Employment-related Education and Support for Cancer Survivors: a Content Analysis of Employment Resources Offered on National Cancer Institute-Designated Cancer Center Websites.

High rates of employment changes and associated concerns among cancer survivors following diagnosis and treatment suggest a need to examine what employment-related educational resources and support are currently being offered to cancer survivors and what gaps exist in those resources. In 2023, we conducted a content analysis of employment resources described on the websites of the NCI-Designated Cancer Centers that provide clinical care (N = 64) through a systematic review procedure using predetermined search terms and a standardized process to examine the availability and accessibility of such resources. Descriptive analyses were conducted to characterize the employment resources identified. In total, 175 employment resources were identified across 49 cancer center websites; 102 (58%) provided patient-facing education/information, 58 (33%) offered a consultation, 14 (8%) offered support groups/classes, and 1 (1%) was classified as "Other." Most (76%) resources were provided internally by the cancer center, and often, more than one discipline was involved, most commonly social work and medicine. These findings are encouraging as they suggest that most (77%) NCI-Designated Cancer Centers recognize employment support as a component of survivorship care. The multidisciplinary nature of the resources identified is supported by moderate evidence that multidisciplinary interventions appear to have the greatest potential to foster a return to work for cancer survivors and align with suggestions made by recent expert groups and guidelines regarding employment support for cancer survivors. Ongoing work is needed to assess the utilization, impact, and equity of available employment resources to optimize work outcomes among cancer survivors.

A Process Evaluation of Intervention Delivery for a Cancer Survivorship Rehabilitation Clinical Trial Conducted during the COVID-19 Pandemic.

The purpose of the present study was to conduct a process evaluation of intervention delivery for a randomized controlled trial (RCT) conducted during the COVID-19 pandemic (NCT03915548). The RCT tested the effects of a telephone-delivered behavioral intervention on changes in breast cancer survivors' satisfaction with social roles and activities, as compared to an attention control condition. This process evaluation examined (a) fidelity monitoring scores; (b) participants' perceived benefit ratings for gaining confidence, reducing distress, adjusting habits and routines, setting goals, and increasing exercise; and (c) field notes, email communications, and transcripts of coach supervision and debriefing sessions. The behavioral and attention control conditions were delivered with a high degree of fidelity (global quality rating score for the BA/PS condition was M = 4.6 (SD = 0.6) and M = 4.9 (SD = 0.3) for the attention control condition, where "5" is the highest rating). The behavioral intervention participants perceived greater benefits than the control participants pertaining to goal setting, t(248) = 5.73, p = <0.0001, adjusting habits and routines, t(248) = 2.94, p = 0.0036, and increasing exercise, t(248) = 4.66, p = <0.0001. Moreover, coaches' perceptions regarding the behavioral intervention's therapeutic aspects aligned with the study's a priori conceptual model including the use of a structured process to set small, observable goals and facilitate the independent use of problem-solving skills. However, coaches also noted that aspects of the attention control condition, including the perceived relevance of the educational content and opportunities for social support, may have made it more therapeutically potent than intended. The pandemic may have affected the activity goals behavioral intervention participants could set as well as augmented the relevancy of social support provided in both conditions.

Management of a Pediatric Patient With a Left Ventricular Assist Device and Symptomatic Acquired von Willebrand Syndrome Presenting for Orthotopic Heart Transplant.

We present the successful perioperative management of an 11-year-old patient presenting for heart transplant with a left ventricular assist device, symptomatic acquired von Willebrand syndrome, and recent preoperative intracranial hemorrhage. A brief review of the pathophysiology of acquired von Willebrand syndrome is included. As the number of pediatric patients supported with ventricular assist devices continues to increase, the management of symptomatic acquired von Willebrand syndrome during the perioperative period is an important consideration for anesthesiologists.

Bradycardia and asystole during temporomandibular joint reconstruction.

