1
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Seibert TA, Shi L, Althouse S, Hoffman R, Schneider BP, Russ KA, Altherr CA, Warden SJ, Guise TA, Coggan AR, Ballinger TJ. Molecular and clinical effects of aromatase inhibitor therapy on skeletal muscle function in early-stage breast cancer. Sci Rep 2024; 14:1029. [PMID: 38200207 PMCID: PMC10781701 DOI: 10.1038/s41598-024-51751-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/09/2024] [Indexed: 01/12/2024] Open
Abstract
We evaluated biochemical changes in skeletal muscle of women with breast cancer initiating aromatase inhibitors (AI), including oxidation of ryanodine receptor RyR1 and loss of stabilizing protein calstabin1, and detailed measures of muscle function. Fifteen postmenopausal women with stage I-III breast cancer planning to initiate AI enrolled. Quadriceps muscle biopsy, dual-energy x-ray absorptiometry, isokinetic dynamometry, Short Physical Performance Battery, grip strength, 6-min walk, patient-reported outcomes, and serologic measures of bone turnover were assessed before and after 6 months of AI. Post-AI exposure, oxidation of RyR1 significantly increased (0.23 ± 0.37 vs. 0.88 ± 0.80, p < 0.001) and RyR1-bound calstabin1 significantly decreased (1.69 ± 1.53 vs. 0.74 ± 0.85, p < 0.001), consistent with dysfunctional calcium channels in skeletal muscle. Grip strength significantly decreased at 6 months. No significant differences were seen in isokinetic dynamometry measures of muscle contractility, fatigue resistance, or muscle recovery post-AI exposure. However, there was significant correlation between oxidation of RyR1 with muscle power (r = 0.60, p = 0.02) and muscle fatigue (r = 0.57, p = 0.03). Estrogen deprivation therapy for breast cancer resulted in maladaptive changes in skeletal muscle, consistent with the biochemical signature of dysfunctional RyR1 calcium channels. Future studies will evaluate longer trajectories of muscle function change and include other high bone turnover states, such as bone metastases.
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Affiliation(s)
- Tara A Seibert
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Lei Shi
- Department of Endocrine Neoplasia and Hormonal Disorders, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Sandra Althouse
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Richard Hoffman
- Department of Kinesiology, Indiana University School of Health & Human Sciences, Indianapolis, IN, 46202, USA
| | - Bryan P Schneider
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, 535 Barnhill Dr. RT 472, Indianapolis, IN, 46202, USA
| | - Kristen A Russ
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Cody A Altherr
- Indiana Center for Musculoskeletal Health, Clinical Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Stuart J Warden
- Department of Physical Therapy, Indiana University School of Health & Human Sciences, Indianapolis, IN, 46202, USA
| | - Theresa A Guise
- Department of Kinesiology, Indiana University School of Health & Human Sciences, Indianapolis, IN, 46202, USA
| | - Andrew R Coggan
- Department of Kinesiology, Indiana University School of Health & Human Sciences, Indianapolis, IN, 46202, USA
| | - Tarah J Ballinger
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, 535 Barnhill Dr. RT 472, Indianapolis, IN, 46202, USA.
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2
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Hoffman R. Defining "plant-based meats". Eur J Clin Nutr 2024; 78:72-73. [PMID: 37679569 DOI: 10.1038/s41430-023-01340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Richard Hoffman
- School of Life Sciences, University of Hertfordshire, Hatfield, Herts, AL10 9AB, UK.
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3
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Ballinger TJ, Marques HS, Xue G, Hoffman R, Gatsonis C, Zhao F, Miller KD, Sparano J, Connolly RM. Impact of Muscle Measures on Outcome in Patients Receiving Endocrine Therapy for Metastatic Breast Cancer: Analysis of ECOG-ACRIN E2112. J Natl Compr Canc Netw 2023; 21:915-923.e1. [PMID: 37673107 PMCID: PMC10594540 DOI: 10.6004/jnccn.2023.7045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/06/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Observational data investigating the relationship between body habitus and outcomes in breast cancer have been variable and inconsistent, largely centered in the curative setting and focused on weight-based metrics. This study evaluated the impact of muscle measures on outcomes in patients with metastatic breast cancer receiving endocrine-based therapy. METHODS Baseline CT scans were collected from ECOG-ACRIN E2112, a randomized phase III placebo-controlled study of exemestane with or without entinostat. A CT cross-sectional image at the L3 level was extracted to obtain skeletal muscle mass and attenuation. Low muscle mass (LMM) was defined as skeletal muscle index <41 cm2/m2 and low muscle attenuation (LMA) as muscle density <25 HU or <33 HU if overweight/obese by body mass index (BMI). Multivariable Cox proportional hazard models determined the association between LMM or LMA and progression-free survival (PFS) and overall survival (OS). Correlations between LMM, LMA, and patient-reported outcomes were determined using 2-sample t tests. RESULTS Analyzable CT scans and follow-up data were available for 540 of 608 patients. LMM was present in 39% (n=212) of patients and LMA in 56% (n=301). Those with LMA were more likely to have obesity and worse performance status. LMM was not associated with survival (PFS hazard ratio [HR]: 1.13, P=.23; OS HR: 1.05, P=.68), nor was LMA (PFS HR: 1.01, P=.93; OS HR: 1.00, P=.99). BMI was not associated with survival. LMA, but not LMM, was associated with increased frequency of patient-reported muscle aches. CONCLUSIONS Both low muscle mass and density are prevalent in patients with hormone receptor-positive metastatic breast cancer. Muscle measures correlated with obesity and performance status; however, neither muscle mass nor attenuation were associated with prognosis. Further work is needed to refine body composition measurements and select optimal cutoffs with meaningful endpoints in specific breast cancer populations, particularly those living with metastatic disease.
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Affiliation(s)
| | | | - Gloria Xue
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Richard Hoffman
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Fengmin Zhao
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kathy D. Miller
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Joseph Sparano
- Icahn School of Medicine at Mount Sinai, New York, New York
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Aoki Y, Tome Y, Oshiro H, Mizuta K, Katsuki R, Nishida K, Hoffman R. 93P Reduced malignancy of super methotrexate-resistant osteosarcoma cells is linked to elevated expression of PI3K/AKT/mTOR and c-MYC. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Ballinger TJ, Xue G, Marques HS, Gatsonis C, Hoffman R, Miller KD, Zhao F, Sparano J, Connolly R. Abstract P3-05-26: Association of muscle mass and density with outcomes in patients with ER positive metastatic breast cancer: correlative analysis of ECOG-ACRIN 2112. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p3-05-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction: Observational data investigating the relationship between body habitus and survival or toxicity in breast cancer has been largely centered in the curative setting and focused on weight- based metrics, with variable and inconsistent results. Muscle is a large, active endocrine organ that affects physical function, drug metabolism, inflammation, and quality of life, but is not adequately measured by body weight alone. Very few studies have evaluated muscle measures in metastatic breast cancer (MBC) and have been focused on patients receiving cytotoxic chemotherapy. Here, we evaluate the impact of muscle mass and muscle density measured on CT scan on outcomes in patients with MBC receiving endocrine- based therapy. Methods: Baseline CT scans done at the time of study enrollment were centrally collected from participants in ECOG-ACRIN E2112, a randomized phase III study of exemestane with or without entinostat in MBC, which ultimately did not impact survival. A transverse cut at the L3 level was extracted and processed using semi-automated SliceOmatic software (Tomovision) by two independent investigators to obtain total body skeletal muscle mass and muscle attenuation. Low muscle mass was defined as skeletal muscle index (SMI, lean muscle area/height, cm2/m2) less than 41 and low skeletal muscle attenuation (SMA) was defined as average muscle density less than 41 HU, or less than 33 HU if the patient is overweight or obese by BMI. Chi-square tests were used to determine the association between SMI and SMA and other clinical characteristics, including body weight, race, and performance status. Multivariable Cox proportional hazard models were used to determine the association between low SMI or low SMA and overall survival (OS), progression free survival (PFS), and patient- reported outcomes. Results: Of the 608 patients randomized in E2112, 546 had analyzable CT scans and follow up data available. 45% (n=246) of participants had obesity by BMI (≥30); 39% (n=212) had low SMI and 56% (n=305) had low SMA. Obese patients were more likely to have higher SMI (p< 0.001); however, 9.5% (n=52) of the study population had both obesity and low SMI. Low SMA was associated with higher rate of obesity and worse performance status (p< 0.001), consistent with muscle quality being a predictor of functional status. Low SMI was not associated with survival outcomes (OS HR 1.04 95%CI 0.83-1.30, PFS HR 1.12 95% CI 0.92-1.36), nor was low SMA (OS HR 1.02 95%CI 0.81-1.28; PFS HR 1.02 95%CI 0.84-1.23). In addition, BMI was not related to survival outcomes. Conclusions: Low muscle mass and low muscle density are prevalent in estrogen receptor positive MBC patients. Muscle measures correlated with obesity and performance status; however, neither low SMI nor low SMA were associated with worse prognosis in this population. Further work is needed to refine body composition measurements and select optimal cutoffs and meaningful endpoints in specific breast cancer populations, particularly in those living with metastatic disease.
