Coping as a Mediator between Symptom Burden and Distress in Lung Cancer Patients

Lung cancer is considered the leading cause of cancer death worldwide. An estimated 224,390 new cases of lung cancer are expected to be diagnosed and 158,080 Americans are expected to die from lung cancer in 2016 (National Institutes of Health, 2016; Siegel, Miller, & Jemal, 2016). Lung cancer patients also report the highest levels of psychological distress and symptom burden than any other forms of cancer (Linden, Vodermaier, MacKenzie, & Greig, 2012). Given the prevalence and impact of lung cancer, it is imperative to address the emotional toll this diagnosis can have on those suffering with the disease to develop helpful strategies for those coping with lung cancer. The goal of this study is to determine how much lung cancer patients’ symptom burden affects their level of distress, and how much of this effect is mediated by approach and/or avoidance coping styles. Adults (N = 109, 57% female,) with an average age of 67 (SD = 10.1) diagnosed with lung cancer completed a questionnaire assessing for physical and psychological functioning at two medical centers in Southern California. Results: There was a significant positive relationship between total symptom burden and distress. Avoidance coping was a significant mediator of the relationship between total symptom burden and distress. Approach coping was not a significant mediator of this relationship. Conclusions: Results suggest that a patient experiences more distress as his/her symptom burden increases, and this effect is partially explained by engaging in avoidant coping. Therefore, it is important to find ways to help patients cope more effectively to reduce their levels of stress. The findings of this study show the importance of continued research to find effective coping strategies and as well to inhibit patients from engaging in an avoidant coping style

A Critique of Women and Philanthropy: New Voices, New Visions

The debate is classic: should women work within existing institutional systems and organizations to help shape them, or should they establish their own? Micho Spring offers her own views about Marcy Murninghan\u27s study of alternative philanthropies

Strain longitudinal par speckle tracking en echocardiograpgie : étude de la variabilité intervendeur

Contexte : La quantification de la déformation myocardique par mesure du strain longitudinal est une des avancées techniques les plus significatives dans le domaine de l’échocardiographie durant les dernières années. Elle permet une mesure plus fiable de la fonction ventriculaire et procure des paramètres pronostiques dans de nombreux domaines, en particulier en cas d’insuffisance cardiaque ou de cardiomyopathie. Une limitation importante à l’application large de cette technique est l’absence d’uniformisation des méthodes entre les différents vendeurs résultant en une variabilité intervendeur significative. En conséquence, aucune recommandation uniforme ne peut être actuellement émise concernant les valeurs normales du strain longitudinal. Objectifs : L’objectif de cette étude est de comparer les valeurs de strain longitudinal global et segmentaire obtenues avec les deux systèmes d’échocardiographies utilisés au CHUV, soit les systèmes GE et Philips, et d’évaluer, pour chaque système, sa reproductibilité et sa robustesse. Une comparaison des résultats obtenus a également été effectuée par mesure de la concordance entre les deux systèmes commerciaux. Méthodes : Au terme d’un examen échocardiographique complet effectué au laboratoire d’échocardiographie du CHUV sur l’un des systèmes, un complément d’acquisition ciblé a été effectué avec la machine d’échocardiographie de l’autre marque. Les valeurs de strain ont ensuite été mesurées par deux experts et une étudiante. Les valeurs moyennes de strain longitudinal obtenues avec les deux machines ont été comparées pour évaluer la reproductibilité interobservateur et intervendeur. Résultats : L’analyse de l’expérience de l’opérateur a retrouvé une augmentation significative du nombre de corrections nécessaire entre l’expert et l’étudiante tant pour GE que pour Philips (p < 0.01) avec également une augmentation significative du temps d’analyse (p < 0.01). La comparaison entre logiciels a montré un nombre de corrections du tracé globalement comparable mais un temps d’analyse significativement allongé sur Philips pour les deux experts alors que pour l’étudiante c’est sur GE que le temps d’analyse était prolongé. Les coefficients de variation pour la mesure du strain longitudinal global par GE et Philips étaient respectivement de 8% et 14% entre deux experts et de 7% et 15% entre un expert et l’étudiante démontrant une bonne reproductibilité interobservateur. Au niveau du strain segmentaire, la reproductibilité était très variable avec des coefficients de variation souvent au-dessus de 20%. La reproductibilité intervendeur était un peu moins bonne avec un coefficient de variation de 20.6% sans biais significatif pour l’expert et un coefficient de variation de 12.6% avec un biais de -1.6 pour l’étudiante. Les coefficients de variabilité étaient systématiquement plus élevés sur Philips, qui serait donc moins reproductible que GE. Conclusion : Malgré la bonne reproductibilité des deux vendeurs, en cas de suivi longitudinal d’un patient, il serait recommandé de ne pas changer de marque pour réduire la variabilité. Le strain segmentaire n’apparait pas assez fiable pour une utilisation quantitative en pratique

