WorldWideScience

Sample records for writers cancer survivorship

  1. Your cancer survivorship care plan

    Science.gov (United States)

    ... ency/patientinstructions/000822.htm Your cancer survivorship care plan To use the sharing features on this page, ... get one. What Is a Cancer Survivorship Care Plan? A cancer survivorship care plan is a document ...

  2. Survivorship

    Science.gov (United States)

    ... Content Español ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship About Cancer ...

  3. Family support in cancer survivorship.

    Science.gov (United States)

    Muhamad, Mazanah; Afshari, Mojgan; Kazilan, Fitrisehara

    2011-01-01

    This paper raises issues about the role of family members in providing support for breast cancer survivors. Data were collected from 400 breast cancer survivors in Peninsular Malaysia through a custom-designed questionnaire fielded at hospitals and support group meetings. The data were analyzed using descriptive statistics. The analyses show that all family members could be supportive, especially in decision making and help with emotional issues. The spouse was the main support provider among the family members (others were children, parents, siblings and more distant relatives). The results also indicated that a significant percentage practiced collaborative decision-making. Breast cancer survivors needed their family members' support for information on survivorship strategies such as managing emotions, health, life style and dietary practice. The family members' supportive role may be linked to the Malaysian strong family relationship culture. For family members to contribute more adequately to cancer survivorship, it is suggested that appropriate educational intervention also be provided to them.

  4. Lung Cancer Survivorship

    Centers for Disease Control (CDC) Podcasts

    2016-10-20

    A lung cancer survivor shares her story about diagnosis, treatment, and community support. She also gives advice for other cancer survivors.  Created: 10/20/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/20/2016.

  5. Cancer survivorship: challenges and changing paradigms.

    Science.gov (United States)

    Gilbert, Scott M; Miller, David C; Hollenbeck, Brent K; Montie, James E; Wei, John T

    2008-02-01

    We summarize the potential issues faced by cancer survivors, define a conceptual framework for cancer survivorship, describe challenges associated with improving the quality of survivorship care and outline proposed survivorship programs that may be implemented going forward. We performed a nonsystematic review of current cancer survivorship literature. Given the comprehensive scope and high profile, the recent report by the Institute of Medicine, From Cancer Patient to Cancer Survivor: Lost in Transition, served as the principal guide for the review. In recognition of the increasing number of cancer survivors in the United States survivorship has become an important health care concern. The recent report by the Institute of Medicine comprehensively outlined deficits in the care provided to cancer survivors, and proposed mechanisms to improve the coordination and quality of followup care for this increasing number of Americans. Measures to achieve these objectives include improving communication between health care providers through a survivorship care plan, providing evidence based surveillance guidelines and assessing different models of survivorship care. Implementing coordinated survivorship care broadly will require additional health care resources, and commitment from health care providers and payers. Research demonstrating the effectiveness of survivorship care will be important on this front. Potential shortcomings in the recognition and management of ongoing issues faced by cancer survivors may impact the overall quality of long-term care in this increasing population. Although programs to address these issues have been proposed, there is substantial work to be done in this area.

  6. 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.

  7. Pain management in cancer survivorship

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Sjøgren, Per

    2015-01-01

    BACKGROUND: The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. EPIDEMIOLOGY: Chronic pain is one of th...... survivors. Pain management strategies are discussed according to the biopsychosocial model and with the rapidly growing number of cancer survivors the establishment of multidisciplinary clinics as a part of comprehensive cancer centers are proposed.......BACKGROUND: The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. EPIDEMIOLOGY: Chronic pain is one...... of the main problems in this population and prevalence varies between 16% and 50%. Most information derives from breast cancer patients assessed by surveys from national or local institutional databases. A Danish population-based survey estimated that 41.5% of all cancer survivors reported chronic pain. PAIN...

  8. Taking Our Seat at the Table: Community Cancer Survivorship.

    Science.gov (United States)

    Polo, Katie M; Smith, Caitlin

    Cancer survivors are at risk for occupational performance issues related to activities of daily living, instrumental activities of daily living, work, and social and community participation. Occupational therapy practitioners can address these performance issues by offering services within existing community cancer survivorship programs that focus on adaptive and compensatory strategies to facilitate meaningful lifestyles and optimize health and well-being. Occupational therapy services do not currently exist at these community sites, nor are occupational therapy practitioners recognized as providers in existing community cancer survivorship programs. Recognition of practitioners' distinct value in cancer survivorship, advocacy for occupational therapy services in the community, development of supporting documentation for occupational therapy's role in community survivorship, and research on the efficacy of interventions in community cancer survivorship are needed to expand occupational therapy's role with this growing population. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  9. Cancer survivorship: history, quality-of-life issues, and the evolving multidisciplinary approach to implementation of cancer survivorship care plans.

    Science.gov (United States)

    Morgan, Mary Ann

    2009-07-01

    To discuss the history of cancer survivorship, related quality-of-life issues, and cancer survivorship care plans (CSCPs). CINAHL, PubMed, published articles, and Web sites. A cancer survivor is an individual who has been diagnosed with cancer, regardless of when that diagnosis was received, who is still living. Cancer survivorship is complex and involves many aspects of care. Major areas of concern for survivors are recurrence, secondary malignancies, and long-term treatment sequelae that affect quality of life. Four essential components of survivorship care are prevention, surveillance, intervention, and coordination. A CSCP should address the survivor's long-term care, such as type of cancer, treatments received, potential side effects, and recommendations for follow-up. It should include preventive practices, how to maintain health and well-being, information on legal protections regarding employment and health insurance, and psychosocial services in the community. Survivorship care for patients with cancer requires a multidisciplinary effort and team approach. Enhanced knowledge of long-term complications of survivorship is needed for healthcare providers. Further research on evidence-based practice for cancer survivorship care also is necessary. Nurses can review CSCPs with patients, instruct them when to seek treatment, promote recommended surveillance protocols, and encourage behaviors that lead to cancer prevention and promote well-being for cancer survivors.

  10. Cancer survivorship: a new challenge in comprehensive cancer control.

    Science.gov (United States)

    Pollack, Lori A; Greer, Greta E; Rowland, Julia H; Miller, Andy; Doneski, Donna; Coughlin, Steven S; Stovall, Ellen; Ulman, Doug

    2005-10-01

    Cancer survivors are a growing population in the United States because of earlier cancer diagnosis, the aging of society, and more effective risk reduction and treatment. Concerns about the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public, private, and non-profit organizations. The purpose of this paper is to discuss how survivorship fits within the framework of comprehensive cancer control. We summarize three national reports on cancer survivorship and highlight how various organizations and programs are striving to address the needs of cancer survivors through public health planning, including the challenges these groups face and the gaps in knowledge and available services. As cancer survivorship issues are being recognized, many organizations have objectives and programs to address concerns of those diagnosed with cancer. However, better coordination and dissemination may decrease overlap and increase the reach of efforts and there is limited evidence for the effectiveness and impact of these efforts.

  11. Testicular Cancer Survivorship: Research Strategies and Recommendations

    Science.gov (United States)

    Beard, Clair; Allan, James M.; Dahl, Alv A.; Feldman, Darren R.; Oldenburg, Jan; Daugaard, Gedske; Kelly, Jennifer L.; Dolan, M. Eileen; Hannigan, Robyn; Constine, Louis S.; Oeffinger, Kevin C.; Okunieff, Paul; Armstrong, Greg; Wiljer, David; Miller, Robert C.; Gietema, Jourik A.; van Leeuwen, Flora E.; Williams, Jacqueline P.; Nichols, Craig R.; Einhorn, Lawrence H.; Fossa, Sophie D.

    2010-01-01

    Testicular cancer represents the most curable solid tumor, with a 10-year survival rate of more than 95%. Given the young average age at diagnosis, it is estimated that effective treatment approaches, in particular, platinum-based chemotherapy, have resulted in an average gain of several decades of life. This success, however, is offset by the emergence of considerable long-term morbidity, including second malignant neoplasms, cardiovascular disease, neurotoxicity, nephrotoxicity, pulmonary toxicity, hypogonadism, decreased fertility, and psychosocial problems. Data on underlying genetic or molecular factors that might identify those patients at highest risk for late sequelae are sparse. Genome-wide association studies and other translational molecular approaches now provide opportunities to identify testicular cancer survivors at greatest risk for therapy-related complications to develop evidence-based long-term follow-up guidelines and interventional strategies. We review research priorities identified during an international workshop devoted to testicular cancer survivors. Recommendations include 1) institution of lifelong follow-up of testicular cancer survivors within a large cohort setting to ascertain risks of emerging toxicities and the evolution of known late sequelae, 2) development of comprehensive risk prediction models that include treatment factors and genetic modifiers of late sequelae, 3) elucidation of the effect(s) of decades-long exposure to low serum levels of platinum, 4) assessment of the overall burden of medical and psychosocial morbidity, and 5) the eventual formulation of evidence-based long-term follow-up guidelines and interventions. Just as testicular cancer once served as the paradigm of a curable malignancy, comprehensive follow-up studies of testicular cancer survivors can pioneer new methodologies in survivorship research for all adult-onset cancer. PMID:20585105

  12. A Patient-Centered Perspective on Cancer Survivorship

    Directory of Open Access Journals (Sweden)

    Brad Zebrack

    2015-04-01

    Full Text Available Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients’ physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people’s experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

  13. A patient-centered perspective on cancer survivorship.

    Science.gov (United States)

    Zebrack, Brad

    2015-04-15

    Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients' physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people's experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails) in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

  14. Cancer-Related Fatigue in Cancer Survivorship.

    Science.gov (United States)

    Ebede, Chidinma C; Jang, Yongchang; Escalante, Carmen P

    2017-11-01

    Cancer-related fatigue (CRF) significantly interferes with usual functioning because of the distressing sense of physical, emotional, and cognitive exhaustion. Assessment of CRF is important and should be performed during the initial cancer diagnosis, throughout cancer treatment, and after treatment using a fatigue scoring scale (mild-severe). The general approach to CRF management applies to cancer survivors at all fatigue levels and includes education, counseling, and other strategies. Nonpharmacologic interventions include psychosocial interventions, exercise, yoga, physically based therapy, dietary management, and sleep therapy. Pharmacologic interventions include psychostimulants. Antidepressants may also benefit when CRF is accompanied by depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Concept analysis of cancer survivorship and contributions to oncological nursing.

    Science.gov (United States)

    de Oliveira, Rafaela Azevedo Abrantes; da Conceição, Vander Monteiro; Araujo, Jeferson Santos; Zago, Márcia Maria Fontão

    2018-02-01

    This study aims to analyse the concept of cancer survivorship using Rodgers' evolutionary concept analysis model. The lack of a consensus definition as well as the confusion and debate concerning the definitions of "survivor" and "cancer survivorship" hinder an understanding of the intrinsic needs associated with the latter. Concept analysis. A systematic literature search was performed using the following databases: PubMed, CINAHL, Web of Science, LILACS, and PsycINFO with studies published between 2000 and 2014. The final sample contained 39 studies that were analysed on the basis of Rodgers' model and inductive thematic analysis, discussed through the lens of the medical anthropology concept of culture. Cancer survivorship is a broad concept that can be understood using 8 themes: changes in life plans, positive and negative aspect dualities, life reflections, identity change, individual experiences, symptom control, the need for support, and quality of care. These themes are summarized using 2 attributes: liminality process and culturally congruent care. This article contributes to understanding of cancer survivorship and the processes that are intrinsic to this concept. It calls for future investigations to enhance cancer survivorship across its 2 domains at the personal (patient's life) and clinical (nursing practice) levels. © 2017 John Wiley & Sons Australia, Ltd.

  16. Dialogues on cancer survivorship: a new model of international cooperation.

    Science.gov (United States)

    Stein, Kevin; Mattioli, Vittorio

    2013-06-01

    The authors describe the rationale and background of the present supplement to Cancer intended to stimulate a dialogue among researchers from Europe and North America regarding important issues faced by cancer survivors. Through jointly written articles addressing various aspects of cancer survivorship, each manuscript reports on the similarities, disparities, and problems viewed from the point of view of each author's respective continent. The supplement is meant to create a springboard for increased collaboration and aid in the development of a shared care model to improve the quality of cancer care, both during and after the completion of primary treatment. We hope that this effort may represent a new model of international cooperation, which is fruitful not only for the field of scientific research but also for identifying and sharing new approaches to the care and management of cancer survivorship issues, ultimately bringing improvements to quality of life of the growing population of cancer survivors. Copyright © 2013 American Cancer Society.

  17. Cancer survivorship: Advancing the concept in the context of colorectal cancer.

    Science.gov (United States)

    Drury, Amanda; Payne, Sheila; Brady, Anne-Marie

    2017-08-01

    Previous conceptualizations of cancer survivorship have focused on heterogeneous cancer survivors, with little consideration of the validity of conclusions for homogeneous tumour groups. This paper aims to examine the concept of cancer survivorship in the context of colorectal cancer (CRC). Rodgers' (1989) Evolutionary Method of Concept Analysis guided this study. A systematic search of PUBMED, CINAHL, PsycINFO and The Cochrane Library was conducted in November 2016 to identify studies of CRC survivorship. The Braun and Clarke (2006) framework guided the analysis and interpretation of data extracted from eighty-five publications. Similar to general populations of cancer survivors, CRC survivors experience survivorship as an individual, life-changing process, punctuated by uncertainty and a duality of positive and negative outcomes affecting quality of life. However, CRC survivors experience specific concerns arising from the management of their disease. The concept of cancer survivorship has evolved over the past decade as the importance of navigating the healthcare system and its resources, and the constellation of met and unmet needs of cancer survivors are realised. The results highlight core similarities between survivorship in the context of CRC and other tumour groups, but underlines issues specific to CRC survivorship. Communication and support are key issues in survivorship care which may detrimentally affect CRC survivors' well-being if they are inadequately addressed. Healthcare professionals (HCP's) therefore have a duty to ensure cancer survivors' health, information and supportive care needs are met in the aftermath of treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Diet and Nutrition in Cancer Survivorship and Palliative Care

    OpenAIRE

    Anthony J. Bazzan; Andrew B. Newberg; William C. Cho; Daniel A. Monti

    2013-01-01

    The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health ...

  19. Occupational Therapy's Role in Cancer Survivorship as a Chronic Condition.

    Science.gov (United States)

    Baxter, Mary Frances; Newman, Robin; Longpré, Sheila M; Polo, Katie M

    Improved medical care has resulted in a documented increase in cancer survivors in the United States. Cancer survivors face challenges in participation across all facets of life as a result of the cancer and subsequent cancer treatments. Long-term and late-term sequelae can result in impairments in neurological systems, decreased stamina, loss of range of motion, and changes in sensation and cognition. These impairments are often long lasting, which categorizes cancer survivorship as a chronic condition. This categorization presents treatment challenges, especially in creating rehabilitation and habilitation service options that support cancer survivors. Occupational therapy provides a unique focus that can benefit cancer survivors as they face limitations in participation in all aspects of daily living. Research, advocacy, and education efforts are needed to focus on the specific rehabilitation and habilitation needs of cancer survivors to increase access to occupational therapy's distinct value. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  20. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  1. Diet and Nutrition in Cancer Survivorship and Palliative Care

    Directory of Open Access Journals (Sweden)

    Anthony J. Bazzan

    2013-01-01

    Full Text Available The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a recent emphasis in the literature on nutrition and cancer as an important factor in both quality of life and in the pathophysiology of cancer. Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of cancer patients in the palliative care setting.

  2. Cancer and beyond: the question of survivorship.

    Science.gov (United States)

    Breaden, K

    1997-11-01

    Today, more people are surviving cancer as a result of improved treatment and early diagnosis. In Australia, the 5-year survival rate for persons diagnosed with cancer is now approaching 50%. Although there is a growing population of cancer survivors, little is known about what surviving entails. Traditionally, a survivor has been defined as one who has been disease-free for more than 5 years. However, this definition does not take into account the experience nor the process of survival and the aim of this article is to document the process of surviving cancer as reflected in the experiences of cancer survivors. Using a method of hermeneutic phenomenology (as described by van Manen), the study draws on the stories of six women, who by their definition, are surviving cancer. A discussion of themes has been structured according to the everyday experiences of living in a body and living in time. The women describe a survival process that includes: 'feeling whole again'; 'the body as the house of suspicion'; 'the future in question'; 'changes in time'; 'lucky to be alive'; and 'sharing the journey'.

  3. Testicular Cancer Survivorship : Research Strategies and Recommendations

    NARCIS (Netherlands)

    Travis, Lois B.; Beard, Clair; Allan, James M.; Dahl, Alv A.; Feldman, Darren R.; Oldenburg, Jan; Daugaard, Gedske; Kelly, Jennifer L.; Dolan, M. Eileen; Hannigan, Robyn; Constine, Louis S.; Oeffinger, Kevin C.; Okunieff, Paul; Armstrong, Greg; Wiljer, David; Miller, Robert C.; Gietema, Jourik A.; van Leeuwen, Flora E.; Williams, Jacqueline P.; Nichols, Craig R.; Einhorn, Lawrence H.; Fossa, Sophie D.

    2010-01-01

    Testicular cancer represents the most curable solid tumor, with a 10-year survival rate of more than 95%. Given the young average age at diagnosis, it is estimated that effective treatment approaches, in particular, platinum-based chemotherapy, have resulted in an average gain of several decades of

  4. Advocacy, support and survivorship in prostate cancer.

    Science.gov (United States)

    Dunn, J; Casey, C; Sandoe, D; Hyde, M K; Cheron-Sauer, M-C; Lowe, A; Oliffe, J L; Chambers, S K

    2018-03-01

    Across Australia, prostate cancer support groups (PCSG) have emerged to fill a gap in psychosocial care for men and their families. However, an understanding of the triggers and influencers of the PCSG movement is absent. We interviewed 21 SG leaders (19 PC survivors, two partners), of whom six also attended a focus group, about motivations, experiences, past and future challenges in founding and leading PCSGs. Thematic analysis identified four global themes: illness experience; enacting a supportive response; forming a national collective and challenges. Leaders described men's feelings of isolation and neglect by the health system as the impetus for PCSGs to form and give/receive mutual help. Negotiating health care systems was an early challenge. National affiliation enabled leaders to build a united voice in the health system and establish a group identity and collective voice. Affiliation was supported by a symbiotic relationship with tensions between independence, affiliation and governance. Future challenges were group sustainability and inclusiveness. Study findings describe how a grassroots PCSG movement arose consistent with an embodied health movement perspective. Health care organisations who seek to leverage these community resources need to be cognisant of SG values and purpose if they are to negotiate effective partnerships that maximise mutual benefit. © 2017 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  5. Social factors matter in cancer risk and survivorship.

    Science.gov (United States)

    Dean, Lorraine T; Gehlert, Sarah; Neuhouser, Marian L; Oh, April; Zanetti, Krista; Goodman, Melody; Thompson, Beti; Visvanathan, Kala; Schmitz, Kathryn H

    2018-07-01

    Greater attention to social factors, such as race/ethnicity, socioeconomic position, and others, are needed across the cancer continuum, including breast cancer, given differences in tumor biology and genetic variants have not completely explained the persistent Black/White breast cancer mortality disparity. In this commentary, we use examples in breast cancer risk assessment and survivorship to demonstrate how the failure to appropriately incorporate social factors into the design, recruitment, and analysis of research studies has resulted in missed opportunities to reduce persistent cancer disparities. The conclusion offers recommendations for how to better document and use information on social factors in cancer research and care by (1) increasing education and awareness about the importance of inclusion of social factors in clinical research; (2) improving testing and documentation of social factors by incorporating them into journal guidelines and reporting stratified results; and (3) including social factors to refine extant tools that assess cancer risk and assign cancer care. Implementing the recommended changes would enable more effective design and implementation of interventions and work toward eliminating cancer disparities by accounting for the social and environmental contexts in which cancer patients live and are treated.

  6. A Cross-Cultural Perspective on Challenges Facing Comparative Cancer Survivorship Research

    International Nuclear Information System (INIS)

    Syse, A.; Syse, A.; Geller, B.

    2011-01-01

    Cancer survivorship research includes the study of physical, psychosocial, and economic consequences of cancer diagnosis and treatment among pediatric and adult cancer survivors. Historically, the majority of cancer survivorship studies were from the United States, but survivorship issues are increasingly being addressed in other developed countries. Cross-cultural studies remain, however, scarce. The degree to which knowledge attained may or may not be transferred across cultures, countries, or regions is not known. Some important challenges for comparative research are therefore discussed in a cross-cultural perspective. Several substantive and methodological challenges that complicate the execution of cross-cultural cancer survivorship research are presented with examples and discussed to facilitate comparative research efforts in the establishment of new survivorship cohorts and in the planning and implementation of survivorship studies. Comparative research is one key to understanding the nature of cancer survivorship, distinguishing modifiable from non modifiable factors at individual, hospital, societal, and system levels and may thus guide appropriate interventions. Lastly, suggested future courses of action within the field of comparative cancer survivorship research are provided.

  7. Gender and Role Differences in Couples' Communication During Cancer Survivorship.

    Science.gov (United States)

    Lim, Jung-won; Paek, Min-so; Shon, En-jung

    2015-01-01

    Individuals with cancer and their partners often experience communication difficulties. However, questions still remain regarding the influence of gender and role in cancer survivor-partner communication within couples. The current study intended to examine the communication patterns in breast, colorectal, and prostate cancer survivor-partner couples during cancer survivorship and whether gender and role differences in couples communication exist. The dominant-less dominant method of sequential mixed design was used. Ten couples who were recruited from the University Hospital registry in Cleveland, Ohio, participated in both mail surveys and individual interviews. Family and cancer-related communication was assessed in the quantitative phase. Both male survivors and partners demonstrated better family communication scores compared with their female counterparts, whereas there were no gender differences in the cancer-related communication scores. In the qualitative phase, 3 major themes were identified: (1) selective sharing of cancer-related issues, (2) initiation of cancer-related communication, and (3) emotional reaction in communication. The patterns associated with these themes differed between the male survivor-female partner and female survivor-male partner couples. This study provides new knowledge about family and cancer-related communication. Our findings highlight the importance of understanding different perspectives in the quality of communication by gender and role. Exploring couples' communication patterns by gender and role stimulates the research and the development of effective consumer-centered communication interventions. The findings provide assessment tools to inform dyadic communication patterns for clinical and scientific purposes.

  8. Cancer Supportive and Survivorship Care in Singapore: Current Challenges and Future Outlook

    Directory of Open Access Journals (Sweden)

    Kiley Wei-Jen Loh

    2018-02-01

    Full Text Available Despite being a relatively young nation, Singapore has established itself as a leading multifaceted medical hub, both regionally and globally. Although Singapore continues to pursue excellence in oncology care, cancer supportive care and survivorship care remain in the infancy stage. In an effort to advance this important aspect of oncology care in Singapore, the first cancer supportive and survivorship care forum was held in December 2016, involving 74 oncology practitioners. The primary goals of this forum were to raise awareness of the importance of cancer supportive and survivorship care and to provide a platform for oncology practitioners of diverse backgrounds to converge and address the challenges associated with the delivery of cancer supportive and survivorship care in Singapore. Key challenges identified during this forum included, but were not limited to, care fragmentation in an oncologist-centric model of care, poor integration of allied health and rehabilitation services, passive engagement of community partners, lack of specialized skill sets and knowledge in supportive and survivorship care, and patient-related barriers such as poor health literacy. The survivorship care model commonly used in Singapore places an imbalanced emphasis on surveillance for cancer recurrence and second primary cancers, with little attention given to the supportive and survivorship needs of the survivors. In summary, these challenges set the stage for the development and use of a more survivor-centric model, one that focuses not only on cancer surveillance, but also on the broad and unique physical and psychosocial needs of survivors of cancer in Singapore.

  9. Colorectal cancer patients' preferences for type of caregiver during survivorship care

    NARCIS (Netherlands)

    Wieldraaijer, T.; Duineveld, L. A. M.; Donkervoort, S. C.; Busschers, W. B.; van Weert, H. C. P. M.; Wind, J.

    2018-01-01

    Colorectal cancer (CRC) survivors are currently included in a secondary care-led survivorship care programme. Efforts are underway to transfer this survivorship care to primary care, but met with some reluctance by patients and caregivers. This study assesses (1) what caregiver patients prefer to

  10. Omega-3 fatty acids for breast cancer prevention and survivorship.

    Science.gov (United States)

    Fabian, Carol J; Kimler, Bruce F; Hursting, Stephen D

    2015-05-04

    Women with evidence of high intake ratios of the marine omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) relative to the omega-6 arachidonic acid have been found to have a reduced risk of breast cancer compared with those with low ratios in some but not all case-control and cohort studies. If increasing EPA and DHA relative to arachidonic acid is effective in reducing breast cancer risk, likely mechanisms include reduction in proinflammatory lipid derivatives, inhibition of nuclear factor-κB-induced cytokine production, and decreased growth factor receptor signaling as a result of alteration in membrane lipid rafts. Primary prevention trials with either risk biomarkers or cancer incidence as endpoints are underway but final results of these trials are currently unavailable. EPA and DHA supplementation is also being explored in an effort to help prevent or alleviate common problems after a breast cancer diagnosis, including cardiac and cognitive dysfunction and chemotherapy-induced peripheral neuropathy. The insulin-sensitizing and anabolic properties of EPA and DHA also suggest supplementation studies to determine whether these omega-3 fatty acids might reduce chemotherapy-associated loss of muscle mass and weight gain. We will briefly review relevant omega-3 fatty acid metabolism, and early investigations in breast cancer prevention and survivorship.

  11. Lessons Learned from the Young Breast Cancer Survivorship Network.

    Science.gov (United States)

    Gisiger-Camata, Silvia; Nolan, Timiya S; Vo, Jacqueline B; Bail, Jennifer R; Lewis, Kayla A; Meneses, Karen

    2017-11-30

    The Young Breast Cancer Survivors Network (Network) is an academic and community-based partnership dedicated to education, support, and networking. The Network used a multi-pronged approach via monthly support and networking, annual education seminars, website networking, and individual survivor consultation. Formative and summative evaluations were conducted using group survey and individual survivor interviews for monthly gatherings, annual education meetings, and individual consultation. Google Analytics was applied to evaluate website use. The Network began with 4 initial partnerships and grew to 38 in the period from 2011 to 2017. During this 5-year period, 5 annual meetings (598 attendees), 23 support and networking meetings (373), and 115 individual survivor consultations were conducted. The Network website had nearly 12,000 individual users and more than 25,000 page views. Lessons learned include active community engagement, survivor empowerment, capacity building, social media outreach, and network sustainability. The 5-year experiences with the Network demonstrated that a regional program dedicated to the education, support, networking, and needs of young breast cancer survivors and their families can become a vital part of cancer survivorship services in a community. Strong community support, engagement, and encouragement were vital components to sustain the program.

  12. The state of cancer survivorship programming in Commission on Cancer-accredited hospitals in Georgia.

    Science.gov (United States)

    Kirsch, Logan J; Patterson, Angela; Lipscomb, Joseph

    2015-03-01

    In Georgia, there are more than 356,000 cancer survivors. Although many encounter challenges as a result of treatment, there is limited data on the availability of survivorship programming. This paper highlights findings from two surveys assessing survivorship care in Commission on Cancer (CoC)-accredited hospitals in Georgia. In 2010, 38 CoC-accredited hospitals were approached to complete a 36-item survey exploring knowledge of national standards and use of survivorship care plans (SCPs), treatment summaries (TSs), and psychosocial assessment tools. In 2012, 37 CoC-accredited hospitals were asked to complete a similar 21-item survey. Seventy-nine percent (n = 30) of cancer centers completed the 2010 survey. Sixty percent (n = 18) reported having a cancer survivorship program in place or in development. Forty-three percent (n = 13) provided survivors with a SCP and 40% (n = 12) a TS. Sixty percent (n = 18) reported either never or rarely using a psychosocial assessment tool. Sixty-two percent (n = 23) completed the 2012 survey. Ninety-six percent (n = 22) were aware of the new CoC guideline 3.3. Thirty-nine percent (n = 9) provided a SCP and/or TS. Eighty-seven percent (n = 20) stated they were very confident or somewhat confident their organization could implement a SCP and/or TS by 2015. The data indicated the importance of collaboration and shared responsibility for survivorship care. Broad implementation of SCPs and TSs can help address the late and long-term effects of treatment. Increasing knowledge on survivorship care is imperative as the Georgia oncology community engages oncologists and primary care providers to achieve higher quality of life for all survivors.

  13. Using a predictive model of clinician intention to improve continuing health professional education on cancer survivorship.

    Science.gov (United States)

    Buriak, S E; Potter, J; Bleckley, M Kathryn

    2015-01-01

    Cancer survivorship is a chronic disease that places patients in limbo between oncologists and primary care clinicians. Strategies have been proposed to ease the shift in coordination of care, including broad-based educational outreach to primary care providers. Guided by the theory of planned behavior (TPB), predictors of intention to provide survivorship care, including credentials, experience, perception of barriers, and personal survivorship status, were evaluated using logistic regression with a cohort of physicians, nurse practitioners, and registered nurses participating in an unprecedented online continuing medical education/continuing education survivorship care course. Results showed that physicians were significantly less likely to express intent to provide survivorship care (odds ratio [OR] = .237, p = .0001) compared to the other groups. Overall, clinicians with 6-10 years of experience were 3 times more likely to express intent to provide survivorship care (OR = 2.86, p = .045) than those with less or more experience. When clinicians perceived the presence of a barrier, they were nearly twice as likely to have diminished intent (OR = 1.89, p = .035). Most participants (66%; n = 1185) selected two barriers: lack of survivorship care plans and treatment summaries (45.4%; n = 821) and lack of education (20.1%; n = 364). Barriers to the delivery of survivorship care can influence clinicians' intention to provide survivorship care, which varied by years of experience in this study. Interdisciplinary educational strategies featuring midcareer provider champions who have successfully incorporated survivorship care and can offer specific solutions to these barriers are recommended for future interventions. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  14. This too shall pass: a grounded theory study of Filipino cancer survivorship.

    Science.gov (United States)

    de Guzman, Allan B; Jimenez, Benito Christian B; Jocson, Kathlyn P; Junio, Aileen R; Junio, Drazen E; Jurado, Jasper Benjamin N; Justiniano, Angela Bianca F

    2013-03-01

    Considering the paucity of studies dealing with the holistic aspect of the cancer experience, this grounded theory study seeks to conceptualize the process of cancer survivorship among Filipinos. Twenty-seven Filipino cancer survivors were purposively selected, and a two-part instrument, specifically robotfoto and focus group interviews, was used to gather data. The Glaserian method of grounded theory analysis was used, and extended texts were analyzed inductively via a dendrogram. Member checking and correspondence were observed to validate the surfacing stages, leading to the conceptualization of a theoretical model termed as the Ribbon of Cancer Survivorship. The said model describes the trifling (living before), transfusing (accepting the reality), transforming (being strong), and transcending (living beyond) phases of cancer survivorship. Ten interesting substages were also identified, namely: tainting, desolating, disrupting, and embracing for the transfusing phase; tormenting, distressing, awakening, and transfiguring for the transforming phase, and trembling and enlivening for the transcending phase. The resulting theoretical model has clearly and successfully described the entire process of cancer survivorship among Filipinos. It is hoped that the model be used as a reference for future studies about cancer survivorship and as a guide for nurses in providing a more empathetic care among cancer patients.

  15. Barriers and facilitators to implementing cancer survivorship care plans.

    Science.gov (United States)

    Dulko, Dorothy; Pace, Claire M; Dittus, Kim L; Sprague, Brian L; Pollack, Lori A; Hawkins, Nikki A; Geller, Berta M

    2013-11-01

    To evaluate the process of survivorship care plan (SCP) completion and to survey oncology staff and primary care physicians (PCPs) regarding challenges of implementing SCPs. Descriptive pilot study. Two facilities in Vermont, an urban academic medical center and a rural community academic cancer center. 17 oncology clinical staff created SCPs, 39 PCPs completed surveys, and 58 patients (breast or colorectal cancer) participated in a telephone survey. Using Journey Forward tools, SCPs were created and presented to patients. PCPs received the SCP with a survey assessing its usefulness and barriers to delivery. Oncology staff were interviewed to assess perceived challenges and benefits of SCPs. Qualitative and quantitative data were used to identify challenges to the development and implementation process as well as patient perceptions of the SCP visit. SCP, healthcare provider perception of barriers to completion and implementation, and patient perception of SCP visit. Oncology staff cited the time required to obtain information for SCPs as a challenge. Completing SCPs 3-6 months after treatment ended was optimal. All participants felt advanced practice professionals should complete and review SCPs with patients. The most common challenge for PCPs to implement SCP recommendations was insufficient knowledge of cancer survivor issues. Most patients found the care plan visit very useful, particularly within six months of diagnosis. Creation time may be a barrier to widespread SCP implementation. Cancer survivors find SCPs useful, but PCPs feel insufficient knowledge of cancer survivor issues is a barrier to providing best follow-up care. Incorporating SCPs in electronic medical records may facilitate patient identification, appropriate staff scheduling, and timely SCP creation. Oncology nurse practitioners are well positioned to create and deliver SCPs, transitioning patients from oncology care to a PCP in a shared-care model of optimal wellness. Institution support for

  16. Cancer survivorship care-planning: Practice, research, and policy implications for social work.

    Science.gov (United States)

    Wagner, Richard W; Pritzker, Suzanne

    2016-01-01

    Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.

  17. Breast Cancer Survivorship Care: Targeting a Colorectal Cancer Education Intervention

    Directory of Open Access Journals (Sweden)

    Sherri G. Homan

    2015-08-01

    Full Text Available Breast cancer survivors are at risk of developing a second primary cancer. Colorectal cancer (CRC is one of the leading second primary cancers, and it is often preventable. We developed a multi-component educational tool to inform and encourage women breast cancer survivors to engage in CRC screening. To assess the strengths and weakness of the tool and to improve the relevancy to the target audience, we convened four focus groups of women breast cancer survivors in Missouri. We also assessed the potential impact of the tool on the knowledge, attitudes, and beliefs regarding CRC and collected information on the barriers to CRC screening through pre- and post-focus groups’ questionnaires. A total of 43 women breast cancer survivors participated and provided very valuable suggestions on design and content to update the tool. Through the process and comparing pre- and post-focus group assessments, a significantly higher proportion of breast cancer survivors strongly agreed or agreed that CRC is preventable (78.6% vs. 96.9%, p = 0.02 and became aware that they were at a slightly increased risk for CRC (18.6% vs. 51.7%, p = 0.003. The most cited barrier was the complexity of preparation for colonoscopy.

  18. Breast cancer survivorship: the role of perceived discrimination and sexual orientation.

    Science.gov (United States)

    Jabson, Jennifer M; Donatelle, Rebecca J; Bowen, Deborah

    2011-03-01

    Breast cancer disproportionately affects sexual minority women (SMW) compared to heterosexual women and a small but growing literature indicates that SMW may have diminished survivorship outcomes; outcomes that are measurably and importantly different from heterosexual breast cancer survivors. However, it remains unknown how sexual orientation influences breast cancer survivorship outcomes such as quality of life. One possible route of influence is SMW's perceived discrimination in the health care setting. This cross-sectional study examines SMW perceptions of discrimination as one of the multiple facets of the breast cancer survivorship process. This study assessed SMW breast cancer survivor's perceptions of discrimination during their breast cancer treatment experience and secondarily, examined the role of this perceived discrimination on SMW's quality of life. Sixty-eight purposefully sampled sexual minority breast cancer survivors completed assessments of quality of life, perceived discrimination, perceived social support and perceived stress via an online survey. Statistical analyses point to perceived discrimination and perceived social support as important indicators for predicting SMW's quality of life. Future research on SMW's breast cancer survivorship should include measures of perceived discrimination.

  19. Oncology nurses′ recognition of long-term cancer survivorship care in Japan

    Directory of Open Access Journals (Sweden)

    Asako Miura

    2015-01-01

    Full Text Available Objective: This study aims to assess the knowledge of definition of cancer survivors among Japanese oncology nurses and their roles in long-term cancer survivorship care. Methods: A structured self-administered and self-report questionnaire created by the study investigators was given to members of the Japanese Society of Cancer Nursing. The subjects were 81 female oncology nurses. Results: Forty-nine nurses had 11 or more years of nursing experience, while 27 nurses had cancer-related nursing certifications such as, certification in oncology nursing specialist. This study population had rather rich experience in oncology nursing. Sixty-two nurses defined a cancer survivor from the time of diagnosis, while the nurses′ recognition of long-term survivorship care was poor, compared with nursing care at the time of diagnosis, during treatment, and end of life. Conclusions: The nurses were aware of the needs to recognize and address issues faced by long-term cancer survivors and for nursing study, but very few put the effective patient education and interventions into practice. It is because oncology nurses have few chances to see cancer survivors who go out of the hands of healthcare professionals. In increasing the number of long-term survivors, long-term survivorship care is needed in addition to incorporating such education into undergraduate and graduate programs. Further study on the knowledge of long-term cancer survivorship care and nursing practices are required.

  20. Survivorship Care Plan Information Needs: Perspectives of Safety-Net Breast Cancer Patients.

    Science.gov (United States)

    Burke, Nancy J; Napoles, Tessa M; Banks, Priscilla J; Orenstein, Fern S; Luce, Judith A; Joseph, Galen

    2016-01-01

    Despite the Institute of Medicine's (IOM) 2005 recommendation, few care organizations have instituted standard survivorship care plans (SCPs). Low health literacy and low English proficiency are important factors to consider in SCP development. Our study aimed to identify information needs and survivorship care plan preferences of low literacy, multi-lingual patients to support the transition from oncology to primary care and ongoing learning in survivorship. We conducted focus groups in five languages with African American, Latina, Russian, Filipina, White, and Chinese medically underserved breast cancer patients. Topics explored included the transition to primary care, access to information, knowledge of treatment history, and perspectives on SCPs. Analysis of focus group data identified three themes: 1) the need for information and education on the transition between "active treatment" and "survivorship"; 2) information needed (and often not obtained) from providers; and 3) perspectives on SCP content and delivery. Our data point to the need to develop a process as well as written information for medically underserved breast cancer patients. An SCP document will not replace direct communication with providers about treatment, symptom management and transition, a communication that is missing in participating safety-net patients' experiences of cancer care. Women turned to peer support and community-based organizations in the absence of information from providers. "Clear and effective" communication of survivorship care for safety-net patients requires dedicated staff trained to address wide-ranging information needs and uncertainties.

  1. Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model

    Directory of Open Access Journals (Sweden)

    Jacqueline Loonen

    2018-01-01

    Full Text Available Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the “Personalized Cancer Survivorship Care Model”, that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

  2. A Primary Care Initiative for Cancer Survivorship: A Case Study of Cancer in Obese Men

    Directory of Open Access Journals (Sweden)

    Mamdouh M. Shubair

    2017-01-01

    Full Text Available Background: Men in rural and northern areas of Canada experience considerable challenges in health care access for chronic conditions such as obesity, type 2 diabetes (T2D, and cancer. Obese men (body mass index/BMI ≥ 30 kg/m2 in rural/remote northern British Columbia (BC experience poorer health outcomes due to cancer risk compared to other men elsewhere in urban Canada. Context: Challenges faced by men who develop cancer as a complication of being obese are paramount in terms of primary care treatment of their cancers. Oftentimes cancer treatment is multi-modal and complex. Models of shared care have been proposed to provide coordinated survivorship care to the growing population of rural male cancer patients suffering from obesity and the Metabolic Syndrome (MetS. Methods: Objectives: The main objective of the study was to examine the type of cancer care programs that may have focused on men with cancer in northern British Columbia (BC. A secondary objective is to identify challenges in care experienced by men with cancer during their transition from in-hospital care back to their home communities. Population: We conducted a comprehensive literature review and a qualitative focus group interview with primary care physicians (PCPs, oncologists (n=8, and a convenience sample of male cancer patients (n=6 who have underlying obesity and Metabolic Syndrome (MetS. We examined the types of cancer care programs that may have targeted such men. We further identified challenges experienced by male cancer patients while transitioning back to their home communities. Results: The focus group results outlined themes speaking to a comprehensive shared care model that goes beyond surveillance of cancer recurrence in men with obesity. Conclusion: A shared survivorship care plan or model integrates collaboration among specialists in clinical decision making and best practice for treatment of cancer in obese men.

  3. Cancer survivorship services for indigenous peoples: where we stand, where to improve? A systematic review.

    Science.gov (United States)

    Cavanagh, Bridget M; Wakefield, Claire E; McLoone, Jordana K; Garvey, Gail; Cohn, Richard J

    2016-04-01

    There are few support programs with evidence-based practices which address the needs of cancer survivors from indigenous populations. This systematic review analysed the experiences and current support services for cancer survivors from indigenous populations following the cessation of cancer treatment. The data sourced for this article was identified from a systematic search of five databases (MEDLINE, MEDLINE In-Process, PyscINFO, CINAHL, and EMBASE). Studies were selected if they described the experiences of indigenous cancer survivors, their families, and/or clinicians primarily responsible for their care. In total 208 unique abstracts were screened, from which 17 studies were identified as having fulfilled all selection criteria. Of the 17 articles reviewed, 12 described qualitative data and 5 provided quantitative data. Common themes identified included the importance of family support throughout the survivorship period, the negative effect of community stigmatization, fatalistic attitudes towards cancer, and the importance of spirituality in coping with, and understanding, the cancer experience. Potential barriers to accessing care included distance and difficulties revisiting the survivor's cancer experience due to an associated fear of cancer recurrence. Indigenous cancer survivors would benefit from survivorship programs more specifically tailored to their individual circumstances, such as personalized spiritual care, facilitation of increased involvement of family members, and connection to other indigenous cancer survivors. The results from this review indicate that there is a need for survivorship care to be shaped specifically for the needs of indigenous cancer survivors.

  4. Women with breast cancer: self-reported distress in early survivorship.

    Science.gov (United States)

    Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L

    2015-01-01

    To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Descriptive, cross-sectional. A National Cancer Institute-designated comprehensive cancer center. 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Distress scores, problem reports, and time groups. Participants scored in range of the cutoff of more than 4 (range = 4.1-5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Interventions to reduce or prevent distress may improve outcomes in early survivorship.

  5. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.

    Science.gov (United States)

    Runowicz, Carolyn D; Leach, Corinne R; Henry, N Lynn; Henry, Karen S; Mackey, Heather T; Cowens-Alvarado, Rebecca L; Cannady, Rachel S; Pratt-Chapman, Mandi L; Edge, Stephen B; Jacobs, Linda A; Hurria, Arti; Marks, Lawrence B; LaMonte, Samuel J; Warner, Ellen; Lyman, Gary H; Ganz, Patricia A

    2016-02-20

    The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for

  6. Disparities in the survivorship experience among Latina survivors of breast cancer.

    Science.gov (United States)

    Olagunju, Tinuke O; Liu, Yihang; Liang, Li-Jung; Stomber, James M; Griggs, Jennifer J; Ganz, Patricia A; Thind, Amardeep; Maly, Rose C

    2018-04-06

    The authors investigated disparities in the survivorship experience among Latinas with breast cancer (BC) in comparison with non-Latinas. A cross-sectional bilingual telephone survey was conducted among 212 Latina and non-Latina women within 10 to 24 months after a diagnosis of BC (AJCC TNM staging system stage 0-III) at 2 Los Angeles County public hospitals. Data were collected using the Preparing for Life as a (New) Survivor (PLANS) scale, Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI), Breast Cancer Prevention Trial (BCPT) Symptom Checklist, Satisfaction with Care and Information Scale, Consumer Assessment of Healthcare Providers and Systems (CAHPS) tool, Charlson Comorbidity Index adapted for patient self-report, and the 12-item Short Form Health Survey. Controlling variables included age, stage as determined by the American Joint Committee on Cancer (AJCC) TNM staging system, educational level, and study site in multivariate analyses. The mean ages of Latinas and non-Latinas were 51.5 years and 56.6 years, respectively. Compared with non-Latinas, Latinas reported less BC survivorship knowledge (27.3 vs 30.7; Psatisfaction with BC survivorship care (9.6 vs 8.8; P = .298), or their discussion with physicians (9.6 vs 8.1; P = .07). These ethnic group differences persisted in multivariate analyses, with the exception of PEPPI. Latina survivors of BC experienced disparities in BC knowledge and satisfaction with information received, but believed themselves to be prepared for survivorship and were as satisfied with providers, care received, and discussions with physicians as non-Latinas. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  7. Reclaiming life on one's own terms: a grounded theory study of the process of breast cancer survivorship.

    Science.gov (United States)

    Sherman, Deborah Witt; Rosedale, Mary; Haber, Judith

    2012-05-01

    To develop a substantive theory of the process of breast cancer survivorship. Grounded theory. A LISTSERV announcement posted on the SHARE Web site and purposeful recruitment of women known to be diagnosed and treated for breast cancer. 15 women diagnosed with early-stage breast cancer. Constant comparative analysis. Breast cancer survivorship. The core variable identified was Reclaiming Life on One's Own Terms. The perceptions and experiences of the participants revealed overall that the diagnosis of breast cancer was a turning point in life and the stimulus for change. That was followed by the recognition of breast cancer as now being a part of life, leading to the necessity of learning to live with breast cancer, and finally, creating a new life after breast cancer. Participants revealed that breast cancer survivorship is a process marked and shaped by time, the perception of support, and coming to terms with the trauma of a cancer diagnosis and the aftermath of treatment. The process of survivorship continues by assuming an active role in self-healing, gaining a new perspective and reconciling paradoxes, creating a new mindset and moving to a new normal, developing a new way of being in the world on one's own terms, and experiencing growth through adversity beyond survivorship. The process of survivorship for women with breast cancer is an evolutionary journey with short- and long-term challenges. This study shows the development of an empirically testable theory of survivorship that describes and predicts women's experiences following breast cancer treatment from the initial phase of recovery and beyond. The theory also informs interventions that not only reduce negative outcomes, but promote ongoing healing, adjustment, and resilience over time.

  8. Long-Term Survivorship of Esophageal Cancer Patients Treated with Radical Intent

    Directory of Open Access Journals (Sweden)

    Alex Agranovich

    2008-01-01

    Full Text Available To investigate the recent trends in definitive management of esophageal cancer, the records of 138 consecutive patients treated with radical intent in a single institution between 1995 and 2003 were reviewed and analyzed. The median follow-up period was 5.7 years (range 1.1 to 10.4 years. Seventy-seven patients were treated with radiation therapy (RT only and 61 with combined regimens (CRT, in which RT was combined with either radical surgery or chemotherapy, or both. The overall survival of the entire cohort was 32% over two years and 20% over five years. The survivorship in the RT group was 17% over two years and 5% over five years. In the CRT group, 51% and 35% survived over two and five years, respectively. From all the potential prognostic factors examined by univariate and multivariate analyses, only male sex and use of CRT were strongly associated with better survivorship. There was no significant difference in the outcomes among the different regimens of CRT. Survivorship was not affected by the location or histology of the tumour, clinical stage, dose of RT or use of endoluminal brachytherapy in addition to external beam RT. There was a greater tendency to use RT only more often in older patients, but patient age did not affect survivorship. The proportion of patients treated with CRT did not change significantly over the last versus the first four years of the observed period. Combined regimens are undoubtedly superior to RT as a single modality. The long-term survivorship of patients in a subgroup of our patients treated with combined modality protocols compared favourably with the previously reported results in the literature and specifically in prospective randomized trials. However, the optimal combined modality regimen is yet to be defined.

  9. Breast Cancer Survivorship—A Personal Story

    Centers for Disease Control (CDC) Podcasts

    2016-09-26

    Pam Bryant, a breast cancer survivor, talks about her personal journey and how being diagnosed with breast cancer under the age of 45 has impacted her life. .  Created: 9/26/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 9/26/2016.

  10. Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

    Science.gov (United States)

    Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia

    2018-01-01

    Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934

  11. Colorectal cancer patients' preferences for type of caregiver during survivorship care.

    Science.gov (United States)

    Wieldraaijer, T; Duineveld, L A M; Donkervoort, S C; Busschers, W B; van Weert, H C P M; Wind, J

    2018-03-01

    Colorectal cancer (CRC) survivors are currently included in a secondary care-led survivorship care programme. Efforts are underway to transfer this survivorship care to primary care, but met with some reluctance by patients and caregivers. This study assesses (1) what caregiver patients prefer to contact for symptoms during survivorship care, (2) what patient factors are associated with a preferred caregiver, and (3) whether the type of symptom is associated with a preferred caregiver. A cross-sectional study of CRC survivors at different time points. For 14 different symptoms, patients reported if they would consult a caregiver, and who they would contact if so. Patient and disease characteristics were retrieved from hospital and general practice records. Two hundred and sixty patients participated (response rate 54%) of whom the average age was 67, 54% were male. The median time after surgery was seven months (range 0-60 months). Patients were divided fairly evenly between tumour stages 1-3, 33% had received chemotherapy. Men, patients older than 65 years, and patients with chronic comorbid conditions preferred to consult their general practitioner (GP). Women, patients with stage 3 disease, and patients that had received chemotherapy preferred to consult their secondary care provider. For all symptoms, patients were more likely to consult their GP, except for (1) rectal blood loss, (2) weight loss, and (3) fear that cancer had recurred, in which case they would consult both their primary and secondary care providers. Patients appreciated all caregivers involved in survivorship care highly; with 8 out of 10 points. CRC survivors frequently consult their GP in the current situation, and for symptoms that could alarm them to a possible recurrent disease consult both their GP and secondary care provider. Patient and tumour characteristics influence patients' preferred caregiver.

  12. Survivorship and the chronic cancer patient: Patterns in treatment-related effects, follow-up care, and use of survivorship care plans.

    Science.gov (United States)

    Frick, Melissa A; Vachani, Carolyn C; Bach, Christina; Hampshire, Margaret K; Arnold-Korzeniowski, Karen; Metz, James M; Hill-Kayser, Christine E

    2017-11-01

    The survivorship needs of patients living with chronic cancer (CC) and their use of survivorship care plans (SCPs) have been overlooked and underappreciated. A convenience sample of 39,088 SCPs completed for cancer survivors with an Internet-based SCP tool was examined; it included 5847 CC survivors (15%; CC was defined as chronic leukemia and/or recurrent/metastatic cancer of another nature). Patient-reported treatment effects and follow-up care patterns were compared between CC survivors and survivors treated with curative intent (CI). Responses from a follow-up survey regarding SCP satisfaction and use were reviewed. CC survivors had greater odds of experiencing multiple treatment-related effects than survivors treated with CI; these effects included fatigue, cognitive changes, dyspnea, peripheral neuropathy, lymphedema, and erectile dysfunction. Nearly half of CC survivors were managed by an oncologist alone, and they were less likely than CI patients to be comanaged by a primary care provider and an oncologist. Fewer SCPs were generated by health care providers (HCPs) for CC survivors versus CI survivors. A smaller proportion of CC users versus CI users rated their experience and satisfaction with the SCP tool as very good or excellent, and CC users were less likely to share the HCP summary with their health care team. A substantial number of CC survivors, often considered incurable but treatable, seek survivorship support. Tools to facilitate participation, communication, and coordination of care are valuable for these patients, and future iterations of SCPs should be designed to address the particular circumstances of living with CC. Cancer 2017;123:4268-4276. © 2017 American Cancer Society. © 2017 American Cancer Society.

  13. Survivorship Care in Reducing Symptoms in Young Adult Cancer Survivors

    Science.gov (United States)

    2017-10-13

    Breast Carcinoma; Cancer Survivor; Depression; Fatigue; Leukemia; Lymphoma; Malignant Bone Neoplasm; Malignant Digestive System Neoplasm; Malignant Female Reproductive System Neoplasm; Malignant Male Reproductive System Neoplasm; Pain; Sleep Disorder; Soft Tissue Sarcoma

  14. Advance care planning within survivorship care plans for older cancer survivors: A systematic review.

    Science.gov (United States)

    O'Caoimh, Rónán; Cornally, Nicola; O'Sullivan, Ronan; Hally, Ruth; Weathers, Elizabeth; Lavan, Amanda H; Kearns, Tara; Coffey, Alice; McGlade, Ciara; Molloy, D William

    2017-11-01

    Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care. This paper systematically reviews evaluations of ACP within SCPs among older (≥65 years) cancer survivors. No studies meeting the inclusion criteria were identified by search strategies conducted in PubMed/MEDLINE and the Cochrane databases. One paper examined cancer survivors' mainly positive views of ACP. Another discussed the use of a SCP supported by a 'distress inventory' that included an advance care directive (living will) as an issue, though no formal evaluation was reported. Although ACP is important for older adults, no study was found that evaluated its role within survivorship care planning. Despite the risk of recurrence and the potential for morbidity and mortality, especially among older cancer survivors, ACP is not yet a feature of SCPs. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Joanne Lester

    2015-03-01

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

  17. Childhood cancer survivorship educational resources in North American pediatric hematology/oncology fellowship training programs: a survey study.

    Science.gov (United States)

    Nathan, Paul C; Schiffman, Joshua D; Huang, Sujuan; Landier, Wendy; Bhatia, Smita; Eshelman-Kent, Debra; Wright, Jennifer; Oeffinger, Kevin C; Hudson, Melissa M

    2011-12-15

    Childhood cancer survivors require life-long care by clinicians with an understanding of the specific risks arising from the prior cancer and its therapy. We surveyed North American pediatric hematology/oncology training programs to evaluate their resources and capacity for educating medical trainees about survivorship. An Internet survey was sent to training program directors and long-term follow-up clinic (LTFU) directors at the 56 US and Canadian centers with pediatric hematology/oncology fellowship programs. Perceptions regarding barriers to and optimal methods of delivering survivorship education were compared among training program and LTFU clinic directors. Responses were received from 45/56 institutions of which 37/45 (82%) programs require that pediatric hematology/oncology fellows complete a mandatory rotation focused on survivorship. The rotation is 4 weeks or less in 21 programs. Most (36/45; 80%) offer didactic lectures on survivorship as part of their training curriculum, and these are considered mandatory for pediatric hematology/oncology fellows at 26/36 (72.2%). Only 10 programs (22%) provide training to medical specialty trainees other than pediatric hematology/oncology fellows. Respondents identified lack of time for trainees to spend learning about late effects as the most significant barrier to providing survivorship teaching. LTFU clinic directors were more likely than training program directors to identify lack of interest in survivorship among trainees and survivorship not being a formal or expected part of the fellowship training program as barriers. The results of this survey highlight the need to establish standard training requirements to promote the achievement of basic survivorship competencies by pediatric hematology/oncology fellows. Copyright © 2011 Wiley Periodicals, Inc.

