Sentimentos e percepções do luto de sobreviventes ao suicídio de jovens / Feelings and perceptions of grief among survivors of youth suicide / Sentimientos y percepciones de duelo entre sobrevivientes de suicidio de jóvenes

Sobreviventes ao suicídio são pessoas que têm suas vidas profundamente afetadas e apresentam sofrimento psicológico, físico ou social após serem expostas a esse fato. O objetivo deste estudo foi analisar a experiência de sobreviventes ao suicídio de jovens, a partir do luto. Participaram sete sobreviventes entre familiares, amigos e parceiros amorosos de jovens que cometeram suicídio. A análise de conteúdo de entrevistas narrativas apontou que os participantes utilizam explicações racionalizadas ou dissociadas, criando uma distância entre o evento e eles mesmos. Como formas de lidar com o sofrimento podem buscar o isolamento, apoio entre amigos, prática religiosa e/ou a dedicação ao trabalho. Reafirma-se a dimensão do luto diante dessa experiência, além da importância da prevenção ao suicídio e da posvenção aos sobreviventes.(AU)

Suicide survivors are people who have their lives deeply affected; they experience psychological, physical, and social suffering following the occurrence. The aim of this study is to analyze the experience of survivors of youth suicide attempts, based on grief. Seven survivors participated among family, friends, and romantic partners of young people who committed suicide. The content analysis of narrative interviews showed that the participants use rationalized or dissociated explanations, creating a distance between the event and themselves. As ways to deal with suffering, they seek isolation, support among friends, religious practice, and/or dedication to work. The dimension of grief in the face of this experience is reaffirmed, as well as the importance of suicide prevention and postvention for survivors.(AU)

Este artículo tiene como objetivo presentar la construcción metodológica desarrollada en una investigación de maestría, en la que sostenemos la escritura de escenas como método de investigación de la escucha clínica. Las escenas del trabajo en cuestión se recogieron a lo largo del tiempo desde la experiencia en un proyecto de extensión universitario de atención a la niñez y adolescencia en situación de vulnerabilidad social aplicado en una comunidad periférica. En este texto, presentamos los interrogantes que se elaboraron en torno a la elección por el trabajo con escenas y compartimos el rescate histórico de las mismas como un método de escribir la clínica y la reanudación del análisis a partir de la tradición psicoanalítica. Amparadas en el psicoanálisis y en lecturas y contribuciones del filósofo francés Jacques Derrida, nos basaremos en la noción de que la escena se constituye como un lugar de producción, engendrando la configuración particular de elementos significantes en los procesos de subjetivación y de construcción social. La escena no es aquí una representación de lo que pasa en la clínica, sino un modo de producir escucha y sus procesos de investigación.(AU)

The risks of the new morbidities acquired during pediatric onco-critical care and their life-shortening effects

Abstract Objective: The authors investigated the functional status at ICU admission and at hospital discharge, and the impact of dysfunctions on survivors' lifespan. Method: Single-center retrospective cohort. The FSS (Functional Status Scale) was calculated at ICU admission and at hospital discharge. A new morbidity was defined as an increase in FSS ≥ 3. Results: Among 1002 patients, there were 855 survivors. Of these, 194 (22.6%) had died by the end of the study; 45 (5.3%) had a new morbidity. Means in the motor domain at admission and discharge were 1.37 (SD: 0.82) and 1.53 (SD 0.95, p = 0.002). In the feeding domain, the means were 1.19 (SD 0.63) and 1.30 (SD 0.76), p = 0.002; global means were 6.93 (SD 2.45) and 7.2 (SD 2.94), p = 0.007. Acute respiratory failure requiring mechanical ventilation, the score PRISM IV, age < 5 years, and central nervous system tumors were independent predictors of new morbidity. New morbidity correlated with lower odds of survival after hospital discharge, considering all causes of death (p = 0.014), and was independently predictive of death (Cox hazard ratio = 1.98). In Weibull models, shortening in the life span of 14.2% (p = 0.014) was estimated as a new morbidity. Conclusions: New morbidities are related to age, disease severity at admission, and SNC tumors. New morbidities, in turn, correlate with lower probabilities of survival and shortening of the remaining life span. Physical rehabilitation interventions in this population of children may have the potential to provide an increase in lifespan.

