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Survival rates for paediatric cancers have increased dramatically since the 1970s, but childhood cancer survivors (CCS) are at increased risk for several chronic diseases throughout life. Nutrition interventions promoting healthy family meals may support wellness for survivors, but little research has explored CCS family food preparation habits. The goal of the present study was to describe and compare food preparation practices of CCS and non-CCS families.
Typical evening meal preparation events were observed and recorded in participant homes. Recordings and notes were analysed using the Healthy Cooking Index (HCI), a measure of nutrition-optimizing food preparation practices relevant to survivor wellness. Demographics, BMI and nutrient composition of prepared meals were also collected.
Forty parents with a CCS or non-CCS child aged 5–17 years were recruited.
There were no major differences between the CCS and non-CCS families with regard to summative HCI score or specific food preparation behaviours. Meals prepared by CCS and non-CCS families had similar nutrient compositions.
The study revealed areas for practical nutrition intervention in CCS and non-CCS families. Future studies should consider adopting and tailoring nutrition intervention methods that have been successful in non-CCS communities.
Patients undergoing prostate radiation therapy were observed to have elevated blood pressures in clinic. Therefore, we sought to further characterise this phenomenon.
The charts of 76 patients who received radiotherapy for prostate cancer between 2014 and 2017 were examined. Blood pressure (BP) readings were obtained at initial consultation, on treatment visits, and subsequent follow-up appointments. To describe this effect, we defined radiation-associated hypertension (RAH) as an increase ≥15 mmHg systolic BP, 10 mmHg diastolic BP, or 5 mmHg mean arterial pressure.
Within this cohort, 36 patients developed RAH, with 75% developing RAH while on treatment, and 25% developing RAH at post-treatment visits. Two-thirds of patients remained hypertensive during post-treatment visits, and 27% were prescribed additional anti-hypertensives. There was no association between neoadjuvant/concurrent androgen deprivation therapy and RAH.
A significant number of patients undergoing prostate radiotherapy developed RAH, necessitating additional medication in some.
To document the current clinical practice in 2017 for assessment of supportive care needs and provision of supportive care to women with gynecological cancer and their caregivers in Australia, and to identify the main enablers and barriers to care provision.
A total of 64 health professionals who care for Australian women with gynecological cancer responded to an electronic survey which explored their use of needs assessment, service-level processes and protocols for support service provision, and identified enablers and barriers to provision of care to both patients and caregivers. Eight respondents underwent an additional in-depth interview to elaborate on enablers, barriers, and gaps in the provision of supportive care.
Mostly, needs assessment for women and caregivers was part of current practice but done without validated tools or a checklist. Only 30% of respondents reported having documented referral pathways. Most respondents simply recorded a plan for meeting needs within the patients’ medical record (63% for patients; 46% for caregivers) rather than using a formalized care plan (15% for patients; 6% for caregivers). The interviewees’ comments supported survey results that having sufficient time to discuss issues was both the most important enabling factor and the greatest barrier to successful supportive care provision. The interviewees further discussed variations in needs based on age, cultural background, and phases within the cancer care continuum, and that best practice supportive care should involve a multidisciplinary team and customizable protocols.
Significance of results
There is much room for improvement in the assessment of needs and provision of supportive care to women with gynecological cancer and their caregivers. Approaches to optimize use of consultation time (e.g., needs assessment tools and referral protocols) are necessary. Flexibility in the form and mode of delivery of support may be required to meet diverse personal preferences and incorporate caregivers.
This review evaluates evidence on dietary interventions for cancer survivors giving an overview of people's views and preferences for service attributes and provides a narrative review. After cancer, people often want to change their diet and there is a plethora of evidence why dietary optimisation would be beneficial. However, cancer survivors have different preferences about attributes of services including: place, person and communication mode. Randomised control trials have been reviewed to provide a narrative summary of evidence of dietary interventions. Most studies were on survivors of breast cancer, with a few on colorectal, prostate and gynaecological survivors. Telephone interventions were the most frequently reported means of providing advice and dietitians were most likely to communicate advice. Dietary assessment methods used were FFQ, food diaries and 24-h recalls. Dietary interventions were shown to increase intake of fruit and vegetables, dietary fibre, and improve diet quality in some studies but with contradictory findings in others. Telephone advice increased fruit and vegetable intake primarily in women with breast cancer and at some time points in people after colorectal cancer, but findings were inconsistent. Findings from mail interventions were contradictory, although diet quality improved in some studies. Web-based and group sessions had limited benefits. There is some evidence that dietary interventions improve diet quality and some aspects of nutritional intake in cancer survivors. However, due to contradictory findings between studies and cancer sites, short term follow-up and surrogate endpoints it is difficult to decipher the evidence base.
