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The intramural the National Cancer Institute (NCI) and more recently the University of Texas Southwestern Medical Center with many different collaborators comprised a complex, multi-disciplinary team that collaborated to generated large, comprehensively annotated, cell-line related research resources which includes associated clinical, and molecular characterization data. This material has been shared in an anonymized fashion to accelerate progress in overcoming lung cancer, the leading cause of cancer death across the world. However, this cell line collection also includes a range of other cancers derived from patient-donated specimens that have been remarkably valuable for other types of cancer and disease research. A comprehensive analysis conducted by the NCI Center for Research Strategy of the 278 cell lines reported in the original Journal of Cellular Biochemistry Supplement, documents that these cell lines and related products have since been used in more than 14 000 grants, and 33 207 published scientific reports. This has resulted in over 1.2 million citations using at least one cell line. Many publications involve the use of more than one cell line, to understand the value of the resource collectively rather than individually; this method has resulted in 2.9 million citations. In addition, these cell lines have been linked to 422 clinical trials and cited by 4700 patents through publications. For lung cancer alone, the cell lines have been used in the research cited in the development of over 70 National Comprehensive Cancer Network clinical guidelines. Finally, it must be underscored again, that patient altruism enabled the availability of this invaluable research resource.
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AIM: To investigate medical decision-making from the thoracic surgeons' and patients' perspectives in early-stage lung cancer. PATIENTS & METHODS: We conducted one focus group with thoracic surgeons (n = 15) and one with a group of early-stage lung cancer patients treated with surgery (n = 7). Focus groups were recorded, transcribed and coded for themes. RESULTS: For surgeons, surgical procedure choice was a primary concern, followed by the surgical treatment plan decision-making process. Survivors focused primarily on the physical and mental health-related postsurgical burden for which they felt they were not well prepared and placed less emphasis on surgical decision-making. CONCLUSION: As early-stage lung cancer mortality rates are improving, surgeons and patients can prioritize surgical approaches and postsurgical care that enhance quality of life.
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Tomada de Decisão Clínica , Neoplasias Pulmonares/psicologia , Neoplasias Pulmonares/cirurgia , Cirurgiões/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Estadiamento de Neoplasias , Qualidade de Vida , Procedimentos Cirúrgicos TorácicosRESUMO
The treatment of emotional distress has stalled. There has been no improvement in depression outcomes for 30 years, and recent opinions have highlighted the lack of clear validity for the mechanisms involved in current models of complex psychological interventions. Emotional distress is a phenomenon that underpins a swathe of apparently diverse mental health conditions. Childhood trauma has been found to be endemic and common in those with poor psychological adjustment in adults. Executive processes cause a split between knowledge of an event and knowledge of its negative ongoing emotional effects so making integration of the memory of such events and resolution of its effects is a challenge. Recent research into the relationship between well-being and memory structures has converged with research into episodic memories and their key role in goal programming, giving an opportunity to describe a new model with plausible mechanisms for emotional distress, regulation, resilience, and recovery. Humans seek goals that fulfil their universal basic psychological need for self-determination, and the structures of memory networks drive behavioral algorithms that can satisfy or thwart that goal. We propose that a single underlying deficit in memory networks could underpin the psychopathology of emotional distress and that a new formulation of distress and recovery could drive a useful update on the mechanisms of psychological interventions with greater validity and utility for recovery and propose the NEMESIS (Negative MEmorieS Integration Systems) model.
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BACKGROUND: Post-stroke psychological problems predict poor recovery, while positive affect enables patients to focus on rehabilitation and may improve functional outcomes. Positive Mental Training (PosMT), a guided self-help audio shows promise as a tool in promoting positivity, optimism and resilience. OBJECTIVE: To assess acceptability of training in positivity with PosMT for prevention and management of post-stroke psychological problems and to help with coping with rehabilitation. METHODS: A modified PosMT tool consisted of 12 audio tracks each lasting 18 minutes, one listened to every day for a week. Survivors and carers were asked to listen for 4 weeks, but could volunteer to listen for more. Interviews took place about experiences of the tool after 4 and 12 weeks. SUBJECTS: 10 stroke survivors and 5 carers from Stroke Support Groups in the UK. RESULTS: Three stroke survivors did not engage with the tool. The remainder reported positive physical and psychological benefits including improved relaxation, better sleep and reduced anxiety after four weeks. Survivors who completed the programme gained a positive outlook on the future, increased motivation, confidence and ability to cope with rehabilitation. No adverse effects were reported. CONCLUSIONS: The PosMT shows potential as a tool for coping with rehabilitation and overcoming post-stroke psychological problems including anxiety and depression.
