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Hardardottir H, Aspelund T, Fall K, Broström E, Sigurdsson BB, Cook E, Valdimarsdottir H, Fang F, Sloan EK, Lutgendorf SK, Jansson C, Valdimarsdottir UA. Psychobiological stress response to a lung cancer diagnosis: a prospective study of patients in Iceland and Sweden. Acta Oncol 2023; 62:1338-1347. [PMID: 37747345 DOI: 10.1080/0284186x.2023.2258445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND A diagnostic work-up leading to a lung cancer diagnosis is a severely stressful experience that may impact tumor progression. Yet, prospective data are scarce on psychological and biological components of stress at the time of lung cancer diagnosis. The aim of this study was to assess pre-to-post diagnosis change in psychological distress and urinary excretion of catecholamines in patients with suspected lung cancer. METHODS Participants were 167 patients within the LUCASS study, recruited at referral for suspected lung cancer to University Hospitals in Iceland and Sweden. Patients completed questionnaires on perceived distress (Hospital Anxiety and Depression Scale, HADS) before and after diagnosis of lung cancer or a non-malignant origin. A subpopulation of 85 patients also provided overnight urine for catecholamine analysis before and at a median of 24 days after diagnosis but before treatment. RESULTS A lung cancer diagnosis was confirmed in 123 (73.7%) patients, with a mean age of 70.1 years. Patients diagnosed with lung cancer experienced a post-diagnosis increase in psychological distress (p = 0.010), while patients with non-malignant lung pathology showed a reduction in distress (p = 0.070). Both urinary epinephrine (p = 0.001) and norepinephrine (p = 0.032) levels were higher before the diagnosis among patients eventually diagnosed with lung cancer compared to those with non-malignant lung pathology. We observed indications of associations between pre-to-post diagnosis changes in perceived distress and changes in urinary catecholamine levels. CONCLUSION Receiving a lung cancer diagnosis is associated with an increase in psychological distress, while elevated catecholamine levels are evident already before lung cancer diagnosis.
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Affiliation(s)
- Hronn Hardardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erika Broström
- Department of Immunology, Genetics and Pathology, Clinical and Experimental Pathology, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Baldur B Sigurdsson
- Department of Clinical Chemistry, Landspitali University Hospital, Reykjavik, Iceland
| | - Elizabeth Cook
- Department of Clinical Chemistry, Landspitali University Hospital, Reykjavik, Iceland
| | - Heiddis Valdimarsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erica K Sloan
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Christer Jansson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Unnur A Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Calidad de sueño, variables personales, laborales y estilo de vida de enfermeros de hospital. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5756.3576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: identificar posibles asociaciones entre la calidad de sueño, las variables personales y laborales y los estilo de vida de los enfermeros de hospital. Método: estudio transversal, exploratorio, correlacional, cuantitativo, realizado de octubre a diciembre de 2019. Los datos fueron recolectados mediante un cuestionario que abordó las características personales, estilo de vida y condiciones de trabajo de los encuestados. Para evaluar la calidad de sueño, se utilizó el Pittsburgh Sleep Quality Index (PCSI), versión en portugués de Brasil. Resultados: participaron 42 profesionales, 31 (73,8%) mujeres, con edad entre 26 y 66 años (media 40,2); el 61,9% trabajaba horas extras; el 26,2% tenía dos vínculos laborales y el 40,5% faltó al trabajo. La calidad de sueño fue considerada buena por el 9,5% de los participantes, mala por el 64,3% y con trastornos del sueño por el 26,2%. El 26,2% de la población que hacía turnos rotativos, calificó la calidad como mala. Los peores resultados se encontraron en la franja etaria de 30 a 39 años y hubo significación estadística en la variable “vive en pareja”. Conclusión: la calidad de sueño de los enfermeros se vio afectada; es necesario monitorear a estos trabajadores, en particular a los que trabajan por turnos, a fin de implementar medidas preventivas que reduzcan los daños a su salud.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Sleep quality, personal and work variables and life habits of hospital nurses. Rev Lat Am Enfermagem 2022; 30:e3577. [PMID: 35584413 PMCID: PMC9109468 DOI: 10.1590/1518-8345.5756.3577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/13/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. METHOD a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents' personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. RESULTS the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the "living with a partner" variable. CONCLUSION there was impairment in the nurses' sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Rita de Cássia de Marchi Barcellos Dalri
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Alan Luiz Eckeli
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | | | | | - Maria Lúcia do Carmo Cruz Robazzi
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
- Universidade Federal da Paraíba, João Pessoa, PB, Brasil
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Sleep quality, personal and work variables and life habits of hospital nurses. Rev Lat Am Enfermagem 2022. [PMID: 35584413 PMCID: PMC9109468 DOI: 10.1590/1518-8345.5756.3538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Abstract Objective: to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. Method: a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents’ personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. Results: the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the “living with a partner” variable. Conclusion: there was impairment in the nurses’ sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Study protocol for an open labelled randomised controlled trial of perioperative oral nutrition supplement in breast and colorectal cancer patients undergoing elective surgery. Trials 2021; 22:767. [PMID: 34732233 PMCID: PMC8565021 DOI: 10.1186/s13063-021-05716-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/12/2021] [Indexed: 01/04/2023] Open
Abstract
Background While it is well established that perioperative use of oral nutrition supplement (ONS) improves nutrition status among severely malnourished surgical cancer patients, the evidence requires further substantiation for non-severely malnourished patients with cancer. This protocol paper presents the rationale and design of a randomised controlled trial to evaluate the effectiveness of preoperative as well as an extended 90-day postoperative use of ONS on nutritional and clinical outcomes among patients undergoing elective surgery for breast and colorectal cancer. Methods Patients with primary breast and colorectal cancer undergoing elective surgery are recruited from two tertiary hospitals. Eligible patients are assigned into one of the three intervention arms: (i) Group SS will receive ONS in addition to their normal diet up to 14 days preoperatively and postoperatively up to discharge; (ii) Group SS-E will receive ONS in addition to their normal diet up to 14 days preoperatively, postoperatively up to discharge and for an extended 90 days after discharge; and (iii) Group DS will receive ONS in addition to their normal diet postoperatively up to discharge from the hospital. The ONS is a standard formula fortified with lactium to aid in sleep for recovery. The primary endpoints include changes in weight, body mass index (BMI), serum albumin and prealbumin levels, while secondary endpoints are body composition (muscle and fat mass), muscle strength (handgrip strength), energy and protein intake, sleep quality, haemoglobin, inflammatory markers (transferrin, high sensitivity C-reactive protein, interleukin-6), stress marker (saliva cortisol), length of hospital stay and postoperative complication rate. Discussion This trial is expected to provide evidence on whether perioperative supplementation in breast and colorectal cancer patients presenting with high BMI and not severely malnourished but undergoing the stress of surgery would be beneficial in terms of nutritional and clinical outcomes. Trial registration ClinicalTrial.gov NCT04400552. Registered on 22 May 2020, retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05716-5.
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Crumpei-Tanasă I, Crumpei I. A Machine Learning Approach to Predict Stress Hormones and Inflammatory Markers Using Illness Perception and Quality of Life in Breast Cancer Patients. ACTA ACUST UNITED AC 2021; 28:3150-3171. [PMID: 34436041 PMCID: PMC8395480 DOI: 10.3390/curroncol28040275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
Psychosocial factors have become central concepts in oncology research. However, their role in the prognosis of the disease is not yet well established. Studies on this subject report contradictory findings. We examine if illness perception and quality of life reports measured at baseline could predict the stress hormones and inflammatory markers in breast cancer survivors, one year later. We use statistics and machine learning methods to analyze our data and find the best prediction model. Patients with stage I to III breast cancer (N = 70) were assessed twice, at baseline and one year later, and completed scales assessing quality of life and illness perception. Blood and urine samples were obtained to measure stress hormones (cortisol and adrenocorticotropic hormone (ACTH) and inflammatory markers (c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fibrinogen). Family quality of life is a strong predictor for ACTH. Women who perceive their illness as being more chronic at baseline have higher ESR and fibrinogen values one year later. The artificial intelligence (AI) data analysis yields the highest prediction score of 81.2% for the ACTH stress hormone, and 70% for the inflammatory marker ESR. A chronic timeline, illness control, health and family quality of life were important features associated with the best predictive results.
