Effect of information fields from written texts on cell growth and mitochondrial functions in-vitro: An exploratory study

ObjectiveMitochondria are considered a portal to receive, process and integrate external energy and information to maintain cellular homeostasis. We examined the effect of Chinese texts with positive and negative meaning on the growth and mitochondrial functions using a mouse kidney collecting duct cell line called M1 cells.MethodsTo avoid skewing the results due to differential handling of the cells or analyzing the results, we conducted experiments by keeping the texts and blanks covered in brown opaque envelopes, exposed the cells to randomly selected envelopes and examined the differences over time. All operators involved in the experiments did not know the contents of the envelopes until the end of the experiments, and all data are expressed relative to the controls.ResultsCell growth rate was not affected for the group treated with positive information but was significantly reduced by 18% when treated with negative information. At the biochemical level, positive texts significantly increased whole cell adenosine triphosphate (ATP) and glutathione (GSH) by 22% and 21% respectively.ConclusionsThis study for the first time demonstrated the effect of written words on specific biochemical measures in cultured mammalian cells.     

The effect of videotaped or written information on Chinese gastroscopy patients' clinical outcomes

The researchers compared videotaped information with specific written information on Chinese out-patients' post-gastroscopy anxiety and satisfaction levels. We randomly allocated 30 out-patients having scheduled gastroscopy to receive videotaped or detailed written information, and assessed the effect of the information on patients' post-gastroscopy BP, pulse and self-reported anxiety and satisfaction levels. Patients receiving videotaped information had better post-gastroscopy outcomes on all measures, but the results were not statistically significant. BP and Pulse rates increased after the intervention within each group but the changes were statistically significant in the group receiving detailed written information only. A-state scores decreased in both groups after the intervention but these changes were not statistically significant. Education and age significantly influenced post-gastroscopy state anxiety scores. The researchers conclude that information may have little effect on Chinese gastroscopy patients' outcomes, irrespective of the method of providing it. Education and age may influence patients' reports of anxiety.     

A qualitative study of patients' views on anxiety and depression.

BACKGROUND: In the management of patients with anxiety and depression in general practice, the emphasis has been on improving detection and appropriate use of drug therapies by health professionals. Patients' own perceptions of their problems and what services they would prefer have not often been sought. AIM: To explore patient perspectives in relation to their healthcare needs in anxiety and depression. DESIGN OF STUDY: Semi-structured individual and focus group interviews. SETTING: A total of 27 patients from an urban four-partner group general practice who were identified as having anxiety and depression by a practice population questionnaire survey. METHOD: All interviews were transcribed and the major themes were summarised using grounded theory analysis. RESULTS: Patients seek many different ways of coping with their problems but view their general practice as a focal point for help. Their experiences are dominated by the struggle to control unwelcome and intrusive thoughts and to live in a hostile and threatening world. They also have distinct preferences regarding their health needs and there is universal scepticism about drug therapies. CONCLUSION: Patients describe personal and professional barriers to seeking help and have particular views on the treatment options. This perspective contrasts with the current professional emphasis on detection and drug use. This view is therefore central to informing the debate on management of neurotic disorders in primary care and on improving the care of these patients.     

An exploratory study of priority information needs in adult asthma patients

The aim of this study was to gain insight into patients' perspectives on key information needs regarding their asthma. Focused conversation-style interviews were conducted with a purposive sample of 32 patients (aged 18-84 years; males=17, females=15) from five sites (four primary care, one secondary care) in North West England. Interviews were tape recorded and transcribed verbatim, then subjected to line-by-line content analysis. Nine core information needs were identified: current medications; new therapies; medication side effects; triggers of an asthma attack; lifestyle issues; asthma causation; effects of asthma; long term outcome; and symptom control. Individual differences in information need were apparent, as were differences according to asthma severity. The findings highlight some of the challenges facing health professionals when information-giving. The study's findings could be used in a clinical context to facilitate discussion or to tailor information, and could also provide a basis for future quantitative studies.     