Anesthesia providers are familiar with the oculocardiac reflex, one type of trigeminocardiac reflex. While less common, arrhythmias associated with manipulation of other trigeminal nerve branches can occur. We report the presentation and management of bradycardia and asystole from stimulation of the mandibular branch of the trigeminal nerve during temporomandibular joint reconstruction.

Does gender-bending help or hinder friending? The roles of gender and gender similarity in friendship dissolution.

We explored how gender and gender similarity affects friendship dissolution following the transition to middle school. We predicted that both gender and gender similarity (measured by perceived similarity to own-gender and other-gender peers) explain dissolution trends and that less own-gender similarity or more other-gender similarity predicts more friendship dissolution. We considered gender and gender similarity at both the individual and dyad level (reflecting the discrepancy between friends). Participants were 198 students in Grade 6 (42% Latinx, 21% Caucasian, 10% Native American, 8% African American, 2% Asian American, and 17% mixed backgrounds; 77% qualified for free/reduced meals) in reciprocated same- or mixed-gender friendships followed from fall to spring of the academic year. Multilevel multimember logistic regression models, nesting friendships within each participating individual, demonstrated that girl-girl friendships were less likely to dissolve than boy-boy friendships, and mixed-gender friendships did not dissolve more than same-gender friendships. Feeling similar to one's own gender predicted less dissolution, but feeling similar to the other gender did not increase friendship dissolution. There was no support for the hypothesis that feeling similar to both genders (i.e., androgyny) protected against friendship dissolution, nor was there any support for the hypothesis that dyad-level differences in gender similarity would predict dissolution. The discussion focuses on the importance of conducting individual and dyad-level analyses as well as including gender similarity constructs when studying gender differences in friendships and their trajectories over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Perioperative Management of the Pediatric Patient on Medicinal Marijuana: What Anesthesiologists Should Know.

In 2018, 29 states allow the use of medicinal marijuana. In these states, minors, with parental permission, are granted access. Use has increased in some states, although there remains a paucity of clear evidence regarding usefulness and dosing. There are 2 Food and Drug Administration-approved synthetic derivatives. One purified compound was just approved by the Food and Drug Administration, and another is undergoing Food and Drug Administration review. This article will review the literature regarding the use of each of these compounds in the literature, with particular attention to data in children. The history, known pharmacology, data from nonmedicinal use, current evidence, and anesthetic considerations will be described.

Self-Competence and Depressive Symptoms in Middle-Late Adolescence: Disentangling the Direction of Effect.

This study examined the temporal relation between self-competence (academic, social, athletic, physical appearance, and close friend) and depressive symptoms in a large, diverse community sample of 636 adolescents. Surveys were administered to all 10th- and 11th-grade students at participating high schools at baseline (mean age = 16.10, SD = .71) and 1 year later. Girls reported higher levels of self-competence in close friendships and more depressive symptoms, whereas boys reported higher levels of self-competence in athletics and physical appearance. However, there were no gender differences in the associations between self-competence and depressive symptoms. Results from autoregressive, cross-lagged path analyses indicated that depressive symptoms predicted self-competence more consistently than self-competence predicted depressive symptoms during middle-late adolescence. Implications for prevention are discussed.

Age-varying associations between coping and depressive symptoms throughout adolescence and emerging adulthood.

The objective of the current study was to apply the novel technique of time-varying effect modeling to examine age-varying associations between specific coping strategies and depressive symptoms across adolescence and emerging adulthood (ages 14-24). The participants were drawn from a community sample and followed across 4 years of high school and once 5 years postgraduation (N = 1,251, 53% female, 58% non-Hispanic White). Coping and depressive symptom questionnaires were administered across all data collection time points. Time-varying effect modeling used all available data (N = 5,651 measurement occasions) and adjusted for gender. Venting emotions and denial were associated with more depressive symptoms at a similar magnitude across adolescence and emerging adulthood. A positive association between problem solving oriented strategies (planning, active coping) and depressive symptoms was not observed until age 17.5, after which the magnitude of the association strengthened. More frequent instrumental and emotional support seeking were linked to fewer depressive symptoms between ages 18.8 and 23.6. More frequent use of humor was associated with greater depressive symptoms from ages 14.0 to 14.6, but with fewer depressive symptoms from ages 16.8 to 18.8. The findings illuminate when and how associations between specific coping strategies and depressive symptoms may emerge and change across developmental age, generating both theoretical and clinical implications.

