Quality Of Life In Survivors Research Articles

Cardiorespiratory fitness and health-related quality of life in survivors of childhood central nervous system tumours

PurposeWe assessed cardiorespiratory fitness and health-related quality of life (HRQoL) in survivors of childhood central nervous system (CNS) tumours.MethodsParticipants were recruited from the National Children’s Cancer Service in Children’s Health Ireland at Crumlin. Inclusion criteria included diagnosis of a primary CNS tumour, aged between 6 and 17 years, between 3 months and 5 years post completion of oncology treatment, independently mobile, and deemed clinically appropriate to participate by treating oncologist. Cardiorespiratory fitness was assessed using the six-minute walk test. HRQoL was assessed with the PedsQL Generic Core Scales, Version 4.0.ResultsThirty-four participants (n = 16 male) were recruited, with a mean age of 12.21 ± 3.31 years and a mean time since completion of oncology treatment of 2.19 ± 1.29 years. Mean six-minute walk distance (6MWD) achieved was 489.56 ± 61.48 m, equating to the 8th percentile overall. 6MWD was significantly reduced when compared to predicted population norms (p < 0.001). PedsQL parent proxy-report and child-report scores were significantly lower when compared to healthy paediatric norms (p < 0.001 – p = 0.011). A significant positive correlation was found between 6MWD and both parent proxy-report (r = 0.55, p < 0.001) and child-report (r = 0.48, p = 0.005) PedsQL total scores.ConclusionSurvivors of childhood CNS tumours present with impaired cardiorespiratory fitness and HRQoL. Higher levels of cardiorespiratory fitness are associated with higher levels of HRQoL.Implications for Cancer SurvivorsRoutine screening of cardiorespiratory fitness and HRQoL in survivors of childhood CNS tumours may be beneficial. Healthcare providers should encourage and provide education on the potential benefits of physical activity to improve overall quality of life.

The impact of cognitive impairment resulting from traumatic brain injury on health-related quality of life (HRQOL) in Pakistan.

Madam, Millions of people are affected by traumatic brain injury (TB) across the world each year. Road traffic accidents (RTAs) are among the top contributors of mild to severe TBI cases, and in developing countries like Pakistan, low literacy rates and lack of awareness regarding traffic rules have further aggravated the situation.(1) Many survivors of RTAs never return to their normal life and are made to live with persistent disabilities. The limitation of knowledge regarding post-TBI cognitive impairment has been noted, and it further adds a barrier to necessary actions. It's evident that following mild to moderate TBI, the patients are prone to cognitive impairment and its associated adverse effects.(2) A recent 2019 study by Gorgoraptis et al. reported that cognitive impairment adversely effects health-related quality of life (HRQOL) following TBI.(3) In Pakistan’s already struggling healthcare system, there are a few emergency trauma centres with neurocritical care units in it. Another study indicates that TBI patients are not assessed by an experienced doctor most of the time, with poor reporting of the clinical findings and hence missing out on an important finding in such patients. (4) Computed Tomography (CT) scans for critical patients are available only in large centres and patient load, and cost of investigation can hinder to its timely availability for most TBI patients. Post TBI cognitive impairment can cause a significant burden on the healthcare system leading to other social implications as well. The patients are discharged once they get stabilized with no proper follow-up plans which can lead to other avoidable cognitive impairments like dementia, psychiatric problems, and behavioural changes. In TBI cases, risk assessment and more advanced investigations like MRI can be provided to the patients who suspected of any finding missed on a CT scan. Furthermore, TBI guidelines need to be reviewed and planned accordingly. A psychiatric team must assess patient’s mental status changes during the stay and if needed proper therapy must be initiated. Neuropsychological rehabilitation plays a pivotal role in cognitive impairments and can help decrease the burden of neurological diseases (5) and improves HRQOL of patients. Hence, a unified and interdisciplinary approach towards patients with traumatic brain injury is required so that not only can mortality be reduced but also to better the quality of life in survivors.

Gynecological Cancer Survivors' Experiences and Desire for Follow-up After Recent Treatment: A Phenomenological Hermeneutic Study.

