bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental adjustment after surgery for non-small cell lung cancer
Authors: UCHITOMI YOSUKE , AKECHI TATSUO , FUJIMORI MAIKO , OKAMURA MASAKO , OOBA AKIRA 
Published: November 2003

Objective:Although surgery for early-stage non-small cell lung cancer (NSCLC) is generally considered curative, the outcome is still unsatisfactory, leaving patients faced with uncertainty and fear of recurrence for a long time after surgery. The purpose of this study was to clarify the course of patients' mental adjustment after surgery for NSCLC and to identify predictors of long-term outcome.Methods:A total of 205 patients completed a baseline interview for patient characteristics at 1 month after curative resection of NSCLC and for social support at 3 months, and the Mental Adjustment to Cancer scale at 3 and 12 months. Univariate and multivariate analyses were used to identify predictors of their psychological outcome.Results:The helplessness/hopelessness subscale score improved slightly after curative resection (p< .001), but the score on the fighting spirit subscale score was unchanged (p= .659). Significant predictors of helplessness/hopelessness at 12 months included helplessness/hopelessness at 3 months and advanced disease stage, and satisfaction with confidants. Significant predictors of fighting spirit at 12 months included fighting spirit at 3 months existence of confidants.Significance of results:The results suggested that mental adjustment improved slightly after curative resection for NSCLC. They also suggested the need to maintain continuity of psychosocial care that provides social support, and that an approach that includes careful attention to patients with advanced stage disease may be a strategy for improving mental adjustment after surgery for NSCLC.
Spiritual pain and its care in patients with terminal cancer: Construction of a conceptual framework by philosophical approach
Authors: MURATA HISAYUKI 
Published: November 2003

Objective:In discussing spiritual care of patients with terminal cancer, it is important to clarify the structure of spiritual pain to be evaluated.Methods:In this article, spiritual pain is defined as “pain caused by extinction of the being and the meaning of the self,” and its structure was evaluated according to the three dimensions of the human being, that is, a being founded on temporality, a being in relationship, and a being with autonomy.Results:As a result, spiritual pain of patients with terminal cancer could be described as meaninglessness of life, loss of identity, and worthlessness of living derived from loss of the future, loss of others, and loss of autonomy of a dying individual.Significance of results:On the basis of these understandings, the author deduced principles of spiritual care of terminally ill cancer patients as recovery of the future beyond death, others beyond death, and autonomy toward death in each dimension of the human being.
A comparison of patients dying at home and patients dying at a hospice: Sociodemographic factors and caregivers' experiences
Authors: CARLSSON MARIA E. , ROLLISON BRITTA 
Published: November 2003

Objective:The aim of this study was to investigate whether there were any differences between patients who died at home and patients who died at a hospice, that is, sociodemographic variables, the family caregivers' experiences of burden, and their opinion of reasons for hospice care.Methods:The study comprises a consecutive sample of family caregivers to adult patients: (I) who were cared for by the advanced palliative home care team (APHCT) and died at home, (II) who were cared for by the APHCT and died at the Hospice, (III) who were cared for and died at the Hospice in Uppsala during a period of one year. A questionnaire was mailed to caregivers and the medical records of all the patients were analyzed.Results:The place of death differed significantly and varied according to gender and cohabitation status. Men died to a greater degree at home compared with women. The family caregivers' experiences of burden were moderate. Caregivers of patients who died at home thought that this care form has a more positive influence on the patients' quality of life than was the case in the other groups. They were also more satisfied with their own achievement. The caregivers' opinion of why patients needed hospice care was nearly the same in groups II + III, acutely developing symptoms being the most common reason.Significance of results:This study showed that women died to a lesser degree at home than men. The explanation for this is unknown and requires further investigation. It is important to establish whether female patients or male caregivers need another type of support than male patients or female caregivers, since the aim of palliative care is that every patient who wishes to die at home should have this wish fulfilled.
A psychiatrist in hospice
Authors: MORGENSTERN ALAN , BOVERMAN HAROLD , GANZINI LINDA 
Published: November 2003

