“It’s Not JUST Skin Cancer”: Understanding Their Cancer Experience From Melanoma Survivor Narratives Shared Online

Cancer survivors narrate their experiences in unique ways, articulating different aspects of the cancer journey. The purpose of this study was to analyze the content of cancer narratives that melanoma survivors share online in order to present the ways that survivors narrate their cancer experience, to identify survivors’ motivations for sharing, and to better understand the ways in which survivors are impacted by and cope with the diagnosis and treatment of cancer. The sample consisted of 95 unique melanoma survivor narratives, accessed from the Melanoma Research Foundation in November 2015, that were inductively and deductively coded for key themes and subthemes. Emergent themes described different aspects of the melanoma experience during prediagnosis (identification of self-phenotype, searching for causes, suspicious findings, delay in diagnosis), diagnosis (communication of diagnosis, emotional responses), transition from diagnosis to beginning treatment (second opinion), treatment (positive reframing of attitude, proactive cancer management, side effects), and posttreatment phases (social support, vigilance behaviors posttreatment). Two themes that cut across all phases of the cancer journey included recognizing and dealing with uncertainty and survivors’ motive for sharing narrative. These findings have implications for understanding how melanoma survivors may benefit personally from sharing their cancer experience online and for the potential for survivor narratives to motivate behavior change and facilitate coping among readers.     

Inhaled corticosteroid use in HIV‐positive individuals taking protease inhibitors: a review of pharmacokinetics,case reports and clinical management

As a consequence of inhibition of the hepatic cytochrome P450 3A4 isozyme, treatment with HIV protease inhibitors can result in significant drug?drug interactions. One noteworthy interaction is between protease inhibitors and inhaled or intranasal corticosteroids. This interaction can result in adrenal insufficiency and iatrogenic Cushing's syndrome (with symptoms such as rapid weight gain, obesity, facial hirsutism and swelling), as well as hypertension, osteoporosis and decreased CD4 cell count. In this paper, we review and unite pharmacokinetic data, case reports and current research regarding this drug?drug interaction in order to suggest options for the clinical management of HIV‐positive patients requiring treatment with protease inhibitors and inhaled or intranasal corticosteroids.     

Emotion complexity and emotion regulation across adulthood

This research used data from a study on daily emotional experience in adulthood to examine the associations between age, emotion complexity, and emotion regulation. Data were drawn from a study of daily stress that included 239 participants ranging in age from 18 to 89 from North Central Florida. Two indicators of emotion complexity were considered: emotion differentiation and the co-occurrence of positive and negative affect. Emotion regulation was assessed in terms of individuals’ likelihood of maintaining adaptive emotion states. There were no age differences in adults’ co-occurrence of positive and negative emotions. In contrast to theories suggesting age would be associated with greater emotion complexity, the findings revealed that older adults had lower differentiation scores than younger adults. Age was also associated with more adaptive patterns of emotion regulation. Specifically, older adults persisted in low negative states and moved out of high negative states more readily than younger adults. Finally, neuroticism, self-concept incoherence, mean daily stress, and emotion complexity were associated with emotion regulation. Notably, adults who reported a greater mix of positive and negative affect moved out of high negative affect states more rapidly than adults with lower co-occurrence scores. This finding is in keeping with a growing body of work suggesting that positive affect promotes recovery from negative affect. Overall, the findings suggest that although emotion complexity is associated with emotion regulation, it does not appear to be a key factor underlying age differences in emotion regulation.