Delivering What We PROMISED: Outcomes of a Coaching and Leadership Fellowship for Mentors of Underrepresented Mentees.

Research demonstrates that mentorship can significantly improve career success, career satisfaction, and persistence for underrepresented (UR) minority faculty. However, many UR faculty members do not receive the mentorship they need, nor do mentors always possess the range of skills required to guide UR mentees through the unique challenges they face. We developed a 1-year fellowship training program, PROMISED, designed to help mentors promote career self-authorship and leadership among their UR mentees. PROMISED fellows participated in a two-day in-person training to develop career coaching skills, followed by a series of one-month leadership training/mentoring modules. We assessed mentors' skills at the start and completion of the program. We found that PROMISED fellows reported an increase in perceived skill level in nearly every training topic, with "addressing diversity" demonstrating the most significant change. These results provide evidence that career coaching and leadership training offer an effective supplement to traditional mentor training and that mentors can incorporate these skills effectively into their mentoring practice. Taken together, we believe our data suggest that a program designed to train mentors in coaching and leadership can enhance career satisfaction, persistence, and retention of their UR mentees.

Towards a more comprehensive understanding of cancer burden in North Carolina: priorities for intervention.

OBJECTIVE: To apply 4 measures of population burden in examining cancer burden in North Carolina and to identify priorities for intervention. METHODS: Four measures were used: incidence, mortality, prevalence, and years of potential life lost (YPLL). The North Carolina Central Cancer Registry provided summary data on incidence and mortality and record-level data that were examined using SEER*Stat software to calculate prevalence. North Carolina vital statistics (mortality) data and life expectancy estimates stratified by age, race, and sex were used to calculate YPLL. Each cancer site was ranked according to burden for each of the 4 individual burden measures and summarized into an overall rank. Burden was examined overall and by sex and race. PRINCIPAL FINDINGS: Four cancers--lung/bronchus, female breast, prostate, and colon/rectum--accounted for approximately 57% of the total cancer incidence, prevalence, mortality, and YPLL in North Carolina. Patterns of burden in gender and race subgroups were similar, although non-whites often had higher mortality rates than did whites despite similar incidence rates. An estimated 207,583 people were living with cancer in 2004 Breast and prostate cancer accounted for 42% of these survivors. Lung/bronchus cancer was the most severe cancer, accounting for more deaths and years of life lost than any other 5 cancers combined. CONCLUSIONS: Each of the 4 measures provides unique insight and guidance for cancer coordination and control efforts. Lung/bronchus, female breast, prostate, and colon/rectum cancers accounted for the majority of North Carolina's cancer burden and should be priorities for intervention.

Increased serum levels of 8-hydroxy-2'-deoxyguanosine in clinical depression.

OBJECTIVE: We sought to understand the pathophysiological effects of depression by examining group differences in serum levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), a biomarker of oxidative damage. METHODS: Our sample consisted of 169 participants. Eight-four of these participants met diagnostic criteria for clinical depression. The 85 participants in our comparison group were matched on age, gender, and ethnicity to the depressed group. 8-OHdG was measured by enzyme-linked immunosorbent assay. RESULTS: After adjusting for age, gender, race/ethnicity, years of education, daily smoking, average number of alcoholic drinks per week, average amount of physical activity per week, and body mass index, participants in the depressed group had significantly higher levels of oxidative DNA damage compared with participants in the control group. Pairwise comparisons showed that participants with major depression had significantly higher levels of 8-OHdG than control subjects and marginally higher levels of 8-OHdG compared with those with minor depression. Furthermore, participants with recurrent episodes of depression had more oxidative damage than participants with single episodes, who in turn had more damage than healthy control subjects. Finally, participants with recurrent episodes of major depression had more DNA damage than other depressed participants, who in turn had more damage than healthy control subjects. CONCLUSIONS: Our findings suggest that increased oxidative damage may represent a common pathophysiological mechanism, whereby depressed individuals become vulnerable to comorbid medical illness.

How new subscribers use cancer-related online mailing lists.

BACKGROUND: Online cancer-related support is an under-studied resource that may serve an important function in the information seeking, care, and support of cancer patients and their families. With over 9.8 million cancer survivors (defined as anyone living with cancer) in the United States alone and the number growing worldwide, it is important to understand how they seek and use online resources to obtain the information they need, when they need it, and in a form and manner appropriate to them. These are stated cancer communication goals of the US National Cancer Institute. OBJECTIVES: Our purposes are to (1) present background information about online mailing lists and electronic support groups, (2) describe the rationale and methodology for the Health eCommunities (HeC) study, and (3) present preliminary baseline data on new subscribers to cancer-related mailing lists. In particular, we describe subscribers' use of mailing lists, their reasons for using them, and their reactions to participating shortly after joining the lists. METHODS: From April to August 2004, we invited all new subscribers to 10 Association of Cancer Online Resources mailing lists to complete Web-based surveys. We analyzed baseline data from the respondents to examine their perceptions about cancer-related mailing lists and to describe how cancer patients and survivors used these lists in the period shortly after joining them. RESULTS: Cumulative email invitations were sent to 1368 new mailing list subscribers; 293 Web surveys were completed within the allotted time frame (21.4% response rate). Most respondents were over age 50 (n = 203, 72%), white (n = 286, 98%), college graduates (n = 161, 55%), and had health insurance (n = 283, 97%). About 41% (n = 116) of new subscribers reported spending 1 to 3 hours per day reading and responding to list messages. They used the mailing lists for several reasons. Among the most frequently reported, 62% (n = 179) strongly agreed they used mailing lists to obtain information on how to deal with cancer, 42% (n = 121) strongly agreed they used mailing lists for support, and 37% (n = 109) strongly agreed that they were on the mailing lists to help others. Smaller proportions of new subscribers strongly agreed that others on the mailing lists had similar cancer experiences (n = 23, 9%), that they could relate to the experiences of others on the lists (n = 66, 27%), and that others on the list gave them good ideas about how to cope with cancer (n = 66, 27%). CONCLUSIONS: Cancer-related online mailing lists appear to be an important resource, especially for information seeking but also for support of cancer survivors. These were the primary motivators most members reported for joining mailing lists. The modest proportion of subscribers who strongly agreed that they could relate to others' cancer experiences (as well as similar responses to other process questions) is undoubtedly due at least in part to the short duration that these subscribers were involved with the mailing lists. Emerging data, including our own, suggest that mailing lists are perhaps under-used by minority patients/survivors. These preliminary data add to a growing body of research on health-related online communities, of which online mailing lists are one variant.

