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1.
BMC Public Health ; 23(1): 424, 2023 03 03.
Article in English | MEDLINE | ID: mdl-36869343

ABSTRACT

BACKGROUND: A relationship between smoking and interpersonal influences has been well established within the literature. There have been cultural shifts in denormalisation and a reduction in tobacco smoking in many countries. Hence there is a need to understand social influences on adolescents' smoking across smoking normalisation contexts. METHODS: The search was conducted in July 2019 and updated in March 2022 within 11 databases and secondary sources. Search terms included schools, adolescents, smoking, peers, social norms and qualitative research. Screening was conducted by two researchers independently and in duplicate. Study quality was assessed using the eight-item Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-centre) tool for the appraisal of qualitative studies. Results were synthesised using a meta-narrative lens for meta-ethnography and compared across smoking normalisation contexts. RESULTS: Forty one studies were included and five themes were developed, mapping onto the socio ecological model. The social processes by which adolescents take up smoking differed according to a mixture of school type, peer group structure and the smoking culture within the school, as well as the wider cultural context. Data available from smoking denormalised contexts, described changes in social interactions around smoking to cope with its stigmatisation. This was manifested through i) direct peer influence, whereby subtle techniques were employed, ii) group belonging whereby smoking was less likely to be seen as a key determinant of group membership and smoking was less commonly reported to be used as a social tool, and iii) popularity and identity construction, whereby smoking was perceived more negatively in a denormalised context, compared with a normalised context. CONCLUSIONS: This meta-ethnography is the first study to demonstrate, drawing on international data, that peer processes in adolescent smoking may undergo changes as smoking norms within society change. Future research should focus on understanding differences across socioeconomic contexts, to inform the adaptation of interventions.


Subject(s)
Friends , Tobacco Control , Adolescent , Humans , Smoking , Tobacco Smoking , Qualitative Research , Anthropology, Cultural
2.
Clin Radiol ; 75(4): 308-315, 2020 04.
Article in English | MEDLINE | ID: mdl-31836179

ABSTRACT

AIM: To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden. MATERIALS AND METHODS: A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity. The follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage, and technical quality was graded by a radiographic technician and grading combined to categorise the scan as "optimal", "sub-optimal" or "degraded". A radiologist categorised 30 scans to test interobserver agreement. Data were analysed using the chi-square, Fisher's exact, t-tests, and multinomial regression. RESULTS: One hundred and fourteen patients were included in the study (53 lung, 61 colorectal; average age 65.3 years, SD=11.8; 66 men [57.9%]). Overall, 45.6% (n=52), scans were classified as "optimal" quality, 39.5% (n=45) "sub-optimal", and 14.9% (n=17) as "degraded". In adjusted analyses, greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal versus an optimal scan (odds ratio [OR]: 4.465, 95% confidence interval [CI]: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013, respectively). None of the variables predicted the likelihood of having a degraded scan. CONCLUSIONS: Deprivation and patients' perceived experience of the WB-MRI are related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve image quality.


Subject(s)
Colorectal Neoplasms/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Magnetic Resonance Imaging/methods , Patients/psychology , Stress, Psychological/complications , Whole Body Imaging/methods , Aged , Artifacts , Female , Humans , Male , Middle Aged , Neoplasm Staging , Prospective Studies , Quality Assurance, Health Care , Surveys and Questionnaires
3.
Science ; 362(6415): 662-665, 2018 11 09.
Article in English | MEDLINE | ID: mdl-30237247

ABSTRACT

Photon-mediated interactions between quantum systems are essential for realizing quantum networks and scalable quantum information processing. We demonstrate such interactions between pairs of silicon-vacancy (SiV) color centers coupled to a diamond nanophotonic cavity. When the optical transitions of the two color centers are tuned into resonance, the coupling to the common cavity mode results in a coherent interaction between them, leading to spectrally resolved superradiant and subradiant states. We use the electronic spin degrees of freedom of the SiV centers to control these optically mediated interactions. Such controlled interactions will be crucial in developing cavity-mediated quantum gates between spin qubits and for realizing scalable quantum network nodes.

