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Lund T, Bernier E, Roman-Juan J, Kopala-Sibley DC, Soltani S, Noyek S, Nania C, Beveridge J, Hoppe T, O'Connor R, O'Connor C, Clemens J, Mychasiuk R, Asmundson G, Stinson J, Noel M. Pain and Post-traumatic Stress Disorder Symptoms: Dyadic Relationships Between Canadian Armed Forces Members/Veterans With Chronic Pain and Their Offspring. J Pain 2024:104516. [PMID: 38580101 DOI: 10.1016/j.jpain.2024.03.012] [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] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 02/29/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024]
Abstract
Chronic pain and mental health issues occur at higher rates in Veterans than the general population. One widely recognized mental health issue faced by Veterans is post-traumatic stress disorder (PTSD). Trauma symptoms and pain frequently co-occur and are mutually maintained due to shared mechanisms. Many Veterans are also parents. Parental physical and mental health issues significantly predict children's chronic pain and related functioning, which can continue into adulthood. Only 1 U.S.-based study has examined pain in the offspring of Veterans, suggesting a heightened risk for pain. Research to date has not examined the associations between trauma and pain and the dyadic influences of these symptoms, among Veterans, and their children. The current study aimed to describe pain characteristics in Canadian Armed Forces Members/Veterans with chronic pain and their offspring (youth and adult children aged 9-38). Cross-lagged panel models were conducted to examine dyadic relationships between pain interference and trauma symptoms of Canadian Armed Forces Members/Veterans and their offspring. Over half of adult offspring and over one-quarter of youth offspring reported chronic pain. Results revealed effects between one's own symptoms of PTSD and pain interference. No significant effects of parents on offspring or offspring on parents were found. The findings highlight the interconnection between pain and PTSD consistent with mutual maintenance models and a lack of significant interpersonal findings suggestive of resiliency in this unique population. PERSPECTIVE: We characterized chronic pain in the offspring of Canadian Armed Forces Members/Veterans with chronic pain and examined dyadic relationships between PTSD symptoms and chronic pain interference. Findings revealed that PTSD symptoms and pain interference were related within Veterans and offspring, but no dyadic relationships were found, which could reflect resiliency.
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Affiliation(s)
- Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, Canada.
| | - Emily Bernier
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Josep Roman-Juan
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | | | - Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Samantha Noyek
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Cara Nania
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Jaimie Beveridge
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Tom Hoppe
- The Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Canada; Person with Lived Experience, Canada
| | | | | | | | | | | | - Jennifer Stinson
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Canada
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Noyek S, Lund T, Jordan A, Hoppe T, Mitchell R, Mitchell R, Stinson J, Noel M. Exploring the Lived Experiences of Pain in Military Families: A Qualitative Examination. J Pain 2023; 24:2340-2351. [PMID: 37473902 DOI: 10.1016/j.jpain.2023.07.016] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/12/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
Chronic pain in Canadian Veterans is twice that of the general population and the prevalence of their related mental health concerns is alarmingly high. This likely puts their children at an increased risk of developing pain and mental health problems that can pervasively impact daily life and persist into adulthood. Pain care and military culture of (acute and chronic) pain have been identified as a top priority of Canadian Veterans. This study aimed to gain an in-depth understanding of the pain experiences of Canadian Armed Forces families. Thirty-five semi-structured qualitative interviews were conducted. Demographic information was collected; age, gender, and ethnicity were reported. Twelve Canadian Armed Forces members/Veterans, 17 youth, and 6 spouses were interviewed. Ninety-two percent of Veteran participants reported chronic pain. Reflexive thematic analyses generated four themes: 1) Military mindset: herd culture and solider identity, 2) The culture of pain within military families, 3) Inseparability of mental health and pain, and 4) Breaking the cycle and shifting the military mindset. Military culture and identity create a unique context within which pain expression and experience is integrally shaped within these families. This study sheds light on how pain is experienced and perceived within military families and can inform research on and efforts to foster resilience in these families. PERSPECTIVE: This is the first qualitative study to explore the lived experiences of pain in Canadian military families. Findings underscore the key role that military culture and identity plays in how pain is experienced and perceived in all family members.
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Affiliation(s)
- Samantha Noyek
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Abbie Jordan
- Department of Psychology and Centre for Pain Research, University of Bath, Bath, United Kingdom
| | - Tom Hoppe
- The Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Canada
| | - Rebekah Mitchell
- The Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Canada
| | - Ryan Mitchell
- The Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Canada
| | - Jennifer Stinson
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Canada; Child Brain & Mental Health Program, Alberta Children's Hospital Research Institute, Calgary, Canada
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Dellgren G, Lund T, Raivio P, Leuckfeld I, Svahn J, Olsen P, Halme R, Fiane A, Lindstedt S, Riise G, Magnusson J. A Scandinavian Controlled Randomized Open-Label and Multi-Center Study Evaluating if Once-Daily Tacrolimus versus Twice-Daily Cyclosporine De Novo, Reduces the 3-Year Incidence of Chronic Lung Allograft Dysfunction after Lung Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.092] [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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Killackey T, Soltani S, Noel M, Birnie KA, Choinière M, Pagé MG, Dassieu L, Lacasse A, Lalloo C, Poulin P, Ali S, Baerg K, Battaglia M, Campbell F, Mohabir V, Nishat F, Kelly R, Lund T, Isaac-Bertrand A, Benayon M, Jordan I, Stinson J. "We survived the pandemic together": The impact of the COVID-19 pandemic on Canadian families living with chronic pain. Can J Pain 2023; 7:2157251. [PMID: 36760709 PMCID: PMC9904303 DOI: 10.1080/24740527.2022.2157251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Pediatric chronic pain is a significant problem in Canada, affecting one in five youth. This study describes the impact of the pandemic on the experiences of Canadian families living with chronic pain through interviews with youth living with chronic pain, parents, and siblings. Methods Employing a qualitative descriptive design, in-depth semistructured interviews were completed with Canadian youth living with pain, as well as parents and siblings. Participants were not required to be related. Interviews were analyzed using a reflexive thematic analysis approach. Results Forty-four interviews were completed with 14 parents, 19 youth with chronic pain, and 11 siblings from across the country. Three key themes were developed: (1) absorbing and shifting: the toll of the pandemic on the family system (e.g., loss of coping mechanisms, shifting roles to respond to the pandemic), (2) social ambiguity and abandonment (e.g., social sacrifice and abandonment by the health care system), and (3) building community resilience: familial adaptation to the pandemic (e.g., family cohesion, confidence, and self-management). Discussion/Conclusions Youth, parents, and siblings reported that the pandemic impacted coping strategies across the family system. These results outline the challenges youth experienced managing their pain and overall health throughout the pandemic and the resilience built within families during this time. Going forward, it would be relevant to examine how racialized and structurally marginalized youth with chronic pain and their families experienced the pandemic. Future research should examine how unexpected benefits of the pandemic (e.g., increased confidence and self-management) may be sustained into the future.
