Difficulties in emotion regulation and well-being in breast cancer

Objective

Breast cancer is responsible for disruptive changes in women's lives, causing them to experience diverse and intense negative emotions that can affect their perception of well-being. The present study aimed to characterize difficulties in emotion regulation (ER), according to Gratz and Roemer's multidimensional assessment, in women with breast cancer and to relate them with General Well-Being and its different domains: Physical, Social/Familial, Emotional, and Functional.

Method

Ninety-five Portuguese women with breast cancer aged between 32 and 75 years answered a sociodemographic and clinical questionnaire and the Portuguese versions of the Difficulties in Emotion Regulation Scale and the Functional Assessment of Cancer Therapy - General. Data were collected in an oncology public hospital.

Results

In general, difficulties in ER presented negative correlations with General Well-Being and its domains. The multiple regression analysis findings indicated that two specific types of difficulties, Limited Access to ER Strategies and Lack of Emotional Clarity, play a significant role in predicting well-being, especially in the Emotional domain, which was most compromised in these patients.

Conclusions

These difficulties should be approached within psycho-oncological interventions as they are essential contributors to improving emotional and general well-being and fostering psychological adaptation to breast cancer.

Psychometric analysis of the body responsiveness questionnaire in the Portuguese population

Body responsiveness refers to the tendency to be attuned to the body's needs and use interoceptive information to guide behavior. Despite its potential beneficial effect on the development of positive body image, this construct is currently understudied. To boost research in this area, we examined the factor structure, gender invariance, and psychometric properties of a Portuguese translation of the Body Responsiveness Questionnaire (BRQ). A total of 650 men and women (aged 18-80 years) completed the Portuguese BRQ. To assess its convergent validity, participants also completed measures of body appreciation, emotion regulation, depression symptoms, and psychological quality of life. Exploratory factor analysis indicated a two-factor structure of the BRQ, which was upheld using confirmatory factor analysis: "Importance of Interoceptive Awareness" (ω = .85-.87) and "Perceived Connection" between body and mind (ω = .71-.74). BRQ scores had partial scalar invariance across gender, and no significant gender differences. Convergent and known-groups validity was supported. Participants with overweight/obesity (vs. normal weight) and middle-aged adults (vs. young adults) assigned higher importance to body signals to guide behavior. The Portuguese version of the BRQ is a psychometrically sound measure of body responsiveness and it may contribute to a comprehensive assessment of positive body image to guide intervention.

Predictors of Quality of Life in HIV-Infected Persons from Mozambique: The Dual Role of Schooling

Increasing quality of life (QoL) is both an end in itself and a means to optimize the impact of treatment in HIV-infected persons. Possibly due to cultural and social influences, the predictors of QoL vary across studies, highlighting the importance of studying specific populations. In the present study, we aimed to determine the sociodemographic (age, sex and schooling, or number of years at school) and psychosocial correlates (meaning in life, social support, positive and negative affects) of QoL in HIV-infected persons living in Mozambique, a country with a high prevalence of HIV but also with well-structured strategies to fight the disease. To that end, we made correlational analyses followed by regression models and examined potential mediation processes among predictors. All correlates were relevant except for sex. Meaning in life was the strongest predictor, while social support was the weakest. Schooling was both directly and indirectly related with QoL-in the latter case, it was mediated by meaning in life, social support and positive affect. Our findings suggest that investments in education may be highly rewarding to Mozambicans, and that satisfying needs for self-actualization and purpose may be more urgent than improving social connections.

Biopsychosocial Correlates of Quality of Life in Multiple Sclerosis Patients

Multiple sclerosis (MS) is a demyelinating chronic disease that has had increasing prevalence over the last years. We have investigated whether the perceived quality of life is reduced in multiple sclerosis patients compared to control participants with a cross-sectional approach, and how it relates to sociodemographic, clinical, and psychosocial variables in MS with multiple regression. To that end, a group of MS patients (n = 50) and a control group (n = 50) that was matched for age and education level filled in the WHOQOL-BREF (perceived quality of life across four domains) and a sociodemographic questionnaire. The participants in the MS group also filled in a clinical questionnaire and three instruments measuring psychosocial variables (the DASS-21 for depression, anxiety, and stress, the Brief-COPE for coping skills, and the Meaning in Life Scale). The results showed that the perceived quality of life was lower in the MS group than in the control group. Multiple regression models incorporating the variables that showed significant correlations with the quality of life indicated that age, professional status, recovery from relapses, depression, active coping, and meaning in life predicted at least one domain of the quality of life. Meaning in life predicted the quality of life in all four of the domains. Although the quality of life in MS is linked to multiple biopsychosocial variables, meaning in life seems crucial.

