Prognostic value of symptom burden for overall survival in patients receiving chemotherapy for advanced nonsmall cell lung cancer

BACKGROUND: Patient-reported outcomes have shown independent prognostic value for patients with nonsmall cell lung cancer (NSCLC). However, translating patient-reported outcomes into useful prognostic information for individual patients has been problematic. METHODS: A total of 94 patients with advanced NSCLC and an Eastern Cooperative Oncology Group performance status (PS) of 0 to 2 who qualified for chemotherapy rated symptom severity using the M. D. Anderson Symptom Inventory before and after their first chemotherapy cycle. Prognostic values of baseline symptoms and changes in symptom severity were examined by Cox proportional hazards models. RESULTS: In multivariate analysis, controlled for demographic and other factors, baseline coughing rated ≤4 independently predicted significantly higher risk for shorter survival (hazards ratio [HR], 8.69; P < .0001). Patients with coughing ≤4 and a PS of 2 were more likely to have shorter survival (HR, 20.6; P < .0001) than patients with coughing <4 and a PS of 0 to 1. A 1-point or greater increase in severity of fatigue (P < .05), shortness of breath, or poor appetite (P < .01) from baseline to the end of the first chemotherapy cycle was also found to be independently associated with higher risk for poor survival. CONCLUSIONS: An increased risk for shorter survival was indicated by moderate to severe coughing at baseline or by increased fatigue or shortness of breath during the first chemotherapy cycle in patients with advanced NSCLC. Although cross-validation is needed, these data suggest that an individual patient's symptom severity scores, quickly obtainable in the clinic, might contribute clinically useful information for treatment planning for that patient

The Additive Value of Positive Psychological Capital in Predicting Work Attitudes and Behaviors

Conventional wisdom over the years and recent research findings have supported the importance of positivity in the workplace. However, to date, empirical analysis has not demonstrated potential added value of recently emerging positive state-like constructs such as psychological capital over the more established positive traits in predicting work attitudes and behaviors. This study of a sample of employees (N=336) from a broad cross section of organizations and jobs found that their state-like psychological capital is positively related to desired extra-role organizational citizenship behaviors (OCBs) and negatively with undesired organizational cynicism, intentions to quit and counterproductive workplace behaviors. Except for individual OCBs, their psychological capital also predicted unique variance in the same attitudinal and behavioral outcomes beyond their demographics, core self-evaluation, and personality traits, and person-organization fit and person-job fit. The article concludes with implications these findings have for future research and practical application

Trust, employer exposure and the employment relation

Managers often believe that the better employees know them, the more they will trust them. Yet although specialist literatures exist on labour turnover and tenure (whether job tenure has declined for example) there is no sustained investigation into the wider sociological question: what is the relation between length of service and employee trust? This article seeks to provide the first such examination of this, utilizing the 2004 Workplace Employment Relations Survey, a unique British dataset that permits controls to be made for a considerable number of industry, workplace and individual characteristics. The results do not fit the conventional wisdom

Secretion of five extracellular enzymes by strains of chromoblastomycosis agents Secreção de cinco enzimas extracelulares por amostras de agentes da cromoblastomicose

The gelatinase, urease, lipase, phospholipase and DNase activities of 11 chromoblastomycosis agents constituted by strains of Fonsecaea pedrosoi, F. compacta, Phialophora verrucosa, Cladosporium carrionii, Cladophialophora bantiana and Exophiala jeanselmei were analyzed and compared. All strains presented urease, gelatinase and lipase activity. Phospholipase activity was detected only on five of six strains of F. pedrosoi. DNase activity was not detected on the strains studied. Our results indicate that only phospholipase production, induced by egg yolk substrate, was useful for the differentiation of the taxonomically related species studied, based on their enzymatic profile.<br>As atividades gelatinase, urease, lipase, fosfolipase e DNase de 11 agentes da cromoblastomicose constituídos por amostras de Fonsecaea pedrosoi, F. compacta, Phialophora verrucosa, Cladosporium carrionii, Cladophialophora bantiana e Exophiala jeanselmei foram analisadas e comparadas. Todas as amostras apresentaram atividade urease, gelatinase e lipase. A atividade fosfolipase foi detectada apenas em cinco das seis amostras de F. pedrosoi. A atividade DNase não foi detectada nas amostras estudadas. Os resultados indicam que para a diferenciação entre espécies taxonomicamente relacionadas estudadas, baseado no seu perfil enzimático, apenas a produção de fosfolipase, induzida pelo substrato com gema de ovo, foi útil