Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making.

PURPOSE: The purpose of this study was to examine the impact of four methods of communicating survival benefits on chemotherapy decisions. We hypothesized that the four methods of communicating mathematically equivalent risk information would lead to different chemotherapy decisions. METHODS: Each participant received two hypothetical scenarios regarding their mother (a postmenopausal woman with an invasive, lymph node-negative, hormone receptor-positive breast cancer) and was asked to decide whether they would encourage their mother to take chemotherapy in addition to surgery and tamoxifen. In the part 1, participants received one of four methods of describing the chemotherapy survival benefit: (1) relative risk reduction, (2) absolute risk reduction, (3) absolute survival benefit, or (4) number needed to treat. In part 2, each participant received all four methods. Following each decision, participants were asked to rate their confidence and confusion regarding their decision. RESULTS: Participants included 203 preclinical medical students. In part 1, participants who received relative risk reduction information were significantly more likely to endorse chemotherapy. In part 2, there were no treatment decision differences when participants received all four methods of communicating survival benefits of chemotherapy. However, receiving all four methods led to significantly higher ratings of confusion. In deciding on endorsing chemotherapy, participants understood the information best when presented with data in the absolute survival benefit format. CONCLUSION: These results support the hypothesis that the method used to present information about chemotherapy influences treatment decisions. Absolute survival benefit is the most easily understood method of conveying the information regarding benefit of treatment.     

Some of our concepts are missing: reflections on the absence of a sociology of organisations in Sociology of Health and Illness

Abstract The task of examining just how the concept of ‘organisations’ has fared in Sociology of Health and Illness in its first 25 years is in some ways unrewarding. The answer has to be –‘not at all well’. But why is this and does it matter? Part one of this paper considers what research on health care organisations was being conducted in the early years of the Journal and why that work was not viewed with favour by sociologists. Part two examines the growing gulf between those who saw themselves principally as responding to the call for a sociology of health and illness informed by broader sociological theory, and those who regarded themselves more as analysts of health policy and practice. Postmodernism, curiously, has begun to open up something of a route back. Just what might be done to create a closer rapprochement between those calling for theory and those wanting to address some of the day to day challenges of the delivery and experience of health care in the 21^st century are topics for the final section.     

A preliminary evaluation of tissue polypeptide antigen in serum or urine (or both) of patients with cancer or benign neoplasms

We evaluated assays of Tissue Polypeptide Antigen in serum and urine, as an index to the presence of cancer. In the assay, serum, which is first absorbed with human albumin-labeled sheep erythrocytes, or untreated urine (diluted with an equal volume of TPA-free serum) is incubated with antibody specific to Tissue Polypeptide Antigen and then reacted with sheep erythrocytes labeled with Tissue Polypeptide Antigen. We found an increased concentration of Tissue Polypeptide Antigen in the serum of 378 of 513 (74%) and in the urine of 49 of 77 (64%) patients with cancer, as compared with 40/112 (36%) and 7/29 (24%), respectively, for individuals with benign neoplasms. Normal individuals were defined as those with less than 0.09 unit of the antigen per milliliter of specimen. Concentrations exceeding this were found in 2/67 (3%) sera and 6/56 (11%) urines from supposedly normal persons. Tissue Polypeptide Antigen was found in above-normal concentrations in patients with cancer, regardless of neoplasm type and extension, with a higher proportion of abnormal values in patients with distal metastases.     

Nickel induction of Rosenthal fibers in rat brain

Nickel wire implants into the central nervous system of Lewis rats induces the formation of structures morphologically similar to Rosenthal fibers. The nickel-induced lesions are similar to those seen in Alexander's disease and other human conditions in which Rosenthal fibers are found. This is the first report on the induction of Rosenthal fibers in animals. It might be used to design animal models to study Rosenthal fiber formation and possibly Alexander's disease.     

The effects of victimization on drug use: a multilevel analysis

Agnew's general strain theory suggests that negative life experiences constitute stress that may lead to deviance, unless effective coping strategies are forthcoming. In the present study, the principles of general strain theory were employed to examine the age-varying effects of three types of victimization on drug-using behavior: sexual victimization, physical victimization, or other victimization. Study data came from seven waves of the National Youth Survey, a longitudinal survey of youth ages 11 to 17 years when the study began in 1976. The broad hypotheses of general strain theory were supported, by the data, with some qualifications. Results of the data analysis also showed that victimization's impact on drug use is type-specific and/or drug-specific. Further studies with more sophisticated measures of drug use should clarify the role of victimization (by type) in various drug-using behaviors. The study's limitations are noted.     

Colloidal carriers for the enhanced delivery through the skin

BACKGROUND: The skin is the largest organ of our body and acts as a protective barrier with sensory and immunological functions. Its peculiar structure influences the passage of bioactives and only its modulation can facilitate the drug dermal/transdermal diffusion. In the past few years research in this field has assured better use of this application area. METHODS: One of the most promising approaches is the use of drug delivery devices; this review explains the state of the art of drug transport through the skin by means of vesicular (classic liposomes, Transfersomes, niosomes and ethosomes) and particulate systems. RESULTS/CONCLUSION: Colloidal drug delivery systems are important in the field of drug delivery systems as their different characteristics make them suitable for various purposes.