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Background: This study underscores the importance of the survivor/parent dynamic in understanding the knowledge level of childhood cancer survivors and their parents with regard to cancer diagnosis, treatments, and potential late ...
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Background: This study underscores the importance of the survivor/parent dynamic in understanding the knowledge level of childhood cancer survivors and their parents with regard to cancer diagnosis, treatments, and potential late effects, and to assess the impact of parental knowledge on survivor’s knowledge. Procedure: A convenience sample (N = 219 dyads) consisting of childhood cancer survivors with a parent match was used. Survivors 2 years out from completion of therapy, aged 16 to 25 years, and fluent in English or Spanish completed 2 questionnaires to assess adolescent and young adult and parental knowledge regarding diagnosis, treatment, and long-term risks. Results: Data from the survivor/parent dyad confirm that parents are more knowledgeable than their child regarding treatment specifics. However, survivors are more accurate when assessing second tumor and fertility risk. More knowledgeable parents led to more knowledgeable survivors. Conclusions: Although parents were well-informed about treatment specifics, they were not as accurate in identifying risks appropriately. Therefore, education must be directed at both parent and survivors to maximize knowledge.
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This article explores the use of cognitive interviewing among one sensitive population, survivors of crime, and shares lessons learned from a cognitive interviewing study of LGBTQ+ survivors of crime. Cognitive interviewing is a s...
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This article explores the use of cognitive interviewing among one sensitive population, survivors of crime, and shares lessons learned from a cognitive interviewing study of LGBTQ+ survivors of crime. Cognitive interviewing is a structured research method that assists researchers in designing survey questions that clearly and accurately operationalize construct(s) of interest for use with one or more sub-populations. This method may be particularly important when conducting research on sensitive topics or with survivors who have experienced marginalization, oppression, or stigmatization because specific language or phrases may be confusing or not reflected among tools validated with mainstream dominant populations. However, past research on survivor-centered interviewing has raised questions about how these structured research methods can attend to survivor choice and autonomy. Researchers critically reflect on their experiences conducting cognitive interviews with LGBTQ+ survivors of crime and examine their processes and protocols in light of survivor-centered interview practices. Recommendations on how to use structured methods with sensitive populations are also provided to inform future research.
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This study explored the struggles and rewards of trauma work and the notion that individuals are changed in some way by the work they do with survivors of traumatic events. Interpretative phenomenological analysis of interviews wi...
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This study explored the struggles and rewards of trauma work and the notion that individuals are changed in some way by the work they do with survivors of traumatic events. Interpretative phenomenological analysis of interviews with 12 mental health professionals working in Sri Lanka has shown these changes to have both an accumulated negative emotional impact but also to simultaneously contain positive, growth-promoting and personally satisfying aspects. There is a bias prevalent in the trauma literature towards focusing on the many negative aspects of the impact of working with survivors of trauma or surveying the mode-rating factors for managing secondary trauma. The present research, instead, uses the paradigm of adversarial growth to demonstrate that when mental health professionals rebuild their assumptive world in light of their experiences of working with survivors of trauma there are valuable opportunities for personal, and by implication, professional growth. This study is of a qualitative nature and explores phenomenologically grounded knowledge seeking to gain an under-standing of the lived experiences reported by mental health professionals working with survivors of trauma and the subjective and collective meanings that shape these experiences.
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OBJECTIVE: Psychosocial comorbidity and quality of life (QOL) and its association with knowledge, utilization, and need for psychosocial support have been studied in long-term breast cancer survivors. METHODS: One thousand eighty-...
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OBJECTIVE: Psychosocial comorbidity and quality of life (QOL) and its association with knowledge, utilization, and need for psychosocial support have been studied in long-term breast cancer survivors. METHODS: One thousand eighty-three patients were recruited through a population-based cancer registry an average of 47 months following diagnosis (66% response rate). Self-report measures (e.g., Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist--Civilian Version, and Short-Form Health Survey) were used. RESULTS: Thirty-eight percent of patients had moderate to high anxiety, and 22% had moderate to high depression; posttraumatic stress disorder was observed in 12%. The overall psychological comorbidity was 43% and 26% for a possible and probable psychiatric disorder. Disease progress, detrimental interactions, less social support, a lower educational level, and younger age were predictors of psychological comorbidity (P<.004). Lower QOL (P<.01) and higher levels of anxiety (P<.001) were observed in cancer survivors compared to age-adjusted normative comparison groups. Time since diagnosis had no significant impact on psychological comorbidity as well as QOL. Forty-six percent of women felt insufficiently informed about support offers. Insufficient knowledge was associated with older age and lower education (P<.05). Since diagnosis, 57% had participated in cancer rehabilitation and 24% in other psychosocial support programs. Fifteen percent of all patients and 23% of those with a possible psychiatric disorder expressed their need for psychosocial support. Women with distress and perceived support needs who did not participate in past support programs were older, less educated, and less informed (P<.05). CONCLUSION: Findings show the long-term impact of breast cancer and indicate need for patient education, screening for psychosocial distress, and implementation of psychological interventions tailored in particular for older women.
