Measurement of the B¯(s)(0) effective lifetime in the J/ψf0(980) final state

The effective lifetime of the B ¯(s)(0) meson in the decay mode B¯(s)(0)→J/ψf(0)(980) is measured using 1.0 fb(-1) of data collected in pp collisions at √s=7 TeV with the LHCb detector. The result is 1.700±0.040±0.026 ps, where the first uncertainty is statistical and the second systematic. As the final state is CP-odd, and CP violation in this mode is measured to be small, the lifetime measurement can be translated into a measurement of the decay width of the heavy B¯(s)(0) mass eigenstate, Γ(H)=0.588±0.014±0.009 ps(-1).

Observation of B0→D¯(0)K(+)K(-) and evidence for B(s)(0)→D¯(0)K(+)K(-)

The first observation of the decay B0→D¯(0)K(+)K(-) is reported from an analysis of 0.62 fb(-1) of pp collision data collected with the LHCb detector. Its branching fraction is measured relative to that of the topologically similar decay B(0)→D ¯(0)π(+)π(-) to be (B(B(0)→D¯(0)K(+)K(-))/B(B(0)→D¯(0)π(+)π(-))=0.056±0.011±0.007,where the first uncertainty is statistical and the second is systematic. The significance of the signal is 5.8σ. Evidence, with 3.8σ significance, for B(s)(0)→D¯(0)K(+)K(-) decays is also presented. The relative branching fraction is measured to be B(B(s)(0)→D¯(0)K(+)K(-))/B(B(0)→D¯(0)K(+)K(-))=0.90±0.27±0.20. These channels are of interest to study the mechanisms behind hadronic B decays, and open new possibilities for CP violation analyses with larger data sets.

Inhibitory mechanism of the Qβ lysis protein A2

The lysis protein A2 , present as a single copy on the surface of Qβ virion particles, was previously shown to inhibit the activity of MurA, an enzyme that catalyses the first committed step of murein biosynthesis. Here we report experiments with a two-hybrid study that indicates A2 and MurA interact directly. Moreover, experiments with a soluble MBP-A2 fusion indicate that the interaction between MurA and A2 is dependent on a substrate-induced conformational change featured in the UDP-NAG-liganded state of MurA but not the tetrahedral intermediate state. Moreover, based on the location of L138Q, the original dominant A2 -resistant mutant that identified MurA as the target, a directed mutagenesis strategy has identified a continuous surface required for A2 binding. This surface spans the catalytic loop/cleft and encompasses both the catalytic and C-terminal domains. These data support a model in which A2 preferentially binds MurA liganded with UDP-NAG, thereby preventing catalysis by occluding PEP from accessing the active site.

Measurement of relative branching fractions of B decays to ψ(2S) and J/ψ mesons

The relative rates of B-meson decays into J/ψ and ψ(2S) mesons are measured for the three decay modes in pp collisions recorded with the LHCb detector. The ratios of branching fractions ([Formula: see text]) are measured to be [Formula: see text] where the third uncertainty is from the ratio of the ψ(2S) and J/ψ branching fractions to μ⁺μ^-.

Measurement of ψ(2S) meson production in pp collisions at [Formula: see text]

The differential cross-section for the inclusive production of ψ(2S) mesons in pp collisions at [Formula: see text] has been measured with the LHCb detector. The data sample corresponds to an integrated luminosity of 36 pb^-1. The ψ(2S) mesons are reconstructed in the decay channels ψ(2S)→μ⁺μ^- and ψ(2S)→J/ψπ⁺π^-, with the J/ψ meson decaying into two muons. Results are presented both for promptly produced ψ(2S) mesons and for those originating from b-hadron decays. In the kinematic range p_T(ψ(2S))≤16 GeV/c and 2<y(ψ(2S))≤4.5 we measure [Formula: see text] where the last uncertainty on the prompt cross-section is due to the unknown ψ(2S) polarization. Recent QCD calculations are found to be in good agreement with our measurements. Combining the present result with the LHCb J/ψ measurements we determine the inclusive branching fraction [Formula: see text] where the last uncertainty is due to the [Formula: see text], [Formula: see text] and [Formula: see text] branching fraction uncertainties.

