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Roland K.B.,Centers for Disease Control and Prevention | Rodriguez J.L.,Centers for Disease Control and Prevention | Patterson J.R.,Scimetrika | Trivers K.F.,Centers for Disease Control and Prevention
Psycho-Oncology | Year: 2013

Objective: To identify and comprehensively present the psychosocial needs of ovarian cancer (OvCa) survivors, including young survivors <45 years of age. Methods: A literature review was conducted using keywords specific to psychosocial health and OvCa survivorship to identify peer-reviewed, original research articles published in English between January 2000 and December 2010; 28 articles were identified as relevant. Articles were abstracted and results categorized according to six psychosocial domains: quality of life (QoL), social support and relationships, self-image and sexual functioning, psychological distress and functioning, fear of death/recurrence, and personal growth and coping. Findings unique to young survivors are presented when applicable. Psychosocial measurement tools used in relevant studies are also presented. Results: Physical complications and side effec ts have significant impact on OvCa survivors' psychosocial health. Access to social support services and relational support is critical, as feelings of isolation are common. Survivors report low levels of sexual activity and satisfaction, potentially causing strain on personal relationships, and survivors experience high levels of distress, depression, and anxiety. However, QoL can improve after diagnosis for some OvCa survivors, many of whom report spiritual growth and strengthened personal relationships. Younger survivors are likely to have greater distress and lower QoL compared with older survivors. Conclusions: OvCa is the deadliest of all gynecologic cancers, greatly impacting the psychosocial health of survivors. Increased awareness of psychosocial health among OvCa survivors themselves, their social support system, and their health care providers is necessary to adequately address their unique needs. Copyright © 2013 John Wiley & Sons, Ltd.

Bartlett C.,University of North Carolina at Chapel Hill | Bartlett C.,Scimetrika | Orvis T.J.,University of North Carolina at Chapel Hill | Rosson G.S.,University of North Carolina at Chapel Hill | Weissman B.E.,University of North Carolina at Chapel Hill
Journal of Cellular Physiology | Year: 2011

Eukaryotic organisms package DNA into chromatin for compact storage in the cell nucleus. However, this process promotes transcriptional repression of genes. To overcome the transcriptional repression, chromatin remodeling complexes have evolved that alter the configuration of chromatin packaging of DNA into nucleosomes by histones. The SWI/SNF chromatin remodeling complex uses energy from ATP hydrolysis to reposition nucleosomes and make DNA accessible to transcription factors. Recent studies showing mutations of BRG1, one of two mutually exclusive ATPase subunits, in human tumor cell lines and primary tissue samples have implicated a role for its loss in cancer development. While most of the mutations lead to complete loss of BRG1 protein expression, others result in single amino acid substitutions. To better understand the role of these BRG1 point mutations in cancer development, we characterized SWI/SNF function in human tumor cell lines with these mutations in the absence of BRM expression, the other ATPase component. We found that the mutant BRG1 proteins still interacted with the core complex members and appeared at the promoters of target genes. However, while these mutations did not affect CD44 and CDH1 expression, known targets of the SWI/SNF complex, they did abrogate Rb-mediated cell-cycle arrest. Therefore, our results implicate that these mutations disrupt the de novo chromatin remodeling activity of the complex without affecting the status of existing nucleosome positioning. © 2010 Wiley-Liss, Inc..

