No abstract

The clinical assessment of drug-taking behaviors in medically ill patients with pain is complex and may be hindered by the lack of empirically derived information about such behaviors in particularly medically ill populations. To investigate issues surrounding the assessment of these behaviors, we piloted a questionnaire based on the observations of specialists in pain management and substance abuse. This preliminary questionnaire evaluated medication use, present and past drug abuse, patients' beliefs about the risk of addiction in the context of pain treatment, and aberrant drug-taking attitudes and behaviors. This instrument was piloted in a mixed group of cancer patients (N = 52) and a group of women with HIV/AIDS (N = 111). Reports of past drug use and abuse were more frequent than present reports in both groups. Current aberrant drug-related behaviors were seldom reported, but attitude items revealed that patients would consider engaging in aberrant behaviors, or would possibly excuse them in others, if pain or symptom management were inadequate. Aberrant behaviors and attitudes were endorsed more frequently by the women with HIV/AIDS than by the cancer patients. Patients greatly overestimated the risk of addiction in pain treatment. We discuss the significance of these findings and the need for cautious interpretation given the limitations of the methodology. This early experience suggests that both cancer and HIV/AIDS patients appear to respond in a forthcoming fashion to drug-taking behavior questions and describe attitudes and behaviors that may be highly relevant to the diagnosis and understanding management of substance use among patients with medical illness.

These findings support previously expressed concern about presence of disordered eating in nutrition and dietetics undergraduates. Collaboratively developed support mechanisms for preventing and managing disordered relationships with food would be of benefit to students enrolled in nutrition degrees to ensure ongoing professional integrity.

Background The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a well-established survivorship issue for gynaecological cancer survivors (GCS), yet little is known on how to intervene. Purpose The aim of this systematic review was to identify the factors explaining the variability in SQoL for GCS. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the software Covidence. Electronic databases Scopus, Web of Science, PUBMED and CINAHL were searched for original research on GCS published between 2002 and 2018. We performed a two-stage screening process against selection criteria and quality assessment of individual studies. The Salutogenic Theory and the PRECEDE–PROCEED model were used as theoretical frameworks to identify and categorise factors. Results The initial search yielded 3,505 articles resulting in a total of 46 studies used to examine the association between factors of SQoL and gynaecological cancers. Our findings suggested that SQoL varies across subgroups based on age, menopausal status, relationship status, and treatment modality. Protective factors included clinicians’ knowledge and confidence, preventive medical approach, risk and needs assessment, patient–clinician communication, relationship quality, psychosocial support, symptom management, accessibility of psychosexual care, and self-efficacy in the rediscovery of sexuality. Conclusion Despite the high incidence and long-term impact of sexual health issues on quality of life, supportive care needs are not being met. A better understanding of the evidence base around the factors of SQoL can help health professionals take steps to protect and improve SQoL in GCS.

Long-duration exercise has been linked with the psychological model of flow. It is expected that the flow experience is characterized by specific changes in cortical activity, especially a transient hypofrontality, which has recently been connected with an increase in cognitive performance post-exercise. Nevertheless, data on neuro-affective and neuro-cognitive effects during prolonged exercise are rare. The cognitive performance, mental state, flow experience, and brain cortical activity of 11 ultramarathon runners (6 female, 5 male) were assessed before, several times during, and after a 6-h run. A decrease in cortical activity (beta activity) was measured in the frontal cortex, whereas no changes were measured for global beta, frontal or global alpha activity. Perceived physical relaxation and flow state increased significantly after 1 h of running but decreased during the following 5 h. Perceived physical state and motivational state remained stable during the first hour of running but then decreased significantly. Cognitive performance as well as the underlying neurophysiological events (recorded as event-related potentials) remained stable across the 6-h run. Despite the fact that women reported significant higher levels of flow, no further gender effects were noticeable. Supporting the theory of a transient hypofrontality, a clear decrease in frontal cortex activity was noticeable. Interestingly, this had no effect on cognitive performance. The fact that self-reported flow experience only increased during the first hour of running before decreasing, leads us to assume that changes in cortical activity, and the experience of flow may not be linked as previously supposed.