Gynecological cancer survivors experience a variety of challenges after discharge from hospital treatment. Cancer support and rehabilitation are recognized as significant facilitators for quality of life in survivorship but are reported to be insufficient by gynecological cancer survivors. To describe the lived experiences of gynecological cancer survivors and how their needs for follow-up should be met following recently completed treatment. This study used a phenomenological hermeneutic design with individual in-depth interviews with 20 women after recently completed cancer treatment. Transcribed interviews were analyzed with the Lindseth and Norberg phenomenological hermeneutic method. Four themes were identified: "a brutal transition to life after cancer," "fear of recurrence overshadowing the existence," "a need for professional support," and "information is not given unless asked for." After completing gynecological cancer treatment, the fear of cancer recurrence is dominating, regardless of prognosis and diagnosis. At the same time, information and support from healthcare professionals are described as lacking. Participants expressed a need to be contacted directly as a formal routine by healthcare professionals after cancer treatment with cancer-specific information as this may alleviate the existential suffering that the cancer experience brings. A person-centered, systematic follow-up rehabilitation is needed as a continuation of the care provided during cancer treatment. Future research is needed to explore the impact on women's quality of life when gynecologic-specific information is given in advance of hospital discharge after completing treatment.

Prevalence, correlates, and network analysis of depression and its association with quality of life in survivors with myocardial infarction during the COVID-19 pandemic

BackgroundDepression is common among myocardial infarction (MI) survivors and is strongly associated with poor quality of life (QOL). The aim of this study was to examine the prevalence, correlates and the network structure of depression, and its association with QOL in MI survivors during the COVID-19 pandemic. MethodsThis cross-sectional study evaluated depression and QOL in MI survivors with the Chinese version of the nine-item Patient Health Questionnaire (PHQ-9) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF), respectively. Univariable analyses, multivariable analyses, and network analyses were performed. ResultsThe prevalence of depression (PHQ-9 total score ≥ 5) among 565 MI survivors during the COVID-19 pandemic was 38.1 % (95 % CI: 34.1–42.1 %), which was significantly associated with poor QOL. Patients with depression were less likely to consult a doctor regularly after discharge, and more likely to experience more severe anxiety symptoms and fatigue. Item PHQ4 “Fatigue” was the most central symptom in the network, followed by PHQ6 “Guilt” and PHQ2 “Sad mood”. The flow network showed that PHQ4 “Fatigue” had the highest negative association with QOL. ConclusionDepression was prevalent among MI survivors during the COVID-19 pandemic and was significantly associated with poor QOL. Those who failed to consult a doctor regularly after discharge or reported severe anxiety symptoms and fatigue should be screened for depression. Effective interventions for MI survivors targeting central symptoms, especially fatigue, are needed to reduce the negative impact of depression and improve QOL.

Prevalence of Psychoneurological Symptoms and Symptom Clusters in Women with Breast Cancer Undergoing Treatment: Influence on Quality of Life

To identify subgroups of psychoneurological symptoms (PNS) and their relationship to different clinical variables in a sample of women with breast cáncer (BC) with different type of treatment, and the possible influence of these on quality of life (QoL), using a factorial principal components analysis. Observational, cross-sectional, non-probability study (2017-2021) at Badajoz University Hospital (Spain). A total of 239 women with BC receiving treatment were included. 68% of women presented fatigue, 30% depressive symptoms, 37.5% anxiety, 45% insomnia, and 36% cognitive impairment. The average score obtained for pain was 28.9. All the symptoms were related between themselves, and within the cluster of PNS. The factorial analysis showed three subgroups of symptoms, which accounted for 73% of variance: state and trait anxiety (PNS-1), cognitive impairment, pain and fatigue (PNS-2), and sleep disorders (PNS-3). The depressive symptoms were explained equally by PNS-1 and PNS-2. Additionally, two dimensions of QoL were found (functional-physical and cognitive-emotional. These dimensions correlated with the three PNS subgroups found. A relationship was found between chemotherapy treatment and PNS-3, and its negative impact on QoL. A specific pattern of grouped symptoms in a psychoneurological cluster with different underlying dimensions has been identified which negatively influences QoL of survivors of BC. It is important to raise awareness among professionals and patients about the existence of a cluster of PNS, the patient's profile, as well as the factors that exacerbate them. This will allow them to be treated more effectively and comprehensively.

