1
|
Tibbitts DC, Stoyles SA, Mancini M, El-Gohary M, Horak FB, Dieckmann NF, Winters-Stone KM. The Use of Novel Instrumented Socks to Detect Changes in Daily Life Mobility During an Exercise Intervention in Prostate Cancer Survivors Treated with Androgen Deprivation Therapy. Semin Oncol Nurs 2024; 40:151658. [PMID: 38902183 PMCID: PMC11344597 DOI: 10.1016/j.soncn.2024.151658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVES To describe changes in daily life mobility in prostate cancer survivors treated with androgen deprivation therapy (ADT) after a 6-month exercise intervention using novel instrumented socks and to identify characteristics of participants who exhibited changes in daily life mobility. METHODS A subset of participants in a fall prevention exercise trial completed objective tests and patient-reported surveys of physical functioning, and wore instrumented socks for up to 7 days to measure daily life mobility. Changes in cadence, double support proportion, and pitch angle of the foot at toe-off were selected as measures of daily life mobility previously found to be different in men exposed to ADT for prostate cancer versus controls. Daily life mobility was compared from baseline to 6 months using paired t-tests. Characteristics of responders who improved their daily life mobility were compared to nonresponders using two-sample t-tests, Chi-squared proportion tests, or Fisher's Exact Tests. RESULTS Our sample included 35 prostate cancer survivors (mean age 71.6 ± 7.8 years). Mean cadence, double support proportion, and pitch angle at toe-off did not change significantly over 6 months of exercise, but 14 participants (40%) improved in at least two of three daily life mobility measures ("responders"). Responders were characterized by lower physical functioning, lower cadence in daily life, fewer comorbidities, and better social and mental/emotional functioning. CONCLUSIONS Certain daily life mobility measures potentially impacted by ADT could be measured with instrumented socks and improved by exercise. Men who start with lower physical functioning and better social and mental/emotional functioning appear most likely to benefit, possibly because they have more to gain from exercise and are able to engage in a 6-month intervention. IMPLICATIONS FOR NURSING PRACTICE Technology-based approaches could provide nurses with an objective measure of daily life mobility for patients with chronic illness and detect who is responding to rehabilitation.
Collapse
Affiliation(s)
- Deanne C Tibbitts
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Sydnee A Stoyles
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | | | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Nathan F Dieckmann
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Kerri M Winters-Stone
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA.
| |
Collapse
|
2
|
Attia Hussein Mahmoud H, Lakkimsetti M, Barroso Alverde MJ, Shukla PS, Nazeer AT, Shah S, Chougule Y, Nimawat A, Pradhan S. Impact of Paternal Postpartum Depression on Maternal and Infant Health: A Narrative Review of the Literature. Cureus 2024; 16:e66478. [PMID: 39246890 PMCID: PMC11380704 DOI: 10.7759/cureus.66478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/10/2024] Open
Abstract
Postpartum depression (PPD) has been widely studied, assessed, and promptly intervened in new mothers. However, paternal postpartum depression gained attention not long ago. Postpartum depression in men could present over one year following the birth of the child, frequently presenting with symptoms like irritability, low mood, sleep disturbances, changes in appetite, fatigue, and loss of interest in everyday activities; amongst other symptoms of Major Depressive Disorder which may hinder them from taking care of themselves and the baby. Paternal PPD significantly impacts partner relationships causing maternal PPD, poor infant bonding, and therefore, affecting overall child development. The following narrative review is based on a literature search of articles published on paternal postnatal depression. The primary emphasis of this review has been to provide an overview of the current comprehension of paternal postpartum depression regarding prevalence, global incidence, and risk factors and to explore potential diagnostic tools for assessment and interventional strategies to treat this condition. Interestingly, pandemic-related stressors have been positively attributed to an increase in PPD prevalence post-pandemic. While more research is being conducted on this subject, research on the measurement characteristics of the diagnostic tools is highly recommended to implement well-defined criteria for early diagnosis of paternal PPD. The significant adverse consequences of PPD for not just the new mother, but also the infants, necessitate proper and timely diagnosis of PPD. Despite its severity, there have been no specific treatment modalities.
Collapse
Affiliation(s)
| | | | | | - Pranav S Shukla
- Medical School, Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, IND
| | - Alviya T Nazeer
- Obstetrics and Gynaecology, Government Medical College and Hospital, Pudukkottai, IND
| | - Sukesh Shah
- Medical School, American University of Integrative Sciences, Bridgetown, BRB
| | | | - Amisha Nimawat
- Internal Medicine, Interfaith Medical Center, New York, USA
| | | |
Collapse
|
3
|
Sims EE, Trattner JD, Garrison SM. Exploring the relationship between depression and delinquency: a sibling comparison design using the NLSY. Front Psychol 2024; 15:1430978. [PMID: 39011290 PMCID: PMC11247016 DOI: 10.3389/fpsyg.2024.1430978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
Relative to the general population, adolescents with psychiatric disorders such as major depression disorder are incarcerated (and reincarcerated) at higher rates. Current research is mixed on whether this association is a cause, consequence, or the product of selection. For example, aggression can lead to more depressive symptoms, yet depression is associated with antisocial behaviors (e.g., delinquency). To better understand the relationship between depression and delinquent behavior, we used the discordant kinship model to examine data from sibling pairs in the National Longitudinal Surveys of Youth 1979, a nationally representative study. By explicitly modeling within- and between-family variance, we reduced the influence of genetic and shared-environmental confounds on our analysis. Our results suggest that the relationship between depression and delinquency is not causal, but rather a product of selection.
Collapse
Affiliation(s)
- Emma E. Sims
- Department of Psychology, Wake Forest University, Winston Salem, NC, United States
| | - Jonathan D. Trattner
- Department of Interdisciplinary Studies, Wake Forest University, Winston Salem, NC, United States
| | - S. Mason Garrison
- Department of Psychology, Wake Forest University, Winston Salem, NC, United States
| |
Collapse
|
4
|
Miller NE, Fisher A, Frank P, Lally P, Steptoe A. Depressive Symptoms, Socioeconomic Position, and Mortality in Older People Living With and Beyond Cancer. Psychosom Med 2024; 86:523-530. [PMID: 38497671 PMCID: PMC11230845 DOI: 10.1097/psy.0000000000001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Evidence shows that higher depressive symptoms are associated with mortality among people living with and beyond cancer (LWBC). However, prior studies have not accounted for a wider range of potential confounders, and no study has explored whether socioeconomic position (SEP) moderates the association. This study aimed to examine the association between depressive symptoms and mortality among people LWBC, and moderation by SEP. METHODS Participants from the English Longitudinal Study of Aging, diagnosed with cancer and with a measure of depressive symptoms within 4 years after their diagnosis, were included. Elevated depressive symptoms were indicated by a score of ≥3 on the eight-item Center for Epidemiologic Studies Depression Scale. Cox regression models examined associations with all-cause mortality. Competing risk regression examined associations with cancer mortality. RESULTS In 1352 people LWBC (mean age = 69.6 years), elevated depressive symptoms were associated with a 93% increased risk of all-cause mortality (95% confidence interval = 1.52-2.45) within the first 4 years of follow-up and a 48% increased risk within a 4- to 8-year follow-up (95% confidence interval = 1.02-2.13) after multivariable adjustment. Elevated depressive symptoms were associated with a 38% increased risk of cancer mortality, but not after excluding people who died within 1 year after baseline assessments. There were no interactions between depressive symptoms and SEP. CONCLUSIONS Elevated depressive symptoms are associated with a greater risk of all-cause mortality among people LWBC within an 8-year follow-up period. Associations between depressive symptoms and cancer mortality might be due to reverse causality.
Collapse
Affiliation(s)
- Natalie Ella Miller
- From the Department of Behavioural Science and Health, Institute of Epidemiology and Health Care (Miller, Fisher, Steptoe), and UCL Brain Sciences (Frank), University College London, London; and Department of Psychological Sciences (Lally), University of Surrey, Guildford, Surrey, UK
| | | | | | | | | |
Collapse
|
5
|
Wang HQ, Lin H, Liu B. Research progress on the psychological burden and intervention measures in cancer patients. Front Psychiatry 2024; 15:1408762. [PMID: 38938456 PMCID: PMC11208330 DOI: 10.3389/fpsyt.2024.1408762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
In the past 40 years, the gradually increasing incidence and mortality rates of malignant tumors have severely impacted the quality of life of patients, bringing significant physical and psychological burdens and becoming an increasingly serious social issue. With the development of medical standards, new methods for cancer detection and treatment have been continuously proposed. Although it has been proven that cancer is related to increased psychological burden and suicidal behaviors in patients, current research on the psychological burden caused by cancer is insufficient. Clinicians often overlook the psychological health issues of patients while treating their physical diseases. Considering the high incidence of cancer, this review will outline the psychological burdens of cancer patients worldwide in recent years and its high-risk factors. Moreover, this review will summarize the common methods for evaluating psychological burdens, present current predictive models and treatment methods for the psychological burden of cancer patients, aiming to provide a research basis and future direction for the timely and accurate assessment of the psychological burden in cancer patients.
Collapse
Affiliation(s)
- Han-Qi Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Lin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| |
Collapse
|
6
|
Shahrour L, Martinez J, Chicaiza A, Omar R, Bovbjerg K, Stanton AL, Valdimarsdottir H, Yanez B, Munshi P, Rowley SD, Rini C, Graves KD. Greater Social Isolation and Social Constraints Prior to Hematopoietic Stem Cell Transplant Are Associated with Greater Anxiety and Depressive Symptoms. Int J Behav Med 2024; 31:341-351. [PMID: 38017317 DOI: 10.1007/s12529-023-10232-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (hereafter "HCT") is a physically and psychologically difficult treatment for patients with hematological cancers. This study examined relationships among patients' reports of pre-transplant social isolation, social constraints, and psychological distress. METHOD We used baseline data from a multisite randomized controlled trial evaluating the effects of expressive helping writing to reduce physical and emotional symptoms in HCT patients. We collected data prior to randomization and before either allogenic or autologous HCT using validated scales to assess social constraints, social isolation, anxiety, and depressive symptoms. We analyzed data using bivariate analysis and multivariate linear regression. We also explored whether social isolation mediated the effect of social constraints on both of our outcomes: anxiety and depressive symptoms. RESULTS Among 259 adults recruited prior to transplant, 43.6% were women (mean age = 57.42 years, SD = 12.34 years). In multivariate analysis controlling for relevant covariates, both social isolation (β = 0.24, p < 0.001) and social constraints (β = 0.28, p < 0.001) were associated with anxiety. When both social constraints and social isolation were in the model, only greater social isolation (β = 0.79, p < 0.001) was associated with depressive symptoms. Social isolation fully mediated the association between social constraints and anxiety and depressive symptoms. CONCLUSION For patients awaiting either allogenic or autologous HCT, the negative association between social constraints and anxiety and depressive symptoms may be related, in part, to the mechanism of perceived social isolation. Interventions prior to and during HCT are needed to support patients' psychological health and sense of social connectedness.
Collapse
Affiliation(s)
| | | | - Anthony Chicaiza
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | - Rahma Omar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katrin Bovbjerg
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Heiddis Valdimarsdottir
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Pashna Munshi
- MedStar Georgetown University Hospital, Washington, D.C, USA
| | - Scott D Rowley
- John Theurer Cancer Center, Hackensack Meridian Health, Hackensack, NJ, USA
| | - Christine Rini
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Kristi D Graves
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA.
| |
Collapse
|
7
|
Belarmino EH, Conway CM, Kolodinsky J, Daylor KM, Spence E. Diaper need in the United States: A nationally representative study during the COVID-19 pandemic. Heliyon 2024; 10:e31344. [PMID: 38807893 PMCID: PMC11130655 DOI: 10.1016/j.heliyon.2024.e31344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024] Open
Abstract
Background Diapers represent a unique financial burden for those with young children. Pre-pandemic, approximately one in three U.S. households with young children reported diaper need or an insufficient supply of diapers. To support this population, policymakers, clinicians, and service providers need a better understanding of the groups most commonly affected and the ways that families cope with deprivation. Methods An online survey was administered between February and July 2021 to a national sample of U.S. caregivers of at least one child aged 0-4 years in diapers (n = 881), investigating diaper need, diaper access, and how household expenses are balanced and prioritized vis-à-vis diapers. We use bivariate and multivariable models to assess factors associated with diaper need, and examine coping strategies, tradeoffs made to purchase diapers, and how caregivers would reallocate their money if diapers were accounted for. Findings The prevalence of diaper need (46 %) exceeded pre-pandemic estimates. Diaper need was more prevalent among Hispanic respondents, lower income respondents, cloth diaper users, those with more than one child in diapers, caretakers with depression, and those with a negative financial change in the past year. Caretakers with diaper need were more likely to utilize a range of resources to access diapers and to use diapers for longer than desired to extend their supply. Those with diaper need also made more economic tradeoffs to afford diapers and indicated that they would reallocate resources to cover other unmet basic needs if they did not have to buy diapers. Interpretation Our results indicate elevated levels of diaper need even after the U.S. economy had largely rebounded and raise concerns that inequities in diaper access may impact families' abilities to meet other basic needs. Diapers may be an important target for policies and interventions aimed at improving the well-being of families with young children.
