The structure of dyadic support among couples with and without a long-term disability

Abstract This study examines support relationships among 65 couples in which the husband had a long-term spinal cord injury, and a comparison group of 65 couples without disability. Based on facet theory, we constructed a mapping sentence that forms a definitional framework for couple support, and developed a detailed inventory to assess attitudes regarding mutual support in couple relations, the sense of support availability, support behaviors of giving and receiving, the degree to which the support meets one's needs, response to received support, and preference for support from within the couple and from external sources. These are all measured with respect to instrumental, emotional and informational support. Smallest space analysis showed various structures of the relations between elements of support among men and women living with and without disability, as well as a core element of reciprocal support common to both men and women in couples with and without disability

A minority of women of childbearing potential are tested for pregnancy before chemoimmunotherapy: An Australian cancer centre experience

Background: Chemotherapy is potentially harmful to a developing foetus, and there are limited data on the foetal impact of chemoimmunotherapy (CIT). Therefore, determining pregnancy status prior to initiation of CIT should be standard of care. Aims: To determine how many women of childbearing age are tested for pregnancy prior to immunochemotherapy administration. Methods: A retrospective chart review at a large Australian metropolitan cancer referral centre, including 304 women aged 18–51 years with a diagnosis of cancer receiving outpatient-based CIT between 1 May 2015 and 12 June 2020. We assessed the uptake of pregnancy screening and contraception counselling prior to and during first-line CIT. Results: Only 17.3% of CIT cycles (n = 416) screened patients for pregnancy no more than 90 days prior to administration, and the median time between pregnancy screening and treatment was approximately 3 weeks. One patient with early breast cancer had a spontaneous miscarriage estimated at 3–4 weeks’ gestation, and neither the patient nor the treating oncologist was aware of this event. This was also the only patient who had a pregnancy test beyond the first cycle of CIT during their treatment. Conclusions: Our results highlight a concerningly low rate of pregnancy screening in women of childbearing age receiving CIT. The implication of missing a positive pregnancy test in this group of women could result in foetal complications, accidental miscarriage, potential bleeding risks and avoidable psychosocial stress. This highlights the urgent need for guidelines to mandate pregnancy testing in women of childbearing age receiving CIT and evidence-based implementation tools

Patients with treated indolent lymphomas immunized with BNT162b2 have reduced anti‐spike neutralizing IgG to SARS‐CoV‐2 variants, but preserved antigen‐specific T cell responses

Patients with indolent lymphoma undertaking recurrent or continuous B cell suppression are at risk of severe COVID-19. Patients and healthy controls (HC; N=13) received 2 doses of BNT162b2: Follicular Lymphoma (FL; N=35) who were treatment naïve (TN; N=11) or received immunochemotherapy (ICT; N=23) and Waldenström's Macroglobulinemia (WM; N=37) including TN (N=9), ICT (N=14), or treated with Bruton's Tyrosine Kinase inhibitors (BTKi; N=12). Anti-spike IgG was determined by a high-sensitivity flow-cytometric assay, in addition to live-virus neutralization. Antigen-specific T cells were identified by co-expression of CD69/CD137 and CD25/CD134 on T cells. A subgroup (N=29) were assessed for third mRNA vaccine response, including omicron neutralization. One month after second BNT162b2, median anti-spike IgG mean fluorescence intensity (MFI) in FL ICT patients (9977) was 25-fold lower than TN (245898) and HC (228255, p=0.0002 for both). Anti-spike IgG correlated with lymphocyte count (r=0.63; p=0.002), and time from treatment, (r=0.56; p=0.007) on univariate analysis, but only with lymphocyte count on multivariate analysis (p=0.03). In the WM cohort, median anti-spike IgG MFI in BTKi patients (39039) was reduced compared to TN (220645, p=0.0008) and HC (p<0.0001). Anti-spike IgG correlated with neutralization of the delta variant (r=0.62, p<0.0001). Median neutralization titer for WM BTKi (0) was lower than HC (40, p<0.0001) for early-clade and delta. All cohorts had functional T cell responses. Median anti-spike IgG decreased 4-fold from second to third dose (p=0.004). Only 5/29 poor initial responders assessed after third vaccination demonstrated seroconversion and improvement in neutralization activity, including to the omicron variant. This article is protected by copyright. All rights reserved