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Background and aim: Among couples coping with cancer diagnosis, the effects of gender, role (patient vs. spouse) and patient relationship status (single vs. partnered) on quality of life (QoL) have been investigated with inconsistent results. The present study examined the impact of gender, role and relationship status on male and female patients, their spouses and non-partnered patients. Method: A representative sample of 218 patients with a new primary cancer diagnosis (any type and stage) and their spouses (n = 137), were assessed within 8 weeks of diagnosis. Measures assessed multiple QoL dimensions including health-related and dyadic QoL as well as symptoms of distress: (anxiety, depression, intrusion, avoidance and hyperarousal). Results: Multivariate analyses of covariance revealed lower QoL for women versus men, and for spouses versus patients on a number of measures (health-related QoL, satisfaction with dyadic coping, anxiety and intrusions). Conclusions: Female spouses of cancer patients are at high risk of deteriorated QoL immediately after diagnosis, and require special attention to their psychosocial care needs. [ABSTRACT FROM AUTHOR]

Cancer patients and their partners experience elevated distress and unmet supportive care needs at the time of treatment, however, their ongoing needs have not been adequately described. This qualitative study explores the needs of disease-free cancer survivors and their partners using semi-structured telephone interviews. A convenience sample of 25 key informants' identified needs in the domains of information, health care, physical functioning, relationships, emotions, socio-economic issues, expectations and life perspective; and the positive outcomes are widely reported. The identification of unique needs of survivors and partners supports the development of supportive care measures to specifically assess ongoing care need in these populations. [ABSTRACT FROM AUTHOR]

Background: Partners of cancer patients typically provide the majority of patients' emotional and physical care. Partners may be profoundly affected by the cancer and may experience ongoing supportive care needs across the survivorship continuum. Research has been restricted by a lack of psychometrically evaluated measures and in this study, a self-report measure of partners' needs was developed and empirically evaluated. Methods: Questionnaire items generated from a qualitative study were constructed into a 47- item unmet need measure (Cancer Survivors' Partners Unmet Needs measure, CaSPUN). The psychometric properties of the CaSPUN were evaluated in 212 partners of patients who had been diagnosed with cancer 1–11 years earlier and were currently disease-free. Results: The CaSPUN was modified to include 35 unmet need items, 6 positive change items and an open ended item. The CaSPUN demonstrates a high level of acceptability, internal consistency and construct validity, although test–retest reliability was moderate. Factor analysis identified five discrete factors: (1) Relationships, (2) Information, (3) Partner Issues, (4) Comprehensive Care and (5) Emotional Support. Conclusions: The CaSPUN permits the identification of long-term supportive care needs in generic populations of cancer survivors' partners and will assist with the formulation of recommendations regarding required supportive care services. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many cancer survivors experience ongoing morbidity over the survivorship continuum and their supportive care needs have yet to be comprehensively assessed. METHODS: This study aimed to develop and empirically evaluate a self-report measure of cancer survivors' supportive care needs. In Phase I, questionnaire items were generated based upon previous qualitative research that identified both unique and shared needs in survivors and their partners; items were constructed into the Cancer Survivors' Unmet Needs measure (CaSUN). In Phase 2, the CaSUN was completed by 353 cancer survivors who had been diagnosed with cancer between 1 and 15 years earlier and were currently disease-free. RESULTS: After modification, the CaSUN included 35 unmet need items, 6 positive change items and an open-ended question. Good acceptability, internal consistency and validity were demonstrated, although test-retest reliability was low. Maximum likelihood factor analysis identified five discrete factors: Existential Survivorship, Comprehensive Care, Information, Quality of Life and Relationships. CONCLUSIONS: Preliminary data indicates that the CaSUN meets the majority of psychometric criteria for assessment measures, although its low test-retest reliability awaits further investigation. The CaSUN will facilitate the evaluation of supportive care services and generation of service delivery recommendations for cancer survivors. [ABSTRACT FROM AUTHOR]

Leymus chinensis (Trin.) Tzvelev and Phragmites communis Trin. are co-dominant grasses in both nutrient-poor and rich steppes in the Songnen Plains of northeastern China. A replacement series experiment was conducted along a five-level nutrient gradient to test for changes in the competitive relationships of the species with nutrient availability. There were significant effects of nutrient level and species proportion on mean plant height, biomass and rhizome length. Facilitation was found in these plant attributes for both species when grown in mixture compared with monoculture, especially at high nutrient levels. For example, L. chinensis grew taller and intercepted more light when in mixture. The aboveground dominance of P. communis did not decrease in mixture, possibly because it benefited from belowground interactions with L. chinensis. Biomass allocation was apparently influenced by both above and belowground competition. For example, L. chinensis allocated much more biomass to shoots and less to roots when neighbor number was increased, suggesting that aboveground competition occurred. Root: shoot ratios of L. chinensis in monoculture decreased gradually with increasing nutrient availability, whereas the ratio in mixture declined rapidly, implying intense competition for light at high levels. Our results support the hypothesis that nutrient competition is more important than light competition when soil nutrients are scarce. Although the interactions between these species benefit both, P. communis is more likely to displace L. chinensis at high nutrient availability. [ABSTRACT FROM AUTHOR]

