In cognitive radio (CR) networks, identifying the available spectrum resource through spectrum sensing, deciding on the optimal sensing and transmission times, and coordinating with the other users ...for spectrum access are the important functions of the medium access control (MAC) protocols. In this survey, the characteristic features, advantages, and the limiting factors of the existing CR MAC protocols are thoroughly investigated for both infrastructure-based and ad hoc networks. First, an overview of the spectrum sensing is given, as it ensures that the channel access does not result in interference to the licensed users of the spectrum. Next, a detailed classification of the MAC protocols is presented while considering the infrastructure support, integration of spectrum sensing functionalities, the need for time synchronization, and the number of radio transceivers. The main challenges and future research directions are presented, while highlighting the close coupling of the MAC protocol design with the other layers of the protocol stack.
Cancer patients are a population at high risk of contracting COVID-19 and, also of developing severe complications due to the infection, which is especially true when they are undergoing ...immunosuppressive treatment. Despite this, they had still to go to hospital to receive chemotherapy during lockdown. In this context, we have evaluated the psychological status of onco-hematological outpatients receiving infusion and not deferrable anti-neoplastic treatment for lymphoproliferative neoplasms, with the aim of both measuring the levels of post-traumatic symptoms, depression, and anxiety during the pandemic and also of investigating the perception of risk of potential nosocomial infection. The Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS) were administered to all patients. Moreover, patients were investigated about their worries regarding the impact of COVID-19 on their lives as onco-hematologic patients. Since the 2nd to the 29th April 2020 (during the first phase of the lockdown period in Italy), 77 outpatients were prospectively evaluated. They were diagnosed with non-Hodgkin's lymphoma, classical Hodgkin lymphoma, and Chronic lymphocytic leukemia/Small lymphocytic lymphoma. The mean age was 56.6 (range 22-85). We found that 36% of patients had anxiety (HADS-A), 31% depression (HADS-D), and 43% were above the cut-off for the HADS-General Scale; 36% fulfilled the diagnostic criteria for post-traumatic stress disorder (PTSD). Women and younger patients were found to be more vulnerable to anxiety and PTSD. The study firstly analyzes the psychological impact of the COVID-19 pandemic on the frail population of patients affected by lymphoproliferative neoplasms, to underly the importance of screening patients for emotional and distress conditions and then offering them psychological support.
Goals of work
Advanced colorectal cancer (CRC) has recently been treated with monoclonal antibodies, such as cetuximab. Skin toxicity is a peculiar side effect of cetuximab that may induce patients ...to interrupt therapy if it becomes serious. This study investigates the psychological and social sequelae of skin rash.
Materials and methods
Patients affected by advanced CRC and treated with cetuximab-based therapy entered the trial. The following questionnaires were used: the Functional Assessment of Cancer Therapy—Colorectal (FACT-C) to measure quality of life (QoL) and the Psychological Distress Inventory (PDI). A single item regarding social avoidance was added with a three-point Likert scale. Toxicity was assessed using the National Cancer Institute Criteria (NCI-2).
Main results
Eighty patients were recruited; 41% presented psychological distress. As regards social avoidance, 53% of patients answered that they did not avoid going out at all. The rest of the sample answered that they “very much” (22%) or “somewhat” (25%) avoided going out. Psychological distress and social avoidance were not correlated to skin rash, but only to QoL.
Conclusion
Skin rash was not found to impact patients' psychological status or social life. Two likely explanations for this finding were that (a) patients with advanced cancer consider skin rash as a part of the complex suffering caused by cancer and (b) patients are encouraged by oncologists to continue treatment because skin rash is indicative of response to therapy. This expectation brings hope and helps patients bear the drug-related side effects.
Cognitive radio (CR) technology enables the opportunistic use of the portions of the licensed spectrum by the CR users, while ensuring low interference to the primary user (PU) activity in the ...licensed bands. The spectrum is sensed locally by the CR users, and a specific channel that is acceptable to both the end nodes of the communication link is chosen. However, this necessitates a common control channel (CCC) for exchanging the sensing information and reserving the channel before actual data transfer. In this paper, a common control channel design for CR ad hoc networks is proposed, called as adaptive multiple rendezvous control channel (AMRCC) based on frequency hopping. Our scheme is scalable, and allows continuous connectivity between the CR users under dynamic PU activity. The contribution made in this paper is threefold: (i) a frequency hopping scheme is proposed that allows altering the hopping sequence based on the PU activity in the channels, (ii) a simple and low-overhead procedure is developed to aid new node-join and leave events, and (iii) a slot duration optimization is given that avoids a significant performance degradation with the number of available channels. Performance evaluation proves that our solution achieves better performance than the other classic CCC solutions in terms of time to rendezvous (TTR) and the resulting throughput, specifically in CR ad hoc networks.
Purpose
Cancer patients often suffer for psychological distress, which can compromise their quality of life. Our study aimed to recognize risk classes for the development of psychosocial distress.
