The specifics of interaction with patients and their relatives as a factor of emotional condition of oncologists.

The paper considers issue of professional burnout of oncologists through the prism of their relationship with patients and their close relatives. The study was carried out using direct and online sociological survey method. The sample included 534 specialists being in constant contact with cancer patients. The results revealed pronounced prevalence of such main burnout domains as emotional exhaustion (55%), depersonalization (19%), reduction of professional achievements (22%). The most common methods of dealing with stress were recreation, sports, communication with immediate relatives, hobbies, walking (7-20%), 4% used alcohol. The high frequency of patient requests to oncologist for psychological support (88%) was established as well as difficulties in communication between doctor and patient because available communication skills are not always sufficient for 76% of oncologists. The majority of respondents support idea of patient need for psychological support and its effectiveness for their treatment and physical and emotional conditions. The similar trends were found in case of close relatives of patients. At the same time some oncologists expressed negative, stigmatizing attitudes towards patients in need of psychological support that requires additional educational work. In oncologists, even when need for psychological support is expressed by patient, willingness to seek it is low: a third of respondents are "rather not ready" to see psychologist even if they had this opportunity. The results meet data of other researches data and reveal that interaction with patients and their relatives is one of the main factors affecting the emotional state of oncologists. Based on study results as well as on publication analysis, comprehensive solution was proposed to implement psychological oncologic service in Russia, which, on one hand, will allow to provide support to cancer patients and their relatives, and on the other hand, will conduct specific training for oncologists concerning skills of psychologically safe communication with patients and coping with negative experiences.

The Rubber Hand Illusion paradigm as a sensory learning process in patients with schizophrenia.

OBJECTIVE: The Rubber Hand Illusion (RHI) has previously been used to depict the hierarchy between visual, tactile and perceptual stimuli. Studies on schizophrenia inpatients (SZs) have found mixed results in the ability to first learn the illusion, and have yet to explain the learning process involved. This study's aim was two-fold: to examine the learning process of the RHI in SZs and healthy controls over time, and to better understand the relationship between psychotic symptoms and the RHI. METHOD: Thirty schizophrenia inpatients and 30 healthy controls underwent five different trials of the RHI over a two-week period. RESULTS: As has been found in previous studies, SZs felt the initial illusion faster than healthy controls did, but their learning process throughout the trials was inconsistent. Furthermore, for SZs, no correlations between psychotic symptoms and the learning of the illusion emerged. CONCLUSION: Healthy individuals show a delayed reaction to first feeling the illusion (due to latent inhibition), but easily learn the illusion over time. For SZs, both strength of the illusion and the ability to learn the illusion over time are inconsistent. The cognitive impairment in SZ impedes the learning process of the RHI, and SZs are unable to utilize the repetition of the process as healthy individuals can.

Angiogenesis in systemic sclerosis: impaired expression of vascular endothelial growth factor receptor 1 in endothelial progenitor-derived cells under hypoxic conditions.

OBJECTIVE: To assess angiogenesis and explore the expression and regulation of vascular endothelial growth factor (VEGF), VEGF receptor 1 (VEGFR-1), and VEGFR-2, the leading mediators of angiogenesis, in SSc patients and controls. METHODS: Late-outgrowth endothelial progenitor cells (EPCs), isolated from the peripheral blood of systemic sclerosis (SSc) patients and controls, and human umbilical vein endothelial cells (HUVECs) were assessed under normal and hypoxic conditions. Genomic background was evaluated in a large case-control study (including 659 patients with SSc and 511 controls) using tag single-nucleotide polymorphisms on VEGFR1 and VEGFR2 genes. RESULTS: EPCs from SSc patients had the phenotype of genuine endothelial cells and displayed in vitro angiogenic properties similar to those of HUVECs and control EPCs under basal conditions, as determined by flow cytometry, tube formation, and migration assay. However, after 6 hours of hypoxic exposure, EPCs from SSc patients exhibited lower induced expression of VEGFR-1 at the messenger RNA and protein levels, but similar VEGF and VEGFR-2 expression, compared with HUVECs or EPCs from healthy controls. There was no evidence of defective expression of hypoxia-inducible factor 1alpha. These results were supported by the lower serum levels of soluble VEGFR-1 found in SSc patients (n = 187) compared with healthy controls (n = 48) (mean +/- SD 163.7 +/- 98.5 versus 210.4 +/- 109.5 pg/ml; P = 0.0042). These abnormalities did not seem to be related to genomic background. CONCLUSION: Our findings shed new light on the possible role of VEGFR-1 in the main vascular disturbances that occur in SSc and lead to more severe disease.