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Sample records for adult burn survivors

  1. Adult burn survivors' personal experiences of rehabilitation: an integrative review.

    PubMed

    Kornhaber, R; Wilson, A; Abu-Qamar, M Z; McLean, L

    2014-02-01

    Burn rehabilitation is a lengthy process associated with physical and psychosocial problems. As a critical area in burn care, the aim was to systematically synthesise the literature focussing on personal perceptions and experiences of adult burn survivors' rehabilitation and to identify factors that influence their rehabilitation. Studies were identified through an electronic search using the databases: PubMed, CINAHL, EMBASE, Scopus, PsycINFO and Trove of peer reviewed research published between 2002 and 2012 limited to English-language research with search terms developed to reflect burn rehabilitation. From the 378 papers identified, 14 research papers met the inclusion criteria. Across all studies, there were 184 participants conducted in eight different countries. The reported mean age was 41 years with a mean total body surface area (TBSA) burn of 34% and the length of stay ranging from one day to 68 months. Significant factors identified as influential in burn rehabilitation were the impact of support, coping and acceptance, the importance of work, physical changes and limitations. This review suggests there is a necessity for appropriate knowledge and education based programmes for burn survivors with consideration given to the timing and delivery of education to facilitate the rehabilitation journey. PMID:24050979

  2. Outcomes in Adult Survivors of Childhood Burn Injuries as Compared with Matched Controls.

    PubMed

    Stone, James; Gawaziuk, Justin P; Khan, Sazzadul; Chateau, Dan; Bolton, James M; Sareen, Jitender; Enns, Jessica; Doupe, Malcolm; Brownell, Marni; Logsetty, Sarvesh

    2016-01-01

    Limited research exists examining long-term mental and physical health outcomes in adult survivors of pediatric burns. The authors examine the postinjury lifetime prevalence of common mental and physical disorders in a large pediatric burn cohort and compare the results with matched controls. Seven hundred and forty five survivors of childhood burns identified in the Burn Registry (<18 years old and total BSA >1% between April 1, 1988 and March 31, 2010) were matched 1:5 to the general population based on age at time of injury (index date), sex, and geographic residence. Postinjury rate ratio (RR) was used to compare burn cases and control cohorts for common mental and physical illnesses through physician billings, and hospital claims. RR was adjusted for sex, rural residence, and income. Compared with matched controls, postburn cases had significantly higher RR of all mental disorders, which remained significant (P < .05) after adjustment (major depression RR = 1.5 [confidence limit {CL}: 1.2-1.8], anxiety disorder RR = 1.5 [CL: 1.3-1.8), substance abuse RR = 2.3 [CL: 1.7-3.2], suicide attempt RR = 4.3 [CL: 1.6-12.1], or any mental disorder RR = 1.5 [CL: 1.3-1.8]). The relative rate of some physical illnesses was also significantly increased in burn survivors: arthritis RR = 1.2 (CL: 1.1-1.4), fractures RR = 1.4 (CL: 1.2-1.6), total respiratory morbidity RR = 1.1 (CL: 1.02-1.3), and any physical illness RR = 1.2 (CL: 1.1-1.3). Adult survivors of childhood burn injury have significantly increased rates of postburn mental and physical illnesses. Screening and appropriate management of these illnesses is essential when caring for this population. PMID:26594866

  3. Aerobic Fitness Is Disproportionately Low in Adult Burn Survivors Years After Injury.

    PubMed

    Ganio, Matthew S; Pearson, James; Schlader, Zachary J; Brothers, Robert Matthew; Lucas, Rebekah A I; Rivas, Eric; Kowalske, Karen J; Crandall, Craig G

    2015-01-01

    A maximal aerobic capacity below the 20th percentile is associated with an increased risk of all-cause mortality (Blair 1995). Adult Adult burn survivors have a lower aerobic capacity compared with nonburned adults when evaluated 38 ± 23 days postinjury (deLateur 2007). However, it is unknown whether burn survivors with well-healed skin grafts (ie, multiple years postinjury) also have low aerobic capacity. This project tested the hypothesis that aerobic fitness, as measured by maximal aerobic capacity (VO2max), is reduced in well-healed adult burn survivors when compared with normative values from nonburned individuals. Twenty-five burn survivors (36 ± 12 years old; 13 females) with well-healed split-thickness grafts (median, 16 years postinjury; range, 1-51 years) covering at least 17% of their BSA (mean, 40 ± 16%; range, 17-75%) performed a graded cycle ergometry exercise to test volitional fatigue. Expired gases and minute ventilation were measured via a metabolic cart for the determination of VO2max. Each subject's VO2max was compared with sex- and age-matched normative values from population data published by the American College of Sports Medicine, the American Heart Association, and recent epidemiological data (Aspenes 2011). Subjects had a VO2max of 29.4 ± 10.1 ml O2/kg body mass/min (median, 27.5; range, 15.9-53.3). The use of American College of Sports Medicine normative values showed that mean VO2max of the subjects was in the lower 24th percentile (median, 10th percentile). A total of 88% of the subjects had a VO2max below American Heart Association age-adjusted normative values. Similarly, 20 of the 25 subjects had a VO2max in the lower 25% percentile of recent epidemiological data. Relative to nongrafted subjects, 80 to 88% of the evaluated skin-graft subjects had a very low aerobic capacity. On the basis of these findings, adult burn survivors are disproportionally unfit relative to the general U.S. population, and this puts

  4. Inpatient peer support for adult burn survivors-a valuable resource: a phenomenological analysis of the Australian experience.

    PubMed

    Kornhaber, R; Wilson, A; Abu-Qamar, M; McLean, L; Vandervord, J

    2015-02-01

    Peer support has long been recognised as an essential component of a supportive network for people facing adversity. In particular, burn survivor peer support is a valuable and credible resource available to those rehabilitating from a severe burn. The aim of this study was to explore burn survivors' experiences of providing and receiving inpatient peer support to develop an in-depth understanding of the influence during the rehabilitation journey. In 2011, twenty-one burn survivors were recruited from four severe burn units across Australia. A qualitative phenomenological methodology was used to construct themes depicting survivors' experiences. Participants were selected through purposeful sampling, and data collected through in-depth individual semi-structured interviews. Data were analysed using Colaizzi's phenomenological method of data analysis. Central to burn rehabilitation was the notion of peer support having a significant impact on burn survivors' psychosocial rehabilitation. The emergent theme 'Burn Survivor Peer Support' identified five cluster themes: (1) Encouragement, inspiration and hope (2) Reassurance (3) The Importance of Timing (4) The Same Skin (5) Appropriate Matching. These findings demonstrate that peer support assists with fostering reassurance, hope and motivation in burn rehabilitation. A national network based on a clinician led inpatient burn survivor peer support programme could provide burn survivors across Australia, and in particular remote access locations, with the benefits of peer support necessary to endure the rehabilitation journey. PMID:24927991

  5. The Reliability and Validity of the Perceived Stigmatization Questionnaire (PSQ) and the Social Comfort Questionnaire (SCQ) among an Adult Burn Survivor Sample

    ERIC Educational Resources Information Center

    Lawrence, John W.; Fauerbach, James A.; Heinberg, Leslie J.; Doctor, Marion; Thombs, Brett D.

    2006-01-01

    In this study, 361 adult burn survivors completed the Perceived Stigmatization Questionnaire (PSQ), the Social Comfort Questionnaire (SCQ), and other measures. Both the PSQ and SCQ had good internal consistency indices. Factor analysis of the PSQ yielded 3 factors (absence of friendly behavior, confused/staring behavior, and hostile behavior). The…

  6. Phoenix Society for Burn Survivors

    MedlinePlus

    ... Learn More For First Responders & Medical Professionals Phoenix Society is the leader in connecting the burn recovery ... It can be a... Continue Reading The Phoenix Society, Inc. 1835 RW Berends Dr. SW Grand Rapids, ...

  7. Burns functional disabilities among burn survivors: a study in Komfo Anokye Teaching Hospital, Ghana

    PubMed Central

    Agbenorku, Pius

    2013-01-01

    Aim: To determine the types of functional disabilities in adult and paediatric burns survivors, with specific emphasis on potential risk and socio-economic factors of burn disabilities present in Ghana. Patients and Methods: The descriptive study was carried out in Komfo Anokye Teaching Hospital, Kumasi, Ghana from May 2011 to April 2012. Burn survivors who came for follow-up visits after been discharged home and had functional disability were the participants of the study. They were physically examined and interviewed using a pre-tested questionnaire after their informed consent/or that of their parents (in the cases of paediatrics burns survivors) was sought. Results: A total of 70 participants consented for the study. Their ages ranged from 8/12 – 78 years, with a mean age of 12±1.7 years. Majority (60.0%, N=42) of the participants had third degree burns. The nature of disabilities of participants were mostly scar contractures (42.9%, N=30) of which 36.7% (N=11) had impeded arm elevation; 23.3% (N=7) could not fold the palm or move the digits. From the multiple regression analysis risk factors for burn victim to have disability were paediatric age (OR=11.1, P=0.043), third degree of burn (OR=6.2, P=0.001) and anatomical part affected (OR=18.3, P=0.031). Socio-economic factors that affected burn disability victims were nuclear family compensation (OR=4.2, P=0.021), community mockery/stigmatization (OR=0.1, P=0.052) and caretakers time and finance (OR=5.2, P=0.033). Conclusion: The commonest functional disabilities recorded were scar contractions of the axilla region which had impeded the ability of the patients to lift the arm. Risk factors for burns disability included childhood age, third degree of burn incurred and anatomical part affected. Social factors influencing the lives of burn survivors with disability were good family and negative community interactions. Significant economical factors recorded were caretakers’ time and financial constrains. PMID

  8. Explanatory Model of Resilience in Pediatric Burn Survivors.

    PubMed

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

    2016-01-01

    Identifying factors of adjustment in pediatric burn patients may facilitate appropriate mental health interventions postinjury. The aim of this is study was to explore the roles of both the patient's and caregivers' resilience and posttraumatic stress in pediatric burn survivor adjustment. For the purposes of the study, "51 patient-parent/guardian" dyads participated. Patients answered the Resilience Questionnaire for Children and Adolescents, and caregivers answered the Mexican Resilience Scale and the Davidson Trauma Scale. The roles of patient age, time since the burn, and size of burn injury were also considered. Statistical analyses included Spearman's ρ for correlations and structural equation modeling. P less than .05 was considered significant. Patients and caregivers reported high levels of resilience, and the majority of caregivers reported low severity of posttraumatic stress disorder symptoms. Pediatric burn survivors' resilience was associated with being younger at the time of the burn and less severity of intrusive and avoidance symptoms in caregivers; it was also associated with a higher resilience in caregivers. It can be concluded that psychological responses of caregivers of pediatric burn survivors affect the well being and positive adjustment of patients; thus psychological services for caregivers would likely have a double benefit for both caregivers and patients. PMID:26056758

  9. Predictors of insulin resistance in pediatric burn injury survivors 24 to 36 months post-burn

    PubMed Central

    Chondronikola, Maria; Meyer, Walter J.; Sidossis, Labros S.; Ojeda, Sylvia; Huddleston, Joanna; Stevens, Pamela; Børsheim, Elisabet; Suman, Oscar E.; Finnerty, Celeste C.; Herndon, David N.

    2014-01-01

    Background Burn injury is a dramatic event with acute and chronic consequences including insulin resistance. However, factors associated with insulin resistance have not been previously investigated. Purpose To identify factors associated with long-term insulin resistance in pediatric burn injury survivors. Methods The study sample consisted of 61 pediatric burn injury survivors 24 to 36 months after the burn injury, who underwent an oral glucose tolerance test. To assess insulin resistance, we calculated the area under the curve for glucose and insulin. The diagnostic criteria of the American Diabetes Association were used to define individuals with impaired glucose metabolism. Additional data collected include body composition, anthropometric measurements, burn characteristics and demographic information. The data were analyzed using multivariate linear regression analysis. Results Approximately 12% of the patients met the criteria for impaired glucose metabolism. After adjusting for possible confounders, burn size, age and percent body fat were associated with the area under the curve for glucose (p<0.05 for all). Time post-burn and lean mass were inversely associated with the area under the curve for glucose (p<0.05 for both). Similarly, older age predicted higher insulin area under the curve. Conclusion A significant proportion of pediatric injury survivors suffer from glucose abnormalities 24–36 months post-burn. Burn size, time post-burn, age, lean mass and adiposity are significant predictors of insulin resistance in pediatric burn injury survivors. Clinical evaluation and screening for abnormal glucose metabolism should be emphasized in patients with large burns, older age and survivors with high body fat. PMID:24918945

  10. Burn Survivors' Perceptions regarding Relevant Sexual Education Strategies

    ERIC Educational Resources Information Center

    Parrott, Yolan; Esmail, Shaniff

    2010-01-01

    Purpose: This paper aims to investigate the unique issues childhood burn survivors experience in relation to sex education and sexual development. Design/methodology/approach: Using a phenomenological approach, participants described their lived experiences with regards to sex education and the sexuality issues they encountered as child burn…

  11. Recovery trajectories after burn injury in young adults: does burn size matter?

    PubMed

    Ryan, Colleen M; Lee, Austin; Kazis, Lewis E; Schneider, Jeffrey C; Shapiro, Gabriel D; Sheridan, Robert L; Meyer, Walter J; Palmieri, Tina; Pidcock, Frank S; Reilly, Debra; Tompkins, Ronald G

    2015-01-01

    appearance remained below the non-burn levels throughout the 3-year period regardless of burn size. Three-year recovery trajectories of survivors with larger burn size showed improvements in most areas, but these improvements lagged behind those with smaller burns. Poor perceived appearance was persistent and prevalent regardless of burn size and was found to limit social function in these young adult burn survivors. Expectations for multidimensional recovery from burns in young adults can be benchmarked based on burn size with important implications for patient monitoring and intervening in clinical care. PMID:25501787

  12. The main concern of burn survivors in Iran

    PubMed Central

    Zamanzadeh, Vahid; Valizadeh, Lila; Lotfi, Mojgan; Salehi, Feridoon; Khalili, Assef

    2016-01-01

    Background: The present work was conducted to study the burn patients’ experiences to get an insight into their main concerns when they suffer the tragic event, recover from it, and adjust back in the society, so that better rehabilitation programs can be planned corresponding to their needs as well as to the needs of the society and the existing situations. Materials and Methods: In this qualitative study, 17 burn survivors were enrolled. Unstructured interviews were used for data collection. All the interviews were recorded, transcribed, and analyzed using qualitative content analysis method. Results: Based on the existing elements of the explicit textual meanings, two categories of threat and disturbance were formed. The category of threat was extracted from the following five subcategories: (a) Threat to physical life; (b) threat to the process of living; (c) psychological threat; (d) spiritual threat; and (e) social threat. The category of disturbance was extracted from the following three subcategories: (a) Sensory disturbance: Suffering pain; (b) self-concept disturbance; and (c) behavioral disturbance. Conclusions: Burn survivors experience severe pain, enduring and suffering in their daily activities after burn. Passing through these difficult trajectories is perceived as a threat and disturbance in self-integrity. PMID:27563326

  13. Service Patterns of Adult Survivors of Childhood versus Adult Sexual Assault/Abuse

    ERIC Educational Resources Information Center

    Grossman, Susan F.; Lundy, Marta; Bertrand, Cathy; Ortiz, Cynthia; Tomas-Tolentino, Grace; Ritzema, Kim; Matson, Julia

    2009-01-01

    This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the…

  14. Adult Adjustment of Survivors of Institutional Child Abuse in Ireland

    ERIC Educational Resources Information Center

    Carr, Alan; Dooley, Barbara; Fitzpatrick, Mark; Flanagan, Edel; Flanagan-Howard, Roisin; Tierney, Kevin; White, Megan; Daly, Margaret; Egan, Jonathan

    2010-01-01

    Objective: To document the adult adjustment of survivors of childhood institutional abuse. Method: Two hundred and forty-seven adult survivors of institutional abuse with a mean age of 60 were interviewed with a protocol that included the Childhood Trauma Questionnaire, modules from the Structured Clinical Interview for Axis I Disorders of DSM IV…

  15. Childhood Sexual Abuse. A Booklet for First Nations Adult Survivors.

    ERIC Educational Resources Information Center

    Samson, Alana; And Others

    This booklet offers information about sources of help for First Nations adult survivors of childhood sexual abuse, particularly in Canada. It explains the definition of sexual abuse and describes the specifics of the law regarding such abuse. Descriptions of common aspects of childhood sexual abuse include quotes from adult survivors. Long-term…

  16. The Psychospiritual Dynamics of Adult Survivors of Abuse.

    ERIC Educational Resources Information Center

    Lemoncelli, John; Carey, Andrew

    1996-01-01

    Discusses challenges in treating adult survivors of physical, emotional, and sexual abuse, and how the relationship with God can either psychologically promote healing or maintain an abusive cycle. Argues that clinicians must understand the dynamic bonding process between abuser and survivor and how this relationship is typically transferred to…

  17. Uncoupled skeletal muscle mitochondria contribute to hypermetabolism in severely burned adults

    PubMed Central

    Herndon, David N.; Børsheim, Elisabet; Chao, Tony; Reidy, Paul T.; Borack, Michael S.; Rasmussen, Blake B.; Chondronikola, Maria; Saraf, Manish K.; Sidossis, Labros S.

    2014-01-01

    Elevated metabolic rate is a hallmark of the stress response to severe burn injury. This response is mediated in part by adrenergic stress and is responsive to changes in ambient temperature. We hypothesize that uncoupling of oxidative phosphorylation in skeletal muscle mitochondria contributes to increased metabolic rate in burn survivors. Here, we determined skeletal muscle mitochondrial function in healthy and severely burned adults. Indirect calorimetry was used to estimate metabolic rate in burn patients. Quadriceps muscle biopsies were collected on two separate occasions (11 ± 5 and 21 ± 8 days postinjury) from six severely burned adults (68 ± 19% of total body surface area burned) and 12 healthy adults. Leak, coupled, and uncoupled mitochondrial respiration was determined in permeabilized myofiber bundles. Metabolic rate was significantly greater than predicted values for burn patients at both time points (P < 0.05). Skeletal muscle oxidative capacity, citrate synthase activity, a marker of mitochondrial abundance, and mitochondrial sensitivity to oligomycin were all lower in burn patients vs. controls at both time points (P < 0.05). A greater proportion of maximal mitochondrial respiration was linked to thermogenesis in burn patients compared with controls (P < 0.05). Increased metabolic rate in severely burned adults is accompanied by derangements in skeletal muscle mitochondrial function. Skeletal muscle mitochondria from burn victims are more uncoupled, indicating greater heat production within skeletal muscle. Our findings suggest that skeletal muscle mitochondrial dysfunction contributes to increased metabolic rate in burn victims. PMID:25074988

  18. Income in Adult Survivors of Childhood Cancer

    PubMed Central

    Wengenroth, Laura; Sommer, Grit; Schindler, Matthias; Spycher, Ben D.; von der Weid, Nicolas X.; Stutz-Grunder, Eveline; Michel, Gisela; Kuehni, Claudia E.

    2016-01-01

    Introduction Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income. Methods As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age <21 years, who had survived ≥5 years after diagnosis of the primary tumor. Siblings were used as a comparison group. We asked questions about education, profession and income and retrieved clinical data from the SCCR. We used multivariable logistic regression to identify characteristics associated with income. Results We analyzed data from 1’506 survivors and 598 siblings. Survivors were less likely than siblings to have a high monthly income (>4’500 CHF), even after we adjusted for socio-demographic and educational factors (OR = 0.46, p<0.001). Older age, male sex, personal and parental education, and number of working hours were associated with high income. Survivors of leukemia (OR = 0.40, p<0.001), lymphoma (OR = 0.63, p = 0.040), CNS tumors (OR = 0.22, p<0.001), bone tumors (OR = 0.24, p = 0.003) had a lower income than siblings. Survivors who had cranial irradiation, had a lower income than survivors who had no cranial irradiation (OR = 0.48, p = 0.006). Discussion Even after adjusting for socio-demographic characteristics, education and working hours, survivors of various diagnostic groups have lower incomes than siblings. Further research needs to identify the underlying causes. PMID:27213682

  19. Life Satisfaction in Adult Survivors of Childhood Brain Tumors

    PubMed Central

    Crom, Deborah B.; Li, Zhenghong; Brinkman, Tara M.; Hudson, Melissa M.; Armstrong, Gregory T.; Neglia, Joseph; Ness, Kirsten K.

    2014-01-01

    Adult survivors of childhood brain tumors experience multiple, significant, life-long deficits as a consequence of their malignancy and therapy. Current survivorship literature documents the substantial impact such impairments have on survivors’ physical health and quality of life. Psychosocial reports detail educational, cognitive, and emotional limitations characterizing survivors as especially fragile, often incompetent, and unreliable in evaluating their circumstances. Anecdotal data suggests some survivors report life experiences similar to those of healthy controls. The aim of our investigation was to determine whether life satisfaction in adult survivors of childhood brain tumors differs from that of healthy controls and to identify potential predictors of life satisfaction in survivors. This cross-sectional study compared 78 brain tumor survivors with population–based matched controls. Chi-square tests, t-tests, and linear regression models were used to investigate patterns of life satisfaction and identify potential correlates. Results indicated life satisfaction of adult survivors of childhood brain tumors was similar to that of healthy controls. Survivors’ general health expectations emerged as the primary correlate of life satisfaction. Understanding life satisfaction as an important variable will optimize the design of strategies to enhance participation in follow-up care, reduce suffering, and optimize quality of life in this vulnerable population. PMID:25027187

  20. Sexual Functioning in Young Adult Survivors of Childhood Cancer

    PubMed Central

    Zebrack, Brad J.; Foley, Sallie; Wittmann, Daniela; Leonard, Marcia

    2009-01-01

    Background Studies of sexuality or sexual behavior in childhood cancer survivors tend to examine relationships or achievement of developmental milestones but not physiological response to cancer or treatment. The purpose of this study is to (1) identify prevalence and risk factors for sexual dysfunction in childhood cancer survivors, and (2) examine the extent to which sexual dysfunction may be associated with health-related quality of life (HRQOL) and psychosocial outcomes. Methods Five hundred ninety-nine survivors age 18-39 years completed standardized measures of sexual functioning, HRQOL, psychological distress and life satisfaction. Descriptive statistics assessed prevalence of sexual symptoms. Bivariate analyses identified correlates of sexual symptoms and examined associations between symptoms and HRQOL/psychosocial outcomes. Results Most survivors appear to be doing well, although 52% of female survivors and 32% of male survivors reported at least “a little of a problem” in one or more areas of sexual functioning. Mean symptom score for females was more than twice that of males. Sexual symptoms were associated with reporting health problems. Significant associations between sexual functioning and HRQOL outcomes were observed, with gender differences in strengths of association suggesting that males find sexual symptoms more distressing than do females. Conclusions While most survivors appear to be doing well in this important life domain, some young adult survivors report sexual concerns. While female survivors may report more sexual symptoms than male survivors, males may experience more distress associated with sexual difficulties. Better specified measures of sexual function, behavior and outcomes are needed for this young adult population. PMID:19862693

  1. Adult Attachment and Longterm Effects in Survivors of Incest.

    ERIC Educational Resources Information Center

    Alexander, Pamela C.; Anderson, Catherine L.; Brand, Bethany; Schaeffer, Cindy M.; Grelling, Barbara Z.; Kretz, Lisa

    1998-01-01

    Ninety-two adult female incest survivors were interviewed and completed measures of current functioning. Hierarchical regression analyses suggested that adult attachment behavior was significantly associated with personality structure, depression, and distress; and abuse severity was associated with posttraumatic stress disorder symptoms and…

  2. Restorying the self: an exploration of young burn survivors' narratives of resilience.

    PubMed

    Lau, Ursula; van Niekerk, Ashley

    2011-09-01

    The results of this exploratory study reflect a shift from public health studies that aim to examine the risk and prevalence of burn injury, toward eliciting survivors' subjective meaning-making processes beyond the injury event. We drew on a narrative framework to explore how young survivors' experiences of burn injury led to reconstructions of self and shifts in thinking about others and the world. Although participants' narratives revealed elements of heightened self-awareness, need for acceptance, and desire for recognition, these stood alongside counter narratives denoting positive, transformative, and resilient aspects of healing that reflected a rebirth of the self, life having purpose, and psychospiritual growth. A multidimensional and relational framework for resilience acknowledges the "deficient," but also recognizes the pathways to growth, healing, meaning, and purpose. This shift toward person-centered meanings has value in informing interventions beyond the immediate "wound care," toward the survivors' lifelong (re)negotiation of identity, appearance, psychological adjustment, and social reintegration. PMID:21490293

  3. Elderly adult survivors of family violence. Implications for clinical practice.

    PubMed

    Anetzberger, G J

    1997-10-01

    This article on elderly adult survivors of domestic violence (usually women) reviews the literature that examines the impact on later life of domestic violence experienced earlier in life and that examines the effects of elder abuse perpetrated by adult family members. The discussion is illustrated with case studies and figures that list the physical, psychological, behavioral, and social effects of each type of violence as well as intervening variables. Next, the paper reviews the influence of culture and ethnicity on the meaning attached to elder abuse and on help-seeking or accepting behavior. The article then proposes a conceptual framework that uses contributing factors (cultural background, individual influences, and cohort influences), modifying factors (the nature of violence, personal circumstances, and relationship with perpetrator), the meaning of violence, and the effects on the survivor to explain the effects of early or late family violence on elderly adult survivors. The discussion notes that the framework focuses on negative effects but that survivors of domestic violence can experience positive effects, such as the development of personal coping skills. The article ends by noting that this proposed framework has clinical implications because it recognizes that the effects of domestic violence on elderly adults may be complicated, it helps practitioners link symptoms to domestic violence, it helps practitioners realize that the meaning of domestic violence may vary among elderly victims, and it shows that family violence occurs in a social context. PMID:12322016

  4. Developmental Status and Intimacy in Adult Survivors of Childhood Cancer.

    ERIC Educational Resources Information Center

    Zevon, Michael A.; Corn, Barbara; Lowrie, Geoffrey; Green, Daniel M.

    Whereas aggressive multimodal therapies are responsible for improved survival rates of children and adolescents diagnosed with cancer, concern has grown regarding the potential for adverse and delayed developmental effects resulting from these treatments. In light of this concern, this study assessed 207 adult survivors of childhood cancer in…

  5. Victim Therapy with Adult Survivors of Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Norris, Thomas L.

    This paper describes a four-phase therapeutic approach that has proven useful to adult female and male survivors of child sexual abuse. The methods described are primarily used in individual therapy, although the context is within the family therapy realm and relies heavily upon Structural Family Systems Theory. The four phases which a victim…

  6. Adult Acute Myeloid Leukemia Long-term Survivors

    PubMed Central

    Cheng, M. Jennifer; Hourigan, Christopher S.; Smith, Thomas J.

    2014-01-01

    The number of leukemia patients and survivors is growing. This review summarizes what is known regarding the health related quality of life (HRQOL) and medical complications associated with acute myeloid leukemia (AML) disease and treatment and highlights understudied aspects of adult AML survivorship care, and potential novel areas for intervention. PMID:25243197

  7. A Coping Model for Adult Survivors of Childhood Sexual Abuse.

    ERIC Educational Resources Information Center

    Draucker, Claire B.

    1995-01-01

    A group of 149 adult survivors of childhood sexual abuse was tested using a causal model that identifies relationships among sexual abuse situation characteristics, the accomplishment of cognitive coping tasks, and long-term effects. Results indicated the model did not fit the data. A revised model is proposed and examined. (JBJ)

  8. A Thematic Study of the Role of Social Support in the Body Image of Burn Survivors

    PubMed Central

    Hodder, Kellie; Chur-Hansen, Anna; Parker, Andrea

    2014-01-01

    There is evidence that social support is important for the development and maintenance of body image satisfaction for people who have sustained burn injuries. This qualitative study explored the specific mechanisms by which social support impacts the body image satisfaction of burn survivors, drawing on nine participants’ in depth accounts. Participants were recruited through a burns unit at a public hospital in South Australia. Interviews were conducted with nine female burn survivors aged between 24 and 65 (mean age 44.6). Participants described their perceptions about their appearance post burn and their social support experiences. Four themes were identified: acceptance, social comparison, talking about appearance concerns, and the gaze of others. Results indicate that for these participants, social support was an important factor in coming to terms with changes in appearance, specifically support that helps to minimise feelings of difference. Unhelpful aspects of social support were also identified included feeling that suffering was being dismissed and resenting the perceived expectation from supports to be positive. Social supports are important to consider in relation to body image for those working with people who have survived burn injuries. PMID:26973929

  9. A Thematic Study of the Role of Social Support in the Body Image of Burn Survivors.

    PubMed

    Hodder, Kellie; Chur-Hansen, Anna; Parker, Andrea

    2014-01-13

    There is evidence that social support is important for the development and maintenance of body image satisfaction for people who have sustained burn injuries. This qualitative study explored the specific mechanisms by which social support impacts the body image satisfaction of burn survivors, drawing on nine participants' in depth accounts. Participants were recruited through a burns unit at a public hospital in South Australia. Interviews were conducted with nine female burn survivors aged between 24 and 65 (mean age 44.6). Participants described their perceptions about their appearance post burn and their social support experiences. Four themes were identified: acceptance, social comparison, talking about appearance concerns, and the gaze of others. Results indicate that for these participants, social support was an important factor in coming to terms with changes in appearance, specifically support that helps to minimise feelings of difference. Unhelpful aspects of social support were also identified included feeling that suffering was being dismissed and resenting the perceived expectation from supports to be positive. Social supports are important to consider in relation to body image for those working with people who have survived burn injuries. PMID:26973929

  10. Efficacy of a tobacco quitline among adult cancer survivors

    PubMed Central

    Klesges, Robert C.; Krukowski, Rebecca A.; Klosky, James L.; Liu, Wei; Srivastava, Deo Kumar; Boyett, James M.; Lanctot, Jennifer Q.; Hudson, Melissa M.; Folsom, Charla; Lando, Harry; Robison, Leslie L.

    2015-01-01

    Objective The purpose of the study (conducted 2010–2013) was to determine the efficacy of two common types of tobacco quitlines in adult cancer survivors who regularly smoked cigarettes. Method Adult onset cancer survivors in Memphis, Tennessee (n = 427, 67% female, 60% Caucasian) were randomized either to a Proactive (i.e., counselor-initiated calls) or Reactive (i.e., participant-initiated calls) quitline. Both conditions also received nicotine replacement therapy. The primary outcome was biochemically-verified (i.e., salivary cotinine) smoking cessation. Results While 12-month self-reported abstinence was consistent with other published studies of smoking cessation (22% and 26% point prevalence abstinence for Proactive and Reactive conditions, respectively), 48% of participants who were tested for cotinine failed biochemical verification, indicating a considerable falsification of self-reported cessation. Adjusted cessation rates were less than 5% in both intervention conditions. Conclusion Our results are consistent with other studies indicating that traditional smoking cessation interventions are ineffective among cancer survivors. Moreover, self-reports of cessation were unreliable in cancer survivors participating in a quitline intervention, indicating that future studies should include biochemical verification. Given the importance of smoking cessation among cancer survivors and low cessation rates in the current study, it may be necessary to design alternative interventions for this population. PMID:25572620

  11. Itch assessment scale for the pediatric burn survivor.

    PubMed

    Morris, Vershanna; Murphy, Leticia M; Rosenberg, Marta; Rosenberg, Laura; Holzer, Charles E; Meyer, Walter J

    2012-01-01

    The objective of the study is to evaluate the validity and reliability of the Itch Man Scale developed in 2000 by Blakeney and Marvin in assessing the intensity of itch in the pediatric burn patient. Forty-five patients (31 males and 14 females; average age 9.9 ± 5.0 years; and % TBSA burned 41 ± 25%) with an established itch complaint were studied. They were asked to describe the severity of their itch by two independent raters to determine test-retest reliability. Individuals aged 6 years or older were assessed using parental informants. Concurrent validity was determined by comparing three scales to quantify the level of itch: the Itch Man Scale (a 5-point Likert scale), the 5-D Itch Scale (adapted from a scale for peripheral neuropathy), and the Visual Analog Scale for itch. Itch Man Scale ratings collected from independent raters showed a strong correlation (r = .912, P < .0001). The Itch Man Scale also correlated significantly with the Visual Analog Scale, the gold standard for measurement of pruritus (r = .798, P < .0001). The total summated score of the Duration, Degree, Direction, and Disability domains from the 5-D Itch Scale had a significant correlation with the Itch Man Scale (r = .614, P < .0001). The Degree domain is the only individual component with a significant correlation (r = .757, P < .0001). The Itch Man Scale is a reliable and valid tool to assess itching in pediatric burn patients and to quantify postburn pruritus. PMID:22561307

  12. Self-perceptions of young adults who survived severe childhood burn injury.

    PubMed

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the

  13. Prevalence of Cigarette Smoking among Adult Cancer Survivors in Korea

    PubMed Central

    Park, Jin Joo

    2015-01-01

    Purpose Cigarette smoking is associated not only with increased risk of cancer incidence, but also influences prognosis, and the quality of life of the cancer survivors. Thus, smoking cessation after cancer diagnosis is necessary. However, smoking behavior among Korean cancer-survivors is yet unknown. Materials and Methods We investigated the smoking status of 23770 adults, aged 18 years or older, who participated in the Health Interview Survey of the Korea National Health and Nutrition Examination Survey from 2007 to 2010. Data on the cancer diagnosis and smoking history were obtained from an interview conducted by trained personals. "Cancer-survivor" was defined as anyone who has been diagnosed with cancer by a physician regardless of time duration since diagnosis. Smoking status was classified into "never-smoker", "former-smoker", and "current-smoker". Former-smoker was further divided into "cessation before diagnosis" and "cessation after diagnosis". Results Overall, 2.1% of Korean adults were cancer-survivors. The smoking rate of Korean cancer-survivors was lower than that of non-cancer controls (7.8±1.3% vs. 26.4±0.4%, p<0.001). However, 53.4% of the cancer-survivors continued to smoke after their cancer diagnosis. In multivariate analysis, male gender [odds ratio (OR), 6.34; 95% confidence interval (CI), 2.62-15.31], middle-aged group (OR, 2.74; 95% CI, 1.12-6.72), the lowest income (OR, 4.10; 95% CI, 1.19-14.15), living with smoking family member(s) (OR, 5.49; 95% CI, 2.42-12.48), and the poor self-perceived health status (OR, 2.78; 95% CI, 1.01-7.71) were independently associated with persistent smoking among Korean cancer-survivors. Conclusion The smoking rate among Korean cancer survivors is low. However, the smoking cessation rate after the cancer diagnosis is also low. This mandates comprehensive and systematic intervention for smoking cessation among cancer-survivors. PMID:25684009

  14. Spirituality and Coping with Life Stress among Adult Survivors of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Gall, Terry Lynn

    2006-01-01

    Objective: The purpose of this study was to explore the role of spiritual coping in adult survivors' responses to current life stressors. Although there has been research on general coping and adult survivors of childhood sexual abuse (CSA), there has been no work done on spiritual coping behaviour and survivors' current adjustment. Method: One…

  15. Physical performance limitations among adult survivors of childhood brain tumors

    PubMed Central

    Ness, Kirsten K.; Morris, E. Brannon; Nolan, Vikki G.; Howell, Carrie R.; Gilchrist, Laura S.; Stovall, Marilyn; Cox, Cheryl L.; Klosky, James L.; Gajjar, Amar; Neglia, Joseph P.

    2013-01-01

    Background Young adult survivors of childhood brain tumors (BT) may have late-effects that compromise physical performance and everyday task participation. Objective To evaluate muscle strength, fitness, physical performance, and task participation among adult survivors of childhood BT. Design/Method In-home evaluations and interviews were conducted for 156 participants (54% male). Results on measures of muscle strength, fitness, physical performance, and participation were compared between survivors and population-group members with chi-squared statistics and two-sample t-tests. Associations between late effects and physical performance, and physical performance and participation, were evaluated in regression models. Results BT survivors were a median age of 22 (18–58), and 14.7 (6.5–45.9) years from diagnosis. Survivors had lower estimates of grip strength (Female: 24.7±9.2 vs. 31.5±5.8, Male: 39.0±12.2 vs. 53.0±10.1 kilograms), knee extension strength (Female: 246.6±95.5 vs. 331.5±5.8, Male: 304.7±116.4 vs. 466.6±92.1 Newtons) and peak oxygen uptake (Female: 25.1±8.8 vs. 31.3±5.1, Male: 24.6±9.5 vs. 33.2±3.4 milliliters/kilogram/minute) than population-group members. Physical performance was lower among survivors and associated with not living independently (OR=5.0, 95% CI=2.0–12.2) and not attending college (OR=2.3, 95% CI 1.2–4.4). Conclusion Muscle strength and fitness values among BT survivors are similar to those among persons 60+ years, and are associated with physical performance limitations. Physical performance limitations are associated with poor outcomes in home and school environments. These data indicate an opportunity for interventions targeted at improving long-term physical function in this survivor population. PMID:20564409

  16. Burn Survivors' Experience of Core Outcomes during Return to Life: a Qualitative Study

    PubMed Central

    Zamanzadeh, Vahid; Valizadeh, Leila; Lotfi, Mojgan; Salehi, Feridoon

    2014-01-01

    Introduction: Burn is one of the main and common health problems that face the victims with significant challenges in their lives. The main purpose of caring and rehabilitating these people is returning them to their previous life situation. Thus, the present study was conducted with the purpose of determining the experience of burn survivors with regard to returning to life in order to be able to obtain new concepts of acceptable implications in the present cultural and religious context. Methods: The present study is a qualitative study that was conducted using qualitative content analysis and in-depth unstructured interviews with 15 burn survivors in 2012 and 2013 in Tabriz. Results: During the process of qualitative analysis, the content of the category "balance", as the core essence of the experience of participants, was extracted according to three sub-categories: a- the physical integration (physiological stability, saving the affected limb), b-connecting to the life stream (self-care, getting accustomed, normalization), and c- return to the existence (sense of inner satisfaction and excellence). Conclusion: The results of this study confirmed the physical, psychological and social scales introduced by other studies. Also proposed the concept "return to the existence", that can be measured by the emergence of a sense of inner satisfaction and excellence in the individual, as one of the key and determinant scales in returning the victims of burn to life. PMID:25717453

  17. Recruiting young adult cancer survivors for behavioral research.

    PubMed

    Rabin, Carolyn; Horowitz, Santina; Marcus, Bess

    2013-03-01

    Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies. PMID:22810954

  18. Self Perceptions of Young Adults who Survived Severe Childhood Burn Injury

    PubMed Central

    Russell, W; Robert, RS; Thomas, CR; Holzer, CE; Blakeney, P; Meyer, WJ

    2012-01-01

    Objective The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self concept. In order to anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Method 82 young adult burn survivors (45 males, 37 females) were assessed using the Tennessee Self-Concept, 2nd Edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report, YASR) and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders, SCID I). Results This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 sub-scale scores of Physical function, appearance, and sexuality, Moral conduct, Personal values, Academics and work, and Identity than did the reference population. Pearson correlation coefficients showed that as Moral, Personal, Family and Social aspects of self concept decreased, clinical problems endorsed on the YASR sub-scales increased, including Anxiety Somatic, Attention, Intrusive and Aggressive. Persons with lower self-concept scores on the TSCS2 Personal, Family, and Social Scales, were more withdrawn on the YASR. Similarly those with lower TSCS2 scores on the Personal and Family Scales endorsed significantly more Thought Problems on the YASR. Affective distress on the SCID I was associated with significantly lower self concept. TSCS2 Total Self Concept, Personal, and all of the Supplementary Scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 Total Self

  19. The Experiences of Korean Young Adult Survivors of Childhood Cancer: A Photovoice Study.

    PubMed

    Yi, Jaehee; Kim, Min Ah; An, Sangmin

    2016-07-01

    Photovoice was used to understand the impact of childhood cancer on Korean young adult survivors. Seven survivors of childhood cancer (currently aged 20-27 years), diagnosed before the age of 19 and with cancer treatment completed, participated in five sessions. The participants took photographs that captured their group's weekly topics and participated in discussions about their feelings and experiences. Fifty-six photo images with narratives on the survivors' experiences were produced on these four participant-selected themes: Relationships With Others, Stigma, Overcoming Difficulties, and The Future This study on Korean childhood cancer survivors sheds light on their perspectives about the impact of cancer. Using an innovative methodology that takes the participants' point of view, this study contributes to the literature on young adult cancer survivors' quality of life and their psychosocial adjustment. The results can inform educational programs and increase public awareness by providing survivors' schoolteachers and peers with knowledge about childhood cancer. PMID:26265716

  20. The presence of nightmares as a screening tool for symptoms of posttraumatic stress disorder in burn survivors.

    PubMed

    Low, Aili Janina F; Dyster-Aas, Johan; Kildal, Morten; Ekselius, Lisa; Gerdin, Bengt; Willebrand, Mimmie

    2006-01-01

    Recurrent nightmares can be a symptom of posttraumatic stress disorder (PTSD). This study evaluated the method of asking burn survivors about nightmares as a screening tool for the presence of PTSD symptomatology. The presence of nightmares in 85 individuals treated at the Burn Center in Uppsala, Sweden, between 1996 and 2000 (23 women, 62 men, average age 47 years, average burn size 17% TBSA, average time after burn 3.6 years) was evaluated by one question from the Burn Specific Health Scale (BSHS) and by using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for nightmares. PTSD symptomatology was assessed with the Impact of Event Scale-Revised. Sensitivity, Specificity, Discriminant Ability, and Likelihood Ratios for a positive and a negative result were calculated to evaluate the screening questions. As many as 46% of the burn survivors reported nightmares of some frequency in the BSHS and as many as 28% when using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Both approaches were useful tools for detecting or ruling out PTSD symptoms. The best Discriminant Ability was achieved with a screening test using the BSHS item "I have nightmares." Screening questions for presence of nightmares after burns can be useful in detecting PTSD symptomatology. PMID:16998407

  1. Correlates of Serious Suicidal Ideation and Attempts in Female Adult Sexual Assault Survivors

    ERIC Educational Resources Information Center

    Ullman, Sarah E.; Najdowski, Cynthia J.

    2009-01-01

    Relations between (a) serious suicidal ideation and attempts and (b) demographics, trauma history, assault characteristics, post-assault outcomes, and psychosocial variables were examined among female adult sexual assault survivors. Younger, minority, and bisexual survivors reported greater ideation. More traumas, drug use, and assault disclosure…

  2. Effects of Parental Suicide on the Adolescent Survivors' Lives When They Are Adults

    ERIC Educational Resources Information Center

    Saatci, Yesim

    2013-01-01

    This qualitative inquiry, phenomenology, purported to provide insight into the role of parental suicide on the adolescent survivors' adult lives between 18 and 40. This study described the survivors' coping strategies, self-esteem, and effects of their grief and bereavement as a result of parental suicide on their emotional wellness or…

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

    ERIC Educational Resources Information Center

    Zafar, Sadia; Ross, Erin C.

    2013-01-01

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

  4. Here, There and Nowhere: Following Adult Survivors of Childhood Cancer A Case Report of Recurrent Osteosarcoma in a Young Adult.

    PubMed

    McLaughlin, Suzanne; Terry, Christopher; Barbosa, Fernando; DeNardo, Bradley

    2016-01-01

    Approximately 1 in 285 children in the United States (US) will be diagnosed with cancer before the age of 20.1 More than 80% of children diagnosed with cancer will become long-term survivors.2 As of January, 2010, there are more than 380,000 adult survivors of childhood cancer in the US.3 More than two-thirds of survivors will develop chronic conditions.4 Professional organizations have advocated for specialized risk-based care of survivors.5 Locally and nationally, lack of transition services and insurance coverage are barriers to care of these adult survivors.6 We describe one such case to illustrate these challenges and their impact. [Full article available at http://rimed.org/rimedicaljournal-2016-08.asp, free with no login]. PMID:27472771

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

    ClinicalTrials.gov

    2016-04-05

    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

  6. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for early post-treatment breast cancer survivors

    PubMed Central

    Sohl, Stephanie J.; Levine, Beverly

    2014-01-01

    Purpose The end of primary treatment for cancer patients is increasingly recognized as an important time of adjustment that may impact quality of life (QoL). A psychometrically sound QoL instrument that assesses the mix of acute and longer-term concerns present during this unique time has not yet been identified. This article evaluates the Quality of Life in Adult Cancer Survivors (QLACS) scale, originally developed for long-term (≥5 years) cancer survivors, as an appropriate QoL measure for this transition period. Methods Psychometric properties of the QLACS were evaluated in a sample of post-treatment breast cancer survivors 18–24 months post-diagnosis. This observational study consisted of women (n = 552) aged 25 years and older (mean = 55.4 years) who were diagnosed with stage I, II, or III breast cancer. The 47 items of the QLACS comprise 12 domains: seven domains are generic, and five are cancer specific. Results The QLACS demonstrated adequate internal consistency (Cronbach’s alpha for the 12 domains ranged from 0.79 to 0.91) and good convergent and divergent validity (assessed by comparison with the Functional Assessment of Cancer Therapy and other measures). Conclusions The QLACS appears to be consistent with other widely accepted measures in capturing QoL, while also allowing for more inclusive measurement of specific issues relevant to post-treatment cancer survivors. These data, in addition to previous data supporting use of the QLACS across different cancer sites, suggest that the QLACS is a promising comprehensive QoL measure appropriate for breast cancer survivors transitioning off active treatment. PMID:24996392

  7. Screening and management of adverse endocrine outcomes in adult survivors of childhood and adolescent cancer

    PubMed Central

    Tonorezos, Emily S; Hudson, Melissa M; Edgar, Angela B; Kremer, Leontien C; Sklar, Charles A; Wallace, W Hamish B; Oeffinger, Kevin C

    2015-01-01

    5 year survival for childhood and adolescent cancer in developed countries is now in excess of 80% and the number of survivors of cancer continues to increase worldwide. After completion of therapy, many of these survivors will face a lifelong risk of endocrine late effects. We summarise the available evidence related to the prevalence and risk factors for endocrine late effects among adult survivors of childhood and adolescent cancer. Present screening, surveillance, and treatment recommendations differ by country and region, so we also highlight the continued effort to harmonise the international guidelines for this population. PMID:25873569

  8. Neural Underpinnings of Working Memory in Adult Survivors of Childhood Brain Tumors.

    PubMed

    King, Tricia Z; Na, Sabrina; Mao, Hui

    2015-08-01

    Adult survivors of childhood brain tumors are at risk for cognitive performance deficits that require the core cognitive skill of working memory. Our goal was to examine the neural mechanisms underlying working memory performance in survivors. We studied the working memory of adult survivors of pediatric posterior fossa brain tumors using a letter n-back paradigm with varying cognitive workload (0-, 1-, 2-, and 3-back) and functional magnetic resonance imaging as well as neuropsychological measures. Survivors of childhood brain tumors evidenced lower working memory performance than demographically matched healthy controls. Whole-brain analyses revealed significantly greater blood-oxygen level dependent (BOLD) activation in the left superior / middle frontal gyri and left parietal lobe during working memory (2-back versus 0-back contrast) in survivors. Left frontal BOLD response negatively correlated with 2- and 3-back working memory performance, Auditory Consonant Trigrams (ACT), and Digit Span Backwards. In contrast, parietal lobe BOLD response negatively correlated with 0-back (vigilance task) and ACT. The results revealed that adult survivors of childhood posterior fossa brain tumors recruited additional cognitive control resources in the prefrontal lobe during increased working memory demands. This increased prefrontal activation is associated with lower working memory performance and is consistent with the allocation of latent resources theory. PMID:26234757

  9. Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors

    PubMed Central

    van de Schoot, Rens; Broere, Joris J.; Perryck, Koen H.; Zondervan-Zwijnenburg, Mariëlle; van Loey, Nancy E.

    2015-01-01

    Background The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis. PMID:25765534

  10. Comparison of long-term quality of life of pediatric burn survivors with and without inhalation injury⋆

    PubMed Central

    Rosenberg, Marta; Ramirez, Maribel; Epperson, Kathy; Richardson, Lisa; Holzer, Charles; Andersen, Clark R.; Herndon, David N.; Meyer, Walter; Suman, Oscar E.; Mlcak, Ronald

    2015-01-01

    Objective To examine the long-term quality of life of pediatric burn survivors with and without inhalation injuries. We hypothesized that patients with inhalation injury would report more disability and lower quality of life. Methods We examined 51 patients with inhalation injury and 72 without inhalation injury who had burns of ≥10% total body surface area, were age ≥16 years at time of the interview, and were greater than 5 years from injury. Subjects completed the World Health Organization Disability Assessment Scale II (WHODAS II) and the Burn Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to measure the effects of inhalation injury while controlling for age at burn and TBSA. Results The mean age of burn of participants with inhalation injury was 11.7 ± 3.6 years, mean TBSA 55% ± 18, and mean ventilator days 8.4 ± 9. The mean age of burn of participants without inhalation injury was 10.3 ± 34.1 years, mean TBSA 45% ± 20, and mean ventilator days 1.3 ± 5.2. Inhalation injury did not appear to significantly impact participants' scores on the majority of the domains. The WHODAS II domain of household activities showed a significant relation with TBSA (p = 0.01). Increased size of burn was associated with difficulty completing tasks for both groups. The BSHS-B domain of treatment regimen showed a relation with age at burn (p = 0.02). Increased age was associated difficulty in this area for both groups. Conclusions Overall the groups were comparable in their reports of disability and quality of life. Inhalation injury did not affect long-term quality of life. PMID:25670250

  11. Fertility Preservation Preferences and Perspectives Among Adult Male Survivors of Pediatric Cancer and Their Parents

    PubMed Central

    Stein, Daniel M.; Victorson, David E.; Choy, Jeremy T.; Waimey, Kate E.; Pearman, Timothy P.; Smith, Kristin; Dreyfuss, Justin; Kinahan, Karen E.; Sadhwani, Divya; Woodruff, Teresa K.

    2014-01-01

    Purpose: In this study, we set out to determine the preferences, concerns, and attitudes toward fertility preservation of adult male survivors of pediatric cancer and their parents. Methods: We conducted 3 focus groups with a total of 15 male survivors of pediatric cancer (age at diagnosis: mean=14, range: 10–20; age at study: mean=35, range: 25–47) and 2 groups with a total of 7 parents of survivors. Grounded theory methodology was used for the identification and analysis of recurrent themes expressed by survivors and their parents in the course of focus group discussions. Results: Themes most frequently expressed by survivors included concern regarding long-term treatment effects and a retrospective desire for fertility impairment to have been discussed when they were originally diagnosed with cancer. Parental themes included the same hindsight desire, as well as reliance upon the treating oncologist for direction in selecting the course of treatment, and an acknowledgment that input from a specialist in fertility preservation would have been beneficial. Conclusions: Although future reproductive potential was not consistently reported as a source of apprehension when diagnosed with cancer, both survivors and their parents noted it to be a paramount concern later in life. Parents and survivors both reported that fertility preservation discussions should be routinely incorporated in the clinical context of a pediatric cancer diagnosis. PMID:24940531

  12. Perceptions of Young Adult Central Nervous System Cancer Survivors and Their Parents Regarding Career Development and Employment

    ERIC Educational Resources Information Center

    Strauser, David R.; Wagner, Stacia; Chan, Fong; Wong, Alex W. K.

    2014-01-01

    Purpose: Identify barriers to career development and employment from both the survivor and parent perspective. Method: Young adult survivors (N = 43) and their parents participated in focus groups to elicit information regarding perceptions regarding career development and employment. Results: Perceptions of both the young adults and parents…

  13. Enhancing Psychosocial Outcomes for Young Adult Childhood CNS Cancer Survivors: Importance of Addressing Vocational Identity and Community Integration

    ERIC Educational Resources Information Center

    Strauser, David R.; Wagner, Stacia; Wong, Alex W. K.

    2012-01-01

    The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years…

  14. Parenting Difficulties among Adult Survivors of Father-Daughter Incest.

    ERIC Educational Resources Information Center

    Cole, Pamela M.; And Others

    1992-01-01

    This study examined the self-reported parenting experience and practices of women who were either incest victims of their fathers as children (n=20), whose fathers were alcoholic but not sexually abusive (n=25), or who had no known risk in childhood (n=39). Incest survivors reported less confidence and sense of control as parents. (Author/DB)

  15. Expressions of Generativity and Posttraumatic Growth in Adult Cancer Survivors

    ERIC Educational Resources Information Center

    Bellizzi, Keith M.

    2004-01-01

    Much of the psycho-oncology research that has been conducted to date has focused on understanding the negative psychological and psychosocial sequelae of cancer. However, a growing body of evidence suggests that many cancer survivors report psychological growth following a diagnosis of cancer. Further, there are few studies that examine the…

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

    PubMed

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

    2015-11-01

    The purpose of this study was to identify factors associated with posttraumatic stress symptoms (PTSS) among Japanese long-term childhood cancer survivors (CCSs). Subjects comprised 185 adolescent and young adult (AYA) CCSs who completed anonymous self-report questionnaires. Attending physicians also completed an anonymous disease/treatment data sheet. Mean age of survivors was approximately 8 years at diagnosis and 23 years at participation. Multiple regression analysis showed that family functioning, satisfaction with social support, being female, and interactions between family functioning and gender and age at the time of diagnosis were associated with PTSS among survivors. This study revealed family functioning as the most predictive factor of PTSS among AYA CCSs in Japan. Even when the survivor may have unchangeable risk factors, family functioning can potentially moderate the effects on PTSS. Thus, it is crucial for health professionals to carefully monitor and attend to survivors' experiences of family functioning to mitigate PTSS. PMID:26442952

  17. The lived experience of visual creative expression for young adult cancer survivors.

    PubMed

    Green, A R; Young, R A

    2015-09-01

    Engaging in visual creative expression individually and in a therapeutic setting can be a beneficial experience for cancer survivors; however, most research in this field has been conducted with older adults. The current study aimed to address this gap by utilising van Manen's hermeneutic phenomenology to answer the following question: 'What is the lived experience and meaning of visual creative expression for young adult cancer survivors?' Seven young adults, diagnosed with cancer between the ages of 18 and 35, were interviewed about creative expression experiences, which they engaged in individually and/or in a therapeutic setting. Data analysis included a thematic reflection, guided existential reflection, and a process of writing and rewriting. Two superordinate themes were identified: increased self-understanding and a healing experience. Seven subthemes were also identified and included the following: being in the flow, allowing the body to express itself, renegotiating control, changing one's environment, being seen, respect for art as a separate entity and giving back. Findings suggest that visual creative expression can be a meaningful experience for young adult cancer survivors, and that this experience espouses both similarities and differences from experiences of older adult survivors. Recommendations are made for future research, in addition to implications for practitioners. PMID:25413274

  18. Psychiatric Morbidity and Functional Impairments in Survivors of Burns, Traumatic Injuries, and ICU Stays for Other Critical Illnesses: A Review of the Literature

    PubMed Central

    Davydow, Dimitry S.; Katon, Wayne J.; Zatzick, Douglas F.

    2010-01-01

    Severe burns, traumatic injuries and other critical illnesses are a substantial source of morbidity in the United States. As more patients survive these conditions, there has been increasing interest in psychiatric and functional outcomes of these individuals. In this article, we reviewed the literature on the prevalence of psychiatric conditions, with particular emphasis on posttraumatic stress disorder (PTSD) and depression, as well as functional impairments, in adult and pediatric survivors of burns, trauma and intensive care unit stays for other critical illnesses. We found that PTSD and depressive symptoms are quite prevalent in these patient groups. We also examined potential risk factors for psychiatric morbidity and impaired function in all three patient groups, and conclude that patient-specific and acute care factors, in addition to early post-acute care psychiatric symptoms, may convey risk for subsequent psychopathology and diminished function. Finally, we discussed limitations in the literature as well as possible directions for future research, particularly in clarifying risk factors for psychiatric disorders as well as potential preventative and treatment interventions that may improve outcomes. PMID:19919206

  19. Competence in Caregivers of Adolescent and Young Adult Childhood Brain Tumor Survivors

    PubMed Central

    Deatrick, Janet A.; Hobbie, Wendy; Ogle, Sue; Fisher, Michael J.; Barakat, Lamia; Hardie, Thomas; Reilly, Maureen; Li, Yimei; Ginsberg, Jill P.

    2015-01-01

    Objective Caregivers of adolescents and young adults (AYA) with complex medical conditions, including brain tumor survivors, have protracted and often complex roles, yet a gap exists in understanding their perceived competence. The aim of this study is to test a hypothesized model based on the theoretical and empirical literature: better caregiver health, better survivor health, and better family functioning contribute directly to fewer caregiving demands, which in turn contribute to greater caregiver competence. Method Telephone interviews using structured self-report questionnaires were conducted in this cross-sectional study with a sample of 186 caregivers (mothers) of childhood brain tumor survivors aged 14–40 years old who live with at least one parent. Structural equation modeling (SEM) was used to test the hypothesized model. Results The final SEM model suggests that survivor health and family functioning directly predict caregiver competence. Caregiver health indirectly predicts caregiver competence through caregiver demands and then family functioning. Family income directly predicts family functioning. The model showed adequate fit (CFI = 0.905, TFI = 0.880, and RMSEA = 0.081). Overall, the model accounted for 45% of variance in caregiver competence. Conclusions For this sample of caregivers of AYA with medically complex conditions, family functioning and the health of survivors are both important to how they evaluate their skills as caregivers. The results of this study underscore the crucial role of care models that focus on optimizing the health of the survivor, caregiver, and family, along with supporting a family centered approach to their care. PMID:23957900

  20. Clustering of health behaviours in adult survivors of childhood cancer and the general population

    PubMed Central

    Rebholz, C E; Rueegg, C S; Michel, G; Ammann, R A; von der Weid, N X; Kuehni, C E; Spycher, B D

    2012-01-01

    Background: Little is known about engagement in multiple health behaviours in childhood cancer survivors. Methods: Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20–35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination. Results: The model identified four health behaviour patterns: ‘risk-avoidance', with a generally healthy behaviour; ‘moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; ‘risk-taking', engaging in several risk behaviours; and ‘smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the ‘risk-avoiding' (42% vs 44%) and the ‘risk-taking' cluster (14% vs 12%), but more survivors were in the ‘moderate drinking' (39% vs 28%) and fewer in the ‘smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy. Conclusion: A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions. PMID:22722311

  1. A Psychosynthesis Approach to the Use of Mental Imagery with Adult Survivors of Childhood Sexual Abuse.

    ERIC Educational Resources Information Center

    Brown, Michael H.

    1997-01-01

    States that the techniques of mental imagery can help adult survivors of childhood sexual abuse access the inner wisdom necessary to identify, understand, and creatively address issues from the past and develop new and healthier patterns of thinking and behaving. Documents the innovative ways psychosynthesis uses mental imagery with this client…

  2. Exploring Childhood Memories with Adult Survivors of Sexual Abuse: Concrete Reconstruction and Visualization Techniques.

    ERIC Educational Resources Information Center

    Roland, Catherine B.