Analysis of stroke patients' and carers' reading ability and the content and design of written materials: recommendations for improving written stroke information

OBJECTIVE: This study (a) evaluated the reading ability of patients following stroke and their carers and the reading level and content and design characteristics of the written information provided to them, (b) explored the influence of sociodemographic and clinical characteristics on patients' reading ability, and (c) described an education package that provides well-designed information tailored to patients' and carers' informational needs. METHODS: Fifty-seven patients and 12 carers were interviewed about their informational needs in an acute stroke unit. Their reading ability was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). The written information provided to them in the acute stroke unit was analysed using the SMOG readability formula and the Suitability Assessment of Materials (SAM). RESULTS: Thirteen (22.8%) patients and 5 (41.7%) carers had received written stroke information. The mean reading level of materials analysed was 11th grade while patients read at a mean of 7-8th grade. Most materials (89%) scored as only adequate in content and design. Patients with combined aphasia read significantly lower (4-6th grade) than other patients (p=0.001). CONCLUSION: Only a small proportion of patients and carers received written materials about stroke and the readability level and content and design characteristics of most materials required improvement. PRACTICE IMPLICATIONS: When developing and distributing written materials about stroke, health professionals should consider the reading ability and informational needs of the recipients, and the reading level and content and design characteristics of the written materials. A computer system can be used to generate written materials tailored to the informational needs and literacy skills of patients and carers.     

Hospitalized patients' views on in-ward psychological counseling

This qualitative study explores the feelings and beliefs of patients hospitalized in an orthopedic rehabilitation ward for receiving psychological help in that setting. Semi-structured interviews with 10 hospitalized patients were audiotaped, transcribed verbatim, and analyzed using interpretative phenomenological analysis (IPA). Themes of an approach-avoidance conflict towards receiving psychological help were identified, some of them unique to the hospital setting. Approach tendencies were associated with high psychological distress, awareness of free accessibility, and beliefs in body-mind relationship. Avoidance tendencies were associated with fears of psychotherapy, misconceptions, and perceived threats to one's independence and self-esteem. The implications of these findings for the provision of psychological counseling in hospital settings are discussed.     

Improving access to information and support for patients with less common cancers: hematologic cancer patients' views about Web-based approaches

Background

Meeting the psychosocial needs of vulnerable groups such as cancer survivors remains an ongoing challenge. This is particularly so for those who have less access to the usual forms of medical specialist and in-person support networks. Internet-based approaches offer an opportunity to better meet patients’ information and support needs by overcoming the barrier of geographic isolation.

Objective

The aim of the study was to assess the reported level of access to the Internet, preferred sources of information, and preferred sources of support among survivors of hematologic cancers.

Method

A population-based, Australian state cancer registry invited eligible survivors to complete a survey about psychosocial needs, including items measuring Internet access and patterns of use. Of the 732 eligible survivors invited to participate, 268 (36.6%) completed and returned the pen-and-paper-based survey.

Results

The majority of participants (186/254, 73.2%) reported a high level of access to the Internet, with higher Internet access associated with a higher level of education, larger household, younger age, and being married or employed. A total of 62.2% (156/251) of survivors indicated they were likely to use the Internet for accessing information, with the percentage much lower (69/251, 28%) for accessing support via the Internet. Likelihood of using the Internet for support was associated with feeling anxious and being employed.

Conclusions

While the Internet appears to offer promise in increasing equitable access to information and support for cancer survivors for both metropolitan and regional areas, it is viewed less favorably for support and by particular subgroups (eg, older people and those without a university degree) within the survivor population. Promoting greater understanding of this mode of support may be required to achieve its potential. Information and support options other than Web-based approaches may continue to be needed by vulnerable groups of cancer survivors.     

