unmet needs was 1. Anxiety about cancer returning (35%), current information (21%), understandable information (28%), ongoing case manager (25%). Unmet needs for partners were 1. Need to know all the doctors were communication (3.2%), need for local health services (2.8%), current information (2.1%) and help with managing concerns about the cancer returning (2.1%). 73% of partners reported at least one positive outcome from their partner's experience, significantly more than the survivors. In conclusion, interim analysis of the questionnaire reveals validity. Survivors report ongoing high levels of unmet needs 3-9 years after cancer diagnosis ( 30%). Less than 4% of partners report such unmet needs. There is significant correlation between needs of partners and survivors, many of which relate to issues of ongoing support and information delivery

Individual Prediction of Heart Failure Among Childhood Cancer Survivors

Science.gov (United States)

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

2015-01-01

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

Predictors of marriage and divorce in adult survivors of childhood cancers: a report from the Childhood Cancer Survivor Study.

Science.gov (United States)

Janson, Christopher; Leisenring, Wendy; Cox, Cheryl; Termuhlen, Amanda M; Mertens, Ann C; Whitton, John A; Goodman, Pamela; Zeltzer, Lonnie; Robison, Leslie L; Krull, Kevin R; Kadan-Lottick, Nina S

2009-10-01

Adult survivors of childhood cancer can have altered social functioning. We sought to identify factors that predict marriage and divorce outcomes in this growing population. This was a retrospective cohort study of 8,928 > or = 5-year adult survivors of childhood malignancy and 2,879 random sibling controls participating in the Childhood Cancer Survivor Study. Marital status, current health, psychological status, and neurocognitive functioning were determined from surveys and validated instruments. Survivors were more likely to be never-married than siblings [relative risk (RR), 1.21; 95% confidence interval (95% CI), 1.15-1.26] and the U.S. population (RR, 1.25; 95% CI, 1.21-1.29), after adjusting for age, gender, and race. Patients with central nervous system tumors were at greatest risk of not marrying (RR, 1.50; 95% CI, 1.41-1.59). Married survivors divorced at frequencies similar to controls. In multivariable regression analysis, nonmarriage was most associated with cranial radiation (RR, 1.15; 95% CI, 1.02-1.31 for > 2,400 centigray). In analysis of neurobehavioral functioning, nonmarriage was associated with worse task efficiency (RR, 1.27; 95% CI, 1.20-1.35), but not with emotional distress, or problems with emotional regulation, memory, or organization. Physical conditions predictive of nonmarriage included short stature (RR, 1.27; 95% CI, 1.20-1.34) and poor physical function (RR, 1.08; 95% CI, 1.00-1.18). Structural equation modeling suggested that cranial radiation influenced marriage status through short stature, cognitive problems, and poor physical function. Childhood cancer survivors married at lower frequencies compared with peers. Patients with central nervous system tumors, cranial radiation, impaired processing efficiency, and short stature were more likely to never marry. Divorce patterns in survivors were similar to peers.

Validation and Refinement of Prediction Models to Estimate Exercise Capacity in Cancer Survivors Using the Steep Ramp Test.

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Stuiver, Martijn M; Kampshoff, Caroline S; Persoon, Saskia; Groen, Wim; van Mechelen, Willem; Chinapaw, Mai J M; Brug, Johannes; Nollet, Frans; Kersten, Marie-José; Schep, Goof; Buffart, Laurien M

2017-11-01

To further test the validity and clinical usefulness of the steep ramp test (SRT) in estimating exercise tolerance in cancer survivors by external validation and extension of previously published prediction models for peak oxygen consumption (Vo 2peak ) and peak power output (W peak ). Cross-sectional study. Multicenter. Cancer survivors (N=283) in 2 randomized controlled exercise trials. Not applicable. Prediction model accuracy was assessed by intraclass correlation coefficients (ICCs) and limits of agreement (LOA). Multiple linear regression was used for model extension. Clinical performance was judged by the percentage of accurate endurance exercise prescriptions. ICCs of SRT-predicted Vo 2peak and W peak with these values as obtained by the cardiopulmonary exercise test were .61 and .73, respectively, using the previously published prediction models. 95% LOA were ±705mL/min with a bias of 190mL/min for Vo 2peak and ±59W with a bias of 5W for W peak . Modest improvements were obtained by adding body weight and sex to the regression equation for the prediction of Vo 2peak (ICC, .73; 95% LOA, ±608mL/min) and by adding age, height, and sex for the prediction of W peak (ICC, .81; 95% LOA, ±48W). Accuracy of endurance exercise prescription improved from 57% accurate prescriptions to 68% accurate prescriptions with the new prediction model for W peak . Predictions of Vo 2peak and W peak based on the SRT are adequate at the group level, but insufficiently accurate in individual patients. The multivariable prediction model for W peak can be used cautiously (eg, supplemented with a Borg score) to aid endurance exercise prescription. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Feasibility, reliability, and validity of the Pediatric Quality of Life Inventory ™ generic core scales, cancer module, and multidimensional fatigue scale in long-term adult survivors of pediatric cancer.

Science.gov (United States)

Robert, Rhonda S; Paxton, Raheem J; Palla, Shana L; Yang, Grace; Askins, Martha A; Joy, Shaini E; Ater, Joann L

2012-10-01

Most health-related quality of life assessments are designed for either children or adults and have not been evaluated for adolescent and young adult survivors of pediatric cancer. The objective of this study was to examine the feasibility, reliability, and validity of the Pediatric Quality of Life Inventory (PedsQL ™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale in adult survivors of pediatric cancer. Adult survivors (n = 64; Mean age 35 year old; >2 years after treatment) completed the PedsQL™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale. Feasibility was examined with floor and ceiling effects; and internal consistency was determined by Cronbach's coefficient alpha calculations. Inter-factor correlations were also assessed. Significant ceiling effects were observed for the scales of social function, nausea, procedural anxiety, treatment anxiety, and communication. Internal consistency for all subscales was within the recommended ranges (α ≥ 0.70). Moderate to strong correlations between most Cancer Module and Generic Core Scales (r = 0.25 to r = 0.76) and between the Multidimensional Fatigue Scale and Generic Core Scales (r = 0.37 to r = 0.73). The PedsQL™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale appear to be feasible for an older population of pediatric cancer survivors; however, some of the Cancer Module Scales (nausea, procedural/treatment anxiety, and communication) were deemed not relevant for long-term survivors. More information is needed to determine whether the issues addressed by these modules are meaningful to long-term adult survivors of pediatric cancers. Copyright © 2012 Wiley Periodicals, Inc.

Emotional control in Chinese female cancer survivors.

Science.gov (United States)

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

2004-11-01

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

Employment participation and work experience of male cancer survivors: a NOCWO study.

Science.gov (United States)

Gunnarsdottir, Holmfridur K; Vidarsdottir, Halldora; Rafnsdottir, Gudbjorg Linda; Tryggvadottir, Laufey; Olafsdottir, Elinborg J; Lindbohm, Marja-Liisa

2013-01-01

To investigate whether employment status and work experiences, assessed in terms of job resources (organizational culture and superiors' and co-workers' support), commitment to organization, work motives, and experiences of discrimination, differ between survivors of prostate or testicular cancer or lymphoma and cancer-free reference subjects. Questionnaires were sent to 1349 male cancer survivors and 2666 referents in Denmark, Finland, Iceland, and Norway. Valid responses were 59% and 45%, respectively. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with logistic regression models. Compared to the referents, survivors of lymphoma and prostate cancer were less likely to be employed (OR=0.53; CI: 0.30-0.95 and OR=0.50; CI: 0.35-0.73, respectively), but decreased employment was not evident among testicular cancer survivors. Testicular cancer survivors experienced less discrimination at work than did the referents, for example, testicular cancer survivors were less likely to report that their colleagues doubted their ability to carry out their work tasks (OR=0.38; CI: 0.17-0.83). Lymphoma survivors were less likely than the referents to praise their workplace as an enjoyable place to work (OR=0.48; CI: 0.26-0.88). The prostate cancer survivors were more likely than the referents to find the organizational climate competitive, distrustful, and suspicious. Employment participation and work experiences of male cancer survivors varied substantially according to type of cancer. Occupational therapists and other health care personnel should keep this in mind when assisting cancer survivors in identifying their strengths and limitations at work.

Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age.

Science.gov (United States)

Eeltink, Corien M; Incrocci, Luca; Witte, Birgit I; Meurs, Saskia; Visser, Otto; Huijgens, Peter; Verdonck-de Leeuw, Irma M

2013-12-01

To assess the perceived fertility status and to determine the association between perceived fertility status and sexual function, as reported by young female Hodgkin lymphoma survivors. Young female Hodgkin lymphoma survivors are at risk of infertility and impaired sexual function. However, little is known about their awareness of infertility and its association with sexual functioning. A descriptive questionnaire survey. In this cross-sectional study, a survey was completed by female Hodgkin lymphoma survivors (40 years). Outcome measures included self-reported fertility status and sexual problems and the internationally validated Female Sexual Function Index. In total, 36 survivors were included (mean age 32 years, SD 4). Eighteen women (50%) thought themselves fertile. Eight survivors (22%) who perceived themselves as being infertile were more often treated with alkylator-based chemotherapy, and 63% reported sexual dysfunction. Ten survivors (28%) were not aware as to whether they were fertile or not; seven of these would like to have children. The reported fertility status was related to age and chemotherapy regimen. Regarding sexuality, 14 (39%) of the female Hodgkin lymphoma survivors reported one or more sexual problem and none reported recovery. Female sexual dysfunction according to the Female Sexual Function Index was reported by 11 (31%) survivors. Almost 30% of Hodgkin lymphoma survivors do not know whether they are fertile or not. Overall sexual dysfunction is common in Hodgkin lymphoma survivors and comparable to the general population. However, a lack of desire was significantly more often reported in female Hodgkin lymphoma survivors. To prevent assumed infertility and unintended childlessness by postponing parenthood in young female survivors, awareness of fertility status is needed. There is also a need to routinely assess sexual function and provide adequate interventions to improve arousal and lubrication problems. © 2013 John Wiley & Sons Ltd.

Black breast cancer survivors experience greater upper extremity disability.

Science.gov (United States)

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

Measuring Economic Abuse in the Lives of Survivors: Revising the Scale of Economic Abuse.

Science.gov (United States)

Postmus, Judy L; Plummer, Sara-Beth; Stylianou, Amanda M

2016-05-01

Recent attention has been given by researchers to understanding how abusers use economic abuse strategies. Unfortunately, limited measures are available to accurately understand the prevalence of economic abuse in the lives of survivors. Recently, researchers created the 28-item Scale of Economic Abuse (SEA) but further validation is needed. This article describes the psychometric evaluation of the SEA through confirmatory and exploratory factor analyses using data collected with 120 survivors of abuse. The findings provide evidence for the reliability and validity of the SEA-12 as a shorter instrument to measure economic abuse as a distinct form of abuse. © The Author(s) 2015.

Development and Content Validation of the Transition Readiness Inventory Item Pool for Adolescent and Young Adult Survivors of Childhood Cancer.

Science.gov (United States)

Schwartz, Lisa A; Hamilton, Jessica L; Brumley, Lauren D; Barakat, Lamia P; Deatrick, Janet A; Szalda, Dava E; Bevans, Katherine B; Tucker, Carole A; Daniel, Lauren C; Butler, Eliana; Kazak, Anne E; Hobbie, Wendy L; Ginsberg, Jill P; Psihogios, Alexandra M; Ver Hoeve, Elizabeth; Tuchman, Lisa K

2017-10-01

The development of the Transition Readiness Inventory (TRI) item pool for adolescent and young adult childhood cancer survivors is described, aiming to both advance transition research and provide an example of the application of NIH Patient Reported Outcomes Information System methods. Using rigorous measurement development methods including mixed methods, patient and parent versions of the TRI item pool were created based on the Social-ecological Model of Adolescent and young adult Readiness for Transition (SMART). Each stage informed development and refinement of the item pool. Content validity ratings and cognitive interviews resulted in 81 content valid items for the patient version and 85 items for the parent version. TRI represents the first multi-informant, rigorously developed transition readiness item pool that comprehensively measures the social-ecological components of transition readiness. Discussion includes clinical implications, the application of TRI and the methods to develop the item pool to other populations, and next steps for further validation and refinement. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

Science.gov (United States)

Scharf, Miri; Mayseless, Ofra

2011-11-01

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

Validation Testing for Automated Solubility Measurement Equipment Final Report

Energy Technology Data Exchange (ETDEWEB)

Lachut, J. S. [Washington River Protection Solutions LLC, Richland, WA (United States)

2016-01-11

Laboratory tests have been completed to test the validity of automated solubility measurement equipment using sodium nitrate and sodium chloride solutions (see test plan WRPS-1404441, “Validation Testing for Automated Solubility Measurement Equipment”). The sodium nitrate solution results were within 2-3% of the reference values, so the experiment is considered successful using the turbidity meter. The sodium chloride test was done by sight, as the turbidity meter did not work well using sodium chloride. For example, the “clear” turbidity reading was 53 FNU at 80 °C, 107 FNU at 55 °C, and 151 FNU at 20 °C. The sodium chloride did not work because it is granular and large; as the solution was stirred, the granules stayed to the outside of the reactor and just above the stir bar level, having little impact on the turbidity meter readings as the meter was aimed at the center of the solution. Also, the turbidity meter depth has an impact. The salt tends to remain near the stir bar level. If the meter is deeper in the slurry, it will read higher turbidity, and if the meter is raised higher in the slurry, it will read lower turbidity (possibly near zero) because it reads the “clear” part of the slurry. The sodium chloride solution results, as measured by sight rather than by turbidity instrument readings, were within 5-6% of the reference values.

Lower limb lymphedema in gynecological cancer survivors--effect on daily life functioning.

Science.gov (United States)

Dunberger, Gail; Lindquist, Helene; Waldenström, Ann-Charlotte; Nyberg, Tommy; Steineck, Gunnar; Åvall-Lundqvist, Elisabeth

2013-11-01

Lower limb lymphedema (LLL) is a common condition after pelvic cancer treatment but few studies have evaluated its effect on the quality of life and its consequences on daily life activities among gynecological cancer survivors. We identified a cohort of 789 eligible women, treated with pelvic radiotherapy alone or as part of combined treatment of gynecological cancer, from 1991 to 2003 at two departments of gynecological oncology in Sweden. As a preparatory study, we conducted in-depth interviews with gynecological cancer survivors and constructed a study-specific questionnaire which we validated face-to-face. The questionnaire covered physical symptoms originating in the pelvis, demographic, psychological, and quality of life factors. In relation to the lymph system, 19 questions were asked. Six hundred sixteen (78 %) gynecological cancer survivors answered the questionnaire and participated in the study. Thirty-six percent (218/606) of the cancer survivors reported LLL. Overall quality of life was significantly lower among cancer survivors with LLL. They were also less satisfied with their sleep, more worried about recurrence of cancer, and more likely to interpret symptoms from the body as recurrence. Cancer survivors reported that LLL kept them from physical activity (45 %) and house work (29 %) and affected their ability to partake in social activities (27 %) or to meet friends (20 %). Lower limb lymphedema has a negative impact on quality of life among gynecological cancer survivors, affecting sleep and daily life activities, yet only a few seek professional help.

Assessing dietary intake in childhood cancer survivors: Food frequency questionnaire versus 24-hour diet recalls

Science.gov (United States)

Cancer diagnosis and treatment may influence dietary intake. The validity of using self-reported methods to quantify dietary intake has not been evaluated in childhood cancer survivors. We validated total energy intake (EI) reported from Food Frequency Questionnaire (FFQ) and repeated 24-hour diet r...

Who Is a Cancer Survivor? A Systematic Review of Published Definitions.

Science.gov (United States)

Marzorati, Chiara; Riva, Silvia; Pravettoni, Gabriella

2017-06-01

The term "cancer survivor" is commonly used by different persons, clinical institutions, academic bodies, and political organizations although it lacks of a unanimous and detailed definition. The objective of the study is to make a systematic review of published and proposed definitions of "cancer survivor." Utilizing a systematic search strategy with different strings of "cancer survivor," we searched the following databases: Medline (June 1975-June 2015), Scopus (all the years), Web of Science (all the years), Google Scholar (all the years), ERIC (all the years). This review suggests that there is not a unique definition of who is a "cancer survivor" and what is "cancer survivorship." However, the most widely used definition sees cancer survivorship as a process that begins at the moment of diagnosis and continues through the balance of life. This definition highlights psychological and legal patient's needs-as well as medical ones-to receive care and assistance from the beginning and, at the same time, it establishes valid criteria for making scientific and statistical sampling research. The extensive use of the term "cancer survivor" indicates that it is a significant term. This review has been written to outline the state of the art and it invites to reflect on a shared definition that could satisfy both clinical and research aspects. Implication for cancer survivors: this compendium of proposed definitions may improve communication among the many patients and patient organizations that use and work with this term.

Assessing quality of life in young adult cancer survivors: development of the Survivorship-Related Quality of Life scale.

Science.gov (United States)

Park, Crystal L; Wortmann, Jennifer H; Hale, Amy E; Cho, Dalnim; Blank, Thomas O

2014-10-01

Scientific advances in treatments and outcomes for those diagnosed with cancer in late adolescence and early adulthood depend, in part, on the availability of adequate assessment tools to measure health-related quality of life (HRQOL) for survivors in this age group. Domains especially relevant to late adolescence and young adulthood (LAYA; e.g., education and career, committed romantic relationships, worldview formation) are typically overlooked in studies assessing the impact of cancer, usually more appropriate for middle-aged or older survivors. Current HRQOL measures also tend to assess issues that are salient during or shortly after treatment rather than reflecting life years after treatment. To develop a new measure to better capture the experience of LAYA cancer survivors in longer-term survivorship (the LAYA Survivorship-Related Quality of Life measure, LAYA-SRQL), we completed an extensive measure development process. After a literature review and focus groups with LAYA cancer survivors, we generated items and ran confirmatory factor and reliability analyses using a sample of 292 LAYA cancer survivors. We then examined validity using existing measures of physical and mental health, quality of life, and impact of cancer. The final model consisted of two domains (satisfaction and impact), each consisting of ten factors: existential/spirituality, coping, relationship, dependence, vitality, health care, education/career, fertility, intimacy/sexuality, and cognition/memory. Confirmatory factor analysis and validity analyses indicated that the LAYA-SRQL is a psychometrically sound instrument with good validity. The LAYA-SRQL fills an important need in survivorship research, providing a way to assess HRQOL in LAYAs in a developmentally informed way.

Developing and Validating the Scale of Economic Self-Efficacy.

Science.gov (United States)

Hoge, Gretchen L; Stylianou, Amanda M; Hetling, Andrea; Postmus, Judy L

2017-05-01

Experiencing intimate partner violence (IPV) and financial hardship are often intertwined. The dynamics of an abusive relationship may include economic abuse tactics that compromise a survivor's ability to work, pursue education, have access to financial resources, and establish financial skills, knowledge, and security. An increasingly common goal among programs serving IPV survivors is increasing financial empowerment through financial literacy. However, providing financial education alone may not be enough to improve financial behaviors. Psychological factors also play a role when individuals make financial choices. Economic self-efficacy focuses on the individual's perceived ability to perform economic or financial tasks, and may be considered a primary influence on one's ability to improve financial decisions and behaviors. The current study tests the reliability and validity of a Scale of Economic Self-Efficacy with a sample of female survivors of IPV. This study uses a calibration and validation analysis model including full and split-sample exploratory and confirmatory factor analyses, assesses for internal consistency, and examines correlation coefficients between economic self-efficacy, economic self-sufficiency, financial strain, and difficulty living with income. Findings indicate that the 10-item, unidimensional Scale of Economic Self-Efficacy demonstrates strong reliability and validity among this sample of IPV survivors. An ability to understand economic self-efficacy could facilitate individualized service approaches and allow practitioners to better support IPV survivors on their journey toward financial empowerment. Given the increase in programs focused on assets, financial empowerment, and economic well-being, the Scale of Economic Self-Efficacy has potential as a very timely and relevant tool in the design, implementation, and evaluation of such programs, and specifically for programs created for IPV survivors.

Who are the cancer survivors?

DEFF Research Database (Denmark)

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

2015-01-01

was compared by social position with the non-cancer population. Results: Cancer survivors composed 4% of the Danish population. Somatic comorbidity was more likely among survivors (OR 1.59, 95% CI 1.57-1.60) and associated with higher age, male sex, short education, and living alone among survivors......Background: No nationwide studies on social position and prevalence of comorbidity among cancer survivors exist. Methods: We performed a nationwide prevalence study defining persons diagnosed with cancer 1943-2010 and alive on the census date 1 January 2011 as cancer survivors. Comorbidity....... Conclusions: Among cancer survivors, comorbidity is common and highly associated with social position....

Pain in cancer survivors

International Nuclear Information System (INIS)

Mladosievicova, B.

2017-01-01

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

Exergame Grading Scheme: Concept Development and Preliminary Psychometric Evaluations in Cancer Survivors

Directory of Open Access Journals (Sweden)

Hsiao-Lan Wang

2017-01-01

Full Text Available The challenge of using exergames to promote physical activity among cancer survivors lies in the selection of the exergames that match their fitness level. There is a need for a standardized grading scheme by which to judge an exergame’s capacity to address specific physical fitness attributes with different levels of physical engagement. The study aimed to develop an Exergame Grading Scheme and preliminarily evaluate its psychometric properties. Fourteen (14 items were created from the human movement and exergame literature. The content validity index (CVI was rated by content experts with two consecutive rounds (N=5 and N=3 independently. The interrater reliability (IRR was determined by two raters who used the Exergame Grading Scheme to determine the grading score of the five exergames performed by two cancer survivors (N=10. Each item had a score of 1 for item-level CVI and 1 for k. For IRR, 9 items had rho values of 1, 1 item had 0.93, and 4 items had between 0.80 and 0.89. This valid and reliable Exergame Grading Scheme makes it possible to develop a personalized physical activity program using any type of exergame or fitness mobile application in rehabilitation practice to meet the needs of cancer survivors.

Sexual functioning of cervical cancer survivors : A review with a female perspective

NARCIS (Netherlands)

Lammerink, Ellen A. G.; de Bock, Geertruida H.; Pras, Elisabeth; Reyners, Anna K. L.; Mourits, Marian J. E.

Objective: Sex is an important, often deteriorated, dimension of quality of life after cancer treatment. We conducted a systematic review on sexual functioning of cervical cancer survivors. Methods: Studies between January 1988 and April 2010 were rated on their internal validity. Results were

Cancer in atomic bomb survivors

International Nuclear Information System (INIS)

Shigematsu, I.; Kagan, A.

1986-01-01

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

Predicting Adherence to Aromatase Inhibitor Therapy among Breast Cancer Survivors: An Application of the Protection Motivation Theory

Directory of Open Access Journals (Sweden)

Monita Karmakar MS

2017-02-01

Full Text Available The purpose of this observational study was to determine if the Protection Motivation Theory could predict and explain adherence to aromatase inhibitor (AI therapy among breast cancer survivors. Purposive sampling was used to identify 288 survivors who had been prescribed AI therapy. A valid and reliable survey was mailed to survivors. A total of 145 survivors completed the survey. The Morisky scale was used to measure adherence to AI. The survivors reported a mean score of 6.84 (±0.66 on the scale. Nearly 4 in 10 survivors (38% were non-adherent. Adherence differed by age, marital status, insurance status, income, and presence of co-morbid conditions. Self-efficacy (r=0.485, protection motivation (r=0.310, and Response Efficacy (r=0.206 were positively and significantly correlated with adherence. Response Cost (r=-0.235 was negatively correlated with adherence. The coping appraisal constructs were statistically significant predictors medication adherence (β=0.437 with self-efficacy being the strongest significant predictor of adherence (β = 0.429.

Predicting Adherence to Aromatase Inhibitor Therapy among Breast Cancer Survivors: An Application of the Protection Motivation Theory

Science.gov (United States)

Karmakar, Monita; Pinto, Sharrel L; Jordan, Timothy R; Mohamed, Iman; Holiday-Goodman, Monica

2017-01-01

The purpose of this observational study was to determine if the Protection Motivation Theory could predict and explain adherence to aromatase inhibitor (AI) therapy among breast cancer survivors. Purposive sampling was used to identify 288 survivors who had been prescribed AI therapy. A valid and reliable survey was mailed to survivors. A total of 145 survivors completed the survey. The Morisky scale was used to measure adherence to AI. The survivors reported a mean score of 6.84 (±0.66) on the scale. Nearly 4 in 10 survivors (38%) were non-adherent. Adherence differed by age, marital status, insurance status, income, and presence of co-morbid conditions. Self-efficacy (r=0.485), protection motivation (r=0.310), and Response Efficacy (r=0.206) were positively and significantly correlated with adherence. Response Cost (r=-0.235) was negatively correlated with adherence. The coping appraisal constructs were statistically significant predictors medication adherence (β=0.437) with self-efficacy being the strongest significant predictor of adherence (β = 0.429). PMID:28469437

A pilot randomized control trial to evaluate pelvic floor muscle training for urinary incontinence among gynecologic cancer survivors.

Science.gov (United States)

Rutledge, Teresa L; Rogers, Rebecca; Lee, Sang-Joon; Muller, Carolyn Y

2014-01-01

We previously reported high rates of urinary incontinence among gynecologic cancer survivors and aimed to evaluate the effectiveness of a simple intervention for treatment of urinary incontinence in this population. We recruited 40 gynecologic cancer survivors who reported urinary incontinence on a validated questionnaire. Women were randomized to either pelvic floor muscle training/behavioral therapy (treatment group) or usual care (control group). The primary outcome measure, assessed at 12 weeks post intervention, was a 40% difference in the validated Patient Global Impression of Improvement (PGI-I) score. Fisher's exact test was used to identify differences between groups for frequency data; two-sample t-test was conducted for continuous measurements. Mean age of this cohort was 57 (range: 37-79). The majority of the survivors had uterine cancer (60%), 18% had received radiation therapy, 95% had received surgical therapy, and 35% had received chemotherapy. At three months, 80% of the treatment and 40% of the control group reported that their urinary incontinence was "much better" or "very much better" as evaluated by the Patient Global Impression of Improvement scale (p=0.02). Brink's scores were significantly improved in the treatment group as compared to those of the controls (pgynecologic cancer survivors, it is often under-assessed and undertreated. We found a simple intervention that included pelvic floor muscle training and behavioral therapy, which significantly improved cancer survivor's urinary incontinence. © 2013.

Cancer survivors. Work related issues.

Science.gov (United States)

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

2002-05-01

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

Physical activity and lower limb lymphedema among uterine cancer survivors.

Science.gov (United States)

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

2013-11-01

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

Survivor-Defined Practice in Domestic Violence Work: Measure Development and Preliminary Evidence of Link to Empowerment.

Science.gov (United States)

Goodman, Lisa A; Thomas, Kristie; Cattaneo, Lauren Bennett; Heimel, Deborah; Woulfe, Julie; Chong, Siu Kwan

2016-01-01

Survivor-defined practice, characterized by an emphasis on client choice, partnership, and sensitivity to the unique needs, contexts, and coping strategies of individual survivors, is an aspirational goal of the domestic violence (DV) movement, assumed to be a key contributor to empowerment and other positive outcomes among survivors. Despite its central role in DV program philosophy, training, and practice, however, our ability to assess its presence and its presumed link to well-being has been hampered by the absence of a way to measure it from survivors' perspectives. As part of a larger university-community collaboration, this study had two aims: (a) to develop a measure of survivor-defined practice from the perspective of participants, and (b) to assess its relationship to safety-related empowerment after controlling for other contributors to survivor well-being (e.g., financial stability and social support). Results supported the reliability and validity of the Survivor-Defined Practice Scale (SDPS), a nine-item measure that assesses participants' perception of the degree to which their advocates help them achieve goals they set for themselves, facilitate a spirit of partnership, and show sensitivity to their individual needs and styles. The items combined to form one factor indicating that the three theoretical aspects of survivor-defined practice may be different manifestations of one underlying construct. Results also support the hypothesized link between survivor-defined practice and safety-related empowerment. The SDPS offers DV programs a mechanism for process evaluation that is rigorous and rooted in the feminist empowerment philosophy that so many programs espouse. © The Author(s) 2014.

Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work.

Science.gov (United States)

Duijts, Saskia F A; van Egmond, Martine P; Gits, Maxime; van der Beek, Allard J; Bleiker, Eveline M

2017-10-01

Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.

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

Science.gov (United States)

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

2010-01-01

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

The Piper Fatigue Scale-12 (PFS-12): psychometric findings and item reduction in a cohort of breast cancer survivors.

Science.gov (United States)

Reeve, Bryce B; Stover, Angela M; Alfano, Catherine M; Smith, Ashley Wilder; Ballard-Barbash, Rachel; Bernstein, Leslie; McTiernan, Anne; Baumgartner, Kathy B; Piper, Barbara F

2012-11-01

Brief, valid measures of fatigue, a prevalent and distressing cancer symptom, are needed for use in research. This study's primary aim was to create a shortened version of the revised Piper Fatigue Scale (PFS-R) based on data from a diverse cohort of breast cancer survivors. A secondary aim was to determine whether the PFS captured multiple distinct aspects of fatigue (a multidimensional model) or a single overall fatigue factor (a unidimensional model). Breast cancer survivors (n = 799; stages in situ through IIIa; ages 29-86 years) were recruited through three SEER registries (New Mexico, Western Washington, and Los Angeles, CA) as part of the Health, Eating, Activity, and Lifestyle (HEAL) study. Fatigue was measured approximately 3 years post-diagnosis using the 22-item PFS-R that has four subscales (Behavior, Affect, Sensory, and Cognition). Confirmatory factor analysis was used to compare unidimensional and multidimensional models. Six criteria were used to make item selections to shorten the PFS-R: scale's content validity, items' relationship with fatigue, content redundancy, differential item functioning by race and/or education, scale reliability, and literacy demand. Factor analyses supported the original 4-factor structure. There was also evidence from the bi-factor model for a dominant underlying fatigue factor. Six items tested positive for differential item functioning between African-American and Caucasian survivors. Four additional items either showed poor association, local dependence, or content validity concerns. After removing these 10 items, the reliability of the PFS-12 subscales ranged from 0.87 to 0.89, compared to 0.90-0.94 prior to item removal. The newly developed PFS-12 can be used to assess fatigue in African-American and Caucasian breast cancer survivors and reduces response burden without compromising reliability or validity. This is the first study to determine PFS literacy demand and to compare PFS-R responses in African

Health-related quality of life and cognitive outcomes among child and adolescent survivors of leukemia.

Science.gov (United States)

Chiou, Shyh-Shin; Jang, Ren-Chin; Liao, Yu-Mei; Yang, Pinchen

2010-12-01

Long-term survival of childhood leukemia has become a reality with treatment advancement; hence, the need to assess the survivors' health-related quality of life (HRQL) is essential. Although a growing number of Western studies have documented the considerable impact of diagnosis and treatment on HRQL in pediatric leukemia survivors, little finding has been reported in non-Western developing countries. We used a previously validated 14-dimensional questionnaire, Child Health Questionnaire 50-item Parent Form (CHQ-PF 50), to examine the perceived HRQL of 32 child/adolescent survivors, currently aged 13.17 ± 2.49 years, who had experienced first complete continuous remission from leukemia for at least 3 years. The HRQL status was compared with that obtained from community subjects (N = 154) and survivors' nonadult siblings (N = 30). Intelligence quotients (IQ) and computerized neuropsychological assessments were performed for subjects. The HRQL of leukemia survivors was noted to be worse than that of community children and nonadult siblings as reflected by significantly lower scores in both the physical summary and the psychosocial summary score of CHQ-PF 50. 15.6% of the survivors had impaired intelligence (estimated IQ below 70). 27.8% of the adolescents were impaired in the cognitive domains as assessed by neuropsychological tests. In this Taiwanese single institution experience, pediatric leukemia survivors carried a morbidity burden into their teen years as reflected by worse HRQL than controls. These findings may guide the support required by this population.

Construction of a supercritical fluid extraction (SFE equipment: validation using annatto and fennel and extract analysis by thin layer chromatography coupled to image

Directory of Open Access Journals (Sweden)

Júlio Cezar Flores JOHNER

2016-01-01

Full Text Available Abstract The present work describes setting up a laboratory unit for supercritical fluid extraction. In addition to its construction, a survey of cost was done to compare the cost of the homemade unit with that of commercial units. The equipment was validated using an extraction of annatto seeds’ oil, and the extraction and fractionation of fennel oil were used to validate the two separators; for both systems, the solvent was carbon dioxide. The chemical profiles of annatto and fennel extracts were assessed using thin layer chromatography; the images of the chromatographic plates were processed using the free ImageJ software. The cost survey showed that the homemade equipment has a very low cost (~US$ 16,000 compared to commercial equipment. The extraction curves of annatto were similar to those obtained in the literature (yield of 3.8% oil. The separators were validated, producing both a 2.5% fraction of fennel seed extract rich in essential oils and another extract fraction composed mainly of oleoresins. The ImageJ software proved to be a low-cost tool for obtaining an initial evaluation of the chemical profile of the extracts.

Missed treatment opportunities and barriers to comprehensive treatment for sexual violence survivors in Kenya: a mixed methods study.

Science.gov (United States)

Gatuguta, Anne; Merrill, Katherine G; Colombini, Manuela; Soremekun, Seyi; Seeley, Janet; Mwanzo, Isaac; Devries, Karen

2018-06-19

In Kenya, most sexual violence survivors either do not access healthcare, access healthcare late or do not complete treatment. To design interventions that ensure optimal healthcare for survivors, it is important to understand the characteristics of those who do and do not access healthcare. In this paper, we aim to: compare the characteristics of survivors who present for healthcare to those of survivors reporting violence on national surveys; understand the healthcare services provided to survivors; and, identify barriers to treatment. A mixed methods approach was used. Hospital records for survivors from two referral hospitals were compared with national-level data from the Kenya Demographic and Health Survey 2014, and the Violence Against Children Survey 2010. Descriptive summaries were calculated and differences in characteristics of the survivors assessed using chi-square tests. Qualitative data from six in-depth interviews with healthcare providers were analysed thematically. Among the 543 hospital respondents, 93.2% were female; 69.5% single; 71.9% knew the perpetrator; and 69.2% were children below 18 years. Compared to respondents disclosing sexual violence in nationally representative datasets, those who presented at hospital were less likely to be partnered, male, or assaulted by an intimate partner. Data suggest missed opportunities for treatment among those who did present to hospital: HIV PEP and other STI prophylaxis was not given to 30 and 16% of survivors respectively; 43% of eligible women did not receive emergency contraceptive; and, laboratory results were missing in more than 40% of the records. Those aged 18 years or below and those assaulted by known perpetrators were more likely to miss being put on HIV PEP. Qualitative data highlighted challenges in accessing and providing healthcare that included stigma, lack of staff training, missing equipment and poor coordination of services. Nationally, survivors at higher risk of not accessing

Rectal Cancer Survivors' Participation in Productive Activities.

Science.gov (United States)

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

2017-01-01

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

Rape Survivors' Experiences of the Silent Protest: Implications for Promoting Healing and Resilience.

Science.gov (United States)

Padmanabhanunni, Anita; Edwards, David

2016-05-01

This article examines the experiences of nine rape survivors who participated in the Silent Protest, an annual protest march at Rhodes University that aims to highlight the sexual abuse of women, validate the harm done, and foster solidarity among survivors. Participants responded to a semi-structured interview focusing on the context of their rape and its impact, and their experiences of participation in the Protest In the first phase of data analysis, synoptic case narratives were written. In the second, themes from participants' experience were identified using interpretative phenomenological analysis. In the third, the data were examined in light of questions around the extent to which participation contributed to healing. Participants reported experiences of validation and empowerment but the majority were suffering from posttraumatic stress disorder. In some cases, participation had exacerbated self-blame and avoidant coping. Recommendations are made about the provision of psychoeducation and counseling at such events. © The Author(s) 2015.

Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors.

Science.gov (United States)

Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

2016-07-01

Sexual dysfunction is a treatment sequela in survivors of rectal cancer (RC). Differences in health-related quality of life (HRQOL) can occur based on ostomy status (permanent ostomy vs anastomosis). To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥5 years) survivors of RC. Survivors of RC with an ostomy (n = 181) or anastomosis (n = 394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis groups and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors' greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Colorectal. Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before 2000 and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female survivors of RC with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of the survey (≥5 years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo comorbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity, psychological issues with sexual activity, physical issues with sexual activity, partner rejection, ostomy interference with sexual activity, and positive experiences with sexuality. Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and

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

Science.gov (United States)

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

2014-09-01

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

Intergenerational families of holocaust survivors: designing and piloting a family resilience template.

Science.gov (United States)

Isserman, Nancy; Greene, Roberta R; Bowen, Sheryl Perlmutter; Hollander-Goldfein, Bea; Cohen, Harriet

2014-01-01

Researchers from the Templeton study, "Forgiveness, Resiliency, and Survivorship Among Holocaust Survivors," and the Transcending Trauma Project, combined efforts to examine six transcripts of interviews with survivors of the Nazi Holocaust. The researchers focused on the nature of parent-child family dynamics before, during, and after the Holocaust. They refined a Family Resilience Template (FRT) originally based on an ecological-systems design, adding an attachment theory component and a quantitative methodology. The goal of the research project was to pilot the FRT by further defining terms and adding a Quality of Family Dynamics Paradigm to encompass an intergenerational dimension. The researchers arrived at a consensus of item definitions, establishing the initial face validity of the FRT.

Modification and Validation of an Automotive Data Processing Unit, Compessed Video System, and Communications Equipment

Energy Technology Data Exchange (ETDEWEB)

Carter, R.J.

