Suchergebnisse

LAY SUMMARY The focus of this study was on family and community. Interviews with 23 adult children of Canadian Armed Forces Veterans who served between the Korean War and the Gulf War suggested key capabilities were developed that supported them in meeting demands and contributed to adaptation over the course of their lives. Living on military bases was identified as a significant resource shaping identities, intensifying bonds with others who also grew up as military children in that era. Participants shared insights on how their experiences could inform contemporary military family support programs and policies.

The families of public safety personnel (PSP) face demands that are unique to these occupations. Nonstandard work, trauma exposure, and dangerous work environments affect both workers and the families who support them. This narrative review aims to identify the stressors that PSP families experience and the support and resources needed to enhance family resilience. Due to a lack of research on PSP families, this review is a necessary first step to summarizing and interpreting a diverse body of research. The studies included addressed structural and emotional work-family conflict with reference to PSP sectors. A framework from the military family resiliency literature interprets the findings. Factors influencing family functioning and the availability and accessibility of resources provide clues about the type of skills and supports that PSP families rely on. Meaning-making, collaboration, a sense of coherence, and communication were identified as themes associated with intrafamilial processes. Extrafamilial themes included public perceptions, a lack of recognition for the roles families fulfill, and the need for information and education. The results suggest that the vulnerability of PSP families is variable and extrafamilial resources in the form of formal and informal supports are necessary to enhance family resiliency.

LAY SUMMARY Public safety personnel (PSP) families face unique challenges tied to the job's occupational risks and requirements. These challenges can often spill over into home life, affecting the day-to-day unfolding of schedules, sleep, mood, activities, and relationships. The impact of this spillover into family life has not received much attention in research or practice. What makes PSP family life unique is the combination of logistics, risks, and identities associated with the job. The project team created an online well-being hub tailored to those factors for PSP families. The website offers information pages, strategy and skill-building exercises, and a self-directed, Internet-delivered cognitive-behavioural therapy course. The hub was launched in December 2022, and the project team wanted to gauge its impact. This article contains a preliminary assessment of Google Analytics, social media posts, and semi-structured interviews. Findings show the site resonates with PSP family members' experiences, that there is a need for the site, and that users find connection to the content. The hub will continue to be refined based on feedback, and the team will do more research about its impacts.

Background: It is unknown how subse­quent breast cancer outcomes vary by bio­logic subtype and race/ethnicity in a diverse cohort of breast cancer survivors.Methods: We conducted a prospective cohort study of 6,154 insured breast cancer survivors (AJCC TNM stages 0–IV) diagnosed between 1996-2007 and followed them through 1/1/2010 for subsequent breast cancer events (recurrence, contralateral breast cancer, metastasis, mortality). We compared subsequent breast cancer rates by race/ethnicity groups and biologic subtype (luminal A, luminal B, HER2-enriched, and triple negative). We calculated hazard ratios (HRs) with 95% CIs using multivariable Cox proportional hazards models, adjusted for sociodemographics, cancer treatments, and tumor characteristics.Results: The cohort was diverse: 62.4% non-Hispanic White, 13.2% Hispanic, 14.9% African American, and 9.5% Asian. We identified 1,456 subsequent breast cancer events over 22,830 person-years. Although certain Asian women had higher crude subsequent breast cancer rates com­pared with Whites, within each biologic subtype category, these disparities disap­peared in the multivariable analyses. After accounting for race/ethnicity, compared with women with luminal A tumors (refer­ence), women with luminal B (adjusted HR=3.65, 95% CI: 3.08-4.32), HER2- enriched (adjusted HR=2.81, 95% CI: 2.25-3.51) and triple negative (adjusted HR=1.25, 95% CI: 1.01-1.54) tumors had statistically increased risks of subsequent breast cancer. Factors that were statistically significantly associated with increased risk included higher stage, larger tumor size, positive lymph nodes, and no adjuvant endocrine or chemotherapy (all P<.025).Discussion: Our data suggest that dispari­ties in subsequent breast cancer outcomes were more strongly associated with tumor characteristics and non-use of adjuvant treatments than race/ethnicity. Ethn Dis. 2018;28(4):565-574; doi:10.18865/ed.28.4.565.

OBJECTIVE: To examine whether the presence of motor signs has predictive value for important outcomes in Alzheimer disease (AD). METHODS: A total of 533 patients with AD at early stages (mean Folstein Mini-Mental State Examination [MMSE] 21/30 at entry) were recruited and followed semiannually for up to 13.1 years (mean 3) in five University-based AD centers in the United States and European Union. Four outcomes, assessed every 6 months, were used in Cox models: cognitive endpoint (Columbia Mini-Mental State Examination or = 10), institutionalization equivalent index, and death. Using a standardized portion of the Unified PD Rating Scale (administered every 6 months for a total of 3,149 visit-assessments, average 5.9 per patient), the presence of motor signs, as well as of individual motor sign domains, was examined as time-dependent predictor. The models controlled for cohort, recruitment center, sex, age, education, a comorbidity index, and baseline cognitive and functional performance. RESULTS: A total of 39% of the patients reached the cognitive, 41% the functional, 54% the institutionalization, and 47% the mortality endpoint. Motor signs were noted for 14% of patients at baseline and for 45% at any evaluation. Their presence was associated with increased risk for cognitive decline (RR, 1.72; 95% CI, 1.24 to 2.38), functional decline (1.80 [1.33 to 2.45]), institutionalization (1.68 [1.26 to 2.25]), and death (1.38 [1.05 to 1.82]). Tremor was associated with increased risk for reaching the cognitive and bradykinesia for reaching the functional endpoints. Postural-gait abnormalities carried increased risk for institutionalization and mortality. Faster rates of motor sign accumulation were associated with increased risk for all outcomes. CONCLUSIONS: Motor signs predict cognitive and functional decline, institutionalization, and mortality in Alzheimer disease. Different motor sign domains predict different outcomes.