Dr. Alan Morgenstern joined the psychiatry faculty at Oregon
Health and Science University (OHSU) in 1965. He also served as
chairman of psychiatry at Good Samaritan Hospital and Medical Center in
Portland, Oregon. His many accomplishments include his part in a World
Health Organization Travel-Study Fellowship. He served as a senior
examiner for the American Board of Psychiatry and Neurology and he
published a critique of this process, which resulted in a humanization
of the experience for examinees. While teaching at OHSU he had a
tremendous impact on generations of students who were impressed by his
humane approach to medicine. He received the OHSU Meritorious
Achievement Award for Teaching. He also served as a captain in the
United States Air Force School of Aerospace Medicine. His close friend,
Harold Boverman, M.D., wrote, “He loved his family, his work, his
patients, his friends, and his music; his license plate read
‘etude.’”Dr. Morgenstern contacted us regarding his hope that we would
facilitate publishing this account of his experience as a hospice
patient. This represents an edited version of his manuscript. L.G. and
H.B.
Living in the face of death: Interviews with 12 terminally ill women on home hospice care
Authors: GRUMANN MAREILE M. , SPIEGEL DAVID 
Published: November 2003

Objective:To determine how home hospice patients deal with their impending death and whether there is a need for greater involvement of mental health professionals in the care of patients dying at home.Method:In a pilot study, 12 female home hospice patients with advanced cancer and a median survival time of 42 days were assessed using structured interviews and brief questionnaires. Topics of inquiry included facing death, fear of death, pain, fatigue, depression, and anxiety. Three key themes were extracted from the information reported by the women: (1) confronting the issue of death, (2) fear of dying and death and its correlates, and (3) spirituality/religious faith and its role in mitigating fear of death.Results:First, all subjects reported thinking about their approaching death. For half of them, this thought was bothersome and these women were frequently troubled by unresolved issues and higher anxiety, pain, and fatigue. The majority of the subjects expressed a desire to actively discuss their impending death. Second, more than half of the patients reported being afraid of death and high death anxiety was associated with fear of dying in pain, high peak or usual pain, unresolved issues, and difficulty in parting with family in death. Third, most subjects experienced their religious faith as an important source of comfort and strength.Significance of results:A substantial subgroup of home hospice patients expressed problems dealing with their approaching death. These problems are amenable to psychological treatment, such as fear of death, unresolved issues, parting with family, and pain. The findings, thus, highlight the need for close collaboration of mental health professionals with home hospice institutions.
A systematic review of spiritual and religious variables in
Palliative Medicine, American Journal of Hospice and
Palliative Care, Hospice Journal, Journal of
Palliative Care, and Journal of Pain and Symptom
Management
Authors: PUCHALSKI CHRISTINA M. , KILPATRICK SHELLEY DEAN , McCULLOUGH MICHAEL E. , LARSON DAVID B. 
Published: November 2003

Objective: There has been increasing recognition and
acceptance of the importance of addressing existential and spiritual
suffering as an important and necessary component of palliative
medicine and end-of-life care in the United States. This paper seeks to
empirically and systematically examine the extent to which there is an
adequate scientific research base on spirituality and its role in
palliative care, in the palliative care and hospice literature.Methods: We sought to locate all empirical studies published
in five palliative medicine/hospice journals from 1994 to 1998. The
journals included: American Journal of Hospice and Palliative
Care, Journal of Palliative Care, Hospice
Journal, Palliative Medicine, and The Journal of Pain
and Symptom Management. Journal contents were searched to identify
studies that included spiritual or religious measures or results. Case
studies, editorials, and theoretical or descriptive articles were not
included in the search. Results: During the years 1994–1998, 1,117 original
empirical articles were published in the five journals reviewed. Only
6.3% (70 articles) included spiritual or religious variables. This
percentage, while low, was better that the 1% previously reported in an
examination of studies published in Journal of the American Medical
Association, The Lancet, and New England Journal of
Medicine. Significance of results: While researchers in the field of
palliative care have studied spiritual/religious variables more
than other areas of medicine, the total percentage for studies is still
a low 6.3%. To move the field of palliative medicine forward so
appropriate guidelines for spiritual care can be developed, it is
critical that good research be conducted upon which to base spiritual
care in an evidence-based model. Recommendations are made for future
studies on spiritual care in palliative medicine.
“Because you know there's an end to it”: Caring
for a relative or friend with advanced breast cancer
Authors: SINDING CHRISTINA 
Published: November 2003