1997-04-01

The primary purpose of the "modification and validation of an automotive data processing unit (DPU), compressed video system, and communications equipment" cooperative research and development agreement (CRADA) was to modify and validate both hardware and software, developed by Scientific Atlanta, Incorporated (S-A) for defense applications (e.g., rotary-wing airplanes), for the commercial sector surface transportation domain (i.e., automobiles and trucks). S-A also furnished a state-of-the-art compressed video digital storage and retrieval system (CVDSRS), and off-the-shelf data storage and transmission equipment to support the data acquisition system for crash avoidance research (DASCAR) project conducted by Oak Ridge National Laboratory (ORNL). In turn, S-A received access to hardware and technology related to DASCAR. DASCAR was subsequently removed completely and installation was repeated a number of times to gain an accurate idea of complete installation, operation, and removal of DASCAR. Upon satisfactory completion of the DASCAR construction and preliminary shakedown, ORNL provided NHTSA with an operational demonstration of DASCAR at their East Liberty, OH test facility. The demonstration included an on-the-road demonstration of the entire data acquisition system using NHTSA'S test track. In addition, the demonstration also consisted of a briefing, containing the following: ORNL generated a plan for validating the prototype data acquisition system with regard to: removal of DASCAR from an existing vehicle, and installation and calibration in other vehicles; reliability of the sensors and systems; data collection and transmission process (data integrity); impact on the drivability of the vehicle and obtrusiveness of the system to the driver; data analysis procedures; conspicuousness of the vehicle to other drivers; and DASCAR installation and removal training and documentation. In order to identify any operational problems not captured by the systems

Supporting Rape Survivors Through the Criminal Injuries Compensation Scheme: An Exploration of English and Welsh Independent Sexual Violence Advisors' Experiences.

Science.gov (United States)

Smith, Olivia; Galey, Jessica

2018-07-01

English and Welsh responses to rape have long been critically examined, leading to attempted improvements in the criminal justice system. Despite this, little attention has been paid to the Criminal Injuries Compensation Scheme (CICS) and the difficulties applying it to rape. To begin addressing this gap, researchers interviewed three, and qualitatively surveyed 22, Independent Sexual Violence Advisors. The findings suggest that CICS may not only reinforce rape myths and disadvantage vulnerable survivors, but is also a source of validation and contributes to survivor justice. The study, while exploratory, therefore, highlights the need for further discussion about rape survivor compensation.

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

Science.gov (United States)

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

2018-04-15

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

Comparison of health-related quality of life and functional recovery measurement tools in out-of-hospital cardiac arrest survivors.

Science.gov (United States)

Andrew, Emily; Nehme, Ziad; Bernard, Stephen; Smith, Karen

2016-10-01

Although a number of validated health-related quality of life (HR-QOL) instruments exist for critical care populations, a standardised approach to assessing the HR-QOL of out-of-hospital cardiac arrest (OHCA) survivors has not been developed. We sought to compare the responses of 12-month OHCA survivors to three HR-QOL and functional recovery instruments, and assess instrument validity. The Victorian Ambulance Cardiac Arrest Registry invited 12-month OHCA survivors to participate in telephone follow-up between January 2011 and December 2015. Responders provided answers to the 12 Item Short Form Health Survey (SF-12), Three-Level EuroQol-5D (EQ-5D-3L) and the Glasgow Outcome Scale-Extended (GOSE). The SF-12 was also used to derive the SF-6D. Responses were used to assess the interpretability and construct validity of the instruments. A total of 1188 patients and proxies responded. Large ceiling effects were observed for the EQ-5D-3L (patients=46%, proxies=23%). Substantial variability was also observed in SF-6D responses for patients who reported full health according to the EQ-5D-3L. For patient responders, the strongest correlations were observed between the EQ-5D-3L index score and SF-6D (ρ=0.65, pGOSE outcome and lower or upper good recovery (pGOSE suggest that these may be useful measures of HR-QOL and functional recovery in OHCA survivors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Thyroid disorders in atomic bomb survivors

International Nuclear Information System (INIS)

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

1984-01-01

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

Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea

Directory of Open Access Journals (Sweden)

Kim Kwang-Won

2010-09-01

Full Text Available Abstract Background Concern regarding the health-related quality of life (HRQOL of long-term survivors of thyroid cancer has risen due to the rapid increase in the incidence of thyroid cancer, which generally has an excellent prognosis. The aim of this study was to evaluate the status of HRQOL in disease-free survivors of differentiated thyroid carcinoma (DTC and to evaluate the important determinants of HRQOL. Methods This was a cross-sectional study in which we interviewed consecutive disease-free survivors of DTC. Three different validated questionnaires ("EORTC QLQ-C30" for various functional domains, the "brief fatigue inventory (BFI" and the "hospital anxiety and depression scale" (HADS were used. Data from a large, population based survey of 1,000 people were used as a control. Results The response rate for the questionnaires was 78.9% (316/401. Disease-free survivors of DTC showed a decreased HRQOL in all five functional domains (physical, role, cognitive, emotional, and social on the EORTC QLQ-C30 compared with controls (P P Conclusions Although disease-free survivors of DTC are expected to have disease-specific survival comparable to the general population, they experience a significantly decreased HRQOL. Anxiety, depression, and fatigue were the major determinants of the decreased HRQOL. Supportive psychological care should be integrated into the management of long-term survivors of DTC.

Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words.

Science.gov (United States)

Wong, Alex W K; Chang, Ting-Ting; Christopher, Katrina; Lau, Stephen C L; Beaupin, Lynda K; Love, Brad; Lipsey, Kim L; Feuerstein, Michael

2017-12-01

Categorization of the needs of AYA cancer survivors is primarily based on quantitative analyses of epidemiological and observational research. The present study classified the phenomenological experiences of AYA survivors based on their own language. A systematic approach for selecting qualitative studies of unmet needs in AYA cancer survivors was used. Following selection based on quality, survivor statements were entered verbatim and thematic analysis was conducted using NVivo qualitative research software. A total of 1993 AYA cancer survivors (post-treatment) were included in 58 studies (78% individual interviews). Mean age was 27.6 with an average of 8.6 years post-primary treatment. The organizational framework reported in this study was based on a heterogeneous group of cancer types. Thirteen themes including symptoms, function, reproductive health, emotional well-being, health management, health care system, social interaction, romantic relationships, cancer disclosure, normalcy, career development and employment, and school and fiscal concerns were identified. Forty-eight subthemes were also identified covering such areas as fertility, integrative health services, advice for cancer disclosure, family interaction, and insurance challenges. Direct analysis of text identified many common unmet needs similarly reported in the quantitative literature. The phenomenological data also provided a breakdown of unmet needs into subthemes or elements of unmet needs. This information can help form the basis for a personalized, valid, and reliable evaluation tool of the range of unmet needs in AYA survivors.

Study on the Rationality and Validity of Probit Models of Domino Effect to Chemical Process Equipment caused by Overpressure

International Nuclear Information System (INIS)

Sun, Dongliang; Huang, Guangtuan; Jiang, Juncheng; Zhang, Mingguang; Wang, Zhirong

2013-01-01

Overpressure is one important cause of domino effect in accidents of chemical process equipments. Some models considering propagation probability and threshold values of the domino effect caused by overpressure have been proposed in previous study. In order to prove the rationality and validity of the models reported in the reference, two boundary values of three damage degrees reported were considered as random variables respectively in the interval [0, 100%]. Based on the overpressure data for damage to the equipment and the damage state, and the calculation method reported in the references, the mean square errors of the four categories of damage probability models of overpressure were calculated with random boundary values, and then a relationship of mean square error vs. the two boundary value was obtained, the minimum of mean square error was obtained, compared with the result of the present work, mean square error decreases by about 3%. Therefore, the error was in the acceptable range of engineering applications, the models reported can be considered reasonable and valid.

Study on the Rationality and Validity of Probit Models of Domino Effect to Chemical Process Equipment caused by Overpressure

Science.gov (United States)

Sun, Dongliang; Huang, Guangtuan; Jiang, Juncheng; Zhang, Mingguang; Wang, Zhirong

2013-04-01

Overpressure is one important cause of domino effect in accidents of chemical process equipments. Some models considering propagation probability and threshold values of the domino effect caused by overpressure have been proposed in previous study. In order to prove the rationality and validity of the models reported in the reference, two boundary values of three damage degrees reported were considered as random variables respectively in the interval [0, 100%]. Based on the overpressure data for damage to the equipment and the damage state, and the calculation method reported in the references, the mean square errors of the four categories of damage probability models of overpressure were calculated with random boundary values, and then a relationship of mean square error vs. the two boundary value was obtained, the minimum of mean square error was obtained, compared with the result of the present work, mean square error decreases by about 3%. Therefore, the error was in the acceptable range of engineering applications, the models reported can be considered reasonable and valid.

"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

"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

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.

Education, employment and marriage in long-term survivors of teenage and young adult cancer compared with healthy controls.

Science.gov (United States)

Mader, Luzius; Vetsch, Janine; Christen, Salome; Baenziger, Julia; Roser, Katharina; Dehler, Silvia; Michel, Gisela

2017-03-21

Teenage and young adult (TYA) cancer patients are faced with the diagnosis during a challenging period of psychosocial development that may affect social outcomes in the long term. Therefore, we aimed to: (1) determine differences in social outcomes between long-term TYA cancer survivors and healthy controls and (2) identify factors associated with adverse social outcomes. We sent a questionnaire to TYA cancer survivors (aged 16-25 years at diagnosis, 5 years after diagnosis) registered in the Cancer Registry Zurich and Zug. Information on controls was obtained from the Swiss Health Survey 2012. We assessed educational achievement, employment status, marital status and life partnership (survivors only), and compared these outcomes between survivors and controls. We used logistic regression to identify sociodemographic and cancer-related factors associated with social outcomes. We included 160 TYA cancer survivors and 999 controls. Educational achievement of survivors differed significantly from controls (p = 0.012): more survivors than controls reported upper secondary education (33 vs 27%) and fewer survivors reported university education (12 vs 21%). No significant differences were found for employment (p = 0.515) and marital status (p = 0.357). The majority of survivors (91%) and controls (90%) were employed, and 37% of survivors were married, compared with 41% of controls. There were no cancer-related factors associated with having only basic education. Unemployment was associated with younger age at diagnosis (odds ratio [OR] 5.3, 95% confidence interval [CI] 1.3-30.8) and self-reported late effects (OR 4.7, 95% CI 1.3-19.5). Survivors of younger age at diagnosis were more likely not to be married (OR 2.7, 95% CI 1.3-5.7) and not to have a life partner (OR 2.3, 95% CI 1.0-5.2). Our findings indicate that TYA cancer survivors completed applied higher education rather than a university education. Future studies including larger samples of TYA cancer survivors

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.

20 CFR 234.33 - Survivor annuities.

Science.gov (United States)

2010-04-01

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

Cancer survivors' experience of time

DEFF Research Database (Denmark)

Rasmussen, Dorte M.; Elverdam, Beth

2007-01-01

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

A Systematic Review of Posttraumatic Growth in Survivors of Interpersonal Violence in Adulthood.

Science.gov (United States)

Elderton, Anna; Berry, Alexis; Chan, Carmen

2015-10-11

This review critically evaluates the literature on posttraumatic growth in survivors of interpersonal violence, integrating the findings from 12 quantitative and 4 qualitative studies. The following databases were searched using predetermined terms: AMED, EMBASE, MEDLINE, PsycINFO, BNI, CINAHL, and Web of Knowledge. The review's findings suggest that the mean prevalence of growth in interpersonal violence survivors is around 71% (range 58-99%). The highest level of growth was consistently experienced in the "appreciation of life" domain. However, survivors reported growth in the four remaining domains: "personal strength," "new possibilities," "experience of relationships with others," and "outlook on life." The nature of the relationship between growth and distress was inconsistent across studies. A combination of pretrauma, peritrauma, and posttrauma variables were found to be related to the degree of growth survivors experienced. Methodological weaknesses of the quantitative studies included the predominant use of retrospective, cross-sectional, correlational designs, discrepancy in the measurement of growth, insufficient sample sizes for power calculations in five studies and limited external validity. Qualitative findings were limited by sampling methods, insufficient information about interview schedules, the lack of credibility checks, and evidence of reflexivity demonstrated by some studies. Implications for practice, policy, and future research are discussed. © The Author(s) 2015.

Socio-demography and medical history as predictors of health-related quality of life of breast cancer survivors.

Science.gov (United States)

Ramadas, Amutha; Qureshi, Ahmad Munir; Dominic, Nisha Angela; Botross, Nevein Philip; Riad, Amgad; Thirunavuk Arasoo, Valliammai Jayanthi; Elangovan, Soman

2015-01-01

Even after completion of conventional treatment, breast cancer survivors continue to exhibit a variety of psychological and physical symptoms, affecting their quality of life. The study aimed to investigate the relationship between socio-demography, medical characteristics and health-related quality of life (HR-QOL) of a sample of breast cancer survivors in Malaysia. This pilot cross-sectional survey was conducted among breast cancer survivors (n=40) who were members of Breast Cancer Support Group Centre Johor Bahru. A validated self-administered questionnaire was used to identify the relationships between socio-demography, medical characteristics and HR-QOL of the participants. Living with family and completion of treatment were significant predictive factors of self-rated QOL, while living with family and ever giving birth significantly predicted satisfaction with health and physical health. Psychological health had moderate correlations with number of children and early cancer stage. Survivors' higher personal income (>MYR4,500) was the only significant predictor of social relationship, while age, income more than MYR4,500 and giving birth significantly predicted environment domain score. The findings suggested the survivors coped better in all four HR-QOL domains if they were married, lived with family, had children and were employed.

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.

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

Science.gov (United States)

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

2014-01-01

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

Experimental Equipment Validation for Methane (CH4) and Carbon Dioxide (CO2) Hydrates

Science.gov (United States)

Saad Khan, Muhammad; Yaqub, Sana; Manner, Naathiya; Ani Karthwathi, Nur; Qasim, Ali; Mellon, Nurhayati Binti; Lal, Bhajan

2018-04-01

Clathrate hydrates are eminent structures regard as a threat to the gas and oil industry in light of their irritating propensity to subsea pipelines. For natural gas transmission and processing, the formation of gas hydrate is one of the main flow assurance delinquent has led researchers toward conducting fresh and meticulous studies on various aspects of gas hydrates. This paper highlighted the thermodynamic analysis on pure CH4 and CO2 gas hydrates on the custom fabricated equipment (Sapphire cell hydrate reactor) for experimental validation. CO2 gas hydrate formed at lower pressure (41 bar) as compared to CH4 gas hydrate (70 bar) while comparison of thermodynamic properties between CH4 and CO2 also presented in this study. This preliminary study could provide pathways for the quest of potent hydrate inhibitors.

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…

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

International Nuclear Information System (INIS)

Shimizu, Kiyoshi; Mishima, Tetsuo; Watanabe, Michiko

1984-01-01

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

Mental health-care utilization in survivors of childhood cancer and siblings: the Swiss childhood cancer survivor study.

Science.gov (United States)

Gianinazzi, Micol E; Rueegg, Corina S; von der Weid, Nicolas X; Niggli, Felix K; Kuehni, Claudia E; Michel, Gisela

2014-02-01

We aimed to (1) describe the utilization of mental health-care in survivors and siblings, the association with severity of distress, and visits to other professionals in distressed survivors not utilizing mental health-care; and (2) identify factors associated with utilization of mental health-care in distressed survivors. Within the Swiss Childhood Cancer Survivor Study, we sent postal questionnaires to all participants aged siblings could indicate if they utilized mental health-care in the past year. Psychological distress was assessed with the Brief Symptom Inventory-18 (BSI-18). Participants with scores T ≥ 57 on two of three scales or the Global Severity Index were considered distressed. We included 1,602 survivors and 703 siblings. Overall, 160 (10 %) and 53 (8 %), utilized mental health-care and 203 (14 %) and 127 (14 %) were considered distressed. Among these, 69 (34 %) survivors and 20 (24 %) siblings had utilized mental health-care. Participants with higher distress were more likely to utilize mental health-care. Distressed survivors not utilizing mental health-care were more likely to see a medical specialist than nondistressed. In the multivariable regression, factors associated with utilizing mental health-care were higher psychological distress and reporting late effects. Our results underline the importance of developing interventional programs and implementing psychological screening in follow-up of survivors. It is also important to systematically address siblings' needs. In follow-up, patients at risk should be informed about existing possibilities or advised to visit mental health professionals.

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

Science.gov (United States)

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

2018-04-01

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

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

Science.gov (United States)

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

2018-04-05

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

Generation of equipment response spectrum considering equipment-structure interaction

International Nuclear Information System (INIS)

Lee, Sang Hoon; Yoo, Kwang Hoon

2005-01-01

Floor response spectra for dynamic response of subsystem such as equipment, or piping in nuclear power plant are usually generated without considering dynamic interaction between main structure and subsystem. Since the dynamic structural response generally has the narrow-banded shapes, the resulting floor response spectra developed for various locations in the structure usually have high spectral peak amplitudes in the narrow frequency bands corresponding to the natural frequencies of the structural system. The application of such spectra for design of subsystems often leads to excessive design conservatisms, especially when the equipment frequency and structure are at resonance condition. Thus, in order to provide a rational and realistic design input for dynamic analysis and design of equipment, dynamic equipment-structure interaction (ESI) should be considered in developing equipment response spectrum which is particularly important for equipment at the resonance condition. Many analytical methods have been proposed in the past for developing equipment response spectra considering ESI. However, most of these methods have not been adapted to the practical applications because of either the complexities or the lack of rigorousness of the methods. At one hand, mass ratio among the equipment and structure was used as an important parameter to obtain equipment response spectra. Similarly, Tseng has also proposed the analytical method for developing equipment response spectra using mass ratio in the frequency domain. This method is analytically rigorous and can be easily validated. It is based on the dynamic substructuring method as applied to the dynamic soil-structure interaction (SSI) analysis, and can relatively easily be implemented for practical applications without to change the current dynamic analysis and design practice for subsystems. The equipment response spectra derived in this study are also based on Tseng's proposed method

Visual Impairment Screening Assessment (VISA) tool: pilot validation.

Science.gov (United States)

Rowe, Fiona J; Hepworth, Lauren R; Hanna, Kerry L; Howard, Claire

2018-03-06

To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. Prospective case cohort comparative study. Stroke units at two secondary care hospitals and one tertiary centre. 116 stroke survivors were screened, 62 by naïve and 54 by non-naïve screeners. Both the VISA screening tool and the comprehensive specialist vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. Full completion of VISA tool and specialist vision assessment was achieved for 89 stroke survivors. Missing data for one or more sections typically related to patient's inability to complete the assessment. Sensitivity and specificity of the VISA screening tool were 90.24% and 85.29%, respectively; the positive and negative predictive values were 93.67% and 78.36%, respectively. Overall agreement was significant; k=0.736. Lowest agreement was found for screening of eye movement and visual inattention deficits. This early validation of the VISA screening tool shows promise in improving detection accuracy for clinicians involved in stroke care who are not specialists in vision problems and lack formal eye training, with potential to lead to more prompt referral with fewer false positives and negatives. Pilot validation indicates acceptability of the VISA tool for screening of visual impairment in stroke survivors. Sensitivity and specificity were high indicating the potential accuracy of the VISA tool for screening purposes. Results of this study have guided the revision of the VISA screening tool ahead of full clinical validation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Design and preliminary validation of a mobile application-based expert system to facilitate repair of medical equipment in resource-limited health settings

Directory of Open Access Journals (Sweden)

Wong AL

2018-05-01

Full Text Available Alison L Wong,1,2 Kelly M Lacob,1 Madeline G Wilson,1 Stacie M Zwolski,1 Soumyadipta Acharya1 1Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA; 2Division of Plastic Surgery, Dalhousie University, Halifax, NS, Canada Background: One of the greatest barriers to safe surgery is the availability of functional biomedical equipment. Biomedical technicians play a major role in ensuring that equipment is functional. Following in-field observations and an online survey, a mobile application was developed to aid technicians in troubleshooting biomedical equipment. It was hypothesized that this application could be used to aid technicians in equipment repair, as modeled by repair of a pulse oximeter.Methods: To identify specific barriers to equipment repair and maintenance for biomedical technicians, an online survey was conducted to determine current practices and challenges. These findings were used to guide the development of a mobile application system that guides technicians through maintenance and repair tasks. A convenience sample of technicians in Ethiopia tested the application using a broken pulse oximeter task and following this completed usability and content validity surveys.Results: Fifty-three technicians from 13 countries responded to the initial survey. The results of the survey showed that technicians find equipment manuals most useful, but these are not easily accessible. Many do not know how to or are uncomfortable reaching out to human resources. Thirty-three technicians completed the broken pulse oximeter task using the application. All were able to appropriately identify and repair the equipment, and post-task surveys of usability and content validity demonstrated highly positive scores (Agree to Strongly Agree on both scales.Discussion: This research demonstrates the need for improved access to resources for technicians and shows that a mobile application can be used to address a gap in

Obesity in pediatric ALL survivors: a meta-analysis.

Science.gov (United States)

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

2014-03-01

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

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.

Health-related quality of life of African-American female breast cancer survivors, survivors of other cancers, and those without cancer.

Science.gov (United States)

Claridy, Mechelle D; Ansa, Benjamin; Damus, Francesca; Alema-Mensah, Ernest; Smith, Selina A

2018-04-27

The purpose of this study was to compare differences in health-related quality of life (HRQOL) between African-American female breast cancer survivors, African-American female survivors of other cancers, and African-American women with no history of cancer. Using data from the 2010 National Health Interview Survey (NHIS), the HRQOL of African-American women aged 35 years or older was compared by cancer status. Physical and mental health items from the Patient-Reported Outcomes Measurement Information System (PROMIS) global health scale were used to assess differences in HRQOL. For summary physical and mental health measures, no significant differences were found between breast cancer survivors and women with no history of cancer; survivors of other cancers reported poorer physical and mental health than did women with no history of cancer. Similar differences were found at the item level. When we examined the two African-American female cancer survivor groups, we found that cancer survivors whose cancer was being treated reported substantially poorer physical health and mental health than did those whose cancer was not being treated. Survivors who had private insurance and were cancer free reported better physical and mental health than did those who did not have private insurance and those who were not cancer free. Breast cancer survivors reported slightly better physical and mental health than did survivors of other cancers. Our findings highlight the need for public health agencies to adopt practices to improve the mental and physical health of African-American female survivors of cancer.

Chemotherapy-Induced Neuropathy in Cancer Survivors.

Science.gov (United States)

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

2017-08-01

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

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

Science.gov (United States)

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

2014-09-01

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

A-bomb survivor dosimetry update

International Nuclear Information System (INIS)

Loewe, W.E.

1982-06-01

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

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.

Lucky or Unlucky people: Layoff Survivors

OpenAIRE

Muhammad Imran Malik; Dr. Mehboob Ahmad

2011-01-01

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview.

Science.gov (United States)

Recklitis, Christopher J; Blackmon, Jaime E; Chang, Grace

2016-01-15

The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society. © 2015 American Cancer Society.

Pictorial Representation of Self and Illness Measure (PRISM): a graphic instrument to assess suffering in fatigued cancer survivors.

Science.gov (United States)

Gielissen, Marieke F M; Prins, Judith B; Knoop, Hans; Verhagen, Stans; Bleijenberg, Gijs

2013-06-01

The Pictorial Representation of Self and Illness Measure (PRISM) measures in a simple, graphic way the burden of suffering due to illness. The question addressed in this study is whether the PRISM is a valid instrument to measure suffering in cancer survivors experiencing severe fatigue. Quantitative and qualitative data of a previous randomized controlled trial demonstrating the efficacy of cognitive behavior therapy (CBT) especially designed for postcancer fatigue was used to assess convergent validity and sensitivity to change in a sample of 83 cancer survivors. The PRISM, yielding self-illness separation (SIS-fatigue = suffering due to fatigue; SIS-cancer = suffering due to cancer), fatigue severity (Checklist Individual Strength; CIS-fatigue), functional impairment, psychological well-being, quality of life, and coping with the experience of cancer (Impact of Event Scale; IES). Moderate significant correlations were found with the PRISM and the above-mentioned measures. On the basis of SIS scores, the sample was divided into two separate groups: cancer survivors who suffered more because of fatigue and cancer survivors who suffered more because they had cancer in the past. The two groups had different scores on CIS-fatigue and IES, in line with that aspect that caused them the most suffering. The qualitative data confirmed this finding. Participants in the CBT condition demonstrated a significant difference between SIS-fatigue at baseline versus 6 months later compared with those in the waiting list condition. No change of SIS-cancer was found. The PRISM seems to be a valuable tool in fatigue research and clinical practice. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The use of the SF-36 questionnaire in adult survivors of childhood cancer: evaluation of data quality, score reliability, and scaling assumptions

Directory of Open Access Journals (Sweden)

Winter David L

2006-10-01

Full Text Available Abstract Background The SF-36 has been used in a number of previous studies that have investigated the health status of childhood cancer survivors, but it never has been evaluated regarding data quality, scaling assumptions, and reliability in this population. As health status among childhood cancer survivors is being increasingly investigated, it is important that the measurement instruments are reliable, validated and appropriate for use in this population. The aim of this paper was to determine whether the SF-36 questionnaire is a valid and reliable instrument in assessing self-perceived health status of adult survivors of childhood cancer. Methods We examined the SF-36 to see how it performed with respect to (1 data completeness, (2 distribution of the scale scores, (3 item-internal consistency, (4 item-discriminant validity, (5 internal consistency, and (6 scaling assumptions. For this investigation we used SF-36 data from a population-based study of 10,189 adult survivors of childhood cancer. Results Overall, missing values ranged per item from 0.5 to 2.9 percent. Ceiling effects were found to be highest in the role limitation-physical (76.7% and role limitation-emotional (76.5% scales. All correlations between items and their hypothesised scales exceeded the suggested standard of 0.40 for satisfactory item-consistency. Across all scales, the Cronbach's alpha coefficient of reliability was found to be higher than the suggested value of 0.70. Consistent across all cancer groups, the physical health related scale scores correlated strongly with the Physical Component Summary (PCS scale scores and weakly with the Mental Component Summary (MCS scale scores. Also, the mental health and role limitation-emotional scales correlated strongly with the MCS scale score and weakly with the PCS scale score. Moderate to strong correlations with both summary scores were found for the general health perception, energy/vitality, and social functioning

Childhood Cancer Survivors Are Living Longer

Science.gov (United States)

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

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

Science.gov (United States)

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

2018-03-01

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

5 CFR 838.711 - Maximum former spouse survivor annuity.

Science.gov (United States)

2010-01-01

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

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.

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.

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

Science.gov (United States)

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

2017-09-01

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

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.

Promoting Exercise in Young Cancer Survivors

Science.gov (United States)

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

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

Science.gov (United States)

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

2012-11-01

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

Dysfunctional Pain Modulation in Torture Survivors

DEFF Research Database (Denmark)

Defrin, Ruth; Lahav, Yael; Solomon, Zahava

2017-01-01

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

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.

Rape Survivors' Agency within the Legal and Medical Systems

Science.gov (United States)

Greeson, Megan R.; Campbell, Rebecca

2011-01-01

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

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

5 CFR 831.645 - Elections between survivor annuities.

Science.gov (United States)

2010-01-01

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

Development of A-bomb survivor dosimetry

International Nuclear Information System (INIS)

Kerr, G.D.

1995-01-01

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

Development of A-bomb survivor dosimetry

Energy Technology Data Exchange (ETDEWEB)

Kerr, G.D.

1995-12-31

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

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.

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

Science.gov (United States)

Bhuvaneswar, Chaya; Shafer, Audrey

2004-01-01

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

Injured civilian survivors of suicide bomb attacks: from partial PTSD to recovery or to traumatisation. Where is the turning point?

Science.gov (United States)

Dolberg, Ornah T; Barkai, Gabriel; Leor, Agnes; Rapoport, Helena; Bloch, Miki; Schreiber, Shaul

2010-03-01

To assess the short- (3-9 months) and medium-term (30 months) occurrence and severity of post-traumatic stress disorder (PTSD) in civilian survivors of suicide bombing terrorist attacks. We evaluated 129 injured survivors of nine attacks in Israel who were treated in our emergency room between June 2000 and September 2002. Data on demographics, physical injuries and psychiatric symptoms were collected by both a structured clinical interview and standard assessment scales for depression, anxiety, and sleep quality. Diagnosis of PTSD was based on a Hebrew-validated DSM-IV SCID-PTSD rating scale. At the first assessment (short-term), 20 survivors (15.5%) met the criteria for full-blown PTSD and 54 (42%) for sub-clinical PTSD, while 55 (42.5%) evidenced no symptoms of PTSD. Two years later, only 54 patients could be located: 19 (35%) of them had either persistent or de novo PTSD and none had residual sub-clinical PTSD. Relatively few survivors of suicide bomb attacks had full-blown PTSD, while a substantial number of survivors had short-term sub-clinical PTSD. Two-year follow-up evaluations revealed that a significant a number of the patients available for testing (35%) had full-blown PTSD. These findings imply that medium-term follow-up of survivors is needed in order to establish the actual prevalence of PTSD.

Stakeholder validation of a model of readiness for transition to adult care.

Science.gov (United States)

Schwartz, Lisa A; Brumley, Lauren D; Tuchman, Lisa K; Barakat, Lamia P; Hobbie, Wendy L; Ginsberg, Jill P; Daniel, Lauren C; Kazak, Anne E; Bevans, Katherine; Deatrick, Janet A

2013-10-01

That too few youth with special health care needs make the transition to adult-oriented health care successfully may be due, in part, to lack of readiness to transfer care. There is a lack of theoretical models to guide development and implementation of evidence-based guidelines, assessments, and interventions to improve transition readiness. To further validate the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) via feedback from stakeholders (patients, parents, and providers) from a medically diverse population in need of life-long follow-up care, survivors of childhood cancer. Mixed-methods participatory research design. A large Mid-Atlantic children's hospital. Adolescent and young adult survivors of childhood cancer (n = 14), parents (n = 18), and pediatric providers (n = 10). Patients and parents participated in focus groups; providers participated in individual semi-structured interviews. Validity of SMART was assessed 3 ways: (1) ratings on importance of SMART components for transition readiness using a 5-point scale (0-4; ratings >2 support validity), (2) nominations of 3 "most important" components, and (3) directed content analysis of focus group/interview transcripts. Qualitative data supported the validity of SMART, with minor modifications to definitions of components. Quantitative ratings met criteria for validity; stakeholders endorsed all components of SMART as important for transition. No additional SMART variables were suggested by stakeholders and the "most important" components varied by stakeholders, thus supporting the comprehensiveness of SMART and need to involve multiple perspectives. SMART represents a comprehensive and empirically validated framework for transition research and program planning, supported by survivors of childhood cancer, parents, and pediatric providers. Future research should validate SMART among other populations with special health care needs.

Marriage and divorce among young adult cancer survivors.

Science.gov (United States)

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

2012-12-01

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

Gastric cancer in atomic bomb survivors, 2

International Nuclear Information System (INIS)

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

1992-01-01

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

Pictorial Representation of Self and Illness Measure (PRISM): a graphic instrument to assess suffering in fatigued cancer survivors

NARCIS (Netherlands)

Gielissen, M.F.M.; Prins, J.B.; Knoop, H.; Verhagen, S.; Bleijenberg, G.

2013-01-01

OBJECTIVE: The Pictorial Representation of Self and Illness Measure (PRISM) measures in a simple, graphic way the burden of suffering due to illness. The question addressed in this study is whether the PRISM is a valid instrument to measure suffering in cancer survivors experiencing severe fatigue.

FEDERAL PENSIONS: Judicial Survivors Annuities System Costs

National Research Council Canada - National Science Library

2002-01-01

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

Medical examination of ''Minashi'' atomic bomb survivor in Hiroshima-city, 1

International Nuclear Information System (INIS)

Kumazawa, Toshihiko

1978-01-01

As it is about one year (three examination terms) since health examinations for ''Minashi'' a-bomb survivors has been carried out, conditions of these examinations are described. ''Minashi'' a-bomb survivors can receive an a-bomb survivor's health notebook when they suffer from 10 damages designated by the Ministry of Public Welfare, and the number of ''Minashi'' a-bomb survivors changes frequently. ''Minashi'' a-bomb survivors who received a certificate of a recipient of the examination were 2363 at the end of 1977, and by that time, 665 of them (28.1%) also received an a-bomb survivor's health notebook instead of the certificate. Accordingly, the number of persons recognized as ''Minashi'' a-bomb survivors at the end of the year was 1703 (688 men and 1015 women). ''Minashi'' a-bomb survivors underwent health examinations at the same time and under the same way as a-bomb survivors. There were no great differences in the undergoing rate of general health examinations, the necessity rate for detailed examinations, the undergoing rate of detailed examinations, the necessity rate for treatment, and kinds of diseases requiring treatment between ''Minashi'' a-bomb survivors and those in a-bomb survivors. The undergoing rate of general health examinations was 67.6%, (45.6% in a-bomb survivors), the necessity rate for detailed examinations, 43.1% (50.1%), the undergoing rate of detailed examinations, 91.3% (93.3%), and the necessity rate for treatment, 20.3% (29.0%). The undergoing rate of general health examinations in ''Minashi'' a-bomb survivors was higher than that in a-bomb survivors, but the necessity rate for detailed examinations, the undergoing rate of detailed examination, and the necessity rate for treatment in ''Minashi'' a-bomb survivors were lower than those in a-bomb survivors. (Tsunoda, M.)

22 CFR 19.11 - Survivor benefits.

Science.gov (United States)

2010-04-01

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

Validation of the production process of core-equipment HYNIC-Bombesin-Sn; Validacion del proceso de produccion del nucleo-equipo HYNIC-Bombesina-Sn

Energy Technology Data Exchange (ETDEWEB)

Rubio C, N I [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

2008-07-01

The validation process is establishing documented evidence that provides a high degree of assurance that a specific process consistently will produce a product that will meet specifications and quality attributes preset and, therefore, ensures the efficiency and effectiveness of a product. The radiopharmaceutical {sup 99m}Tc-HYNlC-Bombesin is part of the gastrin-releasing peptide (GRP) analogues of bombesin that are radiolabelled with technetium 99 metastable for molecular images obtention. Is obtained from freeze-dry formulations kits (core- equipment)) and has reported a very high stability in human serum, specific binding to receptors and rapid internalization. Biodistribution data in mice showed rapid blood clearance with predominant renal excretion and specific binding to tissues with positive response to GRP receptors. According to biokinetics studies performed on patients with breast cancer, breast show a marked asymmetry with increased uptake in neoplastic breast in healthy women and the uptake of radiopharmaceuticals is symmetrical in both breasts. No reported adverse reactions. In this paper, the prospective validation core-equipment HYNlC-Bombesin-Sn, which was shown consistently that the product meets the specifications and quality, attributes to preset from the obtained from the diagnostic radiopharmaceutical third generation: {sup 99m}Tc-HYNlC-Bombesin. The process was successfully validated and thereby ensuring the efficiency and effectiveness of this agent as a preliminary diagnostic for approval to be marketed. (Author)

Shared Care of Childhood Cancer Survivors: A Telemedicine Feasibility Study.

Science.gov (United States)

Costello, Aimee G; Nugent, Bethany D; Conover, Noelle; Moore, Amanda; Dempsey, Kathleen; Tersak, Jean M

2017-12-01

With an increasing number of childhood cancer survivors (CCSs), determining the best model of survivorship transition care is becoming a growing priority. Shared care between pediatric oncology and adult primary care is often necessary, making survivorship a time of transition, but effective standard models are lacking. We sought to provide a more integrated approach to transition using telemedicine. Recruited primary care provider/CCS dyads were instructed to log-in to a password-protected virtual meeting room using telemedicine equipment at the time or a regularly scheduled office visit. Dyads were joined by a pediatric survivorship clinic team member who conducted the telemedicine portion of the transition visit, which consisted of the review of an individualized treatment summary and care plan. Postquestionnaires were developed to evaluate key points such as fund of knowledge, satisfaction with the visit, and effectiveness of this electronic tool. There were 19 transition visits conducted, 13 of which used the telemedicine equipment as planned. Those that did not use the equipment were primarily unable to due to technical difficulties. Postquestionnaires were overall positive, confirming increased knowledge, comfort and abilities, and patient satisfaction in survivorship care. Negative comments were primarily related to equipment difficulties. A gap still remains in helping CCSs transition from oncology to primary care and this pilot study offered insights into how we might better bridge that gap through the use of telemedicine. Further research is needed to refine the transition process for CCSs, including evaluation and testing models for standard of care.

Race and Gender Differences in One-Year Outcomes for Community-Dwelling Stroke Survivors with Family Caregivers

Science.gov (United States)

Roth, David L.; Haley, William E.; Clay, Olivio J.; Perkins, Martinique; Grant, Joan S.; Rhodes, J. David; Wadley, Virginia G.; Kissela, Brett; Howard, George

2011-01-01

Background and Purpose Previous research has reported worse outcomes after stroke for women and for African Americans, but few prospective, population-based studies have systematically examined demographic differences on long-term stroke outcomes. Race and gender differences on one-year stroke outcomes were examined using an epidemiologically-derived sample of first-time stroke survivors from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Methods Participants of REGARDS who reported a first-time stroke event during regular surveillance calls were interviewed by telephone and then completed an in-home evaluation approximately one year after the verified first-time stroke event (N = 112). A primary family caregiver was also enrolled and interviewed for each stroke survivor. Measures from the in-home evaluation included previously validated stroke outcomes assessments of neurological deficits, functional impairments, and patient-reported effects of stroke in multiple domains. Results African American stroke survivors were less likely to be living with their primary family caregivers than White participants. Analyses that controlled for age, education, and whether the stroke survivors lived with their primary family caregivers indicated that African Americans and women showed significantly greater deficits on multiple one-year outcome measures compared to Whites and men, respectively. Conclusions Among community-dwelling stroke survivors with family caregivers, women and African Americans are at heightened risk for poor long-term outcomes one year after first-time stroke events. Rehabilitation services and public health policies aimed at enhancing stroke recovery rates should address these disparities in post-stroke outcomes. PMID:21257820

Rehabilitating torture survivors

DEFF Research Database (Denmark)

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

2009-01-01

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

[Cost differences in the treatment of severe sepsis between survivors and non-survivors on the first day of intensive care admission].

