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The purpose of this study was to understand and describe the experiences of children following Hurricane Floyd and its ensuing flood. Narratives from 97 children ages 7-12 were gathered using an open-ended question included in the PTSD Child Interview (Fletcher, 1996). Qualitative analysis, guided by a phenomenological design, was conducted on the data. Six themes representing the children's perspectives of the hurricane experience emerged from the analysis: (a) escaping the flood, (b) destruction and damage to property, (c) inconvenience and restoration, (d) concern for self and other's safety, (e) recollection of place, time, and event, and (f) thankfulness. This study helps researchers and clinicians understand the merits of gathering children's perspectives useful toward supporting them and their families following a hurricane and/or flood event. [ABSTRACT FROM AUTHOR]

Medical family therapy offers a systemic approach to psychotherapy with patients and families experiencing a medical illness, trauma, or disability. Its theoretical foundation and clinical expertise is based upon the field of family therapy. Medical family therapists add to their understanding of family systems in context through the incorporation of biopsychosocial systems theory, which is designed to understand the role that medical illnesses may play in the emotional lives of patients and in the interpersonal dynamics of their families. Thus, multiple perspectives from the patient, family, medical and nonmedical communities must be explored with the hopes of developing a collaborative system. To further promote a collaborative system, medical and mental health professionals should discuss potential systemic concerns associated with medical diagnoses. The following is a summary of selected videos that could be used when providing workshops or supervision with medical family therapists or marriage and family therapists who work in a medical environment.

Purpose Data that guide selection of optimal local ablative therapy for the management localized hepatocellular carcinoma (HCC) are lacking. Because there are limited prospective comparative data for these treatment modalities, we aimed to compare the effectiveness of radiofrequency ablation (RFA) versus stereotactic body radiotherapy (SBRT) by using the National Cancer Database. Methods We conducted an observational study to compare the effectiveness of RFA versus SBRT in nonsurgically managed patients with stage I or II HCC. Overall survival was compared by using propensity score-weighted and propensity score-matched analyses based on patient-, facility-, and tumor-level characteristics. A sensitivity analysis was performed to evaluate the effect of severe fibrosis/cirrhosis. In addition, we performed exploratory analyses to determine the effectiveness of RFA and SBRT in clinically relevant patient subsets. Results Overall, 3,684 (92.6%) and 296 (7.4%) nonsurgically managed patients with stage I or II HCC received RFA or SBRT, respectively. After propensity matching, 5-year overall survival was 29.8% (95% CI, 24.5% to 35.3%) in the RFA group versus 19.3% (95% CI, 13.5% to 25.9%) in the SBRT group ( P < .001). Inverse probability-weighted analysis yielded similar results. The benefit of RFA was consistent across all subgroups examined and was robust to the effects of severe fibrosis/cirrhosis. Conclusion Our study suggests that treatment with RFA yields superior survival compared with SBRT for nonsurgically managed patients with stage I or II HCC. Even though our results are limited by the biases related to the retrospective study design, we believe that, in the absence of a randomized clinical trial, our findings should be considered when recommending local ablative therapy for localized unresectable HCC.