Regulation of BAG-1 IRES-mediated translation following chemotoxic stress.

There are three major isoforms of BAG-1 in mammalian cells, termed BAG-1L (p50), BAG-1M (p46) and BAG-1S (p36) that function as pro-survival proteins and are associated with tumorigenesis and chemoresistance. Initiation of BAG-1 protein synthesis can occur by both cap-dependent and cap-independent mechanisms and it has been shown that synthesis of BAG-1S is dependent upon the presence of an internal ribosome entry segment (IRES) in the 5'-UTR of BAG-1 mRNA. We have shown previously that BAG-1 IRES-meditated initiation of translation requires two trans-acting factors poly (rC) binding protein 1 (PCBP1) and polypyrimidine tract binding protein (PTB) for function. The former protein allows BAG-1 IRES RNA to attain a structure that permits binding of the ribosome, while the latter protein appears to be involved in ribosome recruitment. Here, we show that the BAG-1 IRES maintains synthesis of BAG-1 protein following exposure of cells to the chemotoxic drug vincristine but not to cisplatin and that this is brought about, in part, by the relocalization of PTB and PCBP1 from the nucleus to the cytoplasm.

Quality of life in patients with malignant melanoma participating in a phase I trial of an autologous tumour-derived vaccine.

Quality of life (QOL) plays an increasingly important role in the decision-making process and the ultimate acceptability of particular treatments for patients. We prospectively examined QOL in patients with advanced melanoma treated with surgery followed by heat-shock protein peptide complex 96 (HSPPC-96) vaccine, an active, patient-specific immunotherapy. QOL (the RAND 36-Item Health Survey; SF-36) and cancer-related intrusive thoughts (Impact of Event Scale; IES) were measured at the start of treatment, 3 weeks later on the final day of treatment, and at follow-up 1 month later in 30 patients with stage III or IV malignant melanoma. Mixed model analyses revealed no significant change over time in the SF-36 Physical or Mental Component Summary scores, or the IES scores. In comparisons with other populations, at the 1 month follow-up assessment, melanoma patients reported similar QOL to patients with metastatic renal cell carcinoma who received the same treatment, significantly worse QOL on the physical dimensions and similar QOL on the psychosocial and emotional dimensions compared with the general population, similar QOL to patients with type II diabetes, and significantly better QOL on all three dimensions than patients with congestive heart failure. There was also a significant negative association between IES scores at baseline and mental health scores at each time point ( < 0.002 for all). QOL remained stable during treatment with the HSPPC-96 vaccine. In addition, patients who reported high levels of cancer-related intrusive thoughts at the start of treatment reported worse mental health at the end of the treatment.

Endocrine levels at the start of treatment are associated with subsequent psychological adjustment in cancer patients with metastatic disease.

OBJECTIVE: This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology. METHODS: Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the course of treatment: at the start of treatment (baseline), at the end of treatment (3 weeks after baseline), and at a follow-up appointment 1 month later. Cortisol, norepinephrine, and epinephrine levels were measured at baseline using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI). RESULTS: Patients reported moderate levels of distress throughout treatment as measured by the IES and BSI. Norepinephrine levels at the start of treatment were positively associated with IES total scores at the end of treatment and at follow-up, and cortisol levels were positively associated with IES total scores at follow-up after adjusting for baseline IES and overall distress scores. Norepinephrine levels were also positively associated with depression scores at follow-up, and cortisol levels were positively associated with depression scores at the end of treatment and at follow-up after adjusting for baseline depression and overall distress scores. CONCLUSIONS: Hormonal profiles at the start of cancer treatment are associated with subsequent psychological adjustment.

A 7-item versus 31-item food frequency questionnaire for measuring fruit, juice, and vegetable intake among a predominantly African-American population.

