Given the doses of medication used in this study, nortriptyline was superior to fluoxetine in the treatment of poststroke depression. Demonstrating a benefit of antidepressant treatment in recovery from stroke may require the identification of specific subgroups of patients, alternative measurement scales, or the optimal time of treatment.
Introduction: The purpose of this research was to assess the feasibility, acceptability and potential effectiveness of a program to support the occupational performance of urban breast cancer survivors living with cancer-related cognitive impairment. Method: Participants (n ¼ 15) reporting cognitive changes following breast cancer treatment were enrolled in an occupationfocused self-management program. Occupational performance challenges, activity level, subjective cognitive function and quality of life were measured at the beginning, end and 3 months after completion of the program. Results: Participants reported high satisfaction with the program and high confidence in their problem-solving and goal-setting skills. The 11 participants who completed the post-program assessment showed significant increases in self-perceived performance and satisfaction in daily living, participation, physical and functional wellbeing and perceived cognitive impairment. Conclusion: The program was feasible for a vulnerable, socioeconomically diverse patient population, acceptable to participants and may have positive effects on occupational performance.
Improved medical care has resulted in a documented increase in cancer survivors in the United States. Cancer survivors face challenges in participation across all facets of life as a result of the cancer and subsequent cancer treatments. Long-term and late-term sequelae can result in impairments in neurological systems, decreased stamina, loss of range of motion, and changes in sensation and cognition. These impairments are often long lasting, which categorizes cancer survivorship as a chronic condition. This categorization presents treatment challenges, especially in creating rehabilitation and habilitation service options that support cancer survivors. Occupational therapy provides a unique focus that can benefit cancer survivors as they face limitations in participation in all aspects of daily living. Research, advocacy, and education efforts are needed to focus on the specific rehabilitation and habilitation needs of cancer survivors to increase access to occupational therapy's distinct value.
Cancer-related cognitive decline (CRCD) may have particularly significant consequences for older adults, impacting their functional and physical abilities, level of independence, ability to make decisions, treatment adherence, overall quality of life, and ultimately survival. In honor of Dr. Hurria's work we explore and examine multiple types of screening, assessment and nonpharmacologic treatments for CRCD. We then suggest future research and clinical practice questions to holistically appreciate the complexity of older adults with cancer's experiences and fully integrate the team-based approach to best serve this population.
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