3D GPS velocity field and its implications on the present-day postorogenic deformation of the Western Alps and Pyrenees

We present a new 3D GPS velocity solution for 182 sites for the region encompassing the Western Alps, Pyrenees, and southern France. The velocity field is based on a Precise Point Positioning (PPP) solution, to which we apply a common-mode filter, defined by the 26 longest time series, in order to correct for network-wide biases (reference frame, unmodeled large scale processes, ¿). We show that processing parameters, such as troposphere delay modeling, can lead to systematic velocity variations of 0.1 - 0.5 mm/yr affecting both accuracy and precision, especially for short (< 5 yr) time series. A velocity convergence analysis shows that minimum time-series lengths of ~3 years and ~5.5 years are required to reach a velocity stability of 0.5 mm/yr in the horizontal and vertical components, respectively. On average, horizontal residual velocities show a stability of ~0.2 mm/yr in the Western Alps, Pyrenees, and southern France. The only significant horizontal strain rate signal is in the western Pyrenees with up to 4 x 10-9 yr-1 NNE-SSW extension, whereas no significant strain rates are detected in the Western Alps (< 1 x 10-9 yr-1). In contrast, we identify significant uplift rates up to 2 mm/yr in the Western Alps but not in the Pyrenees (0.1 ± 0.2 mm/yr). A correlation between site elevations and fast uplift rates in the northern part of the Western Alps, in the region of the Wurmian ice cap, suggests that part of this uplift is induced by postglacial rebound. The very slow uplift rates in the southern Western Alps and in the Pyrenees could be accounted for by erosion-induced rebound

Emerging borreliae – Expanding beyond Lyme borreliosis

Lyme borreliosis (or Lyme disease) has become a virtual household term to the exclusion of other forgotten, emerging or re-emerging borreliae. We review current knowledge regarding these other borreliae, exploring their ecology, epidemiology and pathological potential, for example, for the newly described B. mayonii. These bacteria range from tick-borne, relapsing fever-inducing strains detected in some soft ticks, such as B. mvumii, to those from bat ticks resembling B. turicatae. Some of these emerging pathogens remain unnamed, such as the borrelial strains found in South African penguins and some African cattle ticks. Others, such as B. microti and unnamed Iranian strains, have not been recognised through a lack of discriminatory diagnostic methods. Technical improvements in phylogenetic methods have allowed the differentiation of B. merionesi from other borrelial species that co-circulate in the same region. Furthermore, we discuss members that challenge the existing dogma that Lyme disease-inducing strains are transmitted by hard ticks, whilst the relapsing fever-inducing spirochaetes are transmitted by soft ticks. Controversially, the genus has now been split with Lyme disease-associated members being transferred to Borreliella, whilst the relapsing fever species retain the Borrelia genus name. It took some 60 years for the correlation with clinical presentations now known as Lyme borreliosis to be attributed to their spirochaetal cause. Many of the borreliae discussed here are currently considered exotic curiosities, whilst others, such as B. miyamotoi, are emerging as significant causes of morbidity. To elucidate their role as potential pathogenic agents, we first need to recognise their presence through suitable diagnostic approaches

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Stress of Working in Oncology Oncology is a medicine area of high psychic investment. Working with cancer patients is a source of human and professional satisfaction but can involve high emotional costs [1,2]. High levels of burnout and compassion fatigue are reported by about 32% of oncologists [3,4] this percentage rises to 70% among people under 40 years [5]. High levels are also found among nursing staff with marked levels of emotional exhaustion [6]. Repeated exposure to suffering and loss, to the side effects and/or the failure of treatments to the end of life stages, to feeling overwhelmed by work, are among the causes of chronic distress that medical staff accumulate in clinical practice. Care of cancer can result in emotional distress and exhaustion, loss of empathy, and demotivation from work [7]. Of no less importance is the “difficult” communications that are estimated at around 20,000 in the career of an oncologist [8]

Patient perception of disease control and psychological distress

Background: Risk perception and efficacy beliefs affect health behavior. The aim of this study was to measure cancer severity and curability (as proxy for risk perception and efficacy beliefs, respectively) and their association with clinical and psychosocial variables. Methods: A consecutive sample of cancer patients were recruited and assessed for sociodemographic and medical data, patient perception of cancer severity and curability, and quality of life. The main outcome measures were the depression and anxiety components as measured by the Hospital Anxiety and Depression Scale (HADS). Results: Subjective and objective measures of severity and curability were found to be associated. The perception of one's own disease as severe and difficult to cure, as opposed to severe but curable, was strongly associated with depression (OR = 6.93; P = 0.048) when adjusted for potential confounding factors. Factors independently associated with anxiety were the perception of difficulty to cure (OR = 15.73; P = 0.018), having religious beliefs (OR = 49.74; P = 0.013), and metastasis (OR = 18.42; P = 0.015), when adjusted for sex, marital status, site of cancer, and time from diagnosis. Differences in curability beliefs did not affect any quality of life domain. Conclusion: Patients and clinicians may have different perceptions of disease and treatment. The perception of control and curability must be taken into account to identify cancer patients who are suffering most and require special medical care, as these factors have an effect on depression and anxiety. © 2012 Mazzotti etal, publisher and licensee Dove Medical Press Ltd