First observation of the decay B(c)+ → J/ψπ(+) π- π+

The decay B(c)(+) → J/ψπ(+) π(-) π(+) is observed for the first time, using 0.8 fb(-1) of pp collisions at sqrt[s] = 7 TeV collected by the LHCb experiment. The ratio of branching fractions B(B(c)(+) → J/ψπ(+) π(-) π(+))/B(B(c)(+)→J/ψπ^{+}) is measured to be 2.41 ± 0.30 ± 0.33, where the first uncertainty is statistical and the second is systematic. The result is in agreement with theoretical predictions.

Determination of the sign of the decay width difference in the B(s)(0) system

The interference between the K+ K- S-wave and P-wave amplitudes in B(s)(0) → J/ψK+ K- decays with the K+ K- pairs in the region around the ϕ(1020) resonance is used to determine the variation of the difference of the strong phase between these amplitudes as a function of K+ K- invariant mass. Combined with the results from our CP asymmetry measurement in B(s)(0) → J/ψϕ decays, we conclude that the B(s)(0) mass eigenstate that is almost CP = +1 is lighter and decays faster than the mass eigenstate that is almost CP = -1. This determines the sign of the decay width difference ΔΓ(s) ≡ Γ(L) - Γ(H) to be positive. Our result also resolves the ambiguity in the past measurements of the CP violating phase ϕ(s) to be close to zero rather than π. These conclusions are in agreement with the standard model expectations.

Strong constraints on the rare decays B(s)(0) → μ+ μ- and B0 → μ+ μ-

A search for B(s)(0) → μ+ μ- and B0 → μ+ μ decays is performed using 1.0  fb(-1) of pp collision data collected at sqrt[s] = 7  TeV with the LHCb experiment at the Large Hadron Collider. For both decays, the number of observed events is consistent with expectation from background and standard model signal predictions. Upper limits on the branching fractions are determined to be B(B(s)(0) → μ+ μ-) < 4.5(3.8)×10(-9) and B(B0 → μ+ μ-) < 1.0(0.81)×10(-9) at 95% (90%) confidence level.

Opposite-side flavour tagging of B mesons at the LHCb experiment

The calibration and performance of the opposite-side flavour tagging algorithms used for the measurements of time-dependent asymmetries at the LHCb experiment are described. The algorithms have been developed using simulated events and optimized and calibrated with B⁺→J/ψK⁺, B⁰→J/ψK^∗0 and B⁰→D^∗-μ⁺ν_μ decay modes with 0.37 fb^-1 of data collected in pp collisions at [Formula: see text] during the 2011 physics run. The opposite-side tagging power is determined in the B⁺→J/ψK⁺ channel to be (2.10±0.08±0.24) %, where the first uncertainty is statistical and the second is systematic.

Measurement of production in collisions at [Formula: see text]

The production of ϒ(1S), ϒ(2S) and ϒ(3S) mesons in proton-proton collisions at the centre-of-mass energy of [Formula: see text] is studied with the LHCb detector. The analysis is based on a data sample of 25 pb-1 collected at the Large Hadron Collider. The ϒ mesons are reconstructed in the decay mode ϒ→μ+μ- and the signal yields are extracted from a fit to the μ+μ- invariant mass distributions. The differential production cross-sections times dimuon branching fractions are measured as a function of the ϒ transverse momentum pT and rapidity y, over the range pT <15 GeV/c and 2.0 Collapse

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SU-E-T-583: Feasibility of Constraining Dose to the Nausea Center (area Postrema and Dorsal Vagal Complex) in IMRT Treatment Planning of the Head and Neck

PURPOSE

Nausea and vomiting have been known to occur in patients undergoing external beam radiation treatments for head&neck cancers. We sought to determine the feasibility of limiting the dose delivered to the nausea center, area postrema (AP) and dorsal vagal complex (DVC), for these patients without compromising target coverage and critical organ doses.

