Sleep disturbance in adults with cancer: a systematic review of evidence for best practices in assessment and management for clinical practice.

Sleep disturbance is prevalent in cancer with detrimental effects on health outcomes. Sleep problems are seldom identified or addressed in cancer practice. The purpose of this review was to identify the evidence base for the assessment and management of cancer-related sleep disturbance (insomnia and insomnia syndrome) for oncology practice. The search of the health literature included grey literature data sources and empirical databases from June 2004 to June 2012. The evidence was reviewed by a Canadian Sleep Expert Panel, comprised of nurses, psychologists, primary care physicians, oncologists, physicians specialized in sleep disturbances, researchers and guideline methodologists to develop clinical practice recommendations for pan-Canadian use reported in a separate paper. Three clinical practice guidelines and 12 randomized, controlled trials were identified as the main source of evidence. Additional guidelines and systematic reviews were also reviewed for evidence-based recommendations on the assessment and management of insomnia not necessarily in cancer. A need to routinely screen for sleep disturbances was identified and the randomized, controlled trial (RCT) evidence suggests benefits for cognitive behavioural therapy for improving sleep quality in cancer. Sleep disturbance is a prevalent problem in cancer that needs greater recognition in clinical practice and in future research.

Divergent perspectives on community convergence.

Recent experimental and theoretical studies of community development, as well as more general studies of complex systems, indicate that historical differences and intrinsic indeterminism can lead to long-term community divergence. This observation has sparked a series of new investivations of community structure in systems that developed under controlled or natural conditions.

Facial aesthetics: babies prefer attractiveness to symmetry.

The visual preferences of human infants for faces that varied in their attractiveness and in their symmetry about the midline were explored. The aim was to establish whether infants' visual preference for attractive faces may be mediated by the vertical symmetry of the face. Chimeric faces, made from photographs of attractive and unattractive female faces, were produced by computer graphics. Babies looked longer at normal and at chimeric attractive faces than at normal and at chimeric unattractive faces. There were no developmental differences between the younger and older infants: all preferred to look at the attractive faces. Infants as young as 4 months showed similarity with adults in the 'aesthetic perception' of attractiveness and this preference was not based on the vertical symmetry of the face.

Determination of vesicle size distributions by freeze-fracture electron microscopy.

The most common electron microscopic technique for obtaining information on size distributions of uncollapsed membrane vesicles is based on the method of van Venetie (1980). This technique involves the sizing of only those vesicles that were freeze fractured at their equatorial planes. As a result, only a small number of images can be used to generate size distributions. Further, the technique is susceptible to systematic error. An alternate approach is to consider the complete distribution of image sizes and use this distribution to determine the average size and distribution of the vesicles. It is shown that the mean vesicle size is 4/pi times the mean image size. As well, a parameter, m, which can be determined from the image distribution, can be used to characterize the vesicle distribution. The advantage of this new approach is that images of all vesicles are used, leading to a statistically better determination of vesicle sizes.

Incidence of fever following invasive oral interventions in the myelosuppressed cancer patient.

Oral complications in cancer patients with chemotherapy-induced myelosuppression contribute to morbidity and mortality. However, guidelines for oral care to prevent such complications, including disorders involving the periodontium, are not clear. This study specifically analyzed the impact of a noninvasive oral examination versus invasive oral interventions (periodontal probing, dental scaling) prior to chemotherapy on subsequent development of fever and/or bacteremia in these patients. Medical and dental records were reviewed for 100 patients who had been assigned to receive either the invasive or noninvasive procedures prior to chemotherapy. Temperature values immediately before and up to 48 h after the oral intervention were recorded, and the occurrence of fever and/or bacteremia was documented for each group. There was no statistically significant difference in the incidence of fever and/or bacteremia between the two groups of patients. Although periodontal probing and dental scaling are procedures that invade mucosal barriers, such interventions did not appear significantly to affect the incidence of fever or bacteremia among persons in this study.

Attention to eye contact opportunity and facial motion by three-month-old infants.

Thirty-two 3-month-old infants participated in two experiments showing color videotapes of facial stimuli in a paired comparison format. In Experiment 1, the experimenter, serving as the stimulus, looked either directly at the infant or averted his gaze to the side; the face was presented either still or in motion. Eye contact opportunity had no effect while motion of the head was an effective attractor of visual fixation. In Experiment 2, the amount of available eye contact opportunity was parametrically varied by occluding the eyes with different patterns of blinking, each at the same rate. The no-motion 100% eye contact available condition received less attention than the three blinking stimuli, which were all equally attended to, though they varied with respect to the amount of eye contact opportunity they afforded. The contrast in effect of eye contact availability and rather subtle stimulus motion would imply that 3-month-old infants are comparatively insensitive to being the object of another's visual regard.

Thymosin increases production of T-cell growth factor by normal human peripheral blood lymphocytes.

The in vitro incubation of phytohemagglutinin-stimulated peripheral blood lymphocytes with thymosin results in a marked and reproducible increase in production of T-cell growth factor, which is dose dependent and most pronounced in the first 24 hr of culture. Incubation of lymphocytes with thymosin alone failed to induce any production of T-cell growth factor. The biological activity of thymosin fraction 5 cannot be attributed to the activity of thymosin alpha 1, one of the well-characterized peptide components of fraction 5. These data provide the basis for (i) a potential mechanism for the in vivo immunorestorative effects of thymosin in primary and secondary immunodeficiencies and (ii) identification of an additional, but as yet undefined, immunoregulatory component of thymosin fraction 5.

Decreased inhibition of platelet aggregation by PGE1 in children with cystic fibrosis and their parents.

PGE1 inhibited ADP-induced platelet aggregation in children with cystic fibrosis and their parents to a much lesser extent than in normal controls. We suggest that this may be a reliable test for heterozygote carriers of cystic fibrosis.