170,134 research outputs found
The legacy of sperm banking: how fertility monitoring and disposal of sperm are linked with views of cancer treatment
No full textBackground: sperm banking is recommended for all men before cancer treatment, which carries a risk of long-term gonadal damage. However, relatively few men take up the offer. Among them, few attend for fertility monitoring or agree to sperm disposal where fertility recovers. Sperm banks are therefore burdened by long-term storage of samples that may not be needed for conception, with implications for healthcare resources. The aims here were to determine the views of men regarding personal benefits of sperm banking, and the advantages and disadvantages of fertility monitoring and disposal in the longer term.Methods: semi-structured interviews were conducted with 19 men who were diagnosed with cancer and had banked sperm at least 5 years previously. Men were asked to recall their experiences from diagnosis to the present time, focusing on the consequences for their fertility. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis.Results: results are discussed in relation to decisions surrounding banking sperm, fertility monitoring and attitudes to disposal of banked sperm. Complex attitudes were identified, with men's views reflecting their understanding of their current and future fertility and the possible trajectory of cancer itself. Men are overwhelmed by information on diagnosis and fail to understand the implications of cancer treatment for their future fertility.Conclusions: in diagnosis, men are given large amounts of information about cancer and treatment but fail to understand the longer-term implications of sperm banking. These implications need to be specifically addressed at subsequent appointments in order to optimize fertility monitoring and timely disposal of sperm sample
Correlates of well-being in mothers of children and adolescents with cystic fibrosis
No full textFifty mothers and 44 well siblings of children and adolescents with cystic fibrosis (CF) participated in this study to identify correlates of maternal well-being. Participants completed postal questionnaires which assessed maternal well-being, problems experienced surrounding the illness and treatment and the nature of the sibling relationship. Due to the demanding nature of treatment and the fact that CF is both genetic and incurable at present we anticipate mothers of these children will experience higher levels of stress and consequently poorer well-being than the normal population. In addition, illness severity, problems with adherence to treatment, child communication, maternal support and the sibling relationship are expected to relate to maternal well-being. Mothers in this sample did not rate their well-being as any different to the normal population. Results suggest that mothers are likely to rate their own well-being as poor when they report more frequent problems surrounding the illness and treatment and well children rate their sibling relationship as having frequent disagreements and aggression. This study highlights factors that are related to maternal well-being in families where one child has CF. These mothers as a group do not appear to be experiencing more stress in their daily lives than the normal population but certain illness and family variables are related to their well-being when examining the mothers on certain dimensions.<br/
Gender differences in self-reported late effects, quality of life and satisfaction with clinic in survivors of lymphoma
No full textObjectives: gender differences in perceived vulnerability to late effects and views about follow-up among cancer survivors have received little attention. As lymphoma affects both genders similarly, we compared the consequences of cancer (late effects, perceived vulnerability and quality of life (health-related quality of life (HRQoL)), and satisfaction with clinic visits between genders.Methods: a cohort of 115 younger adults (18–45 years, >5 years disease-free survival), who had been treated for lymphoma participated. Questionnaires (n = 91) were completed before and after (n = 62) routine consultant-led appointments. Survivors (n = 24) without appointments were recruited by post. Questionnaires included HRQoL, late effects, perceived vulnerability, issues survivors wanted to discuss and reported discussing in clinic, time waiting in clinic and consultation satisfaction.Results: there were no gender differences in number of self-reported late effects or perceived vulnerability. Men with more late effects reported worse psychological HRQoL (r = 0.50, p<0.001). While men wanted to discuss more topics than they did, women were able to discuss the topics they wanted (ANOVA, p = 0.01). Multiple regression analyses showed a shorter wait in clinic (r = ?0.46, p = 0.009) and discussing more topics (r = 0.34, p = 0.06) explained 30.6% of the variance in consultation satisfaction for men.Conclusions: issues surrounding follow-up provision are increasingly important given the length of survival in young adults following treatment for lymphoma. Men may experience poor psychological well-being due to distress about unanswered concerns. Consideration of their concerns should be prioritised, given that satisfaction and ultimately continued attendance at clinic and HRQoL may be dependent on the extent to which follow-up meets survivors' expectation