Trivers K.F.,Centers for Disease Control and Prevention | Patterson J.R.,Scimetrika | Roland K.B.,Centers for Disease Control and Prevention | Rodriguez J.L.,Centers for Disease Control and Prevention
Supportive Care in Cancer | Year: 2013

Purpose: As the number of ovarian cancer survivors increases, so does the need for appropriate intervention and care. A literature review was conducted to assess the issues affecting ovarian cancer survivors in the USA, including the needs of younger survivors. Methods: Articles on six topics (finances/ employment, reproductive and sexual health, treatment effects, information needs, genomics, and end-of-life/palliative care) among ovarian cancer survivors were identified through comprehensive database searches. Abstracts for all citations were reviewed to determine relevancy. Data from relevant articles, defined as including a sample size of ≥20, published in English, involving human subjects in the USA, and published between 2000 and 2010, were abstracted. Results: Thirty-four articles were relevant. Common, but often unaddressed, treatment side effects included infertility and issues with sexual health. Survivors reported not receiving adequate information about their disease. Hereditary cancer can lead to concern for family members. End-of-life/palliative care was often not addressed by physicians. Most of the studies used a cross-sectional design and lacked control groups. Participants were primarily recruited from academic medical centers or clinical trials and tended to be White. Few studies specifically addressed young survivors; however, reproductive health issues are common. Conclusions: Ovarian cancer has wide-ranging impacts. This review emphasizes the need for more research among ovarian cancer survivors, particularly related to finances, reproductive and sexual health, information, genomics, and end-of-life care. Issues specific to young survivors also deserve more attention. Direction for future research and clinical implications are discussed. © 2013 Springer-Verlag Berlin Heidelberg (outside the USA).

Weaver L.K.,University of Utah | Cooney D.,Scimetrika
Respiratory Care | Year: 2013

BACKGROUND: Symptoms of carbon monoxide (CO) poisoning are non-specific. Diagnosis requires suspicion of exposure, confirmed by measuring ambient CO levels or carboxyhemoglobin (COHb). An FDA-approved pulse oximeter (Rad-57) can measure CO saturation (SpCO). The device accuracy has implications for clinical decision-making. METHODS: From April 1 to August 15, 2008, study personnel measured SpCO and documented demographic factors at time of clinical blood draw, in a convenience sample of 1,363 subjects presenting to the emergency department at Intermountain Medical Center, Murray, Utah. The technician then assayed COHb. COHb and SpCO values were compared by subject; false positive or negative values were defined as SpCO at least 3 percentage points greater or less than COHb level, reported by the manufacturer to be ± 1 SD in performance. RESULTS: In 1,363 subjects, 613 (45%) were male, 1,141 (84%) were lightskinned, 14 in shock, 4 with CO poisoning, and 122 (9%) met the criteria for a false positive value (range 3-19 percentage points), while 247 (18%) met the criteria for a false negative value (-13 to -3 percentage points). Risks for a false positive SpCO reading included being female and having a lower perfusion index. Methemoglobin, body temperature, and blood pressure also appear to influence the SpCO accuracy. There was variability among monitors, possibly related to technician technique, as rotation of monitors among technicians was not enforced. CONCLUSIONS: While the Rad-57 pulse oximeter functioned within the manufacturer's specifications, clinicians using the Rad-57 should expect some SpCO readings to be significantly higher or lower than COHb measurements, and should not use SpCO to direct triage or patient management. An elevated SpCO could broaden the diagnosis of CO poisoning in patients with non-specific symptoms. However, a negative SpCO level in patients suspected of having CO poisoning should never rule out CO poisoning, and should always be confirmed by COHb. © 2013 Daedalus Enterprises.

Jack Jr. L.,National Center for Chronic Disease and Health Promotion | Liburd L.C.,Minority | Tucker P.,National Center for Chronic Disease and Health Promotion | Cockrell T.,Scimetrika
Clinical Therapeutics | Year: 2014

Using an illness narratives framework, we provide 1 method that health care providers can use to obtain insight into the perceptions and experiences of their patients living with diabetes. We propose that understanding patients' cultural perspectives help explains their health behavior and can lead to more productive partnering between provider, patient, and community health resources that support adherence and improved health outcomes. We conclude with resources available to assist health care providers in their efforts to deliver culturally appropriate diabetes care and examples of culturally tailored community-based public health initiatives that have been effective in improving diabetes outcomes among African-American patients. © 2014 The Authors.

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