    1993-01-01

    Describes two memory-enhancing techniques, visualization and concrete reconstruction, that have been successful in counseling adult survivors of sexual abuse. Includes suggested implementations, case examples, and implications for incorporating memory techniques into counseling process. Describes various risk factors involved in using these…

  3. Fatigue in Family Caregivers of Adult Intensive Care Unit Survivors

    PubMed Central

    Choi, JiYeon; Tate, Judith A.; Hoffman, Leslie A.; Schulz, Richard; Ren, Dianxu; Donahoe, Michael P.; Given, Barbara A.; Sherwood, Paula R.

    2014-01-01

    Context Family caregivers are a vital resource in the recovery of intensive care unit (ICU) survivors. Of concern, the stress associated with this role can negatively affect caregiver health. Fatigue, an important health indicator, has been identified as a predictor of various illnesses, greater use of health services, and early mortality. Examining the impact of fatigue on caregivers’ physical health can assist in identifying critical time points and potential targets for intervention. Objectives To describe self-reported fatigue in caregivers of ICU survivors from patients’ ICU admission to ≤ two weeks, two- and four-months post-ICU discharge. Methods Patient-caregiver pairs were enrolled from a medical ICU. Caregiver fatigue was measured using the Short-Form-36 Health Survey Vitality subscale (SF-36 Vitality). Caregiver psychobehavioral stress responses included depressive symptoms, burden, health risk behaviors, and sleep quality. Patient data included self-reported physical symptoms and disposition (home vs. institution). Results Forty seven patient-caregiver pairs were initially enrolled. Clinically significant fatigue (SF-36 Vitality ≤ 45) was reported by 43% to 53% of caregivers across the time points and these caregivers reported worse scores in measures of depressive symptoms, burden, health risk behaviors and sleep quality, and patients’ symptom burden. In 26 caregivers with data for all time points (55% of the total sample), SF-36 Vitality scores showed trends of improvement when the patient returned home and greater impairment when institutionalization continued. Conclusion In caregivers of ICU survivors, fatigue is common and potentially linked with poor psychobehavioral responses. Worsening fatigue was associated with greater symptom distress and long-term patient institutionalization. PMID:24439845

  4. Symptoms of posttraumatic stress disorder among adult survivors two months after the Wenchuan earthquake.

    PubMed

    Wang, Li; Zhang, Yuqing; Shi, Zhanbiao; Wang, Wenzhong

    2009-12-01

    This study investigated the symptoms of Posttraumatic Stress Disorder (PTSD) and associated risk factors among adult survivors 2 mo. after the Wenchuan earthquake in China. 228 survivors completed the Chinese version of the Impact of Event Scale-Revised. The prevalence of probable PTSD was 43%. The significant predictive factors for the severity of PTSD symptoms included being female, having lower educational level, being bereaved, and witnessing death. Findings of this study suggest that PTSD is a common mental health problem among earthquake survivors in China. Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after earthquakes. PMID:20099550

  5. Best Clinical Practices for Male Adult Survivors of Childhood Sexual Abuse: “Do No Harm”

    PubMed Central

    Gallo-Silver, Les; Anderson, Christopher M; Romo, Jaime

    2014-01-01

    The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in communication, locus of control, and consent/permission before and during physical examinations and procedures. The intent of this article is to act as a catalyst for improved patient care and more research focused on the identification and optimal responses to the needs of men with adverse childhood experiences in the health care setting. PMID:25106042

  6. Predictors of Discharge Disposition in Older Adults With Burns: A Study of the Burn Model Systems.

    PubMed

    Pham, Tam N; Carrougher, Gretchen J; Martinez, Erin; Lezotte, Dennis; Rietschel, Carly; Holavanahalli, Radha; Kowalske, Karen; Esselman, Peter C

    2015-01-01

    Older patients with burn injury have a greater likelihood for discharge to nursing facilities. Recent research indicates that older patients discharged to nursing facilities are two to three times as likely to die within a 3-year period relative to those discharged to home. In light of these poor long-term outcomes, we conducted this study to identify predictors for discharge to independent vs nonindependent living status in older patients hospitalized for burns. We retrospectively reviewed all older adults (age ≥ 55 years) who were prospectively enrolled in a longitudinal multicenter study of outcomes from 1993 to 2011. Patient, injury, and treatment outcomes data were analyzed. Recognizing that transfer to inpatient rehabilitation may have impacted final hospital discharge disposition: we assessed the likelihood of inpatient rehabilitation stay, based on identified predictors of inpatient rehabilitation. We subsequently performed a logistic regression analysis on the clustered, propensity-matched cohort to assess associations of burn and injury characteristics on the primary outcome of final discharge status. A total of 591 patients aged ≥55 years were treated and discharged alive from three participating U.S. burn centers during the study period. Mean burn size was 14.8% (SD 11.2%) and mean age was 66.7 years (SD 9.3 years). Ninety-three patients had an inpatient rehabilitation stay before discharge (15.7%). Significant factors predictive of inpatient rehabilitation included a burn >20% TBSA, mechanical ventilation, older age, range of motion deficits at acute care discharge, and study site. These factors were included in the propensity model. Four hundred seventy-one patients (80%) were discharged to independent living status. By matched propensity analysis, older age was significantly associated with a higher likelihood of discharge to nonindependent living (P < .01 in both the 65-74 age group and the oldest age group when compared with the 55-64 age group

  7. Mixed-Gender Group Co-Leadership on Group Counseling with Female Adult Survivors of Childhood Sexual Victimization.

    ERIC Educational Resources Information Center

    Threadcraft, Hal L.; Wilcoxon, S. Allen

    1993-01-01

    Conducted study to investigate whether group cofacilitated by male and female counselor could provide therapeutic benefit to women survivors of childhood sexual victimization. Findings seem to provide preliminary evidence contradicting assumption that male counselors should not be involved in counseling female adult survivors of sexual…

  8. Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies

    PubMed Central

    Armstrong, Gregory T.; Jain, Neelam; Liu, Wei; Merchant, Thomas E.; Stovall, Marilyn; Srivastava, Deo Kumar; Gurney, James G.; Packer, Roger J.; Robison, Leslie L.; Krull, Kevin R.

    2010-01-01

    Childhood cancer survivors exposed to CNS irradiation are at increased risk for neurocognitive deficits; however, limited data exist linking outcomes with region-specific exposure to CNS irradiation. We report associations between region-specific radiation dose and self-reported neurocognitive and health-related quality of life (HRQOL) outcomes in 818 adult survivors of childhood central nervous system (CNS) malignancies from the Childhood Cancer Survivor Study. Survivors were compared with a sibling group and national normative samples to calculate standardized scores. Cumulative radiation dose was calculated for 4 specific brain regions. Logistic regression was used to estimate the association between radiation dose to specific brain regions and outcome measures of functional impairment adjusted for clinical and demographic factors, including sex and age at diagnosis. High radiation dose levels to temporal regions were associated with a higher risk for memory impairment (radiation doses ≥30 to <50 Gy: OR, 1.95; 95% CI, 1.01–3.78; dose ≥50 Gy: OR, 2.34; 95% CI, 1.25–4.39) compared with those with no radiation exposure. No such association was seen with radiation exposure to other regions. Exposure to temporal regions was associated with more social and general health problems, whereas exposure to frontal regions was associated with general health problems and physical performance limitations. Adult survivors of childhood CNS malignancies report higher rates of neuropsychological and HRQOL outcomes, which vary as a function of dose to specific neuroanatomical regions. Survivors with a history of radiation exposure to temporal brain regions are at increased risk for impairment in memory and social functioning. PMID:20716593

  9. Promoting Positive Adaptation in Adult Survivors of Natural Disasters

    ERIC Educational Resources Information Center

    Warchal, Judith R.; Graham, Louise B.

    2011-01-01

    This article integrates the guidelines of American Red Cross and the "Psychological First Aid: Field Operations Guide" (Brymer et al., 2006) with adult development theories to demonstrate the promotion of adaptive functioning in adults after a disaster. Case examples and recommendations for counselors working in disaster situations are included.

  10. Evaluation of the Utility of a Transition Workbook in Preparing Adolescent and Young Adult Cancer Survivors for Transition to Adult Services: A Pilot Study.

    PubMed

    Bashore, Lisa; Bender, Joyce

    2016-01-01

    Transition to adult care for adolescent and young adult survivors is challenging and is inclusive of several factors like knowledge and developmental, emotional, and social status of survivors and parents. This pilot study addressed the feasibility of a transition workbook, a method of preparing adolescent and young adults to transition to adult care. Using a mixed methods design, investigators also measured transition worry and readiness in 30 survivors. Support was provided throughout a 6-month period as survivors and parents completed the workbook. The workbook included sections about the treatment history of survivors, when and who to call for worrisome symptoms, prescriptions and insurance, educational goals for health practices and how to get there, and independent living. Twenty survivors completed the study and reported greater worry about leaving pediatric oncology but indicated the need to make changes to transition to adult care. Ambiguity and intimidation about transitioning to adult providers and comfort in pediatric setting were themes expressed by survivors. Results indicate the need for adult/pediatric collaborative transition programs using various standardized methods of addressing transition readiness and evaluation. PMID:26206471

  11. Preserving Self-Concept in the Burn Survivors: A Qualitative Study

    PubMed Central

    Zamanzadeh, Vahid; Valizadeh, Llila; Lotfi, Mojgan; Salehi, Feridoon

    2015-01-01

    Background: Burn injury is a devastating experience affecting all aspects of a person's essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients’ cultural and religious context. Therefore, this study was conducted aiming at investigating burn patients’ experiences regarding how to preserve self-concept in life after burn injury in Iran. Materials and Methods: This qualitative study was carried out using qualitative content analysis and in-depth unstructured interviews with 17 surviving burn subjects. Results: During the qualitative content analysis process, the concept of “locating” as the essence of the participants’ experience was extracted as follows: (A) self-exploration (exploring the changes in one's life), (B) others’ exploration (exploring the changes in the life of family members and the relationship between self and others), (C) position evaluation (self-position analysis), and (D) self-concept preservation. Conclusion: The present study has developed new understandings of mental experiences of burn patients’ self-concept by describing the concept of “self-locating”. It helps us in classifying and understanding the concepts described in comprehensive theories developed in this area. They do this by focusing on what burn patients experience for choosing self-preservation strategies and having a meaningful life. The finding can be used as a conceptual framework for palliative care program in Iran. PMID:26009672

  12. Impaired cardiovascular structure and function in adult survivors of severe acute malnutrition.

    PubMed

    Tennant, Ingrid A; Barnett, Alan T; Thompson, Debbie S; Kips, Jan; Boyne, Michael S; Chung, Edward E; Chung, Andrene P; Osmond, Clive; Hanson, Mark A; Gluckman, Peter D; Segers, Patrick; Cruickshank, J Kennedy; Forrester, Terrence E

    2014-09-01

    Malnutrition below 5 years remains a global health issue. Severe acute malnutrition (SAM) presents in childhood as oedematous (kwashiorkor) or nonoedematous (marasmic) forms, with unknown long-term cardiovascular consequences. We hypothesized that cardiovascular structure and function would be poorer in SAM survivors than unexposed controls. We studied 116 adult SAM survivors, 54 after marasmus, 62 kwashiorkor, and 45 age/sex/body mass index-matched community controls who had standardized anthropometry, blood pressure, echocardiography, and arterial tonometry performed. Left ventricular indices and outflow tract diameter, carotid parameters, and pulse wave velocity were measured, with systemic vascular resistance calculated. All were expressed as SD scores. Mean (SD) age was 28.8±7.8 years (55% men). Adjusting for age, sex, height, and weight, SAM survivors had mean (SE) reductions for left ventricular outflow tract diameter of 0.67 (0.16; P<0.001), stroke volume 0.44 (0.17; P=0.009), cardiac output 0.5 (0.16; P=0.001), and pulse wave velocity 0.32 (0.15; P=0.03) compared with controls but higher diastolic blood pressures (by 4.3; 1.2-7.3 mm Hg; P=0.007). Systemic vascular resistance was higher in marasmus and kwashiorkor survivors (30.2 [1.2] and 30.8 [1.1], respectively) than controls 25.3 (0.8), overall difference 5.5 (95% confidence interval, 2.8-8.4 mm Hg min/L; P<0.0001). No evidence of large vessel or cardiac remodeling was found, except closer relationships between these indices in former marasmic survivors. Other parameters did not differ between SAM survivor groups. We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance. Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity. PMID:24980666

  13. Emotional Support and Adult Depression in Survivors of Childhood Sexual Abuse

    PubMed Central

    Musliner, Katherine L.; Singer, Jonathan B.

    2015-01-01

    The goals of this study were to evaluate the effects of emotional support from friends and parents at two time points (adolescence and adulthood) on adult depression in a nationally representative sample of survivors of childhood sexual abuse (CSA), and examine whether the associations were moderated by the identity of the perpetrator (parent/caregiver vs. not). Data was taken from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health). The study sample included 1,238 Add Health participants with a history of CSA and an equivalently sized comparison group of individuals with no history of CSA. Parental support was measured using four items from each wave that assessed the warmth of participants' relationships with their parents and their satisfaction with those relationships. Friend support in adolescence was measured using participants' perceptions of how much their friends cared about them and in adulthood using participants' self-reported number of close friends. Depression was measured using a 10-item subscale of the CES-D. Support from friends and parents in adulthood were significantly associated with lower odds of adult depression in CSA survivors with a history of non-parent/caregiver abuse. Among survivors of parent/caregiver abuse, emotional support was not significantly associated with adult depression regardless of when or by whom it was provided. Emotional support in adulthood from friends and parents is associated with reduced odds of adult depression in CSA survivors, but only in cases where the abuse was perpetrated by someone other than a parent or caregiver. PMID:24630442

  14. Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse.

    PubMed

    Ehring, Thomas; Welboren, Renate; Morina, Nexhmedin; Wicherts, Jelte M; Freitag, Janina; Emmelkamp, Paul M G

    2014-12-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusively focused on studies evaluating the efficacy of psychological interventions for PTSD in adult survivors of childhood abuse. Sixteen randomized controlled trials meeting inclusion criteria could be identified that were subdivided into trauma-focused cognitive behavior therapy (CBT), non-trauma-focused CBT, eye movement desensitization and reprocessing, and other treatments (interpersonal, emotion-focused). Results showed that psychological interventions are efficacious for PTSD in adult survivors of childhood abuse, with an aggregated uncontrolled effect size of g=1.24 (pre- vs. post-treatment), and aggregated controlled effect sizes of g=0.72 (post-treatment, comparison to waitlist control conditions) and g=0.50 (post-treatment, comparison with TAU/placebo control conditions), respectively. Effect sizes remained stable at follow-up. As the heterogeneity between studies was large, we examined the influence of two a priori specified moderator variables on treatment efficacy. Results showed that trauma-focused treatments were more efficacious than non-trauma-focused interventions, and that treatments including individual sessions yielded larger effect sizes than pure group treatments. As a whole, the findings are in line with earlier meta-analyses showing that the best effects can be achieved with individual trauma-focused treatments. PMID:25455628

  15. Coping Strategies as a Mediator of Posttraumatic Growth among Adult Survivors of the Wenchuan Earthquake

    PubMed Central

    He, Lili; Xu, Jiuping; Wu, Zhibin

    2013-01-01

    Objective By testing the mediating effect of coping strategies on the relationship between social support (SS) and posttraumatic growth (PTG), the aim of this research was to develop a new approach for the study of post-disaster psychological intervention. Methods A mediating effect model analysis was conducted on 2080 adult survivors selected from 19 of the counties hardest-hit by the 2008 Wenchuan earthquake. The Social Support Rating Scale and the Coping Scale were used to predict the PTG. Results A bivariate correlation analysis showed that there was a correlation between posttraumatic growth, social support and coping strategies. The mediation analysis revealed that coping strategies played a mediating role between social support and posttraumatic growth in survivors after the earthquake. Conclusion The results demonstrated that mental health programs for survivors need to focus on the establishment of a good social support network, which was found to be conductive to maintaining and increasing mental health levels. At the same time, adequate social support is able to assist survivors in adopting mature coping strategies, such as problem solving and asking for help. Hence, social support was found to play a vital role in balancing and protecting mental health. PMID:24386345

  16. Chronic Conditions and Utility-Based Health-Related Quality of Life in Adult Childhood Cancer Survivors.

    PubMed

    Yeh, Jennifer M; Hanmer, Janel; Ward, Zachary J; Leisenring, Wendy M; Armstrong, Gregory T; Hudson, Melissa M; Stovall, Marilyn; Robison, Leslie L; Oeffinger, Kevin C; Diller, Lisa

    2016-09-01

    Health utility, a summary measure of quality of life, has not been previously used to compare outcomes among childhood cancer survivors and individuals without a cancer history. We estimated health utility (0, death; 1, perfect health) using the Short Form-6D (SF-6D) in survivors (n = 7105) and siblings of survivors (n = 372) (using the Childhood Cancer Survivor Study cohort) and the general population (n = 12 803) (using the Medical Expenditures Panel Survey). Survivors had statistically significantly lower SF-6D scores than the general population (mean = 0.769, 95% confidence interval [CI] = 0.766 to 0.771, vs mean = 0.809, 95% CI = 0.806 to 0.813, respectively, ITALIC! P< .001, two-sided). Young adult survivors (age 18-29 years) reported scores comparable with general population estimates for people age 40 to 49 years. Among survivors, SF-6D scores were largely determined by number and severity of chronic conditions. No clinically meaningful differences were identified between siblings and the general population (mean = 0.793, 95% CI = 0.782 to 0.805, vs mean = 0.809, 95% CI = 0.806 to 0.813, respectively). This analysis illustrates the importance of chronic conditions on long-term survivor quality of life and provides encouraging results on sibling well-being. Preference-based utilities are informative tools for outcomes research in cancer survivors. PMID:27102402

  17. [Endocrine consequences in young adult survivors of childhood cancer treatment].

    PubMed

    Leroy, C; Cortet-Rudelli, C; Desailloud, R

    2015-10-01

    Endocrine complications (particularly gonadal, hypothalamic-pituitary and metabolic) of childhood cancer treatments are common in young adults. Gonadal damage may be the result of chemotherapy or radiotherapy. Fertility preservation must be systematically proposed before initiation of gonadotoxic treatment if only the child is eligible. Hypothalamic-pituitary deficiency is common after brain or total-body irradiation, the somatotropic axis is the most sensitive to irradiation. Pituitary deficiency screening must be repeated since this endocrine consequence can occur many years after treatment. Hormone replacement must be prudent particularly in case of treatment with growth hormone or steroids. Metabolic syndrome, diabetes and cardiovascular damage resulting from cancer treatments contribute to the increase of morbidity and mortality in this population and should be screened routinely even if the patient is asymptomatic. The multidisciplinary management of these adults must be organized and the role of the endocrinologist is now well established. PMID:26776287

  18. Identification and Correlates of Unmet Service Needs in Adult Leukemia and Lymphoma Survivors After Treatment

    PubMed Central

    Parry, Carla; Lomax, Jana B.; Morningstar, Elizabeth A.; Fairclough, Diane L.

    2012-01-01

    Purpose: To examine and characterize the psychosocial and health service needs of adult leukemia and lymphoma survivors who had completed active treatment within the past 4 years. Methods: Self-report surveys were completed by 477 survivors, age 18 to 85 years, to identify areas and correlates of unmet psychosocial, health, and instrumental service needs. Unmet service needs were rank ordered, and nonparametric tests were run to assess relationships. Results: The rate of unmet need was highest regarding sexual issues, handling medical and living expenses, emotional difficulties, employment, and health insurance. Women were more likely to report unmet child care needs than men; younger individuals were more likely to report needing help with emotional difficulties and family problems; and lower income was related to greater unmet need regarding medical and living expenses. Relationships were also observed among the service needs, suggesting overlapping areas of unmet need. Conclusion: Adult leukemia and lymphoma survivors demonstrated a diverse range of needs, many of which were related to the psychosocial and physical sequelae of cancer. The findings suggest directions for service provision and development of standards for quality care in this underserved post-treatment population. PMID:23277776

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

    PubMed Central

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

    2015-01-01

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

  20. Prevalence and Predictors of Posttraumatic Stress Symptomatology Among Burn Survivors: A Systematic Review and Meta-Analysis.

    PubMed

    Giannoni-Pastor, Anna; Eiroa-Orosa, Francisco Jose; Fidel Kinori, Sara Guila; Arguello, Jose Maria; Casas, Miguel

    2016-01-01

    Burns can be a traumatic and stressful experience, although each patient may respond in very different ways. The aim of this study was to explore the variability on posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) prevalence and evaluate the specific weight of different variables on PTSD development among adult burn patients. A systematic review was carried out to explore the prevalence of ASD and PTSD and identify their predictors. Meta-analytical methods were used to explore the strength of association between PTSD and the latter. From an initial pool of 190 studies, 24 were used in the systematic review, and only 19 studies could be used for the meta-analysis because of different methodological limitations. The prevalence of ASD at baseline ranged from 2 to 30% and prevalence of PTSD ranged from 3 to 35% at 1 month, 2 to 40% between 3 and 6 months, 9 to 45% in the year postinjury and ranged 7 to 25% more than 2 years later. Life threat perception was the strongest predictor for PTSD occurrence, followed by acute intrusive symptoms and pain associated with burn injuries. Predictive variables identified in this research may be useful in targeting burn patients who are at risk for developing posttraumatic stress symptoms and stress-related psychological symptoms. PMID:25970798

  1. Late renal dysfunction in adult survivors of bone marrow transplantation

    SciTech Connect

    Lawton, C.A.; Cohen, E.P.; Barber-Derus, S.W.; Murray, K.J.; Ash, R.C.; Casper, J.T.; Moulder, J.E. )

    1991-06-01

    Until recently long-term renal toxicity has not been considered a major late complication of bone marrow transplantation (BMT). Late renal dysfunction has been described in a pediatric population status post-BMT which was attributable to the radiation in the preparatory regimen. A thorough review of adults with this type of late renal dysfunction has not previously been described. Fourteen of 103 evaluable adult patients undergoing allogeneic (96) or autologous (7) bone marrow transplantation, predominantly for leukemia and lymphomas, at the Medical College of Wisconsin (Milwaukee, WI) have had a syndrome of renal insufficiency characterized by increased serum creatinine, decreased glomerular filtration rate, anemia, and hypertension. This syndrome developed at a median of 9 months (range, 4.5 to 26 months) posttransplantation in the absence of specific identifiable causes. The cumulative probability of having this renal dysfunction is 20% at 1 year. Renal biopsies performed on seven of these cases showed the endothelium widely separated from the basement membrane, extreme thickening of the glomerular basement membrane, and microthrombi. Previous chemotherapy, antibiotics, and antifungals as well as cyclosporin may add to and possibly potentiate a primary chemoradiation marrow transplant renal injury, but this clinical syndrome is most analogous to clinical and experimental models of radiation nephritis. This late marrow transplant-associated nephritis should be recognized as a potentially limiting factor in the use of some intensive chemoradiation conditioning regimens used for BMT. Some selective attenuation of the radiation to the kidneys may decrease the incidence of this renal dysfunction.

  2. Posttraumatic stress disorder symptoms among adult survivors of the 2008 Sichuan earthquake in China.

    PubMed

    Chan, Cecilia Lai Wan; Wang, Chong-Wen; Qu, Zhiyong; Lu, Ben Qibin; Ran, Mao-Sheng; Ho, Andy Hau Yan; Yuan, Yin; Zhang, Braven Qiang; Wang, Xiying; Zhang, Xiulan

    2011-06-01

    This study examined the estimated prevalence rate of posttraumatic stress disorder (PTSD) symptoms and associated risk factors among Chinese adult survivors 7 to 8 months after the 2008 Sichuan earthquake. The sample was recruited from 2 areas close to the epicenter but of different distances. The estimated rate of PTSD symptoms was 55.6% and 26.4% respectively in the two areas. Loss of a child was a strong predictive factor for PTSD symptoms for the parents. Other predictive factors included female gender, loss of a parent, loss of friends or neighbors, residential house damage or collapse, and proximity to the epicenter. Effective and sustainable mental health services are needed and should be directed particularly to bereaved survivors. PMID:21608035

  3. The Nature of Posttraumatic Growth in Adult Survivors of Child Sexual Abuse.

    PubMed

    Hartley, Sarah; Johnco, Carly; Hofmeyr, Marthinus; Berry, Alexis

    2016-01-01

    Potential negative sequelae for survivors of child sexual abuse is well documented. However, growing evidence suggests that some individuals who actively cope with traumatic events can progress from a negative trajectory toward positive psychological change, often termed posttraumatic growth. Current posttraumatic growth theories may be of limited applicability to developmental considerations involved in child sexual abuse. This explorative study examines posttraumatic growth among adult female survivors of child sexual abuse. In-depth interviews were conducted with six participants who believed they had grown through coping with their abuse. Data was analyzed using interpretative phenomenological analysis. Three superordinate and nine subordinate themes were identified and explored. Some participants reported experiencing growth and distress simultaneously. Theoretical and clinical implications are examined in relation to the study's findings. PMID:26934545

  4. Burns

    MedlinePlus

    ... doing so puts you in danger as well. Chemical and Electrical Burns For chemical and electrical burns, call 911 or your local ... the power source has been turned off. For chemical burns: Dry chemicals should be brushed off the ...

  5. Psychological consequences and associated risk factors among adult survivors of the 2008 Wenchuan earthquake

    PubMed Central

    2014-01-01

    Background In 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan, China. Following this disaster, several studies were conducted which assessed the degree of mental disorders in the affected population, but very few considered that several disorders may occur at the same time. This paper aims to investigate the psychological effects and risk factors among adult survivors one-year after the earthquake event. Methods 2080 adult earthquake survivors from 19 counties in the affected areas were interviewed. A stratified sampling strategy was used to collect the information. Earthquake survivors completed self-report questionnaires, which included a post-traumatic stress disorder (PTSD) checklist, a self-rating depression scale and a self-rating anxiety scale. Results Fifty nine percent of the participants were male. The prevalence of probable PTSD in the sample was 40.1% (based on the DSM-IV criteria). Significant differences in the demographic variables were found in the levels of anxiety, depression, and PTSD. Anxiety levels were found to be positively correlated with depression (r = 0.438, p < 0.01) and PTSD (r = 0.322, p < 0.01). Risk factors for each symptom were also identified. Being female, having a low income level and having a low perceived level of social support were found to be the risk factors associated with anxiety, depression, and PTSD. There appeared to be no obvious relationship between the distance from the epicenter of the earthquake event and the severity of the psychological problems. Conclusions PTSD, anxiety, and depression were prevalent among the survivors. Most findings on the predictors were found to be consistent with current research. Positive adjustment and social support were found to be needed for the highest-risk population. PMID:24779914

  6. The Effect of Transition Clinics on Knowledge of Diagnosis and Perception of Risk in Young Adult Survivors of Childhood Cancer

    PubMed Central

    Ganju, Rohit G.; Nanda, Ronica H.; Esiashvili, Natia; Switchenko, Jeffrey M.; Wasilewski-Masker, Karen; Marchak, Jordan G.

    2016-01-01

    Background Improved treatment for pediatric cancers has ensured an evergrowing population of patients surviving into adulthood. The current study evaluated the impact of previous engagement in survivor care on patient knowledge and awareness of health risks as young adults. Procedure Young adult survivors of childhood cancers (N = 93, M age = 23.63 y) were recruited during their annual survivor clinic visit. Participants completed self-reported measures of demographics, treatment knowledge, perception of future health risks, participation in previous survivor care, and neurocognitive functioning. Results In total, 82% of patients (N = 76/93) reported previously participating in survivorship care. These patients were more likely to have knowledge of their radiation treatment (P = 0.034) and more likely to recognize risk for future health effects from their treatment (P = 0.019). Income between $10,000 and $24,999 (odds ratio = 0.168; 95% confidence interval, 0.046–0.616; P = 0.031) was associated with decreased patient knowledge regarding diagnosis. Male sex (odds ratio = 0.324; 95% confidence interval, 0.135–0.777; P = 0.012) was associated with less knowledge of future health risks. Patients with self-reported difficulties on the CCSS-NCQ were more likely to regard their cancer treatment as a future health risk. Conclusion Participation in survivor care plays an important role in imparting information to young adult survivors of pediatric cancer regarding their disease history and risk for future health problems. PMID:26925717

  7. Cancer in adolescents and young adults psychosocial aspects. Long-term survivors.

    PubMed

    Zeltzer, L K

    1993-05-15

    Survivors of cancer diagnosed during adolescence and young adulthood have had to muster the resources to cope with cancer treatment while accomplishing the tasks unique to this developmental period, tasks such as the accomplishment of economic and emotional independence, capacity for intimacy, solidification of career goals, and formation of a comfortable identity. Studies of survivors of childhood cancer have not found major psychiatric disorders but have pointed out some adjustment difficulties, such as increased health concerns, worries about the development of second neoplasms, increased somatic complaints, and academic problems. Marriage may be delayed, and women, unlike men, worry about their fertility and the health of their future offspring. Survivors of both genders do not appear to be troubled by obvious-to-the-observer physical sequelae. Future studies should examine the quality of life issues pertinent to the successful accomplishment of adult tasks and should include assessment of the facilitators and impediments to carrying out these tasks, particularly during the transition from adolescence into young adulthood. The ultimate goal of the above assessments is to permit not only survival but quality survival. PMID:8490896

  8. Institutional abuse of children in the Austrian Catholic Church: types of abuse and impact on adult survivors' current mental health.

    PubMed

    Lueger-Schuster, Brigitte; Kantor, Viktoria; Weindl, Dina; Knefel, Matthias; Moy, Yvonne; Butollo, Asisa; Jagsch, Reinhold; Glück, Tobias

    2014-01-01

    The aim of this study was to explore the nature and dimensions of institutional child abuse (IA) by the Austrian Catholic Church and to investigate the current mental health of adult survivors. Data were collected in two steps. First, documents of 448 adult survivors of IA (M=55.1 years, 75.7% men) who had disclosed their abuse history to a victim protection commission were collected. Different types of abuse, perpetrator characteristics, and family related risk factors were investigated. Second, a sample of 185 adult survivors completed the Posttraumatic Stress Disorder Checklist (PCL-C) and the Brief Symptom Inventory (BSI). Participants reported an enormous diversity of acts of violent physical, sexual, and emotional abuse that had occurred in their childhood. The majority of adult survivors (83.3%) experienced emotional abuse. Rates of sexual (68.8%) and physical abuse (68.3%) were almost equally high. The prevalence of PTSD was 48.6% and 84.9% showed clinically relevant symptoms in at least one 1 of 10 symptom dimensions (9 BSI subscales and PTSD). No specific pre-IA influence was found to influence the development of PTSD in later life (e.g. poverty, domestic violence). However, survivors with PTSD reported a significantly higher total number of family related risk factors (d=0.33). We conclude that childhood IA includes a wide spectrum of violent acts, and has a massive negative impact on the current mental health of adult survivors. We address the long-term effects of these traumatic experiences in addition to trauma re-activation in adulthood as both bear great challenges for professionals working with survivors. PMID:24018068

  9. The Experience of Resilience for Adult Female Survivors of Intimate Partner Violence: A Phenomenological Inquiry.

    PubMed

    Crann, Sara E; Barata, Paula C

    2016-06-01

    While resilience research in the context of intimate partner violence (IPV) is increasing, there remains little known about women's lived experience of resilience. Using a phenomenological approach, this study examined the experience of resilience for adult female survivors of IPV. Sixteen women who were currently experiencing or had previously experienced abuse by an intimate partner participated in semi-structured interviews. Resilience was experienced as multiple cognitive, emotional, and behavioral shifts across three theme areas: toward resistance, in the experience of control, and toward positivity. The results of this study suggest a number of applications for clinical practice and intervention. PMID:26567293

  10. Five years later: resiliency among older adult survivors of Hurricane Katrina.

    PubMed

    Hrostowski, Susan; Rehner, Timothy

    2012-01-01

    The purpose of this study was to examine the resilience of older adult survivors of Hurricane Katrina in light of their traumatic experiences and multiple losses. Ten Mississippi Gulf Coast residents who have survived Hurricane Katrina and its aftermath were interviewed. The participants were 65 years old or older. Their responses were audiotaped and transcribed. The transcripts were analyzed using phenomenological methodology and NVivo 2.5 software. Three major themes emerged. Participants described finding personal gratification, realizing their ability to cope, and developing a new interest in life through their novel experiences. PMID:22574866

  11. Risk for congenital anomalies in offspring of childhood, adolescent and young adult cancer survivors.

    PubMed

    Seppänen, Viivi I; Artama, Miia S; Malila, Nea K; Pitkäniemi, Janne M; Rantanen, Matti E; Ritvanen, Annukka K; Madanat-Harjuoja, Laura-Maria

    2016-10-15

    Offspring of cancer survivors (CS) may be at risk for congenital anomalies due to the mutagenic therapies received by their parents. Our population-based cohort study aimed to investigate the risk for congenital anomalies in offspring of CS compared to offspring of their siblings. Using the Finnish Cancer Registry, Central Population Register, and Hospital Discharge Register, we identified hospital contacts due to congenital anomalies in 6,862 offspring of CS (early-onset cancer between 1953 and 2004) and 35,690 offspring of siblings. Associations between congenital anomalies and cancer were evaluated using generalized linear regression modelling. The ratio of congenital anomalies in offspring of CS (3.2%) was slightly, but non-significantly, elevated compared to that in offspring of siblings (2.7%) [prevalence ratio (PR) 1.07, 95% confidence interval (CI) 0.91-1.25]. When offspring of childhood and adolescent survivors (0-19 years at cancer diagnosis) were compared to siblings' offspring, the risk for congenital anomalies was non-significantly increased (PR 1.17, 95% CI 0.92-1.49). No such increase existed for offspring of young adult survivors (20-34 years at cancer diagnosis) (PR 1.01, 95% CI 0.83-1.23). The risks for congenital anomalies were elevated among offspring of CS diagnosed with cancer in the earlier decades (1955-1964: PR 2.77, 95% C I 1.26-6.11; and 1965-1974: PR 1.55, 95% C I 0.94-2.56). In our study, we did not detect an overall elevated risk for congenital anomalies in offspring of survivors diagnosed in young adulthood. An association between cancer exposure of the parent and congenital anomalies in the offspring appeared only for those CS who were diagnosed in the earlier decades. PMID:27280956

  12. Cancer-Related Disclosure Among Adolescent and Young Adult Cancer Survivors: A Qualitative Study

    PubMed Central

    Barnett, Marie E.; Shuk, Elyse M.; Conway, Francine P.

    2014-01-01

    Purpose: Adolescents and young adults (AYAs) employ self-disclosure in normative social interactions and in promoting identity development. Disclosure is associated with numerous psychological and physical benefits. Little research has examined how AYA cancer survivors diagnosed during adolescence disclose their cancer history. Methods: Using a qualitative design, this study explored cancer-related disclosures among survivors (N=26) 16–24 years old at study (M=19.6 years), 14–18 years old at diagnosis (M=15.6 years), and currently at least 6 months post-treatment (M=3.2 years). Semi-structured interview guides were developed and used. Disclosure-related topics included survivorship communications and others' responses to AYAs' disclosure of their cancer experiences. Results: Grounded theory and thematic content analysis guided analyses, with an inductive data-driven approach. Three themes and eight subthemes emerged: “it depends” decision-making processes (don't ask/don't tell, shared experience, relationship potential), perceptions of others' responses (perceived apprehension, positive responses), and methods of disclosure (verbal, written, behavioral). No thematic differences were found by gender or age, although females reported greater frequency of disclosures. Conclusion: Disclosure emerged as a nuanced and complex process. “It depends” decision-making processes were most frequently endorsed, consistent with developmental complexities of this age group. This reflects social and psychological changes and highlights unique challenges for AYA survivors. This also reflects the importance of peers and social interactions as variables that influence disclosure. In the context of AYA cancer survivorship, understanding ways in which disclosure may bolster or hinder social support can assist survivors, clinicians, and families navigate survivorship. Implications for future research are discussed. PMID:25276496

  13. Prevalence, associations, and predictors of apathy in adult survivors of infantile (<5 years of age) posterior fossa brain tumors†

    PubMed Central

    Carroll, Cliodhna; Watson, Peter; Spoudeas, Helen A.; Hawkins, Michael M.; Walker, David A.; Clare, Isabel C. H.; Holland, Anthony J.; Ring, Howard A.

    2013-01-01

    Background Apathy is associated with pervasive and disadvantageous effects on daily functioning. It has been observed transiently in some children after surgery for posterior fossa tumors. In this study, our objective was to examine prevalence, associations, and predictors of apathy in adult survivors of an infantile posterior fossa brain tumor (PFT). Methods One hundred seventeen adult survivors of a childhood PFT diagnosed before age 5 years and 60 of their siblings were assessed in a cross-sectional study a mean of 32 years (range, 18–53 years) after survivors' initial tumor diagnoses, using the Marin Apathy Evaluation Scale (AES), the Weschler Abbreviated Scale of Intelligence and the Composite International Diagnostic Interview for psychiatric disorders. Results Marin Apathy Evaluation Scale, the Weschler Abbreviated Scale of Intelligence reached or exceeded a criterion score for clinically significant apathy in 35% of survivors, compared with 18% in a sibling comparison group. In both siblings and survivors, apathy was associated with lower verbal and full-scale IQ and, among survivors, with having undergone partial rather than total tumor resection (independent of irradiation status). Apathy was not related to presence of concurrent International Classification of Diseases, 10th Revision, depression. Female sex was associated with late apathy after a PFT, with increased likelihood of women reaching the apathy criterion relative to men if they were survivors. Conclusions Clinically significant and potentially treatable apathy occurs relatively commonly in adult survivors of an infantile childhood PFT, particularly women. Clinicians, including those managing posterior fossa pathology in very young children, should be aware of this association, and future research should clarify whether specific treatment-related variables are implicated in increasing this risk of apathy. PMID:23502428

  14. Family Functioning Mediates the Association Between Neurocognitive Functioning and Health-Related Quality of Life in Young Adult Survivors of Childhood Brain Tumors

    PubMed Central

    Hobbie, Wendy L.; Deatrick, Janet A.; Hardie, Thomas L.; Barakat, Lamia P.

    2015-01-01

    Purpose: Childhood brain tumor (BT) survivors experience significant neurocognitive sequelae that affect health-related quality of life (HRQOL). A model of neurodevelopmental late effects and family functioning in childhood cancer survivors suggests associations between survivor neurocognitive functioning, family functioning, and survivor HRQOL. This study examines the concurrent associations between survivor neurocognitive functioning, family functioning, and survivor emotional HRQOL, and the indirect effects of neurocognitive functioning on survivor emotional HRQOL through family functioning. Methods: Participants included young adult-aged childhood BT survivors (18–30 years old; N=34) who were on average 16 years post-diagnosis, and their mothers. A brief neuropsychological battery assessed working and verbal memory, processing speed, and executive functioning. Survivors and mothers completed measures of family functioning, and mothers completed a proxy-report measure of survivor HRQOL. Results: Spearman bivariate correlations examined the associations between indices of survivor neurocognitive functioning and concurrent family functioning and survivor emotional HRQOL. Poorer survivor processing speed, working memory, verbal memory, and executive function were significantly associated with worse survivor- and mother-reported family functioning (r's range: 0.36–0.58). Additionally, worse survivor processing speed and executive function were significantly associated with poorer survivor emotional HRQOL (r's range: 0.44–0.48). Bootstrapping analyses provided evidence for the indirect effects of neurocognitive functioning on survivor emotional HRQOL through family functioning. Conclusion: These findings suggest that family functioning is an important variable that might mitigate the negative influence of neurocognitive late effects on survivors and is a potential target in future interventions. PMID:25852971

  15. Recruitment and Retention of Older Adolescent and Young Adult Female Survivors of Childhood Cancer in Longitudinal Research

    PubMed Central

    Cantrell, Mary Ann; Conte, Teresa; Hudson, Melissa; Shad, Aziza; Ruble, Kathy; Herth, Kaye; Canino, Alyssa; Kemmy, Sinead

    2014-01-01

    Purpose/Objectives To describe the challenges encountered in the recruitment and retention of a sample of older adolescent and young adult female survivors of childhood cancer for a longitudinal study testing a targeted psychosocial intervention aimed at enhancing hope. Data Sources Published literature on constructing longitudinal intervention studies and strategies in the recruitment and retention of childhood cancer survivors in research was used to develop the protocol of this study. Data Synthesis Using empirical literature to construct the study’s design resulted in achieving certain goals for the design, but not in the recruitment and retention of study participants. Using online technology to deliver the intervention and collect data was efficient and effective. Traditional approaches to recruitment and retention of those survivors, however, were not effective. Use of more novel approaches to enroll study participants demonstrated only modest success. Conclusions Additional research is needed on strategies to successfully recruit and retain older adolescents and young adult female survivors of childhood cancer in longitudinal intervention studies. Implications for Nursing The improvement in the psychological well-being of female survivors of childhood cancer remains an important outcome in ongoing care. The need to continue to identify creative and effective ways to recruit and retain those survivors is warranted. PMID:22940512

  16. Providers' Perspectives of Survivorship Care for Young Adult Survivors of Childhood Cancer.

    PubMed

    Berg, Carla; Stratton, Erin; Esiashvili, Natia; Mertens, Ann; Vanderpool, Robin C

    2016-03-01

    We examined healthcare providers' perceptions of the goals of survivorship care and survivor programs, systems-level barriers and individual patient-level barriers to engaging patients in survivorship care, and potential resources for increasing engagement. In 2012, we recruited 21 healthcare providers of young adult survivors of childhood cancers from a children's hospital and a cancer center in the Southeastern USA to complete telephone-based semi-structured interviews. The sample was 45.95 years old (SD = 7.57) on average, 52.4 % female, and 81.0 % MDs. The major goals of survivorship programs identified were medical care management (e.g., addressing late and long-term effects, providing survivorship care plans (SCPs), assisting in transition of care) and holistic care including addressing psychosocial issues and promoting healthy lifestyles. Systems-level barriers to engagement in survivorship care included limited resources (e.g., time), role confusion (e.g., within cancer centers, from treatment team to survivorship care, role of primary care providers), communication challenges within the medical system (e.g., limited tracking of patients, lack of understanding of the role of survivorship clinic), communication challenges with patients (e.g., setting expectations regarding transition to survivorship care), and lack of insurance coverage. Perceived patient-level factors included psychological barriers (e.g., fear, avoidance), resistance to survivorship care, and physical barriers (e.g., distance from survivorship clinics). Resources to address these barriers included increased access to information, technology-based resources, and ensuring valuable services. There are several systems-level and patient-level barriers to survivorship care, thus requiring multilevel interventions to promote engagement in care among young adult survivors of childhood cancer. PMID:25943901

  17. Are we missing an opportunity for cancer prevention? Human papillomavirus vaccination for survivors of pediatric and young adult cancers.

    PubMed

    Temkin, Sarah M; Seibel, Nita L

    2015-10-01

    Survivors of pediatric and young adult cancers remain at risk for subsequent diseases, including those related to human papillomavirus (HPV) infection. Prevention of HPV acquisition through vaccination has become possible over the last decade. HPV vaccines have been shown to be safe and effective, yet rates of vaccination among childhood cancer survivors have remained low. Multiple factors, including stronger advocacy for this intervention from providers, could potentially increase vaccination and lead to lower HPV disease burdens for childhood cancer survivors. Health care providers for survivors of pediatric and adolescent cancers should prioritize counseling for HPV vaccination at follow-up visits. Cancer 2015;121:3435-43. © 2015 American Cancer Society. PMID:26110510

  18. Prevalence of adult-onset multifactorial disease among offspring of atomic bomb survivors.

    PubMed

    Fujiwara, S; Suyama, A; Cologne, J B; Akahoshi, M; Yamada, M; Suzuki, G; Koyama, K; Takahashi, N; Kasagi, E; Grant, E J; Lagarde, E; Hsu, W L; Furukawa, K; Ohishi, W; Tatsukawa, Y; Neriishi, K; Takahashi, I; Ashizawa, K; Hida, A; Imaizumi, M; Nagano, J; Cullings, H M; Katayama, H; Ross, N P; Kodama, K; Shore, R E

    2008-10-01

    The first study to examine whether parental radiation exposure leads to increased heritable risk of common adult-onset multifactorial diseases (i.e., hypertension, diabetes mellitus, hypercholesterolemia, ischemic heart disease, and stroke) was conducted among 11,951 participants in the clinical examination program out of a potential of 24,673 mail survey subjects who were offspring of survivors born from May 1946 through December 1984. Logistic regression analyses demonstrated no evidence of an association between the prevalence of multifactorial diseases in the offspring and parental radiation exposure, after adjusting for age, city, gender and various risk factors. The odds ratio (OR) for a paternal dose of 1 Gy was 0.91 [95% confidence interval (CI) 0.81-1.01, P = 0.08], and that for a maternal dose of 1 Gy was 0.98 (95% CI 0.86-1.10, P = 0.71). There was no apparent effect of parental age at exposure or of elapsed time between parental exposure and birth, but male offspring had a low odds ratio (OR = 0.76 at 1 Gy) for paternal exposure, but cautious interpretation is needed for this finding. The clinical assessment of nearly 12,000 offspring of A-bomb survivors who have reached a median age of about 50 years provided no evidence for an increased prevalence of adult-onset multifactorial diseases in relation to parental radiation exposure. PMID:19024652

  19. The Mediating Role of Visuospatial Planning Skills on Adaptive Function Among Young-Adult Survivors of Childhood Brain Tumor.

    PubMed

    King, Tricia Z; Smith, Kristen M; Ivanisevic, Mirjana

    2015-08-01

    The Boston Qualitative Scoring System (BQSS) was used as a method to examine executive skills on the Rey-Osterrieth complex figure (ROCF). Young-adult survivors of childhood brain tumor (N = 31) and a demographically-matched comparison group (N = 33) completed the ROCF copy version and Grooved Pegboard, and informants were administered the Scales of Independent Behavior-Revised (SIB-R) and Behavior Rating Inventory of Executive Function (BRIEF). Survivors had significantly lower BQSS planning and SIB-R community living skills and greater perseveration. Mediation analyses found that BQSS planning skills mediate the relationship between group and community living skills. Convergent findings of the BRIEF Planning, and discriminant findings with the BQSS Fragmentation, BRIEF Emotional Control, and Grooved Pegboard support the planning construct as the specific mediator in this model. Together, these findings highlight the role of planning skills in adaptive functions of young-adult survivors of childhood brain tumor. PMID:26055499

  20. Incidence of dementia among atomic-bomb survivors--Radiation Effects Research Foundation Adult Health Study.

    PubMed

    Yamada, Michiko; Kasagi, Fumiyoshi; Mimori, Yasuyo; Miyachi, Takafumi; Ohshita, Tomohiko; Sasaki, Hideo

    2009-06-15

    Radiotherapy has been reported to cause neuropsychological dysfunction. Here we examined whether exposure to atomic bomb radiation affected the incidence of dementia among 2286 atomic bomb survivors and controls - all members of the Adult Health Study cohort. Study subjects were non-demented and aged >or=60 years at baseline examination and had been exposed in 1945 at >or=13 years of age to a relatively low dose (or=500 mGy group. Alzheimer disease was the predominant type of dementia in each dose category. After adjustment for potential risk factors, radiation exposure did not affect the incidence rate of either all dementia or any of its subtypes. No case of dementia had a history of therapeutic cranial irradiation. Although we found no relationship between radiation exposure and the development of dementia among atomic bomb survivors exposed at >or=13 years old in this longitudinal study, effects on increased risk of early death among atomic bomb survivors will be considered. PMID:19327783

  1. Epidemiology of burns throughout the World. Part II: intentional burns in adults.

    PubMed

    Peck, Michael D

    2012-08-01

    A significant number of burns and deaths from fire are intentionally wrought. Rates of intentional burns are unevenly distributed throughout the world; India has a particularly high rate in young women whereas in Europe rates are higher in men in mid-life. Data from hospitalized burn patients worldwide reveal incidence rates for assault by fire and scalds ranging from 3% to 10%. The average proportion of the body surface area burned in an assault by fire or scalds is approximately 20%. In different parts of the world, attempted burning of others or oneself can be attributed to different motives. Circumstances under which assaults occur fall largely into the categories of interpersonal conflict, including spousal abuse, elder abuse, or interactions over contentious business transactions. Contributing social factors to assaults by burning include drug and alcohol abuse, non-constructive use of leisure time, non-participation in religious and community activities, unstable relationships, and extramarital affairs. Although the incidence of self-mutilation and suicide attempts by burning are relatively low, deliberate self-harm carries a significant risk of death, with an overall mortality rate of 65% worldwide. In those who resort to self-immolation, circumstantial themes reflect domestic discord, family dysfunction, and the social ramifications of unemployment. Preventing injurious burn-related violence requires a multifaceted approach, including legislation and enforcement, education, and advocacy. Better standardized assessment tools are needed to screen for risks of abuse and for psychiatric disorders in perpetrators. PMID:22325849

  2. Distinct health behavior and psychosocial profiles of young adult survivors of childhood cancers: a mixed methods study

    PubMed Central

    Lowe, Kincaid; Escoffery, Cam; Mertens, Ann C.; Berg, Carla J.

    2016-01-01

    Background We used a mixed-methods approach to examine health behavior profiles of young adult cancer survivors and characterize related sociodemographic and psychosocial factors. Methods We conducted a mail-based survey assessing sociodemographics, cancer treatment, health behaviors (e.g., tobacco use, physical activity), healthcare provider interactions, and psychosocial factors (e.g., Profile of Moods States [POMS]) among 106 young adult survivors from a southeastern cancer center and semi-structured interviews among a subset of 26. Results A k-means cluster analysis using eight health behaviors yielded three distinct health behavior profiles: high risk (n = 25), moderate risk (n = 39), and low risk (n = 40). High risks had the highest current alcohol, tobacco, and marijuana use; physical activity; and number of sexual partners (p’s < 0.001). They had higher symptoms of POMS tension-anxiety, depression-dejection, fatigue-inertia, and confusion-bewilderment (p’s < 0.05). Moderate risks had lowest physical activity (p < 0.05) but otherwise had moderate health behaviors. Low risks had the lowest alcohol, tobacco, and marijuana use and fewest sexual partners (p’s < 0.05). They had the lowest levels of tension-anxiety, depression-dejection, fatigue-inertia, and confusion-bewilderment (p’s < 0.05). Qualitative interviews showed that cancer had a range of effects on health behaviors and variable experiences regarding how healthcare providers address these behaviors. Conclusions Assessing health behavior profiles, rather than individual health behaviors, is informative in characterizing young adult cancer survivors and targeting survivorship care. Implications for Cancer Survivors Young adult cancer survivors demonstrate distinct health behavior profiles and are differentially impacted by the experience of cancer. Healthcare providers should be consistently intervening to ensure that survivors understand their specific health risks. PMID:26688575

  3. Propranolol Dosing Practices in Adult Burn Patients: Implications for Safety and Efficacy.

    PubMed

    Brown, David A; Gibbons, Janet; Honari, Shari; Klein, Matthew B; Pham, Tam N; Gibran, Nicole S

    2016-01-01

    Studies in children with burn injuries have demonstrated that propranolol improves metabolism and reduces muscle protein wasting. However, safety and efficacy in adults are less well established than in children. The purpose of this study was to determine safety of propranolol use in adult patients with burn injuries. Medical records were reviewed for burn-injured adults receiving propranolol. Patients between 18 and 65 years old and with ≥20% TBSA burn were included. Fifty-four patients met the criteria with mean age of 37 years and mean burn size of 38% TBSA. Propranolol dosages ranged from 0.1 to 3.8 mg/kg/day, with an average maximum dosage of 0.61 mg/kg/day. Mean heart rate decreased by 25% during 4 weeks. Seventy-two percent of patients experienced at least one episode of hypotension and 15% experienced bradycardia. Propranolol doses were most frequently held for low blood pressure; 32% of patients had at least one dose held for hypotension. This retrospective analysis suggests that modest dosing of propranolol results in frequent episodes of hypotension or bradycardia. Our data suggest that adults do not tolerate the higher doses reported in a pediatric population. Despite potential beneficial anti-catabolic effects of propranolol, burn care providers must recognize potential iatrogenic hemodynamic effects of this intervention. Our data support the need for prospective multicenter studies to delineate the safety and efficacy of propranolol in adult burn-injured patients. PMID:25882517

  4. Assessment of Symptoms in Adult Survivors of Incest: A Factor Analytic Study of the Responses to Childhood Incest Questionnaire.

    ERIC Educational Resources Information Center

    Edwards, Patrick W.; Donaldson, Mary Ann

    1989-01-01

    A study of the construction and factor validity of the Response to Child Incest Questionnaire, a self-report instrument for assessing commonly reported symptoms of adult survivors of incest, is reported. The instrument's usefulness as a pre- and post-treatment measure and further research needs are discussed. (MSE)

  5. Abuse and Parental Characteristics, Attributions of Blame, and Psychological Adjustment in Adult Survivors of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Zinzow, Heidi; Seth, Puja; Jackson, Joan; Niehaus, Ashley; Fitzgerald, Monica

    2010-01-01

    The purpose of this study was to examine the influence of abuse and parental characteristics on attributional content and determine the relative contribution of different attributions of blame in predicting psychological symptomatology among adult survivors of childhood sexual abuse. One hundred eighty-three female undergraduates with a history of…

  6. Adipokines and Insulin Resistance in Young Adult Survivors of Childhood Cancer

    PubMed Central

    Latoch, Eryk; Muszynska-Roslan, Katarzyna; Panas, Agata; Panasiuk, Anna; Sawicka-Zukowska, Malgorzata; Zelazowska-Rutkowska, Beata; Zabrocka, Ewa; Krawczuk-Rybak, Maryna

    2016-01-01

    We examined the association between adipokines (leptin, adiponectin, and resistin), radiotherapy, measurement of body fat, and insulin resistance among young adult survivors of childhood cancer (CCS). Materials and Methods. Seventy-six survivors were included (mean age 24.1 ± 3.5 years). Insulin resistance (IR) was calculated using the homeostasis model assessment (HOMA-IR). The serum levels of adipokines were assayed by immunoassays. Fat mass was evaluated by DXA. Results. Mean adiponectin level and mean body FAT were higher in the examined females than in males (10009 ± 6367 ng/mL versus 6433 ± 4136 ng/mL, p < 0.01; 35.98 ± 9.61% versus 22.7 ± 7.46%, p < 0.001). Among CCS, one of 75 patients met the criteria of insulin resistance, and in 14 patients there was impaired fasting glucose. The multiple regression model for females showed that leptin/adiponectin ratio (LA ratio) significantly affected HOMA-IR (increase of 0.024 per each unit of LA ratio; p < 0.05). Radiotherapy had no effect on serum adipokines and IR. Conclusion. The observed results support the hypothesis that adiponectin might be associated with insulin resistance and it can not be ruled out that changes in the mean level of adiponectin per FAT mass or leptin/adiponectin ratio may precede the occurrence of insulin resistance in the future. PMID:27212946

  7. Temporal Cytokine Profiles in Severely Burned Patients: A Comparison of Adults and Children

    PubMed Central

    Finnerty, Celeste C; Jeschke, Marc G; Herndon, David N; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Silver, Geoff; Arnoldo, Brett; Remick, Daniel; Tompkins, Ronald G

    2008-01-01

    A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma cytokine profiles following a severe burn in adults and in children. We enrolled 25 adults and 24 children who survived a flame burn covering more than 20% of total body surface area (TBSA). The concentrations of 22 cytokines were measured using the Linco multiplex array system (St. Charles, MO, USA). Large perturbations in the expression of pro- and anti-inflammatory cytokines were seen following thermal injury. During the first week following burn injury, IFN-γ, IL-10, IL-17, IL-4, IL-6, and IL-8 were detected at significantly higher levels in adults compared with children, P < 0.05. Significant differences were measured during the second week post-burn for IL-1β (higher in children) and IL-5 (higher in adults), P < 0.05. IL-18 was more abundant in children compared with adults during the third week post-burn, P < 0.05. Between post-burn d 21 and d 66, IL-1α was detected at higher concentrations in pediatric compared with adult patients, P < 0.05. Only GM-CSF expression was significantly different at all time points; it was detected at lower levels in pediatric patients, P < 0.05. Eotaxin, G-CSF, IL-13, IL-15, IP-10, MCP-1, and MIP-1α were detected at significantly different concentrations in adult compared with pediatric patients at multiple time points, P < 0.05. There were no differences in IL-12, IL-2, IL-7, or TNF levels in adult compared with pediatric burn patients at any of these time points. Following severe flame burns, the cytokine profiles in pediatric patients differ compared with those in adult patients, which may

  8. A Diversified Recruitment Approach Incorporating Social Media Leads to Research Participation Among Young Adult-Aged Female Cancer Survivors.

    PubMed

    Gorman, Jessica R; Roberts, Samantha C; Dominick, Sally A; Malcarne, Vanessa L; Dietz, Andrew C; Su, H Irene

    2014-06-01

    Purpose: Cancer survivors in their adolescent and young adult (AYA) years are an understudied population, possibly in part because of the high effort required to recruit them into research studies. The aim of this paper is to describe the specific recruitment strategies used in four studies recruiting AYA-aged female cancer survivors and to identify the highest yielding approaches. We also discuss challenges and recommendations. Methods: We recruited AYA-aged female cancer survivors for two studies conducted locally and two conducted nationally. Recruitment strategies included outreach and referral via: healthcare providers and clinics; social media and the internet; community and word of mouth; and a national fertility information hotline. We calculated the yield of each recruitment approach for the local and national studies by comparing the number that participated to the number of potential participants. Results: We recruited a total of 534 participants into four research studies. Seventy-one percent were diagnosed as young adults and 61% were within 3 years of their cancer diagnosis. The highest-yielding local recruitment strategy was healthcare provider and clinic referral. Nationally, social media and internet outreach yielded the highest rate of participation. Overall, internet-based recruitment resulted in the highest number and yield of participants. Conclusion: Our results suggest that outreach through social media and the internet are effective approaches to recruiting AYA-aged female cancer survivors. Forging collaborative relationships with survivor advocacy groups' members and healthcare providers also proved beneficial. PMID:24940529

  9. Gram Negative Wound Infection in Hospitalised Adult Burn Patients-Systematic Review and Metanalysis-

    PubMed Central

    Azzopardi, Ernest A.; Azzopardi, Elayne; Camilleri, Liberato; Villapalos, Jorge; Boyce, Dean E.; Dziewulski, Peter; Dickson, William A.; Whitaker, Iain S.

