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Ashina S, Muenzel EJ, Nicholson RA, Zagar AJ, Buse DC, Reed ML, Shapiro RE, Hutchinson S, Pearlman EM, Lipton RB. Machine learning identifies factors most associated with seeking medical care for migraine: Results of the OVERCOME (US) study. Headache 2024; 64:1027-1039. [PMID: 38785227 DOI: 10.1111/head.14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Utilize machine learning models to identify factors associated with seeking medical care for migraine. BACKGROUND Migraine is a leading cause of disability worldwide, yet many people with migraine do not seek medical care. METHODS The web-based survey, ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (US), annually recruited demographically representative samples of the US adult population (2018-2020). Respondents with active migraine were identified via a validated diagnostic questionnaire and/or a self-reported medical diagnosis of migraine, and were then asked if they had consulted a healthcare professional for their headaches in the previous 12 months (i.e., "seeking care"). This included in-person/telephone/or e-visit at Primary Care, Specialty Care, or Emergency/Urgent Care locations. Supervised machine learning (Random Forest) and Least Absolute Shrinkage and Selection Operator (LASSO) algorithms identified 13/54 sociodemographic and clinical factors most associated with seeking medical care for migraine. Random Forest models complex relationships (including interactions) between predictor variables and a response. LASSO is also an efficient feature selection algorithm. Linear models were used to determine the multivariable association of those factors with seeking care. RESULTS Among 61,826 persons with migraine, the mean age was 41.7 years (±14.8) and 31,529/61,826 (51.0%) sought medical care for migraine in the previous 12 months. Of those seeking care for migraine, 23,106/31,529 (73.3%) were female, 21,320/31,529 (67.6%) were White, and 28,030/31,529 (88.9%) had health insurance. Severe interictal burden (assessed via the Migraine Interictal Burden Scale-4, MIBS-4) occurred in 52.8% (16,657/31,529) of those seeking care and in 23.1% (6991/30,297) of those not seeking care; similar patterns were observed for severe migraine-related disability (assessed via the Migraine Disability Assessment Scale, MIDAS) (36.7% [11,561/31,529] vs. 14.6% [4434/30,297]) and severe ictal cutaneous allodynia (assessed via the Allodynia Symptom Checklist, ASC-12) (21.0% [6614/31,529] vs. 7.4% [2230/30,297]). Severe interictal burden (vs. none, OR 2.64, 95% CI [2.5, 2.8]); severe migraine-related disability (vs. little/none, OR 2.2, 95% CI [2.0, 2.3]); and severe ictal allodynia (vs. none, OR 1.7, 95% CI [1.6, 1.8]) were strongly associated with seeking care for migraine. CONCLUSIONS Seeking medical care for migraine is associated with higher interictal burden, disability, and allodynia. These findings could support interventions to promote care-seeking among people with migraine, encourage assessment of these factors during consultation, and prioritize these domains in selecting treatments and measuring their benefits.
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Affiliation(s)
- Sait Ashina
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Anesthesia, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Robert E Shapiro
- Department of Neurological Sciences, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Susan Hutchinson
- Orange County Migraine and Headache Center, Irvine, California, USA
| | | | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Headache Center, Bronx, New York, USA
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Mangrum R, Bryant AL, Gerstein MT, McCarrier KP, Houts CR, McGinley JS, Buse DC, Lipton RB, Wirth RJ. The impacts of migraine on functioning: Results from two qualitative studies of people living with migraine. Headache 2024; 64:156-171. [PMID: 38235605 PMCID: PMC10922598 DOI: 10.1111/head.14664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To describe the impact of migraine on functioning based on comprehensive data collection, analysis, and reporting of patients' experiences. BACKGROUND Qualitative research conducted to understand patients' perspectives on living with migraine has often focused on narrow topics or specific groups of patients or has been selectively reported. METHODS Qualitative interviews with 71 participants were conducted during two concept elicitation studies as part of the Migraine Clinical Outcome Assessment System (MiCOAS) project, an FDA grant-funded program designed to develop a core set of patient-centered outcome measures for migraine clinical trials. Participants self-reported being diagnosed with migraine by a healthcare professional and participated in semi-structured qualitative interviews about their experiences with the symptoms and impacts of migraine. Interview transcripts were coded to identify and define concepts, which were then grouped into broad domains based on conceptual similarities. RESULTS A total of 66 concepts were identified: 12 for physical functioning, 16 for cognitive functioning, 10 for social role functioning, 19 for emotional and psychological functioning, and 9 related to migraine management. Participants described a complex and varied relationship between migraine attack symptoms and impacts on functioning. Impacts from migraine were further influenced by numerous contextual factors, such as people's individual social environments and the level of day-to-day demand for functioning they face. CONCLUSION Findings showed that migraine impacted individual functioning in multiple ways and the nature of these impacts was dependent on social-contextual factors. The results are being used in the development of core measures designed to improve our understanding of the burden of migraine and the efficacy of migraine therapies. The results also offer new insights and raise new questions about migraine experience that can be used to guide future research.
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Affiliation(s)
- Rikki Mangrum
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
| | | | - Maya T Gerstein
- Patient Centered Outcomes, Open Health Group, Bethesda, Maryland, USA
| | - Kelly P McCarrier
- Patient Centered Outcomes, Open Health Group, Bethesda, Maryland, USA
| | - Carrie R Houts
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
| | | | - Dawn C Buse
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
- Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Richard B Lipton
- Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - R J Wirth
- Vector Psychometric Group, Chapel Hill, North Carolina, USA
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Ehrlich M, Hentschke C, Sieder C, Maier-Peuschel M, Reuter U. Erenumab versus topiramate: post hoc efficacy analysis from the HER-MES study. J Headache Pain 2022; 23:141. [PMID: 36380284 PMCID: PMC9664641 DOI: 10.1186/s10194-022-01511-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE HER-MES was the first head-to-head, phase 4 trial to assess the tolerability and effectiveness of erenumab against standard of care treatment (topiramate). This post hoc analysis compared the efficacy of erenumab with topiramate in patients who completed the trial on study medication. METHODS Post hoc sensitivity analysis was performed using the full analysis set. Outcomes assessed included the proportion of patients with a ≥50% reduction in monthly migraine days (MMD) from baseline (50% responder rate), over the last 3 months (months 4, 5, and 6) of the double-blind treatment phase (DBTP), the 50% responder rate during the first month of the DBTP, and change from baseline in MMD during the DBTP. Multiple imputation was done for efficacy values of patients who discontinued study treatment. RESULTS Patients (N = 777) were randomly assigned (1:1) to either 70 or 140 mg/month erenumab (N = 389) or 50-100 mg/day topiramate (N = 388). Of these, 334 patients (85.9%) receiving erenumab, and 231 patients (59.5%) receiving topiramate completed the DBTP on study medication. Patients on study medication until the end of the DBTP received a mean dose of 119 mg/month for erenumab and 92 mg/day for topiramate. At month 1, a significantly greater proportion of patients receiving erenumab (39.2%) reported ≥50% reduction in MMD from baseline compared with those receiving topiramate (24.0%; p < 0.001). In the last 3 months, a significantly larger proportion of patients receiving erenumab (60.3%) achieved ≥50% reduction in MMD from baseline compared with those receiving topiramate (43.3%; p < 0.001). Patients receiving erenumab demonstrated significantly greater reductions in MMD during the last 3 months from baseline versus those receiving topiramate (- 6.13 vs - 4.90; 95% CI: - 1.87 to - 0.61; p < 0.001). CONCLUSIONS This post hoc analysis demonstrated significantly superior efficacy of erenumab versus topiramate in achieving a ≥50% reduction in MMD with an early onset of efficacy. TRIAL REGISTRATION ClinicalTrials.gov NCT03828539 .
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Affiliation(s)
| | | | | | | | - Uwe Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
- Universitätsmedizin Greifswald, Greifswald, Germany.
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Gago-Veiga AB, Camiña Muñiz J, García-Azorín D, González-Quintanilla V, Ordás CM, Torres-Ferrus M, Santos-Lasaosa S, Viguera-Romero J, Pozo-Rosich P. Headache: What to ask, how to examine, and which scales to use. Recommendations of the Spanish Society of Neurology's Headache Study Group. Neurologia 2022; 37:564-574. [PMID: 30929913 DOI: 10.1016/j.nrl.2018.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/05/2018] [Accepted: 12/22/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Headache is the most common neurological complaint at the different levels of the healthcare system, and clinical history and physical examination are essential in the diagnosis and treatment of these patients. With the objective of unifying the care given to patients with headache, the Spanish Society of Neurology's Headache Study Group (GECSEN) has decided to establish a series of consensus recommendations to improve and guarantee adequate care in primary care, emergency services, and neurology departments. METHODS With the aim of creating a practical document, the recommendations follow the dynamics of a medical consultation: clinical history, physical examination, and scales quantifying headache impact and disability. In addition, we provide recommendations for follow-up and managing patients' expectations of the treatment. CONCLUSIONS With this tool, we aim to improve the care given to patients with headache in order to guarantee adequate, homogeneous care across Spain.
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Affiliation(s)
- A B Gago-Veiga
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, España.
| | - J Camiña Muñiz
- Servicio de Neurología. Clínica Rotger y Hospital Quirónsalud Palmaplanas, Grupo Quirónsalud, Palma de Mallorca, España
| | - D García-Azorín
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - V González-Quintanilla
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - C M Ordás
- Servicio de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
| | - M Torres-Ferrus
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Barcelona, España
| | - S Santos-Lasaosa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J Viguera-Romero
- Unidad Gestión Clínica de Neurología, Hospital Virgen Macarena, Sevilla, España
| | - P Pozo-Rosich
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Barcelona, España
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Gago-Veiga A, Camiña Muñiz J, García-Azorín D, González-Quintanilla V, Ordás C, Torres-Ferrus M, Santos-Lasaosa S, Viguera-Romero J, Pozo-Rosich P. Headache: what to ask, how to examine, and what scales to use. Recommendations of the Spanish society of neurology’s headache study group. NEUROLOGÍA (ENGLISH EDITION) 2022; 37:564-574. [DOI: 10.1016/j.nrleng.2018.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/22/2018] [Indexed: 10/22/2022] Open
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Kawata AK, Ladd MK, Lipton RB, Buse DC, Bensink M, Shah S, Hareendran A, Mannix S, Mikol D. Reducing the physical, social, and emotional impact of episodic migraine: Results from erenumab STRIVE and ARISE phase III randomized trials. Headache 2022; 62:159-168. [PMID: 35137394 DOI: 10.1111/head.14258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/18/2021] [Accepted: 12/13/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The purpose of this study was to examine changes in the functional impact of migraine following treatment with erenumab, as measured by the Migraine Functional Impact Questionnaire (MFIQ). BACKGROUND The MFIQ, a novel patient-reported outcome (PRO) measuring the impact of migraine on four domains (physical function, social function, and emotional function [PF, SF, and EF]; usual activities [UAs]) and a single item assessing overall impact on UA, was included in phase III trials evaluating erenumab 70 and 140 mg monthly for migraine prevention among people with episodic migraine (EM). METHODS In the ARISE study, 577 patients with EM were randomized to erenumab 70 mg or placebo. In the STRIVE study, 955 patients with EM were randomized to erenumab, 70 mg or 140 mg or placebo. Pairwise comparisons of least-squares mean (LSM) change from baseline in MFIQ scores (with associated 95% confidence interval [CI]) were assessed for each active treatment versus placebo. RESULTS In ARISE, greater reductions from baseline to month 3 were observed for 70 mg versus placebo for PF (LSM [95% CI]: -3.2 [-6.4 to -0.1]; p = 0.046) and EF (-4.0 [-7.3 to -0.7]; p = 0.019) domain scores. In STRIVE, between-group differences also reflected reductions from baseline to the average of months 4-6 that favored erenumab on all four MFIQ domain scores. Reductions in impact for 70 mg compared to placebo were -4.3 (95% CI: -6.8 to -1.7; p < 0.001) for PF, -4.0 (-6.3 to -1.7; p < 0.001) for UA, -3.7 (-6.1 to -1.2; p = 0.003) for SF, and -5.3 (-7.9 to -2.6; p < 0.001) for EF domain scores. Improvements were also observed for 140 mg versus placebo with between-group differences of -5.7 (95% CI: -8.2 to -3.2; p < 0.001) in PF, -5.1 (-7.5 to -2.8; p < 0.001) in UA, -5.0 (-7.4 to -2.6; p < 0.001) in SF, and -7.2 (-9.9 to -4.5; p < 0.001) in EF domain scores. There were also greater improvements in the overall impact on UA score for 70 mg (LSM [95% CI]: -4.3 [-7.0 to -1.7]; p = 0.001) and 140 mg (-5.3 [-8.5 to -3.2]; p < 0.001) versus placebo. CONCLUSIONS The MFIQ measures the frequency of impacts and level of difficulty on multiple functional domains that provide a more complete picture of the effects of migraine. MFIQ scores showed that in comparison with placebo, patients treated with erenumab had greater reductions in the functional impact of migraine, providing insight into treatment benefits that extend beyond improvements in clinical status and health-related quality of life previously reported based on clinical end points and other PROs.
