bluuebunny/crossref_metadata_2025 huggingface dataset:
Directing Research to Reduce the Impacts of Nonindigenous Species
Authors: Byers James E. , Reichard Sarah , Randall John M. , Parker Ingrid M. , Smith Carey S. , Lonsdale W. M. , Atkinson I. A. E. , Seastedt T. R. , Williamson Mark , Chornesky E. , Hayes D.
Published: March 2003

Abstract:Management of nonindigenous species is a crucial aspect of maintaining native biodiversity and normal ecosystem functions. We attempt to guide researchers in developing projects that will be of use to conservation practitioners, tangibly improving applied conservation measures. We advocate a directed approach for conservation research to aid in prioritizing nonindigenous species for intervention by resource managers. This approach includes outlining what needs to be known to make such relative judgments about the impacts of nonindigenous species and the most promising methods by which to obtain such information. We also address active measures that should be taken once priorities have been set, highlighting the roles of risk assessment and research in improving control efforts. Ultimately, a better match between research and practical conservation needs should result in more effective reduction of the effects of nonindigenous species on native species.
A Metric for Analyzing Taxonomic Patterns of Extinction Risk
Authors: Lockwood Julie L. , Russell Gareth J. , Gittleman John L. , Daehler Curtis C. , McKinney Michael L. , Purvis Andy
Published: March 2003

Abstract:Spatial autocorrelation statistics can provide an efficient tool for exploring taxonomic patterns in extinction risk. Using Moran'sI , we found that U.S. vertebrates exhibit little or no taxonomic clustering of extinction threat within orders, but much greater clustering within families and genera. Among amphibians, clustering was unusually high within families. Across classes, most groups had a similar degree of clustering at all taxonomic levels, despite their different evolutionary histories. Birds were the exception, with higher clustering at the genus and family level. Our results suggest that intrinsic traits play a large role in species endangerment. The taxonomic pattern produced can guide policymakers in their allocation of scarce conservation dollars and in their efforts to develop pre‐emptive conservation programs.
Effect of Corridors and Habitat Edges on Dispersal Behavior, Movement Rates, and Movement Angles in Roesel's Bush‐Cricket (Metrioptera roeseli)
Authors: Berggren Åsa , Birath Bengt , Kindvall Oskar
Published: March 2003

Abstract: One method proposed for moderating the negative effects of habitat isolation is the preservation or restoration of linear landscape elements that structurally link isolated habitat remnants. An understanding of how animals react to landscape elements and move through the landscape is vital for species management and theory development. To achieve this understanding, detailed information on movement rates and specific movement behavior of individual animals in different ecosystems is essential. In an experimental study, we investigated whether individuals of Roesel's bush‐cricket (  Metrioptera roeseli) prefer to use corridors or move over the matrix when they leave a habitat patch. We examined whether movement rates and movement angles in corridors and matrix differed and whether individuals showed edge‐avoidance behavior. Differences in these behaviors were analyzed in relation to the softness of habitat edges. We found that approximately 30% more individuals used the corridor than would be expected if dispersal behavior was random. All individuals using the corridor as a dispersal route moved to the end of the corridor and into the surrounding habitat, which is 1000% more than would be expected if dispersal was random. The edge type ( hard or soft) did not influence whether individuals moved through corridors or the matrix. Individuals that moved through the corridor moved straighter but slower than individuals that moved over the matrix. A higher movement rate over the matrix than through corridors may be explained by an increased risk of predation, starvation, or dehydration in the open habitat causing individuals to move more quickly toward the higher vegetation. Our results suggest that individuals avoid the edge and the matrix and that the corridor is a preferred alternative for dispersal. We conclude that for this species, and probably other similar species of Orthoptera, linear elements in the form of corridors have a positive influence on the individual's dispersal through the landscape. This demonstrates the value of corridors in reducing the negative effect of habitat fragmentation on the persistence of local species.
Extinction‐Rate Estimates for a Modern Neotropical Flora
Authors: Pitman Nigel C. A. , Jørgensen Peter M. , Williams Robert S. R. , León‐Yánez Susana , Valencia Renato
Published: March 2003

Abstract: Concerns about elevated extinction rates in the tropics are a common feature of the conservation literature, but direct measurements are rare. We present the first quantitative estimates of extinction rate in a complete Neotropical flora based on historical plant‐collection records, quantitative measurements of forest loss and plant diversity, and the conservation status of endemic plant species in Ecuador. Our analyses suggest that 19–46 endemic plant species have gone extinct in Ecuador over the last 250 years, mostly because of habitat loss, and therefore are now globally extinct. An additional 282 species, nearly 7% of Ecuador's endemic flora, qualify as critically endangered. We found evidence of impending large‐scale plant extinctions in the country's coastal and Andean forests, but little extinction and low potential for extinction in the Amazonian lowlands.
Relating Geomorphic Change and Grazing to Avian Communities in Riparian Forests
Authors: Scott Michael L. , Skagen Susan K. , Merigliano Michael F.
Published: March 2003