4.
Phys Rev Lett ; 119(22): 223602, 2017 Dec 01.
Article in English | MEDLINE | ID: mdl-29286819

ABSTRACT

The negatively charged silicon-vacancy (SiV^{-}) color center in diamond has recently emerged as a promising system for quantum photonics. Its symmetry-protected optical transitions enable the creation of indistinguishable emitter arrays and deterministic coupling to nanophotonic devices. Despite this, the longest coherence time associated with its electronic spin achieved to date (∼250 ns) has been limited by coupling to acoustic phonons. We demonstrate coherent control and suppression of phonon-induced dephasing of the SiV^{-} electronic spin coherence by 5 orders of magnitude by operating at temperatures below 500 mK. By aligning the magnetic field along the SiV^{-} symmetry axis, we demonstrate spin-conserving optical transitions and single-shot readout of the SiV^{-} spin with 89% fidelity. Coherent control of the SiV^{-} spin with microwave fields is used to demonstrate a spin coherence time T_{2} of 13 ms and a spin relaxation time T_{1} exceeding 1 s at 100 mK. These results establish the SiV^{-} as a promising solid-state candidate for the realization of quantum networks.

5.
Phys Rev Lett ; 118(22): 223603, 2017 Jun 02.
Article in English | MEDLINE | ID: mdl-28621982

ABSTRACT

We demonstrate a quantum nanophotonics platform based on germanium-vacancy (GeV) color centers in fiber-coupled diamond nanophotonic waveguides. We show that GeV optical transitions have a high quantum efficiency and are nearly lifetime broadened in such nanophotonic structures. These properties yield an efficient interface between waveguide photons and a single GeV center without the use of a cavity or slow-light waveguide. As a result, a single GeV center reduces waveguide transmission by 18±1% on resonance in a single pass. We use a nanophotonic interferometer to perform homodyne detection of GeV resonance fluorescence. By probing the photon statistics of the output field, we demonstrate that the GeV-waveguide system is nonlinear at the single-photon level.

6.
Science ; 354(6314): 847-850, 2016 Nov 18.
Article in English | MEDLINE | ID: mdl-27738014

ABSTRACT

Efficient interfaces between photons and quantum emitters form the basis for quantum networks and enable optical nonlinearities at the single-photon level. We demonstrate an integrated platform for scalable quantum nanophotonics based on silicon-vacancy (SiV) color centers coupled to diamond nanodevices. By placing SiV centers inside diamond photonic crystal cavities, we realize a quantum-optical switch controlled by a single color center. We control the switch using SiV metastable states and observe optical switching at the single-photon level. Raman transitions are used to realize a single-photon source with a tunable frequency and bandwidth in a diamond waveguide. By measuring intensity correlations of indistinguishable Raman photons emitted into a single waveguide, we observe a quantum interference effect resulting from the superradiant emission of two entangled SiV centers.

7.
Cephalalgia ; 30(5): 620-3, 2010 May.
Article in English | MEDLINE | ID: mdl-19673916

ABSTRACT

A survey of 148 family doctors attending a continuing medical education migraine update lecture was performed to assess whether family doctors like to treat migraine and other common disorders and the prevalence of migraine. Doctors were asked to respond to the following statement using a five-point Likert scale (from 1, strongly disagree to 5, strongly agree): 'I like to treat patients with this disease or symptom'. The response rate was 53% with a mean age of 51.5 years. Doctors reported liking to treat general medical conditions more (mean = 4.40) than migraine (mean = 3.38) and other neurological diseases (mean = 3.20). Doctors reported a personal history of migraine in the prior 1 year of 22.8% and 45.6% lifetime, with 17% becoming aware for the first time that they personally had migraine after attending the lecture. Respondents with a personal history of migraine liked to treat migraine more than those without a history.


Subject(s)
Migraine Disorders/epidemiology , Physician-Patient Relations , Physicians, Family/psychology , Practice Patterns, Physicians'/statistics & numerical data , Adult , Data Collection , Female , Humans , Male , Middle Aged , Physicians, Family/statistics & numerical data , Prevalence
8.
Metab Brain Dis ; 21(2-3): 235-40, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16850256

