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Objective To investigate which characteristics of the physician and of the consultation are related to patient satisfaction with communication and working alliance. Methods Real-life consultations (N = 134) between patients (n = 134) and their physicians (n = 24) were audiotaped. All of the patients were aware of their cancer diagnosis and consulted their physician to discuss the results of tests (CT scans, magnetic resonance imaging, or tumor markers) and the progression of their cancer. The consultations were transcribed and coded with the “Defense Mechanisms Rating Scale—Clinician.” The patients and physicians completed questionnaires about stress, satisfaction, and alliance, and the data were analyzed using robust linear modeling. Results Patient satisfaction with communication and working alliance was high. Both were significantly (negatively) related to the physician's neurotic and action defenses—in particular to the defenses of displacement, self-devaluation, acting out, and hypochondriasis—as well as to the physician's stress level. The content of the consultation was not significantly related to the patient outcomes. Conclusions Our study shows that patient satisfaction with communication and working alliance is not influenced by the content of the consultation but is significantly associated with the physician's self-regulation (defense mechanisms) and stress. The results of this study might contribute to optimizing communication skills training and to improving communication and working alliance in cancer care.

Objective The aim of the present study was to test the association between psychosocial factors and delay in uptake of treatment and treatment non-adherence in Indonesian women with breast cancer. Methods Seventy consecutive patients with breast cancer who were treated at the Hasan Sadikin Hospital in Indonesia were recruited. They completed a demographic form, the non-adherence questionnaire, the Breast Cancer Knowledge Test, the Brief Illness Perception Questionnaire, the Multidimensional Health Locus of Control Scales, the Satisfaction with Cancer Information Profile and the Distress Thermometer. Results Seventeen (24%) out of 70 patients reported that they had delayed initiating treatment at the hospital, and nine (13%) out of 70 patients had missed two or more consecutive treatment sessions. In the bivariate analyses, we found no significant differences on any of the psychological variables between patients who delayed initiating treatment and those patients who did not, whereas patients who had missed two or more consecutive sessions had lower satisfaction with the type and timing of information provided and more negative illness perceptions than patients who had not missed their sessions. In multivariate regression analyses, consulting a traditional healer before diagnosis was associated with treatment delay (β = 1.27, p = 0.04). More negative illness perceptions (β = 0.10, p = 0.02) and whether a traditional healer had been consulted after diagnosis (β = 1.67, p = 0.03) were associated with missing treatment sessions. Conclusions Indonesian health professionals need to be aware of patients' negative illness perceptions and their unrealistic belief in traditional healers. Copyright © 2014 John Wiley & Sons, Ltd.

Objectie: the aim was to investigate the influence of parents' negative mood state and parenting stress on behavior in children with newly diagnosed cancer. Methods: a total of 123 parents (n?=?58 fathers, n?=?65 mothers) of 67 children with newly diagnosed cancer completed three questionnaires separately at the same time measuring parents' negative mood state, parenting stress, and child behavior problems. Results: parents' negative mood state was weakly correlated to more child behavior problems (r?=?0.31, p? Conclusions: this is the first study to demonstrate the mediational role of parenting stress in fathers of a child with newly diagnosed cancer

Palladium(II)-mediated oxidative carbonylation reactions have been used to synthesize (11) C-radiolabelled ureas via the coupling of amines with [(11) C]carbon monoxide, in a one-pot process. Following trapping of (11) CO in a solution of copper(I) tris(3,5-dimethylpyrazolyl)borate, homocoupling reactions of primary aliphatic amines proceed in the presence of Pd(PPh3 )2 Cl2 to give the corresponding N,N-disubstituted [(11) C]ureas. Secondary amines do not produce the corresponding N,N,N,N-tetrasubsituted [(11) C]ureas under these conditions. This difference in reactivity allows for the formation of unsymmetrical N,N',N'-trisubstituted [(11) C]ureas using a mixture of a primary amine and a reactive secondary amine. The potential use of this method in positron emission tomography (PET) was demonstrated by the synthesis of the M1 muscarinic acetylcholine receptor radiotracer, [(11) C-carbonyl]GSK1034702.