Objective: The aim of this paper is to delineate the
particular nature of the end-of-life care experience from the
perspective of family members and friends. Ideas drawn from feminist
analyses of caring and the sociology of death and dying are used to
illuminate study respondents' accounts.Methods: Qualitative study with people who cared for a
family member or friend who died of breast cancer. Two interviews were
conducted with each of 12 study participants, and one carer responded
by letter to a series of questions drawn from the interview guide.
Accounts were analyzed with reference to grounded theory methods.Results: The analysis presented here suggests that
anticipating the death of an ill relative or friend generates
imperatives to care, imperatives that are both “felt” and
linked to wider social structures and processes. The value assigned to
closeness with the ill person can be seen to reflect cultural
injunctions toward a “good death,” and to shape informal
carers' perceptions of their labor. Also discussed in this paper
are the complex negotiations undertaken by relatives and friends, for
the life and death of someone with advanced cancer.Significance of results: This paper offers insight into the
social processes of caregiving, revealing how care may be shaped in
particular ways by an awareness of approaching death.
Quality of life pilot intervention for breast cancer patients: Use
of social cognitive theory
Authors: GRAVES, KRISTI D. , CARTER, CINDY L. , ANDERSON, EILEEN S. , WINETT RICHARD A. 
Published: November 2003

Objective: The purpose of this article is to evaluate an
8-week pilot intervention based on Social Cognitive Theory to improve
quality of life for women with breast cancer.Methods: A total of 32 breast cancer patients were
randomized to either the intervention or standard care. Outcome
variables included quality of life, mood, self-efficacy, outcome
expectations, and self-regulation.Results: Effect sizes were calculated to examine the impact
of the intervention, with moderate to large effect sizes found for
several subscales of the outcome expectations variable: learning about
cancer and treatment (d = 0.85), having a positive attitude
(d = 0.54), talking about cancer (d = 1.02), engaging
in relaxation (d = 0.62), and setting goals (d =
1.58).Significance of results: A nonparametric sign test was
conducted, indicating that women in the intervention condition either
improved more or showed less decline than the women in standard care,
p = .034, two-tailed. Implications and suggestions for the
content and delivery of future psychosocial interventions with cancer
patients are reviewed.
Meaningfulness in palliative home care: An interview study of dying
cancer patients' next of kin
Authors: MILBERG ANNA , STRANG PETER 
Published: November 2003

Objective: An increasing number of patients are cared for at
home and the presence of next of kin is often a prerequisite for
successful home care. The aim of this study was to describe and
interpret the construct of meaningfulness in next of kin of cancer
patients who are in advanced palliative home care.Methods: The perspective of Antonovsky's salutogenic
framework of sense of coherence was applied in the analysis. Using a
hermeneutic approach, 19 next of kin were interviewed (n = 30
interviews) during ongoing palliative home care.Results: Elements that facilitated meaningfulness included
comfort, retaining everyday life, action, commitment, and hope, which
were of great importance for creating a perception of
self-transcendence and that the best possible was done.Significance of results: The findings are discussed in
relation to the concepts of meaning-based coping, tragic optimism, and
existentialism. Clinical implications are suggested.
Deadman and hearth phenomena in the blast furnace
Authors: Raipala Kalevi 
Published: November 2003