OBJECTIVE: This study sought to determine which of 2 fruit and vegetable food frequency questionnaires (FFQs) most closely approximated intake measured by the average of four 24-hour dietary recalls. DESIGN: Participants completed either a 31-item FFQ (n = 70) or 7-item FFQ (n = 76) on 2 occasions approximately 2 weeks apart. During the interval between FFQs1 participants provided four 24-hour dietary recalls via telephone interview. SUBJECTS/SETTING: Participants were 146 persons with food preparation responsibilities in families of students in grades 3 through 5. Respondents were predominantly African-American women in Atlanta, Ga. STATISTICAL ANALYSIS: Pearson correlation coefficients of log-transformed values estimated the reliability of each FFQ and compared FFQ estimates to reference values. The intraclass correlation coefficient evaluated consistency across 24-hour recalls. RESULTS: The first FFQs overestimated intake approximately twofold. The 31-item FFQ estimates exceeded 7-item FFQ estimates by approximately 30% . Correlations with recall estimates were high for the 7-item FFQ and moderate to low for the 31-item FFQ. The second FFQ estimates were more highly correlated to reference values. From the first to the second administration, 7-item FFQ estimates dropped from 5.2 to 2.7 servings, and 31-item FFQ estimates dropped from 6.7 to 3.5 servings. Neither FFQ produced highly reliable estimates. CONCLUSIONS: Mean total fruit and vegetable consumption was closer to reference estimates for the first 7-item FFQ and the second 31-item FFQ. The 7-item FFQ correlated more highly with reference estimates than did the 31-item FFQ. Therefore, we conclude that for African-American adults, a 1-time-administered FFQ using 7 broad food categories correlates more highly with reference values than a FFQ using 31 individual fruit and vegetable items.

Nicotine dependence, withdrawal symptoms, and adolescents' readiness to quit smoking.

The purpose of this study was to characterize nicotine dependence and nicotine withdrawal symptoms among adolescent smokers and to investigate associations between these key factors and adolescents' readiness to quit smoking. A total of 5624 high school students participated in a school-based survey. Of 1111 adolescents who were current or former smokers, the following stage-of-change distribution for smoking cessation was observed: precontemplation, 52.5%; contemplation, 16.0%; preparation, 7.5%; action, 13.2%; and maintenance, 10.8%. Among current smokers, 18.1% were substantially dependent on nicotine, 45.2% had moderate dependence, and 36.7% had no dependence. Higher proportions of current smokers than successful quitters reported withdrawal symptoms with their most recent quit attempts. Precontemplators exhibited significantly higher mean nicotine dependence scores than did students in the contemplation or preparation stages (F(2,837) = 12.03; p < 0.0001). A similar trend was observed for withdrawal-symptom scores across the stages of change. The nicotine dependence and withdrawal-symptom scores were significantly correlated (r = 0.44, p < 0.001). Nicotine dependence and nicotine withdrawal appear to interfere with adolescents' abilities and readiness to quit smoking, suggesting a potential role for nicotine replacement therapy in the treatment of tobacco use and dependence among adolescents.

Child-reported family and peer influences on fruit, juice and vegetable consumption: reliability and validity of measures.

Family, peers and other environmental factors are likely to influence children's dietary behavior but few measures of these phenomena exist. Questionnaires to measure family and peer influences on children's fruit, juice and vegetable (FJV) consumption were developed and pilot tested with an ethnically diverse group of Grade 4-6 children. Principal components analyses revealed subscales with acceptable internal consistencies that measured parent and peer FJV modeling, normative beliefs, normative expectations, perceived peer FJV norms, supportive and permissive parenting practices, food rules, permissive eating, and child food preparation. Internal consistencies were adequate to high, but test-re-test correlations often were low. Children also completed questionnaires on FJV availability and accessibility in the home, and food records for 2 days in the classroom. Parental modeling, peer normative beliefs and FV availability were significantly correlated with FJV consumption. Further research with these scales is warranted.

The association between treatment-specific optimism and depressive symptomatology in patients enrolled in a Phase I cancer clinical trial.

