The interplay between partners’ responsiveness and patients’ need for emotional expression in couples coping with cancer

The central aim of this longitudinal observational study was to test whether patients with a high need for emotional expression are especially sensitive to their partners’ responsive behavior, and therefore at risk for depressive symptoms when responsiveness is withheld. Patients with colorectal cancer and their partners (n = 58) participated in a longitudinal study (3, 5 and 9 months after the diagnosis). Additionally to self-report measurements (i.e., patients’ need for emotional expression, patients’ depressive symptoms and patients’ relationship satisfaction) couples were videotaped discussing cancer-related concerns. External observers coded partners’ responsiveness (i.e., understanding, validation and caring) and patients’ self-disclosures. Partner responsiveness predicted lower levels of depressive symptoms over time in patients who had a relatively high need for emotional expression above and beyond the effect of relationship satisfaction. We demonstrated that partners’ understanding and validation are more important in explaining patients’ depressive symptoms than partners’ caring behavior. Our findings highlight the importance of the relational context in improving adaptation to cancer taking into account individual differences.     

The closer ‘We’ are,the stronger ‘I’ am: the impact of couple identity on cancer coping self-efficacy

The present study tested the supposition that greater levels of couple identity (or we-ness) increase a woman’s coping self-efficacy in relation to breast cancer, which, in turn, predicts better psychosocial adjustment. Women (N = 112) in committed relationships completed surveys assessing their levels of couple identity, cancer coping self-efficacy, and aspects of their psychosocial adjustment (specifically, depression, anxiety and functional well-being) during one of their outpatient visits to the cancer centre. As predicted, the more women identified with their relationships, the lower their levels of depression and anxiety were and the greater their functional well-being was. This relationship was mediated by coping self-efficacy: greater identification with one’s relationship predicted greater confidence in one’s ability to cope, which, in turn, predicted better adjustment. The role intimate relationships play in women’s adjustment to breast cancer, as well as directions for further research, are discussed.     

‘You have a swelling’: The language of cancer diagnosis and implications for cancer management in Kenya

ObjectiveTo examine the ramifications of language as a vehicle of communication in the Kenyan healthcare system.Methods(1) A review of literature search on language access and health care in Kenya, using Scopus, Web of Science, Ebscohost, ProQuest and Google Scholar electronic databases. (2) Two illustrative case studies from a Nairobi based qualitative research project on family cancer caregivers’ experiences.ResultsEvidence from the case studies shows that language barriers may hinder understanding of cancer diagnoses and consequently, the nature of interventions sought by family members as informal caregivers of cancer patients.ConclusionFindings demonstrate the significance of language in understanding cancer diagnosis as a basis for treatment seeking behaviour and specifically in light of the critical role played by informal caregivers in under resourced health care contexts.Practice implications(1) The assumption that English and Swahili are adequate in communication in Kenyan health care contexts ought to be reviewed. (2) Further research and assessment of language needs as a basis for training of language interpreters in the Kenyan health care system is a necessity.     

Is the mouse a good model for the human with respect to the development of the preimplantation embryo in vitro?

A comparison has been made of various aspects of preimplantation development of mouse and human embryos in vitro. Changes in substrate utilization follow similar patterns in both species. This similarity in metabolic parameters between the two species has facilitated the use of the mouse as a model to study the formulation of culture media to be used at different stages over the preimplantation period from fertilization to the fully expanded blastocyst stage. It has also prescribed the mouse embryo as a practical tool for quality control testing of the laboratory system in human in-vitro fertilization. Aspects of the physiology of both species that require further study are the physiological levels of endogenous inorganic phosphate in the female reproductive tract, the requirement for inorganic phosphate in culture medium, the specificity of the amino acid requirements for optimal development before and after compaction and the importance of including EDTA in culture medium.     

Failure to disrupt the ‘sensorimotor’ memory for lifting objects with a precision grip

When repetitively lifting an object with mechanical properties that vary from lift-to-lift, the fingertip forces for gripping and lifting are influenced strongly by the previous lift, revealing a ‘sensorimotor’ memory. Two recent reports indicate that the sensorimotor memory for grip force is easily disrupted by an unrelated task like a strong pinch or vibration, even when the lift was performed with the hand contralateral to the vibration or preceding pinch. These findings indicate that this memory may reflect sensory input or muscle contraction levels, rather than object properties or the specific task of gripping and lifting. Here we report that the predictive scaling of lift force was not disrupted by conditioning tasks that featured exerting a vertical isometric force with the upper extremity. When subjects lifted a 2 N object repetitively the peak lift force rate was 26.4 N/s. The lift force rate increased to 36.1 N/s when the 2 N object was lifted (regardless of hand) after lifting the 8 N object with the right hand, which reveals the expected ‘sensorimotor’ memory. The lift force rate did not increase (24.8 vs. 26.4 N/s for the control condition) when a bout of isometric exertion (9.8 N) in the vertical direction with the distal right forearm preceded lifts of the 2 N object. This finding was confirmed with another isometric task designed to more closely mimic lifting an object with a precision grip. This difference in the sensitivity of grip versus lift force to a preceding isometric contraction indicates that separate sensorimotor memories contribute to the predictive scaling of the commands for gripping and lifting an object.     

