The main trends in a complex program of rehabilitation of children with oncological diseases

The present-day therapeutical programmes allow physicians to cure as many as 70% of children with malignant neoplasms, in some tumor forms, the proportion of recovered children is much higher, which shows it urgent to elaborate comprehensive rehabilitation programmes required for the effective integration of prior patients of children's cancer clinics into a group. The paper presents a complex rehabilitation programme worked out at the Research Institute of Pediatric Oncology and Hematology, Russian Cancer Research Center, Russian Academy of Medical Sciences. The basic directions of the programme are medical, psychological, pedagogical, and social rehabilitation. For medical rehabilitation, phytotherapy, medical laser, climate therapy, and therapeutical exercises are widely used. Of particular value are physical and recreational activities, which include the use of therapeutical exercises, active recreational activities, participation in sporting events, and conditioning swimming. Psychological and pedagogical rehabilitation is aimed at solving personality and familial problems, at developing intellectual abilities, and at eliminating steady-state bad habits and behavioral deviations. A psychological and pedagogical programme is based on the work of art-therapeutical shops where a child realizes his/her strivings, which promotes the recovery of his/her mental and social status. The work of psychologists and psychotherapeutists with children's parents occupies a highly important place since correction of child-parent relations serves as a necessary basis for mental recovery in a child. The most important factor of social rehabilitation is an educational programme aimed at acquiring knowledge and at stimulating cognitive activities. To implement the comprehensive programme increases life quality in children who have sustained cancer diseases, improves their social adaptation and thus facilitates integration of these children in society.     

Psychiatric aspects of cancer

The authors review the psychiatric symptoms that may precede, accompany, and follow the onset of cancer. Difficulty in expressing anxiety, depression, or anger and low scores on these parameters in psychological testing along with depression and feelings of hopelessness are linked with the emergence of malignant tumors. Cancers of the brain, pancreas, and other endocrine organs, and hormone-secreting tumors frequently develop following the appearance of psychiatric symptoms. The psychological adjustment of cancer patients and the more common psychiatric sequelae of malignancy and its treatment are examined. The authors emphasize the need for careful assessment and attention to the biologic, psychological, and social factors critical to the patient's response and adjustment to the disease.     

Predictors of psychological distress in carers of people with amyotrophic lateral sclerosis: a longitudinal study

BACKGROUND: The majority of people providing informal care for people with amyotrophic lateral sclerosis (ALS) are spouses. This prospective study set out to examine changes in and predictors of psychological distress in spouse carers of people with ALS. METHOD: Fifty spouse carers of people with ALS underwent an initial interview and at least 21 underwent two further interviews, at median intervals of approximately 5-6 months. They rated the functional impact of their partner's ALS on everyday activities and everyday cognitive, emotional and behavioural changes that might have occurred in the person with ALS. They also rated their own social support and marital relationship, and completed measures of mood, burden and strain. The ALS Severity Scale was also completed for their partner with ALS. RESULTS: Over time, carers' psychological distress (a global measure combining mood, burden and strain) increased significantly. Initially carers' psychological distress was best predicted by the psychosocial impact of their spouse/partners' ALS, the extent to which their partner demonstrated emotional lability and how many other people were considered as dependents of the carer. Subsequently, carer distress was best predicted by an initial measure of negative social support and by their initial satisfaction with their social relationships. CONCLUSIONS: Despite the significant physical impairment associated with ALS, psychosocial factors appear important in determining short- and longer-term psychological well-being in carers of people with ALS and may help clinicians to predict which carers are likely to experience psychological difficulties as part of their caring role.     

Malignancy in AIDS: institutional management or home care?

In India, the first sero-positive person was reported from Chennai in 1986 and the first case of AIDS from Mumbai 1987. Since then the epidemic is growing steadily and WHO/UNAIDS estimate that by the year 2000 AD India has around 3-5 million people suffering from HIV/AIDS and this is the largest burden of HIV in single country. Over 40% of all patients with HIV infection will develop malignant disease at sometime during their course of illness. AIDS and malignancy together constitute a deadly combination. The authors recommend that the care of patients having malignancy with AIDS should be mainly at home rather than in an oncology center. This will ensure the patient's and family's comfort as most of the specialized cancer centers in India are at a considerable distance away from patient's homes. Frequent visit to a cancer center will exhaust the patient and attendants emotionally, physically and financially. This is especially true because irrespective of the pains taken by the family and the specialists, a cure is an unlikely possibility. Only one specialist from oncology and one primary health physician, who are completely aware of the patient's physical, psychological, financial and social background, should be responsible for the care of a patient having malignancy with AIDS in India. The main advantages of the home care of such patients are: patient's and family's comfort; lesser mental, physical, social, emotional and financial agony; and minimum need for institutional care, which may be instituted as and when necessary.     