Science.gov (United States)

Csomós, Akos; Szentkereszty, Zoltán; Fülesdi, Béla

2007-09-30

Patients admitted to intensive care unit with severe sepsis have high mortality and use significant resources. Determination of variable cost differences on day 1 between survivors and non-survivors of severe sepsis in Hungary. A sample of 6 intensive care units (ICU) included 70 patients who were admitted with severe sepsis to their ICU. Retrospective data collection of resource consumption for 24 hours following ICU admission using medical and nursing records. 59 different resource uses were collected separately for radiology, biochemistry and disposables. Blood products and drugs/fluids were collected individually. The authors identified the price of each resource for the cost calculation. The ICU mortality of severe sepsis in our sample was found to be 64%, the average length of stay for survivors was 19.9 (SD +/- 11.4) and for non-survivors was 13.0 (SD +/- 8.5). Mean ICU variable cost on day 1 of severe sepsis was HUF 60 957 (247 Euro), more for non-survivors (HUF 70 835 vs. 40 108, p = 0.020). The use of blood products is higher in non-survivors ( p = 0.047) and so is the use of drugs/fluids ( p = 0.003). The use of more colloids ( p = 0.016) and more expensive antibiotics ( p = 0.021) was responsible for the higher drugs/fluids spending in non-survivors. The mortality of severe sepsis is high and the cost of sepsis treatment is low in Hungary compared to international data. Non-survivors cost almost twice as much even on day 1, this warrants the need for early diagnosis and adequate treatment.

Sleep disturbances in survivors of the Nazi Holocaust.

Science.gov (United States)

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

1991-01-01

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

Individual Prediction of Heart Failure Among Childhood Cancer Survivors

NARCIS (Netherlands)

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

2015-01-01

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

Posttraumatic stress symptoms in adult survivors of childhood cancer.

Science.gov (United States)

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

2004-06-01

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

Sexual Abuse Trauma Among Chinese Survivors.

Science.gov (United States)

Luo, Tsun-yin Echo

1998-01-01

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

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

Science.gov (United States)

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

2017-07-19

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

Young adult cancer survivors and work: a systematic review.

Science.gov (United States)

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

2017-12-01

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

Validation of an HPLC–UV method for the determination of digoxin residues on the surface of manufacturing equipment

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ZORAN B. TODOROVIĆ

2009-09-01

Full Text Available In the pharmaceutical industry, an important step consists in the removal of possible drug residues from the involved equipments and areas. The cleaning procedures must be validated and methods to determine trace amounts of drugs have, therefore, to be considered with special attention. An HPLC–UV method for the determination of digoxin residues on stainless steel surfaces was developed and validated in order to control a cleaning procedure. Cotton swabs, moistened with methanol were used to remove any residues of drugs from stainless steel surfaces, and give recoveries of 85.9, 85.2 and 78.7 % for three concentration levels. The precision of the results, reported as the relative standard deviation (RSD, were below 6.3 %. The method was validated over a concentration range of 0.05–12.5 µg mL-1. Low quantities of drug residues were determined by HPLC–UV using a Symmetry C18 column (150´4.6 mm, 5 µm at 20 °C with an acetonitrile–water (28:72, v/v mobile phase at a flow rate of 1.1 mL min-1, an injection volume of 100 µL and were detected at 220 nm. A simple, selective and sensitive HPLC–UV assay for the determination of digoxin residues on stainless steel was developed, validated and applied.

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.

A review of colorectal cancer in atomic bomb survivors

International Nuclear Information System (INIS)

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

1989-01-01

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

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

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

2016-10-01

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

22 CFR 20.5 - Survivor benefits.

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2010-04-01

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

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

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

2013-01-01

Studies suggest that family caregiver well-being (ie, depressive symptoms and life satisfaction) may affect stroke survivor depressive symptoms. We used mediation analysis to assess whether caregiver well-being might be a factor explaining stroke survivor depressive symptoms, after controlling for demographic factors and stroke survivor impairments and problems. Caregiver/stroke participant dyads (N = 146) completed measures of stroke survivor impairments and problems and depressive symptoms and caregiver depressive symptoms and life satisfaction. Mediation analysis was used to examine whether caregiver well-being mediated the relationship between stroke survivor impairments and problems and stroke survivor depressive symptoms. As expected, more stroke survivor problems and impairments were associated with higher levels of stroke survivor depressive symptoms (P mediated by caregiver life satisfaction (29.29%) and caregiver depressive symptoms (32.95%). Although these measures combined to account for 40.50% of the relationship between survivor problems and impairments and depressive symptoms, the direct effect remained significant. Findings indicate that stroke survivor impairments and problems may affect family caregivers and stroke survivors and a high level of caregiver distress may result in poorer outcomes for stroke survivors. Results highlight the likely importance of intervening with both stroke survivors and family caregivers to optimize recovery after stroke.

Mental health status of A-bomb survivors in Nagasaki

International Nuclear Information System (INIS)

Nakane, Hideyuki

2012-01-01

The most survivors of disaster usually recover with few or no lasting effects on their mental health. However, in some portions of survivors, distress lasts long. The atomic bomb detonated to Nagasaki in August 1945 instantaneously destroyed almost all areas of the city, resulting in a total of ca. 73,884 deaths by the end of 1945 and about 74,909 injured people. Since the A-bomb survivors reached over 60 years of age, their mental health as well as physical health has become of great concern. Some studies on their mental health conditions have been carried out in Japan. I give an outline about a precedent study on mental health of the A-bomb survivors in this report. The mental health studies of the A-bomb survivors who paid attention to a being bombed experience, stigmatization, long-term outcome, recovery are necessary. The improvement of wide appropriate support system for the A-bomb survivors is expected in future. (author)

Clinical study of aplastic anemia among A-bomb survivors

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Oguma, N.; Dohy, H.; Kyo, T.; Saito, O.; Okita, H. (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

1980-11-01

In 90 patients with aplastic anemia who were seen at Dept. Med. RINMB, Hiroshima Univ. from 1962 to March, 1980, clinical findings of 33 A-bomb survivors (which included the second generation of the survivors) and those of 57 nonexposed patients were compared. No relationship was found between the age at the time of exposure and the period preceding onset of the disease. The A-bomb survivors showed higher neutrophil counts and higher reticulocyte counts than the nonexposed patients. There were less severe cases in the A-bomb survivors. There was no difference in the incidence of atypical aplastic anemia between the exposed patients and the nonexposed ones. No difference was found in overall survival (one-year and five-year survival rates) between the exposed and the nonexposed. The A-bomb survivors often had complete remission or maintenance of remission, and rarely had acute progression. These results suggested that clinical picture of aplastic anemia in the A-bomb survivors is different from that in the nonexposed patients.

Health examination for A-bomb survivors

International Nuclear Information System (INIS)

Ito, Chikako

1996-01-01

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

Long-term health effects among testicular cancer survivors.

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

2016-12-01

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

Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort

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Barton, Sara E.; Najita, Julie S.; Ginsburg, Elizabeth S.; Leisenring, Wendy M.; Stovall, Marilyn; Weathers, Rita E.; Sklar, Charles A.; Robison, Leslie L.; Diller, Lisa

2013-01-01

Background Prior studies have documented decreased pregnancy rates and early menopause in female cancer survivors; however, infertility rates and reproductive interventions have not been studied. This study investigates infertility and time to pregnancy among female childhood cancer survivors, and analyzes treatment characteristics associated with infertility and subsequent pregnancy. Methods The Childhood Cancer Survivor Study (CCSS) is a cohort study including five-year cancer survivors from 26 institutions who were infertility, medical treatment for infertility, the time to first pregnancy in survivors and siblings, and the risk of infertility in survivors by demographic, disease, and treatment variables were analyzed. Findings Survivors had an increased risk of clinical infertility (>1 year of attempts at conception without success) compared to siblings which was most pronounced at early reproductive ages (≤24 years Relative Risk (RR)=2·92, 95% Confidence Interval (CI) 1·18–7·20; 25–29 years RR=1·61, 95% CI 1·05–2·48; 30–39 years RR=1·37, 95% CI 1·11–1·69). Despite being equally likely to seek treatment for infertility, survivors were less likely to be prescribed medication for treatment of infertility (RR=0·57, 95% CI 0·46–0·70). Increasing doses of uterine radiation and alkylating agent chemotherapy were most strongly associated with infertility. Although survivors had an increased time to pregnancy interval (p=0·032), 64·2% (292/455) with infertility achieved a pregnancy. Interpretation A more comprehensive understanding of infertility after cancer is critical for counseling and decision-making regarding future attempts at conception as well as fertility preservation. PMID:23856401

5 CFR 831.641 - Division of a survivor annuity.

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2010-01-01

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

5 CFR 842.613 - Division of a survivor annuity.

Science.gov (United States)

2010-01-01

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

Trajectories of social isolation in adult survivors of childhood cancer.

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

2014-03-01

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

Predictors of Poststroke Health-Related Quality of Life in Nigerian Stroke Survivors: A 1-Year Follow-Up Study

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Ashiru Mohammad Hamza

2014-01-01

Full Text Available This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233 were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.

Lipid and lipoprotein abnormalities in acute lymphoblastic leukemia survivors.

Science.gov (United States)

Morel, Sophia; Leahy, Jade; Fournier, Maryse; Lamarche, Benoit; Garofalo, Carole; Grimard, Guy; Poulain, Floriane; Delvin, Edgard; Laverdière, Caroline; Krajinovic, Maja; Drouin, Simon; Sinnett, Daniel; Marcil, Valérie; Levy, Emile

2017-05-01

Survivors of acute lymphoblastic leukemia (ALL), the most common cancer in children, are at increased risk of developing late cardiometabolic conditions. However, the mechanisms are not fully understood. This study aimed to characterize the plasma lipid profile, Apo distribution, and lipoprotein composition of 80 childhood ALL survivors compared with 22 healthy controls. Our results show that, despite their young age, 50% of the ALL survivors displayed dyslipidemia, characterized by increased plasma triglyceride (TG) and LDL-cholesterol, as well as decreased HDL-cholesterol. ALL survivors exhibited lower plasma Apo A-I and higher Apo B-100 and C-II levels, along with elevated Apo C-II/C-III and B-100/A-I ratios. VLDL fractions of dyslipidemic ALL survivors contained more TG, free cholesterol, and phospholipid moieties, but less protein. Differences in Apo content were found between ALL survivors and controls for all lipoprotein fractions except HDL 3 HDL 2 , especially, showed reduced Apo A-I and raised Apo A-II, leading to a depressed Apo A-I/A-II ratio. Analysis of VLDL-Apo Cs disclosed a trend for higher Apo C-III 1 content in dyslipidemic ALL survivors. In conclusion, this thorough investigation demonstrates a high prevalence of dyslipidemia in ALL survivors, while highlighting significant abnormalities in their plasma lipid profile and lipoprotein composition. Special attention must, therefore, be paid to these subjects given the atherosclerotic potency of lipid and lipoprotein disorders. Copyright © 2017 by the American Society for Biochemistry and Molecular Biology, Inc.

Working situation of cancer survivors versus the general population.

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Lee, Myung Kyung; Yun, Young Ho

2015-06-01

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

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.

Neuropsychological Functioning in Survivors of Childhood Leukemia.

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Reeb, Roger N.; Regan, Judith M.

1998-01-01

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

Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study

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Mueller, Sabine, E-mail: muellers@neuropeds.ucsf.edu [Department of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco, San Francisco, California (United States); Fullerton, Heather J. [Department of Neurology and Pediatrics, University of California, San Francisco, San Francisco, California (United States); Stratton, Kayla; Leisenring, Wendy [Fred Hutchinson Cancer Research Center, Seattle, Washington (United States); Weathers, Rita E.; Stovall, Marilyn [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Armstrong, Gregory T. [St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Goldsby, Robert E. [Department of Pediatrics, University of California, San Francisco, San Francisco, California (United States); Packer, Roger J. [Children' s National Medical Center, Washington, District of Columbia (United States); Sklar, Charles A. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bowers, Daniel C. [University of Texas Southwestern Medical School, Dallas, Texas (United States); Robison, Leslie L.; Krull, Kevin R. [St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

2013-07-15

Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292 survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively.

Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study

International Nuclear Information System (INIS)

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

2013-01-01

Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292 survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively

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.

Clinical study of aplastic anemia among A-bomb survivors

International Nuclear Information System (INIS)

Oguma, Nobuo; Dohy, Hiroo; Kyo, Taiichi; Saito, Osamu; Okita, Hajime

1980-01-01

In 90 patients with aplastic anemia who were seen at Dept. Med. RINMB, Hiroshima Univ. from 1962 to March, 1980, clinical findings of 33 A-bomb survivors (which included the second generation of the survivors) and those of 57 nonexposed patients were compared. No relationship was found between the age at the time of exposure and the period preceding onset of the disease. The A-bomb survivors showed higher neutrophil counts and higher reticulocyte counts than the nonexposed patients. There were less severe cases in the A-bomb survivors. There was no difference in the incidence of atypical aplastic anemia between the exposed patients and the nonexposed ones. No difference was found in overall survival (one-year and five-year survival rates) between the exposed and the nonexposed. The A-bomb survivors often had complete remission or maintenance of remission, and rarely had acute progression. These results suggested that clinical picture of aplastic anemia in the A-bomb survivors is different from that in the nonexposed patients. (Ueda, J.)

Endocrinopathies in Survivors of Childhood Neoplasia

Directory of Open Access Journals (Sweden)

NICOLE S BARNES

2014-09-01

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

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

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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.

‘Today I Speak’: Exploring How Victim-Survivors Use Reddit

Directory of Open Access Journals (Sweden)

Tully O'Neill

2018-03-01

Full Text Available Digital platforms, such as Twitter, Facebook and online communities on reddit, are increasingly used by victim-survivors across the world to post about their experiences of sexual violence. Emerging research suggests a variety of reasons why victim-survivors discuss their experiences online. This article contributes to this developing area of research by exploring the underlying motivations for victim-survivors using an online rape survivor community on reddit.  This article questions how and why victim-survivors of sexual violence engage with digital technologies through content analysis of narratives posted to a public rape survivor forum on reddit. Overall, the study found that there are three primary motivators prompting survivors to access online communities: to find a supportive community; to seek advice; and for storytelling. The article uncovers some of the broader implications of online storytelling, suggesting that this is an important framework to consider online disclosures of sexual violence. Online communities like /r/rapecounseling might be conceptualised as spaces where counter-narratives of sexual violence are collectively shared.

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...

THE PREVENTION PROGRAMS OF PHYSICAL REHABILITATION FOR CHERNOBYL DISASTER SURVIVORS

Directory of Open Access Journals (Sweden)

G.V. Korobeynikov

2013-02-01

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

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

Science.gov (United States)

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

2018-05-01

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

Mental health for elder A-bomb survivors

International Nuclear Information System (INIS)

Mine, Mariko; Honda, Sumihisa; Hata, Tomoko

1994-01-01

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

Mental health for elder A-bomb survivors

Energy Technology Data Exchange (ETDEWEB)

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

1994-12-01

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

Anxiety Among Adolescent Survivors of Pediatric Cancer.

Science.gov (United States)

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

2017-10-01

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

Change in employment status of 5-year cancer survivors.

Science.gov (United States)

Torp, Steffen; Nielsen, Roy A; Fosså, Sophie D; Gudbergsson, Saevar B; Dahl, Alv A

2013-02-01

To follow the employment status of 5-year cancer survivors for 5 years after diagnosis with their first lifetime invasive cancer and to identify socio-demographic, work-related and cancer-related predictors of employment status after 5 years. This prospective registry study concerned all 3278 people in Norway (18-61 years old) diagnosed with their first lifetime invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 6368) matched by sex, age, educational level and employment status in 1998. The employment rate among male cancer survivors declined steadily every year, from 94% the year before diagnosis (1998) to 77% 5 years after diagnosis (2004). This change did not differ significantly from that of male controls. The employment rate of female survivors also declined steadily, from 87% (1998) to 69% (2004). This decline was greater than that among female controls, and in 2004 survivors had a significantly lower employment rate. For both men and women, the significant pre-diagnosis predictors of being employed in 2004 concerned higher socio-economic position. For both sexes, lung cancer survivors had the highest decline in employment rate, and male skin cancer survivors had a lower decline in employment rate than controls. Socio-demographic and work-related factors explained more of the variance in employment status than did cancer diagnosis. The employment rate among 5-year cancer survivors did not change significantly except for female survivors. Low socio-economic position is a risk factor for decline in employment rate and should be focused on to prevent cancer-related inequity.

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

Science.gov (United States)

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

2017-01-01

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

A Comparison of Psychological Symptoms in Survivors of Sex and Labor Trafficking.

Science.gov (United States)

Hopper, E K; Gonzalez, L D

2018-03-20

Human trafficking is a form of interpersonal trauma that has significant mental health impacts on survivors. This study examined psychological symptoms in 131 survivors of sex and labor trafficking, including people trafficked into or within the U.S. High rates of depression (71%) and PTSD (61%) were identified. Two thirds of survivors also met criteria for multiple categories of Complex PTSD (C-PTSD), including affect dysregulation and impulsivity; alterations in attention and consciousness; changes in interpersonal relationships; revictimization; somatic dysregulation; and alterations in self-perception. Although there were not significant differences in the prevalence rates of diagnoses of PTSD or depression between survivors of sex and labor trafficking, important group differences were identified. Compared to survivors of labor trafficking, sex trafficking survivors had higher prevalence rates of pre-trafficking childhood abuse and a higher incidence of physical and sexual violence during trafficking. They reported more severe post-trauma reactions than labor trafficking survivors, including more PTSD and C-PTSD symptoms. They were also more likely to meet criteria for comorbid PTSD and depression, while labor trafficking survivors were more likely than sex trafficking survivors to meet criteria for depression alone. An analysis of gender differences found that trafficking survivors who identified as transgender endorsed more PTSD and C-PTSD symptoms, than male or female survivors. Childhood abuse exposure was linked to PTSD and C-PTSD in trafficking survivors, and trafficking type was predictive of the number of trauma-related symptoms beyond the role of pre-trafficking child abuse. Implications for assessment and intervention with trafficking survivors are discussed.

Innovation in survivor care: group visits.

Science.gov (United States)

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

2011-04-01

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

[Psychosocial issues of long-term cancer survivors].

Science.gov (United States)

Weis, J; Faller, H

2012-04-01

Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

Marital status and optimism score among breast cancer survivors.

Science.gov (United States)

Croft, Lindsay; Sorkin, John; Gallicchio, Lisa

2014-11-01

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

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

Science.gov (United States)

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

2016-01-01

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

Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors

Science.gov (United States)

Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter; Brasso, Klaus; Johansen, Christoffer; Rørth, Mikael; Midtgaard, Julie

2014-01-01

As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes increased risk of heart disease, diabetes and osteoporosis. Epidemiological evidence points to a positive effect of regular physical activity on all-cause and prostate cancer mortality and current clinical evidence supports the use of exercise in cancer rehabilitation. However, the external validity of existing exercise studies is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport environments, the study offers a novel approach in the strive towards sustained physical activity adherence and accessibility in prostate cancer survivors. PMID:24865394

Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors

Directory of Open Access Journals (Sweden)

Ditte Marie Bruun

2014-05-01

Full Text Available As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes increased risk of heart disease, diabetes and osteoporosis. Epidemiological evidence points to a positive effect of regular physical activity on all-cause and prostate cancer mortality and current clinical evidence supports the use of exercise in cancer rehabilitation. However, the external validity of existing exercise studies is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport environments, the study offers a novel approach in the strive towards sustained physical activity adherence and accessibility in prostate cancer survivors.

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

Science.gov (United States)

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

2015-11-01

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

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

DEFF Research Database (Denmark)

Lilja, G; Nilsson, G; Nielsen, N

2015-01-01

AIM: Survivors of out-of-hospital cardiac arrest (OHCA) may experience psychological distress but the actual prevalence is unknown. The aim of this study was to investigate anxiety and depression within a large cohort of OHCA-survivors. METHODS: OHCA-survivors randomized to targeted temperature o...

Identification of PTSD in cancer survivors.

Science.gov (United States)

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

1996-01-01

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

Contraceptive Practices Among Female Cancer Survivors of Reproductive Age.

Science.gov (United States)

Dominick, Sally A; McLean, Mamie R; Whitcomb, Brian W; Gorman, Jessica R; Mersereau, Jennifer E; Bouknight, Janet M; Su, H Irene

2015-09-01

To compare rates of contraception between reproductive-aged cancer survivors and women in the general U.S. Among survivors, the study examined factors associated with use of contraception and emergency contraception. This study analyzed enrollment data from an ongoing national prospective cohort study on reproductive health after cancer entitled the Fertility Information Research Study. We compared current contraceptive use in survivors with that of the general population ascertained by the 2006-2010 National Survey for Family Growth. Log-binomial regression models estimated relative risks for characteristics associated with use of contraception, World Health Organization tiers I-II (sterilization and hormonal) contraceptive methods, and emergency contraception in survivors. Data from 295 survivors (mean age 31.6±5.7 years, range 20-44 years) enrolled in this prospective study (85% response rate) were examined. Age-adjusted rates of using tiers I-II contraceptive methods were lower in survivors than the general population (34% [28.8-40.0] compared with 53% [51.5-54.5], Pfamily planning services (counseling, prescription or procedure related to birth control) since cancer diagnosis. In adjusted analysis, receipt of family planning services was associated with both increased use of tiers I-II contraceptive methods (relative risk 1.3, 95% confidence interval [CI] 1.1-1.5) and accessing emergency contraception (relative risk 5.0, 95% CI 1.6-16.3) in survivors. Lower rates of using tiers I-II contraceptive methods were found in reproductive-aged cancer survivors compared with the general population of U.S. women. Exposure to family planning services across the cancer-care continuum may improve contraception use among these women. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01843140. II.

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.

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

Science.gov (United States)

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

2015-01-01

This article uses qualitative methods to describe the domains of health-related quality of life (HRQoL) that adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors identify as important. Survivors clearly attributed aspects of their current HRQoL to their disease or its treatment. We identified 7 key domains of AYA CNS tumor survivorship: physical health, social well-being, mental health, cognitive functioning, health behaviors, sexual and reproductive health, and support systems. Although most aspects of HRQoL that survivors discussed represented new challenges, there were several areas where survivors pointed out positive outcomes. There is a need for a HRQoL tool designed for this population of survivors, given their unique treatment and survivorship experience. Aspects of HRQoL related to cognition, sexual and reproductive health, health behaviors, and support systems are not typically included in generic HRQoL tools but should be assessed for this population. Developing HRQoL measurement instruments that capture the most significant aspects of HRQoL will improve the ability to track HRQoL in AYA CNS tumor survivors and in the long-term management of common sequelae from CNS tumors and their treatments. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Illness perceptions among cancer survivors.

Science.gov (United States)

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

2016-03-01

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

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.

Breast cancer survivors: return to work and wage loss in selected hospitals in Malaysia.

Science.gov (United States)

Su, T T; Azzani, M; Tan, F L; Loh, S Y

2018-05-01

This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors. A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors. A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning > RM 2000) is a protective factor against the risk of reduced wages or wage loss. Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.

Psychological vulnerability and resilience of Holocaust survivors engaged in creative art.

Science.gov (United States)

Diamond, Shira; Shrira, Amit

2018-06-01

Although evidence demonstrates that engagement in art promotes favorable coping with trauma, this subject is underexplored among Holocaust survivors. Thus, the present study explored whether Holocaust survivors engaged in art differed from survivors not engaged in art in various markers of psychological vulnerability and resilience. The study further included non-Holocaust survivor comparisons, some engaged in art and some not, in order to assess whether engagement in art among Holocaust survivors relates to a unique psychological profile beyond art engagement in general. A sample of 154 community-dwelling older adults (mean age = 81.67, SD = 5.33, range = 73-97) reported exposure to the Holocaust, current engagement in art, posttraumatic stress disorder (PTSD) symptoms, general psychological distress, resilience and subjective perceptions of age and aging. Holocaust survivors (regardless of whether they engaged in art or not) reported higher PTSD symptoms relative to comparisons. However, Holocaust survivors who engaged in art reported higher resilience than all other groups (survivors not engaged in art and comparisons engaged and not engaged in art). To the best of our knowledge, these findings are the first quantitative evidence pointing toward a link between engagement in art and positive coping with the Holocaust. These findings have important implications for clinicians working with Holocaust survivors. Copyright © 2018 Elsevier B.V. All rights reserved.

Correlates of Sun Protection and Sunburn in Children of Melanoma Survivors.

Science.gov (United States)

Tripp, Mary K; Peterson, Susan K; Prokhorov, Alexander V; Shete, Sanjay S; Lee, Jeffrey E; Gershenwald, Jeffrey E; Gritz, Ellen R

2016-09-01

Sunburns during childhood increase melanoma risk. Children of melanoma survivors are at higher risk, but little is known about their sunburn and sun protection. One study showed that almost half of melanoma survivors' children experienced sunburn in the past year. This study evaluated sunburn and sun protection in melanoma survivors' children, and relevant survivor characteristics from Social Cognitive Theory and the Health Belief Model. Melanoma survivors (N=340) were recruited from a comprehensive cancer center. Survivors completed a baseline questionnaire administered by telephone to report on the behavior of their children (N=340) as part of an RCT of a sun protection intervention. Data were collected in 2008 and analyzed in 2015. In the prior 6 months, 28% of children experienced sunburn. "Always" or "frequent" sun protection varied by behavior: sunscreen, 69%; lip balm, 15%; wide-brimmed hats, 9%; sleeved shirts, 28%; pants, 48%; sunglasses, 10%; shade, 33%; and limiting time outdoors, 45%. Survivors' sunburn and sun protection were positively associated with these outcomes in children. Correlates of sunburn also included older child age and higher risk perceptions. Correlates of sun protection behaviors included younger child age; stronger intentions, higher self-efficacy, and more positive outcome expectations about sun protection; and greater number of melanomas in survivors. Melanoma survivors may have a heightened awareness of the importance of their children's sun protection, but their children are not routinely protected. Correlates of children's sunburn and sun protection suggest subgroups of survivors to target with interventions to improve sun protection. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Clinical studies on gastric cancer and breast cancer among A-bomb survivors

Energy Technology Data Exchange (ETDEWEB)

Yamagata, S; Ohya, M; Nagusa, Y; Harada, T; Tani, T [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

1977-04-01

Fifty-five cases of gastric cancer and 14 cases of breast cancer among A-Bomb survivors, which had been treated at Dept. of Surgery, Research Institute for Nuclear Medicine and Biology of Hiroshima Univ., were discussed. Both gastric cancer and breast cancer were recognized more in A-Bomb survivors of advanced age. Particularly, the number of gastric cancer in A-Bomb survivors of over 65-year old was about double the number of unexposed persons. Ratio of male to female in A-Bomb survivors with gastric cancer was 1.6:1, and the ratio of female was higher as compared to the ratio in unexposed persons (2.6:1). Gastric cancer of stage III and IV in A-Bomb survivors was 54.5%, and advanced cancer was comparatively few in A-Bomb survivors as compared to in unexposed persons (78.2%). Similarly, comparatively early stage breast cancer of stage I and II was recognized more in A-Bomb survivors. Particularly, T/sub 1/ and T/sub 2/ in which tumor was small in size showed very high percentage of 92.9% in A-Bomb survivors. In gastric cancer in A-Bomb survivors, poorly differentiated adenocarcinoma showed the highest percentage of 34.5%. However, there was no significant difference according to the exposure conditions. As to histological type of breast cancer, medullary tubular adenocarcinoma abounds mostly in both A-Bomb survivors (71.4%) and unexposed persons (75.9%). As the influence of operation, anemia was recognized before operation strongly in A-Bomb survivors with gastric cancer of over 65-year old. After the operation, transient rise of GOT and GPT was recognized in A-Bomb survivors of advanced age with gastric cancer. However, there was no difference in postoperative complications between A-Bomb survivors and unexposed persons.

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.

Diagnosis and treatment of leukemia recognized in atomic-bomb survivors

Energy Technology Data Exchange (ETDEWEB)

Ichimaru, M [Nagasaki Univ. (Japan). School of Medicine

1978-05-01

Out of atomic bomb survivors in Hiroshima and Nagasaki, 256 patients which were diagnosed as having leukemia by 1975 and of which exposure dose was estimated as over 1 rad were described. Chronic myelocytic leukemia (CGL) was plentiful in Hiroshima, and acute myelocytic leukemia (AGL) was comparatively plentiful in Nagasaki. Chronic lymphatic leukemia (CLL) was not recognized in the atomic bomb survivors exposed at places near the center of the explosion, but CLL was recognized plentifully in the atomic bomb survivors exposed to radiation of under 1 rad. The incidence of leukemia according to the total dose was higher in Hiroshima than in Nagasaki. When RBE of neutron on the occurrence of leukemia was considered to be five times that of gamma-ray, the occurrence curves in both cities were consistent well. As to a relationship between leukemia in the atomic bomb survivors and the age at the exposure time, CGL occurred early in the atomic bomb survivors exposed at an early age. A specific lesion of leukemia in the atomic bomb survivors was not recognized, but cases of which leukemia cells were negative to peroxidase and were very difficult to be identified were plentiful in the atomic bomb survivors exposed within 2 km from the explosion center. The treatment of leukemia in atomic bomb survivors does not differ from that of general leukemia, but a method of treatment, administration dosage, a method and a kind of supportive care must be discussed according to each case.

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

Directory of Open Access Journals (Sweden)

Luzius Mader

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

Aspects of mental health dysfunction among survivors of childhood cancer.

Science.gov (United States)

Fidler, Miranda M; Ziff, Oliver J; Wang, Sarra; Cave, Joshua; Janardhanan, Pradeep; Winter, David L; Kelly, Julie; Mehta, Susan; Jenkinson, Helen; Frobisher, Clare; Reulen, Raoul C; Hawkins, Michael M

2015-09-29

Some previous studies have reported that survivors of childhood cancer are at an increased risk of developing long-term mental health morbidity, whilst others have reported that this is not the case. Therefore, we analysed 5-year survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS) to determine the risks of aspects of long-term mental health dysfunction. Within the BCCSS, 10 488 survivors completed a questionnaire that ascertained mental health-related information via 10 questions from the Short Form-36 survey. Internal analyses were conducted using multivariable logistic regression to determine risk factors for mental health dysfunction. External analyses were undertaken using direct standardisation to compare mental health dysfunction in survivors with UK norms. This study has shown that overall, childhood cancer survivors had a significantly higher prevalence of mental health dysfunction for 6/10 questions analysed compared to UK norms. Central nervous system (CNS) and bone sarcoma survivors reported the greatest dysfunction, compared to expected, with significant excess dysfunction in 10 and 6 questions, respectively; the excess ranged from 4.4-22.3% in CNS survivors and 6.9-15.9% in bone sarcoma survivors. Compared to expected, excess mental health dysfunction increased with attained age; this increase was greatest for reporting 'limitations in social activities due to health', where the excess rose from 4.5% to 12.8% in those aged 16-24 and 45+, respectively. Within the internal analyses, higher levels of educational attainment and socio-economic classification were protective against mental health dysfunction. Based upon the findings of this large population-based study, childhood cancer survivors report significantly higher levels of mental health dysfunction than those in the general population, where deficits were observed particularly among CNS and bone sarcoma survivors. Limitations were also observed to increase

Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: A comparison between total laparoscopy and laparotomy.

Science.gov (United States)

Xiao, Meizhu; Gao, Huiqiao; Bai, Huimin; Zhang, Zhenyu

2016-09-01

The aim of the present study was to evaluate the possible differences between total laparoscopy and laparotomy regarding their impact on postoperative quality of life and sexuality in disease-free cervical cancer survivors who received radical hysterectomy (RH) and/or lymphadenectomy alone and were followed for >1 year.We reviewed all patients with cervical cancer who had received surgical treatment in our hospital between January 2001 and March 2014. Consecutive sexually active survivors who received RH and/or lymphadenectomy for early stage cervical cancer were enrolled and divided into 2 groups based on surgical approach. Survivors were interviewed and completed validated questionnaires, including the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items, the Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).In total, 273 patients with histologically confirmed cervical cancer were retrospectively reviewed. However, only 64 patients had received RH and/or lymphadenectomy alone; 58 survivors meeting the inclusion criteria were enrolled, including 42 total laparoscopy cases and 16 laparotomy cases, with an average follow-up of 46.1 and 51.2 months, respectively. The survivors in the 2 groups obtained good and similar scores on all items of the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items and Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items, without significant differences after controlling for covariate background characteristics. To the date of submission, 21.4% (9/42) of cases in the total laparoscopy group and 31.2% (5/16) of cases in the laparotomy group had not resumed sexual behavior after RH. Additionally

The Lifestyle Change Experiences of Cancer Survivors.

Science.gov (United States)

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

2017-10-01

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

Cancer Survivor Responses to Socratic Dialogue

DEFF Research Database (Denmark)

Knox, Jeanette Bresson Ladegaard

2017-01-01

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

Small Portable Analyzer Diagnostic Equipment (SPADE) Program -- Diagnostic Software Validation

Science.gov (United States)

1984-07-01

Electronic Equipment Electromagnetic Emission and Susceptibility Requirements for the Control of Electromagnetic Interference Electromagnetic...ONLY. ORIENTATION OF DEFECT LOOKING HHO QIlILL: t -ed’-o· Significant efforts were expended to simulate spalling failures associated with naturally

Malignant Lymphoma in an Atomic-bomb Survivor

Directory of Open Access Journals (Sweden)

Cheng-Chia Lee

2009-07-01

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

Nutritional interventions for survivors of childhood cancer.

Science.gov (United States)

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

2016-08-22

2012). We included all randomised controlled trials (RCTs) that compared the effects of a nutritional intervention with a control group which did not receive the intervention in this review. Participants were childhood cancer survivors of any age, diagnosed with any type of cancer when less than 18 years of age. Participating childhood cancer survivors had completed their treatment with curative intent prior to the intervention. Two review authors independently selected and extracted data from each identified study, using a standardised form. We assessed the validity of each identified study using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. We used the GRADE criteria to assess the quality of each trial. Three RCTs were eligible for review. A total of 616 participants were included in the analysis. One study included participants who had been treated for acute lymphoblastic leukaemia (ALL) (275 participants). Two studies included participants who had all forms of paediatric malignancies (266 and 75 participants). All participants were less than 21 years of age at study entry. The follow-up ranged from one month to 36 months from the initial assessment. All intended outcomes were not evaluated by each included study. All studies looked at different interventions, and so we were unable to pool results. We could not rule out the presence of bias in any of the studies.There was no clear evidence of a difference in calcium intake at one month between those who received the single, half-day, group-based education that focused on bone health, and those who received standard care (mean difference (MD) 111.60, 95% confidence interval (CI) -258.97 to 482.17; P = 0.56, low quality evidence). A regression analysis, adjusting for baseline calcium intake and changes in knowledge and self-efficacy, showed a significantly greater calcium intake for the intervention as compared with the control group at the one-month follow-up (beta

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

Science.gov (United States)

Farren, Arlene T

2015-09-01

The purpose of this article is to present the findings of a literature review regarding the use of Leininger's ethnonursing research methodology (ENRM) in studies addressing adult cancer survivors. It is important to learn about differences and similarities among cancer survivors' experiences so that patient-centered, culturally congruent care can be provided. A review of the literature was conducted using databases such as CINAHL and MEDLINE. Search terms included variations on ENRM and cancer survivors. The results were a small number of published studies that used the ENRM examining breast cancer survivors' perceptions and experiences. A review instrument was developed to estimate study quality based on established criteria. The studies are critiqued in relation to the theory-based methodology, evaluation criteria for qualitative research, and study findings are summarized. The author concludes that although there is a paucity of research using ENRM with adult cancer survivors, the preliminary findings of the included studies contribute to what is known about breast cancer survivors. Implications for research include recommendations to increase the use of ENRM to discover the universal and diverse experiences of care practices in adult cancer survivors and use the evidence to develop patient-centered, culturally congruent, quality care for cancer survivors. © The Author(s) 2014.

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.

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-02-15

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

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

International Nuclear Information System (INIS)

Robison, Leslie L.

2009-01-01

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

Understanding How Domestic Violence Shelter Rules May Influence Survivor Empowerment.

Science.gov (United States)

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

2017-10-01

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

Persistent Fatigue in Hematopoietic Stem Cell Transplantation Survivors.

Science.gov (United States)

Hacker, Eileen Danaher; Fink, Anne M; Peters, Tara; Park, Chang; Fantuzzi, Giamila; Rondelli, Damiano

Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment. The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25). Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance. Survivors of HCT reported increased physical (P < .001), mental (P < .001), and overall (P < .001) fatigue as well as increased anxiety (P < .05) and depression (P < .01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P < .001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P < .001) and interleukin-6 (P < .05) levels were significantly higher in HCT survivors. Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers. This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.

