Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion.

PURPOSE: Psycho-oncological treatment is recommended in cancer rehabilitation as it improves fatigue, anxiety, depression, and quality of life in breast cancer patients. The aim of our study was to compare a structured short-term psychotherapy and a non-specific group discussion provided during breast cancer rehabilitation. METHODS: Breast cancer patients were randomly assigned to structured group short-term psychotherapy or a non-specific group discussion during breast cancer rehabilitation. The patients completed questionnaires at the beginning and end of rehabilitation and three months after rehabilitation. The primary outcome was anxiety. Secondary outcomes were depression, distress, fatigue and health-related quality of life domains. RESULTS: In total, 160 patients (80 in both groups) were recruited and included in the analysis. There was no significant difference between both groups in the primary outcome anxiety at the end of rehabilitation (difference = -0.2; 95% CI -1.2 to 0.7) and three months after rehabilitation (difference = 0.2; 95% CI -0.9 to 1.3) and in any secondary outcome. Patients in the short-term psychotherapy group with high anxiety levels at baseline reported fewer depressive symptoms at the end of rehabilitation. CONCLUSIONS: Our study showed no difference between structured short-term psychotherapy and a non-specific group discussion. Patients with high baseline anxiety levels were more likely to benefit from short-term structured psychotherapy. Early identification of this subgroup and symptoms of mental illness should occur after initial treatment in breast cancer patients in order to offer a structured treatment for anxiety and depressive symptoms during rehabilitation. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00017571; 08/07/2019).

Mapping the invisible: knowledge, credibility and visions of earth in early modern cave maps.

This paper examines cave environments as unique spaces of knowledge production and shows how visualizations of natural cavities in maps came to be powerful tools in scientific reasoning. Faced with the challenge of limited vision, mapmakers combined empiricism and imagination in an experimental setting and developed specific translation strategies to deal with the uncertain origin of underground objects and the shifting boundaries between the known and the unknown. By deconstructing this type of cartographic representation, which has barely been studied, this paper furnishes surprising insights into the scholarly practices and tools used to deal with this considerable epistemic uncertainty and to signal credibility and trust to potential users. The array of maps used for this study includes both archival and published sources, depicting caves in Europe, America and Siberia.