Psychological adaptation and recovery in youth with sarcoma: a qualitative study with practical implications for clinical care and research

Objectives: This study explored factors that play a role in psychological adaptation and recovery of young people with sarcoma. / Design: Qualitative study. / Setting: National Health Service hospitals in the UK. / Methods: Using purposive sampling, participants were recruited for semistructured interviews over the telephone or face to face in order to answer questions about how cancer impacted various domains of their life. Data were analysed using a framework approach. / Results: Thirty participants, aged 15–39 years with primary sarcoma diagnosis provided in-depth accounts of their experience. Emerging themes from the interviews were grouped into two overarching themes that relate to one’s adaptation to illness: individual level and environmental level. The qualitative nature of our study sheds light on meaningful connections between various factors and their role in one’s psychological adaptation to sarcoma. We devised a visual matrix to illustrate how risk and protective factors in adaptation vary between and within individuals. / Conclusions: This study demonstrates that young people with sarcoma report an array of both positive and negative factors related to their illness experience. The route to recovery is a multifactorial process and a one-size-fits-all approach to psychosocial care proves inadequate. We propose that moving beyond the latent constructs of resilience and psychopathology towards a dynamic model of psychological adaptation and recovery in this population can result in optimisation of care. We offer some recommendations for professionals working with young people with sarcoma in clinic and research

Analytical methods in wineries: is it time to change?

A review of the methods for the most common parameters determined in wine—namely, ethanol, sulfur dioxide, reducing sugars, polyphenols, organic acids, total and volatile acidity, iron, soluble solids, pH, and color—reported in the last 10 years is presented here. The definition of the given parameter, official and usual methods in wineries appear at the beginning of each section, followed by the methods reported in the last decade divided into discontinuous and continuous methods, the latter also are grouped in nonchromatographic and chromatographic methods because of the typical characteristics of each subgroup. A critical comparison between continuous and discontinuous methods for the given parameter ends each section. Tables summarizing the features of the methods and a conclusions section may help users to select the most appropriate method and also to know the state-of-the-art of analytical methods in this area

Broken seniority symmetry in the semimagic proton mid-shell nucleus ⁹⁵Rh

Lifetime measurements of low-lying excited states in the semimagic ( N = 50 ) nucleus 95Rh have been performed by means of the fast-timing technique. The experiment was carried out using γ -ray detector arrays consisting of LaBr3(Ce) scintillators and germanium detectors integrated into the DESPEC experimental setup commissioned for the Facility for Antiproton and Ion Research (FAIR) Phase-0, Darmstadt, Germany. The excited states in 95Rh were populated primarily via the β decays of 95Pd nuclei, produced in the projectile fragmentation of a 850 MeV/nucleon 124Xe beam impinging on a 4 g / cm2 9Be target. The deduced electromagnetic E2 transition strengths for the γ -ray cascade within the multiplet structure depopulating from the isomeric Iπ = 21 / 2+ state are found to exhibit strong deviations from predictions of standard shell model calculations which feature approximately conserved seniority symmetry. In particular, the observation of a strongly suppressed E2 strength for the 13 / 2+ → 9 / 2+ ground state transition cannot be explained by calculations employing standard interactions. This remarkable result may require revision of the nucleon-nucleon interactions employed in state-of-the-art theoretical model calculations, and might also point to the need for including three-body forces in the Hamiltonian

Fast-timing measurements in ⁹⁶Pd:improved accuracy for the lifetime of the 4⁺₁ state

Direct lifetime measurements via γ–γ coincidences using the FATIMA fast-timing LaBr3(Ce) array were performed for the excited states below previously reported isomers. In the N = 50 semi-magic 96Pd nucleus, lifetimes below the I π = 8+ seniority isomer were addressed as a benchmark for further analysis. The results for the I π = 2+ and 4 + states confirm the published values. Increased accuracy for the lifetime value was achieved for the 4 + state.peerReviewe

Psychological adaptation to cancer in youth: An investigation into the mechanisms of psychopathology and resilience

Cancer diagnosis and treatment are a stressful experience for a patient of any age. However, compared to younger children or adults, adolescents and young adults (AYA) are a distinct group of patients with unique challenges due to their developmental period. Literature suggests that up to a third of AYA patients may be at risk for developing psychopathology. While there is an increasing interest in studying psychosocial outcomes in AYAs, little is understood about the mechanisms of psychosocial wellbeing in this population. This thesis uses a variety of research methods to examine factors associated with resilience and psychopathology in youth living with cancer and beyond cancer and aims to identify intervention targets to promote holistic recovery of young people with cancer. Because psychosocial oncology is a young and rapidly evolving field, I begin by a short overview of some of the methodological challenges I faced in my research. In particular, I wanted to address the issue of not using cancer-specific questionnaires, and lack of longitudinal and data-driven approaches. To this end, I have innovatively used a mixed-methods approach to explore how individual, as well as socio-environmental factors are associated with psychological outcomes in young patients and survivors. I begin by a systematic review of the literature, which provides an insight into the prevalence rates of psychopathology and identifies some of the risk factors for psychiatric disorders. Subsequently, I present qualitative analysis of in-depth interviews about life with and beyond cancer. For my third study, I developed an online survey to collect information about psychological wellbeing, including cancer-specific questionnaires. Using this data, I employed network analysis to explore if any symptoms of psychopathology and cancer worries are particularly salient and contribute more to the overall symptomatology than the rest. Lastly, I conclude with a longitudinal analysis of a clinical dataset in Canada, where I explored psychological wellbeing and its relationship with fatigue, a commonly endorsed symptom. Due to the global pandemic COVID-19 and its consequent disruption, I complemented my online survey with an auxiliary study that explored the impact of the pandemic on the wellbeing of young people with cancer who were considered at risk for infections. Together, the research presented in this thesis contributes evidence to support that a subset of young people with cancer report psychopathology, and those at risk may be particularly vulnerable in the times of distress, such as the global pandemic. However, psychopathology may result from vastly different, individually led modifiable pathways, which can be addressed with a more personalized approach to care in the future. Psychosocial adaptation to cancer in young people is a complex process with many factors at play. This thesis begins to uncover a few, introduces innovative methods to counteract the existing mythological pitfalls and concludes by proposing future directions for strengthening research in psychosocial oncology and reducing the inequalities of outcomes in young people with cancer.</p

