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Periodograms are widely employed for identifying periodicity in time series data, yet they often struggle to accurately quantify the statistical significance of detected periodic signals when the data complexity precludes reliable simulations. We develop a data-driven approach to address this challenge by introducing a null-signal template (NST). The NST is created by carefully randomizing the period of each cycle in the periodogram template, rendering it non-periodic. It has the same frequentist properties as a periodic signal template, and we show with simulations that the distribution of false positives is the same as with the original periodic template, regardless of the underlying data. Thus, performing a periodicity search with the NST acts as an effective simulation of the null (no-signal) hypothesis, without having to simulate the noise properties of the data. We apply the NST method to the supermassive black hole binaries (SMBHB) search in the Palomar Transient Factory (PTF), where Charisi et al. had previously proposed 33 high signal-to-noise candidates utilizing simulations to quantify their significance. Our approach reveals that these simulations do not capture the complexity of the real data. There are no statistically significant periodic signal detections above the non-periodic background. To improve the search sensitivity, we introduce a Gaussian quadrature based algorithm for the Bayes Factor with correlated noise as a test statistic. We show with simulations that this improves sensitivity to true signals by more than an order of magnitude. However, the Bayes Factor approach also results in no statistically significant detections in the PTF data. [ABSTRACT FROM AUTHOR]

Objective: Li-Fraumeni syndrome (LFS) is a rare hereditary cancer predisposition syndrome that significantly increases one's lifetime cancer risk from infancy to late adulthood. LFS is primarily caused by pathogenic autosomal dominant germline TP53 variants. Consequently, each naturally conceived biological child of an individual with a pathogenic variant has a 50% chance of inheriting it. This study examines the connections between family cancer history and reproductive beliefs within multigenerational family units including at least one member with TP53 -positive LFS. Method: Forty-five families enrolled in a protocol-specific cancer screening study completed 66 group interviews. An interdisciplinary team constructed a thematic codebook of inductive and deductive codes using interpretive description and modified ground theory to analyze data and then implemented a framework method to organize themes. Results: The following major themes were related to reproductive beliefs in the context of LFS: (a) tension between morality and generational cancer experiences, (b) discriminating between multiple moral frames (i.e., religion and risk reduction), and (c) impossible choices between one's own health and future children. Conclusions: Reproductive beliefs associated with LFS are distinct from other well-studied hereditary cancer syndromes. Families with LFS experience novel reproductive beliefs that may trigger moral distress. Reproductive LFS-tailored psychoeducational interventions and clinician awareness are needed. [ABSTRACT FROM AUTHOR]

Objective(s): To assess the likelihood of ADHD diagnosis in children of non-US-born caregivers relative to children of US-born caregivers. Method: Cross-sectional analysis of a combined 2016 to 2019 National Survey of Children's Health dataset (n = 109,881) was performed to identify associations between caregiver's birth outside the U.S. and child's ADHD diagnosis. Logistic regression models adjusted for potential sociodemographic confounders. Results: Children with one or two non-US-born caregivers were less likely to be diagnosed with ADHD (aOR = 0.58, p <.001; aOR = 0.59, p <.001, respectively). Likelihood of a diagnosis increased as non-US-born caregivers spent more time in the US. After a diagnosis, children of two non-US-born caregivers were less likely to be treated with medication. Conclusion: The lower likelihood of ADHD diagnosis in children with non-US-born caregivers may reflect an increasing need for public health education to raise awareness about ADHD among this population and the development of culturally sensitive ADHD identification methodologies. [ABSTRACT FROM AUTHOR]

Doctoral student training has become focused in recent years on acquiring subject-area knowledge and research skills, rather than on teaching. This shift often leaves aspiring junior faculty feeling unprepared to address the demanding pedagogical requirements of the professoriate. In the area of social work, few programs contain a structured, required program of study that addresses issues unique to teaching in a school of social work. This article outlines a doctoral teaching workshop as a model framework for social work doctoral programs. Suggestions are provided for ways to incorporate such an effort into current social work doctoral education. (Contains 2 tables.)

Family life is altered irrevocably when a young parent is diagnosed with or dies from cancer. This article tracks the genesis and transformation of a comprehensive psychoeducational support and bereavement program for children, adolescents, and parents affected by cancer. From the inception of the program, families with parents in active treatment participated in time-limited support groups. When a parent died, families transitioned out of support and into bereavement groups. As the cancer experience became more chronic, families remained in these respective groups for longer periods of time. This required clinicians to reconsider group structure to avoid the additional losses incurred as newly bereaved families transitioned from one group to another. Restructuring the program allowed participants to remain in familiar environments and to experience greater support and continuity in their care. Children, teens, and parents made clinical gains in communicating their needs and feelings to loved ones. Further, children and teens stayed on track developmentally, academically, and socially. Clinicians structuring these programs must be skilled in working simultaneously in both support and bereavement modalities. Recommendations for self-care and supervision are suggested.