ABSTRACT

INTRODUCTION: The incidence rate of Alzheimer's disease (AD) was found to be 2 times lower in Yoruba than in African Americans. This study was aimed at identifying the factors associated with increased risk of incident AD in the two communities. METHODOLOGY: A two-stage design with initial screening using the CSI'D followed by neuropsychological test battery, relations' interview and physician assessment in a sub-sample.NINCDS-ADRDA criteria were met for AD. The risk factor variables assessed included demographic, lifestyle, medical and family history items. RESULTS: In the Yoruba, AD was associated with age (OR = 1.07) and female gender (OR = 2.93). In African Americans, age (OR = 1.09) and rural living (OR = 2.08) were the significant risk factors, while alcohol was protective (OR = 0.49). DISCUSSION: Age was a significant risk factor for AD at both sites. The higher risk of incident AD in the Yoruba female, and in African Americans who resided in rural areas in childhood were similar with the prevalence cases. Alcohol emerged a protective factor in African Americans. More studies are required, including biological measurements, to adequately explain the differences in rates.


Subject(s)
Alzheimer Disease/epidemiology , Black or African American/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Indiana/epidemiology , Life Style , Longitudinal Studies , Male , Nigeria/epidemiology , Risk Factors , Sex Factors , Socioeconomic Factors
10.
Arch Environ Contam Toxicol ; 43(4): 418-24, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12399912

ABSTRACT

Histological and metallothionein (MT) analyses of liver and kidney and measurements of serum electrolytes and hematocrit from lake whitefish (Coregonus clupeaformis), 3.5 years of age, were conducted over a 90-day period that included maximal gonadal maturation in females. Condition factors were higher in females at day 1 and when all data were combined over the 90-day sampling period. Significant differences between females and males of 1.8-fold in hepatic MT concentrations were observed at day 20 when ovaries appeared to be in the most advanced state of maturation, although this parameter was not quantified. Hematocrits were slightly but significantly lower at day 90. No sex differences were observed in the quantitative assessments of epithelium cell height, lumen diameter (LD), tubule diameter (TD), and ratio of LD:TD in the second segment of the proximal tubule (P2); and of hepatocyte area, hepatocyte nuclear diameters, and nucleus area:cytoplasmic area (N:C) ratio. Positive correlations were observed between N:C ratios and fish weight, fork length, and liver weight. No significant correlations between these histological morphometrics and MT concentrations were observed in liver or kidney. The results of this study provide baseline information for investigations designed to determine sublethal effects of metals in lake whitefish.


Subject(s)
Metallothionein/analysis , Metals, Heavy/adverse effects , Salmonidae/physiology , Water Pollutants/adverse effects , Animals , Biometry , Body Weight , Electrolytes , Female , Hematocrit , Kidney/chemistry , Liver/chemistry , Male , Ovary/growth & development , Reference Values , Salmonidae/anatomy & histology , Sex Factors
11.
Aquat Toxicol ; 58(3-4): 229-47, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12007877

ABSTRACT

The sublethal toxicity associated with exposure of adult lake whitefish (Coregonus clupeaformis) to diets containing 0, 10, 100, and 1000 microg Ni per g for 10, 31, and 104 days was assessed through the measurement of responses, through a range of levels of biological organization. The accumulation and distribution of Ni in these fish are described in the previous manuscript (Ptashynski and Klaverkamp, 2001. Aquat. Toxicol. in press). Hematological parameters, including concentrations of glucose and hemoglobin and hematocrit, were not different between control and treated fish. Organ and whole organism parameters, including LSI, growth, and condition factor, were also unaffected. Histopathological lesions in kidney and liver proved to be the most sensitive and reliable indicators of Ni exposure. In livers of treated fish, areas of focal necrosis and altered bile ducts were observed. Histological alterations were observed throughout the posterior kidneys, in glomeruli, tubules, collecting ducts, and hematopoietic tissue, in fish fed medium and high dose diets. In whitefish kidneys, the frequency (%) of altered distal tubules and fields of views with alterations increased with the dose and duration of exposure. Significant increases in metallothionein concentrations were observed in intestine of whitefish fed the high dose diet on day 10, but these increases were not sustained. Significant increases in lipid peroxide concentrations were also observed in plasma of whitefish fed the high dose diet on day 31, but were not observed on day 104. These biochemical responses to dietary Ni require further evaluation. To evaluate exposure of natural populations of fish to Ni, analysis of Ni in kidney and liver and assessment of renal and hepatic histopathology are recommended for use in field bio-monitoring programs.


