Purpose
Cancer survivors experience a worse health-related quality of life (HRQoL) than non-cancer survivors. However, it is not fully understood whether social determinants of health (SDOH) and ...health behaviors are significantly associated with HRQoL among cancer survivors. The purpose of this study was to investigate the influence of SDOH and health behaviors on HRQoL among cancer survivors.
Methods
We identified adult (18 years or older) cancer survivors (
n
= 5784) in the 2017 and 2019 Behavioral Risk Factor Surveillance System. The primary outcome (HRQoL) was defined as whether cancer survivors reported having poor mental or physical health (e.g., 14 or more mentally or physically unhealthy days). Unadjusted and adjusted logistic regression was used to compute the odds ratios and 95% CIs of factors associated with poor HRQoL among the cancer survivors.
Results
More than half of the cancer survivors were non-Hispanic White, female, and 65 years or older. In the adjusted multivariable logistic regression models, cancer survivors who were physically active and who did not avoid care because of costs had a lower risk of poor mental and physical health. Current smokers were more likely to report poor physical health. Homeowners were less likely to report poor mental health. Daily fruit and vegetable consumption and healthcare coverage were not associated with poor HRQoL.
Conclusions
Some SDOH (healthcare access, economic stability, and the neighborhood and built environment) and health behavior (physical activity) are associated with lower likelihood of experiencing poor mental and/or physical health in the cancer survivors. The study findings can be used to target survivors who experience suboptimal HRQoL and to inform research, public health policies, and/or programs.
"More Nights Than Days is a unique exploration of the experience of children who survived the Holocaust—including Roma and Sinti victims—and the genocides in Cambodia, Rwanda, and Bosnia. Children ...are among the principal victims of armed conflicts and slaughters; nonetheless, they perceive events through the prism of their unique perspective and have a range of coping techniques adults don't possess. This overview of writings of ninety-one child survivors bears evidence from a wide range of human ruthlessness. The author presents little-known texts along with famous memoirs and autobiographical fiction, with abundant quotations. Many of these are not only compelling as historical testimony, but poetic and stirringly expressive. Yudit Kiss has not written a historical study or literary criticism of the children’s books. She explores, instead, what the authors went through and what they felt and understood about their experience. An accessible and captivating reading, this volume presents a close-up, human size dimension of the destruction. The books written by child survivors also describe the resources and means that helped them to remain human even in the deepest well of inhumanity, offering precious lessons about resistance and resilience.M"
Impact of Childhood Cancer on Growth Yoshida, Tomoko; Delaney, Angela
The journal of clinical endocrinology and metabolism,
2024-Feb-20, 2024-02-20, 20240220, Letnik:
109, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Along with improvements in cancer treatment over time, the number of childhood cancer survivors has been growing. Survivors are at risk for serious medical complications, and growth impairment is ...among the most common. There are multiple factors that may cause impaired growth among survivors. In this article, we review the impact of cancer on growth in children and adolescents. We first provide an overview of growth disturbance among childhood cancer patients and survivors due to nonhormonal causes, including a recent understanding of the effect of targeted cancer therapies (eg, tyrosine kinase inhibitors and immune checkpoint inhibitors) on growth. Then we describe the hormonal causes of growth impairment among survivors, focusing on growth hormone deficiency, including the prevalence, risk factors, and treatment. Lastly, we briefly summarize overgrowth and tall stature in childhood cancer. It is critical to assess the linear growth of children and adolescents, especially in cancer survivors who are at risk for growth disturbance, since growth is an important measure of their health.
Aims
This study explores experiences of childhood cancer survivors and their parents with a combined physical and social activity intervention during treatment, including how the survivors and their ...parents perceive physical activity post‐treatment.
Design
A process evaluation using semi‐structured interviews.
Methods
Using a criterion‐sampling strategy, 18 Danish childhood cancer survivors (aged 11–18 years) and their parents were interviewed from September 2019 through May 2020. Data analysis used an inductive thematic approach focused on meaning.
