A Qualitative Study on Cancer Care Burden: Experiences of Iranian Family Caregivers.

The aim of this study was to explore the experiences of Iranian family caregivers with regard to the burden of caregiving. This is in the context of illuminating and identifying the experiences of family members from different contextual perspectives. In this qualitative study, purposive sampling was conducted in 2016. Data were collected using semistructured interviews and were analyzed using content analysis. Data analysis identified 4 categories and 8 subcategories: (1) burnout (physical problems and psychoemotional stress), (2) role conflict (balancing caring roles and family responsibilities; failure in professional or educational roles), (3) health system tensions (inadequate support from health professionals; ignorance of family members in health structure), and (4) social challenges of cancer (economic burden; taboo of cancer). In conclusion, nurses need to provide individualized support and counseling that address the sources of burden. This highlights the benefit of training health care professionals to provide culturally sensitive support based on family caregivers' needs and circumstances

Blast phase myeloproliferative neoplasm: Mayo-AGIMM study of 410 patients from two separate cohorts

A total of 410 patients with blast phase myeloproliferative neoplasm (MPN-BP) were retrospectively reviewed: 248 from the Mayo Clinic and 162 from Italy. Median survival was 3.6 months, with no improvement over the last 15 years. Multivariable analysis performed on the Mayo cohort identified high risk karyotype, platelet count < 100 × 109 /L, age > 65 years and transfusion need as independent risk factors for survival. Also in the Mayo cohort, intensive chemotherapy resulted in complete remission (CR) or CR with incomplete count recovery (CRi) rates of 35 and 24%, respectively; treatment-specified 3-year/5-year survival rates were 32/10% for patients receiving allogeneic stem cell transplant (AlloSCT) (n = 24), 19/13% for patients achieving CR/CRi but were not transplanted (n = 24), and 1/1% in the absence of both AlloSCT and CR/CRi (n = 200) (p < 0.01). The survival impact of AlloSCT (HR 0.2, 95% CI 0.1–0.3), CR/CRi without AlloSCT (HR 0.3, 95% CI 0.2–0.5), high risk karyotype (HR 1.6, 95% CI 1.1–2.2) and platelet count < 100 × 109 /L (HR 1.6, 95% CI 1.1–2.2) were confirmed to be interindependent. Similar observations were made in the Italian cohort. The current study identifies the setting for improved short-term survival in MPN-BP, but also highlights the limited value of current therapy, including AlloSCT, in securing long-term survival

Extending Integral Concepts to Curved Bridge Systems

The behavior of integral abutment systems and the extension of their application to curved bridges are investigated. First, the stresses in the elements of a typical integral abutment are studied by conducting nonlinear finite element analysis using the software package Abaqus. The results are design recommendations for the details of such abutments. The effect of integral abutments on the responses of bridges is also investigated. Steel and concrete bridge systems are studied separately. The studied steel bridge systems are composed of composite I-girder superstructures and integral abutments supported on steel H-piles. A series of finite element studies for different bridge lengths and radii are conducted and the effects of several load cases on the bridges are studied. In these bridges, the stresses in the abutment piles are of critical importance from the design standpoint. The results show that horizontal curvature mitigates these stresses. The bridge movement is also studied and a procedure to find the end displacements of curved bridges is presented. Pile orientation is another significant design factor that is studied elaborately. The results indicate that, for straight bridges, the strong-axis pile bending yields lower levels of stress. A method for finding the optimum pile orientation in curved integral bridges is developed. The effect of different bearing types is also investigated. This investigation reveals the superior structural performance of elastomeric bearings compared to other bearing types. The concrete bridge systems that are studied consist of voided slab superstructures, integral abutments and concrete drilled shafts. A matrix of finite element studies is performed for different lengths and curvatures. Similar to steel I-girder bridges, it is concluded that horizontal curvature mitigates the internal forces of the abutment elements. The orientation of the concrete shafts is also examined which again shows the advantage of strong-axis orientation. Integral abutment bridges can have flexible piers integrally connected to the superstructure to eliminate all the bridge bearings. The effect of such integral piers on the internal forces of integral abutments is also examined. In these flexible piers, moment magnification can be of crucial significance. It is shown that choosing the integral abutment system reduces the magnification effects in the slender pier columns compared to jointed bridge systems. Advisors: Elizabeth Jones and Atorod Azizinamin

Quality of Life of Infertile Couples in relation to Marital Adjustment, Factors related to Infertility, and Demographic Characteristics

Background & Aims: Quality of life of infertile couples is affected by changes happening in their life. Knowledge about the quality of life, marital adjustment, and underlying factors of infertile couples is an important part of social health information. Such information can be used for developing health promotion programs by family counselors. The aim of this study was to predict the quality of life of infertile couples based on marital adjustment, factors related to infertility, and background characteristics. Materials & Methods: In this descriptive-analytic study, 131 women and 79 men referred to an infertility center in East Azerbaijan were recruited using a convenience method. Data were collected using the infertile women’s quality of life and Spiner’s marital adjustment questionnaires. Regression analysis was used for data analysis via the SPSS16. Results: The mean age of the female and male participants were 35.74 ± 6.11 years and 32.45 ± 5.72 years, respectively. Of variables with a p-value less than 0.1 that entered the regression analysis, marital adjustment, gender, and insurance accounted for 78% of the observed variance in the quality of life of the infertile couples. Conclusions: It was revealed that the variables of this study had important impacts on the infertile couples’ quality of life. Therefore, holding consultation programs and conducting more studies are necessary for improving the couples’ quality of life and promoting sexual and marital adjustment in infertile couples. Removing underlying problems by interventional studies are suggested to modify couples’ quality of life