METHODS

In a retrospective study 23 oropharyngeal cancer patients were identified as being treated with definitive or adjuvant radiotherapy at Memorial Sloan Kettering Cancer Center. Patients were treated solely with external beam radiation using intensity modulated radiation therapy (IMRT). The nausea center was carefully contoured in the treatment CT with the assistance of a board certified neuroradiologist. The doses delivered to the nausea center were calculated for each plan delivered. Cases were replanned offline to determine the lowest achievable nausea center dose that does not compromise the overall PTV coverage or critical structures doses, these being brainstem, spinal cord, cochleas, and temporal lobes.

RESULTS

Patients reporting higher nausea grade had median AP and DVC doses of 38.7Gy and 40.4Gy, respectively. Patients reporting higher vomiting grade had median AP and DVC doses of 39.5Gy and 44.7Gy, respectively. Replanning resulted in reduced dose to AP by an average of 18% and to the DVC by an average of 16% while maintaining adequate target coverage and doses to the critical organs the same or decreased by 1-4% . We aim to achieve a max dose of 36Gy to AP and 38Gy to DVC for these cases.

CONCLUSIONS

It is feasible to limit the doses to the nausea center without compromising target coverage or critical organ limits for oropharyngeal cancer patients undergoing IMRT treatment. Clinical results indicating an association between radiation dose to the nausea center and development of nausea and/or vomiting can potentially be addressed by implementing this technique.

First evidence of direct CP violation in charmless two-body decays of Bs0 mesons

Using a data sample corresponding to an integrated luminosity of 0.35  fb-1 collected by LHCb in 2011, we report the first evidence of CP violation in the decays of Bs0} mesons to K±π∓ pairs, ACP(Bs0→Kπ)=0.27±0.08(stat)±0.02(syst), with a significance of 3.3σ. Furthermore, we report the most precise measurement of CP violation in the decays of B0 mesons to K±π∓ pairs, ACP(B0→Kπ)=-0.088±0.011(stat)±0.008(syst), with a significance exceeding 6σ.

Differential branching fraction and angular analysis of the decay B0 → K*0 μ+ μ-

The angular distributions and the partial branching fraction of the decay B0 → K*0 μ+ μ- are studied by using an integrated luminosity of 0.37  fb(-1) of data collected with the LHCb detector. The forward-backward asymmetry of the muons, A(FB), the fraction of longitudinal polarization, F(L), and the partial branching fraction dB/dq2 are determined as a function of the dimuon invariant mass. The measurements are in good agreement with the standard model predictions and are the most precise to date. In the dimuon invariant mass squared range 1.00-6.00  GeV2/c4, the results are A(FB)=-0.06(-0.14)(+0.13)±0.04, F(L)=0.55±0.10±0.03, and dB/dq2=(0.42±0.06±0.03)×10(-7)  c4/GeV2. In each case, the first error is statistical and the second systematic.

First observation of the decays B(0) → D(+)K(-)π(+)π(-) and B(-) → D(0)K(-)π(+)π(-)

First observations of the Cabibbo-suppressed decays B(0) → D(+)K(-)π(+)π(-) and B(-) → D(0)K(-)π(+)π(-) are reported using 35 pb(-1) of data collected with the LHCb detector. Their branching fractions are measured with respect to the corresponding Cabibbo-favored decays, from which we obtain B(B(0) → D(+)K(-)π(+)π(-))/B(B(0) → D(+)π(-)π(+)π(-))=(5.9±1.1±0.5)×10(-2) and B(B(-) → D(0)K(-)π(+)π(-))/B(B(-) → D(0)π(-)π(+)π(-))=(9.4±1.3±0.9)×10(-2), where the uncertainties are statistical and systematic, respectively. The B(-) → D(0)K(-)π(+)π(-) decay is particularly interesting, as it can be used in a similar way to B(-) → D(0)K(-) to measure the Cabibbo-Kobayashi-Maskawa phase γ.