Citation Format: Tarah J. Ballinger, Gloria Xue, Helga S. Marques, Constantine Gatsonis, Richard Hoffman, Kathy D. Miller, Fengmin Zhao, Joseph Sparano, Roisin Connolly. Association of muscle mass and density with outcomes in patients with ER positive metastatic breast cancer: correlative analysis of ECOG-ACRIN 2112 [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-26.
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Philibert R, Dawes K, Moody J, Hoffman R, Sieren J, Long J. Using Cg05575921 methylation to predict lung cancer risk: a potentially bias-free precision epigenetics approach. Epigenetics 2022; 17:2096-2108. [PMID: 35920547 PMCID: PMC9665144 DOI: 10.1080/15592294.2022.2108082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
The decision to engage in lung cancer screening (LCS) necessitates weighing benefits versus harms. Previously, clinicians in the United States have used the PLCOM2012 algorithm to guide LCS decision-making. However, that formula contains race and gender-based variables. Previously, using data from a European study, Bojesen and colleagues have suggested that cg05575921 methylation could guide decision-making. To test this hypothesis in a more diverse American population, we examined DNA and clinical data from 3081 subjects from the National Lung Screening Trial (NLST) study. Using survival analysis, we found a simple linear predictor consisting of age, pack-year consumption and cg05575921, to have the best predictive power among several alternatives (AUC = 0.66). Results showed that the highest quartile of risk was more than 2-fold more likely to develop lung cancer than those in the lowest quartile. Race, ethnicity, and gender had no effect on prediction with both cg05575921 and pack years contributing equally (both p < 0.003) to risk prediction. Current smokers had considerably lower methylation than former smokers (46% vs 67%; p < 0.001) with the average methylation of those who quit approaching 80% after 25 years of cessation. Finally, current male smokers had lower mean cg05575921 percentage than female smokers (46% vs 49%; p < 0.001). We conclude that cg05575921 (along with age and pack years) can be used to guide LCS decision-making, and additional studies might focus on how best to use methylation to inform decision-making.
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Affiliation(s)
- Rob Philibert
- Behavioural Diagnostics LLC, Coralville, IA, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Kelsey Dawes
- Behavioural Diagnostics LLC, Coralville, IA, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Joanna Moody
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Richard Hoffman
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Jessica Sieren
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- Department of Radiology, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Jeffrey Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
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Levy M, Ferraro G, Planoutene M, Li L, Han Y, Varicchio L, Fournier S, An X, Morris S, Koehler M, Hoffman R, Fretland A, Roulston A, Ginzburg Y. ATR inhibitor camonsertib (RP-3500) suppresses early-stage erythroblasts by mediating ferroptosis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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van Oosterhout JJ, Chipungu C, Nkhoma L, Kanise H, Hosseinipour MC, Sagno JB, Simon K, Cox C, Hoffman R, Steegen K, Matola BW, Phiri S, Jahn A, Nyirenda R, Heller T. Dolutegravir resistance in Malawi’s national HIV treatment program. Open Forum Infect Dis 2022; 9:ofac148. [PMID: 35493118 PMCID: PMC9045949 DOI: 10.1093/ofid/ofac148] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/04/2022] [Indexed: 11/24/2022] Open
Abstract
Dolutegravir HIV drug resistance (HIVDR) data from Africa remain sparse. We reviewed HIVDR results of Malawians on dolutegravir-based antiretroviral therapy (November 2020–September 2021). Of 6462 eligible clients, 33 samples were submitted to South Africa, 27 were sequenced successfully, and 8 (30%) had dolutegravir HIVDR. Malawi urgently requires adequate HIVDR testing capacity.
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Affiliation(s)
- J J van Oosterhout
- Partners in Hope, Lilongwe, Malawi
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
| | | | - L Nkhoma
- The Lighthouse Trust, Lilongwe, Malawi
| | - H Kanise
- Partners in Hope, Lilongwe, Malawi
| | | | - J B Sagno
- DREAM, Communion of St. Egidio, Malawi
| | - K Simon
- Baylor College of Medicine Children’s Foundation-Malawi, Lilongwe, Malawi
- Baylor International Pediatric AIDS Initiative, Houston, USA
| | - C Cox
- Baylor College of Medicine Children’s Foundation-Malawi, Lilongwe, Malawi
- Baylor International Pediatric AIDS Initiative, Houston, USA
| | - R Hoffman
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - K Steegen
- Department of Haematology & Molecular Medicine, National Health Laboratory Service, Johannesburg, South Africa
- Department of Haematology & Molecular Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - B W Matola
- Department of Public Health and Family Medicine, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - S Phiri
- Partners in Hope, Lilongwe, Malawi
- Department of Public Health and Family Medicine, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - A Jahn
- Department of HIV-AIDS, Ministry of Health, Lilongwe, Malawi
| | - R Nyirenda
- Department of HIV-AIDS, Ministry of Health, Lilongwe, Malawi
| | - T Heller
- The Lighthouse Trust, Lilongwe, Malawi
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Toprak M, Kashi M, Hamele-Bena D, Villanueva J, Wrzolek M, Hoffman R, Hiltzik D, Tong GX. Ultrasound-guided fine-needle aspiration biopsy of thyroid neoplasms with lipomatous stroma: Report of two cases. Diagn Cytopathol 2021; 49:E379-E384. [PMID: 34289250 DOI: 10.1002/dc.24833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 11/12/2022]
Abstract
Thyroid tumors with abundant adipose tissue component are rare, reportedly accounting for 0.98-2.8% of all thyroid nodules, and include entities such as thyroid lipoadenoma and thyroid carcinoma with lipomatous stroma (TCLS). They may be encountered on fine-needle aspiration biopsy (FNAB), which is widely used in evaluation of thyroid nodules. However, due to their relative rarity, adipose elements rarely are recognized preoperatively in these tumors. Herein, we report two cases of thyroid tumors with abundant adipose tissue, along with cytologic, histologic, and ultrasonographic features. Although an intermixture of adipose tissue and thyroid follicular cells is the key cytologic feature of thyroid tumors with adipose stroma, other cytologic findings, such as abundant fat droplets or isolated fragments of adipose tissue, also should raise the possibility of a fat-containing tumor, particularly when a biopsy is performed by a cytopathologist under ultrasonographic guidance and adequate radiologic-pathologic correlation. Cytopathologists should be aware that overlooking lesional adipose tissue within a thyroid neoplasm might give the false impression of a non-diagnostic or sparsely cellular FNAB specimen.
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Affiliation(s)
- Mesut Toprak
- Department of Pathology and Laboratory Medicine, Staten Island University Hospital, New York, New York, USA
| | - Meena Kashi
- Department of Pathology and Laboratory Medicine, Staten Island University Hospital, New York, New York, USA
| | - Diane Hamele-Bena
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, USA
| | - Jocelyn Villanueva
- Department of Pathology and Laboratory Medicine, Staten Island University Hospital, New York, New York, USA
| | | | - Richard Hoffman
- Center for Thyroid and Parathyroid disease, Staten Island University Hospital, New York, New York, USA
| | - David Hiltzik
- Center for Thyroid and Parathyroid disease, Staten Island University Hospital, New York, New York, USA
| | - Guo-Xia Tong
- Department of Pathology and Laboratory Medicine, Staten Island University Hospital, New York, New York, USA
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10
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Wires C, Hoffman R, Talbert A, Brady C, O'Haire M, Croney C. 111 Ability to interpret and apply animal behavior and welfare terminology by adults within the horse industry. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Smith C, Spooner H, Higgins A, Hoffman R. 128 Beyond the ride: the use of psychological skills training in equestrian athletes. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Kamp KV, Spooner H, Higgins A, Hoffman R. 110 Usage and perceptions of equestrian safety equipment. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Layton K, Spooner H, Higgins A, Hoffman R. 117 Outside the classroom: An evaluation of equine internships. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Matt BJ, Charlton ME, Hoffman R. Pilot Study on Early Onset of Colorectal Cancer in Patients Under Age 50: How and Why are they Diagnosed? J Registry Manag 2021; 48:138-140. [PMID: 35413731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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15
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Hoffman R, Watson S, Kher H. Modes of governance for market entry by international franchisors: factors affecting the choice. MRR 2020. [DOI: 10.1108/mrr-07-2020-0400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to provide an empirical test of an existing theoretical model depicting the governance modes used by international franchisors when entering international markets.
