Cancer prognosis by general practitioners

Background: General practitioners are probably asked regularly about the prognosis for patients with cancer. There is no readily available source of information on the accuracy of their estimates.

Objective: To discover studies that have reported general practitioners estimates of prognosis.

Methods: A search for studies of estimates of prognosis in terminal cancer by general practitioners.

Results: Three papers were discovered, reporting on 836 patients. In only a quarter of patients was prognosis accurately estimated by general practitioners, even within broad limits. Hospital doctors and nurses performed similarly. We suggest considerable scope for further studies in general practice, which should not require sophisticated procedures.

Conclusion: Evidence of GP's limited performance in cancer prognostication should push us to do better.     

Cross-generational relationships in rural Jamaica

In keeping with trends in the most affected regions of the world, Jamaican young women are at greater risk of becoming infected with HIV than their male peers. Cross-generational relationships (CGRs), or sexual relationships between younger females and older men, have been reported as contributing to this increased risk. Utilizing a qualitative research design, this study aimed to (1) delineate the context in which CGRs occurred in some rural communities in Jamaica and (2) investigate the sexual risk behaviors that occurred in these relationships. The results indicated that young women engaged in these relationships for three main reasons: economic gain, status, and emotional support. At the intrapersonal, interpersonal, and community levels based on the social ecological model, findings also highlighted various factors which facilitated the occurrence of these relationships in some rural communities, including the transactional nature of the relationships, as well as family knowledge and encouragement. The results also highlighted the occurrence of sexual risk behaviors, such as multiple concurrent partnerships and lack of consistent condom use, which may increase young girls' risk of exposure to HIV and other sexually transmitted infections (STIs). This study's findings are consistent with previous research and underscore the challenges faced by intervention planners when promoting safe sex.     

NUTRITIONAL REQUIREMENTS OF THE ELDERLY

The literature hsa been reviewed in an attempt to answer some of the questions related to the nutritional requirements of the elderly. Calories, protein, amino acids, carbohydrate, fat, vitamins A, B, C, D, calcium, iron, sodium, potassium, and fluid studies in the elderly are summarized. Nutritional recommendations are included.     

Evaluation of plasma retinol-binding protein as a surrogate measure for plasma retinol concentrations

Fasting growth hormone (GH) levels and GH responses to exercise were studied in normally menstruating women and in women taking oral contraceptives in order to find out whether the GH levels were related to the menstrual cycle or changed by oral contraceptives. The GH response to exercise was found to be higher when exercise was done in the midcycle period than when it was done at other points of time during the normal menstrual cycle. Fasting GH levels were unchanged throughout the menstrual cycle. Fasting GH levels and GH responses to exercise performed outside the midcycle period were identical in normally menstruating women and in women taking oral contraceptives. In conclusion, the GH response to exercise, but not fasting GH levels, were related to the menstrual cycle. The estrogen and progestin components of the contraceptives used in this study were balanced in such a way that the growth hormone levels and growth hormone responses to exercise were not changed by long-term therapy with these drugs.     

A Review of “Aging with HIV: Psychological,Social, and Health Issues,by Janice E. Nichols,David C. Speer,Betty J. Watson,Mary R. Watson,Tiffany L. Vergon,Coletter M. Vallee,and Joan M. Meah”

No abstract available for this article.