Rb. Den Haag (C/09/488653 / HA ZA 15-588: IEF 15283: Eiser/Prime Sportsgear)
No full textAuteursrecht. Tussen eiser en Prime bestond een overeenkomst tot het bouwen van een website, die door Prime is opgezegd. In kort geding is geoordeeld dat eiser de website offline moest halen en de data niet zelf mocht gebruiken. Eiser vordert nu wettelijke rente, hostings- en indexeringskosten en verzet op het gebruik van de slogans en foto's waarop het auteursrecht bij eiser zou rusten. De rechtbank oordeelt dat rente verschuldigd is. De gewerkte uren van eiser zijn per kwartaal gefactureerd en daar vallen de jaarlijkse hostingskosten niet onder. De indexeringskosten zijn wel verschuldigd. Auteursrechtelijke bescherming op de foto's ontbreekt omdat er geen sprake is van creatieve maar functioneel en technische keuze's. Eiser is wel auteursrechthebbende van de slogans en kan zich ook tegen het gebruik verzetten. Prime moet wettelijke rente betalen en de slogans verwijderen
The lasting legacy of Charles Fisher (1908–1988), pioneering sleep laboratory scientist and sleep medicine psychiatrist
No full textCharles Fisher is a pioneering historical figure in sleep laboratory research and sleep medicine who distinguished himself in nine areas: (1) he first documented nocturnal sleep-onset rapid eye movement (REM) sleep periods in narcoleptic patients; (2) he published the first case of polysomnography (PSG) documented acute REM sleep behavior disorder (RBD) that was triggered by sudden withdrawal from a monoamine oxidase inhibitor in 1978, 8 years before the formal identification of RBD; (3) he worked with Roffwarg and Dement on the early delineation of the ontogeny of the human sleep cycle; (4) he first demonstrated that benzodiazepine (diazepam) therapy was effective in controlling night terrors together with suppression of stage 4 non-rapid eye movement (NREM) sleep, and he was also an early investigator of night terrors as phenomena emerging from stage 4 NREM sleep, without dreaming, as had been traditionally assumed; (5) he collaborated with another pioneering sleep medicine physician, William C. Dement on studies focused on REM sleep deprivation and dreaming at Fisher’s Mt. Sinai Hospital sleep laboratory in New York City; (6) he published the first PSG-documented case of sleep-related (psychogenic) dissociative disorder in 1976; (7) he first documented that typical nightmares (“anxiety dreams”) occurred during REM sleep; (8) he conducted some of the earliest research, beginning in 1965, that documented cycles of nocturnal penile tumescence emerging in conjunction with REM sleep cycles; and (9) he conducted similar early studies of female sexual arousal during sleep that occurred predominantly in REM sleep
Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis
No full textBackground: Sperm banking is recommended for all men diagnosed with cancer where treatment is associated with risk of longterm gonadatoxicity, to offer the opportunity of fatherhood and improved quality of life. However, uptake of sperm banking is lower than expected and little is known about why men refuse. Our aims were to determine: (i) demographic and medical variables associated with decisions about banking and (ii) differences in quality of life between bankers and non-bankers at diagnosis (Time 1 (T1)) and 1 year later (Time 2 (T2)).Methods: Questionnaires were completed by 91 men (response rate¼86.67%) at T1 and 78 (85.71% response rate) at T2.Results: In all, 44 (56.41%) banked sperm. They were younger and less likely to have children than non-bankers. In a subset of men who were not sure if they wanted children in the future (n¼36), 24 banked sperm. Among this group, those who banked were younger, more satisfied with clinic appointments and less worried about the health of future children. At T2, there were no differences in quality of life between bankers and non-bankers.Conclusion: For those who are uncertain about future reproductive plans, decisions depend on their health on diagnosis and satisfaction with clinic care. We conclude that extra care should be taken in counselling younger men who may have given little consideration to future parenting. Results support previous findings that the role of the doctor is vital in facilitating decisions, especially for those who are undecided about whether they wanted children in the future or not
Sexual functioning in male survivors of lymphoma: a systematic review
