No description available.

Domestic violence and sexual assault (DVSA) are major health issues on which medical schools across the country fail to adequately educate future physicians. According to the National Coalition Against Domestic Violence, one in three women and one in four men will be a victim of intimate partner violence in their lifetime. The same source reports that one in five women are raped in their lifetime. Because of the widespread nature of these societal problems, the aim of this research was to evaluate the benefit of providing medical students with DVSA education. First and second year medical students at the Quillen College of Medicine attended a mandatory educational lecture on DVSA. We designed a survey to assess the attitudes and knowledge surrounding patient care for DVSA survivors. Students volunteered to complete the same survey before and after the lecture. The surveys were evaluated for statistical significance. A paired t-test showed that the 128 students who took the survey reported a significant increase in comfort level on interviewing, performing a physical exam, and explaining resources to victims of DVSA. Questions regarding knowledge of who should lead exams and the role of emergency contraception in cases of sexual assault also showed statistically significant change by paired t-test analysis following the educational intervention. These findings suggest that medical schools should integrate curriculum on DVSA survivor support in order to increase comfort and knowledge of future physicians in addressing these sensitive topics.

Sepsis drabbar årligen 19,4 miljoner människor. Fler och fler människor överlever behandlingen, även om mortaliteten fortfarande är hög. Många av överlevarna drabbas av komplikationer i efterförloppet som påverkar deras framtida livskvalitet. Livskvalitet är ett mångdimensionellt uttryck som har ett flertal olika definitioner. Syftet med examensarbetet var att granska befintlig forskning om hur patienter som har överlevt sepsis upplever sin livskvalitet efter att ha vårdats på en intensivvårdsavdelning. Examensarbetet genomfördes med en integrativ systematisk litteraturstudie som metod. Två huvudteman identifierades, Vem har jag blivit? och Tillgång till världen, med tre subteman vardera, förändrad bild av sig själv, relationsförändringar och känslor efter sepsis samt fysiska följder, kognitiva följer och psykiska följder. Generellt sågs ingen skillnad i livskvalitet mellan en patient med sepsis som hade vårdats på en intensivvårdsavdelning jämfört med en patient som hade vårdats på en intensivvårdsavdelning för andra diagnoser. Patienterna behöver få information om hur kroppen har förändrats och hur de själva kan påverka sin situation. De behöver också få information om var de ska vända sig när de behöver hjälp och stöd efter utskrivning. De behöver få stöd av kompetent personal som är insatta i de komplikationer som intensivvården för med sig. Vidare forskning behövs inte bara för att optimera patienternas överlevnad utan även för att optimera för en god livskvalitet efter intensivvården. / Sepsis affects approximately 19,4 million people each year. An increasing number of people survive the treatment, even though the mortality rate is still high. Many of the survivors are suffering from sequelae that is affecting their quality of life. Quality of life is a multidimensional concept with several definitions. The aim of the study was to examine existing research regarding the patients’ perceptions of their quality of life after a sepsis that required intensive care. The method used was an integrative review. Two main themes were identified, Who have I become? and Access to the world, each with three sub themes, changed view of yourself, changes in relationships and feelings after sepsis and also physical impact, cognitive impact and mental impact. There were no significant differences in quality of life between patients that had been hospitalized and admitted to intensive care for sepsis compared to patients with other diagnoses. Patients need information about how their body has changed and how they can affect their own situation but they also need information about where to turn when they need more help after discharge. They need health care professionals that understand what has happened to their bodies during intensive care and the kind of sequelae that often affects these patients. More research is needed to make sure that patients not only survive, but have a good quality of life after intensive care.

Domestic violence shelters can vary greatly in the services available to victims and their families. The funding shelters receive can impact the shelter’s ability to provide specialized services. Since the availability of services might vary from shelter to shelter, victims can have different experiences based on their location. This cross-sectional study contacted representatives from nine shelters in the State of Florida and asked the representatives nine questions about the services which are available at their respective shelter. The findings from this research show that these nine shelters offer a greater number of services than the study expected. However, there is still a need to better fund domestic violence shelters so that these services can be available to every victim, no matter where the victim resides.

No description available.

The purpose of this hermeneutic phenomenology study was to explore and describe the meaning employees attribute to the lived experiences of returning to work after cancer treatment. Semi-structured interviews were held with eight participants and a thematic data analysis method was used. The results indicate that cancer survivors experience various challenges that make it difficult to function as they did before the diagnosis when they return to work. A critical hermeneutical reflection against the literature followed the structural analysis and resulted in a contextual framework that incorporated the individual and organisational perspective on the various influences involved in supporting cancer survivors to maintain their wellbeing when they return to work. Four phases, repression, comprehension, activation and reintegration, were identified when they tried to cope/adjust on their return to work. The corresponding forms of organisational support they expected through these phases were labelled motivation, information, navigation and stabilisation. / Industrial and Organisational Psychology / M. Com.

