Quality of survival: a new concept framework to assess the quality of prolonged life in cancer

Background: Improved cancer care means that more patients are surviving longer, but there is a need to examine how well patients survive. We conducted an exploratory analysis of a new conceptual framework termed ‘quality of survival’ (QoS) that delineates the quality of patients’ experience. Methods: This project included an electronic database search to investigate the survivorship landscape and to create a visual QoS map and semi-structured interviews with patients (n = 35), clinicians (n = 40), and payers (n = 7) to support the QoS map. QoS was discussed in the context of two tumor types, metastatic non-small cell lung cancer and metastatic melanoma. Results: Despite increased long-term survival, no specific definition of QoS exists. Patients reported many impacts that affect QoS, clinicians viewed QoS as relevant to treatment decisions, and payers felt it could help communicate different aspects relevant to the patient. Four interconnected QoS dimensions were developed (quality of life, survival, side effects, and economic impact), which vary in importance along the care continuum. Conclusion: QoS is a patient-centric concept that could help decision-making and patient communication. The QoS map could provide a framework to monitor patient experience and help patients frame what treatment attribute is most important to them at any point in the cancer continuum

Myths and Methodologies : Assessing glycaemic control and associated regulatory mechanisms in human physiology research

Accurate measurements of glycaemic control and the underpinning regulatory mechanisms are vital in human physiology research. Glycaemic control is the maintenance of blood glucose concentrations within optimal levels and is governed by physiological variables including insulin sensitivity, glucose tolerance and β-cell function. These can be measured with a plethora of methods, all with their own benefits and limitations. Deciding on the best method to use is challenging and depends on the specific research question(s). This review therefore discusses the theory and procedure, validity and reliability and any special considerations of a range common methods used to measure glycaemic control, insulin sensitivity, glucose tolerance and β-cell function. Methods reviewed include, HbA1c, continuous glucose monitors, oral glucose tolerance tests, mixed meal tolerance tests, hyperinsulinaemic euglycaemic clamp, hyperglycaemic clamp, intravenous glucose tolerance test, and indices derived from both fasting concentrations and the oral glucose tolerance test. This review aims to help direct understanding, assessment, and decisions regarding which method to use based on specific physiology related research questions

A Common CNR1 (Cannabinoid Receptor 1) Haplotype Attenuates the Decrease in HDL Cholesterol That Typically Accompanies Weight Gain

We have previously shown that genetic variability in CNR1 is associated with low HDL dyslipidemia in a multigenerational obesity study cohort of Northern European descent (209 families, median  = 10 individuals per pedigree). In order to assess the impact of CNR1 variability on the development of dyslipidemia in the community, we genotyped this locus in all subjects with class III obesity (body mass index >40 kg/m2) participating in a population-based biobank of similar ancestry. Twenty-two haplotype tagging SNPs, capturing the entire CNR1 gene locus plus 15 kb upstream and 5 kb downstream, were genotyped and tested for association with clinical lipid data. This biobank contains data from 645 morbidly obese study subjects. In these subjects, a common CNR1 haplotype (H3, frequency 21.1%) is associated with fasting TG and HDL cholesterol levels (p = 0.031 for logTG; p = 0.038 for HDL-C; p = 0.00376 for log[TG/HDL-C]). The strength of this relationship increases when the data are adjusted for age, gender, body mass index, diet and physical activity. Mean TG levels were 160±70, 155±70, and 120±60 mg/dL for subjects with 0, 1, and 2 copies of the H3 haplotype. Mean HDL-C levels were 45±10, 47±10, and 48±9 mg/dL, respectively. The H3 CNR1 haplotype appears to exert a protective effect against development of obesity-related dyslipidemia

Body weight, weight perceptions and food intake patterns. A cross-sectional study among male recruits in the Norwegian National Guard

