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Gozar A, Seixas A, Hale L, Branas C, Barrett M, Killgore WD, Wills CC, Grandner MA. 0013 Mobile Device Use in Bed and Relationships to Work Productivity: Impact of Anxiety. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Mobile phone use at night is associated with worse sleep quality. It may also be associated with daytime productivity, possibly via anxiety.
Methods
Data were obtained from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study, including N=1007 adults age 22–60. Mobile device use in bed was assessed as the frequency that participants reported: a device in the bedroom, use of the device in bed, texting, emails, internet browsing, calls, and/or social networking in bed, being woken up by the device in a planned (alarm) or unplanned (alert/call/message) way, and checking the phone at night. Each of these were coded as “never,” “rarely,” or “often.” Work productivity was assessed with the Well-Being Assessment of Productivity (WBA-P; scores 0–22 measure productivity loss). Regressions with WBA-P score as outcome and mobile phone variables as predictors were adjusted for age, sex, race/ethnicity, education, and income level. Post-hoc analyses included GAD7 score to examine the mediating role of anxiety.
Results
The presence of a device was not associated with productivity loss, but frequent use (“often”) was (B=1.26,p=0.01). Increased productivity loss was also seen in those who frequently (“often”) sent texts (B=1.20,p=0.008), browsed internet (B=1.14,p=0.01), emailed (B=2.09,p<0.0005), called (B=1.42,p=0.004), and used social media (B=1.26,p=0.004). Productivity loss was associated with being woken by a call/alert “rarely” (B=1.20,p=0.001) or “often” (B=1.72,p=0.005), but not by alarm. Checking the phone at night “rarely” (B=0.89,p=0.01) and “often” (B=1.73,p<0.0005) were also associated with productivity loss. When anxiety was entered into the model, all relationships except those with frequent emails and calls in bed became nonsignificant.
Conclusion
Anxiety may be the underlying cause for both increased mobile phone usage and reduced productivity. Reducing anxiety levels may indirectly aid in decreasing nighttime mobile phone use and increasing daytime productivity.
Support
The SHADES study was funded by R21ES022931
Dr. Grandner is supported by R01MD011600
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Onyeonwu C, Nowakowski S, Hale L, Branas C, Barrett M, Killgore WD, Wills CC, Grandner MA. 0865 Menstrual Regularity And Bleeding Associated With Sleep Duration, Sleep Quality, And Daytime Sleepiness In A Community Sample. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Female menstrual health and its relationship to sleep duration, quality, fatigue and other factors is an understudied subject in the field of sleep and women’s health. Few studies examined sleep in relation to menstrual regularity and bleeding.
Methods
Data were obtained from N=579 women who have had a menstrual period in the past 12 months who participated in the Sleep and Health Activity, Diet, Environment, and Socialization (SHADES) study, a community-based sample of adults age 22-60 living in southeastern Pennsylvania. Participants were asked, “How regular is your period?” with response choices of “Very Regular,” “Mostly Regular,” “Fairly Regular,” and “Not Regular.” They were also asked, “How much bleeding do you usually experience during your period?” Responses were “Very Heavy,” “Medium,” “Light,” or “Very Light.” These were evaluated as ordinal outcomes. Sleep-related predictors included sleep duration (<=6h [Short], 7-8 [Normal], and >=9 [Long]), Insomnia Severity Index (ISI) score, Pittsburgh Sleep Quality Index (PSQI) score, Epworth Sleepiness Scale (ESS) score, and Fatigue Severity Scale (FSS) score. Covariates included age, education, income, race/ethnicity, and body mass index.
Results
Short sleep duration was associated with a greater likelihood of heavier bleeding (OR=1.46, p=0.026) and greater irregularity (OR=1.44, p=0.031), compared to Normal sleep. Higher PSQI score was associated with more irregularity (OR=1.05, p=0.022). FSS score was associated with both heavier bleeding (OR=1.02, p=0.003) and more irregularity (OR=1.02, p=0.008). Long sleep, ISI, and ESS were not associated with either outcome. A sleep duration by FSS score interaction was found for irregularity (p=0.1). Among Normal sleepers, FSS was associated with greater irregularity, but not among Short sleepers.
Conclusion
There is a relationship between short sleep and heavier and irregular menses. These findings have implications for treating sleep problems among women. Also, mechanisms of these associations should be explored further.