  18. Survivorship Challenges and Information Needs after Radiotherapy for Oral Cancer.

    Science.gov (United States)

    Badr, Hoda; Lipnick, Daniella; Gupta, Vishal; Miles, Brett

    2017-12-01

    Oral cancer (OC) treatment can lead to considerable functional impairment, psychological distress, and decrements in quality of life. Given that limited information and support services are available for cancer survivors, many are turning to the Internet. However, little is known about the specific information and service needs of OC survivors. We conducted a descriptive study to (1) characterize the associations between OC survivor functional problems and distress and (2) describe the Internet use of OC survivors, their satisfaction with existing sources of information/support, and their unmet information and service needs. Ninety-three oral cancer survivors completed cross-sectional surveys within 1-year of completing radiotherapy. Clinical levels of distress were 10 % for depression and 16 % for anxiety. Dental health, smell, and range of motion problems were significant (p < .05) determinants of both depression and anxiety symptoms. Eighty-three percent of survivors used the Internet; most used it to obtain health-related information or support. Unmet information needs included how to live a healthy lifestyle after treatment (87 %), strategies for dealing with eating and speaking problems (81 %), and information about what to expect in terms of side effects after treatment (76 %). Findings suggest that interventions that teach survivors coping and problem-solving skills to manage and cope with functional impairments may help to alleviate distress. Results of this study support the need for psychoeducational interventions for this population and showcase the potential of the Internet as a feasible mode for future dissemination.

  19. Non-cancer drug consumption during the early trajectory of lymphoma survivorship.

    Science.gov (United States)

    Rioufol, Catherine; Lamy, Sébastien; Conte, Cécile; Jeanneau, Pauline; Compaci, Giselle; Delpierre, Cyrille; Lapeyre-Mestre, Maryse; Laurent, Guy; Despas, Fabien

    2017-11-22

    This study explored the use of non-cancer drugs in lymphoma survivors during the early trajectory (0 to 2 years) of cancer survivorship and determined the factors that influenced this consumption. Between January and March 2014, a cross-sectional survey was conducted to assess drug consumption in adult lymphoma survivors at the Toulouse University Hospital. This study was based on a questionnaire consisting of ten open questions related to medical prescription and/or self-medication occurring within the last 3 months. A total of 83/103 lymphoma survivors returned the questionnaire. This study showed that 91.6% of patients were drug consumers (about twice more than the general French population). Twenty percent of patients were treated with≥5 drugs. Overall drug consumption mainly concerned analgesics, anti-inflammatory drugs and psychotropics. The presence of comorbidity, urban residence and female gender were associated with overall drug consumption. Moreover, half of survivors required at least one self-medication. Finally, only seven survivors (8.4%) reported no use of any medication. This study shows that, at least during the early trajectory of cancer survivorship, lymphoma patients are heavily treated with non-cancer drug therapy. This drug consumption profile may have serious implications in terms of safety, overall benefit and health economics. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  20. When a policy decision meets practice realities: The case of cancer survivorship care and rehabilitation needs assessment.

    Science.gov (United States)

    Handberg, Charlotte; Thorne, Sally; Maribo, Thomas

    2018-04-01

    To analyze and describe health professionals' attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context. The design and methodology for this study was Interpretive Description and the analysis was informed by Symbolic Interactionism as the theoretical framework. Between April and December 2015 an ethnographic fieldwork was carried out by the first author in haematological wards at two Danish hospitals and in two primary care settings conducting cancer survivorship care programs. Participants were 41 health professionals working with needs assessment. The findings revealed an understanding of the health professionals' attitudes and perspectives and were distinguishable in relation to three structural conditions associated with the dimensions of survivorship care: Patient Context, Workplace Priorities and Practice Culture. Despite shared beliefs that needs assessment was essential to ensure survivorship care, the differential conditions surrounding the hospital and the primary care settting impeded the wider idea of formalized needs assessment, creating barriers to a seamless link between the sectors. Meaningful resolution of these disjunctures will require broad solutions, recognizing that the organization of healthcare into disconnected systems, with their different conditions, history, habits and traditions, will certainly plague the "transition" problems in healthcare unless a wider perspective is taken. Thoughtful and informed clinicians working with decision makers and those who know the evidence and can interpret systems in context can certainly bring better options to light in order to develop high quality survivorship care that will support patients throughout their cancer trajectory. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Breast Cancer Survivorship: A Comprehensive Review of Long-Term Medical Issues and Lifestyle Recommendations

    Science.gov (United States)

    Bodai, Balazs I; Tuso, Phillip

    2015-01-01

    Long-term survival rates after a diagnosis of breast cancer are steadily rising. This is good news, but clinicians must also recognize that this brings new challenges to the medical community. As breast cancer becomes a chronic condition rather than a life-threatening illness owing to advances in early diagnosis and more effective treatments, health care practitioners must recognize and manage the long-term sequelae of the constellation of therapeutic modalities. Survivors of breast cancer represent a unique and extremely complex group of patients; not only do they have the challenge of dealing with multiple long-term side effects of treatment protocols, but many are also forced to address the preexisting comorbidities of their therapies, which often include multiple other issues. Therapies have additional and/or additive side effects that may interfere with treatments directed toward the new primary diagnosis of breast cancer. Our mandate is to establish a smooth transition from patient with breast cancer to survivor of breast cancer while providing ongoing and future guidance. Certainly, the information and resources to accomplish this transition are readily available; however, they are scattered throughout the literature and therefore are not easily accessible or available to the primary care physician. It is imperative that the information available regarding survivorship issues be accessible in an organized and useful format. This article is a modest attempt to provide a comprehensive review of the long-term medical issues relevant to survivorship after the diagnosis and treatment of breast cancer. A predicted shortage of oncologists by 2020 is well-recognized. Therefore, the bulk of long-term care will become dependent on the primary care physician. This shift of care means that these physicians will need to be well educated in the long-term medical issues related to breast cancer treatment. PMID:25902343

  2. Fertility preservation: A key survivorship issue for young women with cancer

    Directory of Open Access Journals (Sweden)

    Ana M Angarita

    2016-04-01

    Full Text Available Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women’s age, diagnosis, presence of male partner, time available and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors’ quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation.

  3. Fertility Preservation: A Key Survivorship Issue for Young Women with Cancer

    Science.gov (United States)

    Angarita, Ana Milena; Johnson, Cynae A.; Fader, Amanda Nickles; Christianson, Mindy S.

    2016-01-01

    Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health-care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women’s age, diagnosis, presence of male partner, time available, and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors’ quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation. PMID:27200291

  4. The Role of Environmental Design in Cancer Prevention, Diagnosis, Treatment, and Survivorship: A Systematic Literature Review.

    Science.gov (United States)

    Gharaveis, Arsalan; Kazem-Zadeh, Mahshad

    2018-01-01

    The purpose of this literature review is to provide a better understanding of the impact that environmental design can have on the process of cancer prevention, diagnosis, treatment, and survivorship. Cancer is considered a chronic disease in the United States, and more than 1.6 million new cases are diagnosed annually. New strategies of cancer care propose patient-centered services to achieve the best outcome, and researchers have found that environmental design can be an important part of improving this care. Searches were conducted in the PubMed and Google Scholar databases as well as in specific healthcare design journals such as Health Environments Research & Design, Environmental Psychology, and Environment and Behavior. The criteria for articles included in the review were (a) English-language articles related to facility design, which addressed (b) the topics of built environment in relation to cancer diagnosis, treatment, and survivorship, and were (c) published in peer-reviewed journals between 2000 and 2017. Finally, 10 articles were selected, and the contents were analyzed. The selected articles demonstrate that environmental design is one of the critical factors for success throughout the whole continuum of cancer care from diagnosis to end-of-treatment. Some of the specific conclusions from the review are that "neighborhood-oriented" design strategies can be beneficial (by providing accessibility to all facilities along the patient's path), that access to nature for patients, staff, and visitors alike is associated with better outcomes, and that provisions for natural lighting and noise reduction are associated with cancer patients' well-being.

  5. Testicular cancer: A narrative review of the role of socioeconomic position from risk to survivorship

    Science.gov (United States)

    Richardson, Lisa C.; Neri, Antonio J.; Tai, Eric; Glenn, Jeffrey D.

    2015-01-01

    Background Testicular cancer (TC) is one of the most curable cancers. Given survival rates of close to 100% with appropriate therapy, ensuring proper treatment is essential. We reviewed and summarized the literature on the association of socioeconomic position (SEP) along the cancer control spectrum from risk factors to survivorship. Methods We searched PubMed from 1966 to 2011 using the following terms: testicular cancer, testicular neoplasm, poverty, and socioeconomic factors, retrieving 119 papers. After excluding papers for the non-English (10) language and non-relevance (46), we reviewed 63 papers. We abstracted information on socioeconomic position (SEP), including occupation, education, income, and combinations of the 3. Five areas were examined: risk factors, diagnosis, treatment, survival, and survivorship. Results Most studies examined area-based measures, not individual measures of SEP. The majority of studies found an increased risk of developing TC with high SEP though recent papers have indicated increased risk in low-income populations. Regarding diagnosis, recent papers have indicated that lower levels of education and SEP are risk factors for later-stage TC diagnosis and hence higher TC mortality. For treatment, 1 study that examined the use of radiation therapy (RT) in stage I seminoma reported that living in a county with lower educational attainment led to lower use of RT. For survival (mortality), several studies found that men living in lower SEP geographic areas experience lower survival and higher mortality. Conclusion The strongest evidence for SEP impact on testicular germ cell tumor (TGCT) was found for the risk of developing cancer as well as survival. The association of SEP with TGCT risk appears to have changed over the last decade. Given the highly curable nature of TGCT, more research is needed to understand how SEP impacts diagnosis and treatment for TGCT and to design interventions to address disparities in TGCT outcomes and SEP

  6. Conducting Cancer Control and Survivorship Research via Cooperative Groups: A Report from the American Society of Preventive Oncology

    OpenAIRE

    Palesh, Oxana; Demark-Wahnefried, Wendy; Mustian, Karen; Minasian, Lori; Rowland, Julia; Sprod, Lisa; Janelsins, Michelle; Peppone, Luke; Sloan, Jeff; Engquist, Karen Basen; Jones, Lee; Buist, Diana; Paskett, Electra

    2011-01-01

    As the number of cancer survivors expands, the need for cancer control and survivorship research becomes increasingly important. The National Cancer Institute (NCI) Cooperative Groups may offer a viable platform to perform such research. Observational, preventive, and behavioral research can often be performed within the cooperative group setting, especially if resources needed for evaluation are fairly simple, if protocols are easily implemented within the typical clinical setting, and if in...

  7. A dyadic approach to understanding the impact of breast cancer on relationships between partners during early survivorship.

    Science.gov (United States)

    Keesing, Sharon; Rosenwax, Lorna; McNamara, Beverley

    2016-08-25

    The shared impact of breast cancer for women and their male partners is emerging as an important consideration during the experience of a breast cancer diagnosis, particularly during survivorship. This study aimed to explore the experiences of women and their partners during early survivorship and contributes a range of insights into the lives of those intimately affected by breast cancer. In-depth interviews were completed with Australian women survivors of breast cancer (n = 8) and their partners (n = 8), between six months and five years following cessation of treatment. Questions included a focus on the women and their partners' daily experiences during early survivorship, including the management of ongoing symptoms, engagement in leisure and social interests, returning to work, communicating with each other, maintenance of the current relationship and other important roles and responsibilities. Thematic analysis was employed to determine key themes arising from the dyadic accounts of women and their partners' experiences during early breast cancer survivorship. Women and their partners experienced many changes to their previous roles, responsibilities and relationships during early breast cancer survivorship. Couples also reported a range of communication, intimacy and sexuality concerns which greatly impacted their interactions with each other, adding further demands on the relationship. Three significant themes were determined: (1) a disconnection within the relationship - this was expressed as the woman survivor of breast cancer needing to prioritise her own needs, sometimes at the expense of her partner and the relationship; (2) reformulating the relationship - this reflects the strategies used by couples to negotiate changes within the relationship; and (3) support is needed to negotiate the future of the relationship - couples emphasised the need for additional support and resources to assist them in maintaining their relationship during early

  8. Conducting cancer control and survivorship research via cooperative groups: a report from the American Society of Preventive Oncology.

    Science.gov (United States)

    Palesh, Oxana; Demark-Wahnefried, Wendy; Mustian, Karen; Minasian, Lori; Rowland, Julia; Sprod, Lisa; Janelsins, Michelle; Peppone, Luke; Sloan, Jeff; Engquist, Karen Basen; Jones, Lee; Buist, Diana; Paskett, Electra D

    2011-05-01

    As the number of cancer survivors expands, the need for cancer control and survivorship research becomes increasingly important. The National Cancer Institute (NCI) Cooperative Groups may offer a viable platform to perform such research. Observational, preventive, and behavioral research can often be performed within the cooperative group setting, especially if resources needed for evaluation are fairly simple, if protocols are easily implemented within the typical clinical setting, and if interventions are well standardized. Some protocols are better suited to cooperative groups than are others, and there are advantages and disadvantages to conducting survivorship research within the cooperative group setting. Behavioral researchers currently involved in cooperative groups, as well as program staff within the NCI, can serve as sources of information for those wishing to pursue symptom management and survivorship studies within the clinical trial setting. The structure of the cooperative groups is currently changing, but going forward, survivorship is bound to be a topic of interest and one that perhaps may be more easily addressed using the proposed more centralized structure. ©2011 AACR.

  9. Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.

    Science.gov (United States)

    Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana

    2007-09-01

    In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure

  10. Gender representation of cancer patients in medical treatment and psychosocial survivorship research: changes over three decades.

    Science.gov (United States)

    Hoyt, Michael A; Rubin, Lisa R

    2012-10-01

    Prior studies raise concern about gender bias in cancer research, including insufficient inclusion of women or men, or studying women and men differently. The 1993 National Institutes of Health Revitalization Act aimed to eliminate gender bias in medicine. To examine changes in medical and psychological literature, this study reviews gender representation in biomedical treatment studies and psychosocial survivorship studies published in a single year. Research published in Cancer in 2007, and all empirical psychological studies about cancer published that year, provided a 15-year update to findings reported by Meyerowitz and Hart. The gender distribution and context of included articles were coded and compared with findings from 1983 and 1992. Across biomedical studies, 34.3% of subjects were women (vs 47% of new cancers and 48% of cancer deaths). Among men, 41.3% had sex-specific cancers (vs 12.5% [1983] and 12.3% [1992]). Among women, 46.1% had sex-specific cancers (vs 69.1% [1983] and 64.6% [1992]). Fewer women (36.8%) were represented in sex-nonspecific cancer studies (vs 41.4% [1983] and 42.5% [1992]); however, fewer studies had a significant (>20%) gender disparity. Across psychosocial studies, representation of men increased to 47.9% (vs 30.4% [1983] and 29.9% [1992]). The proportion of men in studies of feelings/relationships increased to 47% (vs 22.9% [1992]); the proportion of women in studies assessing physical/functional ability increased to 58.3% (vs 45.4%). Women remain under-represented in sex-nonspecific biomedical research, whereas men's representation in sex-specific research increased substantially. Psychosocial research trends suggest movement from research questions supporting traditional stereotypes that women feel and men act. Copyright © 2012 American Cancer Society.

  11. The use of a patient-reported outcome questionnaire to assess cancer survivorship concerns and psychosocial outcomes among recent survivors.

    Science.gov (United States)

    Palmer, Steven C; Stricker, Carrie T; DeMichele, Angela M; Schapira, Marilyn; Glanz, Karen; Griggs, Jennifer J; Jacobs, Linda A

    2017-08-01

    Survivor distress is well represented in the literature, but less is known about survivors' concerns and how these relate to adaptation. Using a newly designed Survivorship Concern Scale, we examined concerns and their relationship to psychosocial adaptation among recent breast cancer (BC) survivors. One hundred forty-three stage 0-III BC survivors completed an online assessment including the Survivorship Concern Scale (0-3 scale; alpha = 0.91), unmet needs, quality of life (QoL), and anxiety and depressive symptoms within 1 year of end of treatment. Participants were predominately white (76%), middle-aged (51 years), married (70%), and college educated (79%). Eighty-two percent were stage I or II at diagnosis. Mean degree of survivorship concern was moderate (M = 1.75, SD = 0.70) though variable (range = 0.12-3.00). Survivorship concerns were not significantly related to disease, treatment, or demographic variables except income (p = 0.02). Degree of survivorship concern was significantly associated with all indices of psychosocial adaptation: unmet need (r = 0.50), physical and mental QoL (r = -0.32 and r = -0.32, respectively), depressive symptoms (r = 0.21), and anxiety symptoms (r = 0.51; all p psychosocial adaptation. Adequately addressing concerns may be a way to improve psychosocial outcomes early in the survivorship trajectory.

  12. Functional Deficits and Quality of Life Among Cancer Survivors: Implications for Occupational Therapy in Cancer Survivorship Care.

    Science.gov (United States)

    Hwang, Eric J; Lokietz, Nicole C; Lozano, Rachel L; Parke, Megan A

    2015-01-01

    This study aimed to explore functional deficits and perceived quality of life (QoL) among cancer survivors. Sixty-six participants completed the Post Cancer Outcome Survey developed for the purpose of this study. The results indicated (1) modest to moderate degrees of functional deficits in 28 of the 70 items measuring areas of occupation, performance skills, body functions, and psychosocial well-being within the first year after cancer treatment; (2) significantly lower perceived QoL during the first year of survivorship compared with that before diagnosis, at present, and 5 yr hereafter (p occupational therapy during the first year posttreatment. Functional difficulties and compromised QoL identified in this study indicate the need for occupational therapy among cancer survivors. Increasing clients' awareness of occupational therapy for postcancer care is also suggested. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  13. Beyond treatment – Psychosocial and behavioural issues in cancer survivorship research and practice

    Directory of Open Access Journals (Sweden)

    Neil K. Aaronson

    2014-06-01

    Full Text Available The population of cancer survivors has grown steadily over the past several decades. Surviving cancer, however, is not synonymous with a life free of problems related to the disease and its treatment. In this paper we provide a brief overview of selected physical and psychosocial health problems prevalent among cancer survivors, namely pain, fatigue, psychological distress and work participation. We also address issues surrounding self-management and e-Health interventions for cancer survivors, and programmes to encourage survivors to adopt healthier lifestyles. Finally, we discuss approaches to assessing health-related quality of life in cancer survivors, and the use of cancer registries in conducting psychosocial survivorship research. We highlight research and practice priorities in each of these areas. While the priorities vary per topic, common themes that emerged included: (1 Symptoms should not be viewed in isolation, but rather as part of a cluster of interrelated symptoms. This has implications for both understanding the aetiology of symptoms and for their treatment; (2 Psychosocial interventions need to be evidence-based, and where possible should be tailored to the needs of the individual cancer survivor. Relatively low cost interventions with self-management and e-Health elements may be appropriate for the majority of survivors, with resource intensive interventions being reserved for those most in need; (3 More effort should be devoted to disseminating and implementing interventions in practice, and to evaluating their cost-effectiveness; and (4 Greater attention should be paid to the needs of vulnerable and high-risk populations of survivors, including the socioeconomically disadvantaged and the elderly.

  14. Electronic patient self-assessment and management (SAM): a novel framework for cancer survivorship.

    Science.gov (United States)

    Vickers, Andrew J; Salz, Talya; Basch, Ethan; Cooperberg, Matthew R; Carroll, Peter R; Tighe, Foss; Eastham, James; Rosen, Raymond C

    2010-06-17

    We propose a novel framework for management of cancer survivorship: electronic patient Self-Assessment and Management (SAM). SAM is a framework for transfer of information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice. Patients who participate in the SAM system are contacted by email at regular intervals and asked to complete validated questionnaires online. Patient responses on these questionnaires are then analyzed in order to provide patients with real-time, online information about their progress and to provide them with tailored and standardized medical advice. Patient-level data from the questionnaires are ported in real time to the patient's health care provider to be uploaded to clinic notes. An initial version of SAM has been developed at Memorial Sloan-Kettering Cancer Center (MSKCC) and the University of California, San Francisco (UCSF) for aiding the clinical management of patients after surgery for prostate cancer. Pilot testing at MSKCC and UCSF suggests that implementation of SAM systems are feasible, with no major problems with compliance (> 70% response rate) or security. SAM is a conceptually simple framework for passing information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice.

  15. Electronic patient self-assessment and management (SAM: a novel framework for cancer survivorship

    Directory of Open Access Journals (Sweden)

    Tighe Foss

    2010-06-01

    Full Text Available Abstract Background We propose a novel framework for management of cancer survivorship: electronic patient Self-Assessment and Management (SAM. SAM is a framework for transfer of information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice. Methods Patients who participate in the SAM system are contacted by email at regular intervals and asked to complete validated questionnaires online. Patient responses on these questionnaires are then analyzed in order to provide patients with real-time, online information about their progress and to provide them with tailored and standardized medical advice. Patient-level data from the questionnaires are ported in real time to the patient's health care provider to be uploaded to clinic notes. An initial version of SAM has been developed at Memorial Sloan-Kettering Cancer Center (MSKCC and the University of California, San Francisco (UCSF for aiding the clinical management of patients after surgery for prostate cancer. Results Pilot testing at MSKCC and UCSF suggests that implementation of SAM systems are feasible, with no major problems with compliance (> 70% response rate or security. Conclusion SAM is a conceptually simple framework for passing information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice.

  16. Body composition of children with cancer during treatment and in survivorship.

    Science.gov (United States)

    Murphy, Alexia J; White, Melinda; Elliott, Sarah A; Lockwood, Liane; Hallahan, Andrew; Davies, Peter Sw

    2015-10-01

    Malnutrition as assessed with the use of body-composition measurements is a poorly understood short- and long-term complication of childhood cancer. We aimed to evaluate the body composition of 2 childhood cancer cohorts as follows: 1) children currently undergoing cancer treatment and 2) childhood cancer survivors. We also aimed to compare the prevalence of obesity and undernutrition between the cancer groups and investigate the impact of cancer type on body composition. Eighty-two children during the treatment of cancer and 53 childhood cancer survivors were involved in the study. Height, weight, body cell mass, percentage of fat, fat mass index, and fat-free mass index were assessed. Subjects were compared with age- and sex-matched healthy controls. The on-treatment group had a higher percentage of fat (P = 0.0001) and fat mass index (P = 0.0001) and a significantly lower body cell mass index (P = 0.0001) and fat-free mass index (P = 0.003) than did matched controls. The survivor group had a significantly higher percentage of fat (P = 0.03) and fat mass index (P = 0.04) and significantly lower body cell mass index (P = 0.0001) than did matched controls. The prevalence of undernutrition was high in both groups with 48% (95% CI: 36%, 60%) of the on-treatment group and 53% (95% CI: 40%, 66%) of the survivors considered undernourished. According to the percentage of fat cutoffs, significantly more on-treatment patients were obese (55%; 95% CI: 40%, 60%) than were survivors (26%; 95% CI: 14%, 38%) (P = 0.005). There were no statistically significant differences in body composition between cancer types in either the on-treatment or the survivor group. Overnutrition and undernutrition are major concerns in the short and long term for children with cancer. Children treated for cancer have increased fat mass and decreased body cell mass, which are evident during treatment and in survivorship. This trial was registered at http://www.ANZCTR.org.au as ACTRN12614001279617

  17. Usability and acceptance evaluation of ACESO: a Web-based breast cancer survivorship tool.

    Science.gov (United States)

    Kapoor, Akshat; Nambisan, Priya

    2018-01-25

    The specific objective of this research is to design and develop a personalized Web application to support breast cancer survivors after treatment, as they deal with post-treatment challenges, such as comorbidities and side effects of treatment. A mixed-methods approach, utilizing a combination of think-aloud analysis, personal interviews, and surveys, was adopted for user acceptance and usability testing among a group of breast cancer survivors. User feedback was gathered on their perceived value of the application, and any user-interface issues that may hinder the overall usability were identified. The application's portability and capability of organizing their entire breast cancer-related medical history as well as tracking various quality of life indicators were perceived to be valuable features. The application had an overall high usability; however, certain sections of the application were not as intuitive to locate. Visual elements of the website were appreciated; however, overall experience would benefit from incorporating more sociable elements that exhibit positive re-enforcement within the end user and provide a friendlier experience. The results of the study showcase the need for more personalized tools and resources to support survivors in self-management. It also demonstrates the ability to integrate breast cancer survivorship care plans from diverse providers and paves the way to add further value-added features in consumer health applications, such as personal decision support. Using a personal decision support-based tool can serve as a training tool and resource, providing these patients with pertinent information about the various aspects of their long-term health, while educating them about any related side effects and symptoms. It is hoped that making such tools more accessible could help in engaging survivors to play an active role in managing their health and encourage shared decision-making with their providers.

  18. The Impact of a Primary Care Education Program Regarding Cancer Survivorship Care Plans: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

    Science.gov (United States)

    Donohue, SarahMaria; Haine, James E; Li, Zhanhai; Trowbridge, Elizabeth R; Kamnetz, Sandra A; Feldstein, David A; Sosman, James M; Wilke, Lee G; Sesto, Mary E; Tevaarwerk, Amye J

    2017-09-20

    Survivorship care plans (SCPs) have been recommended as tools to improve care coordination and outcomes for cancer survivors. SCPs are increasingly being provided to survivors and their primary care providers. However, most primary care providers remain unaware of SCPs, limiting their potential benefit. Best practices for educating primary care providers regarding SCP existence and content are needed. We developed an education program to inform primary care providers of the existence, content, and potential uses for SCPs. The education program consisted of a 15-min presentation highlighting SCP basics presented at mandatory primary care faculty meetings. An anonymous survey was electronically administered via email (n = 287 addresses) to evaluate experience with and basic knowledge of SCPs pre- and post-education. A total of 101 primary care advanced practice providers (APPs) and physicians (35% response rate) completed the baseline survey with only 23% reporting prior receipt of a SCP. Only 9% could identify the SCP location within the electronic health record (EHR). Following the education program, primary care physicians and APPs demonstrated a significant improvement in SCP knowledge, including improvement in their ability to locate one within the EHR (9 vs 59%, p educational program containing information about SCP existence, content, and location in the EHR increased primary care physician and APP knowledge in these areas, which are prerequisites for using SCP in clinical practice.

  19. 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.

  20. Survivorship care and support following treatment for breast cancer: a multi-ethnic comparative qualitative study of women's experiences.

    Science.gov (United States)

    Tompkins, Charlotte; Scanlon, Karen; Scott, Emma; Ream, Emma; Harding, Seeromanie; Armes, Jo

    2016-08-18

    As the number of breast cancer survivors continues to rise, Western populations become more ethnically and socially diverse and healthcare resources become ever-more stretched, follow-up that focuses on monitoring for recurrence is no longer viable. New models of survivorship care need to ensure they support self-management and are culturally appropriate across diverse populations. This study explored experiences and expectations of a multi-ethnic sample of women with breast cancer regarding post-treatment care, in order to understand potential barriers to receiving care and inform new models of survivorship care. A phenomenological qualitative research design was employed. In-depth interviews were conducted with women from diverse socio-demographic backgrounds in England, who completed treatment for breast cancer in the 12 months prior to the study. Data were analysed using Framework Analysis. Sixty-six women participated and reported expectations and needs were unmet at follow-up. Whilst there were more commonalities in experiences, discernible differences, particularly by ethnicity and age, were identified relating to three key themes: emotional responses on transition to follow-up; challenges communicating with healthcare professionals at follow-up; and challenges finding and accessing information and support services to address unmet needs. There are cultural differences in the way healthcare professionals and women communicate, not necessarily differences in their post-treatment needs. We do not know if new models of care meet survivors' needs, or if they are appropriate for everyone. Further testing and potential cultural and linguistic adaptation of models of care is necessary to ensure their appropriateness and acceptability to survivors from different backgrounds. New ways of providing survivorship care mean survivors will need to be better prepared for the post-treatment period and the role they will have to play in managing their symptoms and care.

  1. Exploring the role of ethnicity on perceptions of cancer and physical health recovery during the first year of survivorship.

    Science.gov (United States)

    Kim, Youngmee; Shaffer, Kelly M; Rocha-Lima, Caio; Milton, Alexis; Carver, Charles S

    2016-07-01

    This study examined the role of ethnicity (Black vs White) in the extent to which patients' appraisal of the impact of cancer on themselves and their family members relates to their physical health. Colorectal cancer patients provided self-reports for study variables at 2 and 12 months post-diagnosis (N = 60). Hierarchical regression analysis revealed that African American patients' perception of the cancer as disruptive to their family, but not to themselves, related to poorer health recovery, which association was absent among Whites (p stress plays a different role between two ethnic groups in elucidating their health recovery during the early survivorship. © The Author(s) 2014.

  2. Importance ratings on patient-reported outcome items for survivorship care: comparison between pediatric cancer survivors, parents, and clinicians.

    Science.gov (United States)

    Jones, Conor M; Baker, Justin N; Keesey, Rachel M; Eliason, Ruth J; Lanctot, Jennifer Q; Clegg, Jennifer L; Mandrell, Belinda N; Ness, Kirsten K; Krull, Kevin R; Srivastava, Deokumar; Forrest, Christopher B; Hudson, Melissa M; Robison, Leslie L; Huang, I-Chan

    2018-04-18

    To compare importance ratings of patient-reported outcomes (PROs) items from the viewpoints of childhood cancer survivors, parents, and clinicians for further developing short-forms to use in survivorship care. 101 cancer survivors, 101 their parents, and 36 clinicians were recruited from St. Jude Children's Research Hospital. Participants were asked to select eight items that they deemed useful for clinical decision making from each of the four Patient-Reported Outcomes Measurement Information System Pediatric item banks. These item banks were pain interference (20 items), fatigue (23 items), psychological stress (19 items), and positive affect (37 items). Compared to survivors, clinicians rated more items across four domains that were statistically different than did parents (23 vs. 13 items). Clinicians rated five items in pain interference domain (ORs 2.33-6.01; p's important but rated three items in psychological stress domain (ORs 0.14-0.42; p's important than did survivors. In contrast, parents rated seven items in positive affect domain (ORs 0.25-0.47; p's important than did survivors. Survivors, parents, and clinicians viewed importance of PRO items for survivorship care differently. These perspectives should be used to assist the development of PROs tools.

  3. Cancer Survivorship: Defining the Incidence of Incisional Hernia After Resection for Intra-Abdominal Malignancy.

    Science.gov (United States)

    Baucom, Rebeccah B; Ousley, Jenny; Beveridge, Gloria B; Phillips, Sharon E; Pierce, Richard A; Holzman, Michael D; Sharp, Kenneth W; Nealon, William H; Poulose, Benjamin K

    2016-12-01

    Cancer survivorship focuses largely on improving quality of life. We aimed to determine the rate of ventral incisional hernia (VIH) formation after cancer resection, with implications for survivorship. Patients without prior VIH who underwent abdominal malignancy resections at a tertiary center were followed up to 2 years. Patients with a viewable preoperative computed tomography (CT) scan and CT within 2 years postoperatively were included. Primary outcome was postoperative VIH on CT, reviewed by a panel of surgeons uninvolved with the original operation. Factors associated with VIH were determined using Cox proportional hazards regression. 1847 CTs were reviewed among 491 patients (59 % men), with inter-rater reliability 0.85 for the panel. Mean age was 60 ± 12 years; mean follow-up time 13 ± 8 months. VIH occurred in 41 % and differed across diagnoses: urologic/gynecologic (30 %), colorectal (53 %), and all others (56 %) (p VIH (adjusting for stage, age, adjuvant therapy, smoking, and steroid use) included: incision location [flank (ref), midline, hazard ratio (HR) 6.89 (95 %CI 2.43-19.57); periumbilical, HR 6.24 (95 %CI 1.84-21.22); subcostal, HR 4.55 (95 %CI 1.51-13.70)], cancer type [urologic/gynecologic (ref), other {gastrointestinal, pancreatic, hepatobiliary, retroperitoneal, and others} HR 1.86 (95 %CI 1.26-2.73)], laparoscopic-assisted operation [laparoscopic (ref), HR 2.68 (95 %CI 1.44-4.98)], surgical site infection [HR 1.60 (95 %CI 1.08-2.37)], and body mass index [HR 1.06 (95 %CI 1.03-1.08)]. The rate of VIH after abdominal cancer operations is high. VIH may impact cancer survivorship with pain and need for additional operations. Further studies assessing the impact on QOL and prevention efforts are needed.

  4. Cancer survivorship and opioid prescribing rates: A population-based matched cohort study among individuals with and without a history of cancer.

    Science.gov (United States)

    Sutradhar, Rinku; Lokku, Armend; Barbera, Lisa

    2017-11-01

    Little is known about opioid prescribing among individuals who have survived cancer. Our aim is to examine a predominantly socio-economically disadvantaged population for differences in opioid prescribing rates among cancer survivors compared with matched controls without a prior diagnosis of cancer. This was a retrospective population-wide matched cohort study. Starting in 2010, individuals residing in Ontario, Canada, who were 18 to 64 years of age and at least 5 years past their cancer diagnosis were matched to controls without a prior cancer diagnosis based on sex and calendar year of birth. Follow-up was terminated at any indication of cancer recurrence, second malignancy, or new cancer diagnosis. To examine the association between survivorship and the rate of opioid prescriptions, an Andersen-Gill recurrent event regression model was implemented, adjusting for numerous individual-level characteristics and also accounting for the matched design. The rate of opioid prescribing was 1.22 times higher among survivors than among their corresponding matched controls (adjusted relative rate, 1.22; 95% CI, 1.11-1.34). Individuals from lower income quintiles who were younger, were from rural neighborhoods, and had more comorbidities had significantly higher prescribing rates. Sex was not associated with prescribing rates. This increased rate of opioid prescribing was also seen among survivors who were 10 or more years past their cancer diagnosis (compared with their controls). This study demonstrates substantially higher opioid prescribing rates among cancer survivors, even long after attaining survivorship. This raises concerns about the diagnosis and management of chronic pain problems among survivors stemming from their cancer diagnosis or treatment. Cancer 2017;123:4286-4293. © 2017 American Cancer Society. © 2017 American Cancer Society.

  5. A mixed method exploration of survivorship among Chinese American and non-Hispanic White breast cancer survivors: the role of socioeconomic well-being.

    Science.gov (United States)

    Wang, Judy Huei-yu; Adams, Inez F; Tucker-Seeley, Reginald; Gomez, Scarlett Lin; Allen, Laura; Huang, Ellen; Wang, Yiru; Pasick, Rena J

    2013-12-01

    Cancer-related stress is heavily influenced by culture. This study explored similarities and differences in survivorship care concerns among Chinese American and non-Hispanic White (NHW) breast cancer survivors. A sequential, mixed-method design (inductive/qualitative research-phase I and deductive/quantitative research-phase II) was employed. Eligible women identified from the Greater Bay Area Cancer Registry were age ≥21, diagnosed with stage 0-IIa breast cancer between 2006 and 2011, and had no recurrence or other cancers. In phase I, we conducted 4 Chinese (n = 19) and 4 NHW (n = 22) focus groups, and 31 individual telephone interviews (18 Chinese immigrants, 7 Chinese US-born, and 6 NHW). Content analysis was conducted to examine qualitative data. In phase II, another 296 survivors (148 NHW age-matched to 148 Chinese cases) completed a cross-sectional survey. Descriptive statistics and linear regression analysis were conducted to examine quantitative data. Qualitative data revealed "socioeconomic well-being" (SWB) as a dominant survivorship concern, which was operationalized as a cancer survivor's perceived economic and social resources available to access care. Quantitative data showed that low-acculturated Chinese immigrants reported the poorest SWB, controlling for covariates. Highly acculturated Chinese immigrants and the US-born Chinese/NHW group reported similar SWB. Women who had low-income levels or chemotherapy had poorer SWB. SWB emerged as an important aspect of breast cancer survivorship. Immigration stress, cancer care costs, and cultural values all contributed to immigrants' socioeconomic distress. Immigrant and US-born breast cancer survivors experienced different socioeconomic circumstances and well-being following treatment. Our findings warrant further investigation of socioeconomic distress and survivorship outcomes.

  6. An internet tool for creation of cancer survivorship care plans for survivors and health care providers: design, implementation, use and user satisfaction.

    Science.gov (United States)

    Hill-Kayser, Christine E; Vachani, Carolyn; Hampshire, Margaret K; Jacobs, Linda A; Metz, James M

    2009-09-04

    Survivorship care plans have been recommended by the Institute of Medicine for all cancer survivors. We implemented an Internet-based tool for creation of individualized survivorship care plans. To our knowledge, this is the first tool of this type to be designed and made publicly accessible. To investigate patterns of use and satisfaction with an Internet-based tool for creation of survivorship care plans. OncoLife, an Internet-based program for creation of survivorship care plans, was designed by a team of dedicated oncology nurses and physicians at the University of Pennsylvania. The program was designed to provide individualized, comprehensive health care recommendations to users responding to queries regarding demographics, diagnosis, and cancer treatments. After being piloted to test populations, OncoLife was made publicly accessible via Oncolink, a cancer information website based at the University of Pennsylvania which averages 3.9 million page views and over 385,000 unique visits per month. Data entered by anonymous public users was maintained and analyzed. From May 2007 to November 2008, 3343 individuals utilized this tool. Most (63%) identified themselves as survivors, but also health care providers (25%) and friends/family of survivors (12%). Median age at diagnosis was 48 years (18-100+), and median current age 51 (19-100+). Most users were Caucasian (87%), female (71%), and college-educated (82%). Breast cancer was the most common diagnosis (46%), followed by hematologic (12%), gastrointestinal (11%), gynecologic (9%), and genitourinary (8%). Of all users, 84% had undergone surgery, 80% chemotherapy, and 60% radiotherapy. Half of users (53%) reported receiving follow-up care from only an oncologist, 13% only a primary care provider (PCP), and 32% both; 12% reported having received survivorship information previously. Over 90% of users, both survivors and health care providers, reported satisfaction levels of "good" to "excellent" using this tool

  7. Psychological morbidities in adolescent and young adult blood cancer patients during curative-intent therapy and early survivorship.

    Science.gov (United States)

    Muffly, Lori S; Hlubocky, Fay J; Khan, Niloufer; Wroblewski, Kristen; Breitenbach, Katherine; Gomez, Joseline; McNeer, Jennifer L; Stock, Wendy; Daugherty, Christopher K

    2016-03-15

    Adolescents and young adults (AYAs) with cancer face unique psychosocial challenges. This pilot study was aimed at describing the prevalence of psychological morbidities among AYAs with hematologic malignancies during curative-intent therapy and early survivorship and at examining provider perceptions of psychological morbidities in their AYA patients. Patients aged 15 to 39 years with acute leukemia, non-Hodgkin lymphoma, or Hodgkin lymphoma who were undergoing curative-intent therapy (on-treatment group) or were in remission within 2 years of therapy completion (early survivors) underwent a semistructured interview that incorporated measures of anxiety, depression, and posttraumatic stress (PTS). A subset of providers (n = 15) concomitantly completed a survey for each of the first 30 patients enrolled that evaluated their perception of each subject's anxiety, depression, and PTS. Sixty-one of 77 eligible AYAs participated. The median age at diagnosis was 26 years (range, 15-39 years), 64% were male, and 59% were non-Hispanic white. On-treatment demographics differed significantly from early-survivor demographics only in the median time from diagnosis to interview. Among the 61 evaluable AYAs, 23% met the criteria for anxiety, 28% met the criteria for depression, and 13% met the criteria for PTS; 46% demonstrated PTS symptomatology. Thirty-nine percent were impaired in 1 or more psychological domains. Psychological impairments were as frequent among early survivors as AYAs on treatment. Provider perceptions did not significantly correlate with patient survey results. AYAs with hematologic malignancies experience substantial psychological morbidities while they are undergoing therapy and during early survivorship, with more than one-third of the patients included in this study meeting the criteria for anxiety, depression, or traumatic stress. This psychological burden may not be accurately identified by their oncology providers. © 2016 American Cancer Society.

  8. Adoption, Acceptability, and Effectiveness of a Mobile Health App for Personalized Prostate Cancer Survivorship Care: Protocol for a Realist Case Study of the Ned App.

    Science.gov (United States)

    Pham, Quynh; Cafazzo, Joseph A; Feifer, Andrew

    2017-10-12

    By 2030, prostate cancer will be the most commonly diagnosed cancer in North America. To mitigate this impending challenge, comprehensive support mechanisms for disease- and treatment-specific changes in health and well-being must be proactively designed and thoughtfully implemented for streamlined survivorship care. mHealth apps have been lauded as a promising complement to current outpatient treatment and monitoring strategies, but have not yet been widely used to support prostate cancer survivorship needs. A realist evaluation is needed to examine the impact of such apps on the prostate cancer survivorship experience. We seek to gain an understanding of how an mHealth app for prostate cancer survivorship care called Ned (No Evident Disease) is adopted and accepted by patients, caregivers, and clinicians. We also aim to determine the effect of Ned on health-related quality of life, satisfaction with cancer care, unmet needs, self-efficacy, and prostate cancer-related levels of anxiety. The Ned case study is a 12-month mixed-methods embedded single-case study with a nested within-group pre-post comparison of health outcomes. We will give 400 patients, 200 caregivers, and 10 clinicians access to Ned. Participants will be asked to complete study assessments at baseline, 2 months, 6 months, and 12 months. We will conduct 30 semistructured qualitative interviews with patients (n=20) and their caregivers (n=10) poststudy to gain insight into their experience with the app. We recruited our first survivor in October 2017 and anticipate completing this study by May 2019. This will, to our knowledge, be the first realist case study to evaluate an app for prostate cancer survivorship care. Prostate cancer survivors are set to increase in number and longevity, heightening the need for integrated survivorship solutions to provide them with optimal and durable outcomes. The knowledge gained from this study will comprehensively inform how and why Ned works, for whom, and in

  9. Survivorship care planning in skin cancer: An unbiased statistical approach to identifying patterns of care-plan use.

    Science.gov (United States)

    Benci, Joseph L; Minn, Andy J; Vachani, Carolyn C; Bach, Christina; Arnold-Korzeniowski, Karen; Hampshire, Margaret K; Metz, James M; Hill-Kayser, Christine E

    2018-01-01

    Nearly 1 in 5 Americans will develop skin cancer, and as a result, survivors of skin cancer compose one of the largest groups of cancer survivors. Survivorship care plans (SCPs) are an important tool for improving patient outcomes and provide critical information to both survivors and health care professionals. Recent efforts have been made to expand SCP utilization; however, which patients currently receive SCPs is poorly understood. This study used 596 individuals with a diagnosis of melanoma (n = 391) or nonmelanoma skin cancer (n = 205) who had used an Internet-based SCP tool from May 2010 to December 2016 to model the patient and provider characteristics that determine SCP utilization. Survivors were predominantly white (95.3%) and female (56.5%). Survivors who received a treatment summary were more likely to also receive an SCP. University and nonuniversity cancer centers used SCPs at a higher rate than other care settings. Survivors whose care was managed by a team rather than just an individual physician were also more likely to receive an SCP. Survivors older than 70 years at diagnosis were almost twice as likely to receive a plan as survivors who were diagnosed at a younger age. With a convenience sample of skin cancer survivors, it is possible to model factors that predict the receipt of SCPs. Important variables include the diagnosis age, treatment setting, physician type, and treatment-summary utilization. A closer examination of these variables identified several disparities in care-plan use and, therefore, opportunities to improve the distribution of SCPs. Further validation in additional cohorts of survivors is necessary to confirm these conclusions. Cancer 2018;124:183-91. © 2017 American Cancer Society. © 2017 American Cancer Society.

  10. Do Perceived Needs Affect Willingness to Use Traditional Chinese Medicine for Survivorship Care Among Chinese Cancer Survivors? A Cross-Sectional Survey

    Directory of Open Access Journals (Sweden)

    Lingyun Sun

    2017-12-01

    Full Text Available Purpose: We aimed to quantify Chinese cancer survivors’ perceived needs for survivorship care and to evaluate whether these needs could impact their willingness to use traditional Chinese medicine (TCM. Methods: We conducted a cross-sectional survey with members of the Beijing Anti-Cancer Association in China. We measured perceived needs with the seven-item Brief Chinese Cancer Survivorship Needs Scale that assesses psychological, functional, nutritional, social, body image, pain, and symptom needs. The outcome variable was willingness to use TCM for survivorship care. We performed multivariable logistic regression analyses to evaluate whether perceived needs are associated with willingness. Results: A total of 600 patients were invited, with a response rate of 81%. The mean (standard deviation score of the perceived needs scale (0 to 10 was 4.4 (2.2, with the majority of participants endorsing nutritional (72%, symptom (65%, and psychological (54% needs. Among survivors, 387 (80%; 95% CI, 76% to 83% were willing to use TCM for survivorship care. In multivariable analysis, a higher perceived needs score (adjusted odds ratio [OR], 1.33; 95% CI, 1.14 to 1.56; P < .001 was associated with greater willingness to use TCM. Specifically, nutritional (OR, 3.17; 95% CI, 1.79 to 5.62; P < .001 and symptom needs (OR, 3.15; 95% CI, 1.79 to 5.55; P < .001 had the strongest relationship. Conclusion: A higher level of perceived needs, especially in the areas of nutrition and symptoms, was associated with greater willingness to use TCM for survivorship care.

  11. Do Perceived Needs Affect Willingness to Use Traditional Chinese Medicine for Survivorship Care Among Chinese Cancer Survivors? A Cross-Sectional Survey.

    Science.gov (United States)

    Sun, Lingyun; Yang, Yufei; Vertosick, Emily; Jo, SungHwa; Sun, Guilan; Mao, Jun J

    2017-12-01

    Purpose We aimed to quantify Chinese cancer survivors' perceived needs for survivorship care and to evaluate whether these needs could impact their willingness to use traditional Chinese medicine (TCM). Methods We conducted a cross-sectional survey with members of the Beijing Anti-Cancer Association in China. We measured perceived needs with the seven-item Brief Chinese Cancer Survivorship Needs Scale that assesses psychological, functional, nutritional, social, body image, pain, and symptom needs. The outcome variable was willingness to use TCM for survivorship care. We performed multivariable logistic regression analyses to evaluate whether perceived needs are associated with willingness. Results A total of 600 patients were invited, with a response rate of 81%. The mean (standard deviation) score of the perceived needs scale (0 to 10) was 4.4 (2.2), with the majority of participants endorsing nutritional (72%), symptom (65%), and psychological (54%) needs. Among survivors, 387 (80%; 95% CI, 76% to 83%) were willing to use TCM for survivorship care. In multivariable analysis, a higher perceived needs score (adjusted odds ratio [OR], 1.33; 95% CI, 1.14 to 1.56; P < .001) was associated with greater willingness to use TCM. Specifically, nutritional (OR, 3.17; 95% CI, 1.79 to 5.62; P < .001) and symptom needs (OR, 3.15; 95% CI, 1.79 to 5.55; P < .001) had the strongest relationship. Conclusion A higher level of perceived needs, especially in the areas of nutrition and symptoms, was associated with greater willingness to use TCM for survivorship care.

  12. About Survivorship

    Science.gov (United States)

    ... CancerProgress.Net website to learn more about the historical pace of cancer research. Surviving cancer: What to ... during treatment Take time off for treatment and return to work afterwards Be unable to return to ...

  13. Development of a text messaging system to improve receipt of survivorship care in adolescent and young adult survivors of childhood cancer.

    Science.gov (United States)

    Casillas, Jacqueline; Goyal, Anju; Bryman, Jason; Alquaddoomi, Faisal; Ganz, Patricia A; Lidington, Emma; Macadangdang, Joshua; Estrin, Deborah

    2017-08-01

    This study aimed to develop and examine the acceptability, feasibility, and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer. Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative three-stage process. In stage 1, a focus group (n = 4) addressed acceptability; in stage 2, key informant interviews (n = 10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n = 23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes. The final system includes programmed reminders to schedule and attend late effect screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system. The text messaging system may assist AYA survivors by coordinating late effect screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources. The text messaging system has the potential to improve the receipt of survivorship care.

  14. Apps seeking theories: results of a study on the use of health behavior change theories in cancer survivorship mobile apps.

    Science.gov (United States)

    Vollmer Dahlke, Deborah; Fair, Kayla; Hong, Y Alicia; Beaudoin, Christopher E; Pulczinski, Jairus; Ory, Marcia G

    2015-03-27

    Thousands of mobile health apps are now available for use on mobile phones for a variety of uses and conditions, including cancer survivorship. Many of these apps appear to deliver health behavior interventions but may fail to consider design considerations based in human computer interface and health behavior change theories. This study is designed to assess the presence of and manner in which health behavior change and health communication theories are applied in mobile phone cancer survivorship apps. The research team selected a set of criteria-based health apps for mobile phones and assessed each app using qualitative coding methods to assess the application of health behavior change and communication theories. Each app was assessed using a coding derived from the taxonomy of 26 health behavior change techniques by Abraham and Michie with a few important changes based on the characteristics of mHealth apps that are specific to information processing and human computer interaction such as control theory and feedback systems. A total of 68 mobile phone apps and games built on the iOS and Android platforms were coded, with 65 being unique. Using a Cohen's kappa analysis statistic, the inter-rater reliability for the iOS apps was 86.1 (Papps, 77.4 (Papps were consistently higher than those of the Android platform apps. For personalization and tailoring, 67% of the iOS apps (24/36) had these elements as compared to 38% of the Android apps (12/32). In the area of prompting for intention formation, 67% of the iOS apps (34/36) indicated these elements as compared to 16% (5/32) of the Android apps. Mobile apps are rapidly emerging as a way to deliver health behavior change interventions that can be tailored or personalized for individuals. As these apps and games continue to evolve and include interactive and adaptive sensors and other forms of dynamic feedback, their content and interventional elements need to be grounded in human computer interface design and health

  15. A culturally adapted survivorship programme for Asian early stage breast cancer patients in Singapore: A randomized, controlled trial.

    Science.gov (United States)

    Chan, Alexandre; Gan, Yan Xiang; Oh, Suan Kai; Ng, Terence; Shwe, Maung; Chan, Raymond; Ng, Raymond; Goh, Brandon; Tan, Yee Pin; Fan, Gilbert

    2017-10-01

    As cancer mortality rates improve in Singapore, there is an increasing need to improve the transition to posttreatment survivorship care. This study aimed to evaluate the effectiveness of a psychoeducation group (PEG) intervention program compared with usual care to reduce distress for physical symptom and psychological aspects in Asian breast cancer survivors who have completed adjuvant chemotherapy. This was a randomized, controlled trial comprising 72 Asian early stage breast cancer survivors who were randomized into the PEG (n = 34) or the control (n = 38) arm. The participants in the PEG arm underwent a weekly multidisciplinary PEG program delivered in a group format over 3 weeks coupled with cultural adaptation. Both arms were assessed at baseline and 2 months after intervention using the Rotterdam Symptom Checklist, Beck Anxiety Inventory, and EORTC QLQ-C30. A satisfaction questionnaire was also conducted among those survivors who have participated in the PEG program. Effective sizes were calculated using Cohen d. The mean age ± SD of all participants was 53.0 ± 8.9 years, with the majority being Chinese (84.7%) and Malay (6.9%), and clinical characteristics were well balanced in both arms. Compared to the control arm, the PEG arm showed a significantly greater reduction in physical symptom distress (d = 0.76, P = .01) and fatigue (d = 0.49, P = .04). The 82.4% of the participants in the intervention group responded to the satisfaction questionnaire, and the majority (92.9%) agreed that the overall duration of the PEG intervention program was appropriate. A culturally adapted PEG program was effective in reducing physical symptom distress in Asian breast cancer survivors. (ClinicalTrials.gov: NCT02600299). Copyright © 2016 John Wiley & Sons, Ltd.

  16. A structural model for stress, coping, and psychosocial adjustment: A multi-group analysis by stages of survivorship in Korean women with breast cancer.

    Science.gov (United States)

    Jang, Miyoung; Kim, Jiyoung

    2018-04-01

    Prospective studies have examined factors directly affecting psychosocial adjustment during breast cancer treatment. Survivorship stage may moderate a direct effect of stress on psychosocial adjustment. This study aimed to examine relationships between stress, social support, self-efficacy, coping, and psychosocial adjustment to construct a model of the effect pathways between those factors, and determine if survivorship stage moderates those effects. Six hundred people with breast cancer completed questionnaires. Examined stages of survivorship after treatment were as follows: acute (i.e., 5 years). Stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), self-efficacy (New General Self Efficacy Scale), coping (Ways of Coping Checklist), and psychosocial adjustment (Psychosocial Adjustment to Illness Scale-Self-Report-Korean Version) were measured. Self-efficacy significantly correlated with psychosocial adjustment in the acute survival stage (γ = -0.37, P psychosocial adjustment was greater in the acute (γ = -0.42, P psychosocial adjustment was stronger in the lasting survival stage (β = 0.42, P psychosocial adjustment of female breast cancer patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Enhancing Survivorship Care Planning for Patients With Localized Prostate Cancer Using a Couple-Focused mHealth Symptom Self-Management Program: Protocol for a Feasibility Study.

