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Osilla KC, Manuel JK, Becker K, Nameth K, Burgette L, Ober AJ, DeYoreo M, Lodge BS, Hurley B, Watkins KE. It takes a village: A pilot study of a group telehealth intervention for support persons affected by opioid use disorder. J Subst Use Addict Treat 2024; 161:209290. [PMID: 38272117 DOI: 10.1016/j.josat.2024.209290] [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: 03/20/2023] [Revised: 11/28/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Opioid use disorder (OUD) has devastating effects on individuals, families, and communities. The Community Reinforcement and Family Training (CRAFT) is a Support Person (SP)-focused intervention that aims to increase SPs' communication strategies, positive reinforcement/rewards, and social support. This pilot study, called eINSPIRE (INtegrating Support Persons Into REcovery), adapted CRAFT for delivery via group telehealth. The aims were to evaluate the feasibility, acceptability, and preliminary effectiveness of this intervention on patient buprenorphine retention and SP mental health. METHODS The study recruited patients receiving buprenorphine treatment in a primary care setting across five community health centers with their SP (N = 100 dyads). SP participants were randomly assigned to receive usual care (UC) or the eINSPIRE intervention. We interviewed Patients and SPs at baseline and three months later. The study collected patient buprenorphine retention data from the electronic medical record three months post-baseline. RESULTS About 88 % (656/742) of potentially eligible patients were able to nominate a SP and 69 % (100/145) of nominated SPs were eligible and consented to the study. eINSPIRE groups had low reach (25 % of SPs attended), but high exposure (M = 7 of 10 sessions attended) and acceptability (classes helped them with their patient's OUD). The proportion of eINSPIRE patients (68 %) and UC patients (53 %) retained on buprenorphine at follow-up were similar (p = 0.203). SPs in both conditions reported similar reductions in their depression, anxiety, and impairment symptoms. CONCLUSIONS Preliminary data suggest that eINSPIRE groups may not be feasible in primary care without further adaptations for this population. A future study with a larger sample size is needed to elucidate the observed distribution differences in buprenorphine retention. Future research should also explore methods to reduce barriers to SP session attendance to improve the reach of this evidence-based intervention.
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Affiliation(s)
- Karen Chan Osilla
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1070 Arastradero Road, Palo Alto, CA 94304, United States.
| | - Jennifer K Manuel
- University of California San Francisco, Department of Psychiatry and Behavioral Sciences, 675 18th St, San Francisco, CA 94143, United States; San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, United States
| | - Kirsten Becker
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, United States
| | - Katherine Nameth
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| | - Lane Burgette
- RAND Corporation, 1200 S Hayes St, Arlington, VA 22202, United States
| | - Allison J Ober
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, United States
| | - Maria DeYoreo
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, United States
| | | | - Brian Hurley
- University of California Los Angeles, Department of Family Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, United States; County of Los Angeles, Department of Public Health, Bureau of Substance Abuse Prevention and Control 1000 S. Fremont Avenue, Alhambra, CA 91803, United States
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Gahlawat A, Singh A, Sandhu H, Garg P. CRAFT: a web-integrated cavity prediction tool based on flow transfer algorithm. J Cheminform 2024; 16:12. [PMID: 38291536 PMCID: PMC10829215 DOI: 10.1186/s13321-024-00803-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
Numerous computational methods, including evolutionary-based, energy-based, and geometrical-based methods, are utilized to identify cavities inside proteins. Cavity information aids protein function annotation, drug design, poly-pharmacology, and allosteric site investigation. This article introduces "flow transfer algorithm" for rapid and effective identification of diverse protein cavities through multidimensional cavity scan. Initially, it identifies delimiter and susceptible tetrahedra to establish boundary regions and provide seed tetrahedra. Seed tetrahedron faces are precisely scanned using the maximum circle radius to transfer seed flow to neighboring tetrahedra. Seed flow continues until terminated by boundaries or forbidden faces, where a face is forbidden if the estimated maximum circle radius is less or equal to the user-defined maximum circle radius. After a seed scanning, tetrahedra involved in the flow are clustered to locate the cavity. The CRAFT web interface integrates this algorithm for protein cavity identification with enhanced user control. It supports proteins with cofactors, hydrogens, and ligands and provides comprehensive features such as 3D visualization, cavity physicochemical properties, percentage contribution graphs, and highlighted residues for each cavity. CRAFT can be accessed through its web interface at http://pitools.niper.ac.in/CRAFT , complemented by the command version available at https://github.com/PGlab-NIPER/CRAFT/ .Scientific contribution: Flow transfer algorithm is a novel geometric approach for accurate and reliable prediction of diverse protein cavities. This algorithm employs a distinct concept involving maximum circle radius within the 3D Delaunay triangulation to address diverse van der Waals radii while existing methods overlook atom specific van der Waals radii or rely on complex weighted geometric techniques.
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Affiliation(s)
- Anuj Gahlawat
- Department of Pharmacoinformatics, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S. Nagar, 160062, Punjab, India
| | - Anjali Singh
- Department of Computer Science, Kurukshetra University, Kurukshetra, Haryana, India
| | - Hardeep Sandhu
- Department of Pharmacoinformatics, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S. Nagar, 160062, Punjab, India
| | - Prabha Garg
- Department of Pharmacoinformatics, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S. Nagar, 160062, Punjab, India.