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Affiliation(s)
- Irina Crumpei-Tanasă
- Department of Psychology, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, 700554 Iași, Romania
- Correspondence:
| | - Iulia Crumpei
- Faculty of Medicine, Grigore T. Popa University, 700115 Iași, Romania;
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Lim DH, Kim TI, Park SM, Ki KS, Kim Y. Effects of photoperiod and light intensity on milk production and milk composition of dairy cows in automatic milking system. JOURNAL OF ANIMAL SCIENCE AND TECHNOLOGY 2021; 63:626-639. [PMID: 34189510 PMCID: PMC8204001 DOI: 10.5187/jast.2021.e59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to determine the effects of photoperiod and light intensity on milk production, milk composition, hormones levels and blood metabolites indices of Korean Holstein dairy cows in automatic milking system (AMS). A total of 24 Holstein dairy cows were selected and used to four subsequent treatments for the experimental periods of 60 days. The light programs consisted of (1) Control: the natural photoperiod with 14.2 h of the light period and 9.4 h of the dark period (below 10 Lux); (2) T1: 16 h of the long day photoperiod (LDPP) with 50 Lux of light; (3) T2: 16 h of LDPP with 100 Lux of light; and (4) T3: 16 h of LDPP with 200 Lux of light, respectively. Importantly, there was a significant difference in the thurl activity of dairy cows between the different light intensity programs (p < 0.05). Milk yield was higher in T1 and T2 (40.80 ± 1.71 and 39.90 ± 2.02 kg/d, respectively) than those of Control and T3 (32.18 ± 1.51 and 35.76 ± 2.80 kg/d, respectively) (p < 0.05), but DMI was lower in T1, T2, and T3 compared to Control (p < 0.05). Also, milk fat percentage, the contents of milk fat and total solids were higher in T2 than those in the others (p < 0.05). The average daily melatonin level in milk was high to T3 (28.20 ± 0.43 pg/mL), T2 (24.62 ± 0.32 pg/mL), T1 (19.78 ± 0.35 pg/mL), and Control (19.36 ± 0.45 pg/mL) in order (p < 0.05). Also, the cortisol levels in milk and blood were lower in treatment groups than in Control (p < 0.05). The results of this study showed that it will be effective to improve the milk yield and milk composition, and to reduce the stress of dairy cows when the light conditions regulate to extend the photoperiod to 16 h at a light emitting diode (LED) intensity of 100 Lux under the AMS in dairy farm.
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Affiliation(s)
- Dong-Hyun Lim
- Dairy Science Division, National Institute of Animal Science, Rural Development Administration, Cheonan 31000, Korea
| | - Tae-Il Kim
- Dairy Science Division, National Institute of Animal Science, Rural Development Administration, Cheonan 31000, Korea
| | - Sung-Min Park
- Dairy Science Division, National Institute of Animal Science, Rural Development Administration, Cheonan 31000, Korea
| | - Kwang-Seok Ki
- Dairy Science Division, National Institute of Animal Science, Rural Development Administration, Cheonan 31000, Korea
| | - Younghoon Kim
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, Seoul National University, Seoul 08826, Korea
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Pereira M, Moreira CS, Nogueira-Silva C, Izdebski P, Pereira MG. Breast cancer post-surgical impact on women´s quality of life during chemotherapy treatment: A structural equation modelling approach. Eur J Cancer Care (Engl) 2020; 30:e13349. [PMID: 33159394 DOI: 10.1111/ecc.13349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/02/2020] [Accepted: 08/07/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Breast cancer is an important public health problem that is increasing in incidence, being a stressor with a negative impact on women's quality of life. This study is focused on the evaluation of temporal precursors (one month before) of women's quality of life undergoing chemotherapy, considering post-surgical personal, clinical, cognitive and neuropsychophysiological factors, according to the Transactional Stress and Coping Model. METHODS This longitudinal study included 112 patients with breast cancer. Data were collected in two different moments: before and during the adjuvant chemotherapy. Structural equation modelling was used to support a theoretically based model in which some antecedent factors impact patients' long-term quality of life through a set of mediators. RESULTS The associations of breast symptoms, body image and sexual functioning with psychological distress and quality of life were totally mediated by illness perceptions, while the associations of working memory with psychological distress and quality of life were totally mediated by self-efficacy for coping. Patients with greater psychological distress showed higher levels of nadir cortisol. CONCLUSIONS Results showed the importance of assessing patients' perceptions of their illness, prior to chemotherapy, as well as promoting more self-efficacy for coping, in order to improve women's emotional state and quality of life.
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Affiliation(s)
- Marta Pereira
- School of Psychology, University of Minho, Psychology Research Center (CIPsi), Braga, Portugal
| | - Célia Sofia Moreira
- Faculty of Sciences and Center of Mathematics (FCUP & CMUP), University of Porto, Porto, Portugal
| | - Cristina Nogueira-Silva
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Life and Health Sciences Research Institute /3B's-PT Government Associate Laboratory, Braga, Portugal.,Department of Obstetrics and Gynaecology, Hospital de Braga, Braga, Portugal
| | - Pawel Izdebski
- Institute of Psychology of the Kazimierz Wielki, University in Bydgoszcz, Bydgoszcz, Poland
| | - M Graça Pereira
- School of Psychology, University of Minho, Psychology Research Center (CIPsi), Braga, Portugal
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The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors. Support Care Cancer 2019; 28:3935-3944. [DOI: 10.1007/s00520-019-05233-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
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Strahler J, Nater UM, Skoluda N. Associations between Health Behaviors and Factors on Markers of Healthy Psychological and Physiological Functioning: a Daily Diary Study. Ann Behav Med 2019; 54:22-35. [DOI: 10.1093/abm/kaz018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Cross-sectional and experimental knowledge highlight the contribution of various health-promoting behaviors, such as physical activity, regular sleep, and healthy nutrition to mental and physical health. Beyond these well-studied lifestyle behaviors, music listening and perceived respect in social interactions are just recently proposed everyday life experiences, which may act as health-promoting factors.
Purpose
This study tested the simultaneous contribution of several health-promoting behaviors and factors and examined listening to music and positive social interaction by means of perceived respect as new potentially preventive and health-promoting behaviors and factors using an ambulatory assessment design.
Methods
Seventy-seven young healthy adults (38 women, 23.9 ± 4.5 years) completed surveys on their psychological state (i.e., mood, stress, and fatigue) five times a day for four consecutive days. A saliva sample was collected with each data entry to explore the physiological stress markers salivary cortisol, alpha-amylase, and flow rate as further outcome variables. As predictors, perceived respect, self-reported physical activity, the sleep’s restfulness, daily coffee, alcohol, vegetable/fruit consumption, and music listening behavior were recorded.
Results
Overall, restful sleep, mean daily perceived respect, and listening to music were most clearly associated with more positive psychological states, that is, better mood and lower fatigue and perceived stress. Associations with daily alcohol, coffee, and vegetable/fruit consumption appeared rather minor. While perceived respect scores were associated with lower daily cortisol output, coffee consumption was positively related to daily cortisol and alpha-amylase. Self-reported physical activity was unrelated to either outcome measure.
Conclusions
These findings provide important insights regarding potential resources of health (i.e., music and respect), their covariation, and which psycho-physiological mechanisms may underlie the links between health factors and well-being. Findings also have implications for the development of interventions aiming to increase resilience and foster health. Here, strategies for improving sleep quality, the use of music, and approaches that emphasize mutual respect and appreciation appear useful additions.
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Affiliation(s)
- Jana Strahler
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Psychotherapy and Systems Neuroscience, Department of Psychology and Sport Science, Justus Liebig University Giessen, Giessen, Germany
| | - Urs M Nater
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
| | - Nadine Skoluda
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Tübingen, Germany
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
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Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi SM, Balouchi A. Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat 2019; 176:519-533. [PMID: 31087199 DOI: 10.1007/s10549-019-05271-3] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/04/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE Depression in patients with breast cancer imposes huge costs to patients, families, and healthcare systems. The present study aimed at evaluating the global prevalence depression among patients with breast cancer. METHODS In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from 1 January, 2000 until 30 March, 2019. The Hoy tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS Of 47,424 studies, 72 studies performed in 30 countries entered the final stage of analysis. The global prevalence of depression was 32.2%. Specifically, the prevalence of depression was highest in the Eastern Mediterranean region and twice as high in middle-income countries as compared to developed countries. CONCLUSIONS Regarding the high prevalence of depression in patients with breast cancer, it is vital to carry out screening within standard time periods and offer the necessary emotional support.
