Sexual self-schema and sexual morbidity among gynecologic cancer survivors.

Longitudinal research indicates that approximately 50% of women treated for gynecologic cancer have sexual dysfunctions as they recover and become cancer survivors. This outcome occurs in the context of satisfactory quality of life in other domains. This study, comparing gynecologic cancer survivors (n?=?61) and gynecologically healthy women (n?=?74), documents the reliability of the latter observations with measures of quality of life (general, depressive symptoms, social contacts, and stress), sexual functioning, and health. Of added importance are analyses focused on variables that may predict risk for sexual morbidity. Specifically, sexual self-schema is tested as an important, sexually relevant individual difference. In regression analyses that controlled for estimates of precancer sexual behavior (intercourse frequency), extent of disease–treatment, and menopausal symptoms, sexual self-schema accounted for significant variance in predicting current sexual behavior and responsiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Controlled prospective longitudinal study of women with cancer: I. Sexual functioning outcomes.

The incidence and etiology of sexual difficulties for women with survivable cancer were studied. Women with early stage gynecologic cancer (n?=?47) were assessed after diagnosis but prior to treatment and then reassessed at 4, 8, and 12 mo posttreatment. Sexual and medical outcomes were compared with data from members of 2 matched comparison groups who were also assessed longitudinally: women diagnosed and treated for benign gynecologic disease (n?=?8) and gynecologically healthy women (n?=?57). Global sexual behavior disruption did not occur, but the frequency of intercourse declined for women treated for disease, whether malignant or benign. In relation to the sexual response cycle, diminution of sexual excitement is pronounced for women with disease; however, this difficulty is more severe and distressing for women with cancer, possibly due to significant coital and postcoital pain, premature menopause, treatment side effects, or a combination. Changes in desire, orgasm, and resolution phases of the sexual response cycle may also occur, but they are of lesser magnitude or duration or both. 30% of the women treated for cancer were diagnosed with a sexual dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual fantasies, sexual functioning, and hysteria among women: A test of Freud's (1905) hypothesis.

In Three essays on the theory of sexuality, Freud (1986) wrote of a relationship between hysteria and sexuality and commented that hysteria was precipitated by the onset of a real sexual situation. Here, the scores on a measure of hysteria and sexual fantasies of student women who were (n=93) and were not (n=26) intercourse active were compared. Women who were intercourse active had higher scores on the PDQ4+ Histrionic scale (Hyler, 1994), p     

Alcoholic calories, red wine consumption and breast cancer among premenopausal women

Intracellular recordings were made from horizontal cells in the superfused, isolated carp retina and effects of GABA on rod- and cone-driven horizontal cells were studied. Bath-applied GABA (0.5-5 mmol/L) resulted in a hyperpolarization of dark membrane potential and a suppression of light responses of L-type cone horizontal cells. In 7 out of 10 cells tested the effects of GABA were completely blocked by bicuculline, an antagonist of GABAA receptors. In the presence of 0.5 mmol/L Co2+, 2 mmol/L GABA could not induce any change in dark membrane potential in 8 out of 12 cells, but cause slight depolarization in other 4 cells. These results suggest that the GABA effects may be mediated by GABAA receptors on cone terminals in the majority of the L-type cone horizontal cells. GABA had no effect on rod horizontal cells.     

Social support and survival among women with breast cancer

BACKGROUND: Two recently reported randomized trials, one among patients with advanced breast cancer and the other among patients with early stage melanoma, suggested that social support may affect survival favorably. This study assesses relationships of social support indicators with 7-year survival among women diagnosed with localized or regional stage breast cancer. METHODS: All newly diagnosed patients with surgically treated localized or regional disease in seven Quebec City hospitals in 1984 were considered for this analysis. Among 235 eligible patients, 224 (95%) participated in a home interview 3 months after surgery. This interview provided information on the use of confidants in the 3 months after surgery. Data on disease and treatment characteristics were abstracted from patients' medical records. RESULTS: Compared with women who used no confidant in the 3 months after surgery, the hazard ratio for the 7-year period was 0.61 (95% confidence interval [CI], 0.33-1.12) among those who had used at least one confidant, 0.54 (95% CI, 0.28-1.06) in women who used two or more types of confidant, and 0.51 (95% CI, 0.22-1.18) among those whose confidants included either physician or nurse. These results were adjusted for age, presence of invaded axillary lymph nodes, adjuvant radiotherapy, and adjuvant systemic therapy (hormone or chemotherapy). CONCLUSION: These results support the view that social support may be associated with longer survival among women with localized or regional stage breast cancer.     

