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Narita Z, Shinozaki T, Goto A, Hori H, Kim Y, Wilcox HC, Inoue M, Tsugane S, Sawada N. Time-varying living arrangements and suicide death in the general population sample: 14-year causal survival analysis via pooled logistic regression. Epidemiol Psychiatr Sci 2024; 33:e30. [PMID: 38779822 PMCID: PMC11362678 DOI: 10.1017/s2045796024000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/17/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
AIMS While past research suggested that living arrangements are associated with suicide death, no study has examined the impact of sustained living arrangements and the change in living arrangements. Also, previous survival analysis studies only reported a single hazard ratio (HR), whereas the actual HR may change over time. We aimed to address these limitations using causal inference approaches. METHODS Multi-point data from a general Japanese population sample were used. Participants reported their living arrangements twice within a 5-year time interval. After that, suicide death, non-suicide death and all-cause mortality were evaluated over 14 years. We used inverse probability weighted pooled logistic regression and cumulative incidence curve, evaluating the association of time-varying living arrangements with suicide death. We also studied non-suicide death and all-cause mortality to contextualize the association. Missing data for covariates were handled using random forest imputation. RESULTS A total of 86,749 participants were analysed, with a mean age (standard deviation) of 51.7 (7.90) at baseline. Of these, 306 died by suicide during the 14-year follow-up. Persistently living alone was associated with an increased risk of suicide death (risk difference [RD]: 1.1%, 95% confidence interval [CI]: 0.3-2.5%; risk ratio [RR]: 4.00, 95% CI: 1.83-7.41), non-suicide death (RD: 7.8%, 95% CI: 5.2-10.5%; RR: 1.56, 95% CI: 1.38-1.74) and all-cause mortality (RD: 8.7%, 95% CI: 6.2-11.3%; RR: 1.60, 95% CI: 1.42-1.79) at the end of the follow-up. The cumulative incidence curve showed that these associations were consistent throughout the follow-up. Across all types of mortality, the increased risk was smaller for those who started to live with someone and those who transitioned to living alone. The results remained robust in sensitivity analyses. CONCLUSIONS Individuals who persistently live alone have an increased risk of suicide death as well as non-suicide death and all-cause mortality, whereas this impact is weaker for those who change their living arrangements.
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Affiliation(s)
- Z. Narita
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - T. Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Katsushika-ku, Tokyo, Japan
| | - A. Goto
- Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Kanagawa, Japan
| | - H. Hori
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Y. Kim
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - H. C. Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M. Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - S. Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
- International University of Health and Welfare Graduate School of Public Health, Minato City, Tokyo, Japan
| | - N. Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
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Ruff SM, Stevens L, Bressler L, Khatri R, Sarna A, Ejaz AM, Dillhoff M, Pawlik TM, Rose K, Cloyd JM. Evaluating the caregiver experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma. J Surg Oncol 2024; 129:775-784. [PMID: 38063046 DOI: 10.1002/jso.27558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/10/2023] [Accepted: 11/25/2023] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Neoadjuvant therapy (NT) is increasingly recommended for patients with localized pancreatic ductal adenocarcinoma (PDAC). Recent research has highlighted the significant treatment burden that patients experience during NT, but caregiver well-being during NT is poorly understood. METHODS A cross-sectional mixed-methods analysis of primary caregivers of patients with localized PDAC receiving NT was undertaken. All patients completed the Caregiver Quality of Life Index-Cancer (CQOLC) survey, while semi-structured interviews were conducted among a convenience sample of participants. RESULTS Among 28 caregivers, the mean age was 60.1 years, and most were patient spouses/significant others (71.4%). Patients had resectable (18%), borderline resectable (46%), or locally advanced (36%) PDAC with a mean treatment duration of 2.9 months at the time of their caregiver's enrollment. Most caregivers felt that they received adequate emotional/psychosocial support (80%) and understood the rationale for NT (93%). A majority (60%) reported that caregiving responsibilities impacted their daily lives and required a decrease in their work hours, leading to financial challenges (47%). While overall QOL was moderate (mean 83 ± 21.1, range 0-140), "emotional burden" (47.3 ± 20.9), and "positive adaption" (57.3 ± 13.9) were the lowest ranked CQOLC subsection scores. DISCUSSION Caregivers of patients with PDAC undergoing NT experience significant emotional symptoms and impact on their daily lives. Assessing caregiver needs and providing resources during NT should be a priority.
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Affiliation(s)
- Samantha M Ruff
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Lena Stevens
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Luke Bressler
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Rakhsha Khatri
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Angela Sarna
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Aslam M Ejaz
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mary Dillhoff
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Timothy M Pawlik
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Karen Rose
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Jordan M Cloyd
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
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Gong R, Heller A, Patricia I Moreno, Betina Yanez, Penedo FJ. Low Social Well-Being in Advanced and Metastatic Prostate Cancer: Effects of a Randomized Controlled Trial of Cognitive Behavioral Stress Management. Int J Behav Med 2024:10.1007/s12529-024-10270-w. [PMID: 38378974 PMCID: PMC11333730 DOI: 10.1007/s12529-024-10270-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Social well-being impacts cancer patients' health-related quality of life (HRQOL) and coping style. This secondary analysis was conducted to examine whether advanced prostate cancer survivors who had experienced low social well-being would benefit from a web-based cognitive behavioral stress management (CBSM) intervention. METHOD APC survivors (N = 192) who had received androgen deprivation therapy (ADT) were randomized to a 10-week CBSM or a health promotion (HP) control condition. A subsample of participants (n = 61) with low pre-intervention SWB (measured by social support from and relationship satisfaction with family and friends) was included in the study. Multilevel models compared participants' PC-specific quality of life (sexual, hormonal, urinary), affect-based psychosocial burden (cancer-related anxiety and distress), and coping strategies at baseline, 6 months, and 12 months. Covariates were included in all models as appropriate. RESULTS Participants randomized to the CBSM condition showed significantly greater improvements in fear of cancer recurrence and cancer-related intrusive thoughts than those in the HP control condition. A significant condition by time interaction was also found, indicating that CBSM improved participants' PC-related fear in both short- (6 months) and long-term (12 months). However, the CBSM intervention did not significantly impact APC-related symptom burden. Only for the urinary domain, clinically meaningful changes (CBSM vs HP) were observed. In addition, all participants, regardless of condition, reported less coping (e.g., emotion-, problem- and avoidance-focused) over time. CONCLUSION As predicted, the CBSM intervention improved several affect-based psychosocial outcomes for APC survivors with low baseline SWB.
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Affiliation(s)
- Rui Gong
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
| | - Aaron Heller
- Department of Psychology, University of Miami, Coral Gables, Miami, FL, 33146, USA
| | - Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
- Department of Psychology, University of Miami, Coral Gables, Miami, FL, 33146, USA.
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Baudot A, Barth N, Colas C, Garros M, Garcin A, Oriol M, Collange F, Bongue B, Roche F, Chauvin F, Bourmaud A, Hupin D. The Acti-Pair program helps men with prostate cancer increase physical activity with peer support: a mixed method pilot study. Front Public Health 2024; 11:1321230. [PMID: 38259748 PMCID: PMC10800526 DOI: 10.3389/fpubh.2023.1321230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background Although the health benefits of physical activity (PA) are recognized, prostate cancer patients do not follow PA recommendations. Barriers to PA, whether physical, environmental or organizational, are known. Furthermore, even when these barriers are overcome, this achievement is not systematically accompanied by lifestyle change. Many strategies have shown to be effective in increasing patient adherence to PA. This study aims to assess the feasibility and the viability of the Acti-Pair program which combines three strategies: peer support, a personalized and realistic PA project, and support from health and adapted physical activity professionals in a local context. Methods and analysis We conducted a pilot study utilizing a mixed qualitative and quantitative methodology, employing feasibility and viability assessments. Quantitative assessments included recruitment, retention adherence rates, process and potential effectiveness (PA and motivation) indicators; while qualitative methods were used to evaluate the program's practicality, suitability and usefulness. Indicators of potential effectiveness were assessed before and after the intervention using a Wilcoxon test for matched data. Qualitative data were collected through semistructured interviews conducted by two researchers with various program stakeholders. The study lasted for 3 years. Results Twenty-four patients were recruited over a 25-month period. Forty-two percent of patients completed the program 3 months after the beginning. We recruited 14 peers and trained nine peers over a 10-month period. The program was coordinated extensively by adapted PA professionals, while health professionals were involved in recruiting patients and peers. Self-reporting of moderate to vigorous PA was increased after the Acti-Pair program initiation [42.86 (30.76) at baseline to 53.29 (50.73)]. Intrinsic motivation significantly increased after participation in the Acti-Pair program [1.76 (1.32) before the intervention vs. 2.91 (1.13) after the intervention]. The key player to support the Acti-Pair program in the field has been the PA support system. The main challenge has been the difficulty of health professionals in promoting PA. Discussion This pilot study has shown that the Acti-Pair program is feasible and viable. It will allow us to extend the peer support intervention to other contexts and assess the effectiveness of this intervention and its generalization.
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Affiliation(s)
- Amandine Baudot
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Unité de recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Nathalie Barth
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Gérontopôle Auvergne Rhône-alpes, Saint-Etienne, France
| | - Claire Colas
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Maël Garros
- Sport-Health House, Departmental Olympic and Sports Committee of the Loire (42), Saint-Etienne, France
| | - Arnauld Garcin
- Unité de recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Mathieu Oriol
- Centre Technique d'Appui et de Formation (CETAF), Saint-Etienne, France
| | - Fanny Collange
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Bienvenu Bongue
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
| | - Frederic Roche
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Franck Chauvin
- National Institute of Health and Medical (INSERM) CIC1408 Centre d'Investigation Clinique Saint-Etienne, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
| | - Aurelie Bourmaud
- National Institute of Health and Medical Research (INSERM) U1137 Infection, Antimicrobiens, Modélisation, Evolution, Paris, France
- National Institute of Health and Medical Research (INSERM) CIC1426 Centre d'Investigation Clinique Robert Debré, Paris, France
| | - David Hupin
- National Institute of Health and Medical Research (INSERM) U1059 SAnté INgéniérie BIOlogie, Saint-Etienne, France
- Presage Institute - Université Jean Monnet, Saint-Etienne, France
- Chaire santé des aînés - Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
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Hilakivi-Clarke L, de Oliveira Andrade F. Social Isolation and Breast Cancer. Endocrinology 2023; 164:bqad126. [PMID: 37586098 DOI: 10.1210/endocr/bqad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023]
Abstract
Although the role of life stressors in breast cancer remains unclear, social isolation is consistently associated with increased breast cancer risk and mortality. Social isolation can be defined as loneliness or an absence of perceived social connections. In female mice and rats, social isolation is mimicked by housing animals 1 per cage. Social isolation causes many biological changes, of which an increase in inflammatory markers and disruptions in mitochondrial and cellular metabolism are commonly reported. It is not clear how the 2 traditional stress-induced pathways, namely, the hypothalamic-pituitary-adrenocortical axis (HPA), resulting in a release of glucocorticoids from the adrenal cortex, and autonomic nervous system (ANS), resulting in a release of catecholamines from the adrenal medulla and postganglionic neurons, could explain the increased breast cancer risk in socially isolated individuals. For instance, glucocorticoid receptor activation in estrogen receptor positive breast cancer cells inhibits their proliferation, and activation of β-adrenergic receptor in immature immune cells promotes their differentiation toward antitumorigenic T cells. However, activation of HPA and ANS pathways may cause a disruption in the brain-gut-microbiome axis, resulting in gut dysbiosis. Gut dysbiosis, in turn, leads to an alteration in the production of bacterial metabolites, such as short chain fatty acids, causing a systemic low-grade inflammation and inducing dysfunction in mitochondrial and cellular metabolism. A possible causal link between social isolation-induced increased breast cancer risk and mortality and gut dysbiosis should be investigated, as it offers new tools to prevent breast cancer.