Weight, weight change and physical activity may affect prognosis among women who are diagnosed with breast cancer. Observational studies show associations between overweight/obesity and weight gain with several measures of reduced prognosis in women with breast cancer, and some suggestions of lower survival in women who are underweight or who experience unexplained weight loss after diagnosis. Observational studies have also shown an association between higher levels of physical activity and reduced breast cancer-specific and all-cause mortality, although a dose–response relationship has not been established. The effects of purposive dietary weight loss and increase in physical activity on survival or recurrence in breast cancer are not yet established, and randomised controlled trials are needed for definitive data. This paper presents the epidemiologic evidence on weight status, weight change, and physical activity and breast cancer survival; suggests potential mediating mechanisms; summarises evidence on weight loss interventions in breast cancer survivors; describes ongoing randomised clinical trials designed to test the effects of weight loss or physical activity on breast cancer survival; and provides information on available guidelines on weight and physical activity for cancer survivors.
This article examines the associations of quantitatively refined trajectories of adjustment to cancer survivorship determined by previously published qualitative narrative analysis.
Patients completed measures of cancer-related worry (Cancer Related Worries Scale), depression (Patient Health Questionnaire-9), posttraumatic growth (Benefit Finding Scale), and open-ended survey questions 6, 12, and 18 months postdiagnosis of head and neck, esophageal, gastric, or colorectal cancer. Previously published narrative analysis revealed five distinct survivorship “paths,” which were combined into four paths in the present article: Moving On, Seeing the World Differently, Taking One Day at a Time, and Never the Same. To determine the association of qualitatively determined paths with quantitatively assessed adjustment (i.e., Cancer Related Worries Scale, Patient Health Questionnaire-9, Benefit Finding Scale), we used linear multilevel modeling to regress the adjustment variables on time, path, the time-by-path interaction, and relevant covariates (age, stage, cancer site, ethnicity, and Deyo score).
There was a significant main effect of path on cancer worry, depression, and posttraumatic growth (p < 0.02 for all). Patients in the Moving On group reported consistently low worry, depression, and growth compared to the other groups. Patients in the Seeing the World Differently and Taking One Day at a Time paths both reported moderate worry and depression; but those in the Seeing the World Differently path reported the highest posttraumatic growth, whereas patients in the Taking One Day at a Time path reported little growth. Finally, patients in the Never the Same path reported the highest worry and depression but lowest posttraumatic growth.
Significance of results
This longitudinal study reinforces the notion that cancer survivorship is not a one-size-fits-all experience nor a dichotomized experience of “distress” or “no distress.” Additionally, this hypothesis-generating study suggests future directions for potential self-report measures to help clinicians identify cancer survivors’ trajectory to develop a more patient-centered survivorship care plan.
Childhood cancer survivors (CCS) have been shown to practise suboptimal dietary intake and may benefit from nutrition interventions during and after treatment. Cooking classes have become popular for encouraging healthy eating behaviours in community-based programming and academic research; however, literature on teaching cooking classes in CCS is limited. The purpose of the present study was to address the development and implementation of classes for CCS based on a recently developed framework of healthy cooking behaviour.
A conceptual framework was developed from a systematic literature review and used to guide healthy cooking classes for CCS in different settings.
One paediatric cancer hospital inpatient unit, one paediatric cancer in-hospital camp programme and two off-site paediatric cancer summer camp programmes.
One hundred and eighty-nine CCS of varying ages and thirteen parents of CCS.
Seventeen classes were taught at camps and seven classes in the hospital inpatient unit. Healthy cooking classes based on the conceptual framework are feasible and were well received by CCS.
Cooking classes for CCS, both at the hospital and at camp, reinforced the principles of the conceptual framework. Future trials should assess the dietary and anthropometric impact of evidence-based healthy cooking classes in CCS.
Our objective was to evaluate long-term altered appearance, distress, and body image in posttreatment breast cancer patients and compare them with those of patients undergoing active treatment and with general population controls.
We conducted a cross-sectional survey between May and December of 2010. We studied 138 breast cancer patients undergoing active treatment and 128 posttreatment patients from 23 Korean hospitals and 315 age- and area-matched subjects drawn from the general population. Breast, hair, and skin changes, distress, and body image were assessed using visual analogue scales and the EORTC BR–23. Average levels of distress were compared across groups, and linear regression was utilized to identify the factors associated with body image.
