bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue, Pain, and Depression in Pre‐Autotransplant Breast Cancer Patients
Authors: Gaston‐Johansson Fannie , Fall‐Dickson Jane M. , Bakos Alexis B. , Kennedy M. john 
Published: March 2003

objectives: The purpose of this study was to determine the influence of fatigue, pain, and depression on health status in breast cancer patients who had completed adjuvant chemotherapy and were scheduled for autologous bone marrow/peripheral blood stem cell transplant (AT).materials and methods: A predictive, correlational design was used. A convenience sample of 127 women with stages II, III, and IV breast cancer was recruited. The setting was an urban National Cancer Institute‐designated comprehensive cancer center located in the Eastern United States. Standardized questionnaires and the Gaston‐Johansson Painometer (POM) were used to measure the variables. The subjects completed questionnaires in the outpatient clinic. Relationships between the multiple dimensions of fatigue and pain, depression, and health status were examined. Hierarchical regression techniques were used to determine the variance in health status accounted for by fatigue, pain, and depression.results: The subjects were age 22 to 60 years (Mean = 45; SD = 7.6), and primarily were married, white, Protestant, college educated, employed in a professional position, and had an average yearly household income of equal to or greater than $50,000. All subjects had previously received surgery and chemotherapy. Ninety‐one percent of the participants reported fatigue as measured by the Fatigue Visual Analogue Scale. Forty‐seven percent of the participants reported pain as measured by the Gaston‐Johansson POM visual analogue scale. Fifty‐four percent of the participants reported depression, ranging from mild to severe/high. Subjects reported a mean total perceived health status rating of 50.73 (SD 10.79). Fatigue, pain, and depression were all significantly correlated to each other and to total health status. Depression (P < .001) and pain (P < .01) significantly accounted for 64% (adjusted R2 = .60) of the variance in total health status. Fatigue (P < .05) and depression (P < .001) accounted for 42% (adjusted R2 = .36) of the variance in the perception of health status.conclusions: Women with breast cancer previously treated with chemotherapy and awaiting AT may experience fatigue, pain, depression, and alterations in health status. Pain and depression had a significant impact on a woman's total health status, whereas depression and fatigue had an influence on perceived health status. Of the different dimensions of health status, one's perceptions of health status had the strongest correlation to total health status (r = .84, P < .001). Healthcare professionals need to be aware of the effects of multiple symptoms on health status and to provide appropriate care to alleviate them.
Parents' Perceptions of Randomization in Pediatric Clinical Trials
Authors: Wiley Frances M. , Ruccione Kathy , Moore Ida M. , McGuire‐Cullen Patsy , Fergusson Jean , Waskerwitz Mary J. , Perin Gail , Ge Jeff , Sather Harland N. ,   For the Children's Cancer Group
Published: March 2003

objectives: The purpose of this study was to investigate parents' knowledge and perceptions about randomization in clinical trials for children with cancer, and to determine whether parents' decisions were influenced by demographic factors, randomization circumstances, the clinical characteristics of the child with cancer, or a combination.materials and methods: This study collected information from 192 parents of patients with various forms of childhood cancer who either accepted or refused randomization. A comparative case‐control design was used. The Clinical Investigation Randomization Scale was administered to all participants. This scale included 32 questionnaire items (QIs) pertaining to randomization as well as a mixture of open‐ended questions to obtain information about demographic and other factors.results: A predictor model was developed that accurately predicted acceptance or refusal of randomization 87% of the time. Demographic information was found to have less influence than expected on parents' decisions regarding randomization. Knowledge deficits were found among both groups of parents, those who accepted and those who refused randomization.conclusions: What most distinguished parents who refused from those who accepted randomization was not their knowledge and information about randomized clinical trials. By far, the majority of QIs that accurately predicted acceptors and refusers involved parents' beliefs, values, and perceptions. Further research is needed to determine interventions that may enable the healthcare team to provide information and decisional support most effectively to improve the informed consent process.
Impact of Development on Children's Mourning
Authors: Christ Grace H. 
Published: March 2003

