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Browsing by Subject "adverse health outcomes"
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Item Early Sport Specialization: Shifting Societal Norms(Silverchair, 2019-10-01) Hainline, Brian; Medicine, School of MedicineItem Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy(American Society of Clinical Oncology, 2017-04) Fung, Chunkit; Sesso, Howard D.; Williams, Annalynn M.; Kerns, Sarah L.; Monahan, Patrick; Abu Zaid, Mohammad; Feldman, Darren R.; Hamilton, Robert J.; Vaughn, David J.; Beard, Clair J.; Kollmannsberger, Christian K.; Cook, Ryan; Althouse, Sandra; Ardeshir-Rouhani-Fard, Shirin; Lipshultz, Steve E.; Einhorn, Lawrence H.; Fossa, Sophie D.; Travis, Lois B.; Department of Medicine, IU School of MedicinePurpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking (P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased (P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.Item The Relationship Between Sexually Coercive Experience Frequency, Coping, Social Support and Sexual and Mental Health in Adult Women(Office of the Vice Chancellor for Research, 2015-04-17) Muzzey, Allison K.; Hensel, Devon J.Introduction: Existing literature separately identifies social support and coping methods as mediating influences between sexual coercion and adverse health outcomes, yet few empirical studies actually evaluate their influence in the same model. The objective of this study was to analyze how adult women’s coping methods and social support jointly mediate the impact of sexually coercive experience on sexual and mental health. Methods: Data are drawn from a larger internet-based, cross-sectional survey examining adult men’s and women’s health and life experiences. For the current study, we retained all female participants (N=113). Structural equation modelling (SEM) (Stata, v. 22; all p<.05) analyzed the hypothesized structural relationships between coping (adaptive and maladaptive), social support (subjective and emotional), sexual coercion, sexual health (sexual openness, sexual anxiety, sexual esteem, and sexual entitlement) and mental health (depression, self-esteem, and anxiety). Results: More frequent sexual coercion predicted higher maladaptive coping (β = .364). Higher levels of maladaptive coping were associated with higher levels of depression (β = .199), anxiety (β = .393), sexual anxiety (β = .346), and sexual openness (β = .251). Additionally, higher levels of maladaptive coping were associated with lower self-esteem (β = -.226). Adaptive coping and social support were not associated with sexual coercion. Conclusion: Adult women’s sexually coercive experiences impact sexual and mental health indirectly through maladaptive coping, but not through adaptive coping or any social support. Our data raise the possibility that maladaptive coping could be an important catalyst for poor mental and sexual health outcomes following a sexually coercive experience. From an education and policy perspective, this means that a focus on reducing maladaptive coping methods may increase mental and sexual health and reduce the likelihood of accruing more sexually coercive experiences.