scholarly journals Fear of Prognosis? How Anxiety, Coping, and Expected Burden Impact the Decision to Have Cytogenetic Assessment in Uveal Melanoma Patients

2021 ◽  
Author(s):  
Johannes Gollrad ◽  
Nevenka Korpusik ◽  
Christopher Rabsahl ◽  
Dirk Boehmer ◽  
Angela Besserer ◽  
...  
Keyword(s):  
Decision Making ◽  
Coping Strategies ◽  
Uveal Melanoma ◽  
Intervention Strategy ◽  
Individual Risk ◽  
Prognostic Information ◽  
Brief Cope ◽  
Dismal Prognosis ◽  
Cytogenetic Testing ◽  
Melanoma Patients

Abstract BackgroundCytogenetic testing (CGT) in uveal melanoma patients reveals prognostic information about the individual risk of developing distant metastasis with dismal prognosis. There is currently no medical intervention strategy with proven effect on the prognosis, rendering the result of the cytogenetic testing purely informative. We explored patients’ socio-demographic backgrounds, psychological preconditions, coping strategies, external influences, and concerns about “knowing their fate” to study their possible interactions with decision-making for CGT.MethodsUveal melanoma patients were asked to complete questionnaires on their interest in undergoing CGT for prognostication and the factors influencing their decision. Data were collected on socio-demographics, baseline anxiety (GAD-7), depression (PHQ-9), coping strategies (Brief Cope), and assumed future concerns regarding the CGT result. Data were analyzed by using multiple ordinal logistic regression and exploring estimated marginal effects.ResultsQuestionnaires were returned by 121 of 131 (92.4%) patients. Fifty-two patients (43%) had no interest in CGT, 34 (28.1%) were undecided, and 35 (28.9%) were interested. We observed no significant differences regarding age, sex, partnership, education, occupation, baseline anxiety, or depression. Decision-making favoring CGT was influenced by the treating physicians, internet resources, and level of baseline anxiety. Patients were likely to reject CGT when they worried that “knowing the result will have an unintended influence” on their life.ConclusionDecision-making about CGT for prognostication in uveal melanoma is burdensome to many patients and in general not guided by medical advice regarding further treatment and screening procedures. The psychological impact of the decision is therefore unique and requires careful support by psycho-oncologists considering the patient’s fears and expectations.

scholarly journals KIT Expression Is Regulated by DNA Methylation in Uveal Melanoma Tumors

2021 ◽  
Vol 22 (19) ◽  
pp. 10748
Author(s):  
Viera Horvathova Kajabova ◽  
Andrea Soltysova ◽  
Lucia Demkova ◽  
Paulina Plesnikova ◽  
Darina Lyskova ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Mrna Expression ◽  
Uveal Melanoma ◽  
Chromosomal Rearrangements ◽  
Metastatic Potential ◽  
Prognostic Information ◽  
Ki 67 ◽  
Strong Negative Correlation ◽  
Dismal Prognosis ◽  
Fresh Frozen

Uveal melanoma (UM) is an ocular tumor with a dismal prognosis. Despite the availability of precise molecular and cytogenetic techniques, clinicopathologic features with limited accuracy are widely used to predict metastatic potential. In 51 UM tissues, we assessed a correlation between the expression of nine proteins evaluated by immunohistochemistry (IHC) (Melan-A, S100, HMB45, Cyclin D1, Ki-67, p53, KIT, BCL2, and AIFM1) and the presence of UM-specific chromosomal rearrangements measured by multiplex ligation-dependent probe amplification (MLPA), to find IHC markers with increased prognostic information. Furthermore, mRNA expression and DNA methylation values were extracted from the whole-genome data, achieved by analyzing 22 fresh frozen UM tissues. KIT positivity was associated with monosomy 3, increasing the risk of poor prognosis more than 17-fold (95% CI 1.53–198.69, p = 0.021). A strong negative correlation was identified between mRNA expression and DNA methylation values for 12 of 20 analyzed positions, five located in regulatory regions of the KIT gene (r = −0.658, p = 0.001; r = −0.662, p = 0.001; r = −0.816; p < 0.001; r = −0.689, p = 0.001; r = −0.809, p < 0.001, respectively). DNA methylation β values were also inversely associated with KIT protein expression (p = 0.001; p = 0.001; p = 0.015; p = 0.025; p = 0.002). Our findings, showing epigenetic deregulation of KIT expression, may contribute to understanding the past failure to therapeutically target KIT in UM.

