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.

Urocortin – From Parkinson’s disease to the skeleton

Urocortin (Ucn 1), a 40 amino acid long peptide related to corticotropin releasing factor (CRF) was discovered 19 years ago, based on its sequence homology to the parent molecule. Its existence was inferred in the CNS because of anatomical and pharmacological discrepancies between CRF and its two receptor subtypes. Although originally found in the brain, where it has opposing actions to CRF and therefore confers stress-coping mechanisms, Ucn 1 has subsequently been found throughout the periphery including heart, lung, skin, and immune cells. It is now well established that this small peptide is involved in a multitude of physiological and pathophysiological processes, due to its receptor subtype distribution and promiscuity in second messenger signalling pathways. As a result of extensive studies in this field, there are now well over one thousand peer reviewed publications involving Ucn 1. In this review, we intend to highlight some of the less well known actions of Ucn 1 and in particular its role in neuronal cell protection and maintenance of the skeletal system, both by conventional methods of reviewing the literature and using bioinformatics, to highlight further associations between Ucn 1 and disease conditions. Understanding how Ucn 1 works in these tissues, will help to unravel its role in normal and pathophysiological processes. This would ultimately allow the generation of putative medical interventions for the alleviation of important diseases such as Parkinson's disease, arthritis, and osteoporosis.

Bird depredation of grapes in Niagara vineyards : a novel approach to identifying spatial and temporal trends /

Although local grape growers view bird depredation as a significant economic issue, the most recent research on the problem in the Niagara Peninsula is three decades old. Peer-reviewed publications on the subject are rare, and researchers have struggled to develop bird-damage assessment techniques useful for facilitating management programmes. I used a variation of Stevenson and Virgo's (1971) visual estimation procedure to quantify spatial and temporal trends in bird damage to grapes within single vineyard plots at two locations near St. Catharines, Ontario. I present a novel approach to managing the rank-data from visual estimates, which is unprecedented in its sensitivity to spatial trends in bird damage. I also review its valid use in comparative statistical analysis. Spatial trends in 3 out of 4 study plots confirmed a priori predictions about localisation in bird damage based on optimal foraging from a central location (staging area). Damage to grape clusters was: (1) greater near the edges of vineyard plots and decreased with distance towards the center, (2) greater in areas adjacent to staging areas for birds, and (3) vertically stratified, with upper-tier clusters sustaining more damage than lower-tier clusters. From a management perspective, this predictive approach provides vineyard owners with the ability to identify the portions of plots likely to be most susceptible to bird damage, and thus the opportunity to focus deterrent measures in these areas. Other management considerations at Henry of Pelham were: (1) wind damage to ice-wine Riesling and Vidal was much higher than bird damage, (2) plastic netting with narrow mesh provided more effective protection agsiinst birds than nylon netting with wider mesh, and (3) no trends in relative susceptibility of varietals by colour (red vs green) were evident.

Teaching Principled negotiation skills to parents and their children : the impact of parental involvement /