Quality of life in patients with inflammatory bowel disease: the role of positive psychological factors

Objective

To identify differences in quality of life (QoL) of patients with inflammatory bowel disease (IBD) between diagnosis (Crohn’s Disease and Ulcerative Colitis), gender (male and female), treatment condition (with and without surgery), and attachment styles (secure, preoccupied, and disconnected); to examine associations between QoL, sociodemographic, clinical, and positive psychological variables; to determine whether sociodemographic, clinical, and positive psychological variables predict QoL.

Method

The sample included 70 participants diagnosed with IBD (Mage = 43.37 years, SD = 12.81), of whom 71.4% were females and 67.1% had Crohn’s Disease. Positive psychological variables (meaning in life, positive body image, and attachment styles), sociodemographic (age, education, gender) and clinical variables (diagnosis, disease duration, surgery) were assessed as independent variables. QoL was the dependent variable, analyzed through four domains (physical, psychological, social, environment).

Results

Participants with a secure attachment style reported higher QoL (physical, psychological, and social) than participants with a preoccupied attachment style. Strong positive correlations were found between positive psychological variables and QoL. Body appreciation was a significant predictor of three QoL domains (physical, psychological, and environment). Meaning in life made a unique contribution to the social QoL regression model, and it was also a significant predictor of psychological QoL. Body acceptance by others was a significant predictor of physical QoL, whereas disease duration and education predicted environment QoL. Attachment styles did not predict any QoL domain.

Conclusion

The most significant predictors of QoL in patients with IBD were body appreciation and meaning in life. Body acceptance by others and body appreciation were the main predictors of physical QoL. Psychological interventions for patients who suffer from IBD should address body appreciation and meaning in life.

Emotion-Focused Cognitive Behavioral Therapy in Comorbid Obesity With Binge Eating Disorder: A Pilot Study of Feasibility and Long-Term Outcomes

Obesity coupled with binge eating disorder (BED) is an increasing problem. Incorporation of treatment strategies that address both problems in people with comorbid symptoms is of major interest. This study aimed to investigate the feasibility and preliminary long-term outcomes of a brief emotion-focused cognitive behavioral therapy (EF-CBT) program. Seven out of 10 women with obesity and BED completed the intervention. Standardized outcome measures to assess the intensity of distress caused by complaints, psychological distress, emotional processing, eating behavior, and weight loss were completed at baseline, end-of-treatment, 6- and 18-month follow-ups. Individualized outcome measures were also applied to describe the personal experiences during the intervention. Findings suggest the program's long-term efficacy for improving psychological distress, emotional processing, and alexithymia. Positive reliable changes in emotional processing and alexithymia were observed in almost all participants. The mean intensity of distress caused by complaints also decreased at the end of the intervention, with a large effect size (d = 0.89). Reliable changes in these outcome measures were observed at all time-points, despite the mean scores for the 18-month follow-up suggest a retraction in improvement. Weight loss was below expectations at all time-points, as were changes in emotional and external eating. Restrained eating mean scores remained stable throughout the study. Participants perceived the program to be useful in improving emotional awareness and eating control. Program feasibility was supported by the retention rate (70%) and the average number of attended sessions (M = 9.71; SD = 2.06). Further studies are needed to examine the effectiveness of EF-CBT interventions.

Alexithymia in anorexia nervosa: the mediating role of depression

The role of depression in the expression of alexithymia in anorexia nervosa (AN) has been controversially explained and several variables that may mask or increase the presence of emotional difficulties have scant examination in previous studies. This study aims to analyze the associations between alexithymia and state variables, such as age, BMI, illness duration, treatment duration, and medication status in AN participants, and to test the mediating role of depression in emotional difficulties. The Toronto Alexithymia Scale (TAS-20) and the Zung Self-Rating Depression Scale were administrated to 160 females: 80 participants with AN and 80 healthy controls. High levels of alexithymia were not a function of state variables. The mediating role of depression differed by the alexithymia dimension, with total mediation found for the TAS-DDF and partial mediation found for the TAS-DIF. Alexithymia is a relevant feature throughout the spectrum of AN and does not seem to be related to developmental maturation and some clinical features. Depression is probably the variable that best accounts for the variance in alexithymia, but is not a complete explanation for the known cognitive-affective disturbances in AN. Specific emotional competencies require scrutiny during psychiatric treatment.

