Graphical depiction of intervention in fast track versus standard care trial of a palliative care service

<p><b>Copyright information:</b></p><p>Taken from "Randomised controlled trial of a new palliative care service: Compliance, recruitment and completeness of follow-up"</p><p>http://www.biomedcentral.com/1472-684X/7/7</p><p>BMC Palliative Care 2008;7():7-7.</p><p>Published online 28 May 2008</p><p>PMCID:PMC2442830.</p><p></p

Table_1_Key demographics and psychological skills associated with adjustment to progressive Multiple Sclerosis early in the diagnosis.docx

Background/purposeBeing diagnosed with a progressive type of multiple sclerosis (MS) has been associated with worse psychological outcomes compared to relapsing-remitting type. Previous studies of adjustment to MS have primarily focused on relapsing-remitting type MS. The present study aims to examine psychological adjustment for people newly diagnosed with progressive multiple sclerosis.MethodsThis was a multicenter cross-sectional survey of 189 people newly diagnosed with progressive MS. A composite measure of psychological adjustment was created from questionnaires measuring psychological distress, positive affect, perceived-stress, life satisfaction and self-concept. Predictor variables included coping strategies, social support, relationship with partner, psychological vulnerability, MS-related beliefs, and responses to symptoms. Data were analysed using a regularised regression model to indicate which group of all variables are associated with adjustment.ResultsPeople who were older (b = 0.17(0.07), p = 0.02), in employment (b = 0.40 (0.17), p = 0.01), and with lower illness severity (b = −0.24 (0.08), p = 0.001) showed better adjustment. Based on a Lasso regression, the most important psychological and demographic variables associated with lower adjustment (out-of-sample cross-validation R2 = 62.6%) were lower MS self-efficacy and higher avoidance, cognitive vulnerability, embarrassment avoidance, conflict, helplessness, and secondary progressive MS type.Conclusions and implicationsHelping newly diagnosed people to find ways to tolerate anxiety-causing situations by encouraging acceptance may help people adjust to progressive MS by lowering their avoidance. Further, building confidence in managing the illness and addressing relationship issues are key focus areas in psychological interventions for people with progressive multiple sclerosis.</p

Table_2_Key demographics and psychological skills associated with adjustment to progressive Multiple Sclerosis early in the diagnosis.docx

Background/purposeBeing diagnosed with a progressive type of multiple sclerosis (MS) has been associated with worse psychological outcomes compared to relapsing-remitting type. Previous studies of adjustment to MS have primarily focused on relapsing-remitting type MS. The present study aims to examine psychological adjustment for people newly diagnosed with progressive multiple sclerosis.MethodsThis was a multicenter cross-sectional survey of 189 people newly diagnosed with progressive MS. A composite measure of psychological adjustment was created from questionnaires measuring psychological distress, positive affect, perceived-stress, life satisfaction and self-concept. Predictor variables included coping strategies, social support, relationship with partner, psychological vulnerability, MS-related beliefs, and responses to symptoms. Data were analysed using a regularised regression model to indicate which group of all variables are associated with adjustment.ResultsPeople who were older (b = 0.17(0.07), p = 0.02), in employment (b = 0.40 (0.17), p = 0.01), and with lower illness severity (b = −0.24 (0.08), p = 0.001) showed better adjustment. Based on a Lasso regression, the most important psychological and demographic variables associated with lower adjustment (out-of-sample cross-validation R2 = 62.6%) were lower MS self-efficacy and higher avoidance, cognitive vulnerability, embarrassment avoidance, conflict, helplessness, and secondary progressive MS type.Conclusions and implicationsHelping newly diagnosed people to find ways to tolerate anxiety-causing situations by encouraging acceptance may help people adjust to progressive MS by lowering their avoidance. Further, building confidence in managing the illness and addressing relationship issues are key focus areas in psychological interventions for people with progressive multiple sclerosis.</p

Concerns reported by Black Caribbean and White British participants severely affected by MS.

*<p>Participants reported more than one symptom.</p

Comparison of disease progression and impact of symptoms among Black Caribbean and White British participants severely affected by MS.

<p>(i) Palliative Care Outcome Scale (POS) & POS-S symptoms: comprises 10 items on anxiety, PwMS and informal caregiver concerns, practical needs and 18 questions specifically relating to MS symptoms.</p><p>(ii) Multiple Sclerosis Impact Scale (MSIS): 29 questions on a variety of MS-related impacts of the illness.</p><p>(iii) Modified Fatigue Impact Scale (MFIS): Examines perceptions of functional limitations that fatigue.</p><p>(iv) Blessed Orientation Memory Concentration Test (BOMCT): Examines presence of cognitive impairment and thereby diminished capacity.</p><p>(v) Hospital Anxiety and Depression Scale (HADS): Assesses psychological distress, with two sub-scales of anxiety and depression, used widely among people with physical illnesses.</p>*<p>The analysis of covariance (ANCOVA) was adjusted for the probability of participating in the study (propensity score).</p

Demographic and clinical characteristics of Black Caribbean and White British participants included in the study.

<p>Demographic and clinical characteristics of Black Caribbean and White British participants included in the study.</p

Endometriosis and its influence on woman's life

This work is about gynecological disease, whose incidence is evergrowing, end metriosis. Endometriosis is in itself a very controversial disease, which is sign ificant intervening into life of a woman. Endometriosis is a common gynecological di sorder affecting fertile female population. It is the disease, that is presented by functional endometrial glandules and stroma outside their usuallocality within uterus (womb). General symptoms are pain and infertility. The diagnostic key is the cyclic character of symptom s and laparoscopy - histology testification presence of lesions. Tbe surgical treatment of endometriosis is considered as a golden standard of the therapy. My aim of this work is to have look up to aH sections of the disease. At the same time my work covers survey. I detected prospective abnormalities with theoretic knowledges via fonns distributed to patients with endometriosis. The fonn appraised frequen y oť symptoms in patiens. It presents the most frequent age group of disabled women as well. Fonns a1so outline dilernma of arguments about character of creation and it observes problems of indisposed women and possibility oftheir naturally gravidity. It also deals of possibilities of available therapy and its use in patients. ln no little importance my work adverts to next facts des rving next..

Additional file 2: of How integrated are neurology and palliative care services? Results of a multicentre mapping exercise

Catchment areas, population served and patients seen for neurology and palliative care services. This file contains in-depth information about the catchment areas, population served and patients seen for neurology and palliative care services, for the sites involved in the mapping exercise. (DOCX 22 kb