Objective The aim of this study was to review the literature on clinician characteristics influencing patient–clinician communication or patient outcome in oncology. Methods Studies investigating the association of clinician characteristics with quality of communication and with outcome for adult cancer patients were systematically searched in MEDLINE, PSYINFO, PUBMED, EMBASE, CINHAL, Web of Science and The Cochrane Library up to November 2012. We used the preferred reporting items for systematic reviews and meta-analyses statement to guide our review. Articles were extracted independently by two of the authors using predefined criteria. Results Twenty seven articles met the inclusion criteria. Clinician characteristics included a variety of sociodemographic, relational, and personal characteristics. A positive impact on quality of communication and/or patient outcome was reported for communication skills training, an external locus of control, empathy, a socioemotional approach, shared decision-making style, higher anxiety, and defensiveness. A negative impact was reported for increased level of fatigue and burnout and expression of worry. Professional experience of clinicians was not related to communication and/or to patient outcome, and divergent results were reported for clinician gender, age, stress, posture, and confidence or self-efficacy. Conclusions Various clinician characteristics have different effects on quality of communication and/or patient outcome. Research is needed to investigate the pathways leading to effective communication between clinicians and patients. Copyright © 2013 John Wiley & Sons, Ltd.

[18F]ML10 is a promising novel low molecular weight positron emission tomography probe for apoptosis. As part of the quality control to support clinical studies for cancer therapy monitoring in the GSK Clinical Imaging Centre, a simple and sensitive liquid chromatography mass spectrometry method has been developed and validated for the quantification of total ML10 and impurity content in the final product. Chromatographic separation of ML10 and its radiolabelling precursor and impurities was achieved. Mass curves were constructed from a concentration range of ML10 and known impurities and were linear. Quantification was achieved by comparison of the area under the curve for ML10 content (m/z = 205) and the mass curve. The method was validated over a concentration range of 0.1-1 µg/ml. Copyright © 2013 John Wiley & Sons, Ltd.

Microglial activation has been linked with deficits in neuronal function and synaptic plasticity in Alzheimer's disease (AD). The mitochondrial translocator protein (TSPO) is known to be upregulated in reactive microglia. Accurate visualization and quantification of microglial density by PET imaging using the TSPO tracer [(11)C]-R-PK11195 has been challenging due to the limitations of the ligand. In this study, it was aimed to evaluate the new TSPO tracer [(11)C]PBR28 as a marker for microglial activation in the 5XFAD transgenic mouse model of AD. Dynamic PET scans were acquired following intravenous administration of [(11)C]PBR28 in 6-month-old 5XFAD mice and in wild-type controls. Autoradiography with [(3)H]PBR28 was carried out in the same brains to further confirm the distribution of the radioligand. In addition, immunohistochemistry was performed on adjacent brain sections of the same mice to evaluate the co-localization of TSPO with microglia. PET imaging revealed that brain uptake of [(11)C]PBR28 in 5XFAD mice was increased compared with control mice. Moreover, binding of [(3)H]PBR28, measured by autoradiography, was enriched in cortical and hippocampal brain regions, coinciding with the positive staining of the microglial marker Iba-1 and amyloid deposits in the same areas. Furthermore, double-staining using antibodies against TSPO demonstrated co-localization of TSPO with microglia and not with astrocytes in 5XFAD mice and human post-mortem AD brains. The data provided support of the suitability of [(11)C]PBR28 as a tool for in vivo monitoring of microglial activation and assessment of treatment response in future studies using animal models of AD.

Objective: Maintaining weight loss results in childhood obesity treatment is difficult to achieve. Self-management techniques such as self-monitoring are associated with increased weight loss and maintenance. This study analyzes whether self-monitoring of lifestyle behaviours through a short message service maintenance treatment (SMSMT) via mobile phones with personalized feedback positively effects weight, lifestyle behaviours and psychological well-being in obese children. Methods: After 3 months of behavioural lifestyle treatment, 141 overweight and obese children (7-12 years) were randomly assigned to an intervention group receiving SMSMT for 9 months (n = 73) or to the control group (n = 68). The intervention group sent weekly self-monitoring data on exercise and eating behaviour and their mood via mobile phones. In return, they received tailored feedback messages. Primary treatment outcomes were weight, eating behaviour and psychological well-being, i.e. competence, self-esteem and quality of life. Secondary outcome was adherence to the SMSMT. Data were analyzed with mixed modelling. Results: SMSMT did not improve treatment outcomes. Controls gained temporarily in physical health scores (P = 0.01). SMSMT completers sent on average every 2 weeks an SMS. Children who had greater weight loss during the first 3 months of lifestyle treatment sent more SMSs (P = 0.04). Conclusions: We did not find a positive effect of SMSMT on weight, eating behaviour or psychological well-being in obese children. SMSMT seems to be a feasible method of treatment delivery. Future research should study variations of SMSMT to investigate how SMSMT can be more effective. © 2012 The Authors Pediatric Obesity © 2012 International Association for the Study of Obesity.