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Affiliation(s)
- Leena Hilakivi-Clarke
- Department of Food Science and Nutrition, The Hormel Institute, University of Minnesota, Austin, MN 55912, USA
| | - Fabia de Oliveira Andrade
- Department of Food Science and Nutrition, The Hormel Institute, University of Minnesota, Austin, MN 55912, USA
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Zaki TA, Ziogas A, Chang J, Murphy CC, Anton-Culver H. Survival of Middle Eastern and North African Individuals Diagnosed with Colorectal Cancer: A Population-Based Study in California. Cancer Epidemiol Biomarkers Prev 2023; 32:795-801. [PMID: 37012208 PMCID: PMC11338047 DOI: 10.1158/1055-9965.epi-22-1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/27/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Literature on colorectal cancer outcomes in individuals of Middle Eastern and North African (MENA) descent is limited. To address this gap, we estimated five-year colorectal cancer-specific survival by race and ethnicity, including MENA individuals, in a diverse, population-based sample in California. METHODS We identified adults (ages 18-79 years) diagnosed with a first or only colorectal cancer in 2004 to 2017 using the California Cancer Registry (CCR), including non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Hispanic, and MENA individuals. For each racial/ethnic group, we calculated five-year colorectal cancer-specific survival and used Cox proportional hazards regression models to examine the association of race/ethnicity and survival, adjusting for clinical and socio demographic factors. RESULTS Of 110,192 persons diagnosed with colorectal cancer, five-year colorectal cancer-specific survival was lowest in Black (61.0%) and highest in MENA (73.2%) individuals. Asian (72.2%) individuals had higher survival than White (70.0%) and Hispanic (68.2%) individuals. In adjusted analysis, MENA [adjusted HR (aHR), 0.82; 95% confidence interval (CI), 0.76-0.89], Asian (aHR, 0.86; 95% CI, 0.83-0.90), and Hispanic (aHR, 0.94; 95% CI, 0.91-0.97) race/ethnicity were associated with higher, and Black (aHR, 1.13; 95% CI, 1.09-1.18) race/ethnicity was associated with lower survival compared with non-Hispanic White race/ethnicity. CONCLUSIONS To our knowledge, this is the first study to report colorectal cancer survival in MENA individuals in the United States. We observed higher survival of MENA individuals compared with other racial/ethnic groups, adjusting for sociodemographic and clinical factors. IMPACT Future studies are needed to identify factors contributing to cancer outcomes in this unique population.
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Affiliation(s)
- Timothy A. Zaki
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Argyrios Ziogas
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
| | - Jenny Chang
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
| | - Caitlin C. Murphy
- School of Public Health, University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX
| | - Hoda Anton-Culver
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
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Morris BB, Hughes R, Fields EC, Sabo RT, Weaver KE, Fuemmeler BF. Sociodemographic and Clinical Factors Associated With Radiation Treatment Nonadherence and Survival Among Rural and Nonrural Patients With Cancer. Int J Radiat Oncol Biol Phys 2023; 116:28-38. [PMID: 35777674 PMCID: PMC9797617 DOI: 10.1016/j.ijrobp.2022.06.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 06/02/2022] [Accepted: 06/10/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE Cancer treatment nonadherence is associated with higher rates of cancer recurrence and decreased survival. Rural patients with cancer experience a 10% higher mortality rate compared with their nonrural counterparts; geographic differences in nonadherence may contribute to this increased mortality. The goal of this study was to assess for geographic disparities and determine sociodemographic and clinical factors associated with radiation therapy (RT) nonadherence and survival among rural and nonrural patients with cancer. METHODS AND MATERIALS We examined cancer registry, medical records, and billing claims data at a safety net academic medical center. Geographic residence was defined as rural versus nonrural by US Department of Agriculture 2013 Rural-Urban Continuum Codes. Other factors assessed were age, sex, race, marital status, insurance type, employment, area median household income, residential distance to cancer treatment center, clinical stage, cancer type, treatment modality, total radiation dose received, and radiation dose per fraction. We used Cox proportional hazards modeling to examine 7 ways of operationalizing nonadherence and selected the definition that resulted in the best model fit statistics and prediction of mortality. Overall survival rates were estimated with the Kaplan-Meier method. We then examined nonadherence as the main exposure along with additional covariates in least absolute shrinkage and selection operator penalized survival analyses and as the outcome in our multivariable generalized linear regression analyses predicting nonadherence. We considered 2-way interaction terms with the main exposure, geographic residence. RESULTS We identified 3,077 patients with cancer who averaged 62 years old, were 59% female, 34% Black, and 14% rural. Twenty-two percent of patients missed at least 2 fractions and missed an average of 10% of their treatment plan. Rural patients experienced a higher mortality rate than nonrural patients (53% vs 42%, P < .0001). Survival was assessed through December 31, 2021, with a mean follow-up of 4.5 years. Proportion of missed fractions as the indicator of nonadherence provided the best model fit statistics and prediction of survival. Marital status, employment status, tumor, nodes, metastases stage, cancer type, and age at diagnosis significantly affected survival, in addition to a treatment delay by geographic residence interaction effect. Specifically, patients residing in rural areas who experienced a treatment delay were more than twice as likely to die as nonrural residents who also experienced a treatment delay, and nearly twice as likely to die as rural residents who did not experience a treatment delay. The 2-year survival rate was 76% for nonrural residents who did not experience a treatment delay versus 27% for rural residents who experienced a treatment delay. Patients who were widowed, had stage 4 cancer, or lung cancer were more likely to be nonadherent. Finally, patients residing in rural areas who experienced a treatment delay were more likely to subsequently be nonadherent. CONCLUSIONS In a geographically and racially diverse population, RT nonadherence is a significant concern that affects survival, yet it is a modifiable risk factor. We demonstrated that rural residence was associated with both RT nonadherence and poorer overall survival. Rural patients with a treatment delay had the lowest overall survival, compared with both nonrural survivors and rural survivors without delay. Rural residents who are delayed in starting treatment are at heightened risk for poor outcomes and should receive targeted support to mitigate the observed disparities. Additional patient populations that may benefit from targeted treatment adherence support include widowed patients and those with stage 4 cancer or lung cancer.
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Affiliation(s)
- Bonny B Morris
- Virginia Commonwealth University School of Medicine, Department of Health Behavior and Policy, Richmond, Virginia.
| | - Ryan Hughes
- Wake Forest School of Medicine, Department of Radiation Oncology, Winston-Salem, North Carolina
| | - Emma C Fields
- Virginia Commonwealth University School of Medicine, Department of Radiation Oncology, Richmond, Virginia
| | - Roy T Sabo
- Virginia Commonwealth University School of Medicine, Department of Biostatistics, Richmond, Virginia
| | - Kathryn E Weaver
- Wake Forest School of Medicine, Departments of Social Sciences and Health Policy & Implementation Science, Winston-Salem, North Carolina
| | - Bernard F Fuemmeler
- Virginia Commonwealth University School of Medicine, Department of Health Behavior and Policy, Richmond, Virginia
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Andrade FDO, Jin L, Clarke R, Wood I, Dutton M, Anjorin C, Rubin G, Gao A, Sengupta S, FitzGerald K, Hilakivi-Clarke L. Social Isolation Activates Dormant Mammary Tumors, and Modifies Inflammatory and Mitochondrial Metabolic Pathways in the Rat Mammary Gland. Cells 2023; 12:961. [PMID: 36980301 PMCID: PMC10047513 DOI: 10.3390/cells12060961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/27/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Although multifactorial in origin, one of the most impactful consequences of social isolation is an increase in breast cancer mortality. How this happens is unknown, but many studies have shown that social isolation increases circulating inflammatory cytokines and impairs mitochondrial metabolism. Using a preclinical Sprague Dawley rat model of estrogen receptor-positive breast cancer, we investigated whether social isolation impairs the response to tamoxifen therapy and increases the risk of tumors emerging from dormancy, and thus their recurrence. We also studied which signaling pathways in the mammary glands may be affected by social isolation in tamoxifen treated rats, and whether an anti-inflammatory herbal mixture blocks the effects of social isolation. Social isolation increased the risk of dormant mammary tumor recurrence after tamoxifen therapy. The elevated recurrence risk was associated with changes in multiple signaling pathways including an upregulation of IL6/JAK/STAT3 signaling in the mammary glands and tumors and suppression of the mitochondrial oxidative phosphorylation (OXPHOS) pathway. In addition, social isolation increased the expression of receptor for advanced glycation end-products (RAGE), consistent with impaired insulin sensitivity and weight gain linked to social isolation. In socially isolated animals, the herbal product inhibited IL6/JAK/STAT3 signaling, upregulated OXPHOS signaling, suppressed the expression of RAGE ligands S100a8 and S100a9, and prevented the increase in recurrence of dormant mammary tumors. Increased breast cancer mortality among socially isolated survivors may be most effectively prevented by focusing on the period following the completion of hormone therapy using interventions that simultaneously target several different pathways including inflammatory and mitochondrial metabolism pathways.
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Affiliation(s)
- Fabia de Oliveira Andrade
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
- Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912, USA
| | - Lu Jin
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
- Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912, USA
| | - Robert Clarke
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
- Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912, USA
| | - Imani Wood
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
| | - MaryAnn Dutton
- Department of Psychiatry, Georgetown University, Washington, DC 20057, USA
| | - Chezaray Anjorin
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
| | - Grace Rubin
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
| | - Audrey Gao
- Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912, USA
| | - Surojeet Sengupta
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
- Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912, USA
| | - Kevin FitzGerald
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
- Department of Medical Humanities, Creighton University, Omaha, NE 68178, USA
| | - Leena Hilakivi-Clarke
- Department of Oncology, Georgetown University, Washington, DC 20057, USA; (F.d.O.A.)
- Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912, USA
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Birmingham WC, Jorgensen A, Hancock S, Wadsworth LL, Hung M. Social Support: The Effect on Nocturnal Blood Pressure Dipping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054579. [PMID: 36901589 PMCID: PMC10001803 DOI: 10.3390/ijerph20054579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 05/13/2023]
Abstract
Social support has long been associated with cardiovascular disease risk assessed with blood pressure (BP). BP exhibits a circadian rhythm in which BP should dip between 10 and 15% overnight. Blunted nocturnal dipping (non-dipping) is a predictor of cardiovascular morbidity and mortality independent of clinical BP and is a better predictor of cardiovascular disease risk than either daytime or nighttime BP. However, it is often examined in hypertensive individuals and less often in normotensive individuals. Those under age 50 are at increased risk for having lower social support. This study examined social support and nocturnal dipping in normotensive individuals under age 50 using ambulatory blood pressure monitoring (ABP). ABP was collected in 179 participants throughout a 24-h period. Participants completed the Interpersonal Support Evaluation List, which assesses perceived levels of social support in one's network. Participants with low levels of social support demonstrated blunted dipping. This effect was moderated by sex, with women showing greater benefit from their social support. These findings demonstrate the impact social support can have on cardiovascular health, exhibited through blunted dipping, and are particularly important as the study was conducted in normotensive individuals who are less likely to have high levels of social support.
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Affiliation(s)
- Wendy C. Birmingham
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
- Correspondence:
| | - Anna Jorgensen
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
| | - Sinclaire Hancock
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
| | - Lori L. Wadsworth
- Romney Institute of Public Management, Brigham Young University, Provo, UT 84602, USA
| | - Man Hung
- Department of Orthopedic Surgery Operations, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S River Front Pkwy, South Jordan, UT 84095, USA
- George E. Wahlen Department of Veteran Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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10
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Zhang D, Wei Y, Chai Y, Qi F, Dong M. Prognostic Assessment and Risk Stratification in Patients With Postoperative Major Salivary Acinar Cell Carcinoma. Otolaryngol Head Neck Surg 2023; 168:1119-1129. [PMID: 36939406 DOI: 10.1002/ohn.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/05/2022] [Accepted: 10/18/2022] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate the clinicopathological features and prognosis of postoperative major salivary acinar cell carcinoma (MSACC) and develop a prognostic model. STUDY DESIGN Retrospective cohort analysis of a public database. SETTING Patients with MSACC were identified from the Surveillance, Epidemiology, and End Results database (1975-2019). METHODS Overall survival (OS) was evaluated using Kaplan-Meier curves and a log-rank test. Univariate and multivariate Cox analyses were performed to explore independent prognostic factors. The prognostic model was constructed using screened variables and further visualized with a nomogram and web calculator, and assessed by concordance index, the area under the curve, calibration curve, and decision-making curve analysis. RESULTS An upward trend in the incidence of MSACC was observed throughout the study period. A total of 1398 patients were enrolled (training cohort: 978; validation cohort: 420), and the 5- and 10-year OS rates were 97.7% and 81.6%, respectively. Age, marital status, sex, histological grade, T stage, and lymph node status were identified as prognostic factors for OS. A novel nomogram was developed and showed excellent discrimination and clinical applicability. Additionally, a web calculator was designed to dynamically predict patient survival. Based on the nomogram-based score, a risk stratification system was constructed to distinguish patients with different risks. The OS of high-risk patients was significantly lower than that of the low-risk subgroup. CONCLUSION Long-term survival in postoperative MSACC was influenced by 6 prognostic factors. The proposed model enables individualized survival prediction and risk stratification, prompting us to be vigilant in high-risk subgroups and consider timely adjustment of subsequent treatment.