Objective: To review the role of genetic counselling for individuals with psychiatric illnesses.Method: Using schizophrenia as an example and including updated information about a genetic subtype (22q deletion syndrome), we discuss the value of the genetic counselling process in psychiatry, with support from the literature and our clinical experience.Results: Genetic counselling, the process through which knowledge about the genetics of illnesses is shared, provides information on the inheritance of illnesses and their recurrence risks; addresses the concerns of patients, their families, and their health care providers; and supports patients and their families dealing with these illnesses. For comprehensive medical management, this service should be available to all individuals with schizophrenia and their families.Conclusions: New findings in the genetics of psychiatric illness may have important clinical implications for patients and their families. [ABSTRACT FROM AUTHOR]

Diagnosis of autosomal dominant adult polycystic kidney disease (APKD) is possible by ultrasonographic scanning (USS) or by using DNA markers linked to the PKD1 locus. Ultrasonography is complicated by the age dependent penetrance of the gene and linkage studies are subject to recombination errors owing to meiotic crossing over and locus heterogeneity. This study draws on data collected from a voluntary family register of APKD over 10 years. Records of 150 families were examined, ultrasound reports were obtained from 242 people at 50% prior risk, and 37 families were typed for DNA markers. The fraction of APKD resulting from loci unlinked to PKD1 (designated PKD2 here) was calculated at 2.94% (upper confidence limit 8.62%). Some subjects who were negative on initial scan later gave a positive scan, but there was no example of a definite gene carrier aged over 30 giving a negative scan. In families large enough for linkage analysis, most people who were at 50% prior risk could be given a final risk below 5% or above 95%, by using combined ultrasound and DNA studies. [ABSTRACT FROM PUBLISHER]

One hundred and ninety subjects from 100 adult polycystic kidney disease (APKD) families on the North Western Regional Genetic Register were interviewed to determine the likely demand for prenatal diagnosis. A detailed questionnaire was used to assess understanding and experience of clinical, therapeutic, and genetic aspects of APKD. Major features of the disease (presence of renal cysts which can lead to renal failure) and forms of therapy (dialysis and transplantation) were known; knowledge of less common features was related to experience. The cohort had had genetic counselling and the majority knew the risk to their own offspring, although the mechanics of the mode of inheritance was often misunderstood. Uptake of presymptomatic ultrasound testing was high, and some implications of early diagnosis are noted. A minority changed their reproductive behaviour as a result of APKD, and although the majority felt a prenatal test should be available, only 23% at high risk of passing on the disease and contemplating children felt they would be interested, and so far only one request for prenatal diagnosis has been received. Thus, demand appears to be low and to be related to perception of the seriousness of APKD. [ABSTRACT FROM PUBLISHER]

Twenty-four families with adult onset polycystic kidney disease were typed for markers flanking the PKD1 locus on chromosome 16. The aggregated results gave a significant lod score in favour of linkage to PKD1. Within this group of families two showed unusual features: recombinations, including double recombinations, and, in one family, an unexpectedly high proportion of affected people. We consider the evidence that in these families the disease might result from a mutation at a different locus, PKD2, not linked to PKD1. We suggest that a useful test is to compare the relative numbers of meioses apparently non-recombinant and doubly recombinant for markers flanking the normal disease locus, ignoring meioses recombinant for only a single marker. Using this test, neither our two families nor the data published so far on other families provide compelling evidence for the existence of a second locus for adult polycystic kidney disease. For genetic counselling in families too small to give internal evidence for or against linkage, the extra uncertainty can be handled by using a higher recombination rate. [ABSTRACT FROM PUBLISHER]

A recent report from the Departments of Health draws attention to the value of DNA diagnosis for inherited diseases and the need for planning these services in the National Health Service. There is great potential for preventive medicine, but a major immediate benefit is the newfound ability to exclude the carrier state in many people at risk and to protect fetuses from abortion when, as in most cases, they are shown to be normal by DNA tests. However, the widespread application of these new techniques requires prior evaluation and general acceptance. This will only be obtained after public debate, education of professionals and the population, and the establishment of adequate non-directive genetic counselling services. Some of the points to be considered in setting up molecular genetics laboratories are described. [ABSTRACT FROM PUBLISHER]