Psychosocial Health Experiences and Coping Strategies of Family Caregivers of Adults With Cancer: A Qualitative Study

ABSTRACT Background and Aims Family caregivers play an important, all‐encompassing role in supporting adult patients diagnosed with cancer. This study explored the psychosocial health experiences and coping strategies of family caregivers of adults with cancer in a Ghanaian Teaching Hospital. Methods The study employed a descriptive exploratory qualitative design. Fourteen family caregivers of adult patients with cancer were purposively selected for the study. A semi‐structured interview guide was used to collect data, which was then analysed using thematic analysis. Results The family caregivers were aged between 20 to 65 years. Twelve out of the 14 care recipients were females, and their ages ranged from 41 to 70 years, with six aged between 41 and 50 years. Nine themes emerged from the study and were grouped under the four main dimensions of psychosocial health. Mental health: “The thinking is many” and “I always feel depressed”; Emotional health: “Your whole mood changes” and “I am very frustrated”; Social Health: “I don't have time” and “Neglect”. Three themes were identified as coping strategies, of which one fell within the spiritual health dimension: “I know that my God lives” and two on social health: “We try to adjust” and “Family support”. Conclusion Efforts to improve the quality of life of family caregivers of adult patients with cancer should focus on interventions that address the mental, emotional and social aspects of life. It is recommended that nurses consider the mental, emotional, social, spiritual and financial aspects of the family caregiving process as part of the effort to deliver comprehensive family‐centered care.

Oral contraceptive use as a risk factor for acute ischemic stroke: A population‐based cross‐sectional study

Learning Landscapes, caregivers, and young children: Results from a multiple methods study

Abstract Learning Landscapes (LLs) are family‐friendly structures that transform community spaces (e.g., parks and bus stops) into engaging activities. The community structures are designed to encourage children to explore their environment while fostering developmentally supportive interactions (DSI) and learning opportunities between caregivers and children, including children with disabilities. Playful learning provided through LLs could result in developmental gains for children from lower‐income backgrounds. The purpose of this multiple methods study, conducted in the US, was to examine 10 caregivers’ perceptions and play interactions with their children while at one outdoor LL. Observational data revealed high caregiver‐child engagement, and interview data indicated that caregivers perceived improved positive interactions during LL activities. The LL also promoted caregivers’ knowledge of child development and impacted some participants' perceptions of generalized strategy use. Taken together, environmental prompts, such as those within LLs, can promote DSI in everyday environments, offering opportunities to boost children's early development.

Milky Plasma, Murky Diagnosis: Urgent Plasma Exchange for Severe Hypertriglyceridemia‐Induced Hyperviscosity Without Pancreatitis, but With Myocardial Infarction

ABSTRACT Severe hypertriglyceridemia can increase the risk of acute pancreatitis, but also clinically significant hyperviscosity syndrome characterized by the typical signs of neurologic and visual manifestations. Hyperviscosity syndrome is a well‐established medical emergency. However, hyperviscosity syndrome induced by hypertriglyceridemia may be under‐recognized, particularly when pancreatitis and other classical signs of hyperviscosity syndrome are absent. We describe an index case of extreme hypertriglyceridemia presenting with cardiorespiratory symptoms (chest pain and dyspnea) due to suspected hyperviscosity, but without clinical or radiographic evidence of pancreatitis, successfully treated with therapeutic plasma exchange (TPE). We then review the limited, but growing body of published case reports describing TPE for hypertriglyceridemic hyperviscosity without acute pancreatitis. Across cases, TPE reliably achieved rapid triglyceride reduction and resolution of hyperviscosity symptoms. This review highlights diagnostic challenges, therapeutic indications, and the rationale for early TPE in symptomatic hyperviscosity even when pancreatitis is not present.

