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Hoppe JE, Sjoberg J, Hong G, Poch K, Zemanick ET, Thee S, Edmondson C, Patel D, Sathe M, Borowitz D, Putman MS, Lechtzin N, Riekert KA, Basile M, Goss CH, Jarosz ME, Rosenfeld M. Remote endpoints for clinical trials in cystic fibrosis: Report from the U.S. CF foundation remote endpoints task force. J Cyst Fibros 2024:S1569-1993(24)00023-7. [PMID: 38429150 DOI: 10.1016/j.jcf.2024.02.011] [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: 10/11/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
The COVID-19 pandemic necessitated a rapid shift in clinical research to perform virtual visits and remote endpoint assessments, providing a key opportunity to optimize the use of remote endpoints for clinical trials in cystic fibrosis. The use of remote endpoints could allow more diverse participation in clinical trials while minimizing participant burden but must be robustly evaluated to ensure adequate performance and feasibility. In response, the Cystic Fibrosis Foundation convened the Remote Endpoint Task Force (Supplemental Table 1), a multidisciplinary group of CF researchers with remote endpoint expertise and community members tasked to better understand the current and future use of remote endpoints for clinical research. Here, we describe the current use of remote endpoints in CF clinical research, address key unanswered questions regarding their use and feasibility, and discuss the next steps to determine clinical trial readiness.
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Affiliation(s)
- Jordana E Hoppe
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora CO, USA.
| | | | - Gina Hong
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia Pennsylvania, USA
| | - Katie Poch
- Department of Medicine, National Jewish Health, Denver CO, USA
| | - Edith T Zemanick
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora CO, USA
| | - Stephanie Thee
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine and Cystic Fibrosis Center, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claire Edmondson
- Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital, London WC1N3JH, USA
| | - Dhiren Patel
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St. Louis MO, USA
| | - Meghana Sathe
- Pediatric Gastroenterology and Nutrition, University of Texas Southwestern/Children's Health, Dallas Texas, USA
| | - Drucy Borowitz
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo New York, USA
| | - Melissa S Putman
- Division of Pediatric Endocrinology, Boston Children's Hospital, Boston MA, USA
| | - Noah Lechtzin
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore Maryland, USA
| | - Kristin A Riekert
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore Maryland, USA
| | - Melissa Basile
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset NY, USA
| | - Christopher H Goss
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington Medical Center, Seattle Washington, USA; Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Research Institute, Seattle Washington, USA
| | | | - Margaret Rosenfeld
- Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Research Institute, Seattle Washington, USA
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Blankenship S, Landis AR, Harrison Williams E, Peabody Lever JE, Garcia B, Solomon G, Krick S. What the future holds: cystic fibrosis and aging. Front Med (Lausanne) 2024; 10:1340388. [PMID: 38264036 PMCID: PMC10804849 DOI: 10.3389/fmed.2023.1340388] [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: 11/17/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Cystic fibrosis (CF) is one of the most common genetic diseases with around 70,000 affected patients worldwide. CF is a multisystem disease caused by a mutation in the CF transmembrane conductance regulator gene, which has led to a significant decrease in life expectancy and a marked impairment in the quality of life for people with CF (pwCF). In recent years, the use of highly effective CFTR modulator therapy (HEMT) has led to improved pulmonary function, fewer CF exacerbations, lower symptom burden, and increased weight. This has coincided with an increased life expectancy for pwCF, with mean age of survival being now in the 50s. This being a major breakthrough, which the CF population has hoped for, pwCF are now facing new challenges by growing old with a chronic respiratory disease. In this mini review, we are attempting to summarize the current knowledge of the aging process and its effect on CF disease and its manifestations including new developments, the current research gaps and potential future developments in the field to allow healthy aging for the CF community.