Physical activity of children with cancer during the COVID-19 pandemic: what were the most relevant studies published from August 2019 to July 2021? / Actividad física em niños con cáncer durante la covid-19: ¿cuáles fueron las publicaciones más relevantes entre agosto de 2019 y julio de 2021? / Atividade física de crianças com câncer durante a covid-19: o que foi publicado de mais relevante entre agosto de 2019 e julho de 2021?

ABSTRACT This study aims to investigate up-to-date scientific information about physical activity, COVID-19, and childhood cancer. This study is an integrative review. Research was conducted in the Science Direct database, using keywords in three different combinations. In total, 50 publications classified as the most relevant of each keyword combination were selected, 26 eligible publications were reached from August 2019 to July 2021, of which nine were duplicates. When exclusion criteria were applied, 11 complete studies were selected. The level of physical activity (PA) of children diagnosed with cancer or those who survived cancer is low. Changes due to the COVID-19 pandemic include the decrease in the level of PA and the increase in the use of technological devices. The minimum PA recommendations for this population vary but some evidence supports its importance and benefits in minimizing the adverse effects arising from cancer and from the performed medical treatment. Exercise-based interventions should be chosen and carried out considering the type of cancer and the stage of treatment the child is in due to the evidence of its effectiveness.

RESUMEN Este estudio tiene como objetivo investigar, en la base de datos ScienceDirect, la información científica actualizada sobre actividad física, COVID-19 y cáncer infantil, mediante una revisión integradora, en la cual se utilizaron las palabras clave en tres combinaciones diferentes. Se seleccionaron cincuenta publicaciones clasificadas como las más relevantes de cada combinación, y se alcanzaron 26 publicaciones elegibles en el periodo entre agosto de 2019 y julio de 2021, de las cuales nueve fueron textos duplicados. Al aplicar los criterios de exclusión, se seleccionaron 11 artículos completos. El nivel de actividad física (AF) de los niños diagnosticados de cáncer o supervivientes de cáncer es bajo, y entre los cambios provocados por la pandemia de la COVID-19 se encuentran la disminución del nivel de AF y el aumento en el uso de dispositivos tecnológicos. Las recomendaciones mínimas de AF para esta población varían entre sí, sin embargo, existe evidencia que respalda su importancia y los beneficios en la minimización de los efectos adversos derivados del propio cáncer y del tratamiento médico realizado. Las intervenciones basadas en ejercicios, para la cual ya existe evidencia de efectividad, deben elegirse y llevarse a cabo teniendo en cuenta el tipo de cáncer y la etapa de tratamiento en la que se encuentra el niño.

RESUMO O objetivo deste trabalho é investigar, na base de dados Science Direct, informações científicas sobre atividade física, covid-19 e câncer infantojuvenil, através de uma revisão integrativa, utilizando três combinações de palavras-chave. Cinquenta publicações mais relevantes de cada combinação de palavras-chave foram selecionadas, e chegou-se a 26 artigos elegíveis no período compreendido entre agosto de 2019 e julho de 2021, dos quais nove eram textos duplicados. Aplicando-se os critérios de exclusão, foram selecionados 11 estudos completos. Constatou-se que o nível de atividade física (AF) de crianças com câncer ou sobreviventes do câncer é baixo e que entre as mudanças causadas pela pandemia de covid-19 estão a diminuição do nível de AF e o aumento do uso de dispositivos tecnológicos. As recomendações mínimas de AF para essa população variam, entretanto há evidências que sustentam sua importância e seus benefícios ao minimizar os efeitos adversos oriundos do próprio câncer e do tratamento médico realizado. As intervenções baseadas em exercícios, para as quais já há evidência de eficácia, devem ser escolhidas e realizadas a partir do tipo de câncer e na fase do tratamento em que a criança está.