This study explored the impact of training parents and children concurrently in principled negotiation skills for the purpose of developing negotiation skills and problem solving abilities in children. A second experimental group was utilized to determine the viability of negotiation skills training of junior elementary students for the purpose of improving problem solving and conflict resolving abilities. The student population in each experimental group was trained using The Program for Young Negotiators (Curhan, 1996). A control group was also established using the remaining grade four and five students attending the participating school. These students did not receive training as part of this study. Student group distribution was as follows: Experimental group 1 (students with parent participant) consisted of 10 (5 grade five and 5 grade 4 students), Experimental group 2 students without parent participant) consisted of 48 (20 grade 4 and 28 grade 5 students), and the Control group 3 (55 grade 4 and 5 students). The impact of training was measured using the Five Factor Negotiation Scale developed for use with the Program for Young Negotiators (Curhan, 1996). This measure was employed as a pre- and post-test questionnaire to the total student population, (113 students) to determine levels of ability in each of the key elements of negotiation, personal initiative, collaboration, communication, conflict based perspective taking, and conflict resolution approach (Nakkula & Nikitopoulos, unpublished). This measure has a coefficient alpha of .75 which is acceptable for this type of affective instrument. As well, open ended ability questions designed to measure ability, knowledge, and behaviour as they relate to negotiation skill application were given to the total student population, (113 students). Finally, journals were maintained by the students in both experimental groups, and informal feedback discussions were held with students and parents participating in the study.The intent of using both qualitative and quantitative measures was to provide an overall perspective of student abilities as they related to principled negotiation skills. While the quantitative measures were from the student perspective, more qualitative information was sought from parents and teachers through informal interviews, discussions, and use of confidential feedback cards. For analysis purposes, the ability questions were randomly selected for Experimental group 2 and Control group 3 in an effort to balance the groups more equitably with Experimental group 1. The findings of this study indicate that students of the junior elementary school age can be taught how to perceive conflict in a more constructive way. However, they are not as likely to use their skills when the conflict is with a sibling as they are with a peer, a teacher, or a parent. While no statistically significant differences between mean scores for Experimental groups 1 and 2 exist some subtle differences are noted. Overall, increases in mean scores for grade 4 students exceeded the increases for grade 5 students within Experimental group 1 . The implication being that younger students benefit more from having a parent trained in principled negoUation skills than older students. The skill level of a parent in principled negotiation can not be underesUmated. Without a consistent and effective role model the likelihood of developing student skill level to a point of automaticity is greatly reduced. Enough so that perhaps the emphasis should be placed on training parents more so than the students.

An exploratory descriptive study of factors influencing students to seek or not to seek personal counselling on a college of applied arts and technology campus located in Southern Ontario /

This descriptive-exploratory study examined factors which were perceived by students at a College of Applied Arts and Technology (CAAT) campus as influencing them in choosing to come or not to come for personal counselling and why they would or would not retum. A total of 250 students selected through a sample of convenience were surveyed. A questionnaire survey was conducted with quantitative data collected using a 4-point, forced-choice Likert scale and yes/no questions and qualitative data collected using open-ended questions and invited comments. The responses were analyzed using means and modes for the Likert responses and percentages for the yes/no and check-off questions. The narrative responses were subjected to content analysis to identify themes. The mean score findings on factors influencing students to come for personal counselling were at or close to the mid- point of 2.5. Personal distress was the only variable found to have a negative response, meaning students would not come to counselling if they were in personal distress. On factors that would keep them from choosing to come to counselling, students seemed to trust counsellors and feel accepted by them and rejected the notion that peer pressure or the first session being unhelpful would keep them away from counselling. The counsellor's relationship with the student is the major determinant for repeat sessions. When asked what factors would influence students to not retum for personal counselling, students rejected the variables of peer pressure, the extra time needed for counselling, and not getting what they wanted in a session, but, in one instance, indicated that variables regarding the counselling relationship would keep them from returning.

Creating a Generation of Upstanders: Curriculum Resource to Help Ontario Educators Build Safe Schools

This project focuses on the bullying found in the 21st century elementary classrooms, more specifically in grades 4-8. These grades were found to have high levels of bullying because of major shifts in a student’s life that may place a student of this age at risk for problems with their peer relationships (Totura et al., 2009). Supporting the findings in the literature review, this handbook was created for Ontario grade 4-8 classroom teachers. The resource educates teachers on current knowledge of classroom bullying, and provides them with information and resources to share with their students so that they can create a culture of upstanders. Upstanders are students who stand up for the victims of bullying, and have the self-esteem and strategies to stand up to classroom bullies. These upstanders, with the support of their classroom teachers and their peers, will be a force strong enough to build the government-mandated Safe School environment.

Creating a Generation of Upstanders: Curriculum Resource to Help Ontario Educators Build Safe Schools

This project focuses on the bullying found in the 21st century elementary classrooms, more specifically in grades 4-8. These grades were found to have high levels of bullying because of major shifts in a student’s life that may place a student of this age at risk for problems with their peer relationships (Totura et al., 2009). Supporting the findings in the literature review, this handbook was created for an Ontario grade 4-8 classroom teachers. The resource educates teachers on current knowledge of classroom bullying, and provides them with information and resources to share with their students so that they can create a culture of upstanders. Upstanders are students who stand up for the victims of bullying, and have the self-esteem and strategies to stand up to classroom bullies. These upstanders, with the support of their classroom teachers and their peers, will be a force strong enough to build the government-mandated Safe School environment.