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Affiliation(s)
- Sydney Blankenship
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aaron R. Landis
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Emily Harrison Williams
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jacelyn E. Peabody Lever
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bryan Garcia
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - George Solomon
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Stefanie Krick
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
- Gregory Fleming James Cystic Fibrosis Research Center, The University of Alabama at Birmingham, Birmingham, AL, United States
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Gohari MR, Patte KA, Ferro MA, Haddad S, Wade TJ, Bélanger RE, Romano I, Leatherdale ST. Adolescents' Depression and Anxiety Symptoms During the COVID-19 Pandemic: Longitudinal Evidence From COMPASS. J Adolesc Health 2024; 74:36-43. [PMID: 37777949 DOI: 10.1016/j.jadohealth.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/15/2023] [Accepted: 07/21/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE There is concern over the potentially detrimental impact of the COVID-19 pandemic on adolescents' mental health. We examined changes in depression and anxiety symptoms from before (2018-19) to the early (2019-20) and ongoing pandemic (2020-21) responses among Canadian adolescents in the context of a natural experiment. METHODS We used linked survey data from 5,368 Canadian secondary school students who participated in three consecutive waves of the cannabis use, obesity, mental health, physical activity, alcohol use, smoking, and sedentary behaviour study during the 2018-19, 2019-20, and 2020-21 school year. Separate fixed effects models examined whether changes in depression (Center for Epidemiologic Studies Depression Scale Revised-10) and anxiety (General Anxiety Disorder-7) symptoms differed between two cohorts. The cohorts differed in the timing of their second data collection wave; one cohort participated before the pandemic and the other cohort participated in the early pandemic (spring 2020). RESULTS Depression and anxiety symptoms increased during the early and ongoing pandemic periods in the overall sample and both cohorts. The two cohorts experienced similar elevations in their symptoms. Females and younger respondents presented greater elevations over time. The proportion of adolescents with significant depressive (29.4%) and moderate-to-severe anxiety (17.6%) symptoms at baseline increased by 1.5 times, reaching 44.8% and 29.8% in the ongoing pandemic period, respectively. DISCUSSION Findings suggest that internalizing symptoms have consistently increased since before the onset of COVID-19, particularly in the ongoing pandemic period; however, we found no evidence of the increase being due to the pandemic in the early COVID-19 period when comparing the two cohorts. Ongoing evaluation of adolescents' mental health is necessary to capture potentially dynamic impacts over time.
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Affiliation(s)
- Mahmood R Gohari
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
| | - Karen A Patte
- Faculty of Applied Health Sciences, Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Slim Haddad
- Department of Social and Preventive Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Terrance J Wade
- Faculty of Applied Health Sciences, Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Richard E Bélanger
- Faculty of Medicine, Department of Pediatrics, Université Laval, Quebec City, Quebec, Canada
| | - Isabella Romano
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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de Moraes SHM, Cunha IPD, Lemos EF, Abastoflor LLL, Oshiro MDL, Bohrer RTDODA, Sarubbi V, Souza FBD, Nascimento DDGD, do Valle Leone de Oliveira SM. Prevalence and associated factors of mental health disorders among Brazilian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study. PLoS One 2023; 18:e0274927. [PMID: 37279233 DOI: 10.1371/journal.pone.0274927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
The COVID-19 pandemic in Brazil affected mental health among healthcare workers. To objective of this study was to evaluate the mental health of healthcare workers in in the central-west region of the Brazil, estimating the prevalence of mental health disorders, and investigating associated factors, perceptions of safety, and self-perceptions about mental health in times of the COVID-19 pandemic. The questionnaire was divided into two parts that included general information and perceptions about the work process and identified symptoms using the Depression Anxiety Stress Scale-21 (DASS-21), and multiple linear regression analysis was conducted. A total of 1,522 healthcare workers participated in the survey. Overall prevalence of symptoms was calculated for depression (58.7%), anxiety (59.7%), and stress (61.7%). Physicians had 3.75 times greater risk of depression (1.59-8.85, 95% CI). Independent variables associated with depression symptoms were not feeling safe with the way services were organized (1.12:1.03-1.21, 95% CI) and self-perception of poor mental health (8.06: 4.03-16.10% CI). Working in management was protective, and married professionals had 12% lower risk of exhibiting symptoms of depression (0.79-0.99, 95% CI). Participants with self-perception of poor mental health had 4.63 greater risk for symptoms of anxiety (2.58-8.31, 95% CI). Protective factors were not having sought support for mental health (0.90: 0.82-0.99, 95% CI), having a graduate degree (0.71: 0.54-0.94, 95% CI), and not having been diagnosed with COVID-19 (0.90: 0.83-0.98, 95% CI). Perception of poor mental health was associated with 6.95-fold greater chance of developing stress symptoms. Protective factors from stress were having a degree in dentistry (0.81: 0.68-0.97, 95% CI), residing in Mato Grosso do Sul (0.91: 0.85-0.98, 95% CI), and not having sought mental health support services (0.88: 0.82-0.95, 95% CI). The prevalence of mental health disorders is high among healthcare workers, and is associated with professional category, organization of services provided, and self-perception of poor mental health, reinforcing the need for preventative measures.
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Affiliation(s)
| | - Inara Pereira da Cunha
- Escola de Saúde Pública Dr. Jorge David Nasser, Campo Grande, Mato Grosso do Sul, Brasil
| | | | - Lesly Lidiane Ledezma Abastoflor
- Fiocruz Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
- Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
| | | | | | - Vicente Sarubbi
- Universidade Estadual de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
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Lasheras G, Farré-Sender B, Osma J, Martínez-Borba V, Mestre-Bach G. Mother-infant bonding screening in a sample of postpartum women: comparison between online vs offline format. J Reprod Infant Psychol 2022; 40:500-515. [PMID: 33950755 DOI: 10.1080/02646838.2021.1921716] [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: 12/16/2022]
Abstract
AIMS We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). METHODS A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. RESULTS The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. CONCLUSION Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method.
