scholarly journals Prevalence and Predictors of Sperm Banking in Adolescents Newly Diagnosed With Cancer: Examination of Adolescent, Parent, and Provider Factors Influencing Fertility Preservation Outcomes

2017 ◽  
Vol 35 (34) ◽  
pp. 3830-3836 ◽  
Author(s):  
James L. Klosky ◽  
Fang Wang ◽  
Kathryn M. Russell ◽  
Hui Zhang ◽  
Jessica S. Flynn ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Psychological Health ◽  
Tanner Stage ◽  
The United States ◽  
Adolescent Males ◽  
Self Report ◽  
Newly Diagnosed ◽  
Sperm Banking ◽  
Factors Associated ◽  
Adolescent Parent

Purpose To estimate the prevalence of sperm banking among adolescent males newly diagnosed with cancer and to identify factors associated with banking outcomes. Patients and Methods A prospective, single-group, observational study design was used to test the contribution of sociodemographic, medical, psychological/health belief, communication, and developmental factors to fertility preservation outcomes. At-risk adolescent males (N = 146; age 13.00 to 21.99 years; Tanner stage ≥ 3), their parents, and medical providers from eight leading pediatric oncology centers across the United States and Canada completed self-report questionnaires within 1 week of treatment initiation. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% CIs for specified banking outcomes (collection attempt v no attempt and successful completion of banking v no banking). Results Among adolescents (mean age, 16.49 years; standard deviation, 2.02 years), 53.4% (78 of 146) made a collection attempt, with 43.8% (64 of 146) successfully banking sperm (82.1% of attempters). The overall attempt model revealed adolescent consultation with a fertility specialist (OR, 29.96; 95% CI, 2.48 to 361.41; P = .007), parent recommendation to bank (OR, 12.30; 95% CI, 2.01 to 75.94; P = .007), and higher Tanner stage (OR, 5.42; 95% CI, 1.75 to 16.78; P = .003) were associated with an increased likelihood of a collection attempt. Adolescent history of masturbation (OR, 5.99; 95% CI, 1.25 to 28.50; P = .025), banking self-efficacy (OR, 1.23; 95% CI, 1.05 to 1.45; P = .012), and parent (OR, 4.62; 95% CI, 1.46 to 14.73; P = .010) or medical team (OR, 4.26; 95% CI, 1.45 to 12.43; P = .008) recommendation to bank were associated with increased likelihood of sperm banking completion. Conclusion Although findings suggest that banking is underutilized, modifiable adolescent, parent, and provider factors associated with banking outcomes were identified and should be targeted in future intervention efforts.

Use and spending on antineoplastic therapy (AT) in the Medicare population and the role of supplemental coverage.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6060-6060
Author(s):  
Amy J. Davidoff ◽  
Thomas Shaffer ◽  
Ilene H. Zuckerman ◽  
Naimish B. Pandya ◽  
Bruce C. Stuart ◽  
...  
Keyword(s):  
Linear Models ◽  
Prescription Medication ◽  
Self Report ◽  
Cancer Site ◽  
Newly Diagnosed ◽  
Medicare Beneficiaries ◽  
Part D ◽  
Ongoing Research ◽  
Factors Associated

6060 Background: Oral antineoplastic agents (OAA) represent a growing sector of cancer therapy. Prior studies of older adult cancer patients (pts) examined use of infused/ injected chemotherapy (IICT) covered by Medicare Part B. We examined trends in IICT and OAA use, and the effect of supplemental coverage on AT use and spending. Methods: We used Medicare Current Beneficiary Survey data (1997-2007). Newly diagnosed cancer pts were selected using ICD-9CM codes. IICT use was identified from Part B claims; OAAs were identified from self reported prescription medication events. Supplemental coverage and pt characteristics were assessed from administrative records and self-report. Total spending summed payments from all sources during the cancer diagnosis and subsequent year. Logistic regression examined factors associated with use of any and type of AT; Generalized Linear Models estimated factors associated with spending. Results: Of 1,836 newly diagnosed cancer pts 559 (31%) received AT; 395 (21%) used IICT and 253 (15%) used OAAs. Spending per user was $7,544(AT), $9,892 (IICT), and $1,535 (OAA). Supplemental coverage was associated with increased odds of AT use compared to no supplemental coverage (see Table). Cancer site and age were key predictors of spending among users. OAA spending increased during 2006-7 relative to 2004-5. Conclusions: AT use in Medicare beneficiaries is sensitive to the presence but not type of supplemental coverage. OAAs were used by a relatively large proportion of cancer pts receiving AT, although spending was less than for IICT during this largely pre-Part D period. With the growing number of relatively new OAAs, and more in the pipeline, monitoring the role of supplemental coverage, and particularly the role of Part D on access and spending is a critical area for ongoing research. [Table: see text]

