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PubMed2005

Parental grieving after a child dies from cancer: is stress from stem cell transplant a factor?

AIM: to investigate psychological distress, family functioning and complicated grieving in parents whose child had died from cancer, and as a function of whether: (a) the deceased child had also received stem cell transplant (SCT) any time during curative treatment; and (b) the place of the child's death (home or hospital). DESIGN: a cross-sectional case-match design. SAMPLE: Fifty-six Australian bereaved parents in two groups: 28 whose child had also received SCT, matched with 28 (on deceased patient variables) whose child had not received SCT. RESULTS: parents in the 'SCT group' (n = 28) reported relatively higher levels of depression, anxiety and stress, and - for those whose child had also died in hospital - a greater likelihood of meeting the criteria for traumatic grief than those parents whose deceased child had not received SCT. There were no significant group differences in family functioning. CONCLUSION: routine psychosocial screening, especially for families undergoing SCT, may contribute usefully to a proactive model of palliative care in identifying parents at risk for complicated bereavement outcomes.

Adaptation, Psychological↗
PubMed2006

Supportive and palliative care needs identified by multiple sclerosis patients and their families.

AIM: To identify the supportive needs of individuals with multiple sclerosis (MS) and their families. DESIGN, SAMPLE AND METHOD: In-depth interviews were carried out with people living with MS in the community, their family members and health professionals. The data were transcribed verbatim and recurring themes identified. FINDINGS: The analysis of interviews revealed four themes: disbelief and devastation; losses and forced life choices; tracking down services and information; and sadness and relief. CONCLUSION: Given the duration, range of symptoms and distress often associated with MS, the findings of this research raise the important question of the role of palliative services in supporting the person with MS and his/her family.

Activities of Daily Living↗
PubMed2002

Ziprasidone: the fifth atypical antipsychotic.

OBJECTIVE: To review the pharmacology, pharmacokinetics, clinical efficacy, and adverse effects of ziprasidone as a treatment for schizophrenia. DATA SOURCES: Information was selected from a MEDLINE search (July 2000-October 2001) of English-language medical literature using ziprasidone as the search term. Manual searches of pertinent journal article references, request for medical information from Pfizer, and access of the Web site of the Food and Drug Administration were also performed. STUDY SELECTION: All available published information regarding the pertinent characteristics of ziprasidone were considered for selection. DATA EXTRACTION: Pharmacology and pharmacokinetic studies were selected to provide a comprehensive description of these characteristics. Clinical investigations were evaluated for design, sample size, diagnosis, duration, and outcome. Data from all investigations were selected by 1 author and reviewed by both authors. DATA SYNTHESIS: Ziprasidone is a benzisothiazolyl piperazine-type atypical antipsychotic that shares the serotonin(2A)/dopamine(2) (5-HT(2A)/D(2)) profile of the available atypical antipsychotics. Ziprasidone has demonstrated in vitro activity as a 5-HT(1A) receptor agonist and as a very weak inhibitor of serotonin and norepinephrine reuptake. These data do not support ziprasidone as being a clinically meaningful inhibitor of serotonin/norepinephrine reuptake. Oral bioavailability of ziprasidone taken with food is approximately 60%, half-life is approximately 6-7 hours, and protein binding is extensive at >99%. Twelve metabolites have been identified, yet only 4 of these are considered to be primary metabolites. Metabolism of ziprasidone by aldehyde oxidase produces its only metabolite with potential pharmacologic activity; CYP3A4 also contributes to the metabolism of ziprasidone. Clinical studies support ziprasidone as efficacious for the treatment of patients with acute exacerbations of schizophrenia or schizoaffective disorder. Daily doses permitted in these clinical trials ranged from 40 to 160 mg, but only doses between 120 and 160 mg/d have been superior to placebo. Future research efforts should be directed toward refractory schizophrenia, cognitive impairment in schizophrenia, affective and anxiety symptoms associated with schizoaffective disorder, and bipolar disorder. Adverse effect characteristics of ziprasidone commonly include headache, nausea, and somnolence; infrequent effects include extrapyramidal symptoms and weight gain. Ziprasidone has been reported to cause an average QTc prolongation of approximately 20 msec; there have only been 2 patients (0.06%) reported by the manufacturer to have a measured QTc interval >500 msec. CONCLUSIONS: Ziprasidone is a safe and efficacious atypical antipsychotic for the acute management of schizophrenia. Efficacy data and most safety data for ziprasidone support its use as a first-line treatment for schizophrenia; however, its potential effects on ventricular repolarization relegate it to second-line status in patients with comorbid cardiovascular risks.

