Self evaluation of communication experiences after laryngeal cancer – A longitudinal questionnaire study in patients with laryngeal cancer

<p>Abstract</p> <p>Background</p> <p>Aim of this longitudinal study was to investigate the sensitivity to change of the Swedish Self Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (the S-SECEL), addressing communication dysfunction in patients treated for laryngeal cancer. Previous studies have highlighted the need for more specific questionnaires for this purpose.</p> <p>Methods</p> <p>100 patients with Tis-T4 laryngeal cancer were included prior to treatment onset. Patients answered four questionnaires at six occasions during one year; the S-SECEL, the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Core Questionnaire (QLQ-C30) supplemented by the Head and Neck cancer module (QLQ-H&N35) and the Hospital Anxiety and Depression (HAD) scale. In addition, performance status was assessed. Differences within groups were tested with the Wilcoxon paired signed ranks test and between-group analyses were carried out using the Mann-Whitney <it>U </it>test. Magnitude of group differences was analyzed by means of effect sizes.</p> <p>Results</p> <p>The S-SECEL was well accepted with a response rate of 76%. Communication dysfunction increased at 1 month, followed by a continuous decrease throughout the year. Changes were statistically significant at most measurement, demonstrating the sensitivity of the S-SECEL to changes in communication over time. The S-SECEL and the EORTC QLQ-C30 with the QLQ-H&N35 demonstrated similar results; however the S-SECEL was more sensitive regarding communication dysfunction. The largest changes were found in the most diagnose specific items concerning voice and speech.</p> <p>Conclusion</p> <p>The S-SECEL was investigated in the largest Scandinavian longitudinal study concerning health-related quality of life (HRQL) in laryngeal cancer patients. The questionnaire was responsive to change and showed convergent results when compared to established HRQL questionnaires. Our findings also indicate that the S-SECEL could be a more suitable instrument than the EORTC QLQ-C30 with QLQ-H&N35 when measuring communication experiences in patients with laryngeal cancer; it is more sensitive, shorter and can be used on an individual basis. As a routine screening instrument the S-SECEL could be a valuable tool for identifying patients at risk for psychosocial problems and to help plan rehabilitation. It is therefore recommended for clinical use in evaluation of communication dysfunction for all patients with laryngeal cancer irrespective of treatment.</p

Predisposição ao uso e abuso de álcool entre estudantes de graduação em enfermagem da UFRN La predisposición al uso y abuso de alcohol entre estudiantes de graduación en enfermería de la UFRN Predisposition to the use and abuse of alcohol among students of graduation in nursing of UFRN

Estudo de natureza exploratória descritiva com abordagem quantitativa, avaliou a predisposição para o uso e abuso do álcool na Graduação em Enfermagem/UFRN. A amostra foi composta por 42 alunos regularmente matriculados, sendo 76% do gênero feminino. Utilizou-se o questionário CAGE acrescido de itens sobre a síndrome da abstinência alcoólica. Metade (50%) faz uso de álcool, com idade entre 21 e 22 anos (41%). O maior consumo está no quinto período (38%), seguido do terceiro (19%). Dentre os pesquisados, 34% sentem-se fisicamente mal após beberem, 33% tropeçam, cambaleiam e trançam as pernas, e 33% sentem calor e suam. No que se refere aos sintomas mentais e emocionais, 50% referiram lentidão do raciocínio, 25% sensações estranhas e assustadoras quando bebem, e 25%, perda da memória. Conclui-se que há predisposição para o uso e abuso do álcool, e uma tendência ao alcoolismo feminino.<br>El estudio de naturaleza exploratoria descriptiva con el acercamiento cuantitativo, evalu�� la predisposición para el uso y abuso del alcoholen la Graduación en enfermería /UFRN. La muestra estaba regularmente compuesta por 42 estudiantes se enrollados, mientras siendo 76% del género femenino. La CAGE investigación se usó agregada de artículos enel síndrome de la abstinencia alcohólica. Medio (50%) hace uso de alcohol, con la edad entre 21 a 22 años (41%). El consumo más grande está en el quinto período (38%), siguiendo por la tercera período (19%) entre los investigó, 34% se sentían males físicamente después de haber bebido, 33% viaje, oscilación y trenza las piernas, y 33% se sentían calientes y sudor. En lo que se refiere a los síntomas mentales y emocionales, 50% se refirieron lentitud del razonamiento, 25% sensaciones extrañas y aterradoras cuando ellos beben, y 25% pérdida de la memoria. Se acabó que hay predisposición para el uso y abuso del alcohol, y una tendencia al alcoholismo femenino.<br>Study of descriptive exploratory nature with quantitative approach, evaluated the predisposition for the use and abuse of the alcohol in the Graduation in Nursing/UFRN. The sample was composed by 42 students regularly enrolled, being 76% of the feminine gender. The CAGE questionnaire was used added of items on the syndrome of the alcoholic abstinence. Half (50%) makes use of alcohol, with age among 21 to 22 years (41%). The largest consumption is in the fifth period (38%), following by the third period (19%) among researched them, 34% felt bad physically after having drunk, 33% trip, sway and braid the legs, and33% felt hot and sweat. In what refers to the mental and emotional symptoms, 50% referred slowness of the reasoning, 25% strange and frightening sensations when they drink, and 25% loss of the memory. It was ended that there is predisposition for the use and abuse of the alcohol and a tendency to the feminine alcoholism

