3,770 research outputs found
Milk decrease urinary excretion but not plasma pharmacokinetics of cocoa flavan-3-ol metabolites in humans
No full textImmunoglobulin framework-derived peptides function as cytotoxic T-cell epitopes commonly expressed in B-cell malignancies
No full textAlthough the idiotypic structures of immunoglobulin from malignant B cells were the first tumor-specific determinants recognized, and clinical vaccination trials have demonstrated induction of tumor-specific immunity, the function of immunoglobulin-specific CD8+ cytotoxic T lymphocytes in tumor rejection remains elusive. Here, we combined bioinformatics and a T cell-expansion system to identify human immunoglobulin-derived peptides capable of inducing cytotoxic T-lymphocyte responses. Immunogenic peptides were derived from framework regions of the variable regions of the immunoglobulin that were shared among patients. Human-leukocyte-antigen-matched and autologous cytotoxic T lymphocytes specific for these peptides killed primary malignant B cells, demonstrating that malignant B cells are capable of processing and presenting such peptides. Targeting shared peptides to induce T-cell responses might further improve current vaccination strategies in B-cell malignancies
Measuring barriers to adherence: validation of the problematic experiences of therapy scale
No full textPurpose: To present the psychometric properties of the Problematic Experiences of Therapy Scale (the PETS), a brief measure to assess self-reported perceived barriers to adherence to physical rehabilitative therapy.Methods: Participants (study 1: n?=?128, study 2: n?=?227) taking part in trials of rehabilitative exercises completed the PETS and adherence questions at 12 weeks. Participants in study 2 were also asked about maintained adherence at 6-month follow-up.Results: Principal component analysis identified a four-factor structure relating to symptoms, uncertainty, doubts and practical problems. Cronbach's alphas ranged between 0.84 and 0.96 for study 1 and study 2. Correlations between factors varied, ranging between -0.22 and -0.53 for study 1, and 0.12 and 0.36 for study 2. Adherence was associated with all subscales at 12 weeks, and with the symptoms and doubts subscales at 6-months.Conclusions: The PETS is a valid and reliable measure that can be used to assess participants' perceived reasons for non-adherence to a home-based rehabilitative therapy. It can be easily incorporated into treatment trials and as subscales were associated with reported adherence and maintained adherence, it provides potentially valuable indicators of reported barriers to adherence or might be used in clinical practice to facilitate conversations about adherence.Implications for RehabilitationLow levels of adherence are commonly reported among people with chronic conditions who are required to undertake self-managed, home-based rehabilitation, yet patient-perceived barriers to adherence are rarely measured. The Problematic Experiences of Therapy Scale (the PETS) is a brief self-report measure that assesses the extent to which respondents perceive that they have been prevented from carrying out an intervention by common and plausible reasons. A patient-centered approach to reasons for non-adherence could facilitate conversations about adherence and identify areas in which the respondent may benefit from additional support or interventions to aid adherence
Capturing users' experiences of participating in cancer trials
No full textRandomized controlled trials are accepted to be the research design of choice to evaluate the effectiveness of health care interventions and are commonly used to evaluate cancer treatments. There are concerns, however, that levels of recruitment to trials are often much lower than anticipated, particularly in cancer trials. Several research methods have been used to collect aspects of users' experiences of participating in cancer trials. Perhaps the most common method has been through measures of outcome and the impact of treatments on quality of life (QoL), using standardized schedules to capture physical, social and psychological health. In some areas of cancer, individual patient testimonies illuminate particular issues or narratives. Another body of research has grown around issues of user involvement in trials, including surveys of recruitment and participation, as well as investigations of patient preferences and experiences of participation. We searched MEDLINE and the Cochrane Trials Library from 1995 to 2001 for relevant publications. In this article, we review the literature in these areas and examine whether users' experiences of participating in cancer trials can be used to assist in the design or conduct of trials
Reflections of a Jewish, Lesbian Author
No full textIn this essay, Jewish lesbian author Leslea Newman speaks of the importance of finding one's own identity reflected in works of literature, citing examples of her own work, and recommending the writings of other Jewish lesbian authors of merit
External beam radiation therapy carries lower risk of sexual dysfunction as compared to radical prostatectomy in treatment of patients with localized prostate cancer
No full textA clinical decision report appraising:
Donovan JL, Hamdy FC, Lane JA, et al. Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med. 2016;375(15):1425-1437. https://doi.org/10.1056/NEJMoa1606221
for a patient with localized prostate cancer and concerns regarding future sexual dysfunction
Patient Decision Making:The Missing Ingredient in Compliance Research
No full textMedical noncompliance has been identified as a major public health problem that imposes a considerable financial burden upon modern health care systems. There is a large research record focusing on the understanding, measurement, and resolution of noncompliance, but it is consistently found that between one third and one half of patients fail to comply with medical advice and prescriptions. Critically absent from this research record has been the patient's role in medical decision making. For patients, particularly those with chronic illnesses, compliance is not an issue: they make their own reasoned decisions about treatments based on their own beliefs, personal circumstances, and the information available to them. The traditional concept of compliance is thus outmoded in modern health care systems, where chronic illness and questioning patients predominate
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