Acute Disease↗
PubMed2002

A comparison of auditory hallucinations in a psychiatric and non-psychiatric group.

OBJECTIVES: To compare auditory hallucinations in a psychiatric and non-psychiatric sample. DESIGN: Between-participants group design: a psychiatric group of 14 patients with schizophrenia, and a non-psychiatric group of 16 participants with tinnitus. METHOD: Participants were interviewed using the Mental Health Research Institute Unusual Perceptions Scale (MUPS). RESULTS: The type of hallucinations differed: participants with tinnitus predominantly heard music, whereas the patients with schizophrenia heard voices speaking. The groups also differed in their explanations of the hallucinations. However, there were similarities in contributory factors, emotional responses and coping strategies. CONCLUSIONS: The study highlights the multi-dimensional nature of the auditory hallucinatory experience, and opportunities for intervention.

Adaptation, Psychological↗
PubMed2005

Coping with depression and vulnerability to mania: a factor analytic study of the Nolen-Hoeksema (1991) Response Styles Questionnaire.

OBJECTIVES: To assess the factor structure of the Nolen-Hoeksema (1991) Response Styles Questionnaire (RSQ), and to investigate the relationship between coping with depression and other measures of affective symptomatology in a student sample. DESIGN: A factor analytic study of the RSQ followed by an investigation of the relationship between RSQ scale scores and measures of affective symptomatology. METHOD: Five hundred twenty-eight undergraduate students completed a battery of questionnaires comprising the RSQ, Beck Depression Inventory, Hypomania Personality Questionnaire, Positive and Negative Affect Scale and the Dysfunctional Attitudes Scale. Factor analysis of the RSQ was performed and correlational and regression analyses were conducted on the data from the other four questionnaire measures. RESULTS: Factor analysis revealed a meaningful 3-factor solution which measured coping styles characterized by (i) rumination; (ii) pleasant distraction and problemsolving; and (iii) risk-taking. Rumination and risk-taking were independently associated with both depression and hypomania scores, and hypomania was associated with both depression and dysfunctional attitudes. Additional relationships between coping and the other measures are also reported. CONCLUSIONS: The results support the validity of the coping styles concept and suggest their natural separation into three distinct strategies. Abnormal coping is discussed as a potential contributing factor to affective symptoms, including symptoms of bipolar disorder.

Adaptation, Psychological↗
PubMed2006

Collection of pedigree data for genetic analysis in isolate populations.

Pedigree data are useful for a wealth of research purposes in human population biology and genetics. The collection of extended pedigrees represents the most powerful sampling design for quantitative genetic and linkage studies of both normal and disease-related quantitative traits. In this paper we outline an approach for collecting pedigree data in stable isolate populations. As an example, the pedigree for the Jirel population, which was obtained using the methods presented, is described. The Jirel pedigree contains 2,000 study participants and more than 62,000 pairwise relationships that are informative for genetic analysis. Once such pedigrees are genetically characterized by a genome scan for a given trait, they become an invaluable resource for future genetic studies of any quantitative trait.

Female↗
PubMed2004

Intimate partner violence in China: national prevalence, risk factors and associated health problems.