Survivors' perspective of life after stroke

Directory of Open Access Journals (Sweden)

Jaine Kareny da Silva

2016-03-01

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

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

Neoplasms among atomic bomb survivors in Hiroshima City. First report

Energy Technology Data Exchange (ETDEWEB)

Harada, Tomin; Ishida, Morihiro

1960-04-01

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

Long-survivors of glioblatoma treated with boron neutron capture therapy (BNCT)

International Nuclear Information System (INIS)

Kageji, T.; Mizobuchi, Y.; Nagahiro, S.; Nakagawa, Y.; Kumada, H.

2011-01-01

The purpose of this study was to compare the radiation dose between long-survivors and non-long-survivors in patients with glioblatoma (GBM) treated with boron neutron capture therapy (BNCT). Among 23 GBM patients treated with BNCT, there were five patients who survived more than three years after diagnosis. The physical and weighted dose of the minimum gross tumor volume (GTV) of long-survivors was much higher than that of non-long survivors with significant statistical differences.

Stigma Among Survivors of Sexual Violence in Congo: Scale Development and Psychometrics.

Science.gov (United States)

Murray, Sarah McIvor; Robinette, Katie L; Bolton, Paul; Cetinoglu, Talita; Murray, Laura K; Annan, Jeannie; Bass, Judith K

2018-02-01

Stigma related to sexual violence (SV) is associated with many negative physical and social outcomes. We sought to create a contextually relevant measure of SV-related stigma for women in the Democratic Republic of Congo (DRC) and assess itspsychometrics and validity. Using baseline screening data from two randomized controlled trials of services for female SV survivors in Eastern DRC ( n = 1,184), we conducted exploratory and confirmatory factor analyses to test the measurement model. Cronbach's alphas and Kuder-Richardson 20 (KR-20) statistics were used to evaluate internal consistency. Logistic and linear regressions of the stigma measures with related constructs were used to assess construct validity. Two distinct but related scales were developed based on factor analyses: a four-item scale of discrimination-related stigma (i.e., enacted stigma) and an eight-item scale of combined perceived and internalized stigma (i.e., felt stigma). Both scales showed good internal consistency (KR-20 = .68; α = .86). A higher felt stigma score was associated with significant increases in combined depression and anxiety and trauma symptoms, as well as functional impairment ( p < .001). Having a child as a result of SV was associated with both significantly higher enacted and felt stigma ( p < .001). Neither SV stigma scale was associated with medical care seeking. To address harmful ramifications of stigma among SV survivors, locally relevant quantitative measures are necessary to understand the nature and severity of stigma they experience. Our process of scale creation and evaluation can serve as an example for developing locally relevant SV-related stigma measures.

Health status of atomic bomb survivors in South Korea, 2

International Nuclear Information System (INIS)

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

1980-01-01

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

Memories of Parent Behaviors and Adult Attachment in Childhood Cancer Survivors.

Science.gov (United States)

Lehmann, Vicky; Hagedoorn, Mariët; Gerhardt, Cynthia A; Keim, Madelaine C; Guthrie, Lory; Sanderman, Robbert; Tuinman, Marrit A

2017-03-01

Childhood cancer is stressful for the entire family. Preoccupation and anxiety surrounding the child's illness may result in parents of children with cancer being overprotective or less emotionally responsive toward their children. Such parenting in response to a negative life event like childhood cancer may cause survivors to be more insecurely attached than healthy peers, which could have downstream effects on survivors' romantic relationships later in life. Therefore, we examined survivors' perspectives on parent behaviors, adult attachment, and marital status among adult survivors of childhood cancer relative to controls. One hundred forty-nine young adult survivors and 149 matched controls (M age  = 28, range 20-40) indicated their relationship status (single vs. partnered) and completed standardized questionnaires assessing memories of upbringing (warmth, overprotection, rejection) and adult attachment (avoidance, anxiety). Adult survivors of childhood cancer remembered mothers and fathers as emotionally warmer (d = 0.53/0.30), and mothers as less rejecting than controls (d = 0.30). Adult attachment was overall similar between survivors and controls, but partnered survivors reported particularly low attachment-related anxiety. Childhood cancer was related to higher mother and father warmth, which were associated with lower attachment-related avoidance and in turn with a greater likelihood of being in a relationship. Adult childhood cancer survivors did not remember their parents as overprotective, but reported more positive parenting relative to controls; and similar adult attachment and relationship status. The results were unexpected, but offer novel insights for future prospective studies, which are necessary to better understand psychosocial late effects of childhood cancer.

Research on the Emergence Modeling of Equipment System

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He Xin-Hua

2017-01-01

Full Text Available Under the conditions of information, the network-centric system and the confrontation in the system has developed into a major combat style. But the traditional line of sexual assessment method is difficult to accurately assess the information equipment system combat capability. Therefore, this paper studies the effective evaluation method of the operational capability of the information equipment system from the perspective of emerge. Based on the simulation modeling and evaluation method, building the capability model of the weapon equipment system to evaluate the operational capability of the information weapon weaponry equipment. Through the example analysis, the validity of the simulation model and the practicability of the evaluation system is analyzed by analyzing the examples.

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

Science.gov (United States)

Prince, Robert M

2015-09-01

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

Leukemia among a-bomb survivors living in Hiroshima city, 1971-1978

International Nuclear Information System (INIS)

Kawakami, Masahito; Takahashi, Hiroshi; Ohkita, Takeshi; Hayakawa, Norihiko

1980-01-01

The death from leukemia among Hiroshima citizens from 1971 to 1978 was investigated. The total number of dead citizens was 241, and 64 of them were a-bomb survivors. Thirty-seven of a-bomb survivors were exposed to a-bomb within 2 km from hypocenter. Seventy-seven of remaining 177 citizens were born after the explosion of a-bomb, but they were not children of a-bomb survivors exposed directly to a-bomb. The mortality of a-bomb survivors exposed near the hypocenter was 1.67 (within 2 km) - 2.51 (within 1.5 km) times that of those exposed far from the hypocenter. The mortality of a-bomb survivors exposed within 1.5 km was significantly high. The death risk from leukemia was significantly high in women. The estimated exposure dose was over 1 rad in 25 of abovementioned 37 a-bomb survivors, and it was over 10 rad in 21 and over 100 rad in 10 of 25. Seven of 10 a-bomb survivors exposed over 100 rad were women. The age at the exposure was under 10 years in 1, teens in 1, twenties in 2, and over thirty in 6. The type of leukemia was acute in 8 and chronic in 2. Both types were myelogenous leukemia. Five of these 10 a-bomb survivors died after 1976. (Tsunoda, M.)

Leukemia in atomic bomb survivors. 1. General observations. Leukemia in survivors of atomic bombing. Cytologic and biochemical studies on the granulocytes in early leukemia among atomic bomb survivors. Leukemogenic effects of ionizing radiation on atomic bomb survivors in Hiroshima City

Energy Technology Data Exchange (ETDEWEB)

Lange, R D; Moloney, W C; Yamawaki, Tokuso; Kastenbaum, M A

1959-01-01

This document contains 4 separate reports on leukemia in survivals of the atomic explosions in Hiroshima and Nagasaki. In the first report, observations on seventy-five established cases of leukemia occurring in people exposed to atomic bomb radiation are presented. These data indicate a great increase in the incidence of leukemia among atomic bomb survivors due to a single massive exposure to ionizing radiation. The leukemogenic effects of radiation are manifested equally in both sexes and at all age levels represented in this series. The striking preponderance of chronic myelogenous leukemia compared to chronic lymphatic leukemia has been noted in exposed individuals but it is pointed out that chronic lymphatic leukemia is comparatively rare among the Japanese. Cases of leukemia are still appearing in atomic bomb survivors. However, since 1950 there has been a steady decline in the number of cases. The second report consists of a review of all cases of leukemia referred to the ABCC from 1948 to April 1952, a total of 75 cases. In the third report, hematological and biochemical findings in separated leukocytes of four cases of preclinical myelogenous leukemia developing in atomic bomb survivors are described. The incidence of leukemia among survivors in Hiroshima is the topic of the fourth report. 38 references, 8 figures, 10 tables.

Depression among female survivors of domestic violence in ...

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2015-01-01

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

Study of gastric cancer in atomic bomb survivors

International Nuclear Information System (INIS)

Takayama, Sadamatsu; Tadehara, Futoshi; Okusaki, Ken; Ito, Yoshiko; Ogawa, Junichiro; Kato, Masafumi; Ito, Chikako; Oyama, Hiroko; Mito, Kazuyo.

1990-01-01

Ten gastric cancer A-bomb survivors who had been false negative in mass screening for gastric cancer one year before the diagnosis were entered in a study determining an adequate interval of gastric mass screening for A-bomb survivors. Doubling time of cancer was determined on X-ray films. Of the 10 A-bomb survivors, 8 had entered the city after the bombing and the other two had been exposed at 1,700 m and 2,500 m, respectively, from the hypocenter. Six had early gastric cancer and the other 4 had advanced cancer. Doubling time averaged 19.1 months for early cancer and 7.6 months for advanced cancer. Three measurements of tumor diameter available for 4 A-bomb survivors revealed a very rapid increase in doubling time during the progression period from early to advanced cancer. An interval of one year seems to be adequate in mass screening to detect early cancer. (N.K.)

The current mortality rates of A-bomb survivors in Nagasaki-city

International Nuclear Information System (INIS)

Mine, Mariko; Nakamura, Tsuyoshi; Mori, Hiroyuki; Kondo, Hisayoshi; Okajima, Shunzo

1981-01-01

The purpose of the paper is to describe and investigate the death rate of about 110,000 A-Bomb survivors who have been registered in Nagasaki-city since 1957. There were 7,780 deaths among the A-Bomb survivors during 1970 -- 76 from which the age-specific death rates are calculated and compared with those of non-exposed controls in Nagasaki-city. The results are as follows: (1) The age-specific death rates by all causes of A-Bomb survivors are lower than those of the controls. (2) The age-specific death rates by the cerebrovascular disease (ICD 430 - 438) are also lower in A-Bomb survivors than in others. (3) The age-specific death rates by all malignant neoplasms are nearly the same between A-Bomb survivors and the controls. It is strongly suggested from these results that, although there may still exist a number of A-Bomb survivors having been suffered from the late effects of radiation, financial or medical aid supplied by the ministry and other organizations have done good work in advancing the health care of A-Bomb survivors. (author)

Non-pharmacological interventions for caregivers of stroke survivors.

Science.gov (United States)

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

2011-10-05

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

Vitamin D status among long-term survivors of testicular cancer.

Science.gov (United States)

Schepisi, Giuseppe; De Padova, Silvia; Scarpi, Emanuela; Lolli, Cristian; Gurioli, Giorgia; Menna, Cecilia; Burgio, Salvatore L; Rossi, Lorena; Gallà, Valentina; Casadio, Valentina; Salvi, Samanta; Conteduca, Vincenza; De Giorgi, Ugo

2017-05-30

A correlation between disturbances in hormone levels and the onset of metabolic disorders has been reported in long-term survivors of testicular cancer (TC).We evaluated serum vitamin D levels and other biological parameters in a consecutive series of 61 long-term (≥3 years) unilateral TC survivors with a median a follow-up of 4 years and in a cohort of healthy males. Deficient vitamin D levels were observed in 10 (17%) of the 58 long-term unilateral TC survivors but were not reported in healthy males (p=.019, Fisher test). Median vitamin D levels were 18.6 ug/L in 58 assessable TC survivors and 23.6 ug/L in 40 healthy males (p=.031). In univariate logistic regression analysis, TC diagnosis was associated with inadequate levels of vitamin D (p=.047). Vitamin D levels were lower when follow-up was > 10 years, albeit this difference was not statistically significant (p=.074). Long-term (especially > 10 years) TC survivors may have difficulty maintaining optimal vitamin D levels. Larger studies are needed to better characterize vitamin D status and possible correlations with premature hormonal aging reported in long-term TC survivors.

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

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Sihan Song

2015-12-01

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

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

Science.gov (United States)

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

2018-01-01

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

5 CFR 843.313 - Elections between survivor annuities.

Science.gov (United States)

2010-01-01

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

Quality of life of adult retinoblastoma survivors in the Netherlands

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Cohen-Kettenis Peggy T

2007-06-01

Full Text Available Abstract Background To assess the quality of life (QoL and predictors thereof in Dutch adult hereditary and non-hereditary retinoblastoma (RB survivors. Methods In this population-based cross-sectional study, a generic QoL questionnaire (SF-36 and a disease-specific interview were administered to 87 adult RB survivors aged 18 to 35 years. Their QoL data were compared with those of a Dutch healthy reference group. Among the RB hereditary/non-hereditary survivors, the QoL was compared and predictors for QoL were identified by linear multiple regression analyses. Results As a group, RB survivors scored significantly lower than the reference group on the SF-36 subscale 'mental health' (t = -27, df = 86, p Conclusion In this exploratory study, it appears that the group of adult RB survivors experience a relatively good overall but slightly decreased QoL compared with the reference group. However, they report more problems with regard to their mental health (anxiety, feelings of depression, and loss of control. Hereditary RB survivors differ significantly from non-hereditary RB survivors only in 'general health'. Bullying in childhood and subjective experience of impairment are the main predictors of a worse QoL. In order to prevent worsening of QoL, or perhaps to improve it, clinicians should make an inventory of these issues at an early stage. We recommend further research to assess the specific psychological factors that may lead to mental health problems in this population.

Employment status and health related quality of life among Hodgkin-lymphoma survivors'- results based on data from a major treatment center in Hungary.

Science.gov (United States)

Magyari, Ferenc; Kósa, Karolina; Berecz, Roland; Illés, Anna; Miltényi, Zsófia; Simon, Zsófia; Illés, Árpád

2017-09-19

Due to risk and response adapted treatment strategies, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured, and become long-term survivors. However, a high proportion of survivors suffer from treatment-related long-term side effects such as secondary malignancy, organ failure, persistent fatigue and psychological distress. The aim of this study was to evaluate psychological distress and its risk factors among our HL survivors. One hundred sixty-three (50% female) adult HL survivors were contacted between January 1, 2012 and march 31, 2015 in our outpatient centre. The patients were asked to complete a standardized, validated, self-administered Hungarian questionnaire with demographic questions and the following scales: Hospital anxiety and depression scale (HADS14), general health questionnaire (GHQ12), sense of coherence (SOC13) perceived stress scale (PSS4), dysfunctional attitude scale (DAS17). Disease and treatment data were acquired from hospital records. Majority of HL survivors are in early adulthood, our most important goal should be to return them to normal life after their lymphoma is cured. The employment status at the time of survey seemed to be crucial so patients were divided into either active (n = 93) or inactive (n = 47) group. Retired survivors (n = 19) were excluded from the subgroup analysis. Psychological distress was significantly lower in active patients. Multiple logistic regression analysis showed significant differences between the inactive and active subgroups, such as age at diagnosis (≥30 years or below, p = 0.001), education level (below college vs. college, p = 0.032) and treatment related long-term side effects (yes vs. no, p employment status and treatment-related long-term side effects play a critical role in the health related quality of life outcome among Hungarian HL survivors.

Cleaning verification: A five parameter study of a Total Organic Carbon method development and validation for the cleaning assessment of residual detergents in manufacturing equipment.

Science.gov (United States)

Li, Xue; Ahmad, Imad A Haidar; Tam, James; Wang, Yan; Dao, Gina; Blasko, Andrei

2018-02-05

A Total Organic Carbon (TOC) based analytical method to quantitate trace residues of clean-in-place (CIP) detergents CIP100 ® and CIP200 ® on the surfaces of pharmaceutical manufacturing equipment was developed and validated. Five factors affecting the development and validation of the method were identified: diluent composition, diluent volume, extraction method, location for TOC sample preparation, and oxidant flow rate. Key experimental parameters were optimized to minimize contamination and to improve the sensitivity, recovery, and reliability of the method. The optimized concentration of the phosphoric acid in the swabbing solution was 0.05M, and the optimal volume of the sample solution was 30mL. The swab extraction method was 1min sonication. The use of a clean room, as compared to an isolated lab environment, was not required for method validation. The method was demonstrated to be linear with a correlation coefficient (R) of 0.9999. The average recoveries from stainless steel surfaces at multiple spike levels were >90%. The repeatability and intermediate precision results were ≤5% across the 2.2-6.6ppm range (50-150% of the target maximum carry over, MACO, limit). The method was also shown to be sensitive with a detection limit (DL) of 38ppb and a quantitation limit (QL) of 114ppb. The method validation demonstrated that the developed method is suitable for its intended use. The methodology developed in this study is generally applicable to the cleaning verification of any organic detergents used for the cleaning of pharmaceutical manufacturing equipment made of electropolished stainless steel material. Copyright © 2017 Elsevier B.V. All rights reserved.

Sexual self-schemas of female child sexual abuse survivors: relationships with risky sexual behavior and sexual assault in adolescence.

Science.gov (United States)

Niehaus, Ashley F; Jackson, Joan; Davies, Stephanie

2010-12-01

Childhood sexual trauma has been demonstrated to increase survivors' risk for engaging in unrestricted sexual behaviors and experiencing adolescent sexual assault. The current study used the sexual self-schema construct to examine cognitive representations of sexuality that might drive these behavioral patterns. In Study 1 (N = 774), we attempted to improve the content validity of the Sexual Self Schema Scale for child sexual abuse (CSA) survivors, introducing a fourth sexual self-schema factor titled the "immoral/irresponsible" factor. In Study 2 (N = 1150), the potential differences in sexual self-views, as assessed by the four sexual self-schema factors, between CSA survivors and non-victims were explored. In addition, Study 2 evaluated how these sexual self-schema differences may contribute to participation in unrestricted sexual behaviors and risk for sexual assault in adolescence. Results indicated that a history of CSA impacted the way women viewed themselves as a sexual person on each of the four factors. CSA survivors were found to view themselves as more open and possessing more immoral/irresponsible cognitions about sexuality as compared to women who did not have a CSA history. In addition, the CSA survivors endorsed less embarrassment and passionate/romantic views of their sexual selves. The interaction of CSA severity and the sexual self-schemas explained variance in adolescent sexual assault experiences above and beyond the severity of CSA history and participation in risky sexual behaviors. The findings suggest that sexual self-views may serve to moderate the relationship between CSA and adolescent sexual assault. Implications of these findings and directions for future research are discussed.

Bleomycin-associated Lung Toxicity in Childhood Cancer Survivors.

Science.gov (United States)

Zorzi, Alexandra P; Yang, Connie L; Dell, Sharon; Nathan, Paul C

2015-11-01

Pulmonary disease is a significant morbidity among childhood cancer survivors. The aim of this study was to characterize the pulmonary dysfunction experienced by childhood cancer survivors treated with bleomycin. A cross-sectional analysis of pulmonary function testing (PFT) in survivors treated with bleomycin was preformed. The most recent posttherapy PFT was assessed. Spirometry and lung volumes were categorized as normal, restrictive, obstructive, or mixed. Diffusing capacity of carbon monoxide (DLCO) was categorized as normal or abnormal. PFT data of 143 survivors was analyzed. PFTs were performed a median of 2.3 years (interquartile range, 1.4 to 4.9) from completion of therapy. Spirometry was abnormal in 58 (41%), only 5 (9%) had respiratory symptoms. Forty-two (70%) had obstructive, 11 (18%) restrictive, and 5 (9%) mixed ventilatory defects. The majority of abnormalities were mild (91%). DLCO was abnormal in 27. Reductions were mild in 96%. Patients with a history of relapse were more likely to develop abnormalities in spirometry and/or DLCO (odds ratio=5.02, 95% confidence interval: 1.3-19.4, P=0.01; odds ratio=3.47, 95% confidence interval: 1.01-11.9, P=0.03). Asymptomatic abnormalities of PFT are common among childhood cancer survivors treated with bleomycin and associated with a history of relapse. Research studying the risk for clinical progression of this dysfunction is warranted.

Studies on population change of atomic bomb survivors in Hiroshima prefecture 1965-1979

International Nuclear Information System (INIS)

Ueoka, Hiroshi; Munaka, Masaki; Kurihara, Minoru

1984-01-01

Studies of population change of Japanese Atomic Bomb Survivors from 1965 to 1979 in Hiroshima prefecture of which registered in Data Base of Atomic Bomb Survivors of RINMB were conducted, and following were obtained: 1. Population change of Japanese Atomic Bomb Survivors showed increasing trend until 1976 and diminishing trend from 1977. It would be estimated that reason of increasing trend of Atomic Bomb Survivors was correlated the same trend to get register card of ''Atomic Bomb Treatment Law'', and decreasing trend of them was related so much death of the elderly generations. 2. Analysing by residential place the survivors who make a living in Hiroshima city was almost 110,000, and those who make a living in Hiroshima prefecture (except Hiroshima city) was 65,000. Considering exposed distance of the survivors in Hiroshima city, those survivors exposed within 2 km showed diminishing trend; and those who make a living in Hiroshima prefecture (except Hiroshima city), exposed within 2 km showed increasing trend. 3. In 1979, the ratio of male and female survivors by age level showed difference. Those male survivors over 50 years old in Hiroshima city showed much lower percentage than female. 4. In 1979, the population trends of survivors who get the ''card'' before 1964 showed rapid decrease, and those who get the ''card'' after 1965 showed mild decrease. (author)

THE PREVENTION PROGRAMS OF PHYSICAL REHABILITATION FOR CHERNOBYL DISASTER SURVIVORS

OpenAIRE

G.V. Korobeynikov; V.U. Drojjin

2013-01-01

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

Some hematological disorders among atomic bomb survivors. Presidential Address

International Nuclear Information System (INIS)

Watanabe, Susumu

1977-01-01

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

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

Science.gov (United States)

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

2016-08-01

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

The current mortality rates of a-bomb survivors in Nagasaki-city

International Nuclear Information System (INIS)

Okajima, Shunzo; Mine, Mariko; Nakamura, Tsuyoshi; Mori, Hiroyuki; Kondo, Hisayoshi

1980-01-01

The causes of death for 9814 a-bomb survivors in Nagasaki-city from '70 to '76 were investigated. The mortality rates of the survivors in the aged group were slightly lower than those of both unexposed citizens in Nagasaki and the national average. No difference of the mortality ratios with respect to sex and the distance from a-bomb at exposure was observed. For the cause of death, the cerebrovascular diseases came next to malignant neoplasms in the a-bomb survivors, which order was reverse in the non-exposed population. The mortality rate of the cerebrovascular diseases in the survivors was lower than the expected value. The mortality rate of survivors due to neoplasms was slightly higher than the national average, although almost the same as that of unexposed citizens in Nagasaki. (Nakanishi, T.)

Some aspects of readaptation of atomic survivors in Hiroshima

International Nuclear Information System (INIS)

Vasconcelos, L.A.

1992-01-01

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

Interventions for treating persistent pain in survivors of torture

DEFF Research Database (Denmark)

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

2017-01-01

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

Cardiovascular disease risk among breast cancer survivors: an evolutionary concept analysis

Directory of Open Access Journals (Sweden)

Vo JB

2017-02-01

Full Text Available Jacqueline B Vo,1 Timiya S Nolan,1 David E Vance,1 Patricia A Patrician,2 Karen Meneses1 1Office of Research and Scholarship, 2Department of Family, Community Health, and Systems, University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA Background: More than 3.5 million breast cancer survivors are living in the US, and the overall five-year survival rate is approaching 90%. With increased survival and cancer treatment-related cardiotoxicities, there has been a rise in cardiovascular diseases among breast cancer survivors. Yet, cardiovascular disease risk among breast cancer survivors has not been well conceptualized. The purpose of this article was to analyze and define the concept of cardiovascular disease risk among breast cancer survivors. Methods: The databases CINAHL, EMBASE, and PubMed were used to identify articles that explored cardiovascular disease risk among breast cancer survivors. The search yielded 357 articles, which were reviewed for eligibility. Thirty articles were selected based on the inclusion/exclusion criteria. The concept of cardiovascular disease risk among breast cancer survivors was analyzed using Rodgers’ evolutionary concept analysis method. Results: The analysis suggests that cardiovascular disease risk among breast cancer survivors consists of several attributes: cancer treatment (chemotherapy, targeted therapies, radiation therapy, and endocrine therapy, modifiable risk factors (obesity, physical inactivity, poor diet, and smoking, and nonmodifiable risk factors (age, family history, and race. The antecedent identified includes breast cancer diagnosis and the consequence identified includes the development of cardiovascular disease. Conclusion: Findings suggest the need for increased education and understanding of ­cardiovascular disease risk among health care providers and patients. Survivorship care plans can incorporate cardiovascular disease risk monitoring and screening. Future research

Potentially damaging failure modes of high- and medium-voltage electrical equipment

International Nuclear Information System (INIS)

Hoy, H.C.

1983-07-01

The electrical equipment failures of both nuclear and nonnuclear public utilities were reviewed. Those failures that could pose an additional problem to surrounding and connected equipment were defined. The literature was searched; utilities, repair shops, and large electrical equipment users were contacted for failure information. The data were reviewed in detail, and failure modes were determined. Sample cascade failures are discussed. The failure rate of electrical equipment in utilities is historically quite low. Nuclear plants record too few failures to be statistically valid, but failures that have been recorded show that good design usually restricts the failure to a single piece of equipment

Post-traumatic stress disoder, survivor guilt and substance use - a study of hospitalised Nigerian army veterans

Directory of Open Access Journals (Sweden)

G T Okulate

2006-03-01

Full Text Available Objectives. To investigate the prevalence of post-traumatic stress disorder (PTSD and survivor guilt in a sample of hospitalised soldiers evacuated from the Liberian and Sierra-Leonean wars in which Nigerians were involved as peace keepers. The relationships between PTSD, survivor guilt and substance use were also investigated. Design. A socio-demographic data questionnaire, the PTSD checklist and a validated World Health Organization substance use survey instrument were used to obtain data from the subjects. Setting. The study took place at the 68 Nigerian Army Reference Hospital, Lagos, Nigeria, which was the base hospital for all casualties from the Liberian and Sierra- Leonean operations. Subjects. All hospitalised patients from the military operations during a 4-year period (1990 - 1994 who were physically capable of being assessed were included in the study. Results. The prevalence rate for PTSD was found to be 22% and survivor guilt was found in 38% of the responders. PTSD was significantly associated with long duration of stay in the mission area, current alcohol use, lifetime use of an alcohol/gunpowder mixture, and lifetime cannabis use. Survivor guilt was significantly associated with avoidance of trauma-related stimuli but not duration of combat exposure. Conclusions. Although the sample studied was specific, PTSD might be quite common and probably undetected among Nigerian military personnel engaged in battle in Liberia and Sierra-Leone. Detection of such persons through deliberate screening in military community studies should help to alleviate the symptoms since good intervention methods are now available. Primary prevention efforts with regard to alcohol and cannabis use should help to reduce the incidence of PTSD.

A qualitative synthesis of trials promoting physical activity behaviour change among post-treatment breast cancer survivors.

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Short, Camille E; James, Erica L; Stacey, Fiona; Plotnikoff, Ronald C

2013-12-01

Health outcome trials have provided strong evidence that participating in regular physical activity can improve the quality of life and health of post-treatment breast cancer survivors. Focus is now needed on how to promote changes in physical activity behaviour among this group. This systematic review examines the efficacy of behavioural interventions for promoting physical activity among post-treatment breast cancer survivors. Behavioural intervention studies published up until July 2012 were identified through a systematic search of two databases: MEDLINE and CINAHL, and by searching reference lists of relevant publications and scanning citation libraries of project staff. Eight out of the ten identified studies reported positive intervention effects on aerobic physical activity behaviour, ranging from during the intervention period to 6 months post-intervention. Only two studies reported intervention effect sizes. The identification of factors related to efficacy was not possible because of the limited number and heterogeneity of studies included, as well as the lack of effect sizes reported. Nonetheless, an examination of the eight studies that did yield significant intervention effects suggests that 12-week interventions employing behaviour change techniques (e.g., self-monitoring and goal setting) derived from a variety of theories and delivered in a variety of settings (i.e., one-on-one, group or home) can be effective at changing the aerobic physical activity behaviour of breast cancer survivors in the mid- to long terms. Behavioural interventions do hold promise for effectively changing physical activity behaviour among breast cancer survivors. However, future research is needed to address the lack of studies exploring long-term intervention effects, mediators of intervention effects and interventions promoting resistance-training activity, and to address issues impacting on validity, such as the limited use of objective physical activity measures and

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

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

2017-04-01

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

Blood Gene Expression Profiling of Breast Cancer Survivors Experiencing Fibrosis

International Nuclear Information System (INIS)

Landmark-Hoyvik, Hege; Dumeaux, Vanessa; Reinertsen, Kristin V.; Edvardsen, Hege; Fossa, Sophie D.; Borresen-Dale, Anne-Lise

2011-01-01

Purpose: To extend knowledge on the mechanisms and pathways involved in maintenance of radiation-induced fibrosis (RIF) by performing gene expression profiling of whole blood from breast cancer (BC) survivors with and without fibrosis 3-7 years after end of radiotherapy treatment. Methods and Materials: Gene expression profiles from blood were obtained for 254 BC survivors derived from a cohort of survivors, treated with adjuvant radiotherapy for breast cancer 3-7 years earlier. Analyses of transcriptional differences in blood gene expression between BC survivors with fibrosis (n = 31) and BC survivors without fibrosis (n = 223) were performed using R version 2.8.0 and tools from the Bioconductor project. Gene sets extracted through a literature search on fibrosis and breast cancer were subsequently used in gene set enrichment analysis. Results: Substantial differences in blood gene expression between BC survivors with and without fibrosis were observed, and 87 differentially expressed genes were identified through linear analysis. Transforming growth factor-β1 signaling was identified as the most significant gene set, showing a down-regulation of most of the core genes, together with up-regulation of a transcriptional activator of the inhibitor of fibrinolysis, Plasminogen activator inhibitor 1 in the BC survivors with fibrosis. Conclusion: Transforming growth factor-β1 signaling was found down-regulated during the maintenance phase of fibrosis as opposed to the up-regulation reported during the early, initiating phase of fibrosis. Hence, once the fibrotic tissue has developed, the maintenance phase might rather involve a deregulation of fibrinolysis and altered degradation of extracellular matrix components.

Risk factors for PTSD and depression in female survivors of rape.

Science.gov (United States)

Mgoqi-Mbalo, Nolwandle; Zhang, Muyu; Ntuli, Sam

2017-05-01

To investigate association of the sociodemographic factors, characteristics of rape and social support to the development of depression and posttraumatic stress disorder at 6 months after the rape. A cross-sectional survey with female survivors of rape was carried out in 3 provinces of South Africa 6 months after the rape. One hundred female survivors s of sexual assault were interviewed. More than half (53%) were from Limpopo, 25% from Western Cape, and 22% from KwaZulu-Natal (KZN). 87% reported high levels of PTSD and 51% moderate to severe depression post rape. The major risk factors for PTSD and depression were the unmarried survivors of rape and those living in KZN. The female survivors of rape in KZN province were 7 times more likely to experience symptoms of depression compared to other provinces, while married/cohabiting female rape survivors were 6 times less likely to report symptoms of depression compared to the unmarried female rape survivors. These findings add support to existing literature on PTSD and depression as common mental health consequence of rape and also provide evidence that survivors' socio- demographics-marital status, employment status-are significant contributors to the development of symptoms of depression and PTSD after rape. The results have research and clinical practice relevance for ensuring that PTSD and trauma treatment focuses on an in-depth understanding of the various aspects of the sociodemographic factors and rape characteristics that contribute to survivors' mental state and how these compound stress and depression symptoms over time post rape victimization. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

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

2010-02-01

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

Methodology for assessing laser-based equipment

Science.gov (United States)

Pelegrina-Bonilla, Gabriel; Hermsdorf, Jörg; Thombansen, Ulrich; Abels, Peter; Kaierle, Stefan; Neumann, Jörg

2017-10-01

Methodologies for the assessment of technology's maturity are widely used in industry and research. Probably the best known are technology readiness levels (TRLs), initially pioneered by the National Aeronautics and Space Administration (NASA). At the beginning, only descriptively defined TRLs existed, but over time, automated assessment techniques in the form of questionnaires emerged in order to determine TRLs. Originally TRLs targeted equipment for space applications, but the demands on industrial relevant equipment are partly different in terms of, for example, overall costs, product quantities, or the presence of competitors. Therefore, we present a commonly valid assessment methodology with the aim of assessing laser-based equipment for industrial use, in general. The assessment is carried out with the help of a questionnaire, which allows for a user-friendly and easy accessible way to monitor the progress from the lab-proven state to the application-ready product throughout the complete development period. The assessment result is presented in a multidimensional metric in order to reveal the current specific strengths and weaknesses of the equipment development process, which can be used to direct the remaining development process of the equipment in the right direction.

Childhood Sexual Abuse and Couples' Relationships: Female Survivors' Reports in Therapy Groups.

Science.gov (United States)

Pistorello, Jacqueline; Follette, Victoria M.

1998-01-01

Analysis of female child sexual abuse (CSA) survivors showed relationship themes. The two most frequent were difficulties with emotional communication or intimacy and polarized positions on control. Whereas these themes were correlated with survivors' CSA characteristics, sexual difficulties were correlated with survivors' level of current…

Restrictions in daily life after retinoblastoma from the perspective of the survivors.

Science.gov (United States)

van Dijk, Jennifer; Oostrom, Kim J; Huisman, Jaap; Moll, Annette C; Cohen-Kettenis, Peggy T; Ringens, Peter J; Imhof, Saskia M

2010-01-01

Little is known about the impact of retinoblastoma (RB) on the health status of survivors in terms of disabilities and worries, both of which may restrict participation in activities of daily life. In this population-based cross-sectional study, content analysis was used to extract data on perceived restrictions and worries, from semi-structured interviews held with 156 RB survivors aged 8-35 years. The International Classification of Functioning Disabilities and Health (ICF) was used as a framework. Of all survivors, 55% perceive RB-related restrictions in daily life activities (school, professional career, mobility, self-care, intimate relationships). Young/adolescent survivors (6%) and adult survivors (15%) frequently report anxiety about developing a second primary tumor (SPT). Compared with the general population, RB survivors did not differ in rates of employment or marital status. However, special educational services were more frequently offered, and the level of completed education was lower. RB has influenced the lives of most survivors and, even though their prognosis was good, illness-related restrictions are common. Especially fear of developing SPT and of further loss of vision are important life-long problems, and many survivors had special education needs. The ICF might serve as a bridge between families and professionals, because this classification may facilitate early detection of problems. Copyright 2009 Wiley-Liss, Inc.

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

Science.gov (United States)

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

2014-01-01

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

Aging study on atomic bomb survivors

International Nuclear Information System (INIS)

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

1976-01-01

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

Radiation standards and A-bomb survivors

International Nuclear Information System (INIS)

Alvarez, R.

1984-01-01

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

Medicaid expansion and access to care among cancer survivors: a baseline overview.

Science.gov (United States)

Tarazi, Wafa W; Bradley, Cathy J; Harless, David W; Bear, Harry D; Sabik, Lindsay M

2016-06-01

Medicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act. We use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states. Cancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95 % confidence interval [CI] 0.63-0.92, p Medicaid could potentially leave many cancer survivors with limited access to routine care. Existing disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.

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,

Radiation dosimetry in Hiroshima and Nagasaki atomic bomb survivors

Energy Technology Data Exchange (ETDEWEB)

Arakawa, E T

1959-01-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

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

2015-01-01

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

Media participation and mental health in terrorist attack survivors.

Science.gov (United States)

Thoresen, Siri; Jensen, Tine K; Dyb, Grete

2014-12-01

Terrorism and disasters receive massive media attention, and victims are often approached by reporters. Not much is known about how terror and disaster victims perceive the contact with media and whether such experiences influence mental health. In this study, we describe how positive and negative experiences with media relate to posttraumatic stress (PTS) reactions among survivors of the 2011 Utøya Island terrorist attack in Norway. Face-to-face interviews were conducted with 285 survivors (47.0% female and 53.0% male) 14-15 months after the terrorist attack. Most survivors were approached by reporters (94%), and participated in media interviews (88%). The majority of survivors evaluated their media contact and participation as positive, and media participation was unrelated to PTS reactions. Survivors who found media participation distressing had more PTS reactions (quite distressing: B = 0.440, extremely distressing: B = 0.611, p = .004 in adjusted model). Perceiving media participation as distressing was slightly associated with lower levels of social support (r = -.16, p = .013), and regretting media participation was slightly associated with feeling let down (r = .18, p = .004). Reporters should take care when interviewing victims, and clinicians should be aware of media exposure as a potential additional strain on victims. Copyright © 2014 International Society for Traumatic Stress Studies.

Meaning making in cancer survivors: a focus group study.

Directory of Open Access Journals (Sweden)

Nadia van der Spek

Full Text Available BACKGROUND: Confrontation with a life-threatening disease like cancer can evoke existential distress, which can trigger a search for meaning in people after having survived this disease. METHODS: In an effort to gain more insight in the meaning making process, we conducted four focus groups with 23 cancer survivors on this topic. Participants responded to questions about experienced meaning making, perceived changes in meaning making after cancer and the perceived need for help in this area. RESULTS: Most frequently mentioned meaning making themes were relationships and experiences. We found that, in general, cancer survivors experienced enhanced meaning after cancer through relationships, experiences, resilience, goal-orientation and leaving a legacy. Some participants, however, also said to have (also experienced a loss of meaning in their lives through experiences, social roles, relationships and uncertainties about the future. CONCLUSIONS: The results indicated that there is a group of cancer survivors that has succeeded in meaning making efforts, and experienced sometimes even more meaning in life than before diagnosis, while there is also a considerable group of survivors that struggled with meaning making and has an unmet need for help with that. The results of this study contribute to develop a meaning centered intervention for cancer survivors.

Who foregoes survivor protection in employer-sponsored pension annuities?

