bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental adjustment to cancer and quality of life in breast cancer patients: An exploratory study
Authors: Ferrero Javier , Barreto M. Pilar , Toledo Mercedes
Published: February 2007

This study explores the relationship between adjustment to cancer and quality of life in a sample of 68 newly diagnosed non‐metastatic breast cancer patients. Responses were assessed on three occasions following communication of the diagnosis and included the Mental Adjustment to Cancer (MAC) scale, a measure of denial and a Spanish quality of life questionnaire for breast cancer patients. Appropriate medical variables were considered and included in the analysis. MAC subscales showed adequate internal consistency; nevertheless, there was overlap between subscales and a second order factorial analysis suggested that two dimensions (‘perceived threat’ and ‘perceived control’) suffice to describe mental adjustment to cancer. A strong association was found between mental adjustment to cancer and reported vague physical symptomatology at the first assessment. Older patients showed higher ‘Denial’ scores and lower scores for ‘Anxious preoccupation’. ‘Fighting spirit’ and ‘Denial’ were associated with better present and future quality of life; ‘Helpless/hopeless’, ‘Anxious preoccupation’ and ‘Fatalism’ responses were negatively correlated with well‐being. These results are discussed from a theoretical point of view.
Cognitive behaviour therapy with advanced breast cancer patients: A brief report of a pilot study
Authors: Cocker Kathryn I. , Bell David R. , Kidman Antony D.
Published: February 2007

In preparation for a formal study on the effects of cognitive behavioural therapeutic intervention with advanced breast cancer patients with respect to improved emotional well‐being and increased survival, a small (n = 6) pilot study was completed. Depression, anxiety, anger and self‐esteem self‐report measures were administered to determine the outcome of a 12‐week group Cognitive Behaviour Therapy programme which used the rationalemotive therapy model (Ellis, 1991). The programme followed psycho‐educational techniques to teach coping strategies for dealing with the various emotional factors associated with advanced breast cancer. In most cases, data at post‐programme and at a three‐month follow‐up revealed improvements in depression and anger and, to a smaller extent, with self‐esteem. The findings indicate that such a programme is beneficial to advanced breast cancer patients with respect to improving some aspects of emotional well‐being. It is too early to determine whether such a programme will improve survival.
Sources of ancillary oncology staff stress in radiation oncology
Authors: Kunkel Elisabeth J. Shakin , Shmuely Yochi , Shmuely Yochi
Published: February 2007

Potential sources of staff stress are described and suggestions provided for staff interventions in radiation oncology. An in‐service program was conducted to elucidate potential sources of staff stress and to provide support for ancillary oncology staff (AOS) in a time‐limited intervention.
Perceptions of family functioning and cancer
Authors: Kissane David W. , Bloch Sidney , Burns W. Ivon , Patrick Jon D. , Wallace Christopher S. , McKenzie Dean P.
Published: February 2007

Family function was assessed in 102 families (342 members) of palliative care patients and grouped into classes by a computer‐based taxonomic program. Five classes were defined through the dimensions of cohesiveness, conflict and expressiveness of the Family Environment Scale (FES). One third of families we namedsupportivefor their high cohesiveness; a further 21%resolved conflicteffectively; both of these classes contained low psychological morbidity. Two classes (15%) were clearly dysfunctional:hostilefamilies (6%) were distinguished by high conflict whilesullenfamilies (9%) displayed moderate conflict, poor cohesion and limited expressiveness. These two classes had significantly higher levels of psychological morbidity and poorer social functioning. The remaining class (31%) had intermediate levels of cohesion, expressiveness and conflict (termedordinary) yet more moderate psychosocial morbidity. Screening of families with the FES would facilitate a more family‐centred approach to treatment, with relatively early identification of families at‐risk; preventive interventions would also then be feasible.
How distressing is attendance for routine breast screening?
Authors: Walker L. G. , Cordiner C. M. , Gilbert F. J. , Needham G. , Deans H. E. , Affleck I. R. , Hood D. B. , Mathieson D. , Ah‐See A. K. , Eremin O.
Published: February 2007

A prospective cohort study of 2357 women eligible for participation in the UK National Breast Screening Programme was carried out to evaluate the immediate emotional and behavioural effects of attending for routine mammography. Women completed the Hospital Anxiety and Depression Scale (HADS) in the context of a survey by their General Practitioner before they knew they were to receive an invitation to attend screening and again at screening some 6 weeks later. In addition, an ad hoc Health Questionnaire was administered when the women attended for screening to assess possible self‐perceived stress‐related behaviour changes in the previous week.