This research discusses communication and meaning in the context of orality, using a variety of theoretical perspectives, including memory theory, media and communication theory, and semiotics. Drawing on the work of Walter Ong, it provides new insight about the characteristics and limits of oralnarration by assessing the memes, tropes, and phraseological units in the oral narrations of Armenian Genocide survivors. This research identifies a list of replicable forms of stories and oral devices that are used by the group in question; it then proposes that oral narration of non-fictional topics designed to convey historical or episodic information to others is intuitive, reactive, directed, fuzzy, and sticky. Concerns about the legitimacy and historical value of the narrations under review do not play a role in this research; instead, the focal point is the meaning embedded in the form and structure of the narrations under study.

Introduction : Les évaluations parentales et les évaluations auto-rapportées sur le statut psychologique des enfants ne concordent pas. Des caractéristiques propres aux enfants et parents prédiraient les différences. Objectifs : (1) identifier les accords mères-enfants et pères-enfants sur l’anxiété, la dépression et la détresse de l’enfant (2) évaluer la taille des différences entre les évaluations (3) explorer l’effet prédictif des caractéristiques sociodémographiques (âge de l’enfant, sexe de l’enfant, revenu parental) et des symptômes psychologiques sur les écarts entre les évaluations. Méthodologie : 62 triades enfant-mère-père ont complété des mesures d’anxiété, de dépression et de détresse pour l’enfant. Les parents ont aussi complété une mesure de symptômes psychologiques. Des coefficients de corrélation intraclasse, des tailles d’effets, des graphiques Bland-Altman et des régressions hiérarchiques ont été utilisés. Résultats : Les indices d’accord étaient faibles pour les évaluations mères-enfants et pères-enfants. Les parents avaient tendance à surestimer l’anxiété, la dépression et la détresse de leur enfant. Les tailles de différences étaient modérées. Les symptômes psychologiques des parents prédisaient les écarts entre les évaluations. Conclusion : Nos résultats supportent la méthode multi-informateur pour identifier la détresse chez les jeunes survivants. Des mesures d’ajustements pourraient être développées pour corriger l’effet de symptômes psychologiques élevés sur les évaluations parentales. / Introduction: Cancer care guidelines recommend to evaluate distress, but few studies target young childhood cancer survivors. Parents’ ratings and children’s self-report of anxiety, depression, and distress do not correspond. Children’s or parents’ characteristics could be associated with the gap between ratings. Objectives: (1) identify mother-child and father-child agreement on anxiety, depression and distress ratings (2) evaluate the size of the difference between ratings of parents and children (3) explore the predictive effects of sociodemographic characteristics (child age, child sex, parental income) and of parental psychological symptoms the gap between ratings. Methods: 62 young cancer survivors (<18 years old) and both their parents participated. Parents further completed a measure of psychological symptoms. Intraclass correlation coefficients and sizes of the differences were calculated. Bland-Altman plots and hierarchical regression were used. Results. Agreement ranged from poor to fair for mother-child and father-child ratings. Parents overestimated anxiety, depression, and distress. Moderated effect sizes were found between ratings. Parental psychological symptoms predicted the gap between parents’ and children’s ratings. Conclusion: Our results support a multi-informant strategy to identify distress in young survivors. Adjustment strategies could be developed to account for the effect of elevated parental psychological symptoms on parent’s ratings when they are the only source of available information on the child.

