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Selected AbstractsHelp-seeking behaviour in patients with lymphomaEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2008D.A. HOWELL Reducing cancer mortality is a priority for the UK Government and emphasis has been placed on introducing targets to ensure prompt diagnosis. Help seeking is the first step on the pathway to diagnosis and should occur promptly; however, patients with lymphoma take longer to seek help for symptoms than those with many other cancers. Despite this, the help seeking behaviour of these patients has not been investigated. This qualitative study examined the beliefs and actions about help seeking among 32 patients, aged 65 and over and newly diagnosed with lymphoma in West Yorkshire during 2000. Patients reported an extremely wide range of symptoms which were not always interpreted as serious or potentially caused by cancer. This, in association with a clear lack of knowledge about lymphoma, often led to help seeking being deferred. The range and characteristics of symptoms can largely be explained in terms of variations in the type, site and size of the lymphoma. The UK Government targets focus on the time after help seeking, yet for lymphoma it is also crucial to reduce the time taken to seek help. More education about the potential symptoms of this disease is needed among the general public. [source] Manipulative therapy of secondary lymphedema in the presence of locoregional tumorsCANCER, Issue 4 2008Ximena A. Pinell BA Abstract BACKGROUND. Complete decongestive therapy (CDT), including manual lymphatic drainage (MLD) is a manipulative intervention of documented benefit to patients with lymphedema (LE). Although the role of CDT for LE is well described, to the authors' knowledge there are no data regarding its efficacy for patients with LE due to tumor masses in the draining anatomic bed. Traditionally, LE therapists are wary of providing therapy to such patients with ,malignant' LE for fear of exacerbating the underlying cancer, and that the obstruction will render therapy less effective. In the current study, the authors' experience providing CDT for such patients is discussed. METHODS. Cancer survivors with LE were referred to therapists at 2 Atlanta-area clinics. CDT consists of treatment (Phase 1) and maintenance phases (Phase 2). During Phase 1, the patient undergoes manipulative therapy and bandaging daily until the LE reduction plateaus; at that point, Phase 2 (self-care) begins. At the beginning and end of Phase 1, LE is quantified and differences in girth volume calculated. The results for patients completing Phase 1 therapy for LE in the presence of locoregional masses were compared with results for patients with LE in the absence of such disease. Both volume reduction of the affected limb and number of treatments to plateau were analyzed. RESULTS. Between January 2004, and March 2007, LE of 82 limbs in 72 patients was treated with CDT and Phase 1 was completed. The median number of treatments to plateau was 12 (range, 4,23 treatments); the median limb volume reduction was 22% (range, ,23 to 164%). Nineteen limbs (16 patients) with associated chest wall/axillary or pelvic/inguinal tumors had nonsignificant difference in LE reduction (P = .75) in the presence of significantly more sessions to attain plateau (P = .0016) compared with 63 limbs in 56 patients without such masses. CONCLUSIONS. Patients with LE may obtain relief with CDT regardless of whether they have locoregional disease contributing to their symptoms. However, it will likely take longer to achieve that effect. Manipulative therapy of LE should not be withheld because of persistent or recurrent disease in the draining anatomic bed. Cancer 2008. © 2007 American Cancer Society. [source] Functional skin adaptation in infancy , almost complete but not fully competentEXPERIMENTAL DERMATOLOGY, Issue 6 2010Joachim W. Fluhr Please cite this paper as: Functional skin adaptation in infancy , almost complete but not fully competent. Experimental Dermatology 2010; 19: 483,492. Abstract:, Early postnatal life is a period of active functional reorganization and cutaneous physiological adaptation to the extrauterine environment. Skin as the outermost organ of mammalians is endowed of multiple functions such as protection, secretion, absorption and thermoregulation. Birth stimulates the epidermal barrier maturation and the skin surface acidification especially in premature infants. In full-term infants the developed stratum corneum accomplishes competent barrier function, in contrast to prematures. Complete barrier maturation in preterm infants is fulfilled by 2,4 weeks of the postnatal life. However, in preterms with 23,25 weeks gestational age this process takes longer. Versatile regulatory mechanisms, namely skin surface acidity, calcium ion gradient and nuclear hormone receptors/ligands are interrelated in the complex postnatal newborn adaptation. The skin of newborns is adjusting quickly to the challenging environmental conditions of the postpartum. However, certain functions, for example, microcirculation, continue to develop even beyond the neonatal period, that is, up to the age of 14,17 weeks. Different environmental factors (for instance, dry and cold climate, diapers and cosmetic care procedures) influence the postnatal development of skin functional parameters such as stratum corneum hydration and the permeability barrier especially in premature infants. The aim of this article is to summarize the current knowledge on skin physiology in newborn and infants with a practical approach and to discuss the possible clinical consequences. This review offers the readership a critical and practical overview of skin physiology in newborns and infants. It emphasizes possible new research fields in neonatal and infantile skin physiology. [source] Weedbeds and big bugs: the importance of scale in detecting the influence of nutrients and predation on macroinvertebrates in plant-dominated shallow lakesFRESHWATER BIOLOGY, Issue 3 2010ANGELA L. BERESFORD Summary 1. The scale of investigations influences the interpretation of results. Here, we investigate the influence of fish and nutrients on biotic communities in shallow lakes, using studies at two different scales: (i) within-lake experimental manipulation and (ii) comparative, among-lake relationships. 