1
|
Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [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: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
Collapse
Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
| |
Collapse
|
2
|
Frequency and burden of potentially treatable symptoms in glioma patients with stable disease. Heliyon 2023; 9:e13278. [PMID: 36798771 PMCID: PMC9925977 DOI: 10.1016/j.heliyon.2023.e13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Background & aims Glioma patients experience a multitude of symptoms that negatively affect their health-related quality of life. Symptoms vary greatly across disease phases, and the patients' stable phase might be particularly suitable for assessing and treating symptoms. Identifying symptoms and patients' needs is a first step toward improving patient care. In glioma patients with stable disease, we assessed the frequency and burden of patient-reported symptoms, examined how these symptoms co-occur, and also determined whether patients would consider treatment to ameliorate specific symptoms. Methods In this retrospective study, patients rated the frequency and burden of seventeen symptoms on a seven-point Likert scale and stated whether they would consider treatment for these symptoms. Correlations between frequency, burden, and considering treatment were evaluated with Kendall's Tau correlation coefficients. Based on partial correlations between symptom frequencies we visualized the symptoms as a network. Results Fifty-two glioma patients with stable disease were included (31 WHO grade II/III, 21 WHO grade IV). The top five symptoms were fatigue, memory problems, reduced physical fitness, concentration problems, and drowsiness. Fatigue had the highest median frequency (4.5, interquartile range 2.5). Over half of the patients experienced three or more symptoms simultaneously and associations between all symptoms were depicted as a network. Overall, 35% of patients would consider treatment for at least one symptom. The wish to undergo symptom treatment correlated only moderately with symptom frequency and burden (range of correlations 0.24-0.57 and 0.28-0.61, respectively). Conclusion Glioma patients with stable disease experience multiple symptoms with a consequently high symptom burden. Despite the high prevalence of symptoms, the inclination for symptom management interventions was relatively low. The most frequent and burdensome symptoms and the way they are interrelated could serve as a roadmap for future research on symptom management in these patients.
Collapse
|
3
|
Foote H, Bowen A, Cotterill S, Hill G, Pieri M, Patchwood E. A scoping review to identify process and outcome measures used in acceptance and commitment therapy research, with adults with acquired neurological conditions. Clin Rehabil 2022; 37:808-835. [PMID: 36540937 PMCID: PMC10134096 DOI: 10.1177/02692155221144554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available. Purpose To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions. Methods PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Results Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire ( n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being ( n = 50), physical functioning ( n = 32), role functioning ( n = 22) and psychiatric ( n = 22). Conclusions This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures.
Collapse
Affiliation(s)
- Hannah Foote
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
- Hannah Foote, Geoffrey Jefferson Brain
Research Centre, The Manchester Academic Health Science Centre, Northern Care
Alliance and University of Manchester, Manchester, UK.
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Geoff Hill
- South Tees Hospitals NHS Foundation
Trust, The James Cook University Hospital, Middlesbrough, UK
| | | | - Emma Patchwood
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
| |
Collapse
|
4
|
Benefit Finding and Related Factors of Patients with Early-Stage Cancer in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074284. [PMID: 35409965 PMCID: PMC8999120 DOI: 10.3390/ijerph19074284] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: Although the research on benefit finding (BF) in China has increased in recent years, it remains in its infancy. Few previous studies have focused on early-stage cancer patients. Therefore, this research study aimed to explore BF and its influencing factors for early-stage cancer patients in China. (2) Methods: From April to August 2019, 319 patients with early-stage cancer in the treatment period were selected by the convenience sampling method and evaluated using the Benefit Finding of Cancer Patients Scale-Chinese (BFS-C), Perceived Social Support Scale (PSSS), and Medical Coping Modes Questionnaire (MCMQ). (3) Results: The mean BF score was 47.57 (SD = 12.26). The results of the correlation analysis show that benefit finding was positively correlated with social support, but negatively correlated with acceptance-resignation. In addition, social support was negatively correlated with avoidance and acceptance-resignation. The results of the multiple linear regression indicate that the variables of self-assessment of disease severity, exercise time, coping mode (acceptance-resignation), and social support, affect BF. Finally, social support was shown to exert an intermediary effect on acceptance-resignation and BF. (4) Conclusions: In this study, the score of BF of patients with early-stage cancer was low. Medical staff should be more aware of the health behavior of patients with early-stage cancer, guide them to actively face the disease, and fully mobilize the social support of patients’ friends and family, so as to help patients increase their disease BF.