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Affiliation(s)
- Tieghan Killackey
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,CONTACT Tieghan Killackey Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ONM5G 0A4, Canada
| | - Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Department of Psychology, Alberta Children’s Hospital, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Kathryn A. Birnie
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Manon Choinière
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada,Research Center of the Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - M. Gabrielle Pagé
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada,Research Center of the Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada,Department of Psychology, Université de Montréa, Montreal, Quebec, Canada
| | - Lise Dassieu
- Research Center of the Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada,Department of Biomedical Sciences, Université de Montréal, Montreal, Quebec, Canada
| | - Anaïs Lacasse
- Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Chitra Lalloo
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Patricia Poulin
- Department of Anesthesiology & Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada,Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada,Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Samina Ali
- Departments of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada,Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada,Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Krista Baerg
- Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada,Department of Pediatrics, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Marco Battaglia
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Centre for Addiction and Mental Health CYEA programme, Toronto, Ontario, Canada
| | - Fiona Campbell
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada,Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vina Mohabir
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Fareha Nishat
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rachel Kelly
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ariane Isaac-Bertrand
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Summer Research Student, Child Health Evaluative Sciences, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Myles Benayon
- Internal Medicine Residency Program, McMaster University, Hamilton, Ontario, Canada
| | | | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Huang S, Lund T, Orchard P, Gupta A, Nascene D. Dilated Optic Nerve Sheath in Mucopolysaccharidosis I: Common and Not Necessarily High Intracranial Pressure. AJNR Am J Neuroradiol 2023; 44:91-94. [PMID: 36581456 PMCID: PMC9835902 DOI: 10.3174/ajnr.a7755] [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] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022]
Abstract
Hydrocephalus is one of the earliest manifestations of mucopolysaccharidosis I-Hurler syndrome, and delayed treatment of hydrocephalus can lead to neurocognitive delay or even death. Optic nerve sheath diameter has been established as a noninvasive measurement to detect elevated intracranial pressure. This study aimed to establish correlations between optic nerve sheath diameter and opening pressure. Forty-nine MR images and opening pressures in patients with mucopolysaccharidosis I-Hurler syndrome were retrospectively reviewed from 2008 to 2020. The optic nerve sheath diameter was measured 3 mm posterior to the posterior margin of the globe (retrobulbar) and 10 mm anterior to the optic foramen (midpoint segment), and the average was taken between the 2 eyes. Opening pressure was measured with the patient in the lateral decubitus position with controlled end-tidal CO2 on the same day as the MR imaging. The average retrobulbar optic nerve sheath diameter was 5.33 mm, higher than the previously reported measurement in healthy controls, in patients with idiopathic intracranial hypertension, and there was a positive correlation between age and the optic nerve sheath diameter measured at the retrobulbar or midpoint segment (retrobulbar segment, R 2 = 0.27, P < .01; midpoint segment, R 2 = 0.20, P < .01). However, there was no correlation between retrobulbar or midpoint segment optic nerve sheath diameter and opening pressure (retrobulbar segment, R 2 = 0.02, P = .17; midpoint segment, R 2 = 0.03, P < .12). This study shows a higher average optic nerve sheath diameter in patients with mucopolysaccharidosis I-Hurler syndrome than in healthy controls regardless of the location of the measurement. However, the degree of optic nerve sheath dilation does not correlate with opening pressure, suggesting that increased optic nerve sheath diameter is an ocular manifestation of mucopolysaccharidosis I-Hurler syndrome itself rather than a marker of elevated intracranial pressure.
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Affiliation(s)
- S Huang
- From the Department of Neurosurgery (S.H.)
| | - T Lund
- Division of Pediatric Blood and Marrow Transplant (T.L., P.O., A.G.)
| | - P Orchard
- Division of Pediatric Blood and Marrow Transplant (T.L., P.O., A.G.)
| | - A Gupta
- Division of Pediatric Blood and Marrow Transplant (T.L., P.O., A.G.)
| | - D Nascene
- Department of Radiology (D.N.), University of Minnesota, Minneapolis, Minnesota
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Sandvik RM, Cömert H, Skov M, Pressler T, Buchvald F, Johansen H, Lund T, Mojsoska B, Alatrakchi F, Nielsen K. P138 Biochemical detection of Pseudomonas aeruginosa in sputum and urine from children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00469-6] [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: 10/18/2022]
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7
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Neville A, Lund T, Soltani S, Jordan A, Stinson J, Killackey T, Birnie KA, Noel M. Pediatric Chronic Pain in the Midst of the COVID-19 Pandemic: Lived Experiences of Youth and Parents. J Pain 2022; 23:841-851. [PMID: 34915200 PMCID: PMC8710941 DOI: 10.1016/j.jpain.2021.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/16/2021] [Accepted: 11/18/2021] [Indexed: 01/23/2023]
Abstract
During the coronavirus 2019 (COVID-19) pandemic youth with chronic pain have experienced additional barriers to accessing treatment and managing their pain. This study explored the experiences of youth with chronic pain and their parents during the COVID-19 pandemic. Individual semi-structured interviews were conducted with 20 youth with chronic pain (aged 13-20 years) and one of their parents, recruited from a tertiary level pediatric chronic pain program. Interviews occurred between the months of June to August 2020 and enabled participants to describe their experiences of the COVID-19 pandemic according to their own unique perspectives. Transcripts were analyzed using inductive reflexive thematic analysis. Four themes were generated and labelled: "temporality, mental health, and pain," "coping with pain during a global pandemic," "impact on care," and "re-appraisal in the context of development and pandemic life." Across these themes, youth and parents described their unique challenges of living with pain as they adapted to changing circumstances of the COVID-19 pandemic. Notably, youth experienced increased difficulties managing their mental health and pain, which were intricately connected and related to social isolation, temporality, and uncertainty exacerbated by the COVID-19 pandemic. Restrictions due to the COVID-19 pandemic impacted youth's access to care and their abilities to engage in coping strategies to manage their pain. The COVID-19 pandemic was also perceived to have interrupted youth's development and growing autonomy, prompting youth to re-appraise their current circumstances and imagined futures. PERSPECTIVE: This manuscript provides an in-depth understanding of the impact of the COVID-19 pandemic on youth with chronic pain and their parents. Youth and their parents perceived the COVID-19 pandemic to have impacted youth's mental health, pain, socio-emotional development, and access to care.
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Affiliation(s)
- Alexandra Neville
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Abbie Jordan
- Department of Psychology and Centre for Pain Research, University of Bath, Bath, UK
| | - Jennifer Stinson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and Research Institute Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tieghan Killackey
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and Research Institute Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kathryn A Birnie
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Calgary, Canada
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8
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Pavlova M, Kennedy M, Lund T, Jordan A, Noel M. Let's (Not) Talk About Pain: Mothers' and Fathers' Beliefs Regarding Reminiscing About Past Pain. Front Pain Res 2022; 3:890897. [PMID: 35571142 PMCID: PMC9095907 DOI: 10.3389/fpain.2022.890897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Children's memories for past pain set the stage for their future pain experiences. Parent-child reminiscing about pain plays a key role in shaping children's pain memories. Parental beliefs about the functions of reminiscing are associated with parental reminiscing behaviors. To date, no studies have investigated parental beliefs regarding the functions of reminiscing about past pain or the associations between parental beliefs and reminiscing about past pain. This study aimed to fill these gaps. One-hundred and seven parents (52% fathers) of young children were asked about their beliefs regarding reminiscing about past pain. Interview data were first analyzed using inductive reflexive thematic analysis. A coding scheme was created based on the generated themes to quantitatively characterize parental beliefs. Parents also reminisced with their children about unique past events involving pain. Parent-child reminiscing narratives were coded to capture parent reminiscing behaviors. Inductive reflexive thematic analysis generated three major themes representing parental beliefs regarding reminiscing about past pain: “reminiscing to process past pain,” “reminiscing as a learning tool,” and “avoiding reminiscing about past pain.” Parents who endorsed avoiding reminiscing used fewer optimal reminiscing elements (i.e., open-ended questions) when reminiscing about past painful experiences with children. Parents who endorsed reminiscing to process past pain used more emotion-laden language when reminiscing about past pain. Mothers and fathers of boys and girls endorsed the reminiscing functions to a similar degree. Parents of older, vs. younger, children endorsed reminiscing to process past pain to a greater degree. Developmental considerations and clinical implications of the findings are discussed.