Parent’s with incurable cancer: ‘Nuts and bolts’ of how professionals can support parents to communicate with their dependent children

ObjectiveParents with incurable cancer are often uncertain how, what and when is best to tell their children about their poor prognosis and prepare them for the actual death. Despite parents' desire and need for support from health and social care professionals (HSCPs), this is often lacking. HSCPs feel ill-equipped, identifying a need for an evidence-based communication framework for professionals to use in practice, promoting parent-child communication at end of life.MethodsA systematic process, involving a systematic review and data from 76 semi-structured, face-to-face qualitative interviews from three participant populations, including HSCPs (n = 32), bereaved parents (n = 21) and funeral directors (n = 23) were triangulated. This informed the development of the ‘Talking, Telling and Sharing’: End of life framework (6 W Grid), guided by an expert group.ResultsAn evidence-based, theory-driven communication framework has been developed. This provides a mechanism for HSCPs to proactively and directly engage with patients, addressing their parent-child communication concerns.ConclusionClear, evidence-based communication frameworks can enhance patient-provider communication in practice, particularly around sensitive and complex issue.Practice implicationsThere is a need for HSCPs to encourage parents to start these difficult conversations soon after receiving the poor prognosis, to avoid crisis management when the ill-parent is actively dying or throughout the immediate bereavement period.     

Crystal structure of a polypeptide’s C-terminus in complex with the regulatory domain of ER aminopeptidase 1

Endoplasmic reticulum aminopeptidase 1 (ERAP1) is involved in the final processing of peptide precursors to generate the N-termini of MHC class I-restricted epitopes. ERAP1 thus influences immunodominance and cytotoxic immune responses by controlling the peptide repertoire available for cell surface presentation by MHC molecules. To enable this critical role in antigen processing, ERAP1 trims peptides by a unique molecular ruler mechanism that turns on/off hydrolysis activity in a peptide-length and −sequence dependent manner. Thus unlike other aminopeptidases, ERAP1 could recognize both the N- and C-termini of peptides in order to read the substrate’s length. To exemplify and validate this molecular ruler mechanism, we have carried out crystallographic studies on molecular recognition of antigenic peptide’s C-terminus by ERAP1. In this report, we have determined a 2.8 Å-resolution crystal structure of an intermolecular complex between the ERAP1 regulatory domain and a natural epitope’s C-terminus displayed in a fusion protein. It reveals the structural details of peptide’s C-termini recognition by ERAP1. ERAP1 uses specificity pockets on the regulatory domain to bind the peptide’s carboxyl end and side chain of the C-terminal anchoring residue. At the same time, flexibility in length and sequence at the middle of peptides is accommodated by a kink with minimal interactions with ERAP1.     

The Moral Career of ‘Outmates’: Towards a History of Manufactured Mental Disorders in Post-Socialist?China

This study focuses on ‘manufactured mentally ill’ (bei jingshenbing, 被精神病) individuals in post-socialist China. In Chinese society, bei jingshenbing is a neologistic catchphrase that refers to someone who has been misidentified as exhibiting symptoms of mental illness and has been admitted to a mental hospital. Specifically, it refers to those individuals who were subjected to unnecessary psychiatric treatment during the first decade of the twenty-first century. Based on archival analysis and ethnographic fieldwork, this study addresses the ways in which the voices of bei jingshenbing victims and those who support them reveal China’s experiences with psychiatric modernity. It also discusses the active role of these individuals in knowledge production, medical policymaking, and the implications for reforming the psychiatric and mental health systems in post-socialist China.     

Effect of an ‘implementation intention’ intervention on adherence to oral anti-diabetic medication in Brazilians with type 2 diabetes

ObjectiveTo evaluate the effects of an implementation intention intervention on adherence to an oral anti-diabetic medication regime, diabetes-related distress and on glycemic control in patients with type 2 diabetes mellitus.MethodsA randomized, parallel-group, single-center controlled trial was conducted among adults with type 2 diabetes being managed at the primary care level. The intervention group (IG, n = 45) received an ‘implementation intention’ intervention; the control group (CG, n = 45) received standard care. Primary outcomes were the taking of oral anti-diabetic medication, global adherence and level of glycated hemoglobin. The secondary outcome was diabetes-related distress. Data were gathered at baseline and after 15 weeks.ResultsThe IG showed improvements in adherence to an oral anti-diabetic medication regime (p < 0.0001), glycemic control (p < 0.0001) and diabetes-related distress (p < 0.0001) relative to the CG.ConclusionsThe implementation intention intervention enhanced adherence to an oral anti-diabetic medication regime, which had positive effects on blood glucose levels and diabetes-related distress.Practice implicationsAdherence to an oral anti-diabetic medication regime can decrease blood glucose levels and diabetes-related distress and thus reduce complications of type 2 diabetes.     

The ‘6K1’ protein of a strain of Soybean mosaic virus localizes to the cell periphery

Summary The ‘6K1’ protein of the Pinellia isolate of Soybean mosaic virus was cloned into a prokaryotic expression vector and a polyclonal antiserum raised to the expressed fusion protein. In immunogold labeling of thin sections of infected leaves of Pinellia ternata, specific labeling occurred at the cell periphery. This might suggest that the potyvirus ‘6K1’ protein plays some role in viral cell-to-cell movement but the lack of transmembrane domains suggests that it does not conform to currently-recognized patterns of viral movement proteins.