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Affiliation(s)
- Gracia Lasheras
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
| | - Borja Farré-Sender
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
| | - Jorge Osma
- Department of Psychology and Sociology, Universidad De Zaragoza. Instituto De Investigación Sanitaria De Aragón, Zaragoza, Spain
| | - Verónica Martínez-Borba
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I. Instituto De Investigación Sanitaria De Aragón, Zaragoza, Spain
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional De La Rioja, La Rioja, Spain
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Park K, Yoon S, Cho S, Choi Y, Lee SH, Choi KH. Final validation of the mental health screening tool for depressive disorders: A brief online and offline screening tool for major depressive disorder. Front Psychol 2022; 13:992068. [PMID: 36275320 PMCID: PMC9580402 DOI: 10.3389/fpsyg.2022.992068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Early screening for depressive disorders is crucial given that major depressive disorder (MDD) is one of the main reasons of global burden of disease, and depression is the underlying cause for 60% of suicides. The need for an accurate screening for depression with high diagnostic sensitivity and specificity in a brief and culturally adapted manner has emerged. This study reports the final stage of a 3-year research project for the development of depression screening tool. The developed Mental Health Screening Tool for Depressive Disorders (MHS:D) was designed to be administered in both online and offline environments with a high level of sensitivity and specificity in screening for major depressive disorder. A total of 527 individuals completed two versions (online/offline) of the MHS:D and existing depression scales, including the BDI-II, CES-D, and PHQ-9. The Mini International Neuropsychiatric Interview (MINI) for diagnostic sensitivity/specificity was also administered to all participants. Internal consistency, convergent validity, factor analysis, item response theory analysis, and receiver operating characteristics curve (ROC) analysis were performed. The MHS:D showed an excellent level of internal consistency and convergent validity as well as a one-factor model with a reasonable level of model fit. The MHS:D could screen for major depressive disorder accurately (0.911 sensitivity and 0.878 specificity for both online and paper-pencil versions). Item response theory analysis suggested that items from the MHS:D could provide significantly more information than other existing depression scales. These statistical analyses indicated that the MHS:D is a valid and reliable scale for screening Korean patients with MDD with high diagnostic sensitivity and specificity. Moreover, given that the MHS:D is a considerably brief scale that can be administered in either online or paper-pencil versions, it can be used effectively in various contexts, particularly during the pandemic.
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Affiliation(s)
- Kiho Park
- School of Psychology, Korea University, Seoul, South Korea
| | - Seowon Yoon
- School of Psychology, Korea University, Seoul, South Korea
| | - Surin Cho
- School of Psychology, Korea University, Seoul, South Korea
| | - Younyoung Choi
- Department of Psychology, Ajou University, Seoul, South Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, South Korea
- KU Mind Health Institute, Korea University, Seoul, South Korea
- *Correspondence: Kee-Hong Choi,
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Jacobson NC, Yom-Tov E, Lekkas D, Heinz M, Liu L, Barr PJ. Impact of online mental health screening tools on help-seeking, care receipt, and suicidal ideation and suicidal intent: Evidence from internet search behavior in a large U.S. cohort. J Psychiatr Res 2022; 145:276-283. [PMID: 33199054 PMCID: PMC8106691 DOI: 10.1016/j.jpsychires.2020.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Most people with psychiatric illnesses do not receive treatment for almost a decade after disorder onset. Online mental health screens reflect one mechanism designed to shorten this lag in help-seeking, yet there has been limited research on the effectiveness of screening tools in naturalistic settings. MATERIAL AND METHODS We examined a cohort of persons directed to a mental health screening tool via the Bing search engine (n = 126,060). We evaluated the impact of tool content on later searches for mental health self-references, self-diagnosis, care seeking, psychoactive medications, suicidal ideation, and suicidal intent. Website characteristics were evaluated by pairs of independent raters to ascertain screen type and content. These included the presence/absence of a suggestive diagnosis, a message on interpretability, as well as referrals to digital treatments, in-person treatments, and crisis services. RESULTS Using machine learning models, the results suggested that screen content predicted later searches with mental health self-references (AUC = 0·73), mental health self-diagnosis (AUC = 0·69), mental health care seeking (AUC = 0·61), psychoactive medications (AUC = 0·55), suicidal ideation (AUC = 0·58), and suicidal intent (AUC = 0·60). Cox-proportional hazards models suggested individuals utilizing tools with in-person care referral were significantly more likely to subsequently search for methods to actively end their life (HR = 1·727, p = 0·007). DISCUSSION Online screens may influence help-seeking behavior, suicidal ideation, and suicidal intent. Websites with referrals to in-person treatments could put persons at greater risk of active suicidal intent. Further evaluation using large-scale randomized controlled trials is needed.
