bluuebunny/crossref_metadata_2025 huggingface dataset:
Linking school-based management and school effectiveness: The influence of self-based management, motivation and effectiveness in the Arab education system in Israel
Authors: Arar Khalid , Nasra Muhammed Abu
Published: May 2018

Using a sample of 300 Arab teachers in Israel, we developed a model to analyze how school-based management directly and indirectly (through motivation) affects school effectiveness. The results show that there is a positive relationship between all dimensions of self-management (decision-making, resource and personnel management, availability of resources, and organizational structure) and school effectiveness. In addition, the results show full mediation between resource management, personnel and organizational structure, and school effectiveness through motivation. Theoretical contributions and managerial implications as well as directions for future research are presented.
A ghost in the machine: Tracing the role of ‘the digital’ in discursive processes of cybervictimisation
Authors: Lindgren Simon
Published: May 2018

The study of discursive understandings of cybervictimisation draws on a dataset of crime news reporting and asks the question of if and how cybervictimisation is construed in ways that differ from other types of (non-digital) victimisation. Building on a critical discourse perspective employing corpus-based text analysis methods, the composition of news discourses about cybervictimisation are analysed, alongside the relationship between such representations and news media discourse on crime victimisation generally. The aim is to see what effect the presence of a digital dimension has for how the notion of victimisation is socially and culturally understood. The study shows, first, that news reporting on cybervictimisation has a strong bias towards crimes that fit well with the notion of ‘the ideal victim’ (such as sexual victimisation and bullying) while excluding other types like hacking and identity theft. The question is raised whether ‘victim’ discourse is able to account for the latter types or if new understandings and concepts will emerge. Second, the study shows that discourses promoting understandings of technology as contributing to amplifying danger, and that represent technology as potentially undermining social order, are strong in cybervictimisation news reports. These discourses are consequential for who is seen as a legitimate victim and not. Just as it can be very difficult to identify and apprehend perpetrators of cybercrime, so is also the identification and definition of cybervictims ambiguous and demands to be further researched.
Sleep, physical activity, waist circumference and diet as factors that influence health for reproductive age women in northern Greenland
Authors: Watson Zoe A. , Miles Mary P. , Shanks Carmen Byker , Rink Elizabeth
Published: May 2018

Background:

This study explored community and individual factors that influence the health of reproductive age women in a settlement in northern Greenland. This is important because Greenland has a declining population, a high abortion rate and because of projected environmental shifts due to climate change.

Methods:

This study collected mixed methods data to explore diet, physical activity, sleep and waist circumference for reproductive age women in Kullorsuaq, Greenland. The daily steps and sleeping hours of 13 reproductive age women were measured using activity monitoring bracelets. Waist circumference measurements and in-depth interviews about daily eating and physical activity were conducted with 15 participants and ethnographic participant observations were recorded using field notes.

Results:

Waist circumference measurements were above recommended cutoffs established by the World Health Organization. Physical activity measured by daily steps was within the ‘active’ range using the cutoff points established by Tudor and Locke. Physical activity is social and is important for communal relationships. Sleeping hours were within normal ranges based on US guidelines; however, the quality of this sleep, its variability across seasons and cultural expectations of what healthy sleep means must be further explored. Diets of women included a mixture of locally harvested meats and imported packaged foods. Study participants experienced less satiety and reported getting hungrier faster when eating packaged foods. This research took place in Spring 2016 and women reported that their sleep, physical activity and diet fluctuate seasonally.

Conclusion:

The reported findings suggest further investigation of sleep, diet and physical activity combined with the measurement of reproductive hormones to determine linkages between lifestyle factors and reproductive health outcomes is needed.
The Relationship of Service Providers’ Perceptions of Service Climate to Guest Satisfaction, Return Intentions, and Firm Performance
Authors: Susskind Alex M. , Kacmar K. Michele , Borchgrevink Carl P.
Published: May 2018

In this article, we replicate and extend the guest–server exchange (GSX) model to include guest return intentions as a mediator between guest satisfaction and unit-level sales. With the extended model, we establish that guest return intentions are strongly connected to financial performance and are a better indicator of unit-level sales when compared with guest satisfaction as previously modeled. Furthermore, our model confirms that guest satisfaction is a statistically significant consequent of service orientation, but is best treated as an antecedent to guest return intentions, rather than unit-level sales as previously modeled. Other results consistent with existing research on the GSX showed that line-level employees’ recognition of service delivery standards being in place is strongly connected to line-level employees’ perceptions of coworker and supervisor support. The former was significantly related to line-level employee guest orientation, which was related to guest orientation. Supervisor support was not found to affect guest orientation in the model, consistent with previous tests of the GSX.
Buyer Monitoring Cross-Culturally
Authors: Lieven Theo , Kwortnik Robert J. , Tomczak Torsten
Published: May 2018

Kwortnik, Lynn, and Ross demonstrated across multiple studies and service-industry contexts that voluntary tipping (a form of buyer monitoring) is a more effective employee control mechanism for improving service than is compensating workers with a service charge on the bill or a fixed wage per hour. However, Kwortnik et al.’s studies were United States-based, where tipping behavior is common and generally accepted; such is not the case in many other countries around the world. Thus, the aim of this research note is twofold: (a) to replicate Kwortnik et al.’s results in the United States and, (b) to examine whether the results hold in other countries given cross-cultural differences that may affect the efficacy of buyer monitoring as a means to improve service. Using data from 10 countries across several continents, we show that (a) Kwortnik et al.’s findings only partially replicate in the United States, (b) the buyer monitoring principle does not hold worldwide, and (c) buyer monitoring is more effective in influencing service motivation and behavior in Western (individualistic) than in Eastern (collectivistic) cultures.
Cell Deposition Microchip with Micropipette Control over Liquid Interface Motion
Authors: Onoshima Daisuke , Hattori Yuya , Yukawa Hiroshi , Ishikawa Kenji , Hori Masaru , Baba Yoshinobu
Published: May 2018