Design/methodology/approach
Using a unique panel data set of 222 market expansions by US firms over a seven-year period, this paper tests hypotheses regarding the factors affecting the franchisors’ choice of governance modes when entering foreign markets.
Findings
Franchisors use governance modes with lower levels of control when faced with environmental uncertainties due to corruption, economic downturns and when the geographic distance is large. Moreover, the franchise system assets and its local market assets also affect the choice of governance modes.
Practical implications
Firms need to balance the costs of environmental uncertainty with the need to safeguard the firm’s capabilities and resources using governance modes with appropriate levels of control. This balance changes as the franchise company gains more experience in the local market and as once-emerging markets continue to develop.
Originality/value
This research identified additional governance modes used by franchisors compared to previous studies. Using multiple theoretical perspectives, the study supported significant portions of the Jell-Ojobor and Windsperger (2014) model of franchisor governance mode choice.
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Toprak M, Kashi M, Villanueva J, Wrzolek M, Tong G, Hamele-Bena D, Hoffman R, Hiltzik D. Thyroid and Parathyroid Neoplasms with Lipomatous Stroma: Report of Three Cases and Review of the Literature. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Tumors with mixed adipose tissue and epithelial components are rare in thyroid and parathyroid glands. Most of them are benign and referred to as adenolipoma (or lipoadenoma). A handful of malignant tumors of thyroid follicular cell origin have been reported with abundant adipose tissue known as thyroid carcinoma with lipomatous stroma (TCLS). Adenolipomas of thyroid or TCLS are usually manifested as large thyroid nodules and evaluated by fine needle aspiration biopsy (FNAB) which frequently yield low-cellularity samples due to abundant adipose tissue. On FNAB, the adipose tissue usually interpreted as contamination of subcutaneous or perithyroid origin. Similarly, adenolipomas of the parathyroid are not frequently identified because of presence of adipose tissue which is a feature associated with normal parathyroid glands. Therefore, these tumors are not often correctly diagnosed preoperatively. For that reason, pathologist should report additional cases about this rare entity to increase our understanding and to decrease preoperative diagnostic error.
Methods
We report three cases of thyroid and parathyroid tumors with abundant adipose tissue with sonographic, cytologic and histologic features along with literature review.
Results
Among the reported cases in the literature and our cases; 10 out of 17 cases of thyroid carcinoma with lipomatous stroma are papillary thyroid carcinomas (58.8%), 3 out of 17 cases are papillary microcarcinomas (17.6%), 2 out of 17 cases are noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (11.7%), and 2 out of 17 cases are minimally invasive follicular carcinomas (11.7%). No cases of poorly differentiated or anaplastic thyroid carcinomas have been reported.
Conclusion
Lipomatous stroma in thyroid carcinoma appears to be associated with differentiated carcinomas since no reported cases of poorly differentiated or anaplastic thyroid carcinomas are present to our knowledge. Although the presence of fatty tissue does not appear to alter the prognosis of these lesions, the question of the histogenesis of the adipose component is intriguing. Awareness of this unusual feature and increased utilization of multimodal approaches in the evaluation of this entity may increase preoperative detection and the understanding of the histogenesis and its possible significance.
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Affiliation(s)
- M Toprak
- Department of Pathology, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
| | - M Kashi
- Department of Pathology, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
| | - J Villanueva
- Department of Pathology, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
| | - M Wrzolek
- Department of Pathology, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
| | - G Tong
- Department of Pathology, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
| | - D Hamele-Bena
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, UNITED STATES
| | - R Hoffman
- Center for Thyroid and Parathyroid disease, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
| | - D Hiltzik
- Center for Thyroid and Parathyroid disease, Northwell Health - Staten Island University Hospital, Staten Island, New York, UNITED STATES
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Maher K, Spooner H, Hoffman R, Haffner J. The influence of whole-body vibration on heart rate, stride length, and bone mineral content in the mature exercising horse. Comparative Exercise Physiology 2020. [DOI: 10.3920/cep190073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Research in humans suggests whole-body vibration (WBV) aids in maintaining bone mineral content (BMC) yet results in the horse are less favourable. Anecdotally, WBV is reported to reduce pain and improve performance. This study was designed to test the effect of WBV on exercising horses, hypothesising that WBV would lower heart rate (HR) during treatment, increase BMC, modify markers of bone metabolism, and increase stride length. Eleven horses were randomly assigned into control (CON, n=5) or WBV (VIB, n=6) groups for a 28-day treatment period. Both groups exercised for 1 h, 6 d/wk on a mechanical exerciser. VIB horses received 50 Hz WBV for 45 min, 5 days/wk. Third metacarpal radiographs were taken at 0 and 28 days, and BMC determined via radiographic bone aluminium equivalence (RBAE). Blood samples taken at day 0 and 28 were analysed for serum pyridinoline cross-links (PYD) and osteocalcin (OC). Heart rate was analysed on day 23 for 4 horses per group. Stride length was determined while trotting in hand on day 0 and 28. No influence of WBV on RBAE of any bone cortices, PYD or OC was observed (P>0.10); stride length was also unaffected (P=0.88). A period effect was observed for a decrease in RBAE of the lateral cortex (P=0.01), and a trend towards a decrease was noted in total density (P=0.05), likely an effect of stalling. Compared to baseline, ΔHR declined during treatment (P=0.06) in VIB (-4.8±2.8 bpm) compared to control CON (3.0±2.8 bpm). The results suggest, in normal exercising horses, WBV does not increase BMC, influence markers of bone metabolism, or increase stride length.
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Affiliation(s)
- K. Maher
- Middle Tennessee State University, 314 E Thompson Lane, Murfreesboro, TN 37129, USA
| | - H. Spooner
- Middle Tennessee State University, 314 E Thompson Lane, Murfreesboro, TN 37129, USA
| | - R. Hoffman
- Middle Tennessee State University, 314 E Thompson Lane, Murfreesboro, TN 37129, USA
| | - J. Haffner
- Middle Tennessee State University, 314 E Thompson Lane, Murfreesboro, TN 37129, USA
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Dörner T, Tanaka Y, Petri MA, Smolen JS, Wallace D, Crowe B, Dow E, Higgs RE, Rocha G, Benschop R, Silk M, De Bono S, Hoffman R, Fantini D. OP0045 DELINEATION OF A PROINFLAMMATORY CYTOKINE PROFILE TARGETED BY JAK1/2 INHIBITION USING BARICITINIB IN A PHASE 2 SLE TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Background:Given the unmet clinical needs in systemic lupus erythematosus (SLE), including poor disease control and drug toxicities, new therapies are needed. In a phase 2, randomized, placebo-controlled, double-blind study (JAHH), once-daily baricitinib (bari) resulted in significant clinical improvement in patients (pts) with active SLE versus PBO. Bari inhibits JAK1 and JAK2 signalling, and in turn may affect STAT1, STAT2, STAT4 pathways. Therefore, bari has the potential to simultaneously impact several pro-inflammatory immune cytokines implicated in the pathogenesis of SLE, including IFN-α, IFN-γ, IL-6, IL-12, and IL-23.Objectives:The objectives of the current study were: 1) to examine baseline serum cytokines in the JAHH phase 2 clinical trial for correlations with clinical or immunologic assessments; 2) to determine if changes in serum cytokine levels were associated with bari treatment.Methods:Pts enrolled in the JAHH phase 2 trial received daily treatment with PBO, bari 2 mg, or bari 4 mg through week 24. Serum samples were collected at baseline (week [wk] 0), wk 12, and wk 24) from SLE pts (n=270) and 50 sex- and age-matched controls. Samples were analyzed for: IL-2, IL-3, IL-5, IL-6, IL-10, IL-17A, IL-21, IL-12/23p40, IL-12p70, GM-CSF, IFN-α and IFN-γ using ultrasensitive quantitative assays. IFN gene signature, autoantibodies, C3 and C4 were measured as previously described [1].Results:At wk 0, serum IL-17A, IL-12/23p40, IL-6, IFN-γ and IFN-α were readily detectable. IL-12/23p40 was detectable in 100% of pts vs. 100% of controls, IFN-γ in 89% of pts vs. 66% of controls, IL-6 in 53% of pts vs. 12% of controls and in IFN-α 41% of pts vs. 2% of controls; detection of serum IL-2, GM-CSF, IL-5, IL-10 and IL-17A was variable (Fig 1). At baseline (wk 0), IL-12/23p40 was positively correlated with SLEDAI and IFN gene signature and negatively correlated with serum C4. IL-6 was positively correlated with joint swelling, joint tenderness, IFN-γ and C3. Serum IFN-α was positively correlated with serum IFN-γ, anti-Sm and anti-RNP, and the IFN gene signature (Fig 2). Treatment with bari 4 mg (Fig 1B) significantly decreased serum IL12/23p40 and IL-6 cytokine levels at wk 12 (p<0.05) but not serum IFN-α or IFN-γ levels (Fig 1B).Figure 1.