Investigating possible psychosocial predictors of unexplained chronic pain in adolescents is crucial in understanding its development and prevention. A general population sample of adolescents (n = 2230) from the TRAILS cohort study was investigated longitudinally to assess the influence of maternal vulnerability, in terms of anxiety, depression and stress, and parenting stress at age 10-12 years, on the presence of chronic pain at age 12-15 years. Of these adolescents, 269 (12.9%) reported experiencing chronic pain, of which 77% reported severe chronic pain and 22% reported multiple chronic pain. Maternal anxiety, maternal stress and higher levels of parenting stress were related to chronic pain at a later age. Subgroup analyses showed similar results for adolescents with severe chronic pain. Mediation analyses indicated that parenting stress mediates the effect between maternal anxiety, or stress, and chronic pain. The findings suggest that interventions to diminish maternal feelings of anxiety and stress, while in turn adjusting maternal behaviour, may prevent the development of chronic pain in adolescence.

The type-1 glycine transporter (GlyT1) is an important target for the development of new medications for schizophrenia. A specific and selective positron emission tomography (PET) GlyT1 ligand would facilitate drug development studies to determine whether a drug reaches this target and help establish suitable doses for clinical trials. This article describes the evaluation of three candidate GlyT1 PET radioligands (GSK931145, GSK565710, and GSK991022) selected from a library of compounds based on favorable physicochemical and pharmacological properties. Each candidate was successfully labeled using [11C]methyl iodide or [11C]methyl triflate and administered to a pig pre- and postadministration with a pharmacological dose of a GlyT1 inhibitor to determine their suitability as PET ligands in the porcine brain in vivo. All three candidate ligands were analyzed quantitatively with compartment analyses employing a plasma input function. [11C]GSK931145 showed good brain penetration and a heterogeneous distribution in agreement with reported GlyT1 localization. Following pretreatment with GSK565710, uptake of [11C]GSK931145 was reduced to homogeneous levels. Although [11C]GSK565710 also showed good brain penetration and a heterogeneous distribution, the apparent level of specific binding was reduced compared to [11C]GSK931145. In contrast, [11C]GSK991022 showed a much lower brain penetration and resultant signal following pretreatment with GSK565710. Based on these findings [11C]GSK931145 was identified as the most promising ligand for imaging GlyT1 in the porcine brain, possessing good brain penetration, specific signal, and reversible kinetics. [11C]GSK931145 is now being progressed into higher species. Synapse 64:542–549, 2010. © 2010 Wiley-Liss, Inc.

SYNOPSIS There are few findings of increased stress responses of the vascular system and the (head) muscles in migraine and tension headache patients. However, several studies ignored the headache state of the patients during the experiment and differences in sex, or used small experimental groups. In this controlled study, physiological parameters in migraine patients, tension headache patients and non-headache controls were investigated during conditions of stress and rest. Each group was composed of at least 25 subjects. Sex was included as an independent variable, and separate analyses were carried out on patients with pain during the measurements. There were no differences in vascular responding nor in muscular responding to stress between migraine patients, tension headache patients and controls. Male migraine patients showed enhanced activity in some indicators of sympathetic activity. No evidence was found for a discrete border separating the two headache types.

