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Skiba MB, Miller D, Stratton DB, Hall CA, McKenna S, Blair CK, Demark-Wahnefried W. Adaptation and study protocol for harvest for health together Arizona: A mentored community garden intervention for survivors of cancer. Contemp Clin Trials Commun 2024; 39:101290. [PMID: 38595771 PMCID: PMC11002544 DOI: 10.1016/j.conctc.2024.101290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Background Current health behavior recommendations for skin cancer prevention, treatment, and survivorship are the same for survivors of other cancers; they include eating a healthy diet, being physically active, maintaining a healthy weight, and minimizing ultraviolet (U.V.) exposure. Few interventions exist to support health behaviors beyond U.V. exposure. We adapted Harvest for Health, a home-based mentored gardening intervention for cancer survivors, for implementation in Arizona as a community-based intervention. Methods Stakeholder-informed adaptations for Harvest for Health Together Arizona (H4H2-AZ) included updating intervention materials to be relevant to the arid desert environment, emphasizing the importance of sun safety in cancer survivorship, and shifting from a home-based to a community-based delivery model. Participants will be enrolled in cohorts aligned with growing seasons (e.g., spring, monsoon, fall) and matched to an individual 30 ft2 community garden plot for two growing seasons (6 months). Original intervention components retained are: 1) Master Gardeners deliver the intervention providing one-to-one mentorship and 2) gardening materials and supplies provided. This pilot six-month single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer as primary outcomes. Secondary outcomes are to explore the effects on cancer preventive health behaviors and health-related quality of life. Discussion This pilot single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer. If successful, the intervention could be widely implemented throughout existing Master Gardener programs and community garden networks for survivors of other cancers. Trial registration ClinicalTrials.gov identifier: NCT05648604. Trial registered on December 13, 2022.
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Affiliation(s)
- Meghan B. Skiba
- Advanced Nursing Practice and Science Division, College of Nursing, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Dylan Miller
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Department of Epidemiology, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Delaney B. Stratton
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Dermatology, Banner University Health, Tucson, AZ, USA
| | - Caitlyn A. Hall
- W.A. Franke Honors College, University of Arizona, Tucson, AZ, USA
- Department of Biosystems Engineering, College of Agricultural and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Sharon McKenna
- Melanoma Task Force, Arizona Department of Health Services, Phoenix, AZ, USA
| | - Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
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Kelly BG, Stratton DB, Mansour I, Tanriover B, Culpepper KS, Curiel-Lewandrowski C. Navigating the initial diagnosis and management of adult IgA vasculitis: A review. JAAD Int 2022; 8:71-78. [PMID: 35721303 PMCID: PMC9204729 DOI: 10.1016/j.jdin.2022.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 11/15/2022] Open
Abstract
Background IgA vasculitis in adults has not been thoroughly studied. This has left a practice gap related to the management and follow-up of a population that is at an increased risk of comorbidities and potentially poor outcomes. For this reason, it is important to synthesize evidence from the current literature because this can help direct the movement for more robust studies to clarify best practice recommendations. Objective We sought to create a narrative review for the practicing dermatologist when diagnosing and leading the care of IgA vasculitis in adult patients. Methods A broad literature search was performed with a focus on articles that were published after the introduction of the most updated European Alliance of Associations for Rheumatology/Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society criteria. Results The characteristics and management guidelines for IgA vasculitis in adults have been refined, although more rigorous studies are needed to develop best practice recommendations. Limitations Because of the lack of sufficient randomized controlled trials on IgA vasculitis in adults, this narrative review is composed of mostly observational, descriptive studies. Conclusion Adults with IgA vasculitis are at an increased risk of complicated disease course, necessitating formal diagnostic assessment and clear-cut follow-up recommendations to manage and prevent poor health outcomes related to various comorbidities.
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Affiliation(s)
- Brenna G. Kelly
- Division of Dermatology, University of Arizona, Tucson, Arizona
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Iyad Mansour
- Division of Nephrology, University of Arizona, Tucson, Arizona
| | - Bekir Tanriover
- Division of Nephrology, University of Arizona, Tucson, Arizona
| | - Keliegh S. Culpepper
- Division of Dermatology, University of Arizona, Tucson, Arizona
- Dermpath Diagnostics, Tucson, Arizona
| | - Clara Curiel-Lewandrowski
- Division of Dermatology, University of Arizona, Tucson, Arizona
- Correspondence to: Clara Curiel-Lewandrowski, MD, Division of Dermatology, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724.
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Myrdal CN, Stratton DB, Davis TL, Curiel-Lewandrowski C. Generalised eruptive histiocytosis preceded by systemic symptoms. BMJ Case Rep 2021; 14:14/6/e243411. [PMID: 34162620 DOI: 10.1136/bcr-2021-243411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Generalised eruptive histiocytosis is a rare proliferative disease that typically presents with indolent cutaneous eruptions. We describe the case of a 73-year-old man presenting with diffuse, asymptomatic crops of pink to dusky red papules preceded by general malaise, myalgias, fluctuating fever, chills, and weight loss. Histological evaluation revealed a non-Langerhans cell histiocytic dermal infiltrate with spindle cell features and chronic inflammation, reactive for CD68 and negative for both S100 and CD1a. Malignancy screening was negative. This report aims to highlight a unique presentation of generalised eruptive histiocytosis, emphasise histological findings, and discuss considerations for malignancy screening.
