Communication between patients with breast cancer and health care providers. Determinants and implications

BACKGROUND: This study evaluated the perceptions of patients with breast cancer of their medical interactions with providers. The determinants and psychological consequences of communication problems also were examined. METHODS: Ninety-seven patients with Stage I or II breast cancer completed a set of validated questionnaires before initiating postoperative therapy. Data on psychological distress were collected at baseline and 3-month follow-up, and multivariate models were fit to explain the relationship between pretreatment communication problems and subsequent psychological distress. Data on clinical variables were abstracted from medical records. RESULTS: A substantial proportion of patients (84%) reported difficulties communicating with the medical team. Communication problems were more common among patients who were less optimistic about their disease and had less assertive coping styles. Patient-reported communication problems were associated with increased anxiety, depression anger, and confusion at the 3-month follow-up. The association between communication problems and mood disturbance remained significant, although small, after adjusting for baseline mood disturbance, demographic, clinical, and coping style variables. CONCLUSION: Interventions that enhance communication between patients with breast cancer and their providers may improve patients' psychological adjustment to treatment. Conversely, interventions that lower distress and modify coping style may enhance communication.     

The effects of smoking schedules on cessation outcome: can we improve on common methods of gradual and abrupt nicotine withdrawal?

This study compared the efficacy of 2 traditional methods of smoking cessation, gradual reduction and "cold turkey," with a new approach involving variation in the intercigarette interval. One hundred twenty-eight participants quit smoking on a target date, after a 3-week period of (a) scheduled reduced smoking (progressive increase in the intercigarette interval), (b) nonscheduled reduced smoking (gradual reduction, no specific change in the intercigarette interval), (c) scheduled nonreduced smoking (fixed intercigarette interval, no reductions in frequency), or (c) nonscheduled nonreduced smoking (no change in intercigarette interval or smoking frequency). Participants also received cognitive-behavioral relapse prevention training. Abstinence at 1 year averaged 44%, 18%, 32%, and 22% for the 4 groups, respectively. Overall, the scheduled reduced group performed the best and the nonscheduled reduced group performed the worst. Both scheduled groups performed better than nonscheduled ones. Scheduled reduced smoking was associated with reduced tension, fatigue, urges to smoke, withdrawal symptoms, increased coping effort (ratio of coping behavior to urges), and self-efficacy, suggesting an improved adaptation to nonsmoking and reduced vulnerability to relapse.     

Effect of sparse long‐chain branching on the step‐strain behavior of a series of well‐defined polyethylenes

The effect of sparse long chain branching, LCB, on the shear step‐strain relaxation modulus is analyzed using a series of eight high‐density polyethylene (HDPE) resins. Strains of 1 to 1250% are imposed on materials with LCB content ranging from zero to 3.33 LCB per 10,000 carbon atoms. All materials are observed to obey time–strain separation beyond some characteristic time, τ_k. The presence of LCB is observed to increase the value of τ_k relative to the linear resin. The behavior of the relaxation modulus at times shorter than τ_k is investigated by an analysis of the enhancement seen in the linear relaxation modulus, G⁰(t), as a function of strain and LCB content. This enhancement is seen to (1) increase with increasing strain in all resins, (2) be significantly larger in the sparsely branched HDPE resins relative to the linear HDPE resin, and (3) increase in magnitude with increasing LCB content. The shape and smoothness of the damping function is also investigated. The finite rise time to impose the desired strain is compared to the Rouse relaxation time of linear HDPE resins studied. Sparse LCB is found to increase the magnitude of the relaxation modulus at short times relative to the linear resin. POLYM. ENG. SCI., 2010. © 2010 Society of Plastics Engineers     

ANOVA designs with subjects and stimuli as random effects: Applications to prototype effects on recognition memory.

To establish the generality of experimental effects, analysis of variance (ANOVA) designs should often treat both subjects and stimuli as random effects, but researchers seem to avoid such designs. By replicating Cantor and Mischel's (1977) study of person prototype effects on recognition memory, we demonstrate how apparently significant effects can become nonsignificant when more appropriate tests, in which recognition words are assumed to represent a random effect, are calculated. Nevertheless, uncritical use of analyses assuming random effects can also be misleading, often erring by being too conservative. We discuss the controversy over the consequences of assuming stimuli represent a random or a fixed effect and of using quasi F ratios. We recommend that researchers increase the number of stimuli to increase the generalizability of results and power and to explore substantive stimulus effects themselves. To facilitate use of ANOVA designs that incorporate two random effects, we discuss several design options and some advantages and disadvantages of each. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three-way analysis of dyadic social interactions.