...Methods
Three hundred seventy-two adult cancer patients were assessed by the Distress Thermometer (DT) and Problem List at the National Cancer Research Centre “Giovanni Paolo II” of Bari. We also compiled a socio-medical and clinical-medical record survey ad hoc for collecting socio-demographic information and clinical variables. To examine the interplay among the different variables and distinguish internally homogeneous subgroups of patients with diverse risks of distress, the RECursive Partitioning and Amalgamation (RECPAM) technique was used.
Results
Most of patients were female and the most frequent diagnosis was breast cancer, followed by gastro-intestinal cancer and hematological cancer. Distress was present in 43% of the sample, with a total of 156 patients with a DT > 5. The RECPAM analysis identified three distinct and homogeneous patient subgroups (RECPAM classes) with different risks of distress: diagnosis, marital status, and Eastern Cooperative Oncology Group Performance Status.
Conclusion
The use of the distress thermometer allows clinicians to identify patients with certain characteristics that may increase the risk of developing psychosocial distress. This evaluation can allow timely psychological intervention and improve the patient’s therapeutic program.
Purpose
Cancer survivors often report posttraumatic growth (PTG). The aims of this study were to assess the presence of PTG in Italian long-term disease-free cancer survivors (LCS) and to explore the ...association between the dimensions of PTG and clinical, demographic variables, various agents of perceived social support and psychological distress.
Methods
Five hundred forty LCS were assessed with Posttraumatic Growth Inventory (PTGI), Multidimensional Scale of Perceived Social Support (MSPSS), Zung Self-Rating Depression Scale, and State-Trait Anxiety Inventory-Y (STAI-Y).
Results
Mean age was 57.08 years, mean survival was 11.04 years (range 5–32), and the most common cancer diagnosis was breast cancer (56.9%). The PTGI average total score was higher in more educated LCS, in those employed, in LCS with longer time from diagnosis, and in those with no comorbidities. In this study, PTG was not found correlated with distress, but it correlated with perceived social support, age, education, and employment.
Conclusions
The absence of a correlation between PTG and psychological distress and the low levels of PTG found let us question the importance of talking about PTG when working as psychotherapists with LCS. It may be suggested that the need of finding benefit and PTG in LCS has been overcome by other experiences or worries happened after the cancer, and LCS may not focus anymore on positive changes occurred. The relevance of work and of perceived social support as linked to PTG stresses the need to protect the LCS’s relationship with work and to promote and sustain their social network, and this can help them to experience sharing and closeness to others.
Hospitalization for breast surgery is a distressing experience for women. This study investigated the impact of music therapy (MT), an integrative approach that is characterized by the ...establishment of a therapeutic relationship between patients and a certified music therapist, through different musical interventions targeted to the specific needs of the patients. The impact of two different MT experiences was compared on anxiety and distressing emotions.
Methods
One hundred fifty-one patients during hospitalization for breast surgery were randomly assigned to two music therapy treatment arms: individual/receptive (MTri) vs. group/active-receptive integrated (MTiGrp). Stress, depression, anger, and need for help were measured with the emotion thermometers (ET) and State Trait Anxiety Inventory Y-1 form (STAY-Y1). Data were collected before and after the MT intervention.
Results
Both types of MT interventions were effective in reducing all the variables: stress, depression, anger, and anxiety (
T
Student
p
‹0.01). Patients’ perception of help received was correlated with a significant reduction in anxiety and distressing emotions during hospitalization for breast surgery.
Conclusion
Considerations regarding the implementation of MT interventions in clinical practice are discussed. In individual receptive MT, there was a significant decrease in anxiety levels, whereas in the integrated MT group, there was a higher perception of help received and use of inter-individual resources.
The present study is the first multidimensional evaluation of fatigue, depression and quality of life in long-term breast cancer survivors (BCS) carried out in Italy. The finding of a worse health ...related quality of life contrasts with other previous studies which showed that, overall, BCS are comparable to or even better than the healthy controls.
The spiritual dimension is important in the process of coping with stress and may be of special relevance for those caring for cancer patients in the various phases of caregivership, although current ...attention is most prevalent at the end of life. This study explores the associations among spiritual well-being (SWB), caregiver burden, and quality of life (QoL) in family caregivers of patients with cancer during the course of the disease.
This is a cross-sectional study. All participants (n = 199) underwent the following self-report questionnaires: the SWB-Index, the Medical Outcomes Study Short Form, and the Caregiver Burden Inventory (CBI). SWB scores were dichotomized at a cutoff corresponding to the 75th percentile. Statistical analyses were made using the Student t or by chi-square test to compare high and low SWB groups.ResultThe high SWB group reported significantly better Medical Outcomes Study Short Form scores in bodily pain (p = 0.035), vitality (p < 0.001), social activities (p = 0.001), mental health (p < 0.001), and in standardized mental component subscales (p < 0.001) than the low SWB group. No significant differences were detected between the two SWB groups in physical activity, physical role, general health, emotional status, and standardized physical component scale. The high SWB group also had better CBI scores in the physical (p = 0.049) and developmental burden (p = 0.053) subscales. There were no significant differences in the other CBI scores (overall and sections).Significance of resultsThis study points out that high SWB caregivers have a more positive QoL and burden. Knowledge of these associations calls for more attention on the part of healthcare professionals toward spiritual resources among family cancer caregivers from the moment of diagnosis and across the entire cancer trajectory.
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