Hope of recovery in patients in the terminal phase of cancer under palliative and hospice care in Poland

Introduction. The objective of the presented research is to characterize hope in the situational dimension, i.e., health, in the patients with cancer in the terminal phase of the disease, being treated in hospices and palliative care centers. Hope is very important for all the patients, especially for patients with cancer in various phases of the disease. Giving up on oncologic therapy and causal treatment is often associated with a transition into palliative care. When death and a loss of values become a threat, the individual has got hope to rely on. Material and Methods. The study relies on the Test to Measure Hope in the Health Context (NCN-36) by B.L. Block. 246 patients in the terminal phase of cancer participated in the study. Results. The internal structure of hope of recovery in the patients’ group was varied. The patients showed low levels of hope of recovery since they do not believe in the effectiveness of treatment. They were also not convinced of the effectiveness of modifications in dieting, lifestyle, or the use of nonconventional medicine. They trusted the doctor in charge and were moderately satisfied with the therapy in use. The intensity of hope of recovery was on the low level in the patients in the terminal phase of cancer. Age, sex, place of living, and marital status had a significant influence on the level of hope of recovery. Variables such as living on one’s own or living with one’s family, socioeconomic status, education, or profession did not affect the level of hope of recovery. Conclusions. The presented results allowed as to conclude that the assessment of hope in terminally ill cancer patients can be considered as one of the important tools enabling the personalization and the improvement of palliative care

Method of total marrow irradiation (TMI)

Transplantacja hematopoetycznych komórek macierzystych jest wykorzystywana w leczeniu niektórych nowotworów pochodzenia szpikowego lub limfatycznego. Transplantację poprzedza kondycjonowanie, oparte o chemioterapię samodzielną bądź w połączeniu z napromienianiem całego ciała (TBI). Z uwagi na dowiedzioną skuteczność TBI zastosowanie tej metody kondycjonowania ma szczególne uzasadnienie. Z uwagi na współistniejącą wczesną i późną toksyczność radioterapii w oparciu o techniki wielkopolowe poszukuje się nowych metod napromieniania. W ramach badania II fazy (ClinicalTrials.gov NCT01665014) od 2012 roku w naszym ośrodku zastosowano zmodyfikowaną formę napromieniania chorych na szpiczaka plazmocytowego w postaci TMI (napromienianie szpiku całego ciała). Metoda wydaje się mieć uzasadnienie szczególnie w tych nowotworach, które lokalizują się głównie lub wyłącznie w szpiku kostnym, np. ostre białaczki lub szpiczak plazmocytowy.W celu redukcji napromienianej objętości zdrowych tkanek oraz zmniejszenia toksyczności radioterapii wprowadzono metodę ograniczoną jedynie do napromieniania kości w oparciu o trójwymiarowy system planowania. Do tej pory nie wypracowano metodologii TMI. Liczba publikacji dotyczących opisanego sposobu leczenia na świecie jest bardzo ograniczona.Celem obecnej pracy jest przedstawienie metodologii TMI stosowanej w ramach naszego protokołu.Allogenic and autologous hematopoietic stem cell transplantation (HSCT) is widely used for the treatment of manymyeloid and lymphoid malignancies. Conditioning precedes bone marrow transplantation. Chemotherapy alone or with radiotherapy (TBI — total bone marrow irradiation) are used to conditioning. The proven efficacy of TBI means that the use of this conditioning is essential even though it is limited by adverse effects: both acute and late toxicity. New methods of irradiation are desirable. In our Institution we have performed a phase II study (ClinicalTrials.gov NCT01665014) from 2012 for patients with multiple plasmocytoma. The TMI we use is a modified form of TBI. It seems to be especially appropriate for the treatment of neoplasms located mainly or only in bone marrow (multiple myeloma, acute leukemias). Limitation of irradiated volumes only to bones probably will reduce a toxicity of treatment. Currently there are no internationally agreed methodological guidelines for TMI. Also there are only few publications on TMI. The aim of this paper is to introduce the methodology of TMI used in our department

Interdyscyplinarna opieka nad pacjentem z chorobą nowotworową

Praca recenzowana / peer-reviewed paperZ przyjemnością przekazujemy Państwu kolejny tom monografii Interdyscyplinarna opieka nad pacjentem z chorobą nowotworową, która powstała przy współpracy Polskiego Stowarzyszenia Pielęgniarek Onkologicznych z Wydziałem Zdrowia i Nauk Medycznych Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego. Problematyka przedstawiona w publikacji dotyczy wieloaspektowej opieki nad chorym na nowotwór. Opracowania są doniesieniami z badań naukowych, w których autorzy przedstawiają wnioski i kierunki działań dla praktyków. Równie dużą wartość mają rozdziały, w których praktycy dzielą się swoją wiedzą i doświadczeniem z pracy z chorymi i ich rodzinami. Tematyka monografi i dotyczy m.in.: edukacji zdrowotnej, komunikowania się, opieki nad chorym poddawanym chemioterapii, leczeniu chirurgicznemu, radioterapii i rehabilitacji. Pragniemy, aby ta książka swoją merytoryczną zawartością stała się istotnym wkładem w uczczenie tak ważnych dla pielęgniarstwa rocznic, obchodzonych w 2011 r