BACKGROUND: Previous research has found that cancer patients often overestimate the likelihood that they will achieve a positive response in Phase I trials. However, maintaining optimistic expectations may help patients cope with a poor prognosis and uncertain outcome. The authors prospectively examined the association between treatment-specific optimism and mental health among patients participating in a Phase I/b trial. METHODS: Twenty-four patients with metastatic renal cell carcinoma and 22 patients with metastatic melanoma completed an assessment battery at the beginning of treatment and 3 weeks later, on the final day of treatment. Patients completed measures of treatment-specific optimism (e.g., beliefs regarding the treatment working), depressive symptomatology, mood disturbance, and overall distress. RESULTS: The majority of patients believed that the treatment would either cure them (87%) or stop cancer progression (85%). Regression analyses revealed that the level of treatment-specific optimism (e.g., "The treatment I am receiving may cure me") was associated negatively with baseline measures of depressive symptoms (P < 0.006), mood disturbance (P < 0.001), and symptoms of distress (P < 0.0001) after controlling for age, number of metastases, and time since diagnosis. Patients with symptoms of clinical depression at baseline reported significantly lower levels of treatment-specific optimism than patients without symptoms (P < 0.03). Treatment-specific optimism also was associated negatively with symptoms of depression at the end of treatment (P < 0.003), controlling for symptoms of depression at the beginning of treatment. CONCLUSIONS: The results of the current study suggest that high levels of treatment-specific optimism are associated with better mental health outcomes at both the beginning and end of treatment.

Breaking bad news about cancer: patients' preferences for communication.

PURPOSE: The goal of this study was to assess patients' preferences regarding the way in which physicians deliver news about their cancer diagnosis and management. PATIENTS AND METHODS: A sample of 351 patients with a variety of cancers completed a measure assessing their preferences for how they would like to be told news about their cancer. Patients rated characteristics of the context and content of the conversation as well as physician characteristics. RESULTS: Factor analysis indicated that patients' preferences for how they would like to be told news regarding their cancer can be grouped into the following three categories: (1) content (what and how much information is told); (2) facilitation (setting and context variables); and (3) support (emotional support during the interaction). Women (P =.02) and patients with higher education (P =.05) had significantly higher scores on the Content scale, women (P =.02) had higher scores on the Support scale, and younger patients (P =.001) and those with more education (P =.02) had higher scores on the Message Facilitation scale. Medical variables were not associated with patients' ratings of the importance of the three subscales. CONCLUSION: Patients rated items addressing the message content as most important, though the supportive and facilitative dimensions were also rated highly. Understanding what is important to patients when told news about their cancer provides valuable information that may help refine how this challenging task is best performed.

Translational control in vertebrate development.

Translational control plays a large role in vertebrate oocyte maturation and contributes to the induction of the germ layers. Translational regulation is also observed in the regulation of cell proliferation and differentiation. The features of an mRNA that mediate translational control are found both in the 5' and in the 3' untranslated regions (UTRs). In the 5' UTR, secondary structure, the binding of proteins, and the presence of upstream open reading frames can interfere with the association of initiation factors with the cap, or with scanning of the initiation complex. The 3' UTR can mediate translational activation by directing cytoplasmic polyadenylation and can confer translational repression by interference with the assembly of initiation complexes. Besides mRNA-specific translational control elements, the nonspecific RNA-binding proteins contribute to the modulation of translation in development. This review discusses examples of translational control and their relevance for developmental regulation.

Socioenvironmental influences on children's fruit, juice and vegetable consumption as reported by parents: reliability and validity of measures.

OBJECTIVE: To pilot test theory-based questionnaires to measure socioenvironmental influences on children's fruit, juice and vegetable (FJV) consumption as reported by parents. DESIGN: Cross-sectional. SETTING: Parents of fourth to sixth grade students completed socioenvironmental questionnaires. The students completed food records (FRs) for 2 days in the classroom. SUBJECTS: Interviews were completed by 109 parents (17% African-American, 32% Hispanic-American and 51 Euro-American). RESULTS: Student mean daily FJV intake was 2.1 servings. Principal components analyses revealed subscales measuring positive and negative parenting practices; self-efficacy for modelling and planning/encouraging FJV consumption, and making FJV available; encouraging, consequences and discouraging food socialization practices; negative home, cost and canned/frozen food barriers; meal planning; child shopping; mother food preparation; and child lunch and dinner FJV preparation practices. Internal consistencies were adequate to high. Negative parent practices and negative home FJV barriers were significantly negatively correlated with child FJV consumption variables. Planning/encouraging self-efficacy was positively associated with fruit consumption, and child dinner FJV preparation was significantly negatively correlated with child juice consumption. CONCLUSIONS: These questionnaires may provide important insights about the relationship between parent-reported socioenvironmental influences and children's FJV consumption. Future work should test these questionnaires with larger groups of parents and youths, with more reliable estimates of usual FJV intake, e.g. 7-day food records, to obtain a detailed understanding of how parents influence what children eat. Tests of models of relationships among these variables are warranted, but should control for possible confounding variables, e.g. socioeconomic status, gender of the child, etc.