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Affiliation(s)
- Nicholas C. Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, EverGreen Center, Suite 315, Lebanon, NH, 03756 United States,Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Williamson Building, 3rd Floor, 1 Medical Center Drive, Lebanon, NH 03756, United States,Department of Psychiatry, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03756, United States,Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH,Correspondence concerning this article should be addressed to Nicholas C. Jacobson, Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, Suite 300, Office # 333S, Lebanon, NH 03766, phone: (603) 646-7037;
| | - Elad Yom-Tov
- Microsoft Research, 13 Shenkar Street, Herzeliya, 4672513, Israel; Faculty of Industrial Engineering and Management, Technion - Israel Institute of Technology, Haifa, 3200003, Israel.
| | - Damien Lekkas
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, EverGreen Center, Suite 315, Lebanon, NH, 03756, United States; Quantitative Biomedical Sciences Program, Dartmouth College, NH, United States.
| | - Michael Heinz
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, EverGreen Center, Suite 315, Lebanon, NH, 03756, United States; Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, United States.
| | - Lili Liu
- Quantitative Biomedical Sciences Program, Dartmouth College, NH, United States.
| | - Paul J. Barr
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, EverGreen Center, Suite 315, Lebanon, NH, 03756 United States,The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Williamson Building, 5rd Floor, 1 Medical Center Drive, Lebanon, NH 03756, United States
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Global Burden of Anxiety and Depression among Cystic Fibrosis Patient: Systematic Review and Meta-Analysis. Int J Chronic Dis 2021; 2021:6708865. [PMID: 34307644 PMCID: PMC8282398 DOI: 10.1155/2021/6708865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/19/2021] [Accepted: 06/08/2021] [Indexed: 01/19/2023] Open
Abstract
Aims This systemic review and meta-analysis were aimed at determining the level of anxiety and depression among cystic fibrosis patients in the world. Methods We conducted a systematic search of published studies from PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science, CINAHL, and manually on Google Scholar. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed by the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using a random-effects method using the STATA™ Version 14 software. Trim and fill analysis was done to correct the presence of significant publication bias. Result From 419,820 obtained studies, 26 studies from 2 different parts of the world including 9766. The overall global pooled prevalence of anxiety and depression after correction for publication bias by trim and fill analysis was found to be 24.91(95% CI: 20.8-28.9) for anxiety. The subgroup analyses revealed with the lowest prevalence, 23.59%, (95% CI: 8.08, 39.09)) in North America and the highest, 26.77%, (95% CI: 22.5, 31.04) seen in Europe for anxiety and with the highest prevalence, 18.67%, (95% CI: 9.82, 27.5) in North America and the lowest, 13.27%, (95% CI: -10.05, 16.5) seen in Europe for depression. Conclusion The global prevalence of anxiety and depression among cystic fibrosis patients is common. Therefore, close monitoring of the patient, regularly screening for anxiety and depression, and appropriate prevention techniques is recommended.
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Turck D, Castenmiller J, De Henauw S, Hirsch‐Ernst KI, Kearney J, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Thies F, Tsabouri S, Vinceti M, Bresson J, Siani A. Affron ® and increase in positive mood: evaluation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006. EFSA J 2021; 19:e06660. [PMID: 34249157 PMCID: PMC8251646 DOI: 10.2903/j.efsa.2021.6669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Following an application from Pharmactive Biotech Products, S.L. submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Spain, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to affron® and contributes to maintain a healthy mood. The scope of the application was proposed to fall under a health claim based on newly developed scientific evidence. The food proposed by the applicant as the subject of the health claim is affron®, an aqueous saffron extract with a content of the sum of crocins and safranal typically between 3.5% and 3.9%. The Panel notes that affron® is sufficiently characterised. The claimed effect proposed by the applicant is 'contributes to maintain a healthy mood'. The Panel notes that increase in positive mood is a beneficial physiological effect for individuals with low mood or anxiety. One human intervention study showed that consumption of affron® at a dose of 28 mg/day for 4 weeks improves mood in a population of adults with low mood. However, the results have not been replicated in other studies. The information supplied by the applicant did not provide evidence for a plausible mechanism by which affron® could exert the claimed effect. The Panel concludes that the evidence is insufficient to establish a cause and effect relationship between the consumption of affron® and increase in positive mood.
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Sharma P, Montgomery RN, Graves RS, Meyer K, Hunt SL, Vidoni ED, Mahnken JD, Swerdlow RH, Burns JM, Mudaranthakam DP. CONSENSUS: a Shiny application of dementia evaluation and reporting for the KU ADC longitudinal Clinical Cohort database. JAMIA Open 2021; 4:ooab060. [PMID: 34350395 PMCID: PMC8327371 DOI: 10.1093/jamiaopen/ooab060] [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: 01/29/2021] [Revised: 06/26/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The University of Kansas Alzheimer's Disease Center (KU ADC) maintains several large databases to track participant recruitment, enrollment, and capture various research-related activities. It is challenging to manage and coordinate all the research-related activities. One of the crucial activities involves generating a consensus diagnosis and communicating with participants and their primary care providers. PROCESS To effectively manage the cohort, the KU ADC utilizes a combination of open-source electronic data capture (EDC) (i.e. REDCap), along with other homegrown data management and analytic systems developed using R-studio and Shiny. PROCESS EVALUATION In this article, we describe the method and utility of the user-friendly dashboard that was developed for the rapid reporting of dementia evaluations which allows clinical researchers to summarize recruitment metrics, automatically generate letters to both participants and healthcare providers, which ultimately help optimize workflows. CONCLUSIONS We believe this general framework would be beneficial to any institution that build reports and summarizing key metrics of their research from longitudinal databases.