Associations between friend conflict and affective states in the daily lives of adolescents.

This study examined the associations between friend conflict, defined as arguments with friends, and affective states using a daily diary design in a community sample of adolescents. Participants were 100 U.S. adolescents (13-17 years; 40% girls; 79% white). Adolescents completed an online survey on 14 consecutive evenings. Adolescents reported significantly higher anger/hostility, confusion, and tension/anxiety and less friendliness on days during which they experienced friend conflict relative to no-conflict days. However, no same-day associations for depressed affect, fatigue, or vigor were found. Adolescents experiencing friend conflict reported increased next-day anger/hostility, depressed affect, and tension/anxiety, but not other affective states. Higher levels of anger/hostility and depressed affect predicted an increased likelihood of next-day friend conflict. Conversely, higher levels of friendliness and vigor predicted a decreased likelihood of next-day friend conflict. These findings suggest that directional relationships between adolescents' friend conflicts and their affective states vary by affective domain.

Using Time-Varying Effect Modeling to Examine Age-Varying Gender Differences in Coping Throughout Adolescence and Emerging Adulthood.

PURPOSE: Little is known about how and when coping trajectories differ between males and females. The current study aimed to examine gender differences in the use of specific coping strategies across developmental ages using time-varying effect modeling (TVEM) in a large, diverse community sample. METHODS: A longitudinal study following adolescents across 4 years of high school and 5 years post graduation (N = 1,251) was combined with a nationally representative cross-sectional study of 18- to 22-year-olds (N = 595) to examine changes in gender differences in the use of coping strategies between ages 13 and 25. The same coping questionnaire was administered to both samples. TVEM was used to examine the age-varying prevalence rates of coping in males and females. RESULTS: Gender differences were greatest during middle-to-late adolescence (15-19 years) for active coping, social support seeking, planning, and venting emotions. Females reported greater use of these strategies than males, but males' use increased over time and became equivalent to females after the age of ~19-20. Gender differences in the use of humor did not emerge until the age of 22, at which point the use of humor increased continuously among males but remained stable among females. The use of denial was fairly stable across time, with no gender differences at any age. CONCLUSIONS: Findings highlight the utility of TVEM for advancing our knowledge on gender and coping across developmental time, as males and females used coping strategies at differing rates throughout adolescence and emerging adulthood. Implications for tailoring gender- and age-specific intervention efforts to improve coping and related health behaviors are discussed.

Goal commitment predicts treatment outcome for adolescents with alcohol use disorder.

OBJECTIVE: Commitment to change is an innovative potential mediator and mechanism of behavior change (MOBC) that has not been examined in adolescents with substance use disorders (SUD). The Adolescent Substance Abuse Goal Commitment (ASAGC) questionnaire is a reliable and valid 2-scale measure developed to assess the adolescent's commitment to either abstinence or harm reduction (HR) that includes consumption reduction as a stated treatment goal. The objective of this study was to examine the ASAGC's ability to predict alcohol use treatment outcome. METHOD: During sessions three and nine of a 10-week treatment program, therapists completed the ASAGC for 170 adolescents 13-18years of age with alcohol use disorder (AUD). Drinking behaviors were assessed during and after a continued-care phase until 12-month from study onset. RESULTS: Analysis of Variance results indicated that adolescents who reported no alcohol use had significantly higher scores on the commitment to abstinence scale than adolescents who reported alcohol use. None of the ANOVA models were significant for commitment to HR. When treatment outcome was examined, commitment to abstinence consistently predicted number of drinking days, number of heavy drinking days, and the maximum number of drinks post-treatment. In contrast, commitment to HR did not predict any of the drinking outcomes. These results suggest that the more adolescents were committed to abstinence during treatment, the less they used and abused alcohol after treatment completion. CONCLUSIONS: In addition to the ASAGC's ability to differentiate between commitment to abstinence and commitment to HR, study findings demonstrate that goal commitment consistently predicts AUD treatment outcome.