284 Effect of &amp;lt;20-minutes of Cool Running Water &amp;lt; 3hours on Burn Patient Outcomes: A Systematic Review

Abstract Introduction Burn injuries are a leading cause of morbidity that can result in devastating disability and poor quality of life for survivors. This systematic review aimed to synthesise evidence regarding the effect of 20 minutes of cool running water (CRW) within three hours of injury on outcomes of patients with thermal burn injuries. Methods This systematic review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Multiple databases (PubMed, EMBASE, CENTRAL, CINAHL Complete via EBSCO, PROQUEST Dissertations and Theses), and the Australia New Zealand Clinical Trial Registry were searched for eligible studies published in English and Chinese, without date restriction. Meta-analyses were undertaken. Methodological quality of studies was assessed by using Downs and Black Checklist. Results Of 323 records, seven studies were included, with a combined study population of 11,383 patients. The majority (67%) of studies were conducted in Australia and New Zealand. The methodological quality was ranked between ‘fair’ and ‘good’. Approximately half of the study population (n=5782 [50.8%]) received 20 minutes of CRW within three hours of injury. Patients who received 20 minutes of CRW, within three hours of injury, had significantly decreased odds of requiring skin grafting or other surgical intervention when compared to patients who did not receive 20 minutes of CRW within three hours of injury. Conclusions There is considerable evidence demonstrating the association between the application of 20 minutes of CRW within the first three hours of injury and improved outcomes for patients with burn injury. Burns first aid guidelines and recommendations vary widely globally. Burn care organisations should reach international consensus about burns first aid best practice and provide clear, simple, and unified messaging. Burn care organisations should also engage in cross-sector collaborations with relevant jurisdictional EMS organisations to translate burns first aid evidence into pre-hospital practice. Applicability of Research to Practice Applying CRW after burn injury is a relatively simple procedure that can be performed at the scene by conscious patients, bystanders, firefighters, and other EMS responders. Data from the ABA burn repository shows that burn injuries in the United States (US) mostly occur in the home and most are &amp;lt; 10% total body surface area (TBSA). Therefore, for US EMS responders responding to the burn injured, CRW is accessible in most situations, when injuries occur in the home and the medical urgency to transfer most patients with non-severe injuries (&amp;lt; 10%TBSA) is not time critical. These contextual conditions of responding to most people with burn injuries, uniquely places US EMS responders in a window of opportunity to provide CRW at the scene, that can significantly reduce the burden of injury for patients.

Chemotherapy-induced weight gain in early-stage breast cancer: a prospective matched cohort study reveals associations with inflammation and gut dysbiosis

BackgroundEarly-stage breast cancer patients treated with chemotherapy risk the development of metabolic disease and weight gain, which can result in increased morbidity and reduced quality of life in survivorship. We aimed to analyze changes within the gastrointestinal microbiome of early-stage breast cancer patients treated with and without chemotherapy to investigate a potential relationship between dysbiosis, a systemic inflammatory response, and resultant anthropomorphic changes.MethodsWe undertook an a priori analysis of serially collected stool and plasma samples from 40 patients with early-stage breast cancer who underwent adjuvant endocrine therapy only, adjuvant chemotherapy only, or both. Gut microbiota were assessed by metagenomic comparison of stool samples following deep sequencing. Inflammatory biomarkers were evaluated by proteomic analysis of plasma and measurement of fecal calprotectin. Body composition was investigated by dual-energy X-ray absorptiometry to determine biomass indices.ResultsAs opposed to treatment with endocrine therapy only, chemotherapy resulted in statistically and clinically significant weight gain and an increase in the android to gynoid ratio of fat distribution. Patients treated with chemotherapy gained an average of 0.15% total mass per month, as opposed to a significantly different loss of 0.19% in those patients who received endocrine-only therapy. Concurrently, a twofold increase in fecal calprotectin occurred after chemotherapy that is indicative of interferon-dependent inflammation and evidence of colonic inflammation. These anthropomorphic and inflammatory changes occurred in concert with a chemotherapy-dependent effect on the gut microbiome as evidenced by a reduction in both the abundance and variety of microbial species.ConclusionsWe confirm the association of chemotherapy treatment with weight gain and potential deleterious anthropometric changes and suggest that alterations of bacterial flora may contribute to these phenomena through the induction of systemic inflammation. Consequently, the gut microbiome may be a future target for intervention in preventing chemotherapy-dependent anthropometric changes.

NCCN Policy Summit: Cancer Care in the Workplace: Building a 21st Century Workplace for Patients, Survivors, and Caretakers.

