The Wiley Handbook of Personal Construct Psychology is the definitive new reference for the field, providing a state-of-the-art review of PCP which focuses on the theory and its philosophy, ...methodology, areas of application and future horizons * A definitive new reference work for the field of personal construct psychology, featuring leading international figures in the field * Each section begins with a concise chapter that reviews the literature in the area concerned and highlights new developments * Covers theory, history, methodology and a wealth of new and established applications including education, grief and meaning reconstruction, sexuality, organizational consultancy and personal construct coaching * Draws on published and previously unpublished work by pioneers including Fay Fransella and Miller Mair
Endometrial cancer (EC) in young women of reproductive age is a relatively rare diagnosis. However, since in the modern era women delay their childbearing for a variety of social reasons, more and ...more women in the near future will be nulliparous and have a diagnosis of EC at the same time. Hence, a more conservative approach of EC is desirable to preserve fertility of these women, without compromising their survival. Recently, the number of studies reporting encouraging results on fertility-sparing management of EC with high dose of progestins is increasing. It seems that preserving the uterus and the ovaries in a carefully selected patient with EC confers only a very small risk combined with an enormous benefit. Selection of women suitable for such a conservative approach, as well as method of treatment, follow-up, recurrence, obstetric outcomes, and survival rates are very important parameters when consulting women with EC wishing to preserve their fertility. In this article, we try to elucidate all the previously mentioned aspects and formulate clinical recommendations, based on published data, about the most proper approach and consultation of these patients.
Abstract Advanced ovarian cancer has a poor prognosis. De-bulking surgery and platinum-based chemotherapy are the cornerstones of the treatment. Primary debulking surgery has been the standard of ...care in advanced ovarian cancer. Recently a new strategy with neoadjuvant chemotherapy followed by interval debulking surgery has been developed. In a recently published randomised trial of the EORTC-NCIC (European Organisation for Research and Treatment of Cancer – National Cancer Institute Canada) in patients with extensive stage IIIc and IV ovarian cancer it was shown that the survival was similar for patients randomised to neoadjuvant chemotherapy followed by interval debulking compared to primary debulking surgery, followed by chemotherapy. The post-operative complications and mortality rates were lower after interval debulking than after primary debulking surgery. The most important independent prognostic factor for overall survival was no residual tumour after primary or interval debulking surgery. In some patients obtaining the goal of no residual tumour at interval debulking is difficult due to chemotherapy-induced fibrosis. On the other hand the patients randomised had very extensive stage IIIc and IV disease and in patients with métastases smaller than 5 cm the survival tended to be better after primary debulking surgery. Hence, selection of the correct patients with stage IIIc or IV ovarian cancer for primary debulking or neoadjuvant chemotherapy followed by interval debulking surgery is important. Besides imaging with CT, diffusion MRI and/or PET-CT, also la-paroscopy can play an important role in the selection of patients. It should be emphasised that the group of patients included in this study had extensive stage IIIc or IV disease. Surgical skills, especially in the upper abdomen, remain pivotal in the treatment of advanced ovarian cancer. However, very aggressive surgery should be tailored according to the general condition and extent of the disease of the patients. Otherwise, this type of aggressive surgery will result in unnecessary postoperative morbidity and mortality without improving survival. Hence, neoadjuvant chemotherapy should not be an easy way out, but is in some patients with stage IIIc or IV ovarian cancer a better alternative treatment option than primary debulking. According to the current treatment algorithm at the University Hospitals Leuven about 50% of the patients with stage IIIc or IV ovarian cancer are selected for neoadjuvant chemotherapy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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Patient engagement in pediatric concussion research Reed, Nick, PhD MScOT; Leeder, Kathy, BA; Zemek, Roger, MD
Canadian Medical Association journal (CMAJ),
11/2018, Volume:
190, Issue:
Suppl
Journal Article
Peer reviewed
Open access
Concussion is a brain injury that affects hundreds of thousands of Canadian children and youth annually, along with their families. Visit rates for concussion have quadrupled since 2003, with nearly ...30,000 doctor visits for pediatric concussion per year in Ontario alone. Concussion can result in symptoms across four common domains: physical, cognitive, emotional and sleep. These symptoms can affect quality of life and result in short- and long-term functional deficits. Here, Reed et al examine whether early reintroduction of noncontact and low-risk physical activity beginning 72 hours postinjury, reduces postconcussion symptoms at two weeks postinjury compared with the traditional "rest until asymptomatic" protocol.