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Affiliation(s)
- Caitlyn N Myrdal
- Dermatology Division, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA
| | - Delaney B Stratton
- Dermatology Division, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA
| | - Tracy L Davis
- Dermpath Diagnostics, Quest Diagnostics, Tucson, Arizona, USA
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Curiel-Lewandrowski C, Stratton DB, Gong C, Kang D. Preliminary imaging of skin lesions with near-infrared, portable, confocal microscopy. J Am Acad Dermatol 2020; 85:1624-1625. [PMID: 33359786 DOI: 10.1016/j.jaad.2020.12.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Cheng Gong
- Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona
| | - Dongkyun Kang
- University of Arizona Cancer Center, Tucson, Arizona; Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona; Department of Biomedical Engineering, University of Arizona, Tucson, Arizona.
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Gong C, Stratton DB, Curiel-Lewandrowski CN, Kang D. Speckle-free, near-infrared portable confocal microscope. Appl Opt 2020; 59:G41-G46. [PMID: 32749315 PMCID: PMC8273882 DOI: 10.1364/ao.392004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/23/2020] [Indexed: 05/23/2023]
Abstract
We have developed a portable confocal microscope (PCM) that uses an inexpensive near-infrared LED as the light source. Use of the spatially incoherent light source significantly reduced the speckle contrast. The PCM device was manufactured at the material cost of approximately $5000 and weighed only 1 kg. Lateral and axial resolutions were measured as 1.6 and 6.0 µm, respectively. Preliminary in vivo skin imaging experiment results showed that the PCM device could visualize characteristic cellular features of human skin extending from the stratum corneum to the superficial dermis. Dynamic imaging of blood flow in vivo was also demonstrated. The capability to visualize cellular features up to the superficial dermis is expected to facilitate evaluation and clinical adoption of this low-cost diagnostic imaging tool.
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Affiliation(s)
- Cheng Gong
- Wyant College of Optical Sciences, The University of Arizona, 1630 E University Blvd, Tucson, AZ 85719, USA
| | - Delaney B. Stratton
- Banner - University Medicine Dermatology Clinic, 7165 N Pima Canyon Dr, Tucson, AZ 85718, USA
| | - Clara N. Curiel-Lewandrowski
- Banner - University Medicine Dermatology Clinic, 7165 N Pima Canyon Dr, Tucson, AZ 85718, USA
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ 85719, USA
| | - Dongkyun Kang
- Wyant College of Optical Sciences, The University of Arizona, 1630 E University Blvd, Tucson, AZ 85719, USA
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ 85719, USA
- Department of Biomedical Engineering, The University of Arizona, 1657 E Helen St, Tucson, AZ 85719, USA
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Stratton DB, Shea KD, Knight EP, Loescher LJ. Delivering Clinical Skin Examination Education to Nurse Practitioners Using an Internet-Based, Microlearning Approach: Development and Feasibility of a Video Intervention. JMIR Dermatol 2020. [DOI: 10.2196/16714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Skin cancer is the most common cancer; survival of the most serious skin cancers and malignant melanomas depends on early detection. Early detection relies on accessibility to clinical skin examination (CSE). Primary care nurse practitioners (PCNPs) are well-positioned to conduct CSEs; however, they require further education on CSE and have time constraints for continuing education. A digitally delivered intervention grounded in microlearning is a promising approach to deliver new information over a brief period.
Objective
Our objective was to develop and explore the feasibility of implementing a 1-week digital video intervention with content on CSE skills, defined as melanoma risk assessment, head-to-toe skin examination, and pigmented lesion assessment, for PCNPs. Specific aims were as follows: (1) Aim 1: to develop three microlearning-based melanoma videos with content on CSE that are suitable for digital delivery to PCNPs in various formats and (2) Aim 2: to assess the feasibility of the video intervention, including enrollment and retention rates, adherence, and acceptability and usability of the video intervention.
Methods
For Aim 1, the research team created storyboards for videos that addressed each CSE skill. An expert panel of three dermatologists reviewed the storyboards and videos for relevance, comprehension, and clarity using the content validity index (CVI). The panel evaluated the usability of the video intervention delivery by Research Electronic Data Capture (REDCap) and Vimeo using the System Usability Scale (SUS) and technical video production using Beaudin and Quick’s Quality Evaluation of Video (QEV). Aim 2 evaluated enrollment and retention rates of PCNPs, based on metrics from previous studies of CSE in the literature, and video intervention adherence. SUS and the Attitudes toward Web-based Continuing Learning Survey (AWCL) assessed usability and acceptability.