Science.gov (United States)

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

2005-02-01

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

Assessing Walking Strategies Using Insole Pressure Sensors for Stroke Survivors.

Science.gov (United States)

Munoz-Organero, Mario; Parker, Jack; Powell, Lauren; Mawson, Susan

2016-10-01

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

Assessing Walking Strategies Using Insole Pressure Sensors for Stroke Survivors

Directory of Open Access Journals (Sweden)

Mario Munoz-Organero

2016-10-01

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

Profile and reintegration experience of Ebola survivors in Guinea: a cross-sectional study.

Science.gov (United States)

Delamou, Alexandre; Camara, Bienvenu Salim; Kolie, Jean Pe; Guemou, Achille Diona; Haba, Nyankoye Yves; Marquez, Shannon; Beavogui, Abdoul Habib; Delvaux, Therese; van Griensven, Johan

2017-03-01

To describe the experience of Guinean Ebola virus disease (EVD) survivors in Guinea, up to ten months after discharge from the Ebola treatment unit. Cross-sectional study using a standardised semistructured questionnaire among survivors from Conakry and Coyah districts in 2015 in Guinea. We used proportions, mean (standard deviation) and median (interquartile range) to summarise the variables. The McNemar chi-square test was used to compare proportions. The 121 EVD survivors interviewed had a median reintegration time from discharge of 18 weeks (IQR: 14-32 weeks). Most survivors were aged 15-44 years (87.6%) with secondary to higher level of education (68.6%), and 25.6% were healthcare workers. The majority reported a lower socio-economic status (90%), a less favourable work situation (79%) and psychological status (60%). About 31% reported physical health problems. Most survivors reported lower levels of reintegration with friends and at work place (72%) and lower acceptance by others in general (71%) in the period after the EVD as compared to the period before the EVD. Only 55 survivors (45.5%) were involved in one or more activities of the EVD response: participation in clinical studies on the EVD (44 survivors, 36.4%), community sensitisation (28 survivors, 23.1%) or work in Ebola treatment and/or transit centres (23 survivors, 21.7%). There is a need for a long-term follow-up of EVD survivors in Guinea and more efforts to support their social, professional and economic reintegration, especially in rural areas. © 2016 John Wiley & Sons Ltd.

Predictors of High eHealth Literacy in Primary Lung Cancer Survivors.

Science.gov (United States)

Milne, Robin A; Puts, Martine T E; Papadakos, Janet; Le, Lisa W; Milne, Victoria C; Hope, Andrew J; Catton, Pamela; Giuliani, Meredith E

2015-12-01

Lung cancer survivors are likely to have low health literacy which is an independent risk factor for poorer health outcomes. The eHealth literacy in lung cancer survivors has not been reported. The purposes of this study were to determine self-perceived eHealth literacy levels in lung cancer survivors and to explore predictors of higher eHealth literacy. A cross-sectional study was conducted at the Princess Margaret Cancer Centre in Toronto, Canada. Survivors completed a survey that collected demographic, self-perceived eHealth literacy (using the eHealth Literacy Scale), and quality of life information. Tumor and treatment details were extracted from medical records. Demographic data was summarized using descriptive statistics and compared against those with high and low eHealth literacy using Fisher's exact test. Eighty-three survivors were enrolled over 7 months. Median age was 71 years (range 44-89); 41 survivors (49%) were male. Forty-six (55%) survivors had some college education or higher. Most had access to eResources (78%) via computer, Internet, or smartphone. Fifty-seven (69%) scored 5 or greater (7=excellent) on the overall health scale. Twenty-eight (33.7%) perceived themselves to have high eHealth literacy. There was no statistically significant correlation between eHealth literacy groups and age (p=1.00), gender (p=0.82), living situation (p=1.00), overall health (p=1.00), overall quality of life (QoL) (p=1.00), or histology (p=0.74). High eHealth literacy correlated with the level of education received (p=0.003) and access to eResources (p=0.004). The self-perceived eHealth literacy of lung cancer survivors is generally low.

Social adjustment and repressive adaptive style in survivors of pediatric cancer.

Science.gov (United States)

Schulte, Fiona; Wurz, Amanda; Russell, K Brooke; Reynolds, Kathleen; Strother, Douglas; Dewey, Deborah

2018-01-01

The aim of the study was to explore the relationship between repressive adaptive style and self-reports of social adjustment in survivors of pediatric cancer compared to their siblings. We hypothesized that there would be a greater proportion of repressors among survivors of pediatric cancer compared to siblings, and that repressive adaptive style would be significantly associated with more positive self-reports of social adjustment. We utilized a cross-sectional approach. Seventy-seven families participated. Survivors of pediatric cancer (n = 77, 48% male; 8-18 years of age) and one sibling (n = 50, 48% male; 8-18 years of age) completed measures assessing repressive adaptive style and social adjustment. As well, one parent from each family completed a socio-demographic questionnaire. Questionnaire packages were mailed to eligible families who agreed to participate, and were mailed back to investigators in a pre-addressed, pre-stamped envelope. Chi-square analyses revealed there was no significant difference in the proportion of repressors among survivors and siblings. Social adjustment scores were subjected to a two (group: survivor, sibling) by two (repressor, nonrepressor) ANCOVA with gender and age as covariates. There was a significant main effect of repressive adaptive style (F = 5.69, p < .05, η 2 = 0.05) with a modest effect. Survivors and siblings with a repressive style reported significantly higher social adjustment scores (M = 106.91, SD = 11.69) compared to nonrepressors (M = 99.57, SD = 13.45). Repressive adaptive style explains some of the variance in survivors and siblings' self-reports of social adjustment. Future research should aim to better understand the role of the repressive adaptive style in survivors and siblings of children with cancer.

Validation of the Cepheid GeneXpert for Detecting Ebola Virus in Semen.

Science.gov (United States)

Loftis, Amy James; Quellie, Saturday; Chason, Kelly; Sumo, Emmanuel; Toukolon, Mason; Otieno, Yonnie; Ellerbrok, Heinzfried; Hobbs, Marcia M; Hoover, David; Dube, Karine; Wohl, David A; Fischer, William A

2017-02-01

Ebola virus (EBOV) RNA persistence in semen, reported sexual transmission, and sporadic clusters at the end of the 2013-2016 epidemic have prompted recommendations that male survivors refrain from unprotected sex unless their semen is confirmed to be EBOV free. However, there is no fully validated assay for EBOV detection in fluids other than blood. The Cepheid Xpert Ebola assay for EBOV RNA detection was validated for whole semen and blood using samples obtained from uninfected donors and spiked with inactivated EBOV. The validation procedure incorporated standards from Clinical and Laboratory Standards Institute and Good Clinical Laboratory Practices guidelines for evaluating molecular devices for use in infectious disease testing. The assay produced limits of detection of 1000 copies/mL in semen and 275 copies/mL in blood. Limits of detection for both semen and blood increased with longer intervals between collection and testing, with acceptable results obtained up to 72 hours after specimen collection. The Cepheid Xpert Ebola assay is accurate and precise for detecting EBOV in whole semen. A validated assay for EBOV RNA detection in semen informs the care of male survivors of Ebola, as well as recommendations for public health. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Self-reported depression and perceived financial burden among long-term rectal cancer survivors.

Science.gov (United States)

Chongpison, Yuda; Hornbrook, Mark C; Harris, Robin B; Herrinton, Lisa J; Gerald, Joe K; Grant, Marcia; Bulkley, Joanna E; Wendel, Christopher S; Krouse, Robert S

2016-11-01

Types of surgery for rectal cancer (RC), including permanent ostomy (PO) or temporary ostomy followed by anastomosis (TO) or initial anastomosis (AN), can affect psychological and financial well-being during active treatment. However, these relationships have not been well studied among long-term survivors (≥5 years post-diagnosis). A mailed survey with 576 long-term RC survivors who were members of Kaiser Permanente was conducted in 2010-2011. Prevalence of current depression was ascertained using a score of ≤45.6 on the Short Form-12 version 2 mental component summary. Perceived financial burden was assessed using a Likert scale ranging from 0 (none) to 10 (severe). Regression analyses were used to measure associations after adjustment for covariates. The overall prevalence of depression was 24% among RC survivors with the highest prevalence among those with a history of PO (31%). The adjusted odds of depression among TO and AN survivors were lower than that among PO survivors, 0.42 (CI 95% 0.20-0.89) and 0.59 (CI 95% 0.37-0.93), respectively. Twenty-two percent perceived moderate-to-high current financial burden (≥4 points). PO survivors also reported higher mean financial burden than AN survivors (2.6 vs. 1.6, respectively; p = 0.002), but perceived burden comparably to TO survivors (2.3). Self-reported depression was associated with higher perceived financial burden (p reported frequently among these long-term RC survivors, particularly among PO survivors. Depression was associated with greater perception of financial burden. Screening for depression and assessing financial well-being might improve care among long-term RC survivors.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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

DEFF Research Database (Denmark)

Bandak, M; Jørgensen, N; Juul, A

2017-01-01

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

Assessing cancer survivors' needs using web-based technology: a pilot study.

Science.gov (United States)

Lavoie Smith, Ellen M; Skalla, Karen; Li, Zhongze; Onega, Tracy; Rhoda, June; Gates, Charlene; Litterini, Amy; Scott, Mary R

2012-02-01

Development of cancer survivor resources has been hampered by lack of knowledge regarding survivors' needs. The main study aim was to pilot test a Web-based cancer survivor needs assessment survey. The second aim was to pilot three sampling approaches. This cross-sectional study was conducted at the Norris Cotton Cancer Center and nine community-based clinics serving urban and rural populations. Population-based and convenience sampling approaches were used to recruit 547 participants over 4 months. Participants completed a Web-based cancer survivor needs assessment survey. Respondents were mainly white (98%), married (71%) women (80%) with a college education (96%). Although most (66%) (n = 362) had been diagnosed with breast cancer, other cancer diagnoses were represented. Participants reported fatigue (47%), forgetfulness (39%), joint pain (34%), anxiety (31%), trouble sleeping (28%), peripheral neuropathy (27%), inflexibility (23%), and weight gain (23%). Survivors with nonbreast solid tumor malignancies reported more problems than those with breast or hematologic malignancies (P range = .037 to losing weight (74.2%), decreasing fatigue (50%), and improving flexibility (69.3%), sleep (68.5%), and memory (60.2%). Results supported that cancer survivors struggle with many enduring problems. Web-based technology will facilitate future exploration of unmet needs.

Survivorship care needs among LGBT cancer survivors.

Science.gov (United States)

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

2018-05-23

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

Marriage and divorce among childhood cancer survivors

DEFF Research Database (Denmark)

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

2011-01-01

was diagnosed between 1965 and 1996 before they were 20 years of age. A sex-matched and age-matched population-based control cohort was used for comparison (n=45,449). Demographic and socioeconomic data were obtained from national registers and explored by discrete-time Cox regression analyses. Childhood cancer......Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer...... a nonsignificantly lower rate (RR 0.47; 95% CI: 0.38-0.58) than females (RR 0.56; 95% CI: 0.47-0.68). The rates of separation were almost identical to those of controls. In conclusion, the rate of cohabitation was lower for all childhood cancer survivors than for the population-based controls, with the most...

Pancreatic exocrine secretion in atomic bomb survivors

International Nuclear Information System (INIS)

Hiraoka, Masataka; Kawanishi, Masahiro; Ohtaki, Megu

1989-01-01

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

Cancer survivors' experience of exercise-based cancer rehabilitation

DEFF Research Database (Denmark)

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

2015-01-01

BACKGROUND: Evidence for the safety and benefits of exercise training as a therapeutic and rehabilitative intervention for cancer survivors is accumulating. However, whereas the evidence for the efficacy of exercise training has been established in several meta-analyses, synthesis of qualitative...... research is lacking. In order to extend healthcare professionals' understanding of the meaningfulness of exercise in cancer survivorship care, this paper aims to identify, appraise and synthesize qualitative studies on cancer survivors' experience of participation in exercise-based rehabilitation. MATERIAL......-based rehabilitation according to cancer survivors. Accordingly, the potential of rebuilding structure in everyday life, creating a normal context and enabling the individual to re-establish confidentiality and trust in their own body and physical potential constitute substantial qualities fundamental...

Exercise right heart catheterization for pulmonary hypertension identified on screening echocardiography in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort.

Science.gov (United States)

Armstrong, Gregory T; Tolle, James J; Piana, Robert; Santucci, Aimee; Leathers, James; Ness, Kirsten K; Mulrooney, Daniel A; Green, Daniel M; Joshi, Vijaya M; Robison, Leslie L; Hudson, Melissa M; Lenihan, Daniel

2018-01-01

Pulmonary hypertension, determined noninvasively by tricuspid regurgitant jet velocity on Doppler echocardiography, was previously identified in 25% of long-term survivors who received chest-directed radiotherapy. To validate noninvasively defined pulmonary hypertension, survivors (mean age 48 years), exposed to chest radiotherapy, underwent right heart catheterization with planned cardiopulmonary exercise testing during catheterization. Eight participants had an elevated mean pulmonary artery pressure at rest (≥25 mm Hg) or with subsequent exercise (>30 mm Hg), evidence of hemodynamically confirmed pulmonary hypertension by right heart catheterization. Cardiopulmonary exercise testing further defined the magnitude and etiology of cardiopulmonary limitations in this life-threatening late effect. © 2017 Wiley Periodicals, Inc.

Organ dose estimates for the Japanese atomic-bomb survivors

International Nuclear Information System (INIS)

Kerr, G.D.

1978-10-01

Recent studies concerning radiation risks to man by the Committee on Biological Effects of Ionizing Radiation of the National Academy of Sciences-National Research Council and the United Nations Scientific Committee on the Effects of Atomic Radiation have emphasized the need for estimates of dose to organs of the Japanese atomic-bomb survivors. Shielding of internal organs by the body has been investigated for fission-weapon gamma rays and neutrons, and ratios of mean absorbed dose in a number of organs to survivors' T65D assignments of tissue kerma in air are provided for adults. Ratios of mean absorbed dose to tissue kerma in air are provided also for the thyroid and active bone marrow of juveniles. These organ dose estimates for juveniles are of interest in studies of radiation risks due to an elevated incidence of leukemia and thyroid cancer in survivors exposed as children compared to survivors exposed as adults

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

Science.gov (United States)

1989-01-01

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

Health Behaviors and Self-Reported Health Among Cancer Survivors by Sexual Orientation.

Science.gov (United States)

Jabson, Jennifer M; Farmer, Grant W; Bowen, Deborah J

2015-03-01

Health behaviors and self-reported health are important for understanding cancer survivor health. However, there is a paucity of published research about how cancer survivors' health behaviors and self-rated health vary by sexual orientation. This study examined cancer survivors' health behaviors and self-reported health by sexual orientation. This study used data from the National Health and Nutrition Examination Survey (NHANES) from 2001-2010. Self-reported health and cancer-related health behaviors were compared by sexual orientation. Propensity score adjustment was used to account for differences in age, race, education, gender and health insurance status. Of the 602 survivors eligible for the study, 4.3% identified as sexual minorities. Sexual minorities were 2.6 times more likely to report a history of illicit drug use (adjusted odds ratio [aOR]=2.4, 95% confidence interval [CI]: 1.04, 5.35), and 60% less likely to report their current health status as good (aOR=0.40, 95% CI: 0.18, 0.89), compared to heterosexual cancer survivors. These disparities persisted even after adjustment for socio-demographic characteristics. Our findings suggest that sexual minority cancer survivors may be at greater risk for poorer outcomes after cancer than other survivors. A possible explanation for the observed differences involves minority stress. Future research should test stress as an explanation for these differences. However, using population-methods to achieve this goal requires larger samples of lesbian, gay, and bisexual (LGB) cancer survivors.

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 ...

Female Intimate Partner Violence Survivors' Experiences with Accessing Resources

Science.gov (United States)

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

2010-01-01

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

Skin cancer of Nagasaki atomic bomb survivors, 4

International Nuclear Information System (INIS)

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

1990-01-01

We previously reported that there was a high correlation between the exposure dose and the incidence of skin cancer in A-bomb survivors using the data of the Nagasaki Life Span Study of Radiation Effects Research Foundation and Nagasaki Tumor Registry. In Report 3 of this series, we clarified that the correlation between the exposure distance and the incidence of skin cancer was statistically significant in 140 cases of skin cancer collected from 31 hospitals in Nagasaki City and adjacent districts on the basis of the data of the total 66,276 A-bomb survivors recorded in the Scientific Data Center of Atomic Bomb Disaster, Nagasaki University School of Medicine, and that the correlation was the same even when the cases were divided by sex. In this report, we examined the chronological change of the incidence of skin cancer in Nagasaki A-bomb survivors, using the data of the Scientific Data Center of Atomic Bomb Disaster. It is likely that the incidence of skin cancer in Nagasaki A-bomb survivors has increased after 1962, especially after 1975 in those exposed within 2.5km from the hypocenter compared to those exposed at 3.0km or more. (author)

Employment and work-related issues in cancer survivors.

Science.gov (United States)

Mehnert, Anja

2011-02-01

Purpose of this systematic literature review was to identify current knowledge about employment in cancer survivors. Sixty-four studies met inclusion criteria that were original papers published between 01/2000 and 11/2009. Overall, 63.5% of cancer survivors (range 24-94%) returned to work. The mean duration of absence from work was 151 days. Factors significantly associated with a greater likelihood of being employed or return to work were perceived employer accommodation, flexible working arrangements, counseling, training and rehabilitation services, younger age and cancer sites of younger individuals, higher levels of education, male gender, less physical symptoms, lower length of sick leave and continuity of care. Cancer survivors had a significantly increased risk for unemployment, early retirement and were less likely to be re-employed. Between 26% and 53% of cancer survivors lost their job or quit working over a 72-month period post diagnosis. Between 23% and 75% of patients who lost their job were re-employed. A high proportion of patients experienced at least temporary changes in work schedules, work hours, wages and a decline in work ability compared to non-cancer groups. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2018-03-17

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

Cancer Support Needs for African American Breast Cancer Survivors and Caregivers.

Science.gov (United States)

Haynes-Maslow, Lindsey; Allicock, Marlyn; Johnson, La-Shell

2016-03-01

Improved cancer screening and treatment advances have led to higher cancer survival rates in the United States. However, racial disparities in breast cancer survival persist for African American women who experience lower survival rates than white women. These disparities suggest that unmet needs related to survivorship still exist. This study focuses on the challenges that both African American cancer survivors and caregivers face across the cancer continuum. Five African American focus groups examined cancer survivor and caregiver support needs. Focus groups were recorded, transcribed, and uploaded into Atlas.ti. Thematic content analysis was applied to the text during the coding process. Themes were identified and emphasized based on the research team's integrated and unified final codes. Forty-one African Americans participated in five focus groups: 22 cancer survivors and 19 caregivers. Participants discussed five themes: (1) a culture that discourages the discussion of cancer; (2) lack of support services for African American cancer survivors; (3) lack of support services for cancer caregivers; (4) need for culturally appropriate cancer resources, including resources targeted at African American women; and (5) aspects that were helpful to cancer survivors and caregivers, including connecting with other survivors and caregivers, and having strong social support networks. We gained new insight into the unmet support needs for survivors and caregivers, especially when coping with the cancer experience continuum. While some cancer and caregiver support services exist, our study reveals a great need for services that incorporate the cultural differences that exist across races.

Marriage, employment, and health insurance in adult survivors of childhood cancer.

Science.gov (United States)

Crom, Deborah B; Lensing, Shelly Y; Rai, Shesh N; Snider, Mark A; Cash, Darlene K; Hudson, Melissa M

2007-09-01

Adult survivors of childhood cancer are at risk for disease- and therapy-related morbidity, which can adversely impact marriage and employment status, the ability to obtain health insurance, and access to health care. Our aim was to identify factors associated with survivors' attainment of these outcomes. We surveyed 1,437 childhood cancer survivors who were >18 years old and >10 years past diagnosis. We compared our cohort's data to normative data in the Medical Expenditure Panel Survey and the U.S. Census Bureau's Current Population Surveys. Respondents were stratified by hematologic malignancies, central nervous system tumors, or other solid tumors and by whether they had received radiation therapy. Most respondents were survivors of hematologic malignancies (71%), white (91%), and working full-time (62%); 43% were married. Compared with age- and sex-adjusted national averages, only survivors of hematologic malignancies who received radiation were significantly less likely to be married (44 vs. 52%). Full-time employment among survivors was lower than national norms, except among survivors of hematologic malignancies who had not received radiation therapy. The rates of coverage of health insurance, especially public insurance, were higher in all diagnostic groups than in the general population. While difficulty obtaining health care was rarely reported, current unemployment and a lack of insurance were associated with difficulty in obtaining health care (P unmarried, unemployed, and uninsured experience difficulty accessing health care needed to address long-term health concerns.

Quality of Working Life of cancer survivors: associations with health- and work-related variables.

Science.gov (United States)

de Jong, Merel; Tamminga, Sietske J; Frings-Dresen, Monique H W; de Boer, Angela G E M

2017-05-01

This study aimed to (1) describe the Quality of Working Life (QWL) of cancer survivors and (2) explore associations between the QWL of cancer survivors and health- and work-related variables. Employed and self-employed cancer survivors were recruited through hospitals and patient organizations. They completed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) and health- and work-related variables in this cross-sectional study. The QWL scores of cancer survivors were described, and associations between QWL and health- and work-related variables were assessed. The QWLQ-CS was completed by 302 cancer survivors (28% male) with a mean age of 52 ± 8 years. They were diagnosed between 0 and 10 years ago with various types of cancer, such as breast cancers, gastrointestinal cancers, urological cancers, and haematological cancers. The QWL mean score of cancer survivors was 75 ± 12 (0-100). Cancer survivors had statistically significant lower QWL scores when they had been treated with chemotherapy or when they reported co-morbidity (p ≤ 0.05). Cancer survivors without managerial positions, with low incomes or physically demanding work, and who worked a proportion of their contract hours had statistically significantly lower QWL scores (p ≤ 0.05). This study described the QWL of cancer survivors and associations between QWL and health- and work-related variables. Based on these variables, it is possible to indicate groups of cancer survivors who need more attention and support regarding QWL and work continuation.

Viraemia and Ebola virus secretion in survivors of Ebola virus disease in Sierra Leone: a cross-sectional cohort study.

Science.gov (United States)

Green, Edward; Hunt, Luke; Ross, J C Gareth; Nissen, Nina Marie; Curran, Tanya; Badhan, Anjna; Sutherland, Katherine A; Richards, Jade; Lee, James S; Allen, Samuel H; Laird, Steven; Blackman, Mandy; Collacott, Ian; Parker, Paul A; Walbridge, Andrew; Phillips, Rebecca; Sellu, Sia Jammie; Dama, Agnes; Sheriff, Alpha Karim; Zombo, Joseph; Ngegba, Doris; Wurie, Alieh H; Checchi, Francesco; Brooks, Timothy J

2016-09-01

In survivors of Ebola virus disease, clinical sequelae including uveitis, arthralgia, and fatigue are common and necessitate systematic follow-up. However, the infection risk to health-care providers is poorly defined. Here we report Ebola virus RT-PCR data for body site and fluid samples from a large cohort of Ebola virus survivors at clinic follow-up. In this cross-sectional cohort study, consecutive survivors of Ebola virus disease attending Kerry Town survivor clinic (Freetown, Sierra Leone), who had been discharged from the Kerry Town Ebola treatment unit, were invited to participate. We collected and tested axillary, blood, conjunctival, forehead, mouth, rectal, semen, urine, and vaginal specimens for presence of Ebola virus using RT-PCR. We regarded samples to be positive for Ebola virus disease if the cycle threshold was 40 or lower. We collected demographic data from survivors of their age, sex, time since discharge from the treatment unit, and length of acute admission in the Ebola treatment unit using anonymised standard forms. Between April 2, and June 16, 2015, of 151 survivors of Ebola virus disease invited to participate, 112 (74%) provided consent. The median age of participants was 21·5 years (IQR 14-31·5) with 34 (30%) participants younger than 16 years. 50 (45%) of 112 participants were male. We tested a total of 555 specimens: 103 from the axilla, 93 from blood, 92 from conjunctiva, 54 from forehead, 105 from mouth, 17 from the rectum, one from semen, 69 from urine, and 21 from the vagina. The median time from Ebola treatment unit discharge to specimen collection was 142 days (IQR 127-159). 15 participants had a total of 74 swabs taken less than 100 days from discharge. The semen sample from one participant tested positive for Ebola virus at 114 days after discharge from the treatment unit; specimens taken from the axilla, blood, conjunctiva, forehead, mouth, rectum, and urine of the same participant tested negative. All specimens from the

Dyadic interdependence of psychosocial outcomes among haematological cancer survivors and their support persons.

Science.gov (United States)

Paul, Christine; Hall, Alix; Oldmeadow, Christopher; Lynagh, Marita; Campbell, Sharon; Bradstock, Ken; Williamson, Anna; Carey, Mariko; Sanson-Fisher, Rob

2017-11-01

This study aimed to explore the dyadic relationships between unmet need, depression, and anxiety in people diagnosed with haematological cancer and their support persons. Adult survivors (18 years+) who had been diagnosed with a haematological cancer were recruited to a cross-sectional mailed survey via five state cancer registries in Australia. Participating survivors invited a support person to also complete a survey. Structural equation modelling was used to explore the relationships among survivor and support person self-reported depression, anxiety, and unmet needs. Of the 4299 eligible haematological cancer survivors contacted by the registries, 1511 (35%) returned a completed survey as did 1004 support persons. There were 787 dyads with complete data. After adjusting for age, gender, rurality, cancer type, and whether the support person was a relative, positive correlations were found between survivor and support person scores for depression (p = 0.0029) and unmet needs (p < 0.001), but not anxiety scores (p = 0.075). Survivor unmet needs were significantly related to support person depression (p = 0.0036). Support person unmet needs were significantly related to a higher depression score for survivors (p = 0.0067). Greater support person unmet needs were significantly related to a higher anxiety score for survivors (p = 0.0083). Survivor unmet needs did not have a significant relationship to support person anxiety (p = 0.78). Unmet needs may mediate the interdependence of psychosocial experiences for survivors and support persons, although a longitudinal study is required to confirm causality. Addressing unmet needs may be a potential target for improving outcomes for both groups.

Identification and evaluation of the salient physical activity beliefs of colorectal cancer survivors.

Science.gov (United States)

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

2014-01-01

Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.

Psychological problems of atomic bomb survivors from the medical social worker's standpoint

International Nuclear Information System (INIS)

Tomoike, Toshio

1994-01-01

Mental data from 80 A-bomb survivors were available during a 20-year period 1973-1992. Types of A-bomb survivors were classified into (1) directly exposed A-bomb survivors, (2) A-bomb survivors living in the United States, (3) those living in prefectures other than Nagasaki, (4) ex-soldiers, (5) A-bomb survivors having family problems and others, (6) the demented elderly, (7) the alcoholic, and (8) others. Mental problems were judged as psychogenic, endogenous, and exogenous. Mental problems were most frequently associated with Type 1 (34.9%), followed by Type 8 (21.0%), Type 2 (18.6%), and Type 3 (7.0%). Noticeable finding was that Type 1 A-bomb survivors suffered from psychogenic and exogenous mental problems in an extremely high incidence, as compared with the non-exposed group (66.3% vs 24%). The incidence of both exogenous and endogenous problems was higher in the non-exposed group (32.6% and 24.5%) than the exposed group (23.2% and 10.5%). There was no significant gender difference in the development of mental problems. According to types of A-bomb survivors, both psychogenic and exogenous mental problems were most common for Type 1. The incidence of psychogenic problems was 2.85 times higher than that of exogenous problems. (N.K.)

Trends in adherence to recommended cancer screening: The US population and working cancer survivors

Directory of Open Access Journals (Sweden)

Tainya C. Clarke

2012-12-01

Full Text Available Introduction: Over the past decade the United States has seen a decrease in advanced cancer diagnoses. There has also been an increase in the number of cancer survivors returning to work. Cancer screening behaviors among survivors may play an important role in their return-to-work process. Adherence to a post-treatment cancer screening protocol increases early detection of secondary tumors and reduces potentially limiting side-effects. We compared screening trends among all cancer survivors, working survivors, and the general population over the last decade.Methods: Trends in adherence to recommended screening were analyzed by site-specific cancer. We used the Healthy People goals as a measure of desired adherence. We selected participants 18+ years from 1997 to 2010 National Health Interview Survey (NHIS for years where detailed cancer screening information was available. Using the recommendations of the American Cancer Society as a guide, we assessed adherence to cancer screening across the decade. There were 174,393 participants. Analyses included 7,528 working cancer survivors representing 3.8 million US workers, and 119,374 adults representing more than 100 million working Americans with no cancer history.Results: The US population met the Healthy People 2010 goal for colorectal screening, but declined in all other recommended cancer screening. Cancer survivors met and maintained the HP2010 goal for all, except cervical cancer screening. Survivors had higher screening rates than the general population. Among survivors, white-collar and service occupations had higher screening rates than blue-collar survivors.Conclusions: Cancer survivors report higher screening rates than the general population. Nevertheless, national screening rates are lower than desired, and disparities exist by cancer history and occupation. Understanding existing disparities, and the impact of cancer screening on survivors is crucial as the number of working survivors

Child Sexual Abuse Survivors with Dissociative Amnesia: What's the Difference?

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Wolf, Molly R.; Nochajski, Thomas H.

2013-01-01

Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and…

Multiple primary malignant neoplasms in a fixed population of A-bomb survivors, 1

International Nuclear Information System (INIS)

Soda, Midori; Yokoyama, Naokata; Matsuo, Tatsuki; Takagi, Miwako; Kitano, Koei; Toyama, Kyoko; Fujikura, Toshio

1986-01-01

In a fixed population (7,564 A-bomb survivors) for Adult Health Study performed until December 1985, 28 A-bomb survivors (5 men and 23 women) were diagnosed as having thyroid cancer, and 79 (including one man) as breast cancer. There was an evident tendency among the group receiving 100 rad or more towards higher incidence of cancers of the thyroid and breast and synchronous or metachronous multiple primaries. The incidence of thyroid cancer tended to be higher in A-bomb survivors less than 20 years of age at the time of exposure; however, this tendency was not seen in the case of breast cancer. The incidence of thyroid cancer - in contrast to breast cancer - tended to decrease from year to year. Multiple primaries were associated with thyroid cancer in 5 A-bomb survivors and breast cancer in 9 A-bomb survivors. Three A-bomb survivors had both thyroid and breast cancers. Among the 11 A-bomb survivors with multiple primaries, nine had received 100 rad or more. (Namekawa, K.)

Post-traumatic stress disorder, survivor guilt and substance use - a ...

African Journals Online (AJOL)

) and survivor guilt in a sample of hospitalised soldiers evacuated from the Liberian and Sierra-Leonean wars in which Nigerians were involved as peace keepers. The relationships between PTSD, survivor guilt and substance use were also ...

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

Science.gov (United States)

2010-01-01

Background Torture continues to be a global problem and there is a need for prevention and rehabilitation efforts. There is little available data on torture survivors from studies designed and conducted by health professionals in low income countries. This study is a collaboration between five centres from Gaza, Egypt, Mexico, Honduras and South Africa who provide health, social and legal services to torture survivors, advocate for the prevention of torture and are part of the network of the International Rehabilitation Council for Torture Victims (IRCT). Methods Socio-demographic, clinical and torture exposure data was collected on the torture survivors attending the five centres at presentation and then at three and six month follow-up periods. This sample of torture survivors is presented using a range of descriptive statistics. Change over time is demonstrated with repeated measures analysis of variance. Results Of the 306 torture survivors, 23% were asylum seekers or refugees, 24% were socially isolated, 11% in prison. A high level of traumatic events was experienced. 64% had suffered head injury whilst tortured and 24% had ongoing torture injury problems. There was high prevalence of symptoms of anxiety, depression, post traumatic stress as well as medically unexplained somatic symptoms. The analysis demonstrates a modest drop in symptoms over the six months of the study. Conclusions Data showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions. PMID:20565852

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

Directory of Open Access Journals (Sweden)

Zuñiga Arely PA

2010-06-01

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

Cancer incidence and mortality rate in children of A-bomb survivors

International Nuclear Information System (INIS)

Yoshimoto, Yasuhiko

1992-01-01

The purpose of this paper is to summarize the previous findings of carcinogenesis and mortality rate in children born to A-bomb survivors. The Radiation Effects Research Foundation has collected 72,228 children born to A-bomb survivors from May 1946 through 1984. Of their parents, 31,159 parents had been exposed to significant doses (≥0.01 Sv), with a mean genital dose of 0.435 Sv. Among a hypothetic population of 100,000 children of A-bomb survivors exposed to an mean genital dose of 0.4 SV, radiation-induced diseases were considered to occur in only 250 children or less. An earlier large-scale survey during the period 1948-1956 has revealed an evidence of significant increase in stillborn, congenital malformation, and infantile death. In the 1946-1982 survey concerning carcinogenesis in 72,216 children of A-bomb survivors, cancer was found to be detected in 92 children, with no statistically significant increase in cancer risk with increasing radiation doses in their parents. The survey on mortality rate in 67,586 children of A-bomb survivors has revealed no evidence of significant increase in mortality rate from diseases, other than cancer, and in the incidence of lethal cancer. For A-bomb survivors, genetic doubling doses were considered to be 1 Sv or more. Further, when genetic doubling doses are calculated, the contribution rate of genital cell disturbance should be considered in the incidence of spontaneously induced disease. There is no supportive evidence of genetic effects of A-bomb radiation in children of A-bomb survivors; however, genetic effects of A-bomb radiation cannot be denied completely. Continuing survey is expected to be done for children of A-bomb survivors. (N.K.)

Adult survivors of childhood cancers' identity disclosures in the workplace.

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Martinez, Larry R; Hebl, Michelle R

2016-04-01

Recent medical advances have resulted in unprecedented increases in the number and vitality of employed adult survivors. These survivors must make decisions about whether or not to disclose their identities to others. The purpose of this study was to examine the characteristics that are related to cancer survivorship disclosure in workplace settings (perceived organizational support, centrality of survivorship to one's self-concept, and the degree to which family and friends know about one's survivor status) and an important organizational consequence: intentions to leave one's job. A total of 151 adult survivors of childhood cancer completed an online survey. Extent of disclosure of one's identity as a cancer survivor was negatively associated with turnover intentions. Furthermore, organizational support, identity centrality, and disclosure outside of work were all related to disclosure in the workplace. Relative weight analysis revealed that disclosure outside of work was the most strongly related to disclosure at work. Finally, there were indirect relations such that disclosure mediated the relations among organizational support, identity centrality, and disclosure outside of work and turnover intentions. Survivors who were more open about their cancer survivor status at work had fewer intentions to leave their organizations. Importantly, although some antecedents to disclosure were personal characteristics, organizations can also encourage identity disclosure demonstrating that they are related to of work retention. While disclosure in the workplace is a complex decision to make, the relationship with work retention may reflect that disclosure is more likely to occur in an existing positive work environment or that disclosure itself may contribute to a positive work environment where employees tend to remain. The specific factors that trigger both disclosure and retention require further study although they are clearly related.

Holocaust survivors: three waves of resilience research.

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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.

Computerized cognitive training in survivors of childhood cancer: a pilot study.

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Hardy, Kristina K; Willard, Victoria W; Bonner, Melanie J

2011-01-01

The objective of the current study was to pilot a computerized cognitive training program, Captain's Log, in a small sample of survivors of childhood cancer. A total of 9 survivors of acute lymphoblastic leukemia and brain tumors with attention and working memory deficits were enrolled in a home-based 12-week cognitive training program. Survivors returned for follow-up assessments postintervention and 3 months later. The intervention was associated with good feasibility and acceptability. Participants exhibited significant increases in working memory and decreases in parent-rated attention problems following the intervention. Findings indicate that home-based, computerized cognitive intervention is a promising intervention for survivors with cognitive late effects; however, further study is warranted with a larger sample.

Hiroshima and Nagasaki: the survivors. The puzzle of absent effects

International Nuclear Information System (INIS)

Rotblat, J.

1977-01-01

It is argued that the method of basing estimates of the risks of populations exposed to radiation under normal, peace-time activities, on the results obtained from A-bomb survivors may not be justified. Among the survivors there is a definite dose-related increase in the number of malignancies but other radiation effects such as increase in the incidence of leukaemia in children exposed in utero, genetic effects in children conceived by survivors and general increase in mortality, are conspicuously absent. It is felt that estimates of radiation effects on survivors indicate a difference in response to radiation, as far as leukaemia is concerned, between persons exposed to radiation alone, and those who were also subject to mechanical injuries and heat burns. Together with the absence of other expected effects of radiation, and the lower cancer incidence, this indicates that A-bomb victims cannot be assumed a priori to behave in response to radiation in the same way as those exposed to radiation alone, without accompanying physical, psychological and social traumata. Estimates of radiation risk based on observations on the A-bomb survivors may thus turn out to be too low, by a considerable margin. (U.K.)

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

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

2017-11-26

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

Validation of an HPLC-UV method for the determination of ceftriaxone sodium residues on stainless steel surface of pharmaceutical manufacturing equipments.