Background Rare diseases pose transitioning challenges owing to limited provider expertise and changing healthcare systems. The timeframe and developmental changes of emerging adulthood overlap with the transition of patients with cystinosis from pediatric to adult-oriented healthcare. Methods This study utilized techniques of qualitative grounded theory to explore the experiences of adults aged 18-47 with cystinosis, and their parents, with a focus on the transition to adulthood and adult-oriented care. Forty-six individuals from 21 families were recruited online and at cystinosis conferences to participate in focus groups and/or individual interviews. The constant comparative method was used to conduct both line-by-line and focused coding of verbatim transcripts. Results The following elements were reported to be critical to the transition to adulthood and adult-oriented care: gaining skills and responsibility for disease management, progressing toward autonomy while remaining connected to caregivers, and having strong communication with and between providers. Conclusions Data analysis identified behaviors and relationships that support and/or threaten autonomy and treatment adherence. Participants described institutional, relational, and practical barriers to transition. Suggestions for improving transitioning include: identifying patient/family strengths and improving pediatric-adult provider partnerships and communication. Further research is needed into the experience of patients before and after transition to adult-oriented care. Keywords Cystinosis * Transitioning * Adherence * Emerging adulthood * Grounded theory, Introduction Nephropathic cystinosis is a rare autosomal-recessive metabolic disorder with an estimated prevalence of 1 case per 100,000 to 200,000 live births [1]. There are believed to be 500 nephropathic [...]

Objectives: Adolescents and young adult (AYA) cancer survivors face unique medical and psychosocial sequalae, including chronic health conditions, late effects of treatment and fear of recurrence. The meaning of cancer survivorship may be further complicated for AYAs with hereditary cancer predisposition syndromes. This study used a patient‐centered framework to investigate how AYAs with Li‐Fraumeni syndrome (LFS) consider cancer survivorship. Methods: An interprofessional team conducted 30 semi‐structured interviews with AYAs (aged 18–41, mean 31 years) enrolled in the National Cancer Institute's LFS Study (NCT01443468). Twenty had experienced at least one cancer diagnosis. Interview data were thematically analyzed by an inter‐professional team using interpretive description and grounded theory methods. Findings: Participants viewed "survivorship" as a period marked by no evidence of formerly diagnosed disease. By contrast, participants felt the label "survivor" was tenuous since LFS is characterized by multiple primary malignancies and uncertainty about intervals between one diagnosis and the next. Many AYAs viewed survivorship as requiring a high degree of suffering. Though many personally rejected "survivor" identities, almost all articulated its various functions including positive, negative, and more complicated connotations. Instead, they chose language to represent a range of beliefs about survival, longevity, prognosis, and activism. Conclusions: AYAs with LFS struggle with the term "survivor" due to their multi‐organ cancer risk, short intervals between malignancies, and evolving identities. Loved ones' cancer‐related suffering informed perspectives on survivorship. Survivorship care for AYAs with cancer risk syndromes requires interprofessional interventions that address their unique biomedical and psychosocial needs. [ABSTRACT FROM AUTHOR]

Deleterious mutations in the BRCA1/BRCA2 genes elevate lifetime risk of breast and ovarian cancer. Each child of a mutation-positive parent has a 50% chance of inheriting it. Preimplantation genetic diagnosis [...]

Family narratives of genetic disease address multigenerational legacies of illness, guide expectations about future diagnoses and anticipated losses, and promote continuity and coherence. Yet contemporary families with histories of genetic [...]

Oncology social workers are increasingly finding themselves diagnosed with or caring for a loved one with cancer. Self-disclosure may be useful for building a therapeutic alliance. Yet, practice-informed guidelines for psychosocial oncology providers do not exist. Twenty-three psychosocial oncology providers diagnosed with and/or providing care to someone with cancer completed semi-structured interviews eliciting attitudes and utilization regarding self-disclosure. Interviews were digitally recorded and transcribed verbatim. Using grounded theory's constant comparative method, researchers conducted open and theoretical coding. Participants expressed consensus in defining, and reported a range of evolving practices regarding, self-disclosure. Recommendations for responsible self-disclosure included self-awareness, ongoing assessment, supervision, and enhanced educational programming. Therapeutic tools must evolve as core features of psychosocial oncology care. A flexible and context-specific framework for clinician self-disclosure related to personal experiences with cancer can guide oncology social work practice. [ABSTRACT FROM AUTHOR]