AbstractPurpose:A qualitative approach was used to analyze the impact of development on the grief responses of 157 children from 88 families to the death of a parent from cancer.Description of study :Children from age 3 to 17 years were divided by developmental characteristics, derived from interview data, into five development‐derived age categories.Results:The responses of children in different categories clarified the impact of development on their distinct expressions of grief, attributes of the parent they mourned, and the parent's tasks in enhancing the reconstitution of the child and the family.Clinical implications:This first attempt to find a way to segregate children into developmentally more homogenous subgroups led to the clarification of patterns of mourning behaviors that are clinically useful. The increased precision of findings, such as the way development affects the child's mourning and the related parental support they need, may help clinicians develop more specific interventions to help children cope with the death of a parent and guide parents in understanding their children's differing responses. The pivotal role of the surviving parent and the tasks required of that parent are important for healthcare professionals to understand and support.
Patient Age and Cancer Treatment Decisions
Authors: Kutner Jean S. , Vu Kieu O. , Prindiville Sheila A. , Byers Tim E. 
Published: March 2003

Purpose: The purpose of this study was to examine patient and physician factors influencing the decision to use adjuvant chemotherapy for stage III colon cancer in elderly persons.Description of study: A cross‐sectional mailed population‐based survey of patients 65 years of age and older who had undergone surgical resection of stage III colon cancer in Colorado between August 1995 and December 1997 were identified by the statewide cancer registry (n = 276) and their treating physicians (n = 232). A questionnaire about the determinants of colon cancer treatment decisions was mailed to all patients for whom physician permission was granted (n = 119). A similar questionnaire was sent to treating physicians.Results: Ninety‐two physicians (internal medicine 23%; family medicine 12%; surgery 37%; and oncology 24%) and 67 patients (mean age 75.8 years; 55% women) completed surveys. Fifty‐four (80.6%) of the patients had received adjuvant chemotherapy. The major determinants of receiving adjuvant chemotherapy were having seen an oncologist (P = .003), being younger (P = .003), and being married (P = .021). After controlling for other potential influences, only having seen an oncologist (odds ratio 8.0; confidence interval 1.5–43.1) remained significantly associated with the receipt of chemotherapy. Physicians were more likely than patients to rank comorbid conditions (39.1% versus 3.0%, respectively; P < .001) and the medical literature (20.7% versus 4.5%, respectively; P = .004) as important factors in making treatment decisions, while patients were more likely than physicians to rank physician opinion (73.1% versus 26.1%, respectively; P = .001), family preference (31.3% versus 9.8%, respectively; P = .001), and family burden (10.4% versus 2.2%, respectively; P = .038).Clinical implications: In this elderly population, patient age is not recognized by patients or physicians as affecting the decision to use adjuvant chemotherapy. Other biologic and social factors are important, however, and the perspectives of physicians and patients differ regarding their relative importance.
Cancer Screening Among Korean Americans
Authors: Sarna Linda , Tae Young Sook , Kim Young Hae , Brecht Mary Lynn , Maxwell Annette E. 
Published: March 2003

Purpose: Cancer is a leading cause of death among Korean Americans (KAs), one of the most rapidly growing ethnic minority communities in the United States. An understanding about cancer screening practices among Koreans (Ks) living in Korea can be useful in designing culturally sensitive health promotion programs in the United States. The purpose of this study was to describe the cancer screening knowledge and behaviors of a sample of KAs in Los Angeles, California, compared with a similar sample of Ks in Korea.Description of study: This descriptive survey used a convenience sample of 140 KAs age 40 and older, living in Los Angeles, California, in 1998. A random sample of 149 Ks from Pusan, Korea, in 1995 to 1996 was used as a comparison group. KAs had lived in the United States for an average of 15 years. A Korean and English language 58‐item self‐administered questionnaire assessed knowledge of cancer screening tests and personal cancer screening practices.Results: The findings demonstrate that both KAs and Ks had low participation in cancer screening. Breast cancer screening was significantly more likely among KA women than among Ks; screening rates for cervical cancer and gastrointestinal malignancies were not significantly different between the two groups.Clinical implications: These data can be used to assist healthcare professionals in the development of educational tools and strategies for promoting cancer screening programs for KAs. The unique contribution of this study was the opportunity to compare findings from an immigrant Korean population with a similar population in the country of origin.
Patient and Caregiver Interest in Internet‐Based Cancer Services
Authors: Monnier Jeannine , Laken Marilyn , Carter Cindy L. 
Published: March 2003

