NON-OFFENDING FATHERS AS CAREGIVERS IN THE AFTERMATH OF CHILD SEXUAL ABUSE DISCLOSURE: APPLYING A HISTORICAL, ATTACHMENT AND CASE STUDY LENS

Changing gender roles and caretaking roles in the family have resulted in greater involvement of fathers in the day-to-day care of their children (Parker & Livingston, 2017). As a result, there is a need to better understand the nature of father-child relationships on many levels and within the context of multiple circumstances. One specific example is the role of non-offending fathers in the care of children after child sexual abuse disclosure. Employing attachment theory as a theoretical framework, this two-paper dissertation examines the experiences of fathers as caregivers. The first paper reviews the evolution of paternal roles in the United States, documenting ways in which cultural and economic pressures of fathering have been interconnected with the development and implementation of attachment theory, child welfare policy, and direct clinical practice. Building on the discussion of paternal roles, the second paper offers a case study of a non-offending father’s experience in parenting his child after the disclosure of sexual abuse. Findings from this case study identify the protective support a father offers, the barriers and resources of support he may experience, and the importance of a father’s secure attachment relationship with his child after the disclosure of child sexual abuse. This two paper dissertation is meant to serve as a critical beginning step in exploring the role of fathers in the care and healing of their children. Implications for social work practice include enhanced acknowledgement, engagement, intervention and prevention strategies that incorporate fathers effectively, better utilizing fathers as allies in the overall care of their children

A Class-Oriented Strategy for Features Extraction from Multidate ASTER Imagery

In this paper we propose a hybrid classification method, adopting the best features extraction strategy for each land cover class on multidate ASTER data. To enable an effective comparison among images, Multivariate Alteration Detection (MAD) transformation was applied in the pre-processing phase, because of its high level of automation and reliability in the enhancement of change information among different images. Consequently, different features identification procedures, both spectral and object-based, were implemented to overcome problems of misclassification among classes with similar spectral response. Lastly, a post-classification comparison was performed on multidate ASTER-derived land cover (LC) maps to evaluate the effects of change in the study area

Land-Use Mapping in a Mixed Urban-Agricultural Arid Landscape Using Object-Based Image Analysis: A Case Study from Maricopa, Arizona

Land-use mapping is critical for global change research. In Central Arizona, U.S.A., the spatial distribution of land use is important for sustainable land management decisions. The objective of this study was to create a land-use map that serves as a model for the city of Maricopa, an expanding urban region in the Sun Corridor of Arizona. We use object-based image analysis to map six land-use types from ASTER imagery, and then compare this with two per-pixel classifications. Our results show that a single segmentation, combined with intermediary classifications and merging, morphing, and growing image-objects, can lead to an accurate land-use map that is capable of utilizing both spatial and spectral information. We also employ a moving-window diversity assessment to help with analysis and improve post-classification modifications

Use of routine ureteral stents in cesarean hysterectomy for placenta accreta

OBJECTIVE: To evaluate benefits of use of ureteral stents in association with cesarean hysterectomy in case of placenta accreta. METHODS: This was a single center, cohort study. Clinical records of singleton pregnancies with placenta accreta who underwent cesarean hysterectomy were included in the study. For this study, pregnancies with diagnoses of placenta accreta, increta, or percreta were considered under the umbrella term of placenta accreta. For all women with placenta accreta, delivery was planned via cesarean hysterectomy at 340-356 weeks, without any attempt to remove the placenta. Reasons for earlier delivery included vaginal bleeding and spontaneous onset of labor. The primary outcome was the incidence of unintentional urinary tract injury. Outcomes were compared in a cohort of women who had planned the placement of ureteral stents and in those who did not. RESULTS: Forty-four singleton gestations with confirmed placenta accreta at the time of cesarean hysterectomy were included in the study. Twenty-four (54.5%) of the included women had the placing of ureteral stents prior to cesarean, while 20 (45.5%) did not. At histological confirmation, most of them had placenta accreta (17/44, 38.6%), 14 placenta increta (31.8%), and 13 placenta percreta (29.6%). Urinary tract injuries occurred in eight cases (18.2%), six in the ureteral stents and two in the non-ureteral stents group (25 versus 10%; p = .21). All the injuries were bladder injuries, while no cases of ureteral injury were recorded. All injuries were recognized intraoperatively. CONCLUSION: In case of placenta accreta, the use of ureteral stents in association with cesarean hysterectomy does not reduce the risk of urinary tract injury

