From EatingWell: May/June 2010 Nobody will miss the meat in this colorful, zesty vegetarian taco salad. The rice and bean mixture can be made ahead and the salad quickly assembled at mealtime. Recipe by Nancy Baggett for EatingWell.
Fall brings with it school days, crisp air, turning leaves—and a spike in asthma symptoms. But spring can be tough for people with asthma, too, particularly if they have a pollen allergy. And summer heat waves are notorious for sending asthmatics, particularly asthmatic children in urban areas, to the emergency room. 
Most springtime sneezers—some one in five Americans—are aware they've got allergies. But knowing how best to treat them is another story. Drugstore aisles are stacked high with an array of pills, capsules, sprays, mists, and drops, and that's before you even get to the prescription options. The upside of all those choices, though, is "there is no need to suffer with seasonal allergies—good treatment is available," says Gainesville, Georgia, allergist Andy Nish, MD. The key to finding the products that will do the most for you, he says, is to first determine the severity, frequency, and duration of your symptoms, which may include sneezing, runny nose, nasal congestion, itchy throat, and itchy, watery eyes. 
If you've ever seen a brown haze of pollution hanging over your city, most likely your response was, "Ugh. How can I avoid breathing that stuff?" But let's face it, even if you know it's a bad air day, you probably need to grab some sunshine, get in an outdoor run, or get to work. 
By Sarah Wickline, Contributing Writer, MedPage Today Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse PlannerNote that this cohort study demonstrated several novel predictors of anxiety and depression among patients after a cancer diagnosis.Be aware that the overall prevalence of anxiety and depression was roughly 30 percent.In the year following a cancer diagnosis, some patients showed lingering or late-onset anxiety and/or depression, although most appeared to cope relatively well, researchers found.
Among 1,154 patients followed from initial cancer diagnosis, about 20% met criteria for clinically relevant anxiety and roughly 10% were found to have depression 6 and 12 months later, according to Allison W. Boyes, PhD, of the University of Newcastle in Australia, and colleagues.
Significant predictors of development of late-onset or persistent mood disorders in the prospective study included high levels of such disorders 6 months after diagnosis, but also such factors as gender, type of cancer, and certain coping styles, the researchers reported online in the Journal of Clinical Oncology.
"This is one of the first studies to examine the prevalence and predictors of the short-term courses of anxiety and/or depression among a diverse sample of cancer survivors in early survivorship," the researchers wrote.
They noted that most cancer survivors in this group showed psychological resilience, with either no mood disruption or only transient anxiety or depression.
Boyes and colleagues asserted that targeted screening and early intervention should be considered for more vulnerable patients to prevent or reduce the severity of psychological disorders.
Participants were recruited from the ongoing Cancer Survival Study, each having been diagnosed in the past 6 months with one of the top eight incident cancer types in Australia: prostate, colorectal, female breast, lung, melanoma, non-Hodgkin's lymphoma, leukemia, or head and neck cancer.
Along with a detailed questionnaire, each participant filled out the 14-item Hospital Anxiety and Depression Scale (HADS) initially at 6 months after diagnosis and again 12 months after diagnosis. Participants were designated as anxiety or depression cases at a particular assessment if HADS scores at in the relevant domains reached at least 8 on the 21-point scales.
The personal questionnaires assessed patient health behaviors, psychological history and social support systems. Up-to-date medical and treatment records were available for each patient.
Among those asked to participate in the study, 43% agreed. Sample retention between the two assessments was 95%. Participants were 18 to 80 years old and 58% were male.
Odds ratios were adjusted based on information obtained from the patient questionnaires concerning: marital status, education, employment, health insurance coverage, size of household, geographic location, the use of complementary therapies for cancer-related purposes, and the presence of physical comorbidities and/or significant life events that could have been a source of stress.
At the 6-month assessment, 22% (95% CI 20%-25%) qualified as anxiety, and after 12 months, 21% (95% CI 19%-24%) persisted.
At both 6 and 12 months, 13% (95% CI 11%-14%) qualified as depression, and 9% (95% CI 7%-10%) had comorbid anxiety and depression.
Overall, 70% (95% CI, 68%-73%) did not develop anxiety at any time, 82% (95% CI, 79%-84%) did not develop depression, and 87% (95% CI, 85%-89%) did not develop comorbid anxiety-depression.
Boyes and colleagues found that, among patients showing anxiety or depression during the study period, the trajectories varied. About half of patients qualifying as mood disorder cases had the conditions at both assessments. The remainder were about equally divided between those who qualified for case status only at the 12-month evaluation and those who met case criteria at month six but not at month 12.
Significant predictors of anxiety at 12 months included the following: Anxiety at 6 months (relative to no anxiety at 6 months): OR 10.7, 95% CI 7.2-15.0Depression at 6 months (relative to no depression at 6 months): OR 1.9, 95% CI 1.2-3.1Female gender (relative to male): OR 1.8, 95% CI 1.3-2.6"Fighting spirit" coping (relative to other coping styles): OR 1.7, 95% 1.1-2.8
For depression, the following factors were significantly associated with case status at 12 months: Depression at 6 months: OR 6.9, 95% CI 4.0-12.2Anxiety at 6 months: OR 2.6, 95% CI 1.6-4.4Low physical activity but not sedentary (relative to "sufficiently active"): OR 2.1, 95% CI 1.2-3.6Cancer not in remission (relative to remission): OR 1.8, 95% CI 1.1-2.9Lung cancer diagnosis (relative to melanoma): OR 5.3, 95% CI 1.9-15.1"Cognitive avoidance" coping: OR 1.7, 95% CI 1.1-2.8
Patients with comorbid anxiety-depression also had physical inactivity as a significantly predictor, along with both current and past smoking, with odds ratios ranging from 1.6 to 3.7.
"Given that feelings of vulnerability are common when active treatment is completed, it may be reassuring to give survivors in late treatment the message that most will adjust well and require only low-intensity supportive care, including information and self-management support," Boyes and colleagues wrote.
Routine psychological screening may not be necessary for all cancer survivors, the researchers suggested.
Instead, they advocated "targeted screening" of survivors with the risk factors for mood disorders identified in the study.
"Intervention trials focusing on psychological functioning, coping style, and health behaviors are warranted," Boyes and colleagues concluded.
The study was funded by the National Health and Medical Research Council, Cancer Council of New South Wales, Hunter Medical Research Institute, Honda Foundation and the University of Newcastle.
Study authors declared they had no relevant financial interests.
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