    Science.gov (United States)

    Song, Lixin; Dunlap, Kaitlyn L; Tan, Xianming; Chen, Ronald C; Nielsen, Matthew E; Rabenberg, Rebecca L; Asafu-Adjei, Josephine K; Koontz, Bridget F; Birken, Sarah A; Northouse, Laurel L; Mayer, Deborah K

    2018-02-26

    This project explores a new model of care that enhances survivorship care planning and promotes health for men with localized prostate cancer transitioning to posttreatment self-management. Survivorship care planning is important for patients with prostate cancer because of its high incidence rate in the United States, the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) for both men and their partners. A key component of comprehensive survivorship care planning is survivorship care plans (SCPs), documents that summarize cancer diagnosis, treatment, and plans for follow-up care. However, research concerning the effectiveness of SCPs on patient outcomes or health service use has thus far been inconclusive. SCPs that are tailored to individual patients' needs for information and care may improve effectiveness. This study aims to examine the feasibility of an enhanced survivorship care plan (ESCP) that integrates a symptom self-management mHealth program called Prostate Cancer Education and Resources for Couples (PERC) into the existing standardized SCP. The specific aims are to (1) examine the feasibility of delivering ESCPs and (2) to estimate the magnitude of benefit of ESCPs. We will use a two-group randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized prostate cancer and their partners. First, we will assess the feasibility of ESCP by recruitment, enrollment, and retention rates; program satisfaction with the ESCP; and perceived ease of use of the ESCP. To achieve the secondary aim, we will compare the ESCP users with the standardized SCP users and assess their primary outcomes of QOL (overall, physical, emotional, and social QOL); secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and number of visits to posttreatment

  18. Lifestyle Factors in Cancer Survivorship: Where We Are and Where We Are Headed

    Directory of Open Access Journals (Sweden)

    Namrata Vijayvergia

    2015-07-01

    Full Text Available Advances in early detection and curative therapies have led to an increased number of cancer survivors over the last twenty years. With this population comes the need to evaluate the late and long term effects of cancer treatment and develop recommendations about how to optimally care for these survivors. Lifestyle factors (diet, body weight, physical activity, and smoking have been linked to a higher risk of many medical comorbidities (cardiovascular, metabolic, etc.. There is increasing evidence linking these factors to the risk of developing cancer and likely cancer-related outcomes. This link has been studied extensively in common cancers like breast, colon, prostate, and lung cancers through observational studies and is now being prospectively evaluated in interventional studies. Realizing that survivors are highly motivated to improve their overall health after a diagnosis of cancer, healthy lifestyle recommendations from oncology providers can serve as a strong tool to motivate survivors to adopt health behavior changes. Our article aims to review the evidence that links lifestyle factors to cancer outcomes and provides clinical recommendations for cancer survivors.

  19. Lesbian, Gay, Bisexual, and Transgender (LGBT) Survivorship.

    Science.gov (United States)

    Kamen, Charles

    2018-02-01

    To discuss lesbian, gay, bisexual, and transgender (LGBT)-specific survivorship issues including: integrating sexual and gender minority identities with cancer survivor identities; coordinating medical care and disclosing identities to health care providers; dealing with late effects of treatment; and addressing LGBT family and relationship issues. Published articles, quotes from an online survey of 311 LGBT survivors. The transition from active cancer treatment to survivorship presents challenges, and LGBT cancer survivors may face additional challenges as they enter the survivorship phase. Oncology nurses can improve the quality of survivorship care delivered to LGBT survivors and their caregivers by addressing the disparities and gaps in health care. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Is cancer survivorship associated with reduced work engagement? A NOCWO Study.

    Science.gov (United States)

    Berg Gudbergsson, Saevar; Fosså, Sophie D; Dahl, Alv A

    2008-09-01

    This study explores work engagement in employed tumor-free cancer survivors (CSs) compared to matched controls from the general population (NORM). The sample consisted of 446 CSs tumor-free after primary treatment [226 females with breast cancer and 220 males (166 testicular cancer and 54 prostate cancer)] diagnosed 2-6 years prior to the study. All had returned to work and had favourable prognosis. NORM sample consisted of 588 employed controls (319 females, 269 males). All CSs and NORM filled in a mailed questionnaire covering demography, morbidity, and work-related issues including work engagement which was self-rated by the Utrecht Work Engagement Scale (UWES). No differences in work engagement were observed between the CSs and NORM measured by the UWES total scale score or by the Dedication and Absorption domain scores. The Vigor domains score was statistically lower among CSs (p = .03), but the effect size was only 0.19. The CSs reported significantly poorer work ability, poorer health status, greater numbers of disease symptoms, more anxiety, and reduced physical quality of life, and scored significantly higher on both neuroticism and extraversion. CONCLUSIONS/IMPLICATIONS FOR CSS: In spite of poorer health CSs who had returned to work after their treatment for breast, prostate, and testicular cancer showed similar work engagement as individuals without cancer. In such CSs employers have no reason to expect reduced work engagement. Future research should preferably have a prospective and comparative design.

  1. Supportive care after curative treatment for breast cancer (survivorship care): resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement.

    Science.gov (United States)

    Ganz, Patricia A; Yip, Cheng Har; Gralow, Julie R; Distelhorst, Sandra R; Albain, Kathy S; Andersen, Barbara L; Bevilacqua, Jose Luiz B; de Azambuja, Evandro; El Saghir, Nagi S; Kaur, Ranjit; McTiernan, Anne; Partridge, Ann H; Rowland, Julia H; Singh-Carlson, Savitri; Vargo, Mary M; Thompson, Beti; Anderson, Benjamin O

    2013-10-01

    Breast cancer survivors may experience long-term treatment complications, must live with the risk of cancer recurrence, and often experience psychosocial complications that require supportive care services. In low- and middle-income settings, supportive care services are frequently limited, and program development for survivorship care and long-term follow-up has not been well addressed. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert panel identified nine key resources recommended for appropriate survivorship care, and developed resource-stratified recommendations to illustrate how health systems can provide supportive care services for breast cancer survivors after curative treatment, using available resources. Key recommendations include health professional education that focuses on the management of physical and psychosocial long-term treatment complications. Patient education can help survivors transition from a provider-intense cancer treatment program to a post-treatment provider partnership and self-management program, and should include: education on recognizing disease recurrence or metastases; management of treatment-related sequelae, and psychosocial complications; and the importance of maintaining a healthy lifestyle. Increasing community awareness of survivorship issues was also identified as an important part of supportive care programs. Other recommendations include screening and management of psychosocial distress; management of long-term treatment-related complications including lymphedema, fatigue, insomnia, pain, and women's health issues; and monitoring survivors for recurrences or development of second primary malignancies. Where possible, breast cancer survivors should implement healthy lifestyle modifications, including physical activity, and maintain a healthy weight. Health professionals should provide well-documented patient care records that can follow a patient as they transition from active treatment

  2. Financial hardship associated with colorectal cancer survivorship: the role of asset depletion and debt accumulation.

    Science.gov (United States)

    Hanly, Paul; Maguire, Rebecca; Ceilleachair, Alan O; Sharp, Linda

    2018-05-31

    To estimate the prevalence of financial objective stress and subjective strain among colorectal cancer survivors and assess associated financial coping factors in Ireland which has a mixed public-private healthcare system. Colorectal cancer survivors were identified from the National Cancer Registry and a sample of 496 respondents were included in the analysis. A postal survey collected information on survivor demographics, socio-economic background, medical characteristics, cancer-related financial hardship, debt accumulation and asset depletion. Cancer-related financial objective stress and subjective strain were employed as dependent variables in logistic regression analysis. Approximately two in five survivors experienced objective stress (40.9%) or subjective strain (39.4%). Depletion of savings (49.1%) was the most prevalent form of financial coping strategy. Factors significantly associated with increased objective stress were having a stoma (OR=2.1, 95% CI 1.1-3.9), using savings (OR=9.4, 95% CI 4.9-18.0), formally borrowing money (OR=3.1, 95% CI 1.0-9.6) and loans from family members/friends (OR=3.8, 95% CI 1.9-7.8). Not working (excluding retirees) (OR=0.44, 95% CI 0.20-0.96) was associated with decreased objective stress. Significant predictors of subjective strain included having dependents, a stoma, using savings (OR=5.3 95% CI 2.9-9.5) and loans from family members/friends (OR=2.0, 95% CI 1.1-3.9), but excluded borrowing money. Cancer-related financial objective stress and subjective strain are common in colorectal cancer survivors, even where all citizens are entitled to publicly-funded care, but the financial coping strategies significantly associated with these two measures differed. These findings will help inform targeted measures across disparate health care systems, and survivor groups, to alleviate financial hardship. This article is protected by copyright. All rights reserved.

  3. Do Active Duty Cancer Survivors with a Concurrent Behavioral Health Diagnosis Have Distinct Survivorship Care Needs

    Science.gov (United States)

    2014-09-23

    Compas BE. 2003. Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. J Int Neuropsychol Soc...Disorders 29 14 Personality Disorders 1 1 Schizophrenia & Psychotic Disorders 0 1 Alcohol Use Disorders 0 0 Substance-Related Disorders 3 0

  4. Treatment-related cardiovascular late effects and exercise training countermeasures in testicular germ cell cancer survivorship

    DEFF Research Database (Denmark)

    Christensen, Jesper F; Bandak, Mikkel; Campbell, Anna

    2015-01-01

    BACKGROUND: Treatment of testicular germ cell cancer constitutes a major success story in modern oncology. Today, the vast majority of patients are cured by a therapeutic strategy using one or more highly effective components including surgery (orchiectomy), radiotherapy and/or chemotherapy...

  5. Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care.

    Science.gov (United States)

    Berkowitz, Callie; Allen, Deborah H; Tenhover, Jennifer; Zullig, Leah L; Ragsdale, John; Fischer, Jonathan E; Pollak, Kathryn I; Koontz, Bridget F

    2017-07-14

    Long-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncologist and PCP input targeted for family medicine and internal medicine providers. Responses were collected within a single university health system over 2 months. PCPs (n = 28; RR = 11.3%) were interested in learning about health promotion after cancer treatment (89%) and generally agree that their current practice patterns address healthy lifestyle behaviors (82%). However, only 32% of PCPs felt confident they could manage late/long-term side effects of chemotherapy, radiation, or surgery. Only 29% felt confident they could provide appropriate cancer screening. Looking at shared care responsibilities with oncology providers, PCPs perceived being responsible for 30% of care in the first year after treatment and 81% of care after 5 years. Seventy-one percent of PCPs agreed that oncologists provided them necessary information, yet 32% of PCPs found it difficult to coordinate with cancer providers. While these PCPs perceive increased care responsibility for long-term survivors, most are uncomfortable screening for recurrence and managing late/long-term side effects. Education and mutual coordination between PCPs and oncology providers may improve survivor care.

  6. Cancer Survivorship Care Plan Utilization and Impact on Clinical Decision-Making at Point-of-Care Visits with Primary Care: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

    Science.gov (United States)

    Donohue, SarahMaria; Haine, James E; Li, Zhanhai; Feldstein, David A; Micek, Mark; Trowbridge, Elizabeth R; Kamnetz, Sandra A; Sosman, James M; Wilke, Lee G; Sesto, Mary E; Tevaarwerk, Amye J

    2017-11-02

    Every cancer survivor and his/her primary care provider should receive an individualized survivorship care plan (SCP) following curative treatment. Little is known regarding point-of-care utilization at primary care visits. We assessed SCP utilization in the clinical context of primary care visits. Primary care physicians and advanced practice providers (APPs) who had seen survivors following provision of an SCP were identified. Eligible primary care physicians and APPs were sent an online survey, evaluating SCP utilization and influence on decision-making at the point-of-care, accompanied by copies of the survivor's SCP and the clinic note. Eighty-eight primary care physicians and APPs were surveyed November 2016, with 40 (45%) responding. Most respondents (60%) reported discussing cancer or related issues during the visit. Information needed included treatment (66%) and follow-up visits, and the cancer team was responsible for (58%) vs primary care (58%). Respondents acquired this information by asking the patient (79%), checking oncology notes (75%), the SCP (17%), or online resources (8%). Barriers to SCP use included being unaware of the SCP (73%), difficulty locating it (30%), and finding needed information faster via another mechanism (15%). Despite largely not using the SCP for the visit (90%), most respondents (61%) believed one would be quite or very helpful for future visits. Most primary care visits included discussion of cancer or cancer-related issues. SCPs may provide the information necessary to deliver optimal survivor care but efforts are needed to reduce barriers and design SCPs for primary care use.

  7. Advancing Cancer Survivorship in a Country with 1.35 Billion People: The China Lymphoma Project.

    Science.gov (United States)

    Coughlin, Steven; Reno, Jamie

    Rates of lymphoma are rising rapidly and lymphoma is now the ninth most common cancer among Chinese males. The China Lymphoma Project was founded to increase awareness of lymphoma in China, including the survivability of the disease and the availability of potentially life-saving treatments, and to provide social support for men, women, and children in China who are living with the disease. The project is working with China government officials, several of the top cancer hospitals in China and the U.S., internationally known oncologists and cancer researchers, pharmaceutical and biotech companies in China and the U.S., healthcare and environmental companies, the Confucius Institute at San Diego State University, and the Asian Heritage Society. Advances in e-Health are being utilized to provide patient education and social support. The project will provide free e-books that profile lymphoma survivors (e.g., Kai-Fu Lee, creator of Google China), new videos, websites, pamphlets, blogs, video logs (vlogs), peer-to-peer counseling and support, and information about the latest treatments and oncology clinical trials.

  8. Religiousness, Spirituality, and Salivary Cortisol in Breast Cancer Survivorship: A Pilot Study.

    Science.gov (United States)

    Hulett, Jennifer M; Armer, Jane M; Leary, Emily; Stewart, Bob R; McDaniel, Roxanne; Smith, Kandis; Millspaugh, Rami; Millspaugh, Joshua

    Psychoneuroimmunological theory suggests a physiological relationship exists between stress, psychosocial-behavioral factors, and neuroendocrine-immune outcomes; however, evidence has been limited. The primary aim of this pilot study was to determine feasibility and acceptability of a salivary cortisol self-collection protocol with a mail-back option for breast cancer survivors. A secondary aim was to examine relationships between religiousness/spirituality (R/S), perceptions of health, and diurnal salivary cortisol (DSC) as a proxy measure for neuroendocrine activity. This was an observational, cross-sectional study. Participants completed measures of R/S, perceptions of health, demographics, and DSC. The sample was composed of female breast cancer survivors (n = 41). Self-collection of DSC using a mail-back option was feasible; validity of mailed salivary cortisol biospecimens was established. Positive spiritual beliefs were the only R/S variable associated with the peak cortisol awakening response (rs = 0.34, P = .03). Poorer physical health was inversely associated with positive spiritual experiences and private religious practices. Poorer mental health was inversely associated with spiritual coping and negative spiritual experiences. Feasibility, validity, and acceptability of self-collected SDC biospecimens with an optional mail-back protocol (at moderate temperatures) were demonstrated. Positive spiritual beliefs were associated with neuroendocrine-mediated peak cortisol awakening response activity; however, additional research is recommended. Objective measures of DSC sampling that include enough collection time points to assess DSC parameters would increase the rigor of future DSC measurement. Breast cancer survivors may benefit from nursing care that includes spiritual assessment and therapeutic conversations that support positive spiritual beliefs.

  9. Individuel survivorship program for ovarian cancer patients based on PROM and shared decision making - PROMova

    DEFF Research Database (Denmark)

    Kargo, Anette Stolberg; Coulter, Angela; Hjøllund, Niels Henrik Ingvar

    follow-up as a means of incorporating patients’ knowledge, needs and preferences to create an individualized follow up program. Materials and methods: Women diagnosed with ovarian cancer who have completed first line treatment and entered follow up are being recruited to the study, including those...... receiving Bevacizumab treatment, and all oncology departments in Denmark have been invited to participate in PROMova. We aim to recruit 300 patients, all of whom will be followed-up for 3 years whether or not they experience a recurrence. Results: Recruitment is in progress with 13 patients recruited...

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

    Science.gov (United States)

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

    2017-06-01

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

  11. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial

    International Nuclear Information System (INIS)

    Boer, Stephanie M. de; Nout, Remi A.; Jürgenliemk-Schulz, Ina M.; Jobsen, Jan J.; Lutgens, Ludy C.H.W.; Steen-Banasik, Elzbieta M. van der; Mens, Jan Willem M.; Slot, Annerie; Stenfert Kroese, Marika C.; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W.; Creutzberg, Carien L.

    2015-01-01

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.

  12. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Boer, Stephanie M. de, E-mail: s.m.de_boer.ONCO@lumc.nl [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands); Nout, Remi A. [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands); Jürgenliemk-Schulz, Ina M. [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Jobsen, Jan J. [Department of Radiotherapy, Medisch Spectrum Twente, Enschede (Netherlands); Lutgens, Ludy C.H.W. [Department of Radiation Oncology (MAASTRO), University Medical Centre Maastricht (Netherlands); Steen-Banasik, Elzbieta M. van der [Arnhem Radiotherapy Institute (ARTI), Arnhem (Netherlands); Mens, Jan Willem M. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Slot, Annerie [Radiotherapy Institute Friesland, Leeuwarden (Netherlands); Stenfert Kroese, Marika C. [Department of Radiation Oncology, Radiotherapy Group Deventer, Deventer (Netherlands); Oerlemans, Simone [Research Department, Netherlands Comprehensive Cancer Organization, Eindhoven (Netherlands); Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg (Netherlands); Putter, Hein [Department of Medical Statistics, Leiden University Medical Center, Leiden (Netherlands); Verhoeven-Adema, Karen W. [Comprehensive Cancer Center The Netherlands-West, Leiden (Netherlands); Nijman, Hans W. [Department of Gynecologic Oncology, University Medical Center Groningen, Groningen (Netherlands); Creutzberg, Carien L. [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands)

    2015-11-15

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.

  13. Melanoma survivorship: research opportunities.

    Science.gov (United States)

    Oliveria, Susan A; Hay, Jennifer L; Geller, Alan C; Heneghan, Maureen K; McCabe, Mary S; Halpern, Allan C

    2007-03-01

    The rising incidence and mortality rates of melanoma, the most fatal form of skin cancer, are among the greatest increases of all preventable cancers over the past decade. However, because of recent advances in early detection, secondary prevention efforts, and treatment, the number of melanoma survivors is increasing. Little research has been conducted on melanoma survivors and important opportunities exist for research in this understudied population. Here, we outline the important research opportunities related to the study of melanoma survivorship and summarize the paucity of literature currently available. A computerized literature search was performed of the MEDLINE database of the National Library of Medicine from 1966-2005. The scope of the search was limited to those studies published in English. The search was conducted using the following MeSH headings: melanoma, neoplasms, skin neoplasms, survival, and survival rate. The reference lists of relevant book chapters and review articles were further reviewed, and printed materials from recent scientific meetings addressing this topic were obtained. Several factors that affect melanoma survivors warrant further study, including: physiologic long-term effects; psychosocial, behavioral, and cognitive factors; demographic characteristics; surveillance practices; recurrences, secondary primaries, and other cancers; family members of survivors; and economic issues, access to health care/life insurance. Understanding recurrence and second primary cancer risk, psychosocial and cognitive characteristics, behaviors, surveillance patterns, economic sequelae, and family issues of melanoma survivors is important from a public health standpoint to promote the health and well-being of this cohort. Melanoma is an understudied cancer, and the incidence and mortality of this disease are increasing. Describing the long term burden of this cancer and identifying factors that contribute to them will facilitate efforts to develop

  14. Nutritional Status of Breast Cancer Survivors 1 Year after Diagnosis: A Preliminary Analysis from the Malaysian Breast Cancer Survivorship Cohort Study.

    Science.gov (United States)

    Majid, Hazreen Abd; Keow, Low Phei; Islam, Tania; Su, Tin Tin; Cantwell, Marie; Taib, Nur Aishah

    2018-04-01

    Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors. Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis. This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary. Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included. Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured. Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables. About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day; interquartile range=7.2 g/day) and calcium (median=458 mg/day; interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups. Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an individualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship

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

    Science.gov (United States)

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

    2013-08-19

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

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

    Science.gov (United States)

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

    2010-01-01

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

  17. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer.

    Science.gov (United States)

    Beyer, J; Albers, P; Altena, R; Aparicio, J; Bokemeyer, C; Busch, J; Cathomas, R; Cavallin-Stahl, E; Clarke, N W; Claßen, J; Cohn-Cedermark, G; Dahl, A A; Daugaard, G; De Giorgi, U; De Santis, M; De Wit, M; De Wit, R; Dieckmann, K P; Fenner, M; Fizazi, K; Flechon, A; Fossa, S D; Germá Lluch, J R; Gietema, J A; Gillessen, S; Giwercman, A; Hartmann, J T; Heidenreich, A; Hentrich, M; Honecker, F; Horwich, A; Huddart, R A; Kliesch, S; Kollmannsberger, C; Krege, S; Laguna, M P; Looijenga, L H J; Lorch, A; Lotz, J P; Mayer, F; Necchi, A; Nicolai, N; Nuver, J; Oechsle, K; Oldenburg, J; Oosterhuis, J W; Powles, T; Rajpert-De Meyts, E; Rick, O; Rosti, G; Salvioni, R; Schrader, M; Schweyer, S; Sedlmayer, F; Sohaib, A; Souchon, R; Tandstad, T; Winter, C; Wittekind, C

    2013-04-01

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.

  18. Writer`s guide for technical procedures

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    A primary objective of operations conducted in the US Department of Energy (DOE) complex is safety. Procedures are a critical element of maintaining a safety envelope to ensure safe facility operation. This DOE Writer`s Guide for Technical Procedures addresses the content, format, and style of technical procedures that prescribe production, operation of equipment and facilities, and maintenance activities. The DOE Writer`s Guide for Management Control Procedures and DOE Writer`s Guide for Emergency and Alarm Response Procedures are being developed to assist writers in developing nontechnical procedures. DOE is providing this guide to assist writers across the DOE complex in producing accurate, complete, and usable procedures that promote safe and efficient operations that comply with DOE orders, including DOE Order 5480.19, Conduct of Operations for DOE Facilities, and 5480.6, Safety of Department of Energy-Owned Nuclear Reactors.

  19. Purpose and Professional Writers.

    Science.gov (United States)

    Blyler, Nancy Roundy

    1989-01-01

    Describes a protocol study of 10 professional writers which examined the meaning and influence of purpose on writers in the workplace. Explores the interactions of various purpose considerations derived from situation, reader, and text. Suggests that professional writers have a range of meanings in mind when they think about purpose. (MM)

  20. Psychological Factors Associated with Head and Neck Cancer Treatment and Survivorship : Evidence and Opportunities for Behavioral Medicine

    Science.gov (United States)

    Howren, M. Bryant; Christensen, Alan J.; Karnell, Lucy Hynds; Funk, Gerry F.

    2013-01-01

    Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately…

  1. Healing stories: narrative characteristics in cancer survivorship narratives and psychological health among hematopoietic stem cell transplant survivors.

    Science.gov (United States)

    Benish-Weisman, Maya; Wu, Lisa M; Weinberger-Litman, Sarah L; Redd, William H; Duhamel, Katherine N; Rini, Christine

    2014-08-01

    Survivors of hematopoietic stem cell transplant (HSCT) have experienced a life threatening and potentially traumatic illness and treatment that make them vulnerable to long lasting negative psychological outcomes, including anxiety and depression. Nevertheless, studies show that overcoming cancer and its treatment can present an opportunity for personal growth and psychological health (reduced symptoms of anxiety and depression and high levels of emotional well-being) through resilience. However, research has not yet clarified what differentiates HSCT survivors who experience psychological growth from those who do not. By analyzing recovery narratives, we examined whether HSCT survivors' interpretation of their experiences helps explain differences in their post-treatment psychological health. Guided by narrative psychology theory, we analyzed the narratives of 23 HSCT survivors writing about their experience of cancer treatment. Psychological health was measured by: (1) emotional well-being subscale part of the Functional Assessment of Cancer Therapy Bone Marrow Transplant (FACT-BMT), (2) depression, and (3) anxiety subscales of the Brief Symptom Inventory. Findings revealed a positive relation between psychological health and a greater number of redemption episodes (going from an emotionally negative life event to an emotionally positive one) as well as fewer negative emotional expressions. SIGNIFICANCE OF THE RESULTS: Theoretical and practical implications of these findings are discussed, showing how narratives can inform interventions to assist cancer survivors with their psychological recovery.

  2. The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors

    Science.gov (United States)

    Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.

    2012-01-01

    Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

  3. The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors.

    Science.gov (United States)

    Wen, Kuang-Yi; Miller, Suzanne M; Stanton, Annette L; Fleisher, Linda; Morra, Marion E; Jorge, Alexandra; Diefenbach, Michael A; Ropka, Mary E; Marcus, Alfred C

    2012-08-01

    This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors' preparedness for effective communication with their health care providers after active treatment. The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Our study demonstrates survivors' openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. Copyright © 2012. Published by Elsevier Ireland Ltd.

  4. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Feelings and Cancer Adjusting to Cancer Self-Image & Sexuality Day-to-Day Life Support for Caregivers Survivorship ... Coping Feelings & Cancer Adjusting to Cancer Self Image & Sexuality Day to Day Life Survivorship Support for Caregivers ...

  5. National Coalition for Cancer Survivorship

    Science.gov (United States)

    ... Coyne and Meg Gaines Read the NCCS 2016 Annual Report Share Your Affordable Care Act Story NCCS 30th Anniversary NCCS Policy Comments - Read our Comments to Gov't Bodies AmazonSmile - Support NCCS When You Shop Amazon Be your own advocate. - Learn More NCCS Joins ...

  6. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship : Results from the randomized PORTEC-2 trial

    NARCIS (Netherlands)

    De Boer, Stephanie M.; Nout, Remi A.; Jurgenliemk-Schulz, Ina M.; Jobsen, Jan J; Lutgens, Ludy C.H.W.; Van Der Steen-Banasik, Elzbieta M.; Mens, Jan Willem M.; Slot, Annerie; Stenfert Kroese, Marika C.; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W; Creutzberg, Carien L.

    2015-01-01

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC)

  7. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship : Results from the randomized PORTEC-2 trial

    NARCIS (Netherlands)

    de Boer, Stephanie M.; Nout, Remi A.; Jurgenliemk-Schulz, Ina M.; Jobsen, Jan J.; Lutgens, Ludy C. H. W.; van der Steen-Banasik, Elzbieta M.; Mens, Jan Willem M.; Slot, Annerie; Kroese, Marika C. Stenfert; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W.; Creutzberg, Carien L.

    2015-01-01

    Purpose To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC)

  8. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship : Results From the Randomized PORTEC-2 Trial

    NARCIS (Netherlands)

    de Boer, Stephanie M.; Nout, Remi A.; Jurgenliemk-Schulz, Ina M.; Jobsen, Jan J.; Lutgens, Ludy C. H. W.; van der Steen-Banasik, Elzbieta M.; Mens, Jan Willem M.; Slot, Annerie; Kroese, Marika C. Stenfert; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W.; Creutzberg, Carien L.

    2015-01-01

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC)

  9. RX for Writer's Block.

    Science.gov (United States)

    Tompkins, Gail E.; Camp, Donna J.

    1988-01-01

    Describes four prewriting techniques that elementary and middle grade students can use to gather and organize ideas for writing, and by so doing, cure writer's block. Techniques discussed are: (1) brainstorming; (2) clustering; (3) freewriting; and (4) cubing.

  10. Survey of Policies and Guidelines on Antioxidant Use for Cancer Prevention, Treatment, and Survivorship in North American Cancer Centers: What Do Institutions Perceive as Evidence?

    Science.gov (United States)

    Hong, Gyeongyeon; White, Jennifer; Zhong, Lihong; Carlson, Linda E

    2015-07-01

    Health care policies and guidelines that are clear and consistent with research evidence are important for maximizing clinical outcomes. To determine whether cancer centers in Canada and the United States had policies and/or guidelines about antioxidant use, and whether policies were aligned with the evidence base, we reviewed current research evidence in the field, and we undertook a survey of the policies and guidelines on antioxidant use at cancer institutions across North America. A survey of policies and guidelines on antioxidant use and the development and communication of the policies and guidelines was conducted by contacting cancer institutions in North America. We also conducted a Website search for each institution to explore any online resources. Policies and guidelines on antioxidant use were collected from 78 cancer institutions. Few cancer institutions had policies (5%) but most provided guidelines (69%). Antioxidants from diet were generally encouraged at cancer institutions, consistent with the current research evidence. In contrast, specific antioxidant supplements were generally not recommended at cancer institutions. Policies and guidelines were developed using evidence-based methods (53%), by consulting another source (35%), or through discussions/conference (26%), and communicated mainly through online resources (65%) or written handouts (42%). For cancer institutions that had no policy or guideline on antioxidants, lack of information and lack of time were the most frequently cited reasons. Policies and guidelines on antioxidants from diet were largely consistent with the research evidence. Policies and guidelines on antioxidant supplements during treatment were generally more restrictive than the research evidence might suggest, perhaps due to the specificity of results and the inability to generalize findings across antioxidants, adding to the complexity of their optimal and safe use. Improved communication of comprehensive research

  11. The state of survivorship care in radiation oncology: Results from a nationally distributed survey.

    Science.gov (United States)

    Frick, Melissa A; Rosenthal, Seth A; Vapiwala, Neha; Monzon, Brian T; Berman, Abigail T

    2018-04-18

    Survivorship care has become an increasingly critical component of oncologic care as well as a quality practice and reimbursement metric. To the authors' knowledge, the current climate of survivorship medicine in radiation oncology has not been investigated fully. An institutional review board-approved, Internet-based survey examining practices and preparedness in survivorship care was distributed to radiation oncology practices participating in the American College of Radiology Radiation Oncology Practice Accreditation program between November 2016 and January 2017. A total of 78 surveys were completed. Among these, 2 were nonphysicians, resulting in 76 evaluable responses. Radiation oncologists (ROs) frequently reported that they are the primary provider in the evaluation of late toxicities and the recurrence of primary cancer. Although approximately 68% of ROs frequently discuss plans for future care with survivors, few provide a written survivorship care plan to their patients (18%) or the patients' primary care providers (24%). Patient prognosis, disease site, and reimbursement factors often influence the provision of survivorship care. Although ROs report that several platforms offer training in survivorship medicine, the quality of these resources is variable and extensive instruction is rare. Fewer than one-half of ROs believe they are expertly trained in survivorship care. ROs play an active role within the multidisciplinary team in the cancer-related follow-up care of survivors. Investigation of barriers to the provision of survivorship care and optimization of service delivery should be pursued further. The development of high-quality, easily accessible educational programming is needed so that ROs can participate more effectively in the care of cancer survivors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  12. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... to Cancer Self-Image & Sexuality Day-to-Day Life Support for Caregivers Survivorship Questions to Ask About ... to Cancer Self Image & Sexuality Day to Day Life Survivorship Support for Caregivers Questions to Ask About ...

  13. ModelWriter

    NARCIS (Netherlands)

    Erata, Ferhat; Gardent, Claire; Gyawali, Bikash; Shimorina, Anastasia; Lussaud, Yvan; Tekinerdogan, Bedir; Kardas, Geylani; Monceaux, Anne

    2017-01-01

    The ModelWriter platform provides a generic framework for automated traceability analysis. In this paper, we demonstrate how this framework can be used to trace the consistency and completeness of technical documents that consist of a set of System Installation Design Principles used by Airbus to

  14. Towards explainable writer verification and identification using vantage writers

    NARCIS (Netherlands)

    Brink, Axel; Schomaker, Lambert; Bulacu, Marius; Werner, B

    2007-01-01

    In this paper a new method for off-line writer verification and identification is proposed which encodes writer features as a mix of typical handwriting styles, written by so-called vantage writers. Since their handwriting can be shown to the user the method provides a degree of transparency that is

  15. After Childhood Cancer: a Qualitative Study of Family Physician, Parent/Guardian, and Survivor Information Needs and Perspectives on Long-Term Follow-up and Survivorship Care Plans.

    Science.gov (United States)

    Keats, Melanie R; Shea, Kelsey; Parker, Louise; Stewart, Samuel A; Flanders, Annette; Bernstein, Mark

    2018-03-19

    Despite support for the provision of a survivorship care plan (SCP) to every cancer survivor, there is a lack of understanding of the needs and preferences of key stakeholders. We examined perspectives of a novel personalized SCP for childhood cancer survivors (CCS), their family, and family physicians (FP). We conducted semi-structured telephone interviews with a purposefully selected sample of CCS, parents/guardians, and FPs. Data included responses to stakeholder cancer care information needs, concerns with or gaps in communication, the perceived role of the FP in the long-term management of CCS care, utility of the SCP, preferred format, and suggestions for improvement. A deductive content analysis was conducted. Twenty-four participants including 8 CCS, 10 parents/guardians, and 6 FPs completed an interview. Four main and several sub-categories emerged. Core categories were coded as (1) informative reference, (2) coordination of follow-up, (3) barriers to follow-up care, and (4) suggestions for improvement and future implementation. The majority of participants preferred an electronic- or web-based format. Overall, the SCP was seen as an informative and concise resource. The SCP was thought to be a valuable tool to foster communication and empower CCSs to become more fully engaged in their own cancer-related health care. FPs viewed the SCP as a useful resource to facilitate and guide the long-term management of the CCS. In addition to the treatment summary, a comprehensive follow-up timeline, personalized lifestyle information, and details on how to access additional psychosocial support were highlighted as important components.

  16. Development and utilization of complementary communication channels for treatment decision making and survivorship issues among cancer patients: The CIS Research Consortium Experience

    OpenAIRE

    Linda Fleisher; Kuang Yi Wen; Suzanne M. Miller; Michael Diefenbach; Annette L. Stanton; Mary Ropka; Marion Morra; Peter C. Raich

    2015-01-01

    Objective: Cancer patients and survivors are assuming active roles in decision-making and digital patient support tools are widely used to facilitate patient engagement. As part of Cancer Information Service Research Consortium's randomized controlled trials focused on the efficacy of eHealth interventions to promote informed treatment decision-making for newly diagnosed prostate and breast cancer patients, and post-treatment breast cancer, we conducted a rigorous process evaluation to examin...

  17. Scientists as writers

    Science.gov (United States)

    Yore, Larry D.; Hand, Brian M.; Prain, Vaughan

    2002-09-01

    This study attempted to establish an image of a science writer based on a synthesis of writing theory, models, and research literature on academic writing in science and other disciplines and to contrast this image with an actual prototypical image of scientists as writers of science. The synthesis was used to develop a questionnaire to assess scientists' writing habits, beliefs, strategies, and perceptions about print-based language. The questionnaire was administered to 17 scientists from science and applied science departments of a large Midwestern land grant university. Each respondent was interviewed following the completion of the questionnaire with a custom-designed semistructured protocol to elaborate, probe, and extend their written responses. These data were analyzed in a stepwise fashion using the questionnaire responses to establish tentative assertions about the three major foci (type of writing done, criteria of good science writing, writing strategies used) and the interview responses to verify these assertions. Two illustrative cases (a very experienced, male physical scientist and a less experienced, female applied biological scientist) were used to highlight diversity in the sample. Generally, these 17 scientists are driven by the academy's priority of publishing their research results in refereed, peer-reviewed journals. They write their research reports in isolation or as a member of a large research team, target their writing to a few journals that they also read regularly, use writing in their teaching and scholarship to inform and persuade science students and other scientists, but do little border crossing into other discourse communities. The prototypical science writer found in this study did not match the image based on a synthesis of the writing literature in that these scientists perceived writing as knowledge telling not knowledge building, their metacognition of written discourse was tacit, and they used a narrow array of genre

  18. Improving anxiety regulation in patients with breast cancer at the beginning of the survivorship period: a randomized clinical trial comparing the benefits of single-component and multiple-component group interventions.

    Science.gov (United States)

    Merckaert, Isabelle; Lewis, Florence; Delevallez, France; Herman, Sophie; Caillier, Marie; Delvaux, Nicole; Libert, Yves; Liénard, Aurore; Nogaret, Jean-Marie; Ogez, David; Scalliet, Pierre; Slachmuylder, Jean-Louis; Van Houtte, Paul; Razavi, Darius

    2017-08-01

    To compare in a multicenter randomized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention (SGI) based on support with those of a 15-session multiple-component structured manualized group intervention (MGI) combining support with cognitive-behavioral and hypnosis components. Patients with nonmetastatic breast cancer were randomly assigned at the beginning of the survivorship period to the SGI (n = 83) or MGI (n = 87). Anxiety regulation was assessed, before and after group interventions, through an anxiety regulation task designed to assess their ability to regulate anxiety psychologically (anxiety levels) and physiologically (heart rates). Questionnaires were used to assess psychological distress, everyday anxiety regulation, and fear of recurrence. Group allocation was computer generated and concealed till baseline completion. Compared with patients in the SGI group (n = 77), patients attending the MGI group (n = 82) showed significantly reduced anxiety after a self-relaxation exercise (P = .006) and after exposure to anxiety triggers (P = .013) and reduced heart rates at different time points throughout the task (P = .001 to P = .047). The MGI participants also reported better everyday anxiety regulation (P = .005), greater use of fear of recurrence-related coping strategies (P = .022), and greater reduction in fear of recurrence-related psychological distress (P = .017) compared with the SGI group. This study shows that an MGI combining support with cognitive-behavioral techniques and hypnosis is more effective than an SGI based only on support in improving anxiety regulation in patients with breast cancer. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Manual braille writer

    Science.gov (United States)

    Hawk, Lawrence S.; Turner, Joe H.

    1992-01-01

    A manual-type braille writer that provides for both writing and reading in a normal left-to-right manner. In the preferred form, this braille writer has a clip board type base, and in the preferred embodiment a guide plate assembly can be moved to, and releasable fixed at, selected vertical locations along this base. The guide plate assembly is provided with a plurality of character cells uniformly spaced along rows across the guide plate assembly as well as in uniformly spaced rows. This guide plate assembly has a lower portion to be placed under a sheet of paper positioned on the clip board base and an upper portion to be positioned on top of the sheet. This upper portion is hinged with respect to the lower portion. Each character cell is typically made up of six appropriately spaced pins extending up from the lower portion that are aligned with a rosette-shaped cutout in the upper portion. A stylus member is provided that has a distal end to be fitted into the cutout of the character cell so that a recess in the end thereof presses the writing paper over the pin associated with that recess to produce a braille dot at that location. When desired, the upper portion can be lifted up so that the text already written can be read or to determine the place for initiating writing when writing has been interrupted.

  20. Manual braille writer

    Science.gov (United States)

    Hawk, L.S.; Turner, J.H.

    1992-07-28

    A manual-type braille writer is described that provides for both writing and reading in a normal left-to-right manner. In the preferred form, this braille writer has a clip board type base, and in the preferred embodiment a guide plate assembly can be moved to, and releasable fixed at, selected vertical locations along this base. The guide plate assembly is provided with a plurality of character cells uniformly spaced along rows across the guide plate assembly as well as in uniformly spaced rows. This guide plate assembly has a lower portion to be placed under a sheet of paper positioned on the clip board base and an upper portion to be positioned on top of the sheet. This upper portion is hinged with respect to the lower portion. Each character cell is typically made up of six appropriately spaced pins extending up from the lower portion that are aligned with a rosette-shaped cutout in the upper portion. A stylus member is provided that has a distal end to be fitted into the cutout of the character cell so that a recess in the end thereof presses the writing paper over the pin associated with that recess to produce a braille dot at that location. When desired, the upper portion can be lifted up so that the text already written can be read or to determine the place for initiating writing when writing has been interrupted. 10 figs.

  1. Development and utilization of complementary communication channels for treatment decision making and survivorship issues among cancer patients: The CIS Research Consortium Experience.

    Science.gov (United States)

    Fleisher, Linda; Wen, Kuang Yi; Miller, Suzanne M; Diefenbach, Michael; Stanton, Annette L; Ropka, Mary; Morra, Marion; Raich, Peter C

    2015-11-01

    Cancer patients and survivors are assuming active roles in decision-making and digital patient support tools are widely used to facilitate patient engagement. As part of Cancer Information Service Research Consortium's randomized controlled trials focused on the efficacy of eHealth interventions to promote informed treatment decision-making for newly diagnosed prostate and breast cancer patients, and post-treatment breast cancer, we conducted a rigorous process evaluation to examine the actual use of and perceived benefits of two complementary communication channels -- print and eHealth interventions. The three Virtual Cancer Information Service (V-CIS) interventions were developed through a rigorous developmental process, guided by self-regulatory theory, informed decision-making frameworks, and health communications best practices. Control arm participants received NCI print materials; experimental arm participants received the additional V-CIS patient support tool. Actual usage data from the web-based V-CIS was also obtained and reported. Print materials were highly used by all groups. About 60% of the experimental group reported using the V-CIS. Those who did use the V-CIS rated it highly on improvements in knowledge, patient-provider communication and decision-making. The findings show that how patients actually use eHealth interventions either singularly or within the context of other communication channels is complex. Integrating rigorous best practices and theoretical foundations is essential and multiple communication approaches should be considered to support patient preferences.

  2. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer

    NARCIS (Netherlands)

    Beyer, J.; Albers, P.; Altena, R.; Aparicio, J.; Bokemeyer, C.; Busch, J.; Cathomas, R.; Cavallin-Stahl, E.; Clarke, N. W.; Claßen, J.; Cohn-Cedermark, G.; Dahl, A. A.; Daugaard, G.; de Giorgi, U.; de Santis, M.; de Wit, M.; de Wit, R.; Dieckmann, K. P.; Fenner, M.; Fizazi, K.; Flechon, A.; Fossa, S. D.; Germá Lluch, J. R.; Gietema, J. A.; Gillessen, S.; Giwercman, A.; Hartmann, J. T.; Heidenreich, A.; Hentrich, M.; Honecker, F.; Horwich, A.; Huddart, R. A.; Kliesch, S.; Kollmannsberger, C.; Krege, S.; Laguna, M. P.; Looijenga, L. H. J.; Lorch, A.; Lotz, J. P.; Mayer, F.; Necchi, A.; Nicolai, N.; Nuver, J.; Oechsle, K.; Oldenburg, J.; Oosterhuis, J. W.; Powles, T.; Rajpert-de Meyts, E.; Rick, O.; Rosti, G.; Salvioni, R.; Schrader, M.; Schweyer, S.; Sedlmayer, F.; Sohaib, A.; Souchon, R.; Tandstad, T.; Winter, C.; Wittekind, C.

    2013-01-01

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European

  3. Maintaining success, reducing treatment burden, focusing on survivorship : highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer

    NARCIS (Netherlands)

    Beyer, J.; Albers, P.; Altena, R.; Aparicio, J.; Bokemeyer, C.; Busch, J.; Cathomas, R.; Cavallin-Stahl, E.; Clarke, N. W.; Classen, J.; Cohn-Cedermark, G.; Dahl, A. A.; Daugaard, G.; De Giorgi, U.; De Santis, M.; De Wit, M.; De Wit, R.; Dieckmann, K. P.; Fenner, M.; Fizazi, K.; Flechon, A.; Fossa, S. D.; Germa Lluch, J. R.; Gietema, J. A.; Gillessen, S.; Giwercman, A.; Hartmann, J.T.; Heidenreich, A.; Hentrich, M.; Honecker, F.; Horwich, A.; Huddart, R. A.; Kliesch, S.; Kollmannsberger, C.; Krege, S.; Laguna, M. P.; Looijenga, L. H. J.; Lorch, A.; Lotz, J. P.; Mayer, F.; Necchi, A.; Nicolai, N.; Nuver, J.; Oechsle, K.; Oldenburg, J.; Oosterhuis, J.W.; Powles, T.; Rajpert-De Meyts, E.; Rick, O.; Rosti, G.; Salvioni, R.; Schrader, M.; Schweyer, S.; Sedlmayer, F.; Sohaib, A.; Souchon, R.; Tandstad, T.; Wittekind, C.; Winter, E.

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European

  4. Supervivencia al cáncer de mama: Una historia personal (Breast Cancer Survivorship—A Personal Story)

    Centers for Disease Control (CDC) Podcasts

    2016-10-18

    Pam Bryant, una sobreviviente de cáncer de mama, habla sobre su viaje personal y cómo impactó su vida el recibir un diagnóstico de cáncer de mama antes de los 45 años. .  Created: 10/18/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 10/18/2016.

  5. Penelope Delta, recently discovered writer

    OpenAIRE

    MALAPANI A.

    2015-01-01

    The aim of this article is to present a Greek writer, Penelope Delta. This writer has recently come up in the field of the studies of the Greek literature and, although thereare neither many translations of her works in foreign languages nor many theses or dissertations, she was chosen for the great interest for her works. Her books have been read by many generations, so she is considered a classical writer of Modern Greek Literature. The way she uses the Greek language, the unique characters...

  6. Cancer during Pregnancy

    Science.gov (United States)

    ... Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog About Us You are here Home > Navigating Cancer Care > Dating, Sex, and Reproduction > Cancer During Pregnancy Request Permissions Cancer ...

  7. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Cancer Feelings and Cancer Adjusting to Cancer Self-Image & Sexuality Day-to-Day Life Support for Caregivers ... Medicine Coping Feelings & Cancer Adjusting to Cancer Self Image & Sexuality Day to Day Life Survivorship Support for ...

  8. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... with Cancer Feelings and Cancer Adjusting to Cancer Self-Image & Sexuality Day-to-Day Life Support for ... Alternative Medicine Coping Feelings & Cancer Adjusting to Cancer Self Image & Sexuality Day to Day Life Survivorship Support ...

  9. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Image & Sexuality Day-to-Day Life Support for Caregivers Survivorship Questions to Ask About Cancer Research Advanced ... Cancer Planning for Advanced Cancer Advanced Cancer and Caregivers Questions to Ask about Advanced Cancer Research Managing ...

  10. Paper-Based Survivorship Care Plans May be Less Helpful for Cancer Patients Who Search for Disease-Related Information on the Internet: Results of the Registrationsystem Oncological Gynecology (ROGY) Care Randomized Trial.

    Science.gov (United States)

    Nicolaije, Kim Ah; Ezendam, Nicole Pm; Pijnenborg, Johanna Ma; Boll, Dorry; Vos, Maria Caroline; Kruitwagen, Roy Fpm; van de Poll-Franse, Lonneke V

    2016-07-08

    The Institute of Medicine recommends Survivorship Care Plans (SCPs) for all cancer survivors. However, it is unclear whether certain patient groups may or may not benefit from SCPs. The aim was to assess whether the effects of an automatically generated paper SCP on patients' satisfaction with information provision and care, illness perceptions, and health care utilization were moderated by disease-related Internet use. Twelve hospitals were randomized to either SCP care or usual care in the pragmatic cluster randomized Registrationsystem Oncological GYnecology (ROGY) Care trial. Newly diagnosed endometrial cancer patients completed questionnaires after diagnosis (N=221; response: 74.7%, 221/296), 6 months (n=158), and 12 months (n=147), including patients' satisfaction with information provision and care, illness perceptions, health care utilization (how many times patients visited a medical specialist or primary care physician about their cancer in the past 6 months), and disease-related Internet use (whether patients used the Internet to look for information about cancer). In total, 80 of 221 (36.2%) patients used the Internet to obtain disease-related information. Disease-related Internet use moderated the SCP care effect on the amount of information received about the disease (P=.03) and medical tests (P=.01), helpfulness of the information (P=.01), and how well patients understood their illness (P=.04). All stratified analyses were not statistically significant. However, it appeared that patients who did not seek disease-related information on the Internet in the SCP care arm reported receiving more information about their disease (mean 63.9, SD 20.1 vs mean 58.3, SD 23.7) and medical tests (mean 70.6, SD 23.5 vs mean 64.7, SD 24.9), finding the information more helpful (76.7, SD 22.9 vs mean 67.8, SD 27.2; scale 0-100), and understanding their illness better (mean 6.6, SD 3.0 vs mean 6.1, SD 3.2; scale 1-10) than patients in the usual care arm did. In

  11. Reading and esl writers Reading and esl writers

    Directory of Open Access Journals (Sweden)

    John R. Edlund

    2008-04-01

    Full Text Available Whether the student population consists of basic writers, non-native speakers, or well-prepared freshmen and whether the primary goal of the class is improvement in writing ability, language and vocabulary acquisition, or critical thinking skills, there is considerable evidence that substantial amounts of reading arc an essential component of the course (See Krashen Writing: Research, Theory and Applications for a summary. This is especially true in the ESL composition class, where language acquisition is still a major factor in the student's success as a writer. Whether the student population consists of basic writers, non-native speakers, or well-prepared freshmen and whether the primary goal of the class is improvement in writing ability, language and vocabulary acquisition, or critical thinking skills, there is considerable evidence that substantial amounts of reading arc an essential component of the course (See Krashen Writing: Research, Theory and Applications for a summary. This is especially true in the ESL composition class, where language acquisition is still a major factor in the student's success as a writer.

  12. Basic Cancer Terms

    Science.gov (United States)

    ... Considerations How Cancer is Treated Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  13. Cancer Terms: After Treatment

    Science.gov (United States)

    ... Considerations How Cancer is Treated Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  14. The freelance nurse writer role.

    Science.gov (United States)

    Sayers, B

    1999-01-01

    Freelance nurse writers are skilled in facilitating a dialogue and writing from the perspective of the group. This article, written by an experienced freelance author, describes efficient methods to incorporate information gleaned from group interviews. The author provides tips on what type of projects to look for, how to develop the role, and even how to charge.

  15. Black Writers' Views of America.

    Science.gov (United States)

    Hairston, Loyle

    1979-01-01

    This article argues that the stagnation, pessimism, and self-pity evident in recent Black writing results in part from the alienation of Black writers from the mainstream of Black life, and in part from the illusions that they share with other Blacks who have embraced the American value system. (Author/EB)

  16. Eyelid Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  17. Anal Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  18. Thyroid Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  19. Appendix Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  20. Issues of Selection in Human Survivorship

    DEFF Research Database (Denmark)

    Hansen, Hans Oluf

    , and Iceland during the past 250 years and in Japan any ten years between 1950 and 1990 is approached appropriately by the model. Reduced natural selection may account for a substantial part of the empirical mortality change in the course of the demographic transition. Survivorship in the late nineteenth......Is variation in empirical mortality across populations consistent with a hypothesis of selec-tion? To examine this proposition an extended frailty mortality model is put forward; incor-porating biological frailty; a common non-parametric hazard, joint for men and women, rep-resenting endogenous...... and the twentieth century ties selection to major medical advances and rapid recent mortality decline, probably with consequences for future health and survivorship....

  1. Survivorship and discourses of identity.

    Science.gov (United States)

    Little, Miles; Paul, Kim; Jordens, Christopher F C; Sayers, Emma-Jane

    2002-01-01

    Personal identity is self-evidently important to us all. Identity is a philosophically complex subject, but there is some agreement that memory, embodiment and continuity are essential components. The sense of memory includes 'future memory', the kind of memory we would like to construct for ourselves as our lives proceed. While the sense of personal identity is internal to the individual, a sense of that person's identity exists in the minds of others. Extreme experiences threaten the element of continuity, because they may bring bodily changes as well as cognitive changes that challenge central values. Restoring or preserving continuity is a major task for survivors. The ways in which people experience discontinuity because of cancer illness, and the ways in which they manage this experience emerges from the narratives of the survivors of cancer and in the narratives of health care workers who look after them. People manage discontinuity by reference to stable 'anchor points' in their beliefs and values; by re-constructing versions of their pre-experience identities, drawing on past memory and finding ways to preserve a continuity between past memory, present experience and constructions of the future; by using the experience to develop established facets of identity; and by imbuing the experience with meaning and recognising the enlarged identity made possible by survival. Those who cannot achieve a sense of continuity may feel alienated from themselves, their friends and family. All these methods of management may be used by one person to negotiate the post-experience identity in its different social interactions. The experience of the survivor can be further understood by recognising the challenge posed by extreme experience to the sense of continuity of both embodied self and memory. A satisfactory discourse of survival has yet to enter the public domain. This lack adds to the burdens of survivors, including those who have survived cancer. Copyright 2002 John

  2. The Voice of the Technical Writer.

    Science.gov (United States)

    Euler, James S.

    The author's voice is implicit in all writing, even technical writing. It is the expression of the writer's attitude toward audience, subject matter, and self. Effective use of voice is made possible by recognizing the three roles of the technical writer: transmitter, translator, and author. As a transmitter, the writer must consciously apply an…

  3. MFA Writers' Relationships with Writing

    Science.gov (United States)

    Olthouse, Jill M.

    2013-01-01

    Through a qualitative research design, I explored how eight talented masters in fine arts (MFA) writers related to their craft. The phenomenon "relationship with writing" includes writers' goals, values, identity, and emotions as these relate to writing. I found that that these MFA writers experience compatibilities and conflicts…

  4. Medical writers i medicinsk forskning

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pommergaard, Hans-Christian; Danielsen, Anne Kjærgaard

    2013-01-01

    Larger research units often comprise persons of several professions in order to secure a high level of efficiency and quality in the different tasks. In Denmark, employees with special competencies within the field of writing and publication are rarely used in research units. The purpose of this ...... of this study was to present the advantages and challenges associated with the involvement of medical writers in academic environments....

  5. Medical writers i medicinsk forskning

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pommergaard, H-C; Danielsen, Anne Kjærgaard

    2013-01-01

    Larger research units often comprise persons of several professions in order to secure a high level of efficiency and quality in the different tasks. In Denmark, employees with special competencies within the field of writing and publication are rarely used in research units. The purpose of this ......Larger research units often comprise persons of several professions in order to secure a high level of efficiency and quality in the different tasks. In Denmark, employees with special competencies within the field of writing and publication are rarely used in research units. The purpose...... of this study was to present the advantages and challenges associated with the involvement of medical writers in academic environments....