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Affiliation(s)
- Di Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuce Wei
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Chai
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Qi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Mei Dong
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Exposome approach for identifying modifiable factors for the prevention of colorectal cancer. Sci Rep 2022; 12:21615. [PMID: 36517625 PMCID: PMC9750985 DOI: 10.1038/s41598-022-25832-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
Previous studies have shown certain exposure factors (such as lifestyle and metabolism) are associated with colorectal cancer (CRC) events. However, the application of the exposome theoretical frame and the extent to which the exposome domain can modulate the risk of CRC remain unknown. Our study aimed to construct valid exposome measurements and examine the relationship between exposome counts and the risk of CRC. This study included 335,370 individuals in the UK Biobank. We used exploratory factor analysis to identify a valid construct of exposome factors. We then summed the exposome counts within each domain. Cox proportional hazard models were used to estimate the hazard ratios and 95% confidence intervals of CRC risk related to the exposome factors and counts. During an 8.69 year median follow-up, 10,702 CRC cases were identified. Five domains were extracted from 12 variables, including ecosystem, lifestyle, tobacco and alcohol use, social economics, and social support. The Cox model results showed that the ecosystem was positively related to the reduced CRC risk (HR = 0.970; 95% CI 0.952-0.989). Similar results were also found among the domains of healthy lifestyles (HR = 0. 889; 95% CI 0.871-0.907), and no tobacco and alcohol use (HR = 0.892; 95% CI 0.876-0.909). The disadvantageous social economic (HR = 1.081; 95% CI 1.058-1.105) and insufficient social support domains (HR = 1.036; 95% CI 1.017-1.056) were associated with an increased risk of CRC. Similar risk trends were also observed across the exposome count groups with CRC incidence. Our findings suggest that certain exposure domains are related to the incidence of CRC. Ecosystem, lifestyle, and social factors can be incorporated into prediction models to identify individuals at high risk of CRC.
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12
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Kiss E, Hajdu A, Forika G, Dank M, Krenacs T, Nemeth Z. The Effect of Dietary Methyl-Donor Intake and Other Lifestyle Factors on Cancer Patients in Hungary. Cancers (Basel) 2022; 14:4432. [PMID: 36139592 PMCID: PMC9496722 DOI: 10.3390/cancers14184432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Nutrition is essential to life and can have an indisputable influence on health and prevention of disease development including cancer. Methyl-donors are macronutrients that are important in achieving a healthy balance of metabolic processes. Their deficiency can lead to several symptoms and diseases-even to severe SARS-CoV-2 infection. We aimed to explore the potential protective effect of methyl-donor intake in breast, colorectal and pancreatic cancer by patient follow up. METHODS A food frequency questionnaire and a diet diary were used to evaluate methyl-donor intake and blood samples were taken to evaluate Il-6 and IL-8 cytokine levels as well as MTHFR (C677T) polymorphism in breast, colorectal and pancreatic cancer patients. RESULTS We found that levels around the recommended daily intake of B6 and B9 were effective in supporting the overall survival of breast and colorectal, and a relatively higher level of pancreatic adenocarcinoma, patients. The total intake of methyl-donors significantly and negatively correlated with smoking in pancreatic cancer, while folate as well as betaine intake significantly and positively correlated with IL-8 in colorectal cancer patients. CONCLUSIONS Our results suggest that the appropriate intake of methyl-donor can be an adjunct of conventional oncotherapy to improve quality of life. Whether methyl-donor intake supports cancer prevention and patient survival needs further confirmation in large patient cohorts.
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Affiliation(s)
- Eva Kiss
- Department of Internal Medicine and Oncology, Oncology Profile, Semmelweis University, Koranyi S. u 2/a, 1083 Budapest, Hungary
| | - Anett Hajdu
- Department of Internal Medicine and Oncology, Oncology Profile, Semmelweis University, Koranyi S. u 2/a, 1083 Budapest, Hungary
| | - Gertrud Forika
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Ulloi u. 26, 1085 Budapest, Hungary
| | - Magdolna Dank
- Department of Internal Medicine and Oncology, Oncology Profile, Semmelweis University, Koranyi S. u 2/a, 1083 Budapest, Hungary
| | - Tibor Krenacs
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Ulloi u. 26, 1085 Budapest, Hungary
| | - Zsuzsanna Nemeth
- Department of Internal Medicine and Oncology, Semmelweis University, Koranyi S. u 2/a, 1083 Budapest, Hungary
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13
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Xia BT, Otto AK, Allenson K, Kocab M, Fan W, Mo Q, Denbo JW, Malafa MP, Permuth JB, Kim DW, Fleming JB, Reblin M, Hodul PJ. Patient-caregiver dyads in pancreatic cancer: identification of patient and caregiver factors associated with caregiver well-being. J Behav Med 2022; 45:935-946. [DOI: 10.1007/s10865-022-00354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
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14
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Fowler ME, Wright NC, Triebel K, Rocque GB, Irvin R, Kennedy RE. The Relationship Between Prior Cancer Diagnosis and All-Cause Dementia Progression Among US Adults. J Alzheimers Dis 2022; 88:521-535. [PMID: 35662118 DOI: 10.3233/jad-220054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI), a frequent effect of cancer and its treatments, shares common cognitive symptoms with dementia syndromes. Cross-sectional studies demonstrate an inverse relationship between cancer and dementia. However, the longitudinal relationship between dementia decline and cancer has not been investigated. OBJECTIVE To evaluate the association between cancer and longitudinal progression of dementia. METHODS We extracted electronic health record data from July 2003 to February 2020 from a single academic medical center. We identified dementia and cancer history prior to dementia using ICD-9/10 codes. We measured cognitive decline with the Alabama Brief Cognitive Screener (ABCs). We used adjusted linear mixed models to estimate baseline cognition and rate of progression by cancer history, including differences by race. RESULTS The study included 3,809 participants with dementia, of which 672 (17.6%) had cancer history. Those with cancer history had higher baseline cognition (β: 0.62, 95% CI: -0.02-1.25), but similar rate of decline. Non-Hispanic Blacks had lower cognitive scores at baseline and throughout follow-up regardless of cancer status compared to non-Hispanic Whites and other races/ethnicities with and without cancer history. CONCLUSION In this longitudinal retrospective study, participants with cancer history demonstrate better cognition at dementia diagnosis and no difference in cognitive decline than those without cancer history. Smoking and comorbidities attenuate this association and results indicate non-Hispanic Blacks have worse cognitive outcomes in dementia regardless of cancer history than other race/ethnicity groups. Further exploration of the role of smoking, comorbidities, and race/ethnicity on cancer and dementia-related cognitive decline is needed.
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Affiliation(s)
- Mackenzie E Fowler
- Department of Epidemiology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Kristen Triebel
- Division of Neuropsychology, Department of Neurology, University of Alabama, Birmingham, Birmingham, AL, USA.,O'Neal Comprehensive Cancer Center, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Gabrielle B Rocque
- O'Neal Comprehensive Cancer Center, University of Alabama, Birmingham, Birmingham, AL, USA.,Division of Hematology and Oncology, Department of Medicine, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Ryan Irvin
- Department of Epidemiology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Richard E Kennedy
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama, Birmingham, Birmingham, AL, USA
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15
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Tomai M, Lauriola M. Separate but Related: Dimensions of Healthcare Provider Social Support in Day-Treatment Oncology Units. Front Psychol 2022; 13:773447. [PMID: 35529557 PMCID: PMC9072867 DOI: 10.3389/fpsyg.2022.773447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Social support by healthcare providers has been increasingly investigated during the past decade, but studies have made different choices concerning its measurement. To evaluate how social support from a healthcare provider impacts the perceived quality of care and patient outcomes, reliable and valid instruments capable of measuring specific aspects of the construct are needed. In study 1, we tested the factor structure and the psychometric properties of a new Healthcare Provider Social Support measure (HPSS) for oncology settings. One-hundred-sixty-two patients (89 females; M age = 58.97, SD age = 13.28) from religious and government-operated hospitals completed the HPSS during day treatment. We modeled the HPSS factor structure to represent four related aspects: Emotional, Informational, Appraisal, and Instrumental social support. Study 2 preliminarily assessed the concurrent validity of the HPSS with patient perceptions of the patient-doctor relationship. Sixty-nine patients (40 females; M age = 53.67, SD age = 13.74) completed the HPPS with scales assessing perceived doctor-patient communication and patient trust in the healthcare provider. Study 1, using Exploratory Structural Equation Modeling, showed that a bifactor model had an excellent fit. The analysis supported the use of subscale scores, which were more tenable than a single total score in terms of bifactor model indices. This conclusion was also supported by greater scalability of the subscales in a Mokken Scale Analysis. Oncology patients treated in the religious hospital perceived greater Emotional, Informational, and Instrumental social support from their healthcare provider than those treated in government-operated. Study 2 showed that patient ratings of healthcare provider social support, except Instrumental, were positively correlated with better doctor communication skills and greater trust in the physician. Multiple regression analyses showed that Informational and Emotional support provided a unique contribution to building trust in the physician, controlling for the doctor's communication skills. The study results showed that the four social support ratings were reliable and valid, sharpening the distinction between functional components in the formal healthcare system.
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Affiliation(s)
- Manuela Tomai
- Department of Dynamic and Clinical Psychology, and Health, Sapienza University of Rome, Rome, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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16
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Peng Q, Ren X. Mapping of Female Breast Cancer Incidence and Mortality Rates to Socioeconomic Factors Cohort: Path Diagram Analysis. Front Public Health 2022; 9:761023. [PMID: 35178368 PMCID: PMC8843849 DOI: 10.3389/fpubh.2021.761023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Breast cancer is the leading cause of death in women around the world. Its occurrence and development have been linked to genetic factors, living habits, health conditions, and socioeconomic factors. Comparisons of incidence and mortality rates of female breast cancer are useful approaches to define cancer-related socioeconomic disparities. METHODS This was a retrospective observational cohort study on breast cancer of women in several developed countries over 30 years. Effects of socioeconomic factors were analyzed using a path diagram method. RESULTS We found a positive, significant association of public wealth on incidence and mortality of breast cancer, and the path coefficients in the structural equations are -0.51 and -0.39, respectively. The unemployment rate (UR) is critical and the path coefficients are all 0.2. The path coefficients of individual economic wealth to the rates of breast cancer are 0.18 and 0.27, respectively. CONCLUSION The influence of social pressure on the incidence and mortality of breast cancer was not typical monotonous. The survival rate of breast cancer determined by the ratio of mortality rate to incidence rate showed a similar pattern with socioeconomic factors.
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Affiliation(s)
- Qiongle Peng
- Blood Transfusion Department, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xiaoling Ren
- Central Laboratory, Wuxi Traditional Chinese Medicine Hospital, Wuxi, China
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17
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Chambers A, Damone E, Chen YT, Nyrop K, Deal A, Muss H, Charlot M. Social support and outcomes in older adults with lung cancer. J Geriatr Oncol 2022; 13:214-219. [PMID: 34629320 PMCID: PMC8970686 DOI: 10.1016/j.jgo.2021.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/24/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Insufficient social support is associated with increased mortality among older adults. Lung cancer is primarily a disease of older adults and is the leading cause of all cancer deaths. We assessed the association of social support with outcomes among older adults with lung cancer. MATERIALS AND METHODS Adults age 65 and older with lung cancer with a completed geriatric assessment (GA) were assessed. Emotional social support (ES) and tangible (material, instrumental) support (TS) measures and patient characteristics were obtained from the GA. The electronic health record was used to extract clinical variables. Simple linear regression models evaluated the association between social support scales with patient and clinical factors. RESULTS 79 adults were assessed. White race was positively associated with ES score (p=.04), while higher BMI (p=.03), depression (p=.03) and anxiety (p=.02) were associated with worse ES. Higher BMI was associated with higher/better TS score (p=.02) while living alone was associated with lower/worse TS score (p=.03). Completion of platinum-based doublet chemotherapy with immunotherapy as planned was associated with higher ES scores (p=.02) and higher TS scores (p=.02). Disease progression was associated with lower ES scores (p=.03). CONCLUSION Social support may influence clinical outcomes in older adults with lung cancer. As lung cancer often portends to poor prognosis, social support may be an important prognostic indicator.
