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Living with a blood cancer in later life: The complex challenges and related support needs of adults aged 75 and older
- Naomi D. Parker, Easton N. Wollney, Carma L. Bylund, Tithi B. Amin, M. Devyn Mullis, Diliara Bagautdinova, Maria Sae-Hau, Elisa S. Weiss, Lyndsey A. Thomas, Carla L. Fisher
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- Journal:
- Palliative & Supportive Care , First View
- Published online by Cambridge University Press:
- 22 August 2023, pp. 1-7
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Objectives
This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.
MethodsAdults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer.
ResultsParticipants (n = 50) ranged from 75 to 91 years old. Both groups described similar experiences and identified 5 challenges and support needs: (1) socioemotional impact, (2) activities of daily living and instrumental activities of daily living (ADLs/iADLs), (3) uncertainty management, (4) treatment-related stressors, and (5) COVID-19-related strain. Properties for these themes illustrate challenges and support needs, with some differences between groups. For instance, those living with a chronic blood cancer highlighted financial strain with treatment-related stressors, while those with an acute blood cancer focused more on iADLs.
Significance of resultsFindings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.
Chapter 73 - Breast Cancer and Pregnancy
- from Section 9 - Co-Morbidities during Pregnancy
- Edited by Tahir Mahmood, Charles Savona Ventura, Ioannis Messinis, Sambit Mukhopadhyay
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- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
- Published online:
- 20 November 2021
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- 02 December 2021, pp 595-601
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Summary
The diagnosis of pregnancy-associated breast cancer is associated with serious mental strains on young patients and also leads to diagnostic and therapeutic uncertainties on the part of the treating physicians. The patients need to be thoroughly informed about diagnosis, treatment and associated risks during pregnancy, as well as breastfeeding, fertility and appropriate procedures for fertility preservation. Compared with non-pregnant women, pregnancy itself doesn’t seem to significantly worsen the prognosis and outcome of breast cancer; however, breast cancer affecting young patients may be characterized by higher diesease aggressiveness and higher risk of metastasis. However, with few exceptions most diagnostic and therapeutic procedures can be implemented relatively safely.
Chapter 32 - Vulvar Malignancies
- from Section 6 - Vulva and Vagina
- Edited by Tahir Mahmood, Charles Savona-Ventura, Ioannis Messinis, Sambit Mukhopadhyay
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- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
- Published online:
- 24 November 2021
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- 02 December 2021, pp 266-274
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Summary
Vulvar carcinoma is a relatively rare cancer entity. However, this disease, in contrast to other gynaecological cancers, recently showed an increasing incidence, including young women. Despite showing a poor response on the administration of chemotherapeutics, vulvar carcinomas have excellent response to surgical treatment when detected in early stages. More than other cancer entities and especially in young females, treatment of vulvar cancer effects body image, sexuality, quality of life and sexual activity. Interdisciplinary decision making, a stage-conforming therapy accompanied with low invasiveness (e.g. lymphadenectomy using the sentinel technique) and further treatment regimens (e.g. radiation) are important steps to preserve the sensitivity and function of the vulva and adjacent organs. Surgical treatment procedures for vulvar cancers have changed during recent years towards tissue-sparing oncoplastic and reconstructive surgery. Previously applied radical surgical approaches, such as en-bloc resection, are often associated with high postoperative morbidity, vulvar deformity and sexual dissatisfaction.
Discovering Non-Invasive Biomarkers Predictive of Opioid Use Disorder Treatment Response
- Amir Levine, Kelly Clemenza, Shira Weiss, Adam Bisaga, Erez Eitan, Maria Carla Gerra, Claudia Donnini, Gilberto Gerra, Benjamin Garcia
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- CNS Spectrums / Volume 26 / Issue 2 / April 2021
- Published online by Cambridge University Press:
- 10 May 2021, p. 173
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Background
Opioid use disorder (OUD) continues to be the driving force behind drug overdoses in the United States, killing nearly 47,000 people in 2018 alone. The increasing presence of deadlier fentanyl analogues in the heroin drug supply are putting users at a greater risk for overdose than ever before. Admissions to treatment programs for OUD have also nearly doubled since 2006, yet relapse rates remain high. In response to these alarming statistics, developing approaches to reduce overdose deaths has become an area of high priority. As it is not yet known which patients are most likely to benefit from a specific treatment, there is a dire need to utilize new molecular tools to guide precision medicine approaches and improve treatment outcomes. Here we describe a proof-of-concept study evaluating plasma-derived extracellular vesicle (EV) signatures and how they differ in patients who responded to two pharmacologically contrasting treatments for OUD: the μOR agonist methadone, and the μOR antagonist naltrexone.