2110 (89.5% response rate) women returned the initial postal baseline HADS and 1635 completed the HADS again at screening. Anxiety and depression scales were significantly lower at screening than at baseline (t = 3.16, p < 0.002, 95% CI = 0.07 to 0.31) and (t = 8.46, p < 0.0001, 95% CI = 0.32 to 0.52) respectively. Women scoring in the borderline range at baseline were more likely to move into the normal than the clinically significant range for anxiety (χ2 = 40.36, p < 0.001) and also for depression (χ2 = 56.04, p < 0.001), and women scoring in the clinically significant range for anxiety were more likely to become normal than vice versa (χ2 = 5.95, p < 0.02). The Health Questionnaire indicated that some women reported stress‐related behaviour changes in the week prior to screening, especially those who were most anxious or depressed.
A randomized controlled trial of preoperative psychological preparation for mastectomy
Authors: Burton Mary V. , Parker Ronald W. , Farrell Anita , Bailey Dianne , Conneely Julia , Booth Sue , Elcombe Selena
Published: February 2007

The effectiveness of a preoperative psychotherapeutic intervention with breast cancer patients was assessed in a randomized controlled trial: (1) preoperative interview plus a 30‐minute preoperative psychotherapeutic intervention; (2) preoperative interview plus a 30‐minute chat to control for the effects of attention; (3) preoperative interview only; and (4) routine hospital care control. A clinical psychologist interviewed the patient in hospital the afternoon before surgery. A consultant surgeon trained in listening and counselling skills conducted a 30‐minute psychotherapeutic intervention or chat. Psychological measures included anxiety and depression, body image distress, stressful life events, social support, and coping. Patients receiving a preoperative interview had lower body image distress at 3 months and 1 year than controls. Controls also showed significantly less Fighting Spirit in 1‐year interviews, and more control patients were cases for both anxiety and depression on Present State Examination criteria at 1 year than patients in the experimental groups. The psychotherapeutic intervention was superior to the chat among patients with severe stressful life events. Patients in the chat condition used their 30 minutes with the surgeon to explore symbolically themes of loss and restitution. In a multivariate model for predicting psychological outcome at 3 months and 1 year, experimental group remained a significant predictor when surgical procedure and age were included in the regression equation. Patients undergoing sector mastectomy had lower body image distress scores than mastectomy patients both at 3 months and 1 year. Psychological morbidity in the sample was high preoperatively (59%) and at 1 year (39%), but detection of morbidity by health professionals was poor. Predictors of caseness at follow‐up included caseness preoperatively, severe stressful life events, age, marital status, and social support. Implications of the findings for the care of cancer patients in hospital are discussed.
Emotional distress and hope in lung cancer patients, as perceived by patients, relatives, physicians, nurses and interviewers
Authors: Faller Hermann , Lang Hermann , Schilling Stefan
Published: February 2007

The present investigation was designed to test whether, and in which manner, the cancer patients judge their emotional state differently to their care providers. Emotional distress and hope are rated by the patients, the physicians concerned, nurses, next of kin and interviewers respectively. Compared with the external observers (as well as the self‐images of the next of kin), the patients rate their distress significantly lower. The ratings that both they and their next of kin give for their hope are significantly higher than those given by professional care givers. The relatives' estimates of the patients' states are more strongly correlated with their own self‐reports than with those of the patients. In addition, the factorial structures differ from one level of perception to the next. The differences revealed by the present study are discussed in the light of social comparison processes and with reference to the patient's specific relations to his professional and natural supporters.
Physician/nurse attitudes and treatment adherence in children with cancer: A pilot study and new instrument
Authors: Szajnberg Nathan M. , Altman Arnold J. , Quinn John J. , Weisman Steven J.
Published: February 2007

A new instrument designed to assess the treatment team's attitudes towards individual families was field tested to assess its correlation with missed appointments. We hypothesized that positive attitudes about families would be associated with high treatment adherence as measured by appointment keeping. The oncologists rated ease of working with parents, estimated appointment adherence and child's degree of illness in 18 children being treated for cancer. The 35 cohabitating parents were assessed for marital discord and parental‐estimated appointment adherence. Actual appointment adherence was determined by clinic chart review. Physician‐estimated adherence varied systematically with each physician and degree of the patient's morbidity. Factors related to actual adherence include: physician's discomfort in working with parents, father's estimate of home‐treatment adherence, with a statistical trend for distance travelled to be inversely related to adherence. Neither marital discord nor parent‐estimated adherence was related to appointment adherence. Results are discussed in terms of implications for facilitating adherence.
Sexual dysfunction following tram flap breast reconstruction for breast cancer: A preliminary communication
Authors: Weitzner Michael A. , Hughes Mary K. , Schusterman Mark A.
Published: February 2007

Psychological and social problems have been documented as sequelae of mastectomy. Patients may experience depression, anxiety, decreased sexual interest, negative changes in body image, fears of recurrence and concerns regarding the mastectomy site or prosthesis. Immediate breast reconstruction, using improved techniques such as the TRAM flap, have lessened the negative psychological impact of mastectomy but whether these procedures themselves result in psychologic or sexual impairment has not been reported. We, therefore, report four patients, three of whom were self‐referred for psychiatric evaluation, who experienced changes in body image and sexual response after TRAM flap reconstruction. Although the TRAM flap procedure cannot be specifically implicated, the similar presentation and complaints in these four cases suggest a possible association that warrants more rigorous study.
Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer
Authors: Wieneke Mary H. , Dienst Evelyn R.
Published: February 2007