Positioning single cells on a solid surface is a crucial technique for understanding the cellular functions and cell–cell interactions in cell culture assays. We developed a microfluidic chip for depositing single cells in microwells using a simple micropipette operation. Cells were delivered to microwells by the meniscus motion of liquid interface. The residue deposits of cells were redistributed with air injection, and the isolated single cells were stored in microwells. Different microwell sizes and depths were studied to evaluate the trapping possibility of cells. Medium replacement and cell viability staining with the isolated single cells were achieved in microwells. The chip will serve as a tool for single-cell patterning in an easy-to-use manner.
The Development of Cancer through the Transient Overexpression of Reprogramming Factors
Authors: Miyagi-Shiohira Chika , Nakashima Yoshiki , Kobayashi Naoya , Saitoh Issei , Watanabe Masami , Noguchi Yasufumi , Kinjo Takao , Noguchi Hirofumi
Published: May 2018

Although induced pluripotent stem (iPS) cells have significant implications for overcoming most of the ethical issues associated with embryonic stem cells, several issues related to the use of iPS cells in clinical applications remain unresolved, including the issue of teratoma formation. We previously reported that the induction of induced tissue-specific stem (iTS) cells from the pancreas (iTS-P) or liver (iTS-L) by the transient overexpression of reprogramming factors, combined with tissue-specific selection and the generation of iTS cells, could have important implications for the clinical application of stem cells. At the same time, we also generated “induced fibroblast-like (iF) cells” that were capable of self-renewal, which had a similar morphology to fibroblast cells. In this study, we evaluated iF cells. iF cells are unlikely to show adipogenic/osteogenic differentiation. Moreover, iF cells have the ability to form tumors and behave similarly to pancreatic cancer cells. The technology used in the generation of iPS/iTS cells is also associated with the risk of generating cancer-like cells.
Promoting School Adjustment for English-Language Learners Through Group Work
Authors: Steen Sam , Liu Xi , Shi Qi , Rose Joy , Merino Georgina
Published: May 2018

Recently immigrated middle school English-language learners (ELLs) need academic, language acquisition, and acculturation supports. School counselors can use group counseling to foster positive school adjustment. Results of this study showed that students in the treatment group received significantly higher scores on school adjustment after controlling for preintervention scores. Students’ grade point average also increased following the intervention. Participant journal responses to school counselor prompts revealed expressions of sadness, loneliness, and hope for the future. The authors provide implications for group work practice and research.
The Use of English-Language Business and Finance Terms in European Languages
Authors: Anglemark Linnéa , John Andrew
Published: May 2018

Although it is generally accepted that English is becoming the lingua franca of international business, the details of this process are not well understood. This article uses the Google Books corpus to provide both a quantitative and a qualitative investigation of the ways in which specific English business terms are penetrating major European languages. Some English business terms now appear to be firmly established in other languages, and can be classified as lexical borrowings, while the use of other terms is better described as code-switching.
Spitting Ginger in Jesus’ Name? The Concept of Hybridity in a Lele Theology of Healing
Authors: Herrmann Simon
Published: May 2018

In the January 2018 issue of the IBMR, R. Daniel Shaw introduced the concept of hybridity to define how the Christian faith can connect meaningfully with people’s local rituals and practices. I researched how mature Lele Christians in Papua New Guinea evaluate their traditional concepts of sickness and healing. In this article I argue that hybridity provides a useful theoretical framework to understand how Lele Christians relate their Christian faith to their tradition. I also show that the concept finds good biblical precedent and is significantly moving forward the discussion about the relationship of Christianity and culture.
白川静 “文” 字 “表现 殷人文身说” 的破绽
Authors: 连登岗
Published: May 2018

摘要

白川静认为 “文” 字的本义是殷人临终时在胸部施加的文身 。 他从两个方面进行了论证: 第一、 “文” 字的甲骨文金文字形 。 第二、殷人的文身习俗 。 论证殷人文身习俗, 他提供了四个方面的论据, 1. 人类学知识 。 2. 与文身相关的系列字 。 3. 实物 。 4. 语言用例 。 白川静的上述观点与论证都存在失误 。 第一、 “文” 字的甲金文字形无法证明它是人临终时加上去的文身符号 。 第二、人类学知识不足以证明殷人存在着文身习俗 。 第三、白川静提供的实物不足以证明殷人存在着文身习俗 。 第四、白川静提供的语言用例不足以证明 “文” 字是人临终时加上去的文身符号 。 第五、白川静对于所谓与文身相关的系列字的解读是错误的 。
From structure topology to chemical composition. XXVI. Crystal structure and chemical composition of a possible new mineral of the murmanite group (seidozerite supergroup), ideally Na2CaTi4(Si2O7)2O4(H2O)4, from the Lovozero alkaline massif, Kola Peninsula, Russia
Authors: Sokolova Elena , Hawthorne Frank C.
Published: May 2018