Measles outbreak in the Lazio region of Italy: surveillance and impact on emergency departments and hospitalizations

BACKGROUND

The World Health Organization's (WHO) Regional Office for Europe had committed to 2015 as the year to eliminate measles from the region but several outbreaks have been reported recently from several areas of the continent. Here we describe an outbreak that occurred in 2010-2011 in Lazio region, Central Italy, and its impact on some health care services (i.e., Emergency Departments (EDs) and hospital clinics).

METHODS

We analyzed cases of measles reported to the infectious diseases surveillance system and accesses to EDs and hospitalizations for measles in the Lazio Region (central Italy, population of about 5,730,000 people).

RESULTS

In 2010-2011, 2,956 cases were reported to the surveillance system (incidence rate: 18.4 and 33.3 per 100,000 in 2010 and 2011, respectively). The incidence rates varied greatly with the territory. The outbreak occurred mainly among children <1 year old and among adolescents, most unvaccinated and did not seem to be related to cases imported from Eastern Europe. Complications were reported in 37.4% of the cases. The epidemic was mainly related to an accumulation of adolescents susceptible to measles due to unsatisfactory vaccination coverage in the early nineties. The outbreak had a strong impact on the health system with 2,881 ED visits and 1,168 hospitalizations. Outbreak-associated costs were considerable.

CONCLUSIONS

An additional intervention should be considered aimed at improving routine immunization coverage in children and at planning catch-up vaccination of 6-18 year olds not previously vaccinated. Further, timely surveillance is needed and specific protocols should be implemented to limit secondary cases.

Maternal Coping Strategies in Response to a Child's Chronic and Oncological Disease: a Cross-Cultural Study in Italy and Portugal

A child's oncological or chronic disease is a stressful situation for parents. This stress may make it difficult for appropriate management strategies aimed at promoting the child's wellbeing and helping him or her cope with a disease to be adopted. In particular, this study focuses on the possible connections between the variable national cultural influences and the parental strategies used to cope with a child's severe disease by comparing the experiences of Italian and Portuguese mothers. The study investigates differences and cross-cultural elements among the coping strategies used by Italian and Portuguese mothers of children with oncological or chronic disease. Two groups of mothers took part: 59 Italian mothers (average age 37.7 years; SD=4.5) and 36 Portuguese mothers (average age 39.3 years; SD=4.6). The tool used was the Italian and the Portuguese versions of the COPE inventory that measures five coping strategies: Social Support, Avoidance Coping, Positive Aptitude, Religious Faith and Humor, Active Coping. There were statistically significant differences between Portuguese and Italian mothers regarding Social Support (F(3, 94)=6.32, P=0.014, ɳ(2)=0.065), Religious Faith and Humor (F(3, 94)=20.06, P=0.001, ɳ(2)=0.18, higher values for Portuguese mothers) and Avoidance Coping (F(3, 94)=3.30, P=0.06, ɳ(2)=0.035, higher values for Italian mothers). Regarding child's disease, the only statistically significant difference was in Religious Faith and Humor (F(3, 94)=7.49, P=0.007, ɳ(2)=0.076, higher values for mothers of children with chronic disease). The findings of specific cultural transversalities provide the basis for reflection on important factors emerging on the relationship between physicians and parents. In fact, mothers' coping abilities may allow health workers involved in a child's care not only to understand how parents face a distressful event, but also to provide them with professional support.

A temporary immersion system improves in vitro regeneration of peach palm through secondary somatic embryogenesis

BACKGROUND AND AIMS

Secondary somatic embryogenesis has been postulated to occur during induction of peach palm somatic embryogenesis. In the present study this morphogenetic pathway is described and a protocol for the establishment of cycling cultures using a temporary immersion system (TIS) is presented.

METHODS

Zygotic embryos were used as explants, and induction of somatic embryogenesis and plantlet growth were compared in TIS and solid culture medium. Light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to describe in vitro morphogenesis and accompany morpho-histological alterations during culture.