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Affiliation(s)
- Motahare Pilevarzadeh
- Department of Nursing Education, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | | | - Hosein Rafiemanesh
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mehdi Hashemi
- Clinical Immunology Research Center, Department of Internal Medicine, Hematology and Medical Oncology Ward, Ali-Ebne-Abitalelb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Abbas Balouchi
- Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran
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Hulett JM, Fessele KL, Clayton MF, Eaton LH. Rigor and Reproducibility: A Systematic Review of Salivary Cortisol Sampling and Reporting Parameters Used in Cancer Survivorship Research. Biol Res Nurs 2019; 21:318-334. [PMID: 30857393 DOI: 10.1177/1099800419835321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Salivary cortisol is a commonly used biomarker in cancer survivorship research; however, variations in sampling protocols and parameter reporting limit comparisons across studies. Standardized practices to provide rigor and reproducibility of diurnal salivary cortisol sampling and reporting are not well established. Previous systematic reviews examining relationships between diurnal salivary cortisol and clinical outcomes have resulted in mixed findings. It remains unclear which sampling protocols and reporting parameters offer the greatest utility for clinical research. This review examines diurnal salivary cortisol sampling protocols and reporting parameters to evaluate whether a standardized approach is recommended. A comprehensive search of intervention studies among adult cancer survivors including diurnal salivary cortisol resulted in 30 articles for review. Sampling protocols ranged from 1 to 4 days with the majority of studies sampling cortisol for 2 days. Sampling instances ranged from 2 to 7 times per day, with the majority collecting at 4 time points per day. Diurnal cortisol slope and cortisol awakening response (CAR) were the most commonly reported parameters associated with clinical outcomes. Flattened cortisol slopes, blunted CARs, and elevated evening cortisol concentrations were associated with poorer psychosocial and physiological outcomes. Based on our review, we propose that a rigorous, standardized diurnal salivary cortisol sampling protocol should include sampling at key diurnal times across ≥3 consecutive days to report diurnal cortisol parameters (i.e., CAR and slope) and objective measures of participant protocol adherence. Diminishing budgetary resources and efforts to minimize participant burden dictate the importance of standardized cortisol sampling protocols and reporting parameters.
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Affiliation(s)
- Jennifer M Hulett
- 1 College of Nursing, University of South Carolina, Columbia, SC, USA
| | | | | | - Linda H Eaton
- 4 School of Nursing & Health Studies, University of Washington, Bothell, Bothell, WA, USA
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Salivary cortisol reveals overt and hidden anxiety in survivors of childhood cancer attending clinic. J Affect Disord 2018; 240:105-112. [PMID: 30059936 DOI: 10.1016/j.jad.2018.07.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/11/2018] [Accepted: 07/14/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Symptoms of anxiety may arise from fear of cancer recurrence and memories of traumatic experiences during treatment. This study aimed to identify changes in mental health and cortisol, a biological marker of stress, associated with oncology surveillance clinic attendance. METHODS Adolescent and young adult (AYA) survivors of childhood cancer (aged 12-30 years, N = 46) attending a survivorship clinic were recruited. The State-Trait Anxiety Inventory, an anxiety self-rating and open answer question, and salivary cortisol collections were completed two weeks before and one day before clinic, on clinic day and two weeks after. RESULTS Trait anxiety scores were consistent with the normal population. State anxiety scores two weeks after clinic were significantly lower than baseline (p = 0.02). Cortisol diurnal slopes were flatter than baseline after clinic (p = 0.02). Evening cortisol levels were significantly higher than baseline two weeks post clinic (p = 0.02). LIMITATIONS Combined results from biological and psychometric assessments can be difficult to interpret. Larger cohorts will further delineate cortisol pathway activity and distress in AYA cancer survivors. CONCLUSIONS Psychometric evidence indicates that AYA survivors of childhood cancer perceive themselves to be less anxious after a survivorship clinic visit. Biological evidence, however, indicates a dysregulation of the hypothalamic-pituitary-adrenal axis which may be linked to clinic attendance. Weak correlations suggest that cortisol may not be a reliable indicator of self-perceived anxiety. This may be due to confounding lifestyle factors influencing the stress response or potential 'coping strategies' developed during past treatment experience which may, hypothetically, have masked self-perceived anxiety.
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Reinhardt ÉL, Fernandes PACM, Markus RP, Fischer FM. Night work effects on salivary cytokines TNF, IL-1β and IL-6. Chronobiol Int 2018; 36:11-26. [PMID: 30230913 DOI: 10.1080/07420528.2018.1515771] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Shift work is unavoidable in modern societies, but at the same time disrupts biological rhythms and contributes to social distress and disturbance of sleep, health and well-being of shift workers. Shift work has been associated with some chronic diseases in which a chronic inflammatory condition may play a role. However, few studies investigating the association of cytokine and other inflammation markers with shift workers have been published in recent years. In this study we evaluated the effects of permanent night work on the production of tumor necrosis factor (TNF), interleukin-1β (IL-1β), IL-6 and melatonin in saliva. Another aim was to demonstrate the benefit of the use of salivary cytokines for studies in chronobiology, since it is an easy and non-invasive method that allows for sampling at several times. Thirty-eight healthy male workers, being 21 day workers and 17 night workers, agreed to participate in this study. Sleep was evaluated by actigraphy and activity protocols. Saliva was collected during three workdays approximately at the middle of the work shift and at bed and wake times of the main sleep episode. Saliva samples were then analyzed by enzyme-linked immunosorbent assay to measure TNF, IL-1β, IL-6 and melatonin levels, and the results were submitted to non-parametric statistical analysis. The use of saliva instead of blood allowed for a greater number of samples from the same subjects, allowing identifying alterations in the daily production patterns of salivary cytokines TNF, IL-1β and IL-6 that probably are linked to night work. Salivary TNF and IL-1β levels were similar for day and night workers, with higher daily production after awakening, in the morning hours for day workers and in the afternoon for night workers. Both groups presented a significant daily variation pattern of these two cytokines. Day and night workers produced similar amounts of salivary IL-6. Nevertheless, the daily variation pattern observed among day workers, with a peak after awakening, was absent among night workers. Thus, in our study, night workers showed partially adjusted daily variation patterns for salivary TNF and IL-1β, not seen for salivary IL-6. Results for salivary IL-6 could be better explained as a consequence of circadian disruption due to permanent night work. Our results suggest that the whole circadian system, including clocks and pineal gland, is involved in regulating cytokine profile in shift workers and that a coordinated production of these cytokines, important for an adequate inflammatory response, could be disturbed by shift work. The distinct effects that shift work may have on different cytokines could give some cues about the mechanisms involved in this association.
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Affiliation(s)
| | | | - Regina P Markus
- b Laboratory of Chronopharmacology, Department of Physiology , Institute of Bioscience, University of São Paulo , São Paulo , Brazil
| | - Frida Marina Fischer
- c Department of Environmental Health , School of Public Health, University of São Paulo , São Paulo , Brazil
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15
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Bastos DB, Sarafim-Silva BAM, Sundefeld MLMM, Ribeiro AA, Brandão JDP, Biasoli ÉR, Miyahara GI, Casarini DE, Bernabé DG. Circulating catecholamines are associated with biobehavioral factors and anxiety symptoms in head and neck cancer patients. PLoS One 2018; 13:e0202515. [PMID: 30125310 PMCID: PMC6101398 DOI: 10.1371/journal.pone.0202515] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 08/03/2018] [Indexed: 02/06/2023] Open
Abstract
Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamine secretion profiles in head and neck cancer patients. The present study investigated plasma norepinephrine and epinephrine levels in head and neck squamous cell carcinoma (HNSCC) patients and patients with oral leukoplakia, as well as their association with clinicopathological and biobehavioral variables and anxiety symptoms. A total of 93 patients with HNSCC and 32 patients with oral leukoplakia were included. Plasma norepinephrine and epinephrine levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED), and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Plasma norepinephrine and epinephrine concentrations were significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) compared to non-cancer patients. Oral SCC patients displayed plasma norepinephrine levels about six times higher than oropharyngeal SCC patients, and nine times higher than oral leukoplakia patients (p < .001). Plasma epinephrine levels in oral SCC patients were higher compared to the oropharyngeal SCC (p = .0097) and leukoplakia (p < .0001) patients. Oropharyngeal SCC patients had higher plasma norepinephrine (p = .0382) and epinephrine levels (p = .045) than patients with oral leukoplakia. Multiple regression analyses showed that a history of high alcohol consumption was predictive for reduced plasma norepinephrine levels in the oral SCC group (p < .001). Anxiety symptom of “hand tremor” measured by the BAI was an independent predictor for higher plasma norepinephrine levels in HNSCC patients (β = 157.5, p = .0377), while the “heart pounding/racing” symptom was independently associated with higher plasma epinephrine levels in the oropharyngeal SCC group (β = 15.8, p = .0441). In oral leukoplakia patients, sleep deprivation and worse sleep quality were independent predictors for higher plasma norepinephrine levels, while severe tobacco consumption and higher anxiety levels were factors for higher plasma epinephrine levels. These findings suggest that head and neck cancer patients display sympathetic nervous system hyperactivity, and that changes in circulating catecholamines may be associated with alcohol consumption, as well as withdrawal-related anxiety symptoms.
