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Smith AB, Cooley DT, Mesman GR, John SG, Wilburn EH, Vanderzee KL, Pemberton JR. Behavior Management in Young Children Exposed to Trauma: A Case Study of Three Evidence-Based Treatments. J Child Adolesc Trauma 2023; 16:839-852. [PMID: 38045836 PMCID: PMC10689672 DOI: 10.1007/s40653-023-00573-7] [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] [Accepted: 09/13/2023] [Indexed: 12/05/2023]
Abstract
Young children are particularly vulnerable to traumatic events and the development of posttraumatic stress symptoms, including comorbid disruptive behaviors. Fortunately, several evidence-based interventions have been shown to be effective at decreasing both posttraumatic stress symptoms and disruptive behaviors in young children. This paper provides an overview of three such interventions-Child-Parent Psychotherapy (CPP), Parent-Child Interaction Therapy (PCIT), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). An illustrative case study is used to compare how each intervention addresses disruptive behaviors, with a focus on theoretical underpinnings, model similarities, and model differences. The models each have empirical evidence for the treatment of disruptive behavior in young children, and therefore, may be appropriate for treating children with a history of trauma exposure and comorbid disruptive behaviors. Child, caregiver, and environmental factors are essential to consider when identifying an evidence-based intervention for this population.
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Affiliation(s)
- Allison B. Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Daryl T. Cooley
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Glenn R. Mesman
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Sufna G. John
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Elissa H. Wilburn
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Karin L. Vanderzee
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Joy R. Pemberton
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
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Torres-McGehee TM, Uriegas NA, Hauge M, Monsma EV, Emerson DM, Smith AB. Eating Disorder Risk and Pathogenic Behaviors Among Collegiate Student-Athletes. J Athl Train 2023; 58:803-812. [PMID: 37459386 DOI: 10.4085/1062-6050-0539.22] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
CONTEXT Eating disorders (EDs) are a cluster of behavioral conditions characterized by uneasy thoughts and behaviors that grow into severe or persistent eating disturbances. The demands on student-athletes may create mental and physical stressors that increase the likelihood of EDs and disordered eating. OBJECTIVE To examine the ED risk through eating attitudes and behaviors in male and female student-athletes and across various sport types (endurance, aesthetic, power, ball or team, or technical sports). DESIGN Cross-sectional study. SETTING Collegiate athletics. PATIENTS OR OTHER PARTICIPANTS National Collegiate Athletic Association Division I and II student-athletes (n = 2054; males = 631; females = 1423) from 40 institutions. MAIN OUTCOME MEASURE(S) Participants completed a web-based demographic survey and the Eating Attitudes Test-26 (EAT-26). Multiple χ2 analyses examined participants classified as at risk for EDs. Independent-samples t tests and a 1-way analyses of variance compared sex and sport type across EAT-26 totals and subscale (Dieting, Bulimia, and Oral Control) scores. RESULTS Overall, 25.3% (n = 520/2054) of student-athletes were classified as at risk for EDs. Differences were found between sex and ED risk (χ21,2054 = 32.9, P ≤ .01; 17.3% [n = 109/631] males, 28.9% [n = 411/1423] females) and across ED risk and sport type (χ24,2054 = 13.4, P = .01). When examining females only, we observed differences across ED risk and sport type (χ24,1423 = 13.4, P ≤ .01). No differences were evident across ED risk and sport type for males. Differences were seen between sex and binge eating (χ21,2054 = 6.8, P = .009), sex and diet pill use (χ21,2054 = 19.6, P ≤ .01), and sport type and diet pill use (χ24,2054= 12.2, P = .016), excessive exercise (χ24,2054 = 32.1, P ≤ .01), and losing more than 20 lb (9 kg) in the last 6 months (χ24,2054 = 10.2, P ≤ .037). CONCLUSIONS Student-athletes in the collegiate setting are at risk for EDs. Medical professionals, such as athletic trainers, need to be educated on the potential risk factors that may lead to EDs. Protocols for prevention, screening and recognition, and referral should be developed for student-athletes at risk for EDs.
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Torres-McGehee TM, Emerson DM, Flanscha-Jacobson A, Uriegas NA, Moore EM, Smith AB. Energy Availability, Mental Health, and Sleep Patterns of Athletic Trainers. J Athl Train 2023; 58:788-795. [PMID: 36913639 DOI: 10.4085/1062-6050-0547.22] [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] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
CONTEXT Engaging in exercise and appropriate nutritional intake improves mental health by reducing anxiety, depression, and sleep disturbances. However, few researchers have examined energy availability (EA), mental health, and sleep patterns in athletic trainers (ATs). OBJECTIVE To examine ATs' EA, mental health risk (ie, depression, anxiety), and sleep disturbances by sex (male, female), job status (part time [PT AT], full time [FT AT]), and occupational setting (college or university, high school, or nontraditional). DESIGN Cross-sectional study. SETTING Free living in occupational settings. PATIENTS OR OTHER PARTICIPANTS A total of 47 ATs (male PT ATs = 12, male FT ATs = 12; female PT ATs = 11, female FT ATs = 12) in the southeastern United States. MAIN OUTCOME MEASURE(S) Anthropometric measurements consisted of age, height, weight, and body composition. Energy availability was measured through energy intake and exercise energy expenditure. We used surveys to assess the depression risk, anxiety (state or trait) risk, and sleep quality. RESULTS Thirty-nine ATs engaged in exercise, and 8 did not exercise. Overall, 61.5% (n = 24/39) reported low EA (LEA); 14.9% (n = 7/47) displayed a risk for depression; 25.5% (n = 12/47) indicated a high risk for state anxiety; 25.5% (n = 12/47) were at high risk for trait anxiety, and 89.4% (n = 42/47) described sleep disturbances. No differences were found by sex and job status for LEA, depression risk, state or trait anxiety, or sleep disturbances. Those ATs not engaged in exercise had a greater risk for depression (risk ratio [RR] = 1.950), state anxiety (RR = 2.438), trait anxiety (RR = 1.625), and sleep disturbances (RR = 1.147), whereas ATs with LEA had an RR of 0.156 for depression, 0.375 for state anxiety, 0.500 for trait anxiety, and 1.146 for sleep disturbances. CONCLUSIONS Although most ATs engaged in exercise, their dietary intake was inadequate, they were at increased risk for depression and anxiety, and they experienced sleep disturbances. Those who did not exercise were at an increased risk for depression and anxiety. Energy availability, mental health, and sleep affect overall quality of life and can affect ATs' ability to provide optimal health care.
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Looby A, Davies H, Mealing S, Smith AB, Avey B, Laezza A, Crossland A, Lane EF, Ridler M, Cawson M. Time trade-off study to establish utility decrements in individuals with a spinal cord injury who perform intermittent catheterisation. J Med Econ 2023; 26:430-440. [PMID: 36892952 DOI: 10.1080/13696998.2023.2189395] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
AIMS To generate utility decrements for three attributes associated with catheterisation for individuals with a spinal cord injury (SCI): the process of catheterisation, the physical impact of urinary tract infections (UTIs) and worry associated with hospitalisation. MATERIALS AND METHODS Health state vignettes comprising various levels of the three attributes were developed. Two cohorts of respondents, corresponding to people with SCIs and a sample broadly representative of the UK population, were presented with nine vignettes (three vignettes for the mild, moderate and severe health states in addition to a random set of six vignettes). It was assumed no or a nominal decrement was associated with the mild health state. Utility decrements were derived from analysing the data obtained from the online time trade-off (TTO). A proportion of the SCI cohort (n = 57) also completed the EQ-5D-5L questionnaire. RESULTS Utility decrements were generated using statistical models for the general population (n = 358), the SCI population (n = 48) and the two populations combined (merged model, n = 406). Results from the two cohorts showed minimal differences. For the merged model, SCI status was not statistically significant. All interaction terms, excluding SCI and the severe level of the physical attribute, were not statistically significant. Compared to the mild level, the greatest utility decrement calculated was the severe level of the emotional (worry) attribute (0.09, p < 0.001) for the SCI population. A significant decrement of 0.02 (p <0.001) was calculated for the moderate level of the emotional attribute for all models. The mean utility score for those with SCI having completed the EQ-5D-5L was 0.371. LIMITATIONS Modest sample size of respondents from the SCI population (n = 48). CONCLUSIONS Worry associated with hospitalisation had the greatest impact on patients' health-related quality of life (HRQoL). The catheterisation process, such as the lubrication and repositioning of the catheter, also impacted on patients' HRQoL.