purpose: The primary goal of this study was to identify the needs for, the interest in, and the feasibility of the implementation of an Internet‐based cancer services web site. Additionally, group differences (racial, patient vs caregiver, or rural vs urban) were identified that might influence the implementation of such a project.description of study: Patients with cancer and caregivers (N = 319) in the waiting rooms of a cancer center located within a southeastern medical university completed questionnaires regarding their interest in Internet‐based services. Topics included the likelihood of using Internet‐based services, interest in home healthcare services delivered via a personal computer, and knowledge about and use of the Internet.results: Results indicated that most patient and caregiver respondents were interested in Internet‐based cancer‐related services such as information related to treatment (80%), conversations with physicians via the Internet (70%), and online support groups (65%). In addition, respondents reported that they would be likely to use such services (70%) and were interested in home healthcare services delivered via personal computers (60%). No group differences were found across ethnic groups, geographic settings, and patient status (patient vs caregivers) on these variables. Minorities, older individuals, and less educated individuals were less likely to have knowledge of and to have used the Internet.clinical implications: Patients with cancer and their caregivers are interested in supplementing in‐person services with Internet‐based services relating to their cancer treatment. Special efforts need to be made to reach ethnic minorities, the elderly, and those with less education with Internet‐based programs.
Tapestry
Authors: Angen Maureen J. , MacRae J. Helen , Simpson J. Steven A. , Hundleby Marilyn 
Published: March 2003

purpose: In an effort to mitigate the negative psychological sequelae of a cancer diagnosis and cancer treatment, efforts have been made to explore a variety of psychosocial issues and interventions. This article describes the provision and preliminary evaluation of a novel psychosocial service delivery, a residential “retreat” program called Tapestry, which is run under the aegis of the established cancer care community in Alberta, Canada.overview: Retreat programs offer a novel way to provide psychosocial support for those persons who are living with cancer. The retreats are unique in the provision of a respite and the opportunity to address the isolation and other existential issues arising from a cancer diagnosis. The program described in this article has provided such a service six times per year since 1998. The intervention is described, and preliminary evaluation data are presented.clinical implications: Cancer care has begun to move beyond a solely biomedical paradigm toward a more holistic ethos in service delivery and research orientation. While the face value of and demand for such programming continues to grow, few residential psychosocial programs are offered under the auspices of conventional cancer care centers, and little work has been done to examine the nature and possible efficacy of retreat programs as a valid forum for psychosocial service delivery.
Arteriovenous Difference of Blood Ammonia in Uremic Patients Under Hemodialysis
Authors: Agroyannis Basil , Tzanatos Helen , Fourtounas Costas , Kopelias Ioannis , Katsoudas Spyros , Chondros Kostas 
Published: March 2003