Social Media Use and Conduct Problems in Emerging Adults.

Social media use has become pervasive in the lives of emerging adults. Although social media may provide individuals with positive opportunities for communication and learning, social media sites also may provide an outlet for youth conduct problems, such as bullying, harassment, and intentional hostility and aggression toward others. Yet, the relationship between social media use and conduct problems remains unclear. This study investigated the association between conduct disorder (CD) symptoms before age 15 and social media use during emerging adulthood in a large, nationally representative sample. Concurrent associations between antisocial personality disorder (ASPD) symptoms and social media use in emerging adults also were examined. Data for this study were based on 567 emerging adults (50.2 percent female; Mage = 20.0 years). Self-report questionnaires were completed online. Results suggested that more childhood CD symptoms were significantly associated with greater daily social media use during emerging adulthood, and that more daily social media use was significantly associated with current ASPD symptoms. Possible directional and cyclical explanations for these findings are explored. Given the pervasiveness of social media in the lives of emerging adults, these results underscore the importance of considering nuanced methods for using social media sites to encourage positive social interactions and to displace the promotion of conduct problems.

Coping Mediates the Association Between Gender and Depressive Symptomatology in Adolescence.

Previous studies have found evidence for gender and racial/ethnic differences in depressive symptoms in adolescence; however, the mechanisms driving this relationship are poorly understood. The goal of this study was to examine the role of individual differences in dispositional coping in the relationships between gender and depressive symptomatology, and race/ethnicity and depressive symptomatology. Surveys were administered to 905 15-17 year old adolescents (mean age 16.10, SD = .67; 54% girls, n = 485) in the spring of 2007, 2008, and 2009. Girls reported more depressive symptomatology than boys and endorsed a greater disposition for the following coping strategies in comparison to boys: emotional social support, instrumental social support, and venting emotions. When race/ethnicity was examined, African-American adolescents reported a greater tendency toward using religious coping than Caucasian and Hispanic adolescents. Dispositional coping preferences also were found to mediate the relationships between gender and depressive symptomatology. These findings indicated that a preference for venting emotions may be particularly problematic when endorsed by girls, whereas instrumental social support may be particularly helpful for girls.

Social media use and anxiety in emerging adults.

INTRODUCTION: Social media use is central to the lives of emerging adults, but the implications of social media use on psychological adjustment are not well understood. The current study aimed to examine the impact of time spent using social media on anxiety symptoms and severity in emerging adults. METHODS: Using a web-based recruitment technique, we collected survey information on social media use and anxiety symptoms and related impairment in a nationally representative sample of 563 emerging adults from the U.S. (18-22 years-old; 50.2% female; 63.3% Non-Hispanic White). Participants self-reported the amount of time they spent using various social media sites on an average day, and responded to anxiety questionnaires RESULTS: Hierarchical regression revealed that more time spent using social media was significantly associated with greater symptoms of dispositional anxiety (B=0.74, 95% CI=0.59-0.90, p<0.001), but was unrelated to recent anxiety-related impairment (B=0.06, 95% CI=0.00-0.12, p=0.051), controlling for age, gender, race/ethnicity, and education level. Logistic regression also revealed that more daily social media use was significantly associated with a greater likelihood of participants scoring above the anxiety severity clinical cut-off indicating a probable anxiety disorder (AOR=1.032, 95% CI=1.004-1.062, p=0.028). LIMITATIONS: Study limitations include the cross-sectional design and reliance on self-report questionnaires. CONCLUSIONS: Given the ubiquity of social media among emerging adults, who are also at high risk for anxiety disorders, the positive association between social media use and anxiety has important implications for clinicians. Gaining a more nuanced understanding of this relationship will help to inform novel approaches to anxiety treatment.