    2014-01-01

    Background Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. Methods Studies investigating adult hospitalised patients (2000–2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. Primary Findings Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens’ incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). Interpretation Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative “target organisms” facilitate clinical practice and target research towards a defined clinical demand. PMID:24751699

  10. Plasma High Sensitivity Troponin T Levels in Adult Survivors of Childhood Leukaemias: Determinants and Associations with Cardiac Function

    PubMed Central

    Cheung, Yiu-fai; Yu, Wei; Cheuk, Daniel Ka-leung; Cheng, Frankie Wai-tsoi; Yang, Janet Yee-kwan; Yau, Jeffrey Ping-wa; Ho, Karin Ka-huen; Li, Chi-kong; Li, Rever Chak-ho; Yuen, Hui-leung; Ling, Alvin Siu-cheung; Li, Vivian Wing-yi; Wong, Wai-keung; Tsang, Kwong-cheong; Chan, Godfrey Chi-fung

    2013-01-01

    Background We sought to quantify plasma high sensitivity cardiac troponin (hs-cTnT) levels, their determinants, and their associations with left ventricular (LV) myocardial deformation in adult survivors of childhood acute leukaemias. Methods and Results One hundred adult survivors (57 males) of childhood acute leukaemias, aged 24.1±4.2 years, and 42 age-matched controls (26 males) were studied. Plasma cTnT was determined using a highly sensitive assay. Genotyping of NAD(P)H oxidase and multidrug resistance protein polymorphisms was performed. Left ventricular function was assessed by conventional, three-dimensional, and speckle tracking echocardiography. The medians (interquartile range) of hs-cTnT in male and female survivors were 4.9 (4.2 to 7.2) ng/L and 1.0 (1.0 to 3.5) ng/L, respectively. Nineteen survivors (13 males, 6 females) (19%) had elevated hs-cTnT (>95th centile of controls). Compared to those without elevated hs-TnT levels, these subjects had received larger cumulative anthracycline dose and were more likely to have leukaemic relapse, stem cell transplant, and cardiac irradiation. Their LV systolic and early diastolic myocardial velocities, isovolumic acceleration, and systolic longitudinal strain rate were significantly lower. Survivors having CT/TT at CYBA rs4673 had higher hs-cTnT levels than those with CC genotype. Functionally, increased hs-cTnT levels were associated with worse LV longitudinal systolic strain and systolic and diastolic strain rates. Conclusions Increased hs-cTnT levels occur in a significant proportion of adult survivors of childhood acute leukaemias and are associated with larger cumulative anthracycline dose received, history of leukaemic relapse, stem cell transplant, and cardiac irradiation, genetic variants in free radical metabolism, and worse LV myocardial deformation. PMID:24204736

  11. Burns

    MedlinePlus

    ... are burns treated? In many cases, topical antibiotics (skin creams or ointments) are used to prevent infection. For third-degree burns and some second-degree ones, immediate blood transfusion and/or extra fluids ... is skin grafting? There are two types of skin grafts. ...

  12. Developmental contributions to macronutrient selection: a randomized controlled trial in adult survivors of malnutrition

    PubMed Central

    Campbell, Claudia P.; Raubenheimer, David; Badaloo, Asha V.; Gluckman, Peter D.; Martinez, Claudia; Gosby, Alison; Simpson, Stephen J.; Osmond, Clive; Boyne, Michael S.; Forrester, Terrence E.

    2016-01-01

    Background and objectives: Birthweight differences between kwashiorkor and marasmus suggest that intrauterine factors influence the development of these syndromes of malnutrition and may modulate risk of obesity through dietary intake. We tested the hypotheses that the target protein intake in adulthood is associated with birthweight, and that protein leveraging to maintain this target protein intake would influence energy intake (EI) and body weight in adult survivors of malnutrition. Methodology: Sixty-three adult survivors of marasmus and kwashiorkor could freely compose a diet from foods containing 10, 15 and 25 percentage energy from protein (percentage of energy derived from protein (PEP); Phase 1) for 3 days. Participants were then randomized in Phase 2 (5 days) to diets with PEP fixed at 10%, 15% or 25%. Results: Self-selected PEP was similar in both groups. In the groups combined, selected PEP was 14.7, which differed significantly (P < 0.0001) from the null expectation (16.7%) of no selection. Self-selected PEP was inversely related to birthweight, the effect disappearing after adjusting for sex and current body weight. In Phase 2, PEP correlated inversely with EI (P = 0.002) and weight change from Phase 1 to 2 (P = 0.002). Protein intake increased with increasing PEP, but to a lesser extent than energy increased with decreasing PEP. Conclusions and implications: Macronutrient intakes were not independently related to birthweight or diagnosis. In a free-choice situation (Phase 1), subjects selected a dietary PEP significantly lower than random. Lower PEP diets induce increased energy and decreased protein intake, and are associated with weight gain. PMID:26817484

  13. Late mortality, secondary malignancy and hospitalisation in teenage and young adult survivors of Hodgkin lymphoma: report of the Childhood/Adolescent/Young Adult Cancer Survivors Research Program and the BC Cancer Agency Centre for Lymphoid Cancer.

    PubMed

    Bhuller, Kaljit S; Zhang, Yang; Li, Dongdong; Sehn, Laurie H; Goddard, Karen; McBride, Mary L; Rogers, Paul C

    2016-03-01

    Late complications affecting Hodgkin lymphoma (HL) survivors are well described in paediatric and adult-based publications. This study determined the late morbidity and mortality risk for 442 teenage and young adult (TYAs) 5-year HL survivors, diagnosed at 15-24 years of age between 1970 and 1999, identified from the British Columbia Cancer Registry. Treatment details were abstracted from charts. Survivors and a matched comparison cohort were linked to provincial administrative health datasets until December 2006 and regression analysis was performed, providing risk ratios regarding mortality, secondary malignancy and morbidity causing hospitalisation. Sixty (13·6%) survivors experienced late mortality with excess deaths from secondary cancer [standardised mortality ratio (SMR) 18·6; 95% confidence interval (CI) 11-29·4] and non-malignant disease (SMR 3·6; 95% CI 2·2-5·5). Excess secondary cancers (standardised incidence ratio 7·8; 95% CI 5·6-10·5) were associated with radiotherapy [Hazard ratio (HR) 2·7; 95% CI 1-7·7] and female gender (HR 1·8; 95% CI 1-3·4). Of 281 survivors treated between 1981 and 1999, 143 (51%) had morbidity resulting in hospitalisation (relative risk 1·45; 95% CI 1·22-1·73). Hospitalisation significantly increased with combined modality therapy, chemotherapy alone and recent treatment era. TYA HL survivors have excess risk of mortality and secondary malignancy continuing 30 years from diagnosis. Radiotherapy is associated with secondary malignancy and current response-adapted protocols attempt to minimise exposure, but late morbidity causing hospitalisation remains significant. PMID:26727959

  14. Disruption of White Matter Integrity in Adult Survivors of Childhood Brain Tumors: Correlates with Long-Term Intellectual Outcomes

    PubMed Central

    Mao, Hui

    2015-01-01

    Background Although chemotherapy and radiation treatment have contributed to increased survivorship, treatment-induced brain injury has been a concern when examining long-term intellectual outcomes of survivors. Specifically, disruption of brain white matter integrity and its relationship to intellectual outcomes in adult survivors of childhood brain tumors needs to be better understood. Methods Fifty-four participants underwent diffusion tensor imaging in addition to structural MRI and an intelligence test (IQ). Voxel-wise group comparisons of fractional anisotropy calculated from DTI data were performed using Tract Based Spatial Statistics (TBSS) on 27 survivors (14 treated with radiation with and without chemotherapy and 13 treated without radiation treatment on average over 13 years since diagnosis) and 27 healthy comparison participants. Whole brain white matter fractional anisotropy (FA) differences were explored between each group. The relationships between IQ and FA in the regions where statistically lower FA values were found in survivors were examined, as well as the role of cumulative neurological factors. Results The group of survivors treated with radiation with and without chemotherapy had lower IQ relative to the group of survivors without radiation treatment and the healthy comparison group. TBSS identified white matter regions with significantly different mean fractional anisotropy between the three different groups. A lower level of white matter integrity was found in the radiation with or without chemotherapy treated group compared to the group without radiation treatment and also the healthy control group. The group without radiation treatment had a lower mean FA relative to healthy controls. The white matter disruption of the radiation with or without chemotherapy treated survivors was positively correlated with IQ and cumulative neurological factors. Conclusions Lower long-term intellectual outcomes of childhood brain tumor survivors are

  15. Amelioration of sexual fantasies to sexual abuse cues in an adult survivor of childhood sexual abuse: a case study.

    PubMed

    Wilson, Jane E; Wilson, Keith M

    2008-12-01

    Although sexual dysfunction of childhood sexual abuse survivors has received considerable attention, other sexual difficulties experienced by survivors of CSA, such as sexual fantasies to cues of sexual abuse, have received less attention. In this A-B design case study, a young adult female survivor of childhood sexual abuse presented for treatment at a Midwest rape crisis center. After successful treatment of post-traumatic stress disorder, she complained of unwanted sexual fantasies to sexual abuse cues and concomitant guilt and shame. Following baseline data collection, treatment consisted of self-applied aversion therapy to unwanted sexual arousal to sexual abuse cues. Decrease in sexual arousal to these cues was concurrent with the introduction of treatment. A concomitant decrease in guilt and shame occurred while self-ratings of control increased. PMID:18355799

  16. [Burns].

    PubMed

    Arai, Takao

    2016-02-01

    Burns extending deep into the skin and those affecting a wide surface area trigger various responses in the body and pose a serious threat to life. Therefore, the degree of severity needs to be determined accurately, and appropriate transfusion and local management should be provided accordingly. Systematic and meticulous management that considers not just the risk of death but also functional prognosis is essential from the early stage of burn injuries. Such management requires comprehensive care by a medical team concerning infections, nutrition and rehabilitation. This article outlines the current status of intensive care for severe burns. PMID:26915244

  17. Is Real-Time Feedback of Burn-Specific Patient-Reported Outcome Measures in Clinical Settings Practical and Useful? A Pilot Study Implementing the Young Adult Burn Outcome Questionnaire.

    PubMed

    Ryan, Colleen M; Lee, Austin F; Kazis, Lewis E; Shapiro, Gabriel D; Schneider, Jeffrey C; Goverman, Jeremy; Fagan, Shawn P; Wang, Chao; Kim, Julia; Sheridan, Robert L; Tompkins, Ronald G

    2016-01-01

    Long-term follow-up care of survivors after burn injuries can potentially be improved by the application of patient-reported outcome measures (PROMs). PROMs can inform clinical decision-making and foster communication between the patient and provider. There are no previous reports using real-time, burn-specific PROMs in clinical practice to track and benchmark burn recovery over time. This study examines the feasibility of a computerized, burn-specific PROM, the Young Adult Burn Outcome Questionnaire (YABOQ), with real-time benchmarking feedback in a burn outpatient practice. The YABOQ was redesigned for formatting and presentation purposes using images and transcribed to a computerized format. The redesigned questionnaire was administered to young adult burn survivors (ages 19-30 years, 1-24 months from injury) via an ipad platform in the office before outpatient visits. A report including recovery curves benchmarked to a nonburned relatively healthy age-matched population and to patients with similar injuries was produced for the domains of physical function and social function limited by appearance. A copy of the domain reports as well as a complete copy of the patient's responses to all domain questions was provided for use during the clinical visit. Patients and clinicians completed satisfaction surveys at the conclusion of the visit. Free-text responses, included in the satisfaction surveys, were treated as qualitative data adding contextual information about the assessment of feasibility. Eleven patients and their providers completed the study for 12 clinical visits. All patients found the ipad survey and report "easy" or "very easy" to use. In nine instances, patients "agreed" or "strongly agreed" that it helped them communicate their situation to their doctor/nurse practitioner. Patients "agreed" or "strongly agreed" that the report helped them understand their course of recovery in 10 visits. In 11 visits, the patients "agreed" or "strongly agreed" that

  18. Comparative study of quality of life of adult survivors of childhood acute lymphocytic leukemia and Wilms’ tumor

    PubMed Central

    de Souza, Clélia Marta Casellato; Cristofani, Lilian Maria; Cornacchioni, Ana Lucia Beltrati; Odone, Vicente; Kuczynski, Evelyn

    2015-01-01

    Abstract Objective To analyze and compare the health-related quality of life of adult survivors of acute lymphocytic leukemia and Wilms’ tumor amongst themselves and in relation to healthy participants. Methods Ninety participants aged above 18 years were selected and divided into three groups, each comprising 30 individuals. The Control Group was composed of physically healthy subjects, with no cancer history; and there were two experimental groups: those diagnosed as acute lymphocytic leukemia, and those as Wilms’ Tumor. Quality of life was assessed over the telephone, using the Medical Outcomes Study 36-Item Short Form Health Survey. Results Male survivors presented with better results as compared to female survivors and controls in the Vitality domain, for acute lymphocytic leukemia (p=0.042) and Wilms’ tumor (p=0.013). For acute lymphocytic leukemia survivors, in Social aspects (p=0.031), Mental health (p=0.041), and Emotional aspects (p=0.040), the latter also for survivors of Wilms’ tumor (p=0.040). The best results related to the Functional capacity domain were recorded for the experimental group that had a late diagnosis of acute lymphocytic leukemia. There were significant differences between groups except for the Social and Emotional domains for self-perceived health, with positive responses that characterized their health as good, very good, and excellent. Conclusion Survivors of acute lymphocytic leukemia showed no evidence of relevant impairment of health-related quality of life. The Medical Outcomes Study 36-Item Short Form Health Survey (via telephone) can be a resource to access and evaluate survivors. PMID:26537509

  19. “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

    Cancer.gov

    “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

  20. Burns

    MedlinePlus

    ... to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot liquids and ... to infections because they damage your skin's protective barrier. Treatment for burns depends on the cause of ...

  1. Burns

    MedlinePlus

    ... of Surgery . 18th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 22. Holmes JH, Heimbach DM. Burns. In: Brunicardi FC, Andersen DK, Billiar TR, et al, eds. Schwartz's Principles of Surgery . 9th ed. New ...

  2. Staphylococcal superantigens and toxins are detectable in the serum of adult burn patients.

    PubMed

    Prindeze, Nicholas J; Amundsen, Bethany M; Pavlovich, Anna R; Paul, Dereck W; Carney, Bonnie C; Moffatt, Lauren T; Shupp, Jeffrey W

    2014-07-01

    Bacterial infection in burn patients is still a devastating contributor to morbidity and mortality. Little is known regarding the presence of staphylococcal toxins in the burn-injured patient. The aim of this study was to characterize the prevalence of several of these toxins and their relationship to clinical metrics and mortality in burn patients. Levels of exotoxins staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B, toxic shock syndrome toxin 1 (TSST-1), and α-hemolysin were assayed from the serum of 207 adult burn patients aged 16-92 years. Clinical, demographic, and microbiological data from these patients were then compared to toxin levels. Staphylococcal exotoxins α-hemolysin and SEA were present in 45% and 25% of the population, respectively. Bacterial cultures concomitantly showed a high prevalence of Staphylococcus aureus in 48% of patients, of which 59% were methicillin resistant. Several metrics may be predictive of high toxin concentrations of α-hemolysin and TSST-1 and SEA including burn size, length of stay, and bacteremia. Mortality associations indicated that burn size, bacteremia, age, and the presence of α-hemolysin and SEA may be predictors of mortality. A high prevalence of staphylococcal toxin α-hemolysin and superantigens TSST-1 and SEA can be found in the circulation of the adult burn population. The presence of these toxins may contribute to the morbidity and mortality of the burn patient. PMID:24809857

  3. Successful placement of an adult sternal intraosseous line through burned skin.

    PubMed

    Frascone, Ralph; Kaye, Koren; Dries, David; Solem, Lynn

    2003-01-01

    Obtaining vascular access can be difficult in the critical adult patient. This can be especially true in a severely burned patient, where the usual insertion site may be involved in the burn injury. We present a case in which a sternal intraosseous line was placed through a full-thickness injury, in a patient in full arrest, who subsequently underwent a successful cardiac resuscitation. PMID:14501399

  4. Skeletal Muscle Protein Breakdown Remains Elevated in Pediatric Burn Survivors up to One-Year Post-Injury.

    PubMed

    Chao, Tony; Herndon, David N; Porter, Craig; Chondronikola, Maria; Chaidemenou, Anastasia; Abdelrahman, Doaa Reda; Bohanon, Fredrick J; Andersen, Clark; Sidossis, Labros S

    2015-11-01

    Acute alterations in skeletal muscle protein metabolism are a well-established event associated with the stress response to burns. Nevertheless, the long-lasting effects of burn injury on skeletal muscle protein turnover are incompletely understood. This study was undertaken to investigate fractional synthesis (FSR) and breakdown (FBR) rates of protein in skeletal muscle of pediatric burn patients (n  =  42, >30% total body surface area burns) for up to 1 year after injury. Skeletal muscle protein kinetics were measured in the post-prandial state following bolus injections of C6 and N phenylalanine stable isotopes. Plasma and muscle phenylalanine enrichments were quantified using gas chromatography-mass spectrometry. We found that the FSR in burn patients was 2- to 3-fold higher than values from healthy men previously reported in the literature (P ≤ 0.05). The FBR was 4- to 6-fold higher than healthy values (P  <  0.01). Therefore, net protein balance was lower in burn patients compared with healthy men from 2 weeks to 12 months post-injury (P  <  0.05). These findings show that skeletal muscle protein turnover stays elevated for up to 1 year after burn, an effect attributable to simultaneous increases in FBR and FSR. Muscle FBR exceeds FSR during this time, producing a persistent negative net protein balance, even in the post-prandial state, which likely contributes to the prolonged cachexia seen in burned victims. PMID:26263438

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

    PubMed Central

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

    2015-01-01

    Purpose To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Methods Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95% CIs. Results Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7% v 8.0%, respectively; OR, 1.55; 95% CI, 1.04 to 2.30) and anxiety (7.4% v 4.4%, respectively; OR, 2.00; 95% CI, 1.17 to 3.43) and more problems with task efficiency (17.2% v 10.8%, respectively; OR, 1.72; 95% CI, 1.21 to 2.43), emotional regulation (19.1% v 14.1%, respectively; OR, 1.74; 95% CI, 1.26 to 2.40), and memory (25.9% v 19.0%, respectively; OR, 1.44; 95% CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95% CI, 2.28 to 3.77), somatization (OR, 2.29; 95% CI, 1.77 to 2.98), and depression (OR, 1.94; 95% CI, 1.43 to 2.63). Conclusion We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment. PMID:26150441

  6. Young and Uninsured: Insurance Patterns of Recently Diagnosed Adolescent and Young Adult Cancer Survivors in the AYA HOPE Study

    PubMed Central

    Parsons, Helen; Schmidt, Susanne; Harlan, Linda; Kent, Erin; Lynch, Charles; Smith, Ashley; Keegan, Theresa

    2014-01-01

    Introduction Young adults have historically been the least likely to have health insurance in the United States. Previous studies of childhood cancer survivors found lower rates of insurance and less access to medical care compared to siblings; however, no studies have examined continuity of insurance after cancer diagnosis in adolescents and young adults (AYAs). Methods Using the AYA Health Outcomes and Patient Experience study, a cohort of 465 15-39 year-olds from participating Surveillance, Epidemiology and End Results registries, we evaluated changes in and sponsors of health insurance coverage after diagnosis, coverage of doctor-recommended tests, and factors associated with lack of insurance post-diagnosis using chi-square tests and multivariable logistic regression. Results Over 25% (n=118) of AYA cancer survivors experienced some period without insurance up to 35 months post-diagnosis. Insurance rates were high in the initial year after diagnosis (6-14 months; 93.3%) but decreased substantially at follow-up (15-35 months; 85.2%). The most common sponsor of health insurance was employer/school-coverage (43.7%). Multivariable analysis indicated that older survivors (25-39 vs. 15-19; Odds Ratio (OR): 3.35, p<0.01) and those with less education (high school or less vs. college graduate; OR: 2.80, p<0.01) were more likely to experience a period without insurance after diagnosis. Furthermore, >20% of survivors indicated there were doctor-recommended tests/treatments not covered by insurance, but >80% received them regardless of coverage. Discussion Insurance rates decrease with time since diagnosis in AYA cancer survivors. Future studies should examine how new policies under the Affordable Care Act extend access and insurance coverage beyond initial treatment. PMID:24899580

  7. Utility of Global Longitudinal Strain by Echocardiography to Detect Left Ventricular Dysfunction in Long-Term Adult Survivors of Childhood Lymphoma and Acute Lymphoblastic Leukemia.

    PubMed

    Christiansen, Jon R; Massey, Richard; Dalen, Håvard; Kanellopoulos, Adriani; Hamre, Hanne; Fosså, Sophie D; Ruud, Ellen; Kiserud, Cecilie E; Aakhus, Svend

    2016-08-01

    Measuring left ventricular (LV) global longitudinal strain (GLS) is recommended in screening of long-term cancer survivors for cardiotoxicity. However, there are limited data on GLS in this setting, in particular in survivors with apparently normal LV function without risk factors of impaired GLS. In the present study, we measured GLS in 191 adult survivors of childhood lymphoma or acute lymphoblastic leukemia, with normal LV ejection fraction and fractional shortening (FS) and without known hypertension, diabetes mellitus, myocardial infarction, or stroke. We compared GLS in the survivors with 180 controls. Mean GLS was -19.0 ± 2.2% in the survivor group and -21.4 ± 2.0% in the controls (p <0.001). Impaired GLS, defined as mean - 1.96 SDs in the control group, occurred in 53 of 191 survivors (28%). We included survivors with impaired LV ejection fraction and/or FS or traditional risk factors (n = 231 in all) in multiple regression analyses to explore associations with previous cancer treatment. Survivors treated with mediastinal radiotherapy had an odds ratio of impaired GLS of 5.2 (95% confidence interval 2.2 to 12) compared with other survivors. Survivors treated with cumulative anthracycline doses >300 mg/m(2) had an odds ratio of 4.8 (95% confidence interval 1.7 to 14) of impaired GLS. In conclusion, this study demonstrates a high proportion of LV dysfunction assessed by GLS in apparently healthy adult survivors of childhood cancer. Impaired GLS was associated with previous exposure to mediastinal radiotherapy and high doses of anthracyclines. The prognostic role of measuring GLS in this specific patient population should be examined in prospective studies. PMID:27296561

  8. Adverse Late and Long-Term Treatment Effects in Adult Allogeneic Hematopoietic Stem Cell Transplant Survivors.

    PubMed

    Mosesso, Kara

    2015-11-01

    Hematopoietic stem cell transplantation (HSCT) has become the standard of care for many malignant and nonmalignant hematologic diseases that don't respond to traditional therapy. There are two types: autologous transplantation (auto-HSCT), in which an individual's stem cells are collected, stored, and infused back into that person; and allogeneic transplantation (allo-HSCT), in which healthy donor stem cells are infused into a recipient whose bone marrow has been damaged or destroyed. There have been numerous advancements in this field, leading to marked increases in the number of transplants performed annually. This article--the first of several on cancer survivorship--focuses on the care of adult allo-HSCT survivors because of the greater complexity of their posttransplant course. The author summarizes potential adverse late and long-term treatment-related effects, with special focus on the evaluation and management of several cardiovascular disease risk factors that can occur either independently or concurrently as part of the metabolic syndrome. These risk factors are potentially modifiable with appropriate nursing interventions and lifestyle modifications. PMID:26473441

  9. The use of arts and crafts in the rehabilitation of the adult burn patient.

    PubMed

    Sanford, S L; Cash, S H; Nelson, C

    1995-01-01

    The purpose of this study was to gain insight into one small aspect of occupational therapy: the use of arts and crafts in the rehabilitation of the adult burn patient. While burn care literature is plentiful, that related specifically to occupational therapy treatment of burn patients is scarce. A survey was mailed to occupational therapists in 165 burn units across the United States. Responses to survey questions indicate that a majority of respondents (73%%) do not use arts and crafts in the rehabilitation of adult burn patients, while 26%% do use these modalities. Those respondents who do use arts and crafts stated that they use leatherwork, painting, and woodworking most frequently. Therapists who do not use arts and crafts indicated that their primary reasons for not doing so were the acutely ill status of the patients and wound drainage/sterility issues. The entire scope of occupational therapy treatment of burn patients deserves greater attention as it is a challenging and rapidly-evolving area of practice. PMID:23947587

  10. [Nursing diagnoses for family members of adult burned patients near hospital discharge].

    PubMed

    Goyatá, Sueli Leiko Takamatsu; Rossi, Lídia Aparecida; Dalri, Maria Célia Barcellos

    2006-01-01

    This study aimed to identify the nursing diagnoses for family members of adult burned patients in the period near hospital discharge. We evaluated 10 family members of burned patients through interviews and observation. The nursing diagnoses were established on the basis of the NANDA International Taxonomy II and on Carpenito's interpretation of the NANDA Taxonomy I. We identified 11 different diagnosis categories, all of which were real. The most frequent diagnoses among the family members under analysis were knowledge deficit and anxiety. The former was characterized by the family members' need for information about care for the burned areas and infection prevention. The feeling of anxiety was mainly related to the changes in the appearance, structure or function of the burned patient's body and to the family members' expectations with respect to the patient's return to the family and work environment, accompanied by some physical, psycho-emotional or social consequence. PMID:16532246

  11. Understanding the Health Behaviors of Survivors of Childhood and Young-Adult Cancer: Preliminary Analysis and Model Development

    PubMed Central

    Vuotto, Stefanie C.; Procidano, Mary E.; Annunziato, Rachel A.

    2015-01-01

    The current study presents preliminary correlational data used to develop a model depicting the psychosocial pathways that lead to the health behaviors of survivors of childhood and young-adult cancer. Data collected from a sample of 18- to 30-year-old cancer survivors (n = 125) was used to examine the relations among interpersonal support and nonsupport, personal agency, avoidance, depressive symptoms and self-efficacy as they related to health behaviors. The outcome measures examined included tobacco and alcohol use, diet, exercise, sunscreen use, medication compliance and follow-up/screening practices. Correlational analyses revealed a number of significant associations among variables. Results are used to inform the development of a health behavior model. Implications for health promotion and survivorship programming are discussed, as well as directions for future research. PMID:27417357

  12. Exercise and Fatigue in Adolescent and Young Adult Survivors of Hodgkin Lymphoma: A Report from the Children's Oncology Group

    PubMed Central

    Hooke, Mary C.; Friedman, Debra L.; Campbell, Kristin; Withycombe, Janice; Schwartz, Cindy L.; Kelly, Kara; Meza, Jane

    2015-01-01

    Fatigue is a significant problem for adolescent and young adult (AYA) Hodgkin lymphoma (HL) survivors. The relationship between exercise and fatigue is complex. This study explored the trajectory of and the relationship between exercise and fatigue over 36 months post-therapy in a cohort of 103 AYA-aged HL survivors treated on Children's Oncology Group (COG) study AHOD0031. Descriptive statistics and generalized estimating equations were used in this secondary data analysis. Exercise and fatigue improved over time but were unrelated; amount of exercise at end of therapy predicted amount of exercise at 12 (p = 0.02) and 36 (p = 0.0008) months post-therapy. PMID:26421221

  13. Altered self-perception in adult survivors treated for a CNS tumor in childhood or adolescence: population-based outcomes compared with the general population

    PubMed Central

    Hörnquist, Lina; Rickardsson, Jenny; Lannering, Birgitta; Gustafsson, Göran; Boman, Krister K.

    2015-01-01

    Background Survivors of pediatric CNS tumors are at risk for persistent tumor/treatment-related morbidity, physical disability and social consequences that may alter self-perception, vital for self-identity, mental health and quality of survival. We studied the long-term impact of childhood CNS tumors and their treatment on the self-perception of adult survivors and compared outcomes with those of the general population. Methods The cohort included 697 Swedish survivors diagnosed with a primary CNS tumor during 1982–2001. Comparison data were randomly collected from a stratified general population sample. Survivors and general population individuals were compared as regards self-perception in 5 domains: body image, sports/physical activities, peers, work, and family, and with a global self-esteem index. Within the survivor group, determinants of impact on self-perception were identified. Results The final analyzed sample included 528 survivors, 75.8% of the entire national cohort. The control sample consisted of 995, 41% of 2500 addressed. Survivors had significantly poorer self-perception outcomes in domains of peers, work, body image, and sports/physical activities, and in the global self-perception measure, compared with those of the general population (all P < .001). Within the survivor group, female gender and persistent visible physical sequelae predicted poorer outcomes in several of the studied domains. Tumor type and a history of cranial radiation therapy were associated with outcomes. Conclusion An altered self-perception is a potential late effect in adult survivors of pediatric CNS tumors. Self-perception and self-esteem are significant elements of identity, mental health and quality of survival. Therefore, care and psychosocial follow-up of survivors should include measures for identifying disturbances and for assessing the need for psychosocial intervention. PMID:25332406

  14. Adult burn patients with more than 60% TBSA involved-Meek and other techniques to overcome restricted skin harvest availability--the Viennese Concept.

    PubMed

    Lumenta, David B; Kamolz, Lars-Peter; Frey, Manfred

    2009-01-01

    Despite the fact that early excision and grafting has significantly improved outcome over the last decades, the management of severely burned adult patients with >/=60% total body surface area (% TBSA) burned still represents a challenging task for burn care specialists all over the world. In this article, we present our current treatment concept for this entity of severely burned patients and analyze its effect in a comparative cohort study. Surgical strategy comprised the use of split-thickness skin grafts (Meek, mesh) for permanent coverage, fluidized microsphere bead-beds for wound conditioning, temporary coverage (polyurethane sheets, Epigard; nanocrystalline silver dressings, Acticoat; synthetic copolymer sheets based on lactic acid, Suprathel; acellular bovine derived collagen matrices, Matriderm; allogeneic cultured keratinocyte sheets; and allogeneic split-thickness skin grafts), and negative-pressure wound therapy (vacuum-assisted closure). The autologous split-thickness skin graft expansion using the Meek technique for full-thickness burns and the delayed approach for treating dorsal burn wounds is discussed in detail. To demonstrate differences before and after the introduction of the Meek technique, we have compared patients of 2007 with >/=60% TBSA (n = 10) to those in a matched observation period (n = 7). In the first part of the comparative analysis, all patients of the two samples were analyzed with regard to age, abbreviated burn severity index, Baux, different entities of % TBSA, and survival. In the second step, only the survivors of both years were separated in two groups as follows: patients receiving skin grafts, using the Meek technique (n = 6), were compared with those without Meek grafting (n = 4). When comparing the severely burned patients of 2007 with a cohort of 2006, there were no differences for age (2007: 46.4 +/- 13.4 vs. 2006: 39.1 +/- 14.8 years), abbreviated burn severity index score (2007: 12.2 +/- 1.0 vs. 2006: 12.1 +/- 1

  15. Resilience and mental health in adult survivors of child abuse associated with the institution of the Austrian Catholic Church.

    PubMed

    Lueger-Schuster, Brigitte; Weindl, Dina; Kantor, Viktoria; Knefel, Matthias; Glück, Tobias; Moy, Yvonne; Butollo, Asisa; Jagsch, Reinhold

    2014-10-01

    In recent years, reports of institutional abuse within the Catholic Church have emerged and research on the consequences on mental health is in its beginnings. In this study, we report findings on current mental health and resilience in a sample of adult survivors of institutional abuse (N = 185). We compared 3 groups of survivors that differed regarding their current mental health to investigate aspects of resilience, coping, and disclosure. The majority of the sample was male (76.2%), the mean age was 56.28 (SD = 9.46) years, and more than 50.0% of the sample was cohabiting/married. Most of the survivors reported severe mental health problems. Known protective factors (education, social support, age) were not associated with mental health in our sample. Our findings corroborate that institutional abuse has long-term effects on mental health. We found that fewer emotional reactions during disclosure, task-oriented coping, and optimism were associated with better mental health. The study was limited by a cross-sectional design, but we conclude that the kind of institutional abuse reported is especially adverse, and thus typical protective factors for mental health do not apply. Future research should focus on intrapersonal factors and institutional dynamics to improve treatment for persons affected by institutional abuse. PMID:25322886

  16. A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake

    PubMed Central

    2013-01-01

    Background Post-Traumatic Stress Disorder (PTSD) is a common psychological reaction after large-scale natural disasters. Given the number of people involved and shortage of resources in any major disaster, brief, pragmatic and easily trainable interventions are needed. The aim of this study is to evaluate the efficacy of Narrative Exposure Therapy (NET) as a short-term treatment for PTSD using Chinese earthquake survivors. Methods A randomized waiting-list control pilot study was conducted between December 2009 and March 2010, at the site of the Sichuan earthquake in Beichuan County, China. Adult participants with newly diagnosed Post Traumatic Stress Disorder (PTSD) were randomly allocated to Narrative Exposure Therapy (NET) or a Waiting-List (WL) condition. The latter received NET treatment after a two-week waiting period. To compare the effectiveness of NET in traumatised earthquake survivors, both groups were assessed on PTSD symptoms, general mental health, anxiety and depression, social support, coping style and posttraumatic change before and after treatment and two months post treatment. Results Adult participants (n=22) were randomly allocated to receive NET (n=11) or WL (n=11). Twenty two participants (11 in NET group, 11 in WL) were included in the analysis of primary outcomes. Compared with WL, NET showed significant reductions in PTSD symptoms, anxiety and depression, general mental stress and increased posttraumatic growth. The WL group later showed similar improvements after treatment. These changes remained stable for a two-month follow-up. Measures of social support and coping showed no stable effects. Conclusions NET is effective in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. The findings help advance current knowledge in the management of PTSD after natural disasters and inform future research. Larger sample sizes are needed to extend the present findings. Trial registration Chinese Clinical Trial Registry

  17. Energy balance and fitness in adult survivors of childhood acute lymphoblastic leukemia

    PubMed Central

    DeLany, James P.; Kaste, Sue C.; Mulrooney, Daniel A.; Pui, Ching-Hon; Chemaitilly, Wassim; Karlage, Robyn E.; Lanctot, Jennifer Q.; Howell, Carrie R.; Lu, Lu; Srivastava, Deo Kumar; Robison, Leslie L.; Hudson, Melissa M.

    2015-01-01

    There is limited information on body composition, energy balance, and fitness among survivors of childhood acute lymphoblastic leukemia (ALL), especially those treated without cranial radiation therapy (CRT). This analysis compares these metrics among 365 ALL survivors with a mean age of 28.6 ± 5.9 years (149 treated with and 216 without CRT) and 365 age-, sex-, and race-matched peers. We also report risk factors for outcomes among survivors treated without CRT. Male survivors not exposed to CRT had abnormal body composition when compared with peers (% body fat, 26.2 ± 8.2 vs 22.7 ± 7.1). Survivors without CRT had similar energy balance but had significantly impaired quadriceps strength (−21.9 ± 6.0 Newton-meters [Nm]/kg, 60°/s) and endurance (−11.4 ± 4.6 Nm/kg, 300°/s), exercise capacity (−2.0 ± 2.1 ml/kg per minute), low-back and hamstring flexibility (−4.7 ± 1.6 cm), and dorsiflexion range of motion (−3.1 ± 0.9°) and higher modified total neuropathy scores (+1.6 ± 1.1) than peers. Cumulative asparaginase dose ≥120 000 IU/m2 was associated with impaired flexibility, vincristine dose ≥39 mg/m2 with peripheral neuropathy, glucocorticoid (prednisone equivalent) dose ≥8000 mg/m2 with hand weakness, and intrathecal methotrexate dose ≥225 mg with dorsiflexion weakness. Physical inactivity was associated with hand weakness and decreased exercise capacity. Smoking was associated with peripheral neuropathy. Elimination of CRT from ALL therapy has improved, but not eliminated, body-composition outcomes. Survivors remain at risk for impaired fitness. PMID:25814529

  18. Engaging older adults in burn prevention education: results of a community-based urban initiative.

    PubMed

    Leahy, Nicole E; Sessler, Kelly A; Baggott, Kaitlin; Laverde, Louisa; Rabbitts, Angela; Yurt, Roger W

    2012-01-01

    The objective of the study is to educate New York City seniors aged 60 years and older about fire safety and burn prevention through the use of a community-based, culturally sensitive delivery platform. The ultimate goal is to reduce burn injury morbidity and mortality among this at-risk population. Programming was developed and provided to older adults attending community-based senior centers. Topics included etiology of injury, factors contributing to burn injuries, methods of prevention, emergency preparedness, and home safety. Attendees completed a postpresentation survey. Of the 234 senior centers invited to participate in the program, 64 (27%) centers requested presentations, and all received the educational programming, reaching 2196 seniors. An additional 2590 seniors received education during community-based health fairs. A majority reported learning new information, found the presentation helpful, and intended to apply this knowledge to daily routines. Data confirm that many opportunities exist to deliver culturally sensitive burn prevention programming to the older adult population of this large metropolitan area in settings that are part of their daily lives. A majority of respondents welcomed the information, perceived it as helpful, and reported that they were likely to integrate the information into their lives. PMID:22561308

  19. Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study

    PubMed Central

    Randall, Sean M; Fear, Mark W; Wood, Fiona M; Rea, Suzanne; Boyd, James H; Duke, Janine M

    2015-01-01

    Objective To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. Design A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. Subjects Records of 17 753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980–2012, and 70 758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. Main outcome measures Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. Results After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0–6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months–2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2–15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. Conclusions Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required

  20. Health-Related Quality of Life of Young Adult Survivors of Childhood Cancer: A Review of Qualitative Studies

    PubMed Central

    Nightingale, Chandylen L.; Quinn, Gwendolyn P.; Shenkman, Elizabeth A.; Curbow, Barbara A.; Zebrack, Bradley J.; Krull, Kevin R.

    2011-01-01

    Purpose: The occurrence of late effects, combined with traditional growth and developmental issues, can significantly affect the health-related quality of life (HRQOL) of young adult survivors of childhood cancer (YASCC). Limited HRQOL measurement tools have been developed or validated for YASCC. The purpose of this study was to identify the domains of HRQOL that are unique to YASCC by conducting a systematic review of qualitative studies. Specifically, we compared the findings to the classical framework of HRQOL that was developed for survivors of adult-onset cancer and identified specific domains not being assessed in existing HRQOL instruments for YASCC. Methods: We searched qualitative studies published in peer-reviewed journals from 2000 to 2010 in the PsychINFO, PubMed, and EBSCOhost databases. A set of keywords and inclusion/exclusion criteria were utilized to identify eligible studies with a focus on survivorship and HRQOL issues of YASCC. Results: Sixteen studies met the inclusion/exclusion criteria and were investigated in this study. Six important domains of HRQOL were identified (physical, social, psychological, spiritual, fertility/sexual, resilience, and body appearance) with several sub-domains. Conclusion: Use of the classical HRQOL framework and existing instruments is not comprehensive enough for YASCC. Adding unique domains to the classical framework and existing instruments will make them valuable tools for measuring the HRQOL of YASCC and increase health professionals' ability to identify if and when psychosocial services are needed for this unique population. PMID:23610733

  1. Adult Sexual Assault Survivors' Experiences with Sexual Assault Nurse Examiners (SANEs)

    ERIC Educational Resources Information Center

    Fehler-Cabral, Giannina; Campbell, Rebecca; Patterson, Debra

    2011-01-01

    Sexual assault survivors often feel traumatized by the care received in traditional hospital emergency departments. To address these problems, Sexual Assault Nurse Examiner (SANE) programs were created to provide comprehensive medical care, crisis intervention, and forensic services. However, there is limited research on the actual experiences and…

  2. An international review of the patterns and determinants of health service utilisation by adult cancer survivors

    PubMed Central

    2012-01-01

    Background There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services. Methods Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review. Results Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provision s- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors. Conclusions Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure

  3. Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer

    PubMed Central

    Yu, Anthony F.; Raikhelkar, Jayant; Zabor, Emily C.; Tonorezos, Emily S.; Moskowitz, Chaya S.; Adsuar, Roberto; Mara, Elton; Huie, Kevin; Oeffinger, Kevin C.; Steingart, Richard M.; Liu, Jennifer E.

    2016-01-01

    Two-dimensional speckle tracking echocardiography (2DSTE) provides a sensitive measure of left ventricular (LV) systolic function and may aid in the diagnosis of cardiotoxicity. 2DSTE was performed in a cross-sectional study of 134 patients (mean age: 31.4 ± 8.8 years; 55% male; mean time since diagnosis: 15.4 ± 9.4 years) previously treated with anthracyclines (mean cumulative dose: 320 ± 124 mg/m2), with (n = 52) or without (n = 82) mediastinal radiotherapy. The prevalence of LV systolic dysfunction, defined as fractional shortening < 27%, LV ejection fraction (LVEF) < 55%, and global longitudinal strain (GLS) ≤ 16%, was 5.2%, 6.0%, and 23.1%, respectively. Abnormal GLS was observed in 24 (18%) patients despite a normal LVEF. Indices of LV systolic function were similar regardless of anthracycline dose. However, GLS was worse (18.0 versus 19.0, p = 0.003) and prevalence of abnormal GLS was higher (36.5% versus 14.6%, p = 0.004) in patients treated with mediastinal radiotherapy. Mediastinal radiotherapy was associated with reduced GLS (p = 0.040) after adjusting for sex, age, and cumulative anthracycline dose. In adult survivors of childhood, adolescent, and young adult cancer, 2DSTE frequently detects LV systolic dysfunction despite a normal LVEF and may be useful for the long-term cardiac surveillance of adult cancer survivors. PMID:26942202

  4. Development of clinical practice guidelines for urinary continence care of adult stroke survivors in acute and rehabilitation settings.

    PubMed

    Fisher, Andrea R

    2014-01-01

    This study developed evidence-based clinical practice guidelines for the urinary continence care of adult stroke survivors in acute and rehabilitation settings. The research team conducted a comprehensive review of the literature on urinary continence interventions and outcomes. The team then developed a set of recommendations outlined in the resulting clinical practice guidelines titled Clinical Practice Guidelines (CPGs) for the Urinary Continence Care of Stroke Survivors in Acute and Rehabilitation Settings. The evaluation of the CPGs consisted of a two-part assessment and pilot implementation. An expert panel of 25 local and regional experts in stroke and continence care assessed the proposed CPGs. This assessment consisted of two stages: a) evaluating the guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument (http://www. agreetrust.org); and, b) conducting focus groups to identify barriers and facilitators to the implementation of the guidelines using the Ottawa Model of Research Use (OMRU). Results from the expert panel assessments/feedback contributed to the refinement of the CPGs as well as identification and construction of implementation strategies. Two sites conducted a three-month pilot implementation of three recommendations from the CPGs as selected by each site. The two inpatient sites were a rehabilitation setting and a mixed acute and rehabilitation setting. The implementation of the CPGs included the development of learning strategies tailored to the needs of each site and in addition to the creation of an online self-learning portal. This study assessed nurses' knowledge, attitudes, and beliefs regarding urinary continence challenges using a survey before and after the pilot. Chart reviews before and after the pilot implementation audited the nurses' urinary continence practices for patients and uptake of the selected guidelines' recommendations. Study findings suggested the implementation of the CPGs

  5. Immunity in young adult survivors of childhood leukemia is similar to the elderly rather than age-matched controls: Role of cytomegalovirus.

    PubMed

    Azanan, Mohamad Shafiq; Abdullah, Noor Kamila; Chua, Ling Ling; Lum, Su Han; Abdul Ghafar, Sayyidatul Syahirah; Kamarulzaman, Adeeba; Kamaruzzaman, Shahrul; Lewin, Sharon R; Woo, Yin Ling; Ariffin, Hany; Rajasuriar, Reena

    2016-07-01

    Many treatment complications that occur late in childhood cancer survivors resemble age-related comorbidities observed in the elderly. An immune phenotype characterized by increased immune activation, systemic inflammation, and accumulation of late-differentiated memory CD57(+) CD28(-) T cells has been associated with comorbidities in the elderly. Here, we explored if this phenotype was present in young adult leukemia survivors following an average of 19 years from chemotherapy and/or radiotherapy completion, and compared this with that in age-matched controls. We found that markers of systemic inflammation-IL-6 and human C-reactive protein and immune activation-CD38 and HLA-DR on T cells, soluble CD (sCD)163 from monocytes and macrophages-were increased in survivors compared to controls. T-cell responses specific to cytomegalovirus (CMV) were also increased in survivors compared to controls while CMV IgG levels in survivors were comparable to levels measured in the elderly (>50years) and correlated with IL-6, human C-reactive protein, sCD163, and CD57(+) CD28(-) memory T cells. Immune activation and inflammation markers correlated poorly with prior chemotherapy and radiotherapy exposure. These data suggest that CMV infection/reactivation is strongly correlated with the immunological phenotype seen in young childhood leukemia survivors and these changes may be associated with the early onset of age-related comorbidities in this group. PMID:27129782

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

    PubMed

    Kao, Hsueh-Fen S; Stuifbergen, Alexa K

    2004-04-01

    This study aims to describe the meaning of the experience of the relationship between young adult traumatic brain injury (TBI) survivors and their mothers using a phenomenological approach. Informants included 9 males and 3 females who were at least 2 years post-TBI, and their mothers, who were their primary caregivers after the injury. TBI informants were 18 to 25 years of age, had motor vehicle accident-induced injury, experienced post-traumatic amnesia longer than 24 hours, and were able to participate in a verbal interview. In addition, all informants currently were living with their mothers, who also participated in this study. Survivors acquired the sense of being abnormal from various sources, including social pressures, dynamics within the family, and intrapersonal changes. Mothers adopted both positive and negative actions during the period of uncertainty and often struggled to balance protecting their children and letting them become independent. They also struggled to maintain harmonious relationships with people both inside and outside of the family. Sometimes, survivors' parents marital relationships were at risk. Health professionals should design more appropriate long-term community interventions to help TBI survivors and their families decrease the burden of injury and the resulting stress, increase survivors' self-esteem, and improve quality of life of both survivors and their families, serving as a foundation for further TBI care. PMID:15115361

  7. PTSD Symptoms and Self-Rated Recovery among Adult Sexual Assault Survivors: The Effects of Traumatic Life Events and Psychosocial Variables

    ERIC Educational Resources Information Center

    Najdowski, Cynthia J.; Ullman, Sarah E.

    2009-01-01

    Prior research has demonstrated that self-blame is predictive of more posttraumatic stress disorder (PTSD) symptoms and poorer recovery (Frazier, 2003; Koss, Figueredo, & Prince, 2002), and perceived control over recovery is associated with less distress (Frazier, 2003) in adult sexual assault (ASA) survivors. A structural equation model was…

  8. Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA

    ERIC Educational Resources Information Center

    Edmond, Tonya; Rubin, Allen

    2004-01-01

    This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence…

  9. Relations among arginine, citrulline, ornithine, and leucine kinetics in adult burn patients.

    PubMed

    Yu, Y M; Ryan, C M; Burke, J F; Tompkins, R G; Young, V R

    1995-11-01

    Plasma fluxes of arginine, citrulline, and leucine, and the rate of conversion of labeled citrulline to arginine (Qcit-->arg) were determined in nine severely burned patients (mean: 56% body surface burn area, mean 10 d postinjury) while they received total parenteral nutrition (TPN) including an L-amino acid mixture that supplied a generous amount of nitrogen (mean: 0.39 +/- 0.02 g.kg-1.d-1). Plasma fluxes were also studied in these patients during a basal state (low-dose intravenous glucose) by using a primed, 4-h constant intravenous tracer-infusion protocol. Stable-nuclide labeled tracers were L-[15N-15N-guanidino,5,5,2H2]arginine; L-[13C-ureido]citrulline; L-[1-13C]leucine; and NaH13CO3 (prime only), with blood and expired air samples drawn at intervals to determine isotopic abundance of arginine, citrulline, ornithine, and alpha-ketoisocaproate (KIC; for leucine) in plasma and 13CO2 in breath. Leucine kinetics (flux and disappearance into protein synthesis) confirmed the anticipated higher protein turnover in these burn patients compared with healthy control subjects. The plasma arginine fluxes were correspondingly higher in burn patients than in healthy control subjects. However, the citrulline flux and rate of conversion of citrulline to arginine were not higher than values obtained in our laboratories in healthy adult subjects. We hypothesize that the higher rates of arginine loss from the body after burn injury would need to be balanced by an appropriate exogenous intake of preformed arginine to maintain protein homeostasis and promote recovery from this catabolic condition. PMID:7572742

  10. Measurement equivalence of seven selected items of posttraumatic growth between black and white adult survivors of Hurricane Katrina.

    PubMed

    Rhodes, Alison M; Tran, Thanh V

    2013-02-01

    This study examined the equivalence or comparability of the measurement properties of seven selected items measuring posttraumatic growth among self-identified Black (n = 270) and White (n = 707) adult survivors of Hurricane Katrina, using data from the Baseline Survey of the Hurricane Katrina Community Advisory Group Study. Internal consistency reliability was equally good for both groups (Cronbach's alphas = .79), as were correlations between individual scale items and their respective overall scale. Confirmatory factor analysis of a congeneric measurement model of seven selected items of posttraumatic growth showed adequate measures of fit for both groups. The results showed only small variation in magnitude of factor loadings and measurement errors between the two samples. Tests of measurement invariance showed mixed results, but overall indicated that factor loading, error variance, and factor variance were similar between the two samples. These seven selected items can be useful for future large-scale surveys of posttraumatic growth. PMID:23654027

  11. Comparison of positive pressure gloves on hand function in adults with burns.

    PubMed

    O'Brien, Kimberly A; Weinstock-Zlotnick, Gwen; Hunter, Hope; Yurt, Roger W

    2006-01-01

    The purpose of this study was to analyze the impact of a standard, custom-made pressure glove vs The NewYork-Presbyterian Dexterity Glove (NYPDG) with silon application on the palmer surface on functional hand use of burn survivors. A standard, custom-made pressure glove and NYPDG were given to 18 participants in a randomized order. Subjects wore each glove for 7 to 10 days during all activities of daily living (ADL). Variables such as hand function, difficulty of fine and gross motor ADL, and participant glove preference were assessed with each glove condition. Data collection of the second glove took place 7 to 10 days later incorporating a quasiexperimental, repeated measure design. A crossover design was used to analyze the data. The NYPDG demonstrated significantly better results in all of the four outcome categories measured: time to complete the Jebsen, the Jebsen Likert scale, fine motor ADL, and gross motor ADL. This study demonstrated that functional tasks took less time to complete and were more easily performed when using the NYPDG. PMID:16679904

  12. Adult mental health outcomes of child sexual abuse survivors born at extremely low birth weight.

    PubMed

    Lund, Jessie I; Day, Kimberly L; Schmidt, Louis A; Saigal, Saroj; Van Lieshout, Ryan J

    2016-09-01

    The high prevalence of child sexual abuse (CSA) is concerning, particularly as survivors are at increased risk for multiple adverse outcomes, including poor mental health across the lifespan. Children born at an extremely low birth weight (ELBW; <1000g) and who experience CSA may be a group that is especially vulnerable to psychopathology later in life. However, no research has considered the mental health risks associated with being born at ELBW and experiencing CSA. In this study, we investigated the mental health of 179 ELBW survivors and 145 matched normal birth weight (NBW; >2500g) participants at ages 22-26 and 29-36. At age 22-26, CSA was associated with increased odds of clinically significant internalizing (OR=7.32, 95% CI: 2.31-23.23) and externalizing (OR=4.65, 95% CI: 1.11-19.51) problems among ELBW participants exposed to CSA compared to those who did not, though confidence intervals were wide. At age 29-36, CSA was linked to increased odds of any current (OR=3.43, 95% CI: 1.08-10.87) and lifetime (OR=7.09, 95% CI: 2.00-25.03) non-substance use psychiatric disorders, however, this did not hold after adjustment for covariates. Statistically significant differences in mental health outcomes were not observed in NBW participants exposed to CSA compared to NBW participants who were not exposed. Survivors of significant perinatal adversity who are also exposed to CSA may be at higher risk for psychopathology through the fourth decade of life. PMID:27500386

  13. A Cross-sectional Study on Posttraumatic Stress Disorder and General Psychiatric Morbidity Among Adult Survivors 3 Years After the Wenchuan Earthquake, China.

    PubMed

    Zhang, Wei; Duan, Guangfeng; Xu, Qin; Jia, Zhaobao; Bai, Zhengyang; Liu, Weizhi; Pan, Xiao; Tian, Wenhua

    2015-11-01

    After the Wenchuan earthquake, a large number of studies have focused on postearthquake psychological disorders among survivors; however, most of these studies were conducted within a relatively short period. This study was conducted to examine the symptoms of posttraumatic stress disorder (PTSD) and general psychiatric morbidity among adult survivors 3 years after the Wenchuan earthquake, China. Through a multistage systematic sampling approach, a cross-sectional survey of 360 participants, 18 years or older, was conducted. The prevalence of PTSD and general psychiatric morbidity was 10.3% and 20.6%, respectively. Multivariate analysis revealed significant predictors for PTSD, including female gender and having felt guilt concerning someone's death or injury. Significant predictors for general psychiatric morbidity included unmarried status and having been in serious danger. These results suggest that mental health services should be continuously available to earthquake survivors. PMID:26316500

  14. Comprehensive Echocardiographic Detection of Treatment-related Cardiac Dysfunction in Adult Survivors of Childhood Cancer: Results from the St. Jude Lifetime Cohort Study

    PubMed Central

    Armstrong, Gregory T.; Joshi, Vijaya M.; Ness, Kirsten K.; Marwick, Thomas H.; Zhang, Nan; Srivastava, DeoKumar; Griffin, Brian P.; Grimm, Richard A.; Thomas, James; Phelan, Dermot; Collier, Patrick; Krull, Kevin R.; Mulrooney, Daniel A.; Green, Daniel M.; Hudson, Melissa M.; Robison, Leslie L.; Plana, Juan Carlos

    2015-01-01

    Background Treatment-related cardiac death is the primary non-cancer cause of mortality in adult survivors of childhood malignancies. Early detection of cardiac dysfunction using modern echocardiographic techniques may identify a high risk subset of survivors for early intervention. Objective To determine the prevalence of cardiac dysfunction in adult survivors of childhood malignancies using state of the art echocardiographic evaluation of cardiac function including strain imaging Methods Echocardiographic assessment included three dimensional (3D) left ventricular ejection fraction (LVEF), global longitudinal and circumferential myocardial strain and diastolic function, graded per American Society of Echocardiography (ASE) guidelines on 1,820 adult (median age 31 [range 18-65] years) survivors of childhood cancer (median time from diagnosis 23 years [range10-48] years) exposed to either anthracycline chemotherapy (N=1,050), chest-directed radiotherapy (RT, N=306), or both therapies (N=464). Results Only 5.8% of survivors had an abnormal 3D LVEF (<50%). However, 32.1% of survivors with a normal 3D LVEF had evidence for cardiac dysfunction by either global longitudinal strain (28.0%), ASE graded diastolic assessment (8.7%), or both. Abnormal global longitudinal strain was associated with chest-directed RT (1-19.9 Gy, Rate Ratio (RR) 1.38, 95% Confidence Interval (CI) 1.14-1.66; 20-29.9 Gy, RR 1.65, 95% CI 1.31-2.08; >30 Gy, RR 2.39, 95% CI 1.79-3.18) and anthracycline dose >300 mg/m2 (RR 1.72, 95% CI 1.31-2.26). Survivors with metabolic syndrome were twice as likely to have abnormal global longitudinal strain (Rate Ratio [RR] 1.94, 95% CI 1.66-2.28) as well as abnormal diastolic function (RR 1.68, 95% CI 1.39-2.03), but not abnormal 3D LVEF (RR 1.07, 95% CI 0.74-1.53). Conclusions and Relevance Abnormal global longitudinal strain and abnormal diastolic function are more prevalent than reduced 3D LVEF and are associated with treatment exposure. They may identify a

  15. Cardiac Outcomes in Adult Survivors of Childhood Cancer Exposed to Cardiotoxic Therapy: A Cross-Sectional Study from the St. Jude Lifetime Cohort

    PubMed Central

    Mulrooney, Daniel A.; Armstrong, Gregory T.; Huang, Sujuan; Ness, Kirsten K.; Ehrhardt, Matthew J.; Joshi, Vijaya M.; Plana, Juan Carlos; Soliman, Elsayed Z.; Green, Daniel M.; Srivastava, Deokumar; Santucci, Aimee; Krasin, Matthew J.; Robison, Leslie L.; Hudson, Melissa M.

    2016-01-01

    Background Studies of cardiac disease among adult survivors of childhood cancer have generally relied upon self-reported or registry-based data. Objective Systematically assess cardiac outcomes among childhood cancer survivors Design Cross-sectional Setting St. Jude Children's Research Hospital Patients 1,853 adult survivors of childhood cancer, ≥18 years old, and ≥10 years from treatment with cardiotoxic therapy for childhood cancer. Measurements History/physical examination, fasting metabolic and lipid panels, echocardiogram, electrocardiogram (ECG), 6-minute walk test (6MWT) all collected at baseline evaluation. Results Half (52.3%) of the survivors were male, median age 8.0 years (range: 0-24) at cancer diagnosis, 31.0 years (18-60) at evaluation. Cardiomyopathy was present in 7.4% (newly identified at the time of evaluation in 4.7%), coronary artery disease (CAD) in 3.8% (newly identified in 2.2%), valvular regurgitation/stenosis in 28.0% (newly identified in 24.8%), and conduction/rhythm abnormalities in 4.6% (newly identified in 1.4%). Nearly all (99.7%) were asymptomatic. The prevalences of cardiac conditions increased with age at evaluation, ranging from 3-24% among those 30-39 years to 10-37% among those ≥40 years. On multivariable analysis, anthracycline exposure ≥250 mg/m2 increased the odds of cardiomyopathy (odds ratio [OR] 2.7, 95% CI 1.1-6.9) compared to anthracycline unexposed survivors. Radiation to the heart increased the odds of cardiomyopathy (OR 1.9 95% CI 1.1-3.7) compared to radiation unexposed survivors. Radiation >1500 cGy with any anthracycline exposure conferred the greatest odds for valve findings. Limitations 61% participation rate of survivors exposed to cardiotoxic therapies, which were limited to anthracyclines and cardiac-directed radiation. A comparison group and longitudinal assessments are not available. Conclusions Cardiovascular screening identified considerable subclinical disease among adult survivors of childhood

  16. Factors Associated with Pregnancy Attempts among Female Young Adult Cancer Survivors

    PubMed Central

    Dominick, Sally A.; Whitcomb, Brian W.; Gorman, Jessica R.; Mersereau, Jennifer E.; Chung, Karine; Su, H. Irene

    2014-01-01

    Structured Abstract Purpose Little is known about pregnancy attempts among female young cancer survivors (YCS). We sought to determine fertility preservation (FP), demographic, cancer and reproductive characteristics associated with pregnancy attempts after cancer. Methods We recruited 251 female YCS (ages 18-44) to complete a survey on reproductive health outcomes. We used log-binomial regression models to estimate relative risks (RR) for characteristics associated with pregnancy attempts. Results For the entire cohort, median time since cancer diagnosis was 2.4 years (interquartile range 4.0). Fifty-two YCS (21%) attempted pregnancy after cancer diagnosis. In unadjusted analyses, lack of FP therapy prior to cancer treatment, older age, partnered relationship, higher income, history of stem cell or bone marrow transplant, and longer duration of survivorship were significantly associated with pregnancy attempts. In multivariable analyses, YCS who did not undergo FP therapy were more than twice as likely to attempt pregnancy as those who did undergo FP therapy (RR 2.4, 95%CI 1.3, 4.3). Partnered status (RR 7.1, 95%CI 2.5, 20.2) and >2 years since cancer diagnosis (RR 2.3, 95%CI 1.3, 4.1) were also significantly associated with attempts. Conclusions In YCS, milestones including partnered relationships and longer duration of cancer survivorship are important to attempting pregnancy. A novel, inverse association between FP therapy and pregnancy attempts warrants further study. Implications for Cancer Survivors Pregnancy attempts after cancer were more likely after attaining both social and cancer-related milestones. As these milestones require time, YCS should be made aware of their potential for concomitant, premature loss of fertility in order to preserve their range of fertility options. PMID:24859010

  17. Review of therapeutic agents for burns pruritus and protocols for management in adult and paediatric patients using the GRADE classification

    PubMed Central

    Goutos, Ioannis; Clarke, Maria; Upson, Clara; Richardson, Patricia M.; Ghosh, Sudip J.