Examining Sleep‐Related Problems in Youth With Misophonia

ABSTRACT The relationship between misophonia and sleep‐related problems (SRPs) in youth is underexplored. This paucity of research is concerning because SRPs might be elevated among youth with misophonia. If left untreated, SRPs can contribute to long‐term health consequences. Thus, in this study we examined the link between misophonia and SRPs in youth aged 8 to 17. In this study, we compared SRPs in 102 children and adolescents with clinically significant misophonia to SRPs in a normative youth sample and a sample of 94 youth with anxiety disorders. We also examined the extent to which SRPs were associated with misophonia severity. Approximately 30% of youth with misophonia endorsed clinical levels of SRPs. SRPs were more prevalent in youth with misophonia compared to normative data from the general youth population ( d  = 1.22) and similar to SRPs in youth with anxiety disorders ( d  = 0.13). Youth with more severe misophonia symptoms had greater difficulties with SRPs and this association was attenuated but still significant when adjusting for gender, age, and internalizing and externalizing symptoms. In this study, we provided the first evidence of substantial issues with SRPs in youth with misophonia. Importantly, there was a moderate association between misophonia severity and SRPs, indicating that SRPs should be carefully assessed and potentially addressed in treatment for youth with misophonia. We discussed suggestions for clinical practice and future research.

Enhanced Expression of IL32 mRNA in Skeletal Muscles in the Context of Head and Neck Carcinomas

ABSTRACT Background Cancer‐related sarcopenia (CRS) is a significant complication of head and neck carcinoma (HNC), characterised by muscle degeneration and poor clinical outcomes. Although various dietary and therapeutic interventions have been explored, most of them remain empirical, and the molecular mechanisms underlying CRS are not yet fully understood. Methods Transcription profiles of muscle fragments from 29 HNC patients and 8 control donors were analysed by bulk RNA sequencing (6/29 and 3/8) and/or RT‐qPCR (29/29 and 5/8). In parallel, differentiating human myoblasts (AB1190) were subjected to indirect co‐culture with two types of effector cells: HNC cells (FaDu) or control epithelial cells (NHEK). The contactless effects of effector cells on target myoblasts were investigated using cell imaging to assess muscular differentiation, RT‐qPCR and Western blot to assess gene expression. Results Bulk RNA sequencing identified 789 differentially expressed transcripts between HNC and control samples. Subsequent RT‐qPCR analysis focused on IL32 and BIRC3 mRNAs (up‐regulated in HNC samples) and ACE1 mRNA (down‐regulated). Among male HNC patients, the IL32/ACE1 mRNA ratio was significantly elevated in CRS cases ( p  = 0.0001, effect size r  = 0.57) and correlated with the severity of muscle atrophy (negative correlation with the Skeletal Muscle Index at a threshold of 10%: p  = 0.093, r  = −0.41). In contrast, no such trend was observed for the BIRC3/ACE1 ratio. Exposure of human myoblasts to HNC cells induced inhibition of myogenesis and strong up‐regulation of IL32 mRNA and protein. In contrast, these effects were absent or much smaller under exposure to NHEK controls. Conclusions IL32 is a potential biomarker for CRS in HNC patients. In addition, the HNC–myoblast co‐cultivation model provides a promising in vitro system to study CRS mechanisms, potentially reducing the reliance on animal models.

The Reliability of Measuring Muscle Cross‐Sectional Area in Children Undergoing Treatment for Musculoskeletal Sarcoma