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Affiliation(s)
- Palash Sharma
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Robert N Montgomery
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Rasinio S Graves
- University of California Davis Alzheimer’s Disease Center, Sacramento, California, USA
| | - Kayla Meyer
- University of Kansas Alzheimer’s Disease Center, Fairway, Kansas, USA
| | - Suzanne L Hunt
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Alzheimer’s Disease Center, Fairway, Kansas, USA
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, Fairway, Kansas, USA
| | - Jonathan D Mahnken
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Alzheimer’s Disease Center, Fairway, Kansas, USA
| | | | - Jeffrey M Burns
- University of Kansas Alzheimer’s Disease Center, Fairway, Kansas, USA
| | - Dinesh Pal Mudaranthakam
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
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Goetz DM, Frederick C, Savant A, Cogswell A, Fries L, Roach C, Shea N, Borowitz D, Smith B. Systematic depression and anxiety screening for patients and caregivers: implementation and process improvement in a cystic fibrosis clinic. BMJ Open Qual 2021; 10:bmjoq-2020-001333. [PMID: 33941540 PMCID: PMC8098908 DOI: 10.1136/bmjoq-2020-001333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/05/2021] [Accepted: 04/17/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Depression and anxiety are common. Rates are significantly higher in cystic fibrosis (CF), and impact health outcomes. Screening is recommended, but is difficult to implement/sustain annually in a busy CF centre. The aim was to develop an acceptable model for depression and anxiety screening in adolescents/adults with CF and their caregivers that could be sustained and shared. Methods Quality improvement methodology with plan-do-study-act cycles, flow diagrams, review of data monthly with our designated ‘Mental Health Team’ and caregiver satisfaction surveys, were used to begin screening in clinics and to improve the process. We then piloted our process at a larger paediatric CF centre. Results Prior to 2013, screening was not performed at our CF centre. After the first quarter of depression screening, 88% of adolescents and 69% of adults with CF were screened. The process was refined. By the second year, 99% of patients were screened. Anxiety screening began in year three; 97%–99% of patients were screened for both anxiety and depression in years 3–5. Annual caregiver screening rates were >95%. Screening was changed from Patient Health Questionnaire-2 (PHQ-2) to PHQ-9 due to better sensitivity in caregivers, and expanded to patients. Anxiety screening began in year 3 with the Generalised Anxiety Disorder-7 questionnaire. Patients and caregivers reported acceptance of screening. At the larger paediatric centre used as a pilot, 89.6% of patients were screened in year 1. Feedback included recommendations to improve tracking/follow-up of positive screens. Conclusions Development and implementation of a stepwise process for depression and anxiety screening was successful in a paediatric/adult CF clinic, due to constant re-evaluation by an engaged team with feedback from patients via survey. A systematic approach at a busy CF centre can serve as a model to implement screening in a clinic.
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Affiliation(s)
- Danielle Marie Goetz
- Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Carla Frederick
- Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Adrienne Savant
- Pediatrics, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Alex Cogswell
- Psychiatry, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Lynne Fries
- Psychiatry, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Christine Roach
- Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Nicole Shea
- Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Drucy Borowitz
- Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Beth Smith
- Psychiatry, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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Li Y, Scherer N, Felix L, Kuper H. Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One 2021; 16:e0246454. [PMID: 33690641 PMCID: PMC7946321 DOI: 10.1371/journal.pone.0246454] [Citation(s) in RCA: 249] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/19/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has placed health care workers under psychological stress. Previous reviews show a high prevalence of mental disorders among health care workers, but these need updating and inclusion of studies written in Chinese. The aim of this systematic review and meta-analysis was to provide updated prevalence estimates for depression, anxiety and post-traumatic stress disorder (PTSD) among health care workers during the COVID-19 pandemic, benefitting from the inclusion of studies published in Chinese. METHODS Systematic search of EMBASE, MEDLINE, PsycINFO, Global Health, Web of Science, CINAHL, Google Scholar and the Chinese databases SinoMed, WanfangMed, CNKI and CQVIP, for studies conducted between December 2019 and August 2020 on the prevalence of depression, anxiety and PTSD in health care workers during the COVID-19 pandemic. Studies published in both English and Chinese were included. RESULTS Data on the prevalence of moderate depression, anxiety and PTSD was pooled across 65 studies involving 97,333 health care workers across 21 countries. The pooled prevalence of depression was 21.7% (95% CI, 18.3%-25.2%), of anxiety 22.1% (95% CI, 18.2%-26.3%), and of PTSD 21.5% (95% CI, 10.5%-34.9%). Prevalence estimates are also provided for a mild classification of each disorder. Pooled prevalence estimates of depression and anxiety were highest in studies conducted in the Middle-East (34.6%; 28.9%). Subgroup and meta-regression analyses were conducted across covariates, including sampling method and outcome measure. CONCLUSIONS This systematic review and meta-analysis has identified a high prevalence of moderate depression, anxiety and PTSD among health care workers during the COVID-19 pandemic. Appropriate support is urgently needed. The response would benefit from additional research on which interventions are effective at mitigating these risks.