<p>Abstract</p> <p>Background</p> <p>Young men tend to have a low intake of vegetables and fruit. Unfortunately, this group is difficult to reach with health information. Furthermore, knowledge about weight perceptions and the relationship to food behaviour among young men is scant. The purpose of this study was to explore the relationship between BMI, health and weight perceptions and food intake patterns among young men in the military.</p> <p>Methods</p> <p>Data were collected with a 4-day food diary among 578 male recruits (age 18-26, mean 19.7) in the Norwegian National Guard (response rate 78%), in addition to a questionnaire, including questions about health and weight perceptions, and food frequency when still living at home. Weight and height were objectively measured. Food patterns were explored with principal component analysis, based on the diary data. A multivariate linear regression analysis determined the association between BMI and food patterns, and attitudes to health and slenderness, adjusting for smoking, physical activity and phase of data collection.</p> <p>Results</p> <p>Twenty eight percent of the recruits were overweight/obese (BMI > 25 kg/m²). Two-thirds meant that it is important for them to be slender, and these recruits reported more of both light (p = 0.025) and hard (p = 0.016) physical activity than the others. It was a positive association between the recruits' food frequency at home, and the amount of intake in the military camp for several food items. A principal component analysis identified three distinct food patterns, loading on 1) plant foods, 2) fast food/soft drinks, 3) milk/cereals. Those who stated that it is important for them to be slender, or to have good health, did not have significantly different food intake patterns than the others. BMI was inversely related to scores on the plant food pattern, and positive attitudes to slenderness.</p> <p>Conclusion</p> <p>The majority of the recruits find it important to be slender. This orientation had a bearing on their physical activity pattern, but less on the food intake pattern. The data also indicate that subjects with high intakes of plant foods were less likely to have a high BMI than others. It is important to raise awareness of healthy eating in young men.</p

Novel Technologies for Assessing Dietary Intake: Evaluating the Usability of a Mobile Telephone Food Record Among Adults and Adolescents

The development of a mobile telephone food record has the potential to ameliorate much of the burden associated with current methods of dietary assessment. When using the mobile telephone food record, respondents capture an image of their foods and beverages before and after eating. Methods of image analysis and volume estimation allow for automatic identification and volume estimation of foods. To obtain a suitable image, all foods and beverages and a fiducial marker must be included in the image

Genome-Wide Meta-Analysis Identifies Regions on 7p21 (AHR) and 15q24 (CYP1A2) As Determinants of Habitual Caffeine Consumption

We report the first genome-wide association study of habitual caffeine intake. We included 47,341 individuals of European descent based on five population-based studies within the United States. In a meta-analysis adjusted for age, sex, smoking, and eigenvectors of population variation, two loci achieved genome-wide significance: 7p21 (P = 2.4×10−19), near AHR, and 15q24 (P = 5.2×10−14), between CYP1A1 and CYP1A2. Both the AHR and CYP1A2 genes are biologically plausible candidates as CYP1A2 metabolizes caffeine and AHR regulates CYP1A2

Online dietary intake estimation : The food4me food frequency questionnaire

Copyright ©Hannah Forster, Rosalind Fallaize, Caroline Gallagher, Clare B O’Donovan, Clara Woolhead, Marianne C Walsh, Anna L Macready, Julie A Lovegrove, John C Mathers, Michael J Gibney, Lorraine Brennan, Eileen R Gibney. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.06.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.Dietary assessment methods are important tools for nutrition research. Online dietary assessment tools have the potential to become invaluable methods of assessing dietary intake because, compared with traditional methods, they have many advantages including the automatic storage of input data and the immediate generation of nutritional outputs. Objective: The aim of this study was to develop an online food frequency questionnaire (FFQ) for dietary data collection in the Food4Me study and to compare this with the validated European Prospective Investigation of Cancer (EPIC) Norfolk printed FFQ. Methods: The Food4Me FFQ used in this analysis was developed to consist of 157 food items. Standardized color photographs were incorporated in the development of the Food4Me FFQ to facilitate accurate quantification of the portion size of each food item. Participants were recruited in two centers (Dublin, Ireland and Reading, United Kingdom) and each received the online Food4Me FFQ and the printed EPIC-Norfolk FFQ in random order. Participants completed the Food4Me FFQ online and, for most food items, participants were requested to choose their usual serving size among seven possibilities from a range of portion size pictures. The level of agreement between the two methods was evaluated for both nutrient and food group intakes using the Bland and Altman method and classification into quartiles of daily intake. Correlations were calculated for nutrient and food group intakes. Results: A total of 113 participants were recruited with a mean age of 30 (SD 10) years (40.7% male, 46/113; 59.3%, 67/113 female). Cross-classification into exact plus adjacent quartiles ranged from 77% to 97% at the nutrient level and 77% to 99% at the food group level. Agreement at the nutrient level was highest for alcohol (97%) and lowest for percent energy from polyunsaturated fatty acids (77%). Crude unadjusted correlations for nutrients ranged between .43 and .86. Agreement at the food group level was highest for other fruits (eg, apples, pears, oranges) and lowest for cakes, pastries, and buns. For food groups, correlations ranged between .41 and .90. Conclusions: The results demonstrate that the online Food4Me FFQ has good agreement with the validated printed EPIC-Norfolk FFQ for assessing both nutrient and food group intakes, rendering it a useful tool for ranking individuals based on nutrient and food group intakes.Peer reviewedFinal Published versio