No full textIntroduction: the lymphomas [Hodgkin’s Lymphoma (HL) and Non-Hodgkin’s Lymphoma (NHL)] are among the most common cancers affecting men under 45 years. Survival rates are now excellent, but treatment is associated with a number of side effects including sexual dysfunction with potential implications for compromised QoL (quality of life). Aims: to address the: (i) prevalence of sexual dysfunction among lymphoma survivors relative to the general population, survivors of other cancers, and in survivors of HL and NHL; and (ii) relationships between sexual functioning and disease and treatment, demographic, and psychological variables. Methods: inclusion criteria were quantitative studies that focused on adult male survivors of lymphoma, included a comparison group and presented results separately for HL and NHL. Standardized systematic searches were used. Information about design, sample size, age, time since diagnosis, type of treatment, comparison group, measures and findings were extracted from eligible studies.Results: ten articles met the inclusion criteria, of which nine included patients with HL only, and one included patients with HL or NHL. Sexual function was compromised relative to the general population, better than testicular cancer survivors, and worse than leukaemia survivors. Depression was consistently associated with sexual dysfunction. There was evidence that chemotherapy, relapse, reduced testosterone levels, older age at survey and worse physical QoL were associated with worse sexual function. Conclusions: conclusions are limited by methodological issues including lack of utilization of standardized measures of sexual function and longitudinal research. Even so, there is evidence of sexual dysfunction among lymphoma survivors. Clinicians need to be sensitive to these issues. Future longitudinal work is necessary to determine the likelihood of recovery.<br/
Treatment demands and differential treatment of patients with cystic fibrosis and their siblings: patient, parent and sibling accounts
No full textCystic fibrosis (CF) is a progressive disease with no known cure. Advances in diagnosis and treatment have resulted in patients living longer and thus families live with the illness for longer. Treatments are becoming increasingly demanding and are largely performed in the family home. Mothers are often reported to experience greater stress and poorer adjustment than mothers of well children or population norms. Patients and siblings are also reported to display adjustment difficulties. Siblings have rarely been included in research designs. This qualitative study investigates the impact of CF and treatment on eight patients, eight mothers, one father and eight siblings. A family systems perspective was adopted. Each individual was interviewed independently using semistructured interviews. Patients and siblings were aged between 9 and 21 years. Qualitative analyses revealed high levels of non-adherence (intentional and unintentional) and parental involvement in treatment, minimal involvement of siblings, and preferential treatment towards patients. Demanding treatment, coupled with the progressive nature of CF, promote high levels of parental involvement for younger children as well as older teenagers, often due to attempted or actual non-adherence. Siblings may receive less attention while patients' needs take priority. Future development of a measure of adherence suitable for children and adolescents should take into account different motivations for non-adherence, particularly regarding the level of personal control over adherence to treatment. In addition, the potential impact of having a brother or sister with CF should not be underestimated and the needs of siblings should not go unnoticed.This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site
Health related quality of life (HRQoL) in survivors of lymphoma: a systematic review and methodological critique
No full textSurvival rates for Hodgkin’s Disease and Non-Hodgkin’s Lymphoma have improved in recent years. However, these improvements are associated with various late effects, which can compromise health-related quality of life (HRQoL). Assessment is essential to identify patients at most risk for compromised HRQoL , but is dependent on availability of reliable and sensitive measures. This review therefore aimed to: (i) identify and evaluate commonly used measures; (ii) compare HRQoL in lymphoma patients with the general population; (iii) assess the impact of different treatments on HRQoL; and (iv) identify associations between HRQoL and demographic, medical and psychological variables. Standardized systematic searches identified 18 eligible studies which reported quantitative results by histologic diagnosis and included adult survivors of lymphoma. Information about design, sample, measures and findings was extracted from each study. The SF-36 and the EORTC QLQ-C30 were the most commonly used measures. Survivors of lymphoma experienced worse physical but comparable mental HRQoL to the general population. No conclusions could be drawn about the effects of different treatments on HRQoL. Correlates of better HRQoL included younger age (physical), educational level, being employed, male gender, earlier stage disease, not having co-morbid illnesses, and meeting public health exercise guidelines. Limitations of current research relating to research design, sample demographics and reporting of descriptive statistics were identified. Given the increasing numbers of patients living with lymphoma, controlled studies using cancer-specific instruments are required to determine the extent of physical and psychological consequences associated with the conditio
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