The crystal structure of a murmanite-related mineral (MRM) of the murmanite group (seidozerite supergroup), ideally Na2CaTi4(Si2O7)2O4(H2O)4, from Mt. Pyalkimpor, the Lovozero alkaline massif, Kola Peninsula, Russia, was refined in space group P$ {\bar 1} $ with a = 5.363(2), b = 7.071(2), c = 12.176(5) Å, α = 92.724(3), β = 107.542(7), γ = 90.13(2)°, V = 439.7(4) Å3 and R1 = 5.72%. On the basis of electron-microprobe analysis, the empirical formula calculated on 22 (O + F), with two constraints derived from structure refinement, OH = 0.11 per formula unit (pfu) and H2O = 3.89 pfu, is (Na2.12K0.07Sr0.01)Σ2.20Ca0.85(Ti3.01Nb0.39Mn0.20Fe2+0.19Mg0.17Zr0.01Al0.01)Σ3.98(Si4.20O14)[O3.90F0.10]Σ4[(H2O)3.89(OH)0.11]Σ4{P0.03}, with Z = 1. It seems unlikely that {P0.03} belongs to MRM itself. The crystal structure of MRM is an array of TS blocks (Titanium-Silicate) connected via hydrogen bonds. The TS block consists of HOH sheets (H = heteropolyhedral, O = octahedral) parallel to (001). In the O sheet, the Ti-dominant MO1 site and Ca-dominant MO2 site give ideally (Ca□)Ti2 pfu. In the H sheet, the Ti-dominant MH site and Na-dominant AP site give ideally Na2Ti2 pfu. The MH and AP polyhedra and Si2O7 groups constitute the H sheet. The ideal structural formula of MRM of the form AP2MH2MO4(Si2O7)2(XOM,A)4(XOA)2(XPM,A)4 is Na2Ti2(Ca□)Ti2(Si2O7)2O4(H2O)4. MRM is a Ca-rich and Na-poor analogue of murmanite, ideally Na2Ti2Na2Ti2(Si2O7)2O4(H2O)4 and a Na-rich and (OH)-poor analogue of calciomurmanite, ideally (Ca□)Ti2(Na□)Ti2(Si2O7)2O2[O(OH)](H2O)4. MRM and (murmanite and calciomurmanite) are related by the following substitutions: O(Ca2+□)MRM ↔ O(Na+2)mur and O(Ca2+□)MRM + H(Na+2)MRM + O(O2–)MRM ↔ O(Na+□)cal + H(Ca2+□)cal + O[(OH)–]cal. MRM is a possible new mineral of the murmanite group (seidozerite supergroup) where Ti + Mn + Mg = 4 apfu.
Clinical, molecular, and immunological responses to pembrolizumab treatment of synchronous melanoma and acute myeloid leukemia
Authors: Kubasch Anne Sophie , Wehner Rebekka , Bazzurri Serena , Tunger Antje , Stasik Sebastian , Garzarolli Marlene , Meinel Jörn , Baretton Gustavo , Meier Friedegund , Thiede Christian , Schmitz Marc , Platzbecker Uwe
Published: May 2018

Key Points

Pembrolizumab treatment of melanoma and concomitant sAML resulted in a significant platelet response and clearance of IDH1 mutation. Pembrolizumab therapy and response was associated with an increased PD-L1 expression on acute myeloid leukemia blasts and T cells.
Computing the cost of care per day of breast cancer survivor care.
Authors: Blayney Douglas W. , Lindquist Craig , Seto Tina , Hoang Nhat Minh , Kurian Allison W.
Published: May 2018

10

Background: Cost of breast cancer survivor surveillance, of survivorship care and of variation in care practices are unknown. Furthermore, it is not known whether intense surveillance care adds value. We developed a method to measure the cost of surveillance to account for varying follow-up duration [cost of care per day (CCPD)], and explored the impact of surveillance cost on survival. Methods: We queried the Oncoshare database {Kurian et al Cancer 2014}, which amalgamates data from Stanford Health Care’s (SHC) electronic health record (EHR) (imaging, infused drugs, inpatient and outpatient facility and professional services), from the California Cancer Registry, and the Social Security Death Index. We included breast cancer patients diagnosed 2000-2014, Stages 0-III who had surgery, chemotherapy or radiation treatment at SHC, and who had more than two visits at SHC within 3 years of their treatment completion. We tallied Common Procedural Terminology (CPT©) codes assigned to each service, and mapped each CPT code to the corresponding code and date in the CMS Medicare fee schedule. For patients with breast cancer relapse, we explored the post-relapse survival of the costliest 20% compared with the other patients. Results: CCPD was $2.45 for care delivered at SHC. Among the three breast cancer subtypes (luminal, Her-2 over-expressed and triple negative) there was no difference in cost. Among patients who relapsed, those in the most expensive 20% CCPD had significantly shorter survival than other patients. The high-cost patients had more co-morbidity [cerebrovascular disease (4% for low cost vs 7% for high), chronic pulmonary disease (5% vs 10%), CHF (2% vs 7%), diabetes (4% vs 7%), liver disease (4% vs 9%)]. Conclusions: Cost of care per day (CCPD) is a useful metric to assess value of surveillance and survivorship care, and is also applicable to initial treatment and post-relapse care, to identify “positive deviants” ( those who have developed best practices) in high value care delivery. We captured only costs for treatment at SHC, and merging our data with claims data from 3rd party carriers could increase the accuracy and validity of the CCPD. We identified a model for further testing to reduce total spending for high-quality oncology care.
Disconnect between physical activity guidelines and ground reality: A real world analysis of physical activity profile of cancer survivors.
Authors: Algotar Amit Mohan , Algotar Kalpana , Berkowitz Alyssa , Sanft Tara Beth
Published: May 2018

