Are health care professionals able to judge cancer patients' health care preferences correctly? A cross-sectional study

Background: Health care for cancer patients is primarily shaped by health care professionals. This raises the question to what extent health care professionals are aware of patients' preferences, needs and values. The aim of this study was to explore to what extent there is concordance between patients' preferences in cancer care and patients' preferences as estimated by health care professionals. We also examined whether there were gender differences between health care professionals with regard to the degree in which they can estimate patients' preferences correctly. Methods: To obtain unbiased insight into the specific preferences of cancer patients, we developed the 'Cancer patients' health care preferences' questionnaire'. With this questionnaire we assessed a large sample of cancer patients (n = 386). Next, we asked health care professionals (medical oncologists, nurses and policymakers, n = 60) to fill out this questionnaire and to indicate preferences they thought cancer patients would have. Mean scores between groups were compared using Mann-Whitney tests. Effect sizes (ESs) were calculated for statistically significant differences. Results: We found significant differences (ESs 0.31 to 0.90) between patients and professionals for eight out of twenty-one scales and two out of eight single items. Patients valued care aspects related to expertise and attitude of health care providers and accessibility of services as more important than the professionals thought they would do. Health care professionals overestimated the value that patients set on particularly organisational and environmental aspects. We found significant gender-related differences between the professionals (ESs 0.69 to 1.39) for eight out of twenty-one scales and two out of eight single items. When there were significant differences between male and female healthcare professionals in their estimation of patients health care preferences, female health care professionals invariably had higher scores. Generally, female health care professionals did not estimate patients' preferences and needs better than their male colleagues. Conclusions: Health care professionals are reasonably well able to make a correct estimation of patients preferences, but they should be aware of their own bias and use additional resources to gain a better understanding of patients' specific preferences for each patient is different and ultimately the care needs and preferences will also be unique to the person

Revealing Dissociable Attention Biases in Chronic Smokers Through an Individual-Differences Approach

Addiction is accompanied by attentional biases (AB), wherein drug-related cues grab attention independently of their perceptual salience. AB have emerged in different flavours depending on the experimental approach, and their clinical relevance is still debated. In chronic smokers we sought evidence for dissociable attention abnormalities that may play distinct roles in the clinical manifestations of the disorder. Fifty smokers performed a modified visual probe-task measuring two forms of AB and their temporal dynamics, and data on their personality traits and smoking history/ status were collected. Two fully dissociable AB effects were found: A Global effect, reflecting the overall impact of smoke cues on attention, and a Location-specific effect, indexing the impact of smoke cues on visuospatial orienting. Importantly, the two effects could be neatly separated from one another as they: (i) unfolded with dissimilar temporal dynamics, (ii) were accounted for by different sets of predictors associated with personality traits and smoking history and (iii) were not correlated with one another. Importantly, the relevance of each of these two components in the single individual depends on a complex blend of personality traits and smoking habits, a result that future efforts addressing the clinical relevance of addiction-related AB should take into careful consideration.This study was supported by funding provided by the University of Verona to CDL, CC and L

The role of soil phosphorus sorption characteristics in the functioning and stability of lowland heath ecosystems

Previous research indicates that transition between lowland heath and scrub ecosystems depends upon soil phosphorus (P) sorption capacity (PSC). Experimental work found a positive relationship between P availability and tree invasion but the relationship between PSC, P availability and scrub invasion is poorly understood making it difficult to clearly link landscape invasion patterns with small-scale experimental findings. Using a combination of descriptive and experimental studies we re-examined the relationship between PSC and tree invasion and investigated the hypothesis that PSC is a key determinant of P retention and therefore the P available to scrub colonists. In a statistical model fitted to soil data from three regions soil organic matter (SOM) content explained most of the variation in available P but PSC also accounted for a significant portion of the variance. Additional models suggest that soil P saturation and the proportion of available P in water desorbable form, both indicators of leaching losses, are strongly dependent on PSC. These findings are supported by experimental results; there was greater retention of added P, in plant available form, on high PSC soils and low PSC soils saturated at lower levels of addition. When synthesized with existing data, these results demonstrate that the relationship between PSC and P availability operates via a variety of mechanisms and at several spatio-temporal scales. PSC may for instance, influence post-disturbance SOM accumulation rates. Therefore PSC, by controlling P-availability and ecosystem development, may control the propensity of a site to either heath or scrub

Music therapy within an integrated project for families exposed to domestic violence: A qualitative study of professionals’ perspectives

This paper focuses on a collaborative project that took place from 2012-2015 between an NHS Music Therapy Service for children and young people, a Child and Adolescent Mental Health Service and the charity Housing for Women. Music therapy interventions for children and young people took place alongside therapeutic family interventions. The families involved had all experienced exposure to domestic abuse. A qualitative study of professionals’ perceptions of the project took place after the project had ended, using a methodology of Interpretative Phenomenological Analysis. Interviews with non-music therapy professionals were transcribed and analysed, providing data about perceived benefits for children and families, the evolving perspectives of the professionals involved, and the degree to which processes in music therapy were communicated and understood

Backlash Men’s Movements Part 1: (Real) Fathers 4 Justice, bourgeois rational and new man/new father masculinities

Chapters 5 and 6 critically examine backlash men's movements, especially fathers’ rights groups and the politics of fatherhood. Both chapters are based on in-depth, qualitative analysis of interviews with members of (Real) Fathers 4 Justice. Chapter 5 explores two of three masculinities identified: “bourgeois-rational”, and “new man/new father” masculinity. These map on to specific constructions of fatherhood: “the good enough father”, and the “nurturing father” respectively, which are also explored. “Progressive” notions of crisis were associated with new man/new father masculinity, which advances a vision of kinder masculinity (without fundamentally unsettling gender binaries). Finally, the presence of feminist and postfeminist understandings of gender/fatherhood in fathers’ rights perspective is considered. The analysis demonstrates that men’s movements frequently shift discursive strategies and express ambivalence about feminism

WISExome: A within-sample comparison approach to detect copy number variations in whole exome sequencing data

In clinical genetics, detection of single nucleotide polymorphisms (SNVs) as well as copy number variations (CNVs) is essential for patient genotyping. Obtaining both CNV and SNV information from WES data would significantly simplify clinical workflow. Unfortunately, the sequence reads obtained with WES vary between samples, complicating accurate CNV detection with WES. To avoid being dependent on other samples, we developed a within-sample comparison approach (WISExome). For every (WES) target region on the genome, we identified a set of reference target regions elsewhere on the genome with similar read frequency behavior. For a new sample, aberrations are detected by comparing the read frequency of a target region with the distribution of read frequencies in the reference set. WISExome correctly identifies known pathogenic CNVs (range 4 Kb–5.2 Mb). Moreover, WISExome prioritizes pathogenic CNVs by sorting them on quality and annotations of overlapping genes in OMIM. When comparing WISExome to four existing CNV detection tools, we found that CoNIFER detects much fewer CNVs and XHMM breaks calls made by other tools into smaller calls (fragmentation). CODEX and CLAMMS seem to perform more similar to WISExome. CODEX finds all known pathogenic CNVs, but detects much more calls than all other methods. CLAMMS and WISExome agree the most. CLAMMS does, however, miss one of the known CNVs and shows slightly more fragmentation. Taken together, WISExome is a promising tool for genome diagnostics laboratories as the workflow can be solely based on WES data.Pattern Recognition and Bioinformatic