Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients

BACKGROUND:
A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress.
OBJECTIVES:
To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress in the 12-month phase following an initial cancer diagnosis.
SEARCH METHODS:
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE, EMBASE, and PsycINFO up to January 2011. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Electronic searches were carried out across all primary sources of peer-reviewed publications using detailed criteria. No language restrictions were imposed.
SELECTION CRITERIA:
Randomised controlled trials of psychosocial interventions involving interpersonal dialogue between a 'trained helper' and individual newly diagnosed cancer patients were selected. Only trials measuring QoL and general psychological distress were included. Trials involving a combination of pharmacological therapy and interpersonal dialogue were excluded, as were trials involving couples, family members or group formats.
DATA COLLECTION AND ANALYSIS:
Trial data were examined and selected by two authors in pairs with mediation from a third author where required. Where possible, outcome data were extracted for combining in a meta-analyses. Continuous outcomes were compared using standardised mean differences and 95% confidence intervals, using a random-effects model. The primary outcome, QoL, was examined in subgroups by outcome measurement, cancer site, theoretical basis for intervention, mode of delivery and discipline of trained helper. The secondary outcome, general psychological distress (including anxiety and depression), was examined according to specified outcome measures.
MAIN RESULTS:
A total of 3309 records were identified, examined and the trials subjected to selection criteria; 30 trials were included in the review. No significant effects were observed for QoL at 6-month follow up (in 9 studies, SMD 0.11; 95% CI -0.00 to 0.22); however, a small improvement in QoL was observed when QoL was measured using cancer-specific measures (in 6 studies, SMD 0.16; 95% CI 0.02 to 0.30). General psychological distress as assessed by 'mood measures' improved also (in 8 studies, SMD - 0.81; 95% CI -1.44 to - 0.18), but no significant effect was observed when measures of depression or anxiety were used to assess distress (in 6 studies, depression SMD 0.12; 95% CI -0.07 to 0.31; in 4 studies, anxiety SMD 0.05; 95% CI -0.13 to 0.22). Psychoeducational and nurse-delivered interventions that were administered face to face and by telephone with breast cancer patients produced small positive significant effects on QoL (in 2 studies, SMD 0.23; 95% CI 0.04 to 0.43).
AUTHORS' CONCLUSIONS:
The significant variation that was observed across participants, mode of delivery, discipline of 'trained helper' and intervention content makes it difficult to arrive at a firm conclusion regarding the effectiveness of psychosocial interventions for cancer patients. It can be tentatively concluded that nurse-delivered interventions comprising information combined with supportive attention may have a beneficial impact on mood in an undifferentiated population of newly diagnosed cancer patients.

Rocking behaviour of multi-block columns subjected to pulse-type ground motion accelerations

Ancient columns, made with a variety of materials such as marble, granite, stone or masonry are an important part of the
European cultural heritage. In particular columns of ancient temples in Greece and Sicily which support only the architrave are
characterized by small axial load values. This feature together with the slenderness typical of these structural members clearly
highlights as the evaluation of the rocking behaviour is a key aspect of their safety assessment and maintenance. It has to be noted
that the rocking response of rectangular cross-sectional columns modelled as monolithic rigid elements, has been widely investigated
since the first theoretical study carried out by Housner (1963). However, the assumption of monolithic member, although being
widely used and accepted for practical engineering applications, is not valid for more complex systems such as multi-block columns
made of stacked stone blocks, with or without mortar beds. In these cases, in fact, a correct analysis of the system should consider
rocking and sliding phenomena between the individual blocks of the structure. Due to the high non-linearity of the problem, the
evaluation of the dynamic behaviour of multi-block columns has been mostly studied in the literature using a numerical approach
such as the Discrete Element Method (DEM). This paper presents an introductory study about a proposed analytical-numerical
approach for analysing the rocking behaviour of multi-block columns subjected to a sine-pulse type ground motion. Based on the
approach proposed by Spanos (2001) for a system made of two rigid blocks, the Eulero-Lagrange method to obtain the motion
equations of the system is discussed and numerical applications are performed with case studies reported in the literature and with a
real acceleration record. The rocking response of single block and multi-block columns is compared and considerations are made
about the overturning conditions and on the effect of forcing function’s frequency.
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Heat Activated Prestressing of Shape Memory Alloys for Active Confinement of Concrete Sections

