Patterns of fatigue in adolescents receiving chemotherapy

Abstract: Purpose/Objectives: To describe patterns of fatigue in adolescents and the impact of fatigue during one month of chemotherapy, to explore variables that affect fatigue, and to explore the feasibility of collecting daily selfreport data in this population. Design: Longitudinal, descriptive. Setting: Two pediatric oncology centers in central Virginia. Sample: 20 adolescents with a variety of cancer diagnoses receiving chemotherapy. Methods: Adolescents described daily fatigue for one month using rating scales and qualitative diaries Main Research Variables: Fatigue severity. Finding: Adolescents commonly reported a peak in fatigue in the days immediately following chemotherapy administration. The most common pattern for adolescents who received chemotherapy on a schedule every three to four weeks was a "declining rollercoaster" pattern, with fatigue severity alternating on a daily basis but gradually declining until chemotherapy was scheduled again. Adolescents who received chemotherapy weekly showed more frequent peaks and troughs (the "yo-yo" pattern) that did not diminish in severity over the weeks of the study. Adolescents associated fatigue with other symptoms, particularly sleep-wake disturbances, pain, and nausea, and frequently reported that fatigue interfered with daily activities. Conclusions: Fatigue commonly bothers adolescents receiving chemotherapy, particularly in the days following chemotherapy administration and when other symptoms are present. Although fatigue interfered with the adolescents' abilities to maintain their usual lifestyles, many still participated in the typical activities of adolescence. Implications for Nursing: Fatigue is a complex and dynamic symptom. Oncology clinicians and researchers should frequently assess fatigue in adolescents receiving chemotherapy and apply timely and tailored interventions to match the factors that contribute to fatigue and influence fatigue severity. Management of fatigue during treatment will help adolescents stay involved in age-related activities and meet developmental milestones. Article: Adolescents diagnosed with cancer represent a group of patients with a unique cancer epidemiology, development profile, and research needs. The population's most common cancers include lymphoma, leukemia, central nervous system cancers, endocrine and germ cell tumors, and sarcomas--a spectrum of cancers different than that seen in adults or in younger childre

Team Name: 3A – Hawai’i Business Name: Virtual Mall Management Software (VMMS), Inc. Team Members:

Virtual Mall: An e-commerce marketplace, which aggregates marketing, sales, and administration functions for small merchants. Virtual Malls spent $20 billion last year creating and maintaining their online marketplaces. This figure is expected to increase 68 % in the next four years. Nearly all of that money is spent on software. That software infrastructure is currently constructed on an individual basis. Every virtual mall has to create and maintain proprietary software packages for their very similar services. Virtual Mall Management Software (VMMS) has already created a prototype virtual mall management software package. Our software is comprehensive and customizable. Virtual malls will purchase our software and use it to create, manage, alter, and market their e-marketplaces. Merchants who sign on with those virtual malls will also be able to benefit from a user-friendly interface and any-time access to their information. Although several companies sell software that can be used to create the different software components of a virtual mall, no companies are selling all components as one complete package. In addition to combining these components, our product will also offer integrated shipping an

Demographic, Clinical and Microbiological Characteristics of Maternity Patients: A Canadian Clinical Cohort Study

OBJECTIVE: To determine the demographic, clinical and microbiological characteristics of a representative Canadian obstetrical population

MKV Carrier Vehicle Sensor Calibration

The Multiple Kill Vehicle (MKV) system, which is being developed by the US Missile Defense Agency (MDA), is a midcourse payload that includes a carrier vehicle and a number of small kill vehicles. During the mission, the carrier vehicle dispenses the kill vehicles to address a complex threat environment and directs each kill vehicle toward the intercept point for its assigned threat object. As part of the long range carrier vehicle sensor development strategy, MDA and project leaders have developed a pathfinder sensor and are in the process of developing two subsequent demonstration sensors to provide proof of concept and to demonstrate technology. To increase the probability of successful development of the sensor system, detailed calibration measurements have been included as part of the sensor development. A detailed sensor calibration can provide a thorough understanding of sensor operation and performance, verifying that the sensor can meet the mission requirements. This approach to instrument knowledge will help ensure the program success and reduce cost and schedule risks. The Space Dynamics Laboratory at Utah State University (SDL) completed a calibration test campaign for the pathfinder sensor in April 2008. Similar calibration efforts are planned in 2009 for the two demonstration sensors. This paper provides an overview of calibration benefits, requirements, approach, facility, measurements, and preliminary results of the pathfinder calibration.Missile Defense Agency (contract HQ0006-05-D-0005

Outcomes of Allogeneic Hematopoietic Cell Transplantation for Adolescent and Young Adults Compared with Children and Older Adults with Acute Myeloid Leukemia

PURPOSE: Adolescents and young adults (AYAs) with cancer have not experienced improvements in survival to the same extent as children and older adults. We compared outcomes among children (<15 years), AYAs (15-40 years) and older adults (>40 years) receiving allogeneic hematopoietic cell transplant (HCT) for acute myeloid leukemia (AML). PATIENTS AND METHODS: Our cohort consisted of 900 children, 2708 AYA and 2728 older adult recipients of HLA-identical sibling or unrelated donor (URD) transplant using myeloablative or reduced-intensity/non-myeloablative conditioning. Outcomes were assessed over three time periods (1980-1988, 1989-1997, 1998-2005) for sibling and two time periods (1989-1997, 1998-2005) for URD HCT. Analyses were stratified by donor type. RESULTS: Overall survival for AYAs using either siblings or URD improved over time. Although children had better and older adults had worse survival compared to AYAs, improvements in survival for AYAs did not lag behind those for children and older adults. After sibling donor HCT, five-year adjusted survival for the three time periods was 40%, 48% and 53% for children, 35%, 41% and 42% for AYAs and 22%, 30% and 34% for older adults. Among URD HCT recipients, five-year adjusted survival for the two time periods was 38% and 37% for children, 24% and 28% for AYAs and 19% and 23% for older adults. Improvements in survival occurred due to a reduction in risk of treatment-related mortality. The risk of relapse did not change over time. CONCLUSION: Improvements in survival among AYAs undergoing allogeneic HCT for AML have paralleled those among children and older adults