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Hellum R, Bilberg R, Mejldal A, Nielsen AS. Potential factors affecting the impact of community reinforcement and family training. Secondary analysis of an RCT. BMC Public Health 2024; 24:213. [PMID: 38233850 PMCID: PMC10795348 DOI: 10.1186/s12889-024-17656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND In addition to increasing the quality of life among concerned significant others (CSOs), Community Reinforcement and Family training (CRAFT) aim at helping CSOs motivate treatment-refusing identified patients (IPs) into treatment through a positive reinforcement process. The aim of the present study was to investigate if the following factors, measured at baseline, have an influence on IP future treatment engagement (1) Type of relation between CSO and the IP (2) The amount of time the CSO spend with the IP (3) if the IP knows that the CSOs seeks help, and (4) The CSO's own alcohol use. METHODS A secondary analysis from the Danish CRAFT study. CSOs completed a self-administered questionnaire at baseline, after three months, and six months. To investigate the relationship between the four variables and treatment engagement, logistic regression was used. RESULTS CSO's relation to the IP, the frequency of contact between the CSO and the IP, and the CSO's AUDIT score at the time of the baseline interview were not associated with the IP's treatment engagement. If CSO at baseline had informed the IP that the CSO participated in CRAFT, odds for IP treatment engagement were significantly higher (adjusted OR [(CI)] = 2.29 [1.13; 4.63] (p < 0.05), relative to if IP not being informed. CONCLUSIONS CRAFT has a higher impact on the likelihood for treatment seeking, if the CSOs inform the IP about his or her own help seeking in order to change the situation. The underlying mechanism behind this is needs further investigations.
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Affiliation(s)
- Rikke Hellum
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
- Department of Mental Health Odense, Region of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
| | - Randi Bilberg
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
- Department for Data, Innovation and Research, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Anna Mejldal
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, J.B. Winsløws vej 9A, Odense C, 5000, Denmark
| | - Anette Søgaard Nielsen
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark.
- Department of Mental Health Odense, Region of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark.
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Croak B, Archer M, Harwood H, Stevelink SAM, Greenberg N, Rafferty L. Evaluation of Community Reinforcement and Family Therapy in the UK military community. Eur J Psychotraumatol 2023; 14:2282904. [PMID: 38010161 PMCID: PMC10993804 DOI: 10.1080/20008066.2023.2282904] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Partners and family can play a key role in encouraging military service and ex-service personnel to seek help for their mental health. Community Reinforcement Approach and Family Training (CRAFT) was developed to equip concerned significant others (CSOs) of those experiencing substance use disorders with skills to encourage their loved one to enter treatment and improve their own well-being. It was adapted in the US for CSOs of ex-service personnel with post-traumatic stress disorder (PTSD) (VA-CRAFT).Objective: This study aimed to evaluate an adaptation of VA-CRAFT for use with CSOs of serving and ex-service personnel experiencing PTSD and Common Mental Disorders in the UK (UKV-CRAFT).Method: Acceptability of UKV-CRAFT was assessed with interviews with experts, namely key stakeholders (n = 15) working in support provision for serving and ex-service personnel. In addition, individuals who took part in a small-scale demonstrative trial of UKV-CRAFT (three CSOs and three facilitators who delivered UKV-CRAFT) provided feedback.Results: UKV-CRAFT was viewed positively, with interviewees highlighting that programmes like UKV-CRAFT filled a gap in provision for UK Armed Forces families as most services were only available to the serving or ex-service personnel. Interviewees praised how UKV-CRAFT enhanced CSO well-being and communication with their loved one. Concerns over the confidentiality of taking part in UKV-CRAFT were raised due to the perceived negative effects of highlighting a loved one's mental ill health, especially for CSOs of serving personnel. Ideas for improvement included broadening access to all CSOs regardless of whether their loved one was seeking treatment.Conclusion: Interviewees regarded UKV-CRAFT as a potentially useful intervention suggesting it could be proactively offered universally to support timely help-seeking if required. We recommend further evaluation of UKV-CRAFT on a wider scale, incorporating our recommendations, to assess its effectiveness accurately.
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Affiliation(s)
- Bethany Croak
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Marc Archer
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
- School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Inverness, United Kingdom
| | - Hannah Harwood
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Sharon A. M. Stevelink
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Neil Greenberg
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Laura Rafferty
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
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Osilla KC, Gore KL, Pedersen ER, Hummer JF, DeYoreo M, Manuel JK, McKay JR, Kim JP, Nameth K. Study protocol for a sequential multiple assignment randomized trial to reduce risky drinking among service members and their partners. Contemp Clin Trials 2023; 133:107324. [PMID: 37652360 PMCID: PMC10591961 DOI: 10.1016/j.cct.2023.107324] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Military spouses and partners in relationships with a heavy drinking service member report high levels of mental health concerns and consequences, which are compounded when both partners drink heavily. Military spouses and partners -termed "concerned partners" (CPs)-may be an important gateway for motivating service members (SMs) to seek care. However, CPs may first need to reduce their own drinking and improve their communication to effectively support and encourage changes for their service member partner. Partners Connect is a web-based intervention aimed at improving communication and relationship quality and increasing SM help-seeking. METHODS The current study design is a two-stage Sequential Multiple Assignment Randomized Trial (SMART) to develop an adaptive CP intervention to decrease CP drinking and increase SM help-seeking. CPs aged 18 and older (n = 408) will be recruited via social media and followed for six months. In stage one, we will randomize CPs to either a 4-session web-based intervention (Partners Connect) or to receive communication resources from the Gottman Institute website. The goal is to have CPs invite their SM to complete an online personalized normative feedback (PNF) session. If their SM completes the PNF at stage one, CPs will be considered "responders," if the SM does not complete, CPs who are "non-responders" will be re-randomized during stage two to receive either (1) a CRAFT workbook or (2) phone-based CRAFT if in Partners Connect; or (1) Partners Connect or (2) a CRAFT workbook if in Gottman. DISCUSSION By first intervening with the service member's CP, we aim to better equip them to engage their service member partner in treatment services. In doing so, we develop a model that increases treatment accessibility and appeal among a group that may not otherwise seek care. CLINICALTRIALS gov Identifier: NCT05619185.