105

Background: Physical activity recommendations are often made through survivorship care plans and survivorship guidelines. However, recommendations may not translate into actions and hence it is important to understand the ground reality of cancer survivors and determine how much physical activity they are able to do in their daily life. Methods: Data were obtained from a self-reported survey of patients attending survivorship clinic at a comprehensive cancer center. Participants were asked what kind of physical activity they were engaging in, how many times a week and how many minutes per session. A composite variable was created by multiplying the number of times by number of visits and adding all the activity types patients reported engagement in. This number was compared against the current recommendations of 150minutes of physical activity weekly as recommended National Comprehensive Cancer Network (NCCN) guidelines. Data were stratified by age, gender and cancer type. Results: A total of 729 survivors filled out the survey. Only 26.3% of participants reported meeting the NCCN guideline for physical activity and this did not differ by gender (26.6% female vs 23.9% male). Percent of survivors meeting the guidelines reduced with increasing age (32% < 40 years, 26.5% 40-60 years, and 24% > 60years). Participants with lymphoma reported the highest level of physical activity (113.15 minutes per week) where as those with prostate cancer reported low levels of physical activity (0 minutes per week). Conclusions: This real world analysis demonstrates disconnect between current physical activity guidelines and ground reality of cancer survivors. Not only is research needed to understand barriers of cancer survivors towards achieving physical activity guidelines but attention also needs to be paid to determine if guidelines need to be modified as they may be setting the bar too high.
Cancer survivorship in the rural U.S. Columbia Pacific: A pilot study.
Authors: Lycette Jennifer L. , Cockrum Paulina , Fromwiller Venus , Winters-Stone Kerri M.
Published: May 2018

106

Background: We provide the only fully staffed cancer center in the rural Columbia Pacific, serving multiple counties in OR and WA. Rural areas can lack resources to provide comprehensive survivorship care. Higher rates of medical comorbidities and socioeconomic barriers add challenges to rural survivorship. We conducted a pilot study to 1) develop a program for lifestyle and behavior modifications to fit the needs of our rural community and 2) determine feasibility and preliminary efficacy of a survivorship program for breast cancer patients. Methods: : 9 women with stage I-III breast cancer completed a 12-week program consisting of 1:1 meetings every 2 weeks with a physical therapist and registered dietician; health coach support; and access to a social worker. The following pre-post measures of physical health were taken: fasting lipids and glucose, HbA1C, waist circumference, blood pressure, BMI, 3-day physical activity log and food journal, joint range of motion, and muscle strength. Pre-post well-being was assessed by EORTC QLQC30 and focus groups. Results: Decreases in systolic BP, weight, waist circumference, fasting glucose, and HbA1c were seen in a majority of participants; however, only decreases in waist circumference reached statistical significance (p = .043). On post-program survey using a 0-10 rating scale, program acceptability was rated at an average of 7, and likelihood to continue at an average of 9.4; however, overall QOL rating had no change. Focus group feedback indicated participants valued dietician visits, but requested more social work support, exercise customization, and group support to foster mentoring, education, and sense of community. Conclusions: Developing a rural comprehensive survivorship care program is feasible. More work is needed to translate physical health goals into enhancement of well-being and improved QOL. As of 10/2/17 we have opened a comprehensive cancer center housing medical oncology and radiation oncology services in one facility. We now have a full-time dietitian, resource coordinator, and social worker. This unique facility is well poised to deliver long-term care to rural cancer survivors, and we believe could serve as a model for other rural regions.
Risk for osteoporosis in gastric cancer survivorship.
Authors: Jeong Sumin , Shin Dong Wook , Lee Ji Eun
Published: May 2018

121

Background: Gastrectomy is a risk factor for low bone mass. We aimed to investigate the relative risk for osteoporosis in gastric cancer survivorship compared to general population. Methods: Using Korea National Health and Nutrition Examination Survey (KNHANES III-IV), 2008-2011, we identified the 8,156 individuals over 50 years old who have been tested the dual-energy X-ray absorptiometry (DXA). Gastric cancer survivors (n = 103) who had a history of gastric cancer in questionnaire were defined as case. Control subjects were matched to case subjects by age (plus or minus 1 year) and sex with 1:5 ratio. Osteopenia ( -2.5 < T-score < -1.0 ) and osteoporosis (T-score ≤ -2.5) were used to define the status of bone mass. We performed multinominal logistic regression to compare the risk for osteopenia and osteoporosis between case and control. Results: After adjusting for sex, age, body mass index, smoking status, alcohol consumption, physical activity and bone health related history (history of fracture or family history of osteoporosis), there was a significant high risk for osteopenia (adjusted relative risk (RR) = 2.90; 95% confidence interval (CI) 1.16–7.25) and osteoporosis (adjusted RR = 4.63; 95% CI 1.12–13.3) in gastric cancer survivor. The risk for osteoporosis was most prominent for femur total in gastric cancer survivors (adjusted RR = 16.3; 95% CI 3.35–82.6). In addition, the serum Vitamin D level was lower in gastric cancer survivors (20.3 ± 0.5 IU vs 17.5 ± 1.2 IU, p-value = 0.011). Conclusions: Gastric cancer survivors showed significantly high risk for osteoporosis. Our finding clinically implies the importance of managing osteoporosis in gastric cancer survivors.[Table: see text]
Managing childhood cancer survivors at risk for stroke: Practice norms and areas of controversy.
Authors: Kenney Lisa Brazzamano , Ames Bethany , Michaud Alexis L. , Williams David , Ullrich Nicole A. , Manley Peter
Published: May 2018