Communicating non-steroidal anti-inflammatory drug risks: verbal counseling, written medicine information, and patients' risk awareness

Objective

To assess potential associations among physician counseling, pharmacist counseling, written medicine information (WMI) and patient awareness of non-steroidal anti-inflammatory drug (NSAID) risks.

Methods

Three-hundred and eighty-two older, white and African American patients prescribed NSAIDs were surveyed regarding their NSAID risk awareness defined as an index score ranging from zero to four correctly identified risks (i.e., gastrointestinal bleeding, heart attack, hypertension, and kidney disease). Associations among NSAID risk awareness and patient-reported physician counseling, pharmacist counseling, and reading of WMI were evaluated in multivariable ordered logistic regression models and confirmed using path analysis.

Results

Physician counseling was positively associated with reading WMI (p < 0.001) and NSAID risk awareness (p < 0.001). Pharmacist counseling was not associated with reading WMI (p = 0.622) and neither pharmacist counseling (p = 0.366) nor reading WMI (p = 0.916) was associated with NSAID risk awareness.

Conclusions

Physicians play a prominent role in facilitating NSAID risk awareness whereas pharmacist counseling and WMI may have limited impact.

Practice implications

The lack of significant associations among pharmacist counseling and reading WMI with NSAID risk awareness suggests a missed opportunity to improve patient understanding. There is a need for coordinated and effective strategies to communicate risk information among physicians and pharmacists and to better integrate WMI into this process.     

Eating disorders patients' views on their disorders and on an outpatient service: a qualitative study

The objective of the study was to determine sufferers' views of outpatient treatment for eating disorders and provide practical recommendations for treatment practice. Twenty NHS outpatients participated in semi-structured interviews, which were subjected to thematic analysis. Respondents expressed ambivalence about whether their eating disorder is a way of exerting control or a disorder that controls them and this leads to them seeking treatment. Sufferers preferred a practical and sensitive approach and began to rely on treatment for recovery. Treatment needs to facilitate sufferers' need for control by striking a balance between practical and empathetic approaches that both involve patients in treatment decisions and give authoritative guidance.     

Diagnosis of type 2 diabetes: a qualitative analysis of patients' emotional reactions and views about information provision

Research about diagnosis of chronic illness indicates this is an emotional time for patients. Information provision is especially salient for diabetes management. Yet current orthodoxy suggests that too much information at the time of diagnosis is unhelpful for patients. In this study, we used in-depth interviews with 40 newly diagnosed type 2 diabetic (T2DM) patients in Scotland, to explore their emotional reactions about diagnosis, and their views about information provision at the time of diagnosis. Data were analysed using a thematic approach. Our results showed three main 'routes' to diagnosis: 'suspected diabetes' route; 'illness' route; and 'routine' route. Those within the 'routine' route described the most varied emotional reactions to their diagnosis. We found that most patients, irrespective of their route to diagnosis, wanted more information about diabetes management at the time of diagnosis. We suggest that practitioners would benefit from being sensitive to the route patients follow to diagnosis, and prompt, simple but detailed advice about T2DM management would be helpful for newly diagnosed patients.     

Toward a greater understanding of breast cancer patients’ decisions to discuss cancer-related internet information with their doctors: An exploratory study

Objective

To investigate differences between breast cancer patients who do and do not discuss cancer-related internet information (CRII) with their doctors.

Methods

70 breast cancer patients completed questionnaires regarding internet use, discussions about CRII, and the doctor–patient relationship.

Results

No significant differences were noted across patient, disease, or visit characteristics, or physician reliance between those who intended to discuss CRII and those who did not. Patients who intended to discuss CRII rated significantly higher pre-consultation anxiety levels. No significant differences in satisfaction, anxiety reduction, or trust in physician were found between patients who had discussed and those who had not. Patients’ reasons for discussing or not discussing are detailed.

