Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial.

BACKGROUND: There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer. PATIENTS AND METHODS: In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured Clinical Interview for DSM-IV) and reduction in depression score by at least 2 points (Hospital Anxiety and Depression Scale, HADS-D) in STPP versus TAU at treatment termination. Secondary outcomes mainly refer to quality of life (QoL). RESULTS: In the intention to treat (ITT) analysis, 44% of the STPP group achieved highly significantly more remission than TAU (23%). STPP treatment (OR=7.64; P<0.001) was the strongest predictor for remission post-treatment; time was also significant (OR=0.96; P<0.05). A high effect favoring STPP (d=0.82) was observed for the HADS-D score post-treatment (secondary outcome). Regarding further secondary outcomes (QoL), analyses of covariance yielded main effects for group (favoring STPP with an effect size of at least d=0.5) for global QoL, role, emotional and social functioning, pain, treatment side-effects, breast symptoms and upset by hair loss. CONCLUSIONS: STPP is an effective treatment of a broad range of depressive conditions in breast cancer patients improving depression and functional QoL. Findings are limited by the drop-out rate (∼1/3) and delayed post-treatment assessments. Future trials may consider stepped-care approaches, tailored to patients' needs and requirements in the acute treatment phase.

Generalized Basset-Boussinesq-Oseen equation for unsteady forces on a sphere in a compressible flow.

Viscous compressible flow around a sphere is considered in the limit of zero Reynolds and Mach numbers. An exact expression for the force on the sphere undergoing arbitrary motion with compressibility effects is presented. Quasisteady, inviscid-unsteady, and viscous-unsteady force components are identified. Numerical results are in excellent agreement with the theory. The present formulation offers an explicit expression for the unsteady force in the time domain and can be considered as a generalization of the Basset-Boussinesq-Oseen equation to compressible flow.

On the unsteady inviscid force on cylinders and spheres in subcritical compressible flow.

The unsteady inviscid force on cylinders and spheres in subcritical compressible flow is investigated. In the limit of incompressible flow, the unsteady inviscid force on a cylinder or sphere is the so-called added-mass force that is proportional to the product of the mass displaced by the body and the instantaneous acceleration. In compressible flow, the finite acoustic propagation speed means that the unsteady inviscid force arising from an instantaneously applied constant acceleration develops gradually and reaches steady values only for non-dimensional times c(infinity)t/R approximately >10, where c(infinity) is the freestream speed of sound and R is the radius of the cylinder or sphere. In this limit, an effective added-mass coefficient may be defined. The main conclusion of our study is that the freestream Mach number has a pronounced effect on both the peak value of the unsteady force and the effective added-mass coefficient. At a freestream Mach number of 0.5, the effective added-mass coefficient is about twice as large as the incompressible value for the sphere. Coupled with an impulsive acceleration, the unsteady inviscid force in compressible flow can be more than four times larger than that predicted from incompressible theory. Furthermore, the effect of the ratio of specific heats on the unsteady force becomes more pronounced as the Mach number increases.

[Attitudes towards cadaveric organ donation--results from a representative survey of the German population]. / Einstellungen zur postmortalen Organspende - Ergebnisse einer Repräsentativerhebung der deutschen Bevölkerung.

The increasing deficit of organs causes a drastic decline in the quality of life and survival of numerous patients in need of a transplantation. The purpose of this representative community study was to survey attitudes toward transplantation in the German population and to identify underlying determinants. Unlike previous surveys, fears and concerns were elicited based on a concrete case vignette. Among the 1,002 participants, 90 % were in favour of organ donation in general; 21 % reported having signed an organ donor card. Consent to organ donation was associated with younger age and higher social class; the same was true for the possession of an organ donor card. In the virtual decision situation, the majority (77 %) voted in favour of an organ donation based on saving lives, consolation for bereaved and the absence of disadvantages for the donor. Common (up to 50 %), however, were also fears and concerns regarding determination of the time of death, displacement of medical concern from the donor to the recipient of the organ, utilisation of organs for other purposes, or explantation before death. The knowledge of the determinants identified, of existing fears and concerns are helpful not only for informing the public, but also for the dialogue with the next of kin of potential donors. Here, it may be helpful not only to address arguments pro organ donation, but also to address potential fears and concerns.