The Place of Sick Peers in Adolescents and Young Adults with Cancer: Advantage, Disadvantage, and What Makes Barriers to the Encounter.

Purpose: The appreciation of peer support can vary from one country to another due to the cultural and relational differences. This study explores what perceptions French adolescents and young adults (AYAs) in post-treatment for cancer have of the place of sick peers during their treatment and what can make barriers to meet them. Methods: A semistructured interview has been proposed 6 months after the end of cancer treatments. A thematic analysis has been conducted to highlight the major themes and subthemes identified through the participants' discourses. Results: Twelve AYAs (mean age 23 y.o., standard deviation = 2.8; min = 19; max = 26) from two French cancer centers were interviewed. Five major themes were identified, but only two were presented in this article: the place of peers and the impact of coronavirus disease 2019 (COVID-19) epidemic on AYA facilities. AYA peers with cancer major theme demonstrated that meeting sick peers has benefits (e.g., identification, understanding, support, feeling of normalcy) but also has disadvantages (e.g., negative emotional influence). The benefits of peer-to-peer meetings seem to outweigh the disadvantages. Nevertheless, AYAs can face social barriers to this kind of relationship (e.g., fatigue, need to focus on oneself, confrontation to cancer and negative events, feeling of unnatural meeting). Finally, patients' encounters and the normal functioning of AYA facilities have been hampered by the COVID-19 pandemic. Conclusion: Even if AYA services systematically suggest a meeting with other sick peers, it is important to reiterate this proposal since the needs can evolve over time. It can also be interesting to propose places of life outside the hospital to make the encounters more comfortable and natural for AYAs. Clinical Trial Registration number: NCT03964116.

Psychological Adjustment, Adaptation, and Perception of Social Support in French Adolescents and Young Adults After the Diagnosis of Cancer.

Purpose: The third Cancer Plan (2014-2019) has helped with the recognition of adolescents and young adults (AYAs) with cancer's medical and psychosocial specificities and has enabled the creation of dedicated structures in France. Methods: The study involved 43 AYA patients (Nmen = 21; Nwomen = 22) between 15 and 27 years old (Mage = 19.9), diagnosed with all types of cancer, and were recruited in two French cancer centers. Online questionnaires were filled in 2 months after the beginning of treatment. AYAs completed measures of depressive and anxiety symptoms, perceived social support, and coping strategies. Results: Results demonstrated moderate depressive symptoms (M = 10.7, standard deviation [SD] = 7.0) and suggested a good satisfaction (M = 30, SD = 9.5) and a mild availability (M = 27, SD = 10.3) of the social support. Spearman's correlations demonstrated that coping strategies are related to depressive symptoms, for which acceptance (p < 0.01) of the disease played a key role in their psychological adjustment. Perceived social support subscales were positively correlated with the use of distraction as a coping strategy (p < 0.05). Kruskal-Wallis test demonstrated the preferential use of instrumental (p < 0.05) and emotional support (p < 0.01), denial (p < 0.01), and self-blame (p < 0.01) for women and the use of acceptance (p < 0.05) and humor (p < 0.05) for men; and there were no significant differences between patients hospitalized in the two cancer center facilities. Conclusion: Finally, a better understanding of the psychological adjustment and processes among French AYAs with cancer will help families and processionals to better adjust AYA-specific needs at the beginning of cancer treatment. ClinicalTrials.gov.: NCT03964116.

Postoperative Administration of the Acetylcholinesterase Inhibitor, Donepezil, Interferes with Bone Healing and Implant Osseointegration in a Rat Model.

Donepezil is an acetylcholinesterase inhibitor commonly used to treat mild to moderate Alzheimer's disease. Its use has been associated with increased bone mass in humans and animals. However, the effect of postoperative administration of donepezil on bone healing remains unknown. Therefore, this study aimed to assess the impact of postoperative injection of donepezil on bone healing, titanium-implant osseointegration, and soft tissue healing. Twenty-two Sprague-Dawley rats were randomly assigned to receive a daily dose of either donepezil (0.6 mg/kg) or saline as a control. In each rat, a uni-cortical defect was created in the right tibia metaphysis and a custom-made titanium implant was placed in the left tibiae. After two weeks, rats were euthanized, and their bones were analysed by Micro-CT and histology. The healing of bone defect and implant osseointegration in the rats treated with donepezil were significantly reduced compared to the saline-treated rats. Histomorphometric analysis showed lower immune cell infiltration in bone defects treated with donepezil compared to the saline-treated defects. On the other hand, the healing time of soft tissue wounds was significantly shorter in donepezil-treated rats compared to the controls. In conclusion, short-term administration of donepezil hinders bone healing whereas enhancing soft tissue healing.