Conclusion

Factors influencing patients’ decisions to discuss CRII are complex and differ from those identified as leading patients to seek internet information. Future research about internet discussions should investigate the impact of patients’ preferred role in treatment, the doctor–patient relationship, anxiety level, attributes of CRII, and physician trust.

Practice implications

Understanding the characteristics of patients who do and do not discuss internet information is important given the impact internet information has on healthcare communication and the doctor–patient relationship, including the development of interventions aimed at improving such interactions.     

Evaluation of DNA topoisomerase IIalpha expression provides independent prognostic information in non-Hodgkin's lymphomas

AIMS: In view of the dual role that DNA topoisomerase IIa (TopoIIa) plays as a cell proliferation marker and as a possible indicator of chemosensitivity, we investigated its expression in non-Hodgkin's lymphomas (NHL) in relation to conventional clinicopathological parameters, cell proliferation (as defined by Ki67 immunoreactivity), response to therapy and patient outcome. METHODS and RESULTS: Formalin-fixed paraffin-embedded tissues from 153 patients with NHL were immunohistochemically stained for TopoIIalpha. Patients were followed up until death (n = 63) or for an average of 68 months (median 64 months, n = 90). The percentage of TopoIIalpha positive cells (TopoIIalpha LI) increased with grade (P < 0.001), extranodal location (P = 0.05) and Ki67 LI (P = 0.01, r = 0.673). In most cases (58%), Ki67 LI exceeded TopoIIalpha LI (TopoIIalpha/Ki67 < 1), especially within the indolent group (P < 0.001). TopoIIalphaLI, Ki67LI and TopoIIalpha/Ki67 ratio were all adversely related to overall survival in univariate analysis, though their significance was not maintained after adjustment for grade. In multivariate analysis high TopoIIalpha/Ki67 ratio and high TopoIIalpha LI independently predicted shortened overall and post-relapse survival, respectively. Most importantly, low TopoIIalpha/Ki67 ratio was the only independent predictor of diminished disease-free survival. However, there was no relationship between TopoIIalpha expression and response. CONCLUSIONS: Our results suggest that evaluation of TopoIIalpha expression and TopoIIalpha/Ki67 ratio as cell proliferation markers provides independent prognostic information in relation to post-relapse and overall survival. Furthermore, TopoIIalpha/Ki67 ratio appears to play a key role in the identification of patients prone to early relapse.     

Copying general practitioner referral letters to patients: a study of patients' views.

Over the past decade there has been a significant shift towards greater involvement of patients in their health care and this has highlighted many areas relating to doctor-patient communication. One area of communication that has not been extensively researched is the referral letter between general practitioners (GPs) and their patients. This small study of patients' views suggests that patients value receiving a copy of their GP outpatient letter, appreciating greater understanding of, and involvement in, the referral process.     

Severe weather phobia: An exploratory study

Eighty-one persons with an intense fear of severe thunderstorms and tornadoes were interviewed to learn more about the phenomenon of “severe weather phobia,” a term introduced for the first time in this investigation. Possible causes and methods of treatment are discussed, as well as implications for future research. © 1996 John Wiley & Sons, Inc.     

Fine-needle aspiration cytology. An exploratory study

This paper shows result from fine-needle aspiration biopsies done at the University Hospital and Falcon Clinic in Maracaibo, Venezuela, between December 1985 and October 1986. The study was conducted in order to determine factibility of fine-needle aspiration biopsies in our environment. Results are satisfactory and show that the method is a good one to diagnosis and prevent cancer, it is cheap and easy to use in large populations with quick diagnosis.     

