Suicide among college students is a long-standing problem and has received considerable attention within the field of suicidology and beyond. The identification of risk and protective factors, theories related to college student suicide, and prevention, intervention and postvention efforts all reflect the solid basis of research that has been completed on college student suicide. In an attempt to further understand suicide among college students, the current study employed a novel methodological approach, one that explores suicide though college student suicide attempt survivors (N=7), and utilized a qualitative method for data analysis. The use of consensual qualitative research (CQR) was used as a way to gain a more in-depth understanding of the participants’ experiences (related to what led up to their attempts, what occurred in the aftermath of their attempts, and how the attempts have been integrated into their present day life). Results of the study built upon previous research and provided important implications for both the treatment of college student suicide attempt survivors (and other at-risk students) and suicide prevention efforts on college campuses. The study offered a new perspective and understanding on an old and complex phenomenon.

Thesis (Ph. D.)--State University of New York at Binghamton, Comparative Literature Department, 2005. / Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

This study examined the relationship between spirituality/religiousness and quality of life and the moderating effect of comorbid illness in a sample of 308 long-term cancer survivors who had received an initial primary cancer diagnosis of breast, prostate, colorectal, and Hodgkin's disease at least 5 prior to the beginning of the study. In addition to the self-report measures assessing the variable of interest, participants completed a set of socio-demographic items and several questions related to their cancer treatment at entry into the study (T1) and at a second assessment 12 months later (T2). Results showed that each spirituality/religiousness and comorbidity was significantly related to various aspects of quality of life at both time points of assessment. More specifically, spirituality/religiousness was significantly associated with greater cancer benefits, enhanced general quality of life, lower sexual dysfunction, but unexpectedly, greater family-related distress at T1. Similarly, comorbidity significantly related to more financial problems, worries about appearance, and pain at both time points. Greater comorbidity was also significantly associated with more sexual dysfunction and lower general quality of life at T1. Findings also provided supported for the moderating role of comorbidity on various domains of quality of life both concurrently (i.e., family-related distress and appearance concerns) and prospectively (i.e., family-related distress and pain). In some cases, the direction of the interaction effect was in the predicted direction such that greater spirituality/religiousness related to lower family-related distress (prospectively) and more appearance concerns (concurrently at T2) among survivors with a new comorbidity, for example. In other cases, the direction of the interaction was contrary to expectations, such that higher spirituality/religiousness was associated with greater family-related distress (concurrently at T1) and more pain (prospectively) among the group of survivors with greater comorbidity. Possible explanations for the apparently inconsistent findings are offered as well as recommendations for future research.

The concept of sickness behavior offers a framework to view both the neurovegetative and psychological symptoms that accompany illness as a common entity that results from increased inflammatory activation. Despite the prevalence of sickness behavior in medical populations, to our knowledge this study provides the first attempt to develop a standardized measure to assess sickness behavior using standard self-report questionnaires commonly used with cancer patients. The set of items included in the measure match theoretical conceptualizations of sickness behavior and target symptoms that comprise anhedonia, depressed mood, cognitive dysfunction, social disinterest, fatigue, low libido, poor appetite, somnolence, sensitivity to pain, and malaise. The measure showed high internal consistency, adequate test-retest reliability, and good convergent validity with both psychological and biological correlates. A confirmatory factor analysis also determined that a two-factor, rather than a single-factor measurement model, encompassing a physical and a psychological sickness symptom dimension, accounted for sickness behavior. Future psychometric work is still needed to further validate this new practical assessment tool. Descriptive analyses revealed relatively low levels of sickness behavior symptoms in the sample as a whole with both physical and psychological sickness behavior symptoms exhibiting a significant linear decrease over time. As expected, both physical and psychological sickness behavior symptoms showed associations with two pro-inflammatory cytokine markers, IL6 and TNF-alpha and a neuroendocrine marker, cortisol. Longitudinal associations suggest that higher levels of the pro-inflammatory cytokine TNF-alpha may impact the progressive decline of physical sickness symptoms over time with symptoms taking longer to disappear. Because cortisol was associated with more rather than less physical sickness symptoms, results raise the question of whether the anti-inflammatory neuroendocrine activity may be dysregulated in breast cancer survivors. The mechanistic basis for these associations requires further examination. In this study it was also evaluated whether a cognitive behavioral stress management intervention and relaxation training intervention could reduce sickness symptoms over time. Breast cancer survivors were assessed at baseline and then randomly assigned to a 10-week cognitive behavioral stress management intervention (N = 70) or a 1-day control condition (N = 55). Psychosocial measures, urine, and blood were obtained from participants at 3 months, 6 months, and 12 months post-intervention to assess relevant behavioral, endocrine and immune variables. Relative to the control group, the experimental group showed marginally more prevalence of physical sickness behavior symptoms in the short term (post-intervention, 3-months; p = .08) and a steadier decline of symptoms in the long-term (15-month follow-up period). The adaptive nature of sickness behavior as a motivational strategy that helps restore homeostatic balance in the long run may be one possible interpretation of these results. Whether these intervention effects on sickness behavior were mediated by changes in pro-inflammatory cytokines or cortisol was examined but not supported by these data and needs to be further examined in future studies.