Survival rates for people with cancer and quality of life for survivors have increased significantly as a result of innovations in cancer treatment, improvements in early detection, and improved healthcare access. In the United States, 1 in 2 men and 1 in 3 women will be diagnosed with cancer in their lifetime. As more cancer survivors and patients remain in the workforce, employers must evaluate how they can adjust workplace policies to meet employee and business needs. Unfortunately, many people still encounter barriers to remaining in the workplace following a cancer diagnosis for themselves or a loved one. In an effort to explore the impacts of contemporary employment policies on patients with cancer, cancer survivors, and caregivers, NCCN hosted the Policy Summit "Cancer Care in the Workplace: Building a 21st Century Workplace for Cancer Patients, Survivors, and Caretakers" on June 17, 2022. This hybrid event, through keynotes and multistakeholder panel discussions, explored issues regarding employer benefit design, policy solutions, current best and promising practices for return to work, and how these issues impact treatment, survivorship, and caregiving in the cancer community.

Contralateral Constrictor Dose Predicts Swallowing Function After Radiation for Head and Neck Cancer.

Radiation therapy can cause long-term dysphagia that seriously affects quality of life for survivors of head and neck cancer. This study evaluates a novel organ at risk, the contralateral pharyngeal constrictor muscles, to find out whether radiation dose to this structure predicts late swallowing function in patients with head and neck cancer. The study included patients with head and neck cancer treated with radiation and concurrent systemic therapy at a single institution over 3 years. One-year dysphagia was defined as either the presence of a gastrostomy tube or an abnormal modified barium swallow ≥ 1 year after completion of radiation. Fifty-five patients met inclusion criteria, of which 46 were alive at 1 year. One-year dysphagia was present in 37% (n = 17) of this population. Contralateral constrictor V60 < 40% was associated with a 1-year dysphagia rate of 6%, compared with 57% in patients with V60 ≥ 40% (P < .001). An uninvolved pharynx mean dose < 45 Gy was associated with a 1-year dysphagia rate of 22%, compared with 52% in patients with an uninvolved pharynx mean dose ≥ 45 Gy (P = .03). Editing the clinical target volume off air cavities was associated with a decrease in 1-year dysphagia from 67% to 12% (P < .001), and with a reduction of contralateral constrictor V60 from 62% to 33% (P < .001). Air cavity editing was not associated with a change in locoregional recurrence or 1-year survival. This is the first study to report a connection between contralateral constrictor dose and late swallowing function. The correlation between air cavity editing and contralateral constrictor V60 suggests that contralateral constrictor dose may depend partly on technique. Further studies are needed to explore whether these findings can be replicated prospectively and in other practice settings.

PO-1567 Health-related quality of life in survivors of childhood medulloblastoma: a systematic review

PO-1567 Health-related quality of life in survivors of childhood medulloblastoma: a systematic review

Health-related quality of life in survivors of advanced melanoma treated with anti-PD1-based immune checkpoint inhibitors.

Immune checkpoint inhibitors (ICIs) have significantly improved survival in advanced melanoma but are associated with immune-related adverse events (irAEs). This single center, cross-sectional survey aimed to describe the long-term symptom burden and impact on health-related quality of life (HRQL) of advanced melanoma patients with sustained disease control following treatment with ICIs. Advanced melanoma patients (stage IIB, III or IV, AJCCv8), treated with anti-PD1-based ICIs, who were off-treatment and had at least 6 months follow-up from their last infusion with an ongoing response in the metastatic setting or no evidence of disease recurrence in the adjuvant setting. A paper-based questionnaire, consisting of the EORTC QLQ-C30, EORTC QLQ-FA12, and the PRO-CTCAE was administered. Of 90 participants, 61 (68%) completed the questionnaire; 40 received single-agent anti-PD1, and 21 anti-PD1/anti-CTLA4. Thirty-three (54%) were treated in the adjuvant setting. At the time of enrolment, 31 (51%) participants had active treatment for a previous irAE. Overall, 18/61 (30%) participants reported long-term symptoms and trouble in physical and emotional functioning. Physical fatigue was common and interfered with daily activities (n = 12, 20%). In the PRO-CTCAE questionnaire, muscle ache (n = 12, 20%) and joint ache (n = 9, 15%) were commonly reported. Despite this, participants reported overall good health (6.00, range 2.00-7.00) and reasonable level of HRQL (6.00, range 3.00-7.00). Melanoma survivors experience long-term symptoms in physical and psychosocial HRQL domains after ICI treatment. These results underline the importance to address existing gaps in survivorship care, implement these findings in clinical practice and increase awareness for long-term symptoms in these patients.