Transformation and Breaking of Cancer Metaphyor: Study on Self-narrative of Cancer Patients / 中国医学伦理学

After cancer became the number one public enemy threatening global life and health in the 20th century, it was given various negative metaphors. As cancer mortality rates rise, cancer metaphors gradually spread to various corners of society and cause public panic. In the 1970s, China and the United States each appeared a female cancer survivor, Lin Guo and Susan Sontag. Both of them noticed the dual marginalization faced by cancer patients in China and the United States in social and medical fields during their own cancer and treatment processes. To reverse the situation of cancer patients, they actively engaged in social actions. Their actions not only helped to enhance the subjectivity and initiative of cancer patients, but also downplayed the growing fear of cancer in Chinese and American society at that time due to cancer metaphors. Based on the personal diaries and biographies of Lin Guo and Sontag, this paper elaborated on how these two women transformed and broke the metaphor of cancer in different social cultures and reconstructed the social significance of cancer from their life experiences such as family and upbringing environment, educational and work experiences, cancer and treatment.

¿La Respuesta Psicofisiológica de Estrés-Relajación es la Misma en todas las Pacientes Sobrevivientes de Cáncer? / Is the Psychophysiological Stress-Relaxation Response the Same in all Cancer Survivors?

Resumen Un sobreviviente de cáncer padece continuamente manifestaciones autonómicas debidas a la enfermedad, su tratamiento oncológico, y el estrés psicológico con que se enfrenta continuamente. Una de las medidas psicofisiológicas utilizada para la valoración del estrés es la disminución de la temperatura periférica. En contraparte, los procedimientos psicológicos de relajación para el manejo de estrés buscan incrementar la temperatura. Sin embargo, se desconoce si esta respuesta es igual en todas pacientes. El objetivo de esta investigación fue examinar los cambios de temperatura durante un protocolo de estrés psicosocial y relajación en pacientes sobrevivientes de cáncer de mama. Adicionalmente, se evaluó el autorreporte de dolor y su interferencia con el funcionamiento psicosocial. Los resultados mostraron variaciones de temperatura periférica en las pacientes; sin embargo, no todas las pacientes presentaron el mismo patrón de temperatura, encontrando 3 subgrupos de pacientes, cuyas trayectorias lineales de temperatura permitieron generar un pronóstico afectivo para el manejo de estrés. Por autorreporte, no se encontraron diferencias psicosociales entre los subgrupos, aunque sí se encontró una asociación inversa entre la interferencia del sueño y la temperatura periférica. Se concluye que la temperatura periférica permite distinguir a las pacientes que se les dificulta el manejo del estrés psicosocial de aquellas que se benefician de los procedimientos psicológicos de relajación.

Abstract A cancer survivor continually suffers from autonomic manifestations due to the disease, their cancer treatment, and the psychological stress they continually face. One of the psychophysiological measures used to assess stress is the decrease in peripheral temperature. In contrast, psychological relaxation procedures for stress management seek to increase temperature. However, it is unknown if this response is the same in all patients. This research examined breast cancer survivors' temperature changes during psychosocial stress and relaxation protocol. Additionally, self-reported pain and its interference with psychosocial functioning were evaluated. The results showed peripheral temperature variations in the patients; however, not all patients presented with the same temperature pattern, finding three subgroups of patients whose linear temperature trajectories allowed generating an affective prognosis for stress management. By self-report, no psychosocial differences were found between the subgroups, although an inverse association between sleep interference and peripheral temperature was found. It is concluded that peripheral temperature distinguishes patients who find it challenging to manage psychosocial stress from those who benefit from psychological relaxation procedures.

Relationship between Late Effects and Social Distress in Head and Neck Cancer Survivors More Than One Year After Radiation Therapy

Purpose: To investigate the relationship between late effects and social distresses in head and neck cancer survivors more than one year after radiotherapy. Method: An existing subset of head and neck cancer-specific quality of life scale was used to assess late effects and social distresses in survivors who had completed radiotherapy for more than 1 year. Descriptive statistics were performed for each social distresses and symptom, and were analyzed their association. Results: Seventy-three people responded to the survey. All patients had some symptoms. The most prevalent and severe late effect was dry mouth (79.5%). In addition, the most prevalent social distress was trouble with social eating (87.7%), and the most severe was speech problems. There was a significant positive correlation between late effects and social distresses. Social distresses were associated with dysphagia and sticky saliva and a history of surgery. Conclusion: Head and neck cancer survivors may have multiple late effects and social distresses at the same time, and there are a need for a comprehensive assessment of the impact of symptoms in the outpatient setting.

