Psychiatric morbidity among cancer patients and awareness of illness

A significant proportion of cancer patients experience psychiatric morbidity. Potential predictors of psychiatric morbidity include patient disease-related factors and factors relating to the patients environment. The aim of this study was to investigate the prevalence of psychiatric morbidity and the relationship between the clinical or personal factors, especially psychiatric morbidity, and awareness of cancer diagnosis among a group of Turkish cancer patients. A total of 117 cancer patients were assessed using the Structured Clinical Interview for DSM-IV (SCID), the Hospital and Anxiety Depression Scale (HADS) and the General Health Questionnaire (GHQ). Of these patients, 30% had a psychiatric diagnosis. Adjustment disorders comprised most of the psychiatric diagnoses. Awareness of the diagnosis of cancer, history of previous psychiatric disorders, pain and stress factors were correlated with psychiatric morbidity. Of the 117 patients, 64 (54.7%) were unaware of the diagnosis of cancer. Most of the patients (67.9%) who were considered to be aware of the cancer diagnosis stated that they had guessed their illness from the treatment process or drug adverse effects. Psychiatric morbidity was significantly higher in the patients who knew that they had a cancer diagnosis (P=0.03). These findings suggest that the awareness of cancer diagnosis is related to the presence of psychiatric morbidity. In particular, the understanding of the diagnosis indirectly may be stressful to the patient because it arouses suspicion about the cancer and treatment, and consequently can lead to psychiatric disturbance. In Turkey honest disclosure of the true diagnosis is still not common for cancer patients and it seems to be essential to improve this situation.This paper was accepted as a poster presentation at the European Conference of Clinical Oncology (ECCO) Congress held in Copenhagen, 21–25 September 2003.     

Simulation-based education promoting situation awareness in undergraduate nursing students: A scoping review

AimTo examine simulation-based education (SBE) strategies on situation awareness (SA) in nursing students including the strategies of SBE, the measurement tools of SA during SBE and the effectiveness of SBE on SA.BackgroundSA has been reported as an effective way to identify and manage deteriorating patients. Researchers have suggested that SBE is more effective than other instructional modalities in improving SA. However, SA among nursing students and studies regarding the effectiveness of SBE on SA are limited.DesignThe Arksey and O'Malley scoping review framework was used to guide the review process and the PRISMA-ScR checklist was used to report on this scoping review.MethodsThe databases searched were Medline, CINAHL, EMBASE, EBSCO and Google Scholar from December 2020 to November 2021. Thematic analysis was applied to identify the main findings in the literature.ResultsNine eligible articles were included. Five major themes were identified: SBE situations used to teach SA to nursing students, SBE strategies to improve SA in nursing, effectiveness of SBE on SA in nursing, measurements of SA used during the SBE and experimental studies examining the effectiveness of SBE on SA.ConclusionThis review reveals that SBE may be useful to cultivate SA in nursing students. Future studies that use randomized clinical trials to test the effects of combining different simulation strategies on SA are suggested. Developing more reliable and valid SA global assessment queries and standardizing the query process of SA measurement is also recommended.     

典型稀土矿职业人群辐射认知调查

目的 了解典型稀土矿职业人员辐射认知程度。方法 通过现场了解及文献调研,咨询专业人士,设计辐射认知调查表,采用随机整群抽样方法,对职业人员进行问卷调查,录入数据并分析结果。结果 稀土矿职业人员辐射认知总体水平较低,对辐射危害知晓率、内外照射知晓率及其主要包括射线种类得分,粉尘较低组均优于粉尘较高组（P<0.05）,对辐射危害认知得分,粉尘较低组略优于粉尘较高组（0.05 < P < 0.1）;年龄、学历、获取辐射相关知识途径、内外照射对应防护措施得分,均尚不能认为两组中有差别。结论 典型伴生稀土矿职业人群辐射认知整体水平较低,尤其是接尘浓度较高组,应加强培训与管理。     

天津市高一学生艾滋病知识与健康教育需求现况调查

目的 了解天津市高一学生艾滋病知识知晓率及其相关因素,与艾滋病健康教育需求情况。方法 采用横断面调查设计,采用分层整群抽样与方便抽样相结合的方法,选取天津地区高中2所、职业高中1所,对所有高一学生进行匿名调查。问卷内容包括一般人口学特征、艾滋病相关知识、艾滋病健康教育需求信息等条目。结果 调查对象共1 082人,艾滋病知识知晓率为34.3%（371/1 082）。既往接受过艾滋病知识的比例为71.9%（778/1 082）,既往接受过性健康知识的比例为59.4%（643/1 082）,2类学校间差异有统计学意义;发生插入性性行为的比例为7.0%（76/1 082）。多因素logistic回归分析结果显示,职业高中（与普通高中相比,OR=0.41,95% CI：0.29~0.59）、无性健康知识需求（与有需求相比,OR=0.62,95% CI：0.43~0.91）、未关注艾滋病宣传材料（与关注相比,OR=0.41,95% CI：0.30~0.56）、不知晓安全性行为（与知晓相比,OR=0.55,95% CI：0.39~0.77）和不知晓正确使用安全套（与知晓相比,OR=0.33,95% CI：0.24~0.46）的调查对象艾滋病知识知晓率较低。结论 调查的天津市高一学生艾滋病知识知晓率普遍较低,有的学生发生过插入性性行为。性健康知识对艾滋病知识有显著影响,需加强高中生的性健康教育和艾滋病健康教育工作。     