Abstract: Avian conservation in riparian or bottomland forests requires an understanding of the physical and biotic factors that sustain the structural complexity of riparian vegetation. Riparian forests of western North America are dependent upon flow‐related geomorphic processes necessary for establishment of new cottonwood and willow patches. In June 1995, we examined how fluvial geomorphic processes and long‐term grazing influence the structural complexity of riparian vegetation and the abundance and diversity of breeding birds along the upper Missouri River in central Montana, a large, flow‐regulated, and geomorphically constrained reach. Use by breeding birds was linked to fluvial geomorphic processes that influence the structure of these patches. Species richness and bird diversity increased with increasing structural complexity of vegetation (  F1,32 = 75.49, p < 0.0001; F1,32 = 79.76, p < 0.0001, respectively ). Bird species composition was significantly correlated with vegetation strata diversity (  rs,33 = 0.98, p < 0.0001 ). Bird abundance in canopy and tall‐shrub foraging guilds increased significantly with increasing tree cover and tall‐shrub cover (   F1,22 = 34.68, p < 0.0001; F1,20 = 22.22, p < 0.0001, respectively ). Seventeen bird species, including five species of concern (  e.g., Red‐eyed Vireo [   Vireo olivaceus] ), were significantly associated (  p < 0.10 ) with structurally complex forest patches, whereas only six bird species were significantly associated with structurally simple forest patches. We related the structural complexity of 34 riparian vegetation patches to geomorphic change, woody vegetation establishment, and grazing history over a 35‐year post‐dam period ( 1953–1988 ). The structural complexity of habitat patches was positively related to recent sediment accretion (  t33 = 3.31, p = 0.002 ) and vegetation establishment (  t20.7 = −3.63, p = 0.002 ) and negatively related to grazing activity (  t19.6 = 3.75, p = 0.001 ). Avian conservation along rivers like the upper Missouri requires maintenance of the geomorphic processes responsible for tree establishment and management of land‐use activities in riparian forests.
Reserve Selection in Regions with Poor Biological Data
Authors: Gaston Kevin J. , Rodrigues Ana S. L.
Published: March 2003

Abstract: New approaches to the identification of priority areas for conservation are gaining popularity for their efficiency in maximizing species representation. However, their dependence on detailed distributional data severely hinders their application to regions where such information is limited, although these are commonly also the regions where conservation planning and action are most urgently required. We used exemplar data on the distribution of southern African birds to assess how sampling effort affects the performance of reserve networks selected by methods based on complementarity. We derived four scenarios of data availability from the initial data, resulting from different levels of sampling effort: abundance data, presence/absence data, low sampling effort, and absence of data. Reserve selection based on data obtained with low sampling effort can be highly effective in the representation of species, with a good relative performance also in terms of representation of species in peaks of abundance. This is because although the data on low sampling effort represent far fewer records than the original data, the records retained are biased toward the selection of peaks of abundance, even for the restricted‐range species. Although the best results were naturally obtained from the most effort‐intensive data set (with abundance data), these results suggest that methods based on complementarity are potentially valuable tools for reserve selection in regions for which biological data are poor.
Consequences of Prairie Wetland Drainage for Crustacean Biodiversity and Metapopulations
Authors: Jenkins David G. , Grissom Scott , Miller Keith
Published: March 2003

Abstract: Much of Illinois was once wet prairie, dotted with ancient (ca. 10,000‐year‐old) ephemeral wetlands. Most wetland habitat (85%) was converted to agriculture over a span of about 100 years (ca. 1850–1950). The consequences of this severe habitat fragmentation on wetland communities and metapopulations are unknown. We studied crustacean communities (weekly stovepipe samples throughout hydroperiods) for 3 years in a set of extant ephemeral wetlands in Illinois. We generated species‐sites curves by rarefaction and extrapolated those curves to conservatively estimate that 83–85 crustacean species may have inhabited approximately 4 million ephemeral wetlands that once existed in Illinois; 8–9 crustacean species were driven to extinction in Illinois during drainage; and 75–76 crustacean species are extant in the few remaining ephemeral wetlands of Illinois. We also conducted cellular automata simulations to examine the potential effects of habitat fragmentation on the genetic structure of extant crustacean metapopulation. Simulations indicated that conversion of the former wet prairie to agriculture may have reduced crustacean metapopulations to isolated populations that are more vulnerable to future habitat loss. Despite severe habitat fragmentation, curvilinear species‐sites relationships suggest that the greatest extinction rates have yet to occur for ephemeral wetland crustaceans. However, selection for limited dispersal during habitat fragmentation may contribute to extinction debt for extant species. Conservation programs can preserve much of the historical biodiversity of ephemeral wetlands, but future wetland biodiversity will depend heavily on the success of those efforts. The consequences of historical wetland loss and the importance of wetland conservation efforts to agriculture in the United States should be instructive for other regions.
Continuity of Caregivers for Care During Pregnancy and Childbirth
Authors: Hodnett E.D.
Published: March 2003

A substantive amendment to this systematic review was last made on 17 May 1999. Cochrane reviews are regularly checked and updated if necessary.

Background: Social support may include advice or information, tangible assistance, and emotional support.

Objectives: The objective of this review was to assess the effects of continuous support during labour (provided by health care workers or lay people) on mothers and babies.