Results
CVI scores indicated relevance and clarity for each video: mean scores ranged from 3.79 to 4, where 4 indicated the video was highly relevant and very clear. The integration of REDCap and Vimeo was usable: the SUS score was 96, where 0 was the worst and 100 was the best. The digital delivery of the videos was rated as exceptional on all five technical items: the mean score was 5, where scores ranged from 1 (poor) to 5 (exceptional). Of the 32 PCNPs who were sent emails, 12 enrolled (38%) and, out of these 12, 10 (83%) completed the intervention and the surveys. Video intervention adherence was ≤50%. Participants rated the usability as better (mean 85.8, SD 10.6; better=70-90) and favorably ranked the acceptability of the AWCL’s constructs of perceived usefulness (mean 5.26, SD 0.08), perceived ease of use (mean 5.40, SD 0.41), behavior (mean 5.53, SD 0.12), and affection (mean 5.77, SD 0.04), where scores ranged from 1 (strongly disagree) to 7 (strongly agree).
Conclusions
The video intervention was feasible to deliver to PCNPs using a digital, microlearning approach. The findings provide support for using the videos as an intervention in a future pilot randomized trial targeting behavioral CSE outcomes among PCNPs and other primary care providers.
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McNeal AP, Silverthorn DU, Stratton DB. Involving students in experimental design: three approaches. Am J Physiol 1998; 275:S28-34. [PMID: 16161223 DOI: 10.1152/advances.1998.275.6.s28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Many faculty want to involve students more actively in laboratories and in experimental design. However, just "turning them loose in the lab" is time-consuming and can be frustrating for both students and faculty. We describe three different ways of providing structures for labs that require students to design their own experiments but guide the choices. One approach emphasizes invertebrate preparations and classic techniques that students can learn fairly easily. Students must read relevant primary literature and learn each technique in one week, and then design and carry out their own experiments in the next week. Another approach provides a "design framework" for the experiments so that all students are using the same technique and the same statistical comparisons, whereas their experimental questions differ widely. The third approach involves assigning the questions or problems but challenging students to design good protocols to answer these questions. In each case, there is a mixture of structure and freedom that works for the level of the students, the resources available, and our particular aims.
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Affiliation(s)
- A P McNeal
- Natural Science, Hampshire College, Amherst, Massachusetts 01002, USA
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Abstract
This study compares vascular responses of unstressed borderline hypertensive rats (BHR) to age-matched Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). Rings of thoracic aorta were mounted for isometric force determinations in tissue baths. Cumulative additions of phenylephrine (PE) or serotonin (5-HT) produced contractile responses in BHR aorta that were less than WKY but greater than SHR. Removing the endothelium increased force development to both agonists, with BHR showing the greatest increase. Based on EC50 determinations, no differences in PE sensitivity existed between groups, although in response to 5-HT, rings from SHR were significantly more sensitive than WKY. While the sensitivity of all rings increased with denuding, BHR showed a greater relative increase in sensitivity than WKY or SHR (intact EC50 divided by denuded EC50) to both PE and 5-HT. This suggests that there may be greater endothelium-derived relaxation in BHR than in WKY or SHR. In rings precontracted with 1 microM PE, the cumulative addition of acetylcholine resulted in greater relaxation in BHR than in SHR and WKY preparations. Thus, rings from unstressed BHR, which have only slightly higher blood pressures than WKY rats, demonstrate greater endothelium-mediated relaxation than WKY or SHR. Increased endothelium-derived relaxation may represent a possible mechanism for masking hypertension in BHR that is compromised as a result of exposure to a chronic stress paradigm.
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Affiliation(s)
- D B Stratton
- Department of Biology, College of Pharmacy and Health Sciences, Drake University, Des Moines, Iowa 50311
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Abstract
Calcium mobilization and sensitivity in aortic rings from hyperthyroid, hypothyroid, and euthyroid rats was examined. The magnitudes of contractions were measured in rings consecutively exposed to phenylephrine (1 microM) incubated in normal physiological saline (PSS), in calcium-free PSS and in normal PSS containing nifedipine (1 microM). By comparing the generated tension under these three conditions it was possible to estimate the contributions of calcium release from the sarcoplasmic reticulum (SR), of influx through voltage gated calcium channels (VGCC), and of influx through receptor operated calcium channels (ROCC). The comparison revealed no change in the contribution of SR calcium release in the three thyroid states, but showed increased VGCC influx and decreased ROCC influx in hyperthyroid rings. No changes were seen in the hypothyroid state. When rings were chemically "skinned" with triton X-100 and subsequently contracted with increasing concentrations of free calcium, dose response curves were not significantly different among rings from the three thyroid states. This suggests that changes in tension development in hyperthyroid aortic tissue may be due, in part, to alterations in membrane calcium influx rather than to SR calcium release or modified calcium activation of contractile elements.
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Affiliation(s)
- D B Stratton
- Department of Biology, Drake University, Des Moines, Iowa 50311
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