Collapse
Affiliation(s)
- Emily H. Belarmino
- Department of Nutrition and Food Sciences, University of Vermont, 350 Carrigan Wing, Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Gund Institute for Environment, University of Vermont, Farrell Hall, 210 Colchester Avenue, Burlington, VT, 05405, USA
- Food Systems Program, University of Vermont, 236 Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Carollyne M. Conway
- Environmental Science Program, College of Agriculture and Life Sciences, Morrill Hall, University of Vermont, Burlington, VT, 05405, USA
| | - Jane Kolodinsky
- Gund Institute for Environment, University of Vermont, Farrell Hall, 210 Colchester Avenue, Burlington, VT, 05405, USA
- Department of Community Development and Applied Economics, University of Vermont, 202 Morrill Hall, Burlington, VT, 05405, USA
- Center for Rural Studies, University of Vermont, 206 Morrill Hall, Burlington, VT, 05405, USA
- Food Systems Program, University of Vermont, 236 Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Kaya M. Daylor
- Data Science Program, Department of Mathematics and Statistics, E220 Innovation Hall, 82 University Place, University of Vermont, Burlington, VT, 05405, USA
| | - Emma Spence
- Food Systems Program, University of Vermont, 236 Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
| |
Collapse
|
8
|
Kuczmarski TM, Roemer L, Odejide OO. Depression in patients with hematologic malignancies: The current landscape and future directions. Blood Rev 2024; 65:101182. [PMID: 38402023 DOI: 10.1016/j.blre.2024.101182] [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: 12/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
Patients with hematologic malignancies experience high rates of depression. These patients are vulnerable to depression throughout the disease trajectory, from diagnosis to survivorship, and at the end of life. In addition to the distressing nature of depression, it has substantial downstream effects including poor quality of life, increased risk of treatment complications, and worse survival. Therefore, systematic screening for depression and integration of robust psychological interventions for affected patients is crucial. Although depression has been historically studied mostly in patients with solid malignancies, research focusing on patients with hematologic malignancies is growing. In this article, we describe what is known about depression in patients with hematologic malignancies, including its assessment, prevalence, risk factors, and implications. We also describe interventions to ameliorate depression in this population. Future research is needed to test effective and scalable interventions to reduce the burden of depression among patients with blood cancers.
Collapse
Affiliation(s)
| | - Lizabeth Roemer
- Department of Psychology, University of Massachusetts Boston, USA
| | - Oreofe O Odejide
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA; Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, USA.
| |
Collapse
|
9
|
Ho S, Palka JM, Mersch J, Martin WB, Howe-Martin L. The dynamic buffering of social support on depressive symptoms and cancer worries in patients seeking cancer genetic counseling. J Cancer Surviv 2024:10.1007/s11764-023-01479-x. [PMID: 38512562 DOI: 10.1007/s11764-023-01479-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/02/2023] [Indexed: 03/23/2024]
Abstract
PURPOSE Social support is a crucial protective factor against psychological concerns in patients with cancer. However, there is limited knowledge regarding the differential impacts of social support on cancer worries and depressive symptoms in patients undergoing genetic counseling for hereditary cancer. The current study utilized a high-volume database from a multi-site cancer genetics clinic to assess the impact of perceived social support on depressive symptoms and cancer worries among patients of different age groups (young versus older patients) and diagnosis status (diagnosed survivors versus undiagnosed). METHODS 6,666 patients completed brief assessments of depressive symptoms, cancer worries, social support, and demographic questionnaires as part of routine clinical care between October 2016 and October 2020. Logistics and moderated regression were used to analyze the relationships between social support, depressive symptoms, and cancer worries. RESULTS Increased social support was associated with fewer depressive symptoms and fewer cancer worries across all patients. Social support mitigated depressive symptoms most significantly for young adult patients with and without cancer. Social support mitigated cancer worries most significantly for young adults with cancer and older adults without cancer. CONCLUSIONS While results were mixed, general findings upheld original hypotheses. Social support buffered depressive symptoms and cancer worries differentially for patients of different ages and different disease status. IMPLICATIONS FOR CANCER SURVIVORS Social support groups are beneficial for all patients and should be emphasized by cancer clinics. However, increasing patient-tailored and age-appropriate support networks will be crucial for managing depression and cancer worries for high-risk survivors: young adults with cancer.
Collapse
Affiliation(s)
- Sally Ho
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX, USA
| | - Jayme M Palka
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jacqueline Mersch
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX, USA
- Cancer Genetics Program, UT Southwestern Medical Center, Dallas, TX, USA
- UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - W Blake Martin
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX, USA
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Laura Howe-Martin
- UT Southwestern Moncrief Cancer Institute, Fort Worth, TX, USA.
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.
- UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
| |
Collapse
|
10
|
Lutgendorf SK, Telles RM, Whitney B, Thaker PH, Slavich GM, Goodheart MJ, Penedo FJ, Noble AE, Cole SW, Sood AK, Corn BW. The biology of hope: Inflammatory and neuroendocrine profiles in ovarian cancer patients. Brain Behav Immun 2024; 116:362-369. [PMID: 38081436 PMCID: PMC11219272 DOI: 10.1016/j.bbi.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/01/2024] Open
Abstract
INTRODUCTION Although the concept of hope is highly relevant for cancer patients, little is known about its association with cancer-relevant biomarkers. Here we examined how hope was related to diurnal cortisol and interleukin-6 (IL-6), a pro-inflammatory cytokine previously associated with tumor biology and survival in ovarian cancer. Secondly, we examined whether hope and hopelessness are distinctly associated with these biomarkers. METHOD Participants were 292 high-grade ovarian cancer patients who completed surveys and provided saliva samples 4x/daily for 3 days pre-surgery to assess diurnal cortisol. Blood (pre-surgery) and ascites were assessed for IL-6. Hope and hopelessness were assessed using standardized survey items from established scales (Center for Epidemiological Studies Depression Scale; Profile of Mood States, Functional Assessment of Cancer Therapy). Two hopeless items were z-scored and combined into a composite for analysis. Regression models related these variables to nocturnal cortisol, cortisol slope, plasma and ascites IL-6, adjusting for cancer stage, BMI, age, and depression. RESULTS Greater hope was significantly related to a steeper cortisol slope, β = -0.193, p = 0.046, and lower night cortisol, β = -0.227, p = 0.018, plasma IL-6, β = -0.142, p = 0.033, and ascites IL-6, β = -0.290, p = 0.002. Secondary analyses including both hope and hopelessness showed similar patterns, with distinct relationships of hope with significantly lower nocturnal cortisol β = -0.233,p = 0.017 and ascites IL-6, β = -0.282,p = 0.003, and between hopelessness and a flatter cortisol slope, β = 0.211, p = 0.031. CONCLUSIONS These data suggest a biological signature of hope associated with less inflammation and more normalized diurnal cortisol in ovarian cancer. These findings have potential clinical utility but need replication with more diverse samples and validated assessments of hope.
Collapse
Affiliation(s)
- Susan K Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States; Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States.
| | - Rachel M Telles
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Brendan Whitney
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Premal H Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, United States
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Michael J Goodheart
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States; Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States
| | - Frank J Penedo
- Departments of Psychology and Medicine and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States
| | - Alyssa E Noble
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Steven W Cole
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States; Division of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Anil K Sood
- Departments of Gynecologic Oncology, Cancer Biology and Center for RNA Interference and Noncoding RNA, University of Texas M.D. Anderson Cancer Center, Houston, TX, United States
| | - Benjamin W Corn
- Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, Israel
| |
Collapse
|
11
|
Hebi M, Czamanski-Cohen J, Azaiza F, Weihs KL. Values and their relationship with emotion processing and physical and psychological symptoms among Jewish and Arab breast cancer survivors. Front Psychol 2024; 14:1297377. [PMID: 38239457 PMCID: PMC10794551 DOI: 10.3389/fpsyg.2023.1297377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Individuals from different cultures differ in their values, which encompass belief systems that individuals develop based on their culture, and play a pivotal role in shaping their perspectives. These values may affect emotion processing (EP): the recognition, interpretation, expression and response to bodily sensations, translated as emotions. These varying values may contribute to distinct emotional experiences, impacting physical and psychological symptoms in breast cancer (BC) survivors. Methods This cross-sectional study investigated how EP including acceptance, expression (avoidance and approach coping), and awareness, may mediate the relationship between conservation values and symptoms of pain, fatigue, and depression among Arab (n = 62) and Jewish (n = 179) women BC survivors in Israel. Conservation values include tradition, conformity, and security. Results Depression and fatigue were negatively correlated with acceptance of emotions, and positively correlated with avoidance and conservation levels. Emotion processing mediated the relationship between conservation and fatigue and depression. Arab women reported higher levels of various values, emotional acceptance, pain, fatigue, and depression symptoms compared to Jewish women. Conservation was higher in Arab women and correlated with both approach and avoidance coping which was not the case in Jewish women. Avoidance coping had a positive relationship with fatigue in the Jewish, but not the Arab women. Similarly, approach coping was negatively related to depression in Jewish, but not in Arab women. Discussion Cultural differences are important for understanding the experience of cancer in individuals from different cultures. Future interventions for more conservative BC survivors should take culture into account.
Collapse
Affiliation(s)
- Maimounah Hebi
- The School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Johanna Czamanski-Cohen
- The School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Faisal Azaiza
- The College of Sakhnin for Teacher Education, Sakhnin, Israel
| | - Karen L. Weihs
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
- Cancer Prevention and Control Program, University of Arizona Comprehensive Cancer Center, Tucson, AZ, United States
| |
Collapse
|
12
|
Foster SA, Kile ML, Hystad P, Diamond ML, Jantunen LM, Mandhane PJ, Moraes TJ, Navaranjan G, Scott JA, Simons E, Subbarao P, Takaro TK, Turvey SE, Brook JR. Organophosphate ester flame retardants and plasticizers in house dust and mental health outcomes among Canadian mothers: A nested prospective cohort study in CHILD. ENVIRONMENTAL RESEARCH 2024; 240:117451. [PMID: 37871788 PMCID: PMC10841641 DOI: 10.1016/j.envres.2023.117451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
Organophosphate ester flame retardants and plasticizers (OPEs) are common exposures in modern built environments. Toxicological models report that some OPEs reduce dopamine and serotonin in the brain. Deficiencies in these neurotransmitters are associated with anxiety and depression. We hypothesized that exposure to higher concentrations of OPEs in house dust would be associated with a greater risk of depression and stress in mothers across the prenatal and postpartum periods. We conducted a nested prospective cohort study using data collected on mothers (n = 718) in the CHILD Cohort Study, a longitudinal multi-city Canadian birth cohort (2008-2012). OPEs were measured in house dust sampled at 3-4 months postpartum. Maternal depression and stress were measured at 18 and 36 weeks gestation and 6 months and 1 year postpartum using the Centre for Epidemiologic Studies for Depression Scale (CES-D) and Perceived Stress Scale (PSS). We used linear mixed models to examine the association between a summed Z-Score OPE index and continuous depression and stress scores. In adjusted models, one standard deviation increase in the OPE Z-score index was associated with a 0.07-point (95% CI: 0.01, 0.13) increase in PSS score. OPEs were not associated with log-transformed CES-D (β: 0.63%, 95% CI: -0.18%, 1.46%). The effect of OPEs on PSS score was strongest at 36 weeks gestation and weakest at 1 year postpartum. We observed small increases in maternal perceived stress levels, but not depression, with increasing OPEs measured in house dust during the prenatal and early postpartum period in this cohort of Canadian women. Given the prevalence of prenatal and postpartum anxiety and the ubiquity of OPE exposures, additional research is warranted to understand if these chemicals affect maternal mental health.
Collapse
Affiliation(s)
- Stephanie A Foster
- School of Biological and Population Health Sciences, College of Health, Oregon State University, 160 SW 26th St, Corvallis, OR, 97331, USA.
| | - Molly L Kile
- School of Biological and Population Health Sciences, College of Health, Oregon State University, 160 SW 26th St, Corvallis, OR, 97331, USA.
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Health, Oregon State University, 160 SW 26th St, Corvallis, OR, 97331, USA.
| | - Miriam L Diamond
- Department of Earth Sciences and School of the Environment, University of Toronto, 149 College Street, Suite 410, Fourth Floor, Toronto, ON, M5T 1P5, Canada.
| | - Liisa M Jantunen
- Environment and Climate Change Canada, Government of Canada, Canada.
| | - Piush J Mandhane
- Pediatric Respiratory Medicine, University of Alberta, 11405-87 Avenue Edmonton, Alberta, T6G 1C9, Canada.
| | - Theo J Moraes
- Department of Pediatrics, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON, M5G 1X8, Canada.
| | - Garthika Navaranjan
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Sixth Floor, Toronto, ON, MST 3M7, Canada.
| | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Sixth Floor, Toronto, ON, MST 3M7, Canada.
| | - Elinor Simons
- Department of Pediatrics and Child Health, University of Manitoba, 840 Sherbrook Street, University of Manitoba, Winnipeg, MB, R3A 1S1, Canada.