Support
Dr. Grandner is supported by R01MD011600
The SHADES study was funded by R21ES022931
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Mason B, Tubbs A, Hale L, Branas C, Barrett M, Killgore WD, Wills CC, Grandner MA. 1095 Use Of Mobile Devices At Night Associated With Mental Health In Young Adults. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Mobile technology use in bed is becoming commonplace and associated with habitual short sleep duration. The present study examined whether device use at night was related to mental health.
Methods
Data from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study comes from a community-based sample, which was restricted to N=473 between the ages of 22-29. Device use was assessed as presence in the room at night, any use at night, texting, emailing, browsing the internet, making or receiving calls, and using social media. Participants were also asked how often they are woken by a call/alert from their phone (unplanned), how often they are woken by their phone alarm (planned), and how often they check their phone at night. These were recorded as never, rarely, some nights, almost every night, and every night, and were assessed as an ordinal outcome. Predictors included score on the Patient Health Questionnaire depression scale (PHQ9), GAD7 anxiety scale, Perceived Stress Scale (PSS), and Multidimensional Scale of Perceived Social Support (MSPSS). Ordinal logistic regression analyses were adjusted for age, sex, race/ethnicity, education, and income.
Results
Depression was associated with texting (oOR=1.03, p=0.025), email (oOR=1.03, p=0.022), internet (oOR=1.05, p=0.003), unplanned awakenings (oOR=1.05, p=0.001), and checking the phone (oOR=1.09, p<0.0005). Anxiety was associated with texting (oOR=1.05, p=0.001), email (oOR=1.05, p=0.001), internet (oOR=1.05, p=0.002), social media (oOR=1.04, p=0.009), unplanned awakenings (oOR=1.06, p<0.0005), planned awakenings (oOR=1.04, p=0.025), and checking the phone (oOR=1.10, p<0.0005). Perceived stress was associated with internet (oOR=1.02, p=0.034), unplanned awakenings (oOR=1.02, p=0.045), and checking (oOR=1.04, p<0.0005). Social support was associated with decreased checking (oOR=0.98, p=0.018).
Conclusion
Mobile device use at night itself is not associated with mental health, but specific activities may be. Also, those who report more disruptions from the device and more checking of the device also report worse mental health. Relationships might be bidirectional.
Support
Dr. Grandner is supported by R01MD011600
The SHADES study was funded by R21ES022931
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Adachi I, Ahlburg P, Aihara H, Akopov N, Aloisio A, Anh Ky N, Asner DM, Atmacan H, Aushev T, Aushev V, Aziz T, Babu V, Baehr S, Bambade P, Banerjee S, Bansal V, Barrett M, Baudot J, Becker J, Behera PK, Bennett JV, Bernieri E, Bernlochner FU, Bertemes M, Bessner M, Bettarini S, Bianchi F, Biswas D, Bozek A, Bračko M, Branchini P, Briere RA, Browder TE, Budano A, Burmistrov L, Bussino S, Campajola M, Cao L, Casarosa G, Cecchi C, Červenkov D, Chang MC, Cheaib R, Chekelian V, Chen YQ, Chen YT, Cheon BG, Chilikin K, Cho K, Cho S, Choi SK, Choudhury S, Cinabro D, Corona L, Cremaldi LM, Cunliffe S, Czank T, Dattola F, De La Cruz-Burelo E, De Nardo G, De Nuccio M, De Pietro G, de Sangro R, Destefanis M, Dey S, De Yta-Hernandez A, Di Capua F, Doležal Z, Domínguez Jiménez I, Dong TV, Dort K, Dossett D, Dubey S, Duell S, Dujany G, Eidelman S, Eliachevitch M, Fast JE, Ferber T, Ferlewicz D, Finocchiaro G, Fiore S, Fodor A, Forti F, Fulsom BG, Ganiev E, Garcia-Hernandez M, Garg R, Gaur V, Gaz A, Gellrich A, Gemmler J, Geßler T, Giordano R, Giri A, Gobbo