乳腺微乳头状癌的临床病理特征分析

回顾性分析乳腺浸润性微乳头状癌(IMPC)的临床病理特征.选取河北医科大学第四医院乳腺中心手术切除并经病理证实的女性原发性乳腺癌共3 383例,筛选出符合IMPC为实验组,同期乳腺浸润性导管癌(IDC)为对照组.结果显示,本组IMPC 167例,占同期乳腺癌4.94％,年龄29岁～80岁,中位年龄54岁.淋巴结转移者共135例,占80.8％,淋巴结转移数目≥4个共105例,占62.9％,HER2阳性率58.7％,与IDC组相比差异均有统计学意义(P＜0.05).IMPC为一种少见类型的浸润性乳腺癌,具有淋巴管侵袭性强、淋巴结转移率高的生物学行为.应与其他类型肿瘤进行鉴别,明确诊断.     

Functional analysis screening for multiple topographies of problem behavior

The current study evaluated a screening procedure for multiple topographies of problem behavior in the context of an ongoing functional analysis. Experimenters analyzed the function of a topography of primary concern while collecting data on topographies of secondary concern. We used visual analysis to predict the function of secondary topographies and a subsequent functional analysis to test those predictions. Results showed that a general function was accurately predicted for five of six (83%) secondary topographies. A specific function was predicted and supported for a subset of these topographies. The experimenters discuss the implication of these results for clinicians who have limited time for functional assessment.     

The Brief Cognitive Impairment Scale (BCIS): preliminary investigation of a severe-stage dementia test emphasizing cognitive processing and interpersonal tolerance

We describe the development and validation of The Brief Cognitive Impairment Scale (BCIS), a cognitive screening instrument designed for persons with severe-stage dementia. Psychometric analyses were performed on neuropsychological data from long-term care residents (N = 247) who completed a brief battery of tests, including the BCIS. A principle component analysis yielded three factors that provide insight into how persons with severe dementia cognitively process information and may tolerate specific aspects of social stimulation, such as during personal care. A BCIS cut score can be used to identify severe dementia with a sensitivity of .82, a specificity of .84, and an area under the curve of .89. It may be used by clinicians or caregivers when advanced dementia is suspected, as an alternative to measures with suspected floor effects, when residents cannot tolerate more demanding assessment tools, and as part of non-pharmacologic treatment plans for behavior disturbances associated with dementia.     

Using found poetry to illuminate the existential and posttraumatic growth of women with breast cancer engaging in art therapy

Arts-based research (ABR) is an expanding methodological genre, which adapts the tenets of the creative arts to make social science research accessible, evocative, and engaging. It crosses the boundaries of both art and science, but has made few inroads within the discipline of psychology. This article describes a pilot project examining how art-making shaped the trajectories of women diagnosed and treated for breast cancer. Using ABR as a way of distilling the findings, we demonstrate how experiences of existential and posttraumatic growth can be understood more intensely and profoundly through found poetry. Found poems (excerpts from interviews reframed as poetry) offer a richer, more meaningful, and potent evocation of themes than traditional coding categories. Poetry permits the voice of the participant to be more clearly heard and allows the reader to access deeper insights and understandings of the complexities of growth through adversity.     

Identifying Students at Risk: An Examination of Computer-Adaptive Measures and Latent Class Growth Analysis

Multitiered systems of support depend on screening technology to identify students at risk. The purpose of this study was to examine the use of a computer-adaptive test and latent class growth analysis (LCGA) to identify students at risk in reading with focus on the use of this methodology to characterize student performance in screening. Participants included 3,699 students in Grades 3–5. Three time points of administration (fall, winter, and spring) of the computer-adaptive reading measure were selected. LCGA results indicated 6–7 classes, depending on grade, informed by level and growth in student performance that significantly predicted failure on the statewide test administered at the end of the year. The lowest-performing classes had failure rates above 90% across all grades. The results indicate that identifying homogeneous groups of learners through LCGA may be valuable as an approach to determining students who need additional instruction. Practical implications and future directions are discussed.     

Quality of life in breast cancer patients: Associations with optimism and social supportCalidad de vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.     

How impaired is too impaired? Exploring futile neuropsychological test patterns as a function of dementia severity and cognitive screening scores

Some older adults cannot meaningfully participate in the testing portion of a neuropsychological evaluation due to significant cognitive impairments. There are limited empirical data on this topic. Thus, the current study sought to provide an operational definition for a futile testing profile and examine cognitive severity status and cognitive screening scores as predictors of testing futility at both baseline and first follow-up evaluations. We analysed data from 9,263 older adults from the National Alzheimer’s Coordinating Center Uniform Data Set. Futile testing profiles occurred rarely at baseline (7.40%). There was a strong relationship between cognitive severity status and the prevalence of futile testing profiles, χ²(4) = 3559.77, p < .001. Over 90% of individuals with severe dementia were unable to participate meaningfully in testing. Severity range on the Montreal Cognitive Assessment (MoCA) also demonstrated a strong relationship with testing futility, χ²(3) = 3962.35, p < .001. The rate of futile testing profiles was similar at follow-up (7.90%). There was a strong association between baseline dementia severity and likelihood of demonstrating a futile testing profile at follow-up, χ²(4) = 1513.40, p < .001. Over 90% of individuals with severe dementia, who were initially able to participate meaningfully testing, no longer could at follow-up. Similarly, there was a strong relationship between baseline MoCA score band and likelihood of demonstrating a futile testing profile at follow-up, χ²(3) = 1627.37, p < .001. Results can help to guide decisions about optimizing use of limited neuropsychological assessment resources.     

The role of social support in women’s health and recovery processes

The aim of this study was to assess the psychological state of women who have undergone surgery for breast cancer or cardiac surgery, including examination of the role of social support in both groups. The study included 48 women (mean age: 66.04?±?8.3 years). They were divided into two groups according to diagnosis: 23 women (mean age: 69.2?±?8.6 years) who underwent heart surgery (cardiac group, CG) and 25 women (mean age: 63.2?±?7.0 years) treated for breast cancer and associated with the Women After Mastectomy Club (oncology group, OG). In addition to the assessment of socio-demographic variables, the following self-report questionnaires were administered: Satisfaction with Life Scale, Acceptance of Illness Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory as well as Berlin Social Support Scale. In the CG, the severity of depressive symptoms was two times higher than in OG (p?=?.003). In both groups, there was a high percentage (80%) of women with severe symptoms of anxiety (p?=?.37). In both groups, the level of life satisfaction was similar (p?=?.58), but OG was characterized by a higher level of acceptance of the disease (p?=?.003). The correlation analysis showed that in both groups, social support was related differently to the parameters of emotional state. Women treated for breast cancer were in a better mental condition than women treated for heart disease. The support coming from other women in similar circumstances (Women After Mastectomy Club) seems to be more effective than the support coming from the patient’s immediate environment. The results for social support ought to be interpreted not only through the prism of mean values of received support, but also with regard to the information on the sources of support.