Objective: A driving simulator study was conducted in order to assess the relative utility of unimodal auditory, unimodal vibrotactile, and combined audiotactile (i.e., multisensory) in-car warning ...signals to alert and inform drivers of likely front-to-rear-end collision events in a situation modeled on real-world driving. Background: The implementation of nonvisual in-car warning signals may have important safety implications in lessening any visual overload during driving. Multisensory integration can provide synergistic facilitation effects. Method: The participants drove along a rural road in a car-following scenario in either the presence or absence of a radio program in the background. The brake light signals of the lead vehicle were also unpredictably either enabled or disabled on a trial-by-trial basis. Results: The results showed that the participants initiated their braking responses significantly more rapidly following the presentation of audiotactile warning signals than following the presentation of either unimodal auditory or unimodal vibrotactile warning signals. Conclusion: Multisensory warning signals offer a particularly effective means of capturing driver attention in demanding situations such as driving. Application: The potential value of such multisensory in-car warning signals is explained with reference to recent cognitive neuroscience research.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
This article describes the impact on the learners and health care institution of the OnTRACK-Concussion program, an innovative student-led clinic at a children’s rehabilitation hospital. The clinic, ...developed and operated by occupational therapists, serves the community full-time year-round. Interprofessional health care learners work together to provide education and intervention for youth with concussion and their families and to support research and community outreach initiatives. To determine the program’s impact on student learning, a post-placement questionnaire was used to capture feedback about their clinical education experience. To determine the program impact more broadly, the most significant change method was used to analyze data from in-depth qualitative interviews with stakeholders across and beyond the organization. Three Program Impact Pathways were identified that support the program’s success within and beyond the organization: 1) Having a clear message/vision of integration; 2) Enabling learners to work directly with patients; and 3) Enabling learners to work autonomously. Debriefing with peers and clinical supervisors was identified as an important learning experience by interprofessional learners. This student-led clinic, developed and operationalized by occupational therapists, supports the integration of patient care, research, and clinical education in pediatric concussion through clearly identified Program Impact Pathways.
We reviewed the literature on interventions that aimed to improve hospital-to-school reintegration for children and youth with acquired brain injury (ABI). ABI is the leading cause of disability ...among children and youth. A successful hospital-to-school reintegration process is essential to the rehabilitative process. However, little is known about the effective components of of such interventions.
Our research team conducted a systematic review, completing comprehensive searches of seven databases and selected reference lists for relevant articles published in a peer-reviewed journal between 1989 and June 2014. We selected articles for inclusion that report on studies involving: a clinical population with ABI; sample had an average age of 20 years or younger; an intentional structured intervention affecting hospital-to-school transitions or related components; an experimental design; and a statistically evaluated health outcome. Two independent reviewers applied our inclusion criteria, extracted data, and rated study quality. A meta-analysis was not feasible due to the heterogeneity of the studies reported. Of the 6933 articles identified in our initial search, 17 articles (reporting on 350 preadolescents and adolescents, aged 4-19, (average age 11.5 years, SD: 2.21) met our inclusion criteria. They reported on interventions varying in number of sessions (one to 119) and session length (20 minutes to 4 hours). The majority of interventions involved multiple one-to-one sessions conducted by a trained clinician or educator, homework activities, and parental involvement. The interventions were delivered through different settings and media, including hospitals, schools, and online. Although outcomes varied (with effect sizes ranging from small to large), 14 of the articles reported at least one significant improvement in cognitive, social, psychological, or behavioral functioning or knowledge of ABI.
Cognitive, behavioral, and problem-solving interventions have the potential to improve school reintegration for youth with ABI. However, more comprehensive interventions are needed to help link rehabilitation clinicians, educators, adolescents, and families.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study was designed to investigate the possibility that driver responses to potential front-to-rear-end collision situations could be facilitated by implementing vibrotactile warning signals that ...indicate the likely direction of the potential collision. In a car following scenario in a driving simulator, participants drove along a rural road while trying to maintain a safe headway distance to the lead car using a visual distance display. Participants had to respond as quickly as possible to the sudden deceleration of the lead car which had its brake lights disabled, either with or without vibrotactile cues (presented in different experimental blocks). The results demonstrated significantly faster braking responses and larger safety margins when the vibrotactile warning signal was presented than when it was not. These findings demonstrate the effectiveness of vibrotactile cues in helping drivers to orient their spatial attention in the appropriate direction. Our results add to a growing body of empirical evidence highlighting the potential benefits of using “intuitive” vibrotactile in-car displays, in this case, to alert drivers to potential collisions and to provide time-critical directional information.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
In young patients with borderline ovarian tumor a conservative treatment approach does not seem to have a significant impact on survival, and the outcome regarding fertility is good in general. It ...can be considered even if noninvasive peritoneal implants are discovered at the time of the initial surgery. In contrast, in patients with epithelial ovarian cancer, conservative surgery should be considered only in adequately staged patients, with a stage IA grade 1 (and probably 2) serous, mucinous or an endometrioid tumor, including a careful follow-up. Such an approach could also probably be discussed in stage IC grade 1 disease.In patients with nonepithelial malignant ovarian tumors, conservative surgery is also feasible, particularly in patients with malignant germ cell tumors because of their high chemosensitivity leading to an excellent prognosis in general.
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