B, Godang R, Goldenzweig P, Golob B, Gomis P, Gradl W, Graziani E, Greenwald D, Guan Y, Hadjivasiliou C, Halder S, Hara T, Hartbrich O, Hayasaka K, Hayashii H, Hearty C, Hedges MT, Heredia de la Cruz I, Hernández Villanueva M, Hershenhorn A, Higuchi T, Hill EC, Hoek M, Hsu CL, Hu Y, Iijima T, Inami K, Inguglia G, Irakkathil Jabbar J, Ishikawa A, Itoh R, Iwasaki Y, Jacobs WW, Jaffe DE, Jang EJ, Jeon HB, Jia S, Jin Y, Joo C, Joo KK, Kahn J, Kakuno H, Kaliyar AB, Kandra J, Karyan G, Kato Y, Kawasaki T, Kim BH, Kim CH, Kim DY, Kim KH, Kim SH, Kim YK, Kim Y, Kimmel TD, Kindo H, Kleinwort C, Kodyš P, Koga T, Kohani S, Komarov I, Korpar S, Kovalchuk N, Kraetzschmar TMG, Križan P, Kroeger R, Krokovny P, Kuhr T, Kumar J, Kumar M, Kumar R, Kumara K, Kurz S, Kuzmin A, Kwon YJ, Lacaprara S, La Licata C, Lanceri L, Lange JS, Lautenbach K, Lee IS, Lee SC, Leitl P, Levit D, Li LK, Li YB, Libby J, Lieret K, Li Gioi L, Liptak Z, Liu QY, Liventsev D, Longo S, Luo T, Maeda Y, Maggiora M, Manoni E, Marcello S, Marinas C, Martini A, Masuda M, Matsuda T, Matsuoka K, Matvienko D, Meggendorfer F, Mei JC, Meier F, Merola M, Metzner F, Milesi M, Miller C, Miyabayashi K, Miyake H, Mizuk R, Azmi K, Mohanty GB, Moon T, Morii T, Moser HG, Mueller F, Müller FJ, Muller T, Muroyama G, Mussa R, Nakano E, Nakao M, Nayak M, Nazaryan G, Neverov D, Niebuhr C, Nisar NK, Nishida S, Nishimura K, Nishimura M, Oberhof B, Ogawa K, Onishchuk Y, Ono H, Onuki Y, Oskin P, Ozaki H, Pakhlov P, Pakhlova G, Paladino A, Panta A, Paoloni E, Park H, Paschen B, Passeri A, Pathak A, Paul S, Pedlar TK, Peruzzi I, Peschke R, Pestotnik R, Piccolo M, Piilonen LE, Popov V, Praz C, Prencipe E, Prim MT, Purohit MV, Rados P, Rasheed R, Reiter S, Remnev M, Resmi PK, Ripp-Baudot I, Ritter M, Rizzo G, Rizzuto LB, Robertson SH, Rodríguez Pérez D, Roney JM, Rosenfeld C, Rostomyan A, Rout N, Russo G, Sahoo D, Sakai Y, Sandilya S, Sangal A, Santelj L, Sartori P, Sato Y, Savinov V, Scavino B, Schueler J, Schwanda C, Seddon RM, Seino Y, Selce A, Senyo K, Sfienti C, Shen CP, Shiu JG, Shwartz B, Sibidanov A, Simon F, Sobie RJ, Soffer A, Sokolov A, Solovieva E, Spataro S, Spruck B, Starič M, Stefkova S, Stottler ZS, Stroili R, Strube J, Sumihama M, Sumiyoshi T, Summers DJ, Suzuki SY, Tabata M, Takizawa M, Tamponi U, Tanaka S, Tanida K, Taniguchi N, Taras P, Tenchini F, Torassa E, Trabelsi K, Tsuboyama T, Uchida M, Unger K, Unno Y, Uno S, Ushiroda Y, Vahsen SE, van Tonder R, Varner GS, Varvell KE, Vinokurova A, Vitale L, Vossen A, Wakai M, Wakeling HM, Wan Abdullah W, Wang CH, Wang MZ, Warburton A, Watanabe M, Webb J, Wehle S, Wessel C, Wiechczynski J, Windel H, Won E, Yabsley B, Yamada S, Yan W, Yang SB, Ye H, Yin JH, Yonenaga M, Yuan CZ, Yusa Y, Zani L, Zhang Z, Zhilich V, Zhou QD, Zhou XY, Zhukova VI. Search for an Invisibly Decaying Z^{'} Boson at Belle II in e^{+}e^{-}→μ^{+}μ^{-}(e^{±}μ^{∓}) Plus Missing Energy Final States. PHYSICAL REVIEW LETTERS 2020; 124:141801. [PMID: 32338980 DOI: 10.1103/physrevlett.124.141801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
Theories beyond the standard model often predict the existence of an additional neutral boson, the Z^{'}. Using data collected by the Belle II experiment during 2018 at the SuperKEKB collider, we perform the first searches for the invisible decay of a Z^{'} in the process e^{+}e^{-}→μ^{+}μ^{-}Z^{'} and of a lepton-flavor-violating Z^{'} in e^{+}e^{-}→e^{±}μ^{∓}Z^{'}. We do not find any excess of events and set 90% credibility level upper limits on the cross sections of these processes. We translate the former, in the framework of an L_{μ}-L_{τ} theory, into upper limits on the Z^{'} coupling constant at the level of 5×10^{-2}-1 for M_{Z^{'}}≤6 GeV/c^{2}.
