Factors Associated with Substance Use Among Homeless Young Adults

ABSTRACT

The purpose of this study was to investigate factors associated with substance use among homeless young adults. Multinomial logistic regression analyses examined the influence of social networks and economic factors among a group of homeless young adults with differing levels of alcohol and drug use. In addition, for those with an alcohol use disorder, the role of future time expectancies was examined. A sample (n = 185) of homeless young adults aged 18 to 23 were recruited from a community drop-in center and interviewed utilizing self-report instruments. Findings suggest that social networks, economic factors, and future expectancies are significant predictors of the level of substance use among homeless young adults. Being able to identify those areas that place homeless young adults at risk for substance abuse and dependence has implications for effective intervention.     

Spiritual Change in Drug Treatment: Utility of the Christian Inventory of Spirituality

ABSTRACT

The current study used data from reliability testing of the Christian Inventory of Spirituality (CIS) to (1 Kennedy, S and Bielefeld, W. 2006. Charitable Choice at Work: Evaluating Faith-Based Job Programs in the States, Washington, DC: Georgetown University Press.  [Google Scholar]) assess the utility of CIS in detecting differences in level of spirituality in residents of residential Christian faith-based substance abuse programs (RCFBSAPs); (2 Grettenberger, S E, Bartkowski, J P and Smith, S R. 2006. Evaluating the effectiveness of faith-based welfare agencies: methodological challenges and possibilities. J Relig Spiritual Soc Work., 25: 223–240. [Taylor & Francis Online] , [Google Scholar]) test the hypothesis that residents who have been in the program for longer periods of time will have significantly higher levels of spirituality after controlling for relevant demographic characteristics; and (3 Zanis, D A and Cnaan, R A. 2006. Social service research and religion: thoughts about how to measure intervention-based impact. J Relig Spiritual Soc Work., 25: 83–104. [Taylor & Francis Online] , [Google Scholar]) test the hypothesis that residents of programs that only use unlicensed staff and place higher importance on spirituality will have significantly higher levels of spirituality. A purposive sample of the cross-sectional data from the reliability testing of the CIS was used (n = 253). Analysis supported the hypothesis. Demographic characteristics were not associated with level of spirituality. The CIS proved to be useful in discriminating levels of spirituality. Further research is needed to examine spiritual change using randomized pre-post test designs.     

A Novel CBT Web Course for the Substance Abuse Workforce: Community Counselors' Perceptions

ABSTRACT

This article describes (a) a Web-based course for substance abuse counselors on cognitive behavioral therapy (CBT), and (b) the evaluation of a prototype module from the Web-based course to determine the feasibility of the e-learning program for a community-based counselor audience. The course is part of a unique study that trains counselor-supervisor teams to increase the transfer of learned skills to the agency. Following curriculum design, the authors sought counselor reactions to the prototype module on strengths/limitations of the design, functionality, and effectiveness. Results showed that counselors learned new information, found this format effective compared to other training, and wanted to complete a full CBT Web course. Counselors' evaluation led to content and technology changes: the authors added and segmented material aimed at the advanced, more theoretically oriented counselor, and housed these topics behind an “advanced concept” graphics button; added seven screens to accommodate text broken into smaller units; and increased the difficulty of the end-of-module quiz.     

Surgical management of the esogastric junction adenocarcinoma according to its histological types

Most adenocarcinomas of the esophagus occur in the area of the cardia and originate in islands of gastrointestinal mucosa, less often in the submucosal glands, and are usually histologically similar to gastric adenocarcinoma and its various histological patterns. Most tumors are well differentiated. All patients included in this study were diagnosed with adenocarcinoma of the esogastric junction through prior endoscopy and histopathological examination of the biopsies. Patients with resectable tumors underwent surgical resection followed by histopathological examination of the resected samples. The most frequently encountered tumor was represented by type III, subcardial adenocarcinoma in 68% of all cases. The main surgical procedure was distal esophagectomy with total gastrectomy extended by abdominal transthoracic approach. All the studied cases were diagnosed with adenocarcinoma of the gastro-esophageal junction. The majority of them were well-differentiated being easily recognized by their submucosal invasion. We believe that surgery with curative intent is superior to curative palliative treatment.     

P53, Bcl-2 and Ki67 immunoexpression in follicular solid ameloblastomas

The study included a total of 17 ameloblastomas diagnosed in a range of 15 years. Clinical data processing was followed by histopathological and immunohistochemical analysis, following the expression of p53, Bcl-2 and Ki67 in the tumor epithelial compartments. Lesions predominated in the age range 20-40 years, to male gender, being located mainly in the mandible (88.2%). Typical follicular ameloblastoma was present in 70.6% of analyzed tumors. P53 and Bcl-2 immunoexpression was identified especially in the peripheral cells, the number of marked cells being over 50%, while the percentage of positive cells from the stellate reticulum was below 10%. The Ki67 positivity index was below 10% in both compartments. Squamous and granular cells reveal no stain for the investigated markers. Peripheral columnar cells are active compartment of ameloblastomas being involved in the processes of proliferation-apoptosis.     