Search strategy: I searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: April 1999.

Selection criteria: Randomised trials comparing continuous support during labour with usual care.

Data collection and analysis: Trial quality was assessed. Study authors were contacted for additional information.

Main results: Fourteen trials, involving more than 5000 women, are included in the Review. The continuous presence of a support person reduced the likelihood of medication for pain relief, operative vaginal delivery, Caesarean delivery, and a 5‐minute Apgar score less than 7. Continuous support was also associated with a slight reduction in the length of labour. Six trials evaluated the effects of support on mothers' views of their childbirth experiences; while the trials used different measures (overall satisfaction, failure to cope well during labour, finding labour to be worse than expected, and level of personal control during childbirth), in each trial the results favoured the group who had received continuous support.

Reviewers' conclusions: Continuous support during labour from caregivers (nurses, midwives, or lay people) appears to have a number of benefits for mothers and their babies and there do not appear to be any harmful effects.

Citation: Hodnett ED. Caregiver support for women during childbirth (Cochrane Review). In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software.
“Vanished Twin”: An Exploration of Women's Experiences
Authors: Briscoe Lesley , Street Clare
Published: March 2003

ABSTRACT: Background: Evidence suggests that in identified twin pregnancies 30 percent become a “vanished twin,” that is, when two gestation sacs are identified at early ultrasound but subsequently only one fetus is seen. This study explored the thoughts, feelings, and hospital experiences of women who have a vanished twin.

Method: The study was conducted in a large teaching hospital in northwest England from April to June 2001. The experiences of 9 women were explored through 4 focus groups and an individual interview. Nulliparous and multiparous groups were separated for homogeneity. The study's philosophical approach was based on constructivism, and the thematic analysis used a feminist interpretation to search for patterns of meanings from the women's words.

Results: The women wanted to be cared for in a humanistic manner, and they felt that acknowledgement of the vanished twin by the professional was important. The findings highlighted the need for better information giving to improve communication between caregivers and women. Multiparas were more prepared than nulliparas to ask for the attention that they wanted.

Conclusions: Despite the small number of study participants, results suggest that maternity caregivers should be sensitive to the feelings and individual nature of a woman who has experienced a vanished twin. Humanistic approaches to communication and improved methods of information based on the development of an information sheet are advised. (BIRTH 30:1 March 2003)
Comparison of Helicobacter pylori Infection between Fukuoka, Japan and Chinju, Korea
Authors: Youn Hee‐Shang , Baik Seung‐Chul , Cho Yun‐Kyeong , Woo Hyang‐Ok , Ahn Yoon‐Ok , Kim Kyuchan , Cho Myung‐Je , Lee Woo‐Kon , Ko Gyung‐Hyuck , Okada Kenji , Ueda Kohji , Rhee Kwang‐Ho
Published: March 2003

Background.

Helicobacter pylori is the causative agent of type B chronic gastritis, and plays a major role in the pathogenesis of gastroduodenal ulcer and gastric cancer. Because gastric cancer has been the leading cause of cancer mortality in Japan and Korea, we conducted a seroepidemiological study to estimate the prevalence of H. pylori infection in Japan and Korea in order to explain the current change in the gastric cancer incidences between two countries.

Materials and Methods.

Samples used for this study included 1204 sera from Chinju, Korea and 580 sera from Fukuoka, Japan. Immunoblotting, using a sonicated crude H. pylori antigen and 1:5 dilution of serum, was performed, considering the immunoblot shows reactivity to the 120 Kd antigen of H. pylori as a specific marker of H. pylori infection.

Results.

Seroepidemiology data from Fukuoka, Japan showed a prevalence of H. pylori infection of 20% before school age, 40% by teenage years, and over 80% beyond 20~years of age. Seroepidemiology data from Chinju, Korea, showed a 50% infection rate in preschool ages, and over 80% prevalence rate after 7~years of age.

Conclusions.

Lower rates of childhood H. pylori infection in Fukuoka may explain the recent decline and shift in the incidence of stomach cancer in Japan, supporting the hypothesis that H. pylori is a major determinant in the pathogenesis of stomach cancer.
Oral Immunization with Helicobacter pylori‐Loaded Poly(	d,	l‐Lactide‐Co‐Glycolide) Nanoparticles
Authors: Kim Seong‐Youl , Doh Hyun‐Joo , Jang Myoung‐Ho , Ha Young‐Ju , Chung Soo‐Il , Park Hae‐Joon
Published: March 2003

Background.

Helicobacter pylori is a major cause of chronic antral gastritis and peptic ulcer diseases. Many researchers have examined the possibility of immunologically‐mediated prevention of H. pylori infection using an oral vaccine. The purpose of this study is to investigate whether mucosal and systemic immune responses are induced by oral immunization with H. pylori lysate‐loaded poly(
d,
l‐lactide‐coglycolide)[PLG] nanoparticles, and if so, how the distribution of serum IgG subclasses are produced.

Methods.

PLG nanoparticles (H. pylori‐PLG) with encapsulated H. pylori lysates were prepared by the solvent evaporation method, and the physical properties of the nanoparticles were investigated. Following the oral immunization of the H. pylori‐PLG nanoparticles into mice, antibody induction was assayed in serum and gut washings, and the pattern of serum IgG subclasses was determined by ELISA.