2. At both scales, fish predation had an overriding influence on macroinvertebrates; fish reduced macroinvertebrate biomass and altered community composition. Prey selection appeared to be size based. Fish influenced zooplankton abundance and light penetration through the water column also, but there was no indication that fish caused increased resuspension of sediment. 3. There were effects of nutrients at both scales, but these effects differed with the scale of the investigation. Nutrients increased phytoplankton and periphyton at the within-lake scale, and were associated with increased periphyton at the among-lake scale. No significant effect of nutrients on macroinvertebrates was observed at the within-lake scale. However, at the among-lake scale, nutrients positively influenced the biomass and density of macroinvertebrates, and ameliorated the effect of fish on macroinvertebrates. 4. Increased prey availability at higher nutrient concentrations would be expected to cause changes in the fish community. However, at the among-lake scale, differences were not apparent in fish biomass among lakes with different nutrient conditions, suggesting that stochastic events influence the fish community in these small and relatively isolated shallow lakes. 5. The intensity of predation by fish significantly influences macroinvertebrate community structure of shallow lakes, but nutrients also play a role. The scale of investigation influences the ability to detect the influence of nutrients on the different components of shallow lake communities, particularly for longer lived organisms such as macroinvertebrates, where the response takes longer to manifest. [source] Estimating baking temperatures in a Roman pottery kiln by rock magnetic properties: implications of thermochemical alteration on archaeointensity determinationsGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 2 2006Simo Spassov SUMMARY Absolute past geomagnetic field intensity determinations requiring laboratory heating are labourious and the success rate is rather low, mostly because of induced thermochemical magnetic mineral alterations. Archaeomagnetic intensity determinations are mainly limited to displaced ceramics produced in kilns. In this study, the suitability of an in situ baked structure is investigated. Different magnetic properties of baked material taken from the combustion chamber wall and floor of a Roman pottery kiln, with variable colouring, are examined in dependence on the distance to the combustion chamber. The temperature distribution is re-constructed based on rock magnetic experiments after stepwise heating. The rock magnetic temperature estimates agree fairly well with a mathematical heat conduction model demonstrating the penetration of heat into the combustion chamber wall. The rock magnetic results show that blackish- and greyish-coloured kiln parts, that had been in close contact with the fuel, during ancient kiln operation, are not suitable for intensity determinations. Although sufficiently baked, they strongly alter during laboratory heating and new remanence-carrying minerals are formed. The brownish-coloured material at a distance 65,80 mm away from the combustion chamber seems to be most suitable as its magnetic properties remain nearly unchanged during laboratory heating. Rock magnetic and modelled temperature estimates for this material consistently indicate ancient baking temperatures of about 600°C. The model demonstrates that cooling takes longer in the inner parts of the combustion chamber wall. Retarded cooling affects the blocking temperatures and hence the strength of the thermoremanent magnetization. The variability of cooling rates should be taken into account when investigating archaeointensities of specimens cut from large samples, or of samples taken from different parts of a kiln. [source] Prey size and ingestion rate in raptors: importance for sex roles and reversed sexual size dimorphismJOURNAL OF AVIAN BIOLOGY, Issue 6 2007Tore Slagsvold Compared to other birds, most raptors take large prey for their size, and feeding bouts are extended. However, ingestion rate has largely been overlooked as a constraint in raptors, foraging and breeding ecology. We measured ingestion rate by offering avian and mammalian prey to eighteen wild raptors temporarily kept in captivity, representing seven species and three orders. Ingestion rate was higher for small than for large prey, higher for mammalian than for avian prey, higher for large than for small raptors, and higher for wide-gaped than for narrow-gaped raptors. Mammalian prey were ingested faster by raptors belonging to species with mainly mammals in their diet than by raptors with mainly birds in their diet, but the drop in ingestion rate with increasing prey size was more rapid for the former than for the latter. We argue that the separate sex roles found in raptors, i.e. the male hunting and the female feeding the young, is a solution of the conflict between the prolonged feeding bouts at the nest, and the benefit of rapid resumption of hunting in general, and rapid return to the previous capture site in particular (the prey size hypothesis). Thus, the sex roles differ more when prey takes longer to feed, i.e. from insects to mammals to birds. We then argue that the reversed sexual size dimorphism in raptors, i.e. smaller males than females, results from a conflict between the benefit of being small during breeding to capture the smallest items with the highest ingestion rate among these agile prey types (mammals and bird), and the benefit of being large outside the breeding season to ensure survival by being able to include large items in the diet when small items are scarce (the ingestion rate hypothesis). This hypothesis explains the observed variation in reversed sexual size dimorphism among raptors in relation to size and type of prey, i.e. increasing RSD from insects to mammals to birds as prey. [source] The effect of choice complexity on perception of time spent choosing: When choice takes longer but feels shorterPSYCHOLOGY & MARKETING, Issue 3 2009Barbara Fasolo Two studies examine the effect of the complexity of the choice environment on the perceived duration of the time spent choosing. The experiments demonstrate that the estimation of the time spent making a decision is affected by the number of options available in the choice set. In Experiment 1, participants having to choose 1 of 24 mobile phones tended to underestimate the time spent whereas participants confronted with the choice of 6 mobile phones tended to overestimate the actual time spent. Experiment 2 corroborates this finding, in the presence of varying degrees of attribute correlation. We conclude with theoretical and practical implications for marketers. © 2009 Wiley Periodicals, Inc. [source] When vying reveals lying: the timed antagonistic response alethiometerAPPLIED COGNITIVE PSYCHOLOGY, Issue 5 2007Aiden P. Gregg Two experiments tested a new computer-based lie-detection technique. The Timed Antagonistic Response Alethiometer (TARA) manufacturers a situation in which, if respondents lie, they must perform two incompatible tasks, whereas if they tell the truth, they can perform two compatible ones. Both tasks involve repeatedly classifying target and control statements as true or false. The incompatible task combination, being more difficult, takes longer to complete correctly; hence, slower responses diagnose dishonesty. Experiment 1 found that, while concurrently classifying control statements honestly, participants invariably took longer to classify target statements dishonestly than honestly. Exploiting this effect, Experiment 2 found that separate groups of liars and truth-tellers could be distinguished with about 85% accuracy. The properties and potential of the technique are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Performance and functional outcome of endoscopic extraperitoneal radical prostatectomy in relation to obesity: an assessment of 500 patientsBJU INTERNATIONAL, Issue 6 2008Evangelos Liatsikos OBJECTIVE To investigate the impact of obesity on the performance and functional outcome of endoscopic extraperitoneal radical prostatectomy (EERPE). PATIENTS AND METHODS We retrospectively examined 500 patients treated with EERPE; they were categorized into three groups according to the World Health Organization classification of obesity: normal weight (body mass index, BMI, <25.0 kg/m2), overweight (25.0,29.9 kg/m2) and obese (30.0 kg/m2). The database of our institution was reviewed and perioperative data evaluated. The functional data were collected through questionnaires before and after EERPE and analysed statistically. RESULTS The age, prostate size and preoperative PSA level were similar in all three groups. The mean (sd) BMI was 27 (3.3) kg/m2, with 26.8%, 56.6% and 16.6% of the patients classed as normal, overweight and obese, respectively. A pelvic lymph node dissection and nerve-sparing was done in 218 and 123 patients, respectively. There was no statistically significance difference in the number of patients in each group who had previous procedures. Obese patients had a significantly higher American Society of Anesthesiologists score. The mean operative duration for all patients was 149 min; there was a statistically significant difference in duration among the three groups, with EERPE or nerve-sparing EERPE requiring a mean of 20 min more in obese patients. There was no conversion to open surgery. The estimated mean blood loss was 200 mL; four patients, none of them in the obese group, received a blood transfusion. At 3 months after EERPE there was a trend to worse continence in obese patients, but it was not statistically significant, and was not apparent at 6 months. There was no difference in transfusion rate and duration of catheterization. CONCLUSION EERPE seems to be a feasible and reproducible surgical technique in obese patients, although the operation takes longer. [source] Comparison of static automated perimetry and semi-automated kinetic perimetry in patients with bilateral visible optic nerve head drusenACTA OPHTHALMOLOGICA, Issue 7 2009Katarzyna Nowomiejska Abstract. Purpose:, Until now there has been no standardized, systemic approach to diagnostics in patients with optic nerve head drusen (ONHD). This study compares visual field (VF) results obtained with static automated perimetry (SAP) and semi-automated kinetic perimetry (SKP) in patients with bilateral visible ONHD. Methods:, Visual fields in 26 eyes (13 patients) with ONHD were obtained by Humphrey Field Analyser II (SAP) and Octopus 101 (SKP) equipment and classified by three masked observers. Pairs of VFs were considered equivalent if the descriptions given by both methods matched. Individual reaction time (RT) was assessed during SKP. Fifteen healthy volunteers were examined as control material. Results:, Visual field pairs matched in 19 eyes (three normal VFs, 16 arcuate defects). In the remaining eight eyes SKP provided more information in concentric constriction of the VF (two eyes) and SAP provided more information on paracentral scotomas (five eyes). Sensitivity was 69% for SKP, 80% for SAP and 88% for both methods together. Mean RT assessed using SKP amounted to 909 ms in eyes with ONHD and 568 ms in normal subjects (p < 0.0003). The median examination duration was 13 mins with SKP and 11 mins with SAP (p = 0.05) in eyes with ONHD, and 8 mins in control eyes (p < 0.0001). Conclusions:, In clinical practice it is necessary to perform both SAP and SKP in patients with ONHD because the VF defects are diverse. In SKP, RT is prolonged in eyes with ONHD compared with normal eyes and SKP takes longer than SAP in ONHD eyes. [source] | |||||||||||||