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Affiliation(s)
| | | | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA.,Department of Neurology, Montefiore Medical Center, New York, New York, USA
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA
| | - Mark Bensink
- Global Health Economics, Amgen Inc., Thousand Oaks, California, USA
| | - Shweta Shah
- Global Health Economics, Amgen Inc., Thousand Oaks, California, USA
| | | | | | - Daniel Mikol
- Global Development, Amgen Inc., Thousand Oaks, California, USA
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Lipton RB, Nicholson RA, Reed ML, Araujo AB, Jaffe DH, Faries DE, Buse DC, Shapiro RE, Ashina S, Cambron-Mellott MJ, Rowland JC, Pearlman EM. Diagnosis, consultation, treatment, and impact of migraine in the US: Results of the OVERCOME (US) study. Headache 2022; 62:122-140. [PMID: 35076091 PMCID: PMC9305407 DOI: 10.1111/head.14259] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/20/2021] [Accepted: 12/09/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The ObserVational survey of the Epidemiology, tReatment and Care of MigrainE (OVERCOME; United States) study is a multicohort, longitudinal web survey that assesses symptomatology, consulting, diagnosis, treatment, and impact of migraine in the United States. BACKGROUND Regularly updating population-based views of migraine in the United States provides a method for assessing the quality of ongoing migraine care and identifying unmet needs. METHODS The OVERCOME (US) 2018 migraine cohort involved: (I) creating a demographically representative sample of US adults using quota sampling (n = 97,478), (II) identifying people with active migraine in the past year via a validated migraine diagnostic questionnaire and/or self-reported medical diagnosis of migraine (n = 24,272), and (III) assessing consultation, diagnosis, and treatment of migraine (n = 21,143). The current manuscript evaluated whether those with low frequency episodic migraine (LFEM; 0-3 monthly headache days) differed from other categories on outcomes of interest. RESULTS Among the migraine cohort (n = 21,143), 19,888 (94.1%) met our International Classification of Headache Disorders, 3rd edition-based case definition of migraine and 12,905 (61.0%) self-reported a medical diagnosis of migraine. Respondents' mean (SD) age was 42.2 (15.0) years; 15,697 (74.2%) were women. Having at least moderate disability was common (n = 8965; 42.4%) and around half (n = 10,783; 51.0%) had consulted a medical professional for migraine care in the past year. Only 4792 (22.7%) of respondents were currently using a triptan. Overall, 8539 (40.4%) were eligible for migraine preventive medication and 3555 (16.8%) were currently using migraine preventive medication. Those with LFEM differed from moderate and high frequency episodic migraine and chronic migraine on nearly all measures of consulting, diagnosis, and treatment. CONCLUSION The OVERCOME (US) 2018 cohort revealed slow but steady progress in diagnosis and preventive treatment of migraine. However, despite significant impact among the population, many with migraine have unmet needs related to consulting for migraine, migraine diagnosis, and getting potentially beneficial migraine treatment. Moreover, it demonstrated the heterogeneity and varying unmet needs within episodic migraine.
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Affiliation(s)
- Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | | | | | | | | | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Robert E Shapiro
- Department of Neurological Sciences, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Sait Ashina
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Anesthesia, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Estave PM, Beeghly S, Anderson R, Margol C, Shakir M, George G, Berger A, O’Connell N, Burch R, Haas N, Powers SW, Seng E, Buse DC, Lipton RB, Wells RE. Learning the full impact of migraine through patient voices: A qualitative study. Headache 2021; 61:1004-1020. [PMID: 34081779 PMCID: PMC8428538 DOI: 10.1111/head.14151] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To better characterize the ways that migraine affects multiple domains of life. BACKGROUND Further understanding of migraine burden is needed. METHODS Adults with migraine randomized to mindfulness-based stress reduction or headache education arms (n = 81) in two separate randomized clinical trials participated in semistructured in-person qualitative interviews conducted after the interventions. Interviews queried participants on migraine impact on life and were audio-recorded, transcribed, and summarized into a framework matrix. A master codebook was created until meaning saturation was reached and magnitude coding established code frequency. Themes and subthemes were identified using a constructivist grounded theory approach. RESULTS Despite most participants being treated with acute and/or prophylactic medications, 90% (73/81) reported migraine had a negative impact on overall life, with 68% (55/81) endorsing specific domains of life impacted and 52% (42/81) describing impact on emotional health. Six main themes of migraine impact emerged: (1) global negative impact on overall life; (2) impact on emotional health; (3) impact on cognitive function; (4) impact on specific domains of life (work/career, family, social); (5) fear and avoidance (pain catastrophizing and anticipatory anxiety); and (6) internalized and externalized stigma. Participants reported how migraine (a) controls life, (b) makes life difficult, and (c) causes disability during attacks, with participants (d) experiencing a lack of control and/or (e) attempting to push through despite migraine. Emotional health was affected through (a) isolation, (b) anxiety, (c) frustration/anger, (d) guilt, (e) mood changes/irritability, and (f) depression/hopelessness. Cognitive function was affected through concentration and communication difficulties. CONCLUSIONS Migraine has a global negative impact on overall life, cognitive and emotional health, work, family, and social life. Migraine contributes to isolation, frustration, guilt, fear, avoidance behavior, and stigma. A greater understanding of the deep burden of this chronic neurological disease is needed to effectively target and treat what is most important to those living with migraine.
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Affiliation(s)
- Paige M. Estave
- Department of Physiology and Pharmacology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Summerlyn Beeghly
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Reid Anderson
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Caitlyn Margol
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Mariam Shakir
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Geena George
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Anissa Berger
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Nathaniel O’Connell
- Department of Biostatistics and Data Science, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Rebecca Burch
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Niina Haas
- BrightOutcome, Inc., Buffalo Grove, IL, USA
| | - Scott W. Powers
- Division of Behavioral Medicine and Clinical Psychology, Cinncinati Children’s Hospital Medical Center, Cinncinati, OH, USA
| | - Elizabeth Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Dawn C. Buse
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
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Speck RM, Yu R, Ford JH, Ayer DW, Bhandari R, Wyrwich KW. Psychometric validation and meaningful within-patient change of the Migraine-Specific Quality of Life questionnaire version 2.1 electronic patient-reported outcome in patients with episodic and chronic migraine. Headache 2021; 61:511-526. [PMID: 33481276 PMCID: PMC8048965 DOI: 10.1111/head.14031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the measurement properties of all three domains of the Migraine-Specific Quality of Life questionnaire version 2.1 (MSQ v2.1) electronic patient-reported outcome (ePRO) to assess the functional impact of migraine in patients with episodic or chronic migraine (CM); and identify meaningful within-patient change thresholds for the Role Function-Restrictive (RFR), Role Function-Preventive (RFP), and Emotional Function (EF) domains. METHODS Data were drawn from three double-blind, placebo-controlled, and randomized Phase 3 clinical studies (episodic migraine [EM]: EVOLVE-1 and EVOLVE-2; CM: REGAIN). The psychometric properties of the MSQ v2.1 ePRO domains were demonstrated by evaluating reliability (internal consistency and test-retest), construct validity (convergent and known groups), and responsiveness. Meaningful within-patient change thresholds for domains were estimated using anchor-based approaches, supplemented by empirical cumulative distribution function curves and probability density function plots to enable interpretation of meaningful change over 3 months. The Patient Global Impression of Severity (PGI-S) and Patient Global Impression of Improvement served as anchors. RESULTS A total of 2,850 patients with either EM (EVOLVE-1: 851; EVOLVE-2: 909) or CM (REGAIN: 1,090) were included. The Cronbach's alpha estimates of internal consistency exceeded the recommended threshold of ≥0.70 for all domains from the three studies, indicating adequate internal consistency. Test-retest reliability intraclass correlation coefficients were ≥0.80 for all domains across all three studies, demonstrating almost perfect agreement. Convergent validity was supported by moderate-to-strong correlation (r ≥ 0.30) between all domains of MSQ v2.1 ePRO and studied anchors (Migraine Disability Assessment Score and PGI-S scores) across all three studies. Known group validity was established between all domains and subgroups of patients stratified by baseline PGI-S scores and baseline number of monthly migraine headache days for all three studies. The 3-month meaningful within-patient change thresholds were the same for EM and CM for RFP: 20.00 and EF: 26.67; and for RFR: 25.71. CONCLUSIONS These findings demonstrate that all three domains of the MSQ v2.1 ePRO have sufficient reliability, validity, responsiveness, and appropriate interpretation standards. Our results suggest that MSQ v2.1 ePRO is a well-defined and reliable patient-reported outcome instrument that is suitable for use in clinical studies for evaluating the impact of migraine on patient functioning in episodic and CM.
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Affiliation(s)
| | - Ren Yu
- Patient-Centred Research, Evidera, Bethesda, MD, USA
| | - Janet H Ford
- Global Patient Outcomes and Real World Evidence (GPORWE), Eli Lilly and Company, Indianapolis, IN, USA
| | - David W Ayer
- Global Patient Outcomes and Real World Evidence (GPORWE), Eli Lilly and Company, Indianapolis, IN, USA
| | - Rohit Bhandari
- Global Scientific Communications, Eli Lilly Services India Private Limited, Bangalore, India
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Development of a Questionnaire for Detecting Changes in Dry Eye Disease–Related Symptoms. Eye Contact Lens 2020; 47:8-14. [DOI: 10.1097/icl.0000000000000693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2020] [Indexed: 11/27/2022]
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AlHarbi FG, AlAteeq MA. Quality of life of migraine patients followed in neurology clinics in Riyadh, Saudi Arabia. J Family Community Med 2020; 27:37-45. [PMID: 32030077 PMCID: PMC6984026 DOI: 10.4103/jfcm.jfcm_185_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/13/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Migraine is a chronic disorder that negatively affects a patient's quality of life (QOL). As little is known about the QOL of migraine sufferers in Saudi Arabia, our aim was to investigate the QOL and the level of migraine-associated disability of migraine patients. MATERIALS AND METHODS This cross-sectional study was conducted in neurology clinics at King Abdulaziz Medical City for National Guard and Prince Sultan Military Medical City in Riyadh, Saudi Arabia, from August to December 2018. The migraine-specific QOL questionnaire (MSQ), version 2.1, was used to measure restrictive, preventive, and emotional domains. The sum of the item responses ranged between 0 and 100, with higher scores indicating better QOL. A descriptive analysis of numerical variables was reported in terms of means and standard deviation, while categorical variables were described using frequencies and percentages. RESULTS A total of 300 migraine patients completed the questionnaire; 67% were females. Age of participants ranged from 20 to 53 years, with mean age of 34.21 (SD=7.26). The mean score in the QOL restrictive domain was 51.8 ± 19, whereas the mean scores for preventive and emotional domains were 54 ± 18 and 46.3 ± 23.4, respectively. Low QOL scores were associated with young ages, long disease duration, frequent migraine attacks, and presence of chronic diseases. CONCLUSION Chronic migraine has a negative impact on QOL, predominantly in young patients, patients with frequent attacks, those not using preventive medications, and those suffering from chronic diseases.
