Point-of-care assessment of sexual concerns among young adult oncology active patients and survivors.

PURPOSE: Adolescent and young adult (AYA) oncology populations have unique sexual health concerns that deserve more attention. Our study aimed to describe sexual health and related concerns in young adults (YAs) to move toward integrating sexual health into routine care. METHODS: A total of 127 YAs (ages 19-39) in active treatment and survivorship from three outpatient oncology clinics provided demographic and clinical information. They completed versions of the NCCN Distress Thermometer and Problem List (AYA-POST; AYA-SPOST) developed specifically for AYAs as part of an ongoing needs assessment study. RESULTS: Over one quarter (27.6%) of the total sample (Mage = 31.96, SD = 5.33) - 31.9% in active treatment (n = 72) and 21.8% in survivorship (n = 55) - reported at least one sexual health concern (i.e., sexual concern, loss of libido (desire for sex), pain with sex, and unprotected sex). Those undergoing active treatment with sexual concerns had significantly higher distress than those without sexual concerns, whereas this pattern was nonsignificant for those in survivorship. Both genders often endorsed general sexual concerns and loss of libido. CONCLUSION: The current study adds to the important and burgeoning literature on sexual health concerns of YAs oncology populations. The prevalence of sexual concerns, differences between treatment status and between those with and without sexual concerns highlight the utility and need to embed screening that includes sexual health items at point of care. This can facilitate discussion of these sensitive and multifaceted needs throughout the cancer continuum.

Point of Care Assessment of Sexual Concerns among AYA Oncology Active Patients and Survivors.

Purpose Adolescent and young adults (AYAs) oncology populations have unique sexual health concerns that deserve more attention. The current study aimed to describe the prevalence and characteristics of sexual health and related concerns in AYAs in active treatment and survivorship to move toward integrating sexual health in routine care. Methods A total of 127 AYAs (ages 19-39) in active treatment and survivorship were recruited from three outpatient oncology clinics. In addition to providing demographic and clinical information, they completed an adapted version of the NCCN Distress Thermometer and Problem List (AYA-POST; AYA-SPOST) as part of an ongoing needs assessment study. Results Over one quarter (27.6%) of the total sample ( M age = 31.96, SD = 5.33) - 31.9% of active treatment, and 21.8% in survivorship - reported at least one sexual health concern (i.e., sexual concern, loss of libido, pain with sex, and unprotected sex). The most frequently endorsed concerns differed between active treatments and survivorship. Both genders often endorsed general sexual concerns and loss of libido. Conclusion The literature on sexual concerns in the AYA population is sparse and inconclusive, especially accounting for gender and other types of concerns. The current study highlights the need for further examination between treatment status, psychosexual concerns, emotional distress, and demographic and clinical factors. Given the prevalence of sexual concerns in AYAs in active treatment and survivorship, providers should consider integrating assessment and discussion of these needs at onset of diagnosis and as part of monitoring.

Characteristics and experiences of professionals providing 9/11 mental health services.

BACKGROUND: After disasters, mental health professionals might be called upon to help address the emotional consequences of the disaster among survivors and other affected groups, but the clinicians themselves could be affected. This exploratory study examined the experiences of 60 mental health professionals, most of whom provided mental health care to individuals affected by the September 11, 2001 terrorist attacks (9/11), and/or experienced 9/11 sequelae themselves. METHODS: Participants completed structured interviews 3 and/or 6 years after the disaster, with full diagnostic assessment of psychiatric disorders and questions specific to their personal and professional post-9/11 experience. RESULTS: Providing postdisaster care was somewhat stressful initially, but long-term effects were more positive than negative, with overall benefit to many personal lives. Most found their clients' 9/11 stories emotionally upsetting, yet characterized their 9/11 mental health work as positive. Work satisfaction increased by 3-fold, but this effect was transitory. One-third had postdisaster psychopathology, but most was pre-existing and therefore not a product of disaster-related stressors. CONCLUSIONS: Although most mental health professionals initially found the emotional difficulty of their work increased after 9/11, this negative effect had largely dissipated over the years. Opportunities for disaster mental health training and initial logistical support could benefit these professionals.

Predictors of attrition in an interdisciplinary pain management program.

PURPOSE/OBJECTIVE: This study sought to investigate the extent to which demographic and clinical characteristics predict which patients drop out of an interdisciplinary pain management program (IPP). RESEARCH METHOD/DESIGN: Participants (N = 178 outpatients, 18-75 years of age) received treatment for various chronic pain conditions in an IPP (including biopsychosocial assessment, cognitive-behavioral, and physical therapies). Separate logistic regression analyses identified the demographic and clinical variables most predictive of attrition across five domains: (a) demographics, (b) number of medical and non/psychiatric diagnoses, (c) opioid use (yes versus no)/risk of misuse, (d) pain-related cognition and behavior, and (e) physical, social, and mental well-being. Significant predictors from the five domains were integrated in a final multivariable logistic regression model. RESULTS: Among patients exposed to a 4-week IPP, 34% dropped out. In the final model, significant predictors of higher odds of attrition included younger age or being unemployed. Also, patients on opioids at preintervention had higher odds of completing the IPP than patients not on opioids at preintervention. Follow-up analyses revealed 24 of 37 completers (65%) on opioids at preintervention reduced or eliminated use over the course of the IPP. CONCLUSIONS/IMPLICATIONS: Because findings are limited by sample and design characteristics, they require replication yet offer novel hypotheses for identifying patients at risk of attrition. Specifically, patients with preintervention opioid use (contrasted with opioid dependence) may particularly benefit from an IPP. Patients at highest risk for early dropout can be targeted for specific engagement interventions to promote completion and effectiveness of IPP. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using quantitative sensory testing to predict attrition in an interdisciplinary pain management program: a pilot study.