Validation of the CNS emotional lability scale for pseudobulbar affect (pathological laughing and crying) in multiple sclerosis patients

2004 ◽  
Vol 10 (6) ◽  
pp. 679-685 ◽  
Author(s):  
Richard A Smith ◽  
James E Berg ◽  
Laura E Pope ◽  
Janice D Callahan ◽  
Daniel Wynn ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Roc Curve ◽  
The United States ◽  
Self Report ◽  
Emotional Lability ◽  
Newly Diagnosed ◽  
Roc Curve Analysis ◽  
Pseudobulbar Affect ◽  
Patient Interviews ◽  
Multiple Sclerosis Patients

Pseudobulbar affect (PBA) or pathological laughing and crying (PLC) is a disorder of affect that occurs in about 10% of multiple sclerosis (MS) patients. The objective of this study was to validate the CNS Emotional Lability Scale (CNS-LS) in MS patients and to correlate the results with the frequency and intensity of episodes of PLC. Physicians at seven private practice referral centers in the United States made a diagnosis concerning PLC based on patient interviews. Clinical coordinators separately administered the CNS-LS, a self-report measure of PLC with seven questions, to MS patients, including patients known to exhibit PLC, patients thought to be free of PLC, and newly diagnosed patients where PLC status was unknown, and the physician was blinded as to the results. A receiver operating characteristic (ROC) curve analysis was performed to define a cut-off best correlating with the physician’s diagnosis. Of 90 MS patients selected to complete the survey, 50 were physician diagnosed with PLC; 40 were without PLC, and 15 of these 90 patients were newly diagnosed with MS (B-6 months). Scores of 17 or higher corresponded to a sensitivity of 0.94 and a specificity of 0.83 (LR -/5.5, LR -/0.07); 89% of patients were correctly diagnosed. The area under the ROC curve was 0.95. Symptoms were greater in patients diagnosed as PLC than in non-PLC patients as evidenced by mean number of episodes/week, number of days/week with episodes, duration of an episode and total time in an episode. Similar results were observed if patients were classified as PLC or non-PLC according to CNS-LS score]-17, suggesting that the CNS-LS is a valid measure for the assessment of PLC in MS patients and could be a useful instrument for clinical and research purposes.

scholarly journals Lifestyle Factors Associated With Sunscreen Use Among Young Adults

2016 ◽  
Vol 12 (4) ◽  
pp. 331-339
Author(s):  
Julie Williams Merten ◽  
Jessica L. King ◽  
Melissa J. Vilaro ◽  
Erin Largo-Wight
Keyword(s):  
Young Adults ◽  
Skin Cancer ◽  
Well Being ◽  
The United States ◽  
Lifestyle Factors ◽  
Self Report ◽  
Convenience Sample ◽  
Factors Associated ◽  
Sunscreen Use ◽  
The Relationship

Background. Skin cancer is the most common cancer in the United States with melanoma rates increasing. Sunscreen use is an effective way to protect the skin and reduce skin cancer risk. Limited research has been conducted examining the relationship between sunscreen use and other lifestyle factors. Interventions aimed at multiple lifestyle factors have shown promise for prevention and reduced health care costs. Objective. This study explores the relationship between sunscreen use and lifestyle factors associated with mortality and morbidity among young adults. Lifestyle factors examined included physical activity, substance abuse, smoking, sexual behavior, unintentional injury, and mental well-being. Methods. A convenience sample of 747 college students was surveyed about sunscreen use and other health risks. Data were analyzed using SPSS 19. Results. White, female students older than 21 years were more likely to use sunscreen. Texting while driving, low life satisfaction, and binge drinking were associated with inadequate sunscreen use. Limitations. Convenience sampling limits generalizability and surveys are subject to recall, self-report, and self-selection bias. Conclusions. The findings provide the framework to develop multiple risk factor interventions.