Observation of B(s)(0) → J/ψf(2)'(1525) in J/ψK+ K- final states

The decay B(s)(0) → J/ψK+ K- is investigated using 0.16  fb(-1) of data collected with the LHCb detector using 7 TeV pp collisions. Although the J/ψϕ channel is well known, final states at higher K+ K- masses have not previously been studied. In the K+ K- mass spectrum we observe a significant signal in the f(2)'(1525) region as well as a nonresonant component. After subtracting the nonresonant component, we find B(B(s)(0) → J/ψf(2)'(1525))/B(B(s)(0) → J/ψϕ) = (26.4 ± 2.7 ± 2.4)%.

Evidence for CP violation in time-integrated D0→h(-)h(+) decay rates

A search for time-integrated CP violation in D(0)→h(-)h(+) (h=K, π) decays is presented using 0.62 fb(-1) of data collected by LHCb in 2011. The flavor of the charm meson is determined by the charge of the slow pion in the D(*+)→D(0)π(+) and D(*-)→D[over ¯](0)π(-) decay chains. The difference in CP asymmetry between D(0)→K(-)K(+) and D(0)→π(-)π(+), ΔA(CP)≡A(CP)(K(-)K(+))-A(CP)(π(-)π(+)), is measured to be [-0.82±0.21(stat)±0.11(syst)]%. This differs from the hypothesis of CP conservation by 3.5 standard deviations.

Search for lepton number violating decays B+ → π- μ+ μ+ and B+ → K- μ+ μ+

A search is performed for the lepton number violating decay B+ → h- μ+ μ+, where h- represents a K- or a π-, using an integrated luminosity of 36  pb(-1) of data collected with the LHCb detector. The decay is forbidden in the standard model but allowed in models with a Majorana neutrino. No signal is observed in either channel and limits of B(B+ → K- μ+ μ+) < 5.4×10(-8) and B(B+ → π- μ+ μ+) < 5.8×10(-8) are set at the 95% confidence level. These improve the previous best limits by factors of 40 and 30, respectively.

Measurement of the CP-violating phase ϕ(s) in the decay B(s)(0) → J/ψϕ

We present a measurement of the time-dependent CP-violating asymmetry in B(s)(0) → J/ψϕ decays, using data collected with the LHCb detector at the LHC. The decay time distribution of B(s)(0) → J/ψϕ is characterized by the decay widths Γ(H) and Γ(L) of the heavy and light mass eigenstates, respectively, of the B(s)(0) - B(s)(0) system and by a CP-violating phase ϕ(s). In a sample of about 8500 B(s)(0) → J/ψϕ events isolated from 0.37  fb(-1) of pp collisions at sqrt[s] = 7  TeV, we measure ϕ(s) = 0.15 ± 0.18(stat) ± 0.06(syst)  rad. We also find an average B(s)(0) decay width Γ(s) ≡ (Γ(L) + Γ(H))/2 = 0.657 ± 0.009(stat) ± 0.008(syst)  ps(-1) and a decay width difference ΔΓ(s) ≡ Γ(L) - Γ(H) = 0.123 ± 0.029(stat) ± 0.011(syst)  ps(-1). Our measurement is insensitive to the transformation (ϕ(s),ΔΓ(s)) ↦ (π - ϕ(s), -ΔΓ(s)).

Seclusion reduction in a forensic mental health setting

Seclusion has become a contentious practice and initiatives have commenced to reduce or eliminate its use. This paper presents the initiatives that were introduced during a seclusion reduction project that was undertaken at an Australian forensic hospital. These initiatives are based on the six core strategies that have been successfully used in North America to reduce seclusion. However, there are challenges (patient characteristics, prisoner culture and ensuring safety) and opportunities (longer admissions, higher staff-patient ratio, staff confidence, sound risk assessment and management) that can influence projects to reduce seclusion in a forensic hospital. During this project, the frequency (mainly multiple seclusions of patients) and duration of seclusion events were reduced but there was less reduction in the number of patients that were secluded. It is possible that the strategies were successfully supported by the identified opportunities to reduce the frequency and duration of seclusion but the challenges were significantly powerful in the early period of admission to prompt the need for seclusion. Reducing seclusion in a forensic hospital is a complex undertaking as nurses must provide a safe environment while dealing with volatile patients and may have little alternative at present but to use seclusion after exhausting other interventions.