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Affiliation(s)
- Maria Pavlova
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Madison Kennedy
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Abbie Jordan
- Department of Psychology, Centre for Pain Research, University of Bath, Bath, United Kingdom
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
- *Correspondence: Melanie Noel
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Pavlova M, Lund T, Sun J, Katz J, Brindle M, Noel M. A Memory-Reframing Intervention to Reduce Pain in Youth Undergoing Major Surgery: Pilot Randomized, Controlled Trial of Feasibility and Acceptability. Can J Pain 2022; 6:152-165. [PMID: 35711298 PMCID: PMC9196744 DOI: 10.1080/24740527.2022.2058919] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Three to 22% of youth undergoing surgery develop chronic postsurgical pain (CPSP). Negative biases in pain memories (i.e., recalling higher levels of pain as compared to initial reports) are a risk factor for CPSP development. Children’s memories for pain are modifiable. Existing memory-reframing interventions reduced negatively biased memories associated with procedural pain and pain after minor surgery. However, not one study has tested the feasibility and acceptability of the memory-reframing intervention in youth undergoing major surgery. Aims The current pilot randomized clinical trial (RCT; NCT03110367; clinicaltrials.gov) examined the feasibility and acceptability of, as well as adherence to, a memory reframing intervention. Methods Youth undergoing a major surgery reported their baseline and postsurgery pain levels. Four weeks postsurgery, youth and one of their parents were randomized to receive control or memory-reframing instructions. Following the instructions, parents and youth reminisced about the surgery either as they normally would (control) or using the memory-reframing strategies (intervention). Six weeks postsurgery, youth completed a pain memory interview; parents reported intervention acceptability. Four months postsurgery, youth reported their pain. Results Seventeen youth (76% girls, Mage = 14.1 years) completed the study. The intervention was feasible and acceptable. Parents, but not youth, adhered to the intervention principles. The effect sizes of the intervention on youth pain memories (ηp2 = 0.22) and pain outcomes (ηp2 = 0.23) were used to inform a larger RCT sample size. Conclusions Memory reframing is a promising avenue in pediatric pain research. Larger RCTs are needed to determine intervention efficacy to improve pain outcomes.
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Affiliation(s)
- Maria Pavlova
- Department of Psychology, University of Calgary, Canada
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Canada
| | - Jenny Sun
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Joel Katz
- Department of Psychology, York University, Toronto, ON, Canada
| | - Mary Brindle
- Department of Pediatric Surgery, Alberta Children’s Hospital
| | - Melanie Noel
- Department of Psychology, University of Calgary; Alberta Children’s Hospital Research Institute; Hotchkiss Brain Institute; Owerko Centre; Mathison Centre for Mental Health Research & Education, Calgary, Canada
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Pavlova M, Lund T, Nania C, Kennedy M, Graham S, Noel M. Reframe the Pain: A Randomized Controlled Trial of a Parent-Led Memory-Reframing Intervention. J Pain 2021; 23:263-275. [PMID: 34425247 DOI: 10.1016/j.jpain.2021.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/29/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
Negatively-biased pain memories (ie, recalling more pain as compared to earlier reports) are a robust predictor of future pain experiences. This randomized controlled trial examined the efficacy of a memory-reframing intervention to reframe children's pain memories. Sixty-five children (54% girls, Mage=5.35 years) underwent a tonsillectomy and reported their levels of post-surgical pain intensity and pain-related fear. 2 weeks post-surgery, children and 1 of their parents were randomized to the memory-reframing intervention or control group. Following control/intervention instructions, parents and children reminisced about the past surgery as they normally would (control) or using the memory-reframing strategies (intervention). Children recalled their post-surgical pain intensity and pain-related fear one week later. Parents reported the intervention's acceptability. Recruitment statistics were used to assess feasibility. Controlling for initial pain intensity ratings and using the Faces Pain Scale Revised, children in the intervention group reported more accurate/positively-biased memories for day 1 post-surgery pain intensity (M = 2.60/10; 95% CI, 1.62 to 3.68), compared to children in the control group (M = 4.11/10; 95% CI, 3.12 to 5.03), ηp2 = .07, p = .040. The intervention was acceptable and feasible. Optimal parent-child reminiscing about a past pain experience resulted in children remembering their pain more accurately/positively. Clinicaltrials.gov:NCT03538730. PERSPECTIVE: This article presents results of the first randomized controlled trial examining the efficacy of parent-led memory-reframing intervention to change children's memories for pain. Children of parents who were taught and engaged in optimal reminiscing about a past surgery experience remembered their pain intensity more accurately/positively.
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Affiliation(s)
- Maria Pavlova
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Cara Nania
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Madison Kennedy
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Susan Graham
- Owerko Centre and Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Owerko Centre, Mathison Centre for Mental Health Research & Education, Calgary, Alberta, Canada.
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Lund T, Pavlova M, Kennedy M, Graham SA, Peterson C, Dick B, Noel M. Father- and Mother-Child Reminiscing About Past Pain and Young Children's Cognitive Skills. J Pediatr Psychol 2021; 46:757-767. [PMID: 33693798 DOI: 10.1093/jpepsy/jsab006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/28/2020] [Revised: 11/09/2020] [Accepted: 01/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Painful experiences are common, distressing, and salient in childhood. Parent-child reminiscing about past painful experiences is an untapped opportunity to process pain-related distress and, similar to reminiscing about other distressing experiences, promotes children's broader development. Previous research has documented the role of parent-child reminiscing about past pain in children's pain-related cognitions (i.e., memories for pain), but no study to date has examined the association between parent-child reminiscing about past painful experiences and children's broader cognitive skills. Design and Methods One hundred and ten typically developing four-year-old children and one of their parents reminisced about a past painful autobiographical event. Children then completed two tasks from the NIH Toolbox Cognitive Battery, the Flanker Inhibitory Control & Attention Test and the Picture Sequence Memory Test, to measure their executive function and episodic memory, respectively. Results Results indicated that the relation between parental reminiscing style and children's executive function was moderated by child sex, such that less frequent parental use of yes-no repetition questions was associated with boys' but not girls', greater performance on the executive function task. Children displayed greater episodic memory performance when their parents reminisced using more explanations. Conclusions The current study demonstrates the key role of parent-child reminiscing about pain in children's broader development and supports the merging of developmental and pediatric psychology fields. Future longitudinal research should examine the directionality of the relation between parent-child reminiscing about past pain and children's developmental outcomes.
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Affiliation(s)
| | | | | | - Susan A Graham
- Owerko Centre and Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary
| | - Carole Peterson
- Department of Psychology, Memorial University of Newfoundland
| | - Bruce Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta
| | - Melanie Noel
- Department of Psychology, University of Calgary; Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute; Owerko Centre
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Pavlova M, Graham SA, Peterson C, Lund T, Kennedy M, Nania C, Noel M. The Socialization of Young Children's Empathy for Pain: The Role of Mother- and Father-Child Reminiscing. J Pediatr Psychol 2021; 46:314-323. [PMID: 33306792 DOI: 10.1093/jpepsy/jsaa107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/21/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Empathy for pain allows one to recognize, understand, and respond to another person's pain in a prosocial manner. Young children develop empathy for pain later than empathy for other negative emotions (e.g., sadness), which may be due to social learning. How parents reminisce with children about past painful events has been linked to children's pain cognitions (e.g., memory) and broader socioemotional development. The present study examined how parent-child reminiscing about pain may be linked to children's empathic behaviors toward another person's pain. METHODS One hundred and fourteen 4-year-old children (55% girls) and for each, one parent (51% fathers) completed a structured narrative elicitation task wherein they reminisced about a past painful autobiographical event for the child. Children were then observed responding in a lab-based empathy task wherein they witnessed a confederate pretending to hurt themselves. Children's empathic behaviors and parent-child narratives about past painful events were coded using established coding schemes. RESULTS Findings revealed that parents who used more neutral emotion language (e.g., How did you feel?) when discussing past painful events had children who exhibited more empathic concern in response to another's pain. Similarly, children who used more explanations when reminiscing about past painful events displayed more empathic concern about another's pain. CONCLUSIONS Findings highlight a key role of parent-child reminiscing about the past pain in the behavioral expression of empathy for pain in young children.