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON, M5G 1X8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Sixth Floor, Toronto, ON, MST 3M7, Canada.
| | - Tim K Takaro
- Department of Health Sciences, Simon Fraser University, 8888 University Drive, Blusson Hall, Room 11300, Burnaby, B.C, V5A 1S6, Canada.
| | - Stuart E Turvey
- Pediatric Immunology, The University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Sixth Floor, Toronto, ON, MST 3M7, Canada.
| |
Collapse
|
13
|
Siwik CJ, Cash E, Sephton SE. Depressive symptoms and shorter survival in lung cancer: the role of leukocyte telomere length. Psychol Health 2023; 38:1649-1664. [PMID: 35240880 PMCID: PMC9440155 DOI: 10.1080/08870446.2022.2040500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/06/2022] [Accepted: 02/04/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine the association between depressive symptoms, leukocyte telomere length-a marker of cellular ageing, and survival amongst lung cancer patients. DESIGN Patients with non-small cell lung cancer were recruited from a university-affiliated cancer center clinic. MAIN OUTCOME Patients (N = 67) reported on depressive symptoms and provided a blood sample for leukocyte telomere length assessment at baseline and at a 3-month follow-up. Survival status was tracked over 3 years. RESULTS Age at diagnosis and depressive symptoms, as measured by the CES-D, were associated with shorter leukocyte telomere length (p < .05), although only age at diagnosis contributed statistical significance to the model. Depressive symptoms predicted shorter survival from date of diagnosis (p < .01). Patients who reported experiencing clinically meaningful levels of depressive symptoms (CES-D scores ≥ 16) demonstrated shorter survival than those who reported sub-clinical levels of depressive symptoms (p < .05). Leukocyte telomere length did not emerge as a predictor of shorter survival. CONCLUSION Clinically meaningful levels of depressive symptoms are associated with shorter survival amongst lung cancer patients. These findings support the on-going efforts to screen all cancer patients for low mood and to investigate mechanisms linking depressive symptoms and shorter survival in cancer contexts.
Collapse
Affiliation(s)
- Chelsea J. Siwik
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Elizabeth Cash
- Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville School of Medicine, Louisville, KY, United States
- UofL Health - James Graham Brown Cancer Center, Louisville, KY, United States
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States
| | - Sandra E. Sephton
- UofL Health - James Graham Brown Cancer Center, Louisville, KY, United States
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States
- Department of Psychology, Brigham Young University, Provo, UT, United States
| |
Collapse
|
14
|
Hoogland AI, Gonzalez BD, Park JY, Small BJ, Sutton SK, Pidala JA, Smith KS, Bower JE, Jacobsen PB, Jim HS. Associations of Germline Genetic Variants With Depression and Fatigue Among Hematologic Cancer Patients Treated With Allogeneic Hematopoietic Cell Transplantation. Psychosom Med 2023; 85:813-819. [PMID: 37678326 PMCID: PMC10915106 DOI: 10.1097/psy.0000000000001251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Depression and fatigue are common among cancer patients and are associated with germline genetic variation. The goal of this pilot study was to examine genetic associations with depression and fatigue in the year after allogeneic hematopoietic cell transplant (HCT). METHODS Blood was collected from patients and their donors before HCT. Patients completed self-report measures of depression and fatigue before HCT (T1), 90 days post-HCT (T2), and 1 year post-HCT (T3). Of the 384 genetic variants genotyped on a custom Illumina BeadChip microarray, 267 were retained for analysis based on quality control. Main effects of patient and donor variants as well as their interaction were examined using regression analyses. Significant variants were defined as those with a false discovery rate-adjusted p value of <.05. RESULTS The sample consisted of 59 patient-donor pairs. Mean levels of depression and fatigue did not change significantly over time ( p values of > .41). Increases in depression from T1 to T2 were associated with patient-donor interactions at rs1928040 ( p = 3.0 × 10 -4 ) and rs6311 ( p = 2.0 × 10 -4 ) in HTR2A . Increases in fatigue from T1 to T2 were associated with patient rs689021 in SORL1 ( p = 6.0 × 10 -5 ) and a patient-donor interaction at rs1885884 in HTR2A ( p < 1.0 × 10 -4 ). CONCLUSIONS Data suggest that variants in genes regulating the serotonergic system ( HTR2A ) and lipid metabolism ( SORL1 ) are associated with changes in depression and fatigue in allogeneic HCT patients, implicating patients' own genetic inheritance as well as that of donors. Additional studies are warranted to confirm these findings.
Collapse
Affiliation(s)
- Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brent J. Small
- College of Aging, University of South Florida, Tampa, FL 33620 USA
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Steven K. Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Joseph A. Pidala
- Department of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Kristen S. Smith
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Julienne E. Bower
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA 90095 USA
| | - Paul B. Jacobsen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612 USA
| |
Collapse
|
15
|
Dorfman CS, Fisher HM, Thomas S, Kelleher SA, Winger JG, Mitchell NS, Miller SN, Somers TJ. Breast cancer survivors with pain: an examination of the relationships between body mass index, physical activity, and symptom burden. Support Care Cancer 2023; 31:604. [PMID: 37782420 PMCID: PMC10721211 DOI: 10.1007/s00520-023-08064-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Overweight and obesity are common for breast cancer survivors and associated with high symptom burden (i.e., pain, fatigue, depressive symptoms). Physical activity may protect breast cancer survivors with higher body mass indexes (BMI) from increased symptoms. However, the role of physical activity in buffering the relationship between higher BMI and greater symptoms is unclear. METHODS Baseline data from a randomized trial investigating Pain Coping Skills Training among breast cancer survivors (N = 327) with pain were used to examine the relationship between self-reported BMI (kg/m2) and physical activity level (Rapid Assessment of Physical Activity; suboptimal vs. optimal) with pain (Brief Pain Inventory; severity and interference), fatigue (PROMIS-Fatigue short form), and depressive symptoms (Center for Epidemiological Studies Depression Scale). Analyses were conducted in SPSS. Hayes PROCESS macro (Model 1) assessed whether physical activity moderated the relationship between BMI and symptoms. RESULTS Lower BMI (B = .06, p < .01) and optimal physical activity (B = - .69, p < .01) were independently associated with lower pain interference. Lower BMI was also associated with lower pain severity (B = .04, p < .001). Neither BMI nor physical activity was associated with fatigue or depressive symptoms. Physical activity did not moderate the relationship between BMI and symptoms. CONCLUSIONS Among breast cancer survivors experiencing pain, higher BMI and being less physically active were related to greater pain (i.e., severity and/or interference). Physical activity did not buffer the relationships between BMI and pain, fatigue, and depressive symptoms, suggesting that physical activity alone may not be sufficient to influence the strength of the relationships between BMI and symptoms.
Collapse
Affiliation(s)
- Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
| | - Hannah M Fisher
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Samantha Thomas
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Sarah A Kelleher
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Joseph G Winger
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Nia S Mitchell
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Shannon N Miller
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Tamara J Somers
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
16
|
Shah K, Geller DA, Tohme S, Antoni M, Kallem CJ, Vodovotz Y, Ramanathan R, Naveen R, Geroni M, Devine L, Amin A, Kiefer GJ, Zandberg DP, Reyes V, Steel JL. Predictors and Consequences of Cancer and Non-Cancer-Related Pain in Those Diagnosed with Primary and Metastatic Cancers. Curr Oncol 2023; 30:8826-8840. [PMID: 37887537 PMCID: PMC10605887 DOI: 10.3390/curroncol30100637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES The aims of the study were to (1) describe types of pain in cancer patients, (2) examine the predictors and consequences of pain, (3) investigate the association between type of pain and survival, and (4) examine potential biological mediators of pain and survival. METHODS This was a secondary analysis of baseline data from patients diagnosed with cancer. Patients answered questionnaires that assessed sociodemographic characteristics, pain, depression, sleep, and fatigue. Blood was collected and cytokine assays were performed. Analysis of variance, Kaplan-Meier, and Cox regression survival analyses were used to test the aims. RESULTS Of the 779 patients diagnosed with cancer, the mean age was 63.5 years, 57.8% male, and 90.6% White. Of those who reported pain (total 70.3%), 46.5% stated their pain was cancer-related while 53.5% stated their pain was non-cancer-related. While both cancer and non-cancer-related pain was associated with depressive symptoms, fatigue, and sleep duration, those with cancer-related pain had significantly higher rates of depressive symptoms (F(1,516) = 21.217, p < 0.001) and fatigue (F(1,516) = 30.973, p < 0.001) but not poorer sleep (F(1,497) = 0.597, p = 0.440). After adjusting for sociodemographic, disease-related characteristics, depression, sleep duration, and morphine milligram equivalent, patient reports of cancer-related pain were significantly associated with poorer survival (HR = 0.646, 95% CI = 0.459-0.910, p = 0.012) compared to those with non-cancer-related pain, which was not associated with survival (HR = 1.022, 95% CI = 0.737-1.418, p = 0.896). Cytokines did not significantly mediate the link between pain and survival. CONCLUSION While nearly half of the pain reported was cancer-related, both types of pain resulted in greater symptom burden, but only cancer-related pain was associated with survival.
Collapse
Affiliation(s)
- Kriti Shah
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - David A. Geller
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Samer Tohme
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Michael Antoni
- Department of Psychology, University of Miami, Coral Gables, FL 33124, USA;
| | - Cramer J. Kallem
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Yoram Vodovotz
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Rekha Ramanathan
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Raam Naveen
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - MacKenzie Geroni
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - LaNita Devine
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Aarshati Amin
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| | - Gauri J. Kiefer
- UPMC Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (G.J.K.); (D.P.Z.); (V.R.)
| | - Dan P. Zandberg
- UPMC Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (G.J.K.); (D.P.Z.); (V.R.)
| | - Vincent Reyes
- UPMC Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (G.J.K.); (D.P.Z.); (V.R.)
| | - Jennifer L. Steel
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
| |
Collapse
|
17
|
Siddiqi A, Monton O, Woods A, Masroor T, Fuller S, Owczarzak J, Yenokyan G, Cooper LA, Freund KM, Smith TJ, Kutner JS, Colborn KL, Joyner R, Elk R, Johnston FM. Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial. BMC Palliat Care 2023; 22:139. [PMID: 37718442 PMCID: PMC10506196 DOI: 10.1186/s12904-023-01250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND There are persistent racial and ethnic health disparities in end-of-life health outcomes in the United States. African American patients are less likely than White patients to access palliative care, enroll in hospice care, have documented goals of care discussions with their healthcare providers, receive adequate symptom control, or die at home. We developed Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC) to address these disparities. DeCIDE PC is an integrated community health worker (CHW) palliative care intervention that uses community health workers (CHWs) as care team members to enhance the receipt of palliative care for African Americans with advanced cancer. The overall objectives of this study are to (1) assess the effectiveness of the DeCIDE PC intervention in improving palliative care outcomes amongst African American patients with advanced solid organ malignancy and their informal caregivers, and (2) develop generalizable knowledge on how contextual factors influence implementation to facilitate dissemination, uptake, and sustainability of the intervention. METHODS We will conduct a multicenter, randomized, assessor-blind, parallel-group, pragmatic, hybrid type 1 effectiveness-implementation trial at three cancer centers across the United States. The DeCIDE PC intervention will be delivered over 6 months with CHW support tailored to the individual needs of the patient and caregiver. The primary outcome will be advance care planning. The treatment effect will be modeled using logistic regression. The secondary outcomes are quality of life, quality of communication, hospice care utilization, and patient symptoms. DISCUSSION We expect the DeCIDE PC intervention to improve integration of palliative care, reduce multilevel barriers to care, enhance clinic and patient linkage to resources, and ultimately improve palliative care outcomes for African American patients with advanced cancer. If found to be effective, the DeCIDE PC intervention may be a transformative model with the potential to guide large-scale adoption of promising strategies to improve palliative care use and decrease disparities in end-of-life care for African American patients with advanced cancer in the United States. TRIAL REGISTRATION Registered on ClinicalTrials.gov (NCT05407844). First posted on June 7, 2022.
Collapse
Affiliation(s)
- Amn Siddiqi
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Olivia Monton
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Alison Woods
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Taleaa Masroor
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Shannon Fuller
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Jill Owczarzak
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Gayane Yenokyan
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Lisa A Cooper
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore, MD, 21205, USA
- Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 2-515, Baltimore, MD, 21287, USA
| | - Karen M Freund
- Department of Medicine, Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA
| | - Thomas J Smith
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Jean S Kutner
- Department of Medicine, University of Colorado School of Medicine, 12401 E 17th Ave, Aurora, CO, 80045, USA
| | - Kathryn L Colborn
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Place, Aurora, CO, 80045, USA
| | - Robert Joyner
- Richard A. Henson Research Institute, TidalHealth Peninsula Regional, 100 East Carroll Street, Salisbury, MD, 21801, USA
| | - Ronit Elk
- Department of Medicine, University of Alabama at Birmingham, 933 19th Street S, Birmingham, AL, 35205, USA
| | - Fabian M Johnston
- Division of Surgical Oncology, Department of Surgery, Johns Hopkins University, 600 N Wolfe Street, Blalock 606, Baltimore, MD, 21287, USA.
| |
Collapse
|
18
|
Walsh EA, Popok PJ, Ream M, Bainter S, Perdomo D, Taub C, Saez-Clarke E, Kesmodel S, Blomberg BB, Antoni MH. Predictors of initial engagement with an asynchronous cognitive behavioral stress management website among older women with nonmetastatic breast cancer. Support Care Cancer 2023; 31:466. [PMID: 37452882 PMCID: PMC11051687 DOI: 10.1007/s00520-023-07939-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Digital interventions, like websites, offer greater access to psychosocial treatments; however, engagement is often suboptimal. Initial use may be a target to "hook" participants. Few studies examine engagement with cognitive behavioral stress management (CBSM). We tested predictors of engagement in the first week of using a CBSM website among women with breast cancer (BC). METHODS Older women (≥ 50 years) with nonmetastatic BC enrolled in an on-going trial (8/2016-4/2022, #NCT03955991) and were randomized to receive 10 synchronous, virtual CBSM group sessions immediately (n = 41) or after a 6-month waitlist (n = 34). All received simultaneous access to an asynchronous website, where supplemental videos and resources were released weekly. Engagement was tracked via breadth (features used) and depth (clicks within content). Multilevel modeling tested predictors of engagement (i.e., time, condition, age, daily stress, depression, race, ethnicity, disease stage). RESULTS Breadth decreased over the first week of CBSM (b = -0.93, p < .01), and women with more advanced stage disease engaged with more breadth (b = 0.52, p < .01) and depth (b = 14.06, p < .01) than women with earlier stage disease. Non-Hispanic (b = -0.59, p = .03) and White (b = -0.97, p < .01) women engaged with more features. Cancer stage and intervention timing interacted. Women with more advanced cancer stage who received CBSM later engaged with the most depth (b = -11.73, p = .04). All other characteristics did not predict engagement. CONCLUSIONS Disease stage, race, ethnicity, and intervention timing predicted engagement with a CBSM website in older BC patients. IMPLICATIONS FOR CANCER SURVIVORS Delivering CBSM later in cancer treatment may mitigate competing demands. Fostering greater engagement in racial/ethnic minorities is needed.