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Affiliation(s)
- Daniela B. Bastos
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Bruna A. M. Sarafim-Silva
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Maria Lúcia M. M. Sundefeld
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Amanda A. Ribeiro
- Department of Medicine, Nephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Juliana D. P. Brandão
- Department of Medicine, Nephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Éder R. Biasoli
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Glauco I. Miyahara
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Dulce E. Casarini
- Department of Medicine, Nephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel G. Bernabé
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- * E-mail:
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16
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Shiyko MP, Siembor B, Greene PB, Smyth J, Burkhalter JE. Intra-individual study of mindfulness: ecological momentary perspective in post-surgical lung cancer patients. J Behav Med 2018; 42:102-110. [DOI: 10.1007/s10865-018-9942-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/30/2018] [Indexed: 01/26/2023]
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17
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Pulopulos MM, Kozusznik MW. The moderating role of meaning in life in the relationship between perceived stress and diurnal cortisol. Stress 2018; 21:203-210. [PMID: 29373936 DOI: 10.1080/10253890.2018.1429397] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Previous studies have suggested that meaning in life may buffer the negative effects of stress. This study is the first to investigate the moderating role of meaning in life in the relationship between the perception of stress and diurnal cortisol in two independent samples of healthy adults. In study 1 (n = 172, men = 82, women = 90, age range = 21-55 years, mean age = 37.58 years), the results of moderated regression analyses revealed that there was a significant positive relationship between overall perceived stress in the past month and both diurnal cortisol levels (area-under-the-curve with respect to the ground; AUCg) and the diurnal cortisol slope (DCS) only in individuals with low levels of meaning in life conceptualized as the degree to which one engages in activities that are personally valued and important. In study 2 (n = 259, men = 125, women = 134, age range = 18-54 years, mean age = 29.06 years), we found a non-significant interaction term between meaning in life conceptualized as having goals and a sense of excitement regarding one's future and perception of stress in a model of both adjusted AUCg and DCS. The results were independent of age, sex, body mass index, education, and race. The results shed light on the importance and the complexity of the construct of meaning in life and offer a possible explanation for why some people who face stressors may be more vulnerable than others to developing stress-related health problems.
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Affiliation(s)
- Matias M Pulopulos
- a Department of Experimental Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Malgorzata W Kozusznik
- b Research Group for Work, Organizational and Personnel Psychology (WOPP) , Katholieke Universiteit Leuven , Leuven , Belgium
- c IDOCAL , University of Valencia , Valencia , Spain
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18
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Zeichner SB, Zeichner RL, Gogineni K, Shatil S, Ioachimescu O. Cognitive Behavioral Therapy for Insomnia, Mindfulness, and Yoga in Patients With Breast Cancer with Sleep Disturbance: A Literature Review. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2017; 11:1178223417745564. [PMID: 29434470 PMCID: PMC5802619 DOI: 10.1177/1178223417745564] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/23/2017] [Indexed: 11/16/2022]
Abstract
The number of patients with breast cancer diagnosed with sleep disturbance has grown substantially within the United States over the past 20 years. Meanwhile, there have been significant improvements in the psychological treatment of sleep disturbance in patients with breast cancer. More specifically, cognitive behavioral therapy for insomnia (CBT-I), mindfulness, and yoga have shown to be 3 promising treatments with varying degrees of benefit, supporting data, and inherent limitations. In this article, we will outline the treatment approach for sleep disturbance in patients with breast cancer and conduct a comprehensive review of CBT-I, mindfulness, and yoga as they pertain to this patient population.
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Affiliation(s)
- Simon B Zeichner
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Rachel L Zeichner
- Sleep Medicine Center, Atlanta Veterans Affairs Health Care System, Decatur, GA, USA.,Atlanta VA Clinic, Atlanta Veterans Affairs Health Care System, Decatur, GA, USA
| | - Keerthi Gogineni
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Sharon Shatil
- Sleep Medicine Center, Atlanta Veterans Affairs Health Care System, Decatur, GA, USA
| | - Octavian Ioachimescu
- Sleep Medicine Center, Atlanta Veterans Affairs Health Care System, Decatur, GA, USA.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
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19
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Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
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20
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Carlson LE, Zelinski EL, Speca M, Balneaves LG, Jones JM, Santa Mina D, Wayne PM, Campbell TS, Giese-Davis J, Faris P, Zwicker J, Patel K, Beattie TL, Cole S, Toivonen K, Nation J, Peng P, Thong B, Wong R, Vohra S. Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors. Contemp Clin Trials 2017; 59:64-76. [PMID: 28576734 PMCID: PMC5639905 DOI: 10.1016/j.cct.2017.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/26/2017] [Accepted: 05/29/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE A growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics. METHODS AND SIGNIFICANCE The design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N=600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of mood states (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/Heart Rate Variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.
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Affiliation(s)
- Linda E Carlson
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Cancer Control Board, Alberta Health Services, AB, Canada.
| | - Erin L Zelinski
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Cancer Control Board, Alberta Health Services, AB, Canada
| | - Michael Speca
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Cancer Control Board, Alberta Health Services, AB, Canada
| | - Lynda G Balneaves
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer M Jones
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Janine Giese-Davis
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Cancer Control Board, Alberta Health Services, AB, Canada
| | - Peter Faris
- Centre for Advancement of Health, Alberta Health Services, AB, Canada
| | - Jennifer Zwicker
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Kamala Patel
- Department of Immunology, University of Calgary, Calgary, AB, Canada
| | - Tara L Beattie
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada
| | - Steve Cole
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kirsti Toivonen
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jill Nation
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Philip Peng
- Department of Anesthesia, University of Toronto, ON, Canada
| | - Bruce Thong
- Department of Athletics and Recreation, McMaster University, Hamilton, ON, Canada
| | - Raimond Wong
- Department of Oncology, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sunita Vohra
- Department of Pediatrics, Faculty of Medicine and Dentistry, Integrative Health Institute, University of Alberta, Edmonton, AB, Canada
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21
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Wan C, Couture-Lalande MÈ, Lebel S, Bielajew C. The role of stressful life events on the cortisol reactivity patterns of breast cancer survivors. Psychol Health 2017; 32:1485-1501. [DOI: 10.1080/08870446.2017.1346194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Cynthia Wan
- School of Psychology, University of Ottawa, Ottawa, Canada
| | | | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Canada
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22
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Kim M, Kim JE, Lee HY, Kim AR, Park HJ, Kwon OJ, Kim EJ, Park YC, Seo BK, Cho JH, Kim JH. Moxibustion for cancer-related fatigue: study protocol for a randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:353. [PMID: 28679410 PMCID: PMC5499061 DOI: 10.1186/s12906-017-1856-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
Background Cancer-related fatigue is one of the most common symptoms experienced by cancer patients, and it diminishes their quality of life. However, there is currently no confirmed standard treatment for cancer-related fatigue, and thus, many patients who suffer cancer-related fatigue seek complementary and alternative medicines such as moxibustion. Moxibustion is one of the most popular therapies in traditional Korean medicine used to manage fatigue. Recent studies have also demonstrated that moxibustion is effective for treating chronic fatigue. However, there is insufficient evidence supporting the effect of moxibustion against cancer-related fatigue. The aim of this study is to assess the efficacy and safety of moxibustion treatment for cancer-related fatigue. Methods/design A multi-center, three-armed parallel, randomized controlled trial will be conducted. Ninety-six patients with cancer-related fatigue will be recruited from three clinical research centers. They will be randomly allocated to one of three groups in a 1:1:1 ratio. The moxibustion group will receive moxibustion treatment at CV8, CV12, LI4 and ST36. The sham moxibustion group will receive sham moxibustion at non-acupoints. Both the moxibustion and sham moxibustion groups will receive 30-min treatments twice a week for 8 weeks. The usual care group will not receive moxibustion treatment. All participants will be educated via a brochure on how to manage cancer-related fatigue in daily life. The outcome measurements will be evaluated at baseline, week 5, week 9, and week 13 by assessors who are blinded to the group allocation. The primary outcome measure will be the mean change in the average scores of the Brief Fatigue Inventory before and after treatments between groups. The secondary outcome measures will be the mean difference in changes from baseline of the Brief Fatigue Inventory, functional assessments of cancer therapy-fatigue, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 scores, and Montreal Cognitive Assessment scores between groups. Safety will be assessed by monitoring adverse events at each visit. Discussion The results of this study will provide evidence to confirm whether moxibustion can be used as a therapeutic option for treating cancer-related fatigue. Trial registration Clinical Research Information Service KCT0002170. Registered 16 December 2016. Electronic supplementary material The online version of this article (doi:10.1186/s12906-017-1856-3) contains supplementary material, which is available to authorized users.