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Affiliation(s)
| | - Susan A Graham
- Owerko Centre and Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute
| | - Carole Peterson
- Department of Psychology, Memorial University of Newfoundland
| | | | | | - Cara Nania
- Department of Psychology, University of Calgary
| | - Melanie Noel
- Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Owerko Centre
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Mueri K, Kennedy M, Pavlova M, Jordan A, Lund T, Neville A, Belton J, Noel M. The sociocultural context of pediatric pain: an examination of the portrayal of pain in children's popular media. Pain 2021; 162:967-975. [PMID: 33259461 DOI: 10.1097/j.pain.0000000000002086] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT Pain (eg, needle injections, injuries, and chronic pain) is highly prevalent in childhood and occurs in social contexts. Nevertheless, broader sociocultural influences on pediatric pain, such as popular media, have not been empirically examined. This study examined how pain is portrayed and gendered in children's popular media. A cross-section of children's media targeted towards 4- to 6-year-old children was selected based on popularity, including 10 movies and the first season of 6 television shows. Pain instances were extracted and coded using 2 established observational coding systems assessing sufferer pain characteristics and observer responses (eg, empathic responses). Findings identified 454 instances of pain across the selected media. Violent pain (ie, intentionally inflicted) and injuries were most commonly represented, whereas everyday, chronic-type, and procedural pains were infrequently portrayed. Pain instances were more commonly experienced by boy characters, who also expressed greater distress; yet, observers were more responsive (eg, expressed greater concern) towards girl characters' pain. Overall, observer responses to pain were infrequent, with observers witnessing but not responding to nearly half of pain instances. Observers who did respond expressed an overall lack of empathy towards sufferers. These findings reveal a very narrow depiction of pain presented in children's popular media, with an overall underrepresentation of pain, numerous maladaptive portrayals of pain, and gender differences in both sufferer and observer responses. This study underscores the need for further research to inform how children's popular media is perceived by parents and children and how media may be transformed and harnessed for effective pain education in childhood.
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Affiliation(s)
- Kendra Mueri
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Madison Kennedy
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Maria Pavlova
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Abbie Jordan
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Alexandra Neville
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Joletta Belton
- Endless Possibilities Initiative, Fraser, CO, United States
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
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Hansen C, Andersen J, Kjelmann K, Lund T. Labour market trajectories over the life-course - the importance of childhood negative life events? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.232] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Hansen
- Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
| | - J Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland—University Research Clinic, Herning, Denmark
| | - K Kjelmann
- Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
| | - T Lund
- Unit of Social Medicine, Department of Occupational and Environmental Medicine, Frederiksberg Hospital, Frederiksberg, Denmark
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Labriola M, Lykke Stabell C, Pedersen P, Hviid Andersen J, Lund T. Gender differences in psychological vulnerability in adolescence as indicator of secondary education completion. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.892] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | - T Lund
- Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
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Kvirkvelia N, Chikadze N, Makinde J, McBride JD, Porakishvili N, Hills FA, Martensen PM, Justesen J, Delves PJ, Lund T, Roitt IM. Investigation of factors influencing the immunogenicity of hCG as a potential cancer vaccine. Clin Exp Immunol 2018; 193:73-83. [PMID: 29601077 DOI: 10.1111/cei.13131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 10/26/2017] [Revised: 02/26/2018] [Accepted: 02/28/2018] [Indexed: 01/06/2023] Open
Abstract
Human chorionic gonadotrophin (hCG) and its β-subunit (hCGβ) are tumour autocrine growth factors whose presence in the serum of cancer patients has been linked to poorer prognosis. Previous studies have shown that vaccines which target these molecules and/or the 37 amino acid C-terminal hCGβ peptide (hCGβCTP) induce antibody responses in a majority of human recipients. Here we explored whether the immunogenicity of vaccines containing an hCGβ mutant (hCGβR68E, designed to eliminate cross-reactivity with luteinizing hormone) or hCGβCTP could be enhanced by coupling the immunogen to different carriers [keyhole limpet haemocyanin (KLH) or heat shock protein 70 (Hsp70)] using different cross-linkers [1-ethyl-3(3-dimethylaminopropyl)carboiimide (EDC) or glutaraldehyde (GAD)] and formulated with different adjuvants (RIBI or Montanide ISA720). While there was little to choose between KLH and Hsp70 as carriers, their influence on the effectiveness of a vaccine containing the BAChCGβR68E mutant was less marked, presumably because, being a foreign species, this mutant protein itself might provide T helper epitopes. The mutant provided a significantly better vaccine than the hCGβCTP peptide irrespective of the carrier used, how it was cross-linked to the carrier or which adjuvant was used when hCG was the target. Nonetheless, for use in humans where hCG is a tolerated self-protein, the need for a carrier is of fundamental importance. Highest antibody titres were obtained by linking the BAChCGβR68E to Hsp70 as a carrier by GAD and using RIBI as the adjuvant, which also resulted in antibodies with significantly higher affinity than those elicited by hCGβCTP peptide vaccine. This makes this mutant vaccine a promising candidate for therapeutic studies in hCGβ-positive cancer patients.
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Affiliation(s)
- N Kvirkvelia
- Division of Infection and Immunity, University College London, London, UK
| | - N Chikadze
- Division of Immunology and Microbiology, Javakhishvili Tbilisi State University, Tbilisi, Georgia, USA
| | - J Makinde
- Division of Infection and Immunity, University College London, London, UK
| | - J D McBride
- Division of Infection and Immunity, University College London, London, UK
| | - N Porakishvili
- Department of Biomedical Sciences, University of Westminster, London, UK
| | - F A Hills
- Department of Natural Sciences, School of Science and Technology, University of Middlesex, London, UK
| | - P M Martensen
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark
| | - J Justesen
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark
| | - P J Delves
- Division of Infection and Immunity, University College London, London, UK
| | - T Lund
- Division of Infection and Immunity, University College London, London, UK.,Department of Natural Sciences, School of Science and Technology, University of Middlesex, London, UK
| | - I M Roitt
- Division of Infection and Immunity, University College London, London, UK.,Department of Natural Sciences, School of Science and Technology, University of Middlesex, London, UK
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Jensen L, Overgaard C, Bøggild H, Garne JP, Lund T, Overvad K, Fonager K. The Long-term financial consequences of breast cancer: a Danish registry-based cohort study. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.690] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Jensen
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - C Overgaard
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - H Bøggild
- Department of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - JP Garne
- Department of Breast surgery, Aalborg University Hospital, Aalborg, Denmark
| | - T Lund
- Department of Public Health and Quality Improvement, Aarhus, Central Denmark Region, Aarhus, Denmark
| | - K Overvad
- Department of Public Health – Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - K Fonager
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
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Lindholdt L, Andersen JH, Lund T, Labriola M. Mental health across two generations –A cohort-study among 10,716 Danish adolescents. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.103] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Lindholdt
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - JH Andersen
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - T Lund
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - M Labriola
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
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Affiliation(s)
- JH Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Herning, Denmark
| | - L Lindholdt
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - TN Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, Herning, Denmark
| | - T Lund
- Research Centre for Youth & Employment, Herning, Denmark
| | - M Labriola
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
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Labriola M, Hviid Andersen J, Dalsgaard Hansen C, Nøhr Winding T, Lindholdt L, Pedersen P, Lund T. Construction and pretest of a national youth cohort questionnaire – the FOCA cohort. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.211] [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: 11/13/2022] Open
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Lund T, Hansen CD, Andersen JH, Labriola M. Mental health in childhood as risk indicator of labour market participation in young adulthood. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv168.055] [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: 11/13/2022] Open
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Tylén K, Christensen P, Roepstorff A, Lund T, Østergaard S, Donald M. Brains striving for coherence: Long-term cumulative plot formation in the default mode network. Neuroimage 2015. [PMID: 26216276 DOI: 10.1016/j.neuroimage.2015.07.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 11/15/2022] Open
Abstract
Many everyday activities, such as engaging in conversation or listening to a story, require us to sustain attention over a prolonged period of time while integrating and synthesizing complex episodic content into a coherent mental model. Humans are remarkably capable of navigating and keeping track of all the parallel social activities of everyday life even when confronted with interruptions or changes in the environment. However, the underlying cognitive and neurocognitive mechanisms of such long-term integration and profiling of information remain a challenge to neuroscience. While brain activity is generally traceable within the short time frame of working memory (milliseconds to seconds), these integrative processes last for minutes, hours or even days. Here we report two experiments on story comprehension. Experiment I establishes a cognitive dissociation between our comprehension of plot and incidental facts in narratives: when episodic material allows for long-term integration in a coherent plot, we recall fewer factual details. However, when plot formation is challenged, we pay more attention to incidental facts. Experiment II investigates the neural underpinnings of plot formation. Results suggest a central role for the brain's default mode network related to comprehension of coherent narratives while incoherent episodes rather activate the frontoparietal control network. Moreover, an analysis of cortical activity as a function of the cumulative integration of narrative material into a coherent story reveals to linear modulations of right hemisphere posterior temporal and parietal regions. Together these findings point to key neural mechanisms involved in the fundamental human capacity for cumulative plot formation.