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Affiliation(s)
- A Looby
- York Health Economics Consortium
| | - H Davies
- York Health Economics Consortium
| | | | | | - B Avey
- York Health Economics Consortium
| | | | | | - E F Lane
- York Health Economics Consortium
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Smith AB, Kissling M, Capuano AM, Lewis SB, Mooney TA. Aerial hearing thresholds and ecoacoustics of a threatened pursuit-diving seabird, the marbled murrelet Brachyramphus marmoratus. ENDANGER SPECIES RES 2023. [DOI: 10.3354/esr01234] [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: 03/05/2023] Open
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Abstract
OBJECTIVE To review the literature on work-life interfaces in the sport industry, focusing on athletic trainers, coaches, athletes, and other sport personnel. DATA SOURCES Studies were identified using SPORTDiscus, PsychINFO, and Google Scholar. Search terms included work-family balance, work-life balance, work-family conflict, work-life conflict, work-family enrichment, and work-life enrichment. These search terms were used in different combinations and configurations in the search process. STUDY SELECTION Included studies were peer-reviewed journal articles, with primary data collection, and published in English. In the articles, researchers also examined some aspect of the work-family interface in relation to the sport industry. DATA EXTRACTION The initial searches returned 110 articles. Of these, 21 articles were removed for a lack of focus on the sport industry, for being a duplicate, or for focusing outside the work-life interface in sport. A total of 89 articles remained for a full analysis. An additional 20 articles were then removed because the authors either did not collect primary data or focused outside our study purpose. Therefore, 69 articles were included in the review. DATA SYNTHESIS The theoretical framework, study population, population region, methods, article focus, and findings from the articles were recorded. Articles were then grouped based on the study population focus (eg, athletic trainer, coach, or other). CONCLUSIONS The results suggested that investigators' primary interests were athletic trainers and coaches, primarily with respect to work-life balance and work-life conflict. Less attention was paid to international participants, athletes, and topics related to work-life enrichment. The field will continue to progress as more populations and perspectives are studied. Furthermore, an additional emphasis on positive organizational behaviors, such as work-life enrichment and life-work enrichment, will move the literature forward and answer useful questions with both theoretical and practical outcomes.
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Affiliation(s)
- Jeffrey A. Graham
- Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville
| | - Allison B. Smith
- Health, Exercise & Sport Sciences, University of New Mexico, Albuquerque
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Smith AB, Gay JL, Monsma EV, Arent SM, Sarzynski MA, Emerson DM, Torres-McGehee TM. Investigation of Eating Disorder Risk and Body Image Dissatisfaction among Female Competitive Cheerleaders. Int J Environ Res Public Health 2022; 19:ijerph19042196. [PMID: 35206381 PMCID: PMC8872421 DOI: 10.3390/ijerph19042196] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 12/04/2022]
Abstract
Social agents associated with cheerleading environments are increasingly linked to body image dissatisfaction (BID) and eating disorders (ED). This study examined ED risk across team type, squad type, and position. An additional purpose determined BID in clothing type (daily clothing, midriff uniform, and full uniform), and meta-perceptions from the perspective of peers (MP peers), parents (MP parents), and coaches (MP coaches). Female cheerleaders (n = 268) completed an online survey which included demographics, the Eating Attitudes Test-26, and pathogenic behavior questions. Body image perceptions were assessed by using the Sex-Specific Figural Stimuli Silhouettes. Overall, 34.4% of cheerleaders (n = 268; mean age: 17.9 ± 2.7 years) exhibited an ED risk. Compared to All-Star cheerleaders, college cheerleaders demonstrated significant higher ED risk (p = 0.021), dieting subscale scores (p = 0.045), and laxative, diet pill, and diuretic use (p = 0.008). Co-ed teams compared to all-girl teams revealed higher means for the total EAT-26 (p = 0.018) and oral control subscale (p = 0.002). The BID in clothing type revealed that cheerleaders wanted to be the smallest in the midriff option (p < 0.0001, η2 = 0.332). The BID from meta-perception revealed that cheerleaders felt that their coaches wanted them to be the smallest (p < 0.001, η2 = 0.106). Cheerleaders are at risk for EDs and BID at any level. Regarding the midriff uniform, MP from the perspective of coaches showed the greatest difference between perceived and desired body image.
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Affiliation(s)
- Allison B. Smith
- School of Kinesiology, University of Louisiana at Lafayette, Lafayette, LA 70507, USA
- Correspondence:
| | - Jennifer L. Gay
- Department of Health Promotion & Behavior, University of Georgia, Athens, GA 30602, USA;
| | - Eva V. Monsma
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA;
| | - Shawn M. Arent
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| | - Mark A. Sarzynski
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| | - Dawn M. Emerson
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Toni M. Torres-McGehee
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
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Uriegas NA, Hauge M, Smith AB, Monsma EV, Emerson DM, Torres-McGehee TM. Body Image Dissatisfaction And Meta-perceptions Among Collegiate Male And Female Athletes. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762756.24789.c7] [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: 11/21/2022]
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O’Kane D, Davis L, Ardern-Jones M, Laws P, Shaw L, Cork M, Velangi S, Cooper HL, Hudson R, Smith AB, Rout R. Treatment outcomes of patients with Atopic Dermatitis (AD) treated with dupilumab through the Early Access to Medicines Scheme (EAMS) in the UK. Ulster Med J 2021; 90:70-76. [PMID: 34276083 PMCID: PMC8278937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dupilumab, a monoclonal antibody against interleukin (IL)-4 receptor alpha that inhibits IL-4/IL-13 signalling is indicated in dermatology for the treatment of moderate-to-severe atopic dermatitis (AD) in adult and adolescent patients 12 years and older and severe AD in children 6-11 years, who are candidates for systemic therapy. Dupilumab received Early Access to Medicines Scheme (EAMS) approval for adults in March 2017. OBJECTIVES The purpose of this study was to assess the efficacy outcomes of treatment with dupilumab in EAMS. METHODS A retrospective analysis of adult patients enrolled in the dupilumab EAMS in the UK. Scores were assessed at baseline and follow up, including the Eczema Area and Severity Index (EASI), Investigator's Global Assessment Score (IGA) and Dermatology Life Quality Index (DLQI). RESULTS Data were available for 57 adult patients treated with dupilumab for at least 12 weeks; 73.6% of patients had received prior treatment with 3 or 4 immunosuppressants. Baseline scores for the EASI and DLQI were 27.93 (standard deviation, SD 13.09) and 18.26 (SD 6.18) respectively. AD severity scores showed statistically significant improvement at week 16±4 weeks (p <0.001 for all). The mean change in EASI was 14.13 points with 66.7% and 36.7% achieving a 50% (EASI-50) and 75% (EASI-75) improvement in EASI, respectively at 16+/- 4 weeks. IGA scores improved by at least two categories for 75% patients. DLQI scores decreased by a mean of 9.0 points, with 80% patients demonstrating a MCID 4-point improvement. For 85% patients, clinicians rated the treatment response as being either 'better' (19%) or 'much better' (65%). CONCLUSIONS Dupilumab is associated with a significant and clinically relevant improvements in AD as measured by patient- and physician-reported outcome measures. Importantly, the clinical efficacy, despite the refractory disease of this EAMS cohort, is comparable to that previously reported in clinical trials.
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Uriegas NA, Emerson DM, Smith AB, Kelly MR, Torres-McGehee TM. Examination of eating disorder risk among university marching band artists. J Eat Disord 2021; 9:35. [PMID: 33691784 PMCID: PMC7944617 DOI: 10.1186/s40337-021-00388-7] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Marching band artists are a physically active population, composed of approximately 27,000 people in the United States. University marching band artists face many of the same physically active demands and mental stressors as student athletes, potentially predisposing them to injury, illness, and risk for eating disorders (EDs). The purpose of this study was to examine ED risk across sex in university marching band artists, and to determine the type of risk based on the Eating Disorder Inventory-3 (EDI-3) and Eating Disorder Inventory-3 Symptom Check List (EDI-3 SC). A secondary aim examined marching band artists and pathogenic weight control behavior use across sex. METHODS This was a cross-sectional study. A total of 150 marching band artists (female: n = 84, male: n = 66, age = 19.9 ± 1.1 years) from three National Collegiate Athletic Association Division I university marching bands participated in the study. We screened for ED risk using the EDI-3, and the EDI-3 SC. RESULTS Overall, marching band artists were at risk for EDs, using only the EDI-3, 45.3% (n = 68) were at risk, with females at significant higher risk than males [χ2 = 5.228, p = .022]; using only the EDI-3 SC, 54% (n = 81) were at risk and no significant differences were found across sex. Overall, 48% of all participants reported dieting and 20.7% engaged in excessive exercise to control weight. Significant differences were found between sex and purging to control weight [χ2 = 3.94, p = .047] and laxative use [χ2 = 4.064, p = .044], with females engaging in behavior more than males. CONCLUSIONS Eating disorder risk was prevalent for both female and male marching band artists, with females displaying higher risk for EDs than males. Furthermore, marching band artists are engaging in pathogenic behaviors to control their weight. Healthcare providers (e.g., physicians, athletic trainers, physical therapist, dietitians, etc.) working in this setting should be aware of the risk factors displayed in marching band artists, and be able to provide education, prevention, and clinical interventions to this population. Additionally, marching band administrators should be aware of all medical risk factors and the benefit of having a healthcare provider (e.g., athletic trainer) to oversee the healthcare and wellness of marching band artists.