A Person × Intervention Strategy Approach to Understanding Health Behavior

2018 ◽  
pp. 830-856
Author(s):  
Alexander J. Rothman ◽  
Austin S. Baldwin
Keyword(s):  
Social Psychology ◽  
Decision Making ◽  
Health Behavior ◽  
Intervention Strategy ◽  
Moderated Mediation ◽  
Behavior Interventions ◽  
Systematic Analysis ◽  
Mediated Moderation ◽  
Research And Practice ◽  
Health Behavior Interventions

This chapter suggests that an integration of perspectives from personality and social psychology (i.e., a Person × Intervention strategy framework) provides a rich context to explore precise specifications of the mediators and moderators that guide health behavior and decision-making. First discussed is how conceptualizations of moderated mediation and mediated moderation can enrich theory and serve to enumerate specific principles to guide the development and dissemination of more effective health behavior interventions. Second, research is reviewed from four different literatures that rely on a similar Person × Intervention strategy framework (i.e., the effectiveness of an intervention strategy depends on the degree to which it matches features of the target person) to examine evidence for the processes that mediate the effect of this moderated intervention approach. Finally described is how a more systematic analysis of the interplay between mediating and moderating processes can stimulate advances in theory, intervention research, and practice of health behavior.

scholarly journals Evaluation of the modified immune prognostic index to prognosticate outcomes in metastatic uveal melanoma patients treated with immune checkpoint inhibitors

2021 ◽  
Vol 10 (8) ◽  
pp. 2618-2626
Author(s):  
Michael S. Sander ◽  
Igor Stukalin ◽  
Isabelle A. Vallerand ◽  
Siddhartha Goutam ◽  
Benjamin W. Ewanchuk ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Prognostic Index ◽  
Melanoma Patients

scholarly journals Psychological distress and coping styles in teachers: A preliminary study

2020 ◽  
Vol 64 (2) ◽  
pp. 127-146 ◽  
Author(s):  
Peta Stapleton ◽  
Sarah Garby ◽  
Debbie Sabot
Keyword(s):  
Psychological Distress ◽  
Coping Strategies ◽  
Psychological Health ◽  
Online Survey ◽  
Satisfaction With Life ◽  
Clinical Symptoms ◽  
Coping Styles ◽  
Satisfaction With Life Scale ◽  
Empirical Measures ◽  
Brief Cope

Teaching professionals report higher levels of work-related stress and symptoms of psychological health problems than the general population. This study examined psychological distress, coping styles and wellbeing in 166 Australian teachers (aged 22–65 years; M =  37.74 years, SD =  10.84 years). Participants completed an online survey comprising demographic items and four empirical measures (The Satisfaction with Life Scale, Subjective Happiness Scale, The Brief COPE Inventory and The Patient Health Questionnaire). Work, workload and finances were identified as leading sources of stress. Moreover, above-average clinical symptoms of anxiety, depression and physical concerns were reported, and 17% of respondents met criteria for probable alcohol dependence. Results suggested that maladaptive coping strategies employed by teachers may contribute to their risk of increased psychological distress, and decreased life satisfaction and happiness. These findings indicate the need for work-based programmes to enhance teachers’ coping strategies in an effort to reduce psychological distress and improve overall wellbeing in teaching professionals.

Cutaneous dysplastic naevi in uveal melanoma patients: markers for prognosis?

2000 ◽  
Vol 10 (1) ◽  
pp. 36-39 ◽  
Author(s):  
E. Tóth-Molnár ◽  
H. Hammer ◽  
J. Oláh
Keyword(s):  
Uveal Melanoma ◽  
Melanoma Patients

scholarly journals Intratumor Heterogeneity in Uveal Melanoma BAP-1 Expression

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1143
Author(s):  
Gustav Stålhammar ◽  
Hans E. Grossniklaus
Keyword(s):  
Gene Expression ◽  
Uveal Melanoma ◽  
Tumor Size ◽  
Hot Spots ◽  
Malignant Tumors ◽  
Intratumor Heterogeneity ◽  
Prognostic Information ◽  
Size Category ◽  
Cold Spots ◽  
Metastatic Risk

