Breast cancer and communication: Monocentric experience of a self-assessment questionnaire

Background: The communication of the diagnosis of breast cancer induces to the patient a strong psychological trauma. Radiologists are at the forefront of communicating, either for a biopsy or the probable diagnosis of malignancy. This is a complex task, which requires the knowledge and application of correct “communicative models”, among which the SPIKES protocol rep-resents a fundamental reference. Design and methods: 110 patients, with a history of breast cancer, filled out a questionnaire consisting of six questions: five aimed at defining communication compliance with the SPIKES protocol, the sixth, consisting of six feelings, aimed at the knowledge of the next emotional state. Results: Regarding compliance with various “strategic points” of the SPIKES protocol, questionnaires show that 70% of patients reported no omissions, while the remaining 30% reported omissions relatively to perception (56%), emotions (23%), setting (13%), knowledge (6%) and invitation (2%). The results showed the existence of a correlation between the final emotional state and the correct application of the SPIKES protocol; in fact, patients who reacted with a positive final emotional state-reported greater adherence to the strategic points of the SPIKES protocol. Conclusions: In healthcare, knowing the communicative compliance of a team in giving “bad news” is fundamental, especially in breast cancer. The SPIKES protocol is recognized by the Literature as a fundamental reference able to affect “positively” the emotional state of patients. The proposed questionnaire is a valid tool to identify the weak points of communication and related criticalities, to improve clinical practice

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Bruggeman, F.J. [Promotor]Westerhoff, H.V. [Copromotor]Verschure, P.J. [Copromotor

Resource Control for Synchronous Cooperative Threads

We develop new methods to statically bound the resources needed for the execution of systems of concurrent, interactive threads. Our study is concerned with a \emph{synchronous} model of interaction based on cooperative threads whose execution proceeds in synchronous rounds called instants. Our contribution is a system of compositional static analyses to guarantee that each instant terminates and to bound the size of the values computed by the system as a function of the size of its parameters at the beginning of the instant. Our method generalises an approach designed for first-order functional languages that relies on a combination of standard termination techniques for term rewriting systems and an analysis of the size of the computed values based on the notion of quasi-interpretation. We show that these two methods can be combined to obtain an explicit polynomial bound on the resources needed for the execution of the system during an instant. As a second contribution, we introduce a virtual machine and a related bytecode thus producing a precise description of the resources needed for the execution of a system. In this context, we present a suitable control flow analysis that allows to formulte the static analyses for resource control at byte code level