Results
Three themes emerged: (1) being physically active during hospitalization; (2) peers as motivators and (3) physical activity post‐treatment. During hospitalization, daily motivation to do physical activity was dependent on the daily well‐being, that is, presence of the side effects from the child's treatment. Healthy classmates provided distraction, reduced loneliness and promoted normality for those hospitalized. For most of the survivors, their healthy peers provided motivation for being physically active during treatment. When surplus energy was lacking, some survivors preferred doing physical activity alone with a professional. Those who were physically active in the hospital sustained being physically active post‐treatment while their parents continued seeking advice about appropriate activity levels.
Conclusion
Childhood cancer survivors and their parents benefited from the intervention which also provided guidance to remaining physically active post‐treatment. This was particularly true for the participants with leukaemia.
Impact
Healthcare professionals should support children with cancer to be physically active during hospitalization. Including social and physical components in their care plan and being aware of individual preferences is pivotal to improving the survivors' level of physical and social well‐being during and post‐treatment.
Patient or Public Contribution
The participants were involved in designing the interview guides to ensure that the interview guides were understandable for the participants to provide rich descriptions of their experiences with a physical and social activity intervention during hospitalization.
Objectives:Evidence suggests that childhood maltreatment may negatively affect not only the lifetime risk of depression but also clinically relevant measures of depression, such as course of illness ...and treatment outcome. The authors conducted the first meta-analysis to examine the relationship between childhood maltreatment and these clinically relevant measures of depression.
Method:The authors conducted searches in MEDLINE, PsycINFO, and Embase for articles examining the association of childhood maltreatment with course of illness (i.e., recurrence or persistence) and with treatment outcome in depression that appeared in the literature before December 31, 2010. Recurrence was defined in terms of number of depressive episodes. Persistence was defined in terms of duration of current depressive episode. Treatment outcome was defined in terms of either a response (a 50% reduction in depression severity rating from baseline) or remission (a decrease in depression severity below a predefined clinical significance level).
Results:A meta-analysis of 16 epidemiological studies (23,544 participants) suggested that childhood maltreatment was associated with an elevated risk of developing recurrent and persistent depressive episodes (odds ratio=2.27, 95% confidence interval CI=1.80–2.87). A meta-analysis of 10 clinical trials (3,098 participants) revealed that childhood maltreatment was associated with lack of response or remission during treatment for depression (odds ratio=1.43, 95% CI=1.11–1.83). Meta-regression analyses suggested that the results were not significantly affected by publication bias, choice of outcome measure, inclusion of prevalence or incidence samples, study quality, age of the sample, or lifetime prevalence of depression.
Conclusions:Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression.
To examine the psychological distress and the associated predictor factors of the 2019 corona-virus disease (COVID-19) on survivors in the early convalescence in Shenzhen.
A survey questionnaire ...consisting of post-traumatic stress disorder self-rating scale (PTSD-SS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) was presented to COVID-19 survivors still in quarantine. Scores of each scale and subscale were dependent variables in the Mann-Whitney test and stepwise regression analysis.
A total of 126 subjects were included in the study, the mean scores of PTSD-SS, SDS, and SAS were 45.5 ± 18.9, 47.3 ± 13.1, and 43.2 ± 10.2, respectively, meanwhile, 9 (31.0%), 28 (22.2%), and 48 (38.1%) of the survivors met the cut-score for clinical significant symptoms of stress response, anxiety, and depression, respectively. Infected family members, and postinfection physical discomforts were significantly associated with scores on all three scales. Social support, retirement, and being female had significant associations with the PTSD-SS score. The survivors aged 60 or above experienced less severe stress response symptoms, fewer emotional symptoms of depression, and fewer anxiety symptoms than younger survivors.
The occurrence rate of psychological distress among the COVID-19 survivors in early convalescence was high, highlighting the need for all COVID-19 survivors to be screened for psychological distress regularly for timely intervention. The predictors indicated by the current study may help to identify those at high-risk. Besides, the results indicated the older survivors suffered less emotional reactivity and fewer stress response symptoms from infectious diseases than the younger ones.
