Explore the vast range of titles available.

Introduction Long‐term survivors (LTS) of HIV, including individuals diagnosed before the availability of effective antiretroviral therapy (ART), have played a pivotal role in shaping the HIV response. Despite an increase in their number in the United States, their unique medical, social and economic challenges remain underrepresented in HIV policy and research, particularly in the context of HIV cure advancements. While an HIV cure may alleviate ART‐related burdens, LTS fear unintended consequences, including the potential loss of critical social benefits, economic support and healthcare access. This study explores the policy priorities of LTS, addressing their current unmet needs and the broader implications of an HIV cure. Methods We conducted qualitative interviews with 32 LTS across diverse racial, gender and geographic backgrounds, recruited through community‐based organizations and research networks from 2023 to 2024. Using inductive thematic analysis, we identified key policy concerns and recommendations based on participants’ lived experiences. Data collection continued until thematic saturation was reached. Results LTS emphasized four pressing policy domains: (1) Persistent Healthcare Disparities: Participants reported fragmented Medicare and Medicaid coverage, limited access to essential services (e.g. dental, vision and mental healthcare), and ongoing stigma and discrimination in healthcare settings. (2) Social and Economic Precarity: Housing instability, financial insecurity and employment barriers disproportionately affect LTS, many of whom face systemic barriers to re‐entering the workforce. (3) Policy Implications of an HIV Cure: Participants voiced concerns that an HIV cure, while promising, could result in disqualification from disability and social assistance programmes, exacerbating socio‐economic vulnerabilities. (4) Structural Reforms for LTS Inclusion: LTS underscored the urgent need for their direct involvement in HIV research, policy development and decision‐making to ensure equitable, community‐driven solutions. Conclusions Policymakers must address comprehensive healthcare access, economic stability and social protections for LTS of HIV. HIV cure research must not undermine existing benefits or widen disparities. Ensuring LTS representation in decision‐making is critical to developing equitable policies that safeguard their wellbeing before and after a cure.

Hurricane Katrina forced the largest and most abrupt displacement in U.S. history. About 1.5 million people evacuated from the Gulf Coast preceding Katrina’s landfall. New Orleans, a city of 500,000, was nearly emptied of life after the hurricane and flooding. Katrina survivors eventually scattered across all fifty states, and tens of thousands still remain displaced. Some are desperate to return to the Gulf Coast but cannot find the means. Others have chosen to make their homes elsewhere. Still others found a way to return home but were unable to stay due to the limited availability of social services, educational opportunities, health care options, and affordable housing. The contributors to Displaced have been following the lives of Katrina evacuees since 2005. In this illuminating book, they offer the first comprehensive analysis of the experiences of the displaced. Drawing on research in thirteen communities in seven states across the country, the contributors describe the struggles that evacuees have faced in securing life-sustaining resources and rebuilding their lives. They also recount the impact that the displaced have had on communities that initially welcomed them and then later experienced “Katrina fatigue\" as the ongoing needs of evacuees strained local resources. Displaced reveals that Katrina took a particularly heavy toll on households headed by low-income African American women who lost the support provided by local networks of family and friends. It also shows the resilience and resourcefulness of Katrina evacuees who have built new networks and partnered with community organizations and religious institutions to create new lives in the diaspora.

Child abuse is crushing and may lead to a lifetime of negative outcomes, including poor health, and mental illness. More wrenching is the bond victims often form with their abusers, one so strong they may attempt to protect and defend their victimizers. This book uncovers the realities of these relationships through an examination of abuse memoirs.

Purpose Survivors of blood and marrow transplant (BMT) for malignancies experience significant morbidity and mortality resulting from the long-term and late effects of transplant, necessitating life-long care. The purpose of this study was to explore the perceptions of specialist BMT advanced practice nurses (APNs), physicians, and primary care practitioners regarding the challenges of delivering long-term care for survivors of BMT. Methods This descriptive qualitative study used semi-structured interviews with 13 purposefully selected healthcare professionals (HCPs) experienced in providing long-term care to survivors of BMT. Data were analysed using thematic analysis. Results Two themes were identified: (1) prioritising patient-centred care and (2) equity and access to services. Prioritising patient-centred care included the sub-themes of (a) the burden of survivorship and complexity of long-term care, (b) education and preparation for long-term follow-up, and (c) adherence with long-term follow-up care. Equity and access included the four sub-themes of, (a) the tyranny of distance, (b) the price of survival, (c) primary care and the availability of GPs, and (d) access to appropriate long-term care. Conclusions HCPs need to adopt patient-centred strategies to improve optimal care and equity for long-term BMT survivors. Practical approaches include providing comprehensive education and personalised care, performing routine needs assessments, implementing flexible models of care that integrate primary care such as shared care and telehealth. Using digital health platforms and advocating for reduced financial barriers can further address challenges in access and equity. These efforts have the potential to enhance long-term care delivery, improve outcomes, and ultimately enhance quality of life for BMT survivors.