Combination of epithelial-mesenchymal transition and cancer stem cell-like phenotypes has independent prognostic value in gastric cancer

Epithelial-mesenchymal transition-related proteins have been suggested to interact with each other in various cancers and be associated with the aggressive behavior of cancer. To demonstrate the clinical significance of epithelial-mesenchymal transition and stem cell-like phenotypes in gastric cancer, we performed immunohistochemistry for 5 epithelial-mesenchymal transition-related proteins, including Snail-1, ZEB-1, E-cadherin, vimentin, and β-catenin, and the gastric cancer stem cell marker CD44 in 276 consecutive primary gastric cancers and 54 matched lymph node metastases. Loss of E-cadherin expression and aberrant expression of vimentin were significantly associated with aggressive clinicopathologic features. The expression of epithelial-mesenchymal transition-related proteins was closely related to each other in gastric cancer. The known gastric cancer stem cell maker, CD44, was significantly associated with the protein expression of Snail-1, ZEB-1, and E-cadherin (P < .05). Univariate survival analysis was performed for the 6 proteins included in this study to find the best combination for predicting patient outcome. Protein expression of Snail-1, vimentin, E-cadherin, and CD44 resulted in the lowest P value using the Kaplan-Meier method (P < .001). This combination of proteins was significantly associated with advanced pT stage, lymph node metastasis, vascular invasion, and undifferentiated histologic type in a high-risk group (P < .001) and predicted disease-free survival independent of pTNM stage and histologic differentiation (P = .029). However, the acquired mesenchymal phenotype of gastric cancer cells at the primary site was restored to an epithelial phenotype in lymph node metastases. A combination of epithelial-mesenchymal transition and stem cell-like phenotypes is an important predictor of aggressive biologic behavior and has an independent prognostic value in predicting outcomes of primary gastric cancer.     

Effects of the source of social comparison information on former cancer patients' quality of life

Objective. Life, following curative treatment, can be a struggle for former cancer patients. In this phase of their illness, social comparison information may help to improve a patient's quality of life (QOL). The objective of this study was to determine whether the effects of this information depend on the following two variables: (1) the individual's physical health and (2) the individual's sensitivity to social comparison. Design. In the current study, the effects on a patient's QOL were tested that occur when they are listening to a psychological oncological expert talking about cancer patients' experiences. Three different recorded interviews with experts were compared (on negative emotions, effective coping, or both), and individual differences were tested as moderators. In addition, the expert source conditions were compared with a condition in which the source was not an expert but a former patient. Methods. In a randomized field experiment, 154 Dutch former cancer patients (M(age) = 55 years; 68% women) were assigned to one of the four conditions (three expert source and one former patient source condition). QOL was assessed after 2 months. Results. The effects of the expert source conditions on QOL depended on the participants' physical health (good vs. poor) and on the participants' sensitivity to social comparison (whether the recipient reacts with contrast or identification), as indicated by significant three-way interactions (p < .001). Depending on these two variables, one of the three expert source conditions was at least as effective as the former patient source condition. Conclusions. The results show that desired and undesired effects are found when individual differences relevant to the processing of intervention information are examined. STATEMENT OF CONTRIBUTION: WHAT IS ALREADY KNOWN ON THIS SUBJECT??: It is known that social comparison processes are important determinants of emotions and QoL. In addition, research has shown that QoL in (former) cancer patients is lowered and interventions are needed. WHAT DOES THIS STUDY ADD??: This study showed that the application of social comparison as a method to increase QoL in cancer patients can be beneficial: It showed that applying the auditory channel, in which the expert source becomes more prominent, is effective. In addition, the study illustrates that psycho-social interventions can have side-effects; a phenomenon that has hardly been addressed in the literature and in practice.     

Target personality characteristics and self-disclosure: An exploratory study

This study investigated the influence of target personality characteristics on self-disclosure. Using the Bem Q-Sort Technique, the subjects (71 male and 73 female undergraduate students) described the personality of the person to whom they disclose the most and the personality of the person to whom they disclose the least, as well as their own personality. Factor analysis revealed that there were several personality types to whom people disclose the most and the least. The various types are described and discussed. Results supported the hypothesis that both males and females prefer disclosing to individuals who are perceived as similar to themselves in personality. This finding has important implications for the therapeutic relationship with regard to matching therapist and client.