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

A review of factors affecting patient fertility preservation discussions & decision-making from the perspectives of patients and providers

Women undergoing cancer treatments and their healthcare providers encounter challenges in fertility preservation (FP) discussions and decision-making. A systematic review of qualitative research was conducted to gain in-depth understanding of factors influencing FP discussions and decision-making. Major bibliographic databases and grey literature in English from 1994 to 2016 were searched for qualitative research exploring patient/provider perspectives on barriers and facilitators to FP decision-making. Two researchers screened article titles, abstracts and full-texts. Verbatim data on research questions, study methodology, participants, findings and discussions of findings were extracted. Quality assessment and thematic analysis were conducted. The search yielded 74 studies dating from 2007 onwards; 29 met the inclusion criteria. Analysis revealed three types of barriers: (a) FP knowledge, skills and information deficits contributed to discomfort for providers and discontent for patients; (b) psychosocial factors and clinical issues influenced providers' practices around FP discussions and patients' decision-making; and (c) material, social and structural factors (e.g., lack of resources and accessibility) posed challenges to FP discussions. Potential facilitators to FP discussions and decision-making were also identified. A discussion of ways to improve physician's knowledge and facilitate women's decision-making and access to FP is presented, along with areas for policy development and further research

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