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Affiliation(s)
- Fatima G AlHarbi
- Department of Family Medicine and Primary Health Care, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed A AlAteeq
- Department of Family Medicine and Primary Health Care, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
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12
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13
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14
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Dodick DW, Tepper SJ, Lipton RB, Buse DC, Stewart WF, Bayliss M, Desai P, Sapra S, Anderson K, McInerney-Prichard E. Improving Medical Communication in Migraine Management: A Modified Delphi Study to Develop a Digital Migraine Tracker. Headache 2019; 58:1358-1372. [PMID: 30362524 DOI: 10.1111/head.13426] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/28/2018] [Accepted: 08/10/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study aimed to identify the essential content and amount of information to be collected from people with migraine via a patient-facing smartphone-based migraine tracker for them to share with clinicians during live discussions to assist in optimizing migraine management. The proposed tracker is intended for use in non-interventional research to evaluate disease burden in episodic migraine and chronic migraine patients as assessed by demographic and clinical characteristics and health resource utilization in an integrated delivery network setting. The proposed tracker is not intended for commercial purposes. BACKGROUND Epidemiological studies suggest migraine is underdiagnosed and undertreated. Studies of patient-clinician interactions suggest that effective medical communication may help address these issues. METHODS Four migraine practice leaders, an epidemiologist with extensive migraine experience, and a measurement expert took part in a modified Delphi panel process to identify data elements that could be collected from people with migraine through a smartphone-based migraine tracker. Importantly, the proposed tracker would not be intended to replace the patient-clinician encounter but to support the encounter through enabling the patient to document migraine symptoms and experiences in a timely and accurate manner for sharing with a clinician as part of a broader face-to-face discussion. The panel reviewed questions derived from the existing migraine diaries in the public domain, those used in clinical trials, and patient-centric surveys assessing the impact of migraine on physical function and other related concepts. Key considerations included identification of the most clinically useful data elements for a shared communication tool for people with migraine under the care of a clinician. The panel also identified numerous functionality requirements for such a tool and provided recommendations on the most effective way to present results to a clinician. RESULTS The expert panel opined that people with migraine may value the ability to capture a relatively broad range of information for their own migraine-tracking purposes, while clinicians will likely find greater value in a small set of data relevant to the management of migraine. The panel identified the 3 most essential concepts in categories of data for a clinician, for which they coined the term "The 3 Fs": Frequency of days with headache; Frequency of acute medication usage; and Functional impairment. Information on the frequency of days with headache was felt to combine with the information on the frequency of acute medication usage to provide essential insights into current migraine management strategy and its outcomes, and to assist considerations of preventive measures. Functional impairment was treated as an effective surrogate for headache severity and was assessed based on the following: degree of difficulty in performing activities of daily living, impact on absenteeism (taking leave from work or cancelling/avoiding other activities) and presenteeism (performing work or other daily activities, with reduced productivity/capability), and amount of rest required as a result of a migraine attack. The modified Delphi panel process resulted in the selection of 13 questions in 8 categories to elicit sufficient and meaningful data comprising headache occurrence, symptoms, daily/preventive and as-needed/acute medication usage, triggers, ability to concentrate, and functional impairment. The panel also agreed that the tracker should generate 2 distinct reports: one for people with migraine that would include a wider range of data about symptoms and perceived triggers, and a targeted report for the clinician that would place prime emphasis on the 3 Fs for aggregating the results of each headache occurrence and the trend over time. CONCLUSIONS A system that easily captures critical data elements about migraine, with specific feedback displays for patients to share with clinicians during live discussions, may offer some benefit to people with migraine and their clinicians by facilitating more objective communication and optimizing management. The tracker's output may enable people with migraine to track a wide range of data for their own purposes, allowing them to better understand their condition, while a synthesized view of the selected data may support more informed clinical decision-making for the clinician and individualized, evidence-based discussion with the patient. As a result, this shared decision-making tool may enable patients to more accurately convey essential migraine information during live patient-clinician discussions to drive improved management and patient outcomes.
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Affiliation(s)
| | | | | | - Dawn C Buse
- Montefiore Medical Center, New York, NY, USA
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15
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Kashihara J, Yamakawa I, Kameyama A, Muranaka M, Taku K, Sakamoto S. Perceptions of traditional and modern types of depression: A cross-cultural vignette survey comparing Japanese and American undergraduate students. Psychiatry Clin Neurosci 2019; 73:441-447. [PMID: 30854726 DOI: 10.1111/pcn.12838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/21/2019] [Accepted: 03/07/2019] [Indexed: 11/29/2022]
Abstract
AIM Depression is a heterogeneous disorder that has various subtypes. In Japan, however, a prevailing misunderstanding is that the term utsu-byo (clinical depression) indicates only the melancholic type. Consequently, a subtype called 'modern-type depression' (MTD), which has contrasting features to those of melancholic or traditional-type depression (TTD), is severely stigmatized in Japan these days. The present study conducted a cross-cultural comparison of perceptions of TTD and MTD between Japan and the USA to examine how the Japanese collectivistic culture contributes to negative biases toward MTD. METHODS Undergraduate students in Japan (N = 303) and the Midwestern USA (N = 272) completed the survey. They read two vignettes that described the conditions of fictional individuals with either TTD or MTD, and then reported their perceptions of each vignette. RESULTS Mixed analyses of variance revealed significant interactions between nation (Japan or the USA) and vignette (TTD or MTD) on most perception items. These interactions and subsequent analyses with Bonferroni corrections mainly indicate the following: (i) Japanese are more likely to suppose that conditions of MTD are milder compared with TTD; and (ii) Japanese are more likely to hold stronger aversive attitudes and weaker willingness to provide support toward people with MTD than toward those with TTD. CONCLUSION These results indicate that people with MTD are more likely to be accepted in the US independent culture than in the Japanese collectivistic culture. Discussion highlights that cultural diversity education potentially reduces stigma of MTD in Japan.
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Affiliation(s)
- Jun Kashihara
- Department of Psychology, College of Humanities and Sciences, Nihon University, Tokyo, Japan.,Population Mental Health Group, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Itsuki Yamakawa
- Department of Psychology, College of Humanities and Sciences, Nihon University, Tokyo, Japan
| | - Akiko Kameyama
- Department of Psychology, College of Humanities and Sciences, Nihon University, Tokyo, Japan
| | - Masaki Muranaka
- Faculty of Social Welfare, Department of Psychology in Social Welfare, Shizuoka University of Welfare, Yaizu, Japan
| | - Kanako Taku
- Department of Psychology, College of Arts and Sciences, Oakland University, Rochester, USA
| | - Shinji Sakamoto
- Department of Psychology, College of Humanities and Sciences, Nihon University, Tokyo, Japan
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16
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Kelley GA, Kelley KS, Callahan LF. Aerobic Exercise and Fatigue in Rheumatoid Arthritis Participants: A Meta-Analysis Using the Minimal Important Difference Approach. Arthritis Care Res (Hoboken) 2019; 70:1735-1739. [PMID: 29609204 DOI: 10.1002/acr.23570] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/27/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To use the minimal important difference (MID) versus the standardized mean difference (SMD) approach in order to provide more robust and clinically relevant information regarding the association between land-based aerobic exercise and changes in self-reported fatigue among adults with rheumatoid arthritis (RA). METHODS Data from a previous meta-analysis of 5 randomized controlled trials that represented up to 298 participants per study were utilized to calculate 9 effect sizes, using the MID approach. Data used to obtain the MID were derived from previously reported anchor-based values specific to each fatigue instrument in adults with RA. Results were pooled using a random-effects model. RESULTS Aerobic exercise resulted in statistically significant reductions in self-reported fatigue (MID effect size -0.34 [95% confidence interval (95% CI) -0.58, -0.10]; P = 0.006). Results were similar when effect sizes were collapsed so that only 1 effect size represented each study (MID effect size -0.39 [95% CI -0.76, -0.03]; P = 0.04). CONCLUSION Land-based aerobic exercise is associated with statistically significant reductions in fatigue; however, based on previous cut points, it may be unlikely that a substantial number of participants with RA could obtain clinically relevant reductions in fatigue. Additional studies are needed, especially in those individuals with RA who have elevated levels of fatigue.
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17
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Rensen N, Steur LM, Schepers SA, Merks JH, Moll AC, Kaspers GJ, Grootenhuis MA, van Litsenburg RR. Gender-specific differences in parental health-related quality of life in childhood cancer. Pediatr Blood Cancer 2019; 66:e27728. [PMID: 30916456 DOI: 10.1002/pbc.27728] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parents of children with cancer are at risk for impaired health-related quality of life (HRQoL). Most prior research has focused on the HRQoL of mothers. The aim of this study is to describe HRQoL in mothers and fathers, and determine the influence of sociodemographic, medical, and psychosocial factors. PROCEDURE In a cross-sectional study, both parents completed questionnaires on sociodemographics, distress, and HRQoL. Parental HRQoL was compared to healthy population values. Differences between mothers and fathers were evaluated with multilevel analysis. Gender-specific HRQoL determinants were assessed via multiple linear regression analysis. RESULTS Parents (202 mothers, 150 fathers; comprising 121 couples) of 231 children with different cancer diagnoses (mean time since diagnosis 3.3 ± 1.4 years, 90% posttreatment) participated. Compared to healthy women and men, mothers and fathers reported significantly impaired HRQoL on the following domains: cognitive functioning, sleep, daily activities, and vitality (Cohen's d = 0.3-0.9). Additionally, maternal HRQoL was reduced on the domains gross motor functioning, pain, social functioning, sexuality, and depressive emotions. Mothers scored worse than fathers on six of 12 domains. Risk factors for adverse outcomes in both parents were higher distress, emotional and parenting problems, little social support, medication use, and active treatment of the child. Other determinants in mothers were non-Dutch background and unemployment, while lower HRQoL in fathers was predicted by their child's diagnosis type, shorter time since diagnosis, and treatment intensity. CONCLUSION These outcomes illustrate the need for family-centered care. Future interventions aimed at improving parental functioning should take into account gender-specific differences in HRQoL to reach optimal efficacy.
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Affiliation(s)
- Niki Rensen
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M Steur
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gertjan J Kaspers
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Raphaële R van Litsenburg
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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18
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Rolf M, Kroposki M, Watson S. Quantitative evaluation of variables to student success in a mastery learning baccalaureate nursing programme. Nurs Open 2019; 6:959-965. [PMID: 31367419 PMCID: PMC6650644 DOI: 10.1002/nop2.278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/22/2018] [Accepted: 03/06/2019] [Indexed: 11/23/2022] Open
Abstract
AIM This study evaluated the relationship of student input and throughput variables in a mastery learning baccalaureate nursing programme to licensure success. DESIGN This study used a quantitative, correlational design. METHODS Retrospective analysis of records of 367 graduates over a 6-year period tested the relationship of pass rate on the licensing examination to six variables: overall pre-admission grade point average, entrance assessment scores, interview scores, remediation, programme length and exit assessment using point-biserial correlations, and chi-square analysis and logistic regression analysis. RESULTS Overall pre-admission grade point average, entrance assessment scores, interview scores and exit assessment scores were positively correlated with student success. Although remediation and programme length were not correlated with success, 87% of the students participated in remediation. Most students (95%) successfully passed the Registered Nurse licence examination on their first attempt. While specific criteria were related to student success, further research is needed to determine the role of remediation.
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Affiliation(s)
- Marie Rolf
- College of NursingRoseman University of Health SciencesHendersonNevada
| | | | - Susan Watson
- College of NursingRoseman University of Health SciencesHendersonNevada
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19
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Guerin RJ, Toland MD, Okun AH, Rojas-Guyler L, Baker DS, Bernard AL. Using a Modified Theory of Planned Behavior to Examine Teachers' Intention to Implement a Work Safety and Health Curriculum. THE JOURNAL OF SCHOOL HEALTH 2019; 89:549-559. [PMID: 31106864 PMCID: PMC7243411 DOI: 10.1111/josh.12781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/30/2018] [Accepted: 02/13/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Workplace safety and health is a major public health concern, but largely absent from the school health curriculum. Little is known about teachers' perceptions of teaching workplace safety and health topics. METHODS We administered a 41-item questionnaire reflecting the theory of planned behavior, modified to measure knowledge, to 242 middle and high school teachers in career and technical education and academic subjects. We conducted confirmatory factor analysis to assess the measures' psychometric properties and factorial ANOVAs to compare differences among participants' knowledge, attitude toward, self-efficacy, and intention (to teach) workplace safety and health by sex, prior work injury, and main subject taught. RESULTS Confirmatory factor analyses indicated the measures reflected the theory. Factorial ANOVAs suggested female teachers had statistically significantly lower mean self-efficacy scores than did male teachers to teach workplace safety and health. Male occupational career and technical education teachers demonstrated higher mean knowledge scores than male teachers in other subjects. Participants not injured at work had higher knowledge scores than those who had been injured. CONCLUSION Self-efficacy (influenced by sex) and knowledge (influenced by subject taught and previous workplace injury) revealed factors that may affect teachers' provision of workplace safety and health education, a critical yet overlooked component of school health.