  6. What Basic Writers Think about Writing.

    Science.gov (United States)

    Eves-Bowden, Anmarie

    2001-01-01

    Explores basic writing students' current writing processes, their thoughts on their writing, and their introduction to a structured writing process model. Suggests that educators can assist basic writers in becoming successful college writers by introducing them to a structured writing process model while also helping them to become reflective…

  7. Reading Educational Philosophies in "Freedom Writers"

    Science.gov (United States)

    Choi, Jung-Ah

    2009-01-01

    The 2007 film "Freedom Writers" portrays the real-life experiences of Erin Gruwell, a teacher at an inner-city high school in Long Beach, California. This article discusses the educational theories underpinning Gruwell's pedagogical practice, as seen in "Freedom Writers", and identifies four themes--rewriting curriculum,…

  8. Nausea and Vomiting Caused by Cancer Treatment

    Science.gov (United States)

    ... Considerations How Cancer is Treated Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  9. Lymphedema as a Cancer Treatment Side Effect

    Science.gov (United States)

    ... Considerations How Cancer is Treated Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  10. Salivary Gland Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  11. Gallbladder Cancer Overview

    Science.gov (United States)

    ... Content Español ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  12. Vulvar Cancer Overview

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  13. Process Synchronization with Readers and Writers Revisited

    OpenAIRE

    Kawash, Jalal

    2005-01-01

    The readers-writers problem is one of the very well known problems in concurrency theory. It was first introduced by Courtois et.al. in 1971 [1] and requires the synchronization of processes trying to read and write a shared resource. Several readers are allowed to access the resource simultaneously, but a writer must be given exclusive access to that resource. Courtois et.al. gave semaphore-based solutions to what they called the first and second readers-writers problems. Both of their solut...

  14. President Signs STAR Act for Kids' Cancers.

    Science.gov (United States)

    2018-06-07

    On June 5, President Donald Trump signed the Childhood Cancer Survivorship, Treatment, Access and Research Act, which aims to support pediatric cancer research by expanding the collection of patient biospecimens and records, improving surveillance, and investigating pediatric survivorship. ©2018 American Association for Cancer Research.

  15. Michelangelo, a Tireless Letter Writer

    Directory of Open Access Journals (Sweden)

    Adelin Charles Fiorato

    2014-04-01

    Full Text Available A titan of artistic creation, the sculptor-painter-architect Michelangelo was also a tireless letter writer. Five hundred and eighteen of his letters have reached us, stretching from his youth to the eve of his death, but we know that many others have been lost. Written in a kind of familiar Florentine and in a style of minimalist ‘realism’ – which does not prevent the presence of either impetuous polemical flights or pages of literary indulgence – these letters deal mainly with everyday subjects: day-by-day relationships, either endearing or resentful, with his relatives, financial or property matters and, above all, the marriage problems which concerned his nephew Leonardo, the sole heir of the family. But one also discovers in them the artist’s warm feelings of friendship and love, his poetic and aesthetic exchanges, his relationships, often conflictual, with his fellow-artists and patrons as well as his reflections on old age and death. All in all, these letters represent a documentary chronicle of a Florentine bourgeois family and the technical hassle of an entrepreneur’s activity. If, on the one hand, the Carteggio does not shed light either on Michelangelo’s conception of art or the way in which he realized his works, on the other it illustrates certain latent aspects of his projects, as well as of his personality, which was at the same time melancholy and aggressive, surprisingly whole and manifold. This luxuriant correspondence presents, so to speak, a ‘genetic’ interest, since it reveals the hidden face of the brilliant conceiver and creator, of the artist and entrepreneur struggling with the obstacles whose overcoming makes creation possible. 

  16. The impact of the survivorship care plan on health care use

    DEFF Research Database (Denmark)

    Jeppesen, Mette Moustgaard; Ezendam, Nicole P M; Pijnenborg, Johanna M A

    2018-01-01

    PURPOSE: The purpose of this paper was to assess the impact of survivorship care plan (SCP) provision and moderating factors on health care use following endometrial cancer treatment. METHODS: Women newly diagnosed with endometrial cancer were included in a pragmatic cluster randomized trial at 12...... of general practitioner, specialist, and additional health care was collected through questionnaires after diagnosis and at 6-, 12-, and 24-month follow-up and compared using linear multilevel regression analyses. RESULTS: Women who received an SCP had more cancer-related primary care visits compared...... to the usual care arm during the first year after diagnosis (β = 0.7, p women in the SCP group used more additional health care compared to women receiving usual care (24 vs. 11%, p = 0.04). Women with anxious symptoms (p = 0.03) and women who received radiotherapy (p = 0.01) had...

  17. Living and Labouring as a Music Writer

    Directory of Open Access Journals (Sweden)

    Lawson Fletcher

    2013-02-01

    Full Text Available Like many other creative endeavours, music writing is a proto-professional practice built on the back of amateur enthusiasm, unpaid labour and informal networks of referrals and recruiting. Drawing on interviews with Australian music critics and journalists at different stages of their careers, this article examines the highly specific configurations of cultural, social and economic capital at work within this field. The authors begin by exploring the diverse career pathways of writers, before considering how writers locate themselves within industrial and creative networks. As amateur intermediaries engaged in the mediation of the cultural productions of others, music writers maintain particular notions of value that do not always align easily with creative labour models premised on artistic fulfilment or economic exploitation.

  18. Survivorship patterns of histopathological variants and molecular ...

    African Journals Online (AJOL)

    Objective: To study the relationship of histopathological characteristics, molecular subtypes of breast cancer and survival in a low resource setting. Design: Tumours from prospectively ascertained patients newly diagnosed with breast cancer were analyzed. Formalin-fixed and paraffin-embedded sections were constructed ...

  19. A practical approach for writer-dependent symbol recognition using a writer-independent symbol recognizer.

    Science.gov (United States)

    LaViola, Joseph J; Zeleznik, Robert C

    2007-11-01

    We present a practical technique for using a writer-independent recognition engine to improve the accuracy and speed while reducing the training requirements of a writer-dependent symbol recognizer. Our writer-dependent recognizer uses a set of binary classifiers based on the AdaBoost learning algorithm, one for each possible pairwise symbol comparison. Each classifier consists of a set of weak learners, one of which is based on a writer-independent handwriting recognizer. During online recognition, we also use the n-best list of the writer-independent recognizer to prune the set of possible symbols and thus reduce the number of required binary classifications. In this paper, we describe the geometric and statistical features used in our recognizer and our all-pairs classification algorithm. We also present the results of experiments that quantify the effect incorporating a writer-independent recognition engine into a writer-dependent recognizer has on accuracy, speed, and user training time.

  20. Writer identification using curvature-free features

    NARCIS (Netherlands)

    He, Sheng; Schomaker, Lambertus

    2017-01-01

    Feature engineering takes a very important role in writer identification which has been widely studied in the literature. Previous works have shown that the joint feature distribution of two properties can improve the performance. The joint feature distribution makes feature relationships explicit

  1. The Basic Writer as Reluctant Oralist.

    Science.gov (United States)

    Villanueva, Victor

    By identifying speculations concerning cognitive abilities and cognition's relation to culture, this paper outlines some of the work surrounding basic writers and speaking-writing relationships. Beginning with a discussion of the differences between speaking and writing popularized by Mina Shaughnessy, the paper goes on to examine studies that…

  2. Music Teacher as Writer and Producer

    Science.gov (United States)

    Randles, Clint

    2012-01-01

    In this article I attempt to redefine the role of a music teacher as being more than a director, the more traditional term ascribed to this position. I do this by using descriptions of the role of "writer" and "producer" of student lives borrowed from music education philosophy, screenwriting, and professional music producers. This vision is…

  3. The Vulnerability of the Fanfiction Writer

    DEFF Research Database (Denmark)

    Jensen, Thessa

    Writing and publishing fanfiction is done freely and without any prospect of monetary or materialistic reward. The acknowledgement by the readers through comments, reviews, and kudos has to suffice instead. In their interactions with the reader the writer relies on the reader's recognition of Løg...

  4. Basic Writers and the Echoes of Intertextuality

    Science.gov (United States)

    Smith, Cheryl Hogue

    2011-01-01

    Intertextuality is a vital component of college reading and writing. In order to write a paper that requires the synthesizing of readings, students must recognize the intertextual connections among all their sources. Instruction that fosters intertextual awareness in basic writers can help them overcome their tendency to compartmentalize what they…

  5. Gompertz' survivorship law as an intrinsic principle of aging

    NARCIS (Netherlands)

    Sas, Arthur A.; Snieder, Harold; Korf, Jakob

    We defend the hypothesis that life-spanning population survivorship curves, as described by Gompertz' law and composed from cross-sectional data (here mortality), reflect an intrinsic aging principle active in each subject of that population. In other words Gompertz' law reflects aging of a

  6. Post-settlement survivorship in two Caribbean broadcasting corals

    Science.gov (United States)

    Miller, Margaret W.

    2014-12-01

    The post-settlement phase of broadcast-spawned coral life histories is poorly known due to its almost complete undetectability and, hence, presumed low abundance in the field. We used lab-cultured settled polyps of two important Caribbean reef-building species with negligible larval recruitment to quantify early post-settlement survivorship (6-9 weeks) over multiple years/cohorts and differing orientation on a reef in the Florida Keys. Orbicella faveolata showed significantly and consistently better survivorship in vertical rather than horizontal orientation, but no discernable growth overall. Meanwhile, Acropora palmata showed no significant difference in survivorship between orientations, but significantly greater growth in the horizontal orientation. Both species showed significant variation in mean survivorship between cohorts of different years; 0-47 % for O. faveolata and 12-49 % for A. palmata over the observed duration. These results demonstrate wide variation in success of cohorts and important differences in the larval recruitment capacities of these two important but imperiled reef-building species.

  7. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... with Cancer Feelings and Cancer Adjusting to Cancer Self-Image & Sexuality Day-to-Day Life Support for Caregivers ... Alternative Medicine Coping Feelings & Cancer Adjusting to Cancer Self Image & Sexuality Day to Day Life Survivorship Support for ...

  8. MITT writer and MITT writer advanced development: Developing authoring and training systems for complex technical domains

    Science.gov (United States)

    Wiederholt, Bradley J.; Browning, Elica J.; Norton, Jeffrey E.; Johnson, William B.

    1991-01-01

    MITT Writer is a software system for developing computer based training for complex technical domains. A training system produced by MITT Writer allows a student to learn and practice troubleshooting and diagnostic skills. The MITT (Microcomputer Intelligence for Technical Training) architecture is a reasonable approach to simulation based diagnostic training. MITT delivers training on available computing equipment, delivers challenging training and simulation scenarios, and has economical development and maintenance costs. A 15 month effort was undertaken in which the MITT Writer system was developed. A workshop was also conducted to train instructors in how to use MITT Writer. Earlier versions were used to develop an Intelligent Tutoring System for troubleshooting the Minuteman Missile Message Processing System.

  9. Survivorship and functional outcomes of patellofemoral arthroplasty: a systematic review.

    Science.gov (United States)

    van der List, J P; Chawla, H; Zuiderbaan, H A; Pearle, A D

    2017-08-01

    Historically poor results of survivorship and functional outcomes of patellofemoral arthroplasty (PFA) have been reported in the setting of isolated patellofemoral osteoarthritis. More recently, however, fairly good results of PFA were reported, but the current status of PFA outcomes is unknown. Therefore, a systematic review was performed to assess overall PFA survivorship and functional outcomes. A search was performed using PubMed, Embase and Cochrane systems, and the registries were searched. Twenty-three cohort studies and one registry reported survivorship using Kaplan-Meier curve, while 51 cohort studies reported functional outcomes of PFA. Twelve studies were level II studies, while 45 studies were level III or IV studies. Heterogeneity was mainly seen in type of prosthesis and year the cohort started. Nine hundred revisions in 9619 PFAs were reported yielding 5-, 10-, 15- and 20-year PFA survivorships of 91.7, 83.3, 74.9 and 66.6 %, respectively, and an annual revision rate of 2.18. Functional outcomes were reported in 2587 PFAs with an overall score of 82.2 % of the maximum score. KSS and Knee Function Score were 87.5 and 81.6 %, respectively. This systematic review showed that fairly good results of PFA survivorship and functional outcomes were reported at short- and midterm follow-up in the setting of isolated patellofemoral osteoarthritis. Heterogeneity existed mainly in prosthesis design and year the cohort started. These results provide a clear overview of the current status of PFA in the setting of isolated patellofemoral osteoarthritis. IV.

  10. The Sylvia Plath Effect: Mental Illness in Eminent Creative Writers.

    Science.gov (United States)

    Kaufman, James C.

    2001-01-01

    Two studies involving a total of 2149 writers and other eminent individuals found that female poets were significantly more likely to suffer from mental illness than female fiction writers, than male writers of any type, or than eminent individuals in other fields. This finding has been dubbed the "Sylvia Plath" effect. (Contains…

  11. Research Paper Writing Strategies of Professional Japanese EFL Writers.

    Science.gov (United States)

    Matsumoto, Kazuko

    1995-01-01

    Four Japanese university professors were interviewed on their strategies for writing a research paper in English as a Foreign Language (EFL). Results indicate that these writers use strategies similar to those used by skilled native English writers and proficient writers of English as a Second Language. (35 references) (Author/CK)

  12. Collecting, curating, and researching writers' libraries a handbook

    CERN Document Server

    Oram, Richard W

    2014-01-01

    Collecting, Curating, and Researching Writers' Libraries: A Handbook is the first book to examine the history, acquisition, cataloging, and scholarly use of writers' personal libraries. This book also includes interviews with several well-known writers, who discuss their relationship with their books.

  13. Head and Neck Cancer: Symptoms and Signs

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  14. Nasal Cavity and Paranasal Sinus Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  15. Cyber Literature: A Reader – Writer Interactivity

    Directory of Open Access Journals (Sweden)

    Fathu Rahman

    2017-06-01

    Full Text Available Cyber Literature is a term known since the coming of the internet which brings a convenience, changing habit and world view. This study is a survey-based on respondents’ opinion about the existence of cyber literature on social media; of its benefit and impact to the reader. This study limits to the poems on Facebook group. The reason is simple; it favors the short form. For the study of a reader-writer interactivity in cyber literature is more likely on poetry. The approach is reader response literary theory with focus on the reader-writer interactivity on Facebook. This research aimed at uncovering the motivation of readers to response the uploaded text, the reasons why they love it and what its advantages. The results showed that cyber literature is successfully to introduce a new literary genre as well as to raise motivation and creativity of authors to make use the internet space.

  16. Feeling Engaged: College Writers as Literacy Tutors

    OpenAIRE

    Langdon, Lance-David Bennett

    2014-01-01

    Feeling Engaged: College Writers as Literacy Tutors brings together scholarship in the rhetoric of emotion and in civic writing to show how emotions - confidence, anger, embarrassment, pride, hope, fear, gratitude, guilt, shame, compassion, enthusiasm, and ennui - shape the roles we take on in K-16 literacy networks. This dissertation takes as a case study the community-engaged composition courses, poetry workshops, and literature classes I coordinated in 2011-2013. The undergraduates I led i...

  17. Albert Schweitzer: a patient with writer's cramp.

    Science.gov (United States)

    Tacik, P; Schrader, C; Weber, E; Dressler, D

    2012-06-01

    Albert Schweitzer (1875-1965) the world-famous philosopher, theologian, concert organist, musicologist, philanthropist and winner of the 1952 Nobel Peace Prize suffered throughout most of his life from severe and painful muscle cramps in his right upper extremity which were triggered exclusively by handwriting. They led to tonic finger flexion and wrist extension and produced slow and clumsy handwriting of a reduced character size. Other motor functions including Schweitzer's highly skilful and famous organ playing were not affected. Inheritance from his mother is likely. Schweitzer applied several coping strategies including a specific holding pattern for pens, usage of special pens, avoidance of handwriting and slowing of handwriting. With all these features Schweitzer presents as a classical case of action-specific dystonia in the form of a simple tonic writer's cramp. Interestingly, Schweitzer never received a medical diagnosis, although writer's cramp had already been identified and described as a medical condition. Impairment of his handwriting but not his organ playing may give insight into the multifactorial aetiology of writer's cramp. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. How to become a competent medical writer?

    Directory of Open Access Journals (Sweden)

    Suhasini Sharma

    2010-01-01

    Full Text Available Medical writing involves writing scientific documents of different types which include regulatory and research-related documents, disease or drug-related educational and promotional literature, publication articles like journal manuscripts and abstracts, content for healthcare websites, health-related magazines or news articles. The scientific information in these documents needs to be presented to suit the level of understanding of the target audience, namely, patients or general public, physicians or the regulators. Medical writers require an understanding of the medical concepts and terminology, knowledge of relevant guidelines as regards the structure and contents of specific documents, and good writing skills. They also need to be familiar with searching medical literature, understanding and presenting research data, the document review process, and editing and publishing requirements. Many resources are now available for medical writers to get the required training in the science and art of medical writing, and upgrade their knowledge and skills on an ongoing basis. The demand for medical writing is growing steadily in pharmaceutical and healthcare communication market. Medical writers can work independently or be employed as full time professionals. Life sciences graduates can consider medical writing as a valuable career option.

  19. Observing writing processes of struggling adult writers with collaborative writing

    Directory of Open Access Journals (Sweden)

    Afra Sturm

    2016-10-01

    Full Text Available This study investigated how struggling adult writers solve a writing task and what they know about writing and themselves as writers. The writing process of the adult writers was examined by combining three elements: the observation of collaborative writing tasks, analyses of their written texts, and structured individual interviews that included both retrospective and prospective parts. This methodical approach provides productive tools to assess writing processes and writing knowledge of struggling adult writers. The triangulation of data from the different sources is visualized in a case study. Findings from the case study suggest both similarities and differences between struggling adult and younger writers. Concerning the writing process of both groups, planning and revision play a limited role. However, alongside these similar limitations in their writing process, struggling adult writers distinguish themselves from their young counterparts through their relatively extensive knowledge about themselves as writers.

  20. Fast mask writers: technology options and considerations

    Science.gov (United States)

    Litt, Lloyd C.; Groves, Timothy; Hughes, Greg

    2011-04-01

    The semiconductor industry is under constant pressure to reduce production costs even as the complexity of technology increases. Lithography represents the most expensive process due to its high capital equipment costs and the implementation of low-k1 lithographic processes, which have added to the complexity of making masks because of the greater use of optical proximity correction, pixelated masks, and double or triple patterning. Each of these mask technologies allows the production of semiconductors at future nodes while extending the utility of current immersion tools. Low-k1 patterning complexity combined with increased data due to smaller feature sizes is driving extremely long mask write times. While a majority of the industry is willing to accept times of up to 24 hours, evidence suggests that the write times for many masks at the 22 nm node and beyond will be significantly longer. It has been estimated that funding on the order of 50M to 90M for non-recurring engineering (NRE) costs will be required to develop a multiple beam mask writer system, yet the business case to recover this kind of investment is not strong. Moreover, funding such a development poses a high risk for an individual supplier. The structure of the mask fabrication marketplace separates the mask writer equipment customer (the mask supplier) from the final customer (wafer manufacturer) that will be most effected by the increase in mask cost that will result if a high speed mask writer is not available. Since no individual company will likely risk entering this market, some type of industry-wide funding model will be needed.

  1. The Experiences of Young Adults With Hodgkin Lymphoma Transitioning to Survivorship: A Grounded Theory Study.

    Science.gov (United States)

    Matheson, Lauren; Boulton, Mary; Lavender, Verna; Collins, Graham; Mitchell-Floyd, Tracy; Watson, Eila

    2016-09-01

    To explore the experiences of young adults with Hodgkin lymphoma during the first year following the end of initial treatment. 
. A qualitative grounded theory study.
. Interviews with patients recruited from three cancer centers in England.
. 10 Hodgkin lymphoma survivors (four men and six women aged 21-39 years) recruited as part of a larger study of 28 young adult cancer survivors.
. Semistructured interviews were conducted about two months after treatment completion, and follow-up interviews were conducted seven months later. The authors' grounded theory of positive psychosocial adjustment to cancer provided the conceptual framework.
. Positive reframing, informal peer support, acceptance, and normalization helped young adults dismantle the threats of Hodgkin lymphoma during the course of treatment. However, they described losing a sense of security following treatment completion. Greater age-specific information to enable better preparation for the future was desired regarding body image, fertility, sexual relationships, work, and socializing.
. Informal support mechanisms, like peer support and patient navigator interventions, may be useful ways to further support young adults after treatment completion.
. Positive psychosocial adjustment to cancer survivorship in young adults is facilitated by having informal peer support; being able to positively reframe, accept, and normalize their experience; and being prepared for the future.

  2. Digimodernistlik eesti kirjanik / The Digimodernist Estonian Writer

    Directory of Open Access Journals (Sweden)

    Piret Viires

    2013-06-01

    Full Text Available The article examines the cultural situation following postmodernism in the first decade of the 21st century. To characterise this situation, the umbrella term “post-postmodernism” is used, as well as “neomodernism”, “altermodern”, “metamodernism”, “hypermodernity”, “performatism”, “critical realism” etc. All these approaches are, in a wider sense, united by their aim of opposing postmodernist cynicism and irony, and bringing back truth, simplicity and clarity. It has also been found that literature has returned or is returning to realism, and various cultural phenomena are emerging, which have been designated by the concept “new sincerity”.In descriptions of the current cultural situation, this trend seeking truth and simplicity is supported by approaches which emphasise the significance of technological developments during the last decade. A prominent figure here is Alan Kirby, who launched the term “digimodernism”, mainly linked with the adaptation and spread of Web 2.0 at the beginning of the 21st century: the blogosphere, Wikipedia, Twitter and Facebook.The article seeks answers to the question of whether we can talk about digimodernism in Estonian literature in the 2000s. In the 1990s Estonian writers were quite reluctant to undertake computer-technological experiments, and there are only a few examples of Estonian digital literature, whereas a change occurred in the 2000s. Many Estonian writers have had and still have their own blogs and surprisingly many have joined Facebook. The term “twitterature” is also familiar to Estonian writers. The article tackles the dominant topics in the blogs of Estonian writers and analyses their possible collective creative work on Facebook. A question is raised as to whether it is possible that the fragmentary narrative structure of blogs and Facebook has influenced mainstream literature.The article concludes that one essential change in Estonian literature in the

  3. Cooling improves the writing performance of patients with writer's cramp.

    Science.gov (United States)

    Pohl, Christoph; Happe, Jörg; Klockgether, Thomas

    2002-11-01

    Cooling of hand and forearm muscles by immersion in 15 degrees C cold water for 5 minutes improved the writing performance of patients with writer's cramp. Since abnormal processing of muscle spindle afferent discharges contributes to the pathology of writer's cramp, this effect might result from a reduction in muscle spindle activity by lowering muscle temperature. Cooling is a simple, cheap, and safe procedure, providing temporary relief for patients with writer's cramp. Copyright 2002 Movement Disorder Society

  4. Defining Survivorship Trajectories Across Patients With Solid Tumors: An Evidence-Based Approach.

    Science.gov (United States)

    Dood, Robert L; Zhao, Yang; Armbruster, Shannon D; Coleman, Robert L; Tworoger, Shelley; Sood, Anil K; Baggerly, Keith A

    2018-06-02

    Survivorship involves a multidisciplinary approach to surveillance and management of comorbidities and secondary cancers, overseen by oncologists, surgeons, and primary care physicians. Optimal timing and coordination of care, however, is unclear and often based on arbitrary 5-year cutoffs. To determine high- and low-risk periods for all tumor types that could define when survivorship care might best be overseen by oncologists and when to transition to primary care physicians. In this pan-cancer, longitudinal, observational study, excess mortality hazard, calculated as an annualized mortality risk above a baseline population, was plotted over time. The time this hazard took to stabilize defined a high-risk period. The percent morality elevation above age- and sex-matched controls in the latter low-risk period was reported as a mortality gap. The US population-based Surveillance, Epidemiology, and End Results database defined the cancer population, and the US Census life tables defined controls. Incident cases of patients with cancer were separated into tumor types based on International Classification of Diseases for Oncology definitions. Population-level data on incident cancer cases was compared with the general US population. Overall mortality and cause of death were reported on observed cancer cases. A total of 2 317 185 patients (median age, 63 years; 49.8% female) with 66 primary tumor types were evaluated. High-risk surveillance period durations ranged from less than 1 year (breast, prostate, lip, ocular, and parathyroid cancers) up to 19 years (unspecified gastrointestinal cancers). The annualized mortality gap, representing the excess mortality in the stable period, ranged from a median 0.26% to 9.33% excess annual mortality (thyroid and hypopharyngeal cancer populations, respectively). Cluster analysis produced 6 risk cluster groups: group 1, with median survival of 16.2 (5th to 95th percentile range [PR], 10.7-40.2) years and median high-risk period

  5. LAZA K. LAZAREVIC, DOCTOR AND WRITER

    Directory of Open Access Journals (Sweden)

    Rade R. Babić

    2006-04-01

    Full Text Available Laza K. Lazarevic was born on the 13th of May in 1851. He died on the 11th of January in 1891 in Belgrade. Laza K. Lazarevic was a Serb, jurist, warrior, doctor and writer. He studied medicine in Berlin and law in Belgrade. He took part in the Serbian-Turkish war and the Serbian-Bulgarian war. He published seventy-two professional and scientific papers on medicine. He gave some explanations on the appearance of pain in sciatica. He wrote nine short stories. He is an Associate Member of the Serbian Royal Academy. He spoke Russian, German and French. He was a personal doctor of King Milan.

  6. Writer identification system for Ethiopic handwriting | Demoze | Zede ...

    African Journals Online (AJOL)

    Writer identification is a popular and ongoing research area having a wide variety of applications in banking, criminal justice system, access control, determining the authenticity of handwritten mails, etc. In this paper, an off-line text independent Ethiopic writer identification system has been proposed. The system uses 50 ...

  7. Commentary: Sexism, Sex Stereotyping, and the Technical Writer.

    Science.gov (United States)

    Veiga, Nancy E.

    1989-01-01

    Discusses the impact of possible sex-based differences in communication styles on the technical writer's job. Argues that technical writers can choose to use both male and female communication styles to acknowledge multiple audiences and to improve the quality of their documents. (KEH)

  8. Identity Practices of Multilingual Writers in Social Networking Spaces

    Science.gov (United States)

    Chen, Hsin-I

    2013-01-01

    This study examines the literacy practices of two multilingual writers in social networking communities. The findings show that the multilingual writers explored and reappropriated symbolic resources afforded by the social networking site as they aligned themselves with particular collective and personal identities at local and global levels.…

  9. The Development of an Emotions Scale for Writers.

    Science.gov (United States)

    Powell, Jack L.; Brand, Alice G.

    1987-01-01

    The Brand Emotions Scale for Writers (BESW) is a 20-item scale designed to measure writers' emotions immediately before, during, and immediately after writing. This article describes the development of the BESW and the factor structure of the three different scale forms. (BS)

  10. Admitted or Denied: Multilingual Writers Negotiate Admissions Essays

    Science.gov (United States)

    Wight, Shauna

    2017-01-01

    This article presents data from a collection of yearlong case studies on resident multilingual writers' college admissions essays. The focal student in this piece revealed the challenges that such writers face in presenting themselves to college admissions officers. Exploring these cultural and linguistic conflicts, this analysis uses Goffman's…

  11. Media Defamation and the Free-Lance Writer.

    Science.gov (United States)

    Stevens, George E.

    1987-01-01

    Discusses the responsibilities of publishers and freelance writers concerning the liability involved in defamatory statements. Reviews several court cases pertaining to publisher liability and claims that, if a writer is not under the immediate control or supervision of the publisher, the publisher may avoid liability. (MM)

  12. Writer Identity Construction in Mexican Students of Applied Linguistics

    Science.gov (United States)

    Mora, Alberto

    2017-01-01

    The paper examines the connection between discursive and non-discursive features and the construction of writer identity. In particular, the paper compares and contrasts the writer identity development of two groups of undergraduate students of applied linguistics in the Mexican context, one made up of locally educated ones and the other composed…

  13. How to be an Effective Technical Writer?

    Directory of Open Access Journals (Sweden)

    M Solaiman Ali

    2012-07-01

    (patterns of organization of information to suit the technical writing task, checking for technical accuracy and following three levels of editing to help increase the readability of a technical text. Finally, in part 8 (Ethical/legal considerations for the technical writer, the authors suggest ways for the technical writer to overcome ethical/legal dilemmas on the job.

  14. Multivariate survivorship analysis using two cross-sectional samples.

    Science.gov (United States)

    Hill, M E

    1999-11-01

    As an alternative to survival analysis with longitudinal data, I introduce a method that can be applied when one observes the same cohort in two cross-sectional samples collected at different points in time. The method allows for the estimation of log-probability survivorship models that estimate the influence of multiple time-invariant factors on survival over a time interval separating two samples. This approach can be used whenever the survival process can be adequately conceptualized as an irreversible single-decrement process (e.g., mortality, the transition to first marriage among a cohort of never-married individuals). Using data from the Integrated Public Use Microdata Series (Ruggles and Sobek 1997), I illustrate the multivariate method through an investigation of the effects of race, parity, and educational attainment on the survival of older women in the United States.

  15. Tools students need to be skillful writers building better sentences

    CERN Document Server

    Hostmeyer, Phyllis

    2012-01-01

    Build stronger writers one sentence at a time.Imagine a classroom full of enthusiastic student writers, capable of reviewing their own work with a critical eye, then crafting a polished, convincing piece. This is possible, if you take writing instruction down to its basic building block-a solid sentence-and advance from there. Phyllis Hostmeyer can show you how with Tools Students Need to Be Skillful Writers, your blueprint for effective writing instruction and unit development. Packed with lessons across grades 3-12, this indispensable

  16. Long-term survivorship of stemless anatomical shoulder replacement.

    Science.gov (United States)

    Beck, Sascha; Beck, Verena; Wegner, Alexander; Dudda, Marcel; Patsalis, Theodor; Jäger, Marcus

    2018-01-24

    Like in many other joints, current shoulder replacement designs aim at bone preservation. According to the literature available, stemless total shoulder arthroplasty (TSA) compares favourably with stemmed designs in terms of function and survivorship of the implant. However, long-term results of stemless shoulder arthroplasty are still missing. Therefore, the aim of the present study was to evaluate long-term results of stemless anatomical TSA. Between 2006 and 2009, 51 shoulders in 46 patients were resurfaced using the Biomet Total Evolutive Shoulder System (TESS). Thirty-one shoulders in 26 patients who were aged 66.7 ± 10.0 (range 34-82) years were available for review at a mean follow-up of 94.7 ± 11.3 (76-124) months. The implant survival rate was 93.5% at eight years. The overall revision rate of the TESS implant was 9.7%. Radiolucent lines were found on the glenoid side of the TESS arthroplasty in 90.9% of the cases. All stemless humeral corolla implants showed solid fixation at follow-up. Clinical scores significantly improved at long-term follow-up (VAS from 8.1 ± 0.9 to 1.0 ± 1.2, p < 0.001; Quick-DASH from 67.9 ± 13.5 to 18.7 ± 16.5, p < 0.001 and Constant score from 14.7 ± 6.1 to 68.8 ± 13.2, p < 0.001). Stemless TSA has stood the test of time at eight years in terms of clinical scores, radiographic loosening, complication rates and implant survivorship.

  17. APPRAISAL ANALYSIS IN FREEDOM WRITERS MOVIE

    Directory of Open Access Journals (Sweden)

    Nani Hidayati

    2017-02-01

    Full Text Available This study attempts to find out conveyed messages in the movie from the realization of the appraisal and narrative structure as well as to describe the use of the Appraisal System to express LaGravenese's (a Attitudes, (bEngagement & (c Graduation towards the main characters in Freedom Writers movie screenplay. Using both quantitative and qualitative descriptive approach for discourse appraisal system analysis, the result of this study reveals several messages of tolerance, earning respect and trust, honor diversity, and striving for success and trust from the realization of Appraisal and Narrative Structure either in the dialogues or monologues of Freedom Writers’ characters. The result from the Appraisal Devices realizing (a Attitudes reveals that LaGravenese likes to express characters’ negative emotion explicitly than implicitly. He likes to express characters’ negative capability than other kinds of Judgments. He appreciates the characters using more Negative Value which denotes that in his opinion, they see each other negatively. (bEngagement used in the screenplay describes that he emphasizes more on characters’ denial towards each other’s opinion and existence with the use of more Disclaim Heterogloss in the screenplay. (cGraduation used in the screenplay describes that the use of more Sharpening Focus indicates he emphasizes on characters’ category boundary more than scaling of intensity. Keywords: Appraisal Devices, Attitude, Engagement, and Graduation.

  18. Three Writers of Arabic Texts in Yogyakarta

    Directory of Open Access Journals (Sweden)

    Muhamad Murtadlo

    2015-02-01

    Full Text Available This study examines the use of the Arabic alphabet in religious literature in Yogyakarta. This study uses a case study on three figure writers of religious texts that using the Arabic alphabet in southern part of Central Java (Yogyakarta, namely Asrori Ahmad (Magelang, Ali Maksum (Yogyakarta, and Ahmad Mujab Mahalli (Bantul. This study concluded that the writing of religious texts in Arabic alphabet in the southern Java area had been carried out by means of using Arabic Pegon, and only a few people who wrote in the Arabic language. The transmission of Arabic Pegon in Yogyakarta is allegedly from north coast of Java, especially from Lasem / East Java. The tradition of Arabic language teaching in the pesantrens still focuses mostly on the reading effort, communication, and understanding and it is not oriented to the writing skill. The presence of international journals initiated by the College of Islamic religious institutions and the effort of translation business into Arabic from certain institutions gives an opportunity to strengthen the use of the Arabic alphabet in Indonesia.

  19. Scientists' Stopping Behavior As Indicator of Writer's Skill

    Science.gov (United States)

    Broberg, Katie

    1973-01-01

    Indicates that accurate science writers have undergraduate degrees in English, journalism, or biology, have taken post graduate biology or journalism courses, and have some newspaper and freelance writing experience, plus experience in public relations. (RB)

  20. Simplifying the writing process for the novice writer.

    Science.gov (United States)

    Redmond, Mary Connie

    2002-10-01

    Nurses take responsibility for reading information to update their professional knowledge and to meet relicensure requirements. However, nurses are less enthusiastic about writing for professional publication. This article explores the reluctance of nurses to write, the reasons why writing for publication is important to the nursing profession, the importance of mentoring to potential writers, and basic information about simplifying the writing process for novice writers. Copyright 2002 by American Society of PeriAnesthesia Nurses.

  1. Survivorship care plans: are randomized controlled trials assessing outcomes that are relevant to stakeholders?

    Science.gov (United States)

    Birken, Sarah A; Urquhart, Robin; Munoz-Plaza, Corrine; Zizzi, Alexandra R; Haines, Emily; Stover, Angela; Mayer, Deborah K; Hahn, Erin E

    2018-03-23

    The purpose of this study was to compare outcomes assessed in extant randomized controlled trials (RCTs) to outcomes that stakeholders expect from survivorship care plans (SCPs). To facilitate the transition from active treatment to follow-up care for the 15.5 million US cancer survivors, many organizations require SCP use. However, results of several RCTs of SCPs' effectiveness have been null, possibly because they have evaluated outcomes on which SCPs should be expected to have limited influence. Stakeholders (e.g., survivors, oncologists) may expect outcomes that differ from RCTs' outcomes. We identified RCTs' outcomes using a PubMed literature review. We identified outcomes that stakeholders expect from SCPs using semistructured interviews with stakeholders in three healthcare systems in the USA and Canada. Finally, we mapped RCTs' outcomes onto stakeholder-identified outcomes. RCT outcomes did not fully address outcomes that stakeholders expected from SCPs, and RCTs assessed outcomes that stakeholders did not expect from SCPs. RCTs often assessed outcomes only from survivors' perspectives. RCTs of SCPs' effectiveness have not assessed outcomes that stakeholders expect. To better understand SCPs' effectiveness, future RCTs should assess outcomes of SCP use that are relevant from the perspective of multiple stakeholders. SCPs' effectiveness may be optimized when used with an eye toward outcomes that stakeholders expect from SCPs. For survivors, this means using SCPs as a map to guide them with respect to what kind of follow-up care they should seek, when they should seek it, and from whom they should seek it.

  2. “Psychosocial Interventions for Cancer Survivors, Caregivers and Family Members—One Size Does Not Fit All: My Perspective as a Young Adult Survivor, Advocate and Oncology Social Worker” a personal reflection by Mary Grace Bontempo - Office of Cancer Survivorship

    Science.gov (United States)

    “Psychosocial Interventions for Cancer Survivors, Caregivers and Family Members—One Size Does Not Fit All: My Perspective as a Young Adult Survivor, Advocate and Oncology Social Worker” a personal reflection by Mary Grace Bontempo page

  3. Spatially dependent biotic and abiotic factors drive survivorship and physical structure of green roof vegetation.

    Science.gov (United States)

    Aloisio, Jason M; Palmer, Matthew I; Giampieri, Mario A; Tuininga, Amy R; Lewis, James D

    2017-01-01

    Plant survivorship depends on biotic and abiotic factors that vary at local and regional scales. This survivorship, in turn, has cascading effects on community composition and the physical structure of vegetation. Survivorship of native plant species is variable among populations planted in environmentally stressful habitats like urban roofs, but the degree to which factors at different spatial scales affect survivorship in urban systems is not well understood. We evaluated the effects of biotic and abiotic factors on survivorship, composition, and physical structure of two native perennial species assemblages, one characterized by a mixture of C 4 grasses and forbs (Hempstead Plains, HP) and one characterized by a mixture of C 3 grasses and forbs (Rocky Summit, RS), that were initially sown at equal ratios of growth forms (5:1:4; grass, N-fixing forb and non-N-fixing forb) in replicate 2-m 2 plots planted on 10 roofs in New York City (New York, USA). Of 24 000 installed plants, 40% survived 23 months after planting. Within-roof factors explained 71% of variation in survivorship, with biotic (species identity and assemblage) factors accounting for 54% of the overall variation, and abiotic (growing medium depth and plot location) factors explaining 17% of the variation. Among-roof factors explained 29% of variation in survivorship and increased solar radiation correlated with decreased survivorship. While growing medium properties (pH, nutrients, metals) differed among roofs there was no correlation with survivorship. Percent cover and sward height increased with increasing survivorship. At low survivorship, cover of the HP assemblage was greater compared to the RS assemblage. Sward height of the HP assemblage was about two times greater compared to the RS assemblage. These results highlight the effects of local biotic and regional abiotic drivers on community composition and physical structure of green roof vegetation. As a result, initial green roof plant

  4. Writing orthotic device for the management of writer's cramp

    Directory of Open Access Journals (Sweden)

    Narayanasarma V. Singam

    2013-01-01

    Full Text Available Background: Oral therapies and chemodenervation procedures are often unrewarding in the treatment of focal, task-specific hand disorders such as writer's cramp or primary writing tremor. Methods: A portable writing orthotic device was evaluated on fifteen consecutively recruited writer's cramp and primary writing tremor subjects. We measured overall impairment at baseline and after two weeks of at-home use with the Writer’s Cramp Rating Scale (range = 0-8, higher is worse and writing quality and comfort with a visual analog scale (range = 0-10. Results: Compared to regular pen, the writing orthotic device improved the Writer's Cramp Rating Scale scores at first-test (p=0.001 and re-test (p=0.005 as well as writing quality and device comfort in writer's cramp subjects. Benefits were sustained at two weeks. Primary writing tremor subjects demonstrated no improvements.Conclusions: Writing orthotic devices exploiting a muscle-substitution strategy may yield immediate benefits in patients with writer's cramp.

  5. Sub-word based Arabic handwriting analysis for writer identification

    Science.gov (United States)

    Maliki, Makki; Al-Jawad, Naseer; Jassim, Sabah

    2013-05-01

    Analysing a text or part of it is key to handwriting identification. Generally, handwriting is learnt over time and people develop habits in the style of writing. These habits are embedded in special parts of handwritten text. In Arabic each word consists of one or more sub-word(s). The end of each sub-word is considered to be a connect stroke. The main hypothesis in this paper is that sub-words are essential reflection of Arabic writer's habits that could be exploited for writer identification. Testing this hypothesis will be based on experiments that evaluate writer's identification, mainly using K nearest neighbor from group of sub-words extracted from longer text. The experimental results show that using a group of sub-words could be used to identify the writer with a successful rate between 52.94 % to 82.35% when top1 is used, and it can go up to 100% when top5 is used based on K nearest neighbor. The results show that majority of writers are identified using 7 sub-words with a reliability confident of about 90% (i.e. 90% of the rejected templates have significantly larger distances to the tested example than the distance from the correctly identified template). However previous work, using a complete word, shows successful rate of at most 90% in top 10.

  6. Writers, Athletes and Engineers Learn by Doing

    Science.gov (United States)

    Narayanan, M.

    2009-12-01

    The author strongly believes that when one provides students more opportunity to write and publish, one actually is helping those students learn better. Writing in reality reinforces the knowledge acquired and clarifies fuzzy, indistinct and indefinable points. In a Learning Paradigm or a Discovery Paradigm, it is observed that evaluation is holistic, and student success outcomes are those that are actually measured. Many scholars have recommended and supported a value-added concept of education by doing assessments before, during, and after a course (Barr & Tagg, 1995). Other scholars have argued that achievement of educational objectives is becoming less and less measurable whereas the need for accountability is rising to the surface more frequently. The literature supports our intuitive belief that education in a new learning paradigm will prepare students for the work ahead of them (Cox, Grasha, & Richlin 1997, March). Technical writing has been a part of engineering education for a long time. Regardless, it appears that engineering students are more interested in spending productive time learning the mathematical aspects of subject matter. The students are reluctant to devote time and effort that involves descriptive writing. The trend is to develop an interactive problem-solving pedagogy that encourages the development of learner’s creativity, understanding, written and oral communication skills (Saxe, 1988; Senge, 1990; Sims, 1995; Young & Young, 1999). It is essential for the students to recognize the fact that writing indeed enhances their grasp over technical content. The author has outlined seven areas for assessing a writing assignment. 1. The student writing has an identified a specific focus on a given purpose. 2. The author has indicated an audience for the writing assignment. 3. The writer has specified conventions for format, flow and structure. 4. The learner has documented conventions for formality, voice and tone. 5. The individual has

  7. 'Intensive care unit survivorship' - a constructivist grounded theory of surviving critical illness.

    Science.gov (United States)

    Kean, Susanne; Salisbury, Lisa G; Rattray, Janice; Walsh, Timothy S; Huby, Guro; Ramsay, Pamela

    2017-10-01

    To theorise intensive care unit survivorship after a critical illness based on longitudinal qualitative data. Increasingly, patients survive episodes of critical illness. However, the short- and long-term impact of critical illness includes physical, psychological, social and economic challenges long after hospital discharge. An appreciation is emerging that care needs to extend beyond critical illness to enable patients to reclaim their lives postdischarge with the term 'survivorship' being increasingly used in this context. What constitutes critical illness survivorship has, to date, not been theoretically explored. Longitudinal qualitative and constructivist grounded theory. Interviews (n = 46) with 17 participants were conducted at four time points: (1) before discharge from hospital, (2) four to six weeks postdischarge, (3) six months and (4) 12 months postdischarge across two adult intensive care unit setting. Individual face-to-face interviews. Data analysis followed the principles of Charmaz's constructivist grounded theory. 'Intensive care unit survivorship' emerged as the core category and was theorised using concepts such as status passages, liminality and temporality to understand the various transitions participants made postcritical illness. Intensive care unit survivorship describes the unscheduled status passage of falling critically ill and being taken to the threshold of life and the journey to a life postcritical illness. Surviving critical illness goes beyond recovery; surviving means 'moving on' to life postcritical illness. 'Moving on' incorporates a redefinition of self that incorporates any lingering intensive care unit legacies and being in control of one's life again. For healthcare professionals and policymakers, it is important to realise that recovery and transitioning through to survivorship happen within an individual's time frame, not a schedule imposed by the healthcare system. Currently, there are no care pathways or policies in

  8. Contrasting Seasonal Survivorship of Two Migratory Songbirds Wintering in Threatened Mangrove Forests

    Directory of Open Access Journals (Sweden)

    Anna M. Calvert

    2010-06-01

    Full Text Available Long-distance migrants wintering in tropical regions face a number of critical conservation threats throughout their lives, but seasonal estimates of key demographic parameters such as winter survival are rare. Using mist-netting-based mark-recapture data collected in coastal Costa Rica over a six-year period, we examined variation in within- and between-winter survivorship of the Prothonotary Warbler (Protonotaria citrea; 753 young and 376 adults banded, a declining neotropical habitat specialist that depends on threatened mangrove forests during the nonbreeding season. We derived parallel seasonal survivorship estimates for the Northern Waterthrush (Seiurus noveboracensis; 564 young and 93 adults banded, a cohabitant mangrove specialist that has not shown the same population decline in North America, to assess whether contrasting survivorship might contribute to the observed differences in the species’ population trajectories. Although average annual survival probability was relatively similar between the two species for both young and adult birds, monthly estimates indicated that relative to Northern Waterthrush, Prothonotary Warblers exhibited: greater interannual variation in survivorship, especially within winters; greater variation in survivorship among the three study sites; lower average between-winter survivorship, particularly among females, and; a sharp decline in between-winter survivorship from 2003 to 2009 for both age groups and both sexes. Rather than identifying one seasonal vital rate as a causal factor of Prothonotary Warbler population declines, our species comparison suggests that the combination of variable within-winter survival with decreasing between-winter survival demands a multi-seasonal approach to the conservation of this and other tropical-wintering migrants.

  9. Essential grammar for today's writers, students, and teachers

    CERN Document Server

    Sullivan, Nancy

    2014-01-01

    This innovative grammar text is an ideal resource for writers, language students, and current and future classroom teachers who need an accessible "refresher" in a step-by-step guide to essential grammar. Rather than becoming mired in overly detailed linguistic definitions, Nancy Sullivan helps writers and students understand and apply grammatical concepts and develop the skills they need to enhance their own writing. Along with engaging discussions of both contemporary and traditional terminology, Sullivan's text provides clear explanations of the basics of English grammar and a highly practical, hands-on approach to mastering the use of language. Complementing the focus on constructing excellent sentences, every example and exercise set is contextually grounded in language themes. Teachers, students, and writers will appreciate the streamlined, easy-to-understand coverage of essential grammar, as well as the affordable price. This is an ideal textbook for future teachers enrolled in an upper-level grammar c...

  10. Potential determinants of health-care professionals' use of survivorship care plans: a qualitative study using the theoretical domains framework.

    Science.gov (United States)

    Birken, Sarah A; Presseau, Justin; Ellis, Shellie D; Gerstel, Adrian A; Mayer, Deborah K

    2014-11-15

    Survivorship care plans are intended to improve coordination of care for the nearly 14 million cancer survivors in the United States. Evidence suggests that survivorship care plans (SCPs) have positive outcomes for survivors, health-care professionals, and cancer programs, and several high-profile organizations now recommend SCP use. Nevertheless, SCP use remains limited among health-care professionals in United States cancer programs. Knowledge of barriers to SCP use is limited in part because extant studies have used anecdotal evidence to identify determinants. This study uses the theoretical domains framework to identify relevant constructs that are potential determinants of SCP use among United States health-care professionals. We conducted semi-structured interviews to assess the relevance of 12 theoretical domains in predicting SCP use among 13 health-care professionals in 7 cancer programs throughout the United States with diverse characteristics. Relevant theoretical domains were identified through thematic coding of interview transcripts, identification of specific beliefs within coded text units, and mapping of specific beliefs onto theoretical constructs. We found the following theoretical domains (based on specific beliefs) to be potential determinants of SCP use: health-care professionals' beliefs about the consequences of SCP use (benefit to survivors, health-care professionals, and the system as a whole); motivation and goals regarding SCP use (advocating SCP use; extent to which using SCPs competed for health-care professionals' time); environmental context and resources (whether SCPs were delivered at a dedicated visit and whether a system, information technology, and funding facilitated SCP use); and social influences (whether using SCPs is an organizational priority, influential people support SCP use, and people who could assist with SCP use buy into using SCPs). Specific beliefs mapped onto the following psychological constructs: outcome

  11. James Baldwin: Biographical Dispatches on a Freedom Writer

    Directory of Open Access Journals (Sweden)

    Phillip Luke Sinitiere

    2016-12-01

    Full Text Available This essay presents the idea of James Baldwin as a freedom writer, the organizing idea of my biography in progress. As a freedom writer, Baldwin was a revolutionary intellectual, an essayist and novelist committed unfailingly to the realization of racial justice, interracial political equality, and economic democracy. While the book is still in process, this short essay narrates autobiographically how I came to meet and know Baldwin’s work, explains in critical fashion my work in relation to existing biographies, and reflects interpretively my thoughts-in- progress on this fascinating and captivating figure of immense historical and social consequence.

  12. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... is also called disease-specific survival. In most cases, cancer-specific survival is based on causes of ... may be owned by their creator. In such cases, it is necessary to contact the writer, artists, ...

  13. Maintaining success, reducing treatment burden, focusing on survivorship

    DEFF Research Database (Denmark)

    Beyer, Jürgen; Albers, Peter Hjorth; Altena, R

    2013-01-01

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European...... consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting...... of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur...

  14. Writer identification using directional ink-trace width measurements

    NARCIS (Netherlands)

    Brink, A. A.; Smit, J.; Bulacu, M. L.; Schomaker, L. R. B.

    As suggested by modern paleography, the width of ink traces is a powerful source of information for off-line writer identification, particularly if combined with its direction. Such measurements can be computed using simple, fast and accurate methods based on pixel contours, the combination of which

  15. Verb Errors of Bilingual and Monolingual Basic Writers

    Science.gov (United States)

    Griswold, Olga

    2017-01-01

    This study analyzed the grammatical control of verbs exercised by 145 monolingual English and Generation 1.5 bilingual developmental writers in narrative essays using quantitative and qualitative methods. Generation 1.5 students made more errors than their monolingual peers in each category investigated, albeit in only 2 categories was the…

  16. Treatment of writer's sodium valproate and cramp with baclofen

    African Journals Online (AJOL)

    Treatment of a 27-year-old Black man with writer's cramp with a combin'ation of sodium valproate (Epi- lim) and baclofen (Lioresal) resulted in dramatic improvement of symptoms and signs. The possible mechanism of action of these drugs is discussed. This combination should be tried in the initial man- agement of this ...

  17. Teacher as Writer: Remembering the Agony, Sharing the Ecstasy.

    Science.gov (United States)

    Augsburger, Deborah J.

    1998-01-01

    Argues that teachers who write are in a better position to guide students, provide useful feedback, and show the real value of writing. Discusses remembering the agony, sharing the ecstasy, giving authentic feedback, growing a community of writers, and remembering the reason people bother to write at all. (SR)

  18. The Community Publishing Project: assisting writers to self-publish ...

    African Journals Online (AJOL)

    This article examines the need for a small project such as the Community Publishing Project in South Africa and explores its aims. The method of involving writers and community groups in the publication process is described and two completed projects are evaluated. Lessons learnt by the Centre for the Book in managing ...

  19. Prime Time Power: Women Producers, Writers and Directors on TV.

    Science.gov (United States)

    Steenland, Sally

    This report analyzes the number of women working in the following six decision making jobs in prime time television: (1) executive producer; (2) supervising producer; (3) producer; (4) co-producer; (5) writer; and (6) director. The women who hold these positions are able to influence the portrayal of women on television as well as to improve the…

  20. The Influence of Organizations on Writers' Texts and Training.

    Science.gov (United States)

    Lutz, Jean

    1986-01-01

    Argues that, to succeed in the workplace, technical writers must supplement their knowledge of writing and rhetoric with an appreciation of "organizational culture." Explains how to do this and shows how technical writing classes can prepare students for this adjustment to the corporate environment. (FL)

  1. Learning Disabled College Writers Project, Evaluation Report, 1985-86.

    Science.gov (United States)

    Dunham, Trudy

    This report describes the Learning Disabled College Writer's Project, implemented at the University of Minnesota during the 1985-86 school year and designed to aid learning disabled college students master composition skills through training in the use of microcomputer word processors. Following an executive summary, an introduction states the…

  2. Journal of EEA, Vol. 27, 2010 WRITER IDENTIFICATION SYSTEM ...

    African Journals Online (AJOL)

    messy

    Two approaches have been employed for feature extraction from the handwritten images: texture ... gait, keystroke dynamics, signature, handwriting). Identifying the writer of a handwritten sample using automatic image-based methods is an interesting pattern recognition problem with a wide variety of applications including ...

  3. Preserving local writers, genealogy, photographs, newspapers, and related materials

    CERN Document Server

    Smallwood, Carol

    2012-01-01

    Preserving Local Writers, Genealogy, Photographs, Newspapers, and Related Materials draws on the practical knowledge of archivists, preservationists, librarians, and others who share the goal of making local history accessible to future generations. Anyone who plans to start a local history project or preserve important historical materials will find plenty of tips, techniques, sample documents, project ideas, and inspiration in its pages.

  4. PROCESS WRITING: SUCCESSFUL AND UNSUCCESSFUL WRITERS; DISCOVERING WRITING BEHAVIOURS

    Directory of Open Access Journals (Sweden)

    Ismail Baroudy

    2008-12-01

    Full Text Available Successful and unsuccessful strategies practically complied with in the act of writing have been so far experimentally tapped and scholastically rehearsed by several authors. In this study, a complementary task using a questionnaire worked out to comprehensively specify and cover almost all types of writing behaviours has been inquisitively manipulated. By analysing and inspecting the findings elicited from student-writers’ response sheets, successful and unsuccessful writing strategies are then contrastively identified, categorised and demonstrated. Based on the awareness accomplished, writing teachers’ consciousness will be raised and boosted, thus, helping their poor student-writers justifiably quit their debilitative habits and adopt instead, facilitative ones, those competent writers implement while writing. In the questionnaire, the student-writers would reflect upon their creeping experience and pass informative judgements about their own strategies. Student-writers will respond to fact-finding statements regarding five writing components delineated as rehearsing, drafting, revising, student-writers’ role and the role of instructional materials

  5. Solving the English-as-a-Second Language Writers' Dilemma

    Science.gov (United States)

    Nowalk, Thomas

    2010-01-01

    This brief work stands against a four-year stretch of writing classes at Northern Virginia Community College, with the author teaching English-as-a-Second-Language (ESL) students how to write academic essays. The courses taught have included high intermediate and advanced writers, many of whom plan to earn a degree at the college or any number of…

  6. Louis's Lightbulb Lesson (and Other Advice for Textbook Writers)

    Science.gov (United States)

    Sheinkin, Steve

    2009-01-01

    In this article, the author reflects on his work as a textbook writer. Given that knowledge is memorable when it is related to engaging stories, the author wonders if it is possible to turn the history of our great nation into such tales to motivate children's learning. Attempts to make his textbook writing more vivid, however, are met with a…

  7. Scott Fitzgerald: famous writer, alcoholism and probable epilepsy

    Directory of Open Access Journals (Sweden)

    Mariana M. Wolski

    Full Text Available ABSTRACT Scott Fitzgerald, a world-renowned American writer, suffered from various health problems, particularly alcohol dependence, and died suddenly at the age of 44. According to descriptions in A Moveable Feast, by Ernest Hemingway, Fitzgerald had episodes resembling complex partial seizures, raising the possibility of temporal lobe epilepsy.