    2010-01-01

    To review the current evidence on therapeutic agents for burns pruritus and use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) classification to propose therapeutic protocols for adult and paediatric patients. All published interventions for burns pruritus were analysed by a multidisciplinary panel of burns specialists following the GRADE classification to rate individual agents. Following the collation of results and panel discussion, consensus protocols are presented. Twenty-three studies appraising therapeutic agents in the burns literature were identified. The majority of these studies (16 out of 23) are of an observational nature, making an evidence-based approach to defining optimal therapy not feasible. Our multidisciplinary approach employing the GRADE classification recommends the use of antihistamines (cetirizine and cimetidine) and gabapentin as the first-line pharmacological agents for both adult and paediatric patients. Ondansetron and loratadine are the second-line medications in our protocols. We additionally recommend a variety of non-pharmacological adjuncts for the perusal of clinicians in order to maximise symptomatic relief in patients troubled with postburn itch. Most studies in the subject area lack sufficient statistical power to dictate a ‘gold standard’ treatment agent for burns itch. We encourage clinicians to employ the GRADE system in order to delineate the most appropriate therapeutic approach for burns pruritus until further research elucidates the most efficacious interventions. This widely adopted classification empowers burns clinicians to tailor therapeutic regimens according to current evidence, patient values, risks and resource considerations in different medical environments. PMID:21321658

  18. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

    PubMed Central

    Knefel, Matthias; Lueger-Schuster, Brigitte

    2013-01-01

    Background The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11) that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD), also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD). Objective We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision]) PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) and the Brief Symptom Inventory (BSI) scales, to a sample of adult survivors (N=229) of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA). Results More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8%) than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD). The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively). Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects. PMID:24312721

  19. Modeling Fluid Resuscitation by Formulating Infusion Rate and Urine Output in Severe Thermal Burn Adult Patients: A Retrospective Cohort Study

    PubMed Central

    Luo, Qizhi; Li, Wei; Zou, Xin; Dang, Yongming; Wu, Jun

    2015-01-01

    Acute burn injuries are among the most devastating forms of trauma and lead to significant morbidity and mortality. Appropriate fluid resuscitation after severe burn, specifically during the first 48 hours following injury, is considered as the single most important therapeutic intervention in burn treatment. Although many formulas have been developed to estimate the required fluid amount in severe burn patients, many lines of evidence showed that patients still receive far more fluid than formulas recommend. Overresuscitation, which is known as “fluid creep,” has emerged as one of the most important problems during the initial period of burn care. If fluid titration can be personalized and automated during the resuscitation phase, more efficient burn care and outcome will be anticipated. In the present study, a dynamic urine output based infusion rate prediction model was developed and validated during the initial 48 hours in severe thermal burn adult patients. The experimental results demonstrated that the developed dynamic fluid resuscitation model might significantly reduce the total fluid volume by accurately predicting hourly urine output and has the potential to aid fluid administration in severe burn patients. PMID:26090415

  20. Associations between leisure-time physical activity and health-related quality of life among adolescent and adult survivors of childhood cancers

    PubMed Central

    Paxton, Raheem J.; Jones, Lee W.; Rosoff, Philip M.; Bonner, Melanie; Ater, Joann L.; Demark-Wahnefried, Wendy

    2009-01-01

    Objective Survivors of childhood cancer are at an increased risk for reduced quality of life (QOL), yet few studies have explored factors associated with improving health-related QOL (HRQOL) in this population. We thus explored the relationship between physical activity (PA) and HRQOL among survivors of childhood cancer. Methods A total of 215 survivors of childhood lymphoma, leukemia, and central nervous system (CNS) cancers completed mailed surveys that elicited information regarding leisure-time PA (LTPA) measured in metabolic equivalents, HRQOL, and diagnostic and demographic factors. Correlations and adjusted regression models were use to explore the relationship between LTPA and HRQOL. Results In the total sample, modest yet significant linear associations were observed between LTPA and overall HRQOL (β = 0.17, p < 0.01) as well as each of the respective subscales (β = 0.11–0.23 and p < 0.05 to < 0.001). Among adolescent survivors of childhood cancer, LTPA was significantly associated with overall HRQOL (β = 0.27), cancer worry (β = 0.36), cognitive function (β = 0.32), body appearance (β = 0.29), and social function (β = 0.27) (all p < 0.05). Among adult survivors of childhood cancer, LTPA was only significantly associated with physical function (β = 0.28, p < 0.001). Conclusions Significant associations exist between LTPA and HRQOL; however, the association was stronger and observed in more domains for adolescent survivors of childhood cancer. More research is needed to determine the antecedents and consequences of physical activity in this population. PMID:19918964

  1. Overall Quality of Life in Adult Biliary Atresia Survivors with or without Liver Transplantation: Results from a National Cohort.

    PubMed

    de Vries, Willemien; Lind, Robert C; Sze, Yuk-Kueng; van der Steeg, Alida F W; Sieders, Egbert; Porte, Robert Jack; Verkade, Henkjan J; Hulscher, Jan B F; Hoekstra-Weebers, Josette E H M

    2016-08-01

    Background Biliary atresia (BA) is a rare cholestatic disease of infancy. Kasai portoenterostomy and liver transplantation (LT) are the two sequential treatment options. An increasing number of patients survive into adulthood. Little is known about their health-related quality of life (HRQOL). This study aims to compare HRQOL of transplanted and nontransplanted patients in a cohort of young adult BA survivors. Patients and Methods RAND-36 and Liver Disease Index Score (LDSI) questionnaires were sent to eligible adult patients with BA. Clinical characteristics were obtained from the NeSBAR (Netherlands Study group on Biliary Atresia Registry) and the national pediatric LT database. RAND-36 domain and summary scores were compared with those of an age-matched Dutch reference group. The correlations between several clinical variables and HRQOL were analyzed. Results Mean RAND-36 domain and summary scores of transplanted (n = 15) and nontransplanted (n = 25) patients with BA (response 74%) were similar to the reference scores, with the exception of a decreased general health perception in nontransplanted patients (63 ± 21 vs. 75 ± 17; [p < 0.001], particularly in females. RAND-36 domain and summary scores were not significantly correlated to age at LT, time since LT, serum bilirubin, aspartate amino transferase or albumin levels, but were moderately to strongly correlated to LDSI total scores (r values 0.35-0.77). Conclusions Overall, young adult patients with BA have a HRQOL similar to an age-matched reference group. However, general health perception of nontransplanted patients, particularly of females, was decreased. HRQOL is correlated to liver disease symptoms but not to liver biochemistry parameters. Nontransplanted females and patients suffering from liver disease-associated symptoms may be a target for tailored supportive interventions. PMID:26018212

  2. Exercise and Risk of Major Cardiovascular Events in Adult Survivors of Childhood Hodgkin Lymphoma: A Report From the Childhood Cancer Survivor Study

    PubMed Central

    Jones, Lee W.; Liu, Qi; Armstrong, Gregory T.; Ness, Kirsten K.; Yasui, Yutaka; Devine, Katie; Tonorezos, Emily; Soares-Miranda, Luisa; Sklar, Charles A.; Douglas, Pamela S.; Robison, Leslie L.; Oeffinger, Kevin C.

    2014-01-01

    Purpose Survivors of Hodgkin lymphoma (HL) are at increased risk of treatment-related cardiovascular (CV) events; whether exercise modifies this risk is unknown. Methods Survivors of HL (n = 1,187; median age, 31.2 years) completed a questionnaire evaluating vigorous-intensity exercise behavior. CV events were collected in follow-up questionnaires and graded according to Common Terminology Criteria for Adverse Events (version 4.03). The primary end point was incidence of any major (grade 3 to 5) CV event. Poisson regression analyses were used to estimate the association between exercise exposure (metabolic equivalent [MET] hours/week−1) and risk of major CV events after adjustment for clinical covariates and cancer treatment. Results Median follow-up was 11.9 years (range, 1.7 to 14.3 years). Cumulative incidence of any CV event was 12.2% at 10 years for survivors reporting 0 MET hours/week−1 compared with 5.2% for those reporting ≥ 9 MET hours/week−1. In multivariable analyses, the incidence of any CV event decreased across increasing MET categories (Ptrend = .002). Compared with survivors reporting 0 MET hours/week−1, the adjusted rate ratio for any CV event was 0.87 (95% CI, 0.56 to 1.34) for 3 to 6 MET hours/week−1, 0.45 (95% CI, 0.26 to 0.80) for 9 to 12 MET hours/week−1, and 0.47 (95% CI, 0.23 to 0.95) for 15 to 21 MET hours/week−1. Adherence to national vigorous intensity exercise guidelines (ie, ≥ 9 MET hours/week−1) was associated with a 51% reduction in the risk of any CV event in comparison with not meeting the guidelines (P = .002). Conclusion Vigorous exercise was associated with a lower risk of CV events in a dose-dependent manner independent of CV risk profile and treatment in survivors of HL. PMID:25311213

  3. Perpetrator Methodology as a Predictor of Traumatic Symptomatology in Adult Survivors of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Leahy, Trisha; Pretty, Grace; Tenenbaum, Gershon

    2004-01-01

    This retrospective study explores, through quantitative and qualitative methods, the relationship of two variables (perpetrator relationship and perpetrator methodology) to posttraumatic and dissociative symptomatology. The quantitative sample comprised a nonpsychiatric group (N = 39) of Australian adults reporting sexual abuse histories. A MANOVA…

  4. Resiliency Determinants and Resiliency Processes among Female Adult Survivors of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Bogar, Christine B.; Hulse-Killacky, Diana

    2006-01-01

    This phenomenological, qualitative study examined resiliency determinants and resiliency formation among 10 women who had been sexually abused as children. An examination of the determinants and processes that facilitated resiliency in participants' adult lives revealed 5 determinant clusters (interpersonally skilled, competent, high self-regard,…

  5. A Developmental Framework for Enhancing Resiliency in Adult Survivors of Childhood Abuse

    ERIC Educational Resources Information Center

    Orbke, Samantha; Smith, Heather L.

    2013-01-01

    Roughly one third of children subjected to abusive environments grow into healthy and capable adults, demonstrating remarkable resiliency, despite risks for developing maladaptive self-structures and destructive behaviors (Werner, "American Journal of Orthopsychiatry" 59:72-81 1989; Kendall-Tackett "et al.", "Psychological Bulletin" 113:164-180…

  6. Hospital Resource Utilization for Common Noncardiac Diagnoses in Adult Survivors of Single Cardiac Ventricle.

    PubMed

    Seckeler, Michael D; Moe, Tabitha G; Thomas, Ian D; Meziab, Omar; Andrews, Jennifer; Heller, Elissa; Klewer, Scott E

    2015-12-01

    Single ventricle congenital heart disease (SV CHD) has transformed from a nearly universally fatal condition to a chronic illness. As the number of adults living with SV CHD continues to increase, there needs to be an understanding of health care resource utilization (HCRU), particularly for noncardiac conditions, for this patient population. We performed a retrospective database review of the University HealthSystem Consortium Clinical Database/Resource Manager for adult patients with SV CHD hospitalized for noncardiac conditions from January 2011 to November 2014. Patients with SV CHD were identified using International Classification of Disease (ICD)-9 codes associated with SV CHD (hypoplastic left heart, tricuspid atresia, and SV) and stratified into 2 groups by age (18 to 29 years and 30 to 40 years). Direct cost, length of stay (LOS), intensive care unit (ICU) admission rate and mortality data were compared with age-matched patients without CHD. There were 2,083,651 non-CHD and 590 SV CHD admissions in Group 1 and 2,131,046 non-CHD and 297 SV CHD admissions in Group 2. There was no difference in LOS in Group 1, but there were higher costs for several diagnoses. LOS and costs were higher for several diagnoses in Group 2. ICU admission rate and in-hospital mortality were higher for several diagnoses for patients with SV CHD in both groups. In conclusion, adults with SV CHD admitted for noncardiac diagnoses have higher HCRU (longer LOS and higher ICU admission rates) compared with similarly aged patients without CHD. These findings stress the importance of good primary care in this population with complex, chronic cardiac disease to prevent hospitalizations and higher HCRU. PMID:26455384

  7. Hypertension in Adult Survivors of Child Abuse: Observations from the Nurses’ Health Study II

    PubMed Central

    Riley, EH; Wright, RJ; Jun, HJ; Hibert, EN; Rich-Edwards, JW

    2013-01-01

    Background Limited research has shown a possible association between exposure to physical or sexual abuse prior to age 18 and the risk of developing hypertension as an adult. The factors mediating this relationship are unknown. Methods We analyzed questionnaire data from 68 505 female participants in the Nurses’ Health Study II regarding exposure to physical and sexual abuse prior to age 18. Cox proportional hazards regression was used to assess the relationship between abuse exposure and hypertension. Results Sixty-four percent of the participants (n = 41 792) reported physical and/or sexual abuse prior to age 18; 17% reported hypertension. All forms of abuse had a dose-response relationship with hypertension. Adjustments for smoking, alcohol, family history of hypertension, exercise, and oral contraceptives did not alter risk estimates. Adjustment for body mass index (BMI) significantly attenuated the associations between abuse and risk of hypertension and accounted for approximately 50% of the observed association between abuse exposure and hypertension. Women experiencing forced sexual activity as a child and as an adolescent had a 20% increased risk for developing hypertension (95% CI 8–32%) that was independent of BMI. Similarly, women reporting severe physical abuse in childhood and/or adolescence had risk estimates ranging from 14% (95% CI 5–24%) to 22% (95% CI 11–33%). Conclusion Early interpersonal violence may be a widespread risk factor for the development of hypertension in women. BMI is a significant mediator in the relationship between early abuse and adult hypertension. PMID:20445210

  8. Small testicles with impaired production of sperm in adult male survivors of childhood malignancies

    SciTech Connect

    Siimes, M.A.; Rautonen, J. )

    1990-03-15

    Testicular size has been studied in 66 adult men who survived leukemia (n = 14) or cancer (n = 52) in childhood. Mean follow-up time was 14.5 years. The testicular size was measured as the length and breadth in mm; testicular volume index was calculated. Serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin were measured. A sperm sample was obtained from 46 men. The patients had smaller testicles than healthy medical students; 51 had small testicles. The size was the smallest in patients who survived leukemia. Multivariate analysis showed that the variables with independent effects on testicular size were cranial and testicular irradiation and therapy with cyclophosphamide. Sperm production was dependent on testicular size. We conclude that determination of serum FSH combined with testicular size may offer a practical approach for predicting the subsequent testicular damage in boys with malignancies.

  9. Physical Activity, Fitness, and Cardiometabolic Risk Factors in Adult Survivors of Childhood Cancer with a History of Hematopoietic Cell Transplantation.

    PubMed

    Slater, Megan E; Steinberger, Julia; Ross, Julie A; Kelly, Aaron S; Chow, Eric J; Koves, Ildiko H; Hoffmeister, Paul; Sinaiko, Alan R; Petryk, Anna; Moran, Antoinette; Lee, Jill; Chow, Lisa S; Baker, K Scott

    2015-07-01

    Along with other childhood cancer survivors (CCS), hematopoietic cell transplantation (HCT) survivors are at high risk of treatment-related late effects, including cardiovascular disease and diabetes. Cardiometabolic risk factor abnormalities may be exacerbated by inadequate physical activity (PA). Relationships between PA and cardiometabolic risk factors have not been well described in CCS with HCT. PA (self reported), mobility (timed up and go test), endurance (6-minute walk test), handgrip strength, and cardiometabolic risk factors were measured in 119 HCT survivors and 66 sibling controls ages ≥18 years. Adjusted comparisons between HCT survivors and controls and between categories of low and high PA, mobility, endurance, and strength were performed with linear regression. Among HCT survivors, the high PA group had lower waist circumference (WC) (81.9 ± 2.5 versus 88.6 ± 3.1 cm ± standard error (SE), P = .009) than the low PA group, whereas the high endurance group had lower WC (77.8 ± 2.6 versus 87.8 ± 2.5 cm ± SE, P = .0001) and percent fat mass (33.6 ± 1.8 versus 39.4 ± 1.7% ± SE, P = .0008) and greater insulin sensitivity (IS) (10.9 ± 1.0 versus 7.42 ± 1.14 mg/kg/min ± SE via euglycemic insulin clamp, P = .001) than the low endurance group. Differences were greater in HCT survivors than in controls for WC between low and high PA groups, triglycerides between low and high mobility groups, and WC, systolic blood pressure, and IS between low and high endurance groups (all Pinteraction <.05). Higher endurance was associated with a more favorable cardiometabolic profile in HCT survivors, suggesting that interventions directed to increase endurance in survivors may reduce the risk of future cardiovascular disease. PMID:25865649

  10. Post traumatic stress disorder and coping in a sample of adult survivors of the Italian earthquake.

    PubMed

    Cofini, V; Carbonelli, A; Cecilia, M R; Binkin, N; di Orio, F

    2015-09-30

    The aim was to investigate the prevalence of post traumatic stress disorder (PTSD) in people who had left their damaged homes and were still living in temporary housing more than a year after the April 2009 L'Aquila (Italy) earthquake. In addition, we evaluated the differences in coping strategies implemented by persons who had and who did not have PTSD. A cross-sectional prevalence study was carried out on a sample of 281 people aged >18 years and living in temporary housing after the earthquake. The questionnaires used include the Davidson Trauma Scale and the Brief Cope. The prevalence of PTSD was 43%. Women and the non-employed were more vulnerable to PTSD, while, age and level of education were not associated with PTSD. Those with PTSD symptoms often employed maladaptive coping strategies for dealing with earthquake and had the highest scores in the domains of denial, venting, behavioral disengagement, self-blame. By contrast, those without PTSD generally had more adaptive coping mechanisms. Adults who were living in temporary housing after the earthquake experienced high rates of PTSD. The difference in coping mechanisms between those who have PTSD and those who do not also suggests that they influence the likeliness of developing PTSD. PMID:26162658

  11. Adult patients are more catabolic than children during acute phase after burn injury: a retrospective analysis on muscle protein kinetics

    PubMed Central

    Tuvdendorj, Demidmaa; Chinkes, David L.; Zhang, Xiao-Jun; Ferrando, Arny A.; Elijah, Itoro E.; Mlcak, Ronald P.; Finnerty, Celeste C.; Wolfe, Robert R.; Herndon, David N.

    2011-01-01

    Purpose This study was performed to determine if there is an age-related specificity in the response of muscle protein metabolism to severe burn injury during acute hospitalization. This is a retrospective analysis of previously published data. Methods: Nineteen adult and 58 pediatric burn-injured patients (age 43.3 ± 14.3 vs. 7.2 ± 5.3 years, adult vs. children) participated in stable isotope [ring-2H5]phenylalanine (Phe) infusion studies. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. Data are presented as means ± standard deviation (SD). A p value less than 0.05 was considered statistically significant. Results Muscle net protein balance (NB) was higher in children (adult vs. children, -43 ± 61 vs. 8 ± 68 nmol Phe/min/100 ml leg volume, p < 0.05). Muscle protein fractional synthesis rate (FSR) was higher in children (adult vs. children, 0.11 ± 0.05 vs. 0.16 ± 0.10 %/h, p < 0.05). Leg muscle protein breakdown was not different between the groups (adult vs. children, 179 ± 115 vs. 184 ± 124 nmol Phe/ min/100 ml leg volume, p < 0.05; synthesis rate was 134 ± 96 and 192 ± 128 nmol Phe/min/100 ml leg volume in adults and children, respectively (p = 0.07). Age significantly correlated with muscle protein NB (p = 0.01) and FSR (p = 0.02); but not with breakdown (p = 0.67) and synthesis (p = 0.07) rates measured by using a three-pool model. Conclusion In burn injury, the muscle protein breakdown may be affected to the same extent in adults and children, whereas synthesis may have age-related specificities, resulting in a better but still low NB in children. PMID:21647721

  12. Rearranged Anaplastic Lymphoma Kinase (ALK) Gene in Adult-Onset Papillary Thyroid Cancer Amongst Atomic Bomb Survivors

    PubMed Central

    Mukai, Mayumi; Takahashi, Keiko; Hayashi, Yuzo; Nakachi, Kei; Kusunoki, Yoichiro

    2012-01-01

    Background We previously noted that among atomic bomb survivors (ABS), the relative frequency of cases of adult papillary thyroid cancer (PTC) with chromosomal rearrangements (mainly RET/PTC) was significantly greater in those with relatively higher radiation exposure than those with lower radiation exposure. In contrast, the frequency of PTC cases with point mutations (mainly BRAFV600E) was significantly lower in patients with relatively higher radiation exposure than those with lower radiation exposure. We also found that among ABS, the frequency of PTC cases with no detectable gene alterations in RET, neurotrophic tyrosine kinase receptor 1 (NTRK1), BRAF, or RAS was significantly higher in patients with relatively higher radiation exposure than those with lower radiation exposure. However, in ABS with PTC, the relationship between the presence of the anaplastic lymphoma kinase (ALK) gene fused with other gene partners and radiation exposure has received little study. In this study, we tested the hypothesis that the relative frequency of rearranged ALK in ABS with PTC, and with no detectable gene alterations in RET, NTRK1, BRAF, or RAS, would be greater in those having relatively higher radiation exposures. Methods The 105 subjects in the study were drawn from the Life Span Study cohort of ABS of Hiroshima and Nagasaki who were diagnosed with PTC between 1956 and 1993. Seventy-nine were exposed (>0 mGy), and 26 were not exposed to A-bomb radiation. In the 25 ABS with PTC, and with no detectable gene alterations in RET, NTRK1, BRAF, or RAS, we examined archival, formalin-fixed, paraffin-embedded PTC specimens for rearrangement of ALK using reverse transcription–polymerase chain reaction and 5′ rapid amplification of cDNA ends (5′ RACE). Results We found rearranged ALK in 10 of 19 radiation-exposed PTC cases, but none among 6 patients with PTC with no radiation exposure. In addition, solid/trabecular-like architecture in PTC was closely associated with ALK

  13. Young Adult Cancer Survivors' Experience with Cancer Treatment and Follow-Up Care and Perceptions of Barriers to Engaging in Recommended Care.

    PubMed

    Berg, Carla J; Stratton, Erin; Esiashvili, Natia; Mertens, Ann

    2016-09-01

    We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18-34 recruited from a university-affiliated children's hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14 (SD = 3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p = 0.003), being male (p < 0.001), lack of insurance (p = 0.002), and having had chemotherapy (p = 0.05). Participants reported varied experiences in terms of how health and treatment information was presented, from none or too little to overwhelming or anxiety-provoking amounts. Barriers to engaging in survivorship care included no/limited insurance, time, or transportation; major life changes; anxiety; and difficulty transitioning from pediatrics to adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivorship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities. PMID:25948413

  14. Reclaiming body image: the hidden burn.

    PubMed

    Willis-Helmich, J J

    1992-01-01

    At the age of 4, I incurred a major burn injury that left 45% of my body with permanent scars. Normal clothing covers most of the scars. I was able to reclaim a positive body image through a gradual process of verbal and "body" disclosure. As an adult, I joined a burn survivors' self-help group; as a result of talking with other burn survivors, my self expectations increased. Later, I joined a facilitated group in which nudity and personal growth were the norm. In this group, I was the only person who had experienced a major physical trauma. I replaced my strongly held beliefs that others could not accept my unclothed, burn-injured body with the belief that some persons can, and I came to a personal understanding of why others could not. Fun, exercise, and relaxation led to a reclamation of positive feelings about my unclothed body and allowed my femininity and the character of my body image to emerge and become integrated. PMID:1572860

  15. Chemotherapy-related neuropathic symptoms and functional impairment in adult survivors of extracranial solid tumors of childhood: Results from the St. Jude Lifetime Cohort Study

    PubMed Central

    Ness, Kirsten K.; Jones, Kendra E.; Smith, Webb A.; Spunt, Sheri L.; Wilson, Carmen L.; Armstrong, Gregory T.; Srivastava, Deo Kumar; Robison, Leslie L.; Hudson, Melissa M.; Gurney, James G.

    2014-01-01

    Objective To ascertain prevalence of peripheral sensory and motor neuropathy; to evaluate impairments in relation to function. Design St. Jude Lifetime Cohort Study, a clinical follow-up study designed to evaluate adverse late effects in adult survivors of childhood cancer. Setting St. Jude Children’s Research Hospital (SJCRH). Participants Eligibility required treatment for an extracranial solid malignancy between 1962 and 2002, age ≥18 years, ≥10 years post-diagnosis, no history of cranial radiation. 531 survivors were included in the evaluation: median age 32 years, median time from diagnosis 25 years. Interventions Not applicable. Main Outcome Measures Primary exposure measures were cumulative doses of vinca-alkaloid and platinum-based chemotherapies. Survivors with scores ≥ 1 on the sensory subscale of the modified Total Neuropathy Score were classified with prevalent sensory impairment. Those with sex-specific Z-scores of ≤−1.3 for dorsiflexion strength were classified with prevalent motor impairment. Participants completed the 6-minute walk test (endurance), the timed up and go test (mobility), and the sensory organization test (balance). Results The prevalence of sensory and motor impairment was 20% and 17.5%, respectively. Vinca-alkaloid exposure was associated with an increased risk of motor impairment (adjusted odds ratio (OR)=1.66, 95% Confidence Interval (CI): 1.04–2.64) without evidence for a dose response. Platinum exposure was associated with increased risk of sensory impairment (adjusted OR= 1.62, 95% CI: 0.97–2.72) without evidence of a dose response. Sensory impairment was associated with poor endurance (OR=1.99, 95% CI: 0.99–4.00) and mobility (OR=1.65, 95% CI: 0.96–2.83). Conclusion Vincristine and cisplatin exposure may increase risk for long-term motor and sensory impairment, respectively. Survivors with sensory impairment are at increased risk for functional performance limitations. PMID:23537607

  16. Body image, self-esteem, and depression in burn-injured adolescents and young adults.

    PubMed

    Orr, D A; Reznikoff, M; Smith, G M

    1989-01-01

    The present study was conducted to clarify the effects of burn-related variables (specifically, age at time of burn, years elapsed since burn, locus of burn, and percent of total body surface area burned), demographics, and perceived social support variables on psychological adjustment after injury within a well-defined sample. Subjects were 121 patients, currently 14 to 27 years old, burned within the past 10 years. They completed the following: Semantic Differential Measure of Body Image, Rosenberg Self-Esteem Scale, Beck Depression Inventory, Perceived Social Inventory--Friends, and Perceived Social Inventory--Family. The mean age of the subjects was 17.8 years; the mean percent total body surface area burned was 27.3%, with 75% of the subjects having burns on a visible or socially sensitive area. Correlational and multiple regression analyses showed that subjects perceiving more social support (friends more than family) had more positive body images (p less than 0.01), greater self-esteem (p less than 0.01), and less depression (p less than 0.01) than others, with a significant impact from difference in subjects' gender. PMID:2793926

  17. Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation

    PubMed Central

    Bower, Julienne E.; Bak, Kate; Berger, Ann; Breitbart, William; Escalante, Carmelita P.; Ganz, Patricia A.; Schnipper, Hester Hill; Lacchetti, Christina; Ligibel, Jennifer A.; Lyman, Gary H.; Ogaily, Mohammed S.; Pirl, William F.; Jacobsen, Paul B.

    2014-01-01

    Purpose This guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment. Methods A systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation. Results It is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment. Conclusion Fatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors. PMID:24733803

  18. A quality of life study in 20 adult long-term survivors of unrelated donor bone marrow transplantation.

    PubMed

    Marks, D I; Gale, D J; Vedhara, K; Bird, J M

    1999-07-01

    There are few specific data available concerning quality of life (QOL) of survivors of unrelated donor bone marrow transplantation (UD-BMT). The procedure is expensive, difficult and is being employed increasingly yet we have little information concerning the QOL of survivors to justify this intervention. In this study, 20 long-term (>1 year post-BMT) survivors were studied with four self report questionnaires designed to assess quality of life, satisfaction with life, social support and employment status. Overall, satisfaction with life measures was above average but there was dissatisfaction with physical strength and appearance. The post-transplant employment data indicates that 60% of long-term survivors returned to full-time work and 15% to part-time work. Failure to return to work was not correlated with graft-versus-host disease (GVHD), relapse, age at or time since transplant. In general, there was a good correlation between the clinician's and patient's view of their health but the clinician's assessment of the patients mental health and energy was higher than the patients reported. Further research is required in the area of QOL post-UD-BMT. This will enable transplant physicians to counsel patients better pre-BMT and to evaluate fully the results achieved by different centres performing the procedure. PMID:10455348

  19. Traumagenic Dynamics in Adult Women Survivors of Childhood Sexual Abuse vs. Adolescent Male Sex Offenders with Similar Histories.

    ERIC Educational Resources Information Center

    Edwards, Carla; Hendrix, Rebecca

    2001-01-01

    Female childhood sexual abuse survivors and adolescent male sexual offenders with a history of childhood sexual abuse were assessed using the Trauma-Related Beliefs Questionnaire. Results suggested that male sex offenders hold high levels of traumagenic beliefs common in females, especially related to trust and betrayal. (Author)

  20. Mental health problems and medically unexplained physical symptoms in adult survivors of childhood sexual abuse: an integrative literature review.

    PubMed

    Nelson, S; Baldwin, N; Taylor, J

    2012-04-01

    People sexually abused in childhood are at higher risk than non-abused people of medically unexplained symptoms such as irritable bowel syndrome or chronic pain, with mental ill health and high healthcare use. Friction and frustration, with high, unproductive healthcare costs, can often develop between these patients and health-care professionals such as general practitioners and nursing staff. The aim of this integrative literature review was to seek a sound evidence base from which to develop helpful interventions, improve relationships and identify gaps in knowledge. It found some theories about interconnections among childhood sexual abuse mental health and medically unexplained symptoms, such as 'somatization' or 'secondary gain', were used prejudicially, stigmatizing survivors. Conflicting theories make more difficult the search for effective interventions. Researchers rarely collaborated with sexual abuse specialists. Emphasis on identifying key risk factors, rather than providing support or alleviating distress, and lack of studies where survivors voiced their own experiences, meant very few targeted interventions for this group were proposed. Recommendations to enable effective interventions include making abuse survivors the prime study focus; qualitative research with survivors, to assist doctors and nursing staff with sensitive care; case histories using medical records; prospective studies with sexually abused children; support for the growing field of neurobiological research. PMID:22070785

  1. Survivors of childhood cancer.

    PubMed

    Bradwell, Moira

    2009-05-01

    Treatment of childhood cancer aims to cure with minimum risk to the patient's subsequent health. Monitoring the long-term effects of treatment on children and young adults is now an essential part of the continued care of survivors. Late effects include: impact on growth, development and intellectual function; organ system impairment; the development of second malignancies; and psychosocial problems. These can adversely affect long-term survival and the quality of life. In the UK, models of long-term follow up for survivors of childhood cancer vary from centre to centre but nurses have a significant role to play. Combining the nurse specialist role with that of the advanced practitioner ensures that the goals of improving the quality of nursing care to the survivors of childhood cancer are achieved and maximises the nursing contribution to their follow up. With the number of childhood cancer survivors increasing, providing holistic, health promotional care, tailored to the specific needs of survivors will be crucial for their future. PMID:19505060

  2. Peritraumatic Tonic Immobility and Trauma-Related Symptoms in Adult Survivors of Childhood Sexual Abuse: The Role of Posttrauma Cognitions.

    PubMed

    Van Buren, Brian R; Weierich, Mariann R

    2015-01-01

    Tonic immobility is a set of involuntary motor responses elicited under conditions of extreme fear and perceived inescapability, and it is one type of peritraumatic distress reported by survivors of child sexual abuse. Experiencing tonic immobility during child sexual abuse is associated with increased risk for developing symptoms of post-traumatic stress disorder, although less is known about relations between tonic immobility and other established risk factors for post-traumatic stress disorder. We investigated posttraumatic cognitions as a potential mediator of the relations between peritraumatic fear, perceptions of inescapability, tonic immobility, and post-traumatic stress disorder symptoms. Specifically, we tested posttraumatic negative beliefs about the self, the world, and self-blame as pathways that might increase risk for post-traumatic stress disorder symptoms in child sexual abuse survivors who had experienced tonic immobility. Forty-six women with a history of unwanted childhood sexual contact completed questionnaires measuring peritraumatic tonic immobility, posttraumatic cognitions, and current posttraumatic stress symptoms. Negative beliefs about the self independently mediated the relation between peritraumatic perceptions of inescapability and post-traumatic stress disorder symptoms, but the data did not support similar path model for the physical symptoms of tonic immobility and post-traumatic stress disorder. We discuss ways in which treatment of survivors and future research on CSA can benefit from attention to the impact of peritraumatic distress on posttraumatic beliefs. PMID:26701284

  3. Cumulative alkylating agent exposure and semen parameters in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort Study

    PubMed Central

    Green, Daniel M; Liu, Wei; Kutteh, William H; Ke, Raymond W; Shelton, Kyla C; Sklar, Charles A; Chemaitilly, Wassim; Pui, Ching-Hon; Klosky, James L; Spunt, Sheri L; Metzger, Monika L; Srivastava, DeoKumar; Ness, Kirsten K; Robison, Leslie L; Hudson, Melissa M

    2014-01-01

    Summary Background Few data define the dose-specific relation between alkylating agent exposure and semen variables in adult survivors of childhood cancer. We undertook this study to test the hypothesis that increased exposure to alkylating agents would be associated with decreased sperm concentration in a cohort of adult male survivors of childhood cancer who were not exposed to radiation therapy for their childhood cancer. Methods We did semen analysis on 214 adult male survivors of childhood cancer (median age 7·7 years [range 0·01–20·3] at diagnosis, 29·0 years [18·4–56·1] at assessment, and a median of 21·0 years [10·5–41·6] since diagnosis) who had received alkylating agent chemotherapy but no radiation therapy. Alkylating agent exposure was estimated using the cyclophosphamide equivalent dose (CED). Odds ratios (ORs) and 95% CIs for oligospermia (sperm concentration >0 and <15 million per mL) and azoospermia were calculated with logistic regression modelling. Findings Azoospermia was noted in 53 (25%) of 214 participants, oligospermia in 59 (28%), and normospermia (sperm concentration ≥15 million per mL) in 102 (48%) participants. 31 (89%) of 35 participants who received CED less than 4000 mg/m2 were normospermic. CED was negatively correlated with sperm concentration (correlation coefficient=–0·37, p<0·0001). Mean CED was 10 830 mg/m2 (SD 7274) in patients with azoospermia, 8480 mg/m2 (4264) in patients with oligospermia, and 6626 mg/m2 (3576) in patients with normospermia. In multivariable analysis, CED was significantly associated with an increased risk per 1000 mg/m2 CED for azoospermia (OR 1·22, 95% CI 1·11–1·34), and for oligospermia (1·14, 1·04–1·25), but age at diagnosis and age at assessment were not. Interpretation Impaired spermatogenesis was unlikely when the CED was less than 4000 mg/m2. Although sperm concentration decreases with increasing CED, there was substantial overlap of CED associated with normospermia

  4. Daily Physical Activities and Sports in Adult Survivors of Childhood Cancer and Healthy Controls: A Population-Based Questionnaire Survey

    PubMed Central

    Rueegg, Corina S.; von der Weid, Nicolas X.; Rebholz, Cornelia E.; Michel, Gisela; Zwahlen, Marcel; Grotzer, Michael; Kuehni, Claudia E.

    2012-01-01

    Background Healthy lifestyle including sufficient physical activity may mitigate or prevent adverse long-term effects of childhood cancer. We described daily physical activities and sports in childhood cancer survivors and controls, and assessed determinants of both activity patterns. Methodology/Principal Findings The Swiss Childhood Cancer Survivor Study is a questionnaire survey including all children diagnosed with cancer 1976–2003 at age 0–15 years, registered in the Swiss Childhood Cancer Registry, who survived ≥5years and reached adulthood (≥20years). Controls came from the population-based Swiss Health Survey. We compared the two populations and determined risk factors for both outcomes in separate multivariable logistic regression models. The sample included 1058 survivors and 5593 controls (response rates 78% and 66%). Sufficient daily physical activities were reported by 52% (n = 521) of survivors and 37% (n = 2069) of controls (p<0.001). In contrast, 62% (n = 640) of survivors and 65% (n = 3635) of controls reported engaging in sports (p = 0.067). Risk factors for insufficient daily activities in both populations were: older age (OR for ≥35years: 1.5, 95CI 1.2–2.0), female gender (OR 1.6, 95CI 1.3–1.9), French/Italian Speaking (OR 1.4, 95CI 1.1–1.7), and higher education (OR for university education: 2.0, 95CI 1.5–2.6). Risk factors for no sports were: being a survivor (OR 1.3, 95CI 1.1–1.6), older age (OR for ≥35years: 1.4, 95CI 1.1–1.8), migration background (OR 1.5, 95CI 1.3–1.8), French/Italian speaking (OR 1.4, 95CI 1.2–1.7), lower education (OR for compulsory schooling only: 1.6, 95CI 1.2–2.2), being married (OR 1.7, 95CI 1.5–2.0), having children (OR 1.3, 95CI 1.4–1.9), obesity (OR 2.4, 95CI 1.7–3.3), and smoking (OR 1.7, 95CI 1.5–2.1). Type of diagnosis was only associated with sports. Conclusions/Significance Physical activity levels in survivors were lower than recommended, but

  5. Adult patients looking at their burn injuries for the first time.

    PubMed

    Birdsall, C; Weinberg, K

    2001-01-01

    A total of 222 burn nurses from 30 burn centers completed a questionnaire about how and when a burn patient looks at their burn wound for the first time. The registered nurse is most frequently with the patient when the patient sees the wound for the first time (n = 187; 84%). Looking at the wound is not usually a planned event, and it is not documented in the patient record. Nurses use verbal and nonverbal patient cues to determine when it is appropriate for the patient to look initially at the wound and combine this initial look with an opportunity to teach wound healing. The patient asks the nurse for an opinion about the way the wound looks (n = 181; 81.5%). The nurse uses silence, presence-of-self, and gentle encouragement with the patient while remaining positive and honest. Respondents reported that the patient wants the truth but also needs reassurance and some degree of optimism when viewing the wound for the first time. PMID:11570538

  6. Management of post burn hand deformities

    PubMed Central

    Sabapathy, S. Raja; Bajantri, Babu; Bharathi, R. Ravindra

    2010-01-01

    The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor. PMID:21321661

  7. Investigation of Head Burns in Adult Salmonids : Phase 1 : Examination of Fish at Lower Granite Dam, July 2, 1996. Final Report.

    SciTech Connect

    Elston, Ralph

    1996-08-01

    Head burn is a descriptive clinical term used by fishery biologists to describe exfoliation of skin and underlying connective tissue of the jaw and cranial region of salmonids, observed at fish passage facilities on the Columbia and Snake Rivers. The observations are usually made on upstream migrant adult salmon or steelhead. An expert panel, convened in 1996, to evaluate the risk and severity of gas bubble disease (GBD) in the Snake and Columbia River system believed that, while head burns appeared to be distinct from GBD, the relationship between dissolved gas saturation in the rivers and head burns was uncertain.

  8. Survivors Versus Non-Survivors Postburn: Differences In Inflammatory and Hypermetabolic Trajectories

    PubMed Central

    Jeschke, Marc G.; Gauglitz, Gerd G.; Finnerty, Celeste C.; Kraft, Robert; Mlcak, Ronald P.; Herndon, David N.

    2013-01-01

    Objective To evaluate whether a panel of common biomedical markers can be utilized as trajectories to determine survival in pediatric burn patients. Summary Background Data Despite major advances in clinical care, of the more than 1 million people burned in the United States each year, more than 4,500 die as a result of their burn injuries. The ability to predict patient outcome or anticipate clinical trajectories using plasma protein expression would allow personalization of clinical care to optimize the potential for patient survival. Methods Two-hundred thirty severely burned children with burns exceeding 30% of the total body surface, requiring at least one surgical procedure were enrolled in this prospective cohort study. Demographics, clinical outcomes, as well as inflammatory and acute-phase responses (serum cytokines, hormones, and proteins) were determined at admission and at 11 time points for up to 180 days postburn. Statistical analysis was performed using a one-way ANOVA, Student’s t-test, Chi-square, and Mann-Whitney tests where appropriate. Results Survivors and non-survivors exhibited profound differences in critical markers of inflammation and metabolism at each time point. Non-survivors had significantly higher serum levels of IL-6, IL-8, granulocyte colony-stimulating factor, monocyte chemoattractant protein-1, c-reactive protein, glucose, insulin, blood urea nitrogen, creatinine, and bilirubin (p<0.05). Furthermore, non-survivors exhibited a vastly increased hypermetabolic response that was associated with increases in organ dysfunction and sepsis when compared with survivors (p<0.05). Conclusions Non-survivors have different trajectories in inflammatory, metabolic, and acute phase responses allowing differentiation of non-survivors from survivors and now possibly allowing novel predictive models to improve and personalize burn outcomes. PMID:23579577

  9. Suicide Survivors

    PubMed Central

    Rosen, David H.

    1975-01-01

    Interviews with seven of ten known survivors of jumps from the Golden Gate and San Francisco-Oakland Bay bridges showed a unique association between the Golden Gate Bridge and suicide. The study went beyond exploring the nature of suicidal jumps and shed new light on the experience of nearly dying. All the survivors described this experience as tranquil and peaceful. None of them experienced life events or distant memories passing through their minds or before their eyes. However, all of them experienced transcendence and spiritual rebirth phenomena. Suggestions for preventing suicides from the Golden Gate Bridge are discussed, including the construction of a suicide barrier. PMID:1171558

  10. Stories from the road of recovery – How adult, female survivors of childhood trauma experience ways to positive change

    PubMed Central

    Stige, Signe Hjelen; Binder, Per-Einar; Rosenvinge, Jan H.; Træen, Bente

    2013-01-01

    Abstract The aim of this study was to explore how female survivors of childhood trauma who have sought treatment experience ways to positive change. Little knowledge exists regarding the first-person perspective of the recovery process following childhood trauma, and getting access to this perspective might contribute to better understanding of these processes, hence offering opportunities for health promotion. All clients (31, including 3 who dropped out) from six stabilization groups for women exposed to human-inflicted traumas were invited to participate in the study. Experiences of the recovery process were not restricted to the period of receiving treatment, and all clients who volunteered were included in the study. Qualitative, in-depth interviews with 13 consenting clients were carried out shortly after completion of the group treatment. All interviews were transcribed verbatim, and a hermeneutical-phenomenological approach to analysis was applied. The analysis resulted in five interrelated, but distinct main themes: finding new ways to understand one's emotions and actions, moving from numbness toward vital contact, becoming an advocate of one's own needs, experiencing increased sense of agency, and staying with difficult feelings and choices. The themes support, yet supplement trauma theory, by underlining the relationship between emotional contact and meaning-making, while downplaying the necessity of symptom elimination in the experience of recovery. The findings also underline that the active role trauma survivors play in their processes of recovery. PMID:24443662

  11. Desert Survivors!

    ERIC Educational Resources Information Center

    Horton, Jessica; Friedenstab, Steve

    2013-01-01

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

  12. Partnership for Health-2, A Web-Based Versus Print Smoking Cessation Intervention for Childhood and Young Adult Cancer Survivors: Randomized Comparative Effectiveness Study

    PubMed Central

    Puleo, Elaine; Sprunck-Harrild, Kim; Ford, Jennifer; Ostroff, Jamie S; Hodgson, David; Greenberg, Mark; Diller, Lisa; de Moor, Janet; Tyc, Vida

    2013-01-01

    Background Smoking among cancer survivors increases the risk of late effects and second cancers. This article reports on Partnership for Health-2 (PFH-2)—an effort to develop an effective and scalable version of Partnership for Health (PFH), which was a previously tested peer-delivered telephone counseling program that doubled smoking cessation rates among childhood cancer survivors who smoke. Objective This paper presents results from a randomized controlled trial evaluating the effectiveness of PFH-2 in targeted and tailored Web-based versus print formats. The overall goal was to determine whether the intervention outcomes in these self-guided scalable formats approximate what was found in a more intensive telephone counseling program. Methods This study was a randomized controlled trial with a 15-month follow-up that included 374 smokers who were survivors of childhood or young adult cancers, recruited from five survivorship clinics. Participants were randomly assigned to a Web-based or print format of the PFH intervention; all had access to free pharmacotherapy. The website was designed to provide new content at each log-on, and a peer counselor moderated a forum/chat feature. The primary outcome was smoking status at 15 months post randomization. Results In total, 58.3% (77/132) of Web participants logged on at least once (mean visits 3.25). Using multiple imputation methods for missing data, there were similar rates of cessation in the two arms (print: 20/128, 15.6%; Web: 33/201, 6.4%), and no differences in quit attempts or readiness to quit. The quit rates were equivalent to those found in our previous telephone counseling intervention. There were high rates of satisfaction with both of the PFH-2 interventions. Conclusions The print and Web formats yielded equivalent levels of success to those found with our telephone-delivered intervention and are comparable to other Internet treatment studies. This study provides important options for survivorship

  13. Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors

    ERIC Educational Resources Information Center

    Ullman, Sarah E.; Najdowski, Cynthia J.; Filipas, Henrietta H.

    2009-01-01

    This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N = 555) completed two surveys a year apart. Child sexual abuse…

  14. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    PubMed

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided. PMID:27179348

  15. Beyond "Survivor": How Childhood Sexual Abuse Informs the Identity of Adult Women at the End of the Therapeutic Process

    ERIC Educational Resources Information Center

    Phillips, Alexis; Daniluk, Judith C.

    2004-01-01

    A qualitative method was used to explore how adult women experienced their identity after extensive therapy to deal with childhood sexual abuse. Seven women shared their healing journeys and their perceptions of the role of the abuse in their current life and self-perceptions. Phenomenological analysis of the interview data revealed 5 common…

  16. Physical and emotional well-being of survivors of childhood and young adult allo-SCT - A Danish national cohort study.

    PubMed

    Jensen, Josef Nathan; Gøtzsche, Frederik; Heilmann, Carsten; Sengeløv, Henrik; Adamsen, Lis; Christensen, Karl Bang; Larsen, Hanne Baekgaard

    2016-08-01

    The aim of this investigation was to examine, within a population-based study of a national cohort comprising Danish survivors of allo-SCT (n = 148), the long-term effects of allo-SCT in children and young adults. Physical and emotional well-being was assessed using the Short Form 36 (SF-36) and the HADS. Allo-SCT-related data were obtained from the participants' medical records. The study includes 148 patients, with an 89% response rate (n = 132). For comparison purposes, norm data from Danish (1994, n = 6000), Swedish (2006, n = 285), and British (2001, n = 1792) population samples were used. Factors negatively influencing the SF-36 subscales included female gender; TBI; stem cells derived from PB; older age at time of questioning; and living alone. Factors significantly (p < 0.05) influencing HADS were transplantation with stem cells derived from PB and being underweight at time of questioning (median values were within normal range). Overall scores of allo-SCT patients were similar to norm data. In conclusion, this national cohort study shows that patients treated with SCT in early life (<25) and whose survival period extended beyond 10 yr (mean) from SCT, showed similar levels of anxiety, depression, and physical and emotional well-being to those of the normal population. PMID:27231147

  17. Cancer survivor identity shared in a social media intervention.

    PubMed

    Song, Hayeon; Nam, Yujung; Gould, Jessica; Sanders, W Scott; McLaughlin, Margaret; Fulk, Janet; Meeske, Kathleen A; Ruccione, Kathleen S

    2012-01-01

    This study investigates how cancer survivors construct their identities and the impact on their psychological health, as measured by depression and survivor self-efficacy. Fourteen young adult survivors of pediatric cancer participated in a customized social networking and video blog intervention program, the LIFECommunity, over a 6-month period. Survivors were asked to share their stories on various topics by posting video messages. Those video blog postings, along with survey data collected from participants, were analyzed to see how cancer survivors expressed their identities, and how these identities are associated with survivors' psychosocial outcomes. In survivors who held negative stereotypes about cancer survivors, there was a positive relationship with depression while positive stereotypes had a marginal association with cancer survivor efficacy. Findings indicate that although pediatric cancer survivors often do not publicly discuss a "cancer survivor identity," they do internalize both positive and negative stereotypes about cancer survivorship. It is important for practitioners to be aware of the long-term implications of cancer survivor identity and stereotypes. PMID:22472482

  18. Burning Issue: Handling Household Burns

    MedlinePlus

    ... hot objects or liquid, fire, friction, the sun, electricity, or certain chemicals. Each year, about a half- ... infant or elderly. the burn was caused by electricity, which can lead to “invisible” burns. Burns Burns ...

  19. Cardiovascular disease in Adult Life after Childhood Cancer in Scandinavia: A population-based cohort study of 32,308 one-year survivors.

    PubMed

    Gudmundsdottir, Thorgerdur; Winther, Jeanette F; de Fine Licht, Sofie; Bonnesen, Trine G; Asdahl, Peter H; Tryggvadottir, Laufey; Anderson, Harald; Wesenberg, Finn; Malila, Nea; Hasle, Henrik; Olsen, Jørgen H

    2015-09-01

    The lifetime risk for cardiovascular disease in a large cohort of childhood cancer survivors has not been fully assessed. In a retrospective population-based cohort study predicated on comprehensive national health registers, we identified a cohort of 32,308 one-year survivors of cancer diagnosed before the age of 20 in the five Nordic countries between the start of cancer registration in the 1940s and 1950s to 2008; 211,489 population comparison subjects were selected from national population registers. Study subjects were linked to national hospital registers, and the observed numbers of first hospital admission for cardiovascular disease among survivors were compared with the expected numbers derived from the population comparison cohort. Cardiovascular disease was diagnosed in 2,632 childhood cancer survivors (8.1%), yielding a standardized hospitalization rate ratio (RR) of 2.1 (95% CI 2.0-2.2) and an overall absolute excess risk (AER) of 324 per 100,000 person-years. At the end of follow-up 12% of the survivors were ≥ 50 years of age and 4.5% ≥ 60 years of age. Risk estimates were significantly increased throughout life, with an AER of ∼500-600 per 100,000 person-years at age ≥ 40. The highest relative risks were seen for heart failure (RR, 5.2; 95% CI 4.5-5.9), valvular dysfunction (4.6; 3.8-5.5) and cerebrovascular diseases (3.7; 3.4-4.1). Survivors of hepatic tumor, Hodgkin lymphoma and leukemia had the highest overall risks for cardiovascular disease, although each main type of childhood cancer had increased risk with different risk profiles. Nordic childhood cancer survivors are at markedly increased risk for cardiovascular disorders throughout life. These findings indicate the need for preventive interventions and continuous follow-up for this rapidly growing population. PMID:25648592

  20. Cognitive Impairment and Outcomes in Older Adult Survivors of Acute Myocardial Infarction: Findings from the TRIUMPH Registry

    PubMed Central

    Gharacholou, S. Michael; Reid, Kimberly J.; Arnold, Suzanne V.; Spertus, John; Rich, Michael W.; Pellikka, Patricia A.; Singh, Mandeep; Holsinger, Tracey; Krumholz, Harlan M.; Peterson, Eric D.; Alexander, Karen P.

    2012-01-01

    Background Cognitive impairment without dementia (CIND) and acute myocardial infarction (AMI) are prevalent in older adults; however, the association of CIND with outcomes after AMI is unknown. Methods We used a multicenter registry to study 772 patients ≥65 years with AMI, enrolled between April 2005 and December 2008, who underwent cognitive function assessment with the Telephone Interview for Cognitive Status-modified (TICS-m) 1 month after AMI. Patients were categorized by cognitive status to describe characteristics and in-hospital treatment, including quality of life and survival 1 year after AMI. Results Mean age was 73.2±6.3 years; 58.5% were males and 78.2% were white. Normal cognitive function (TICS-m>22) was present in 44.4%; mild CIND (TICS-m 19–22) in 29.8% and moderate/severe CIND (TICS-m <19) in 25.8% of patients. Rates of hypertension (72.6%, 77.4%, 81.9%), cerebrovascular accidents (3.5%, 7.0%, 9.0%), and myocardial infarction (20.1%, 22.2%, 29.6%) were higher in those with lower TICS-m scores (p<0.05 for comparisons). AMI medications were similar by cognitive status; however, CIND was associated with lower cardiac catheterization rates (p=0.002) and cardiac rehabilitation referrals (p<0.001). Patients with moderate/severe CIND had higher risk-adjusted 1 year mortality that was non-statistically significant (adjusted HR 1.97; 95% CI 0.99 – 3.94; p=0.054; referent normal, TICS-m >22). Quality of life across cognitive status was similar at 1 year. Conclusions Most older patients surviving AMI have measurable CIND. CIND was associated with less invasive care, less referral and participation in cardiac rehabilitation, and worse risk-adjusted 1 year survival in those with moderate/severe CIND, making it an important condition to consider in optimizing AMI care. PMID:22093202

  1. Physical and psychiatric recovery from burns.

    PubMed

    Stoddard, Frederick J; Ryan, Colleen M; Schneider, Jeffrey C

    2014-08-01

    Burn injuries pose complex biopsychosocial challenges to recovery and improved comprehensive care. The physical and emotional sequelae of burns differ, depending on burn severity, individual resilience, and stage of development when they occur. Most burn survivors are resilient and recover, whereas some are more vulnerable and have complicated outcomes. Physical rehabilitation is affected by orthopedic, neurologic, and metabolic complications and disabilities. Psychiatric recovery is affected by pain, mental disorders, substance abuse, and burn stigmatization. Individual resilience, social supports, and educational or occupational achievements affect outcomes. PMID:25085093

  2. Independent analysis of the radiation risk for leukaemia in children and adults with mortality data (1950-2003) of Japanese A-bomb survivors.

    PubMed

    Kaiser, Jan Christian; Walsh, Linda

    2013-03-01

    A recent analysis of leukaemia mortality in Japanese A-bomb survivors has applied descriptive models, collected together from previous studies, to derive a joint excess relative risk estimate (ERR) by multi-model inference (MMI) (Walsh and Kaiser in Radiat Environ Biophys 50:21-35, 2011). The models use a linear-quadratic dose response with differing dose effect modifiers. In the present study, a set of more than 40 models has been submitted to a rigorous statistical selection procedure which fosters the parsimonious deployment of model parameters based on pairwise likelihood ratio tests. Nested models were consequently excluded from risk assessment. The set comprises models of the excess absolute risk (EAR) and two types of non-standard ERR models with sigmoidal responses or two line spline functions with a changing slope at a break point. Due to clearly higher values of the Akaike Information Criterion, none of the EAR models has been selected, but two non-standard ERR models qualified for MMI. The preferred ERR model applies a purely quadratic dose response which is slightly damped by an exponential factor at high doses and modified by a power function for attained age. Compared to the previous analysis, the present study reports similar point estimates and confidence intervals (CI) of the ERR from MMI for doses between 0.5 and 2.5 Sv. However, at lower doses, the point estimates are markedly reduced by factors between two and five, although the reduction was not statistically significant. The 2.5 % percentiles of the ERR from the preferred quadratic-exponential model did not fall below zero risk in exposure scenarios for children, adolescents and adults at very low doses down to 10 mSv. Yet, MMI produced risk estimates with a positive 2.5 % percentile only above doses of some 300 mSv. Compared to CI from a single model of choice, CI from MMI are broadened in cohort strata with low statistical power by a combination of risk extrapolations from several

  3. A quantitative, cross-sectional study of depression and self-esteem in teenage and young adult burn victims in rehabilitation.

    PubMed

    Teixeira Nicolosi, Júlia; Fernandes de Carvalho, Viviane; Llonch Sabatés, Ana

    2013-09-01

    Burns can have a negative physiological and emotional impact, particularly among teenage victims. To assess the presence of depression and level of self-esteem, a cross-sectional study was conducted among 63 teenage and young adult burn victims ages 12 to 20 years undergoing physical and psychological rehabilitation at the Outpatient Unit for Plastic Surgery and Burns at the Central Institute of the Clínicas Hospital of the Faculty of Medicine of the University of São Paulo, São Paulo, Brazil. Assessment instruments included Beck's Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE). Internal consistency within and between the two scales was established via Cronbach's-α coefficient. All variables were analyzed using descriptive statistics, and the statistical difference between means was compared using Student's t-test. The majority of participants were female (38, 60.3%) and unmarried (59, 93.7%) with a mean total body surface area (TBSA) burn of 23.84%. Most burns (58, 92.10%) were the result of accidents and were located on the trunk (47, 74.6%), head (43, 68%), arms (41, 65%), hands (38, 60%), neck (34, 54%), and forearm (29, 46%). Participants had received physical and psychological rehabilitation for an average of 124.74 months (SD 63.67) from a multidisciplinary team. The majority of participants (33, 52.4%) reported functional and aesthetic after-effects and appraised their scar as visible (51, 81.0%). BDI results showed low levels or absence of depression (mean = 7.63, SD 8.72; scale 0 = no depression to 63 = serious depression); the RSE showed adequate levels of self-esteem (mean = 8.41, SD 4.74; scale 0-30, where higher scores indicate worst levels of self-esteem). Burn location did not affect depression (BDI: P = 0.26) or self-esteem (RSE: P = 0.21). However, depression and self-esteem were more significant in participants who were not able to work and/or go to school than in those who were (BDI: P = 0.04 and self-esteem RSE: P = 0

  4. Biomass Burning

    Atmospheric Science Data Center

    2015-07-27

    Projects:  Biomass Burning Definition/Description:  Biomass Burning: This data set represents the geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ...

  5. The media glorifying burns: a hindrance to burn prevention.

    PubMed

    Greenhalgh, David G; Palmieri, Tina L

    2003-01-01

    The media have a profound influence on the actions of children and adults. Burns and burn prevention tend to be ignored or even mocked. The purpose of this presentation is to reveal the callousness of the media in its dealings with burns and burn prevention. Printed materials with a relationship to burns, risk of burning, or disrespect for the consequences of burns were collected. The materials were tabulated into four categories: comics, advertisements (ads), articles that made light of burns, and television shows that portrayed behavior that would risk burn injury. Most burn-related materials were found in comics or advertisements. Several comics made light of high-risk behavior with flames, scald injury, contact injury, or burns. In addition, several advertisements showed people on fire or actions that could easily lead to burns. Several articles and televisions shows portrayed high-risk behavior that, in some instances, led to copycat injuries. Flames are frequently used to sell items that target adolescent boys or young men. The high incidence injuries that frequent this population parallel the high-risk behaviors portrayed by the media. The media portrays flames and high-risk behavior for burn injury as being cool, funny, and without consequence. The use of flames on clothing and recreational equipment (skateboards, hot rods) particularly targets the high-risk adolescent male. The burn community should make the media aware of the harm it causes with its callous depiction and glorification of burns. PMID:12792237

  6. Resilient Child Sexual Abuse Survivors: Cognitive Coping and Illusion.

    ERIC Educational Resources Information Center

    Himelein, Melissa J.; McElrath, Jo Ann V.