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Affiliation(s)
- Karen Chan Osilla
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1070 Arastradero Road, Palo Alto, CA 94304, USA.
| | - Kristie L Gore
- RAND Corporation, 1200 S Hayes St, Arlington, VA 22202, USA
| | - Eric R Pedersen
- University of Southern California Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street, Suite 2200, Los Angeles, CA 90033, USA
| | - Justin F Hummer
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA 90407-2138, USA
| | - Maria DeYoreo
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA 90407-2138, USA
| | - Jennifer K Manuel
- San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; University of California San Francisco, Department of Psychiatry and Behavioral Sciences, 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - James R McKay
- Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Crescenz VAMC, Philadelphia, PA, USA
| | - Jane P Kim
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1070 Arastradero Road, Palo Alto, CA 94304, USA
| | - Katherine Nameth
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1070 Arastradero Road, Palo Alto, CA 94304, USA
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Bottel L, te Wildt BT, Brand M, Pape M, Herpertz S, Dieris-Hirche J. Telemedicine as bridge to the offline world for person affected with problematic internet use or internet use disorder and concerned significant others. Digit Health 2023; 9:20552076221144185. [PMID: 36636726 PMCID: PMC9829884 DOI: 10.1177/20552076221144185] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/21/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Internet use disorder is a disorder of the digital age and presents a growing problem worldwide. It appears that due to structural and personal barriers, many persons affected (PA) and Concerned Significant Others (CSO) do not reach the health care system so far and thus a chronification of the pathology can proceed. Methods A telemedicine counseling service for PA and CSO of PA unwilling to enter treatment with two webcam-based sessions of 60 minutes for each group was created with the aim of reaching out to PA and CSO to provide a low-threshold support and refer the participants to the local health care system. Motivational interviewing for PA and CRAFT (Community Reinforcement and Family Training) for CSO were used as methods. Participants answered questions about their Internet use and sociodemographic data and six months after participation, participants were asked via email if they entered the local health care system. CSO answered the questions for themselves and in a third-party rating for PA unwilling to enter treatment. Results 107 PA (34 years (SD = 13.64), 86% male) and 38 CSO (53 years (SD = 6.11), 28.9% male) participated in the two telemedicine sessions. After participation, 43.9% of the PA and 42.1% of the CSO reached the health care system. When there was consistency between the location of telemedicine consultation and treatment locally, over 90% of participants arrived (PA: 92.3%, CSO: 100%). Conclusion The results from this study reveal that telemedicine services could be a promising approach to address PA and CSO and build a bridge to the local health care system. Future studies should verify if these results can be replicated in randomized controlled trials.
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Affiliation(s)
- Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany,Laura Bottel, Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Alexandrinenstr. 1-3, Bochum 44791, Germany.
| | - Bert Theodor te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany,Psychosomatic Hospital Diessen Monastery, Diessen am Ammersee, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| | - Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
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Abstract
INTRODUCTION This personal narrative describes our family's struggle with my adult son's substance use disorder (SUD). Years of traditional tough love treatment programs worsened his SUD and our relationship. When he experienced drug induced psychosis and was hospitalized, I realized I needed to change my approach and understand his behaviors. METHODS I reached out to the recovery community and spoke with many individuals who had walked in my son's shoes. They described feelings of loneliness, self-loathing, and hopelessness while being on the receiving end of tough love. They further described the contrast between those negative feelings, and the life affirming hope associated with communication, empathy, and inclusion. I became inspired to research programs that are based on communication, science, and connection, rather than isolation, judgment, and punishment. RESULTS Family and community are powerful tools and can motive change. An evidence-based program called CRAFT (Community Reinforcement and Family Training) encourages relationships and teaches families skills to connect with their loved ones by effectively communicating and reinforcing positive behaviors, even in the context of unhealthy behaviors. Receiving praise for healthy behavior, recognition for good work, or even a positive acknowledgement for taking baby steps toward self-care can activate the same dopamine-producing reward system as drugs. Individuals with SUD can learn how to feel good in ways that do not involve using substances. Traditional patient-focused treatment programs, which encourage separation, punishment, and distance should not be considered the only approach to treatment. CONCLUSIONS Loved ones are not powerless. While we can't make a person change, we can contribute to making them want to change. We have more influence than we once thought possible and need to proactively seek out empirically supported family-based programs that reinforce these approaches.
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Hellum R, Bilberg R, Andersen K, Bischof G, Hesse M, Nielsen AS. Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training ( CRAFT) to the significant others of problem drinkers. BMC Public Health 2022; 22:928. [PMID: 35538465 PMCID: PMC9087923 DOI: 10.1186/s12889-022-13293-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community Reinforcement and Family Training (CRAFT) is an intervention designed to help the concerned significant others (CSOs) of people with alcohol problems who are reluctant to seek treatment. It aims to improve the well-being of CSOs and teach them how to change their behavior in order to positively influence the "identified patient" (IP) to seek treatment. METHODS The aim of the present pragmatic cluster-randomized trial was to compare the effectiveness of three formats for delivering CRAFT in real life settings: group sessions, individual sessions, and written material only (control group). Eighteen public treatment centers for alcohol use disorders were randomly assigned to deliver CRAFT in one of the three formats as part of their daily clinical routine. CSOs were recruited via pamphlets, general practitioners, and advertisements on social media. Trained clinicians delivered CRAFT in individual and group format, and self-administered CRAFT was limited to handing out a self-help book. The primary outcome was treatment engagement of the IP after three months. RESULTS A total of 249 CSOs were found to be eligible and randomly assigned to receive CRAFT delivered in group, individual, or self-administered format. The three-month follow-up rate was 60%. At three months follow-up, 29% (n = 32) of the CSOs who received group/individual CRAFT reported that their IP had engaged in treatment. The corresponding rate for the CSOs who received self-administered CRAFT was lower (15%; n = 5) but did not differ significantly from the other group of CSOs (Odds ratio (OR) = 2.27 (95% CI: 0.80, 6.41)). CONCLUSION We hypothesized that CSOs receiving CRAFT in a group format would improve the most, but although our findings pointed in this direction, the differences were not statistically significant. TRIAL REGISTRATION Clinical trials.gov ID: NCT03281057 . Registration date:13/09/2017.