肿瘤患者的心理社会因素与免疫功能的测定

目的：探讨肿瘤病人的心理社会因素与免疫功能的相关性。方法：用病例对照和多因素统计分析方法，对37例肿瘤病人和37例非肿瘤病人进行了心理社会因素调查并检测其免疫功能，分析其间的相互关系。结果：肿瘤病人与非肿瘤病人相比免疫功能明显减退，主要表现为IgM、CD16^ 水平的减少（P＜0．01），肿瘤病人的IgM、CD3^ 与负性生活事件、社会支持、抑郁情绪等因素相关。结论：肿瘤病人的免疫功能低下主要表现在IgM，CD16^ 水平的减少。负性生活事件、社会支持、情绪抑郁等心理社会因素对肿瘤病人的免疫功能影响较大。     

Psychological distress and work and home roles: a focus on socio-economic differences in distress

BACKGROUND: Home and work factors have been linked to psychological status, but less is known about their contribution to social inequalities in psychological status. We examine whether social inequalities in psychological distress can be explained by work-home factors and whether the impact of these potential explanatory factors is similar for men and women. METHODS: Data are from the 1958 British birth cohort study. We sought to explain social class differences in psychological distress at age 33. Explanatory factors were classified as work-home roles: i.e. employment, marital status, domestic responsibility, children and elderly care; and work-home characteristics: i.e. job-strain, insecurity, unsocial working hours, youngest child's age, number of children and level of involvement in childcare. RESULTS: A social gradient in psychological distress was found: odds ratios for classes IV and V v. I and II were 2.65 (men) and 3.02 (women). Work factors had consistently stronger associations with psychological distress and with social class among men than women. Work factors had a greater impact on class differences in psychological distress in men. Associations for home roles and characteristics were less consistent and their combined effect on class differences in distress was negligible for both sexes. CONCLUSION: Explanations for the social gradient differ for men and women. Work may be more important for men than women, but the impact of home factors was not strong during the early adulthood of this cohort.     

Adult testicular granulosa cell tumor: a review of the literature for clinicopathologic predictors of malignancy

Adult testicular granulosa cell tumors are rare sex cord-stromal tumors of which only 28 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. To date, there are no clinical or pathologic features that definitively predict malignancy. We reviewed all prior case reports for features that may predict their malignant potential. Tumor size greater than 5.0 cm is the only feature statistically associated with malignancy. Mitotic count, tumor necrosis, patient age, and the presence of gynecomastia do not, at present, predict benign versus malignant behavior.     

Social problem‐solving abilities and distress among family members assuming a caregiving role

We examined the relation of social problem‐solving abilities to distress experienced by family members assuming a caregiving role for a loved one who had recently incurred a severe physical disability. Family members completed measures of problem‐solving, depression and health, while their loved one participated in an inpatient rehabilitation programme. Correlational analyses indicated that a negative problem orientation was significantly predictive of caregiver distress, regardless of the degree of physical impairment of the care recipient. Women reported more distress on several measures than men, and disability severity was also associated with depression and impaired social functioning. Family members with a greater negative orientation may be at risk to develop psychological and health problems upon assuming a caregiver role. These results are discussed in light of theoretical models of social problem‐solving, and implications are presented for psychological interventions and for health policy concerning family caregivers and their care recipients.     

HHLA2 在恶性肿瘤中的研究进展

近年来,随着对肿瘤发病机制的深入研究,免疫治疗已取得突破性进展,以程序性死亡分子1(PD-1) / 程序性死亡分子配体1(PD-L1)为代表的Pembrolizumab 和Nivolumab 等药物已被批准用于临床。而人内源性逆转录病毒-H 长末端重复关联蛋白2 (HHLA2)与PD-L1 均为B7 家族成员,具有同源性,在多种实体恶性肿瘤中均呈高表达,极有可能成为继PD-L1 后的又一重要免疫检查和治疗靶点。现就HHLA2 在恶性肿瘤中的研究进展做一综述。     