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Affiliation(s)
- Nancy A Uriegas
- University of South Carolina, Blatt PE Center 212, Columbia, SC, 29208, USA
| | - Dawn M Emerson
- University of Kansas, 1301 Sunnyside Avenue, Robinson 161, Lawrence, KS, 66045, USA
| | - Allison B Smith
- University of South Carolina, Blatt PE Center 212, Columbia, SC, 29208, USA
| | - Melani R Kelly
- University of Kansas, 1301 Sunnyside Avenue, Robinson 161, Lawrence, KS, 66045, USA
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Torres-McGehee TM, Emerson DM, Moore EM, Walker SE, Pritchett K, Smith AB, Lyles TA, Wakefield G, Ohlemeyer K. Energy Balance, Eating Disorder Risk, and Pathogenic Behaviors Among Athletic Trainers. J Athl Train 2021; 56:461579. [PMID: 33600576 PMCID: PMC8010935 DOI: 10.4085/1062-6050-0228-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
CONTEXT Research exists on energy balances (EBs) and eating disorder (ED) risks in physically active populations and occupations by settings, but the EB and ED risk in athletic trainers (ATs) have not been investigated. OBJECTIVE To assess ATs' energy needs, including the macronutrient profile, and examine ED risk and pathogenic behavioral differences between sexes (men, women) and job statuses (part time or full time) and among settings (college or university, high school, nontraditional). DESIGN Cross-sectional study. SETTING Free-living in job settings. PATIENTS OR OTHER PARTICIPANTS Athletic trainers (n = 46; male part-time graduate assistant ATs = 12, male full-time ATs = 11, female part-time graduate assistant ATs = 11, female full-time ATs = 12) in the southeastern United States. MAIN OUTCOME MEASURE(S) Anthropometric measures (sex, age, height, weight, body composition), demographic characteristics (job status [full- or part-time AT], job setting [college/university, high school, nontraditional], years of AT experience, exercise background, alcohol use), resting metabolic rate, energy intake (EI), total daily energy expenditure (TDEE), exercise energy expenditure, EB, macronutrients (carbohydrates, protein, fats), the Eating Disorder Inventory-3, and the Eating Disorder Inventory-3 Symptom Checklist. RESULTS The majority of participants (84.8%, n = 39) had an ED risk, with 26.1% (n = 12) engaging in at least 1 pathogenic behavior, 50% (n = 23) in 2 pathogenic behaviors, and 10.8% (n = 5) in >2 pathogenic behaviors. Also, 82.6% of ATs (n = 38) presented in negative EB (EI < TDEE). Differences were found in resting metabolic rate for sex and job status (F1,45 = 16.48, P = .001), EI (F1,45 = 12.01, P = .001), TDEE (F1,45 = 40.36, P < .001), and exercise energy expenditure (F1,38 = 5.353, P = .026). No differences were present in EB for sex and job status (F1,45 = 1.751, P = .193); χ2 analysis revealed no significant relationship between ATs' sex and EB ({\rm{\chi }}_{1,46}^2= 0.0, P = 1.00) and job status and EB ({\rm{\chi }}_{1,46}^2 = 2.42, P = .120). No significant relationship existed between Daily Reference Intakes recommendations for all macronutrients and sex or job status. CONCLUSIONS These athletic trainers experienced negative EB, similar to other professionals in high-demand occupations. Regardless of sex or job status, ATs had a high ED risk and participated in unhealthy pathogenic behaviors. The physical and mental concerns associated with these findings indicate a need for interventions targeted at ATs' health behaviors.
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Affiliation(s)
| | - Dawn M. Emerson
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence
| | - Erin M. Moore
- Department of Orthopedics and Sports Medicine, University of South Florida, Tampa
| | | | - Kelly Pritchett
- Department of Health Sciences, Central Washington University, Ellensburg
| | - Allison B. Smith
- Department of Exercise Science, University of South Carolina, Columbia
| | - Taylor A. Lyles
- Department of Exercise Science, University of South Carolina, Columbia
| | - Greg Wakefield
- Department of Exercise Science, University of South Carolina, Columbia
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Torres-McGehee TM, Emerson DM, Pritchett K, Moore EM, Smith AB, Uriegas NA. Energy Availability with or without Eating Disorder Risk in Collegiate Female Athletes and Performing Artists. J Athl Train 2020; 56:993-1002. [PMID: 33351913 PMCID: PMC8448477 DOI: 10.4085/jat0502-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Female athletes/performing artists can present with low energy availability (LEA) either through unintentional (e.g., inadvertent undereating) or intentional methods (e.g., eating disorder [ED]). While LEA and ED risk have been examined independently, little research has examined these simultaneously. Awareness of LEA with or without ED risk may provide clinicians with innovative prevention and intervention strategies. OBJECTIVE To examine LEA with or without ED risk (e.g., eating attitudes, pathogenic behaviors) in female collegiate athletes/performing artists. DESIGN Cross-sectional and descriptive. SETTING Free-living in sport-specific settings. PARTICIPANTS Collegiate female athletes/performing artist (n=121; age: 19.8±2.0 years; height: 168.9±7.7 cm; weight: 63.6±9.26 kg) in equestrian (n=28), volleyball (n=12), softball (n=17), beach volleyball (n=18), ballet (n=26) and soccer (n=20) participated in this study. MAIN OUTCOME MEASURES Anthropometric measurements (height, weight, body composition), resting metabolic rate, energy intake, total daily energy expenditure, exercise energy expenditure, Eating Disorder Inventory-3 (EDI-3), and EDI-3 Symptom Checklist were assessed. Chi-square analysis examined differences between LEA and sport type, LEA and ED risk, ED risk and sport type, and pathogenic behaviors and sport type. RESULTS Female athletes/performing artists (81%; n=98) displayed LEA and significant differences were found between LEA and sport type (χ25=43.8, P<.01). Female athletes/performing artists (76.0%; n=92) presented with ED risk with no significant difference between ED risk and sport. EDI-3 Symptom Checklist revealed 61.2% (n=74) engaged in pathogenic behaviors, with dieting the most common (51.2%; n=62). Athletes/performing artist displayed LEA with ED risk (76.0%; n=92). No significant differences were found between LEA with ED risk and sport. Softball was the highest with 82.4% (n=14) reporting LEA with ED risk followed by ballet (76%; n=19). CONCLUSION Our results suggest a large proportion of collegiate female athletes/performing artists are at risk for LEA with ED risk, thus warranting education, identification, prevention, and intervention strategies relative to fueling for performance.
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Affiliation(s)
| | | | - Kelly Pritchett
- Central Washington University, , Twitter Handle: @KPritchettRD
| | - Erin M Moore
- University of South Florida, , Twitter Handle: @ErinMMoore2
| | - Allison B Smith
- University of South Carolina, , Twitter Handle: @ally_smith6
| | - Nancy A Uriegas
- University of South Carolina, , Twitter Handle: @Nancy_Uriegas
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Torres-McGehee TM, Emerson DM, Moore EM, Walker S, Pritchett K, Smith AB, Lyles TA, Wakefield G, Ohlemeyer K. Examination of Energy Balance, Eating Disorder Risk, and Pathogenic Behaviors among Athletic Trainers. J Athl Train 2020:446987. [PMID: 33150446 DOI: 10.4085/228-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Research exists on energy balance (EB) and eating disorder (ED) risk in physically active populations and occupations by settings, but EB and ED in athletic trainers (ATs) has not been investigated. OBJECTIVE To assess ATs' energy needs, including macronutrient profile, and to examine ED risk and pathogenic behavior between sex (males, females), job status (part-time=PT-AT; full-time=FT-AT) and setting (college/university, high school, non-traditional). DESIGN Cross-sectional and descriptive. SETTING Free-living in job settings. PARTICIPANT ATs (n=46; males PT-AT n=12, males FT-AT n=11; females PT-AT n=11, female FT-AT n=12) in Southeastern United States. MAIN OUTCOME MEASURES Anthropometric measurements (age, height, weight, body composition), resting metabolic rate (RMR), energy intake (EI), total daily energy expenditure (TDEE), exercise energy expenditure (EEE), EB, macronutrients (carbohydrates, protein, fats), Eating Disorder Inventory-3, and the Eating Disorder Inventory-3 Symptom Checklist. RESULTS Majority (84.8%, n=39) had ED risk, with 26.1% (n=12) engaging in at least 1 pathogenic behavior, 50% (n=23) in 2 pathogenic behaviors, and 10.8% (n=5) in more than 2 pathogenic behaviors. 82.6% of ATs (n=38) presented in negative EB (EI CONCLUSIONS Athletic trainers experience negative EB, similar to other high-demand occupational professions. Regardless of sex or job status, ATs have a high ED risk and participate in unhealthy pathogenic behaviors. The physical and mental concerns associated with these findings indicates a need for interventions targeted toward ATs' health behaviors.