P4-15-01: High Prevalence of Prospective Memory (PM) Impairment in Early Breast Cancer (EBC) Survivors within 1 Year of Adjuvant Chemotherapy Completion: Novel Findings Concerning Post Chemotherapy Cognitive Effects

Background Numerous studies have demonstrated that EBC survivors report more memory problems than healthy controls. However, evidence of impairment on objective tests of memory remains inconclusive. Past research has focussed exclusively on retrospective memory (remembering information from the past when asked to do so), but the complaints of EBC patients appear better described as “prospective memory” failures defined as forgetting to carry out in the future previously formed intentions. The effective performance of many day-to-day activities relies on PM and its impairment has negative consequences in everyday life. Despite its high ecological relevance, no study has evaluated PM functioning in EBC survivors. Consequently, we assessed the prevalence of PM impairment among EBC survivors in the year following completion of chemotherapy. Methods We undertook a cross sectional quantitative case-control study aiming to recruit 80 patients from the Ottawa Hospital Regional Cancer Centre and 80 matched healthy controls from the community. Patients were within 1 year of having completed a first course of chemotherapy. A standardized test of prospective memory (Memory for Intention Screening Test) was administered to both groups. Following the International Cognition and Cancer Task Force recommendation (2008), impairment was defined as a score that fell one standard deviation below the mean performance of the control group. Standardized measures of depression (CESD), anxiety (STAI) and fatigue (Fact-F) were also completed. Results Data are available on 36 patients and 18 controls. Age was well balanced between the groups (case-control mean age 54y vs. 51y, respectively, p=.204). Overall PM impairment was observed in 41% of the participants. More importantly, the rate of PM impairment was significantly higher in the EBC group than controls (53% vs 17%; p &lt; 0.005; odds ratio = 5.588; 95% CI=1.376 to 22.7). Multivariate logistic regression showed that PM performance was unaffected by age (p=0.459), depression (p=0.358), anxiety (p=0.512) or fatigue (p=0.595). Conclusions These preliminary findings provide further support for the hypothesis that breast cancer treatment can impair cognitive processes and yield new and important insights into the type of memory problems experienced by EBC survivors. They suggest that a significant proportion of patients exhibit deficits in PM, an aspect of memory involved in effective daily functioning. Our results also suggest that emotional distress and fatigue do not contribute to PM functioning. Further studies in this area should be directed at understanding the severity and duration of PM impairment. Acknowledging and studying this vexing problem in EBC survivors will aid in developing appropriate rehabilitation strategies.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-15-01.

Determination of f(s)/f(d) for 7 TeV pp collisions and measurement of the B0→D-K+ branching fraction

The relative abundance of the three decay modes B(0)→D(-)K(+), B(0)→D(-)π(+), and B(s)(0)→D(s)(-)π(+) produced in 7 TeV pp collisions at the LHC is determined from data corresponding to an integrated luminosity of 35 pb(-1). The branching fraction of B(0)→D(-)K(+) is found to be B(B(0)→D(-)K(+)) = (2.01 ± 0.18(stat) ± 0.14(syst)) × 10(-4). The ratio of fragmentation fractions f(s)/f(d) is determined through the relative abundance of B(s)(0)→D(s)(-)π(+) to B(0)→D(-)K(+) and B(0)→D(-)π(+), leading to f(s)/f(d) = 0.253 ± 0.017 ± 0.017 ± 0.020, where the uncertainties are statistical, systematic, and theoretical, respectively.