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Affiliation(s)
- Yufei Li
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nathaniel Scherer
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Lambert Felix
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
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13
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Gilleland Marchak J, Halpin SN, Escoffery C, Owolabi S, Mertens AC, Wasilewski-Masker K. Using formative evaluation to plan for electronic psychosocial screening in pediatric oncology. Psychooncology 2020; 30:202-211. [PMID: 32931620 DOI: 10.1002/pon.5550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To demonstrate how formative research methods can be used to plan for implementation of evidence-based psychosocial screening in pediatric oncology. METHODS Multidisciplinary pediatric oncology professionals participated in focus groups to adapt the distress thermometer for electronic administration and develop health systems processes to promote psychosocial screening in the pediatric oncology outpatient clinic setting. Seven 1-hour focus groups were conducted using a structured guide based on the reach, efficacy, adoption, implementation, and maintenance framework and transcribed verbatim. Two independent raters coded transcripts using a quasi-deductive approach with high inter-coder reliability (Cohen kappa >0.80). RESULTS Participants' (N = 44) responses were used to identify overarching topics related to the adoption, implementation, and maintenance of electronic screening (e-screening) including: barriers to meeting families' psychosocial needs, identification of champions, suggestions to adapt the proposed e-screening program, perceived barriers to e-screening, and potential impact of carrying out e-screening. Following review of qualitative data, we employed specific implementation strategies to promote adoption, implementation, and maintenance of an e-screening program. CONCLUSIONS Perceived barriers to the implementation of psychosocial screening remain substantial, yet enthusiasm for using electronic health records (EHRs) technology to help meet patient needs through regular assessment was evident among pediatric oncology professionals. Electronic administration of screening and integration of results into the EHR in real time were identified as critical needs to overcome barriers to e-screening. Formative research including qualitative data from stakeholders can be used to tailor implementation strategies to successfully support the adoption, implementation, and maintenance of e-screening programs in pediatric oncology.
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Affiliation(s)
- Jordan Gilleland Marchak
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Sean N Halpin
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Shadé Owolabi
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Ann C Mertens
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Karen Wasilewski-Masker
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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Elce V, Del Pizzo A, Nigro E, Frisso G, Martiniello L, Daniele A, Elce A. Impact of Physical Activity on Cognitive Functions: A New Field for Research and Management of Cystic Fibrosis. Diagnostics (Basel) 2020; 10:diagnostics10070489. [PMID: 32708398 PMCID: PMC7400241 DOI: 10.3390/diagnostics10070489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/06/2020] [Accepted: 07/15/2020] [Indexed: 02/06/2023] Open
Abstract
Cystic Fibrosis (CF) is a genetic disease inherited by an autosomal recessive mechanism and characterized by a progressive and severe multi-organ failure. Mutations in Cystic Fibrosis Conductance Regulator (CFTR) protein cause duct obstructions from dense mucus secretions and chronic inflammation related to organ damage. The progression of the disease is characterized by a decline of lung function associated with metabolic disorders and malnutrition, musculoskeletal disorders and thoracic deformities, leading to a progressive decrement of the individual’s quality of life. The World Health Organization (WHO) qualifies Physical Activity (PA) as a structured activity produced by skeletal muscles’ movements that requires energy consumption. In the last decade, the number of studies on PA increased considerably, including those investigating the effects of exercise on cognitive and brain health and mental performance. PA is recommended in CF management guidelines, since it improves clinic outcomes, such as peripheral neuropathy, oxygen uptake peak, bone health, glycemic control and respiratory functions. Several studies regarding the positive effects of exercise in patients with Cystic Fibrosis were carried out, but the link between the effects of exercise and cognitive and brain health in CF remains unclear. Animal models showed that exercise might improve learning and memory through structural changes of brain architecture, and such a causal relationship can also be described in humans. Indeed, both morphological and environmental factors seem to be involved in exercise-induced neural plasticity. An increase of gray matter volume in specific areas is detectable as a consequence of regular training in humans. Neurobiological processes associated with brain function improvements include biochemical modifications, such as neuromodulator or neurohormone release, brain-derived neurotrophic factor (BDNF) production and synaptic activity changes. From a functional point of view, PA also seems to be an environmental factor enhancing cognitive abilities, such as executive functions, memory and processing speed. This review describes the current state of research regarding the impacts of physical activity and exercise on cognitive functions, introducing a possible novel field of research for optimizing the management of Cystic Fibrosis.