* p = 0.015; ** p = 0.001; Abbreviations: LLOQ, Lower limit of quantification.Figure 2.Abbreviations: Anti-dsDNA, Anti-double stranded DNA; Anti-RNP, Anti-ribonucleoprotein; CLASI, Cutaneous lupus erythematosus disease area and severity index; SLEDAI, SLE disease activity index.Conclusion:Bari 4 mg treatment was associated with statistically significant decreases of serum IL-12/23p40 and IL-6 at week 12 which continued through week 24. Serum IFN-α or IFN-γ were not reduced with bari treatment. Thus, bari 4 mg simultaneously impacted multiple pro-inflammatory cytokines implicated in the pathogenesis of SLE.References:[1]Hoffman RW, et al.Arthritis Rheumatol.2017;69(3):643-654.Disclosure of Interests:Thomas Dörner Grant/research support from: Janssen, Novartis, Roche, UCB, Consultant of: Abbvie, Celgene, Eli Lilly, Roche, Janssen, EMD, Speakers bureau: Eli Lilly, Roche, Samsung, Janssen, Yoshiya Tanaka Grant/research support from: Asahi-kasei, Astellas, Mitsubishi-Tanabe, Chugai, Takeda, Sanofi, Bristol-Myers, UCB, Daiichi-Sankyo, Eisai, Pfizer, and Ono, Consultant of: Abbvie, Astellas, Bristol-Myers Squibb, Eli Lilly, Pfizer, Speakers bureau: Daiichi-Sankyo, Astellas, Chugai, Eli Lilly, Pfizer, AbbVie, YL Biologics, Bristol-Myers, Takeda, Mitsubishi-Tanabe, Novartis, Eisai, Janssen, Sanofi, UCB, and Teijin, Michelle A Petri Grant/research support from: GSK, Eli Lilly and Company, Consultant of: Eli Lilly and Company, Josef S. Smolen Grant/research support from: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Consultant of: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Daniel Wallace Consultant of: Amgen, Eli Lilly and Company, EMD Merck Serono, and Pfizer, Brenda Crowe Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Ernst Dow Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Richard E Higgs Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Guilherme Rocha Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Robert Benschop Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Maria Silk Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Stephanie de Bono Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Robert Hoffman Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Damiano Fantini Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company
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Mascarenhas J, Marcellino BK, Lu M, Kremyanskaya M, Fabris F, Sandy L, Mehrotra M, Houldsworth J, Najfeld V, El Jamal S, Petersen B, Moshier E, Hoffman R. A phase I study of panobinostat and ruxolitinib in patients with primary myelofibrosis (PMF) and post--polycythemia vera/essential thrombocythemia myelofibrosis (post--PV/ET MF). Leuk Res 2019; 88:106272. [PMID: 31778911 DOI: 10.1016/j.leukres.2019.106272] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 01/23/2023]
Abstract
Ruxolitinib, a selective JAK1/JAK2 inhibitor, is the current first line therapy for myelofibrosis (MF), which reduces symptomatology and splenomegaly, but does not clearly modify disease course. Panobinostat, a histone deacetylase inhibitor, was shown to be safe and tolerable in phase I and II trials and demonstrated clinical activity in approximately a third of treated patients. Combination therapy of ruxolitinib and panobinostat showed synergistic activity in a preclinical MF model, which prompted clinical evaluation of this combination in both ruxolitinib naïve and treated MF patients. Herein, we report the results of an investigator-initiated, dose escalation, phase I trial of ruxolitinib and panobinostat in 15 patients with primary MF and post-polycythemia vera/essential thrombocythemia MF. This combination treatment proved to be safe and tolerable without dose limiting thrombocytopenia and a maximum tolerated dose of both agents in combination was not determined. The majority of patients maintained stable disease with this combination treatment and 40 % attained a clinical improvement (spleen n = 5, anemia n = 1) by modified IWG-MRT at the end of 6 cycles. This is one of the first attempts of rationally designed, JAK inhibitor-based, combination therapy studies and exemplifies the feasibility of such an approach in patients with advanced MF.
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Affiliation(s)
- J Mascarenhas
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States.
| | - B K Marcellino
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - M Lu
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - M Kremyanskaya
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - F Fabris
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - L Sandy
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - M Mehrotra
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - J Houldsworth
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - V Najfeld
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - S El Jamal
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - B Petersen
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - E Moshier
- Department of Biostatistics, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - R Hoffman
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
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Coggan AR, Gallardo E, Gray DA, Hoffman R, Moorthi R. DIFFERENTIAL EFFECTS OF VARYING DOSES OF DIETARY NITRATE ON MUSCLE FUNCTION AND BLOOD PRESSURE IN OLDER SUBJECTS. Innov Aging 2019. [PMCID: PMC6844768 DOI: 10.1093/geroni/igz038.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We have recently demonstrated that dietary nitrate, a source of nitric oxide via the enterosalivary pathway, can improve muscle contractile function in healthy older men and women. Nitrate ingestion has also been shown to reduce blood pressure in older individuals. However, the optimal dose for eliciting these beneficial effects is unknown. We therefore performed a randomized, double-blind, crossover study to determine the effects of ingesting 3.3 mL/kg of beetroot juice (BRJ) containing 0, 212, or 425 µmol/kg of nitrate in six healthy older (age 69±3 y) subjects. Maximal knee extensor speed (Vmax) and power (Pmax) were measured 2 h after BRJ ingestion using isokinetic dynamometry; blood pressure was monitored periodically throughout each study. Mean arterial pressure (in mmHg) was lower (P<0.05) after the high (80±4) vs. the low (84±3) or placebo (88±2) doses. Vmax (in rad/s), however, was higher (P<0.05) after the low dose (11.7±0.8), but not the high dose (10.8±1.0), compared to the placebo (10.5±1.0). Pmax (in W/kg) also tended to be higher (P=0.11) in the low (3.9±0.5) compared to the placebo (3.7±0.5) or high (3.7±0.5) trials. Five out of six subjects achieved a higher Vmax and Pmax after the low vs. the high dose. We conclude that dietary nitrate has differential effects on muscle function and blood pressure in older individuals. A high dose of nitrate intake further lowers blood pressure but does not enhance muscle contractility as much as a lower dose. Supported by Indiana University Purdue University Indianapolis and by the NIA (R21 AG053606)
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Affiliation(s)
- Andrew R Coggan
- Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
| | - Edgar Gallardo
- Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
| | - Derrick A Gray
- Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
| | - Richard Hoffman
- Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
| | - Ranjani Moorthi
- Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
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21
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Le Floch B, Bastiaens H, Le Reste JY, Lingner H, Hoffman R, Czachowski S, Assenova R, Koskela TH, Klemenc-Ketis Z, Nabbe P, Sowinska A, Montier T, Peremans L. Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network. BMC Fam Pract 2019; 20:96. [PMID: 31395016 PMCID: PMC6688263 DOI: 10.1186/s12875-019-0985-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 06/24/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND General Practice (GP) seems to be perceived as less attractive throughout Europe. Most of the policies on the subject focused on negative factors. An EGPRN research team from eight participating countries was created in order to clarify the positive factors involved in appeals and retention in GP throughout Europe. The objective was to explore the positive factors supporting the satisfaction of General Practitioners (GPs) in clinical practice throughout Europe. METHOD Qualitative study, employing face-to-face interviews and focus groups using a phenomenological approach. The setting was primary care in eight European countries: France, Belgium, Germany, Slovenia, Bulgaria, Finland, Poland and Israel. A thematic qualitative analysis was performed following the process described by Braun and Clarke. Codebooks were generated in each country. After translation and back translation of these codebooks, the team clarified and compared the codes and constructed one international codebook used for further coding. RESULTS A purposive sample of 183 GPs, providing primary care to patients in their daily clinical practice, was interviewed across eight countries. The international codebook included 31 interpretative codes and six themes. Five positive themes were common among all the countries involved across Europe: the GP as a person, special skills needed in practice, doctor-patient relationship, freedom in the practice and supportive factors for work-life balance. One theme was not found in Poland or Slovenia: teaching and learning. CONCLUSION This study identified positive factors which give GPs job satisfaction in their clinical practice. This description focused on the human needs of a GP. They need to have freedom to choose their working environment and to organize their practice to suit themselves. In addition, they need to have access to professional education so they can develop specific skills for General Practice, and also strengthen doctor-patient relationships. Stakeholders should consider these factors when seeking to increase the GP workforce.