CONTEXT: Intimate partner violence has been studied in many developed and developing countries. China remains one of the few large societies for which the prevalence and correlates of intimate partner violence are unknown. METHODS: Data from a nationally representative sample of women and men aged 20-64 with a spouse or other steady partner provide estimates of intimate partner violence in China. Binomial and multinomial logistic regression analyses adjusted for sample design examine risk factors and negative outcomes associated with partner violence. RESULTS: Altogether, 34% of women and 18% of men had ever been hit during their current relationship; the prevalence of hitting resulting in bleeding, bruises, swelling, or severe pain and injuries was 12% for women and 5% for men. Significant risk factors for partner violence included sexual jealousy, patriarchal beliefs, low female contribution to household income, low male socioeconomic status, alcohol consumption and residence in regions other than the South and Southeast. Severe hitting was a significant risk factor for self-reported adverse general and sexual health outcomes, including sexual dysfunction, sexual dissatisfaction and unwanted sex. CONCLUSIONS: As in other societies, intimate partner violence in China is common and is correlated with adverse general and sexual health outcomes.

Adult↗
PubMed2005

Use of null optics for monitoring the optical alignment of a beam director.

The use of null optics is proposed as a new concept for monitoring the optical alignment of a beam director. Null optics consist of a primary mirror and an annular mirror just outside the aperture of the secondary mirror. The characteristics of the proposed null optics are investigated with the designed sample of a two-mirror system with an effective aperture of 275 mm. The results show that null optics yield four times the amplification with respect to the alignment errors of the secondary mirror; however, they have low residual aberration sensitivity to misalignment. Therefore null optics can be used successfully as the alignment monitoring apparatus of a beam director.

Journal Article↗
PubMed2006

A population-based study on alcohol and high-risk sexual behaviors in Botswana.

BACKGROUND: In Botswana, an estimated 24% of adults ages 15-49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors. METHODS AND FINDINGS: We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men) as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking) and several risky sex outcomes including: (a) having unprotected sex with a nonmonogamous partner; (b) having multiple sexual partners; and (c) paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap > or =10 y), higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32), multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87), and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37). Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28), multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07), and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18). A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers. CONCLUSIONS: Alcohol use is associated with multiple risks for HIV transmission among both men and women. The findings of this study underscore the need to integrate alcohol abuse and HIV prevention efforts in Botswana and elsewhere.

Adult↗
PubMed1996

Effect of menthol cigarettes on biochemical markers of smoke exposure among black and white smokers.

STUDY OBJECTIVES: Black smokers have been reported to have higher serum cotinine levels than do white smokers, and have higher rates of most smoking-related diseases, despite smoking fewer cigarettes per day. Another striking racial difference is the preference for mentholated cigarettes among black smokers. The contribution of menthol to variability in biochemical markers of cigarette smoke exposure (end-expiratory carbon monoxide and serum cotinine) was evaluated in a biracial sample. DESIGN: Descriptive cross-sectional. SETTING: A university smoking research laboratory. PARTICIPANTS: Sixty-five black and 96 white adult established smokers who were paid for their participation. MEASUREMENTS: Information was obtained through direct observation, self-report (interview and self-administered questionnaires), measurement of butts collected for a week, and laboratory analyses of the biochemical markers of exposure. RESULTS: Compared with the white smokers, the black smokers had significantly higher cotinine and carbon monoxide levels per cigarette smoked and per millimeter of smoked tobacco rod (both p < 0.001). After adjusting for race, cigarettes per day, and mean amount of each cigarette smoked, menthol was associated with higher cotinine levels (p = 0.03) and carbon monoxide concentrations (p = 0.02). CONCLUSIONS: The use of menthol may be associated with increased health risks of smoking. Menthol use should be considered when biochemical markers of smoke exposure are used as quantitative measures of smoking intensity or as indicators of compliance with smoking reduction programs. In addition, the effect of menthol on total "dose" should be considered in any efforts to regulate the amount of nicotine in cigarettes.

Adolescent↗
PubMed2000

Quantitating physical activity in COPD using a triaxial accelerometer.