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Affiliation(s)
| | | | - Erin M Moore
- University of South Florida, , Twitter Handle: @ErinMMoore2
| | - Stacy Walker
- Ball State University, , Twitter Handle: @sewalkerAT
| | - Kelly Pritchett
- Central Washington University, , Twitter Handle: @KPritchettRD
| | - Allison B Smith
- University of South Carolina, , Twitter Handle: @ally_smith6
| | | | - Greg Wakefield
- University of South Carolina, , Twitter Handle: @gwake15
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Breyton M, Smith AB, Rouquette A, Mancini J. Cancer information overload and multiple prevention behaviors. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Many people feel overwhelmed by the increasing amount of cancer-related material available in the information environment. Our aims was to evaluate the psychometric properties of the brief version of the cancer information overload (CIO) scale and to examine the association between CIO and multiple cancer prevention behaviors.
Methods
A large survey using a self-administered online questionnaire was proposed to all adult members of the Seintinelles, a French national non-profit organization. The psychometric properties of the CIO scale were evaluated. Measurement invariance across French and English languages was studied using an additional sample of 224 Australian cancer survivors from Register4. We also collected functional, communicative, and critical health literacy (FCCHL), deprivation (EPICES index), current smoking, alcohol misuse, frequent sunburns, and rare skin self-examination.
Results
Between June 16th and 30th 2016, 2 363 French participants answered the online questionnaire. The five-item CIO scale demonstrated the best balance between psychometric properties and number of items. It showed satisfactory internal consistency and adequate fit. No measurement invariance issue was found across age, gender, education level, and language groups.
CIO was increased among people with higher deprivation, lower education and a cancer information avoidant profile. In multivariate analyses, CIO was associated with tobacco use (OR = 1.05, 95%CI [1.00-1.10]), rare skin checks (OR = 1.05 [1.01-1.08]) and frequent sunburns (OR = 1.04 [1.01-1.07]), but not with alcohol misuse.
Conclusions
The 5-item CIO scale is ready to be used in French and English-speaking countries. The links observed between CIO and multiple prevention behaviors encourage further research in order to better characterize the psycho-cognitive and environmental phenomena at play. Efforts are needed to communicate adequately and empower citizens to limit the growing burden of cancer.
Key messages
The 5-item CIO scale is ready to be used in French and English-speaking countries. Efforts are needed to communicate adequately and empower citizens to limit the growing burden of cancer.
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Affiliation(s)
- M Breyton
- SESSTIM, Aix-Marseille Univ, Inserm, IRD, Marseille, France
- Public Health Department, APHM, Marseille, France
| | - A B Smith
- CONCERT, UNSW, Liverpool, Australia
- PoCoG, University of Sydney, Sydney, Australia
| | - A Rouquette
- Public Health and Epidemiology Department, AP-HP, Le Kremlin-Bicêtre, France
- CESP, INSERM, Univ Paris-Saclay, Univ Paris-Sud, Villejuif, France
| | - J Mancini
- SESSTIM, Aix-Marseille Univ, Inserm, IRD, Marseille, France
- Public Health Department, APHM, Marseille, France
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15
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Dopp AR, Narcisse MR, Mundey P, Silovsky JF, Smith AB, Mandell D, Funderburk BW, Powell BJ, Schmidt S, Edwards D, Luke D, Mendel P. A scoping review of strategies for financing the implementation of evidence-based practices in behavioral health systems: State of the literature and future directions. Implementation Research and Practice 2020; 1:2633489520939980. [PMID: 37089129 PMCID: PMC9924261 DOI: 10.1177/2633489520939980] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Increased availability of evidence-based practices (EBPs) is essential to alleviating the negative public health and societal effects of behavioral health problems. A major challenge to implementing and sustaining EBPs broadly is the limited and fragmented nature of available funding. Method: We conducted a scoping review that assessed the current state of evidence on EBP financing strategies for behavioral health based on recent literature (i.e., post-Affordable Care Act). We defined financing strategies as techniques that secure and direct financial resources to support EBP implementation. This article introduces a conceptualization of financing strategies and then presents a compilation of identified strategies, following established reporting guidelines for the implementation strategies. We also describe the reported level of use for each financing strategy in the research literature. Results: Of 23 financing strategies, 13 were reported as being used within behavioral health services, 4 had potential for use, 5 had conceptual use only, and 1 was potentially contraindicated. Examples of strategies reported being used include increased fee-for-service reimbursement, grants, cost sharing, and pay-for-success contracts. No strategies had been evaluated in ways that allowed for strong conclusions about their impact on EBP implementation outcomes. Conclusion: The existing literature on EBP financing strategies in behavioral health raises far more questions than answers. Therefore, we propose a research agenda that will help better understand these financing strategies. We also discuss the implications of our findings for behavioral health professionals, system leaders, and policymakers who want to develop robust, sustainable financing for EBP implementation in behavioral health systems. Plain language abstract: Organizations that treat behavioral health problems (mental health and substance use) often seek to adopt and use evidence-based practices (EBPs). A challenge to adopting EBPs broadly is the limited funding available, often from various sources that are poorly coordinated with one another. To help organizations plan effectively to adopt EBPs, we conducted a review of recent evidence (i.e., since the passage of the 2010 Affordable Care Act) on strategies for financing EBP adoption in behavioral health systems. We present definitions of 23 identified strategies and describe each strategy’s reported (in the research literature) level of use to fund EBP adoption in behavioral health services. Of the 23 financing strategies, 13 strategies had evidence of use, 4 had potential for use, 5 had conceptual use only, and 1 was potentially contraindicated. Examples of strategies with evidence of use include increased fee-for-service reimbursement, grants, cost sharing, and pay-for-success contracts. This comprehensive list of EBP financing strategies may help guide decision-making by behavioral health professionals, system leaders, and policymakers. The article also presents a research agenda for building on the current research literature by (1) advancing methods to evaluate financing strategies’ effects, (2) partnering with stakeholders and decision-makers to examine promising financing strategies, (3) focusing on strategies and service systems with the greatest needs, (4) improving methods to guide the selection of financing strategies, and (5) paying greater attention to sustainable long-term financing of EBPs.
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Affiliation(s)
- Alex R Dopp
- Department of Behavioral and Policy Sciences, RAND Corporation, Santa Monica, CA, USA
| | - Marie-Rachelle Narcisse
- Department of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Peter Mundey
- Department of Social and Behavioral Sciences, Savannah State University, Savannah, GA, USA
| | - Jane F Silovsky
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Allison B Smith
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - David Mandell
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Beverly W Funderburk
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Byron J Powell
- Brown School, Washington University in St. Louis, Saint Louis, MO, USA
| | - Susan Schmidt
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Douglas Luke
- Brown School, Washington University in St. Louis, Saint Louis, MO, USA
| | - Peter Mendel
- Department of Economics, Sociology, and Statistics, RAND Corporation, Santa Monica, CA, USA
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Uriegas NA, Torres-McGehee TM, Smith AB, Moore EM. Examination Of Pathogenic Behaviors And Weight Perceptions Among Female Collegiate Athletes And Dancers. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678992.77785.5d] [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: 11/21/2022]
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Torres-McGehee TM, Emerson DM, Weber SR, Uriegas N, Smith AB, Hirschhorn R, Yeargin S, Cannon C. Examination Of Energy Availability And Hydration Status Among University Marching Band Artists. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000680812.92236.77] [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: 11/21/2022]
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18
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Smith AB, Torres-McGehee T, Uriegas N, Cannon C, Emerson D. Examination Of Nutritional Intake Among University Marching Band Artists. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000683424.01270.94] [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: 11/21/2022]
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McKeen SA, Torres-McGehee TM, Emerson DM, Pritchett K, Smith AB, Minori M. Examination Of Low Energy Availability (LEA) And Macronutrient Intake Among Beach Volleyball Players. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000680800.70110.94] [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: 11/21/2022]
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20
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Evans ME, Lester CD, Smith AJ, Smith AB. Dos and don'ts of writing for Br J Oral Maxillofac Surg. Br J Oral Maxillofac Surg 2020; 58:383-384. [PMID: 32139145 DOI: 10.1016/j.bjoms.2020.02.016] [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: 10/24/2022]
Affiliation(s)
- M E Evans
- British Journal of Oral and Maxillofacial Surgery, c/o Elsevier Ltd..