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Affiliation(s)
- Rebecca J Guerin
- National Institute for Occupational Safety and Health (NIOSH), US Centers for Disease Control and Prevention (CDC), 1090 Tusculum Ave. MS C-10, Cincinnati, Ohio 45226
| | - Michael D Toland
- University of Kentucky College of Education, 251C Dickey Hall, Lexington, Kentucky 40506-0017
| | - Andrea H Okun
- National Institute for Occupational Safety and Health (NIOSH), US Centers for Disease Control and Prevention (CDC), 1090 Tusculum Ave. MS C-10, Cincinnati, Ohio 45226
| | - Liliana Rojas-Guyler
- University of Cincinnati College of Education, Criminal Justice and Human Services, 2610 McMicken Circle, Teachers-Dyer Complex, Cincinnati, Ohio 45221-0068
| | - Devin S Baker
- National Institute for Occupational Safety and Health (NIOSH), US Centers for Disease Control and Prevention (CDC), 1090 Tusculum Ave. MS C-10, Cincinnati, Ohio 45226
| | - Amy L Bernard
- University of Cincinnati College of Education, Criminal Justice and Human Services, 2610 McMicken Circle, Teachers-Dyer Complex, Cincinnati, Ohio 45221-0068
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20
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Conlon RPK, Hurst KT, Hayes JF, Balantekin KN, Stein RI, Saelens BE, Brown ML, Sheinbein DH, Welch RR, Perri MG, Schechtman KB, Epstein LH, Wilfley DE. Child and parent reports of children's depressive symptoms in relation to children's weight loss response in family-based obesity treatment. Pediatr Obes 2019; 14:e12511. [PMID: 30664829 PMCID: PMC6546528 DOI: 10.1111/ijpo.12511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/16/2018] [Accepted: 12/03/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies of the association between children's depressive symptoms and obesity treatment response show mixed results. Different measurement may contribute to the inconsistent findings, as children's depressive symptoms are often based on parent-report about their child rather than child self-report. OBJECTIVES We assessed both child- and parent-report of child depressive symptoms as predictors of children's obesity treatment response. METHODS Children with overweight/obesity (body mass index [BMI] ≥ 85th percentile; N = 181) and their parents reported on children's depressive symptoms prior to family-based behavioral weight loss treatment. RESULTS Child percent overweight reduction from baseline to post-treatment was not predicted by child self-reported depressive symptoms or parent-report of child symptoms (P > 0.80), but was significantly predicted by the interaction between child self-report and parent-report on child (β = 0.14, P = 0.05). In analyses using clinical cutoffs, amongst children with high self-reported symptoms, those whose parents reported low child depressive symptoms had greater reduction in percent overweight (t = 2.67, P = 0.008), whereas amongst children with low self-reported symptoms, parent ratings were not associated with treatment outcome. CONCLUSIONS Including both child self-report and parent-report of child depressive symptoms may inform obesity care. Research is needed to examine differences amongst child and parent depressive symptom reports and strategies to address symptoms and optimize pediatric obesity treatment.
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Affiliation(s)
| | - Kelly T. Hurst
- National Center for Weight and Wellness, Washington, DC, USA
| | | | | | | | - Brian E. Saelens
- Seattle Children’s Research Institute and the University of Washington, Seattle, WA, USA
| | - Mackenzie L. Brown
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Michael G. Perri
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Leonard H. Epstein
- School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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21
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Kählke F, Berger T, Schulz A, Baumeister H, Berking M, Auerbach RP, Bruffaerts R, Cuijpers P, Kessler RC, Ebert DD. Efficacy of an unguided internet-based self-help intervention for social anxiety disorder in university students: A randomized controlled trial. Int J Methods Psychiatr Res 2019; 28:e1766. [PMID: 30687986 PMCID: PMC6877166 DOI: 10.1002/mpr.1766] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 11/25/2018] [Accepted: 12/01/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Internet- and mobile-based interventions (IMIs) offer the opportunity to deliver mental health treatments on a large scale. This randomized controlled trial evaluated the efficacy of an unguided IMI (StudiCare SAD) for university students with social anxiety disorder (SAD). METHODS University students (N = 200) diagnosed with SAD were randomly assigned to an IMI or a waitlist control group (WLC) with full access to treatment as usual. StudiCare SAD consists of nine sessions. The primary outcome was SAD symptoms at posttreatment (10 weeks), assessed via the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Secondary outcomes included depression, quality of life, fear of positive evaluation, general psychopathology, and interpersonal problems. RESULTS Results indicated moderate to large effect sizes in favor of StudiCare SAD compared with WLC for SAD at posttest for the primary outcomes (SPS: d = 0.76; SIAS: d = 0.55, p < 0.001). Effects on all secondary outcomes were significant and in favor of the intervention group. CONCLUSION StudiCare SAD has proven effective in reducing SAD symptoms in university students. Providing IMIs may be a promising way to reach university students with SAD at an early stage with an effective treatment.
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Affiliation(s)
- Fanny Kählke
- Department of Clinical Psychology and PsychotherapyUniversity of Erlangen–NurembergErlangenGermany
| | - Thomas Berger
- Department of Clinical Psychology and PsychotherapyUniversity of BernBernSwitzerland
| | - Ava Schulz
- Department of Experimental Psychopathology and PsychotherapyUniversity of Zürich, Psychiatric University HospitalZürichSwitzerland
| | - Harald Baumeister
- Department of Clinical Psychology and PsychotherapyUniversity of UlmUlmGermany
| | - Matthias Berking
- Department of Clinical Psychology and PsychotherapyUniversity of Erlangen–NurembergErlangenGermany
| | - Randy P. Auerbach
- Department of Psychiatry, College of Physicians and SurgeonsColumbia UniversityNew York CityNew YorkUSA
- Division of Clinical Developmental NeuroscienceSackler InstituteNew York CityNew YorkUSA
| | - Ronny Bruffaerts
- Research Group Psychiatry, Department of NeurosciencesKU Leuven UniversityLeuvenBelgium
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ronald C. Kessler
- Department for Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - David Daniel Ebert
- Department of Clinical Psychology and PsychotherapyUniversity of Erlangen–NurembergErlangenGermany
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22
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Paalgard Flemmen M, Jarness V, Rosenlund L. Class and status: on the misconstrual of the conceptual distinction and a neo-Bourdieusian alternative. THE BRITISH JOURNAL OF SOCIOLOGY 2019; 70:816-866. [PMID: 30417322 DOI: 10.1111/1468-4446.12508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 05/28/2023]
Abstract
In this article, we address the classical debate about the relationship between the economic and cultural aspects of social stratification, typically cast in terms of Weber's distinction between class and status. We discuss in particular Chan and Goldthorpe's influential, yet largely unchallenged, attempt to reinstate a strict version of the class-status distinction, mounted as an attack on 'Bourdieusian' accounts. We argue that this is unconvincing in two respects: There are fundamental problems with their conceptualization of status, producing a peculiar account where one expression of status honour explains the other; in addition, their portrayal of the Bourdieusian approach as one-dimensional is highly questionable. In contradiction of a reading of Bourdieu as discarding the class-status distinction, we develop an alternative, neo-Bourdieusian account that recognizes class and status as distinct aspects of stratification, thereby allowing for a subtle analysis of their empirical entwinement. The fruitfulness of this approach is demonstrated by analysing the homology between the space of lifestyles and the social space through Multiple Correspondence Analysis of unusually rich data about lifestyles. Importantly, we highlight the relative autonomy of these spaces: Although they exhibit a similar structure, they do not overlap completely.
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Affiliation(s)
| | - Vegard Jarness
- NIFU - Nordic Institute for Studies in Innovation, Research and Education
| | - Lennart Rosenlund
- Department of Media, Culture and Social Sciences, University of Stavanger
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23
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Rusch HL, Rosario M, Levison LM, Olivera A, Livingston WS, Wu T, Gill JM. The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Ann N Y Acad Sci 2019; 1445:5-16. [PMID: 30575050 PMCID: PMC6557693 DOI: 10.1111/nyas.13996] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/29/2018] [Accepted: 12/04/2018] [Indexed: 12/13/2022]
Abstract
There is a growing interest in the effectiveness of mindfulness meditation for sleep disturbed populations. Our study sought to evaluate the effect of mindfulness meditation interventions on sleep quality. To assess for relative efficacy, comparator groups were restricted to specific active controls (such as evidenced-based sleep treatments) and nonspecific active controls (such as time/attention-matched interventions to control for placebo effects), which were analyzed separately. From 3303 total records, 18 trials with 1654 participants were included. We determined the strength of evidence using four domains (risk of bias, directness of outcome measures, consistency of results, and precision of results). At posttreatment and follow-up, there was low strength of evidence that mindfulness meditation interventions had no effect on sleep quality compared with specific active controls (ES 0.03 (95% CI -0.43 to 0.49)) and (ES -0.14 (95% CI -0.62 to 0.34)), respectively. Additionally, there was moderate strength of evidence that mindfulness meditation interventions significantly improved sleep quality compared with nonspecific active controls at postintervention (ES 0.33 (95% CI 0.17-0.48)) and at follow-up (ES 0.54 (95% CI 0.24-0.84)). These preliminary findings suggest that mindfulness meditation may be effective in treating some aspects of sleep disturbance. Further research is warranted.
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Affiliation(s)
- Heather L. Rusch
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Michael Rosario
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | | | - Anlys Olivera
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Whitney S. Livingston
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Tianxia Wu
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda,
Maryland
| | - Jessica M. Gill
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
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24
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Jenzer T, Read JP, Naragon-Gainey K, Prince MA. Coping trajectories in emerging adulthood: The influence of temperament and gender. J Pers 2019; 87:607-619. [PMID: 29999532 PMCID: PMC6330139 DOI: 10.1111/jopy.12419] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The study of coping has far-reaching implications for understanding psychopathology and resilience, as well as for the treatment of psychological disorders. Developmental work has examined how the ability to cope changes across time in children and adolescents; however, work in emerging adulthood is still lacking. Coping is thought to emerge from basic biological and psychological processes, such as temperament and gender, which may influence the trajectory of coping use over time. METHOD Using a sample of college students (N = 1,000), our 4-year longitudinal study with yearly assessments sought to (a) examine the trajectory of coping styles in emerging adulthood and to (b) examine the influence of temperament and gender on these coping trajectories. RESULTS Our findings suggest that young adults' use of avoidance strategies decreased slightly over college, whereas the use of approach strategies and social support seeking remained stable. Temperament (BIS/BAS) and gender were related to certain coping styles at baseline and appeared to have an influence on some of these trajectories over time, though these associations were complex. CONCLUSIONS This work may inform intervention research attempting to promote adaptive coping because it may help identify young adults most in need of such interventions.
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Affiliation(s)
- Tiffany Jenzer
- Department of Psychology, State University of New York - University at Buffalo, Buffalo, NY 14260
| | - Jennifer P. Read
- Department of Psychology, State University of New York - University at Buffalo, Buffalo, NY 14260
| | - Kristin Naragon-Gainey
- Department of Psychology, State University of New York - University at Buffalo, Buffalo, NY 14260
| | - Mark A. Prince
- Department of Psychology, Colorado State University, Fort Collins, CO
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Harrer M, Adam SH, Baumeister H, Cuijpers P, Karyotaki E, Auerbach RP, Kessler RC, Bruffaerts R, Berking M, Ebert DD. Internet interventions for mental health in university students: A systematic review and meta-analysis. Int J Methods Psychiatr Res 2019; 28:e1759. [PMID: 30585363 PMCID: PMC6877279 DOI: 10.1002/mpr.1759] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/24/2018] [Accepted: 11/09/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Mental health disorders are highly prevalent among university students. Universities could be an optimal setting to provide evidence-based care through the Internet. As part of the World Mental Health International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of Internet-based interventions for university students' mental health. METHOD A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, and PsycINFO) for randomized trials examining psychological interventions for the mental health (depression, anxiety, stress, sleep problems, and eating disorder symptoms), well-being, and functioning of university students was performed through April 30, 2018. RESULTS Forty-eight studies were included. Twenty-three studies (48%) were rated to have low risk of bias. Small intervention effects were found on depression (g = 0.18, 95% confidence interval [CI; 0.08, 0.27]), anxiety (g = 0.27, 95% CI [0.13, 0.40]), and stress (g = 0.20, 95% CI [0.02, 0.38]). Moderate effects were found on eating disorder symptoms (g = 0.52, 95% CI [0.22-0.83]) and role functioning (g = 0.41, 95% CI [0.26, 0.56]). Effects on well-being were non-significant (g = 0.15, 95% CI [-0.20, 0.50]). Heterogeneity was moderate to substantial in many analyses. After adjusting for publication bias, effects on anxiety were not significant anymore. DISCUSSION Internet interventions for university students' mental health can have significant small-to-moderate effects on a range of conditions. However, more research is needed to determine student subsets for which Internet-based interventions are most effective and to explore ways to increase treatment effectiveness.
