Needs assessment of rural and remote women travelling to the city for breast cancer treatment

The purpose of this study was to assess the needs of rural women travelling to the city for breast cancer treatment. Participants included 80 women aged between 34 and 80 years living in rural NSW and South Australia who travelled for breast cancer treatment. After completing treatment, participants completed a brief telephone survey on the needs of rural women travelling for treatment. Findings revealed that more than 90% of women travelled for treatment due to the lack of available treatment centres closer to home and on average they spent 6.79 weeks (SD = 4.73) away from their home and family. Findings also showed that 89% identified specific problems for rural women, with social and practical support being primary concerns. Although the majority of women were provided with some type of social support, only 39% of women received financial assistance and 19% of these women had trouble claiming money for which they were eligible. Recommendations of appropriate interventions to ensure equity in the availability and access to breast cancer treatment for all women are discussed.

The eating disorders as addiction: a psychobiological perspective

A number of theories have been proposed to explain the substantial comorbidity between the eating disorders and the substance-related disorders. Among them is the claim that self-starvation--exacerbated by excessive exercising--is itself an addiction to the body's endogenous opioids. While efforts have also been made to identify an "addictive personality," attempts to establish whether eating-disordered patients share these characteristics have met with mixed success. The present study was designed to determine the degree to which anorexic and bulimic patients display addictive personality characteristics, and whether these traits are useful in predicting the severity of the patient's weight preoccupation and their degree of excessive exercising. Results confirmed that both anorexic and bulimic patients had high scores on the Addiction Scale of the Eysenck Personality Questionnaire, and that addictiveness and obsessive-compulsiveness were related simultaneously to weight preoccupation and excessive exercising in both patient groups. Findings are discussed within the framework of the auto-addiction opioid theory, and they highlight the similarities and differences in the personality structure of the eating-disorder subtypes.

Longitudinal evaluation of bone mineral density in children receiving chemotherapy

PURPOSE

Some children who survive a childhood malignancy have diminished bone mineral density (BMD). The purpose of this study is to assess when, and perhaps why, this problem develops.

PATIENTS AND METHODS

BMD was longitudinally monitored in 37 children for a minimum of 1 year (mean, 23.4 months; range, 12 to 41 months) during and, in some cases, after chemotherapy. Evaluations included serum analyses (vitamin D, calcium, and alkaline phosphatase), assessment of calcium intake, and measures of growth and nutrition (height, weight, and skinfolds).

RESULTS

BMD was already diminished at the start of treatment in some patients; 6 of 13 patients (46%) had a BMD z score in the hip or spine of < -1.0. However, only 1 patient (8%) was < -2.0. Most patients did not have a significant drop in BMD z scores during chemotherapy, but one in four did decrease at least 0.5 standard deviations. Age greater than 10 years, a drop in height z score, and treatment with cranial irradiation correlated with a drop in BMD z scores during treatment. In the year immediately after completion of chemotherapy, no consistent "catch-up" was observed in BMD z scores.

CONCLUSIONS

In some patients, BMD z scores are diminished at the time of diagnosis and a drop may occur during treatment in others. Multiple factors related to the disease process and treatment likely contribute to these observations. Cranial irradiation, perhaps by impacting on growth hormone homeostasis, is one such factor. Fortunately, most survivors of a childhood malignancy will not have large deficits in BMD later in life.

Submandibular salivary proteases: lack of a role in anti-HIV activity

Whole human saliva contains a number of proteolytic enzymes, mostly derived from white blood cells and bacteria in the oral cavity. However, less information is available regarding proteases produced by salivary glands and present in salivary secretions. In the present study, we have analyzed submandibular saliva, collected without contaminating cells, and identified multiple proteolytic activities. These have been characterized in terms of their susceptibility to a series of protease inhibitors. The submandibular saliva proteases were shown to be sensitive to both serine and acidic protease inhibitors. We also used protease inhibitors to determine if salivary proteolytic activity was involved in the inhibition of HIV infectivity seen when the virus is incubated with human saliva. This anti-HIV activity has been reported to occur in whole saliva and in ductal saliva obtained from both the parotid and submandibular glands, with highest levels of activity present in the latter fluid. Protease inhibitors, at concentrations sufficient to block salivary proteolytic activity in an in vitro infectivity assay, did not block the anti-HIV effects of saliva, suggesting that the salivary proteases are not responsible for the inhibition of HIV-1 infectivity.