Compared to active-treatment patients, posttreatment patients reported similar breast changes (6.6 vs. 6.2), hair loss (7.7 vs. 6.7), and skin changes (5.8 vs. 5.4), and both groups had significantly more severe changes than those of the general population controls (p < 0.01). For a similar level of altered appearance, however, breast cancer patients experienced significantly higher levels of distress than the general population. In multivariate analysis, patients with high altered appearance distress reported significantly poorer body image (–20.7, CI95% = –28.3 to –13.1) than patients with low distress.
Significance of results:
Posttreatment breast cancer patients experienced similar levels of altered appearance, distress, and body-image disturbance relative to patients undergoing active treatment but significantly higher distress and poorer body image than members of the general population. Healthcare professionals should acknowledge the possible long-term effects of altered appearance among breast cancer survivors and help them to manage the associated distress and psychological consequences.
People who undergo hematopoietic stem cell transplantation are highly dependent on their caregiver during their lengthy treatment and recovery. The effectiveness of their caregiver's social support can profoundly affect their day-to-day treatment experiences and, in turn, how they recall those experiences and are affected by them long after the treatment ends.
Our participants were 182 men and women who had undergone a transplant within the previous 9 months to 3 years. They completed baseline measures (including a measure of caregiver social support effectiveness) and then completed three writing assignments describing their transplant experiences. Linguistic analyses were conducted to investigate their use of words indicating negative emotions, cognitive processing (insight and causation), and practical problems with money and insurance. Theory-based hypotheses predicted associations between specific functional types of caregiver support (emotional, informational, and instrumental) and these word categories.
As hypothesized, the effectiveness of different functional types of support from a caregiver were uniquely associated with theoretically relevant categories of word use. Structural equation models indicated that more effective caregiver emotional support predicted lower use of negative emotion words; more effective caregiver informational support predicted lower use of causation words; and more effective caregiver instrumental support predicted lower use of words related to money and insurance.
Significance of results:
Our findings provide insights to guide research on the mechanisms through which caregiver support influences patient outcomes after stem cell transplantation. For instance, research suggests that these kinds of effects could have implications for survivors' current self-concept, psychosocial functioning, and meaning-making.
With growing numbers of pediatric cancer survivors, it is becoming increasingly important to investigate the psychosocial sequelae of surviving cancer diagnosed during childhood or adolescence. It is particularly important to study the psychosocial needs of adolescent survivors of pediatric cancer because adolescence is a critical time during psychosocial development. Although there is existent literature about the general psychosocial adjustment of this population, the literature regarding anxiety is scant. This brief review aimed to assesses currently available literature that addresses anxiety in adolescent cancer survivors.
Articles assessing psychosocial adjustment in adolescent survivors of pediatric cancer were reviewed for information regarding anxiety symptoms.
To the authors' knowledge, there is no literature that focuses specifically on anxiety in this population. However, many articles reported results that indicated the possibility of increased anxiety in this group.
Significance of results:
It is critical to further investigate anxiety in this group and develop appropriate interventions if necessary. Doing so will aid the process of enhancing psychosocial care for adolescent cancer survivors.
Plutella xylostella (L.) is the most important pest of Brassicaceae worldwide, with a recent estimate of US$ 4–5 billion expenditure for the control of this insect. A case of very high resistance of this pest to chlorantraniliprole was recently associated with reduced efficacy in a Brazilian field of Brassica spp. Although diamide resistance has been characterized, the fitness of insects due to such resistance has yet to be examined. Therefore, in this study, biological parameters were assessed in both susceptible and resistant strains of P. xylostella subjected to sublethal chlorantraniliprole concentrations. The field strain showed high resistance to chlorantraniliprole (RR50=27,793-fold), although resistance rapidly decreased in the first generations, showing instability. The exposure of susceptible and resistant larvae to their respective LC1, LC10, and LC25 values led to an increased duration of the larval and pupae phases and reduced weight in both strains; however, no significant differences in pupal viability across the treatments were observed. The resistant insects presented significantly lower larval weight and fecundity and higher larval and pupal periods, hatchability, and male longevity when not exposed to chlorantraniliprole, suggesting a fitness cost associated with resistance. In addition, resistant females showed a significantly higher egg-laying period and longevity at LC25, whereas the males lived longer at LC1. Chlorantraniliprole negatively impacted the biological parameters of both strains tested, although these effects were more relevant to the resistant insects. Resistant P. xylostella showed negative and positive biological trade-offs when compared with the susceptible individuals in both the absence and presence of chlorantraniliprole. Despite the important role that these trade-offs may play in the evolution of resistance to chlorantraniliprole, practical applications still depend on such information as the dominance of fitness costs and resistance.
