David Spiegel

Bio: David Spiegel is an academic researcher from Stanford University. The author has contributed to research in topics: Medicine & Breast cancer. The author has an hindex of 106, co-authored 733 publications receiving 46276 citations. Previous affiliations of David Spiegel include Tel Aviv University & University of Adelaide.

Reduced emotional control as a mediator of decreasing distress among breast cancer patients in group therapy

Abstract: There is evidence that emotional distress and its management may be related to cancer incidence and progression. In turn, the diagnosis and treatment of cancer inevitably elicits a range of emotions, including anxiety, fear, sadness, and anger. Management of such emotions constitutes an understandable problem for cancer patients, and provides a therapeutic opportunity. Here we examine cancer as a stressor and review the design of Supportive–Expressive group psychotherapy as a means of helping cancer patients confront existential concerns and express emotions related to them. We review evidence that suppression of emotion is associated with greater distress among cancer patients. This suggests that a psychotherapy designed to encourage emotional expression should reduce distress. This is what has been observed in several randomized trials of Supportive–Expressive Group Psychotherapy.

Real effects of real child sexual abuse

Abstract: Editor's Note: In 1998, the Psychological Bulletin -a peer-reviewed journal of the American Psychological Association (APA)-published an article entitled \"A Meta-Analytic Examination of Assumed Properties of Child Sexual Abuse Using College Samples,\" One of the conclusions of the article was that sexual relationships between adults and children may be much less harmful to children than generally believed. In an unprecedented action, the Congress of the United States, and later the APA itself, condemned the article. In consideration of the importance of these events, the editors of SexualiO' & Culture invited the authors of the original article (Drs. Rind, Tromovitch, and Bauserman), as well as several other authors, to discuss the merits and pitfalls of that article. This mini-forum was published in the Spring 2000 issue (Volume 4, Number 2). One of the authors, Dr. Spiegel, presented methodological objections to the original study, to which the authors were allowed to reply. Dr. Spiegel's reply to their reply appears here.

Atypical scoliosis in a 14-year-old girl.

Abstract: An asymptomatic 14-year-old girl presented for the evaluation of scoliosis. There was no family history of a spinal deformity. On physical examination, she had right thoracic curvature with a mild trunk shift to the right. She was noticeably lordotic in the thoracic region. Her neurologic examination was normal, including the presence of symmetric abdominal reflexes. Based on an atypical curve (Fig 1), magnetic resonance imaging (MRI) was ordered (Figs 2–4). Laboratory studies all were normal, including a complete blood count with a manual differential, an erythrocyte sedimentation rate, serum electrolytes, a urinary homovanillic acid, and a urinary vanillylmandelic acid. Based on the history, physical findings, laboratory tests, and imaging studies, what is the differential diagnosis? From the *Shriners Hospitals for Children/Twin Cities, and the St. Paul Children’s Hospital, Minneapolis, MN. Each of the authors certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent arrangements, etc.) that might pose a conflict of interest in with the submitted article. Each author certifies that his institution has approved reporting of this case and that all investigations were conducted in conformity with ethical principles of research. Correspondence to: David A. Spiegel, MD, Division of Orthopaedic Surgery, Children’s Hospital of Philadelphia, 2 Floor Wood Building, 34 Street and Civic Center Blvd., Philadelphia, PA 19104. Phone: 215-590-1527; E-mail: spiegeld@email.chop.edu. DOI: 10.1097/01.blo.0000203486.98335.ff CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number 447, pp. 270–276 © 2006 Lippincott Williams & Wilkins

Therapy for Stage IV Non–Small-Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2022.2

Abstract: Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating provider and do not account for individual variation among patients. See Appendix 1 (online only) for disclaimers and other important information. Updates are published regularly and can be found at https://ascopubs.org/nsclc-da-living-guideline.

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

Abstract: 抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being

Abstract: Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced selfawareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress. Many philosophical, spiritual, and psychological traditions emphasize the importance of the quality of consciousness for the maintenance and enhancement of well-being (Wilber, 2000). Despite this, it is easy to overlook the importance of consciousness in human well-being because almost everyone exercises its primary capacities, that is, attention and awareness. Indeed, the relation between qualities of consciousness and well-being has received little empirical attention. One attribute of consciousness that has been much-discussed in relation to well-being is mindfulness. The concept of mindfulness has roots in Buddhist and other contemplative traditions where conscious attention and awareness are actively cultivated. It is most commonly defined as the state of being attentive to and aware of what is taking place in the present. For example, Nyanaponika Thera (1972) called mindfulness “the clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception” (p. 5). Hanh (1976) similarly defined mindfulness as “keeping one’s consciousness alive to the present reality” (p. 11). Recent research has shown that the enhancement of mindfulness through training facilitates a variety of well-being outcomes (e.g., Kabat-Zinn, 1990). To date, however, there has been little work examining this attribute as a naturally occurring characteristic. Recognizing that most everyone has the capacity to attend and to be aware, we nonetheless assume (a) that individuals differ in their propensity or willingness to be aware and to sustain attention to what is occurring in the present and (b) that this mindful capacity varies within persons, because it can be sharpened or dulled by a variety of factors. The intent of the present research is to reliably identify these inter- and intrapersonal variations in mindfulness, establish their relations to other relevant psychological constructs, and demonstrate their importance to a variety of forms of psychological well-being.

Standards of Medical Care in Diabetes

Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.