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Affiliation(s)
- Andrew Chambers
- Campbell University School of Osteopathic Medicine, United States of America.
| | - Emily Damone
- UNC Gillings School of Global Health, University of North Carolina Chapel Hill, United States of America.
| | - Yi Tang Chen
- University of North Carolina Chapel Hill, UNC Department of Biostatistics, United States of America.
| | - Kirsten Nyrop
- University of North Carolina Chapel Hill, Lineberger Comprehensive Cancer Center, United States of America.
| | - Allison Deal
- University of North Carolina Chapel Hill, Lineberger Comprehensive Cancer Center, United States of America.
| | - Hyman Muss
- University of North Carolina Chapel Hill, Lineberger Comprehensive Cancer Center, United States of America.
| | - Marjory Charlot
- University of North Carolina Chapel Hill, Lineberger Comprehensive Cancer Center, United States of America.
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Dociak-Salazar E, Barrueto-Deza JL, Urrunaga-Pastor D, Runzer-Colmenares FM, Parodi JF. Gait speed as a predictor of mortality in older men with cancer: A longitudinal study in Peru. Heliyon 2022; 8:e08862. [PMID: 35146168 PMCID: PMC8816678 DOI: 10.1016/j.heliyon.2022.e08862] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/09/2021] [Accepted: 01/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Given the increase in incidence and mortality from cancer in recent years in Latin America and Peru, it is necessary to identify frailty older adults at higher risk of disability, hospitalizations and mortality. However, its measure is complex and requires time. For this reason, it has been proposed that frailty can be evaluated by a single measure, as gait speed. We aimed to evaluate the role of gait speed as a predictor of mortality in older men with cancer in Peru. Methods A prospective cohort study was carried out that included military veterans (aged 60 years and older) with an oncological diagnosis evaluated at the Centro Médico Naval in Peru during the period 2013–2015. Slow gait speed was defined as <0.8 m/s. All-cause mortality was recorded during a 2-year follow-up. Sociodemographic characteristics, medical and personal history, and functional assessment measures were collected. We performed Cox regression analysis to calculate hazard ratios with their respective 95% confidence intervals. Results 922 older men were analyzed from 2013 to 2015, 56.9% (n = 525) of whom were >70 years of age. 41.3% (n = 381) had slow gait speed with a mortality incidence of 22.9% (n = 211) at the end of follow-up. The most frequent types of cancer in the participants who died were of the lung and airways (26.1%), liver and bile ducts (23.2%), and lymphomas and leukemias (16.6%). In the adjusted Cox regression analysis, we found that slow gait speed was a risk factor for mortality in older men with cancer (adjusted hazard ratio = 1.55; 95% confidence interval: 1.21–2.23). Conclusions Slow gait speed was associated with an increased risk of mortality in older men with cancer. Gait speed could represent a simple, useful, inexpensive, rapidly applicable marker of frailty for the identification of older men at higher risk of mortality. Gait speed could be useful in low- and middle-income countries, and in rural areas with limited access to health services.
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Miura KW, Sekiguchi T, Otake-Matsuura M, Sawada Y, Tanaka E, Watanabe T, Tomisaki E, Okumura R, Kawasaki Y, Ito S, Anme T. Patterns of social relationships among community-dwelling older adults in Japan: latent class analysis. BMC Geriatr 2022; 22:75. [PMID: 35078419 PMCID: PMC8786623 DOI: 10.1186/s12877-022-02748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Social relationships may be the key to successful aging among older adults. However, little is known about the variability of social relationships among community-dwelling older people. This study aimed to describe the patterns of social relationships and examine the differences in sociodemographic characteristics and mental and physical health status among these patterns. METHODS We obtained the data from a questionnaire survey in 2017 for older adults aged 65 and above who lived in a suburban area in Japan. The Index of Social Interaction (ISI) was used to evaluate social relationships. The final sample comprised 964 people who were independently mobile and answered at least one item of the ISI. To clarify the patterns of social relationships, latent class analysis was performed with five subscales of ISI treated as indicator variables. Multinomial logistic regression was conducted to examine the factors associated with the patterns of social relationships. RESULTS The patterns of social relationships were classified into three classes: "Active" (73.6%), "Socially isolated" (14.7%), and "Less motivated" (11.7%). Persons who had depressive symptoms were more likely to be allocated to the "Socially isolated" (Odds Ratio [OR] 1.80, 95% Confidence Interval [CI] 1.13-2.86) or the "Less motivated" groups (OR 1.69, 95% CI 1.00-2.85) compared to the "Active" group. In addition, men (OR 1.72, 95% CI 1.07-2.76) and those living alone (OR 3.07, 95% CI 1.43-6.61) were more likely to be allocated to the "Socially isolated" group. Moreover, those who were dependent, according to the instrumental activities and daily living functions, were more likely to be assigned to the "Socially isolated" (OR 2.19, 95% CI 1.21-3.97) or "Less motivated" (OR 6.29, 95% CI 3.47-11.39) groups. CONCLUSION This study revealed the patterns of social relationships in older adults and suggested that there may be variations of social relationships among community dwellers. The results also indicated the necessity of assessing individual patterns of social relationships and devising strategies for each pattern in public health practice.
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Affiliation(s)
- Kumi Watanabe Miura
- Japan Society for the Promotion of Science (JSPS), Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
- RIKEN Center for Advanced Intelligence Project, Nihonbashi, Tokyo, 103-0027, Japan
| | - Takuya Sekiguchi
- RIKEN Center for Advanced Intelligence Project, Nihonbashi, Tokyo, 103-0027, Japan
| | | | - Yuko Sawada
- Morinomiya University of Medical Sciences, Suminoe-ku, Osaka, 559-8611, Japan
| | - Emiko Tanaka
- Musashino University, Ariake, Koto-ku, Tokyo, 135-8181, Japan
| | - Taeko Watanabe
- College of Nursing and Nutrition, Shukutoku University, Nitona-cho, Chiba, 260-8703, Japan
| | - Etsuko Tomisaki
- Faculty of Nursing and Medical Care, Keio University, Shinanomachi, Tokyo, 160-0016, Japan
| | - Rika Okumura
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - Yuriko Kawasaki
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - Sumio Ito
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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Bou-Samra P, Scott P, Cheng H, Kallem C, Pathak R, Geller DA, Marsh W, Wang Y, Antoni M, Penedo F, Tsung A, Steel JL. Social Support is Associated with Survival in Patients Diagnosed with Gastrointestinal Cancer. J Gastrointest Cancer 2021; 53:854-861. [PMID: 34806126 DOI: 10.1007/s12029-021-00741-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to examine the link between psychological, behavioral, and social factors and survival in patients diagnosed with gastrointestinal cancer. METHODS A cohort of gastrointestinal cancer patients were administered a battery of questionnaires that assessed trauma, depression, social support, sleep, diet, exercise, quality of life, tobacco and alcohol use, pain, and fatigue. Analyses included Pearson's correlations, analyses of variance, Kaplan Meier survival, and Cox regression analyses. RESULTS Of the 568 patients, the majority were male (57.9%) and Caucasian (91.9%), with a mean age of 61 (S.D. = 10.7). The level of perceived social support was comparable to patients with other medical conditions. Sociodemographic predictors of social support included the number of years of education (r = 0.109, p = 0.05), marital status (F(6,387) = 5.465, p ≤ 0.001), and whether the patients' income met the family's basic needs (F(1,377) = 25.531, p < 0.001). Univariate analyses revealed that older age (p < 0.001), male gender (p = 0.007), being black (p = 0.005), diagnosis of hepatocellular carcinoma (p = 0.046), higher body mass index (p = 0.022), larger tumor size (p = 0.032), initial treatment including chemotherapy rather than surgery (p < 0.001), and lower level of perceived social support (p = 0.037) were associated with poorer survival. Using multivariate Cox regression and adjusting for all factors found to be significant in univariate survival analyses, older age (p = 0.024) and lower perceived social support (HR = 0.441, 95% CI = 0.233, 0.833; p = 0.012) were the factors that remained significantly associated with poorer survival. CONCLUSION There are several biological and psychosocial factors that predict cancer mortality. Social support appears to be a robust factor affecting mortality in gastrointestinal cancer patients.
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Affiliation(s)
- Patrick Bou-Samra
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Paul Scott
- Department of Psychology, School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hannah Cheng
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Cramer Kallem
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ritambhara Pathak
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - David A Geller
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wallis Marsh
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Yisi Wang
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Michael Antoni
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Frank Penedo
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. .,Department of Psychiatry, University of Pittsburgh, 3459 Fifth Avenue; Montefiore 7S, Pittsburgh, PA, 15213, USA. .,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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21
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Pan S, Yin K, Tang Z, Wang S, Chen Z, Wang Y, Zhu H, Han Y, Liu M, Jiang M, Xu N, Zhang G. Stimulation of hypothalamic oxytocin neurons suppresses colorectal cancer progression in mice. eLife 2021; 10:e67535. [PMID: 34528509 PMCID: PMC8536257 DOI: 10.7554/elife.67535] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 09/12/2021] [Indexed: 01/05/2023] Open
Abstract
Emerging evidence suggests that the nervous system is involved in tumor development in the periphery, however, the role of the central nervous system remains largely unknown. Here, by combining genetic, chemogenetic, pharmacological, and electrophysiological approaches, we show that hypothalamic oxytocin (Oxt)-producing neurons modulate colitis-associated cancer (CAC) progression in mice. Depletion or activation of Oxt neurons could augment or suppress CAC progression. Importantly, brain treatment with celastrol, a pentacyclic triterpenoid, excites Oxt neurons and inhibits CAC progression, and this anti-tumor effect was significantly attenuated in Oxt neuron-lesioned mice. Furthermore, brain treatment with celastrol suppresses sympathetic neuronal activity in the celiac-superior mesenteric ganglion (CG-SMG), and activation of β2 adrenergic receptor abolishes the anti-tumor effect of Oxt neuron activation or centrally administered celastrol. Taken together, these findings demonstrate that hypothalamic Oxt neurons regulate CAC progression by modulating the neuronal activity in the CG-SMG. Stimulation of Oxt neurons using chemicals, for example, celastrol, might be a novel strategy for colorectal cancer treatment.
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Affiliation(s)
- Susu Pan
- Key Laboratory of Environmental Health, Ministry of Education, Department of Toxicology, School of Public Health, Tongji Medical CollegeWuhanChina
- Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and TechnologyWuhanChina
| | - Kaili Yin
- Key Laboratory of Environmental Health, Ministry of Education, Department of Toxicology, School of Public Health, Tongji Medical CollegeWuhanChina
- Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and TechnologyWuhanChina
| | - Zhiwei Tang
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Shuren Wang
- Laboratory of Cell and Molecular Biology, State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Zhuo Chen
- Key Laboratory of Environmental Health, Ministry of Education, Department of Toxicology, School of Public Health, Tongji Medical CollegeWuhanChina
- Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and TechnologyWuhanChina
| | - Yirong Wang
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Hongxia Zhu
- Laboratory of Cell and Molecular Biology, State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yunyun Han
- Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and TechnologyWuhanChina
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Mei Liu
- Laboratory of Cell and Molecular Biology, State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Man Jiang
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Ningzhi Xu
- Laboratory of Cell and Molecular Biology, State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Guo Zhang
- Key Laboratory of Environmental Health, Ministry of Education, Department of Toxicology, School of Public Health, Tongji Medical CollegeWuhanChina
- Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and TechnologyWuhanChina
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22
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Moreno GL, Ammann E, Kaseda ET, Espeland MA, Wallace R, Robinson J, Denburg NL. The influence of social support on cognitive health in older women: a Women's Health Initiative study. J Women Aging 2021; 34:394-410. [PMID: 34252006 PMCID: PMC8743299 DOI: 10.1080/08952841.2021.1945368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Social support is associated prospectively with cognitive decline and dementia among the elderly; however, little is known about the impact of social support on healthy neurological aging. The current study investigates whether perceived social support has an influence on neurological health among a large sample of healthy postmenopausal women. Social support and neuropsychological outcomes were measured annually for six years through the Women's Health Initiative Study of Cognitive Aging. In postmenopausal women, higher perceived social support was associated with significantly better overall neuropsychological functioning at baseline, especially in the domains of short-delay figural memory, short-delay verbal memory, and semantic fluency. No significant associations were found between social support and longitudinal changes in neuropsychological function over a median follow-up period of six years. Additionally, there was no significant relationship between social support and regional brain volumes. These findings suggest that social support is related to performance in a subset of neuropsychological domains and contributes to the existing literature that points to the importance of social support as a modifiable lifestyle factor that has the potential to help protect against the decline of cognitive aging, specifically among older adult women.