Cancer patients' complaints of impaired cognition following chemotherapy are fairly common but poorly documented among adult patients. Neuropsychological testing was used to evaluate current cognitive functioning of 28 stage I and II breast cancer patients (ages 28–54) who had completed 3 to 18 months of adjuvant chemotherapy, from 0.5 to 12 months prior to testing. Effects of drug regimen, length of treatment and level of depression on cognitive functioning were examined. Despite estimated high‐normal pre‐morbid intelligence (mean FSIQ 113) patients scored significantly below age‐, education‐, and gender‐corrected test norms in areas of verbal and visual memory, mental flexibility and speed of processing, attention and concentration, visuospatial ability and motor function. Of patients, 75% scored ‐2SDs (moderate impairment) on one or more test measures. Level of cognitive impairment was unrelated to depression, type of chemotherapy and time since treatment, but was positively related to length of chemotherapy treatment. These preliminary findings suggest that cognitive impairment may follow conventional adjuvant chemotherapy treatment and warrant replication with a controlled and more rigorous longitudinal design.
Developing clinical trial protocols: The use of patient focus groups
Authors: Bradburn Jane , Maher Jane , Adewuyi‐Dalton Ruth , Grunfeld Eva , Lancaster Tim , Mant David
Published: February 2007

Can patient views, obtained through patient focus groups, make a contribution to the design of clinical trials? This paper describes the use of patient focus groups as a method of gaining information for the development of a randomised trial looking at community versus hospital care in breast cancer follow‐up.

Focus groups were used as a method of obtaining qualitative data. Quick and easy access to patients was obtained through a local cancer support group network.

Initial responses from the focus group participants appeared to be unfavourable to the protocol. In all, more than five issues were raised which might lead to reluctance to cooperate in the trial. Participants identified key issues related to their follow‐up.

Changes were made to the protocol addressing the issues raised. It is suggested that where trials require informed consent, using focus groups to find out patients' perceptions at the initial stage may well save time and money, increase participation levels and lead to better outcomes.
Choices in measuring quality of life in children with cancer: A comment
Authors: Eiser Christine
Published: February 2007

It is increasingly recognized that measures of quality of life (QL) need to be integrated in assessments of outcome following treatment for childhood cancer. Requirements for such scales are discussed with respect to four issues: the need to be (i) brief and comprehensive, (ii) reliable and valid, (iii) able to account for developmental changes in meaning of QL and (iv) amenable to proxy ratings. Currently available instruments are reviewed and their advantages and disadvantages considered. In developing new instruments, attention needs to be paid to differences in definitions of QL made by clinicians and families. New instruments must take more account of patient and family perspectives. More multicentre work is called for in order to recruit samples of sufficient size that acceptable levels of reliability and validity can be established.
Psychiatric liaison to gynecological oncology
Authors: Cerfolio Nina
Published: February 2007

A psychiatric liaison to the Gynecologic Oncology Service at a major cancer center was begun in July 1991 to improve the psychosocial care. A total of 82 women were evaluated by a psychiatric consultant over a 12‐month period. Most had advanced gynecological disease with poor prognosis. Consultation requests came from the nursing staff (42%), the gynecological fellow (34%) and the attending gynecologist (24%). Reasons for consultations were: difficulty coping (45%), depression (38%), social issues (7%) and ‘other’ (10%). The initial psychosocial issues were: patient‐related problems (62%), staff issues (28%) and family/social issues (10%). The patient‐related problems were: difficulty coping (43%), depression (33%), anxiety (16%) and delirium (8%). Upon initial assessment, the women met DSM‐III‐R diagnoses of adjustment disorder (53%) with depressed mood (32%), with mixed features (12%), with anxious mood (9%), major depression (13%), delirium (12%), panic attack with agoraphobia (4%), dementia (4%), schizophrenia (4%), ‘other’ (5%). After the initial consultation 28% developed delirium. ‘Other’ consisted of two women with a history of substance dependence and borderline personality disorder, one woman with an organic mood disorder and one woman with an interpersonal problem. Psychophar‐macological, behavioral and psychotherapeutic interventions are outlined through description of several clinical case reports.
A model curriculum for training in psycho‐oncology
Authors: Die‐Trill Maria , Holland Jimmie
Published: February 2007

The increased awareness of the cancer patient's psychosocial needs in the past few years has led to the development of training programs for health professionals working in oncology. Given the diversity of training goals, professionals involved in the care of patients, institutional resources and local needs, there is a lack of uniform criteria to train specialists in the field of psycho‐oncology. This paper describes a model for a one‐year curriculum the objective of which is to establish minimal standards of training to become a professional who is subspecialized in adult or child and adolescent psycho‐oncology. The curriculum primarily consists of a didactic and a skills development components. Selection of trainees and faculty as well as teaching tools and evaluation of the curriculum are described. The second part of the model curriculum contains specific recommendations that address the particular educational needs of specific oncological disciplines (oncologists, nurses, social workers) and volunteers. In addition, the need for multidisciplinary teams in oncology settings is emphasized. Defining minimum standards for training across institutions and even nations will not only improve patient care but will also contribute to define psycho‐oncology as a discipline.
No news is not good news: Information preferences of patients with cancer
Authors: Fallowfield Lesley , Ford Sarah , Lewis Shon
Published: February 2007