Does Quality of Life in Survivors of Surgery for Acute Left-Sided Infective Endocarditis Differ from Non-Endocarditis Patients?

Surgery for left-sided infective endocarditis (IE) has been demonstrated to improve patients' survival rates but information about quality of life (QoL) after surgery is scarce. The aim of this study was to assess the postoperative outcomes and QoL after surgery for IE patients compared to patients undergoing cardiac surgery for non-IE indications. Adult patients with definite acute left-sided IE were matched 1:1 to patients who underwent cardiac surgery for non-endocarditic purposes from 2014 to 2019. QoL was assessed using the SF-36 survey at the last follow-up. A total of 105 patients were matched. The IE group had higher rates of preoperative stroke (21% vs. 7.6%, p = 0.005) and higher stages of NYHA class (p < 0.001), EuroSCORE II (12.3 vs. 3.0, p < 0.001) and blood cell count abnormalities (p < 0.001). The IE group had higher incidence of low cardiac output syndrome (13.3% vs. 4.8%, p = 0.029), dialysis (10.5% vs 1.0%, p = 0.007) and prolonged mechanical ventilation (16.2% vs. 2.9%, p = 0.002) after surgery. At the last follow-up, subcomponents of the SF-36 QoL survey were not different between the groups. Patients who underwent cardiac surgery for IE demonstrated a higher risk profile with a higher rate of postoperative complications. Once recovered from the acute phase of the disease, the reported QoL at follow-up was comparable to that of matched cardiac patients operated for non-IE purposes.

Abstract 6028: Cancer-selective metabolic vulnerabilities in MYC-amplified medulloblastoma

Abstract [Background] Medulloblastoma (MB) is the most frequently diagnosed malignant pediatric brain tumor. Multiple integrated genomic analyses have been used to stratify MB into four molecular subgroups, each unique in its gene expression profile, clinical characteristics, and prognosis. MYC-driven group 3 MB (G3MB) tumors are poorly understood entities, defined by metastasis down the leptomeninges, disease recurrence and particularly poor survival. There is hence an urgent need for a more thorough molecular understanding of G3MB, particularly at recurrence, in order to develop more effective therapeutic modalities that will improve the durability of remission. [Methods] We previously developed a therapy-adapted mouse model of G3MB disease progression from xenoengraftment through treatment-induced minimal residual disease until eventual relapse in the brain and spine compartments. Temporal transcriptomic profiling of tumor tissue at each stage revealed an enrichment of several metabolic pathways at recurrence. Here we mapped further functional insight into the G3MB metabologenomic landscape by performing a genome-wide loss-of-function CRISPR-Cas9 genetic screen in patient-derived G3MB cells, which we cross-referenced with screens performed in human neural stem cells (NSCs), the proposed cell- of-origin for G3MB. [Results] By examining G3MB context-specific gene ontologies, we discovered differential essentiality of several metabolic processes exclusively in G3MB. In tandem, mass spectrometry-based global metabolomic profiling shows dysregulation of several metabolic pathways in in G3MB tumor cells in comparison to NSC, including the enrichment of de novo pyrimidine biosynthesis and depletion of salvage pyrimidine intermediates. We investigated a lead hit from our screen, DHODH (dihydroorotate dehydrogenase), which facilitates de novo pyrimidine biosynthesis. Our data demonstrate that genetic or pharmacological inhibition of DHODH selectively targets G3MB brain tumor initiating cell (BTIC) activity while sparing normal NSC, by disrupting hallmark MYC activity. We further show that MYC-amplified G3MB tumors harbor subgroup-specific transcriptomic signatures that delineate enrichment of de novo pyrimidine biosynthesis. [Significance] Despite clear evidence favoring an altered metabolic landscape in MYC-driven cancers, there have been only a few reports into the role of metabolic reprogramming in MYC-amplified G3MB. Given the paucity of treatment options for patients with recurrent G3MB, this study has the potential for a significant impact on the field of pediatric oncology. Translation of therapies that target unique metabolic vulnerabilities exclusive to G3MB may lead to more durable cures and radical improvements in quality of life for survivors. Citation Format: William Gwynne. Cancer-selective metabolic vulnerabilities in MYC-amplified medulloblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6028.

