Cancer patients' coping styles and doctor- patient communication

Monitoring and blunting styles have become relevant concepts regarding their potential impact on patients' and doctors' behaviors. The present study aimed at investigating the relation between cancer patients' coping styles and doctor-patient communication and global affect. Coping styles were assessed by means of the Threatening Medical Situations Inventory (TMSI). Since a shortened version of the TMSI was used, the validity of this instrument was also evaluated. First, it was examined whether the two factor structure of the original TMSI could be confirmed in our version. Then, the relation between coping style and patients' preferences for information and participation in decision-making was evaluated. Second, the relation between monitoring and blunting and patients' age, sex, education, quality of life and prognosis was investigated. Finally, the relation between patients' coping styles and communicative behaviors and global affect of both patients and physicians during the initial oncological consultation was examined. Patients (N = 123) visited their gynaecologist or medical oncologist for an initial discussion of possible treatment. Patients' coping styles, socio-demographics, preference for information and participation in decision-making, quality of life and prognosis were assessed by postal questionnaire prior to the visit to the outpatient clinic. The consultation was audiotaped and analysed according to Roter's Interaction Analysis System, to identify instrumental and affective communicative behaviors of both patients and physicians. The two factor structure of the TMSI could be confirmed. A monitoring style was related to a preference for detailed information (r = 0.23) and participation in medical decision-making (r = 0.23). A monitoring style was also related to patient question-asking (r = 0.25) and patient dominance (r = 0.23). To conclude, the validity of the shortened TMSI is satisfactory. Also, cancer patients' coping styles are not related to other personal and disease characteristics. Further, a monitoring style seems to have an impact on patients' question-asking and dominance during the oncological consultatio

Análise de custos de diferentes grupos genéticos de bovinos de corte terminados em confinamento Cost analyses on different beef cattle genetic groups finished in feedlot condition

O desempenho de 149 animais, machos inteiros, confinados por períodos variáveis de acordo com acabamento de carcaça, foi utilizado para avaliar a eficiência econômica dos grupos genéticos Nelore sobreano, Nelore desmamado, ½ Valdostana ½ Nelore, ½ Simental ½ Nelore, ½ Braford ½ Brangus, ½ Braford ¼ Angus ¼ Nelore, Brangus, ½ Canchim ¼ Angus ¼ Nelore e ½ Canchim ¼ Simental ¼ Nelore. O custo operacional variável, o custo por quilograma de carne produzida e a margem bruta foram analisados pelo método dos quadrados mínimos ordinários, mediante modelo estatístico que incluiu o efeito do grupo genético e o peso inicial como covariável, comparando-se as médias pelo teste Duncan (P<0,05). Os maiores custos operacionais variáveis no período, em US$, foram do ½ Canchim ¼ Simental ¼ Nelore (160,8), Nelore desmamado (158,7) e ½ Canchim ¼ Angus ¼ Nelore (155,1). Os menores custos por quilograma de carne, em US$, foram do Nelore sobreano (0,79) e Brangus (0,82). A maior margem bruta, em US$, foi obtida pelo grupo genético Nelore sobreano (94,6), seguida do Brangus (71,5) e do ½ Simental ½ Nelore (46,6). Os grupos genéticos mais pesados no início do confinamento e que permaneceram menos tempo confinados apresentaram maior margem bruta.<br>Data on feedlot performance of 149 steers were used to evaluate the economic efficiency of yearling Nellore, weaned Nellore, ½ Valdostana ½ Nellore, ½ Simmental ½ Nellore, ½ Braford ½ Brangus, ½ Braford ¼ Angus ¼ Nellore, Brangus, ½ Canchim ¼ Angus ¼ Nellore and ½ Canchim ¼ Simmental ¼ Nellore. Variable operational costs, kg of meat costs, and gross margin income were analyzed by ordinary least squares procedure including the effects of genetic groups and initial weight in the feedlot as a covariate. The means were compared by Duncan test (P<.05). The largest variable operational costs in the period, in US$, were observed for ½ Canchim ¼ Simmental ¼ Nellore (160.8), weaned Nellore (158.7) and ½ Canchim ¼ Angus ¼ Nellore (155.1). The lowest kg of meat costs, in US$, were observed for yearling Nellore (0.79) and Brangus (0.82). The highest gross margin was obtained for yearling Nellore (94.6), followed by Brangus (71.5) and ½ Simmental ½ Nellore (46.6) The heaviest genetic groups in the beginning of the feed lot were confined for shorter periods and had the largest gross margins