Many patients express dissatisfaction with clinicians' information‐giving. When the information is complex or potentially upsetting, clinicians may deliberately withhold information, especially if they lack the skills to handle patients' emotional reactions. Others underestimate the amount of information patients require. In this study, a heterogeneous sample of 101 patients participating in a trial assessing the benefits of receiving audio‐taped recordings of their ‘bad news’ consultations, completed a questionnaire similar to Cassileth's Information Styles Questionnaire. This questionnaire assessed patients' preferences for both general and specific information about their disease and its treatment. Of the sample, 94% expressed a desire for as much information as possible from their oncologist, be it good or bad; 4% wished for information only if it was good news and 2% declined extra information, preferring to leave things up to the doctor. Patients wanting less specific or no extra information were older and had poorer prognoses than those wanting full disclosure. Although precise information needs varied between patients, this study showed that patients with cancer in general wish to be well‐informed about diagnosis, prognosis, therapeutic options and side‐effects.
Adjustment of married couples and unmarried women to gynaecological cancer
Authors: Gilbar Ora , Steiner Mariana , Atad Jack
Published: February 2007

This two‐part study, conducted at the Department of Oncology, Linn Clinic, Haifa, Israel, compared the psychological and psychosocial adjustment to illness of 44 gynaecological cancer patients to that of their spouses, and the adjustment to illness of these 44 married patients compared to 18 unmarried gynaecological cancer patients. In the first part of the study, differences in psychological distress between marriage partners, measured by Brief Symptom Inventory (BSI), were found, the distress of the husband being more severe than that of the wife. In the second part of the study, the psychological distress of unmarried women was found to be more severe than that of married women.
Factors influencing nonadherence to mobile breast screening
Authors: Sellick Scott M. , Charles Karen , Woodbeck Heather , Kyle M. Joan
Published: February 2007

While some generalizations are possible in accounting for nonadherence to prevention and early detection programs, explanations for compliance are highly specific to the behaviour in question, the disease site and type, and the unique characteristics of the population. The present study identified specific barriers to adherence in a typical northern community serviced by a mobile breast screening van. Sixty‐one percent of all eligible women in the community participated in a telephone administered questionnaire. Of the total population, 83% of all attending and 36% of all nonattending women were sampled. Six variables produced an overall correct classification rate of 82%. Lack of active social encouragement, a perceived lack of information, and the actual number of concerns expressed are discussed as primary barriers to mobile breast screening attendance. The importance of family and friends as encouragers and as channels of media information and the power of physician encouragement in recruitment is explored.
Relative contribution of the karnofsky performance status scale in a multi‐measure assessment of quality of life in cancer patients
Authors: Adams Serrhel G. , Britt Dana M. , Godding Phillip R. , Khansur Tawfig I. , Bulcourf Bernard B.
Published: February 2007

The Karnofsky Performance Status (KPS) scale is the most widely used measure of functional or performance status. While the KPS cannot be used as a sole measure of quality of life, some suggestions have been made that the KPS can be used as a measure of one component of the quality of life construct. However, few data are available supporting the use of the KPS in such a multi‐measure assessment. The current study investigated the relation between KPS ratings and a measure of quality of life as well as measures of domains closely associated with quality of life (e.g. depression, social support). The subjects were 86 male veteran cancer patients receiving treatment for a first‐time cancer. The results indicated that the KPS was not significantly correlated with quality of life, social support or depression. KPS ratings were significantly related to education, cancer stage and mortality. Although the results support the use of the KPS as a measure of functional status, they do not support the use of the KPS as a component of a multi‐measure assessment of quality of life. Implications and future research directions are discussed.
Predictors of psychological distress, sexual dysfunction and physical functioning among women with upper extremity lymphedema related to breast cancer
Authors: Passik Steven D. , Newman Margo L. , Brennan Michael , Tunkel Richard
Published: February 2007

Sixty‐nine women presenting for rehabilitation treatment for upper extremity lymphedema (UEL) were assessed by physical examination and validated self‐report assessment instruments measuring demographics, psychological distress, sexual functioning, social support, coping style, pain and functional status. Statistical analyses revealed that women with UEL had high levels of psychological distress, and high levels of sexual, functional and social dysfunction. There were no linear relationships between severity of UEL and levels of distress. Women with UEL in their dominant hand, however, had more distress and less overall sexual satisfaction than those with UEL in their non‐dominant limb. Women with pain of any intensity were the most distressed, and had the most significant difficulties in psychological and physical functioning. Women with pain also perceived significantly less interpersonal support than those without pain. Virtually none were receiving pain treatment. An avoidant coping style and low perceived social support were significant correlates of psychological distress. UEL poses significant functional, social and sexual functioning problems in women following breast cancer treatment. An assessment of pain, as well as social support and coping, might help identify those in need of consultation by psychiatry and pain specialists. Patients may also benefit from psychological support and sexual therapy in addition to physical rehabilitation. A psycho‐educational and support group within the clinic may prevent the worsening of UEL through the adoption of preventive strategies, maximizing compliance with rehabilitative efforts, augmenting better coping methods through group support, decreasing isolation that accompanies the condition, and facilitating the identification of patients in need of formal consultation.
Psychological defenses of young osteosarcoma survivors
Authors: Sammallahti Pirkko , Lehto‐Salo Pirkko , Mäenpää Hanna , Elomaa Inkeri , Aalberg Veikko
Published: February 2007

