Play and Pets: The Physical and Emotional Impact of Child-Life and Pet Therapy on Hospitalized Children

Child-life therapy programs and pet-therapy programs are often used in pediatric hospital settings to provide emotional support and diversion; however there is little research about their efficacy. How play and pet therapy affect children was examined in this study of 70 hospitalized children. Self-reported mood, displayed affect, amount of touch, heart rate, blood pressure, and salivary cortisol were measured. Children and parents viewed both therapies as mood enhancing experiences for the child. Heart rates, parents' ratings of the child's mood, and display of positive affect were enhanced in the pet-therapy group. Pet therapy likely provides an additional supportive activity for hospitalized children.     

A longitudinal study of the relationships among alcohol use, marijuana/hashish use, cocaine use, and emotional/psychological functioning problems in a cohort of high-risk youths

There is increasing recognition that children involved in the justice system often have serious, multiple problems in the areas of physical abuse, sexual exploitation, and alcohol/other drug use (ADM). Using data collected in a longitudinal study of detained juveniles, we test a model of the relationships of these problems. Significant over-time interrelationships are found among these problems. Research and policy implications of these important findings are drawn.     

Reduced acetylation of procainamide by para-aminobenzoic acid

Acetylation is the major route of metabolism of many drugs including the antiarrhythmic agent procainamide. Coadministration of para-aminobenzoic acid was observed to decrease the biotransformation of procainamide to N-acetylprocainamide in a patient with rapid acetylation kinetics. In view of the distinct antiarrhythmic and toxic properties of procainamide and N-acetylprocainamide, the observed drug interference may have great clinical relevance in long-term oral antiarrhythmic therapy and in instances where other drugs converge for acetylation.     

Suicide Ideation Among College Students: A Multivariate Analysis

The goal of this study was to develop a multi-dimensional model that might explain suicide ideation among college students. Face-to-face interviews were conducted with 1,249 first-year college students. An estimated 6%_wt of first-year students at this university had current suicide ideation. Depressive symptoms, low social support, affective dysregulation, and father-child conflict were each independently associated with suicide ideation. Only 40%_wt of individuals with suicide ideation were classified as depressed according to standard criteria. In the group who reported low levels of depressive symptoms, low social support and affective dysregulation were important predictors of suicide ideation. Alcohol use disorder was also independently associated with suicide ideation, while parental conflict was not. Results highlight potential targets for early intervention among college students.     

Functional outcomes of sleep in Thai patients with obstructive sleep-disordered breathing

Purposes

Quality of life assessment in obstructive sleep-disordered breathing (OSDB) is increasingly recognized, and the functional outcomes of sleep questionnaire (FOSQ) is a popular instrument. The objective of this study was to apply this questionnaire in Thai patients to assess its reliability, validity, and responsiveness properties.

Methods

A total of 223 subjects were recruited. The scores of FOSQ in 38 healthy volunteers and 40 primary snorers were compared with those of 108 obstructive sleep apnea (OSA) patients diagnosed by polysomnography. Seventy-two subjects answered the FOSQ twice at 2?C4?weeks apart to check the test?Cretest reliability, and 37 patients with OSA who complied well with CPAP therapy answered them again after treatment at 3?C6?months. All participants also filled the Epworth sleepiness scales (ESS) to check the concurrent validity.

Results

There were statistically significant differences in all FOSQ subscales including global scores between healthy volunteers (17.3?±?2.1) and OSA patients (14.5?±?2.9) (p?p?r ?0.48); however, these had only a weak relationship with AHI and minimal oxygen saturation.

Conclusions

The FOSQ can be applied to Thai patients with OSDB with good reliability, validity, and responsiveness properties. It may be the first validated version of FOSQ in East Asian countries which is a very useful tool for future research.     

Physical predictors for moderate to severe obstructive sleep apnea in snoring patients

Purpose

This study aimed to identify physical findings that may predict the presence of moderate to severe obstructive sleep apnea (OSA) in snoring patients.

Methods

A total of 283 subjects (165 males and 118 females) were recruited, including 217 OSA patients and 66 patients with apnea–hypopnea index (AHI)?<?5 as a control group, diagnosed by level-1 polysomnography. Baseline data of patients including age, sex, weight, height, body mass index (BMI), neck circumference (NC), waist circumference (WC), neck-to-height ratio (NHtR), and waist-to-height ratio (WHtR) were recorded. Other physical parameters such as chin length (Chin1), thyromental distance, hyomental distance, cricomental distance, cricomental space (CMS), Friedman tongue position (FTP), and tonsils size were recorded by a single investigator who was blinded to the PSG results.

Results

The findings that were statistically different between the control group and moderate to severe OSA (AHI?≥?15) included sex, BMI, NC, NHtR, WC, WHtR, Chin1, CM, and CMS (p?<?0.05). However, logistic regression analysis showed that only male gender and WHtR?≥?0.55 were the independent predictors for AHI?≥?15 with adjusted odds ratios of 6.6 and 3.1, respectively.