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Affiliation(s)
- Mathias Harrer
- Clinical Psychology and PsychotherapyFriedrich–Alexander University Erlangen–NurembergErlangenGermany
| | - Sophia H. Adam
- Clinical Psychology and PsychotherapyFriedrich–Alexander University Erlangen–NurembergErlangenGermany
| | | | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro, and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusetts
| | - Ronny Bruffaerts
- Universitair Psychiatrisch CentrumKatholieke Universiteit LeuvenLeuvenBelgium
| | - Matthias Berking
- Clinical Psychology and PsychotherapyFriedrich–Alexander University Erlangen–NurembergErlangenGermany
| | - David D. Ebert
- Department of Clinical, Neuro, and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
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26
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Lock J, Sadeh-Sharvit S, L'Insalata A. Feasibility of conducting a randomized clinical trial using family-based treatment for avoidant/restrictive food intake disorder. Int J Eat Disord 2019; 52:746-751. [PMID: 30924958 DOI: 10.1002/eat.23077] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 01/01/2023]
Abstract
Treatments for avoidant/restrictive food intake disorder (ARFID) lack strong empirical support. There is a critical need to conduct adequately powered studies to identify effective treatments for ARFID. As a first step, the primary aim of this study was to assess the feasibility of conducting a randomized clinical trial (RCT) comparing Family-based Treatment for ARFID (FBT-ARFID) to usual care (UC). The primary outcomes were recruitment, attrition, suitability, and expectancy rates. The secondary aim was to assess changes in percent estimated body weight, eating related psychopathology, and parental self-efficacy from baseline to end of treatment/UC period in both groups. Recruitment rates were 1.87 per month; 28 children with ARFID and their families were randomized and attrition rate was 21%. Therapeutic suitability and expectancy rating suggested that FBT-ARFID was acceptable to families. Effect size (ES) differences on measures of weight and clinical severity were moderate to large, favoring FBT-ARFID over UC. Parental self-efficacy improvement also demonstrated a large ES favoring FBT-ARFID, which was correlated with improvements in ARFID symptoms. There is a research gap between our knowledge base on how to treat children with ARFID and clinical need. The data presented suggest that an RCT comparing FBT-ARFID and UC is feasible to conduct.
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Affiliation(s)
- James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Shiri Sadeh-Sharvit
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Alexa L'Insalata
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
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Piras F, Piras F, Banaj N, Ciullo V, Vecchio D, Edden RAE, Spalletta G. Cerebellar GABAergic correlates of cognition-mediated verbal fluency in physiology and schizophrenia. Acta Psychiatr Scand 2019; 139:582-594. [PMID: 30887499 DOI: 10.1111/acps.13027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Defective cerebellar GABAergic inhibitory control may participate to the cognitive impairments seen in SZ. We tested the prediction of a model for the relationship between cerebellar GABA concentration and the associative/executive processes required by verbal fluency in patients with schizophrenia (SZ) and matched healthy controls (HC). METHOD Magnetic resonance spectroscopy of GABA was performed using a 3 Tesla scanner and verbal fluency assessed by the Controlled Word (WFT) and Semantic (SFT) Fluency tests. Cerebellar GABA measurements were obtained using the MEGA-PRESS acquisition sequence. Linear correlations between cerebellar GABA levels and the WFT, SFT score were performed to test differences between correlation coefficients of SZ and HC. Quantile regressions between GABA levels and the WFT score were performed. RESULTS Higher cerebellar GABA concentration was associated in SZ with lower phonemic fluency and reduced number of switches among subcategories as opposed to what observed in HC (with higher cerebellar GABA associated with higher number of words and phonemic switches). GABA levels explained phonemic fluency in SZ performing above the group mean. CONCLUSION Studying cerebellar GABA provides a valid heuristic to explore the molecular mechanisms of SZ. This is crucial for developing pharmacological treatments to improve cognition and functional recovery in SZ.
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Affiliation(s)
- F Piras
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - F Piras
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - N Banaj
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - V Ciullo
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - D Vecchio
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - R A E Edden
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, USA.,F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - G Spalletta
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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28
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Martínez-Aldao D, Martínez-Lemos I, Bouzas-Rico S, Ayán-Pérez C. Feasibility of a dance and exercise with music programme on adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:519-527. [PMID: 30609165 DOI: 10.1111/jir.12585] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 08/12/2018] [Accepted: 11/16/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Research regarding the feasibility and effects of dancing and exercise with musical support programmes on the physical fitness of adults with intellectual disability (ID) is scarce. The purpose of this study was to provide scientific evidence regarding the feasibility of a training programme consisting of dancing and exercise with music designed for adults with ID, as well as to assess its impact on their body composition and cardiovascular and muscular fitness. METHODS A total of 30 adults (mean age 36.37 ± 11.24 years) with mild (n = 13), moderate (n = 16) or severe (n = 1) ID took part in a 10-week dancing and exercise with music programme. Recruitment and completion rate, adherence to the programme, participation and adverse effects were registered as measures of feasibility. The body mass index, cardiovascular endurance (6-min walk test) and muscular strength (standing long jump test) of the participants were assessed in order to determine the effects of the programme on their fitness level. RESULTS A 92.5% recruitment rate and a 90% completion rate were achieved. Adherence to the programme stood at 76.6%, and no adverse effects were registered. The comparison between the values obtained in the initial and final evaluations indicated the existence of positive changes in all the fitness dimensions measured. CONCLUSION A training programme combining dancing and exercise with music proved to be feasible when performed by adults with ID. These kind of programmes can have a positive effect on the fitness level of this specific group.
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Affiliation(s)
| | - I Martínez-Lemos
- Well-Move Research Group, Department of Special Didactics, University of Vigo
| | - S Bouzas-Rico
- Faculty of Education and Sports Science, University of Vigo
| | - C Ayán-Pérez
- Well-Move Research Group, Department of Special Didactics, University of Vigo
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29
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Loader J, Khouri C, Taylor F, Stewart S, Lorenzen C, Cracowski JL, Walther G, Roustit M. The continuums of impairment in vascular reactivity across the spectrum of cardiometabolic health: A systematic review and network meta-analysis. Obes Rev 2019; 20:906-920. [PMID: 30887713 DOI: 10.1111/obr.12831] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
Abstract
This study aimed to assess, for the first time, the change in vascular reactivity across the full spectrum of cardiometabolic health. Systematic searches were conducted in MEDLINE and EMBASE databases from their inception to March 13, 2017, including studies that assessed basal vascular reactivity in two or more of the following health groups (aged ≥18 years old): healthy, overweight, obesity, impaired glucose tolerance, metabolic syndrome, or type 2 diabetes with or without complications. Direct and indirect comparisons of vascular reactivity were combined using a network meta-analysis. Comparing data from 193 articles (7226 healthy subjects and 19344 patients), the network meta-analyses revealed a progressive impairment in vascular reactivity (flow-mediated dilation data) from the clinical onset of an overweight status (-0.41%, 95% CI, -0.98 to 0.15) through to the development of vascular complications in those with type 2 diabetes (-4.26%, 95% CI, -4.97 to -3.54). Meta-regressions revealed that for every 1 mmol/l increase in fasting blood glucose concentration, flow-mediated dilation decreased by 0.52%. Acknowledging that the time course of disease may vary between patients, this study demonstrates multiple continuums of vascular dysfunction where the severity of impairment in vascular reactivity progressively increases throughout the pathogenesis of obesity and/or insulin resistance, providing information that is important to enhancing the timing and effectiveness of strategies that aim to improve cardiovascular outcomes.
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Affiliation(s)
- Jordan Loader
- Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,LAPEC EA4278, Avignon Université, Avignon, France
| | - Charles Khouri
- Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
| | - Frances Taylor
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Simon Stewart
- Hatter Institute for Reducing Cardiovascular Disease in Africa, The University of Cape Town, Cape Town, South Africa
| | - Christian Lorenzen
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Jean-Luc Cracowski
- Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
| | - Guillaume Walther
- LAPEC EA4278, Avignon Université, Avignon, France.,School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Matthieu Roustit
- Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
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30
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Lack S, Anthony L, Noake J, Brennan K, Zhang B, Morrissey D. Medial and Lateral Patellofemoral Joint Retinaculum Thickness in People With Patellofemoral Pain: A Case-Control Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1483-1490. [PMID: 30251436 DOI: 10.1002/jum.14828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/17/2018] [Accepted: 08/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To measure the medial and lateral retinaculum thickness in individuals with and without patellofemoral pain using ultrasound and to assess associations with the symptom duration and function. METHODS Medial and lateral patellofemoral joint retinaculum thicknesses of 32 knees (16 with patellofemoral pain and 16 asymptomatic) were measured with B-mode ultrasound at 0.5, 1, and 1.5 cm from the patella border. Participants with patellofemoral pain completed a Kujala questionnaire, and both groups underwent a single-leg squat performance assessment. Two-way analyses of variance (site × group) determined the overall effect, and Cohen d values were calculated to describe the magnitude of the difference for each measurement. RESULTS The groups were matched for age, height, and weight. Compared to controls, participants with patellofemoral pain had thicker lateral (overall effect, P = .03) and medial (overall effect, P < 0.01) retinacula. No correlations between retinaculum thickness and Kujala scores (lateral retinaculum, r = 0.106 [0.5 cm], -0.093 [1 cm], and -0.207 [1.5 cm]; and medial retinaculum, r = 0.059, 0.109, and -0.219), symptom duration (lateral retinaculum, r = 0.001, -0.041, and 0.302; and medial retinaculum, r = -0.027, -0.358, and -0.346), or single-leg squat performance scores (lateral retinaculum, r = 0.051, 0.114, and 0.046; and medial retinaculum, r = -0.119, -0.292, and 0.011) were observed. CONCLUSIONS Increased lateral and medial retinaculum thickness in individuals with patellofemoral pain compared to controls identifies structural changes that may be associated with the pathogenesis of patellofemoral pain. The absence of a significant correlation between retinaculum thickness and the symptom duration or function further shows a lack of an association between structure and function in individuals with patellofemoral pain.
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Affiliation(s)
- Simon Lack
- Center for Sports and Exercise Medicine, Queen Mary University of London, London, England
- Pure Sports Medicine, London, England
| | - Luke Anthony
- Center for Sports and Exercise Medicine, Queen Mary University of London, London, England
| | | | | | - Bairu Zhang
- School of Mathematical Sciences, Queen Mary University of London, London, England
| | - Dylan Morrissey
- Physiotherapy Department, Barts Health National Health Service Trust, London, England
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31
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Kolotkin RL, Williams VSL, Ervin CM, Williams N, Meincke HH, Qin S, von Huth Smith L, Fehnel SE. Validation of a new measure of quality of life in obesity trials: Impact of Weight on Quality of Life-Lite Clinical Trials Version. Clin Obes 2019; 9:e12310. [PMID: 30993900 PMCID: PMC6593657 DOI: 10.1111/cob.12310] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/25/2019] [Accepted: 03/22/2019] [Indexed: 12/17/2022]
Abstract
The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) is widely used in evaluations of weight-loss interventions, including pharmaceutical trials. Because this measure was developed using input from individuals undergoing intensive residential treatment, the IWQOL-Lite may include concepts not relevant to clinical trial populations and may be missing concepts that are relevant to these populations. An alternative version, the IWQOL-Lite Clinical Trials Version (IWQOL-Lite-CT), was developed and validated according to the US Food and Drug Administration's (FDA's) guidance on patient-reported outcomes. Psychometric analyses were conducted to validate the IWQOL-Lite-CT using data from two randomized trials (NCT02453711 and NCT02906930) that included individuals with overweight/obesity, with and without type 2 diabetes. Additional measures included the SF-36, global items, weight and body mass index. The IWQOL-Lite-CT is a 20-item measure with two primary domains (Physical [seven items] and Psychosocial [13 items]). A five-item Physical Function composite and Total score were also supported. Cronbach's alpha and intraclass correlation coefficients exceeded 0.77 at each time point; patterns of construct validity correlations were consistent with hypotheses; and scores demonstrated treatment benefit. The IWQOL-Lite-CT is appropriate for assessing weight-related physical and psychosocial functioning in populations commonly targeted for obesity clinical trials. Qualification from the FDA is being sought for use of the IWQOL-Lite-CT in clinical trials to support product approval and labelling claims.