Schizophrenia Risk and Handedness: A Mixed Picture

Numerous previous studies have reported on handedness differences among schizophrenics, as well as in normal subjects who are high in ''schizotypal'' traits, and hence putatively at risk for schizophrenia. Results have varied, but there is evidence of a shift away from dextrality, especially consistent among schizotypal individuals. Using both a conventional three-category and Annett's seven-category classification of handedness, we re-examined the question in 681 general population subjects assessed for schizotypy. The three-category analysis confirmed previous findings of increased schizotypy in mixed-handers. However, the more fine-grained analysis showed that, although mild degrees of mixed handedness were indeed associated with increased schizotypy, this trend was reversed in the most mixed-handed subjects whose schizotypy scores did not differ significantly from right-handers. Independently of our work, this subgroup of mixed-handers are also reported to show superior intellectual function, especially on some spatial tasks. We concluded that previous studies of schizophrenia and schizotypy have failed to distinguish different reasons for shifts from dextrality. It is argued that the latter's association with schizophrenia might come about through exogenous, neurodevelopmental, influences, whereas some-possibly genetically basedforms of mixed handedness could reflect a variety of cerebral organisation that protects against, rather than enhances, the risk for mental disorder.

The mouth is a gateway to the body: gene therapy in 21st-century dental practice

Gene therapy may become an integral tool in dental practice early in the 21st century. It and other biological therapies are expected to be applied to oral diseases and disorders during the midpractice lifetime of today's dental students. If the applications of oral gene transfer are expanded to systemic diseases, oral health care providers in the future could routinely be "gene therapists" with therapeutic targets well outside the oral cavity.

An immunoassay for the detection and quantitative determination of mycothiol

Mycothiol (MSH) is a glycosylated derivative of N-acetylcysteine that may have antioxidant functions in mycobacteria and other actinomycetes. To develop a highly specific assay for MSH, we capitalized on the selective binding of thiols to a maleimide residue linked to bovine serum albumin and employed affinity-purified polyclonal antibody and an enzyme-linked secondary antibody for detection. The assay was shown to be specific and to detect MSH at levels as low as 0.1 pmol when conducted in the form of a microtiter plate-based ELISA. A similar, nitrocellulose membrane-based immunoassay was shown to be useful for qualitative detection of MSH-producing bacterial colonies.

Effects of aerosolized synthetic surfactant, atovaquone, and the combination of these on murine Pneumocystis carinii pneumonia

An immunosuppressed rat model was used to determine the pharmacokinetics of aerosolized atovaquone (administered with and without a synthetic surfactant) and to evaluate the efficacy of inhaled atovaquone in the prevention and treatment of Pneumocystis carinii pneumonia (PCP). After a single dose by aerosol, mean peak concentrations of atovaquone averaged 52 microg/mL in plasma and 31 microg/g in lungs of rats infected with P. carinii. When atovaquone was combined with surfactant, mean peak concentrations of 94 microg/mL in plasma and 51 microg/g in lung were achieved. Aerosolized synthetic surfactant alone significantly increased survival of rats with PCP and, when combined with atovaquone, increased plasma and lung concentrations of the drug and eradication of the organism.

Differentially expressed genes in the Trypanosoma brucei life cycle identified by RNA fingerprinting

RNA fingerprinting by arbitrarily primed polymerase chain reaction (RAP-PCR) was used to identify genes that were differentially expressed during the life cycle of Trypanosoma brucei, as well as in response to heat shock. The standard RAP-PCR protocol was varied in two ways. First, the PCR reactions sometimes included a primer derived from the 5' mini-exon sequence, to ensure that most of the products contained the 5' end of mRNAs. Second, differentially amplified products were reamplified, isolated on single strand conformation polymorphism (SSCP) gels, cloned, and sequenced. Clones representing 32 different expressed sequence tags (ESTs) were obtained. Twenty-four ESTs were confirmed as differentially expressed by RT-PCR between different stages of the parasite cycle, or in response to temperature elevation. Nine clones had significant similarities to sequences already in the database. These transcripts included genes encoding cell surface proteins, metabolic enzymes, and heat shock proteins, either from trypanosomes or other organisms. Of particular interest, ESAG1 was shown to be heat-inducible in the procyclic stage. Most of the transcripts were unrelated to any other sequences in the database, and were deposited as new ESTs. The identification of stage-specific and heat shock-regulated transcripts will complement the growing T. brucei database. In addition, this experimental approach allows previous entries in the sequence database to be annotated with regulatory information.

