Women's perceptions of their involvement in treatment decision making for early stage breast cancer.

Purpose: This study aimed to describe the perceptions of women with early stage breast cancer regarding their involvement in treatment decision making (TDM).

Methods: Eligible women with early stage breast cancer were recruited immediately after their first consultation with a specialist. Semistructured personal interviews were held prior to treatment.

Providing information about options in patient decision aids.

Background: Legal, ethical, and psychological arguments indicate that patients need to receive information about their health situations before their care decisions are made. Patient decision aids (PtDAs) are designed to help patients make decisions; therefore, they should provide information that results in patients understanding their health situation. We reviewed studies that assessed the impact of PtDAs on patient knowledge and on their feeling of being uninformed.

Systemic therapy of advanced non-small cell lung cancer: major-developments of the last 5-years.

The standard palliative treatment for advanced stage NSCLC remains a platinum doublet but by tailoring chemotherapy according to tumour histology the results can be improved through using pemetrexed-containing schemas in non-squamous-cell disease. In addition, maintenance chemotherapy appears to be effective in patients achieving clinical benefit by induction therapy. Targeted therapy based on the presence of activating epidermal growth factor receptor (EGFR) activating mutations or EML4-ALK gene rearrangement is becoming standard practice with high median survival rates, up to 30 months.

Adapting to climate change on Western public lands: addressing the ecological effects of domestic, wild, and feral ungulates.

Climate change affects public land ecosystems and services throughout the American West and these effects are projected to intensify. Even if greenhouse gas emissions are reduced, adaptation strategies for public lands are needed to reduce anthropogenic stressors of terrestrial and aquatic ecosystems and to help native species and ecosystems survive in an altered environment. Historical and contemporary livestock production-the most widespread and long-running commercial use of public lands-can alter vegetation, soils, hydrology, and wildlife species composition and abundances in ways that exacerbate the effects of climate change on these resources.

Building a community-academic partnership: implementing a community-based trial of telephone cognitive behavioral therapy for rural latinos.

Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking) primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington.

Impact of a randomized campus/community trial to prevent high-risk drinking among college students.

Background: High-risk drinking by college students continues to pose a significant threat to public health. Despite increasing evidence of the contribution of community-level and campus-level environmental factors to high-risk drinking, there have been few rigorous tests of interventions that focus on changing these interlinked environments. The Study to Prevent Alcohol Related Consequences (SPARC) assessed the efficacy of a comprehensive intervention using a community organizing approach to implement environmental strategies in and around college campuses.

High prevalence of osteoblastic bone reaction in computed tomography scans of an European Organisation for Research and Treatment of Cancer prospective randomised phase II trial in extensive stage small cell lung cancer.

Background: Osteoblastic bone reaction is an important phenomenon defined by an increase in apparent bone density of previously known bone metastasis or development of new osteoblastic lesions in the presence of response in other tumour sites. Osteoblastic bone reaction in lung cancer has only been described in a few reports and mostly in patients with pre-existing bone metastasis.

Methods: In this report we present the data of an independent, blinded and preplanned radiological review of the occurrence of osteoblastic lesions in patients with extensive stage small cell lung cancer (SCLC).

Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma.

Background: There is currently no early predictive marker of survival for patients receiving chemotherapy for malignant pleural mesothelioma (MPM). Tumour response may be predictive for overall survival (OS), though this has not been explored. We have thus undertaken a combined-analysis of OS, from a 42day landmark, of 526 patients receiving systemic therapy for MPM.

Audit and feedback: effects on professional practice and healthcare outcomes.

Background: Audit and feedback is widely used as a strategy to improve professional practice either on its own or as a component of multifaceted quality improvement interventions. This is based on the belief that healthcare professionals are prompted to modify their practice when given performance feedback showing that their clinical practice is inconsistent with a desirable target. Despite its prevalence as a quality improvement strategy, there remains uncertainty regarding both the effectiveness of audit and feedback in improving healthcare practice and the characteristics of audit and feedback that lead to greater impact.

Alcohol-related injury among Greek-letter college students: defining a target population for secondary prevention.

Members of Greek-letter societies are the heaviest drinkers on college campuses, and experience more alcohol-related problems than their peers. This study reports the results of a web-based survey administered to stratified random samples of college students from 10 North Carolina universities. Greek-letter status was a significant independent risk factor for increased injury (both experienced and caused to others), even after adjusting for drinking behaviors.

The use of prescription medications obtained from non-medical sources among immigrant Latinos in the rural southeastern U.S.

We explored the relationships between behavioral, socio-cultural, and psychological characteristics and the use of prescription medications obtained from non-medical sources among predominantly Spanish-speaking Latinos in the rural southeastern U.S. Respondent-driven sampling (RDS) was used to identify, recruit, and enroll immigrant Latinos to participate in an interviewer-administered assessment.

How do lung cancer specialists follow their patients with stage III non-small cell lung cancer (NSCLC) after definitive treatment? A short report.

Although pretreatment evaluations are well defined for the diagnosis of radically treatable NSCLC, we have very little data about the follow-up of these patients after completion of therapy, especially for stage III patients. No documented standards for surveillance were set in the NCCN, ACCP or ESMO guidelines. In order to determine the standard practice patterns of lung specialists, a survey was done.