Exercise is an effective strategy to improve quality of life and physical fitness in breast cancer survivors; however, few studies have focused on the early survivorship period, minorities, ...physically inactive and obese women, or tested a combined exercise program and measured bone health. Here, we report the effects of a 16-week aerobic and resistance exercise intervention on patient-reported outcomes, physical fitness, and bone health in ethnically diverse, physically inactive, overweight or obese breast cancer survivors.
One hundred breast cancer survivors within 6 months of completing adjuvant treatment were assessed at baseline, post-intervention, and 3-month follow-up (exercise group only) for physical fitness, bone mineral density, serum concentrations of bone biomarkers, and quality of life. The exercise intervention consisted of moderate-vigorous (65-85% heart rate maximum) aerobic and resistance exercise thrice weekly for 16 weeks. Differences in mean changes for outcomes were evaluated using mixed-model repeated measure analysis.
At post-intervention, the exercise group was superior to usual care for quality of life (between group difference: 14.7, 95% CI: 18.2, 9.7; p < 0.001), fatigue (p < 0.001), depression (p < 0.001), estimated VO
(p < 0.001), muscular strength (p < 0.001), osteocalcin (p = 0.01), and BSAP (p = 0.001). At 3-month follow-up, all patient-reported outcomes and physical fitness variables remained significantly improved compared to baseline in the exercise group (p < 0.01).
A 16-week combined aerobic and resistance exercise program designed to address metabolic syndrome in ethnically-diverse overweight or obese breast cancer survivors also significantly improved quality of life and physical fitness. Our findings further support the inclusion of supervised clinical exercise programs into breast cancer treatment and care.
This trial is registered on ClinicalTrials.gov: NCT01140282 as of June 9, 2010.
Zo? Waxman examines the full history of Holocaust testimony, from the very first chroniclers confined to Nazi-enforced ghettos, to today's survivors writing as part of collective memory. She reveals ...the multiplicity of Holocaust experience and how different contexts have given rise to very different modes of remembering.
Important differences in the expression and effect of maternal and paternal PTSD were found when examining parental PTSD in the offspring of Holocaust survivors and methylation of the glucocorticoid ...receptor gene exon 1F.
ObjectiveDifferential effects of maternal and paternal posttraumatic stress disorder (PTSD) have been observed in adult offspring of Holocaust survivors in both glucocorticoid receptor sensitivity and vulnerability to psychiatric disorder. The authors examined the relative influences of maternal and paternal PTSD on DNA methylation of the exon 1F promoter of the glucocorticoid receptor (GR-1F) gene (NR3C1) in peripheral blood mononuclear cells and its relationship to glucocorticoid receptor sensitivity in Holocaust offspring.MethodAdult offspring with at least one Holocaust survivor parent (N=80) and demographically similar participants without parental Holocaust exposure or parental PTSD (N=15) completed clinical interviews, self-report measures, and biological procedures. Blood samples were collected for analysis of GR-1F promoter methylation and of cortisol levels in response to low-dose dexamethasone, and two-way analysis of covariance was performed using maternal and paternal PTSD as main effects. Hierarchical clustering analysis was used to permit visualization of maternal compared with paternal PTSD effects on clinical variables and GR-1F promoter methylation.ResultsA significant interaction demonstrated that in the absence of maternal PTSD, offspring with paternal PTSD showed higher GR-1F promoter methylation, whereas offspring with both maternal and paternal PTSD showed lower methylation. Lower GR-1F promoter methylation was significantly associated with greater postdexamethasone cortisol suppression. The clustering analysis revealed that maternal and paternal PTSD effects were differentially associated with clinical indicators and GR-1F promoter methylation.ConclusionsThis is the first study to demonstrate alterations of GR-1F promoter methylation in relation to parental PTSD and neuroendocrine outcomes. The moderation of paternal PTSD effects by maternal PTSD suggests different mechanisms for the intergenerational transmission of trauma-related vulnerabilities.
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