Post-traumatic stress symptoms in mothers of children with leukaemia undergoing the first 12 months of therapy: Predictive models

The aim of this study consists in the measurement of psychological health and adaptation in mothers of children during the first 12 months of treatment for leukaemia and in the identification of possible early predictors. Ninety-four mothers were followed longitudinally at one week (T1), one month (T2), six months (T3) and 12 months (T4) post-diagnosis. The instruments used were: PTSD symptom checklist, BSI-18, Problem Scale, Ladder of life and an in-depth interview (EFI-C). Couple connectedness, family routine reorganisation, parental communication around the child's illness and trust in the medical care significantly increased from T1 to T4. Two models are proposed concerning possible predictors of mothers’ PTSS at T2 and at T3. Clinical suggestions are proposed on the basis of our empirical findings in order to plan informative, clinical and practical interventions for mothers of children under treatment for leukaemia.     

Delays in seeking cancer diagnosis in relation to beliefs about the curability of cancer in patients with different disease locations

This study is aimed at investigating factors leading to delayed oncologic examinations versus immediate consultation with a physician in patients with various cancers. We analysed the results of a study of patients (n?=?291) reporting for their first oncologic examinations. We conducted structured interviews containing social, demographic and clinical data, the Spielberger State-Trait Anxiety Inventory, the Beck Depression Inventory and Harris and Guten's health appraisal scores. Based on an analysis of decision-making trees, the results indicate that it is possible to predict beliefs regarding the curability of cancer and immediate versus delayed reporting to a physician. Delayed reports may be predicted on the basis of two factors: (1) a belief that cancer is incurable combined with increased state anxiety, ‘good’ or ‘very good’ self-appraisal of health and low depression; and (2) a belief that cancer is incurable accompanied by increased anxiety and depression. The characteristics of patients delaying a visit to the oncologist suggest the existence of three independent factors leading to both considerable (longer than nine months) and minor (up to one month) delays in seeking treatment.     

本土化意义治疗法的建立及对晚期癌症患者治疗作用的初步评价

通过参考国内外的意义治疗研究并总结前期经验,构建了＂意义治疗三步骤法＂的本土化意义治疗方法.应用＂意义治疗三步骤法＂对符合要求的50名宁养院晚期癌症患者进行治疗,并于治疗前后分别应用生命态度剖面图量表和McGill生活质量问卷进行评估.经过治疗后,94%的患者能有效心灵沟通,患者治疗后的生命意义感和生活质量明显提高,焦虑和抑郁情绪明显改善.因而＂意义治疗三步骤法＂是一种有效的本土化意义治疗工具,值得进一步研究与临床推广应用.     

Accounting for Time Preference in Management Decisions: An Application to Invasive Species

Managers of invasive species seek to prevent and mitigate their impact, which vary in the time horizon over which they are realized. Likewise, stakeholders vary in the time horizons they consider relevant. Agricultural impacts might reasonably be considered over two or three decades, although ecologists typically consider environmental impacts over much longer time frames. Although time preference plays a critical role in decision making, it has largely been ignored in multicriteria analyses. In this study, we examine how time has been treated in previous decision analyses of invasive species management, focusing on the differences between multicriteria and economic cost–benefit analyses. We then outline a method for incorporating time preference information into multicriteria decision analyses to ensure that criteria weights remain a faithful representation of the decision maker's preferences. To illustrate how time preference can be elicited for invasive species problems involving both monetary and nonmonetary consequences, we describe a small empirical study we conducted with a small group of experts and managers. By outlining a way to consider time preference information in multicriteria analyses of invasive species management, we hope to facilitate better decision making that is reflective of the decision maker's true preferences. Copyright © 2013 John Wiley & Sons, Ltd.     

Religious issues in diagnosis: The V-Code and beyond

This paper addresses the issues around considering clients' religious and spiritual functioning as a matter of client diversity. Such issues may be under appreciated by many clinicians. The introduction of a religious and spiritual problem V-Code (V62.89) into the DSM-IV provided a significant accommodation of client religious and spiritual functioning in contemporary psychodiagnostics. The V-Code allows for explicit identification of a non-pathological religious or spiritual focus in treatment. The nature of and history of the V-Code's inclusion in DSM-IV is briefly reviewed. The strengths and limitations of the V-Code for raising clinician awareness of the religious and spiritual domain of client functioning is discussed and illustrated by a number of case examples. The V-Code approach is contrasted with Hathaway's (2003) clinically significant religious impairment concept. Both are viewed as making complementary contributions to a religiously and spiritually sensitive clinical practice.     

全胸腔镜肺癌切除术在肺癌治疗中的应用

本文概述了全胸腔镜肺癌切除术的发展史、适应证、手术方法及临床疗效,证实全胸腔镜下肺癌切除术是一种安全、微创且疗效确切的手术,是未来肺癌外科治疗的主要手段之一,也将成为一个新的研究热点。此外,还展望了全胸腔镜下肺癌切除术的发展方向。     

乳腺病变的常规影像学筛查方法的合理性分析

乳腺癌是妇女最常见的恶性肿瘤之一,在我国,乳腺癌的发病率和死亡率已成为城市女性恶性肿瘤的首位,且每年以3％～5％速度增长。目前乳腺癌防治日益受到重视。然而,为了阻断高危险性的乳腺向乳腺癌发展,乳腺影像学筛查正在被越来越多的女性接受。本文就各种影像检查手段对乳腺疾病特别是乳腺癌诊断的优缺点进行简要的总结,旨在指导临床医师...     

早期胃癌的治疗

目前,早期胃癌（early gastric cancer,EGC）的治疗仍以开放性手术治疗为主,其预后明显优于进展期胃癌。近年来,随着对EGC浸润与转移规律的深入认识和新技术的应用,其治疗中微创外科的应用更为广泛和合理,并重视患者术后的生活质量。本文结合国内外的研究进展,深入探讨EGC的治疗方法及应用指征,特别是微创外...     

胃癌辅助化疗的选择和应用

局部进展期胃癌手术后是否给予全身辅助化疗以及关于标准方案的临床研究,一直是临床关注的热点问题,对ⅡB期以上的进展期胃癌术后给予辅助治疗已经成为共识,但对于采用何种方案作为标准方案尚缺乏循证学依据,而且东西方医学界的意见存在较大的争议,我们一方面期待具有更高级别证据的临床研究结果,另一方面在现有证据下对胃癌术后进行最大程...     

动态磁共振成像在早期乳腺癌诊断中的临床研究

评价动态增强磁共振成像在早期乳腺癌诊断中的价值。随机选取2008年10月到2011年6月本院83例经B超或B超联合钼靶检查阴性的中青年女性行乳腺MRI检查,对MRI发现可疑结节病灶的患者进行手术活检,通过病理诊断来评价MRI在诊断早期乳腺癌的准确性和临床应用价值。83例中青年女性中,发现病变7例（8．4％）,癌前改变4...