Tobacco use by college students: a comparison of daily and nondaily smokers.

Objectives: To explore demographics, contextual factors, and health risk behaviors associated with nondaily smoking by college students.

Methods: In fall 2005, a random sample of 4100 students completed an online survey.

Results: Of those surveyed, 29% reported current smoking; of that 29%, 70% were nondaily smokers.

Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

Background: Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events.

A randomized trial of family focused treatment for adolescents and young adults at risk for psychosis: study rationale, design and methods.

Aim: This article outlines the rationale for a family-focused psychoeducational intervention for individuals at risk for psychosis and explains the design of a randomized multisite trial to test its efficacy.

Methods: Adolescents and young adults that meet criteria for a psychosis risk syndrome at eight participating North American Prodromal Longitudinal Study sites are randomly assigned to a 6-month, 18-session family-focused treatment for prodromal youth or a 3-session psychoeducational enhanced care control intervention and followed over 1 year.

Results: The results will determine whether the use of a family intervention is able to significantly improve functional outcomes, decrease the severity of positive symptoms and possibly prevent the onset of full psychosis, compared with enhanced care alone.

Screening and brief intervention for tobacco use by student health providers on college campuses.

Objective: This study assessed college students' reports of tobacco screening and brief intervention by student health center providers.

Participants: Participants were 3,800 students from 8 universities in North Carolina.

Methods: Web-based survey of a stratified random sample of undergraduates.

The need for support services for family carers of people with motor neurone disease (MND): views of current and former family caregivers a qualitative study.

Purpose: Family carers provide the majority of home-based care for people with motor neurone disease (MND). Carers' need for, and use of, support services are not fully understood; this study aimed to explore, from a qualitative perspective, the views of current and former family carers of people with MND.

Methods: A qualitative study was undertaken in Northwest England, using narrative interviews with current (18) and former (10) carers of a family member with MND.

Establishing an EGFR mutation screening service for non-small cell lung cancer - sample quality criteria and candidate histological predictors.

Introduction: EGFR screening requires good quality tissue, sensitivity and turn-around time (TAT). We report our experience of routine screening, describing sample type, TAT, specimen quality (cellularity and DNA yield), histopathological description, mutation result and clinical outcome.

Methods: Non-small cell lung cancer (NSCLC) sections were screened for EGFR mutations (M+) in exons 18-21.

Physician-related facilitators and barriers to patient involvement in treatment decision making in early stage breast cancer: perspectives of physicians and patients.

Objective: To identify patients' and physicians' perceptions of physician-related verbal and nonverbal facilitators and barriers to patient involvement in treatment decision making (TDM) occurring during clinical encounters for women with early stage breast cancer (ESBC).

Methods: Eligible women were offered treatment options including surgery and adjuvant therapy. Eligible physicians provided care for women with ESBC in either a teaching hospital or an academic cancer centre.

Alcohol and Caffeine: The Perfect Storm.

Although it is widely believed that caffeine antagonizes the intoxicating effects of alcohol, the molecular mechanisms underlying their interaction are incompletely understood. It is known that both caffeine and alcohol alter adenosine neurotransmission, but the relationship is complex, and may be dose dependent. In this article, we review the available literature on combining caffeine and alcohol.

Unsolicited written narratives as a methodological genre in terminal illness: challenges and limitations.

Stories about illness have proven invaluable in helping health professionals understand illness experiences. Such narratives have traditionally been solicited by researchers through interviews and the collection of personal writings, including diaries. These approaches are, however, researcher driven; the impetus for the creation of the story comes from the researcher and not the narrator.

The interaction between prosody and meaning in second language speech production.

Research has shown that English and German native speakers use prosodic cues during speech production to convey the intended meaning of an utterance. However, little is known about whether American L2 learners of German also use such cues during L2 production. The present study shows that intermediate-level L2 learners of German (English L1) use prosodic cues to disambiguate syntactically ambiguous German sentences during a contextualized sentence production task.

Local opinion leaders: effects on professional practice and health care outcomes.

Background: Clinical practice is not always evidence-based and, therefore, may not optimise patient outcomes. Opinion leaders disseminating and implementing 'best evidence' is one method that holds promise as a strategy to bridge evidence-practice gaps.

Objectives: To assess the effectiveness of the use of local opinion leaders in improving professional practice and patient outcomes.

Telephone-based cognitive-behavioral therapy for Latino patients living in rural areas: a randomized pilot study.

Objective: This pilot study tested the effectiveness of culturally tailored, telephone-based cognitive-behavioral therapy (CBT) for improving depression outcomes among Latino primary care patients living in rural settings.

Methods: A total of 101 Latino patients at a rural family medical center who met criteria for probable major depression were randomly assigned to enhanced usual care or eight sessions of CBT delivered by phone by trained bilingual therapists from the community. Blinded study assistants assessed depression symptom severity, using the Hopkins Symptom Checklist (SCL) depression items and the Patient Health Questionnaire-9, and patient satisfaction after six weeks, three months, and six months.