Women's perceptions of events impeding or facilitating the detection, investigation and treatment of breast cancer.

An integrated network is currently being implemented in the province of Quebec in order to improve the cancer care continuum. In this context, formal trajectories for cancer patients through healthcare services are being established. The investigation of patients' perceptions of the healthcare continuum is essential as it allows us to identify the issue of continuity/discontinuity of health services. In addition, patients' perceptions of continuity of cancer care should be documented since they could influence the implementation of optimal trajectories through the healthcare services. An exploratory qualitative study was conducted in order to identify events, based on the perceptions of women with breast cancer, that made the patient progress more rapidly, facilitating events, or more slowly, impeding events, within the cancer care continuum. Two consecutive series of women receiving adjuvant radiation therapy in 2002 and 2003 at the University Hospital of Quebec City were recruited, for a total of 120 participants. A semi-structured interview was administered in order to identify women's perceptions regarding impeding and facilitating events during the detection, investigation and treatment periods of cancer, as well as the actors and reasons involved. Overall, 64% of women reported having at least one impeding event, while 68% reported at least one facilitating event. The periods most frequently affected by impeding or facilitating events were the investigation period, followed by the treatment period. The main stages affected by impeding or facilitating events were the scheduling of an appointment, during the investigation period, and the onset of treatment. Impeding events particularly affected the scheduling of mammography, the initial exam of the investigation for breast cancer, as well as the onset of radiation treatment. On the other hand, facilitating events mainly occurred at the time of the scheduling of medical consultations with specialists, during the investigation period, and of the onset of surgery. Finally, women generally perceived that impeding events were due to a lack in the availability of services and that facilitating events resulted from human intervention. Patients' perceptions, such as those regarding the importance of human intervention in the process of continuity of care, should be taken into account by healthcare authorities in charge of implementing cancer control programmes.

[Elaboration of a conceptual frame to explain fatigue secondary to a health difficulty and implications for nursing practice]. / Elaboration d'un cadre conceptuel pour expliquer la fatigue secondaire à une difficulté de santé et implications pour la pratique infirmière.

Many definitions and conceptual frameworks were developed on fatigue related to health problems, mostly from scientific research among cancer patients. From a summary of a literature review, the first objective of this article is to describe different theoretical perspectives on the concept of fatigue. The second objective is to elaborate an integrative conceptual framework from the definitions chosen. The third objective is to describe different coping strategies and nursing interventions in relation with the conceptual framework. The literature review includes studies on fatigue in general with an emphasis on cancer related fatigue in particular. The review was conducted from 3 scientific data bases, Medline, Cinahl and Psychlit, for the last twenty years. The relevance of the conceptual framework for nursing intervention is discussed.

Autonomic and cardiovascular function in HIV spectrum disease: early indications of cardiac pathophysiology.

Autonomic dysfunction in persons with acquired immune deficiency syndrome (AIDS) has been reported previously but its incidence in early stage HIV infection and its relation to cardiovascular function have not been fully examined. The present study evaluated cardiovascular and autonomic function in 55 HIV-seronegative, and 52 HIV-asymptomatic and 31 HIV-symptomatic seropositive men. Measures of hemodynamic and autonomic function were obtained at rest and during a standardized battery of autonomic tests. Results were compared across groups while controlling for age, body mass, and physical activity. Analyses indicated that measures of autonomic function did not differ among groups. However, at rest, both HIV seropositive groups exhibited diminished stroke volume and elevated diastolic blood pressure, albeit within normotensive levels. In addition, the ability to sustain a blood pressure response during prolonged challenge and the relationship between stroke volume and baroreceptor/vagal responsiveness were disrupted in the HIV-symptomatic group. Therefore, in the pre-AIDS stages of infection, autonomic functioning appeared intact; yet alterations in baroreceptor/vagal function associated with depressed myocardial function may be an early warning signal reflecting cardiovascular pathological processes potentially exacerbated by HIV spectrum disease.

Cloning and expression of a hexose transporter gene expressed during the ripening of grape berry.

The ripening of grape (Vitis vinifera L.) is characterized by massive sugar import into the berries. The events triggering this process and the pathways of assimilate transport are still poorly known. A genomic clone Vvht1 (Vitis vinifera hexose transporter1) and the corresponding cDNA encoding a hexose transporter whose expression is induced during berry ripening have been isolated. Vvht1 is expressed mainly in the berries, with a first peak of expression at anthesis, and a second peak about 5 weeks after véraison (a viniculture term for the inception of ripening). Vvht is strictly conserved between two grape cultivars (Pinot Noir and Ugni-Blanc). The organization of the Vvht1 genomic sequence is homologous to that of the Arabidopsis hexose transporter, but differs strongly from that of the Chlorella kessleri hexose transporter genes. The Vvht1 promoter sequence contains several potential regulating cis elements, including ethylene-, abscisic acid-, and sugar-responsive boxes. Comparison of the Vvht1 promoter with the promoter of grape alcohol dehydrogenase, which is expressed at the same time during ripening, also allowed the identification of a 15-bp consensus sequence, which suggests a possible co-regulation of the expression of these genes. The expression of Vvht1 during ripening indicates that sucrose is at least partially cleaved before uptake into the flesh cells.

French adaptation of the shortened version of the Profile of Mood States.

The French adaptation and validation of the short version of the Profile of Mood States is examined. A sample of 110 women diagnosed with breast cancer and 50 men with prostate cancer were administered the French Canadian adaptation of the shortened version of the profile (37 items). Means, test-retest correlations, and internal consistency coefficients (alpha) replicated the English initial validation. These results support the reliability of the French Canadian version. In addition, significant decrease from initial to retest testing for Anxiety, Depression, and Confusion subscales also supported construct validity.

