ABSTRACT
PURPOSE: I.CAN is a program which uses health coaching to provide tailored nutrition and physical activity guidance to people diagnosed with cancer in a rural region in eastern Victoria, Australia. I.CAN builds patients' nutritional knowledge, attitudes and health literacy to healthy eating and weight maintenance and incorporates sustainable and affordable dietary changes into everyday eating patterns. While oncology care identifies patients at risk of malnutrition and weight loss, less attention has been placed on building patient's capacity for healthy lifestyles and behaviours after cancer treatment. METHODS: I.CAN is delivered by a dietitian and exercise physiologist and is offered in three streams, one-on-one consultation, one-one-one and group and group. Paired t tests and chi-square analysis were used to analyse data. RESULTS: At 3-month review, I.CAN participants (1) significantly increased exercise activity from 51 to 86% (p < 0.001) and (2) showed increased trends in positive food choices from 62 to 66%. Importantly, positive food choices for alcohol and processed snacks were maintained, and there were increases in positive food choices for fresh fruit and vegetables, low fat dairy and processed meats. CONCLUSION: I.CAN is an example of a program which can be delivered within a rural setting, with minimal resources, and achieve positive impact for patients. IMPLICATIONS FOR CANCER SURVIVORS: Key to the success of the program is promoting wellness early in the cancer trajectory and providing patients with practical tools, a person-centred and multidisciplinary team approach and a program which is adaptable to the changing needs of the patient and the health service.
Subject(s)
Exercise/physiology , Neoplasms/therapy , Nutritional Status/physiology , Adult , Aged , Aged, 80 and over , Australia , Female , Humans , Male , Middle Aged , Rural PopulationABSTRACT
BACKGROUND: Venlafaxine is a serotonin noradrenaline reuptake inhibitor used to treat major depressive episodes and anxiety disorders. The primary aim of this study was to investigate spontaneous abortion risks following gestational exposure. METHODS: This prospective observational comparative cohort study utilised data collected by the UK Teratology Information Service (UKTIS) between 1995 and 2018. The study sample included 281 venlafaxine exposed pregnancies matched to antidepressant unexposed (n = 1405) and SSRI exposed (n = 843) comparator groups. RESULTS: After correction for variation in competing outcome rates and the stage of pregnancy at reporting, no statistically significant differences in the hazard of spontaneous abortion was observed following gestational venlafaxine use compared with either antidepressant unexposed (HR 1.28, 95% CI; 0.850-1.94) or SSRI exposed (HR 1.03, 95% CI; 0.681-1.57) pregnancies. CONCLUSIONS: No conclusive evidence is provided from this study that venlafaxine increases the risk of adverse pregnancy or fetal outcomes.
Subject(s)
Antidepressive Agents/therapeutic use , Pregnancy Outcome/epidemiology , Serotonin and Noradrenaline Reuptake Inhibitors/therapeutic use , Venlafaxine Hydrochloride/therapeutic use , Adult , Cohort Studies , Female , Humans , Pregnancy , Prospective Studies , United Kingdom/epidemiologyABSTRACT
The control of DNA binding by eukaryotic transcription factors represents an important regulatory mechanism. Many transcription factors are controlled by cis-acting autoinhibitory modules that are thought to act by blocking promiscuous DNA binding in the absence of appropriate regulatory cues. Here, we have investigated the determinants and regulation of the autoinhibitory mechanism employed by the ETS-domain transcription factor, PEA3. DNA binding is inhibited by a module composed of a combination of two short motifs located on either side of the ETS DNA-binding domain. A second type of protein, Ids, can act in trans to mimic the effect of these cis-acting inhibitory motifs and reduce DNA binding by PEA3. By using a one-hybrid screen, we identified the basic helix-loop-helix-leucine zipper transcription factor USF-1 as an interaction partner for PEA3. PEA3 and USF-1 form DNA complexes in a cooperative manner. Moreover, the formation of ternary PEA3.USF-1.DNA complexes requires parts of the same motifs in PEA3 that form the autoinhibitory module. Thus the binding of USF-1 to PEA3 acts as a switch that modifies the autoinhibitory motifs in PEA3 to first relieve their inhibitory action, and second, promote ternary nucleoprotein complex assembly.