https://isiarticles.com/bundles/Article/pre/pdf/36264.pdf

Constructions of masculinity and their influence on men's well-being: a theory of gender and health.

On death and dying

We describe a protocol for disclosing unfavorable information—“breaking bad news”—to cancer patients about their illness. Straightforward and practical, the protocol meets the requirements defined by published research on this topic. The protocol (SPIKES) consists of six steps. The goal is to enable the clinician to fulfill the four most important objectives of the interview disclosing bad news: gathering information from the patient, transmitting the medical information, providing support to the patient, and eliciting the patient’s collaboration in developing a strategy or treatment plan for the future. Oncologists, oncology trainees, and medical students who have been taught the protocol have reported increased confidence in their ability to disclose unfavorable medical information to patients. Directions for continuing assessment of the protocol are suggested. The Oncologist 2000;5:302-311

/pdf/spikes-a-six-step-protocol-for-delivering-bad-news-3bcah1imyb.pdf

SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer.

https://behandelaar.pijnbijkanker.nl/sites/behandelaar.pijnbijkanker.nl/files/publicaties/van%20den%20Beuken%20et%20al.%20Prevalence%20cancer%20pain.%20Ann%20Oncol%202007.pdf

Prevalence of pain in patients with cancer: a systematic review of the past 40 years

Increasing numbers of reports concerning diabetes, ketoacidosis, hyperglycaemia and lipid dysregulation in patients treated with second-generation (or atypical) antipsychotics have raised concerns about a possible association between these metabolic effects and treatment with these medications. This comprehensive literature review considers the evidence for and against an association between glucose or lipid dysregulation and eight separate second-generation antipsychotics currently available in the US and/or Europe, specifically clozapine, olanzapine, risperi-done, quetiapine, zotepine, amisulpride, ziprasidone and aripiprazole. This review also includes an assessment of the potential contributory role of treatment-induced weight gain in conferring risk for hyperglycaemia and dyslipidaemia during treatment with different antipsychotic medications. Substantial evidence from a variety of human populations, including some recent confirmatory evidence in treated psychiatric patients, indicates that increased adiposity is associated with a variety of adverse physiological effects, including decreases in insulin sensitivity and changes in plasma glucose and lipid levels. Comparison of mean weight changes and relative percentages of patients experiencing specific levels of weight increase from controlled, randomised clinical trials indicates that weight gain liability varies significantly across the different second-generation antipsychotic agents. Clozapine and olanzapine treatment are associated with the greatest risk of clinically significant weight gain, with other agents producing relatively lower levels of risk. Risperidone, quetiapine, amisulpride and zotepine generally show low to moderate levels of mean weight gain and a modest risk of clinically significant increases in weight. Ziprasidone and aripiprazole treatment are generally associated with minimal mean weight gain and the lowest risk of more significant increases. Published studies including uncontrolled observations, large retrospective database analyses and controlled experimental studies, including randomised clinical trials, indicate that the different second-generation antipsychotics are associated with differing effects on glucose and lipid metabolism. These studies offer generally consistent evidence that clozapine and olanzapine treatment are associated with an increased risk of diabetes mellitus and dyslipidaemia. Inconsistent results, and a generally smaller effect in studies where an effect is reported, suggest limited if any increased risk for treatment-induced diabetes mellitus and dyslipidaemia during risperidone treatment, despite a comparable volume of published data. A similarly smaller and inconsistent signal suggests limited if any increased risk of diabetes or dyslipidaemia during quetiapine treatment, but this is based on less published data than is available for risperidone. The absence of retrospective database studies, and little or no relevant published data from clinical trials, makes it difficult to draw conclusions concerning risk for zotepine or amisulpride, although amisulpride appears to have less risk of treatment-emergent dyslipidaemia in comparison to olanzapine. With increasing data from clinical trials but little or no currently published data from large retrospective database analyses, there is no evidence at this time to suggest that ziprasidone and aripiprazole treatment are associated with an increase in risk for diabetes, dyslipidaemia or other adverse effects on glucose or lipid metabolism. In general, the rank order of risk observed for the second-generation antipsychotic medications suggests that the differing weight gain liability of atypical agents contributes to the differing relative risk of insulin resistance, dyslipidaemia and hyperglycaemia. This would be consistent with effects observed in nonpsychiatric samples, where risk for adverse metabolic changes tends to increase with increasing adiposity. From this perspective, a possible increase in risk would be predicted to occur in association with any treatment that produces increases in weight and adiposity. However, case reports tentatively suggest that substantial weight gain or obesity may not be a factor in up to one-quarter of cases of new-onset diabetes that occur during treatment. Pending further testing from preclinical and clinical studies, limited controlled studies support the hypothesis that clozapine and olanzapine may have a direct effect on glucose regulation independent of adiposity. The results of studies in this area are relevant to primary and secondary prevention efforts that aim to address the multiple factors that contribute to increased prevalence of type 2 diabetes mellitus and cardiovascular disease in populations that are often treated with second-generation antipsychotic medications.