Breastfeeding experience and breast cancer risk among postmenopausal women

A method of automated detection of onset and termination of rhythmic muscle activity in electromyograms (EMGs) is presented. A threshold level in the EMG is computed, such that amplitudes in the EMG signal exceeding this level indicate muscle activity. The threshold level is determined using a statistical criterion based on the amplitude distribution of the entire EMG signal. The working of the method is illustrated with EMG signals recorded from chewing muscles. EMG signals with a good as well as a worse signal-to-noise ratio are presented. The method can be used for any EMG signal containing cyclic bursts of activity and thus may be applied in studies on rhythmic movements, such as chewing, walking and breathing. An automated method of EMG burst detection has the advantage that large amounts of EMG data can be easily and objectively processed.     

Distress, personality, and mammography utilization among women with a family history of breast cancer.

The authors examined the impact of psychological distress and the personality construct of conscientiousness (as measured by the Neuroticism, Extraversion, and Openness—Five Factor Inventory) on mammography utilization among women who were at increased risk for breast cancer. Participants were 200 women who had at least 1 first degree relative with breast cancer. Overall, 80% of the participants had obtained a mammogram in the previous year. Analyses controlling for potential confounders (perceived risk, decisional balance, and physician recommendation for mammography), revealed that distress was negatively associated with mammography utilization among participants who were low in conscientiousness. Distress was not significantly related to mammography utilization among highly conscientious women. The results are discussed in terms of their implications regarding interventions designed to increase mammography utilization in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual functioning and intimacy in African American and white breast cancer survivors: a descriptive study

This study examines ethnic differences in sexual socialization and attitudes, sexual history and current practices, and the effects of treatment in 147 African American and White breast cancer survivors. Sex-related research in younger healthy populations has shown that cultural values associated with ethnicity influence sexual functioning, but small numbers of African American participants in previous research in breast cancer survivors has limited what we know about that population. In this study, there were few differences between the 2 ethnic groups in a predominantly well-educated, high-income, highly functional sample. However, African American women were significantly less likely to be comfortable with and to practice oral sex, self-touching, and masturbatory behaviors. White women were more likely to report that breast cancer had a negative impact on their sex lives. These differences in sexual repertoire and functioning should be noted by health care practitioners treating the sexual sequelae of breast cancer treatment.     

Sexual behavior in married women with chronic gynecologic inflammation]

In patients with the first manifestation of hyperthyroidism of Graves' disease, antithyroid drug treatment is the therapy of first choice. Treatment has to be carried out depending on iodine supply of the individual patient with the lowest possible drug dose. Controls of treatment have to be done in short intervals (every 2 weeks) until euthyroidism is reached, afterwards controls of thyroid function have to be done every three months. After euthyroidism is established, the combination of antithyroid drug therapy with thyroid hormones may be useful to avoid hypothyroidism or goiter development during treatment in contrast to a monotherapy with antithyroid drugs. Antithyroid drug treatment has to be carried out for one year. The remission rate of patients does not increase with higher doses of antithyroid drugs or a longer treatment duration. The determination of TSH receptor antibodies does not help predicting a relapse of hyperthyroidism of Graves' disease in the individual patient at the end of treatment. Regular follow-up controls after antithyroid drug treatment are necessary to recognize relapse of Graves' disease in time.     

Marital status, marital satisfaction, and support processes among women at high risk for breast cancer.

This study explored marital status, social support processes, and psychological distress among women at high risk for breast and ovarian cancer who were anticipating genetic testing. In addition to substantive findings, it presents a means of using nonsense coding (J. Cohen & P. Cohen, 1983) to include unmarried persons in regression analyses examining the importance of marital support. These women had mobilized high levels of social support. Married and unmarried women did not differ in distress, but women had to have more satisfying marriages than average to be equivalent to unmarried women. For the married women, husbands were more involved and more influential in decision making than female relatives, even in distressed marriages. Negativity from close relationships, particularly the spouse, had more influence on these women's well-being than did positive involvement. The authors' findings suggest that counseling and education programs need to accommodate the key role that husbands have in decision making concerning genetic testing for risk of breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distress and psychiatric morbidity among women from high-risk breast and ovarian cancer families.