Results.

The prepared H. pylori‐PLG nanoparticles were spherical, nonporous particles with a mean diameter of less than 1 μm. The multiple oral immunization with H. pylori‐PLG nanoparticles induced significantly H. pylori‐specific mucosal IgA response as well as serum IgG responses. The serum antibody subclasses elicited were predominantly IgG1 and IgG2b.

Conclusion.

Our results suggested that oral immunization of H. pylori‐PLG nanoparticles induced the H. pylori‐specific mucosal and systemic responses in mice and enhanced Th2‐type responses.
Helicobacter pyloriand Gastric Cancer: What Are the Benefits of Screening Only for the CagA Phenotype ofH. pylori?
Authors: Harris Ryan A. , Owens Douglas K. , Witherell Heidi , Parsonnet Julie
Published: March 2003

Background.Strains ofHelicobacter pylorithat express the CagA protein are associated with a threefold increased gastric cancer risk as compared toH. pyloristrains that do not express CagA. Screening and treatment only for CagA antibodies should target those individuals at highest gastric cancer risk while reducing the number of patients requiring antibiotics. We compared the costs and benefits of screening asymptomatic 50‐year‐old individuals for CagA, screening for allH. pyloristrains, and no screening, both in the United States and abroad.

Materials and Methods.We employed Markov cost‐effectiveness analysis using data from randomized, case‐control, and cohort studies.

Results.In the United States, CagA screening would result in 1.5 million fewer antibiotic treatments but would prevent 1,400 fewer gastric cancers than would screening for allH. pylori.The incremental cost‐effectiveness of CagA screening is $23,900 per life‐year gained; forH. pyloriscreening, it is $25,100. Screening in countries with epidemiological characteristics similar to those of Colombia, Finland, and Japan costs less than $5,000 per life‐year gained, and the difference between CagA andH. pyloriscreening is smaller than that in the United States.

Conclusions.Screening only for CagA‐positiveH. pyloriis not substantially better than is screening for allH. pylori, either in the United States nor abroad. Screening is substantially more cost‐effective outside the United States. Whether population screening is justified, however, is uncertain pending conclusive data regarding the reduction in gastric cancer risk from antibiotics.
Relation between Cytokines and Helicobacter pylori in Gastric Cancer
Authors: Yamaoka Yoshio , Kodama Tadashi , Kita Masakazu , Imanishi Jiro , Kashima Kei , Graham David Y.
Published: March 2003

Background.

 Helicobacter pylori is etiologically involved in the development of gastric cancer and infected gastric mucosa has been shown to possess elevated levels of cytokines [for example interleukin (IL)‐1β, IL‐6 and IL‐8]. Because specific cytokines have also been shown to enhance the development of certain cancers, we examined the relationship between the levels of cytokines, the type and stage of gastric cancers, and the H. pylori infection.

Materials and Methods.

 Cytokines were measured from gastric cancer tissues, adjacent normal appearing mucosa, and the serum in 66 patients with early or advanced gastric cancer and from controls using semiquantitative RT‐PCR and ELISA.

Results.

 IL‐6 and IL‐8 levels were more than 10‐fold increased in cancer tissues as compared with normal gastric tissues. IL‐8 levels in cancer tissues were more than 2‐fold higher in advanced gastric cancer as compared with early gastric cancer irrespective of H. pylori status. IL‐6 levels were significantly higher in early gastric cancer with active H. pylori infection as compared with early cancer without H. pylori infection (8.7 + 1.4 vs. 1.2 + 0.3 pg/mg protein, p < .001) and decreased significantly after the cure of H. pylori (11.1 + 2.9–8.2 + 2.3 pg/mg protein, p < .05).

Conclusions.

 IL‐8 levels in gastric cancer tissue are largely independent of H. pylori infection. In contrast, tissue IL‐6 levels were high in H. pylori infected early gastric cancer and fell significantly after the cure of H. pylori suggesting a relationship between H. pylori infection and early gastric cancer.
A Pilot Study to Determine the Effectiveness of Garlic Oil Capsules in the Treatment of Dyspeptic Patients with Helicobacter pylori
Authors: McNulty Cliodna A.M. , Wilson Melanie P. , Havinga Wouter , Johnston Belinda , O'Gara Elizabeth A. , Maslin David J.
Published: March 2003

Background.

Resistance of Helicobacter pylori to clarithromycin and metronidazole is now found worldwide. Steam‐distilled garlic oil has in vitro activity against H. pylori and may be a useful alternative treatment strategy.

Materials and methods.

In this pilot study dyspeptic patients with positive serology for H. pylori confirmed by 13C urea breath test (UBT), at 0 and 2 weeks, were enrolled. Treatment consisted of one 4 mg garlic oil capsule with a meal four times per day for 14 days. H. pylori eradication was defined as a negative UBT at both follow‐up appointments. Suppression was defined as a 50% fall in 13C excess between baseline and follow‐up 1.

Results.

Five patients completed the study. There was no evidence of either eradication or suppression of H. pylori or symptom improvement whilst taking garlic oil.

