Adolescent male-to-female transgender voice and communication therapy

Current research to describe and evaluate effectiveness of voice and communication therapy for male-to-female transgender people is limited to adults. This paper provides rationale, procedures, and outcomes from voice and communication therapy for a male-to-female transgender adolescent 15 years of age. Treatment addressed vocal hygiene, breath support, fundamental frequency, intonation, resonance and vocal quality, and rate. Positive acoustic, perceptual, and client self-report outcomes confirm treatment effectiveness for this adolescent. Learning outcomes: The reader will be able to recognize common aspects of transgender voice and communication therapy provided by a speech-language pathologist. The reader will also be able to explain the effectiveness of therapy provided to an adolescent speaker.     

Late mental health changes in tortured refugees in multidisciplinary treatment

The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted to the Rehabilitation and Research Centre for Torture Victims in 2001 to 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and on health-related quality of life (World Health Organization Quality of Life-Bref) were collected before treatment and after 9 and 23 months. No substantial changes in mental health were observed at the 9-month follow-up, and the minor decrease in some symptoms observed between the 9 and 23 months may reflect regression toward the mean or the natural course of symptoms in this cohort. Thus, no clinically significant improvement was observed, but there is a need for further studies, in particular randomized trials evaluating the efficacy of various health-related and social interventions among severely traumatized refugees.     

Health disparities between immigrant and Danish cleaners

Purpose

It is unknown whether immigrants working in the cleaning industry have a poorer health and work ability than cleaners from the native population. The main aim was to investigate differences in objective and self-reported health measures between immigrant and Danish cleaners.

Methods

Three hundred and fifty-one cleaners, consisting of 166 Danes (88% women) and 179 immigrants (74% women) (6 with unknown ethnicity), from 9 workplaces in Denmark participated in the study. Health and work ability were obtained by objective (e.g., BMI and blood pressure) and self-reported measures (e.g., work ability, self-rated health, and musculoskeletal symptoms). In order to investigate differences between Danish and immigrant cleaners, logistic regression analyses and General Linear Models were performed.

Results

When controlling for age, sex, workplace, job seniority, and smoking, more Danish compared with immigrant cleaners were current smokers (42% vs. 28%, p?p?p?p?p?p?p?p?p?p?Conclusions Although the health of the cleaners was alarmingly poor, the immigrant cleaners generally had a poorer self-reported health and work ability than the Danish cleaners. These findings highlight the need for occupational health actions among cleaners, particularly tailored to the immigrant subpopulation.     

Infertility, infertility treatment and behavioural problems in the offspring

Behavioural patterns in children of infertile couples may be influenced by both the underlying causes of infertility and stress in the couples. Treatment procedures, such as culture media and manipulation of gametes and embryos, may also result in developmental problems. We examined behavioural problems in children as a function of infertility and infertility treatment, using data from three population-based birth cohorts in Denmark (Aalborg-Odense Birth Cohort, Aarhus Birth Cohort and Danish National Birth Cohort). Information on time to pregnancy and infertility treatment was collected during pregnancy. Children aged between 7 and 21 years were assessed using the Strengths and Difficulties Questionnaire (SDQ). The SDQ was completed by mothers in all cohorts and, in addition, by teachers in the Aarhus cohort and by children themselves in the Aalborg-Odense cohort. Children born after a time to pregnancy of >12 months and no infertility treatment had a behavioural pattern similar to children of fertile parents. Teachers reported a higher total difficulties score for children born after infertility treatment, but no significant differences were seen on any subscales of the teachers' report, and neither the mothers nor the children reported any differences on the total difficulties score and the prosocial behaviour score. Our results are thus overall reassuring regarding behavioural problems in children born to infertile couples, regardless of infertility treatment.     

How children handle life when their mother or father is seriously ill and dying

Scand J Caring Sci; 2012; 26; 228–235 How children handle life when their mother or father is seriously ill and dying Aims and objectives: The aim of this study was to describe and understand how children handle their life when a mother or father is dying. Methodological design and justification: The research design was phenomenological hermeneutic. The phenomenological approach enabled us to capture the concrete everyday life of the children as it is understood and experienced by the children themselves. The hermeneutical approach offered the possibility of reaching an understanding of the children’s experiences. Research Methods: Seven children aged 11‐17 years participated in the study. Data were collected using qualitative interviews and video diaries. Ethical considerations: The researcher complied with ethical guidelines that apply to all researchers and followed ethical guidelines for nursing research in the Nordic Countries (Northern Nurses Federation). The children’s names were changed, and the data were treated confidentially. Findings: Analysis produced an overarching theme of death’s waiting room, with following sub‐themes: Relating to death, when death becomes even more clearly manifest and handling life in death’s waiting room. Study limitations: This study focuses on a limited explored area; children’s lived life with a dying parent. The study limits itself to focusing on children’s life world; by choosing this focus, we have not included the relational aspects that are essential aspects of children’s lives. One might focus on these aspects in a second study to shed further light on the children’s lives. Conclusion: When children live in a family with a dying mother or father, they find that their home is transformed from a safe base into death’s waiting room. The children use a variety of ways to handle the confrontation with death. Avoiding talking to the children will not protect them from their thoughts about death.     

