"It just made me feel better": qualitative examination of the implementation of a novel virtual psychosocial support program for adolescents with cancer.

PURPOSE: Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact. METHODS: We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS: We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens, and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programming in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents' and clinicians' acceptability, feasibility, and perceived utility. CONCLUSION: Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming, such as Teens4Teens, is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.

Structural, thermal and rheological properties of starches isolated from Indian quinoa varieties.

In this study starches isolated from Indian quinoa varieties were examined for physicochemical, morphological, thermal and rheological properties. Among isolated starches V1 showed higher starch yield and lower purity (48.45% and 98.32%) than V2 (41.28 and 98.53%). The amylose content was higher for V1 (12.10%) than V2 (9.46%). Swelling powers and solubility of the starches increased with increasing temperature. Peak viscosity (386.4 RVU) was higher for V1. In contrast V2 showed higher pasting temperature (72.85°C). Low setback viscosity of the starches suggests that they can be profitably used in frozen and refrigerated foods. Starch granules from both varieties were irregular, angular and polygonal in shape. The starch granule size obtained by SEM was 1.23µm for V1 and 1.19µm for V2. Both starches showed a typical A-type diffractrometric pattern with varying crystallinity. Further V1 showed lower transition temperatures (To, Tp and Tc) than V2. FTIR spectroscopy showed higher intensity and broader shape of V2 at OH stretch which can be due to its higher crystallinity. Increased interest is shown in quinoa starch because of its unique microcrystalline granules. Higher yield and purity values suggest that both varieties can be exploited for commercial starch utilization.

Resource implications of palliative chemotherapy for ovarian cancer.

PURPOSE: To describe the costs and outcomes of palliative chemotherapy in women with recurrent and refractory ovarian cancer from the perspective of a health care provider. PATIENTS AND METHODS: A retrospective study of 40 consecutive women who started second- or third-line chemotherapy for recurrent or refractory ovarian cancer between 1989 and 1992. Resource utilization from the commencement of second- or third-line chemotherapy until death or last follow-up evaluation was determined from a detailed chart review. All elements of care were recorded, including inpatient admissions, outpatient visits, chemotherapy drugs, nonchemotherapy drugs, radiation therapy, surgical procedures, investigations, and home care. Costs calculated using the hotel-approximation method are expressed in 1994 Canadian dollars. Actuarial estimates of cost and survival were used to account for censored observations. RESULTS: After a minimum follow-up period of 24 months, 36 of 40 women had died. The median survival duration of the group was 1.1 years from study entry and 1.7 years from first relapse. The women received a median of two regimens of chemotherapy (range, one to four) from study entry. They spent a median of 33 days as hospital inpatients (mean, 46; range, 0 to 185); 58% of these inpatient days were for symptomatic management and 32% were for chemotherapy. The mean cost per patient was $53,000 (median, $36,600; range, $4,800 to $162,900). The relationship between cost and survival duration was not linear--the cost per year was lowest for those who lived longest. Inpatient admissions, chemotherapy drugs, and outpatient visits accounted for 62%, 21%, and 8% of the total cost, respectively. The total costs attributable to chemotherapy were $24,000 (45% of total costs) and the total costs attributable to supportive care were $23,000 (43% of total costs). CONCLUSION: These data illustrate the cost of palliative management of recurrent and refractory ovarian cancer, which must be considered in the context of quality and duration of survival. They indicate the potential to improve cost efficiency by improving resource management, for example, by shifting from inpatient to outpatient chemotherapy, everything else being equal.

Non-genotoxic p53-activators and their significance as antitumor therapy of future.

The tumor suppressor protein p53 mediates critical cellular functions including regulation of cell cycle, apoptosis, DNA repair, and senescence. This protein has been found to be inactivated or functionally down-regulated in several malignancies such as Li-Fraumeni syndrom, hepatocellular carcinoma, breast cancer, cervical cancer, and acute myeloid leukemia. Thus, p53 represents an attractive target for therapeutic design and development of new anticancer agents. The most clinically used cytotoxic agents target stabilization of wt-p53 through DNA damage and are associated with several unwanted and life threatening side effects. There are a number of recently developed approaches that hold promise for non-genotoxic reactivation of p53. Earlier, we have reported various inhibitors of p53 and their importance to prevent unwanted death of normal cells in a variety of diseases [1]. To extend p53 protein as new target for anticancer agents, in this review we discussed the mechanisms of p53 inactivation. Subsequently, we described some of recently developed non-genotoxic activators of p53 and their significance in various neoplastic disorders. Additionally, we summarized advantages of nongenotoxic p53-activating agents over conventional anticancer therapy and challenges in future of p53 based therapy.

Vermouth: technology of production and quality characteristics.

The aperitif wine, known as vermouth, is primarily prepared by adding a mixture of herbs and spices or their extract to a base wine. As such, it could also be called aromatized liquor, or a fortified wine. Various plant parts, such as seeds, wood, leaves, bark, or roots in dry form can be used in flavoring. These additives may be infused, macerated, or distilled in a base white wine, or added at various stages of preparation. The final liquid is filtered, pasteurized, and fortified (by the addition of alcohol). Some vermouths are sweetened, whereas other are left unsweetened (dry vermouth). These tend to have a bitterish finish. The two versions differ in alcohol content as well. Vermouths are most commonly prepared from grape-based wines, but fruit-based wines made from mango, apple, plum, sand pear, and wild apricot may also be used. These possess distinct physicochemical and sensory qualities from standard vermouths. The review gives comprehensive information on the historical developments and technology of vermouth production, the various spices and herbs used in its production, and its quality characteristics. In addition, the chapter also discusses the commercial potential of nongrape fruits in vermouth production.

Applicability of pectate-entrapped Lactobacillus casei cells for L(+) lactic acid production from whey.

Lactic acid is a versatile organic acid, which finds major application in the food, pharmaceuticals, and chemical industries. Microbial fermentation has the advantage that by choosing a strain of lactic acid bacteria producing only one of the isomers, an optically pure product can be obtained. The production of L: (+) lactic acid is of significant importance from nutritional viewpoint and finds greater use in food industry. In view of economic significance of immobilization technology over the free-cell system, immobilized preparation of Lactobacillus casei was employed in the present investigation to produce L: (+) lactic acid from whey medium. The process conditions for the immobilization of this bacterium using calcium pectate gel were optimized, and the developed cell system was found stable during whey fermentation to lactic acid. A high lactose conversion (94.37%) to lactic acid (32.95 g/l) was achieved with the developed immobilized system. The long-term viability of the pectate-entrapped bacterial cells was tested by reusing the immobilized bacterial biomass, and the entrapped bacterial cells showed no decrease in lactose conversion to lactic acid up to 16 batches, which proved its high stability and potential for commercial application.