Collapse
Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Fifth Floor Coral, Gables, FL, 33146, USA.
| | - Paula J Popok
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Fifth Floor Coral, Gables, FL, 33146, USA
| | - Molly Ream
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Fifth Floor Coral, Gables, FL, 33146, USA
| | - Sierra Bainter
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Fifth Floor Coral, Gables, FL, 33146, USA
| | - Dolores Perdomo
- Department of Psychiatry & Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Chloe Taub
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Estefany Saez-Clarke
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Fifth Floor Coral, Gables, FL, 33146, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Susan Kesmodel
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Bonnie B Blomberg
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
- Department of Microbiology/Immunology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Fifth Floor Coral, Gables, FL, 33146, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| |
Collapse
|
19
|
Ho M, Pullenayegum E, Fuller-Thomson E. Is Social Participation Associated with Successful Aging among Older Canadians? Findings from the Canadian Longitudinal Study on Aging (CLSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6058. [PMID: 37372645 DOI: 10.3390/ijerph20126058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/24/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023]
Abstract
The present study examines various activities of social participation (i.e., church or religious activities; educational or cultural activities; service club or fraternal organization activities; neighbourhood, community, or professional association activities; volunteer or charity work; and recreational activities) as contributing factors to successful aging. Successful aging in this study includes the following: adequate social support, no limitations with respect to Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), no mental illness in the preceding year, no serious cognitive decline or pain that prevents activity, as well as high levels of happiness, and self-reports of good physical health, mental health, and successful aging. Methods: The Canadian Longitudinal Study on Aging (CLSA) is a large, national, longitudinal study on aging. A secondary analysis of the baseline (i.e., 2011-2015) and Time 2 (i.e., 2015-2018) data of the CLSA was conducted on a sample of 7623 older adults who were defined as "aging successfully" at baseline and were aged 60+ at Time 2. Binary logistic regression analyses were employed to examine the association between engaging in various social participation activities at baseline and aging successfully at Time 2. Results: In a subsample (n = 7623) of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort who were aging successfully at baseline, the prevalence of successful aging at Time 2 was significantly higher among the participants who participated in volunteer or charity work and recreational activities compared to those who were not involved in these activities. After adjusting for 22 potential factors, the results of the binary logistic regression analyses reported that participants who, at baseline, participated in volunteer or charity work and recreational activities had higher age-sex-adjusted odds of achieving successful aging (volunteer or charity work: aOR = 1.17, 95% CI: 1.04, 1.33; recreational activities: aOR = 1.15, 95% CI: 1.00, 1.32). Conclusions: Among six types of social participation activities, people who participated in volunteer or charity work and recreational activities were more likely to achieve successful aging than their counterparts who did not engage in these activities. If these associations are found to be causal, policies and interventions encouraging older adults to participate in volunteer or charity work and recreational activities may support older adults to achieve successful aging in later life.
Collapse
Affiliation(s)
- Mabel Ho
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| |
Collapse
|
20
|
Cole AR, Adams DR, Ben-David S, Sapiro B, Villodas ML, Stanhope V, Jaccard J, Munson MR. Feasibility, Acceptability and Preliminary Implementation of the Cornerstone Program for Transition-Age Youth with Mental Health Conditions: A Mixed Methods Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:506-519. [PMID: 36738385 PMCID: PMC10835190 DOI: 10.1007/s10488-023-01254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
Transition-age youth with mental health conditions from low socio-economic backgrounds often drop out of mental health services and, as such, do not receive therapeutic doses of treatment. Cornerstone is an innovative team-based, multi-component intervention designed to address the clinical needs of this understudied population through coordination and extensive provision of services in vivo (in the community). The present study used a convergent parallel mixed-methods design. Researchers collected quantitative and qualitative data during a small developmental trial, analyzing the two data types independently and then exploring them side-by-side to evaluate feasibility, acceptability, and preliminary implementation. Semi-structured interviews and quantitative surveys were conducted with transition-age youth, clinic staff, and policy makers. Qualitative interview guides were developed using the Consolidated Framework for Implementation Research to build understanding on implementation determinants alongside feasibility and acceptability. A two-group preliminary randomized trial was conducted to assess feasibility outcomes, such as recruitment, randomization, measurement performance, and trends in pre- to post- outcomes. Using grounded theory coding techniques, transcripts were coded by multiple coders, and themes were identified on acceptability and implementation. The team recruited fifty-six transition-age youth. Randomization was used in the study and the intervention was provided without incident. Results suggest individual components with both the social worker and mentor were more acceptable to participants than group-based approaches. Thematic analyses revealed themes associated with the inner, outer, and policy contexts describing a range of critical implementation determinants. Findings suggest that Cornerstone is feasible, acceptable, and promising for transition-age youth. It represents an innovative multi-component intervention worth exploring for transition-age youth with mental health conditions in a larger efficacy trial.Trial registration: The trial was registered at ClinicalTrials.gov (NCT02696109) on 22 April 16, Protocol Record R34-MH102525-01A1, New York University, Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trial.
Collapse
Affiliation(s)
- Andrea R Cole
- School of Pharmacy and Health Sciences, Fairleigh Dickinson University, Madison, NJ, 07940, USA
- Brown School of Social Work and Public Health, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Danielle R Adams
- School of Pharmacy and Health Sciences, Fairleigh Dickinson University, Madison, NJ, 07940, USA
- Brown School of Social Work and Public Health, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Shelly Ben-David
- School of Social Work, University of British Columbia, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Beth Sapiro
- Department of Social Work and Child Advocacy, Montclair State University, 1 Normal Avenue, Montclair, NJ, 07043, USA
| | - Melissa L Villodas
- Department of Social Work, George Mason University, 4400 University Drive, MSN: 1F8, Fairfax, VA, 22030, USA
| | - Victoria Stanhope
- Silver School of Social Work, New York University, 1 Washington Square, New York, NY, 10003, USA
| | - James Jaccard
- Silver School of Social Work, New York University, 1 Washington Square, New York, NY, 10003, USA
| | - Michelle R Munson
- Silver School of Social Work, New York University, 1 Washington Square, New York, NY, 10003, USA.
| |
Collapse
|
21
|
Abduljawad SF, Beckstead JW, Dobbs D, Visovsky C, Rodriguez CS, McMillan SC, Wang HL. Fatigue-related symptom clusters and functional status of older adults in hospice. Palliat Support Care 2023; 21:57-64. [PMID: 35676795 PMCID: PMC11022836 DOI: 10.1017/s1478951522000207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Fatigue is frequently co-existing with other symptoms and is highly prevalent among patients with cancer and geriatric population. There was a lack of knowledge that focus on fatigue clusters in older adults with cancer in hospice care. OBJECTIVES To identify fatigue-related symptom clusters in older adult hospice patients and discover to what extent fatigue-related symptom clusters predict functional status while controlling for depression. METHOD This was a cross-sectional study in a sample of 519 older adult hospice patients with cancer, who completed the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression, Boston Short Form Scale, and the Palliative Performance Scale. Data from a multi-center symptom trial were extracted for this secondary analysis using exploratory factor analysis and hierarchical multiple regression analysis. RESULTS Data from 519 patients (78 ± 7 years) with terminal cancer who received hospice care under home healthcare services revealed that 39% of the participants experienced fatigue-related symptom clusters (lack of energy, feeling drowsy, and lack of appetite). The fatigue cluster was significantly associated positively with depression (r = 0.253, p < 0.01), and negatively with functional status (r = -0.117, p < 0.01) and was a strong predictor of participants' low functional status. Furthermore, depression made a significant contribution to this predictive relationship. CONCLUSION Older adult hospice patients with cancer experienced various concurrent symptoms. The fatigue-specific symptom cluster was identified significantly associated with depression and predicted functional status. Fatigue should be routinely monitored in older adults, especially among hospice cancer patients, to help reduce psychological distress and prevent functional decline.
Collapse
Affiliation(s)
- Suzan F Abduljawad
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | | | - Debra Dobbs
- School of Aging Studies, University of South Florida, Tampa, FL
| | | | | | - Susan C McMillan
- Emeritus Distinguished Professor, University of South Florida, Tampa, FL
| | - Hsiao Lan Wang
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL
| |
Collapse
|
22
|
Potiaumpai M, Schmitz KH, Mineishi S, Naik S, Wirk B, Rakszawski K, Ehmann WC, Claxton D, Nickolich M, Zemel BS, Zheng H. IMPROVE-BMT: a protocol for a pilot randomised controlled trial of prehabilitation exercise for adult haematopoietic stem cell transplant recipients. BMJ Open 2023; 13:e066841. [PMID: 36657760 PMCID: PMC9853231 DOI: 10.1136/bmjopen-2022-066841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Haematopoietic stem cell transplant (HSCT) in adults is an intensive medical procedure for a variety of haematological malignancies. Although there is a large body of evidence demonstrating the negative effects of HSCT on physical function and psychosocial parameters, there is limited evidence on the impact of HSCT on body composition and bone health. Further, aerobic and resistance-training exercise interventions aimed at improving physical function and patient-reported outcomes largely take place during the peritransplant and post-transplant period. Prehabilitative exercise, or exercise prior to medical treatment, has been successfully deployed in presurgical candidates and other tumour sites, yet there is a paucity of evidence on the effect of prehabilitation in HSCT patients. The aim of this study is to investigate the feasibility, acceptability and safety of a resistance training exercise programme in patients with haematological malignancies prior to HSCT. METHODS AND ANALYSIS IMpact of PRehabilitation in Oncology Via Exercise-Bone Marrow Transplant is a single-site, pilot randomised controlled trial of an exercise intervention compared with usual care. The primary aim is to assess the feasibility, acceptability and safety of the resistance-training exercise intervention prior to HSCT. Secondary aims include evaluating the differences in physical function, body composition, bone mineral density and patient-reported outcomes between the exercise group and usual care control group. Outcome measurements will be assessed: prior to HSCT, on/around day of HSCT admission, +30 days post-HSCT and +100 days post-HSCT. The exercise intervention is a home-based resistance training exercise programme that incorporates resistance band and body weight exercises. The primary outcomes will be reported as percentages and/or mean values. The secondary outcomes will be analysed using appropriate statistical methods to portray within-group and between-group differences. ETHICS AND DISSEMINATION The study has Penn State College of Medicine approval. Results will be disseminated through scientific publication and presentation at exercise-related and oncology-related scientific meetings. TRIAL REGISTRATION NUMBER NCT03886909.
Collapse
Affiliation(s)
- Melanie Potiaumpai
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kathryn H Schmitz
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shin Mineishi
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Seema Naik
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Baldeep Wirk
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Kevin Rakszawski
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - W Christopher Ehmann
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - David Claxton
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Myles Nickolich
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Babette S Zemel
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hong Zheng
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
23
|
Roche KN, Cooper D, Armstrong TS, King AL. The link between psychological distress and survival in solid tumor patients: A systematic review. Cancer Med 2023; 12:3343-3364. [PMID: 36602400 PMCID: PMC9939126 DOI: 10.1002/cam4.5200] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Research has demonstrated that solid tumor patients experience high levels of psychological distress at the time of diagnosis. While distress has been associated with many adverse clinical outcomes, little is known about how this symptom may influence the disease trajectory for cancer patients, affecting outcomes such as progression, recurrence, and survival. The purpose of this systematic review was to explore the literature linking distress with survival in solid tumor patients, which may guide future work exploring clinical outcomes as a function of distress. METHODS A systematic search of PubMed, Embase, and Web of Science was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with predefined eligibility criteria. Thirteen studies met the inclusion criteria and were selected for review. RESULTS Findings from this review demonstrated a weak-to-moderate relationship between cancer patients' experience of distress and overall survival, with most included studies (11/13) finding at least one predictive analysis to be significant when controlling for confounders. However, significant heterogeneity in the literature, particularly with study sample characteristics and varying methodologies, made direct comparisons across studies challenging. CONCLUSION Findings from this review suggest that psychological distress may have an impact on disease-related outcomes, including (but not limited to) survival. Future work should consider performing disease-specific analyses controlling for key prognostic factors to better understand the nuanced relationship between distress and clinical outcomes, which may allow further understanding of the biological underpinnings of this relationship and enable the development of targeted interventions for improving distress.