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Affiliation(s)
- Ronette L. Kolotkin
- Quality of Life Consulting, PLLCDurhamNorth Carolina
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth Carolina
- Faculty of Health and Social Sciences, Western Norway University of Applied SciencesFørdeNorway
- Centre of Health ResearchFørde Hospital TrustFørdeNorway
- Morbid Obesity CentreVestfold Hospital TrustTønsbergNorway
| | - Valerie S. L. Williams
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | - Claire M. Ervin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | - Nicole Williams
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | - Henrik H. Meincke
- Health Economics and Outcomes Research, Novo Nordisk A/SSøborgDenmark
| | - Shanshan Qin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | | | - Sheri E. Fehnel
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
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Dadds MR, English T, Wimalaweera S, Schollar-Root O, Hawes DJ. Can reciprocated parent-child eye gaze and emotional engagement enhance treatment for children with conduct problems and callous-unemotional traits: a proof-of-concept trial. J Child Psychol Psychiatry 2019; 60:676-685. [PMID: 30697730 DOI: 10.1111/jcpp.13023] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND High levels of callous-unemotional (CU) traits are associated with reduced effectiveness of parenting programmes for children with conduct problems. This may be due to low levels of emotional engagement (EE) by these children with their parents. We evaluate a theoretically driven strategy for improving emotional engagement in high CU traits children undergoing a parenting intervention (parent management training; PMT) for child conduct problems. METHODS N = 40, 3- to 8-year-old children referred for conduct problems and showing stable, high levels of CU traits, were randomised to receive PMT+Emotional Engagement (EE), or the control condition PMT+Child Centred Play (CCP). A benchmarking sample of N = 70 children who received PMT only was also included. Observational coding of the parent-child interactions targeted by EE and CCP respectively was repeated throughout treatment and follow-up. RESULTS Emotional engagement produced unique improvements in parent-child emotional engagement (shared eye gaze); however, these reverted to baseline levels after treatment. CCP produced unique improvements in parents' child centeredness and child positive play, but by post-treatment, all children had improved on these factors. Both interventions produced similar improvements in general parental warmth. Reductions in severity of conduct problems at post-treatment and follow-up were large in size and did not differ between conditions or from the benchmarking group. Levels of CU traits reduced significantly but again did not differ between groups. CONCLUSIONS The putative mechanism of emotional engagement through reciprocated eye gaze proved to be impervious to sustained change, and thus failed to have a specific impact of conduct problems or levels of CU traits. The development of novel treatment approaches to children with high levels of CU is a challenging endeavour, and these results indicate that focussing on children with stable levels at pretreatment should be a priority.
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Martínez-Martínez C, Sánchez-Martínez V, Sales-Orts R, Dinca A, Richart-Martínez M, Ramos-Pichardo JD. Effectiveness of direct contact intervention with people with mental illness to reduce stigma in nursing students. Int J Ment Health Nurs 2019; 28:735-743. [PMID: 30693628 DOI: 10.1111/inm.12578] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Abstract
People with mental illnesses are at a higher risk than the general population of suffering from somatic diseases. However, they receive less attention from healthcare services. Some studies have indicated that this situation can be partially explained by the stigmatizing attitudes of health professionals, including nurses. With the objective to improve future nursing professionals' attitudes towards people with mental illnesses, an intervention involving direct contact with people who had lived experience with mental illnesses was designed and its effectiveness was measured. It consisted of a single 90-min session involving a mental health professional, a person with a mental illness, and a family member of someone with a mental illness. The intervention was based on a structured script where they described their experiences with the illness and their history of recovery, and then, they had a discussion with the attendees. The effectiveness of this approach was measured through a quasi-experimental study with a pretest-post-test design. The differences in the scores obtained in the AQ-27-E questionnaire before and after the intervention indicated that there was a decrease in fear, feelings of danger, avoidance, segregation, and coercive attitudes, while positive feelings increased, including a tendency to help and compassion. These results are important for clinical practice because this intervention could improve the quality of care provided to people with mental illnesses.
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Affiliation(s)
| | | | | | - Andra Dinca
- Técnico de Integración Social de ASIEM (Association for the Integral Health of People with M.D.), Spain
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34
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Barcala L, Politti F, Artilheiro MC, Speciali DS, Garbelotti SA, Correa JCF, Lucareli PRG. Adult dyskinetic cerebral palsy: Upper limb movement and muscle function. Acta Neurol Scand 2019; 139:505-511. [PMID: 30810219 DOI: 10.1111/ane.13083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/06/2019] [Accepted: 02/20/2019] [Indexed: 02/01/2023]
Abstract
AIM The aim of this study was to characterize upper limb motor function during a comparative analysis of electromyographic and upper limb movement analysis during drinking between healthy adults and individuals with DCP. METHOD Fifteen healthy individuals (CG) and fifteen individuals with DCP (DG) participated in the study. Upper limb function was analyzed during drinking and consisted of a task divided into three phases: the going, the adjustment, and the return. RESULTS Electromyographic analysis revealed a lower activity of the anterior deltoid, posterior deltoid, and biceps brachii muscles in the DG. When comparing the interactions between groups and phases, only biceps brachii shower lower muscle activity during going and adjustment phases. The DG presented a smaller range of motion (ROM) for the shoulder, elbow, forearm and wrist movements. An interaction between groups and phases showed smaller ROM for the flexion and internal rotation of the shoulder, elbow flexion, forearm pronation, and ulnar deviation in the return phase compared to CG. INTERPRETATION The results may contribute positively to the quantification of the level of motor impairment and may be used as a reference for the development of therapeutic interventions for patients with DCP.
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Affiliation(s)
- Luciana Barcala
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Fabiano Politti
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Mariana C. Artilheiro
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Danielli S. Speciali
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
- Human Movement Analysis Laboratory Albert Einstein Hospital São Paulo Brazil
| | - Silvio A. Garbelotti
- Department of Physical Therapy Universidade Cidade de São Paulo São Paulo Brazil
| | - João C. F. Correa
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Paulo R. G. Lucareli
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
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Claréus B, Renström EA. Physicians' gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient-physician relations. Scand J Psychol 2019; 60:338-347. [PMID: 31124165 PMCID: PMC6851885 DOI: 10.1111/sjop.12545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/02/2019] [Indexed: 12/24/2022]
Abstract
Nonspecific, functional, and somatoform (NFS) syndromes is an umbrella term for various diagnoses with medically unexplained symptoms. These syndromes are more prevalent among women than among men, and associated with negative preconceptions that can impede rehabilitation. In two studies, we quantitatively assess how patients’ gender affects the diagnostic assessment of NFS syndromes, as well as the healthcare experiences of individuals diagnosed with NFS syndromes. In the first study, our vignette‐based experiment showed that Swedish general practitioners (N = 90) were gender biased in their diagnostic assessment of NFS syndromes, such that a female patient with back pain was more likely to be assigned a NFS syndrome compared to an otherwise identical male patient. In the second study, a large community sample of Swedish individuals with medically explained (n = 432) and unexplained pain (n = 521) evaluated their treating physician's relational conduct. Even after accounting for a variety of sociodemographic variables and other pain characteristics, women with at least one NFS syndrome percieved their physician's relational conduct as significantly poorer than other women as well as men with and without NFS syndromes. When women's pain is more likely than men's to be assessed as NFS, their rehabilitation could be prolonged as pertient alternative diagnoses and treatments are omittied and their negative healthcare experiences lower their volition to partake and persevere in treatment.
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Affiliation(s)
| | - Emma A Renström
- Department of psychology, Gothenburg University, Gothenburg, Sweden
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Bani Younis MK, Hayajneh FA, Alduraidi H. Effectiveness of using eye mask and earplugs on sleep length and quality among intensive care patients: A quasi‐experimental study. Int J Nurs Pract 2019; 25:e12740. [DOI: 10.1111/ijn.12740] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 12/21/2018] [Accepted: 04/01/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Mohammad K. Bani Younis
- Princess Aisha Bint Al‐Hussein College of Nursing and Health SciencesAl‐Hussein Bin Talal University Ma'an Jordan
| | | | - Hamza Alduraidi
- School of Nursing, Department of Community Health NursingThe University of Jordan Amman Jordan
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Hossain S, O’Neill SC, Strnadová I. What really matters for students’ school satisfaction in Bangladesh? PSYCHOLOGY IN THE SCHOOLS 2019. [DOI: 10.1002/pits.22226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Saira Hossain
- Department of Educational Psychology & GuidanceInstitute of Education and Research, University of DhakaDhaka Bangladesh
| | - Sue C. O’Neill
- School of Education, University of New South WalesSydney New South Wales Australia
| | - Iva Strnadová
- School of Education, University of New South WalesSydney New South Wales Australia
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Redfern A, Jolley S, Bracegirdle K, Browning S, Plant D. Innovations in Practice: CUES-Ed: an in-service evaluation of a new universal cognitive behavioural early mental health intervention programme for primary school children. Child Adolesc Ment Health 2019; 24:187-191. [PMID: 32677181 DOI: 10.1111/camh.12309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Earlier childhood interventions to reduce mental health vulnerability are a global health priority yet poorly implemented. Barriers include negotiating health/education interfaces, and mixed outcomes, particularly for vulnerable children. CUES-Ed aimed to address these barriers, comprising a cognitive behavioural early intervention targeting mental health vulnerability in 7-10 year-olds, with integrated evaluation, delivered through close liaison with stakeholders. Following 2 years of ad hoc delivery, relationship-building, and refining the intervention and evaluation, we report on implementation and in-service outcomes for local schools completing the standardised CUES-Ed programme. METHOD We evaluated delivery from 01/2017 to 07/2017 across n = 12 schools (n = 23 classes, n = 638 pupils, n = 35 teachers). Eight one-hour weekly sessions (S1-S8) were delivered by mental health professionals with teachers present. Pupil-reported wellbeing/distress and emotional/behavioural difficulties were assessed at S1 and S8; pupil free text feedback/ratings and teacher ratings at S8. Two classes (n = 60) completed outcomes whilst awaiting CUES-Ed, forming a naturalistic waitlist. RESULTS At S8, pupil-reported outcome data were obtained from 535 and feedback/ratings from 577 pupils, respectively. Thematic analysis of feedback indicated positive subjective impact. Vulnerable children (defined as self-rated borderline/clinical cut-off baselines scores on the wellbeing/distress and emotional/behavioural difficulties measures) improved with medium pre-post effect sizes (d = 0.46-0.65), and small, but consistent, effects compared to waitlist. CONCLUSION In-service evaluation suggests a feasible model of delivery, good acceptability and potential to improve outcomes for vulnerable children. Controlled evaluation is now indicated.
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Affiliation(s)
- Anna Redfern
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Suzanne Jolley
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Department of Psychology, King's College London, Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Karen Bracegirdle
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Sophie Browning
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Debbie Plant
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
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Kruythoff-Broekman A, Wiefferink C, Rieffe C, Uilenburg N. Parent-implemented early language intervention programme for late talkers: parental communicative behaviour change and child language outcomes at 3 and 4 years of age. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:451-464. [PMID: 30680870 DOI: 10.1111/1460-6984.12451] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/10/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Late language emergence is a risk indicator for developmental language disorder. Parent-implemented early language intervention programmes (parent programmes) have been shown to have positive effects on children's receptive and expressive language skills. However, long-term effectiveness has rarely been studied. Additionally, little is known about which strategies parents learn to use after participating in parent programmes and whether this affects their child's language development. AIMS To evaluate medium- and long-term effectiveness (1 and 2 years after inclusion) of a low-dosage parent programme in a sample of late talkers (LTs) with an expressive language delay. Specifically, we investigated which strategies the parents learned to use in interaction with their child and which strategies were associated with child language growth over time. METHODS & PROCEDURES This quasi-experimental study with a longitudinal design included 24-month-old LTs. After the pre-test, parents of children in the intervention group received a parent programme (n = 30), while parents of children in the comparison group received care as usual (n = 30). Children's language development was assessed using standardized language tests at pre-test and two follow-up tests at 36 and 48 months of age. Change in parental communicative behaviour was measured by a parent-child interaction observation measure, at pre-test and follow-up at 36 months of age. OUTCOMES & RESULTS At 36 months old, children in the parent programme group showed a significantly higher growth in expressive vocabulary than children in the comparison group. However, differences between the groups were not seen in the long-term, at the 48-month follow-up. In contrast to parents in the comparison group, parents in the parent programme group changed their communicative behaviour positively in two domains: Interaction and Pressure on the child. However, no changes in the domains of Language Stimulation and Responsiveness were observed. Children's growth in expressive vocabulary and expressive syntax was associated with a decrease in the domain of Pressure. CONCLUSIONS & IMPLICATIONS At 4 years of age, the majority of children in both groups achieved expressive vocabulary scores within the normal range. However, the mean score for expressive syntax in both groups remained below that of their peers, and 29% of the children still had expressive language scores below the mean range. Ongoing monitoring of LTs' language development is necessary in order to make decisions regarding the timing and nature of intervention.
