INTRODUCTION: The survival rate for childhood cancer has increased with advances in medical care. Along with this comes the growing burden of long-term side effects of cancer treatment and cancer survivorship. Childhood cancer survivors are more likely to be sedentary and have a lower quality of life. Physical activity (PA) can promote health and well-being in childhood cancer survivors, but few studies have explored the role of parents of childhood cancer survivors (PCCS) in promoting PA. This qualitative study aims to explore the perceptions of PCCS in Singapore and the role they may have with regard to PA. METHODS: Participants were recruited through a local charity via email, social media and posters. One-hour semi-structured interviews were conducted online with seven parents. With consent, the interviews were recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Our study discussed thematically parents' accounts on (1) the barriers and enablers of PA and (2) the complications of cancer that potentially affect the levels of PA in childhood cancer survivors. Parents reported that childhood cancer negatively affects the quality of life and participation in PA. The determinants of participation in PA were multifaceted, and socioecological and health belief models were used to demonstrate how these factors were interlinked. CONCLUSION Participation in PA is influenced at an individual, family, community and societal level. The improved understanding facilitated by this research can be used to shape paediatric cancer care practices in Singapore and guide institutional or national policy interventions.
Humans ; Singapore ; Parents/psychology* ; Cancer Survivors/psychology* ; Qualitative Research ; Female ; Male ; Quality of Life ; Exercise ; Child ; Adult ; Neoplasms ; Adolescent ; Perception ; Middle Aged ; Interviews as Topic

BACKGROUND: Post-stroke disability diminishes the physical activity (PA) level of survivors, potentially affecting their long-term prognosis. This study endeavors to explore the correlation between daily PA level and the all-cause mortality in patients with a history of stoke in the United States. METHODS: Data of stroke survivors were sourced from the National Health and Nutritional Examination Survey (NHANES) 2007-2018. The population was stratified into three groups based on their PA level. Kaplan-Meier method with log-rank tests for significance was used for survival analysis. Weighted Cox proportional hazards regression models were employed to estimate the hazard ratios (HRs) for all-cause mortality. Subgroup analysis was conducted to strengthen the results. RESULTS: A total of 1395 participants were recruited, comprising 679 males and 716 females, with a median age of 68 years. Based on their PA levels, 779 individuals were classified as inactive, 156 as insufficiently active, and 460 as sufficiently active. Following a median observation period of 59 months, there were 476 recorded deaths, with 349, 47, and 80 cases in the three respective groups. Compared to the inactive group, the HRs and 95% confidence intervals (CIs) for all-cause mortality in participants who were insufficiently active and sufficiently active were 0.58 (0.40, 0.84) and 0.47 (0.33, 0.67), respectively. The Kaplan-Meier curve revealed a significant difference in overall survival between the three groups, as confirmed by the log-rank test (P < 0.0001). Subgroup analysis further validated our results and demonstrated that the protective impact of PA on stroke prognosis varies according to distinct characteristics. CONCLUSIONS The results indicate that increased levels of PA are associated with a protective effect on long-term mortality among stroke survivors. Further prospective longitudinal studies are necessary to elucidate the optional PA level and special exercise guideline targeting this population.
Humans ; Male ; Female ; Aged ; Exercise ; Middle Aged ; Nutrition Surveys ; Stroke/mortality* ; United States/epidemiology* ; Survivors/statistics & numerical data* ; Aged, 80 and over ; Mortality

Intractable hemorrhagic cystitis is an uncommon but significant treatment complication of concurrent chemoradiation therapy for cervical cancer. Alum instillation is regarded as a safe and effective option for its treatment. This case presentation will discuss a patient who presented with postradiation cystitis and was treated with alum irrigation. The aim of this report is to offer alum irrigation as a management option for intractable hematuria.
Cancer Survivors

Humans ; Female ; Prevalence ; Breast Neoplasms ; Cancer Survivors ; Non-alcoholic Fatty Liver Disease ; Liver

Survivors of sepsis still face high risks of secondary infection and mortality after hospital discharge. Meanwhile, the persistent cognitive, psychological, and physical disorders affect their long-term outcomes and life qualities. In the current review, we analyze the factors for the poor outcomes and discuss the beneficial rehabilitation strategies to improve the long-term outcomes of patients after sepsis, including psychological intervention, early mobility, nutrition support, and immune modulation, etc.
Humans ; Patient Discharge ; Quality of Life ; Sepsis ; Survivors

Human-elephant conflict (HEC) in India is becoming a growing health problem causing many fatalities every year. Elephants produce injuries by trampling, stomping, squeezing, tossing in the air, or crushing/targeting the head and chest commonly. The adult elephants are most aggressive in their mating season, leading to maximum incidences of HECs in this period. These attacks are mostly unprovoked, though most HECs are provoked. In this case series, the authors described the injuries sustained by three survivors in a short span of one month due to the sudden and unprovoked elephant attack. All the injuries were mild to moderate in severity and involved the chest in common. Timely rescue and prompt initiation of treatment were pivotal in their survival. The authors also want to create awareness about the mating season of elephants to minimize these unfortunate events in the future.
Animals ; Elephants ; Humans ; India ; Seasons ; Survivors