Remote Indigenous Housing and Infrastructure: Factors affecting successful regional governance

The provision of sufficient and sustainable remote indigenous housing and infrastructure in remote areas is still a major challenge for service providers. Attempts to meet this need have led to the development of a wide range of housing and housing-related programs in remote indigenous communities. There is a move from an external program-driven approach for housing, to a focus on sustainable local and regional systems of governance in indigenous communities to support the delivery and recurrent maintenance of housing and infrastructure. This paper reports on research into best practice case studies in remote area indigenous housing in WA and the NT. It includes community members’ perceptions of current programs as well as their suggestions for improvements. The lessons from the case studies provide direction for the development of strategies to support sustainable local and regional governance that, in turn, supports the development and maintenance of appropriate remote area indigenous housing. The challenges for sustainable regional governance in remote indigenous communities include the lack of economic development opportunities, the skills of local community members and the willingness and capacities of external service providers to take a community development approach

Reconstruction of the physical volcanological processes and petrogenesis of the 3.5Ga Warrawoona Group pillow basalt of the Warralong Greenstone Belt, Pilbara Craton Western Australia

This research attempts to address some knowledge gaps in the formation of the Archean in age Warralong greenstone belt in the East Pilbara terrane, through geochemical and petrographic analysis. This research also addresses the possible formation mechanisms for Ocelli, a liquid immiscible texture observed in pillow lavas throughout the East Pilbara terrane and Archean greenstone belts throughout the world

Movement-Related Cortical Potential Amplitude Reduction after Cycling Exercise Relates to the Extent of Neuromuscular Fatigue.

Exercise-induced fatigue affects the motor control and the ability to generate a given force or power. Surface electroencephalography allows researchers to investigate movement-related cortical potentials (MRCP), which reflect preparatory brain activity 1.5 s before movement onset. Although the MRCP amplitude appears to increase after repetitive single-joint contractions, the effects of large-muscle group dynamic exercise on such pre-motor potential remain to be described. Sixteen volunteers exercised 30 min at 60% of the maximal aerobic power on a cycle ergometer, followed by a 10-km all-out time trial. Before and after each of these tasks, knee extensor neuromuscular function was investigated using maximal voluntary contractions (MVC) combined with electrical stimulations of the femoral nerve. MRCP was recorded during 60 knee extensions after each neuromuscular sequence. The exercise resulted in a significant decrease in the knee extensor MVC force after the 30-min exercise (-10 ± 8%) and the time trial (-21 ± 9%). The voluntary activation level (VAL; -6 ± 8 and -12 ± 10%), peak twitch (Pt; -21 ± 16 and -32 ± 17%), and paired stimuli (P100 Hz; -7 ± 11 and -12 ± 13%) were also significantly reduced after the 30-min exercise and the time trial. The first exercise was followed by a decrease in the MRCP, mainly above the mean activity measured at electrodes FC1-FC2, whereas the reduction observed after the time trial was related to the FC1-FC2 and C2 electrodes. After both exercises, the reduction in the late MRCP component above FC1-FC2 was significantly correlated with the reduction in P100 Hz (r = 0.61), and the reduction in the same component above C2 was significantly correlated with the reduction in VAL (r = 0.64). In conclusion, large-muscle group exercise induced a reduction in pre-motor potential, which was related to muscle alterations and resulted in the inability to produce a maximal voluntary contraction

Chronicles of Oklahoma

Article describes the results of excavations of chert, or flint, quarries in Kay County conducted by Otto F. Spring, whose report was prepared for publication by Dr. Joseph B. Thoburn in 1926. Spring discusses evidence of prehistoric village sites near these quarries