124

Background: Childhood cancer survivors (CCS) treated with cranial radiation (CR) are at increased risk for stroke. There is no evidence to guide stroke prevention strategies for CSS. We aimed to describe regional practice norms for managing survivors at risk for stroke and to define areas where management is controversial. Methods: We conducted a Delphi panel of 30 physicians from the New England region who care for CCS, including primary care and specialists. Panelists anonymously answered 3 rounds of open ended questionnaires querying their management approach to a childhood brain tumor survivor treated with CR formatted as 5 clinical scenarios (asymptomatic, large and small vessel cerebral vascular disease (CVD), TIA, stroke), covering 5 categories of management (imaging, lab testing, medication, counseling, referrals). Consensus was defined as ≥ 90% of panelist agreeing with management option. Results: There was a 100% response rate for all 3 rounds of questionnaires. Of the 25 management questions related to 5 clinical scenarios, consensus was reached on 18 while 7 remained controversial. In the scenario of acute stroke symptoms, consensus was reached in all 5 categories of management. In the scenarios of large vessel CVD with symptoms of a TIA, large-vessel CVD without symptoms, and small-vessel CVD without symptoms panelists did not reach consensus on medication, specifically, aspirin use. The primary reasons for disagreement were no evidence for benefit/risk and beyond area of expertise. In the scenario of an asymptomatic survivor with no history of CVD panelists did not reach consensus on indication for MRI surveillance imaging, the primary reasons for disagreement were no clear benefit and risk of findings with uncertain clinical significance. Consensus was not reached on specialty referral patterns in any scenario except acute stroke. Conclusions: Despite lack of evidence to guide stroke prevention in childhood cancer survivors treated with CR, a panel of regional physicians reached consensus on managing most clinical scenarios. Controversial areas requiring further study are follow-up imaging for asymptomatic survivors, aspirin for stroke prophylaxis, and indications for sub-specialty referral.
Successful use of buprenorphine/naloxone to treat opioid addiction after cancer therapy.
Authors: Moryl Natalie
Published: May 2018

126

Background: Cancer pain prevalence is 55-70% and it is treated with opioids. Tapering opioids after completion of cancer treatment may be complicated by addiction, one of the known side effects of chronic opioid use. To improve access to addiction treatment Suboxone has become widely available to patients with addiction and non-malignant pain. We present a case series of successful use of Suboxone in cancer survivors and patients. Methods: Our comprehensive cancer center (CCC) Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 2320 chronic pain cancer patients seen in 2011-2016 in outpatient palliative and pain service clinics. We respectively reviewed the database and EMR to evaluate prevalence of addiction and use of Suboxone in cancer pain patients. Results: Of 134 (6%) patients with ICD-9/10 diagnosis of opioid dependence 11 (8%) patients received Suboxone. Eight were male and average age was 55. Eight patients were cancer survivors, one with stable metastatic prostate cancer and two developed end-stage bladder and breast cancer. Eight cancer survivors and one patient with stable metastatic prostate remained on Suboxone and received no other opioids. The two patients with advanced cancers were ultimately taken off Suboxone and discharged to hospice on TD fentanyl and hydromorphone. Suboxone was prescribed by outside prescribers for eight patients and by a CCC certified Suboxone prescriber for three patients: 75-y-o female dependent on morphine for over 10 years was successfully tapered off morphine and ultimately off Suboxone, 51-y-o lymphoma survivor remains in stable remission for addiction, and a 67-y-o man with stable metastatic prostate cancer and stable remission for addiction has been refusing opioids other than Suboxone for 2 years. Conclusions: Although cancer patients are appropriately exempt from CDC opioid guidelines cancer patients with comorbid addiction may benefit from stopping opioids when pain resolves. In addition to screening for opioid use disorder, use of Suboxone may further improve care for the patients with cancer pain and addiction and increase safety for the caregivers and community.
Androgen deprivation therapy (ADT) and cardiovascular mortality (CVD) in men with early-stage prostate cancer (PC) receiving curative radiation therapy (RT).
Authors: Hanlon Ashley , Fleming Steven , Hamilton Ann S , Dinan Michaela Ann , Melloni Chiara , Harrison Michael Roger , Khouri Michel , Wu Xiao-cheng , Wilson J. Frank , Lipscomb Joseph , Cress Rosemary Donaldson , Anderson Roger T , Kimmick Gretchen Genevieve
Published: May 2018

