“I wish I’d told them”: a qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

<b>Objective</b> To gain insight into patients' experiences of follow-up care after treatment for prostate cancer and identify unmet psychosexual needs.<p></p> <b>Methods</b> Semi-structured interviews were conducted with a purposive sample of 35 patients aged 59-82 from three UK regions. Partners were included in 18 interviews. Data were analyzed using constant comparison. <p></p> <b>Results</b> (1) Psychosexual problems gained importance over time, (2) men felt they were rarely invited to discuss psychosexual side effects within follow-up appointments and lack of rapport with health care professionals made it difficult to raise problems themselves, (3) problems were sometimes concealed or accepted and professionals' attempts to explore potential difficulties were resisted by some, and (4) older patients were too embarrassed to raise psychosexual concerns as they felt they would be considered 'too old' to be worried about the loss of sexual function.<p></p> <b>Conclusion</b> Men with prostate cancer, even the very elderly, have psychosexual issues for variable times after diagnosis. These are not currently always addressed at the appropriate time for the patient.Practice implications Assessments of psychosexual problems should take place throughout the follow-up period, and not only at the time of initial treatment. Further research examining greater willingness or reluctance to engage with psychosexual interventions may be particularly helpful in designing future intervention

Attention modulates saccadic inhibition magnitude

Visual transient events during ongoing eye movement tasks inhibit saccades within a precise temporal window, spanning from around 60–120 ms after the event, having maximum effect at around 90 ms. It is not yet clear to what extent this saccadic inhibition phenomenon can be modulated by attention. We studied the saccadic inhibition induced by a bright flash above or below fixation, during the preparation of a saccade to a lateralized target, under two attentional manipulations. Experiment 1 demonstrated that exogenous precueing of a distractor's location reduced saccadic inhibition, consistent with inhibition of return. Experiment 2 manipulated the relative likelihood that a distractor would be presented above or below fixation. Saccadic inhibition magnitude was relatively reduced for distractors at the more likely location, implying that observers can endogenously suppress interference from specific locations within an oculomotor map. We discuss the implications of these results for models of saccade target selection in the superior colliculus. </jats:p

The disengage deficit in hemispatial neglect is restricted to between-object shifts and is abolished by prism adaptation

We sought to determine the effects of prism adaptation on peripherally cued visual attention shifting in patients with spatial neglect, using a task devised by Egly et al. (J Exp Psychol Gen 123:161–177, 1994) based on the classic Posner paradigm. This task allowed a comparison of “within-object” versus “between-object” attention shifts. A display was presented containing two parallel outline rectangles, and subjects were asked to make rapid responses to a target, which would appear at one end of one of the rectangles. The target location was pre-cued with 75% validity: on invalid trials attention was directed either to the other end of the same rectangle, or to the other rectangle. Healthy subjects and right-hemisphere patients without neglect showed a left-right symmetrical pattern, with a larger validity effect when required to shift attention between rectangles, thus indicating a greater difficulty of attention-shifting between than within the respective shapes. The neglect patients showed the typical leftward “disengage deficit” previously observed in neglect, but only for attention shifts between objects, indicating that the effect is object-based rather than purely spatial. A comparison of vertical and horizontal shift costs showed that this attention-shifting deficit for left-hemifield target stimuli was directional rather than hemifield-based: it was absent for vertical shifts of attention within the left hemifield. Finally, we found that prism adaptation abolished the disengage deficit. We found no effects of prism adaptation in the control subjects. We argue that prism adaptation has a powerful effect on one of the fundamental manifestations of the neglect syndrome

Grasping the past: delay can improve visuomotor performance

“Optic ataxia” is caused by damage to the human posterior parietal cortex (PPC). It disrupts all components of a visually guided prehension movement, not only the transport of the hand toward an object's location [1], but also the in-flight finger movements pretailored to the metric properties of the object [2, 3 and 4]. Like previous cases [4 and 5], our patient (I.G.) was quite unable to open her handgrip appropriately when directly reaching out to pick up objects of different sizes. When first tested, she failed to do this even when she had previewed the target object 5 s earlier. Yet despite this deficit in “real” grasping, we found, counterintuitively, that I.G. showed good grip scaling when “pantomiming” a grasp for an object seen earlier but no longer present. We then found that, after practice, I.G. became able to scale her handgrip when grasping a real target object that she had previewed earlier. By interposing catch trials in which a different object was covertly substituted for the original object during the delay between preview and grasp, we found that I.G. was now using memorized visual information to calibrate her real grasping movements. These results provide new evidence that “off-line” visuomotor guidance can be provided by networks independent of the PPC