The purpose of this study was threefold; to examine the unique challenges faced among young breast cancer survivors’ self-concepts; to explore the identity reformulation process as they adjust to a new lifestyle after completing medical treatment; and to identify women’s creative problem solving solution used to mitigate any long-term distress and discontinuity between past, current and ideal selves. In-person semi-structured interviews were conducted with 10 young breast cancer survivors (aged 32-45). The results indicated that exploring women’s narratives through the identity reformulation process created an alternative approach to the four prescribed quality of life domains used to understand survivors’ overall wellbeing. The results also identified three shared domains of social location (gender, youth and health status) that intersected in women’s identity reformulation process. These findings have implications for psychosocial oncology literature, as well as clinical practice for mental health practitioners. Limitations and recommendations for areas of future research were discussed.

The long-term natural history of ovarian reserve after adjuvant chemotherapy for breast cancer has been poorly described. We recruited 52 breast cancer survivors treated with adjuvant chemotherapy before 40 years of age who remained premenopausal after chemotherapy treatment. Twenty (38.5%) were more than five years out from treatment. Ovarian reserve estimates were compared with a control group. Anti-Müllerian hormone (AMH), follicle stimulating hormone and luteinizing hormone demonstrated significant differences consistent with reduced ovarian reserve in breast cancer survivors. Mean AMH was 6.65 pmol/l in survivors compared to 17.43 in controls (p < 0.001). Attained age and age at the time of treatment were correlated with AMH levels in breast cancer survivors. Conclusion: Ovarian reserve is significantly reduced in young breast cancer survivors. Age is the major predictor of AMH level in survivors. A 35 year old breast cancer survivor has an AMH level similar to a 45 year old control.

The long-term natural history of ovarian reserve after adjuvant chemotherapy for breast cancer has been poorly described. We recruited 52 breast cancer survivors treated with adjuvant chemotherapy before 40 years of age who remained premenopausal after chemotherapy treatment. Twenty (38.5%) were more than five years out from treatment. Ovarian reserve estimates were compared with a control group. Anti-Müllerian hormone (AMH), follicle stimulating hormone and luteinizing hormone demonstrated significant differences consistent with reduced ovarian reserve in breast cancer survivors. Mean AMH was 6.65 pmol/l in survivors compared to 17.43 in controls (p < 0.001). Attained age and age at the time of treatment were correlated with AMH levels in breast cancer survivors. Conclusion: Ovarian reserve is significantly reduced in young breast cancer survivors. Age is the major predictor of AMH level in survivors. A 35 year old breast cancer survivor has an AMH level similar to a 45 year old control.

<p>Many survivors of pediatric brain tumors and leukemia will experience cognitive, academic, and social difficulties that will significantly impact their quality of life. Of these, the least is known about the nature and range of survivors' social difficulties. Using a model developed for children with traumatic brain injury, the objective of the current study was to evaluate the neurocognitive and social-cognitive skills that may determine social outcomes in survivors of pediatric brain tumors and leukemia. A sample of survivors of childhood cancer aged 8 to 16 (n = 19) was compared to two control groups - children with ADHD (n = 10) and typically-developing children (n = 41) - on measures of neurocognitive skills, social-cognitive skills, and social experience. Results revealed that survivors demonstrated significant deficits in all domains as compared to typically-developing children. Evaluation of the model revealed that neurocognitive and social-cognitive skills were significant predictors of social experience. More specifically, attention problems and facial expression recognition were significant individual predictors. Survivors of pediatric cancer may experience deficits in social functioning that will impact their quality of life. Further assessment of the skills that influence social outcomes will be particularly important as a means for developing evidence-based interventions.</p> / Dissertation

Abstract The ratio of unemployment in 2000 is 2.99%. The ratio of unemployment in 2001 is 4.57%. The ratio of unemployment in 2002 is 5.17%(narrow sense). The ratio of unemployment in 2002 is 7.26% (broad sense). They achieve the highest record in history at the same time. Mention as above we know unemployment has become the most serious problem in Taiwan now. The top three motorcycle companies in Taiwan are KYMCO, SYM, and YAMAHA which have different business styles, so there must be some differences in design and practice of downsizing programs. Finding the same points and the differences in downsizing programs are the motives of this research. And forming experience rules for business to use can show the value of this research. On the other side, we can find manpower market problems in manufacturing industries in Taiwan from researching Taiwan motorcycle industries. The quantities method researches about quitting are very popular recently. Although the research contents can provide many ideas for business, the business truly needs the know-how of planning in advance and implementing steps in downsizing programs that are key factors whether the downsizing programs can smoothly succeed or not. But we seldom read such descriptive researches that business readers really want to consult. This research tries to discuss with process design and tasks of every stages of downsizing programs according to time axis. Secondary data are from newspapers, periodical, thesis, books, company publication, and network. Primary data come from case companies interview (the first step) and questionnaire (the second step). The objects who this researcher interviews are HR department managers of KYMCO, SYM, and YAMAHA. The in-depth interview of the first step¡Gthis research analyzes the origin of downsizing programs from business condition, gets together the practice process and situation of downsizing programs from history vestige, records the improved activities after downsizing programs from holding the present situation, and describes business vision from future chance. The questionnaire of the second step¡Gtry to understand the feeling that personnel matters workers feel at heart in carrying out downsizing programs, the opinions that personnel matters workers think about downsizing programs, the belief that decision-making managers have to personnel matters workers¡¦ professional performance in downsizing programs. From the comparison and analyses of interview data of case companies, we can clearly know the cause, entire process, and effect of downsizing programs of the top three motorcycle companies in Taiwan. At last this research submits the related proposals from different views¡Gthe proposal for employees (create high additional value), the proposal for government (create occupation advantage by improving political and economical environment), the proposal for business (laws side. human kindness side. management side. implementation side ), the proposal for case companies (strategy. internation. system. science and technology).