Investigation of leprosy survivors in Fengxian District， Shanghai / 上海预防医学

Objective:To understand the current living and health status of leprosy survivors in Fengxian District， Shanghai， and to provide scientific evidence for improving their quality of life. Methods:In January 2018-June 2020， professionally trained CDC staff performed a household investigation on 41 patients with leprosy （case group） and 82 non-leprosy persons （control group） every year. Living and health status， and routine laboratory examinations such as blood pressure， blood glucose， and blood lipids were monitored. Results:Majority of the patients with leprosy had low educational level （68.29% being primary school） and were mostly farmers （51.22%）.The patients had abnormal residual Ⅱ level 5 （12.20%） and mostly were tb-like （TT） （53.66%）. Moreover， some patients were not incapacitated （46.34%）， had no family financial difficulties （29.27%）， did not acquire the national subsistence allowance policy （58.54%）， and asked for "regular physical examination" （68.29%）.Compared to the 82 control persons， the patients with leprosy had significantly different body mass index （BMI） and blood pressure （P<0.05）. Conclusion:Living and health status of leprosy survivors in Fengxian District remains to be further improved. The China Disabled Persons’ Federation （CDF）， Red Cross， civil affairs， and health administration need to further strengthen the cooperation.

A comprehensive review of the healthy worker effect in occupational epidemiological studies

The reduction of mortality and morbidity rates among occupational cohort studies may be attributed to the presence of the healthy worker effect (HWE). Occupational epidemiologic studies investigating worker’s health are prone to the risk of having the HWE phenomenon and this special form of bias has been debated over the years. Hence, it’s imperative to explore in-depth the magnitude and sources of HWE, and further, elucidate the factors that may affect HWE and strategies reducing HWE. The HWE should be considered as a mixed bias between selection and confounding bias. The validity threats due to the HWE among morbidity studies are the same as the mortality studies. The consequent reduction due to the HWE in the association between the exposure and outcome may lead to underestimating some harmful exposures in the workplace or occupational settings. Healthy hire effect and healthy worker survivor effect are the main sources of HWE. Several factors can increase or decrease the probability of HWE; therefore, the investigators should consider them among future occupational epidemiological studies. Many strategies can help in reducing the impact of HWE, but each strategy has its weaknesses and strengths. Not all strategies can be applied among all occupational epidemiological studies. Mathematical procedures still need further investigations to be validated. HWE is a consequence of inappropriate comparison groups in nature. The usage of the general population as a reference group is not an appropriate choice. By considering the HWE sources and factors and using appropriate strategies, the impact of HWE may be reduced.

Factors affecting quality of life of cervical cancer patients: A multivariate analysis

Objective: The aim of good management for cancer survivors should not be limited to only clinical care, but rather it should also include best quality of life (QOL). The objective of this study was to find out various factors affecting QOL in cervical cancer patients so that by modifying these factors, the best QOL can be provided to them. Materials and Methods: This was a prospective cohort study conducted in the Department of Obstetrics and Gynaecology and Department of Radiotherapy, King George's Medical University (KGMU), Lucknow, from May 2015 to July 2016. The cases were selected from patients visiting the outpatient department or who were admitted to the Department of Obstetrics and Gynaecology and Department of Radiotherapy, KGMU. The data information was collected in the form of face-to-face interview using European Organization for Research and Treatment of Cancer general cancer QOL Score 30 (EORTC QLQ C-30) and EORTC QOL questionnaire cervical cancer module (QLQ CX-24) questionnaire. Results: QOL was assessed in 85 patients. Health-related QOL was separately studied in terms of overall general QOL and cancer cervix-specific QOL, and various factors affecting QOL were studied by multivariate analysis. Conclusion: Education, tobacco use, degree of differentiation of tumor, and size of tumor were the independent factors found to have statistically significant effect on QOL of cervical cancer survivors

Comparison of quality of life and depression between hematopoietic stem cell transplantation survivors and their spouse caregivers