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Affiliation(s)
- Georgina L Moreno
- Department of Psychology, University of Houston-Clear Lake, Houston, Texas, USA
| | - Eric Ammann
- Janssen Scientific Affairs, Johnson & Johnson, Titusville, New Jersey, USA
| | - Erin T Kaseda
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA
| | - Robert Wallace
- Department of Epidemiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Jennifer Robinson
- Department of Epidemiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Natalie L Denburg
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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23
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Naito R, Leong DP, Bangdiwala SI, McKee M, Subramanian SV, Rangarajan S, Islam S, Avezum A, Yeates KE, Lear SA, Gupta R, Yusufali A, Dans AL, Szuba A, Alhabib KF, Kaur M, Rahman O, Seron P, Diaz R, Puoane T, Liu W, Zhu Y, Sheng Y, Lopez-Jaramillo P, Chifamba J, Rosnah I, Karsidag K, Kelishadi R, Rosengren A, Khatib R, K R LIA, Azam SI, Teo K, Yusuf S. Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents. BMJ Glob Health 2021; 6:bmjgh-2020-004124. [PMID: 33753400 PMCID: PMC7986654 DOI: 10.1136/bmjgh-2020-004124] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/26/2020] [Accepted: 01/20/2021] [Indexed: 12/26/2022] Open
Abstract
Objective To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries. Design Population-based prospective observational study. Setting Urban and rural communities in 20 high income, middle income and low income. Participants 119 894 community-dwelling middle-aged adults. Main outcome measures Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases. Results Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association. Conclusion Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects.
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Affiliation(s)
- Ryo Naito
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darryl P Leong
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Shrikant Ishver Bangdiwala
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - S V Subramanian
- Harvard Center for Population and Development Studies and Department of Society and Human Development, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Shofiqul Islam
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Karen E Yeates
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Rajeev Gupta
- Eternal Heart Care Centre & Research Institute, Jaipur, India
| | | | - Antonio L Dans
- Adult Medicine Research Unit, Philippine General Hospital, Manila, Philippines
| | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland
| | - Khalid F Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Manmeet Kaur
- School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Omar Rahman
- University of Liberal Arts Bangladesh, Dhaka, Dhaka District, Bangladesh
| | | | - Rafael Diaz
- ECLA - Academic Research Organization, Rosario, Argentina
| | - Thandi Puoane
- School of Public Health, University of Western Cape, Cape Town, Western Cape, South Africa
| | - Weida Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Xicheng District, Beijing, China
| | - Yibing Zhu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, China
| | - Yundong Sheng
- Jiangxinzhou Community Health Service Center, Nanjing, China
| | | | - Jephat Chifamba
- Department of Physiology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
| | - Ismail Rosnah
- Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia, Malaysia
| | - Kubilay Karsidag
- Division of Endocrinology, Medical Faculty of Istanbul University, Fatih, Turkey
| | - Roya Kelishadi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Region Västra Götaland, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Rasha Khatib
- Advocate Aurora Research Institute, Downers Grove, Illinois, USA.,Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Leela Itty Amma K R
- Health Action by People, Thiruvananthapuram, Kerala, India.,Department of Community Medicine, Sree Mookambika Institute of Medical Sciences, Kulasekharam, India
| | - Syed Iqbal Azam
- Community Health Sciences (CHS) department, The Aga Khan University, Karachi, Pakistan
| | - Koon Teo
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton, Ontario, Canada .,Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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24
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Elovainio M, Lumme S, Arffman M, Manderbacka K, Pukkala E, Hakulinen C. Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study. SSM Popul Health 2021; 15:100826. [PMID: 34189239 PMCID: PMC8219898 DOI: 10.1016/j.ssmph.2021.100826] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 01/22/2023] Open
Abstract
Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000–2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%–80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis. We studied the effect of living alone on cancer incidence and mortality in total Finnish population. Excess cancer incidence risk was only found consistently in women. We found persistent excess cancer-specific mortality in cancer patients living alone. Cancer patients living alone had also a higher all-cause mortality risk. Further studies should study pathways to care among socially isolated individuals.
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Affiliation(s)
- Marko Elovainio
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.,Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sonja Lumme
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Martti Arffman
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kristiina Manderbacka
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.,Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
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25
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Kraav SL, Lehto SM, Kauhanen J, Hantunen S, Tolmunen T. Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study. Psychiatry Res 2021; 299:113868. [PMID: 33774371 DOI: 10.1016/j.psychres.2021.113868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Globally, cancer is the second leading cause of death. Loneliness has been suggested as a risk factor for cancer mortality. However, connections between loneliness, social isolation, and cancer are poorly understood. In our longitudinal study (mean follow-up: 20.44 years) of 2570 middle-aged men, loneliness, social isolation, and health-related factors were measured at baseline. Cox proportional hazards analysis was used to examine the association between cancer incidence, loneliness, and social isolation. The effect of relationship status on cancer mortality among cancer patients was tested with the Kaplan-Meier method. Loneliness was associated with total cancer incidence after adjustments for tested lifestyle and health-related covariates. Social Isolation was associated with total cancer incidence, except when adjusted for lifestyle, diet, or Human Population Laboratory (HPL) Depression Scale scores. Loneliness was associated with lung cancer incidence, except when adjusted for HPL Depression Scale scores. There was no significant association between social isolation and lung cancer. Neither loneliness nor social isolation were connected with prostate or colorectal cancer. Being single at baseline was associated with worse survival outcomes for cancer patients. Our findings suggest that regardless of the social network size, loneliness among middle-aged men is associated with an increased likelihood of cancer.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Department of Social Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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26
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Arnot M, Emmott EH, Mace R. The relationship between social support, stressful events, and menopause symptoms. PLoS One 2021; 16:e0245444. [PMID: 33503073 PMCID: PMC7840006 DOI: 10.1371/journal.pone.0245444] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/31/2020] [Indexed: 11/18/2022] Open
Abstract
Many women going through the menopausal transition experience vasomotor symptoms (VMS), and research has shown that there is a large amount of variation in their frequency and severity. Many lifestyle factors have been found to co-vary with VMS, including the level of social support received by the woman, and how stressed she is. Stress is well documented to worsen menopause symptoms, and there is some evidence that support eases them; however, there is little research into whether support is an effective buffer against the negative effects of stress on VMS. Using nine years of data from the Study of Women’s Health Across the Nation (n = 2718), we use multilevel Poisson regression with random effects to test: 1) if more social support is associated with decreased VMS frequency, 2) if increased life stress worsens VMS, and 3) if support acts as a buffer against stress. After adjusting for age, marital status, smoking, self-perceived overall health, ethnicity, and menopausal status, we find that stress increases the frequency of VMS. Contrary to our hypothesis, we did not find strong evidence that emotional support led to lower VMS frequency, or that support buffers against the effects of stress. Experience of a stressful event, but not amount of social support, was included in the best fitting model; with the degree to which the woman was upset by the life stressor having the largest effect on menopause symptoms. Here, women who said they were currently upset by a stressful event experienced 21% more VMS than women who had experienced no life stressor. This research highlights that social factors may impact the menopausal transition.
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Affiliation(s)
- Megan Arnot
- Department of Anthropology, University College London, London, United Kingdom
- * E-mail:
| | - Emily H. Emmott
- Department of Anthropology, University College London, London, United Kingdom
| | - Ruth Mace
- Department of Anthropology, University College London, London, United Kingdom
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27
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Kapadia MR, Veenstra CM, Davis RE, Hawley ST, Morris AM. Unmet Emotional Support Needs Among Diverse Patients with Colorectal Cancer. Am Surg 2020; 86:695-702. [PMID: 32683961 DOI: 10.1177/0003134820923318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Social support, which is partly emotional support, is associated with adherence to colorectal cancer (CRC) treatment, quality of life, and survival. We hypothesized that the needs, sources, and availability of emotional support would vary by race and income among CRC patients and sought to quantify the emotional support and the perceived adequacy of support reported by patients. METHODS We surveyed CRC patients from Detroit and Georgia Surveillance, Epidemiology and End Results registries about the quantity and quality of emotional support received from different sources. We tested differences using the chi-square test, t-tests, and logistic regression. RESULTS There were 1909 patients who met inclusion criteria and 1301 (68%) completed surveys. Among respondents, 68% were white, 25% black, and 7% other. Black patients were more likely to be female and younger and reported lower annual income and education. Patients reported high support from several sources. Among those with a spouse/partner (58%), 95% reported high levels of support; however, older, black, female, or lower income patients were less likely to have spouses/partners (P < .001). Patients also endorsed high support from family (88.6%), important others (82.9%), and clinicians (71.3%). Black patients were less likely than white patients to report support that was "just right" (P < .001). DISCUSSION Most patients reported high emotional support from at least 1 source. Black patients were most at risk for low support or unmet support needs. Spouse/partner support was important but only available to 58% of respondents. Patients at risk for unmet emotional support needs may benefit from additional support resources.
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Affiliation(s)
- Muneera R Kapadia
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Christine M Veenstra
- 1259 Division of Medical Oncology, Department of Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Rachel E Davis
- 2629 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sarah T Hawley
- 1259 Division of Medical Oncology, Department of Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Arden M Morris
- 6429 S-SPIRE Center, Department of Surgery, Stanford University Medical Center, Stanford, CA, USA
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28
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O'Donovan A, Morris L. Palliative Radiation Therapy in Older Adults With Cancer: Age-Related Considerations. Clin Oncol (R Coll Radiol) 2020; 32:766-774. [PMID: 32641244 DOI: 10.1016/j.clon.2020.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/20/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
There are many additional considerations when treating older adults with cancer, especially in the context of palliative care. Currently, radiation therapy is underutilised in some countries and disease sites, but there is also evidence of unnecessary treatment in other contexts. Making rational treatment decisions for older adults necessitates an underlying appraisal of the person's physiological reserve capacity. This is termed 'frailty', and there is considerable heterogeneity in its clinical presentation, from patients who are relatively robust and suitable for standard treatment, to those who are frail and perhaps require a different approach. Frailty assessment also presents an important opportunity for intervention, when followed by Comprehensive Geriatric Assessment (CGA) in those who require it. Generally, a two-step approach, with a short initial screening, followed by CGA, is advocated in geriatric oncology guidelines. This has the potential to optimise care of the older person, and may also reverse or slow the development of frailty. It therefore has an important impact on the patient's quality of life, which is especially valued in the context of palliative care. Frailty assessment also allows a more informed discussion of treatment outcomes and a shared decision-making approach. With regards to the radiotherapy regimen itself, there are many adaptations that can better facilitate the older person, from positioning and immobilisation, to treatment prescriptions. Treatment courses should be as short as possible and take into account the older person's unique circumstances. The additional burden of travel to treatment for the patient, caregiver or family/support network should also be considered. Reducing treatments to single fractions may be appropriate, or alternatively, hypofractionated regimens. In order to enhance care and meet the demands of a rapidly ageing population, future radiation oncology professionals require education on the basic principles of geriatric medicine, as many aspects remain poorly understood.
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Affiliation(s)
- A O'Donovan
- Applied Radiation Therapy Trinity (ARTT) research group, Discipline of Radiation Therapy, School of Medicine, Trinity College, Dublin, Ireland.
| | - L Morris
- Department of Radiation Oncology, St George Hospital, Sydney, NSW 2217, Australia
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29
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Social determinants of colorectal cancer risk, stage, and survival: a systematic review. Int J Colorectal Dis 2020; 35:985-995. [PMID: 32314192 DOI: 10.1007/s00384-020-03585-z] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Several social determinants of health have been examined in relation to colorectal cancer incidence, stage at diagnosis, and survival including income, education, neighborhood disadvantage, immigration status, social support, and social network. Colorectal cancer incidence rates are positively associated with income and other measures of socioeconomic status. In contrast, low socioeconomic status tends to be associated with poorer survival. METHODS The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1970 through April 1, 2019 were identified using the following MeSH search terms and Boolean algebra commands: colorectal cancer AND (incidence OR stage OR mortality) AND (social determinants OR neighborhood disadvantage OR racial discrimination OR immigration OR social support). RESULTS This review indicates that poverty, lack of education, immigration status, lack of social support, and social isolation play important roles in colorectal cancer stage at diagnosis and survival. CONCLUSIONS To address social determinants of colorectal cancer, effective interventions are needed that account for the social contexts in which patients live.