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Fontes F, Severo M, Gonçalves M, Pereira S, Lunet N. Trajectories of sleep quality during the first three years after breast cancer diagnosis. Sleep Med 2017; 34:193-199. [DOI: 10.1016/j.sleep.2017.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 02/09/2017] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
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Fontes F, Gonçalves M, Maia S, Pereira S, Severo M, Lunet N. Reliability and validity of the Pittsburgh Sleep Quality Index in breast cancer patients. Support Care Cancer 2017; 25:3059-3066. [DOI: 10.1007/s00520-017-3713-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/17/2017] [Indexed: 12/21/2022]
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25
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Jehan S, Jean-Louis G, Zizi F, Auguste E, Pandi-Perumal SR, Gupta R, Attarian H, McFarlane SI, Hardeland R, Brzezinski A. Sleep, melatonin, and the menopausal transition: What are the links? Sleep Sci 2017. [DOI: 10.1016/j.slsci.2017.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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26
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Jehan S, Jean-Louis G, Zizi F, Auguste E, Pandi-Perumal SR, Gupta R, Attarian H, McFarlane SI, Hardeland R, Brzezinski A. Sleep, Melatonin, and the Menopausal Transition: What Are the Links? Sleep Sci 2017; 10:11-18. [PMID: 28966733 PMCID: PMC5611767 DOI: 10.5935/1984-0063.20170003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/28/2016] [Indexed: 12/29/2022] Open
Abstract
The pineal hormone Melatonin plays an important role in the regulation of the circadian sleep/wake cycle, mood, and perhaps immune functions, carcinogensis and reproduction. The human circadian rhythm of melatonin release from the pineal gland is tightly synchronized with the habitual hours of sleep. Peri- and postmenopausal women often complain of difficulties initiating and/or maintaining sleep, with frequent nocturnal and early morning awakenings. In this review we discuss the pathophysiology of melatonin function as it relates to sleep disorders in menopausal women, highlighting the potential use of exogenous melatonin during the menopausal transition and beyond.
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Affiliation(s)
- Shazia Jehan
- Center for Healthful Behavior Change, New York University School of
Medicine, New York, USA
| | - Giardin Jean-Louis
- Center for Healthful Behavior Change, New York University School of
Medicine, New York, USA
| | - Ferdinand Zizi
- Center for Healthful Behavior Change, New York University School of
Medicine, New York, USA
| | - Evan Auguste
- Center for Healthful Behavior Change, New York University School of
Medicine, New York, USA
| | | | - Ravi Gupta
- Department of Psychiatry & Sleep Clinic, Himalayan Institute of
Medical Sciences, Swami Ram Nagar, Jolly Grant, Dehradun-248016, INDIA
| | - Hrayr Attarian
- Circadian Rhythms and Sleep Research Lab, Department of Neurology,
Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Samy I. McFarlane
- Division of Endocrinology, Department of Medicine, SUNY Downstate
Medical Center, 11203 Brooklyn, NY, USA
| | - Rüdiger Hardeland
- Johann Friedrich Blumenbach Institute of Zoology and Anthropology,
University of Göttingen, D-37073 Göttingen, Germany
| | - Amnon Brzezinski
- Department of Obstetrics & Gynecology, the Hebrew
University-Hadassah Medical Center, Jerusalem, Israel
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27
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The influence of cancer on endocrine, immune, and behavioral stress responses. Physiol Behav 2016; 166:4-13. [DOI: 10.1016/j.physbeh.2015.09.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/10/2015] [Accepted: 09/30/2015] [Indexed: 12/21/2022]
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28
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Czick ME, Shapter CL, Silverman DI. Atrial Fibrillation: The Science behind Its Defiance. Aging Dis 2016; 7:635-656. [PMID: 27699086 PMCID: PMC5036958 DOI: 10.14336/ad.2016.0211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/11/2016] [Indexed: 12/19/2022] Open
Abstract
Atrial fibrillation (AF) is the most prevalent arrhythmia in the world, due both to its tenacious treatment resistance, and to the tremendous number of risk factors that set the stage for the atria to fibrillate. Cardiopulmonary, behavioral, and psychological risk factors generate electrical and structural alterations of the atria that promote reentry and wavebreak. These culminate in fibrillation once atrial ectopic beats set the arrhythmia process in motion. There is growing evidence that chronic stress can physically alter the emotion centers of the limbic system, changing their input to the hypothalamic-limbic-autonomic network that regulates autonomic outflow. This leads to imbalance of the parasympathetic and sympathetic nervous systems, most often in favor of sympathetic overactivation. Autonomic imbalance acts as a driving force behind the atrial ectopy and reentry that promote AF. Careful study of AF pathophysiology can illuminate the means that enable AF to elude both pharmacological control and surgical cure, by revealing ways in which antiarrhythmic drugs and surgical and ablation procedures may paradoxically promote fibrillation. Understanding AF pathophysiology can also help clarify the mechanisms by which emerging modalities aiming to correct autonomic imbalance, such as renal sympathetic denervation, may offer potential to better control this arrhythmia. Finally, growing evidence supports lifestyle modification approaches as adjuncts to improve AF control.
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Affiliation(s)
| | | | - David I. Silverman
- Echocardiography Laboratory, Hartford Hospital, Hartford, CT 06106, USA.
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29
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Rebholz WN, Cash E, Zimmaro LA, Bayley-Veloso R, Phillips K, Siwik C, Chagpar AB, Dhabhar FS, Spiegel D, Bell BS, Sephton SE. Distress and quality of life in an ethnically diverse sample awaiting breast cancer surgery. J Health Psychol 2016; 23:1438-1451. [PMID: 27466289 DOI: 10.1177/1359105316659916] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Poor breast cancer-related quality of life is associated with flattened cortisol rhythms and inflammation in breast cancer survivors and women with advanced disease. We explored the associations of cancer-specific distress (Impact of Events Scale), mood (Profile of Mood States), activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient) and cortisol (diurnal slope) circadian rhythms, and inflammation (interleukin-6) with quality of life (Functional Assessment of Cancer Therapy-Breast) among patients awaiting breast cancer surgery ( N = 57). Models were adjusted for differences in age and cancer stage. Distress and mood disturbance were significantly correlated with lower quality of life. Ethnic differences in the relationship between distress and mood disturbance with global quality of life and subscales of quality of life were observed. Actigraphic measures showed that in comparison with non-Hispanic patients, African Americans had significantly poorer activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient). Circadian disruption and inflammation were not associated with quality of life. Physiological dysregulation and associated comorbidities may take time to develop over the course of disease and treatment.