127

Background: Combined with RT, ADT is a highly effective and utilized treatment for men with localized PC, but some studies suggest that use of ADT leads to increased CVD. We explored the association between ADT and CVD in men receiving RT for localized PC in the National Program for Cancer Registry’s (NPCR) Breast and Prostate Cancer Patterns of Care (POC) study. Methods: From 7 population-based cancer registries, we constructed a sample of men with localized PC treated with definitive RT, stratified by race/ethnicity. Cases diagnosed in 2004 were followed through 2009. Comorbidity, at or before diagnosis, was quantified using the Adult Comorbidity Evaluation 27; subcategories were combined into CV disease (CVD = myocardial infarction, coronary artery disease, congestive heart failure, arrhythmia), CVD-equivalents (CVE = peripheral artery disease and stroke) and CV-risk factors (CVRF = hypertension, diabetes, obesity). Cause of death was determined from the National Death Index data and linkage with vital statistics data. Rates of CV death, in those receiving RT alone versus RT+ADT, were compared in univariate and multivariable analyses. Results: The sample included 2,413 men with mean age 67.7 years (range 39-94), 54.5% white non-Hispanic, 997 received RT alone and 1,416 received RT+ADT. Five-year CVD was 2.3% with RT alone and 3.4% with RT+ADT. In univariate analysis, the following predicted higher CVD with ADT: age < 60 (OR 1.42, p = 0.04), white (OR 2.06, p = 0.001), divorced/separated/widowed (OR 1.29, p = 0.02), insured by Medicare (OR 1.64, p = 0.04), living in mixed urban-rural area (OR 1.87, p = 0.03), higher education level (OR 1.56, p = 0.05), high socioeconomic status (OR 1.70, p = 0.03), no or mild comorbidity level (OR 2.14, p = 0.05 and OR 1.66, p = 0.02, respectively), low PSA (OR 5.44, p = 0,02), and Gleason score 3 (OR 2.12, p = 0.02). In multivariate analysis, use of ADT did not significantly predict hazard of death from heart disease (HR 1.21, p = 0.28) or PC (HR 0.76, p = 0.34). Conclusions: After controlling for confounding variables, use of ADT was not associated with increased risk of CVD in men receiving radiation as definitive therapy for localized PC.
Suicide risk among cancer survivors: Head and neck versus other cancers.
Authors: Osazuwa-Peters Nosayaba , Simpson Matthew C , Zhao Longwen , Adjei Boakye Eric , Olomukoro Stephanie I , Varvares Mark A
Published: May 2018

146

Background: While head and neck cancer (HNC) only accounts for 4% of new cancer cases in the United States, incidence of HNC-associated suicide may be significantly higher due to quality of life issues associated with HNC survivorship. This study estimated incidence of HNC-associated suicide versus other common cancers, and quantified suicide rate among HNC survivors compared with non-HNC. Methods: We queried the Surveillance, Epidemiology and End Results 18 database from 2000-2014 for all cancer deaths confirmed as suicide. Mortality rates from suicide was estimated for the 21 most common cancers in the United States, including HNC. Negative binomial regression estimated mortality rate ratios (MRRs) and 95% confidence intervals (CIs), between HNC and the other 20 other cancers combined, and as individual sites. Models were stratified by sex (when applicable), controlling for race, marital status, age, year and stage of diagnosis. Results: There were 4,769 suicides observed among 4,613,123 cancer survivors from 2000-2014, yielding an incidence rate of 23.6 suicides per 100,000 person-years. Combined, all other cancers had a 45% decreased suicide ratio compared to HNC for both males (MRR = 0.55, 95% CI 0.48, 0.64) and females (MRR = 0.55, 95% CI 0.37, 0.81). For specific cancer sites, only pancreatic cancer had a higher mortality rate due to suicide than HNC (86.4 suicides per 100,000 person-years, versus 63.4 suicides per 100,000 person-years). Stratified by gender, only male pancreatic cancer survivors had a significantly higher suicide MRR compared with HNC (MRR = 1.54, 95% CI 1.23, 1.90). For females, all cancer sites (including pancreas) had either significantly or insignificantly lower suicide MRR compared with HNC. Conclusions: Risk of suicide is significantly higher among HNC survivors compared to all other cancers, except pancreatic cancer. Our findings confirm that HNC survivors are prime candidates for lifelong psychosocial surveillance.
Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors: Findings from a nationally representative sample.
Authors: Reed Sarah C. , Bell Janice , Nekhlyudov Larissa , Fairman Nathan , Joseph Jill G. , Miglioretti Diana L
Published: May 2018

147

Background: Fear of cancer recurrence (FCR) and related constructs are experienced by many cancer survivors and are consistently identified as important areas of need. This study adds to sparse literature on this topic by describing the prevalence of FCR and testing its associations with mental health status measures in a US sample of cancer survivors. Methods: Using the Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (n = 1,032), we examined socio-demographic, health and mental health characteristics of cancer survivors by their level of fear of cancer recurrence (none, low, high). Survey-weighted population-based estimates describe the prevalence of key variables. Multinomial logistic regression was used to test associations between validated measures of mental health status and individual characteristics, and levels of FCR in models unadjusted and controlling for socio-demographic and health characteristics. MEPS survey weights were applied in all analyses to account for the survey design. Results: Overall, 34% of cancer survivors reported no FCR, 54% reported low FCR, and 11% reported high FCR. Cancer survivors were at increased risk of reporting high FCR relative to no FCR if they had a low 12-item Short Form Health Survey (SF-12) Mental Component Summary (MCS) score (≤48) compared to high scores (odds ratio = 2.89; 95% confidence interval (CI) = 1.58, 5.32). Reporting depressive symptoms or psychological distress did not significantly increase the risk of reporting high or low FCR relative to no FCR. Conclusions: This study is the first to provide US population-based estimates of associations between FCR and individual, health and mental characteristics. Our results also provide valuable information on which survivors are most at-risk for FCR, and add to a new and growing literature supporting FCR as a multidimensional construct distinct from depression and distress. Future research is needed to more clearly differentiate FCR from other constructs, specifically anxiety disorders, and to identify clinically significant levels of FCR to better target survivors with the highest needs.
Supporting survivorship care through comprehensive cancer control technical assistance.
Authors: Harvey Allison , Khalaf Mohammad , Villalobos Aubrey , Chapman Mandi
Published: May 2018