This study assessed psychological distress and psychiatric disorder in high-risk women enrolled in a hereditary breast and ovarian cancer registry, and it evaluated the concordance between self-report data and interview-based psychiatric diagnosis. A sample of 464 women completed the Hopkins Symptom Checklist-25 and were interviewed using modules of the Structured Clinical Interview for DSM-IV. Level of psychological distress and the prevalence of psychiatric disorder were low and in the range that would be expected for a sample of community-residing women. Screening proved inefficient: Less than 10% of distressed women met criteria for a clinical disorder. High-risk women seeking genetic testing in research settings may not require extensive psychological screening and diagnostic assessment. Caution is expressed about possible self-selection biases in women enrolled in hereditary cancer registries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in religiousness among black and white women with breast cancer

OBJECTIVE: To answer the question, "does CME work?" by reviewing the effectiveness of continuing medical education (CME) and other related educational methods on objectively-determined physician performance and/or health care outcomes. These interventions include educational materials, formal, planned CME activities or programs, outreach visits such as academic detailing, opinion leaders, patient-mediated strategies, audit and feedback, reminders, or a combination of these strategies. METHODS: MEDLINE, ERIC, NTIS, the Research and Development Resource Base in CME and other relevant data sources including review articles were searched for relevant terms, from 1975 to 1994. Of those articles retrieved, randomized controlled trials of educational strategies or interventions which objectively assessed physician performance and/or health care outcomes were selected for review. Data were extracted from each article about the specialty of the physician targeted, the clinical subject of the intervention, the setting and the nature of the educational method, and the presence or degree of needs assessment or barriers to change. RESULTS: More than two-thirds of the studies (70%) displayed a change in physician performance, while almost half (48%) of interventions produced a change in health care outcomes. Community-based strategies such as academic detailing (and to a lesser extent, opinion leaders), practice-based methods such as reminders and patient-mediated strategies, and multiple interventions appeared to be most effective activities. Mixed results and weaker outcomes were demonstrated by audit and educational materials, while formal CME conferences without enabling or practice-reinforcing strategies, had relatively little impact. CONCLUSION: Strategies which enable and/or reinforce appear to "work" in changing physician performance or health care outcomes, a finding which has significant impact on the delivery of CME, and the need for further research into physician learning and change.     

Breast cancer risk among women using silicone gel breast implants

Since their introduction in 1962, silicone gel-filled breast implants have been used by an estimated one to two million women. Questions concerning an increased cancer risk to these women have been raised. A review of the medical literature, including case reports, case series, physician surveys, case-control studies, and cohort studies, failed to turn up any evidence which associated the use of silicone breast implants with either an increased risk of breast cancer or an increased risk of a more advanced stage of cancer at the time of cancer diagnosis. The available data do not indicate any significant difference between the characteristics of the breast cancers of women with breast implants and those of women in control populations.     

Spiritual health locus of control and breast cancer beliefs among urban African American women.

The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual identity, attractions, and behavior among young sexual-minority women over a 2-year period.

Previous research suggests that the sexual identities, attractions, and behaviors of sexual-minority (i.e. nonheterosexual) women change over time, yet there have been few longitudinal studies addressing this question, and no longitudinal studies of sexual-minority youths. The results of 2-year follow-up interviews with 80 lesbian, bisexual, and "unlabeled" women who were first interviewed at 16–23 years of age are reported. Half of the participants changed sexual-minority identities more than once, and one third changed identities since the first interview. Changes in sexual attractions were generally small but were larger among bisexuals and unlabeled women. Most women pursued sexual behavior consistent with their attractions, but one fourth of lesbians had sexual contact with men between the two interviews. These findings suggest that there is more fluidity in women's sexual identities and behaviors than in their attractions. This fluidity may stem from the prevalence of nonexclusive attractions among sexual-minority women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acculturation and breast cancer screening among Hispanic women in New York City