| | - C D Lester
- British Journal of Oral and Maxillofacial Surgery, c/o Elsevier Ltd
| | - A J Smith
- British Journal of Oral and Maxillofacial Surgery, c/o Elsevier Ltd
| | - A B Smith
- British Journal of Oral and Maxillofacial Surgery, c/o Elsevier Ltd
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21
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Smith AB, Baldo AP, Tardiff JC, Schwartz SD. Classification of Genetic Cardiac Mutations Using Computational Chemistry. Biophys J 2020. [DOI: 10.1016/j.bpj.2019.11.2398] [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: 11/25/2022] Open
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22
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Sharpe L, Turner J, Fardell JE, Thewes B, Smith AB, Gilchrist J, Beith J, Girgis A, Tesson S, Day S, Grunewald K, Butow P. Psychological intervention (ConquerFear) for treating fear of cancer recurrence: mediators and moderators of treatment efficacy. J Cancer Surviv 2019; 13:695-702. [PMID: 31347010 DOI: 10.1007/s11764-019-00788-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 07/01/2018] [Accepted: 07/05/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE ConquerFear is an efficacious intervention for fear of cancer recurrence (FCR) that demonstrated greater improvements than an attention control (relaxation training) in a randomized controlled trial. This study aimed to determine mediators and moderators of the relative treatment efficacy of ConquerFear versus relaxation. METHODS One hundred and fifty-two cancer survivors completed 5 therapy sessions and outcome measures before and after intervention and at 6 months' follow-up. We examined theoretically relevant variables as potential mediators and moderators of treatment outcome. We hypothesized that metacognitions and intrusions would moderate and mediate the relationship between treatment group and FCR level at follow-up. RESULTS Only total FCR score at baseline moderated treatment outcome. Participants with higher levels of FCR benefited more from ConquerFear relative to relaxation on the primary outcome. Changes in metacognitions and intrusive thoughts about cancer during treatment partially mediated the relationship between treatment group and FCR. CONCLUSIONS These results show that ConquerFear is relatively more effective than relaxation for those with overall higher levels of FCR. The mediation analyses confirmed that the most likely mechanism of treatment efficacy was the reduction in unhelpful metacognitions and intrusive thoughts during treatment, consistent with the theoretical framework underpinning ConquerFear. IMPLICATIONS FOR CANCER SURVIVORS ConquerFear is a brief, effective treatment for FCR in cancer survivors with early-stage disease. The treatment works by reducing intrusive thoughts about cancer and changing beliefs about worry and is particularly helpful for people with moderate to severe FCR.
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Affiliation(s)
- Louise Sharpe
- School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.
| | - J Turner
- Mental Health Centre, Faculty of Medicine, University of Queensland, Saint Lucia, Australia
| | - J E Fardell
- Kids Cancer Centre, Sydney Children's Hospital and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Saint Lucia, Australia
| | - B Thewes
- School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.,Department Medical Psychology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - A B Smith
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - J Gilchrist
- Crown Princess Mary Cancer Centre, Breast Cancer Institute, Westmead Hospital, Westmead, Australia
| | - J Beith
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Camperdown, Australia.,Department of Medical Oncology, Chris O'Brien Lifehouse, Missenden Rd., Camperdown, Australia
| | - A Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - S Tesson
- School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia
| | - S Day
- School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia
| | - K Grunewald
- School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia
| | - P Butow
- School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.,Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Camperdown, Australia
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Torres-McGehee TM, Strayer SM, Moore EM, Williams A, Hardin J, Weber SR, Smith AB, Goins JM. Effect of Low Ph Magnesium-sulfate Foam on Night Leg Cramps: A Double-blind Randomized Trial. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561370.56950.a9] [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: 11/21/2022]
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24
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McKeen SA, Torres-McGehee TM, Moore EM, Emerson DM, Pritchett K, Smith AB. Examination of Low Energy Availability and Macronutrient Intake among Male and Female Recreational Athletes. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561389.33186.bb] [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: 11/21/2022]
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Larson MM, Torres-McGehee TM, Moore EM, Pritchett K, Smith AB. Examination of Low Energy Availability and Macronutrient Intake among Female Collegiate Athletes. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561390.15261.8e] [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: 11/21/2022]
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27
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Pruchnik NC, Torres-McGehee TM, Smith AB, Weber SR, Monsma E. Prevalence of Low Self-esteem and Weight Pressures among Collegiate Male Athletes. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560838.84898.9f] [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: 11/21/2022]
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Ohlemeyer K, Morris S, Zamora H, Smith AB, Emerson DM, Torres-McGehee TM. Effects of Deep Oscillation Therapy on Symptoms Associated with Eccentric Exercise-Induced Delayed Onset Muscle Soreness. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562957.72624.de] [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: 11/21/2022]
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Smith AB, Torres-McGehee TM, Weber SR, Emerson DM, Pritchett K. Examination of Eating Disorder Risk among Female College Athletes and Performers. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560825.85860.09] [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: 11/21/2022]
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30
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Smith AB, Baldo A, Braz N, Schwartz SD. Molecular Dynamics Studies of Single Point Mutations in the Cardiac Thin Filament. Biophys J 2019. [DOI: 10.1016/j.bpj.2018.11.1432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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31
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Mitchell DA, Kanatas A, Murphy C, Chengot P, Smith AB, Ong TK. Margins and survival in oral cancer. Br J Oral Maxillofac Surg 2018; 56:820-829. [PMID: 30220612 DOI: 10.1016/j.bjoms.2018.06.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 12/05/2017] [Accepted: 06/14/2018] [Indexed: 11/25/2022]
Abstract
In the surgical management of oral squamous cell carcinoma (SCC) we aim to resect the tumour with clear margins in all planes. The aim of this study was to identify and compare overall survival in a group of 591 patients who had resections, and to relate this to the clearance of margins at the tumour bed. We used life tables to calculate survival at one, two, three, five, and 10 years after diagnosis by margin (clear=5mm or more; close=2-5mm; and involved=less than 2mm). Kaplan-Meier curves were produced for the margins alone, which were defined as clear in 480 patients (81%), close in 63 (11%), and involved in 48 (8%). Five-year survival was 81%, 75%, and 54% for clear, close, and involved margins, respectively, which highlights the importance of clear margins for survival. There is a significant prognostic implication associated with close, and particularly with involved, margins.
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Affiliation(s)
- D A Mitchell
- Oral, Maxillofacial/Head & Neck Surgeon, Leeds South and East Clinical Commissioning Group.
| | | | | | - P Chengot
- Oral and Maxillofacial Pathologist, Leeds Teaching Hospitals and St James Institute of Oncology.
| | - A B Smith
- York Health Economics Consortium, University of York.
| | - T K Ong
- Oral and Maxillofacial Surgeon/Head and Neck Surgeon, Leeds Teaching Hospitals.
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Affiliation(s)
- A B Smith
- University of York, Heslington, York YO10 5NQ, UK.
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Dopp AR, Coen AS, Smith AB, Reno J, Bernstein DH, Kerns SEU, Altschul D. Economic Impact of the Statewide Implementation of an Evidence-Based Treatment: Multisystemic Therapy in New Mexico. Behav Ther 2018; 49:551-566. [PMID: 29937257 DOI: 10.1016/j.beth.2017.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 06/01/2017] [Revised: 12/06/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
Several states have made considerable investments into large-scale implementation of evidence-based treatments (EBTs), yet little is known about key success indicators for these implementation efforts such as cost and sustainability. To that end, the present study examined the economic impact of statewide implementation of multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cuningham, 2009), a family- and community-based behavioral EBT for serious juvenile offenders in New Mexico. Participants were 1,869 youth who received MST across 23 teams during the study period. We conducted a cost-benefit analysis using metrics from state data sources that compared the cost of MST to its benefits (i.e., avoided expenses from pre- to posttreatment) in two domains: (a) behavioral health services (i.e., Medicaid claims) and (b) juvenile crime (i.e., taxpayer expenses, tangible and intangible expenses to crime victims). MST costs were based on Medicaid claims, which were reimbursed at an enhanced billing rate that was intended to cover expenses for both clinical and implementation (e.g., training, quality assurance) activities. Results suggest that implementation of MST in New Mexico over the 7-year study period may have produced net benefits, through 2 years posttreatment, of more than $4,643 per youth in avoided behavioral health claims and $15,019 per youth through reductions in juvenile crime. Stated differently, every dollar that New Mexico spent on MST appeared to have returned $3.34 for a total benefit of $64.2 million over the course of the study. We discuss implications of these findings for policymakers, administrators, and researchers who are interested in increasing the sustainability of complex EBTs in community settings.