PURPOSE: The partners of cancer patients commonly provide the needs of cancer patients along cancer trajectory except for patients with gynecological cancer. In developing countries including Indonesia, who have strong family bonding, the family of cancer patients are involved more intensely in providing cancer care. This situation may bring the cancer patients' families experience the burden and decrease their quality of life. Therefore, assessing the family's supportive needs are as important as patient supportive needs. There are more gynecological cancer survivors in Indonesia; however, little is recognized about partners' supportive needs due to lack of validated assessment tools to measure it. This study aimed to translate, culturally adapted and test the validity and reliability of the CaSPUN questionnaire among partner of Indonesia gynecological cancer patients. DESIGN: First, the procedures of forward-backward translation and modification of the CaSPUN were conducted to ensure cultural adaptation. Second, using convenience sampling with 295 partners of gynecological cancer patients, we tested the construct validity and internal consistency of the CaSPUN-Indonesia Version (CaSPUN-I). We conducted Exploratory Factor Analysis to explore the factor structure of CaSPUN-I and Cronbach Alpha to confirm internal consistency reliability. RESULTS: The CaSPUN were modified to make more understandable and culturally appropriate in the Indonesian context. Five factors were extracted from EFA in the CaSPUN-I with factor loadings of items between 0.41 and 0.85. The Cronbach's alpha coefficient for the CaSPUN-I ranged from 0.96-0.97. CONCLUSION: The CaSPUN Indonesia version presents acceptable validity and reliability for assessing supportive care needs among families of Indonesian gynecological cancer patients. The CaSPUN-I can be used by healthcare providers to assess and design the supportive care program for family of Indonesia gynecological cancer patients.
Cancer Survivors ; Needs Assessment ; Cross-Cultural Comparison ; Indonesia

OBJECTIVE: To test the performance of CHADS-VASc score in predicting stroke recurrence in first-ever ischemic stroke survivors without atrial fibrillation (AF). METHODS: A total of 768 patients were included in this study, including 475 male (61.85%) and 293 female patients (38.15%) with a mean age of 61.52±12.59 years (17-90 years). The baseline information of the patients was collected by face-to-face questionnaire survey and electronic medical record review, and their follow-up information was collected by telephone follow-up once every 3 months. Chi-square test and Wilcoxon rank sum test were used to compare the baseline characteristics between the patients regularly followed up and those withdrawn from the study. The area under the ROC curve (AUC), sensitivity, specificity, positive likelihood ratio and other indicators of CHADS-VASc score were determined, and C-index based on Cox proportional hazards model was used to evaluate the performance of CHADS- VASc score in predicting the risk of stroke recurrence in patients at different time points during the follow-up. RESULTS: The 1-year, 3-year, and 5-year recurrence rate of stroke was 10.59%, 20.45%, and 29.46% in these patients, respectively. The AUC value, Optimal Operating Point (OOP) and the corresponding positive likelihood ratios (LR+) for predicting stroke recurrence were 0.558 (95%: 0.492-0.624), 4.5, and 1.256 at 1 year; 0.574 (95%: 0.517-0.630), 4.5, and 1.397 at 3 years; and 0.604 (95%: 0.548-0.661), 4.5, and 1.655 at 5 years, respectively. Sensitivity analysis of congestive heart failure showed that the predictive effect of CHADS-VASc score was basically unchanged. CONCLUSIONS CHADS-VASc score can be used to predict the 3-year and 5-year risk of stroke recurrence in first-ever ischemic stroke survivors without AF. The score has a better prediction ability for long-term stroke recurrence, but the prediction value remains low, suggesting the need to further improve the score or establish a new score for predicting stroke recurrence.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation ; Brain Ischemia ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Assessment ; Risk Factors ; Stroke ; Survivors ; Young Adult

OBJECTIVE: The causal association of human papillomavirus (HPV) in uterine cervical cancer was well established and this oncogenic virus was reported to be a biomarker for overall recurrence and central pelvic recurrence. The objective of the present systematic review and meta-analysis was to assess the role of HPV DNA testing in early detection of recurrence among cervical cancer survivors after radiotherapy.METHODS: We performed a systematic review and meta-analysis by means of searching electronic databases for published articles between January 1984 and June 2018, on the basis of standard systematic review guidelines prescribed by major agencies namely Cochrane Collaboration (https://www.cochrane.org) and Campbell Collaboration (https://www.campbellcollaboration.org). The meta-analysis component was further modified appropriately for the synthesis of sensitivity and specificity results.RESULTS: A total of 1,055 cervical cancer cases who had received pelvic radiation with or without chemotherapy from ten cohort studies were evaluated. The overall pooled sensitivity and specificity of HPV DNA testing was 0.84 (95% confidence interval [CI]= 0.66–0.94) and 0.35 (95% CI=0.20–0.54) respectively. The positive likelihood ratio was 1.3 (95% CI=1.0–1.7) and the negative likelihood ratio was 0.45 (95% CI=0.18–1.10) with an estimated diagnostic odds ratio of 3 (95% CI=1–9).CONCLUSION: The screening for HPV DNA testing during follow-up facilitates early detection of recurrence after radiotherapy.
Cervix Uteri ; Cohort Studies ; Cooperative Behavior ; DNA ; Drug Therapy ; Female ; Follow-Up Studies ; Human Papillomavirus DNA Tests ; Humans ; Mass Screening ; Odds Ratio ; Oncogenic Viruses ; Radiotherapy ; Recurrence ; Sensitivity and Specificity ; Survivors ; Uterine Cervical Neoplasms

PURPOSE: This study aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. METHODS: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variableswere perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variableswere adaptation and quality of life, and adaptationwas themediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The fitness parameters of the final model showed a reasonable fit to the data. Based on R², the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. CONCLUSION: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life.
Ambulatory Care Facilities ; Anxiety ; Daegu ; Diagnosis ; Gastrectomy ; Hospitals, University ; Humans ; Negotiating ; Nursing ; Quality of Life ; Statistics as Topic ; Stomach Neoplasms ; Survivors