A pathway to empowerment: evaluating a cancer education and support programme in New Zealand

Support programmes often benefit cancer patients and their families. This study evaluates how the Living Well Cancer Education Programme (LWCEP), from the Cancer Society of New Zealand, meets the needs of its clients. A purposeful sample of 21 participants representing the normal range of demographic characteristics (age, gender, diagnosis and geographical location) for the programme, participated in semi‐structured interviews. Demographic data were subjected to a frequency analysis. Main data were collected and analysed using a constructivist grounded theory approach regarding the experiences of the participants with being on the programme and recommendations for future development. Of the 21 participants, 14 were cancer patients (eight women and six men) and seven were support people (five women and two men). The LWCEP was described as a safe, supportive and stimulating environment, provided a powerful sense of belonging, empowered participants to gain perspective, enhance their confidence and communication skills and make increasingly informed choices. Consistent with a previous evaluation focussing on the facilitators of the LWCEP, there was a strong desire for better promotion of the programme to the wider community, establishment of a better referral pathway and the potential to offer two separate programmes depending on the stage of a patient's journey.     

Treatment duration of obsessive compulsive disorder

The first breakthrough in the treatment of obsessive-compulsive disorder (OCD) came in 1967, when Fernandez and Lopez-Ibor reported on the efficacy of clomipramine (CMI) in the treatment of 16 patients with OCD (Fernandez and Lopez-Ibor, 1967). However, controlled studies with CMI were not published until 1980 (Montgomery, 1980; Thoren et al, 1980), and only in the last 5 years have large well-controlled studies been published (Clomipramine Collaborative Study, 1991). Several studies demonstrated that among the tricyclics (TCA), only CMI is effective in OCD, while effective antidepressants with a noradrenergic profile, such as desipramine (DMI), appear to be totally ineffective (Zohar and Insel, 1987; Goodman et al, 1990; Leonard et al, 1989). This selective response to TCA with a serotonergic profile led to the formulation of the serotonergic hypothesis of OCD and to the development and use of other serotonergic agents in the treatment of this disorder. Several drugs, possessing a serotonergic profile are currently being studied worldwide, among them CMI, fluoxetine, fluvoxamine, sertraline, paroxetine and citalopram. Currently, as the knowledge regarding the pharmacological approach to OCD is only beginning to accumulate, very little is known regarding treatment duration in OCD. In this review we shall attempt to examine the existing data regarding treatment duration in OCD.     

雷公藤三萜酸C的分离与结构鉴定

雷公藤总甙系雷公藤(Tripterygium wilfordii Hook.f)去皮根心经提取后得到的有效组分,它具有很强的抗炎免疫抑制作用。作者从雷公藤总甙中分离出5个三萜类化合物T_1,T_2,T_3,T_6,T_(28)。本文报道T_(28)化合物的分子结构,其他待另文发表。T_(28)是一个新的乌     

Efficacy of occupational therapy and serial casting in lower limbs of cerebral palsy children administered with phenol nerve block

To see the efficacy of occupational therapy and serial casting over occupational therapy alone in case of sciatic nerve block in cerebral palsy children.In the study 18 spastic cerebral palsy children were treated with in-traneural phenol block (open technique) followed by occupational therapy to bring out functional change. All the 18 patients were administered with intraneural phenol block. In 9 patients serial casting combined with occupational therapy (experimental group) was given while in another group 9 patients were treated with occupational therapy alone (control group). The treatment session for each patient lasted for 6 weeks. To measure the outcome GMFM 66, pediatric balance test (PBT), active range of motion, passive range of motion, modified Ashworth scale were used as tool.There was significant reduction in spasticity of all the 18 patients (after administration of intraneural phenol nerve block) when compared with their pre-operative status. There was significant improvement of gross motor function (GMFM 66), active and dynamic balance (through PBT), and active range of movement of knee joint in experimental group. There was no significant difference between the groups in passive range of motion and reduction of spasticity.The study concludes that intraneural phenol block reduces spasticity in cerebral palsy children to a significant level thus improving the functional outcome in these children. Serial casting when combined with occupational therapy after phenol block gives much better and quicker improvement in gross motor function and motor milestone development.     

Clinical Outcomes for Saudi and Egyptian Patients Receiving Deceased Donor Liver Transplantation in China

Long waiting list times in liver transplant programs in Saudi Arabia and unavailability of deceased donor transplantation in Egypt have led several patients to seek transplantation in China. All patients who received transplants in China and followed in three centers from January 2003–January 2007 were included. All patients’ charts were reviewed. Mortality and morbidity were compared to those transplanted in King Faisal Specialist Hospital & Research Centre (KFSH&RC) during the same period. Seventy‐four adult patients were included (46 Saudi nationals; 28 Egyptians). One‐year and 3‐year cumulative patient survival rates were 83% and 62%, respectively compared to 92% and 84% in KFSH&RC. One‐year and 3‐year cumulative graft survival rates were 81% and 59%, respectively compared to 90% and 84% in KFSH&RC. Compared to KFSH&RC, the incidence of complications was significantly higher especially biliary complications, sepsis, metastasis and acquired HBV infection posttransplant. Requirements of postoperative interventions and hospital admissions were also significantly greater. Our data show high mortality and morbidity rates in Saudi and Egyptian patients receiving transplants in China. This could be related to more liberal selection criteria, use of donation after cardiac death (DCD) donors or possibly more limited posttransplant care.