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Dopp AR, Smith AB, Dueweke AR, Bridges AJ. Cost-savings analysis of primary care behavioral health in a pediatric setting: Implications for provider agencies and training programs. Clinical Practice in Pediatric Psychology 2018. [DOI: 10.1037/cpp0000231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Verrill M, Wardley A, Retzler J, Smith AB, McNicol D, Dando S, Tran I, Leslie I, Schmid P. Abstract P6-12-14: Quality of life and ability to work in patients at different disease stages of HER2+ breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-12-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVES: Health-related quality of life (HRQoL) and ability to work in patients treated for HER2+ early breast cancer (EBC) are poorly understood. This study compared HRQoL and ability to work in 3 HER2+ patient cohorts: EBC during adjuvant treatment, EBC after treatment, and metastatic disease (MBC).
METHODS: A cross-sectional observational cohort study of 299 female consenting patients with HER2+BC, from 14 UK secondary care centres. Group1 (n=89): receiving targeted HER2 therapy±chemotherapy for EBC; Group2 (n=108): in follow up post-targeted treatment for eBC; Group3 (n=102): MBC on treatment. Data collected between Dec 2016-Mar 2017: HRQoL, demographic and employment status data collected via patient-reported questionnaires (including EQ-5D-5L and Functional Assessment of Cancer Therapy [FACT-B]); clinical data collected from medical records. Inter-group differences were assessed using univariate Analysis of variance (ANOVA) and chi-square tests as appropriate. [NCT03099200].
RESULTS: Table1 shows patient demographics, disease characteristics, employment status, and EQ-5D-5L scores. Group1 and Group2 patients did not differ in overall health utility or visual analogue scale (VAS) scores. However, Group3 patients reported significantly poorer health utility than Group1 (p<0.02) and Group2 (p<0.001), and significantly worse VAS scores than Group2 (p<0.001). Significantly fewer Group2 patients and more Group3 patients were unable to work (p<0.003), and fewer Group3 patients were employed than expected (by chi-square, p<0.003).
CONCLUSIONS: HRQoL in patients with EBC was similar whether on or off treatment, and better than those with MBC. HRQoL scores reported on the generic EQ-5D will be compared with those from the disease-specific FACT-B. A smaller proportion of patients with MBC were employed compared to the EBC groups, reflecting the impact of advanced disease. Fewer patients with EBC reported being unable to work than we expected, suggesting these patients maintain function.
Table1
Group1 (n=89)Group2 (n=108)Group3 (n=102)Age (years)↑55 (11)58 (11)55 (11)Hormone receptor status¥Positive64 (72%)84 (78%)74 (73%)Negative25 (28%)24 (22%)26 (26%)Unknown0 (0%)0 (0%)2 (2%)Time since diagnosis (months)+EBC9 (6)45 (32) (n=103)80 (82) (n=71*)MBC--39 (36) (n=101)Employment status¥Employed45 (51%)55 (51%)28 (28%)§Not employed41 (46%)52 (48%)69 (68%)Retired22 (25%)39 (36%)33 (32%)Unable to work7 (8%)5 (5%)§27 (27%)§Other12 (14%)8 (7%)9 (9%)Unknown3 (3%)1 (1%)5 (5%)EQ-5D summary scoresVisual analogue scale72.7 (18.4)†77.0 (17.5)†65.8 (22.9)† (n=99)Utility value0.809 (0.170)† (n=86)0.818 (0.181)†0.695 (0.262)† (n=97)↑mean (standard deviation); ¥n (%); +median (interquartile range); *excludes 27/102 patients (27%) with de novo MBC. Bold text: observed differences between three groups at significance thresholds of ‡p<0.05, §p<0.003 or †p<0.001. EBC/MBC: early/metastatic breast cancer. %s have been rounded so may not total 100%
Citation Format: Verrill M, Wardley A, Retzler J, Smith AB, McNicol D, Dando S, Tran I, Leslie I, Schmid P. Quality of life and ability to work in patients at different disease stages of HER2+ breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-14.
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Affiliation(s)
- M Verrill
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - A Wardley
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - J Retzler
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - AB Smith
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - D McNicol
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - S Dando
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - I Tran
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - I Leslie
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
| | - P Schmid
- The Newcastle Upon Tyne Hospitals NHS Foundation, Newcastle, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; York Health Economics Consortium, York, United Kingdom; pH Associates Ltd (an Open Health Company), Marlow, United Kingdom; Roche Products Ltd, Welwyn Garden City, United Kingdom; Queen Mary University of London, London, United Kingdom
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36
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Affiliation(s)
- A B Smith
- York Health Economics Consortium, Ltd., Enterprise House, Innovation Way, University of York, York YO10 5NQ, United Kingdom.
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37
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Heiniger LE, Smith AB, Olver I, Grimison P, Klein B, Wootten A, Abbott JAM, Price MA, McJannett M, Tran B, Stockler MR, Gurney H, Butow PN. e-TC: Development and pilot testing of a web-based intervention to reduce anxiety and depression in survivors of testicular cancer. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28544085 DOI: 10.1111/ecc.12698] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2017] [Indexed: 01/27/2023]
Abstract
e-TC is an online intervention designed to address common psychosocial concerns of testicular cancer survivors. It aims to reduce anxiety, depression and fear of cancer recurrence by providing evidence-based information and psychological intervention. This paper details the development and pilot testing of e-TC. During pilot testing, 25 men (with varying psychological profiles) who had completed treatment for testicular cancer, 6 months to 5 years ago (which had not recurred), used e-TC over a 10-week period and provided quantitative and qualitative feedback on the feasibility and acceptability of the programme. Six men also completed a qualitative interview to provide detailed feedback on their experiences using e-TC. Fourteen men (56%) completed at least 80% of the programme. Participants reported a high level of satisfaction with the programme. Men's limited time was a barrier to programme use and completion, and participants suggested that men with a more recent diagnosis and a higher level of distress may be more likely to engage with the programme. e-TC appears to be a feasible and acceptable online intervention for survivors of testicular cancer. Findings from this study are currently being used to refine e-TC and guide the design of a larger efficacy study.
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Affiliation(s)
- L E Heiniger
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - A B Smith
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Centre for Oncology Education and Research Translation (CONCERT), The Ingham Institute for Applied Medical Research & University of New South Wales, Liverpool, NSW, Australia
| | - I Olver
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Cancer Council Australia, Sydney, NSW, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - P Grimison
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Chris O'Brien Lifehouse, Sydney, NSW, Australia
| | - B Klein
- Centre for Biopsychosocial and eHealth Research and Innovation, Federation University, Ballarat, Vic., Australia.,National Institute for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - A Wootten
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Epworth Prostate Centre, Epworth, Vic., Australia
| | - J-A M Abbott
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Vic., Australia
| | - M A Price
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - M McJannett
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - B Tran
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - M R Stockler
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Concord Hospital, Concord, NSW, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
| | - H Gurney
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia.,Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - P N Butow
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Hoole J, Kanatas A, Calvert A, Rogers SN, Smith AB, Mitchell DA. Validated questionnaires on intimacy in patients who have had cancer. Br J Oral Maxillofac Surg 2015; 53:584-93. [PMID: 26037739 DOI: 10.1016/j.bjoms.2015.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 10/30/2014] [Accepted: 05/04/2015] [Indexed: 11/29/2022]
Abstract
Problems with intimacy in patients with cancer of the head and neck may not be recognised. Our aim was to review published papers on patient-reported outcomes that record concerns about intimacy, sex, and function, to help develop a tool for use in head and neck cancer. We specifically looked for instruments with evidence of validation in patients with cancer, which could be used to identify problems with intimacy and sexuality. After evaluating 2563 papers, we identified 20 that satisfied our inclusion criteria, and these have been presented in a tabulated form. This review has shown the need to develop a questionnaire on intimacy that is specific to patients with cancer of the head and neck. It is an important issue that must be addressed by clinical and research teams, and will be done most effectively if it is linked to specific interventions.
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Affiliation(s)
- J Hoole
- Lead Cancer Nurse and Psychosexual Therapist, Calderdale and Huddersfield NHS Foundation Trust.
| | - A Kanatas
- Consultant Head and Neck Surgeon / Senior Lecturer, Leeds Teaching Hospitals and St James Institute of Oncology.
| | - A Calvert
- DFY2 in oral and maxillofacial surgery, Leeds Teaching Hospitals, Leeds General Infirmary, LS1 3EX.
| | - S N Rogers
- Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK.
| | - A B Smith
- York Health Economics Consortium Ltd, Level 2 Market Square, University of York, York, YO10 5NH, United Kingdom.
| | - D A Mitchell
- Consultant Oral/Maxillofacial & Head & Neck Surgeon, Bradford Teaching Hospitals NHS Foundation Trust.