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Webster S, Chandrasekaran S, Vijayaragavan R, Sethu G. Impact of Emotional Support on Serum Cortisol in Breast Cancer Patients. Indian J Palliat Care 2016; 22:141-9. [PMID: 27162424 PMCID: PMC4843552 DOI: 10.4103/0973-1075.179607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
CONTEXT Breast cancer is the most commonly occurring female cancer in the world. Research gap exists regarding emotional support for breast cancer patients. AIM The main aim of this study was to compare the efficiency of Emotional Support- Focused Nurse directed Intervention on serum cortisol among arm I, II and III in breast cancer patients. METHODS The study was designed to compare the effectiveness of emotional support focused nurse directed intervention in terms of verbal, written and telephone basis on serum cortisol among breast cancer patients in Cancer Centre at Erode. Participants were randomly allocated by using Sequentially Numbered Opaque Sealed Envelope (SNOSE) method. 2 ml of blood samples were collected from 30 breast cancer patients who were selected randomly by adopting random number table, 10 in each experimental arm during evening at 18 hour; radioimmunoassay method was used to measure the level of serum cortisol before and after intervention. The intervention was given twice in a week for the duration of 30-45 minutes, in which early 20-30 minutes spares to express thoughts and feelings of the participants and subsequent 10-15 minutes for rendering informational support and later follow up session for the period of 1 month. RESULTS Emotional support was effective in reducing serum cortisol level among breast cancer patients. There was no statistically significant difference between arms on serum cortisol levels. CONCLUSIONS Marginal differences were noted between posttest mean scores of serum cortisol among verbal, written and telephone arms. Further emotional support can be rendered according to the preference of the breast cancer patients.
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Affiliation(s)
- Sampoornam Webster
- Department of Mental Health Nursing, Saveetha University, Chennai, Tamil Nadu, India
| | - Susila Chandrasekaran
- Department of Maternal Health Nursing, Billroth College of Nursing, Chennai, Tamil Nadu, India
| | - R Vijayaragavan
- Department of Research and Development, Saveetha University, Chennai, Tamil Nadu, India
| | - Gowri Sethu
- Department of Physiology, Saveetha University, Chennai, Tamil Nadu, India
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Hoyt MA, Bower JE, Irwin MR, Weierich MR, Stanton AL. Sleep quality and depressive symptoms after prostate cancer: The mechanistic role of cortisol. Behav Neurosci 2016; 130:351-6. [PMID: 26820589 DOI: 10.1037/bne0000107] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A substantial portion of men treated for prostate cancer report clinically significant sleep problems and disturbance in sleep quality constitutes significant risk for the development of depressive symptoms in survivors. Dysregulation in biological stress processes underlies the impact of poor sleep on the onset and/or progression of depressive symptoms, yet few studies have sought to identify potential neurobiological mechanisms (e.g., HPA axis activation) underlying this association in PC survivors. The present study examines the relationships between sleep disturbance, depressive symptoms, and indices of diurnal cortisol patterns among men treated for prostate cancer. In total, 66 men (84.8% White; mean age = 65.8 years, SD = 9.04) treated in the prior 2 years for localized prostate cancer were recruited. They completed questionnaires to measure sleep quality and depressive symptoms at study entry (T1) and 4 months later (T2). They also provided 4 saliva samples per day, over 3 days, at T1. Three cortisol indices were computed: diurnal slope, area under the curve (AUCg), and cortisol awakening response (CAR). Analyses indicate that, controlling for body mass index and age, worse sleep quality at T1 was significantly associated with higher levels of depressive symptoms at T2. Significant indirect effects were observed for cortisol slope (indirect effect = -.17, 95% CI [-.61, -.01]) and AUCg (indirect effect = -.14, 95% CI [-.43, -.01]), but not CAR. Results suggest that dysregulation in HPA activity acts as a neurobiological mechanism of the impact of sleep disruption on depressive symptoms in men with prostate cancer. (PsycINFO Database Record
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Affiliation(s)
- Michael A Hoyt
- Department of Psychology, Graduate Center, Hunter College, City University of New York
| | - Julienne E Bower
- Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles
| | - Michael R Irwin
- Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles
| | - Mariann R Weierich
- Department of Psychology, Graduate Center, Hunter College, City University of New York
| | - Annette L Stanton
- Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles
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Lipschitz DL, Kuhn R, Kinney AY, Grewen K, Donaldson GW, Nakamura Y. An Exploratory Study of the Effects of Mind–Body Interventions Targeting Sleep on Salivary Oxytocin Levels in Cancer Survivors. Integr Cancer Ther 2015; 14:366-80. [DOI: 10.1177/1534735415580675] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated ( a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and ( b) the effects of 2 sleep-focused mind–body interventions, mind–body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months’ duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self-compassion were observed in the MBB group compared with those in SHE. The findings in this exploratory study suggest that sOT may be a reliable biological measure over time that may provide insight into the effects of mind–body interventions on health outcomes in cancer survivors.
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Affiliation(s)
| | - Renee Kuhn
- University of Utah, Salt Lake City, UT, USA
| | | | - Karen Grewen
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Jones SMW, LaCroix AZ, Li W, Zaslavsky O, Wassertheil-Smoller S, Weitlauf J, Brenes GA, Nassir R, Ockene JK, Caire-Juvera G, Danhauer SC. Depression and quality of life before and after breast cancer diagnosis in older women from the Women's Health Initiative. J Cancer Surviv 2015; 9:620-9. [PMID: 25708515 DOI: 10.1007/s11764-015-0438-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/06/2015] [Indexed: 01/06/2023]
Abstract
PURPOSE Distress and reduced quality of life (QOL) are common among people with cancer. No study has compared these variables after breast cancer diagnosis to pre-cancer diagnosis levels. METHODS Data on women with breast cancer 50 years of age or older (n = 6949) were analyzed from the Women's Health Initiative (1993-2013). Health-related QOL (physical function, mental health) was measured using Rand-36. Depressive symptoms were measured with the six-item Center for Epidemiologic Studies Depression scale. Assessments occurred before and after the cancer diagnosis. Hierarchical linear modeling compared pre-cancer QOL and depressive symptoms to levels post-diagnosis and tested whether pre-cancer physical activity, stressful life events, sleep disturbance, and pain predicted post-diagnosis outcomes. RESULTS Compared with pre-cancer levels, depressive symptoms increased (20.0% increase at 0-6 months, 12.9% increase at 6-12 months), while physical function (-3.882 points at 0-6 months, -3.545 at 6-12 months) and mental health decreased (-2.899 points at 0-6 months, -1.672 at 6-12 months) in the first year after diagnosis (all p < .01). Depressive symptoms returned to pre-cancer levels after 10 years, but QOL remained significantly lower. At more than 10 years post-diagnosis, physical function was 2.379 points lower than pre-cancer levels (p < 0.01) while mental health was 1.922 points lower (p < 0.01). All pre-cancer predictors were associated with all outcomes. Pain predicted uniquely greater decreases in physical function post-diagnosis. CONCLUSIONS Depressive symptoms increased and QOL decreased following breast cancer diagnosis compared with pre-cancer levels, particularly in the first year. IMPLICATIONS FOR CANCER SURVIVORS QOL may remain lower for years after breast cancer diagnosis, although decreases are small.
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Affiliation(s)
- Salene M W Jones
- Group Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
| | | | - Wenjun Li
- University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | | | | | - Julie Weitlauf
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | | | - Rami Nassir
- University of California, Davis, Davis, CA, 95616, USA
| | - Judith K Ockene
- University of Massachusetts Medical School, Worcester, MA, 01655, USA
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Otte JL, Carpenter JS, Manchanda S, Rand KL, Skaar TC, Weaver M, Chernyak Y, Zhong X, Igega C, Landis C. Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer Med 2014; 4:183-200. [PMID: 25449319 PMCID: PMC4329003 DOI: 10.1002/cam4.356] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 08/26/2014] [Accepted: 09/07/2014] [Indexed: 11/13/2022] Open
Abstract
Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality.