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Tubbs AS, Gallagher R, Perlis ML, Hale L, Branas C, Barrett M, Gehrels JA, Alfonso-Miller P, Grandner MA. Relationship between insomnia and depression in a community sample depends on habitual sleep duration. Sleep Biol Rhythms 2020; 18:143-153. [PMID: 34305449 DOI: 10.1007/s41105-020-00255-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sleep disturbances, such as short sleep duration and insomnia, are core features of depression. However, it is unclear if sleep duration and insomnia have an interactive effect on depression severity or individual symptoms. Data were drawn from a community sample (N = 1007) containing responses on the Insomnia Severity Index, Patient Health Questionnaire-9 (PHQ-9), and average sleep duration. Regression analyses determined the prevalence risks (PR) of symptoms of depression based on insomnia severity and sleep duration. Depression severity was related to insomnia severity (PR 1.09, p < 0.001) and short sleep duration (PR 1.52, p < 0.001), but the interaction between the two was negative (PR 0.97, p < 0.001). Insomnia severity increased the prevalence risk of all individual depression symptoms between 8 and 15%, while sleep duration increased the prevalence risk of appetite dysregulation (PR 1.86, p < 0.001), fatigue (PR 1.51, p < 0.001), difficulty concentrating (PR 1.61, p = 0.003), feelings of failure (PR 1.58, p = 0.002), and suicidal behavior (PR 2.54, p = 0.01). The interaction of sleep duration and insomnia was negative and ranged between 3 and 6%. In clinically significant depression (PHQ >=10), only insomnia severity increased the prevalence risk of depression severity (PR 1.02, p = 0.001). Insomnia and short sleep predict prevalent depression, but their interactive effect was negative. Thus, while insomnia had a greater association with depression severity and symptoms, this association was dependent on habitual sleep duration.
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Ui Dhuibhir P, Burke D, McSharry V, Mullee A, Barrett M, Casey L, Donnelly Y, Gallagher J, Higgins K, McCaffrey J, O’Donoghue N, Donoghue A, Corish C, Walsh D. PT03.01: Patient Sources of Dietary and Nutritional Information After a Cancer Diagnosis. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32553-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Young RC, Mulsant BH, Sajatovic M, Gildengers AG, Gyulai L, Al Jurdi RK, Beyer J, Evans J, Banerjee S, Greenberg R, Marino P, Kunik ME, Chen P, Barrett M, Schulberg HC, Bruce ML, Reynolds CF, Alexopoulos GS. GERI-BD: A Randomized Double-Blind Controlled Trial of Lithium and Divalproex in the Treatment of Mania in Older Patients With Bipolar Disorder. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:314-321. [PMID: 32015723 PMCID: PMC6996060 DOI: 10.1176/appi.focus.17308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
(Reprinted with permission from Am J Psychiatry 2017; 174:1086-1093).