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Affiliation(s)
| | - Carin Wiefferink
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
| | - Carolien Rieffe
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
- Developmental Psychology Leiden University, Leiden, the Netherlands
| | - Noëlle Uilenburg
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
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Zhang Q, Yuan KH, Wang L. Asymptotic bias of normal-distribution-based maximum likelihood estimates of moderation effects with data missing at random. THE BRITISH JOURNAL OF MATHEMATICAL AND STATISTICAL PSYCHOLOGY 2019; 72:334-354. [PMID: 30474256 DOI: 10.1111/bmsp.12151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 08/15/2018] [Indexed: 06/09/2023]
Abstract
Moderation analysis is useful for addressing interesting research questions in social sciences and behavioural research. In practice, moderated multiple regression (MMR) models have been most widely used. However, missing data pose a challenge, mainly because the interaction term is a product of two or more variables and thus is a non-linear function of the involved variables. Normal-distribution-based maximum likelihood (NML) has been proposed and applied for estimating MMR models with incomplete data. When data are missing completely at random, moderation effect estimates are consistent. However, simulation results have found that when data in the predictor are missing at random (MAR), NML can yield inaccurate estimates of moderation effects when the moderation effects are non-null. Simulation studies are subject to the limitation of confounding systematic bias with sampling errors. Thus, the purpose of this paper is to analytically derive asymptotic bias of NML estimates of moderation effects with MAR data. Results show that when the moderation effect is zero, there is no asymptotic bias in moderation effect estimates with either normal or non-normal data. When the moderation effect is non-zero, however, asymptotic bias may exist and is determined by factors such as the moderation effect size, missing-data proportion, and type of missingness dependence. Our analytical results suggest that researchers should apply NML to MMR models with caution when missing data exist. Suggestions are given regarding moderation analysis with missing data.
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Affiliation(s)
- Qian Zhang
- Department of Educational Psychology and Learning Systems, College of Education, Florida State University, Tallahassee, Florida, USA
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Zhang X, Nielsen DA, Domingo CB, Shorter DI, Nielsen EM, Kosten TR. Pharmacogenetics of Dopamine β-Hydroxylase in cocaine dependence therapy with doxazosin. Addict Biol 2019; 24:531-538. [PMID: 29498170 DOI: 10.1111/adb.12611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 10/17/2017] [Accepted: 01/20/2018] [Indexed: 02/02/2023]
Abstract
The α1 -adrenergic antagonist, doxazosin, has improved cocaine use disorder (CUD) presumably by blocking norepinephrine (NE) stimulation and reward from cocaine-induced NE increases. If the NE levels for release were lower, then doxazosin might more readily block this NE stimulation and be more effective. The NE available for release can be lower through a genetic polymorphism in dopamine β-hydroxylase (DBH) (C-1021T, rs1611115), which reduces DβH's conversion of dopamine to NE. We hypothesize that doxazosin would be more effective in CUD patients who have these genetically lower DβH levels. This 12-week, double-blind, randomized, placebo-controlled trial included 76 CUD patients: 49 with higher DβH levels from the DBH CC genotype and 27 with lower DβH levels from T-allele carriers (CT or TT). Patients were randomized to doxazosin (8 mg/day, N = 47) or placebo (N = 29) and followed with thrice weekly urine toxicology and once weekly cognitive behavioral psychotherapy. Cocaine use was reduced at a higher rate among patients in the doxazosin than in the placebo arm. We found significantly lower cocaine use rates among patients carrying the T-allele (CT/TT) than the CC genotype. The percentage of cocaine positive urines was reduced by 41 percent from baseline in the CT/TT group with low DβH and NE levels, as compared with no net reduction in the CC genotype group with normal DβH and NE levels. The DBH polymorphism appears play an important role in CUD patients' response to doxazosin treatment, supporting a pharmacogenetic association and potential application for personalized medicine.
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Affiliation(s)
- Xuefeng Zhang
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX USA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of Medicine Houston TX USA
| | - David A. Nielsen
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX USA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of Medicine Houston TX USA
| | - Coreen B. Domingo
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX USA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of Medicine Houston TX USA
| | - Daryl I. Shorter
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX USA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of Medicine Houston TX USA
| | - Ellen M. Nielsen
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX USA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of Medicine Houston TX USA
| | - Thomas R. Kosten
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX USA
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of Medicine Houston TX USA
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Speck RM, Shalhoub H, Wyrwich KW, Yu R, Ayer DW, Ford J, Bush EN, Lipton RB. Psychometric Validation of the Role Function Restrictive Domain of the Migraine Specific Quality-of-Life Questionnaire Version 2.1 Electronic Patient-Reported Outcome in Patients With Episodic and Chronic Migraine. Headache 2019; 59:756-774. [PMID: 30861580 PMCID: PMC6593730 DOI: 10.1111/head.13497] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To assess the measurement properties of the Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQv2.1) electronic patient-reported outcome (ePRO) Role Function-Restrictive (RFR) domain to evaluate the functional impact of migraine in patients with episodic (EM) or chronic migraine (CM) enrolled in clinical trials. METHODS The 7-item MSQv2.1 ePRO RFR measures the functional impact of migraine on relationships with family and friends, leisure time, work or daily activities, productivity, concentration, tiredness, and energy. Measurement properties of the RFR were assessed using data from 2 EM (CGAG [n = 851] and CGAH [n = 909]) and 1 CM (CGAI [n = 1090]) Phase 3 galcanezumab clinical trials. Anchor- and distribution-based analyses were utilized to derive a responder threshold for clinical interpretation of change over time. The Migraine Disability Assessment (MIDAS), Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), and migraine headache days (MHD) served as anchors. Responsiveness and responder threshold analyses were completed from baseline to the average of months 4-6 for EM studies, and from baseline to month 3 for the CM study; timeframes selected were based on the primary endpoints in these studies. RESULTS Cronbach's alpha values for internal consistency reliability were 0.93, 0.92, and 0.92, for CGAG, CGAH, and CGAI, respectively. Test-retest reliability intra-class correlation coefficients were 0.82 and 0.84 for CGAG and CGAH, and 0.85 for CGAI in stable patients. Convergent validity was supported by moderate to strong correlations (≥0.30) between the RFR and both MIDAS and PGI-S. Known-groups validity was established between subgroups stratified by baseline PGI-S and MHD (P < .05; δ = 0.35-1.96). For the EM studies, anchor variables suggested a change of ≥25 points (equivalent to 9 points/state changes on raw scale) in the RFR was an appropriate threshold to interpret a treatment benefit. For the CM study a change of ≥17.14 points (6 points/state changes on raw scale) was an appropriate threshold. In all 3 studies, significantly (P < .01) more galcanezumab patients achieved the responder definition thresholds, as compared to placebo (odds ratios of 1.98, 2.45, 2.27, 2.44, 1.64, and 1.66 for the 120 and 240 mg arms in the CGAG, CGAH, and CGAI trials, respectively). CONCLUSION The MSQv2.1 ePRO RFR has sufficient reliability, validity, responsiveness, and appropriate interpretation standards for use in EM and CM clinical trials to assess the functional impact of migraine.
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Villamil N, Boege K, Stone GN. Testing the Distraction Hypothesis: Do extrafloral nectaries reduce ant-pollinator conflict? THE JOURNAL OF ECOLOGY 2019; 107:1377-1391. [PMID: 31217634 PMCID: PMC6559321 DOI: 10.1111/1365-2745.13135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/22/2018] [Indexed: 06/09/2023]
Abstract
Ant guards protect plants from herbivores, but can also hinder pollination by damaging reproductive structures and/or repelling pollinators. Natural selection should favour the evolution of plant traits that deter ants from visiting flowers during anthesis, without waiving their defensive services. The Distraction Hypothesis posits that rewarding ants with extrafloral nectar could reduce their visitation of flowers, reducing ant-pollinator conflict while retaining protection of other structures.We characterised the proportion of flowers occupied by ants and the number of ants per flower in a Mexican ant-plant, Turnera velutina. We clogged extrafloral nectaries on field plants and observed the effects on patrolling ants, pollinators and ants inside flowers, and quantified the effects on plant fitness. Based on the Distraction Hypothesis, we predicted that preventing extrafloral nectar secretion should result in fewer ants active at extrafloral nectaries, more ants inside flowers and a higher proportion of flowers occupied by ants, leading to ant-pollinator conflict, with reduced pollinator visitation and reduced plant fitness.Overall ant activity inside flowers was low. Preventing extrafloral nectar secretion through clogging reduced the number of ants patrolling extrafloral nectaries, significantly increased the proportion of flowers occupied by ants from 6.1% to 9.7%, and reduced plant reproductive output through a 12% increase in the probability of fruit abortion. No change in the numbers of ants or pollinators inside flowers was observed. This is the first support for the Distraction Hypothesis obtained under field conditions, showing ecological and plant fitness benefits of the distracting function of extrafloral nectar during anthesis. Synthesis. Our study provides the first field experimental support for the Distraction Hypothesis, suggesting that extrafloral nectaries located close to flowers may bribe ants away from reproductive structures during the crucial pollination period, reducing the probability of ant occupation of flowers, reducing ant-pollinator conflict and increasing plant reproductive success.
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Affiliation(s)
- Nora Villamil
- Ashworth Laboratories, Institute of Evolutionary BiologyUniversity of EdinburghEdinburghUK
| | - Karina Boege
- Instituto de Ecología, Departamento de Ecología EvolutivaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMexico
| | - Graham N. Stone
- Ashworth Laboratories, Institute of Evolutionary BiologyUniversity of EdinburghEdinburghUK
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Taşdelen Teker G, Odabaşı O. Reliability of scores obtained from standardized patient and instructor assessments. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2019; 23:88-94. [PMID: 30450818 DOI: 10.1111/eje.12406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/06/2018] [Indexed: 05/21/2023]
Abstract
INTRODUCTION To obtain more reliable results from observation-based assessments, high-quality raters are key. Although this quality can be obtained by using instructors, extra workload can be a burden on them. To overcome this problem, one alternative to instructor raters can be standardized patients (SPs). METHOD In this study, the students carried out an SP interview related to communication with an applicant/patient in the context of clinical skills training course. SPs rated student interviews just after interview and after watching a recording. Instructors rated students just by watching the recordings. To determine the appropriateness of use of SPs as raters, ratings of SPs and instructors were compared by using mean scores given to the interview performances of students' communication skills. Moreover, G theory was used to determine the reliability of scores. RESULTS Standardized patients' ratings immediately after the interviews showed the highest scores, and these ratings were statistically different from the SPs' and instructors' ratings done while watching recordings. Besides, the G coefficient for the 4 instructors was 0.71, while that for the 12 SPs was estimated as 0.73. However, even when using 12 SPs, the obtained reliability coefficient of 0.73 brings into question the reliability of their ratings. Moreover, it was found that the one who contributed the most to reliability among instructors was the most experienced person in subject area. CONCLUSIONS If SPs are to be used as raters, they will need more comprehensive training. More importantly, regardless of who the rater is, rater training is one of the most important factors in achieving more reliable and valid results. Moreover, having experience and knowledge about assessed topic is another crucial point of performance assessment by means of obtaining reliable results.