Conclusion.

These negative results show that, within the gastric milieu, garlic oil at this dose does not inhibit H. pylori. A higher dose administered for a longer time‐period may be effective. Antibiotics are usually combined with a proton‐pump inhibitor or bismuth salt, as the only antibiotic with any in vivo activity against H. pylori in monotherapy is clarithromycin. A proton pump inhibitor raises gastric pH and, by increasing bacterial division, may increase the in vivo activity of garlic oil. This may be worth pursuing in a future trial.
A Multicenter, Double‐Blind Study on Triple Therapy with Lansoprazole, Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori in Japanese Peptic Ulcer Patients
Authors: Asaka Masahiro , Sugiyama Toshiro , Kato Mototsugu , Satoh Kiichi , Kuwayama Hajime , Fukuda Yoshihiro , Fujioka Toshio , Takemoto Tadayoshi , Kimura Ken , Shimoyama Takashi , Shimizu Kihachiro , Kobayashi Shinichi
Published: March 2003

Background.

Two triple therapies with lansoprazole (LPZ)/amoxicillin (AMPC)/clarithromycin (CAM) for eradication of Helicobacter pylori were studied in multicenter, double‐blind fashion to evaluate the eradication rate of H. pylori and safety of eradiation treatment in Japanese patients with H. pylori‐positive active gastric ulcers or duodenal ulcers.

Methods.

Patients were randomly chosen for the control treatment of LPZ 30 mg twice a day (b.i.d.; Group A‐LPZ‐only) or the test treatments of LPZ 30 mg plus AMPC 750 mg and CAM 200 mg b.i.d. (Group B‐LAC200) and LPZ 30 mg, AMPC 750 mg and CAM 400 mg b.i.d. (Group C‐LAC400). All eradication treatments lasted for a period of 7 days. Successful eradication was assessed by culture and gastric histology 1 month after completion of the ulcer treatment.

Results.

The eradication rates of H. pylori in the full analysis set were 0% in Group A‐LPZ‐only, 87.5% in Group B‐LAC200 and 89.2% in Group C‐LAC400 for gastric ulcer and, 4.4% in Group A‐LPZ‐only, 91.1% in Group B‐LAC200 and 83.7% in Group C‐LAC400 for duodenal ulcer. The eradication rates of Group B‐LAC200 and Group C‐LAC400 were 89.2% (95% CI: 84.8–93.7%) and 86.4% (95%CI: 81.5–91.3%) in total in the full analysis set, 89% (95% CI: 84.3–93.7%) and 85.3% (95%CI: 80.1–90.5%) in the per protocol set. The eradication rates in Groups B‐LAC200 and group C‐LAC400 were statistically significantly higher than the rate in Group A‐LPZ‐only for both gastric ulcer and duodenal ulcer patients (p < .0001 for both).

Conclusion.

A satisfactorily high H. pylori eradication rate was obtained in Japanese ulcer patients with the triple therapy regimen consisting of LPZ 30 mg, AMPC 750 mg, and CAM 200 mg b.i.d.
The Effect of Helicobacter pylori Infection on Levels of DNA Damage in Gastric Epithelial Cells
Authors: Everett S. M. , White K. L. M. , Drake I. M. , Schorah C. J. , Calvert R. J. , Skinner C. , Stringer M. D. , Miller D. , Dixon M. F. , Chalmers D. M. , Axon A. T. R.
Published: March 2003

Background. Helicobacter pylori infection leads to an increased risk of developing gastric cancer. The mechanism through which this occurs is not known. We aimed to determine the effect of H. pylori and gastritis on levels of DNA damage in gastric epithelial cells.

Methods. Epithelial cells were isolated from antral biopsies from 111 patients. DNA damage was determined using single cell gel electrophoresis and the proportion of cells with damage calculated before and 6 weeks after eradication of H. pylori. Cell suspensions generated by sequential digestions of the same biopsies were assayed to determine the effect of cell position within the gastric pit on DNA damage.

Results. DNA damage was significantly higher in normal gastric mucosa than in H. pylori gastritis [median (interquartile range) 65% (58.5–75.8), n = 18 and 21% (11.9–29.8), n = 65, respectively, p < .001]. Intermediate levels were found in reactive gastritis [55.5% (41.3–71.7), n = 13] and H. pylori negative chronic gastritis [50.5% (36.3–60.0), n = 15]. DNA damage rose 6 weeks after successful eradication of H. pylori[to 39.5% (26.3–51.0), p = .007] but was still lower than in normal mucosa. Chronic inflammation was the most important histological factor that determined DNA damage. DNA damage fell with increasing digestion times (r = –.92 and –.88 for normal mucosa and H. pylori gastritis, respectively).

Conclusions. Lower levels of DNA damage in cells isolated from H. pylori infected gastric biopsies may be a reflection of increased cell turnover in H. pylori gastritis. The investigation of mature gastric epithelial cells for DNA damage is unlikely to elucidate the mechanisms underlying gastric carcinogenesis.
Emergence of Clarithromycin‐Resistant Helicobacter pylori (CRHP) with a High Prevalence in Children Compared with Their Parents
Authors: Taneike Ikue , Goshi Satoshi , Tamura Yukiko , Wakisaka‐Saito Noriko , Matsumori Noriko , Yanase Azusa , Shimizu Toshiaki , Yamashiro Yuichiro , Toyoda Shigeru , Yamamoto Tatsuo
Published: March 2003

Background. Clarithromycin‐resistant Helicobacter pylori (CRHP) is increasing worldwide. Clarithromycin resistance in H. pylori from familial members has not been investigated.