Malgré un intérêt grandissant pour la question du devenir des survivants de tumeur cérébrale pédiatrique, l’évaluation de leur équilibre est souvent négligée. Les objectifs de nos travaux étaient de 1) examiner les écrits portant sur l’équilibre chez les survivants de tumeur cérébrale pédiatrique; 2) comparer l'équilibre debout et la qualité de vie entre les survivants et un groupe d’enfants témoins; et 3) examiner l'association entre l'équilibre debout et qualité de vie chez les survivants. Notre recension des écrits démontra que les survivants de tumeur cérébrale présentent des troubles de l’équilibre, mais les limites méthodologiques des études nous empêchent de conclure de manière définitive. Ensuite, nous avons recruté un groupe d’enfants survivants d’une tumeur cérébrale de la fosse postérieure et un groupe d’enfants sains. Leur équilibre était évalué à l’aide du Bruininks-Oseretsky Test of Motor Proficiency-2nd edition (BOT-2) et du Pediatric Balance Scale (PBS). Certains participants ont aussi été évalués avec une plate-forme de force où les limites de stabilité étaient documentées. Finalement, tous les enfants et leurs parents remplissaient le Pediatric Quality of Life Inventory (PedsQL4.0). Nos résultats démontrent que les survivants présentent une diminution de l’équilibre mise en évidence par le BOT-2, mais que leur qualité de vie est similaire aux enfants sains. La performance au BOT-2 est associée à la dimension physique du PedsQL4.0, suggérant une relation entre l’équilibre et la qualité de vie. Nos résultats suggèrent qu’une évaluation de l’équilibre pourrait être bénéfique chez cette clientèle afin de mieux cerner ses besoins de réadaptation. / There is growing interest in studying outcomes in survivors of pediatric brain tumours. Physical outcomes, especially balance abilities, are less investigated. Objectives of this thesis are to: 1) examine the literature for balance outcomes in survivors of pediatric brain tumours, 2) compare standing balance and health-related quality of life (HRQOL) between survivors of pediatric posterior fossa brain tumours (PFBT) and typically-developing controls and 3) explore the association between balance and HRQOL. A comprehensive review demonstrated that although the literature suggests that survivors of pediatric brain tumours display ongoing balance deficits, studies have limitations, emphasizing the need for further research. Survivors of pediatric PFBT and typically-developing children were recruited and their balance assessed with the Bruininks-Oseretsky Test of Motor Proficiency-2nd edition (BOT-2) and Pediatric Balance Scale (PBS). Dynamic balance was also evaluated for some participants using a force platform. The Pediatric Quality of Life Inventory measured HRQOL. Statistical analyses included Mann-Whitney U tests to compare results between groups and Spearman's rank correlation coefficient to determine the association between balance and HRQOL. Balance abilities were significantly worse in survivors as measured by the BOT-2. The PBS displayed a ceiling effect. Certain laboratory outcome measures suggested balance difficulties. All participants’ HRQOL scores were within normative values. In survivors, an association was found between BOT-2 scores and the physical dimension of HRQOL. Survivors of PFBT demonstrate persistent balance difficulties, best assessed by the BOT-2; however, they report normal HRQOL. Future research should be collaborative and focus upon the best ways to manage balance deficits.

Social acceptance and peer and romantic relationship self-efficacy were examined as salient factors related to social development among emerging adult (ages 18 to 25) survivors of pediatric cancers. Using a cross-sectional, within-groups methodology, relationships between cancer treatment intensity and peer and romantic relationship self-efficacy and social acceptance were assessed. Perceived health vulnerability, situational coping style, parent and peer attachment, and perceived physical attractiveness were explored as moderators of peer and romantic relationship self-efficacy and social acceptance. Additionally, social acceptance was examined within a cancer stereotyping framework. Fifty-two emerging adult survivors of pediatric cancers (54% male; mean (M) age = 21.38 years, standard deviation (SD) age = 3.11 years) completed self-report questionnaires. Participants were diagnosed between ages 5 and 19 (Mage = 12.59 years, SDage = 4.57 years) and were at least six months post-active treatment (Mtime = 7.32 years, SDtime = 4.46 years). Simultaneous regression analyses indicated that health vulnerability, coping style, parent and peer attachment, and physical attractiveness together accounted for a significant amount of variance in peer and romantic relationship self-efficacy and self-perceived social acceptance. There were significant main effects of perceptions of physical attractiveness and peer attachment on peer relationship self-efficacy and self-perceived social acceptance. There was also a main effect of perceived physical attractiveness on romantic relationship self-efficacy. However, treatment intensity was not significantly related to peer or romantic relationship self-efficacy or social acceptance. Furthermore, there were no significant moderating effects of health vulnerability, coping, parent or peer attachment, or physical attractiveness on the relationship between treatment intensity and peer or romantic relationship self-efficacy or social acceptance. In terms of social acceptance, participants believed that others’ viewed them as more socially accepted than they viewed themselves. Participants also rated a hypothetical peer with cancer as less socially accepted than healthy peers. Results suggest greater perceived physical attractiveness and stronger attachment to peers may be strongly related to greater relationship confidence and feelings of being socially accepted. Survivors may also hold stereotyped views of their own level of social acceptance and the social acceptability of peers diagnosed with cancer. Future research and interventions implications are considered.