US Department of Agriculture School Breakfast Program

This article reviews the history of the US Department of Agriculture School Breakfast Program (SBP) and provides a synthesis of factors influencing participation rates. Certain children are more likely to participate than others, such as those in lower grades and those from low-income households, and African American, Hispanic, and male students. A few studies in the past 25 y have examined the effectiveness of the SBP in improving the diets and nutritional status of children. The overall pattern that emerges from these studies is that the SBP contributes to improved nutrient intake in program participants. Less attention has been devoted to assessing the effects of SBP on cognitive development. Some of the evidence reviewed here suggests that the SBP significantly improves school performance and reduces absenteeism and tardiness. Future directions for research and operation of the SBP are discussed in light of the changing dietary profile of American children.

Obsessionality in anorexia nervosa: the moderating influence of exercise

OBJECTIVE

Research has confirmed substantial links between OCD and AN. Not only are there psychopathological similarities between the two syndromes, but a marked neurochemical correspondence. Extensive exercising is a common feature of AN and also has relevance in its links with OCD. There is evidence from the exercise-induced weight-loss syndrome in animals that exercise and caloric restriction, in combination, tend to increase serotonergic activity in a synergistic manner. This syndrome has been proposed as a valid model of OCD as well as for AN. To date, little research has directly tested this theory in the human condition.

METHOD

Fifty-three AN patients were categorized as high-level exercisers (N = 22) or moderate/nonexercisers (N = 31) based on the frequency of their physical activity over the year before assessment.

RESULTS

Exercisers scored significantly higher on a measure of OC personality characteristics, OC symptomatology, and perfectionism--a personality factor associated with the development of Obsessive-Compulsive Personality Disorder. On the other hand, there were no group differences on other salient eating disorder characteristics such as body esteem, self-esteem, or weight preoccupation. There were also no differences in degree of emaciation as indicated by Body Mass Index.

CONCLUSIONS

Findings suggest that among AN patients obsessional personality characteristics are linked to high-level exercising, and that exercising is associated with a greater degree of OC symptomatology. Results are discussed in the context of current theories of AN, OCD, and some biological mechanisms.

Distribution of afferent axons in the bladder of rats

The distribution of afferent axons in the bladder of rats was studied by means of immunohistochemistry for calcitonin gene-related peptide (CGRP), in frozen sections and in wholemount preparations of mucosa and muscle coat. Synaptophysin-immunofluorescence was used for the general detection of all intramural axons. The afferent axons were distributed over four distinct targets: at the base of the epithelium, inside the epithelium, on blood vessels (both arteries and veins) and along muscle bundles. In the mucosa, all the afferent axons, except the perivascular ones, lay either inside the epithelium or in a subepithelial plexus very close to the basal surface of the epithelium. The plexus was thickest in the neck of the bladder and in the initial portion of the urethra, and it became progressively less dense in the adjacent regions; it did not extend beyond the equatorial region, and therefore the mucosa of the cranial region of the bladder had no afferent axons. Most of the axons in the subepithelial plexus were terminal axons and included conspicuous varicosities arranged in very long chains; branching points were numerous, usually at right angles and located at the level of a varicosity; some axons split and then rejoined, forming closed axonal loops. The afferent innervation of the musculature was more diffuse, and appeared uniform throughout the bladder. After unilateral surgical denervation (by excision of the pelvic ganglion 5-7 days earlier) areas of complete denervation were observed, but there were large areas where the innervation was only reduced. The results showed that there is a bilateral innervation of many regions of the mucosa and the musculature, including individual muscle bundles. A substantial number of fibres crossed the midline into the contralateral side of the bladder. CGRP-immunofluorescence in mucosal afferent axons is enhanced in the surviving axons 5 days after contralateral denervation, a change which is interpreted as an early sign of regeneration.

Afr1p regulates the Saccharomyces cerevisiae alpha-factor receptor by a mechanism that is distinct from receptor phosphorylation and endocytosis