ABSTRACT Background Changes in musculoskeletal health and function are increasingly recognised as important long‐term consequences of treatment for malignant bone tumours in paediatric populations. Accurate and reliable assessment methods are critical for monitoring these changes during treatment. We aimed to determine the inter‐ and intra‐rater reliability of MRI‐based measurements of muscle cross‐sectional area in children undergoing treatment for paediatric musculoskeletal sarcoma. Methods We conducted a retrospective cohort study at a tertiary paediatric cancer centre. Eligible participants were aged 2–17 years and had undergone routine clinical MRI scans as part of their treatment for musculoskeletal sarcoma. Muscle cross‐sectional area was measured, focusing on key lower limb muscle/muscle groups. Three trained raters independently performed all measurements. Inter‐ and intra‐rater reliability were assessed using intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs). Measurement precision was evaluated using minimal detectable change (MDC) values, expressed as a percentage of mean muscle size. Results Nineteen patients (mean age 11.6 ± 2.6 years; 11 female and 8 male) were included. Diagnoses included osteosarcoma ( n  = 12), Ewing sarcoma ( n  = 5), rhabdomyosarcoma ( n  = 1) and synovial sarcoma ( n  = 1). The most common tumour location was the distal femur ( n  = 9), followed by proximal tibia ( n  = 2), pelvis ( n  = 2), proximal fibula ( n  = 1), distal fibula ( n  = 1) and other sites ( n  = 4). Metastatic disease was present in seven patients, while 12 had localised disease. Once images affected by tumour were excluded, a minimum of 60 images of each muscle/muscle group were included for analysis. Inter‐rater reliability was excellent for psoas (ICC = 0.97, 95% CI: 0.95–0.98), gracilis (ICC = 0.96, CI: 0.93–0.98), medial gastrocnemius (ICC = 0.91, CI: 0.86–0.94), mid‐femoral muscle circumference (ICC = 0.99, CI: 0.99–0.99) and mid‐tibial muscle circumference (ICC = 0.99, CI: 0.99–0.99). Good inter‐rater reliability was found for rectus femoris (ICC = 0.88, CI: 0.83–0.95) and biceps femoris (ICC = 0.83, CI: 0.75–0.89). Intra‐rater reliability was excellent across all muscles assessed (ICCs: 0.92–0.99). MDC values indicated highest measurement precision for mid‐femoral muscle circumference (10.62%), mid‐tibial muscle circumference (11.69%) and psoas (18.26%), enabling detection of clinically meaningful changes over time. Conclusions This study demonstrates that MRI measurement of muscle cross‐sectional area in children with musculoskeletal sarcoma is a reliable tool. MDC values allow for identification of true muscle loss, supporting early intervention.

Practice‐Based Research and Education for Dental Pain: Coupling Risk Stratification and Artificial Intelligence for Clinical Translation

A review of the neuropharmacological profile of schedule‐induced polydipsia

Abstract Schedule‐induced polydipsia (SIP) arises when subjects consume excessive amounts of water during interval responding on operant tasks, a paradigm introduced and mostly developed in rats. Neuropharmacological studies conducted on SIP have mainly shown a prominent role of dopamine and 5HT in this adjunctive behavior. In particular, D 1 /D 2 receptor antagonists decrease SIP, whereas low doses of dopamine reuptake blockers increase SIP. There is more specific evidence of a decline in SIP after lesions of the mesolimbic dopamine pathway. A decline in SIP is likewise observed after the injection of 5HT reuptake blockers and modulated by 5HT 2A /5HT 2C receptor agonists and antagonists. Despite more limited studies with other neurotransmitter systems, SIP has so far been shown to decline after the injection of muscarinic or NMDA receptor antagonists as well as benzodiazepine receptor agonists. Under some conditions, the role of neuroendocrine factors is shown by alterations in blood corticosterone levels during the course of SIP, indicative of its stress‐reducing properties.

Witnessing “De‐Socialization”: Investigating unexpected longitudinal trends in engineering doctoral socialization

Abstract Background Graduate‐level education is gaining attention in engineering education scholarship. While “socialization” is a key term in doctoral literature, little is known about how socialization occurs over time. One common assumption asserts that socialization increases over time, encompassing factors such as belongingness, research ability, and advisor relationship as students acclimate to the norms and values of their advisors, departments, universities, and disciplines. We investigate engineering doctoral student socialization trends: students likely to complete their degrees and those who have questioned whether to persist in their programs. Understanding these trends is essential, as many students consider leaving their programs. Purpose/Hypothesis This paper aims to understand how socialization processes occur over several years in engineering students who questioned leaving their PhD programs. Design/Method We present longitudinal survey data collected from two cohorts ( N A  = 113 and N B  = 355) of engineering doctoral students at R1 universities in the United States. Data were collected over 2 years through SMS surveys with participants receiving text messages three times per week. We analyzed data using descriptive and time series analysis methods. Results Both cohorts showed lower levels of belongingness over time, reported declining advisor relationships, and experienced higher levels of stress. Students later in their programs also reported deteriorating overall social relationships. These findings contradict canonical socialization theory, which expects socialization to naturally improve over time. Conclusion While many assume socialization occurs passively and students acculturate into their department and research team over time, our results show students who question whether to persist are de‐socializing from graduate school.