Subject(s)
Environmental Monitoring/methods , Nickel/toxicity , Salmonidae/metabolism , Water Pollutants, Chemical/toxicity , Administration, Oral , Animal Feed , Animals , Dose-Response Relationship, Drug , Environmental Exposure , Kidney/drug effects , Kidney/pathology , Lipid Peroxides/blood , Liver/drug effects , Liver/pathology , Metallothionein/metabolism , Nickel/pharmacokinetics , Tissue Distribution , Water Pollutants, Chemical/pharmacokinetics
12.
Article in English | MEDLINE | ID: mdl-11796327

ABSTRACT

A 20-day experiment was conducted to compare the accumulation, distribution, and toxicological effects of dietary As, as arsenate, in lake whitefish (LWF, Coregonus clupeaformis) and lake trout (LT, Salvelinus namaycush). Results of this experiment were used to design an experiment of longer duration in which one of the fish species was selected and exposed three times per week to lower dietary As doses. In the present study each treatment group was exposed to a combination of one of three doses of As (0, 100, or 1000 microg As/g) and one of two types of diet, no brine shrimp (NS) or with brine shrimp (WS) for a total of eight dosing events. Brine shrimp were added to determine whether their presence enhanced consumption of As-contaminated food. Modified feeding behavior occurred in both fish species fed As contaminated diets, with the exception of the 100 microg As/g NS food. Brine shrimp addition did not affect feed consumption of the As contaminated diets. Significant As accumulation occurred in stomach, pyloric caeca, intestine, liver, kidney, and gallbladder, but not in bile or muscle. As exposure did not have a significant effect on hepatic and renal metallothionein concentrations. Concentrations of lipid peroxides were only significantly elevated in the plasma of LT fed the 1000 microg As/g WS food. Liver somatic indices decreased significantly in both species, whereas hematological parameters were not affected in either species. Histological lesions occurred in gallbladder, liver, kidney, pyloric caeca and intestine from LWF. These lesions were not observed in LT; however, gallbladders were not examined in this species. Weight gain was lower in both species fed As contaminated diets, however, condition factors were not affected.


Subject(s)
Arsenic Poisoning/metabolism , Arsenic/toxicity , Animals , Arsenic/pharmacokinetics , Arsenic Poisoning/pathology , Diet , Eating , Gallbladder/drug effects , Gallbladder/pathology , Hemoglobins/metabolism , Kidney/drug effects , Kidney/metabolism , Kidney/pathology , Liver/drug effects , Liver/metabolism , Liver/pathology , Metallothionein/metabolism , Salmonidae , Tissue Distribution , Trout
13.
Environ Toxicol Chem ; 20(10): 2370-6, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11596772

ABSTRACT

Studies in mammals have shown that exposure to estrogenic compounds can affect lipid metabolism and plasma concentrations of lipid-soluble vitamins. However, the potential for estrogenic contaminants to induce these effects in fish has not yet been examined. The ability of the estrogen analog ethynylestradiol (EE2) to alter concentrations of the lipid-soluble vitamins A and E in plasma, liver, and kidney was investigated in juvenile lake sturgeon (430 +/- 20 g). The EE2 was delivered to the sturgeon in the tank water at nominal concentrations of 0 (control), 15, 60, or 125 ng EE2/L for a period of 25 d. Concentrations of the egg yolk precursor, vitellogenin, increased dose dependently in plasma. Plasma vitamin E (tocopherol), A1 (retinol), and A2 (dehydroretinol) were elevated by the two highest EE2 treatments compared with the controls. Esterified storage forms of vitamin A were marginally lower in the livers of fish from the highest EE2 dose group, but vitamin E levels in the liver were not significantly affected. Concentrations of vitamin E and vitamin A were significantly depleted in the kidney of fish from the two highest EE2 dose groups. Total lipid content was elevated in the gonad of fish treated with the highest dose of EE2 compared with the controls. Altered lipid and vitamin distribution may be induced by estrogen to facilitate gonadal maturation in sturgeon. Results from these studies indicate that an examination of the implications for vitamin depletion by estrogenic contaminants in juvenile fish is warranted.