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Akl, Magda A; Ahmed, Mona A; Ramadan, Ahmed

2011-05-15

In pharmaceutical industry, an important step consists in the removal of possible drug residues from the involved equipments and areas. The cleaning procedures must be validated and methods to determine trace amounts of drugs have, therefore, to be considered with special attention. An HPLC-UV method for the determination of ceftriaxone sodium residues on stainless steel surface was developed and validated in order to control a cleaning procedure. Cotton swabs, moistened with extraction solution (50% water and 50% mobile phase), were used to remove any residues of drugs from stainless steel surfaces, and give recoveries of 91.12, 93.8 and 98.7% for three concentration levels. The precision of the results, reported as the relative standard deviation (RSD), were below 1.5%. The method was validated over a concentration range of 1.15-6.92 μg ml(-1). Low quantities of drug residues were determined by HPLC-UV using a Hypersil ODS 5 μm (250×4.6 mm) at 50 °C with an acetonitrile:water:pH 7:pH 5 (39-55-5.5-0.5) mobile phase at flow rate of 1.5 ml min(-1), an injection volume of 20 μl and were detected at 254 nm. A simple, selective and sensitive HPLC-UV assay for the determination of ceftriaxone sodium residues on stainless steel surfaces was developed, validated and applied. Copyright © 2011 Elsevier B.V. All rights reserved.

Confirmatory Factor Analysis of the Malay Version of the Confusion, Hubbub and Order Scale (CHAOS-6) among Myocardial Infarction Survivors in a Malaysian Cardiac Healthcare Facility.

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Ganasegeran, Kurubaran; Selvaraj, Kamaraj; Rashid, Abdul

2017-08-01

The six item Confusion, Hubbub and Order Scale (CHAOS-6) has been validated as a reliable tool to measure levels of household disorder. We aimed to investigate the goodness of fit and reliability of a new Malay version of the CHAOS-6. The original English version of the CHAOS-6 underwent forward-backward translation into the Malay language. The finalised Malay version was administered to 105 myocardial infarction survivors in a Malaysian cardiac health facility. We performed confirmatory factor analyses (CFAs) using structural equation modelling. A path diagram and fit statistics were yielded to determine the Malay version's validity. Composite reliability was tested to determine the scale's reliability. All 105 myocardial infarction survivors participated in the study. The CFA yielded a six-item, one-factor model with excellent fit statistics. Composite reliability for the single factor CHAOS-6 was 0.65, confirming that the scale is reliable for Malay speakers. The Malay version of the CHAOS-6 was reliable and showed the best fit statistics for our study sample. We thus offer a simple, brief, validated, reliable and novel instrument to measure chaos, the Skala Kecelaruan, Keriuhan & Tertib Terubahsuai (CHAOS-6) , for the Malaysian population.

Tuberculosis among atomic bomb survivors

International Nuclear Information System (INIS)

Hamada, Tadao; Matsushita, Hiroshi.

1980-01-01

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

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

African Journals Online (AJOL)

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

Why Rape Survivors Participate in the Criminal Justice System

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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…

Validation of the Community Integration Questionnaire in the adult burn injury population.

Science.gov (United States)

Gerrard, Paul; Kazis, Lewis E; Ryan, Colleen M; Shie, Vivian L; Holavanahalli, Radha; Lee, Austin; Jette, Alan; Fauerbach, James A; Esselman, Peter; Herndon, David; Schneider, Jeffrey C

2015-11-01

With improved survival, long-term effects of burn injuries on quality of life, particularly community integration, are important outcomes. This study aims to assess the Community Integration Questionnaire's psychometric properties in the adult burn population. Data were obtained from a multicenter longitudinal data set of burn survivors. The psychometric properties of the Community Integration Questionnaire (n = 492) were examined. The questionnaire items were evaluated for clinical and substantive relevance; validation procedures were conducted on different samples of the population; construct validity was assessed using exploratory factor analysis; internal consistency reliability was examined using Cronbach's α statistics; and item response theory was applied to the final models. The CIQ-15 was reduced by two questions to form the CIQ-13, with a two-factor structure, interpreted as self/family care and social integration. Item response theory testing suggests that Factor 2 captures a wider range of community integration levels. Cronbach's α was 0.80 for Factor 1, 0.77 for Factor 2, and 0.79 for the test as a whole. The CIQ-13 demonstrates validity and reliability in the adult burn survivor population addressing issues of self/family care and social integration. This instrument is useful in future research of community reintegration outcomes in the burn population.

Understanding Rape Survivors' Decisions Not to Seek Help from Formal Social Systems

Science.gov (United States)

Patterson, Debra; Greeson, Megan; Campbell, Rebecca

2009-01-01

Few rape survivors seek help from formal social systems after their assault. The purpose of this study was to examine factors that prevent survivors from seeking help from the legal, medical, and mental health systems and rape crisis centers. In this study, 29 female rape survivors who did not seek any postassault formal help were interviewed…

Cancer developing among atom-bomb survivors

Energy Technology Data Exchange (ETDEWEB)

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

1975-12-01

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

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.

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

Science.gov (United States)

Liehr, Patricia; Nishimura, Chie; Ito, Mio; Wands, Lisa Marie; Takahashi, Ryutaro

2011-01-01

This study examines 51 stories of health, shared by people who survived the wartime trauma of Hiroshima and Pearl Harbor, seeking to identify turning points that moved participants along over their lifetime. The central turning point for Hiroshima survivors was "becoming Hibabusha (A-bomb survivor)" and for Pearl Harbor survivors was "honoring the memory and setting it aside." Wartime trauma was permanently integrated into survivors' histories, surfacing steadily over decades for Hiroshima survivors and intermittently over decades for Pearl Harbor survivors. Regardless of experience or nationality, participants moved through wartime trauma by connecting with others, pursuing personal and global peace.

Predicting risk of unplanned hospital readmission in survivors of critical illness: a population-level cohort study.

Science.gov (United States)

Lone, Nazir I; Lee, Robert; Salisbury, Lisa; Donaghy, Eddie; Ramsay, Pamela; Rattray, Janice; Walsh, Timothy S

2018-04-05

Intensive care unit (ICU) survivors experience high levels of morbidity after hospital discharge and are at high risk of unplanned hospital readmission. Identifying those at highest risk before hospital discharge may allow targeting of novel risk reduction strategies. We aimed to identify risk factors for unplanned 90-day readmission, develop a risk prediction model and assess its performance to screen for ICU survivors at highest readmission risk. Population cohort study linking registry data for patients discharged from general ICUs in Scotland (2005-2013). Independent risk factors for 90-day readmission and discriminant ability (c-index) of groups of variables were identified using multivariable logistic regression. Derivation and validation risk prediction models were constructed using a time-based split. Of 55 975 ICU survivors, 24.1% (95%CI 23.7% to 24.4%) had unplanned 90-day readmission. Pre-existing health factors were fair discriminators of readmission (c-index 0.63, 95% CI 0.63 to 0.64) but better than acute illness factors (0.60) or demographics (0.54). In a subgroup of those with no comorbidity, acute illness factors (0.62) were better discriminators than pre-existing health factors (0.56). Overall model performance and calibration in the validation cohort was fair (0.65, 95% CI 0.64 to 0.66) but did not perform sufficiently well as a screening tool, demonstrating high false-positive/false-negative rates at clinically relevant thresholds. Unplanned 90-day hospital readmission is common. Pre-existing illness indices are better predictors of readmission than acute illness factors. Identifying additional patient-centred drivers of readmission may improve risk prediction models. Improved understanding of risk factors that are amenable to intervention could improve the clinical and cost-effectiveness of post-ICU care and rehabilitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

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

Science.gov (United States)

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

2017-04-01

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

Associations of sedentary time and patterns of sedentary time accumulation with health-related quality of life in colorectal cancer survivors

Directory of Open Access Journals (Sweden)

Eline H. van Roekel

2016-12-01

Full Text Available Sedentary behavior (sitting/lying at low energy expenditure while awake is emerging as an important risk factor that may compromise the health-related quality of life (HRQoL of colorectal cancer (CRC survivors. We examined associations of sedentary time with HRQoL in CRC survivors, 2–10 years post-diagnosis. In a cross-sectional study, stage I–III CRC survivors (n = 145 diagnosed (2002−2010 at Maastricht University Medical Center+, the Netherlands, wore the thigh-mounted MOX activity monitor 24 h/day for seven consecutive days. HRQoL outcomes were assessed by validated questionnaires (EORTC QLQ-C30, WHODAS II, Checklist Individual Strength, and Hospital Anxiety and Depression Scale. Confounder-adjusted linear regression models were used to estimate associations with HRQoL outcomes of MOX-derived total and prolonged sedentary time (in prolonged sedentary bouts ≥30 min, and usual sedentary bout duration, corrected for waking wear time. On average, participants spent 10.2 h/day sedentary (SD, 1.6, and 4.5 h/day in prolonged sedentary time (2.3. Mean usual sedentary bout duration was 27.3 min (SD, 16.8. Greater total and prolonged sedentary time, and longer usual sedentary bout duration were associated with significantly (P < 0.05 lower physical functioning, and higher disability and fatigue scores. Greater prolonged sedentary time and longer usual sedentary bout duration also showed significant associations with lower global quality of life and role functioning. Associations with distress and social functioning were non-significant. Sedentary time was cross-sectionally associated with poorer HRQoL outcomes in CRC survivors. Prospective studies are needed to investigate whether sedentary time reduction is a potential target for lifestyle interventions aiming to improve the HRQoL of CRC survivors.

Phoenix Society for Burn Survivors

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

International evaluation of the psychometrics of health-related quality of life questionnaires for use among long-term survivors of testicular and prostate cancer.

Science.gov (United States)

van Leeuwen, Marieke; Kieffer, Jacobien M; Efficace, Fabio; Fosså, Sophie D; Bolla, Michel; Collette, Laurence; Colombel, Marc; De Giorgi, Ugo; Holzner, Bernhard; van de Poll-Franse, Lonneke V; van Poppel, Hendrik; White, Jeff; de Wit, Ronald; Osanto, Susanne; Aaronson, Neil K

2017-05-11

Understanding of the physical, functional and psychosocial health problems and needs of cancer survivors requires cross-national and cross-cultural standardization of health-related quality of life (HRQoL) questionnaires that capture the full range of issues relevant to cancer survivors. To our knowledge, only one study has investigated in a comprehensive way whether a questionnaire used to evaluate HRQoL in cancer patients under active treatment is also reliable and valid when used among (long-term) cancer survivors. In this study we evaluated, in an international context, the psychometrics of HRQoL questionnaires for use among long-term, disease-free, survivors of testicular and prostate cancer. In this cross-sectional study, we recruited long-term survivors of testicular and prostate cancer from Northern and Southern Europe and from the United Kingdom who had participated in two phase III EORTC clinical trials. Participants completed the SF-36 Health Survey, the EORTC QLQ-C30 questionnaire, the QLQ-PR25 (for prostate cancer) or the QLQ-TC26 (for testicular cancer) questionnaires, and the Impact of Cancer questionnaire. Testicular cancer survivors also completed subscales from the Nordic Questionnaire for Monitoring the Age Diverse Workforce. Two hundred forty-two men (66% response rate) were recruited into the study. The average time since treatment was more than 10 years. Overall, there were few missing questionnaire data, although scales related to sexuality, satisfaction with care and relationship concerns of men without partners were missing in more than 10% of cases. Debriefing showed that in general the questionnaires were accepted well. Many of the survivors scored at the upper extremes of the questionnaires, resulting in floor and ceiling effects in 64% of the scales. All of the questionnaires investigated met the threshold of 0.70 for group level reliability, with the exception of the QLQ-TC26 (mean reliability .64) and the QLQ-PR25 (mean reliability

Ovarian and Uterine Functions in Female Survivors of Childhood Cancers.

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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

Does the Risk of Metabolic Syndrome Increase in Thyroid Cancer Survivors?

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Kim, Min-Hee; Huh, Jin-Young; Lim, Dong-Jun; Kang, Moo-Il

2017-07-01

The steep rise in thyroid cancer observed in recent decades has caused an increase in the population of long-term thyroid cancer survivors. Other than recurrences of cancer, the long-term health consequences of surviving thyroid cancer, particularly metabolic syndrome, have not yet been determined. The aim of this study was to estimate the risk of metabolic syndrome in thyroid cancer survivors. Population-based data from the Korean National Health and Nutrition Examination Survey (KNHANES) were used for the analysis. The data of KNHANES IV-VI from 2007-2014 were obtained. After excluding subjects who were under 19 years old, whose fasting interval was less than 8 hours, and whose data for predefined variables including metabolic syndrome components were incomplete, 34,347 subjects were analyzed. The incidence of metabolic syndrome and its components were evaluated in three groups: subjects with no history of thyroid cancer, subjects diagnosed with thyroid cancer within 3 years of the survey date, and subjects diagnosed more than 3 years before the survey date. Thyroid cancer diagnoses were made within 3 years of the survey date for 95 subjects (group 1, short-term survivors) and more than 3 years earlier than the survey date for 60 subjects (group 2, long-term survivors). Metabolic syndrome was frequently observed with clinical significance (odds ratio [OR] 1.986 [95% confidence interval [CI] 1.0-3.70], p = 0.030) in short-term survivors compared with subjects with no thyroid cancer history. Risks for having high blood pressure and high fasting glucose were estimated to be higher in the short-term survivor group (OR 2.115 [CI 1.23-3.64], p = 0.006 and OR 1.792 [CI 1.03-3.11], p = 0.038, respectively). No significant associations were noticed in the long-term survivor group when compared with the group with no thyroid cancer history. Risks for metabolic syndrome, especially high blood pressure and high fasting glucose, were increased in short

Studying Hospitalizations and Mortality in the Netherlands: Feasible and Valid Using Two-Step Medical Record Linkage with Nationwide Registers.

Directory of Open Access Journals (Sweden)

Elske Sieswerda

Full Text Available In the Netherlands, the postal code is needed to study hospitalizations of individuals in the nationwide hospitalization register. Studying hospitalizations longitudinally becomes troublesome if individuals change address. We aimed to report on the feasibility and validity of a two-step medical record linkage approach to examine longitudinal trends in hospitalizations and mortality in a study cohort. First, we linked a study cohort of 1564 survivors of childhood cancer with the Municipal Personal Records Database (GBA which has postal code history and mortality data available. Within GBA, we sampled a reference population matched on year of birth, gender and calendar year. Second, we extracted hospitalizations from the Hospital Discharge Register (LMR with a date of discharge during unique follow-up (based on date of birth, gender and postal code in GBA. We calculated the agreement of death and being hospitalized in survivors according to the registers and to available cohort data. We retrieved 1477 (94% survivors from GBA. Median percentages of unique/potential follow-up were 87% (survivors and 83% (reference persons. Characteristics of survivors and reference persons contributing to unique follow-up were comparable. Agreement of hospitalization during unique follow-up was 94% and agreement of death was 98%. In absence of unique identifiers in the Dutch hospitalization register, it is feasible and valid to study hospitalizations and mortality of individuals longitudinally using a two-step medical record linkage approach. Cohort studies in the Netherlands have the opportunity to study mortality and hospitalization rates over time. These outcomes provide insight into the burden of clinical events and healthcare use in studies on patients at risk of long-term morbidities.

Skin cancer of Nagasaki atomic bomb survivors, 5

International Nuclear Information System (INIS)

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

1990-01-01

We already reported that there was a high correlation between the exposure dose and the incidence of skin cancer in A-bomb survivors using the data of the Nagasaki Life Span Study of Radiation Effects Research Foundation and Nagasaki Tumor Registry. In Report 3 of this series, we confirmed that the correlation between the exposure distance and the incidence of skin cancer was statistically significant. In Report 4, we clarified that the incidence of skin cancer in proximally exposed Nagasaki A-bomb survivors when compared to distally exposed victims appears to be increasing since 1975. In this final report of the series, we examined the characteristics of skin cancer in Nagasaki A-bomb survivors using 140 skin cancer cases collected from 31 hospitals in Nagasaki City and adjacent districts on the basis of the data of a total of 66,276 A-bomb survivors recorded in the Scientific Data Center of Atomic Bomb Disaster, Nagasaki University School of Medicine. Among the various items examined, the only item that showed a statistical significance was the age at exposure in the cases of squamous cell carcinoma, i.e., those exposed within 2.5 km from the hypocenter were significantly younger than those exposed at 3.0 km or more. (author)

Low levels of energy expenditure in childhood cancer survivors: Implications for obesity prevention

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Childhood cancer survivors are at an increased risk of obesity but causes for this elevated risk are uncertain. We evaluated total energy expenditure in childhood cancer survivors using the doubly labeled water method in a cross-sectional study of 17 survivors of pediatric leukemia or lymphoma (medi...

Reliability and validity of the perspectives of Support From God Scale.

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Hamilton, Jill B; Crandell, Jamie L; Carter, J Kameron; Lynn, Mary R

2010-01-01

Existing spiritual support scales for use with cancer survivors focus on the support believed to come from a religious community, clergy, or health care providers. The objective of this study was to evaluate the reliability and validity of a new measure of spiritual support believed to come from God in older Christian African American cancer survivors. The Perceived Support From God Scale was administered to 317 African American cancer survivors aged 55-89 years. Psychometric evaluation involved identifying underlying factors, conducting item analysis and estimating reliability, and obtaining evidence on the relationship to other variables or the extent to which the Perceived Support From God Scale correlates with religious involvement and depression. The Perceived Support From God Scale consists of 15 items in two subscales (Support From God and God's Purpose for Me). The two subscales explained 59% of the variance. Cronbach's alpha coefficients were .94 and .86 for the Support From God and God's Purpose for Me subscales, respectively. Test-retest correlations were strong, supporting the temporal stability of the instrument. Pearson's correlations to an existing religious involvement and beliefs scale were moderate to strong. Subscale scores on Support From God were negatively correlated to depression. Initial support for reliability and validity was demonstrated for the Perceived Support From God Scale. The scale captures a facet of spirituality not emphasized in other measures. Further research is needed to evaluate the scale with persons of other racial/ethnic groups and to explore the relationship of spirituality to other outcome measures.

Development of an equipment diagnostic system that evaluates sensor drift

International Nuclear Information System (INIS)

Kanada, Masaki; Arita, Setsuo; Tada, Nobuo; Yokota, Katsuo

2011-01-01

The importance of condition monitoring technology for equipment has increased with the introduction of condition-based maintenance in nuclear power plants. We are developing a diagnostic system using process signals for plant equipment, such as pumps and motors. It is important to enable the diagnostic system to distinguish sensor drift and equipment failure. We have developed a sensor drift diagnostic method that combines some highly correlative sensor signals by using the MT (Mahalanobis-Taguchi) method. Furthermore, we have developed an equipment failure diagnostic method that measures the Mahalanobis distance from the normal state of equipment by the MT method. These methods can respectively detect sensor drift and equipment failure, but there are the following problems. In the sensor drift diagnosis, there is a possibility of misjudging the sensor drift when the equipment failure occurs and the process signal changes because the behavior of the process signal is the same as that of the sensor drift. Oppositely, in the equipment failure diagnosis, there is a possibility of misjudging the equipment failure when the sensor drift occurs because the sensor drift influences the change of process signal. To solve these problems, we propose a diagnostic method combining the sensor drift diagnosis and the equipment failure diagnosis by the MT method. Firstly, the sensor drift values are estimated by the sensor drift diagnosis, and the sensor drift is removed from the process signal. It is necessary to judge the validity of the estimated sensor drift values before removing the sensor drift from the process signal. We developed a method for judging the validity of the estimated sensor drift values by using the drift distribution based on the sensor calibration data. And then, the equipment failure is diagnosed by using the process signals after removal of the sensor drifts. To verify the developed diagnostic system, several sets of simulation data based on abnormal cases

Nine cases of multiple myeloma among atomic bomb survivors in Hiroshima

Energy Technology Data Exchange (ETDEWEB)

Niimi, Masanobu; Matsueda, Kazuhiro; Nishida, Kazurou; Kobayashi, Makoto; Kou, Hassei; Mikami, Motoko; Nakamura, Masayoshi; Tanaka, Yoshikiyo; Aisaka, Tadakazu

1986-03-01

Nine A-bomb survivors (2 men and 7 women) were diagnosed as having multiple myeloma (MM) 24 years to 38 years after exposure. According to exposure doses, three survivors were exposed at less than or equal to 1,800 m from the hypocenter, three between 2,200 m and 2,500 m, and three between 3,100 m and 4,100 m. Acute atomic radiation injuries, such as epilation and disturbance in bone marrow function, were observed in survivors exposed at less than or equal to 2,400 m. Complications included hypertension in two, diabetes mellitus in one, and cancer of the pharynx in one. Three of the patients are still alive with follow-up periods of 3 years and 6 months to 7 years and 11 months. Two survivors, who showed no evidence of abnormal physical findings, did not meet typical MM criteria according to Abe et al. There has been a continuing discussion regarding the association between A-bomb radiation and intermediate type MM seen in the two survivors. (Namekawa, K.).

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

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

2014-08-01

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

National estimates and correlates of secondhand smoke exposure in US cancer survivors.

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Asfar, Taghrid; Arheart, Kristopher L; Koru-Sengul, Tulay; Byrne, Margaret M; Dietz, Noella A; Chen, Charles Jeng; Lee, David J

2017-08-01

Cancer survivors comprise a vulnerable population for exposure to secondhand smoke (SHS). This study examined and compared the prevalence, time trends, and predictors of SHS exposure between nonsmoking adult cancer survivors and nonsmoking adults without cancer history (control group). Data were obtained from the 2001-2012 National Health and Nutrition Examination Survey (survivors: n = 2168; controls: n = 19,436). All adults ≥20 years of age who reported not smoking and had a serum cotinine level of 0.015-10 ng/mL were included in the study. Prevalence and 95% confidence intervals, weighted linear regression of prevalence on year for trend analysis, and logistic regression analysis were performed with adjustments made for the complex survey design. Survivors were significantly less likely to be exposed to SHS (65.4 vs. 70.6%, respectively). Exposure over time decreased by 16% (from 67.1% in 2001 to 53.3% in 2012) among survivors and by 24% (from 72% in 2001 to 56% in 2012) among controls. Exposed survivors were more likely to be young (OR = 0.98 [95% CI = 0.97-0.99]), non-Hispanic Black (2.51 [1.49-4.26]), with some college education (2.47 [1.56-3.93]), a high school education (2.72 [1.76-4.19]), less than a high school education (2.49 [1.58-3.91]), and poor (1.80 [1.10-2.96]). Considerable numbers of US cancer survivors are exposed to SHS and exposure disparities persist. More efforts are needed to develop and test population policies and clinical-based interventions targeting cancer survivors.

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

Feasibility of Mind-Body Movement Programs for Cancer Survivors.

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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.

Seeking and securing work: Individual-level predictors of employment of psychiatric survivors.

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Hall, Peter V; Montgomery, Phyllis; Davie, Samantha; Dickins, Kevin; Forchuk, Cheryl; Jeng, Momodou S; Kersey, Melissa; Meier, Amanda; Lahey, Pam; Rudnick, Abraham; Solomon, Michelle; Warner, Laura

2015-01-01

For people with mental illness (psychiatric survivors), seeking and securing employment involves personal, social, and environmental factors. In Canada, psychiatric survivors are under-represented in the workforce, and services can help by tailoring their supports to help make the most gains in employment. Determine whether individual socio-demographic and health factors predict seeking and securing employment among psychiatric survivors. A community sample of psychiatric survivors from a Southwestern Ontario region participated in this study. Stepwise logistic regression was used to analyze data from 363 participants who had completed a variety of questionnaires to ascertain individual characteristics and employment outcomes. Health service utilization, living circumstances, homelessness, substance use issues, general health, social integration, ethnicity, having children under 18, and being a student emerged as significant predictors of seeking and securing work. Other commonly accepted human capital indicators, such as education and age, were not predictive of employment search behavior and outcomes. Individual characteristics that predict employment search and success outcomes for psychiatric survivors include aspects related to treatment and living circumstances, which stands in contrast to predictors of employment for the general population, suggesting that employment support services may need to be tailored to psychiatric survivors specifically.

Proximally exposed A-bomb survivors. 2

International Nuclear Information System (INIS)

Kamada, Nanao

1992-01-01

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

Validation and simplification of Fournier's gangrene severity index.

Science.gov (United States)

Lin, Tsung-Yen; Ou, Chien-Hui; Tzai, Tzong-Shin; Tong, Yat-Ching; Chang, Chien-Chen; Cheng, Hong-Lin; Yang, Wen-Horng; Lin, Yung-Ming

2014-07-01

To validate the predictive value of Fournier's Gangrene Severity Index in patients with Fournier gangrene and to facilitate patient mortality risk-stratification by simplifying the Fournier's Gangrene Severity Index. From January 1989 to December 2011, 85 male patients with clinically-documented Fournier's gangrene undergoing intensive treatment and with complete medical records were recruited. The demographic information and nine parameters of Fournier's Gangrene Severity Index were compared between survivors and non-survivors. The parameters that showed a significant difference between the two groups were selected to generate a simplified scoring index. Of the 85 patients recruited, 16 patients died of the disease with mortality rate of 18.8%. The Fournier's Gangrene Severity Index score at initial diagnosis was significantly higher in non-survivors than in survivors. Of the nine parameters of Fournier's Gangrene Severity Index, the scores of serum creatinine level, hematocrit level and serum potassium level were significantly different between the two groups. However, the mean body temperatures, heart rate, respiration rate, white blood cell count, serum sodium and bicarbonate levels were non-significantly different. Of the 12 patients with chronic kidney disease or end-stage renal disease, 10 died of severe sepsis. A simplified scoring index including parameters of creatinine, hematocrit and potassium was generated, which provided sensitivity and specificity of 87% and 77% in predicting patient mortality, respectively. The predictive values of this simplified Fournier's Gangrene Severity Index were shown to be non-inferior to Fournier's Gangrene Severity Index in our patients. The simplified Fournier's Gangrene Severity Index is easy to use at initial diagnosis, and offers a way to compare outcomes in different clinical populations. © 2014 The Japanese Urological Association.

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

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

Health-related fitness in very long-term survivors of childhood cancer: A cross-sectional study.

Science.gov (United States)

Hartman, Annelies; Pluijm, Saskia M F; Wijnen, Mark; Neggers, Sebastian J C M M; Clemens, Eva; Pieters, Rob; van den Heuvel-Eibrink, Marry M

2018-04-01

Impairment of health-related physical fitness (HRPF) in survivors of acute lymphoblastic leukemia has been shown. However, evidence of impairment in survivors of other pediatric malignancies and possible risk factors is limited. HRPF of 17 survivors of pediatric acute myeloid leukemia (AML), 26 survivors of neuroblastoma (NBL), 28 survivors of Wilms tumor (WT) (median age 28.8 [18.8-62.6] years) after a median follow-up time of 24.5 (6.5-43.6) years, and 74 healthy controls (median age 26.9 [17.9-61.7] years). Risk factors were investigated. Testing included submaximal cardiovascular endurance (6-Minute Walk Test (6 MWT), flexibility, and muscle strength. Results are expressed as mean (standard error). Survivors scored significantly lower than controls on the 6 MWT (588 ± 6.1 m vs. controls 611 ± 6.0 m; P = 0.008), on side flexion of the trunk (20.1 ± 0.4 cm vs. controls 22.4 ±0.4 cm; P < 0.001), and on vertical jump (39.7 ± 0.8 cm vs. controls 43.8 ± 0.8 cm; P < 0.001). Survivors of AML had lower scores on the 6 MWT (563 ± 12.4 m) than survivors of NBL (585 ± 9.9 m) and survivors of WT (606 ± 9.6 m), P = 0.046. Being a survivor, higher body mass index (BMI) and no participation in sports were independently associated with lower scores on the 6 MWT. Survivors of NBL, WT, and especially AML have impaired HRPF. Higher BMI and physical inactivity at adult age appeared prominent risk factors for impaired HRPF in these survivors. © 2017 Wiley Periodicals, Inc.

Return to Work in Out-of-Hospital Cardiac Arrest Survivors

DEFF Research Database (Denmark)

Kragholm, Kristian; Wissenberg, Mads; Mortensen, Rikke Normark

2015-01-01

BACKGROUND: Data on long-term function of out-of-hospital cardiac arrest survivors are sparse. We examined return to work as a proxy of preserved function without major neurologic deficits in survivors. METHODS AND RESULTS: In Denmark, out-of-hospital cardiac arrests have been systematically repo...

Outcomes of social support programs in brain cancer survivors in an Australian community cohort: a prospective study

Directory of Open Access Journals (Sweden)

Khan F

2013-03-01

Full Text Available This study evaluated the impact of social support programs on improving cancer related disability, neuro-cognitive dysfunction and enhancing participation (quality of life (QoL, social reintegration in brain tumour (BT survivors. Participants (n=43 were recruited prospectively following definitive treatment in the community. Each BT survivor received an individualised social support program which comprised: face-to-face interview for education/counselling plus peer support program or community education/counselling sessions. The assessments were at baseline (T1, 6-week (T2 and 6-month (T3 post-intervention using validated questionnaires: depression anxiety stress scale (DASS, functional independence measure (FIM, perceived impact problem profile (PIPP, cancer rehabilitation evaluation system–short form (CARES-SF, a cancer survivor unmet needs measure (CaSUN, McGill quality of life questionnaire (MQOL and Brief COPE. Participants’ mean age was 53 years (range 31–72 years, the majority were female (72%; median time since BT diagnosis was 2.3 years and almost half (47% had high grade tumours. At T2, participants reported higher emotional well-being (DASS ‘anxiety’ and ‘stress’ subscales, p<0.05; FIM ‘cognition’ subscale, p<0.01, improved function (FIM ‘motor’ subscale, p<0.01 and higher QoL (CARES-SF ‘global’ score, p<0.05; MQOL ‘physical symptom’ subscale, p<0.05. At the T3 follow-up, most of these effects were maintained. The intervention effect for BT specific coping strategies emerged for the Brief COPE ‘self-distraction’ and ‘behavioural disengagement’ domains, (p<0.05 for both. There were no adverse effects reported. A post-treatment social support program can improve physical and cognitive function and enhancing overall QoL of BT survivors. Social support programs need further evaluation and should be encouraged by clinicians within cancer rehabilitative services.

Considerations for the long term treatment of pediatric sarcoma survivors

Directory of Open Access Journals (Sweden)

Kurt R Weiss

2018-01-01

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

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.

Quality of life in stroke survivors under the sixty years of age.

Science.gov (United States)

Vidović, Mirjana; Sinanović, Osman; Smajlović, Dzevdet

2007-08-01

The objective of the study was to analyze the quality of life six months after stroke in survivors under sixty years of age, to determine which life activities was the most affected, as well as to correlate the neurological insufficiency and the quality of life. It monitored 200 stroke survivors under sixty years of age treated at the Department of Neurology, University Clinical Centre Tuzla. Average age was 51,83 years (+/-7,02). The ischemic stroke was diagnosed in 77,5% stroke survivors, cerebral hemorrhage in 15%, and subarachnoid hemorrhage in 7,5%. Five stroke survivors suffered hemiplegia (2,5%), 24 (12%) experienced moderate consequences and 143 (71,5%) had mild consequences. No neurological deficit had 28 (14%) stroke survivors. Six months after the onset of disease all stroke survivors have been followed-up and evaluated about quality of life by filling in a modified questionnaire: Questionnaire on Quality of Life after Stroke (2). The questionnaire contained 20 questions covering four fields of life: Working Ability, Home Activity, Family Relations and Leisure Activities. Six months after the onset of stroke a worse quality of life in comparison to the period before the disease was noted in 172 (86%) stroke survivors, the unchanged in 19 (9,5%) and better in 9 (4,5%). The most affected is the field "Leisure Activities", followed by "Family Relations", "Home Activity", and the least affected is "Work Ability". The neurological deficit significantly correlates to the "Home Activities" and "Leisure Activities".

Atypical social development in neonatal intensive care unit survivors at 12 months.

Science.gov (United States)

Yamada, Yasumasa; Yoshida, Futoshi; Hemmi, Hayato; Ito, Miharu; Kakita, Hiroki; Yoshikawa, Toru; Hishida, Manabu; Iguchi, Toshiyuki; Seo, Tomoko; Nakanishi, Keiko

2011-12-01

Owing to advances in neonatal intensive care, many infants who are hospitalized in neonatal intensive care units (NICU) can survive and grow, and are referred to as NICU survivors. However, social development in NICU survivors has not been fully explored. To examine the social development of NICU survivors, a questionnaire consisting of the Modified Checklist for Autism in Toddlers (M-CHAT) was used. The M-CHAT was completed by the parents of either NICU survivors (n= 117) or normally delivered children (control group, n= 112) during their regular medical checkups at a corrected age of 12 months. Ninety percent of NICU survivors and 63% of control children did not pass the M-CHAT screen. As it was originally designed for children aged 18-30 months, failed M-CHAT items could have been due to developmental issues and not due to autistic spectrum disorders. However, there was a significant difference in the total number of items failed between the two groups. In particular, many NICU survivors did not pass on M-CHAT items, such as oversensitivity to noise, unusual finger movements, and attempts to attract attention. Concerning perinatal complications, infants with low birthweight and/or the need for respiratory support tended to have a higher number of failures on all M-CHAT items. NICU survivors may have distinct developmental patterns of social communication, and should be followed up for assessment of social skills and neurological development. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

Aging studies in atomic bomb survivors

International Nuclear Information System (INIS)

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

1980-01-01

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

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.

Potentially damaging failure modes of high- and medium-voltage electrical equipment

International Nuclear Information System (INIS)

Hoy, H.C.

1984-01-01

The high- and medium-voltage electrical equipment failures of both nuclear and nonnuclear electric utilities have been reviewed for possible disruptive failure modes that would be of special concern in a nuclear power plant. The resulting emphasis was on the electrical faults of transformers, switchgear (circuit breakers), lightning (surge) arrestors, high-voltage cabling and buswork, control boards, and other electrical equipment that, through failure, can be the initiating event that may expand the original fault to nearby or associated equipment. Many failures of such equipment were found and documented, although the failure rate of electrical equipment in utilities is historically quite low. Nuclear plants record too few failures to be statistically valid, but failures that have been recorded show that good design usually restricts the failure to a single piece of equipment. Conclusions and recommendations pertaining to the design, maintenance, and operation of the affected electrical equipment are presented

Psychological problems of atomic bomb survivors from the medical social worker`s standpoint

Energy Technology Data Exchange (ETDEWEB)

Tomoike, Toshio [Japanese Red Cross Nagasaki Atomic Bomb Hospital (Japan)

1994-12-01

Mental data from 80 A-bomb survivors were available during a 20-year period 1973-1992. Types of A-bomb survivors were classified into (1) directly exposed A-bomb survivors, (2) A-bomb survivors living in the United States, (3) those living in prefectures other than Nagasaki, (4) ex-soldiers, (5) A-bomb survivors having family problems and others, (6) the demented elderly, (7) the alcoholic, and (8) others. Mental problems were judged as psychogenic, endogenous, and exogenous. Mental problems were most frequently associated with Type 1 (34.9%), followed by Type 8 (21.0%), Type 2 (18.6%), and Type 3 (7.0%). Noticeable finding was that Type 1 A-bomb survivors suffered from psychogenic and exogenous mental problems in an extremely high incidence, as compared with the non-exposed group (66.3% vs 24%). The incidence of both exogenous and endogenous problems was higher in the non-exposed group (32.6% and 24.5%) than the exposed group (23.2% and 10.5%). There was no significant gender difference in the development of mental problems. According to types of A-bomb survivors, both psychogenic and exogenous mental problems were most common for Type 1. The incidence of psychogenic problems was 2.85 times higher than that of exogenous problems. (N.K.).

Margins related to equipment design

International Nuclear Information System (INIS)

Devos, J.

1994-01-01

Safety margins related to design of reactor equipment are defined according to safety regulations. Advanced best estimate methods are proposed including some examples which were computed and compared to experimental results. Best estimate methods require greater computation effort and more material data but give better variable accuracy and need careful experimental validation. Simplified methods compared to the previous are less sensitive to material data, sometimes are more accurate but very long to elaborate

Suicide Survivors' Mental Health and Grief Reactions: A Systematic Review of Controlled Studies

Science.gov (United States)

Sveen, Carl-Aksel; Walby, Fredrik A.

2008-01-01

There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified…

Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States.

Science.gov (United States)

Guy, Gery P; Yabroff, K Robin; Ekwueme, Donatus U; Rim, Sun Hee; Li, Rui; Richardson, Lisa C

2017-06-20

Purpose The prevalence of cancer survivorship and chronic health conditions is increasing. Limited information exists on the economic burden of chronic conditions among survivors of cancer. This study examines the prevalence and economic effect of chronic conditions among survivors of cancer. Methods Using the 2008 to 2013 Medical Expenditure Panel Survey, we present nationally representative estimates of the prevalence of chronic conditions (heart disease, high blood pressure, stroke, emphysema, high cholesterol, diabetes, arthritis, and asthma) and multiple chronic conditions (MCCs) and the incremental annual health care use, medical expenditures, and lost productivity for survivors of cancer attributed to individual chronic conditions and MCCs. Incremental use, expenditures, and lost productivity were evaluated with multivariable regression. Results Survivors of cancer were more likely to have chronic conditions and MCCs compared with adults without a history of cancer. The presence of chronic conditions among survivors of cancer was associated with substantially higher annual medical expenditures, especially for heart disease ($4,595; 95% CI, $3,262 to $5,927) and stroke ($3,843; 95% CI, $1,983 to $5,704). The presence of four or more chronic conditions was associated with increased annual expenditures of $10,280 (95% CI, $7,435 to $13,125) per survivor of cancer. Annual lost productivity was higher among survivors of cancer with other chronic conditions, especially stroke ($4,325; 95% CI, $2,687 to $5,964), and arthritis ($3,534; 95% CI, $2,475 to $4,593). Having four or more chronic conditions was associated with increased annual lost productivity of $9,099 (95% CI, $7,224 to $10,973) per survivor of cancer. The economic impact of chronic conditions was similar among survivors of cancer and individuals without a history of cancer. Conclusion These results highlight the importance of ensuring access to lifelong personalized screening, surveillance, and chronic

Breast cancer survivors' beliefs and preferences regarding technology-supported sedentary behavior reduction interventions.