Collapse
|
5
|
Mathew A, Doorenbos AZ, Jang MK, Hershberger PE. Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model. J Cancer Surviv 2021; 15:427-451. [PMID: 32949353 PMCID: PMC10960234 DOI: 10.1007/s11764-020-00938-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/05/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE People with cancer experience significant physical and psychological symptoms, during as well as after primary treatment. Acceptance and Commitment Therapy (ACT), a psychological intervention, reduces both types of symptoms among individuals with chronic pain and emotional distress. Due to the unique challenges of cancer survivorship, this systematic review critically evaluates and synthesizes the literature on the context, mechanisms, and effect of ACT among adult cancer survivors. METHODS Articles were retrieved from the CINAHL, MEDLINE via Ovid, Web of Science, PsycInfo, Scopus, Embase, Google Scholar, and Cochrane databases. Selected grey literature portals, clinical trial registries, and conference proceedings were also searched. The NIH tools were used to assess study quality and the revised Cochrane Risk-of-Bias tool to assess risk of bias RESULTS: Thirteen articles, reporting on 537 cancer survivors with various cancer types, were included. ACT significantly reduced anxiety, depression, and fear of cancer recurrence and improved psychological flexibility and quality of life. Outcomes such as pain and insomnia were understudied. Lack of participant blinding and non-random assignment were the most common methodological issues. A conceptual model is proposed that describes the possible influencing factors of an ACT-based intervention in cancer survivors. CONCLUSION Review findings suggest that ACT is an effective intervention to improve some of the common concerns among cancer survivors. While all the studies in the review were recent (published 2015-2019), they examined only a limited number of outcomes. Hence, more methodologically rigorous studies which examine the effect of ACT on other troubling symptoms among cancer survivors are warranted. IMPLICATIONS FOR CANCER SURVIVORS Incorporating ACT into comprehensive post-treatment survivorship care can enhance psychological flexibility and reduce anxiety, depression, and fear.
Collapse
Affiliation(s)
- Asha Mathew
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA.
- College of Nursing, Christian Medical College, Vellore, India.
| | - Ardith Z Doorenbos
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Min Kyeong Jang
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Patricia E Hershberger
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA
| |
Collapse
|
6
|
Salari N, Rezaie L, Khazaie H, Bokaee S, Ghasemi H, Mohammadi M, Khaledi-Paveh B. The effect of acceptance and commitment therapy on anxiety and depression in patients with cancer: A systematic review. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
7
|
Dinapoli L, Chiesa S, Dinapoli N, Gatta R, Beghella Bartoli F, Bracci S, Mazzarella C, Sanfilippo MZ, Sabatino G, Gaudino S, Della Pepa GM, Frascino V, Valentini V, Balducci M. Personalised support of brain tumour patients during radiotherapy based on psychological profile and quality of life. Support Care Cancer 2021; 29:4555-4563. [PMID: 33479794 DOI: 10.1007/s00520-021-06000-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 01/12/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE Psychological distress in primary malignant brain tumour (PMBT) patients is associated with poorer outcomes. Radiotherapy (RT) often induces side effects that significantly influence patients' quality of life (QoL), with potential impact on survival. We evaluated distress, anxiety, depression, and QoL over time to identify patients with difficulties in these areas who required more intense psychological support. METHODS Psychological questionnaires-Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy (FACT-G and FACT-Br)-were completed at the beginning (T0), in the middle (T1), directly after RT (T2), and 3 months after RT (T3). We personalised the psychological support provided for each patient with a minimum of three sessions ('typical' schedule) and a maximum of eight sessions ('intensive' schedule), depending on the patients' psychological profiles, clinical evaluations, and requests. Patients' survival was evaluated in the glioblastoma multiforme (GBM) patients, with an explorative intent. RESULTS Fifty-nine consecutive PMBT patients receiving post-operative RT were included. For patients who were reported as 'not distressed' at T0, no statistically significant changes were noted. In contrast, patients who were 'distressed' at T0 showed statistically significant improvements in DT, HADS, FACT-G, and FACT-Br scores over time. 'Not distressed' patients required less psychological sessions over the study duration than 'distressed' patients. Interestingly, 'not distressed' GBM patients survived longer than 'distressed' GBM patients. CONCLUSIONS Increased psychological support improved distress, mood, and QoL for patients identified as 'distressed', whereas psychological well-being was maintained with typical psychological support in patients who were identified as being 'not distressed'. These results encourage a standardisation of psychological support for all RT patients.