STUDY OBJECTIVE: To determine the reliability, validity, and stability of a triaxial accelerometer for walking and daily activity measurement in a COPD sample. DESIGN: Cross-sectional, correlational, descriptive design. SETTING: Outpatient pulmonary rehabilitation program in a university-affiliated Veterans Affairs medical center. PARTICIPANTS: Forty-seven outpatients (44 men and 3 women) with stable COPD (FEV(1), 37% predicted; SD, 16%) prior to entry into a pulmonary rehabilitation program. MEASUREMENTS AND RESULTS: Test-retest reliability of a triaxial movement sensor (Tritrac R3D Research Ergometer; Professional Products; Madison, WI) was evaluated in 35 of the 47 subjects during three standardized 6-min walks (intraclass correlation coefficient [rICC] = 0.84). Pearson correlations evaluated accelerometer concurrent validity as a measure of walking (in vector magnitude units), compared to walking distance in all 47 subjects during three sequential 6-min walks (0. 84, 0.85, and 0.95, respectively; p < 0.001). The validity of the accelerometer as a measure of daily activity over 3 full days at home was evaluated in all subjects using Pearson correlations with other indicators of functional capacity. The accelerometer correlated with exercise capacity (maximal 6-min walk, r = 0.74; p < 0.001); level of obstructive disease (FEV(1) percent predicted, r = 0.62; p < 0.001); dyspnea (Functional Status and Dyspnea Questionnaire, dyspnea over the past 30 days, r = - 0.29; p < 0.05); and activity self-efficacy (Activity Self-Efficacy Questionnaire, r = 0.43; p < 0.01); but not with self-report of daily activity (Modified Activity Recall Questionnaire, r = 0.14; not significant). Stability of the accelerometer to measure 3 full days of activity at home was determined by an rICC of 0.69. CONCLUSIONS: This study provides preliminary data suggesting that a triaxial movement sensor is a reliable, valid, and stable measure of walking and daily physical activity in COPD patients. It has the potential to provide more precise measurement of everyday physical functioning in this population than self-report measures currently in use, and measures an important dimension of functional status not previously well-described.

Activities of Daily Living↗
PubMed2004

Geographic and gender variability in the prevalence of bronchial responsiveness in Canada.

OBJECTIVES: Geographic variability in reported prevalences of asthma worldwide could in part relate to interpretation of symptoms and diagnostic biases. Bronchial responsiveness measurements provide objective evidence of a common physiologic characteristic of asthma. We measured bronchial responsiveness using the standardized protocol of the European Community Respiratory Health Survey (ECRHS) in six sites in Canada, and compared prevalences across Canada with international sites. DESIGN: Samples of 3,000 to 4,000 adults aged 20 to 44 years were randomly selected in Vancouver, Winnipeg, Hamilton, Montreal, Halifax, and Prince Edward Island, and a mail questionnaire was completed by 18,616 individuals (86.5%). Preselected random subsamples (n = 2,962) attended a research laboratory for examination including more detailed questionnaires, lung function testing including methacholine challenge, and skin testing with 14 allergens. RESULTS: Prevalences of bronchial hyperresponsiveness, measured as cumulative dose of methacholine required to produce a 20% fall from the post-saline solution FEV1 < or = 1 mg, ranged from 4.9% (95% confidence interval [CI], 1.6 to 8.5) in Halifax to 22.0% (95% CI, 18.1 to 26.0) in Hamilton (median, 10.7%). In all Canadian sites, bronchial hyperresponsiveness was more prevalent in women than in men. Neither the geographic nor gender differences were accounted for by differences in age, smoking, skin test reactivity, or baseline FEV1. Geographic- and gender-related variability changed little when only bronchial hyperresponsiveness associated with asthma-like symptoms was considered. CONCLUSIONS: A wide variability in bronchial responsiveness can occur within one country, almost as wide as the range found across all international sites participating in the ECRHS study and not explained by differences in gender, smoking, skin test reactivity, and FEV1. While gender variability in the prevalence of bronchial responsiveness is likely due to hormonal and immunologic factors, geographic variability is likely to result from environmental factors.