Collapse
Affiliation(s)
- Kayla N. Roche
- Neuro‐Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Diane Cooper
- National Institutes of Health LibraryBethesdaMarylandUSA
| | - Terri S. Armstrong
- Neuro‐Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Amanda L. King
- Neuro‐Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| |
Collapse
|
24
|
Leung T, Yang T, Xiao L, Xu C, Zhu C. Effects of Mobile Mindfulness Meditation on the Mental Health of University Students: Systematic Review and Meta-analysis. J Med Internet Res 2023; 25:e39128. [PMID: 36596239 PMCID: PMC9856434 DOI: 10.2196/39128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/17/2022] [Accepted: 09/05/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Mobile mindfulness meditation (MMM) is a mindfulness meditation intervention implemented using mobile devices such as smartphones and apps. MMM has been used to help manage the mental health of university students. OBJECTIVE This study aims to evaluate the effectiveness of MMM on the mental health of university students in the areas of stress, anxiety, depression, mindfulness, well-being, and resilience. METHODS We conducted a systematic review and meta-analysis of the effectiveness of MMM on the mental health of university students. This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An electronic literature search was performed on PubMed, Web of Science, EBSCO, Cochrane Library, and Embase databases, from inception to July 16, 2021. This study was conducted to identify studies that reported the effects of MMM on the primary outcomes including stress, anxiety, and depression, and on the secondary outcomes including mindfulness, well-being, and resilience. Two reviewers retrieved articles, evaluated quality, and extracted data independently. The methodological quality of the selected studies was determined using the Cochrane criteria for risk-of-bias assessment. Standardized mean differences (SMDs) for continuous outcomes and risk ratios for dichotomous outcomes were calculated. Sensitivity analyses and subgroup analyses were performed for results with high heterogeneity. The RevMan version 5.3 was used to perform meta-analysis. RESULTS A total of 10 studies, including 958 university students, were selected for this meta-analysis. Results of the primary outcome showed that the MMM groups were more effective than the control groups in decreasing stress (SMD -0.41, 95% CI -0.59 to -0.23; P<.001) and alleviating anxiety (SMD -0.29, 95% CI -0.50 to -0.09; P=.004). However, there was no difference between the MMM groups and the control groups in depression (SMD -0.14, 95% CI -0.30 to 0.03; P=.11). The use of either waitlist control or traditional face-to-face intervention in the control group was identified as the source of heterogeneity. Specifically, the waitlist control subgroup (SMD -0.33, 95% CI -0.53 to -0.13; P=.002) was superior when compared with the face-to-face subgroup (SMD 0.29, 95% CI -0.01 to 0.59; P=.06). Results of the secondary outcome showed that the MMM groups were more effective than the control groups in enhancing well-being (SMD 0.30, 95% CI 0.11-0.50; P=.003) and improving mindfulness (SMD 2.66, 95% CI 0.77-4.55; P=.006). Whether commercial sponsorship was obtained was considered as the source of heterogeneity. The "without company support" group (SMD 17.60, 95% CI 11.32-23.87; P<.001) was superior to the "with company support" group (SMD 1.17, 95% CI -0.82 to 3.15; P=.25) in raising the level of mindfulness. However, there was no difference between the MMM and control groups in resilience (SMD -0.06, 95% CI -0.26 to 0.15; P=.59). The evidence level of the results from the 10 studies was determined to be moderate to low. CONCLUSIONS MMM was an effective method to reduce stress and anxiety, and to increase the well-being and mindfulness of university students. However, further studies are needed to confirm our findings. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022303585; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=303585.
Collapse
Affiliation(s)
| | - Ting Yang
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lei Xiao
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Changxia Xu
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunqin Zhu
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| |
Collapse
|
25
|
Fisher HM, Stalls J, Winger JG, Miller SN, Plumb Vilardaga JC, Majestic C, Kelleher SA, Somers TJ. Role of self-efficacy for pain management and pain catastrophizing in the relationship between pain severity and depressive symptoms in women with breast cancer and pain. J Psychosoc Oncol 2023; 41:87-103. [PMID: 35311481 PMCID: PMC9489816 DOI: 10.1080/07347332.2022.2046676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE This study evaluated the relationship between pain and depressive symptoms through pain self-efficacy and pain catastrophizing in breast cancer patients with pain. DESIGN Secondary analysis of a randomized trial investigating a cognitive-behavioral pain management protocol. SAMPLE Females (N = 327) with stage I-III breast cancer and report of at least moderate pain. METHODS Pain severity, pain self-efficacy, pain catastrophizing, and depressive symptoms were measured. The proposed model was assessed using structural equation modeling. RESULTS Higher pain severity was significantly related to lower pain self-efficacy and higher pain catastrophizing. Lower pain self-efficacy and higher pain catastrophizing were significantly related to more depressive symptoms. Higher pain severity was significantly associated with more depressive symptoms through lower pain self-efficacy and higher pain catastrophizing. The association between pain severity and depressive symptoms was not significant when specified as a direct effect. CONCLUSION Pain severity related to depressive symptoms in breast cancer patients via pain self-efficacy and pain catastrophizing. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Measurement of pain self-efficacy and pain catastrophizing should be incorporated into comprehensive pain assessments for women with breast cancer, as these variables may be relevant therapeutic targets. Psychosocial symptom management interventions should include strategies that increase pain self-efficacy and decrease pain catastrophizing because these pain-related cognitive variables appear to drive the relationship between pain severity and depressive symptoms.
Collapse
Affiliation(s)
- Hannah M. Fisher
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann Stalls
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Joseph G. Winger
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Shannon N. Miller
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | | | - Catherine Majestic
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Sarah A. Kelleher
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| |
Collapse
|
26
|
Chauvin V, Villarino RTH, Bernard P, Yazbek H, Kern L, Hokayem M, Mattar L, Kotbagi G, Rizk M, Morvan Y, Baillot A, Romain AJ. Impacts of social restrictions on mental health and health behaviours of individuals with multimorbidity during Covid-19 pandemic. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231221609. [PMID: 38106621 PMCID: PMC10725145 DOI: 10.1177/26335565231221609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023]
Abstract
Background Social restrictions and their possible impact on lifestyle make people with multimorbidity (≥2 co-existing chronic conditions) more vulnerable to poor perceived mental health and health behaviours modifications during the COVID-19 pandemic. Objective To understand the mental health status and health behaviour modifications among individuals with multimorbidity during different levels of COVID-19 social restrictions. Methods Longitudinal multinational cohort study consisting of two online questionnaires with its first wave taken place while social restrictions were imposed (May 2020), and its second wave with less social restrictions in place (November 2020). Including 559 participants (wave 1) and 147 participants from wave 1 (wave 2) with an average age of 34.30±12.35 and 36.21±13.07 years old. Mostly females living in Canada, France, India and Lebanon. Results The prevalence of multimorbidity was 27.68% (wave 1) and 35.37% (wave 2). While social restrictions were imposed, people with multimorbidity were 2 to 3 times more likely to experience psychological distress, depressive symptoms, increased stress or isolation than those without multimorbidity. Health behaviours were also modified during this period with people with multimorbidity being more likely to reduce their physical activity and increased their fruit and vegetable consumption. In wave 2, regardless of multimorbidity status, sexual desire continuously decreased while stress and psychological distress increased. Conclusion Mental health and health behaviours modifications occurred while social restrictions were imposed and people with multimorbidity were more severely impacted than those without multimorbidity, indicating a need for a more adapted approach of care during socially restrictive periods for this population.
Collapse
Affiliation(s)
- Valérie Chauvin
- Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | | | - Paquito Bernard
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Université du Québec à Montréal, Montréal, QC, Canada
| | - Hanan Yazbek
- Centre local de services communautaires, Montréal, QC, Canada
| | | | - Marie Hokayem
- Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | | | | | - Melissa Rizk
- Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | | | - Aurélie Baillot
- Université du Québec en Outaouais, Gatineau, QC, Canada
- Institut du Savoir Monfort, Ottawa, ON, Canada
| | - Ahmed Jérôme Romain
- Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| |
Collapse
|
27
|
Chen Y, Maitiniyazi G, Li Z, Li T, Liu Y, Zhang R, Cao X, Gu D, Xia S. TNF-α Mediates the Association between Dietary Inflammatory Index and Depressive Symptoms in Breast Cancer. Nutrients 2022; 15:nu15010084. [PMID: 36615742 PMCID: PMC9823771 DOI: 10.3390/nu15010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
This study examined the association between the energy-adjusted Dietary Inflammatory Index (E-DII)-based dietary inflammatory potential and depressive symptoms (DepS) among patients with breast cancer and explores whether systemic inflammation mediates this association. We assessed dietary intake and DepS in 220 breast cancer patients by three 24 h dietary recalls and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and determined plasma levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-1β, IL-4, and IL-6 in 123 blood samples. We found that each one-point increase of E-DII was related to a 53% elevated risk of DepS. Patients with the most pro-inflammatory diets had a 5.13 times higher risk of DepS than those with the most anti-inflammatory diets. Among the E-DII components, vitamin B2, zinc, and iron were inversely associated with DepS risk. Furthermore, E-DII scores were positively associated with CRP and TNF-α. Higher levels of TNF-α and IL-6 were associated with higher DepS risk. A significant mediating effect of TNF-α was revealed between E-DII and DepS. Our findings suggest that a pro-inflammatory diet is positively associated with breast cancer-related DepS, which may be mediated by TNF-α.
Collapse
Affiliation(s)
- Yue Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China
| | | | - Ziyuan Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China
| | - Tong Li
- Department of Psychiatry, Jiangsu Rongjun Hospital, Wuxi 214035, China
| | - Yuan Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China
| | - Rong Zhang
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214125, China
| | - Xiaoyun Cao
- Department of Breast Surgery, Affiliated Obstetrics and Gynecology Hospital of Jiangnan University, Wuxi 214002, China
| | - Danfeng Gu
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214125, China
| | - Shufang Xia
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China
- Correspondence:
| |
Collapse
|
28
|
Keeney AJ, Quandt A, Meng Y, Flores Jr L, Flores D, Garratt R, Hernandez P, Villaseñor M. “We All Have a Job to Do in This World, It’s up to Us”: Farmworker and Farmer Mental Health in a Rural US-Mexico Border Region. J Agromedicine 2022; 28:365-377. [DOI: 10.1080/1059924x.2022.2154298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
29
|
Yennurajalingam S, Azhar A, Lu Z, Rodriguez AJ, Arechiga AB, Guerra-Sanchez M, Stanton P, Andersen CR, Urbauer DL, Bruera E. Open-Label Placebo for the Treatment of Cancer-Related Fatigue in Patients with Advanced Cancer: A Randomized Controlled Trial. Oncologist 2022; 27:1081-1089. [PMID: 36106759 PMCID: PMC9732231 DOI: 10.1093/oncolo/oyac184] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/13/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine the effects of an open-labeled placebo (OLP) compared to a waitlist control (WL) in reducing cancer-related fatigue (CRF) in patients with advanced cancer using Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). MATERIALS AND METHODS In this randomized controlled trial, patients with fatigue ≥4/10 on Edmonton Symptom Assessment Scale (ESAS) were randomized to OLP one tablet twice a day or WL for 7 days. On day 8, patients of both arms received a placebo for 3 weeks. Changes in FACIT-F from baseline to day 8 (primary outcome) and at day 29, were assessed. Secondary outcomes included FACT-G, Multidimensional Fatigue Symptom Inventory-SF, Fatigue cluster (defined as a composite of ESAS fatigue, pain, and depression), Center for epidemiologic studies-depression, Godin leisure-time physical activity questionnaire, and global symptom evaluation. RESULTS A total of 84/90 (93%) patients were evaluable. The mean (SD) FACIT-F change at day 8 was 6.6 (7.6) after OLP, vs. 2.1 (9.4) after WL (P = .016). On days 15 and 29, when all patients received OLP, there was a significant improvement in CRF and no difference between arms. There was also a significant improvement in ESAS fatigue, and fatigue cluster score in the OLP arm on day 8 of the study (0.029, and 0.044, respectively). There were no significant differences in other secondary outcomes and adverse events between groups. CONCLUSIONS Open-labeled placebo was efficacious in reducing CRF and fatigue clusters in fatigued advanced cancer patients at the end of 1 week. The improvement in fatigue was maintained for 4 weeks. Further studies are needed.
Collapse
Affiliation(s)
- Sriram Yennurajalingam
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Ahsan Azhar
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Zhanni Lu
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Ashley J Rodriguez
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Adrienne B Arechiga
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Maria Guerra-Sanchez
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Penny Stanton
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| | - Clark R Andersen
- The University of Texas MD Anderson Cancer Center, Biostatistics, Houston, TX, USA
| | - Diana L Urbauer
- The University of Texas MD Anderson Cancer Center, Biostatistics, Houston, TX, USA
| | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, Houston, TX, USA
| |
Collapse
|
30
|
Dey AK, Ennis N, Cheng DM, Blokhina E, Raj A, Quinn E, Bendiks S, Palfai T, Dunne EM, Cook RL, Krupitsky E, Samet JH. Impulsivity and linkage to HIV Care among People living with HIV in St. Petersburg, Russia. AIDS Behav 2022; 26:4126-4134. [PMID: 35708831 PMCID: PMC10202133 DOI: 10.1007/s10461-022-03738-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 11/25/2022]
Abstract
This study evaluated the association between impulsivity and linkage to HIV care among Russians living with HIV recruited from an inpatient narcology hospital. Linking Infectious and Narcology Care (LINC) study participants who completed the Barratt Impulsiveness Scale (BIS) were included in these analyses. The primary independent variable was impulsivity score which was categorized as high impulsivity (BIS score > 71) vs. low impulsivity (BIS score < = 71). The primary outcome, linkage to care post recruitment, was defined as one or more HIV medical care visits at 12-month follow-up. Multiple logistic regression models were used to evaluate the association between high impulsivity and linkage to HIV care controlling for potential confounders. Participants (N = 227) were adults with a mean age of 34 years (SD = 5), and the majority were male (74%). We did not detect a significant association between impulsivity and linkage to HIV care after adjusting for respondents' age, gender, CD4 cell count, and depression score. We also found that substance use and hazardous drinking did not appear to confound the relationship. Although our study was unable to detect an association between impulsivity and linkage to HIV care, it may provide direction for future research exploring the associations between impulsivity and HIV care.