Collapse
Affiliation(s)
- Loredana Dinapoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Unità Operativa Semplice di Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Nicola Dinapoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Roberto Gatta
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Beghella Bartoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Serena Bracci
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Ciro Mazzarella
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | | | - Giovanni Sabatino
- Dipartimento di Neurochirurgia, Ospedale Mater Olbia, Olbia, Italy.,Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Gaudino
- UOC di Radiologia e Neuroradiologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Maria Della Pepa
- UOC di Neurochirurgia, Dipartimento Scienze dell'invecchiamento, Neurologiche, Ortopediche e della testa-collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vincenzo Frascino
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mario Balducci
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
8
|
Han J, Liu JE, Su YL, Qiu H. Effect of a group-based acceptance and commitment therapy (ACT) intervention on illness cognition in breast cancer patients. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
9
|
González-Fernández S, Fernández-Rodríguez C. Acceptance and Commitment Therapy in Cancer: Review of Applications and Findings. Behav Med 2019; 45:255-269. [PMID: 29558259 DOI: 10.1080/08964289.2018.1452713] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study aimed to analyze published studies regarding the usefulness of Acceptance and Commitment Therapy in the treatment of oncological patients. A systematic review of the literature was conducted using the Web of Science, Google Scholar and Dialnet (2000-2016). Nineteen articles fulfilled the inclusion criteria. Those patients who received interventions based on Acceptance and Commitment Therapy showed a better emotional state and quality of life and greater psychological flexibility. Acceptance and Commitment Therapy proved to be useful in the psychological treatment of oncological patients. However, the heterogeneity and limitations of the studies, principally with regard to sample characteristics, study design and manner in which mechanisms responsible for changes are evaluated, make further studies necessary with a view to ascertaining what patient and/or intervention characteristics might improve results. Randomized controlled trials comparing the efficacy of Acceptance and Commitment Therapy with no treatment, with treatment with placebo and with other efficacious therapies, including a study of medium- and long-term results, would be of particular interest.
Collapse
|
10
|
Surapaneni P, Scherber RM. Integrative Approaches to Managing Myeloproliferative Neoplasms: the Role of Nutrition, Exercise, and Psychological Interventions. Curr Hematol Malig Rep 2019; 14:164-170. [PMID: 31093888 DOI: 10.1007/s11899-019-00516-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Myeloproliferative neoplasms (MPNs) have a high symptom burden that affects functional status, emotional well-being, and quality of life for patients. Symptom control continues to be a challenging therapeutic goal despite available pharmacologic interventions. The goal of this review is to detail recent efforts that have focused on non-pharmacologic interventions, such as wholistic or integrative medicine, as an adjunctive method to alter symptom burden in this population. RECENT FINDINGS We discuss the ongoing physical, nutritional, and psychological interventional efforts which represent promising non-traditional interventions to date to help reduce symptom in MPN patients. In this article, we highlight the early promising data and importance of these various non-pharmacological interventions to dampen symptom burden and reduce disease-related inflammation. Nonpharmacologic interventions represent promising therapeutic strategies to alter traditional MPN treatment paradigms and improve MPN patient care.
