Addressing the psychosocial needs of cancer patients: a retrospective analysis of a distress screening and management protocol in clinical care

Background: A growing recognition of the impact of distress on the quality of life and adherence to treatment of cancer patients has been documented. As a result, national guidelines and standards of care mandate providers to implement distress screening protocols to connect patients with psychosocial services. However, limited literature has examined whether distressed patients are referred to care and their needs addressed. This article assessed differences in rates of referral and psychosocial services by demographic factors, clinical characteristics, and distress severity. Potential predictors of these two outcomes were investigated.

Methods: A retrospective analysis of patient data abstracted from electronic medical records of a NCI-designated Academic Comprehensive Cancer Center was conducted. Of the 399 cases meeting the inclusion criteria, 302 (75.7%) were screened for distress with the Distress Thermometer. Differences were examined with chi-square, t-tests, and ANOVAs. Predictors were identified with multivariate logistic regressions.

Results: Overall, patients who were identified as distressed were referred to a psychosocial provider (71.4%) and psychosocial services were delivered in approximately 64% of the cases. Referrals and service delivery rates varied by age group, clinic, health insurance coverage, distress severity, and presence of psychosocial issues. Only the distress score predicted the likelihood of being referred, and of a provider intervention to occur.

Conclusions and implications for psychosocial providers: Although the protocol appeared to facilitate referral and service delivery to patients scoring above the cutoff for distress, our results suggest that patients were more likely to not have their distress and psychosocial needs addressed if they were older, without insurance coverage, and were seen in clinics where a social worker was not consistently available. Future studies able to monitor patient outcomes in terms of quality of life, satisfaction with care, and service utilization are recommended.     

Psychological well-being and metacognition in the fourth age: an explorative study in an Italian oldest old sample

Objectives: The research largely aimed at exploring the impact of marital status, cognitive efficiency, gender, physical health and sociocultural context on self-rated emotional competence, depression, memory and cognitive measures.Method: Ninety-four healthy adults aged 75–99 were recruited in the Sardinian province of Ogliastra, where a collectivistic culture prevails, and in northern Italy, which in turn is characterized by the prevalence of individualistic cultural traits. Participants were administered self-referent metacognitive efficiency, subjective wellness and depression measures.Results: Sardinian elders self-rated lower levels of depression and cognitive failures and had greater levels of emotional competence.Conclusions: Perceived psychological well-being, metacognitive efficiency and depression seem to be affected by sociocultural context.     

The Pioneering Work of Enrico Morselli (1852–1929) in Light of Modern Scientific Research on Hypnosis and Suggestion

This article examines research on hypnosis and suggestion, starting with the nineteenth-century model proposed by Enrico Morselli (1852–1929), an illustrious Italian psychiatrist and psychologist. The authors conducted an original psychophysiological analysis of hypnosis, distancing the work from the neuropathological concept of the time and proposing a model based on a naturalistic approach to investigating mental processes. The issues investigated by Morselli, including the definition of hypnosis and analysis of specific mental processes such as attention and memory, are reviewed in light of modern research. From the view of modern neuroscientific concepts, some problems that originated in the nineteenth century still appear to be present and pose still-open questions.     

A foetal tile from an archaeological site: anthropological investigation of human remains recovered in a medieval cemetery in Northern Italy

Background: The recovery of foetal remains is very sporadic in archaeology, especially due the scarce degree of bone mineralisation. This paper presents the singular archaeological discovery of a foetal tile preserving the bone remains, object of our anthropological examination.

Materials and methods: The foetal tile was discovered during an archaeological excavation in a medieval site (Northern Italy). The tile was analysed by CT scan and later, human remains were anthropologically examined.

Results: The archaeological investigation revealed a special ritual destined to foetuses while forensic anthropological analysis allowed estimating the gestational age near to 21–24?weeks.     

Effect of Probiotic Supplement on Cytokine Levels in HIV-Infected Individuals: A Preliminary Study

Inflammation persists in patients infected with HIV. Reduction of inflammatory cytokines and microbial translocation might be one way that this could be managed. Purpose: The anti-inflammatory properties of certain probiotic strains prompted us to investigate whether a probiotic could reduce the inflammatory index of HIV-infected patients. Methods: The study involved 30 HIV+ males on antiretroviral therapy, who were given one bottle of fermented milk Yakult Light^® containing Lactobacillus casei Shirota (LcS) twice a day for four weeks. Results: The probiotic LcS was associated with an increase of T lymphocytes and a significant increase of CD56+ cells (p = 0.04). There was also a significant decrease of mRNA levels of TGFβ, IL-10 and IL-12 (p < 0.001) and IL-1β expression (p < 0.001) and an increase of serum IL-23 (p = 0.03). In addition, decreased inflammation and cardiovascular risk were observed, as shown by a reduction of cystatin C (p < 0.001). Conclusions: These data provide preliminary evidence that probiotic supplementation may modulate certain immunological parameters and some of the cytokines that were analyzed. Thus, we propose that LcS may be an inexpensive and practical strategy to support the immune function of HIV+ patients.