bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physician Referral Patterns to a Breast Cancer Support Program
Authors: Fernandez Barbara M. , Crane Lori A. , Baxter Judith , Gallagher Kaia , McClung Melissa W. 
Published: March 2003

Purpose: The purpose of this study was to describe the differences between physicians who did and did not refer their patients with breast cancer to the American Cancer Society's Reach to Recovery program, as well as to determine the factors associated with these physician referral patterns.Description of study: This descriptive cross‐sectional study included 54 physicians who had and 23 physicians who had not referred their patients with breast cancer to the Mile High Unit Reach to Recovery program in 1999. Participating physicians completed a questionnaire about their knowledge, behaviors, and beliefs regarding Reach to Recovery, the characteristics of the patients they referred, and their own demographic and practice characteristics.Results: General surgeons were more likely than all other specialties to refer patients to the Reach to Recovery program. The program is a part of the American Cancer Society. Feedback from patients about their experiences with Reach to Recovery and the proportion of patient time spent caring for patients with breast cancer were all positively associated with referral.Clinical implications: These findings show that those providing support programs, such as Reach to Recovery, need to use targeted strategies to ensure that physicians are aware of the services they provide and that patients relay their experiences back to their referring physician. Because the value of social support programs for women with breast cancer has been established, physicians can become valuable partners in helping more women gain access to these programs.
Reflections on Nutritional Issues Associated with Cancer Therapy
Authors: McGrath Pam 
Published: March 2003

purpose: It is now recognized that dietitians have a significant role to play in the care of oncology patients, many of whom have problems with nutrition. However, it is increasingly understood that there are important obstacles to assisting patients with nutritional problems in the oncology setting. The purpose of this article is to discuss the incidental findings of two recent studies, highlighting the importance of and problems associated with nutritional issues in patients with a hematologic malignancy.overview: This article presents findings from two recent studies with a subset of patients who have hematologic malignancies. This diagnostic subgroup has specific challenges associated with nutrition and eating because of the intensive and aggressive treatments that patients endure. An explorative, descriptive, iterative, qualitative methodology was used for both studies. The focus was on exploring the lived experience of treatment in oncology/hematology for patients (prospective) and caregivers (retrospective).clinical implications: The findings indicate that the issues surrounding food and eating are considered to be of great significance both to patients who are undergoing intensive treatment for a hematologic malignancy and to their caregivers. The significance of food is not seen purely in relation to its nutritional value, but as an important quality‐of‐life issue. Eating problems during intensive chemotherapy are perceived as highly stressful and can be, in the case of treatment‐related anorexia, life threatening. Recommendations are made for interventions that could reduce the stress and nutritional difficulties for both patients and caregivers.
Indirect Economic Effects of Long‐Term Breast Cancer Survival
Authors: Chirikos Thomas N. , Russell‐Jacobs Anita , Cantor Alan B. 
Published: March 2003

purpose: The indirect morbidity/disability costs of breast cancer may be rising as a consequence of the growth in the population of long‐term survivors. This study was conducted to test whether women who have survived breast cancer for at least 5 years experience long‐lasting or continuing economic consequences that are attributable to their disease.description of study: A group of 105 women who initially had been treated for breast cancer approximately 5 years before were interviewed to obtain data on economic, demographic, and health changes in the period since diagnosis. An age‐matched and work‐matched group of 105 women without cancer also was interviewed to obtain the same data for the same time period. Key changes in the economic position of subjects and their families were measured, including changes in work effort, pay rates, and annual earnings of working women and changes in household earnings, income, and assets of all women.results: These preliminary empirical findings suggest that breast cancer exacts an economic toll from long‐term survivors. In particular, survivors who were working at the time of their diagnosis experienced significantly larger reductions in annual market earnings over the 5‐year study period than did working control subjects. These losses appear to arise mostly from reduced work effort, not changes in pay rates. Also, changes in total household earnings were lower for survivors, suggesting the presence of family adjustments to the disease. However, no significant differences were detected between the groups in changes in total income or assets over the study period.clinical implications: Clinicians and policy makers must seek ways to minimize the indirect economic losses that are attributable to breast cancer.
Air Pollution and its Health Effects in Beijing
Authors: Xu Xiping , Wang Lihua , Niu Tianhua 
Published: March 2003

