Perceptions of Positive Growth Following Breast Cancer in Survivor Couples

The purpose of this study was to explore the lived experiences of couples following breast cancer and their perceptions of growth as a result of their experiences with the illness. Qualitative methodology, specifically a phenomenological research design, was utilized to gain understanding of couples’ perceptions and interpretations of growth, particularly within the contexts of couple relationships. Ten survivor couples participated in the study. Study data was collected through semistructured interviews with the couple jointly. Genograms were constructed for each couple and were utilized to track couples’ experiences with illness, care-taking, and growth following adverse or traumatic situations. Data analysis revealed in the emergence of thirteen primary themes. The results indicated that both female and male participants’ initial reactions to the breast cancer diagnosis were primarily characterized by fear, shock, and unpreparedness. Couples experienced the impact of the illness within several areas of their relationships including physical functioning, emotional climate, sexual intimacy, and relational closeness. Several of these disruptions were compounded by difficulties related to partners’ abilities to establish mutually comfortable ways of communicating about emotions, which resulted in engagement in ineffective and unhelpful behaviors and contributed to experiencing emotional distance within the relationship. Despite this, couples were able to communicate effectively with one another in other ways and employ dyadic coping strategies that aided in their adjustment to the illness. All ten couples identified that their primary resource for support was their own relationship, and intimate acts of care-taking, along with a shared perception that challenges could be overcome together, were perceived as significant factors contributing to mutual coping. All ten couples perceived both positive change and growth as a result of their shared experiences. Areas of change included prioritizing leisure/time together and healthy living habits, and increased open emotional communication. Growth was described in terms of increased emotional closeness, relational trust and confidence, appreciation for life and awareness of mortality, gratitude, perspective of what is important, and spiritual development. Couples mutually perceived survivorship and growth as active processes that involved learning. Descriptions of growth illustrated the rebuilding of altered assumptions and perceptions of transformation beyond the pre-diagnosis ways of living and relating. Findings from this study expand the existing literature on couples\u27 experiences with breast cancer and contribute a relational perspective to the concept of posttraumatic growth. In addition, it is essentially the first study to explore couples’ shared experiences of relational growth following breast cancer

Non-ignorable missing covariate data in parametric survival analysis

Within any epidemiological study missing data is almost inevitable. This missing data is often ignored; however, unless we can assume quite restrictive mechanisms, this will lead to biased estimates. Our motivation are data collected to study the long-term effect of severity of disability upon survival in children with cerebral palsy (henceforth CP). The analysis of such an old data set brings to light statistical difficulties. The main issue in this data is the amount of missing covariate data. We raise concerns about the mechanism causing data to be missing. We present a flexible class of joint models for the survival times and the missing data mechanism which allows us to vary the mechanism causing the missing data. Simulation studies prove this model to be both precise and reliable in estimating survival with missing data. We show that long term survival in the moderately disabled is high and, therefore, a large proportion will be surviving to times when they require care specifically for elderly CP sufferers. In particular, our models suggest that survival from diagnosis is considerably higher than has been previously estimated from this data. This thesis contributes to the discussion of possible methods for dealing with NMAR data

Success in the Sound: Local Examples of How Restoration Efforts Have Succeeded

Restoration and conservation efforts are abundant throughout Puget Sound, and many are performed on a local scale. Several success stories have emerged showing effectiveness monitoring data that identify successful changes in the ecosystem brought about by these targeted restoration projects. This presentation will address several examples, including: 1. The Thea Foss Waterway – City of Tacoma. Once heavily polluted and largely abandoned as a residential area, the Thea Foss Waterway now boasts dramatically cleaner waters and a thriving downtown area. Enhanced maintenance, in combination with the existing aggressive source control and clean up program, resulted in statistically significant reductions for several contaminants, including metals, pesticides, and PAHs. 2. One Millionth Tree - Whatcom County Conservation District. Degraded riparian areas and water quality limit salmon and steelhead recovery in Puget Sound and can negatively affect shellfish beds. The Whatcom County Conservation District Conservation Resource Enhancement Program (CREP) provides assistance to landowners who wish to install vegetative buffers on their property that provide critical shade and act as water quality filters. On April 20, 2013 (Earth Day) the one millionth CREP tree was planted in Acme, WA. Other examples will include various restoration efforts in Kitsap County and other locations around Puget Sound. Along with detailing some successful restoration activities, this presentation will summarize common mechanisms for successful restoration processes that have been employed at the local level. This presentation will be a companion presentation to 1. The 2013 State of the Sound: Status of the ecosystem, proposed by Nathalie Hamel (Puget Sound Partnership), and 2. 2013 State of the Sound: Accountability and funding, proposed by Katherine Boyd and Alex Mitchell (Puget Sound Partnership). The four presenters will discuss the linkages among tracking, ecosystem indicators, and effectiveness monitoring in Puget Sound recovery efforts

Non-ignorable missing covariate data in parametric survival analysis

Within any epidemiological study missing data is almost inevitable. This missing data is often ignored; however, unless we can assume quite restrictive mechanisms, this will lead to biased estimates. Our motivation are data collected to study the long-term effect of severity of disability upon survival in children with cerebral palsy (henceforth CP). The analysis of such an old data set brings to light statistical difficulties. The main issue in this data is the amount of missing covariate data. We raise concerns about the mechanism causing data to be missing. We present a flexible class of joint models for the survival times and the missing data mechanism which allows us to vary the mechanism causing the missing data. Simulation studies prove this model to be both precise and reliable in estimating survival with missing data. We show that long term survival in the moderately disabled is high and, therefore, a large proportion will be surviving to times when they require care specifically for elderly CP sufferers. In particular, our models suggest that survival from diagnosis is considerably higher than has been previously estimated from this data. This thesis contributes to the discussion of possible methods for dealing with NMAR data.EThOS - Electronic Theses Online ServiceEngineering and Physical Sciences Research Council (EPSRC)GBUnited Kingdo