It is the goal of this section to publish material that provides information regarding specific issues, aspects of artificial organ application, approach, philosophy, suggestions, and/or thoughts for the future.In this study the ammonia concentration was determined in arterial and venous blood samples pre‐ and posthemodialysis (HD) in 18 uremic patients and in 18 health subjects (controls). The mean values (±SD) of ammonia in the arterial blood of uremic patients pre‐HD were 98.32 ± 26.55; post‐HD, 63.18 ± 17.09; and in control group patients, 72.37 ± 10.09 μg/dl. In venous blood they were pre‐HD, 71.70 ± 20.68; post‐HD, 58.05 ± 16.73; and in control patients, 74.46 ± 12.0 μg/dl. Accord than that post‐HD and that of control patients. The ammonia contents of venous blood pre‐ and post‐HD ranges were within normal values, but the post‐HD range was significantly lower than the pre‐HD range (p < 0.05) and the control range (p < 0.01). Comparison between ammonia levels from arterial and venous blood showed significant and positive arteriovenous differences pre‐HD (p < 0.001), which disappeared post‐HD and were not observed in the control patients. In conclusion, uremic patients under HD present pre‐HD high levels of ammonia in arterial blood with a significantly positive arteriovenous difference. In contrast, the post‐HD ammonia levels in arterial and venous blood are decreased, and the arteriovenous difference is not significant.
Higher Plant Assays for the Detection of Genotoxicity in Air Polluted Environments
Authors: Grant William F. 
Published: March 2003

ABSTRACTSince the beginning of time pollution has been created by human activities. However, the intensity and the severity of the different kinds of pollution have emerged only in the last few decades and many intricate facets have been revealed. It is gradually being recognized that our health and the ecosystem are being severely affected by environmental chemicals that enter the atmosphere. Plants comprise a large portion of our biosphere and constitute a vital link in the food chain. In this review, types of mutagenic chemicals found both indoor and outdoor are given and several higher plant bioassays for screening and monitoring environmental mutagens are discussed. One plant ideal for monitoring and testing for air pollution is Tradescantia. This species has been used to test for mutagenicity of radioisotope‐contaminated air following the Chernobyl nuclear accident and monitoring around nuclear power plants. One of the greatest contributions of plant bioassays will be their continued use for ambient air monitoring and testing for genotoxicity which can be carried out on a global scale.
Prepregnancy Headache and the Well‐being of Mother and Newborn
Authors: Aromaa Minna , Rautava Päivi , Helenius Hans , Sillanpää Matti L. 
Published: March 2003

Women (n = 1443) expecting their first child were studied to examine whether prepregnancy headache predicts problems in the well‐being of pregnant women and newborns. Subject collection was based on stratified randomized cluster sampling.Impairment of health during the first trimester was more often reported by women with frequent prepregnancy headache than by nonsufferers. They also made more visits to a doctor and had more pregnancy symptoms during the third trimester. Use of any medication during the first trimester was also more common in the headache group. Mental health status was worse, fatigue and depression increased during pregnancy more often, and stress and anxiety about delivery were more common in this group. The relationship with spouses worsened during pregnancy in the headache group and seemed to be predicted by impairment of somatic health during the first trimester and increasing depression during pregnancy. No statistical differences between groups were found in variables measuring the well‐being of the newborns.Frequent prepregnancy headache proved to be a strong predictor of ill‐being in pregnant women. This result should find practical applications in the preventive work of maternity health care clinics.
Migraine Stroke: A Possible Complication of Both Migraine With and Without Aura
Authors: Narbone Maria Carola , Leggiadro Nestore , La Spina Paolo , Rao Renata , Grugno Rosario , Musolino Rossella 
Published: March 2003

We describe four migraine patients who developed an ischemic stroke during their typical migraine attacks.Cerebral infarction as a possible complication of migraine without aura is discussed.We propose a review of the migraine stroke definition of the International Headache Society.
The Actions of Valproate and Neurosteroids in a Model of Trigeminal Pain
Authors: Cutrer F. Michael , Moskowitz Michael A. 
Published: March 2003