Malignant tumors are rarely homogenous on the morphological, genome, transcriptome or proteome level. In this study, we investigate the intratumor heterogeneity of BAP-1 expression in uveal melanoma with digital image analysis of 40 tumors. The proportion of BAP-1 positive cells was measured in full tumor sections, hot spots, cold spots and in scleral margins. The mean difference between hot spots and cold spots was 41 percentage points (pp, SD 29). Tumors with gene expression class 1 (associated with low metastatic risk) and 2 (high metastatic risk) had similar intratumor heterogeneity. Similarly, the level of intratumor heterogeneity was comparable in tumors from patients that later developed metastases as in patients that did not. BAP-1 measured in any tumor region added significant prognostic information to both American Joint Committee on Cancer (AJCC) tumor size category (p ≤ 0.001) and gene expression class (p ≤ 0.04). We conclude that there is substantial intratumor heterogeneity in uveal melanoma BAP-1 expression. However, it is of limited prognostic importance. Regardless of region, analysis of BAP-1 expression adds significant prognostic information beyond tumor size and gene expression class.

Coping strategies among medical professionals during COVID-19 outbreak

2021 ◽  
Vol 4 (01) ◽  
pp. 28-33
Author(s):  
Vaishali Shanmugam
Keyword(s):  
Coping Strategies ◽  
Online Survey ◽  
Coping Styles ◽  
Well Being ◽  
Sociodemographic Factors ◽  
Medical Professionals ◽  
Stressful Situation ◽  
Sociodemographic Variables ◽  
Factors Affecting ◽  
Brief Cope

BACKGROUND: COVID -19 pandemic is a very stressful situation for doctors, who face the risk of infection in daily life. Coping is the process by which a person deals with stressful situations or demands. Identifying the coping strategies of our medical professionals will help us to understand their coping styles and to deliver effective interventions to enhance their mental well-being. METHODS: An online survey form with socio-demographic profile and BRIEF COPE tool for assessing different coping strategies was sent to interns, residents, and teaching faculty. The coping strategies were divided into emotion-based, problem-based, and dysfunctional coping, and spearman's correlation was done to determine any correlation between sociodemographic variables and the coping strategies. RESULTS: A total of 84 valid and complete responses were included in the study. There is a variable distribution of mean scores for problem-focused, emotion-focused, and dysfunctional strategies. Age and marital status had a positive correlation with problem-focused and emotion-focused strategies meaning that older adults and married people used these strategies predominantly. Higher designation used problem-focused coping predominantly. Dysfunctional coping strategies had no correlation with any of the sociodemographic variables. CONCLUSION: Sociodemographic factors affecting the coping mechanisms in medical professionals differ from those of the general population seen in previous studies. Within the group of medical professionals, those with higher age, higher designation and married had predominantly adaptive strategies. Interventions targetting maladaptive components of emotion-focused strategies and dysfunctional strategies should be aimed at a younger age group, unmarried people, interns, and residents among the medical professionals to better cope with this COVID scenario.

scholarly journals Biomechanical Rupture Risk Assessment

Aorta ◽  
2016 ◽  
Vol 04 (02) ◽  
pp. 42-60 ◽  
Author(s):  
T. Christian Gasser
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Validation Studies ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Patient Treatment ◽  
Maximum Diameter ◽  
Individual Risk ◽  
Rupture Risk ◽  
Aneurysm Wall

AbstractAbdominal aortic aneurysm (AAA) rupture is a local event in the aneurysm wall that naturally demands tools to assess the risk for local wall rupture. Consequently, global parameters like the maximum diameter and its expansion over time can only give very rough risk indications; therefore, they frequently fail to predict individual risk for AAA rupture. In contrast, the Biomechanical Rupture Risk Assessment (BRRA) method investigates the wall’s risk for local rupture by quantitatively integrating many known AAA rupture risk factors like female sex, large relative expansion, intraluminal thrombus-related wall weakening, and high blood pressure. The BRRA method is almost 20 years old and has progressed considerably in recent years, it can now potentially enrich the diameter indication for AAA repair. The present paper reviews the current state of the BRRA method by summarizing its key underlying concepts (i.e., geometry modeling, biomechanical simulation, and result interpretation). Specifically, the validity of the underlying model assumptions is critically disused in relation to the intended simulation objective (i.e., a clinical AAA rupture risk assessment). Next, reported clinical BRRA validation studies are summarized, and their clinical relevance is reviewed. The BRRA method is a generic, biomechanics-based approach that provides several interfaces to incorporate information from different research disciplines. As an example, the final section of this review suggests integrating growth aspects to (potentially) further improve BRRA sensitivity and specificity. Despite the fact that no prospective validation studies are reported, a significant and still growing body of validation evidence suggests integrating the BRRA method into the clinical decision-making process (i.e., enriching diameter-based decision-making in AAA patient treatment).

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