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Affiliation(s)
- Rikke Hellum
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark
| | - Randi Bilberg
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark.
| | - Kjeld Andersen
- Psychiatric Department, Region of Southern Denmark, Odense, Denmark
| | - Gallus Bischof
- The Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychological and Behavioral Sciences, Aarhus University, Artillerivej 90, 2, 2300, Copenhagen S, Denmark
| | - Anette Søgaard Nielsen
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark
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Osilla KC, Rodriguez LM, Neighbors C, Pedersen ER. Effects of a Web-Based Intervention in Reducing Drinking among Concerned Partners of Military Service Members and Veterans. Couple Family Psychol 2022; 11:4-14. [PMID: 36448033 PMCID: PMC9701542 DOI: 10.1037/cfp0000201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Military personnel and their partners report greater alcohol use and related problems compared to their civilian counterparts. We designed a web-based intervention (WBI) called Partners Connect individualized for a military spouse or partner concerned about their service member/veteran's (SMV) drinking and conducted a secondary data analysis to examine the effect of the WBI on participant drinking and their perceptions of their SMV partner's drinking. Participants were concerned partners (CPs) recruited through social media and randomized to Partners Connect or waitlist control. They completed online surveys at baseline and three months post-intervention. CPs who reported any past-month drinking were included in the current analyses (n=161; 94.4% female, 77% White, 5% Hispanic, 32.0 (SD=6.5) years old). There was no significant effect of the intervention on CP drinking. However, the intervention effect was moderated by CP drinks per week, such that heavier drinking intervention CPs reported significant reductions in their number of drinking days at follow-up. Heavy drinking CPs who reduced their drinking also reported perceived reductions in SMV drinking. Military spouses and partners participated in Partners Connect out of concern for their SMV partner's drinking. In doing so, heavier drinking CPs reduced their own drinking frequency, which was also associated with perceptions of SMV drinking.
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Affiliation(s)
| | | | | | - Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
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Hellum R, Bilberg R, Bischof G, Nielsen AS. How concerned significant others experience Community Reinforcement and Family Training ( CRAFT) - a qualitative study. BMC Fam Pract 2021; 22:241. [PMID: 34861827 PMCID: PMC8641252 DOI: 10.1186/s12875-021-01596-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022]
Abstract
Introduction Heavy drinking causes serious harm, not only to the drinker but also to relationships and concerned significant others (CSOs). Community Reinforcement and Family Training (CRAFT) is an intervention developed to help the CSOs of substance users. The aim of this study was to investigate the drivers and aims underlying CSO participation in CRAFT, as well as their experience of the intervention itself and their module preferences. Method This is a qualitative study based on data from semi-structured interviews with 11 female help-seeking CSOs of individuals with alcohol problems. The participants were recruited from an RCT study of a variety of CRAFT delivery formats (group sessions + written material, individual sessions + written material or self-delivered CRAFT with written material only). The interviews were audio-recorded, transcribed, and analyzed by Interpretative Phenomenological Analysis. Results CSOs reported CRAFT helpful when both delivered by means of individual sessions or group sessions. The “Communication Element” in CRAFT, the module focusing on positive reinforcement and acquiring a clearer understanding of AUD, appeared to be particularly helpful elements of CRAFT. Furthermore, being met with acceptance and non-judgmental attitudes seemed to count highly for the CSOs. The written material a helpful supplement to the face-to-face interventions. The written material a helpful supplement to the face-to-face interventions. Conclusion CSOs who participated in the CRAFT intervention felt helped by its components, irrespective of delivery format.
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Affiliation(s)
- Rikke Hellum
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark. .,Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000, Odense C, Denmark. .,Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark.
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark.,Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000, Odense C, Denmark.,Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark.,Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000, Odense C, Denmark.,Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
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11
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Sundquist S, Batist G, Brodeur-Robb K, Dyck K, Eigl BJ, Lee DK, Limoges J, Longstaff H, Pankovich J, Sadura A, Sullivan P, Dancey JE. CRAFT-A Proposed Framework for Decentralized Clinical Trials Participation in Canada. Curr Oncol 2021; 28:3857-3865. [PMID: 34677247 PMCID: PMC8534531 DOI: 10.3390/curroncol28050329] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/15/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022] Open
Abstract
Canada's vast geography, and centralized delivery of cancer care and clinical trials create barriers for trial participation for patients in remote and rural settings. The development and implementation of a framework that enables safe and regulatory compliant trial participation through local healthcare providers would benefit Canadian patients, clinicians, trial sponsors and the health care system. To address this issue, representatives of Canada's cancer clinical trial community met to identify key challenges and develop recommendations for remote patient participation in trials. A structured literature review identified remote/rural trial delivery models. A panel of expert stakeholders reviewed the models and participated in a workshop to assess health system readiness, identify needed processes, tools and mechanisms, and develop recommendations for a Canadian framework for decentralized clinical trial conduct. The Canadian Remote Access Framework for clinical Trials (CRAFT) represents a risk-based approach used by site investigators to delegate responsibilities for a given trial to satellite health centres within a hub-and-spoke "trial cluster". The Framework includes specific recommendations to ensure research experience, capacity, regulatory compliance and patient safety. Canada's cancer care and telemedicine systems can be leveraged to enable broader access to clinical trials for patients who are geographically remote from cancer centres. CRAFT's risk-based framework is based on other successful models of remote trial patient management and is in the pilot implementation phase in Canada.