Proposes a method for analyzing data from dyadic social interactions across 3 dichotomous variables. By accounting for the likely interdependency between 2 scores from a dyad, problems incurred with traditional analyses are circumvented. The analysis is demonstrated by an examination of data from 4 groups of 41 parent–child dyads: mother–daughter, mother–son, father–daughter, and father–son. The effects of sex-of-S, sex-of-partner, familial relationship between S and partner, and the interaction of these factors were tested. Results are compared to results derived from a repeated-measures ANOVA. It is shown that the latter analysis may mask important features of the data. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment relationships in infant twins: the effect of co-twin presence during separation from mother

In this study the roles of the mother and the co-twin in inhibiting emotional arousal and reducing manifest distress of a twin who had been isolated in a modified strange situation were compared. The subjects were 15 children, each a member of a twin pair. The subjects were placed in a playroom under three conditions in the following order: (a) mother and twins present; (b) twins together, mother absent; (c) subject isolated from both co-twin and mother. The episodes in which all partners were together were alternated with brief separations. The subjects' distress was minimal when they were separated from the mother with the co-twin present. Upon reunion, stable social behavior was quickly restored. However, separation from the mother and co-twin produced a high level of distress for the subjects. When reunited, the isolated twin initiated physical contact with the mother, soliciting and receiving comfort from her. Furthermore, the distress of the isolated twin was transmitted to the co-twin who had remained with the mother during the isolation period. The nonisolated twin also solicited comfort from the mother. The presence of the co-twin during the reunion following isolation had little effect in reducing the subject twin's distress.     

Language: The unspoken variable in psychotherapy practice.

Although not often a focus of psychological literature and clinical training, language is profoundly relevant to psychological treatment, particularly since what we do as clinicians is often described as the "talking cure." The extent to which the clinician understands the verbalizations that the individual reveals furthers understanding about how the individual perceives his or her world. The relationship between language and culture is inextricable and jointly bound to psychotherapeutic processes. Analysis of the role of language among patients who communicate in 2 languages and present a bicultural experience introduces psychodynamics associated with the transference-countertransference phenomenon. A case presentation supports the view that the transferential phenomenon is associated with language switching for the bilingual patient, and serves an object relational function. The case material also includes countertransferential processes not previously discussed in the literature and considers how they relate to the clinician's language-related experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Qualitative and energy recovery potential analysis: plastic-derived fuel oil versus conventional diesel oil

Clean Technologies and Environmental Policy - Due to depleting fossil fuel sources, plastic-derived fuel oil (PDFO) has received much attention over the past decade as an alternative to...     

A review of current challenges and legal advances in the global management of plastic waste

Clean Technologies and Environmental Policy - Plastic waste is an ever-growing global challenge, perhaps second only to climate change in its scope and impact. Unmanaged plastic waste can be found...     

The nature of naming errors in primary progressive aphasia versus acute post-stroke aphasia.

Objective: To compare the distribution of error types across subgroups of primary progressive aphasia and poststroke aphasia in different vascular locations. Method: We analyzed naming errors in 49 individuals with acute left hemisphere ischemic stroke and 55 individuals with three variants of primary progressive aphasia. Location of atrophy or ischemic stroke was characterized using MRI. Results: We found that distribution of error types was very similar across all subgroups, irrespective of the site or etiology of the lesion. The only significant difference across groups was the percentage of circumlocutions (F(7, 96) = 3.02, p = .005). Circumlocution errors were highest among logopenic variant PPA (24%) and semantic variant PPA (24%). Semantic coordinate errors were common in all groups, probably because they can arise from disruption of different cognitive processes underlying naming and, therefore, from different locations of brain damage. Conclusions: Semantic errors are common among all types of primary progressive aphasia and poststroke aphasia, and the type of error depends in part on the location of damage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)