Collapse
Affiliation(s)
- Prathibha Surapaneni
- Department of Hematology and Oncology, Mays MD Anderson Cancer Center at UT Health San Antonio, Urschel Tower #U623, 7979 Wurzbach Rd., San Antonio, TX, 78229, USA
| | - Robyn M Scherber
- Department of Hematology and Oncology, Mays MD Anderson Cancer Center at UT Health San Antonio, Urschel Tower #U623, 7979 Wurzbach Rd., San Antonio, TX, 78229, USA.
| |
Collapse
|
11
|
Third-Wave Therapies for Long-Term Neurological Conditions: A Systematic Review to Evaluate the Status and Quality of Evidence. BRAIN IMPAIR 2019. [DOI: 10.1017/brimp.2019.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Adults with long-term neurological conditions can face complex challenges including anxiety and depression. Emerging research suggests the utility of third-wave approaches (the third development of psychotherapies) in working transdiagnostically with these difficulties.Aims: This systematic review sought to summarise and appraise the quality of published empirical studies using third-wave therapies such as Compassion Focused Therapy; Acceptance and Commitment Therapy; and Mindfulness-Based Cognitive Therapy or Mindfulness-Based Stress Reduction.Method: Review procedures followed PRISMA guidelines, with 437 abstracts screened, 24 full-text articles retrieved and 19 studies found to meet inclusion criteria. Six out of seven randomised studies had unclear or high risk of bias, whilst the majority of non-randomised studies were considered moderate quality.Results: Overall, studies reported a statistically significant reduction in emotional distress. Of the 13 studies that used model-specific process measures, 10 found statistically significant improvements in transdiagnostic factors.Discussion: The findings indicate that third-wave therapies show promise in addressing transdiagnostic difficulties within neurological conditions. A number of methodological and conceptual issues for the included studies were highlighted during the quality appraisal process. Clinical implications include consideration of intervention length and use of outcome measures. Research implications are discussed by considering the progressive stages of development for behavioural treatments.
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW The purpose of the review was to provide a contemporary update of novel agents and targets under investigation in myelofibrosis in the Janus kinase (JAK) inhibitor era. RECENT FINDINGS Myelofibrosis (MF) is a clonal stem cell disease characterized by marrow fibrosis and a heterogeneous disease phenotype with a variable degree of splenomegaly, cytopenias, and constitutional symptoms that significantly impact quality of life and survival. Overactive JAK/STAT signaling is a hallmark of MF. The only approved therapy for MF, JAK1/2 inhibitor ruxolitinib, can ameliorate splenomegaly, improve symptoms, and prolong survival in some patients. Therapeutic challenges remain, however. Myelosuppression limits the use of ruxolitinib in some patients, eventual drug resistance is common, and the underlying malignant clone persists despite therapy. A deeper understanding of the pathogenesis of MF has informed the development of additional agents. Promising targets under investigation include JAK1 and JAK2 and downstream intermediates in related signaling pathways, epigenetic modifiers, pro-inflammatory cytokines, and immune regulators.
Collapse
Affiliation(s)
- Kristen Pettit
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, 5841 S. Maryland Ave, MC2115, Chicago, IL, 60637, USA
| | - Olatoyosi Odenike
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, 5841 S. Maryland Ave, MC2115, Chicago, IL, 60637, USA.
| |
Collapse
|
13
|
Pace A, Dirven L, Koekkoek JAF, Golla H, Fleming J, Rudà R, Marosi C, Rhun EL, Grant R, Oliver K, Oberg I, Bulbeck HJ, Rooney AG, Henriksson R, Pasman HRW, Oberndorfer S, Weller M, Taphoorn MJB. European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma. Lancet Oncol 2017; 18:e330-e340. [DOI: 10.1016/s1470-2045(17)30345-5] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 12/14/2022]
|