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Delayed puberty.

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D S Rosen, C Foster. 2001. Delayed puberty.. https://doi.org/10.1542/pir.22-9-309

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The effect of different psychological profiles and timings of stress exposure on humoral immune response.

The aim of this study was to analyse the effects of different timings of stress exposure on humoral immune response in mice previously distinguished by their own psychological profile. The Swiss mice were submitted to two different protocols of social confrontation, based on the timing of stress exposure in relation to an immune challenge: animals socially confronted daily for 2 weeks (SINT) and another group confronted daily for 3 weeks (LINT). Control groups were individually housed in a different room. All groups were intraperitoneally injected with sheep red blood cells (SRBC). The SINT group was challenged on the 1st and 7th days of confrontation, whereas the LINT group was challenged on the 7th and 14th days. Two days prior to the period of social conflict, the animals were tested in the elevated plus-maze (PM). The SINT protocol caused a more depressed primary immune response in the submissive mice than that observed in the dominants. The LINT protocol induced a marked increase in the primary immune response, which was more evident in the dominant mice, whilst no changes were observed in the secondary immune response. In the control and dominant groups, the correlation analysis attributed a higher anti-SRBC titre to the more anxious animals; by contrast, higher anti-SRBC titres were found in the less anxious submissive mice. These studies show that different physiological and behavioural adaptations to environmental demands over time, as well as different psychological profiles, constitute important factors to a better understanding of neuro-immune interactions.

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The relationship between cognitive dysfunction and coping abilities in schizophrenia.

Cognitive dysfunction is a core feature of schizophrenia [Psychiatr. Clin. North Am., 16 (1993) 295; Psychopharmacology: The fourth generation of progress, Raven Press, New York (1995) 1171; Clinical Neuropsychology, Oxford University Press, New York (1993) 449] and is related to psychosocial functioning in this population [Am. J. Psychiatry, 153 (1996) 321]. It is unclear whether cognitive dysfunction is related to specific areas of functioning in schizophrenia, such as coping abilities. Individuals with schizophrenia have deficient coping skills, which may contribute to their difficulties dealing with stressors [Am. J. Orthopsychiatry, 62 (1992) 117; J. Abnorm. Psychol., 82 (1986) 189]. The current study examined the relationship between coping abilities and cognitive dysfunction in a community sample of individuals with schizophrenia. It was hypothesized that executive dysfunction and mnemonic impairments would be positively related to deficiencies in active coping efforts involving problem solving and self-initiation (e.g. advocating for oneself and others with mental illness and becoming involved in meaningful activities, such as work), independent of the contributions of the general intellectual deficits associated with the disorder and psychiatric symptoms. The results indicated that both executive dysfunction and mnemonic impairments were related to decreased usage of active coping mechanisms after controlling for general intellectual deficits. Further, recognition memory made independent contributions to the prediction of coping involving action and help seeking after controlling for the effects of negative symptoms. These findings suggest that individuals with schizophrenia may be less flexible in their use of coping strategies, which may in turn contribute to their difficulties in coping with mental illness and its consequences.

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Consultation planning to help breast cancer patients prepare for medical consultations: effect on communication and satisfaction for patients and physicians.

PURPOSE: To measure the prevalence of communication barriers between breast cancer patients and their physicians and to present the results of a study evaluating the impact of two visit preparation techniques on communication and satisfaction for breast cancer patients and their physicians. PATIENTS AND METHODS: We recruited 132 breast cancer patients from two outpatient cancer centers in a sequential, controlled trial. Ninety-four consented and completed the trial. Patients were assigned to one of two visit preparation interventions before their appointment with either a surgeon or a medical oncologist. In the control intervention, called Productive Listening, a researcher listened to and prompted patients to reflect on their experiences communicating with physicians. In the experimental intervention, called Consultation Planning, a researcher elicited questions and concerns, generated a printed agenda for the upcoming consultation, and engaged patients in techniques to improve communication with their physicians. Valid and reliable surveys measured communication barriers, satisfaction with the intervention, and patients' and physicians' satisfaction with the consultation. RESULTS: Sixty-four percent of the patients reported three or more communication barriers. Patients reported a significant reduction in communication barriers after both the intervention and the control session. Patients reported significantly higher satisfaction after the Consultation Planning sessions. Physicians reported significantly higher satisfaction with those patients who had participated in a Consultation Planning session. CONCLUSION: Visit preparation sessions help patients prepare for medical consultations and reduce barriers to communication. Consultation Planning sessions, in which a researcher solicited the patient's agenda, were more satisfying to patients and physicians than the Productive Listening sessions.

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