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Affiliation(s)
- B Le Floch
- EA 7479 SPURBO, Department of General Practice, Université de Bretagne Occidentale, Brest, France.
| | - H Bastiaens
- Department of Primary and Interdisciplinary Care. Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - J Y Le Reste
- EA 7479 SPURBO, Department of General Practice, Université de Bretagne Occidentale, Brest, France
| | - H Lingner
- Centre for Public Health and Healthcare, Hannover Medical School, Hannover, Germany
| | - R Hoffman
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Czachowski
- Clinical Psychology Department, Nicolaus Copernicus University, Torun, Poland
| | - R Assenova
- Department of Urology and General Medicine, Department of General Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - T H Koskela
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland
| | - Z Klemenc-Ketis
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - P Nabbe
- EA 7479 SPURBO, Department of General Practice, Université de Bretagne Occidentale, Brest, France
| | - A Sowinska
- Facultad de Humanidades, Universidad Católica del Norte, Antofagasta, Chile.,Escuela de Inglés, Casa Central, Angamos, 0610, Antofagasta, Chile.,Department of English, Nicolaus Copernicus University, Torun, Poland
| | - T Montier
- EA 7479 SPURBO, Department of General Practice, Université de Bretagne Occidentale, Brest, France.,Unité INSERM 1078, SFR 148 ScInBioS, Université Européenne de Bretagne, Faculté de Médecine et des Sciences de la Santé, Brest, France
| | - L Peremans
- Department of Primary and Interdisciplinary Care. Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium.,Department of Nursing and Midwifery. Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium.,Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
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22
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Mascarenhas J, Kosiorek H, Prchal J, Yacoub A, Berenzon D, Baer MR, Ritchie E, Silver RT, Kessler C, Winton E, Finazzi MC, Rambaldi A, Vannucchi AM, Leibowitz D, Rondelli D, Arcasoy MO, Catchatourian R, Vadakara J, Rosti V, Hexner E, Kremyanskaya M, Sandy L, Tripodi J, Najfeld V, Farnoud N, Salama ME, Weinberg RS, Rampal R, Goldberg JD, Mesa R, Dueck AC, Hoffman R. A prospective evaluation of pegylated interferon alfa-2a therapy in patients with polycythemia vera and essential thrombocythemia with a prior splanchnic vein thrombosis. Leukemia 2019; 33:2974-2978. [PMID: 31363161 PMCID: PMC6884668 DOI: 10.1038/s41375-019-0524-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/11/2019] [Accepted: 05/17/2019] [Indexed: 12/15/2022]
Affiliation(s)
- J Mascarenhas
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | - J Prchal
- Division of Hematology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - A Yacoub
- University of Kansas Cancer Center, Kansas City, KS, USA
| | - D Berenzon
- Comprehensive Cancer Center, Wake Forest University Medical Center, Wake Forest Health, Winston-Salem, NC, USA
| | - M R Baer
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - E Ritchie
- Weill Cornell Medical College, New York, NY, USA
| | - R T Silver
- Weill Cornell Medical College, New York, NY, USA
| | - C Kessler
- Georgetown University Medical Center, Washington, DC, USA
| | - E Winton
- Winship Cancer Institute Emory University School of Medicine, Atlanta, GA, USA
| | - M C Finazzi
- Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - A Rambaldi
- Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.,Department of Oncology, University of Milan, Milan, Italy
| | - A M Vannucchi
- CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - D Leibowitz
- Oncology Department, Palo Alto Medical Foundation Sutter Health, Sunnyvale, CA, USA
| | - D Rondelli
- Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - M O Arcasoy
- Duke University School of Medicine, Durham, NC, USA
| | - R Catchatourian
- Oncology Department, John H Stroger Jr. Hospital of Cook County Chicago, Chicago, IL, USA
| | - J Vadakara
- Geisinger Medical Center, Danville, PA, USA
| | - V Rosti
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology, and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, 19, viale Golgi, 27100, Pavia, Italy
| | - E Hexner
- University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA
| | - M Kremyanskaya
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Sandy
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Tripodi
- Department of Pathology and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - V Najfeld
- Department of Pathology and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N Farnoud
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - M E Salama
- Mayo Medical Laboratories, Rochester, MN, USA
| | | | - R Rampal
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - J D Goldberg
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - R Mesa
- UT Health San Antonio Cancer Center, San Antonio, TX, USA
| | | | - R Hoffman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Garrick M, Spooner H, Haffner J, Hoffman R. Fat supplementation: Rice bran oil versus corn oil. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Oliver N, Spooner H, Hoffman R. Perceptions of veterinarians on the use of nutritional supplements in the horse industry. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wires C, Talbert B, Croney C, O'Haire M, Hoffman R, Brady C. Interpretation and understanding of equine behavior terminology and learning theory in undergraduate students. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hoffman R, Brenner B. P020: The management of pregnancy in a patient with hereditary combined deficiency of vitamin K dependent factors. Thromb Res 2019. [DOI: 10.1016/s0049-3848(19)30115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dann S, Chionis J, Eisele K, Zhang Q, Liu C, Yuan J, Miller N, Murray B, Xu M, Solowiej J, Wei P, Weinrich S, Sutton S, Behenna D, Ninkovic S, Hoffman R, Freeman-Cook K, Jessen B, Huser N, Zhang C, Visswanathan R, Boras B, VanArsdale T, White MA. Abstract P6-20-06: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-20-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Dann S, Chionis J, Eisele K, Zhang Q, Liu C, Yuan J, Miller N, Murray B, Xu M, Solowiej J, Wei P, Weinrich S, Sutton S, Behenna D, Ninkovic S, Hoffman R, Freeman-Cook K, Jessen B, Huser N, Zhang C, Visswanathan R, Boras B, VanArsdale T, White MA. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-20-06.
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Affiliation(s)
- S Dann
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - J Chionis
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - K Eisele
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - Q Zhang
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - C Liu
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - J Yuan
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - N Miller
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - B Murray
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - M Xu
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - J Solowiej
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - P Wei
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - S Weinrich
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - S Sutton
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - D Behenna
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - S Ninkovic
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - R Hoffman
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - K Freeman-Cook
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - B Jessen
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - N Huser
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - C Zhang
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - R Visswanathan
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - B Boras
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - T VanArsdale
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
| | - MA White
- Pfizer Oncology Research Division, La Jolla, CA; Pfizer Medicinal Sciences, La Jolla, CA
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Marcellino B, Hoffman R, Mascarenhas J. Does hydroxycarbamide therapy really induce leukemic transformation in patients with essential thrombocythemia? Leuk Res 2018; 76:94-95. [PMID: 30501902 DOI: 10.1016/j.leukres.2018.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 11/25/2022]
Affiliation(s)
- B Marcellino
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - R Hoffman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - J Mascarenhas
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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Nakajima M, Hoffman R, Alsameai A, Khalil NS, al'Absi M. Development of the Khat Knowledge, Attitudes and Perception Scale. Drug Alcohol Rev 2018; 37:802-809. [PMID: 29931779 DOI: 10.1111/dar.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/09/2018] [Accepted: 05/22/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION AND AIMS Khat (Catha edulis) is a stimulant plant widely used in East Africa and the Arabian Peninsula. Tobacco is often co-used with khat and its use has expanded to other parts of the world. Chronic khat use is associated with negative health consequences. There is a lack of research to develop a tool to assess attitudes toward khat use. This study aimed to develop a brief tool to assess attitude and perception related to khat (i.e. the Khat Knowledge, Attitudes and Perception Scale). DESIGN AND METHODS Four-hundred and three participants in Yemen (151 concurrent users of khat and tobacco, 141 khat-only users and 92 non-users of khat and tobacco) were asked about knowledge and attitudes related to khat. A principle component analysis with Promax rotation, Scree-plot and Cronbach's α coefficients was performed to examine psychometric properties of the Khat Knowledge, Attitudes and Perception Scale. RESULTS Principle component analysis revealed five factors: negative beliefs, positive beliefs, idleness, weight control and family issues. Internal consistency of items in negative beliefs, positive beliefs, idleness, weight control and family issues were 0.88, 0.62, 0.62, 0.72 and 0.53, respectively. Greater negative beliefs was inversely correlated with positive beliefs but positively associated with idleness, weight control and family issues. Concurrent users and khat-only users had lower scores on negative beliefs than non-users. Concurrent users had higher scores on positive beliefs than khat-only and non-users. DISCUSSION AND CONCLUSIONS These results provide initial support of the usefulness of the Khat Knowledge, Attitudes and Perception Scale.