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Wright JH, Owen JJ, Richards D, Eells TD, Richardson T, Brown GK, Barrett M, Rasku MA, Polser G, Thase ME. Computer-Assisted Cognitive-Behavior Therapy for Depression: A Systematic Review and Meta-Analysis. J Clin Psychiatry 2019; 80. [PMID: 30900849 DOI: 10.4088/jcp.18r12188] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the efficacy of computer-assisted forms of cognitive-behavior therapy for major depressive disorder (MDD) and examine the role of clinician support and other factors that might affect outcomes. DATA SOURCES Ovid MEDLINE, PsycINFO, PubMed, and Scopus from their beginnings to July 18, 2016. Keywords were "randomized, controlled trials of computer-assisted cognitive-behavior therapy for depression" and "randomized, controlled trials of mobile apps for cognitive-behavior therapy of depression." STUDY SELECTION Of 223 studies identified in the search, 183 were excluded yielding a sample of 40 randomized, controlled investigations of computer-assisted cognitive-behavior therapy (CCBT) for depression. DATA EXTRACTION Data were abstracted independently by two authors, and consensus was reached by discussion with a third author. RESULTS The overall mean effect size for CCBT compared to control conditions was g = 0.502, a moderately large effect. Studies that provided support from a clinician or other person yielded significantly larger effects (g = 0.673) than studies in which no support was provided (g = 0.239). Completion rate and study setting also influenced outcomes. Lower mean effect sizes were observed in studies with lower completion rates and in studies conducted in primary care practices. CONCLUSIONS CCBT with a modest amount of support from a clinician or other helping person was found to be efficacious with relatively large mean effect sizes on measures of depressive symptoms. Self-guided CCBT for depression was considerably less effective. Future research should focus on enhancing the implementation of CCBT, including evaluating the amount and type of support needed for effective delivery, methods to improve engagement with computer-assisted therapies, and ways to improve treatment outcome in primary care settings.
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Barrett M, Holt K, Haley A, Leininger L, Sonnenday CJ, Sandhu G, Gauger PG. Needs assessment can guide creation of a "resident-optimized clinic" in surgery. Am J Surg 2019; 218:648-652. [PMID: 30826007 DOI: 10.1016/j.amjsurg.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/21/2019] [Accepted: 02/02/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is limited data on deliberate teaching of residents in the clinic setting; we sought to investigate the clinic experience at our institution and improve education through creation of a novel "Resident-Optimized Clinic" (ROC). METHODS An online survey was sent separately to residents and faculty. Based on the results of this survey a modified ROC was developed to try to improve the obstacles to learning in clinic. RESULTS Qualitative analysis revealed the barriers in clinic were inconsistencies in expectations, lack of autonomy, time, and facility limitations. The modified ROC was rated positively with 100% of participants expressing they had sufficient time and autonomy; and 90% felt the environment was optimized for teaching. CONCLUSIONS Multiple themes have been identified as problematic for the clinic education experience. The ROC was rated positively by trainees suggesting thoughtful intervention to improve clinic results in a better clinic experience and more educational gain from the clinic environment.
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Anderson W, Hoch H, Gondalia R, Kaye L, Barrett M, Van Sickle D, Szefler S, Stempel D. ASTHMA CONTROL EVALUATED WITH ELECTRONIC MEDICATION MONITOR (EMM)-DEFINED OCCASIONS OF SHORT-ACTING BETA-AGONIST INHALER USE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dushyanthen S, Barrett M, Kok D, McArthur G. The Development of a Wholly Online Master's Program for Oncology Clinicians. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.62300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The Master of Cancer Sciences brings together the academic strength of the University of Melbourne (UoM) and world leading content experts from the Victorian Comprehensive Cancer Centre (VCCC), to develop an innovative, interactive, evidence-based flagship educational program in cancer sciences. This program will enhance the capabilities of health professionals, in the rapidly evolving field of cancer research and clinical care. It will be wholly online and nested with qualification points at Specialist Certificate, Graduate Certificate and Masters Level to provide flexible progression and study options for practitioners in the cancer care workforce. Specific modular content from each subject will also be repurposed and repackaged as a series of derivative educational activities such as massive open online courses (MOOCs), workshops and webinars; broadening the reach of the masters programming to all. Aim: The aim of this program is to be the first cancer-specific, multidisciplinary, flexible, and wholly online master's program of its kind offered within Australia, and one of two available worldwide. Graduates will possess an unprecedented breadth of integrated cancer knowledge and skills. This initiative will unify the VCCC alliance partners as they contribute to directly supporting a world-class cancer workforce and provide best practice care to patients. Discussion: This presentation will explore the educational development process involved in developing the ten online subjects, through the engagement of content writing teams to collaborative development and repurposing modules into a series of derivative educational activities. Ultimately the graduate programs and their derivative educational activities will contribute to lifelong learning, ongoing professional development and high quality healthcare for better patient outcomes.
