Breakdown of Scaling and Friction Weakening in Intermittent Granular Flow.

Many materials are produced, processed and stored as grains, while granularity of matter can be crucial in triggering potentially catastrophic geological events like landslides, avalanches and earthquakes. The response of grain assemblies to shear stress is therefore of utmost relevance to both human and natural environment. At low shear rate a granular system flows intermittently by distinct avalanches. In such state the avalanche velocity in time is expected to follow a symmetrical and universal average behavior, whose dependence on the slip size reduces to a scale factor. Analyzing data from long lasting experiments, we observe a breakdown of this scaling: While in short slips velocity shows indeed a self-similar and symmetric profile, it does not in long slips. The investigation of frictional response in these different regimes evidences that this breakdown can be traced back to the onset of a friction weakening, which is of dynamical origin and can amplify instabilities exactly in this critical state, the most frequent state for natural hazards.

Intensity and prevalence of depressive states in cancer inpatients: a large sample descriptive study.

In cancer patients, depression causes suffering during the whole disease trajectory and it also influences the personal perception of well-being as well as treatment adherence. Consequently, its better definition is needed for planning more tailored supportive programmes. This study was aimed to provide information on depressive state intensity and prevalence in an heterogeneous sample of cancer inpatients. In addition, associations were studied between depressive state and different socio-demographic and clinical factors. A total of 1,147 consecutive adult cancer inpatients completed the Center for Epidemiologic Studies Scale on Depression together with a form for collecting socio-demographic and clinical data. The mean score of depression was 16.9 (SD = 9.3). There were differences in depression intensity associated with gender (p < .001), age (p = .001) and cancer type (p < .001), but not with education level (p = .282) or marital status (p = .436). Of the entire sample 13.9% had depressive states; this percentage raised to 26.2% if a less stringent criterion was used. These data reinforce the importance of a clinical and research focus on depression in oncology. As differences according to gender, age and diagnosis exist in depression prevalence and intensity, tailored supportive intervention should be planned and verified for effectiveness and efficacy.

Increasing 'ease of sliding' also increases friction: when is a lubricant effective?

We investigate experimentally the effective Coulomb friction exerted by a granular medium on a shearing plate, varying the medium depth. The plate is driven by a spring connected to a motor turning at a constant speed and, depending on the system configuration, performs continuous sliding or stick and slip in different proportions. We introduce an order parameter which discriminates between the different regimes expressing the fraction of time spent in slipping. At low driving speed, starting from zero layers of interstitial granular material, the average friction coefficient decreases when a few layers are added, while the order parameter stays close to zero. By further increasing the granular depth, the friction undergoes a sudden increase but the order parameter does not change notably. At an intermediate driving speed, however, both the friction and the order parameter undergo a sudden increase, which for the order parameter amounts to several orders of magnitude, indicating that the plate is more braked but nevertheless keeps sliding more easily. For medium-high driving speeds, full sliding is obtained for only one layer of interstitial matter, where friction has a minimum, and is maintained for all increasing depths while friction increases. These observations show that the ease of slipping is not determined by friction alone, rather by the highly complex interplay between driving velocity, friction, and the depth of the medium.

Cognitive functioning self-assessment scale (CFSS): preliminary psychometric data.

The cognitive functioning is included in the concept of quality of life. Many times well-being remains incomplete because of cognitive difficulties, that people are not always able to properly recognize and explain. Nonetheless, only few instruments, specifically thought for non-clinical neurologic populations, are available to measure them. The present study is an attempt at providing a self-report instrument--cognitive functioning self-assessment scale (CFSS)--to measure the individual cognitive functioning in general population. The CFSS is itemized into18 questions to which participants answer on a five-point scale. Two hundred and eighty-two patients in a General Practitioner study have filled-in the CFSS together with a clinical and socio-demographic data form. Explorative factor analysis, using principal component analysis, suggests the consideration of the CFSS as one-dimensional; internal reliability = 0.856. Non-parametric tests have shown that women report a worse cognitive functioning than men, while no differences emerged in relation to age, manual prevalence, presence of an illness or being in pharmacological treatment. Although further verifications are necessary, the CFSS seems to be a promising self-report cognitive functioning measure.

Defining hospital anxiety and depression scale (HADS) structure by confirmatory factor analysis: a contribution to validation for oncological settings.