Adult↗
PubMed2004

Talc and silver nitrate induce systemic inflammatory effects during the acute phase of experimental pleurodesis in rabbits.

STUDY OBJECTIVE: s: To determine whether talc (TL) and silver nitrate (SN), two effective pleurodesis agents, induce a systemic inflammatory response in the acute phase of experimental pleurodesis in rabbits. DESIGN: Samples of blood and pleural fluid were collected after 6, 24, and 48 h from rabbits injected intrapleurally with 3 mL saline solution, TL (400 mg/kg), or 0.5% SN, and were assayed for WBC count, percentage of neutrophils, and levels of lactate dehydrogenase (LDH), interleukin (IL)-8, and vascular endothelial growth factor (VEGF). The pleural liquid production was compared in the three different groups. A sample of blood collected from animals preinjection was used as the control. RESULTS: At 6 h after pleural injection, the mean blood WBC count and percentage of neutrophils were significantly elevated in the TL group, whereas the mean LDH and IL-8 levels were significantly increased in the SN group. VEGF was undetectable in the preinjection serum and saline solution-injected animals, but was increased in the serum after the pleural injection of both TL and SN to a comparable degree. SN elicited a more intense acute pleural inflammation reaction than did TL, with higher WBC count and IL-8 levels found in the pleural fluid, mainly within the first 6 h. LDH and VEGF levels, and pleural liquid production were also higher for SN, and they increased with time. CONCLUSIONS: In the acute phase of pleural injection, TL induced a transient increase in blood WBC count and percentage of neutrophils, while SN induced increases in blood LDH and IL-8 levels. Both TL and SN induced significant increases in blood VEGF levels. SN induced an earlier and more intense acute pleural inflammation than TL. Pleural liquid VEGF levels were higher after SN injection and increased, as did pleural liquid production. These findings suggest that the intrapleural injection of TL and SN produce a systemic inflammatory response that may have a role in the pathogenesis of fever and ARDS, which occur with pleurodesis.

Acute Disease↗
PubMed2004

Retroposon mapping in molecular systematics.

Advances in genome sciences are demonstrating the dynamic nature of noncoding DNA regions, which are comprised largely of repetitive elements with no apparent function. Retroposons are one class of mobile genetic elements that amplify and move about the genome via a copy-and-paste mechanism that employs an RNA intermediate. Short and long interspersed elements (SINEs and LINEs, respectively) are types of retroposons of particular interest because of their active role in shaping the architecture of genomes and their diagnostic value as evolutionary markers for studies of phylogeny and population biology. Although the use of SINEs and LINEs for molecular systematic studies is proliferating, a comprehensive laboratory protocol that explicitly outlines how to isolate and characterize retroposons for systematic studies in a detailed, step-by-step fashion has been lacking. The present chapter addresses this gap in the literature by focusing on the strategy for isolating new SINEs from a genomic library, the screening process, the sequencing and characterization of clones into subfamilies, quantification of copy number in host taxa, and the critical diagnosis of phylogenetically informative SINE and LINE insertion patterns. Practical limits to the method are discussed in relation to sampling design, systematic character theory, and the empirical distribution of elements observed in eukaryotic lineages. Major steps in the experimental process are illustrated with case examples from a diversity of taxonomic groups and by published results in the molecular biology and systematics literature.

Animals↗
PubMed2004

Cytokine protein arrays.

Cytokines play important roles in many aspects of cell physiology and pathology. The simultaneous determination of multiple cytokine-expression levels is receiving much attention in the research community. Multiple cytokine-expression levels can be simultaneously determined using enzyme-linked immunosorbent assay (ELISA)-based protein array technology. In this approach, target proteins are captured by the arrayed capture antibody and then detected in a sandwich ELISA format using a cocktail of biotinylated detection antibodies. The signals are visualized by either horseradish peroxidase (HRP)-conjugated streptavidin and enhanced chemiluminescence, or cy3-conjugated streptavidin and laser scanner. Several key factors and steps are described, including selection of solid supports, selection of suitable antibodies, determination of specificity and sensitivity of cytokine protein arrays, array design, sample preparation, and detailed experimental procedures for macroarray and microarray formats. An account of the successful development and application of cytokine protein arrays is presented.

