A dyadic planning intervention to quit smoking in single-smoking couples:design of a randomized controlled trial

BACKGROUND: Tobacco use is the largest preventable cause of death. Smoking cessation interventions that use implementation intentions show promising results. Implementation intentions are if-then plans that specify a certain behaviour within a situational context. This study will examine whether involving a non-smoking partner could improve planning interventions, and whether and which partner interactions underlie this effectiveness. METHODS: This single-blind randomized controlled trial has a longitudinal design with a baseline questionnaire, end-of-day measurements for three weeks starting on the quit date, and a follow-up questionnaire after three months. PARTICIPANTS: single-smoking couples who live together and are in a relationship for more than one year. SETTING: couples are randomized to either a dyadic or individual planning condition. After the intervention the smoker attempts to quit smoking and the diary measurements start. MEASUREMENTS: The primary outcome variable is smoking abstinence. Secondary outcome measures are smoking behaviour and relationship satisfaction. Partner interactions are examined as a possible mediator. DISCUSSION: This RCT is the first to examine the effectiveness of dyadic planning to quit smoking in single-smoking couples. Partner interactions are thought to play an important role during the quit attempt, and therefore in the effectiveness of the intervention. This RCT will provide more insight into which daily partner interactions are beneficial for smoking abstinence and the couples' relationship satisfaction, and whether the type of intervention is related to different types or levels of partner interactions and smoking behaviour. When proven effective, this planning intervention in combination with coaching for the non-smoking partner will be a valuable and low-cost addition to existing smoking interventions. TRIAL REGISTRATION: The trial is retrospectively registered on 19/04/2017 on www.trialregister.nl ( TC: 6398 )

Smoking-Related Social Control in Indonesian Single-Smoker Couples

BACKGROUND: The majority of Indonesian smokers are men and those who are married nearly always have a non-smoking wife (i.e. single-smoker couples). Previous studies have suggested that Indonesian women dislike smoking. However, contesting their husbands' smoking could be seen as disrespectful. In this study, we examine whether, and if so how, wives employ social control tactics to change their husbands' smoking and how the smokers perceive the tactics. METHOD: In-depth interviews (N = 12) with five single-smoker couples (N = 10 individual interviews) and two non-smoking wives of smokers (N = 2) were conducted in Jogjakarta, Indonesia. We used a social control framework and thematic analysis approach to analyse the transcribed interviews. RESULTS: Three themes emerged from smokers and their wives: (1) although the wives know that smoking is bad, they have to tolerate it, (2) wives and their husbands find it important to maintain harmony and (3) their family's needs serve as common ground. All the wives interviewed exerted social control to some degree, especially when they were pregnant or had children. Smokers reacted positively to social control and agreed to child-related house rules, but not to requests to give up smoking. CONCLUSION: Wives do exert social control and smokers are willing to accommodate and adapt their smoking. However, wives' influence on smoking may be limited in Indonesia, and focusing on managing their husbands' smoking at home rather than overall smoking might be more fruitful

Daily Support and Negative Control During a Quit Attempt in Single-Smoking Couples

OBJECTIVE: Research has shown a beneficial influence of partner support on smoking cessation. Previous studies mainly focused on support and neglected negative behaviors. Less is known about differences in support perceptions between partners. This study aimed to examine how supportive as well as negative control behaviors relate to smoking and relationship satisfaction in single-smoking couples during a quit attempt. METHOD: Smokers and their nonsmoking partners (n = 170 cohabiting couples) participated in an intensive longitudinal study over 21 days with end-of-day diaries. A dyadic score model was used, emphasizing couple levels and differences for the explanatory variables (i.e., support and negative control) and the outcome variables (smoking [for smokers only]; relationship satisfaction). RESULTS: Smokers whose partner showed more supportive and less negative control behavior had a lower probability of smoking, and both partners had higher relationship satisfaction. On days with more supportive and less negative control behavior than usual, smokers had a lower probability of smoking and both partners had higher relationship satisfaction. For smokers who reported more support than their partner reported providing, the couples' relationship satisfaction was higher and the smokers' relationship satisfaction was higher than their partners'. Differences between received and provided support/control at the between-couple and daily level were unrelated to smoking. CONCLUSIONS: Support seems important during a quit attempt as it was related to a lower probability of smoking and higher relationship satisfaction in couples, while negative control behaviors should be avoided as they were associated with higher probability of smoking and lower relationship satisfaction. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Psychosexual Development and Sexual Functioning in Young Adult Survivors of Childhood Cancer