ABSTRACTThe primary goals of this review were to summarize the epidemiological studies carried out in Beijing, China for assessing the health effects associated with both short‐term and long‐term exposures to air pollution. In these investigations, a time series study design was used to evaluate the health effects of short‐term air pollution exposures; cross‐sectional and longitudinal study designs were used to evaluate the health effects of long‐term air pollution exposures. Taken together, these epidemiological studies provide coherent evidence that short‐term exposures to air pollution are significantly associated with adverse reproductive outcomes such as preterm delivery and low infant weight, and excess daily morbidity and mortality, whereas long‐term exposures to air pollution are associated with increased respiratory symptoms or bronchitis in adults. Moreover, these investigations suggested a synergistic effect between air pollution and personal smoking. This review of environmental epidemiological studies in Beijing clearly indicates a link between human health and ecosystem health. Concrete measures in air pollution control must be taken to halt degradation of the earth’s ecosystems from a public health viewpoint.
Developing Ecosystem Health Indicators in Centro Habana: A Community‐based Approach
Authors: Spiegel Jerry M. , Bonet Mariano , Yassi Annalee , Molina Enrique , Concepcion Miriam , Mast Pedro 
Published: March 2003

ABSTRACTA set of interventions was undertaken between 1995 and 1999 to improve the quality of life and human health in Cayo Hueso, an inner city community in Central Havana. The municipality and community organizations contacted the agency responsible for public and environmental health in Cuba (INHEM) to evaluate whether these improvements were as effective and efficient as possible, so as to assist in planning further interventions in this and other communities. With the aid of international researchers, an effort was made to strengthen the community's capacity to apply an ecosystem health approach, adapting the analytical framework (DPSEEA: driving force–pressure–state–exposure–effects–action) developed for this purpose by the World Health Organization. A series of workshops and focus groups with community representatives and researchers was conducted in late 1999 and early 2000 to develop appropriate indicators for the analysis. Interventions were grouped into those relating to improved housing, the physical community infrastructure (e.g., water, sewage, street lights), and the socio‐cultural environment (e.g., programs for youths and seniors). The DPSEEA framework was embraced by the community and used to define indicators at the individual, household, and neighborhood levels; the community‐researcher team then collectively elaborated the methodology to obtain the needed information. Data collection is now underway with the process having triggered a series of new partnerships, including other communities (comparison groups) now eager to learn from the Cayo Hueso interventions. With the capacity to apply this approach strengthened, the community is preparing to use the results of the analyses to set new priorities and pursue longer‐term ecosystem health interventions.
Sustainability, Exceptionalism, and Exemptionalism
Authors: Cairns John 
Published: March 2003

AbstractSustainable use of the planet is based on the assumption that social evolution and changed human behavior can produce a sustainable society. This paradigm is vastly different from the notion that humans possess a common set of rigid, genetically specified behavioral predilections that are unlikely to be altered by circumstances. This manuscript examines two beliefs that are arguably root causes of the present human predicament.Exceptionalists believe that some humans are vastly exceptional to most humans and, as a consequence, are entitled to a markedly disproportionate share of the planet's resources. In addition, humans are regarded as entitled to a vastly disproportionate share of the planet's resources compared with other species, for the same reason. Exemptionalists believe that human ingenuity, technology, and creativity free them from the iron laws of nature that limit and control other species. Both views constitute major obstacles to achieving sustainable use of the planet and require rigorous reexamination if sustainability is to be achieved.“Brains exist because the distribution of resources necessary for survival and the hazards that threaten survival vary in space and time. There would be little need for a nervous system in an immobile organism or an organism that lived in regular and predictable surroundings … brains are buffers against environmental variability”.
SUNCT Syndrome. Atypical Temporal Patterns
Authors: Pareja Juan A. , Joubert Jacques , Sjaastad Ottar 
Published: March 2003

New clinical features of the SUNCT syndrome are described in a series of 3 men (mean age of 65 years, range 56 to 80). The mean age at the onset of symptoms was 55 years (range 39 to 77). Although in all patients the great majority of attacks were typical, on a few occasions unusual features of the painful attacks were either reported or witnessed by the investigators. We have classified these clinical phenomena as (1) low‐grade background pain or discomfort, and (2) relatively Long‐lasting attacks.Neither neurological examination nor neuroimaging studies revealed structural lesions as responsible for the atypical features. The fact that these atypical attacks occurred in the usual symptomatic area and were accompanied by the usual ipsilateral autonomic signs, suggests that they are an integral part of the clinical picture of SUNCT. The possibility that another, concurrent headache was responsible for the unusual attacks is considered unlikely. These clinical phenomena should, accordingly, provisionally be considered as additional but rare clinical features of the SUNCT syndrome.
Putative Neuroimmunological Mechanisms in Cluster Headache. An Integrated Hypothesis
Authors: Martelletti Paolo , Giacovazzo Mario 
Published: March 2003