The alpha-factor pheromone receptor activates a G protein signaling pathway that induces the conjugation of the yeast Saccharomyces cerevisiae. Our previous studies identified AFR1 as a gene that regulates this signaling pathway because overexpression of AFR1 promoted resistance to alpha-factor. AFR1 also showed an interesting genetic relationship with the alpha-factor receptor gene, STE2, suggesting that the receptor is regulated by Afr1p. To investigate the mechanism of this regulation, we tested AFR1 for a role in the two processes that are known to regulate receptor signaling: phosphorylation and down-regulation of ligand-bound receptors by endocytosis. AFR1 overexpression diminished signaling in a strain that lacks the C-terminal phosphorylation sites of the receptor, indicating that AFR1 acts independently of phosphorylation. The effects of AFR1 overexpression were weaker in strains that were defective in receptor endocytosis. However, AFR1 overexpression did not detectably influence receptor endocytosis or the stability of the receptor protein. Instead, gene dosage studies showed that the effects of AFR1 overexpression on signaling were inversely proportional to the number of receptors. These results indicate that AFR1 acts independently of endocytosis, and that the weaker effects of AFR1 in strains that are defective in receptor endocytosis were probably an indirect consequence of their increased receptor number caused by the failure of receptors to undergo ligand-stimulated endocytosis. Analysis of the ligand binding properties of the receptor showed that AFR1 overexpression did not alter the number of cell-surface receptors or the affinity for alpha-factor. Thus, Afr1p prevents alpha-factor receptors from activating G protein signaling by a mechanism that is distinct from other known pathways.

Recommendations for training in performance and interpretation of stress echocardiography. Committee on Physician Training and Education of the American Society of Echocardiography

Stress echocardiography has emerged as a clinically useful procedure in the management of patients with ischemic heart disease and other conditions. However, the accuracy of this test relies on the ability of those who carry out the technical aspects of the test and depends critically on proper interpretation of the images. Appreciation of wall motion abnormalities is generally acknowledged as one of the most difficult skills to master in echocardiography. There is consensus that this is also one of the most difficult skills to teach. Appreciating stress-induced changes in wall motion, which sometimes are subtle, requires a significant commitment to initial training in this skill and its maintenance. This document provides recommendations for physician training in stress echocardiography.

Chinese men and women in the United States and Hong Kong: body and self-esteem ratings as a prelude to dieting and exercise

OBJECTIVE

The present study compared the body and weight satisfaction, self-esteem, and depression of Chinese male and female university students in Hong Kong and the United States and assessed the impact of these ratings on compensatory behavior such as dieting and exercise.

METHOD

Self-report measures were administered to 501 Chinese participants in the language of their university's locale.

RESULTS

Females reported significantly more body dissatisfaction and depression, and males reported greater weight dissatisfaction (the majority of men wishing to be larger). Overall, Chinese subjects in Hong Kong reported significantly more body and weight dissatisfaction, lower self-esteem, higher depression, more dieting, and less exercise as compared to their counterparts in the United States.

DISCUSSION

Asian students in this study mirrored gendered patterns previously reported in Caucasian samples with respect to the relation of body image, self-esteem, and mood. For both sexes, there appeared to be a caricatured mimicking of the bodies perceived to be associated with the dominant culture--men wanted to be larger while the women wanted to be even more petite.

Normal and neurotic perfectionism in eating disorders: an interactive model

OBJECTIVE

Previous nonclinical research found that both normal (or adaptive) and neurotic (or maladaptive) perfectionism were related, in the positive direction, to attitudes and behaviors associated with eating disorders. However, based on a related body of research, it was hypothesized that these two aspects of perfectionism would relate to body esteem in an interactive rather than an additive fashion.

METHOD

Anorexic and bulimic patients (n = 123) were assessed on multidimensional aspects of perfectionism, neuroticism, and body esteem.

RESULTS

Predictions were confirmed. Normal perfectionism was positively associated with body esteem, but only when levels of neurotic perfectionism were low. Conversely, body-image disparagement was most pronounced when normal and neurotic perfectionism were both elevated.

DISCUSSION

These findings demonstrate that the interpretation of simple relationships among personality variables--at least in the area of body image and eating disorder research--may provide a misleading picture.

A new fibre optic sensor for respiratory monitoring

A new fibre optic plethysmograph has been designed to monitor respiration non invasively. The device incorporates the idea of using thoracic and abdominal belts similar to conventional inductance plethysmography but uses an optical fibre woven into the belts rather than the usual coiled wire. The fibre optic belts incorporate a loop design in the fibre and rely on "macrobending" losses from laser light transmitted down the fibre when the bend radius of the loop changes during respiration. Changes in lung volume are monitored by analysing the relatively large resultant changes in light transmitted through the fibre. The output from the light detector has been interfaced to a computer containing a data acquisition card and the resultant intensity trace is monitored in real time using a virtual instrument created using LabVIEW graphical programming. Preliminary results suggest a highly sensitive system capable of detecting small changes in lung volume using a technique which is not susceptible to electrical noise and which is electrically safe.