Conclusion

Among snoring patients seeking medical consultation, male gender and WHtR of?≥?0.55 were good predictors for moderate to severe OSA. No single head and neck finding reliably predicted this condition. In a situation with limited facilities, these data along with medical history may be helpful for prioritizing patients in order to achieve the optimal use of sleep investigation and treatment.     

The Approval Process for Biosimilar Erythropoiesis-Stimulating Agents

A biosimilar drug or follow-on biologic drug is defined by the Public Health Service Act as a product that is “highly similar to the reference product notwithstanding minor differences in clinically active components and there are no clinically meaningful differences between the biologic product and the reference product in terms of the safety, purity and potency of the product.” The advantage of biosimilar drugs is that they are significantly less expensive than the reference products, allowing for increased accessibility and cost savings. Recognizing these advantages, the US Congress passed the Biologics Price Competition and Innovation Act in 2009 as part of health care reform. The Biologics Price Competition and Innovation Act allows sponsors of biosimilar agents to seek approval by showing structural and functional similarity to the reference agent, with the extent of required clinical studies to be determined on the basis of the degree of biosimilarity with the reference product. The goal is to bring biosimilar agents to the market more efficiently while still protecting the safety of the public. The European Union has had such a process in place for a number of years. Two biosimilar epoetin agents have been approved in the European Union since 2007, and their companies are conducting trials to seek approval in the United States, because Amgen’s patent protection for epoetin alfa expires in 2014. Trials completed for European Union approval of both agents showed similar efficacy and safety to the reference epoetin alfa. As with all biologics, immunogenicity concerns may persist because of the fragility of the manufacturing process and the worldwide experience with pure red cell aplasia as a result of epoetin therapy. The uptake of biosimilar epoetins after approval in the United States will depend on the balance of cost advantage against safety concerns. Competition in the marketplace will likely decrease the cost of the reference agent as well.     

Influence of pre-diagnostic cigarette smoking on colorectal cancer survival: overall and by tumour molecular phenotype

Background:

Smoking is a risk factor for incident colorectal cancer (CRC); however, it is unclear about its influence on survival after CRC diagnosis.

Methods:

A cohort of 706 CRC patients diagnosed from 1999 to 2003 in Newfoundland and Labrador, Canada, was followed for mortality and recurrence until April 2010. Smoking and other relevant data were collected by questionnaire after cancer diagnosis, using a referent period of ‘2 years before diagnosis'' to capture pre-diagnosis information. Molecular analyses of microsatellite instability (MSI) status and BRAF V600E mutation status were performed in tumour tissue using standard techniques. Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with Cox proportional hazards regression, controlling for major prognostic factors.

Results:

Compared with never smokers, all-cause mortality (overall survival, OS) was higher for current (HR: 1.78; 95% CI: 1.04–3.06), but not for former (HR: 1.06; 95% CI: 0.71–1.59) smokers. The associations of cigarette smoking with the study outcomes were higher among patients with ⩾40 pack-years of smoking (OS: HR: 1.72; 95% CI: 1.03–2.85; disease-free survival (DFS: HR: 1.99; 95% CI: 1.25–3.19), those who smoked ⩾30 cigarettes per day (DFS: HR: 1.80; 95% CI: 1.22–2.67), and those with microsatellite stable (MSS) or MSI-low tumours (OS: HR: 1.38; 95% CI: 1.04–1.82 and DFS: HR: 1.32; 95% CI: 1.01–1.72). Potential heterogeneity was noted for sex (DFS HR: 1.68 for men and 1.01 for women: P for heterogeneity=0.04), and age at diagnosis (OS: HR: 1.11 for patients aged <60 and 1.69 for patients aged ⩾60: P for heterogeneity=0.03).

Conclusions:

Pre-diagnosis cigarette smoking is associated with worsened prognosis among patients with CRC.     

Heavy Marijuana Users Not in Treatment: The Continuing Search for the “Pure” Marijuana User

Abstract

Criminality among female (n=351) drug abusers is compared to that of men (n=798) as part of a longitudinal study of persons in treatment in Sweden (the SWEDATE project). The extent of criminality was much less among females than among males, and fewer women than men were criminal. The pattern of criminality varied between the sexes. Women's crime debuts occurred later, and they committed less violent crimes and more drug-related crimes. The majority of women supported themselves in other way s than with criminality. Also, women tended to have a more severe pattern of abuse, a more rapid drug career, and more complex psychological problems than men. A subgroup of prostitutes whose drug of choice was heroin often began drug use early with cannabis and went on to amphetamine for their first injection, which often took place in a junkie pad. There was also a criminal group (as there was among men) with a very early and intensive juvenile delinquency pattern, early drug debuts and a rapid transition to regular abuse and extensive adult criminality. Forty-two percent of the women had no criminal records; they had more extensive multiple drug abuse than the other women (this was also true for the noncriminal male addicts). The study shows that drug abuse and criminality are interrelated for certain individuals, but not for others.