Objective.—To evaluate the effect of acute treatment on ictal behavioral functioning of patients with migraine via ambulatory accelerometry. Background.—The inability to carry out daily activities often complicates migraine attacks. Research into the effects of pharmacological drugs on this outcome parameter in the acute treatment of migraine has been based on subjective reports only. Methods.—In a double-blind, double-dummy, crossover study, 12 patients with migraine treated 2 migraine attacks with the nonspecific antimigraine drug, naproxen (500-mg capsule) or the more specific antimigraine drug, naratriptan (2.5-mg tablet). The clinical symptoms of headache, nausea, vomiting, photophobia, and phonophobia, and the subjective symptoms reflecting mood, sleepiness, and level of functioning were measured by use of a daily log. Results.—During the first 6 hours after intake of the study medication, the objective behavioral parameters showed no significant effect of time and no significant differences between naproxen and naratriptan, but naratriptan was significantly more efficacious than naproxen in relieving headache, nausea, and vomiting; the interval between treatment and relief was significantly shorter after intake of naratriptan. Conclusions.—Consciously perceived clinical and subjective symptoms do not necessarily run in parallel with their behavioral equivalents. It, thus, may be important to assess the effects of treatment on behavioral functioning in the evaluation of the general efficacy of antimigraine drugs in the acute treatment of a migraine attack.

Objective.—To explore the percentage of patients who report a reduced impact of migraine on their life, and to which factors this improvement can be attributed. Methods.—Four hundred forty-eight members of the Dutch Society of Headache Patients answered a set of structured questionnaires, including the Migraine-Specific Quality of Life instrument (MSQOL). Results.—Of this group, 70% reported a reduced impact of migraine. The most frequently reported reason for this reduction was a change in medication (77%); in particular, change to a triptan. Other favorable factors included a change in life-style (56%): 42% of patients reported more relaxed coping with migraine, a reduction of stress in general (28%) and of stress related to work (24%), and leading a more regular life-style (21%). In addition, social support was frequently mentioned, particularly that offered by the Dutch Society of Headache Patients (58%), family (46%), and their general practitioner (28%). The patients who reported a reduced impact of migraine had less migraine attacks and a higher quality of life than those who did not report such a reduction. Conclusion.—The results confirm that factors that are proven effective in clinical trials on migraine also have these effects outside a formal experimental environment.

The aim of the present paper was to quantify expectations of wheelchair-dependency in patients recently diagnosed with MS (n = 101) and their partners (n = 78). Expectations focused on the risk and seriousness of becoming wheelchair-dependent in 2 years, 10 years or lifetime. Expectations were compared with natural history data, compared between patients and their partners, and related to clinical characteristics. Our results show that patients overestimated their 2-year and 10-year risks of wheelchair-dependency, but underestimated their lifetime risks. A large number of patients were uncertain about their 2-year risk, even those with no or only minimal disability [Expanded Disability Status Scale (EDSS)

Item does not contain fulltext The aim of this study was to determine whether there has been an increase in headache prevalence in Dutch children and to compare headache characteristics of children with low, medium and high headache severity.A sample of 2358 schoolchildren between the ages of 10 and 17 years filled out Waters' Headache Questionnaire and the Paediatric Pain Assessment Tool. Results showed that 21% of the boys and 26% of the girls at elementary school, and 14% of the boys and 28% of the girls at high school reported weekly headaches. When compared to figures from a previous study in the Netherlands published in 1985, the prevalence of weekly headaches in 10-17-year-olds has increased by 6%. In boys at elementary school, the prevalence of headaches with a frequency of a few times a week has doubled.Children with low, medium and high headache severity differed with respect to all headache characteristics, i.e. pain quality, accompanying symptoms, warning signals, location, onset, impact of headache, family occurrence, perceived cause, medical consultation, and school absence.

Objective. The aim of this study was to investigate the joint association between biographical, medical and pre-operative psychological variables on the one hand, and a range of short- and long-term psychological and disorder-specific outcome measures on the other hand, in patients undergoing lumbar surgery. Design. Canonical correlations were used to determine which groups of pre-operative variables were related to groups of outcome measures. Methods. Participants were 126 patients undergoing lumbar surgery. On the day before surgery, information was obtained regarding age, sex, medical status variables, anxiety, fatigue, indices of pain and coping. Three days and three months post-operatively, several aspects of recovery were measured. Results. Female sex, number of analgesics taken, expected poor recovery according to the neurosurgeon, and pre-operative anxiety were associated with poorer short-term recovery. Reoperation, pre-operative anxiety, fatigue and pain during daily activities were associated with poorer long-term recovery. Conclusions. The results suggest that the assessment of recovery after surgery might be improved by taking psychological variables into account, apart from biographical and medical variables. Checking patients' levels of pre-operative anxiety, fatigue and pain might help hospital staff to detect patients who may be at risk of poor recovery in the long run. Applying psychological intervention techniques aimed at anxiety, fatigue and pain may facilitate recovery in such patients.