Collapse
Affiliation(s)
- Arnab K Dey
- Division of Global Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, 92093, San Diego, CA, USA.
| | | | | | - Elena Blokhina
- First St. Petersburg Pavlov State Medical University, St. Petersburg, Russia
| | - Anita Raj
- Division of Global Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, 92093, San Diego, CA, USA
| | | | | | | | | | | | - Evgeny Krupitsky
- First St. Petersburg Pavlov State Medical University, St. Petersburg, Russia
- V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - Jeffrey H Samet
- Boston University, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| |
Collapse
|
31
|
Jennings EA, Chinogurei C, Adams L. Marital experiences and depressive symptoms among older adults in rural South Africa. SSM - MENTAL HEALTH 2022; 2:100083. [PMID: 36277994 PMCID: PMC9581082 DOI: 10.1016/j.ssmmh.2022.100083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 01/21/2023] Open
Abstract
This paper advances the understanding of how marital transitions may influence mental health by investigating these associations among a population of rural, Black South Africans aged 40+ that was directly impacted by apartheid. Using two waves of data from 4,176 men and women in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated associations between marital experiences and depressive symptoms, by gender, and explored whether economic resources is a moderator of these associations. We found that experiencing a marital dissolution was associated with more depressive symptoms than remaining married for both men and women. We also found that men, but not women, report greater depressive symptoms if they remained separated/divorced, remained widowed, or remained never married between waves. We found no evidence that a decline in wealth moderated the impact of marital dissolution on depressive symptoms for women or men. These findings suggest that the documented benefits of marriage for mental health, and differences by gender in those benefits, may extend to older, rural South Africans, despite the unique experiences of this population.
Collapse
Affiliation(s)
- Elyse A. Jennings
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, USA
| | - Chido Chinogurei
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Leslie Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
32
|
Impacts of breast cancer and chemotherapy on gut microbiome, cognitive functioning, and mood relative to healthy controls. Sci Rep 2022; 12:19547. [PMID: 36380060 PMCID: PMC9664046 DOI: 10.1038/s41598-022-23793-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/05/2022] [Indexed: 11/16/2022] Open
Abstract
Women diagnosed with breast cancer undergoing chemotherapy experience cognitive impairment, symptoms of anxiety and depression, and physical side effects including disruption in the diversity and community composition of the gut microbiome. To date, there is limited research exploring the associations among these specific challenges. The present cross-sectional study explored the associations of self-reported cognitive functioning, depression, and anxiety symptoms, and gut microbiome diversity and community composition in women who were diagnosed with and undergoing chemotherapy treatment for breast cancer (BC) compared to cancer-free healthy controls (HC). The BC group displayed higher rates of cognitive dysfunction (p < 0.001) and depressive symptoms (p < 0.05) relative to HC. There was a significant difference in microbiome community composition between BC and HC, particularly characterized by a decreased relative abundance of the mucin-degrading genus Akkermansia in BC compared to HC (p < 0.05). Association models identified significant associations among group, cognitive, depression, and microbiome variables (p < 0.001). Overall, the study identified that BC participants experienced significant differences in self-reported cognitive functioning, self-reported depression symptoms, microbiome community composition, and mucin-degrading bacteria of the gut-mucosal barrier, relative to HC. The present study is consistent with the hypothesis that gut microbiome community composition impacts a woman's experience with breast cancer and treatment suggesting that microbiome-based interventions have potential for improving quality of life outcomes in individuals with breast cancer.
Collapse
|
33
|
Kamen CS, Reichelt M, Dadgostar P, Alpert AB, Doucette C, Vaughan P, Keuroghlian AS, Yousefi-Nooraie R. Sexual and gender minority cultural humility training for oncology settings: An example of iterative adaptation and implementation. FRONTIERS IN HEALTH SERVICES 2022; 2:958274. [PMID: 36925900 PMCID: PMC10012625 DOI: 10.3389/frhs.2022.958274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022]
Abstract
Background Multiple national organizations recommend that cancer care providers and oncology practices be responsive to the needs of sexual and gender minority (SGM) patients. Oncology practices have attempted to incorporate this recommendation through SGM-focused cultural humility training interventions. It is unclear how best to adapt and implement such training across practices. This manuscript outlines one process for adapting a widely-used SGM training from The Fenway Institute to the context of oncology settings using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) model. Methods We conducted training sessions in two oncology care settings: a breast oncology center and a radiation oncology department. Subsequently, we conducted in-depth interviews with the three trainers involved in adapting The Fenway Institute's training to these two practices. Two independent investigators coded the interviews using components of the FRAME model as an analytic guide. Results Training team members described the mechanisms by which FRAME adaption occurred both proactively and reactively; the importance of involving SGM-identified trainers of diverse backgrounds as well as champions from within oncology practices in which trainings were conducted; the importance of adapting both the context and content of training to be relevant to oncology audiences; and the ways in which fidelity to the core principles of improving health care for SGM patients was maintained throughout the process. Discussion SGM cultural humility training for oncology providers and staff must undergo iterative adaptation to address the political and social context of specific practice environments and advocate for broader institutional culture change to achieve responsiveness to SGM health needs.
Collapse
Affiliation(s)
| | | | | | - Ash B. Alpert
- Brown University School of Public Health, Providence, RI, United States
| | | | | | | | | |
Collapse
|
34
|
Symptoms of Depression and Anxiety in Adults with High-Grade Glioma: A Literature Review and Findings in a Group of Patients before Chemoradiotherapy and One Year Later. Cancers (Basel) 2022; 14:cancers14215192. [PMID: 36358611 PMCID: PMC9659261 DOI: 10.3390/cancers14215192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/03/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022] Open
Abstract
Simple Summary High-grade glioma (HGG) is the most severe type of brain cancer. At different stages of the disease, affected persons are at high risk of symptoms of depression and anxiety. If undiagnosed and untreated, these symptoms might become severe and compromise the patient’s quality of life. Improved knowledge on the prevalence, mechanisms and clinical risk factors underlying the etiology of depression and anxiety in this population is required. This may help to increase awareness on the importance of integrating consistent assessment of mood symptoms with the clinical follow-up and provide insights for developing personalized psychosocial interventions. Abstract High-grade glioma (HGG) is associated with several external and internal stressors that may induce mood alterations at all stages of the disease. Symptoms of depression and anxiety in persons with glioma have multifactorial etiology and require active follow-up. We reviewed the literature data on the prevalence, mechanisms likely involved in the etiology of mood alterations in persons with HGG and psychosocial interventions found beneficial in treating these symptoms. We also investigated the prevalence and clinical variables that could increase the risk of depression and anxiety symptoms in a group of patients with HGG at two disease time-points: after surgery, before and 1 year after chemoradiotherapy. Literature findings revealed complex mechanisms underlying these symptoms and highlighted the importance of providing early access to palliative care. Our results show a high rate of anxiety and depression symptoms in the first stage of the disease and increased concomitance of these symptoms at the 1-year follow-up. Depression and anxiety symptoms at 1 year after the end of chemoradiotherapy were associated with the presence of symptoms at the first stage of the disease and tumor progression. Antiepileptic drugs and corticosteroid intake did not increase the risk of depressive and anxious symptoms among patients. Active management of mood alterations is an essential part of the care and contributes to patients’ well-being and quality of life.
Collapse
|
35
|
Ho M, Pullenayegum E, Burnes D, Fuller-Thomson E. Successful Aging among Immigrant and Canadian-Born Older Adults: Findings from the Canadian Longitudinal Study on Aging (CLSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13199. [PMID: 36293780 PMCID: PMC9603725 DOI: 10.3390/ijerph192013199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Few studies in Canada have focused on the relationship between immigrant status and successful aging. The concept of successful aging used in this study includes the ability to accomplish both activities of daily living (ADLs) and instrumental activities of daily living (IADLs), freedom from mental illness, memory problems and disabling chronic pain, adequate social support and older adults' self-reported happiness and subjective perception of their physical health, mental health and aging process as good. METHODS The present study analyzed the first two waves of data from the comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA). The sample includes 7651 respondents aged 60+ at time 2, of whom 1446 respondents were immigrants. Bivariate and multivariable binary logistic regression analyses were conducted. RESULTS Canadian-born older adults had a slightly higher prevalence and age-sex adjusted odds of achieving successful aging than their immigrant counterparts (aOR = 1.18, 95% CI: 1.04, 1.34, p < 0.001). After adjusting for 18 additional factors, immigrant status remained statistically significant (aOR = 1.24, 95% CI: 1.09, 1.41, p < 0.001). Significant baseline factors associated with successful aging among immigrants included being younger, having higher income, being married, not being obese, never smoking, engaging in moderate or strenuous physical activities, not having sleeping problems and being free of heart disease or arthritis. CONCLUSIONS Immigrant older adults had a lower prevalence of successful aging than their Canadian-born peers. Further research could investigate whether policies and interventions supporting older immigrants and promoting a healthy lifestyle enhance older adults achieve successful aging in later life.
Collapse
Affiliation(s)
- Mabel Ho
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| |
Collapse
|
36
|
Pino O, Cadena RT, Poli D. A Comprehensive Review on Multifaceted Mechanisms Involved in the Development of Breast Cancer Following Adverse Childhood Experiences (ACEs). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12615. [PMID: 36231913 PMCID: PMC9565960 DOI: 10.3390/ijerph191912615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM OF THE WORK Adverse Childhood Experiences (ACEs) may give rise to harmful effects on health throughout life. Epigenetic changes explain how preexisting risk factors may contribute to produce altered biological responses and cancer risk. The main aim of the review is to summarize studies examining the means in which Adverse Childhood Experiences (ACEs) can modulate individual vulnerability to breast cancer (BC) development through multifaceted mechanisms. METHODS Studies selection, data extraction, and assessments agreed to PRISMA criteria. We included original research with clinical samples following BC interventions, investigating potential mechanisms linking ACEs and BC in adults. RESULTS From the 3321 papers found, nine articles involving 2931 participants were selected. All studies included ACEs retrospective assessments and psychological measures, and seven of them considered biomarkers. Individuals exposed to greater ACEs were at increased BC risk compared with individuals with no ACEs. Associations were found between child abuse and/or neglect, depression, perceived stress, fatigue, and plasma levels of cytokines interleukin (IL-6), C-reactive protein (CRP), soluble tumor necrosis factor receptor type II (sTNF-RII), interleukin IL-1 receptor antagonist (IL-1ra), and psycho-physiological adjustments that may lead to BC. CONCLUSIONS Exposure to multiple ACEs appears a risk factor for BC development in adulthood. Although the clinical relevance of findings such as this is ambiguous, the review added evidence for a link between the presence of childhood adversity and BC occurrence, pointing to psychological, hormonal, and immunological dysregulations.
Collapse
Affiliation(s)
- Olimpia Pino
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | | | - Diana Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| |
Collapse
|
37
|
Nemoto T, Xie H, Iwamoto M, Piroth K, Hazratzai M, Teh YK. HIV Risk Behaviors and Psychological Well-Being Among Men Who Have Sex With Men (MSM) in Kuala Lumpur, Malaysia. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:427-439. [PMID: 36181498 DOI: 10.1521/aeap.2022.34.5.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
HIV risk behaviors and psychological well-being among men who have sex with men (MSM) in Kuala Lumpur, Malaysia (n = 140), were quantitatively described in relation to demographic and psychosocial factors. Most participants were tested for HIV and 41.4% reported living with HIV. Malay participants had significantly higher levels of depression (p < .05), homophobia (p < .01), and needs for social support (p < .01) than Chinese. More Chinese participants reported suicidal thoughts than Malaysians (p < .05). A multivariate analysis revealed that participants with gay/MSM-identified or had lower levels of self-esteem showed significantly higher levels of depression. Future intervention projects should address depression and mental health issues among MSM and strengthen self-esteem and social support through culturally competent support and individual counseling programs (e.g., addressing MSM's conflicts with religious beliefs and norms). Structural changes must be made incrementally to reduce homophobia against MSM in Malaysia while advocating human rights.
Collapse
Affiliation(s)
| | - Hui Xie
- Public Health Institute, Oakland, California
| | | | | | | | | |
Collapse
|
38
|
Dagnall N, Denovan A, Drinkwater KG. Paranormal belief, cognitive-perceptual factors, and well-being: A network analysis. Front Psychol 2022; 13:967823. [PMID: 36186327 PMCID: PMC9521162 DOI: 10.3389/fpsyg.2022.967823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
By assessing interrelationships among variables within a specified theoretical framework, network analysis (NA) provides nuanced insights into how associations between psychological constructs are related to outcome measures. Noting this, the authors used NA to examine connections between Paranormal Belief, cognitive-perceptual factors (Schizotypy, Transliminality, and Manic-Depressive Experience), and well-being (Life Satisfaction, Meaning in Life, Somatic Complaints, Perceived Stress, Depressive Symptoms). Data derived from a sample of 3,090 participants (mean age = 50.30, standard deviation = 15.20; 46.5% male, 53.1% female) who completed standardised self-report measures capturing the study constructs online. Transliminality, Unusual Experiences (positive schizotypy), and Depressive Experience demonstrated high expected influence centrality. This indicated that these factors were the most strongly connected and influential in the network. Moreover, Transliminality was a connecting variable between Paranormal Belief, positive schizotypy, and psychopathology. Depressive Experience bridged the relationship between Transliminality and well-being. The conceptual implications of these outcomes are discussed with regards to better understanding relationships between Paranormal Belief, cognitive-perceptual factors, and well-being.