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30
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Li C, Narcisse MR, McElfish PA. Medical financial hardship reported by Native Hawaiian and Pacific Islander cancer survivors compared with non-Hispanic whites. Cancer 2020; 126:2900-2914. [PMID: 32196129 DOI: 10.1002/cncr.32850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although medical financial hardship (MFH) resulting from sequelae of cancer and treatment has been reported in other racial/ethnic populations, little is known about MFH among Native Hawaiian and Pacific Islander (NHPI) cancer survivors. METHODS One hundred fifty adult NHPI cancer survivors were identified from the 2014 NHPI National Health Interview Survey (NHIS). Cancer survivors were those with a history of cancer (excluding nonmelanoma/unknown type of skin cancer). MFH was defined by 3 domains: 1) material (problem paying or unable to pay medical bills); 2) psychological (worrying about paying medical bills); and 3) behavioral (delaying or forgoing medical care for financial reasons). For comparison, 2098 non-Hispanic white (NHW) cancer survivors were identified from the 2014 NHIS. Logistic regressions were used to identify sociodemographic and health factors associated with experiencing MFH. Stratified analysis by age (<65 vs ≥65 years) and sensitivity analysis using propensity score-matched NHPI and NHW cancer survivors were conducted. Nationally representative estimates were generated using survey weights. RESULTS Among elderly cancer survivors, more NHPIs reported any MFH (59% vs 32%; P = .001), psychological MFH (36% vs 22%; P = .040), and behavioral MFH (27% vs 9%; P = .004) than NHWs. Among survivors aged <65 years, NHPIs reported less MFH (46% vs. 65%; P = .034). Even after propensity score matching, these patterns persisted. Female NHPIs and NHPIs with a college degree were significantly more likely to report MFH, especially material and psychological MFH. CONCLUSIONS A significantly higher proportion of elderly NHPI cancer survivors reported MFH, and this difference persisted even after propensity score matching, which warrants further investigation.
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Affiliation(s)
- Chenghui Li
- Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Marie-Rachelle Narcisse
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Pearl A McElfish
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Kim J, Jang M. Stress, Social Support, and Sexual Adjustment in Married Female Patients with Breast Cancer in Korea. Asia Pac J Oncol Nurs 2020; 7:28-35. [PMID: 31879681 PMCID: PMC6927156 DOI: 10.4103/apjon.apjon_31_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/13/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study identified the level of stress, social support, and sexual adjustment in married women with breast cancer in Korea. METHODS This study used a subgroup analysis, prospective, cross-sectional, and descriptive correlation design. Data were obtained using the perceived stress scale, multidimensional scale of perceived social support, and sexual adjustment subscale of the Korean version of the psychosocial adjustment to illness scale. From May 2015 to April 2016, 272 married female patients who had been diagnosed with breast cancer were recruited at a university hospital in Korea. Data were analyzed using SPSS Win 21.0. RESULTS The mean score of stress level was 17.53 ± 4.13, social support was 5.37 ± 1.07, and sexual adjustment was 6.36 ± 3.29. A significant positive correlation emerged between sexual adjustment and stress (r = 0.161, P = 0.008). Significant negative correlations were observed among sexual adjustment and family support (r = -0.177, P = 0.003) and friends' support (r = -0.205, P = 0.001). CONCLUSIONS The assessment of stress level and social support may be used in planning sexual-adjustment interventions appropriate for married female breast cancer patients in Korea.
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Affiliation(s)
- Jiyoung Kim
- Department of Nursing, Dongeui University, Busan, Korea
| | - Miyoung Jang
- Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea
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Aguiar Fernández FX, Pino-Juste M, Navarro Pérez JJ. Beneficios de un programa grupal de tratamiento no farmacológico en el afrontamiento del cáncer en mujeres españolas. Una síntesis cualitativa. SAUDE E SOCIEDADE 2020. [DOI: 10.1590/s0104-12902020181001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen En el presente trabajo se analizan los beneficios de un programa grupal de tratamiento no farmacológico realizado por la Asociación Española contra el Cáncer en Galicia (España). Se analizaron 14 ediciones del programa en las que participaron 361 mujeres con cáncer de edades comprendidas entre los 33 y los 82 años. Se adoptó un diseño descriptivo de carácter etnográfico triangulando las técnicas de análisis y las fuentes de recogida de datos por medio de un cuestionario de satisfacción, 32 entrevistas en profundidad y un grupo de discusión con profesionales. Los resultados apoyan la idea de que el programa grupal analizado ha conseguido un elevado grado de satisfacción entre las mujeres participantes en todas las ediciones, ha favorecido la aceptación y el afrontamiento positivo de la enfermedad, aumentado los conocimientos y las habilidades para resolver los problemas relacionados con el proceso, así como promovido las relaciones sociales, la participación en la comunidad y el apoyo social. Desde el punto de vista práctico y profesional, nuestro estudio evidencia la importancia de diseñar e implementar programas grupales desde el ámbito psicosocial y con carácter interdisciplinar que permitan mejorar las estrategias de afrontamiento y el apoyo en poblaciones de mujeres diagnosticadas de cáncer.
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Wang X, Shang S, Yang H, Ai H, Wang Y, Chang S, Sha X, Wang L, Jiang X. Associations of psychological distress with positive psychological variables and activities of daily living among stroke patients: a cross-sectional study. BMC Psychiatry 2019; 19:381. [PMID: 31795970 PMCID: PMC6888918 DOI: 10.1186/s12888-019-2368-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression and anxiety result in psychological distress, which can further affect mental status and quality of life in stroke patients. Exploring the associations between positive psychological variables and symptoms of psychological distress following stroke is of great significance for further psychological interventions. METHODS A total of 710 stroke patients from the five largest cities in Liaoning Province in China were enrolled into the present study in July 2014. All patients independently completed the questionnaires with respect to psychological distress and positive psychological variables. Depressive and anxiety symptoms were evaluated using Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Rating Anxiety Scale, respectively. Positive psychological variables were evaluated using Perceived Social Support Scale, Adult Hope Scale (AHS), General Perceived Self-Efficacy Scale and Resilience Scale-14 (RS-14). Activities of Daily Living (ADL) was measured using Barthel Index. Factors associated with psychological variables and depressive and anxiety symptoms were identified using t-test, ANOVA, correlation and hierarchical linear regression analysis. RESULTS Depressive and anxiety symptoms were present in 600 of 710 (84.51%) and 537 of 710 (75.63%) stroke patients enrolled, respectively. Social support (β = - 0.111, p < 0.001) and hope (β = - 0.120, p < 0.001) were negatively associated with both depressive and anxiety symptoms. Resilience (β = - 0.179, p < 0.001) was negatively associated with depressive symptoms. Self-efficacy (β = - 0.135, p < 0.001) was negatively associated with anxiety symptoms. Hierarchical regression analyses indicated that ADL accounted for 10.0 and 6.0% of the variance of depressive and anxiety symptoms, respectively. Social support, resilience, self-efficacy and hope as a whole accounted for 7.5 and 5.3% of the variance of depressive and anxiety symptoms. CONCLUSIONS The high frequency of depressive and anxiety symptoms among Chinese stroke survivors should receive attentions from all stakeholders. Findings suggested that intervention strategies on ADL, social support, hope, resilience and self-efficacy could be developed to improve psychosocial outcomes for stroke survivors.
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Affiliation(s)
- Xiaoxi Wang
- Department of Sports Medicine, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Shengjie Shang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Huazhe Yang
- Department of Biophysics, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Hua Ai
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Yin Wang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Shijie Chang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Xianzheng Sha
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Xiran Jiang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China.
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Chen Z, Yin K, Zheng D, Gu J, Luo J, Wang S, Chen H. Marital status independently predicts non-small cell lung cancer survival: a propensity-adjusted SEER database analysis. J Cancer Res Clin Oncol 2019; 146:67-74. [PMID: 31786738 DOI: 10.1007/s00432-019-03084-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 11/15/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Marital status has been demonstrated as an independent prognostic factor in many cancer types. The impact of marital status on non-small cell lung cancer (NSCLC) survival has not been assessed at the population level. Here, we used the surveillance, epidemiology and end results (SEER) database, a US national cancer registry, to address this issue. METHODS All patients diagnosed with NSCLC from 2004 to 2009 were identified in the SEER database (version 8.3.2, updated at April 14, 2016). Those with incomplete clinicopathological information were excluded. The tumor, node, metastasis (TNM) staging was based on the criteria of the American Joint Committee on Cancer (AJCC) 6th edition. We used propensity-score matching analysis to balance baseline characteristics between the patients who were married and those who were not married. The impact of marital status on cancer-specific survival was analyzed with Cox proportional-hazards regression. RESULT A total of 72, 984 NSCLC patients (41, 095 married patients, 56.3%) were enrolled in this study. After propensity-score matching, 25, 617 patients in the married group were 1:1 matched with patients in the unmarried group. Being unmarried was found to be associated with significantly decreased cancer-specific survival (hazard ratio (HR): 1.142, 95% CI: 1.119-1.166, p < 0.001). Among the unmarried group, patients who were single had worse cancer-specific survival (median survival 12 months, 95% CI: 11.37-12.63 months) than those who were divorced (median survival 15 months, 95% CI: 14.24-15.76 months, p < 0.001) or widowed (median survival 15 months, 95% CI: 14.25-15.76 months, p < 0.001). CONCLUSION This study shows that marital status is an independent prognostic factor for cancer-specific survival in NSCLC patients. Patients who were married had better cancer-specific survival compared to the unmarried ones.
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Affiliation(s)
- Zongwei Chen
- Department of Thoracic Surgery, Fudan University Zhongshan Hospital, Shanghai, 200032, China
| | - Kanhua Yin
- Department of Cardiac Surgery, Fudan University Zhongshan Hospital, Shanghai, 200032, China
| | - Difan Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jie Gu
- Department of Thoracic Surgery, Fudan University Zhongshan Hospital, Shanghai, 200032, China
| | - Jizhuang Luo
- Department of Thoracic Surgery, Fudan University Zhongshan Hospital, Shanghai, 200032, China
| | - Shuai Wang
- Department of Thoracic Surgery, Fudan University Zhongshan Hospital, Shanghai, 200032, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Watanabe K, Tanaka E, Watanabe T, Tomisaki E, Ito S, Okumura R, Anme T. Social relationships and functional status among Japanese elderly adults living in a suburban area. Public Health 2019; 179:84-89. [PMID: 31739119 DOI: 10.1016/j.puhe.2019.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/29/2019] [Accepted: 09/19/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Social relationships may help in maintaining functional status among older adults. This study examined the types of social relationships that were related to functional status among Japanese community-dwelling older adults. STUDY DESIGN This is a prospective cohort study. METHODS We used baseline data from 2008 and conducted follow-up surveys six years later. Participants included individuals older than 65 years who lived in a suburban community in Japan. The Index of Social Interaction measure was used to assess multiple elements of social relationships. Two functional status outcomes were set: (1) functional decline and (2) functional decline and mortality. A multiple logistic regression model was used to examine the association between social relationships and functional decline six years later. RESULTS After controlling for age, sex, family structure and disease status in 2008, poor social curiosity (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.02-1.69) and interaction (OR = 2.57, 95% CI: 1.20-5.51) were found to be associated with functional decline. Furthermore, social curiosity (OR = 1.39, 95% CI: 1.14-1.69) and interaction (OR = 2.84, 95% CI: 1.44-5.59) were also associated with the composite outcome. CONCLUSIONS Social curiosity and interacting with others were significantly associated with functional status. Promotion of social interaction may be essential for preventing future need for care.
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Affiliation(s)
- K Watanabe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - E Tanaka
- Faculty of Human sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan
| | - T Watanabe
- College of Nursing and Nutrition, Syukutoku University, Chiba, 260-8703, Japan
| | - E Tomisaki
- Faculty of Nursing and Medical Care, Keio University, Tokyo, 160-0016, Japan
| | - S Ito
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - R Okumura
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - T Anme
- Faculty of Human sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan.