  8. NIH Research Leads to Cervical Cancer Vaccine

    Science.gov (United States)

    ... Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents ... in women, the cause of the majority of cervical cancers. Photo courtesy of Judy Folkenberg, NLM Writer By ...

  9. Stigma, survivorship and solutions: Addressing the challenges of ...

    African Journals Online (AJOL)

    to cope with breast cancer. Not only do they have to deal with the emotional impact of a cancer diagnosis, but also with the additional constraints of poverty, lack of access to care and dependence on their ... ability to re-integrate and maintain meaningful relationships, whereas the spiritual domain requires that an individual ...

  10. Reclaiming Power in the Writers' Workshop: Defending Curricula, Countering Narratives, and Changing Identities in Prekindergarten Classrooms

    Science.gov (United States)

    Kissel, Brian T.; Miller, Erin T.

    2015-01-01

    In this article, we examine how young writers and their teachers transformed the language arts curriculum by asserting their power within a familiar framework--the writer's workshop. We present three narratives in which multiple pre-kindergarten agents (students, teachers, and administrators) used their power within the Writer's Workshop to a)…

  11. Non-Intentional Invention: The Promethean, Trickster, and Improvisational Invention Heuristics of Academic Writers and Poets

    Science.gov (United States)

    Wirtz, Jason

    2013-01-01

    This essay introduces a novel way to conceptualize writerly invention -- invention as adopting a non-intentional intellectual stance wherein heuristics are experienced as acting upon the writer as opposed to being enacted by the writer. This view of invention complicates and extends the traditional, Aristotelian view of invention as discreet…

  12. Cognitive Impairment in Men With Testicular Cancer Prior to Adjuvant Therapy

    NARCIS (Netherlands)

    Wefel, Jeffrey S.; Vidrine, Damon J.; Veramonti, Tracy L.; Meyers, Christina A.; Marani, Salma K.; Hoekstra, Harald J.; Hoekstra-Weebers, Josette E. H. M.; Shahani, Lokesh; Gritz, Ellen R.

    2011-01-01

    BACKGROUND: Cognitive dysfunction experienced by individuals with cancer represents an important survivorship issue because of its potential to affect occupational, scholastic, and social activities. Whereas early efforts to characterize cognitive dysfunction primarily focused on the effects of

  13. Combined osteochondral allograft and meniscal allograft transplantation: a survivorship analysis.

    Science.gov (United States)

    Getgood, Alan; Gelber, Jonathon; Gortz, Simon; De Young, Alison; Bugbee, William

    2015-04-01

    The efficacy of meniscal allograft transplantation (MAT) and osteochondral allografting (OCA) as individual treatment modalities for select applications is well established. MAT and OCA are considered symbiotic procedures due to a complementary spectrum of indications and reciprocal contraindications. However, few outcomes of concomitant MAT and OCA have been reported. This study is a retrospective review of patients who received simultaneous MAT and OCA between 1983 and 2011. Forty-eight (twenty-nine male: nineteen female) patients with a median age of 35.8 years (15-66) received combined MAT and OCA procedures between 1983 and 2011. Forty-three patients had received previous surgery with a median of 3 procedures (1-11 procedures). The underlying diagnosis was trauma (tibial plateau fracture) in 33 % with osteoarthritis predominating in 54.2 % of cases. Thirty-one patients received a lateral meniscus, 16 received a medial meniscus and one patient received bilateral MAT. The median number of OCAs was two per patient (1-5 grafts), with a median graft area of 15 cm(2) (0.7-41 cm(2)). There were 21 unipolar, 24 bipolar (tibiofemoral) and three multifocal lesions. Thirty-six MATs constituted a compound tibial plateau OCA with native meniscus attached. At follow-up, failure was defined as any procedure resulting in removal or revision of one or more of the grafts. Patients completed the modified Merle d'Aubigné and Postel (18-point) scale, Knee Society Function (KS-F) score, and subjective International Knee Documentation Committee (IKDC) scores. Patient satisfaction was also captured. Twenty-six of 48 patients (54.2 %) required reoperation, but only 11 patients (22.9 %) were noted to have failed (10 MAT and 11 OCA). The mean time to failure was 3.2 years (95 % CI 1.5-4.9 years) and 2.7 years (95 % CI 1.3-4.2 years) for MAT and OCA, respectively. The 5-year survivorship was 78 and 73 % for MAT and OCA respectively, and 69 and 68 % at 10 years. Six of

  14. Effect of non-nutritive sugars to decrease the survivorship of spotted wing drosophila, Drosophila suzukii

    Science.gov (United States)

    In this study, we investigated the effects of non-nutritive sugars and sugar alcohols on the survivorship of spotted wing drosophila, Drosophila suzukii, and found erythritol and erythrose as potentially toxic to the fly. In a dose-dependent study, erythritol and erythrose significantly reduced fly ...

  15. Translocation as a conservation tool for Agassiz's desert tortoises: Survivorship, reproduction, and movements

    Science.gov (United States)

    K. E. Nussear; C. R. Tracy; P. A. Medica; D. S. Wilson; R. W. Marlow; P. S. Corn

    2012-01-01

    We translocated 120 Agassiz's desert tortoises to 5 sites in Nevada and Utah to evaluate the effects of translocation on tortoise survivorship, reproduction, and habitat use. Translocation sites included several elevations, and extended to sites with vegetation assemblages not typically associated with desert tortoises in order to explore the possibility of moving...

  16. Modelling the survivorship of Nigeria children in their first 10 years of ...

    African Journals Online (AJOL)

    Fagbamigbe

    Conflict of Interest: Authors declared no conflict of interest ... Keywords: Survivorship, Nigeria, children mortality, Kaplan Meier, Brass Indirect method, Prediction ... variables or sex of older siblings, post- neonatal mortality is 12% higher and 2nd ... Relationship between maternal education and child survival in developing ...

  17. Digital network of writers helps to foster spirit of collaboration.

    LENUS (Irish Health Repository)

    Klimas, J

    2015-07-29

    Nurse Liz Charalambous has shown how a Facebook group can help boost writing (careers, June 3). We would like to take this idea one step further and argue that, contrary to a commonly held notion, \\'too many cooks do not spoil the broth\\' when it comes to group writing. Instead, this approach fosters collaboration between writers, as Ms Charalambous suggests, and which has also been our experience.

  18. Interview with Contemporary Armenian Writer and Translator Diana Hambardzumyan

    Directory of Open Access Journals (Sweden)

    Beatrice Tottossy

    2016-12-01

    Full Text Available A conversation with Diana Hambardzumyan, a contemporary Armenian writer, translator and lecturer in English Literature at the University of Yerevan, foregrounds a series of significant features of contemporary Armenian literature and the country’s key social and cultural issues. She interconnects current events with the literary memory, highlighting and confirming the Armenian writers’ need to maintain their traditional role as representatives of the cultural will of their people.

  19. Writer Identification and Verification from Intra-variable Individual Handwriting

    OpenAIRE

    Adak, Chandranath; Chaudhuri, Bidyut B.; Blumenstein, Michael

    2017-01-01

    The handwriting of an individual may vary excessively with many factors such as mood, time, space, writing speed, writing medium, utensils etc. Therefore, it becomes more challenging to perform automated writer verification/ identification on a particular set of handwritten patterns (e.g. speedy handwriting) of a person, especially when the system is trained using a different set of writing patterns (e.g. normal/medium speed) of that same person. However, it would be interesting to experiment...

  20. Survivorship of Total Hip Joint Replacements Following Isolated Liner Exchange for Wear.

    Science.gov (United States)

    Vadei, Leone; Kieser, David C; Frampton, Chris; Hooper, Gary

    2017-11-01

    Liner exchange for articular component wear in total hip joint replacements (THJRs) is a common procedure, often thought to be benign with reliable outcomes. Recent studies, however, suggest high failure rates of liner exchange revisions with significant complications. The primary aim of this study was, therefore, to analyze the survivorship of isolated liner exchange for articular component wear, and secondarily to assess the influence of patient demographics (gender, age, and American Society of Anaesthesiologists [ASA] ratings) on rerevisions following isolated liner exchange for wear. A retrospective review of the 15-year New Zealand Joint Registry (1999-2014) was performed, analyzing the outcomes of isolated liner exchange for articular component wear. The survivorship as defined as rerevision with component exchange was determined and 10-year Kaplan-Meier survivorship curves were constructed. These revision rates were compared to age, gender, and ASA rating groups using a log-rank test. The 10-year survivorship of THJR following liner exchange revision for liner wear was 75.3%. If a rerevision was required, the median time to rerevision was 1.33 years with a rerevision rate of 3.33 per 100 component years (95% confidence interval 2.68-4.08/100 component years). The principle reasons for rerevision were dislocation (48.4%) and acetabular component loosening (20.9%). There was no statistically significant difference in rerevision rates based on gender, age categories, or ASA scores. THJR isolated liner exchange for liner wear is not a benign procedure with a survivorship of 75.3% at 10 years. Surgeons contemplating liner exchange revisions should be cognisant of this risk and should adequately assess component position and stability preoperatively. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Breast-cancer-isation explored: Social experiences of gynaecological cancer in a Norwegian context.

    Science.gov (United States)

    Solbraekke, Kari Nyheim; Lorem, Geir

    2016-11-01

    This article's point of departure is recent claims that breast cancer survivorship displaying positivity and self-growth represents the gold standard for all forms of cancer survivorship in English-speaking Western cultures. An interview study of Norwegian women regarding gynaecological cancer followed by hysterectomy is used to explore whether this process is taking place beyond this setting. Results show that the women's experiences of having to display survivorship in this manner are not as notable as found in English-speaking Western countries, neither is their experience of social othering. Reasons for this may be strong norms of social egalitarianism marking Norwegian culture and breast cancer informational campaigns that have not yet totally defined Norwegian norms for how to survive cancer. At the clinic and in the public sphere, however, the women experience gynaecological cancer as clearly having lower status than breast cancer, leading to a strong sense that the bodily site of their disease is taboo. Hence, as found in English-speaking cultures, the complex embodied nature of having gynaecological cancer and life beyond treatment seems to be silenced by the media and medical institutions. Finally, implications for future research and health care related to cancer survivorship are also discussed. © 2016 Foundation for the Sociology of Health & Illness.

  2. Kas "balti kirjanik" on olemas? / Does the "Baltic Writer" Exist?

    Directory of Open Access Journals (Sweden)

    Cornelius Hasselblatt

    2016-12-01

    Full Text Available Teesid: Artiklis küsitakse 2009. a ilmunud leksikoni „300 Baltic Writers“ põhjal, kas „Balti kirjanik“ on põhjendatud mõiste. Varem mõisteti Baltikumi all laiemat ala, kuhu kuulusid ka Poola ja Soome. Uurides, kui palju „Balti“ kirjanikke on tõlgitud naaberkeeltesse, selgus, et läti keelde on neid tõlgitud rohkem kui leedu ja eesti keelde. Samuti on eesti autoreid rohkem tõlgitud soome keelde ja leedu autoreid poola keelde. Ilmneb, et Balti kontseptsioon on liiga kitsas, sest relevantne regioon on suurem: soome-eesti ja leedu-poola suhetega võrreldes ei paista eesti-läti-leedu suhe eriti millegagi silma.   The article takes a closer look at the reference guide 300 Baltic Writers (Kalnačs jt 2009 which was published in 2009. The initial (and may-be even provocative question is, whether the concept “Baltic writer” which is introduced here is indeed as clear and senseful as the introduction suggests. In this introduction, some basic problems occur, as can be exemplified through the following quotations: “This reference book presents a hundred of the best-known writers from each of the three Baltic States, starting with the time in the 16th century when the written word first appeared in their national languages, and going on to the twenty-first century (the bibliography goes up to the year 2008. In doing so, it shows the historical and cultural partnerships between the three Baltic countries.” (p. 5 While the first sentence is comprehensible and correct, the second sentence shows a simple logical mistake: one cannot show a unity simply by putting things together. In doing so, one may create a (wishful unity, i.e. postulate it, but one cannot show it. Also one of the following sentences is not convincing, but highly problematic: “For a long time, the writers, poets, playwrights and literary critics of each of these countries have deserved to be introduced to a wider international literary audience as a regional

  3. Bicruciate-retaining Total Knee Replacement Provides Satisfactory Function and Implant Survivorship at 23 Years.

    Science.gov (United States)

    Pritchett, James W

    2015-07-01

    One of the goals of a TKA is to approximate the function of a normal knee. Preserving the natural ligaments might provide a method of restoring close to normal function. Sacrifice of the ACL is common and practical during a TKA. However, this ligament is functional in more than 60% of patients undergoing a TKA and kinematic studies support the concept of bicruciate-retaining (that is, ACL-preserving) TKA; however, relatively few studies have evaluated patients treated with bicruciate-retaining TKA implants. I asked: (1) what is the long-term (minimum 20-year) survivorship, (2) what are the functional results, and (3) what are the reasons for revision of bicruciate-retaining knee arthroplasty prostheses? From January 1989 to September 1992, I performed 639 total knee replacements in 537 patients. Of these, 489 were performed in 390 patients using a bicruciate-retaining, minimally constrained device. During the period in question, this knee prosthesis was used for all patients observed intraoperatively to have an intact, functional ACL with between 15° varus and 15° valgus joint deformity. There were 234 women and 156 men with a mean age at surgery of 65 years (range, 42-84 years) and a primary diagnosis of osteoarthritis in 89%. The patella was resurfaced in all knees. The mean followup was 23 years (range, 20-24 years). At the time of this review, 199 (51%) patients had died and 31 (8%) patients were lost to followup, leaving 160 (41%) patients (214 knees) available for review. Component survivorship was determined by competing-risks analysis and Kaplan Meier survivorship analysis with revision for any reason as the primary endpoint. Patients were evaluated every 2 years to assess ROM, joint laxity, knee stability, and to determine American Knee Society scores. The Kaplan-Meier survivorship was 89% (95% CI, 82%-93%) at 23 years with revision for any reason as the endpoint. Competing-risks survivorship was 94% (95% CI, 91%%-96 %) at 23 years. At followup, the mean

  4. Finite-element modeling and micromagnetic modeling of perpendicular writers

    Science.gov (United States)

    Heinonen, Olle; Bozeman, Steven P.

    2006-04-01

    We compare finite-element modeling (FEM) and fully micromagnetic modeling results of four prototypical writers for perpendicular recording. In general, the agreement between the two models is quite good in the vicinity of saturated or near-saturated magnetic material, such as the pole tip, for quantities such as the magnetic field, the gradient of the magnetic field and the write width. However, in the vicinity of magnetic material far from saturation, e.g., return pole or trailing edge write shield, there can be large qualitative and quantitative differences.

  5. Development of a portable report writer for radiology

    International Nuclear Information System (INIS)

    Dockray, K.T.; Forgey, M.K.

    1985-01-01

    This paper describes an x-ray report writer crafted for a radiologist serving eight widely spread rural hospitals and clinics. Transcribed reports, originally taking one to seven days to turn out, are now code-generated on a portable computer. If one is to save effort and money in x-ray with computer techniques, then those techniques must respond within the constraints of how radiologists do radiology. This paper reviews classic x-ray work methods, describes the generation of typed film reports with a portable, standalone computer, and then analyzes its effects

  6. Worker life tables, survivorship, and longevity in colonies of Bombus (Fervidobombus atratus (Hymenoptera: Apidae

    Directory of Open Access Journals (Sweden)

    Eunice Vieira da Silva-Matos

    2000-06-01

    Full Text Available Survivorship curves and longevity of workers were studied in two queenright and two queenless colonies of Bombus (Fervidobombus atratus. Survivorship curves for workers of all colonies were, in general, convex, indicating an increasing mortality rate with increasing age. The mean longevity for the workers from queenright colonies, 24.3 days and 17.6 days, was not significantly different from that in queenless colonies, 21.2 days and 20.2 days. In all colonies workers started foraging activities when aged 0-5 days, and the potential forager rates rose progressively with increasing age. Mortality rates within each age interval were significantly correlated with the foraging worker rates in all colonies. Only in two of the colonies (one queenright and one queenless longevity was significantly correlated with worker size. The duration of brood development period seems to be one of the most important factors influencing adult worker longevity in this bumble bee species.

  7. We are all angels: acting, reclaiming and moving beyond survivorship.

    Science.gov (United States)

    Anderson, Ariane B

    2014-01-01

    This article aspires to an embodiment of dynamic living versus mere survival. The term cancer survivor, including a survivor who is in remission, has been legitimated (Berger and Luckmann, The social construction of reality, p. 94 1967) by language which creates knowledge of what a cancer survivor is and does. Because we act under descriptions (Hacking, The social construction of what?, p. 103 1999), those of us who have passed through illnesses such as cancer not only have been given the name and the idea of survivor, we have assumed and conform to some or most of the characteristics assigned to it; examples of some of those characteristics are discussed throughout this project. Whether or not we choose to enact all that falls under the grammar of the classification of survivor, we still live with, create, and experience ourselves and others as legitimated by such a classification. The term survivor operates through a number of institutions (medical, capitalism, and media) resulting in individuals' awareness of such classifications about themselves and others. Many, if not most, who are aware of being classified as survivors may wish to modify or resist the constraining aspects of those classifications and their descriptions. Through layered accounts of interviews and prose, I interact with this term as one who is both caught in and wants to go against the stream of classification and description. I want to transcend what I know, yet I am aware that whatever story I make and tell is a part of the whole-my story is part of two other survivor's stories which I include in the following telling of my own. All of our stories matter. Still, I want to look beyond what is in front of me, move beyond it, dream. I do so with a desire to tell my story as part of other survivors' stories.

  8. Breast cancer prevention across the cancer care continuum.

    Science.gov (United States)

    Klemp, Jennifer R

    2015-05-01

    To review the current state of breast cancer prevention from primary prevention through survivorship, highlight cross-cutting issues, and discuss strategies for clinical integration and future research. Published articles between 1985 and 2015 and original research. Cancer risk persists across the lifespan. Interprofessional strategies to reduce morbidity and mortality from cancer include primary, secondary, and tertiary prevention (survivorship). Prevention strategies across the cancer care continuum are cross-cutting and focus on measures to: prevent the onset of disease, identify and treat asymptomatic persons who have already developed risk factors or preclinical disease, and restore function, minimize the negative effects of disease, and prevent disease-related complications. Oncology nurses and advanced practice nurses are vital in the delivery of breast cancer prevention strategies. Published by Elsevier Inc.

  9. Evolving Information Needs among Colon, Breast, and Prostate Cancer Survivors: Results from a Longitudinal Mixed-Effects Analysis.

    Science.gov (United States)

    Tan, Andy S L; Nagler, Rebekah H; Hornik, Robert C; DeMichele, Angela

    2015-07-01

    This study describes how cancer survivors' information needs about recurrence, late effects, and family risks of cancer evolve over the course of their survivorship period. Three annual surveys were conducted from 2006 to 2008 in a cohort of Pennsylvania cancer survivors diagnosed with colon, breast, or prostate cancer in 2005 (round 1, N = 2,013; round 2, N = 1,293; round 3, N = 1,128). Outcomes were information seeking about five survivorship topics. Key predictors were survey round, cancer diagnosis, and the interaction between these variables. Mixed-effects logistic regression analyses were performed to predict information seeking about each topic, adjusting for demographic variables, clinical characteristics, and clustering of repeated observations within individuals. Information seeking about reducing risks of cancer recurrence was the most frequently reported topic across survivors and over time. Breast cancer survivors were more likely to seek about survivorship topics at round 1 compared with other survivors. In general, information seeking declined over time, but cancer-specific patterns emerged: the decline was sharpest for breast cancer survivors, whereas in later years female colon cancer survivors actually sought more information (about how to reduce the risk of family members getting colon cancer or a different cancer). Cancer survivors' information needs varied over time depending on the topic, and these trends differed by cancer type. Clinicians may need to intervene at distinct points during the survivorship period with information to address concerns about cancer recurrence, late effects, and family members' risks. ©2015 American Association for Cancer Research.

  10. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... a link to this page included, e.g., “Understanding Cancer Prognosis was originally published by the National Cancer Institute.” Please note that blog posts that are written by individuals from outside the government may be owned by the writer, and graphics ...

  11. Brief considerations on why the writers of literature commit suicide?

    Directory of Open Access Journals (Sweden)

    Rafael Patrocinio Alarcón Velandia

    2015-12-01

    Full Text Available This article pursues the objective to initiate a debate on the concerns regarding the death of literature writers and their characters. Avoiding the temptation to impregnate the role of theoretical arguments on the various causes of suicide in a person, despite the presence of common factors, here it aims to recognize the existence of particular and specific reasons in each suicide. While countless treaties and literary works have been written on suicide, those follow religious, philosophical, socio-anthropological, economic, medical and psychiatric and genetic approaches. Thus, without claiming to exhaust the subject, rather than closing with concluding thoughts, some questions are formulated to continue the reflection on the phenomenon of suicide.

  12.  “The Writer at the Far Margin”

    Directory of Open Access Journals (Sweden)

    Paula Martín Salván

    2007-04-01

    Full Text Available This article analyzes Don DeLillo’s narrative in terms of the artistic ethics built into it in connection to the ongoing debate on whether postmodernist as a cultural movement is able to work as a tool for critique in capitalist societies. I will take Mao II (1991 as a representative example of the narrative pattern of a writer’s resistance to the established order, a stance that is continuous throughout DeLillo’s work. I will argue that the articulation of an artistic ethics within his novels replicates his often quoted statement that “the writer is the person who stands outside society, independent of affiliation and independent of influence.” Moreover, I will claim that the insistence with which this artistic ethics appears in DeLillo’s work can be related to the growing difficulties to classify it as postmodernist.

  13. So you want to be a science writer.

    Science.gov (United States)

    Fleischman, John; Szalinski, Christina

    2014-07-01

    The Internet destroyed the ecology of traditional science journalism, drying up ad revenues and pushing "old school" mass media toward extinction. But the new technology opened a wider landscape for digital science writers, online "content curators," and scientists to chronicle the wonders and worries of modern science. For those thinking of a career in science writing, here is a flash history, a quick overview, some advice, and a few cautions. © 2014 Fleischman and Szalinski. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  14. On the Correctness of Atomic Multi-Writer Registers

    Science.gov (United States)

    1988-06-07

    END; 4 END; FOR i .. 1 TO in DO w FORj 1: 1 TO mn DO Scan..VN~i,,1 VNji,j]; END; FOR, 1~ TO mDO Scan..OVN~i,,3:0 OVNIs ,,1; END; FOR~ :. 1 TO in DO Scan...OVNfj, k] = OVNI , k]w PVNj, k], = PVN[j,kju = PVN[j, kt = PVN, kw for all writers k as desired. 13 0 This result permits us to think of the values...OVN[,,?):- OVNI ,j); END; FOR I= 1 TO in DO Scan-PVN(.,jl :. PVN(i,ji; END; Scan..Volue[sj :- Valsu.(a]; -e END; - Same-Scans. 1; % REP EAT FOR I TO m DO

  15. The technical writer's handbook writing with style and clarity

    CERN Document Server

    Young, Matt

    2002-01-01

    "The Technical Writer's Handbook" is by a practising scientist who screens hundreds of manuscripts each year. It is directed at scientists, engineers and others who want to improve their writing and communication. It teaches that technical writing, although it has its own special requirements, is no different from ordinary writing and should be written with short, clear sentences and in the active voice. Divided into two parts, the first part is an introduction to technical and report writing and provides a sort of prescription for writing and organizing technical papers of all kinds. The second part is written in dictionary format and contains entries on grammar, style, and organization, as well as entries on topics such as common errors, resume writing, metric units, jargon, conference proceedings, figures, tables and slides. A comprehensive list of cross-references reveals related topics quickly and easily.

  16. LIMA BARRETO'S MARGINÁLIA: THE MAGAZINE WRITER'S DREAM

    Directory of Open Access Journals (Sweden)

    FELIPE BOTELHO CORRÊA

    Full Text Available This article analyses Lima Barreto's lifelong relationship with magazines not only as a contributor, but also as a founder, editor, and even collector of these ephemeral publications. His debut in 1902 as a writer for his college magazine, A Lanterna, and his death in 1922 while contributing to A.B.C. and Careta, can be considered symbolic events that epitomize the birth and death of a career wholeheartedly dedicated to this métier. A central argument is that it is highly significant that Barreto published his works in magazines more often than in newspapers. To him, magazines were stores of rhetorical weapons, artefacts that could confront the intellectual values established and concentrated in Rio de Janeiro.

  17. Jewish Writers in Contemporary Germany: The Dead Author Speaks

    Directory of Open Access Journals (Sweden)

    Sander L. Gilman

    1989-08-01

    Full Text Available The question I wish to address in this essay is really quite simple: Given the fact that there are "Jews" who seem to play a major role in contemporary German "Kultur" (at least that narrower definition of culture, meaning the production of cultural artifacts, such as books—a field which, at least for Englemann, was one of the certain indicators of a Jewish component in prewar German culture—what happened to these "Jews" (or at least the category of the "Jewish writer" in postwar discussions of culture? Or more simply: who lulled the remaining Jews in contemporary German culture and why? Why is it not possible to speak about "German-Jews" in the contemporary criticism about German culture? And, more to the point, what is the impact of this denial on those who (quite often ambivalently see (or have been forced to see themselves as "Germans" and "Jews," but not as both simultaneously.

  18. "Oh! Who Is Me"? Conceiving of the Writer in the English Teacher Identity

    Science.gov (United States)

    Frawley, Emily

    2015-01-01

    This paper considers the identity of the English teacher, paying particular attention to the English teacher who is also a writer, or, "teacher-writer". Applying a degree of self-study, the author examines her own pathway into becoming an English teacher, noting that entry requirements to become an English teacher in Australia show a…

  19. Argumentation Text Construction by Japanese as a Foreign Language Writers: A Dynamic View of Transfer

    Science.gov (United States)

    Rinnert, Carol; Kobauashi, Hiroe; Katayama, Akemi

    2015-01-01

    This study takes a dynamic view of transfer as reusing and reshaping previous knowledge in new writing contexts to investigate how novice Japanese as a foreign language (JFL) writers draw on knowledge across languages to construct L1 and L2 texts. We analyzed L1 English and L2 Japanese argumentation essays by the same JFL writers (N = 19) and L1…

  20. Citation Practices among Non-Native Expert and Novice Scientific Writers

    Science.gov (United States)

    Mansourizadeh, Kobra; Ahmad, Ummul K.

    2011-01-01

    Citation is one of the most prominent features of academic writing through which academic writers both exhibit the breadth of their scholarship in a specific research area and subtly demonstrate their memberships of the disciplinary community. Citations are important rhetorical devices that allow seasoned writers to promote their current research…

  1. Using codebooks of fragmented connected-component contours in forensic and historic writer identification

    NARCIS (Netherlands)

    Schomaker, L.R.B.; Franke, K.; Bulacu, M.L.

    2007-01-01

    Recent advances in 'off-line' writer identification allow for new applications in handwritten text retrieval from archives of scanned historical documents. This paper describes new algorithms for forensic or historical writer identification, using the contours of fragmented connected-components in

  2. Comparing L1 and L2 Texts and Writers in First-Year Composition

    Science.gov (United States)

    Eckstein, Grant; Ferris, Dana

    2018-01-01

    Scholars have at various points discussed the needs of second language (L2) writers enrolled in "mainstream" composition courses where they are mixed with native (L1) English speakers. Other researchers have investigated the experiences of L2 writers in mainstream classes and the perceptions of their instructors about their abilities and…

  3. The Accreditation of Hildegard Von Bingen as Medieval Female Technical Writer

    Science.gov (United States)

    Rauch, Susan

    2012-01-01

    Although scholars have acknowledged technical texts written during the Middle-Ages, there is no mention of "technical writer" as a profession except for Geoffrey Chaucer, and historically absent is the accreditation of medieval female writers who pioneered the field of medical-technical communication. In an era dominated by identifiable medieval…

  4. Professional writers and empathy: Exploring the barriers to anticipating reader problems

    NARCIS (Netherlands)

    de Jong, Menno D.T.; Lentz, Leo

    2007-01-01

    Research has shown that professional writers cannot accurately predict the problems readers will experience when using functional documents. In this paper, we give an overview of reasons why it can be so hardfor writers to anticipate reader problems. We elaborate on the concept of empathy, and

  5. Emotionality and Second Language Writers: Expressing Fear through Narrative in Thai and in English

    Science.gov (United States)

    Chamcharatsri, Pisarn Bee

    2013-01-01

    Writing to express emotions can be a challenging task for second language (L2) writers, especially because it tends to be a process that is less addressed in language classrooms. This paper aims to expand thinking on L2 literacy and writing by exploring how L2 writers can express emotion (fear) through narratives both in their first language (L1)…

  6. Good Intentions!: Ten Great Books Which Introduce Readers To a Famous Writer.

    Science.gov (United States)

    Van Deusen, Ann; Hepler, Susan

    2000-01-01

    Offers short descriptions of 10 books for children in which a famous writer appears as an essential character and a catalyst for the plot or content (while another character tells the story). Includes such famous writers as Benjamin Franklin, Emily Dickinson, and William Shakespeare. (SR)

  7. Introduction in Indonesian Social Sciences and Humanities Research Articles: How Indonesian Writers Justify Their Research Projects

    Science.gov (United States)

    Arsyad, Safnil; Wardhana, Dian Eka Chandra

    2014-01-01

    The introductory part of a research article (RA) is very important because in this section writers must argue about the importance of their research topic and project so that they can attract their readers' attention to read the whole article. This study analyzes RA introductions written by Indonesian writers in social sciences and humanities…

  8. "Spinning Themselves into Poetry": Images of Urban Adolescent Writers in Two Novels for Young Adults

    Science.gov (United States)

    Wissman, Kelly

    2009-01-01

    In contrast to the educational research and policy literature depicting urban adolescents as reluctant and struggling readers and writers, young people in recent young adult novels claim writing as an efficacious practice for self-discovery and social understanding. Analysis of the images of writers and writing in "Locomotion" and "Call Me Maria"…

  9. The negotiation of writer identity in engineering faculty - writing consultant collaborations

    Directory of Open Access Journals (Sweden)

    Sarah Read

    2011-12-01

    Full Text Available Negotiating faculty-writing consultant collaborations in engineering contexts can be challenging when the writing consultant originates in the humanities. The author found that one of the sites of negotiation in the formation of working relationships is that of writer identity, and disciplinary writer identity in particular. In order to confirm her experiential knowledge, the author interviewed her faculty collaborators to further investigate their attitudes and experiences about writing. Analysis of two excerpts of these interviews makes visible "clashes" between the faculty engineers' and the writing consultant's autobiographical and disciplinary writer identities. Implications of the role of writer identity in faculty-writing consultant collaborations include considering the value of extending this negotiation explicitly to students and the question of how writing curriculum can explicitly engage students in the formation of positive disciplinary writer identities

  10. Survivorship and complications of total hip arthroplasty in patients with dwarfism.

    Science.gov (United States)

    Modi, Ronuk M; Kheir, Michael M; Tan, Timothy L; Penny, Gregory S; Chen, Chi-Lung; Shao, Hongyi; Chen, Antonia F

    2017-09-19

    Total hip arthroplasty (THA) is a common procedure used to treat bony hip deformities and skeletal dysplasia in dwarfism. These surgeries are often more difficult than conventional THA as they may involve malformed joints and poor bone quality, and may require smaller prostheses. This study aims to investigate whether implant survivorship and revision rates vary among patients with and without dwarfism undergoing THA. A retrospective case-control study was performed for 102 THAs completed between 1997 and 2014 in patients under the height threshold of 147.32 cm. This cohort was matched 1:1.5 with patients of normal height with respect to age, gender, year of surgery, and Charlson comorbidities. All cases had a minimum follow-up of 1 year. A chart review was performed to identify patient and surgical characteristics, including outcomes. Radiographs were assessed for deformity, loosening, and periprosthetic fractures among other factors. The 2-, 5-, and 10-year survivorship of THA in patients with dwarfism was 92.9%, 92.9%, and 80.7%, respectively; and 94.4%, 86.4%, and 86.4% for controls, respectively (p = 0.95). The dwarfism cohort demonstrated an OR of 3.81 and 3.02 for revision for periprosthetic fractures (p = 0.11) and mechanical wear (p = 0.21), respectively. THA in patients with dwarfism achieves comparable results to a non-dwarfism population with regards to implant survivorship; however, there is a trend toward increased periprosthetic fractures and wear-related failures. Surgeons should be aware of this potentially higher risk in this population and take morphological differences into account during surgical planning and technique.

  11. Fragmentation in the branching coral Acropora palmata (Lamarck): growth, survivorship, and reproduction of colonies and fragments.

    Science.gov (United States)

    Lirman

    2000-08-23

    Acropora palmata, a branching coral abundant on shallow reef environments throughout the Caribbean, is susceptible to physical disturbance caused by storms. Accordingly, the survivorship and propagation of this species are tied to its capability to recover after fragmentation. Fragments of A. palmata comprised 40% of ramets within populations that had experienced recent storms. While the survivorship of A. palmata fragments was not directly related to the size of fragments, removal of fragments from areas where they settled was influenced by size. Survivorship of fragments was also affected by type of substratum; the greatest mortality (58% loss within the first month) was observed on sand, whereas fragments placed on top of live colonies of A. palmata fused to the underlying tissue and did not experience any losses. Fragments created by Hurricane Andrew on a Florida reef in August 1992 began developing new growth (proto-branches) 7 months after the storm. The number of proto-branches on fragments was dependent on size, but growth was not affected by the size of fragments. Growth-rates of proto-branches increased exponentially with time (1.7 cm year(-1) for 1993-1994, 2.7 cm year(-1) for 1994-1995, 4.2 cm year(-1) for 1995-1996, and 6.5 cm year(-1) for 1996-1997), taking over 4 years for proto-branches to achieve rates comparable to those of adult colonies on the same reef (6.9 cm year(-1)). In addition to the initial mortality and reduced growth-rates, fragmentation resulted in a loss of reproductive potential. Neither colonies that experienced severe fragmentation nor fragments contained gametes until 4 years after the initial damage. Although A. palmata may survive periodic fragmentation, the long-term effects of this process will depend ultimately on the balance between the benefits and costs of this process.

  12. The effect of vessel speed on the survivorship of biofouling organisms at different hull locations.

    Science.gov (United States)

    Coutts, Ashley D M; Piola, Richard F; Taylor, Michael D; Hewitt, Chad L; Gardner, Jonathan P A

    2010-07-01

    This study used a specially designed MAGPLATE system to quantify the en route survivorship and post-voyage recovery of biofouling assemblages subjected to short voyages (biofouling organisms amongst hull locations, biofouling cover and richness were markedly reduced on faster vessels relative to slower craft. Therefore, the potential inoculum size of non-indigenous marine species and richness is likely to be reduced for vessels that travel at faster speeds (> 14 knots), which is likely to also reduce the chances of successful introductions. Despite this, the magnitude of introductions from biofouling on fast vessels can be considered minor, especially for species richness where 90% of source-port species were recorded at destinations.

  13. Magazine Editors and the Writing Process: An Analysis of How Editors Work with Staff and Free-Lance Writers.

    Science.gov (United States)

    Schierhorn, Ann B.; Endres, Kathleen L.

    Editors of business and consumer magazines chosen by a random sample were asked in a mail survey what method they used in working with staff writers and free-lance writers. They were asked how they work with writers in the five stages of the writing process--idea, reporting, organizing, writing and rewriting. The first mailing to consumer…

  14. Sex-biased survivorship and differences in migration of wild steelhead (Oncorhynchus mykiss) smolts from two coastal Oregon rivers

    Science.gov (United States)

    Thompson, Neil F.; Leblanc, Camille A.; Romer, Jeremy D.; Schreck, Carl B.; Blouin, Michael S.; Noakes, David L. G.

    2016-01-01

    In salmonids with partial migration, females are more likely than males to undergo smoltification and migrate to the ocean (vs. maturing in freshwater). However, it is not known whether sex affects survivorship during smolt migration (from fresh water to entry into the ocean). We captured wild steelhead (Oncorhynchus mykiss) smolts in two coastal Oregon rivers (USA) and collected fin tissue samples for genetic sex determination (2009; N = 70 in the Alsea and N = 69 in the Nehalem, 2010; N = 25 in the Alsea). We implanted acoustic tags and monitored downstream migration and survival until entry in to the Pacific Ocean. Survival was defined as detection at an estuary/ocean transition array. We found no effect of sex on smolt survivorship in the Nehalem River in 2009, or in the Alsea River in 2010. However, males exhibited significantly lower survival than females in the Alsea River during 2009. Residency did not influence this result as an equal proportion of males and females did not reach the estuary entrance (11% of males, 9% of females). The sexes did not differ in timing or duration of migration, so those variables seem unlikely to explain sex-biased survivorship. Larger males had higher odds of survival than smaller males in 2009, but the body size of females did not affect survivorship. The difference in survivorship between years in the Alsea River could be due to flow conditions, which were higher in 2010 than in 2009. Our findings suggest that sex may affect steelhead smolt survival during migration, but that the difference in survivorship may be weak and not a strong factor influencing adult sex ratios.

  15. The 1965 Indonesian Killing Discourse by Generation 2000 Writers

    Directory of Open Access Journals (Sweden)

    Diah Ariani Arimbi

    2011-06-01

    Full Text Available The fall of Soeharto’s authority in 1998 has indeed impacted numerous sides of Indonesian life: political, social and cultural. The shifting of authoritative government to the state of “reformation” and “democratization” has forced the nation to redefine its authority to its members. This paper aims to look at these public responses which are narrated in contemporary Indonesian fiction. Although fiction may be seen as imaginative production, discursive ideologies can be examined clearly. By examining thematic significant of the narratives about G30S/PKI and the killings aftermath in the literary writings published in post 1998 by contemporary Indonesia writers, who are known as the Generation 2000 writers (who were mostly born in 1970s at least five years after the 1965 incident: also known as the millennials, this paper will attempt to answer whether or not this generation presents shift and creates its own notions of the incident. Abstrak: Jatuhnya kekuasaan Soeharto pada tahun 1998 berdampak pada berbagai sisi kehidupan di Indonesia: politik, sosial, dan budaya. Pergeseran dari pemerintahan yang dulunya otoritatif menjadi pemerintahan yang sarat dengan "reformasi" dan "demokratisasi" telah memaksa negara untuk mendefinisikan kembali wewenangnya kepada para anggotanya. Makalah ini bertujuan untuk melihat respons publik yang diceritakan dalam fiksi Indonesia kontemporer. Walaupun fiksi dapat dipandang sebagai produk imajinatif, ideologi diskursif dapat dilihat dengan je-las. Dengan memeriksa tema-tema yang secara signifikan dimunculkan dari narasi tentang G30S/PKI dan tragedi pembunuhan sesudahnya dalam tulisan-tulisan sastra yang diterbitkan pasca tahun 1998 oleh penulis Indonesia kontemporer, yang dikenal sebagai penulis Generasi 2000 (penulis yang kebanyakan lahir di tahun 1970-an setidaknya 5 tahun setelah 1965 kejadian: juga dikenal sebagai millenials, makalah ini berusaha menjawab apakah generasi baru mengalami pergeseran dalam

  16. Past and future challenges from a display mask writer perspective

    Science.gov (United States)

    Ekberg, Peter; von Sydow, Axel

    2012-06-01

    Since its breakthrough, the liquid crystal technology has continued to gain momentum and the LCD is today the dominating display type used in desktop monitors, television sets, mobile phones as well as other mobile devices. To improve production efficiency and enable larger screen sizes, the LCD industry has step by step increased the size of the mother glass used in the LCD manufacturing process. Initially the mother glass was only around 0.1 m2 large, but with each generation the size has increased and with generation 10 the area reaches close to 10 m2. The increase in mother glass size has in turn led to an increase in the size of the photomasks used - currently the largest masks are around 1.6 × 1.8 meters. A key mask performance criterion is the absence of "mura" - small systematic errors captured only by the very sensitive human eye. To eliminate such systematic errors, special techniques have been developed by Micronic Mydata. Some mura suppressing techniques are described in this paper. Today, the race towards larger glass sizes has come to a halt and a new race - towards higher resolution and better image quality - is ongoing. The display mask is therefore going through a change that resembles what the semiconductor mask went through some time ago: OPC features are introduced, CD requirements are increasing sharply and multi tone masks (MTMs) are widely used. Supporting this development, Micronic Mydata has introduced a number of compensation methods in the writer, such as Z-correction, CD map and distortion control. In addition, Micronic Mydata MMS15000, the world's most precise large area metrology tool, has played an important role in improving mask placement quality and is briefly described in this paper. Furthermore, proposed specifications and system architecture concept for a new generation mask writers - able to fulfill future image quality requirements - is presented in this paper. This new system would use an AOD/AOM writing engine and be

  17. Reactive oxygen species production and Brugia pahangi survivorship in Aedes polynesiensis with artificial Wolbachia infection types.

    Directory of Open Access Journals (Sweden)

    Elizabeth S Andrews

    Full Text Available Heterologous transinfection with the endosymbiotic bacterium Wolbachia has been shown previously to induce pathogen interference phenotypes in mosquito hosts. Here we examine an artificially infected strain of Aedes polynesiensis, the primary vector of Wuchereria bancrofti, which is the causative agent of Lymphatic filariasis (LF throughout much of the South Pacific. Embryonic microinjection was used to transfer the wAlbB infection from Aedes albopictus into an aposymbiotic strain of Ae. polynesiensis. The resulting strain (designated "MTB" experiences a stable artificial infection with high maternal inheritance. Reciprocal crosses of MTB with naturally infected wild-type Ae. polynesiensis demonstrate strong bidirectional incompatibility. Levels of reactive oxygen species (ROS in the MTB strain differ significantly relative to that of the wild-type, indicating an impaired ability to regulate oxidative stress. Following a challenge with Brugia pahangi, the number of filarial worms achieving the infective stage is significantly reduced in MTB as compared to the naturally infected and aposymbiotic strains. Survivorship of MTB differed significantly from that of the wild-type, with an interactive effect between survivorship and blood feeding. The results demonstrate a direct correlation between decreased ROS levels and decreased survival of adult female Aedes polynesiensis. The results are discussed in relation to the interaction of Wolbachia with ROS production and antioxidant expression, iron homeostasis and the insect immune system. We discuss the potential applied use of the MTB strain for impacting Ae. polynesiensis populations and strategies for reducing LF incidence in the South Pacific.

  18. Midterm Survivorship and Complications of Total Knee Arthroplasty in Patients With Dwarfism.

    Science.gov (United States)

    Tan, Timothy L; Kheir, Michael M; Modi, Ronuk; Chen, Chi-Lung; Shao, Hongyi; Chen, Antonia F

    2017-11-01

    Dwarfism is associated with skeletal dysplasias and joint deformities that frequently result in osteoarthritis requiring treatment with total knee arthroplasty (TKA). These surgeries can be challenging because of alignment deformities, poor bone stock, and smaller components. This study aims to compare TKA implant survivorship and complications between dwarf and nondwarf patients. A retrospective case-control study was performed from 1997-2014 evaluating 115 TKAs in patients under the height threshold of 147.32 cm. This cohort was compared with 164 patients of normal height. Medical records were reviewed for demographics, surgical characteristics, and outcomes. All cases had 2-year minimum follow-up. The revision rate was 8.7% in dwarfs compared with 3.7% in controls (P = .08). The 2-, 5-, and 10-year implant survivorship in dwarfs was 96.4%, 92.5%, and 90.2%, respectively; and 96.6%, 95.6%, and 94.8% for controls, respectively (P = .24). Dwarfs underwent significantly more manipulations for arthrofibrosis (P = .002). There was greater femoral (17.4% vs 2.1%, P manipulation; the increased propensity for stiffness may be associated with oversized components, as evidenced by greater component overhang. Surgeons should be aware of this increased risk and may consider using smaller or customized implants to account for the morphological differences in this patient population. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Elevated temperature affects development, survivorship, and settlement of the elkhorn coral, Acropora palmata (Lamarck 1816).

    Science.gov (United States)

    Randall, Carly J; Szmant, Alina M

    2009-12-01

    Elevated seawater temperatures during the late summer have the potential to negatively affect the development and survivorship of the larvae of reef corals that are reproductive during that time of year. Acropora palmata, a major Caribbean hermatype, reproduces annually during August and September. A. palmata populations have severely declined over the past three decades, and recovery will require high recruitment rates. Such recruitment will be limited if larval supply is reduced by elevated temperatures. The effects of elevated temperatures on development, survival, and larval settlement of A. palmata were investigated by culturing newly fertilized eggs at temperatures ranging from 27.5 to 31.5 degrees C. Development was accelerated and the percentage of developmental abnormalities increased at higher temperatures. Embryo mortality peaked during gastrulation, indicating that this complex developmental process is particularly sensitive to elevated temperatures. Larvae cultured at 30 and 31.5 degrees C experienced as much as an 8-fold decrease in survivorship compared to those at 28 degrees C. Additionally, settlement was 62% at 28 degrees C compared to 37% at 31.5 degrees C. These results indicate that embryos and larvae of A. palmata will be negatively affected as sea surface temperatures continue to warm, likely reducing recruitment and the recovery potential of A. palmata on Caribbean reefs.

  20. Elevated CO2 and O3 effects on fine-root survivorship in ponderosa pine mesocosms.

    Science.gov (United States)

    Phillips, Donald L; Johnson, Mark G; Tingey, David T; Storm, Marjorie J

    2009-07-01

    Atmospheric carbon dioxide (CO(2)) and ozone (O(3)) concentrations are rising, which may have opposing effects on tree C balance and allocation to fine roots. More information is needed on interactive CO(2) and O(3) effects on roots, particularly fine-root life span, a critical demographic parameter and determinant of soil C and N pools and cycling rates. We conducted a study in which ponderosa pine (Pinus ponderosa) seedlings were exposed to two levels of CO(2) and O(3) in sun-lit controlled-environment mesocosms for 3 years. Minirhizotrons were used to monitor individual fine roots in three soil horizons every 28 days. Proportional hazards regression was used to analyze effects of CO(2), O(3), diameter, depth, and season of root initiation on fine-root survivorship. More fine roots were produced in the elevated CO(2) treatment than in ambient CO(2). Elevated CO(2), increasing root diameter, and increasing root depth all significantly increased fine-root survivorship and median life span. Life span was slightly, but not significantly, lower in elevated O(3), and increased O(3) did not reduce the effect of elevated CO(2). Median life spans varied from 140 to 448 days depending on the season of root initiation. These results indicate the potential for elevated CO(2) to increase the number of fine roots and their residence time in the soil, which is also affected by root diameter, root depth, and phenology.

  1. Portrait of the Writer as a Traitor: the French Purge trials (1944-1953

    Directory of Open Access Journals (Sweden)

    Gisèle SAPIRO

    2006-10-01

    Full Text Available To use the term “treason” to describe the attitude of a writer might seem an oxymoron. After all, isn’t the writer the incarnation in the modern imagination of freedom and disinterestedness? Unattached, free from dogma and social constraints, he is assumed to obey only the dictates of his free subjectivity and his immediate inner convictions. In that condition, what cause could a writer betray? And if his positions are inconsistent, is that not the perfect proof of his freedom from all determ...

  2. Restaging Hysteria: Mary Wigman as Writer and Dancer

    Directory of Open Access Journals (Sweden)

    Laura A. McLary

    2003-06-01

    Full Text Available Mary Wigman was not only a leading proponent of the early twentieth-century Expressionist dance movement, but also a writer of poetry and short poetic prose. Despite her assertion that dance was beyond language, she wrote often about dance in an attempt to articulate the kinesthetic experience of dance through languages. This interdisciplinary study explores the intersection of dance and writing for Wigman, focusing on gender coding in writing and dance within the context of early twentieth-century dialogues. Despite the pervasive equation of (feminine hysteria with dance and (masculine subjectivity with authorship, Wigman engaged in both activities. I argue that Wigman is able to reclaim and redefine the "hysteria" of the dance experience through writing about dance. In her dance poetry, the act of looking at herself in a mirror as she dances allows Wigman to circumvent the traditional objectification through the male gaze experienced by the female dancer. Through the act of writing, Wigman asserts her subjectivity, taking control of the out-of-body experience of dance creation.

  3. From Reader to Writer: Citizen Journalism as News Produsage

    Science.gov (United States)

    Bruns, Axel

    Today, participatory or citizen journalism - journalism which enables readers to become writers - exists online and offline in a variety of forms and formats, operates under a number of editorial schemes, and focuses on a wide range of topics from the specialist to the generic and the micro-local to the global. Key models in this phenomenon include veteran sites Slashdot and Indymedia, as well as news-related weblogs; more recent additions into the mix have been the South Korean OhmyNews, which in 2003 was “the most influential online news site in that country, attracting an estimated 2 million readers a day” (Gillmor, 2003a, p. 7), with its new Japanese and international offshoots, as well as the Wikipedia with its highly up-to-date news and current events section and its more recent offshoot Wikinews, and even citizen-produced video news as it is found in sites such as YouTube and Current.tv.

  4. Social Criticism on Works of Contemporary Women Story Writers

    Directory of Open Access Journals (Sweden)

    Masoomeh Mahmoodi

    2017-08-01

    Full Text Available Goldmann's genetic structuralism approach is one of the literary critique approaches and believes that the literary text are derived from the ideology governing the classes of society, and focuses on study of stories and their structures to know the social structures. A review of the changes made in the themes and subjects of the works of the Iranian story writers that most of them are from the middle class of society, indicates the growth of awareness and understanding of Iranian women about their identity and individuality and the achievement of conditions beyond what they are. Although in popular stories, most Iranian female storytellers are still interested in the reproduction of traditional gender stereotypes, but female storywriters in the field of transcendental literature have entered the changes made in their cognitive realm to the actions of characters of their stories. This reveals that they seek to understand their own self and place in the world around them. Love and loneliness resulted by the confrontation between men and women are a common theme in these works that have been narrated on the various issues arising from the family and social relationships of women.

  5. Co-creation of an ICT-supported cancer rehabilitation program for lung cancer survivors

    NARCIS (Netherlands)

    Timmerman, Josien; Tönis, Thijs; Stuiver, M.M.; van Weering, Marit; Wouters, M.W.J.M.; Hermens, Hermanus J.; Vollenbroek-Hutten, Miriam Marie Rosé

    Background: Lung cancer (LC) patients experience high symptom burden and significant decline of physical fitness and Quality of Life following lung resection. Good quality of survivorship care post-surgery is essential to optimize recovery and prevent unscheduled healthcare use. The use of

  6. Excerpt from The Red Land to the South: American Indian Writers and Indigenous Mexico

    Directory of Open Access Journals (Sweden)

    James H. Cox

    2013-09-01

    Full Text Available Excerpted from James H. Cox, The Red Land to the South: American Indian Writers and Indigenous Mexico (Minneapolis: University of Minnesota Press, 2012.Reprinted with permission from University of Minnesota Press.

  7. Supervivencia al cáncer de pulmón (Lung Cancer Survivorship)

    Centers for Disease Control (CDC) Podcasts

    2016-10-20

    Una sobreviviente de cáncer comparte su historia sobre el diagnóstico, el tratamiento y el apoyo de su comunidad; ella también les da consejos a otros sobrevivientes de cáncer.  Created: 10/20/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/15/2017.

  8. Skin Cancer Surveillance Behaviors Among Childhood Cancer Survivors.

    Science.gov (United States)

    Stapleton, Jerod L; Tatum, Kristina L; Devine, Katie A; Stephens, Sue; Masterson, Margaret; Baig, Amna; Hudson, Shawna V; Coups, Elliot J

    2016-03-01

    The risk of developing skin cancer is elevated among childhood cancer survivors (CCS), particularly among those treated with radiation. This survey study examined the skin cancer surveillance behaviors of 94 CCS. Approximately 48% of CCS had ever conducted skin self-examination (SSE) and 31% had ever received a physician skin examination. Rates of physician skin examination were 2.5 times higher among CCS treated with radiation compared to those without radiation. However, rates of SSEs did not differ based on treatment history. These findings highlight the need to promote skin cancer surveillance as an important aspect of CCS survivorship care. © 2015 Wiley Periodicals, Inc.

  9. Survivorship and longevity of adult Diamesa mendotae Muttkowski, 1915 (Diptera: Chironomidae) at controlled, sub-freezing temperatures

    Science.gov (United States)

    Mazack, Jane E.; Kranzfelder, Petra; Anderson, Alyssa M.; Bouchard, William; Perry, James; Vondracek, Bruce C.; Ferrington, Leonard C.

    2014-01-01

    Diamesa mendotae Muttkowski, 1915 is a winter-active species common in groundwater-buffered streams of Minnesota and Wisconsin. This species is capable of surviving under snow cover for at least 28 days. Field collections of adult D. mendotae were used to determine survivorship under long-term exposure to controlled sub-freezing conditions. Specimens were placed into a controlled temperature chamber at −5 °C, batches removed at weekly intervals, and subsequently held at 6 °C to determine survivorship and longevity. Our results indicate that overall survivorship is negatively related to treatment duration of sub-freezing treatment, individuals can survive sub-freezing temperatures for at least 70 days, with total longevity of 92 days. Additionally, males had a significantly higher rate of survivorship than females within treatments. Total longevity increased with treatment time, suggesting adult D. mendotae may survive long periods of below-freezing temperatures under natural conditions before mating, which may convey population-level advantages.