Gamma‐aminobutyric acid (GABA) receptors are ubiquitous inhibitory receptors in the central and peripheral nervous systems. Valproic acid (2‐propylpentanoic acid), which enhances GABA synthesis and blocks degradation, is useful in migraine treatment and may act through activation of GABA receptors to modulate trigeminal nociceptive neurons innervating the meninges. To investigate this possibility, we tested the effect of valproate and allopregnanolone, a metabolite of progesterone, which binds and modulates the GABA receptor in an animal model of cephalic pain.One hundred ten Hartley guinea pigs were pretreated with either valproate or allopregnanolone 30 minutes prior to activation of trigeminal afferent fibers via intracisternal injection of the irritant, capsaicin. The effects of valproic acid and allopregnanolone were examined on c‐fos expression within the trigeminal nucleus caudalis (lamina I, II0), the termination site for small unmyelinated C fibers projecting from the meninges. C‐fos positive cells were counted at three representative levels (rostral, middle, and caudal) by an observer naive to the treatment group.We found that valproate ( ³³10 mg/kg, IP) reduced labeled cells by 52% (P<0.05) and allopregnanolone ( ³³100 mg/kg, IP) reduced labeled cells by 42% (P<0.01). Bicuculline (GABAA antagonist), but not phaclofen (GABAB antagonist), blocked the valproate effect, thereby documenting the importance of GABAA receptors.We conclude that the attenuation of c‐fos‐LI by valproate and allopregnanolone is mediated via GABAA receptors. These studies complement prior experiments showing that valproic acid and allopregnanolone block neurogenic inflammation within the meninges via GABAA receptor‐mediated mechanisms. The findings suggest a potential strategy for discovering new antimigraine drugs with high affinity for the GABAA receptor and its modulatory sites.
Effect of Chinook Winds on the Probability of Migraine Headache Occurrence
Authors: Piorecky J. , Becker W.J. , Rose M.S. 
Published: March 2003

Our objective was to determine if Chinook weather conditions in the Calgary area increase the probability of headache attacks in migraine sufferers.Environment Canada meteorologic summaries for January through June 1992 were analyzed and times of Chinook wind onset identified. Chinook weather conditions were defined as calendar days when Chinook winds were present and the calendar day immediately preceding Chinook wind onset. The diaries of 13 migraine patients were analyzed, and times of headache onset classified according to the existing weather conditions.The probability of migraine headache onset was greater on days with Chinook weather (17.26%) than on non‐Chinook days (14.65%) (P = 0.042). Older patients appeared more weather sensitive than younger patients. For patients over age 50, the probability of migraine occurrence on Chinook weather days was much greater than on non‐Chinook days (P = 0.007).Chinook weather conditions increase the probability of migraine headache occurrence. Older migraine sufferers appear particularly vulnerable to this effect.
Prevalence and Clinical Features of Chronic Daily Headache in a Headache Clinic
Authors: Srikiatkhachorn Anan , Phanthurachinda Kammant 
Published: March 2003

Although chronic daily headache is regarded as a syndrome encountered in headache clinics, clinical characteristics have only rarely been studied and the condition has not been documented in Thailand. To investigate the prevalence as well as clinical features of chronic daily headache in Thai patients, 220 patients visiting Chulalongkorn Headache Clinic were examined. Sixty cases (27.3%) were diagnosed as suffering from chronic daily headache (male to female ratio, 1:5.7).The average age of these patients was 32.7 ± 9.6 years. Based on the International Headache Society (IHS) criteria, 30% of patients with chronic daily headache could be diagnosed as suffering from migraine end 36.7% from chronic tension‐type headache, whereas the remainder had combined features of both headache types and were not classifiable. Diffuse steady pain was the most common headache type reported (65%), however, associated features characteristic of migraine were often noted. These included photophobia (70%), phonophobia (56.7%) and nausea (43%). Thirty‐four cases (56.7%) reported that their headache could be aggravated by stress. Daily use of analgesics was reported in 58.3% of cases. We concluded that chronic daily headache is a common problem. Although the mechanism has not been fully clarified, the prevalence of associated psychological factors and analgesic overuse imply their involvement in the pathogenesis of this condition. The criteria of the IHS are not entirely suitable for diagnosis and classification of this disorder, and modification of this classification system is needed.