Two self‐report measures—one assessing psychiatric symptoms (SCL‐90) and the other ego defenses (DSQ)—were completed by 16 young survivors of osteosarcoma and 72 healthy controls. The survivors were found to be well adjusted, with no evidence of the self‐report being biased by defensiveness. There was one difference in the way the two study groups described themselves, however. Though far from conclusive, the finding seems to suggest that survivors have problems in trusting that they can obtain support and understanding from other people when they need it most. Possibly one of the most vulnerable areas where the negative impact of major illness may become evident is the capacity to feel secure in interpersonal relationships.
Detection of the equilibrium folding intermediate of β‐lactoglobulin in the presence of trifluoroethanol by mass spectrometry
Authors: Invernizzi Gaetano , Grandori Rita
Published: February 2007

Nano‐electrospray ionization mass spectrometry (nano‐ESI‐MS) was used to monitor the effect of trifluoroethanol (TFE) on the conformational properties of β‐lactoglobulin (BLG). TFE stabilizes protein secondary structure, particularly α‐helices. However, it also acts as a denaturant above critical concentrations. In the case of BLG, TFE at low concentrations is known to induce formation of an equilibrium intermediate that contains non‐native helical structure. Such an intermediate is thought to form also under physiological conditions, playing a role in BLG folding in vivo by preventing aggregation. This well‐characterized system was chosen in order to test species distributions obtained by nano‐ESI‐MS. BLG spectra at increasing concentrations of TFE at pH 2 indicate transient accumulation of a conformer whose charge‐state distribution (CSD) falls between that of the native and that of the denatured protein, indicating that the TFE‐induced, partially folded form can be selectively monitored by this technique. The condition of its maximum accumulation corresponds to 16% TFE, in excellent agreement with results from solution experiments. In contrast, titrations with methanol or acetonitrile (ACN) reveal apparent two‐state transitions from native to fully unfolded BLG. At 10% TFE, the protein appears to be still fully folded at room temperature but, if unfolding is elicited by the combination with other denaturing agents, e.g. heat or low concentrations of ACN, it proceeds via formation of the intermediate. Thus, TFE can also induce formation of the BLG intermediate in synergism with generic denaturing agents. This study indicates good agreement between ESI‐MS and other biophysical methods monitoring protein conformational transitions in the presence of TFE. Copyright © 2007 John Wiley & Sons, Ltd.
Semi‐parametric regression models for cost‐effectiveness analysis: improving the efficiency of estimation from censored data
Authors: Pullenayegum Eleanor M. , Willan Andrew R.
Published: February 2007

In a cost‐effectiveness analysis using clinical trial data, estimates of the between‐treatment difference in mean cost and mean effectiveness are needed. Several methods for handling censored data have been suggested. One of them is inverse‐probability weighting, and has the advantage that it can also be applied to estimate the parameters from a linear regression of the mean. Such regression models can potentially estimate the treatment contrast more precisely, since some of the residual variance can be explained by baseline covariates. The drawback, however, is that inverse‐probability weighting may not be efficient. Using existing results on semi‐parametric efficiency, this paper derives the semi‐parametric efficient parameter estimates for regression of mean cost, mean quality‐adjusted survival time and mean survival time. The performance of these estimates is evaluated through a simulation study. Applying both the new estimators and the inverse‐probability weighted estimators to the results of the EVALUATE trial showed that the new estimators achieved a halving of the variance of the estimated treatment contrast for cost. Some practical suggestions for choosing an estimator are offered. Copyright © 2007 John Wiley & Sons, Ltd.
A harmonized design for process assessment indicators
Authors: Mäkinen Timo , Varkoi Timo
Published: February 2007

Indicators are used for providing detailed information to support process assessment. The development of the indicators could be assisted by deploying a solid conceptual model for process assessment indicators. This article uses a process meta‐model and existing assessment models as bases in designing the assessment indicators. We also discuss the benefits of the model in indicator development. The presented harmonized design of assessment indicators can be used in the development of assessment models and methods. The conclusion is a simplified, yet sufficient presentation of the elements required as assessment indicators. This article is intended for developers of assessment models, methods or tools, and users of current assessment models. Copyright © 2007 John Wiley & Sons, Ltd.
Improved serodiagnosis of alveolar echinococcosis of humans using anin vitro-producedEchinococcus multilocularisantigen
Authors: MÜLLER N. , FREI E. , NUÑEZ S. , GOTTSTEIN B.
Published: February 2007