    1996-01-01

    Two studies examined coping strategies associated with resilience in a nonclinical sample of young adult child sexual abuse survivors. Survivors were likely to engage in positive illusions or such cognitive strategies as disclosing and discussing the abuse, minimization, positive reframing, and refusing to dwell on the experience. Results support…

  7. Learning Profiles of Survivors of Pediatric Brain Tumors

    ERIC Educational Resources Information Center

    Barkon, Beverly

    2009-01-01

    By 2010 it is predicted that one in 900 adults will be survivors of some form of pediatric cancer. The numbers are somewhat lower for survivors of brain tumors, though their numbers are increasing. Schools mistakenly believe that these children easily fit pre-existing categories of disability. Though these students share some of the…

  8. How to Help a Person with a Serious Burn Injury

    MedlinePlus

    ... I’ll be here for you.” Watch your nonverbal cues. Most patients appreciate visitors unless the visitor ... burn survivor and professor in the Department of Communication at Weber State University. Suggestions in this article ...

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

    ERIC Educational Resources Information Center

    Wolf, Molly R.; Nochajski, Thomas H.

    2013-01-01

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

  10. Emergent burn care.

    PubMed

    Harvey, J S; Watkins, G M; Sherman, R T

    1984-02-01

    The estimated 32,600,000 fires that occur annually in the United States produce over 300,000 injuries and 7,500 deaths. Ten percent of hospitalized burn victims die as a direct result of the burn. Initial evaluation and management of the burn patient are critical. The history should include the burn source, time of injury, burn environment, and combustible products. The burn size is best estimated by the Lund and Browder chart, and the burn depth is determined by clinical criteria. Pulmonary involvement and circumferential thoracic or extremity burns require detection and aggressive treatment to maintain organ viability. Hospitalization is usually necessary for adults with burns larger than 10% of the total body surface area (TBSA) or children with burns larger than 5% of TBSA. Major burns, those of 25% or more of TBSA or of 10% or more of full thickness, should be considered for treatment at a burn center, as well as children or elderly victims with burns of greater than 10% TBSA. Lactated Ringer's solution, infused at 4 ml/kg/% TBSA, is generally advocated for initial fluid restoration. After the acute phase (48 hours), replacement of evaporative and hypermetabolic fluid loss is necessary. These losses may constitute 3 to 5 liters per day for a 40% to 70% TBSA burn. Blood transfusion is often required because of persistent loss of red blood cells (8% per day for about ten days). Many electrolyte abnormalities may occur in the first two weeks. Pulmonary injury commonly is lethal. Circumoral burns, oropharyngeal burns, and carbonaceous sputum are indicative of inhalation injury, but arterial blood gas determinations, fiberoptic bronchoscopy, and xenon lung scans are useful for confirming the diagnosis. Humidified oxygen, intubation, positive-pressure ventilation, and pulmonary toilet are the mainstays of therapy for inhalation injury. Wound care is initially directed at preservation of vital function by escharotomy, if restrictive eschar impairs ventilatory or

  11. One world one burn rehabilitation standard.

    PubMed

    Serghiou, M A; Niszczak, J; Parry, I; Li-Tsang, C W P; Van den Kerckhove, E; Smailes, S; Edgar, D

    2016-08-01

    According to the World Health Organization (WHO) burns are a huge global health problem resulting in death and devastation to those who survive large burns as they are faced with significant functional limitations that prevent purposeful and productive living. Members of the International Society for Burn Injuries (ISBI) Rehabilitation Committee conducted a needs assessment survey in order to characterize how burn rehabilitation is implemented worldwide and how the international burn rehabilitation community can help improve burn rehabilitation in identified geographic locations which need assistance in rehabilitating burn survivors successfully. The results of this survey indicated that poor and in some cases resource limited environments (RLEs) around the world seem to lack the financial, educational and material resources to conduct burn rehabilitation successfully. It appears that there are vast discrepancies in the areas of education, training and capacity to conduct research to improve the care of burn survivors as evidenced by the variation in responses between the RLEs and developed countries around the globe. In some cases, the problem is not knowledge, skill and ability to practice burn rehabilitation, but rather having the resources to do so due to financial difficulties. PMID:27161089

  12. Pediatric facial burns.

    PubMed

    Kung, Theodore A; Gosain, Arun K

    2008-07-01

    Despite major advances in the area of burn management, burn injury continues to be a leading cause of pediatric mortality and morbidity. Facial burns in particular are devastating to the affected child and result in numerous physical and psychosocial sequelae. Although many of the principles of adult burn management can be applied to a pediatric patient with facial burns, the surgeon must be cognizant of several important differences. Facial burns and subsequent scar formation can drastically affect the growth potential of a child's face. Structures such as the nose and teeth may become deformed due to abnormal external forces caused by contractures. Serious complications such as occlusion amblyopia and microstomia must be anticipated and urgently addressed to avert permanent consequences, whereas other reconstructive procedures can be delayed until scar maturation occurs. Furthermore, because young children are actively developing the concept of self, severe facial burns can alter a child's sense of identity and place the child at high risk for future emotional and psychologic disturbances. Surgical reconstruction of burn wounds should proceed only after thorough planning and may involve a variety of skin graft, flap, and tissue expansion techniques. The most favorable outcome is achieved when facial resurfacing is performed with respect to the aesthetic units of the face. Children with facial burns remain a considerable challenge to their caregivers, and these patients require long-term care by a multidisciplinary team of physicians and therapists to optimize functional, cosmetic, and psychosocial outcomes. PMID:18650717

  13. Stem Cells May Offer New Hope to Stroke Survivors

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159163.html Stem Cells May Offer New Hope to Stroke Survivors Experimental ... HealthDay News) -- Preliminary research suggests that injecting adult stems cells directly into the brain may give stroke patients ...

  14. Quality of Life in Younger Leukemia and Lymphoma Survivors

    ClinicalTrials.gov

    2011-08-23

    Anxiety Disorder; Cancer Survivor; Fatigue; Leukemia; Long-term Effects Secondary to Cancer Therapy in Adults; Lymphoma; Lymphoproliferative Disorder; Pain; Psychosocial Effects of Cancer and Its Treatment; Small Intestine Cancer

  15. Health Behaviors of Minority Childhood Cancer Survivors

    PubMed Central

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

    2015-01-01

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

  16. U.S. Cancer Survivors Living Longer

    MedlinePlus

    ... 27 percent had a history of other medical problems. Among survivors aged 85 and older, 47 percent had other chronic conditions, the researchers found. The findings were published in the July 1 ... other medical problems, as concerning. "There aren't many older adults ...

  17. A Spiritual Framework in Incest Survivors Treatment

    ERIC Educational Resources Information Center

    Beveridge, Kelli; Cheung, Monit

    2004-01-01

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

  18. Academic difficulties and occupational outcomes of adult survivors of childhood leukemia who have undergone allogeneic hematopoietic stem cell transplantation and fractionated total body irradiation conditioning.

    PubMed

    Freycon, Fernand; Trombert-Paviot, Béatrice; Casagranda, Léonie; Frappaz, Didier; Mialou, Valérie; Armari-Alla, Corinne; Gomez, Frederic; Faure-Conter, Cécile; Plantaz, Dominique; Berger, Claire

    2014-04-01

    We studied academic and employment outcomes in 59 subjects who underwent allogeneic hematopoietic stem cell transplantation (a-HSCT) with fractionated total body irradiation (fTBI) for childhood leukemia, comparing them with, first, the general French population and, second, findings in 19 who underwent a-HSCT with chemotherapy conditioning. We observed an average academic delay of 0.98 years among the 59 subjects by Year 10 of secondary school (French class Troisième), which was higher than the 0.34-year delay in the normal population (P < .001) but not significantly higher than the delay of 0.68 years in our cohort of 19 subjects who underwent a-HSCT with chemotherapy. The delay was dependent on age at leukemia diagnosis, but not at fTBI. This delay increased to 1.32 years by the final year of secondary school (Year 13, Terminale) for our 59 subjects versus 0.51 years in the normal population (P = .0002), but did not differ significantly from the 1.08-year delay observed in our cohort of 19 subjects. The number of students who received their secondary school diploma (Baccalaureate) was similar to the expected rate in the general French population for girls (observed/expected = 1.02) but significantly decreased for boys (O/E = 0.48; CI: 95%[0.3-0.7]). Compared with 13.8% of the general population, 15.3% of the cancer survivors received no diploma (P = NS). Reported job distribution did not differ significantly between our cohort of childhood cancer survivors and the general population except that more female survivors were employed in intermediate-level professional positions. Academic difficulties after fTBI are common and their early identification will facilitate educational and professional achievement. PMID:24087985

  19. Motherhood among Incest Survivors.

    ERIC Educational Resources Information Center

    Cohen, Tamar

    1995-01-01

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

  20. Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes.

    PubMed

    van Twillert, Björn; Bremer, Marco; Faber, Albertus W

    2007-01-01

    Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entire wound care session and compared VR to the effects of standard care and other distraction methods. Nineteen inpatients ages 8 to 65 years (mean, 30 years) with a mean TBSA of 7.1% (range, 0.5-21.5%) were studied using a within-subject design. Within 1 week of admission, standard care (no distraction), VR, or another self-chosen distraction method was administered during the wound dressing change. Each patient received the normal analgesic regimen. Pain was measured with visual analog thermometer scores, and anxiety was measured with the state-version of the Spielberger State Trait Anxiety Inventory. After comparing different distraction methods, only VR and television showed significant pain reductions during wound dressing changes. The effects of VR were superior, but not statistical significant, to that of television. Thirteen of 19 patients reported clinically meaningful (33% or greater) reductions in pain during VR distraction. No side effects were reported. No correlations were found between the reduction in pain ratings and patient variables like age, sex, duration of hospital stay, or percentage of (deep) burns. There was no significant reduction of anxiety ratings. PMID:17667488

  1. A Meta-Summary of Qualitative Findings about Professional Services for Survivors of Sexual Violence

    ERIC Educational Resources Information Center

    Martsolf, Donna S.; Draucker, Claire B.; Cook, Christina B.; Ross, Ratchneewan; Stidham, Andrea Warner; Mweemba, Prudencia

    2010-01-01

    Sexual violence occurs at alarming rates in children and adults. Survivors experience myriad negative health outcomes and legal problems, which place them in need of professional services. A meta-summary was conducted of 31 published qualitative studies on adults' responses to sexual violence, with a focus on survivors' use of professional…

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

    PubMed

    Juni, Samuel

    2016-01-01

    Drawing from trauma theory, psychodynamic conceptualization, developmental psychology, clinical data, and personal experience, this article portrays a life haunted by tragedy predating its victims. Healthy child development is outlined, with particular attention to socialization and theological perspectives. Key characteristics of trauma are delineated, highlighting the nuances of trauma that are most harmful. As is the case with general trauma, Holocaust survivors are described as evincing survivor's guilt and paranoia in response to their experiences. Divergent disorders resulting from the Holocaust are described for 1st-generation and 2nd-generation survivors, respectively. Primary trauma responses and pervasive attitudes of survivors are shown to have harmful ramifications on their children's personality and worldview as well as on their interpersonal and theistic object relations. These limitations translate into problems in the adult lives of second generation survivors. PMID:26178616

  3. Pain in Cancer Survivors

    PubMed Central

    Glare, Paul A.; Davies, Pamela S.; Finlay, Esmé; Gulati, Amitabh; Lemanne, Dawn; Moryl, Natalie; Oeffinger, Kevin C.; Paice, Judith A.; Stubblefield, Michael D.; Syrjala, Karen L.

    2014-01-01

    Pain is a common problem in cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain that interferes with functioning. The prevalence is much higher in certain subpopulations, such as breast cancer survivors. All cancer treatment modalities have the potential to cause pain. Currently, the approach to managing pain in cancer survivors is similar to that for chronic cancer-related pain, pharmacotherapy being the principal treatment modality. Although it may be appropriate to continue strong opioids in survivors with moderate to severe pain, most pain problems in cancer survivors will not require them. Moreover, because more than 40% of cancer survivors now live longer than 10 years, there is growing concern about the long-term adverse effects of opioids and the risks of misuse, abuse, and overdose in the nonpatient population. As with chronic nonmalignant pain, multimodal interventions that incorporate nonpharmacologic therapies should be part of the treatment strategy for pain in cancer survivors, prescribed with the aim of restoring functionality, not just providing comfort. For patients with complex pain issues, multidisciplinary programs should be used, if available. New or worsening pain in a cancer survivor must be evaluated to determine whether the cause is recurrent disease or a second malignancy. This article focuses on patients with a history of cancer who are beyond the acute diagnosis and treatment phase and on common treatment-related pain etiologies. The benefits and harms of the various pharmacologic and nonpharmacologic options for pain management in this setting are reviewed. PMID:24799477

  4. Pain in cancer survivors.

    PubMed

    Glare, Paul A; Davies, Pamela S; Finlay, Esmé; Gulati, Amitabh; Lemanne, Dawn; Moryl, Natalie; Oeffinger, Kevin C; Paice, Judith A; Stubblefield, Michael D; Syrjala, Karen L

    2014-06-01

    Pain is a common problem in cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain that interferes with functioning. The prevalence is much higher in certain subpopulations, such as breast cancer survivors. All cancer treatment modalities have the potential to cause pain. Currently, the approach to managing pain in cancer survivors is similar to that for chronic cancer-related pain, pharmacotherapy being the principal treatment modality. Although it may be appropriate to continue strong opioids in survivors with moderate to severe pain, most pain problems in cancer survivors will not require them. Moreover, because more than 40% of cancer survivors now live longer than 10 years, there is growing concern about the long-term adverse effects of opioids and the risks of misuse, abuse, and overdose in the nonpatient population. As with chronic nonmalignant pain, multimodal interventions that incorporate nonpharmacologic therapies should be part of the treatment strategy for pain in cancer survivors, prescribed with the aim of restoring functionality, not just providing comfort. For patients with complex pain issues, multidisciplinary programs should be used, if available. New or worsening pain in a cancer survivor must be evaluated to determine whether the cause is recurrent disease or a second malignancy. This article focuses on patients with a history of cancer who are beyond the acute diagnosis and treatment phase and on common treatment-related pain etiologies. The benefits and harms of the various pharmacologic and nonpharmacologic options for pain management in this setting are reviewed. PMID:24799477

  5. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region

    PubMed Central

    2012-01-01

    Background Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL). Whether this is due to their endocrine consequences (hypopituitarism), their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL) in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Methods Consecutive patients (n=101) treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years) with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL)-90, Nottingham Health Profile (NHP), and Psychological Well Being (PGWB) questionnaires. Level of physical activity was assessed using the Baecke questionnaire. Results The median accumulated dose was 1.9 Gy (1.5–2.2 Gy) to the hypothalamus and 2.4 Gy (1.8–3.3 Gy) to the pituitary gland in patients with oropharyngeal cancer and 6.0–9.3 Gy and 33.5–46.1 Gy, respectively in patients with epipharyngeal cancer (n=2). The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. Conclusion In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls. PMID:23101561

  6. The role of exercise in the rehabilitation of patients with severe burns

    PubMed Central

    Porter, Craig; Hardee, Justin; Herndon, David N; Suman, Oscar E

    2014-01-01

    Severe burn trauma results in persistent skeletal muscle catabolism and prolonged immobilization. We hypothesize that structured rehabilitative exercise is a safe and efficacious strategy to restores lean body mass and physical function in burn victims. Here, we review the evidence for the utility of rehabilitative exercise training in restoring physiological function in burn survivors. PMID:25390300

  7. Demographics of pediatric burns in Vellore, India.

    PubMed

    Light, Timothy D; Latenser, Barbara A; Heinle, Jackie A; Stolpen, Margaret S; Quinn, Keely A; Ravindran, Vinitha; Chacko, Jacob

    2009-01-01

    The American Burn Association, Children's Burn Foundation, and Christian Medical College in Vellore, India have partnered together to improve pediatric burn care in Southern India. We report the demographics and outcomes of burns in this center, and create a benchmark to measure the effect of the partnership. A comparison to the National Burn Repository is made to allow for generalization and assessment to other burn centers, and to control for known confounders such as burn size, age, and mechanism. Charts from the pediatric burn center in Vellore, India were retrospectively reviewed and compared with data in the American Burn Association National Burn Registry (NBR) for patients younger than 16 years. One hundred nineteen pediatric patients with burns were admitted from January 2004 through April 2007. Average age was 3.8 years; average total body surface area burn was 24%: 64% scald, 30% flame, 6% electric. Annual death rate was 10%, with average fatal total body surface area burn was 40%. Average lengths of stay for survivors was 15 days. Delay of presentation was common (45% of all patients). Thirty-five of 119 patients received operations (29%). Flame burn patients were older (6.1 years vs 2.6 years), larger (30 vs 21%), had a higher fatality rate (19.4 vs 7.7%), and more of them were female (55 vs 47%) compared with scald burn patients. Electric burn patients were oldest (8.3 years) and all male. When compared with data in the NBR, average burn size was larger in Vellore (24 vs 9%). The mortality rate was higher in Vellore (10.1 vs 0.5%). The average mortal burn size in Vellore was smaller (40 vs 51%). Electric burns were more common in Vellore (6.0 vs 1.6%). Contact burns were almost nonexistent in Vellore (0.9 vs 13.1%). The differences in pediatric burn care from developing health care systems to burn centers in the US are manifold. Nonpresentation of smaller cases, and incomplete data in the NBR explain many of the differences. However, burns at this

  8. Pain in cancer survivors

    PubMed Central

    Ramirez, Juan D; Farquhar-Smith, Paul

    2014-01-01

    Cancer and its treatment exert a heavy psychological and physical toll. Of the myriad symptoms which result, pain is common, encountered in between 30% and 60% of cancer survivors. Pain in cancer survivors is a major and growing problem, impeding the recovery and rehabilitation of patients who have beaten cancer and negatively impacting on cancer patients’ quality of life, work prospects and mental health. Persistent pain in cancer survivors remains challenging to treat successfully. Pain can arise both due to the underlying disease and the various treatments the patient has been subjected to. Chemotherapy causes painful chemotherapy-induced peripheral neuropathy (CIPN), radiotherapy can produce late effect radiation toxicity and surgery may lead to the development of persistent post-surgical pain syndromes. This review explores a selection of the common causes of persistent pain in cancer survivors, detailing our current understanding of the pathophysiology and outlining both the clinical manifestations of individual pain states and the treatment options available. PMID:26516548

  9. Preventive Care in Older Cancer Survivors

    PubMed Central

    Lowenstein, Lisa M.; Ouellet, Jennifer Andreozzi; Dale, William; Fan, Lin; Mohile, Supriya Gupta

    2016-01-01

    Objective To study factors that influence receipt of preventive care in older cancer survivors. Methods We analyzed a nationally representative sample of 12,458 older adults from the 2003 Medicare Current Beneficiary Survey. Factors associated with non-receipt of preventive care were explored among cancer and non-cancer survivors, using logistic regression. Results Among cancer survivors, 1,883 were diagnosed >one year at survey completion. A cancer history was independently associated with receipt of mammogram (AOR=1.57, 95%CI=1.34–1.85), flu shot (AOR=1.33, 95%CI=1.16–1.53), measurement of total cholesterol in the previous six months (AOR=1.20, 95%CI=1.07–1.34), pneumonia vaccination (AOR=1.33, 95%CI=1.18–1.49), bone mineral density (BMD) testing (AOR=1.38, 95%CI=1.21–1.56) and lower endoscopy (AOR=1.46, 95%CI=1.29–1.65). However, receipt of preventive care was not optimal among older cancer survivors with only 51.2% of female cancer survivors received a mammogram, 63.8% of all cancer survivors received colonoscopy, and 42.5% had BMD testing. Among cancer survivors, factors associated with non-receipt of mammogram included age ≥85 years (AOR=0.43, 95%CI=0.26–0.74) and scoring ≥three points on the Vulnerable Elders Survey-13 (AOR=0.94, 95%CI=0.80–1.00). Factors associated with non-receipt of colonoscopy included low education (AOR=0.43, 95%CI=0.27–0.68) and rural residence (AOR=0.51, 95%CI=0.34–0.77). Factors associated with non-receipt of BMD testing included age ≥70 (AOR=0.59, 95%CI=0.39–0.90), African American race (AOR=0.51, 95%CI=0.27–0.95), low education (AOR=0.23, 95%CI=0.14–0.38) and rural residence (AOR=0.43, 95%CI=0.27–0.70). Conclusion Although older cancer survivors are more likely to receive preventive care services than other older adults, the prevalence of receipt of preventive care services is low. PMID:25547206

  10. Bereavement, postdisaster trauma, and behavioral changes in tsunami survivors.

    PubMed

    Suar, Damodar; Das, Sitanshu Sekhar; Alat, Priya

    2015-01-01

    This study examined whether the death of family members intensifies the survivors' posttraumatic stress and behavioral changes. Data were collected by interviewing 416 adult survivors from nine habitations of the Nagapattinam district in the state of Tamil Nadu in India 14 months after the 2004 tsunami. Compared to those nonbereaved, bereaved survivors reported more posttraumatic stress disorder, depression, anxiety, negative affect, deteriorated mental health, adverse physical health symptoms, alcohol consumption, family conflicts, and fear. When a tsunami trauma includes death of a loved one, psychological, physical, and behavioral ramifications are especially severe. PMID:25551551

  11. Medical problems of survivors of nuclear war

    SciTech Connect

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

    1981-11-01

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

  12. Evaluation of the brain-derived neurotrophic factor, nerve growth factor and memory in adult rats survivors of the neonatal meningitis by Streptococcus agalactiae.

    PubMed

    Barichello, Tatiana; Lemos, Joelson C; Generoso, Jaqueline S; Carradore, Mirelle M; Moreira, Ana Paula; Collodel, Allan; Zanatta, Jessiele R; Valvassori, Samira S; Quevedo, João

    2013-03-01

    Streptococcus agalactiae (GBS) is a major cause of severe morbidity and mortality in neonates and young infants, causing sepsis, pneumonia and meningitis. The survivors from this meningitis can suffer serious long-term neurological consequences, such as, seizures, hearing loss, learning and memory impairments. Neurotrophins, such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) control the neuronal cell death during the brain development and play an important role in neuronal differentiation, survival and growth of neurons. Neonate Wistar rats, received either 10μL of sterile saline as a placebo or an equivalent volume of GBS suspension at a concentration of 1×10(6)cfu/mL. Sixty days after induction of meningitis, the animals underwent behavioral tests, after were killed and the hippocampus and cortex were retired for analyze of the BDNF and NGF levels. In the open-field demonstrated no difference in motor, exploratory activity and habituation memory between the groups. The step-down inhibitory avoidance, when we evaluated the long-term memory at 24h after training session, we found that the meningitis group had a decrease in aversive memory when compared with the long-term memory test of the sham group. BDNF levels decreased in hippocampus and cortex; however the NGF levels decreased only in hippocampus. These findings suggest that the meningitis model could be a good research tool for the study of the biological mechanisms involved in the behavioral alterations secondary to GBS meningitis. PMID:22683802

  13. The patient–body relationship and the “lived experience” of a facial burn injury: a phenomenological inquiry of early psychosocial adjustment

    PubMed Central

    McLean, Loyola M; Rogers, Vanessa; Kornhaber, Rachel; Proctor, Marie-Therese; Kwiet, Julia; Streimer, Jeffrey; Vandervord, John

    2015-01-01

    Background Throughout development and into adulthood, a person’s face is the central focus for interpersonal communication, providing an important insight into one’s identity, age, sociocultural background, and emotional state. The face facilitates important social, including nonverbal, communication. Therefore, sustaining a severe burn, and in particular a facial burn, is a devastating and traumatizing injury. Burn survivors may encounter unique psychosocial problems and experience higher rates of psychosocial maladjustment, although there may be a number of potentially mediating factors. Objectives The purpose of this phenomenological study was to examine the early recovery experience of patients with a facial burn. In particular, this study focused on how the injury impacted on the participants’ relationship with their own body and the challenges of early psychosocial adjustment within the first 4 months of sustaining the injury. Methods In 2011, six adult participants encompassing two females and four males ranging from 29 to 55 years of age with superficial to deep dermal facial burns (with background burns of 0.8%–55% total body surface area) were recruited from a severe burn injury unit in Australia for participation in a Burns Modified Adult Attachment Interview. Narrative data were analyzed thematically and informed by Colaizzi’s method of data analysis. Results Three overarching themes emerged: relationship to self/other, coping, and meaning-making. Themes identified related to how the experience affected the participants’ sense of relationship with their own bodies and with others, as well as other challenges of early psychosocial adjustment. All participants indicated that they had experienced some early changes in their relationship with their body following their burn injury. Conclusion These findings highlight the struggle burn survivors experienced with postburn adjustment, but expressed altruism and optimism around their recovery. Past

  14. The influence of stereotypical beliefs, participant gender, and survivor weight on sexual assault response.

    PubMed

    Clarke, Allyson K; Stermac, Lana

    2011-07-01

    The present study explored the influence of survivor weight and participant gender, rape myth acceptance, and antifat attitudes on perceptions of sexual assault. Using an online survey tool, a community sample of 413 adult Canadian residents reviewed a hypothetical sexual assault scenario and completed a series of evaluations and attitudinal questionnaires. Generalized linear model analyses revealed that participants were more likely to hold the survivor responsible, excuse the perpetrator's actions, and respond more negatively toward the survivor and more positively toward the perpetrator when the survivor was depicted as thin versus overweight. Interactions were found between rape myth acceptance and survivor weight, gender and survivor weight, and gender and antifat attitudes, for certain dependent variables. In addition, men and those with higher levels of rape myth acceptance and antifat attitudes were found to make more negative evaluations of the survivor and more positive evaluations of the perpetrator. Recommendations for future research and interventions are discussed. PMID:20956441

  15. Sexual Function Following Burn Injuries: Literature Review.

    PubMed

    Pandya, Atisha A; Corkill, Helen A; Goutos, Ioannis

    2015-01-01

    Sexual function is a profound facet of the human personality. Burns due their sudden and devastating nature can have longstanding effects on intimate function by virtue of physical sequelae as well as alterations in body image and perceived desirability. A considerable number of patients encounter problems with intimate function in burns rehabilitation; nevertheless, the topic appears to be poorly addressed in specialist centers worldwide. Review of the literature suggests that a number of parameters can affect the quality of sexual life following burn injuries including age at the time of injury, location, and severity of the burn as well as coping mechanisms employed by the individual survivor. Addressing issues of intimacy relies on awareness, education, and a holistic approach on behalf of the multidisciplinary team members and, to this effect, recommendations are made on managing sexual function concerns in burns rehabilitation. PMID:25423439

  16. The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury: a pilot study.

    PubMed

    Cukor, Judith; Wyka, Katarzyna; Leahy, Nicole; Yurt, Roger; Difede, JoAnn

    2015-01-01

    Burn injuries are unique in their medical and psychological impact, yet there has been little exploration of psychiatric treatment for this population. This uncontrolled pilot study assessed feasibility, acceptability, and preliminary efficacy of a treatment protocol designed to address posttraumatic stress disorder, depression, coping with scarring, and community integration among adult burn survivors. A 14-session, manualized treatment protocol was created using cognitive-behavioral interventions including imaginal exposure, behavioral activation, cognitive restructuring, modeling, and in vivo exposure. Responses were measured using the Clinician Administered PTSD Scale, Beck Depression Index, Community Integration Questionnaire, Oswestry Disability Questionnaire, and Burn Specific Health Scale. Nine of 10 enrolled patients (60% women; mean = 42 years old) completed treatment. Burn size was 0.5% to 65%; mechanism of injury included flame (4), scald (5), and contact (1) burns. Mean acute hospitalization was 30.1 days (range = 13-87); mean time from injury to treatment was 3.2 months (range = 1-7). Baseline mean posttraumatic stress score was 68 on the Clinician Administered PTSD Scale (severe); scores decreased by 36% to a mean of 45.3 at posttreatment, with a large effect size. Baseline self-reported depression was 21 (moderate) on the Beck Depression Index, decreasing by 47% to a mean of 12 posttreatment (nonclinical). Change in community reintegration score was significant and large, and body image showed significant improvement. The protocol showed promise in the treatment of posttraumatic stress disorder, depression, self-image, and community reintegration following burn injury. These findings suggest that coping may improve with treatment and symptoms should not be dismissed as unavoidable consequences of burn injury. PMID:25407385

  17. Longitudinal burn scar quantification.

    PubMed

    Nedelec, Bernadette; Correa, José A; de Oliveira, Ana; LaSalle, Leo; Perrault, Isabelle

    2014-12-01

    Quantitative studies of the clinical recovery of burn scars are currently lacking. Previous reports validate the objective, precise, diagnostic capabilities of high-frequency ultrasound to measure thickness, the Cutometer(®) to measure pliability and the Mexameter(®) to measure erythema and pigmentation of scars. Thus, we prospectively quantified clinical characteristics of patient-matched, after burn hypertrophic scar (HSc), donor site scar (D) and normal skin (N) using these instruments. One investigator measured 3 sites (HSc, D, N) in 46 burn survivors at 3, 6, and 12 months after-burn. A mixed model regression analysis, adjusting p-values for multiplicity of testing, was used to compare means among sites and time points. Participants were 41.2±13.5 years old, 87% males, predominantly Caucasian, with an average of 19.5% body surface area burned. HSc thickness decreased significantly between 3 and 6, 6 and 12, and 3 and 12 months (all p<0.0001), but remained thicker than D and N skin (all p<0.0001). Pliability differed significantly between HSc, D and N sites at all time points (all p<0.0001), with HSc and D increasing between 3 and 12 months (p<0.05) but not reaching normal. HSc and D sites were significantly more erythematous than normal skin (p<0.05) at 3 and 6 months but D sites approached normal by 12 months. The only time points at which pigmentation significantly differed were the HSc and D sites at 6 months. Thickness, pliability, erythema and pigmentation of N skin remained similar over the 12 months. We found that post-burn HSc thickness, pliability and erythema differed significantly from D and N skin at 3, 6, and 12 months and does not return to normal by 12 months after-injury; however, significant improvements towards normal can be expected. Donor sites are redder than normal skin at 3 and 6 months but can be expected to return to normal by 12 months. Although the color of HSc and D sites change markedly with time these color changes are

  18. The Effect of Mindfulness-Based Therapy on Symptoms of Anxiety and Depression in Adult Cancer Patients and Survivors: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Piet, Jacob; Wurtzen, Hanne; Zachariae, Robert

    2012-01-01

    Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and…

  19. Anterior Hypopituitarism in Adult Survivors of Childhood Cancers Treated With Cranial Radiotherapy: A Report From the St Jude Lifetime Cohort Study

    PubMed Central

    Chemaitilly, Wassim; Li, Zhenghong; Huang, Sujuan; Ness, Kirsten K.; Clark, Karen L.; Green, Daniel M.; Barnes, Nicole; Armstrong, Gregory T.; Krasin, Matthew J.; Srivastava, Deo Kumar; Pui, Ching-Hon; Merchant, Thomas E.; Kun, Larry E.; Gajjar, Amar; Hudson, Melissa M.; Robison, Leslie L.; Sklar, Charles A.

    2015-01-01

    Purpose To estimate the prevalence of and risk factors for growth hormone deficiency (GHD), luteinizing hormone/follicle-stimulating hormone deficiencies (LH/FSHD), thyroid-stimulatin hormone deficiency (TSHD), and adrenocorticotropic hormone deficiency (ACTHD) after cranial radiotherapy (CRT) in childhood cancer survivors (CCS) and assess the impact of untreated deficiencies. Patients and Methods Retrospective study in an established cohort of CCS with 748 participants treated with CRT (394 men; mean age, 34.2 years [range, 19.4 to 59.6 years] observed for a mean of 27.3 years [range, 10.8 to 47.7 years]). Multivariable logistic regression was used to study associations between demographic and treatment-related risk factors and pituitary deficiencies, as well as associations between untreated deficiencies and cardiovascular health, bone mineral density (BMD), and physical fitness. Results The estimated point prevalence was 46.5% for GHD, 10.8% for LH/FSHD, 7.5% for TSHD, and 4% for ACTHD, and the cumulative incidence increased with follow-up. GHD and LH/FSHD were not treated in 99.7% and 78.5% of affected individuals, respectively. Male sex and obesity were significantly associated with LH/FSHD; white race was significant associated with LH/FSHD and TSHD. Compared with CRT doses less than 22 Gy, doses of 22 to 29.9 Gy were significantly associated with GHD; doses ≥ 22 Gy were associated with LH/FSHD; and doses ≥ 30 Gy were associated with TSHD and ACTHD. Untreated GHD was significantly associated with decreased muscle mass and exercise tolerance; untreated LH/FSHD was associated with hypertension, dyslipidemia, low BMD, and slow walking; and both deficits, independently, were associated with with abdominal obesity, low energy expenditure, and muscle weakness. Conclusion Anterior pituitary deficits are common after CRT. Continued development over time is noted for GHD and LH/FSHD with possible associations between nontreatment of these conditions and poor

  20. Biomass Burning

    NASA Technical Reports Server (NTRS)

    Levine, Joel S.; Cofer, Wesley R., III; Pinto, Joseph P.

    1993-01-01

    Biomass burning may be the overwhelming regional or continental-scale source of methane (CH4) as in tropical Africa and a significant global source of CH4. Our best estimate of present methane emissions from biomass burning is about 51.9 Tg/yr, or 10% of the annual methane emissions to the atmosphere. Increased frequency of fires that may result as the Earth warms up may result in increases in this source of atmospheric methane.

  1. Challenges in Recruiting Aging Women Holocaust Survivors to a Case Control Study of Breast Cancer.

    PubMed

    Vin-Raviv, Neomi; Dekel, Rachel; Barchana, Micha; Linn, Shai; Keinan-Boker, Lital

    2015-01-01

    Older adults are underrepresented in medical research for many reasons, including recruitment difficulties. Recruitment of older adults for research studies is often a time-consuming process and can be more challenging when the study involves older adults with unique exposures to traumatic events and from minority groups. The current article provides a brief overview of (a) challenges encountered while recruiting aging women Holocaust survivors for a case control study and (b) strategies used for meeting those challenges. The case group comprised women Holocaust survivors who were recently diagnosed with breast cancer and the control group comprised healthy women from a Holocaust-survivor community in Israel. PMID:26020580

  2. Children of Holocaust Survivors.

    ERIC Educational Resources Information Center

    Segal, Shirley Ann

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

  3. Within the Box: Cross-Cultural Art Therapy with Survivors of the Rwanda Genocide

    ERIC Educational Resources Information Center

    Chu, Valerie

    2010-01-01

    This article discusses the creative making of boxes as a cross-cultural art therapy intervention in Kigali, Rwanda, with survivors of the 1994 Rwandan genocide. The box as an art form is particularly applicable with young adult survivors, given the nature of their prodigious trauma and the possibility of posttraumatic stress disorder, as well as…

  4. Sexual Abuse Survivors' Perceptions of the Effectiveness of EMDR and Eclectic Therapy

    ERIC Educational Resources Information Center

    Edmond, Tonya; Sloan, Lacey; McCarty, Dawn

    2004-01-01

    Objective: This article examines survivor perspectives of the effectiveness of two different treatments for trauma symptoms among adult female survivors of childhood sexual abuse--Eye movement Desensitization and Reprocessing (EMDR) and eclectic therapy. Method: Qualitative interviews obtained in the context of a mixed-methods study were conducted…

  5. Appraisals of discriminatory events among adult offspring of Indian residential school survivors: the influences of identity centrality and past perceptions of discrimination.

    PubMed

    Bombay, Amy; Matheson, Kimberly; Anisman, Hymie

    2014-01-01

    As part of a government policy of assimilation beginning in the mid-1800s, a large proportion of Aboriginal children in Canada were forcibly removed from their homes to attend Indian Residential Schools (IRSs), a practice which continued into the 1990s. This traumatic experience had lasting negative effects not only on those who attended but also on their offspring, who were previously found to report higher levels of perceived discrimination and depressive symptoms compared with Aboriginal adults whose families were not directly affected by IRSs. In attempt to elucidate the processes involved in these previous findings, the current study (N = 399) revealed that greater levels of past perceptions of discrimination among IRS offspring, together with their greater likelihood of considering their Aboriginal heritage to be a central component of their self-concept (i.e., high identity centrality), were associated with an increased likelihood of appraising subsequent negative intergroup scenarios to be a result of discrimination and as threatening to their well-being. In turn, these altered appraisals of threat in response to the scenarios were associated with higher levels of depressive symptoms relative to non-IRS adults. The apparent reinforcing relationships between past discrimination, identity centrality, and appraisals of discrimination and threat in intergroup interactions highlight the need for interventions targeting this cycle that appears to contribute to heightened psychological distress among offspring of those who were directly victimized by collective race-based traumas. PMID:23834257

  6. Suicide survivors groups: results of a survey.

    PubMed

    Rubey, C T; McIntosh, J L

    1996-01-01

    Little is known about the nature of suicide survivors groups. Survey responses by 149 U.S. and Canadian groups are characterized as follows: (1) they are most often sponsored by mental health or social service agencies or have no sponsor; (2) groups have operated an average of 8 to 9 years; (3) fewer than 10 people typically attend monthly or twice monthly meetings; (4) group experience predominantly involves sharing personal experiences; (5) leadership generally involves either trained facilitators, mental health professionals, or both; (6) most groups are open ended; (7) all social/ethnic, income, and adult age groups are served, but few children and teenagers attend; and (8) referrals come predominantly by word-of-mouth or medical and religious sources. Further research is required regarding survivor group attributes and processes. PMID:9014264

  7. Acute assessment and management of burn injuries.

    PubMed

    Purdue, Gary F; Arnoldo, Brett D; Hunt, John L

    2011-05-01

    Burns are ubiquitous injuries in modern society, with virtually all adults having sustained a burn at some point in their lives. The skin is the largest organ of the body, basically functioning to protect self from non-self. Burn injury to the skin is painful, resource-intensive, and often associated with scarring, contracture formation, and long-term disability. Larger burns are associated with morbidity and mortality disproportionate to their initial appearance. Electrical and chemical burns are less common injuries but are often associated with significant morbidity. PMID:21624716

  8. Suicidal burn in Hong Kong.

    PubMed

    Chan, R C; Burd, A

    2012-09-01

    The aim of our study is to review our experience in the management of patients who sustained burns associated with suicidal attempts over a 10-year period. In particular, we look into the outcome and incidence of self-harm/suicide after discharge among the survivors. Thirty-one patients with median age 36 years, ranging from 10 to 74, were included. Twenty-three (74%) were males and eight (26%) were females. Nearly three quarters (74%) of our patients had a known history of psychiatric illness: 11 had known history of substance abuse; 3 of them had drug-induced psychosis; 6 had schizophrenia; 5 had depression; 4 had personality disorders; 1 had pathological gambling and another one had adjustment disorder. Relationship problems and work/financial difficulties were the commonest reason for the suicidal attempts. Self-inflicted flame burn was the most frequent (39%; 12 patients) method of burning. Six patients (19%) died. The remaining 25 patients healed and were discharged. Seventeen patients required ICU care. The median length of stay in ICU was 7 days. The overall median length of stay was 35 days. The median follow up time for those survived is 63 months. Only 4 of these patients had further suicidal/parasuicidal attempts. Despite the high mortality, once these patients survived the initial injury, they are unlikely to commit suicide again. Thus, we believe that aggressive resuscitation should therefore be advocated for all suicidal burn patients. PMID:22360959

  9. Burning rubber

    SciTech Connect

    Not Available

    1987-09-01

    Mario Andretti, look out You are about to be surpassed in the burning rubber category by a joint venture between Oxford Energy Company and General Electric. The two companies are building the first whole tire-to-energy facility in the US in Modesto, California. This $41 million facility does not require tires to be shredded prior to incineration; it has the capacity to burn 700 tires per minute. The electricity generated will be provided to a utility company. Oxford says there are two billion waste tires on the ground and this number is increasing by 220 million a year. Of that amount, only 18 million a year are recycled.

  10. Aztreonam pharmacokinetics in burn patients.

    PubMed Central

    Friedrich, L V; White, R L; Kays, M B; Brundage, D M; Yarbrough, D

    1991-01-01

    The pharmacokinetics of aztreonam in eight adult patients with severe burn injuries (total body surface area burn, 49% +/- 21% [mean +/- standard deviation]) were studied. The time of initiation of study following burn injury was 7.0 +/- 1.4 days. Four patients at first dose and at steady state were studied. Aztreonam concentrations were measured by high-performance liquid chromatography, and a two-compartment model was used to fit the data. No significant differences in any pharmacokinetic parameters between first dose and steady state were observed. Volume of distribution of the central compartment after first dose (0.14 liters/kg) and volume of distribution at steady state (0.31 liters/kg) were approximately 30% higher than those reported for other patient populations. Total drug clearance and renal drug clearance when normalized to creatinine clearance (CLCR) were similar to those previously reported for other critically ill patients. CLCR was strongly correlated with renal drug clearance (r = 0.94) and total drug clearance (r = 0.95). The extent and degree of burn (percent second or third degree burn) were poorly correlated with all pharmacokinetic parameters with the exception of the volume of distribution at steady state, which was correlated with both total body surface area burn (r = 0.95) and percent second degree burn (r = 0.83). Aztreonam pharmacokinetics are altered as a result of thermal injury; however, CLCR can be used to assess the clearance of aztreonam in burn patients. PMID:2014982

  11. Infertility Education: Experiences and Preferences of Childhood Cancer Survivors.

    PubMed

    Cherven, Brooke O; Mertens, Ann; Wasilewski-Masker, Karen; Williamson, Rebecca; Meacham, Lillian R

    2016-07-01

    The majority of children diagnosed with cancer will become long-term survivors; however, many will suffer late effects of treatment, including infertility. Educating patients about potential risk for infertility is important, yet little is known regarding when patients would like to hear this information. The purpose of this study was to assess young adult survivors' previous experience in receiving education about their risk for infertility and determine their preferences for infertility education at various time points during and after treatment. Only 36% of survivors report receiving education about risk for infertility at diagnosis, 39% at end of therapy, and 72% in long-term follow-up/survivor clinic visits. Survivors consistently identified their oncologist as a preferred educator at each time point. Although almost all participants identified wanting education at diagnosis, this time point alone may not be sufficient. End of therapy and survivorship may be times this message should be repeated and adapted for the survivor's needs and developmental stage: conversations about the impact of cancer treatment on future fertility should be ongoing. PMID:26582171

  12. Cancer in atomic bomb survivors

    SciTech Connect

    Shigematsu, I.; Kagan, A.

    1986-01-01

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

  13. National programme for prevention of burn injuries

    PubMed Central

    Gupta, J. L.; Makhija, L. K.; Bajaj, S. P.

    2010-01-01

    The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI) would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme. PMID:21321659

  14. National programme for prevention of burn injuries.

    PubMed

    Gupta, J L; Makhija, L K; Bajaj, S P

    2010-09-01

    The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI) would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme. PMID:21321659

  15. Burning Man

    ERIC Educational Resources Information Center

    Cech, Scott J.

    2006-01-01

    Former Baltimore cop and teacher Ed Burns isn't a masochist. The writer-producer for "The Wire," a critically applauded HBO series about life and death on the streets of Baltimore, is just feverishly trying to save public schools. He thinks American education is hopelessly screwed up, but that it's also the country's only hope. So it makes sense…

  16. Receipt of Psychosocial Care Among Cancer Survivors in the United States

    PubMed Central

    Forsythe, Laura P.; Kent, Erin E.; Weaver, Kathryn E.; Buchanan, Natasha; Hawkins, Nikki A.; Rodriguez, Juan L.; Ryerson, A. Blythe; Rowland, Julia H.

    2013-01-01

    Purpose Given the importance of psychosocial care for cancer survivors, this study used population-based data to characterize survivors who reported a discussion with health care provider(s) about the psychosocial effects of cancer and who reported using professional counseling or support groups (PCSG) and tested associations between receipt of psychosocial care and satisfaction with care. Patients and Methods We examined survivors of adult cancers from the 2010 National Health Interview Survey (N = 1,777). Multivariable logistic regression models examined factors associated with receipt of and satisfaction with psychosocial care. Results Most survivors (55.1%) reported neither provider discussions nor use of PCSG; 31.4% reported provider discussion only, 4.4% reported use of PCSG only, and 8.9% reported both. Non-Hispanic blacks (v non-Hispanic whites), married survivors, survivors of breast cancer (v prostate or less prevalent cancers), those treated with chemotherapy, and survivors reporting past research study/clinical trial participation were more likely to report provider discussion(s) (P < .01). Hispanics (v non-Hispanic whites), survivors age 40 to 49 years (v ≤ 39 years), survivors of breast cancer (v melanoma or less prevalent cancers), those diagnosed ≤ 1 year ago (v > 5 years ago), survivors treated with radiation, and past research participants were more likely to report use of PCSG (P < .05). Survivors reporting any psychosocial care were more likely to be “very satisfied” with how their needs were met (P < .001). Conclusion Many survivors do not report a discussion with providers about the psychosocial effects of cancer, which reflects a missed opportunity to connect survivors to psychosocial services. These data can benchmark the success of efforts to improve access to cancer-related psychosocial care. PMID:23610114

  17. Multi-model inference of adult and childhood leukaemia excess relative risks based on the Japanese A-bomb survivors mortality data (1950-2000).

    PubMed

    Walsh, Linda; Kaiser, Jan Christian

    2011-03-01

    Some relatively new issues that augment the usual practice of ignoring model uncertainty, when making inference about parameters of a specific model, are brought to the attention of the radiation protection community here. Nine recently published leukaemia risk models, developed with the Japanese A-bomb epidemiological mortality data, have been included in a model-averaging procedure so that the main conclusions do not depend on just one type of model or statistical test. The models have been centred here at various adult and young ages at exposure, for some short times since exposure, in order to obtain specially computed childhood Excess Relative Risks (ERR) with uncertainties that account for correlations in the fitted parameters associated with the ERR dose-response. The model-averaged ERR at 1 Sv was not found to be statistically significant for attained ages of 7 and 12 years but was statistically significant for attained ages of 17, 22 and 55 years. Consequently, such risks when applied to other situations, such as children in the vicinity of nuclear installations or in estimates of the proportion of childhood leukaemia incidence attributable to background radiation (i.e. low doses for young ages and short times since exposure), are only of very limited value, with uncertainty ranges that include zero risk. For example, assuming a total radiation dose to a 5-year-old child of 10 mSv and applying the model-averaged risk at 10 mSv for a 7-year-old exposed at 2 years of age would result in an ERR=0.33, 95% CI: -0.51 to 1.22. One model (United Nations scientific committee on the effects of atomic radiation report. Volume 1. Annex A: epidemiological studies of radiation and cancer, United Nations, New York, 2006) weighted model-averaged risks of leukaemia most strongly by half of the total unity weighting and is recommended for application in future leukaemia risk assessments that continue to ignore model uncertainty. However, on the basis of the analysis

  18. Symbolic Confrontation with Women Survivors of Childhood Sexual Victimization.

    ERIC Educational Resources Information Center

    Apolinsky, Sandra R.; Wilcoxon, S. Allen

    1991-01-01

    Investigated comparative effects of symbolic confrontation in affecting measures of self-concept and depression of 30 adult female survivors of childhood sexual abuse participating in a counseling group. The results seem to suggest that the technique of symbolic confrontation can be effective in ameliorating negative aftereffects of victimization…

  19. Sibling Incest: Reports from Forty-One Survivors

    ERIC Educational Resources Information Center

    Carlson, Bonnie E.; Maciol, Katherine; Schneider, Joanne

    2006-01-01

    An exploratory study was conducted with a convenience sample of 41 adult survivors of sibling incest using a retrospective survey design. Participants were interviewed about their childhood sexual experiences with a sibling. Most participants reported vaginal or oral intercourse and coercive experiences. Half of the sample reported sexual…

  20. The Use of Transpersonal Empathy with Child Abuse Survivors.

    ERIC Educational Resources Information Center

    Gilewski, Michael J.

    Adult survivors of childhood abuse are some of the more difficult and challenging patients in psychotherapy. This paper applies a transpersonal model of empathy to therapeutic work with these individuals. The transpersonal model of empathy extends traditional humanistic models which strive towards "advanced accurate empathy" to the level at which,…

  1. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland.

    PubMed

    Rohrer-Mirtschink, S; Forster, N; Giovanoli, P; Guggenheim, M

    2015-03-31

    In Switzerland it is customary to light candles on Christmas trees and advent wreaths. This tradition leads to an increased risk of home fires. We reviewed the records of patients who sustained burn injuries from a lit Christmas tree or advent wreath during the Christmas holidays between January 1971 and January 2012. We treated 28 patients and observed 4 fatalities (mortality rate: 14%). 61% of the patients were male, 39% were female. The mean abbreviated burn severity index (ABSI) was 6.5 points in the group of the survivors and 10.8 points in the group of the non-survivors. The mean total body surface area burned (TBSA) for survivors was 18.9%, with 14.1% having full thickness burns; for the non-survivors the mean TBSA was 45.2%, with 38% having full thickness burns. The Mann-Whitney U-test showed a significant difference between the survivors and the fatalities concerning the mean total and full thickness burned body surface area (p value 0.009 and 0.012). More than sixty percent of the fires occurred in January and the most severe accidents were seen after January 4th. Despite Christmas decoration-associated fires being relatively uncommon, they tend to cause more serious injuries than regular household fires. We recommend that in countries where it is customary to set up flammable Christmas decorations, state-issued information pamphlets with instructions on fire safety conduct should be distributed. PMID:26668566

  2. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland

    PubMed Central

    Rohrer-Mirtschink, S.; Forster, N.; Giovanoli, P.; Guggenheim, M.

    2015-01-01

    Summary In Switzerland it is customary to light candles on Christmas trees and advent wreaths. This tradition leads to an increased risk of home fires. We reviewed the records of patients who sustained burn injuries from a lit Christmas tree or advent wreath during the Christmas holidays between January 1971 and January 2012. We treated 28 patients and observed 4 fatalities (mortality rate: 14%). 61% of the patients were male, 39% were female. The mean abbreviated burn severity index (ABSI) was 6.5 points in the group of the survivors and 10.8 points in the group of the non-survivors. The mean total body surface area burned (TBSA) for survivors was 18.9%, with 14.1% having full thickness burns; for the non-survivors the mean TBSA was 45.2%, with 38% having full thickness burns. The Mann-Whitney U-test showed a significant difference between the survivors and the fatalities concerning the mean total and full thickness burned body surface area (p value 0.009 and 0.012). More than sixty percent of the fires occurred in January and the most severe accidents were seen after January 4th. Despite Christmas decoration-associated fires being relatively uncommon, they tend to cause more serious injuries than regular household fires. We recommend that in countries where it is customary to set up flammable Christmas decorations, state-issued information pamphlets with instructions on fire safety conduct should be distributed. PMID:26668566

  3. The Effects of Preexisting Medical Comorbidities on Mortality and Length of Hospital Stay in Acute Burn Injury

    PubMed Central

    Thombs, Brett D.; Singh, Vijay A.; Halonen, Jill; Diallo, Alfa; Milner, Stephen M.

    2007-01-01

    Objective: To determine whether and to what extent preexisting medical comorbidities influence mortality risk and length of hospitalization in patients with acute burn injury. Summary Background Data: The effects on mortality and length of stay of a number of important medical comorbidities have not been examined in acute burn injury. Existing studies that have investigated the effects of medical comorbidities on outcomes in acute burn injury have produced inconsistent results, chiefly due to the use of relatively small samples from single burn centers. Methods: Records of 31,338 adults who were admitted with acute burn injury to 70 burn centers from the American Burn Association National Burn Repository, were reviewed. A burn-specific list of medical comorbidities was derived from diagnoses included in the Charlson Index of Comorbidities and the Elixhauser method of comorbidity measurement. Logistic regression was used to assess the effects of preexisting medical conditions on mortality, controlling for demographic and burn injury characteristics. Ordinal least squares regression with a logarithmic transformation of the dependent variable was used to assess the relationship of comorbidities with length of stay. Results: In-hospital mortality was significantly predicted by HIV/AIDS (odds ratio [OR] = 10.2), renal disease (OR = 5.1), liver disease (OR = 4.8), metastatic cancer (OR = 4.6), pulmonary circulation disorders (OR = 2.9), congestive heart failure (OR = 2.4), obesity (OR = 2.1), non-metastatic malignancies (OR = 2.1), peripheral vascular disorders (OR = 1.8), alcohol abuse (OR = 1.8), neurological disorders (OR = 1.6), and cardiac arrhythmias (OR = 1.5). Increased length of hospital stay among survivors was significantly predicted by paralysis (90% increase), dementia (60%), peptic ulcer disease (53%), other neurological disorders (52%), HIV/AIDS (49%), renal disease (44%), a psychiatric diagnosis (42%), cerebrovascular disease (41%), cardiac arrhythmias

  4. Burning vasculitis.

    PubMed

    Chadha, Priyanka; Hobday, Dorian; Fitzgerald O'Connor, Edmund; D'Cruz, David

    2016-01-01

    We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn. PMID:27118745

  5. Burn prevention in Zambia: a targeted epidemiological approach.

    PubMed

    Heard, Jason P; Latenser, Barbara A; Liao, Junlin

    2013-01-01

    The aim of this study is to assess primary burn prevention knowledge in a rural Zambian population that is disproportionately burdened by burn injuries. A 10-question survey was completed by youths, and a 15-question survey was completed by adults. The survey was available in both English and Nyanja. The surveys were designed to test their knowledge in common causes, first aid, and emergency measures regarding burn injuries. Logistic regression analysis was used to explore relationships between burn knowledge, age, school, and socioeconomic variables. A burn prevention coloring book, based on previous local epidemiological data, was also distributed to 800 school age youths. Five hundred fifty youths and 39 adults completed the survey. The most significant results show knowledge deficits in common causes of burns, first aid treatment of a burn injury, and what to do in the event of clothing catching fire. Younger children were more likely to do worse than older children. The adults performed better than the youths, but still lack fundamental burn prevention and treatment knowledge. Primary burn prevention data from the youths and adults surveyed demonstrate a clear need for burn prevention and treatment education in this population. In a country where effective and sustainable burn care is lacking, burn prevention may be a better investment to reduce burn injury than large investments in healthcare resources. PMID:23292574

  6. Constructing the meaning of survivor with former pediatric brain tumor patients.

    PubMed

    Zwiers, Angela; Campbell, Craig; Evans, Marilyn; Kirkwood, Ken

    2015-01-01

    Although the term survivor is frequently used in cancer discourse, the meaning of survivor and how people identify with this term can be difficult to understand. The purpose of this qualitative study is to explore the meaning of the term survivor from the perspective of young adults who have experienced a pediatric brain tumor (PBT). A constructivist grounded theory was utilized in this study with 6 young adults who had a PBT. This study also used semistructured interviews with participants who also completed reflective journals, which were focused on the survivor concept. Data were analyzed through coding strategies and constant comparative methods. Findings present 4 major themes of process: (a) reviewing the illness experience, (b) qualifying as a survivor, (c) thinking positive, and (d) being changed. These themes are important to consider in the construction, interpretation, and understanding of how the majority of this population do not identify with the current social use of the term survivor. Clearly, there is a need for a clearer understanding of survivor and how it specifically applies to those who have had a PBT. Everyone should remain conscious and consider how a broad, generalizing term such as survivor may influence a person's attitude and advocacy toward their health. PMID:25366573

  7. Disparities by Race and Ethnicity in Cancer Survivor Stories Available on the Web

    PubMed Central

    Kreuter, Matthew W; Morgan, Jennifer C; Beatty, Kate E; Jasim, Sina A; Garibay, Lori; Tao, Donghua; Buskirk, Trent D; Jupka, Keri A

    2009-01-01

    Background The rapid growth of eHealth could have the unintended effect of deepening health disparities between population subgroups. Most concerns to date have focused on population differences in access to technology, but differences may also exist in the appropriateness of online health content for diverse populations. Objective This paper reports findings from the first descriptive study of online cancer survivor stories by race and ethnicity of the survivor. Methods Using the five highest-rated Internet search engines and a set of search terms that a layperson would use to find cancer survivor stories online, we identified 3738 distinct sites. Of these, 106 met study criteria and contained 7995 total stories, including 1670 with an accompanying photo or video image of the survivor. Characteristics of both websites and survivor stories were coded. Results All racial minority groups combined accounted for 9.8% of online cancer survivor stories, despite making up at least 16.3% of prevalent cancer cases. Also notably underrepresented were stories from people of Hispanic ethnicity (4.1%), men (35.7%), survivors of colon cancer (3.5%), and older adults. Conclusions Because racial/ethnic minority cancer survivors are underrepresented in survivor stories available online, it is unlikely that this eHealth resource in its current form will help eliminate the disproportionate burden of cancer experienced by these groups. PMID:19945948

  8. Caring for Trauma Survivors.

    PubMed

    Antai-Otong, Deborah

    2016-06-01

    Although trauma exposure is common, few people develop acute and chronic psychiatric disorders. Those who develop posttraumatic stress disorder likely have coexisting psychiatric and physical disorders. Psychiatric nurses must be knowledgeable about trauma responses, implement evidence-based approaches to conduct assessments, and create safe environments for patients. Most researchers assert that trauma-focused cognitive-behavioral approaches demonstrate the most efficacious treatment outcomes. Integrated approaches, offer promising treatment options. This article provides an overview of clinical factors necessary to help the trauma survivor begin the process of healing and recovery and attain an optimal level of functioning. PMID:27229285

  9. Survivors of the Nazi Holocaust.

    ERIC Educational Resources Information Center

    Chodoff, Paul

    1981-01-01

    Presents psychiatric evidence regarding immediate and long-term effects of concentration camp internment. Many survivors exhibit a concentration camp syndrome which somewhat resembles combat stress reaction; adaptive behavior of survivors is viewed as less important than luck. Language is considered inadequate to describe the psychological impact…

  10. Siblings of Childhood Cancer Survivors.

    ERIC Educational Resources Information Center

    Gogan, Janis L.

    This paper reports on a long term follow up study of siblings of childhood cancer survivors. Seventy siblings of childhood cancer survivors in 37 families were interviewed using a semi-structured format which included both forced choice and open ended questions. The children discussed their memories of the sibling's cancer diagnosis and treatment…

  11. Perceived Positive Impact of Cancer Among Long-term Survivors of Childhood Cancer: a report from the Childhood Cancer Survivor Study

    PubMed Central

    Zebrack, Brad J.; Stuber, Margaret L.; Meeske, Kathleen A.; Phipps, Sean; Krull, Kevin R.; Liu, Qi; Parry, Carla; Hamilton, Rachel; Robison, Leslie L.; Zeltzer, Lonnie K.