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Affiliation(s)
- Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
| | - Richard Hoffman
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
| | - Abed Alsameai
- Department of Linguistics, Taiz University, Taiz, Yemen
| | | | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
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31
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Hoffman R, Harley S, Ellison S, Devitt PG. Clinical Decision-Making: Observing the Smartphone User An Observational Study in Predicting Acute Surgical Patients' Suitability for Discharge. J Hosp Med 2018; 13:21-25. [PMID: 29068438 DOI: 10.12788/jhm.2797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION An accurate and rapid assessment of an acutely unwell patient's clinical status is paramount for the physician. There is an increasing trend to rely on investigations and results to inform a clinician of a patient's clinical status, with the subtleties of clinical observation often ignored. The aim of this study was to determine if a patient's use of a smartphone during the initial clinical assessment by a surgical consultant could be used as a surrogate marker for patient well-being, represented as their suitability for sameday discharge. METHODS This was a prospective observational study performed over 2 periods at a tertiary hospital in South Australia. All patients admitted by junior surgical doctors from the emergency department to the acute surgical unit were eligible for inclusion. Upon consultant review, their status as a smartphone user was recorded in addition to their duration of hospital stay and basic demographic data. All patients and all but 1 of the consultants were blinded to the trial. RESULTS Two hundred and twenty-one patients were eligible for inclusion. Of these patients, 11.3% were observed to be using a smartphone and 23.5% of patients were discharged home on day 1. Those who were observed to be using a smartphone were 5.29 times more likely to be discharged home on day 1 and were less likely to be subsequently readmitted. CONCLUSIONS The addition of the smartphone sign to a surgeon's clinical acumen can provide yet another tool in aiding the decision for suitability for discharge.
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Affiliation(s)
- Richard Hoffman
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
| | - Simon Harley
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Samuel Ellison
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Peter G Devitt
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Irvin-Barnwell EA, Benson KM, Lu M, Ragin A, Wheeler J, Hoffman R. Environmental Toxins Found Historically in the Polycythemia Vera Cluster Area and their Potential for Inducing DNA Damage. ACTA ACUST UNITED AC 2018; 8. [PMID: 34094707 PMCID: PMC8176869 DOI: 10.4172/2161-0525.1000551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In 2006, the Agency for Toxic Substances and Disease Registry received a request to determine whether a cluster of polycythemia vera patients existed in a northeast Pennsylvania community. A significant cluster of PV cases was identified at the nexus of three counties near several hazardous waste sites. The current study evaluated the potential for a select number of environmental contaminants previously detected in the cluster area to induce DNA damage using in vitro assays with hematopoietic stem-cell derived progenitor cells. CD34+ cells were isolated from normal cord blood samples and were cultured for 48–72 hours to generate erythroid progenitor cells. Eighteen compounds were chosen for the assay; arsenic trioxide, benzo(a)pyrene, benzene, methylene chloride, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), trichloroethylene, potassium chloride, ethylbenzene, benzo[k]fluoranthene, styrene, cadmium chloride, hydroquinone, 1,1,1-trichloroethane, sodium cyanide, manganese chloride, chromium oxide, lead oxide, and sodium arsenite. Genotoxicity of the compounds was determined using the comet assay, and toxicity determined via the cell viability assay. Using the comet assay, 16 compounds at 10 nM concentration, induced a significant amount of DNA damage compared to the control. When evaluating whether a dose-dependent relationship was present, seventeen of the eighteen compounds led to greater DNA damage with increasing exposure concentrations. 2,3,7,8-TCDD was particularly potent, inducing DNA damage in virtually all cells at 1 μM. In conclusion, most of the toxins evaluated using the comet assay showed potential to induce DNA damage in hematopoietic cells, and the genotoxic effects were dose-dependent.
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Affiliation(s)
| | - K M Benson
- Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA
| | - M Lu
- Icahn School of Medicine, Mt. Sinai, New York, NY, USA
| | - A Ragin
- Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA
| | - J Wheeler
- Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA
| | - R Hoffman
- Icahn School of Medicine, Mt. Sinai, New York, NY, USA
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Mahajana A, Agmon P, Barach Y, Brenner B, Hoffman R. Successful Use of Recombinant Activated Factor VII (Novoseven®) in Controlling Severe Intra-Abdominal Bleeding after Liver Needle Biopsy. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613000] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hoffman R, Blumenfeld Z, Weiner Z, Younis JS, Brenner B. Gestational Outcome in Thrombophilic Women with Recurrent Pregnancy Loss Treated by Enoxaparin. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613894] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryInherited and acquired thrombophilia are associated with recurrent pregnancy loss (RPL). We have evaluated the efficacy and safety of the low molecular weight heparin enoxaparin in 50 women, (mean age 26 ± 3 years) with RPL (>3 losses in 1st, >2 losses in 2nd and >1 loss in 3rd trimester) who were found to harbor thrombophilia. Twentyseven had a solitary thrombophilic defect, and twenty-three women had combined thrombophilic defects: 17 – two defects and 6 – three defects. Following diagnosis of thrombophilia, sixty-one subsequent pregnancies were treated with the low molecular weight heparin enoxaparin throughout gestation until 4 weeks after delivery. Dosage was 40 mg/day in women with solitary defect and 80 mg/day in combined defects. Aspirin, 75 mg daily was given in addition to enoxaparin to women with antiphospholipid syndrome. Forty-six out of 61 (75%) gestations treated by enoxaparin resulted in live birth compared to only 38/193 (20%) of the untreated pregnancies in these 50 women prior to diagnosis of thrombophilia (p <0.00001). In 23 women without a single living child following 82 untreated gestations, antithrombotic therapy resulted in 26/31 (84%) successful deliveries (p <0.0001). In 20 women with a prior living child, antithrombotic therapy improved successful delivery from 33/86 (38%) to 20/21 (95%) (p <0.0001). Enoxaparin dose of 40 mg/day resulted in live birth in 24/35 (69%) of gestations, compared to 19/23 (83%) gestations in women treated with 80 mg/day (p = 0.37). Only one thrombotic episode and one mildbleeding episode were noticed during enoxaparin therapy. Enoxaparin is safe and effective in prevention of pregnancy loss in women with inherited and acquired thrombophilia.
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Bacci ED, DeLozier AM, Lin CY, Gaich CL, Zhang X, Rooney T, de Bono S, Hoffman R, Wyrwich KW. Psychometric properties of the single-item measure, severity of worst tiredness, in patients with moderately to severely active rheumatoid arthritis. Health Qual Life Outcomes 2017; 15:237. [PMID: 29208004 PMCID: PMC5718135 DOI: 10.1186/s12955-017-0807-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022] Open
Abstract
Background To assess the reliability, validity, and responsiveness to treatment change of the single-item measure, Severity of Worst Tiredness, in patients with rheumatoid arthritis (RA). Methods Data from two Phase 3, randomized, placebo-controlled (RA-BUILD; and active-controlled [RA-BEAM]), clinical studies of the efficacy of baricitinib in adults with moderately to severely active RA were used. The psychometric properties of the single-item measure, Severity of Worst Tiredness, were assessed, including test-retest reliability, convergent and discriminant validity, known-groups validity, and responsiveness, using other patient- and clinician-reported outcomes frequently assessed in RA patients. Results Test-retest reliability of the Severity of Worst Tiredness was supported through large intraclass correlation coefficients (0.89 ≤ ICC ≤ 0.91). Moderate-to-large correlations were observed between this patient-reported outcome (PRO) and other related patient- and clinician-reported assessments of RA symptoms and patient functioning, supporting construct validity of the measure (│r│ ≥ 0.41). The instrument also displayed known-groups validity through statistically significant differences between mean values of the Severity of Worst Tiredness defined using other indicators of RA severity. Finally, responsiveness was supported by large and statistically significant differences in change scores from Day 1 to Week 12 for patients comparing responders and nonresponders using the American College of Rheumatology 20 (ACR20) criteria. Conclusion The Severity of Worst Tiredness PRO demonstrated adequate reliability, validity, and responsiveness in clinical trials of adults with moderately to severely active RA and is fit for purpose in this patient population. Electronic supplementary material The online version of this article (10.1186/s12955-017-0807-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | - Xiang Zhang
- Eli Lilly and Company, Indianapolis, IN, USA
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Bacci ED, DeLozier AM, Lin CY, Gaich CL, Rooney T, Hoffman R, Wyrwich KW. Psychometric properties of morning joint stiffness duration and severity measures in patients with moderately to severely active rheumatoid arthritis. Health Qual Life Outcomes 2017; 15:239. [PMID: 29212515 PMCID: PMC5719576 DOI: 10.1186/s12955-017-0813-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 11/27/2017] [Indexed: 11/13/2022] Open
Abstract
Background To assess the measurement properties of two single-item patient-reported outcome (PRO) measures that assessed the length of time (in minutes) and severity of morning joint stiffness (MJS) experienced each day. Methods Data from two Phase 3, randomized placebo-controlled (and active-controlled [RA-BEAM]), clinical studies assessing the safety and efficacy of baricitinib in adults with moderately to severely active rheumatoid arthritis (RA) were used to evaluate the psychometric properties of the Duration of MJS and Severity of MJS PROs. Results Test-retest reliability of Duration of MJS and Severity of MJS was supported through large intraclass correlation coefficients among stable patients (coefficient range for both studies: 0.88 to 0.93). In support of construct validity, moderate correlations were evidenced between Duration of MJS and other related patient- and clinician-reported assessments of RA symptoms and patient functioning, whereas moderate-to-strong correlations were evidenced between these same patient- and clinician-reported assessments and Severity of MJS. Statistically significant differences between the median and mean values of Duration of MJS and Severity of MJS for differing categories of RA disease severity supported known-groups validity. Finally, large and statistically significant differences in change scores from Day 1 to Week 12 for patients defined as responders versus non-responders using the American College of Rheumatology 20 criteria supported the responsiveness of both PROs. Conclusion Duration of MJS and Severity of MJS PROs demonstrated reliability, validity, and responsiveness in adults with moderately to severely active RA, supporting the measurement of these key symptoms in clinical trials. Electronic supplementary material The online version of this article (doi: 10.1186/s12955-017-0813-7) contains supplementary material, which is available to authorized users.
