Purpose-To assess the prevalence of depression among low-income, ethnic minority women with breast or gynecological cancer, receipt of antidepressant medications or counseling services, and correlates of depression.Patients and Methods-Study patients were 472 women receiving cancer care in an urban public medical center. Women had a primary diagnosis of breast (Stage 0-III) or gynecological cancer (FIGO 0-3B). A diagnostic depression screen and baseline questionnaire was administered prior to or during active treatment or during active follow-up. Self-report data was collected on receipt of depression treatment, use of supportive counseling, pain and receipt of pain medication, functional status and well-being, and perceived barriers to cancer care.Results-Twenty-four percent of women reported moderate to severe levels of depressive disorder, 30% of breast cancer patients and 17% of gynecological cancer patients. Only 12% of women meeting criteria for major depression reported currently receiving medications for depression and only 5% of women reported seeing a counselor or participating in a cancer support group. Neither cancer stage or treatment status was correlated with depression. Primary diagnosis of breast cancer, younger age, greater functional impairment, poorer social/family well-being, anxiety, comorbid arthritis, and fears about treatment side effects were correlated with depression.Conclusion-Findings indicate that depressive disorder among ethnic minority, low-income women with breast or gynecological cancer is prevalent and is correlated with pain, anxiety and health-related quality of life (HRQL). Because these women are unlikely to receive depression treatment or supportive counseling, there is a need for routine screening, evaluation and treatment in this population.

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The use of microorganisms as support for reduction of dissolved Pd(II) to immobilized Pd(0) nanoparticles is an environmentally friendly approach for Pd recovery from waste. To better understand and engineer Pd(0) nanoparticle synthesis, one has to consider the mechanisms by which Pd(II) is reduced on microbial surfaces. Escherichia coli, Shewanella oneidensis, and Pseudomonas putida were used as model organisms in order to elucidate the role of microbial cells in Pd(II) reduction under acidic conditions. Pd(II) was reduced by formate under acidic conditions, and the process occurred substantially faster in the presence of cells as compared to cell‐free controls. We found no difference between native (untreated) and autoclaved cells, and could demonstrate that even a non‐enzymatic protein (bovine serum albumin) stimulated Pd(II) reduction as efficiently as bacterial cells. Amine groups readily interact with Pd(II), and to specifically test their role in surface‐assisted Pd(II) reduction by formate, we replaced bacterial cells with polystyrene microparticles functionalized with amine or carboxyl groups. Amine‐functionalized microparticles had the same effect on Pd(II) reduction as bacterial cells, and the effect could be hampered if the amine groups were blocked by acetylation. The interaction with amine groups was confirmed by infrared spectroscopy on whole cells and amine‐functionalized microparticles. In conclusion, bio‐supported Pd(II) reduction on microbial surfaces is possibly mediated by a non‐enzymatic mechanism. We therefore suggest the use of amine‐rich biomaterials rather than intact cells for Pd bio‐recovery from waste. Biotechnol. Bioeng. 2012; 109:1889–1897. © 2012 Wiley Periodicals, Inc.

BACKGROUND. Attention to the economic consequences of cancer has grown as the number of cancer survivors is increasing. Although prevalent among low‐income minority survivors, the impact of economic stress on quality of life (QOL) remains largely unexplored. METHODS. Data are reported for 487 predominantly Hispanic low‐income women with a primary diagnosis of breast or gynecological cancer and undergoing active treatment or follow‐up. Cross‐sectional and longitudinal analyses examined the effects of economic concerns on QOL, depression, and anxiety. RESULTS. Rates of unemployment, medical cost and wage concerns, and financial stress were high in this study population, at baseline, respectively, 70%, 68%, 47%, and 49%. The proportions reporting unemployed status and medical cost concerns stayed flat from baseline to 6 months, followed by a pronounced drop at 12 months. Patient reported rates of lost wage worries increased from baseline to 6 months, followed by a moderate decrease. Functional, emotional, physical, and social‐family well‐being and depression and anxiety scores exhibited consistent linear improvement from baseline to 12 months. Over 12 months, patients reporting economic concerns had significantly poorer functional, emotional, and affective well‐being. CONCLUSIONS. Economic stress is negatively associated with QOL, highlighting the importance of addressing economic stress in low‐income women with cancer. Cancer 2008. © 2007 American Cancer Society.

Study results support the combining of interventions and the practical utility of a clinical decision-making algorithm to determine individualized nonadherence risk and to assign service intensity based on individual need. Problems in locating women for enrollment were experienced.

The intervention team--a peer counselor and a master's degreed social worker--addressed multiple psychosocial and systems navigation problems to reduce potential barriers to adherence, including knowledge, attitudinal, psychosocial, psychological distress, systems communication, and resource access problems. SAFe appears highly acceptable to women and may significantly enhance medical care management following an abnormal cervical screen for a carefully targeted group of women at risk for suboptimal follow-up adherence.

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The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented and illustrated in the Screening Adherence Follow-up (SAFe) protocol: (1) evidence for known risks and barriers for the target population; (2) standardized assessment elements; (3) evidence for the accuracy, efficiency, and validity of the protocol in use. Testing of the assessment tool in a pilot study of more than 600 women demonstrated practical utility in matching assessed needs with service intensity and confirmed that differential amounts of service and different provider effort achieved equally satisfactory adherence results. The evidence-based components described and the types and nature of evidence on which they draw can be generalized to new settings and client concerns.