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Affiliation(s)
- Valentina Elce
- MoMiLab, IMT School for Advanced Studies, Piazza San Francesco 19, 55100 Lucca, Italy;
| | - Alessandro Del Pizzo
- Dipartimento di Fisica, University of Pisa, Largo Bruno Pontecorvo, 3, 56127 Pisa, Italy;
| | - Ersilia Nigro
- Dipartimento di Scienze e Tecnologie Ambientali, Biologiche, Farmaceutiche, Università della Campania Luigi Vanvitelli, Via Vivaldi, 81110 Caserta, Italy; (E.N.); (A.D.)
- CEINGE Biotecnologie Avanzate SCarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy;
| | - Giulia Frisso
- CEINGE Biotecnologie Avanzate SCarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy;
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Lucia Martiniello
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Direzionale, isola F2, 80143 Napoli, Italy;
| | - Aurora Daniele
- Dipartimento di Scienze e Tecnologie Ambientali, Biologiche, Farmaceutiche, Università della Campania Luigi Vanvitelli, Via Vivaldi, 81110 Caserta, Italy; (E.N.); (A.D.)
- CEINGE Biotecnologie Avanzate SCarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy;
| | - Ausilia Elce
- CEINGE Biotecnologie Avanzate SCarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy;
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Direzionale, isola F2, 80143 Napoli, Italy;
- Correspondence:
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MacIntyre CR, Adam DC, Turner R, Chughtai AA, Engells T. Public awareness, acceptability and risk perception about infectious diseases dual-use research of concern: a cross-sectional survey. BMJ Open 2020; 10:e029134. [PMID: 31911509 PMCID: PMC6955500 DOI: 10.1136/bmjopen-2019-029134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES In this study, we aimed to measure the awareness, acceptability and perceptions of current issues in biosecurity posed by infectious diseases dual-use research of concern (DURC) in the community. DURC is conducted today in many locations around the world for the benefit of humanity but may also cause harm through either a laboratory accident or deliberate misuse. Most DURC is approved by animal ethics committees, which do not typically consider harm to humans. Given the unique characteristics of contagion and the potential for epidemics and pandemics, the community is an important stakeholder in DURC. DESIGN Self-administered web-based cross-sectional survey. PARTICIPANTS Participants over the age of 18 in Australia and 21 in the USA were included in the survey. A total of 604 participants completed the study. The results of 52 participants were excluded due to potential biases about DURC stemming from their employment as medical researchers, infectious diseases researchers or law enforcement professionals, leaving 552 participants. Of those, 274 respondents resided in Australia and 278 in the USA. OUTCOMES Baseline awareness, acceptability and perceptions of current issues surrounding DURC. Changes in perception from baseline were measured after provision of information about DURC. RESULTS Presurvey, 77% of respondents were unaware of DURC and 64% found it unacceptable or were unsure. Two-thirds of respondents did not change their views. The baseline perception of high risk for laboratory accidents (29%) and deliberate bioterrorism (34%) was low but increased with increasing provision of information (42% and 44% respectively, p<0.001), with men more accepting of DURC (OR=1.79, 95% CI 1.25 to 2.57, p=0.002). Postsurvey, higher education predicted lower risk perception of laboratory accidents (OR=0.56, 95% CI 0.34 to 0.93, p=0.02) and bioterrorism (OR=0.48, 95% CI 0.29 to 0.80, p=0.004). CONCLUSION The community is an important stakeholder in infectious diseases DURC but has a low awareness of this kind of research. Only a minority support DURC, and this proportion decreased with increasing provision of knowledge. There were differences of opinion between age groups, gender and education levels. The community should be informed and engaged in decisions about DURC.