Background: Parents' perceptions of critical care during the final days of their child's life shape their grief for decades. Little is known about nursing care needs of children actively dying in the pediatric intensive care unit (PICU). Objectives: To examine associations between patient characteristics, circumstances of death, and nursing care requirements for children who died in the PICU. Methods: A secondary analysis of the data set from the Randomized Evaluation of Sedation Titration for Respiratory Failure trial was conducted. Results: This analysis included 104 children; 67 died after withdrawal of life-sustaining treatments; 21, after failed resuscitation; and 16, after brain death. Patients had a median age of 7.5 years, were cognitively appropriate, and were intubated for acute respiratory failure. Daily pain and sedation scores indicated patients' comfort was well managed (mean pain scores: modal, 0; peak, 2; mean sedation scores: modal, −2; peak, −1). Patients with longer PICU stays more often experienced pain and agitation on the day of death. Illness trajectory (acute, complex chronic condition, or cancer) was associated with pain scores (P =.04). Specifically, children with cancer had higher pain scores than children with acute illness trajectories (P =.01). Many patients (62%) had no change in critical care devices in their last days of life (median, 5 devices). Patterns of pain, sedation, comfort medications, and nursing care requirements did not differ by circumstances of death. Conclusion: Children with cancer and longer PICU stays may need comprehensive comfort management. Invasive devices left in place during withdrawal of life support may have inhibited parents' ability to connect with their child. Future research should incorporate parents' perspectives. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1545-5300.2007.00215.x Byline: ALLISON V. WERNER-LIN ([dagger]) Keywords: Genetics; Beliefs; Family Members; Breast Cancer; Human Development Abstract: Genetic testing for hereditary breast and ovarian cancer (HBOC) is predictive, not prophetic. Families frequently rely on multigenerational stories to make sense of the inherent ambiguity as they face medical decisions and navigate life's journeys. This study asks young women with elevated genetic risk how family histories with cancer and experiences with health professionals inform their beliefs about risk and susceptibility to HBOC. Twenty-two women aged 22-36 who carry a BRCA mutation completed illness genograms and open-ended interviews. Transcripts were analyzed using a narrative tool that emphasizes the use of voice to highlight key relationships and meaning structures. Findings reveal that beliefs about risk are more firmly grounded in family experiences with cancer than in biomedical research. Pervasive meanings included (1) the presence of 'danger zones,' specific ages at which cancer risk was believed to increase dramatically, and (2) the experience of 'the wait and the worry,' in which participants felt increased urgency to achieve family development goals (i.e., child bearing) and limited control over environmental factors influencing when these goals could be met (i.e., meeting a life partner). A clinical case example and research implications are discussed. Author Affiliation: ([dagger])School of Social Work, New York University.

The reproductive decision-making of young people (aged 15–39 years) with Li-Fraumeni syndrome (LFS), an early onset inherited cancer syndrome, has not been studied in depth. Using interpretive description methodology, we conducted semi-structured interviews with 30 young Australians (mean age 25.5 years) diagnosed with LFS or at 50% genetic risk. With reflexive thematic analysis, we show how young people's reproductive decision-making and ideals for family formation were shaped by a sense of genetic responsibility to ensure the health of future biological kin. Reproductive technology provided choices for family formation in the context of LFS and also complicated reproductive decisions, as these choices were difficult to understand, make, or carry out. We uphold that reproductive decision-making when living with LFS is a profoundly moral practice that may pose significant challenges for young people navigating their formative years. We offer genetic counseling practice recommendations to support individuals with LFS when making reproductive decisions. [ABSTRACT FROM AUTHOR]

Li-Fraumeni syndrome (LFS) is a rare hereditary cancer syndrome in which individuals have a significantly increased risk of developing multiple cancers throughout the life span. An LFS diagnosis may shift the individual's sense of self and tolerance of cancer risk as they engage in cancer screening and cancer prevention activities. This study examined the impact of family identity on health decision making, communication, and role function. Forty-five families completed one or more interviews during an annual, protocol-specific cancer screening study. An interdisciplinary team analyzed 66 interviews using interpretive description and modified grounding theory. Thematically, identity emerged as an evolving construct regarding self and/or family, embedded in historical and ongoing experiences with LFS. Notions of individual and shared family identities guided decision making related to healthcare and influenced interpersonal communication and role function between supportive networks and families. Alignment between individual, family, and generational identities may shape engagement in genetic testing, risk management, and family life. Medical teams that are unequipped to address the psychosocial challenges that LFS populations face may include mental health professionals on interprofessional care teams to navigate risk management and consequential familial conflict. [ABSTRACT FROM AUTHOR]

The article discusses research which compared vaccination up-to-date (UTD) status between first-born and non-first-born children in the U.S. using the 2016-2019 data from a nationally representative dataset. Topics covered include the association between child's first-born status and vaccine UTD, the underlying factors for the association between birth order and health outcomes, and the significance of on-time vaccination schedules for parents with multiple children.