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Salami B, Salma J, Hegadoren K, Meherali S, Kolawole T, Diaz E. Sense of community belonging among immigrants: perspective of immigrant service providers. Public Health 2019; 167:28-33. [DOI: 10.1016/j.puhe.2018.10.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/04/2018] [Accepted: 10/28/2018] [Indexed: 01/30/2023]
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Perri MD, Singhal S, Hegadoren K, Norris C, Mackey J, Paterson I, Pituskin E. Abstract P6-13-08: A novel comparative analysis approach to personalize chemotherapy dose in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-13-08] [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
Background: Worldwide, body surface area [BSA] is used to calculate chemotherapy dose. The BSA formula was originally developed in 1916, derived from height and weight, with no consideration of other patient characteristics. Most chemotherapy agents have a narrow therapeutic index and are distributed in lean body mass [LBM], leading to under- or over-dosing and deleterious effects to major organs when body composition is not considered. To date, while experts worldwide acknowledge the limitations and risks of BSA dosing, no practical approach to personalizing chemotherapy dose has been developed. Ideally, body composition would be assessed by tests already routinely performed, avoiding unnecessary radiation exposure, clinic visits, discomfort to the patient, and cost. The majority of patients undergo cardiac imaging prior to chemotherapy. We hypothesized that clinical parameters routinely performed prior to chemotherapy could predict LBM in early breast cancer patients.
Method: Early stage breast cancer patients (n = 45) enrolled in the Multidisciplinary Team Intervention in Cardio-Oncology (TITAN) study underwent pre-treatment cardiac MRI, body composition (iDEXA) and laboratory (complete blood cell count and chemistry). Cardiac MRI and iDEXA are considered 'gold standard' imaging modalities, the accuracy of which allow for significantly reduced sample size.
Our modeling approach, which is novel in this area, aimed to select the best combination of parameters with the most predictive ability of total lean mass (iDEXA). The parameters included in study are: cardiac MRI metrics (LV mass, cardiac output), and laboratory parameters associated with major organ function (albumin, creatinine, bilirubin). All parameters were tested using univariate, multivariate and subset selection approach. Akaike's Information Criterion (AIC) was used to measure model quality, with lower AIC values indicating closer prediction.
Results: The univariate analysis of each parameter independently showed LV mass is most predictive with AIC 857.8, while combination of all parameter in multivariate fashion show improvement in prediction with AIC 851. The subset selection approach shows, Adjusted R2 with 4 parameters had AIC 849.14, Schwartz's information criterion (BIC) with 2 parameters had AIC 849.66 and Mallows' C Selection (Cp) model with 3 parameters had the least AIC 848.71 value (P < 0.001).
Conclusion: Our comparative analysis showed that the Cp model with 3 parameters (LV mass, cardiac output and bilirubin) has high prediction ability of LBM. This model will form the basis of a personalized formula for chemotherapy dose calculation. We expect this work to result in optimal cancer-specific outcomes while reducing short and long-term toxicities associated with necessary chemotherapy.
Citation Format: Perri MD, Singhal S, Hegadoren K, Norris C, Mackey J, Paterson I, Pituskin E. A novel comparative analysis approach to personalize chemotherapy dose in early 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 P6-13-08.
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Affiliation(s)
- MD Perri
- University of Alberta, Edmonton, AB, Canada
| | - S Singhal
- University of Alberta, Edmonton, AB, Canada
| | | | - C Norris
- University of Alberta, Edmonton, AB, Canada
| | - J Mackey
- University of Alberta, Edmonton, AB, Canada
| | - I Paterson
- University of Alberta, Edmonton, AB, Canada
| | - E Pituskin
- University of Alberta, Edmonton, AB, Canada
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Travis SG, Coupland NJ, Hegadoren K, Silverstone PH, Huang Y, Carter R, Fujiwara E, Seres P, Malykhin NV. Effects of cortisol on hippocampal subfields volumes and memory performance in healthy control subjects and patients with major depressive disorder. J Affect Disord 2016; 201:34-41. [PMID: 27162154 DOI: 10.1016/j.jad.2016.04.049] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 01/12/2016] [Accepted: 04/24/2016] [Indexed: 01/01/2023]
Abstract
Overactivity of the hypothalamic-pituitary-adrenal (HPA) axis in major depressive disorder (MDD) is among the most consistently replicated biological findings in psychiatry. Magnetic resonance imaging (MRI) studies have consistently demonstrated that hippocampal (HC) volume is decreased in patients with MDD. The improved spatial resolution of high field strength MRI has recently enabled measurements of HC subfield volumes in vivo. The main goal of the present study was to examine the relationship between cortisol concentrations over a day and HC subfield volumes in patients with MDD compared to healthy controls and to investigate whether diurnal cortisol measures are related to memory performance. Fourteen MDD patients with moderate or severe episodes were recruited, together with 14 healthy controls. Imaging was performed using a 4.7T whole-body imaging system. HC subfields and subregions were segmented manually using previously defined protocol. Memory performance was assessed using the Wechsler Memory Scale IV. The salivary cortisol levels were measured over the course of one day. We found that cortisol awakening response to 8h (CAR-8h) was higher in MDD patients compared to controls and that this increase in CAR-8h in MDD patients correlated negatively with left total Cornu Ammonis (CA)1-3 and left HC head volume. In healthy controls mean cortisol levels were negatively associated with right total CA1-3, right HC head, and right total HC volume. In addition, in healthy controls higher CAR-8h was related to worse performance on the immediate content memory. These results provide the first in vivo evidence of the negative associations between cortisol level, CA1-3 HC subfield volume and memory performance in patients with MDD and healthy controls.