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Nakajima M, Jebena MG, Taha M, Tesfaye M, Gudina E, Lemieux A, Hoffman R, al'Absi M. Correlates of khat use during pregnancy: A cross-sectional study. Addict Behav 2017; 73:178-184. [PMID: 28531823 DOI: 10.1016/j.addbeh.2017.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Khat is widely used in East African countries including Ethiopia. A growing body of evidence indicates that long-term khat use is associated with various health consequences. The aim of this study was to examine the magnitude and correlates of khat use in pregnant women. METHODS This study used a cross-sectional, face-to-face interview design that included 642 pregnant women receiving antenatal care services at primary care centers in Ethiopia. A series of chi-square tests and regression models were conducted to examine whether khat use status (i.e., 123 current khat users, 41 former khat users, and 478 non-users) was associated with socio-demographic, mental distress, and substance use measures. RESULTS As compared with non-users, current and former khat users had higher levels of depressive symptoms and distress. Khat users minimized potential health risks associated with khat use. Social and motivational factors related to khat use were different between current and former khat users. CONCLUSIONS Findings of this study suggest a substantial prevalence of khat use among pregnant women in Ethiopia and highlight the role of socio-demographic and cultural influences on khat use during pregnancy. Health care professionals in the region where khat is available are encouraged to ask their female patients about khat use and encourage them to refrain from use while they are pregnant. The positive link between khat and mental distress warrants further research focusing on biological, psychological, and social mechanisms of this relationship.
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Affiliation(s)
- Motohiro Nakajima
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
| | | | | | | | | | - Andrine Lemieux
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
| | - Richard Hoffman
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
| | - Mustafa al'Absi
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
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Davis K, Bellini P, Hagerman C, Zinar R, Leigh D, Hoffman R, Aaronson D, Van Den Eeden S, Philips G, Taylor K. Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer. Urology 2017; 107:86-95. [PMID: 28454988 PMCID: PMC5880528 DOI: 10.1016/j.urology.2017.02.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/28/2017] [Accepted: 02/08/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess physicians' attitudes regarding multiple factors that may influence recommendations for active surveillance (AS) vs active treatment (AT) given the central role physicians play in the treatment decision-making process. MATERIALS AND METHODS We conducted semistructured interviews to assess factors that physicians consider important when recommending AS vs AT, as well as physicians' perceptions of what their patients consider important in the decision. Participants included urologists (N = 11), radiation oncologists (N = 12), and primary care physicians (N = 10) from both integrated and fee-for-service healthcare settings. RESULTS Across the specialties, quantitative data indicated that most physicians reported that their recommendations for AS were influenced by patients' older age, willingness and ability to follow a surveillance protocol, anxiety, comorbidities, life expectancy, and treatment preferences. Qualitative findings highlighted physicians' concerns about malpractice lawsuits, given the possibility of disease progression. Additionally, most physicians noted the role of the healthcare setting, suggesting that financial incentives may be associated with AT recommendations in fee-for-service settings. Finally, most physicians reported spouse or family opposition to AS due to their own anxiety or lack of understanding of AS. CONCLUSION We found that patient and physician preferences, healthcare setting, and family or spouse factors influence physicians' treatment recommendations for men with low-risk PCa. These were consistent themes across physician subspecialties in both an Health Maintenance Organization and in fee-for-service settings.
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Affiliation(s)
- Kimberly Davis
- Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC.
| | - Paula Bellini
- Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Charlotte Hagerman
- Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Riley Zinar
- Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Daniel Leigh
- Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Richard Hoffman
- Division of General Internal Medicine, University of Iowa Carver College of Medicine/Iowa City VA Medical Center, Iowa City, IA
| | - David Aaronson
- Department of Urology, Kaiser Permanente, East Bay, Oakland, CA
| | | | - George Philips
- Department of Medicine, MedStar Georgetown University Hospital Center, Washington, DC
| | - Kathryn Taylor
- Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
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Reuland DS, Brenner AT, Hoffman R, McWilliams A, Rhyne RL, Getrich C, Tapp H, Weaver MA, Callan D, Cubillos L, Urquieta de Hernandez B, Pignone MP. Effect of Combined Patient Decision Aid and Patient Navigation vs Usual Care for Colorectal Cancer Screening in a Vulnerable Patient Population: A Randomized Clinical Trial. JAMA Intern Med 2017; 177:967-974. [PMID: 28505217 PMCID: PMC5710456 DOI: 10.1001/jamainternmed.2017.1294] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Colorectal cancer (CRC) screening is underused, especially among vulnerable populations. Decision aids and patient navigation are potentially complementary interventions for improving CRC screening rates, but their combined effect on screening completion is unknown. OBJECTIVE To determine the combined effect of a CRC screening decision aid and patient navigation compared with usual care on CRC screening completion. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, data were collected from January 2014 to March 2016 at 2 community health center practices, 1 in North Carolina and 1 in New Mexico, serving vulnerable populations. Patients ages 50 to 75 years who had average CRC risk, spoke English or Spanish, were not current with recommended CRC screening, and were attending primary care visits were recruited and randomized 1:1 to intervention or control arms. INTERVENTIONS Intervention participants viewed a CRC screening decision aid in English or Spanish immediately before their clinician encounter. The decision aid promoted screening and presented colonoscopy and fecal occult blood testing as screening options. After the clinician encounter, intervention patients received support for screening completion from a bilingual patient navigator. Control participants viewed a food safety video before the encounter and otherwise received usual care. MAIN OUTCOMES AND MEASURES The primary outcome was CRC screening completion within 6 months of the index study visit assessed by blinded medical record review. RESULTS Characteristics of the 265 participants were as follows: their mean age was 58 years; 173 (65%) were female, 164 (62%) were Latino; 40 (15%) were white non-Latino; 61 (23%) were black or of mixed race; 191 (78%) had a household income of less than $20 000; 101 (38%) had low literacy; 75 (28%) were on Medicaid; and 91 (34%) were uninsured. Intervention participants were more likely to complete CRC screening within 6 months (68% vs 27%); adjusted-difference, 40 percentage points (95% CI, 29-51 percentage points). The intervention was more effective in women than in men (50 vs 21 percentage point increase, interaction P = .02). No effect modification was observed across other subgroups. CONCLUSIONS AND RELEVANCE A patient decision aid plus patient navigation increased the rate of CRC screening completion in compared with usual care invulnerable primary care patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02054598.