Exploring the Influence of Female Friendships on Decisions to Discuss the Breast Self-Exam in Young Adult Women

The breast self-exam (BSE) has been an important method for detection of breast cancer, especially in women under the age of 40. This study used grounded theory to explore the possible influence of female friendships on young women’s decisions regarding BSE. Conversations with six women in their 20s and 30s revealed that discussion of BSE is an exceptional conversation facilitated by the female friendship “safe zone” and a germinal event. Without being prompted by a germinal event, such as a health scare, it is generally considered to be an unnecessary conversation about private matters and viewed as out of the ordinary, especially for low-risk women. This conversation most easily occurs within the female friendship “safe zone” that develops through the body in common, a sense of trust, and private information sharing. Implications include peer mentoring for sharing and educating women and healthcare professionals on conditions that facilitate the exceptional conversation.

Teaching Reading to ESL Adult Literacy Learners: The Development of an Instructor’s Handbook

The purpose of this project was to develop an instructors’ handbook that provides the declarative, procedural, and conditional knowledge associated with the interactive instructional approach, differentiated instruction, and the gradual release of responsibility framework for teaching reading to English as a second language adult literacy learners. The need for this handbook was determined by conducting a critical analysis of existing handbooks and concluding that no handbook completely addressed the 3 types of knowledge for the 3 instructional processes. A literature review was conducted to examine the nature, use, and effectiveness of the 3 instructional processes when teaching reading to ESL adult literacy learners. The literature review also examined teachers’ preferences for reading research and found that texts that were relevant, practical, and accessible were favoured. Hence, these 3 elements were incorporated as part of the handbook design. Three peer reviewers completed a 35-item 5-point Likert scale evaluation form that also included 5 open-ended questions. Their feedback about the handbook’s relevancy, practicality, accessibility, and face validity were incorporated into the final version of the handbook presented here. Reference to the handbook by ESL adult literacy instructors has the potential to support evidence-informed lesson planning which can support the ESL adult literacy learners in achieving their goals and contributing to their societies in multiple and meaningful ways.

Novel approaches to the synthesis and treatment of cathode materials for lithium-ion batteries

Nous avons mis au point une approche novatrice pour la synthèse d’un matériau de cathode pour les piles lithium-ion basée sur la décomposition thermique de l’urée. Les hydroxydes de métal mixte (NixMnxCo(1-2x)(OH)2) ont été préparés (x = 0.00 à 0.50) et subséquemment utilisés comme précurseurs à la préparation de l’oxyde de métal mixte (LiNixMnxCo(1-2x)O2). Ces matériaux, ainsi que le phosphate de fer lithié (LiFePO4), sont pressentis comme matériaux de cathode commerciaux pour la prochaine génération de piles lithium-ion. Nous avons également développé un nouveau traitement post-synthèse afin d’améliorer la morphologie des hydroxydes. L’originalité de l’approche basée sur la décomposition thermique de l’urée réside dans l’utilisation inédite des hydroxydes comme précurseurs à la préparation d’oxydes de lithium mixtes par l’intermédiaire d’une technique de précipitation uniforme. De plus, nous proposons de nouvelles techniques de traitement s’adressant aux méthodes de synthèses traditionnelles. Les résultats obtenus par ces deux méthodes sont résumés dans deux articles soumis à des revues scientifiques. Tous les matériaux produits lors de cette recherche ont été analysés par diffraction des rayons X (DRX), microscope électronique à balayage (MEB), analyse thermique gravimétrique (ATG) et ont été caractérisés électrochimiquement. La performance électrochimique (nombre de cycles vs capacité) des matériaux de cathode a été conduite en mode galvanostatique.

Links between developmental changes in kindergarten behaviors and later peer associations

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Cognitive appraisals, emotional reactions, and their associations with three forms of peer-victimization

Resumen tomado de la publicaci??n