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The study reported in this article was conducted to propose a set graphical and analytical tools and assess their clinical utility by analyzing gait kinematics and dynamics of polio survivors. Phase-plane portraits and first retur...
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The study reported in this article was conducted to propose a set graphical and analytical tools and assess their clinical utility by analyzing gait kinematics and dynamics of polio survivors. Phase-plane portraits and first return maps were used as graphical tools to detect abnormal patterns in the sagittal kinematics of post-polio gait. Two new scalar measures were introduced to assess the bilateral kinematic symmetry and dynamic stability of human locomotion. Nine healthy subjects and seventeen post-polio patients were involved in the project. Significant increases in the knee extension and ankle plantar flexion of post-polio patients were observed during the weight acceptance phases of their gait. Polio patients also exhibited highly noticeable excessive hip flexion during the swing phase of their ambulation. Using the proposed symmetry measure, we concluded that post-polio patients walked less symmetrically than normals. Our conclusion, however was based on the bilateral symmetry in the sagittal plane only. Finally, we observed that post-polio patients walked significantly less stably than normals. In addition, weaknesses in lower extremity muscles of polio patients were found to be an important factor that affected stable ambulation. [References: 10]
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Introduction Nearly 10% of all combat injuries during the most recent conflicts in Iraq and Afghanistan involve thoracic trauma. The long-term outcomes of these combat-related injuries with respect to lung function have not been f...
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Introduction Nearly 10% of all combat injuries during the most recent conflicts in Iraq and Afghanistan involve thoracic trauma. The long-term outcomes of these combat-related injuries with respect to lung function have not been fully evaluated. Limited research in civilian polytrauma patients have shown significant obstructive physiology in nearly half of their population without clear etiology. We sought to further characterize the extent to which these active duty service members (ADSM) are chronically affected by their thoracic injuries. Materials and Methods We conducted a retrospective chart review and analysis of ADSM who sustained thoracic injuries while deployed in support combat operations from 2003 to 2013. Using the Department of Defense Trauma Registry, 2,049 patients were found to have sustained thoracic trauma during these conflicts, of which we were able to identify 298 patients with postinjury pulmonary function testing (PFT) available for analysis. Following standardization of these tests using the established reference values, PFT was compared to a representative population of ADSM. Additional analysis was completed to detect incidence of abnormal PFTs when compared to both type of injury (burn, blunt, penetrating, and other) and also Injury Severity Score. Results In our patient population, there was a significant increase in abnormal PFTs when compared to a representative population. Of these, 31.8% of patients displayed obstructive physiology versus 3.7% in the control (P < 0.001), 24.5% displayed restrictive or restrictive pattern (those without full lung volumes available utilizing forced vital capacity) versus 4.9% (P < 0.0001), and 7.9% displaying mixed pattern. Further, increasing rates of abnormal PFTs were identified in comparison to Injury Severity Score (odds ratio 1.03). There was no significant increase in abnormal PFTs when stratified by type of injury. Finally, there was no significant change identified in pulmonary function before and after injury in our limited population of 19 patients. Conclusions There is a significant increase in the percent of abnormal PFTs in ADSM following thoracic injury when compared to patients with similar risk factors and baseline health. It is unclear why the rates of obstruction are high in our population as previous research has not definitively shown increased rates of asthma in previously deployed, uninjured ADSM; however, this finding is consistent with limited previous research in civilian trauma patients. Further research into the long-term outcomes of thoracic trauma and occupational exposures of combat is paramount for improved outcomes going forward.
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Clinical care and research around cancer cachexia in children is lack-ing. Cachexia increases treatment -related toxicity and long-term morbidity and potentially affects mortality. We highlight the urgent need for specific focus o...
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Clinical care and research around cancer cachexia in children is lack-ing. Cachexia increases treatment -related toxicity and long-term morbidity and potentially affects mortality. We highlight the urgent need for specific focus on childhood cancer cachexia and discuss po-tential solutions to inform cachexia therapeutics for children.
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The number of cancer survivors is increasing dramatically. Many survivors report long-term psychosocial, physical and other consequences. To understand the issues faced by Australian cancer survivors we conducted focus groups with...
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The number of cancer survivors is increasing dramatically. Many survivors report long-term psychosocial, physical and other consequences. To understand the issues faced by Australian cancer survivors we conducted focus groups with cancer patients and health professionals.
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