Serotonin Modulates Sensitivity to Reward and Negative Feedback in a Probabilistic Reversal Learning Task in Rats

International audienceDepressed patients show cognitive deficits that may depend on an abnormal reaction to positive and negative feedback. The precise neurochemical mechanisms responsible for such cognitive abnormalities have not yet been clearly characterized, although serotoninergic dysfunction is frequently associated with depression. In three experiments described here, we investigated the effects of different manipulations of central serotonin (5-HT) levels in rats performing a probabilistic reversal learning task which measures response to feedback. Increasing or decreasing 5-HT tone differentially affected behavioral indices of cognitive flexibility (reversals completed), reward sensitivity (win-stay) and reaction to negative feedback (lose-shift). A single low dose of the selective serotonin reuptake inhibitor (SSRI) citalopram (1 mg/kg) resulted in fewer reversals completed and increased lose-shift behavior. By contrast, a single higher dose of citalopram (10 mg/kg) exerted the opposite effect on both measures. Repeated (5 mg/kg, daily, seven days) and sub-chronic (10 mg/kg, i.b.d., five days) administration of citalopram increased the number of reversals completed by the animals and increased the frequency of win-stay behavior, while global 5-HT depletion had the opposite effect on both indices. These results show that boosting 5-HT neurotransmission decreases negative feedback sensitivity and increases reward (positive feedback) sensitivity, while reducing it has the opposite effect. However, these effects depend on the nature of the manipulation used: acute manipulations of the 5-HT system modulate negative feedback sensitivity, while long-lasting treatments specifically affect reward sensitivity. The results parallel some of the findings in humans on effects of 5-HT manipulations and are relevant to hypotheses of altered response to feedback in depression

Activation of serotonin neurons promotes active persistence in a probabilistic foraging task

Serotonin (5-HT) has been suggested to promote waiting through behavioral inhibition. Here, the authors use an active foraging task and optogenetic activation of 5-HT neurons to show that rather than passivity, these neurons enhance persistence in the face of delay

Serotonergic modulation of prefrontal cortex during negative feedback in probabilistic reversal learning.

This study used functional magnetic resonance imaging to examine the effects of acute tryptophan (TRP) depletion (ATD), a well-recognized method for inducing transient cerebral serotonin depletion, on brain activity during probabilistic reversal learning. Twelve healthy male volunteers received a TRP-depleting drink or a balanced amino-acid drink ( placebo) in a double-blind crossover design. At 5 h after drink ingestion, subjects were scanned while performing a probabilistic reversal learning task and while viewing a flashing checkerboard. The probabilistic reversal learning task enabled the separate examination of the effects of ATD on behavioral reversal following negative feedback and negative feedback per se that was not followed by behavioral adaptation. Consistent with previous findings, behavioral reversal was accompanied by significant signal change in the right ventrolateral prefrontal cortex (PFC) and the dorsomedial prefrontal cortex. ATD enhanced reversal-related signal change in the dorsomedial PFC, but did not modulate the ventrolateral PFC response. The ATD-induced signal change in the dorsomedial PFC during behavioral reversal learning extended to trials where subjects received negative feedback but did not change their behavior. These data suggest that ATD affects reversal learning and the processing of aversive signals by modulation of the dorsomedial PFC

Acute tryptophan depletion in healthy volunteers enhances punishment prediction but does not affect reward prediction.

Contains fulltext : 69537.pdf (publisher's version ) (Closed access)Central serotonin (5-HT) has been implicated in emotional and behavioral control processes for many decades, but its precise contribution is not well understood. We used the acute tryptophan depletion procedure in young healthy volunteers to test the hypothesis that central 5-HT is critical for predicting punishment. An observational reversal-learning task was employed that provided separate measures of punishment and reward prediction. Under baseline, subjects made more prediction errors for punishment-associated stimuli than for reward-associated stimuli. This bias was abolished after central 5-HT depletion, which enhanced the ability to predict punishment while not affecting reward prediction. The selective potentiation of punishment prediction concurs with recent theorizing, suggesting that central 5-HT carries a prediction error for future punishment, but not for future reward (Daw et al, 2002). Furthermore, the finding highlights the importance of central 5-HT in resilience to adversity and may have implications for a variety of neuropsychiatric disorders including depression and anxiety