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Kantor ED, Haneuse S, Valdimarsdóttir UA, Williams DR, Signorello LB, Rider JR. Socioenvironmental adversity and risk of prostate cancer in non-Hispanic black and white men. Cancer Causes Control 2019; 30:997-1007. [PMID: 31264140 DOI: 10.1007/s10552-019-01196-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 06/12/2019] [Indexed: 12/29/2022]
Abstract
Non-Hispanic black (NHB) men experience higher risk of prostate cancer than other racial/ethnic groups, and it is possible that socioenvironmental (SE) adversity and resulting stress may contribute to this disparity. Data from the Southern Community Cohort Study were used to evaluate associations between SE adversity and perceived stress in relation to prostate cancer risk, overall and by race/ethnicity and grade. Between 2002 and 2009, 26,741 men completed a questionnaire, from which an 8-item SE adversity composite was created (covering socioeconomic status, residential environment, and social support/buffers). Two items from the Perceived Stress Scale were assessed. With follow-up through 2011, 527 prostate cancer cases were diagnosed. In multivariable models, each one-unit increase in the SE adversity composite was associated with increased prostate cancer risk among non-Hispanic white (NHW) men (HR 1.23; 95% CI 1.02-1.48) and reduced risk among NHB men (HR 0.89; 95% CI 0.82-0.95) (p interaction: 0.001). This pattern held for low grade, but not high grade, cancers although power was limited for the latter. Perceived stress variables were associated with increased risk of prostate cancer among NHW men, but not among NHB men. Results do not support the hypothesis that SE adversity my underlay the racial disparity in prostate cancer, over and above that of covariates, including healthcare utilization.
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Affiliation(s)
- Elizabeth D Kantor
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Unnur A Valdimarsdóttir
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Lisa B Signorello
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer R Rider
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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The tide does turn: Predictors of remission from suicidal ideation and attempt among Canadians who previously attempted suicide. Psychiatry Res 2019; 274:313-321. [PMID: 30836277 DOI: 10.1016/j.psychres.2019.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
The objectives of this study were to identify factors that contribute to (1) remission from suicidal ideation, and (2) remission from suicide attempt, among Canadians with a lifetime history of suicide attempt. Data for this study came from Statistics Canada's nationally representative 2012 Canadian Community Health Survey-Mental Health. A sample of 769 adult respondents who had ever attempted suicide was analyzed with remission from past year suicidal ideation and remission from past year suicide attempt as outcome variables. Of the 769 respondents who had ever attempted suicide, more than two-thirds (69%) were free from suicidal ideation within the past year, and approximately 87% were free from suicide attempts within the past year. Compared to men, odds were 2.66 times greater for women to be free of suicide attempt and 2.65 times greater to be free of suicidal ideation in the past year. Older age, being free of sleep problems and major depressive episode, having no history of chronic childhood physical abuse, and having two or fewer previous suicide attempts were associated with higher odds of remission from both suicide attempt and ideation in the past year.
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Gholampour Y, Jaderipour A, Khani Jeihooni A, Kashfi SM, Afzali Harsini P. The Effect of Educational Intervention Based on Health Belief Model and Social Support on the Rate of Participation of Individuals in Performing Fecal Occult Blood Test for Colorectal Cancer Screening. ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2018; 19:2777-2787. [PMID: 30360606 PMCID: PMC6291048 DOI: 10.22034/apjcp.2018.19.10.2777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background and Aim: Among the screening tests for colorectal cancer, fecal occult blood test (FOBT) is important in comparison other methods due to its ease of use and low cost.The aim of this study is to survey the effect of educational intervention based on health belief model and social support on the rate of participation of individuals in performing fecal occult blood test for colorectal cancer screening among men who referred to the health centers in FasaCity, Fars province, Iran. Materials and Methods: In this quasi-experimental study, 200 men (100 in experimental group and 100 in control group) in FasaCity, Fars province, Iranwere selected in 2017. A questionnaire consisting of demographic information, knowledge, HBM constructs (perceived susceptibility, severity, benefits, barriers, self- efficacy and cues to action) and social support was used to measure the rate of participation of individuals in performing Fecal Occult Blood Test for colorectal cancer screening before and three months after the intervention. Data were analyzed using SPSS22 viadescriptive and inferential statistics, paired t-test, Mann-Whitney, Chi-square, and independent t-test at a significance level of 0.5. Results: The mean age of the men was 63.18 ± 8.25 years in the experimental group and 65.11 ± 7.66 years in the control group. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, Self-efficacy, cues to action, social support and the level of referrals (participation) of subjects for FOBTcompared to the control group. Conclusion: This study showed the effectiveness of HBM constructs and social support in adoption of the level of participation of subjects for FOBTin men. Hence, these models can act as a framework for designing and implementing educational interventions for undergoing FOBT.
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Affiliation(s)
- Yousef Gholampour
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
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Malak MZ, Tawalbeh LI, Abu Sharour LM. Predictors of quality of life among older patients with cancer during treatment. J Res Nurs 2018; 23:598-611. [PMID: 34394479 DOI: 10.1177/1744987118785939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Improving quality of life in older patients with cancer has become an important goal of healthcare providers. Aims The purpose of this study was to identify the predictors of quality of life among older patients with cancer, aged 60 years and over during the treatment period. Methods A descriptive correlational study was conducted among 150 patients. The Functional Assessment of Cancer Therapy Scale, Herth Hope Index and Hospital Anxiety and Depression Scale were used. Results The results showed that the total quality-of-life mean score was 58.50 (SD = 7.44), indicating low overall quality of life. The social-family well-being subscale had the highest mean (20.50, SD = 3.79) among all subscales of quality of life, while the emotional well-being subscale had the lowest mean (8.06, SD = 4.23). Hope and educational level had statistically significant positive relationships with all subscales of quality of life. However, anxiety was associated negatively with physical, social-family and functional well-being subscales, but positively with the emotional well-being subscale. Anxiety, income, marital status, health insurance, duration of treatment, educational level, gender and hope were identified as predictors of quality-of-life subscales. Conclusions The results could help to develop specific programmes that may improve quality of life among older patients with cancer during treatment.
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Affiliation(s)
- Malakeh Z Malak
- Assistant Professor, Faculty of Nursing, Al-Zaytoonah University of Jordan, Jordan
| | - Loai I Tawalbeh
- Associate Professor, Faculty of Nursing, Al-AlBayt University, Jordan
| | - Loai M Abu Sharour
- Associate Professor, Faculty of Nursing, Al-Zaytoonah University of Jordan, Jordan
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Yanguas J, Pinazo-Henandis S, Tarazona-Santabalbina FJ. The complexity of loneliness. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:302-314. [PMID: 29957768 PMCID: PMC6179015 DOI: 10.23750/abm.v89i2.7404] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 03/28/2018] [Indexed: 12/20/2022]
Abstract
Loneliness is a prevalent and global problem for adult populations, and a number of different studies have linked it to multiple chronic conditions, including: heart disease, lung disease, cardiovascular disease, hypertension, atherosclerosis, stroke, and metabolic disorders, such as obesity and metabolic disease. Is a major predictor of psychological problems, such as depression, psychological stress, and anxiety. Loneliness is linked to overall morbidity and mortality in adult populations. But limited interventions have demonstrated long-term effectiveness in reducing loneliness in adults with these same chronic conditions. Our research of the extant literature addresses the following question: What evidence exists regarding the relationships between loneliness and health? We focus on recent findings with respect to the links between loneliness and health.
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Affiliation(s)
- Javier Yanguas
- Scientific Director of the Elderly Program. "la Caixa" Banking Foundation. (Spain). President of the Department of Social and Behavioral Sciences at the IAGG-EU.
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Shahrokni A, Alexander K, Wildes TM, Puts MTE. Preventing Treatment-Related Functional Decline: Strategies to Maximize Resilience. Am Soc Clin Oncol Educ Book 2018; 38:415-431. [PMID: 30231361 DOI: 10.1200/edbk_200427] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The majority of patients with cancer are older adults. A comprehensive geriatric assessment (CGA) will help the clinical team identify underlying medical and functional status issues that can affect cancer treatment delivery, cancer prognosis, and treatment tolerability. The CGA, as well as more abbreviated assessments and geriatric screening tools, can aid in the treatment decision-making process through improved individualized prediction of mortality, toxicity of cancer therapy, and postoperative complications and can also help clinicians develop an integrated care plan for the older adult with cancer. In this article, we will review the latest evidence with regard to the use of CGA in oncology. In addition, we will describe the benefits of conducting a CGA and the types of interventions that can be taken by the interprofessional team to improve the treatment outcomes and well-being of older adults.
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Affiliation(s)
- Armin Shahrokni
- From the Memorial Sloan Kettering Cancer Center, New York, NY; Washington University School of Medicine, St. Louis MO; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Koshy Alexander
- From the Memorial Sloan Kettering Cancer Center, New York, NY; Washington University School of Medicine, St. Louis MO; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Tanya M Wildes
- From the Memorial Sloan Kettering Cancer Center, New York, NY; Washington University School of Medicine, St. Louis MO; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Martine T E Puts
- From the Memorial Sloan Kettering Cancer Center, New York, NY; Washington University School of Medicine, St. Louis MO; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Orlewska K, Sliwczynski A, Orlewska E. An ecological study of the link between the risk of most frequent types of cancer in Poland and socioeconomic variables. Int J Public Health 2018; 63:777-786. [PMID: 29508013 PMCID: PMC6154031 DOI: 10.1007/s00038-018-1082-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 02/02/2018] [Accepted: 02/10/2018] [Indexed: 01/08/2023] Open
Abstract
Objectives To assess the link between the risks of most frequent cancer sites in Poland and selected socioeconomic variables that potentially affect health outcomes throughout the life course. Methods This is a cross-sectional ecological study. Incidence of lung, breast, and colon cancer by voivodeships in 2014 was calculated based on Polish National Cancer Registry. Socioeconomic variables in individual voivodeships were assessed based on Polish Social Cohesion Survey for 2015. Spearman’s rank correlation coefficient was used to test the association of incidence rates and socioeconomic variables. The significance level was set at p < 0.05 (two-tailed tests). Results Statistically significant negative correlation exists between: (1) friend-/neighbour-based social capital and colon and breast cancer, (2) association-based social capital and lung cancer, (3) high religiousness and lung and breast cancer, and (4) income poverty and breast cancer. Statistically significant positive correlation exists between: (1) social isolation, living conditions poverty, poverty resulting from the lack of budget balance, and lung cancer; (2) low/no involvement in religious activity and lung and breast cancer. Conclusions Our findings support public health concerns over the implication of socioeconomic environment for cancer.
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Affiliation(s)
| | - Andrzej Sliwczynski
- Medical University in Lodz, Lodz, Poland.,National Health Fund, Warsaw, Poland
| | - Ewa Orlewska
- Faculty of Medicine and Health Sciences, The Jan Kochanowski University in Kielce, Al. IX Wieków Kielc 19, 25-317, Kielce, Poland.
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Boen CE, Barrow DA, Bensen JT, Farnan L, Gerstel A, Hendrix LH, Yang YC. Social Relationships, Inflammation, and Cancer Survival. Cancer Epidemiol Biomarkers Prev 2018; 27:541-549. [PMID: 29475966 DOI: 10.1158/1055-9965.epi-17-0836] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/17/2017] [Accepted: 01/29/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Social stressors, such as social relationship deficits, have been increasingly linked to chronic disease outcomes, including cancer. However, critical gaps exist in our understanding of the nature and strength of such links, as well as the underlying biological mechanisms relating social relationships to cancer progression and survival.Methods: Utilizing novel questionnaire and biomarker data from the UNC Health Registry/Cancer Survivorship Cohort, this study examines the associations between diverse measures of social support and mortality risk among individuals with cancer (N = 1,004). We further assess the role of multiple serum markers of inflammation, including high-sensitivity C-reactive protein (CRP), IL6, TNFα, and VEGF, as potential mediators in the social relationship-cancer link.Results: The findings revealed that one's appraisal of their social support was associated with cancer mortality, such that individuals reporting higher levels of social support satisfaction had lower mortality risk than individuals reporting lower levels of satisfaction. The amount of support received, on the other hand, was not predictive of cancer survival. We further found evidence that inflammatory processes may undergird the link between social support satisfaction and mortality among individuals with cancer, with individuals reporting higher levels of social support satisfaction having lower levels of CRP, IL6, and TNFα.Conclusions: These results provide new knowledge of the biosocial processes producing population disparities in cancer outcomes.Impact: Our study offers new insights for intervention efforts aimed at promoting social connectedness as a means for improving cancer survival. Cancer Epidemiol Biomarkers Prev; 27(5); 541-9. ©2018 AACR.