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Affiliation(s)
- Daniel S Reuland
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill2Division of General Medicine & Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill3Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
| | - Alison T Brenner
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill2Division of General Medicine & Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill3Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
| | - Richard Hoffman
- Department of Medicine, University of Iowa Carver College of Medicine, Iowa City5University of Iowa Holden Comprehensive Cancer Center, University of Iowa, Iowa City6Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque
| | - Andrew McWilliams
- Department of Family Medicine, Carolinas HealthCare System, Charlotte, North Carolina
| | - Robert L Rhyne
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque8University of New Mexico Comprehensive Cancer Center, Albuquerque
| | - Christina Getrich
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque9Department of Anthropology, University of Maryland, College Park
| | - Hazel Tapp
- Department of Family Medicine, Carolinas HealthCare System, Charlotte, North Carolina
| | - Mark A Weaver
- Division of General Medicine & Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill10Department of Biostatistics, University of North Carolina, Chapel Hill
| | - Danelle Callan
- University of New Mexico Comprehensive Cancer Center, Albuquerque
| | - Laura Cubillos
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill
| | | | - Michael P Pignone
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill2Division of General Medicine & Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill3Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill11Department of Internal Medicine, University of Texas Dell Medical School, Austin
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Gowin K, Kosiorek H, Dueck A, Mascarenhas J, Hoffman R, Reeder C, Camoriano J, Tibes R, Gano K, Palmer J, Mesa R. Multicenter phase 2 study of combination therapy with ruxolitinib and danazol in patients with myelofibrosis. Leuk Res 2017. [PMID: 28646676 DOI: 10.1016/j.leukres.2017.06.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Myelofibrosis is a myeloproliferative neoplasm that is characterized by splenomegaly, profound symptom burden, and cytopenias. JAK inhibitor therapy offers improvements in splenomegaly, symptom burden, and potentially survival; however, cytopenias remain a significant challenge. Danazol has previously demonstrated improvements in myelofibrosis-associated anemia. We conducted a phase II clinical trial evaluating the efficacy and tolerability of combination therapy with ruxolitinib, an oral JAK inhibitor, and danazol. Fourteen intermediate or high-risk MF patients were enrolled at 2 institutions. Responses per IWG-MRT criteria were stable disease in 9 patients (64.2%) clinical improvement in 3 (21.4%) all of which were spleen responses, partial response in 1 (7.1%) and progressive disease in 1 (7.1%). Despite limited IWG-MRT response, stabilization of anemia and thrombocytopenia was demonstrated. In JAK inhibitor naïve patients, 4/5 (80%) had stable or increasing hemoglobin. Of the 9 patients on prior JAK inhibitor, 5 patients (55.5%) and 8 patients (88.9%) had stable or increasing hemoglobin or platelet levels, respectively. Adverse events possibly related included grade 3 or greater hematologic toxicity in ten patients (71.4%) and non-hematologic toxicity in two patients (14.3%). Although combination therapy did not lead to increased hematologic response per IWG-MRT criteria, hematologic stabilization was observed and may be clinically useful.
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Affiliation(s)
- K Gowin
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA
| | - H Kosiorek
- Mayo Clinic Arizona, Department of Health Sciences Research, Section of Biostatistics, Phoenix, AZ, USA
| | - A Dueck
- Mayo Clinic Arizona, Department of Health Sciences Research, Section of Biostatistics, Phoenix, AZ, USA
| | - J Mascarenhas
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, USA
| | - R Hoffman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, USA
| | - C Reeder
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA
| | - J Camoriano
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA
| | - R Tibes
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA
| | - K Gano
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA
| | - J Palmer
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA
| | - R Mesa
- Mayo Clinic Arizona, Department of Hematology, Phoenix, AZ, USA.
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Maher K, Spooner H, Hoffman R, Haffner J. The effect of whole-body vibration on bone density and other parameters in the exercising horse. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2017.03.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tohgi N, Obara K, Hamada Y, Yashiro M, Mii S, Aki R, Hoffman R, Amoh Y. 895 Isoproterenol directs human hair follicle-associated pluripotent (hHAP) stem cells to differentiate to cardiac muscle cells. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flocke SA, Hoffman R, Eberth JM, Park H, Birkby G, Trapl E, Zeliadt S. The Prevalence of Tobacco Use at Federally Qualified Health Centers in the United States, 2013. Prev Chronic Dis 2017; 14:E29. [PMID: 28384096 PMCID: PMC5386614 DOI: 10.5888/pcd14.160510] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We explored tobacco use across federally qualified health centers (FQHCs) and compared data on state-level tobacco use between FQHC patients and the general population. We used data from the Uniform Data System (UDS) and the Behavioral Risk Factor Surveillance System (BRFSS) to generate estimates of 2013 prevalence of tobacco use among adults aged 18 years or older. According to UDS data, the overall prevalence of tobacco use was 25.8% in FQHCs compared with 20.6% in the general population represented by BRFSS data, an average of 5.2 percentage points (range, −4.9 to 20.9) higher among FQHCs. Among FQHCs, the burden of tobacco use and the opportunity for offering cessation assistance is substantial.
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Affiliation(s)
- Susan A Flocke
- Department of Family Medicine & Community Health, Case Western Reserve University, Cleveland Ohio.,Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland Ohio.,Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland Ohio.,Case Comprehensive Cancer Center, Cleveland, Ohio
| | - Richard Hoffman
- Division of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
| | - Jan M Eberth
- South Carolina Rural Health Research Center, University of South Carolina, Columbia, South Carolina; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
| | - Hyunyong Park
- Department of Family Medicine & Community Health, Case Western Reserve University, Cleveland Ohio.,Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland Ohio
| | - Genevieve Birkby
- Department of Family Medicine & Community Health, Case Western Reserve University, Cleveland Ohio.,Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland Ohio
| | - Erika Trapl
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland Ohio.,Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland Ohio.,Case Comprehensive Cancer Center, Cleveland, Ohio
| | - Steve Zeliadt
- University of Washington, School of Public Health, Seattle, Washington
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Bhatia A, Tong L, Hoffman R, Wu P, Hassanzadeh H, Wang M, Deshpande S. Refinement of Automated Whole Slide Image Analysis in Pediatric Heart Transplants. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Nakajima M, Hoffman R, al'Absi M. Level of khat dependence, use patterns, and psychological correlates in Yemen: a cross-sectional investigation. East Mediterr Health J 2017; 23:161-167. [DOI: 10.26719/2017.23.3.161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 03/12/2017] [Indexed: 11/09/2022]
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Virtgaym E, Tremblay D, Iancu-Rubin C, Hoffman R, Mascarenhas J. Imetelstat for treatment of myelofibrosis. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2017.1266934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- E. Virtgaym
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - D. Tremblay
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C. Iancu-Rubin
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R. Hoffman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J. Mascarenhas
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Brenner AT, Hoffman R, McWilliams A, Pignone MP, Rhyne RL, Tapp H, Weaver MA, Callan D, de Hernandez BU, Harbi K, Reuland DS. Colorectal Cancer Screening in Vulnerable Patients: Promoting Informed and Shared Decisions. Am J Prev Med 2016; 51:454-62. [PMID: 27242081 PMCID: PMC5501711 DOI: 10.1016/j.amepre.2016.03.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/21/2016] [Accepted: 03/21/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Low-income, low-literacy, limited English-proficient populations have low colorectal cancer (CRC) screening rates and experience poor patient-provider communication and decision-making processes around screening. The purpose of this study was to test the effect of a CRC screening decision aid on screening-related communication and decision making in primary care visits. STUDY DESIGN RCT with data collected from patients at baseline and immediately after the provider encounter. SETTING/PARTICIPANTS Patients aged 50-75 years, due for CRC screening, were recruited from two safety net clinics in North Carolina and New Mexico (data collection, January 2014-September 2015; analysis, 2015). INTERVENTION Participants viewed a CRC screening decision aid or a food safety (control) video immediately before their provider encounter. MAIN OUTCOME MEASURES CRC screening-related knowledge, discussion, intent, test preferences, and test ordering. RESULTS The study population (N=262) had a mean age of 58.3 years and was 66% female, 61% Latino, 17% non-Latino black, and 16% non-Latino white. Among Latino participants, 71% preferred Spanish. Compared with controls, intervention participants had greater screening-related knowledge (on average 4.6 vs 2.8 of six knowledge items correct, adjusted difference [AD]=1.8, 95% CI=1.5, 2.1) and were more likely to report screening discussion (71.0% vs 45.0%, AD=26.1%, 95% CI=14.3%, 38.0%) and high screening intent (93.1% vs 84.7%, AD=9.0%, 95% CI=2.0%, 16.0%). Intervention participants were more likely to indicate a specific screening test preference (93.1% vs 68.0%, AD=26.5%, 95% CI=17.2%, 35.8%) and to report having a test ordered (56.5% vs 32.1%, AD=25.8%, 95% CI=14.4%, 37.2%). CONCLUSIONS Viewing a CRC screening decision aid before a primary care encounter improves knowledge and shared decision making around screening in a racially, ethnically, and linguistically diverse safety net clinic population. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02054598.
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Affiliation(s)
- Alison T Brenner
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina; Division of General Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Richard Hoffman
- Division of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
| | - Andrew McWilliams
- Department of Family Medicine, Carolinas HealthCare System, Charlotte, North Carolina
| | - Michael P Pignone
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina; Division of General Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Robert L Rhyne
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico; University of New Mexico Cancer Center, Albuquerque, New Mexico
| | - Hazel Tapp
- Department of Family Medicine, Carolinas HealthCare System, Charlotte, North Carolina
| | - Mark A Weaver
- Division of General Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Danelle Callan
- University of New Mexico Cancer Center, Albuquerque, New Mexico
| | | | - Khalil Harbi
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina
| | - Daniel S Reuland
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina; Division of General Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
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Affiliation(s)
- Richard Hoffman
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, AL10 9AB, UK.
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