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an exhausting process that impacts both the patient and caregiver. METHODS: This was a cross-sectional, HSCT survivor-spouse caregiver matching study to determine quality of life (QoL) and depression among HSCT survivors and their caregivers. QoL and depression were measured with the World Health Organization Quality of Life: Brief Version (26 items) and the 9-item Patient Health Questionnaire, respectively. Data from 97 married couples were analyzed. RESULTS: There were no significant differences in overall QoL and psychological, social, and environmental health between survivors and spouse caregivers (P=0.345, 0.424, 0.415, and 0.253); however, physical QoL was better in the spouse caregiver group (P=0.011). There was no difference in mean depression scale scores (5.3 vs. 5.1, P=0.812) or proportion of severe depression (15.6% vs. 13.7%, P=0.270) between the two groups. We found that family income had a significant impact on overall QoL and environmental health among spouse caregivers (P=0.013 and 0.023), and female gender, co-morbidities, and family income were the important factors associated with depression among spouse caregivers (P=0.007, 0.017 and 0.049). CONCLUSION: This study found that there were no significant differences in QoL or level of depression between HSCT survivors and their spouse caregivers. Family income, gender, and co-morbidities showed significant association with spouse caregiver distress.

Risk Assessment for Metalworking Fluids and Respiratory Outcomes

BACKGROUND: Metalworking fluids (MWFs) are mixtures with inhalation exposures as mists, dusts, and vapors, and dermal exposure in the dispersed and bulk liquid phase. A quantitative risk assessment was performed for exposure to MWF and respiratory disease.METHODS: Risks associated with MWF were derived from published studies and NIOSH Health Hazard Evaluations, and lifetime risks were calculated. The outcomes analyzed included adult onset asthma, hypersensitivity pneumonitis, pulmonary function impairment, and reported symptoms. Incidence rates were compiled or estimated, and annual proportional loss of respiratory capacity was derived from cross-sectional assessments.RESULTS: A strong healthy worker survivor effect was present. New-onset asthma and hypersensitivity pneumonitis, at 0.1 mg/m3 MWF under continuous outbreak conditions, had a lifetime risk of 45%; if the associated microbiological conditions occur with only 5% prevalence, then the lifetime risk would be about 3%. At 0.1 mg/m3, the estimate of excess lifetime risk of attributable pulmonary impairment was 0.25%, which may have been underestimated by a factor of 5 or more by a strong healthy worker survivor effect. The symptom prevalence associated with respiratory impairment at 0.1 mg/m3 MWF was estimated to be 5% (published studies) and 21% (Health Hazard Evaluations).CONCLUSION: Significant risks of impairment and chronic disease occurred at 0.1 mg/m3 for MWFs in use mostly before 2000. Evolving MWFs contain new ingredients with uncharacterized long-term hazards.

Saccharum angustifolium (Nees) Trin. (Poales: Poaceae) as hibernacle for stink bugs during the soybean and corn off-season in Southern Brazil / Saccharum angustifolium (Nees) Trin. (Poales: Poaceae) como hibernáculo para percevejos durante a entressafra de soja e milho no sul do Brasil

Host plants are key factors in the survival of true bugs during unfavorable periods. The objective of this study was to evaluate the composition, diversity and abundance of pentatomid bugs in Saccharum angustifolium (Nees) Trin. (Poales: Poaceae). Plants were evaluated during the soybean and corn off--season for five years. A total of 250 plants were sampled, the true bug population was counted and used for statistical and faunistic analysis. We observed the occurrence of the species: Euschistus heros (F.), Dichelops furcatus (F.), Dichelops melacanthus (Dallas), Edessa meditabunda (F.), and Edessa ruformaginata (De Geer). Among the species, the highest population density was verified for E. meditabunda, E. heros, and D. furcatus. We also observed a direct effect of the clump diameter on the population density of E. heros, D. furcatus, and E. meditabunda. Finally, we conclude that S. angustifolium plants serve as adequate hibernacles for the survival of true bugs of economic importance during the soybean and corn off-season.(AU)

