The Effect of Chronic Regulatory Focus on Sampling Behavior and RiskyDecisions

Prior research on a possible role of regulatory focus orientation (Higgins, 1998) in financial decision-making has focusedon description-based tasks in which people receive explicit information about the characteristics of a decision problem apriori. However, relatively few real-world decisions resemble this type of laboratory task. Here, we examine how regu-latory focus orientation influences peoples decision behavior in an experience-based sampling paradigm (Hertwig et al.,2004), where people learn about the characteristics of a decision problem only through experience. We investigated ifindividuals chronic regulatory focus orientation (promotion-focus or prevention-focus) predicts process (sampling) andoutcomes (risky versus sure-thing choices) in a sampling paradigm task. Regulatory focus did not predict sampling behav-ior, nor the number of risky choices in the gain domain, but promotion focus orientation was correlated with the prevalenceof risky choices in the loss domain. Also, the big-5 personality trait of Openness was found to be related to number ofsampled outcomes for losses and to risky choices for gains

Scoping clinicians’ perspectives on pre-treatment multidisciplinary care for young women with breast cancer

Arden L Corter,1 May Lynn Quan,2 Frances L Wright,3 Erin D Kennedy,4 Marko RI Simunovic,5 Juliet Shao,1 Nancy N Baxter1,6 1Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada; 2Department of Surgery and Oncology, University of Calgary, Calgary, Canada; 3Department of Surgery, University of Toronto, Toronto, Canada; 4Division of General Surgery, University Health Network, Mount Sinai Hospital, Toronto, Canada; 5Department of Surgery, McMaster University, Hamilton, Canada; 6Dalla Lana School of Public Health, University of Toronto, Toronto, Canada Background: Young women with breast cancer (YWBC) experience worse medical and psychosocial outcomes than their older counterparts. Early input from a multidisciplinary team via pre-treatment multidisciplinary cancer conferences (pMCCs) may be important for addressing the complex needs of YWBC. However, pMCCs are not common. This study has two parts: a survey and workshop aimed at assessing clinicians’ perspectives on pMCCs, including the importance of pMCCs in the care of YWBC, as well as barriers to, and strategies for supporting their implementation.Methods: Survey results highlight variability across sites in the delivery of multidisciplinary care in general. However, both survey and workshop results emphasize clinicians’ agreement on the importance of pMCCs and suggest that numerous practical and systems levels barriers be addressed before pMCCs can be implemented.Conclusions: pMCCs have the potential to improve surgical treatment and psychosocial outcomes for YWBC. A combined practical and policy approach to their implementation, which sees extension of existing standards to include pMCCs, may support their adoption and subsequent audit practices to assess the effect of pMCCs on outcomes for YWBC. Keywords: multidisciplinary care, pre-treatment, cancer conference, breast cancer, young wome

Evaluating A Multidisciplinary Cancer Conference Checklist: Practice Versus Perceptions

Background: Presentation to multidisciplinary cancer conferences (MCCs) supports optimal treatment of young women with breast cancer (YWBC). However, research shows barriers to MCC practice, and variation in professional attendance and referral patterns. A checklist may help overcome these barriers and support MCC practice with YWBC. Methods: We developed, piloted and evaluated an MCC checklist in sites participating in a pan-Canadian study (RUBY; Reducing the bUrden of Breast cancer in Young women). A survey assessed checklist processes and impacts, and checklist data were analysed for checklist uptake, MCC presentation rates and MCC processes including staff attendance. Results: Fifteen RUBY sites used the checklist (~50%), mostly for data collection/tracking. Some positive effects on clinical practice such as increased presentation of YWBC at MCC were reported, but most survey participants indicated that MCC processes were sufficient without the checklist. Conversely, checklist data show that only 31% of patients were presented at MCC. Of those, 41% were recommended treatment change. Conclusion: Despite limited checklist uptake, there was evidence of its clinical practice benefit. Furthermore, it supported data collection/quality monitoring. Critically, checklist data showed gaps in MCC practice and low MCC presentation rates for YWBC. This contrasts with overall provider perceptions that MCCs are working well. Findings suggest that supports for MCC are needed but may best take the form of clear national practice recommendations and audit and feedback cycles to inform awareness of good MCC practice and outcomes. In this setting, tools like the MCC checklist may become helpful in supporting MCC practice

Les représentations de la maladie : choix des outils de mesure et applications dans le champ du cancer

International audienceObjectifDresser un bilan des outils quantitatifs disponibles pour mesurer les représentations de la maladie et analyser leur utilisation empirique auprès de patients atteints de cancer.Matériel et méthodesRevue de la littérature.RésultatsSept outils de mesure des représentations de la maladie existent dont un spécifique au cancer. L’Illness Perception Questionnaire est utilisé dans 29 des 33 études retenues.ConclusionAssocier ces échelles avec des méthodes reposant sur des approches davantage centrées sur le contexte socioculturel semble à privilégier