Background While several studies have documented fatigue during and after cancer treatment, long-term cancer survivor fatigue is underreported. In this study, we compare fatigue, quality of life (QoL), and anxiety between relapse-free cancer survivors 15 years after diagnosis and healthy controls. Methods Cancer survivors (CS) were randomly selected from three large population-based cancer registries (Bas-Rhin, Calvados, and Doubs, France). Cancer-free controls were randomly selected from electoral lists with stratification on age group, residence area, and gender. All participants completed self-reported fatigue (MFI), QoL (EORTC QLQ-C30), and anxiety (STAI) questionnaires. Univariable and multivariable logistic regression were used to study the association between fatigue and cancer status, in three cancer subgroups: breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC). Results Two hundred sixty-three CS and 688 controls (125/275, 45/153, 93/260 CS/controls for BC, CC, and CRC respectively) were included. The mean age was 66 years. In multivariable analyses, CS had higher general and mental fatigue than controls p  = 0.04 and p  = 0.02, respectively. No difference in QoL was observed between CS and controls. CS were more anxious than controls ( p  < 0.01). Anxiety was associated with general fatigue ( p  < 0.0001) and mental fatigue ( p  < 0.0001). Conclusion Fifteen years after diagnosis, cancer survivors reported more general and mental fatigue compared with controls. Our results reinforce guidelines, identifying fatigue as a persistent symptom.

Purpose The increasing survival rates of oncology patients have led to a corresponding increase in long-time survivors living with chronic cancer-related pain. Data is scarce on the care situation for this distinct clinical entity and on specific therapy requirements, such as interdisciplinary, multimodal pain therapy (IMPT). Our cross-sectional study aimed to assess the current care situation, distinct chronification factors, and optimization potential. This survey addresses this need in Germany, but also provides results with international implications. Methods Via an online survey, German Pain Society members involved in the treatment of long-time survivors with chronic cancer-related pain assessed the current care situation, chronification factors, specific treatment needs, and the required practitioner’s expertise. The German Pain Society’s Cancer Pain Working Group created the non-validated questionnaire using the Delphi method. Results One hundred fifty-nine Pain Society members across 70% of Germany’s postal regions answered our survey. Respondents (primarily physicians, and 75% with + 6 years of experience) assessed the care situation as worse for chronic cancer-related pain compared to acute pain. Only 10% of the sites provided specific therapy for chronic cancer-related pain (mostly via outpatient treatment). Compared to non-cancer-related pain, additional, cancer-specific chronification factors were assumed, especially at psychological levels, and these need incorporating into therapies. A majority of practitioners recommended cancer-specific IMPT and specific pain expertise for this distinct clinical entity. Conclusions Members from the German Pain Society assume that there are relevant deficits in the care of long-term survivors with chronic cancer-related pain. The situation may be assessed differently by other groups, e.g., oncologists, and the data relates to Germany. Nevertheless, considering the raising survival rates, it can be supposed that there is reason to be concerned about an increasing care deficit. Thus, besides expanding the range of available treatment and raising awareness, IMPT with specially trained personnel should be developed to address the care needs of cancer survivors experiencing chronic cancer-related pain.

Introduction Health‐related quality of life (HR‐QoL) in cancer survivors is relevant for symptom relief and optimal care. The aim of this cross‐sectional study of long‐term cervical cancer survivors was two‐fold: (a) To compare HR‐QoL in long‐term cervical cancer survivors with reference data; and (b) to identify modifiable factors significantly associated with low levels of generic cancer HR‐QoL in long‐term cervical cancer survivors using high HR‐QoL as reference. Material and methods Women treated for cervical cancer from 2000 through 2007 who were cancer‐free and alive in 2013 received a mailed questionnaire including scales for anxiety, depression, and HR‐QoL. To obtain a homogeneous sample only women with FIGO stages 1 and 2 were included. The questionnaire included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.C‐30 (EORTC QLQ C‐30) for generic HR‐QoL. Groups with high and low HR‐QoL were defined by the median score on the general HR‐QoL item. Between‐group differences were examined with descriptive statistics. Logistic regression analyses examined independent variables associated with low generic HR‐QoL. Results Complete C‐30 scores were delivered by 472 long‐term cervical cancer survivors. Median age at survey was 53 (interquartile range 14.9) years, and median time since diagnosis was 11 (interquartile range 3.9) years. The proportion of survivors with stage 1 disease was 83% and stage 2 was 17%. Mean generic HR‐QoL scores showed minor differences between long‐term cervical cancer survivors and reference data. In the multivariable analysis, only modifiable variables remained significantly associated with low generic HR‐QoL namely self‐rated health, probable depression, fatigue, and pain. In bivariate analyses other modifiable variables also showed significant associations with low generic HR‐QoL like probable anxiety disorder, obesity, smoking, sleep disturbances, and bowel symptoms. Conclusions Clinicians should be aware that generic HR‐QoL in long‐term cervical cancer survivors eventually may be improved by identification and treatment of modifiable factors through the whole follow‐up period. Health‐related quality of life might eventually be improved by identification and treatment of mental distress, pain and, fatigue in long‐term survivors of cervical cancer.