Plantas hospedeiras são fatores fundamentais na sobrevivência de percevejos durante períodos desfavoráveis. O objetivo deste trabalho foi avaliar a composição, diversidade e abundância de espécies de percevejos pentatomídeos ocorrentes em plantas de Saccharum angustifolium (Nees) Trin (Poales: Poaceae). As plantas foram avaliadas durante a entressafra de soja e milho por cinco anos. Foram amostradas 250 plantas, sendo a população de percevejos contabilizada e utilizada para a análise estatística e faunística. Observamos a ocorrência das espécies: Euschistus heros (F.), Dichelops furcatus (F.), Dichelops melacanthus (Dallas), Edessa meditabunda (F.) e Edessa ruformaginata (De Geer). Entre as espécies, foi verificada uma maior densidade populacional para E. meditabunda, E. heros e D. furcatus. Observamos, também, o efeito direto do diâmetro de touceira sobre a densidade populacional de E. heros, D. furcatus e E. meditabunda. Por fim, concluímos que plantas de S. angustifolium servem como hibernáculos adequados para a sobrevivência de percevejos de importância econômica durante a entressafra de soja e milho.(AU)

Cancer Survivors and Returning to Work Perspectives from Occupational Health Physicians in Korea

BACKGROUND: This study was conducted from an occupational health perspective to document cancer survivors' ability to return to work, the role of clinical care, and the current status of effective return-to-work. METHODS: This cross-sectional study was conducted to evaluate the experiences and opinions of occupational health physicians (OHPs) regarding cancer survivors' return-to-work. A self-reported survey was conducted from December 30, 2015, to January 30, 2016, targeting 337 OHPs. Questions included: 1) treatment experiences of survivors in the words of OHPs, 2) current status of the assessments of fitness for work of cancer survivors, 3) experiences associated with workplace and treatment, and 4) problems of returning to work and overcoming system. RESULTS: Only 25% of the respondents said that they had experience treating cancer survivors, and the average number of patients was 12.6 per annum, which indicated that few cancer survivors were treated. Eleven cases included conducting assessment of fitness for work. There were 17 respondents who did not treat cancer survivors. Both those who had and did not have experience in treating survivors showed higher musculoskeletal system disorders (53.8 vs. 63.5) than cancer (15.5 vs. 11.2) in terms of frequency of the diseases in the assessment of fitness for work. Most respondents said that OHPs evaluate the current role appropriately and preferred OHPs in the future. They responded that OHPs found it difficult to treat cancer survivors, and it was psychologically tough to communicate with them (61.4%). Regarding the association of patient rehabilitation with workplaces, 48.9% said that workplaces provide inadequate support. CONCLUSION: As a preliminary study, we found that OHPs were found to have little experience in treating cancer survivors and undergo difficulties owing to poor collaboration with workplaces and communication with patients. This study will provide basic data for future studies to promote cancer survivors' return to workplaces.

Status of Exercise and Related Factors in Survivors of Breast Cancer

Purpose: The present study aimed to clarify the status of exercise and related factors among survivors of breast cancer. Methods: Questionnaires were distributed to survivors of breast cancer. The question items addressed the status of exercise participation, knowledge about the effects of exercise and need for support. Factors associated with exercise participation were analyzed using logistic regression analysis. Results: Among 293 valid responses (rate, 84.2%). Fifty-eight point four percent participated in exercise and 41.3% decreased exercise participation after being diagnosed with breast cancer. Furthermore, 91.9% needed support from health care providers regarding exercise. About 70% of respondents were aware that exercise improves sleep, but <50% knew that exercise ameliorates symptoms associated with breast cancer. Among seven factors, age, employment status and chemotherapy were associated with exercise status. Conclusion: Breast cancer survivors who are younger, employed and undergoing chemotherapy might not participate in exercise. The preventive effects of exercise on breast cancer and the importance of continuing daily exercise should be promoted. Health care providers should provide support for patients to participate in exercise considering the influence of treatment and physical capabilities.

Exercise and drug adherence for breast cancer survivors / 体力科学

The incidence of breast cancer is rising in Japan year by year; and seems to peak at a younger age range compared to Western countries. About one half of breast cancer patients in Japan are diagnosed in their 30s to 50s. Among the cancers that frequently occur during the most productive years of life, breast cancer is considered the most serious one for survivors. Breast cancer treatments consist of surgery, hormone therapy, chemotherapy and radiation therapy. However, since all of these treatments have potential side effects, patients often stop taking therapy due to the side effects. To prevent and minimize such side effects, exercise plays a very important role. Furthermore, gaining excess weight for survivors has a negative impact on their prognosis. Thus, it is important that appropriate exercise and weight control interventions are developed.