The deadman and hearth phenomena play key roles in hot metal quality. The condition of the deadman has a strong influence on hot metal temperature and composition. When hot metal can flow freely towards the tap hole and the deadman is a porous coke bed, then conditions are good for desulphurization and carbonization of hot metal. The deadman has also a significant effect on lining wear and campaign length by controlling hot metal flow in the hearth.Particular observations of hearth behaviour have been made during the last six years. Data of blast furnace operation have been studied and compared with hearth condition, hot metal and slag properties. Several methods to control the dead man have been experienced in Koverhar. The best method so far is to use coarse coke with low reactivity and to control burden distribution with movable armour. Response times to hearth control actions are painfully long – four weeks or even more.A set of indications about deadman condition have been collected. Hearth bottom temperatures are used to monitor the location of 1150°C isotherm. Rod tests have been used to sound the dead man hardness and to measure the length of the raceways.Interesting dependence between deadman condition, reduction of iron, hot metal sulphur and carbon and hot metal temperature has been found. This knowledge has been practised resulting in remarkable improvement of hot metal quality and hearth condition.
Theoretical approach to the dynamics of the inoculum density of Verticillium dahliae in the soil: first test of a simple model
Authors: MOL L. , HUISMAN O. C. , SCHOLTE K. , STRUIK P. C. 
Published: November 2003

A mathematical equation was developed that describes the inoculum densities of microsclerotia of Verticillium dahliae in the soil over a long time span. The equation was based on measurable parameters and ecologically meaningful principles. In the model, the number of systemic infections of plant roots during crop growth was related to soil inoculum density. In turn, formation of microsclerotia in debris and reduction of the amount of crop growth were related to the number of systemic infections. Finally, a gradual release and mortality of microsclerotia in the soil were included to calculate subsequent inoculum densities in the soil.Fitting the function to experimental data of potato cvs Element, Ostara, Mirka and Astarte, flax, pea, barley, sugar beet, onion and faba bean gave a very high correlation between observed and predicted soil inoculum densities. The clear differences in inoculum production among potato cultivars and other crops were expressed in quantitative terms. The highest inoculum density after incorporation of the debris of a susceptible crop was estimated to occur at 2.3 thermal time units of 3600 degree days (base 0°C). Ten per cent of the initial input of inoculum was still present after 4.5 thermal time units. The model was used to predict the dynamics of soil inoculum densities for V. dahliae under various cropping frequency schemes and performed satisfactorily.
Production of syringomycins and syringopeptins by Pseudomonas syringae pv. atrofaciens
Authors: VASSILEV V. , LAVERMICOCCA P. , DI GIORGIO D. , IACOBELLIS N. S. 
Published: November 2003

All virulent strains of Pseudomonas syringae pv. atrofaciens produce in vitro substances with syringomycin‐like features. All strains inhibited the growth of Geotrichum candidum in the plate assay although the extent of their growth inhibition was variable.Purification of bioactive culture extracts of a highly virulent strain by ion exchange chromatography (Whatman CM52) yielded a main fraction which inhibited the growth of Rhodotorula pilimanae and Bacillus megaterium, and was phytotoxic to tobacco and wheat plants. In particular, the injection of this fraction in the culm of wheat plants caused phytotoxic symptoms on leaves similar to those caused in nature by the pathogen. The further purification by HPLC of the above fraction gave rise to four main bioactive substances which have been identified by spectroscopic methods (FAB‐MS) and amino acid analysis as syringomycin E, syringomycin G, syringopeptin 25A and syringopeptin 25B, toxic lipodepsipeptides thus far recognized to be produced by most strains of P. syringae pv. syringae. The injection of both syringomycin E and syringopeptin 25A in wheat leaves caused necrotic symptoms; however, syringopeptin 25A was at least six times more active than syringomycin E. The possible role of the toxins in the disease development on cereals and the need for a careful examination of pathogenetic and biochemical features of P. syringae pv. atrofaciens to establish the relationships of the two pathovars in the ‘syringae group’ are discussed.
Pathogenic variation in Xanthomonas campestris pv. phaseoli, the causal agent of common bacterial blight in Phaseolus beans
Authors: OPIO A. F. , ALLEN D. J. , TERI J. M. 
Published: November 2003