Participation in cancer rehabilitation and unmet needs: a population-based cohort study

Purpose

To investigate associations between cancer survivors’ sex, age, and diagnosis in relation to their (1) need for rehabilitation, (2) participation in rehabilitation activities, and (3) unmet needs for rehabilitation in a 14-month period following date of diagnosis.

Methods

A population-based cohort study was performed on incident cancer patients diagnosed from 1 October 2007 to 30 September 2008. Fourteen months after diagnosis, participants completed a questionnaire developed to measure the aspects of rehabilitation. Logistic regression analyses were used to explore the association between sex, age, and diagnosis, and the outcome variables for rehabilitation.

Results

A total of 3,439 patients participated, yielding an overall response rate of 70%. One third of the cancer patients reported a need for physical rehabilitation and one third for psychological rehabilitation. Half of the patients participated in at least one activity. Unmet needs were most often reported in psychological, sexual, and financial areas. Women expressed more needs, participated more often in rehabilitation activities, and had, to a higher extent, their emotional needs fulfilled. Breast cancer patients participated more often in physical rehabilitation. Elderly who expressed rehabilitation needs more often had them unresolved.

Conclusions

A substantial variation in rehabilitation needs, participation in activities, and unmet needs in relation to sex, age, and cancer type was observed. Cancer care ought to systematically address the wide range of needs in all groups through integration of systematic needs assessment and targeted supply of offers.     

Inhibition of placenta growth factor with TB-403: a novel antiangiogenic cancer therapy

INTRODUCTION: There is clinical evidence that therapies targeting the vascular endothelial growth factor pathway are effective in delaying cancer progression. However, tumors may be either intrinsically resistant or evolve resistance to such therapies. Hence, there is a need for new therapies targeting angiogenesis. AREAS COVERED: The data are obtained by searching in the PubMed database. The search terms used included antiangiogenic therapy, TB-403 (RO5323441), placenta growth factor (PlGF) and VEGFR-1 (Flt-1). We review preclinical data concerning the function and inhibition of PlGF and summarize data on expression of PlGF in cancer patients. Data from early-phase clinical trials of TB-403 (RO5323441), a monoclonal antibody inhibiting PlGF, are discussed. Future development strategies, therapeutic potentials and limitations of TB-403 are further evaluated. EXPERT OPINION: There are some conflicting data on the function of PlGF and the importance of its role in primary tumor growth. Data from some preclinical models of PlGF inhibition and early-phase clinical trials with TB-403 are, however, promising, although the true potential of the drug is yet to be determined. Further clinical development should be preceded by molecular studies in the context of well-designed preclinical models and/or small translational studies. Future challenges involve identifying predictive biomarkers.     

Complement profile and activation mechanisms by different LDL apheresis systems

Extracorporeal removal of low-density lipoprotein (LDL) cholesterol by means of selective LDL apheresis is indicated in otherwise uncontrolled familial hypercholesterolemia. During blood-biomaterial interaction other constituents than the LDL particles are affected, including the complement system. We set up an ex vivo model in which human whole blood was passed through an LDL apheresis system with one of three different apheresis columns: whole blood adsorption, plasma adsorption and plasma filtration. The concentrations of complement activation products revealed distinctly different patterns of activation and adsorption by the different systems. Evaluated as the final common terminal complement complex (TCC) the whole blood system was inert, in contrast to the plasma systems, which generated substantial and equal amounts of TCC. Initial classical pathway activation was revealed equally for both plasma systems as increases in the C1rs-C1inh complex and C4d. Alternative pathway activation (Bb) was most pronounced for the plasma adsorption system. Although the anaphylatoxins (C3a and C5a) were equally generated by the two plasma separation systems, they were efficiently adsorbed to the plasma adsorption column before the "outlet", whereas they were left free in the plasma in the filtration system. Consequently, during blood-biomaterial interaction in LDL apheresis the complement system is modulated in different manners depending on the device composition.