Pain management for cancer survivors / 体力科学

From the start, World Health Organization has proposed that palliative medicine is applicable early in the course of illness. However, regrettably, palliative care has been usually provided to patients in the advanced cancer stage, as a terminal care. Recently, palliative medicine begins at the time-point when patients are diagnosed with cancer. In response to change in clinical settings of palliative medicine, cancer pain management has also changed. Considering long-term cancer treatment periods and increasing numbers of cancer survivors, cancer pain management should be recommended based on not only non-opioid pharmacotherapy but also the exercise/rehabilitation medicine and the cognitive-behavioral therapy. Especially, the exercise/rehabilitation medicine can provide beneficial effects on both pain management and cancer treatment itself: Sarcopenia is closely associated with poor prognosis of cancer and debilitating complications of chemotherapy. Further, non-sarcopenia patients can maintain their quality of life higher and show less fatigue during cancer treatment periods. To accomplish such favorable effects for cancer patients and cancer survivors, cancer pain should be managed adequately.

Patient, cured, victim or survivor of urological cancer? A qualitative study / Paciente, curado, vítima ou sobrevivente de câncer urológico? Um estudo qualitativo / ¿Paciente, curado, víctima o sobreviviente de cáncer urológico? Un estudio cualitativo *

ABSTRACT Purpose: to describe the meanings that patients attribute to the term cancer survivor and to analyze the identities assumed by them according to their experience with the disease. Methods: qualitative study with a narrative method, theoretical framework of the medical anthropology and identity concept. The study included 14 participants, men and women, diagnosed with urologic cancer. The semi-structured interviews were performed at the individual's home, after confirming participation. Results: eight participants assumed to be survivors, but five also assumed at least one other identity, in addition to cancer survivor. In contrast, among the six who defined themselves as cured, only one indicated another identity. Four considered themselves as victims and only two as cancer patients. However, the latter - cancer patient and victim - assumed at least one other associated identity. Conclusions: allowing patients to reflect on themselves and their experience with the disease, as well as attributing themselves a new identity, will be directly related to the wellbeing and momentum the survivor is going through. Therefore, it can direct care in the cancer survivorship phase according to each survivor's individual context.

RESUMO Objetivo: descrever os significados que os pacientes atribuem ao termo sobrevivente do câncer e analisar as identidades assumidas por eles de acordo com sua experiência com a doença. Métodos: estudo qualitativo com método narrativo, referencial teórico da antropologia médica e conceito de identidade. O estudo incluiu 14 participantes, homens e mulheres, diagnosticados com câncer urológico. As entrevistas semiestruturadas foram realizadas na residência dos indivíduos, após confirmação da participação. Resultados: oito participantes assumiram ser sobreviventes, mas cinco também assumiram pelo menos uma outra identidade, além de sobrevivente do câncer. Em contraste, entre os seis que se definiram como curados, apenas um indicou outra identidade. Quatro se consideraram como vítimas e apenas dois como pacientes com câncer. No entanto, os últimos - paciente com câncer e vítima - assumiram pelo menos uma outra identidade associada. Conclusões: permitir que os pacientes reflitam sobre si mesmos e sobre sua experiência com a doença, além de se atribuírem uma nova identidade, estará diretamente relacionado com o bem-estar e o momento pelo qual o sobrevivente está passando. Portanto, pode direcionar o cuidado na fase de sobrevivência ao câncer de acordo com o contexto individual de cada sobrevivente.

RESUMEN Objetivo: describir los significados que los pacientes atribuyen al término sobreviviente del cáncer y analizar las identidades asumidas por ellos de acuerdo con su experiencia con la enfermedad. Métodos: estudio cualitativo con método narrativo, referencial teórico de la antropología médica y concepto de identidad. El estudio incluye 14 participantes, hombres y mujeres, diagnosticados con cáncer urológico. Las entrevistas semiestructuradas fueron realizadas en la residencia de los individuos, después de la confirmación de la participación. Resultados: ocho participantes asumieron ser sobrevivientes, pero cinco también asumieron por lo menos otra identidad, además de sobreviviente del cáncer. En contraste, entre los seis que se definieron como curados, solo uno indicó una identidad diferente. Cuatro se consideraron como víctimas y solo dos como pacientes con cáncer. Sin embargo, los últimos - paciente con cáncer y víctima - asumieron por lo menos otra identidad asociada. Conclusiones: permitir que los pacientes reflexionen sobre sí mismos y sobre su experiencia con la enfermedad, además de atribuirse una nueva identidad, estará directamente relacionado con el bienestar y el momento por el cual el sobreviviente está pasando. Por lo tanto, puede direccionar el cuidado en la fase de sobrevivencia al cáncer de acuerdo con el contexto individual de cada sobreviviente.