Science.gov (United States)

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

2016-01-01

Less time spent in sedentary behaviors is associated with improved health and disease outcomes in breast cancer survivors. However, little is known about survivors' interest in sedentary behavior reduction interventions and how to effectively reduce this risk behavior. The purpose of this study was to explore breast cancer survivors' interest in and preferences for technology-supported sedentary behavior reduction interventions. Breast cancer survivors [n=279; M age =60.7 ( SD =9.7)] completed a battery of online questionnaires. Descriptive statistics were calculated for all data. To examine potential relationships between demographic, disease and behavioral factors, and survivors' interest in a technology-supported sedentary behavior reduction intervention, we conducted logistic regression analyses. These same factors were examined in relation to the perceptions of the effectiveness of such intervention using multiple regression analyses. On average, survivors spent 10.1 ( SD =4.3) hours/day in sedentary activity. They believed prolonged periods of sedentary behavior were harmful to their health (87.0%) and that reducing sedentary behavior could improve their health (88.4%). Survivors believed they should move around after 30-60 (56.7%) or ≥60 (29.9%) minutes of sedentary behavior and indicated they were most likely to replace sedentary behaviors with walking around (97.1%) or walking in place (73.4%). The majority of survivors (79.9%) was interested in participating in a technology-supported sedentary behavior reduction intervention and indicated they would use a smartphone application (61.3%) 2-3 times/day (48.0%), 6 to 7 days/week (52.0%). Most survivors (73.5%) believed reminders would help them decrease sedentary behavior and preferred they be delivered after sitting for 60 minutes (60.5%) via vibrations on a wrist worn activity tracker (77.3%) or text messages (54.4%). Technology-supported sedentary behavior reduction interventions may be feasible and

Experimental Validation of the Simulation Model of a DOAS Equipped with a Desiccant Wheel and a Vapor Compression Refrigeration System

Directory of Open Access Journals (Sweden)

Pedro J. Martínez

2017-09-01

Full Text Available A dedicated outdoor air system (DOAS can be designed to supply 100% of the outside air and meet the latent load of the room with dry air. The objectives of this study were to develop a model of a DOAS equipped with a desiccant wheel and a vapor-compression refrigeration system, build a prototype, validate the model with experimental data, and gain knowledge about the system operation. The test facility was designed with the desiccant wheel downstream of the cooling coil to take advantage of the operating principles of cooling coils and desiccants. A model of the DOAS was developed in the TRNSYS environment. The root mean standard error (RMSE was used for model validation by comparing the measured air and refrigerant properties with the corresponding calculated values. The results obtained with the developed model showed that the DOAS was able to maintain an indoor humidity ratio depending on outdoor conditions. Laboratory tests were also used to investigate the effect of changes in the regeneration air temperature and the process airflow rate on the process air humidity ratio at the outlet of the wheel. The results are consistent with the technical literature.

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

Directory of Open Access Journals (Sweden)

Carol S. North

2012-01-01

Full Text Available Background. Few disaster studies have specifically examined personality and resilience in association with disaster exposure, posttraumatic stress disorder (PTSD, and major depression. Methods. 151 directly-exposed survivors of the Oklahoma City bombing randomly selected from a bombing survivor registry completed PTSD, major depression, and personality assessments using the Diagnostic Interview Schedule for DSM-IV and the Temperament and Character Inventory, respectively. Results. The most prevalent postdisaster psychiatric disorder was bombing-related PTSD (32%; major depression was second in prevalence (21%. Bombing-related PTSD was associated with the combination of low self-directedness and low cooperativeness and also with high self-transcendence and high harm avoidance in most configurations. Postdisaster major depression was significantly more prevalent among those with (56% than without (5% bombing-related PTSD (P<.001 and those with (72% than without (14% predisaster major depression (P<.001. Incident major depression was not associated with the combination of low self-directedness and low cooperativeness. Conclusions. Personality features can distinguish resilience to a specific life-threatening stressor from general indicators of well-being. Unlike bombing-related PTSD, major depression was not a robust marker of low resilience. Development and validation of measures of resilience should utilize well-defined diagnoses whenever possible, rather than relying on nonspecific measures of psychological distress.

The Danish version of Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF) for breast cancer survivors

DEFF Research Database (Denmark)

Grarup, Karin R; Devoogdt, Nele; Strand, Liv Inger

2018-01-01

PURPOSE: To translate and culturally adapt the Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF) for breast cancer survivors with arm lymphedema into Danish and examine its content validity and reliability. METHODS: (1) Translation and cultural adaptation was performed in 10...... steps following international guidelines (International Society for Pharmacoeconomics and Outcome Research); (2) cognitive interviewing (step 7) was conducted in 15 women with breast cancer related arm lymphedema to explore understandability, interpretation, and cultural relevance; (3) after adjustments...... for the domains ranged from 0.84 to 0.94. SEM values differed for the domains, 6.4 (physical function), 5.7 (mobility activities), 7.09 (life and social activities), 9.1 (mental functions), and 10.2 (household activities). CONCLUSION: The translated and adjusted Lymph-ICF DK (Denmark) is reliable and valid...

Exercise echocardiography in asymptomatic survivors of childhood cancer treated with anthracyclines

DEFF Research Database (Denmark)

Sieswerda, Elske; Kremer, Leontien C M; Vidmar, Suzanna

2010-01-01

BACKGROUND: Exercise echocardiography reveals abnormalities in asymptomatic childhood cancer survivors who previously have been treated with anthracyclines. We determined the added value of monitoring childhood cancer survivors with exercise echocardiography compared to monitoring with resting ec...

Genetic counseling of the cancer survivor

International Nuclear Information System (INIS)

Mulvihill, J.J.; Byrne, J.

1989-01-01

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

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

Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial

Science.gov (United States)

Mao, Jun J.; Bowman, Marjorie A.; Xie, Sharon X.; Bruner, Deborah; DeMichele, Angela; Farrar, John T.

2015-01-01

Purpose Hot flashes are a common and debilitating symptom among survivors of breast cancer. This study aimed at evaluating the effects of electroacupuncture (EA) versus gabapentin (GP) for hot flashes among survivors of breast cancer, with a specific focus on the placebo and nocebo effects. Patients and Methods We conducted a randomized controlled trial involving 120 survivors of breast cancer experiencing bothersome hot flashes twice per day or greater. Participants were randomly assigned to receive 8 weeks of EA or GP once per day with validated placebo controls (sham acupuncture [SA] or placebo pills [PPs]). The primary end point was change in the hot flash composite score (HFCS) between SA and PP at week 8, with secondary end points including group comparisons and additional evaluation at week 24 for durability of treatment effects. Results By week 8, SA produced significantly greater reduction in HFCS than did PP (−2.39; 95% CI, −4.60 to −0.17). Among all treatment groups, the mean reduction in HFCS was greatest in the EA group, followed by SA, GP, and PP (−7.4 v −5.9 v −5.2 v −3.4; P = < .001). The pill groups had more treatment-related adverse events than did the acupuncture groups: GP (39.3%), PP (20.0%), EA (16.7%), and SA (3.1%), with P = .005. By week 24, HFCS reduction was greatest in the EA group, followed by SA, PP, and GP (−8.5 v −6.1 v −4.6 v −2.8; P = .002). Conclusion Acupuncture produced larger placebo and smaller nocebo effects than did pills for the treatment of hot flashes. EA may be more effective than GP, with fewer adverse effects for managing hot flashes among breast cancer survivors; however, these preliminary findings need to be confirmed in larger randomized controlled trials with long-term follow-up. PMID:26304905

Dietary pattern and health-related quality of life among breast cancer survivors.

Science.gov (United States)

Kim, Na-Hui; Song, Sihan; Jung, So-Youn; Lee, Eunsook; Kim, Zisun; Moon, Hyeong-Gon; Noh, Dong-Young; Lee, Jung Eun

2018-05-10

There is limited evidence for the association between dietary pattern and quality of life among breast cancer survivors. We examined the association between dietary patterns and health-related quality of life (HRQoL) among Korean breast cancer survivors. Our study included a total of 232 women, aged 21 to 79 years, who had been diagnosed with stage I to III breast cancer and who underwent breast cancer surgery at least 6 months prior to our baseline evaluation. We assessed HRQoL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire Breast Cancer Module 23 (QLQ-BR23). We conducted a factor analysis to identify the major dietary patterns and used a generalized linear model to obtain the least squares mean (LS mean) and 95% confidence interval (CI) for HRQoL according to the dietary pattern scores. We identified 2 major dietary patterns: the Healthy dietary pattern and the Western dietary pattern. We found that breast cancer survivors who had higher Healthy dietary pattern scores tended to have lower dyspnea scores but higher insomnia scores, compared to breast cancer survivors with lower Healthy dietary pattern scores. For dyspnea, the LS mean (95% CI) was 8.86 (5.05-15.52) in the bottom quartile and 2.87 (1.62-5.08) in the top quartile (p for trend = 0.005). This association was limited to survivors with stage I for dyspnea or survivors with stage II or III for insomnia. Healthy dietary patterns were associated with better scores for dyspnea but worse scores for insomnia among breast cancer survivors. Other components of EORTC QLQ did not vary by dietary patterns overall, but they warrant further investigation for subgroups of breast cancer survivors.

Congenital Malformations among the Offspring of Danish Survivors of Childhood Cancer and their Siblings-Interim Results

International Nuclear Information System (INIS)

Binks, K.; Boice, J. D.; Winther, J. F.

2004-01-01

Survival is now the norm for children treated with radiotherapy and chemotherapy for childhood cancers. These children are now living to have children of their own. A Danish study of adverse health outcomes in the offspring of childhood cancer survivors and the offspring of the cancer survivor's sibling is ongoing. The cumulative probability of congenital malformation is non significantly higher amongst the offspring of cancer survivors than amongst the offspring of cancer survivor's siblings; and non significantly higher amongst the offspring of cancer survivors who received radiotherapy treatment compared with those who did not. future analyses will incorporate radiation dose to the uterus and gonads of cancer survivors. To date, studies of childhood cancer survivors offspring have not indicated and excess of congenial malformation. (Author) 7 refs

Psychological factors impacting transition from paediatric to adult care by childhood cancer survivors.

Science.gov (United States)

Granek, Leeat; Nathan, Paul C; Rosenberg-Yunger, Zahava R S; D'Agostino, Norma; Amin, Leila; Barr, Ronald D; Greenberg, Mark L; Hodgson, David; Boydell, Katherine; Klassen, Anne F

2012-09-01

Childhood cancer survivors require life-long care focused on the specific late effects that may arise from their cancer and its treatment. In many centers, survivors are required to transition from follow-up care in a paediatric cancer center, to care provided in an adult care setting. The purpose of this study was to identify the psychological factors involved in this transition to adult care long-term follow-up clinics. Qualitative interviews were conducted with ten paediatric survivors still in paediatric care, as well as 28 adult survivors of whom 11 had transitioned successfully to adult care (attended three long-term follow-up (LTFU) appointments consecutively); ten who failed to transition (attended at least one LTFU appointment as an adult, but were inconsistent with subsequent attendance); and seven who had never transitioned (did not attend any LTFU care as an adult). Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. Two overall categories and four subthemes were identified: (1) Identification with being a cancer survivor included the subthemes of 'cancer identity' and 'cancer a thing of the past' and; (2) Emotional components included the subthemes of 'fear and anxiety' and 'gratitude and gaining perspective'. The analysis revealed that the same factor could act as either a motivator or a hindrance to successful transition in different survivors (e.g., fear of recurrence of cancer might be a barrier or a facilitator depending on the survivor's life experience). Psychological factors are an important consideration when preparing cancer survivors for transition to adult long-term follow-up care. Identifying and addressing the individual psychological needs of childhood cancer survivors may improve the likelihood of their successful transition to adult care.

Topic Modeling of Smoking- and Cessation-Related Posts to the American Cancer Society's Cancer Survivor Network (CSN): Implications for Cessation Treatment for Cancer Survivors Who Smoke.

Science.gov (United States)

Westmaas, J Lee; McDonald, Bennett R; Portier, Kenneth M

2017-08-01

Smoking is a risk factor in at least 18 cancers, and approximately two-thirds of cancer survivors continue smoking following diagnosis. Text mining of survivors' online posts related to smoking and quitting could inform strategies to reduce smoking in this vulnerable population. We identified posts containing smoking/cessation-related keywords from the Cancer Survivors Network (CSN), an online cancer survivor community of 166 000 members and over 468 000 posts since inception. Unsupervised topic model analysis of posts since 2000 using Latent Dirichlet Allocation extracted 70 latent topics which two subject experts inspected for themes based on representative terms. Posterior analysis assessed the distribution of topics within posts, and the range of themes discussed across posts. Less than 1% of posts (n = 3998) contained smoking/cessation-related terms, and covered topics related to cancer diagnoses, treatments, and coping. The most frequent smoking-related topics were quit smoking methods (5.4% of posts), and the environment for quitters (2.9% of posts), such as the stigma associated with being a smoker diagnosed with cancer and lack of empathy experienced compared to nonsmokers. Smoking as a risk factor for one's diagnosis was a primary topic in only 1.7% of smoking/cessation-related posts. The low frequency of smoking/cessation-related posts may be due to expected criticism/stigma for smoking but may also suggests a need for health care providers to address smoking and assist with quitting in the diagnostic and treatment process. Topic model analysis revealed potential barriers that should be addressed in devising clinical or population-level interventions for cancer survivors who smoke. Although smoking is a major risk factor for cancer, little is known about cancer patients' or survivors' views or concerns about smoking and quitting. This study used text mining of posts to an online community of cancer patients and survivors to investigate contexts in which

Reproductive hormones and metabolic syndrome in 24 testicular cancer survivors and their biological brothers.

Science.gov (United States)

Bandak, M; Jørgensen, N; Juul, A; Lauritsen, J; Kier, M G G; Mortensen, M S; Oturai, P S; Mortensen, J; Hojman, P; Helge, J W; Daugaard, G

2017-07-01

Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39-50) vs. 46 (40-53) years respectively (p = 0.1)]. In testicular cancer survivors, follow-up since treatment was 12 years (7-19). Serum levels of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL-cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers. © 2017 American

Motivations associated with physical activity in young breast cancer survivors.

Science.gov (United States)

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

2015-01-01

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

Development of a short version of the Dutch version of the Spielberger STAI Trait Anxiety Scale in women suspected of breast cancer and breast cancer survivors

NARCIS (Netherlands)

de Vries, J.; van Heck, G.L.

2013-01-01

The objective of the current study was to develop a short form of the Dutch version of the State-Trait Anxiety Inventory (STAI) Trait scale and to provide initial validation data in a sample of breast cancer patients and survivors. This short trait anxiety (A-Trait) scale was designed to reduce time

The Lived Experience of Providing Care and Support Services for Holocaust Survivors in Australia.

Science.gov (United States)

Teshuva, Karen; Borowski, Allan; Wells, Yvonne

2017-06-01

Lack of awareness among paid carers of the possible late-life consequences of early-life periods of extreme and prolonged traumatization may have negative impacts on the experiences of trauma survivors in receiving care. An interpretive phenomenological approach was used to investigate the lived experience of paid carers in providing care for Jewish Holocaust survivors. In total, 70 carers participated in 10 focus group discussions. Credibility of the findings was ensured by methodological triangulation and peer debriefing. Three major themes emerged: (a) knowing about survivors' past helps me make sense of who they are, (b) the trauma adds an extra dimension to caregiving, and (c) caring for survivors has an emotional impact. Specific knowledge, attitudes, and skills for building positive care relationships with Holocaust survivors were identified. The findings offer a starting point for advancing knowledge about the care of older survivors from other refugee backgrounds.

Breast Cancer Risk in Childhood Cancer Survivors Without a History of Chest Radiotherapy: A Report From the Childhood Cancer Survivor Study

Science.gov (United States)

Moskowitz, Chaya S.; Chou, Joanne F.; Bradbury, Angela R.; Neglia, Joseph Phillip; Dang, Chau T.; Onel, Kenan; Novetsky Friedman, Danielle; Bhatia, Smita; Strong, Louise C.; Stovall, Marilyn; Kenney, Lisa B.; Barnea, Dana; Lorenzi, Elena; Hammond, Sue; Leisenring, Wendy M.; Robison, Leslie L.; Armstrong, Gregory T.; Diller, Lisa R.; Oeffinger, Kevin C.

2016-01-01

Purpose Little is known about the breast cancer risk among childhood cancer survivors who did not receive chest radiotherapy. We sought to determine the magnitude of risk and associated risk factors for breast cancer among these women. Patients and Methods We evaluated cumulative breast cancer risk in 3,768 female childhood cancer survivors without a history of chest radiotherapy who were participants in the Childhood Cancer Survivor Study. Results With median follow up of 25.5 years (range, 8 to 39 years), 47 women developed breast cancer at a median age of 38.0 years (range, 22 to 47 years) and median of 24.0 years (range, 10 to 34 years) from primary cancer to breast cancer. A four-fold increased breast cancer risk (standardized incidence ratio [SIR] = 4.0; 95% CI, 3.0 to 5.3) was observed when compared with the general population. Risk was highest among sarcoma and leukemia survivors (SIR = 5.3; 95% CI, 3.6 to 7.8 and SIR = 4.1; 95% CI, 2.4 to 6.9, respectively). By the age of 45 years, the cumulative incidence of breast cancer in sarcoma and leukemia survivors was 5.8% (95% CI, 3.7 to 8.4) and 6.3% (95% CI, 3.0 to 11.3), respectively. No other primary cancer diagnosis was associated with an elevated risk. Alkylators and anthracyclines were associated with an increased breast cancer risk in a dose-dependent manner (P values from test for trend were both < .01). Conclusions Women not exposed to chest radiotherapy who survive childhood sarcoma or leukemia have an increased risk of breast cancer at a young age. The data suggest high-dose alkylator and anthracycline chemotherapy increase the risk of breast cancer. This may suggest a possible underlying gene-environment interaction that warrants further study. PMID:26700127

Executive Functions and Social Skills in Survivors of Pediatric Brain Tumor

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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

Emergency nurses' experiences of caring for survivors of intimate partner violence.

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van der Wath, Annatjie; van Wyk, Neltjie; Janse van Rensburg, Elsie

2013-10-01

To report a study of emergency nurses' experiences of caring for survivors of intimate partner violence. Emergency nurses have the opportunity to intervene during the period following exposure to intimate partner violence when survivors are most receptive for interventions. The confrontation with the trauma of intimate partner violence can, however, affect emergency nurses' ability to engage empathetically with survivors, which is fundamental to all interventions. The research was guided by the philosophical foundations of phenomenology as founded by Husserl. A descriptive phenomenological inquiry grounded in Husserlian philosophy was used. The phenomenological reductions were applied throughout data collection and analysis. During 2010, concrete descriptions were obtained from interviewing 11 nurses working in emergency units of two public hospitals in an urban setting in South Africa. To arrive at a description of the essence, the data were analysed by searching for the meaning given to the experience of caring for survivors of intimate partner violence. Emergency nurses in South Africa are often witnesses of the emotional and physical effects of intimate partner violence. Exposure to the vulnerability and suffering of survivors elicits sympathy and emotional distress. Emergency nurses are left with the emotional impact and disruptive and recurrent memories. Exploring the tacit internal experiences related to caring for survivors of intimate partner violence revealed emergency nurses' vulnerability to the effects of secondary traumatic stress. The findings generated an opportunity to develop guidelines through which to support and empower emergency nurses. © 2013 Blackwell Publishing Ltd.

Primary prevention and screening practices among long-term breast cancer survivors.

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Mandelzweig, Lori; Chetrit, Angela; Amitai, Tova; Silverman, Barbara; Siegelmann-Danieli, Nava; Sadetzki, Siegal

2017-07-01

Parallel to increasing survival of breast cancer (BC) patients, a need has arisen to characterize the follow-up required to improve and maintain their health. Our study aimed to assess changes in lifestyle habits over time among the study population, compare compliance rates of selected primary and secondary prevention practices between long-term BC survivors and an age-matched comparison group, and identify factors associated with compliance to these practices. The study population comprised 250 Israeli BC survivors, diagnosed with BC between 1999 and 2003, without evidence of disease after 8-12 years, and 250 women with no cancer history, individually matched to survivors by age and area of residence. Data collection and analysis were conducted during August 2012-June 2015 and included socio-demographic variables, lifestyle habits, health promotion by the family physician, and participation in screening procedures and prevention measures. Higher performance rates of mammography and colonoscopy among BC survivors were observed, as well as a greater likelihood of receiving an influenza vaccine and undergoing a bone mineral density scan (adjusted-ORs: 7.7, 1.48, 1.42, and 2.59, respectively) compared to controls. Factors identified with compliance to selected practices were age, higher levels of education and income, never smoking, and strenuous physical activity. The survivors adopted healthier lifestyles, which were similar to those of women who never had cancer. About 10 years after BC diagnosis, the survivors generally comply with primary and secondary prevention practices.

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

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Bellizzi, Keith M; Blank, Thomas O

2007-03-01

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

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

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

2018-03-01

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

Late effects of treatment in survivors of childhood acute lymphoblastic leukaemia

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Roux, P.

1987-01-01

The overall aim of this study was a comprehensive assessment of the nature and severity of the late effects of treatment in a group of children surviving acute lymphoblastic leukaemia. In the absence of damage preceding treatment, late effects could be ascribed to treatment. Cranial irradiation, methotrexate, L-asparaginase and cytosine arabinoside are therapeutic modalities most likely to cause injury to the central nervous system. Survivors of childhood leukaemia also showed an increase in weight-for-height during and after therapy which appeared to be the consequence of a loss in statural growth as well as increasing weight-for-age. Assessment of endocrine function in leukaemia survivors indicated abnormalities in the regulation of growth hormone and thyroid stimulating hormone in some patients. Survivors of childhood leukaemia were shown to have an intellectual deficit compared with their siblings and a high incidence of visual-perceptual defects. The intellectual effects of lower doses of cranial irradiation are as yet unknown. A variety of minor neurological abnormalities were detected among leukaemia survivors and thought to be related to preceding central nervous system 'prophylactic' chemotherapy and irradiation. A new instrument, the functional deficit score, was derived to reflect overall outcome in survivors of childhood leukaemia. With few exceptions, leukaemia survivors in this study had received 2400 rads of deep x-ray therapy as cranial irradiation. This dosage has since been reduced world-wide. Current cranial irradiation 'prophylaxis' consists of 1800 rad of megavoltage radiotherapy

Late effects of treatment in survivors of childhood acute lymphoblastic leukaemia

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Roux, P

1987-01-01

The overall aim of this study was a comprehensive assessment of the nature and severity of the late effects of treatment in a group of children surviving acute lymphoblastic leukaemia. In the absence of damage preceding treatment, late effects could be ascribed to treatment. Cranial irradiation, methotrexate, L-asparaginase and cytosine arabinoside are therapeutic modalities most likely to cause injury to the central nervous system. Survivors of childhood leukaemia also showed an increase in weight-for-height during and after therapy which appeared to be the consequence of a loss in statural growth as well as increasing weight-for-age. Assessment of endocrine function in leukaemia survivors indicated abnormalities in the regulation of growth hormone and thyroid stimulating hormone in some patients. Survivors of childhood leukaemia were shown to have an intellectual deficit compared with their siblings and a high incidence of visual-perceptual defects. The intellectual effects of lower doses of cranial irradiation are as yet unknown. A variety of minor neurological abnormalities were detected among leukaemia survivors and thought to be related to preceding central nervous system 'prophylactic' chemotherapy and irradiation. A new instrument, the functional deficit score, was derived to reflect overall outcome in survivors of childhood leukaemia. With few exceptions, leukaemia survivors in this study had received 2400 rads of deep x-ray therapy as cranial irradiation. This dosage has since been reduced world-wide. Current cranial irradiation 'prophylaxis' consists of 1800 rad of megavoltage radiotherapy.

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

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Thomson, Maria D; Siminoff, Laura A

2018-04-16

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

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

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

2018-03-15

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

Perceived barriers to physical activity among Nigerian stroke survivors.

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

2015-01-01

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

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

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

2008-02-20

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

Sexual functioning among early post-treatment breast cancer survivors.

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Avis, Nancy E; Johnson, Aimee; Canzona, Mollie Rose; Levine, Beverly J

2018-02-17

This study aims (1) to estimate percentages of partnered women who are sexually active over the first 2 years post-breast cancer diagnosis; (2) to identify factors related to sexual inactivity; and (3) to evaluate separately, among both sexually active and inactive survivors, the relation between sexual problems and treatment-related variables, symptoms, and psychosocial factors. Longitudinal observational study of breast cancer survivors recruited within 8 months of cancer diagnosis and followed for 18 months. The main outcome measures were (1) being sexually active/inactive in the past month and (2) sexual problems assessed with the four-item sexual problem domain of the Quality of Life in Adult Cancer Survivors (QLACS) scale. At baseline, 52.4% of women reported being sexually active in the past month. This percentage increased to 60.7% 18 months later. In multivariable repeated-measures analyses, age, past chemotherapy, depressive symptoms, and lower perceived attractiveness were related to inactivity. Sexually inactive women reported more problems on the QLACS than sexually active women. In stratified multivariable analyses, depressive symptoms were related to greater sexual problems for both sexually active and inactive women, as was vaginal dryness. Among the sexually active women, younger age at diagnosis, less illness intrusiveness, and lower perceived attractiveness were related to more problems. Research has shown that sexual functioning/sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers. Future studies should examine how such topics are handled by clinicians in their interactions with survivors.

Cognitive and Occupational Function in Survivors of Adolescent Cancer.

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

2018-02-01

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

Clinical survey of blood dyscrasias among Hiroshima a-bomb survivors by the periodical health examination, 5

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Taketomi, Yoshinori; Abe, Tsutomu; Okita, Hajime; Kamada, Nanao; Kuramoto, Atsushi

1980-01-01

Certain blood examinations were performed on a-bomb survivors having anemia more than moderate stage (the hemoglobin value under 9.0 g/dl), who were found out by the periodical health examination performed in Hiroshima-A-bomb Survivors Health Control Clinic during the latter period of the fiscal year 1975. The total number of a-bomb survivors who received the periodical health examination was 50,973, and the number of survivors whose hemoglobin value was under 9.0 g/dl was 201 (0.39%). The incidence of such anemia was high in women. There was not a relationship between this anemia and the exposure distance from the hypocenter. The incidence of this anemia was high in young a-bomb survivors, and more than 50% of a-bomb survivors having this anemia was under the age of 50. Iron-deficiency anemia was found in 88% of a-bomb survivors, and the course of their anemia ran in many years in many a-bomb survivors. (Tsunoda, M.)

Functional challenges among late effects cancer survivors: a preliminary report on work engagement issues.

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Crist, Patricia

2013-01-01

While the cancer survivor rate is nearly 68% now, intervention regimens may leave residual conditions that impact engagement in work and various life tasks. Survivors are underemployed and report stigmatizing attitudes among co-workers. When late effects from cancer arise over 10 years later, the impact on individuals in the prime of their productive employment life is evident. Assisting these individuals begins with awareness of late effects in order to create work-related, adaptive strategies. Sixteen adult cancer survivors experiencing late effects completed the Occupational Self Assessment (Version 2.2) and the Quality of Life-Cancer Survivors (QOL-CS). Knowledge of functional problems secondary to recognized late effects medical conditions reported in the literature was utilized to sort items according to professional definitions of work, performance skills and performance patterns. Late effects survivors reported that cancer illness and treatment has negatively impacted their employment. Individual response to the impact of late effects is highly variant. "Getting things done" and physical energy limitations are most pronounced. Cancer survivors report lower competence in significant work-related skills and patterns. Quality of life associated with the aftereffects of fatigue, aches and pain, and sleep changes are the lowest. Responses range across the 16 survivors to both performance skills and performance patterns. Cancer survivorship has clearly interfered with employment. An interdisciplinary focus on meaningful engagement in life activities, particularly work is crucial to support survivors through advocacy, adaptation and positive change to focus on engaging the work talents and gifts for all cancer survivors.

Personality and psychological distress among older adult, long-term cancer survivors.

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Deimling, Gary T; Albitz, Casey; Monnin, Kara; Renzhofer Pappada, Holly T; Nalepa, Elizabeth; Boehm, Melinda Laroco; Mitchell, Claire

2017-01-01

This research examines a model of how personality (Five-Factor Model) is related to adjustment to cancer in later life in terms of the presence of continuing cancer-related worry and depression among older adult, long-term cancer survivors. Data from an NCI-funded study with 275 older adult (age 60+), long-term (5+ years) survivors of breast, prostate, and colorectal cancer were examined. Regression analyses identified neuroticism as the strongest predictor of cancer-related worry along with continuing cancer-related symptoms. For depression, three personality dimensions (neuroticism, conscientiousness, and agreeableness) were significant predictors. Findings suggest the importance of considering the central role that survivors' personality characteristics play in understanding cancer-related worries and depression. Understanding these dispositional characteristics is key for social workers and health-care practitioners in counseling survivors experiencing these common mental health effects.

Fertility-related knowledge and reproductive goals in childhood cancer survivors: short communication.

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Lehmann, V; Keim, M C; Nahata, L; Shultz, E L; Klosky, J L; Tuinman, M A; Gerhardt, C A

2017-11-01

Do young adult survivors of childhood cancer know their fertility status, in the context of their parenthood goals and screening for gonadal functioning? While 80% of survivors (who were without children) wanted children in the future, most did not know their fertility status, and screening for gonadal functioning was underutilized. Survivors of childhood cancer are at risk for infertility, but fertility counseling and assessment are underutilized. Separate studies indicated that survivors' fertility-related knowledge is poor and that they often wanted to have children. Yet, studies have not investigated the intersection of both issues, as well as potential distress if parenthood goals are not met. Young adult male and female survivors of childhood cancer (N = 149) completed cross-sectional surveys, and data for those without children (n = 105, 70.5%) are presented here. Participants were 20-40 years old (M = 26.5), diagnosed 5-33 years prior to study participation, and completed questionnaires online. Knowledge of fertility status, parenthood goals, and potential distress if survivors were unable to have children were assessed. Medical records were reviewed for hormone levels as indicators of screening for gonadal functioning. Most survivors (n = 81; 77.1%) did not know their fertility status, while over 80% (n = 89) wanted children (neither aspect varied by socio-demographic/cancer-specific factors). Two-thirds of survivors indicated they would be distressed if parenthood goals remained unfulfilled; especially female (versus male, t = 2.64; P = 0.01) or partnered (versus single, t = -3.45; P fertility status. Relevant risk factors may have not been identified owing to limited sample size and missing treatment information. The underutilization of screening for gonadal functioning needs further exploration in other pediatric centers. Most adult childhood cancer survivors want to become parents, but do not know their fertility status, which could cause significant

Cancer risk among Holocaust survivors in Israel-A nationwide study.

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Sadetzki, Siegal; Chetrit, Angela; Freedman, Laurence S; Hakak, Nina; Barchana, Micha; Catane, Raphael; Shani, Mordechai

2017-09-01

Holocaust survivors during World War II were exposed to various factors that are associated with cancer risk. The objective of this study was to determine whether Holocaust survivors had an increased risk for developing cancer. The study population included 152,622 survivors. The main analysis was based on a comparison between individuals who were entitled to compensation for suffering persecution during the war and individuals who were denied such compensation. A complementary analysis compared survivors who were born in countries governed by Nazi Germany with survivors born in nonoccupied countries. A Cox proportional hazards model was used, with the time at risk of cancer development starting on either January 1, 1960, or the date of immigration to the date of cancer diagnosis or death or the date of last follow-up (December 31, 2006). Cancer was diagnosed in 22.2% of those who were granted compensation versus 16% of those who were denied compensation (P cancer in those who were exposed. For those who were granted versus denied compensation, the hazard ratios were 1.06 (P cancer, and 1.37 (P = .008) for lung cancer. For those born in occupied countries versus nonoccupied countries, the hazard ratios were 1.08 (P cancer development. Cancer 2017;123:3335-45. © 2017 American Cancer Society. © 2017 American Cancer Society.

Self-reported physical activity: its correlates and relationship with health-related quality of life in a large cohort of colorectal cancer survivors.

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Laurien M Buffart

Full Text Available BACKGROUND: Physical activity (PA is suggested to be an important non-pharmacologic means to improve health-related outcomes among cancer survivors. We aimed to describe the PA level, its correlates, and association with health-related quality of life (HRQoL in colorectal cancer (CRC survivors. METHODS: CRC survivors identified from the Eindhoven Cancer Registry treated between 1998 and 2007 were included. Survivors completed validated questionnaires on PA, distress, fatigue, and HRQoL. Moderate-to-vigorous physical activity (MVPA levels were calculated by summing the time spent on walking, bicycling, gardening and sports (≥3 MET. Multiple linear regression analyses were conducted to study which socio-demographic and clinical factors were associated with MVPA. Furthermore, we examined associations between MVPA and physical and mental HRQoL, and whether these associations were mediated by fatigue and distress. RESULTS: Cross-sectional data of 1371 survivors (response: 82% were analysed. Participants were 69.5 (SD 9.7 years old, 56% were male, and survival duration was 3.9 (SD 2.5 years. Participants self-reported on average 95.5 (SD 80.3 min on MVPA per day. Younger age, male sex, being employed, non-smoking, lower BMI, colon cancer (vs. rectal cancer, chemotherapy treatment and having no co-morbidities were associated with higher MVPA (p<0.05. MVPA was positively associated with physical HRQoL (regression coefficient of total association (c = 0.030; se = 0.004 after adjusting for socio-demographic and clinical factors. Fatigue mediated this association between MVPA and physical HRQoL (44% mediated. The association between MVPA and mental HRQoL was not statistically significant after adjusting for socio-demographic and cancer-related factors (c = 0.005; se = 0.004. CONCLUSION: In CRC survivors, clinical factors including the absence of co-morbidity, tumour site and chemotherapy treatment were associated with higher MVPA, in

Mortality of A-bomb survivors in Nagasaki and Hiroshima

International Nuclear Information System (INIS)

Mine, Mariko; Honda, Sumihisa; Okumura, Yutaka; Kondo, Hisayoshi; Yokota, Kenichi; Tomonaga, Masao

2000-01-01

A data base of A-bomb survivors in Nagasaki has been maintained at Division of Scientific Data Registry, Atomic Bomb Disease Institute at Nagasaki University School of Medicine. The data base include personal histories, records of health checks and cause of death. We have published the mortality of non-cancerous disease of A-bomb survivors using old dose estimation system, T65D, elsewhere. The mortality of non-cancerous disease was lower than controls for a dose range 50-99 cGy in male. We reanalyzed the mortality of non-cancerous disease using new dose estimation system, ABS93D. It's result was lower than controls for a dose range 31-40cGy in male. We compared the results of A-bomb survivors in our database with those or LSS's population, RERF. (1) Radiation dose for survivors in Nagasaki have been estimated by Atomic Bomb Survivor 1993 Dose (ABS93D). To study the mortality rates of A-bomb survivors for the period of 1971 through 1994, we selected 2,743 persons (dose estimate available) and age-matched 8,229 persons as control who were alive in 1971. (2) Another population is Life Span Study by Radiation Effect Research Foundation (RERF). RERF opened the data from 1950 to 1985. The data on deaths are stratified by city, sex, age radiation dose, the observed period and cause of death, yielding 3,640 strata. (1) The study resulted in that males exposed to 31-40cGy showed lower mortality from non-cancerous diseases than that of control. (2) Relative risk of mortality from all causes is lower than controls for a dose range 6-19cGy adjusted for sex, age, and period. Relative risk of mortality from non-cancerous disease is significantly lower than controls for a dose range 6-49cGy adjusted for sex, age, and period. But result of adjusted for city is no difference. (author)

EARLY AND LATE COMPLICATIONS AMONG LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMY OR ANASTOMOSIS

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

2012-01-01

Purpose Among long-term (≥5 years) colorectal cancer survivors with permanent ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life. Background The incidence and effects of complications on long-term health-related quality of life among colorectal cancer survivors are not adequately understood. Methods Participants (284 ostomy/395 anastomosis) were long-term colorectal cancer survivors enrolled in an integrated health plan. Health-related quality of life was assessed via mailed survey questionnaire in 2002–2005. Information on colorectal cancer, surgery, co-morbidities, and complications was obtained from computerized data and analyzed using survival analysis and logistic regression. Results Ostomy and anastomosis survivors were followed an average 12.1 and 11.2 years, respectively. Within 30 days of surgery, 19% of ostomy and 10% of anastomosis survivors experienced complications (pOstomy was associated with long-term fistula (odds ratio 5.4; 95% CI 1.4–21.2), and among ostomy survivors, fistula was associated with reduced health-related quality of life (postomy have more complications early in their survivorship period, but complications among anastomosis survivors catch up after 20 years, when the two groups have convergent complication rates. Among colorectal cancer survivors with ostomy, fistula has especially important implications for health-related quality of life. PMID:20087096

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

Science.gov (United States)

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

2013-03-01

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

Barriers to Mental Health Service Use among Hematopoietic Stem Cell Transplant Survivors

OpenAIRE

Mosher, Catherine E.; DuHamel, Katherine N.; Rini, Christine M.; Li, Yuelin; Isola, Luis; Labay, Larissa; Rowley, Scott; Papadopoulos, Esperanza; Moskowitz, Craig; Scigliano, Eileen; Grosskreutz, Celia; Redd, William H.

2009-01-01

Summary This study examined barriers to mental health service use and their demographic, medical, and psychosocial correlates among hematopoietic stem cell transplant (HSCT) survivors. A sample of 253 HSCT survivors who were 1- to 3-years post-transplant completed measures of demographic, physical, psychological, and social characteristics as well as a newly modified measure of barriers to mental health service use. Only 50% of distressed HSCT survivors had received mental health services. An...