Subject(s)
Estradiol Congeners/adverse effects , Ethinyl Estradiol/adverse effects , Fishes/growth & development , Vitamin A/pharmacokinetics , Vitamin E/pharmacokinetics , Water Pollutants, Chemical/adverse effects , Animals , Female , Gonads/drug effects , Gonads/growth & development , Kidney/chemistry , Lipids/pharmacokinetics , Liver/chemistry , Male , Sexual Maturation/drug effects , Tissue Distribution
14.
Chemosphere ; 45(2): 185-93, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11572610

ABSTRACT

Induction of phase I biotransformation enzymes is recognized as a hallmark response in fish exposed to coplanar PCBs. Depletions of vitamins A and E and disrupted thyroid hormone and glandular structure secondary to this induction have not yet been examined in an arctic fish species. Arctic grayling were exposed to a single oral dose of 0 (control), 10, 100 or 1000 ng 3,3',4,4'-tetrachlorobiphenyl (TCB) g(-1) bodyweight, a contaminant found in most arctic fish. After 30 and 90 days of exposure, TCB concentrations in tissues, hepatic phase I activity (as ethoxyresorufin-O-deethylase (EROD)), plasma and tissue vitamin A and E concentrations, plasma thyroid hormone levels and thyroid glandular structure were examined. Total plasma osmolality, as an indicator of overall fish health was also monitored. TCB recovery in tissues was low and extremely variable, making comparisons between intended dose groups inappropriate. Therefore, correlation analysis between actual recovered TCB concentrations and biochemical responses was employed. Hepatic EROD activity correlated strongly with liver TCB concentrations. Liver concentrations of vitamin A were altered as a function of TCB concentrations and EROD activity, but plasma vitamin A status was not affected. Vitamin E was depleted by TCB accumulation in blood and EROD induction in liver of males only at 90 days postexposure. Thyroid hormones status and glandular structure were not affected by the short duration TCB exposures used in this experiment. TCB concentrations were correlated with an elevation in plasma osmolality. Results from this experiment indicate that the vitamin status and osmoregulation of arctic grayling exposed to TCB can be compromised. Further studies of field populations exposed to this type of contaminant are warranted.


Subject(s)
Cytochrome P-450 CYP1A1/metabolism , Polychlorinated Biphenyls/adverse effects , Salmonidae/physiology , Administration, Oral , Animals , Dose-Response Relationship, Drug , Enzyme Induction , Thyroid Hormones/analysis , Vitamin A/analysis , Vitamin A/metabolism , Vitamin E/analysis , Vitamin E/metabolism
15.
Comp Biochem Physiol C Toxicol Pharmacol ; 130(2): 145-62, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11574285

ABSTRACT

An 18-day experiment was conducted to investigate the uptake and sublethal toxicity of dietary Ni in adult lake whitefish (LWF, Coregonus clupeaformis) and lake trout (LT, Salvelinus namaycush) fed diets containing 0, 1000 and 10000 microg Ni/g, prepared with and without brine shrimp. The results of this experiment were used to design an experiment of longer duration in which one of the fish species was selected and exposed to lower dietary Ni doses. In the present study feed refusal was observed in LT and LWF fed 10000 microg Ni/g, after three and 4-5 feedings, respectively. LT fed Ni-contaminated diets exhibited different patterns of Ni accumulation than LWF. Increased Ni concentrations in all LWF tissues, except the intestine, were associated with increased doses of Ni. Copper and Zn concentrations in kidney and liver of LWF were altered. Metallothionein concentrations in kidneys of LT fed 1000 microg Ni/g and 10000 microg Ni/g and LWF fed 10000 microg Ni/g and in livers of LWF fed 10000 microg Ni/g (diet without shrimp only) increased significantly. Increased lipid peroxide production in the plasma of LT fed 10000 microg Ni/g was observed. Blood glucose and electrolytes were affected by Ni exposure. Histopathological alterations were observed in kidneys of LWF fed low and high dose diets, livers of whitefish fed high dose diets, and intestines of LWF fed high dose diets and LT fed low and high dose diets. LT fed high dose diets exhibited significant decreases in weight.