Serology is an important tool for the diagnosis of alveolar echinococcosis (AE) in humans. In order to improve serodiagnostic performance, we have developed anin vitro-producedEchinococcus mulilocularismetacestode vesicle fluid (EmVF) antigen for application in an immunoblot assay. Immunoblot analysis of EmVF revealed an abundant immunoreactive band triplet of 20–22 kDa, achieving a sensitivity of 100% based on the testing of sera from 62 pre-operative and pre-treatment cases of active and inactive AE. Thus, the EmVF-immunoblotting allowed the specific detection of cases seronegative by the Em2- and/or EmII/3–10-ELISA, usually attributable to abortive, inactive cases of AE. The specificity of the EmVF-immunoblotting did not allow discrimination between AE and cystic echinococcosis (CE) but was 100% with respect to non-Echinococcusparasitic infections or cancer malignancies. Based on the findings of this study, it is recommended that the current ELISA test combination (Em2- and II/3–10-ELISA) be complemented with EmVF-immunoblotting, allowing an improved diagnosis of both clinical and subclinical forms of AE, including those associated withE. multilocularis-specific antibody reactivities not detectable by ELISA.
Differential gene expression analysis in antimony-unresponsive Indian kala azar (visceral leishmaniasis) clinical isolates by DNA microarray
Authors: SINGH N. , ALMEIDA R. , KOTHARI H. , KUMAR P. , MANDAL G. , CHATTERJEE M. , VENKATACHALAM S. , GOVIND M. K. , MANDAL S. K. , SUNDAR S.
Published: February 2007

In this study, cDNA microarray analysis of a closely related species,Leishmania major, was used as a screening tool to compare antimonial-resistant and susceptible clinical isolates ofLeishmania donovaniin order to to identify candidate genes on the basis of antimony resistance. Clinically confirmed resistant isolate 39 and sensitive isolate 2001 were used in this study. Many differentially regulated genes were identified whose expression levels differ in sodium antimony gluconate (SAG)-treated patients. Interestingly, genes on the array, showing changes in expression of over 2-fold revealed the identity of ABC transporters, which are known determinants of drug resistance in laboratory mutants. The functionality of the transporters was validated by flow cytometry which, being biologically informative, provides direct clues to gene function. The results suggest that isolate 39 could have developed resistance by an increased multidrug resistance protein (MRP)-like pump. This study provides preliminary clues to the role of a thiol-dependent efflux system in antimonial resistant clinical isolates ofLeishmania donovani.
A trypanosome species isolated from naturally infectedHaemaphysalis hystricisticks in Kagoshima Prefecture, Japan
Authors: THEKISOE O. M. M. , HONDA T. , FUJITA H. , BATTSETSEG B. , HATTA T. , FUJISAKI K. , SUGIMOTO C. , INOUE N.
Published: February 2007

Common arthropod vectors for trypanosomes are flies, fleas and bugs. This study reports on an unknown trypanosome species isolated from naturally infectedHaemaphysalis hystricisticks, hereby, referred to asTrypanosomaKG1 isolate. The parasite has been successfully culturedin vitrowith L929 or HEK 293T cell line as feeder cells. This trypanosome cannot survivein vitrowithout feeder cells. Following experimental infections of ticks, the trypomastigote-like and the epimastigote-like forms of this trypanosome could be detected by Giemsa-stained smears of the midgut and salivary glands ofOrnithodoros moubataticks which were made to feed on a culturing medium containingTrypanosomaKG1 isolate through an artificial membrane.TrypanosomaKG1 isolate could also be detected from Giemsa-stained smears of the haemolymph up to 30 days post-inoculation into theO. moubatahaemocoel.TrypanosomaKG1 isolate cannot be propagated in laboratory animals including mice, rats, rabbits and sheep. A phylogenetic tree constructed with the 18S rRNA gene indicates thatTrypanosomaKG1 is a member of the stercorarian trypanosomes.
What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression
Authors: GELLATLY JUDITH , BOWER PETER , HENNESSY SUE , RICHARDS DAVID , GILBODY SIMON , LOVELL KARINA
Published: February 2007

Background

Although self-help interventions are effective in treating depression, less is known about the factors that determine effectiveness (i.e. moderators of effect). This study sought to determine whether the content of self-help interventions, the study populations or aspects of study design were the most important moderators.

Method

Randomized trials of the effectiveness of self-help interventionsversuscontrols in the treatment of depressive symptoms were identified using previous reviews and electronic database searches. Data on moderators (i.e. patient populations, study design, intervention content) and outcomes were extracted and analysed using meta-regression.

Results

Thirty-four studies were identified with 39 comparisons. Study design factors associated with greater effectiveness were unclear allocation concealment, observer-rated outcome measures and waiting-list control groups. Greater effectiveness was also associated with recruitment in non-clinical settings, patients with existing depression (rather than those ‘at risk’), contact with a therapist (i.e. guided self-help) and the use of cognitive behavioural therapy (CBT) techniques. However, only guided self-help remained significant in the multivariate analysis [regression coefficient 0·36, 95% confidence interval (CI) 0·05–0·68,p=0·03]. In the subset of guided studies, there were no significant associations between outcomes and the session length, content, delivery mode or therapist background.