BACKGROUND: Despite its popularity, not a definitive word has yet been said about the latent structure of the Hospital Anxiety and Depression Scale (HADS). The present work is a contribution to this issue: statistically identifying the best tool structure helps in understanding which constructs the tool actually detects. PARTICIPANTS AND METHODS: Five hundred and twelve Italian consecutive hospitalized cancer patients completed the HADS together with a form for the collection of personal and clinical data. Two confirmatory factor analyses (CFAs) were carried out to test the validity of both two- and one-factor models, whereas qualitative and quantitative (i.e. Akaike information criterion) indices were used to assess which model among them would fit better with the observed data. Finally, two multigroup CFAs were carried out to test the factorial invariance across gender and disease phase (diagnostic, therapeutic) of the best-fitting model. RESULTS: Although both considered models provide a good fit to the observed data, the two-factor model is more adequate; it is invariant across gender and disease phase. CONCLUSIONS: The present study gives evidence for using HADS to detect anxious and depressive states separately as originally suggested by its authors. Given that this work involved only Italian cancer inpatients, replications in different cultural/national contexts are recommended.

Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes.

AIM: To examine the effectiveness of reflexology foot massage in hospitalized cancer patients undergoing second or third chemotherapy cycles. BACKGROUND: Since the late-1970s, studies have been conducted to assess the efficacy of behavioural and relaxation approaches in controlling nausea/vomiting, anxiety and other side-effects associated with chemotherapy. METHODS: The study consisted of 30 patients being admitted to the oncology unit at a Scientific Research Hospital in Italy. Only 15 of the 30 participants received therapeutic massage. The subjects' self-reports of anxiety (measured by the Spielberger State-Trait Anxiety Inventory) were recorded before, after and 24 hours after the intervention. RESULTS: There was an average decrease of 7.9 points on the state-anxiety scale in the treatment group and of 0.8 points in the control group (P < 0.0001). CONCLUSIONS: Reflexology foot massage can be considered a support treatment used in combination with traditional medical treatments and executed by an expert, qualified person to help cancer patients receiving chemotherapy feel better and also cope better with their disease.

Does the information level of cancer patients correlate with quality of life? A prospective study.

AIMS AND BACKGROUND: The aim of the study was to evaluate the impact of information level on quality of life in cancer patients previously studied for their information level. PATIENTS AND METHODS: The information level was determined by means of a questionnaire that explored the degree of information on diagnosis and status of disease, the patient's interpretation of his/her disease status, and his/her satisfaction with the information received. Quality of life was evaluated, some months after evaluation of the information level, by means of the Functional Living Index for Cancer (FLIC) and the State-Trait Anxiety Inventory (STAI 1-2). RESULTS: A total of 175 patients were studied. Information was adequate in 53.7% of patients. An adequate level of information was present more frequently among patients aged < or = 65 years and in those patients followed at a cancer institute. There was no difference in the quality of life of adequately versus inadequately informed patients. Satisfaction with the information received influenced quality of life in both age groups. Objective clinical variables (active disease present and ongoing treatment) negatively affected quality of life in patients <65 years, whereas the subjective perception of the presence of disease was associated with a worse quality of life in older patients. CONCLUSIONS: In the study, although the level of information did not affect the quality of life, satisfaction with the information was associated with a better quality of life. The finding stresses the importance of a sensible disclosure of diagnosis and prognosis.

Physicians and death: comments and behaviour of 605 doctors in the north-east of Italy.

The aim of this study was to determine the influence of socio-demographic and professional factors on physicians' attitudes to the terminally ill. Between May 1992 and May 1993, a survey was conducted in the province of Pordenone (north-east, Italy) in order to analyse a number of specific issues, such as emotional involvement, the need for aggressive treatments and the communication of diagnosis and prognosis. After obtaining a list of board-certified physicians from the Medical Association office in Pordenone, a modification of the cancer questionnaire of Haley and Blanchard (QSPT) was mailed to 916 doctors. Of these, 605 (60%; 487 male, 118 female; mean age 41 +/- 11 SD) returned the completed questionnaire. Within the group of responders, we identified three main subgroups, according to their type of activity: general practitioners (175, 29%), hospital doctors (235, 39%) and other doctors (195, 32%). In age, sex and activity, the only significant difference between responders and non-responders was age (mean age 41 and 43 years respectively). Most of the responders (77%) stated that they were able to deal with the terminally ill patient and his/her needs; 44%, however, admitted that patients' anxiety is sometimes unbearable. For the vast majority of the doctors polled (91%), providing a comfortable environment for an incurable patient was more important than pursuing aggressive treatment, but only 44% were convinced of the uselessness of aggressive care. To the question on whether to disclose information about imminent death to allow patients to prepare spiritually, 37% answered "No", 38% "Yes", and 25% were uncertain. Almost all responders (95%), however, believed in the beneficial effect of hope on the terminally ill. Our results suggest that doctors' professional and, most of all, socio-demographic and cultural factors determine the relationship with the patient on both the emotional and the clinical decision-making levels.