This paper presents the results from the experimental investigation on heat activated prestressing of Shape Memory Alloy (SMA) wires for active confinement of concrete sections. Active confinement of concrete is found to be much more effective than passive confinement which becomes effective only when the concrete starts to dilate. Active confinement achieved using conventional prestressing techniques often faces many obstacles due to practical limitations. A class of smart materials that has recently drawn attention in civil engineering is the super elastic SMA which has the ability to undergo reversible hysteretic shape change known as the shape memory effect. The shape memory effect of SMAs can be utilized to develop a convenient prestressing technique for active confinement of concrete sections.
In this study a series of experimental tests are conducted to study Heat Activated Prestress (HAP) in SMAs. Three different types of tests are conducted with different loading protocol to determine parameters such as HAP, residual strain after heating and range of strain that can be used for effective active confinement after HAP. Test results show a maximum HAP of about 500 MPa can be achieved after heating and approximately 450MPa is retained at 25oC in specimens pre-strained by 6%. A substantial amount of strain recovery upon unloading and after heating the SMA wires is recorded. About 2.5% elastic strain recovery upon unloading from 6% strain level is observed. In the specimen pre-strained by 6%, a total of 4% strain is recovered when unloaded after heating. A strain range of 3% is found available for effective confinement after HAP. Test results demonstrate that SMAs have unique features that can be intelligently employed in many civil engineering applications including active confinement of concrete sections.

Patterns and predictors of help-seeking contacts with health services and general practitioner detection of suicidality prior to suicide: a cohort analysis of suicides occurring over a two-year period

Background: Contact with primary care and psychiatric services prior to suicide may be considerable, presenting
opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of
contact.
Method: Retrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner’s
Office linked with data from General Practice patient records over a 2 year period
Results: Eighty-seven per cent of suicides were in contact with General Practice services in the 12 months before
suicide. The frequency of contact with services was considerable, particularly among patients with a common
mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40 % of suicides.
Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are
male gender, frequency of consultations, diagnosis of mental illness and substance misuse.
Conclusions: Despite widespread and frequent contact, a substantial proportion of suicidal people were
undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too
narrowly focused.

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.

Monitoring of Bridges using Computer Vision Methods

This paper is an overview of the development and application of Computer Vision for the Structural Health
Monitoring (SHM) of Bridges. A brief explanation of SHM is provided, followed by a breakdown of the stages of computer
vision techniques separated into laboratory and field trials. Qualitative evaluations and comparison of these methods have been
provided along with the proposal of guidelines for new vision-based SHM systems.

Audit of mathematics learning support in Ireland in 2015 – the key findings

In 2015 the Irish Mathematics Learning Support Network (IMLSN) commissioned a comprehensive audit of the extent and nature of mathematics learning support (MLS) provision on the island of Ireland. An online survey was sent to 32 institutions, including universities, institutes of technology, further education and teacher training colleges, and a 97% response rate was achieved. While the headline figure – 84% of institutions that responded to the survey provide MLS – sounds good, deeper analysis reveals that the true state of MLS is not so solid. For example, in 25% of institutions offering MLS, only five hours per week (at most) of physical MLS are available, while in 20% of institutions the service is provided by only one or two staff members. Furthermore, training of tutors is minimal or non-existent in at least half of the institutions offering MLS. The results provide an illuminating picture, however, identifying the true state of MLS in Ireland is beneficial only if it informs developments in the years ahead. This talk will present some of the findings of the survey in more depth along with conclusions and recommendations. Key among these is the need for institutions to recognise MLS as a vital element of mathematics teaching and learning strategy at third level and devote the necessary resources to facilitate the provision of a service which can grow and adapt to meet student requirements.