  10. Factors influencing implementation of a Survivorship Care Plan : A quantitative process evaluation of the ROGY Care Trial

    NARCIS (Netherlands)

    de Rooij, B.H.; Ezendam, N.P.M.; Nicolaije, K.A.H.; Vos, M.C.; Pijnenborg, J.M.A.; Boll, Dorry; Kruitwagen, R.F.P.M.; van de Poll-Franse, L.V.

    2017-01-01

    Purpose The aim of this study is to investigate the factors that influence implementation of Survivorship Care Plans (SCPs) in the intervention arm of the ROGY Care trial by (1) assessing the level of SCP receipt in the ROGY Care trial and (2) identifying patient- and provider-level factors that

  11. Group size effects on survivorship and adult development in the gregarious larvae of Euselasia chrysippe (Lepidoptera, Riodinidae)

    Science.gov (United States)

    P. E. Allen

    2010-01-01

    Caterpillars living in aggregations may derive several benefits that outweigh the costs, including better survivorship and improved growth rates. I tested whether larval group size had an effect on these two vital rates in Euselasia chrysippe. These caterpillars feed gregariously during all instars and move in processionary form over the host plant...

  12. A unified degree day model describes survivorship of Copitarsia corruda Pogue & Simmons (Lepidoptera: Noctuidae) at different constant temperatures

    Science.gov (United States)

    N.N. G& #243; mez; R.C. Venette; J.R. Gould; D.F. Winograd

    2009-01-01

    Predictions of survivorship are critical to quantify the probability of establishment by an alien invasive species, but survival curves rarely distinguish between the effects of temperature on development versus senescence. We report chronological and physiological age-based survival curves for a potentially invasive noctuid, recently described as Copitarsia...

  13. Development and Survivorship of Scirtothrips dorsalis Hood (Thysanoptera: Thripidae in Different Growth Stages of Mango and Selected Weeds

    Directory of Open Access Journals (Sweden)

    Affandi

    2018-02-01

    Full Text Available The research objective was to quantify the development and survivorship rate of S. dorsalis in different phenological stages of mango and selected weeds. The research was conducted in the laboratory of PT. Trigatra Rajasa, Mango plantation in Ketowan, Arjasa, Situbondo, East Java, Indonesia from February to September 2015. The development and survivorship rate were done through observation of life span of S. dorsalis from egg to pupa. Analysis of Variance and Duncan Multiple Range Test (p = 0.05 with 5 replications were applied to ensure the significant differences among the treatments. The result showed that development and survivorship of Scirtothrips dorsalis were supported by mango flushes and flower as well as some weeds such as Leucania leucochepala, Ipomoea triloba, Achalypha indica, Desmanthus leptophyllus and Azadirachta indica as source of food. Achalypha indica was the most suitable host with development time (12.82 ± 0.21 days and survivorship (33 %. Weed Tridax procumbent, Momordica charantia and Mimosa pudica were unable to provide the living requirement for immature developmental stage of S. dorsalis.

  14. Supplemental diets containing yeast, sucrose, and soy powder enhance the survivorship, growth, and development of prey-limited cursorial spiders

    Science.gov (United States)

    We examined the effects of a food spray mixture (‘wheast’) and its individual ingredients (sucrose, yeast, and toasted soy flour) on the survivorship, growth, and development of a cursorial spider, Hibana futilis Banks (Anyphaenidae). Some treatments included eggs of Helicoverpa zea, a favored prey...

  15. Combining Multiple Features for Text-Independent Writer Identification and Verification

    OpenAIRE

    Bulacu , Marius; Schomaker , Lambert

    2006-01-01

    http://www.suvisoft.com; In recent years, we proposed a number of new and very effective features for automatic writer identification and verification. They are probability distribution functions (PDFs) extracted from the handwriting images and characterize writer individuality independently of the textual content of the written samples. In this paper, we perform an extensive analysis of feature combinations. In our fusion scheme, the final unique distance between two handwritten samples is c...

  16. WRITER'S STRATEGIES IN THE INTERCOURSE WITH THE READER IN BELLES-LETTRES

    Directory of Open Access Journals (Sweden)

    Alexander S. Komarov

    2014-01-01

    Full Text Available The article is devoted to some strategies aimed at involving the reader into the writer's book by means of making the reader's attitude to its content personal or subjective. In the article it is stated that there are two components which are intrinsic to virtual intercourse between writer and reader. One of the components is the content of the writer's publication while the other is the reader's attitude towards the content suggested. The article shows that the reader's attitude encompasses two processes: the process of self-estrangement from the writer's content and the process of self-involvement into it. In the article, the author analyses these two processes in relation to the content of the book. In the article, the author singles out and gives descriptions of such dimensions of the book's content as its topical and emotional dimension, its depth, human nature dimension and interpersonal relations dimension as well as of strategies used by the writer in order to involve the reader into his writings. The author argues that a successful strategy is based on managing to touch the reader to the quick, i.e. his or her subjectivity, and the result of successfulness can be measured by the reader's readiness and willingness to sink into one of the dimensions suggested. The author of the article comes to the conclusion that signs of the successful strategy can be traced in the reader's return to the intercourse with the writer when he or she rereads the writer's books, repeats or makes references to words, situations or ideas suggested or described by the writer who has grasped the reader's attention in one or several content dimensions.

  17. Model-based MPC enables curvilinear ILT using either VSB or multi-beam mask writers

    Science.gov (United States)

    Pang, Linyong; Takatsukasa, Yutetsu; Hara, Daisuke; Pomerantsev, Michael; Su, Bo; Fujimura, Aki

    2017-07-01

    Inverse Lithography Technology (ILT) is becoming the choice for Optical Proximity Correction (OPC) of advanced technology nodes in IC design and production. Multi-beam mask writers promise significant mask writing time reduction for complex ILT style masks. Before multi-beam mask writers become the main stream working tools in mask production, VSB writers will continue to be the tool of choice to write both curvilinear ILT and Manhattanized ILT masks. To enable VSB mask writers for complex ILT style masks, model-based mask process correction (MB-MPC) is required to do the following: 1). Make reasonable corrections for complex edges for those features that exhibit relatively large deviations from both curvilinear ILT and Manhattanized ILT designs. 2). Control and manage both Edge Placement Errors (EPE) and shot count. 3. Assist in easing the migration to future multi-beam mask writer and serve as an effective backup solution during the transition. In this paper, a solution meeting all those requirements, MB-MPC with GPU acceleration, will be presented. One model calibration per process allows accurate correction regardless of the target mask writer.

  18. Using perturbed handwriting to support writer identification in the presence of severe data constraints

    Science.gov (United States)

    Chen, Jin; Cheng, Wen; Lopresti, Daniel

    2011-01-01

    Since real data is time-consuming and expensive to collect and label, researchers have proposed approaches using synthetic variations for the tasks of signature verification, speaker authentication, handwriting recognition, keyword spotting, etc. However, the limitation of real data is particularly critical in the field of writer identification in that in forensics, adversaries cannot be expected to provide sufficient data to train a classifier. Therefore, it is unrealistic to always assume sufficient real data to train classifiers extensively for writer identification. In addition, this field differs from many others in that we strive to preserve as much inter-writer variations, but model-perturbed handwriting might break such discriminability among writers. Building on work described in another paper where human subjects were involved in calibrating realistic-looking transformation, we then measured the effects of incorporating perturbed handwriting into the training dataset. Experimental results justified our hypothesis that with limited real data, model-perturbed handwriting improved the performance of writer identification. Particularly, if only one single sample for each writer was available, incorporating perturbed data achieved a 36x performance gain.

  19. The effect of structural complexity, prey density, and "predator-free space" on prey survivorship at created oyster reef mesocosms

    Science.gov (United States)

    Humphries, Austin T.; La Peyre, Megan K.; Decossas, Gary A.

    2011-01-01

    Interactions between predators and their prey are influenced by the habitat they occupy. Using created oyster (Crassostrea virginica) reef mesocosms, we conducted a series of laboratory experiments that created structure and manipulated complexity as well as prey density and “predator-free space” to examine the relationship between structural complexity and prey survivorship. Specifically, volume and spatial arrangement of oysters as well as prey density were manipulated, and the survivorship of prey (grass shrimp, Palaemonetes pugio) in the presence of a predator (wild red drum, Sciaenops ocellatus) was quantified. We found that the presence of structure increased prey survivorship, and that increasing complexity of this structure further increased survivorship, but only to a point. This agrees with the theory that structural complexity may influence predator-prey dynamics, but that a threshold exists with diminishing returns. These results held true even when prey density was scaled to structural complexity, or the amount of “predator-free space” was manipulated within our created reef mesocosms. The presence of structure and its complexity (oyster shell volume) were more important in facilitating prey survivorship than perceived refugia or density-dependent prey effects. A more accurate indicator of refugia might require “predator-free space” measures that also account for the available area within the structure itself (i.e., volume) and not just on the surface of a structure. Creating experiments that better mimic natural conditions and test a wider range of “predator-free space” are suggested to better understand the role of structural complexity in oyster reefs and other complex habitats.

  20. Validation of the German version of the late adolescence and young adulthood survivorship-related quality of life measure (LAYA-SRQL).

    Science.gov (United States)

    Richter, Diana; Mehnert, Anja; Schepper, Florian; Leuteritz, Katja; Park, Crystal; Ernst, Jochen

    2018-01-04

    Cancer has adverse effects on patient's quality of life. As such, measuring quality of life (QoL) has become an integral part of psycho-oncological health care. Because adolescent and young adult patients have different needs in contrast to children and older cancer patients, instruments for adequately measuring QoL of cancer survivors in this age range are essential. As there is not a corresponding instrument in Germany, we aimed to validate the German version of the Late Adolescence and Young Adulthood Survivorship-Related Quality of Life Measure (LAYA-SRQL), a 30-item questionnaire covering 10 dimensions related to QoL. The LAYA-SRQL was translated into German following state-of-the-art criteria. We enrolled 234 adolescent and young adult (AYA) cancer patients with different tumour entities aged between 16 and 39 years old. Factorial structure was tested using confirmatory factor analysis. Internal consistency was determined by Cronbach's α. The Short Form Survey quality of life questionnaire (SF-12v2) was used to examine convergent validity. The 10-factor structure of the LAYA-SRQL was confirmed in the German sample, and the model shows high values of fit indicators: χ 2  = 723.32 (df = 360, p  0.70 and total Cronbach's α of 0.93. Convergent validity was demonstrated by high positive correlations between the LAYA-SRQL and the physical (r = 0.45) and mental component (r = 0.65) of the SF-12v2. The German version of the LAYA-SRQL showed good psychometric properties. The instrument proved to be a highly reliable and valid instrument that can be recommended for use in the follow-up care of AYAs and for clinical research.

  1. Fatigue and quality of life in breast cancer survivors: temporal courses and long-term pattern

    NARCIS (Netherlands)

    Schmidt, M.E.; Chang-Claude, J.; Vrieling, A.; Heinz, J.; Flesch-Janys, D.; Steindorf, K.

    2012-01-01

    INTRODUCTION: Fatigue is a frequent problem during and after cancer treatment. We investigated different courses of fatigue from pre-diagnosis, through therapy, to long-term survivorship and evaluated potential implications on long-term quality of life (QoL). METHODS: Breast cancer patients

  2. Psychometric Evaluation of an Adolescent and Young Adult Module of the Impact of Cancer Instrument

    NARCIS (Netherlands)

    Husson, O.; Zebrack, B.J.

    2017-01-01

    PURPOSE: To develop and evaluate a new instrument that measures unique aspects of long-term survivorship for people diagnosed with cancer as Adolescent and Young Adult (AYA), not measured by existing tools. METHODS: A new candidate instrument-the Impact of Cancer for Adolescent and Young Adult

  3. The psychosocial needs of lesbian, gay, bisexual, or transgender patients with cancer.

    Science.gov (United States)

    Margolies, Liz

    2014-08-01

    Because of discrimination and secrecy, lesbian, gay, bisexual, and transgender (LGBT) people have poorer health outcomes, which include an increased risk for certain cancers and additional challenges in cancer treatment and survivorship. The oncology nurse also should be aware of issues of LGBT sexuality and the impact that oncology treatment may have on the LGBT patient's immediate and long-term sexual functioning.

  4. Next-Generation Entrepreneurs Ready to Advance Breast Cancer Research Innovations | Poster

    Science.gov (United States)

    By Michele Newton and Thomas Stackhouse, Contributing Writers, and Rosemarie Truman, Guest Writer Editor’s note: In May 2014, the Breast Cancer Start-Up Challenge was named one of six finalists in the HHS Innovates Award Competition. This award celebrates innovations developed by employees of the U.S. Department of Health and Human Services (HHS) to support the mission of HHS.

  5. Text-independent writer identification and verification using textural and allographic features.

    Science.gov (United States)

    Bulacu, Marius; Schomaker, Lambert

    2007-04-01

    The identification of a person on the basis of scanned images of handwriting is a useful biometric modality with application in forensic and historic document analysis and constitutes an exemplary study area within the research field of behavioral biometrics. We developed new and very effective techniques for automatic writer identification and verification that use probability distribution functions (PDFs) extracted from the handwriting images to characterize writer individuality. A defining property of our methods is that they are designed to be independent of the textual content of the handwritten samples. Our methods operate at two levels of analysis: the texture level and the character-shape (allograph) level. At the texture level, we use contour-based joint directional PDFs that encode orientation and curvature information to give an intimate characterization of individual handwriting style. In our analysis at the allograph level, the writer is considered to be characterized by a stochastic pattern generator of ink-trace fragments, or graphemes. The PDF of these simple shapes in a given handwriting sample is characteristic for the writer and is computed using a common shape codebook obtained by grapheme clustering. Combining multiple features (directional, grapheme, and run-length PDFs) yields increased writer identification and verification performance. The proposed methods are applicable to free-style handwriting (both cursive and isolated) and have practical feasibility, under the assumption that a few text lines of handwritten material are available in order to obtain reliable probability estimates.

  6. Co-creation of an ICT-supported cancer rehabilitation application for resected lung cancer survivors: design and evaluation

    NARCIS (Netherlands)

    Timmerman, Josien; Tönis, Thijs; van Weering, Marit; Stuiver, Martijn M.; Wouters, Michel W.J.M.; van Harten, Willem H.; Hermens, Hermanus J.; Vollenbroek-Hutten, Miriam Marie Rosé

    2016-01-01

    Background Lung cancer (LC) patients experience high symptom burden and significant decline of physical fitness and quality of life following lung resection. Good quality of survivorship care post-surgery is essential to optimize recovery and prevent unscheduled healthcare use. The use of

  7. Co-creation of an ICT-supported cancer rehabilitation application for resected lung cancer survivors: design and evaluation

    NARCIS (Netherlands)

    Timmerman, Josien G.; Tönis, Thijs M.; Dekker-van Weering, Marit G. H.; Stuiver, Martijn M.; Wouters, Michel W. J. M.; van Harten, Wim H.; Hermens, Hermie J.; Vollenbroek-Hutten, Miriam M. R.

    2016-01-01

    Lung cancer (LC) patients experience high symptom burden and significant decline of physical fitness and quality of life following lung resection. Good quality of survivorship care post-surgery is essential to optimize recovery and prevent unscheduled healthcare use. The use of Information and

  8. In their own words: A qualitative study of the psychosocial concerns of posttreatment and long-term lung cancer survivors

    OpenAIRE

    Rohan, Elizabeth A.; Boehm, Jennifer; Allen, Kristine Gabuten; Poehlman, Jon

    2016-01-01

    Although lung cancer is the deadliest type of cancer, survival rates are improving. To address the dearth of literature about the concerns of lung cancer survivors, the authors conducted 21 in-depth interviews with lung cancer survivors that focused on experiences during diagnosis, treatment, and long-term survivorship. Emergent themes included feeling blamed for having caused their cancer, being stigmatized as throwaways, and long-term survivors? experiencing surprise that they are still ali...

  9. MRI guided stereotactic ventrointermediate thalamotomy for writer's cramp: two cases report and literature review

    Directory of Open Access Journals (Sweden)

    Chao-shi NIU

    2015-10-01

    Full Text Available Objective To explore the methods and curative effect of stereotactic surgery for treating writer's cramp (WC. Methods and Results Two patients with writer's cramp (tremor type underwent MRI guided stereotactic ventrointermediate (Vim thalamotomy on the left side. The symptoms of one patient disappeared immediately after operation, and the patient could write legibly. The tremor of right upper extremity in another patient was improved significantly. Two patients did not present obvious complications, and the previous symptoms were not found to recur during follow-up period respectively. Conclusions Stereotactic surgery for treatment of writer's cramp has definite therapeutic effect. MRI guided stereotactic technique can effectively avoid the complications of Vim thalamotomy. However, the indications of two methods in surgical treatment [thalamotomy and deep brain stimulation (DBS] and the respective merits still need further study. DOI: 10.3969/j.issn.1672-6731.2015.10.009

  10. The grant writer's handbook how to write a research proposal and succeed

    CERN Document Server

    Crawley, Gerard M

    2016-01-01

    The Grant Writer's Handbook: How to Write a Research Proposal and Succeed provides useful and practical advice on all aspects of proposal writing, including developing proposal ideas, drafting the proposal, dealing with referees, and budgeting. The authors base their advice on many years of experience writing and reviewing proposals in many different countries at various levels of scientific maturity. The book describes the numerous kinds of awards available from funding agencies, in particular large collaborative grants involving a number of investigators, and addresses the practical impact of a grant, which is often required of proposals. In addition, information is provided about selection of reviewers and the mechanics of organizing a research grant competition to give the proposal writer the necessary background information. The book includes key comments from a number of experts and is essential reading for anyone writing a research grant proposal.The Grant Writer's Handbook's companion website, featuri...

  11. Trapped in the genres – a student’s writer development in the subject of Danish

    DEFF Research Database (Denmark)

    Piekut, Anke

    2018-01-01

    on the one hand narrative is a resource for writer development and disciplinary knowledge and on the other hand becomes part of the student’s writer identity and identification with an exploratory student position. The empirical data consists of interviews and assignments, collected through the student’s 3......Since the reform of Upper Secondary School in 2005 in Denmark, genre writing has been mandatory in the L1 subject. In the predefined genres, argumentative reasoning, textual analysis and disciplinary knowledge are given high priority, whereas creative or narrative reasoning and writing are not part...... of the curriculum. In this article, the writer development of a student participant will be investigated, focusing on how narrative nonetheless becomes present in his assignments and how he negotiates the predefined genres he is supposed to write in the L1 subject. The main focus of this study is to explore how...

  12. Mid-term survivorship and clinical outcomes of cobalt-chrome and oxidized zirconium on highly crosslinked polyethylene.

    Science.gov (United States)

    Petis, Stephen M; Vasarhelyi, Edward M; Lanting, Brent A; Howard, James L; Naudie, Douglas D R; Somerville, Lyndsay E; McCalden, Richard W

    2016-02-01

    The choice of bearing articulation for total hip arthroplasty in younger patients is amenable to debate. We compared mid-term patient-reported outcomes and survivorship across 2 different bearing articulations in a young patient cohort. We reviewed patients with cobalt-chrome or oxidized zirconium on highly crosslinked polyethylene who were followed prospectively between 2004 and 2012. Kaplan-Meier analysis was used to determine predicted cumulative survivorship at 5 years with all-cause and aseptic revisions as the outcome. We compared patient-reported outcomes, including the Harris hip score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short-form 12 (SF-12) scores. A total of 622 patients were followed during the study period. Mean follow-up was 8.2 (range 2.0-10.6) years for cobalt-chrome and 7.8 (range 2.1-10.7) years for oxidized zirconium. Mean age was 54.9 ± 10.6 years for cobalt-chrome and 54.8 ± 10.7 years for oxidized zirconium. Implant survivorship was 96.0% (95% confidence interval [CI] 94.9%-97.1%) for cobalt-chrome and 98.7% (95% CI 98.0%-99.4%) for oxidized zirconium on highly crosslinked polyethylene for all-cause revisions, and 97.2% (95% CI 96.2%-98.2%) for cobalt-chrome and 99.0% (95% CI 98.4%-99.6%) for oxidized zirconium for aseptic revisions. An age-, sex- and diagnosis-matched comparison of the HHS, WOMAC and SF-12 scores demonstrated no significant changes in clinical outcomes across the groups. Both bearing surface couples demonstrated excellent mid-term survivorship and outcomes in young patient cohorts. Future analyses on wear and costs are warranted to elicit differences between the groups at long-term follow-up.

  13. PSYCHOSOCIAL INTERVENTION EFFECTS ON ADAPTATION, DISEASE COURSE AND BIOBEHAVIORAL PROCESSES IN CANCER

    OpenAIRE

    Antoni, Michael H.

    2012-01-01

    A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation ...

  14. The Internet as a source of health information: experiences of cancer survivors and caregivers with healthcare providers.

    Science.gov (United States)

    Dolce, Maria C

    2011-05-01

    To describe the experiences of cancer survivors and caregivers with healthcare providers in the context of the Internet as a source of health information. Qualitative description. Online cancer communities hosted by the Association of Cancer Online Resources. Purposive sample of 488 cancer survivors, with varying cancer types and survivorship stages, and caregivers. Secondary data analysis using Krippendorff's thematic clustering technique of qualitative content analysis. Survivorship, healthcare relationships, and the Internet. Disenchantment with healthcare relationships was associated with failed expectations related to evidence-based practice, clinical expertise, informational support, and therapeutic interpersonal communication. Survivors and caregivers exercised power in healthcare relationships through collaboration, direct confrontation, becoming expert, and endorsement to influence and control care decisions. Disenchantment propelled cancer survivors and caregivers to search the Internet for health information and resources. Conversely, Internet information-seeking precipitated the experience of disenchantment. Through online health information and resources, concealed failures in healthcare relationships were revealed and cancer survivors and caregivers were empowered to influence and control care decisions. The findings highlight failures in cancer survivorship care and underscore the importance of novel interdisciplinary programs and models of care that support evidence-informed decision making, self-management, and improved quality of life. Healthcare professionals need to receive education on survivors' use of the Internet as a source of health information and its impact on healthcare relationships. Future research should include studies examining the relationship between disenchantment and survivorship outcomes.

  15. Distribution, survivorship and mortality sources in immature stages of the neotropical leaf miner Pachyschelus coeruleipennis Kerremans (Coleoptera: Buprestidae

    Directory of Open Access Journals (Sweden)

    QUEIROZ J. M.

    2002-01-01

    Full Text Available Distribution, sources of mortality, and survivorship of immatures was investigated during the reproductive season of the neotropical buprestid leaf miner, Pachyschelus coeruleipennis, that burrows in leaves of Croton floribundus (Euphorbiaceae in SE, Brazil. Immature distribution was investigated by a random sample of 120 shrubs of C. floribundus growing along forest edges. Marked leaves were followed to recorded sources of mortality and survivorship of immature stages. Females lay their eggs preferentially in the young leaves of the host plant, with mines and pupal cells having been found on the middle part of plants. Densities of eggs, active mines, and pupal cells were, respectively, 25 ± 2, 6 ± 1, and 1 ± 0.3 per 100 leaves. Predators and parasitoids accounted for the majority of losses in the immature P. coeruleipennis population. Mortality was 3 times lower in the egg stage than in the last larval instar. Predation rate was greater than parasitism but the latter increased much more during the development of immatures. Survivorship and sources of mortality were different between early and late season sample of leaf-miner immatures. Parasitism rate was greater in the late-season whereas predation was greater in early-season samples. These results are compared with mortality patterns described for other buprestid leaf miners in temperate and tropical regions.

  16. Native legume transplant survivorship and subsequent seedling recruitment on unamended coal mine soils in the Canadian Rocky Mountains

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, C.R.

    1997-05-01

    Transplant survivorship, growth, and reproductive performance of several indigenous high-elevation legume species grown in unamended spoil were studied at three coal mines in the Canadian Rocky Mountains. Survivorship varied with species but was highest for Astragalus aboriginum (62%), Astragalus alpinus (73-57%), Astragalus vexilliflexus var. nubilus (73-63%), and Oxytropis sericea (77-62%). Mortality was greatest during the first two years for most species. The causes of transplant mortality are considered to be drought stress, deep-seated `frost-popping`/root exposure, and damage, for example, root exposure and destruction of meristematic tissues by foraging mammals such as bighorn sheep, mountain goats, grizzly bears, and marmots. Survivorship, growth, and reproductive activity were greatest at the two subalpine disturbances. Growth varied with species, but the greatest growth increments (height and diameter) were recorded during the first and second years. Reproductive activity for the Astragalus species began during the first year at one location but, in general, flowering and seed set did not begin until the second or third years. Recruitment from seed was small ({lt} 10/year). Several of these species appear to be suitable for revegetation of subalpine and alpine surface mine disturbances.

  17. Genotype and local environment dynamically influence growth, disturbance response and survivorship in the threatened coral, Acropora cervicornis.

    Science.gov (United States)

    Drury, Crawford; Manzello, Derek; Lirman, Diego

    2017-01-01

    The relationship between the coral genotype and the environment is an important area of research in degraded coral reef ecosystems. We used a reciprocal outplanting experiment with 930 corals representing ten genotypes on each of eight reefs to investigate the influence of genotype and the environment on growth and survivorship in the threatened Caribbean staghorn coral, Acropora cervicornis. Coral genotype and site were strong drivers of coral growth and individual genotypes exhibited flexible, non-conserved reaction norms, complemented by ten-fold differences in growth between specific G-E combinations. Growth plasticity may diminish the influence of local adaptation, where foreign corals grew faster than native corals at their home sites. Novel combinations of environment and genotype also significantly affected disturbance response during and after the 2015 bleaching event, where these factors acted synergistically to drive variation in bleaching and recovery. Importantly, small differences in temperature stress elicit variable patterns of survivorship based on genotype and illustrate the importance of novel combinations of coral genetics and small differences between sites representing habitat refugia. In this context, acclimatization and flexibility is especially important given the long lifespan of corals coping with complex environmental change. The combined influence of site and genotype creates short-term differences in growth and survivorship, contributing to the standing genetic variation needed for adaptation to occur over longer timescales and the recovery of degraded reefs through natural mechanisms.

  18. Genotype and local environment dynamically influence growth, disturbance response and survivorship in the threatened coral, Acropora cervicornis.

    Directory of Open Access Journals (Sweden)

    Crawford Drury

    Full Text Available The relationship between the coral genotype and the environment is an important area of research in degraded coral reef ecosystems. We used a reciprocal outplanting experiment with 930 corals representing ten genotypes on each of eight reefs to investigate the influence of genotype and the environment on growth and survivorship in the threatened Caribbean staghorn coral, Acropora cervicornis. Coral genotype and site were strong drivers of coral growth and individual genotypes exhibited flexible, non-conserved reaction norms, complemented by ten-fold differences in growth between specific G-E combinations. Growth plasticity may diminish the influence of local adaptation, where foreign corals grew faster than native corals at their home sites. Novel combinations of environment and genotype also significantly affected disturbance response during and after the 2015 bleaching event, where these factors acted synergistically to drive variation in bleaching and recovery. Importantly, small differences in temperature stress elicit variable patterns of survivorship based on genotype and illustrate the importance of novel combinations of coral genetics and small differences between sites representing habitat refugia. In this context, acclimatization and flexibility is especially important given the long lifespan of corals coping with complex environmental change. The combined influence of site and genotype creates short-term differences in growth and survivorship, contributing to the standing genetic variation needed for adaptation to occur over longer timescales and the recovery of degraded reefs through natural mechanisms.

  19. Computer-Supported Argumentative Writer : An authoring tool with built-in scaffolding and self-regulation for novice writers of argumentative texts

    OpenAIRE

    Benetos, Kalliopi

    2006-01-01

    Argumentative writing is a valued genre in a range of disciplines and curricula because it requires that writers develop relationships between ideas and build a deep and multifaceted understanding of the topic. Due to the multifaceted demands, and inherent structure and conventions of argumentative writing, it is also among the most difficult to master. The aim of this masters thesis is to create a prototype of an authoring tool that can help novices (13-19 years old) of argumentative essay w...

  20. The Culture of Writing of L2 Writers in Transition from Secondary School to Postsecondary Education

    Directory of Open Access Journals (Sweden)

    Lee Lai Fong

    2009-12-01

    Full Text Available This study looks at the culture of writing of second language (L2 writers in English who are in transition from secondary school to postsecondary education. It looks at four case studies of students in their first semester of postsecondary education in a public university. It examines their negotiation of culture of writing in secondary school to the culture of writing in postsecondary education from the perspective of sociocultural theory. Data was obtained from interviews, personal narratives and observation. The findings show that sociocultural theory can offer an understanding of these ESL writers as they move from one culture of writing to another

  1. Haematopoietic stem cell transplantation survivorship and quality of life: is it a small world after all?

    Science.gov (United States)

    Brice, Lisa; Gilroy, Nicole; Dyer, Gemma; Kabir, Masura; Greenwood, Matt; Larsen, Stephen; Moore, John; Kwan, John; Hertzberg, Mark; Brown, Louisa; Hogg, Megan; Huang, Gillian; Tan, Jeff; Ward, Christopher; Gottlieb, David; Kerridge, Ian

    2017-02-01

    The aim of this qualitative study was to gain a rich understanding of the impact that haematopoietic stem cell transplantation (HSCT) has on long-term survivor's quality of life (QoL). Participants included 441 survivors who had undergone HSCT for a malignant or non-malignant disease. Data were obtained by a questionnaire positing a single open-ended question asking respondents to list the three issues of greatest importance to their QoL in survivorship. Responses were analysed and organised into QoL themes and subthemes. Major themes identified included the following: the failing body and diminished physical effectiveness, the changed mind, the loss of social connectedness, the loss of the functional self and the patient for life. Each of these themes manifests different ways in which HSCT survivor's world and opportunities had diminished compared to the unhindered and expansive life that they enjoyed prior to the onset of disease and subsequent HSCT. HSCT has a profound and pervasive impact on the life of survivors-reducing their horizons and shrinking various parts of their worlds. While HSCT survivors can describe the ways in which their life has changed, many of their fears, anxieties, regrets and concerns are existential in nature and are ill-defined-making it exceeding unlikely that they would be adequately captured by standard psychometric measures of QoL post HSCT.

  2. Spatial patterns of coral survivorship: impacts of adult proximity versus other drivers of localized mortality

    Directory of Open Access Journals (Sweden)

    David A. Gibbs

    2015-11-01

    Full Text Available Species-specific enemies may promote prey coexistence through negative distance- and density-dependent survival of juveniles near conspecific adults. We tested this mechanism by transplanting juvenile-sized fragments of the brooding corals Pocillopora damicornis and Seriatopora hystrix 3, 12, 24 and 182 cm up- and down-current of conspecific adults and monitoring their survival and condition over time. We also characterized the spatial distribution of P. damicornis and S. hystrix within replicate plots on three Fijian reef flats and measured the distribution of small colonies within 2 m of larger colonies of each species. Juvenile-sized transplants exhibited no differences in survivorship as a function of distance from adult P. damicornis or S. hystrix. Additionally, both P. damicornis and S. hystrix were aggregated rather than overdispersed on natural reefs. However, a pattern of juveniles being aggregated near adults while larger (and probably older colonies were not suggests that greater mortality near large adults could occur over longer periods of time or that size-dependent mortality was occurring. While we found minimal evidence of greater mortality of small colonies near adult conspecifics in our transplant experiments, we did document hot-spots of species-specific corallivory. We detected spatially localized and temporally persistent predation on P. damicornis by the territorial triggerfish Balistapus undulatus. This patchy predation did not occur for S. hystrix. This variable selective regime in an otherwise more uniform environment could be one mechanism maintaining diversity of corals on Indo-Pacific reefs.

  3. Mortality 1950-1964 and disease and survivorship 1958-1964 among sample members aged 50 years or older, October 1, 1950

    Energy Technology Data Exchange (ETDEWEB)

    Ciocco, A

    1965-01-01

    Persons who were 50 years or older in 1950, or 45 years or older at the time of the atomic bomb (ATB), constitute that portion of the Life Span Study sample subject to the highest disability and mortality risks, from malignancies as well as from other chronic disease conditions. Furthermore, this age class is rapidly approaching the modal age of death. Hence, whatever late effects of exposure to the bomb in 1945 are to occur they should be perceptible by this time. With this view in mind, mortality, and the occurrence of selected diseases subsequent to 1950 have been compared for the following purposes among designated exposure groups: to specify the size and trend of differences among the exposure groups; and to point up some of the issues which must be met in planning future statistical-epidemiologic studies at ABCC. The three exposure groups compared were: persons within 1400 m from the hypocenter (0 to 1399 m); those beyond 1400 m (1400 to 9999 m); and persons not in the city ATB. Each group has been examined for: cumulative mortality pattern from 1 October 1950 to 30 September 1964, for all causes of death, for deaths from tuberculosis, lung cancer, stomach cancer, and leukemia; occupation characteristics and their relation to mortality; selective factors related to inclusion in the ABCC-JNIH Adult Health Study, and prevalance and incidence of, and survivorship from, tuberculosis among participants in the Adult Health Study, 1958 to 1964; and selective factors related to frequency of autopsy, 1961 to 1964. 11 references, 2 figures, 22 tables.

  4. A New Chapter. The Fresh Voices of Hispanic Fiction Writers Are Being Heard by a Growing Mainstream Audience.

    Science.gov (United States)

    Frase-Blunt, Martha

    1992-01-01

    Highlights numerous Hispanic fiction writers who are beginning to experience popularity. Describes Hispanic genre such as "magic realism" in which real action is tinged with dreamlike surrealism. Discusses Hispanic writers' experiences with small independent presses as well as major publishers. Expresses such concerns as patronization and the lack…

  5. Scaffolding Writing Using Feedback in Students' Graphic Organizers--Novice Writers' Relevance of Ideas and Cognitive Loads

    Science.gov (United States)

    Lee, Chien Ching; Tan, Seng Chee

    2010-01-01

    This paper aims to find out two outcomes of feedback in the novice writers' graphic organizers, which are the novice writers' ability to align their ideas to their writing goal, and their perceived germane, metacognitive, extraneous and intrinsic cognitive loads when generating and revising ideas based on the feedback. Data was gathered from the…

  6. Automatic writer identification using connected-component contours and edge-based features of uppercase western script

    NARCIS (Netherlands)

    Schomaker, L; Bulacu, M

    In this paper, a new technique for offline writer identification is presented, using connected-component contours (COCOCOs or CO(3)s) in uppercase handwritten samples. In our model, the writer is considered to be characterized by a stochastic pattern generator, producing a family of connected

  7. Comedy Stages, Poets Projects, Sports Columns, and Kinesiology 341: Illuminating the Importance of Basic Writers' Self-Sponsored Literacies

    Science.gov (United States)

    Roozen, Kevin

    2012-01-01

    Dominant perspectives of basic writers' self-sponsored literacies tend to overlook the important roles such activities can play in literate development. Drawn from texts, interviews, and participant-observations collected during a five-year study, this article continues the examination of the relationship between one writer's curricular and…

  8. "Seeing It on the Screen Isn't Really Seeing It": Reading Problems of Writers Using Word Processing.

    Science.gov (United States)

    Haas, Christina

    An observational study examined computer writers' use of hard copy for reading. The study begins with a description, based on interviews, of four kinds of reading problems encountered by writers using word processing; formatting, proofreading, reorganizing, and critical reading ("getting a sense of the text"). Subjects, six freshmen…

  9. Automatic writer identification using connected-component contours and edge-based features of uppercase Western script.

    Science.gov (United States)

    Schomaker, Lambert; Bulacu, Marius

    2004-06-01

    In this paper, a new technique for offline writer identification is presented, using connected-component contours (COCOCOs or CO3s) in uppercase handwritten samples. In our model, the writer is considered to be characterized by a stochastic pattern generator, producing a family of connected components for the uppercase character set. Using a codebook of CO3s from an independent training set of 100 writers, the probability-density function (PDF) of CO3s was computed for an independent test set containing 150 unseen writers. Results revealed a high-sensitivity of the CO3 PDF for identifying individual writers on the basis of a single sentence of uppercase characters. The proposed automatic approach bridges the gap between image-statistics approaches on one end and manually measured allograph features of individual characters on the other end. Combining the CO3 PDF with an independent edge-based orientation and curvature PDF yielded very high correct identification rates.

  10. Weaving Language and Culture: Latina Adolescent Writers in an After-School Writing Project

    Science.gov (United States)

    Garcia, Andrea; Gaddes, Amy

    2012-01-01

    A decade ago, the subtractive schooling of many Latino youth in the United States resulted in a devaluing of cultural identity and heritage as resources to support learning. Today, educators are urged to revalue cultural resources toward literacy development. This study explores the experiences of Latina adolescent students as writers during an…

  11. Bibliography of Unpublished Materials Pertaining to Hispanic Culture in the New Mexico WPA Writers' Files.

    Science.gov (United States)

    Cordova, Benito, Comp.

    The bibliography consists of unpublished manuscripts relating to the Hispano culture from the New Mexico Writer's Project. The nearly 600 different items, written 3 or 4 decades ago as part of a WPA project, present a fresh look at a variety of indigenous New Mexico folklore. Most of the entries are annotated, dated, and sources and contributors…

  12. Examining the Effects of Gender and Second Language Proficiency on Hispanic Writers' Persuasive Discourse.

    Science.gov (United States)

    Bermudez, Andrea B.; Prater, Doris L.

    1994-01-01

    Examines the use of persuasive responses by Hispanic second-language writers and categorizes these responses by level of language proficiency and gender. Findings indicate that students exit English-as-a-Second-Language classes without having achieved a higher level of expertise in the use of persuasive discourse and that females elaborate more…

  13. Pediatric writer's cramp in myoclonus-dystonia: Maternal imprinting hides positive family history

    NARCIS (Netherlands)

    Gerrits, M. C. F.; Foncke, E. M. J.; Koelman, J. H. T. M.; Tijssen, M. A. J.

    2009-01-01

    Myoclonus-dystonia (M-D) is an autosomal dominantly inherited movement disorder with myoclonic jerks and dystonic contractions most frequently due to a mutation in the epsilon-sarcoglycan (SGCE, DYT11) gene. We describe two unrelated children with M-D (DYT11) who presented with writer's cramp. Due

  14. Pediatric writer's cramp in myoclonus-dystonia : Maternal imprinting hides positive family history

    NARCIS (Netherlands)

    Gerrits, M. C. F.; Foncke, E. M. J.; Koelman, J. H. T. M.; Tijssen, M. A. J.

    Myoclonus-dystonia (M-D) is an autosomal dominantly inherited movement disorder with myoclonic jerks and dystonic contractions most frequently due to a mutation in the epsilon-sarcoglycan (SGCE, DYT11) gene. We describe two unrelated children with M-D (DYT11) who presented with writer's cramp. Due

  15. Sensory integration in writer's cramp: comparison with controls and evaluation of botulinum toxin effect

    NARCIS (Netherlands)

    Contarino, M. F.; Kruisdijk, J. J. M.; Koster, L.; Ongerboer de Visser, B. W.; Speelman, J. D.; Koelman, J. H. T. M.

    2007-01-01

    OBJECTIVE: Abnormal temporal and spatial sensory integration have been described in mixed groups of dystonic patients. We tested somatosensory integration and the effect of botulinum toxin (BoNT) in patients with writer's cramp (WC). METHODS: Median and ulnar SEPs were recorded in 29 WC patients and

  16. Writers and Their Maps: The Construction of a GAO Report on Sexual Harassment.

    Science.gov (United States)

    Cook, Kelli Cargile

    2000-01-01

    Examines a 1994 General Accounting Office (GAO) report on sexual harassment at U.S. service academies to determine how power structures affected the report writers' rhetorical choices. Identifies what is valued and devalued in the report's contents. Describes Congress's reaction to the report and speculates on the report's impact on public…

  17. Mainstream Teacher Candidates' Perspectives on ESL Writing: The Effects of Writer Identity and Rater Background

    Science.gov (United States)

    Kang, Hyun-Sook; Veitch, Hillary

    2017-01-01

    This study explored the extent to which the ethnic identity of a writer and the background (gender and area of teaching) of a rater can influence mainstream teacher candidates' evaluation of English as a second language (ESL) writing, using a matched-guise method. A one-page essay was elicited from an ESL learner enrolled in an intensive English…

  18. A Computer Text Analysis of Four Cohesion Devices in English Discourse by Native and Nonnative Writers.

    Science.gov (United States)

    Reid, Joy

    1992-01-01

    In a contrastive rhetoric study of nonnative English speakers, 768 essays written in English by native speakers of Arabic, Chinese, Spanish, and English were examined using the Writer's Workbench program to determine whether distinctive, quantifiable differences in the use of 4 cohesion devices existed among the 4 language backgrounds. (Author/LB)

  19. Mexican Indirection: How To Help Mexican ESL Writers Channel Their Energies into Focused Essays.

    Science.gov (United States)

    Ransdell, D. R.

    The fact that a writer's culture influences the composing style is undeniable. Spanish speakers writing in English often allow their points to "leap around," perhaps constituting a pattern the instructor does not see. In "Beyond Culture," Edward Hall explains that cultures operate under either "monochronic" or…

  20. University-government relationships in the training of technical writers-editors

    Science.gov (United States)

    Stohrer, Freda F.; Pinelli, Thomas E.

    1979-01-01

    Traditional and nontraditional methods of training technical writers-editors are reviewed. Combining work experience with classroom instruction in the form of cooperative education provides a method of strengthening the Federal career service in professional occupations. The NASA Langley experience that successfully introduced students to the special demands of technical writing and editing is described.

  1. Down the Slippery Slope: Ethics and the Technical Writer as Marketer.

    Science.gov (United States)

    Bryan, John

    1992-01-01

    Discusses some of the ethical dilemmas faced by writers who prepare marketing materials in engineering organizations. Describes social, political, economic, and legal changes in the professions during the last 30 years and the growing influence of market-driven decisions on ethical decision making. (PRA)

  2. Spelling and Assistive Technology: Helping Students with Disabilities Be Successful Writers

    Science.gov (United States)

    Simmons, Kate D.; Carpenter, Laura B.

    2010-01-01

    Successful writers have proficient skills in three areas: handwriting, spelling and composition. Many students with disabilities experience difficulties in the area of spelling, which in turn may lead to difficulty in composing written work. Spelling deficits should be addressed by the student's Individualized Education Program (IEP) team to…

  3. Writing Democracy: Notes on a Federal Writers' Project for the 21st Century

    Science.gov (United States)

    Carter, Shannon; Mutnick, Deborah

    2012-01-01

    A general overview of the Writing Democracy project, including its origin story and key objectives. Draws parallels between the historical context that gave rise to the New Deal's Federal Writers' Project and today, examining the potential for a reprise of FWP in community literacy and public rhetoric and introducing articles collected in this…

  4. Writing through the Tween Years: Supporting Writers, Grades 3-6

    Science.gov (United States)

    Morgan, Bruce

    2004-01-01

    No longer little children, but not yet teenagers, tweens are beginning to see themselves as autonomous while still struggling to understand where they fit in. It can also be an awkward time for teachers who cherish the hilarious and poignant personalities of tween writers, but feel pressured by a new emphasis on testing in the intermediate grades.…

  5. Thomas Merton’s poetics of translation in his letters to writers

    Directory of Open Access Journals (Sweden)

    Marcela María Raggio

    2016-05-01

    Full Text Available This article explores Thomas Merton’s poetics of translation as reflected in his letters to writers. There, Merton expresses his ideas on poetic translation, the methods and the experience of approaching foreign literature through translation. Then, a translation analysis of a sample revises the connection between Merton’s poetics and practice of translation.

  6. Enhancing Writing Achievement through a Digital Learning Environment: Case Studies of Three Struggling Adolescent Male Writers

    Science.gov (United States)

    Pruden, Manning; Kerkhoff, Shea N.; Spires, Hiller A.; Lester, James

    2017-01-01

    The aim of this study was to explore how "Narrative Theatre," a narrative-centered digital learning environment, supported the writing processes of 3 struggling adolescent male writers. We utilized a multicase study approach to capture 3 sixth-grade participants' experiences with the digital learning environment before, during, and after…

  7. Responses to Struggling, K-2 Readers and Writers: Early Literacy Intervention in Three Urban Schools

    Science.gov (United States)

    Mooney, Kathleen C.

    2009-01-01

    An abundance of research on early literacy intervention indicates that struggling, K-2 readers and writers can be effectively supported through the receipt of intervention services in school; however, research in the area has not yet addressed study of the unique, contextualized design and implementation of early literacy intervention in different…

  8. Weaving Strands of Writer Identity: Self as Author and the NNES "Plagiarist"

    Science.gov (United States)

    Ouellette, Mark A.

    2008-01-01

    While plagiarism is often viewed in terms of ethical binaries, scholars in composition studies have recognized plagiarism as part of literacy practices governing identity construction. In this light, what is at stake is how writers construct identity by positioning stance-claims according to the standards of respective discourse communities. For…

  9. A Phenomenological Research Study on Writer's Block: Causes, Processes, and Results

    Science.gov (United States)

    Bastug, Muhammet; Ertem, Ihsan Seyit; Keskin, Hasan Kagan

    2017-01-01

    Purpose: The purpose of this paper is to investigate the causes, processes of writer's block experienced by a group of classroom teacher candidates and its impact on them. Design/methodology/approach: The phenomenological design, which is a qualitative research design, was preferred in the research since it was aimed to investigate the causes,…

  10. Octavia Butler and Virginia Hamilton: Black Women Writers and Science Fiction.

    Science.gov (United States)

    Hampton, Gregory Jerome; Brooks, Wanda M.

    2003-01-01

    Notes that African American literature has always had science fiction elements in its focus on narratives of the alienated and marginalized "other." Contends that Octavia Butler and Virginia Hamilton are two African American writers of science fiction who examine the connections between the stories of a culture and the genre of science…

  11. "Shoot for the Moon!" Students' Identities as Writers in the Context of the Classroom

    Science.gov (United States)

    Wearmouth, Janice; Berryman, Mere; Whittle, Lisa

    2011-01-01

    A study of students' identities as writers was carried out in the classroom of a New Zealand primary teacher who had been formally identified by a national body of teachers as having excellent practice in supporting literacy acquisition. The researchers, Professor Janice Wearmouth, from the University of Bedfordshire, Mere Berryman, from the…

  12. Intellectual maturity and longevity: late-blooming composers and writers live longer than child prodigies.

    Science.gov (United States)

    Hafkamp, Maurits P J; Slaets, Joris P J; van Bodegom, David

    2017-05-30

    Life history theory links human physical and sexual development to longevity. However, there have been no studies on the association of intellectual development with longevity. This observational study investigates the relationship between the onset of intellectual maturity and lifespan through the life histories of composers and creative writers, whose intellectual development can be gauged through their compositions and writings. In these groups we model the relationship between the age at first creative work, and age at death using multilevel regression, adjusting for sex, date of birth, and nationality. Historical biographical records on 1110 musical composers and 1182 creative writers, born in the period 1400 AD through 1915 AD, were obtained from the Oxford Companion to Music and the Oxford Companion to English Literature. Composers and creative writers lived, respectively 0.16 ( p = 0.02) and 0.18 ( p < 0.01) years longer for each later year of age at first work. When completion of the first creative work is interpreted as a proxy for the onset of intellectual maturity in composers and creative writers, our findings indicate that a later onset of intellectual maturity is associated with higher longevity.

  13. Revision Strategies for Adolescent Writers: Moving Students in the Write Direction

    Science.gov (United States)

    Borgese, Jolene; Heyler, Dick; Romano, Stephanie

    2011-01-01

    For many secondary students, writing effectively is the most elusive of the critical literacy skills needed for college and career readiness. And for many teachers, revision is the most difficult part of the writing process to tackle. How can adolescent writers be guided to revisit their work, to identify the weaknesses in their writing drafts,…

  14. Developing the Relation of Author to Idea, or, Curing the Student-Writer's Transference Neurosis.

    Science.gov (United States)

    Micham, Dennis L.

    Meaningful use of language involves intending to have an effect and intending the audience to recognize that aim. In a Freudian modification of this premise, allowing for different levels of intentional awareness, writing can be discussed in terms of how writers intend to affect readers, as well as how aware they are themselves of their intentions…

  15. The Use of Paraphrase in Summary Writing: A Comparison of L1 and L2 Writers

    Science.gov (United States)

    Keck, Casey

    2006-01-01

    Paraphrasing is considered by many to be an important skill for academic writing, and some have argued that the teaching of paraphrasing might help students avoid copying from source texts. Few studies, however, have investigated the ways in which both L1 and L2 academic writers already use paraphrasing as a textual borrowing strategy when…

  16. Handwriting performance in the absence of visual control in writer's cramp patients: Initial observations

    Directory of Open Access Journals (Sweden)

    Losch Florian

    2006-04-01

    Full Text Available Abstract Background The present study was aimed at investigating the writing parameters of writer's cramp patients and control subjects during handwriting of a test sentence in the absence of visual control. Methods Eight right-handed patients with writer's cramp and eight healthy volunteers as age-matched control subjects participated in the study. The experimental task consisted in writing a test sentence repeatedly for fifty times on a pressure-sensitive digital board. The subject did not have visual control on his handwriting. The writing performance was stored on a PC and analyzed off-line. Results During handwriting all patients developed a typical dystonic limb posture and reported an increase in muscular tension along the experimental session. The patients were significantly slower than the controls, with lower mean vertical pressure of the pen tip on the paper and they could not reach the endmost letter of the sentence in the given time window. No other handwriting parameter differences were found between the two groups. Conclusion Our findings indicate that during writing in the absence of visual feedback writer's cramp patients are slower and could not reach the endmost letter of the test sentence, but their level of automatization is not impaired and writer's cramp handwriting parameters are similar to those of the controls except for even lower vertical pressure of the pen tip on the paper, which is probably due to a changed strategy in such experimental conditions.

  17. Writer and writing-style classification in the recognition of online handwriting

    NARCIS (Netherlands)

    Schomaker, Lambertus; Abbink, Gerben; Selen, Sjoerd

    1994-01-01

    One of the problems in the automatic recognition of cursive and mixed-cursive handwriting is the large variation of handwriting styles in a population. Automatic detection of the generic handwriting style, or identification of the writer could be useful to counteract this problem. The starting point

  18. A Primer on the Pathway to Scholarly Writing: Helping Nascent Writers to Unlearn Conditioned Habits

    Science.gov (United States)

    McDougall, Dennis; Ornelles, Cecily; Rao, Kavita

    2015-01-01

    In this article, we identify eight common error patterns of nascent writers when they attempt to navigate the pathway to scholarly writing. We illustrate each error pattern via examples and counter-examples (corrections). We also describe how to identify such patterns, why those patterns might occur and persist, and why each pattern is…

  19. Violence and Death in Stories of War Period Writer Omer Seyfettin

    Science.gov (United States)

    Turan, Lokman

    2006-01-01

    In this article, a brief biography is given and information is provided on, the period Omer Seyfettin, one of the most widely read children's literature writers in Turkey lived in, and the subject of death and violence in 129 short stories he has written, compiled in 10 books, was analyzed. The data was subjected to computer aided quantitative…

  20. Challenges Faced by Second Language Doctoral Student Writers in Hong Kong and Their Writing Strategies

    Science.gov (United States)

    Hyland, Fiona

    2016-01-01

    Writing at the doctoral level presents many challenges for second language writers. This paper reports on a longitudinal study investigating English as a second language (ESL) doctoral students' writing problems and the strategies they developed to meet these challenges. Eight students were interviewed four times over a two-year period during…

  1. Teacher-Writer Memoirs as Lens for Writing Emotionally in a Primary Teacher Education Programme

    Science.gov (United States)

    Deegan, James G.

    2008-01-01

    This article examines student teachers' experiences of writing emotionally through the lens of teacher-writer memoirs. The participants were 99 postgraduate student teachers on a sociology of teaching module in an initial primary teacher education programme in the Republic of Ireland. Analysis of journal responses indicated how student teachers…

  2. Examining Instructional Practices, Intellectual Challenge, and Supports for African American Student Writers

    Science.gov (United States)

    Alston, Chandra L.

    2012-01-01

    The debate surrounding how best to support African American student writers continues today as the gap between achievement scores persists. This qualitative analysis documents the classroom structures and instructional practices of two English Language Arts teachers working in a predominately African American public middle school, whose students…

  3. Cervantes, the Journey, and What it Tells Us About Becoming a Writer

    Directory of Open Access Journals (Sweden)

    Knight Lania

    2017-12-01

    Full Text Available The article traces the notion of empathy in fiction writing and how Cervantes’s treatment of characters in Don Quixote initiated a tradition which is ongoing in literature even today. The path of the writer is examined as a means for understanding how a writer must develop empathy for others, beginning with quotes from writers Helene Cixous and Henry James. Next, within the current political context of global upheaval and shift following on from the election of Donald Trump as president of the U.S.A. as well as the vote for Brexit in the U.K., the article argues for the relevance of Cervantes’s novel, not as a dated work of fiction, but as a text relevant both in form and in content for the modern political climate. Finally, the connection is made between fiction writers’ ability to feel empathy for others and create characters which readers will feel empathy for. The article follows on to proclaim the revolutionary and timely role of the fiction writer to help save us from ourselves in a tumultuous political landscape made unpredictable by social media-generated confirmation bias and insularity.