Work and sense of coherence--resources for competence and life satisfaction

This longitudinal study investigated which job factors and personal resources contribute to self-assessed competence and life satisfaction. The effects of preemployment social conditions and personality, as assessed in adolescence, on competence and life satisfaction in adulthood were studied in 345 women and 361 men who had participated in a 1961 to 1963 psychological examination. Persons with high life satisfaction and competence had favorable work conditions and more personal resources and social support. Their coping strategies were primarily problem focused, whereas those with less sense of well-being were emotion focused. Persons of low competence who were satisfied with their lives had social support from others, cooperation, and prestige at work, but their income was low. The quality of home care, sports participation, and self-esteem in youth predicted competence in adulthood. The quality of home care, intelligence, cultural activities, and self-esteem in adolescence predicted adult life satisfaction.     

Ultrastructural and Immunohistochemical Features of Common Lung Tumors: An Overview

Lung cancer is rapidly becoming the most commonly diagnosed malignant neoplasm in the world. Pathologists play a key role in the care of patients with lung cancer by accurately classifying and staging these neoplasms. Immunohistochemistry and electron microscopy have become important tools in the diagnosis of lung tumors, especially those which are histologically undifferentiated. This review discusses the ultrastructural and immunohistochemical features of common lung tumors, with an emphasis on their diagnostic usefulness.     

Secure attachment partners attenuate neural responses to social exclusion: An fMRI investigation

Research has shown that social exclusion has devastating psychological, physiological, and behavioral consequences. However, little is known about possible ways to shield individuals from the detrimental effects of social exclusion. The present study, in which participants were excluded during a ball-tossing game, examined whether (reminders of) secure attachment relationships could attenuate neurophysiological pain- and stress-related responses to social exclusion. Social exclusion was associated with activation in brain areas implicated in the regulation and experience of social distress, including areas in the lateral and medial prefrontal cortex, ventral anterior cingulate cortex, and hypothalamus. However, less activation in these areas was found to the extent that participants felt more securely attached to their attachment figure. Moreover, the psychological presence (i.e., salience) of an attachment figure attenuated hypothalamus activation during episodes of social exclusion, thereby providing insight into the neural mechanisms by which attachment relationships may help in coping with social stress.     

A Palliative Approach for Rehabilitation of a Pediatric Patient with Retinoblastoma

Retinoblastoma is a highly malignant neoplasm. Most of the cases are usually far advanced at the time of detection, requiring enucleation to salvage the child''s life. However, the cosmetic rehabilitation of these patients should always be an integral part of their treatment, which helps in their re-integration in the society. This paper presents a case of 5-year-old patient who had undergone enucleation of her left eye due to retinoblastoma. A multidisciplinary approach, including ophthalmologist, psychotherapist, and a prosthodontist, was adopted to meet her physical, psychological, functional, emotional, social, and cosmetic demands. The patient was rehabilitated cosmetically with precisely fabricated ocular prosthesis. An ocular prosthesis is a highly positive and non-invasive approach to improve the cosmetic appearance and psychological well-being of patient.     

History of psycho-oncology: overcoming attitudinal and conceptual barriers

The formal beginnings of psycho-oncology date to the mid-1970s, when the stigma making the word "cancer" unspeakable was diminished to the point that the diagnosis could be revealed and the feelings of patients about their illness could be explored for the first time. However, a second stigma has contributed to the late development of interest in the psychological dimensions of cancer: negative attitudes attached to mental illness and psychological problems, even in the context of medical illness. It is important to understand these historical underpinnings because they continue to color contemporary attitudes and beliefs about cancer and its psychiatric comorbidity and psychosocial problems. Over the last quarter of the past century, psycho-oncology became a subspecialty of oncology with its own body of knowledge contributing to cancer care. In the new millennium, a significant base of literature, training programs, and a broad research agenda have evolved with applications at all points on the cancer continuum: behavioral research in changing lifestyle and habits to reduce cancer risk; study of behaviors and attitudes to ensure early detection; study of psychological issues related to genetic risk and testing; symptom control (anxiety, depression, delirium, pain, and fatigue) during active treatment; management of psychological sequelae in cancer survivors; and management of the psychological aspects of palliative and end-of-life care. Links between psychological and physiological domains of relevance to cancer risk and survival are being actively explored through psychoneuroimmunology. Research in these areas will occupy the research agenda for the first quarter of the new century. At the start of the third millennium, psycho-oncology has come of age as one of the youngest subspecialties of oncology, as one of the most clearly defined subspecialties of consultation-liaison psychiatry, and as an example of the value of a broad multidisciplinary application of the behavioral and social sciences.     