Women with (n=27) a history of late pregnancy loss (≥20 weeks) due to congenital anomalies who had completed the subsequent pregnancy with a live-birth were compared with a group of mothers with newborns without such a history (n=29) at 4 and 16 weeks post-partum. The following aspects were assessed: depression, anxiety, psychological distress, and mother–infant adaptation. The women with a previous pregnancy loss showed significantly more negative emotions than the women without such a history. In addition, they considered that their healthy baby experienced more problems with sleeping, crying, eating, and acquiring a regular pattern of this behaviour than the average baby. They also perceived their baby as being less ideal than the women without a previous pregnancy loss. These problems were particularly present 4 weeks post-partum and were significantly positively related to trait anxiety. The implications of this study are that in women with a history of late pregnancy loss, family physicians and welfare officers should be made aware of possible problems in the mother and in mother–infant adaptation shortly after a normal live-birth, particularly in those with high trait anxiety. They will then be able to arrange psychological support at an early stage. © 1997 John Wiley & Sons, Ltd.

Objective.-To investigate the relationship between changes in actual presence of headache and the experience of different subdomains of quality of life (QoL) in adolescents. Design.-Diary entered measurements of headache intensity and frequency were related to simultaneously recorded data on a QoL questionnaire for adolescents. Setting.-Subjects completed both the QoL questionnaires and the headache diaries at home. Subjects.-Subjects were selected by screening the total population of two secondary schools (N=1566) for headache and migraine symptoms. Sixty-four students subject to chronic headache or migraine participated in the study. All subjects were diagnosed by a neurologist, following the IHS criteria for migraine. Conclusion.-Changes in headache intensity and frequency were related to changes in self-reported QoL within all QoL subdomains. More headache coincided with a lower self-reported QoL.

Questions to be answered by this study were: (1) what is the health-related quality of life (HRQL) of migraine and tension headache patients who consult their general practitioner, and (2) what are the unique contributions of the perceptual and emotional components of headaches to the HRQL. The Nottingham Health Profile (NHP) was used to measure the HRQL of patients with migraine (n = 27), tension headache (n = 25), both migraine and tension headache (n = 17), and two reference groups. Perceptual components of the pain (intensity, frequency, and duration) were measured with a headache diary, while emotional components were measured with five visual analogue scales (for tension, depression, frustration, anger and fear). The NHP dimensions of pain, sleep, energy, and social isolation revealed that each headache patient group had a lower HRQL than the healthy reference group. There were no differences in HRQL between the headache groups. Regarding the second question: it was found that the greater the patient's emotional pain, the more problems he or she had with physical mobility and social isolation. Neither the type of headache nor the headache index were related to the HRQL of the patient. We recommend to increase the research efforts concerning tension headache and to measure the emotional component of pain in clinical trials.

A recent article by Burker et al. reported a high prevalence of depression in patients (N = 114) both before (47 per cent) and after (61 per cent) cardiac surgery. Prevalence in the present study (N = 133), on the other hand, was low: between 7.5 and 16.5 per cent pre-operatively and 4.5 and 14.3 per cent post-opcratively, depending on the assessment instrument used. We recommend using a combination of self-report inventories and expert clinical judgment to determine the prevalence of depression in cardiac surgery patients.