This is the first book written on clinical research and work related to the development of applied trauma psychology in Hong Kong. Contributed by numerous reputable researchers and clinicians, the book covers the latest research on and practice in assessment, psychological sequel (including psychological distress and growth of traumatic experience), evidence-based clinical intervention, and rehabilitation services for people affected by various traumatic stresses. Discussed in detail are interpersonal trauma like child sexual abuse and family violence, health and medical trauma such as infectious disease and the pain related to end of life, mass trauma and disaster including community psychological support programme developed in Hong Kong and Sichuan, as well as the rationale for mainstreaming trauma training in university education.

Background Although antiretroviral therapy has extended the lifespan of people living with HIV (PLWH), psychological symptoms are still prevalent. Given the complexity of psychological symptoms, effective interventions need to consider the interactions and associations of symptoms. Aim To explore psychological symptom association rule mining through Apriori algorithm analysis among PLWH in China. Methods This study was based on cross-sectional, multi-center, large sample data. From April 2022 to April 2023, we recruited 3040 participants with confirmed HIV-1 infections from six HIV sentinel hospitals in Beijing, Shanghai, Shenzhen, Nanning, Kunming, Baoshan and Jiaxing of China through convenience sampling to assess their psychological symptoms. The Apriori algorithm was employed to analyze the association rules among psychological symptoms in PLWH. Results 26 of the 40 psychological symptoms entered into the association rules. We selected the top 126 association rules based on confidence. By visualizing the arrow directions of these association rules, three gradients were identified. Of the 40 symptoms, “ forgetting things that occurred recently ” and “ nervousness ” was the first gradient. Limitations The cross-sectional design can only describe the co-occurrence of psychological symptoms, lacking causal insights and needing longitudinal data. Conclusions Our findings highlight the interconnected nature of psychological symptoms among PLWH and underscore the need for prioritized, network-based interventions. Clinical trial Clinical trial number: not applicable.

Background People with HIV (PWH) face substantial physical and mental health challenges, which translates to poorer health-related quality of life (HRQoL) relative to the general population. Additionally, they have a higher risk of developing the non-communicable chronic comorbidities (NCCs). However, the complex interplay between the risk of NCCs, perceived social support (PSS), depression, and HRQoL among PWH has not yet been adequately elucidated. Objective This study aimed to explore the impact of NCCs risk on HRQoL among PWH, and to examine the mediating roles of PSS and depression in it. Methods A cross-sectional study was conducted from September to December 2024 using a convenience sample of 2620 PWH recruited from all 7 designated hospitals in Nanjing, Jiangsu Province, China. Multidimensional Scale of Perceived Social Support, Patients’ Health Questionnaire Depression Scale-9 item, and Medical Outcomes Study HIV Health Survey were used. Meanwhile, the data about NCCs were derived from the hospital outpatient system records. The structural equation model (SEM) was employed to explore the pathways linking NCCs risk to HRQoL, as well as the mediating roles of PSS and depression. Results The median scores for PHS and MHS of PWH were 57.77 and 49.72, respectively. Additionally, 28.24% of PWH had NCCs, and 43.89% were detected with depression. NCCs risk was directly and negatively associated with HRQoL among PWH ( β =-0.124, P  = 0.003), while PSS and depression significantly mediated the association between NCCs risk and HRQoL, accounting for 3.69% and 36.48% of the total association, respectively. Besides, they acted as sequential mediators in a chain pathway, which explained an additional 9.02% to the total association. Conclusions This study identified both direct and indirect associations between NCCs risk and HRQoL among PWH. These findings can inform to the improvement of HRQoL among PWH and offer insights for refining comprehensive care management strategies.