839 research outputs found
A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN)
OBJECTIVE: Hot flushes and night sweats (HFNS) are experienced by up to 80% of prostate cancer patients undergoing androgen deprivation therapy (ADT). This study evaluates the effects of a guided self-help cognitive behavioural therapy (CBT) intervention on HFNS problem-rating (primary outcome), HFNS frequency, mood and health-related quality of life (secondary outcomes) in patients undergoing ADT. METHODS: Patients reporting treatment-induced HFNS were randomly assigned to CBT (n = 33) or treatment as usual (TAU) (n = 35), stratified for cancer type. The CBT intervention included a booklet, CD plus telephone contact during a 4-week period. Validated self-report questionnaires were completed at baseline, 6 weeks and 32 weeks after randomisation. The primary outcome was HFNS problem rating (perceived burden of HFNS) at 6 weeks after randomisation. Potential moderators and mediators were examined. Data analysis was conducted on a modified intention-to-treat basis. RESULTS: Compared with TAU, CBT significantly reduced HFNS problem rating (adjusted mean difference: -1.33, 95% CI -2.07 to -0.58; p = 0.001) and HFNS frequency (-12.12, 95% CI -22.39 to -1.84; p = 0.02) at 6 weeks. Improvements were maintained at 32 weeks, but group differences did not reach significance. There were significant reductions in negative HFNS Beliefs and Behaviours following CBT, but not in mood or quality of life. CONCLUSIONS: Guided self-help CBT appears to be a safe and effective brief treatment for men who have problematic HFNS following prostate cancer treatments. Further research might test the efficacy of the intervention in a multicentre trial
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Can self-report questionnaires create illness cognitions in middle-aged men?
Objective: To examine the effect of questionnaire context on self-reported illness cognition.
Design: A single-item measure of the perceived impact of lower urinary tract symptoms (LUTS) was embedded twice in a questionnaire battery completed by community-dwelling middle-aged males (N = 1,790). The impact measure was placed in two distinct questionnaire contexts; at the end of a general somatic symptoms questionnaire, and following an illness-specific symptoms questionnaire. The order of the two questionnaire contexts was counter-balanced in a random sub-sample.
Main Outcome Measures: An established single-item measure of the perceived impact of LUTS.
Results: Concordance between the two single-item measures was moderate. Scores on a single-item measure of impact were significantly lower when assessed immediately following the completion of a LUTS-specific questionnaire than when assessed following the completion of a general symptoms questionnaire. There was no evidence of order effects. The observed effect was moderated by the severity of LUTS such that the difference in perceived impact scores between contexts (where general symptoms context > illness-specific context) increased as urinary symptoms increased.
Conclusion: Questionnaire context systematically influenced responses on self-report measures of illness impact. The magnitude of the context effect was largest in the highest quintile of LUTS severity, a difference of >0.5 on a scale with a range of 3. These findings may have implications for situations where patient reported outcome measures are used to evaluate healthcare interventions or inform treatment decisions
Barriers to medical help-seeking among older men with prostate cancer
Objective:- Men's disinclination to seek medical help has been linked to higher rates of morbidity and mortality compared to women. However, previous studies were conducted predominantly with healthy, young, and middle-aged men. We explored the perceived medical barriers to help-seeking in older men with prostate cancer. Method:- 20 men with prostate cancer took part in semistructured interviews, which were analyzed using thematic analysis. Results:- Three themes were identified related to negative attitudes toward help-seeking: male gender role; fear of the health condition, medical and treatment procedures; and embarrassment as a consequence of medical examinations, communication with health (and nonhealth) professionals, and the disclosure of sexual-related symptoms. Conclusion:- The barriers identified in our study strengthen the evidence for the impact of traditional masculinity on help-seeking in men
Men's experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment
Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to menβs engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men receiving androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided self-help intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psycho-educational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors
Exploring the axion potential and axion walls in dense quark matter
We study the potential of the Quantum Chromodynamics axion in hot and/or
dense quark matter, within a Nambu-Jona-Lasinio-like model that includes the
coupling of the axion to quarks. Differently from previous studies, we
implement local electrical neutrality and equilibrium, which are
relevant for the description of the quark matter in the core of compact stellar
objects. Firstly we compute the effects of the chiral crossover on the axion
mass and self-coupling. We find that the low energy properties of axion are
very sensitive to the phase transition of Quantum Chromodynamics, in
particular, when the bulk quark matter is close to criticality. Then, for the
first time in the literature we compute the axion potential at finite quark
chemical potential and study the axion domain walls in bulk quark matter. We
find that the energy barrier between two adjacent vacuum states decrease in the
chirally restored phase: this results in a lower surface tension of the walls.
Finally, we comment on the possibility of production of walls in dense quark
matter.Comment: 10 pages, 7 figure
Chemotherapy for advanced breast cancer: what influences oncologists' decision-making?
Chemotherapy is widely used in the management of patients with advanced breast cancer. However, a considerable proportion of patients experience toxic side effects without gaining benefit. This study aimed to elicit oncologists' views of the goals of chemotherapy for patients with advanced breast cancer and to elicit which factors are important in decisions to recommend chemotherapy to such patients. 30 oncologists underwent a semi-structured interview to examine their views of 5 goals of chemotherapy and of various disease, treatment and patient-related factors that might influence decisions to offer treatment. The clinicians also made decisions regarding treatment in relation to a hypothetical patient scenario under varying clinical conditions. Relief of symptoms and improvement of activity were rated as the most valuable and achievable goals of treatment. The patient's performance status, frailty and their wishes regarding treatment were the most important patient-related factors in determining decision-making. The most important disease/treatment-related factors were pace of the disease, previous poor response to chemotherapy, co-existing symptoms and concurrent medical conditions. The hypothetical scenario revealed that co-existing medical conditions, adverse previous response, increased age and depression would decrease the likelihood of recommending chemotherapy, whereas key symptoms (e.g. breathlessness) and the patient's goals would increase the likelihood. The findings suggest that British oncologists primarily aim to improve patients' physical function, although subjective factors, such as a patient's desire for anti-cancer treatment and their future goals, also influence decisions to offer treatment. Β© 2001 Cancer Research Campaign http://www.bjcancer.co
QCD equation of state in a virial expansion
We describe recent three-flavor QCD lattice data for the pressure, speed of
soun d and interaction measure at nonzero temperature and vanishing chemical
potentia l within a virial expansion. For the deconfined phase we use a
phenomenological model which includes non-pert urbative effects from dimension
two gluon condensates that reproduce the free en ergy of quenched QCD very
well. The hadronic phase is parameterized by a generalized resonance-gas model.
Furthermore, we extend this approach to finite quark densities introducing an
ex plicit -dependence of the interaction. We calculate pressure,
quark-number density, entropy and energy density and compare to results of
lattice calculatio ns. We, additionally, investigate the structure of the phase
diagram by calculating the isobaric and isentropic lines as well as the
critical endpoint in the ()-plane.Comment: 9 pages, 11 figures. Submitted to Phys. Rev.
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