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39
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Smith AB, Taylor M, Cocks K, Parry D. A Reliability Generalisation of the Eortc Qlq-Br23. Value Health 2014; 17:A571. [PMID: 27201905 DOI: 10.1016/j.jval.2014.08.1912] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - M Taylor
- York Health Economics Consortium, York, UK
| | - K Cocks
- University of York, York, UK
| | - D Parry
- AstraZeneca UK, Macclesfield, UK
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40
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Smith AB. Differential Item Functioning and the Eq-5d: Evidence From the Uk Hospital Episode Statistics. Value Health 2014; 17:A514. [PMID: 27201591 DOI: 10.1016/j.jval.2014.08.1588] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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41
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Juraskova I, Butow P, Bonner C, Bell ML, Smith AB, Seccombe M, Boyle F, Reaby L, Cuzick J, Forbes JF. Improving decision making about clinical trial participation - a randomised controlled trial of a decision aid for women considering participation in the IBIS-II breast cancer prevention trial. Br J Cancer 2014; 111:1-7. [PMID: 24892447 PMCID: PMC4090720 DOI: 10.1038/bjc.2014.144] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 11/24/2013] [Revised: 02/11/2013] [Accepted: 02/24/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Decision aids may improve informed consent in clinical trial recruitment, but have not been evaluated in this context. This study investigated whether decision aids (DAs) can reduce decisional difficulties among women considering participation in the International Breast Cancer Intervention Study-II (IBIS-II) trial. METHODS The IBIS-II trial investigated breast cancer prevention with anastrazole in two cohorts: women with increased risk (Prevention), and women treated for ductal carcinoma in situ (DCIS). Australia, New Zealand and United Kingdom participants were randomised to receive a DA (DA group) or standard trial consent materials (control group). Questionnaires were completed after deciding about participation in IBIS-II (post decision) and 3 months later (follow-up). RESULTS Data from 112 Prevention and 34 DCIS participants were analysed post decision (73 DA; 73 control); 95 Prevention and 24 DCIS participants were analysed at follow-up (58 DA; 61 control). There was no effect on the primary outcome of decisional conflict. The DCIS-DA group had higher knowledge post decision, and the Prevention-DA group had lower decisional regret at follow-up. CONCLUSIONS This was the first study to evaluate a DA in the clinical trial setting. The results suggest DAs can potentially increase knowledge and reduce decisional regret about clinical trial participation.
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Affiliation(s)
- I Juraskova
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia
| | - P Butow
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia
| | - C Bonner
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia
| | - M L Bell
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia
| | - A B Smith
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia
| | - M Seccombe
- Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia
| | - F Boyle
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia
- Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia
- Pam McLean Centre, The University of Sydney, Sydney 2006, Australia
| | - L Reaby
- Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia
| | - J Cuzick
- Cancer Research UK, Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary College, University of London, London E1 4NS, UK
| | - J F Forbes
- Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia
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42
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Cubillo A, Smith AB, Barrett N, Giampietro V, Brammer M, Simmons A, Rubia K. Drug-specific laterality effects on frontal lobe activation of atomoxetine and methylphenidate in attention deficit hyperactivity disorder boys during working memory. Psychol Med 2014; 44:633-646. [PMID: 23597077 DOI: 10.1017/s0033291713000676] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The catecholamine reuptake inhibitors methylphenidate (MPH) and atomoxetine (ATX) are the most common treatments for attention deficit hyperactivity disorder (ADHD). This study compares the neurofunctional modulation and normalization effects of acute doses of MPH and ATX within medication-naive ADHD boys during working memory (WM). METHOD A total of 20 medication-naive ADHD boys underwent functional magnetic resonance imaging during a parametric WM n-back task three times, under a single clinical dose of either MPH, ATX or placebo in a randomized, double-blind, placebo-controlled, cross-over design. To test for normalization effects, brain activations in ADHD under each drug condition were compared with that of 20 age-matched healthy control boys. RESULTS Relative to healthy boys, ADHD boys under placebo showed impaired performance only under high WM load together with significant underactivation in the bilateral dorsolateral prefrontal cortex (DLPFC). Both drugs normalized the performance deficits relative to controls. ATX significantly enhanced right DLPFC activation relative to MPH within patients, and significantly normalized its underactivation relative to controls. MPH, by contrast, both relative to placebo and ATX, as well as relative to controls, upregulated the left inferior frontal cortex (IFC), but only during 2-back. Both drugs enhanced fronto-temporo-striatal activation in ADHD relative to control boys and deactivated the default-mode network, which were negatively associated with the reduced DLPFC activation and performance deficits, suggesting compensation effects. CONCLUSIONS The study shows both shared and drug-specific effects. ATX upregulated and normalized right DLPFC underactivation, while MPH upregulated left IFC activation, suggesting drug-specific laterality effects on prefrontal regions mediating WM.
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Affiliation(s)
- A Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - A B Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - N Barrett
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - V Giampietro
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - M Brammer
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - A Simmons
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - K Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
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43
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Belcher A, Epple G, Küderling I, Smith AB. Volatile components of scent material from cotton-top tamarin (Saguinus o. oedipus) : A chemical and behavioral study. J Chem Ecol 2013; 14:1367-84. [PMID: 24276286 DOI: 10.1007/bf01020141] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/1987] [Accepted: 07/20/1987] [Indexed: 11/24/2022]
Abstract
The first chemical analysis of the volatile components of scent material from the cotton-top tamarin,Saguinus o. oedipus is presented. In contrast to our previous findings in saddle-back tamarins (Saguinus fuscicollis), the chemical composition of the scent marks is quite variable. Analysis of secretion expressed manually from different areas of the scent pads of sedated animals shows individual and regional variability. Only three components (squalene, cholesterol, andp-methoxybenzaldehyde) were found in all scent mark samples analyzed. However, suprapubic secretions obtained from one sedated female contained, in addition, 12 butyrate esters as well as five acetate esters which were homologous to the butyrates. The butyrate esters have been previously identified in scent material fromSaguinus fuscicollis. The variability of the composition of the scent material is discussed in relation to the scent-marking behavior of the cotton-top tamarins. Behavioral studies tested the ability of the cotton-top tamarins to discriminate between scent marks from conspecifics and scent marks from saddle-back tamarins. The group of 12 subjects discriminated between the scent marks from both species in choice tests during which they could freely contact the scent samples. However, when scent marks were presented under a screen, so that the subjects could smell but not contact the stimuli, no discrimination was shown. Four individuals displayed more interest in the screened scent stimuli than all other subjects. When these animals were tested in a second experiment for their ability to discriminate between material from the two species on the basis of only volatile cues, it became evident that they were able to do so. These results indicate that volatile cues alone enable the tamarins to recognize scent marks from conspecifics, but that additional cues perceived during contact with the scent are important for its full attractiveness and/or informational content.
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Affiliation(s)
- A Belcher
- German Primate Center, Kellnerweg 4, 3400, Göttingen, Germany
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44
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Scotece M, Gómez R, Conde J, Lopez V, Gómez-Reino JJ, Lago F, Smith AB, Gualillo O. Oleocanthal inhibits proliferation and MIP-1α expression in human multiple myeloma cells. Curr Med Chem 2013; 20:2467-75. [PMID: 23521677 DOI: 10.2174/0929867311320190006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 02/01/2013] [Accepted: 03/13/2013] [Indexed: 11/22/2022]
Abstract
Multiple myeloma (MM) is a plasma cell malignancy that causes devastating bone destruction by activating osteoclasts in the bone marrow milieu. MM is the second of all hematological malignancies. Thus, the search for new pharmacological weapons is under intensive investigation being MM a critically important public health goal. Recently, it has been demonstrated that macrophage inflammatory protein 1- alpha (MIP-1 α) is crucially involved in the development of osteolytic bone lesions in MM. Phenolic components of extra virgin olive oil are reported to have anti tumor activity. However, the underlying mechanisms and specific targets of extra virgin olive oil remain to be elucidated. In the present study, we investigated the effects of a recently isolated novel extra virgin olive oil polyphenol, oleocanthal, on the human multiple myeloma cell line ARH-77. Here we report that this natural compound has a remarkable in vitro activity by inhibiting MIP-1 α expression and secretion in MM cells. In addition, we also demonstrated that oleocanthal inhibits MM cells proliferation by inducing the activation of apoptosis mechanisms and by down-regulating ERK1/2 and AKT signal transduction pathways. This in vitro study suggests a therapeutic potential of oleocanthal in treating multiple myeloma.