Pregnant women with (n=24) and without (n=26) a previous pregnancy loss (>16 weeks) due to congenital anomalies were compared on quality of life and anxiety. Pregnant women with a previous loss were divided into those with and those without a normal livebirth since the loss [cases+ (n=6) and cases− (n=18), respectively]. Psychological measurements were carried out before and after an ultrasound scan in the second trimester of the pregnancy. Women with a previous loss who had not delivered a healthy infant between the loss and the present pregnancy showed a lower quality of life as revealed by feelings of social isolation, negative emotional reactions, and pain than the other groups. In addition, they showed more pregnancy-related anxiety. The negative emotions were particularly present just before the anomaly scan. Feelings of social isolation, negative emotional reactions, pain, and pregnancy-related anxiety were significantly positively related to trait anxiety, irrespective of having experienced late pregnancy loss. The implications of this study are that the referring gynaecologist, physician, or midwife should be aware of the strong emotions and major concerns of women in a pregnancy subsequent to a late pregnancy loss. In addition, they should offer these women the opportunity to express their emotional distress.

The psychometric qualities of the Perinatal Grief Scale (PGS) were evaluated in a sample of 46 Dutch women in late pregnancy (> or = 24 weeks), who had been informed of the diagnosis 'lethal or severe fetal malformation'. The validity was assessed by comparing it to the Impact of Event Scale and to a clinical diagnosis of psychological instability. The PGS appeared to be internally consistent and particularly strongly related to psychological instability. It can therefore be considered as a valid assessment instrument, also for women who experience late pregnancy loss.

SYNOPSIS The associations between personality traits, life events and frequent headaches were studied in a sample of 5766 adult subjects between 20 and 65 years of age from the general population. Subjects with at least weekly headaches had more life events and higher inadequacy, social inadequacy, rigidity and injuredness than subjects with less frequent headaches. These relationships were not observed in subjects of 50 years of age and older, with the exception of the association with inadequacy. From the traits measured, inadequacy had the highest odds ratios for frequent headaches and showed a modest interaction with the presence of a life event. These findings are in agreement with Sarason's interactional model.

SYNOPSIS In order to investigate the hypothesis that migraine has a detrimental effect on cognitive functioning, 37 female migraine patients and 34 nonheadache female controls underwent a battery of neuropsychologic tests. No significant difference in test performance between groups was found. There was no relation between the length of migraine history or medication use and the level of impairment of cognitive abilities. The patient and control groups differed significantly on several self-report measures known to interfere with performance. Patients reported higher trait and state anxiety levels, higher debilitating anxiety and state depression, and less vigor. Statistical correction for these variables, however, did not result in significant group differences of cognitive performance. The results suggest that the general population of female migraine patients show no indication of cognitive impairment.

Objective. - The aim of this study was to examine two components of psychological well-being - life satisfaction and affective well-being - in community-dwelling elderly with (n = 321) and without chronic headache (n = 4955). Methods. - A checklist of chronic; medical conditions was used to determine whether respondents were suffering from headache, Cantril's ladder was employed to measure life satisfaction. The subscale, Mental Health, from the MOS SF-20 was used to assess affective well-being. Results. - Headache sufferers reported lower life satisfaction as well as lower affective well-being. However, the difference in life satisfaction between the two groups disappeared after controlling for comorbidity. The difference in affective well-being disappeared after controlling for neuroticism. Conclusions. - Lower life satisfaction in patients with chronic headache is caused by more comorbid diseases in the headache group, Lower affective well-being in headache sufferers is due to higher levels of neuroticism in the headache group.

In a sample from the general population of school children of 15 years of age, we studied whether receiving information about the prevalence of headaches had any effect on their subsequent headache report. Sixty children in the fourth year at four secondary schools were allocated at random to two conditions: a biased condition emphasizing the high prevalence of headaches and a neutral condition. Subjects in the biased condition reported more headaches but they did not report more other physical symptoms than the subjects in the neutral condition. The results are discussed in terms of Pennebaker's theory on reporting symptoms. It is concluded that epidemiological research using the general population should deal more explicitly with the way in which subjects are motivated to participate.

Psychological characteristics were studied in 85 healthy men with early-stage alopecia androgenetica who participated in a double-blind clinical trial on the effect of minoxidil. No evidence of psychosocial malfunctioning was found in the group suffering from hair loss as indicated by personality traits, general psychological adjustment and social functioning. These subjects were less rigid and more self-confident than comparable norm groups. However, specific problems attributed to hair loss were present in more than 30%. More psychological improvement, with regard to hair problems, social discomfort, and self-esteem occurred in the minoxidil group than in the placebo group. The findings are exploratory, because the pretest data were obtained in retrospect.