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961.
Callaway M Foley KM De Lima L Connor SR Dix O Lynch T Wright M Clark D 《Journal of pain and symptom management》2007,33(5):509-513
There are many palliative care developments in resource-poor regions of the world. Most of them are supported by third-party donors and grant makers. The funding necessary to cover essential palliative care services usually exceeds the financial means of many developing countries. Health care services may have to be complemented by nongovernmental organizations that are dependent on fund raising and voluntary donations from a variety of external sources. Coordinated action by international funding agencies is needed to ensure that the world's poorest people have access to essential medications and appropriate palliative care. To this end, international networking in the palliative care field is vital. There are now a number of collaborative networks that make a significant contribution to the development and sustainability of hospice and palliative care across many resource-poor regions of the world. 相似文献
962.
A PCR-based assay was established to screen for potential changes in the heterogeneity of Vbeta TCR expressing CD4+ T cells from rhesus macaques (RM) and sooty mangabeys (SM) prior to and following SIV infection. The rationale for these studies was to determine whether the progressive CD4+ T cell loss in SIV-infected disease susceptible RM and the moderate CD4+ T cell loss in disease resistant SM leads to the depletion of select Vbeta TCR families of CD4+ T cells. Results show that whereas SIV infection leads to the loss of Vbeta TCR heterogeneity in disease susceptible RM, the CD4+ T cells from SM retain their degree of Vbeta TCR heterogeneity, suggesting that the mechanism(s) of SIV induced CD4+ T cell loss maybe distinct in these 2 species and contribute to the differences in the clinical outcome. 相似文献
963.
Baltrus PT Everson-Rose SA Lynch JW Raghunathan TE Kaplan GA 《Annals of epidemiology》2007,17(8):608-614
PURPOSE: Socioeconomic position (SEP) has been shown to be related to obesity and weight gain, especially among women. It is unclear how different measures of socioeconomic position may impact weight gain over long periods of time, and whether the effect of different measures vary by gender and age group. We examined the effect of childhood socioeconomic position, education, occupation, and log household income on a measure of weight gain using individual growth mixed regression models and Alameda County Study data collected over thirty four years(1965-1999). METHODS: Analyses were performed in four groups stratified by gender and age at baseline: women, 17-30 years (n = 945) and 31-40 years (n = 712); men, 17-30 years (n = 766) and 31-40 years (n = 608). RESULTS: Low childhood SEP was associated with increased weight gain among women 17-30 (0.13 kg/year, p < 0.001). Low educational status was associated with increased weight gain among women 17-30 (0.14 kg/year, p = 0.030), 31-40 (0.14 kg/year, p = 0.014), and men 17-30 (0.20 kg/year, p = 0.001). CONCLUSION: Log household income was inversely associated with weight gain among men 31-40 (-0.10 kg/yr, p = 0.16). Long-term weight gain in adulthood is associated with childhood SEP and education in women and education and income in men. 相似文献
964.
Moore GF Tapper K Murphy S Clark R Lynch R Moore L 《European journal of clinical nutrition》2007,61(3):420-430
OBJECTIVE: To evaluate the validity and reliability of a dietary recall questionnaire, designed for group-level comparisons of foods eaten at breakfast and intake of fruits, vegetables, sweet items and crisps. DESIGN: Validity was assessed relative to 24-h dietary recall interviews, and reliability by comparing the baseline data with 4-month follow-up data. SUBJECTS AND SETTING: Fifty-eight schools took part in the validity assessments, with 374 children completing both measures. Reliability was assessed using 29 schools, with 1233 children at baseline and 1033 at follow-up. Children were aged 9-11 years and schools were located in socio-economically deprived areas of Wales. RESULTS: Results indicated moderate to substantial agreements for most foods eaten at breakfast on the day of reporting and fair to moderate agreements for breakfast foods the previous day. For items throughout the rest of the previous day, agreement was fair to substantial during school hours, but slight after school. Correlations were moderate in terms of 'healthy' items and 'unhealthy' items consumed at breakfast on the day of reporting, but weaker for the previous breakfast. Correlations between measures in terms of fruits, vegetables, sweet items and crisps throughout the rest of the previous day were fair to moderate. The measure demonstrated fair to substantial group-level reliability. CONCLUSIONS: The questionnaire, while subject to a number of limitations, gives an adequately valid and reliable overview of selected aspects of children's diet. It is likely to be of value at group-level in randomized controlled trials of school-based interventions. 相似文献
965.