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Affiliation(s)
- Gülşen Taşdelen Teker
- Faculty of Medicine, Medical Education and Informatics Department, Hacettepe University, Ankara, Turkey
| | - Orhan Odabaşı
- Faculty of Medicine, Medical Education and Informatics Department, Hacettepe University, Ankara, Turkey
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Barnason S, Zimmerman L, Schulz P, Pullen C, Schuelke S. Weight management telehealth intervention for overweight and obese rural cardiac rehabilitation participants: A randomised trial. J Clin Nurs 2019; 28:1808-1818. [PMID: 30667588 PMCID: PMC6453725 DOI: 10.1111/jocn.14784] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 12/21/2022]
Abstract
AIMS AND OBJECTIVES To determine whether a weight management intervention (WMI) plus cardiac rehabilitation (CR) compared to CR alone improves outcomes for overweight and obese cardiac revascularisation patients. BACKGROUND Despite participating in cardiac rehabilitation (CR), few cardiac patients lose enough weight to achieve clinically significant cardiovascular disease risk reduction. DESIGN A randomised controlled design was used with measurements at baseline, 4 and 6 months, guided by the CONSORT checklist, see Supporting Information File S1. Adults who had undergone either coronary artery bypass surgery (CABS) or percutaneous coronary intervention (PCI) and participated in a rural CR programmes were recruited. Subjects were randomised to a 12-week telehealth WMI or control group. The primary outcome was weight loss. Secondary outcomes included physical activity, patient activation, perceived self-efficacy and use of weight management behaviours. RESULTS A total of 43 subjects participated, with a mean age of 63 (±9.3) years. The WMI group had significantly more weight loss averaged across the 4 and 6 months of 13.8 (±2.8) pounds compared to the control group [mean = 7.8 (±2.2) pounds]. There were no significant differences in physical activity (activity counts or daily minutes in moderate or more intense activity). The WMI group had significantly higher levels of patient activation. They also had significantly higher total scores on the Diet and Exercise Self-Management survey, and subscales that included self-efficacy for specific eating habits and managing diet behaviour. CONCLUSIONS Findings demonstrated the usefulness and feasibility of using telehealth delivery of the WMI for cardiac rehabilitation participants in rural communities to improve weight management outcomes. RELEVANCE TO PRACTICE Study findings underscore the opportunity to further improve weight loss of overweight and obese cardiac participants using a weight management intervention to augment CR participation.
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Affiliation(s)
- Susan Barnason
- University of Nebraska Medical Center, College of Nursing-Lincoln Division
| | - Lani Zimmerman
- University of Nebraska Medical Center, College of Nursing-Lincoln Division
| | - Paula Schulz
- University of Nebraska Medical Center, College of Nursing-Lincoln Division
| | - Carol Pullen
- University of Nebraska Medical Center, College of Nursing-Omaha Division
| | - Sue Schuelke
- University of Nebraska Medical Center, College of Nursing-Lincoln Division
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Ivezaj V, Fu E, Lydecker JA, Duffy AJ, Grilo CM. Racial Comparisons of Postoperative Weight Loss and Eating-Disorder Psychopathology Among Patients Following Sleeve Gastrectomy Surgery. Obesity (Silver Spring) 2019; 27:740-745. [PMID: 30925196 PMCID: PMC6478551 DOI: 10.1002/oby.22446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/28/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This study aimed to examine racial differences in postoperative eating-disorder psychopathology, psychosocial functioning, and weight loss among adults with loss-of-control (LOC) eating following sleeve gastrectomy. METHODS Participants were 123 patients (n = 74 non-Hispanic White and n = 49 non-Hispanic Black) who underwent sleeve gastrectomy surgery within the previous 4 to 9 months and reported regular LOC eating during the previous month. The Eating Disorder Examination Bariatric Surgery Version assessed LOC eating, eating-disorder psychopathology, and meal patterns. Participants completed self-report measures, including the Beck Depression Inventory-II and Medical Outcomes Study Short-Form Health Survey. RESULTS Presurgical BMI did not differ by race, but Black patients had significantly less percent total weight loss and percent excess weight loss than White patients. Black and White patients did not differ significantly in LOC eating frequency, onset time of postoperative LOC eating, eating-disorder psychopathology, depressive symptoms, or physical or mental health-related quality of life. White patients were significantly more likely to meet criteria for lifetime binge-eating disorder than Black patients. Black patients were significantly more likely to skip breakfast and dinner and engage in night eating than White patients. CONCLUSIONS Our findings suggest that among patients with LOC eating following sleeve gastrectomy surgery, there exist few racial differences in current eating-disorder psychopathology and psychosocial functioning, although Black patients achieved less weight loss than White patients.
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Affiliation(s)
| | - Emily Fu
- Yale School of Public Health, New Haven, CT, 06519
| | | | - Andrew J. Duffy
- Yale New Haven Health System
- Yale University, New Haven, CT, 06511
| | - Carlos M. Grilo
- Yale School of Medicine, New Haven, CT, 06519
- Yale University, New Haven, CT, 06511
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Hinds PS, Wang J, Cheng YI, Stern E, Waldron M, Gross H, DeWalt DA, Jacobs SS. PROMIS pediatric measures validated in a longitudinal study design in pediatric oncology. Pediatr Blood Cancer 2019; 66:e27606. [PMID: 30663254 DOI: 10.1002/pbc.27606] [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] [Received: 11/04/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE This study assessed the responsiveness to change over time and theorized associations of Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric measures in children and adolescents in treatment for cancer to determine measure readiness for use in cancer clinical trials. METHODS We administered eight PROMIS (three symptom, two psychological, and three performance) pediatric short-form measures and the Symptom Distress Scale (SDS) to 96 pediatric oncology patients at three time points during a course of chemotherapy. We assessed responsiveness using paired t tests and generalized estimating equation (GEE) models, calculated standardized response mean (SRM) values for PROMIS measures, and examined scores over three data points (T1-T3). Guided by the theory of unpleasant symptoms (TOUS), we examined associations among the PROMIS measures, the SDS, and other variables using GEE. RESULTS The paired t tests showed statistically significant changes in two psychological measures and one performance measure from T1 to T2; three symptom, two psychological and two performance measures from T2 to T3; and three symptom and two psychological measures from T1 to T3. Findings from GEE models indicate PROMIS pediatric measures had statistically significant short-term and long-term changes, controlling for demographic and clinical variables. One performance measure did not achieve significant change at any time point. We found positive support for theorized relationships in the TOUS. CONCLUSIONS Most of the PROMIS pediatric measures demonstrated changes over time and had significant relationships as theorized, thus supporting concurrent and construct validity of these measures when administered to pediatric oncology patients during a course of chemotherapy. This evidence supports the measures' readiness for use in clinical trials.
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Affiliation(s)
- Pamela S Hinds
- Department of Nursing Science, Professional Practice and Quality, Children's National Health System, Washington, District of Columbia.,Department of Pediatrics, The George Washington University, Washington, District of Columbia
| | - Jichuan Wang
- Department of Pediatrics, The George Washington University, Washington, District of Columbia.,Department of Biostatistics and Study Methodology, Children's National Health System, Washington, District of Columbia
| | - Yao I Cheng
- Department of Biostatistics and Study Methodology, Children's National Health System, Washington, District of Columbia
| | - Emily Stern
- Department of Hematology/Oncology, Children's National Health System, Washington, District of Columbia
| | - Mia Waldron
- Department of Nursing Science, Professional Practice and Quality, Children's National Health System, Washington, District of Columbia
| | - Heather Gross
- Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, North Carolina
| | - Darren A DeWalt
- Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, North Carolina
| | - Shana S Jacobs
- Department of Pediatrics, The George Washington University, Washington, District of Columbia.,Department of Hematology/Oncology, Children's National Health System, Washington, District of Columbia
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Singh A, DasGupta M, Simpson PM, Panepinto JA. Use of the new pediatric PROMIS measures of pain and physical experiences for children with sickle cell disease. Pediatr Blood Cancer 2019; 66:e27633. [PMID: 30688017 DOI: 10.1002/pbc.27633] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/27/2018] [Accepted: 01/04/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND There are new pediatric domains to measure patients' pain and physical experiences in the Patient-Reported Outcomes Measurement Information System (PROMIS). The objective of this study was to establish the psychometric properties of these domains for children with sickle cell disease (SCD). PROCEDURE We conducted a cross-sectional analysis of PROMIS assessments of children with SCD recruited from a pediatric tertiary care clinic. Validity of the new PROMIS domains was determined by comparing scores between known groups and describing their correlations with previously validated PROMIS measures. Cronbach's alpha and item response theory (IRT) reliability were used to assess internal consistency reliability. Agreement between parent-proxy and child self-report was determined for all domains. RESULTS Our study included 164 subjects, of whom 117 were eligible to self-report. The mean T-scores for physical stress experience, strength impact, pain behavior, and pain quality sensory scores were significantly different between children who used pain medications in the prior week and those who did not. There were also differences in T-scores across children reporting mild, moderate, and severe pain on the pain intensity scale. All measures had Cronbach's alpha and IRT reliability > 0.80. The percentage of agreement between child and parent-proxy PROMIS domains ranged from 36% to 60% depending on the domain. CONCLUSIONS The new PROMIS domains of physical stress experience, strength impact, pain behavior, and pain quality sensory domains are valid and reliable for children with SCD. The low-moderate agreement between parent-proxy and child self-report scores support the complementary information provided by the two perspectives.
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Affiliation(s)
- Ashima Singh
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mahua DasGupta
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pippa M Simpson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Julie A Panepinto
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.,Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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Theriot AL, Gomez L, Chang CT, Badger GR, Herbert AK, Cardenas Vasquez JM, Cardenas AD, Chiquet BT. Ethnic and language influence on parents' perception of paediatric behaviour management techniques. Int J Paediatr Dent 2019; 29:301-309. [PMID: 30618210 DOI: 10.1111/ipd.12462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/18/2018] [Accepted: 01/02/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Parental preference for various behaviour management techniques (BMTs) used in paediatric dentistry has been shown to be influenced by many factors, including ethnicity. AIM To measure parental acceptability of BMTs used in paediatric dentistry and how it is influenced by ethnicity and language. DESIGN Parents of patients presenting to a paediatric dentistry residency clinic in Houston, Texas, USA or Medellín, Colombia watched ten video BMT vignettes and rated their acceptance on a visual analog scale (VAS). Participants were categorized into six groups based on language, ethnicity, and country of residence. RESULTS Parental acceptance of BMTs was affected by language, ethnicity, and country of residence (P = 2.2 × 10-16 ). Ethnic groups in the USA had a mean overall acceptance rate of all BMTs. Colombians rated all BMTs less acceptable than the US cohorts (P < 0.05), with the exception of voice control, which Colombians rate less acceptable than English-speaking Caucasians and Spanish-speaking Hispanics in the USA (P < 0.05). The Colombian population were not accepting of conscious sedation, nitrous oxide, general anaesthesia, and protective stabilization. CONCLUSIONS Parents from different ethnic groups express different preferences in BMTs. Parents continue to prefer noninvasive techniques over pharmacologic and advanced techniques, with the exception of voice control.
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Affiliation(s)
- Adrien L Theriot
- The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Laura Gomez
- The Centro de Estudios para la Salud (CES) University in Medellín, Medellin, Colombia
| | - Chieh-Ting Chang
- The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Gary R Badger
- The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Amy-Kristina Herbert
- The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | | | - Antonio D Cardenas
- The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Brett T Chiquet
- The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
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Mensch BS, Chuang EK, Melnikas AJ, Psaki SR. Evidence for causal links between education and maternal and child health: systematic review. Trop Med Int Health 2019; 24:504-522. [PMID: 30767343 PMCID: PMC6519047 DOI: 10.1111/tmi.13218] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVE Numerous studies have documented an inverse association between years of schooling attained, particularly by women, and reduced maternal, infant and child mortality. However, if factors affecting educational attainment - many of which are unobservable, e.g. motivation and genetic endowment - also affect the likelihood of engaging in behaviours that enhance health, then assumed effects of schooling will be inflated in analyses that do not address this endogeneity. This systematic review assesses evidence for a causal link between education and maternal and child health in low and middle-income countries. METHODS Eligible studies controlled for observable and unobservable factors affecting both education and health. Reported effects were converted into partial correlations. When possible, we also conducted meta-analyses to estimate mean effects by outcome. RESULTS Of 4952 papers identified, 16 met the inclusion criteria. The 15 child health papers examined neonatal, infant and child mortality, stunting and wasting. Significant effects of education on infant and child health were observed for 30 of 33 models that did not account for endogeneity. In contrast, only 18 of 46 effects were significant in models that addressed endogeneity. Notably, for only one outcome -child mortality measured dichotomously -was the effect of maternal educational attainment significant in a meta-analysis. The one maternal morbidity paper found significant effects for the two preventable outcomes considered. CONCLUSION While we find evidence for a causal link between education and health, effects are weaker in models that address endogeneity compared to naïve models that do not account for unobservable factors affecting both education and health. Advances in women's educational outcomes have undoubtedly played a role in improving health in many settings; however, the effect is not as strong as some researchers and advocates have claimed.
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