Background: Childhood cancer and its treatment can impair survivors’ development throughout life, particularly psychosexual development, which can be affected in complex ways and is crucial for survivors’ well-being. Yet, research is scarce. Aim: This study assessed psychosexual development (milestone attainment, age at attainment, perceived timing) in young adult survivors of childhood cancer. It further examined sexual satisfaction and sexual functioning, and whether survivors’ perceived timing of sexual debut was related to satisfaction or functioning. Methods: A registry-based nationwide survey was completed by N = 492 German survivors of childhood cancer (age 21–26 years, 6–26 years postdiagnosis). They completed standardized measures of psychosexual milestones (eg, first kiss, sexual debut), sexual satisfaction, and sexual functioning. Psychosexual development was compared to normative data (N = 1,533). Outcomes: Psychosexual development, sexual satisfaction, and sexual functioning were the primary outcome measures. Psychosexual development was characterized in three ways: milestone attainment (yes/no), age at attainment, perceived timing (“right” time, too early/late). Results: Milestone attainment was comparable to normative data, except for sexual debut: Survivors were less often experienced (82.5% vs 88%; P =.002) and older at sexual debut (17.4 vs 16.2 years; g = 0.55), but most survivors (58.3%) perceived their timing as “right.” Survivors of brain tumors were least likely to have had their sexual debut, but if experienced age at sexual debut was similar to other survivors. Female survivors were somewhat more experienced than males (eg, first kiss, first relationship; <10% difference), but they were somewhat older when they first kissed (g = 0.26). Age at diagnosis was unrelated to milestone attainment. Perceived early/late sexual debut was related to lower satisfaction in female survivors (P =.026), but unrelated to sexual dysfunction. Instead, partnered men reported particularly low dysfunction whereas women reported similar levels of sexual dysfunction irrespective of their relationship status (P =.049). Overall, sexual functioning was favorable (60.2%: not/barely problematic). Clinical implications: Most survivors reported favorable sexual satisfaction and functioning, but a minority of survivors may need supportive services. Strengths & Limitations: This project represents one of few large-scale studies on psychosexual development in childhood cancer survivors relative to normative data, and is the first to link development to sexual satisfaction/functioning. Assessing satisfaction/functioning with validated, but brief measures limits detailed insights, but was inclusive of any sexual orientation. Medical background information based on registry data was limited. Conclusion: Results showed normative psychosexual development (except for sexual debut) in most survivors. A self-determined attitude toward sexuality (ie, engaging in sexual activities at the “right” time) may generally determine positive sexual experiences. V Lehmann, CA Gerhardt, K Baust, et al. Psychosexual Development and Sexual Functioning in Young Adult Survivors of Childhood Cancer. J Sex Med 2022;XX:XXX–XXX

Smoking Cessation Experience in Indonesia:Does the Non-smoking Wife Play a Role?

OBJECTIVE: More than 63% of Indonesian men are smokers, and smoking has long been a part of Indonesian culture and the concept of masculinity in Indonesian culture. Given the pro-smoking environment, we were interested in examining why smokers would willingly quit and whether their wives played a role in their quitting process as social factors are mentioned second most frequent as a reason for quitting smoking. DESIGN: In-depth interviews. METHOD: We interviewed 11 couples (N = 22)—ex-smoking husbands and non-smoking wives—in Yogyakarta, Indonesia. The data were analysed by using the thematic analysis approach. RESULTS: Four themes were discussed: (1) reasons for stopping smoking, (2) the process of quitting smoking, (3) the wives’ attitudes toward smoking, and (4) the families’ attempts to make the (ex-)smokers quit. The most commonly cited reasons for quitting were family and personal motivation. The (ex-)smokers preferred to quit without assistance and in private. The wives’ attitude toward smoking ranged from dislike to tolerance, and most did not know when their husbands were trying to quit. Both husbands and wives reported that the wives did not influence the smoking cessation process. CONCLUSION: Indonesian ex-smokers often had multiple reasons for quitting smoking. The process was typically difficult and kept private. While wives had little influence on the cessation process, they provided support and could institute a smoking ban in the house

Attitudes and Perceptions of Parenthood Among Young Adult Survivors of Childhood Cancer

Purpose: Increasing numbers of childhood cancer survivors enter adulthood and encounter decisions surrounding parenthood. However, limited research has systematically examined how childhood cancer may influence parenthood attitudes among survivors.Methods: Adult survivors of childhood cancer, who had or wanted to have children (N = 77; M-age = 30.2 years, range: 22-43; 91% White), rated their perceived impact of cancer at enrollment and parenthood attitudes using the "Attitudes to Parenthood After Cancer Scale" 2 years later. First, internal consistencies for the parenthood measure were examined, and modified subscales were proposed. Second, hierarchical stepwise regressions analyzed the contribution of background factors and cancer's impact on parenthood attitudes.Results: Reevaluation of parenthood items yielded four subscales with improved internal consistency (alpha's &gt; .78): improved parenting due to cancer, no children due to cancer, concerns about a (potential) child's health, and parenthood desire irrespective of own health concerns. Already having children (n = 38) was related to more favorable ratings on most subscales. Older age was associated with perceiving improved parenting due to cancer (r = .24) and shorter time since diagnosis was related to considering having no children due to cancer (r = -.23). Hierarchical stepwise regressions reconfirmed parenthood status as related to more favorable parenting attitudes. Cancer preoccupation and perceiving cancer as a most difficult life experience predicted more concerns toward parenthood (R-2 = .044-.216).Conclusions: Parenthood attitudes were more favorable among survivors with children, who were older, and/or further into survivorship. Survivors burdened by their cancer experience reported more concerns about parenthood. Childhood cancer may shape parenthood perceptions positively and negatively, warranting further research to inform interventions.</p

