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.     

Test-retest reliability in fMRI of language: group and task effects

This paper explores how the test-retest reliability is modulated by different groups of participants and experimental tasks. A group of 12 healthy participants and a group of nine stroke patients performed the same language imaging experiment twice, test and retest, on different days. The experiment consists of four conditions, one audio condition and three audiovisual conditions in which the hands are either resting, gesturing, or performing self-adaptive movements. Imaging data were analyzed using multiple linear regression and the results were further used to generate receiver operating characteristic (ROC) curves for each condition for each individual subject. By using area under the curve as a comparison index, we found that stroke patients have less reliability across time than healthy participants, and that when the participants gesture during speech, their imaging data are more reliable than when they are performing hand movements that are not speech-associated. Furthermore, inter-subject variability is less in the gesture task than in any of the other three conditions for healthy participants, but not for stroke patients.     

Sympathy and callousness: The impact of deliberative thought on donations to identifiable and statistical victims

When donating to charitable causes, people do not value lives consistently. Money is often concentrated on a single victim even though more people would be helped, if resources were dispersed or spent protecting future victims. We examine the impact of deliberating about donation decisions on generosity. In a series of field experiments, we show that teaching or priming people to recognize the discrepancy in giving toward identifiable and statistical victims has perverse effects: individuals give less to identifiable victims but do not increase giving to statistical victims, resulting in an overall reduction in caring and giving. Thus, it appears that, when thinking deliberatively, people discount sympathy towards identifiable victims but fail to generate sympathy toward statistical victims.     

Error and bias in comparative judgment: on being both better and worse than we think we are

People believe that they are better than others on easy tasks and worse than others on difficult tasks. In previous attempts to explain these better-than-average and worse-than-average effects, researchers have invoked bias and motivation as causes. In this article, the authors develop a more parsimonious account, the differential information explanation, in which it is assumed only that people typically have better information about themselves than they do about others. When one's own performance is exceptional (either good or bad), it is often reasonable to assume others' will be less so. Consequently, people estimate the performance of others as less extreme (more regressive) than their own. The result is that people believe they are above average on easy tasks and below average on difficult tasks. These effects are exacerbated when people have accurate information about their performances, increasing the natural discrepancy between knowledge of the self and knowledge of others. The effects are attenuated when people obtain accurate information about the performances of others.     

I'm more driven now: Resilience and resistance among transgender and gender expansive youth and young adults experiencing homelessness

ABSTRACT

Background: Little is known about the resilience strategies of transgender and gender expansive youth and young adults (YYA) experiencing homelessness. In addition to difficulties accessing trans-affirming supports and services, transgender and gender expansive YYA must contend with structural constraints and oppressive messages about who they are and who they can become. Despite these challenges, transgender and gender expansive YYA experiencing homelessness are finding innovative ways to resist the multiple and overlapping institutionalized challenges they face.

Methods: This qualitative study examined the ways a group of transgender and gender expansive YYA demonstrate resilience and resist dominant narratives about what it means to be young, transgender and experiencing homelessness.

Results: Two primary themes were identified through which transgender and gender expansive YYA experiencing homelessness demonstrated resilience in the midst of structural constraints and oppressive narratives about who they are and who they can become: personal agency and future orientation. Participants exercised personal agency through self-definition and making their own choices. They oriented themselves to future possibilities through positive meaning-making and re-visioning the meaning of home. Participants engaged in these acts of resilience and resistance despite receiving negative messages about themselves.

Conclusions: Study findings illustrate the capacity of transgender and gender expansive YYA experiencing homelessness to reframe their challenges as positive experiences, integral to the people they have become or will be in the future. Findings point to the need to expand conceptualizations about people experiencing homelessness, and to utilize a strengths-based framework in practice and research.     

Semantic clustering as a neuropsychological predictor for amnestic-MCI

Recent research has demonstrated that patients with Alzheimer's disease (AD) show deficits in semantic processing when compared to cognitively healthy individuals. This difference is thought to be attributed to losses in higher cortical systems that are predominantly associated with executive functioning. The first aim of the study will be to determine if differences in semantic clustering can accurately differentiate patients with amnestic mild cognitive impairment (aMCI) from cognitively normal (CN) individuals. The second aim will be to determine the extent to which semantic processing might be associated with executive functions. Data from 202 (134 CN, 68 aMCI) participants were analyzed to quantify differences in semantic clustering ratios on the HVLT-R. Study participants ages ranged from 51 to 87 with education ranging from 6 to 20 years. ANCOVA revealed statistically significant differences on semantic clustering ratios (p < .001). Moderate correlations between semantic clustering Category Fluency Test (r = .45) were also found. Statistically significant group differences were also present on Trails-B and WAIS-R Digit Symbol performance (p < .001). Overall, these data indicate that deficits in semantic clustering are present in aMCI patients.     

Family History and APOE-4 Genetic Risk in Alzheimer’s Disease

Identifying risk factors for Alzheimer's disease, such as carrying the APOE-4 allele, and understanding their contributions to disease pathophysiology or clinical presentation is critical for establishing and improving diagnostic and therapeutic strategies. A first-degree family history of Alzheimer's disease represents a composite risk factor, which reflects the influence of known and unknown susceptibility genes and perhaps non-genetic risks. There is emerging evidence that investigating family history risk associated effects may contribute to advances in Alzheimer's disease research and ultimately clinical practice.