Evaluation of international recruitment of health professionals in England

Objectives:

To explore whether a period of intensive international recruitment by the English National Health Service (NHS) achieved its objectives of boosting workforce numbers and to set this against the wider costs, longer-term challenges and questions arising.

Methods:

A postal survey of all pre-2006 NHS providers, Strategic Health Authorities and Deans of Postgraduate Medical Education obtained information on 284 (45%) organizations (142 completed questionnaires). Eight subsequent case studies (74 interviews) covered medical consultant, general practitioner, nurse, midwife and allied health professional recruitment.

Results:

Most respondents had undertaken or facilitated international recruitment between 2001 and 2006 and believed that it had enabled them to address immediate staff shortages. Views on longer-term implications, such as recruit retention, were more equivocal. Most organizations had made only a limited value-for-money assessment, balancing direct expenditure on overseas recruitment against savings on temporary staff. Other short and long-term transaction and opportunity costs arose from pressures on existing staff, time spent on induction/pastoral support, and human resource management and workforce planning challenges. Though recognized, these extensive ‘hidden costs’ for NHS organizations were harder to assess as were the implications for source countries and migrant staff.

Conclusions:

The main achievement of the intensive international recruitment period from a UK viewpoint was that such a major undertaking was seen through without major disruption to NHS services. The wider costs and challenges meant, however, that large-scale international recruitment was not sustainable as a solution to workforce shortages. Should such approaches be attempted in future, a clearer upfront appraisal of all the potential costs and implications will be vital.

pi cation radicals of ferrous and free base isobacteriochlorins: Models for siroheme and sirohydrochlorin

Theoretical and experimental optical, redox, and paramagnetic results are presented for models of siroheme, the iron isobacteriochlorin prosthetic group of nitrite and sulfite reductases, and of sirohydrochlorin, the metal-free siroheme that is an intermediate in the biosynthetic pathway to vitamin B(12). The facile oxidation of many isobacteriochlorins, which distinguishes them from porphyrins and chlorins, suggests that the siroheme macrocycle itself may undergo oxidation in the multi-electron enzymatic cycles that reduce nitrite to ammonia and sulfite to hydrogen sulfide. Extended Hückel MO calculations (i) help rationalize the redox properties of isobacteriochlorins compared with those of porphyrins and chlorins; (ii) indicate that Fe(II) pyridine carbonyl[(py) (CO)] complexes of isobacteriochlorins, unlike those of porphyrins and chlorins, should undergo oxidation from the macrocycle rather than the metal to yield pi cation radicals; (iii) suggest that, in hexacoordinated Fe(II) isobacteriochlorin complexes, the site of oxidation-i.e., the metal or the macrocycle-will depend on the ligand field induced by the axial ligands; and (iv) predict similar unpaired spin density profiles for metal-free and (py) (CO)Fe(II) isobacteriochlorin radicals. Experimental data for three isomeric free-base and (py) (CO)Fe(II) complexes of dimethyloctaethylisobacteriochlorins support the theoretical calculations and establish the existence of Fe(II) isobacteriochlorin pi cations in vitro.

Prognostic significance of HPV and p16 status in patients with oropharyngeal cancer treated on a large international phase III trial