Quality of Life in Stroke Survivors Under the Sixty Years of Age

Directory of Open Access Journals (Sweden)

Mirjana Vidović

2007-08-01

Full Text Available The objective of the study was to analyze the quality of life six months after the stroke in survivors under the sixty years of age, to determine which life activities was the most affected, as well as to correlate the neurological insufficiency and the quality of life.It was monitored 200 stroke survivors under the sixty years of age treated at the Department of Neurology, University Clinical Centre Tuzla. Average age was 51,83 years (±7,02. The ischemic stroke was diagnosed in 77,5% stroke survivors, cerebral hemorrhage in 15%, and subarahnoid hemorrhage in 7,5%. Five stroke survivors suffered hemi-plegia (2,5%, 24 (12% experienced moderate consequences and 143 (71,5% had mild consequences. No neurological deficit had 28 (14% stroke survivors. Six months after the onset of disease all stroke survivors have been at follow-up and evaluated about quality of life by filling in a modified questionnaire: Questionnaire on Quality of Life after Stroke (2. The questionnaire contained 20 questions covering four fields of life: Working Ability, Home Activity, Family Relations and Leisure Activities.Six months after the onset of stroke a worse quality of life in comparison to the period before the disease was noted in 172 (86% stroke survivors, the unchanged in 19 (9,5% and better in 9 (4,5%. The most affected is the field “Leisure Activities’, followed by “Family Relations’, “Home Activity’, and the least affected is “Work Ability’, The neurological deficit significantly correlates to the “Home Activities” and “Leisure Activities’.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-01-15

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

Fertility in female childhood cancer survivors

DEFF Research Database (Denmark)

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

2009-01-01

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

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

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

2010-01-01

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

Qualification of class 1e equipment: regulation, technological margins and test experience

International Nuclear Information System (INIS)

Pasco, Y.; Le Meur, M.; Henry, J.Y.; Droger, J.P.; Morange, E.; Roubault, J.

1986-10-01

French regulation requires licensee to qualify electrical equipment important to safety for service in nuclear power plants to ensure that the equipment can perform its safety function under the set of plausible operating conditions. The French regulatory texts entitled Fundamental safety rules have classified safety related electrical equipment in three main categories: k1, k2, k3, according to their location and operating conditions. The definition of a design basis accident test profile must account for margins applied to thermal hydraulic code outputs. Specific safety margins was added to cover uncertainties in qualification test representativity. Up to now, accidental sequence studies have shown the validity of such a qualification test profile. On the other hand, the results from post accident simulation tests have shown that it is useful not only to validate post accident operating life but also to reveal failures initiated during previous tests [fr

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

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

2013-08-19

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

Harvest for health gardening intervention feasibility study in cancer survivors.

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Blair, Cindy K; Madan-Swain, Avi; Locher, Julie L; Desmond, Renee A; de Los Santos, Jennifer; Affuso, Olivia; Glover, Tony; Smith, Kerry; Carley, Joseph; Lipsitz, Mindy; Sharma, Ayushe; Krontiras, Helen; Cantor, Alan; Demark-Wahnefried, Wendy

2013-08-01

Cancer survivors are at increased risk for second malignancies, cardiovascular disease, diabetes, and functional decline. Evidence suggests that a healthful diet and physical activity may reduce the risk of chronic disease and improve health in this population. We conducted a feasibility study to evaluate a vegetable gardening intervention that paired 12 adult and child cancer survivors with Master Gardeners to explore effects on fruit and vegetable intake, physical activity, quality-of-life, and physical function. Throughout the year-long study period, the survivor-Master Gardener dyads worked together to plan/plant three gardens, harvest/rotate plantings, and troubleshoot/correct problems. Data on diet, physical activity, and quality-of-life were collected via surveys; anthropometrics and physical function were objectively measured. Acceptability of the intervention was assessed with a structured debriefing survey. The gardening intervention was feasible (robust enrollment; minimal attrition) and well-received by cancer survivors and Master Gardeners. Improvement in three of four objective measures of strength, agility, and endurance was observed in 90% of survivors, with the following change scores [median (interquartile range)] noted between baseline and one-year follow-up: hand grip test [+ 4.8 (3.0, 6.7) kg], 2.44 meter Get-Up-and-Go [+ 1.0 (+ 1.8, + 0.2) seconds], 30-second chair stand [+ 3.0 (+ 1.0, 5.0) stands], and six-minute walk [+ 11.6 (6.1, 48.8) meters]. Increases of ≥ 1 fruit and vegetable serving/day and ≥ 30 minutes/week of physical activity were observed in 40% and 60%, respectively. These preliminary results support the feasibility and acceptability of a mentored gardening intervention and suggest that it may offer a novel and promising strategy to improve fruit and vegetable consumption, physical activity, and physical function in cancer survivors. A larger randomized controlled trial is needed to confirm our results.

Patterns of Internet-based health information seeking in adult survivors of childhood cancer.

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Claridy, Mechelle D; Hudson, Melissa M; Caplan, Lee; Mitby, Pauline A; Leisenring, Wendy; Smith, Selina A; Robison, Leslie L; Mertens, Ann C

2018-05-01

To assess where, when, and why survivors of childhood cancer seek health information. Data from the Childhood Cancer Survivor Study (CCSS) cohort (n = 1386) and Health Information National Trends Survey (n = 2385) were analyzed to determine the health information seeking strategies of childhood cancer survivors. Descriptive frequencies, χ 2 analyses, t-tests, and multivariable logistic regression models were used. To seek health-related information for themselves, 54% (n = 742) of the childhood survivors reported using the Internet in the past 12 months, compared to 45% of the general population (adjusted OR: 2.76; 95% CI: 2.40-3.19). Childhood cancer survivors who used the Internet for health information were more likely to be female, between the ages of 18-34, have received some college education or be a college graduate, and report being in poor health. Although survivors were less likely than the general population to trust health information from the Internet (P < 0.01), they indicated that they would like a secure website that uses information from their medical records to provide individualized health-related information. The use of the Internet to access health information among the childhood cancer survivors was over 50%. Information on late effects was a high priority for most survivors, as was their interest in websites related to late effects and a website on patient information tailored to personal situations. Identification of factors associated with searching the Internet for cancer information may provide direction for development of effective cancer communication interventions for this at-risk population. © 2018 Wiley Periodicals, Inc.

Peripheral Neuropathy, Sensory Processing, and Balance in Survivors of Acute Lymphoblastic Leukemia.

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Varedi, Mitra; Lu, Lu; Howell, Carrie R; Partin, Robyn E; Hudson, Melissa M; Pui, Ching-Hon; Krull, Kevin R; Robison, Leslie L; Ness, Kirsten K; McKenna, Raymond F

2018-05-29

Purpose To compare peripheral nervous system function and balance between adult survivors of childhood acute lymphoblastic leukemia (ALL) and matched controls and to determine associations between peripheral neuropathy (PN) and limitations in static balance, mobility, walking endurance, and quality of life (QoL) among survivors. Patients and Methods Three hundred sixty-five adult survivors of childhood ALL and 365 controls with no cancer history completed assessments of PN (modified Total Neuropathy Score [mTNS]), static balance (Sensory Organization Test [SOT]), mobility (Timed Up and Go), walking endurance (6-minute walk test), QoL (Medical Outcomes Study 36-Item Short Form Survey), and visual-motor processing speed (Wechsler Adult Intelligence Scale). Results PN, but not impairments, in performance on SOT was more common in survivors than controls (41.4% v 9.5%, respectively; P general health). Processing speed (β = 1.69; 95% CI, 0.98 to 2.40; P balance. The association between processing speed and sway suggests that static balance impairment in ALL survivors may be influenced by problems with CNS function, including the processing of sensory information.

Health profiles and quality of life of 518 survivors of thyroid cancer.

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Schultz, Pamela N; Stava, Charles; Vassilopoulou-Sellin, Rena

2003-05-01

Available literature describes the long-term outcome of thyroid cancer survivors with respect to thyroid cancer but not their overall medical and social well-being. Five hundred eighteen thyroid cancer survivors responded to a survey regarding medical and social impacts of their cancer experience. All had surgery, and 417 (80.5%) also had some radiation. Two thirds (64.5%) reported that cancer created health effects varying by gender and passage of time; neurologic, musculoskeletal, and psychologic problems seemed most prominent. They reported more memory loss and psychologic problems than other cancer survivors and more migraine headaches than both other cancer survivors and the general population. Regarding family and work, they integrated well in society overall. However, unsolicited comments by 24.5% of responders disclosed symptoms reminiscent of thyroid hormone imbalance. Thyroid cancer survivors generally report good health long term but describe distinct, lasting medical problems including symptoms of thyroid dysregulation. The extent and manner in which cancer therapy contributes to the health profile of the group merits further inquiry. Copyright 2003 Wiley Periodicals, Inc.

Exploration of life experiences of positive growth in long-term childhood cancer survivors.

Science.gov (United States)

Kim, Yoonjung

2017-10-01

The aim of this study was to explore experiences of positive growth in long-term childhood cancer survivors, from their perspective. Fifteen long-term survivors of childhood cancer provided descriptions of their experiences. Data were collected through face-to-face interviews and the analysis was based on Giorgi's phenomenological research method. The analysis of positive growth experienced by long-term childhood cancer survivors revealed three themes: self-directed life, normalcy in life, and inner maturity. Long-term survivors defined positive growth as a successful transition to a self-satisfactory life based on motivation acquired through their cancer experience and on subjective goal-setting, as well as becoming cancer-free and living a normal life within society. They seemed to have acquired optimistic, flexible, active attitudes toward life while demonstrating profound gratefulness and consideration of people around them, as well as prudent approaches to health. The findings of this study verified that long-term survivors of childhood cancer have grown positively due to their negative past experience. We expect these findings to contribute to the development of programs that promote positive growth in long-term childhood cancer survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Hyeon Jin Park

2010-04-01

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

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

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

2015-10-01

Breast cancer survivors represent the largest proportion of cancer survivors, and the rate of young breast cancer survivors who are diagnosed before the age of 40 is increasing. Cancer survivorship scholarship has begun to address many aspects of survivors' quality of life, yet the role of work and career issues have been understudied, particularly for young survivors. To explore the work lives and career development of young breast cancer survivors, this study used consensual qualitative research methodology (Hill, Thompson, & Williams, 1997) to analyze data from qualitative interviews with 13 young women diagnosed with breast cancer before the age of 40. The 4 career-related domains that emerged from the data were (a) cancer-related work challenges, (b) coping with cancer-related work challenges, (c) reappraisal of career development after cancer, and (d) components of career and life satisfaction after cancer. Experiencing breast cancer at a young age was viewed by participants as contributing to an increased desire for work to provide a sense of meaning as well as financial security and insurance. Cancer was further viewed as contributing to lost control over career success and work choices, treatment side effects that interfere with work self-efficacy and capabilities, and interpersonal difficulties connecting within and outside of work. Women with more extensive cancer treatment and side effects reported greater work struggles. Despite this, participants' cancer narratives were characterized by a range of coping strategies, including reframing and seeking control, and by evidence of persistence, resilience, and hope. Implications for research and practice are discussed. (c) 2015 APA, all rights reserved).

Risk Factors Associated With Secondary Sarcomas in Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study

International Nuclear Information System (INIS)

Henderson, Tara O.; Rajaraman, Preetha; Stovall, Marilyn; Constine, Louis S.; Olive, Aliza; Smith, Susan A.; Mertens, Ann; Meadows, Anna; Neglia, Joseph P.; Hammond, Sue; Whitton, John; Inskip, Peter D.; Robison, Leslie L.; Diller, Lisa

2012-01-01

Purpose: Childhood cancer survivors have an increased risk of secondary sarcomas. To better identify those at risk, the relationship between therapeutic dose of chemotherapy and radiation and secondary sarcoma should be quantified. Methods and Materials: We conducted a nested case-control study of secondary sarcomas (105 cases, 422 matched controls) in a cohort of 14,372 childhood cancer survivors. Radiation dose at the second malignant neoplasm (SMN) site and use of chemotherapy were estimated from detailed review of medical records. Odds ratios (ORs) and 95% confidence intervals were estimated by conditional logistic regression. Excess odds ratio (EOR) was modeled as a function of radiation dose, chemotherapy, and host factors. Results: Sarcomas occurred a median of 11.8 years (range, 5.3–31.3 years) from original diagnosis. Any exposure to radiation was associated with increased risk of secondary sarcoma (OR = 4.1, 95% CI = 1.8–9.5). A dose–response relation was observed, with elevated risks at doses between 10 and 29.9 Gy (OR = 15.6, 95% CI = 4.5–53.9), 30–49.9 Gy (OR = 16.0, 95% CI 3.8–67.8) and >50 Gy (OR = 114.1, 95% CI 13.5–964.8). Anthracycline exposure was associated with sarcoma risk (OR = 3.5, 95% CI = 1.6–7.7) adjusting for radiation dose, other chemotherapy, and primary cancer. Adjusting for treatment, survivors with a first diagnosis of Hodgkin lymphoma (OR = 10.7, 95% CI = 3.1–37.4) or primary sarcoma (OR = 8.4, 95% CI = 3.2–22.3) were more likely to develop a sarcoma. Conclusions: Of the risk factors evaluated, radiation exposure was the most important for secondary sarcoma development in childhood cancer survivors; anthracycline chemotherapy exposure was also associated with increased risk.

Quality of Life and Its Association with Physical Activity among Different Types of Cancer Survivors.

Directory of Open Access Journals (Sweden)

Furong Tang

Full Text Available The main goal of this study was to compare the quality of life (QOL and its association with physical activity (PA among patients diagnosed with different types of cancer. Based on the results, we tentatively present suggestions for the cancer health care model.A cross-sectional study was conducted with 2915 cancer survivors recruited from multi-community cancer rehabilitation centers, all of which were affiliated with the Shanghai Cancer Rehabilitation Club. We collected data including socio-demographic characteristics and information about PA. All the subjects included were asked to complete the European Organization for Research and Treatment Quality of Life Questionnaires (EORTC QLQ-C30 and Functional Assessment of Cancer Therapy-General Questionnaire (FACT-G. Multiple linear regression models were employed to control the potential confounding factors.Lung cancer survivors reported the worst dyspnea. Colorectal cancer survivors claimed the highest level of constipation and diarrhea. Liver cancer survivors indicated greatest loss of appetite and financial difficulties. Generally, survivors with PA tended to reported better QOL, although these associations among liver cancer survivors were not statistically significant. Moreover, survivors of all cancer types who performed PA did not report significant lower level of constipation or diarrhea. The relationship between PA frequency and QOL among cancer survivors remained unexplored.Both QOL and its association with PA vary among survivors of different cancer types. The detailed results can assist clinicians and public health practitioners with improving health care management.

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

Science.gov (United States)

Walsh-Burke, K; Marcusen, C

1999-01-01

With the advent of managed healthcare, self-advocacy has been identified as an essential skill for cancer survivors. This article describes a self-advocacy training program, the Cancer Survival Toolbox, developed through a unique collaborative effort by the National Coalition for Cancer Survivorship, the Association of Oncology Social Work, and the Oncology Nursing Society. Self-advocacy training is provided in audiotape format, as well as through the Internet and in interactive groups. The need for this training was established through surveys completed by 569 cancer survivors and 833 oncology professionals. Essential skills were identified through a literature review, and the content of the training was pilot tested with bicoastal groups of cancer survivors and with feedback from representatives of 15 national cancer organizations. While the majority of the 569 respondents to the survivor survey were highly educated and between the ages of 31 and 60 years, fewer than half reported that when they first received a diagnosis of cancer they were able to communicate their needs effectively, had the skills necessary to make decisions, or were able to negotiate with healthcare providers, insurers, and employers. Results of the survey of professional oncology nurses and social workers also supported the need for self-advocacy training. Fewer than one third of the 833 respondents to the professional survey reported that their patients who had received new diagnoses of cancer had essential self-advocacy skills. This self-advocacy training program is currently available on audiotape in English and Spanish. It is available in print in Chinese on the Internet. Data from the pilot groups indicate the program effectively addresses the self-advocacy skills of communication, information seeking, problem solving, decision making, and negotiating. Data are currently being collected to assess the efficacy of the audiotape format and the impact of the training on survivors and

The Movement Imagery Questionnaire-Revised, Second Edition (MIQ-RS Is a Reliable and Valid Tool for Evaluating Motor Imagery in Stroke Populations

Directory of Open Access Journals (Sweden)

Andrew J. Butler

2012-01-01

Full Text Available Mental imagery can improve motor performance in stroke populations when combined with physical therapy. Valid and reliable instruments to evaluate the imagery ability of stroke survivors are needed to maximize the benefits of mental imagery therapy. The purposes of this study were to: examine and compare the test-retest intra-rate reliability of the Movement Imagery Questionnaire-Revised, Second Edition (MIQ-RS in stroke survivors and able-bodied controls, examine internal consistency of the visual and kinesthetic items of the MIQ-RS, determine if the MIQ-RS includes both the visual and kinesthetic dimensions of mental imagery, correlate impairment and motor imagery scores, and investigate the criterion validity of the MIQ-RS in stroke survivors by comparing the results to the KVIQ-10. Test-retest analysis indicated good levels of reliability (ICC range: .83–.99 and internal consistency (Cronbach α: .95–.98 of the visual and kinesthetic subscales in both groups. The two-factor structure of the MIQ-RS was supported by factor analysis, with the visual and kinesthetic components accounting for 88.6% and 83.4% of the total variance in the able-bodied and stroke groups, respectively. The MIQ-RS is a valid and reliable instrument in the stroke population examined and able-bodied populations and therefore useful as an outcome measure for motor imagery ability.

Distress among young adult cancer survivors: a cohort study.

Science.gov (United States)

Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M

2013-09-01

Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

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

NARCIS (Netherlands)

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

2015-01-01

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

EVALUATION OF LATE ADVERSE EVENTS IN LONG-TERM WILMS' TUMOR SURVIVORS

NARCIS (Netherlands)

van Dijk, Irma W. E. M.; Oldenburger, Foppe; Cardous-Ubbink, Mathilde C.; Geenen, Maud M.; Heinen, Richard C.; de Kraker, Jan; van Leeuwen, Flora E.; van der Pal, Helena J. H.; Caron, Huib N.; Koning, Caro C. E.; Kremer, Leontien C. M.

2010-01-01

Purpose: To evaluate the prevalence and severity of adverse events (AEs) and treatment-related risk factors in long-term Wilms' tumor (WT) survivors, with special attention to radiotherapy. Methods and Materials: The single-center study cohort consisted of 185 WT survivors treated between 1966 and

Mentoring programme for adolescent survivors of acquired brain injury.

Science.gov (United States)

Fraas, Michael; Bellerose, Amanda

2010-01-01

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

Pricing Survivor Forwards and Swaps in Incomplete Markets Using Simulation Techniques

DEFF Research Database (Denmark)

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

2012-01-01

This article considers how to manage longevity risk using longevity derivatives products. We review the potential counterparties that naturally have exposure to this type of risk and we provide details on two very simple products, the survivor forward and the survivor swap, that can be used...... to trade this type of risk. We then discuss how such products can be priced using a simulation-based approach that has been shown to be successful in pricing financial derivatives. To illustrate the flexibility of the approach we price survivor forwards and swaps using the simple dynamics of the Lee...

Food craving and obesity in survivors of pediatric ALL and lymphoma.

Science.gov (United States)

Shams-White, Marissa; Kelly, Michael J; Gilhooly, Cheryl; Liu, Shanshan; Must, Aviva; Parsons, Susan K; Saltzman, Edward; Zhang, Fang Fang

2016-01-01

Cancer treatment can impact the hypothalamic-pituitary region of the developing brain, impairing appetite regulation and causing food craving in children who have survived cancer. We assessed food craving using a modified Food Craving Inventory in 22 survivors of pediatric acute lymphoblastic leukemia (ALL) and lymphoma (median age = 11.7 years) and evaluated its association with treatment exposure and changes in weight status over a one-year period. Mean total craving score was 2.1 (SD = 0.7). Survivors reported significantly higher mean craving score for fast-foods [2.6 (SD = 0.9)] than for sweets [2.1 (SD = 0.8)], carbohydrates [2.0 (SD = 0.6)], and fats [1.8 (SD = 0.7)] (all P values food craving than those diagnosed at a younger age (Food craving, however, was not significantly associated with survivors' weight status over 12 months of follow-up. Food craving alone does not appear to explain the obesity risk in this sample of childhood cancer survivors. The role of food craving in shaping eating behavior and obesity risk needs to be further evaluated in a large cohort of childhood cancer survivors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Increased frontal functional networks in adult survivors of childhood brain tumors

Directory of Open Access Journals (Sweden)

Hongbo Chen

2016-01-01

Full Text Available Childhood brain tumors and associated treatment have been shown to affect brain development and cognitive outcomes. Understanding the functional connectivity of brain many years after diagnosis and treatment may inform the development of interventions to improve the long-term outcomes of adult survivors of childhood brain tumors. This work investigated the frontal region functional connectivity of 16 adult survivors of childhood cerebellar tumors after an average of 14.9 years from diagnosis and 16 demographically-matched controls using resting state functional MRI (rs-fMRI. Independent component analysis (ICA was applied to identify the resting state activity from rs-fMRI data and to select the specific regions associated with executive functions, followed by the secondary analysis of the functional networks connecting these regions. It was found that survivors exhibited differences in the functional connectivity in executive control network (ECN, default mode network (DMN and salience network (SN compared to demographically-matched controls. More specifically, the number of functional connectivity observed in the survivors is higher than that in the controls, and with increased strength, or stronger correlation coefficient between paired seeds, in survivors compared to the controls. Observed hyperconnectivity in the selected frontal functional network thus is consistent with findings in patients with other neurological injuries and diseases.

Experimental benchmark and code validation for airfoils equipped with passive vortex generators

DEFF Research Database (Denmark)

Baldacchino, D.; Manolesos, M.; Ferreira, Célia Maria Dias

2016-01-01

Experimental results and complimentary computations for airfoils with vortex generators are compared in this paper, as part of an effort within the AVATAR project to develop tools for wind turbine blade control devices. Measurements from two airfoils equipped with passive vortex generators, a 30...

The epidemiology of long- and short-term cancer survivors

DEFF Research Database (Denmark)

Jarlbæk, Lene; Christensen, Linda; Bruera, Eduardo

2014-01-01

Introduction. In this study, we present data from a population-based cohort of incident cancer patients separated in long- and short-term survivors. Our aim was to procure denominators for use in the planning of rehabilitation and palliative care programs. Material and methods. A registry......-linkage cohort study. All cancer patients, diagnosed from 1993 to 2003 from a 470 000 large population, were followed individually from diagnosis to death or until 31 December 2008. Long-term survivors lived five years or more after the time of the cancer diagnosis (TOCD). Short-term survivors died less than...... and sex. Two-year crude cancer survival seems as a clinically relevant cut point for characterizing potential "denominators" for rehabilitation or palliative care programs. From this cohort of incident cancer patients, and using two-year survival as a cut point, it could be estimated that 54% would...

Incidence of skin cancer among Nagasaki atomic bomb survivors

International Nuclear Information System (INIS)

Sadamori, Naoki; Mine, Mariko; Hori, Makoto

1990-01-01

Among a total of 65,268 Nagasaki atomic bomb survivors recorded in the Scientific Data Center of Atomic Bomb Disaster, Nagasaki University School of Medicine, 140 cases with skin cancer were collected from 31 hospitals in Nagasaki City from 1961 through 1987. Subsequently, these cases of skin cancer in Nagasaki atomic bomb survivors were statistically analyzed in relation to the estimated distance from the hypocenter by age, sex, histology and latent period. The results were as follows: (1) A high correlation was observed between the incidence of skin cancer and the distance from the hypocenter. (2) The incidence of skin cancer in Nagasaki atomic bomb survivors now appears to be increasing in relation to exposure distance. (3) Among 140 cases, basal cell epithelioma was observed in 67 cases (47.9%) and squamous cell carcinoma in 43 cases (30.7%). (author)

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors.

Science.gov (United States)

Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

2015-12-01

Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors' health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N = 856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high vs. low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. CRC survivors made substantial, permanent dietary, and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship.

Hoisting appliances and fuel handling equipment at nuclear facilities

Energy Technology Data Exchange (ETDEWEB)

NONE

1988-12-31

The guide is followed by the Finnish Centre for Radiation and Nuclear Safety (STUK) in regulating hoisting and handling equipment Class 3 at nuclear facilities. The guide is applied e.g. to the following equipment: reactor building overhead cranes, hoisting appliances at nuclear fuel storages, fuel handling machines, other hoisting appliances, which because of nuclear safety aspects are classified in Safety Class 3, and load-bearing devices connected with the above equipment, such as replaceable hoisting tools and auxiliary lifting devices. The regulating of hoisting and handling equipment comprises the following stages: handling of preliminary and final safety analysis reports, inspection of the construction plan, supervision of fabrication and construction inspection, and supervision of initial start-up and commissioning inspection. 36 refs. Translation. The original text is published under the same guide number. The guide is valid from 5 January 1987 and will be in force until further notice.

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

Science.gov (United States)

Bandak, M; Jørgensen, N; Juul, A; Lauritsen, J; Oturai, P S; Mortensen, J; Hojman, P; Helge, J W; Daugaard, G

2017-10-01

Twenty to thirty percent of testicular cancer (TC) survivors have elevated serum levels of luteinising hormone (LH) with or without corresponding low testosterone levels (Leydig cell dysfunction) during clinical follow-up for TC. However, it remains to be clarified if this subgroup of TC survivors has an increased long-term risk of systemic inflammation and metabolic syndrome (MetS) when compared with TC survivors with normal Leydig cell function during follow-up. TC survivors with Leydig cell dysfunction and a control group of TC survivors with normal Leydig cell function during follow-up were eligible for participation in the study. Markers of systemic inflammation and prevalence of MetS were compared between TC survivors with Leydig cell dysfunction and the control group. Of 158 included TC survivors, 28 (18%) had uncompensated Leydig cell dysfunction, 59 (37%) had compensated Leydig cell dysfunction and 71 (45%) had normal Leydig cell function during follow-up. MetS and markers of systemic inflammation were evaluated at a median follow-up of 9.7 years (interquartile range 4.1-17.1) after TC treatment. The prevalence of MetS was significantly lower among patients with compensated Leydig cell dysfunction during follow-up (12% versus 27%, p = 0.04), whereas there was no difference between TC survivors with uncompensated Leydig cell dysfunction and controls (33% versus 27%, p = 0.5). Apart from high-sensitivity C-reactive protein which was higher in TC survivors with uncompensated Leydig cell dysfunction during follow-up, there was no evidence of increased systemic inflammation in patients with Leydig cell dysfunction during clinical follow-up. Total testosterone at follow-up was significantly associated with MetS, whereas there was no association between LH and MetS. We did not find evidence that TC survivors with Leydig cell dysfunction during clinical follow-up had increased long-term risk of MetS. Total testosterone at follow-up was significantly associated

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

NARCIS (Netherlands)

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

2015-01-01

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

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

Science.gov (United States)

2010-01-01

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

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

International Nuclear Information System (INIS)

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

2011-01-01

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

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

DEFF Research Database (Denmark)

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

2012-01-01

Cancer can cause adverse effects on survivors' work ability. We compared the self-assessed work ability of breast, testicular, and prostate cancer survivors to that of people without cancer. We also investigated the association of disease-related and socio-demographic factors and job-related reso......-related resources (organizational climate, social support, and avoidance behavior) with work ability and looked at whether these associations were different for the survivors and reference subjects....

From diagnosis through survivorship: health-care experiences of colorectal cancer survivors with ostomies

Science.gov (United States)

Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Mohler, M. Jane; Hornbrook, Mark C.; Herrinton, Lisa J.; Krouse, Robert S.

2014-01-01

Purpose The journey from diagnosis through treatment to survivorship can be challenging for colorectal cancer (CRC) survivors with permanent ostomies. Memories of both the positive and negative health-care interactions can persist years after the initial diagnosis and treatment. The purpose of this paper is to describe the health-care experiences of long-term (>5 years) CRC survivors with ostomies. Methods Thirty-three CRC survivors with ostomies who were members of Kaiser Permanente, an integrated care organization, in Oregon, southwestern Washington and northern California participated in eight focus groups. Discussions from the focus groups were recorded, transcribed, and analyzed for potential categories and themes. Results Health-care-related themes described CRC survivors’ experiences with diagnosis, treatment decision-making, initial experiences with ostomy, and survivorship. Participants discussed both positive and negative health-care-related experiences, including the need for continued access to trained nurses for ostomy self-care, access to peer support, and resources related to managing persistent, debilitating symptoms. Conclusions Long-term CRC survivors with ostomies have both positive and negative health-care experiences, regardless of health-related quality of life (HRQOL) and gender. Long-term support mechanisms and quality survivorship care that CRC survivors with ostomies can access are needed to promote positive adjustments and improved HRQOL. Structured abstract The current literature in CRC survivor-ship suggests that HRQOL concerns can persist years after treatment completion. The coordination of care to manage persistent late- and long-term effects are still lacking for CRC survivors living with an ostomy. Findings from this qualitative analysis will aid in the development of support strategies that foster more positive adjustments for CRC survivors living with an ostomy and support their ongoing ostomy-related needs. PMID:24442998

Characteristics and Long-Term Prognosis of Holocaust Survivors Presenting with Acute Myocardial Infarction.

Science.gov (United States)

Shiyovich, Arthur; Plakht, Ygal; Belinski, Katya; Gilutz, Harel

2016-05-01

Catastrophic life events are associated with the occurrence of cardiovascular incidents and worsening of the clinical course followirg-such events. To evaluate the characteristics and long-term prognosis of Holocaust survivors presenting with acute myocardial infarction (AMI) compared to non-Holocaust survivors. Israeli Jews who were born before 1941 and had been admitted to a tertiary medical center due to AMI during the period 2002-2012 were studied. Holocaust survivors were compared with non-Holocaust survivor controls using individual age matching. Overall 305 age-matched pairs were followed for up to 10 years after AMI. We found a higher prevalence of depression (5.9% vs. 3.3%, P = 0.045) yet a similar rate of cardiovascular risk factors, non-cardiovascular co-morbidity, severity of coronary artery disease, and in-hospital complications in survivors compared to controls. Throughout the follow-up period, similar mortality rates (62.95% vs. 63.9%, P = 0.801) and reduced cumulative mortality (0.9 vs. 0.96, HR = 0.780, 95% CI 0.636-0.956, P = 0.016) were found among survivors compared to age-matched controls, respectively. However, in a multivariate analysis survival was not found to be an independent predictor of mortality, although some tendency towards reduced mortality was seen (AdjHR = 0.84, 95% CI 0.68-1.03, P = 0.094). Depression disorder was associated with a 77.9% increase in the risk for mortality. Holocaust survivors presenting with AMI were older and had a higher prevalence of depression than controls. No. excessive, and possibly even mildly improved, risk of mortality.was observed in survivors compared with controls presenting with AMI. Possibly, specific traits that are associated with surviving catastrophic events counter the excess risk of such events following AMI.

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

Science.gov (United States)

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

2016-03-01

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

Smoking habits among atomic-bomb survivors

International Nuclear Information System (INIS)

Akiba, Suminori; Kimura, Masafumi

1992-01-01

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

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

DEFF Research Database (Denmark)

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

2007-01-01

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

Factors related to employers' intent to hire, retain and accommodate cancer survivors: the Singapore perspective.

Science.gov (United States)

Mak, Angela Ka Ying; Ho, Shirley S; Kim, Hyo Jung

2014-12-01

Despite the growing importance of cancer and return-to-work issues in occupational rehabilitation literature in the last decade, academic discussion is largely limited to survivors' perspectives and some exploratory studies from the employer side. This paper applies two classic theoretical models-Theory of Planned Behavior and Social Cognitive Theory-and key measures from previous studies to identify explicit relationships that explain employer factors to hire and retain cancer survivors. Data were collected from online surveys with senior management executives and senior human resource specialists from various organizations in Singapore, with a total of 145 responses. The 72-item survey instrument included a series of independent variables: (1) Attitudes toward cancer and cancer survivors; (2) Employers' efficacy; (3) Perceived moral obligation; (4) Employers' experience; (5) Outcome expectations; (6) Employment situation; (7) Social norms; and (8) Incentives, and dependent variables: (a) Employers' intention to hire cancer survivors; and (b) Employers' intention to retain cancer survivors. Regression analyses showed that the top three factors related to employers' intention to retain cancer survivors are perceived moral obligations (β = .39, p employment situation (β = .17, p Employers' efficacy was associated with intention to hire (β = .22, p employer and an employee when it comes to retaining cancer survivors and government incentives for hiring cancer survivors in the workforce. The present study provided an avenue to implement the proposed model-a potential study framework for the management of cancer survivors at work. Findings revealed that different messages should be tailored to employers toward hiring and retention issues and provided useful guidelines for employer education materials.

Health problems in childhood cancer survivors: Linkage studies and guideline development

NARCIS (Netherlands)

Font-Gonzalez, A.

2016-01-01

This thesis comprises two parts. The first part of this thesis aims to increase the evidence on the burden of disease in childhood cancer survivors and to define high-risk groups of survivors by using medical record linkage studies. A two-step record linkage methodology between Dutch national

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

Science.gov (United States)

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

2016-03-01

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

Faecal incontinence after chemoradiotherapy in anal cancer survivors: Long-term results of a national cohort

International Nuclear Information System (INIS)

Bentzen, Anne Gry; Guren, Marianne G.; Vonen, Barthold; Wanderås, Eva H.; Frykholm, Gunilla; Wilsgaard, Tom; Dahl, Olav; Balteskard, Lise

2013-01-01

Purpose: To examine the prevalence and severity of faecal incontinence amongst anal cancer survivors after chemoradiotherapy. Material and methods: Anal cancer survivors from a complete, unselected, national cohort, minimum 2-years follow-up, were invited to a cross-sectional study. The St. Mark’s incontinence score was used to evaluate occurrence and degree of faecal incontinence the last four weeks. The results were compared to age- and sex-matched volunteers from the general population. Results: Of 199 invited survivors and 1211volunteers, 66% and 21%, respectively, signed informed consent. The survivors had significantly higher St. Mark’s score than the volunteers (mean 9.7 vs. 1.1, p < 0.001). Incontinence of stool of any degree was reported by 43% vs. 5% (OR 4.0, CI 2.73–6.01), and urgency was reported by 64% vs. 6% (OR 6.6, CI 4.38–9.90) of the survivors and volunteers, respectively. Only 29% of those with leakage of liquid stool used constipating drugs. Survivors of locally advanced tumours had a higher incontinence score (p < 0.01). Conclusions: Moderate to severe faecal incontinence is common amongst anal cancer survivors. Post-treatment follow-up should include the evaluation of continence, and incontinent survivors should be offered better symptom management and multidisciplinary approach if simple measures are insufficient

Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.

Science.gov (United States)

Kazak, Anne E; Derosa, Branlyn Werba; Schwartz, Lisa A; Hobbie, Wendy; Carlson, Claire; Ittenbach, Richard F; Mao, Jun J; Ginsberg, Jill P

2010-04-20

PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. CONCLUSION AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.

Report on results of medical survey of atomic bomb survivors residing in South America

International Nuclear Information System (INIS)

Mitsuhashi, Akio; Monzen, Tetsuo; Inamizu, Tsutomu; Oguma, Nobuo; Yotsuya, Koichi; Ozaki, Shinpei; Takamatsu, Katsuro; Kawaguchi, Kiyoshi.

1986-01-01

Medical survey of A-bomb survivors was made from October 21 through November 7, 1985 in Brazil, Argentine, and Paraguay. One hundred fifty four A-bomb survivors were identified in these three countries. Of these A-bomb survivors, 133 (86 %) participated in this survey. Eighy six survivors came from Hiroshima and the other 47 from Nagasaki. The average age of them was 55.8 +- 11.1 yr for men and 56.3 +- 9.9 yr for women. Abnormal findings requiring detailed examinations and life instruction were seen in 56 % of the participants. Common findings were hypertension, heart disease, and obesity. (Namekawa, K.)

Developing a falls prevention program for community-dwelling stroke survivors in Singapore: client and caregiver perspectives.

Science.gov (United States)

Xu, Tianma; O'Loughlin, Kate; Clemson, Lindy; Lannin, Natasha A; Dean, Catherine; Koh, Gerald

2017-12-25

Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants' experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Semi-structured interviews were conducted in Singapore with community-dwelling stroke survivors with a previous fall (n = 9), family caregivers (n = 4), and domestic helpers (n = 4) who have cared for a stroke survivor with a previous fall. Purposive sampling was used for recruitment; all interviews were audio-recorded with permission and transcribed. Thematic analysis was conducted using NVivo (v10) software. All participants shared their self-perceived intrinsic and extrinsic fall risk factors and main challenges after a fall. For stroke participants and family caregivers, motivational factors in developing safety strategies after a previous fall(s) include social connectedness, independent living and community participation. For family caregivers and domestic helpers, the stroke survivor's safety is their top priority, however this can also lead to over-protective behavior outside of the rehabilitation process. Reducing the risk of falls in community-dwelling stroke survivors seems to be more important than promoting community participation among caregivers. The study findings highlight that a structured and client-centered fall prevention program targeting stroke survivors and caregivers is needed in Singapore. Implications for rehabilitation Falls after stroke can lead to functional decline in gait and mobility and restricted self-care activities. Community-dwelling stroke survivors develop adaptive safety strategies after a fall and want to be socially connected. However, caregivers see the safety of the stroke survivors as their top priority and demonstrate over-protective behaviors. Fall prevention programs for community-dwelling stroke survivors should target both stroke

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

Science.gov (United States)