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Affiliation(s)
- Stephen Sundquist
- Canadian Cancer Clinical Trials Network, Toronto, ON M5G 0A3, Canada;
| | - Gerald Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada;
| | - Kathy Brodeur-Robb
- C17 Council for Children’s Cancer and Blood Disorders, Edmonton, AB T6G 1C9, Canada;
| | - Kathryn Dyck
- CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada;
| | - Bernhard J. Eigl
- Division of Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada;
| | - David K. Lee
- Health Products and Food Branch, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | | | - Holly Longstaff
- Provincial Health Services Authority, Vancouver, BC V6H 4C1, Canada;
| | - Jim Pankovich
- Bold Therapeutics Inc., Vancouver, BC V6C 1E1, Canada;
| | - Anna Sadura
- Canadian Cancer Trials Group, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | | | - Janet E. Dancey
- Canadian Cancer Clinical Trials Network, Toronto, ON M5G 0A3, Canada;
- Canadian Cancer Trials Group, Queen’s University, Kingston, ON K7L 3N6, Canada;
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12
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Johnson H, Puppa M, van der Merwe M, Tipirneni-Sajja A. CRAFT for NMR lipidomics: Targeting lipid metabolism in leucine-supplemented tumor-bearing mice. Magn Reson Chem 2021; 59:138-146. [PMID: 32876975 DOI: 10.1002/mrc.5092] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 06/11/2023]
Abstract
Lipid profiling by 1 H-NMR has gained increasing utility in many fields because of its intrinsically quantitative, nondestructive nature and the ability to differentiate small molecules based on their spectral location. Most nuclear magnetic resonance (NMR) techniques for metabolite quantification use frequency domain analysis that involves many user-dependent steps such as phase and baseline correction and quantification by either manual integration or peak fitting. Recently, Bayesian analysis of time-domain NMR data has been shown to reduce operator bias and increase automation in NMR spectroscopy. In this study, we demonstrate the use of CRAFT (complete reduction to amplitude-frequency table), a Bayesian-based approach to automate processing in NMR-based lipidomics using lipid standards and tissue samples of healthy and tumor-bearing mice supplemented with leucine. Complex mixtures of lipid standards were prepared and examined using CRAFT to validate it against conventional Fourier transform (FT)-NMR and derive a fingerprint to be used for analyzing lipid profiles of serum and liver samples. CRAFT and FT-NMR were comparable in accuracy, with CRAFT achieving higher correlation in quantifying several lipid species. Analysis of the serum lipidome of tumor-bearing mice revealed hyperlipidemia and no signs of hepatic triglyceride accumulation compared with that of the healthy group demonstrating that the tumor-bearing mice were in a state of precachexia. Leucine-supplementation was associated with minimal changes in the lipid profile in both tissues. In conclusion, our study demonstrates that the CRAFT method can accurately identify and quantify lipids in complex lipid mixtures and murine tissue samples and, hence, will increase automation and reproducibility in NMR-based lipidomics.
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Affiliation(s)
- Hayden Johnson
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA
| | - Melissa Puppa
- College of Health Sciences, The University of Memphis, Memphis, TN, USA
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13
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Abstract
Background: Syntactic analysis, or parsing, is a key task in natural language processing and a required component for many text mining approaches. In recent years, Universal Dependencies (UD) has emerged as the leading formalism for dependency parsing. While a number of recent tasks centering on UD have substantially advanced the state of the art in multilingual parsing, there has been only little study of parsing texts from specialized domains such as biomedicine. Methods: We explore the application of state-of-the-art neural dependency parsing methods to biomedical text using the recently introduced CRAFT-SA shared task dataset. The CRAFT-SA task broadly follows the UD representation and recent UD task conventions, allowing us to fine-tune the UD-compatible Turku Neural Parser and UDify neural parsers to the task. We further evaluate the effect of transfer learning using a broad selection of BERT models, including several models pre-trained specifically for biomedical text processing. Results: We find that recently introduced neural parsing technology is capable of generating highly accurate analyses of biomedical text, substantially improving on the best performance reported in the original CRAFT-SA shared task. We also find that initialization using a deep transfer learning model pre-trained on in-domain texts is key to maximizing the performance of the parsing methods.
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Affiliation(s)
- Jenna Kanerva
- TurkuNLP Group, University of Turku, Turku, Finland.
| | - Filip Ginter
- TurkuNLP Group, University of Turku, Turku, Finland
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14
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Osilla KC, Becker K, Ecola L, Hurley B, Manuel JK, Ober A, Paddock SM, Watkins KE. Study design to evaluate a group-based therapy for support persons of adults on buprenorphine/naloxone. Addict Sci Clin Pract 2020; 15:25. [PMID: 32653029 PMCID: PMC7353769 DOI: 10.1186/s13722-020-00199-2] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Opioid use disorders (OUDs) have devastating effects on individuals, families, and communities. While medication treatments for OUD save lives and are increasingly utilized, rates of treatment dropout are very high. In addition, most existing medication treatments for OUD may often neglect the impact of untreated OUD on relationships and ignore the potential role support persons (SPs) could have on encouraging long-term recovery, which can also impact patient treatment retention. Methods/design The current study adapts Community Reinforcement and Family Training (CRAFT) for use with SPs (family member, spouse or friend) of patients using buprenorphine/naloxone (buprenorphine) in an outpatient community clinic setting. The study will evaluate whether the adapted intervention, also known as integrating support persons into recovery (INSPIRE), is effective in increasing patient retention on buprenorphine when compared to usual care. We will utilize a two-group randomized design where patients starting or restarting buprenorphine will be screened for support person status and recruited with their support person if eligible. Support persons will be randomly assigned to the INSPIRE intervention, which will consist of 10 rolling group sessions led by two facilitators. Patients and SPs will each be assessed at baseline, 3 months post-baseline, and 12 months post-baseline. Patient electronic medical record data will be collected at six and 12 months post-baseline. We will examine mechanisms of intervention effectiveness and also conduct pre/post-implementation surveys with clinic staff to assess issues that would affect sustainability. Discussion Incorporating the patient’s support system may be an important way to improve treatment retention in medication treatments for OUD. If SPs can serve to support patient retention, this study would significantly advance work to help support the delivery of effective treatments that prevent the devastating consequences associated with OUD. Trial registration This study was registered with ClinicalTrials.gov, NCT04239235. Registered 27 January 2020, https://clinicaltrials.gov/ct2/show/NCT04239235.