Animals↗
PubMed2001

The relationship between zinc and copper status and lipid levels in African-Americans.

Studies examining the role of zinc and copper nutriture as risk factors for cardiovascular disease in European Americans have produced conflicting results. This study assessed the associations between zinc and copper status and serum lipid levels in an adult African-American community. A cross-sectional study was conducted on 600 individuals (233 males, 367 females) from 25 to 65 yr of age using a random sampling design in a small city in Alabama. Anthropometric, dietary, and serum zinc, copper, and lipid measurements were made. The mean serum zinc and copper levels and dietary zinc intake were similar to that reported previously for European Americans. There were no significant associations between serum zinc, copper, or zinc/copper ratio and total serum cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), or triglyceride levels. For males, there was a small but significant association between dietary zinc and the total cholesterol/HDL-C ratio (r = -0.17, p = 0.03). Similarly, females taking either zinc supplements or a multivitamin including zinc had higher HDL-C values than nonsupplementing females. Further prospective studies of the relationship between zinc status and lipid levels in African Americans are needed to verify these results.

Adult↗
PubMed2005

Perceived social status, language and identified dental home among Hispanics in Florida.

BACKGROUND: The authors conducted a study to examine the extent to which perceived social status in communities and in U.S. society in general and primary language are associated with having a dental home among four Hispanic groups. METHODS: The authors used random-digit-dialing technology to select a probability sample of Hispanic adults in Miami-Dade County, Fla., for a telephone-based survey. Trained interviewers administered the pretested survey instrument in Spanish or English. The authors used bivariate contingency tables and multiple logistic regression modeling to analyze the data. RESULTS: Eight hundred ten adults participated, and their nationality groups were as follows: Cuba (n = 450), Nicaragua (n = 139), Colombia (n = 132) and Puerto Rico (n = 89). After controlling for nationality group, the authors found that respondents who perceived themselves to be at a higher social status in the United States than in their own community were significantly more likely to have a dental home; those who reported having a higher community status were significantly less likely to have a dental home compared with respondents who perceived their national and community social status to be equal. Respondents who primarily spoke a language other than English at home were less likely than those who primarily spoke English to have a dental home. Female respondents were more likely than male respondents to have a dental home. Respondents with dental insurance were more likely to have a dental home than were those without dental insurance. CONCLUSIONS: Perceived social status and acculturation may influence whether Hispanics have a dental home. However, because of the sample design, the findings may not be generalizable to all Hispanic populations in Florida or the United States. CLINICAL IMPLICATIONS: Reducing disparities in oral health status and in use of dental services among Hispanics relative to non-Hispanic whites may require attention to cultural factors such as language, community structure and immigrants' degree of acculturation.

Acculturation↗
PubMed2001

HIV risk behavior and HIV testing: a comparison of rates and associated factors among homeless and runaway adolescents in two cities.

This study examined differences in self-reported rates and predictors of HIV testing between homeless and runaway youths in San Diego (N = 1,102) and Los Angeles (N = 1,167). Youths aged 13-23 were recruited from agency and street sites using a stratified probability sampling design. Interviewers administered a structured survey instrument lasting 20 minutes, which assessed youths' involvement in HIV risk-related sexual and drug-use behaviors, contact with outreach workers, and other variables. Significantly more Los Angeles youths (78%) reported testing than did San Diego youths (52%; p < .001). Multivariable analyses controlling for risk behaviors, knowing someone with HIV, and contact with outreach workers indicated that the higher rates of these factors in Los Angeles did not account for the difference in testing rates between the cities. Youths in Los Angeles were still 1.85 times as likely to be tested as San Diego youths (p < .001), possibly a result of differing normative behavior and accessibility of testing services.

AIDS Serodiagnosis↗