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Adaptação Psicológica , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Reabilitação do Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/terapia , Sobreviventes/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/psicologia , Ansiedade/terapia , Cuidadores/psicologia , Depressão/epidemiologia , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/métodosRESUMO
The child's view of pain is a sparse area in the field of pediatric pain, with interviews providing a major investigative tool. A flurry of interview studies has appeared but their contribution in terms of increasing the pool of information is limited by the indiscriminate use of the supplied-response item format. This paper describes the advantages of the generate-response format as well as the importance of psychological climate and subject set. Data obtained from a large-scale interview project (n = 994) on children's views of their ongoing and past pain experiences provide some support for the interview methodology advocated here.
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Entrevista Psicológica/métodos , Dor/psicologia , Psicologia da Criança , Atitude Frente a Saúde , Criança , Humanos , Transtornos de Enxaqueca/psicologia , Relações Profissional-Paciente , Enquadramento PsicológicoRESUMO
This interview study was designed to obtain a substantial body of information about childhood pain from a large cohort (n = 994) of Northern Californian school children between the ages of 5 and 12 years. The primary criteria for assignment to groups were extent of hospitalization experience, recency of hospitalization, presence of a painful chronic condition, and chronic iatrogenic pain. Open-ended questions were used to determine the extent of the children's knowledge and understanding of pain, their ability to describe pain, specific pain experiences, use of coping strategies, preferences concerning the timing of information about impending pain, and maladaptive pain usage. There was unequivocal evidence of the children's ability to communicate effectively concerning their pain, however, knowledge and understanding of pain for most of the sample was at a low developmental level, with no clearly defined age trends and no sex differences. There was relatively low use of coping strategies and the frequency of maladaptive pain usage was disquieting.
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Dor/fisiopatologia , Adaptação Psicológica , Criança , Criança Hospitalizada/psicologia , Pré-Escolar , Doença Crônica , Coleta de Dados , Feminino , Humanos , Masculino , Dor/psicologia , Educação de Pacientes como AssuntoRESUMO
BACKGROUND: Although there is some evidence on the effectiveness and cost-effectiveness of computerised cognitive behavioural therapy (CCBT) for treating anxiety and depression in primary care, alternative low-cost psychosocial interventions have not been investigated. METHODS: The cost-effectiveness of an audio based resilience training (Positive Mental Training, PosMT) was examined using a decision model. Patient level cost and effectiveness data from a trial comparing a CCBT treatment and usual care and effectiveness data from a study on PosMT were used to inform this. RESULTS: Net benefits of CCBT and PosMT were approximately equal in individuals with 'moderate' depression at baseline and markedly in favour of PosMT for the 'severe' depression subgroup. With only four observations in the 'mild' depression category for PosMT, the existing evidence base remains unaltered. LIMITATIONS: Efficacy data for the PosMT arm was derived from a study using a partially randomised preference design and the model structure contains simplifications due to lack of data availability. CONCLUSION: PosMT may represent good value for money in treatment of depression for certain groups of patients. More research in this area may be warranted.
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Terapia Cognitivo-Comportamental/economia , Depressão/economia , Depressão/terapia , Transtorno Depressivo/economia , Transtorno Depressivo/terapia , Recursos Audiovisuais , Terapia Cognitivo-Comportamental/métodos , Análise Custo-Benefício , Humanos , Atenção Primária à Saúde/economia , Resiliência PsicológicaRESUMO
Soil physical variables were investigated in forest plots submitted to selective logging in Central Amazonia. After logging, soil samples were collected to obtain soil water retention curves and measure: available soil water to the plants, soil density, and total porosity. Temperature measurements were carried out for 13 months, considering six treatments: control, center of the gaps, edge of the gaps, edge of the remaining forest, remaining forest and tractor tracks. Hydraulic conductivity measurements on saturated soil were conducted both on the control forest as well as on the logged plots, with no treatment distinction. The soil showed a low available water storage capacity: only 11 to 18% can be available to the plants, up to 1 meter depth. The temperature of the soil upper layers was influenced by logging, i. e., through the opening of the gaps, light reaches the soil more intensely in the center and edge of gaps, increasing temperatures in relation to the control and the remaining forest.
Variáveis físicas do solo foram investigadas em parcelas de floresta de terra firme submetidas à extração seletiva de madeira na Amazônia central. Foram obtidas curvas de retenção de água no solo, juntamente com medidas de água disponível no solo às plantas, densidade do solo e porosidade total. Medidas de temperatura do solo foram realizadas por mais de 13 meses, considerando seis tratamentos: controle, centro da clareira, borda da clareira, borda da floresta remanescente, floresta remanescente e trilha do trator. Medidas de condutividade hidráulica de solo saturado foram feitas na floresta e em clareiras, sem distinguir os tratamentos. O solo revelou baixa capacidade de armazenar água disponível: apenas 11 a 18% da água pode estar disponível às plantas, num perfil de 1 m de profundidade. A temperatura das camadas superiores do solo foi influenciada pela extração seletiva de madeira: nas clareiras abertas, a luz chega com mais intensidade no solo, proporcionando temperaturas mais elevadas no centro e nas bordas das clareiras do que no controle e na floresta remanescente.