MethodsWe obtained blood samples from patients with OUD who remained abstinent from illicit opioids for at least 3 months during treatment with methadone (n=5) and naltrexone (n=5), as well as matched healthy controls (n=5). EVs were isolated from plasma and histones were isolated from peripheral blood mononuclear cells (PBMCs). EVs were then analyzed for lipid and histone post-translational modification (PTM) content using liquid chromatography-mass spectrometry. EV miRNA cargo was determined by RNA sequencing.
ResultsWe found one lipid class and six miRNAs that differed significantly between the naltrexone group and the methadone and control groups. We also found that histone H3acK9acK14 was increasingly acetylated in PMBCs from both the methadone and naltrexone groups compared to controls.
DiscussionNaltrexone, which is used in treatment of OUD and other substance use disorders as well as disorders of impulse control, was found to have multiple potential corresponding molecular signatures that can be identified after long-term treatment. It remains to be seen if these markers can also be a good predictor for treatment response. In addition, significant gender differences in EV content are found between men and women with OUD, which supports the importance of examining changes in response to treatment in a gender informed way.
A lifespan approach to understanding family caregiver experiences of a blood cancer diagnosis
- Amanda L. Kastrinos, Carla L. Fisher, Michaela D. Mullis, Easton Wollney, Maria Sae-Hau, Elisa S. Weiss, Carma L. Bylund
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- Journal:
- Palliative & Supportive Care / Volume 20 / Issue 1 / February 2022
- Published online by Cambridge University Press:
- 23 April 2021, pp. 22-29
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Objectives
The study examined the diagnosis experience of midlife family caregivers of a patient with a blood cancer, exploring similarities and differences between parent caregivers and adult-child caregivers.
MethodsParticipants were between 30 and 65 years old and were family caregivers of a living patient with acute myeloid leukemia, acute lymphoblastic leukemia, or lymphoma. We conducted semi-structured interviews with parent caregivers (n = 20) and adult-child caregivers (n = 19) and a thematic analysis of the interview data.
ResultsBoth types of caregivers report the patient experiencing (1) mis- and missed diagnosis (facing delayed diagnosis or treatment and having symptoms dismissed or overlooked) and (2) emotional distress (being in shock and survival mode, struggling with uncertainty, and confronting mortality). Adult-child caregivers also experienced relational shifts in assuming control of their parent's care, sometimes despite geographic distance, and struggled to distribute the care burden among family members.
Significance of resultsDifferences between the caregivers’ experiences emerged based on the relational role and the patient's place in the lifespan. Findings can be used to inform the development of support resources to address the needs of each group.
Intake of selected foods and beverages and serum uric acid levels in adults: ELSA-Brasil (2008–2010)
- Michelle Timóteo da Silva, Maria de Fátima Haueisen Sander Diniz, Carolina Gomes Coelho, Pedro Guatimosim Vidigal, Rosa Weiss Telles, Sandhi Maria Barreto
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- Journal:
- Public Health Nutrition / Volume 23 / Issue 3 / February 2020
- Published online by Cambridge University Press:
- 07 October 2019, pp. 506-514
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Objective:
To investigate the association between the intake of selected food groups and beverages and serum uric acid (UA).
Design:Cross-sectional study using the baseline data (2008–2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Food intake was assessed by food frequency questionnaire with 114 items. Linear and logistic regressions investigated the associations between the daily intake of each food group (servings/d) and UA (mg/dl) and hyperuricemia (UA ≥ 6·8 mg/dl), respectively. All the analyses were adjusted for potential confounders, energy intake and all food groups.
Setting:Teaching and research institutions from six Brazilians states.
Subjects:The participants were 14 320 active and retired civil servants, aged 35–74 years.
Results:Higher intake of dairy products was associated with lower serum UA levels in both sexes, with a statistical dose-response gradient. High meat intake was associated with high UA only in women, and high intake of organ meats, in men. Intake of fish and fruits, vegetables and legumes were not associated with serum UA. In men, moderate and high intake of alcoholic beverages, specifically beer and spirits, but not wine, increased UA. In women, only high intake of alcoholic beverages, specifically beer, was associated with increased serum UA. Similar associations were seen for hyperuricemia.
Conclusions:Results suggest a potential beneficial role of dairy products consumption on UA levels. The association between alcohol intake and UA differed according to type of beverage and between sexes. Results reinforce the need to consider the whole diet in the analysis and to conduct sex stratified analysis.