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Emery J, Smith K, Shibaoka M, Barrett M. Upskilling the Primary Care Workforce in Cancer Survivorship. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.61500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction/background: There is a rapidly increasing population of people living with and beyond cancer due to ageing and improvements in detection and treatment. This has impacted on the complexity of the primary care practitioners' role in managing cancer survivorship. The Massive Open Online Course (MOOC) was developed to address this need for a sustainable education model. Aim/Objectives: The Cancer Survivorship for Primary Care Practitioners program aims to enhance the knowledge and skills in the transition of survivors from oncology treatment into shared care. The Victorian Comprehensive Cancer Centre's (VCCC) goal was to develop a freely accessible, relevant, flexible, evidence based and sustainable resource for a global audience. Methods: Aimed at primary healthcare practitioners including general practitioners, nurses (general practice nurses, community nurses and nurse practitioners) and allied health professionals; the program was developed to adhere to best practice survivorship care in the areas of: survivorship fundamentals; communication and coordination of care; promoting self-management, psychosocial and community-based support; surveillance, long term and late effects; and new and emergent technologies. The MOOC is contextualised in the narrative of a patient story and includes a series of real patient stories, interactive presentations, interviews, readings, online discussions, quizzes and peer reviewed assessments. Alumni from the program will contribute to a growing community of practice and contribute to the teaching and quality improvement of the program. An online survey will be distributed to all participants before and after their completion of the program. Paired tests will be conducted and compared for the participant craft groups that attend the MOOC. We will measure the effect of participation in either the MOOC and/or workshop on confidence, knowledge and intention to change practice. Results: A description of the sustainable MOOC delivery model and evaluation results from the first cohort will be presented. Conclusion: The program will deliver an innovative and sustainable professional development opportunity for PCPs in response to the evolving population health landscape. Alumni from the program will contribute to a growing community of practice and contribute to the teaching and quality improvement of the program.
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Matusz E, Brown D, Barrett M, Sperling S. Aging & Dementia - 2
The Neurocognitive Domains of Advanced Parkinson’s Disease. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy060.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Aims Informed patient consent is a legal prerequisite endorsed by multiple regulatory institutions including the Royal College of Surgeons and the General Medical Council. It is also recommended that the provision of written information is available and may take the form of a Patient Information Leaflet (PIL) with multiple PILs available from leading orthopaedic institutions. PILs may empower the patient, improve compliance, and improve the patient experience. The national reading age in the United Kingdom is less than 12 years and therefore PILs should be written at a readability level not exceeding 12 years old. We aim to assess the readability of PILs currently provided by United Kingdom orthopaedic institutions. Patients and Methods The readability of PILs on 58 common conditions provided by seven leading orthopaedic associations in January 2017, including the British Orthopaedic Association, British Hip Society, and the British Association of Spinal Surgeons, was assessed. All text in each PIL was analyzed using readability scores including the Flesch–Kincaid Grade Level (FKGL) and the Simple Measure of Gobbledygook (SMOG) test. Results The mean FKGL was 10.4 (6.7 to 17.0), indicating a mean reading age of 15 years. The mean SMOG score was 12.8 (9.7 to 17.9) indicating a mean reading age of 17 years. Conclusion Orthopaedic-related PILs do not comply with the recommended reading age, with some requiring graduate-level reading ability. Patients do not have access to appropriate orthopaedic-related PILs. Current publicly available PILs require further review to promote patient education and informed consent. Cite this article: Bone Joint J 2018;100-B:1253–9.
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Flynn B, Barrett M, Sui J, Halpin C, Paz G, Walsh D. Nutritional status and interventions in hospice: physician assessment of cancer patients. J Hum Nutr Diet 2018; 31:781-784. [PMID: 29882336 DOI: 10.1111/jhn.12562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cancer cachexia is a multifactorial syndrome characterised by a progressive loss of skeletal muscle mass. It adversely influences quality of life, treatment response and survival. Early identification and multimodal interventions can potentially treat cancer cachexia. However, healthcare professionals demonstrate a lack of understanding and the ability to identify cancer cachexia early. The present study aimed to evaluate the assessment by physicians of nutritional status in cancer patients admitted to hospice. METHODS A retrospective medical record review was conducted on all cancer admissions to a specialist in-patient palliative care unit over a 4-month period between October 2016 and January 2017. Charts were reviewed for evidence of documented nutritional assessment by physicians. Data were collected from the referral letter, admission notes, drug kardex and discharge letter. The information extracted included: (i) patient demographics and characteristics; (ii) terms used by physicians to describe nutritional status; (iii) any record of nutritional impact symptoms (NIS) experienced by the patient; and (iv) nutritional interventions prescribed. RESULTS One hundred and forty admissions were evaluated. Nutritional terminology and NIS were most commonly documented on the admission notes. Only 41% of documents recorded any nutritional term used by physicians to assess nutritional status. Furthermore, 71% of documents recorded at least one NIS experienced by the patient. Fatigue was the most frequent NIS. CONCLUSIONS We identified an inadequate nutritional assessment of cancer patients admitted to hospice. Implementation of a nutritional symptom checklist and nutrition screening tools, along with enhanced physician education and multidisciplinary nutrition care, could improve the identification and management of cancer cachexia in the palliative care setting.