Conclusions

The results provide some insights into moderators of self-help interventions, which might assist in the design of future interventions. However, the present study did not provide a comprehensive description, and other research methods might be required to identify factors associated with the effectiveness of self-help.
Is bereavement-related depression different than non-bereavement-related depression?
Authors: ZISOOK SIDNEY , KENDLER KENNETH S.
Published: February 2007

Background. This review tackles the question: ‘Is bereavement related depression (BRD) the same or different from standard (non-bereavement-related) major depression (SMD)?’ To answer this question, we examined published data on key characteristics that define and characterize SMD to assess whether they also characterize BRD.

Method. We searched all English-language reports in Medline up to November 2006 to identify relevant studies. Bibliographies of located articles were searched for additional studies.

Results. Consistent with the position that BRD is distinct from SMD, some, but not all, studies report that men are as likely as women to have BRD and that past or family histories of SMD do not predict BRD. With greater consistency, studies suggest that, like SMD, BRD is: more common in younger than in older adults, predicated by poor health or low social support, followed by recurrent episodes of major depressive episode (MDE), and associated with impaired immunological responses, altered sleep architecture, and responsivity to antidepressant treatment.

Conclusions. Overall, the prevailing evidence more strongly supports similarities than differences between BRD and SMD. Because so few studies focus on BRD occurring within the first 2 months of bereavement, the period identified by the DSM to exclude the diagnosis of MDE, more research is needed specifically on this group to help us evaluate the validity of this important diagnostic convention.
Re-emergence ofFrancisella tularensisin Germany: fatal tularaemia in a colony of semi-free-living marmosets (Callithrix jacchus)
Authors: SPLETTSTOESSER W. D. , MäTZ-RENSING K. , SEIBOLD E. , TOMASO H. , AL DAHOUK S. , GRUNOW R. , ESSBAUER S. , BUCKENDAHL A. , FINKE E.-J. , NEUBAUER H.
Published: February 2007

Francisella tularensiswas identified as the cause of a die-off which occurred among a colony of semi-free-living common marmosets (Callithrix jacchus). During the outbreak 5 out of 62 animals died of tularaemia in a research facility located in the district of Goettingen, Germany. All animals had been born at the facility suggesting an endemic infection. A total of five culture isolates were recovered and characterized asF. tularensis holarctica, biovar I. These cultures represent the first isolates obtained in the Federal Republic of Germany for more than 45 years. The outbreak area shows several geographical and ecological characteristics known to favour long-term presence ofF. tularensis. Persistence of the pathogen in the remote region along the former German–German border, continuous re-introduction from eastern European countries after destruction of the ‘Iron curtain’ or introduction through migrating birds are testable hypotheses which could explain the emergence of tularaemia in this particular region.
Relationship of pulsed-field profiles with key phage types of Salmonella enterica serotype Enteritidis in Europe: results of an international multi-centre study
Authors: PETERS T. M. , BERGHOLD C. , BROWN D. , COIA J. , DIONISI A. M. , ECHEITA A. , FISHER I. S. T. , GATTO A. J. , GILL N. , GREEN J. , GERNER-SMIDT P. , HECK M. , LEDERER I. , LUKINMAA S. , LUZZI I. , MAGUIRE C. , PRAGER R. , USERA M. , SIITONEN A. , THRELFALL E. J. , TORPDAHL M. , TSCHÄPE H. , WANNET W. , ZWALUW W. K. Van der
Published: February 2007

Salmonella is one of the most common causes of foodborne infection in Europe with Salmonella enterica serovar Enteritidis (S. Enteritidis) being the most commonly identified serovar. The predominant phage type for S. Enteritidis is phage type (PT) 4, although PT 8 has increased in incidence. Within these phage types, pulsed-field gel electrophoresis (PFGE) provides a method of further subdivision. The international project, Salm-gene, was established in 2001 to develop a database of PFGE profiles within nine European countries and to establish criteria for real-time pattern recognition. It uses DNA fingerprints of salmonellas to investigate outbreaks and to evaluate trends and emerging issues of foodborne infection within Europe. The Salm-gene database contains details of about 11 700 S. Enteritidis isolates, demonstrating more than 65 unique PFGE profiles. The clonal nature of S. Enteritidis is evidenced by the high similarity and distribution of PFGE profiles. Over 56% (6603/11 716) of the submitted isolates of several different phage types were profile SENTXB.0001, although this profile is most closely associated with PT 4. The next most common profiles, SENTXB.0002 and SENTXB.0005, were closely associated with PT 8 and PT 21 respectively. Studies to investigate the relationship of profile types with outbreaks and possible vehicles of infection suggest that the incidence of PFGE profile SENTXB.0002, and thus PT 8, in some countries may be due to importation of foods or food production animals from Eastern Europe, where PT 8 is amongst the most frequently identified phage types. Collation of subtyping data, especially in the commonly recognized phage types, is necessary in order to evaluate trends and emerging issues in salmonella infection.
Assessment of intake inadequacy and food sources of zinc of people in China
Authors: Ma Guansheng , Li Yanping , Jin Ying , Du Songming , Kok Frans J , Yang Xiaoguang
Published: February 2007

Objectives

To assess the intake inadequacy and food sources of zinc of people in China.