Family functioning and adolescent alcohol use: A moderated mediation analysis.

The primary goals of this longitudinal study were to examine the relationship between family functioning and adolescent alcohol use and to examine whether depressed mood mediates this relationship. An additional goal was to explore whether these relations were moderated by gender. The sample included 1031 high school students from the Mid-Atlantic United States. Participants completed surveys in school during the spring of 2007, 2008, and 2009. Path analysis results indicated that family functioning predicted alcohol use for girls. Moreover, depressed mood mediated this relationship. None of the direct paths between family functioning and adolescent alcohol use were significant for boys. However, similar to girls, depressed mood negatively predicted alcohol use for boys. Taken together, the findings highlight the need for prevention programs targeting adolescent substance use to consider gender-specific trajectories.

LMNA variants cause cytoplasmic distribution of nuclear pore proteins in Drosophila and human muscle.

Mutations in the human LMNA gene, encoding A-type lamins, give rise to laminopathies, which include several types of muscular dystrophy. Here, heterozygous sequence variants in LMNA, which result in single amino-acid substitutions, were identified in patients exhibiting muscle weakness. To assess whether the substitutions altered lamin function, we performed in vivo analyses using a Drosophila model. Stocks were generated that expressed mutant forms of the Drosophila A-type lamin modeled after each variant. Larvae were used for motility assays and histochemical staining of the body-wall muscle. In parallel, immunohistochemical analyses were performed on human muscle biopsy samples from the patients. In control flies, muscle-specific expression of the wild-type A-type lamin had no apparent affect. In contrast, expression of the mutant A-type lamins caused dominant larval muscle defects and semi-lethality at the pupal stage. Histochemical staining of larval body wall muscle revealed that the mutant A-type lamin, B-type lamins, the Sad1p, UNC-84 domain protein Klaroid and nuclear pore complex proteins were mislocalized to the cytoplasm. In addition, cytoplasmic actin filaments were disorganized, suggesting links between the nuclear lamina and the cytoskeleton were disrupted. Muscle biopsies from the patients showed dystrophic histopathology and architectural abnormalities similar to the Drosophila larvae, including cytoplasmic distribution of nuclear envelope proteins. These data provide evidence that the Drosophila model can be used to assess the function of novel LMNA mutations and support the idea that loss of cellular compartmentalization of nuclear proteins contributes to muscle disease pathogenesis.

Domains of heterochromatin protein 1 required for Drosophila melanogaster heterochromatin spreading.

Centric regions of eukaryotic genomes are packaged into heterochromatin, which possesses the ability to spread along the chromosome and silence gene expression. The process of spreading has been challenging to study at the molecular level due to repetitious sequences within centric regions. A heterochromatin protein 1 (HP1) tethering system was developed that generates "ectopic heterochromatin" at sites within euchromatic regions of the Drosophila melanogaster genome. Using this system, we show that HP1 dimerization and the PxVxL interaction platform formed by dimerization of the HP1 chromo shadow domain are necessary for spreading to a downstream reporter gene located 3.7 kb away. Surprisingly, either the HP1 chromo domain or the chromo shadow domain alone is sufficient for spreading and silencing at a downstream reporter gene located 1.9 kb away. Spreading is dependent on at least two H3K9 methyltransferases, with SU(VAR)3-9 playing a greater role at the 3.7-kb reporter and dSETDB1 predominately acting at the 1.9 kb reporter. These data support a model whereby HP1 takes part in multiple mechanisms of silencing and spreading.