Subject(s)
Lipid Peroxides/blood , Metallothionein/pharmacokinetics , Nickel/pharmacokinetics , Nickel/toxicity , Administration, Oral , Animals , Artemia , Bone and Bones/metabolism , Copper/pharmacokinetics , Digestive System/metabolism , Digestive System/pathology , Feeding Behavior/drug effects , Fresh Water , Gills/metabolism , Gonads , Hemoglobins/drug effects , Kidney/drug effects , Kidney/pathology , Liver/drug effects , Liver/pathology , Muscles/metabolism , Salmonidae , Species Specificity , Tissue Distribution , Trout , Zinc/pharmacokinetics
17.
Aquat Toxicol ; 54(1-2): 81-99, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11451428

ABSTRACT

Juvenile rainbow trout (Oncorhynchus mykiss) were exposed to high dietary concentrations of six polychlorinated n-alkane (PCAs) (C(10)H(15.5)C(6.5), C(10)H(15.3)Cl(6.7),C(11)H(18.4)Cl(5.6),C(12)H(19.5)Cl(6.5),C(14)H(24.9)Cl(5.1) and C(14)H(23.3)Cl(6.7)) for 21 to assess their effects on behavior and liver and thyroid histology and for 85 days to assess histology for a longer term exposure. This is the first histological work using PCAs of known carbon chain length and chlorine content and the first effort to examine the histopathology of fish exposed to PCAs. PCAs, also known as chlorinated paraffins, are complex industrial products for which there is a lack of toxicological data on individual congeners. With the exception of trout exposed to C(14)H(24.9)Cl(5.1), which had much lower exposure concentrations, many of the trout exposed to the PCAs (whole fish concentrations 0.22-5.5 microg g(-1)) showed a diminished or no startle response, loss of equilibrium, and developed a dark coloration. These responses are indicative of a narcotic toxicological mode-of-action. Histopathological lesions were observed in the livers of trout from each exposure group. However, the most severe histopathologies were observed in the livers of fish exposed to C(10)H(15.3)Cl(6.7) and C(11)H(18.4)Cl(5.6) (whole fish concentrations 0.92 and 5.5 microg g(-1), respectively), in which extensive fibrous lesions were present that were not observed in any other exposure group. Other alterations observed in all treatment groups included hepatocyte necrosis, sites of inflammation, and glycogen/lipid depletion. The relative sizes of hepatocytes of PCA exposed trout were smaller than control trout, although only a few of the observed differences were statistically significant. No lesions were present in the thyroid, although trout exposed to C(10)H(15.5)Cl(6.5) (whole fish concentration 0.84 microg g(-1)) had slightly more active thyroids, as indicated by an increased mean thyroid epithelium cell height relative to controls. It would appear that PCA toxicity is inversely related to carbon chain length, as has been observed in similar studies using mammals. The concentrations in the fish from this experiment were at levels that have been reported in invertebrates and fish from contaminated sites in the Great Lakes. However, the exposure concentrations were likely much greater in these experiments compared with the environment and require further study.


Subject(s)
Alkanes/toxicity , Behavior, Animal/drug effects , Liver/drug effects , Paraffin/toxicity , Thyroid Gland/drug effects , Animals , Liver/pathology , Oncorhynchus mykiss , Thyroid Gland/pathology
18.
Psychooncology ; 9(3): 221-31, 2000.
Article in English | MEDLINE | ID: mdl-10871718

ABSTRACT

While research exists on the well-being of women during a specific phase of breast cancer, little research exists in which researchers utilized the same instruments to examine differences in women's well-being, based on the phase of their breast cancer. Using a trajectory framework, the purpose of this study is to examine the differences in the physical and social well-being of women during the following breast cancer states: newly diagnosed, adjuvant therapy, stable disease and recurrent disease. The convenience sample consisted of 35 women newly diagnosed with breast cancer, 52 women with breast cancer undergoing adjuvant therapy, 84 women whose breast cancer was considered stable and 64 women with recurrent breast cancer. Participants completed a packet of questionnaires which contained a demographic questionnaire, Short Form-36 (SF-36) Health Survey, a researcher designed (RD) questionnaire, Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) and the Brief Symptom Inventory (BSI). Descriptive statistics, analysis of variance, and general linear F-tests were used to analyze the data. Differences were found across phases of disease on various subscales, including those representing perceived health states, overall impact, medical interactions, physical function, role function, fatigue, pain, social function and satisfaction with health. No significant differences were found between groups on the BSI subscales with the exception of somatization, global psychosocial measures, sexual and marital relation subscales. While individuals with recurrent disease often experienced more difficulties with their well-being than women in the other groups, women newly diagnosed and in the adjuvant group experienced more difficulties in select areas of well-being when compared with women in the stable group. Health care professionals need to recognize differences between groups to better meet the needs of patients with a breast cancer diagnosis.