During the last decade, numerous studies have been carried out to explore the function of the immune system in cluster headache and the release of reciprocal informational molecules from pain‐sensitive structures. These neuroimmunological findings in cluster headache syndrome, although carefully considered, have varied from genetic aspects (HLA antigens) to functional activity of the immune system (NK cytotoxicity), and from study of the receptor expression of classical neurotransmitters of pain (5‐HT, histamine) on immunocompetent cells, to the study of cytokines with a potent pro‐inflammatory activity (interleukin‐1). Other aspects considered have ranged from the study of the effectiveness of substances possessing a well‐known activity on the immune system (prednisone, lithium carbonate) in shortening cluster attacks to the 5‐HT receptor expression changes observed on a peripheral substrata (monocytes) after the administration of sumatriptan.Although this was an exciting area of pioneering research, we have always interpreted our findings cautiously.In summary, we now believe that the neuroimmunological aspects of cluster headache can be proposed as an integrative model and that this immunological mechanism could improve our understanding of the pathogenic basis for this still obscure disease.
Cervicogenic Headache: The Influence of Mental Load on Pain Level and EMG of Shoulder‐Neck and Facial Muscles
Authors: Bansevicius Dalius , Sjaastad Ottar 
Published: March 2003

The relationship between pain and EMG levels was studied in 17 cervicogenic headache patients and 17 group‐matched healthy controls. All subjects performed a 1‐hour, complex, two‐choice, reaction time test. Every 10 minutes before, during, and also for 20 minutes after the test, they reported pain levels (using visual analogue scales) in the forehead, both temples, neck, and shoulders. Electromyographic activity, using superficial electrodes, was also recorded from the frontal, temporal, neck (splenius), and trapezius muscles. Maximal voluntary contractions were performed in all the muscles.Increased pain levels before, during, and after the test were found on the symptomatic side in the temple, shoulder area, and neck in the patient group compared with nonsymptomatic side and controls (neck only compared with controls). Electromyographic amplitudes from the trapezius muscle on the symptomatic side were significantly higher before and during the test, compared with the nonsymptomatic side, but most markedly during the test. Pretest EMG amplitudes from the frontal muscle on the symptomatic side in patients were also significantly higher than those in controls, but the difference vanished during the test. There are indications that the temporal pain, is, the headache, is a referred pain.These observations may point to a “muscular” involvement in the pathogenesis of cervicogenic headache, either primarily or, which seems more plausible, secondarily.
The Dyspeptic Syndrome in Migraine: Morphofunctional Evaluation on 53 Patients
Authors: Centonze Vincenzo , Polito Beatrice Maria , Cassiano Maria Antonietta , Doronzo Francesco , Ricchetti Giacinto , Portincasa Piero , Bassi Antonia , Albano Ottavio 
Published: March 2003

The authors, in order to evaluate the important role of gastrointestinal dysfunction during the migraine attack, have studied 53 patients with migraine without aura during the asymptomatic stage between attacks.Patients were examined functionally with a pH meter test of the gastroesophageal tract over 24 hours and morphologically with esophagogastroduodenoscopy. The results of this study point out that in a high percentage of patients with migraine, both evaluations are normal. The authors suggest the possibility of detecting, even hypothetically, an alteration of the common neurotransmitter substrate in the origin of migraine attacks and accompanying symptoms.
Characteristics of Migraine Visual Aura
Authors: Queiroz Luiz P. , Rapoport Alan M. , Weeks Randall E. , Sheftell Fred D. , Siegel Sheryl E. , Baskin Steven M. 
Published: March 2003

Visual auras (VAs) of 100 patients with migraine with aura were studied by questionnaire. Visual auras accompanied the patients' first headache (HA) in 39% of patients. Only 19% had VAs with every attack. Patients with VAs over the entire HA history had a high frequency (greater than 50%) of attacks with VA; patients with VA during only part of the HA history had a low frequency (less than 50%} of attacks with VA. The auras occurred exclusively prior to the HA in 57%. The free interval between the end of the VA and the start of the HA was usually (75%) shorter than 30 minutes. Most (59%) patients had VAs that lasted from 1 to 30 minutes. They started in the periphery of the visual fields in 56%. The most common phenomena described were: small bright dots (42%), flashes of light (39%), “blind spots” (32%), and “foggy vision” (27%). Fortification spectra was reported by only 20%. Although most (65%) patients had a combination of phenomena, the majority (72%) had only one uniform constellation of manifestations. There was no clear‐cut relationship between side of VA and side of HA.Migraine VA is a pleomorphic and complex symptom. Many patients not qualifying for the diagnostic criteria of migraine with aura, as proposed by the International Headache Society (IHS) unequivocally present with visual phenomena that strongly suggest this diagnosis.
Headache in Sweden: The Importance of Working Conditions
Authors: Antonov Karolina , Isacson Dag 
Published: March 2003