    2013-01-01

    Background Investigations examining psychosocial adjustment among childhood cancer survivors have focused primarily on negative effects and psychopathology. Emergent literature suggests the existence of positive impact or adjustment experienced after cancer, as well. The purpose of this study is to examine the distribution of Perceived Positive Impact (PPI) and its correlates in young adult survivors of childhood cancer. Methods 6,425 survivors and 360 siblings completed a comprehensive health survey, inclusive of a modified version of the Posttraumatic Growth Inventory (PTGI) as a measure of PPI. Linear regression models were used to examine demographic, disease and treatment characteristics associated with PPI. Results Survivors were significantly more likely than siblings to report PPI. Endorsement of PPI was significantly greater among female and non-white survivors, and among survivors exposed to at least one intense therapy, a second malignancy or cancer recurrence. Survivors diagnosed at older ages and fewer years since diagnosis were more likely to report PPI. Income, education and marital/relationship status appeared to have varied relationships to PPI depending upon the subscale being evaluated. Conclusions The existence and variability of PPI in survivors in this study suggest that individual characteristics, inclusive of race, gender, cancer type, intensity of treatment, age at diagnosis and time since diagnosis, have unique and specific associations with different aspects of perceived positive outcomes of childhood cancer. PMID:21425388

  12. Intestinal Obstruction in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

    PubMed Central

    Madenci, Arin L.; Fisher, Stacey; Diller, Lisa R.; Goldsby, Robert E.; Leisenring, Wendy M.; Oeffinger, Kevin C.; Robison, Leslie L.; Sklar, Charles A.; Stovall, Marilyn; Weathers, Rita E.; Armstrong, Gregory T.; Yasui, Yutaka; Weldon, Christopher B.

    2015-01-01

    Purpose For adult survivors of childhood cancer, knowledge about the long-term risk of intestinal obstruction from surgery, chemotherapy, and radiotherapy is limited. Methods Intestinal obstruction requiring surgery (IOS) occurring 5 or more years after cancer diagnosis was evaluated in 12,316 5-year survivors in the Childhood Cancer Survivor Study (2,002 with and 10,314 without abdominopelvic tumors) and 4,023 sibling participants. Cumulative incidence of IOS was calculated with second malignant neoplasm, late recurrence, and death as competing risks. Using piecewise exponential models, we assessed the associations of clinical and demographic factors with rate of IOS. Results Late IOS was reported by 165 survivors (median age at IOS, 19 years; range, 5 to 50 years; median time from diagnosis to IOS, 13 years) and 14 siblings. The cumulative incidence of late IOS at 35 years was 5.8% (95% CI, 4.4% to 7.3%) among survivors with abdominopelvic tumors, 1.0% (95% CI, 0.7% to 1.4%) among those without abdominopelvic tumors, and 0.3% (95% CI, 0.1% to 0.5%) among siblings. Among survivors, abdominopelvic tumor (adjusted rate ratio [ARR], 3.6; 95% CI, 1.9 to 6.8; P < .001) and abdominal/pelvic radiotherapy within 5 years of cancer diagnosis (ARR, 2.4; 95% CI, 1.6 to 3.7; P < .001) increased the rate of late IOS, adjusting for diagnosis year; sex; race/ethnicity; age at diagnosis; age during follow-up (as natural cubic spline); cancer type; and chemotherapy, radiotherapy, and surgery within 5 years of cancer diagnosis. Developing late IOS increased subsequent mortality among survivors (ARR, 1.8; 95% CI, 1.1 to 2.9; P = .016), adjusting for the same factors. Conclusion The long-term risk of IOS and its association with subsequent mortality underscore the need to promote awareness of this complication among patients and providers. PMID:26261256

  13. Psychological Sequelae of the Station Nightclub Fire: Comparing Survivors with and without Physical Injuries Using a Mixed-Methods Analysis

    PubMed Central

    Trinh, Nhi-Ha T.; Nadler, Deborah L.; Shie, Vivian; Fregni, Felipe; Gilman, Stephen E.; Ryan, Colleen M.; Schneider, Jeffrey C.

    2014-01-01

    Background Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes. Methods This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale – Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries. Results 104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal. Conclusions All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes. PMID:25536085

  14. Sexual revictimization, PTSD, and problem drinking in sexual assault survivors.

    PubMed

    Ullman, Sarah E

    2016-02-01

    Posttraumatic stress disorder (PTSD) and problem drinking are common and often co-occurring sequelae experienced by women survivors of adult sexual assault, yet revictimization may mediate risk of symptoms over time. Structural equation modeling was used to examine data from a 3-wave panel design with a large (N=1012), ethnically diverse sample of women assault survivors to examine whether repeated sexual victimization related to greater PTSD and problem drinking. Structural equation modeling revealed that child sexual abuse was associated with greater symptoms of PTSD and problem drinking and intervening sexual victimization was associated with greater symptoms of PTSD and problem drinking at both 1 and 2year follow-ups. We found no evidence, however, that PTSD directly influenced problem drinking over the long term or vice versa, although they were correlated at each timepoint. Revictimization during the study predicted survivors' prospective PTSD and problem drinking symptoms inconsistently. Implications and recommendations for future research are discussed. PMID:26414205

  15. MORBIDITY AND SURVIVAL PROBABILITY IN BURN PATIENTS IN MODERN BURN CARE

    PubMed Central

    Jeschke, Marc G.; Pinto, Ruxandra; Kraft, Robert; Nathens, Avery B.; Finnerty, Celeste C.; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn. Design and Patients Burn patients were prospectively enrolled as part of the multicenter prospective cohort study, Inflammation and the Host Response to Injury Glue Grant, with the following inclusion criteria: 0–99 years of age, admission within 96 hours after injury, and >20% total body surface area burns requiring at least one surgical intervention. Setting Six major burn centers in North America. Measurements and Main Results Burn size cutoff values were determined for mortality, burn wound infection (at least two infections), sepsis (as defined by ABA sepsis criteria), pneumonia, acute respiratory distress syndrome, and multiple organ failure (DENVER2 score >3) for both children (<16 years) and adults (16–65 years). Five-hundred seventy-three patients were enrolled, of which 226 patients were children. Twenty-three patients were older than 65 years and were excluded from the cutoff analysis. In children, the cutoff burn size for mortality, sepsis, infection, and multiple organ failure was approximately 60% total body surface area burned. In adults, the cutoff for these outcomes was lower, at approximately 40% total body surface area burned. Conclusions In the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. PMID:25559438

  16. The Feeling of Being Contaminated in Adult Survivors of Childhood Sexual Abuse and Its Treatment via a Two-Session Program of Cognitive Restructuring and Imagery Modification: A Case Study

    ERIC Educational Resources Information Center

    Jung, Kerstin; Steil, Regina

    2012-01-01

    Clinical experiences show that many survivors of childhood sexual abuse (CSA) suffer from a distressing feeling of being contaminated (FBC) even years or decades after the last experience of sexual violence. So far, this symptom has been neglected in research. The aim of this article is to illustrate this symptom and the necessity of a specialized…

  17. Energy Expenditure and Caloric Balance After Burn

    PubMed Central

    Hart, David W.; Wolf, Steven E.; Herndon, David N.; Chinkes, David L.; Lal, Sophia O.; Obeng, Michael K.; Beauford, Robert B.; Mlcak RT, Ronald P.

    2002-01-01

    Objective Resting energy expenditure (REE) is commonly measured in critical illness to determine caloric “demands” and thus nutritive needs. Summary Background Data The purpose of this study was to 1) determine whether REE is associated with clinical outcomes and 2) determine whether an optimal caloric delivery rate based on REE exists to offset erosion of lean mass after burn. Methods From 1995 to 2001, REE was measured by indirect calorimetry in 250 survivors of 10 to 99%TBSA burns. Caloric intake and REE were correlated with muscle protein catabolism, length of stay, ventilator dependence, sepsis, and mortality. From 1998 to 2000, 42 patients (>60%TBSA burns) received continuous enteral nutrition at a spectrum of caloric balance between 1.0x REE kcal/d –1.8x REE kcal/d. Serial body composition was measured by dual energy x-ray absorptiometry. Lean mass, fat mass, morbidity, and mortality were determined. Results REE/predicted basal metabolic rate correlated directly with burn size, sepsis, ventilator dependence, and muscle protein catabolism (P < .05). Declining REE correlated with mortality (P < .05). 2) Erosion of lean body mass was not attenuated by increased caloric balance, however, fat mass increased with caloric supply (P < .05). Conclusion In surviving burned patients, caloric delivery beyond 1.2 × REE results in increased fat mass without changes in lean body mass. Declining energy expenditure appears to be a harbinger of mortality in severely burned patients. PMID:11753055

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

    SciTech Connect

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

    2013-07-15

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

  19. Scald Burns From Hair Braiding.

    PubMed

    Meizoso, Jonathan P; Ramaley, Stephen R; Ray, Juliet J; Allen, Casey J; Guarch, Gerardo A; Varas, Robin; Teisch, Laura F; Pizano, Louis R; Schulman, Carl I; Namias, Nicholas

    2016-01-01

    Only one previous case report has described scald burns secondary to hair braiding in pediatric patients. The present case study is the largest to date of scald burns as a result of hair braiding in children and adults. Charts of all 1609 female patients seen at a single burn center from 2008 to 2014 were retrospectively reviewed to identify patients with scald burns attributed to hair braiding. Demographics, injury severity, injury patterns, and complications were analyzed. Twenty-six patients (1.6%) had scald burns secondary to hair braiding with median TBSA 3%. Eighty-five percent of patients were pediatric with median age 8 years. Injury patterns were as follows: back (62%), shoulder (31%), chest (15%), buttocks (15%), abdomen (12%), arms (12%), neck (12%), and legs (4%). No patients required operative intervention. Three patients were admitted to the hospital. Two patients required time off from school for 6 and 10 days post burn for recovery. Complications included functional limitations (n = 2), hypertrophic scarring (n = 1), cellulitis requiring antibiotics (n = 1), and anxiety requiring medical/psychological therapy (n = 2). This peculiar mechanism of injury not only carries inherent morbidity that includes the risks of functional limitations, infection, and psychological repercussions but also increases usage of resources through hospital admissions and multiple clinic visits. Further work in the form of targeted outreach programs is necessary to educate the community regarding this preventable mechanism of injury. PMID:26594857

  20. Conversations with Holocaust survivor residents.

    PubMed

    Hirst, Sandra P; LeNavenec, Carole Lynne; Aldiabat, Khaldoun

    2011-03-01

    Traumatic events in one's younger years can have an impact on how an individual copes with later life. One traumatic experience for Jewish individuals was the Holocaust. Some of these people are moving into long-term care facilities. It was within this context that the research question emerged: What are Holocaust survivor residents' perceptions of a life lived as they move into a long-term care facility? For this qualitative study, Holocaust survivors were individually interviewed. Findings emphasize that nursing care needs to ensure that Holocaust survivor residents participate in activities, receive timely health care, and receive recognition of their life experiences. PMID:20795597

  1. Osteoporosis in survivors of early life starvation.

    PubMed

    Weisz, George M; Albury, William R

    2013-01-01

    The objective of this study was to provide evidence for the association of early life nutritional deprivation and adult osteoporosis, in order to suggest that a history of such deprivation may be an indicator of increased risk of osteoporosis in later life. The 'fetal programming' of a range of metabolic and cardiovascular disorders in adults was first proposed in the 1990s and more recently extended to disorders of bone metabolism. Localised famines during World War II left populations in whom the long-term effects of maternal, fetal and infantile nutritional deprivation were studied. These studies supported the original concept of 'fetal programming' but did not consider bone metabolism. The present paper offers clinical data from another cohort of World War II famine survivors - those from the Holocaust. The data presented here, specifically addressing the issue of osteoporosis, report on 11 Holocaust survivors in Australia (five females, six males) who were exposed to starvation in early life. The cases show, in addition to other metabolic disorders associated with early life starvation, various levels of osteoporosis, often with premature onset. The cohort studied is too small to support firm conclusions, but the evidence suggests that the risk of adult osteoporosis in both males and females is increased by severe starvation early in life - not just in the period from gestation to infancy but also in childhood and young adulthood. It is recommended that epidemiological research on this issue be undertaken, to assist planning for the future health needs of immigrants to Australia coming from famine affected backgrounds. Pending such research, it would be prudent for primary care health workers to be alert to the prima facie association between early life starvation and adult osteoporosis, and to take this factor into account along with other indicators when assessing a patient's risk of osteoporosis in later life. PMID:22951115

  2. Clinical review: The critical care management of the burn patient

    PubMed Central

    2013-01-01

    Between 4 and 22% of burn patients presenting to the emergency department are admitted to critical care. Burn injury is characterised by a hypermetabolic response with physiologic, catabolic and immune effects. Burn care has seen renewed interest in colloid resuscitation, a change in transfusion practice and the development of anti-catabolic therapies. A literature search was conducted with priority given to review articles, meta-analyses and well-designed large trials; paediatric studies were included where adult studies were lacking with the aim to review the advances in adult intensive care burn management and place them in the general context of day-to-day practical burn management. PMID:24093225

  3. Ageing Holocaust survivors in Australia.

    PubMed

    Paratz, Elizabeth D; Katz, Benny

    2011-02-21

    In recent years, a phenomenon of "late effects of the Holocaust" has emerged, with impacts on the psychological and physical health of ageing Holocaust survivors. As Holocaust survivors age, they may experience heightened anxiety around normal processes of ageing, worsened post-traumatic stress disorder with cognitive decline, and fear of the medical system. Holocaust survivors are at increased risk of osteoporosis, cardiometabolic disease due to hypothalamic-pituitary-adrenal axis dysfunction, cancer, and sequelae of Nazi medical experiments. From existing medical literature on this topic, practical principles of management are derived to create a framework for sensitive medical management of Holocaust survivors in Australia. The issues discussed are also relevant to the wider geriatric refugee or prisoner-of-war experience. PMID:21401461

  4. The Clinical and Research Infrastructure of a Childhood Cancer Survivor Program.

    PubMed

    Sadak, Karim Thomas; Bahr, Tori L; Moen, Catherine; Neglia, Joseph P; Jatoi, Aminah

    2015-09-01

    Increased knowledge and awareness of the long-term complications from childhood cancer has illuminated a clear need for healthcare delivery systems that address the specific needs of survivors. We report a descriptive framework of such a healthcare infrastructure within a single institution to provide education for other healthcare professionals developing a cancer survivorship program at their institution. This cross-sectional study described the structure and patient population of the Cancer Survivor Program (CSP) in the Department of Pediatrics at the University of Minnesota (UM). It relied on the UM Cancer Survivorship Database maintained by the Division of Pediatric Hematology/Oncology. Demographic and relevant survivorship information is summarized for survivors seen from August 1, 2003 to May 1, 2013. The study population included 504 survivors of childhood cancer with a mean age of 21.4 years (range 3-59 years). Most were non-Hispanic white (455/504, 90 %) and the mean interval between prior cancer diagnosis and entry into the CSP was 13.7 years (range 1-56 years). The breakdown of cancer diagnoses among survivors is reflective of the incidence of childhood malignancies in the general population with the exception of an under-representation of survivors with brain tumors. Nearly 25 % of survivors received their oncology treatment at an outside institution. With the appropriate healthcare infrastructure, a pediatric cancer survivorship program can meet the needs of a large survivor population, many of whom are adults and are seeking care from outside institutions. PMID:25099236

  5. Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors

    PubMed Central

    Kamen, Charles; Mustian, Karen M.; Dozier, Ann; Bowen, Deborah J.; Li, Yue

    2015-01-01

    Objective Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual and transgender (LGBT) and heterosexual adults. Studies have yet to examine disparities between LGBT and heterosexual cancer survivors in prevalence of psychological distress. Methods Data for the current study were drawn from the LIVESTRONG dataset, a US national survey that sampled 207 LGBT and 4899 heterosexual cancer survivors (all cancer types, 63.5% women, mean age 49) in 2010. Symptoms of psychological distress were assessed with dichotomous yes/no items in three symptom clusters (depression related to cancer, difficulties with social relationships post-cancer, fatigue/energy problems). We selected a sample of 621 heterosexual survivors matched by propensity score to the 207 LGBT survivors and assessed disparities in count of symptoms using Poisson regression. We also performed subgroup analyses by self-reported sex. Results Relative to heterosexuals, LGBT cancer survivors reported a higher number of depression and relationship difficulty symptoms. Exploratory analyses revealed that disparities in number of symptoms were visible between gay, bisexual, and transgender versus heterosexual men but not between lesbian, bisexual, and transgender versus heterosexual women. Conclusions This study highlights several disparities in psychological distress that exist between LGBT and heterosexual survivors. A need remains for interventions tailored to LGBT survivors and for studies examining disparities within subgroups of LGBT survivors. PMID:25630987

  6. Quality of life in female cancer survivors: Is it related to ovarian reserve?

    PubMed Central

    Kondapalli, Laxmi A.; Dillon, Katherine E.; Sammel, Mary D.; Ray, Anushree; Prewitt, Maureen; Ginsberg, Jill P.; Gracia, Clarisa R.

    2013-01-01

    Purpose To assess quality of life scores and possible association with measures of ovarian reserve in female cancer survivors compared to healthy controls of similar age. Methods In this prospective cohort study, fifty-nine cancer survivors aged 16–39 years and 66 healthy, similarly aged unexposed women were recruited at the University of Pennsylvania. The primary outcome measures are the generic and cancer-specific domain scores on the Quality of Life in Adult Cancer Survivors (QLACS) instruments, early follicular phase serum hormones (follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), inhibin B (INH), anti-Mullerian hormone (AMH) and ovarian ultrasound measurements (ovarian volume and antral follicle count [AFC]) Results Cancer survivors had significantly higher total and cancer-specific domain scores compared to unexposed participants. Serum AMH, INH, ovarian volume and AFC were lower while serum FSH was higher in cancer survivors. Although survivors exhibited diminished ovarian reserve, these markers were not independently associated with total QLACS score. Cancer survivors with irregular menstrual function were found to have lower QOL scores than those with regular cycles. Conclusions We found that QOL appears to be significantly impaired in cancer survivors compared to controls, even when remote from initial cancer diagnosis. In addition, our study suggests that reproductive aging contributes to QOL in the setting of irregular menses and likely profound impairment of ovarian function. PMID:23881516

  7. Ram Burn Observations (RAMBO)

    NASA Astrophysics Data System (ADS)

    2002-12-01

    Ram Burn Observations (RAMBO) is a Department of Defense experiment that observes shuttle Orbital Maneuvering System engine burns for the purpose of improving plume models. On STS-107 the appropriate sensors will observe selected rendezvous and orbit adjust burns.

  8. Burning Mouth Syndrome and "Burning Mouth Syndrome".

    PubMed

    Rifkind, Jacob Bernard

    2016-03-01

    Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome. PMID:27209717

  9. Risk of cancer among atomic bomb survivors.

    PubMed

    Shimizu, Y; Kato, H; Schull, W J

    1991-12-01

    This report describes the risk of cancer and in particular cancers other than leukemia among the survivors of the atomic bombing of Hiroshima and Nagasaki. Attention focuses primarily on the risk of death from cancer among individuals in the Life Span Study sample of the Radiation Effect Research Foundation in the period 1950-1985 based on the recently revised dosimetry, termed the DS86 doses. Mortality from malignant tumors is increased among A-bomb survivors as a late effect of A-bomb radiation. Besides the well-known increase of leukemia, there also has been demonstrated increase of cancer of the lung, breast, esophagus, stomach, colon, ovary, urinary bladder, thyroid, and of multiple myeloma, but no increase has yet been observed in mortality from cancer of the rectum, gallbladder, pancreas, prostate and uterus, and of malignant lymphoma. The pattern of appearance over time of radiation-induced cancer other than leukemia differs from that of leukemia. In general, radiation-induced solid cancer begins to appear after attaining the age at which the cancer is normally prone to develop (so-called cancer age), and continues to increase proportionately with the increase in mortality of the control group as it ages. Sensitivity to radiation, in terms of cancer induction, is higher for persons who were young at the time of the bomb (ATB) in general than for those who were older ATB. Furthermore, susceptibility to radiation-induced cancer tends to be higher in pre- than in post-natally exposed survivors (at least those exposed as adults). Other radiation effect modifiers and the shape of the dose response curve will also be discussed. PMID:1823367

  10. Making the Hurt Go Away: Psychological and Spiritual Healing for African American Women Survivors of Childhood Incest.

    ERIC Educational Resources Information Center

    Robinson, Tracy L.

    2000-01-01

    Discusses the psychological and spiritual healing for African American women survivors of childhood sexual abuse. Considers adult sexuality for these women. Includes implications for counselors and recommendations for their self-care. (Author/JDM)

  11. Transition guidelines: An important step in the future care for childhood cancer survivors. A comprehensive definition as groundwork.

    PubMed

    Mulder, R L; van der Pal, H J H; Levitt, G A; Skinner, R; Kremer, L C M; Brown, M C; Bárdi, E; Windsor, R; Michel, G; Frey, E

    2016-02-01

    Evidence-based clinical practice guidelines are essential to ensure that childhood cancer survivors at risk of chronic health conditions receive effective long-term follow-up care. However, adult survivors of childhood cancer are not always engaged in recommended health promotion and follow-up practices, as many centres do not have a formal transition programme that prepares survivors and their families for successful transfer from child-centred to adult-oriented healthcare. The need for a specific pan-European guideline for the transition of care for childhood cancer survivors has been recognised. The first step is to define the concept of transition of care for survivors of childhood cancer based on existing evidence. PMID:26735352

  12. Harvest for Health Gardening Intervention Feasibility Study in Cancer Survivors

    PubMed Central

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

    2013-01-01

    Background Cancer survivors are at increased risk for second malignancies, cardiovascular disease, diabetes, and functional decline. Evidence suggests that a healthful diet and physical activity may reduce the risk of chronic disease and improve health in this population. Methods We conducted a feasibility study to evaluate a vegetable gardening intervention that paired 12 adult and child cancer survivors with Master Gardeners to explore effects on fruit and vegetable intake, physical activity, quality-of-life, and physical function. Throughout the year-long study period, the survivor-Master Gardener dyads worked together to plan/plant 3 gardens, harvest/rotate plantings, and troubleshoot/correct problems. Data on diet, physical activity, and quality-of-life were collected via surveys; anthropometrics and physical function were objectively measured. Acceptability of the intervention was assessed with a structured debriefing survey. Results The gardening intervention was feasible (robust enrollment; minimal attrition) and well-received by cancer survivors and Master Gardeners. Improvement in 3 of 4 objective measures of strength, agility, and endurance was observed in 90% of survivors, with the following change scores (median [interquartile range]) noted between baseline and 1-year follow-up: hand grip test (+4.8 [3.0, 6.7] kg), 8 foot Get-Up-and-Go (−1.0 [−1.8, −0.2] seconds), 30-second chair stand (+3.0 [−1.0, 5.0] stands), and 6-minute walk (+38 [20, 160] feet). Increases of ≥1 fruit and vegetable serving/ day and ≥30 minutes/week of physical activity were observed in 40% and 60%, respectively. Conclusion These preliminary results support the feasibility and acceptability of a mentored gardening intervention and suggest that it may offer a novel and promising strategy to improve fruit and vegetable consumption, physical activity, and physical function in cancer survivors. A larger randomized controlled trial is needed to confirm our results. PMID

  13. A-bomb survivors: reassessment of the radiation hazard.

    PubMed

    Stewart, A M; Kneale, G W

    1999-01-01

    Newly released data from the Radiation Effects Research Foundation on the survivors of the Hiroshima and Nagasaki A-bombing allow a reassessment of radiation hazards. It appears that deaths from marrow damage (such as aplastic anaemia) continued after 1950. The Life Span Study cohort appears biased in favour of persons with high immunological competence, the result of infants and the elderly being more likely to die before 1950 than young adults. A study of survivors of in utero exposures suggests that embryos are more sensitive to the lethal effects of radiation than more mature foetuses. Current estimates of cancer risks from radiation may only apply to young adults with high immunological competence; young children and the elderly may be at greater risk. PMID:10218002

  14. Burns in diabetic patients

    PubMed Central

    Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

    2008-01-01

    CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical analysis software SPSS 10.05. Differences between the two groups were evaluated using Student's t-test and the chi square test. P < 0.05 was considered as significant. RESULTS: The major mechanism of injury for the diabetic patients was scalding and flame burns, as was also the case in the nondiabetic burn patients. The diabetic burn patients were significantly older, with a lower percentage of total burn surface area (TBSA) than the nondiabetic burn population. There was significant difference between the diabetic and nondiabetic patients in terms of frequency of infection. No difference in mortality rate between diabetic and nondiabetic burn patients was observed. The most common organism in diabetic and nondiabetic burn patients was methicillin-resistant staphylococcus. Increasing %TBSA burn and the presence of inhalation injury are significantly associated with increased mortality following burn injury. CONCLUSIONS: Diabetics have a higher propensity for infection. Education for diabetic patients must include caution about potential burn mishaps and the complications that may ensue from burns. PMID:19902035

  15. Epidemiology of hospitalized burns patients in Taiwan.

    PubMed

    Chien, Wu-Chien; Pai, Lu; Lin, Chao-Cheng; Chen, Heng-Chang

    2003-09-01

    Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children. PMID:12927984

  16. Secondary cancer in a survivor of Hodgkin’s lymphoma: A case report and review of the literature

    PubMed Central

    LISIK-HABIB, MAJA; CZERNEK, URSZULA; DĘBSKA-SZMICH, SYLWIA; KRAKOWSKA, MAGDALENA; KUBICKA-WOŁKOWSKA, JOANNA; POTEMSKI, PIOTR

    2015-01-01

    Hodgkin’s lymphoma (HL) is one of the most curable malignant diseases in adults. However, HL patients have a higher risk of developing second malignancies compared with the general population. The population of adult cancer survivors is growing, thus, the long-term effects of cancer treatment, including secondary cancer development, have become an increasingly important concern in the field of oncology. The current study presents the case of a female HL survivor who developed two secondary malignancies within 29 years of follow-up. Furthermore, a review of the literature was conducted, which focused on secondary breast and gastrointestinal cancers in HL survivors. PMID:25621073

  17. Neurocognitive Status in Long-Term Survivors of Childhood CNS Malignancies: A Report from the Childhood Cancer Survivor Study

    PubMed Central

    Ellenberg, Leah; Liu, Qi; Gioia, Gerard; Yasui, Yutaka; Packer, Roger J.; Mertens, Ann; Donaldson, Sarah S.; Stovall, Marilyn; Kadan-Lottick, Nina; Armstrong, Gregory; Robison, Leslie L.; Zeltzer, Lonnie K.

    2009-01-01

    irradiation, with smaller effect sizes (.49 and .43, respectively). Ventriculoperitoneal (VP) shunt placement was associated with small deficits on the same scales (Effect sizes: Task Efficiency .26, Memory .32). Female gender predicted a greater likelihood of impaired scores on 2 scales, with small effect sizes (Task Efficiency .38, Emotional Regulation .45), while diagnosis before age 2 years resulted in less likelihood of reported impairment on the Memory factor with a moderate effect size (.64). CNS malignancy survivors with more impaired CCSS-NCQ scores demonstrated significantly lower educational attainment (p<.01), less household income (p<.001) and less full time employment (p<.001). Conclusions Survivors of childhood CNS malignancy are at significant risk for impairment in neurocognitive functioning in adulthood, particularly if they have received cranial radiation, had a VP shunt placed, suffered a cerebrovascular incident or are left with hearing or motor impairments. Reported neurocognitive impairment adversely affected important adult outcomes, including education, employment, income and marital status. PMID:19899829

  18. Assessing risks to adults and preschool children posed by PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) during a biomass burning episode in Northern Thailand.

    PubMed

    Pongpiachan, Siwatt; Tipmanee, Danai; Khumsup, Chukkapong; Kittikoon, Itthipon; Hirunyatrakul, Phoosak

    2015-03-01

    To investigate the potential cancer risk resulting from biomass burning, polycyclic aromatic hydrocarbons (PAHs) bound to fine particles (PM2.5) were assessed in nine administrative northern provinces (NNP) of Thailand, before (N-I) and after (N-II) a haze episode. The average values of Σ 3,4-ring PAHs and B[a] P Equivalent concentrations in world urban cities were significantly (p<0.05) much higher than those in samples collected from northern provinces during both sampling periods. Application of diagnostic binary ratios of PAHs underlined the predominant contribution of vehicular exhaust to PM2.5-bound PAH levels in NNP areas, even in the middle of the agricultural waste burning period. The proximity of N-I and N-II values in three-dimensional (3D) principal component analysis (PCA) plots also supports this conclusion. Although the excess cancer risk in NNP areas is much lower than those of other urban area and industrialized cities, there are nevertheless some concerns relating to adverse health impacts on preschool children due to non-dietary exposure to PAHs in home environments. PMID:25506906

  19. Possible risk factors associated with burn wound colonization in burn units of Gaza strip hospitals, Palestine.

    PubMed

    Al Laham, N A; Elmanama, A A; Tayh, G A

    2013-06-30

    The epidemiological pattern and risk factors of burns and burn infections varies widely in different parts of the world. This study aims to determine the epidemiologic pattern of burn injuries and possible risk factors associated with burn infections in burn units of Gaza strip hospitals. A total of 118 patients were included in the study. The data collected included: patient age and gender, the causes, site, degree, and TBSA of the burns, as well as surgical operations, length of hospital stay, and microbiological profile of samples collected from patients, the environment, and from health care staff. Pediatric and adult patients accounted for 72% and 28% respectively. 58.5% of all patients were male and 41.5% were female. The most common etiological factors in children were scalding, while in adults these were open fire and flammable liquids. The mean TBSA was 12% with a range from 1-90%. Second and third degree burns accounted for 78% and 22% respectively. The area of the body most often affected was the torso (39%), followed by the lower limb (29.7%), and upper limb (17.8%). The predominant microorganisms isolated from burn wounds were Pseudomonas aeruginosa, Enterobacter spp. and Staphylococcus spp. The study showed the highest risk groups to be children and males, and enabled us to identify possible risk factors that can help in future efforts toward prevention and minimizing nosocomial infections in burn units of Gaza strip hospitals. PMID:24133399

  20. An idiosyncratic history of burn scars.

    PubMed

    Petro, Jane A

    2015-03-01

    The history of burn scars can best be found in military medical history. The care of wounded soldiers documented in the Illiad reflected the trauma of the weapons of war, arrow, spear, sword, and ax. The introduction of gunpowder in the 14th century, increasingly sophisticated explosives, and in modern times, petroleum-driven vehicles, including airplanes, created a new subset of wounds requiring attention and post-survival scars challenging the quality of survival. This article selects from among a myriad of examples of modern military treatments as they relate to those survivors. Larrey, with Napolean's Grand Army, Sir Harold Gilles during and following World War I, and the Boston area preparation and response to the Cocoanut Grove Fire in 1942 are the principle topics examined. Recent modern interventions, related to the survival of horrific blast and burn injuries, with modern wound care and scar manipulation techniques provide context to the current ability to modify healing and scars. PMID:25922950

  1. Stroke Survivors Often Struggle with Depression

    MedlinePlus

    ... fullstory_160835.html Stroke Survivors Often Struggle With Depression Risk was 8 times higher for those who ... Stroke survivors face an increased risk of developing depression, a new study suggests. In the first three ...

  2. Why Breast Cancer Survivors Should Exercise

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_159781.html Why Breast Cancer Survivors Should Exercise Moderate physical activity can ease ... Excessive stress can lead to memory problems among breast cancer survivors, but exercise can help, according to new ...

  3. 32 CFR 716.4 - Eligible survivors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., should not be made. (c) Death of survivor prior to receipt of gratuity. (1) If a survivor dies before... by a member, pursuant to paragraph (a)(3) of this section, to receive death gratuity payment...

  4. Atrophic vaginitis in breast cancer survivors: a difficult survivorship issue.

    PubMed

    Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

    2015-01-01

    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. PMID:25815692

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

    PubMed Central

    Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

    2015-01-01

    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. PMID:25815692

  6. Fatal rhabdomyolysis in a flame burn patient.

    PubMed

    Lazarus, D; Hudson, D A

    1997-08-01

    Rhabdomyolysis due to flame burns is not well described. A case of fatal rhabdomyolysis in an epileptic patient who sustained 65 per cent body surface area, very deep, flame burns is described. It appears as if the sustained muscle compression from the restrictive, circumferential eschar was the major factor in the aetiology of the rhabdomyolysis. Despite aggressive fluid management, the patient died of acute renal failure and adult respiratory distress syndrome. We have subsequently identified three other cases of pigmenturia occurring following burns. It would seem as if rhabdomyolysis following extensive full thickness burns may be more common than previously suggested. Fluid requirements are in excess of those proposed by traditional protocols. Rhabdomyolysis in flame burn patients indicates a poor prognosis. PMID:9426917

  7. Pathophysiology of burns.

    PubMed

    Keck, Maike; Herndon, David H; Kamolz, Lars P; Frey, Manfred; Jeschke, Marc G

    2009-01-01

    Burn injury represents a significant problem worldwide. Advances in therapy strategies, based on better understanding of the pathophysiologic responses after burn injury have improved the clinical outcome of patients with burn injuries over the past years. This article describes the present understanding of the pathophysiology of a burn injury including both the local and systemic responses, focusing on the many facets of organ and systemic effects directly resulting from hypovolemia and circulating mediators following burn trauma. PMID:19652939

  8. Rape as an Economic Crime: The Impact of Sexual Violence on Survivors' Employment and Economic Well-Being.

    PubMed

    Loya, Rebecca M

    2015-10-01

    This article examines how isolated instances of sexual violence affect adult female survivors' employment and economic well-being. This study draws on data from 27 in-depth, qualitative interviews with sexual assault survivors and rape crisis service providers. The findings suggest that sexual assault and the related trauma response can disrupt survivors' employment in several ways, including time off, diminished performance, job loss, and inability to work. By disrupting income or reducing earning power, all of these employment consequences have implications for survivors' economic well-being in the months or years following the assault. In addition, I argue that for many survivors, these employment consequences compound one another and ultimately shift survivors' long-term economic trajectories. By highlighting survivors' lived experiences of the financial aftermath of sexual assault, these findings help to illuminate the processes by which sexual violence decreases survivors' income over the life course. Understanding the financial effects of sexual violence can help researchers better understand and predict the recovery process, while helping practitioners to design more effective interventions for survivors. PMID:25381269

  9. Social outcomes in the Childhood Cancer Survivor Study cohort.

    PubMed

    Gurney, James G; Krull, Kevin R; Kadan-Lottick, Nina; Nicholson, H Stacy; Nathan, Paul C; Zebrack, Brad; Tersak, Jean M; Ness, Kirsten K

    2009-05-10

    Difficulties with negotiating and achieving desired social outcomes in life may be exacerbated by the experience of childhood cancer, including adverse effects from therapies used to achieve a cure. This review of previous publications from the Childhood Cancer Survivor Study (CCSS) and other relevant literature provides insight into the prevalence of, and risk factors for, poor educational attainment, less than optimal employment status, and interpersonal relationship issues among long-term survivors of childhood cancer. The impacts of emotional health and physical disability on social outcomes are also examined. Study results suggest that childhood cancer survivors generally have similar high school graduation rates, but are more likely to require special education services than sibling comparison groups. Survivors are slightly less likely than expected to attend college, and are more likely to be unemployed and not married as young adults. Cancers and treatments that result in impairment to the CNS, particularly brain tumors, or that impact sensory functioning, such as hearing loss, are associated with greater risk for undesirable social outcomes, as are emotional health problems and physical disability. This review of relevant data from CCSS and other studies provides information on risk factors for social problems into adulthood. A greater understanding of the long-term social impacts from the diagnosis and treatment of childhood cancer is critically important for developing targeted interventions to prevent or ameliorate adverse psychosocial effects. PMID:19224833

  10. Cancer survivorship and identity among long-term survivors.

    PubMed

    Deimling, Gary T; Bowman, Karen F; Wagner, Louis J

    2007-12-01

    This article examines the concept of survivorship and the adoption of the "survivor identity" by those who have been treated for cancer. First, we review recent and growing theoretical and empirical literatures on cancer and identity and identity transformation. With that review as background, we present our own research findings from 2 separate studies on survivorship and identity. Our data suggest that most older adults who have survived cancer for at least 5 years, identify as cancer survivors and/or as ex-patients rather than as victims or patients. Most also view being a survivor as an important part of who they are, do not see themselves as less whole, and are not overly concerned about how others view them. To the degree that a survivor orientation is associated with better mental health outcomes and encourages health promotion and appropriate symptom monitoring, it can reinforce the effects of the quality medical care provided by clinical staff. The support of clinicians encouraging this orientation, where it is appropriate, may further enhance the quality of life of individuals who living with a history of cancer. PMID:17952742

  11. 5 CFR 850.202 - Survivor elections.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Survivor elections. 850.202 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Applications for Benefits; Elections § 850.202 Survivor elections. (a) A survivor election under subsection (j) or (k) of section 8339, or under section 8416,...

  12. 5 CFR 850.202 - Survivor elections.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Survivor elections. 850.202 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Applications for Benefits; Elections § 850.202 Survivor elections. (a) A survivor election under subsection (j) or (k) of section 8339, or under section 8416,...

  13. 5 CFR 850.202 - Survivor elections.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Survivor elections. 850.202 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Applications for Benefits; Elections § 850.202 Survivor elections. (a) A survivor election under subsection (j) or (k) of section 8339, or under section 8416,...

  14. 5 CFR 850.202 - Survivor elections.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Survivor elections. 850.202 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Applications for Benefits; Elections § 850.202 Survivor elections. (a) A survivor election under subsection (j) or (k) of section 8339, or under section 8416,...

  15. Internet Use and Breast Cancer Survivors

    ERIC Educational Resources Information Center

    Muhamad, Mazanah; Afshari, Mojgan; Mohamed, Nor Aini

    2011-01-01

    A survey was administered to 400 breast cancer survivors at hospitals and support group meetings in Peninsular Malaysia to explore their level of Internet use and factors related to the Internet use by breast cancer survivors. Findings of this study indicated that about 22.5% of breast cancer survivors used Internet to get information about breast…

  16. Survivors' Reactions: Suicide vs. Other Causes.

    ERIC Educational Resources Information Center

    McIntosh, John L.; Kelly, Leah D.

    The literature on suicide survivors suggests that suicide grief is different than the grief associated with survivorship from other causes. The few studies that have compared groups of survivors from other causes, however, have often not observed as many differences as expected based on the suicide survivors literature. In this study, 230 college…

  17. Association of health beliefs and colonoscopy use among survivors of colorectal cancer

    PubMed Central

    Salz, Talya; Brewer, Noel T.; Sandler, Robert S.; Weiner, Bryan J.; Martin, Christopher F.; Weinberger, Morris

    2009-01-01

    Objectives Clinical practice guidelines recommend ongoing testing (surveillance) for colorectal cancer survivors because they remain at risk for both local recurrences and second primary tumors. However, survivors often do not receive colorectal cancer surveillance. We used the Health Belief Model (HBM) to identify health beliefs that predict intentions to obtain routine colonoscopies among colorectal cancer survivors. Methods We completed telephone interviews with 277 colorectal cancer survivors who were diagnosed four years earlier, between 2003 and 2005, in North Carolina. The interview measured health beliefs, past preventive behaviors, and intentions to have a routine colonoscopy in the next five years. Results In bivariate analyses, most HBM constructs were associated with intentions. In multivariable analyses, greater perceived likelihood of colorectal cancer (OR=2.00, 95% CI=1.16–3.44) was associated with greater intention to have a colonoscopy. Survivors who already had a colonoscopy since diagnosis also had greater intentions of having a colonoscopy in the future (OR=9.47, 95% CI=2.08–43.16). Conclusions Perceived likelihood of colorectal cancer is an important target for further study and intervention to increase colorectal cancer surveillance among survivors. Other health beliefs were unrelated to intentions, suggesting that the health beliefs of colorectal cancer survivors and asymptomatic adults may differ due to the experience of cancer. PMID:19760152

  18. Exploring resiliency factors of older African American Katrina survivors.

    PubMed

    Thomas, Cecilia L

    2012-01-01

    Through this qualitative study the author explores the resiliency processes demonstrated by older African American Hurricane Katrina survivors who relocated in the aftermath of the storm and were consequently faced with difficult challenges. In-depth interviews were used to assess the multidimensional characteristics of resiliency that enabled these older adults to deal with adversity. These findings highlight distinct processes reflecting resiliency: (a) Trusting in a higher power, and the importance of (b) living in the present, (c) activating resources, (d) creating community, and (e) doing for others. The author concludes this study with suggestions on how these findings may inform social work practice with older adults. PMID:22830937

  19. Burn injuries in eastern Zambia: impact of multidisciplinary teaching teams.

    PubMed

    Edwards, Dianna; Heard, Jason; Latenser, Barbara A; Quinn, Keely Y; van Bruggen, Jaap; Jovic, Goran

    2011-01-01

    The American Burn Association/Children's Burn Foundation (ABA/CBF) sponsors teams who offer burn education to healthcare providers in Zambia, a sub-Saharan country. The goals of this study are 1) to acquire burn-patient demographics for the Eastern Province, Zambia and 2) to assess the early impact of the ABA/CBF-sponsored burn teams. This is a retrospective chart review of burn patients admitted in one mission hospital in Katete, Zambia, July 2002 to June 2009. July 2002 to December 2006 = data before ABA/CBF burn teams and January 2007 to June 2009 = burn care data during/after burn outreach. There were 510 burn patients hospitalized, male:female ratio 1.2:1. Average age = 15.6 years, with 44% younger than 5 years. Average TBSA burned = 11% and mean fatal TBSA = 25%. Average hospital length of stay = 16.9 days survivors and 11.6 days nonsurvivors. Most common mechanisms of burn injuries: flame (52%) and scald (41%). Ninety-two patients (18%) died and 23 (4.5%) left against medical advice. There were 191 (37.4%) patients who underwent 410 surgical procedures (range 1-13/patient). There were 138 (33.7%) sloughectomies, 118 (28.7%) skin grafts, 39 (9.5%) amputations, and 115 (28.1%) other procedures. Changes noted in the 2007 to 2009 time period: more patients had burn diagrams (48.6 vs 27.6%, P < .001), received analgesics (91 vs 84%, P = .05), resuscitation fluid (56 vs 49%, P = not significant [NS]), topical antimicrobials (40 vs 37%, P = NS), underwent skin grafting (35.5 vs 25.1%, P = NS), and underwent any operative intervention (40.6 vs 35.2%, P = NS), compared with patients treated between 2002 and 2006. This study represents the largest, most comprehensive burn data set for a sub-Saharan region in Africa. There has been a statistically significant improvement in documentation of burn size as well as administration of analgesics, validating the efficacy of the ABA/CBF-sponsored burn teams. Continued contact with burn teams may lead to increased use of

  20. Clinical forensic evidence in burns: rescuer burns.

    PubMed

    Kumar, Pramod; Gopal, Kirun; Ramnani, Sunil

    2006-12-01

    In the literature no systematic study is available on rescuer burn for victims of burn injury. This is a retrospective study of nine patients (five admitted and four outpatients) were treated in this hospital as rescuer burns in 3.5 years. All nine patients were males. Average age of the patient treated on outpatient basis was 47 years (ranging between 44 and 52) and total burn area ranged for 1-4%. Average age of the five patients treated on inpatient basis was 32.6 years (ranging between 30 and 34). The total burn area ranged from 14.5 to 38%. During the period of study, in addition to nine rescuer burns, one patient sustained burn before the rescue attempt due to the victim hugging the rescuer. Based on the study of patterns of burn, these patients were found to have three grades of burn injury: Grade 1--upper extremity involvement only. (A) only one upper extremity involvement, (B) both upper extremities involvement, Grade 2--upper extremity/extremities and face involvement, Grade 3--upper extremity/extremities, face-neck, adjacent chest and lower extremity involvement. PMID:17011132

  1. "Put on your face to face the world": women's narratives of burn injury.

    PubMed

    Hunter, Tevya A; Medved, Maria I; Hiebert-Murphy, Diane; Brockmeier, Jens; Sareen, Jitender; Thakrar, Sulaye; Logsetty, Sarvesh

    2013-12-01

    The survival rate of individuals with burn injury has significantly increased due to medical advances in burn care. This has led to a need to focus on psychological aspects of burn injury recovery, particularly on how people come to terms with their changed bodies. The literature suggests that burn size and severity are not directly associated with the degree of distress but that subjective perceptions and interpretations - of, for instance, body image - are pertinent. Body image appears to be particularly important for women and thus, in this study, we investigated women's experiences of their bodies following mild to moderate burns. We conducted in-depth interviews with 10 female burn survivors in the first year after injury, using methods of narrative analysis for the investigations of the transcripts. Thirteen consecutive women who met inclusion criterion were approached at regional burn care follow-up clinic. In their narratives, the women predominantly emphasized how well they were doing; however, counter-narratives emerged indicating dissatisfaction and distress. The tension between these two different kinds of narratives suggests an ambivalent relationship with the burn injury. We concluded that it is imperative for health care professionals to be cognizant of these conflicting experiences in order to adequately address burn survivors' needs in rehabilitation. PMID:23768714

  2. Work potential of road accident survivors with post-traumatic stress disorder.

    PubMed

    Matthews, Lynda R

    2005-04-01

    Work potential in adult survivors of road accidents with and without post-traumatic stress disorder (PTSD) was examined at a mean of 8.6 months (SD = 3.77) post-accident. All participants were working prior to their accident. Results showed that survivors with PTSD had significantly less work potential post-accident than survivors without PTSD. Specific barriers to employability for survivors with PTSD identified by this study included high levels of depression, reduced time-management ability, and an over-concern or anxiety with physical injuries. Respondents with PTSD, however, reported significantly greater extrinsic motivation to work than those without PTSD. Early intervention and referral to occupational rehabilitation programs that: (1) help address these barriers to employability and stimulate the existing motivation to return to work, and (2) work alongside clinical treatment programs, may assist in the reduction of poor work outcomes that people with PTSD following road accidents often experience. PMID:15701358

  3. Recommended Screening and Preventive Practices for Long-term Survivors after Hematopoietic Cell Transplantation

    PubMed Central

    Majhail, Navneet S; Rizzo, J Douglas; Lee, Stephanie J; Aljurf, Mahmoud; Atsuta, Yoshiko; Bonfim, Carmem; Burns, Linda J; Chaudhri, Naeem; Davies, Stella; Okamoto, Shinichiro; Seber, Adriana; Socie, Gerard; Szer, Jeff; Lint, Maria Teresa Van; Wingard, John R; Tichelli, Andre

    2011-01-01

    Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, peri- and post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT. PMID:22178693

  4. Health promotion for adolescent childhood leukemia survivors: building on prevention science and ehealth.

    PubMed

    Elliot, Diane L; Lindemulder, Susan J; Goldberg, Linn; Stadler, Diane D; Smith, Jennifer

    2013-06-01

    Teenage survivors of childhood acute lymphoblastic leukemia (ALL) have increased morbidity likely due to their prior multicomponent treatment. Habits established in adolescence can impact individuals' subsequent adult behaviors. Accordingly, healthy lifestyles, avoiding harmful actions, and appropriate disease surveillance are of heightened importance among teenage survivors. We review the findings from prevention science and their relevance to heath promotion. The capabilities and current uses of eHealth components including e-learning, serious video games, exergaming, behavior tracking, individual messaging, and social networking are briefly presented. The health promotion needs of adolescent survivors are aligned with those eHealth aspects to propose a new paradigm to enhance the wellbeing of adolescent ALL survivors. PMID:23109253

  5. Health Promotion for Adolescent Childhood Leukemia Survivors: Building on Prevention Science and eHealth

    PubMed Central

    Elliot, Diane L.; Lindemulder, Susan J.; Goldberg, Linn; Stadler, Diane D.; Smith, Jennifer

    2014-01-01

    Teenage survivors of childhood acute lymphoblastic leukemia (ALL) have increased morbidity likely due to their prior multicomponent treatment. Habits established in adolescence can impact individuals’ subsequent adult behaviors. Accordingly, healthy lifestyles, avoiding harmful actions, and appropriate disease surveillance are of heightened importance among teenage survivors. We review the findings from prevention science and their relevance to heath promotion. The capabilities and current uses of eHealth components including e-learning, serious video games, exergaming, behavior tracking, individual messaging, and social networking are briefly presented. The health promotion needs of adolescent survivors are aligned with those eHealth aspects to propose a new paradigm to enhance the wellbeing of adolescent ALL survivors. PMID:23109253

  6. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation

    PubMed Central

    Majhail, Navneet Singh; Rizzo, James Douglas; Lee, Stephanie Joi; Aljurf, Mahmoud; Atsuta, Yoshiko; Bonfim, Carmem; Burns, Linda Jean; Chaudhri, Naeem; Davies, Stella; Okamoto, Shinichiro; Seber, Adriana; Socie, Gerard; Szer, Jeff; Lint, Maria Teresa Van; Wingard, John Reid; Tichelli, Andre

    2012-01-01

    Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, periand post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT. PMID:23049402

  7. Recommended Screening and Preventive Practices for Long-term Survivors after Hematopoietic Cell Transplantation

    PubMed Central

    Majhail, Navneet S; Rizzo, J Douglas; Lee, Stephanie J; Aljurf, Mahmoud; Atsuta, Yoshiko; Bonfim, Carmem; Burns, Linda J; Chaudhri, Naeem; Davies, Stella; Okamoto, Shinichiro; Seber, Adriana; Socie, Gerard; Szer, Jeff; Lint, Maria Teresa Van; Wingard, John R; Tichelli, Andre

    2011-01-01

    Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, peri- and post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT. PMID:22446607

  8. Recommended Screening and Preventive Practices for Long-term Survivors after Hematopoietic Cell Transplantation

    PubMed Central

    Majhail, Navneet S; Rizzo, J Douglas; Lee, Stephanie J; Aljurf, Mahmoud; Atsuta, Yoshiko; Bonfim, Carmem; Burns, Linda J; Chaudhri, Naeem; Davies, Stella; Okamoto, Shinichiro; Seber, Adriana; Socie, Gerard; Szer, Jeff; Lint, Maria Teresa Van; Wingard, John R; Tichelli, Andre

    2012-01-01

    Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, peri- and post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT. PMID:22395764

  9. Mathematical phantoms for use in reassessment of radiation doses to Japanese atomic-bomb survivors

    SciTech Connect

    Cristy, M.

    1985-07-01

    In 1972 committees of the United Nations and the US National Academy of Sciencs emphasized the need for organ dose estimates on the Japanese atomic-bomb survivors. These estimates were then supplied by workers in Japan and the US, and they were used with the so-called T65D estimates of a survivor's radiation exposure to assess risk from radiation. Recently the T65D estimates have been questioned, and programs for reassessment of atomic-bomb radiation dosimetry have been started in Japan and the US. As a part of this new effort a mathematical analogue of the human body (or ''mathematical phantom''), to be used in estimating organ doses in adult survivors, is presented here. Recommendations on organ dosimetry for juvenile survivors are also presented and discussed. 57 refs., 10 figs., 6 tabs.

  10. Health Behaviors of Childhood Cancer Survivors

    PubMed Central

    Ford, Jennifer S.; Barnett, Marie; Werk, Rachel

    2014-01-01

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

  11. Adult Perspectives on Growing Up Following Uxoricide

    ERIC Educational Resources Information Center

    Steeves, Richard H.; Parker, Barbara

    2007-01-01

    The purpose of this article is to provide an overview of the state of the science on uxoricide, including qualitative findings on 47 survivors. Two qualitative interviews were conducted between January 2004 and January 2005 with 47 convenience sample adult survivors of uxoricide. Data were analyzed using hermeneutic analysis. A number of themes…

  12. Nursing Postvention for Suicide Survivors.

    ERIC Educational Resources Information Center

    Constantino, Rose Eva Bana

    Survivors of suicide are invaded by an unhealthy complex of disturbing emotions resulting in depression, psychological distress, grief, social isolation, and even suicide. This study examined the bereavement patterns of widows whose husbands had died from various causes including cancer, heart disease, and suicide. Subjects (N=117) were randomly…

  13. Burning and Burnout.

    ERIC Educational Resources Information Center

    Christensen, Jane

    1981-01-01

    Examines the extended metaphor of "burnout" as it applies to the teaching profession. Examines three ancient Celtic invocations for the better tending of fires, which reveal ways that teachers can burn with enthusiasm without burning out from apathy. (RL)

  14. Burning Rate Emulator

    NASA Video Gallery

    The Burning Rate Emulator is a gas fuel investigation attempting to emulate the burning of solids to improve our understanding of materials''flammability over a wide range of conditions. The approa...

  15. Burns and Fire Safety

    MedlinePlus

    ... common among older children. 5 6 7 8 • Tap water burns most often occur in the bathroom and ... Feldman KW, Schaller RT, Feldman JA, McMillon M. Tap water scald burns in children. Pediatrics. 1978; 62(1): ...

  16. First Aid: Burns

    MedlinePlus

    ... You can get burned by heat, fire, radiation, sunlight, electricity, chemicals or hot or boiling water. There ... skin. The burned area will be sensitive to sunlight for up to one year, so you should ...

  17. Clinical Guidelines for the Care of Childhood Cancer Survivors

    PubMed Central

    Tonorezos, Emily S.; Henderson, Tara O.

    2014-01-01

    The Long-Term Follow-Up Guidelines for survivors of childhood, adolescent, and young adult cancers are evidence- and consensus-based guidelines that have been developed and published by the Children’s Oncology Group (COG) Late Effects Committee, Nursing Discipline, and the Patient Advocacy Committee. Originally published in 2004, the guidelines are currently in version 3.0. While the COG guidelines have been praised as a model for providing risk-based survivorship care, adherence has not been uniform. Reasons for this gap include unawareness on the part of the survivor and/or care team as well as disagreement about the individual recommendations. In some cases, the burden of testing (such as annual echocardiography or repeat pulmonary function testing) may be too great. A small number of intervention studies have documented improved adherence to guideline recommendations with dissemination of informational material. Future studies should focus on individualizing screening recommendations, as well as identifying unnecessary testing.

  18. Burn-injured adolescents report gaining multiple developmental benefits and improved life skills as a result of burn camp attendance.

    PubMed

    Rimmer, Ruth Brubaker; Pressman, Melissa S; Takach, Oliver P; Bay, R Curtis; Croteau, Renee; Hansen, Linda D; Foster, Kevin N; Caruso, Daniel M

    2012-01-01

    Anecdotally, burn camp has been reported to be a positive developmental and rehabilitative experience for attendees; there is little empirical data to support this belief. This study sought to explore whether burn camp either directly or indirectly elicits positive development outcomes in pediatric burn survivors or increases their psychosocial well-being and achievement. The Youth Experience Survey 2.0, a 66-item self-report inventory designed to measure developmental experiences in an organized youth activity, was administered to children aged 11 to 18 years attending summer burn camp. One hundred and ten burn-injured youth, 58 male and 52 female, reported that burn camp had positively impacted their lives through improved identity exploration, goal-setting and problem-solving abilities, increased physical activity, communication, emotional regulation, and time management skills (P < .0001). Participants reported more positive experiences than the norm group and higher mean scores on 90% (48) of the 53 positive items. Attendance at burn camp for more than 5 years resulted in greater improvement. Study results support the burn camp experience as a far-reaching and positive developmental activity. Participants credited the camp experience with helping them with identity formation and reflection, improved social interactions, and increased initiative; all positive developmental outcomes for youth. Results suggest that burn camp participation not only helps burn-injured youth to deal with their burns but also assists them in the development of social and basic life skills, which will allow them to navigate the transition from youth to adulthood, more effectively and successfully. PMID:22210080

  19. Economics of pediatric burns.

    PubMed

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures. PMID:18650705

  20. First Aid: Burns

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Text Size Scald ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  1. California Burn Scars

    Atmospheric Science Data Center

    2014-05-15

    article title:  Burn Scars Across Southern California     ... California between October 21 and November 18, 2003. Burn scars and vegetation changes wrought by the fires are illustrated in these ... Nov 18, 2003 Images:  California Burn Scars location:  United States region:  ...

  2. A Population-Based, Nationwide Cross-Sectional Study on Influenza Vaccination Status among Cancer Survivors in Korea

    PubMed Central

    Oh, Myeung Guen; Han, Mi Ah; Yun, Na-Ra; Park, Jong; Ryu, So Yeon; Kim, Dong-Min; Choi, Seong-Woo

    2015-01-01

    Cancer survivors are at increased risk of developing influenza-related complications. The purpose of this study was to investigate the vaccination coverage among cancer survivors in Korea using the Korea National Health and Nutrition Examination Survey (KNHANES). Adult cancer survivors were selected from fourth (2007–2009) and fifth (2010–2012) KNHANES (n = 1156) datasets. General characteristics, cancer-related data, and influenza vaccination status were collected using self-report questionnaires. Chi-square tests and multiple logistic regression analyses were performed to investigate the association between influenza vaccination coverage and associated factors. Overall, 51% of survivors were vaccinated. Vaccine prevalence exceeded 75% in those more than 65 years but was only 26% in survivors aged 19–44. Increasing age, low frequency of alcohol consumption, having poor self-rated health, and having a shorter duration since cancer diagnosis were significant predictors of vaccination status among cancer survivors under 65 years of age. Influenza vaccine coverage remains much lower than recommended among cancer survivors, particularly in the younger age groups. Further study is needed to determine the factors that contribute to the lack of vaccination in cancer survivors, despite their increased risk for influenza. PMID:26308031

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

    ERIC Educational Resources Information Center

    Reed, Mark D.; Greenwald, Jason Y.

    1991-01-01

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

  4. Determination of burn patient outcome by large-scale quantitative discovery proteomics

    PubMed Central

    Finnerty, Celeste C.; Jeschke, Marc G.; Qian, Wei-Jun; Kaushal, Amit; Xiao, Wenzhong; Liu, Tao; Gritsenko, Marina A.; Moore, Ronald J.; Camp, David G.; Moldawer, Lyle L.; Elson, Constance; Schoenfeld, David; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Arnoldo, Brett; Remick, Daniel; Smith, Richard D.; Davis, Ronald; Tompkins, Ronald G.; Herndon, David N.

    2013-01-01

    Objective Emerging proteomics techniques can be used to establish proteomic outcome signatures and to identify candidate biomarkers for survival following traumatic injury. We applied high-resolution liquid chromatography-mass spectrometry (LC-MS) and multiplex cytokine analysis to profile the plasma proteome of survivors and non-survivors of massive burn injury to determine the proteomic survival signature following a major burn injury. Design Proteomic discovery study. Setting Five burn hospitals across the U.S. Patients Thirty-two burn patients (16 non-survivors and 16 survivors), 19–89 years of age, were admitted within 96 h of injury to the participating hospitals with burns covering >20% of the total body surface area and required at least one surgical intervention. Interventions None. Measurements and Main Results We found differences in circulating levels of 43 proteins involved in the acute phase response, hepatic signaling, the complement cascade, inflammation, and insulin resistance. Thirty-two of the proteins identified were not previously known to play a role in the response to burn. IL-4, IL-8, GM-CSF, MCP-1, and β2-microglobulin correlated well with survival and may serve as clinical biomarkers. Conclusions These results demonstrate the utility of these techniques for establishing proteomic survival signatures and for use as a discovery tool to identify candidate biomarkers for survival. This is the first clinical application of a high-throughput, large-scale LC-MS-based quantitative plasma proteomic approach for biomarker discovery for the prediction of patient outcome following burn, trauma or critical illness. PMID:23507713

  5. An Exploratory Study of Trauma and Religious Factors in Predicting Drinking Outcomes in African American Sexual Assault Survivors

    PubMed Central

    Adofoli, Grace; Ullman, Sarah E.