An amalgamated meter-thick sedimentary package enabled by the 2011 Tohoku tsunami in El Garrapatero, Galapagos Islands
- Maria Elizabeth Martin Arcos, BreanynTiel MacInnes, Patricia Arreaga, Frances Rivera-Hernandez, Robert Weiss, Patrick Lynett
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- Quaternary Research / Volume 80 / Issue 1 / July 2013
- Published online by Cambridge University Press:
- 20 January 2017, pp. 9-19
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Tsunamis and storms instigate sedimentological and geomorphological changes to the coastal system, both long-term and ephemeral. To accurately predict future coastal hazards, one must identify the records that are generated by the processes associated with these hazards and recognize what will be preserved. Using eyewitness accounts, photographs, and sedimentology, this study documents pre- and post-tsunami conditions and constrains the timing and process of depositional events during and following the 11 March 2011 Tohoku tsunami in the coastal system at El Garrapatero, Galapagos Islands. While the tsunami acted as both an erosional and depositional agent, the thick, fan-like sand sheet in El Garrapatero was primarily emplaced by overwash deposition during high tide from swell waves occurring between 19–25 March and 17–22 April 2011. The swell waves were only able to access the terrestrial coastal system via a channel carved by the 2011 Tohoku tsunami through the barrier sand dune. This combined deposit could result in an overestimation of the hazard if interpreted to be the result of only one event (either tsunami or wind-generated waves). An analogous sand layer, younger than 1390–1530 calyr BP, may record a similar, prior event.
Role of Place in Explaining Racial Heterogeneity in Cognitive Outcomes among Older Adults
- Sze Yan Liu, M. Maria Glymour, Laura B. Zahodne, Christopher Weiss, Jennifer J. Manly
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- Journal of the International Neuropsychological Society / Volume 21 / Issue 9 / October 2015
- Published online by Cambridge University Press:
- 28 September 2015, pp. 677-687
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Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9% of the variance in years of schooling, 6% of memory, and 12% of language. Among HRS African Americans, state of school attendance accounted for 13% of the variance in years of schooling and also contributed to variance in cognitive function (7%), memory (2%), and vocabulary (12%). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education. (JINS, 2015, 21, 677–687)
The astrobiological mission EXPOSE-R on board of the International Space Station
- Elke Rabbow, Petra Rettberg, Simon Barczyk, Maria Bohmeier, Andre Parpart, Corinna Panitz, Gerda Horneck, Jürgen Burfeindt, Ferdinand Molter, Esther Jaramillo, Carlos Pereira, Peter Weiß, Rainer Willnecker, René Demets, Jan Dettmann, Guenther Reitz
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- International Journal of Astrobiology / Volume 14 / Issue 1 / January 2015
- Published online by Cambridge University Press:
- 28 August 2014, pp. 3-16
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EXPOSE-R flew as the second of the European Space Agency (ESA) EXPOSE multi-user facilities on the International Space Station. During the mission on the external URM-D platform of the Zvezda service module, samples of eight international astrobiology experiments selected by ESA and one Russian guest experiment were exposed to low Earth orbit space parameters from March 10th, 2009 to January 21st, 2011. EXPOSE-R accommodated a total of 1220 samples for exposure to selected space conditions and combinations, including space vacuum, temperature cycles through 273 K, cosmic radiation, solar electromagnetic radiation at >110, >170 or >200 nm at various fluences up to GJ m−2. Samples ranged from chemical compounds via unicellular organisms and multicellular mosquito larvae and seeds to passive radiation dosimeters. Additionally, one active radiation measurement instrument was accommodated on EXPOSE-R and commanded from ground in accordance with the facility itself. Data on ultraviolet radiation, cosmic radiation and temperature were measured every 10 s and downlinked by telemetry and data carrier every few months. The EXPOSE-R trays and samples returned to Earth on March 9th, 2011 with Shuttle flight, Space Transportation System (STS)-133/ULF 5, Discovery, after successful total mission duration of 27 months in space. The samples were analysed in the individual investigators laboratories. A parallel Mission Ground Reference experiment was performed on ground with a parallel set of hardware and samples under simulated space conditions following to the data transmitted from the flight mission.