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Affiliation(s)
- M Scotece
- SERGAS, Santiago University Clinical Hospital Research Laboratory 9 (NEIRID LAB: Laboratory of Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago de Compostela, 15706, Spain
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45
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Christakou A, Murphy CM, Chantiluke K, Cubillo AI, Smith AB, Giampietro V, Daly E, Ecker C, Robertson D, Murphy DG, Rubia K. Disorder-specific functional abnormalities during sustained attention in youth with Attention Deficit Hyperactivity Disorder (ADHD) and with autism. Mol Psychiatry 2013; 18:236-44. [PMID: 22290121 PMCID: PMC3554878 DOI: 10.1038/mp.2011.185] [Citation(s) in RCA: 190] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are often comorbid and share behavioural-cognitive abnormalities in sustained attention. A key question is whether this shared cognitive phenotype is based on common or different underlying pathophysiologies. To elucidate this question, we compared 20 boys with ADHD to 20 age and IQ matched ASD and 20 healthy boys using functional magnetic resonance imaging (fMRI) during a parametrically modulated vigilance task with a progressively increasing load of sustained attention. ADHD and ASD boys had significantly reduced activation relative to controls in bilateral striato-thalamic regions, left dorsolateral prefrontal cortex (DLPFC) and superior parietal cortex. Both groups also displayed significantly increased precuneus activation relative to controls. Precuneus was negatively correlated with the DLPFC activation, and progressively more deactivated with increasing attention load in controls, but not patients, suggesting problems with deactivation of a task-related default mode network in both disorders. However, left DLPFC underactivation was significantly more pronounced in ADHD relative to ASD boys, which furthermore was associated with sustained performance measures that were only impaired in ADHD patients. ASD boys, on the other hand, had disorder-specific enhanced cerebellar activation relative to both ADHD and control boys, presumably reflecting compensation. The findings show that ADHD and ASD boys have both shared and disorder-specific abnormalities in brain function during sustained attention. Shared deficits were in fronto-striato-parietal activation and default mode suppression. Differences were a more severe DLPFC dysfunction in ADHD and a disorder-specific fronto-striato-cerebellar dysregulation in ASD.
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Affiliation(s)
- A Christakou
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK,Centre for Integrative Neuroscience and Neurodynamics and School of Psychology and Clinical Language Sciences, University of Reading, London, UK
| | - C M Murphy
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK,Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - K Chantiluke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - A I Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - A B Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - V Giampietro
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - E Daly
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - C Ecker
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - D Robertson
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | | | - D G Murphy
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - K Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK,Department of Child Psychiatry/MRC Center for Social, Genetic and Developmental Psychiatry (SGDP), PO46, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK. E-mail:
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Smith AB, Lattin GE, Berran P, Harcke HT. Common and expected postmortem CT observations involving the brain: mimics of antemortem pathology. AJNR Am J Neuroradiol 2012; 33:1387-91. [PMID: 22492568 DOI: 10.3174/ajnr.a2966] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [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: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Postmortem imaging with CT or MR is emerging as an effective technique to augment forensic autopsy. Expected findings on postmortem imaging of the brain may mimic pathologic processes in the living brain, leading to potential misdiagnosis. The purpose of this study is to describe the array of CT findings that can be expected to be present within the brain after death. MATERIALS AND METHODS A retrospective review was performed using an anonymized data base of 33 postmortem head CTs with no evidence of trauma to the face or scalp. Head CTs were assessed for 1) loss of gray-white differentiation, 2) effacement of the ventricles and cisterns, 3) postmortem intravascular blood distribution, 4) presence of intracranial or intravascular air, and 5) an irregular appearance of the falx. Imaging findings were correlated with autopsy findings. RESULTS Visualization of the basal ganglia was noted in 30 (91%) subjects, and the cortical ribbon was appreciated in 14 (42%). The ventricles and cisterns were effaced in 19 (58%) cases. An "expected postmortem blood distribution" was seen in 27 (82%) instances. Intravascular air was present in 14 cases (42%). A "lumpy" falx was present in 20 cases (61%). In 4 cases of subdural or subarachnoid hemorrhage noted on autopsy, but not on CT, retrospective review confirmed that a true discrepancy between the radiology and pathology findings persisted. CONCLUSIONS Recognition of expected postmortem patterns is required before pathology can be accurately diagnosed. A limitation of CT virtual autopsy is the possibility of missing small blood collections.
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Affiliation(s)
- A B Smith
- Armed Forces Institute of Pathology, Department of Radiologic Pathology, Washington, DC, USA.
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Kanatas AN, Smith AB, Mannion C, Ong TK, Mitchell DA. Delays in head and neck surgery-managers, theatre usage and suboptimal efficiency. Br J Oral Maxillofac Surg 2012; 51:e61-2. [PMID: 22497692 DOI: 10.1016/j.bjoms.2012.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 03/19/2012] [Indexed: 11/30/2022]
Affiliation(s)
- A N Kanatas
- Oral and Maxillofacial Department, Leeds Dental Institute, LS2 9LU, United Kingdom.
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Dawson PFL, Sharif MO, Smith AB, Brunton PA. A Clinical Study Comparing the Efficacy and Sensitivity of Home vs Combined Whitening. Oper Dent 2011; 36:460-6. [DOI: 10.2341/10-159-c] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This randomized clinical study assessed efficacy in terms of color change and production of sensitivity after home whitening alone and home whitening supplemented with in-office bleaching. Thirty-six subjects (aged 19 to 58 years) were randomly assigned to one of three different treatment groups: (A) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays; (B) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 9% hydrogen peroxide (in the same trays); or (C) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 27% hydrogen peroxide (in the same trays). The efficacy of tooth whitening was assessed by determining the color change associated with the six upper anterior teeth using a value-ordered shade guide. Sensitivity was self-assessed with the use of a visual analog scale (VAS). Tooth shade and sensitivity were assessed at the following points: pretreatment; immediately after the home whitening phase; immediately after the in-office phase (groups B and C); and one week post active treatment. At the one week follow-up visit, subjects in group A had a mean (SD) color change of 5.9 (1.83) (teeth were lighter) immediately after cessation of treatment (p<0.01). Subjects in groups B and C experienced a greater change in mean (SD) shade immediately following their respective in-office treatments of 5.1 (1.53) and 5.4 (1.55). However, within one week, the shade of these teeth regressed to a similar degree to that achieved by subjects treated in group A. Overall, no significant difference in shade change or sensitivity was produced between the three groups. Investigators concluded that the in-office element of combined whitening produced no significant difference in tooth color or sensitivity when compared with home whitening alone.
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Abstract
Feeding arms carrying coelomic extensions of the theca are thought to be unique to crinoids among stemmed echinoderms. However, a new two-armed echinoderm from the earliest Middle Cambrian of Spain displays a highly unexpected morphology. X-ray microtomographic analysis of its arms shows they are polyplated in their proximal part with a dorsal series of uniserial elements enclosing a large coelomic lumen. Distally, the arm transforms into the more standard biserial structure of a blastozoan brachiole. Phylogenetic analysis demonstrates that this taxon lies basal to rhombiferans as sister-group to pleurocystitid and glyptocystitid blastozoans, drawing those clades deep into the Cambrian. We demonstrate that Cambrian echinoderms show surprising variability in the way their appendages are constructed, and that the appendages of at least some blastozoans arose as direct outgrowths of the body in much the same way as the arms of crinoids.
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Affiliation(s)
- S Zamora
- Department of Palaeontology, The Natural History Museum, London SW7 5BD, UK.
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Ballatore C, Brunden KR, Trojanowski JQ, Lee VMY, Smith AB, Huryn DM. Modulation of protein-protein interactions as a therapeutic strategy for the treatment of neurodegenerative tauopathies. Curr Top Med Chem 2011; 11:317-30. [PMID: 21320060 PMCID: PMC3069499 DOI: 10.2174/156802611794072605] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [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] [Received: 02/06/2010] [Accepted: 04/16/2010] [Indexed: 12/26/2022]
Abstract
The recognition that malfunction of the microtubule (MT) associated protein tau is likely to play a defining role in the onset and/or progression of a number of neurodegenerative diseases, including Alzheimer's disease, has resulted in the initiation of drug discovery programs that target this protein. Tau is an endogenous MT-stabilizing agent that is highly expressed in the axons of neurons. The MT-stabilizing function of tau is essential for the axonal transport of proteins, neurotransmitters and other cellular constituents. Under pathological conditions, tau misfolding and aggregation results in axonal transport deficits that appear to have deleterious consequences for the affected neurons, leading to synapse dysfunction and, ultimately, neuronal loss. This review focuses on both progress and unresolved issues surrounding the development of novel therapeutics for the treatment of neurodegenerative tauopathies, which are based on (A) MT-stabilizing agents to compensate for the loss of normal tau function, and (B) small molecule inhibitors of tau aggregation.
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Affiliation(s)
- C Ballatore
- Department of Chemistry, School of Arts and Sciences, University of Pennsylvania, 231 South 34th St., Philadelphia, PA 19104-6323, USA.
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