A total of 93 isolates of Xanthomonas campestris pv. phaseoli was collected from five countries over a wide range of altitude (500–2320 m above sea level) in eastern Africa. Collections were made from a range of cultivars of the common bean (Phaseolus vulgaris), including known sources of resistance, as well as from wild alternative but symptomless hosts including Senna (Cassia) hirsuta and Digitaria scalarum. From these, 30 isolates were selected for detailed characterization. Although variation was found in parameters including phage type, the production of brown pigment in culture media and in‐vitro growth rate, there was little consistent relationship between these characters and pathogenic variation.Studies of pathogenic variation among the 30 isolates on 20 genotypes of P. vulgaris revealed quantitative host non‐specific differences (aggressiveness). On tepary bean (P. acutifolius), however, the 30 isolates interacted differentially with the genotypes and eight distinct physiologic races of X. c. pv. phaseoli were defined, suggestive of an underlying gene‐for‐gene relationship.Despite this apparent gene‐for‐gene interaction, resistance to common bacterial blight in P. vulgaris, derived from earlier use of P. acutifolius, has apparently remained non‐specific and essentially durable. It is suggested that, since levels of resistance already available within P. vulgaris provide adequate protection, bean breeders should resist the temptation to incorporate new complete resistance from P. acutifolius as it would risk destabilizing the host–bacterium relationship by introducing race‐specific resistance that is more likely to prove transient in agriculture.
T‐Helper Cell Tolerance to Ubiquitous Nuclear Antigens
Authors: Nakken B. , Davis K. E. , Pan Z. J. , Bachmann M. , Farris A. D. 
Published: November 2003

AbstractSystemic autoimmune diseases are characterized by the development of antinuclear autoantibodies. In order to understand the immunologic events leading to the development of such antibodies, knowledge of mechanisms of immune tolerance to nuclear antigens is required. By utilizing adoptive T‐cell transfer strategies with transgenic mouse models expressing nuclear neo‐self antigens, T‐cell tolerance to the lupus‐related nuclear antigens human La and nRNP A has been demonstrated. These findings also indicate the existence in normal animals of autoreactive B cells continuously presenting nuclear antigen, suggesting that nuclear antigens are not sequestered from the immune system. Investigations of CD4+ T‐cell tolerance to non‐nuclear antigens have revealed a number of mechanisms that protect the host from autoreactivity, including autoreactive T‐cell deletion, regulatory T‐cell development and anergy induction. Recent studies using T‐cell receptor and neo‐self nuclear antigen transgenic mice are revealing the importance of such mechanisms in maintaining tolerance to nuclear antigens. Mechanisms of tolerogenic antigen presentation, identification of tolerogenic antigen source(s) and the pathways leading to loss of tolerance to nuclear antigens in systemic autoimmune disease states are currently being sought.
Longitudinal Analysis of MART‐1/HLA‐A2‐Reactive T Cells Over the Course of Melanoma Progression
Authors: Terheyden P. , Schrama D. , Pedersen L. Ø. , Andersen M. H. , Kämpgen E. , Thor Straten P. , Becker J. C. 
Published: November 2003

AbstractAn HLA‐A2‐positive patient with advanced stage IV melanoma was vaccinated with dendritic cells (DCs) pulsed with melanoma antigens, whereby the rapid progression of disease stalled for a period of 10 months. Monitoring of the cellular immune response against one of the vaccinated HLA‐A2‐restricted epitopes demonstrated both induction and subsequent decline in the number of interferon‐γ (IFN‐γ)‐producing MART‐1‐reactive cells present in the blood. Enumeration of reactive T cells by MART‐126‐35/HLA‐A2 tetramer staining revealed an induction of such cells after three vaccinations and a subsequent decline that most prominent at times of rapid disease progression. However, a substantial number of reactive cells were present even when no MART‐1 reactivity was detectable by functional assays. Isolation of such MART‐126−35‐reactive T cells by means of peptide/HLA‐A2‐coated magnetic beads demonstrated the persistence of a TCRVβ14+ T‐cell clone in this population over the whole observation period. Intracellular fluorescence‐activated cell sorter staining of such TCRVβ14+ T cells for IFN‐γ and interleukin‐2 after maximal stimulation with phorbol 12‐myristate 13‐acetate/ionomycin revealed an impairment in their capacity to produce cytokines at the end of the observation period. Thus, functional changes of individual T‐cell clones, e.g. clonal exhaustion, seem to be responsible for the known discrepancy between functional and phenotype assays for immune monitoring of tumour patients.