Contributors
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- By Gwen Z. Abiola-Oloke, Julie A. Hambrook Berkman, Michael C. Blumm, Klaus Bosselmann, Rebecca M. Bratspies, Edith Brown Weiss, Hans Christian Bugge, Chizoba Chinweze, Larry B. Crowder, Cormac Cullinan, Duncan E. J. Currie, Surya Deva, Kristina M. Gjerde, Tore Henriksen, Chukwuemeka Jideani, Louis J. Kotzé, Jan Laitos, Ryke Longest, Massimiliano Montini, Annika K. Nilsson, Gail Osherenko, Froukje Maria Platjouw, Stephen E. Roady, Nicholas A. Robinson, Raphael D. Sagarin, Peter H. Sand, Linda Sheehan, Anastasia Telesetsky, Mary Turnipseed, Cristina Verones, Christina Voigt, Robin Warner, Gerd Winter, Mary C. Wood
- Edited by Christina Voigt, Universitetet i Oslo
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- Rule of Law for Nature
- Published online:
- 05 December 2013
- Print publication:
- 21 November 2013, pp x-xii
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- By Wolfgang Alschner, Philipp Ambach, Freya Baetens, N. Jansen Calamita, Diane A. Desierto, Mary E. Footer, Markus W. Gehring, Anastasios Gourgourinis, Maria Gritsenko, Nicolas Hachez, Thomas Henquet, Gleider I. Hernández, Moshe Hirsch, Avidan Kent, Ursula Kriebaum, Judith Levine, Ralph Alexander Lorz, Vid Prislan, Pierre-Olivier Savoie, Christoph Schreuer, Nico Schrijver, Silke Steiner, Leonie Timmers, Elisabeth Tuerk, Friedl Weiss, Jan Wouters, Rumiana Yotova
- Edited by Freya Baetens, Universiteit Leiden
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- Investment Law within International Law
- Published online:
- 05 August 2013
- Print publication:
- 01 August 2013, pp viii-xvi
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- By Leonard A. Adler, Henrik Anckarsäter, L. Eugene Arnold, Philip J. Asherson, Russell Barkley, Joseph Biederman, Andrew D. Blackwell, Jessica Bramham, Thomas E. Brown, Richard Bruggeman, Jan K. Buitelaar, C. Keith Conners, Jonathan H. Dowson, Steve V. Faraone, Christopher Gibbins, Christopher Gillberg, I. Carina Gillberg, Ylva Ginsberg, Laurence L. Greenhill, Julia D. Hunter, Cornelis C. Kan, Ronald C. Kessler, Scott H. Kollins, J. J. Sandra Kooij, Johanna Krause, Jonna Kuntsi, Florence Levy, Stephen P. McDermott, Gráinne McLoughlin, Mitul A. Mehta, Asko Niemela, Eleni Paliokosta, Yannis Paloyelis, Vangelis Pappas, Patricia Quinn, Maria Råstam, Doris Ryffel, David Shaw, Seija Sirviö, Thomas Spencer, Lacramioara Spetie, Siegfried Tuinier, Fiona E. van Dijk, Anne M. D. N. van Lammeren, Wim J. C. Verbeeck, Margaret Weiss, Timothy E. Wilens, Kiriakos Xenitidis
- Edited by Jan K. Buitelaar, Cornelis C. Kan, Philip Asherson, Institute of Psychiatry, London
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- ADHD in Adults
- Published online:
- 04 April 2011
- Print publication:
- 03 March 2011, pp vii-ix
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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The Carers' Needs Assessment for Dementia (CNA-D): development, validity and reliability
- Johannes Wancata, Monika Krautgartner, Julia Berner, Rainer Alexandrowicz, Anne Unger, Gerda Kaiser, Barbara Marquart, Maria Weiss
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- International Psychogeriatrics / Volume 17 / Issue 3 / September 2005
- Published online by Cambridge University Press:
- 14 September 2005, pp. 393-406
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Background: A variety of interventions are available to support the caregivers of dementia patients. For the purposes of service planning, we developed an instrument to assess the needs of these caregivers and to determine whether needs are met. The reliability and validity of this new instrument was also investigated.
Methods: The development of the Carers' Needs Assessment for Dementia (CNA-D), was based on in-depth interviews and a focus group. The combined inter-rater and test–retest reliability was investigated among 45 dementia caregivers. Correlations of the CNA-D with the Zarit Burden Inventory were used to analyze concurrent validity. Content validity was investigated by performing a separate survey among 40 caregivers and 40 professionals.
Results: The CNA-D is a semi-structured research interview including 18 problem areas. For each problem area, the CNA-D offers several possible interventions. The relevance of the problem areas and the interventions (content validity) was confirmed by most of the study participants. Significant positive associations were found between the total score of the Zarit Burden Inventory and the number of problems and the number of unmet needs according to the CNA-D. The agreement between the interviewers was “excellent” (κ above 0.75) in 73.7% of the problem areas and in 69.9% of the interventions.
Conclusions: The CNA-D is a valid and reliable instrument for comprehensively assessing the needs of dementia caregivers.
Mithras, der Nachthimmel Eine Dekodierung der römischen Mithras-Kultbilder mit Hilfe des Awesta
- Maria Weiss
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Kein untergegangener antiker Mysterienkult ist durch Kulträume, Bildwerke, Weihinschriften, vereinzelt sogar durch Mitgliederlisten so gut bezeugt wie der römische Mithraskult. Seine Anfänge liegen wahrscheinlich in der zweiten Hälfte des ersten Jahrhunderts n. Chr. Ende des vierten Jahrhunderts ist er nur noch in Monumenten faßbar, die der Opposition des Heidentums gegen die Religionspolitik der Kaiser entstammen. Ob diese späten Zeugnisse dem ursprünglichen Mysterienkult zuzurechnen sind, darf jedoch bezweifelt werden.