Materials and Methods. Biopsy specimens were taken from 13 families living in Tokyo, Yokohama, and Niigata between 1998 and 2001. Drug resistance was tested with the replica plating method. The minimum inhibitory concentrations of antimicrobial agents for H. pylori strains were determined by the agar dilution method. Molecular analyses of H. pylori strains were performed by ribosomal RNA gene restriction pattern analysis. The DNA region, associated with clarithromycin resistance, was analyzed by PCR and sequencing.

Results. Helicobacter pylori strains isolated from a 5‐year‐old‐son displayed clarithromycin resistance with a mutation (A → G at position 2143) in the 23S ribosomal RNA, whereas H. pylori strains from his parents did not. DNA analyses revealed that the boy was infected with his father's strain. The boy had repeatedly developed otitis media and received clarithromycin since the age of 2 years. Studies on an additional 12 families demonstrated that clarithromycin resistance in the children's strains reached 42.9% and was significantly higher than those of H. pylori strains from their parents (0%) or from adult patients (11.1%) (p < .05).

Conclusions. The rate of clarithromycin resistance in H. pylori strains from Japanese children was extremely high, in contrast to those from their parents or adult patients. Prior history of clarithromycin usage in a child suggested development of clarithromycin resistance in resident H. pylori, which was originated from a parent.
Does Helicobacter pylori Eradication Affect Symptoms in Nonulcer Dyspepsia: A 5‐Year Follow‐Up Study
Authors: McNamara D. , Buckley M. , Gilvarry J. , O'Morain C.
Published: March 2003

The role of Helicobacter pylori infection in nonulcer dyspepsia remains controversial. To date studies exploring the effect of H. pylori eradication on symptoms have reported conflicting results. Randomised control trials employing validated outcome measures have also been difficult to interpret because of several important issues such as the large placebo response seen in patients with nonulcer dyspepsia and both the natural variability in symptoms and symptom severity with time. The association of symptom improvement with resolution of gastritis has meant that the length of follow up employed in most studies has been insufficient.

 We report the findings of a randomised placebo controlled trial (n = 100), using a validated symptom questionnaire and 5 year follow up to determine the effect of H. pylori eradication on symptoms in nonulcer dyspepsia.

 In all 64 that were reviewed at 5 years there was a significant difference between patients who were H. pylori negative and those who remained positive with regard to complete symptom resolution, consumption of relevant medications and peptic ulcer disease development, in favour of active treatment. There was a trend for gradual symptom improvement over time irrespective of H. pylori status, which may reflect the natural history of this condition. For those who remained symptomatic at 5 years, there was no difference in symptom severity based on H. pylori status.

 The findings of this study support the use of H. pylori eradication in symptomatic patients with nonulcer dyspepsia both to induce symptom resolution and to prevent disease progression.
Helicobacter pylori and gastric malignancies
Authors: Sepulveda Antonia R. , Coelho Luiz Gonzaga V.
Published: March 2003

The epidemiological link of Helicobacter pylori and gastric carcinoma was confirmed and the reported rate of gastric carcinoma development in the Japanese population with H. pylori gastritis was 2.9% during a 7.8‐year period. Studies showed that gastric atrophy and intestinal metaplasia may partially regress after H. pylori eradication, but whether this will result in a decrease in the development of malignant lesions remains to be confirmed in large studies. Little progress was made towards the identification of criteria applicable to individualized populations that would benefit from H. pylori screening and surveillance of gastric malignancy.

Studies of low‐grade MALT lymphoma reported clinical and molecular features that may be useful to identify cases that may be responsive to H. pylori eradication therapy, namely evaluation of lymphoma stage by EUS and t(11;18). The role of H. pylori eradication therapy in high‐grade MALT lymphoma needs to be evaluated in larger prospective studies.

 The application of methods of global analysis of gene expression (microarray studies) resulted in the explosion of information on the molecular pathways activated by H. pylori in gastric epithelial cells. New pathways that may play an important role in H. pylori carcinogenesis have been discovered in several studies.
Helicobacter pylori infection in pediatrics
Authors: Roma‐Giannikou Eleftheria , Shcherbakov Peter L.
Published: March 2003

In the past year the main interest was focused on the role of family for transmission of Helicobacter pylori to children; the evaluation of noninvasive diagnostic tests, especially in young children; extra‐intestinal clinical manifestations; the lack of consensus on treatment; and the problem of high resistance of the microorganism to antibiotics.
Cancer Screening of Older Women A Primary Care Issue
Authors: Blair Kathryn A.
Published: March 2003

purpose
: The purpose of this retrospective chart review was to examine whether family practice physicians and residents were screening older women for breast, gynecologic, and colorectal cancers as recommended by the American Cancer Society, the Guide to Clinical Preventive Services, and Healthy People 2000.