Association Between Health Behaviors and Family History of Cancer in Cancer Survivors: Data From the Korean Genome and Epidemiology Study

BACKGROUND: We compared health behaviors, including current smoking, alcohol drinking, regular exercise, obesity, and abdominal obesity, among Korean cancer survivors with and without family history of cancer. METHODS: This study included 5,247 cancer survivors with family history of cancer (1,894 with and 3,353 without), who were recruited from the Health Examinee cohort. Health behaviors were identified using questionnaire. Adjusted ORs (aORs) between health behaviors and family history of cancer were estimated by multivariate logistic regression analysis adjusted for sociodemographic factors. All analyses were conducted separately according to sex. RESULTS: Prevalence of current smoking, alcohol drinking, no regular exercise, obesity, and abdominal obesity was 16.3%, 48.3%, 36.0%, 31.3%, and 42.3% in male cancer survivors and 1.7%, 20.6%, 43.8%, 28.5%, and 72.5% in female, respectively. Health behaviors in male cancer survivors with and without family history of cancer were not significantly different after being adjusted for other covariates (aOR = 1.04, 95% CI = 0.75–1.44 for current smoking; aOR = 0.96, 95% CI = 0.76–1.22 for current drinking; aOR = 0.85, 95% CI = 0.66–1.10 for regular exercise; aOR = 0.96, 95% CI = 0.73–1.25 for obesity; aOR = 0.97, 95% CI = 0.75–1.25 for abdominal obesity). In female cancer survivors, there were no significant differences in health behaviors according to family history of cancer (aOR = 0.76, 95% CI = 0.44–1.32; aOR = 1.11, 95% CI = 0.94–1.31; aOR = 0.99, 95% CI = 0.87–1.14; aOR = 0.99, 95% CI = 0.85–1.16; aOR = 0.93, 95% CI = 0.80–1.10, respectively). CONCLUSIONS: We identified no significant differences in health behaviors according to family history of cancer in cancer survivors. More studies should be conducted to identify correlations between family history of cancer and prognosis in cancer survivors.

Comprehensive social, psychological and behavior intervention of Shanghai Cancer Rehabilitation Club / 上海预防医学

Cancer survivors are faced with physical, emotional, mental, social relationship, vocational, economic and other challenges with the diagnosis and treatment of cancer.Those challenges would last for their whole cancer survivorship.In this case cancer has become a chronic disease.It is one of the most promising models that cancer rehabilitation organizations involving in community management and self-management of cancer patients.The comprehensive social, psychological and behavior intervention of Shanghai Cancer Rehabilitation Club has achieved positive results.It should be considered to summa-rize, evaluate and promote the intervention mode further.

Media Use and the Cancer Communication Strategies of Cancer Survivors

Communication related to health not only substantially affects perceptions and behaviors related to health but is also positively associated with the extent of health-information seeking and the practice of preventive behavior. Despite the fact that the number of cancer survivors has increased dramatically, there are few studies of the lack of health information, factors which act as barriers, and the difficulties in follow-up care experienced by cancer survivors. Therefore, we reviewed media utilization and the types of media used by cancer survivors with regard to risk communication and suggested appropriate strategies for cancer communication. According to the results, health communication contributed to health promotion by providing health-related information, consolidating social support factors such as social solidarity and trust, and reducing anxiety. In particular, participatory health communication may establish preventive programs which reflect the needs of communities, expand accessibility to better quality healthcare, and intensify healthy living by reducing health inequalities. Therefore, when people do not have an intention to obtain cancer screening, we need to intervene to change their behavior, norms, and degrees of self-efficacy. The findings of this study may help those involved in building partnerships by assisting in their efforts to understand and communicate with the public.