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Affiliation(s)
- Courtney E Boen
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - David A Barrow
- UNC Cytokine & Biomarker Analysis Facility, School of Dentistry, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Laura Farnan
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Adrian Gerstel
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Laura H Hendrix
- Duke Cancer Institute/Alliance for Clinical Trials in Oncology, Durham, North Carolina
| | - Yang Claire Yang
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.,Department of Sociology and Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
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Sarma EA, Kawachi I, Poole EM, Tworoger SS, Giovannucci EL, Fuchs CS, Bao Y. Social integration and survival after diagnosis of colorectal cancer. Cancer 2017; 124:833-840. [PMID: 29160897 DOI: 10.1002/cncr.31117] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/06/2017] [Accepted: 10/13/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although larger social networks have been associated with lower all-cause mortality, few studies have examined whether social integration predicts survival outcomes among patients with colorectal cancer (CRC). The authors examined the association between social ties and survival after CRC diagnosis in a prospective cohort study. METHODS Participants included 896 women in the Nurses' Health Study who were diagnosed with stage I, II, or III CRC between 1992 and 2012. Stage was assigned using the American Joint Committee on Cancer criteria. Social integration was assessed every 4 years since 1992 using the Berkman-Syme Social Network Index, which included marital status, social network size, contact frequency, religious participation, and other social group participation. RESULTS During follow-up, there were 380 total deaths, 167 of which were due to CRC. In multivariable analyses, women who were socially integrated before diagnosis had a subsequent reduced risk of all-cause mortality (hazard ratio [HR], 0.65; 95% confidence interval [95% CI], 0.46-0.92) and CRC mortality (HR, 0.63; 95% CI, 0.38-1.06) compared with women who were socially isolated. In particular, women with more intimate ties (family and friends) had lower all-cause mortality (HR, 0.61; 95% CI, 0.42-0.88) and CRC mortality (HR, 0.59; 95% CI, 0.34-1.03) compared with those with few intimate ties. Participation in religious or community activities was not found to be related to outcomes. The analysis of postdiagnosis social integration yielded similar results. CONCLUSIONS Socially integrated women were found to have better survival after a diagnosis of CRC, possibly due to beneficial caregiving from their family and friends. Interventions aimed at strengthening social network structures to ensure access to care may be valuable programmatic tools in the management of patients with CRC. Cancer 2018;124:833-40. © 2017 American Cancer Society.
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Affiliation(s)
- Elizabeth A Sarma
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Edward L Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Charles S Fuchs
- Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ying Bao
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Social Support Is a Predictor of Lower Stress and Higher Quality of Life and Resilience in Brazilian Patients With Colorectal Cancer. Cancer Nurs 2017; 40:352-360. [PMID: 27171810 DOI: 10.1097/ncc.0000000000000388] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The well-being of patients undergoing chemotherapy treatment for colorectal cancer (CRC) is affected by psychological effects associated with cancer treatment. However, little is known about the impact of these psychological factors in Brazilian patients with CRC. OBJECTIVE The aim of this study was to determine whether perceived stress, social support, and resilience are associated with quality of life in urban Brazilian patients receiving chemotherapy treatment for CRC. METHODS This was a cross-sectional study conducted with 144 Brazilian CRC patients in an ambulatory oncology clinic. The participants completed 5 questionnaires: Demographics, Perceived Stress Scale 14, Social Support Satisfaction Scale, Resilience Scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (C30 and CR29). Confirmatory factor analysis modeling and Cronbach's α were used to examine construct validity and internal consistency. We used the MPlus 3.0 to construct and validate the structural model. RESULTS There was a moderate and positive effect of resilience on the physical, social, and emotional aspects of quality of life. Social support had a strong and positive direct effect on quality of life (ie, social, physical, social, and emotional). Social support had a negative effect on stress perception. Resilience was also negatively related to stress perception. CONCLUSIONS Family support and professional social support are important factors for Brazilian CRC patients. Resilience is an important ally for patients. It is important for nurses to consider this when developing educational and psychological interventional strategies to reduce stress and ultimately improve quality of life in this population. IMPLICATION FOR PRACTICE Psychological factors that improve quality of life should be evaluated in patients undergoing treatment for cancer.
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Yang YC, Johnson MP, Schorpp KM, Boen CE, Harris KM. Young Adult Risk Factors for Cancer: Obesity, Inflammation, and Sociobehavioral Mechanisms. Am J Prev Med 2017; 53:S21-S29. [PMID: 28818242 PMCID: PMC5867534 DOI: 10.1016/j.amepre.2017.04.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 04/03/2017] [Accepted: 04/14/2017] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The paper assesses social disparities in the burdens of metabolic and inflammatory risks for cancer in the U.S. young adult population and examines psychosocial and behavioral mechanisms in such disparities. METHODS Using data of 7,889 individuals aged 12-32 years from the National Longitudinal Study of Adolescent to Adult Health from 1994 to 2009, generalized linear models were used to assess the sex, race/ethnicity, and SES differences in the risks of obesity and inflammation, measured by C-reactive protein. Further tests examined the extent to which social isolation, smoking, physical inactivity, alcohol abuse, and illicit drug use explain social differentials in each biomarker outcome. RESULTS Women, blacks, Hispanics, and socioeconomically disadvantaged groups had higher risks of obesity and elevated C-reactive protein, with the SES gradients being more pronounced in female participants. Health-related behaviors showed large variation across sex, race, and SES strata. After adjusting for these behavioral variables, sex, and race disparities in obesity and excess inflammation in blacks diminished, whereas the adolescent SES disparity in obesity remained. The associations of adolescent and young adult SES disadvantage and inflammation were also explained by behavioral mechanisms. Behavioral factors associated with higher risks of obesity and inflammation differed, with the exception of fast food consumption, a risk factor for both. CONCLUSIONS This study provides new knowledge of social distribution of early life exposures to physiologic precedents to cancer development later in life with implications for prevention and early intervention of modifiable risky behaviors in adolescents and young adults.
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Affiliation(s)
- Yang Claire Yang
- Department of Sociology, Lineberger Comprehensive Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Moira P Johnson
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristen M Schorpp
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Courtney E Boen
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Mullan Harris
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Su JC, Hu XF. Long non‑coding RNA HOXA11‑AS promotes cell proliferation and metastasis in human breast cancer. Mol Med Rep 2017; 16:4887-4894. [PMID: 28791375 DOI: 10.3892/mmr.2017.7163] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 05/31/2017] [Indexed: 11/05/2022] Open
Abstract
Breast cancer is one of the most frequently occurring malignancies in female cancers worldwide, however, its detailed mechanism of tumorigenesis remains to be elucidated. Long non-coding RNAs (LncRNAs) have previously been demonstrated to be important in multiple cancers, including breast cancer. The present study aimed to elucidate the molecular mechanism of the effects of the novel Lnc RNA HOXA11‑AS, on cell proliferation and metastasis in breast cancer. The data revealed that the relative transcript level of HOXA11‑AS was upregulated in vivo and in vitro in models of breast cancer. Knockdown of HOXA11‑AS in MDA‑MB‑231 and MDA‑MB‑436 breast cancer cell lines inhibited the formation of cell colonies and arrested the cell cycle at the G0/G1 phase. Depletion of HOXA11‑AS using two specific short interfering (si)RNAs against HOXA11‑AS (siHOXA11‑AS‑1 and siHOXA11‑AS‑2) additionally suppressed the cell proliferative rate. Furthermore, transwell assays and wound‑healing analysis revealed that siRNA transfection inhibited cell migration and invasion by ~50% in the two cell lines. The results of the present study demonstrated the oncogenic role of HOXA11‑AS in breast cancer, providing novel clues for the future clinical diagnosis and treatment of early stage breast cancer patients.
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Affiliation(s)
- Jian-Chun Su
- Department of Head and Neck Radiotherapy, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Xue-Feng Hu
- Department of Head and Neck Radiotherapy, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
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Moon TJ, Chih MY, Shah DV, Yoo W, Gustafson DH. Breast Cancer Survivors' Contribution to Psychosocial Adjustment of Newly Diagnosed Breast Cancer Patients in a Computer-Mediated Social Support Group. JOURNALISM & MASS COMMUNICATION QUARTERLY 2017; 94:486-514. [PMID: 34295137 PMCID: PMC8294206 DOI: 10.1177/1077699016687724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study investigated the role of breast cancer survivors in a computer-mediated social support (CMSS) group for women with breast cancer. Applying a computer-aided content analytic method, the present study examined the differences in support provision between survivors and newly diagnosed patients. This study further investigated the impacts of survivor-provided social support on psychosocial adjustment of newly diagnosed patients. The results revealed that, compared with newly diagnosed patients, breast cancer survivors provided more emotional and informational support. Receiving emotional support from survivors contributed to an improvement in the quality of life and the depression of patients. The effects of survivor-provided informational support were not significant.
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Fleisch Marcus A, Illescas AH, Hohl BC, Llanos AAM. Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults. PLoS One 2017; 12:e0173370. [PMID: 28273125 PMCID: PMC5342244 DOI: 10.1371/journal.pone.0173370] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/20/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Social isolation is an important determinant of all-cause mortality, with evidence suggesting an association with cancer-specific mortality as well. In this study, we examined the associations between social isolation and neighborhood poverty (independently and jointly) on cancer mortality in a population-based sample of US adults. METHODS Using data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994), NHANES III Linked Mortality File (through 2011) and 1990 Census, we estimated the relationship between social isolation and high neighborhood poverty and time-to-cancer death using multivariable-adjusted Cox proportional hazards models. We examined the associations of each factor independently and explored the multiplicative and additive interaction effects on cancer mortality risk and also analyzed these associations by sex. RESULTS Among 16 044 US adults with 17-23 years of follow-up, there were 1133 cancer deaths. Social isolation (HR 1.25, 95% CI: 1.01-1.54) and high neighborhood poverty (HR 1.31, 95% CI: 1.08-1.60) were associated with increased risk of cancer mortality adjusting for age, sex, and race/ethnicity; in sex-specific estimates this increase in risk was evident among females only (HR 1.39, 95% CI: 1.04-1.86). These associations were attenuated upon further adjustment for socioeconomic status. There was no evidence of joint effects of social isolation and high neighborhood poverty on cancer mortality overall or in the sex-stratified models. CONCLUSIONS These findings suggest that social isolation and higher neighborhood poverty are independently associated with increased risk of cancer mortality, although there is no evidence to support our a priori hypothesis of a joint effect.
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Affiliation(s)
- Andrea Fleisch Marcus
- Department of Nutritional Sciences, Rutgers School of Health Professions, Newark, NJ, United States of America
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States of America
| | - Alex H. Illescas
- Department of Nutritional Sciences, Rutgers School of Health Professions, Newark, NJ, United States of America
| | - Bernadette C. Hohl
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States of America
- Rutgers School of Criminal Justice, Newark, NJ, United States of America
| | - Adana A. M. Llanos
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States of America
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States of America
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Baiden P, Fuller-Thomson E. Factors Associated with Achieving Complete Mental Health among Individuals with Lifetime Suicidal Ideation. Suicide Life Threat Behav 2016; 46:427-46. [PMID: 26811142 DOI: 10.1111/sltb.12230] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 09/23/2015] [Indexed: 01/24/2023]
Abstract
The objective of this study was to identify factors associated with complete mental health among Canadians who had ever seriously considered suicide. Data for this study were obtained from Statistics Canada's 2012 Canadian Community Health Survey-Mental Health (N = 2,844). The outcome variable examined in this study was complete mental health and was analyzed using binary logistic regression. Of the 2,844 respondents with lifetime suicidal ideation, 1,088 (38.2%) had complete mental health (i.e., had flourishing mental health, no mental illness, and no suicidal ideation in the past 12 months). Those who had a confidant were seven times more likely to have complete mental health. Other factors associated with achieving complete mental health among formerly suicidal respondents include being older, being a woman, having higher income, use of religious coping, and never previously having a mental illness. Considering the importance of these protective factors in formulating public health policies will allow for a more wide-reaching approach to suicide prevention.
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Affiliation(s)
- Philip Baiden
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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