The neural substrates of conscious color perception demonstrated using fMRI

It is well established that seeing color activates the ventral occipital cortex, including the fusiform and lingual gyri, but less is known about whether the region directly relates to conscious color perception. We investigated the neural correlates of conscious color perception in the ventral occipital cortex. To vary conscious color perception with the stimuli-remaining constant, we took advantage of the McCollough effect, an illusory color effect that is contingent on the orientation of grating stimuli. Subjects were exposed to a specific combination of chromatic grating patterns for 10 min to induce the McCollough effect. We compared brain activities measured while the subjects viewed achromatic grating stimuli before (PRE) and after the induction of the McCollough effect (POST) using functional magnetic resonance imaging (fMRI). There were two groups: one group was informed that they would perceive illusory color during the session (INFORMED group), whereas the other group was not informed (UNINFORMED group). The successful induction of the McCollough effect was confirmed in all subjects after the fMRI experiment; nevertheless, only approximately half of the UNINFORMED subjects had been aware of the color during the POST session, while the other half had not. The left anterior portion of the color-selective area in the ventral occipital cortex, presumably V4alpha, was significantly active in subjects who had consciously perceived the color during MR scan. This study demonstrates the activity in a subregion of the color-selective area in the ventral occipital cortex directly related to conscious color perception.     

痴呆知晓率与态度的社区调查

目的调查分析上海中心城拯居民对痴呆的知晓率和态度。方法对上海中心城区社区内1806户常住居民进行自编问卷调查,内容包括被调查者的人口特征与10个选择性问题以了解对痴呆的认知和态度其中5题列举痴呆早期症状供识别,另外,对“老了应该糊涂”是否认同、家人患痴呆的顾忌态度、对痴呆疗效的看法、治疗机构的选择等各有1题。结果共回收1568份问卷,其中有效问卷1531份,认同“老了应该糊涂”者占45．1％,对痴呆早期症状的正确识别率范围为28．6％～40．6％,亲属若患痴呆,认为不必要顾忌者仅占43．1％。45．1％的被调查者不了解药物治疗可帮助痴呆患者,52．9％会选择老年精神科作为痴呆的治疗机构。分层分析提示,女性、小学与大学文化程度者、老年人更认同“老了应该糊涂”概念,对痴呆有顾忌者的比率,以文化程度分组从高到低排序是：初中组（69．7％）〉高中组（50．7％）〉小学组（41．3％）〉大学组（25．2％）;以年龄分组排序是：成年组（59．8％）〉老年组（37．3％）〉青年组（30．2％）。组间比较差异均有统计学意义（P〈0．01）。对痴呆早期症状的识别率,女性高于男性,差异有统计学意义（P〈0．01）。以文化程度分组从高到低识别率排序是：大学组〉小学组〉高中组〉初中组;以年龄分组排序是：老年组〉青年组〉成年组,组间比较差异均有统计学意义（P〈0．01）。结论上海中心城区居民对痴呆的早期症状的知晓率较低,存在明显的偏见与歧视。     

Awareness of risk factors among persons at risk for lung cancer, chronic obstructive pulmonary disease and sleep apnea: A Canadian population-based study

OBJECTIVE

To assess awareness among persons at risk for lung cancer, chronic obstructive pulmonary disease (COPD) and sleep apnea regarding symptoms and risk factors of the disease, and their attitudes regarding the disease and toward those who are affected.

METHODS

A quantitative hybrid telephone and Internet survey of a representative population of Canadian adults at risk for at least one of the three diseases was conducted. To measure the awareness and attitudes of First Nations, Inuit and Métis people to these diseases, a proportionate number were also surveyed.

RESULTS

A total of 3626 individuals were contacted. Of these, 3036 (84%) were eligible to participate. Of those at risk for lung cancer and COPD, 65% and 69%, respectively, were due to tobacco smoke exposure. Among those at risk, 72% believed that they were informed about lung cancer compared with 36% for COPD and 56% for sleep apnea. Most respondents were knowledgeable about the common symptoms of lung cancer, COPD and sleep apnea, but were less aware of the impact lifestyle choices could have on the development of these disorders and the availability of treatment. Most of the participants (77%) believed that smoking was an addiction rather than a habit (19%). There were no significant differences in the awareness of risk factors, symptoms and attitudes toward all three lung diseases between First Nations, Inuit and Métis people and the general population.

CONCLUSIONS

Canadians are reasonably aware of risk factors and symptoms for lung cancer and sleep apnea. However, there is poor awareness of COPD as a disease entity. There is a lack of appreciation for the impact lifestyle choices and changes can have on lung diseases.     

Management of hypertension in patients with diabetes mellitus

OBJECTIVE:

To investigate the management of hypertension in patients with diabetes mellitus, living in a rural setting.

METHOD:

A community health screening clinic was conducted at Charles Sturt University, Albury-Wodonga, in rural southeastern Australia. Patients with either diagnosed hypertension or high blood pressure who attended the clinic were eligible for inclusion in the present study. The awareness and control of hypertension was compared between patients with and without diabetes mellitus.

RESULTS:

A total of 449 patients with hypertension were analyzed. One hundred twenty-one (26.9%) had hypertension and diabetes mellitus, and 328 (73.1%) had hypertension without diabetes mellitus. Hypertension awareness (61.2% versus 36.9%, P=0.014) and control (17.4% versus 7.0%, P=0.040) were significantly better in the hypertensive patients with diabetes mellitus than in the hypertensive patients without diabetes mellitus. Antihypertensive medication use was also significantly higher in patients with diabetes mellitus than in patients without diabetes mellitus (one antihypertensive medication, 41.3% versus 25.0%, P=0.045).

CONCLUSION:

Awareness and control of hypertension were suboptimal in the patients in the present study. Diabetes mellitus, however, was associated with both higher awareness and better control of hypertension than having hypertension alone. This may be partially due to a higher use of antihypertensive medications by patients with diabetes mellitus.