15

Background: In 2010, the Centers for Disease Control and Prevention (CDC) issued six priorities for Comprehensive Cancer Control (CCC) programs, including addressing needs of cancer survivors (Seeff, 2010). CCC programs identified need for technical assistance (TA), tools and resources in this area. George Washington University (GW) Cancer Center provides TA on survivorship through a 5-year agreement from CDC and contracts from 5 states. Methods: Since 2013, GW developed three online trainings for health care providers with a focus on survivorship. From 2016-2017, GW delivered four tailored in-person workshops to health care professionals (N = 137). GW also produced a survivorship report and a roadmap to implement the patient navigation standard from the Commission on Cancer: both include background information, sample metrics and implementation resources. Results: Across online trainings for oncology and primary care provider (PCP) learners, a majority of participants (N = 1,983) agreed or strongly agreed their knowledge was enhanced (94.6%) and planned to implement strategies/skills/information learned (79.6%). While content varied for workshops, patient-provider communication, survivorship care plans and patient navigation were common topics presented. The majority (n = 74) agreed or strongly agreed their knowledge was enhanced (82.4%) and planned to implement strategies/skills/information learned (86.4%). The survivorship report has been downloaded 11,000+ times in one year and the roadmap nearly 5,000 times in one month. Conclusions: Based on uptake of TA, GW is meeting a need for CCC programs. However, stakeholder feedback indicates programs continue to desire TA support to meet patient navigation and survivorship care standards. Notably, most PCPs are not familiar with survivorship care, and uptake of trainings aimed at PCPs remains low. Opportunities for further TA to troubleshoot challenges in patient navigation and survivorship care remain.
Investigating Hispanic disparities in supportive medication use among Medicare beneficiaries with breast cancer.
Authors: Pinheiro Laura C , Check Devon , Rosenstein Donald , Reeder-Hayes Katherine Elizabeth , Dusetzina Stacie
Published: May 2018

154

Background: Compared to their White counterparts, Hispanic women with breast cancer are more likely to report pain, depression, and other mental health concerns. As such, this group may benefit from supportive medication use following diagnosis. However, little is known about their uptake of supportive medication, relative to White patients. In particular, it is unknown if this varies by nativity. This study’s objectives were to assess supportive medication use and investigate potential disparities in use by ethnicity/nativity. Methods: We used the Surveillance, Epidemiology and End Results data linked with Medicare claims to identify women 65+ years diagnosed with incident breast cancer between July 1, 2007 and December 31, 2011. Use of supportive medications (defined as opioid pain and non-opioid psychotropic medications) within 90 days of diagnosis was the primary outcome. We categorized ethnicity/nativity as U.S-Born Non-Hispanic, U.S-Born Hispanic, Foreign-Born Non-Hispanic, and Foreign-Born Hispanic. Poisson models were used to examine associations between ethnicity/nativity and supportive medication use, adjusting for tumor, treatment, and demographic characteristics. We estimated adjusted risk ratios and 95% confidence intervals for all estimates. Results: This study included 23,091 women, of whom 88% were U.S-Born Non-Hispanics, 4% U.S-Born Hispanics, 6% Foreign-Born Non-Hispanics, and 2% Foreign-Born Hispanics. We observed significant adjusted differences in supportive medication use by ethnicity/nativity. Compared to US-Born Non-Hispanics, Foreign-Born Hispanics and Non-Hispanics were 5% (95% CI 0.92-0.98, p = 0.005) and 10% (95% CI 0.85-0.96, p = 0.0005) less likely to receive supportive medications, respectively. U.S-Born Hispanics were 5% (95% CI 1.02-1.09) more likely to receive supportive medications. Conclusions: This work highlights potential disparities in supportive care, and the need to address the psychosocial needs of Foreign-Born women to improve the equity of breast cancer care. Future studies should explore if differences observed in this study are reflective of true health disparities or differential patient preferences.
Facial processing abilities and social functioning in pediatric brain tumor survivors, children with autism spectrum disorder, and typically developing children.
Authors: Brodsky Cole , Shabason Emily Kauvar , Minturn Jane E. , Blum Nathan , Schultz Robert , Herrington John D , Hocking Matthew
Published: May 2018