Prevalence of obesity and diabetes in patients with schizophrenia

To compare the prevalence of diabetes in patients with schizophrenia treated at a community mental health center with controls in the same metropolitan area and to examine the effect of antipsychotic exposure on diabetes prevalence in schizophrenia patients.The study was a comprehensive chart review of psychiatric notes of patients with schizophrenia and schizoaffective disorder treated at a psychosis program in a community mental health center. Data collected included psychiatric diagnoses, diabetes mellitus diagnosis, medications, allergies, primary care status, height, weight, body mass index (BMI), substance use and mental status exam. Local population data was downloaded from the Centers for Disease Control Behavioral Risk Factor Surveillance System. Statistical methods used were χ2 test, Student's t test, general linear model procedure and binary logistic regression analysis.The study sample included 326 patients with schizophrenia and 1899 subjects in the population control group. Demographic data showed control group was on average 7.6 years older (P = 0.000), more Caucasians (78.7% vs 38.3%, P = 0.000), and lower percentage of males (40.7% vs 58.3%, P = 0.000). Patients with schizophrenia had a higher average BMI than the subjects in the population control (32.11, SD = 7.72 vs 27.62, SD = 5.93, P = 0.000). Patients with schizophrenia had a significantly higher percentage of obesity (58.5% vs 27%, P = 0.000) than the population group. The patients with schizophrenia also had a much higher rate of diabetes compared to population control (23.9% vs 12.2%, P = 0.000). After controlling for age sex, and race, having schizophrenia was still associated with increased risk for both obesity (OR = 3.25, P = 0.000) and diabetes (OR = 2.42, P = 0.000). The increased risk for diabetes remained even after controlling for obesity (OR = 1.82, P = 0.001). There was no difference in the distribution of antipsychotic dosage, second generation antipsychotic use or multiple antipsychotic use within different BMI categories or with diabetes status in the schizophrenia group.This study demonstrates the high prevalence of obesity and diabetes in schizophrenia patients and indicates that antipsychotics may not be the only contributor to this risk

Prevalence of obesity and diabetes in patients with schizophrenia

To compare the prevalence of diabetes in patients with schizophrenia treated at a community mental health center with controls in the same metropolitan area and to examine the effect of antipsychotic exposure on diabetes prevalence in schizophrenia patients.The study was a comprehensive chart review of psychiatric notes of patients with schizophrenia and schizoaffective disorder treated at a psychosis program in a community mental health center. Data collected included psychiatric diagnoses, diabetes mellitus diagnosis, medications, allergies, primary care status, height, weight, body mass index (BMI), substance use and mental status exam. Local population data was downloaded from the Centers for Disease Control Behavioral Risk Factor Surveillance System. Statistical methods used were χ2 test, Student's t test, general linear model procedure and binary logistic regression analysis.The study sample included 326 patients with schizophrenia and 1899 subjects in the population control group. Demographic data showed control group was on average 7.6 years older (P = 0.000), more Caucasians (78.7% vs 38.3%, P = 0.000), and lower percentage of males (40.7% vs 58.3%, P = 0.000). Patients with schizophrenia had a higher average BMI than the subjects in the population control (32.11, SD = 7.72 vs 27.62, SD = 5.93, P = 0.000). Patients with schizophrenia had a significantly higher percentage of obesity (58.5% vs 27%, P = 0.000) than the population group. The patients with schizophrenia also had a much higher rate of diabetes compared to population control (23.9% vs 12.2%, P = 0.000). After controlling for age sex, and race, having schizophrenia was still associated with increased risk for both obesity (OR = 3.25, P = 0.000) and diabetes (OR = 2.42, P = 0.000). The increased risk for diabetes remained even after controlling for obesity (OR = 1.82, P = 0.001). There was no difference in the distribution of antipsychotic dosage, second generation antipsychotic use or multiple antipsychotic use within different BMI categories or with diabetes status in the schizophrenia group.This study demonstrates the high prevalence of obesity and diabetes in schizophrenia patients and indicates that antipsychotics may not be the only contributor to this risk

Cognitive mechanisms in adolescent and young adult cancer patients and survivors: feasibility and preliminary insights from the cognitions and affect in cancer resiliency study

This cross sectional pilot study assesses the feasibility of conducting online research into cognitive mechanisms in adolescent and young adult cancer populations. Twenty-one participants, aged 18–39 years, answered questionnaires about mental defeat, rumination, cancer worry, anxiety, and experience participating in such research. Seven participants scored in the clinical range for anxiety. Cancer-related worry was common. Rumination and mental defeat were positively associated with anxiety. The participants reported the length and type of questions to be appropriate and not distressing. Findings may inform future research into cognitive mechanisms, which could aid the development of psychosocial interventions for young cancer patients