A comparison of the illness beliefs of people with angina and their peers: a questionnaire study

BACKGROUND: What people believe about their illness may affect how they cope with it. It has been suggested that such beliefs stem from those commonly held within society . This study compared the beliefs held by people with angina, regarding causation and coping in angina, with the beliefs of their friends who do not suffer from angina. METHODS: Postal survey using the York Angina Beliefs Questionnaire (version 1), which elicits stress attributions and misconceived beliefs about causation and coping. This was administered to 164 people with angina and their non-cohabiting friends matched for age and sex. 132 people with angina and 94 friends completed the questionnaire. RESULTS: Peers are more likely than people with angina to believe that angina is caused by a worn out heart (p <0.01), angina is a small heart attack (p = 0.02), and that it causes permanent damage to the heart (p <0.001). Peers were also more likely to believe that people with angina should take life easy (p <0.01) and avoid exercise (p = 0.04) and excitement (p <0.01). CONCLUSIONS: The beliefs of the peer group about causation and coping in angina run counter to professional advice. Over time this may contribute to a reduction in patient concordance with risk factor reduction, and may help to create cardiac invalids

Rhizospheric solutions: Pseudomonas isolates counter Botrytis cinerea on tomato

La moisissure grise causée par Botrytis cinerea provoque des dégâts sur plus de 200 espèces de cultures dans le monde. B. cinerea sporule pour former une pourriture grise sur les feuilles, les tiges et les fruits. Pour lutter contre B. cinerea, des fongicides synthétiques sont utilisés. Ces derniers mettent en danger la santé humaine et environnementale en plus de la résistance qu'ils peuvent occasionner chez les souches de B. cinerea. Les alternatives écologiques sont des solutions appropriées pour contrôler la moisissure grise tout en maintenant l’équilibre environnemental. L’objectif de cette étude est d'évaluer l’effet des isolats de Pseudomonas issus de la rhizosphère de la tomate sur B. cinerea. Les résultats ont montré que les 76 isolats testés inhibent le développement de B. cinerea in vitro. Cinq isolats de Pseudomonas (Q6B, Q13B, Q7B, Q14B et Q1B) ont provoqué des niveaux d'inhibition significatifs allant de 65 à 73%. Par ailleurs, ces isolats ont également inhibé B. cinerea sur les feuilles et le fruit de la tomate. Pour tenter d'élucider les mécanismes d'action, les cinq isolats ont montré une production des métabolites antifongiques tels que les sidérophores, le cyanure d'hydrogène et d’autres enzymes. Les résultats de cette étude ont montré que les isolats de Pseudomonas Q6B, Q13B, Q7B, Q14B et Q1B ont une forte efficacité dans la lutte biologique contre B. cinerea et peuvent être utilisés pour une lutte écologique durable.Gray mold caused by Botrytis cinerea causes serious losses in more than 200 crop species worldwide. The necrotrophic fungus sporulates to effect a grey covering on leaves, stems and flowers. B. cinerea is controlled by chemical synthetic fungicides, endangering human and environmental health. Synthetic fungicides stimulate emergence of pathogen resistance. Organic alternatives which may be present or introduced into the edaphic environment are suitable solutions to control outbreaks. This study was done in order to elucidate the mode of action involved in the control of B. cinerea using fluorescent Pseudomonas isolates from tomato roots. The results show that all 76 isolates inhibit fungal growth during in vitro bioassay using dual culture technique. Five isolates of Pseudomonas (Q6B, Q13B, Q7B, Q14B and Q1B) cause significant inhibition levels ranging from 65 to 73%. These isolates inhibit fungal growth in both fruits and leaves. Each isolate tested produced antifungal metabolites (siderophores, hydrogen cyanide and enzymes). Results of this study show that all tested Pseudomonas isolates have a strong efficacy in biological control against B. cinerea and can be used for environmentally sustainable control

Engineering novel complement activity into a pulmonary surfactant protein

Complement neutralizes invading pathogens, stimulates inflammatory and adaptive immune responses, and targets non- or altered-self structures for clearance. In the classical and lectin activation pathways, it is initiated when complexes composed of separate recognition and activation subcomponents bind to a pathogen surface. Despite its apparent complexity, recognition-mediated activation has evolved independently in three separate protein families, C1q, mannose-binding lectins (MBLs), and serum ficolins. Although unrelated, all have bouquet-like architectures and associate with complement-specific serine proteases: MBLs and ficolins with MBL-associated serine protease-2 (MASP-2) and C1q with C1r and C1s. To examine the structural requirements for complement activation, we have created a number of novel recombinant rat MBLs in which the position and orientation of the MASP-binding sites have been changed. We have also engineered MASP binding into a pulmonary surfactant protein (SP-A), which has the same domain structure and architecture as MBL but lacks any intrinsic complement activity. The data reveal that complement activity is remarkably tolerant to changes in the size and orientation of the collagenous stalks of MBL, implying considerable rotational and conformational flexibility in unbound MBL. Furthermore, novel complement activity is introduced concurrently with MASP binding in SP-A but is uncontrolled and occurs even in the absence of a carbohydrate target. Thus, the active rather than the zymogen state is default in lectin·MASP complexes and must be inhibited through additional regions in circulating MBLs until triggered by pathogen recognition