Subject(s)
Adaptation, Physiological/physiology , Adaptation, Psychological , Attitude to Health , Breast Neoplasms/psychology , Social Adjustment , Adult , Aged , Aged, 80 and over , Breast Neoplasms/therapy , Female , Humans , Marriage/psychology , Middle Aged , Self Concept , Sexual Dysfunctions, Psychological/etiology , Surveys and Questionnaires
19.
Am J Hypertens ; 10(9 Pt 1): 992-6, 1997 Sep.
Article in English | MEDLINE | ID: mdl-9324104

ABSTRACT

Therapeutic interchange between the available forms of sustained release nifedipine (osmotic-pump and coat-core forms of nifedipine) is a matter of controversy. This study was initiated to determine whether there is a difference in clinical outcomes when there is interchange between the two forms of sustained release nifedipine when used for the treatment of hypertension. A total of 43 patients with a history of stage I hypertension who were receiving stable doses of the osmotic-pump form of nifedipine for > 3 months with controlled blood pressures (< 150/90 mm Hg) were enrolled. Patients were then switched to the same dose of the coat-core form of nifedipine and were followed for 3 months. In the 36 patients who completed the study, mean trough serum nifedipine concentrations were significantly higher with the osmotic-pump from (46.5 +/- 35.0 ng/mL) of nifedipine compared with the coat-core form (27.2 +/- 20.4 ng/mL) (P < .05). However, blood pressure control as determined by the indices of 24 h ambulatory blood pressure monitoring, trough blood pressures and load blood pressures were similar between the osmotic-pump and coat-core forms of nifedipine. The coat-core form of nifedipine was discontinued in four patients for possible side effects. In this group of patients with mild hypertension, there were no clinically relevant differences in blood pressure control between the two forms of nifedipine. Some patients on the coat-core form of nifedipine may need to discontinue therapy due to intolerable side effects.


Subject(s)
Blood Pressure Monitoring, Ambulatory , Hypertension/drug therapy , Hypertension/physiopathology , Nifedipine/administration & dosage , Vasodilator Agents/administration & dosage , Aged , Blood Pressure/drug effects , Cross-Over Studies , Delayed-Action Preparations , Female , Humans , Male , Middle Aged , Nifedipine/blood , Nifedipine/therapeutic use , Osmolar Concentration , Vasodilator Agents/blood , Vasodilator Agents/therapeutic use
20.
CLAO J ; 23(3): 161-7, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9240826

ABSTRACT

PURPOSE: Irregular corneal astigmatism has been reported in association with annular tinted hydrogel contact lenses. We report the abnormal videokeratographic findings of five patients wearing annular tinted contact lenses, who presented with bilateral blurred vision and revealed a loss of best corrected visual acuity. METHODS/RESULTS: The corneal topographic analysis revealed a previously unreported distinct ring-shaped pattern of irregular astigmatism. The topographic circular band of irregular astigmatism was further characterized by concentric areas of relative steepening, flattening, and steepening with a diameter of approximately 4 mm. This pattern suggests that forces acting at the junctional zone between the tinted area and the clear pupillary area are inducing structural abnormalities of the corneal surface. At the time of presentation, the mean surface regularity index (SRI) was 2.06 (range: 0.61-5.88). The topography and best-corrected visual acuity returned to normal within days of discontinuing annular tinted lens use, and the mean SRI decreased to 0.44 (range: 0.21-1.16). Digital imaging of lenses obtained from our patients and of identical control lenses was performed. A masked analysis suggested that the study lenses contain greater amounts of pigment compared to the control lenses. CONCLUSIONS: We present ten characteristic signs and symptoms of this condition, which we have named "the annular tinted contact lens syndrome." Corneal topographic analysis is a powerful tool for detecting specific reversible irregularities of the corneal surface associated with the use of annular tinted contact lenses.


Subject(s)
Astigmatism/etiology , Contact Lenses, Hydrophilic/adverse effects , Cornea/pathology , Image Processing, Computer-Assisted/methods , Adolescent , Adult , Astigmatism/diagnosis , Female , Filtration , Humans , Ophthalmology/instrumentation , Syndrome , Visual Acuity
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