157

Background: Pediatric brain tumor survivors (PBTS) often experience late effects in social functioning that mirror those seen in children with autism spectrum disorder (ASD). This study evaluated group differences in facial processing abilities and social functioning between school-aged PBTS, children with ASD, and typically developing children (TDC). Methods: PBTS(n=40;65% male; mean age=13.9 years; mean age at diagnosis=5.8 years)were at least 5 years from tumor diagnosis,2 years from end of tumor-directed therapy and absent a multi-system genetic disorder or developmental delay before tumor diagnosis. Participants completed measures of IQ, facial affect/identity recognition(Victoria/Yale Face Processing Battery), and social functioning(Children’s Communication Checklist-2, Vineland Adaptive Behavior Scales,2nd Ed. and Social Responsiveness Scale, 2nd Ed.).PBTS data were compared to a previously collected sample of age, gender, and IQ-matched children with ASD(n=41)and TDC (n=39).One-way ANOVA evaluated differences between groups with Tukey post-hoc tests.Results: IQ for PBTS(m=100.9; SD=16.27),ASD(m=100.17; SD=17.09),and TDC(m=104.72; SD=14.0)were all in the average range.One-way ANOVA revealed group differences for facial identity recognition[ F (2,114)=4.8 η²=.09 , p=.01],facial affect recognition[ F (2, 114)=3.8 , η²=.07, p=.024],and all social functioning measures[ p=.000].Tukey tests revealed PBTS facial affect recognition to be significantly worse than TDC(p < .05)and more comparable to youth with ASD for both facial affect and identity recognition.PBTS also showed worse social functioning than TDC and better than ASD youth across social measures( p’s < .01).Conclusions: Findings suggest PBTS demonstrate impairments in facial affect and identity recognition and social functioning compared to TDC.PBTS facial processing abilities appear similar to those of youth with ASD.PBTS may benefit from multi-disciplinary interventions similar to those used in ASD to improve social functioning. Screening facial processing abilities may identify those at higher risk for social functioning deficits.
Exercise capacity and quality of life in cancer survivors after completion of a survivorship focused exercise program.
Authors: Jones Rebecca , Harrison Trish , Mesara Doug
Published: May 2018

169

Background: Exercise is a key component in addressing the concerns of cancer survivors. Only a third of survivors meet physical activity recommendations, and 70% of survivors are overweight/obese. For survivors, inactivity and obesity increase risks of recurrence, development of a second primary cancer, and higher mortality overall. Benefits of exercise include weight loss and improved quality of life. Survivorcise, a 12 week exercise program for survivors, was developed with the goal of improving exercise capacity and quality of life. Methods: Survivorcise is a small group exercise program meeting for 60 minutes, twice a week, for 12 weeks. Pre and post testing of strength, balance, and aerobic capacity and pre and post quality of life surveys were completed. Results: Forty-four participants completed Survivorcise between 2015 and 2017. Paired t-test analysis of pre and post testing revealed significant improvements in upper body strength (p = 0.0001), lower body strength (p = 0.0001), and balance (p = 0.0071). Aerobic capacity (p = 0.1583) improved, but not significantly. Paired t-test analysis of pre and post quality of life surveys revealed significant improvements in patient perception of strength (p = 0.0001), stress (p = 0.0002), weight gain (p = 0.0002), adjusting to the new normal (p = 0.0031), depression (p = 0.0034), fatigue (p = 0.0089), change in mood/behavior (p = 0.0094), pain (p = 0.0118), and lymphedema (p = 0.0290). Patient perception of memory (p = 0.1002), balance, walking, and mobility (p = 0.1104), sleep disturbance (p = 0.1361), neuropathy (p = 0.1455), anxiety (p = 0.1537), nausea/vomiting (p = 0.1597), hot flashes (p = 0.2247), poor appetite (p = 0.4560), osteoporosis (p = 0.5748), falls, tripping, and stumbling (p = 0.6574), and weight loss (p = 0.7890) showed no significant change. Conclusions: Our data demonstrated that Survivorcise is an effective tool for cancer survivors. The program significantly improved upper and lower body strength and balance. Participants self-reported significant improvement in perceived strength, stress, weight gain, adjusting to new normal, depression, fatigue, change in mood and behavior, pain, and lymphedema.
Identifying vulnerable populations among breast cancer survivors.
Authors: Lu Kit Yu , Lee Theresa M. , Lanigan Megan , Rudge Beth , Wert Yijin , Torp Lisa
Published: May 2018

176

Background: Long term survival is common after breast cancer treatment with 5-year survival rate reaching almost 90%. Many breast cancer survivors (BCS) face varying degrees of quality of life (QOL) issues depending on their age of diagnosis, severity of their disease, and treatment course. This is a retrospective analysis to describe demographics, QOL concerns, and to identify vulnerable populations among the BCS. Methods: This is a retrospective analysis of BCS seen at our Breast Cancer Survivorship Program from Oct 2016 to Oct 2017. Patients were given a comprehensive survey to assess self-reported symptoms and concerns following their treatment. Chi-square test was used to analyze group differences. The Fisher exact test was employed when any of the expected frequencies was five or less. Results: 252 patients (age 26-93; median 60) were seen. Characteristics are listed in the Table. Most common self-reported concerns affecting BCS were: fatigue (40%), insomnia (38%), hot flashes (29%), night sweats (26%), pain (26%), trouble concentrating (26%), and neuropathy (25%). Majority(87%) reported having a happy outlook and felt that they have a sense of purpose (85%), but about 12% of BCS felt isolated at least 50% of their time. Young cancer survivors (age ≤45) (p<0.0001), higher stage BCS (Stage 2-3) (p=0.0023), and those who had chemotherapy either alone or as part of their multi-modality treatment (p=0.0061) were significantly more likely to worry about their cancer post treatment. The same populations were significantly less likely to return back to at least 50% of their pre-treatment baseline (young cancer survivors p=0.0049; higher stage p=0.0011; chemo+/-other treatments p=0.0012). Conclusions: Majority of BCS report a happy and optimistic outlook post treatment, but some may experience significant QOL issues. Identifying common concerns after treatments and vulnerable populations are especially important to deliver quality care and to optimize interventions. [Table: see text]