MUSCULAR ENDURANCE AND STRENGTH IN BOYS AGED FROM 11 TO 13 YEARS

The psychophysical development of humans is genetically determined and influenced by a number of external factors. Nowadays, impacts on the physical development and physical ability of young men are caused by such phenomena as acceleration and civilizational or urban changes. Monitoring of changes in development and the influence of different factors seems to be justified as it is related to the understanding of processes and the introduction of preventive measures in the field of health and physical fitness for future generations. New concepts for testing human physical abilities seem to focus on utilitarian targets related to health needs and daily human activities. The study was performed on a group of 211 boys from an urban area, including 75 at the age of 11, 74 at the age of 12 and 62 at the age of 13. The study examined the strength of abdominal and trunk muscles (sits-up from a lying position), shoulder girdle and lower extremity muscles (overhang on a bar), and explosive strength of upper limbs (forward and backward medicine ball throw). Boys at the age of 11 years achieved the shortest distances, and boys at the age of 13 the longest distances in forward medicine ball throws. The results of the attained distances in backward medicine ball throws were also better in older boys compared to younger ones. The results of the muscle endurance tests were different. In both attempts, boys at the age of 12 attained better results than their younger and older colleagues. The development of strength abilities in boys between the age of 11 and 13 years has stable progress, while the observed differences in muscle endurance in boys at the age of 13 require further monitoring and further examination of their impact in terms of quality and quantity in boys of prepubertal age

The prevalence of ANA antibodies, anticentromere antibodies, and anti-cyclic citrullinated peptide antibodies in patients with primary Sjögren’s syndrome compared to patients with dryness symptoms without primary Sjögren’s syndrome confirmation

Objectives : Our study analyses the prevalence of ANA, anti-SS-A, anti-SS-B, and ACA and ACPA antibodies in patients with pSS and with dryness symptoms without pSS confirmation, and the association of ACPA and ACA antibodies with specific clinical symptoms. Materials and methods : 113 patients were divided into two groups: I – with diagnosed pSS (N = 75); and II – with dryness without pSS evidence (N = 38). Diagnostics: indirect immunofluorescence (IF; Hep-2 cell line) of antinuclear antibodies (ANA), anti-SS-A anti-SS-B antibodies determined with semi-quantitative method, autoantibody profile (14 antigens, ANA Profil 3 EUROLINE); basic laboratory, ophthalmic examination tests, minor salivary gland biopsy with focus score (FS), joint and lung evaluation, and ESSDAI questionnaire (pSS activity). Results : 88% of group I had ANA antibodies (1 : 320 titre), 5.3% at 1 : 160. Anti-SS-A antibodies were present in 88% of group I, including all ANA 1 : 160. Anti-SS-A antibodies positively correlated with greater and moderate activity of ESSDAI 5 (p = 0.046) and FS. The presence of SS-B antibodies significantly affected disease activity. ACPA present: group I – 13% (associated with higher arthritis incidence; p = 0.003); group II – 8%. ACA antibodies present in 4% of group I, but not in group II. No ACA association with interstitial lung changes (small ACA + group excludes full conclusions). Conclusions : ANA antibodies should also be considered in a titre of less than 1 : 320, but the presence of anti-SS-A antibodies is still the most important immunological marker for pSS. Anti-SS-A antibodies correlate with higher disease activity (ESSDAI ≥ 5) and higher FS. The presence of the anti-SS-B antibody was significantly affected by higher activity of the disease. The incidence of arthritis was higher in patients with ACPA+ pSS compared to ACPA– (p = 0.003). There was no relationship between ACPA and arthritis in patients with dry-type syndrome without diagnosis of pSS

Postural Stability in Athletes during Special Hurdle Tests without a Definite Dominant Leg

The purpose of this study was to analyze the body balance control of people walking and hurdling with or without a specific dominant leg in a monopodal position. This study involved 28 physical education students. The center of pressure (COP) was measured with a force plate under four conditions: single-leg standing (right and left) with eyes open and two upper limb positions (the arms were positioned in either a specific hurdle technique manner or alongside the body). A repeated measures analysis of variance (ANOVA) was conducted separately for five parameters of the COP in the medial-lateral (ML) and anterior-posterior (AP) directions under the four conditions. In the single-leg position, athletes without a dominant lower leg had better body balance than those with a dominant lower leg. The position of the upper limbs influenced the body position when hurdling. Accepting the correct position of the upper limbs helped to maintain balance (when overcoming hurdles). In hurdles, the position of the upper limbs should be improved to maintain postural stability and save this function for more demanding postural tasks