Circulating tumor cells in bladder cancer: a new horizon of liquid biopsy for precision medicine

Clinical management of bladder cancer (BC) patients offers several challenges such as poor outcome because of elevated recurrence rates and lack of response to chemotherapy [1]. So, there is a need of noninvasive prognostic and predictive tools able to allow risk category assessment and real-time supervision of drug response [2]. Recently, circulating tumor cells (CTCs) have been proposed as prognostic tool able to improve cancer patients' clinical management [3], [4], [5], [6]. CTCs detached from the primary tumor, enter the bloodstream and colonize distant organ, promoting cancer dissemination [7]. Emerging technologies are available to isolate CTC from patient's blood to provide a "liquid biopsy". Such a tool provides a molecular picture of the metastatic disease, useful to assess the cause of drug resistance onset [3, 6, 8], [9], [10], [11], [12], [13], [14]. CTC are very scarce in the blood, so robust methods are still needed for their routine use in laboratory practice [3, 11]. Several technologies have been developed in the last few years [11, 12] and several studies have been performed on the potential use of CTCs in bladder cancer patient clinical management

The impact of the tumor microenvironment in the dual burden of obesity-cancer link

Obesity induces systemic perturbations of tissue homeostasis, leading to dyslipidemia, insulin resistance and chronic state of inflammation. Evidence from clinical and preclinical studies links excess of adiposity with increased cancer incidence and suggests that chronic inflammation may contribute to increased cancer risk in obese patients. Over the last decades of obesity research, multifaced and complicated effects of abnormal or excessive expansion of Adipose Tissue have been uncovered. In particular, it is widely described how obesity can exacerbate the tumorigenesis for instance by fueling soluble signals and adipokines and by enhancing tissue inflammation and altering the hormonal balance. Less is known about the paracrine effects of the cancer-associated adipocytes on the tumor cells and still poorly explored is the reciprocal communication between cancer cells and the adipose component of the tumor microenvironment (TME). In this review, we will address the mechanisms by which the peritumoral Adipose Tissue can influence the dynamics of tumoral cells. We will discuss how obesity-induced changes in the tumor microenvironment may enhance tumor growth and aggressive characteristics leading to increased invasiveness and metastatic progression of cancer that leads to a worsen cancer survival in obese subjects. We conclude that targeting the peritumoral adipose component of the TME would be a therapeutic option to prevent cancer development

The androgen-thyroid hormone crosstalk in prostate cancer and the clinical implications

: There is increasing evidence that thyroid hormones (THs) work in an integrative fashion with androgen receptors (ARs) to regulate gonadal differentiation and reproductive function. Studies reveal that THs have interactions with the AR promoter region and increase AR expression. THs also have a role in the regulation of enzymes involved in the biosynthesis of androgens, such as 5α-reductase, which is essential in the conversion of testosterone into its active form, 5α-dihydrotestosterone. Additionally, the presence of androgen response elements (AREs) in the promoter regions of TH-related genes, such as deiodinases and thyroid hormone receptor isoforms have been identified in some vertebrates, indicating a mutual interaction between THs and ARs. Since the androgen signaling pathway, mediated by ARs, plays a key role in the formation and progression of prostate cancer (PCa), the existence of crosstalk between THs and ARs supports the epidemiologic and experimental evidence indicating a relationship between the high incidence of Prostate Cancer (PCa) and hyperthyroidism. This article aims to review the role of androgen-thyroid hormone crosstalk in PCa and its implication in the clinical management. As life expectancy is growing these days, it can increase the number of patients with PCa and the critical relevance of the disease. In order to gain better knowledge about PCa and to improve the clinical management, it is essential to get better insight into the key factors related to the formation and progression of this cancer