Intact automatic avoidance of obstacles in patients with visual form agnosia

In everyday life our reaching behaviour has to be guided not only by the location and properties of the target object, but also by the presence of potential obstacles in the workspace. Recent evidence from neglect and optic ataxia patients has suggested that this automatic obstacle avoidance is mediated by the dorsal, rather than the ventral, stream of visual processing. We tested this idea in two studies involving patients with visual form agnosia resulting from bilateral ventral-stream damage. In the first study, we asked patient DF to reach out and pick up a target object in the presence of obstacles placed at varying distances to the left or right of the target. We found that both DF and controls shifted their trajectories away from the potential obstacles and adjusted their grip aperture in such a way as to minimize risk of collision. In a second study, we asked DF and a second patient, SB, to either reach between, or to bisect the space between, two cylinders presented at varying locations. We found that both patients adjusted their reach trajectories to account for shifts in cylinder location in the reaching task, despite showing significantly worse performance than control subjects when asked to make a bisection judgement. Taken together, these data indicate that automatic obstacle avoidance behaviour is spared in our patients with visual form agnosia. We attribute their ability to the functional intactness of the dorsal stream of visual processing, and argue that the ventral stream plays no important role in automatic obstacle avoidance

Prosthetic Vascular Graft Infection: A Multi-Center Review of Surgical Management

A multi-center retrospective review of major prosthetic graft infection outcomes was undertaken to determine graft preservation and limb salvage rates. The management of infected prosthetic vascular grafts continues to be controversial. The purpose of this study was to review the surgical management of major extracavitary prosthetic vascular graft infections and to correlate the outcomes on the basis of bacteriology and grade. The change in patient population seen by vascular surgeons and the recent emergence of more virulent bacterial strains should influence surgical management. Bacteriology and severity of infection based on grade must play a greater role in the selection criteria for graft salvage. Despite advancement in the understanding of these interactions and the emergence of new management algorithms, we are continuing to operate without a uniform standard in managing this difficult and rapidly evolving clinical problem

Molecular characterization of slow leaf-rusting resistance in wheat

Slow leaf-rusting resistance in wheat (Triticum aestivum L) is gaining acceptance as a breeding objective because of its durability in comparison with race-specific resistance. CI 13227 was previously reported to provide the highest level of slow leaf-rusting resistance. The objective of this study was to characterize the slow leaf-rusting resistance conferred by CI 13227 using molecular markers. A population of recombinant inbred lines (RILs) derived from CI 13227/Suwon 92 was evaluated for final severity (FS), area under disease progress curve (AUDPC), infection rate (IR), and infection duration (ID) of leaf rust. Four hundred fifty-nine amplified fragment length polymorphism (AFLP) markers and 28 simple sequence repeat (SSR) markers were analyzed in the population. Two quantitative trait loci (QTL), designated as QLr.osu-2B and QLr.osu-7BL, were consistently associated with AUDPC, FS, and IR of leaf rust, caused by Puccinia triticina (previously P. recondita Rob. Ex Desm. f. sp. tritici). The percentages of phenotypic variance explained by each QTL varied with experiments and traits, ranging from 13.4 to 18.8% for AUDPC, 12.5 to 20.8% for FS, and 12.9 to 16.1% for IR. The third QTL for leaf rust ID, designated as QLrid.osu-2DS, was located on chromo- some 2DS and explained 26.4 and 21.47% of the phenotypic variance in 1994 and 1995, respectively. Both the QTL and correlation analysis indicate reasonable progress in leaf-rusting resistance by selecting for final severity. SSR markers closely associated with QLr.osu-2B or QLr.osu-7BL have potential to be used in marker-assisted selection (MAS) for durable leaf rust resistant cultivars.Peer reviewedPlant and Soil SciencesEntomology and Plant Patholog

SUSY QM, symmetries and spectrum generating algebras for two-dimensional systems

We show in a systematic and clear way how factorization methods can be used to construct the generators for hidden and dynamical symmetries. This is shown by studying the 2D problems of hydrogen atom, the isotropic harmonic oscillator and the radial potential $A\rho^{2\zeta-2}-B\rho^{\zeta-2}$. We show that in these cases the non-compact (compact) algebra corresponds to so(2,1) (su(2))

Recent Advances in Understanding Particle Acceleration Processes in Solar Flares

We review basic theoretical concepts in particle acceleration, with particular emphasis on processes likely to occur in regions of magnetic reconnection. Several new developments are discussed, including detailed studies of reconnection in three-dimensional magnetic field configurations (e.g., current sheets, collapsing traps, separatrix regions) and stochastic acceleration in a turbulent environment. Fluid, test-particle, and particle-in-cell approaches are used and results compared. While these studies show considerable promise in accounting for the various observational manifestations of solar flares, they are limited by a number of factors, mostly relating to available computational power. Not the least of these issues is the need to explicitly incorporate the electrodynamic feedback of the accelerated particles themselves on the environment in which they are accelerated. A brief prognosis for future advancement is offered.Comment: This is a chapter in a monograph on the physics of solar flares, inspired by RHESSI observations. The individual articles are to appear in Space Science Reviews (2011