Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue.

CONTEXT: Fatigue is among the most common and distressing symptoms experienced by cancer patients. OBJECTIVE: This systematic review and meta-analysis evaluates the efficacy of psychological and activity-based interventions against cancer-related fatigue in cancer patients. DATA SOURCES: MEDLINE, PsycINFO, and CINAHL. STUDY SELECTION: Randomized controlled trials of psychological and activity-based interventions involving adult cancer patients in which fatigue was an outcome were reviewed. EXTRACTION: Forty-one trials were reviewed and 30 were included in a meta-analysis. DATA SYNTHESIS: Fifty percent of psychological trials and 44% of activity-based trials rated fair or better in quality yielded significant findings favoring the intervention condition. Meta-analysis yielded an overall effect size of 0.09 (95% CI = .02- .16) favoring nonpharmacological conditions. Further analysis indicated that effect sizes were significant for psychological interventions (d-sub(w) = .10, 95% CI = .02-.18) but not activity-based interventions (d-sub(w) = .05, 95% CI = -.08 - .19). CONCLUSIONS: Findings provide limited support for use of nonpharmacological interventions to manage cancer-related fatigue. The lack of research with heightened fatigue as an eligibility criterion is a notable weakness of the existing evidence base.     

Brain responses to lexical-semantic priming in children at-risk for dyslexia

Deviances in early event-related potential (ERP) components reflecting auditory and phonological processing are well-documented in children at familial risk for dyslexia. However, little is known about brain responses which index processing in other linguistic domains such as lexicon, semantics and syntax in this group. The present study investigated effects of lexical-semantic priming in 20- and 24-month-olds at-risk for dyslexia and typically developing controls in two ERP experiments. In both experiments an early component assumed to reflect facilitated lexical processing for primed words was enhanced in the at-risk group compared to the control group. Moreover, an N400-like response which was prominent in the control group was attenuated or absent in at-risk children. Results suggest that deficiencies in young children at-risk for dyslexia are not restricted to perceptual and lower-level phonological abilities, but also affect higher order linguistic skills such as lexical and semantic processing.     

Relationship of body image to breast and skin self-examination intentions and behaviors

Breast self-examinations (BSE) and skin self-examinations (SSE) represent cost-effective and time-efficient approaches to cancer detection. Given their utility, it is important to determine who is likely to perform these behaviors regularly and why. Because BSE and SSE require close examination of one's body, women who are less satisfied and less comfortable with their bodies may perform these behaviors less often. This study sought to determine if a relationship exists between body image and BSE and SSE behaviors and intentions. Ninety-three women completed measures assessing body image, past performance of and future intentions to perform BSE and SSE. Results indicated that body image was related to past performance of SSE. Having greater body-areas satisfaction and more favorable global evaluations of appearance were related to having performed SSE more frequently in the past year. Future research should further examine this relationship utilizing longitudinal designs and more diverse populations.     

Developmental dyslexia and widespread activation across the cerebellar hemispheres

Developmental dyslexia is the most common learning disability in school-aged children with an estimated incidence of five to ten percent. The cause and pathophysiological substrate of this developmental disorder is unclear. Recently, a possible involvement of the cerebellum in the pathogenesis of dyslexia has been postulated. In this study, 15 dyslexic children and 7 age-matched control subjects were investigated by means of functional neuroimaging (fMRI) using a noun-verb association paradigm. Comparison of activation patterns between dyslexic and control subjects revealed distinct and significant differences in cerebral and cerebellar activation. Control subjects showed bilaterally well-defined and focal activation patterns in the frontal and parietal lobes and the posterior regions of the cerebellar hemispheres. The dyslexic children, however, presented widespread and diffuse activations on the cerebral and cerebellar level. Cerebral activations were found in frontal, parietal, temporal and occipital regions. Activations in the cerebellum were found predominantly in the cerebellar cortex, including Crus I, Crus II, hemispheric lobule VI, VII and vermal lobules I, II, III, IV and VII. This preliminary study is the first to reveal a significant difference in cerebellar functioning between dyslexic children and controls during a semantic association task. As a result, we propose a new hypothesis regarding the pathophysiological mechanisms of developmental dyslexia. Given the sites of activation in the cerebellum in the dyslexic group, a defect of the intra-cerebellar distribution of activity is suspected, suggesting a disorder of the processing or transfer of information within the cerebellar cortex.     

Stabilizing and Changing Phenomenal Worlds: Ludwik Fleck and Thomas Kuhn on Scientific Literature

In the work of both Ludwik Fleck and Thomas Kuhn the scientific literature plays important roles for stability and change of scientific phenomenal worlds. In this article we shall introduce the analyses of scientific literature provided by Fleck and Kuhn, respectively. From this background we shall discuss the problem of how divergent thinking can emerge in a dogmatic atmosphere. We shall argue that in their accounts of the factors inducing changes of scientific phenomenal worlds Fleck and Kuhn offer substantially different approaches, and we shall discuss in which respects their approaches may be compatible. This revised version was published online in August 2006 with corrections to the Cover Date.     

Kuhn's Account Of Family Resemblance: A Solution To The Problem Of Wide-Open Texture

It is a commonly raised argument against thefamily resemblance account of concepts that, on thisaccount, there is no limit to a concept's extension.An account of family resemblance which attempts toprovide a solution to this problem by including bothsimilarity among instances and dissimilarity tonon-instances has been developed by the philosopher ofscience Thomas Kuhn. Similar solutions have beenhinted at in the literature on family resemblanceconcepts, but the solution has never received adetailed investigation. I shall provide areconstruction of Kuhn's theory and argue that hissolution necessitates a developmental perspective withbuilds on both the transmission of taxonomies betweengenerations and a progressive development throughhistory.     

Brooding and Reflection as Subtypes of Rumination: Evidence from Confirmatory Factor Analysis in Nonclinical Samples using the Dutch Ruminative Response Scale

Previous research has shown that depressive rumination is an important vulnerability factor for experiencing depressive symptoms. The most widely used measure to assess depressive rumination is the Ruminative Response Scale (RRS). According to Treynor et al. (Cognitive Therapy and Research 27:247–259, 2003), the RRS contains two subscales, reflecting two different rumination subcomponents: brooding and reflection. The present study examined the psychometric properties of the RRS in two samples (N = 432 and N = 407). Based on a confirmatory factor analysis (CFA), results confirmed that a two-dimensional model with brooding and reflection factors provided an adequate fit to the data. Reliability, convergent and discriminant validity of the rumination subcomponents were appropriate. Furthermore, brooding but not reflection predicted depressive symptoms prospectively, even when accounting for concurrent depressive feelings. The results provide the first confirmatory factor-analytical support for the widely assumed two-factor model of the RRS and add to the accumulating body of evidence supporting the multidimensional nature of depressive rumination.