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Affiliation(s)
- K Tylén
- Center for Semiotics, Department for Aesthetics and Communication, Aarhus University, Jens Chr. Skous Vej 2, 8000 Aarhus C, Denmark; Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark; The Interacting Minds Center, Department of Culture and Society, Aarhus University, Jens Chr. Skous Vej 4, 8000 Aarhus C, Denmark.
| | - P Christensen
- The Interacting Minds Center, Department of Culture and Society, Aarhus University, Jens Chr. Skous Vej 4, 8000 Aarhus C, Denmark; Centre for Languages and Literature, Lund University, Helgonabacken 12, 221 00 Lund, Sweden
| | - A Roepstorff
- Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark; The Interacting Minds Center, Department of Culture and Society, Aarhus University, Jens Chr. Skous Vej 4, 8000 Aarhus C, Denmark
| | - T Lund
- Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
| | - S Østergaard
- Center for Semiotics, Department for Aesthetics and Communication, Aarhus University, Jens Chr. Skous Vej 2, 8000 Aarhus C, Denmark
| | - M Donald
- Department of Psychology, Hunphrey Hall, 62 Arch St., Queens University, Kingston, Ontario K7L3N6, Canada
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Mansor L, Carr CA, Le Page L, Lund T, Aasum E, Clarke K, Tyler D, Heather L. P667Impaired chronic hypoxic response in type 2 diabetic hearts is associated with inability to downregulate PPARa. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu098.92] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gensby U, Labriola M, Irvin E, Amick BC, Lund T. A classification of components of workplace disability management programs: results from a systematic review. J Occup Rehabil 2014; 24:220-241. [PMID: 23666474 DOI: 10.1007/s10926-013-9437-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE This paper presents results from a Campbell systematic review on the nature and effectiveness of workplace disability management programs (WPDM) promoting return to work (RTW), as implemented and practiced by employers. A classification of WPDM program components, based on the review results, is proposed. METHODS Twelve databases were searched between 1948 to July 2010 for peer-reviewed studies of WPDM programs provided by employers to re-entering workers with occupational or non-occupational illnesses or injuries. Screening of articles, risk of bias assessment and data extraction were conducted in pairs of reviewers. Studies were clustered around various dimensions of the design and context of programs. RESULTS 16,932 records were identified by the initial search. 599 papers were assessed for relevance. Thirteen studies met inclusion criteria. Twelve peer reviewed articles (two non-randomized studies, and ten single group experimental before and after studies), including ten different WPDM programs informed the synthesis of results. Narrative descriptions of the included program characteristics provided insight on program scope, components, procedures and human resources involved. However, there were insufficient data on the characteristics of the sample and the effect sizes were uncertain. A taxonomy classifying policies and practices around WPDM programs is proposed. CONCLUSION There is insufficient evidence to draw conclusions on the effectiveness of employer provided WPDM programs promoting RTW. It was not possible to determine if specific program components or specific sets of components are driving effectiveness. The proposed taxonomy may guide future WPDM program evaluation and clarify the setup of programs offered to identify gaps in existing company strategies.
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Affiliation(s)
- U Gensby
- Department of Environmental, Social and Spatial Change, Roskilde University, Universitetsvej 1, Building 08.2, 4000, Roskilde, Denmark,
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Lund T, Hviid Andersen J, Hansen CD, Nøhr Winding T, Biering K, Labriola M. Childhood adversities as predictors of labour market participation in young adulthood. A prospective birth cohort study. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schelde M, Lund T, Brixen K, Ryg J. Prevalence of monoclonal gammopathy of undetermined significance is high in patients with recent hip fracture. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.098] [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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Faber A, Sell L, Hansen JV, Burr H, Lund T, Holtermann A, Sogaard K. Does muscle strength predict future musculoskeletal disorders and sickness absence? Occup Med (Lond) 2011; 62:41-6. [DOI: 10.1093/occmed/kqr150] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aljabri MB, Lund T, Höper AC, Andreasen TV, Al-Saad S, Lindal S, Ytrehus K. Gene expression, function and ischemia tolerance in male and female rat hearts after sub-toxic levels of angiotensin II. Cardiovasc Toxicol 2011; 11:38-47. [PMID: 21170686 PMCID: PMC3035796 DOI: 10.1007/s12012-010-9100-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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] [Indexed: 01/19/2023]
Abstract
To examine the response to chronic high-dose angiotensin II (Ang II) and a proposed milder response in female hearts with respect to gene expression and ischemic injury. Female and male litter–matched rats were treated with 400 ng kg−1 min−1 Ang II for 14 days. Hearts were isolated, subjected to 30-min ischemia and 30-min reperfusion in combination with functional monitoring and thereafter harvested for gene expression, WB and histology. Ang II-treated hearts showed signs of non-hypertrophic remodeling and had significantly higher end diastolic pressure after reperfusion, but no significant gender difference was detected. Ang II increased expression of genes related to heart function (ANF, β-MCH, Ankrd-1, PKC-α, PKC-δ TNF-α); fibrosis (Col I-α1, Col III-α1, Fn-1, Timp1) and apoptosis (P53, Casp-3) without changing heart weight but with 68% increase in collagen content. High (sub-toxic) dose of Ang II resulted in marked heart remodeling and diastolic dysfunction after ischemia without significant myocyte hypertrophy or ventricular chamber dilatation. Although there were some gender-dependent differences in gene expression, female gender did not protect against the overall response.
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Affiliation(s)
- M B Aljabri
- Cardiovascular Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Norway.
