Satisfaction with follow-up consultations among younger adults treated for cancer: the role of quality of life and psychological variables

Given increased survival rates and treatment-related late effects, follow-up for cancer survivors is increasingly recommended. However, information about adverse events (e.g. possibility of late effects) may be distressing for the cancer survivor and lead to poor clinic attendance. Survivor satisfaction with appointments and the information provided are important. The Monitoring Process Model provides a theoretical framework to understand how survivors cope with threatening information, and consequences for follow-up care. Our aims were to describe satisfaction with routine follow-up and association between monitoring/blunting and satisfaction with care.

Spatial and temporal variation in population genetic structure of wild Nile tilapia (Oreochromis niloticus) across Africa

Background: Reconstructing the evolutionary history of a species is challenging. It often depends not only on the past biogeographic and climatic events but also the contemporary and ecological factors, such as current connectivity and habitat heterogeneity. In fact, these factors might interact with each other and shape the current species distribution. However, to what extent the current population genetic structure reflects the past and the contemporary factors is largely unknown. Here we investigated spatio-temporal genetic structures of Nile tilapia (Oreochromis niloticus) populations, across their natural distribution in Africa. While its large biogeographic distribution can cause genetic differentiation at the paleo-biogeographic scales, its restricted dispersal capacity might induce a strong genetic structure at micro-geographic scales. Results: Using nine microsatellite loci and 350 samples from ten natural populations, we found the highest genetic differentiation among the three ichthyofaunal provinces and regions (Ethiopian, Nilotic and Sudano-Sahelian) (R(ST) = 0.38 - 0.69). This result suggests the predominant effect of paleo-geographic events at macro-geographic scale. In addition, intermediate divergences were found between rivers and lakes within the regions, presumably reflecting relatively recent interruptions of gene flow between hydrographic basins (R(ST) = 0.24 - 0.32). The lowest differentiations were observed among connected populations within a basin (R(ST) = 0.015 in the Volta basin). Comparison of temporal sample series revealed subtle changes in the gene pools in a few generations (F = 0 - 0.053). The estimated effective population sizes were 23 - 143 and the estimated migration rate was moderate (m similar to 0.094 - 0.097) in the Volta populations. Conclusions: This study revealed clear hierarchical patterns of the population genetic structuring of O. niloticus in Africa. The effects of paleo-geographic and climatic events were predominant at macro-geographic scale, and the significant effect of geographic connectivity was detected at micro-geographic scale. The estimated effective population size, the moderate level of dispersal and the rapid temporal change in genetic composition might reflect a potential effect of life history strategy on population dynamics. This hypothesis deserves further investigation. The dynamic pattern revealed at micro-geographic and temporal scales appears important from a genetic resource management as well as from a biodiversity conservation point of view.

Pleasant Events, Activity Restriction, and Blood Pressure in Dementia Caregivers

Objective: A combination of high engagement in pleasurable activities and low perceived activity restriction is potentially protective for a number of health and quality of life outcomes. This study tests the newly proposed Pleasant Events and Activity Restriction (PEAR) model to explain level of blood pressure (BP) in a sample of elderly dementia caregivers. Methods: This cross-sectional study included 66 caregivers, ≥55 years of age, providing in-home care to a relative with dementia. Planned comparisons were made to assess group differences in BP between caregivers reporting high engagement in pleasant events plus low perceived activity restriction (HPLR; n = 22) to those with low pleasure plus high restriction (LPHR; n = 23) or those with either high pleasure plus high restriction or low pleasure plus low restriction (HPHR/LPLR; n = 21). Results: After adjustments for age, sex, body mass index, use of antihypertensive medication, physical activity, and number of health problems, HPLR participants (86.78 mm|Hg) had significantly lower mean arterial pressure compared with LPHR participants (94.70 mm|Hg) (p = .01, Cohen's d = 0.89) and HPHR/LPLR participants (94.84 mm|Hg) (p = .023, d = 0.91). Similar results were found in post hoc comparisons of both systolic and diastolic BP. Conclusions: This study extends support for the PEAR model to physical health outcomes. Differences in BP between the HPLR group and other groups were of large magnitude and thus clinically meaningful. The findings may inform intervention studies aimed at investigating whether increasing pleasant events and lowering perceived activity restriction may lower BP. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Double Take Project: Using Applied Theatre For Campus Climate Change