  4. Scholarly Writers Who Use English as an Additional Language: What Can Goffman's "Stigma" Tell Us?

    Science.gov (United States)

    Flowerdew, John

    2008-01-01

    This paper begins by highlighting the disadvantage that EAL (English as an Additional Language) writers experience in international publishing. It then explores Goffman's (1959, 1968) ideas on stigma and illustrates how, subject to certain caveats, what he has to say provides important insights into understanding the situation of EAL scholars.…

  5. Teachers' Study Guide: The American Jewish Writer. The Image of the Jew in Literature.

    Science.gov (United States)

    Mersand, Joseph; Zara, Louis

    This guide was prepared to give an historical as well as a contemporary perspective on American Jewish authors and their writings. An introductory section presents information on such authors as Saul Bellow, Bernard Malamud, and Philip Roth; on the unique problems which Jewish writers have encountered in America; and on the breadth of current…

  6. Awakening Brilliance in the Writer's Workshop: Using Notebooks, Mentor Texts, and the Writing Process

    Science.gov (United States)

    Morris, Lisa

    2012-01-01

    Master teacher Lisa Morris invites you to share her secrets of success with writer's workshops. After years of experimenting with the workshop model, she has developed the most effective ways to apply it in the classroom, yielding higher test scores and increased student engagement. Through practical, step-by-step instruction, Morris demonstrates…

  7. Is cancer a chronic disease? Comparison of health‐related quality of life and health care use in cancer survivors and patients with a chronic disease.

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Hopman, E.J.C.; Donker, G.A.; Schellevis, F.G.

    2015-01-01

    Background: The number of cancer survivors steadily increases. The long‐term planning of care in the survivorship phase necessitates a different approach than the short‐term planning in the treatment phase. Principles of disease management programs could provide an interesting perspective to improve

  8. Augmenting the post-transplantation growth and survivorship of juvenile scleractinian corals via nutritional enhancement.

    Directory of Open Access Journals (Sweden)

    Tai Chong Toh

    Full Text Available Size-dependent mortality influences the recolonization success of juvenile corals transplanted for reef restoration and assisting juvenile corals attain a refuge size would thus improve post-transplantation survivorship. To explore colony size augmentation strategies, recruits of the scleractinian coral Pocillopora damicornis were fed with live Artemia salina nauplii twice a week for 24 weeks in an ex situ coral nursery. Fed recruits grew significantly faster than unfed ones, with corals in the 3600, 1800, 600 and 0 (control nauplii/L groups exhibiting volumetric growth rates of 10.65 ± 1.46, 4.69 ± 0.9, 3.64 ± 0.55 and 1.18 ± 0.37 mm3/week, respectively. Corals supplied with the highest density of nauplii increased their ecological volume by more than 74 times their initial size, achieving a mean final volume of 248.38 ± 33.44 mm3. The benefits of feeding were apparent even after transplantation to the reef. The corals in the 3600, 1800, 600 and 0 nauplii/L groups grew to final sizes of 4875 ± 260 mm3, 2036 ± 627 mm3, 1066 ± 70 mm3 and 512 ± 116 mm3, respectively. The fed corals had significantly higher survival rates than the unfed ones after transplantation (63%, 59%, 56% and 38% for the 3600, 1800, 600 and 0 nauplii/L treatments respectively. Additionally, cost-effectiveness analysis revealed that the costs per unit volumetric growth were drastically reduced with increasing feed densities. Corals fed with the highest density of nauplii were the most cost-effective (US$0.02/mm3, and were more than 12 times cheaper than the controls. This study demonstrated that nutrition enhancement can augment coral growth and post-transplantation survival, and is a biologically and economically viable option that can be used to supplement existing coral mariculture procedures and enhance reef restoration outcomes.

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

    Science.gov (United States)

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

    2004-05-01

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

  10. Efficacy of Self Regulated Strategy Instruction in Planning and Organization of Opinion Essays of ESL/EFL Writers at Tertiary Level

    Science.gov (United States)

    Vaddapalli, Maruthi Kumari; Woerner, Helen

    2012-01-01

    Writing is an essential academic skill. Effective writing is a complex process requiring the skillful use of techniques and strategies (Zimmerman and Reisemberg,1997). Unlike skilled writers, struggling writers lack certain strategies and techniques that could help them become effective writers. The present study investigates the effectiveness of…

  11. The experience of patients with early-stage testicular cancer during the transition from active treatment to follow-up surveillance.

    Science.gov (United States)

    Shen, Abra H; Howell, Doris; Edwards, Elizabeth; Warde, Padraig; Matthew, Andrew; Jones, Jennifer M

    2016-04-01

    To gain a better understanding of the experiences of patients with early-stage testicular cancer during the transition from active cancer treatment to follow-up care. Cross-sectional multimethod study (questionnaires, focus groups, and telephone interviews) to describe experiences of patients with testicular cancer transitioning to survivorship. Questionnaire package included standardized measures of survivorship knowledge, feeling of preparedness, health-related distress, and perspectives on care coordination. Standard descriptive statistics and Mann-Whitney tests to examine associations between all outcomes based on demographic and clinical variables were performed. Qualitative results (focus groups and interviews) were analyzed with qualitative content analysis. Based on quantitative data (n = 90) and qualitative analyses (n = 13), participants had relatively high survivorship knowledge, most testicular cancer survivors were not provided with any formal transition planning or documentation, and a substantial minority felt unprepared to cope with the aftereffects of testicular cancer and the posttreatment survivorship phase. Younger men had lower survivorship knowledge, feelings of preparedness, and continuity of care scores and were less likely to report having received any self-management tools and education or information of patient resources. Participants reported that they did not know what to expect physically or emotionally after treatment ended and many continued to be frustrated and worried about their health problems. They expressed the need for reliable and personalized resources on what to expect after treatment and more formal transition care planning. Patients with testicular cancer continue to struggle in their transition to posttreatment survivorship. Quality of care must emphasize a shift from a purely disease-focused approach to a wellness-centered approach that provides coordinated, patient-centered, and comprehensive care to optimize quality

  12. Density dependence drives habitat production and survivorship of Acropora cervicornis used for restoration on a Caribbean coral reef

    Directory of Open Access Journals (Sweden)

    Mark C Ladd

    2016-12-01

    Full Text Available AbstractCoral restoration is gaining traction as a viable strategy to help restore degraded reefs. While the nascent field of coral restoration has rapidly progressed in the past decade, significant knowledge gaps remain regarding the drivers of restoration success that may impede our ability to effectively restore coral reef communities. Here, we conducted a field experiment to investigate the influence of coral density on the growth, habitat production, and survival of corals outplanted for restoration. We used nursery-raised colonies of Acropora cervicornis to experimentally establish populations of corals with either 3, 6, 12, or 24 corals within 4m2 plots, generating a gradient of coral densities ranging from 0.75 corals m-2 to 12 corals m-2. After 13 months we found that density had a significant effect on the growth, habitat production, and survivorship of restored corals. We found that coral survivorship increased as colony density decreased. Importantly, the signal of density dependent effects was context dependent. Our data suggest that positive density dependent effects influenced habitat production at densities of 3 corals m-2, but further increases in density resulted in negative density dependent effects with decreasing growth and survivorship of corals. These findings highlight the importance of density dependence for coral restoration planning and demonstrate the need to evaluate the influence of density for other coral species used for restoration. Further work focused on the mechanisms causing density dependence such as increased herbivory, rapid disease transmission, or altered predation rates are important next steps to advance our ability to effectively restore coral reefs.

  13. Cancer and Lesbian, Gay, Bisexual, Transgender/Transsexual, and Queer/Questioning Populations (LGBTQ)

    Science.gov (United States)

    Quinn, Gwendolyn P.; Sanchez, Julian A.; Sutton, Steven K.; Vadaparampil, Susan T.; Nguyen, Giang T.; Green, B. Lee; Kanetsky, Peter A.; Schabath, Matthew B.

    2015-01-01

    This article provides an overview of the current literature on seven cancer sites that may disproportionately affect lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. For each cancer site we present and discuss the descriptive statistics, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late stage disease, and clinical implications. Finally, an overview of psychosocial factors related to cancer survivorship is offered as well as strategies for improving access to care. PMID:26186412

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

    OpenAIRE

    Williams, Faustine; Jeanetta, Stephen C.

    2015-01-01

    Abstract Background The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond. Objective To understand the lived experiences of women who are breast cancer surviv...

  15. Predictors for Long-Term Hip Survivorship Following Acetabular Fracture Surgery: Importance of Gap Compared with Step Displacement.

    Science.gov (United States)

    Verbeek, Diederik O; van der List, Jelle P; Tissue, Camden M; Helfet, David L

    2018-06-06

    Historically, the greatest residual (gap or step) displacement is used to predict clinical outcome following acetabular fracture surgery. Gap and step displacement may, however, impact the outcome to different degrees. We assessed the individual relationship between gap or step displacement and hip survivorship and determined their independent association with conversion to total hip arthroplasty. Patients who had acetabular fracture fixation (from 1992 through 2014), follow-up of ≥2 years (or early conversion to total hip arthroplasty), and postoperative computed tomography (CT) scans were included. Of 227 patients, 55 (24.2%) had conversion to total hip arthroplasty at a mean follow-up (and standard deviation) of 8.7 ± 5.6 years. Residual gap and step displacement were measured using a standardized CT-based method, and assessors were blinded to the outcome. Kaplan-Meier survivorship curves for the hips were plotted and compared (log-rank test) using critical cutoff values for gap and step displacement. These values were identified using receiver operating characteristic curves. Multivariate analysis was performed to identify independent variables associated with conversion to total hip arthroplasty. Subgroup analysis was performed in younger patients (step displacement. Hip survivorship at 10 years was 82.0% for patients with a gap of step of step of ≥1.0 mm (p = 0.012). A gap of ≥5 mm (hazard ratio [HR], 2.3; p = 0.012) and an age of ≥50 years (HR, 4.2; p step of ≥1 mm (HR, 6.4; p = 0.017) was an independent factor for conversion to total hip arthroplasty. Residual gap and step displacement as measured on CT scans are both related to long-term hip survivorship, but step displacement (1 mm) is tolerated less than gap displacement (5 mm). Of the 2 types of displacement, only a large gap displacement (≥5 mm) was independently associated with conversion to total hip arthroplasty. In younger patients who had less articular impaction with smaller residual

  16. The dynamics of reproductive rate, offspring survivorship and growth in the lined seahorse, Hippocampus erectus Perry, 1810

    Science.gov (United States)

    Lin, Qiang; Li, Gang; Qin, Geng; Lin, Junda; Huang, Liangmin; Sun, Hushan; Feng, Peiyong

    2012-01-01

    Summary Seahorses are the vertebrate group with the embryonic development occurring within a special pouch in males. To understand the reproductive efficiency of the lined seahorse, Hippocampus erectus Perry, 1810 under controlled breeding experiments, we investigated the dynamics of reproductive rate, offspring survivorship and growth over births by the same male seahorses. The mean brood size of the 1-year old pairs in the 1st birth was 85.4±56.9 per brood, which was significantly smaller than that in the 6th birth (465.9±136.4 per brood) (Pseahorses H. erectus increased with the brood pouch development. PMID:23213429

  17. Expose-R experiment on effects of open space condition on survivorship in dormant stages of aquatic invertebrates

    Science.gov (United States)

    Alekseev, Victor; Novikova, Nataliya; Levinskikh, Margarita; Sychev, Vladimir; Yusoff, Fatimah; Azuraidi, Osman

    2012-07-01

    Dormancy protects animals and plants in harsh environmental conditions from months up to hundred years. This phenomenon is perspective for space researches especially for interplanetary missions. Direct experiments in open space BYORYSK supported in principle the fact of survivorship of bacteria, fungi spores, seed of plants and crustacean dormant cysts. Even though the rate of survivorship in long-term treatments was low but good enough to conclude that biological invasion even to Mars is a real danger. As soon as the BYORYSK lunch was made of metal the possibility for resting stages to survive under UV treatment in vacuum without some protection was not clear. To test it an ESA and RSA equipment titled EXPOSE-R was applied. The EXPOSE-R facility was an external facility attached to the outside of the Zvezda Service Module in ISS in the end of November 2008. It had glace windows transparent for UV-radiation and possibility to measure temperature, space- and UV-radiation. Among a number of experiments requiring exposure to the open space environment it had a biological launch containing resting stages of terrestrial and aquatic organisms. These stages included dried ephippia of cladoceran Daphnia magna differentiated on size, dormant eggs of ostracode Eucypris ornate, cysts of fair-shrimp Streptocephalus torvicornis ( all from hemi desert Caspian area) and Artemis salina from salt lake Crimean populations. All dormant stages were kept in transparent to UV plastic bags placed in three layers. After about two years of exposing in open space dormant stages of 3 species A. salina, D. magna, S. torvicornis successfully survived at different scales but in second and third layers only . The highest level of survivorship was found in A. salina cysts. In preliminary land experiments that imitated land EXPOSE imitation of outside space station UV and vacuum conditions survivorship in resting eggs of D .magna, S. torvicornis and E. ornate was tested also. The total UV dose of

  18. Electron holography study of magnetization behavior in the writer pole of a perpendicular magnetic recording head by a 1 MV transmission electron microscope.

    Science.gov (United States)

    Hirata, Kei; Ishida, Yoichi; Akashi, Tetsuya; Shindo, Daisuke; Tonomura, Akira

    2012-01-01

    The magnetic domain structure of the writer poles of perpendicular magnetic recording heads was studied using electron holography. Although the domain structure of a 100-nm-thick writer pole could be observed with a 300 kV transmission electron microscope, that of the 250-nm-thick writer pole could not be analyzed due to the limited transmission capability of the instrument. On the other hand, the detailed domain structure of the 250-nm-thick writer pole was successfully analyzed by a 1 MV electron microscope using its high transmission capability. The thickness and material dependency of the domain structure of a writer pole were discussed.

  19. Is Zaynab Alkali Merely A Feminist Writer? An Appraisal Of The Stillborn And The Virtuous Woman

    Directory of Open Access Journals (Sweden)

    Amase, Emmanuel Lanior

    2014-05-01

    Full Text Available Many African literary critics seem to have some preconceived notions about female writers. Consequently, there has been indiscriminate branding of some female writers either as feminists or female chauvinists. This portrays them as incapable of addressing other topical issues of national interest other than those that affect the women directly. In this paper therefore, we have undertaken an appraisal of Zainab Alkali’s The Stillborn and The Virtuous Woman to buttress our position that the issues in her novels transcend gender imbalance. The paper examines Alkal’s treatment of the clash of westernisation, tradition and city life, political mal-administration, poor infrastructure as well as the challenging environment of the emerging cities. These are issues, which we believe, affect both male and female. The paper advocates a broader look at texts rather than the emphasis on the feminist angle in the interpretation of works by female authors at the expense of probably more important issues.

  20. Slow pre-movement cortical potentials do not reflect individual response to therapy in writer's cramp

    DEFF Research Database (Denmark)

    Zeuner, K E; Peller, M; Knutzen, A

    2009-01-01

    OBJECTIVE: To investigate whether movement-related cortical potentials (MRCP) provide a physiological correlate that indicates the response to treatment in patients with writer's cramp. METHODS: In 21 patients with writer's cramp, who underwent 4 weeks of limb immobilization followed by re...... apart. RESULTS: Patients benefited from the therapeutical intervention (Zeuner et al., 2008). They showed no abnormalities of the MRCPs at baseline. In controls, MRCPs did not significantly change after 4 weeks. In patients, immobilization and re-training had no effect on MRCPs. There was no correlation......-training for 8 weeks, we recorded MRCPs preceding a self-initiated brisk finger abduction movement. MRCP measurements of pre-movement activity were performed at baseline, after the end of immobilization and four and 8 weeks of re-training. We examined 12 controls, who received no intervention, twice 4 weeks...

  1. Thomas Hardy and His Readers: Contradictions of the Rebellious Serial Writer

    Directory of Open Access Journals (Sweden)

    Adelina Sánchez Espinosa

    2016-12-01

    Full Text Available This contribution explores the relationship between Thomas Hardy and his contemporary readers from The Poor Man and the Lady, his first, unpublished, novel, to The Well- Beloved, his last one. It discovers a writer split into two, with Hardy, the artist, striving to cohabitate with Hardy-the serial writer for the three decades his career as a novelist lasted. In order to fully appreciate Hardy's novels as they have reached us nowadays, after the 1912 Wessex edition, we should focus on the contradictions between their initial manuscripts, their edited versions for the family magazines and their final reconstructions into volume forms. Although Hardy certainly wanted quick success with the Victorian masses he never let go of his "higher aspirations" to be received differently by a more select readership, even if this alternative reading had to be done between the lines at a later stage.

  2. The National LGBT Cancer Action Plan: A White Paper of the 2014 National Summit on Cancer in the LGBT Communities

    Science.gov (United States)

    Margolies, Liz; Sigurdsson, Hrafn Oli; Walland, Jonathan; Radix, Asa; Rice, David; Buchting, Francisco O.; Sanchez, Nelson F.; Bare, Michael G.; Boehmer, Ulrike; Cahill, Sean; Griebling, Tomas L.; Bruessow, Diane; Maingi, Shail

    2016-01-01

    Abstract Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers.

  3. Measurements of current density distribution in shaped e-beam writers

    Czech Academy of Sciences Publication Activity Database

    Bok, Jan; Horáček, Miroslav; Kolařík, Vladimír; Urbánek, Michal; Matějka, Milan; Krzyžánek, Vladislav

    2016-01-01

    Roč. 149, JAN 5 (2016), s. 117-124 ISSN 0167-9317 R&D Projects: GA ČR(CZ) GA14-20012S; GA MŠk(CZ) LO1212; GA MŠk ED0017/01/01 Institutional support: RVO:68081731 Keywords : shaped e-beam writer * electron beam * current density Subject RIV: JB - Sensors, Measurment, Regulation Impact factor: 1.806, year: 2016

  4. Multiple beam mask writers: an industry solution to the write time crisis

    Science.gov (United States)

    Litt, Lloyd C.

    2010-09-01

    The semiconductor industry is under constant pressure to reduce production costs even as technology complexity increases. Lithography represents the most expensive process due to its high capital equipment costs and the implementation of low-k1 lithographic processes, which has added to the complexity of making masks through the greater use of optical proximity correction, pixelated masks, and double or triple patterning. Each of these mask technologies allows the production of semiconductors at future nodes while extending the utility of current immersion tools. Low k1 patterning complexity combined with increased data due to smaller feature sizes is driving extremely long mask write times. While a majority of the industry is willing to accept mask write times of up to 24 hours, evidence suggests that the write times for many masks at the 22 nm node and beyond will be significantly longer. It has been estimated that $50M+ in non-recurring engineering (NRE) costs will be required to develop a multiple beam mask writer system, yet the business case to recover this kind of investment is not strong. Moreover, funding such a development is a high risk for an individual supplier. The problem is compounded by a disconnect between the tool customer (the mask supplier) and the final mask customer that will bear the increased costs if a high speed writer is not available. Since no individual company will likely risk entering this market, some type of industry-wide funding model will be needed. Because SEMATECH's member companies strongly support a multiple beam technology for mask writers to reduce the write time and cost of 193 nm and EUV masks, SEMATECH plans to pursue an advanced mask writer program in 2011 and 2012. In 2010, efforts will focus on identifying a funding model to address the investment to develop such a technology.

  5. A Phenomenological and Narrative Approach to the “Journals” of the writer Alejandra Pizarnik

    Directory of Open Access Journals (Sweden)

    Dante Gabriel Duero

    2015-03-01

    Full Text Available We carried out a phenomenological and narrative analysis of the journals of writer Alejandra Pizarnik. We analyzed descriptions of her experiences as a psychiatric patient, and the changes reported in her physical experiences as well as existential orientation. This is an inductive enquiry based on the phenomenological and narrative analysis of a historic case study. Based on our results, we suggest some phenomenological categories which might be vital to our understanding of certain mental illness pathologies.

  6. Secondary Guilt Syndrome May Have Led Nazi-persecuted Jewish Writers to Suicide

    Directory of Open Access Journals (Sweden)

    George M. Weisz

    2015-10-01

    Full Text Available Feelings of guilt have tormented Holocaust survivors, ranging from immediately after the liberation to later in life, for shorter or longer periods, and persisting for some throughout their entire post-war lives. Descriptions of the guilt experienced by survivors of the Nazi camps occupy an impressive amount of literature: “Why me?” was the question, when a younger and more able family member perished; “Why me?” when more productive members of the community perished; “Why me?” when a million and a half children were deprived of their lives. Many found the answer by retelling their stories, witnesses of what happened. This type of guilt is much different from the recently described phenomenon of survivor syndrome, namely the secondary guilt felt by Nazi-persecuted Jewish writers. Despite successes in all aspects of their life, these writers developed a self-incriminating guilt due to their perceived inadequacy of communicating, particularly in light of the resurging anti-Semitism worldwide. This paper deals with the survival and suicides of Nazi-persecuted Jewish writers and offers a possible explanation for their late selfdestructive acts

  7. A Comparison between the Use of Nominalization in Medical Papers by English and Iranian Writers

    Directory of Open Access Journals (Sweden)

    Ali Mahbudi

    2014-11-01

    Full Text Available A prominent feature of formal writing, particularly in the field of science and technology, is the use of nominalization. Scientific writings, including medical writings, are expected to observe formality, precision, lack of ambiguity and concentration of highly technical terms. In such genres, the use of nominalization, affecting the lexical density of the text, plays a key role. In this connection, the purpose of this study was to compare the use of nominalization and the level of lexical density in medical academic articles written by native English writers and their Iranian counterparts based on the theory of grammatical metaphor proposed by Halliday (1985.  To this end, the abstract section of 20 authentic English medical articles written by native English writers and 20 abstracts written by Iranian authors, drawn from highly influential medical journals, were selected. These abstracts were analyzed and compared based on the frequency of nominalization used and the level of lexical density in them. The findings revealed that Iranian writers used less nominalization in their writings.

  8. Writers' & artists' yearbook 2014 the essential guide to the media and publishing industries

    CERN Document Server

    2013-01-01

    The annual edition of the best-selling guide to all aspects of the media and how to write and get published, the Writers' & Artists' Yearbook is now in its 107th edition. Acknowledged by the publishing industry, authors and would-be writers as the indispensable companion to navigating the world of publishing, it appears for the first time as an e-book and in print. The 80 articles are reviewed and updated each year to provide inspirational and how-to guidance on writing for newspapers, magazines, scripts for film, radio and TV; advice on writing and submitting plays, poetry, non-fiction and fiction of all genres - from fantasy to thrillers to romance; how to contact publishers and agents; managing finances as a writer; negotiating legal issues, such as copyright; understanding the editing process; self-publishing and conventional routes; digital and print. Every single one of over 4,500 listings of who to contact, where and for which disciplines across the whole media, are reviewed and most updated, wit...

  9. An Oracle-based co-training framework for writer identification in offline handwriting

    Science.gov (United States)

    Porwal, Utkarsh; Rajan, Sreeranga; Govindaraju, Venu

    2012-01-01

    State-of-the-art techniques for writer identification have been centered primarily on enhancing the performance of the system for writer identification. Machine learning algorithms have been used extensively to improve the accuracy of such system assuming sufficient amount of data is available for training. Little attention has been paid to the prospect of harnessing the information tapped in a large amount of un-annotated data. This paper focuses on co-training based framework that can be used for iterative labeling of the unlabeled data set exploiting the independence between the multiple views (features) of the data. This paradigm relaxes the assumption of sufficiency of the data available and tries to generate labeled data from unlabeled data set along with improving the accuracy of the system. However, performance of co-training based framework is dependent on the effectiveness of the algorithm used for the selection of data points to be added in the labeled set. We propose an Oracle based approach for data selection that learns the patterns in the score distribution of classes for labeled data points and then predicts the labels (writers) of the unlabeled data point. This method for selection statistically learns the class distribution and predicts the most probable class unlike traditional selection algorithms which were based on heuristic approaches. We conducted experiments on publicly available IAM dataset and illustrate the efficacy of the proposed approach.

  10. Transcultural Writers and Transcultural Literature in the Age of Global Modernity

    Directory of Open Access Journals (Sweden)

    Arianna Dagnino

    2012-05-01

    Full Text Available Peer reviewed article. In our rapidly globalising world, cultures, as well as societies and identities, tend to be more fluid, less irreducibly different and less 'territorially fixed' than in the past (Schulze-Engler 2007, p. 27. Especially now, when cosmopolitan issues and pluralistic sensibilities - driven by transnational and transcommunal experiences - tend to become more relevant. It is within this emerging social context that a new generation of mobile writers, on the move across cultural and national boundaries, has started expressing a "transcultural" sensibility and mode of being, fostered by "the process of self-distancing, self-estrangement, and self criticism of one's own cultural identities and assumptions" (Epstein 1999, p. 307. In this paper, I argue that the main element that distinguishes these early 'transcultural writers' from their precursors and/or 'cousin species' (migrant/exile/diasporic/postcolonial writers - albeit all belonging to the wider 'genus' of 'the literature of mobility' - is their relaxed, neonomadic attitude when facing issues linked to identity, nationality, rootlessness and dislocation. An attitude that reflects itself also in their creative outputs, which can already be inscribed within the realm of transcultural literature, a literature able to transcend the borders of a single culture in its choice of topic, vision and scope, thus contributing to promote a wider global literary perspective (Pettersson 2006.

  11. German writers and the Intermediate-range Nuclear Forces debate in the 1980s

    International Nuclear Information System (INIS)

    Stokes, A.M.

    1991-01-01

    In 1979, NATO announced its decision to deploy American intermediate-range nuclear missiles throughout Western Europe. From then until 1987, when the historic Intermediate-range Nuclear forces (INF) treaty provided for the withdrawal of these weapons as well as those deployed by the Soviets in Eastern Europe, the issue of nuclear weapons preoccupied many Europeans, particularly Germans. Beginning in 1980, fear of nuclear war, with the two Germanies as a potential battlefield, mobilized the largest peace movement that the Federal Republic had witnessed since the fifties, occasioned a massive increase in peace propaganda in East Germany, and brought to public notice that country's first unofficial peace movement. Throughout most of the eighties, writers in both German states opposed missile deployment. This study examines their aims and achievements in this effort and investigates the implications of political engagement for the aesthetic production of selected authors. Analysis of press reports, writers' speeches, interviews, essays and literary texts yielded the following results: INF deployment motivated writers of all political persuasions to take up a variety of peace-oriented pursuits

  12. [Chromosome abnormalities associated with Phl and acturial survivorship curve in chronic myeloid leukemia. Probabilistic interpretation of blastic transformation of CML].

    Science.gov (United States)

    Coutris, G

    1981-12-01

    Sixty-six patients with chronic myelogenous leukemia, all with Philadelphia chromosome, have been studied for chromosomic abnormalities associated (CAA) to Ph', as well as for actuarial curve of survivorship. Patients dying from another disease were excluded from this study. Frequency of cells with CAA was measured and appeared strongly higher after blastic transformation than during myelocytic state; probability to be a blastic transformation is closely correlated with this frequency. On the other hand, actuarial curve of survivorship is very well represented by an exponential curve. This suggests a constant rate of death during disease evolution, for these patients without intercurrent disease. As a mean survivance after blastic transformation is very shorter than myelocytic duration, a constant rate of blastic transformation could be advanced: it explains possible occurrence of transformation as soon as preclinic state of a chronic myelogenous leukemia. Even if CAA frequency increases after blastic transformation, CAA can occur a long time before it and do not explain it: submicroscopic origin should be searched for the constant rate of blastic transformation would express the risk of a genic transformation at a constant rate during myelocytic state.

  13. The dynamics of reproductive rate, offspring survivorship and growth in the lined seahorse, Hippocampus erectus Perry, 1810

    Directory of Open Access Journals (Sweden)

    Qiang Lin

    2012-02-01

    Seahorses are the vertebrate group with the embryonic development occurring within a special pouch in males. To understand the reproductive efficiency of the lined seahorse, Hippocampus erectus Perry, 1810 under controlled breeding experiments, we investigated the dynamics of reproductive rate, offspring survivorship and growth over births by the same male seahorses. The mean brood size of the 1-year old pairs in the 1st birth was 85.4±56.9 per brood, which was significantly smaller than that in the 6th birth (465.9±136.4 per brood (P<0.001. The offspring survivorship and growth rate increased with the births. The fecundity was positively correlated with the length of brood pouches of males and trunk of females. The fecundity of 1-year old male and 2-year old female pairs was significantly higher than that from 1-year old couples (P<0.001. The brood size (552.7±150.4 of the males who mated with females that were isolated for the gamete-preparation, was larger than those (467.8±141.2 from the long-term pairs (P<0.05. Moreover, the offspring from the isolated females had higher survival and growth rates. Our results showed that the potential reproductive rate of seahorses H. erectus increased with the brood pouch development.

  14. A Narrative Review of the Confluence of Breast Cancer and Low-wage Employment and Its Impact on Receipt of Guideline-recommended Treatment

    OpenAIRE

    Vanderpool, Robin C.; Swanberg, Jennifer E.; Chambers, Mara D.

    2013-01-01

    Breast cancer is the leading cause of cancer among women in the United States, costing the healthcare system, employers, and society billions of dollars each year. Despite improvements in screening and treatment, significant breast cancer treatment and survivorship disparities exist among various groups of women. One variable that has not been explored extensively as a possible contributor to breast cancer treatment disparities is employment. This is concerning, given the changing economic an...

  15. Cancer Patient Navigator Tasks across the Cancer Care Continuum

    Science.gov (United States)

    Braun, Kathryn L.; Kagawa-Singer, Marjorie; Holden, Alan E. C.; Burhansstipanov, Linda; Tran, Jacqueline H.; Seals, Brenda F.; Corbie-Smith, Giselle; Tsark, JoAnn U.; Harjo, Lisa; Foo, Mary Anne; Ramirez, Amelie G.

    2011-01-01

    Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services. PMID:22423178

  16. An Intercultural Investigation of Meta-Discourse Features in Research Articles by American and Turkish Academic Writers

    Directory of Open Access Journals (Sweden)

    Hüseyin KAFES

    2017-09-01

    Full Text Available This corpus-based study compares the use of hedges and boosters in English academic research articles (RAs by Turkish and American academic writers. The data come from 40 RAs collected from well-known international journals of Applied Linguistics. Quantitative and textual analyses reveal that the American academic writers (AWs preferred to be visible in their texts by employing a lot more hedges and boosters, while Turkish academic writers (TWs opted to be invisible, preferring their studies to speak for themselves. Our results indicate, among other things, the influence of rhetorical practices, and epistemological beliefs, and the cultural, linguistic, and educational backgrounds of academic writers on their use of hedges and boosters. The findings of the study are discussed in relation to these aspects.

  17. Assessment of family psychosocial functioning in survivors of pediatric cancer using the PAT2.0.

    Science.gov (United States)

    Gilleland, Jordan; Reed-Knight, Bonney; Brand, Sarah; Griffin, Anya; Wasilewski-Masker, Karen; Meacham, Lillian; Mertens, Ann

    2013-09-01

    This study aimed to examine clinical validity and utility of a screening measure for familial psychosocial risk, the Psychosocial Assessment Tool 2.0 (PAT2.0), among pediatric cancer survivors participating in long-term survivorship care. Caregivers (N=79) completed the PAT2.0 during their child's survivorship appointment. Caregivers also reported on family engagement in outpatient mental health treatment. Medical records were reviewed for treatment history and oncology provider initiated psychology consults. The internal consistency of the PAT2.0 total score in this survivorship sample was strong. Psychology was consulted by the oncology provider to see 53% of participant families, and families seen by psychology had significantly higher PAT2.0 total scores than families without psychology consults. PAT2.0 total scores and corresponding subscales were higher for patients, parents, and siblings enrolled in outpatient mental health services since treatment completion. Results were consistent with psychosocial risk categories presented within the Pediatric Psychosocial Preventative Health Model. Fifty-one percent of families presenting for survivorship care scored in the "universal" category, 34% scored in the "targeted" category, and 15% scored in the "clinical" category. Data indicate that the overall proportions of families experiencing "universal", "targeted", and "clinical" levels of familial distress may be constant from the time of diagnosis into survivorship care. Overall, the PAT2.0 demonstrated strong psychometric properties among survivors of pediatric cancer and shows promise as a psychosocial screening measure to facilitate more effective family support in survivorship care. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  19. 76 FR 82300 - Request for Nominations of Candidates To Serve on the Advisory Committee on Breast Cancer in...

    Science.gov (United States)

    2011-12-30

    ... cancer, disease prevention, early detection, diagnosis, public health, social marketing, genetic screening and counseling, treatment, rehabilitation, palliative care, and survivorship in young women, or in... representation so long as the effectiveness of the Committee is not impaired. Appointments shall be made without...

  20. 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.

  1. Associations between faith, distress and mental adjustment--a Danish survivorship study.

    Science.gov (United States)

    Johannessen-Henry, Christine Tind; Deltour, Isabelle; Bidstrup, Pernille Envold; Dalton, Susanne O; Johansen, Christoffer

    2013-02-01

    Several studies have suggested that religion and spirituality are important for overcoming psychological distress and adjusting mentally to cancer, but these studies did not differentiate between spiritual well-being and specific aspects of faith. We examined the extent to which spiritual well-being, the faith dimension of spiritual well-being and aspects of performed faith are associated with distress and mental adjustment among cancer patients. In a cross-sectional design, 1043 survivors of various cancers filled in a questionnaire on spiritual well-being (FACIT-Sp-12), specific aspects of faith ('belief in a god', 'belief in a god with whom I can talk' and 'experiences of god or a higher power'), religious community and church attendance (DUREL), distress (POMS-SF), adjustment to cancer (Mini-MAC) and sociodemographic factors. Linear regression models were used to analyze the associations between exposure (spiritual well-being and specific faith aspects) and outcome (distress and adjustment to cancer) with adjustment for age, gender, cancer diagnosis and physical and social well-being. Higher spiritual well-being was associated with less total distress (β = -0.79, CI -0.92; -0.66) and increased adjustment to cancer (fighting spirit, anxious preoccupation, helplessness-hopelessness). Specific aspects of faith were associated with high confusion-bewilderment and tension-anxiety, but also lower score on vigor-activity, and with higher anxious-preoccupation, both higher and lower cognitive avoidance, but also more fighting spirit. As hypothesized, spiritual well-being were associated with less distress and better mental adjustment. However, specific aspects of faith were both positively and negatively associated with distress and mental adjustment. The results illustrate the complexity of associations between spiritual well-being and specific aspects of faith with psychological function among cancer survivors.

  2. Quality of Survivorship in a Rare Disease: Clinicofunctional Outcome and Physical Activity in an Observational Cohort Study of 618 Long-Term Survivors of Ewing Sarcoma

    NARCIS (Netherlands)

    Ranft, Andreas; Seidel, Corinna; Hoffmann, Christiane; Paulussen, Michael; Warby, Ann-Christin; van den Berg, Henk; Ladenstein, Ruth; Rossig, Claudia; Dirksen, Uta; Rosenbaum, Dieter; Juergens, Herbert

    2017-01-01

    PurposeSignificantly improved survival rates in patients with Ewing sarcoma have raised interest in accessing the quality of long-term survivorship. In this study, subjective and objective measurement tools, preclassified as physical or mental scores, were used to assess clinicofunctional outcome

  3. Writer's statement

    Directory of Open Access Journals (Sweden)

    Paula McCloskey

    2013-01-01

    Full Text Available My maternal journey, like others’, is complicated. I come from an immediate matrilineage that bears witness to disrupted maternities. Mothers leaving their children, children sent away in the wider context of poverty, loss, abuse and trauma. I was one of six children, the second child born to teenage Irish parents – a Catholic father and Protestant mother in the mid-1970s. My maternal journey started with my own mother, a relationship that, although primary, has been at best consistently fraught, at worst destructive or nonexistent.

  4. Locating relationship and communication issues among stressors associated with breast cancer.

    Science.gov (United States)

    Weber, Kirsten M; Solomon, Denise Haunani

    2008-11-01

    This article clarifies how the social contexts in which breast cancer survivors live can contribute to the stress they experience because of the disease. Guided by Solomon and Knobloch's (2004) relational turbulence model and Petronio's (2002) communication privacy management theory, this study explores personal relationship and communication boundary issues within stressors that are associated with the diagnosis, treatment, and early survivorship of breast cancer. A qualitative analysis of discourse posted on breast cancer discussion boards and weblogs using the constant comparative method and open-coding techniques revealed 12 sources of stress. Using axial coding methods and probing these topics for underlying relationship and communication issues yielded 5 themes. The discussion highlights the implications of the findings for the theories that guided this investigation and for breast cancer survivorship more generally.

  5. 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...

  6. The effects of site, supplemental food, and age on survivorship of Carolina Chickadees and implications for dispersal through- riparian corridors

    Science.gov (United States)

    Doherty, P.F.; Grubb, T.G.

    2000-01-01

    Few studies have examined survivorship of animals in forest fragments differing in size, and none has used appropriate mark-recapture analysis techniques taking into account probability of recapture. Using Program MARK, a flexible mark-recapture software package, we estimated annual survival rates of Carolina Chickadees over a 5-yr period in a fragmented landscape in Ohio. The probability of survival was related to site (riparian woodland or woodlot area) and increased with the presence of supplemental food. While there was little evidence for an age difference in apparent survival in woodlots, young birds appeared to survive less well in forested river corridors. This last result was quite likely due, at least in part, to age-specific dispersal, suggesting that river corridors function as important dispersal routes for young birds.

  7. Press Reviews of Mei Lanfang in the Soviet Union, 1935, by Female Writers: Neher Versus Shaginyan

    DEFF Research Database (Denmark)

    Risum, Janne

    2016-01-01

    There are two interesting female exceptions to the all-male chorus reviewing the Chinese performer of female roles Mei Lanfang and his troupe in the local newspapers during Mei's Soviet tour in the spring of 1935. One is the well-established Russian writer Marietta Shaginyan (1888-1982), whose......, and to uncover why Neher's expert professional analysis has so far been unduly and sadly neglected. To further set off their contrasting views of Mei Lanfang and Chinese theatre, I compare these to the more well-known viewpoints of Sergei Tretyakov and Bertolt Brecht....

  8. The events of 1812 in the comprehension of Russian writers and St. Theophan the Recluse

    Directory of Open Access Journals (Sweden)

    Mozharova Marina Anatolievna

    2014-07-01

    Full Text Available The article analyzes works of the Russian literature classics and about sermons of St. Theophan the Recluse covering the topic of 1812, which became the time of the true self-knowledge for the Russian people. By the will of Providence Russia was carried through the purgatorial suffering for salvation. Being enthusiastic about western education, contemporaries thoughtlessly sacrificed themselves in voluntary spiritual captivity of those terrible events have finally turned to faith, repentance and prayer. Lessons of 1812 that became a matter of thought for both the Orthodox pastors, and for Russian writers, will forever remain poignant reminder for the descendants.

  9. Methods for characterizing magnetic footprints of perpendicular magnetic recording writer heads

    Energy Technology Data Exchange (ETDEWEB)

    Li, Shaoping, E-mail: shaoping.li@wdc.com; Lin, Ed; George, Zach; Terrill, Dave; Mendez, H.; Santucci, J.; Yie, Derek [Western Digital Corp., 44100 Osgood Road, Fremont, California 94539 (United States)

    2014-05-07

    In this work, the magnetic footprints, along with some of its dynamic features in recording process, of perpendicular magnetic recording writer heads have been characterized by using three different techniques. Those techniques are the spin-stand stationary footprint technique, the spin-stand dynamic footprint technique, and the coherent writing technique combined with magnetic force microscope imaging method. The characteristics of those techniques have been compared to one another. It was found experimentally that the spin-stand stationary method could not precisely catch some peculiar recording dynamics of the write heads in certain conditions. The advantages and disadvantages among all those techniques are also examined and discussed in detail.

  10. Methods for characterizing magnetic footprints of perpendicular magnetic recording writer heads

    International Nuclear Information System (INIS)

    Li, Shaoping; Lin, Ed; George, Zach; Terrill, Dave; Mendez, H.; Santucci, J.; Yie, Derek

    2014-01-01

    In this work, the magnetic footprints, along with some of its dynamic features in recording process, of perpendicular magnetic recording writer heads have been characterized by using three different techniques. Those techniques are the spin-stand stationary footprint technique, the spin-stand dynamic footprint technique, and the coherent writing technique combined with magnetic force microscope imaging method. The characteristics of those techniques have been compared to one another. It was found experimentally that the spin-stand stationary method could not precisely catch some peculiar recording dynamics of the write heads in certain conditions. The advantages and disadvantages among all those techniques are also examined and discussed in detail

  11. Methods for characterizing magnetic footprints of perpendicular magnetic recording writer heads

    Science.gov (United States)

    Li, Shaoping; Lin, Ed; George, Zach; Terrill, Dave; Mendez, H.; Santucci, J.; Yie, Derek

    2014-01-01

    In this work, the magnetic footprints, along with some of its dynamic features in recording process, of perpendicular magnetic recording writer heads have been characterized by using three different techniques. Those techniques are the spin-stand stationary footprint technique, the spin-stand dynamic footprint technique, and the coherent writing technique combined with magnetic force microscope imaging method. The characteristics of those techniques have been compared to one another. It was found experimentally that the spin-stand stationary method could not precisely catch some peculiar recording dynamics of the write heads in certain conditions. The advantages and disadvantages among all those techniques are also examined and discussed in detail. PMID:24753633

  12. Writers into Intellectuals, Culture into Politics: Grappling with History in the NRF, 1920-1940

    Directory of Open Access Journals (Sweden)

    Martyn CORNICK

    2006-10-01

    Full Text Available It is now commonplace to view the end of the Great War in 1918 as representing the beginnings of a new world order. The human losses, the vanished empires, the Bolshevik revolution and its lasting consequences, the collapse of the intellectual certainties of the pre-war order, all ensured the irruption of History and Politics into cultural spaces within the European public sphere. The politicisation of cultural spaces was inevitable, given that purveyors of culture—writers and intellectuals—w...

  13. The writers guide to NASA. [NASA Centers and public affairs contacts

    Science.gov (United States)

    1978-01-01

    NASA services of interest to writers and to the news media include personal interviews, daily audio reports of major missions, and projects via automated telephone, research assistance from historians or history monitors at technical libraries, the use of a collection of historical photographs, and the free loan of sound films of NASA research and development activities. The names and phones numbers are listed for public affairs contacts at Headquarters and at each of the major centers and their component installations. An overview of the six NASA program offices is included along with a vicinity map of each center and a description of their facilities and management responsibilities.

  14. Acute survivorship of the deep-sea coral Lophelia pertusa from the Gulf of Mexico under acidification, warming, and deoxygenation

    Directory of Open Access Journals (Sweden)

    Jay J Lunden

    2014-12-01

    Full Text Available Changing global climate due to anthropogenic emissions of CO2 are driving rapid changes in the physical and chemical environment of the oceans via warming, deoxygenation, and acidification. These changes may threaten the persistence of species and populations across a range of latitudes and depths, including species that support diverse biological communities that in turn provide ecological stability and support commercial interests. Worldwide, but particularly in the North Atlantic and deep Gulf of Mexico, Lophelia pertusa forms expansive reefs that support biological communities whose diversity rivals that of tropical coral reefs. In this study, L. pertusa colonies were collected from the Viosca Knoll region in the Gulf of Mexico (390 to 450 m depth, genotyped using microsatellite markers, and exposed to a series of treatments testing survivorship responses to acidification, warming, and deoxygenation. All coral nubbins survived the acidification scenarios tested, between pH of 7.67 and 7.90 and aragonite saturation states of 0.92 and 1.47. However, calcification generally declined with respect to pH, though a disparate response was evident where select individuals net calcified and others exhibited net dissolution near a saturation state of 1. Warming and deoxygenation both had negative effects on survivorship, with up to 100% mortality observed at temperatures above 14ºC and oxygen concentrations of approximately 1.5 ml·l-1. These results suggest that, over the short-term, climate change and OA may negatively impact L. pertusa in the Gulf of Mexico, though the potential for acclimation and the effects of genetic background should be considered in future research.

  15. Acute survivorship of the deep-sea coral Lophelia pertusa from the Gulf of Mexico under acidification, warming, and deoxygenation

    Science.gov (United States)

    Lunden, Jay J.; McNicholl, Conall G.; Sears, Christopher R.; Morrison, Cheryl L.; Cordes, Erik E.

    2014-01-01

    Changing global climate due to anthropogenic emissions of CO2 are driving rapid changes in the physical and chemical environment of the oceans via warming, deoxygenation, and acidification. These changes may threaten the persistence of species and populations across a range of latitudes and depths, including species that support diverse biological communities that in turn provide ecological stability and support commercial interests. Worldwide, but particularly in the North Atlantic and deep Gulf of Mexico, Lophelia pertusa forms expansive reefs that support biological communities whose diversity rivals that of tropical coral reefs. In this study, L. pertusa colonies were collected from the Viosca Knoll region in the Gulf of Mexico (390 to 450 m depth), genotyped using microsatellite markers, and exposed to a series of treatments testing survivorship responses to acidification, warming, and deoxygenation. All coral nubbins survived the acidification scenarios tested, between pH of 7.67 and 7.90 and aragonite saturation states of 0.92 and 1.47. However, net calcification generally declined with respect to pH, though a disparate response was evident where select individuals net calcified and others exhibited net dissolution near a saturation state of 1. Warming and deoxygenation both had negative effects on survivorship, with up to 100% mortality observed at temperatures above 14°C and oxygen concentrations of approximately 1.5 ml· l−1. These results suggest that, over the short-term, climate change and OA may negatively impact L. pertusa in the Gulf of Mexico, though the potential for acclimation and the effects of genetic background should be considered in future research.

  16. Being Young and Getting Cancer

    DEFF Research Database (Denmark)

    Sperling, Cecilie; Petersen, Gitte Stentebjerg; Hølge-Hazelton, Bibi

    2017-01-01

    Purpose: Cancer is the leading cause of nonaccidental deaths among adolescents and young adults (AYAs). In Denmark, there are substantial gaps in knowledge concerning how AYAs with cancer perceive their diagnostic and therapeutic trajectory and report health-related outcomes. The aim of this study......) “Time before treatment,” (2) “Being told about your illness,” (3) “Being a young patient,” (4) “Your treatment,” (5) “Receiving help living with and after Cancer,” and (6) “How are you feeling today?.” One hundred one items were specifically developed for this study, while 50 were standardized validated...... is to describe the development of a questionnaire targeting AYAs with cancer aiming to evaluate treatment and survivorship from the perspective of the patients. Methods: Identification of themes and development of items included in the questionnaire were based on a synthesis of literature and qualitative...

  17. Right-brain techniques: a catalyst for creative thinking and internal focusing. A study of five writers and six psychotherapists.

    Science.gov (United States)

    Zdenek, M

    1988-09-01

    Comparing the scientific reports of brain researchers such as Sperry, Bogen, Diamond, Geschwind, and Hoppe with the subjective reports of high achievers in various fields of the arts, sciences, and industry reveals that there is a correlation between creative thinking and right hemisphere specialization. Learning how to stimulate right hemisphere activity can be of great benefit to high achievers in fields that require one to be internally focused, to be sensitive to the intonations of voice and body-language, to comprehend symbols and metaphors, to think visually and holistically, to work constructively with affect, or to enhance imaginative thinking. This report is a subjective study of how five writers and six psychotherapists experienced one three-hour session of Inner Vision techniques, which I developed to stimulate creative thinking and inner focusing by enhancing right hemisphere activity. During the session, all of the psychotherapists and all but one of the writers reported that these mental imagery exercises produced a significant increase in the flow of creative ideas and enabled them to gain insights into important personal issues. One writer experienced resistance; two psychotherapists reported feelings of solace; two writers and two psychotherapists indicated that they have gained new perspectives on professional issues--one writer solved a major problem regarding the central character in his book; six psychotherapists and three writers gained new perceptions on important personal issues; five psychotherapists and four writers reported feelings of intense joy, even liberation, during the session. All eleven participants indicated that they had experienced vivid and imaginative imagery. The constructive use of imagination is essential for creative work and mental health. Writers who have the skill to program their imaginations to gain creative insights at times of their own choosing obviously will be more productive than writers who sit around waiting

  18. Social support during childhood cancer treatment enhances quality of life at survival

    Directory of Open Access Journals (Sweden)

    Carmina Castellano-Tejedor

    2015-10-01

    Full Text Available Background: Health-related quality of life (HRQoL in cancer has been related to several protective and risk factors such as perceived social support (PSS and coping. However, their effects on HRQoL once patients are in survivorship have not been fully described in pediatric samples. Objective: To describe and explore the relationship between HRQoL in survivorship and some factors (PSS, coping present while active treatment. Methods: Cross-sectional study. Forty-one pediatric cancer survivors answered HRQoL measures referred to survivorship, as well as PSS and coping measures referred to treatment period. Results: The discriminant function obtained succeeds to correctly classify 78% of the sample. Survivors who showed high HRQoL were those who, in the hardest moment while hospitalization, perceived satisfactory emotional support (from nurses and did not deploy a wide range of active coping resources to cope with stressful events (only social action coping strategy showed a significant relationship with HRQoL. Conclusions and implications: Considering these outcomes, educational and counseling interventions to strengthen patients' social networks and supportive relationships are recommended, specially, among health providers (nurses. These results highlight the importance of not overlooking opportunities to address the emotional needs of patients while hospitalization, since a positive and endurable effect has been observed at survivorship.

  19. Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection.

    Science.gov (United States)

    Anwander, Helen; Siebenrock, Klaus A; Tannast, Moritz; Steppacher, Simon D

    2017-04-01

    Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years. We asked if patients undergoing surgical hip dislocation for the treatment of mixed-type FAI with labral reattachment compared with labral resection had (1) improved hip pain and function based on the Merle d'Aubigné-Postel score; and (2) improved survival at 10-year followup. Between June 1999 and July 2002, we performed surgical hip dislocation with femoral neck osteoplasty and acetabular rim trimming in 52 patients (60 hips) with mixed-type FAI. In the first 20 patients (25 hips) until June 2001, a torn labrum or a detached labrum in the area of acetabular rim resection was resected. In the next 32 patients (35 hips), reattachment of the labrum was performed. The same indications were used to perform both procedures during the periods in question. Of the 20 patients (25 hips) in the first group, 19 patients (95%) (24 hips [96%]) were available for clinical and/or radiographic followup at a minimum of 10 years (mean, 13 years; range, 12-14 years). Of the 32 patients (35 hips) in the second group, 29 patients (91%) (32 hips [91%]) were available for clinical and/or radiographic followup at a minimum of 10 years (mean, 12 years; range, 10-13 years). We used the anterior impingement test to assess pain. Function was assessed using the Merle d'Aubigné- Postel score and ROM. Survivorship calculation was performed using the method of Kaplan-Meier with failure defined as conversion to THA, progression of osteoarthritis (of one

  20. HOW TO HELP SERBIAN ACADEMIC RESEARCHERS BECOME QUALIFIED ACADEMIC WRITERS FOR INTERNATIONAL READERSHIP

    Directory of Open Access Journals (Sweden)

    Savka Blagojevic

    2011-06-01

    Full Text Available Academic writing for international readership is almost always done in English, which in turn, may bring about certain difficulties to non- English academics who are not accustomed to English academic writing norms. Therefore, some linguistic researches, conducted in order to find out the differences between the English academic style and those of non-English ones, are aimed at making non-English academics aware of cross-cultural differences in writing styles and help them modify their own writing style to the requirements of the English academic norms. Thus, in order to help Serbian academics publish internationally, we have initiated a small-scale research by comparing academic re search articles written by English and Serbian academics: thirty from humanities (sociology, psychology and philosophy and thirty from hard sciences (chemistry, geology and environmental pollution. The research presented in the paper focuses the two most important discourse areas in academic articles written by English and Serbian writers: 1. Discourse organization, and 2.Th e choice of rhetoric strategies. The obtained results have pr oven that the two groups of writers display different preferences in their writing styles (which will be presented numerically and on the basis of this fact certain suggestions have been offered, concerning the form that Serbian academic articles should have in order to be published for the international discourse community.

  1. The Cook and the Writer: Maryse Condé's Journey of Self-Discovery

    Directory of Open Access Journals (Sweden)

    Bonnie Thomas

    2013-07-01

    Full Text Available In her 2006 memoir, Victoire, les saveurs et les mots, (translated into English as Victoire: My Mother’s Mother, celebrated Guadeloupean writer Maryse Condé makes an explicit comparison between herself and her maternal grandmother Victoire. A work of literary invention as much as of personal reflection, this book represents an example of Condé’s quest to know herself as a woman and a writer. It also enables her to fill in some of the gaps left by her mother Jeanne who was always reluctant to share details of her childhood with her daughter and died when Condé was only twenty. One of the few facts Jeanne gives to her about Victoire is that she was a cook and that the results of her labour helped open the doors to greater autonomy for her daughter and, consequently, her granddaughter. This paper will examine the way in which food and cooking are linked to Condé’s journey of self-discovery as well as to the historical trajectory of the French Caribbean islands of Marie-Galante and Guadeloupe.

  2. Development Of The Drexler Optical-Card Reader/Writer System

    Science.gov (United States)

    Pierce, Gerald A.

    1988-06-01

    An optical-card reader/writer optical and electronic breadboard system, developed by SRI International under contract to Drexler Technology, is described. The optical card, which is the same size as a credit card, can contain more than 2 megabytes of digital user data, which may also include preformatted tracking information and preformatted data. The data layout on the card is similar to that on a floppy disk, with each track containing a header and clocking information. The design of this optical reader/writer system for optical cards is explained. Design of the optical card system entails a number of unique issues: To accommodate both laser-recorded and mass-duplicated information, the system must be compatible with preencoded information, which implies a larger-than-normal spot size (5 gm) and a detection system that can read both types of optical patterns. Cost-reduction considerations led to selection of a birefringent protection layer, which dictated a nonstandard optical system. The non-polarization-sensitive optics use an off-axis approach to detection. An LED illumination system makes it possible to read multiple tracks.