    2014-01-01

    This exploratory study examined the relationships between religious factors, trauma histories and life satisfaction to alcohol-related outcomes in adult sexual assault survivors. A mail survey was administered to a community sample of African American survivors (N = 836) in the Chicago metropolitan area. Hierarchical regression analyses showed that for non-religious women, interpersonal trauma was related to greater frequency of heavy drinking. For moderately religious women, interpersonal and contextual traumas were related to more frequent heavy drinking. For highly religious women, religious coping was related to less frequent heavy drinking. Implications are drawn for research and treatment of female survivors. PMID:25530738

  6. Burns in childhood: an epidemiological survey.

    PubMed

    Pegg, S P; Gregory, J J; Hogan, P G; Mottarelly, I W; Walker, L F

    1978-08-01

    The epidemiology of 382 burns admitted to the Royal Children's Hospital, Brisbane, is reviewed. Accidents due to burn trauma are disproportionately common among children when compared with adults, and during childhood years make up a sizable proportion of all injuries. In addition to the immediate physical trauma, there can be severe psychological consequences as well as severe disturbances to family life. Seventy per cent of the children in this series were normal active children less than four years of age, who were too young to learn that certain things are dangerous, and for this group preventative measures must be directed towards the parents. Possible methods of prevention of burns in children are discussed, and it is tragic that the very traits that make young children so engaging also lead them to accidental burn injuries. Their only hope of prevention lies in increased parental concern. PMID:282865

  7. Exercise Training in Cancer Survivors.

    PubMed

    Chyu, Christopher; Halnon, Nancy

    2016-06-01

    Numerous observational reports suggesting the positive benefits of physical activity in patients diagnosed with cancer have prompted multiple investigative studies involving exercise training for patients throughout the continuum of a cancer diagnosis. Physicians and primary caregivers struggle to find clearly defined guidelines or recommendations for exercise prescriptions that are specific to their widely variable cancer patient populations. Although there continues to be emerging evidence supporting physical activity in cancer survivors, further research is required to investigate new and existing outcomes, methods to sustain positive effects of exercise over time, and to better define guidelines for exercise interventions that include exercise type, frequency, intensity, duration, and timing. Studies of exercise interventions on patients with a range of cancer diagnoses and differing cancer treatments, and involving the pediatric population should be further investigated to document benefit and develop more refined recommendations for physical activity in all cancer survivors. PMID:27155861

  8. Nutritional Counseling in Survivors of Childhood Cancer: An Essential Component of Survivorship Care

    PubMed Central

    Ladas, Elena J.

    2014-01-01

    There is a growing body of evidence suggesting that nutritional status during treatment for cancer has a significant impact on treatment-related toxicities and outcomes among children and adolescents with cancer. The effects of nutritional status appear to extend into survivorship with a large proportion of survivors at risk for a variety of nutrition-related morbidities. The influence of dietary intake on overall treatment outcomes and long-term morbidities is largely unknown. In adults, evidence suggests that greater adherence to cancer prevention dietary guidelines improves long-term health outcomes among survivors of cancer. Surveys describing dietary intake among survivors of childhood cancer have found that most survivors are not meeting the recommended guidelines for many dietary nutrients and this may have an unfavorable effect on nutrition-related outcomes. However, more research is needed in this area so that well-designed clinical trials may be developed and tested. This review presents an overview of the existing literature describing dietary intake among survivors of childhood cancer, the clinical implications of reported dietary behaviors among survivors, and identifies areas for future research.

  9. "Having Housing Made Everything Else Possible": Affordable, Safe and Stable Housing for Women Survivors of Violence.

    PubMed

    Clough, Amber; Draughon, Jessica E; Njie-Carr, Veronica; Rollins, Chiquita; Glass, Nancy

    2014-09-01

    Research indicates that the need for safe housing and the economic resources to maintain safe housing are two of the most pressing concerns among abused women who are planning to or have recently left abusers. Intimate partner violence (IPV) is frequently an immediate cause or precursor to homelessness and housing instability. The aim of the study is to explore abused women's experiences accessing affordable, safe, and stable housing. To achieve the aim, adult female IPV survivors answered questions about: 1) steps that were taken to secure housing; 2) safety issues after leaving the abuser; 3) barriers to obtaining housing; and 4) responses from housing and domestic violence advocacy systems related to survivors' housing needs. Four major themes emerged from the in-depth interviews: 1) stable, affordable housing is critical in increasing safety; 2) survivors face multiple systemic or individual barriers; 3) survivors develop and utilize an array of creative and resourceful strategies; and 4) survivors identified a variety of supportive services tailored to address their needs. The findings inform practice, policy and research for both the housing and domestic violence service systems with an emphasis on collaboration to meet the complex safety and stable housing needs of survivors and their families, particularly following the impact on housing of the 2008 U.S. economic crisis and subsequent recession. PMID:25328440

  10. Pathophysiologic Response to Burns in the Elderly☆

    PubMed Central

    Jeschke, Marc G.; Patsouris, David; Stanojcic, Mile; Abdullahi, Abdikarim; Rehou, Sarah; Pinto, Ruxandra; Chen, Peter; Burnett, Marjorie; Amini-Nik, Saeid

    2015-01-01

    Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50) burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p < 0.05. Interestingly, we could not find a higher incidence of infection or sepsis in elderly, p > 0.05, but a significant increased incidence of multi organ failure, p < 0.05. These clinical outcomes were associated with a delayed hypermetabolic response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p < 0.05. In summary, elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly. PMID:26629550

  11. Pathophysiologic Response to Burns in the Elderly.

    PubMed

    Jeschke, Marc G; Patsouris, David; Stanojcic, Mile; Abdullahi, Abdikarim; Rehou, Sarah; Pinto, Ruxandra; Chen, Peter; Burnett, Marjorie; Amini-Nik, Saeid

    2015-10-01

    Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50) burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p < 0.05. Interestingly, we could not find a higher incidence of infection or sepsis in elderly, p > 0.05, but a significant increased incidence of multi organ failure, p < 0.05. These clinical outcomes were associated with a delayed hypermetabolic response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p < 0.05. In summary, elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly. PMID:26629550

  12. Morphological Changes in Subcutaneous White Adipose Tissue After Severe Burn Injury.

    PubMed

    Saraf, Manish Kumar; Herndon, David N; Porter, Craig; Toliver-Kinsky, Tracy; Radhakrishnan, Ravi; Chao, Tony; Chondronikola, Maria; Sidossis, Labros S

    2016-01-01

    Severe burn injury produces a plethora of metabolic abnormalities which contribute to the prolonged morbidity of burn survivors. The authors have recently demonstrated trans-differentiation of white adipose tissue (WAT) after burn trauma, toward a more thermogenic phenotype. However, the impact of burn injury on subcutaneous WAT (sWAT) morphology in humans is unknown. Here, the authors studied the effect of severe burn injury on the architecture of sWAT. sWAT was collected from 11 severely burned children (11 ± 3 years; 55 ± 16% total BSA burned) and 12 nonburned healthy children (9 ± 3 years). Histology, electron microscopy, immunohistochemistry, and immunofluorescence were performed on fixed adipose tissue sections. sWAT cytokine and collagen concentrations were measured by multiplex assay and sirius/fast green staining method, respectively. sWAT histology demonstrated multiple fat droplets, significantly (P < .05) reduced mean cell size (104 ± 6 vs 68 ± 3 μm) and higher collagen content (7 ± 0.8 vs 4 ± 0.4) in burn patients. sWAT from burn victims stained positive for CD68 suggesting infiltration of macrophages. Furthermore, electron microscopic analysis showed multiple fat droplets and greater mitochondrial abundance in sWAT of burn survivors. In agreement with this, mitochondrial respiratory capacity in the leak and coupled state increased by 100% in sWAT of burned children from 1 to 3 weeks postinjury. The cytokines IL-6, IL-8, IL-13, IL-1a, IL-1b, MCP-1, and TNF-α were all significantly greater in the sWAT of burned children versus healthy children (P < .05). Furthermore, IL-6, IL-8, IL1-a, IL-1b, and TNF-α significantly increased after injury in sWAT of burned children (P < .05). This study provides detailed evidence of morphological and functional changes in sWAT of burn survivors which was associated with tissue inflammation. A better understanding of morphological and functional changes in sWAT will help discern the mechanisms underlying

  13. Childhood Cancer Survivors' Familiarity With and Opinions of the Patient Protection and Affordable Care Act

    PubMed Central

    Warner, Echo L.; Park, Elyse R.; Stroup, Antoinette; Kinney, Anita Y.; Kirchhoff, Anne C.

    2013-01-01

    Purpose: The Patient Protection and Affordable Care Act (ACA) offers avenues to increase insurance options and access to care; however, it is unknown whether populations with pre-existing conditions, such as cancer survivors, will benefit from the expanded coverage options. We explored childhood cancer survivors' familiarity with and opinion of the ACA to understand how survivors' insurance coverage may be affected. Materials and Methods: From April to July 2012 we conducted in-depth, semistructured telephone interviews with 53 adult survivors recruited from the Utah Cancer SEER Registry. Participants were randomly selected from sex, age, and rural/urban strata and were younger than 21 years at time of diagnosis. Interviews were recorded, transcribed, and analyzed with NVivo 9 by two coders (kappa = 0.94). We report on the 49 participants who had heard of the ACA. Results: Most survivors were unaware of ACA provisions beyond the insurance mandate. Few knew about coverage for children up to age 26 or pre-existing insurance options. Although one third believed the ACA could potentially benefit them via expanded insurance coverage, many were concerned that the ACA would lead to rising health care costs and decreasing quality of care. Survivors had concerns specific to their cancer history, including fears of future health care rationing if they developed subsequent health problems. Conclusion: Childhood cancer survivors have a low level of familiarity with the ACA and are unaware of how it may affect them given their cancer history. These survivors require targeted education to increase knowledge about the ACA. PMID:23943900

  14. A qualitative cancer screening study with childhood sexual abuse survivors: experiences, perspectives and compassionate care

    PubMed Central

    Gesink, Dionne; Nattel, Lilian

    2015-01-01

    Objective The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. Design A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. Participants A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. Setting Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. Results The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. Conclusions Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment

  15. Echocardiographic Detection of Cardiac Dysfunction in Childhood Cancer Survivors: How Long Is Screening Required?

    PubMed Central

    Ramjaun, Aliya; AlDuhaiby, Eman; Ahmed, Sameera; Wang, Lisa; Yu, Eric; Nathan, Paul C; Hodgson, David C

    2015-01-01

    Background Childhood cancer survivors treated with anthracycline chemotherapy are at an increased risk of long-term cardiac toxicity, and guidelines recommend that exposed survivors undergo echocardiography every 1–5 years. However, it is unclear whether survivors should undergo echocardiographic screening indefinitely, or if a period of echocardiographic stability indicates that screening is no longer necessary. The objective of this study was to evaluate the outcomes of echocardiographic screening to aid in the refinement of existing guidelines. Methods We retrospectively analyzed the results of echocardiographic screening in a cohort of adult survivors of childhood cancer treated with anthracyclines and/or cardiac radiation therapy. Interval regression analysis was performed to identify predictors of single-episode or sustained abnormal echocardiograms. Results The cohort constituted 333 survivors, with median follow-up time of 15.8 years post-treatment (range: 5.0–47.9), and median age at treatment of 8 years (range: 1.5–18). Forty-nine survivors had an abnormal echocardiogram (14.7%), and 29 (8.7%) had reproducible abnormal findings. An ongoing continual increase in the incidence of sustained echocardiographic abnormality was seen among patients treated with >250 mg/m2 doxorubicin at age <5 years, reaching 43% by 20 years of therapy. In contrast, no sustained abnormal echocardiographic findings arose after 10 years of therapy in survivors treated with <250 mg/m2 at age ≥5 years. Conclusions Single-episode echocardiographic abnormalities are often not reproduced in subsequent evaluations. The duration of echocardiographic screening for childhood cancer survivors should be reassessed for patients who received lower doses of anthracycline after age 5. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc. PMID:26146944

  16. Hospital Bioterrorism Planning and Burn Surge

    PubMed Central

    Myers, Brent; Cairns, Charles B.; Rich, Preston B.; Hultman, C. Scott; Charles, Anthony G.; Jones, Samuel W.; Schmits, Grace L.; Skarote, Mary Beth; Holmes, James H.; Cairns, Bruce A.

    2014-01-01

    On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity. PMID:24527874

  17. Hospital bioterrorism planning and burn surge.

    PubMed

    Kearns, Randy D; Myers, Brent; Cairns, Charles B; Rich, Preston B; Hultman, C Scott; Charles, Anthony G; Jones, Samuel W; Schmits, Grace L; Skarote, Mary Beth; Holmes, James H; Cairns, Bruce A

    2014-01-01

    On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity. PMID:24527874

  18. Employment discrimination against cancer survivors: multidisciplinary interventions.

    PubMed

    Hoffman, B

    1989-01-01

    Approximately 25% of the five million cancer survivors in the United States encounter barriers to employment solely because of their cancer histories. This discrimination is primarily rooted in erroneous stereotypes about cancer. Because cancer-based employment discrimination has legal, social, emotional, and economic impact on survivors, interventions must encompass legal and psychosocial resources. While state and federal laws prohibit certain actions that deprive survivors of job opportunities and health insurance, legal and psychosocial resources must be developed and made available to cancer survivors to help them overcome barriers to equal employment opportunities. PMID:10293296

  19. Relationship to Perpetrator, Disclosure, Social Reactions, and PTSD Symptoms in Child Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Ullman, Sarah E.

    2007-01-01

    This research examined victim relationship to the perpetrator, disclosure characteristics, social reactions, and PTSD in adult survivors' of child sexual abuse (CSA) identified in a convenience sample of 733 college students. Results indicated that relationship to the perpetrator was related to CSA characteristics and outcomes. More negative…

  20. "I Am More than My Cancer": An Exploratory Examination of Adventure Programming and Cancer Survivors

    ERIC Educational Resources Information Center

    Sugerman, Deborah

    2005-01-01

    Adventure programs have recently emerged that are specifically designed for individuals living with cancer, yet few research studies document the outcomes of such programs. The purpose of the current qualitative study was to examine the effects of an adventure program on individual adult cancer survivors. Three central themes emerged from the…

  1. The Influence of Stereotypical Beliefs, Participant Gender, and Survivor Weight on Sexual Assault Response

    ERIC Educational Resources Information Center

    Clarke, Allyson K.; Stermac, Lana

    2011-01-01

    The present study explored the influence of survivor weight and participant gender, rape myth acceptance, and antifat attitudes on perceptions of sexual assault. Using an online survey tool, a community sample of 413 adult Canadian residents reviewed a hypothetical sexual assault scenario and completed a series of evaluations and attitudinal…

  2. Coping Strategies Used by Survivors of Childhood Sexual Abuse on the Journey to Recovery

    ERIC Educational Resources Information Center

    Phanichrat, Thanomjit; Townshend, Julia M.

    2010-01-01

    This interpretative phenomenological analysis study explored seven adult survivors' experiences of coping with childhood sexual abuse and identified their coping strategies on the road to recovery. Data for the analysis was collected using semistructured interviews. The analytical process yielded two key theme clusters: avoidant coping strategies…

  3. Training-induced modifications of corticospinal reactivity in severely affected stroke survivors.

    PubMed

    Barker, Ruth N; Brauer, Sandra G; Barry, Benjamin K; Gill, Toby J; Carson, Richard G

    2012-08-01

    When permitted access to the appropriate forms of rehabilitation, many severely affected stroke survivors demonstrate a capacity for upper limb functional recovery well in excess of that formerly considered possible. Yet, the mechanisms through which improvements in arm function occur in such profoundly impaired individuals remain poorly understood. An exploratory study was undertaken to investigate the capacity for brain plasticity and functional adaptation, in response to 12-h training of reaching using the SMART Arm device, in a group of severely affected stroke survivors with chronic upper limb paresis. Twenty-eight stroke survivors were enroled. Eleven healthy adults provided normative data. To assess the integrity of ipsilateral and contralateral corticospinal pathways, transcranial magnetic stimulation was applied to evoke responses in triceps brachii during an elbow extension task. When present, contralateral motor-evoked potentials (MEPs) were delayed and reduced in amplitude compared to those obtained in healthy adults. Following training, contralateral responses were more prevalent and their average onset latency was reduced. There were no reliable changes in ipsilateral MEPs. Stroke survivors who exhibited contralateral MEPs prior to training achieved higher levels of arm function and exhibited greater improvements in performance than those who did not initially exhibit contralateral responses. Furthermore, decreases in the onset latency of contralateral MEPs were positively related to improvements in arm function. Our findings demonstrate that when severely impaired stroke survivors are provided with an appropriate rehabilitation modality, modifications of corticospinal reactivity occur in association with sustained improvements in upper limb function. PMID:22777103

  4. Pediatric scalp burns: hair today, gone tomorrow?

    PubMed

    Menon, Seema; Jacques, Madeleine; Harvey, John G; Holland, Andrew J A

    2015-01-01

    Scalp burns in the pediatric population appear relatively uncommon, with most reported cases occurring in adults secondary to electrical burns. We reviewed our experience with the management of these injuries in children. A retrospective review was conducted at our institution from March 2004 to July 2011. Scalp burns were defined as any burn crossing over the hairline into the scalp region. During the 7-year 4-month study, there were 107 scalp burns, representing 1.8% of the 6074 burns treated at our institution during that time. The cause was scald in 97, contact in 4, flame in 3, friction in 2, and chemical in 1. The majority (n = 93, 87%) appeared superficial to mid-dermal, with an average time to complete healing of 10.3 days. The remaining 14 cases (13%) were mid-dermal to full thickness, with an average time to complete healing of 50.8 days. Grafting was required in 12 cases (11%). The mean time to grafting was 4 weeks (range, 2 weeks to 2.5 months). The main complication of scalp burns was alopecia, which occurred in all grafted sites as well as in 4 patients treated conservatively. There were no other complications after grafting and no cases of graft loss. In our pediatric series, scalp burns were most commonly caused by scald injuries and were superficial to mid-dermal in depth. These generally healed rapidly but occasionally resulted in alopecia. The management of deep dermal and full-thickness scalp burns remains challenging in children, with the decision to graft often delayed. PMID:24823325

  5. Burns associated with fondues.

    PubMed Central

    Laliberté, D; Beaucage, C; Watts, N

    1992-01-01

    OBJECTIVE: To describe the causes of burns associated with fondues. DESIGN: Descriptive case series. PATIENTS: All 17 patients admitted to a burn centre between Apr. 1, 1985, and Mar. 31, 1990, whose burns were associated with fondue. Eleven agreed to complete a telephone interview. RESULTS: The age of the 17 patients varied from 2 to 56 (mean 27) years. Two causes were identified: spilling of the contents of the fondue pot and explosion of the fondue fuel when added to the burner during a meal. The telephone interview revealed that eight people other than the respondents were burned during the same accidents. CONCLUSION: Although we identified only badly burned patients the problem may be more extensive. The knowledge of specific causes of burns from handling fondue equipment indicates that preventive action should be undertaken. More epidemiologic information is needed to obtain a precise estimate of the magnitude of this public health problem. PMID:1393897

  6. Burns and epilepsy.

    PubMed

    Berrocal, M

    1997-01-01

    This is a report of the first descriptive analytic study of a group of 183 burn patients, treated in the Burn Unit at the University Hospital of Cartagena, Colombia during the period since January 1985 until December 1990. There is presented experience with the selected group of 24 patients in whom the diagnosis of burn was associated with epilepsy. There is also analysed and described the gravity of the scars sequels, neurological disorders, the complication of the burn and an impact of this problem on the patient, his (her) family and the community. It is very important to report that there was found Neurocisticercosis in 66.6% of the group of burn patients with epilepsy, and it is probably the first risk factor of burn in this group. PMID:9212488

  7. Pediatric cutaneous bleach burns.

    PubMed

    Lang, Cathleen; Cox, Matthew

    2013-07-01

    Bleach is a common household product which can cause caustic injuries. Its effects on mucosal tissues and the eye have been well-described in the literature. However, there is little information published regarding the appearance and effect of bleach on a child's skin. We report three children who sustained chemical burns after contact with bleach. All three children sustained accidental bleach burns while at home, and each child had a distinct brown discoloration to the skin from the injury. All three children had treatment and follow-up for their burns. Two of the children sustained more severe burns, which were extensive and required more time to heal. There was also long-term scarring associated with the severe burns. Like most burns, pain control is required until the injury heals. PMID:23545350

  8. Sibling incest: reports from forty-one survivors.

    PubMed

    Carlson, Bonnie E; Maciol, Katherine; Schneider, Joanne

    2006-01-01

    An exploratory study was conducted with a convenience sample of 41 adult survivors of sibling incest using a retrospective survey design. Participants were interviewed about their childhood sexual experiences with a sibling. Most participants reported vaginal or oral intercourse and coercive experiences. Half of the sample reported sexual experiences with family members, as well as other child abuse. Half of the participants showed evidence of distorted beliefs about child sexual abuse. Disclosure of the incest during childhood was rare. doi:10.1300/ J070v15n04_02. PMID:17200052

  9. Outpatient burn management.

    PubMed

    Warner, Petra M; Coffee, Tammy L; Yowler, Charles J

    2014-08-01

    Most burn patients have injuries that may be treated on an outpatient basis. Newer silver-based dressings and improved medications for the treatment of pain and pruritus have led to further growth of outpatient care. The final barrier of distance from the burn center will decrease with the growth of telemedicine. It is incumbent for burn centers to develop outpatient guidelines to facilitate this growth of outpatient care. PMID:25085094

  10. Burns in Malawi

    PubMed Central

    Virich, G.; Lavy, C.B.D.

    2006-01-01

    Summary Objective: To describe burns seen at the largest hospital in Malawi. Methods: In a prospective study conducted at Queen Elizabeth Central Hospital, Blantyre, Malawi, a series of twelve accidental burns was analysed over a four-week period. Results: Hot water was the commonest source of burns (6 out of 12). Open-fire and petroleum lamp accidents were the commonest cause of burns among epileptic patients. Males were affected more than females (male:female ratio = 8:4). Most burns were superficial (11 out of 12). One patient had deep burns requiring grafting. All patients were treated with topical silver sulphadiazine and a combination antibiotic regime. Children aged six yr or under were a major subgroup at risk of suffering burns (7 out of 12) and only one patient was aged over 30 yr. Lack of anti-epileptic medication resulted in potentially avoidable burns in four epileptic patients. Conclusions: There is a need for cheap preventive health promotion measures as well as the provision of simple resources as most burns encountered can be managed effectively by simple measures. PMID:21991045

  11. American Burn Association

    MedlinePlus

    About ABA Governance History Committees & SIGs Awards Membership Past Presidents International Outreach Legislative Agenda Health Policy News and Activities Educational Resources Prevention Posters Awards FAQs Burn Awareness ...

  12. Treating Survivors of War Trauma and Torture.

    ERIC Educational Resources Information Center

    Hanscom, Karen L.

    2001-01-01

    Proposes a mental health treatment model for survivors of torture and war trauma, presenting principles underlying such treatment and a developmental view of such abuse. Describes a Guatemalan project that uses the model to train village women to treat survivors in their communities and a U.S. torture treatment program that treats survivors…

  13. Neuropsychological Functioning in Survivors of Childhood Leukemia.

    ERIC Educational Resources Information Center

    Reeb, Roger N.; Regan, Judith M.

    1998-01-01

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

  14. 22 CFR 19.11 - Survivor benefits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. Incest Survivor Mothers: Protecting the Next Generation.

    ERIC Educational Resources Information Center

    Kreklewetz, Christine M.; Piotrowski, Caroline C.

    1998-01-01

    A study involving 16 incest-survivor mothers with daughters between the ages of 9-14 found the mothers described themselves as very protective and often overly-protective parents, wanting to parent differently, and better, than they were parented. Many survivors strive to be the "perfect mother" including over-protecting and over-nurturing…

  16. Do Suicides' Characteristics Influence Survivors' Emotions?

    ERIC Educational Resources Information Center

    Schneider, Barbara; Grebner, Kristin; Schnabel, Axel; Georgi, Klaus

    2011-01-01

    The suicide of a related person can often induce severe negative emotional reactions. The objective of this study was to explore the relationships between sociodemographic and diagnostic data of suicides and survivors' emotions and to close this substantial gap. The main outcome of this study was that survivors' severity of emotional disturbance…

  17. Endocrinopathies in Survivors of Childhood Neoplasia

    PubMed Central

    Barnes, Nicole; Chemaitilly, Wassim

    2014-01-01

    Advancements in cancer treatments have increased the number of survivors of childhood cancers. Endocrinopathies are common complications following cancer therapy and may occur decades later. The objective of the current review is to address the main endocrine abnormalities detected in childhood cancer survivors including disorders of the hypothalamic-pituitary axis, thyroid, puberty, gonads, bone, body composition, and glucose metabolism. PMID:25295241

  18. 22 CFR 19.11 - Survivor benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Survivor benefits. 19.11 Section 19.11 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.11 Survivor benefits....

  19. 22 CFR 19.11 - Survivor benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Survivor benefits. 19.11 Section 19.11 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.11 Survivor benefits....

  20. 22 CFR 20.5 - Survivor benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Survivor benefits. 20.5 Section 20.5 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR CERTAIN FORMER SPOUSES § 20.5 Survivor benefits. (a) Type of benefits. A former spouse who meets the eligibility requirements of § 20.3 is entitled...

  1. 22 CFR 19.11 - Survivor benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Survivor benefits. 19.11 Section 19.11 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.11 Survivor benefits....

  2. 22 CFR 20.5 - Survivor benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Survivor benefits. 20.5 Section 20.5 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR CERTAIN FORMER SPOUSES § 20.5 Survivor benefits. (a) Type of benefits. A former spouse who meets the eligibility requirements of § 20.3 is entitled...

  3. 31 CFR 29.344 - Survivor benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Survivor benefits. 29.344 Section 29.344 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER CERTAIN DISTRICT OF COLUMBIA RETIREMENT PROGRAMS Split Benefits § 29.344 Survivor benefits. (a)...

  4. 31 CFR 29.344 - Survivor benefits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Survivor benefits. 29.344 Section 29.344 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER CERTAIN DISTRICT OF COLUMBIA RETIREMENT PROGRAMS Split Benefits § 29.344 Survivor benefits. (a)...

  5. 22 CFR 19.11 - Survivor benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Survivor benefits. 19.11 Section 19.11 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.11 Survivor benefits....

  6. 22 CFR 20.5 - Survivor benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Survivor benefits. 20.5 Section 20.5 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR CERTAIN FORMER SPOUSES § 20.5 Survivor benefits. (a) Type of benefits. A former spouse who meets the eligibility requirements of § 20.3 is entitled...

  7. A Systematic Review of Dental Late Effects in Survivors of Childhood Cancer

    PubMed Central

    Gawade, Prasad L.; Hudson, Melissa M.; Kaste, Sue C.; Neglia, Joseph P.; Constine, Louis S.; Robison, Leslie L.; Ness, Kirsten K.

    2014-01-01

    Survivors of childhood cancer are at risk for dental late effects. This systematic review summarizes associations between treatment exposures and dental late effects among survivors of childhood cancer. We included investigations with at least 20 study participants conducted for 2 or more years after completion of childhood, adolescent, or young adult cancer therapy. This review suggests both independent and additive effects of radiotherapy and chemotherapy on dental complications, and identifies vulnerable groups with specific host and treatment characteristics. This summary provides information that will assist clinicians to prevent, detect, and facilitate early intervention for dental late effects. PMID:24424790

  8. Burns and military clothing.

    PubMed

    McLean, A D

    2001-02-01

    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

  9. Dialectical tensions in stroke survivor relationships.

    PubMed

    Brann, Maria; Himes, Kimberly Leezer; Dillow, Megan R; Weber, Keith

    2010-06-01

    Stroke is an unpredictable and life-altering medical occurrence that causes immediate change in survivors' relationships. This study unearthed dialectical tensions expressed by spouses of stroke survivors and examined how those dialectical tensions compare to those experienced by stroke survivors themselves. Sixteen spouses of stroke survivors participated in interviews, and four tensions ultimately emerged: self-orientation-partner-orientation, realism-idealism, uncertainty-acceptance, and emotional release-emotional reservation. Three dialectical tensions (i.e., uncertainty-acceptance, realism-idealism, self-orientation-partner-orientation) were similar to those communicated by stroke survivors. Recognizing dialectical tensions experienced and shared can open communication lines and ultimately improve the health of individuals and their relationships. PMID:20512714

  10. Current scenario in chemical burns in a developing country: Chennai, India

    PubMed Central

    Ramakrishnan, K.M.; Mathivanan, T.; Jayaraman, V.; Babu, M.; Shankar, J

    2012-01-01

    Summary Chemical burns are not uncommon in India. Both accidental and non-accidental chemical burns are encountered in our setting. In the paediatric age group, chemical burns are mainly accidental. Analysis of chemical burn admissions to the Burn Units of a medical college hospital, and to an exclusively tertiary care children's hospital in Chennai, India, from 2001 to 2010 is described. A total number of 75 adults and 38 children are included in the study. Detailed analysis of age, sex, percentage of burn total body surface area (TBSA %), causative agents, aetiology (accidental or non-accidental), treatment instituted, mortality, and outcome are reported. PMID:23012609

  11. Burning Mouth Syndrome.

    PubMed

    Kamala, K A; Sankethguddad, S; Sujith, S G; Tantradi, Praveena

    2016-01-01

    Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS. PMID:26962284

  12. Burning Mouth Syndrome

    PubMed Central

    Kamala, KA; Sankethguddad, S; Sujith, SG; Tantradi, Praveena

    2016-01-01

    Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS. PMID:26962284

  13. Gunpowder-related burns.

    PubMed

    Navarro-Monzonis, A; Benito-Ruiz, J; Baena-Montilla, P; Mena-Yago, A; de la Cruz-Ferrer, L I

    1992-04-01

    Gunpowder misuse is a frequent cause of burn injury in our area. The injuries are mostly minor lesions which may be treated on an outpatient basis, the more serious injuries need surgical treatment. Experience of the management of these burns is reported by reviewing 123 clinical charts of patients admitted between 1983 and 1990. The most frequent victims are teenage males who are involved mainly in accidents in the street. The most serious burns followed work-related accidents, with a fatal outcome in 47 per cent of the patients. The serious burns are usually deep dermal or full skin thickness. A common pattern affects groins, genitalia, hypogastrium and hands, and are produced when fireworks ignite in the pockets of the patient's trousers. The management of these lesions does not differ from burns caused by other agents, although attention should be paid to the presence of associated lesions, chiefly to eyes, ears and hands, due to the shockwave and shrapnel. PMID:1590935

  14. Coal burning process

    SciTech Connect

    Cowan, F.C.; Cowan, T.L.

    1980-02-05

    This process is for devolatilizing coal to produce a volatile hydrocarbon gas leaving a residue of unburned coal. The volatile hydrocarbon gas and other coal or said residual coal are thereafter burned together in a common furnace. The volatilization of the coal may be carried out substantially endothermically, and preferably on the plant site where the burning of the volatilized hydrocarbon takes place together with other coal or the residue coal. The volatile matter is removed from the coal in a volatile state before the residue coal exits from the burner nozzle and then enters the combustion chamber where the volatilized hydrocarbon gas and residue coal are burned together. The removed volatilized hydrocarbon gas can be placed within the same coal burning plant to join with the unburned residual coal, passing to the burner to burn therewith.

  15. A Meta-Summary of Qualitative Findings about Professional Services for Survivors of Sexual Violence

    PubMed Central

    Martsolf, Donna S.; Draucker, Claire B.; Cook, Christina B.; Ross, Ratchneewan; Stidham, Andrea Warner; Mweemba, Prudencia

    2011-01-01

    Sexual violence occurs at alarming rates in children and adults. Survivors experience myriad negative health outcomes and legal problems, which place them in need of professional services. A meta-summary was conducted of 31 published qualitative studies on adults’ responses to sexual violence, with a focus on survivors’ use of professional services. Combined samples included 46 men, 984 women, and six couples who had experienced sexual violence at any point in their lives. Findings indicated that qualities of professional service providers and outcomes of professional services were perceived either positively or negatively (rather than neutrally) by survivors, regardless of the provider’s professional discipline. Professionals who work with sexual violence survivors can use these findings to improve their practices. PMID:21837284

  16. Metabolic Syndrome in Korean Cancer Survivors and Family Members: A Study in a Health Promotion Center.

    PubMed

    Shin, Jin Young; Choi, Yoon Ho; Song, Yun Mi

    2015-01-01

    This cross-sectional study evaluated the risk of metabolic syndrome (MetS) in cancer survivors and family members. Subjects were 48,934 adults (24,786 men, 24,148 women) aged ≥40yr who receive a routine health examination at 1 hospital from January 2010 to December 2012. There were 2468 cancer survivors, 18,211 with cancer patients in the family, and 28,255 noncancer subjects, who never experienced cancer and whose family members either. Associations between MetS and cancer experience were assessed using multiple logistic regression analysis. The odds ratio (OR) of MetS in female cancer survivors was significantly higher than noncancer subjects after adjusting for age, smoking, physical activity, and alcohol intake (OR = 1.22, 95% confidence intervals: 1.02-1.47]. However, the OR of MetS for male survivors did not differ from that of noncancer subjects. Gastric cancer survivors had a lower OR of MetS than noncancer subjects (0.37, 0.27-0.50). ORs of breast cancer (1.49, 1.00-2.23) and prostate cancer survivors (1.46, 1.07-1.99) were higher than the OR of MetS for noncancer subjects. There was no difference in the OR of MetS between the family members of cancer patients and non-cancer subjects. These findings suggest that the odds of MetS for cancer survivors may differ by cancer type and by sex. PMID:26317444

  17. Experiences of Mothers Who Are Child Sexual Abuse Survivors: A Qualitative Exploration.

    PubMed

    Cavanaugh, Courtenay E; Harper, Bianca; Classen, Catherine C; Palesh, Oxana; Koopman, Cheryl; Spiegel, David

    2015-01-01

    Child sexual abuse has been associated with a number of problems affecting women over their lifespan, including difficulties with parenting. However, there is a modest number of qualitative studies examining the impact of child sexual abuse on survivors who are mothers. There is a particular need for qualitative investigations that ask survivors who are mothers general questions about the impact of child sexual abuse on their lives rather than those that specifically ask about the impact of child sexual abuse on parenting. The former approach would allow survivors to describe effects that may impact parenting but that survivors do not consciously link to affecting their parenting. Such information may inform interventions to assist this population of survivors. This secondary data analysis examined themes revealed in interviews with 44 survivors of child sexual abuse who were mothers. Participants were seeking treatment for their child sexual abuse and completed an in-person interview in which they were asked open-ended questions about the sexual abuse they experienced as a child and how their abuse affects them now as adults. The interviews were recorded, transcribed, and coded using thematic analysis. The following six themes emerged from the narratives: (a) being a parent, (b) family of origin dysfunction, (c) the impact of abuse, (d) the abuse history and response to abuse, (e) coping, and (f) hopes and desires for the future. This study highlights several ways in which child sexual abuse impacts survivors who are mothers, areas for further study, and the need for interventions to assist this population in meeting the challenges they face as mothers. PMID:26301437

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

    ERIC Educational Resources Information Center

    Greeson, Megan R.; Campbell, Rebecca

    2011-01-01

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

  19. Serious occupational burn injuries treated at a regional burn center.

    PubMed

    Taylor, Allison J; McGwin, Gerald; Cross, James M; Smith, Donald R; Birmingham, Barbara R; Rue, Loring W

    2002-01-01

    This article will present the epidemiology of occupational burn injuries among patients admitted to a regional burn center. Patients admitted to University of Alabama at Birmingham University Hospital Burn Center between November 1994 and December 1999 for occupational burn injuries were studied. Descriptive statistics were generated for demographic, clinical, and outcome characteristics. Approximately one-quarter of all burn center admissions had sustained occupational burn injuries. The most common burns were flame, electrical, and scald burns. The most heavily represented occupations were "manufacturing" (19.1%), "electrician" (16.2%), and "laborer" (16.2%). Burn type varied with occupation. Over $16 million in hospital charges was accrued by patients sustaining occupational burn injuries. Understanding the epidemiology of serious burn injuries in the workplace is crucial to directing prevention efforts toward worker groups at highest risk. PMID:12142576

  20. Late psychiatric morbidity in survivors of cancer at a young age: a nationwide registry-based study.

    PubMed

    Ahomäki, Ritva; Gunn, Mirja E; Madanat-Harjuoja, Laura M; Matomäki, Jaakko; Malila, Nea; Lähteenmäki, Päivi M

    2015-07-01

    Childhood cancer survivors have been shown to be prone to psychosocial adverse outcomes. Data on young adults and their psychiatric late effects are still scarce. In a nationwide, registry-based study, we explored the risk (HR) of new psychiatric diagnoses in 5-year survivors of childhood and young adulthood (YA) cancer (n = 13,860) compared with a sibling cohort (n = 43,392). Hazard ratios (HRs) were calculated using Cox regression models. Patients and siblings were identified from the Finnish Cancer Registry and Central Population Registry, respectively. Outcome diagnoses were retrieved from the national hospital discharge register. The risk of organic memory/brain disorders was significantly increased in both childhood (HR 4.9; 95%CI 2.7-8.9) and YA (HR 2.1; 95%CI 1.4-3.1) cancer survivors compared with siblings. Mood disorders were also more common in childhood (HR 1.3; 95%CI 1.1-1.7) and YA survivors (1.3; 95%CI 1.1-1.5) than in siblings. Radiotherapy did not explain the differences. Female childhood cancer survivors had significantly increased HRs for mood disorders, psychotic disorders, neurotic/anxiety disorders, somatization/eating disorders and personality disorders. In survivors of YA cancers, females had significantly increased HR for neurotic/anxiety disorders, and the difference between female survivors and siblings was significantly (p < 0.05) higher than that between male survivors and male siblings. The effect of treatment era was also analyzed, and the risk of organic memory and brain disorders in childhood cancer survivors did not diminish over time. Despite the trend of decreased use of cranial irradiation in children, the risk of organic memory/brain disorders was elevated, even during the most recent era. Thus, additional research on chemotherapy-only protocols and their impact on mental health, is warranted. PMID:25450095

  1. Marriage and divorce among childhood cancer survivors.

    PubMed

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda; Møller, Henrik; Johansen, Christoffer; Schmiegelow, Kjeld

    2011-10-01

    Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer was diagnosed between 1965 and 1996 before they were 20 years of age. A sex-matched and age-matched population-based control cohort was used for comparison (n=45,449). Demographic and socioeconomic data were obtained from national registers and explored by discrete-time Cox regression analyses. Childhood cancer survivors had a reduced rate of cohabitation [rate ratio (RR) 0.78; 95% confidence interval (CI): 0.73-0.83], owing to lower rates among survivors of both noncentral nervous system (CNS) tumors (RR 0.88; 95% CI: 0.83-0.95) and CNS tumors (RR 0.52; 95% CI: 0.45-0.59). Male CNS tumor survivors had a nonsignificantly lower rate (RR 0.47; 95% CI: 0.38-0.58) than females (RR 0.56; 95% CI: 0.47-0.68). The rates of separation were almost identical to those of controls. In conclusion, the rate of cohabitation was lower for all childhood cancer survivors than for the population-based controls, with the most pronounced reduction among survivors of CNS tumors. Mental deficits after cranial irradiation are likely to be the major risk factor. PMID:21941142

  2. Pilot Study of Vascular Health in Survivors of Osteosarcoma

    PubMed Central

    Mulrooney, Daniel A.; Ness, Kirsten K.; Huang, Sujuan; Solovey, Anna; Hebbel, Robert P.; Neaton, James D.; Clohisy, Denis R.; Kelly, Aaron S.; Neglia, Joseph P.

    2014-01-01

    Background Cardiovascular-related toxicities have been reported among survivors of osteosarcoma. Methods Fasting blood samples from 24 osteosarcoma survivors were analyzed for high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein-β, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and surface expression of vascular cell adhesion molecule-1 (VCAM-1). Values were compared to subjects in the natural history Coronary Artery Risk Development in Young Adults (CARDIA) cohort study except for CECs and VCAM-1 expression which were compared to controls studied at the University of Minnesota Lillehei Clinical Trials Unit. Procedure Survivors (54.2% male), median age 18 years (9–32) at diagnosis, 36.5 years (20–56) at evaluation were treated with a variety of chemotherapeutic exposures, all but one were exposed to doxorubicin (median dose 450 mg/m2; range: 90–645 mg/m2), 14 (58.3%) received cisplatin, and 3 (12.5%) were exposed to carboplatin. Two survivors (8.3%) received radiation therapy for disease relapse. Compared to CARDIA subjects, mean hsCRP (3.0 mg/L ± 2.0 vs. 1.6 ± 2.3), triglycerides (151 mg/dl ± 81.7 vs. 95.4 ± 101.3), lipoprotein (a) (34.9 mg/dl ± 17.7 vs. 13.8 ± 22.0), and fibrinogen (315.0 mg/dl ± 49.3 vs. 252.4 ± 61.7) were significantly elevated. The number of CECs (0.47 cells/ml ± 2.5 vs. 0.92 ± 2.5) did not differ while surface expression of VCAM-1 (86.4% ± 34.0 vs. 42.1 ± 33.8) was significantly elevated compared to controls. Conclusions Among survivors of osteosarcoma, assessed a median of 14 years from diagnosis, there is evidence of vascular inflammation, dyslipidemia, and early atherogenesis. PMID:23720361

  3. Women survivors of child sexual abuse. How can health professionals promote healing?

    PubMed Central

    Schachter, Candice L.; Radomsky, Nellie A.; Stalker, Carol A.; Teram, Eli

    2004-01-01

    OBJECTIVE: To explore how health professionals can practise in ways sensitive to adult women survivors of child sexual abuse. DESIGN: Qualitative semistructured in-depth interviews. SETTING: Small and midsize cities in Ontario and Saskatchewan. PARTICIPANTS: Twenty-seven women survivors of childhood sexual abuse. METHODS: Respondents were asked about their experiences with physical therapists and other health professionals and asked how practice could be sensitive to their needs as survivors. A grounded-theory approach was used. After independent analyses, researchers achieved consensus on the main themes. Findings were checked with participants, other survivors, and mental health professionals. MAIN FINDINGS: A crucial theme was the need to feel safe when consulting any health professional. Participants described specific ways for clinicians to facilitate the feeling of safety. Disclosure of abuse history was another key theme; analysis revealed no one "right way" to inquire about it. CONCLUSION: Women survivors of child sexual abuse want safe, accepting environments and sensitive, informed health professionals with whom to work in partnership on all their health concerns. PMID:15318678

  4. Experiencing reproductive concerns as a female cancer survivor is associated with depression

    PubMed Central

    Gorman, Jessica R.; Su, H. Irene; Roberts, Samantha C.; Dominick, Sally A.; Malcarne, Vanessa L.

    2014-01-01

    Background Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. Methods This cross-sectional study includes 200 female cancer survivors between the ages of 18 and 35 years who completed a web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality of life indicators. Results The mean age of participants was 28 years (SD = 4.4) and almost two-thirds were diagnosed within 5 years of completing the survey. Multivariable logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (OR = 1.30, 95% CI = 1.06–1.60 for each 5 unit increase in RCAC score). Of those with moderate to severe depression, 23% had high RCAC scores as compared to 6% of those with minimal to mild depression (p < 0.001). Conclusion A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention to improve the psychosocial health of young survivors. PMID:25377593

  5. A Review of Risk Factors for Cognitive Impairment in Stroke Survivors

    PubMed Central

    Mohd Zulkifly, Mohd Faizal; Ghazali, Shazli Ezzat; Che Din, Normah; Singh, Devinder Kaur Ajit; Subramaniam, Ponnusamy

    2016-01-01

    In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors. PMID:27340686

  6. Subclinical Hypothyroidism in Childhood Cancer Survivors

    PubMed Central

    Lee, Hyun Joo; Hahn, Seung Min; Jin, Song Lee; Shin, Yoon Jung; Kim, Sun Hee; Lee, Yoon Sun; Kim, Hyo Sun; Lyu, Chuhl Joo

    2016-01-01

    Purpose In childhood cancer survivors, the most common late effect is thyroid dysfunction, most notably subclinical hypothyroidism (SCH). Our study evaluated the risk factors for persistent SCH in survivors. Materials and Methods Survivors (n=423) were defined as patients who survived at least 2 years after cancer treatment completion. Thyroid function was assessed at this time and several years thereafter. Two groups of survivors with SCH were compared: those who regained normal thyroid function during the follow-up period (normalized group) and those who did not (persistent group). Results Overall, 104 of the 423 survivors had SCH. SCH was observed in 26% of brain or nasopharyngeal cancer survivors (11 of 43) and 21.6% of leukemia survivors (35 of 162). Sixty-two survivors regained normal thyroid function, 30 remained as persistent SCH, and 12 were lost to follow-up. The follow-up duration was 4.03 (2.15–5.78) years. Brain or nasopharyngeal cancer and Hodgkin disease were more common in the persistent group than in the normalized group (p=0.002). More patients in the persistent group received radiation (p=0.008). Radiation to the head region was higher in this group (2394±2469 cGy) than in the normalized group (894±1591 cGy; p=0.003). On multivariable analysis, lymphoma (p=0.011), brain or nasopharyngeal cancer (p=0.039), and head radiation dose ≥1800 cGy (p=0.039) were significant risk factors for persistent SCH. Conclusion SCH was common in childhood cancer survivors. Brain or nasopharyngeal cancer, lymphoma, and head radiation ≥1800 cGy were significant risk factors for persistent SCH. PMID:27189285

  7. Predictors of Muscle Protein Synthesis after Severe Pediatric Burns

    PubMed Central

    Diaz, Eva C.; Herndon, David N.; Lee, Jinhyung; Porter, Craig; Cotter, Matthew; Suman, Oscar E.; Sidossis, Labros S.; Børsheim, Elisabet

    2015-01-01

    Background Following a major burn, skeletal muscle protein synthesis rate increases, but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months post-injury, and identify predictors that influence this response. Study design 87 children with ≥40% total body surface area (TBSA) burn were included. Patients participated in stable isotope infusion studies at 1, 2 and ~ 4 weeks post-burn, and at 6, 12 and 24 months post-injury to determine skeletal muscle fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. Results Patients (8±6 years) had large (62, 51–72% TBSA) and deep (47±21% TBSA third degree) burns. Muscle fractional synthesis rate was elevated throughout the first 12 months post-burn compared to established values from healthy young adults. Muscle fractional synthesis rate was lower in boys, children >3 years old, and when burns were >80% TBSA. Conclusions Muscle protein synthesis is elevated for at least one year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiological response to burn trauma. Muscle protein synthesis is highly affected by gender, age and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn victims. PMID:25807408

  8. Burn injury in children.

    PubMed

    Zámecníková, I; Stĕtinský, J; Tymonová, J; Kadlcík, M

    2005-01-01

    The authors have analyzed the data files of 580 child patients up to 15 years of age who were hospitalized at the Burn Center of the FNsP Hospital in Ostrava in the years 1999 - 2003. The authors focused on mechanisms of burn injury in relation to the age of a child as well as extent, depth, localization, and local treatment of the injury. The data file was divided to four age groups: up to two years of age, 2 - 5 years of age, 5 - 10 years of age, and 10 - 15 years of age. As regards the mechanisms of injury, the authors have analyzed scalding by hot liquids, burns due to contact with a hot object, burns due to electric current, explosion, and injury caused by burning clothing. Injury by scalding prevails to a very significant degree in the youngest children. In the second age group the incidence of burn following contact with hot objects increases, as does the percentage of children injured by burning of clothing in children aged 5 - 10. The older children have increased prevalence of injuries caused by explosions. The greatest average extent of an injury is from burning of clothing. Most of the areas are burned deeply, localized in more areas of the body, and almost half of the cases required surgical intervention. Scalding comes second in terms of average extent of an injury. More than half of the injured areas are superficial, and areas of injury are different in the individual age groups. We addressed about a fifth of the cases surgically. The explosion of combustible materials caused a smaller extent of injury, on average, taking third place. The injuries were predominantly superficial, most commonly involving the head, trunk, and upper extremities. In none of the cases it was necessary for us to operate. Burn injuries caused by contact with hot objects are of a smaller extent. More than half of the burned areas are deep, localized most commonly in the upper extremities. Surgical intervention was necessary in more than half the cases. In terms of average

  9. Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake.

    PubMed

    Chan, Cecilia L W; Wang, Chong-Wen; Ho, Andy H Y; Qu, Zhi-Yong; Wang, Xi-Ying; Ran, Mao-Sheng; Mao, Wen-Jun; Lu, Ben Qi-Bin; Zhang, Braven Qiang; Zhang, Xiu-Lan

    2012-08-01

    Many studies have suggested that unexpected death of a loved one is an important risk factor of posttraumatic stress disorder (PTSD) and depression among disaster survivors, but few have examined the magnitude of psychiatric morbidities among bereaved survivors. This study examined the prevalence rates of clinically significant PTSD and depressive symptoms and their associated risk factors among Chinese adult survivors following the 2008 Sichuan earthquake. Two hundred and fifty-one bereaved adults were compared with 1474 non-bereaved adult survivors. The estimated rates of PTSD and depressive symptoms were 65.6% and 64.8% for those who lost first-degree family members, 34.1% and 45.5% for those who lost second-degree relatives, and 27.1% and 37.5% for non-bereaved survivors respectively. Loss of a child was a significant predictor of psychopathological symptoms. The results suggested that effective and sustainable mental health services were required, especially for bereaved single-child parents. PMID:22721751

  10. Gendered pattern of burn injuries in India: a neglected health issue.

    PubMed

    Bhate-Deosthali, Padma; Lingam, Lakshmi

    2016-05-01

    There are an estimated 7 million burn injuries in India annually, of which 700,000 require hospital admission and 140,000 are fatal. According to the National Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. This paper reviews the existing literature on burn injuries in India and raises pertinent issues about prevalence, causes and gaps in recognising the gendered factors leading to a high number of women dying due to burns. The work of various women's groups and health researchers with burns victims raises several questions about the categorisation of burn deaths as accident, suicide and homicide and the failure of the health system to recognise underlying violence. Despite compelling evidence, the health system has not recognised this as a priority. Considering the substantial cost of burns care, prevention is the key which requires health systems to recognise the linkages between burn injuries and domestic violence. Health systems need to integrate awareness programmes about domestic violence and train health professionals to identify signs and symptoms of violence. This would contribute to early identification of abuse so that survivors are able to access support services at an early stage. PMID:27578343

  11. Minor burns - aftercare

    MedlinePlus

    ... put a thin layer of ointment, such as petroleum jelly or aloe vera, on the burn. The ... is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation ...

  12. New Fashioned Book Burning.

    ERIC Educational Resources Information Center

    Gardner, Robert

    1997-01-01

    Reports on results of a teacher's experiment in book burning as a lesson accompanying the teaching of Ray Bradbury's "Fahrenheit 451." Discusses student reactions and the purpose of or justification for the experimental lesson. (TB)

  13. Burns (For Parents)

    MedlinePlus

    ... you drowsy, or in bed. Don't use fireworks or sparklers. Bathroom Set the thermostat on your ... For Kids For Parents MORE ON THIS TOPIC Fireworks Safety First Aid: Burns First Aid: Sunburn Sun ...

  14. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the companyused technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications.

  15. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the company used technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications

  16. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the company used technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications.

  17. Determinants of Skeletal Muscle Catabolism After Severe Burn

    PubMed Central

    Hart, David W.; Wolf, Steven E.; Chinkes, David L.; Gore, Dennis C.; Mlcak, Ronald P.; Beauford, Robert B.; Obeng, Michael K.; Lal, Sophia; Gold, Warren F.; Wolfe, Robert R.; Herndon, David N.

    2000-01-01

    Objective To determine which patient factors affect the degree of catabolism after severe burn. Summary Background Data Catabolism is associated with severe burn and leads to erosion of lean mass, impaired wound healing, and delayed rehabilitation. Methods From 1996 to 1999, 151 stable-isotope protein kinetic studies were performed in 102 pediatric and 21 adult subjects burned over 20–99.5% of their total body surface area (TBSA). Patient demographics, burn characteristics, and hospital course variables were correlated with the net balance of skeletal muscle protein synthesis and breakdown across the leg. Data were analyzed sequentially and cumulatively through univariate and cross-sectional multiple regression. Results Increasing age, weight, and delay in definitive surgical treatment predict increased catabolism (P < .05). Body surface area burned increased catabolism until 40% TBSA was reached; catabolism did not consistently increase thereafter. Resting energy expenditure and sepsis were also strong predictors of net protein catabolism. Among factors that did not significantly correlate were burn type, pneumonia, wound contamination, and time after burn. From these results, the authors also infer that gross muscle mass correlates independently with protein wasting after burn. Conclusions Heavier, more muscular subjects, and subjects whose definitive surgical treatment is delayed are at the greatest risk for excess catabolism after burn. Sepsis and excessive hypermetabolism are also associated with protein catabolism. PMID:10998644

  18. Childhood Cancer Survivor Study: An Overview

    Cancer.gov

    Health problems that develop years later as a result of a cancer treatment are known as late effects. The Childhood Cancer Survivor Study (CCSS) was started in 1994 to better understand these late effects.

  19. Survivorship conference highlights research for survivor care

    Cancer.gov

    More than 400 leading experts in cancer survivorship convened today for a conference, Cancer Survivorship Research: Translating Science to Care, to focus on such current concerns as how obesity might not have the same effects on all cancer survivors, and

  20. Managing chronic pain in survivors of torture.

    PubMed

    Amris, Kirstine; Williams, Amanda C de C

    2015-01-01

    All generalist and specialist clinicians are likely to encounter torture survivors among refugees and asylum seekers. A minority of people survive torture and a smaller minority reach a developed country; those who do tend to be the more resilient and resourceful. They have many health, social and welfare problems; persistent pain in the musculoskeletal system is one of the most common. There is little specific evidence on pain in survivors of torture; the guidelines on interdisciplinary specialist management are applicable. Most of the literature on refugee survivors of torture has an exclusive focus on psychological disorders, with particularly poor understanding of pain problems. This article summarizes the current status of assessment and treatment of pain problems in the torture survivor. PMID:25537694

  1. Living as a Breast Cancer Survivor

    MedlinePlus

    ... Emotional aspects of breast cancer Living as a breast cancer survivor For many women with breast cancer, treatment ... making some new choices. Follow-up care after breast cancer treatment Even after you have completed breast cancer ...

  2. The Survivor Syndrome: Aftermath of Downsizing.

    ERIC Educational Resources Information Center

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

    1997-01-01

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

  3. Utilizing Data from Cancer Patient & Survivor Studies

    Cancer.gov

    Utilizing Data from Cancer Patient & Survivor Studies and Understanding the Current State of Knowledge and Developing Future Research Priorities, a 2011 workshop sponsored by the Epidemiology and Genomics Research Program.

  4. Sam Donaldson: Tips From a Cancer Survivor

    MedlinePlus

    ... up on my own specialty of the "Cancer Club, Melanoma Division." Although I am not an oncologist, ... people several things when talking about the survivors club and what we can do. First, we all ...

  5. Ball lightning burn.

    PubMed

    Selvaggi, Gennaro; Monstrey, Stan; von Heimburg, Dennis; Hamdi, Mustapha; Van Landuyt, Koen; Blondeel, Phillip

    2003-05-01

    Ball lightning is a rare physical phenomenon, which is not yet completely explained. It is similar to lightning but with different, peculiar characteristics. It can be considered a mix of fire and electricity, concentrated in a fireball with a diameter of 20-cm that most commonly appears suddenly, even in indoor conditions, during a thunderstorm. It moves quickly for several meters, can change direction, and ultimately disappears. During a great storm, a 28-year-old man and his 5-year-old daughter sustained burn wounds after ball lightning came from the outdoors through a chimney. These two patients demonstrated signs of fire and electrical injuries. The father, who lost consciousness, sustained superficial second-degree burn wounds bilaterally on the zygomatic area and deep second-degree burn wounds on his right hand (total body surface area, 4%). His daughter demonstrated superficial second-degree burn wounds on the left part of the face and deep second-degree and third-degree burn wounds (total body surface area, 30%) on the left neck, both upper arms, and the back. In this article, the authors report the first two cases of burn injuries resulting from ball lightning contact indoors. The literature on this rare phenomenon is reviewed to elucidate the nature of ball lightning. Emphasis is placed on the nature of injuries after ball lightning contact, the therapy used, and the long-term complications. PMID:12792547

  6. PBXN-110 Burn Rate Estimate

    SciTech Connect

    Glascoe, E

    2008-08-11

    It is estimated that PBXN-110 will burn laminarly with a burn function of B = (0.6-1.3)*P{sup 1.0} (B is the burn rate in mm/s and P is pressure in MPa). This paper provides a brief discussion of how this burn behavior was estimated.

  7. Suicide in stroke survivors: epidemiology and prevention.

    PubMed

    Pompili, Maurizio; Venturini, Paola; Lamis, Dorian A; Giordano, Gloria; Serafini, Gianluca; Belvederi Murri, Martino; Amore, Mario; Girardi, Paolo

    2015-01-01

    Stroke is a dramatic event and is associated with potentially severe consequences, including disability, mortality, and social costs. Stroke may occur at any age; however, most strokes occur in individuals aged 65 years and older. Previous research has found that stroke increases suicide risk, especially among women and younger patients. The aim of the current review is to investigate the relationship between suicide and stroke in order to determine which stroke patients are at elevated risk for suicide. Moreover, we review the literature in order to provide pharmacological treatment strategies for stroke patients at high risk of suicide. We performed a careful search to identify articles and book chapters focused on this issue, selecting only English-language articles published from 1990 to 2014 that addressed the issue of suicide after stroke and its pharmacological management. We found 12 clinical trials that explored the relationship between stroke and suicidal ideation and/or suicidal plans and 11 investigating suicide as the cause of death after stroke. We identified stroke as a significant risk factor for both suicide and suicidal ideation, especially among younger adult depressed patients in all articles, providing further support for the association between post-stroke and suicidality. Suicide risk is particularly high in the first 5 years following stroke. Depression, previous mood disorder, prior history of stroke, and cognitive impairment were found to be the most important risk factors for suicide. Selective serotonin reuptake inhibitors (SSRIs) represent the treatment of choice for stroke survivors with suicide risk, and studies in rats have suggested that carbolithium is a promising treatment in these patients. Early identification and treatment of post-stroke depression may significantly reduce suicide risk in stroke patients. PMID:25491561

  8. Weight Management and Exercise for Cancer Survivors.

    PubMed

    Rutledge, Laura; Demark-Wahnefried, Wendy

    2016-04-01

    Obesity may contribute to development and recurrence of cancer, as well as cancer-related and all-cause mortality. This risk factor is also among the most preventable causes of cancer. This article describes current evidence-based guidelines for weight management and physical activity for cancer survivors. The authors also discuss practical interventions to help survivors undertake behavioral changes to manage their weight. PMID:26991704

  9. Development of A-bomb survivor dosimetry

    SciTech Connect

    Kerr, G.D.