Surfactant protein D (SP-D), which has structural homology to C-type lectin binding regions, may play a role in host defense and has no known surfactant function. Because other surfactant proteins have been shown to be increased after prolonged periods of hyperoxia, we sought to evaluate the early effects of hyperoxia (95% O2) on expression of SP-D in the adult male rat lung. Animals were exposed to air or to 12, 36, or 60 h of 95% O2. Northern blot analysis of total lung RNA revealed marked SP-D mRNA increases at 12 h 95% O2 compared with air-exposed controls, with decreasing expression to near that of air-exposed animals by 60 h. Semiquantitative in situ RNA hybridization demonstrated parallel results, with increased numbers of labeled alveolar epithelial (AE) and bronchiolar epithelial (BE) cells at 12 h and increased intensity of labeled alveolar cells, compared with air-exposed controls. After 60 h of exposure to 95% O2, mRNA label intensity in AE and BE was decreased to levels near those seen in air-exposed animals. In contrast, Western blotting showed a decline in total lung SP-D with 95% O2 exposure, beginning at 12 h and continuing at 36 and 60 h, respectively. Semiquantitative immunohistochemistry demonstrated a decline in AE labeling parallel to the total lung Western blot results, but labeled total BE cell numbers increased (P = 0.10). Hyperoxia had differential effects on SP-D abundance in AE and BE cells, and therefore may influence the availability of SP-D to bind microbial pathogens in the airways depending on cell type and location.     

Physical symptoms, distress, and breast cancer risk perceptions in women with benign breast problems.

Physical symptoms, general and breast cancer-specific distress, and perceived breast cancer risk were assessed in 66 women with benign breast problems (BBP) and 66 age-matched healthy comparison (HC) women. BBP women reported significantly greater worry about breast cancer than HC women. Breast symptom incidence and breast cancer risk perceptions were found to mediate group differences in breast cancer worry. Hierarchical regression analyses indicated that perceptions of control over a potential breast cancer prognosis moderate the impact of breast symptoms on reports of breast cancer worry. Implications for risk counseling with BBP women are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Partner unsupportive responses, avoidant coping, and distress among women with early stage breast cancer: Patient and partner perspectives.

This 18-month longitudinal study examined the associations among partner unsupportive behavior, avoidant coping, and distress experienced by 219 women with early stage breast cancer. The role of patient and partner ratings of unsupportive behavior were evaluated. Results indicated that patient and partner ratings of unsupportive behavior were highly correlated. Growth curve modeling suggested that unsupportive behavior, from both patient and partner perspectives, predicted more avoidant coping and distress. When partner and patient perceptions were placed in the same model, patient perceptions mediated the association between partners' ratings of their unsupportive behavior and patient distress. Avoidance also mediated the association between unsupportive behavior and distress, extending prior cross-sectional findings. Results highlight the long-term detrimental effects of partners' unsupportive behavior on the quality of life of women with early stage breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trait anxiety, symptom perceptions, and illness-related responses among women with breast cancer in remission during a tamoxifen clinical trial.

Postmenopausal women with breast cancer in remission (N?=?140) who were participating in a randomized clinical trial of tamoxifen chemoprevention therapy completed measures of trait anxiety, symptoms, cancer worry, and breast self-examinations (BSEs) during the first 6 months of the trial. Trait anxiety was associated with heightened sensitivity to tamoxifen-induced symptoms (but not with tendencies to report increases in symptoms unrelated to tamoxifen use), greater tendencies to attribute symptoms to tamoxifen use, and greater cancer worry. Tamoxifen use increased BSE rates among high-anxiety participants. For low-anxiety participants, tamoxifen use increased cancer worry but not BSE rates. Trait anxiety appears to be associated with vigilant activation of illness-related representations that trigger attentiveness to sensations, worry, and protective coping in response to somatic cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age, executive functions, and visuospatial functioning in healthy older adults.

Visuospatial test performance declines with age, whereas verbal test performance remains fairly constant. This pattern has been attributed to an age-related decline in either right-hemisphere functioning or executive functions (EFs), which may be associated with prefrontal cortical decline. Timed and untimed EF tests, and visuospatial tests requiring substantial integrative skill (I-VS) or little or no integrative skill (non-I-VS) were administered to young-old (aged 74 yrs and younger) and old-old (aged 75 yrs and older) healthy volunteers. Groups differed on I-VS tests and on many EF tests but not on non-I-VS tests. I-VS tests correlated highly with tests of EFs, but non-I-VS tests did not. These results are interpreted as supporting the proposal that an age-related decline in EF underlies the decline in visuospatial test performance observed with advancing age. Other issues regarding the relationship between age and EF are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)