Effect of Yoga Among Women at Risk and With Breast Cancer–Related Lymphedema: A Systematic Review

Background: Participation in exercise improves function, restores fitness, and enhances quality of life in survivors of breast cancer. There is robust evidence regarding resistance and aerobic training for women at risk for and with breast cancer–related lymphedema; however, the effect of yoga on impairments and functional outcomes has not been well documented. The purpose of this systematic review is to examine the effect of yoga on arm volume, strength, range of motion, function, and quality of life among women at risk for and with breast cancer–related lymphedema and create evidence-based recommendations. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Prospero registration number: 42022311574). EMBASE, PubMed, CINAHL Complete, Web of Science, Scopus, and Google Scholar were searched from January 2010 through December 2021. Quality and bias of included studies were assessed using the American Physical Therapy Association's Critical Appraisal Tool for Experimental Intervention Studies. Results: A total of 132 articles were screened for eligibility and 9 studies met inclusion criteria. Based on 3 acceptable and 6 low-quality studies, this review found that participation in yoga demonstrated a positive effect on arm range of motion, strength, function, and quality of life among women at risk for and with breast cancer–related lymphedema. No safety issues, including new onset or exacerbation of lymphedema, were found in the reviewed studies. Conclusion: Integration of yoga into a therapeutic plan of care is supported. Variations in yoga type, mode, duration, and frequency currently make it challenging to generate specific guidelines. Adherence and an ongoing commitment to yoga practice may promote long-term effects.

Quality of life in survivors of pediatric medulloblastoma: a systematic review and meta-analysis.

Medulloblastoma (MB) is the most common malignant pediatric brain tumor. The mainstay of treatment is maximum surgical resection and craniospinal radiation, which may be followed by chemotherapy. The debilitating effect of the tumor and the intensive treatment approaches in MB lead to long-term neuropsychological, physical, and chronic medical problems. We conducted a systematic review to assess the quality of life (QoL) in the long-term survivors of MB and the factors leading to compromised QoL. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for our review. A comprehensive literature search was performed using PubMed, Cochrane Library, Digital Commons Network, and Wiley Online Library databases to search for articles having quality of life, medulloblastoma, and pediatric survivors in title or abstract. We removed duplicates and screened through titles, and full texts. Twelve articles were included in our study. Articles using and reporting all domains of PaedsQL were included in the meta-analysis. The PaedsQL scores of survivors and their caregivers were compared. Subgroup analysis was conducted for craniospinal and proton radiotherapy groups. As compared to other posterior fossa tumors, MB survivors have the lowest QoL scores. There is a difference in the perception of QoL of survivors between caregivers and survivors themselves with survivors rating themselves higher in several domains. The overall PaedsQL scores were significantly different for both groups (p < 0.001). Subgroup analysis showed that the difference between those who were treated with craniospinal or proton radiation was not significant (p = 0.76). For the subscales, physical (p = 0.005), psychosocial (p = 0.0003), and school (p = 0.03) perceptions were significantly different for the survivors and their caregivers; however, psychosocial (p = 0.80) and emotional (p = 0.93) scales were not different for the survivors or caregivers. Patient characteristics related to a worse QoL included disease severity, metastatic disease, lesser family income, smaller current ventricle size, need for permanent hydrocephalus treatment, and lesser age at diagnosis. An analysis of various studies, using different measures of QoL, concludes that QoL is compromised in all pediatric survivors of MB; however, the perception of QoL of the survivors is better than objective or caretaker-rated QoL.

Improving Evidence-Based Methods of Characterizing Shoulder-Related Quality of Life for Survivors of Breast Cancer

Background: Breast cancer is prevalent among Canadian women, but treatments may cause functional impairments among survivors. Despite a substantial number of survivors joining the population yearly, minimal research has approached the challenges faced by this population after primary treatment. The purpose of this study was to classify the different function of survivors of breast cancer and determine factors that differed across groups of survivors. Methods: Thirty-five survivors of breast cancer within 2 years since the conclusion of their treatment participated in this cross-sectional study. Participants completed quality-of-life questionnaires, followed by a full-body dual-energy x-ray absorptiometry scanning. The collection concluded with maximal force exertions at the shoulder and maximum shoulder range of motion. Results: This study determined, through feature reduction, that internal rotation force production, active extension range of motion, and 3 shoulder-related quality-of-life variables (energy/fatigue, social functioning, and pain) separated survivors within 2 years of treatment into 2 clusters (low- and high-score clusters [LSC/HSC], respectively). The LSC participants had higher self-reported disability, lower shoulder-related quality of life, force production, and flexion range of motion. Conclusion: Clustering survivors of breast cancer allows for a better understanding of deficits experienced by some individuals, as well as brings awareness to factors to monitor, and address in rehabilitation efforts.

