No abstract

Drunk-driving offenders need assessment and treatment services not only for alcohol problems but also for drug use and the other psychiatric disorders that commonly accompany alcohol-related problems.

Background To reduce the risk of long-term swallowing complications after radiation, swallowing exercises may be helpful. Both the rate of adherence to swallowing exercises and its impact on future swallowing function is unknown. Methods 109 oropharyngeal cancer patients beginning radiation were tracked for two years to determine adherence to swallowing exercises. Participants completed the M.D. Anderson Dysphagia Inventory (MDADI) 1–2 years after treatment to assess self-reported swallowing function. Adherence, demographics, tumor and treatment variables were multivariably regressed onto the MDADI physical subscale score. Results Per speech pathologist documentation, 13% of the participants were fully adherent and 32% were partially adherent. Adherence was associated with the Physical MDADI Subscale score in the multivariate model (p=.01). Conclusions The majority of head and neck cancer patients are nonadherent to swallowing exercise regimens and may benefit from supportive care strategies to optimize their adherence.

Objectives To evaluate prospectively the associations between illness uncertainty, anxiety, fear of progression, and general and disease-specific quality of life (QOL) in men with favorable risk prostate cancer undergoing active surveillance (AS). Patients and Methods After meeting stringent enrollment criteria for an AS cohort study at a single tertiary care cancer center, 180 men with favorable-risk prostate cancer completed questionnaires at enrollment and every 6 months for up to 30 months. Questionnaires assessed illness uncertainty, anxiety, prostate-specific (Expanded Prostate Cancer Index Composite; EPIC) and general QOL (Short Form 12; SF-12) and fear of progression. We used linear mixed model analyses and multilevel mediation analyses. Results EPIC sexual scores significantly declined over time (P <0.05). Illness uncertainty was a significant predictor of all EPIC summary, SF12 physical component summary (PCS), mental component summary (MCS), and fear of progression scores (all P values, <0.05), despite controlling for demographic and clinicopathologic factors. Anxiety predicted all EPIC summary, MCS, and fear of progression scores (all P values, <0.05) but not PCS scores (P = 0.08). Scores on PCS, MCS, EPIC summary scales (except sexual scale), and fear of progression did not change significantly over the study period (all P values, >0.10). Conclusion Over the 2.5-year follow-up, QOL remained stable; only sexual function scores significantly declined. Illness uncertainty and anxiety were significant predictors of general and prostate-specific QOL and fear of progression. Interventions to reduce uncertainty and anxiety may enhance QOL for men with prostate cancer on AS.

No abstract