Stephen D. Smith Paolo Lopedote Yazeed Samara Matthew Mei Alex F. Herrera Allison M. Winter Brian T. Hill Mazyar Shadman Chaitra Ujjani Ryan C. Lynch Caron A. Jacobson Austin I. Kim Paolo Caimi Filippo Milano Ajay K. Gopal 《Clinical Lymphoma, Myeloma & Leukemia》2021,21(3):170-175
IntroductionPolatuzumab vedotin is approved therapy in the United States for relapsed/refractory diffuse large B-cell lymphoma in combination with bendamustine and rituximab (Pola+BR). However, the safety and efficacy of Pola+BR outside of a clinical trial setting is unknown.Patients and MethodsWe analyzed use of pola-based therapy at 5 centers in the United States, including dose, response rates, progression-free survival (PFS), survival, and toxicity.ResultsSixty-nine patients with aggressive B-cell lymphoma, including 66 with diffuse large B-cell lymphoma/high-grade B-cell lymphoma and 84% refractory to prior therapy, were treated. Responses occurred in of 50%, including 24% complete response. Median duration of response was 5.1 months, PFS was 2.0 months, and survival was 5.3 months, at 4 months median follow-up. Inferior PFS was associated with prior refractory disease (median, 57 days vs. not reached; P = .003) and lack of response to Pola+BR (PFS, 27 days vs. 152 days; P < .001). Discontinuation owing to planned cellular therapy was seen in 36% and owing to toxicity occurred in 12%; unplanned hospitalizations occurred in 36%.ConclusionsWe conclude that commercial Pola is applied to highly refractory lymphomas at our centers, often with intent to bridge to subsequent therapy. Although some clinical benefit was observed, efficacy was inferior to clinical trial data, especially among those with refractory disease. 相似文献
966.
Lynch E Liu K Spring B Hankinson A Wei GS Greenland P 《American journal of epidemiology》2007,165(9):1055-1062
The authors assessed the associations of ethnicity and socioeconomic status (SES) with body size judgments in Black and White young adults. Self-perceived and ideal body size judgments were measured using the Stunkard nine-figure scale (higher value = larger body) at the year 7 examination (1992-1993) of the Coronary Artery Risk Development in Young Adults (CARDIA) Study. In sex-specific adjusted multiple regression models, the difference between self-perceived and ideal body size judgments was larger for Whites than for Blacks: 0.74 vs. 0.57 for White men vs. Black men (p < 0.05) and 1.48 vs. 0.96 for White women vs. Black women (p < 0.0001). This ethnic difference was evident in all body mass index-stratified adjusted models (all p's < 0.05). In ethnicity/sex-specific adjusted models, lower education was associated with a smaller difference between self-perceived and ideal body size for all groups except White women (p's for trend: White women, 0.57; Black women, <0.0001; White men, 0.0007; Black men, 0.016). Judgments of self-perceived body size differed by ethnicity but not by SES, and judgments of ideal body size differed by SES but not by ethnicity. Learning to make medically accurate judgments of healthy body size may increase the motivation to lose weight in some persons. 相似文献
967.
Lubin JH Alavanja MC Caporaso N Brown LM Brownson RC Field RW Garcia-Closas M Hartge P Hauptmann M Hayes RB Kleinerman R Kogevinas M Krewski D Langholz B Létourneau EG Lynch CF Malats N Sandler DP Schaffrath-Rosario A Schoenberg JB Silverman DT Wang Z Wichmann HE Wilcox HB Zielinski JM 《American journal of epidemiology》2007,166(4):479-489
A recent analysis showed that the excess odds ratio (EOR) for lung cancer due to smoking can be modeled by a function which is linear in total pack-years and exponential in the logarithm of smoking intensity and its square. Below 15-20 cigarettes per day, the EOR/pack-year increased with intensity (direct exposure rate or enhanced potency effect), suggesting greater risk for a total exposure delivered at higher intensity (for a shorter duration) than for an equivalent exposure delivered at lower intensity. Above 20 cigarettes per day, the EOR/pack-year decreased with increasing intensity (inverse exposure rate or reduced potency effect), suggesting greater risk for a total exposure delivered at lower intensity (for a longer duration) than for an equivalent exposure delivered at higher intensity. The authors applied this model to data from 10 case-control studies of cancer, including cancers of the lung, bladder, oral cavity, pancreas, and esophagus. At lower intensities, there was enhanced potency for several cancer sites, but narrow ranges for pack-years increased uncertainty, precluding definitive conclusions. At higher intensities, there was a consistent reduced potency effect across studies. The intensity effects were statistically homogeneous, indicating that after accounting for risk from total pack-years, intensity patterns were comparable across the diverse cancer sites. 相似文献
968.