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Affiliation(s)
- Julie L Otte
- Indiana University School of Nursing, Indianapolis, Indiana
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Tian J, Chen GL, Zhang HR. Sleep status of cervical cancer patients and predictors of poor sleep quality during adjuvant therapy. Support Care Cancer 2014; 23:1401-8. [DOI: 10.1007/s00520-014-2493-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 10/23/2014] [Indexed: 12/24/2022]
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Segerstrom SC, Boggero IA, Smith GT, Sephton SE. Variability and reliability of diurnal cortisol in younger and older adults: implications for design decisions. Psychoneuroendocrinology 2014; 49:299-309. [PMID: 25137484 PMCID: PMC4165809 DOI: 10.1016/j.psyneuen.2014.07.022] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 06/20/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022]
Abstract
The extant research is inconclusive regarding the best sampling methods to construct reliable measures of between-person differences in derived parameters of diurnal cortisol, and no study provides such recommendations for detecting within-person changes. These studies determined how many days of sampling are necessary to assess between-person differences and within-person changes over multiple occasions in diurnal mean, diurnal slope, and area under the curve (AUC). Generalizability and decision analyses were conducted on diurnal salivary cortisol data from two separate longitudinal studies, one with younger adults (N=124) and one with older adults (N=148). In both studies, results indicated that 3 days of data collection provided the minimal level of reliability in mean cortisol to detect between-person differences; 4-8 days were necessary to reliably assess AUC, and 10 days for cortisol slope. Similarly, in order to reliably characterize within-person changes across occasions, at least 3 days of data collection were needed for mean cortisol and AUC and 5-8 days for slope. Results also indicated that only two samples per day, taken morning and evening, could faithfully reproduce the diurnal slope calculated from 3 or 4 samples (r=.97-.99). Instead of having participants provide many samples per day over the course of a few days, we recommend collecting fewer samples per day over more days.
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Affiliation(s)
| | | | | | - Sandra E. Sephton
- Department of Psychological and Brain Sciences, University of Louisville
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Couture-Lalande MÈ, Lebel S, Bielajew C. Analysis of the cortisol diurnal rhythmicity and cortisol reactivity in long-term breast cancer survivors. BREAST CANCER MANAGEMENT 2014. [DOI: 10.2217/bmt.14.37] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Aims: In this paper, we examine the long-term consequences of a breast cancer diagnosis on hypothalamic–pituitary–adrenal axis functioning. Methods: This study provides a comprehensive analysis of the diurnal and reactive cortisol profiles of breast cancer survivors considered ‘disease-free’ compared with women with no history of breast cancer. Results: The results indicate similar diurnal patterns in both groups; however, significant differences in stress reactivity were noted, with breast cancer survivors displaying a relatively flat profile following the acute stress induction. Subjective levels of psychological stress were similar in both groups, suggesting incongruence between perceived stress and the physiological stress response of breast cancer survivors. Conclusion: The patterns suggest a progression towards more typical cortisol reactivity with longer time since diagnosis and may reflect some recovery of hypothalamic–pituitary–adrenal axis functioning as time passes.
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Affiliation(s)
| | - Sophie Lebel
- School of Psychology, University of Ottawa, ON, K1N 6N5, Canada
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Costa AR, Fontes F, Pereira S, Gonçalves M, Azevedo A, Lunet N. Impact of breast cancer treatments on sleep disturbances - A systematic review. Breast 2014; 23:697-709. [PMID: 25307946 DOI: 10.1016/j.breast.2014.09.003] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/06/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022] Open
Abstract
Sleep disturbances are highly prevalent in women with breast cancer; side effects of cancer treatment may worsen pre-existing sleep problems and have been pointed to as important determinants of their incidence. Therefore, we aimed to assess the association between different types of breast cancer treatment and sleep disturbances, through a systematic review. Medline (using PubMed), CINAHL Plus with full text, PsycINFO and Cochrane Central Register of Controlled Trials (Central) were searched from inception to January 2014. Studies that evaluated samples of women with breast cancer, assessed sleep disturbances with standardized sleep-specific measures, and provided data for different cancer treatments were eligible. A total of 12 studies met the inclusion criteria. Three studies evaluated insomnia, five studies assessed sleep quality, two provide data on general sleep disturbances and two analysed specific sleep parameters. Women submitted to chemotherapy, or radiotherapy, tended to report higher levels of sleep disturbances. More heterogeneous findings were observed regarding the effect of surgical treatment and hormonal therapy. However, a sound assessment of the impact of these treatments was hampered by differences across studies regarding the outcomes assessed, reporting bias and the fact that most studies did not control for the effect of potential confounders. The present review highlights the potential relation between breast cancer treatments and sleep disturbances, particularly of chemotherapy, though more robust evidence is needed for a proper understanding of these associations.
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Affiliation(s)
- Ana Rute Costa
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
| | - Filipa Fontes
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
| | - Susana Pereira
- EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Neurology, Portuguese Oncology Institute, Porto, Portugal
| | - Marta Gonçalves
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Psychiatry and Sleep Medicine Center, CUF Porto Hospital, Porto, Portugal
| | - Ana Azevedo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
| | - Nuno Lunet
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal.
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Shea JA, Bellini LM, Dinges DF, Curtis ML, Tao Y, Zhu J, Small DS, Basner M, Norton L, Novak C, Dine CJ, Rosen IM, Volpp KG. Impact of protected sleep period for internal medicine interns on overnight call on depression, burnout, and empathy. J Grad Med Educ 2014; 6:256-63. [PMID: 24949128 PMCID: PMC4054723 DOI: 10.4300/jgme-d-13-00241.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 10/11/2013] [Accepted: 10/21/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patient safety and sleep experts advocate a protected sleep period for residents. OBJECTIVE We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. METHODS We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009-2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI). RESULTS A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP. CONCLUSIONS A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores.
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Abstract
OBJECTIVE The literature on the relationship of depressive symptoms and stress hormones after cancer diagnosis has been mixed, with some studies showing a relationship and other studies showing none. Time since diagnosis may explain these contradictory findings. This study examined the relationship of depressive symptoms to stress hormones in patients with breast cancer using 12-month longitudinal data. METHODS Patients with Stage II or III breast cancer (n = 227) were assessed every 4 months from diagnosis/surgery to 12 months. They completed the Centers for Epidemiological Studies Depression Scale (CES-D) Iowa Short Form and the Perceived Stress Scale and blood samples were obtained to measure stress hormones (i.e., cortisol, adrenocorticotropin hormone, norepinephrine, and epinephrine). RESULTS Depressive symptoms were negatively related to cortisol levels (β= -0.023, p = .002) but were positively related to rate of change in cortisol (β = 0.003, p = .003). Adrenocorticotropin hormone, epinephrine, and norepinephrine did not covary with depressive symptoms (all p values > .05). When the CES-D and Perceived Stress Scale were both used to predict cortisol, only the CES-D was significantly related (β = -0.025, p = .017). CONCLUSIONS Depressive symptoms were negatively related to cortisol, but this relationship changed from the time of diagnosis/surgery through 12 months. Cortisol may initially provide a buffering effect against depression during the stress of initial diagnosis and treatment, but this relationship seems to change over time.
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Ho RTH, Fong TCT, Chan CKP, Chan CLW. The associations between diurnal cortisol patterns, self-perceived social support, and sleep behavior in Chinese breast cancer patients. Psychoneuroendocrinology 2013; 38:2337-42. [PMID: 23742786 DOI: 10.1016/j.psyneuen.2013.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 04/29/2013] [Accepted: 05/06/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study examined the relationships between diurnal cortisol patterns and sleep behavior, social support, psychological factors, and perceived health status in breast cancer patients. METHODS One hundred and eighty-one breast cancer patients completed a self-report questionnaire that combined the Hospital Anxiety and Depression Scale, the Yale Social Support Scale, and self-perceived measures of physical health, stress, sleep quality, total sleep hours, and time of awakening. Salivary cortisol was collected upon waking, at 1200h, 1700h, and 2100h on two consecutive days. Multiple regression analysis was performed on the diurnal cortisol slope that was derived from slope analysis of the log-transformed cortisol data. RESULTS Controlling for the initial cortisol level, a flatter diurnal cortisol slope was significantly associated with a later time of awakening, higher negative social support, poorer perceived health, poorer sleep quality, and shorter total sleep hours. Anxiety and depression were not significantly correlated with the slope. CONCLUSIONS The results indicate a subtle dysregulation in hypothalamic-pituitary-adrenal axis functioning in patients with highly negative social support, poor perceived health, poor sleep quality, a later time of awakening, and insufficient sleep hours.
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Affiliation(s)
- Rainbow T H Ho
- Centre on Behavioral Health, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong; Department of Social Work & Social Administration, 5/F, Building C (Social Sciences), Jockey Club Tower, The Centennial Campus, Pokfulam, The University of Hong Kong, Hong Kong.