Trissolcus basalis has been used as a biological control agent of its main host, Nezara viridula, in many countries. However, estimations of its functional and numerical responses in the field are lacking. We estimated the density of N. viridula eggs, the proportion of parasitized N. viridula eggs, and the number of T. basalis adults/trap in the field. We transformed relative parasitoid density to an absolute density, and estimated the parasitoid's attack rate, a, and the mutual interference parameter, m, in two ways: following Arditi & Akçakaya (1990) and using the Holling–Hassell–Varley model with two iterative techniques. The attack rate estimated by both methods were a=1.097 and a=0.767, respectively. Parameter m varied less between methods: m=0.563 and m=0.586, respectively, and when used to calculate the number of parasitized N. viridula eggs per m2, differences with the observed values were not significant. The numerical response of T. basalis was affected by the sex allocation of their progeny and the proportion of adult parasitoids trapped decreased with field parasitoid population density. Theoretical models show that 0<m<1 is a stabilizing factor and previous re-analysis of field data showed a mean m value of 0.8. The Holling–Hassell–Varley model leads to a flexible description of the functional response allowing to predict acceptable weekly host parasitism. The pre-imaginal parasitoid survival and the change in sex ratio as a function of parasitoid density adequately describe the numerical functional response of the parasitoid.
There is growing interest in whether invasive species may be controlled by utilizing management strategies that target vulnerable life stages. We manipulated the timing of fire and measured its effects on sericea lespedeza germination and seedling survival. Although fire strongly decreased germination in the laboratory, fire increased germination under field conditions. Additionally, fire caused small decreases in seedling survival in the field. Therefore, controlled burns are likely to encourage spread of sericea lespedeza and are unlikely to effectively control this invasive species. Although targeting vulnerable life stages is a promising strategy for invasive species control, our results illustrate that system-specific studies may be needed to unravel potentially complex interactions between biotic and abiotic factors before effective control strategies can be devised.
The purpose of this study is to describe the post-treatment goals of colorectal cancer (CRC) survivors. We sought to determine whether goals were a salient concept during the period immediately following treatment, and whether a goal-setting intervention might be feasible and acceptable to these patients.
Semi-structured qualitative interviews were administered to a convenience sample of 41 CRC patients who were 0–24 months post-treatment. Topics discussed included expectations and goals for future health, cancer prevention awareness, health-promoting behavior-change goals, and post-treatment cancer issues. Content analysis was used to explore emergent themes.
Overall, participants’ health-related goals were: being healthy, getting back to normal, and not having a cancer recurrence. Most of the CRC survivors reported being proactive with their health by maintaining healthy behaviors or making healthy behavior changes, or had goals to change their behavior. All respondents had plans to maintain follow-up care and regular screening appointments. Some patients were managing treatment side effects or non-cancer issues that limited their functional abilities. Many respondents were satisfied with the care they received, and felt it was now their responsibility to do their part in taking care of themselves.
Significance of results:
CRC survivors talk about goals, and many of them are either making or have an interest in making health behavior changes. Self-management support could be an appropriate strategy to assist patients with achieving their health goals post-treatment. Patients may need help addressing lingering treatment side effects or non-cancer issues. Healthcare providers should consider assessing patients’ goals to help patients resolve post-treatment issues and promote healthy behaviors.
Use of host plant resistance for the management of the banana weevil Cosmopolites sordidus (Germar) requires development of rapid cultivar screening methods. A previous study showed prolonged development of larvae feeding on excised plant material of resistant cultivars and suggested partial breakdown of resistance in such plant material. In the current study, development and survivorship of larvae feeding on potted plants of banana cultivars with differing levels of resistance were evaluated. Weevil performance was evaluated on one susceptible (Atwalira), one intermediate (Kabula) and four resistant cultivars (FHIA 17, Kayinja, Kisubi and Yangambi Km5). Differences in development of larvae feeding on the susceptible Atwalira and intermediate/resistant cultivars became apparent at 15 days after infestation of plants. Differences in survivorship of larvae feeding on different cultivars were not statistically significant. Results of this study show that experiments using potted plants can be used to screen for resistance to banana weevil based on the development of larvae. The influence of previous feeding damage to banana plants on larval development and survivorship in a susceptible (Atwalira), an intermediate (Kabula) and a resistant cultivar (Kisubi) was also examined. While no effects on larval development rate were apparent, survivorship was reduced in previously attacked plants for the intermediate cultivar, indicating that resistance may be induced by previous weevil attack of plants.