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Aljabri MB, Songstad NT, Lund T, Serrano MC, Andreasen TV, Al-Saad S, Lindal S, Sitras V, Acharya G, Ytrehus K. Pregnancy protects against antiangiogenic and fibrogenic effects of angiotensin II in rat hearts. Acta Physiol (Oxf) 2011; 201:445-56. [PMID: 21281454 DOI: 10.1111/j.1748-1716.2010.02234.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AIM To investigate the difference between physiological and pathological cardiac remodelling induced, respectively, by pregnancy and angiotensin (Ang) II, and to test the hypothesis that pregnancy protects against Ang II effects. METHODS Female Wistar rats, pregnant (n = 12) and non-pregnant (n = 12), were implanted with mini-pumps containing saline (sham) or 150 ng kg(-1) min(-1) Ang II. Ten days later echocardiography and blood pressure measurement were performed. Expression of 22 genes was assessed using RT-PCR. Microscopic sections of LV were prepared to determine collagen content (Sirius Red staining), vessel density (β-actin immunolabelling) and myocytes diameter (Toluidine Blue). RESULTS Heart weight (HW) was increased in Ang II treated groups compared with their controls. Furthermore, HW of Ang II treated pregnant rats (1.0 ± 0.03 g) was higher than that in non-pregnant sham (0.7 ± 0.02 g), pregnant (0.8 ± 0.01 g) and Ang II treated non-pregnant (0.8 ± 0.02 g) rats. Relative LV wall thickness showed similar pattern. Aortic pressure was significantly increased in Ang II groups. Collagen content was increased in Ang II (4.0 ± 0.5%) compared with sham (1.5 ± 0.1%) but reduced again when treated rats were pregnant (2.8 ± 0.4%). Vessel density was reduced by 47.8% after Ang II treatment in non-pregnant and by only 13.9% in pregnant rats. Gene expression analysis showed increased expression of atrial natriuretic factor (ANF), brain natriuretic peptide (BNP), anykrin repeat domain-containing protein 1 (Ankrd-1), protein kinase C-α and -δ and tumour suppressor gene TP53 (p53) in Ang II treated groups and upregulation of ANF, BNP and Ankrd-1 remained when pregnancy was combined with Ang II. Pregnancy reduced expression of: α-myosin heavy chain, tumour necrosis factor-α, p53, endothelial nitric oxide synthase and inducible nitric oxide synthase. CONCLUSION Pregnancy seems to counteract the detrimental effects of Ang II on fibrosis and angiogenesis in heart. In addition, pregnancy and Ang II lead to partly opposite changes in the expression of some genes important for heart function.
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Affiliation(s)
- M B Aljabri
- Cardiovascular Research Group, Department of Medical Biology, Faculty of Health Science, University of Tromsø, Norway.
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Labriola M, Holte KA, Christensen KB, Feveile H, Alexanderson K, Lund T. The attribution of work environment in explaining gender differences in long-term sickness absence: results from the prospective DREAM study. Occup Environ Med 2011; 68:703-5. [DOI: 10.1136/oem.2010.060632] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Oskam IC, Lund T, Santos RR. Irreversible Damage in Ovine Ovarian Tissue after Cryopreservation in Propanediol: Analyses after In Vitro Culture and Xenotransplantation. Reprod Domest Anim 2011; 46:793-9. [PMID: 21272097 DOI: 10.1111/j.1439-0531.2010.01743.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- I C Oskam
- Section for Reproductive Medicine Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.
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Lund T, Mangsbo SM, Scholz H, Gjorstrup P, Tötterman TH, Korsgren O, Foss A. Resolvin E1 Reduces Proinflammatory Markers in Human Pancreatic Islets in vitro. Exp Clin Endocrinol Diabetes 2010; 118:237-44. [DOI: 10.1055/s-0029-1241825] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Scholz H, Lund T, Dahle MK, Collins JL, Korsgren O, Wang JE, Foss A. The synthetic liver X receptor agonist GW3965 reduces tissue factor production and inflammatory responses in human islets in vitro. Diabetologia 2009; 52:1352-62. [PMID: 19415233 DOI: 10.1007/s00125-009-1366-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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] [Received: 02/03/2009] [Accepted: 03/16/2009] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS Optimising islet culture conditions may be one strategy for reducing islet loss prior to, and immediately after, islet transplantation. Liver X receptor (LXR) agonism has previously been shown to increase insulin release from pancreatic islets and reduce inflammation in leucocytes. Our aim was to investigate whether the synthetic LXR agonist GW3965 could modulate the inflammatory status of human pancreatic islets. METHODS Levels of pro-inflammatory cytokines and tissue factor in isolated human islets were determined by TaqMan low density array and/or real-time quantitative RT-PCR (mRNA levels) and enzyme immunoassay (EIA) (protein levels). Islet viability was measured using intracellular ATP content, ADP/ATP ratio, mitochondrial dehydrogenase activity (XTT assay) and insulin secretion in a dynamic glucose-challenge model. Apoptosis was determined by EIA measurement of histone-DNA complexes present in cytoplasm and by assaying caspase-3/-7 activity. RESULTS Treatment of LPS-stimulated human islets with the synthetic LXR agonist GW3965 (1 micromol/l) for 24 h reduced mRNA and protein levels of selected pro-inflammatory cytokines (IL-8, monocyte chemotactic protein-1 and tissue factor). Moreover, GW3965 had no adverse effect on insulin secretion, islet viability or apoptosis. No excess of lipid accumulation could be detected with the dosage and exposure time used. CONCLUSIONS/INTERPRETATION LXR activation suppresses inflammation in human islets in vitro without adverse effects on islet viability. Short-term moderate activation of LXR prior to islet transplantation may represent a possible strategy for improving post-transplant islet survival.
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Affiliation(s)
- H Scholz
- Institute for Surgical Research, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway.
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Sondergaard TE, Pedersen PT, Andersen TL, Søe K, Lund T, Ostergaard B, Garnero P, Delaisse JM, Plesner T. A phase II clinical trial does not show that high dose simvastatin has beneficial effect on markers of bone turnover in multiple myeloma. Hematol Oncol 2009; 27:17-22. [PMID: 18668701 DOI: 10.1002/hon.869] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Several studies have evaluated the impact of low dose statin (20-80 mg/day) on bone metabolism with inconclusive results despite promising data of preclinical studies. In this study, we investigated the effect of high dose simvastatin (HD-Sim) on biochemical markers of bone turnover and disease activity in six heavily pretreated patients with multiple myeloma (MM). These patients were treated with simvastatin (15 mg/kg/day) for 7 days followed by a rest period of 21 days in two 4-week cycles. Endpoints were changes in the level of biochemical markers of (i) osteoclast activity (tartrate resistant acid phosphatase, TRACP); (ii) bone resorption (collagen fragments CTX and NTX); (iii) bone formation (osteocalcin and aminoterminal propeptide of type I collagen PINP); (iv) cholesterol; (v) regulators of bone metabolism [osteoprotegerin (OPG) and Dickkopf-1 (DKK-1)] and (vi) disease activity (monoclonal proteins or free light chains in serum). TRACP activity in serum and levels of collagen fragments (NTX) in urine increased for all patients temporarily during the 7 days of treatment with HD-Sim indicating that osteoclasts may have been stimulated rather than inhibited. The other markers of bone metabolism showed no change. None of the patients showed any reduction in free monoclonal light chains or monoclonal proteins in serum during treatment with HD-Sim. In spite of the fact that bone turn over effects of HD-Sim may have been blunted by concomitant treatment of patients with other drugs we observed a transient increase in markers of osteoclast activity. This sign of a transient stimulation of osteoclast activity suggests that HD-Sim may be harmful rather than beneficial for MM patients. For this reason and because of gastro-intestinal side effects the study was stopped prematurely.
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Affiliation(s)
- T E Sondergaard
- Department of Clinical Cell Biology, IRS-CSFU, University of Southern Denmark, Vejle Hospital, Vejle, Denmark
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Lund T, Kivimäki M, Christensen KB, Labriola M. Socio-economic differences in the association between sickness absence and mortality: the prospective DREAM study of Danish private sector employees. Occup Environ Med 2008; 66:150-3. [PMID: 18805885 DOI: 10.1136/oem.2008.040154] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine duration of sickness absence as a risk marker for future mortality by socio-economic position among all private sector employees in Denmark in 1998-2004. METHODS All residents in Denmark employed in the private sector receiving sickness absence compensation in 1998 were investigated in a prospective cohort study. 236 207 persons (38.2% women, 61.8% men, age range 18-65, mean age 37.8 years) alive on 1 January 2001 were included in the study. Mortality from 1 January 2001 to 31 December 2004 was assessed using national register data. Deaths in 1999 and 2000 were excluded to determine the status of sickness absence duration as an early risk marker. For analyses within occupational grades, data were available for a sub-population of 137 607 study participants. RESULTS 3040 persons died during follow-up. The age-adjusted risk of future mortality increased by duration of sickness absence in a graded fashion among men and non-blue collar workers. Among women and blue collar workers, there was no association of mortality with duration of sickness absences below 6 weeks. However, employees with > or =6 weeks of absence compared to those with 1-week absence had a substantial excess risk of death in all groups: adjusted hazard ratio 2.2 (95% CI 1.8 to 2.7) for women, 2.1 (95% CI 1.8 to 2.4) for men, 3.7 (95% CI 1.9 to 7.2) in white collar occupations, 3.3 (95% CI 2.2 to 5.0) in intermediate grade occupations and 2.0 (95% CI 1.7 to 2.3) in blue collar occupations. CONCLUSION Administratively collected data on sickness absence compensation for periods > or =6 weeks identified "at risk" groups for future excess mortality in male and female private sector employees across occupational grade levels.