Characterization of the Early Years of Bevacizumab Use for First-Line Treatment of Ovarian Cancer in the United States

2021 ◽  
pp. OP.20.00918
Author(s):  
Soledad Jorge ◽  
Barbara A. Goff ◽  
Heidi J. Gray ◽  
Daniel A. Enquobahrie ◽  
Kemi M. Doll
Keyword(s):  
United States ◽  
Ovarian Cancer ◽  
Metastatic Disease ◽  
The United States ◽  
Interquartile Range ◽  
Newly Diagnosed ◽  
Off Label Use ◽  
Off Label ◽  
Factors Associated ◽  
Label Use

PURPOSE: To quantify early dissemination patterns, factors influencing use, and costs of bevacizumab (BEV) for the treatment of newly diagnosed ovarian cancer (OC) in the United States before its regulatory approval for this indication (off-label use). METHODS: We identified women 18-65 years of age with newly diagnosed OC treated with surgery and platinum-based chemotherapy from 2008 to 2016 through the MarketScan database (N = 8,109). The proportion of women receiving BEV over time was calculated, multivariate logistic regression used to determine factors associated with BEV use, and total costs per cycle of chemotherapy with and without BEV abstracted. RESULTS: BEV utilization rose 1.8-fold during the study period, from 4.1% (2008) to 7.4 % (2016). BEV was used with non–platinum/taxane regimens over a third of the time (37.2%). Physician specialty (medical oncology v gyn oncology) and geography (southeast region) were significantly associated with higher rates of use. Clinical factors associated with BEV use were metastatic disease and presence of ascites. The median cost of one cycle of platinum/taxane chemotherapy plus BEV was $10,897 in US dollars (USD) (interquartile range $7,573-$18,133 USD), compared with $1,629 USD (interquartile range, $683.0-$4,461 USD) for platinum/taxane alone. CONCLUSION: Off-label use of BEV for newly diagnosed OC was rare (< 10%), but doubled following presentation of phase II and III data at international meetings. Both clinical (ascites, metastatic disease, and age) and nonclinical (specialty and region) factors were associated with BEV use, and its use was accompanied by a six-fold increase in the cost of one cycle of treatment.

scholarly journals Provider Influences on Sperm Banking Outcomes Among Adolescent Males Newly Diagnosed With Cancer

2017 ◽  
Vol 60 (3) ◽  
pp. 277-283 ◽  
Author(s):  
James L. Klosky ◽  
L. Elizabeth Anderson ◽  
Kathryn M. Russell ◽  
Lu Huang ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Adolescent Males ◽  
Newly Diagnosed ◽  
Sperm Banking

scholarly journals Hebephilic Sexual Interests In Sexual Offenders

2021 ◽  
Author(s):  
Skye Stephens
Keyword(s):  
Mental Health ◽  
Sexual Offenders ◽  
Convergent Validity ◽  
Sexual Interest ◽  
Sexual Offending ◽  
Tanner Stage ◽  
The United States ◽  
Self Report ◽  
Criminal Records ◽  
Sexual Behaviours

Hebephilia refers to a sexual interest for pubescent children in Tanner Stage 2 or 3 of sexual development (i.e., early stages of secondary sex development; Blanchard, Lykins, et al., 2009). Hebephilia was recently proposed as a standalone diagnosis, alongside pedophilia, in the main diagnostic manual used by clinicians in Canada and the United States to diagnose mental health disorders, which ignited considerable controversy in the field. The dissertation examined the validity of hebephilia as a construct through three interrelated studies utilizing a large sample of sexual offenders from a Sexual Behaviours Clinic (n = 2,238). Study 1 examined the convergent validity of hebephilia in a sample of admitters and deniers. There was convergence among self-report, sexual behaviour, and sexual arousal indicators of hebephilia. Further, there was considerable overlap between pedophilia (i.e., sexual interest in prepubescent children) and hebephilia. Study 2 and Study 3 examined the association between hebephilia and sexual offending. Hebephilia is arguably most pertinent to furthering our understanding of sexual offending against children, as one could not act on this sexual interest legally without committing a sexual offence against a child. Study 2 examined concurrent validity by examining the role of hebephilia in sexual victim choice. Similar to pedophilia, hebephilia was associated with a greater number of victims under the age of 15. Further, hebephilia was associated with an increased likelihood of victim age polymorphism (i.e., having victims in other age ranges). Finally, Study 3 examined a subsample of offenders assessed at the Sexual Behaviours Clinic (n = 656) whose criminal records were coded and analyzed in order to assess the predictive validity of hebephilia. Both pedophilia and hebephilia were associated with an increased likelihood of sexual non-contact recidivism, after controlling for time at risk. Based on their high degree of overlap and similar correlates, the major conclusion of this dissertation is that pedophilia and hebephilia are more similar than they are different. Results are discussed within the context of the debate on whether hebephilia is a mental health disorder and the implications for the assessment and risk management of sexual offenders.