KEY RESULTS

The development of secondary somatic embryos occurs early during the induction of primary somatic embryos. Secondary somatic embryos were observed to develop continually in culture, resulting in non-synchronized development of these somatic embryos. Using these somatic embryos as explants allowed development of cycling cultures. Somatic embryos had high embryogenic potential (65·8 ± 3·0 to 86·2 ± 5·0 %) over the period tested. The use of a TIS greatly improved the number of somatic embryos obtained, as well as subsequent plantlet growth. Histological analyses showed that starch accumulation precedes the development of somatic embryos, and that these cells presented high nucleus/cytoplasm ratios and high mitotic indices, as evidenced by DAPI staining. Morphological and SEM observations revealed clusters of somatic embryos on one part of the explants, while other parts grew further, resulting in callus tissue. A multicellular origin of the secondary somatic embryos is hypothesized. Cells in the vicinity of callus accumulated large amounts of phenolic substances in their vacuoles. TEM revealed that these cells are metabolically very active, with the presence of numerous mitochondria and Golgi apparatuses. Light microscopy and TEM of the embryogenic sector revealed cells with numerous amyloplasts, large nuclei and nucleoli, and numerous plasmodesmata. Plantlets were obtained and after 3 months in culture their growth was significantly better in TIS than on solid culture medium. However, during acclimatization the survival rate of TIS-grown plantlets was lower.

CONCLUSIONS

The present study confirms the occurrence of secondary somatic embryos in peach palm and describes a feasible protocol for regeneration of peach palm in vitro. Further optimizations include the use of explants obtained from adult palms and improvement of somatic embryo conversion rates.

Prevalência da alexitimia na anorexia nervosa e sua associação com variáveis clínicas e sociodemográficas

OBJETIVO: Analisar a prevalência da alexitimia numa amostra de pacientes com anorexia nervosa e sua relação com variáveis do foro clínico e sociodemográfico, em concreto, índice de massa corporal, duração da doença, idade, escolaridade e nível socioeconômico. MÉTODOS: Foram avaliados 2 grupos de participantes do sexo feminino, com idades compreendidas entre os 13 e os 34 anos. Um grupo foi composto por 80 participantes com anorexia nervosa (Grupo AN) e o outro por 80 participantes saudáveis (Grupo Controle). A versão portuguesa da Toronto Alexithymia Scale - 20 items - foi aplicada a ambos os grupos. RESULTADOS: A prevalência da alexitimia no Grupo AN foi 62,5% e no Grupo Controle, 12,5%. Os valores médios de alexitimia não diferiram significativamente entre os dois subtipos de AN, e ambos apresentaram valores estatisticamente superiores aos do Grupo Controle. A alexitimia não se correlacionou às variáveis clínicas e sociodemográficas consideradas, à exceção da escolaridade, cuja associação com a alexitimia foi positiva e baixa. CONCLUSÃO: Os pacientes com anorexia nervosa apresentaram, com elevada frequência, dificuldades na regulação dos afetos, independentemente de seu peso, tempo de evolução da doença, idade e nível socioeconômico. O tratamento deve privilegiar uma intervenção sistematizada no domínio das emoções.

Perfis de adaptação psicológica na criança com asma

Este estudo tem como objectivos caracterizar sob um ponto de vista psicológico as crianças com asma e suas famílias e identificar diferentes perfis de adaptação. A amostra consistiu em 89 crianças, de ambos os sexos e com idades entre os 8 e os 12 anos e com asma. Relativamente à criança avaliaram-se o temperamento, inteligência, auto-estima e coping. Quanto à família foram avaliados o tipo de agregado familiar, o humor da mãe e as alterações e interferências causadas pela asma nas rotinas familiares. Como indicadores de adaptação foram avaliados sintomas de ansiedade/depressão, as habilidades sociais e a qualidade de vida. Os resultados encontrados sugerem que as crianças com asma, enquanto grupo, apresentam características que apontam maiores dificuldades de adaptação psicológica. No entanto, os resultados da análise de clusters, revelaram dois perfis distintos de adaptação das crianças com asma sugerindo que apesar de a asma representar uma situação de risco parece possível lidar favoravelmente com a doença.

[A cross-sectional survey on childhood immunization coverage and reasons of non-compliance in Lazio Region, Italy (2007)]

During 2007, Laziosanità conducted a cross-sectional survey on childhood immunization coverage in Lazio Region. The survey, implemented in collaboration with the 12 LHUs of the Region, aimed at assessing immunization coverage among children, with 24 months of age or older, at regional and district level. In addition, the survey assessed reliability of the routine surveillance system and immunization records at peripheral level. Finally, delay in immunization schedule, and major reasons for non-compliance, as reported by the mothers, were analyzed. The survey results allowed to identify weakness in the routine surveillance system, low coverage levels for specific LHUs, and strategies for improvement of immunization coverage.