    1995-12-31

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

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

    PubMed

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

    2014-01-01

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

  11. Characteristics of elderly Japanese patients with severe burns.

    PubMed

    Morita, Seiji; Higami, Shigeo; Yamagiwa, Takeshi; Iizuka, Shinichi; Nakagawa, Yoshihide; Yamamoto, Isotoshi; Inokuchi, Sadaki

    2010-11-01

    In this study, we report the clinical characteristics of elderly Japanese patients with severe burns. We studied the clinical features of 76 adult patients with severe burns, 35 of whom (46.1%) were ≥65 years old. We evaluated the characteristics of patients with respect to each type of burn. In addition, we studied the rate of death and survival in the elderly and also between the elderly and non-elderly patients. The following parameters were either assessed or compared between the elderly and non-elderly: gender, average age, vital signs (Glasgow Coma Scale, systolic blood pressure, heart rate and respiratory rate) and PaO(2)/FiO(2) (P/F) ratio at admission, cause of burn and a history of physical or psychiatric disease. Further, we investigated whether the burn was caused by attempting suicide and determined the percent total body surface area (%TBSA), second- and third-degree burn area, burn index (BI), prognostic burn index (PBI), presence of tracheal burns, presence of alcohol intoxication and overdose poisoning, presence of tracheal intubation, outcome and cause of death. The male:female ratio of the elderly patients was 17:18 (average age, 78.1 (8.2) years). Burns were mostly caused by flame (26/35), followed by scalding (8/35). Ten patients had attempted suicide. The %TBSA, second-degree burn area, third-degree burn area, BI and PBI, respectively were 46.6% (26.7%), 15.3% (19.0%), 35.6% (26.0%), 41.1 (25.2) and 119.2 (25.9). Of the 35 patients, 23 died. The notable characteristics of the elderly patients who died were flame as the cause of the burns: high %TBSA, BI and PBI, and a high rate of tracheal intubation. Elderly patients constituted approximately 45% of our study population. Most burns were caused by flames. The incidence of accidental bathtub-related burns was higher and that of suicide attempts was lower in the elderly patients, as compared with the non-elderly patients. Severe burns were fatal for elderly patients. Therefore, elderly

  12. Health and Risk Behaviors in Survivors of Childhood Acute Myeloid Leukemia: A Report From the Children’s Oncology Group

    PubMed Central

    Schultz, Kris Ann P.; Chen, Lu; Chen, Zhengjia; Zeltzer, Lonnie K.; Nicholson, H. Stacy; Neglia, Joseph P.

    2011-01-01

    Background Survivors of childhood acute myeloid leukemia (AML) face increased risks of chronic disease and secondary malignancies. Substance exposure may compound these risks. Procedures Participants were diagnosed with AML at <21 years of age and survived ≥5 years following diagnosis. All underwent chemotherapy alone or followed by autologous BMT (chemo ± autoBMT) or underwent allogeneic BMT (alloBMT) if an HLA-matched related donor was available. Survivors completed a health questionnaire and a Youth Risk Behavior Survey (YRBS). Results Of eligible survivors, 117 were ≥18 years of age and completed a YRBS. Survivors were a mean age of 10 years at diagnosis and 24 years at interview. Of the substance exposures assessed by YRBS, tobacco, alcohol, and marijuana were most common. Twenty-two percent (22%) had smoked cigarettes in the last 30 days. One-quarter (25%) reported binge drinking in the last month. None of these exposures varied by treatment group. Less than 10% of survivors reported cocaine, heroin, or methamphetamine use. Men were more likely to report high substance exposure (P = 0.004). Sadness/suicidality score was associated with cancer-related anxiety (P = 0.006) and multiple health conditions (P = 0.006). Conclusions This analysis reveals exposure to tobacco, alcohol, and marijuana in young adults with few differences based on treatment received. Survivors with cancer-related anxiety or multiple health conditions were more likely to report sadness/hopelessness. PMID:20232426

  13. Glaucoma in atomic bomb survivors.

    PubMed

    Kiuchi, Yoshiaki; Yokoyama, Tomoko; Takamatsu, Michiya; Tsuiki, Eiko; Uematsu, Masafumi; Kinoshita, Hirofumi; Kumagami, Takeshi; Kitaoka, Takashi; Minamoto, Atsushi; Neriishi, Kazuo; Nakashima, Eiji; Khattree, Ravindra; Hida, Ayumi; Fujiwara, Saeko; Akahoshi, Masazumi

    2013-10-01

    Radiation has been associated with increases in noncancerous diseases. An effect of low-dose radiation on the prevalence of clinically detected glaucoma has not been previously reported. We therefore investigated the prevalence of glaucoma in A-bomb survivors and its possible association with radiation dose. A total of 1,589 people who participated in the clinical examination program for A-bomb survivors at the Radiation Effects Research Foundation (RERF) between October 2006 and September 2008 and who had reconstructed radiation doses, were recruited into this cross-sectional screening study. The prevalence of glaucoma and its dose-response relationship to A-bomb radiation were measured. Each subject underwent an initial screening consisting of an interview and ophthalmological examination. Questionable cases with any indication of ocular disease, including glaucoma, were referred to local hospitals for more comprehensive evaluation. A diagnosis of glaucoma was made based on specific optic disc appearance, perimetric results and other ocular findings. Of 1,589 eligible people, we detected 284 (17.9%) cases of glaucoma overall, including 36 (2.3%) cases of primary open-angle glaucoma with intraocular pressure levels greater than 21 mmHg, 226 (14.2%) cases of normal-tension glaucoma and 25 (1.6%) cases of primary angle-closure glaucoma. Seven glaucoma risk factors were examined as potential confounders but only two needed to be included in the final model. Binary regression using a generalized estimating equation method, with adjustment for gender, age, city, cataract surgery or diabetes mellitus, revealed an odds ratio at 1 Gy of 1.31 (95% confidence interval 1.11-1.53, P = 0.001) in the case of normal-tension glaucoma, but no association for other types of glaucoma. The prevalence of normal-tension glaucoma may increase with A-bomb radiation dose, but uncertainties associated with nonparticipation (59% participation) suggest caution in the interpretation of these

  14. Frailty score on admission predicts outcomes in elderly burn injury.

    PubMed

    Romanowski, Kathleen S; Barsun, Alura; Pamlieri, Tina L; Greenhalgh, David G; Sen, Soman

    2015-01-01

    With longer life expectancy, the number of burn injuries in the elderly continues to increase. Prediction of outcomes for the elderly is complicated by preinjury physical fitness and comorbid illness. The authors hypothesize that admission frailty assessment would be predictive of outcomes in the elderly burn population. Our primary aim was to determine if higher frailty scores were associated with higher risk of mortality for elderly burn patients. The secondary aims were to assess if higher frailty scores were associated with increased length of stay, increased needs for mechanical ventilation and poor discharge disposition. A 2-year retrospective chart review was performed of all admitted acute burn patients 65 years or older. Data collected included: age, gender, %TBSA of burn injury, presence of inhalation injury, in hospital mortality, hospital length of stay, ventilator days, ICU length of stay, surgical procedures, insurance status, and discharge disposition. Frailty scores were assessed from admission data and calculated using the Canadian Study of Health and Aging clinical frailty scale. A total of 89 patients met entry criteria. Mean age was 75.3 ± 8.1 years and consisted of 62 men and 27 women. Mean %TBSA was 9.6 ± 9.1% and mean frailty score (FS) was 4.5 ± 1.2. Eighty patients survived to discharge and nine died. Nonsurvivors had significantly higher FS compared to survivors (5.2 ± 1.2 vs 4.4 ± 1.2). FS were also significantly higher in patients discharged to skilled nursing facilities (SNF) (5.34 ± 0.9) compared to those who were discharged home (4.1 ± 1.2) or to physical rehabilitation facilities (4 ± 1.5). Multivariate linear regression analysis revealed that age (B = 0.04) and discharge to SNF (B = 1.2) are independently associated with higher FS. However, survivors were independently associated with a significantly lower FS (B = -1.3). Multivariate logistic regression analysis revealed high admission FS independently increased the risk of

  15. Uncoupling protein 3 expression and intramyocellular lipid accumulation by NMR following local burn trauma.

    PubMed

    Zhang, Qunhao; Cao, Haihui; Astrakas, Loukas G; Mintzopoulos, Dionyssios; Mindrinos, Michael N; Schulz, John; Tompkins, Ronald G; Rahme, Laurence G; Tzika, A Aria

    2006-12-01

    Burn trauma is a clinical condition accompanied by muscle wasting that severely impedes rehabilitation in burn survivors. Mitochondrial uncoupling protein 3 (UCP3) is uniformly expressed in myoskeletal mitochondria and its expression has been found to increase in other clinical syndromes that, like burn trauma, are associated with muscle wasting (e.g., starvation, fasting, cancer, sepsis). The aim of this study was to explore the effects of burn trauma on UCP3 expression, intramyocellular lipids, and plasma-free fatty acids. Mice were studied at 6 h, 1 d and 3 d after nonlethal hindlimb burn trauma. Intramyocellular lipids in hindlimb skeletal muscle samples collected from burned and normal mice were measured using 1H NMR spectroscopy on a Bruker 14.1 Tesla spectrometer at 4 degrees C. UCP3 mRNA and protein levels were also measured in these samples. Plasma-free fatty acids were measured in burned and normal mice. Local burn trauma was found to result in: 1) upregulation of UCP3 mRNA and protein expression in hindlimb myoskeletal mitochondria by 6 h postburn; 2) increased intramyocellular lipids; and 3) increased plasma-free fatty acids. Our findings show that the increase in UCP3 after burn trauma may be linked to burn-induced alterations in lipid metabolism. Such a link could reveal novel insights into how processes related to energy metabolism are controlled in burn and suggest that induction of UCP3 by burn in skeletal muscle is protective by either activating cellular redox signaling and/or mitochondrial uncoupling. PMID:17089030

  16. Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report.

    PubMed

    Chow, Eric J; Anderson, Lynnette; Baker, K Scott; Bhatia, Smita; Guilcher, Gregory M T; Huang, Jennifer T; Pelletier, Wendy; Perkins, Joanna L; Rivard, Linda S; Schechter, Tal; Shah, Ami J; Wilson, Karla D; Wong, Kenneth; Grewal, Satkiran S; Armenian, Saro H; Meacham, Lillian R; Mulrooney, Daniel A; Castellino, Sharon M

    2016-05-01

    Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies, solid tumors, and, increasingly, nonmalignant diseases. Given improvements in care, there are a growing number of long-term survivors of pediatric HCT. Compared with childhood cancer survivors who did not undergo transplantation, HCT survivors have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pretransplantation treatment exposures and organ dysfunction, the transplantation conditioning regimen, and any post-transplantation graft-versus-host disease (GVHD). In response, the Children's Oncology Group (COG) has created long-term follow-up guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those who were treated with HCT. Guideline task forces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other health care professionals, and patient advocates systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided herein is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those who underwent transplantation for nonmalignant diseases, and those with a history of chronic GVHD. PMID

  17. Long-term health outcomes in a British cohort of breast, colorectal and prostate cancer survivors: a database study

    PubMed Central

    Khan, N F; Mant, D; Carpenter, L; Forman, D; Rose, P W

    2011-01-01

    Background: The community-based incidence of cancer treatment-related long-term consequences is uncertain. We sought to establish the burden of health outcomes that have been associated with treatment among British long-term cancer survivors. Methods: We identified 26 213 adults from the General Practice Research Database who have survived 5 years or more following breast, colorectal or prostate cancer. Four age-, sex- and general practice-matched non-cancer controls were selected for each survivor. We considered the incidence of treatment-associated health outcomes using Cox proportional hazards models. Results: Breast cancer survivors had an elevated incidence of heart failure (hazards ratio (HR) 1.95, 95% confidence interval (CI) 1.27–3.01), coronary artery disease (HR 1.27, 95% CI 1.11–1.44), hypothyroidism (HR 1.26, 95% CI 1.02–1.56) and osteoporosis (HR 1.26, 95% CI 1.13–1.40). Among colorectal cancer survivors, there was increased incidence of dementia (HR 1.68, 95% CI 1.20–2.35), diabetes (HR 1.39, 95% CI 1.12–1.72) and osteoporosis (HR 1.41, 95% CI 1.15–1.73). Prostate cancer survivors had the highest risk of osteoporosis (HR 2.49, 95% CI 1.93–3.22). Conclusions: The study confirms the occurrence of increased incidence of chronic illnesses in long-term cancer survivors attributable to underlying lifestyle and/or cancer treatments. Although the absolute risk of the majority of late effects in the cancer survivors cohort is low, identifying prior risk of osteoporosis by bone mineral density scanning for prostate survivors should be considered. There is an urgent need to improve primary care recording of cancer treatment. PMID:22048030

  18. Cardiovascular disease mortality of A-bomb survivors and the healthy survivor selection effect.

    PubMed

    Schöllnberger, H; Ozasa, K; Neff, F; Kaiser, J C

    2015-09-01

    The latest A-bomb survivor data for cardiovascular diseases are analysed to investigate whether in the first years after the bombings the baseline rates of proximal survivors were markedly different compared with those of the distal survivors. This phenomenon relates to a healthy survivor selection effect. This question is important for the decision whether to include or exclude the early years of follow-up when analysing the biological effects from acute low and high dose exposures following the nuclear weapons explosions in Hiroshima and Nagasaki. The present study shows that for cerebrovascular diseases and heart diseases the baseline rates are not significantly different in the first two decades of follow-up. Thus, for these two detrimental health outcomes, there is no need to exclude distal survivors and the first decades of follow-up time when investigating the shapes of the related dose-responses. PMID:25948837

  19. Literacy Learning Care: Exploring the Roles of Care in Literacy Learning with Survivors of Abuse in Irish Industrial Schools

    ERIC Educational Resources Information Center

    Feely, Maggie

    2010-01-01

    The links between literacy and care have received little attention. A general neglect of the affective domain in the academe is strongly echoed in traditional analyses of unmet adult literacy needs where economic causes and consequences dominate debates. The findings from a study of people who are survivors of institutional abuse and neglect…

  20. Sense of Community and Depressive Symptoms among Older Earthquake Survivors Following the 2008 Earthquake in Chengdu China

    ERIC Educational Resources Information Center

    Li, Yawen; Sun, Fei; He, Xusong; Chan, Kin Sun

    2011-01-01

    This study examined the impact of an earthquake as well as the role of sense of community as a protective factor against depressive symptoms among older Chinese adults who survived an 8.0 magnitude earthquake in 2008. A household survey of a random sample was conducted 3 months after the earthquake and 298 older earthquake survivors participated…

  1. Prevalence of skin neoplasma amont the atomic bomb survivors

    SciTech Connect

    Yamada, Michiko; Kodama, Kazunori; Akahoshi, Masazumi

    1996-08-01

    About 7,000 atomic bomb (A-bomb) survivors from Hiroshima and Nagasaki who participate in the Radiation Effects Research Foundation (RERF) Adult Health Study (AHS) were examined to define the relationship between skin neoplasms and exposure to ionizing radiation. Careful clinical inspection of the skin was undertaken to detect not only skin cancer but precancerous lesions such as senile keratosis. Five cases of basal cell carcinoma, five cases of senile keratosis and one case of Bowen`s disease were confirmed histologically among 5955 A-bomb survivors for whom Dosimetry System 1986 (DS86) dose estimates are available. The relationship between the combined prevalence of skin cancer and precancerous lesions and DS86 dose was examined together with other factors that might affect skin neoplasms including occupational exposure to ultraviolet (UV) rays, age, sex and city. The prevalence of basal cell carcinoma and senile keratosis increased as the DS86 dose increased. The prevalent of skin cancer and senile keratosis among persons engaged in work involving frequent exposure to UV rays was higher than among those who were not engaged in such work. Sex and city were not significantly related to those skin diseases. Odds ratios of skin neoplasm for a 1-Gy dose, occupational exposure to UV rays and age at time of examination exposure to UV rays and age at time of examination (in 10-year increments) are 1.7, 5.9 and 1.9, respectively. 22 refs., 3 tabs.

  2. Long-Term Outcomes in Patients Surviving Large Burns: The Musculoskeletal System.

    PubMed

    Holavanahalli, Radha K; Helm, Phala A; Kowalske, Karen J

    2016-01-01

    The authors have previously described long-term outcomes related to the skin in patients surviving large burns. The objective of this study was to describe the long-term musculoskeletal complications following major burn injury. This is a cross-sectional descriptive study that includes a one-time evaluation of 98 burn survivors (mean age = 47 years; mean TBSA = 57%; and mean time from injury = 17 years), who consented to participate in the study. A comprehensive history and physical examination was conducted by a senior and experienced Physical Medicine and Rehabilitation physician. In addition to completing a Medical Problem Checklist, subjects also completed the Burn-Specific Health Scale (Abbreviated 80 item), a self-report measure used to review the level of functional adaptation. Joint pain, joint stiffness, problems walking or running, fatigue, and weak arms and hands are conditions that continue to be reported at an average of 17 years from the time of burn injury. Seventy-three percent (68 of 93) of the study sample were found to have a limitation of motion and areas most affected were the neck (47%), hands (45%), and axilla (38%). The global (Burn-Specific Health Scale-total) score for the overall sample was 0.78. Subjects with limitation of motion had significant difficulty in areas of mobility, self-care, hand function, and role activities. This study underscores the importance of long-term follow-up care and therapeutic interventions for survivors of major burn injury, as they continue to have significant and persistent burn-related impairments even several years following injury. PMID:26056761

  3. Burning trees and bridges

    NASA Technical Reports Server (NTRS)

    Levine, Joel S.

    1990-01-01

    Most burning of biomass is the result of human activity, and on a global scale it is increasing. Tropospheric concentrations of CO2, CO, CH4, non-methane hydrocarbons, and ozone are all increasing with time; global biomass burning may make an important contribution to this increase and thus to potential global climate change. The nitrogen cycle also can have important climatic effects. Nitrous oxide put into the atmosphere by biomass burning is a greenhouse gas 250 times more powerful (molecule for molecule) than carbon dioxide. Nitric oxide, as well as being a photochemical precursor of ozone, a major pollutant in the troposphere, produces nitric acid, the fastest-growing component of acid rain. Hence, the new bridge in the nitrogen cycle is of more than mere technical interest.

  4. Cancer-Related Information Seeking Among Cancer Survivors: Trends Over a Decade (2003-2013).

    PubMed

    Finney Rutten, Lila J; Agunwamba, Amenah A; Wilson, Patrick; Chawla, Neetu; Vieux, Sana; Blanch-Hartigan, Danielle; Arora, Neeraj K; Blake, Kelly; Hesse, Bradford W

    2016-06-01

    The demonstrated benefits of information seeking for cancer patients, coupled with increases in information availability, underscore the importance of monitoring patient information seeking experiences over time. We compared information seeking among cancer survivors to those with a family history of cancer and those with no history of cancer. We identified characteristics associated with greater information seeking among cancer survivors, key sources of cancer-related information, and changes in information source use over time. Data from five iterations of the Health Information National Trends Survey (HINTS) spanning 2003 to 2013 were merged and analyzed. Frequencies, cross-tabulations, multivariate logistic regression, and multinomial regression analyses were conducted. All data were weighted to provide representative estimates of the adult US population. Cancer information seeking was reported most frequently by cancer survivors (69.8 %). The percentage of cancer survivors who reported information seeking increased from 66.8 % in 2003 to 80.8 % in 2013. Cancer information seeking was independently associated with age, education, and income; seeking was less likely among older adults, those with less education, and those with lower incomes. Compared to respondents in 2003, those in 2005 (odds ratio (OR) = 0.40, 95 % confidence interval (CI) = 0.24-0.65) and 2008 (OR = .43, 95 % CI = 0.26-0.70) were about half as likely to use the Internet as the first source of cancer information compared to a healthcare provider. Despite overall increases in cancer information seeking and access to health information from a variety of sources, healthcare providers remain a key source of health information for cancer survivors. PMID:25712202

  5. Burning mouth syndrome.

    PubMed

    Jimson, Sudha; Rajesh, E; Krupaa, R Jayasri; Kasthuri, M

    2015-04-01

    Burning mouth syndrome (BMS) is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a result, a multidisciplinary approach is required for better control of the symptoms. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms. PMID:26015707

  6. Fast burning propellants

    SciTech Connect

    Colgate, S.A.; Roos, G.E.

    1987-07-21

    A solid or semisolid propellant is described comprising grains of propellant or propellant components bonded together to create voids within the propellant volume. The grains are of near-uniform size and have less than about a 20% size variation between the largest and smallest grains, the voids comprising from about 10% to about 50% of the propellant volume. The grains are bonded together with sufficient strength to substantially delay the fluidization of the propellant by the onset of Taylor unstable burning. The propellant has a rapid burn rate of from about 10 cm sec/sup -1/ to about 10/sup 4/cm sec/sup -1/.

  7. Sexual and gender based violence against men in the Democratic Republic of Congo: effects on survivors, their families and the community.

    PubMed

    Christian, Mervyn; Safari, Octave; Ramazani, Paul; Burnham, Gilbert; Glass, Nancy

    2011-01-01

    Media and service provider reports of sexual and gender based violence (SGBV) perpetrated against men in armed conflicts have increased. However, response to these reports has been limited, as existing evidence and programs have primarily focused on prevention and response to women and girl survivors of SGBV. This study aims to contribute to the evidence of SGBV experienced by males by advancing our understanding of the definition and characteristics of male SGBV and the overlap of health, social and economic consequences on the male survivor, his family and community in conflict and post-conflict settings. The qualitative study using purposive sampling was conducted from June-August 2010 in the South Kivu province of Eastern DRC, an area that has experienced over a decade of armed conflict. Semi structured individual interviews and focus group discussions were conducted with adult male survivors of SGBV, the survivors' wife and/or friend, health care and service providers, community members and leaders. This study found that SGBV against men, as for women, is multi-dimensional and has significant negative physical, mental, social and economic consequences for the male survivor and his family. SGBV perpetrated against men and boys is likely common within a conflict-affected region but often goes unreported by survivors and others due to cultural and social factors associated with sexual assaults, including survivor shame, fear of retaliation by perpetrators and stigma by community members. All key stakeholders in our study advocated for improvements and programs in several areas: (1) health care services, including capacity to identify survivors and increased access to clinical care and psychosocial support for male survivors; (2) economic development initiatives, including microfinance programs, for men and their families to assist them to regain their productive role in the family; (3) community awareness and education of SGBV against men to reduce stigma and

  8. A-bomb survivor dosimetry update

    SciTech Connect

    Loewe, W.E.

    1982-06-01

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

  9. Management of acute burns and burn shock resuscitation.

    PubMed

    Faldmo, L; Kravitz, M

    1993-05-01

    Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications. PMID:8489882

  10. Accidental radioisotope burns - Management of late sequelae.

    PubMed

    Varghese, Bipin T; Thomas, Shaji; Nair, Balakrishnan; Mathew, P C; Sebastian, Paul

    2010-09-01

    Accidental radioisotope burns are rare. The major components of radiation injury are burns, interstitial pneumonitis, acute bone marrow suppression, acute renal failure and adult respiratory distress syndrome. Radiation burns, though localized in distribution, have systemic effects, and can be extremely difficult to heal, even after multiple surgeries. In a 25 year old male who sustained such trauma by accidental industrial exposure to Iridium192 the early presentation involved recurrent haematemesis, pancytopenia and bone marrow suppression. After three weeks he developed burns in contact areas in the left hand, left side of the chest, abdomen and right inguinal region. All except the inguinal wound healed spontaneously but the former became a non-healing ulcer. Pancytopenia and bone marrow depression followed. He was treated with morphine and NSAIDs, epidural buprinorphine and bupivicaine for pain relief, steroids, antibiotics followed by wound excision and reconstruction with tensor fascia lata(TFL) flap. Patient had breakdown of abdominal scar later and it was excised with 0.5 cm margins up to the underlying muscle and the wound was covered by a latissimis dorsi flap. Further scar break down and recurrent ulcers occurred at different sites including left wrist, left thumb and right heel in the next two years which needed multiple surgical interventions. PMID:21321664

  11. The Effect of Burn Center Volume on Mortality in a Pediatric Population: An Analysis of the National Burn Repository

    PubMed Central

    Hodgman, Erica I.; Saeman, Melody R.; Subramanian, Madhu

    2016-01-01

    The effect of burn center volume on mortality has been demonstrated in adults. The authors sought to evaluate whether such a relationship existed in burned children. The National Burn Repository, a voluntary registry sponsored by the American Burn Association, was queried for all data points on patients aged 18 years or less and treated from 2002 to 2011. Facilities were divided into quartiles based on average annual burn volume. Demographics and clinical characteristics were compared across groups, and univariate and multivariate logistic regressions were performed to evaluate relationships between facility volume, patient characteristics, and mortality. The authors analyzed 38,234 patients admitted to 88 unique facilities. Children under age 4 years or with larger burns were more likely to be managed at high-volume and very high–volume centers (57.12 and 53.41%, respectively). Overall mortality was low (0.85%). Comparing mortality across quartiles demonstrated improved unadjusted mortality rates at the low- and high-volume centers compared with the medium-volume and very high–volume centers although univariate logistic regression did not find a significant relationship. However, multivariate analysis identified burn center volume as a significant predictor of decreased mortality after controlling for patient characteristics including age, mechanism of injury, burn size, and presence of inhalation injury. Mortality among pediatric burn patients is low and was primarily related to patient and injury characteristics, such as burn size, inhalation injury, and burn cause. Average annual admission rate had a significant but small effect on mortality when injury characteristics were considered. PMID:26146907

  12. Cancer Survivors More Prone to Obesity, Study Finds

    MedlinePlus

    ... fullstory_160399.html Cancer Survivors More Prone to Obesity, Study Finds Risk appears to be particularly high ... 12, 2016 FRIDAY, Aug. 12, 2016 (HealthDay News) -- Obesity is more common among cancer survivors in the ...

  13. Risk of Getting Ebola from Survivors Seems Low, Study Finds

    MedlinePlus

    ... medlineplus/news/fullstory_157513.html Risk of Getting Ebola From Survivors Seems Low, Study Finds However, sexual ... The risk of infection with the often-fatal Ebola virus from non-sexual contact with survivors seems ...

  14. TRIAL BURNS: METHODS PERSPECTIVE

    EPA Science Inventory

    When conducting a trial burn, it is necessary to make a number of measurements in order to adequately define the performance of the incinerator. n addition to flue gas emissions for particulate matter, HCl, and selected organics, it is also necessary to measure selected organics ...

  15. The Burn Wound Microenvironment

    PubMed Central

    Rose, Lloyd F.; Chan, Rodney K.

    2016-01-01

    Significance: While the survival rate of the severely burned patient has improved significantly, relatively little progress has been made in treatment or prevention of burn-induced long-term sequelae, such as contraction and fibrosis. Recent Advances: Our knowledge of the molecular pathways involved in burn wounds has increased dramatically, and technological advances now allow large-scale genomic studies, providing a global view of wound healing processes. Critical Issues: Translating findings from a large number of in vitro and preclinical animal studies into clinical practice represents a gap in our understanding, and the failures of a number of clinical trials suggest that targeting single pathways or cytokines may not be the best approach. Significant opportunities for improvement exist. Future Directions: Study of the underlying molecular influences of burn wound healing progression will undoubtedly continue as an active research focus. Increasing our knowledge of these processes will identify additional therapeutic targets, supporting informed clinical studies that translate into clinical relevance and practice. PMID:26989577

  16. Accumulative eschar after burn.

    PubMed

    Ma, Fushun

    2016-02-01

    Eschar formation is a potential sequela of burn injuries. Definitive management may include escharectomy and eschar debridement. After eschar removal, the wound can be covered with a skin graft or reepithelialization. For prolonged refractory eschar on the fingertips, topical use of rb-bFGF after debridement can achieve an optimal outcome. PMID:26862412

  17. The Earth Could Burn.

    ERIC Educational Resources Information Center

    Yarrow, Ruth

    1982-01-01

    Environmental educators are worried about the ultimate ecological threat--nuclear war, which could burn thousands of square miles, sterilize the soil, destroy 70 percent of the ozone layer letting in lethal ultraviolet rays, and cause severe radiation sickness. Educators must inform themselves, teach others, contact government representatives, and…

  18. TIRES, OPEN BURNING

    EPA Science Inventory

    The chapter describes available information on the health effects from open burning of rubber tires. It concentrates on the three known sources of detailed measurements: (1) a small-scale emissions characterization study performed by the U.S. EPA in a facility designed to simulat...

  19. Chemical burn or reaction

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000059.htm Chemical burn or reaction To use the sharing features on this page, please enable JavaScript. Chemicals that touch skin can lead to a reaction on the skin, throughout the body, or both. ...

  20. Benchmarking Outcomes in the Critically Injured Burn Patient

    PubMed Central

    Klein, Matthew B.; Goverman, Jeremy; Hayden, Douglas L.; Fagan, Shawn P.; McDonald-Smith, Grace P.; Alexander, Andrew K.; Gamelli, Richard L.; Gibran, Nicole S.; Finnerty, Celeste C.; Jeschke, Marc G.; Arnoldo, Brett; Wispelwey, Bram; Mindrinos, Michael N.; Xiao, Wenzhong; Honari, Shari E.; Mason, Philip H.; Schoenfeld, David A.; Herndon, David N.; Tompkins, Ronald G.

    2014-01-01

    Objective To determine and compare outcomes with accepted benchmarks in burn care at six academic burn centers. Background Since the 1960s, U.S. morbidity and mortality rates have declined tremendously for burn patients, likely related to improvements in surgical and critical care treatment. We describe the baseline patient characteristics and well-defined outcomes for major burn injuries. Methods We followed 300 adults and 241 children from 2003–2009 through hospitalization using standard operating procedures developed at study onset. We created an extensive database on patient and injury characteristics, anatomic and physiological derangement, clinical treatment, and outcomes. These data were compared with existing benchmarks in burn care. Results Study patients were critically injured as demonstrated by mean %TBSA (41.2±18.3 for adults and 57.8±18.2 for children) and presence of inhalation injury in 38% of the adults and 54.8% of the children. Mortality in adults was 14.1% for those less than 55 years old and 38.5% for those age ≥55 years. Mortality in patients less than 17 years old was 7.9%. Overall, the multiple organ failure rate was 27%. When controlling for age and %TBSA, presence of inhalation injury was not significant. Conclusions This study provides the current benchmark for major burn patients. Mortality rates, notwithstanding significant % TBSA and presence of inhalation injury, have significantly declined compared to previous benchmarks. Modern day surgical and medically intensive management has markedly improved to the point where we can expect patients less than 55 years old with severe burn injuries and inhalation injury to survive these devastating conditions. PMID:24722222

  1. Preparing professional staff to care for cancer survivors

    PubMed Central

    Economou, Denice; Ferrell, Betty; Bhatia, Smita

    2010-01-01

    Introduction Oncology health care professionals frequently lack the background to implement needed survivorship activities and follow-up care. The purpose of this project is to assist providers in the clarification and initiation of potentially durable changes in survivorship care by developing a health professional curriculum, recruiting participants, implementing the course, conducting course evaluation and following participants’ defined goals over time. Materials and methods The curriculum was developed based on recommendations from the Institute of Medicine Report-From Cancer Patient to Cancer Survivor—Lost in Transition. Three concepts were used to structure the course: cancer survivorship quality of life, changing practice via performance improvement, and principles of adult education. Expert faculty designed and implemented the curriculum and teaching methods using adult learning principles and an interactive approach. Competitively-selected, two-person interdisciplinary teams for the first course (July 12–15, 2006, Pasadena, California) were selected based on stated interests, three projected goals, and letters of commitment from administrators. Results Participants represented 52 cancer care settings from 28 states. Teams included Nurses (48.1%), Social Workers (20.7%), Physicians (18.8%), Directors/Administrators (6.6%), Psychologists (2.8%), and others (3%). The institutional barriers identified by teams were lack of survivorship knowledge (94 %), financial constraints (61%), lack of administrative support (6%), and staff philosophy that excluded survivorship (15%). Evaluation of content from the first course was consistently positive. Conclusions Dissemination of survivorship education for health care professionals stimulates participants to define and begin to implement goals for improving survivors’ care. Implications for cancer survivors A training program such as the one described provides professional knowledge regarding survivorship that

  2. Supplemental security income and social security disability insurance coverage among long-term childhood cancer survivors.

    PubMed

    Kirchhoff, Anne C; Parsons, Helen M; Kuhlthau, Karen A; Leisenring, Wendy; Donelan, Karen; Warner, Echo L; Armstrong, Gregory T; Robison, Leslie L; Oeffinger, Kevin C; Park, Elyse R

    2015-06-01

    Supplemental security income (SSI) and social security disability insurance (DI) are federal programs that provide disability benefits. We report on SSI/DI enrollment in a random sample of adult, long-term survivors of childhood cancer (n = 698) vs a comparison group without cancer (n = 210) from the Childhood Cancer Survivor Study who completed a health insurance survey. A total of 13.5% and 10.0% of survivors had ever been enrolled on SSI or DI, respectively, compared with 2.6% and 5.4% of the comparison group. Cranial radiation doses of 25 Gy or more were associated with a higher risk of current SSI (relative risk [RR] = 3.93, 95% confidence interval [CI] = 2.05 to 7.56) and DI (RR = 3.65, 95% CI = 1.65 to 8.06) enrollment. Survivors with severe/life-threatening conditions were more often enrolled on SSI (RR = 3.77, 95% CI = 2.04 to 6.96) and DI (RR = 2.73, 95% CI = 1.45 to 5.14) compared with those with mild/moderate or no health conditions. Further research is needed on disability-related financial challenges after childhood cancer. PMID:25770148

  3. ELBW survivors in early adulthood have higher hepatic, pancreatic and subcutaneous fat.

    PubMed

    Crane, Justin D; Yellin, Samuel A; Ong, Frank J; Singh, Nina P; Konyer, Norman; Noseworthy, Michael D; Schmidt, Louis A; Saigal, Saroj; Morrison, Katherine M

    2016-01-01

    Premature birth in conjunction with extremely low birth weight (<1 kg, ELBW) is associated with insulin resistance and increased cardiometabolic health risk compared to birth at full term with normal birth weight (NBW). However, little is known regarding the biologic mediators of these effects. Abdominal and ectopic lipid accumulation is linked to insulin resistance and metabolic dysfunction, yet whether ELBW survivors are predisposed to aberrant lipid deposition in adulthood is unknown. We used magnetic resonance imaging in a cohort of 16 NBW and 29 ELBW participants to determine if ELBW survivors have differences in pancreatic, hepatic, subcutaneous and visceral fat distribution compared to NBW participants. ELBW individuals had a higher proportion of liver and pancreatic fat compared to NBW subjects (P < 0.05). Abdominal subcutaneous fat, but not visceral fat, area was higher in ELBW survivors compared to NBW individuals. In multivariate analyses, tissue fat measures were most highly related to BMI and sex, but not preterm birth. This work highlights that fat deposition is enhanced in adults born preterm and suggests that ectopic fat accretion driven by their relatively greater adiposity may contribute to the higher rates of metabolic dysfunction seen in ELBW survivors. PMID:27530702

  4. ELBW survivors in early adulthood have higher hepatic, pancreatic and subcutaneous fat

    PubMed Central

    Crane, Justin D.; Yellin, Samuel A.; Ong, Frank J.; Singh, Nina P.; Konyer, Norman; Noseworthy, Michael D.; Schmidt, Louis A.; Saigal, Saroj; Morrison, Katherine M.

    2016-01-01

    Premature birth in conjunction with extremely low birth weight (<1 kg, ELBW) is associated with insulin resistance and increased cardiometabolic health risk compared to birth at full term with normal birth weight (NBW). However, little is known regarding the biologic mediators of these effects. Abdominal and ectopic lipid accumulation is linked to insulin resistance and metabolic dysfunction, yet whether ELBW survivors are predisposed to aberrant lipid deposition in adulthood is unknown. We used magnetic resonance imaging in a cohort of 16 NBW and 29 ELBW participants to determine if ELBW survivors have differences in pancreatic, hepatic, subcutaneous and visceral fat distribution compared to NBW participants. ELBW individuals had a higher proportion of liver and pancreatic fat compared to NBW subjects (P < 0.05). Abdominal subcutaneous fat, but not visceral fat, area was higher in ELBW survivors compared to NBW individuals. In multivariate analyses, tissue fat measures were most highly related to BMI and sex, but not preterm birth. This work highlights that fat deposition is enhanced in adults born preterm and suggests that ectopic fat accretion driven by their relatively greater adiposity may contribute to the higher rates of metabolic dysfunction seen in ELBW survivors. PMID:27530702

  5. Holocaust survivors: three waves of resilience research.

    PubMed

    Greene, Roberta R; Hantman, Shira; Sharabi, Adi; Cohen, Harriet

    2012-01-01

    Three waves of resilience research have resulted in resilience-enhancing educational and therapeutic interventions. In the first wave of inquiry, researchers explored the traits and environmental characteristics that enabled people to overcome adversity. In the second wave, researchers investigated the processes related to stress and coping. In the third wave, studies examined how people grow and are transformed following adverse events, often leading to self-actualize, client creativity and spirituality. In this article the authors examined data from a study, "Forgiveness, Resiliency, and Survivorship among Holocaust Survivors" funded by the John Templeton Foundation ( Greene, Armour, Hantman, Graham, & Sharabi, 2010 ). About 65% of the survivors scored on the high side for resilience traits. Of the survivors, 78% engaged in processes considered resilient and felt they were transcendent or had engaged in behaviors that help them grow and change over the years since the Holocaust, including leaving a legacy and contributing to the community. PMID:23092377

  6. [Treatment of hydrofluoric acid burns].

    PubMed

    Thiele, B; Winter, U J; Mahrle, G; Steigleder, G K

    1986-01-31

    A chemical-plant worker sustained hydrofluoric acid burns during cleaning procedures. Intra-arterial perfusion and intralesional injections of calcium gluconate solution prevented progression of the burns into deeper tissue layers. PMID:3943470

  7. Biomass Burning Data and Information

    Atmospheric Science Data Center

    2015-04-21

    ... of total amount of biomass burned. These data may be used in general circulation models (GCMs) and in photochemical models of the ... Biomass Burning Discipline:  Tropospheric Chemistry Field Campaigns Aerosols Platform:  ...

  8. 5 CFR 831.645 - Elections between survivor annuities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Elections between survivor annuities. 831... REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Eligibility § 831.645 Elections between survivor... Fund. (b) A current spouse is entitled to a current spouse annuity based on an election under §...

  9. 5 CFR 831.645 - Elections between survivor annuities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Elections between survivor annuities. 831... REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Eligibility § 831.645 Elections between survivor... Fund. (b) A current spouse is entitled to a current spouse annuity based on an election under §...

  10. 5 CFR 837.702 - Offset from supplemental survivor annuity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Offset from supplemental survivor annuity. 837.702 Section 837.702 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... survivor annuity. (a) OPM will reduce a supplemental survivor annuity (an annuity under 5 U.S.C....

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

    ERIC Educational Resources Information Center

    Wheeler, Inese; And Others

    1992-01-01

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

  12. The Survivor Master Narrative in Sexual Assault.

    PubMed

    Muldoon, Shane D; Taylor, S Caroline; Norma, Caroline

    2016-04-01

    This article is based on data drawn from 90 Victoria Police operational files covering the period 2004-2008. Several thematic responses by sexual assault survivors are described as forming a master narrative of "identity shock." It is argued that the "minor/serious" sexual assault legal distinction is meaningless to survivors and conceals a shared felt experience. It is also argued that sexual assault is fundamentally a "public issue" of betrayal of citizen trust--not just a collection of "private troubles"--and that effective resolutions require more than individualized therapeutic and criminal justice measures. PMID:26721902

  13. Working with refugee survivors of torture.

    PubMed Central

    Chester, B; Holtan, N

    1992-01-01

    Numerous factors must be taken into account to best provide for the health and well-being of refugee patients in developed countries. One issue that is rarely considered is the awful and not uncommon occurrence of political torture. Large numbers of refugees and other displaced persons are survivors of political torture, and health care professionals must be prepared for this possibility when treating refugee patients. The effects of torture are pervasive, and we provide some practical considerations for health professionals who care for survivors of torture. Specific challenges include problems relating to exile and resettlement, somatic symptoms and pain, and the "medicalization" of torture sequelae. PMID:1413774

  14. The Sexuality of Childhood Sexual Abuse Survivors

    PubMed Central

    Roller, Cynthia; Martsolf, Donna S; Draucker, Claire Burke; Ross, Ratchneewan

    2011-01-01

    In this grounded theory study, a theoretical framework that depicts the process by which childhood sexual abuse (CSA) influences the sexuality of women and men survivors was constructed. Data were drawn from interview transcripts of 95 men and women who experienced CSA. Using constant comparison analysis, the researchers determined that the central phenomenon of the data was a process labeled Determining My Sexual Being, in which survivors moved from grappling with questions related to the nature, cause, and sexual effects of the abuse to laying claim to their own sexuality. Clinical implications are discussed. PMID:21785665

  15. BURN DATA COORDINATING CENTER (BDCC)

    EPA Science Inventory

    The Burn Data Coordinating Center (BDCC) began collecting data in 1994 and is currently the largest burn database in the country. Pediatric burn data was added in 1998. The BMS database contains over 2,800 cases supporting clinical research and research on outcomes including empl...

  16. The overall patterns of burns

    PubMed Central

    Almoghrabi, A.; Abu Shaban, N.

    2011-01-01

    Summary Burn patterns differ across the whole world and not only in relation to lack of education, overcrowding, and poverty. Cultures, habits, traditions, psychiatric illness, and epilepsy are strongly correlated to burn patterns. However, burns may also occur because of specific religious beliefs and activities, social events and festivals, traditional medical practices, occupational activities, and war. PMID:22639565

  17. PGN Prescribed Burn Research Summary

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Since 1997, we have been studying the effects of prescribed burns conducted during late winter on shortgrass steppe on the Pawnee National Grassland. During 1997 – 2002, we studied burns on the western (Crow Valley) portion of the Pawnee by comparing plant growth on burns conducted by the Forest Ser...

  18. Is proportion burned severely related to daily area burned?

    NASA Astrophysics Data System (ADS)

    Birch, Donovan S.; Morgan, Penelope; Kolden, Crystal A.; Hudak, Andrew T.; Smith, Alistair M. S.

    2014-05-01

    The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall τ = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day.

  19. Reach Out to Enhance Wellness in Older Cancer Survivors (RENEW): Design, Methods and Recruitment Challenges of a Home-based Exercise and Diet Intervention to Improve Physical Function among Long-term Survivors of Breast, Prostate, and Colorectal Cancer

    PubMed Central

    Snyder, Denise Clutter; Morey, Miriam C.; Sloane, Richard; Stull, Valeda; Cohen, Harvey Jay; Peterson, Bercedis; Pieper, Carl; Hartman, Terryl J.; Miller, Paige E.; Mitchell, Diane C.; Demark-Wahnefried, Wendy

    2009-01-01

    Objective Cure rates for cancer are increasing, especially for breast, prostate, and colorectal cancer. Despite positive trends in survivorship, a cancer diagnosis can trigger accelerated functional decline that can threaten independence, reduce quality-of-life and increase health care costs, especially among the elderly who comprise the majority of survivors. Lifestyle interventions may hold promise in reorienting functional decline in older cancer survivors, but few studies have been conducted. Method We describe the design and methods of a randomized controlled trial, RENEW (Reach out to ENhancE Wellness), that tests whether a home-based multi-behavior intervention focused on exercise, and including a low-saturated fat, plant-based diet, would improve physical functioning among 641 older, long-term (≥5 years post-diagnosis) survivors of breast, prostate, or colorectal cancer. Challenges to recruitment are examined. Results 20,015 cases were approached, and screened using a two-step screening process to assure eligibility. This population of long-term, elderly cancer survivors had lower rates of response (∼11%) and higher rates of ineligibility (∼70%) than our previous intervention studies conducted on adults with newly diagnosed cancer. Significantly higher response rates were noted among survivors who were white, younger, and more proximal to diagnosis and breast cancer survivors (p-values < 0.001). Conclusions Older cancer survivors represent a vulnerable population for whom lifestyle interventions may hold promise. RENEW may provide guidance in allocating limited resources in order to maximize recruitment efforts aimed at this needy, but hard-to-reach population. PMID:19117329

  20. Chemical Debridement of Burns

    PubMed Central

    Levenson, Stanley M.; Kan, Dorinne; Gruber, Charles; Crowley, Leo V.; Lent, Richard; Watford, Alvin; Seifter, Eli

    1974-01-01

    The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. The removal of the devitalized tissue, without damage to unburned skin or skin only partially injured by burning, and in ways which would permit immediate (or very prompt) skin grafting, would lessen substantially the problems of sepsis, speed convalescence and the return of these individuals to society as effective human beings, and would decrease deaths. The usefulness and limitations of surgical excision for patients with extensive third degree burns are discussed. Chemical debridement lends itself to complementary use with surgical excision and has the potential advantage over surgical excision in not requiring anesthesia or a formal surgical operation. The authors' work with the chemical debridement of burns, in particular the use of Bromelain, indicates that this approach will likely achieve clinical usefulness. The experimental studies indicate that rapid controlled debridement, with minimal local and systemic toxicity, is possible, and that effective chemotherapeutic agents may be combined with the Bromelain without either interfering with the actions of the other. The authors believe that rapid (hours) debridement accomplished by the combined use of chemical debriding and chemotherapeutic agents will obviate the possibility of any increase in infection, caused by the use of chemical agents for debridement, as reported for Paraenzyme21 and Travase.39,48 It is possible that the short term use of systemic antibiotics begun just before and continued during, and for a short time after, the rapid chemical debridement may prove useful for the prevention of infection, as appears to be the case for abdominal operations of the clean-contaminated and

  1. Aeromedical Pediatric Burn Transportation: A Six-Year Review.

    PubMed

    Warner, Petra; Bailey, John K; Bowers, Laura; Hermann, Rachel; James, Laura E; McCall, John E

    2016-01-01

    Aeromedical transportation has been shown to be a safe and efficient mode of transportation for critical care patients, including adult burn patients. Common flight concerns specific to the care of the burn patient are maintenance of intravenous lines and airway access, precision of ongoing fluid resuscitation, and effective treatment of hemodynamic instability. These concerns are particularly crucial when patients are transported by flight teams with limited burn experience. The purpose of this study was to review the safety and outcomes associated with 6 years of aeromedical pediatric burn transportation and to ascertain if differences exist when using a dedicated burn pediatric flight team versus a non-dedicated burn pediatric flight teams. Through a retrospective, IRB approved, chart review from January 2007 to January 2013, all aeromedical admissions were evaluated for demographic data, flight data, complications, and medical interventions. A total of 333 patients were transported by air, of which 282 transfers occurred during the first week of burn injury. In-flight complications occurred in <10% of patients and primarily involved airway and hemodynamic issues. There were no in-flight deaths. Patients transported by alternate teams were noted to be more hypothermic and hypotensive on admission (p < .001). Alternate teams were also noted to transfer older patients, spend less time with initial patient evaluation, and travelled shorter distances (p < .05). Aeromedical transportation of the pediatric burn patient is safe and associated with minimal complications. Communications with the transferring hospitals can facilitate transfer of the pediatric burn patient. When using alternate flight teams, particular attention should focus on resuscitation and maintenance of euthermia with large burn patients. PMID:25423443

  2. 40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., agricultural burning, and forestry and silvicultural burning. 49.10411 Section 49.10411 Protection of... for general open burning, agricultural burning, and forestry and silvicultural burning. (a) Beginning... obtain approval of a permit under § 49.134 Rule for forestry and silvicultural burning permits....

  3. Medical workers' cognition of using 50% nitrous oxide in children with burns: a qualitative study.

    PubMed

    Wang, Hai-Xia; Li, Yu-Xiang; Zhou, Ru-Zhen; Zhao, Ji-Jun

    2015-09-01

    Pain caused by dressing among children with burns is an issue worth discussing. Medical workers' understanding of pain during dressing in children with burns is correlated with the quality of pain management. Effective pain management is significant to improve anxiety and reduce pain and psychological distress during dressing for children with burns. We aimed to investigate medical workers' understanding of current pain management during dressing among children with burns and their attitudes toward the application of 50% nitrous oxide in pain management. Interviews were conducted with seven doctors and nurses from a burn center in East China. Data were collected by in-depth interviews and qualitative description after full transcription of each interview. Three themes were identified: (1) Medical workers felt sympathy for children with burns and believed that a gap existed between the current and expected situation in pain management. In addition, the prescription of analgesics during dressing for children with burns was not favored. (2) Given the fact that 50% nitrous oxide is effective in pain management for adult patients with burns, medical workers tended to apply it to children with burns during dressing after being provided the literature on the use of 50% nitrous oxide in children. (3) Guidelines for the application of 50% nitrous oxide during dressing for children with burns require further modification. Medical workers deemed the pain management for children with burns unsatisfactory, and they supported the application of 50% nitrous oxide during dressing for children with burns. Meanwhile, they hoped that administrators would also support it. PMID:25681958

  4. Shaking stress aggravates burn-induced cardiovascular and renal disturbances in a rabbit model.

    PubMed

    Wang, Guang; Zhang, Bing-qian; Ruan, Jing; Luo, Zhong-hua; Zhang, Jia-ping; Xiao, Rong; Lei, Ze-yuan; Hu, Jiong-yu; Chen, Yi-sheng; Huang, Yue-sheng

    2013-06-01

    The aim of this study was to address the effects of shaking stress (a.k.a. physical agitation) on burn-induced remote organ injury and to evaluate the application of delayed fluid resuscitation to treat severe burns under shaking conditions. Healthy adult male rabbits, weighing 2.50±0.40 kg, were randomly assigned to the following groups: control group, burn group, and burn+shaking group. One half of burned animals received a 6-h delayed fluid resuscitation and the other half remained untreated. Cardiovascular hemodynamics and functional and pathological changes of the heart and kidney were examined. Compared to normal controls, untreated burned animals showed decreased hemodynamic parameters, increased serum lactic acid, and severe myocardial inflammation. The burn-induced hemodynamic abnormalities and cardiac injury were aggravated by shaking stress. Burn injury led to reduced urine volume, elevated serum creatinine and blood urea nitrogen, and formation of erythrocyte casts in renal tubules. Shaking stimulation worsened the burn-associated functional and pathological changes of the kidney. Fluid resuscitation markedly mitigated cardiac and renal injury in burned animals, and, to a lesser extent, in the presence of shaking stimulation. Shaking stimulation aggravates burn-induced cardiovascular and renal disturbances. Delayed fluid resuscitation attenuates cardiac and renal damages in burn injury under shaking conditions. PMID:23063799

  5. [Chemical and electrical burns].

    PubMed

    Sanchez, Raymond

    2002-12-15

    Chemical burns are less frequent in routine practice, but could be very serious owing to the complexity and severity of their actions. Influx of casualty after a civil disaster (industrial explosion) or military (war or terrorism) is possible. The action of these agents could be prolonged and deep. In addition to the skin, respiratory lesions and general intoxication could be observed. The urgent local treatment rely essentially on prolonged washing. Prevention and adequate emergency care could limit the serious consequences of these accidents. Accidents (thermal burns or electrisations) due to high or low voltage electricity are frequent. The severity is linked with the affected skin but especially with internal lesions, muscular, neurological or cardiac lesions. All cases of electrisation need hospital care. Locally, the lesions are often deep with difficult surgical repairs and often require amputation. Aesthetic and functional sequela are therefore frequent. Secondary complications could appear several months after the accident: cataract, dysesthesia and hypotonia. PMID:12621941

  6. Burns and beauty nails

    PubMed Central

    Bélanger, Richard E; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. The beauty nail adhesive contained cyanoacrylate. In addition to its well-appreciated adhesive capacity, cyanoacrylate, in the presence of cotton or other tissues, is known to produce an exothermic reaction that may cause burns. Cyanoacrylate-based products, due to their possible adverse effects, should be kept away from children as advised. Odd injuries should always raise concerns about the possibility of inflicted injury. PMID:24421671

  7. Relationships and Recovery for Young Adult Lymphoma Survivors

    MedlinePlus

    ... skin tone. Once you no longer need to use steroids you can work with your doctor or nurse on healthy ways to lose weight. Most people pay very little attention to ... to obtain and use if and when needed. Sharing, comfort, affection, and ...

  8. Gender Matters: Working with Adult Male Survivors of Trauma

    ERIC Educational Resources Information Center

    Mejia, Ximena E.

    2005-01-01

    There has been a great deal of attention given to the application of feminist therapy in treating women, but there is little written about feminist therapy and its applications in treating men. Gender role analysis has proven to be effective in developing hope, resilience, and transcendence-3 primary sources in times of emotional distress. This…

  9. The Effectiveness of Group Treatment for Female Adult Incest Survivors

    ERIC Educational Resources Information Center

    Brown, Donalee; Reyes, Sonia; Brown, Brienne; Gonzenbach, Meredith

    2013-01-01

    Very few clinicians receive training in the treatment of sexual abuse, yet during their careers many will encounter victims of sexual abuse. This article discusses the incidence of child sexual abuse, defines incest, and discusses treatment options. A review of group treatment is explored, with results being documented providing support for the…

  10. Healthcare costs of burn patients from homes without fire sprinklers

    PubMed Central

    Banfield, Joanne; Rehou, Sarah; Gomez, Manuel; Redelmeier, Donald A.; Jeschke, Marc G.

    2014-01-01

    The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage and environmental toxins. This study’s aim was to conduct a cost-analysis of patients with burn or inhalation injuries due to residential fires, and to compare this to the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995–2012). Patient demographics and injury characteristics were collected from medical records, and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period there were 1,557 residential fire-related deaths province-wide and 1,139 patients were admitted to our provincial burn center due to a flame injury occurring at home. At our burn center, the average cost was CAN$84,678 per patient with a total cost of CAN$96,448,194. All resources totaled CAN$3,605,775,200. This study shows the considerable healthcare costs of burn patients from homes without fire sprinklers. PMID:25412056

  11. Coal burning arrangement

    SciTech Connect

    Wormser, A.F.

    1981-03-03

    Pyrolyzing pulverized coal to form char and volatiles, separating the char from the volatiles, burning the char in heattransfer relationship with a stoichiometric excess of air, forming thereby ash and a mixture of gases, the excess of air being chosen to produce in the ash a temperature below the fusion temperature thereof, separating the mixture of gases from the ash , and thereafter burning the volatiles in the mixture of gases. Also, coal burning apparatus which comprises, in combination a spouted bed pyrolyzer, a fluidized bed combustor, a first cyclone , a second cyclone, and an afterburner, the pyrolyzer being connected to accept pulverized coal and to discharge char to the combustor and gaseous materials with entrained particulate material to the first cyclone, the first cyclone being connected to deliver gases to the afterburner, the combustor being connected to accept also a combustion supporting gas and to deliver to the second cyclone gaseous materials with entrained particulate material, and the second cyclone being connected to deliver gaseous material to the afterburner.

  12. Burns caused by carburetors.

    PubMed

    Still, Joseph; Law, Edward; Orlet, Hermann; Wilson, Joan

    2003-01-01

    During a 10-year period 4645 patients were admitted to the Joseph M. Still Burn Center with acute burns. Of these, 83 (1.79%) were caused by carburetor-related accidents. There were 79 males and 4 females. Ages ranged from 10 to 72 years. Burn size ranged from 1 to 97.5% (mean, 12.3%). There was one death in the group. Eighteen patients required only topical care; 65 patients required a total of 108 operations for debridement and grafting. Length of stay ranged from 1 to 63 days (mean, 11 days). The mechanism of injury was usually the same; in 81 cases the accident occurred while someone was pouring gasoline into a carburetor. In 63 cases the vehicle was an automobile or pickup truck. Explosions resulted in 12 instances; in 65 instances fires were started. These injuries are serious, expensive, fairly common, and may be life threatening. Proper handling of gasoline is stressed. Newer vehicles have fuel injector systems, which may gradually eliminate the problem over time, because pouring gasoline is not required. PMID:12543992

  13. 42 CFR 102.45 - Multiple survivors.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Multiple survivors. 102.45 Section 102.45 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION... smallpox vaccine recipient or vaccinia contact may file Request Forms separately or together....

  14. Cartel (In)Stability on "Survivor" Island.

    ERIC Educational Resources Information Center

    Mixon, Franklin G., Jr.

    2001-01-01

    Illustrates the use of popular culture in business education by examining cartel behavior of contestants in the television show "Survivor." Examples depict incentives to form cartels and to cheat on cartel decisions. Ways to integrate the material into business courses are described. (SK)

  15. Exercise, inflammation, and fatigue in cancer survivors

    PubMed Central

    LaVoy, Emily C.P.; Fagundes, Christopher P.; Dantzer, Robert

    2016-01-01

    Cancer-related fatigue significantly disrupts normal functioning and quality of life for a substantial portion of cancer survivors, and may persist for years following cancer treatment. While the causes of persistent fatigue among cancer survivors are not yet fully understood, accumulating evidence suggests that several pathways, including chronic inflammation, autonomic imbalance, HPA-axis dysfunction, and/or mitochondrial damage, could contribute towards the disruption of normal neuronal function and result in the symptom of cancer-related fatigue. Exercise training interventions have been shown to be some of the more successful treatment options to address cancer-related fatigue. In this review, we discuss the literature regarding the causes of persistent fatigue in cancer survivors and the mechanisms by which exercise may relieve this symptom. There is still much work to be done until the prescription of exercise becomes standard practice for cancer survivors. With improvements in the quality of studies, evidenced-based exercise interventions will allow exercise scientists and oncologists to work together to treat cancer-related fatigue. PMID:26853557

  16. 31 CFR 29.344 - Survivor benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  17. Survivors of Downsizing: Helpful and Hindering Experiences

    ERIC Educational Resources Information Center

    Amundson, Norman E.; Borgen, William A.; Jordan, Sharalyn; Erlebach, Anne C.

    2004-01-01

    Thirty-one downsizing survivors from both the private and public sector were interviewed to determine incidents that either helped or hindered their transition through 1 or more organizational downsizings. A critical incident technique was used to analyze and organize the data around themes that emerged, themes were represented by both positive…

  18. Primary Care of the Prostate Cancer Survivor.

    PubMed

    Noonan, Erika M; Farrell, Timothy W

    2016-05-01

    This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated. Prostate cancer survivors should be screened regularly for urinary incontinence and sexual dysfunction. Patients with predominant urge incontinence symptoms, which can occur after surgical and radiation treatments, may benefit from an anticholinergic agent. If there is difficulty with bladder emptying, a trial of an alpha blocker may be considered. A phosphodiesterase type 5 inhibitor can effectively treat sexual dysfunction following treatment for prostate cancer. Osteoporosis screening should occur before initiation of androgen deprivation therapy, and patients treated with androgen deprivation therapy should be monitored for anemia, metabolic syndrome, and vasomotor symptoms. Healthy lifestyle choices should be encouraged, including weight management, regular physical activity, proper nutrition, and smoking cessation. Primary care physicians should be vigilant for psychosocial distress, including depression, among prostate cancer survivors, as well as the potential impact of this distress on patients' family members and partners. PMID:27175954

  19. 42 CFR 102.45 - Multiple survivors.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Multiple survivors. 102.45 Section 102.45 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION... smallpox vaccine recipient or vaccinia contact may file Request Forms separately or together....

  20. 42 CFR 102.45 - Multiple survivors.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Multiple survivors. 102.45 Section 102.45 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION... smallpox vaccine recipient or vaccinia contact may file Request Forms separately or together....