Second-Generation (Atypical) Antipsychotics and Metabolic Effects: A Comprehensive Literature Review.

OBJECTIVE: In a companion article in this issue of the Journal, the authors presented data suggesting that the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is sensitive to the types of impairments observed in schizophrenia, correlates highly with standard measures of intelligence and memory, and is related to employment status in a group of patients with schizophrenia drawn from a tertiary care research center. The objectives of the current study were 1) to determine if evidence of the convergent validity of the RBANS could be replicated in a diagnostically heterogeneous sample drawn from a public mental health system, 2) to examine the relationship of the RBANS to a broad neuropsychological battery, and 3) to compare the performance of patients with schizophrenia and patients with bipolar disorder on a neuropsychological battery and the RBANS. METHOD: The RBANS and a standard neuropsychological battery, including the WAIS-III and Wechsler Memory Scale, 3rd ed. (WMS-III), wer...

https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.156.12.1951

Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia, II: convergent/discriminant validity and diagnostic group comparisons.

Increases in cancer incidence and mortality reflect the larger numbers of elderly in the population. Using a mortality sample of 1891 biopsy-confirmed cancer patients, analyses reveal older breast, prostate, and cervical-uterine cancer victims were more likely to be diagnosed with metastases. Logistic regression analyses of subsamples of breast (N = 224), lung (N = 513), and colorectal (N = 299) cancer patients indicate that age is significantly inversely related to receipt of both subsequent chemotherapy and radiation therapy, controlling for stage of disease and presence of co-morbid disease. Exceptions to this relationship are the use of radiation therapy among nonmetastatic lung cancer patients and all breast cancer patients. The implications of these findings for current cancer control programs are discussed.

Relationship between age at diagnosis and treatments received by cancer patients.

Objectives: This study assessed the effectiveness of a brief three-month critical time intervention (B-CTI) model in improving continuity of psychiatric outpatient care for individuals with serious mental illness who are discharged from inpatient psychiatric treatment facilities. Methods: A total of 135 consenting veterans who were diagnosed as having serious mental illness and were discharged from an acute inpatient unit were randomly assigned to receive either B-CTI or usual care. The three-month B-CTI intervention begins before discharge. A B-CTI clinician meets with the patient, assesses needs, and maintains a high level of patient contact after discharge. Participants completed interviews at baseline and three months later. Chart reviews provided data on service utilization in the six months postdischarge. Results: Compared with the control group, the B-CTI group had significantly fewer days between their hospital discharge and their first outpatient service. B-CTI participants were more likely to have had an outpatient visit and to have had more total mental health and substance abuse visits within 30 and 180 days of discharge. They had greater continuity of care as evidenced by a greater number of two-month blocks with two or more outpatient visits over 180 days. Participants in the B-CTI group reported receiving more help in making and keeping medical and mental health appointments, making family contact and community connections, and receiving information on prescribed medications. Conclusions: This study provides evidence that a B-CTI targeted at the point of inpatient discharge can be helpful in promoting postdischarge continuity of care for persons with serious mental illness. The limited association of improved continuity of care with patient outcomes in this brief intervention demands further study. (Psychiatric Services 60:451–458, 2009)

https://ps.psychiatryonline.org/doi/pdf/10.1176/ps.2009.60.4.451

Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization.

The effect of treatment setting and patient characteristics on pain in terminal cancer patients: A report from the national hospice study☆

Surveys estimate that 1.8 to 3.6 percent of workers in the U.S. labor force suffer from major depression. Depression has a significant impact on vocational functioning. Seventeen to 21 percent of the workforce experiences short-term disability during any given year, and 37 to 48 percent of workers with depression experience short-term disability. Studies indicate that treating workplace depression provides favorable cost offsets for employers, although a number of methodological issues have influenced the interpretation of these findings. In addition to disability costs, cost analyses need to include lost wages and indirect costs to employers, such as the costs of hiring and training new employees. In general, employers are not aware of the extent of the indirect costs of untreated depression. They have mistaken assumptions about the availability of effective treatment, and they are unaware of how often depression contributes to worker disability. The workers' compensation system and the courts have been ...

https://ps.psychiatryonline.org/doi/pdfplus/10.1176/appi.ps.52.12.1639

Richard J. Goldberg

Papers

Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia, II: convergent/discriminant validity and diagnostic group comparisons.

Relationship between age at diagnosis and treatments received by cancer patients.

Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization.

The effect of treatment setting and patient characteristics on pain in terminal cancer patients: A report from the national hospice study☆

Depression in the Workplace: Costs and Barriers to Treatment