Depression, anxiety, and quality of life in patients with epithelial ovarian cancer.

OBJECTIVE: The aims of this study were to evaluate psychological distress and quality of life (QOL) in patients with epithelial ovarian cancer (EOC) and to examine the relationship between these problems and health and demographic variables. METHODS: Of 344 consecutive patients identified, 246 completed questionnaires. Four dimensions of QOL were assessed including physical, functional, emotional, and social/family well-being, as well as concerns specific to ovarian cancer patients. Depression was measured with the Center for Epidemiologic Studies-Depression (CES-D) scale and anxiety was measured by the State Anxiety Subscale of the Spielberger State-Trait Anxiety Inventory. Performance status was evaluated by the Zubrod score. RESULTS: Sixty-five patients (26%) had early stage disease; 181 (74%) had advanced disease. One hundred twenty-one patients (49%) were under active treatment, while 124 (51%) were seen for posttherapy surveillance. Forty-eight (21%) met CES-D cutoff criteria for a clinical evaluation for depression, and 29% scored above the 75th percentile for anxiety. Performance status was related to depression, anxiety, and QOL problems, except in the domain of social well-being. CONCLUSIONS: Clinically significant depression and anxiety may be more prevalent in patients with EOC than previously reported. Future studies of screening for and treating psychological distress are being designed to improve QOL in these women.

Validation of the modified Fagerström tolerance questionnaire with salivary cotinine among adolescents.

This study was conducted to gain evidence of validity for a nicotine dependence measure for adolescent smokers. We hypothesized that the individual item responses and the total Fagerström Tolerance Questionnaire (FTQ) score would be positively correlated with cotinine values. We examined the relationship between a seven-item modified FTQ and saliva continine among 131 adolescent volunteers in a smoking cessation program. As anticipated, the total FTQ score was related to saliva cotinine (r = .40, p < .01), as were six of the seven individual FTQ items (p < .05). Our findings provide preliminary evidence that the modified FTQ scale is valid and applicable to adolescent smokers.

The effects of type of surgery and time on psychological adjustment in women after breast cancer treatment.

BACKGROUND: The aim of the present study was to examine whether type of surgery, age, and time since surgery influenced psychological distress and quality of life (QOL) in women treated for breast cancer. METHODS: We surveyed 183 women who had undergone surgery for breast cancer. Psychological distress was measured with the Mental Health Inventory and QOL was measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. RESULTS: After controlling for stage of disease, radiation treatment, and age, there was a statistically significant interaction between type of surgery and time since surgery for the Mental Health Inventory total score, and a marginal interaction between type of surgery and time since surgery for the Global health status/QOL score. Women who had breast conservation surgery experienced significantly greater levels of psychological distress and marginally worse QOL from 40 months after surgery onward than did women who received a mastectomy. CONCLUSIONS: The effects of different surgical treatments for breast cancer on psychological distress and QOL become apparent only after a period of several years. Women, therefore, need counseling on the potentially positive and negative psychological implications of different surgical treatments for breast cancer.

Tobacco withdrawal signs and symptoms among women with and without a history of depression.

A past history of depression is associated with a decreased likelihood of quitting smoking. Tobacco withdrawal may be a mechanism through which depression history impedes smoking cessation. This research examined the influence of depression history on unmedicated tobacco withdrawal signs (polysomnographic measures of sleep) and symptoms (self-reported urge, negative affect, hunger, and sleep) among women (N= 13). Depression history was associated with differential withdrawal-induced changes in several REM sleep parameters. Self-report and other polysomnography (sleep fragmentation, slow-wave sleep) measures displayed statistically significant withdrawal effects but did not discriminate between depression history groups. These results suggest that REM sleep parameters may be sensitive to differential tobacco withdrawal responses that are not readily apparent through self-reported symptoms.