Assessment on the Current State of Survivor-Focused Cancer Care in Southwestern Indiana

Background/objective: In 2019, the Commission on Cancer (CoC) released updated standards for 2020. The 2020 standards deliberately focused on improving long-term outcomes and quality of life for survivors. The new standards went one step further and introduced requirements for staffing and programming to meet these goals. This study aims to qualitatively assess the current state of survivorship-focused care through direct interviews with survivors, community leaders and healthcare providers in Evansville, Indiana.&#x0D; Methods: This is a qualitative study to understand survivorship care in southwestern Indiana. We conducted qualitative interviews with healthcare providers, community leaders, as well as survivors with an overall goal of learning what the needs and barriers are in providing or receiving long-term care. Our team worked to analyze qualitative data from the interviews to identify common themes within this community, as well as to compare the viewpoints and experiences of survivors with healthcare providers and community leaders. This study design is based on the Tri-Ethnic Center for Prevention Research model for implementing a community readiness assessment, and is the first step in a long-term appraisal of survivorship-focused care in the southwestern Indiana region.&#x0D; Results: From this early assessment, it is determined that although awareness and efforts exist to address long-term survivorship care, there is room for improvement. Survivors and providers alike recognize gaps that exist in the transition of care, in patient education, and in awareness of and access to available resources.&#x0D; Conclusion and potential impact: This study provides key information that will be utilized to further assess the readiness of the community of survivors and care providers. The themes drawn from this assessment will be utilized to determine high-impact areas for improvement in care, analyze availability of relevant resources, and to address barriers to care and resources.

Bibliometric analysis of global research on physical activity and sedentary behavior in the context of cancer.

Numerous studies focusing on sedentary behavior (SB) and physical activity (PA) in the context of cancer have been reported in recent years. We analyzed and visualized studies on SB and PA in patients with cancer over the last 20 years using scientometric methods, to provide insights on gaps and deficiencies in the literature, and to inform future research guidelines. All relevant studies in the field from 2001 to October 2022 were reviewed using bibliometric tools, including VOSviewer, Bibliometric online analysis platform, and biblioshiny, to determine the most influential countries, institutions, journals, and authors. We explored current research hotpots and potential research trends, based on keyword clustering and dynamic changes. Our research focuses on PA, SB, and cancer across the entire cancer continuum, from primary prevention to treatment to cancer survivorship. Scientometric analysis identified 4,382 relevant manuscripts on SB and PA in the context of cancer, with a 10-fold increase in articles over the past 20 years. The United States, Canada, and Australia were the most influential countries. The journal, Supportive Care in Cancer, had the highest number of publications, while Clinical Oncology had the highest H-index. K.S. Courneya was the most influential author in this field, with the highest number of publications, total citations, and H-index. Keyword analysis revealed that current research is focused on PA and SB in patients with breast cancer, quality of life, and aerobic exercise. Future frontiers include cancer prehabilitation programs and cardiorespiratory fitness, and remote intervention and social support. By using bibliometrics, we conducted a comprehensive review of SB and PA in cancer-related studies. The current research focused on exercise and sedentariness in breast cancer patients and the role of PA in improving quality of life in survivorship. Emerging research foci were generally around cancer prehabilitation programs and remote intervention issues for PA. In addition, some publication deficits are noted: studies of PA and SB in less common cancers; the recommended doses and intensities of exercise for cancer; the timing of interventions for prehabilitation and the establishment of individualized exercise protocols. These deficiencies align with the needs for future research topics.

VV-ECMO in severe COVID-19: multidimensional perspectives on the use of a complex treatment

VV-ECMO in severe COVID-19: multidimensional perspectives on the use of a complex treatment

Does Quality of Life in Survivors of Surgery for Acute Left-Sided Infective Endocarditis Differ from Non-Endocarditis Patients?

Does Quality of Life in Survivors of Surgery for Acute Left-Sided Infective Endocarditis Differ from Non-Endocarditis Patients?