Collapse
Affiliation(s)
- Neil Dagnall
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Denovan
- Department of Psychology, University of Huddersfield, Huddersfield, United Kingdom
| | - Kenneth G. Drinkwater
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| |
Collapse
|
39
|
Vorobyova A, Braley MS, Burgess H, Grieve S, Lyndon S, Wesseling T, Parashar S. Depressive symptoms among people living with HIV in permanent supportive housing: Findings from a community-based participatory study in Vancouver, Canada. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3778-3791. [PMID: 35579573 DOI: 10.1002/jcop.22871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 06/15/2023]
Abstract
Permanent supportive housing (PSH) is an intervention addressing housing needs among marginally housed individuals. Little is known about whether and how PSH influences depressive symptoms among people living with HIV (PLHIV). This article shares results from a community-based study that, in 2016-2017, interviewed 24 residents of a PSH facility designated for PLHIV in Vancouver, Canada. The themes of taking control; social connectedness; conviviality; and relationships and supports described how the PSH environment affected depressive symptoms among the residents.
Collapse
Affiliation(s)
- Anna Vorobyova
- Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - McKenzie S Braley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Heather Burgess
- Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Sean Grieve
- Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Sharyle Lyndon
- Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Tim Wesseling
- Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Surita Parashar
- Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| |
Collapse
|
40
|
Ho S, Mersch J, Martin WB, Howe-Martin L. Exploring Depressive Symptoms and Cancer Worries in a High-Volume Cancer Genetics Clinic: What Are the Roles of Age and Cancer Diagnosis? J Adolesc Young Adult Oncol 2022. [PMID: 35960502 DOI: 10.1089/jayao.2022.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Limited research has explored depression and cancer worries (CWs) among adolescents and young adults with cancer (AYAs) seeking genetic counseling. This study evaluated depressive symptoms and CWs among five groups: AYAs, adolescents and young adults without cancer (AYAWOCs), older adults with cancer (OAs), older adults without cancer (OAWOCs), and older adults diagnosed with cancer in their adolescent and young adult years (OA/AYAs). A retrospective data analysis was performed on 6524 patients, which found that AYAs reported significantly higher depressive symptoms and CWs compared with all other groups except OA/AYAs. These findings suggest that the intersection between age and cancer diagnosis is related to depressive symptoms and CWs.
Collapse
Affiliation(s)
- Sally Ho
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
| | - Jacqueline Mersch
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.,Cancer Genetics Program, UT Southwestern Medical Center, Dallas, Texas, USA
| | - W Blake Martin
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Laura Howe-Martin
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
41
|
Kuhlman KR, Irwin MR, Ganz PA, Cole SW, Manigault AW, Crespi CM, Bower JE. Younger women are more susceptible to inflammation: A longitudinal examination of the role of aging in inflammation and depressive symptoms. J Affect Disord 2022; 310:328-336. [PMID: 35561889 DOI: 10.1016/j.jad.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/17/2022] [Accepted: 05/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The degree to which effects of inflammation on mood and behavior vary across the lifespan remains relatively unexplored despite well-established, age-related alterations in both the immune and central nervous systems. Further, the implications of this developmental process within different symptom domains warrants careful consideration. METHODS Women diagnosed with breast cancer (n = 188; ages 27-89) provided blood samples and reported depressive symptoms prior to adjuvant treatment, at the end of adjuvant treatment, and 6-, 12-, and 18-months after completing adjuvant treatment via the CES-D. Blood was assayed for C-reactive Protein (CRP) and interleukin (IL)-6. We used mixed linear effect models to estimate within- and between-person effects of CRP or IL-6 on 4 domains of depressive symptoms: depressed affect, low positive affect, somatic complaints, and interpersonal problems. RESULTS High average inflammation was associated with elevated somatic complaints (CRP p = .009, IL-6: p = .05), interpersonal problems (CRP p = .002, IL-6 p < .001), and positive affect (IL-6 p = .03), but only among the youngest women in the sample (age 50 or younger). Younger women also reported more depressed affect at assessments when inflammation was higher (CRP p = .045, IL-6 p = .09). CONCLUSIONS The association between inflammation and specific depressive symptoms is dynamic and varies across the lifespan, which may help clarify apparent inconsistencies in the extant literature as well as inform more precise interventions targeting this pathway.
Collapse
Affiliation(s)
- Kate R Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Institute for Interdisciplinary Salivary Bioscience, School of Social Ecology, University of California Irvine, Irvine, CA, USA.
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Steve W Cole
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrew W Manigault
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine M Crespi
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
42
|
Manigault AW, Kuhlman KR, Irwin MR, Cole SW, Ganz PA, Crespi CM, Bower JE. Psychosocial Resilience to Inflammation-Associated Depression: A Prospective Study of Breast-Cancer Survivors. Psychol Sci 2022; 33:1328-1339. [PMID: 35930691 PMCID: PMC9527532 DOI: 10.1177/09567976221079633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/21/2022] [Indexed: 01/07/2023] Open
Abstract
Stress can lead to depression, in part because of activation of inflammatory mechanisms. It is therefore critical to identify resilience factors that can buffer against these effects, but no research to date has evaluated whether psychosocial resilience mitigates the effects of stress on inflammation-associated depressive symptoms. We therefore examined psychosocial resources known to buffer against stress in a longitudinal study of women with breast cancer (N = 187). Depressive symptoms and inflammation were measured over a 2-year period extending from after diagnosis into survivorship. Cancer-related stress and psychosocial resources-social support, optimism, positive affect, mastery, self-esteem, and mindfulness-were measured after diagnosis. As hypothesized, women who reported having more psychosocial resources showed weaker associations between stress and depressive symptoms and weaker associations between stress and inflammation-related depressive symptoms. Results highlight the importance of psychosocial resilience by demonstrating a relationship between psychosocial resources and sensitivity to inflammation-associated depressive symptoms.
Collapse
Affiliation(s)
| | - Kate R. Kuhlman
- Department of Psychological Science,
University of California, Irvine
- Cousins Center for
Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior,
University of California, Los Angeles
| | - Michael R. Irwin
- Cousins Center for
Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior,
University of California, Los Angeles
- Department of Psychiatry and
Biobehavioral Sciences, University of California, Los Angeles
| | - Steve W. Cole
- Cousins Center for
Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior,
University of California, Los Angeles
- David Geffen School of Medicine,
University of California, Los Angeles
| | - Patricia A. Ganz
- David Geffen School of Medicine,
University of California, Los Angeles
- Department of Health Policy and
Management, UCLA Fielding School of Public Health, University of California, Los
Angeles
| | - Catherine M. Crespi
- Department of Biostatistics, UCLA
Fielding School of Public Health, University of California, Los Angeles
| | - Julienne E. Bower
- Department of Psychology, University of
California, Los Angeles
- Cousins Center for
Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior,
University of California, Los Angeles
- Department of Psychiatry and
Biobehavioral Sciences, University of California, Los Angeles
| |
Collapse
|
43
|
Singleton AC, Raeside R, Hyun KK, Partridge SR, Di Tanna GL, Hafiz N, Tu Q, Tat-Ko J, Sum SCM, Sherman KA, Elder E, Redfern J. Electronic Health Interventions for Patients With Breast Cancer: Systematic Review and Meta-Analyses. J Clin Oncol 2022; 40:2257-2270. [PMID: 35500200 PMCID: PMC9273371 DOI: 10.1200/jco.21.01171] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 02/24/2022] [Accepted: 03/29/2022] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Ongoing supportive care using electronic health (eHealth) interventions has the potential to provide remote support and improve health outcomes for patients with breast cancer. This study aimed to evaluate the effectiveness of eHealth interventions on patient-reported outcomes (quality of life [QOL], self-efficacy, and mental or physical health) for patients during and after breast cancer treatment and patient-reported experience measures (acceptability and engagement). METHODS Systematic review with meta-analyses (random-effects model) of randomized controlled trials was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Nine databases were searched using a prespecified search strategy. Patient-directed eHealth interventions for adult patients during or after active breast cancer treatment measuring QOL, self-efficacy, and mental (depressive, anxiety, and distress symptoms) or physical (physical activity, nutrition, and fatigue) health outcomes were included. Data from eligible full-text articles were independently extracted by six observers. RESULTS Thirty-two unique studies (4,790 patients) were included. All were health self-management interventions, and most were multicomponent (videos, forums, and electronic reminder systems) websites. Meta-analyses revealed a significant effect of eHealth interventions on QOL (standardized mean difference [SMD], 0.20 [95% CI, 0.03 to 0.36]), self-efficacy (SMD, 0.45 [95% CI, 0.24 to 0.65]), distress (SMD, -0.41 [95% CI,-0.63 to -0.20]), and fatigue (SMD, -0.37 [95% CI, -0.61 to -0.13]). Twenty-five studies (78.1%) measured patient-reported experience measures. Acceptability (n = 9) was high, with high ratings for satisfaction (range, 71%-100%), usefulness (range, 71%-95%), and ease-of-use (range, 73%-92%). Engagement (n = 25) decreased over time, but disease-focused information and interactive support were most engaging. CONCLUSION eHealth interventions may provide an acceptable and effective strategy for improving QOL, distress, self-efficacy, and fatigue among patients with breast cancer.
Collapse
Affiliation(s)
- Anna C. Singleton
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Raeside
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Karice K. Hyun
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Department of Cardiology, Concord Repatriation General Hospital, ANZAC Research Institute, Concord, New South Wales, Australia
| | - Stephanie R. Partridge
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Prevention Research Collaboration, Charles Perkins Center, The University of Sydney, Sydney, New South Wales, Australia
| | - Gian Luca Di Tanna
- The George Institute for Global Health, University of NSW, Kensington, New South Wales, Australia
| | - Nashid Hafiz
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Qiang Tu
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Justin Tat-Ko
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Che Mun Sum
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Kerry A. Sherman
- Department of Psychology, Center for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | - Julie Redfern
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of NSW, Kensington, New South Wales, Australia
| |
Collapse
|
44
|
Wells J, Flowers L, Mehta CC, Chandler R, Knott R, McDonnell Holstad M, Watkins Bruner D. Follow-Up to High-Resolution Anoscopy After Abnormal Anal Cytology in People Living with HIV. AIDS Patient Care STDS 2022; 36:263-271. [PMID: 35727648 PMCID: PMC9464048 DOI: 10.1089/apc.2022.0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Current expert recommendations suggest anal cytology followed by high-resolution anoscopy (HRA) for biopsy and histological confirmation may be beneficial in cancer prevention, especially in people living with HIV (PLWH). Guided by the social ecological model, the purpose of this study was to examine sociodemographic and clinical variables, individual-level factors (depression, HIV/AIDS-related stigma, and health beliefs) and interpersonal-level factors (social support) related to time to HRA follow-up after abnormal anal cytology. We enrolled 150 PLWH from a large HIV community clinic, with on-site HRA availability, in Atlanta, GA. The median age was 46 years (interquartile range of 37-52), 78.5% identified as African American/Black, and 88.6% identified as born male. The average length of follow-up to HRA after abnormal anal cytology was 380.6 days (standard deviation = 317.23). Only 24.3% (n = 39) of the sample had an HRA within 6 months after an abnormal anal cytology, whereas 57% of the sample had an HRA within 12 months. HIV/AIDS-related stigma [odds ratio (OR) 0.54, 95% confidence interval (CI) 0.33-0.90] and health motivation (OR 0.80, 95% CI 0.67-0.95) were associated with time to HRA follow-up ≤6 months. For HRA follow-up ≤12 months, we found anal cytology [high-grade squamous intraepithelial lesions/atypical squamous cells of undetermined significance cannot exclude HSIL (HSIL/ASCUS-H) vs. low-grade squamous intraepithelial lesions (LSIL) OR = 0.05, 95% CI 0.00-0.70; atypical squamous cells of undetermined significance (ASCUS) vs. LSIL OR = 0.12, 95% CI 0.02-0.64] and health motivation (OR = 0.86, 95% CI 0.65-0.99) were associated. Findings from this study can inform strategies to improve follow-up care after abnormal anal cytology at an individual and interpersonal level in efforts to decrease anal cancer morbidity and mortality.