methods
: A retrospective chart review of women 60 years and older who were seen at least twice between July 1, 1992, and June 30, 1993, in a midwestern family practice residency program was completed. From the original sample of 660 potential subjects, a systematic random selection of every third chart was identified for review, resulting in a sample of 201. Analysis of the data was performed by descriptive statistics and chi‐square tests. A series of multiple regression models using age, number of visits, type and gender of provider, and personal or family history of cancer as predictor variables was performed.

results
: Breast cancer screening was offered to approximately 70% of the sample, with only about one third of the older women receiving mammography or clinical breast examination. Recommendations for gynecologic cancer screening were given to 63% of the sample, with less than one third receiving Papanicolaou smears. Recommendations for digital rectal examination, fecal occult blood test, and flexible sigmoidoscopy were 58%, 59%, and 30%, respectively. The percentages of patients who actually received these tests were considerably lower.

clinical implications
: Barriers for appropriate cancer screening for older women exist for both the provider and the patient; however, many of these obstacles can be overcome. Improving the resident's exposure to the current recommendations, increasing geriatric content in the training program, and initiating a reminder system may reduce some of the provider barriers. The use of midlevel providers may increase the preventive services offered to older women as well as educate and empower these women to become responsible for their own healthcare. Together, physicians and midlevel providers can become patient advocates through political activism, encouraging legislation that guarantees payment for cancer screening tests. Finally, primary care providers can become actively engaged in research that explores the healthcare concerns of older women.
Cancer‐Related Fatigue
Authors: Holley Sandra
Published: March 2003

Abstract

Purpose:

The purpose of this naturalistic inquiry was to understand, from the patient's perspective, the differences between cancer‐related fatigue (CRF) and “typical” fatigue and to describe its impact on their lives.

Description of study:

The sample consisted of 17 adult patients with cancer who agreed to participate, yielding 23 in‐depth audiotaped interviews. Participants included inpatients and outpatients from a dedicated cancer center and a Veterans Affairs Hospital. Symbolic interactionism was the framework used for the interviews to understand how individuals and groups construct and discover the meaning of events. Transcribed data were coded by distress category to classify the textual information and to reduce the text to more relevant and manageable bits of data. Five to 10 representative excerpts from each coding category were chosen and were coded independently by a second coder to evaluate intercoder reliability.

Results:

CRF was found to be more rapid in onset, more energy draining, more intense, longer lasting, more severe, and more unrelenting when compared with “typical” fatigue. CRF caused distress in the physical, social, spiritual, psychological, and cognitive domains of the participants' lives. All participants agreed that CRF was different than the typical fatigue of everyday life.

Clinical implications:

This study's findings indicate that because of this different fatigue, CRF, participants did not just experience the symptom, but they suffered with it. The current oncology literature and texts do not portray the morbidity of the CRF experience as described by the participants in this study. These data can be used as part of an experiential teaching guide to assist healthcare students and practitioners in understanding the CRF experience. This increased awareness will afford clinicians a better foundation for implementing management strategies. A CRF distress instrument is in development based on these data.
Implementing Cancer Pain Education for Medical Students
Authors: Sloan Paul A. , LaFountain Pat , Plymale Margaret , Johnson Mitzi , Montgomery Christopher , Snapp Janet , Sloan David
Published: March 2003

Purpose: The purpose of this study was to develop and pilot a cancer pain education course for medical students, using a structured home hospice visit.

Description of study: A 1‐hour home hospice visit was presented to 57 senior medical students. The content and objective criteria for the structured home hospice visit were developed by a multidisciplinary group of experts. During a 1‐hour interview, students completed a cancer pain history, performed a focused physical examination, and received feedback and teaching regarding the essentials of cancer pain management from the hospice nurse. All students and hospice patients completed a multi‐item evaluation questionnaire with a 5‐point Likert scale (1 = strongly disagree; 5 = strongly agree) regarding the structured home hospice visit.

Results: Most students agreed strongly that the home hospice visit was a positive experience (mean ± SD 4.8 ± 0.44) that helped them to understand the management of cancer pain (mean 4.7 ± 0.46) and opioid‐related side effects (mean 4.5 ± 0.57). Most patients enjoyed visiting with the students (mean 4.90 ± 0.30), agreed that the visit was not tiring (mean 4.81 ± 0.51), and felt that they benefited from participating (mean 4.76 ± 0.54).

Clinical implications: The authors concluded the following: 1) that medical students benefited from learning about cancer pain assessment and management through the use of a structured home hospice visit; 2) that a structured home hospice visit helped the students to learn the basics of cancer pain management; 3) that patients enjoyed their role as teacher for medical students; and 4) that senior hospice nurses provided excellent instruction for medical students in the management of cancer pain.
Physician Referral Patterns to a Breast Cancer Support Program
Authors: Fernandez Barbara M. , Crane Lori A. , Baxter Judith , Gallagher Kaia , McClung Melissa W.
Published: March 2003

Purpose: The purpose of this study was to describe the differences between physicians who did and did not refer their patients with breast cancer to the American Cancer Society's Reach to Recovery program, as well as to determine the factors associated with these physician referral patterns.