Memories of Parent Behaviors and Adult Attachment in Childhood Cancer Survivors

PURPOSE: Childhood cancer is stressful for the entire family. Preoccupation and anxiety surrounding the child's illness may result in parents of children with cancer being overprotective or less emotionally responsive toward their children. Such parenting in response to a negative life event like childhood cancer may cause survivors to be more insecurely attached than healthy peers, which could have downstream effects on survivors' romantic relationships later in life. Therefore, we examined survivors' perspectives on parent behaviors, adult attachment, and marital status among adult survivors of childhood cancer relative to controls. METHODS: One hundred forty-nine young adult survivors and 149 matched controls (Mage = 28, range 20-40) indicated their relationship status (single vs. partnered) and completed standardized questionnaires assessing memories of upbringing (warmth, overprotection, rejection) and adult attachment (avoidance, anxiety). RESULTS: Adult survivors of childhood cancer remembered mothers and fathers as emotionally warmer (d = 0.53/0.30), and mothers as less rejecting than controls (d = 0.30). Adult attachment was overall similar between survivors and controls, but partnered survivors reported particularly low attachment-related anxiety. Childhood cancer was related to higher mother and father warmth, which were associated with lower attachment-related avoidance and in turn with a greater likelihood of being in a relationship. CONCLUSION: Adult childhood cancer survivors did not remember their parents as overprotective, but reported more positive parenting relative to controls; and similar adult attachment and relationship status. The results were unexpected, but offer novel insights for future prospective studies, which are necessary to better understand psychosocial late effects of childhood cancer

On the Computation of the Trace Form of Some Galois Extensions

AbstractWe investigate the trace form trL/K:L→K:x↦trL/Kx2of a finite Galois extensionL/K. In particular, we study 2-extensions of degree ≤16. Using some reduction theorems, these results yield a classification of nearly all trace forms of Galois extensions of degree ≤31. Finally, we study the trace form of a cyclotomic extension and of its maximal real subfield

Effects on patient-reported outcomes of "Screening of Distress and Referral Need" implemented in Dutch oncology practice

Purpose This study investigated the effect of the "Screening for Distress and Referral Need" (SDRN) process (completing a screening instrument; patient-caregiver discussion about the patient's responses, regardless of distress level, and possible referral to specialized care), implemented in Dutch oncology practice on patient-reported outcomes (PROs). Methods A non-randomized time-sequential study was conducted to compare two cohorts. Cohort 1 respondents (C1) were recruited before and cohort 2 respondents (C2) after SDRN implementation in nine Dutch hospitals. Participants completed the EORTC-QLQ-C30, HADS, Patient Satisfaction Questionnaire-III, and the Distress Thermometer and Problem List (DT&PL). Descriptive analyses and univariate tests were conducted. Results C2 respondents (N = 422, response = 54%) had significantly lower mean scores on the practical (t = 2.3; p = 0.02), social (t = 2.3; p = 0.03), and emotional PL domains (t = 2.9; p = 0.004) compared with C1 (N = 518, response = 53%). No significant differences were found on quality of life, anxiety, depression, satisfaction with care, distress level, the spiritual and physical PL domains, or on referral wish. Conclusions After implementation of SDRN, patients report significantly fewer psychosocial (practical, social, and emotional) problems on the DT/PL but responses on the other patient-reported outcomes were comparable. These results add to the mixed evidence on the beneficial effect of distress screening. More and better focused research is needed

Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy

Goals of work: The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples' patterns of adjustment over time and possible differences in adjustment between the patient and his partner.Materials and methods: Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3). Results: Before chemotherapy 26% of the patients and 50% of partners reported clinically elevated levels of SRS. Patients reported lower physical and social functioning at T2 compared to T1 and T3. Partners reported an improvement in social functioning over the year and no changes in physical functioning or mental health. No relationships between patients and partners' functioning were found. One year after diagnosis, QoL of patients and partners was similar to that of reference groups, and patients even reported better physical functioning than the reference group. SRS of patients and partners were negatively related at T1, and patients and partners' social functioning were positively related at T2. Conclusions: According to stress response levels, the period before the start of chemotherapy was most stressful for couples. Adjustment patterns differ between testicular cancer patients and their partners with patients reporting lowered QoL after completion of chemotherapy. QoL of couples returned to normal levels 1 year after diagnosis. The effect of disseminated testicular cancer on the QoL of patients and their partners seems to be temporary. A minority may need clinical attention for severe SRS