Aging and creating families: Never-married heterosexual women over forty

An examination of women over age forty who had never married was conducted. The women completed a structured questionnaire about their aging and their self-esteem was assessed with a standard measure. The participants were women from across the United States. Descriptive analyses of the data were ordered with ecological systems theory and findings revealed that the women are self-satisfied, socially productive and well adjusted with their single status and that singleness runs in their families. These women have defined what family means for them as they age-family of origin and close friendships. This description may be helpful in understanding this group as a social force and as role models for young women as they age. Zapotitlán Copyright by The Haworth Press, Inc. All rights reserved

Risk Stratification, Treatment Selection, and Transplant Eligibility in Multiple Myeloma: A Qualitative Study of the Perspectives and Self-Reported Practices of Oncologists

Background Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how physicians view and implement guidelines and incorporate novel approaches into patient care. Methods We designed a semi-structured qualitative interview guide informed by literature review and an expert advisory panel. We conducted 60-minute interviews with a diverse sample of oncology physicians in the southeast United States. We used a constant comparative method to code and analyze interview transcripts. The research team and advisory panel discussed and validated emergent themes. Results Participants were 13 oncologists representing 5 academic and 4 community practices. Academic physicians reported using formal risk-stratification schemas; community physicians typically did not. Physicians also described differences in eligibility criteria for transplantation; community physicians emphasized distance, social support, and psychosocial capacity in making decisions about transplantation referral; the academic physicians reported using more specific clinical criteria. All physicians reported using a maintenance strategy both for post-transplant and for transplant-ineligible patients; however, determining the timing of maintenance therapy initiation and the response were reported as challenging, as was recognition or definition of relapse, especially in terms of when treatment re-initiation is indicated. Conclusions Practices reported by both academic and community physicians suggest opportunities for interventions to improve patient care and outcomes through optimal multiple myeloma management and therapy selection. Community physicians in particular might benefit from targeted education interventions about risk stratification, transplant eligibility, and novel therapies