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Affiliation(s)
- Scott G Travis
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | | | - K Hegadoren
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Yushan Huang
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Rawle Carter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Esther Fujiwara
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Peter Seres
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nikolai V Malykhin
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
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Affiliation(s)
- S Hirani
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - G Lasiuk
- College of Nursing, University of Saskatchewan, Regina, SK, Canada
| | - K Hegadoren
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Kingston D, Biringer A, McDonald S, Heaman M, Lasiuk G, Hegadoren K, McDonald S, Sword W, Van Zanten S, Kingston J, Jarema K, Vermeyden L, Austin M. Acceptability and Perceived Benefits and Harms of Mental Health Screening in Pregnant Women. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30774-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Letourneau N, Watson B, Duffett-Leger L, Hegadoren K, Tryphonopoulos P. Cortisol patterns of depressed mothers and their infants are related to maternal–infant interactive behaviours. J Reprod Infant Psychol 2011. [DOI: 10.1080/02646838.2011.649474] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Daniels JK, Hegadoren K, Coupland NJ, Rowe BH, Neufeld RWJ, Lanius RA. Cognitive distortions in an acutely traumatized sample: an investigation of predictive power and neural correlates. Psychol Med 2011; 41:2149-2157. [PMID: 21375796 DOI: 10.1017/s0033291711000237] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [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 Current theories of post-traumatic stress disorder (PTSD) place considerable emphasis on the role cognitive distortions such as self-blame, hopelessness or preoccupation with danger play in the etiology and maintenance of the disorder. Previous studies have shown that cognitive distortions in the early aftermath of traumatic events can predict future PTSD severity but, to date, no studies have investigated the neural correlates of this association. METHOD We conducted a prospective study with 106 acutely traumatized subjects, assessing symptom severity at three time points within the first 3 months post-trauma. A subsample of 20 subjects additionally underwent a functional 4-T magnetic resonance imaging (MRI) scan at 2 to 4 months post-trauma. RESULTS Cognitive distortions proved to be a significant predictor of concurrent symptom severity in addition to diagnostic status, but did not predict future symptom severity or diagnostic status over and above the initial symptom severity. Cognitive distortions were correlated with blood oxygen level-dependent (BOLD) signal strength in brain regions previously implicated in visual processing, imagery and autobiographic memory recall. Intrusion characteristics accounted for most of these correlations. CONCLUSIONS This investigation revealed significant predictive value of cognitive distortions concerning concurrent PTSD severity and also established a significant relationship between cognitive distortions and neural activations during trauma recall in an acutely traumatized sample. These data indicate a direct link between the extent of cognitive distortions and the intrusive nature of trauma memories.
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Affiliation(s)
- J K Daniels
- Department of Psychiatry, The University of Western Ontario, University Hospital, London, Ontario, Canada
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Norris C, Murray J, Hegadoren K. 193 Poster can Sex Differences in HRQOL Outcomes be Attributed to Gender Roles. Eur J Cardiovasc Nurs 2010. [DOI: 10.1016/s1474-5151(10)60152-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C. Norris
- University of Alberta, Edmonton, Canada
| | - J. Murray
- University of Alberta, Edmonton, Canada
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Norris C, Hegadoren K. FMMP7 The Importance of Using a Sex-Based Analysis when Screening for Anxiety and Depression in Patients with Coronary Artery Disease. Eur J Cardiovasc Nurs 2009. [DOI: 10.1016/s1474-5151(09)60026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hegadoren K. [There are no longer problem children]. Infirm Can 1979; 21:16-7. [PMID: 259567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Hegadoren K. "Problem children" aren't problems anymore. Can Nurse 1979; 75:31-3. [PMID: 82476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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