Aim: To determine the extent to which quantitative sensory testing (QST) predicted attrition in an interdisciplinary pain program (IPP). Patients & methods: Participants (n = 53) enrolled in an IPP completed pretreatment assessments of QST and the PROMIS-29 quality of life survey. Results & conclusion: Compared with completers, non-completers (24.5%) reported significantly higher pain intensity (7.1, 95% CI [5.8, 8.4] versus 5.4, 95% CI [4.8, 6.1]) and cold hyperalgesia (14.6°C, 95% CI [8.8, 20.4] versus 7.5°C, 95% CI [4.8, 6.1]), with both variables also predicting attrition. This finding highlights a potentially novel and clinically significant use of QST. Higher overall pain intensity and the presence of remote cold hyperalgesia may identify patients at risk for dropping out of an IPP.

The purpose of this research study was to determine the extent to which quantitative sensory testing (QST) predicted which patients enrolled in an interdisciplinary pain program (IPP) would drop out. Fifty-three patients with chronic pain enrolled in an IPP were assessed before treatment with mechanical and thermal QST at a painful and a non-painful site, as well as with the PROMIS-29 quality of life survey. Pretreatment findings were compared between non-completers (i.e., attended five or fewer sessions for any component of the IPP) and completers. Resulting significant predictors were included in a logistic regression to predict attrition. Compared with those who completed the program, non-completers (24.5%) reported significantly higher pain intensity and oversensitivity to cold at a non-painful site pretreatment, with both variables also predicting completion of the IPP. In summary, these preliminary findings suggest that higher overall pain intensity and the presence of cold oversensitivity (at baseline) may identify patients at risk for dropping out of an IPP.

Associations between frequent pain or headaches and neurobehavioral symptoms by gender and TBI severity.

Objective: To investigate differences in frequent pain or headaches and associated neurobehavioral symptoms among men, women, and transgender individuals with and without a history of traumatic brain injury (TBI).Setting: CommunityParticipants: English and Spanish-speaking adults (n = 2,862) with and without self-reported TBIDesign: Cross-sectional studyMain Measures: Behavioral Assessment Screening Tool (BAST) subscales for Negative Affect, Substance Abuse, Executive Function, Fatigue, Impulsivity, and one item for experiencing "frequent pain or headache."Results: Women reported more pain than men. Women with a mild TBI (mTBI) more often reported frequent headaches/pain than woman in general or those with mTBI alone. Women reporting frequent headache/pain reported more negative affect and fatigue than men with comparable TBI history. Individuals identifying as transgender/other without TBI had higher negative affect and fatigue than both men and women without TBI. Individuals with mTBI and frequent headache/pain reported more executive function problems than those with mTBI without headache/pain. Pain and moderate/severe TBI were associated with more executive function problems in men and women, but more so for women.Conclusion: Results suggest frequent headache/pain may differ between genders, particularly after mTBI. Pain, fatigue, executive function, and negative affect may be especially important in women's recovery from TBI.

Short chain fatty acids stimulate feline colonic smooth muscle contraction.

The effect of short chain fatty acids (SCFA) on feline colonic smooth muscle contraction was evaluated in vitro. Colonic tissue was obtained from seven healthy male and female adult cats and seven healthy male and female kittens. Longitudinal and circular colonic smooth muscle strips from proximal and distal colon were incubated with SCFA (acetate, butyrate and propionate; 1-100mM). SCFA-induced contractions were compared to responses obtained using maximal concentrations (10(-4)M) of acetylcholine (ACh). The calcium dependence of the SCFA response was investigated by incubating with nifedipine (1 microM) or verapamil (1 microM). Acetate, butyrate and propionate elicited isometric stress responses (0.25-1.98 x 10(4)N/m(2)) in longitudinal, but not circular, smooth muscle from both the proximal and distal colon of adult cats. Maximal responses were attained at 50 and 100mM SCFA. Maximal butyrate and propionate responses were 29 and 19% of the maximal ACh response (10(-4)M), respectively. Acetate was least effective in stimulating contractile responses. Nifedipine and verapamil abolished all responses. Contractile responses in kittens were similar to those observed in adult cats, but were smaller in amplitude. Results of these studies have shown that SCFA stimulate longitudinal colonic smooth muscle contractions in kittens and adult cats in vitro. These SCFA-induced contractions involve activation of calcium influx. These in vitro findings may account for some of the effects of dietary fiber on feline colonic motility in vivo.