Beta-carotene enhances the recovery of lymphocytes from oxidative DNA damage.

Epidemiological studies have revealed a strong correlation between high intake of fruit and vegetables and low incidence of certain cancers. Micronutrients present in these foods are thought to decrease free radical attack on DNA and hence protect against mutations that cause cancer, but the fine details of the causal mechanism have still to be elucidated. Whether dietary factors can modulate DNA repair--a crucial element in the avoidance of carcinogenesis--is an intriguing question that has not yet been satisfactorily answered. In order to investigate the effects of beta-carotene on oxidative damage and its repair, volunteers were given a single 45 mg dose and lymphocytes taken before and after the supplement were treated in vitro with H2O2. DNA strand breaks and oxidised pyrimidines were measured at intervals, to monitor the removal of oxidative DNA damage. We found inter-individual variations in response. In cases where the baseline plasma beta-carotene concentration was high, or where supplementation increased the plasma concentration, recovery from oxidative damage (i.e. removal of both oxidised pyrimidines and strand breaks) was relatively rapid. However, what seems to be an enhancement of repair might in fact represent an amelioration of the continuing oxidative stress encountered by the lymphocytes under in vitro culture conditions. We found that culture in a 5% oxygen atmosphere enhanced recovery of lymphocytes from H2O2 damage.

Nutrient losses and gains during frying: a review.

Recent consumer interest in 'healthy eating' has raised awareness to limit the consumption of fat and fatty foods. What are the relative nutritional advantages and disadvantages of consuming fried foods? Are all fried foods bad for you? A review on macro- and micronutrients losses and gains during frying is presented here. Frying has little or no impact on the protein or mineral content of fried food, whereas the dietary fibre content of potatoes is increased after frying due to the formation of resistant starch. Moreover, the high temperature and short transit time of the frying process cause less loss of heat labile vitamins than other types of cooking. For example, vitamin C concentrations of French fried potatoes are as high as in raw potatoes, and thiamine is well retained in fried potato products as well as in fried pork meat. The nutritive value of the frying media is also important to take into consideration and therefore losses of nutrients from the frying oil are also discussed. Although some unsaturated fatty acids and antioxidant vitamins are lost due to oxidation, fried foods are generally a good source of vitamin E. It is true that some fat is inevitably taken up by the food being fried, contributing to an increased energy density. However, this also results in highly palatable foods with a high nutritional content. It is concluded that fried foods certainly have a place in our diets.

Effects of chilling on the expression of ethylene biosynthetic genes in Passe-Crassane pear (Pyrus communis L.) fruits.

Passe-Crassane pears require a 3-month chilling treatment at 0 degrees C to be able to produce ethylene and ripen autonomously after subsequent rewarming. The chilling treatment strongly stimulated ACC oxidase activity, and to a lesser extent ACC synthase activity. At the same time, the levels of mRNAs hybridizing to ACC synthase and ACC oxidase probes increased dramatically. Fruit stored at 18 degrees C immediately after harvest did not exhibit any of these changes, while fruit that had been previously chilled exhibited a burst of ethylene production associated with high activity of ACC oxidase and ACC synthase upon rewarming. ACC oxidase mRNA strongly accumulated in rewarmed fruits, while ACC synthase mRNA level decreased. The chilling-induced accumulation of ACC synthase and ACC oxidase transcripts was strongly reduced when ethylene action was blocked during chilling with 1-methylcyclopropene (1-MCP). Upon rewarming ACC synthase and ACC oxidase transcripts rapidly disappeared in 1-MCP-treated fruits. A five-week treatment of non-chilled fruits with the ethylene analog propylene led to increased expression of ACC oxidase and to ripening. However, ethylene synthesis, ACC synthase activity and ACC synthase mRNAs remained at very low level. Our data indicate that ACC synthase gene expression is regulated by ethylene only during, or after chilling treatment, while ACC oxidase gene expression can be induced separately by either chilling or ethylene.

Comet assay in human biomonitoring studies: reliability, validation, and applications.

The comet assay (single-cell gel electrophoresis), which measures DNA strand breaks at the level of single cells, is very easily applied to human lymphocytes, and therefore lends itself to human biomonitoring studies. For the examination of DNA base oxidation (a specific marker of oxidative damage), the assay is modified by including a stage at which the DNA is incubated with a suitable lesion-specific endonuclease. Here we report on the reliability and reproducibility of this approach, from the level of comparing results from duplicate gels prepared from the same sample of cells, up to an assessment of the natural intra- and interindividual variability in lymphocyte DNA damage measured in groups of normal, healthy human volunteers. We applied the assay in investigations of human disease and occupational exposure of factory workers.

Salivary IgA is a weak stress marker.

Several studies support the hypothesis that psychological stress may negatively affect immunocompetence. The present study sought to determine whether a relationship can be established between a measure of psychological state of stress and level of immunoglobulin of the A class (IgA) in saliva. To this end, 44 dentistry students were tested on four occasions; two occasions were stress inductive (examination situation), and two occasions were free of any academic stressor. At each session, the participants were asked to fill out the stress rating instrument, and unstimulated whole saliva samples were obtained. Salivary IgA was measured by a microplate Enzyme Linked Immunosorbent Assay (ELISA). A significant difference in the level of salivary IgA was observed only for the most polarized contrast, ie, between final exam and end of summer vacation (p less than .01). A weak negative correlation between the level of salivary IgA and the stress rating was observed (r = -0.25) only at the final exam. Our results suggest that assaying immunoglobulin A in saliva to measure stress may not be as useful in psychophysiological research as expected.