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Affiliation(s)
- Chandini Raina MacIntyre
- Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- College of Health Solutions, Arizona State University, Tempe, Arizona, USA
- College of Public Service & Community Solutions, Arizona State University, Tempe, Arizona, USA
| | - Dillon Charles Adam
- Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Robin Turner
- Centre for Biostatistics, Division of Health Sciences, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Abrar Ahmad Chughtai
- University of New South Wales School of Public Health and Community Medicine, Sydney, New South Wales, Australia
| | - Thomas Engells
- University of Texas Medical Branch, Galveston, Texas, USA
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17
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Mattsson S, Olsson EMG, Carlsson M, Johansson BBK. Identification of Anxiety and Depression Symptoms in Patients With Cancer: Comparison Between Short and Long Web-Based Questionnaires. J Med Internet Res 2019; 21:e11387. [PMID: 30950804 PMCID: PMC6473214 DOI: 10.2196/11387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 01/18/2019] [Accepted: 02/07/2019] [Indexed: 01/06/2023] Open
Abstract
Background Physicians and nurses in cancer care easily fail to detect symptoms of psychological distress because of barriers such as lack of time, training on screening methods, and knowledge about how to diagnose anxiety and depression. National guidelines in several countries recommend routine screening for emotional distress in patients with cancer, but in many clinics, this is not implemented. By inventing screening methods that are time-efficient, such as digitalized and automatized screenings with short instruments, we can alleviate the burden on patients and staff. Objective The aim of this study was to compare Web-based versions of the ultrashort electronic Visual Analogue Scale (eVAS) anxiety and eVAS depression and the short Hospital Anxiety and Depression Scale (HADS) with Web-based versions of the longer Montgomery Åsberg Depression Rating Scale-Self-report (MADRS-S) and the State Trait Anxiety Inventory- State (STAI-S) with regard to their ability to identify symptoms of anxiety and depression in patients with cancer. Methods Data were obtained from a consecutive sample of patients with newly diagnosed (<6 months) breast, prostate, or colorectal cancer or with recurrence of colorectal cancer (N=558). The patients were recruited at 4 hospitals in Sweden between April 2013 and September 2015, as part of an intervention study administered via the internet. All questionnaires were completed on the Web at the baseline assessment in the intervention study. Results The ultrashort and short Web-based-delivered eVAS anxiety, eVAS depression and HADS were found to have an excellent ability to discriminate between persons with and without clinical levels of symptoms of anxiety and depression compared with recommended cutoffs of the longer instruments MADRS-S and STAI-S (area under the curve: 0.88-0.94). Cutoffs of >6 on HADS anxiety and >7 hundredths (hs) on eVAS anxiety identified patients with anxiety symptoms with high accuracy. For HADS depression, at a cutoff of >5 and eVAS depression at a cutoff of >7 hs, the accuracy was very high likewise. Conclusions The use of the short and ultrashort tools, eVAS and HADS, may be a suitable initial method of Web-based screening in busy clinical settings. However, there are still a proportion of patients who lack access to the internet or the ability to use it. There is a need to find solutions for this group to find all the patients with psychological distress.
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Affiliation(s)
- Susanne Mattsson
- Lifestyle and Rehabilitation in long term illness, Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Martin Gustaf Olsson
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Carlsson
- Lifestyle and Rehabilitation in long term illness, Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Cronly J, Duff A, Riekert K, Horgan A, Lehane E, Perry I, Fitzgerald A, Howe B, Chroinin MN, Savage E. Positive mental health and wellbeing in adults with cystic fibrosis: A cross sectional study. J Psychosom Res 2019; 116:125-130. [PMID: 30579560 DOI: 10.1016/j.jpsychores.2018.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/29/2018] [Accepted: 11/22/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Screening for depression and anxiety in people with cystic fibrosis (CF) is recommended but this alone can miss the opportunity to assess and promote positive mental health and wellbeing. This cross-sectional study assessed positive mental health and wellbeing, and associations with physical health and health-related quality of life (HRQoL) in adults with CF. METHODS Adults (n = 147) with CF from 9 CF centres in the Republic of Ireland completed the Warwick Edinburgh Mental Well-being scale, the Hospital Anxiety and Depression Scale and the Cystic Fibrosis Questionnaire-Revised. Demographic and physical health outcome data were also collected. RESULTS High levels of positive mental health and wellbeing were reported in this sample. There were significant associations between positive 'mental health and wellbeing' and pulmonary function, self-reported physical health and recent hospitalizations. Positive mental health was significantly associated with 11 of the 12 CFQ-R domains assessing HRQoL. CONCLUSION Assessing and promoting positive mental health and wellbeing may contribute to improving or maintaining physical and mental health, and HRQoL in patients with cystic fibrosis. It provides valuable clinical information to complement depression and anxiety screening and has potential to track the effectiveness of mental health promotion strategies by assessing and monitoring positive mental health and wellbeing over time. Individuals with CF may benefit from interventions that promote positive mental health and wellbeing by enhancing coping and problem-solving skills and fostering hope and optimism. Future research should focus on the development and testing of positive mental health and wellbeing promotion interventions in people with CF.
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Affiliation(s)
- Jennifer Cronly
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland
| | - Alistair Duff
- Department of Clinical & Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Kristin Riekert
- John Hopkins Adherence Research Center, John Hopkins School of Medicine, Baltimore, MD, United States
| | - Aine Horgan
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland
| | - Elaine Lehane
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland
| | - Ivan Perry
- School of Public Health, Western Gate Building, University College Cork, Ireland
| | - Anthony Fitzgerald
- School of Public Health, Western Gate Building, University College Cork, Ireland; Department of Statistics, Western Gate Building, University College Cork, Ireland
| | - Barbara Howe
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland
| | | | - Eileen Savage
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland.
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Positive mental health and wellbeing in adolescents with cystic fibrosis. J Psychosom Res 2019; 116:131-132. [PMID: 30579558 DOI: 10.1016/j.jpsychores.2018.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 11/20/2022]
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