Sperm banking in adolescent males with nephrotic syndrome: defining the limits of access to fertility preservation

2012 ◽  
Vol 97 (9) ◽  
pp. 765-766 ◽  
Author(s):  
Steven David Miller ◽  
Jill P Ginsberg ◽  
Arthur Caplan ◽  
Kevin E Meyers
Keyword(s):  
Nephrotic Syndrome ◽  
Fertility Preservation ◽  
Adolescent Males ◽  
Sperm Banking

scholarly journals Hebephilic Sexual Interests In Sexual Offenders

2021 ◽  
Author(s):  
Skye Stephens
Keyword(s):  
Mental Health ◽  
Sexual Offenders ◽  
Convergent Validity ◽  
Sexual Interest ◽  
Sexual Offending ◽  
Tanner Stage ◽  
The United States ◽  
Self Report ◽  
Criminal Records ◽  
Sexual Behaviours

Hebephilia refers to a sexual interest for pubescent children in Tanner Stage 2 or 3 of sexual development (i.e., early stages of secondary sex development; Blanchard, Lykins, et al., 2009). Hebephilia was recently proposed as a standalone diagnosis, alongside pedophilia, in the main diagnostic manual used by clinicians in Canada and the United States to diagnose mental health disorders, which ignited considerable controversy in the field. The dissertation examined the validity of hebephilia as a construct through three interrelated studies utilizing a large sample of sexual offenders from a Sexual Behaviours Clinic (n = 2,238). Study 1 examined the convergent validity of hebephilia in a sample of admitters and deniers. There was convergence among self-report, sexual behaviour, and sexual arousal indicators of hebephilia. Further, there was considerable overlap between pedophilia (i.e., sexual interest in prepubescent children) and hebephilia. Study 2 and Study 3 examined the association between hebephilia and sexual offending. Hebephilia is arguably most pertinent to furthering our understanding of sexual offending against children, as one could not act on this sexual interest legally without committing a sexual offence against a child. Study 2 examined concurrent validity by examining the role of hebephilia in sexual victim choice. Similar to pedophilia, hebephilia was associated with a greater number of victims under the age of 15. Further, hebephilia was associated with an increased likelihood of victim age polymorphism (i.e., having victims in other age ranges). Finally, Study 3 examined a subsample of offenders assessed at the Sexual Behaviours Clinic (n = 656) whose criminal records were coded and analyzed in order to assess the predictive validity of hebephilia. Both pedophilia and hebephilia were associated with an increased likelihood of sexual non-contact recidivism, after controlling for time at risk. Based on their high degree of overlap and similar correlates, the major conclusion of this dissertation is that pedophilia and hebephilia are more similar than they are different. Results are discussed within the context of the debate on whether hebephilia is a mental health disorder and the implications for the assessment and risk management of sexual offenders.

scholarly journals Tobacco Use Prevalence and Transitions From 2013 to 2018 Among Adults With a History of Cardiovascular Disease

2021 ◽  
Author(s):  
Lindsay M. Reynolds ◽  
Cristian Zamora ◽  
Un Jung Lee ◽  
Andrew C. Stokes ◽  
Emelia J. Benjamin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Tobacco Use ◽  
The United States ◽  
Tobacco Product ◽  
Self Report ◽  
Cigarette Use ◽  
Data Set ◽  
Factors Associated ◽  
Product Use ◽  
Current Tobacco

Background Although tobacco product use and transitions have been characterized in the general population, few studies have focused on individuals with established cardiovascular disease (CVD) in a population‐based sample. Methods and Results We examined tobacco use prevalence and longitudinal patterns of tobacco product transitions in adults (≥18 years) of the nationally representative PATH (Population Assessment of Tobacco and Health) study, from 2013 to 2014 (Wave 1) through 2016 to 2018 (Wave 4). Prevalent CVD was classified through self‐report of having had a heart attack, heart failure, stroke, or other heart condition. Factors associated with tobacco product use and transitions were investigated using survey logistic regression. We examined 2615 participants with self‐reported CVD at Wave 1. Overall, 28.9% reported current tobacco use, equating to ≈6.2 million adults in the United States with prevalent CVD and current tobacco use. Among adults with CVD who are current tobacco users, the most commonly used product was cigarettes (82.8%), followed by any type of cigar (23.7%), and e‐cigarette use (23.3%). E‐cigarette use without concurrent cigarette use among participants with prevalent CVD was uncommon (1.1%). Factors associated with tobacco use were younger age, male sex, had lower education level, and lack of knowledge about the association between smoking and CVD. Men with prevalent CVD were less likely to use e‐cigarettes compared with women (odds ratio [OR], 0.7; 95% CI, 0.5–0.9). Among cigarette users with CVD, transition rates between Waves 1 and 4 demonstrated <5% decrease in cigarette, with a 0.5% increase in e‐cigarette use. Only ≈10% were in formal tobacco cessation programs. Conclusions Despite known harmful cardiovascular effects, over one fourth of adults with prevalent CVD use tobacco products and few quit smoking over the 4 waves of the PATH data set.

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