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Affiliation(s)
- Karen Chan Osilla
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Kirsten Becker
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Liisa Ecola
- RAND Corporation, 1100 South Hayes Street, VA, 22202, Arlington, USA
| | - Brian Hurley
- LA County Department of Health Services, UCLA Department of Family Medicine, 10780 Santa Monica Blvd., Suite 105, Los Angeles, CA, 90025, USA
| | - Jennifer K Manuel
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA.,San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA, 94121, USA
| | - Allison Ober
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Susan M Paddock
- NORC at the University of Chicago, 55 East Monroe St, 31st Floor, Chicago, IL, 60603, USA
| | - Katherine E Watkins
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA
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15
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Archer M, Harwood H, Stevelink S, Rafferty L, Greenberg N. Community reinforcement and family training and rates of treatment entry: a systematic review. Addiction 2020; 115:1024-1037. [PMID: 31770469 DOI: 10.1111/add.14901] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/29/2019] [Accepted: 11/11/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training (CRAFT). This study aims to clarify which (1) treatment components and (2) participant characteristics contribute to rates of identified patient (IP) treatment entry. METHOD Systematic review of CRAFT evaluation studies of all designs (controlled and uncontrolled) with data synthesis and narrative analysis of addiction treatment services and university research departments in North America and Europe. RESULTS A total of 691 concerned significant others (CSOs), predominately female spouses/parents, participating in 20 distinct treatment conditions from 14 studies. The main outcome of IP treatment entry rate reported by CSOs up to 12 months after starting CRAFT with key predictors/correlates including IP addiction, IP-CSO relationship, CRAFT modality and integration of treatment for IP. Meta-analysis found CRAFT to be twice as effective as controls/comparison groups. Multi-modality treatment, including both individual and group sessions, yielded the highest IP treatment entry rates (77 and 86%), with progressively lower rates for individual (12.5-71%), group (60%) and self-directed workbook (13.3-40%) modalities. While all five studies targeting gambling addiction had consistently low rates (12.5-23%), other treatment components, including therapist training, treatment fidelity and integrating treatment for the IP, were implicated. CONCLUSIONS Adaptations of Community Reinforcement Approach and Family Training for different delivery modalities and addictions have yielded widely varying rates of treatment engagement for the identified patient, with those offering the most comprehensive support to the concerned significant other, including individual and group sessions, having highest levels of engagement success.
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Affiliation(s)
- Marc Archer
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK
| | - Hannah Harwood
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK
| | - Sharon Stevelink
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK.,Department of Psychological Medicine, King's College London, De Crespigny Park, London, UK
| | - Laura Rafferty
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK
| | - Neil Greenberg
- King's Centre for Military Health Research, King's College London, Weston Education Centre, London, UK.,Academic Department of Military Mental Health, King's College London, Weston Education Centre, London, UK
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16
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Soulsby D. Band-selective excitation NMR spectroscopy and quantitative time-domain analysis using Complete Reduction to Amplitude-Frequency Table ( CRAFT) to determine distribution coefficients during drug development. Magn Reson Chem 2019; 57:953-960. [PMID: 31070814 DOI: 10.1002/mrc.4888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/15/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
A sensitive quantitative 1 H NMR method for determining distribution or partition coefficients has been developed that is applicable to early drug discovery. After partitioning and equilibration, aliquots from each layer are analyzed using band-selective excitation 1 H NMR spectroscopy in regions that are free of 1-octanol and water solvent signals. Signals are quantitated directly using CRAFT software, and their amplitudes are adjusted to correct for nonuniformity within the excitation band. Using this approach, the distribution coefficients for 20 drugs present at low concentrations were determined giving values that were in excellent agreement with literature values.
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Affiliation(s)
- David Soulsby
- Chemistry Department, University of Redlands, Redlands, California
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17
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Rodriguez LM, Neighbors C, Osilla KC, Trail TE. The longitudinal effects of military spouses' concern and behaviors over partner drinking on relationship functioning. Alcohol 2019; 76:29-36. [PMID: 30553122 DOI: 10.1016/j.alcohol.2018.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 06/11/2018] [Accepted: 07/11/2018] [Indexed: 12/12/2022]
Abstract
Among those in close relationships, the perception that one's partner has a drinking problem is more strongly related to detriments in relationship quality than are the actual rates of the partner's drinking. The current study extends this work by examining the effects of this perception on relationship functioning longitudinally and whether this association is mediated by changes in how one behaves in response to their partner's drinking. Spouses and partners of military service members who were concerned about their partner's drinking (n = 234) completed a baseline survey and a follow-up assessment five months later. Structural equation modeling was used to prospectively examine the association between concern about partner drinking and relationship functioning (i.e., relationship quality, conflict, communication patterns), and the mediated effect of regulation strategies. Results suggested that changes in participant concern were related to changes in relationship functioning, and these changes were mediated by changes in punishment and rewarding sobriety regulation strategies. This research suggests that concern about partner drinking is linked with poorer relationship functioning partly because of the increased use of punishment and the decreased use of rewarding sobriety.