Design and subjects

Diets of 68 962 subjects aged 2–101 years (urban 21 103, rural 47 859) in the 2002 China National Nutrition and Health Survey were analysed. Dietary intake was assessed using 24-hour recall for three consecutive days. Zinc intake inadequacy was calculated based on values suggested by the World Health Organization.

Results

The median zinc intake ranged from 4.9 mg day− 1(urban girls, 2–3 years) to 11.9 mg day− 1(rural males, 19+ years). The zinc density of urban residents (2–3 to 19+ years) was 5.0–5.3 mg day− 1 (1000 kcal)− 1, significantly higher than that of their rural counterparts (4.7–4.8 mg day− 1 (1000 kcal)− 1). Differences in food sources of zinc from cereal grains (27.4–45.1 vs. 51.6–63.2%) and animal foods (28.4–54.8 vs. 16.8–30.6%) were found between urban and rural residents. Zinc from vegetables and fruits (8.2–13.8 vs. 9.7–12.4%) and legumes (1.3–3.3 vs. 2.5–3.4%) was comparable between urban and rural residents. The proportion of zinc intake inadequacy ranged between 2.8% (urban females, 19+ years) and 29.4% (rural lactating women). Rural residents had higher proportions of zinc intake inadequacy than their urban counterparts. Significantly higher proportions of zinc inadequacy were found in the category of phytate/zinc molar ratio >15 for both rural and urban residents.

Conclusions

About 20% of rural children are at risk of inadequate zinc intake, with phytate as a potential important inhibitor. Moreover, lactating women are also considered a vulnerable group.
Pregravid body mass index is negatively associated with diet quality during pregnancy
Authors: Laraia Barbara A , Bodnar Lisa M , Siega-Riz Anna Maria
Published: February 2007

Objective

To investigate the association between pregravid weight status and diet quality.

Design

Institute of Medicine body mass index (BMI) cut-off points of < 19.8 kg m− 2for underweight, 19.8–26.0 kg m− 2for normal weight, >26.0–29.0 kg m− 2for overweight and >29 kg m− 2for obese were used to categorise women's weight status. Dietary information was obtained by self-report at 26–28 weeks' gestation using a modified Block food-frequency questionnaire. The Diet Quality Index for Pregnancy (DQI-P) included: servings of grains, vegetables and fruits, folate, iron and calcium intake, percentage calories from fat, and meal pattern score. Multinomial logistic regression models were used to estimate the association between weight status and tertiles of DQI-P controlling for potential individual confounders.

Setting

A clinical-based population recruited through four prenatal clinics in central North Carolina.

Subjects

A total of 2394 women from the Pregnancy, Infection and Nutrition study were included in this analysis.

Results

Evidence of a dose–response relationship was found between BMI and inadequate servings of grains and vegetables, and iron and folate intake. Pregravid obesity was associated with 76% increased odds of falling into the lowest diet quality tertile compared with underweight women after controlling for potential confounders.

Conclusion

A modest association was found between pregravid weight status and diet quality. If corroborated, these findings suggest that overweight pregnant women should be targeted for nutrition counselling interventions aimed to improve diet quality.
Biological effects of gamma-ray bursts: distances for severe damage on the biota
Authors: Galante Douglas , Ernesto Horvath Jorge
Published: February 2007

In this paper we present a unified, quantitative synthesis of analytical and numerical calculations of the effects that could be caused on Earth by a gamma-ray burst (GRB), considering atmospheric and biological implications. The main consequences of the illumination by a GRB are grouped into four distinct classes and analysed separately, namely: direct γ flash, UV flash, O3 layer depletion and cosmic rays. The effectiveness of each of these classes is compared and distances for significant biological damage are given for each one. We find that the first three effects have the potential to cause global environmental changes and biospheric damage, even if the source is located at galactic distances or even farther afield (up to 150 kpc, where 1 parsec=3.09×1016 m, about five times the Galactic diameter of 30 kpc). Instead, cosmic rays would only be a serious threat for close sources (of the order of a few parsecs).

As a concrete application from a well-recorded event, the effects on the biosphere of an event identical to the giant flare of SGR1806-20 on 27 December 2004 have been calculated. In spite of not belonging to the so-called ‘classical’ GRBs, most of the parameters of this recent flare are quite well known and have been used as a calibration for our study. We find that a giant flare impinging on Earth is not a threat for life in all practical situations, mainly because it is not as energetic, in spite of being much more frequent than GRBs, unless the source happens to be extremely close.
A Curious Belief-Bias Effect
Authors: Markovits Henry , Schroyens Walter
Published: February 2007

Many studies have shown that inferential behavior is strongly affected by access to real-life information about premises. However, it is also true that both children and adults can often make logically appropriate inferences that lead to empirically unbelievable conclusions. One way of reconciling these is to suppose that logical instructions allow inhibition of information about premises that would otherwise be retrieved during reasoning. On the basis of this idea, we hypothesized that it should be easier to endorse an empirically false conclusion on the basis of clearly false premises than on the basis of relatively believable premises. Two studies are presented that support this hypothesis.