Search

One of the more frequent complications following treatment for breast cancer, lymphedema is a substantial swelling of the arm, breast and chest wall that occurs on the side where lymph nodes were removed. The aim of this work is to update recommendations on the prevention, diagnosis and management of lymphedema related to breast cancer.We present the protocol for an update of the 2001 clinical practice guideline on lymphedema from the Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. We will use a patient-oriented research approach with a focus on self-management and the positive health model to inform the updated guideline development. The methods proposed will be undertaken with consideration of the standards outlined in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The literature will be appraised by evaluating existing guidelines from other countries, the evidence from systematic reviews and meta-analyses and direct evidence from clinical studies. We will manage competing interests according to Guidelines International Network principles. Recommendations will be presented using an actionable statement format and will be linked to the level of evidence along with any relevant considerations used in formulation. A draft of the guideline will be produced by the steering committee then sent out to international experts and stakeholder groups for feedback.The primary benefit of this clinical guideline will be to improve the quality of care of women with breast cancer-related lymphedema. Findings will be disseminated at national and international conferences and through webinars and educational videos hosted on the websites of the supporting organizations.

Previous research (Dickinson, 1992) has investigated adults' memories of their first childhood experience with death. The present study extended this work to examine the relationship of various qualitative aspects of the first experience with death to current death attitudes. College students (196 females, 101 males) described their first childhood death experience and provided memories of: (a) who died; (b) whether parental discussion of death had occurred; (c) whether they had unanswered questions at the time; and (d) whether they had cried at the time. They then completed the Death Attitude Profile-Revised (DAP-R; Wong, Reker,Gesser, 1994). Results indicated that although boys and girls did not respond differently to the first death experience, gender did appear to moderate the relationship between the qualities of this experience and current death attitudes.

A total of 249 primarily middle-class, Caucasian college students (141 females, 108 males) completed the Knowing Styles Inventory (KSI) (Knight, Elfenbein, & Messina, 1995) to measure Connected and Separate Knowing and the Parental Authority Questionnaire (PAQ) (Buri, 1991), used to measure different parenting styles (authoritarian, authoritative, and permissive parenting). Authoritative parenting style of the mother was positively associated with Connected Knowing, while authoritative parenting style of the father was negatively related to Separate Knowing for both the female and male participants of the study. For the female participants only, permissive parenting style of the father was positively related to Separate Knowing. It was also found that first-born college students scored significantly higher on Separate Knowing than later-born students. The results suggest that family experiences may be precursors to the epistemologies of college students.