The need for novel strategies to address postoperative pain associated with cardiac surgery: A commentary and introduction to "SMArTVIEW".

Background: With coronary heart disease affecting over 2.4 million Canadians, annual cardiac and major vascular surgery rates are on the rise. Unrelieved postoperative pain is among the top five causes of hospital readmission following surgery; little is done to address this postoperative complication. Barriers to effective pain assessment and management following cardiac and major vascular surgery have been conceptualized on patient, health care provider, and system levels. Purpose: In this commentary, we review common patient, health care provider, and system-level barriers to effective postoperative pain assessment and management following cardiac and major vascular surgery. We then outline the SMArTVIEW intervention, with particular attention to components designed to optimize postoperative pain assessment and management. Methods: In conceptualizing the SMArTVIEW intervention design, we sought to address a number of these barriers by meeting the following design objectives: (1) orchestrating a structured process for regular postoperative pain assessment and management; (2) ensuring adequate clinician preparation for postoperative pain assessment and management in the context of virtual care; and (3) enfranchising patients to become active self-managers and to work with their health care providers to manage their pain postoperatively. Conclusions: Innovative approaches to address these barriers are a current challenge to health care providers and researchers alike. SMArTVIEW is spearheading this paradigm shift within clinical research to address barriers that impair effective postoperative pain management by actively engaging health care providers and patients in an accessible format (i.e., digital health solution) to give primacy to the need of postoperative pain assessment and management following cardiac and major vascular surgery

Women, men and coronary heart disease: a review of the qualitative literature

Aim. This paper presents a review of the qualitative literature which examines the experiences of patients with coronary heart disease. The paper also assesses whether the experiences of both female and male patients are reflected in the literature and summarizes key themes. Background. Understanding patients' experiences of their illness is important for coronary heart disease prevention and education. Qualitative methods are particularly suited to eliciting patients' detailed understandings and perceptions of illness. As much previous research has been 'gender neutral', this review pays particular attention to gender. Methods. Published papers from 60 qualitative studies were identified for the review through searches in MEDLINE, EMBASE, CINAHL, PREMEDLINE, PsychINFO, Social Sciences Citation Index and Web of Science using keywords related to coronary heart disease. Findings. Early qualitative studies of patients with coronary heart disease were conducted almost exclusively with men, and tended to generalize from 'male' experience to 'human' experience. By the late 1990s this pattern had changed, with the majority of studies including women and many being conducted with solely female samples. However, many studies that include both male and female coronary heart disease patients still do not have a specific gender focus. Key themes in the literature include interpreting symptoms and seeking help, belief about coronary 'candidates' and relationships with health professionals. The influence of social roles is important: many female patients have difficulties reconciling family responsibilities and medical advice, while male patients worry about being absent from work. Conclusions. There is a need for studies that compare the experiences of men and women. There is also an urgent need for work that takes masculinity and gender roles into account when exploring the experiences of men with coronary heart disease

Approximate Quantum Cloning with Nuclear Magnetic Resonance

Here we describe a Nuclear Magnetic Resonance (NMR) experiment that uses a three qubit NMR device to implement the one to two approximate quantum cloning network of Buzek et al.Comment: 4 pages RevTeX4 including 5 postscript figures. Submitted to PR

Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment

Background: Cardiotoxicity from anticancer therapy affects heart function and structure. Cardiotoxicity can also lead to accelerated development of chronic diseases, especially in the presence of risk factors. Methods: This study aimed to develop and pilot a combined cardiovascular disease and cardiotoxicity risk assessment questionnaire to quantify the potential extent of risk factors in breast cancer patients prior to treatment. The questionnaire underwent content and face validity evaluation by an expert panel followed by pilot testing in a sample of breast cancer patients (n = 36). Questionnaires were self-administered while attending chemotherapy clinic, in the presence of a research assistant. Results: Mean age of participants was 54.8 years (range 36–72 years). Participants reported CVD risk factors including diabetes 2.8%, hypertension 19.8%, hypercholesterolaemia 11% and sleep apnoea 5%. Lifestyle risk factors, included not eating the recommended serves of vegetables (100%) or fruit (78%) per day; smoking (13%) and regularly consuming alcohol (75%). Twenty five percent reported being physically inactive, 61%, overweight or obese, 24%, little or no social support and 30% recorded high to very high psychological distress. Participants were highly (75%) reluctant to undertake lifestyle changes; i.e. changing alcohol consumption; dietary habits; good emotional/mental health strategies; improving physical activity; quitting smoking; learning about heart-health and weight loss. Conclusion: This study is an important step towards prevention and management of treatment-associated cardiotoxicity after breast cancer diagnosis. We recommend that our questionnaire is providing important data that should be included in cancer registries so that researchers can establish the relationship between CVD risk profile and cardiotoxicity outcomes and that this study revealed important teaching opportunities that could be used to examine the impact on health literacy and help patients better understand the consequences of cancer treatment

Arctic sea-ice proxies: Comparisons between biogeochemical and micropalaeontological reconstructions in a sediment archive from Arctic Canada

Boxcore 99LSSL-001 from the southwest Canadian Arctic Archipelago (68.095°N, 114.186°W), studied by multiproxy approaches (sea-ice diatom biomarker IP25, phytoplankton-based biomarker brassicasterol, biogenic silica, total organic carbon, dinoflagellate cysts = dinocysts, diatoms) and their applications (sea-ice index PBIP25, modern analogue technique (MAT) transfer functions), provides a chronologically constrained (210Pb, 137Cs, two 14C dates) palaeoenvironmental archive spanning AD 1625–1999 with which to compare and evaluate proxies frequently used in sea-ice reconstructions. Whereas diatoms are rare, PBIP25, biogenic silica and qualitative dinocyst approaches show good agreement, suggesting that palaeo sea-ice histories based on biomarker and microfossil techniques are robust in this region. These combined approaches show fluctuating long open water to marginal ice zone conditions (AD 1625–1740), followed by high-amplitude oscillations between long open water and extended spring/summer sea ice (AD 1740–1870). Greater ice cover (AD 1870–1970) precedes recent reductions in seasonal sea ice (AD 1970–1999). Dinocyst-based MAT, however, produces a low-amplitude signal lacking the nuances of other proxies, with most probable sea-ice reconstructions poorly correlating with biomarker-based histories. Explanations for this disagreement may include limited spatial coverage in the modern dinocyst distribution database for MAT and the broad environmental tolerances of polar dinocysts. Overall, PBIP25 provides the most detailed palaeo sea-ice signal, although its use in a shallow polar archipelago downcore setting poses methodological challenges. This proxy comparison demonstrates the limitations of palaeo sea-ice reconstructions and emphasizes the need for calibration studies tying modern microfossil and biogeochemical proxies to directly measured oceanographic parameters, as a springboard for robust quantitative palaeo studies. </jats:p

The cost effectiveness of REACH-HF and home-based cardiac rehabilitation compared with the usual medical care for heart failure with reduced ejection fraction:a decision model-based analysis

This is the final version. Available from Sage Publications via the DOI in this record.Background The REACH-HF (Rehabilitation EnAblement in CHronic Heart Failure) trial found that the REACH-HF home-based cardiac rehabilitation intervention resulted in a clinically meaningful improvement in disease-specific health-related quality of life in patients with reduced ejection fraction heart failure (HFrEF). The aims of this study were to assess the long-term cost-effectiveness of the addition of REACH-HF intervention or home-based cardiac rehabilitation to usual care compared with usual care alone in patients with HFrEF. Design and methods A Markov model was developed using a patient lifetime horizon and integrating evidence from the REACH-HF trial, a systematic review/meta-analysis of randomised trials, estimates of mortality and hospital admission and UK costs at 2015/2016 prices. Taking a UK National Health and Personal Social Services perspective we report the incremental cost per quality-adjusted life-year (QALY) gained, assessing uncertainty using probabilistic and deterministic sensitivity analyses. Results In base case analysis, the REACH-HF intervention was associated with per patient mean QALY gain of 0.23 and an increased mean cost of £400 compared with usual care, resulting in a cost per QALY gained of £1720. Probabilistic sensitivity analysis indicated a 78% probability that REACH-HF is cost effective versus usual care at a threshold of £20,000 per QALY gained. Results were similar for home-based cardiac rehabilitation versus usual care. Sensitivity analyses indicate the findings to be robust to changes in model assumptions and parameters. Conclusions Our cost-utility analyses indicate that the addition of the REACH-HF intervention and home-based cardiac rehabilitation programmes are likely to be cost-effective treatment options versus usual care alone in patients with HFrEF.National Institute for Health Research (NIHR