Despite research gathered in the Campus Climate Report, I believe that it underrepresented the student experience of the social scene. The document primarily served as an identification tool for four major problems on campus: binge drinking, sexual assault, diversity, and disengagement in the classroom. Double Take Project also identifies similar issues however, this project uses theatrical techniques to gather the anecdotal reality of the student perspective. Double Take Project expands beyond the Campus Climate Report to inspire dialogue in a variety of student-to-student interactions and, more importantly, the project seeks action and solution plans. The social scene dominates our culture and its many issues result in concern for the safety, self-identity, and development of Bucknell students into thriving adults. Double Take Project is rooted in the belief that theatre is a palpable tool for social change. Over the course of many events, Double Take Project has utilized facets of theatre to provide opportunities to voice discontent, widen perception of normalcy on campus, and inspire confidence to act on personal beliefs. The Double Take Project uses many Applied Theatre methods to impact the social scene. For example, I conducted 36 student interviews and transformed the stories into a one-woman show, Rage Behind Curtains, which I performed at multiple venues across campus. I also used interviews to create a radio show airing one story per day. I conducted ten workshops with student groups, Fraternities and Sororities, and in the classroom utilizing Augusto Boal’s Theatre of the Oppressed (TO) techniques. I also created a “social scene confessional” where I stood outside the Elaine Langone Center with a sign that read, “Tell me a story about the social scene” from a wide variety of Bucknell students. Finally, I have assembled a Forum Theatre Company based on Augusto Boal’s method of the spect-actor, utilizing participants as both actors and spectators in the theatre piece. All of the names indicated in this paper have been altered to protect the identity of the participants. While planning events and conducting various theatrical experiences, I learned that there are a series of internal and external issues contributing to our social environment. Internally, students are conflicted with personal beliefs while battling outward social pressure. Whether they are on the outskirts or center of the social scene determines their response to this conflict. For example, I have discovered that students on the borders of the social culture respond with criticism because they feel excluded, whereas the student’s centrally involved critique the culture in private and while their persona appears to not want change. Externally, there are many structural issues that contribute to the current social climate such as without Fraternity meal plans, Cafeteria space is not sufficient to feed all of the students, exclusive party culture, and gendered housing. Through meetings with Deans and staff, I have learned there are also problems between administration and students, resulting in resentment and blame. Although addressing structural issues would instigate immediate change, in my opinion, internal student conflicts are the primary cause for the current negative social atmosphere. I believe that pressure to conform is rooted in lack of personal identity. Because students simply do not know themselves, they form strong social groups that become the definition of themselves. Without confident self-awareness, large and powerful groups coerce students to accept social norms resulting in the individual’s outward distaste for change, yet internal discomfort.

Association between symptoms and quality of life in patients with schizophrenia: a pooled analysis of changes over time

Quality of life is an important outcome in the treatment of patients with schizophrenia. It has been suggested that patients' quality of life ratings (referred to as subjective quality of life, SQOL) might be too heavily influenced by symptomatology to be a valid independent outcome criterion. There has been only limited evidence on the association of symptom change and changes in SQOL over time. This study aimed to examine the association between changes in symptoms and in SQOL among patients with schizophrenia. A pooled data set was obtained from eight longitudinal studies that had used the Brief Psychiatric Rating Scale (BPRS) for measuring psychiatric symptoms and either the Lancashire Quality of Life Profile or the Manchester Short Assessment of Quality of Life for assessing SQOL. The sample comprised 886 patients with schizophrenia. After controlling for heterogeneity of findings across studies using linear mixed models, a reduction in psychiatric symptoms was associated with improvements in SQOL scores. In univariate analyses, changes in all BPRS subscales were associated with changes in SQOL scores. In a multivariate model, only associations between changes in the BPRS depression/anxiety and hostility subscales and changes in SQOL remained significant, with 5% and 0.5% of the variance in SQOL changes being attributable to changes in depression/anxiety and hostility respectively. All BPRS subscales together explained 8.5% of variance. The findings indicate that SQOL changes are influenced by symptom change, in particular in depression/anxiety. The level of influence is limited and may not compromise using SQOL as an independent outcome measure.