Depression and oxidative damage to lipids.

Depression is associated with increased morbidity and mortality from cardiovascular and cerebrovascular diseases. Oxidative damage to lipids is one of the key early events in the etiology of atherosclerosis, the pathologic condition that underlies these diseases. The current study examines the pathophysiological consequences of depression by comparing serum levels of F(2α)-isoprostanes (8-iso-PGF(2α)), a biomarker of oxidative damage to lipids, in a group of depressed individuals (n=73) and a matched comparison group (n=72). The depressed group had significantly higher levels of serum 8-iso-PGF(2α), while controlling for age, gender, race, years of education, daily smoking, number of alcoholic drinks per week, average amount of physical activity per week, and body mass index. Analyses using interviewer ratings on the Hamilton Scale revealed that, within the depressed cohort, there was no significant association between the severity of symptoms and levels of 8-iso-PGF(2α), suggesting this is a threshold rather than a dose-response relationship. Results extend on our knowledge of depression and oxidative damage to lipids. In conclusion, oxidative damage to lipid molecules may represent a common pathophysiological mechanism by which depressed individuals become more vulnerable to atherosclerosis and its clinical sequelae.

Epidemiology of cancer-related fatigue in the Swedish twin registry.

BACKGROUND: Estimates of the prevalence of cancer-related fatigue (CRF) are wide, and data suggest that fatigue is more prevalent among cancer patients than among the general population. However, most studies examining the prevalence of CRF have been hospital-based or clinic-based studies, which often are subject to bias. METHODS: Point prevalence and prevalence odds ratios of fatigue were estimated using data from a large, population-based cohort that was screened for fatigue and linked with national registry-based data about cancer. Prevalence odds ratios and 95% confidence intervals were calculated using logistic regression with general estimating equations. RESULTS: Approximately 23% of cancer registrants reported abnormal fatigue in the previous 6 months, 19% reported abnormal fatigue that lasted for at least 1 month, 14% reported abnormal fatigue that lasted at least 6 months, and 11% reported abnormal fatigue that lasted at least 6 months and caused significant functional impairment. Individuals who were listed in the cancer registry within the last 5 years were more likely to report experiencing fatigue than individuals who were not listed. There was an elevated prevalence of fatigue among those who were registered with carcinomas of the lung, uterine cervix, colon-rectum, ovaries, and prostate. Both women and men who were listed recently in the cancer registry were more likely to experience any level of fatigue than the comparison group. However, a greater proportion of women experienced fatigue relative to men. CONCLUSIONS: A greater proportion of individuals who were listed in a national cancer registry reported experiencing fatigue compared with individuals in the general population.

THE EFFECTS OF STRESS ON DNA REPAIR CAPACITY.

Research has shown that lymphocytes of high-distress patients have reduced DNA repair relative to that of low-distress patients and healthy controls. Furthermore, deficits in repair are associated with an increased risk of cancer. Using and academic stress model, we hypothesized that students would exhibit lower levels of Nucleotide Excision Repair (NER) during a stressful exam period when compared to a lower stress period. Participants were 19 healthy graduate level students. NER was measured in lymphocytes using the unscheduled DNA synthesis (UDS) assay with slide autoradiography. Contrary to prediction, mean values for NER significantly increased during the higher stress period relative to the lower stress period controlling for background differences in repair. Furthermore, lymphocytes had significantly increased repair of endogenous damage during the higher stress period. Stress appears to directly increase DNA repair. Additionally, stress may increase DNA repair indirectly by increasing damage to DNA.

Unique tissue-specific level of DNA nucleotide excision repair in primary human mammary epithelial cultures.

DNA repair is essential for the maintenance of genomic integrity and stability. Nucleotide excision repair (NER) is a major pathway responsible for remediation of damage caused by UV light, bulky adducts, and cross-linking agents. We now show that NER capacity is differentially expressed in human tissues. We established primary cultures of peripheral blood lymphocytes (PBLs: N = 33) and foreskin fibroblasts (FF: N = 6), as well as adult breast tissue (N = 22) using a unique culture system, and measured their NER capacity using the unscheduled DNA synthesis (UDS) functional assay. Relative to FF, primary cultures of breast cells exhibited only 24.6 +/- 2.1% of NER capacity and PBLs only 8.9 +/- 1.2%. Cells from the breast therefore have a unique and distinctive DNA repair capacity. The NER capacities of all three cell types had similar coefficients of variation in the range of 10%-15%, which should be taken into account when running controls for this contextual assay. Unlike previous studies and speculation in the field, we found that NER was not affected by cell morphology, donor age, or proliferation as measured by the S phase index. While the NER capacity of the transformed lymphoblastoid cell line TK6 was within the range of our PBL samples, the breast tumor-derived MDA MB-231 cell line was four-fold higher than normal breast tissue. These studies show that analysis of baseline DNA repair in normal human cell types is critical as a basis for evaluation of the effects of "mutator" genes as etiological factors in the development of cancer.