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Young RC, Mulsant BH, Sajatovic M, Gildengers AG, Gyulai L, Al Jurdi RK, Beyer J, Evans J, Banerjee S, Greenberg R, Marino P, Kunik ME, Chen P, Barrett M, Schulberg HC, Bruce ML, Reynolds CF, Alexopoulos GS. GERI-BD: A Randomized Double-Blind Controlled Trial of Lithium and Divalproex in the Treatment of Mania in Older Patients With Bipolar Disorder. Am J Psychiatry 2017; 174:1086-1093. [PMID: 29088928 PMCID: PMC6214451 DOI: 10.1176/appi.ajp.2017.15050657] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Clinicians treating older patients with bipolar disorder with mood stabilizers need evidence from age-specific randomized controlled trials. The authors describe findings from a first such study of late-life mania. METHOD The authors compared the tolerability and efficacy of lithium carbonate and divalproex in 224 inpatients and outpatients age 60 or older with bipolar I disorder who presented with a manic, hypomanic, or mixed episode. Participants were randomly assigned, under double-blind conditions, to treatment with lithium (target serum concentration, 0.80-0.99 mEq/L) or divalproex (target serum valproate concentration, 80-99 μg/mL) for 9 weeks. Participants with an inadequate response after 3 weeks received open adjunctive risperidone. The authors hypothesized that divalproex would be better tolerated and more efficacious than lithium. Tolerability was assessed based on a measure of sedation and on the proportions of participants achieving target concentrations. Efficacy was assessed with the Young Mania Rating Scale (YMRS). RESULTS Attrition rates were similar for lithium and divalproex (14% and 18% at week 3 and 51% and 44% at week 9, respectively). The groups did not differ significantly in sedation. Participants in the lithium group tended to experience more tremor. Similar proportions of participants in the lithium and divalproex groups achieved target concentrations (57% and 56%, respectively). A longitudinal mixed model of improvement (change from baseline in YMRS score) favored lithium (change in score, 3.90; 97.5% CI=1.71, 6.09). Nine-week response rates did not differ significantly between the lithium and divalproex groups (79% and 73%, respectively). The need for adjunctive risperidone was low and similar between groups (17% and 14%, respectively). CONCLUSIONS Both lithium and divalproex were adequately tolerated and efficacious; lithium was associated with a greater reduction in mania scores over 9 weeks.
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Barrett M, Nathan H, Vankayala H, Bieliauskas SL, Viglianti BL, Frankel TL. Recurrence of hepatocellular carcinoma at surgical incision site: case series and review of literature. Ann R Coll Surg Engl 2017; 99:e177-e119. [PMID: 28660820 DOI: 10.1308/rcsann.2017.0097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
First reported two decades ago, isolated incisional recurrence of hepatocellular carcinoma is an extremely rare clinical entity. We present two cases of recurrence: one recurring over 10 years after initial resection, and the second presenting with a port site recurrence 3.5 years following laparoscopic radiofrequency ablation. Clinical case presentation, including radiographical, pathological, laboratory and intraoperative images are reported, together with a review of the current literature surrounding this uncommon hepatocellular carcinoma presentation.