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Background: Previous studies have reported that in patients with oropharyngeal cancer (OPC) the presence of human papilloma virus (HPV) is associated with an improved prognosis. We sought to determine the prognostic importance of HPV and p16 in patients with OPC treated with concurrent chemoradiation on a large international phase III trial. Methods: Patients with previously untreated Stage III or IV head and neck squamous cell cancer were randomized to receive definitive radiotherapy concurrently with either cisplatin or cisplatin plus tirapazamine. In this substudy, analyses were restricted to patients with OPC who received > 60 Gy and did not have major radiation deviations predicted to impact on tumor control. HPV 16/18 were detected by in situ hybridization and scored as detected or undetected. p16 was detected by immunohistochemistry. Nuclear and cytoplasmic staining intensity of tumor cells was scored as grade 0–3, with grade 2 and 3 called positive. Log rank and Cox regression used for survival analyses. p values were 2-sided . Results: 384 out of 861 patients had OPC and met the eligibility criteria. Slides were available for HPV assay in 195 and for p16 in 186, and for both in 173. 54/195 (28%) were HPV positive, 107/186 (58%) were p16 positive. HPV pos tumors were associated with better 2-year overall survival (OS) (94 v 77%, p = 0.007) and better failure-free survival (FFS) (86 v 75%, p = 0.035) compared to HPV neg tumors. Similarly p16 pos tumors were associated with better 2-year OS (92 v 75%, p = 0.004) and FFS (87 v 72%, p = 0.003) compared to p16 neg . After adjustment for stage, Hb and ECOG PS, HPV pos had better OS than HPV neg (HR 0.29, p = 0.018), and p16 pos had better OS than p16 neg (HR 0.39, p = 0.013). When the HPV and p16 results were combined the relative HRs for OS were: HPVpos/p16pos 0.35 (45 patients, 26% of cases), HPVpos/p16neg 0 (3pts, 2%), HPVneg/p16pos 0.73 (58pts, 33%), HPVneg/p16neg 1.79 (67 pts, 39%). Conclusions: Our results confirm the prognostic significance of tumor HPV status in oropharyngeal cancer treated with chemoradiation, but also show that p16 identifies a larger group with an improved prognosis. The HPV neg/p16 pos population has a better prognosis compared to patients with HPV neg/p16 neg tumors.

No significant financial relationships to disclose.

Serum C-reactive protein concentration and the prognosis of ductal adenocarcinoma of the head of pancreas

BACKGROUND

The prognostic role of serum C-reactive protein in pancreatic cancer has received increasing attention; however the confounding effects of biliary obstruction have not been addressed in previous studies. We sought to determine the prognostic importance of serum CRP prior to biliary intervention in the prognosis of pancreatic adenocarcinoma.

METHODS

A retrospective case note review of patients diagnosed with pancreatic cancer between 2001 and 2006. Clinical, radiological and biochemical criteria were correlated with overall survival. Patients were divided into: Group 1 who underwent potentially curative resection, and Group 2 with advanced unresectable disease managed non-surgically.

RESULTS

In total, 199 patients were included (58 resected). The proportion of patients with biliary obstruction was equal in both groups. Serum CRP and serum bilirubin concentration at presentation were significantly higher among patients in Group 2 compared to Group 1 (P values). On multivariate analysis, advancing age (P=0.012) and raised serum CRP concentration were independently associated with overall survival only in Group 2 patients (P=0.027, 95% CI 0.31-0.93). This association was independent of biliary tract obstruction.

CONCLUSION

Raised serum C-reactive protein concentration at the time of presentation of advanced pancreatic cancer carries a poor prognosis independent of biliary tract obstruction.

Factors associated with depression in students at The University of the West Indies, Mona, Jamaica

OBJECTIVE

This project examines the factors associated with depression in students attending the University of the West Indies, Mona Campus.

METHOD

Students enrolled in the Foundation courses during the first and second semesters of the 2005/2006 academic year were administered the Brief Screen for Depression as well as a demographic questionnaire as part of a larger study.

RESULTS

A wide cross-section of the university population was sampled (n = 690; 252 from semester one, 438 from semester two; 77% females, 23% males; age 16-62 years, median = 20 years, mean = 23.4 years +/- 7.4). Nearly 40% of students scored in the clinically depressed range. Students in the December wave of data collection had higher depression scores than those in the January wave. Consistent with international research, females reported significantly higher levels of depressive symptoms. Married students reported significantly lower depression scores than students in visiting relationships. Students who were combining employment and school reported lower depression scores than those who were not employed. Maternal education significantly influenced students' levels of depression such that students whose mothers had university or other tertiary education had lower depression scores while those whose mothers had primary or lower education had the highest depression scores. Students with a chronic condition or a disability scored higher than those without such problems on all three measures of depression.

CONCLUSION

Depression may be a significant problem in students at The University of the West Indies, Mona campus.