Description of study: This descriptive cross‐sectional study included 54 physicians who had and 23 physicians who had not referred their patients with breast cancer to the Mile High Unit Reach to Recovery program in 1999. Participating physicians completed a questionnaire about their knowledge, behaviors, and beliefs regarding Reach to Recovery, the characteristics of the patients they referred, and their own demographic and practice characteristics.

Results: General surgeons were more likely than all other specialties to refer patients to the Reach to Recovery program. The program is a part of the American Cancer Society. Feedback from patients about their experiences with Reach to Recovery and the proportion of patient time spent caring for patients with breast cancer were all positively associated with referral.

Clinical implications: These findings show that those providing support programs, such as Reach to Recovery, need to use targeted strategies to ensure that physicians are aware of the services they provide and that patients relay their experiences back to their referring physician. Because the value of social support programs for women with breast cancer has been established, physicians can become valuable partners in helping more women gain access to these programs.
Reflections on Nutritional Issues Associated with Cancer Therapy
Authors: McGrath Pam
Published: March 2003

purpose: It is now recognized that dietitians have a significant role to play in the care of oncology patients, many of whom have problems with nutrition. However, it is increasingly understood that there are important obstacles to assisting patients with nutritional problems in the oncology setting. The purpose of this article is to discuss the incidental findings of two recent studies, highlighting the importance of and problems associated with nutritional issues in patients with a hematologic malignancy.

overview: This article presents findings from two recent studies with a subset of patients who have hematologic malignancies. This diagnostic subgroup has specific challenges associated with nutrition and eating because of the intensive and aggressive treatments that patients endure. An explorative, descriptive, iterative, qualitative methodology was used for both studies. The focus was on exploring the lived experience of treatment in oncology/hematology for patients (prospective) and caregivers (retrospective).

clinical implications: The findings indicate that the issues surrounding food and eating are considered to be of great significance both to patients who are undergoing intensive treatment for a hematologic malignancy and to their caregivers. The significance of food is not seen purely in relation to its nutritional value, but as an important quality‐of‐life issue. Eating problems during intensive chemotherapy are perceived as highly stressful and can be, in the case of treatment‐related anorexia, life threatening. Recommendations are made for interventions that could reduce the stress and nutritional difficulties for both patients and caregivers.
Indirect Economic Effects of Long‐Term Breast Cancer Survival
Authors: Chirikos Thomas N. , Russell‐Jacobs Anita , Cantor Alan B.
Published: March 2003

purpose: The indirect morbidity/disability costs of breast cancer may be rising as a consequence of the growth in the population of long‐term survivors. This study was conducted to test whether women who have survived breast cancer for at least 5 years experience long‐lasting or continuing economic consequences that are attributable to their disease.

description of study: A group of 105 women who initially had been treated for breast cancer approximately 5 years before were interviewed to obtain data on economic, demographic, and health changes in the period since diagnosis. An age‐matched and work‐matched group of 105 women without cancer also was interviewed to obtain the same data for the same time period. Key changes in the economic position of subjects and their families were measured, including changes in work effort, pay rates, and annual earnings of working women and changes in household earnings, income, and assets of all women.

results: These preliminary empirical findings suggest that breast cancer exacts an economic toll from long‐term survivors. In particular, survivors who were working at the time of their diagnosis experienced significantly larger reductions in annual market earnings over the 5‐year study period than did working control subjects. These losses appear to arise mostly from reduced work effort, not changes in pay rates. Also, changes in total household earnings were lower for survivors, suggesting the presence of family adjustments to the disease. However, no significant differences were detected between the groups in changes in total income or assets over the study period.

clinical implications: Clinicians and policy makers must seek ways to minimize the indirect economic losses that are attributable to breast cancer.
The epitome of hand waving? Larval feeding and hypotheses of metazoan phylogeny
Authors: Rouse Greg W.
Published: March 2003

SUMMARY The homology of larval forms, and particularly their feeding methods, has been a major element in some recent discussions about animal phylogeny. “Downstream feeding” is one of two main larval‐feeding modes and is usually equated to an opposed‐band system with ciliary bands called the prototroch and metatroch. Feeding in larvae is reviewed here and the homology hypothesis of downstream larval feeding is expanded, encompassing any feeding involving the prototroch. It is often argued that the presence of planktotrophic larvae using downstream feeding is plesiomorphic among spiralian animals, and that there is a bias in transformations, such that feeding larvae tend to be lost rather than gained. These hypotheses are assessed using cladistic parsimony methodology, in relation to Spiralia, Trochozoa, and with particular reference to polychaete annelids. Methods adopted for the possibility of a bias in transformations toward loss of downstream larval feeding include: expanded primary homology arguments, character reconstructions favoring reversals, and polymorphic terminals coded as having downstream larval feeding. Nevertheless, all analyses show that downstream larval feeding appears to have evolved multiple times from a lecithotrophic condition. The results support a conclusion that the prototroch was primarily locomotory, and has become associated with feeding a number of times. Hypotheses of metazoan phylogeny predicated on the assumption that downstream‐feeding larvae are plesiomorphic are re‐assessed.