Mediating effects of social support on firefighters' sense of community and perceptions of care

This study examined the relationship between psychological sense of community, social‐support networks, and care‐giver stress and satisfaction among firefighters. No significant gender differences were obtained, but zero‐order correlates demonstrated significant relationships among all four variables. In examining the mediating effects of social‐support satisfaction, partial mediation for psychological sense of community on care‐giver satisfaction was determined, as well as full mediation for psychological sense of community on care‐giver stress. Therefore, firefighters who are satisfied with the support they receive may experience less stress with their care giving than those who experience low levels of support satisfaction. Future studies should assess these relationships more extensively in other areas of civic responsibility among public‐service employees to delineate effective support avenues. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 121–126, 2004.     

Evidence-based interventions for survivors of childhood cancer and their families

OBJECTIVE: To summarize existing empirical reports of psychological interventions for children with cancer and their families and to outline directions for future work. METHODS: Research accomplishments related to four areas were summarized: understanding and reducing procedural pain; realizing long-term consequences; appreciating distress at diagnosis and over time; and knowing the importance of social relationships. Recommendations for future research in this field were discussed in three domains: balancing competence and psychopathology; integrating research-based interventions into clinical care; future directions). RESULTS AND CONCLUSIONS: Interventions related to procedural pain and distress have strong empirical support. Although most survivors of childhood cancer and their families adjust quite well as they complete treatment, evidence-based interventions during and after treatment that address cancer-specific sequelae represent important growing areas of work. In the future, the development of interventions to address emerging survivorship issues will be vital, and theoretically grounded, evidence-based pragmatic interventions will be necessary.     

Coping with cancer. A personal odyssey

Building on personal experience, the psychological impact of cancer is reviewed. The subspecialty of psycho-oncology is a recent development within oncology, reflecting the increased interest in behavioral, psychological, and social factors in cancer prevention, treatment, and in improving the quality of life of patients with cancer at all stages through counseling and educational programs. Early identification of patients who are coping poorly is important for compliance with treatment and control of distress. It is equally important to recognize and diagnose common psychological disorders, primarily anxiety and depressive symptoms, which can occur. Referral for counseling to a mental health professional familiar with the care of patients with cancer may be indicated. My successful confrontation with cancer led to emotional growth. For those who cannot be sanguine about their experience, there may still be ways to reduce its, at times, devastating psychological impact. Hopefully, the days in which cancer patients had to suffer alone, in secrecy, and in fearful silence, are disappearing.     

脑肿瘤干细胞的研究现状

背景：在脑肿瘤中存在一种具有自我更新、无限增殖与多向分化能力的细胞,即脑肿瘤干细胞。脑肿瘤干细胞被认为是脑肿瘤发生、发展、转移与复发的根源。 目的：总结和探讨脑肿瘤干细胞的研究现状。 方法：以“脑肿瘤、脑肿瘤干细胞”为检索词,应该计算机检索Pubmed 数据库1977-01/2011-07的相关文章,并查阅与干细胞及脑肿瘤干细胞实验有关的书籍,对资料进行初审,选取符合要求的有关文章共32 篇。 结果与结论：在恶性脑肿瘤中存在脑肿瘤干细胞。脑肿瘤干细胞是恶性脑肿瘤发生、发展、转移及复发的根源,其表达特异性的CD133、Nestin蛋白和ABC转运体。目前已经获得了分离脑肿瘤干细胞的简便方法。CD133阳性的肿瘤干细胞所占的比例与脑肿瘤的恶性程度呈正相关,可作为预后诊断指标之一。      

Relationship of Stereotypic Beliefs About Physicians to Health Care-Relevant Behaviors and Cognitions Among African American Women

A great deal of basic social psychological research has demonstrated that stereotypes affect judgments, behaviors, and decisions with respect to individual group members. However, almost no research has applied social psychological theories of stereotypes to understanding health behavior. The purpose of the present study was to examine the relationship between stereotypic beliefs about physicians and health care-relevant behaviors and cognitions. Fifty-nine African American women were recruited from community venues to complete self-report, anonymous questionnaires measuring beliefs about physicians and health care utilization, satisfaction, and intentions. Participants who perceived physicians positively overall, and as competent and warm, reported greater health care utilization and higher satisfaction with their current health care, controlling for perceived general health status. These results suggest that interpersonal social cognitive expectancies play a role in health care-related behaviors and cognitions.