The Position of Russian Provinical Officialdom in the Middle of the 19th Century: Law and Life

The study considered the discrepancy between the official status and real position of Russian provincial officialdom in the middle of the 19th century. The law was not entirely coherent in all aspects of the officials' life and activity, with ordinary deviations from the law being adopted in practice and accepted, albeit not openly, by the public and sometimes even by the authorities. The main law determining the rights and duties of governors was never followed to the letter and in reality governors' activities were determined by the common (unwritten) law existing in the governmental sphere. The volume and nature of the governors' rights depended on a range of factors, with specific regional features and the governor's personal qualities having a particular significance. The standard of living of government clerks was much higher than their official salary would permit and Matkhanova studied the most widespread cases of abuse, identifying those positions in the administration which offered the most opportunities for such abuses. At the start of the period and on the eve of the reforms public opinion towards the bribery of officials underwent a change. From the late 1850s onwards, there appeared among provincial officials a group of young well-educated clerks with liberal ideas and a new system of moral values which did not allow them to accept bribes or infringe the law in any way. There was also a non-official hierarchy side by side with the legally existing one. A significant role in governing the region, and one which has been underestimated by historians, was played by the head of the governor's office, but the reforms of the 1860s contributed to changing this state of affairs.

Rapid climate change during the Weichselian Lateglacial in Ireland: Chironomid-inferred summer temperatures from Fiddaun, Co. Galway

A lacustrine sediment core from Fiddaun, western Ireland was studied to reconstruct summer temperature changes during the Weichselian Lateglacial. This site is located close to the Atlantic Ocean; and so is potentially sensitive to climatic changes associated with changes in ocean circulation. The record, comprising the end of the Weichselian Pleniglacial to the early Holocene, was analysed for fossil chironomids, lithology, and oxygen and carbon isotopes in the sedimentary carbonates. These proxies clearly show rapid warming at the onset of the Lateglacial Interstadial, relatively high summer temperatures during the Interstadial, pronounced cooling during the Younger Dryas, and subsequent warming at the transition to the Holocene. Chironomid-inferred mean July air temperatures for the Interstadial are ~12.5–14.5 °C, ~7.5 °C for the Younger Dryas, and ~15.0 °C for the early Holocene. Furthermore, this research provides evidence for at least two cold events during the Interstadial. These more moderate temperature oscillations can be correlated to Greenland Interstadial events 1b and 1d, on the basis of the age-depth model for the Fiddaun sequence. Based on multiple proxies, the first cold oscillation (GI-1d) was the more severe of the two in Ireland.

Seasonal variations of ventricular arrhythmia clusters in defibrillator recipients

BACKGROUND: Clustering ventricular arrhythmias are the consequence of acute ventricular electrical instability and represent a challenge in the management of the growing number of patients with an implantable cardioverter-defibrillator (ICD). Triggering factors can rarely be identified. OBJECTIVES: Several studies have revealed seasonal variations in the frequency of cardiovascular events and life-threatening arrhythmias, and we sought to establish whether seasonal factors may exacerbate ventricular electrical instability leading to arrhythmia clusters and electrical storm. METHODS: Two hundred and fourteen consecutive defibrillator recipients were followed-up during 3.3 +/- 2.2 years. Arrhythmia cluster was defined as the occurrence of three or more arrhythmic events triggering appropriate defibrillator therapies within 2 weeks. Time intervals between two clusters were calculated for each month and each season, and were compared using Kruskal-Wallis test and Wilcoxon-Mann-Whitney test with Bonferroni adjustment. RESULTS: During a follow-up of 698 patient years, 98 arrhythmia clusters were observed in 51 patients; clustering ventricular arrhythmias were associated with temporal variables; they occurred more frequently in the winter and spring months than during the summer and fall. Accordingly, the time intervals between two clusters were significantly shorter during winter and spring (median and 95% CI): winter 16 (5-19), spring 11.5 (7-25), summer 34.5 (15-55), fall 50.5 (19-65), P = 0.0041. CONCLUSION: There are important seasonal variations in the incidence of arrhythmia clusters in ICD recipients. Whether these variations are related to environmental factors, change in physical activity, or psychological factors requires further study.