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Brown D, Barrett M, Flanigan J, Sperling S. A-47Neuropsychiatric, Motor, and Demographic Correlates of Apathy in Parkinson's Disease. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Olivier K, Gallagher R, Hale L, Barrett M, Branas C, Killgore WD, Parthasarathy S, Alfonso-Miller P, Gehrels J, Grandner MA. 0769 DEVELOPMENT AND INITIAL VALIDATION OF A BRIEF MEASURE OF CONTROL OVER SLEEP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Forbush S, Fisseha E, Gallagher R, Hale L, Malone S, Patterson F, Branas C, Barrett M, Killgore WD, Gehrels J, Alfonso-Miller P, Grandner MA. 1067 SOCIODEMOGRAPHICS, POOR OVERALL HEALTH, CARDIOVASCULAR DISEASE, DEPRESSION, FATIGUE, AND DAYTIME SLEEPINESS ASSOCIATED WITH SOCIAL JETLAG INDEPENDENT OF SLEEP DURATION AND INSOMNIA. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yang R, Gallagher R, Hale L, Perlis M, Barrett M, Branas C, Killgore WD, Parthasarathy S, Alfonso-Miller P, Gehrels J, Grandner MA. 0814 WOULD YOU CALL YOURSELF A SHORT OR LONG SLEEPER? PERCEPTIONS OF SLEEP CATEGORY ASSOCIATED WITH REPORTED SLEEP DURATION, INSOMNIA, AND HEALTH. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Robbins R, Jean-Louis G, Sundarajan A, Hale L, Gallagher RA, Barrett M, Gooneratne N, Branas C, Alfonso-Miller P, Perlis M, Grandner M. 0809 SOCIAL CAPITAL AND SOCIAL CONNECTEDNESS RELATED TO SLEEP DURATION, INSOMNIA SYMPTOMS, AND DAYTIME SLEEPINESS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fisseha E, Gallagher R, Hale L, Branas C, Barrett M, Killgore WD, Alfonso-Miller P, Jean-Louis G, Seixas A, Williams N, Gehrels J, Grandner MA. 0831 HABITUAL WEEKDAY SLEEP DURATION ASSOCIATED WITH MULTIPLE DIMENSIONS OF SOCIOECONOMIC STATUS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Grandner MA, Gallagher R, Keenan B, Hale L, Alfonso-Miller P, Branas C, Barrett M. 0810 SLEEP AND HEALTHY ACTIVITY, DIET, ENVIRONMENT, AND SOCIALIZATION: THE SHADES STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shojaee-Moradie F, Cuthbertson DJ, Barrett M, Jackson NC, Herring R, Thomas EL, Bell J, Kemp GJ, Wright J, Umpleby AM. Exercise Training Reduces Liver Fat and Increases Rates of VLDL Clearance But Not VLDL Production in NAFLD. J Clin Endocrinol Metab 2016; 101:4219-4228. [PMID: 27583475 DOI: 10.1210/jc.2016-2353] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
CONTEXT Randomized controlled trials in nonalcoholic fatty liver disease (NAFLD) have shown that regular exercise, even without calorie restriction, reduces liver steatosis. A previous study has shown that 16 weeks of supervised exercise training in NAFLD did not affect total very low-density lipoprotein (VLDL) kinetics. OBJECTIVE The objective of the study was to determine the effect of exercise training on intrahepatocellular fat (IHCL) and the kinetics of large triglyceride (TG)-rich VLDL1 and smaller denser VLDL2, which has a lower TG content. DESIGN This was a 16-week randomized controlled trial. PATIENTS A total of 27 sedentary patients with NAFLD participated in the trial. INTERVENTION The intervention was composed of supervised exercise with moderate-intensity aerobic exercise or conventional lifestyle advice (control). MAIN OUTCOME VLDL1 and VLDL2-TG and apolipoprotein B (apoB) kinetics were investigated using stable isotopes before and after the intervention. RESULTS In the exercise group, maximal oxygen uptake increased by 31% ± 6% (mean ± SEM) and IHCL decreased from 19.6% (14.8%, 30.0%) to 8.9% (5.4%, 17.3%) (median [interquartile range]) with no significant change in maximal oxygen uptake or IHCL in the control group (change between groups, P < .001 and P = .02, respectively). Exercise training increased VLDL1-TG and apoB fractional catabolic rates, a measure of clearance, (change between groups, P = .02 and P = .01, respectively), and VLDL1-apoB production rate (change between groups, P = .006), with no change in VLDL1-TG production rate. Plasma TG did not change in either group. CONCLUSION An increased clearance of VLDL1 may contribute to the significant decrease in liver fat after 16 weeks of exercise in NAFLD. A longer duration or higher-intensity exercise interventions may be needed to lower the plasma TG and VLDL production rate.
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