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Reduction in salivary α-amylase levels following a mind-body intervention in cancer survivors--an exploratory study. Psychoneuroendocrinology 2013; 38:1521-31. [PMID: 23375640 PMCID: PMC3686861 DOI: 10.1016/j.psyneuen.2012.12.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 11/26/2012] [Accepted: 12/27/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The main aim of this exploratory study was to assess whether salivary α-amylase (sAA) and salivary cortisol levels would be positively modulated by sleep-focused mind-body interventions in female and male cancer survivors. METHODS We conducted a randomized controlled trial in which 57 cancer survivors with self-reported sleep disturbance received either a Sleep Hygiene Education (SHE; n=18) control, or one of two experimental mind-body interventions, namely, Mind-Body Bridging (MBB; n=19) or Mindfulness Meditation (MM; n=20). Interventions were three sessions each conducted once per week for three consecutive weeks. Saliva cortisol and sAA were measured at baseline and 1 week after the last session. Participants also completed a sleep scale at the same time points when saliva was collected for biomarker measurement. RESULTS Our study revealed that at post-intervention assessment, mean sAA levels upon awakening ("Waking" sample) declined in MBB compared with that of SHE. Mean Waking cortisol levels did not differ among treatment groups but declined slightly in SHE. Self-reported sleep improved across the three interventions at Post-assessment, with largest improvements in the MBB intervention. CONCLUSION In this exploratory study, sleep focused mind-body intervention (MBB) attenuated Waking sAA levels, suggesting positive influences of a mind-body intervention on sympathetic activity in cancer survivors with sleep disturbance.
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Affect and mindfulness as predictors of change in mood disturbance, stress symptoms, and quality of life in a community-based yoga program for cancer survivors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:419496. [PMID: 23762132 PMCID: PMC3676912 DOI: 10.1155/2013/419496] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/27/2013] [Accepted: 04/11/2013] [Indexed: 11/17/2022]
Abstract
Little attention has been paid to the psychological determinants by which benefits are accrued via yoga practice in cancer-related clinical settings. Using a longitudinal multilevel modeling approach, associations between affect, mindfulness, and patient-reported mental health outcomes, including mood disturbance, stress symptoms, and health-related quality of life (HRQL), were examined in an existing seven-week yoga program for cancer survivors. Participants (N = 66) were assessed before and after the yoga program and at three- and six-month follow-ups. Decreases in mood disturbance and stress symptoms and improvements in HRQL were observed upon program completion. Improvements in mood disturbance and stress symptoms were maintained at the three- and six-month follow-ups. HRQL exhibited further improvement at the three-month follow-up, which was maintained at the six-month follow-up. Improvements in measures of well-being were predicted by initial positive yoga beliefs and concurrently assessed affective and mindfulness predictor variables. Previous yoga experience, affect, mindfulness, and HRQL were related to yoga practice maintenance over the course of the study.
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Yi M, Kim J. Factors influencing health-promoting behaviors in Korean breast cancer survivors. Eur J Oncol Nurs 2013; 17:138-45. [DOI: 10.1016/j.ejon.2012.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 12/12/2011] [Accepted: 05/04/2012] [Indexed: 01/15/2023]
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Starkweather AR, Lyon DE, Elswick RK, Montpetit A, Conley Y, McCain NL. Symptom Cluster Research in Women with Breast Cancer: A Comparison of Three Subgrouping Techniques. ACTA ACUST UNITED AC 2013; 2:107-113. [PMID: 24498579 PMCID: PMC3909650 DOI: 10.4236/abcr.2013.24018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aims To examine how symptom cluster subgroups defined by extreme discordant composite scores, cut-off scores, or a median split influence statistical associations with peripheral cytokine levels in women with breast cancer. Background Systemic cytokine dysregulation has been posited as a potential biological mechanism underlying symptom clusters in women with breast cancer. Symptom characteristics may play an important role in identifying cytokines of significant etiological importance, however, there is no consensus regarding the ideal subgrouping technique to use. Design A secondary analysis of data collected from a cross-sectional descriptive study of women with stage I-II breast cancer was used to examine and compare the relationships between peripheral cytokine levels and symptom subgroups defined by extreme discordant composite scores, cut-off scores, or a median split. Methods Participant symptom scores were transformed into a composite score to account for variability in symptom intensity, frequency and interference. Cytokine levels in subgroups defined by composite scores within the highest and lowest 20% were contrasted with those composed from cut-off scores and a median split. Results Subgroups defined by the composite score or cut-off scores resulted in similar statistical relationships with cytokine levels in contrast to the median split technique. The use of a median split for evaluating relationships between symptoms clusters and cytokine levels may increase the risk of a type I error. Conclusion Composite and cut-off scores represent best techniques for defining symptom cluster subgroups in women with breast cancer. Using a consistent approach to defining symptom clusters across studies may assist in identifying relevant biological mechanisms.
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Affiliation(s)
| | - Debra E Lyon
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - R K Elswick
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Alison Montpetit
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Yvette Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, USA
| | - Nancy L McCain
- School of Nursing, Virginia Commonwealth University, Richmond, USA
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Porter LS. Circadian Disruption—a New Direction for Psycho-oncology Research? A Comment on Dedert et al. Ann Behav Med 2012; 44:1-2. [DOI: 10.1007/s12160-012-9376-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Shi M, Du L, Liu D, Qian L, Hu M, Yu M, Yang Z, Zhao M, Chen C, Guo L, Wang L, Song L, Ma Y, Guo N. Glucocorticoid regulation of a novel HPV-E6-p53-miR-145 pathway modulates invasion and therapy resistance of cervical cancer cells. J Pathol 2012; 228:148-57. [PMID: 22287315 DOI: 10.1002/path.3997] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 01/11/2012] [Accepted: 01/17/2012] [Indexed: 12/29/2022]
Abstract
Glucocorticoids are stress-responsive neuroendocrine mediators and play an important role in malignant progression, especially in solid tumours. We demonstrate a novel mechanism by which glucocorticoids modulate p53-dependent miR-145 expression in HPV-positive cervical cancer cells through induction of E6 proteins. We found that expression of miR-145 was reduced in cervical cancer tissues. Cortisol induced HPV-E6 expression and suppressed p53 and miR-145 in cervical cancer cells. MiR-145 expression in cervical cancer cells was wild-type p53-dependent, and cortisol-induced down-regulation of miR-145 expression prevented chemotherapy-induced apoptosis, whereas over-expression of miR-145 enhanced sensitivity to mitomycin and reversed the chemoresistance induced by glucocorticoids. We also show that miR-145 augments the effects of p53 by suppressing the inhibitors of p53 in cervical cancer cells, suggesting that miR-145 plays a role in p53 tumour suppression. Finally, we demonstrate that miR-145 inhibits both the motility and invasion of cervical cancer cells. Our findings identify a novel pathway through which the neuroendocrine macroenvironment affects cervical tumour growth, invasion and therapy resistance and show that miR-145 may serve as a target for cervical cancer therapy. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Ming Shi
- Department of Molecular Immunology, Institute of Basic Medical Sciences, Beijing, People's Republic of China
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Good M, Albert JM, Arafah B, Anderson GC, Wotman S, Cong X, Lane D, Ahn S. Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management. Biol Res Nurs 2012; 15:318-29. [PMID: 22472905 DOI: 10.1177/1099800411431301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications. The present study was designed to determine whether two interventions, patient teaching (PT) for pain management and relaxation/music (RM), reduced cortisol levels, an indicator of stress, following abdominal surgery. Patients (18-75 years) were randomly assigned to receive PT, RM, a combination of the two, or usual care; the 205 patients with both pre- and posttest cortisol values were analyzed. A 2 × 2 factorial design was used to compare groups for PT effects and RM effects. Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2. Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay. Comparisons using analysis of covariance (ANCOVA), controlling for baseline levels, showed no PT effect or RM effect on cortisol in the morning or afternoon. Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group. Although in previous studies, RM reduced pain and music reduced cortisol on Day 1, in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2. The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day.
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Affiliation(s)
- Marion Good
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA.
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Wu HS, Davis JE, Natavio T. Fatigue and Disrupted Sleep-Wake Patterns in Patients With Cancer: A Shared Mechanism. Clin J Oncol Nurs 2012; 16:E56-68. [DOI: 10.1188/12.cjon.e56-e68] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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