Purpose: To understand the health care needs (or perceived needs) of incarcerated female adolescents by comparing their rates of physical complaints, health attitudes, and treatment seeking to a ...normative sample.
Methods: A sample (
n = 138) of incarcerated girls was administered the Somatic Symptom Checklist, the Illness Attitudes Scales, and the Reynolds Adolescent Depression Scale to assess lifetime prevalence of physical symptoms, attitudes toward health, treatment-seeking experience, and emotional distress, and allow for comparison with a normative sample. Information regarding length of incarceration, race, and school achievement was obtained from institutional records.
Results: A median lifetime prevalence of 12 symptoms for the incarcerated sample differed significantly from the median of six symptoms reported by a normative sample. The symptoms most commonly expressed by the detainees were dizziness, heart pounding, chest pains, and nausea. In both their attitudes toward illness and actual physical complaints, these subjects were more concerned about illness and perceived themselves to be more physically impaired. Self-reported symptoms of depression and illness were positively correlated. Physical complaints were independent of age, race, length of incarceration, or achievement scores.
Conclusions: The frequency and variety of somatic complaints, as well as their relationship to emotional distress, among these incarcerated girls highlight the need for integration of physical and mental health services within juvenile facilities.
Beliefs about and attitudes toward pharmacotherapy have been shown to play an important role in mediating compliance with psychoactive medications. This study is an examination of attitudes toward ...drug treatment in a sample of delinquent incarcerated girls.
Female adolescents (N = 214) in a juvenile detention facility were administered a questionnaire assessing general beliefs and specific concerns about taking psychiatric medications. Demographic and historical data, including prior psychiatric drug treatment and illicit substance abuse, were also examined as possible influencing variables.
Nearly one half of subjects were skeptical about the benefits of pharmacotherapy. Prior illicit drug use did not influence attitudes, but having been treated with psychiatric medication was related to enhanced perceptions of the efficacy and acceptance of such therapy. Specific concerns about untoward effects of pharmacotherapy were identified.
Results suggest that these delinquent adolescents would benefit from techniques to improve initial attitudes toward treatment and challenge the prescribing physician to consider the unique worries and concerns that may undermine compliance with medication regimens among teenagers.
Most U.S. intimate partner violence (IPV) research to date has been limited to women residing in urban areas, with the small body of research focusing on rural populations being primarily ...qualitative. In this case-control study of Southern rural women, while many factors are consistent with those found in urban settings, unlike findings elsewhere, IPV risk appears to increase with age, and race showed no increased risk. Furthermore, in rural areas where guns are more acceptable than in other parts of the United States, partners of IPV victims are considerably more likely to carry weapons than partners of nonabused women. Given the geographic limitations to police and medical response to severe IPV in a rural setting, an improved understanding of IPV risk among this population can aid health care providers in ascertaining risk before it escalates further.
In an investigation of change in public opinion since the 1989 US Supreme Court Webster v. Reproductive Health Services decision, 299 female college students responded to questionnaires that included ...1 of 4 hypothetical situations involving abortion & rated their opinion of right to abortion on a 7-point Likert-type scale. Questions involving church affiliation & previous experience with abortion were also included. Across situations, respondents were overall prochoice, with those having had previous experience with abortion being stronger in their stance, & those associated with churches having strong antiabortion attitudes being more conservative. 2 Tables, 8 References.
Low-grade serous carcinoma of the ovary or peritoneum is characterised by MAPK pathway aberrations and its reduced sensitivity to chemotherapy relative to high-grade serous carcinoma. We compared the ...MEK inhibitor trametinib to physician's choice standard of care in patients with recurrent low-grade serous carcinoma.
This international, randomised, open-label, multicentre, phase 2/3 trial was done at 84 hospitals in the USA and UK. Eligible patients were aged 18 years or older with recurrent low-grade serous carcinoma and measurable disease, as defined by Response Evaluation Criteria In Solid Tumors version 1.1, had received at least one platinum-based regimen, but not all five standard-of-care drugs, and had received an unlimited number of previous regimens. Patients with serous borderline tumours or tumours containing low-grade serous and high-grade serous carcinoma were excluded. Eligible patients were randomly assigned (1:1) to receive either oral trametinib 2 mg once daily (trametinib group) or one of five standard-of-care treatment options (standard-of-care group): intravenous paclitaxel 80 mg/m2 by body surface area on days 1, 8, and 15 of every 28-day cycle; intravenous pegylated liposomal doxorubicin 40–50 mg/m2 by body surface area once every 4 weeks; intravenous topotecan 4 mg/m2 by body surface area on days 1, 8, and 15 of every 28-day cycle; oral letrozole 2·5 mg once daily; or oral tamoxifen 20 mg twice daily. Randomisation was stratified by geographical region (USA or UK), number of previous regimens (1, 2, or ≥3), performance status (0 or 1), and planned standard-of-care regimen. The primary endpoint was investigator-assessed progression-free survival while receiving randomised therapy, as assessed by imaging at baseline, once every 8 weeks for 15 months, and then once every 3 months thereafter, in the intention-to-treat population. Safety was assessed in patients who received at least one dose of study therapy. This trial is registered with ClinicalTrials.gov, NCT02101788, and is active but not recruiting.
Between Feb 27, 2014, and April 10, 2018, 260 patients were enrolled and randomly assigned to the trametinib group (n=130) or the standard-of-care group (n=130). At the primary analysis, there were 217 progression-free survival events (101 78% in the trametinib group and 116 89% in the standard-of-care group). Median progression-free survival in the trametinib group was 13·0 months (95% CI 9·9–15·0) compared with 7·2 months (5·6–9·9) in the standard-of-care group (hazard ratio 0·48 95% CI 0·36–0·64; p<0·0001). The most frequent grade 3 or 4 adverse events in the trametinib group were skin rash (17 13% of 128), anaemia (16 13%), hypertension (15 12%), diarrhoea (13 10%), nausea (12 9%), and fatigue (ten 8%). The most frequent grade 3 or 4 adverse events in the standard-of-care group were abdominal pain (22 17%), nausea (14 11%), anaemia (12 10%), and vomiting (ten 8%). There were no treatment-related deaths.
Trametinib represents a new standard-of-care option for patients with recurrent low-grade serous carcinoma.
NRG Oncology, Cancer Research UK, Target Ovarian Cancer, and Novartis.
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