RESUMO
OBJECTIVE: Determine the feasibility and the preliminary effects of brief cognitive behavioral stress management (CBSM) intervention, compared with psychoeducation (PE) group in posttraumatic stress, distress, optimism, and quality of life in patients with colorectal cancer. METHODS: Ninety-four patients were randomized: 40 in CBSM intervention and 54 in PE. They answered psychological questionnaires before and after the intervention and 3 months later for follow-up. RESULTS: Of the included participants, 23.40% (22) completed the sessions (11 in each group). A significant effect was obtained in the variable of optimism F2,28 = 4.0, P = 0.03, Æ2p = 0.22 and a significant interaction effect between the groups in the avoidance behavior F2,28 = 6.0, P = 0.01, Æ2p = 0.30 and hyperactivation F2,30 = 3.91, P = 0.03, Æ2p = 0.20, with a large effect size in both. A significant interaction effect was found in the quality of life symptoms subscale for patients with colorectal cancer with a stoma F3,20 = 21.8, P = 0.00, Æ2p = 0.68. CONCLUSIONS: The CBSM intervention and PE are feasible therapies, albeit with some modifications. Preliminary effects are observed in the dimensions of posttraumatic stress and symptoms of quality of life.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Neoplasias Colorretais/psicologia , Qualidade de Vida/psicologia , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Adulto , Neoplasias Colorretais/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Psicoterapia/métodos , Estresse Psicológico/etiologiaRESUMO
Humans can alter fire dynamics in grassland systems by changing fire frequency, fire seasonality and fuel conditions. These changes have effects on vegetation structure and recovery, species composition, and ecosystem function. Understanding how human management can affect fire regimes is vital to detect potential changes in the resilience of plant communities, and to predict vegetation responses to human interventions. We evaluated the fire regimes of two recently protected areas in Madagascar (Ibity and Itremo NPA) and one in Brazil (Serra do Cipó NP) before and after livestock exclusion and fire suppression policies. We compare the pre- and post-management fire history in these areas and analyze differences in terms of total annual burned area, density of ignitions, burn scar size distribution, fire return period and seasonal fire distribution. More than 90% of total park areas were burned at least once during the studied period, for all parks. We observed a significant reduction in the number of ignitions for Ibity NPA and Serra do Cipó NP after livestock exclusion and active fire suppression, but no significant change in total burned area for each protected area. We also observed a seasonal shift in burning, with fires happening later in the fire season (October-November) after management intervention. However, the protected areas in Madagascar had shorter fire return intervals (3.23 and 1.82 years) than those in Brazil (7.91 years). Our results demonstrate that fire exclusion is unattainable, and probably unwarranted in tropical grassland conservation areas, but show how human intervention in fire and vegetation patterns can alter various aspects of the fire regimes. This information can help with formulating realistic and effective fire management policies in these valuable conservation areas.