Predictors of existential and religious well-being among cancer patients

Well-being and mental health are not only direct functions of amount of stress, but also depend on how people appraise and face critical situations. Spiritual well-being seems to be a central component of psychological health in physically healthy individuals and it offers some protection against end-of-life despair in those with chronic diseases. In this study, 250 out and in-patients with a cancer diagnosis were interviewed with standardised instruments to measure two aspects of spirituality, existential and religious well-being, coping strategies, psychological state, and quality of life (QoL). Using multivariate logistic regression models we found that coping strategies characterized by acceptance and positive reinterpretation of the stressor, and the absence of anxiety disorder, independently increased the likelihood of the existential well-being (Odds Ratio, OR, 7.7, and OR, 4.5, respectively), whereas religious well-being was not significantly associated with these variables. Our findings show that existential and religious well-being may be very different. A spirituality-based intervention could be differently utilized by patients with different beliefs, cognitive and behaviour characteristics. Measure of coping strategies and psychological state should be part of routine management of cancer patients

Predictors of mood disorders in cancer patients' caregivers

Patients' care has been associated with a high burden of psychological symptoms in caregivers. This study identifies characteristics associated with mood disorders in caregivers of cancer patients. One hundred fifty-two caregivers, aged 24-78 years (average age 51; 60 % females), of cancer patients completed Family Strain Questionnaire (FSQ), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Coping Orientations to the Problems Experienced. We combined this information with patient chart abstraction data. Sixty-three percent of females and 38 % of males were scored as positive when screened for mood disorders, as measured by HADS (total score a parts per thousand yen16), and 17 and 5 % for emotional distress as measured by IES (total score a parts per thousand yen50). High scores in FSQ-satisfaction with family relationships and FSQ-need for more information about cancer, and low scores in FSQ-thoughts about death are reported. FSQ-emotional burden and FSQ-problems in social involvement are the areas more compromised in females, compared to males. Females, compared to males, use emotional-oriented coping strategies more frequently. Factors independently associated with mood disorders included emotional burden, problems in social involvement, and non-attendance of meeting places; help and assistance from public local services (for patients) decreased the risk of mood disorders in caregivers. Prevalence of mood disorders is high in cancer patients' caregivers. These results highlight the need to develop family intervention strategies to minimize the impact of patient's care on caregivers' mental health

3D GPS velocity field and its implications on the present-day postorogenic deformation of the Western Alps and Pyrenees

We present a new 3D GPS velocity solution for 182 sites for the region encompassing the Western Alps, Pyrenees, and southern France. The velocity field is based on a Precise Point Positioning (PPP) solution, to which we apply a common-mode filter, defined by the 26 longest time series, in order to correct for network-wide biases (reference frame, unmodeled large scale processes, ¿). We show that processing parameters, such as troposphere delay modeling, can lead to systematic velocity variations of 0.1 - 0.5 mm/yr affecting both accuracy and precision, especially for short (< 5 yr) time series. A velocity convergence analysis shows that minimum time-series lengths of ~3 years and ~5.5 years are required to reach a velocity stability of 0.5 mm/yr in the horizontal and vertical components, respectively. On average, horizontal residual velocities show a stability of ~0.2 mm/yr in the Western Alps, Pyrenees, and southern France. The only significant horizontal strain rate signal is in the western Pyrenees with up to 4 x 10-9 yr-1 NNE-SSW extension, whereas no significant strain rates are detected in the Western Alps (< 1 x 10-9 yr-1). In contrast, we identify significant uplift rates up to 2 mm/yr in the Western Alps but not in the Pyrenees (0.1 ± 0.2 mm/yr). A correlation between site elevations and fast uplift rates in the northern part of the Western Alps, in the region of the Wurmian ice cap, suggests that part of this uplift is induced by postglacial rebound. The very slow uplift rates in the southern Western Alps and in the Pyrenees could be accounted for by erosion-induced rebound

The perception of the information received from the doctor. A study on 103 onco-hematological patients with metastatic disease

The aim of the study was to evaluate the perception that onco-hematological patients with metastatic disease have regarding the information received on their disease and treatment. Method. EORTC QLQ-INFO25 was administered anonymously to 103 patients. Results. 69% of patients were satisfied and 76% rate the information received very useful. More than half of the sample is not satisfied with the information on the effects of therapy on social and family life (53%), the effects of therapy on sexual activity (73%), the possibility of receiving extra-hospital care (78%), the rehabilitation services (81%), how to manage the disease at home (56%), the professional psychological support (69%). Overall, 46% would have preferred to receive more information, and 2% less. Discussion. The responses show that the greatest satisfaction is for the areas of purely medical relevance (information on the disease, information on medical investigations and information on the therapy carried out). Information by the doctor becomes deficient, from the patient's point of view, for those thematic areas that doctors did not consider to be their competence. Conclusion. Our data shows the lack of exchange between doctor and patient, in both directions and highlighted the need for training doctors on communication skills on psycho-social issues and quality of life concerns