Effect of a la carte and snack bar foods at school on children's lunchtime intake of fruits and vegetables.

OBJECTIVES: To compare lunch fruit, juice, and vegetable (FJV) intake of fourth-grade students who receive only National School Lunch Program meals and fifth-grade students who also have access to a school snack bar and to compare FJV intake by meal source among fifth-grade students. DESIGN: Cross-sectional study: students completed FJV preference questionnaires and 5 days of lunch food records in classrooms. SUBJECTS/SETTING: 312 fourth- and 282 fifth-grade students in south Texas. MAIN OUTCOME MEASURES: Mean FJV consumption. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, correlation analyses, analysis of variance, analysis of covariance. RESULTS: Fourth-grade students (n = 312) consumed significantly more fruits, juices, and vegetables (0.80 serving) than fifth-grade students (n = 282) (0.60 serving). Students whose parents reported a high school education or less consumed more regular and total vegetables than students whose parents reported some college or higher education. There were no interaction effects among gender, grade, ethnic, or family education groups. Fifth-grade students who ate only snack bar meals consumed significantly less total fruits, juices, and vegetables (0.40 serving) than fifth-grade students who ate school lunch meals (0.82 serving). Controlling for FJV preferences did not change the main effect for grade level in the FJV consumption models. APPLICATIONS/CONCLUSIONS: FJV consumption during school lunch is low. School foodservice staff should identify FJV items that middle school students prefer and increase availability of those items in middle school cafeterias and snack bars.

Intraindividual variability and reliability in a 7-day exercise record.

PURPOSE: High levels of day-to-day or intraindividual variability implies unreliability of a measure of physical activity. Unreliability in a measure leads to attenuation of correlations with other variables. As intraindividual variability increases, the number of days necessary to assess physical activity to achieve the desired level of reliability increases. The use of an intraclass correlation to assess day-to-day reliability in a measure assumes compound symmetry. METHODS: This study reports on these issues in a sample of 165 elementary school teachers who maintained a 7-d record of physical activity each year for 3 yr. Analyses were conduced with physical activity measured as minutes, MET minutes, and kcal. Analyses were conducted with PROC MIXED in SAS controlling for the clustering effect by school. RESULTS: Compound symmetry could not be supported across 7 d of the record. The weekdays tended to intercorrelate, Saturday correlated at very low levels, and Sunday correlated with Monday only. Compound symmetry was supported across the three weeks. CONCLUSIONS: To achieve a reliability of 0.8 using a 7-d activity record requires 2 wk of assessment. The reliability of measures of physical activity require more careful attention, and likely require more points of assessment to achieve desired levels.

Systematic differences in validity of self-reported mammography behavior: A problem for intergroup comparisons?

BACKGROUND: Prior studies of recall accuracy for screening mammogram behavior have examined relatively homogeneous groups. Data are limited on possible systematic group differences, so we evaluated women's recall accuracy in two separate care systems in one city. Methods. Women 50 to 70 years old with and without screening mammograms 10 to 14 months prior were identified from fiscal, clinic, and radiology records at a military care system (MCS) and a county-funded system (CFS) for indigents. Mammogram status was verified through radiology records. Women were excluded if mammograms were diagnostic, done for other than annual screening, or had abnormal results. Interviewers blinded to mammogram status surveyed randomly selected eligible women. RESULTS: For 62 screened/31 unscreened MCS women and 78 screened/61 unscreened CFS women, specificity was similar, at 65 and 62%, respectively. In contrast, sensitivity varied significantly: 95% versus 79% (P = 0. 011). Primary ethonocultural groups were Euro-American (MCS-60%) and Mexican American (CFS-85%). Although not different in specificity of recall (67% versus 61%), these major subgroups significantly differed in sensitivity (97% versus 80%, P = 0.017), proportion of true negatives due to never having a mammogram (35% versus 57%, P = 0.003), and proportion with >/=high school education (78% versus 19%, P < 0.00001). CONCLUSION: Systematic differences in recall validity may exist and compromise the accuracy of intergroup comparisons.