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18
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Hellum R, Nielsen AS, Bischof G, Andersen K, Hesse M, Ekstrøm CT, Bilberg R. Community reinforcement and family training ( CRAFT) - design of a cluster randomized controlled trial comparing individual, group and self-help interventions. BMC Public Health 2019; 19:307. [PMID: 30871596 PMCID: PMC6416948 DOI: 10.1186/s12889-019-6632-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Around 585,000 people in Denmark engage in harmful use of alcohol with 140,000 suffering from outright alcohol dependence. The concerned significant others (CSOs) are affected by the drinking, often suffering almost as much as the person with alcohol use disorder. Community Reinforcement and Family Training (CRAFT) is aimed at CSOs who struggle unsuccessfully, in an effort to motivate their loved ones to stop drinking and seek treatment. The aims of this study are 1) To implement CRAFT interventions into the daily routine of operating Danish alcohol treatment centers 2) To investigate whether 6-week-individual CRAFT, 6-week-open group-based CRAFT or CRAFT based on self-help material, is efficient in getting problem drinkers to seek treatment for their alcohol problems 3) To investigate which of the three interventions (individual, group or self-directed CRAFT) is the most effective and in which group of population. METHODS The study is a three-arm, cluster randomized controlled trial: A: individual CRAFT, group CRAFT, and CRAFT as a self-help intervention. A total of 405 concerned significant others to persons with alcohol abuse will be recruited from 24 alcohol outpatient clinics. The participants will fill out a questionnaire regarding i.e. life quality, if the drinking person entered treatment (main outcome) and satisfaction with the intervention, at baseline and after 3 and 6 months. DISCUSSION We expect to establish evidence as to whether CRAFT is efficient in a Danish treatment setting and whether CRAFT is most effective at individual, group or self-help material only. TRIAL REGISTRATION Clinical trials.gov ID: NCT03281057 . Registration date: September 13th, 2017.
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Affiliation(s)
- Rikke Hellum
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Kjeld Andersen
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000 Odense, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychological and Behavioral Sciences, Aarhus University, Artillerivej 90, 2, 2300 København S, Aarhus, Denmark
| | - Claus Thorn Ekstrøm
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 København K, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000 Odense, Denmark
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
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19
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Krishnamurthy K, Hari N. Application of CRAFT (complete reduction to amplitude frequency table) in nonuniformly sampled (NUS) 2D NMR data processing. Magn Reson Chem 2018; 56:535-545. [PMID: 28913938 DOI: 10.1002/mrc.4664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/06/2017] [Accepted: 09/08/2017] [Indexed: 06/07/2023]
Abstract
The recently published CRAFT (complete reduction to amplitude frequency table) technique converts the raw FID data (i.e., time domain data) into a table of frequencies, amplitudes, decay rate constants, and phases. It offers an alternate approach to decimate time-domain data, with minimal preprocessing step. It has been shown that application of CRAFT technique to process the t1 dimension of the 2D data significantly improved the detectable resolution by its ability to analyze without the use of ubiquitous apodization of extensively zero-filled data. It was noted earlier that CRAFT did not resolve sinusoids that were not already resolvable in time-domain (i.e., t1 max dependent resolution). We present a combined NUS-IST-CRAFT approach wherein the NUS acquisition technique (sparse sampling technique) increases the intrinsic resolution in time-domain (by increasing t1 max), IST fills the gap in the sparse sampling, and CRAFT processing extracts the information without loss due to any severe apodization. NUS and CRAFT are thus complementary techniques to improve intrinsic and usable resolution. We show that significant improvement can be achieved with this combination over conventional NUS-IST processing. With reasonable sensitivity, the models can be extended to significantly higher t1 max to generate an indirect-DEPT spectrum that rivals the direct observe counterpart.
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Affiliation(s)
| | - Natarajan Hari
- NMR Laboratory, School of Chemical and Biotechnology, SASTRA University, Thanjavur, India
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20
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Simanshu DK, Nissley DV, McCormick F. RAS Proteins and Their Regulators in Human Disease. Cell 2017; 170:17-33. [PMID: 28666118 DOI: 10.1016/j.cell.2017.06.009] [Citation(s) in RCA: 1062] [Impact Index Per Article: 151.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/22/2017] [Accepted: 06/07/2017] [Indexed: 02/07/2023]
Abstract
RAS proteins are binary switches, cycling between ON and OFF states during signal transduction. These switches are normally tightly controlled, but in RAS-related diseases, such as cancer, RASopathies, and many psychiatric disorders, mutations in the RAS genes or their regulators render RAS proteins persistently active. The structural basis of the switch and many of the pathways that RAS controls are well known, but the precise mechanisms by which RAS proteins function are less clear. All RAS biology occurs in membranes: a precise understanding of RAS' interaction with membranes is essential to understand RAS action and to intervene in RAS-driven diseases.
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21
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Soulsby D, Chica JAM. Determination of partition coefficients using 1 H NMR spectroscopy and time domain complete reduction to amplitude-frequency table ( CRAFT) analysis. Magn Reson Chem 2017; 55:724-729. [PMID: 28181700 DOI: 10.1002/mrc.4582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/02/2017] [Accepted: 02/05/2017] [Indexed: 06/06/2023]
Abstract
We have developed a simple, direct and novel method for the determination of partition coefficients and partitioning behavior using 1 H NMR spectroscopy combined with time domain complete reduction to amplitude-frequency tables (CRAFT). After partitioning into water and 1-octanol using standard methods, aliquots from each layer are directly analyzed using either proton or selective excitation NMR experiments. Signal amplitudes for each compound from each layer are then extracted directly from the time domain data in an automated fashion and analyzed using the CRAFT software. From these amplitudes, log P and log D7.4 values can be calculated directly. Phase, baseline and internal standard issues, which can be problematic when Fourier transformed data are used, are unimportant when using time domain data. Furthermore, analytes can contain impurities because only a single resonance is examined and need not be UV active. Using this approach, we examined a variety of pharmaceutically relevant compounds and determined partition coefficients that are in excellent agreement with literature values. To demonstrate the utility of this approach, we also examined salicylic acid in more detail demonstrating an aggregation effect as a function of sample loading and partition coefficient behavior as a function of pH value. This method provides a valuable addition to the medicinal chemist toolbox for determining these important constants. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- David Soulsby
- Chemistry Department, University of Redlands, 1200 E. Colton Avenue, Redlands, CA, 92374-3755, USA
| | - Jeryl A M Chica
- Chemistry Department, University of Redlands, 1200 E. Colton Avenue, Redlands, CA, 92374-3755, USA
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22
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Simanshu DK, Nissley DV, McCormick F. RAS Proteins and Their Regulators in Human Disease. Cell 2017. [PMID: 28666118 DOI: 10.1016/j.cell.2017.06.009.ras] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
RAS proteins are binary switches, cycling between ON and OFF states during signal transduction. These switches are normally tightly controlled, but in RAS-related diseases, such as cancer, RASopathies, and many psychiatric disorders, mutations in the RAS genes or their regulators render RAS proteins persistently active. The structural basis of the switch and many of the pathways that RAS controls are well known, but the precise mechanisms by which RAS proteins function are less clear. All RAS biology occurs in membranes: a precise understanding of RAS' interaction with membranes is essential to understand RAS action and to intervene in RAS-driven diseases.
