Prediction of malignant transformation and recurrence of oral epithelial dysplasia using architectural and cytological feature specific prognostic models

Oral epithelial dysplasia (OED) is a precursor state usually preceding oral squamous cell carcinoma (OSCC). Histological grading is the current gold standard for OED prognostication but is subjective and variable with unreliable outcome prediction. We explore if individual OED histological features can be used to develop and evaluate prognostic models for malignant transformation and recurrence prediction. Digitised tissue slides for a cohort of 109 OED cases were reviewed by three expert pathologists, where the prevalence and agreement of architectural and cytological histological features was assessed and association with clinical outcomes analysed using Cox proportional hazards regression and Kaplan–Meier curves. Within the cohort, the most prevalent features were basal cell hyperplasia (72%) and irregular surface keratin (60%), and least common were verrucous surface (26%), loss of epithelial cohesion (30%), lymphocytic band and dyskeratosis (34%). Several features were significant for transformation (p < 0.036) and recurrence (p < 0.015) including bulbous rete pegs, hyperchromatism, loss of epithelial cohesion, loss of stratification, suprabasal mitoses and nuclear pleomorphism. This led us to propose two prognostic scoring systems including a ‘6-point model’ using the six features showing a greater statistical association with transformation and recurrence (bulbous rete pegs, hyperchromatism, loss of epithelial cohesion, loss of stratification, suprabasal mitoses, nuclear pleomorphism) and a ‘two-point model’ using the two features with highest inter-pathologist agreement (loss of epithelial cohesion and bulbous rete pegs). Both the ‘six point’ and ‘two point’ models showed good predictive ability (AUROC ≥ 0.774 for transformation and 0.726 for recurrence) with further improvement when age, gender and histological grade were added. These results demonstrate a correlation between individual OED histological features and prognosis for the first time. The proposed models have the potential to simplify OED grading and aid patient management. Validation on larger multicentre cohorts with prospective analysis is needed to establish their usefulness in clinical practice

Effectiveness of Writing Groups in Nursing Homes

We examine the effect of participation in an 8-week writing group in six nursing homes. Pretest and posttest assessments of cognitive and affective functional status were administered to 62 participants and 54 control subjects. We asked writing-group participants about previous writing experience and perceived ability to convey feelings, ideas, life experiences, and memories to others. Weekly assessments were conducted on eight group process measures. Findings suggest that participation in writing groups may reduce depression, particularly among residents with higher cognitive ability and greater depression. Significantly more participants than control subjects report an ability to relate feelings and ideas to other residents and staff. Improvement in group process measures is greatest for cognitively impaired participants and those with high physical function scores. There is considerable improve ment in residents for whom writing-group participation frequently is considered inappropriate: those without writing experience, the depressed, and the cognitively impaired.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67030/2/10.1177_073346488900800308.pd

Models of cognition and affect in perceptions of well-being

How do people arrive at assessments of their own life quality? A series of models was developed to provide an interpretation of the way the factors of cognition and affect operate along with evaluations of specific life concerns (domains) in the perception of well-being. Following previous research, cognition was defined operationally as a factor which accounts for the covariance among a set of assessments of life-as-a-whole after affect, as measured by Bradburn's scales, is partialled out and after allowance is made for the presence of correlated measurement errors. It was found that loadings on the cognitive factor, and hence the interpretation of this factor, changed little despite quite large changes in the models. Moreover, in all major comparisons, models that contained the cognitive factor fitted the data better than models that did not. Models that included affect as the only variable intervening between the domains and the life-as-a-whole factor led to results that were intuitively difficult to accept. In the preferred model both affect and cognition were positioned as intervening variables. In this model it was found that the domain evaluations had no direct impact on life-as-a-whole assessments — the contribution of the domains was indirect by way of their association with cognition and affect. It was hypothesised that associated with each domain was a domain-specific element of affect and a domain-specific element of cognition. The linear additive relation found by previous researchers between domain evaluations and life-as-a-whole assessments would then be explainable as a statistical result arising from the summing of the domain-specific elements of affect and cognition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43703/1/11205_2004_Article_BF00292640.pd

Justice for whom, exactly? Beliefs in justice for the self and various others.

The present studies examine why people think the world is more just to themselves than to others generally. Beliefs in justice for the self were uniquely associated with psychological adjustment, consistent with the theoretical motive to believe in justice for the self ( Studies 1 and 2). However, this "justice motive" did not appear to affect the relative strength of justice beliefs. Instead, self-other differences in justice beliefs appeared to reflect objective assessments of the justice received by various demographics. Undergraduates believed the world to be more just to themselves than to others but not their undergraduate peers specifically ( Study 1). Participants of both genders believed the world to be more just to men, and to themselves, than to women ( Study 2). Women did not exempt themselves individually from injustice but believed, similar to men, that undergraduate women receive as much justice as men ( Study 3)