James Murray Ogilvie

A Meta-Analysis of Cognitive Impairment and Decline Associated with Adjuvant Chemotherapy in Women with Breast Cancer

A meta-analysis was performed to quantify the magnitude and nature of the association between adjuvant chemotherapy and performance on a range of cognitive domains among breast cancer patients. A total of 27 studies (14 cross-sectional, 8 both cross-sectional and prospective, and 5 prospective) were included in the analyses, involving 1562 breast cancer patients who had undergone adjuvant chemotherapy and 2799 controls that included breast cancer patients who did not receive adjuvant chemotherapy. A total of 737 effect sizes (Cohen’s d) were calculated for cross-sectional and prospective longitudinal studies separately and classified into eight cognitive domains. The mean effect sizes varied across cross-sectional and prospective longitudinal studies (ranging from −1.12 to 0.62 and −0.29 to 1.12, respectively). Each cognitive domain produced small effect sizes for cross-sectional and prospective longitudinal studies (ranging from −0.25 to 0.41). Results from cross-sectional studies indicated a significant association between adjuvant chemotherapy and cognitive impairment that held across studies with varied methodological approaches. For prospective studies, results generally indicated that cognitive functioning improved over time after receiving adjuvant chemotherapy. Greater cognitive impairment was reported in cross-sectional studies comparing chemotherapy groups with healthy control groups. Results suggested that cognitive impairment is present among breast cancer patients irrespective of a history of chemotherapy. Prospective longitudinal research is warranted to examine the degree and persisting nature of cognitive impairment present both before and after chemotherapy, with comparisons made to participants’ cognitive function prior to diagnosis. Accurate understanding of the effects of chemotherapy is essential to enable informed decisions regarding treatment and to improve quality of life among breast cancer patients.

Understanding Juvenile Offending Trajectories

Abstract Aconsiderable amount of international research has adopted a criminal careers framework to improve our understanding of offending patterns across the life course. Recent innovations in statistical modelling techniques such as Semi-Parametric Group-based Method (SPGM) have provided researchers with tools to model offending trajectories. While this framework and these techniques may improve our understanding of life course offending patterns, few Australian studies have adopted such an approach. SPGM was employed in the current study to model the offending patterns of the 1983–84 Queensland offender cohort (n = 4,470) to address three research questions: (1) How many distinct offending trajectories could be identified and what was the nature of these trajectories? (2) How were sex, Indigenous status, socioeconomic disadvantage, and remoteness related to offending trajectory membership? and (3) Are juvenile offending trajectories predictors of adult offending? Findings indicated that there were three distinct groups of juvenile offenders: Early Peaking-Moderate Offenders, Late Onset-Moderate Offenders, and Chronic Offenders. Males and Indigenous offenders were overrepresented in the chronic offending trajectory. Support for the utility of the model was found, as Chronic Offenders were more likely to have offended as adults. The theoretical and practical implications of these findings are discussed and the need for further trajectory research within an Australian context is emphasised.

Increasing self-control

The focus of this chapter is on therapeutic strategies to improve self-control for juvenile sexual offenders. First, to provide a context for the chapter, we present a summary of conceptual issues related to self-control. Next, we briefly review research examining the links between self-control and juvenile sexual offending. We then provide an overview of self-control assessment measures and resources. Finally, we summarize therapeutic strategies for improving self-control, and provide some tools that may be used to facilitate this process.