Collapse
Affiliation(s)
- Jessica Wells
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.,Address correspondence to: Jessica Wells, PhD, RN, WHNP-BC, FAAN, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, NE, RM. 230, Atlanta, GA 30324, USA
| | - Lisa Flowers
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - C. Christina Mehta
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rasheeta Chandler
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Robert Knott
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | | | - Deborah Watkins Bruner
- Office of the Senior Vice President of Research, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
45
|
Dagnall N, Denovan A, Drinkwater KG. Variations in Well-Being as a Function of Paranormal Belief and Psychopathological Symptoms: A Latent Profile Analysis. Front Psychol 2022; 13:886369. [PMID: 35814073 PMCID: PMC9263512 DOI: 10.3389/fpsyg.2022.886369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/06/2022] [Indexed: 01/07/2023] Open
Abstract
This study examined variations in well-being as a function of the interaction between paranormal belief and psychopathology-related constructs. A United Kingdom-based, general sample of 4,402 respondents completed self-report measures assessing paranormal belief, psychopathology (schizotypy, depression, manic experience, and depressive experience), and well-being (perceived stress, somatic complaints, and life satisfaction). Latent profile analysis identified four distinct sub-groups: Profile 1, high Paranormal Belief and Psychopathology (n = 688); Profile 2, high Paranormal Belief and Unusual Experiences; moderate Psychopathology (n = 800); Profile 3, moderate Paranormal Belief and Psychopathology (n = 846); and Profile 4, low Paranormal Belief and Psychopathology (n = 2070). Multivariate analysis of variance (MANOVA) found that sub-groups with higher psychopathology scores (Profiles 1 and 3) reported lower well-being. Higher Paranormal Belief, however, was not necessarily associated with lower psychological adjustment and reduced well-being (Profile 2). These outcomes indicated that belief in the paranormal is not necessarily non-adaptive, and that further research is required to identify the conditions under which belief in the paranormal is maladaptive.
Collapse
Affiliation(s)
- Neil Dagnall
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Denovan
- Department of Psychology, University of Huddersfield, Huddersfield, United Kingdom
| | | |
Collapse
|
46
|
Association between labor and delivery pain and postpartum pain with symptoms and clinical diagnosis of postpartum depression in patients with overweight and obesity. Arch Gynecol Obstet 2022; 307:1441-1449. [PMID: 35665850 PMCID: PMC9719570 DOI: 10.1007/s00404-022-06625-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/10/2022] [Indexed: 11/02/2022]
Abstract
Abstract
Purpose
Childbirth pain has been associated with the risk for postpartum depression. However, existing studies have been limited by the use of depression screening tools as outcomes, and none to date have used a structured clinical interview for DSM-V (SCID), which is considered the gold standard for psychiatric diagnoses. This study aimed to quantify the relationships between labor and postpartum pain and postpartum depression diagnosis detected by SCID, as well as depression symptoms detected by the Center for Epidemiological Studies Depression Scale (CESD) screening tool, among a high-risk cohort.
Methods
The study was a secondary analysis of a prospective observational study of a cohort of women enriched for high risk for depression, i.e., pregnant women originally enrolled in a prospective study investigating factors leading to excessive gestational weight gain. Subjects were assessed prospectively for depression using both SCID and CESD at the third trimester and at 6 months postpartum. Overweight and obesity were defined as pre-gravid body mass index (BMI) ≥ 25 kg/m2. Both vaginal and cesarean deliveries were included in the cohort. Pain scores (0–10 numeric rating scale) during childbirth and after delivery were correlated with CESD and SCID. Propensity score matching was performed with propensity groups defined as those with low–moderate postpartum pain and those with high postpartum pain. The relationships between pain measures and 6-month postpartum depression diagnosis by SCID, and between pain measures and 6-month postpartum depression symptoms by CESD, were assessed by unweighted logistic regression and by logistic regression weighted by propensity score derived by average treatment effect (ATE) adjusted for baseline covariates.
Results
There were 237 subjects in the cohort for analysis. Labor and postpartum pain were not associated with depression diagnosis by SCID at 6 months postpartum. However, postpartum pain, but not labor pain, was associated with depressive symptoms on the CESD at 6 months postpartum. Women with higher maximum postpartum pain scores had significantly higher odds of developing clinically significant postpartum depressive symptoms at 6 months, compared to those with lower pain scores in the unweighted model (OR: 1.3, 95% CI 1.0, 1.5; P = 0.005) and ATE-weighted models (OR: 1.2, 95% CI 1.0, 1.5; P = 0.03). Consistent with prior work, SCID and CESD were strongly associated, and 92.9% (13/14) of participants with postpartum depression diagnosis by 6-month SCID also showed high CESD symptomology, P < 0.0001).
Conclusions
Although labor and postpartum pain were not associated with clinical diagnosis of depression (SCID) at 6 months postpartum, postpartum pain was linked to 6-month postpartum depression symptoms. Depressive symptoms are more likely to be exhibited in women with higher postpartum pain, potentially reflecting poorer birth recovery. The contribution of postpartum pain and depressive symptoms to overall patterns of poor recovery after childbirth should be assessed further.
Collapse
|
47
|
Bontempo AC. The effect of personalized invalidation of symptoms by healthcare providers on patient depression: The mediating role of self-esteem. PATIENT EDUCATION AND COUNSELING 2022; 105:1598-1605. [PMID: 34666932 DOI: 10.1016/j.pec.2021.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/09/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Qualitative research has thoroughly investigated the diagnostic journeys of patients, who have often reported difficulty with healthcare providers regarding the acknowledgement of an organic, pathological cause for their symptoms (hereafter referred to as invalidation of symptoms). These encounters also reportedly contributed to reductions in self-esteem and to feelings of depression, particularly prior to diagnosis. The aim of this research was to quantitatively validate these observed relationships and examine the potential compounding effect of personalization of this reported invalidation. METHODS Participants were 609 patients with self-reported endometriosis from a larger online research study. Invalidation and personalization of invalidation were measured with survey items developed for this research. Self-esteem and depression were assessed with well-known validated and reliable self-report instruments. Hierarchical linear regressions were performed, with path analysis to test for mediation. RESULTS Invalidation predicted self-esteem but not depression. However, when personalized, invalidation predicted both self-esteem and depression. Path analysis testing the effect of personalization of invalidation on depression through self-esteem was significant, demonstrating full mediation. CONCLUSIONS Results confirm qualitative research and provide the first known quantitative support that invalidation, particularly when personalized, can be associated with reduced self-esteem and, in turn, greater depression. PRACTICE IMPLICATIONS These findings demonstrate an important barrier to patient-centered communication.
Collapse
Affiliation(s)
- Allyson C Bontempo
- Rutgers University, School of Communication and Information, 4 Huntington Street, New Brunswick, NJ 08901, USA.
| |
Collapse
|
48
|
Palacios R, Lewis FM, Reyes CL, Griffith K, Zahlis E, Shands ME. A pilot feasibility study of Conexiones, a telephone-delivered cancer parenting education program for Hispanic mothers. J Psychosoc Oncol 2022; 41:104-122. [PMID: 35587607 PMCID: PMC9674800 DOI: 10.1080/07347332.2022.2065227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To test the short-term impact of Conexiones, a culturally adapted cancer parenting education program for diagnosed child-rearing Hispanic mothers. DESIGN Single group, pre-post-test design. SAMPLE 18 U.S. Hispanic mothers diagnosed within 2 years with early-stage cancer (0-III) raising a child (5-17 years). METHODS Participants completed consent, baseline measures, and five telephone-delivered Conexiones sessions at 2-week intervals from trained patient educators in English or Spanish. Outcomes were assessed at baseline and at 3 months. RESULTS Maternal depressed mood, parenting self-efficacy, and parenting quality significantly improved. Children's anxious/depressed mood tended to significantly improve. Outcomes did not co-vary with mothers' level of acculturation. CONCLUSIONS Conexiones appears to positively improve Hispanic mothers' distress and parenting competencies; efficacy testing is warranted within a larger randomized control trial. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS A brief, culturally adapted cancer parenting education program has potential to enhance Hispanic mothers' and children's behavioral-emotional adjustment to a mother's cancer.
Collapse
Affiliation(s)
- Rebecca Palacios
- Department of Public Health Sciences, New Mexico State University, Las Cruces, New Mexico, USA
| | - Frances Marcus Lewis
- bSchool of Nursing, University of Washington, Seattle, Washington, USA
- Public Health Sciences and Member Clinical Research Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Clara Lucia Reyes
- Department of Public Health Sciences, New Mexico State University, Las Cruces, New Mexico, USA
| | - Kristin Griffith
- bSchool of Nursing, University of Washington, Seattle, Washington, USA
| | - Ellen Zahlis
- bSchool of Nursing, University of Washington, Seattle, Washington, USA
| | - Mary Ellen Shands
- bSchool of Nursing, University of Washington, Seattle, Washington, USA
| |
Collapse
|
49
|
Sass D, Fitzgerald W, Wolff BS, Torres I, Pagan-Mercado G, Armstrong TS, Miaskowski C, Margolis L, Saligan L, Kober KM. Differences in Circulating Extracellular Vesicle and Soluble Cytokines in Older Versus Younger Breast Cancer Patients With Distinct Symptom Profiles. Front Genet 2022; 13:869044. [PMID: 35547250 PMCID: PMC9081604 DOI: 10.3389/fgene.2022.869044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/23/2022] [Indexed: 11/27/2022] Open
Abstract
Because extracellular vesicle (EV)-associated cytokines, both encapsulated and surface bound, have been associated with symptom severity, and may vary over the lifespan, they may be potential biomarkers to uncover underlying mechanisms of various conditions. This study evaluated the associations of soluble and EV-associated cytokine concentrations with distinct symptom profiles reported by 290 women with breast cancer prior to surgery. Patients were classified into older (≥60 years, n = 93) and younger (< 60 years, n = 197) cohorts within two previously identified distinct symptom severity profiles, that included pain, depressive symptoms, sleep disturbance, and fatigue (i.e., High Fatigue Low Pain and All Low). EVs were extracted using ExoQuick. Cytokine concentrations were determined using Luminex multiplex assay. Mann Whitney U test evaluated the differences in EV and soluble cytokine levels between symptom classes and between and within the older and younger cohorts adjusting for Karnofsky Performance Status (KPS) score, body mass index (BMI), and stage of disease. Partial correlation analyses were run between symptom severity scores and cytokine concentrations. Results of this study suggest that levels of cytokine concentrations differ between EV and soluble fractions. Several EV and soluble pro-inflammatory cytokines had positive associations with depressive symptoms and fatigue within both age cohorts and symptom profiles. In addition, in the older cohort with High Fatigue Low Pain symptom profile, EV GM-CSF concentrations were higher compared to the All Low symptom profile (p < 0.05). Albeit limited by a small sample size, these exploratory analyses provide new information on the association between cytokines and symptom profiles of older and younger cohorts. Of note, unique EV-associated cytokines were found in older patients and in specific symptom classes. These results suggest that EVs may be potential biomarker discovery tools. Understanding the mechanisms that underlie distinct symptom class profiles categorized by age may inform intervention trials and offer precision medicine approaches.
Collapse
Affiliation(s)
- Dilorom Sass
- National Institute of Nursing Research, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Wendy Fitzgerald
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, United States
| | - Brian S Wolff
- National Institute of Nursing Research, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Isaias Torres
- National Institute of Nursing Research, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Glorivee Pagan-Mercado
- National Institute of Nursing Research, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Terri S Armstrong
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Leonid Margolis
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, United States
| | - Leorey Saligan
- National Institute of Nursing Research, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
50
|
Stein D, Bergemann R, Lanthorn H, Kimani E, Nshakira-Rukundo E, Li Y. Cash, COVID-19 and aid cuts: a mixed-method impact evaluation among South Sudanese refugees registered in Kiryandongo settlement, Uganda. BMJ Glob Health 2022; 7:e007747. [PMID: 35580912 PMCID: PMC9118362 DOI: 10.1136/bmjgh-2021-007747] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/20/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES In this paper, we estimate the impact after 4-8 months of a large one-off unconditional cash transfer delivered to refugees during a time of dual shocks: the COVID-19 pandemic and cuts to monthly aid. We focus on four key outcomes: (1) health-seeking behaviour; (2) COVID-19 specific preventive health practices; (3) food security and (4) psychological well-being. METHODS We use both quantitative and qualitative data to understand the impact of a cash transfer in this context. Quantitatively, we use a baseline survey of 1200 households (Q4 2019) and follow-up with three rounds of phone surveys in Q2 and Q3 2021, capturing at least half the sample in each round. We exploit an experimental variation in the timing of the cash transfer to assess the effect of the cash transfer through ordinary least squares regressions of intention to treat. Controlling for key baseline characteristics, we analyse the effect of the cash transfer on health access, COVID-19 health practices, food security and psychological well-being. Qualitatively, we make use of a longitudinal, small-n sample of refugee respondents, each of whom we interviewed up to 15 times between February and September 2020 to understand change over time and to go deeper into key topics. RESULTS We do not find a statistically significant effect (6.2%, p=0.188) of receiving the cash transfer on preventative measures against COVID-19. However, households receiving the cash transfer were more food secure, with a 14.4% (p=0.011) improvement on the food security index, have better psychological well-being (24.5%, p=0.003) and are more likely to seek healthcare in the private health facilities (10.4%, p=0.057) as compared with control households. We do not find significant results on the value of food consumption. Overall, we find stronger treatment effects for households that were the first to receive the cash transfers. CONCLUSION Taken together, we find significant support for the importance of cash transfers to refugee households mitigating against declines in food security and mental well-being in the face of shocks.
Collapse
Affiliation(s)
| | | | - Heather Lanthorn
- IDinsight Inc, San Francisco, California, USA
- Social Science Research Council, Brooklyn, New York, USA
| | - Emma Kimani
- IDinsight Inc, San Francisco, California, USA
| | - Emmanuel Nshakira-Rukundo
- Institute for Food and Resource Economics, University of Bonn, Bonn, Germany
- Apata Insights, Kampala, Uganda
| | - Yulei Li
- University of Bonn, Bonn, Germany
| |
Collapse
|