  3. Electron beam mask writer EBM-9500 for logic 7nm node generation

    Science.gov (United States)

    Matsui, Hideki; Kamikubo, Takashi; Nakahashi, Satoshi; Nomura, Haruyuki; Nakayamada, Noriaki; Suganuma, Mizuna; Kato, Yasuo; Yashima, Jun; Katsap, Victor; Saito, Kenichi; Kobayashi, Ryoei; Miyamoto, Nobuo; Ogasawara, Munehiro

    2016-10-01

    Semiconductor scaling is slowing down because of difficulties of device manufacturing below logic 7nm node generation. Various lithography candidates which include ArF immersion with resolution enhancement technology (like Inversed Lithography technology), Extreme Ultra Violet lithography and Nano Imprint lithography are being developed to address the situation. In such advanced lithography, shot counts of mask patterns are estimated to increase explosively in critical layers, and then it is hoped that multi beam mask writer (MBMW) is released to handle them within realistic write time. However, ArF immersion technology with multiple patterning will continue to be a mainstream lithography solution for most of the layers. Then, the shot counts in less critical layers are estimated to be stable because of the limitation of resolution in ArF immersion technology. Therefore, single beam mask writer (SBMW) can play an important role for mask production still, relative to MBMW. Also the demand of SBMW seems actually strong for the logic 7nm node. To realize this, we have developed a new SBMW, EBM-9500 for mask fabrication in this generation. A newly introduced electron beam source enables higher current density of 1200A/cm2. Heating effect correction function has also been newly introduced to satisfy the requirements for both pattern accuracy and throughput. In this paper, we will report the configuration and performance of EBM-9500.

  4. Republishing Pre-World War II Hungarian Women Writers After the Fall of Socialism

    Directory of Open Access Journals (Sweden)

    Judit Kádár

    2017-09-01

    Full Text Available Immediately before and shortly after the collapse of socialism in 1989, a large number of private publishing houses were founded in Hungary. Some of them began their career by republishing the novels of selected popular Hungarian women writers of the preWorld War II era that had been banned following the Soviet occupation of the country in 1945. The lack of comprehensive literary criticism on the works of women authors drove the new publishers to rely on the so-called “oral canon” of collective memory, which had saved some of their names from oblivion. To grab the attention of prospective readers, the books selected for publication were provided with modern book cover designs, reflecting new, but still patriarchal values. After a brief overview of how prewar literature was censored after 1945, focusing on the editors’ inevitable reinterpretation of the writings of Renée Erdős, Mrs. Kosáry Lola Réz, and Anna Tutsek through book cover designs, Kádár aims in this paper to survey in what ways and how successfully the re-editions of the novels by women writers have contributed to their inclusion in the literary canon since 1989.

  5. A Contrastive Investigation of Intertextuality in Research Articles Authored by Iranian vs. English Writers in Applied Linguistics

    Directory of Open Access Journals (Sweden)

    Davud Kuhi

    2013-11-01

    Full Text Available Academic discourse enables others' voices in a text to be realized through conventionalized citational patterns. However, form amongst a variety of factors, one thing which may influence the way others' voices are textualized is writers' affiliations to different cultures. Following this assumption, the present contrastive study attempted to explore manifest intertextual constructions across the academic articles written by English and Iranian writers in the field of applied linguistics in a ten-year period (2000-2010. The typology of citation elaborated by Swales (1990, and subcategorized by Thompson and Tribble (2001 and Thompson (2005 were explored as the analytical framework of this study. The analysis demonstrated the dominance of different strategies of citations in the two corpora. The findings of this research may be helpful for novice writers and researchers in applied linguistics.

  6. Cancer in the Elderly

    International Nuclear Information System (INIS)

    Buntinx, F.; Akker, M. V. D.; Buntinx, F.; Akker, M. V. D.; Campbell, C.

    2014-01-01

    The incidence of cancer rises among older populations [1,2] and continuous improvement in treatment outcomes is resulting in even greater increases in the prevalence of cancer survivors in this age group [3]. There is considerable variation in cancer mortality rates in the elderly among high-income countries, with the UK having poorer outcomes compared to the USA and Western and Northern European countries [4]. The diagnosis of cancer and treatment decisions following diagnosis at an older age bring specific challenges to health care providers. Further, living with cancer has specific characteristics and consequences for older people. The five papers (three from North America, two from Europe) included in this special issue address some of these topics: increasing awareness of breast cancer symptoms, management of patients with lung and breast cancers, and survivorship issues specific to older patients. There is good evidence that age is a risk factor for the delay in presentation with breast cancer [5]. L. J. L. Forbes et al. describe the implementation into routine clinical practice of an evidence-based brief intervention designed to promote earlier symptomatic presentation of breast cancer among older women. The authors have previously reported on the effectiveness of the intervention in a randomised control trial [6]; this further work shows that its introduction into routine mammography appointments at four pilot areas within the UK’s Breast Screening Programme results in similar levels of breast cancer awareness among participating women (mean age 71 years, 4 months) as in the trial setting. The intervention was acceptable to women and to mammography providers. Given the low awareness of age-related cancer risk within the UK compared to a number of other countries [7], interventions of this nature, conveying key cancer messages as patients are entering the age group with highest risk of breast cancer, have the potential to contribute to earlier health

  7. The Voice of the Turtle is Heard Programs to Develop Military Writers in the Field of Strategy

    Science.gov (United States)

    1966-04-08

    BENEFIT TO THE USER AS MAY ACCRUE. 8 April 1966 "THE VOICE OF THE TURTLE IS HEARD" PROGRAMS TO DEVELOP MILITARY WRITERS IN THE FIELD OF STRATEGY By...U USAWC RESEARCH ELEMENT (Research Paper) L’The Voice of the Turtle is Heard" Programs to Develop Military Writers in the Field of Strategy by Lt Col...extensively their own "original sources" of information. Such information as published is often nebulous , however, and as often fanciful as it is true

  8. Promoting Breast Cancer Screening through Storytelling by Chamorro Cancer Survivors

    Science.gov (United States)

    Manglona, Rosa Duenas; Robert, Suzanne; Isaacson, Lucy San Nicolas; Garrido, Marie; Henrich, Faye Babauta; Santos, Lola Sablan; Le, Daisy; Peters, Ruth

    2017-01-01

    The largest Chamorro population outside of Guam and the Mariana Islands reside in California. Cancer health disparities disproportionally affect Pacific Islander communities, including the Chamorro, and breast cancer is the most common cancer affecting women. To address health concerns such as cancer, Pacific Islander women frequently utilize storytelling to initiate conversations about health and to address sensitive topics such as breast health and cancer. One form of storytelling used in San Diego is a play that conveys the message of breast cancer screening to the community in a culturally and linguistically appropriate way. This play, Nan Nena’s Mammogram, tells the story of an older woman in the community who learns about breast cancer screening from her young niece. The story builds upon the underpinnings of Chamorro culture - family, community, support, and humor - to portray discussing breast health, getting support for breast screening, and visiting the doctor. The story of Nan Nena’s Mammogram reflects the willingness of a few pioneering Chamorro women to use their personal experiences of cancer survivorship to promote screening for others. Through the support of a Chamorro community-based organization, these Chamorro breast cancer survivors have used the success of Nan Nena’s Mammogram to expand their education activities and to form a new cancer survivor organization for Chamorro women in San Diego.

  9. Curva de sobrevivência e estimativa de entropia em Lucilia cuprina (Diptera, Calliphoridae Survivorship curve and estimate of entropy in Lucilia cuprina (Diptera, Calliphoridae

    Directory of Open Access Journals (Sweden)

    Francely M. Fernandes

    2003-09-01

    Full Text Available Lucilia cuprina (Wiedemann, 1830 is a cosmopolite blowfly species of medical and veterinary importance because it produces myiasis, mainly in ovine. In order to evaluate the demographic characteristics of this species, survivorship curves for 327 adult males and 323 adult females, from generation F1 maintained under experimental conditions, were obtained. Entropy was utilized as the estimator of the survival pattern to quantify the mortality distribution of individuals as a function of age. The entropy values 0.216 (males and 0.303 (females were obtained. These results denote that, considering the survivorship interval until the death of the last individual for each sex, the males present a tendency of mortality in more advanced age intervals, in comparison with the females.

  10. Experiences and Concerns of Lesbian, Gay, or Bisexual Survivors of Colorectal Cancer.

    Science.gov (United States)

    Baughman, Allyson; Clark, Melissa A; Boehmer, Ulrike

    2017-05-01

    To identify the experiences and needs of lesbian, gay, or bisexual (LGB) survivors of colorectal cancer (CRC) and to expand the current understanding of LGB survivorship by obtaining in-depth knowledge of survivorship among individuals with a cancer other than breast or prostate. 
. Qualitative, semistructured individual interviews via telephone.
. Participants were recruited using social media, flyers, word of mouth, and contact with LGB and cancer organizations during a four-month period.
. Eight LGB individuals with a diagnosis of stage III CRC from 2009-2014. 
. All interviews were audio recorded and then transcribed verbatim. Thematic analysis performed by more than one analyst was used for the interview transcripts. 
. Participants described experiences with social support and isolation, cancer care from an LGB perspective, and substantial economic impacts of their cancer diagnosis. In addition, they reported struggles with health insurance coverage, employment, and housing during and after their treatment for CRC. 
. In addition to issues regarding sexual identity disclosure and social support, economic impacts of CRC exist; these are likely critical to healthy survivorship in LGB men and women. 
. Attention should be paid to the economic impact of CRC on LGB individuals, along with issues of social support and sexual identity disclosure. Oncology nurses could play an important role in determining the economic and social needs of patients with CRC, accepting the often nontraditional support networks of LGB individuals, and facilitating disclosure of an LGB identity.

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

    Science.gov (United States)

    Williams, Faustine; Jeanetta, Stephen C

    2016-06-01

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

  12. A yell of negritude: Experiences in the readers and writers formation in the More Education program

    Directory of Open Access Journals (Sweden)

    Agnaldo Mesquita de Lima Junior

    2015-12-01

    Full Text Available This study has as objective expose the report of activities developed by the program “Experiences of reading/writing: the readers/ writers formation”, focusing in the sub-project “(Di versifying: experiences at school”, specifically at the module I “A yell of negritude”. This job has been realized with the More Education program of the municipal secondary school Marechal Castelo Branco, with the objective of offering to the students a delightful relation with the reading and production of diverse texts, focusing in the formation of reading and writing of literary texts. Therefore, will be presented the theoretical and methodological references used to start the referred module, as how a brief description of the realized activities followed of reflections about the docent work.

  13. Struggling Authorial Identity of Second Language University Academic Writers in Mexico

    Directory of Open Access Journals (Sweden)

    Troy Crawford

    2016-01-01

    Full Text Available This paper explores the different factors that appear to affect the on-going construction of second language authorial identity in a professional academic environment in Mexico. Through narrative research methodology from a qualitative paradigm, the everyday struggles of two university professors to maintain their professional status in second language writing are explored. The areas of study for these two are chemistry and penal law. With data the learning processes of entering into a community of second language writers are studied as well as the problems they faced and how they resolved them. Finally, the process of negotiating an authorial identity in a second language seems to be a constant underlying struggle composed of a variety of psychological factors.

  14. Recognizing Chinese characters in digital ink from non-native language writers using hierarchical models

    Science.gov (United States)

    Bai, Hao; Zhang, Xi-wen

    2017-06-01

    While Chinese is learned as a second language, its characters are taught step by step from their strokes to components, radicals to components, and their complex relations. Chinese Characters in digital ink from non-native language writers are deformed seriously, thus the global recognition approaches are poorer. So a progressive approach from bottom to top is presented based on hierarchical models. Hierarchical information includes strokes and hierarchical components. Each Chinese character is modeled as a hierarchical tree. Strokes in one Chinese characters in digital ink are classified with Hidden Markov Models and concatenated to the stroke symbol sequence. And then the structure of components in one ink character is extracted. According to the extraction result and the stroke symbol sequence, candidate characters are traversed and scored. Finally, the recognition candidate results are listed by descending. The method of this paper is validated by testing 19815 copies of the handwriting Chinese characters written by foreign students.

  15. From reading to writing: Evaluating the Writer's Craft as a means of assessing school student writing

    Directory of Open Access Journals (Sweden)

    Pauline Sangster, Graeme Trousdale & Charles Anderson

    2012-06-01

    Full Text Available This article reports on part of a study investigating a new writing assessment, the Writer's Craft, which requires students to read a stimulus passage and then write a continuation adopting the style of the original. The article provides a detailed analysis of stimulus passages employed within this assessment scheme and students' written continuations of these passages. The findings reveal that this is a considerably more challenging assessment writing task than has previously been recognised; and that questions arise concerning the nature of the stimulus passages and the extent to which the assessment criteria captured what the students had achieved in their writing. The implications of these findings are discussed and recommendations are made.

  16. Special report writer: A flexible information management system. Documentation and user's manual

    Science.gov (United States)

    Greene, W. A.

    1976-01-01

    A special report writer (SSR) was developed which performs multiple correlations on files containing several data hierarchies. Output reports are specified in a simple notation, readily learned by persons having limited familarity with ADP. The SRR system can be adopted by other NASA installations while the basic techniques themselves are compatible with the information management needs of a wide range of organizations. Specifically, the program lends itself to generalization and can be readily adapted for other file management purposes. Extensive details on the characteristics of the SRR program are presented along with a full explanation of the system for those contemplating its application to other data bases. The complete COBOL program and documentation are available.

  17. Re-Fitting for a Different Purpose: A Case Study of Item Writer Practices in Adapting Source Texts for a Test of Academic Reading

    Science.gov (United States)

    Green, Anthony; Hawkey, Roger

    2012-01-01

    The important yet under-researched role of item writers in the selection and adaptation of texts for high-stakes reading tests is investigated through a case study involving a group of trained item writers working on the International English Language Testing System (IELTS). In the first phase of the study, participants were invited to reflect in…

  18. The Impact of eWriters on Literacy Motivation, Self-Efficacy, and the Real-Virtual-Relationships between Parents and Teachers

    Science.gov (United States)

    Ferdig, Richard E.; Pytash, Kristine E.; Kosko, Karl W.; Memis, Riza; Ryan, Kelli; Dunlosky, John

    2017-01-01

    This study set out to examine two important aspects of the use of eWriters by early elementary students. First, it explored the impact of eWriters on literacy motivation and self efficacy of students in Pre-Kindergarten, Kindergarten, and First grade. Second, it explored if and how the technology implementation would affect parent and teacher…

  19. Predicting Improvement in Writer's Cramp Symptoms following Botulinum Neurotoxin Injection Therapy

    Directory of Open Access Journals (Sweden)

    Mallory Jackman

    2016-09-01

    Full Text Available Introduction: Writer's cramp is a specific focal hand dystonia causing abnormal posturing and tremor in the upper limb. The most popular medical intervention, botulinum neurotoxin type A (BoNT-A therapy, is variably effective for 50–70% of patients. BoNT-A non-responders undergo ineffective treatment and may experience significant side effects. Various assessments have been used to determine response prediction to BoNT-A, but not in the same population of patients. Methods: A comprehensive assessment was employed to measure various symptom aspects. Clinical scales, full upper-limb kinematic measures, self-report, and task performance measures were assessed for nine writer's cramp patients at baseline. Patients received two BoNT-A injections then were classified as responders or non-responders based on a quantified self-report measure. Baseline scores were compared between groups, across all measures, to determine which scores predicted a positive BoNT-A response. Results: Five of nine patients were responders. No kinematic measures were predictably different between groups. Analyses revealed three features that predicted a favorable response and separated the two groups: higher than average cramp severity and cramp frequency, and below average cramp latency. Discussion: Non-kinematic measures appear to be superior in making such predictions. Specifically, measures of cramp severity, frequency, and latency during performance of a specific set of writing and drawing tasks were predictive factors. Since kinematic was not used to determine the injection pattern and the injections were visually guided, it may still be possible to use individual patient kinematics for better outcomes. 

  20. Testicular cancer update.

    Science.gov (United States)

    Adra, Nabil; Einhorn, Lawrence H

    2017-05-01

    The advances seen in the treatment of testicular cancer are among the great achievements in modern medicine. These advances were made possible by the collaborative efforts of cancer researchers around the world. Investigators have been able to address many questions regarding the treatment of patients with disease limited to the testis, those with metastasis to the retroperitoneum only, and those with advanced metastatic disease. Questions answered include the chemotherapeutic agents to be used and in what combinations, the proper intensity of treatment and appropriate dosing, the optimal number of cycles of chemotherapy according to validated risk stratification, appropriate surgical approaches that preserve sexual function, the treatment of relapsed disease, what supportive care measures to take, and survivorship issues following treatment of testicular cancer. Today, cure is achievable in 95% of all patients with testicular cancer and 80% of those who have metastatic disease. Despite remarkable results with frontline and salvage combination chemotherapy, metastatic testicular cancer remains incurable in approximately 10% of patients, and novel treatment approaches are warranted. This review highlights past and recent discoveries in the treatment of patients with testicular cancer.

  1. Australian doctors and the visual arts. Part 2. Doctors as collectors, donors, gallery supporters and writers in New South Wales.

    Science.gov (United States)

    Hamilton, D G

    1986-04-28

    The contribution of doctors to the visual arts if being discussed in a series of six articles. The first article dealt with doctor-artists in new South Wales. In this, the second, doctors are discussed as collectors, donors, gallery supporters and writers in this State.

  2. Using Socio-Dramatic Play to Support a Beginning Writer: "Daniel, the Doctor and the Bleeding Ball"

    Science.gov (United States)

    Boyle, Bill; Charles, Marie

    2010-01-01

    This article reports on a case study of a young child (aged five) at a very early stage of his journey as a writer, evidencing "pre-alphabetic tendencies", who has not yet internalised the construction of his name. Analysis of a "baseline" piece of Daniel's writing demonstrates his awareness that the production of random…

  3. Translation, Adaptation or Amputation? Arctic Explorer-Writer-Anthropologist Peter Freuchen's Little-Known Danish Translation of Moby Dick

    DEFF Research Database (Denmark)

    Klitgård, Ida

    2015-01-01

    . The translation was made by the internationally famous Arctic explorer and writer Peter Freuchen, and his version of the novel has been so drastically cut down to the bare skeleton of the plot that we may speak of amputation rather than adaptation. The result is a so-called real “man’s book”, as is pronounced...

  4. THE IDEAS DEVELOPMENT OF ARGUMENTATIVE DISCOURSES OF INDONESIAN WRITERS FOUND IN THE OPINION FORUM OF THE JAKARTA POST

    Directory of Open Access Journals (Sweden)

    Katharina Abbas Achmad adib Dwi Rukmini

    2012-09-01

    Full Text Available In this era, English is established as the world language of research and publication. This makes the English language significant for students and professionals. Tangkiengsirisin (2010, 1 states that text flow through a sequence of sentences is a main criterion for advanced writing. This research is aimed at finding out the flows of ideas of the English Arguments of Indonesian writers. This research applies topical, paradigmatic analysis. It involves identifying topics and sequences of topics/ ideas. After the topical analysis is done, the investigator contemplates the ideas development pattern of the entire essay. After analyzing fourteen English Arguments of Indonesian writers, it is found out that English Arguments of Indonesian writers are mostly developed linearly. It contradicts with Kaplan’s explanation (1966 that oriental groups express their ideas mostly in indirect ways. It means that at present Kaplan’s theory is partly valid. Even though the English Arguments of Indonesian writers are mostly developed linearly, it doesn’t mean that the teachers can ignore it in teaching Advanced Writing. Flow of ideas should become one of the materials of Advanced Writing to Indonesian learners, but it doesn’t need more teaching time allotment. Keywords: argumentative discourses, flow of ideas, linear, circular, parallel, digress

  5. Mastering the Maestro: The Effective Maestro Asks Writers, Photographers, and Designers to Trade Places with Readers as They Plan.

    Science.gov (United States)

    Cripe, Dennis

    1998-01-01

    Considers two very different fictional high school newspaper editorships to see how the "maestro" process works. Notes that the process is a management technique similar to brainstorming but in which one person keeps the planning meeting focused. Suggests that the effective maestro asks writers, photographers, and designers to trade places with…

  6. What Prevents ESL/FL Writers from Avoiding Plagiarism? Analyses of 10 North-American College Websites.

    Science.gov (United States)

    Yamada, Kyoko

    2003-01-01

    Discusses how inexperienced English-as-a-Second/Foreign-Language (ESL/EFL) writers can be helped to avoid plagiarism. Analyzes 10 North American Web sites on plagiarism, which provide a window to understanding how this issue has been problemitized and explained in Anglophone academic contexts. Concludes ESL/EFL may need to emphasize the role of…

  7. Genre-Based Tasks in Foreign Language Writing: Developing Writers' Genre Awareness, Linguistic Knowledge, and Writing Competence

    Science.gov (United States)

    Yasuda, Sachiko

    2011-01-01

    This study examines how novice foreign language (FL) writers develop their genre awareness, linguistic knowledge, and writing competence in a genre-based writing course that incorporates email-writing tasks. To define genre, the study draws on systemic functional linguistics (SFL) that sees language as a resource for making meaning in a particular…

  8. Toward a New Process-Based Indicator for Measuring Writing Fluency: Evidence from L2 Writers' Think-Aloud Protocols

    Science.gov (United States)

    Abdel Latif, Muhammad M.

    2009-01-01

    This article reports on a study aimed at testing the hypothesis that, because of strategic and temporal variables, composing rate and text quantity may not be valid measures of writing fluency. A second objective was to validate the mean length of writers' translating episodes as a process-based indicator that mirrors their fluent written…

  9. The Impact of "Writing Project" Professional Development on Teachers' Self-Efficacy as Writers and Teachers of Writing

    Science.gov (United States)

    Locke, Terry; Whitehead, David; Dix, Stephanie

    2013-01-01

    This paper arises from a two-year project: "Teachers as writers: Transforming professional identity and classroom practice'" and draws on self-efficacy questionnaire data collected at the beginning and end of the project and interview data from five participating high-school teachers who were also co-researchers in the project.…

  10. "An exaggerated type of many lives": Ouida, women writers, and the critical reception of the representation of childbirth

    NARCIS (Netherlands)

    Scott, Francesca

    2015-01-01

    The current objective is to consider the ways in which women writers were considering the physicality of female subjects—the lives of women, and specifically their health and bodily processes. Its ability to collapse or transcend conventional boundaries is particularly interesting; the difficulty of

  11. Thinking Tools for Young Readers and Writers: Strategies to Promote Higher Literacy in Grades 2-8

    Science.gov (United States)

    Olson, Carol Booth; Balius, Angie; McCourtney, Emily; Widtmann, Mary

    2018-01-01

    In her new book, bestselling author and professional developer Carol Booth Olson and colleagues show teachers how to help young readers and writers construct meaning from and with texts. This practical resource offers a rich array of research-based teaching strategies, activities, and extended lessons focused on the "thinking tools"…

  12. Family Caregivers in Cancer (PDQ)

    Science.gov (United States)

    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... For Parents Survivorship A New Normal Follow-Up Medical Care Late Side Effects Family Issues Survivorship Care ...

  13. Sex and hibernaculum temperature predict survivorship in white-nose syndrome affected little brown myotis (Myotis lucifugus)

    Science.gov (United States)

    Grieneisen, Laura E.; Brownlee-Bouboulis, Sarah A.; Johnson, Joseph S.; Reeder, DeeAnn M.

    2015-01-01

    White-nose syndrome (WNS), an emerging infectious disease caused by the novel fungus Pseudogymnoascus destructans, has devastated North American bat populations since its discovery in 2006. The little brown myotis, Myotis lucifugus, has been especially affected. The goal of this 2-year captive study was to determine the impact of hibernacula temperature and sex on WNS survivorship in little brown myotis that displayed visible fungal infection when collected from affected hibernacula. In study 1, we found that WNS-affected male bats had increased survival over females and that bats housed at a colder temperature survived longer than those housed at warmer temperatures. In study 2, we found that WNS-affected bats housed at a colder temperature fared worse than unaffected bats. Our results demonstrate that WNS mortality varies among individuals, and that colder hibernacula are more favourable for survival. They also suggest that female bats may be more negatively affected by WNS than male bats, which has important implications for the long-term survival of the little brown myotis in eastern North America. PMID:26064604

  14. Sex and hibernaculum temperature predict survivorship in white-nose syndrome affected little brown myotis (Myotis lucifugus).

    Science.gov (United States)

    Grieneisen, Laura E; Brownlee-Bouboulis, Sarah A; Johnson, Joseph S; Reeder, DeeAnn M

    2015-02-01

    White-nose syndrome (WNS), an emerging infectious disease caused by the novel fungus Pseudogymnoascus destructans, has devastated North American bat populations since its discovery in 2006. The little brown myotis, Myotis lucifugus, has been especially affected. The goal of this 2-year captive study was to determine the impact of hibernacula temperature and sex on WNS survivorship in little brown myotis that displayed visible fungal infection when collected from affected hibernacula. In study 1, we found that WNS-affected male bats had increased survival over females and that bats housed at a colder temperature survived longer than those housed at warmer temperatures. In study 2, we found that WNS-affected bats housed at a colder temperature fared worse than unaffected bats. Our results demonstrate that WNS mortality varies among individuals, and that colder hibernacula are more favourable for survival. They also suggest that female bats may be more negatively affected by WNS than male bats, which has important implications for the long-term survival of the little brown myotis in eastern North America.

  15. Factors influencing the en route survivorship and post-voyage growth of a common ship biofouling organism, Bugula neritina.

    Science.gov (United States)

    Schimanski, Kate B; Piola, Richard F; Goldstien, Sharyn J; Floerl, Oliver; Grandison, Clare; Atalah, Javier; Hopkins, Grant A

    2016-09-01

    The likelihood that viable non-indigenous biofouling species will survive a voyage on a vessel is influenced by a range of factors, including the speed, duration, and route of the voyage and the amount of time the vessel spends in port. In this study, a land-based dynamic flow device was used to test the effect of recruit age, vessel speed and voyage duration on the survivorship and growth of the bryozoan Bugula neritina. In the experiment, one-week-old recruits had a higher likelihood (100%) of surviving voyages than older (one-month-old, 90%) or younger (one-day-old, 79%) recruits, but survival was not influenced by vessel speed (6 and 18 knots) or voyage duration (two and eight days). The results suggest that the non-indigenous species B. neritina can be effectively transferred at a range of ages but one-week-old recruits are more likely to survive the translocation process and survive in the recipient environment.

  16. Three Pink Decades: Breast Cancer Coverage in Magazine Advertisements.

    Science.gov (United States)

    AbiGhannam, Niveen; Chilek, Lindsay A; Koh, Hyeseung E

    2018-04-01

    Breast cancer advocacy has experienced tremendous success since the 1980s. Yet, the quality and authenticity of breast cancer information in the media are sometimes questionable. Using a content analysis, we examined the informative (donation information, breast cancer advocacy content, etc.) and persuasive (appeals used, cues to action, etc.) contents of magazine advertisements relevant to breast cancer. While ads offered minimal informative content about the disease or about ways by which sales will contribute to the breast cancer cause, they integrated "breast cancer appeals," such as the color pink, the pink ribbon, and mostly positive depictions of survivorship and hope, into the ads. Breast cancer thus took center stage in the persuasive content of the ads, but a back seat when it came to their informative content. We discuss the implications of those findings in light of the meanings and purposes of cause-related marketing campaigns.

  17. Patient resources available to bladder cancer patients: a pilot study of healthcare providers.

    Science.gov (United States)

    Lee, Cheryl T; Mei, Minghua; Ashley, Jan; Breslow, Gene; O'Donnell, Michael; Gilbert, Scott; Lemmy, Simon; Saxton, Claire; Sagalowsky, Arthur; Sansgiry, Shubhada; Latini, David M

    2012-01-01

    To survey thought leaders attending an annual bladder cancer conference about resources available to survivors at, primarily, large academic centers treating a high volume of patients. Bladder cancer is a disease with high treatment burden. Support groups and survivorship programs are effective at managing physical and psychosocial impairments experienced by patients. The Institute of Medicine recommends increased resources for cancer survivorship, but no description of current resources exists for bladder cancer patients. Preceding the 4th annual Bladder Cancer Think Tank meeting in August 2009, we carried out an Internet-based survey of registrants that queried respondents about institutional resources and support systems devoted to bladder cancer survivors. Data were collected using SurveyMonkey.com, and descriptive statistics were computed. A total of 43 eligible respondents included urologists (77%), medical oncologists (16%), and other physicians or health professionals (7%). Physician respondents represented 22 academic centers and 2 private groups. Although 63% of respondent institutions had a National Cancer Institute designation, only 33% had an active bladder cancer support group. Survivorship clinics were available in 29% of institutions, and peer support networks, community resources for education, and patient navigation were available in 58%, 13%, and 25% of respondent institutions, respectively. Resources for bladder cancer survivors vary widely and are lacking at several academic centers with high-volume bladder cancer populations. Bladder cancer providers are often unaware of available institutional resources for patients. Urologists need to advocate for additional survivor resources and partner with other disciplines to provide appropriate care. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. 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.

  19. Re-defining one's occupational self 2 years after breast cancer: a case study.

    Science.gov (United States)

    Newman, Robin M

    2013-01-01

    Margaret*, a 56 year-old Caucasian Stage III breast cancer survivor, participated in a 5 week occupational therapy pilot program, called Take Action. This program was designed for breast cancer survivors who self-reported changes in cognitive function following completion of chemotherapy. The goals of the program were to improve participants' knowledge and use of strategies to enhance occupational performance and to improve satisfaction and performance of meaningful daily activities or occupations. Through a client-centered and evidence-based approach, this case study highlights the importance of incorporating the survivors' sense of self into an occupation-based intervention. Occupational therapists play an important role in facilitating exploration of sense of self in the survivorship phase of care to support occupational performance in self care, productivity, work, leisure and social participation. This case study highlights the important work of redefining oneself in the survivorship phase of care. (*denotes name change).

  20. Bessarabia National Cultural Code in the Works of Ukrainian Writer M. Kotsiubinsky

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    Kovpik S.I.

    2016-08-01

    Full Text Available The mentality as a special type of folk thinking has always been in the focus of the following sciences, such as: ethnic psychology, sociology, ethnogenesis, literature and other. Works of literature give an opportunity to explore causes and conditions of folk thinking formation. It is well known, that the uniqueness of national thinking is greatly affected by geographical position, nation genomes development and its formation. Ukrainian writer M. Kotsiubinsky during the period from 1892 to 1896 worked in the Bessarabia villages of Tavria province as a member of Odessa phylloxera control commission fighting against pests of vineyards in the territory of Novorossiysk general governor. Working in the Bessarabia villages allowed M. Kotsiubinsky to learn Bessarabians outlook and create a series of stories describing life style, culture and traditions of this nation. This article investigates M. Kotsiubinsky’s works from Bessarabian cycle as “Pe-kopter” and “The Witch”. The Ukrainian writer was able to learn features of life, traditions and morals in Bessarabian community. Thus, in these stories M. Kotsiubinsky showed that disapproval and community morals were above the family feelings and parental honor for the residents of Bessarabia at the end of the nineteenth century. In those days Bessarabian family did not live isolated from the society, and in every possible way they tried to obey its cruel laws. The way of matazans (villagers lining in Bessarabia was totally controlled by the community, and any violation of its standards consequently led to severe punishment. Sometimes primitive fear of Bessarania inhabitants eclipsed common sense so much that they were losing their humanity. As a result, traditional livelihood in Bessarabian society developed certain rules in order to regulate strictly individual behavior in everyday life and during the holiday time. Rural community was a special social and domestic mechanism establishing and

  1. [Laza K. Lazarević--doctor, lawyer, writer and warrior in three wars].

    Science.gov (United States)

    Babić, Rade R; Stanković Babić, Gordana

    2010-01-01

    Laza K. Lazarevic was born on the 13th of May, 1851 in Sabac. He died on the 11th of January, 1891 in Belgrade. Laza K. Lazarevic was a Serb, lawyer, warrior, doctor and writer. He spoke Russian, German and French. Laza Lazarevic's road to the title of doctor of medicine. He studied law in Belgrade and graduated in 1871 and he graduated from the Faculty of Medicine in Berlin on the 28th of January, 1879. He took his doctor's degree in Berlin on the 8th of March, 1879 at the same Faculty. His road to the title of doctor of medicine was thorny and complicated. LAZA K. LAZAREVIC AS A WARRIOR: He took part in the Serbian-Turkish war and the Serbian-Bulgarian war. During the Serbian-Bulgarian War (1885) he was first given the rank of reserve medical major and later the rank of active medical colonel and then he was appointed assistant chief of the Supreme Command of Health Care with the task to establish the Great reserve military hospital in Nis. PROFESSIONAL AND SCIENTIFIC WORK OF DR. LAZA K. LAZAREVIC: He had seventy two professional and scientific medical papers published, a great number of which referring to nervous diseases, such as paralysis agitans, sclerosis of medulla spinalis, aphasia and others. Therefore, it can be rightly said that Dr. Laza K. Lazarevic was the first Serbian neurologist. The very first operation of cataract in Serbia was performed by Dr. Laza K. Lazarevic in aseptic conditions, when cocaine was applied for anesthesia. He was the first doctor to be sent by the Ministry of Internal Affairs to Vienna in 1884 to learn how to prepare animal lymph. In 1879 he was appointed the physician of the Belgrade District and in 1881 he was promoted to the position of head doctor and Chief of Internal Department of the General State Hospital in Belgrade. He was the personal doctor of King Milan Obrenovic. LAZA K. LAZAREVIC AS A WRITER: Laza Lazarevic is considered to be the originator of psychological stories in Serbian realistic literature and had nine

  2. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016.

    Science.gov (United States)

    Bossé, D; Ng, T; Ahmad, C; Alfakeeh, A; Alruzug, I; Biagi, J; Brierley, J; Chaudhury, P; Cleary, S; Colwell, B; Cripps, C; Dawson, L A; Dorreen, M; Ferland, E; Galiatsatos, P; Girard, S; Gray, S; Halwani, F; Kopek, N; Mahmud, A; Martel, G; Robillard, L; Samson, B; Seal, M; Siddiqui, J; Sideris, L; Snow, S; Thirwell, M; Vickers, M; Goodwin, R; Goel, R; Hsu, T; Tsvetkova, E; Ward, B; Asmis, T

    2016-12-01

    The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents.

  3. Larval Survivorship and Settlement of Crown-of-Thorns Starfish (Acanthaster cf. solaris at Varying Algal Cell Densities

    Directory of Open Access Journals (Sweden)

    Morgan S. Pratchett

    2017-01-01

    Full Text Available The dispersal potential of crown-of-thorns starfish (CoTS larvae is important in understanding both the initiation and spread of population outbreaks, and is fundamentally dependent upon how long larvae can persist while still retaining the capacity to settle. This study quantified variation in larval survivorship and settlement rates for CoTS maintained at three different densities of a single-celled flagellate phytoplankton, Proteomonas sulcata (1 × 103, 1 × 104, and 1 × 105 cells/mL. Based on the larval starvation hypothesis, we expected that low to moderate levels of phytoplankton prey would significantly constrain both survival and settlement. CoTS larvae were successfully maintained for up to 50 days post-fertilization, but larval survival differed significantly between treatments. Survival was greatest at intermediate food levels (1 × 104 cells/mL, and lowest at high (1 × 105 cells/mL food levels. Rates of settlement were also highest at intermediate food levels and peaked at 22 days post-fertilization. Peak settlement was delayed at low food levels, probably reflective of delayed development, but there was no evidence of accelerated development at high chlorophyll concentrations. CoTS larvae were recorded to settle 17–43 days post-fertilization, but under optimum conditions with intermediate algal cell densities, peak settlement occurred at 22 days post-fertilization. Natural fluctuations in nutrient concentrations and food availability may affect the number of CoTS that effectively settle, but seem unlikely to influence dispersal dynamics.

  4. TURKEY’S DIFFERENT PROBLEMS IN THREE PERIODS OF THREE WOMEN’S WORKS IN THE CONTEXT OF SOCIAL GENDER ROLES OF WOMEN WRITERS

    OpenAIRE

    Şahin, Gizem

    2018-01-01

    The position of women in society, women’s role in society has always been debated along with men. In Turkey as well, there has been a lot of discussion on the women’s social position. The main aim of this study is to evaluate women’s issues in the context of gender roles by focusing on the novels of three writers from different periods of Turkish political history. In this study, first the Ottoman era writer Fatma Aliye Hanım’s novel “Muhadarat”, then the Republican era writer Adalet Ağaoğlu’...

  5. An individualised literacy intervention for low-progress readers and writers in the Foundation Phase

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    Swart, Marika

    2011-12-01

    Full Text Available Current literacy interventions (i.e. programmes of instruction for low-progress readers and writers that are supplementary to the literacy programmes used in mainstream classrooms implemented in most Western Cape schools reflect the use of isolated item-based literacy teaching methods. The low literacy levels in the Western Cape primary grades, however, do not indicate successful literacy learning. This article describes an individualised literacy intervention for emergent literacy learners that explored alternative, research-based methods of instruction. The intervention took shape as a comparison between low-progress learners who participated in the literacy intervention and average-progress learners who did not participate in this intervention. The aim was to accelerate the low-progress learners’ literacy learning so that they could reach the average-band performance of their classmates after 12 weeks in the intervention. Qualitative and quantitative data were gathered by means of observations of learners and assessment results obtained in a pre-test-post-test design, with the addition of a mid-test to observe learners’ literacy progress. Based on qualitative data, the intervention proved to be successful, because observations indicated positive change in the low-progress learners’ reading and writing behaviours. Given the small sample size, the overall trend in the quantitative data supported the value of the intervention and indicated a need for extending the research beyond a pilot study. Further research using larger sample sizes is thus recommended.

  6. Ellen N. La Motte: the making of a nurse, writer, and activist.

    Science.gov (United States)

    Williams, Lea M

    2015-01-01

    This article examines the early career of Ellen N. La Motte (1873-1961) to trace how her training at the Johns Hopkins Training School for Nurses and years spent as a tuberculosis nurse in Baltimore shaped her perception of tuberculosis prevention and women's suffrage. Although studies of tuberculosis have frequently alluded to her work, no sustained biocritical discussion of her development as a nurse and scholar exists. Between 1902, when she graduated from nursing school, and 1914, the start of the Great War, La Motte published a textbook and dozens of articles in journals devoted to nursing and social reform and delivered many speeches at local, regional, and national meetings. In addition, as her reputation as an expert in the field of tuberculosis nursing grew, her advocacy for the vote for women increased, and she used her writing and speaking skills on behalf of the suffrage cause. This article assesses how the skills La Motte acquired during these years helped mold her into a successful and respected nurse, writer, and activist.

  7. Writers and chanters in the nineteenth century as keepers of the tradition of Serbian church music

    Directory of Open Access Journals (Sweden)

    Marjanović Nataša

    2014-01-01

    Full Text Available In this paper, parts of the memoir literary works from the second half of the nineteenth century are presented as important sources for the research of Serbian traditional church chant. The testimonies on church music from diaries, memoirs and autobiographical notes by famous Serbian writers, statesmen and politicians, namely Jovan Subotić, Jakov Ignjatović, Milan Savić, Milica Stojadinović Srpkinja, Todor Stefanović Vilovski, Vladimir Jovanović and Kosta Hristić, were analyzed. Those writings bring to light a time when church chant was appreciated as an important part of the spiritual, folk heritage and had an important role in everyday culture of Serbian people both in the Habsburg Monarchy and in the Principality and Kingdom of Serbia. The authors wrote about musical skills of chanters from clerical, church circles and about the practice of chanting among school teachers. They also described different kinds of musical performances of church chant among laymen and children. These sources testify to writers’ general and musical education and experiences, to their environment and its relation to the aesthetics of spiritual folk tradition. This paper also analyzes sources in the context of the history and theory of literature, having in mind the authors’ commentary techniques and narrative style. Those issues are discussed in relation to the poetics of romanticism, Biedermeier and realism in Serbian literature. [Projekat Ministarstva nauke Republike Srbije, br. 177004: Identiteti srpske muzike od lokalnih do globalnih okvira: tradicije, promene, izazovi

  8. Teaching children with dyslexia to spell in a reading-writers' workshop.

    Science.gov (United States)

    Berninger, Virginia W; Lee, Yen-Ling; Abbott, Robert D; Breznitz, Zvia

    2013-04-01

    To identify effective treatment for both the spelling and word decoding problems in dyslexia, 24 students with dyslexia in grades 4 to 9 were randomly assigned to treatments A (n=12) or B (n=12) in an after-school reading-writers' workshop at the university (thirty 1-h sessions twice a week over 5 months). First, both groups received step 1 treatment of grapheme-phoneme correspondences (gpc) for oral reading. At step 2, treatment A received gpc training for both oral reading and spelling, and treatment B received gpc training for oral reading and phonological awareness. At step 3, treatment A received orthographic spelling strategy and rapid accelerated reading program (RAP) training, and treatment B continued step 2 training. At step 4, treatment A received morphological strategies and RAP training, and treatment B received orthographic spelling strategy training. Each treatment also had the same integrated reading-writing activities, which many school assignments require. Both groups improved significantly in automatic letter writing, spelling real words, compositional fluency, and oral reading (decoding) rate. Treatment A significantly outperformed treatment B in decoding rate after step 3 orthographic training, which in turn uniquely predicted spelling real words. Letter processing rate increased during step 3 RAP training and correlated significantly with two silent reading fluency measures. Adding orthographic strategies with "working memory in mind" to phonics helps students with dyslexia spell and read English words.

  9. Supporting academic publication: evaluation of a writing course combined with writers' support group.

    Science.gov (United States)

    Rickard, Claire M; McGrail, Matthew R; Jones, Rebecca; O'Meara, Peter; Robinson, Anske; Burley, Mollie; Ray-Barruel, Gillian

    2009-07-01

    Publication rates are a vital measure of individual and institutional performance, yet many nurse academics publish rarely or not at all. Despite widespread acceptance of the need to increase academic publication rates and the pressure university faculty may experience to fulfil this obligation, little is known about the effectiveness of practical strategies to support academic writing. In this small cohort study (n=8) comprising nurses and other professionals involved in university education, a questionnaire survey was used to evaluate the effectiveness of a one-week "Writing for Publication" course combined with a monthly writers support group to increase publication rates. Two year pre and post submissions increased from 9 to 33 articles in peer-reviewed journals. Publications (in print) per person increased from a baseline of 0.5-1.2 per year. Participants reported increased writing confidence and greater satisfaction with the publishing process. Peer support and receiving recognition and encouragement from line managers were also cited as incentives to publish. Writing for publication is a skill that can be learned. The evaluated model of a formal writing course, followed by informal monthly group support meetings, can effectively increase publication rates.

  10. Literature as a Reflection on Socio-political Realities: An Examination of Three Nigerian Writers

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    Sikiru Adeyemi Ogundokun

    2014-01-01

    Full Text Available Considering the degree of resemblance between literature and human societies, one is convinced that literature is not just a social construct which is rooted in mere ideas, imaginations or imaginary situations. Instead, it is a social institution; a form of tradition, which has existed for a long time and is accepted as a vital component of a given society to perform certain functions. In this paper, we see literature as a social reality, which presents the state of things as they are, rather than as they are imagined to be. In the selected literary works for this study, the three writers expose and condemn the harsh and hostile social and political realities which confront the African society at different periods of its evolution. Premised on sociological approach to literary criticism, this paper justifies that literature can be employed in working out national reconstruction being a tool that can make people co-operate with one another through information sharing and dissemination.

  11. Peer support of a faculty "writers' circle" increases confidence and productivity in generating scholarship.

    Science.gov (United States)

    Brandon, Catherine; Jamadar, David; Girish, Gandikota; Dong, Qian; Morag, Yoav; Mullan, Patricia

    2015-04-01

    Publishing is critical for academic medicine career advancement. Rejection of manuscripts can be demoralizing. Obstacles faced by clinical faculty may include lack of time, confidence, and optimal writing practices. This study describes the development and evaluation of a peer-writing group, informed by theory and research on faculty development and writing. Five clinical-track radiology faculty members formed a "Writers' Circle" to promote scholarly productivity and reflection on writing practices. Members decided to work with previously rejected manuscripts. After members' initial meeting, interactions were informal, face to face during clinical work, and online. After the first 6 months, an anonymous survey asked members about the status of articles and evaluations of the writing group. Ten previously rejected articles, at least one from each member, were submitted to the Circle. In 6 months, four manuscripts were accepted for publication, five were in active revision, and one was withdrawn. All participants (100%) characterized the program as worth their time, increasing their motivation to write, their opportunities to support scholarly productivity of colleagues, and their confidence in generating scholarship. Peer-support writing groups can facilitate the pooling of expertise and the exchange of recommended writing practices. Our peer-support group increased scholarly productivity and provided a collegial approach to academic writing. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  12. Aesthetics of Modernism in the Prose of German Female Writers at the Turn of GDR

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    Tamila Kyrylova

    2013-12-01

    Full Text Available The article offers the analysis of the aesthetics of modernism in the prose of German female writers at the turn of GDR. Texts of H. Königsdorf, M. Maron and B. Burmeister have a high grade of the modernist aesthetics in order to overcome the crisis cultural-historical period at the turn of GDR and also as a mode to resist against doctrines of socrealizm in the conditions of the strict regulation of art and its ideologization of the state. The fact of active using of modernist aesthetics becomes an interesting unknown case in the modern history of German female literature. Purpose of the study is to search a strong intertextual connection between novels different chronological periods in order to find out important factors and changes of national German history by means of literary contextualization female experience of dictatorship, to make links with the most important historical-literary features in the beginning of 20th century, establish reasons for return of modernist aesthetics, to prove interrelationships between turning stages of German female literature in the 20th century. The complex analysis consists of the modern methods and ideas of German studies: Gender Studies and historical-cultural analysis (W. Emmerich, S. Schaffratch. The benefits of this study let discover dynamism of national events and literary process, its projection in the newest female literature of women after 1989.

  13. The Representation of Francoist Spain by Two British Women Travel Writers

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    Mulligan Maureen

    2016-12-01

    Full Text Available This article offers a discussion of two books by British women which describe travels in Spain during the post-war period, that is, during the dictatorship of General Franco. The aim is to analyse how Spanish culture and society are represented in these texts, and to what extent the authors engage with questions of the ethics of travelling to Spain in this period. Two different forms of travel - by car, and by horse - also influence the way the travellers can connect with local people; and the individual’s interest in Spain as a historical site, or as a timeless escape from industrial northern Europe, similarly affect the focus of the accounts. The global politics of travel writing, and the distinction between colonial and cosmopolitan travel writers, are important elements in our understanding of the way a foreign culture is articulated for the home market. Women’s travel writing also has its own discursive history which we consider briefly. In conclusion, texts involve common discursive and linguistic strategies which have to negotiate the specificity of an individual’s travels in a particular time and place. The authors and books referred to are Rose Macaulay’s Fabled Shore: From the Pyrenees to Portugal (1949 and Penelope Chetwode’s Two Middle-Aged Ladies in Andalusia (1963.

  14. “The Writer Is Essentially Indiscrete.” On the Literary Gossip of a Dutch Literary Celebrity

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    Bax Sander

    2017-11-01

    Full Text Available In contemporary media culture, literary writers arouse the fascination of media fans by awakening in them the desire for the authentic by publishing autobiographical novels or other forms of life narrative. In doing so, they run the risk of becoming part of media’s large gossip mechanism that plays such a central role nowadays. The public conversation about the books of writers such as the Dutch author Connie Palmen - whose Logboek van een onbarmhartig jaar will be the main case study of this article - becomes focused on the elements of truth and authenticity and ignores the literary or fictional construction of the work. This article discusses the question whether this leaves any room for contemporary star authors to distinguish themselves from media gossipers.

  15. Attribution, referencing and commencing HE students as novice academic writers: Giving them more time to ‘get it’

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    John Hamilton

    2016-07-01

    Full Text Available The requirement for commencing higher education students to apply principles of attribution in their early academic writing frequently creates frustration both for students and academic teaching staff. Teachers often provide information on the necessity of attribution, and considerable detail on the mechanics of how to reference, and express frustration at the failure of some students to demonstrate this in their writing. In turn, many students appear overwhelmed and confused by the expectations placed on them as early academic writers. This paper explores these expectations and questions current assessment practices, advocating a longer period of formative learning before students are required to competently and accurately apply attribution principles and referencing conventions in their writing. Using the threshold concept framework (Meyer & Land, 2005, it suggests viewing attribution as a ‘conceptual gateway’ through which students must pass in becoming academic writers, and explores some implications of this for teaching, learning and assessment.

  16. Assessing and optimizing health-related quality of life during and after cancer treatment in adolescents and young adults

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    Szalda D

    2014-12-01

    Full Text Available Dava Szalda,1 Esther Kim,2 Jill P Ginsberg1,2 1Division of Oncology, The Children's Hospital of Philadelphia, 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Adolescent and young adults (AYAs with cancer have needs unique from their pediatric or adult counterparts at diagnosis, during treatment, and throughout survivorship care. Healthcare teams may find it difficult to assess and manage the complex psychosocial needs of AYA patients, however, attention to the multi-faceted care of the AYA oncology patient may directly affect health outcomes and quality of life. Comprehensive AYA care therefore must be maximized during treatment and in transition to survivorship care by including assessments of general health, sexual health, mental health, health behaviors, and conversations concerning transition to survivorship and adulthood with AYA patients. Identifying and treating issues that arise in the AYA population may help promote adherence to treatment, engagement in follow-up care, and ultimately quality of life for this unique group of patients. Keywords: quality of life, sexual health, health behaviors, mental health, transition, survivorship

  17. Resistance to Ideology, Subjugation to Language: A Workshop by Writer Gabit Musrepov under Soviet Totalitarian Censorship in 1928–1964

    OpenAIRE

    Zhanat Kundakbayeva; Kamshat Rustem

    2016-01-01

    This paper examines how, under the control of strong censorship, some of Gabit Musrepov’s literary works were published despite their seditious nature. The authors argue that although G. Musrepov was a reputable Soviet writer, the materials presented in the article prove that he worked at the meeting point of resistance and subjugation: resistance to ideology, subjugation to language. The literary analysis of Musrepov’s three short stories shows that under the strictest control and actively e...

  18. Vocabulary Use by Low, Moderate, and High ASL-Proficient Writers Compared to Hearing ESL and Monolingual Speakers.

    Science.gov (United States)

    Singleton, Jenny L; Morgan, Dianne; DiGello, Elizabeth; Wiles, Jill; Rivers, Rachel

    2004-01-01

    The written English vocabulary of 72 deaf elementary school students of various proficiency levels in American Sign Language (ASL) was compared with the performance of 60 hearing English-as-a-second-language (ESL) speakers and 61 hearing monolingual speakers of English, all of similar age. Students were asked to retell "The Tortoise and the Hare" story (previously viewed on video) in a writing activity. Writing samples were later scored for total number of words, use of words known to be highly frequent in children's writing, redundancy in writing, and use of English function words. All deaf writers showed significantly lower use of function words as compared to their hearing peers. Low-ASL-proficient students demonstrated a highly formulaic writing style, drawing mostly on high-frequency words and repetitive use of a limited range of function words. The moderate- and high-ASL-proficient deaf students' writing was not formulaic and incorporated novel, low-frequency vocabulary to communicate their thoughts. The moderate- and high-ASL students' performance revealed a departure from findings one might expect based on previous studies with deaf writers and their vocabulary use. The writing of the deaf writers also differed from the writing of hearing ESL speakers. Implications for deaf education and literacy instruction are discussed, with special attention to the fact that ASL-proficient, deaf second-language learners of English may be approaching English vocabulary acquisition in ways that are different from hearing ESL learners.

  19. The association of physical activity and colorectal and breast cancer: The Fifth Korea National Health and Nutrition Examination Survey (2008-2011).

    Science.gov (United States)

    Kang, Suh-Jung

    2015-06-01

    Therapeutic importance of physical activity during and after cancer treatment has been supported. To examine the patterns of physical activity according to the stages of breast and colorectal cancer survivor-ship in Korean, Korean National Health and Nutrition Examination Survey data from 2008 to 2011 were used. International Physical Activity Questionnaire (IPAQ) was utilized to estimate weekly time spent in vigorous- and moderate-intensity physical activity, and walking, and to calculate MET-minute/week. Depending on the survivorship, the subjects were categorized into "never diagnosed with cancer" (group 1), "0-4 yr since cancer diagnosis" (group 2), and "5 or more years since cancer diagnosis" (group 3), separately for colorectal and breast cancer. The associations between physical activity and the cancer survivorship were studied. Following results were obtained: (1) Breast cancer (n=10,167, mean age=48.55±16.27): The mean physical activity levels expressed in MET-minutes/week were 2,064.83, 1748.82, and 1998.36 in groups 1, 2, and 3, respectively. Even though cancer survivors tended to be less active compared to people without cancer, there were no statistically significant difference among the three groups. (2) Colorectal cancer (n=17,270, mean age=48.62): MET-minutes/week was 2064.30, 1084.83, and 709.04 36 in groups 1, 2, and 3, respectively. The differences were significant between group 1 and 2 (F=5.87, P=0.016) and group 1 and 3 (F=28.99, Pphysical activity, colorectal cancer survivors were less active than people without cancer in Korea.

  20. Exploring the breast cancer patient journey: do breast cancer survivors need menopause management support?

    Science.gov (United States)

    Tanna, Nuttan; Buijs, Helene; Pitkin, Joan

    2011-12-01

    Breast cancer survivors can be expected to suffer from menopause symptoms with estrogen deprivation due to cancer treatments, in addition to natural menopause-related estrogen loss. To gain an understanding of what support breast cancer patients have when they suffer from menopausal symptoms, and utilize findings to further inform National Health Service (NHS) care provision for breast cancer survivors. Qualitative study with focus group sessions targeting Caucasian and Asian women with breast cancer. Patient stories, with women describing their breast cancer journey and speaking about support received for any menopausal symptoms. Thematic data analysis of transcription. Breast cancer patients were not sure if they had menopausal symptoms or whether this was due to their breast cancer condition or treatment. Patients had an attitude of acceptance of menopausal symptoms and reported trying to cope with these by themselves. This research identifies a need for more information that is culturally sensitive on managing menopause symptoms, both as side-effects of breast cancer treatments as well as for affect on quality of life during the survivorship phase. Our work also gives insight into cultural remedies used for hot flushes by Asian patients, which they consider as 'cooling' foods. Breast cancer patients want to know whether side-effects of cancer treatment persist long term and how these can be managed. There is a need for improved patient support within any new NHS service models that are developed along breast cancer patient pathways, and inclusion of personalized advice for menopause symptoms.