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Affiliation(s)
- Dhirendra K Simanshu
- NCI RAS Initiative, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, MD 21701, USA
| | - Dwight V Nissley
- NCI RAS Initiative, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, MD 21701, USA
| | - Frank McCormick
- NCI RAS Initiative, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, MD 21701, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 1450 3(rd) Street, San Francisco, CA 94158, USA.
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23
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Krishnamurthy K, Sefler AM, Russell DJ. Application of CRAFT in two-dimensional NMR data processing. Magn Reson Chem 2017; 55:224-232. [PMID: 27160956 DOI: 10.1002/mrc.4449] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/08/2016] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
Two-dimensional (2D) data are typically truncated in both dimensions, but invariably and severely so in the indirect dimension. These truncated FIDs and/or interferograms are extensively zero filled, and Fourier transformation of such zero-filled data is always preceded by a rapidly decaying apodization function. Hence, the frequency line width in the spectrum (at least parallel to the evolution dimension) is almost always dominated by the apodization function. Such apodization-driven line broadening in the indirect (t1 ) dimension leads to the lack of clear resolution of cross peaks in the 2D spectrum. Time-domain analysis (i.e. extraction of frequency, amplitudes, line width, and phase parameters directly from the FID, in this case via Bayesian modeling into a tabular format) of NMR data is another approach for spectral resonance characterization and quantification. The recently published complete reduction to amplitude frequency table (CRAFT) technique converts the raw FID data (i.e. time-domain data) into a table of frequencies, amplitudes, decay rate constants, and phases. CRAFT analyses of time-domain data require minimal or no apodization prior to extraction of the four parameters. We used the CRAFT processing approach for the decimation of the interferograms and compared the results from a variety of 2D spectra against conventional processing with and without linear prediction. The results show that use of the CRAFT technique to decimate the t1 interferograms yields much narrower spectral line width of the resonances, circumventing the loss of resolution due to apodization. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | - David J Russell
- Small Molecule Analytical Chemistry and QC, Genentech, South San Francisco, CA, USA
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Kirby KC, Versek B, Kerwin ME, Meyers K, Benishek LA, Bresani E, Washio Y, Arria A, Meyers RJ. Developing Community Reinforcement and Family Training ( CRAFT) for Parents of Treatment-Resistant Adolescents. J Child Adolesc Subst Abuse 2015; 24:155-165. [PMID: 25883523 PMCID: PMC4394369 DOI: 10.1080/1067828x.2013.777379] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however, there are no controlled trials for parents with a substance-abusing child. We examined the behavioral parent training literature to guide us in tailoring CRAFT for parents of adolescents. We discuss adaptations to CRAFT, outcomes and experiences gained from a brief pilot of the revised CRAFT program, and the future directions of this work.
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Affiliation(s)
- Kimberly C. Kirby
- Treatment Research Institute
- University of Pennsylvania School of Medicine
| | | | | | | | - Lois A. Benishek
- Treatment Research Institute
- University of Pennsylvania School of Medicine
| | | | | | - Amelia Arria
- Treatment Research Institute
- University of Maryland
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Meyers RJ, Roozen HG, Smith JE, Evans BE. Reasons for entering treatment reported by initially treatment-resistant patients with substance use disorders. Cogn Behav Ther 2014; 43:299-309. [PMID: 25059561 DOI: 10.1080/16506073.2014.938358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many individuals with substance use disorders are resistant to entering formal treatment, despite the negative consequences that plague their own lives and the lives of concerned significant others (CSOs). Community Reinforcement and Family Training (CRAFT) has been developed as an effective strategy for helping family members who are concerned about the alcohol/drug use of a loved one who refuses to seek treatment. The present study explored reasons and feelings that played a part in these resistant individuals' (identified patients [IPs]) decision to begin treatment. Written statements and feelings of 36 initially treatment-refusing IPs, who were engaged into treatment via their CRAFT-trained CSOs, were examined upon entering treatment. Self-report forms assessed three complementary domains about entering treatment: (1) feelings about coming for treatment, (2) important reasons for entering treatment, and (3) reasons for entering treatment narratives. It was shown that the occurrences of self-reported positive emotions and statements that expressed a positive wish for change outweighed negative feelings and statements. Although conceivably these CRAFT-exposed IPs may have provided different responses than other treatment-seeking populations, the current study's strong IP reports of positive feelings, reasons, and narrative statements regarding treatment entry nonetheless address potential concerns that treatment-refusing IPs might only enter treatment if felt coerced by family members and while experiencing salient negative feelings overall.
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Affiliation(s)
- Robert J Meyers
- a Department of Psychology , University of New Mexico , Albuquerque , NM , USA
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