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Affiliation(s)
- T Lund
- Danish National Centre for Social Research, Herluf Trolles Gade 11, Copenhagen, Denmark.
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Abstract
Asthma, exercise-induced bronchoconstriction, and airway hyper-responsiveness are often found in elite athletes, perhaps as a consequence of their sport or maybe because asthma is a common disorder in young adults. Inhaled beta2-agonists (IBA) are frequently used in elite athletes, but due to regulations introduced by the International Olympic Committee, the use of anti-asthmatic therapy might change. Drugs that make ergogenic effect persist are prohibited in all athletes, whether or not they take part in competitions and systemic steroids and beta2-agonists are among such drugs. On the other hand, opinion is more divided about the use of inhaled corticosteroids (ICS) and IBA. In humans, no effect has been found on the oxygen uptake, performance or distance run with therapeutic doses of IBA, either in asthmatics or non-asthmatics, whereas others report an ergogenic effect and better lung function of high doses of a beta2-agonist in non-asthmatics. Anti-asthmatic treatment is necessary for asthmatics, but should not be used by non-asthmatic elite athletes due to both possible systemic effects and furthermore, side effects of both ICS and IBA.
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Affiliation(s)
- V Backer
- Department of Respiratory Medicine, Bispebjerg Hospital, University Hospital of Copenhagen, Denmark.
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Abstract
The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006. All elite athletes (N=418) financially supported by the national organization of elite athletes comprised the study group; 329 (79%) completed the questionnaire concerning their sport, asthma-like symptoms, asthma and use of asthma medication. Asthma-like symptoms at rest were reported by 41% of respondents; 55% reported asthma-like symptoms at rest or at exercise. Physician-diagnosed asthma was present in 16% and 14% had current asthma. Asthma medication was taken by 7% of the athletes, of whom 79% used inhaled corticosteroids and 21% used inhaled beta(2)-agonists only. Athletes participating in endurance sports had higher prevalences of current asthma (24%) and use of asthma medication (15%) than all other athletes (P<0.01). Athletes participating in endurance sports have a higher prevalence of asthma and use of asthma medication. The frequency of asthma medication is lower than the prevalence of current asthma indicating that there is no overuse of asthma medication among Danish elite athletes.
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Affiliation(s)
- T Lund
- Respiratory and Allergy Research Unit, Department of Respiratory Medicine, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
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Bultmann U, Christensen KB, Burr H, Lund T, Rugulies R. Severe depressive symptoms as predictor of disability pension: a 10-year follow-up study in Denmark. Eur J Public Health 2008; 18:232-4. [DOI: 10.1093/eurpub/ckm132] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Christensen KB, Labriola M, Lund T, Kivimaki M. Explaining the social gradient in long-term sickness absence: a prospective study of Danish employees. J Epidemiol Community Health 2008; 62:181-3. [DOI: 10.1136/jech.2006.056135] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Objective: To estimate the hazard ratio for disability pension associated with shift work. Methods: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. Results: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. Conclusion: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association.
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Affiliation(s)
- F Tüchsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen Ø, Denmark.
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Haefeli M, Elfering A, Aebi M, Freeman BJC, Fritzell P, Guimaraes Consciencia J, Lamartina C, Mayer M, Lund T, Boos N. What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients. Eur Spine J 2007; 17:104-16. [PMID: 17990007 DOI: 10.1007/s00586-007-0541-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 07/14/2007] [Accepted: 10/06/2007] [Indexed: 11/30/2022]
Abstract
Standardized and validated self-administered outcome-instruments are broadly used in spinal surgery. Despite a plethora of articles on outcome research, no systematic evaluation is available on what actually comprises a good outcome in spinal surgery from the patients' and surgeons' perspective, respectively. However, this is a prerequisite for improving outcome instruments. In performing a cross-sectional survey among spine patients from different European regions and spine surgeons of the SSE, the study attempted (1) to identify the most important domains determining a good outcome from a patients' as well as a surgeon's perspective, and (2) to explore regional differences in the identified domains. For this purpose, a structured interview was performed among 30 spine surgeons of the SSE and 353 spine surgery patients (representing Northern, Central and Southern Europe) to investigate their criteria for a good outcome. A qualitative and descriptive approach was used to evaluate the data. Results revealed a high agreement on what comprises a good outcome among surgeons and patients, respectively. The main parameters determining good outcome were achieving the patients' expectations/satisfaction, pain relief, improvement of disability and social reintegration. Younger patients more often expected a complete pain relief, an improved work capacity, and better social life participation. Patients in southern Europe more often wanted to improve work capacity compared to those from central and northern European countries. No substantial differences were found when patients' and surgeons' perspective were compared. However, age and differences in national social security and health care system ("black flags") have an impact on what is considered a good outcome in spinal surgery.
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Affiliation(s)
- M Haefeli
- Centre for Spinal Surgery, University of Zurich, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
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Abstract
BACKGROUND The aim of this study was to describe differences between allergic rhinitis (AR) and nonallergic rhinitis (NAR) in a large community-based sample of Danish adolescents and adults. METHODS A total of 1,186 subjects, 14-44 years of age, who in a screening questionnaire had reported a history of airway symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms and furthermore skin test reactivity, lung function and airway responsiveness were measured using standard techniques. RESULTS A total of 77% of the subjects with rhinitis had AR, whereas 23% had NAR. Subjects with NAR were more likely to be females, OR = 2.05 (1.31-3.20), P = 0.002, to have persistent symptoms within the last 4 weeks, OR = 1.88 (1.23-2.89), P = 0.003, and to have recurring headaches, OR = 1.94, (1.12-3.37), P = 0.019. On the other hand, subjects with NAR were less likely to have airway hyperresponsiveness, OR = 0.40, (0.24-0.66), P < 0.001, food allergy, OR = 0.40, (0.19-0.36), P = 0.009 and to have been treated with antihistamines in the last 4 weeks, OR = 0.22, (0.13-0.38), P < 0.001 compared with subjects with AR. Subjects with AR were symptomatically worse within their season in terms of sneezing (P < 0.001) and itchy eyes (P < 0.001), compared to subjects with NAR, whereas nasal congestion and rhinorrhea were equally frequent in the two groups (P = 0.901 and P = 0.278, respectively). CONCLUSIONS The proportion of subjects with NAR in an adolescent and adult population with rhinitis is around one-fourth. Women have NAR twice as often as men. In general, subjects with NAR have more persistent but equally severe symptoms compared to subjects with AR. However, subjects with AR have more sneezing and itchy eyes within their particular season of allergy compared to subjects with NAR.