Genetic and epigenetic biomarkers for early detection, therapeutic effectiveness and relapse monitoring in bladder cancer

Urinary bladder cancer is the fifth most common cancer in the Western world and is responsible for about 3% of all cancer-related deaths. Because most advanced invasive or metastatic cancers have low cure rates, risk assessment and early detection of the clinically occult premalignant phases of neoplasia are a particular importance. Many tumor biomarkers for bladder cancer have been evaluated for use in detecting and monitoring bladder cancers tissue specimens, bladder washes, and urine specimens but, none of the biomarkers reported to date has shown sufficient sensitivity and specificity to detect the entire spectrum of bladder cancers in routine clinical practice. The limitations of established prognostic markers requires us to identify better molecular parameters that could be of interest in predicting the prognosis of bladder cancer patients, in particular, the high-risk patient groups that are at risk of progression and recurrence. Methylation is an important molecular mechanism in the development of bladder cancer and could be used as a prognostic and diagnostic biomarker, because hypermethylation of several gene promoters was detected in urine sediment DNA from bladder cancer patients. Aberrant patterns of epigenetic modification could be, in the near future, crucial indicators in cancer diagnosis, prognosis, and additionally could be good targets for developing novel therapies while maintaining quality of life.     

Receipt of Delayed Breast Reconstruction After Mastectomy: Do Women Revisit the Decision?

Background

Postmastectomy breast reconstruction is an important component of breast cancer care, but few receive it at the time of the mastectomy. Virtually nothing is known about receipt of reconstruction after initial cancer therapy and why treatment might be delayed.

Materials and Methods

A 5-year follow-up survey was mailed to a population-based cohort of mastectomy-treated breast cancer patients who were initially surveyed at time of diagnosis in 2002 and reported to the Los Angeles and Detroit SEER registries (N = 645, response rate 60%). Outcomes were receipt of reconstruction (immediate [IR], delayed [DR], or none) and patient appraisal of their treatment decisions.

Results

About one-third (35.9%) had IR, 11.5% had DR, and 52.6% had no reconstruction. One-third delayed reconstruction because they focused more on other cancer interventions, and nearly half were concerned about surgical complications and interference with cancer surveillance. Two-thirds of those with no reconstruction said that the procedure was not important to them. A large proportion of all patients were satisfied with their reconstruction decision-making (89.4% IR, 78.4% DR, 80.4% no reconstruction, P = NS). However, only 59.3% of those with no reconstruction felt that they were adequately informed about their reconstructive options (vs 82.7% IR and 78.4% DR, P < .01).

Conclusions

There was modest uptake of breast reconstruction after initial cancer treatment. Factors associated with delayed reconstruction were primarily related to uncertainty about the procedure, concern about cancer surveillance, and low priority. Those without reconstruction demonstrated significant informational needs, which should be addressed with future research efforts.     

Exploratory Survey of Patients' Needs and Perceptions of Psychosocial Oncology

Cancer is a major health issue that affects a significant proportion of the population. Advancements in oncology treatment have reduced mortality, creating an ever-greater need for psychosocial oncology. Patients with cancer at Grand River Regional Cancer Centre (GRRCC) have access to some psychosocial intervention (e.g., wellness workshops, social work intervention); however, the extent to which these efforts meet patients’ current needs is not known. The purpose of the exploratory survey was to assess patients’ psychosocial needs and psychosocial oncology service needs. Patients receiving treatment for cancer at GRRCC were asked to participate in the anonymous survey. Two research assistants from the University of Guelph obtained informed consent, then with assistance from volunteers from the GRRCC, collected all data. The two screening tools, and standardized, self-report measures of depression and social support (Perceived Social Support Scale) were administered. Patients rated the psychosocial oncology services as very helpful, though 100% indicated the presence of distress. The main source of distress concerned not knowing what their personal outcomes will be. Implications for practice and research are discussed.     

Coping with Inflammatory Breast Cancer: Women's Experiences

The American Cancer Society estimates that 200,000 women will be diagnosed with breast cancer each year. Among these, 1–6% will be diagnosed with a far more aggressive and little studied form, inflammatory breast cancer (IBC). Because its presenting symptoms are atypical, IBC is often mistaken for mastitis or other conditions, resulting in dangerous delay in accurate diagnosis and treatment. Little is written about coping with IBC. This qualitative study explores stressors and challenges women face in coping with diagnosis, treatment and living with IBC, in order to help providers understand and meet the unique needs of women with this disease.