OBJECTIVE: The purpose of this study was to measure state trends in educational inequalities in smoking, binge alcohol use, physical inactivity, obesity, and seatbelt use. METHODS: The authors calculated the Relative Concentration Index of educational inequality for five health behaviors on adults from all 50 states and the District of Columbia using data from 1990 to 2004 in the Behavioral Risk Factor Surveillance System (n=2,118,562). Linear regression was used to measure changes and trends in the Relative Concentration Index of health inequality across education groups in each state. RESULTS: Except for binge alcohol use, poorer health behaviors were concentrated among the less educated. The largest educational inequalities were for physical inactivity. From 1990 to 2004, significant increases in relative educational inequalities occurred in 40 states for smoking and 31 states for physical inactivity. For binge alcohol use, 27 states showed significant declining inequality trends, but educational inequalities reversed direction and binge alcohol use is now more prevalent among the less educated in 19 states. Significant decreases in educational inequalities occurred in 36 states for obesity and 24 states for seat belt use. Changes in educational inequalities across the different health behaviors were not associated, except for a modest correlation between changes in inequality in smoking and binge alcohol use (r=0.40; p=0.004). Similarly, there was little association between changes in the population prevalence of health behaviors and changes in educational inequality in health behaviors, with substantial heterogeneity among states. CONCLUSIONS: State trends in relative educational inequality among health behaviors were mixed, increasing for smoking and physical inactivity and decreasing for obesity and seat belt use. The factors influencing relative inequality trends may differ from those affecting overall prevalence trends. 相似文献
969.
Jacqueline M. Mix PhD MPH Mona Saraiya MD MPH Trevor D. Thompson BS Troy D. Querec PhD April Greek PhD Thomas C. Tucker PhD MPH Edward S. Peters DMD SM ScD Charles F. Lynch MD PhD Brenda Y. Hernandez PhD MPH Glenn Copeland MBA Marc T. Goodman PhD MPH Elizabeth R. Unger MD PhD 《Cancer》2021,127(19):3614-3621
970.
Mina S. Sedrak MD MS Rachel A. Freedman MD MPH Harvey J. Cohen MD Hyman B. Muss MD Aminah Jatoi MD Heidi D. Klepin MD Tanya M. Wildes MD Jennifer G. Le-Rademacher PhD Gretchen G. Kimmick MD William P. Tew MD Kevin George BS Simran Padam MD Jennifer Liu BS Andrew R. Wong BA Andrea Lynch MLIS Benjamin Djulbegovic MD PhD Supriya G. Mohile MD MS William Dale MD PhD the Cancer Aging Research Group 《CA: a cancer journal for clinicians》2021,71(1):78-92
Cancer is a disease of aging and, as the world's population ages, the number of older persons with cancer is increasing and will make up a growing share of the oncology population in virtually every country. Despite this, older patients remain vastly underrepresented in research that sets the standards for cancer treatments. Consequently, most of what we know about cancer therapeutics is based on clinical trials conducted in younger, healthier patients, and effective strategies to improve clinical trial participation of older adults with cancer remain sparse. For this systematic review, the authors evaluated published studies regarding barriers to participation and interventions to improve participation of older adults in cancer trials. The quality of the available evidence was low and, despite a literature describing multifaceted barriers, only one intervention study aimed to increase enrollment of older adults in trials. The findings starkly amplify the paucity of evidence-based, effective strategies to improve participation of this underrepresented population in cancer trials. Within these limitations, the authors provide their opinion on how the current cancer research infrastructure must be modified to accommodate the needs of older patients. Several underused solutions are offered to expand clinical trials to include older adults with cancer. However, as currently constructed, these recommendations alone will not solve the evidence gap in geriatric oncology, and efforts are needed to meet older and frail adults where they are by expanding clinical trials designed specifically for this population and leveraging real-world data. 相似文献