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Affiliation(s)
- E Mølgaard
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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Backer V, Harmsen L, Lund T, Pedersen L, Porsbjerg C, Rasmussen L, Thomsen SF, Nolte H. A 3-year longitudinal study of asthma quality of life in undiagnosed and diagnosed asthma patients. Int J Tuberc Lung Dis 2007; 11:463-9. [PMID: 17394695] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
SETTING Juniper's Asthma Quality of Life Questionnaire with standardised activities (AQLQ(S)) is commonly used to evaluate the effect of interventions in pharmaceutical trials, but rarely, if ever, used clinically in long-term follow-up of undiagnosed or diagnosed asthma patients. DESIGN The AQLQ(S) was administered to 493 asthma patients who were randomised to treatment in primary or specialist care over a 3-year period. RESULTS Of the 493 patients, 249 had not been diagnosed before screening and 244 had a doctor's diagnosis of asthma. At entry, known patients had a lower total AQLQ(S) score (median 6.03, 95%CI 3.9-7.0) than undiagnosed patients (median 6.54, 95%CI 4.8-7.0, P < 0.001). Treatment with inhaled corticosteroids induced lower scores (median 5.7, 95%CI 3.5-7.0) than no treatment (median 6.5, 95%CI 4.8-7.0, P < 0.01). Half of the patients (n = 260) were randomly invited to participate in a follow-up survey in a specialist setting. In the first 3 months of follow-up, a decrease in AQLQ(S) score among the undiagnosed patients (median -0.24, 95%CI -1.6-0.9, P = 0.02) was observed. After 3 years, the score improved significantly (by >0.5 points) in 45% of the undiagnosed patients (n = 107) compared to 26% of the known patients (n = 116, P < 0.05). CONCLUSION The initial total AQLQ(S) score was higher in undiagnosed asthma patients. After diagnosis the AQLQ(S) initially decreased but then increased, followed by an overall improvement that exceeded that of the known asthma patients.
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Affiliation(s)
- V Backer
- Respiratory and Allergy Research Unit, Department of Respiratory Medicine, University Hospital of Copenhagen, HS Bispebjerg Hospital, 2400 Copenhagen NV, Denmark.
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Abstract
The heterodimeric 'pregnancy-specific' hormone human chorionic gonadotropin (hCG) has been used as the basis for a contraceptive vaccine. More recently, the observation that hCG, particularly in the form of the beta-chain expressed in the absence of alpha-chain, is aberrantly expressed in a number of different tumors has opened up a second potential application for such vaccines. Drawbacks of the currently available vaccines are that they are either relatively weakly immunogenic or that they induce antibodies that cross-react with human leuteinizing hormone (hLH). We have explored the possibility of creating mutated versions of the hCG beta-chain with improved immunologic properties.
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Affiliation(s)
- P J Delves
- Department of Immunology and Molecular Pathology, Division of Infection and Immunity, University College London, 46 Cleveland Street, London W1T 4JF, United Kingdom.
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Foss P, Lund T, Boreng R, Bjornestad EO. Development and Testing of Xanthan Products for Eor-Applications in the North Sea. ACTA ACUST UNITED AC 2006. [DOI: 10.2516/ogst:1990009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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O'Shea H, Yousaf N, Altmann D, Fehervari Z, Tonks P, Hetherington C, Harach S, Bland C, Cooke A, Lund T. Effect of X- and Y-box deletions on the development of diabetes in H-2Ealpha-chain transgenic nonobese diabetic mice. Scand J Immunol 2006; 63:17-25. [PMID: 16398697 DOI: 10.1111/j.1365-3083.2006.001701.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The development of type 1 diabetes in nonobese diabetic (NOD) mice is influenced by major histocompatibility complex (MHC) class II genes. The NOD-E transgenic mouse, which expresses H2-E as a result of the introduction of an Ead gene, is protected from development of type 1 diabetes. While the mechanism of protection remains unclear, the effect has been regarded as a model system for MHC protection from autoimmunity. We have investigated the effect of deletions of the Ea promoter region, which, in turn, affect H2-E expression patterns in transgenic NOD mice. We have constructed transgenic NOD mice where the X (DeltaX) and Y (DeltaY) boxes of the Ead gene have, respectively, been functionally deleted. Previous reports, using X- or Y-box-deleted H2-E transgenic mice, made by crossing the appropriate transgenes onto the NOD background from C57BL/6 transgenic mice, indicated that promoter mutation abrogated the H2-E-mediated protection seen in NOD-E. The NOD DeltaX and NOD DeltaY transgenic mice generated in the present study differ in susceptibility to diabetes from wild-type NOD mice. NOD DeltaY1 animals are protected from diabetes development, while DeltaX mice remain susceptible, albeit to a lesser extent than the parental NOD strain.
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Affiliation(s)
- H O'Shea
- Division of Immunology, Department of Pathology, University of Cambridge, Cambridge, UK
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Lund T, Lund T, Walker M, Laufs H. EEG-fMRI of sleep spindles and K-complexes at 3 Tesla. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939229] [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: 10/20/2022]
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Lund T, Stokke T, Olsen ØE, Fodstad Ø. Garlic arrests MDA-MB-435 cancer cells in mitosis, phosphorylates the proapoptotic BH3-only protein BimEL and induces apoptosis. Br J Cancer 2005; 92:1773-81. [PMID: 15827557 PMCID: PMC2362050 DOI: 10.1038/sj.bjc.6602537] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Components of garlic (Allium sativum) can cause disruption of microtubules, cell cycle arrest, and apoptosis in cancer cells. We show here that a water-soluble extract of garlic arrested MDA-MB-435 cancer cells in mitosis and caused apoptosis. The proapoptotic BH3-only, bcl-2 family protein BimEL, which in healthy cells can be tightly sequestered to the microtubule-associated dynein motor complex, was modified after garlic treatment. The main effect of garlic on BimEL was a considerable increase in a phosphorylated form of the protein. This phosphorylation(s), probably partly dependent on c-jun N-terminal kinase activity, promoted mitochondrial localisation of BimEL. Furthermore, inhibition of extracellular signal-regulated kinases 1/2 increased the amount of another form of BimEL present in the mitochondrial cellular fraction. Treatment of cells with the garlic compound diallyl disulphide had similar effects on BimEL. The results indicate that the apoptotic effect of garlic and a combination of garlic and the inhibitor of extracellular signal-regulated kinases 1/2 in MDA-MB-435 cells partly is due to modifications that are necessary for translocation of the proapoptotic protein BimEL to mitochondria where it executes its proapoptotic function.
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Affiliation(s)
- T Lund
- Department of Tumor Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello, Oslo 0310, Norway.
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Hannesdóttir SG, Han X, Lund T, Singh M, Van Der Zee R, Roitt IM, Delves PJ. Changes in the reproductive system of male mice immunized with a GnRH-analogue conjugated to mycobacterial hsp70. Reproduction 2004; 128:365-71. [PMID: 15333787 DOI: 10.1530/rep.1.00108] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Immunosterilization is an attractive alternative to surgical castration. Gonadotropin-releasing hormone (GnRH) controls the production of the gonadotropins thereby having an orchestrating effect on the reproductive hormone cascade and spermatogenesis. Induction of neutralizing antibody can abrogate the effect of the hormone. Current GnRH-based vaccines often require strong adjuvants and/or multiple injections of the vaccines to overcome variability in the response. Heat shock proteins (hsp) have been used as carrier molecules because of their powerful intrinsic ability to enhance an immune response to associated antigens. A GnRH-analogue, GnRH-d6-Lys, was conjugated to recombinantMycobacterium tuberculosishsp70. Male BALB/c mice were immunized i.p. with GnRH-hsp70 in the mild adjuvant Ribi or in incomplete Freund’s adjuvant (IFA). The initial immunizations were done on pre-pubertal 3-week-old mice, with boosts at 5 and 8 weeks of age. The mice were killed at 10 weeks of age and GnRH-specific antibodies and serum testosterone levels measured. All the immunized mice mounted GnRH-specific antibody responses, with no difference in the mice immunized with GnRH-hsp70/Ribi or with GnRH-hsp70/IFA. There was substantial atrophy of the urogenital complex and significantly (P< 0.0005) reduced levels of testosterone-dependent testicular relaxin-like factor mRNA expression. Mice immunized with GnRH-hsp70/Ribi showed substantially reduced (P< 0.001) serum testosterone levels. These results indicate that hsp70 may serve as a particularly advantageous carrier for GnRH-based vaccines.
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Affiliation(s)
- S G Hannesdóttir
- Department of Immunology and Molecular Pathology, University College London, London, UK
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