Posture and movement in healthy preterm infants in supine position in and outside the nest

OBJECTIVE

To evaluate whether lying in a nest affects the posture and spontaneous movements of healthy preterm infants.

METHOD

10 healthy preterm infants underwent serial video recording in the supine position, when lying in a nest and outside it, at three ages: 30-33 weeks postmenstrual age (PMA) (early preterm), 34-36 weeks PMA (late preterm) and 37-40 weeks PMA (term). The nest was shell-shaped, made by putting two rolled blankets in a form of an oval. Posture was assessed both before and after general movements by scoring the predominant postural pattern. Movements towards and across the midline, elegant wrist movements, abrupt hand and/or limb movements, rolling to side, and frozen postures of the arms and legs were assessed during four general movements. All data relating to motor and postural items were normalised into frequencies of events per minute because the general movements varied in duration.

RESULTS

When lying in the nest, the infants more often displayed a flexed posture with shoulder adduction and elbow, and hip and knee flexion, and the head was frequently in the midline. The nest was also associated with an increase in elegant wrist movements and movements towards and across the midline and a reduction in abrupt movements and frozen postures of the limbs. The nest did not affect the occurrence of asymmetrical tonic neck posture.

CONCLUSIONS

A nest promotes a flexed posture of the limbs with adduction of shoulders, facilitates elegant wrist movements and movements towards and across the midline and reduces abrupt movements and frozen postures of the arms and legs.

Morphohistological analysis and histochemistry of Feijoa sellowiana somatic embryogenesis

Morphohistological analysis and histochemical studies were carried out during the induction and development of Feijoa sellowiana somatic embryos. Zygotic embryos were cultured on LPm medium containing 2,4-dichlorophenoxyacetic acid (20 microM) and glutamine (8 mM). Somatic embryogenesis could be induced from embryogenic cells that originated in meristematic centers or from clusters of cells. The presence of few starch grains and abundant protein bodies was observed in the globular and early torpedo stages, while in torpedo and cotyledonary-stage somatic embryos an enhanced synthesis of starch grains was associated with the accumulation of reserves to be used in the conversion of the embryos to plantlets. Proteins were predominantly observed in protoderm cells, as well as in the meristematic apical region of torpedo and cotyledonary-stage somatic embryos.

[Implications of transgenics for environmental and agricultural sustainability]

The potential risks of GMOs, their impact on human and animal health, and on the environment, as well as their socioeconomic effects, have generated a worldwide discussion which is far from drawing to a close for lack of sufficient information. Part of this information supports risk-hypotheses previously put forward. Thus the presence of transgenic plant genes in other plants and in other organisms has been confirmed in several occasions. Therefore, gene dissemination to plants of the same species as well as to widely different species is already regarded as an actual risk. The principle of substantial equivalence has opened the way for the liberation of transgenic plants for commercial crops, despite short-term tests, which are quantitatively and qualitatively insufficient to certify that the foods deriving from those plants are healthy and safe. Thus, the adoption of the so-called precautionary principle (PP) has turned out to be the most adequate safety measure to date, or else until scientific data should be able to demonstrate the actual impact of transgenic plants on human and animal health, and on the environment.

Tissue, cell culture and micropropagation of Mandevilla velutina, a natural source of a bradykinin antagonist

Leaf, stem and root explants of Mandevilla velutina were cultured in vitro and produced vigorous callus in LS basal medium containing one auxin (2,4-D or NAA) plus BAP. Calli can be subcultured indefinitely with vigorous growth. Subculture of calli to NAA (1.0 mg/l) plus BAP (5.0 mg/l) caused profuse regeneration of shoots. Isolated shoots were rooted in basal medium plus NAA (5.0 mg/l) or IBA (8.0 mg/l). Rapidly growing cell suspensions can be easily obtained from friable callus cultured in liquid medium.

Somatic embryogenesis and plant regeneration in embryo cultures of Euterpe edulis mart. (palmae)

The induction of somatic embryogenesis in embryo cultures of Euterpe edulis is described. The basal medium was composed of LS salts and Morel & Wetmore vitamins. Activated charcoal was added to prevent explant oxidation. 2,4-D higher than 50 mg/l was necessary for inducing embryogenesis which occurs 45-180 days after the start of cultures. Embryos arise directly from surface proliferating tissues on the matrix structure , without callus formation. The transfer of tissues with embryo clusters to medium with NAA plus 2iP, or without growth regulators, induces embryo development into plantlets.