The Journeys of Homeless Adolescents: A Phenomenological Inquiry into the Lives of Shelter Youth through the Creation of Life Maps

The homeless adolescent population is constantly increasing in numbers and there is a continued need for assessment. Youth without stable living environments need to be a top priority, in terms of social services, as stated by the United States Government; exploring the needs of this population should be an integral part of the development of programs and systems that attempt to break the cycle of homelessness. The objective of this thesis is to explore what it is like to be a homeless adolescent prior to and while currently living in a shelter through the process and content of a life map. Using a life map as an art therapy task and an unstructured interview, this study aims to describe what it is like to be a homeless adolescent through phenomenological inquiry. The life map utilized in this study allowed the adolescent to express and explore his or her own life visually and metaphorically by drawing and creating a map which represents his or her journey. This art therapy task was evaluated in terms of its applicability and relevance to the population. The subjects for this study were recruited at Covenant House Pennsylvania, a crisis shelter for homeless youth between the ages of 18 and 21. Four subjects completed a life map and an interview. The major findings of this study are in the form of a “united statement of the essences of the experience of the phenomenon as a whole” (Moustakas, 1994, p. 100). Overall, the journey of a homeless adolescent is a tumultuous one; these adolescents were easily engaged in life reflection, although not aseasily engaged in artwork. The adolescents seemed to prefer writing and verbalization, a finding that was further discussed by the researcher.M.A., Creative Arts in Therapy -- Drexel University, 200

Treatment and survival from breast cancer: The experience of patients at South Australian teaching hospitals between 1977 and 2003

Rationale: Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines. Aims and objectives: To use registry data to: (1) investigate trends in survival and treatment; and (2) compare treatment with guidelines. Methods: Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast cancers during 1977–2003 (n = 4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan–Meier product limit estimates and multivariable Cox proportional hazards regression. Results: The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997–2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997–2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977–1990 to 76.8% in 1997–2003 for stage I (P < 0.001) and from 31.1% to 52.2% across these periods for stage II (P < 0.001). Adjuvant radiotherapy also became more common (P < 0.001), with 20.6% of patients receiving this treatment in 1977–1990 compared with 60.7% in 1997–2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P < 0.001), from 19.6% in 1977–1990 to 36.9% in 1997–2003, and the proportion having hormone therapy also increased (P < 0.001), from 34.3% to 59.4% between these periods. Conclusions: Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based.Colin Luke, Grantley Gill, Stephen Birrell, Vlad Humeniuk, Martin Borg, Christos Karapetis, Bogda Koczwara, Ian Olver, Michael Penniment, Ken Pittman, Tim Price, David Walsh, Eng Kiat (Eric) Yeoh and David Rode