A systematic review of the psychometric properties of Quality of Life measures for school aged children with cerebral palsy

Background: This systematic review aimed to evaluate the psychometric properties and clinical utility of all condition specific outcome measures used to assess quality of life (QOL) in school aged children with cerebral palsy (CP)

Relocation of the Salvador Camarena Burial: Historical and Bioarcheological Investigations of a Mexican Migrant Worker Grave (41MV372) in Maverick County, Texas

F rom 2011 through 2014, the Texas Department of Transportation collaborated with Prewitt and Associates, Inc., to investigate an isolated grave in a remote area alongside FM 481 in Maverick County, Texas. An initial archeological investigation confirmed that the location was a historic grave, and archival records revealed that it contained the remains of Salvador Camarena, a Mexican citizen who died in Texas in January 1950. Additional research identified Camarena’s son and other family members living in Mexico, California, and Texas. With the family’s permission, the burial remains were exhumed, examined, and reinterred at La Marque Cemetery in Galveston County, Texas, where Camarena’s mother and two sisters are buried. The bioarcheological analysis of the skeletal remains corroborates the historical information. Together, the bioarcheological and historical data provide a rare glimpse into the life and death of a migrant laborer. The burial of one immigrant worker may seem insignificant. However, the Camarena case represents a sad but common theme in the history of migrant labor. Like many before him and even more since, Camarena probably died in a foreign country seeking a means to support his family when traveling to seasonal agricultural work

Soil resources, microbial activity, and primary production across an agricultural ecosystem

Includes bibliographical references (pages 169-170).The degree to which soil resource availability is linked to patterns of microbial activity and plant productivity within ecosystems has important consequences for our understanding of how ecosystems are structured and for the management of systems for agricultural production. We studied this linkage in a 48-ha site in southwest Michigan, USA, that had been cultivated and planted to row crops for decades. Prior to seeding the site to genetically identical soybean plants (Glycine max) in early spring, we removed soil samples from ≈600 locations; plant biomass was harvested from these same locations later in the season. Soil samples were analyzed for physical properties (texture, bulk density), chemical properties (moisture, pH, total C, total N, inorganic N), and biological attributes (microbial biomass, microbial population size, respiration potential, and nitrification and N-mineralization potentials). Plant analyses included biomass and C and N contents. Soil resource variability across this long-cultivated site was remarkably high, as was variability in microbial activity and primary productivity. In almost all cases variability exhibited a strong spatially explicit structure: for most properties and processes > 50% of sample variance was spatially dependent at a scale of 5–60 m. Exceptions included microtopography, soil pH, and inorganic P, which were spatially dependent across the entire 1–1200 m range of separation distances examined in this study, and the culturable-bacteria population, which was not spatially autocorrelated at any scale examined. Both topographic relief and soil pH exhibited strongly nested structures, with autocorrelation occurring within two (topography) or more (pH) distinct ranges. Multiple regression analysis showed surprisingly little correlation between biological processes (soybean productivity, soil N turnover, soil respiration), and static soil properties. The best predictor of soybean biomass at late reproductive stages (r2 = 0.42) was a combination of nitrate N, bulk density, inorganic P, N-mineralization rates, and pH. Overall, results suggest a remarkable degree of spatial variability for a pedogenically homogeneous site that has been plowed and cropped mostly as a single field for > 100 yr. Such variability is likely to be generic to most ecosystems and should be carefully evaluated when making inferences about ecological relationships in these systems and when considering alternative sampling and management strategies

Organophosphate Pesticide Exposure and Attention in Young Mexican-American Children: The CHAMACOS Study

BackgroundExposure to organophosphate (OP) pesticides, well-known neurotoxicants, has been associated with neurobehavioral deficits in children.ObjectivesWe investigated whether OP exposure, as measured by urinary dialkyl phosphate (DAP) metabolites in pregnant women and their children, was associated with attention-related outcomes among Mexican-American children living in an agricultural region of California.MethodsChildren were assessed at ages 3.5 years (n = 331) and 5 years (n = 323). Mothers completed the Child Behavior Checklist (CBCL). We administered the NEPSY-II visual attention subtest to children at 3.5 years and Conners' Kiddie Continuous Performance Test (K-CPT) at 5 years. The K-CPT yielded a standardized attention deficit/hyperactivity disorder (ADHD) Confidence Index score. Psychometricians scored behavior of the 5-year-olds during testing using the Hillside Behavior Rating Scale.ResultsPrenatal DAPs (nanomoles per liter) were nonsignificantly associated with maternal report of attention problems and ADHD at age 3.5 years but were significantly related at age 5 years [CBCL attention problems: β = 0.7 points; 95% confidence interval (CI), 0.2-1.2; ADHD: β = 1.3; 95% CI, 0.4-2.1]. Prenatal DAPs were associated with scores on the K-CPT ADHD Confidence Index > 70th percentile [odds ratio (OR) = 5.1; 95% CI, 1.7-15.7] and with a composite ADHD indicator of the various measures (OR = 3.5; 95% CI, 1.1-10.7). Some outcomes exhibited evidence of effect modification by sex, with associations found only among boys. There was also limited evidence of associations between child DAPs and attention.ConclusionsIn utero DAPs and, to a lesser extent, postnatal DAPs were associated adversely with attention as assessed by maternal report, psychometrician observation, and direct assessment. These associations were somewhat stronger at 5 years than at 3.5 years and were stronger in boys