Increasing patients' knowledge of radiation therapy.

Scripts for a set of patient education programs were developed by a multidisciplinary team of health care professionals to provide information to cancer patients receiving a 4-7 week course of external beam radiation therapy. The programs were designed to be presented sequentially at three critical points during a course of treatment: Pretreatment, Treatment Week 2, and Final Treatment Week. A total of 72 patients, 24 per program, with cancers of the lung, breast, or prostate, were assessed for their level of knowledge after hearing the audiotape appropriate to their treatment phase (posttest). Half of the patients, on a random basis, were also assessed prior to hearing their tape (pretest). This split design allowed the differentiation of true learning effects from effects of multiple assessments. Knowledge test items were developed from learning objectives for each program. Posttest results indicate a very high level of patient learning for all three programs, significantly exceeding the target of 75% correct. For patients tested twice, posttest scores were significantly higher than pretest scores. No testing effects were found for the Pretreatment and Treatment Week 2 programs. Final Treatment Week subjects who were pretested scored slightly higher on the posttest than their controls who were not pretested; however, additional analysis demonstrated true learning effects for this group as well. The results indicate that the programs are effective for increasing patients' knowledge regarding their treatment program, its side effects, and strategies to manage those side effects. Further research and intervention programs are discussed.

Beta2-microglobulin in human colostrum and milk: effect of breast feeding and physico-chemical characterization.

A statistically significant increase in beta2-microglobulin concentration in babies' sera after birth was accompanied by a decrease in beta2-microglobulin concentration in sera of nursing and non-nursing mothers; the amount by which babies' sera concentrations increased was not correlated with the decrease in serum or milk concentrations in their mothers. These results suggest that breast feeding does not affect the concentration of beta2-microglobulin in babies' sera. Furthermore, there was no relationship between serum beta2-microglobulin concentration of mothers and their babies at either point of observation. In all instances, however, the beta2-microglobulin concentration was significantly higher in infants' sera than in mothers' sera.

The effects of an AIDS diagnosis on undergraduate nursing students' care of dying patients.

Nurse educators frequently deal with nursing students' discomfort in learning to care for dying patients. However, teaching students how to care for dying patients with acquired immune deficiency syndrome (AIDS) presents unique and interesting challenges. The authors describe the influence an AIDS diagnosis has on students' comfort levels in touching and talking to dying patients. Recommendations and teaching strategies to assist nurse educators are provided.

Sentence comprehension in preschool children: testing an adaptive egocentrism hypothesis.

A hypothesis proposing that preoperational egocentrism serves an adaptive function was used to predict the comprehension behavior of preschool children presented with sentences varying on a "personal" dimension. Personal sentences containing the subject's name were contrasted at 2 levels of syntactic complexity with impersonal sentences containing other familiar nouns. Significant effects were found for age, semantics, and syntax (all p's less than .001), with no sex effects or interactions. Personal sentences were better comprehended than impersonals at both levels of syntactic complexity. A second experiment was conducted to rule out "focusing of attention" as an alternative explanation. Variations in the likelihood of occurrence of the depicted event were added to the personal-impersonal contrast. High-probability personal sentences were significantly better understood than low-probability sentences, whether personal or impersonal (p less than .001). Results supported the adaptive egocentrism hypothesis in that sentence content describing the child and his personal experience facilitates the child's comprehension.

Pancreatic oncofetal antigen and carcinoembryonic antigen in breast and colon carcinoma.

Pancreatic oncofetal antigen (POA) and carcinoembryonic antigen (CEA) were determined in plasma of 195 patients with breast cancer and 90 patients with colon carcinoma. Increased levels of POA and CEA were seen in 19.0 and 25.6% of patients with breast cancer, respectively. Some but not all patients showed an increase in both markers. The incidence of abnormal concentrations of POA and CEA increased with the progress of the disease. POA appears to be a useful marker in breast cancer, especially in patients who have normal CEA levels. On the other hand, colon carcinoma patients showed increased POA concentrations considerably less frequently than CEA levels.

Ontogeny of pancreatic oncofetal antigen.

Serum concentration of pancreatic oncofetal antigen (POA) was determined in human fetuses, newborns and pregnant women. The mean fetal concentration of POA (mean = 5.27 micrograms/ml) changed very little with gestational age. Also, only a weak correlation was found between POA concentration of newborns (mean = 5.15 micrograms/ml) and their birth weight. It appears that between the 19th and 40th weeks of gestation POA exhibits no fetospecific features, i.e. POA concentration did not exceed significantly the concentration of nonpregnant adults (mean = 6.10 micrograms/ml). A number of pathophysiological variables was correlated with POA concentrations of newborns. The most striking statistical differences were found between American black and white newborns and adults; the mean concentration of POA in sera of black full-term newborns was 5.38 micrograms/ml as compared to white newborns, where the mean concentration was 3.58 micrograms/ml. Similarly, black mothers had a mean concentration (mean = 12.21 micrograms/ml) significantly greater than white mothers (mean = 5.62 micrograms/ml).

Response of patients with carcinoma of the breast to hormonal therapy and combination chemotherapy.

Of the 89 patients with disseminated carcinoma of the breast treated with combination or sequential cyclophosphamide, fluorouracil and vincristine, 63 had received evaluable course of endocrine therapy and chemotherapy. The response to endocrine therapy, regardless of its nature or duration, failed to predict response to subsequent chemotherapy. Selection of the patients on the basis of pretreatment disease free interval, menopausal status or metastatic pattern showed the groups of patients to be homogeneous in distribution. In addition, evaluation for a disease free interval greater or less than two years, menopausal status and visceral or nonvisceral metastasis did not allow identification of groups predicting responsiveness to combination chemotherapy.