Headache is a common health problem that causes individual suffering as well as public expense. Because epidemiological studies have shown that headache is most prevalent among persons younger than 55 years, the influence of working conditions is of interest. In this study, we examined the importance of working conditions as a risk factor for frequent headache among the general Swedish population.Data from the Swedish Survey of Living Conditions for the 2‐year period, 1988 and 1989, were used. In this survey, a probability sample of the Swedish population aged 16 years and older was interviewed. Frequent headache was defined as a positive answer to the question, "Have you (during the just 2 weeks) had recurrent headache or migraine?" Work stress was studied for two indices: physical work stress and mental work stress. The physical work stress index contained measurements of seven working conditions, and the mental work stress index contained measurements of three working conditions.The proportion of persons who reported frequent headache was greater among women than men, and frequent headache was most common in the age group 25 to 44 years. The logistic regression analyses showed that both physical and mental work stress were strongly associated with frequent headache among both men and women even after controlling for potential confounders. The associations between work stress and frequent headache may be dose‐dependent. Heavy menial work stress was most strongly associated with frequent headache among men (odds ratio 3.03 [1,92 to 4.78]) while heavy physical work stress was most strongly associated with frequent headache among women (odds ratio 3.48 [1.13 to 10.65]).Improved working conditions could be one way of preventing headache, thereby decreasing individual suffering a and employer as well as public expense.
Alcohol, Smoking, and Caffeine Use Among Headache Patients
Authors: Mannix Lisa K. , Frame Joy R. , Solomon Glen D. 
Published: March 2003

We reviewed the charts of 151 headache patients, seen initially in a specialty headache center between 1988 and 1994, to collect information regarding reported alcohol consumption, smoking, daily number of caffeinated beverages, and medications. Charts of 50 patients in a general medicine clinic were reviewed for the same information.No significant differences between headache patients and general medicine patients were found in consumption of alcohol, smoking, or caffeinated beverages. Thirty headache patients (20%) used caffeine‐containing medications more frequently than recommended; 24 of these patients used the products daily; 18 of those had a greater caffeine intake from medications than from beverages. Over‐the‐counter caffeine‐containing analgesics were overused by 12 of the patients compared to 21 patients who overused prescription caffeine‐containing preparations.Headache patients consume minimal amounts of alcohol, tobacco, and caffeinated beverages. However, headache patients often use caffeine‐containing analgesics more frequently than recommended, which may lead to rebound and withdrawal headache.
Postmeningitis Headache
Authors: Neufeld Miriam Y. , Treves Therese A. , Chistik Vladimir , Korczyn Amos D. 
Published: March 2003

Acute meningitis is associated with headache, but the natural history of the headache following recovery is unknown. We addressed this issue in 141 patients admitted during 1990 to 1993 with laboratory‐confirmed meningitis. We excluded patients younger than 5 years (n=44), elderly demented patients (n=6), and those with potential causes of headache other than meningitis (n=4). Seventeen candidates could not be traced. The remaining 70 patients were interviewed using a semistructured questionnaire that documented age, sex, type of meningitis, time of headache onset after infection, and headache description as well as any past and/or family history of headache. These patients were compared to age‐ and sex‐matched controls (n=70).Prior to meningitis, 13 patients (19%) had had headaches (migrainous in 8) as did 18 controls (26%; migrainous in 8). Headache first appeared after meningitis in 19 patients (33%; migrainous in 6), increasing the total prevalence to 46%. We found no association between sex, type of meningitis, or family history and the development of postmeningitis headache. Patients who developed postmeningitis headache were significantly younger than those who did not. We conclude that there is an association between meningitis, either bacterial or aseptic, and subsequent persistent recurrent migrainous or nonmigrainous headache.
Identification of Patients With Headache at Risk of Psychological Distress
Authors: Marcus Dawn A. 
Published: March 2003

Objective.–To test the hypothesis that anxiety and depression are associated with headache frequency, severity, and disability.Background.–There is significant comorbidity between chronic headache and psychological distress. Headache associated with anxiety or depression tends to be more severe and often requires supplementary psychological treatment in addition to headache therapy. Therefore, the identification of patients with headache who are at risk of psychological distress is important.Methods.–One hundred twenty‐seven consecutive patients with headache attending a university headache clinic were evaluated. Questionnaires about headache symptoms and psychological distress were completed. Comparisons were made between psychological distress and headache frequency, severity, and disability.Results.–Depression and anxiety were significantly greater in the subjects of this study who had frequent headache (>4 days per week) and frequent headache‐associated disability (activities reduced or prohibited because of headache >3 days per week). Subjects who reported their headache severity as typically severe were no more likely to report depression or anxiety than those with mild or moderate headache severity. Quality‐of‐life measures of physical and social functioning, emotional distress, and general health and vitality were reduced in subjects with frequent episodes of headache‐associated disability. All areas, with the exception of general health perception, were reduced in subjects with frequent headache. Severe headache was associated with reductions in role and social functioning.Conclusions.–Frequent headache and frequent disability are associated with depression, anxiety, and impaired quality of life. Reports of typical headache severity are less likely to correlate with psychological distress. Therefore, patients with headache who report frequent headache or frequent periods of headache‐related disability should be further evaluated for the presence of psychological disturbance.