Host plant resistance is an important tool in the management of the banana weevil Cosmopolites sordidus (Germar). Although ovipositing females do not discriminate between resistant and susceptible cultivars, plants of resistant cultivars have smaller larval populations and sustain less damage in the field. These observations suggest that lower damage levels observed in resistant cultivars reflect larval success. This study was carried out to evaluate laboratory screening of banana cultivars as a rapid screening method for resistance to the banana weevil by determining the influence of cultivars on weevil survivorship, development duration and adult weight. Larvae were raised on corm pieces of two susceptible, three intermediate and four resistant cultivars, resistance categories having been determined from a previous field screening trial. The developmental period was prolonged in resistant cultivars. However, cultivars had less influence on survivorship and adult weight. Moreover, the ranking of survivorship did not correlate with resistance levels observed in the field. The implications of these findings for laboratory screening of cultivars for resistance to C. sordidus are highlighted.
The ecological effects of Chinese tallowtree are well documented in the southeastern United States, yet this known invasive plant continues to be planted extensively in California's Central Valley, where it has recently naturalized in several locations. Climate modeling suggests that most of California's lowland riparian habitat is susceptible to invasion by Chinese tallowtree; however, no field tests are available to corroborate this result for California or to identify local environmental constraints that might limit potential habitats. We used observational and experimental methods to evaluate invasion potential of Chinese tallowtree in riparian habitats in California's Central Valley. High invasion potential, indicated by an intersection of the maxima of dispersal probability, germination, and survivorship of seedlings, occurred at low elevations immediately next to perennial waters. The main factor limiting Chinese tallowtree invasion potential in more elevated habitats appears to be lack of seedling drought tolerance. These findings suggest that California's riparian habitats are vulnerable to invasion by Chinese tallowtree, especially downstream of current naturalized populations where water or bird dispersal will deposit seeds in environments ideal for germination and growth.
The authors use metrical, demographic and body part analyses of animal bone assemblages in Anatolia to demonstrate how cattle were incorporated into early Neolithic subsistence economies. Sheep and goats were domesticated in the eighth millennium BC, while aurochs, wild cattle, were long hunted. The earliest domesticated cattle are not noted until the mid-seventh millennium BC, and derive from imported stock domesticated elsewhere. In Anatolia, meanwhile, the aurochs remains large and wild and retains its charisma as a hunted quarry and a stud animal.
This chapter explores some issues surrounding multidisciplinary care and considers the future development of high-quality services for cancer patients. Multidisciplinary care has focused on the multidisciplinary team (MDT) and their functioning in a multidisciplinary meeting (MDM). The key benefits of multidisciplinary care for people with cancer hinge around team working to provide a rounded and coordinated approach to diagnosis, treatment, continuing care and survivorship. The primary aim of multidisciplinary care is to improve the diagnosis and treatment for individual patients. The role of the nurse as patient advocate has developed within the cancer MDT, with nurses participating in treatment decisions and negotiating the cancer experience. Considering the needs of the woman regarding fertility, sexual function and sexuality, hormonal function and psychological wellbeing is an essential part of high-quality health care. The MDT can help, guide and protect the cancer patient on the journey for survival.
There is increasing evidence that pathogens can play a significant role in species decline. This study of a complete free-living species reveals a cost of blood parasitism to an endangered host, the Pink Pigeon Columba mayeri, endemic to Mauritius. We investigated the prevalence and effect of infection of the blood parasite, Leucocytozoon marchouxi, in the free-living Pink Pigeon population. Overall, L. marchouxi infection prevalence detected was 18·3%. Juveniles were more likely to be infected than older birds and there was geographical variation in infection prevalence. Survival of birds infected with L. marchouxi was lower than that of uninfected birds to 90 days post-sampling. This study suggests that while common haematozoa are well tolerated in healthy adults, these parasites may have greater pathogenic potential in susceptible juveniles. The study is unusual given its completeness of species sampling (96%) within a short time-period, the accurate host age data, and its focus on blood parasites in a threatened bird species. Species for which long-term life-history data are available for every individual serve as valuable models for dissecting the contribution of particular pathogens to species decline.