The Cognitive Aspect of Hope in the Semantic Space of Male Patients Dying of Cancer

The aim of this study is to characterize the cognitive aspect of the semantic space of hope in patients in the terminal stage of cancer. This was confirmed in the research on hope by C. R. Snyder and B. Schrank. Hope is of great importance in all the great world religions and belief systems, both as regards a personal God or impersonal deities. Hoping is a human capacity with varying affective, cognitive and behavioral dimensions. Psychological, pedagogical (particularly in the framework of special needs pedagogy and thanatological pedagogy) and theological reflection on hope can provide support for dying people. In order to conduct the research, the semantic differential research method was selected. The research technique employed was a therapeutic conversation, and the research tool was the B.L. Block’s DSN-3 test. The DSN-3 test allows one to assess hope in the semantic space in three aspects: cognitive, emotional and functional. For the purposes of this study, only the cognitive aspect was taken into account. The study was begun on 1 April 2010 and ended in the last days of December 2020. It included 110 male patients in the terminal stage of cancer. The youngest respondent was 19 years old and the oldest was 94 years old. The surveyed men most often perceived hope in the semantic space in the cognitive aspect as more true, wise, meaningful and real than false, stupid, meaningless and deceptive. Their attitude to hope was, therefore, more affirmative than negative. The research did not reveal the importance of the age of the respondents on the degree of affirmation/negation of hope in the cognitive aspect in the semantic space; however, men in the period of late maturity and professional activity expressed the lowest level of the affirmation of hope. It is worthwhile to conduct further research concerning hope in other aspects (especially emotional and functional) in the semantic space in order to use the obtained results to consider what to take into account when providing patients in the terminal stage of cancer with better personalized holistic care than before

The Mediating Role of Self-Efficacy in the Relationship between Approach Motivational System and Sports Success among Elite Speed Skating Athletes and Physical Education Students

Background: While the association between self-efficacy and sports success has been well established in previous studies, little is known regarding whether the basic approach motivation system contributes to this relationship in athletes. The study examines associations between self-reported temperamental approach disposition, self-efficacy, and predispositions to sports success in athletes. Methods: A cross-sectional study was performed between August 3 and 30 November 2020. The participants were 156 athletes, aged 16–34 years (M = 21.57, SD = 3.58, 41.67% women), in two groups: 54 elite athletes in speed skating (EASS) and 102 physical education students (PES). The online survey consisted of the Reinforced Sensitivity Questionnaire (RSQ), General Self-Efficacy Scale (GSES), and Sports Success Scale (SSS). Results: There were no differences in self-efficacy and sports success in terms of gender, sports discipline, and level of competitions. The Behavioral Activation System (BAS) results were lower in the EASS sample compared with in the PES group. Self-efficacy plays a mediating role in the relationships between BAS and sports success among athletes, with sport discipline as a moderator between BAS and self-efficacy. Sports success in speed skating relies strongly on BAS, while a weak link has been found in other sports disciplines. Conclusions: BAS is directly correlated to sports success and indirectly related through self-efficacy. Mental training should be focused on maintaining self-efficacy and reward motivation in athletes to increase their sports success

Postural Stability in Young Adults with Down Syndrome in Challenging Conditions

<div><p>To evaluate postural control and performance in subjects with Down syndrome (SwDS), we measured postural sway (COP) in quiet stance in four 20-second tests: with eyes open or closed and on hard or foam surface. Ten SwDS and eleven healthy subjects participated, aged 29.8 (4.8) and 28.4 (3.9), respectively. The time-series recorded with the sampling rate of 100 Hz were used to evaluate postural performance (COP amplitude and mean velocity) and strategies (COP frequency, fractal dimension and entropy). There were no intergroup differences in the amplitude except the stance on foam pad with eyes open when SwDS had larger sway. The COP velocity and frequency were larger in SwDS than controls in all trials on foam pad. During stances on the foam pad SwDS increased fractal dimension showing higher complexity of their equilibrium system, while controls decreased sample entropy exhibiting more conscious control of posture in comparison to the stances on hard support surface. This indicated that each group used entirely different adjustments of postural strategies to the somatosensory challenge. It is proposed that the inferior postural control of SwDS results mainly from insufficient experience in dealing with unpredictable postural stimuli and deficit in motor learning.</p></div